As much as our symbol is stripes, in person we’re usually patchy like clouded leopards. Zebras don’t just bruise at the slightest knock, we bruise without being knocked at all. Sit in one place for too long? Bruise. Accidentally knee the tank of the bike when cocking a leg over? Bruise. Knock one knee against the other whilst rolling over in bed? Bruise. Slap an insect off your arm, or scratch too hard? Bruises, blood-blisters, occasionally ripped skin.
And here I’m going to use the disclaimer that I will use more than is really seemly over the rest of this month; Not all zebras. Nowhere near all zebras. In the small handful of others that I know in person, I’ve seen ones who bruise when they grip a pencil too hard, and ones who can fall down the stairs and get up without a mark on them. But, in general, we bruise.
Of course, this is a bigger problem when we’re children – A lot of us won’t have any diagnosis, or any other symptoms really, and we’ll be turning up to school covered in bruises. Huge, all-over, fresh-every-day bruises. So, teachers with a keen eye for spotting child endangerment have a tendency to suspect that either our parents are hitting us, or that we’re being hit by other children.
I got the thin end of this wedge as a child – Not just the bruising, but I was also covered neck-to-knees in abnormal, dark red striae, years before most people would get them and on skin that, by most people’s standards, hadn’t been stretched at all. One of the coaches at swimming asked, in hushed tones, if anyone had been hurting me – I answered no, baffled. This was just what skin looked like, in my world. Another confronted my mother, certain that she’d been beating me. Years later, the assumption was that the striae were self-harm, badly hidden but still sticking out of the legs of my fastskin. I, still, was mystified. They didn’t hurt – they never really had – they were just marks. Admittedly, marks that got much pointing and laughing in the changing rooms at school, but just painless red stripes.
In the worst cases, children with EDS end up dragged through social services, and their parents end up branded as child abusers.
One of the problems here is that the parents take the child to the GP, and the child is covered in bruises, and exhausted, and says, repeatedly “I have no idea where I got the bruises from”. And the parent says “I’ve got no idea where they got the bruises from”. And thus, the doctor assumes that the child is covering up for someone, or that the parent is lying, or that another adult in their life has done it, and the witch-hunt begins. But, really, the child genuinely has no idea where the bruises came from, because they were probably generated by walking through brambles or sitting down on a rock.
In the most serious presentations, it can be so much worse – Not just a bit of cosmetic bruising or petechiae, but serious, painful haematomas that can cause compartment syndrome, reduced mobility in the affected limb and other complications, that need actual medical attention.
Hypermobile EDS is probably the least likely to present with the severe bruising – Most likely, and most likely to be severe, is vascular EDS, where it is pretty much one of the defining features that leads to diagnosis in the first place.
In short – Keep an eye out for bruises, stick an ice pack on them when you see them starting to swell up, since that might make them at least appear less violently purple, and go to the doctor if they’re seriously painful or if there’s really serious swelling below them on a limb.
(Notable runners-up to be “B is for…”; Bendy, bleeding gums, bones, breakable fingernails, bed)