Infusing Change – Experts by Experience

Justin McClanahan photo

What if I told you the hardest thing about living with a genetic bleeding disorder, like hemophilia, isn’t the joint damage, the surgeries or any of the other physical hurdles? What if I told you, what “hurts” the most is going through a lifetime worth of struggles, disappointments, obstacles, and being told no! The hardest thing is the tiresome battle of fighting a disease you cannot beat, but only try to manage.

Don’t get me wrong – the repetitive internal bleeding in my joints caused by hemophilia has left its mark. Today, I live with –

  • End-stage arthritis in my right knee resulting in knee replacement
  • End-stage arthritis in my left ankle resulting in fusion
  • End-stage arthritis in my right ankle (requires fusion)
  • Beginning stages of arthritis in toes, an elbow and potentially a shoulder

Physical manifestations of diseases are often easier to diagnose and treat. The important question, that should be asked, is how the damage is affecting the patient between the ears – how can we understand what it is doing to a patient’s mental, emotional health as they try to deal with an illness?

Over the years, I’ve had to give up many things in my life just because they’ve become too physically demanding. This is something that weighs heavy on my mind all the time. Combine these losses with overheard comments from people in public, as well as in the hospital setting, and it becomes difficult to handle. Remember, not all disabilities look like the designated handicap symbol.

Take the case of when I fell and hit my head against the wall. I felt something was wrong, and was concerned I had a head bleed – which is the worst-case scenario for a hemophiliac. I went to the emergency room, and because of my diagnosis, I was seen immediately. Then, I overheard staff talking, just behind the curtain. “I don’t know why he’s back here, he looks fine and there are people who have been here longer. That’s not fair; he shouldn’t have got through so fast.” The comments bothered me – a head bleed is life-threatening! Rather than getting angry, I used this opportunity to educate the staff about hemophilia and why my concern was urgent.

So, how can medical staff treat the whole patient? It’s simple – ask questions. Get to know your patient and what defines them as a person. If their diagnosis robs them of a key attribute, help them find an alternative. Don’t focus on what a patient can no longer do, but focus on how they can find their way back or find something new to conquer.

As a child, my life revolved around sports. At age 12, my parents were instructed to stop me from playing all active sports. The risks were deemed too high, despite being treated prophylactically with factor VIII to prevent further bleeding episodes. Children are not as equipped to handle heavy decisions, especially the ones thrust upon them. I was no different, and my world was crushed. Looking back, I have little or no doubt that I struggled with depression in the time following my removal from sports.

It has been 21 years since, and although I’ve grown to understand why the decision was made, it will forever be a regret of mine – that I didn’t get to play the sports I loved with my best friends.

I’ve also learned that diseases don’t define people – rather, it is what one does in spite of their diagnosis. It took me a long time, but I found ways to adapt. Now, I exercise to stay fit, play golf, and recently started playing sled hockey with the Rochester Mustangs. I also share my health journey with medical students, hemophilia patients and their families, with the hope that my experience can help those in the hemophilia community find better ways to cope and stay healthy.

For medical staff, my goal is to help providers look beyond test results and diagnoses. Learn who your patient is, what drives them, and help them maintain their whole being. Listen, offer alternatives, and know that asking your patient to give up something they love, even if it’s in their own best interest, may only take a minute for you, but will last a lifetime for them.

 Experts by Experience is a collaboration between  Inspire and Mayo Clinic Connect, online support communities for patients and caregivers. By sharing their stories, patients and caregivers awaken, inform, and strengthen the capacity to partner in their care. The stories also help clinicians and non-medical professionals in health care implement patient-informed practices in their interactions and communications, by uncovering opportunities for quality improvement. The series showcases the value of shared experiences and features contributors from around the globe.

About the author: Justin McClanahan was born with severe hemophilia in 1986. Since then, he has learned that life is about adaptability and perseverance. Currently, Justin plays sled hockey with the Rochester Mustangs. He gives an annual presentation to medical students about living with hemophilia, and gives presentations to youth, living with a bleeding disorder, on how to safely stay physically active and manage the mental effects of a genetic disease. When he’s not working in Public Affairs, Justin enjoys spending time with his wife and two sons, and stressing about Minnesota sports. He is working on building his own website to share all things hemophilia, fathering and sports, in addition to his personal takes on Twitter, @MNrube.  

You are an excellent spokesman for what I call "invisible diseases." I first thought deeply about this when I put myself in the shoes of a person my age who developed new-onset epilepsy, and how it would feel to me to be put in that situation. There are also an array of other physical diseases which are similar ( MS and +HIV also immediately comes to mind).

Interestingly, you also speak to people with mental illnesses such as depression. It's important for everyone, and most importantly for clinicians, to recognize that external appearances can often be deceiving.

Thank you for sharing!

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