### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am 40  years old and in college yesterday in A&P2 lab we tested our hematocrit manually reading the results and my rbcs were elevated at 53% where as other females tested were btwn. 46-48, the instructor said since I smoke thats why but other females in my class smoke also and rbcs were not elevated. My mother died of cirrhosis at age 55 which was said to be d/t alcohol but she did not drink near as much or as long in her life as many I know, she had drank daily for past 5 or so years, After her death, 2 years later my brother now 35,( half brother with same mother),  had liver panel with results of elevated enzymes cbc wnl and ended up having genetic testing was then diagnosed with hemochromotosis but they later said they were not sure about that, later due to contd. elevated enzymes he had a biopsy and has some liver scarring.  I know I need to have a CBC and LFTs (at last check over 5 years ago both were wnls) but I am interested in a specialist opinion, I also have a hemangioma in my c6 area diagnosed 6 months after a car wreck after having an MRI d/t contd.  back pain and headaches, Is this possibly related to the elevated rbcs and what should I try to do until i can be treated as i have no insurance and this often deters extensive testing as in the case of my mother whom they were giving Fesoy 325mg to tid. Should i donate blood? and is my blood donatable with this increase in rbcs? I have type O-. Thanks for any information I realize this is an opinion based only on my explanation and doesnt replace a Drs. visit.

### output:

Hello and welcome to Chat Doctor, Smoking causes elevation of red blood cell counts and increase in hematocrit. However, all individuals react differently to same situation. Reducing and cessation of smoking will help to reduce red blood cell counts and hematocrit. Donating blood is not a treatment for high hematocrit and elevated red blood cell counts. Hemangioma of vertebra is a different lesion and is unrelated to high red blood cell count and high hematocrit. Removal of hematoma is the treatment of choice. Yes, you can donate blood if you are above 18 years of age and if free from infections like HIV, syphilis, hepatitis B, hepatitis C and parasitic infections. Thanks and take care Chat Doctor. 