Cruel summer

This has been a hot summer, and as a result, we've seen sickle cell patients running into all kinds of trouble. Sickle cell is an annoying disease in that everything can set off a crisis. If it's too hot or too cold, too much exercise or not enough, dehydrated or drinking the wrong liquids... there are so many triggers and they're all common sorts of things.

Because sickle cell patients have been running into so much trouble, the nurses and physicians are complaining about them and their unbelievable consumption of opioids. I've seen some patients take in enough dilaudid to put down a horse. People accuse them all the time of drug seeking and inappropriate use.

The thing about having sickle cell disease though is that it is rife with chronic ischemic pain. That hurts. It also lowers life expectancy by decades with median age at time of death in the 40's. That sucks.

I hate giving out huge doses of opioids as much as the next guy, but pain is pain, and if I had sickle cell, then I'd want a little more dilaudid too.


Cait said...

Please continue to write and post! As a post-bac pre-med, I enjoy your insights and honest commentary on the profession, the patients and your colleagues. Sincere gratitude for inspiring contemplation and examination of motive and direction.

Anonymous said...

If the people that have sickle cell were of a different race maybe they would not even blink a eye or care they would justify there actions. The majority of people that abuse prescrpition drugs are white.

Ali said...

Wow, so glad I found your blog. I'm looking to become a doctor, specializing in either IM or psychiatry. I also have Sickle-beta thalassemia. I've been fortunate to not suffer greatly with crises, but the (seemingly) annual crises that I do get can easily put me out of commission for a week or two. I wish that more people understood how two-fold the pain is: a literally debilitating, crushing pain that feels like only God Himself can stop. It also hurts knowing that there isn't a known cure...sometimes my mother will say to me, "You shouldn't do that, you don't want to trigger..." Those are ugly words that dare to limit me in anything I hope to accomplish. *sigh*

I also laughed ruefully about the drug reference. I've been dealing with this for 26 years, and I basically just use four Advils=800mg of Ibuprofen and lots of coconut water. I've thrown away lots of Darvocet, Percocet, and Vicodin over the years, scared as hell of developing an addiction.

Anonymous said...

To anonymous above: the problem with this line of thinking is that most people with sickle cell disease are african american, not caucasian.

incidental findings said...

To anon #2 - the point that anon #1 is trying to make is that s/he believes that sickle cell patients are treated poorly because they are black. But in reality, whites make up the vast majority of prescription drug abuse.

Whether you choose to agree is up to you.

Anonymous said...


I recently decided that I would really love to be a doctor when I grow up. Right now, I'm seventeen, turning eighteen in January. For nine years I lived in denial and thought that I wanted to be a pharmacist because my mother said it would be a safer profession with a decent paycheck. However, sophomore year and junior year were turning points in my life and I realized that I can't be a pharmacist because I want to make a difference in people's lives. I don't want a counter-customer relationship.

Thank you for writing your blog. I've been so confused about my life since I confessed to my family because the decision to become a doctor is a huge one. It could make or break me. I really appreciate the honesty with which you write and the fervor with which you obviously work. You've really helped me decide that medicine is something that I'm going to go into.

That might change over the years since I have at least a decade to go, but it's nice to be almost sure. Thanks again. =]

mK said...

How do you not make a difference as a pharmacist

Prescribe the wrong drug and now you end up with a dead customer.