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You have a story to tell. Others want to hear it

If you have inhibitors, or care for someone who does, you have a story that can help others.

Dealing with inhibitors can be hard, even draining. But sharing your story can help someone learn from your experience. It can help inspire someone or let him know that he is not alone. Best of all, your story can motivate someone else to share his story.

To share your story, complete the fields below. A Novo Nordisk Representative may contact you to help you tell your story to others.

Also, by sharing your story, you will become a member of The Changing Possibilities Coalition. The Coalition is a community of inhibitor patients empowered to change what is possible.

Create your profile by filling out the information below.

I am a: Patient Caregiver * First name *    Middle initial Last name * Address line 1  * Address line 2 City *   State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VT WA WI WV WY *   Zip  * Phone -- E-mail * Verify e-mail address * Password * Confirm password * Password question What is your mother's maiden name? What is the color of your eyes? What is your favorite team? What was the name of your first pet? In what city were you born? What is your favorite color? * Password answer * Patient's Information      Patient's first name    Middle initial Patient's last name Patient's date of birth 1 2 3 4 5 6 7 8 9 10 11 12 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 - 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910  * If you are under the age of 18 years, your parent or guardian must provide consent for you to obtain full access to this website. Parent or guardian's first name: * Parent or guardian's last name: * By checking this box, I certify that I am a parent or guardian and grant permission for my child to access this website. * Patient's diagnosis * Hemophilia A Hemophilia B Do you currently have an inhibitor? Yes No How many years ago was the inhibitor diagnosis made? 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Factor VII deficiency Other Treatment information *  Do you currently use a bypassing agent? Yes No Which products are you currently using?             Are you currently undergoing immune tolerance induction (ITI)? Yes No Have you ever tried ITI? Yes No Was it successful? Yes No Disease information * Do you have a target joint? Yes No Which of the following are your target joints for a bleed? (select all that apply) Ankle Shoulder Knee Hip Elbow I have had orthopedic surgery or am currently preparing for it. Yes No For the following questions, please rate your attitude toward orthopedic surgery. 1 2 3 4 5 Strongly disagree Somewhat disagree Not sure Somewhat agree Strongly agree I consider the outcome of my surgery a success. I would recommend surgery to someone considering it. If I had to do it over, I would have surgery again. I am considering elective surgery. Yes No For the following questions, please rate your attitude toward orthopedic surgery. 1 2 3 4 5 Strongly disagree Somewhat disagree Not sure Somewhat agree Strongly agree I would consider surgery, but I have no need for it. I would consider it, but I need to know more about the risks and benefits of surgery. I would like to have surgery, but I cannot find a hematologist willing to recommend it.

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