Hello! I have been a doctor for 21 years. My name is Georgy Olegovich Sapego. This article will ask questions about polycythemia and phlebotomy.
Question: Don't you think that patients with polycythemia will have a shock if they pump out one liter of blood per week?
Answer: Patients with polycythemia usually do not experience the shock of losing a liter of blood per week. Their bone marrow can easily cope with such a load.
Question: Why are you writing about bloodletting immediately into a liter of blood? Losing a liter of blood is death at once!
Answer: Donors donate 0.5 liters and normally. And if a liter, then immediately death? Confuses nothing? The difference is kind of small ...
Question: Explain, please, what is the danger of polycythemia, if not blood clots? The doctor explained to me the danger in thrombus formation.
Answer: Polycythemia does not disrupt circulation too much, but in many different places. In people with respiratory failure or heart failure, this impairs performance and shortness of breath.
Question: Once, lying in intensive care, I saw how the nurse took my blood from a vein and gasped, at my dumb question she turned the test tube over, but the blood did not flow, it did not even crawl. A doctor was immediately called, another dropper. So what was that? Very interesting.
Answer: I do not know. Maybe you have a quirk (people in intensive care are usually not very good), maybe blood clotted in a test tube (this often happens).
Question: They couldn't take blood from my granddaughter's vein. Well, she didn't go, no matter how hard they tried. They ordered me to drink at least a half-liter bottle of water and half an hour later they took blood perfectly on the first try. Why is this so?
Answer: The nurse is weird. Fucked up, kicked the patient out, waited and did the same again. To drink and come back is an excuse to take a break.
Question: To my two youngest children, six and four years old, the doctor said to give more water because the blood is viscous.
Answer: Water does not dilute blood. The kidneys maintain a stable state. All excess water will quickly go into the bladder. And if there is a lack of the liquid part in the blood, the necessary water will quickly return from the tissues to the bloodstream.
Question: What is "a lot of blood" in polycythemia? Like this? How is this expressed?
AnswerA: It's literally a lot of blood cells. If you drain them, they reappear very quickly.
Question: Is it about hemoglobin? Or about platelets too?
Answer: Sometimes it is about erythrocytes, and sometimes - about erythrocytes + leukocytes + platelets. Some kind of blood cells begins to multiply intensively and uncontrollably.
Question: I saw when the blood was drawn into a special polymer bag for plasmapheresis, how it literally turned from a liquid into a jelly-like mass before our eyes - I even felt it through the bag. So I saw with my own eyes how the blood really thickens. How else to explain this?
Answer: Any blood in jelly turns, if it is pulled out of the bloodstream.) It does not thicken, but coagulates. Have you ever butchered a chicken? There, inside the carcass, you can often see dark red clots, similar to jelly. This is coagulated blood. If the blood is taken incorrectly, then it will clot.
Question: And if the blood turns into flakes already in the test tube?
Answer: It happens. This is more often considered a mistake in blood sampling.
Question: Can people with thrombocytopenia not be afraid of blood clots?
Answer: On the contrary, they can be afraid of both blood clots and bleeding. It's like with senile farsightedness - people can't see both near and far.
Question: After a heart attack, my husband had to donate blood for viscosity every 7 days. Laboratory studies were carried out once a week and gave the verdict "clot". And what does it mean?
Answer: Blood clotted in a test tube. Blood sampling error.
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