5 minute read
Medical Insights
The Basics of Blood Disorders
By Catherine Smith
There are many different types of blood disorders which can cause a variety of symptoms, but many of us don’t consider our blood when we start to feel poorly. Here, we share important information about several of the most common blood disorders to look out for. Read on for helpful tips for living with these disorders from local experts.
Anemia
Anemia is a condition characterized by abnormally low levels of healthy red blood cells. Symptoms include exhaustion, weakness, shortness of breath, dizziness, headaches, or an irregular heartbeat. Common types of anemia include:
Iron-deficiency anemia:
The most common cause of anemia is low levels of iron, which is necessary for red blood cell production. People with iron-deficiency anemia may have cold hands and feet or pale skin in addition to the typical symptoms listed above.
Vitamin B12-deficiency anemia:
Low levels of B12 can also impair red blood cell production. Untreated B12 deficiency can cause neurological symptoms like trouble walking, uncontrollable muscle movements, mood changes, confusion, and more.
Hemolytic anemia:
Hemolysis is the body’s normal process of discarding old or unhealthy red blood cells. Hemolytic anemia occurs when this process is impaired, causing the body to destroy healthy cells faster than they can be created.
Common treatments for anemia include medications and dietary supplements. Dr. J. Eric Turner of Peeples Cancer Institute advises, “Taking a daily multivitamin supplement and choosing a healthy diet can help support red blood cell development and limit the effects of anemia.”
Sickle Cell Disease
Sickle cell disease (SCD) is a cluster of inherited disorders relating to abnormalities in hemoglobin, the protein in red blood cells that carries oxygen. With SCD, abnormal hemoglobin causes the red blood cells to become sticky, rigid, and C-shaped. This causes the cells to get stuck in blood vessels and impairs blood flow, leading to significant symptoms such as pain, infection, acute chest syndrome, and stroke. SCD can also cause a form of hemolytic anemia known as sickle cell anemia.
“Bone marrow transplants and gene therapy are emerging as very promising ways to remove many of the lifelong complications from sickle cell disease,” says Dr. Avery Mixon, director of pediatric hematology/oncology at Erlanger. “For patients who aren’t ready or eligible to pursue those options, there are several new drugs on the market that can help decrease symptoms and complications, and some patients rely on chronic transfusional support.”
Additionally, certain lifestyle changes can be helpful. “The key is to prevent sickle pain crises,” Dr. Turner explains. “Sickle cell patients need to stay hydrated, so drinking plenty of water each day is helpful. They should also avoid tobacco use and try to exercise at a moderate level regularly.”
Hemophilia
Hemophilia is a genetic disorder in which the blood does not clot properly. “Hemophilia can lead to internal bleeding, nosebleeds, and bleeding within the joints that can damage the joint space over time,” says Dr. Turner. There is no cure, but highly effective treatments are available and typically involve infusing the blood with the necessary clotting factor. This can be done after injury to stop bleeding or on a regular basis to prevent bleeding episodes.
The CDC reports that hemophilia occurs in far more male births than female. This is because male sex is determined by XY chromosomes as opposed to XX for female. A female baby would need to inherit the gene that causes hemophilia on both X-chromosomes to develop the disorder, while males will be hemophilic if the gene is present in just one. Because of this, Dr. Mixon advises, “Male children from carrier mothers should be tested shortly after birth to see if they have inherited this.”
Though hemophilia has a strong genetic component, Dr. Turner says, “Some people develop hemophilia without a family history, which is called acquired hemophilia. Acquired hemophilia can be associated with pregnancy, some cancers, autoimmune conditions, certain drugs, and multiple sclerosis.”
Venous Thromboembolism
“Venous thromboembolism (VTE) is a significant vascular disease that can cause dangerous complications, including deep vein thrombosis (DVT) and pulmonary embolism, which may lead to long-term disability or even death,” says Dr. Chris LeSar of Vascular Institute of Chattanooga. DVT is a blood clot that forms in the vein, which can impede blood flow or break off and travel to the lungs as a pulmonary embolism, blocking blood flow.
“If you have experienced VTE, the risks of developing recurring clots or further complications may be higher than those who have not experienced this condition. Fortunately, there are measures you can take to help prevent another episode of VTE or limit the risk of complications,” says Dr. LeSar. “Maintaining a healthy lifestyle, regularly exercising, and avoiding smoking are all steps that can significantly reduce the likelihood of developing new blood clots. Additionally, if your doctor prescribes bloodthinning medication, taking it as directed can help reduce the risk of further VTE occurrences. By working with your healthcare provider and following their recommendations, you can take steps to manage your VTE and prevent long-term complications.”
Though disorders of the blood can cause a wide range of symptoms, it can be easy to overlook the possibility that you may have a blood-related condition. If you are experiencing symptoms like unexplained exhaustion or tingling sensations –and certainly if you are experiencing any of the severe symptoms discussed earlier – it is important to check with a doctor for proper testing or treatment.
“Blood, as everyone is aware, is vital to life. Blood that isn’t being made properly in your bone marrow, blood that is diseased, and losing blood all can have anywhere from mild symptoms to life-threatening consequences,” says Dr. Mixon. “As it is vital to your well-being, don’t ignore your symptoms. Have a discussion with your primary care physician to see if any lab work is indicated or if a referral to a hematologist is needed.”
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Reviewed By:
Avery Mixon, MD | Director of Pediatric Hematology/Oncology, Erlanger
J. Eric Turner, MD | Medical Director of Oncology, Peeples Cancer Institute at Hamilton Medical Center
Chris LeSar, MD | Vascular/Endovascular Surgeon, Vascular Institute of Chattanooga
Concussions Fact vs. Fiction
By Catherine Smith
A concussion is a common type of traumatic brain injury that can be more significant than some people realize. Here, we separate the facts of concussions from the fiction with insight from Dr. Jason Robertson, a sports medicine specialist with Center for Sports Medicine and Orthopaedics, and Dr. Matt Campbell, a pediatrician with CHI Memorial Pediatric Diagnostic Associates.
Fiction: Concussions are just minor injuries that are no big deal.
Fact: Concussions are a relatively common injury, but they should not be taken lightly. “Concussions are no longer described or graded as mild because the diagnosis should not be minimized – it can be very serious,” says Dr. Robertson. “There is much we are still learning about the long-term effects of concussions on the developing brain. The most concerning complication is second impact syndrome, which can occur if a second concussion occurs before one is fully recovered – leading to rapid brain swelling and often death.”
Fiction: If you don’t feel immediate symptoms of a concussion, you’re in the clear.
Fact: Some symptoms of concussion tend to show up quickly, but each concussion can be different. “Immediate symptoms you may notice are headache, nausea or vomiting, balance problems, dizziness, light sensitivity, fatigue, slowed reaction time, and confusion,” Dr. Campbell explains. “Symptoms that may develop later are persistent cognitive difficulties (brain fog), emotional instability (like irritability, anxiety, and depression) and memory loss.”
With any potential concussion, it is always important to pay close attention to symptoms. If new symptoms arise or existing symptoms worsen, a trip to the emergency room should not be delayed. “When in doubt if there is a concussion, be safe rather than sorry,” Dr. Campbell advises.
Fiction: After a concussion, people need to be woken up every few hours.
Fact: People with mild symptoms of concussion can often safely recover at home, but this longstanding myth can actually do more harm than good. “People with concussions do not need to be woken up periodically, rather they need ample sleep to allow the brain to heal,” Dr. Campbell clarifies. “Mild symptoms can be treated at home with brain rest. This involves plenty of sleep and limiting activities that make symptoms worse (i.e. screen time, loud music, exercise).”
“Not rushing back to full activity is extremely important for faster recovery,” Dr. Campbell adds. “Taking it slow also helps prevent post-concussion syndrome, where symptoms can last for months to years if you get a second concussion before the first one is resolved.”
Fiction: Blows to the head are the only way to get a concussion.
Fact: “The most common cause of a sports-related concussion (SRC) is a direct blow to the head. American football is the most at risk sport for athletes to sustain a concussion. SRCs may also occur from an indirect, impulsive force that is transmitted to the head and may not involve a direct blow to the head at all,” Dr. Robertson explains.
Concussions that are not related to sports often result from incidents like falls and car accidents. Even if the head is not directly hit, any sort of jolting motion can cause the brain to move in the skull and cause damage.
Fiction: A helmet is a helmet – if it covers your head, it can protect you well enough.
Fact: While it is true that most helmets would be better than being entirely unprotected, helmets are created with specific activities in mind to provide the best protection possible. Specific materials and designs are better for certain activities, but may not provide adequate protection in others. Additionally, one size does not fit all – helmets should be chosen on an individual basis for personal use. Even if you use a helmet that is designed for a specific activity, it may not provide protection if it doesn’t fit properly. Helmets should always be properly fitted to the head, well maintained, and appropriately certified for use. If the helmet begins to show signs of wear and tear, it should be replaced. The CDC has published a number of detailed, activityspecific guides to proper helmet safety. You can find them at: cdc.gov/headsup/helmets/
Fiction: Individuals can go back to sports and other activities as soon as they feel better.
Fact: Athletes should only return to their sport after getting clearance from a physician. Typically, they will follow a six-step return to play progression:
Return to light activities, like school or short walks.
Light aerobic exercise only to increase the heart rate for short periods (5-10 minutes).
Moderate activity that involves body and head movement, such as jogging.
Heavy, non-contact activity according to their normal routine, like weightlifting.
Return to full contact in a controlled practice setting.
Return to competition.
“Symptoms from an SRC typically resolve within 7-10 days. Athletes are often able to return to their sport within that time frame, but everyone is different,” Dr. Robertson says. “There is arguably no more important organ in the body than the brain, especially in our developing children. Although sports are extremely important to the mental and physical growth of our kids, nothing is more important than their long-term health. If there is suspicion of a concussion, protect the child. When in doubt, sit them out.”
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Matt Campbell, MD, FAAP | Pediatrician, CHI Memorial Pediatric Diagnostic Associates
Jason Robertson, MD | Sports Medicine Specialist, Center for Sports Medicine & Orthopaedics
