DEAR DR. DONOHUE: About six months ago, I had a blood count taken. It showed too many blood cells, and my doctor insisted I stop smoking. I had been smoking a pack a day for many years. I stopped cold. Last week, I had another blood count taken, and it stills shows too many blood cells. The doctor thinks I have polycythemia. What is it, and how is it treated? – T.M.

ANSWER: The word “polycythemia” means too many blood cells – “poly” is “many”; “cyt” is “cell”; “hemia” means “blood.” Something mysterious prods the bone marrow – the manufacturing site for all blood cells – to jump up its production. The result is blood filled with red and white blood cells and platelets, the small clot-forming cells. The emphasis is on the red blood cells, and most of the trouble comes from having too many red blood cells.

Smoking can lead to an increase in red blood cells too. Smoking deprives the bone marrow of oxygen, and it’s tricked into thinking that it needs to up its production of red blood cells, the carriers of oxygen. That’s why your doctor insisted you stop smoking. If it had been the cause, your blood count would have normalized when you stopped.

The large number of blood cells crowds the circulation and causes blood to flow sluggishly. That brings on a number of symptoms, like headache, dizziness, ear ringing and a rise in blood pressure. Although platelet numbers are also increased, they don’t work well, and bruising and bleeding are other signs of this illness. Paradoxically, excessive clotting is a danger. Such clotting can bring on heart attacks and strokes. Itching is another symptom of polycythemia.

Treatment consists of lowering the blood cell numbers. Doctors accomplish that by removing blood. It sounds primitive, but it works, and the side effects are just about nonexistent.

If the count doesn’t come down with blood removal, medicines like Hydrea can get the job done.

DEAR DR. DONOHUE: I am 79 and have had trouble swallowing for some time. Food gets caught.

Sometimes undigested food backs up in my mouth. I had a swallowing X-ray with barium. It showed a Zenker’s diverticulum. My doctor wants me to have surgery. Do you think I should, and do you think, at my age, that I can tolerate it? – B.W.

ANSWER: The only way to fix a problem like yours is surgical. No, you are not too old for the surgery. Besides, you are bound to have an exam prior to surgery that will determine if it’s safe to proceed. I am certain that it will be.

A Zenker’s diverticulum is a pouch that develops in the lower throat. Food gets caught in it, and the enlarging pouch makes swallowing difficult. Several hours after eating, some of the food in the pouch makes its way back into the mouth. A Zenker’s pouch also produces gurgling noises in the neck.

There is some danger to a Zenker’s diverticulum. The partially digested food in it can trickle down airways into the lungs and cause great damage there.

DEAR DR. DONOHUE: So often I hear that one out of eight women will have breast cancer. It terrifies me. If you divide the population by two and then take one eighth of that number, you’ll have the number of women that will develop breast cancer. That’s an awfully large number. Is this statistic for real? – K.H.

ANSWER: The statistic is real but misleading. What it means is that, of all women who live to age 85, one in eight of them will come down with breast cancer. The incidence of breast cancer increases with age. Only half of all women actually live to age 85, so the breast cancer threat, while great, is not as great as you might have been led to believe.

The booklet on breast cancer details this common cancer, its detection and its treatment. Readers can obtain a copy by writing: Dr. Donohue – No. 1101, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Can a man receiving oral sex contract a sexual disease? – G.R.

ANSWER: The man could catch herpes if the woman had a cold sore. That’s the herpes-1 virus, which is not the virus that commonly infects the genitals; herpes-2 is. But herpes-1 can do so if there is direct genital contact with a cold sore.

It is possible, but not highly probable, for the man to catch other sexually transmitted diseases in this sort of situation.

In the act you describe, the woman can come down with just about any sexually transmitted disease the man is infected with.

DEAR DR. DONOHUE: What does it mean to have a small heart? When I was a young girl (I am now 59), I was told that I had one. I am in good health. – L.M.

ANSWER: You are in good health. Forget the childhood diagnosis. It’s meaningless.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com


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