Dr. MJ Bazos MD,
Practical Tips for
Preventing a Sickle Cell Crisis
What is sickle cell disease?
Sickle cell disease is a hereditary problem that
causes a type of faulty hemoglobin in red blood cells. Hemoglobin carries oxygen
in the blood.
Normal red blood cells are disc-shaped and very
flexible. In sickle cell disease, some red blood cells can change shape so that
they look like sickles or crescent moons. Because of their shape, they don't
move well through the smallest blood vessels. This can stop or slow blood flow
to parts of the body, causing less oxygen to reach these areas.
What is a sickle cell crisis?
A sickle cell crisis is pain that can begin
suddenly and last several hours to several days. It happens when sickled red
blood cells block small blood vessels that carry blood to your bones. You might
have pain in your back, knees, legs, arms, chest or stomach. The pain can be
throbbing, sharp, dull or stabbing. How often and how bad the pain gets varies a
lot from person to person and from crisis to crisis.
You might be able to treat your pain crisis at
home with medicines that you take by mouth. If these medicines don't control
your pain, or if you can't keep fluids down, you might need to be treated in the
emergency department. If your pain still isn't controlled or you have other
problems, you might need to be treated in the hospital.
What causes a sickle cell crisis?
Most of the time, you won't know what caused
your sickle cell crisis. A crisis usually has more than one cause. However, you
can do several things that might keep a crisis from occurring:
- Don't drink a lot of alcohol.
- Don't smoke. If you do smoke, quit.
- Exercise regularly but not so much that you
become really tired. When you exercise, drink lots of fluids.
- Drink at least 8 glasses of water a day,
especially during warm weather.
- Reduce or avoid stress. Talk to your doctor if
you're depressed or have problems with your family or job.
- Treat any infection as soon as it occurs. When in
doubt, see your doctor.
- Wear warm clothes outside in cold weather and
inside in air-conditioned rooms during hot weather. Also, don't swim in cold
- Tell your doctor if you think you might have a
sleep problem, such as snoring, or if you sometimes stop breathing during sleep
- If you have another medical condition, like
diabetes, get treatment and control the condition.
- If you are pregnant or plan to become pregnant,
get early prenatal care.
- Only travel in commercial airplanes. If you have
to travel in an unpressurized aircraft, talk to your doctor about extra
medicines can I use at home to control my pain?
Some over-the-counter medicines might help
relieve mild pain. Taking acetaminophen ( one brand name: Tylenol) or aspirin
might help. Medicines like ibuprofen (brand names: Advil or Motrin) or naproxen
sodium (brand name: Aleve) might help if you can safely take these medicines.
However, talk to your doctor before you take any medicine for your pain.
If you have moderate to severe pain, your doctor
might prescribe a mild narcotic like codeine. This medicine is often given with
aspirin or acetaminophen. You take this medicine regularly, around the clock,
rather than waiting for the pain to return before taking your next dose.
What else can I do to control the
A heating pad, hot bath, rest or massage might
help. Physical therapy to relax and strengthen your muscles and joints might
lessen your pain. Individual counseling, self-hypnosis and activities to keep
you from thinking about your pain (such as watching television or talking on the
telephone) might also help.
It's important for you to have a positive
attitude, create a supportive environment, and develop coping skills to help you
deal with your disease. Strong family relationships and close personal friends
can be helpful. A support group might help you cope with your disease.
Work with your family doctor to set goals
for coping with your pain. Becoming more actively involved in your
treatment will help you better manage your disease.