Although the Reflection Circle is a basic structure for reflection, not all groups or group members are comfortable or interested in speaking up in this environment right away. Being creative and using a variety of activities helps to gain the participants' interest and can foster comfort and familiarity in the group.
If polyuria is present, patients should be asked about the age at onset, rate of onset (eg, abrupt vs gradual), and any recent clinical factors that may cause polyuria (eg, IV fluids, tube feedings, resolution of urinary obstruction, stroke, head trauma, surgery). Patients should be asked about their degree of thirst.
A variety of symptoms can occur in individuals with polycythemia vera including nonspecific symptoms such as headaches, fatigue, weakness, dizziness or itchy skin; an enlarged spleen (splenomegaly); a variety of gastrointestinal issues; and the risk of blood clot formation, which may prevent blood flow to vital organs.