Laurie Kelley

A Star is Born

Continued from last week; a profile in leadership. Andrea Trinidad, woman with VWD, who is changing lives for all with bleeding disorders in the Philippines. Reprinted with permission from Jojo Silvestre, the Daily Tribune. https://tribune.net.ph/index.php/2019/04/30/ambassador-for-bleeding-disorders/

Star was born with bruises all over her body. At three weeks old, she had a nosebleed that prompted her parents to take her to the emergency room.

Andrea told the doctors that her family has a history of bleeding on both sides. A nephew from her father’s side just got diagnosed with severe hemophilia.

“‘No, she can’t have hemophilia. She is a girl,’ the doctors told me,” recounts Andrea.
Star grew up having at least one nosebleed episode every week. On bad days, she would nosebleed daily. Finally, in 2006, Andrea brought Star to Hong Kong. It was there that she and Star were finally diagnosed with a bleeding disorder called Von Willebrand Disease (VWD).

More common than hemophilia

Hemophilia, VWD and other inherited bleeding disorders have similar symptoms — bruising, nosebleeds, gum bleeds, excessive periods, to name a few. While hemophilia is the most known bleeding disorder, VWD is actually the most common. According to the WFH, VWD affects roughly 1 to 2 percent of the population.

“That was also when I realized that there are very limited resources here for people with bleeding disorders,” Andrea shares. “Managing bleeding disorders is expensive. But the scarcity of medicines — the factors — is something that truly surprised me. That even if you have the capacity to purchase these medicines, there are times you can’t find enough supply.”

Andrea soon started a blog to share the family’s experiences and in some ways, reach out to people around the world who have the same bleeding disorder. She was surprised by the amount of attention her blog received and the number of people who linked up with her. She then saw an opportunity to learn more about rare bleeding disorders and share with others whatever knowledge she could gather. It opened a whole new world for her.

Founding Hemophilia Advocates

In 2008, Andrea met Laurie Kelley, founder of two humanitarian programs — Save One Life and Project SHARE. Laurie came to the Philippines to do a fact-finding mission to gather data on the situation of persons with hemophilia in the Philippines. She invited Andrea to come along. It was an eye-opener to the very sad situation of Filipinos with bleeding disorders. She vowed to help the community and became a local volunteer for Project SHARE and Save One Life.

In 2011, she was invited to become an ambassador for My Girls Blood, a US-based non profit specifically aimed at raising awareness that women can also be affected with bleeding disorders.

In 2016, Andrea along with four others, founded Hemophilia Advocates-Philippines (HAP). The group’s main goal is to push for government-funded treatment for people affected by bleeding disorders.

“Hemophilia and bleeding disorders are lifelong but manageable. If we have access to treatment, we can lead normal lives,” she says.

But that is not so for most affected Filipinos. Treatment for a simple, non-life-threatening bleed, such as internal bleed in the joints, could cost around P100,000 for a single infusion for an adult.

Through the network Andrea helped to build among donors and beneficiaries, HAP has been able to bridge that gap. International organizations, such as Project SHARE, send medicines to HAP, which in turn, distribute to those who badly need them.

Global ambassador

Andrea’s personal advocacy has brought her to different parts of the globe, at her own expense, to link up with other organizations, so she could learn more about it and also seek help for the less privileged Filipinos who also have the bleeding disorder but don’t have the means to get treatment.

“Being an advocate has helped me more,” Andrea says. “Our journey with von Willebrand Disease is no longer as lonely as it used to be. We now belong to a real community of people who ‘speak the same language.’”

When Facebook introduced the Facebook Group, Andrea started a support group, which then became the HAP, which celebrated its second anniversary recently. Aside from providing factors, the organization also helps empower patients through scholarships and business opportunities.

Legislative advocate

Since she started the blog, Andrea worked nonstop with her advocacy. Today, she is busy lobbying for the passage of Senate Bill 1335 or the “Bleeding Disorders Standard of Care Bill,” which seeks to give free treatment for persons with bleeding disorders such as hemophilia, VWD and other inherited bleeding disorders. The bill also seeks the establishment of Hemophilia Treatment Centers across the country.

She also hopes that through the proposed bill, medicines, especially donated factors from overseas, will reach its recipients the soonest possible time.

Andrea and her daughter still occasionally need blood transfusions but she no longer feels helpless unlike before. She is able to live with the disorder while seeking help for others at the same time.

“If I wanted to, I can just focus all my energy on me and my daughter,” she says. “But I believe that I inherited this disorder for a reason. For as long as I can, and for as long as the hemo community needs me, I will continue with my advocacy of helping them.”

Ambassador for bleeding disorders

Excerpted with permission from an on-line article by Jojo G. Silvestre

World Hemophilia Day [April 17] is an international day of observance of which not many people seem to be aware. I am one person who may have a better understanding of bleeding disorders, a unique yet quietly widespread human malady only because my dear friend, Andrea Hernandez Trinidad, president of Hemophillia Advocates-Philippines, internationally-recognized as the face of hemophilia in the Philippines.

I met Andrea in the early years of the new millennium. A former newspaperwoman whose stories appeared on page one of a top daily, she shifted to public relations and, not unexpectedly, was very warm and friendly. It turned out it was not for convenience and business purposes that she had a ready smile. This was one lady, I soon realized, who was sincere in her dealings with others and whose friendliness is not dictated by the so-called exigencies of her profession.

Andrea, from day one of our friendship, had been one socially-confident, articulate and smart gal who dressed up properly (her style could be powerful at one time, sporty the next, or glamorous when the occasion called for it), laughed with gusto and listened attentively. Ours has been a two-way traffic, although I must say I’ve been more on the receiving end (ha ha ha) because, well, she has so much to give and I just don’t mean the “pasalubong” (gifts from travels) that she showers me with whether she needs me to edit something or not.

Managing bleeding disorders is expensive. But the scarcity of medicines — the factors — is something that truly surprised me. That even if you have the capacity to purchase these medicines, there are times you can’t find enough supply.

Although this may be late for World Hemophilia Day itself, I am focusing on her and her special cause — the promotion of awareness of bleeding disorders so that those who suffer from them would be given suitable and timely support which can be best institutionalized through legislation.

According to the website of the World Federation of Hemophilia (WFH), the organization, this year, “is focusing on reaching out and identifying new members of the bleeding disorders community. The WHD 2019 campaign will feature examples of WFH outreach initiatives such as organizing regional workshops, raising awareness of bleeding through media coverage or training health professionals and collecting data. It will combine these examples with submissions from our community about outreach efforts in their own regions or ideas about what would be helpful for future initiatives.”

Andrea comes from a family of public servants in the Visayas. Her maternal great grandfather, Jose Lopez-Vito, was a Supreme Court Justice. On the other hand, her paternal great grandfather, Vicente Vergara, was the first Mayor of Guihulngan, a locality in central Negros.

Her own father, Jesus Trinidad, was a long-term councilor and currently, two of her siblings and few cousins hold different positions in government.

Andrea and her five siblings were practically raised by their mother, Sofia, single-handedly, because their father was a martial law detainee in the 1970s and had to leave his family to work elsewhere after his incarceration.

Andrea remembers seeing her mom having bad monthly periods. Many times she would be confined to bed. She recalls, “In 1988, her bleeding became so bad that doctors wanted to run a biopsy on the lump on her uterus. She didn’t survive the supposed simple operation.

“My mother literally bled to death while undergoing biopsy operation simply because the condition was still unknown in the Philippines at that time,” recalls Andrea.

If it was devastating to the whole family, Andrea would later find out that she had inherited the disease. No wonder that as a teenager, she had a bleeding disorder.

She also experienced multiple bleeds every time she was pregnant, so all her three children were born prematurely. But it was not until her youngest child, Star, was born that she finally suspected that a bleeding disorder runs in her family.

Next week, Part 2: A Star is Born!

From: https://tribune.net.ph/index.php/2019/04/30/ambassador-for-bleeding-disorders/

Hemophilia and Vampires!

It’s Halloween week!

The holiday is a festive one, in which children and adults dress up in traditional costumes like ghosts, Frankenstein, pumpkins, devils and vampires, and nontraditional like pirates, doctors, celebrities and political figures.

I recently watched a holiday classic, The Nightmare Before Christmas, and am reading the classic Dracula, by Bram Stoker—a masterpiece of creativity and writing! If you haven’t read it, please do!

And as vampires are associated with blood, our contributing writer Richard Atwood has investigated literature about hemophilia involving vampires!

Vampire Blood Bank is a book about Lorenzo Zilch, called Larry, a male emergency room nurse at Samaritan Hospital in New York City. Larry narrates his involvement with Aaron E. Newman, a Jewish person with hemophilia who, while walking through Central Park on Thanksgiving night, is bitten by the first ever Jewish vampire!

Aaron turns as a vampire. Yet he has hemophilia. And Aaron abhors the sight of blood, so he cannot bite others! Larry and Aaron then open the Eleventh Hour Blood Bank to meet their needs, though not without others wanting a piece of the action.

Sound interesting? Richard writes that this farcical novel has no redeeming value other than laughter, “which is the best medicine.” The full title is The Saga of a Jewish Hemophiliac Who Can’t Bite So He Opens a Vampire Blood Bank. Almost every page contains a joke or gag designed for mature audiences. Aaron takes treatment for his hemophilia, and for his thirst for blood, from the stockpile at the Eleventh Hour Blood Bank.

He treats himself with four bags of whole blood per day. This treatment is enough to cover his prostate surgery. Aaron finds that being a vampire improves his blood clotting, and even helps his usual symptoms of hemophilia to recede. The commercialization and the profitability of the blood bank become evident for other vampires and for others in the blood business!

The author, Harry Zelenko, grows orchids in New York City in addition to having a writing career. Well, this crazy little novel can’t compare to Dracula, but then, what can? Read and enjoy them both! Happy Halloween!

Know Your Factor Choices

It’s truly a new era in bleeding disorders with new products, new therapies and new indications. Octapharma’s wilate just got approval for indication in adults and adolescents with hemophilia A; previously it was indicated only for VWD. With this news, I realized that we should remind everyone to know what product they use, where it comes from, and why they are using it.

Who chose your product? Was it your hematologist? Did you have any input? You should, and this means bearing the responsibility to read about products, as questions about them and be part of the decision making process.

Back in 1990, when Raising a Child with Hemophilia was first published, we were the first ones to describe parents and patients as consumers, and to treat products like any other commercial product you would buy. We provided the question to ask your doctor, and we explained the different manufacturing processes, and the difference between safety and purity. And we urged parents not to be passive in the treatment process but to help make medical decisions.

It’s more important now than ever. We have a dazzling choice of products, and novel therapies like Hemlibra. Maybe there’s no reason for you to switch products, but you might want to get up to speed on what’s available. Please note: all US FDA-approved products are considered safe and efficacious.

We’ve been writing about products and product choice for decades. I hope you read up on them and be prepared! To help you, we created a chart of products that you can download. Take it to the HTC with you and discuss with your hematologist about choice. You can download it right from our home page or go here.

We also have a chart for VWD products too!

We did our part. Now do yours; know your product, manufacturer, and why you use it. Keep learning… more therapy choices are coming!

NHF’s 71st Bleeding Disorder Conference

I just returned from Anaheim, California, where the 71st bleeding disorder conference was held. From Thursday till Saturday night, this unique community gathered to share stories, learn from one another, hear experts speak on a variety of subjects. I’ve been attending since 1992, and I think I’ve only missed one, in a year when I gave birth to my third child. This year, however, was quite special. It marks the end of an era: NHF CEO Val Bias is stepping down as leader.

I always feel funny using the term CEO with Val, because he is more than just that title to this community. He has been a friend, camp counselor, mentor and activist. He always has a ready smile, and a demeanor that makes you feel he has all the time in the world to chat with you.

Wayne Cook congratulates Val Bias

I didn’t always perceive him that way. I first saw Val when in 1992 I attended my first NHF annual meeting in Atlanta. This was at the height of tensions between the consumer advocacy groups and pharmaceutical companies, during the HIV crisis. One group of activists even dressed as grim reapers, poured red paint on themselves to represent spilled blood, and walked among the booths at the exhibit hall, banging a drum. It was chilling, and everyone was on edge. Many pharma reps left, especially after they had received death threats. The exhibit hall became deserted.

Kim Phelan, executive director of the Coalition for Hemophilia B congratulates Val Bias

I attended one session, a town hall, where people could speak up and bring their complaints and air their views. At the head of the room was a podium and table, at which sat representatives from our community: Bill Sparrow, Rachel Warner, and a few others whose names I can’t recall. In the front row, an angry Michael Rosenberg, who had hemophilia and HIV, and who headed an advocacy group that was seeking justice for the HIV infection of factor. I didn’t know all the issues at that time but watched as Michael eventually was on his feet, yelling at the speakers on the podium, and the room erupted! The community was angry, hurt… poisoned. Children and adults had died. The tension was incredible.

Out of this pandemonium came a voice from the podium asking everyone to calm down and to sit down. It commanded the room, and everyone listened. People stopped shouting; people sat down. I was amazed and wondered, who is this guy, who can bring order to chaos and calm people with a commanding voice and apparently, reputation?

That was my very first impression of Val, a leader in a time of crisis. He has played many roles in our community, including helping to bring the Ricky Ray bill into law, which provided compensation to those with hemophilia who were infected with HIV and hepatitis C. He’s been a fighter on the front line for blood safety, and more recently, a fighter to keep access to all therapies in the face of insurance barriers.

Laurie Kelley with Val Bias

The opening night of NHF last week was a tribute to Val. A beautiful video, with testimonies from former NHF president Mark Skinner and current NHF COO Dawn Rotellini, shared his contributions for the past 11 years as CEO and his contributions to the community overall. It’s a life well lived. It always struck me that while Val too was infected with HIV and hepatitis C (his first wife died shortly after being infected by him), Val never seemed to harbor bitterness. He only sought justice.

We will miss his leadership. But we hope that he will stay visible in the community, to share his warm smile, hearty laugh, wisdom and friendship. He leaves a legacy, and very hard shoes to fill.

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