Discomfort in spleen, self diagnosed, waiting for results...

I'm 31 and both my parents are from southern Italy.

The past 2 or 3 weeks I've had discomfort on my left side below my rib cage.  At first I thought nothing of it, but it hasn't gone away and has been getting worse.  I think my spleen is swollen.  I went to the doctor and he wrote me a referral to have an ultrasound.

In the meantime, I've been doing some research and I think I have beta thalassemia minor.

About 10 years ago, my doctor put me on prescription iron pills because some bloodwork showed anemia.  I wasn't on them very long because I didn't like what they did to my digestive system.  Combined with my Mediterranean background and my current spleen issues, I think his diagnosis was wrong - this is apparently a common misdiagnosis for thalassemics.

I am an American, but I moved to Italy last year.  I don't speak Italian very well and this is my first experience with the Italian healthcare system so everything is a little new to me and I'm not sure what I should do.

First question... If I'm right about thalassemia, is my enlarged spleen anything to be concerned about?  The first non-urgent appointment for an ultrasound is 3 months from now.  I was told I could get it done within 10 days if my doctor thinks it's urgent.  Should I go back to him and offer up my thalassemia theory and see if he can get me in for an ultrasound sooner?

Second... Considering the long wait times to see a specialist, should I try and get a referral to a hematologist before I get the ultrasound?  Or am I putting the horse before the carriage and I should wait to see if I really do have an enlarged spleen before looking for the underlying cause?

Other possibly relevant facts...  I am always very tired.  I've asked my doctor about this (back in the states) and he tested my thyroid and said everything was fine... I did show a vitamin D deficiency though.  Also, besides the results 10 years ago, I'm not sure if any bloodwork since then has showed anemia - it's never been mentioned to me.  I also have a family history of g6pd - another relatively rare genetic disorder common in people of Mediterranean descent.

Thank you in advance for any help/advice you can give me.

Hi Creative,

The spleen does enlarge in thal minor due to hemolysis, the break down of red blood cells (RBCs). It normally is no danger. This should also be easily diagnosed by a physical examination by the doctor. An ultrasound will be more definitive and should give you a measurement of spleen size. However, this will not diagnose thal minor, especially with the possibility that G6PD is a factor, since this can also cause hemolysis. To determine if you are a thal minor, a complete blood count (CBC) and a hemoglobin electrophoresis test should both be done. These are both simple blood tests and you might be able to get them done before the ultrasound. I would also suggest a new vitamin D test to see if you are still deficient. Your level should be higher than 35, and this recommendation has changed much in just the past 10 years, so it should definitely be checked. The levels in the CBC and electrophoresis results can most often diagnose if thalassemia is present, so start there.