This article is from the Richmond Times-Dispatch, published on Saturday, May 10, 1975. Go here to view the article.
Hemophiliacs Get Home Care Tips
By Beverly Orndorff
Times-Dispatch Science Writer
Patients and families of patients with hemophilia are learning to treat themselves at home when an episode of bleeding occurs, thus cutting down on the time and money they would have to spend at a hospital as well as possible later complications.
Such home care programs for hemophiliacs and their families, it was brought out at a workshop here yesterday, have been initiated within the past year by physicians connected with the Medical College of Virginia’s hemophilia treatment program.
And the MCV home care program, in turn, has been modeled after the program established at Tufts University medical school under the direction of Dr. Peter H. Levine, who was one of yesterday’s workshop speakers.
THE WORKSHOP, attended by hemophiliacs and their family members and by physicians, was sponsored by the newly formed United Virginia chapter of the National Hemophilia Foundation and by the departments of pediatrics, medicine and pedodontics at MCV.
The thing that has helped make home care programs possible is medical science’s ability to prepare concentrates of the blood clotting factors that hemophiliacs lack. Those concentrates are prepared from the blood plasma of healthy donors, and when administered via a vein, they essentially allow the normal chain of blood clotting events to occur in hemophiliacs.
Bleeding episodes among hemophiliacs may arise from a variety of causes such as bumps or blows; one of the more common problems is bleeding within joints, particularly the knees, that can lead in time to joint damage.
The home care program described by Dr. Levine yesterday involves teaching hemophiliacs, or their family members, about the nature of the disorder, symptoms they should watch for, and how to give intravenous injections of the concentrates. The patients have supplies of the concentrate, clinic physicians or other personnel are always available for specific queries, and every patient is given a thorough medical examination periodically.
EXPERIENCE FROM the Tufts program has shown, Dr. Levine said, that days lost from work or school have been reduced for hemophiliacs from 26 days a year per patient to about seven — for all illnesses, including common colds and similar maladies.
Hospitalization has been reduced from nearly 10 days to less than one day per year for the average patient, and the average cost of treatments has been reduced by around 40 per cent per patient per year — from nearly $5,500 a year for hospital emergency room treatments to about $3,500 a year for the average home-care patient’s treatment, he said.
He also indicated that patients are not as likely to delay treatment of what they consider “mild bleeds” when they or a family member can treat the condition at home. And, he suggested, prompt treatment may help reduce the occurrence of the joint damage that can result from repeated episodes of bleeding in the joint structures.
MCV’S HOME treatment program for youngsters, said Dr. Nancy B. McWilliams, assistant professor of pediatrics, began in July, and 16 children are now on home care. Also within the past year, the same sort of program was begun from MCV for adults; there are seven adults on home care programs, according to Dr. Lyman Fisher, professor of clinical pathology.
Hemophilia, more generally, is an inherited disease that has been recognized since ancient times. Queen Victoria of England was a carrier of hemophilia; one of her sons had the disorder, and some of her daughters, who married into royal families throughout Europe, were carriers. The disorder is transmitted from mother to son; one of two of a carrier’s sons, on the average, will have the disorder.
