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Preventing a pain crisis: My Pain Plan

Methods of Avoiding Pain Crises
1. Drink lots of fluids: Water, juices, Gatorade are all good choices. Most pops and caffeinated beverages do not provide as beneficial hydration as these other choices

2. Dress warmly: make sure you have a jacket with you whenever you go out, just in case the weather turns cold or wet. Having an umbrella close by will help keep you from getting wet and cold, also.

3. Only swim in water warmer than 84 degrees: Most of the regulated swimming pools in Seattle are this warm, but check with the pool managers to make sure before jumping in. Also, if you begin to feel cold while in the pool, come out right away, dry off quickly, and get warm clothes on.

4. Get enough sleep at night: Having a regular bedtime schedule with at least 9 hours of sleep will give your body time to rest, reduce your stress and give you energy for the next day.

5. Reduce your stress: Take time to relax during the day with yoga, walks or meditation. Avoid situations that increase your stress as much as possible. Plan your days with times of activity separated by times of rest.

6. Stay active: Having regularly scheduled exercise at a level that is comfortable for you at least 3 times a week for 20 minutes will keep your muscles and bones healthy. Make sure to stretch well before exercising, and take it slowly if you are just starting an activity or returning to your activity after a pain crisis.

Helpful Pain Management Strategies
1. Heat: using hot water bottles, warm packs and heating pad to the area where you are having pain can significantly help reduce pain in that area. Make sure the heat source is not so hot that it will burn you, and only keep it on for 20 minutes at a time, with at least 20 minutes between treatments.

2. Rest: Your body needs time to rest when you are having a sickle cell pain crisis, so get plenty of sleep. Yoga is another good method of helping your body rest well.

3. Mobility: While it is important to rest when you are having pain, it is also important to have some exercise during the day to avoid having other complications such as pneumonia. Take at least 3 five minute walks a day, and use your incentive spirometer or take at least 10 deep breaths every 2 hours to keep your lungs functioning well.

4. Massage: Depending on how your pain feels, having someone massage the area can help ease some of the pain. Be sure that your doctor is not concerned about blood clots for you before massaging your legs.

Prevention best medicine for sickle cell pain

The most effective "cure" for sickle-cell pain is avoiding it in the first place, says pediatric hematologist Dr. M.A. Bender.

"It's critical that families understand what causes red blood cells to turn sickle shaped," says Bender, director of the Odessa Brown Sickle Cell Clinic.

Simple measures, like drinking lots of water and taking ibuprofen at the first sign of a cold, can go a long ways towards preventing a pain crisis, he says.

Here Bender answers some common questions about sickle-cell pain and how to prevent it.

Q: Why is sickle cell disease so painful?
A: It isn't always. Sickle cell disease affects different people in different ways. Some have lots of problems, others very few. A relatively small percentage of people experience five or more pain crises a year. This pain occurs after cells sickle and block blood flow to parts of the body, starving tissue of the oxygen and nutrition it needs to survive.

Q: What is a pain crisis?
A: A pain crisis is pain from blocked blood flow and/or dying tissues that can last hours to a couple of days.

Q: What can cause a pain crisis?
A: Common triggers are dehydration, cold temperatures, viruses and infections, overexertion, and injuries - all of which can restrict blood flow and/or promote sickling.

Q: What can I do to help my child avoid a pain crisis?
A: Be aware of the causes (above) and act to avoid them:
  • Make sure your child drinks plenty of water, particularly on warm days.
  • Avoid activities - such as swimming in water cooler than 85 degrees - that will cause your child to become chilled.
  • At the first sign of infection - colds, ear aches, strep throat, flu - give your child ibuprofen and plenty of liquids. (Ibuprofen, an anti-inflammatory, calms down infection-fighting white blood cells, which are much larger than red cells and can cause a traffic jam-like pileup in the blood vessels.
  • Help your child know his or her physical limits to prevent overexertion. Encourage him or her to take frequent breaks while exercising or playing sports.
  • Steer clear of contact sports, including football and soccer, because of the potential for injuries. (Trauma, like infection, stimulates white blood cell activity.)
*In the next issue, Bender will address the most common medications for sickle cell and what to do during a pain crisis.


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