Management of special situations
HAE patients will need to discuss management of the following situations with their HAE Specialist:
Dental treatment
The minor trauma of dental procedures can trigger a facial or laryngeal attack.
Your HAE specialist will liaise with your dentist about the special care that is needed.
This may involve increasing your dose of Danazol or Oxandrolone prior to treatment. It may involve preventative treatment with C1 inhibitor before your treatment.
It is important to have speedy access to C1 Inhibitor or Icatibant in the 24 hours after treatment to deal with any swelling that might occur.
Surgical operations
HAE patients will need to have an injection of C1 Inhibitor prior to any surgical procedure. It is also important to have additional C1 inhibitor readily available in case of any swelling or the airway or other areas in the post operative period. Your specialist will liaise with your surgeon and anaesthetist.
Infections
Infections can trigger a HAE attack.
Birth control
The oestrogen based pill can trigger HAE attacks. A progesterone based pill can be safely prescribed.
Pregnancy
Danazol and Oxandrolone are not suitable for women who are seeking to become pregnant, and they should not be taken during pregnancy.
HAE symptoms can improve or become worse during the hormonal changes of pregnancy. Your specialist will monitor your condition and discuss changes in your HAE management programme if needed.
Hormone replacement therapy and the menopause
Oestrogen based medications are not suitable for HAE patients as they can make symptoms worse.
Some women find that HAE symptoms become less after the menopause – but it is important to always have a HAE management program in place that will keep you safe in case of an unpredictable swelling of the airway.