Hemophilia: Preventing Bleeding Episodes
How can I care for myself?
If you have hemophilia, you can take steps at
home to prevent bleeding episodes and improve
your health.
• Recognize bleeding symptoms.
Bleeding in a muscle
Another common symptom of hemophilia is
bleeding into a muscle (hematoma), which can
be mild or severe. There are many possible
symptoms of bleeding into muscle, including:
• Be active, but exercise with care.
• Bruising.
• Don't take nonprescription medicines unless
your doctor tells you to.
• Swelling.
• Prevent injuries and accidents around your
home.
• Tenderness.
Recognize bleeding symptoms
Many people who have hemophilia know when
they are bleeding even before there are many
symptoms.
Bleeding in a joint
Bleeding into a joint (hemarthrosis), often
without an injury, is the most common bleeding
problem in people who have severe hemophilia.
Bleeding usually occurs in one joint at a time.
Bleeding may occur in any joint, but knees,
elbows, and ankles are most commonly affected.
Sometimes one particular joint, called a target
joint, will tend to bleed most often.
• Muscle hardening.
• Pain, especially when large muscle groups
are affected.
It is important to begin infusion with clotting
factors as soon as possible after a bleeding
episode has started, before any physical signs
develop. Even with treatment, bleeding is
sometimes hard to control. Frequent bleeding
episodes or a serious injury can lead to
complications and excessive blood loss.
Work with your doctor to make a plan for what
to do if you or your child has a bleed.
• Swelling and inflammation in the joint,
caused by repeated episodes of bleeding. If
episodes continue, the swelling may lead to
chronic pain and destruction of the joint.
Be active, but careful
People who have hemophilia can help prevent
bleeding episodes by choosing appropriate
exercises that keep their muscles and joints in
good shape. Exercise helps keep muscles
flexible and strong and helps control weight,
lessening the likelihood of a bleeding episode.
Before you or your child participates in any
sport, the family needs to learn how to
administer clotting factors at home. Injuries can
then be treated quickly. The sooner a bleeding
episode is treated, the less damage bleeding will
do to muscles and joints.
• An infant or child not wanting to move an
arm or leg because of bleeding into an
affected joint. This is often first noticed when
a child begins to walk.
People who have hemophilia need to be careful
when they participate in certain activities in
order to prevent injury and serious bleeding.
Symptoms of bleeding into a joint include:
• Warmth or tingling in the joint during the
early stages of hemarthrosis. This is called
an aura. If bleeding is not treated, mild
discomfort can progress to severe pain.
Stretching and warming up with a few minutes
of gentle exercise are important because muscles
will be less likely to be pulled or torn and
therefore less likely to bleed.
Some exercises and sports carry more risk for
bleeding than others. Some people who have
hemophilia participate in any sport, regardless
of the risk, because they infuse with clotting
factors beforehand.
It can be very hard to try to restrict your child
with hemophilia from playing a sport or being
in an activity, especially when many of his
friends are doing it. Like most children, your
son may be most concerned with "fitting in."
This conflict can be very hard for you and
frustrating for your child. Doctors who
specialize in hemophilia can often help you and
your child handle this sensitive situation.
Sports and activities that are typically
recommended for adults and children who have
hemophilia include:
• Swimming.
• Bicycling (be sure to wear a helmet).
• Walking.
• Tennis.
Sports that are possible but carry an increased
risk of bleeding include:
• Baseball.
• Basketball.
Sports that have a high risk for bleeding include:
• Soccer.
• Football.
• Hockey.
• Weight lifting (with heavy weights).
• Wrestling.
Take nonprescription medicine as
directed
Follow your doctor's directions to take
nonprescription medicine for pain relief. You
might have pain caused by bleeding into the
muscles and joints. Pain is a common problem,
and it is necessary to try to control it carefully.
Doctors often recommend acetaminophen, such
as Tylenol, for pain relief in people who have
hemophilia. Although acetaminophen does not
reduce swelling, it is safer than other medicines.
Nonsteroidal anti-inflammatory drugs
(NSAIDs), such as aspirin and ibuprofen, can
cause bleeding in the stomach or intestines,
interfere with blood clotting, and affect the
function of the cells that first plug a wound
(platelets). Acetaminophen does not have these
side effects. Be safe with medicines. Read and
follow all instructions on the label.
Medicines that people with hemophilia should
not take include the following:
• Aspirin
• Ibuprofen, such as Advil or Motrin
• Medicines that contain salicylate. This
ingredient is closely related to aspirin.
Alka-Seltzer, Pepto-Bismol, and many cough
medicines contain salicylates.
• Other nonsteroidal anti-inflammatory
medicines, such as Aleve. These medicines
are designed to reduce swelling and reduce
pain.
Prevent injuries and accidents
Because a bleeding episode often begins with
an injury, it is important to help prevent falls in
the home.
• Remove and repair household hazards that
can cause falls, including:
◦ Slippery floors. Use nonskid floor wax,
and wipe up spills immediately.
◦ Poor lighting.
◦ Cluttered walkways. Rearrange furniture
to keep furniture out of walking paths.
◦ Throw rugs. Fasten area carpets to the floor
with tape or tacks, and do not use rugs that
slip easily.
◦ Raised doorway thresholds.
◦ Electrical cords. Rearrange cords to keep
them out of walking paths.
• Keep furniture or other items that have sharp
edges away from normal pathways through
your house.
◦ If you live in an area that gets snow and
ice in the winter, have a family member or
friend sprinkle salt or sand on slippery
steps and sidewalks.
• Check the condition of your shoes on a
regular basis.
◦ Check the heels and soles of your shoes
for wear.
◦ Repair or replace worn heels or soles.
◦ Wear low-heeled shoes that fit well and
give your feet good support.
◦ Remove square or rectangular coffee
tables.
◦ Avoid loose-fitting shoes, which can cause
you to lose your balance and fall.
◦ Pad the rocks around fireplaces.
◦ Wear slippers or shoes that have nonskid
soles.
• Take precautions when you go outdoors.
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of this information, which does not replace medical advice. 2015-02-aa66376csp