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Finding the Missing Piece: One man’s journey to a von Willebrand disease diagnosis
Frank, a 65-year-old man, spent decades suffering from von Willebrand disease (VWD) without a diagnosis. His journey, marked by severe bleeds and uncertainty, changed when his granddaughter was diagnosed with VWD. This discovery led to Frank’s diagnosis and treatment with VONVENDI, which allows him to better manage his condition and regain control of his life.
Last Updated on October 19, 2025 by Daily News Staff
Finding the Missing Piece: One man’s journey to a von Willebrand disease diagnosis
(Family Features) “I wanted to live my life like there was nothing wrong, but the fear was always there.”
That’s how 65-year-old Frank described life with von Willebrand disease (VWD), the most common bleeding disorder, affecting more than 3 million Americans.
For Frank, the signs started early with nosebleeds so severe they seemed unstoppable. In his 30s, one gastrointestinal bleed required nearly 7 pints of blood to stabilize him – a staggering amount, considering most adults only have 8-12 pints total.
Life with VWD can mean living in constant uncertainty. Any injury, surgery or even simple dental procedure can trigger a dangerous bleed. Symptoms like frequent bruising or heavy menstrual bleeding in women can affect quality of life. The consequences for Frank, even before his diagnosis, were often urgent and life-threatening.
Hospital visits and bleeds became routine, draining both his body and spirit. Frank lost weight, struggled with temperature swings and each trip home from the hospital felt like borrowed time before his next bleeding episode.
Eventually, his body began rejecting the blood transfusions meant to treat him during these mysterious bleeding episodes – a complication known as hemolytic anemia. With few options left, Frank and his partner, Carla, faced a future filled with fear and uncertainty, unsure how much longer his body could keep going.
Journey to a Diagnosis
Like many living with VWD, Frank spent years searching for answers – managing symptoms without understanding their cause. Bleeds came without warning. Triggers were a mystery. A diagnosis felt out of reach.
Through it all, Frank and Carla were their own fiercest advocates. Carla became his second set of eyes and ears by researching symptoms, writing down questions and sitting beside him in countless exam rooms.
“I realized when he was in the hospital, I must be there with him,” Carla said. “I needed to be there when the doctors and the nurses were talking to him. I slept in his room to be there for morning rounds to make sure everyone had the correct information.”
For years, they pressed on without answers or an official diagnosis until 2013, when everything changed.
Frank’s granddaughter was diagnosed with VWD, which they learned is a hereditary bleeding disorder. In that moment, something clicked. After decades of uncertainty, Frank finally had a clue and a connection.
He and Carla immediately sought out VWD education. Testing confirmed what they suspected: Frank had been living with VWD all along.
“Getting the diagnosis was a turning point,” Frank said. “For the first time, we weren’t just waiting for the next bleed – we finally had a way to take control.”
A Path Forward
Frank finally found hope and a path forward. After discussing which treatment option may be right for him with his health care team, Frank began using VONVENDI® [von Willebrand factor (Recombinant)] on-demand to treat and control his bleeding episodes.
VONVENDI is the only von Willebrand factor (VWF) treatment made without human blood or plasma with approved uses in both adults and children with VWD. For someone whose body had begun rejecting transfusions, having a recombinant option was important. But more than that – it worked for Frank.
“Since starting VONVENDI, I feel like I finally found the right path forward for me,” Frank said. “I can control my bleeds when they happen, and I have a plan in place to treat the next one.”
The U.S. Food and Drug Administration recently approved an expanded indication for VONVENDI, which is now indicated for adults and children with VWD to treat and control bleeding episodes (on-demand), to prevent excessive bleeding during and after surgery (perioperative) and for adult patients only, to reduce the number of bleeding episodes when used regularly (prophylaxis). Please see below for Detailed Important Risk Information or click here for the full Prescribing Information.
With this expanded indication, VONVENDI can now help more patients like Frank – not just control bleeds but also try to prevent them. Frank and Carla know there’s no cure, but for the first time in a long time, they have a plan to address Frank’s VWD bleeds.
Visit VONVENDI.com or speak with your doctor to learn more about VWD and discuss if treatment may be right for you.
VONVENDI [von Willebrand factor (Recombinant)] Important Information
What is VONVENDI?
VONVENDI is used in adults and children with von Willebrand disease to:
- treat and control bleeding episodes
- prevent excessive bleeding during and after surgery
For adult patients only:
- reduce the number of bleeding episodes when used regularly (prophylaxis)
Detailed Important Risk Information
Who should not use VONVENDI?
You should not use VONVENDI if you:
- Are allergic to any ingredients in VONVENDI.
- Are allergic to mice or hamsters.
Tell your healthcare provider if you are pregnant or breastfeeding because VONVENDI may not be right for you.
How should I use VONVENDI?
Your first dose of VONVENDI for each bleeding episode may be administered with a recombinant factor VIII as instructed by your healthcare provider.
Your healthcare provider will instruct you whether additional doses of VONVENDI with or without recombinant factor VIII are needed.
What should I tell my healthcare provider before I use VONVENDI?
You should tell your healthcare provider if you:
- Have or have had any medical problems.
- Take any medicines, including prescription and non-prescription medicines, such as over-the-counter medicines, supplements or herbal remedies.
- Have any allergies, including allergies to mice or hamsters.
- Are breastfeeding. It is not known if VONVENDI passes into your milk and if it can harm your baby.
- Are pregnant or planning to become pregnant. It is not known if VONVENDI can harm your unborn baby.
- Have been told that you have inhibitors to von Willebrand factor (because VONVENDI may not work for you).
- Have been told that you have inhibitors to blood coagulation factor VIII.
What else should I know about VONVENDI and von Willebrand Disease?
Your body can form inhibitors to von Willebrand factor or factor VIII. An inhibitor is part of the body’s normal defense system. If you form inhibitors, they may stop VONVENDI or factor VIII from working properly.
Consult with your healthcare provider to make sure you are carefully monitored with blood tests for the development of inhibitors to von Willebrand factor or factor VIII.
What are the possible side effects of VONVENDI?
You can have an allergic reaction to VONVENDI.
Call your healthcare provider right away and stop treatment if you get a rash or hives, itching, tightness of the throat, chest pain or tightness, difficulty breathing, lightheadedness, dizziness, nausea or fainting.
Side effects that have been reported with VONVENDI include: headache, nausea, vomiting, tingling or burning at infusion site, chest discomfort, dizziness, hot flashes, itching, high blood pressure, muscle twitching, unusual taste, blood clots and increased heart rate.
Tell your healthcare provider about any side effects that bother you or do not go away.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Please see VONVENDI full Prescribing Information.
©2025 Takeda Pharmaceuticals U.S.A., Inc., 500 Kendall Street, Cambridge, MA 02142. 1-877-TAKEDA-7 (1-877-825-3327). All rights reserved. TAKEDA and the TAKEDA Logo are registered trademarks or registered trademarks of Takeda Pharmaceutical Company Limited. VONVENDI is a registered trademark of Baxalta Incorporated. US-VON-1006v1.0 10/25
SOURCE:
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The Long Track Back
Why Downtown Los Angeles Feels Small Compared to Other Cities
Downtown Los Angeles often feels “small” compared to other U.S. cities, but that’s only part of the story. With some of the tallest buildings west of the Mississippi and skyline clusters spread across the region, LA’s downtown reflects the city’s unique polycentric identity—one that, if combined, could form a true mega downtown.
Last Updated on February 18, 2026 by Daily News Staff
Panorama of Los Angeles from Mount Hollywood – California, United States
When people think of major American cities, they often imagine a bustling, concentrated downtown core filled with skyscrapers. New York has Manhattan, Chicago has the Loop, San Francisco has its Financial District. Los Angeles, by contrast, often leaves visitors surprised: “Is this really downtown?”
The answer is yes—and no.
Downtown LA in Context
Compared to other major cities, Downtown Los Angeles (DTLA) is relatively small as a central business district. For much of the 20th century, strict height restrictions capped most buildings under 150 feet, while cities like Chicago and New York were erecting early skyscrapers. LA’s skyline didn’t really begin to climb until the late 1960s.
But history alone doesn’t explain why DTLA feels different. The real story lies in how Los Angeles grew: not as one unified city center, but as a collection of many hubs.
Downtown Los Angeles
A Polycentric City
Los Angeles is famously decentralized. Hollywood developed around the film industry. Century City rose on former studio land as a business hub. Burbank became a studio and aerospace center. Long Beach grew around the port. The Wilshire Corridor filled with office towers and condos.
Unlike other cities where downtown is the place for work, culture, and finance, Los Angeles spread its energy outward. Freeways and car culture made it easy for businesses and residents to operate outside of downtown. The result is a polycentric metropolis, with multiple “downtowns” rather than one dominant core.
A Resident’s Perspective
As someone who lived in Los Angeles for 28 years, I see DTLA differently. While some outsiders describe it as “small,” the reality is that Downtown Los Angeles is still significant. It has some of the tallest buildings west of the Mississippi River, including the Wilshire Grand Center and the U.S. Bank Tower. Over the last two decades, adaptive reuse projects have transformed old office buildings into lofts, while developments like LA Live, Crypto.com Arena, and the Broad Museum have revitalized the area.
In other words, DTLA is large enough—it just plays a different role than downtowns in other American cities.
View of Westwood, Century City, Beverly Hills, and the Wilshire Corridor.
The “Mega Downtown” That Isn’t
A friend once put it to me with a bit of imagination: “If you could magically pick up all of LA’s skyline clusters—Downtown, Century City, Hollywood, the Wilshire Corridor—and drop them together in one spot, you’d have a mega downtown.”
He’s right. Los Angeles doesn’t lack tall buildings or urban energy—it just spreads them out over a vast area, reflecting the city’s unique history, geography, and culture.
A Downtown That Fits Its City
So, is Downtown LA “small”? Compared to Manhattan or Chicago’s Loop, yes. But judged on its own terms, DTLA is a vibrant hub within a much larger, decentralized metropolis. It’s a downtown that reflects Los Angeles itself: sprawling, diverse, and impossible to fit neatly into the mold of other American cities.
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The Knowledge
How a 22-year-old George Washington learned how to lead, from a series of mistakes in the Pennsylvania wilderness
This Presidents Day, I’ve been thinking about George Washington − not at his finest hour, but possibly at his worst.
Christopher Magra, University of Tennessee
This Presidents Day, I’ve been thinking about George Washington − not at his finest hour, but possibly at his worst.
In 1754, a 22-year-old Washington marched into the wilderness surrounding Pittsburgh with more ambition than sense. He volunteered to travel to the Ohio Valley on a mission to deliver a letter from Robert Dinwiddie, governor of Virginia, to the commander of French troops in the Ohio territory. This military mission sparked an international war, cost him his first command and taught him lessons that would shape the American Revolution.
As a professor of early American history who has written two books on the American Revolution, I’ve learned that Washington’s time spent in the Fort Duquesne area taught him valuable lessons about frontier warfare, international diplomacy and personal resilience.
The mission to expel the French
In 1753, Dinwiddie decided to expel French fur trappers and military forces from the strategic confluence of three mighty waterways that crisscrossed the interior of the continent: the Allegheny, Monongahela and Ohio rivers. This confluence is where downtown Pittsburgh now stands, but at the time it was wilderness.
King George II authorized Dinwiddie to use force, if necessary, to secure lands that Virginia was claiming as its own.
As a major in the Virginia provincial militia, Washington wanted the assignment to deliver Dinwiddie’s demand that the French retreat. He believe the assignment would secure him a British army commission.
Washington received his marching orders on Oct. 31, 1753. He traveled to Fort Le Boeuf in northwestern Pennsylvania and returned a month later with a polite but firm “no” from the French.
Dinwiddie promoted Washington from major to lieutenant colonel and ordered him to return to the Ohio River Valley in April 1754 with 160 men. Washington quickly learned that French forces of about 500 men had already constructed the formidable Fort Duquesne at the forks of the Ohio. It was at this point that he faced his first major test as a military leader. Instead of falling back to gather more substantial reinforcements, he pushed forward. This decision reflected an aggressive, perhaps naive, brand of leadership characterized by a desire for action over caution.
Washington’s initial confidence was high. He famously wrote to his brother that there was “something charming” in the sound of whistling bullets.
The Jumonville affair and an international crisis
Perhaps the most controversial moment of Washington’s early leadership occurred on May 28, 1754, about 40 miles south of Fort Duquesne. Guided by the Seneca leader Tanacharison – known as the “Half King” – and 12 Seneca warriors, Washington and his detachment of 40 militiamen ambushed a party of 35 French Canadian militiamen led by Ensign Joseph Coulon de Jumonville. The Jumonville affair lasted only 15 minutes, but its repercussions were global.
Ten of the French, including Jumonville, were killed. Washington’s inability to control his Native American allies – the Seneca warriors executed Jumonville – exposed a critical gap in his early leadership. He lacked the ability to manage the volatile intercultural alliances necessary for frontier warfare.
Washington also allowed one enemy soldier to escape to warn Fort Duquesne. This skirmish effectively ignited the French and Indian War, and Washington found himself at the center of a burgeoning international crisis.
Defeat at Fort Necessity
Washington then made the fateful decision to dig in and call for reinforcements instead of retreating in the face of inevitable French retaliation. Reinforcements arrived: 200 Virginia militiamen and 100 British regulars. They brought news from Dinwiddie: congratulations on Washington’s victory and his promotion to colonel.
His inexperience showed in his design of Fort Necessity. He positioned the small, circular palisade in a meadow depression, where surrounding wooded high ground allowed enemy marksmen to fire down with impunity. Worse still, Tanacharison, disillusioned with Washington’s leadership and the British failure to follow through with promised support, had already departed with his warriors weeks earlier. When the French and their Native American allies finally attacked on July 3, heavy rains flooded the shallow trenches, soaking gunpowder and leaving Washington’s men vulnerable inside their poorly designed fortification.
The battle of Fort Necessity was a grueling, daylong engagement in the mud and rain. Approximately 700 French and Native American allies surrounded the combined force of 460 Virginian militiamen and British regulars. Despite being outnumbered and outmaneuvered, Washington maintained order among his demoralized troops. When French commander Louis Coulon de Villiers – Jumonville’s brother – offered a truce, Washington faced the most humbling moment of his young life: the necessity of surrender. His decision to capitulate was a pragmatic act of leadership that prioritized the survival of his men over personal honor.
The surrender also included a stinging lesson in the nuances of diplomacy. Because Washington could not read French, he signed a document that used the word “l’assassinat,” which translates to “assassination,” to describe Jumonville’s death. This inadvertent admission that he had ordered the assassination of a French diplomat became propaganda for the French, teaching Washington the vital importance of optics in international relations.
Lessons that forged a leader
The 1754 campaign ended in a full retreat to Virginia, and Washington resigned his commission shortly thereafter. Yet, this period was essential in transforming Washington from a man seeking personal glory into one who understood the weight of responsibility.
He learned that leadership required more than courage – it demanded understanding of terrain, cultural awareness of allies and enemies, and political acumen. The strategic importance of the Ohio River Valley, a gateway to the continental interior and vast fur-trading networks, made these lessons all the more significant.
Ultimately, the hard lessons Washington learned at the threshold of Fort Duquesne in 1754 provided the foundational experience for his later role as commander in chief of the Continental Army. The decisions he made in Pennsylvania and the Ohio wilderness, including the impulsive attack, the poor choice of defensive ground and the diplomatic oversight, were the very errors he would spend the rest of his military career correcting.
Though he did not capture Fort Duquesne in 1754, the young George Washington left the woods of Pennsylvania with a far more valuable prize: the tempered, resilient spirit of a leader who had learned from his mistakes.
Christopher Magra, Professor of American History, University of Tennessee
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Urbanism
The Building That Proved Los Angeles Could Go Vertical
Los Angeles once banned skyscrapers, yet City Hall broke the height limit and proved high-rise buildings could be engineered safely in an earthquake zone.
How City Hall Quietly Undermined LA’s Own Height Limits
The Knowledge Series | STM Daily News
For more than half a century, Los Angeles enforced one of the strictest building height limits in the United States. Beginning in 1905, most buildings were capped at 150 feet, shaping a city that grew outward rather than upward.
The goal was clear: avoid the congestion, shadows, and fire dangers associated with dense Eastern cities. Los Angeles sold itself as open, sunlit, and horizontal — a place where growth spread across land, not into the sky.
And yet, in 1928, Los Angeles City Hall rose to 454 feet, towering over the city like a contradiction in concrete.
It wasn’t built to spark a commercial skyscraper boom.
But it ended up proving that Los Angeles could safely build one.
A Rule Designed to Prevent a Manhattan-Style City
The original height restriction was rooted in early 20th-century fears:
- Limited firefighting capabilities
- Concerns over blocked sunlight and airflow
- Anxiety about congestion and overcrowding
- A strong desire not to resemble New York or Chicago
Los Angeles wanted prosperity — just not vertical density.
The height cap reinforced a development model where:
- Office districts stayed low-rise
- Growth moved outward
- Automobiles became essential
- Downtown never consolidated into a dense core
This philosophy held firm even as other American cities raced upward.
Why City Hall Was Never Meant to Change the Rules
City Hall was intentionally exempt from the height limit because the law applied primarily to private commercial buildings, not civic monuments.
But city leaders were explicit about one thing:
City Hall was not a precedent.
It was designed to:
- Serve as a symbolic seat of government
- Stand alone as a civic landmark
- Represent stability, authority, and modern governance
- Avoid competing with private office buildings
In effect, Los Angeles wanted a skyline icon — without a skyline.
Innovation Hidden in Plain Sight
What made City Hall truly significant wasn’t just its height — it was how it was built.
At a time when seismic science was still developing, City Hall incorporated advanced structural ideas for its era:
- A steel-frame skeleton designed for flexibility
- Reinforced concrete shear walls for lateral strength
- A tapered tower to reduce wind and seismic stress
- Thick structural cores that distributed force instead of resisting it rigidly
These choices weren’t about aesthetics — they were about survival.
The Earthquake That Changed the Conversation
In 1933, the Long Beach earthquake struck Southern California, causing widespread damage and reshaping building codes statewide.
Los Angeles City Hall survived with minimal structural damage.
This moment quietly reshaped the debate:
- A tall building had endured a major earthquake
- Structural engineering had proven effective
- Height alone was no longer the enemy — poor design was
City Hall didn’t just survive — it validated a new approach to vertical construction in seismic regions.
Proof Without Permission
Despite this success, Los Angeles did not rush to repeal its height limits.
Cultural resistance to density remained strong, and developers continued to build outward rather than upward. But the technical argument had already been settled.
City Hall stood as living proof that:
- High-rise buildings could be engineered safely in Los Angeles
- Earthquakes were a challenge, not a barrier
- Fire, structural, and seismic risks could be managed
The height restriction was no longer about safety — it was about philosophy.
The Ironic Legacy
When Los Angeles finally lifted its height limit in 1957, the city did not suddenly erupt into skyscrapers. The habit of building outward was already deeply entrenched.
The result:
- A skyline that arrived decades late
- Uneven density across the region
- Multiple business centers instead of one core
- Housing and transit challenges baked into the city’s growth pattern
City Hall never triggered a skyscraper boom — but it quietly made one possible.
Why This Still Matters
Today, Los Angeles continues to wrestle with:
- Housing shortages
- Transit-oriented development debates
- Height and zoning battles near rail corridors
- Resistance to density in a growing city
These debates didn’t begin recently.
They trace back to a single contradiction: a city that banned tall buildings — while proving they could be built safely all along.
Los Angeles City Hall wasn’t just a monument.
It was a test case — and it passed.
Further Reading & Sources
- Los Angeles Department of City Planning – History of Urban Planning in LA
- Los Angeles Conservancy – History & Architecture of LA City Hall
- Water and Power Associates – Early Los Angeles Buildings & Height Limits
- USGS – How Buildings Are Designed to Withstand Earthquakes
- Los Angeles Department of Building and Safety – Building Code History
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