HAPI-C in Davao: Nursing & Rehab Care for Hemophilia & Other Related Bleeding Disorders Workshop

HAPI-C was invited to the Nursing & Rehab Care for Hemophilia & Other Bleeding Disorders workshop at the Grand Menseng Hotel in Davao city. It was organized by the Association of the Hematologists in Mindanao Fund Inc. (AHM) in collaboration with the World Federation of Hemophilia (WFH) and Royal Brisbane Women’s Hospital. The audience of over 100 was comprised of hematologists, physiatrists, surgeons, nurses, and physiotherapists. HAPI-C officers Kristhy Jane Baluran and Edwardson Co attended the event.

In the morning, Dr. Jeannie Ong (hematologist) had a presentation on an overview on Hemophilia. It covered from the history of Hemophilia in the medical field, the mechanics of blood coagulation, hemophilia genetics, symptoms and complications, and treatment.

Dr. Luisa Aportadera (physiatrist) presented musco-skeletal complications in hemophilia, from muscle atrophy resulting from bleeds, progressing to synovitis to repeated bleeds left untreated. She also discussed about muscoskeletal care for patients with hemophilia.

It was followed by an on overview on Von Willebrand disorder (VWD) by hematologist Dr. Hiede Abduraman. It also covered FAQ’s on Von Willebrand disorder. Several slides of the presentation focused on the complications of menstruation and pregnancy in women with VWD.

Ms. Beryl Seizzinik, nurse from the Royal Brisbane Women’s Hospital, presented about the role of nursing care for patients with hemophilia & related bleeding disorders.

Ms. Wendy Poulsen, physiotherapist from the Royal Brisbane Women’s Hospital, presented about the role of physiotherapy / rehabilitative care for patients with hemophilia & related bleeding disorders.

During the open forum, HAPI-C officer Edwardson Co raised a question pertaining to chronic hemophilic arthropathy: How can you tell if a patient with joint synovitis is actually having a bleed, or is it just the arthropathy acting up?

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In the afternoon, the audience was divided into 5 groups for the actual workshop/demonstration. There were 4 groups for nurses and 1 group for physiotherapists, each of them having audience 10-14 members excluding the speakers, doctors, and facilitators.

Kristhy Baluran from HAPI-C was designated to one of the nurses’ groups, having been a recent nursing licensure exam taker. There, they discussed about the nurses’ responsibilities in handling hemophilia patients at the hospital. A hematologist as facilitator from each group also demonstrated on how to properly prepare and administer factor concentrate.

Edwardson Co from HAPI-C was designated to the physiotherapists’ group. Ms. Wendy Poulsen was the main speaker, co-facilitated by Dr. Luisa Aportadera and a physiotherapist. Hypothetical patient cases and physiotherapy techniques were discussed interactively.

As part of the actual demo, several hemophilia patients with various ages and arthropathic conditions were presented to the group. The patients were tasked to perform simple flexibility assessment tests, such as flexing and extending their limbs, as well as walking. From the selected patients, early signs of muscle atrophy joint deformities due to untreated bleeds have been cited early on even among the children.

One adult patient in particular shared his experiences in having an iliopsoas bleed the previous year, leaving him unable to walk for weeks and months. He then related to how important physiotherapy was in helping him recover and how regular exercise keeps him fit and less prone to bleeding.

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Later, Ms. Poulsen introduced the fibreplast, a relatively new product that is more convenient to apply and remove compared to the conventional plaster for casting. In front of another audience, Ms. Seizinnik demonstrated actual infusion of Factor Concentrate to a hemophilia patient.