Individual Consultations in the Initial Assessment/Comprehensive Care Visit

• Hematologist
  

  –	Discuss previous knee surgery, as well as joint disabilities
  –	Discuss frequency of bleeding episodes, response to treatment of bleeds
  –	Discuss available therapies and how they can best be used
  –	Consider inhibitor eradication strategies

• Hemophilia Nurse
  

  –	Disease overview
  –	Patient education regarding situations in which factor administration may be necessary, and appropriate dosing, ability to self-infuse
  –	Brief discussion of potential future health care interventions and how those can be coordinated

• Physical Therapist
  

  –	Performed an assessment on musculoskeletal and functional status, with focus on knees and elbows
  –	Discussed bleed prophylaxis based on the avoidance of specific activities
  –	Recommend PT for general strengthening of muscles and protection of joints

• Social Worker
  

  –	Discussed patient concerns related to increasing disability – personal and family impact
  –	Discuss concerns about insurance coverage for increasingly costly therapies

 

Cindy Leissinger, MD Professor of Medicine, Pediatrics & Pathology Chief, Section of Hematology & Medical Oncology Tulane University School of Medicine