Sickle Cell Crisis: Care Instructions

Sickled and normal red blood cells

Overview

Sickle cell crisis is a painful episode that may begin suddenly in a person with sickle cell disease.

Sickle cell disease turns normal, round red blood cells into cells that look like sickles or crescent moons. The sickle cells are also rigid and aren't able to carry oxygen like normal red blood cells. They can get stuck in blood vessels, blocking blood flow and causing severe pain. The pain can occur in the bones of the spine, the arms and legs, the chest, and the abdomen.

An episode may be called a "painful event" or "painful crisis." Some people who have sickle cell disease have many painful events, while others have few or none.

Treatment depends on the level of pain and how long it lasts. Sometimes taking nonprescription pain relievers can help. Or you may need stronger pain relief medicine that is prescribed or given by a doctor. You may need to be treated in the hospital.

It isn't always possible to know what sets off a painful event. But triggers include being dehydrated, cold temperatures, infection, stress, and not getting enough oxygen.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Create a pain management plan with your doctor. This plan should include the types of medicines you can take and other actions you can take at home to relieve pain.
  • Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • Avoid alcohol. It can make you dehydrated.
  • Dress warmly in cold weather. The cold and windy weather can lead to severe pain.
  • Do not smoke. Smoking can reduce the amount of oxygen in your blood.
  • Get plenty of sleep.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have symptoms of a severe problem from sickle cell.
  • You have symptoms of a stroke. These may include:
    • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
    • Sudden vision changes.
    • Sudden trouble speaking.
    • Sudden confusion or trouble understanding simple statements.
    • Sudden problems with walking or balance.
    • A sudden, severe headache that is different from past headaches.
  • You are in severe pain.
  • You have symptoms of a heart attack. These may include:
    • Chest pain or pressure, or a strange feeling in the chest.
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
    • Lightheadedness or sudden weakness.
    • A fast or irregular heartbeat.
    After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.

Call your doctor now or seek immediate medical care if:

  • You have a fever.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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