Raising Awareness of Bleeding Disorders

Bleeding disorders are rare conditions that affect the body’s ability to form a clot, which leads to prolonged bleeding from injuries and surgery, and sometimes, spontaneous bleeding. While these conditions are relatively rare, it’s a good idea to know their signs and symptoms and where to find treatment. 

For Bleeding Disorders Awareness Month in March, Melissa Kratz, RN, nurse manager at the Hemophilia Treatment Center at LVH–Muhlenberg, shares answers to questions people have about these conditions. 

There are 13 factors that control clotting in the human body. With bleeding disorders, the amount of one or more of these factors is low or not present at all. Hemophilia is one common condition that falls into this category.

Symptoms might include:

• Bleeding into the muscles, soft tissue or joints
• Prolonged bleeding from cuts and during or after surgical procedures
• Frequent, unexplained bruising
• Heavy periods
• Nosebleeds that last longer than 10 minutes

Bleeding disorders are often inherited. Depending on severity, symptoms are identified at birth or later in life (after injury or surgery).

“Some people are diagnosed as a child when they get a scrape, nosebleed or have a surgical procedure. They may have prolonged bleeding or unexplained bruises,” Kratz says. “Others don’t know they have a bleeding disorder until they are older when they start their period or get their wisdom teeth out.” 

The symptoms noted above could be a sign of a bleeding disorder but are likely caused by other conditions. It’s best to consult your primary care clinician. They will test for how much clotting factor your body is producing and its clotting times. If additional testing reveals a bleeding disorder, you will need to see a hematologist (a doctor who specializes in conditions affecting the blood).

Patients with bleeding disorders are referred to the Hemophilia Treatment Center, where clinicians who specialize in treating these conditions offer the latest treatments and advanced care.

Historically, severe bleeding disorders were managed with intravenous medication. However, improved therapies are now available, and families are educated about how to administer the injections at home. 

"Treatment has changed for the better over the years. Our goal for patients is to decrease or prevent bleeding,” Kratz says. “This decreases the risk of chronic pain and joint problems as they age.”

A child who has inherited a bleeding disorder may have mild or severe bleeding symptoms. These include:

• Easy bruising of the skin
• Bleeding from the gums or nose
• Heavy bleeding after injuries or surgery
• Continued oozing after a vaccine or bloodwork

Children with severe bleeding disorders often have bruising or too much bleeding noticed at, or soon after, birth. In these children, bleeding can happen in the skin, gums and nose as well as their brain, intestines, joints or muscles after major, minor or no known injuries. They can also have sporadic bleeding without a cause. 

With hemophilia, an inherited bleeding disorder caused by deficient or missing clotting factors, there can be spontaneous bleeding or prolonged bleeding following injuries or surgery. If the disorder is managed properly, people with hemophilia can live long, healthy lives.

Founded over 30 years ago, the Hemophilia Treatment Center is one of approximately 141 federally funded centers in the United States. It’s a national leader in hemophilia care with J. Nathan Hagstrom, MD, Physician in Chief of Lehigh Valley Reilly Children’s Hospital and Chair of Pediatrics, serving as Regional Director for the Mid-Atlantic Region of federally funded hemophilia treatment centers.

The program is comprehensive and highly responsive, involving clinicians, nurses, dietitians, physical therapists, social workers and genetic counselors. Studies show that people with hemophilia who receive care at a hemophilia treatment center are 40 percent less likely to die of a hemophilia-related complication. 

This advantage comes from a unique expertise to meet the physical, psychosocial and emotional needs of people with hemophilia, factor XI deficiency, von Willebrand disease, other factor deficiencies or a defect in platelet function. Expertise is combined with compassion at the Hemophilia Treatment Center where the team goes above and beyond. 

“We’re part of a multidisciplinary team that is totally devoted to caring for our patients,” Katz says.