By Michael D. Tarantino, MD, Medical Director of the Bleeding & Clotting Disorders Institute
Blood flow in the human body is designed to be fluid and uninterrupted with the intent of delivering oxygen and other nutrients to all tissues. In the healthy state, blood cells and blood vessel linings have smooth surfaces to promote this. When a blood vessel is injured, the harmonious flow of blood is disturbed and changes in the blood cells and blood vessels help limit blood loss, form a clot at the site of injury, and restore streamline flow. One can imagine that the natural process of stopping bleeding is a complex process requiring a balance between preventing bleeding and preventing excessive clotting. Many individuals have disorders of this balance and sometimes end up with excessive bleeding or clotting.
Bleeding Disorders
Persons with bleeding disorders typically lack the ability to produce a firm clot, either because of a defect in blood platelets or blood clotting proteins. The body produces 13 clotting factors. If any are defective or deficient, blood clotting may be abnormal; a mild, moderate or severe bleeding disorder can result. Symptoms of a bleeding disorder include exaggerated bleeding after injury, surgery, trauma, or during the menstrual period. Bleeding may be spontaneous, especially in those with severe bleeding disorders.
Some bleeding disorders, such as hemophilia, can be inherited or acquired. Others can occur from conditions such as anemia, cirrhosis of the liver, HIV, leukemia, and vitamin K deficiency. Bleeding disorders can also result from certain medications that thin the blood, including aspirin, heparin, and warfarin. A common acquired bleeding disorder that involves the platelets is Immune Thrombocytopenia, or ITP. This is usually a temporary problem in children, but in some children and most adults that develop ITP, chronically low platelets results.
Signs and Symptoms
- Signs and symptoms of bleeding disorders include: Excessive nosebleeds
- Prolonged, heavy menstrual periods (menorrhagia)
- Unexplained bruising
- Extended bleeding after minor cuts, blood draws or vaccinations, minor surgery or dental procedures
- Bleeding into joints, muscles, and soft tissues (most commonly in persons with hemophilia)
Treatment
Treatment for bleeding disorders varies, depending on condition and severity. For some bleeding disorders, clotting factor concentrates may be infused prophylactically, or on-demand, to prevent or treat bleeds. Specific factor concentrates are available to supplement many natural clotting factors. For other bleeding disorders, topical products or nasal sprays that augment good blood clotting may be useful. For more profound clotting factor deficiencies where a specific factor concentrate is not available, plasma from the blood bank may be necessary.
Importance of Access to a Hemophilia Treatment Center
As a nonprofit, multi-disciplinary evaluation, treatment, and research facility, the Bleeding & Clotting Disorders Institute (BCDI) is the medical home for children and adults with bleeding and clotting disorders providing specialized health care services, education, advocacy, and state-of-the-art research. The BCDI medical staff recognizes that personalized health care provided by caring, experienced professionals is paramount to achieving the highest quality of life. Combined, our team has over 250 years of experience caring for adults and children with bleeding and clotting disorders.
BCDI understands challenges such as new relationships with the health care system, new treatments and therapies and learning new terminology. Hemophilia Treatment Centers have been an excellent resource due to the staff’s understanding of unique needs associated with a bleeding or clotting disorder.
At BCDI, we deliver state-of-the art medical care and offer tremendous emotional support to patients and families. Our multi-disciplinary team of providers work together to make sure you receive the highest quality of care possible.
When to Visit a Hematologist
If an individual is experiencing symptoms related to bleeding or excessive clotting issues, it is important to consult a board certified hematologist. Being hematology board certified involves sub specialized training, a rigorous process of testing and peer evaluation that is designed and administered by specialists in the specific area of medicine. This specialized knowledge allows assistance in arriving at diagnosis, on-going management of a disorder and opportunities for patients to participate in funded programs or clinical research trials.
Referrals to BCDI come from physicians, hospitals and self-referrals throughout the “downstate” Illinois area. BCDI collaborates with other health care providers for the coordination of care to minimize the need for travel and hospitalizations and to provide the best possible care for patients.
Be sure to read the next segment of this article in the August issue. For more information, contact the Bleeding & Clotting Disorders Institute at 309-692-5337, ilbcdi.org, info@ilbcdi.org, or facebook.com/ILBCDI. Office Hours: Monday-Friday 7:30 a.m.-4:30 p.m. BCDI is located at 9128 N. Lindbergh Drive, Peoria, IL 61615. “Michael D. Tarantino, MD completed his residency in pediatrics at the University of Arizona Health Sciences Center in 1990. He is currently a professor of Pediatrics and Medicine at the University of Illinois College of Medicine. He is board-certified in Pediatric Hematology/Oncology and brings 25 years of experience caring for children and adults with bleeding and clotting disorders.”