Dear Dr. Donohue — Please write something about polycythemia. Mywife was just diagnosed with it. Before she was diagnosed, shecomplained about severe itching and tried many different creams,lotions and ointments without any relief. Finally a doctor made thediagnosis. She has blood taken periodically. the itching hasstopped. how did she get this? — R.T.
Answer — “Polycythemia” (POL-ee-sigh-THEME-ee-uh) literallymeans “too many blood cells” — poly, many; cyt, cells; emia, blood.no one is able to say how people get it. That’s still being workedon.
All varieties of blood cells — white, red and platelets — areproduced in overabundance. Platelets are tiny blood cells whosefunction is to form a clot when a blood vessel breaks.
Blood, packed with too many cells, becomes thick and movessluggishly. That gives rise to symptoms such as headache,dizziness, ear ringing and a rise in systolic blood pressure (thefirst number of a pressure reading). Itching is another sign. Awarm shower or warm bath greatly increases itchiness.
One of the most serious consequences is clotting. A clot in abrain artery is a stroke. Bleeding and easy bruising are othercommon signs. That sounds paradoxical — clotting and bleeding. Andbleeding shouldn’t happen with an excess of platelets. It doesbecause often the platelets are of inferior quality.
Treatment is blood removal. Once the blood count has beenlowered and symptoms have gone, removal can be done lessfrequently, every three months or so.
If blood removal does not achieve control, medicines can beadded to the regimen.
Dear Dr. Donohue — I read what you had to say about gallstonesfor the woman who didn’t want to have her gallbladder removed. Ihave gallstones too, and want them out. my doctor insists I don’tneed an operation. what if I were to have an attack at someinopportune time? I’d rather plan for surgery. is this a rationalapproach? — W.B.
Answer — yes, your approach is a good argument for surgery.However, the odds are that you will never need an operation. Youhave what is called incidental gallstones, gallstones not kickingup any trouble, discovered by chance. the percentage of people withsilent gallstones in the years from 50 to 59 is 12 percent forwomen and 7 percent for men. between the ages of 60 and 69, thepercentages are 16 for women and 17 for men. Only a few of thesepeople will ever have a gallbladder attack. Surgery for silentstones isn’t recommended.
Write Dr. Donohue at P.O. Box 536475, Orlando, Fla.32853-6475.