Tuesday, September 29, 2020



By now I think we all know that the hallmark sign of sickle cell disease is pain crisis. A sickle cell crisis is pain that can begin suddenly and last several hours or go on for days. This happens when sickled red blood cells block small blood vessels that carry blood to the bones.

Sickle cell crisis has some major features which include: 

  • Pain
  • Infections
  • Fatigue & Anemia
  • Leg ulcers among others
Crises can be triggered by sudden change in temperatures, very strenuous or excessive exercise or a shortage of oxygen. The pain associated with a crisis can be mild, moderate or severe and these account for its different stages. Let's examine a little bit of these 3 major stages of pain in sickle cell crisis:

1. Mild Crisis: A mild crisis indicates a painful episode that could be managed at home without the need for hospitalization or going to the E.R. This stage of crisis usually lasts only a few hours and can be managed by drinking fluids, taking over-the-counter medication like ibuprofen or acetaminophen, applying warm compress where it hurts and relaxation.

2. Moderate Crisis: This type of crisis can last for hours or a few days but depending on the pain levels, may be managed at home or the hospital. Pain in this case can happen anywhere in the body like the lower back, leg, joints, the chest or abdomen. Treating moderate sickle cell crisis could mean taking only prescribed medication by a doctor which are stronger than the over-the-counter alternatives or getting IV therapy for fluids at the hospital. Again, depending on pain severity, hospitalization may or may not be required.

3. Severe Crisis: As the name implies, this is the most painful stage of sickle cell crisis and will require hospitalization. Pain in this case can not be managed at home due to the kind of treatment required which could be anything from receiving fluids to blood transfusions/exchanges and even operation. Pain usually lasts for days and going to the E.R is likely in order to commence treatment quickly.

These 3 major stages of sickle cell crisis stem from the 6 broad types of crisis which are:

  • Vaso-occlusive
  • Sequestration
  • Infarctive
  • Aplastic
  • Haemolytic and;
  • Bone Pain crisis
The Vaso-occlusive crisis is the most common type experienced and is where the pain stems from. It is important for sickle cell patients to have a pain management plan with their doctors before the onset of a crisis to minimize the length and severity of pain.



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