Bleeders and Clotters Hematology is the specialty of blood disorders including bleeding and clotting. As a Baptist Hospital hematologist for 15 years, I have learned to determine which hospital patients are bleeders and which are clotters. Bleeding tendency is common among people, and it is not always considered a problem. For example, young women with heavy menstrual bleeding usually do not consider it abnormal, and those who bruise easily often do not experience serious problems — just a “bruising tendency.” However, anybody who starts to have bleeding gums, nosebleeds, or large bruises should seek medical attention to be tested for bleeding disorders, including low platelet count and coagulation disorder.
On the other hand, older people who start to bruise and bleed easily may have more severe blood conditions like bone marrow or liver dysfunction. Having a clotting disorder is a different issue. As many as one million people each year in the U.S. develop leg clots known as deep venous thrombosis (DVT), and half of these people also have lung clots known as pulmonary emboli (PE). Clotting disorders may also sometimes involve strokes caused by clotting in the brain.
Developing a blood clot is a more definable life event than having a bleeding tendency. Usually, blood clotting conditions lead to a hospital visit, where three concerns will be addressed: (1) what caused the clot; (2) what can be done about the clot; and (3) how future clots can be prevented. DVT and PE blood clots may be caused by inherited clotting tendency mutations, the autoimmune clotting disorder known as antiphospholipid syndrome, or sickle cell trait. In older people, clotting may lead to discovering that the person has cancer, though this is uncommon. After a clot is identified, anticoagulant medications, including heparin, are used to help the body dissolve the clot. Sometimes thrombolytic medications, or “clot busters,” may be needed.
Afterwards, the focus shifts to preventing another clot by administering oral anticoagulants. After several months, there will be a decision about long-term prevention. Having one blood clot puts you at higher risk of having another blood clot than if you have never experienced clotting . It is important to discuss your clotting with a hematology expert and to seek guidance about maintenance medications to prevent future blood clots.
Heme Onc Call, the country’s first telemedicine-based hematology practice, was created to reform the way hematology is practiced. After a careful assessment of your bleeding and clotting history and a review of your test results, you will receive education and guidance on your next steps. With our virtual format, you will have access to continuous online communication with your hematology expert.