Sickle-Cell Disease is a term that encompasses a group of inherited blood disorders for which Hemoglobin S is the dominant hemoglobin. The featured hallmark of this disease is pain. Although Sickle-Cell Disease can be found in various parts of the world in persons of African, Mediterranean, Middle-Eastern, Asian and East Indian heritage, it predominantly affects African American, African/Hispanic, Caribbean, and South American people in the United States.
Pain in the leading cause of emergency department visits and hospitalization, and is the major focus of home management for people with Sickle-Cell Disease. Severe pain can be experienced as early as six months of age, and can occur unpredictably at varying intervals throughout the course of a person's life. How pain is discussed and managed during childhood affects an individual's reaction and ability to cope with the pain as an adult. Older children and adults are faced not only with their present pain, but also with the memory of past episodes of pain, and future pain episodes.
It is probably best to first recognize the need for adequate assessment and management of Sickle-Cell pain. There are, however, some barriers that affect the understanding of this disease such as:.
▪ Clinicians" limited knowledge of Sickle-Cell Disease pain, and its.
management. (Disease has yet to become a major concern of some clinicians) .
▪ Clinicians" disbelief of patient's reports of intense pain and the amount of medication required for treatment. (Patients get inadequate dosing of pain reducing medications.).
▪ The variability and unpredictability of the acute episodes of pain. (Because of the different states of pain associated with Sickle-Cell Disease and underlying causes, it is very difficult to predict pain.).
▪ Biases based upon inadequate knowledge of opioid use (e.g. patients", families", and clinicians" fears of addiction).