When 34-year-old Karen turned in her resignation, her boss thought she was joking. One of the most productive members of his sales staff, she had explained that she simply couldn’t risk getting small nicks and cuts while making sales calls because they caused her to bleed for hours.
Like two other members of her family, Karen eventually found out that she suffered from a mild form of von Willebrand disease, a condition marked by excessive or extended bleeding. According to the Mayo Clinic, it’s the most common of inherited bleeding disorders.
Patients with this condition have a deficiency or defect of a blood protein known as von Willebrand factor. As a result, their blood doesn’t clot properly. They bleed often and for long periods of time compared to normal individuals. For women, heavy menstrual bleeding is often the main symptom.
The number one risk factor for contracting von Willebrand’s disease is having a family history of the disorder. If a parent has the gene for this condition, the chances of passing it to a child are 50-50.
Von Willebrand disease is divided into three categories, ranging from the mildest (Type 1) to the most severe (Type 3). Those most greatly afflicted might experience bleeding in the joints and muscles. To be among this group, a patient would have had to inherit the gene from both parents.
The illness is fairly evenly split between men and women in the United States. Race is not considered a risk factor.
The treatment for this illness varies according to the symptoms the patient experiences. Typical complications include swelling and severe pain, anemia or even death from bleeding.
Once the physician has confirmed a von Willebrand’s diagnosis, he or she should explain that it’s a lifelong affliction with no cure but that it can usually be treated effectively. The Mayo Clinic reports that these are the most common forms of treatment:
Desmopressin (DDAVP): Patients receive an injection or nasal spray containing a synthetic hormone. It eggs the body on to produce more von Willebrand factor stored in the lining of the blood vessels. For Type 1 and 2 patients, this can control bleeding. It can be used at the beginning of a menstrual period or before a minor surgical procedure.
Replacement therapy: Doctors use this approach for all types of von Willebrand’s disease. The patient receives infusions of von Willebrand factor and factor VIII.
Prescribed contraceptives: Both the estrogen in birth control pills and an implanted contraceptive device with progesterone, such as Mirena, can help control heavy bleeding during female patients’ cycles.
Antifibrinolytic or clot-stabilizing medications: Two familiar brands include Amicar and Cyklokapron. These drugs slow the breakdown of blood clotting factors. They can assist with keeping a clot in place after it forms and can actually stop bleeding. Von Willebrand’s patients often receive these drugs prior to or right after a tooth extraction or surgical procedure.
Fibrin sealants: Medical personnel use a syringe and apply these sealants like glue on top of a cut.
Home remedies: Patients can help themselves by avoiding blood-thinning produces like aspirin, ibuprofen or other NSAIDs without checking first with their doctor. He or she is likely to recommend other pain relievers like acetaminophen (Tylenol). The physician might also suggest avoiding prescription blood thinners and heparin. Taking some antidepressants – among them Celexa, Lexapro, Prozac, Paxil and Zoloft – can result in platelet dysfunction, which might worsen bleeding symptoms. Staying active by walking, swimming or biking but avoiding activities that can result in bruising or cutting can help patients maintain a healthy weight and keep their muscles flexible.