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Polycythemia vera, loss of balance, aphasia, dizziness, joints hurt, low hemoglobin

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Internal Medicine Specialist
Practicing since : 1998
Answered : 1579 Questions
My father has polycythemia vera. I have been wondering if I may have it too. I spoke with my dr two years ago and she told me that because I was menstruating there is not an accurate test. Is that the case? I am female, 50. I begun bruising easily, a few years ago an eye dr thought i had neurological damage because my vision was blurred and i was seeing 3 of everything, mostly during the night...i also had loss of balance, some aphasia, dizziness and my joints seems to hurt and not sure how much is age related. i went to the dr around 3 months ago for what they thought might be an ulcer. My hemolgobin had dropped a bit compared to to my hemoglobin just after fibroid surgery. Tests were done on liver, pancreas, thyroid, and hemoglobin. Everything was good except for slight elevation in pancreas test and hemo was down slightly from 3 months earlier. Stomach pain is gone as are the balance and aphasia issues from a few years back. Eyes are still an issue as is dizziness but only to the degree that eyes can't focus. I mentioned all of this to dr but i was told what i stated earlier.My father wasn't diagnosed for almost 10 years and I don't have the energy to go through all the tests he did at this point. Just coming off of an UFE..... any thoughts.
Posted Fri, 27 Apr 2012 in Blood Cancer(Leukemia)
Answered by Dr. Jasvinder Singh 39 minutes later

Thanks for posting yoru query.

Polycythemia vera is a blood disorder in which your bone marrow makes too many red blood cells.

Given your age (polycytemia is diagnosed at median age of 60 years), symptoms of joint pains, bruising, blurred vision, dizziness and your family history, it is better to get investigated for polycythemia. Menstruation does not effect the specificity of the test, however it is diagnosed at an elderly age more accurately.

Elevated pancreatic enzymes like lipase are found in pancreatitis, gall bladder disease, overweight and obese people and high trilgycerides levels in blood. Which pancreas test was found elevated in your case?

What is concerning is the bruising without trauma in your case. Based on your symptoms, a few possibilities need to be ruled out which can cause a sudden bruise without any trauma. These include:

1)     Anemia and deficiency of vitamins C, K, B12, or folic acid
2)     Bleeding and clotting defects
3)     Liver disease
4)     Any malignancy including Hodgkin's disease and leukemia

It is good that your thyroid and liver tests have come out normal.

I sincerely advise you to consult a hematologist and get your coagulation profile investigated. You also need a complete blood count and platelet count and levels of vitamin C, K B12 and folic acid. Bone marrow aspiration and biopsy may also be needed to rule out any leukemia and polycytemia but is done as a last investigation if all causes are ruled out. Till then eat a healthy diet and take iron supplements for some days.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. Please do update me with your pancreatic test reports. I will be happy to answer your queries.

Wishing you good health.

Above answer was peer-reviewed by
Follow-up: Polycythemia vera, loss of balance, aphasia, dizziness, joints hurt, low hemoglobin 19 minutes later
At this time I do not remember the exact test. I know it was elevate to 2 or 2 percent. Sorry, Don't remember. Doctor was not concerned at that point. The blood work was done when I had severe abdominal pain and they ran tests for ulcer. THey did not see the elevated thing... forgot name to indicate ulcer. I was sent home with antacids and after about two weeks it was gone ... but it came on suddenly and that had never happened before... that's when they saw hemo slightly low at 11.9 and 3 months earlier it was 12.9. I consulted gastro dr who is friend of mine... he was not concerned... I did not return for follow up hemo to see if they were concerned about bleeding ulcer. I am not overweight. I am thin. My triglycerides were not a concern..Cholesteral is 162. I was enemic from menstrual bleeding. I had the UFE and things returned to normal.
Answered by Dr. Jasvinder Singh 10 hours later

Thanks for getting back to me.

It makes sense to consult a gastroenterologist again and rule out the possibility of some bleeding from the intestine like a duodenal ulcer.

If you have got excessive bleeding during your menses, then that could be a cause of anemia.

A serum amylase and lipase should help in ruling out the possibility of acute pancreatitis as a cause of the abdominal pain.

The possibility of a bleeding peptic ulcer being the cause of abdominal pain is more likely.

I sincerely hope that helps. Take care.
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