Hemophilia has to do with inability to form clots

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DEAR DR. DONOHUE: My great-niece gave birth to a boy about six months ago. Doctors have discovered that he has hemophilia. My sister, the baby’s grandmother, says nothing can be done for it. Is there no treatment? – P.K.

ANSWER: What I am about to say applies to classic hemophilia – hemophilia A, an illness that was rife in many of the royal houses of Europe.

Hemophilia has to do with the inability to form clots when blood vessels break. Clot formation is a complicated process. It involves clotting factors – blood proteins. Clotting factors are designated by Roman numbers. With hemophilia A, there is a deficiency of clotting factor VIII (8). Without enough factor VIII, minor bleeding can turn into a major hemorrhage.

Hemophilia A is mostly a male thing. The defective gene is located on the X sex chromosome. Chromosomes are strands of genes. Men have only one X chromosome. Women have two. Because of that, women don’t often get hemophilia. Their healthy X chromosome protects them even if the other X chromosome carries the bad gene.

A person with hemophilia is always under the threat of having a major bleeding episode. Often, bleeding occurs in joints, and that can lead to joint deformity. However, the situation today is not as bleak as it was years ago. There are treatments available. The missing clotting factor can be supplied in a number of ways. And the medical establishment is on the verge of learning how to provide a good gene for the bad one inherited in this illness.

The odds are that your great-nephew will have a very fulfilling life.

The family should visit the National Hemophilia Foundation’s Web site: www.hemophilia.org.

DEAR DR. DONOHUE: What are floaters? I think I have one. I don’t have a regular eye doctor, and I don’t wear glasses. I can even read without glasses, something that is pretty unusual for a man of 67. – F.W.

ANSWER: Floaters are black dots or what look like strands of very fine spaghetti that dart in and out of a person’s vision. They’re caused by specks of debris that float in the eye’s vitreous, a gel-like substance that fills the back two-thirds of the eyeball. As it floats in the vitreous, the debris casts a shadow on the retina, the vision-sensitive layer of the eye. The shadows are seen as floaters.

Age is one reason why floaters appear. Very nearsighted people – people who cannot see things clearly in the distance – are prone to getting them. Usually they are not an indication of eye trouble.

A sudden onset of floaters or a sudden increase in their numbers can be a danger sign. They can signal that the retina is pulling away from its attachment to the back of the eyeball. If this happens, the person should contact an eye doctor immediately.

DEAR DR. DONOHUE: With age, my voice has become very husky. I sound a lot like actress Lauren Bacall, but I don’t look like her. The change had me so worried that I saw my doctor. He told me that nothing was wrong and that it is just an age thing. Is that an acceptable explanation? – B.W.

ANSWER: Yes, it is. With age, the vocal cords become thin, and that changes the sound of the voice. They can also become swollen, another factor in the voice’s timbre; the voice takes on a somewhat deeper, hoarser quality. It might even break every now and then.

Persistent voice changes can indicate trouble, so you were right to consult your doctor. Vocal nodules, vocal ulcers or even cancer of the voice box are possibilities. The upward reflux of stomach acid is another cause of voice changes.

DEAR DR. DONOHUE: Can a person eat whatever he or she wants if on cholesterol-lowering medicine? – N.B.

ANSWER: No. People still have to pay attention to diet, even if they take cholesterol medicine. Diet adds to the benefits of the medicine, and medicine might not be able to override diet indiscretions.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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