Q: My father, aged 53, has a problem of high haemoglobin (19g/dl-20g/dl) & his RBC count is high too (8m/c.mm) for the last 3 years. Because of this problem, he has a burning sensation in his whole body like eyes, tongue, palms, scalp and other parts too. He is under medication but there is not much relief. Due to the increased burning, he has to change his blood every 2 months. The doctors say that in India one in every 1000 people have this disorder. For such cases new medicine are being invented but are very costly. Please suggest some good medication for my father.

A:From your mail it appears that your father is suffering from polycythaemia vera. I hope the entire work-up, including arterial oxygen saturation, marrow examination, cytogenetics, erythropoietin level etc., has been done prior to making the diagnosis. Phlebotomy (removal of blood) continues to be the main treatment for this condition along with the use of myelosuppressive drugs like hydroxyurea, anagrelide and interferon. The symptoms your father has like burning pain in the hands and feet is referred to as erythromelalgia. There is a high risk of thrombosis (clotting in the blood vessel) is such patients and the use of aspirin and dipyridamole helps. As the red cell and platelet counts return to normal by phlebotomy &/or myelosuppression, there is improvement in symptoms. Please discuss with his treating doctor and be guided by him.