‘Sickle cell crises are preventable’

People living with sickle cell disease have been advised to take diets rich in protein, fruits, and vegetables.

According to an integrative medicine consultant, Dr Emmanso Umobong, taking a required diet can help to alleviate the crises of sickle cell disorder (SCD) patients.

Umobong, who is the director of Emm-mongs Sickle Cell Outreach Programme, urged victims to avoid refined sugars, white flour meals, cholesterol diets, fats and salt intake.

He said they should take supplements with vitamin C, calcium, zinc, magnesium and vitamin D3 and amino acids which are good for SCD patients.

“They should drink enough water because it is important to maintain adequate hydration. As adults, they should take between three and four litres of water on a daily. SCD patients should be exposed to moderate heat in the environment. A steady room temperature must be maintained. They should watch the use of air conditioners,” he said.

Umobong cautioned against malaria and respiratory tracts infections, adding that these can make them more susceptible to crises.

He advised them to avoid drugs, which adversely affect the liver, especially paracetamol used excessively.

“They should not abuse alcohol or inhale harmful chemicals, such as chloroform. Many persevered foods or colored foods contain harmful chemicals,” he said.

He urged them to sleep in well ventilated environment, adding that they must wear warm clothing in cold weather.

Umobong recommended an integrative medicine approach for SCD treatment.

This, he said, involves the use of proven or evidence based modalities whether from the world of orthodox (biomedical in Nigeria) medicines, complementary, traditional or alternative medicines, in a well integrated manner to ensure the health of the patient.

He said sickening of red blood cells under certain conditions is responsible for sickle cell crises.

“Sickle cells are rigid and their shapes obstruct free movement of blood through blood vessels. The condition causes clumping, and as such, blocks those vessels, thus depriving the organs involved from getting adequate oxygen and nutrient supply.

“The result is acute pain in the organs. The pain is nothing other than a warning signal that all is not well with the organ. People can have bone pain crises, abdominal pain crises, acute chest pain crises (acute chest syndrome) and priapism, to mention a few.

He said attention should be paid to conditions, which promote sickle cell crises.

“They are low oxygen tension in the blood. Low available oxygen in the air breathed in could occur in high attitudes, such as mountain tops or flying at great heights, overcrowded environment, poorly ventilated rooms and polluted air,” he said.

He spoke of the need to increased viscosity or thickness of the blood.

“High cholesterol level, increased white/red blood cells, high level of circulating immune substances, high blood sugar levels and moderate to severe dehydration, are required by an SCD patient,” he said.

He also identified poor oxygenation of haemoglobin as another problem. “In red blood cells, this is a condition in which the capacity of the haemoglobin to carry oxygen is interfered with. So many factors can contribute to this. We should note in this circumstance that the air we breathe is rich in oxygen and it will dissolve in the blood as it passes through the lungs yet the haemoglobin cannot take it up.

“There is a substance in red blood cells called glutathione. It is an antioxidant responsible for keeping haemoglobin in the best state to mop up oxygen. When it is low in concentration, the haemoglobin’s ability to carry oxygen is greatly reduced.”

He said there are conditions, which make blood acidic, and as such reduce the oxygen carrying capacity of haemoglobin and predispose people to sickle cell crises.

“Poor health of the liver or spleen: Sickle cells are very vulnerable to severe damage as they pass through these two organs in the body. That is because of their basic structure, in which the cells are arranged more like the gills in the head of a fish. They break the sickle cell into fragment seen as target cells in slides and generate haemoglobin, which may elevate the viscosity of the blood,” he added.