"The soul becomes dyed with the color of its thoughts"

While shadowing an internal medicine doctor, I had the opportunity to meet a patient with Von Willebrand disease (VWD). Upon looking into it, I found that VWD occurs in 1% of the population. It is a genetically inherited (either autosomal dominant or autosomal recessive) blood disorder, in which the blood doesn’t clot properly. In this regard it is similar to hemophilia, but it tends to cause less severe symptoms. Additionally, hemophilia primarily affects males, whereas VWD affects both females and males.

Common symptoms include frequent nosebleeds, blood in the urine or stool, excessive bleeding, etc. but can ultimately vary in longevity and intensity depending on  the person. For example, this patient had great difficulty after her knee surgery due to the heavy bleeding she experienced afterwards. 

The von Willebrand factor is a protein that controls blood clotting. When levels of this protein are insufficient or it functions improperly, small blood cells known as platelets fail to effectively adhere to each other or to blood vessel walls following an injury. This disruption hinders the clotting process and may lead to uncontrollable bleeding in some cases.

When researching this disease, I was most struck by the fact that when women experience their menstrual cycle, they’re at risk of becoming anemic or iron deficient due to the blood loss. Women with this condition may need to change their sanitary pad or tampon every 1-2 hours even with ones that are meant to last up to 6 hours. For the average woman, their period already serves as an unpleasant time of the month, but this seems to multiply in discomfort tenfold for women with VWD. 

The patient I talked to was nearing 70 years old. When I asked her how she dealt with VWD during her menstrual cycle the response was “badly”. Of course, as the years have passed, society is growing to be more receptive to the needs of women during their period. But I hope that they will be even more mindful with women who deal with blood disorders alongside their menstrual cycles, no matter how rare the disorder is.