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Dr. Chip
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 36123
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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Hi, I have been diagnosed with secondary polycythemia recently,

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Hi, I have been diagnosed with secondary polycythemia recently, my red blood cell count is 18.5, and 3 months ago it was 18.8, i have not found out what the secondary cause is yet, but recently found out from my doctor that in 2009 my red blood cell count was 17.7 yet he never informed me at the time, this year i saw a different gp who told me that i have polycythemia, given that the average red blood cell count is between 4-5, should i have had investigations back in 2009. thanks steve
Hi Steve--just for clarification you're referring to your hemoglobin level? Why was the term secondary polycythemia used if no cause was considered like COPD, heart conditions, etc?
Customer: replied 4 years ago.

a gp said suspected polycythemia, repeated blood tests and i had a jak2 gene test which was negative, i was refered to a heamotologist who confirmed secondary polycythemia, who said i may well have cirrhosis of the liver, or was caused by smoking and alcohol, i had an ultrasound which showed a fatty liver, my gp had no idea if this was related, and hasn't suggested any other test to find out the cause, but through my own research i have requested testing for copd, what i need to know back in 2009 i had blood test which showed 17.7 considering i got diagnosed this summer with an 18.8 count, surely the gp should of suspected something wrong back in 2009 given the average is 4-5. thanks

OK--so are you a smoker or were you smoking back in 2009?
Customer: replied 4 years ago.

i have been a light smoker for the last 20 years, in the last 3-4 years i have been coughing and choking up phlem and choking whilst asleep, i recently told the gp this and his answer was ohh, i saw a different doctor last week and she has arranged for me to have a chest x-ray and copd check, what i really want to know is should these invesigations been done in 2009 when the count was only slightly less than it is now

OK Steve--the simple answer is yes. A hemoglobin of 17.7 like what yours was back in 2009 would warrant a full workup for polycythemia and if no secondary cause was found it still would warrant treatment which usually involves phlebotomy--regular blood draws to lower the red cell count--and hydroxyurea. Left untreated, polycythemia puts you at risk for blood clots, heart attack, stroke, and an enlarged spleen
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Customer: replied 4 years ago.

this is exactly what i suspected, my health is pretty poor at the moment, i have lost 2 and a half stone this year, i have seen a neurologist at my own request and been diagnosed with essential tremor and ot tremor in my legs, this has only come along in the last 2 or 3 years, could that be linked to the polycythemia? thankyou very much for being honest and confirming what i already thought, the gp in question is a senior partner in the practice and none of his collegues would give me a straight answer.

Yes, Steve, there can be complications of polycythemia like peripheral neuropathies and tremors. So sorry this wasn't addressed properly from the start