Sickle Cell Anemia crisis

Sickle cell disease is a common hereditary blood disease almost exclusively among people of black African descent. Recent statistics estimate that 3 in 1,000 live births will have sickle cell disease. Severe disease will affect more than 50,000 black Americans. (1)

The first accounting of sickle cell disease that has been documented was in the late 1800’s in patients from Africa. African tribal languages used their own words to describe the disease that were often descriptive terms from children who were suffering from sickle cell crisis. In 1910 Dr. Herrick from Chicago described the symptoms of a 20 year old black male from the West Indies and the blood smear showing “thin, sickle-shaped and crescent-shaped red cells.”

Sickle cell anemia affects the red blood cells which are responsible for delivering oxygen to the tissues and organs of the body. When the red cells aren’t capable of carrying the oxygen, or carry it inefficiently, the body suffers symptoms of lack of oxygen in the system. On top of this, individuals with sickle cell anemia can also suffer from sickle cell crisis. This is a severe attack that can cause pain as the blood vessels become blocked or the defective cells damage the organs in the body.

Researchers have determined several different types of triggers for SC anemia crisis but there will be times that you won’t know what causes a crisis. There can also be more than one cause but there are several things that you can do to keep a crisis from occurring:

*Limit the amount of alcohol

*Don’t smoke, and if you do – quit

*Treat infections as soon as possible

*Drink at least 8 glasses of water each day

*Reduce or avoid stress – get treated for depression if needed

*Control other medical conditions such as diabetes, high blood pressure

*Travel only in a pressurized aircraft

*Get early prenatal care if you become pregnant

Researchers have also determined that one of the major precipitous causes of a sickle cell crisis is the lack of oxygen in the body. And all of the factors that you can control which will help to prevent a crisis involve a decreased oxygen supply in the body.

Blood cells in those who have sickle cell anemia are not always in the sickle shape but rather can change from a round and smooth cell that passes through the small capillaries of the body well to a sickle shape that hooks over each other and causes an occlusive crisis when an area of the body is no longer able to receive oxygen. Individuals will, most commonly, experience pain in the joints – hands, feet, hips, knees, elbows and shoulders. Occlusive crisis can also severely impact the internal organs, especially the spleen.

Men who have SC anemia can have painful and unwanted erections called priapism. This happens as the sickle cells block the outflow of blood from an erect penis. Strokes are also common when a blood vessel in the brain is blocked which can cause disabilities or lasting damage including paralysis or even death. Sickle cells can also clog the blood vessels in the eyes, which will weaken the retina and can cause blindness.

Children with sickle cell anemia will grow more slowly and reach puberty at a later age. The shortage of red blood cells which carry nutrients efficiently will cause the slow growth. Adults are often more slender and smaller than other adults.

After a sickle cell crisis the spleen is responsible for filtering out abnormal blood cells and helps to fight infection. In some cases the spleen will trap cells that should be in the bloodstream which will cause the spleen to grow large and will contribute to anemia.

Controlling pain of a sickle cell crisis can be challenging. Some over the counter medications may help with mild pain but talk with your physician before taking any medication. If you have moderate or severe pain the doctor will prescribe a prescription medication to assist with pain control.

At home individuals can use heat – heating pads, hot baths or hot massages – to help relax the vessels and allow more red blood cells to pass through. Physical therapy to relax and strengthen muscles around the joint can help to decrease pain. Others are helped using self-hypnosis to manage the disease.(1)

RESOURCES

American Family Physician: Practical Tips for Preventing Sickle Cell Crisis

Harvard: Management of Patients with Sickle Cell Disease

University of Michigan: Pain in Sickle Cell Disease

Family doctor: Sickle Cell Disease