| WHAT IS SICKLE CELL? |
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| Sickle cell disease (SCD) is an inherited blood disease that originated from a gene mutation affecting people in Africa, the Middle East, the Mediterranean, and India. Sickle cell anemia is the product of a defect in red blood cells called hemoglobin S (HbS), whereas normal red blood cells contain hemoglobin A (HbA). The abnormal cells form a cresent-shape, making it difficult for them to carry oxygen from the lungs to all parts of the body. The cells get stuck in the small blood vessels and cause a "pile up", thus, causing pain (crisis). Some pain may be able to be controlled at home by taking doctor prescribed pain medications. Other (severe) pain may require emergency medical attention. If the pain is really severe, you may have to be hospitalized and monitered, as you will need stronger doses of medications. |
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| Sickle cell anemia (SCA), which mainly affects African Americans, is categorized into two types: homozygotes and heterozygotes. Idividuals that have SCA are homozygotes and inherited defected genes from both parents. In contrast, heterozygotes, or those with the sickle trait, inherited a flawed gene from only one parent (Sickle Cell Deseases, 1992). Red blood cells, which transport oxygen from the lungs to all parts of the body, are produced in bone marrow. Bone marrow also produces white blood cells, which fight infection, and platelets, which help blood to clot. Sickle cell anemia patients lack an adequate supply of both white blood cells and platelets (Siclke Cell Diseases, n.d.). |
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| The lack or abundance of oxygenated blood and platelets, and the inability to fight off infections may cause serious symptoms and complications in persons with SCA. Most people battling SCA encounter anemia and episodes of pain (Hei & Lottenberg, 2001) called crises. Other symptons of SCA are hand-foot syndrome, frequent infections, stunted growth, and vision problems. The complications of SCA include acute chest syndrome, blindness, clogged blood vessels, gallstones, jaundice, leg ulcers, organ damage, stroke, priapism, and impotence (Sickle Cell Diseases, n.d.). |
| There are many precipitating factors that contribute to the onset of a pain crisis in SCA patients. Porter, Gil, Carson, Anthony, and Ready (2000) conducted the first longitudinal study that examined the role of every day stress and mood in sickle cell disease. They found that persons with poor moods (i.e. angry, agitated) experienced greater levels of pain, whereas those who maintained good moods (i.e. happy, calm) experienced lower levels of pain. They also found that those experiencing greater pain were more likely to visit the emergency room or call for medical assistance. The researchers conclude that the majority of painful episodes stem from psychological stress. Nevertheless, painful episodes are also inclined to cause stress in patients with SCD (Porter et al., 2000). |
| Ballas' (1998) study indicated that cold weather, infection, and menstruation are significant factors in the onset of painful crises. In comparison, Shapiro (1989), Ballis, et al. (1996), and Serjeant, et al. (1994) stated that infections , low oxygen tension, concomitant medical conditions, dehydration, acidosis, extreme physical exercise, physical or psychological stress, alcohol, pregnancy, and cold weather are precipitating factors in sickle cell crises. |
| The More You Know |
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| PRECIPITATING FACTORS |
| Sickle cell can cause many problems and complications in those of us that have the disease. We must continue to gain knowledge about it if we are to conquer it. Only until we gain said kowledge, can we cross that bridge between living with the disease and subjugating it. |