Versiti Comprehensive Center for Bleeding Disorders
Versiti Comprehensive Center for Bleeding Disorders
As a hemophilia treatment center (HTC), Versiti Comprehensive Center for Bleeding Disorders (CCBD) provides diagnosis and ongoing medical and supportive care for patients who are born with or acquire a bleeding or clotting disorder. As the only federally funded Hemophilia Treatment Center of Excellence in southeastern Wisconsin, we aim to provide state-of-the-art, personalized medical care to all our patients.
Our board-certified hematologists lead an expert, multidisciplinary team dedicated solely to caring for patients with bleeding and clotting disorders. Comprehensive care means treating the whole person and their family, addressing physical, mental and emotional wellbeing. Our knowledgeable and dedicated staff provide support in medical and psychosocial care, offering up-to-date information relevant to all aspects of one’s life.
Patients and families treated at a Hemophilia Treatment Center of Excellence report an improved quality of life that inspires them to thrive physically, mentally and emotionally. Our team is skilled in connecting our patients with the resources they need to achieve their health goals.
Common Symptoms of Bleeding Disorders
- Easy bruising
- Heavy or prolonged menstrual periods
- Frequent, prolonged nosebleeds
- Prolonged or unusual bleeding after injury, surgery, childbirth or dental work
Conditions We Treat
Platelets are small, disc-shaped cells that circulate in the blood. Platelets play an important role in the clotting of blood and the beginning repair of injured blood vessels. Platelets stick to, and spread on, areas of damaged blood vessel walls (platelet adhesion). These spreading platelets release substances that activate other nearby platelets that clump at the site of injury to form a platelet plug (platelet aggregation). The surface of these activated platelets then provides a site for blood clotting to occur. Clotting proteins that circulate in the blood are activated on the surface of platelets to form a mesh-like fibrin clot.
- Hereditary PFDs: Most PFDs diagnosed are of the mild, hereditary type. These PFDs do not usually go away. A patient diagnosed with the hereditary type of PFD will usually have it for the rest of their life.
- Acquired PFDs: These are caused by certain medical conditions or from the use of medications that inhibit platelet function, such as aspirin, non-steroidal anti-inflammatory drugs (such as ibuprofen and naproxen), blood thinners, and some antibiotics, antidepressants, anesthetics and heart drugs. Platelet function returns to normal when these medications are stopped.
- Bernard-Soulier syndrome: A more severe, rare hereditary PFD that results in an inability of platelets to stick and spread at sites of blood vessel injury.
- Glanzmann’s thrombasthenia: A rare, severe hereditary PFD that results in an inability of platelets to aggregate.
Thrombophilia is a condition that leads to an increased risk of developing dangerous blood clots in the veins or arteries. Blood clots in veins are called “venous thrombosis” and occur most often in the legs. Blood clots in arteries are called “arterial thrombosis” and cause strokes or heart attacks. Several conditions have been identified that may lead to clots; they may be present at birth (congenital or inherited) or may occur as the result of another condition (acquired).
Under certain circumstances, the system in the blood vessels that regulates the blood clotting process is disturbed and a blood clot abnormally forms within the veins or arteries. Sometimes, these clots become large enough to obstruct the blood flow through that vein or artery. This can interfere with the blood supply to vital tissues, causing pain and swelling of the tissue in that area, and can even cause permanent tissue damage. Clots can grow quickly and can break apart, sending small pieces of the clot (called emboli) through the blood. These can then become lodged in vessels in different areas of the body, most commonly the lungs (pulmonary embolism). An embolus in the vessels of the brain can cause a stroke. Both of these can be life-threatening.
Acquired thrombophilia: A person may develop an acquired thrombophilia at any point in their life. An acquired thrombophilia may be transient, meaning it may disappear on its own, or as a result of treatment. Acquired thrombophilia is not passed from a parent to a child, but a family may have a predisposition to develop acquired thrombophilia. A person may develop an acquired thrombophilia and may also have an inherited thrombophilia. The presence of more than one thrombophilia condition, whether acquired or hereditary, can significantly increase the risk for developing clots. There are several types of acquired thrombophilia that can be detected by appropriate laboratory testing.
Hereditary thrombophilia: Some people are born with thrombophilia either as a result of inheriting an abnormal gene from one parent (heterozygous), inheriting the same abnormal gene from both parents (homozygous), or from a genetic mutation that occurred after conception (spontaneous mutation). People can also inherit more than one abnormal gene (compound heterozygous). People with hereditary thrombophilia have either an inability of the body to produce adequate amounts of normal protein, or the body produces abnormal protein, which does not function normally. A person may have more than one type of hereditary thrombophilia or may have both hereditary and acquired thrombophilia. Hereditary thrombophilia includes:
- Factor V Leiden
- Antithrombin III deficiency
- Protein C deficiency
- Protein S deficiency
- Prothrombin gene mutation
- Elevated LP(a), also known as lipoprotein (a)
- Face-to-face education for patients and families at every outpatient clinic visit with hematologist and nurse coordinator
- Social worker, financial counselor, genetic counselor, pharmacy staff, physical therapist (as needed)
- In-home and office education for newly diagnosed patients and patients in the process of certification for home-based infusions
- In-services for schools and daycare providers
- Infusion supervision support (as needed)
- Education of community health providers, including physicians, outpatient clinic staff, local emergency room staff and inpatient hospital staff that may interface with patients with bleeding disorders
- In-services for school staff and daycare providers who care for children with bleeding disorders
Home Care Program
Versiti CCBD’s Home Care Program offers in-home education and medical/nursing care to CCBD patients and their families, focusing on prevention and treatment. We employ a full-time nurse practitioner as our Outreach and Home Care Coordinator, who is available to provide these services at our patients’ convenience. Providing these services in patients’ homes reduces anxiety and decreases problems associated with scheduling, transportation, travel costs and insurance coverage.
The program supports Versiti CCBD’s vision of appropriate care and maintenance of central lines; encourages an earlier transition to peripheral access and patient independence; and lessens reliance on contracted nursing services, whose staff may be inexperienced in specialized care of patients with bleeding and clotting disorders.
We see pediatric and adult patients at Children’s Wisconsin on the fifth floor within the MACC Fund Center. If you have an appointment in our clinic, please look for specific directions in your appointment letter. Our Comprehensive Hemophilia Clinic on Monday mornings is staffed by Drs. Malec and Friedman; the VWD/New Patient Clinic on Tuesday afternoons is staffed by Dr. Flood; and our Thursday morning and afternoon clinics for new patients and patients with VWD, PFD, thrombophilia, thrombosis and rare bleeding disorders are staffed by Drs. Punzalan, Sharma, Branchford and Friedman.
Lynn Malec, MD, MSc
CCBD Medical Director
Veronica Flood, MD
CCBD Associate Medical Director
Ken Friedman, MD
Rowena Punzalan, MD
Brian Branchford, MD
Outreach and Home Care Coordinator
Senior Registered Nurse
Jeffrey Karst, PhD
Clinical Service Specialist
Clinical Service Specialist
Continuing our legacy of providing outstanding care.
As a “lifespan clinic,” Versiti Comprehensive Center for Bleeding Disorders’ pediatric and adult hematologists are dedicated to caring for patients of all ages. Our longtime medical Director, Joan Gill, MD, established CCBD as a center of excellence committed to improving the lives of patients. Today, our staff of physicians, nurse practitioners, nurses, physical therapist, genetic counselors, social workers, psychologist, pharmacy specialists and research coordinators continue this legacy of excellence in Dr. Gill’s memory.
Note: Bleeding and clotting disorders can be very serious. Do not use this website for medical advice or in the event of a medical emergency. The information posted here is intended for general information only. In the event of an emergency, call 911 or your local emergency assistance number. For medical advice and care, including diagnosis and treatment, consult a medical doctor.