Screenings: What, When, Where
Improved treatments and care means that people with bleeding disorders are living longer. While this is a great benefit, it also means that the aging population should be more aware of their bodies, monitor their health, and get appropriate medical screening for conditions associated with advanced age.
Primary Care
Having a good primary care physician is very important in maintaining your health. By scheduling regular visits with your doctor, you can coordinate age-related screening for conditions like cancer and high cholesterol. If your primary care physician is in the same health system as your Hemophilia Treatment Center (HTC), communication between members of your medical team will be even better.
Know Your Body
Pay attention to bleeding. Know what type of bleeding is usual for you and what bleeding is unusual. Bleeding episodes that aren't typical for you may indicate an age-related or other health issue. Be sure to discuss any of these episodes with your primary care physician (PCP) and at the Hemophilia Treatment Center (HTC) so any health concerns can be identified and treated.
Get Tested for Age-Related Conditions
People with bleeding disorders should be tested for the same age-related conditions as people without bleeding disorders. Fear of the risks involved with colonoscopies and biopsies for people with bleeding disorders means that many may delay or go without testing. When arranging tests that could result in a bleed, contact your Hemophilia Treatment Center (HTC) to prepare and obtain information. Complications from these procedures can be prevented by planning.
Scheduling routine screening, doctor visits, and exams will help you stay on top of your health concerns. Screening should not be limited to the conditions discussed here. Speak with your health care providers about the screening and tests that may be appropriate for you.
You may want to look at the sections below to learn more about screening.
Cardiovascular Disease
The risk of cardiovascular disease (CVD) increases with age. Additional risk factors for cardiovascular disease are high blood pressure (hypertension), high cholesterol and triglyceride levels, a family history of cardiovascular disease at a young age, and a lack of exercise and being overweight. Screening for heart function often involves riding a stationary bike or walking on a treadmill. If arthritis or joint problems make standard cardiovascular screening difficult, speak with your health care provider about other available testing methods. In addition to speaking with your primary care physician (PCP) and a cardiologist as needed, communicate with your Hemophilia Treatment Center (HTC) to ensure that you're getting the care that is right for you.
Cancer
The American Cancer Society recommends screenings for several types of cancer for the general population, and people with bleeding disorders should follow these recommendations. Cancer can sometimes be overlooked because symptoms of the cancer may be attributed to the bleeding disorder.
Liver cancer is the most common type of cancer in individuals with hemophilia who have hepatitis C.
In addition to recommended screenings, alert your medical team to any unusual symptoms, especially if you are at risk for cancer.
Joint Disease
Prophylaxis limits joint disease, especially when initiated prior to joint damage. This treatment was generally not available for individuals in the past, and as a result many aging patients suffer from joint disease. Joint disease may be managed by wearing splints, physical therapy, R.I.C.E. (Rest, Ice, Compression, Elevation), and regular gentle exercise. Speak with your Hemophilia Treatment Center (HTC) about how to improve the health of your joints.
Liver Disease
A major cause of death and disability in people with hemophilia is chronic liver disease from hepatitis C infection. Also, people co-infected with human immunodeficiency virus tend to experience more rapid development of cirrhosis and liver failure. To manage liver disease, your healthcare team may order a liver biopsy. They may also order a blood test to assess the amount of fibrosis in your liver. In case of liver failure or liver cancer, liver transplantation may be an option for certain patients.
Kidney Disease
The main risk factors for kidney (also called renal) disease are human immunodeficiency virus infection, high blood pressure, and kidney bleeding. In order to manage kidney disease, you will likely be evaluated by a kidney specialist (nephrologist) who may order a kidney biopsy. Management options include special diets, medications, better control of blood pressure, and, for advanced kidney failure, dialysis and kidney transplantation.
