Conversation: The conversation between human and AI assistant.
[|Human|] Female, 37, 5 ft 5 about 170 lbs.  Medical History. I smoke about 10 cigarettes a day, have never done recreational drugs and only drink occasionally. 4 months ago I passed 3 kidney stones.  I gave birth to 3 children and had 3 late term miscarriages (4 to 6 mo along).  2 of my children I had to have progesterone shots in order to carry them to term.  After the last one I had severe bleeding issues for over a year causing me to have a partial hysterectomy, I still have my overies.  4 years ago I was diagnosed with high blood pressure and have been on and off medication since, at times it would be under control without medication.  For 2 years now I have continually been told that I have a high red blood count and have had to undergo a phlembotomy several times because of it.  I currently have high blood pressure, sometimes as high as 190/140 or so.  I have a head ache almost all the time.  I have noticed times that my heart seems to beat very very hard or flutter for short times and it causes tension in my chest.  Different doctors have run so many tests and cant tell me why any of this happens.  They dont know what has caused the high red count.  I also have leg pain and swelling which worsens in cold weather and it doesnt really change with activity or rest, they feel very heavy at times.  Most doctors dismiss this.  I am constantly being asked if I have a sunburn even though I dont.  I sweat horribly bad very often even from the slightest activity such as vacuuming in a 70 degree house.  I am constantly tired no matter how much sleep I get.  I have been diagnosed with minor sleep apnea but the machine doesnt seem to help me.  I deal with months of diarrhea and then turn around and am severely constipated for a couple weeks.  I have an increasing amount of facial hair growth that the doctors also dismiss, where I pluck about 200 hairs a week.  They all tell me that my hormone levels are normal although I question that.  I have gone through all of this with 3 different doctors now and get no where, I end up getting frustrated and stop going and then end up running out of my blood pressure medicine for months at a time until I finally decide to give another doctor a try.  I am lost of what to do since no one can tell me what is wrong.
[|AI|]  Hello, You have provided a details' history who h would help me narrow on some diagnostic possibility.  The reason for headache is both high blood pressure and higher RBC s which would cause th3 blood to be more viscous and this per se can cause bad headache. .control the blood pressure and keep your hemoglobin and Packed cell volume under control.  The reddening in cold weather may be as a result of Reynolds phenomenon.  The miscarriage, Reynolds phenomenon, hypertension, hormonal changes can all be explained by some autoimmune disease, So a rheumatologist opinion is worthwhile, get an ANA done and if positive evaluate it further. Smoking can cause polycythemia which can in turn cause other symptoms.  So try omitting the same. Do send the investigation done till now, so I can guide you better. Regards Chat Doctor.