Thread by @Okizle

You have heard people with sickle cell anemia talk about having "crisis".

Do you understand what "crisis" mean?

#SickleCellAwareness

Let's take it back a bit. #SickleCell isn't an attack from your village people. The sequence of event that leads to this condition occurs on a molecular level. Far too tiny to see with your eye but let me explain

#SickleCellAwareness

When you go to the lab to check your genotype, what they look for is a specific set of "proteins" that determine the genotype. This protein is called hemoglobin. Various ingredients combine to form this hemoglobin and they follow a specific sequence

#SickleCellAwareness

Therefore we have what we called the "normal" Adult hemoglobin -HbA.
When two HbA combine, it forms the genotype AA. Like we know.

#SickleCellAwareness

Hemoglobin is the main constituent of the red blood cells, which make up the main constituent of our blood.

This hemoglobin actually performs the function of taking oxygen to the part of body that needs it. When you breathe in that's where your oxygen goes
#SickleCellAwareness

It gives the RBC it's shape which is bi-concave.
In some cases. There's a disturbance called mutation in the building blocks of the hemoglobin. This means the HbA isn't formed. It forms other variants.
One of such is HbS -Sickle cell

#SickleCellAwareness

HbS isn't as strong as HbA. It can't survive so long in low oxygen state. It can't survive so long in a dehydrated state. What happens is that the hemoglobin forms clusters in the RBC. This is called polymerization.

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When this happens, the Red Blood cell loses its shape and attains a sickle shape as shown below (left). The right shows the normal shape of RBC.

Image source: Google.
©Eraxion/123RF
#SickleCellAwareness

But that's just one cell.

You have millions and millions of this cell. So imagine that happening at the same time all over the body.

It blocks the blood vessels and vital organs won't get blood....A crisis!

#SickleCellAwareness

But that's just one type of crisis. We call that Vaso-occlusive crisis because blood isn't getting to were it's needed. Essential organs are deprived of nutrition.

This can manifest as intense pain. Very severe pain.

#SickleCellAwareness

You see why we call them Warriors??? It's a battle every time! Bone pain. Chest pain. Abdominal pain. Persistent, painful and purposeless erection (priapism).

It is very distressing to even observe.

#SickleCellAwareness

Another type of crisis is called the Anemic crisis. Because of low blood level.

Red Blood cells have a life span of 120 days and your body is constantly making new ones every day.

#SickleCellAwareness #SickleCellAwareness

However, a #SickleCell because of its nature lasts less than 90 days and the body isn't replace mature cells fast enough. That's why the level of blood in warriors remain persistently low in what we call a steady state.

#SickleCellAwareness

However supposing there's an acute infection or a condition that causes rapid destruction of RBCs. It means the already low blood level falls even lower precipitating and Anemic Crisis

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Anemic is why many times people living with #SickleCellDisease need a transfusion. The aim of Transfusion is to return them to their steady state again.

#SickleCellAwareness

Now you know what crisis is.

Next time you see a person with #SickleCell talk about their crisis. Do not belittle it. It is literally a fight for life!

#SickleCellAwareness

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