What is Secondary Erythrocytosis?

Too many erythrocytes(RBC's)

Secondary erythrocytosis is a rare disorder that causes an over-production of red blood cells. When too many red blood cells are being produced, the blood becomes thick, hindering its passage through the smaller blood vessels.

Causes

The function of a red blood cell is to deliver oxygen to the body tissues. Smoking interferes with this process, therefore it is a common cause of secondary erythrocytosis.

Others include:

• Carbon monoxide poisoning
• Chronic heart or lung disease
• High altitude
• Cysts of the kidneys
• Brain, liver or uterine tumours

Symptoms

The symptoms of secondary erythrocytosis include the following:

• Weakness
• Headache
• Fatigue
• Lightheadedness
• Shortness of breath
• Visual disturbances
• Pruritis (itching)
• Pain in the chest or leg muscles
• Ruddy complexion
• Confusion
• Ringing in the ears (tinnitus)
• Burning of the hands or feet

It is advisable to consult a doctor as soon as possible if the above symptoms are experienced frequently as it is important to get diagnosed early.

Diagnosis

The doctor must first determine if the erythrocytosis is "primary" or "secondary".

Measuring oxygen levels in the blood with a blood test known as arterial blood gases (ABG's), can help doctors formulate a diagnose of secondary erythrocytosis. Other blood tests include measurement of erythropoietin and red blood cell mass levels.

Additional diagnostic tests may include:

• Chest X-Ray
• Electrocardiogram
• Imaging studies to determine enlargement of the spleen or liver

Treatment & Prevention

Treatment for secondary erythrocytosis should control or eliminate the underlying condition. No medications are available.

The following can be done:

• Provide oxygen supplementation to patients with chronic obstructive pulmonary disease.
• Recommend weight loss in patients with obesity and hypoventilation
• Recommend smoking cessation for patients with carboxyhemoglobin
• Surgically correct arteriovenous shunts

Proper treatment can prevent or delay symptoms and complications of secondary erythrocytosis.

It is possible to prevent is by avoiding things that deprive your body of oxygen for long periods. For example, you can avoid mountain climbing, living at a high altitude, or smoking. 

Following a healthy lifestyle to lower your risk of heart and lung diseases will also help to prevent it. 

7-Day Diet Plan

Day	Breakfast	Lunch	Dinner	Rationale behind plan
1	200ml green tea 1 lotus seed pau 1 banana	Skinless chicken rice with cucumber Lavender Tea	Brown Rice, broccoli with black bean-garlic sauce 1 tablespoon of raisins Honeybush Tea	According to our researched website, these people are required to drink at least 2 cups of herbal Tea and those are: Lavender Tea and green tea. They are also required to take food rich in protein such as: beans and broccoli. Moreover, these people are required to consume antioxidant foods such as: banana, raisins.
2	1 Scrambled egg using Olive oil 1 cup of fresh apple juice	2 chapati with tomato curry 4 Ounces Fresh Pineapple Roseship Tea	2 steamed ostracean with stir- fried red cabbage 250 ml of Cranberry Tea 1 cup of steamed peanuts	According to our researched website, these people are required to drink at least 2 cups of herbal Tea and those are: Roseship Tea and Cranberry tea. They are also required to take food rich in protein such as: egg and peanuts. Moreover, these people are required to consume antioxidant foods such as: apples and red cabbage
3	Soya milk with 2 plain pancakes 1 medium sized apple 1 bowl of steamed chickpeas	300ml fresh orange  juice I bowl of Plain white rice with Stirr fried beans and onions white radish stewed pork rids soup	1 cup of cooked brown rice Pumpkin Curry Raspberry Leaves Tea 1 medium sized guava 1 cup Anise Tea	According to our researched website, these people are required to drink at least 2 cups of herbal Tea and those are: Anise Tea and Raspberry Leaves tea. They are also required to take food rich in protein such as: Beans and chickpeas. Moreover, these people are required to consume antioxidant foods such as: apples, onions and guava.
4	250 ml of fresh blueberry juice with 1 red bean pau 1 medium sized pear	250 ml Chrysanthemum Tea with Plain Rice and Tofu Sambal and stir fired lady’s finger 7 strawberries (1 serving)	1 Cup Tossed Salad Mix I medium sized Steamed cold fish with fired rice Green Tea	According to our researched website, these people are required to drink at least 2 cups of herbal Tea and those are: Chrysanthemum Tea and Green Tea . They are also required to take food rich in protein such as: Soya and cold fish. Moreover, these people are required to consume antioxidant foods such as: blueberry, pear and strawberries
5	1 orange 250ml of Olive Leaf Tea 1 lotus seed Pau 1 cup of low fat yogurt	250ml of tumeric tea 1 plate of fried rice with baked hallibut as in this website (http://www.bassonhook.com/fishforfood/halibutrecipes.html)	250ml of chrysanthemum tea 1 plate of bee hoon stir fried with olive oil and mixed vegetables. 1 small plate of stir fried pepper lentils	According to our researched website, these people are required to drink at least 2 cups of herbal Tea and those are: chrysanthemum tea and tumeric tea. They are also required to take food rich in protein such as: yogurt and lentils. Moreover, these people are required to consume antioxidant foods such as: orange juice and vegetables like mushroom in baked hallibut.
6	1 cup of soya bean milk 1 idiyappam (rice batter steam cooked) with vegetable kurma (vegetable curry with grated coconut)	1 medium sized  bowl of cabbage and potato salad 1 bowl of plain rice with salmon curry 1 cup of banana milk shake 250 ml of Anise Tea	Black Fungus Chicken with Ginger recipe 1 cup of egg soup 1 handful of grapes 250 ml of Green Tea	According to our researched website, these people are required to drink at least 2 cups of herbal Tea and those are: Anise Tea and Green Tea They are also required to take food rich in protein such as: soya bean milk and egg. Moreover, these people are required to consume antioxidant foods such as: grapes and banana milk shake.
7	1 bowl of tomato and egg noodles Peppermint Tea 7 prunes	1 cup of corn soup 5 blueberries 1 plate of rice with grilled eggplant and portobello 1 cup of roasted peanuts	cooked green beans 2 pieces of watermelon 1 bowl of millet porridge 250 ml of Roseship tea.	According to our researched website, these people are required to drink at least 2 cups of herbal Tea and those are: Peppermint tea, Roseship tea. They are also required to take food rich in protein such as: egg. peanuts Moreover, these people are required to consume antioxidant foods such as: blueberries, tomato and prunes

Other than the rationale provided, we have also taken into account that thse people should avoid taking refined foods such as bread, pasta and especially white sugar.

Moreover, these people are require to consume more lean meat than red meat. Furthermore, we have also used healthy oils such as olive oil to make the food more suitable for these people. We have not prescribed any baked goods such as cookies and cakes, French fries and etc as these are also not suitable for these people and is best to be avoided. We have also ensure that none of this foods are or contain alcohol, caffeine or tobacco and these will be harmful for these people.

We have included at least 2 cups of herbal tea for every day's diet as is a safe way to strengthen and tone the body's systems.Moreover, we have avoided prescribing any food that is rich in iron as this might further promote the formation of hemoglobin and hence more red blood cells. Taking any food rich in iron needs to avoided by especially male of 40 to 60 years old as their body conditions does not require much iron compared to female of the similar age and lifestyle.

It is also advisable for these people to consume health supplements such as containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals such as magnesium, calcium, zinc, and selenium. Moreover, consumption of Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 - 3 tablespoonfuls oil, 1 - 3 times daily, to help decrease inflammation and help with immunity. However, this should be avoided by people with gallbladder problems as is may increase bleeding. Probiotic supplement containing Lactobacillus acidophilus, 5 - 10 billion CFUs (colony forming units) a day, could also be consumed when needed for maintenance of gastrointestinal and immune health. However, all these health supplements can only be consumed after consultation with their doctors as some of these may not be suitable to the conditions of some of these people.

Furthermore, these people are highly advised to consume at least 5- 8 glasses of filtered water a day. To add on, we have a main dish such as rice so that we can provide these people with enough energy for the day. There is a good mix of vegetables, fruits and meat so as  to provide the person with a balanced diet which gives them other nutritional benefits as well.

If this diet plan was followed by secondary erythrocytosis patients, the condition can be prevented from worsening and may improve as well. If this diet plan was followed by people of a similar lifestyle in terms of age and gender, as a form of prevention from the disease, the person will become more healthy and will be less prone from getting secondary erythrocytosis.

Posters

Exercise Routine

First Week, 1st day:

Duration: 30 mins

Duration	Type of Exercise	Description
10 mins	Warm up with Medicine Ball	- Straddle Ball Roll - Hip Circle - Total body Stretch
15 mins	Jogging	Jog at a slow constant pace for the 15 minutes without stopping. Jogging pace could reduced. But, try not to stop. However, you are to watch your health as well. If you feel that your body is being overly strained, take a short rest and continue.
5 mins	Stretching with Resistance Band	You are to stretch the different parts of your body after the run to prevent any cramps. You are to stretch especially you thighs, knees, chest, hip, and shoulder area.

First Week, 2nd day:

Duration: 40 mins

Duration	Type of Exercise	Description
15 mins	Warm up with Medicine Ball Slightly more intensive.	- Hip Circle - Planks - Total Body Stretch
15mins	Jogging (you are to complete at least 2 km within given time limit.)	Today, start jogging at a slightly faster rate than yesterday. Ensure, your body is able to take it do and do not over strain.
10 mins	Stretching with resistance ball. (slightly more vigorous)	You are to stretch the different parts of your body after the run to prevent any cramps. You are to stretch especially you thighs, knees, chest, hip, and shoulder area. Thicken the ropes and ensure you are pulling on a greater resistance than the previous day.

First Week, 3rd day:

Duration: 50 mins

Duration	Type of Exercise	Description
15 mins	Warm up with Medicine Ball Slightly more intensive.	- Planks - Pumping - Crunches - Total Body Stretch
20 mins	Jogging (you are to complete at least 2.5 km within given time limit.)	Maintain at the same rate as the previous day. However, today is slightly longer.
2 mins	Yoga	Breathing exercises
5 mins	Running (1km)	Much Higher speed than jogging. Put in full force in activity.
10 mins	Stretching with resistance ball. (slightly more vigorous)	You are to stretch the different parts of your body after the run to prevent any cramps. You are to stretch especially you thighs, knees, chest, hip, and shoulder area. Thicken the ropes and ensure you are pulling on a greater resistance than the previous day.

Second Week, 1st day:

Duration: 55 mins

Duration	Type of Exercise	Description
5 mins	Warm-up with medicine ball
15 mins	Exercise using medicine ball	- Walking Lunge * This form of exercise works out the hamstrings, glutes and quadriceps - Squats *This form of exercise works out the abdominals, adductors, core muscles and calves These two exercises are aimed at preparing the subject for rollerblading.
35 mins	Rollerblading	- Rollerblade around a park for a distance of about 5km. *Rollerblading works out the adductors, abdominals, quadriceps, glutes and hamstrings.

Second Week, 2nd day:

Duration: 55 mins

Duration	Type of Exercise	Description
5 mins	Warm-up with medicine ball	- Straddle Ball Roll - Hip Circle - Ski Bends - Total Body Stretch * This is to warm up and prepare the muscles for further training of the lower body muscles.
	Exercise using medicine ball	- Walking Lunge * This form of exercise works out the hamstrings, glutes and quadriceps - Squats *This form of exercise works out the abdominals, adductors, core muscles and calves These two exercises are aimed at preparing the subject for rollerblading.

Third Week, 1st day:

Duration: 60 mins

Duration	Type of Exercise	Description
5 min	Warm up exercises	Stretching calf and thigh muscles, bicep and tricep stretch, head and neck rotation etc
15 min	Exercise using medicine ball	-Crunches -Plank -Squat -Front raise this trains core muscles and also is more strenuous than the previous exercises
20 min	Jogging	Jog at a constant pace for 20 minutes without stopping. The pace of jogging should be higher than the previous weeks. However if necessary, pace can be reduced while jogging but should not walk or stop jogging.
15 min	Exercise with resistance band.	-biceps: step on the resistance band and pull the band towards you -shoulder: step on the resistance band and pull the band upwards while keeping arms straight. also pull the band to the side while keeping arms straight.
5 min	Cooling down exercise	stretch calf and thigh muscles to prevent muscle aches from the run. also stretch arm muscles (exercises similar to warm up exercises)