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

### input:
Hello dr my name is aslamkhan, 24 years/ male form hubli karnataka. I am medical lab technician doing job in hubli. abou 2 yr back I got severe upper abdomen pain and I got consult to gastro enterologist and he had done endoscopy, hiatus hernia came. I got trearted for 6 months at that time what I saw is my haemoglobin got raised up 19 gm/dl and my platelet count came up 1.54 lacs/cumm I thought it is due to medicines and I stopped all tablets. after some days I saw blood in stool for a week and I got consult to surgeon and he told that some infection and gave tablets at that time my hb level came up to 15.5 gm/dl, and after some days my hb level again got raised up to 18 gm/dl and I got consult to pahologist he suggest to me to go dr kiran kattinmani oncologist and he had done ct scan of abdomen, doppler of abdomen and serum erythropoitin levels and all report came normal and he suggest to me to bangalore to consult dr vineet gupta and gave letter also.but what problem here is  I got selected to abroad for lab technicain job and after some days my medical chek up is there, if that time my hb level is some about 19 definitely they will reject me. last week I have donate 1 unit of blood also. so please reply me what to do for hb get lower and what is reason for that also.Thank you dr.

### output:

Hi Islam, Your condition is known as polycythemia.  What was your erythropoietin level. Are you a smoker or on some herbal medicines? I hope your CT scan was normal. One more thing is you should not donate blood, and it should be discarded as it is a pathological condition. Are your WBC counts normal. You should also do a JAK-2 mutation study and renal Doppler if you are hypertensive. You need to undergo regular therapeutic phlebotomies to maintain your PCV at 45. All the best.