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Dr. Paula Elbirt

Dr. Paula Elbirt, a New York City pediatrician, routinely asks her patients if they bruise easily, if their gums bleed after brushing, and–if they’re girls–if their periods are heavy. Dr. Elbirt also encourages her colleagues to look for the warning signs of bleeding disorders, because she has von Willebrand disease.

Like many women with this common, yet relatively unknown bleeding disorder, Dr. Elbirt took for granted the bleeds of her childhood and teenage years. Her periods may have lasted for two weeks, but so did her mother’s. Dr. Elbirt and her mother both spat mouths full of blood into the sink after brushing their teeth and bled interminably from nicks when they shaved their legs. "I never questioned the bleeding," said Dr. Elbirt, "it was normal in my family."

During the first year of her medical internship, Dr. Elbirt stuck herself while working in the emergency room. "I bled and bled and bled," Dr. Elbirt remembered. A hematologist on the scene who watched while Dr. Elbirt soaked through countless gauze pads as she waited for the bleeding to stop asked Dr. Elbirt many questions about her bleeding episodes. Later the hematologist–Dr. Michael Diaz–gave her a bleeding time test and began talking to her about von Willebrand disease, a condition she was never taught about in medical school.

Dr. Elbirt occasionally uses Stimate to control the bleeding from her mild form of von Willebrand disease. The only problem she has had with the medication is finding it. Pharmacists thought Stimate nasal spray (the treatment for von Willebrand disease) was the same drug as the DDAVP used to treat bed wetting (the bed-wetting formulation is actually 10 times weaker). Fortunately, there is a hemophilia treatment center at Mount Sinai Hospital, one of the hospitals where Dr. Elbirt sees patients, and she was able to get Stimate nasal spray through the HTC.

Dr. Elbirt gets checkups from the hematologist, sees a periodontist (a dentist who specializes in gum disease) every two months to make sure her teeth and gums stay healthy, and because this busy pediatrician has two children of her own (neither of whom inherited the bleeding disorder from their mother) she is very careful to take careful care of herself. "I don’t have time for von Willebrand disease, so I take good care of myself. For me, it’s a very livable condition."

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