I had one doctor tell me I had secondary PV and another tell me I did not. Funny that I can go down the list of symptoms and they all match me to a T. I finally convinced the second doctor to allow me to do labs when I felt that levels were elevating, and to then schedule a phlebotomy on my own. I now have open orders to do both on my own schedule. I can usually tell when its time. I get exhausted from the slightest activity and my torso hurts so badly I feel like it will explode. And then surprise! the labs come back elevated. After 72 years in this body, I think I know it better than someone who only spends 15 minutes with me.