Medicine To Prevent Blood Clots
If you have PV, daily low-dose aspirin tablets may be prescribed to help prevent blood clots and reduce the risk of serious complications.
You may also be offered treatment with low-dose aspirin if you have apparent or secondary polycythaemia and another health problem affecting your blood vessels, such as coronary heart disease or cerebrovascular disease.
What Are Stress And Smokers Polycythemia
Stress polycythemia is a term applied to a chronic state of low plasma volume, which is seen commonly in active, hard-working, anxious, middle-aged men. In these people, the red blood cell volume is normal, but the plasma volume is low. This condition is also known as Gaisbock’s disease, stress erythrocytosis, or pseudopolycythemia.
Smoker’s polycythemia is a similar condition in which increased levels of deoxygenated hemoglobin causes an increase in red blood cell counts.
Lifestyle Changes That Help
As well as improving some cases of apparent polycythaemia, making healthy lifestyle changes can also reduce the risk of potentially serious blood clots for people with all types of polycythaemia.
Having polycythaemia means you’re already at high risk of a blood clot, and being overweight or smoking only increases this risk.
You may find the following advice and information helpful:
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On Average Patients With Known Hu Use Had Moderately High Symptom Burden2
- A prospective study of 1334 patients with PV where a subset of patients received hydroxyurea 2
Adapted with permission from Wolters Kluwer Health, Inc.: Geyer H, Scherber R, Kosiorek H, et al, Symptomatic Profiles of Patients With Polycythemia Vera: Implications of Inadequately Controlled Disease, Journal of Clinical Oncology, volume 34, issue 2, pages 151-159, https://ascopubs.org/doi/full/10.1200/JCO.2015.62.9337.
MPN-10, Myeloproliferative Neoplasm Symptom Assessment Form TSS, total symptom score.
A prospective study of 1334 patients with PV was conducted to assess baseline symptoms with certain disease features: known HU use , known phlebotomy , palpable splenomegaly , or all 3 features , and compared to a control group of patients that lacked the specified feature. Assessment of myeloproliferative neoplasm symptoms was performed by using the MPN-10. All items were evaluated on a 0 to 10 scale. The MPN-10 TSS has a possible range of 0 to 100 with 100 representing the highest level of symptom severity. The TSS for each patient was analyzed to place the patient into the quartiles of low symptom burden , intermediate symptom burden , moderately high symptom burden , or high symptom burden .2
Patients with PV had moderately high symptom burden regardless of blood count control3
- Symptom burden in patients who achieved blood count control versus those who did not was analyzed among 1813 evaluable patients with PV in the prospective, observational REVEAL study3#
How Is Polycythemia Vera Treated
Your healthcare provider will figure out the best treatment based on:
- Your age, overall health, and medical history
- How sick you are
- How well you handle certain medicines, treatments, or therapies
- If your condition is expected to get worse
- What you would like to do
Treatment may include:
- Phlebotomy. This procedure removes blood from your body. At first this must be done often, such as every week. Once enough blood has been removed to reduce your body’s iron stores , you will not need this done as often.
- Certain medicines, including chemotherapy. The medicines help to stop your bone marrow from making too many blood cells. They also keep your blood flow and blood thickness closer to normal.
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Symptoms Of Polycythemia Vera
Polycythemia vera is a blood cancer that develops slowly over time. It affects the bone marrow and specifically involves the development of too many red blood cells. This overabundance of blood cells causes the blood to thicken and lead to significant complications, including the emergence and growth of blood clots.
Polycythemia vera is a rare disease. Often, it builds over time, taking many years to emerge. However, there are symptoms to look out for and recognizing them can help you and your doctor identify the problem and take appropriate actions. When treated correctly, it can be managed and kept from progressing to a more serious blood cancer like leukemia
Pots: A Little Known Cause Of Extreme Fatigue
Everyone knows what being tired feels like at the end of a long day. But some people experience fatigue so severe and so seemingly random that its hard to describe. If that sounds familiar, there could be more going on than daily stress.
While there are many causes of fatigue, one of them is frequently missed and misdiagnosed: postural orthostatic tachycardia syndrome . Physical medicine and neuromuscular specialist Tae Chung, M.D., answers questions about POTS and extreme fatigue as one of its symptoms.
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Characteristics Of The Final Stage
As time passes, scar tissue sometimes replaces bone marrow in people with PV.
Experts call this condition MF, which stands for myelofibrosis. This is the spent phase of PV. It only develops in some people with the disease.
When MF occurs, the bone marrow cannot produce enough healthy blood cells.
Some symptoms of MF include:
- unusual sweating, particularly at night
- itchy skin, which may get worse after a warm bath or shower
- unusual bruising
- bone or joint pain
People with MF may also develop an enlarged spleen or liver. This may cause discomfort and bloating, or a feeling of fullness in the belly. It can also lead to other, more serious, complications, including more frequent infections, a greater risk of bleeding, and anemia.
In rare cases, MF develops into acute myeloid leukemia.
Most cases of PV result from a change in the JAK2 gene. This gene gives the body instructions for making a protein involved in the production of blood cells.
PV causes the blood to become thicker than usual. The blood clots more easily, and it may not flow properly through blood vessels. As a result, it may carry less oxygen to the bodys tissues and organs.
Over time, these changes can cause noticeable symptoms and potentially life threatening complications.
PV advances more quickly and severely in some people than others. Not all people with PV develop MF.
A persons outlook depends on many factors, such as:
When To Seek Immediate Medical Advice
Polycythaemia can cause blood clots. These put you at risk of life-threatening problems such as:
- pulmonary embolisms a blockage in the blood vessel that carries blood from the heart to the lungs
- deep vein thrombosis a blockage that forms in the blood vessels in your leg before moving elsewhere in your body
Seek medical help immediately if you or someone you’re with shows signs of DVT or a pulmonary embolism. These include:
- pain, swelling, redness and tenderness in one of your legs
- a heavy ache in the affected area
- warm skin in the area of the clot
- feeling lightheaded or dizzy
Polycythaemia also increases your risk of heart attack and stroke. Seek emergency medical help if you think that you or someone you’re with is having a heart attack or stroke.
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Key Points About Polycythemia Vera
- Polycythemia vera is a rare blood disorder in which there is an increase in all blood cells, particularly red blood cells.
- The increase in blood cells makes the blood thicker.
- Thick blood can lead to strokes or tissue and organ damage.
- Symptoms include lack of energy or weakness, headaches, dizziness, shortness of breath, visual disturbances, nose bleeds, bleeding gums, heavy menstrual periods, and bruising.
- Treatment may include medicines and phlebotomy, a procedure that removes extra blood from your body.
How Polycythaemia Is Diagnosed
Polycythaemia can be diagnosed by carrying out a blood test to check:
- the number of red blood cells in your blood
- the amount of space the red blood cells take up in the blood
A high concentration of red blood cells suggests you have polycythaemia.
Polycythaemia is sometimes only discovered during a routine blood test for another reason.
Your GP may refer you to a haematologist for more tests, to confirm the diagnosis and to determine the underlying cause.
These may include:
- a blood test to look for the changed JAK2 gene
- an ultrasound scan of your tummy to look for problems in your kidneys
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Experimenting With Facebook Live Videos
Im learning the ropes, making a few Facebook Live videos, so I can share whats on my mind without sitting behind a computer having to methodically key away my thoughts. Im thankful for all the support and many well-wishers that chimed in. Here are a few replies from friends that I think many of you can relate to:
- Thank you for sharing this. I have a lot of good days and then I have 2 or 3 bad days which is so frustrating. No one but my sweet supportive husband sees me on my bad days. Friends only see me when I am feeling good and busy getting things done. Your video let me know I am not alone, and the roller coaster is common for us PVers. Thank you for that.
- A roller coaster ride it is. Love the video You described me perfectly.
- Yep! 100% relate to that. I call thatTHE CURVE BALL. I have found ways to just roll with it. Find things that comfort me and let the to roll off me. Thanks for sharing David. We are all warriors but even a warrior must rest sometimes.
You may have read our articles on itching,brain fog, chronic pain,insomnia etc., but this is the first time weve talked about the most common MPN blood cancer symptom of all!
What Is The Difference Between Polycythemia And Erythrocytosis
Erythrocytosis is sometimes referred to as polycythemia, but the conditions are slightly different: Erythrocytosis is an increase in RBCs relative to the volume of blood. Polycythemiais an increase in both RBC concentration and hemoglobin, the protein in red blood cells that carries oxygen to the bodys tissues.
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What Are The Symptoms Of Polycythemia Vera
When you have more blood and it is thicker than normal, problems can occur. Each persons symptoms may vary. Symptoms may include:
- Lack of energy or weakness
- High blood pressure
These symptoms may look like other blood disorders or health problems. Always see your healthcare provider for a diagnosis.
How Can I Take Care Of Myself And Manage My Symptoms
If youre living with polycythemia vera, its important to keep in touch with your healthcare provider so they can keep track of how your condition is progressing. Let them know how youre responding to treatment and if youre experiencing any side effects. You may continue living a long time without severe symptoms.
In addition to regular testing and treatment, your healthcare provider will likely recommend general lifestyle changes to help prevent blood clots and other complications. For example:
- Exercise. Even moderate exercise can help improve sluggish circulation.
- Avoid smoking. Smoking causes your blood vessels to narrow.
- Avoid low-oxygen environments. High altitudes can reduce oxygen levels in your blood.
- Keep your blood pressure in check. Maintaining a healthy body weight can help with this.
A note from Cleveland Clinic
Polycythemia vera is a kind of cancer, but most people continue living well for decades after diagnosis. It qualifies as a cancer because it involves uncontrolled cell production. However, it takes a long time for uncontrolled production of red blood cells to begin affecting you. And when they do, you can manage your condition for a long time by simply having some of your extra blood drawn.
Last reviewed by a Cleveland Clinic medical professional on 04/25/2022.
References
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How Amber Essenmacher Pa
I like to remind my patients about which symptoms they should watch out for and when to call with questions. I also try to become familiar with a patients day-to-day activity level and how often they are participating in activities they enjoy, so I can determine whether there has been a decline in these activities.
Amber Essenmacher, PA-C, MMS, Medical Science Liaison at Incyte Corporation
White PaperPatient Care in Polycythemia Vera: An Advanced Practice Providers Perspective
Understanding The Symptoms Of Mpns
Myeloproliferative neoplasms are a group of progressive blood cancers characterized by the abnormal production of blood cells in the bone marrow. Although the symptoms of MPNs typically worsen over time, its not unusual for MPN patients to be asymptomatic for extended durations.
Routine medical examinations are critical for all MPN patients regardless of whether or not they are currently exhibiting symptoms. In many cases, the early identification of signs that the disease is progressing can result in improved patient outcomes for people suffering from primary myelofibrosis , essential thrombocythemia and polycythemia vera .
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What Causes Polycythemia Vera
Polycythemia vera occurs in your bone marrow, the soft, spongy material at the center of your bones. This is where new blood cells grow. PV begins when a single gene within a single stem cell in the bone marrow malfunctions. More than 90% of the time, its a gene called JAK2. The mutated gene gives instructions to the stem cell to continually reproduce itself. All of the reproduced cells also continue to reproduce, until the abnormal cells crowd out the normal cells in your bone marrow. Most of the time, the JAK2 gene mutation is acquired, which means it isnt inherited from a family member. It occurs for unknown reasons sometime during your life. But there have been a few documented cases of multiple family members developing polycythemia vera.
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What Tests Confirm The Diagnosis Of Polycythemia
Polycythemia diagnosis
Polycythemia may be diagnosed incidentally on routine blood work. Hemoglobin, hematocrit, and red blood cell concentration are typically found on a complete blood count . Repeating the laboratory tests to confirm the diagnosis is usually advised to rule out possible laboratory or drawing errors.
More importantly, the cause of polycythemia needs to be determined. Medical history and physical examination are important components of the evaluation of polycythemia. The history usually includes questions about smoking history, living at high altitudes for extended periods, breathing difficulties, sleep disturbances, or chronic cough. Other parts of the history may focus on a prior diagnosis of lung disease, heart disease, kidney or liver cancer, bleeding or clotting problems.
A complete physical examination — including the assessment of body habitus , vital signs, oxygen saturation, heart and lung exams, and evaluating for an enlarged spleen — is essential in the evaluation of people with polycythemia.
Evidence of a long-standing low body oxygen level is an important clue in patients with polycythemia. Signs of long-standing hypoxia may include cyanosis , clubbing of the fingers , or pursed-lip breathing. Redness of the palms and soles may be another sign of polycythemia.
Polycythemia vera diagnosis
What Is Polycythemia Vera
Polycythemia vera is a blood disorder that causes your body to produce too many red blood cells. Too many red blood cells can make your blood thick and sluggish and increase your risk of blood clots and complications such as heart attack and stroke. It can also cause vague but irritating symptoms, such as skin itchiness, ringing in your ears, abdominal pain, nose bleeds and blurred or double vision.
Polycythemia vera is a chronic condition with no cure, but medical care can help you manage symptoms and the risk of complications. Other names for polycythemia vera include primary polycythemia, polycythemia rubra vera, erythema and Osler-Vaquez disease.
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How Would You Describe Fatigue Associated With Pots
People with POTS experience fatigue differently. Many describe it as feeling beyond exhausted. Its as if your energy is completely depleted. The fatigue is probably hundreds of times worse than your worst flu. People with POTS may also have trouble concentrating and thinking straight. Doing simple tasks may feel like youve just run a marathon.
This fatigue might come and go, hitting you without warning daily, weekly or less frequently. For some people, extreme fatigue lasts for days. Others may experience periodic attacks. It can come on at any moment even if you just woke up. And there is no amount of sleep or coffee that can make it go away.
