Weak After Phlebotomy to Treat Polycythemia: How to Improve Recovery?

If I remember, you had recent labs too, besides the phlebotomy. How were your numbers this time? It does seem that things are changing from 3 years ago with the frequency of your phlebotomies and more pronounced symptoms. Did you have a bone marrow biopsy yet to check the health of your bone marrow? That’s the blood manufacturing center where all the ‘quality control’ takes place. So that might be a good next step for you. I know the oncologist you like has moved…but with your newer symptoms it feels like time to do a little more investigation.
When you had your phlebotomy did you get a saline IV chaser with that? From my understanding, patients have a little faster recovery time.

No the nurse did not offer a saline chaser. My red cell numbers were elevated hence the earlier schedule. I have requested a visit to the Mayo Clinic even though it is a distance from me. I hope to get some answers thru that visit.
In the interim, it appear I will also enjoy shoulder replacement surgery.
Getting older is not for sissies.

Make sure you have your iron and ferritin levels checked.

I've never heard of a Saline IV chaser, good to know so I can ask if needed. I was just diagnosed in April, had 3 phlebotomies in 3 weeks and one in 2 weeks and now I'm waiting a month since my hemo was at 12. something at the last draw.

I was completely wiped for days but it appears it was the smoke from Canadian fires that did me in.

As I stated, the nurse did not offer the saline chaser, but I was so anxious to get that pipe needle out of my arm, I don't think I would have sat still for the chaser. Also, although the goal was to get 450 in blood, she barely was able to get 400 before I called uncle! And it took forever to get to that point. I can remember when I donated regularly that the bag would fill quicker than the phlebotomist could turn around. So it would appear that things are progressing. Hoping to hear from Mayo Clinic soon.

There are several good articles online that explain about phlebotomies. I picked this one to post from Verywellhealth.com Towards the middle of the article there’s a new heading for “Side Effects of Phlebotomy”. It explains the benefit of saline IV after the treatment replacing the loss of fluid.
https://www.verywellhealth.com/what-is-therapeutic-phlebotomy-4058459#:~:text=If%20the%20symptoms%20persist%20or%20are%20intolerable%2C%20after,via%20the%20IV%20to%20replace%20the%20volume%20removed.
You had quite a few blood draws in a short period to get your numbers down. The volume change can make you feel pretty sluggish. So maybe next time ask about having an IV and see if it makes a difference for you.

You’re not alone in having issues with the smoke from the fires. I can’t imagine how awful it is in Canada to have that level of impact here in the US. I don’t usually have a problems when there are ‘poor air quality’ alerts but both my husband and I were finding it hard to keep up at our usual pace with our daily walks and working outside. That had to really be difficult for you. Hopefully the fires get under control soon for the forests, citizens and wildlife of Canada…and the US.

Ohh that’s tough when it’s a struggle to give blood. I’ve had a couple of those episodes too just trying to find a vein or get any blood out for tests. That was a few years ago and I’m find now. But it’s an entirely different feeling than when you’re able to freely donate blood without a second thought! Hopefully you won’t have that issue again. Do you drink plenty of water a couple of days before the phlebotomy?

I have had some very challenging phlebotomy sessions -- my very first experience involved 5 different locations for the needle in an attempt to draw the blood and my platelets were so high that that needles would clot almost instantly. The phlebotomists gave up and said that they simply couldn't get anything out of me that day and asked me to come back in 48 hours and to make sure I was super hydrated. I drank water like a camel before heading out on a long desert journey! I sloshed when I walked, but it definitely made a difference. They were able to suction the blood out with syringes, it was super thick and sludgey. Now I keep a close eye on my platelet level and suggest syringes when they get too high.

I make it a point to always drink at least 32oz of water in the hours leading up to a phlebotomy. Being well hydrated definitely makes them go better for me.

yes those levels are checked in my routine labs.

I drink 80-120 ounces of water a day, every day. I had to build up to this. I try to stop drinking a hour before bed. The higher amount is when I sweat more. I drink 12 ounces of water during the phlebotomy. After a phlebotomy I have found a Powerade Zero helps me feel fine. I get phlebotomies every six to eight weeks. This routine works for me.