DEAR DR. DONOHUE: From my first menstrual period to the present, I have had heavy bleeding. I have to take iron to keep my blood count up. Gynecologists haven’t found anything wrong with me. Finally, a doctor sent me to a blood doctor, who discovered that I have von Willebrand’s disease. The blood doctor is running more tests. I have no idea what this is or what’s in store for me. Will you tell me? Is it cancer? – S.D.

ANSWER: Definitely, von Willebrand’s is not cancer. It’s the most common inherited bleeding disorder known to medicine.

Making clots is complicated business. But it’s one that keeps us alive when a blood vessel breaks. It involves platelets, the smallest blood cells. They stick to each other when bleeding starts, and they form a plug that seals the break in a bleeding vessel. In addition, clot formation requires clotting factors, proteins in the blood. One of those clotting factors is the von Willebrand factor. People with your illness have too little of that factor, or they have a factor that doesn’t work well.

When the factor deficit is mild, people bleed heavily only after surgery or a major accident. With a slightly greater deficit, frequent nosebleeds or heavy periods are the consequence. A severe deficit, which occurs infrequently, puts people in great danger from bleeding even from minor trauma.

Treatment depends on the extent of the deficit. Patients can be treated with clotting factors. If people have only a slight lack of the factor, they need to be treated only before surgery or when they’ve been involved in a serious trauma. More frequent bleeding calls for treatment with desmopressin, a medicine that raises levels of von Willebrand’s factor. Women with heavy periods can take birth control pills to suppress their periods.

Most patients lead normal lives with little trouble. Wear a bracelet or carry in your wallet some identification that lets emergency workers know you have this clotting disorder.

DEAR DR. DONOHUE: My fingernails are so dry and fragile that they constantly break. I use clear nail lacquer on them, but it hasn’t helped much. Does gelatin work? Do you have any other suggestions? – D.P.

ANSWER: Gelatin doesn’t work.

If you get moisture into your nails, they’ll stop breaking.

Soak your nails in warm water for 10 or 15 minutes. Then coat them with petroleum jelly and put on cotton gloves to keep the jelly on and so you don’t mess up everything in the house. It’s most convenient to do this just before going to bed. The coated nails will absorb water. The petroleum jelly provides a barrier that keeps moisture from evaporating from them.

This regimen isn’t an overnight success. It takes three or four months to see results.

Many doctors say that the B vitamin biotin strengthens nails.

DEAR DR. DONOHUE: I get eight solid hours of sleep every night. I wake up perky. I am not tired during the day. However, I have dark circles under my eyes, and everyone asks me if I have gotten enough sleep. What can I take to lighten those circles? – N.V.

ANSWER: There isn’t any medicine that erases those circles.

The skin under the eye is thin. Some people have even thinner-than-average skin there. The darker color of blood in veins shows through the skin and creates the dark circles. Much of this is genetic, a family trait just like hair color and eye color. The only way I know to address the problem is with cosmetics.

Occasionally allergies, by dilating those beneath-the-eye vessels, give rise to dark circles. Allergy medicines – antihistamines – can sometimes solve allergy-caused circles.

DEAR DR. DONOHUE: What are the effects of low blood calcium? – K.M.

ANSWER: Low calcium levels can cause muscle spasms, erratic heartbeats and personality changes.

The question you want answered by your doctor is, why has your calcium level dropped? Diseases of the kidneys and parathyroid glands can do it.

DEAR DR. DONOHUE: I am 62 and went through menopause about 10 years ago. This past year I have experienced some vaginal bleeding. My gynecologist says I have to have a biopsy of my uterus. I don’t want to go through this. Do you believe it’s necessary? – M.W.

ANSWER: You bet it’s necessary.

In a woman of your age, the concern about vaginal bleeding is cancer of the uterus, also called endometrial cancer.

When detected and treated early, uterine cancer has a high cure rate. Detection involves inspecting a sliver of uterine tissue for microscopic examination.

The biopsy is not a painful procedure. You won’t regret having this procedure done.

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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