Sickle Cell Disease Crisis Triggers

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Some activities and situations can trigger a sickle cell crisis. You may not always be able to prevent crises, but knowing possible triggers can help you avoid them.

Dehydration

When you don’t drink enough water, your blood vessels have less fluid in them, which can make it easier for a sickle cell crisis to start.

Dehydration is Woodson’s number one trigger. “The more I can stay hydrated, the better chances I have of not setting off a pain episode,” he says.

People with sickle cell disease lose water more easily because their kidneys aren’t as efficient, says Crawford Strunk, MD, a hematologist at Cleveland Clinic and the codirector of the Sickle Cell Medical Neighborhood, a lifespan sickle cell comprehensive center in Ohio. “So especially in hot weather, they need to make sure that they’re staying appropriately hydrated,” says Dr. Strunk.

Extreme Temperatures

Extreme temperatures — both cold and hot — can trigger a sickle cell crisis.

When you get cold, your blood vessels narrow, which can slow down blood flow and make it easier for sickled cells to get stuck. And staying in a hot environment can lead to dehydration.

“Without fail, being cold and wet is an automatic ‘I’m going to have a real bad episode’ situation,” says Woodson, who rarely goes swimming during the summers, even on extremely hot days.

“Even if the pool is heated, and it’s been hot for several days, I am extremely cautious because a small gust of wind as I’m coming out of the pool or walking into air-conditioning can become problematic,” says Woodson.

Sudden shifts in weather can also prompt a crisis, says Strunk. “The change in temperature is what really drives it.”

High Altitudes

When you visit a high-altitude location (including traveling by airplane), your body has to adjust to the lower amount of oxygen in the air.

 Low oxygen levels can prompt blood cells to sickle.

Physical and Emotional Stress

Overexertion and overtiredness can be a big issue, says Strunk. Mental and emotional stress and high-intensity physical activity can all trigger sickle cell crises.

Poor Sleep

Lack of sleep may also create the right conditions for a sickle cell crisis. In one study of 53 teenagers with SCD, poor sleep was connected to increased pain and other complications.

Infections

Sickness can be a crisis trigger, says Strunk. “Colds, flus, anything that’s going to stimulate your immune response is going to overdrive your sickle cell disease as well.”



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