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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.

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Last Updated on October 19, 2025 by Daily News Staff

von Willebrand disease

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.”

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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.

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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.

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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

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SOURCE:

Takeda

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Nature

What a bear attack in a remote valley in Nepal tells us about the problem of aging rural communities

A 71-year-old in Nepal’s Nubri valley survives repeated bear attacks as youth outmigration and rapid population aging leave fewer people to protect crops and homes—pushing bears closer to villages and raising urgent questions about safety, conservation rules, and rural resilience.

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A 71-year-old in Nepal’s Nubri valley survives repeated bear attacks as youth outmigration and rapid population aging leave fewer people to protect crops and homes—pushing bears closer to villages and raising urgent questions about safety, conservation rules, and rural resilience.
Dorje Dundul ponders a life living with increased risk of bear attacks. Geoff Childs, CC BY-SA

Geoff Childs, Washington University in St. Louis

Dorje Dundul recently had his foot gnawed by a brown bear – a member of the species Ursus thibetanus, to be precise.

It wasn’t his first such encounter. Recounting the first of three such violent experiences over the past five years, Dorje told our research team: “My wife came home one evening and reported that a bear had eaten a lot of corn from the maize field behind our house. So, we decided to shoo it away. While my wife was setting up camp, I went to see how much the bear had eaten. The bear was just sitting there; it attacked me.”

Dorje dropped to the ground, but the bear ripped open his shirt and tore at his shoulder. “I started shouting and the bear ran away. My wife came, thinking I was messing with her, but when she saw the wounds, she knew what had happened.”

Researchers Dolma Choekyi Lama, Tsering Tinley and I spoke with Dorje – a 71-year-old resident of Nubri, a Buddhist enclave in the Nepalese highlands – as part of a three-year study of aging and migration.

Now, you may be forgiven for asking what a bear attack on a septuagenarian has to do with demographic change in Nepal. The answer, however, is everything.

In recent years, people across Nepal have witnessed an increase in bear attacks, a phenomenon recorded in news reports and academic studies.

Inhabitants of Nubri are at the forefront of this trend – and one of the main reasons is outmigration. People, especially young people, are leaving for education and employment opportunities elsewhere. It is depleting household labor forces, so much so that over 75% of those who were born in the valley and are now ages 5 to 19 have left and now live outside of Nubri.

It means that many older people, like Dorje and his wife, Tsewang, are left alone in their homes. Two of their daughters live abroad and one is in the capital, Kathmandu. Their only son runs a trekking lodge in another village.

Scarcity of ‘scarebears’

Until recently, when the corn was ripening, parents dispatched young people to the fields to light bonfires and bang pots all night to ward off bears. The lack of young people acting as deterrents, alongside the abandonment of outlying fields, is tempting bears to forage closer to human residences.

Outmigration in Nubri and similar villages is due in large part to a lack of educational and employment opportunities. The problems caused by the removal of younger people have been exacerbated by two other factors driving a rapidly aging population: People are living longer due to improvements in health care and sanitation; and fertility has declined since the early 2000s, from more than six to less than three births per woman.

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These demographic forces have been accelerating population aging for some time, as illustrated by the population pyramid constructed from our 2012 household surveys in Nubri and neighboring Tsum.

A not-so-big surprise, anymore

Nepal is not alone in this phenomenon; similar dynamics are at play elsewhere in Asia. The New York Times reported in November 2025 that bear attacks are on the rise in Japan, too, partly driven by demographic trends. Farms there used to serve as a buffer zone, shielding urban residents from ursine intruders. However, rural depopulation is allowing bears to encroach on more densely populated areas, bringing safety concerns in conflict with conservation efforts.

Dorje can attest to those concerns. When we met him in 2023 he showed us deep claw marks running down his shoulder and arm, and he vowed to refrain from chasing away bears at night.

So in October 2025, Dorje and Tsewang harvested a field before marauding bears could get to it and hauled the corn to their courtyard for safekeeping. The courtyard is surrounded by stone walls piled high with firewood – not a fail-safe barrier but at least a deterrent. They covered the corn with a plastic tarp, and for extra measure Dorje decided to sleep on the veranda.

He described what happened next:

“I woke to a noise that sounded like ‘sharak, sharak.’ I thought it must be a bear rummaging under the plastic. Before I could do anything, the bear came up the stairs. When I shouted, it got frightened, roared and yanked at my mattress. Suddenly my foot was being pulled and I felt pain.”

Dorje suffered deep lacerations to his foot. Trained in traditional Tibetan medicine, he staunched the bleeding using, ironically, a tonic that contained bear liver.

Yet his life was still in danger due to the risk of infection. It took three days and an enormous expense by village standards – equivalent to roughly US$2,000 – before they could charter a helicopter to Kathmandu for further medical attention.

And Dorje is not the only victim. An elderly woman from another village bumped into a bear during a nocturnal excursion to her outhouse. It left her with a horrific slash from forehead to chin – and her son scrambling to find funds for her evacuation and treatment.

A woman in the foreground bendds over infront of a valley
A woman weeding freshly planted corn across the valley from Trok, Nubri. Geoff Childs, CC BY-SA

So how should Nepal’s highlanders respond to the increase in bear attacks?

Dorje explained that in the past they set lethal traps when bear encroachments became too dangerous. That option vanished with the creation of Manaslu Conservation Area Project, or MCAP, in the 1990s, a federal initiative to manage natural resources that strictly prohibits the killing of wild animals.

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Learning to grin and bear it?

Dorje reasons that if MCAP temporarily relaxed the regulation, villagers could band together to cull the more hostile bears. He informed us that MCAP officials will hear nothing of that option, yet their solutions, such as solar-powered electric fencing, haven’t worked.

Dorje is reflective about the options he faces as young people leave the village, leaving older folk to battle the bears alone.

“At first, I felt that we should kill the bear. But the other side of my heart says, perhaps I did bad deeds in my past life, which is why the bear bit me. The bear came to eat corn, not to attack me. Killing it would just be another sinful act, creating a new cycle of cause and effect. So, why get angry about it?”

It remains to be seen how Nubri’s residents will respond to the mounting threats bears pose to their lives and livelihoods. But one thing is clear: For those who remain behind, the outmigration of younger residents is making the perils more imminent and the solutions more challenging.

Dolma Choekyi Lama and Tsering Tinley made significant contributions to this article. Both are research team members on the author’s project on population in an age of migration.

Geoff Childs, Professor of Sociocultural Anthropology, Washington University in St. Louis

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.

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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.
LA City Hall. Image Credit: TNC Network & Envato

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.


How Los Angeles City Hall Proved Skyscrapers Could Be Built Safely

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.

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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:

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  • 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


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small business

When TV Talks About Gentrification and Shopping Local — and Where It Gets It Right (and Wrong)

A closer look at how the TV show The Neighborhood tackles gentrification and shopping local—and where the reality of online sales and small business survival is more complex.

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a buy local signage. A closer look at how the TV show The Neighborhood tackles gentrification and shopping local—and where the reality of online sales and small business survival is more complex.
Photo by RDNE Stock project on Pexels.com

In our continuing look at how entertainment—television, movies, and streaming shows—grapples with real-world issues, this time we turn our attention to gentrification and the often-repeated call to “shop local.” Once again, we examine how popular culture frames these conversations, this time through the CBS sitcom The Neighborhood and the episode “Welcome Back to What Used to Be the Neighborhood.”

A Familiar Story: When the Neighborhood Changes

In the episode, Calvin’s favorite longtime restaurant closes its doors and is replaced by a flashy new pet spa. To Calvin, the change symbolizes something much bigger than a single business closing—it represents the slow erosion of the neighborhood he knows and loves. In response, he launches a campaign urging friends and neighbors to buy local in order to protect small businesses from disappearing.

Emotionally, the episode hits home. Many communities across the country have watched beloved neighborhood institutions vanish, replaced by businesses that feel disconnected from the area’s history and culture. In that sense, The Neighborhood gets something very right: gentrification often shows up one storefront at a time.

Where Television Simplifies a Complicated Reality

But, as is often the case with television, the episode also simplifies a much more complex economic reality.

The show frames “shopping local” as a direct alternative to shopping online, subtly suggesting that online platforms are inherently harmful to small businesses. In real life, however, the line between “local” and “online” is no longer so clear.

Many local and small businesses now survive precisely because they sell online—through their own websites, through Amazon, or through other platforms that support independent sellers. For some, online sales are not a threat to local commerce; they are a lifeline.

Why Brick-and-Mortar Isn’t Always Sustainable

Rising costs are a major factor driving these changes. Commercial leases, insurance premiums, utilities, staffing costs, and local fees have all increased dramatically in many cities. For small business owners, keeping a physical storefront open can become financially impossible—even when customer support remains strong.

As a result, some businesses choose to close their brick-and-mortar locations while continuing to operate online. Others scale back to pop-ups, shared spaces, or hybrid models. These businesses may no longer have a traditional storefront, but they are still local—employing local workers, paying local taxes, and serving their communities in new ways.

The Real Issue Behind “Shop Local”

Where The Neighborhood succeeds is in capturing the emotional truth of gentrification: the sense of loss, displacement, and cultural change that comes with rising rents and shifting demographics.

Where it misses the mark is in suggesting that consumer choices alone—simply avoiding online shopping—can solve the problem.

The real challenges facing local and small businesses go far beyond individual buying habits. They include zoning policies, commercial rent practices, corporate consolidation, and economic systems that increasingly favor scale over community presence.

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Visit: https://stmdailynews.com/stm-daily-news-pop-culture-fact-check-do-electric-cars-have-fuses/

A Conversation Worth Having—Even If TV Can’t Finish It

The Neighborhood deserves credit for bringing these issues into mainstream conversation. It sparks discussion, even if it wraps a complicated topic in a sitcom-friendly moral lesson.

The reality is messier. Supporting local businesses today often means rethinking what “local” looks like in a digital economy—and recognizing that survival sometimes requires adaptation, not nostalgia.

Further Reading & External Resources

At STM Daily News, our Local and Small Business coverage continues to explore these real-world dynamics beyond the TV screen, highlighting the challenges, innovations, and resilience of the businesses that keep communities alive—whether their doors are on Main Street or their storefronts live online.

📍 Read more Local and Small Business coverage at: STM Daily News

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  • Rod Washington

    Rod: A creative force, blending words, images, and flavors. Blogger, writer, filmmaker, and photographer. Cooking enthusiast with a sci-fi vision. Passionate about his upcoming series and dedicated to TNC Network. Partnered with Rebecca Washington for a shared journey of love and art. View all posts


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