cicero
11 May 2006 00:11
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Do you rest after a joint or muscle bleeding?
Traditional wisdom has it that you should rest affected joints or muscles after a bleeding, so as not to provoke a new bleeding before the source of the bleeding has healed properly.
I guess this makes sense.
However, I usually tend to just continue doing my daily routine without thinking about resting. For me, this makes the bleeding disappear faster, probably because the blood is more easily dispersed when the muscle or joint is exercised.
What is your experience with this?
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brivard11
24 May 2006 22:15
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I like to use the RICE tactics for about 24 hours and then use it as much as possible to help the blood drain through exercise and so that my joint/muscle does not become a target joint or become weak.
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cicero
25 May 2006 23:27
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RICE tactics?
- not sure I know what that is. Can you explain it? (something with rest and coolant perhaps?)
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brivard11
26 May 2006 01:01
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exactly!
RICE stands for:
Rest
Ice
Compression
Elevation
so after practicing that for 24 hours, I use the injured limb as much as possible to disperese the blood.
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cicero
30 May 2006 07:53
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Thanks for the explanation. Seems like a good strategy - is it something your doctor has recommended?
I can not remember whether I have ever discussed this with my doctor, but I will do this next time I go for a check-up.
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e-win
09 Jun 2006 19:37
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Just to share. In M`sia the doctor also encourage the patient to practice R.I.C.E.
As for me, I only use it sometimes.
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cosmosVIII
11 Jun 2006 05:40
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Talking about ice, there was a session at the congress entitled: "The effect of ice as adjunct therapy in the treatment of haemophiliac bleeds". It seemed interesting, but unfortunately I haven`t seen it. Did anyone see it here?
I have the abstract in front of me, but it appears that they are still only gathering data to come with scientific (or statistical) evidences. I must say for myself that ice always had good effect on my injuries.
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cicero
12 Jun 2006 22:25
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Would be interesting to hear about this session, but I did not go either. Anyone?
It seems to me that 9 out of 10 times I get an injury, ice is not readily available. Also, I do not have a freezer in my apartment [sic!], so even at home, the coldest I can find is usually a carton of milk or similar from the fridge (~+5 deg C). This does not help much, I think.
I think you can buy freezing sprays like they use for athletes who are injured. I have seen them used on TV on soccer players who twist their ancle. Has anyone tried them? If the can is not too large, I suppose one could carry them around with the medicine.
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manon
14 Jun 2006 22:57
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At the congres in Bangkok doctors told that ice can have a negative influence on the clotting. Nevertheless I always seem to benefit from ice when I have a bleed; though I use it only together with clottingfactor.
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cicero
16 Jun 2006 00:23
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I guess that makes sense; most (all?) chemical reactions run slower at a low temperature. Clotting certainly is a chemical reaction, so it should also be slowed down.
On the other hand, the application of ice reduces the blood flow to the area, so the vein or artery contracts, essentially making the "hole" in the wall of the blood vessel smaller and presumably easier to clog.
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Skintd
20 Jun 2006 08:04
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I guess you have a point there ciero.
I have same experience the 1st time i was aprehensive to mobilize my joints or muscles it takes time to subsides the tightness of the joint and muscles bledding.
But when u have a light activity of passive movements or you daily activity like walking.It easily subsides the clotted blood in the joint and its tightnes in muscle areas that been affected especially iliosoas bleeding.
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macca
20 Jun 2006 13:34
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I will generally rest depending on how bad it is.
Generally I work by a "pain - threshold" rather than any consideration of the potential damage I am doing.
Rule of Thumb: If it hurts, don`t hurt it more by moving, walking, running, cart wheels,etc.
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physics
21 Jun 2006 13:20
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Yes of course. I give myself a break when I have an injury, and I limit my activities and movements. And yes, R.I.C.E method is definitely useful.
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wayne
21 Jun 2006 22:24
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I like to have my transfusions when I get home from work, basically before bed. This obviously depends on the severity of the bleed. If it is server then I will have a transfusion at work and take it easy.
As for ice, I find it does help with the pain. I know of a haemophilia that puts ice on his joints after he has done a lot of walking and this has brought the number of bleeds down for him. I try to do the same as well with similar success.
For treatment in the rural areas in South Africa, we do suggest anything cold or cool. Ice is not always available as there is often no electricity in these areas.
Ice does help, but it is no means a replacement for factor
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nship
09 Jul 2006 06:51
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of course ice is no means a replacement for factor, but it helps. Like cicero said, the ice would make the vascular constricted and made the hole a little bit smaller. but still you need the factor to cover the hole, however small it is.
just curious... for you, who are living in the country with the prophylactic transfusion...do you still have joint or muscle bleeding? I thought as you have factors before the bleeding, you would not have those. or is it just a rare occasion?
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wayne
09 Jul 2006 22:01
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Hello nship
I am not on prophylactic, I take mine on demand, unless I know I`m going to be doing some form of activity that could or would give me a bleed. The younger Haemophilia patients are encouraged to go onto prophylactic treatment and the ones I have heard about live normal lives with very little damage to joints or mussels.
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cicero
09 Jul 2006 22:13
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@nship: I think even "normal" people, i.e. non-PWH, get occational bleedings, but most of the time a clot is formed almost immediately, so you may never know.
Haemophilia does not affect the probability of bleedings, only how long those bleedings take to clot. Therefore even on prophylactic treatment you will have bleedings, but they are much less likely to develop.
At least that is how I understand it... :-)
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nship
10 Jul 2006 04:30
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@wayne
hello too :)
I see...the younger ones get the prophylactic. why don`t you? I mean, do you have choice whether or not you want to get prophylactic or demand therapy?
@cicero
you got it right... even to person with normal factor coagulation who does nothing, there`s still bleeding. what I meant was the developed joint or muscle bleeding.
you know? you remind me of my professor. every time I said something wrong, he would click his tongue and made me think twice what, where and how did I do wrong. thank you. :)
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macca
10 Jul 2006 07:59
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@nship
In australia we can get prophylactic treatment. We have the choice of deciding whether or not to recieve it.
Most of the younger patients do because it becomes routine and it is incredibly beneficial in preventing problems for joints that are still developing.
However once you reach to point where you have choice some choose not to have prophylactic treatment. I do not have prophylactic treatment, except where I am going to do something active. Therefore, I recognise the early signs of a bleed and usually give it two doses of treatment.
It simply is because I do not feel I need to give myself treatment all the time (even though I am servere). I fortunately do not suffer to many bleeds and so I exercise the choice not to give my self prophylaxis.
It is very interesting though, because one of the major issues for young sufferers that have been on prophylaxis all their life, as they come to an age where they choose not to have prophylaxis. They face the problem of not knowing when to treat and risking permanent damage or developing a target joint, which can have significant consequences.
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nship
11 Jul 2006 18:41
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@macca...
I see... thank you FYI. Then, it`s very hard for the young ones.
how long do you rest after a joint or muscle bleeding? just until it doesn`t hurt?
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wayne
17 Jul 2006 21:33
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@nship
They reason I am not on prophylactic, I choose not to, for the similar reasons macca wrote. I am also a server haemophilia, by the by. But I should have been on when I was younger, still in school.
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