Sickle Cell Pain: Avoiding Dehydration, Exhaustion and Temperature Extremes

August 29, 2008

SEARCH drSpock

my account | sign in

HOT TOPICS

		Pregnancy Symptoms
		Read with Your Kids -- It's Fun!
		Take Our Quizzes
		Play with Your Baby

TOPICS


	Parents are talking about their children. Join the discussion.

Sickle Cell Pain: Avoiding Dehydration, Exhaustion and Temperature Extremes

by Lewis Hsu, M.D., Ph.D.
reviewed by Laura Jana, M.D., F.A.A.P.

If your child has sickle cell disease, you know how hard it is to watch her suffer the pain crises that accompany this condition. While some episodes are unpredictable and nobody can tell what triggered them, many can be traced to particular situations that you can help your child avoid. In particular, families, doctors, and scientists find that dehydration, exhaustion, and temperature extremes can trigger sickle cell pain (vaso-occlusion).

Dehydration (not having enough water in the body) can be caused by:

Losing water by sweating in hot weather or during exercise

Losing water through diarrhea or vomiting

Losing water because of frequent urination (the disease damages the kidneys, causing them to produce more urine than usual)

Not drinking water because of doctor's orders (in preparation to go under anesthesia, for example)

To compensate, people with sickle cell find that their bodies naturally make them more thirsty than those without the disease. Encouraging a child with sickle cell to drink plenty of fluids may prevent many pain crises and is a good way to help shorten one when it does occur. When a child cannot drink enough for some reason, fluids may need to be given intravenously (i.e., through the veins).

Exhaustion. Exercising to exhaustion makes the body chemistry change to a state called lactic acidosis. Acidosis will often trigger sickle cell pain, and a child with a low blood count will reach this state sooner than one with a higher level. To avoid exhaustion, children with sickle cell should take frequent breaks when playing. During vigorous play, taking a break every 15 to 20 minutes both to rest and to drink usually will allow them to continue their activities without developing lactic acidosis. One young man, for example, often developed sickle cell pain if he played basketball for 30 minutes straight. However, he found that he could cut down on his pain crises by playing the first quarter of a basketball game, resting the second quarter, playing the third, and resting the fourth. Physical education teachers or coaches may need a note from the family or a doctor to explain this situation.

Extremes of temperature. Being either chilled or overheated will change the blood-flow patterns in the body and lead to sickle cell pain. When the weather is cold, dress your child warmly. When the weather is hot and she's spending time outside, make sure that she takes frequent breaks in the shade or an air-conditioned room. Many people find that swimming in unheated water can chill the body quickly and trigger pain; consequently, children with sickle cell should take rest breaks often (every 20 minutes or so) to dry off and warm up. When the weather is changing quickly or your activities will take you from the hot outdoors to cool air conditioning, make sure to dress your child in layers so that you can help regulate her temperature. A sweatsuit or warm-up outfit can be very helpful for staying warm before and after exercise.


RELATED INFORMATION

			The Importance of Fluids for Children with Sickle Cell Disease
			Sickle Cell Disease

Created January 19, 2001
Reviewed January 23, 2001

| |
| | |

THIS SITE DOES NOT PROVIDE MEDICAL ADVICE. The information drSpock.com provides is for educational purposes only and is not a substitute for professional medical advice. Always seek the advice of your health care professional if you have a specific health concern. Mention or advertisement of any product, service, or brand does not constitute endorsement, guarantee, or recommendation by The Dr. Spock Company. Please read our full Terms of Service.