DEAR DR. DONOHUE: I have just been diagnosed with polycythemia. I had a bone marrow test that showed my red blood cells are overproducing. Information on this condition would be appreciated. — L.S.

DEAR DR. DONOHUE: I have never seen polycythemia discussed in your column. I have it. My hematologist wants me to take a not-yet-approved drug. First I must undergo a bone marrow test. I fear the test. I am 86 and in otherwise good health. Is there a standard drug used for this condition? — C.W.

ANSWER: Polycythemia (POL-lee-sigh-THEME-me-uh) is aptly named; “poly” for “many,” ”cyt” for “cells” and “hemia” for “blood.” The bone marrow, the place where all blood cells — red, white and platelets (clotting cells) — are made, has shifted into overproduction. Blood is flooded with red blood cells, white blood cells and platelets.

The increase in blood cells makes the blood viscous and sluggish. Headaches, blurred vision, loss of energy, increased sweating and dizziness are some of the symptoms that arise due to the thick blood. Itching after a warm shower or bath is another consequence. Bleeding results, something that is a paradox, given the increased number of platelets. Their numbers have increased, but their function has decreased. Another paradox is that clots form in arteries and veins.

The initial treatment for polycythemia is periodic removal of blood. In the days before this was the accepted, standard treatment, polycythemia patients lived only six to 18 months. Now, polycythemia patients live 10 or more years.

If blood removal fails to control the blood cell count, medicines are brought in. Hydroxyurea is one of those medicines.

C.W., your doctor has asked you to be part of the testing of a new drug. The decision isn’t the doctor’s; it’s yours. Microscopic examination of the bone marrow is apparently part of the protocol for giving the new drug. Bone marrow examination is not needed in all cases of polycythemia.

It’s altruistic of you to take part in a drug study, but no pressure should be put on you.

DEAR DR. DONOHUE: I thought I had heard of everything, until my sister came down with something called a Baker’s cyst. Her doctor has fixed it, but she still has lots of pain. She’s 72 and feels that she’ll never walk properly again. — B.B.

ANSWER: A Baker’s cyst is a behind-the-knee swelling. It’s a form of bursitis. Bursas are disks located between tendons and bones to reduce friction when the tendon rubs against the bone. A small, one-way tunnel connects this bursa to the knee. Any excess fluid in the knee is drained into the bursa and causes it to swell. It becomes a cyst. If there is a knee problem, it must be fixed. If there isn’t, then the bursa is inflamed for some other reason.

How was your sister treated? Was fluid removed from the cyst? Was cortisone then injected into the cyst? Your sister needs to see her treating doctor again. If she’s not getting any satisfaction from the doctor, she ought to see a different one, preferably an orthopedic surgeon.

DEAR DR. DONOHUE: I read in your column about the lady who found it impossible to inject herself with insulin. I have been a diabetic for the past 26 years and found it impossible to inject myself. My husband found Autoject 2, which is automatically triggered to do the injection for you. She can get information from Diabetic Express, at 1-800-338-4656 or online at www.diabeticexpress.com. It’s a wonderful solution for people like your reader and me. — M.G.

ANSWER: My heartfelt thank-you for providing this information. I’m sure the reader will be equally appreciative, and so will all other insulin-dependent diabetics who find self-injection traumatizing.

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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