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Flu Season—Getting Ready                                          The Center for Disease Control and Prevention’s (CDC)
                                                                  Advisory Committee on Immunization Practices (ACIP)
By: Nancy Spomer, RN, BSN University of Colorado Hemophilia       are recommending the following persons a priority to
& Thrombosis Center                                               receive the novel H1N1 vaccine as it becomes available:
As we approach the end of the summer season and                    • Pregnant women.
turn our attention to preparing for fall and winter,
it is time to be aware of and prepare for cold and flu             • People who live with or care for children
season. This year brings new information and guide-
lines for preventing influenza after a new strain of                 younger than 6 months of age.
the disease was identified in the United States in                 • Health care and emergency medical
April 2009. Originally called “swine flu” this new
strain is officially novel influenza A or H1N1.                      services personnel.

First, the usual seasonal influenza viruses are still              • Persons between the ages of 6 months through
expected in the United States with peak incidence in                 24 years of age.
January but this can vary in different parts of the                • People from ages 25 through 64 years of age
country. Vaccine for seasonal flu will be widely                     who are at higher risk for novel H1N1 because
available this year beginning in September. Anyone                   a of chronic health conditions or compromised
who wants to reduce their chance of getting the flu                  immune systems.
should get the vaccine. Check with your health care
provider about whether the flu vaccine is appropriate             Transmission of seasonal and H1N1 flu is through
for you or family members. Persons with an allergy                coughing or sneezing, or by touching a surface or
to eggs or a history of Guillian-Barre Syndrome                   object that is contaminated and then touching the
should not get the flu vaccine.                                   mucous membranes of the mouth or nose. To stay
                                                                  healthy this season, cover your nose and mouth
H1N1 and seasonal flu may have the following                      with a tissue when you cough or sneeze, then throw
symptoms: fever, cough, sore throat, body aches,                  the tissue in the trash. WASH YOUR HANDS often
headache, chills and fatigue. With H1N1 there have                with soap and water, especially after you cough or
been reports of diarrhea and vomiting. Both flu                   sneeze. Alcohol based hand cleansers are also effec-
viruses may be mild to severe and can vary in                     tive. Avoid touching eyes, nose or mouth. To quote
individuals who seemingly were infected by a                      Mary Pappas, a New York school nurse who first
common source. Different than seasonal flu which                  identified an outbreak of the new H1N1 flu at her
impacts all ages, it appears that children, adoles-
                                                                                                      See: “Flu Season” on page 2
cents, young adults and pregnant women may be
more impacted than other age groups with H1N1.
Although both seasonal and H1N1 can cause severe
disease including death, there is some additional                  Contents
concern associated with H1N1 in the severe form                    Flu Season—Getting Ready ...................................... 1
which can occasionally cause severe pneumonia                      RMHBDA Board of Directors................................... 2
or respiratory failure.                                            Thank You Members & Donors! ............................... 2
                                                                   2009 Family Camp Memories ................................... 3
                                                                   September is Emergency Preparedness Month ....... 5
                                                                   Scientists at University College Target Coagulation .. 7
                                                                   Many Thanks to Our Camp Sponsors! ....................... 8

                                                              1
RMHBDA Board of Directors                             From: “Flu Season” on page 1
President                                             school, “if it’s wet and it’s not yours, don’t touch it.”
                                                      Stay home if you get sick and limit your contact with
 • Kevin Amende, Bozeman, MT                          others. You should stay home for 24 hours after the
Vice President                                        fever is gone (except to seek medical attention).
                                                      Listen for public health advisories regarding school
  • Jim Ferriter, Helena, MT                          closures and avoiding crowds.
Treasurer                                             You should contact your health care provider for
                                                      advice about getting vaccinated in your community.
 • Forrest Berg, Bozeman, MT                          Although not available in the same vaccine, you can
Secretary                                             receive both the seasonal flu vaccine and the H1N1
                                                      vaccine on the same day.
 • Lisa Maxwell, Great Falls, MT
                                                      There are some special precautions for persons with
Board Members                                         hemophilia or bleeding disorders.
 • Orley Arthur, Roundup, MT
                                                       1. If you or your family member are currently
 • Peter Brinkley, Missoula, MT                           taking prophylaxis factor infusions, try to
 • Monica Foster, East Helena, MT                         coordinate the prophylaxis dose on the day
                                                          of receiving the vaccine.
 • Chris Graham, Billings, MT
                                                       2. To help prevent a muscle hemorrhage, have
 • Jermone Hugs, Pryor, MT                                the health care provider use the smallest
                                                          possible needle to administer the vaccine.
Thank You Members & Donors!                            3. Apply pressure and/or coban for 5-10 minutes
Many thanks to our new and renewing members,              after the immunization.
as well as donors. We appreciate you immensely!       As you prepare for severe weather and seasonal
If you know anyone who may want to join RMHBDA,       viruses season, take inventory of your medication and
please use the membership form located on our         infusion supplies—have the necessary medication
web site (www.rockymountainhemophilia.org).           available at all times.
Donations                                             For up-to-date information on seasonal flu and H1N1
 • Thelmar Thornson                                   see: http://www.cdc.gov/h1n1flu/ and www.flu.gov.
Grants
                                                        Rocky Mountain Hemophilia & Bleeding Disorders
 • Hemophilia Alliance                                  Association Newsletter
                                                        Executive Director: Ann L. Schrader
                                                        Editor and designer: Eve Armour.
                                                        Office hours: 1:00 pm to 5 pm; Monday - Wednesday. Send
                                                        comments to: Office Manager, RMHBDA, 2100 Fairway
                                                        Drive, Suite 107, Bozeman, MT 59715; 406-586-4050;
                                                        eve.rmhbda@gmail.com.



                                                  2
2009 Family Camp Memories                                                                         camp was well-
                                                                                                  organized and
As you will see from the paragraphs below, Family                                                 very balanced
Camp 2009 went very well and everyone had a great                                                 with activity and
time. In the next few weeks, we will email a request                                              free time. From
for input on where you think the 2010 family camp                                                 a planning team
should be held and what makes the camp a memorable                                                perspective,
event for you and your family.                                                                    camp was very
                                                                                                  well planned out
By: Jessica Amende, 2009 Camp Committee                                                           and the team I
                                                                                                  worked with was
Family camp 2009 was refreshing! Our family had                                                   super! I appreci-
a great weekend. Even with the monsoon nights,                                                    ated serving with
Luccock Park was a beautiful and restful place for                                                others who are so
this year’s family camp. My kids enjoyed being             Naomi McNabb, youngest member
                                                                                                 reliable and fun!
outside all weekend exploring on the hike, learning        of 2009 Family Camp.
                                                                                                 Thank you to Ann,
through play with the Knight’s Crossing, and of                                                  Lisa M., Lisa G-F,
course eating as many s’mores as possible during           and Eve for all their creativity and organization–
campfire (while their mom was busy socializing!).          you rock! A big “Thank you” to all of our industry
                                                           support as well! It is so great that each of you comes
Sleeping arrangements were an adventure this year          to camp ready to push your sleeves up and help
with three families in our cabin! It was cozy and          wherever you are needed. I appreciate your warmth
invited bedtime card games to all still awake!             and willingness to jump right in. See you all next year!
The only bummer was the narrow beds with slick
liners (two of my three kids fell out of bed more          By: Lisa Maxwell, 2009 Camp Director
than once!).
                                                           The forecast called for 60% chance of rain. Families
Although our overall camper numbers were small             and friends gathered in Paradise Valley for
this year, the quality and time to engage with one         “The Amazing Race” Family Camp 2009 and were
another was great. From a participant’s perspective,                                  See: “Camp Memories” on page 7




Participants of the 2009 RMHBDA Family Camp.


                                                       3
4
September is Emergency                              • Keep as much factor and supplies on hand
                                                      as your insurance will allow.
Preparedness Month                                  • Teach extended family and friends how to
                                                      infuse, as circumstances may require others
• Wear a medical alert bracelet or necklace.          to infuse the patient.
• Place multiple ice packs in the freezer.          • Keep a family manual--a reference notebook
• Always have, in the same place, enough              with pertinent medical information, directions
  cash/change for parking at HTC/hospital             on mixing and infusing factor, maps of the
  or cab/bus/subway fare to get you to the            area for the HTC/hospital, important phone
  HTC or ER.                                          numbers, diagnosis and treatment regimens,
                                                      location of back-up HTC, etc.
• Always take factor and supplies with you
  when you leave home.
• Fill our and regularly update the NHF
  Readiness card for each family member with
  emergency contact information, important
  phone numbers, diagnosis, prescription
  information, etc. NHF Readiness cards can
  be requested through HANDI (800-424-2634).
• Keep important phone numbers (HTC,
  homecare company, physicians, insurance,
  ER, etc.) in multiple locations: on fridge,
  in wallet, on child’s car seat, in school
  bags/work bags/go-bag, with your health
  care insurance papers, etc.                       • Keep an infusion log and take it with you
                                                      in case there is a need for evacuation.
                                                    • Keep a go-bag/small suitcase of factor and
                                                      supplies packed at all times so it is easy to
                                                      grab and go: make sure you take supplies on
                                                      a regular basis in line with expiration dates.
                                                    • Program your emergency contact into your
                                                      phone under “ICE” (In Case of Emergency).
                                                      EMS responders now look for it in cell phones
                                                      and call that number if needed.
                                                    • Program 800-424-2634 (HANDI) into your
                                                      phone in case you need information on avail-
                                                      able HTCs and chapter services in areas to
                                                      which you may have to evacuate.
                                                    • Contact your local emergency management
                                                      office or public health department for
                                                      information on sheltering-in-place and other
                                                      safety procedures for your area.

                                                    RMHBDA Calendar
                                                    •	 September:	Emergency Preparedness Month

                                                    •	 October	29-31:	NHF Annual Meeting in San
                                                       Francisco

                                                    •	 November	11: Board meeting Teleconference

                                                5
6
Scientists at University College                                  From: “Camp Memories” on page 3

Target Coagulation                                                treated to perfect weather for all outdoor activities.
                                                                  The rains only came while we slept! This year’s
By: Pharma Business Week, August 3, 2009                          camp was a perfect blend of activities and family
                                                                  time. If you didn’t hike, you could be in the bean-bag
"A retrospective review was carried out on the methods            tourney; if you were a teen, the Knights Crossing
of obstetric analgesia/anesthesia used in 80 pregnancies          kept your interest. Our family enjoyed
amongst 63 women with inherited bleeding disorders                the fire side s’mores, the astronomy lessons of today
(19 factor XI deficiency, 16 carriers of hemophilia,              and of the past, sharing a cabin with other families,
15 von Willebrand disease, seven platelet function                and settling the controversy of bean-bag Family
disorders, four factor VII deficiency, one factor VII             Champion. Thank you to the families that came to
and XI deficiency and one factor X deficiency).
In 72 pregnancies, the woman was seen antenatally
in a multidisciplinary clinic to discuss and plan pain
relief options," researchers in London, the United
Kingdom report (see also Coagulation).
"Regional block was performed for 41 pregnancies.
The mothers were known to have a bleeding
disorder in 35 of these pregnancies. Prophylactic
cover was given in 10 pregnancies prior to the in-
sertion of regional block but not required in the
remaining 25 pregnancies because the coagulation
defects had spontaneously normalized at term.
There were six reported adverse effects from regional
block similar to that found in the general population:
inadequate anesthesia/analgesia (2), bloody tap (2),
hypotension and a possible dural puncture which was
treated conservatively. There were no reports of
long-term complications," wrote C. Chi and colleagues,
University College.
The researchers concluded: "The findings show that
it is possible to offer women with inherited bleeding
disorders the option of regional block provided their
coagulation defects have normalized, either spon-
taneously during pregnancy or following adequate
haemostatic cover."
Chi and colleagues published their study in Thrombosis
and Haemostasis (Obstetric analgesia and anaesthesia
in women with inherited bleeding disorders. Thrombosis
and Haemostasis, 2009;101(6):1104-1111).
For additional information, contact R.A. Kadir, University
College London, Dept. of Obstetrics & Gynecology, Pond            Participants of the 2009 RMHBDA Family Camp.
St., London NW3 2QG, UK.
                                                                  share and reconnect. You are why we come to camp!
Publisher contact information for the journal Thrombosis
                                                                  Our volunteer industry reps. are a great asset, always
and Haemostasis is: Schattauer GmbH-Verlag Medizin
                                                                  willing to play and help wherever needed—I could
Naturwissenschaften, Holderlinstrasse 3, D-70174 Stuttgart,
                                                                  not do the Family Games without them! The camp
Germany.
                                                                  committee team of Lisa Glass, Jessica Amende, Ann
                                                                  Schrader, and Eve Armour did an outstanding job.
                                                                  A huge “Thank you” to this creative, hard working
                                                                  group—you truly make the job of “director” just a
                                                                  title that someone has to be tagged with.

                                                              7
Many Thanks to Our Camp Sponsors!




      Southwest Montana Astronomical Society




                                               Bozeman, MT 59715
                                               2100 Fairway Drive, Suite 107
                                               RMHBDA
                              8

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Rmhbda Newsletter Sept 2009 Reduced

  • 1. Flu Season—Getting Ready The Center for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) By: Nancy Spomer, RN, BSN University of Colorado Hemophilia are recommending the following persons a priority to & Thrombosis Center receive the novel H1N1 vaccine as it becomes available: As we approach the end of the summer season and • Pregnant women. turn our attention to preparing for fall and winter, it is time to be aware of and prepare for cold and flu • People who live with or care for children season. This year brings new information and guide- lines for preventing influenza after a new strain of younger than 6 months of age. the disease was identified in the United States in • Health care and emergency medical April 2009. Originally called “swine flu” this new strain is officially novel influenza A or H1N1. services personnel. First, the usual seasonal influenza viruses are still • Persons between the ages of 6 months through expected in the United States with peak incidence in 24 years of age. January but this can vary in different parts of the • People from ages 25 through 64 years of age country. Vaccine for seasonal flu will be widely who are at higher risk for novel H1N1 because available this year beginning in September. Anyone a of chronic health conditions or compromised who wants to reduce their chance of getting the flu immune systems. should get the vaccine. Check with your health care provider about whether the flu vaccine is appropriate Transmission of seasonal and H1N1 flu is through for you or family members. Persons with an allergy coughing or sneezing, or by touching a surface or to eggs or a history of Guillian-Barre Syndrome object that is contaminated and then touching the should not get the flu vaccine. mucous membranes of the mouth or nose. To stay healthy this season, cover your nose and mouth H1N1 and seasonal flu may have the following with a tissue when you cough or sneeze, then throw symptoms: fever, cough, sore throat, body aches, the tissue in the trash. WASH YOUR HANDS often headache, chills and fatigue. With H1N1 there have with soap and water, especially after you cough or been reports of diarrhea and vomiting. Both flu sneeze. Alcohol based hand cleansers are also effec- viruses may be mild to severe and can vary in tive. Avoid touching eyes, nose or mouth. To quote individuals who seemingly were infected by a Mary Pappas, a New York school nurse who first common source. Different than seasonal flu which identified an outbreak of the new H1N1 flu at her impacts all ages, it appears that children, adoles- See: “Flu Season” on page 2 cents, young adults and pregnant women may be more impacted than other age groups with H1N1. Although both seasonal and H1N1 can cause severe disease including death, there is some additional Contents concern associated with H1N1 in the severe form Flu Season—Getting Ready ...................................... 1 which can occasionally cause severe pneumonia RMHBDA Board of Directors................................... 2 or respiratory failure. Thank You Members & Donors! ............................... 2 2009 Family Camp Memories ................................... 3 September is Emergency Preparedness Month ....... 5 Scientists at University College Target Coagulation .. 7 Many Thanks to Our Camp Sponsors! ....................... 8 1
  • 2. RMHBDA Board of Directors From: “Flu Season” on page 1 President school, “if it’s wet and it’s not yours, don’t touch it.” Stay home if you get sick and limit your contact with • Kevin Amende, Bozeman, MT others. You should stay home for 24 hours after the Vice President fever is gone (except to seek medical attention). Listen for public health advisories regarding school • Jim Ferriter, Helena, MT closures and avoiding crowds. Treasurer You should contact your health care provider for advice about getting vaccinated in your community. • Forrest Berg, Bozeman, MT Although not available in the same vaccine, you can Secretary receive both the seasonal flu vaccine and the H1N1 vaccine on the same day. • Lisa Maxwell, Great Falls, MT There are some special precautions for persons with Board Members hemophilia or bleeding disorders. • Orley Arthur, Roundup, MT 1. If you or your family member are currently • Peter Brinkley, Missoula, MT taking prophylaxis factor infusions, try to • Monica Foster, East Helena, MT coordinate the prophylaxis dose on the day of receiving the vaccine. • Chris Graham, Billings, MT 2. To help prevent a muscle hemorrhage, have • Jermone Hugs, Pryor, MT the health care provider use the smallest possible needle to administer the vaccine. Thank You Members & Donors! 3. Apply pressure and/or coban for 5-10 minutes Many thanks to our new and renewing members, after the immunization. as well as donors. We appreciate you immensely! As you prepare for severe weather and seasonal If you know anyone who may want to join RMHBDA, viruses season, take inventory of your medication and please use the membership form located on our infusion supplies—have the necessary medication web site (www.rockymountainhemophilia.org). available at all times. Donations For up-to-date information on seasonal flu and H1N1 • Thelmar Thornson see: http://www.cdc.gov/h1n1flu/ and www.flu.gov. Grants Rocky Mountain Hemophilia & Bleeding Disorders • Hemophilia Alliance Association Newsletter Executive Director: Ann L. Schrader Editor and designer: Eve Armour. Office hours: 1:00 pm to 5 pm; Monday - Wednesday. Send comments to: Office Manager, RMHBDA, 2100 Fairway Drive, Suite 107, Bozeman, MT 59715; 406-586-4050; eve.rmhbda@gmail.com. 2
  • 3. 2009 Family Camp Memories camp was well- organized and As you will see from the paragraphs below, Family very balanced Camp 2009 went very well and everyone had a great with activity and time. In the next few weeks, we will email a request free time. From for input on where you think the 2010 family camp a planning team should be held and what makes the camp a memorable perspective, event for you and your family. camp was very well planned out By: Jessica Amende, 2009 Camp Committee and the team I worked with was Family camp 2009 was refreshing! Our family had super! I appreci- a great weekend. Even with the monsoon nights, ated serving with Luccock Park was a beautiful and restful place for others who are so this year’s family camp. My kids enjoyed being Naomi McNabb, youngest member reliable and fun! outside all weekend exploring on the hike, learning of 2009 Family Camp. Thank you to Ann, through play with the Knight’s Crossing, and of Lisa M., Lisa G-F, course eating as many s’mores as possible during and Eve for all their creativity and organization– campfire (while their mom was busy socializing!). you rock! A big “Thank you” to all of our industry support as well! It is so great that each of you comes Sleeping arrangements were an adventure this year to camp ready to push your sleeves up and help with three families in our cabin! It was cozy and wherever you are needed. I appreciate your warmth invited bedtime card games to all still awake! and willingness to jump right in. See you all next year! The only bummer was the narrow beds with slick liners (two of my three kids fell out of bed more By: Lisa Maxwell, 2009 Camp Director than once!). The forecast called for 60% chance of rain. Families Although our overall camper numbers were small and friends gathered in Paradise Valley for this year, the quality and time to engage with one “The Amazing Race” Family Camp 2009 and were another was great. From a participant’s perspective, See: “Camp Memories” on page 7 Participants of the 2009 RMHBDA Family Camp. 3
  • 4. 4
  • 5. September is Emergency • Keep as much factor and supplies on hand as your insurance will allow. Preparedness Month • Teach extended family and friends how to infuse, as circumstances may require others • Wear a medical alert bracelet or necklace. to infuse the patient. • Place multiple ice packs in the freezer. • Keep a family manual--a reference notebook • Always have, in the same place, enough with pertinent medical information, directions cash/change for parking at HTC/hospital on mixing and infusing factor, maps of the or cab/bus/subway fare to get you to the area for the HTC/hospital, important phone HTC or ER. numbers, diagnosis and treatment regimens, location of back-up HTC, etc. • Always take factor and supplies with you when you leave home. • Fill our and regularly update the NHF Readiness card for each family member with emergency contact information, important phone numbers, diagnosis, prescription information, etc. NHF Readiness cards can be requested through HANDI (800-424-2634). • Keep important phone numbers (HTC, homecare company, physicians, insurance, ER, etc.) in multiple locations: on fridge, in wallet, on child’s car seat, in school bags/work bags/go-bag, with your health care insurance papers, etc. • Keep an infusion log and take it with you in case there is a need for evacuation. • Keep a go-bag/small suitcase of factor and supplies packed at all times so it is easy to grab and go: make sure you take supplies on a regular basis in line with expiration dates. • Program your emergency contact into your phone under “ICE” (In Case of Emergency). EMS responders now look for it in cell phones and call that number if needed. • Program 800-424-2634 (HANDI) into your phone in case you need information on avail- able HTCs and chapter services in areas to which you may have to evacuate. • Contact your local emergency management office or public health department for information on sheltering-in-place and other safety procedures for your area. RMHBDA Calendar • September: Emergency Preparedness Month • October 29-31: NHF Annual Meeting in San Francisco • November 11: Board meeting Teleconference 5
  • 6. 6
  • 7. Scientists at University College From: “Camp Memories” on page 3 Target Coagulation treated to perfect weather for all outdoor activities. The rains only came while we slept! This year’s By: Pharma Business Week, August 3, 2009 camp was a perfect blend of activities and family time. If you didn’t hike, you could be in the bean-bag "A retrospective review was carried out on the methods tourney; if you were a teen, the Knights Crossing of obstetric analgesia/anesthesia used in 80 pregnancies kept your interest. Our family enjoyed amongst 63 women with inherited bleeding disorders the fire side s’mores, the astronomy lessons of today (19 factor XI deficiency, 16 carriers of hemophilia, and of the past, sharing a cabin with other families, 15 von Willebrand disease, seven platelet function and settling the controversy of bean-bag Family disorders, four factor VII deficiency, one factor VII Champion. Thank you to the families that came to and XI deficiency and one factor X deficiency). In 72 pregnancies, the woman was seen antenatally in a multidisciplinary clinic to discuss and plan pain relief options," researchers in London, the United Kingdom report (see also Coagulation). "Regional block was performed for 41 pregnancies. The mothers were known to have a bleeding disorder in 35 of these pregnancies. Prophylactic cover was given in 10 pregnancies prior to the in- sertion of regional block but not required in the remaining 25 pregnancies because the coagulation defects had spontaneously normalized at term. There were six reported adverse effects from regional block similar to that found in the general population: inadequate anesthesia/analgesia (2), bloody tap (2), hypotension and a possible dural puncture which was treated conservatively. There were no reports of long-term complications," wrote C. Chi and colleagues, University College. The researchers concluded: "The findings show that it is possible to offer women with inherited bleeding disorders the option of regional block provided their coagulation defects have normalized, either spon- taneously during pregnancy or following adequate haemostatic cover." Chi and colleagues published their study in Thrombosis and Haemostasis (Obstetric analgesia and anaesthesia in women with inherited bleeding disorders. Thrombosis and Haemostasis, 2009;101(6):1104-1111). For additional information, contact R.A. Kadir, University College London, Dept. of Obstetrics & Gynecology, Pond Participants of the 2009 RMHBDA Family Camp. St., London NW3 2QG, UK. share and reconnect. You are why we come to camp! Publisher contact information for the journal Thrombosis Our volunteer industry reps. are a great asset, always and Haemostasis is: Schattauer GmbH-Verlag Medizin willing to play and help wherever needed—I could Naturwissenschaften, Holderlinstrasse 3, D-70174 Stuttgart, not do the Family Games without them! The camp Germany. committee team of Lisa Glass, Jessica Amende, Ann Schrader, and Eve Armour did an outstanding job. A huge “Thank you” to this creative, hard working group—you truly make the job of “director” just a title that someone has to be tagged with. 7
  • 8. Many Thanks to Our Camp Sponsors! Southwest Montana Astronomical Society Bozeman, MT 59715 2100 Fairway Drive, Suite 107 RMHBDA 8