Hemophilia and broken nose

Christabelle · Oct 23, 2014

Other than the need for an infusion of Factor VIII or IX, would the treatment of a broken nose be any different for a person with hemophilia? Would there need to be a hospital stay involved, or could my character get checked out by his doctor and resume his normal post-bleed life?

I thought I was pretty well versed about hemophilia until my character decided to start a fight, and now I'm not finding much information about this situation.

Deb Kinnard · Oct 23, 2014

In the big teaching hospital where I have my day job, broken noses are treated on an outpatient basis. In my 35+ year career, I have never handled a case of hemophilia. It's that rare (at least in my area of the US). And patients who need blood transfusions for other bleeding disorders are often outpatients as well. My hospital has a blood administration "clinic" to which they're admitted, with a nice bed to nap in and pretty much everything they'd get in terms of attention as an inpatient. But still on an ambulatory basis.

I will say, though, having broken my own nose and being normal in terms of bleeding disorders, the puppy bled like I'd stuck a sword up there. Not fun!

Christabelle · Oct 25, 2014

Thanks, Deb.

It's definitely not a common disorder. I appreciate the feedback on how broken noses are generally treated!

Deb Kinnard · Oct 26, 2014

LOL, when I broke my nose, the "treatment" involved an Xray ("The bone's not broken, dearie, just the cartilage") and an ice pack. Only when noses are really badly fractured in the bone, do they treat them at all, and then it's open surgery by a competent ENT surgeon.

I worked in the radiation therapy center of my hospital at the time. Due to the broken nose, I went in to work the next day with two Technicolor black eyes. The cancer patients loved that. "Hey, Deb! Good job, you look worse than we do!"

Christabelle · Oct 27, 2014

Deb Kinnard said:
LOL, when I broke my nose, the "treatment" involved an Xray ("The bone's not broken, dearie, just the cartilage") and an ice pack. Only when noses are really badly fractured in the bone, do they treat them at all, and then it's open surgery by a competent ENT surgeon.

I worked in the radiation therapy center of my hospital at the time. Due to the broken nose, I went in to work the next day with two Technicolor black eyes. The cancer patients loved that. "Hey, Deb! Good job, you look worse than we do!"

I'm sure you cheered your patients up that day! Too bad it was at your poor nose's expense!

Since my character is my MC's brother, I'll give him an ice pack, a couple of towels to clean up with, black eyes, and send him to his doctor to get checked out.

And maybe he'll stay out of fights until my book is finished!

Bolero · Oct 27, 2014

I don't personally know any haemophiliacs - but - wouldn't they stay out of fights? Wouldn't their family be a bit careful around them? As I say, I have no first hand knowledge, that was just my reflex to your question.

Christabelle · Oct 27, 2014

Bolero said:
I don't personally know any haemophiliacs - but - wouldn't they stay out of fights? Wouldn't their family be a bit careful around them? As I say, I have no first hand knowledge, that was just my reflex to your question.

Yeah, that's generally the recommended thing to do, but my character really needed to punch somebody. He's 16 and decided he'd rather deal with a bleed than not fight the other dude (you know, the whole invincible teen mentality). Not necessarily the smartest thing for him to do, but totally in character, IMO.

King Neptune · Oct 27, 2014

There's quite a lot about bloody noses and hemophilia. Apparently they are quite common.

http://www.hemophilia.ca/en/bleedin...ving-with-von-willebrand-disease/nose-bleeds/

http://www.hog.org/handbook/article/3/33/nosebleeds

Christabelle · Oct 27, 2014

King Neptune said:
There's quite a lot about bloody noses and hemophilia. Apparently they are quite common.

http://www.hemophilia.ca/en/bleedin...ving-with-von-willebrand-disease/nose-bleeds/

http://www.hog.org/handbook/article/3/33/nosebleeds

Thanks! Yeah, I already scoured both those sites. Nothing on what to do if you break your nose or damage the cartilage, so I just glossed over it with basically the same protocols given there for a bloody nose and sent him to the doctor.

King Neptune · Oct 27, 2014

Christabelle said:
Thanks! Yeah, I already scoured both those sites. Nothing on what to do if you break your nose or damage the cartilage, so I just glossed over it with basically the same protocols given there for a bloody nose and sent him to the doctor.

I think that would be right. There's nothing to be done unless, as you mentioned, the bone is broken.

usuallycountingbats · Oct 27, 2014

Anecdotally (the sample size is me), I've broken my nose 4 times now. The first time I had it reset under general anaesthetic. Not once has it bled any of the times I've done it. So it's not a given that it will bleed.

franky_s · Oct 27, 2014

Bolero said:
I don't personally know any haemophiliacs - but - wouldn't they stay out of fights? Wouldn't their family be a bit careful around them?

Yes and yes. But, growing up, they (especially boys) are going to want to do all the things their friends can do. Which means getting into scrapes, getting drunk and doing stupid stuff.

My brother's best friend growing up had haemophilia. I promise you, he often ended up with a bloodied nose or other body part. I remember he fell through a window once (after quite a bit of drinking). That was a bit of a scare.

He could usually get the bleeding under control on his own.

Christabelle · Oct 28, 2014

franky_s said:
Yes and yes. But, growing up, they (especially boys) are going to want to do all the things their friends can do. Which means getting into scrapes, getting drunk and doing stupid stuff.

My brother's best friend growing up had haemophilia. I promise you, he often ended up with a bloodied nose or other body part. I remember he fell through a window once (after quite a bit of drinking). That was a bit of a scare.

He could usually get the bleeding under control on his own.

Thanks, Franky! Falling through a window sounds scary for anyone!! Ouch!

My character is normally pretty cautious, but this time, he decides not to care.

bellabar · Oct 30, 2014

Haemophilia varies quite a bit in severity. some people are able to self medicate at home while others will need to come into hospital, there' s quite a range of coagulation deficiency you could give your character.
If he needs to surgery to fix it, they'd usually wait a few days for swelling to go down rather than take him straight away. Haemophiliac patients will usually get an extra dose of recombinant factor VIII ( it's artificial not produced from blood donations anymore)prior to any surgery. It goes in through an intravenous drip. Also, you wouldn't lumber into surgery on a patient with haemophilia at any old hospital, you'd go to the specialist centre in your area.

Finally, having an illness doesn't change someone's character. Sure, it would be recommended not to get into a fight, but if you're the kind of person who's going to pick a fight, haemophilia isn't going to hold you back any more than that teen with asthma who takes up smoking or the woman who's told pregnancy would be dangerous but really wants to be a mother.

Christabelle · Oct 31, 2014

bellabar said:
Haemophilia varies quite a bit in severity. some people are able to self medicate at home while others will need to come into hospital, there' s quite a range of coagulation deficiency you could give your character.
If he needs to surgery to fix it, they'd usually wait a few days for swelling to go down rather than take him straight away. Haemophiliac patients will usually get an extra dose of recombinant factor VIII ( it's artificial not produced from blood donations anymore)prior to any surgery. It goes in through an intravenous drip. Also, you wouldn't lumber into surgery on a patient with haemophilia at any old hospital, you'd go to the specialist centre in your area.

Finally, having an illness doesn't change someone's character. Sure, it would be recommended not to get into a fight, but if you're the kind of person who's going to pick a fight, haemophilia isn't going to hold you back any more than that teen with asthma who takes up smoking or the woman who's told pregnancy would be dangerous but really wants to be a mother.

Good points, Bellabar. My character won't need surgery, fortunately. He'll be able to self administer his factor after the fight and before going to the doctor. He's on the severe end of the hemophilia spectrum, so he's definitely going to see his hematologist ASAP. But other than giving my MC a good scare and getting messing with the other guy's head, no permanent damage done.

Hemophilia and broken nose

Christabelle

Deb Kinnard

Christabelle

Deb Kinnard

Christabelle

Bolero

Christabelle

King Neptune

Christabelle

King Neptune

usuallycountingbats

Procrastinating on the net.

franky_s

still procrastinating

Christabelle

bellabar

figuring it all out

Christabelle