Blood disorder can cause headaches, poor circulation
DEAR DR. GOTT: My husband has been diagnosed with polycythemia vera. He produces too many red blood cells. Tell me what to expect in your expert opinion. Our doctors don’t tell us too much, except that he should be OK.
DEAR READER: Polycythemia vera is a blood disorder in which bone marrow produces too many red blood cells. In some cases, it may also cause an overproduction of white blood cells and platelets. Whatever the reason, an excess of red blood cells causes the blood to thicken. Your husband may have had the condition for a number of years without ever knowing it. It’s likely he either finally developed symptoms or had laboratory work performed for another reason or as part of a routine annual examination. As the disorder progresses, patients develop symptoms and may experience headaches, fatigue, dizziness, shortness of breath, tingling of the extremities and more.
Blood is composed of three types of cells and a liquid known as plasma. The cells are erythrocytes (red blood cells) that carry oxygen throughout the body, white blood cells that fight infection and platelets that help the blood to clot. Under ordinary circumstances, the body regulates blood cells and the ratio of each type within the body; however, in cases such as your husband’s, that control becomes impaired, and his bone marrow is producing an abnormal amount of specific cells.
His blood test likely revealed an elevated level of hemoglobin and hematocrit, a low level of erythropoietin (a kidney hormone that stimulates the development of red blood cells in bone marrow) and oxygen levels lower than the normal range found in healthy people.
Treatment may include medications to suppress his bone marrow’s ability to produce those blood cells, the use of low-dose aspirin, drawing off blood to reduce his blood volume and the number of blood cells he has (phlebotomy), and a recommendation by his physician or hematologist for an antihistamine, H2 receptor blocker or ultraviolet-light treatment to reduce any itching he may experience as a side effect of the polycythemia.
He should avoid temperature extremes and the use of tobacco, exercise as much as his physician allows, and be sure to watch for skin ulcers, particularly of the hands and feet, which can result from poor circulation.
Readers who would like additional information can order my Health Report “Blood: Donations & Disorders” by sending a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title.
DEAR DR. GOTT: I have a low pulse. What are the causes and the cure?
DEAR READER: The normal heart beats between 60 and 100 times per minute when at rest. Lower rates in young people and athletes can be an indication of being physically fit through a training regimen. Other causes of bradycardia (a low pulse) are attributed to coronary-artery disease, hypothyroidism, an electrolyte imbalance, the use of some medications, such as those taken for hypertension, or, rarely, endocarditis or infection.
Treatment depends on the cause. Without symptoms, your physician may choose to monitor you. If medication is involved, he or she may switch you to another brand. If there is damage to your heart’s electrical system, pacemaker insertion may be appropriate.
On the home front, limit your alcohol intake, discontinue smoking, eat a low-salt, healthful diet, and exercise as much as your physician allows or recommends. Above all, follow his or her advice regarding follow-up care.