As I noted all circumstances are different. My doc notes as I don't have a history of clots, even though over 60 now and diagnose 8 yrs ago my overall risk is not super high. That being said I can tell progression in the symptoms associated with it. But staying mentally and physically active really helps. Live your best everyday, and I have also found it helpful to have a couple of people with MPNs (not ET) that we can get together and commiserate with. As this is not a really visible disease (this is good and bad) sometimes people don't realize or remember your situation. Stay strong