In my many years of studying this condition for my own enrichment, i have seen several terms used interchangeably. Personally, I never leave anything to chance in matters health. As a consequence, i set out to determine the correctness in use of these terms: Sickle Cell “ANAEMIA” and Sickle Cell “DISEASE” interchangeably.
Sometimes medics just confuse me too much, not knowing that this lack of clarity causes sleepless nights to many when they think they have one and not the other condition. To the professional it may be a slip of the tongue or they assume the patient cannot comprehend the difference or they expect everyone to understand the difference (as though we all went to med school). If any medic ever comes across this article, understand that if something is threatening my survival, i will make it my business to understand it fully to the last “full stop”. We don’t mind learning, well atleast not me! Please, stop the ambiguities!
SCD refers to sickle cell disease which comes in several types or forms, one of them being SCA referring to “sickle cell anaemia”. Other than SCA, we have SC refers to just the two words “sickle cell”, SBT refers to “sickle beta thalassemia” and SCT refers to “sickle cell trait”. As usual, i have simplified this classification to palatable propotions. Lets leave the complex jargon to the medics and scientists. It is you my daily reader that i am more concerned about not the professionals. These are discussed further below:
Hemoglobin SS (SCA) – The sickle cell hemoglobin S gene is inherited from both parents. This is the most common and most severe form.
Hemoglobin SC (SC) – The sickle cell hemoglobin S gene is inherited from one parent and another type of hemoglobin C is inherited from the other parent.
Hemoglobin Sickle Beta Thalassemia (SBT) – The sickle cell hemoglobin S is inherited from one parent and another anemia, beta thalassemia gene, is inherited from the other parent.
Sickle Cell Trait (SCT) – This is a condition in which there is one normal hemoglobin and one sickle hemoglobin. An individual with the sickle cell trait does not have the disease but can pass the sickle cell gene on to their children, unless ofcourse they conceive a child with a partner who has “dominant” normal haemoglobin. The probability of inheritance will be reduced.
The above distinction implies that the disease is manifested at different levels and not uniformly in all patients suffering from the disease. In essence the degree of symptoms and survival rates varies from one patient to the next. “One shoe doesn’t fit all” as a good doctor quoted.
This means that in one person the symptoms are severe and almost unnoticed in another. These different categories must receive care as per their need.
I wish medical service providers would understand this scientific fact, maybe they would stop discriminating when it comes to essential service provision for this group of people.
Conclusion, it is “incorrect” to use the two terms “Anaemia” and “Disease” interchangeably when it comes to the “sickle cell domain”.
Someone asked, “What is the significance of the patient knowing their SCD type?”
Well, so that other doctors can know what treatment action to use when you end up in their care. For instance, if a Doctor assumes you are Anaemic (SS) the basic procedure might be giving a blood transfusion and iron supplements which end up weakening the patients instead and creating dependency on transfusion to the point where the body doesn’t know how to generate it’s own blood.
With transfusion you become more like a car, “run out of fuel, go to the gas station for refill”. A vicious cycle I might add. The iron medication overload the system if you don’t have iron deficiency of grandiose nature. The sickle cells when they breakdown seem to leave high iron in the patients system even without supplements. So it is more toxic than beneficial in the system.
Doctors always need extra information to give right care. Otherwise they do blanket solution that is counter productive
If you have low haemoglobin (HB) and are haemolysing that’s sort of normal for an SCD patient. They live pretty well with low HB. Haemolysing is breaking of red cells, SO BIG DEAL! These cells will continue to break unless the person is on specialized medication such as those highlighted in my previous post “Sickle Cell Treatment”. Therefore, merely because the Lab results for an SCD patient reveal low Hb and haemolysis is no need to rush them to the ER or start blood transfusion. Alternative investigations and measures suitable for them need to be discussed. They might not even be the SS type! Proper diet can raise and maintain Hb levels to your body’s preferred “normal” not transfusion
Of course there are DANGEROUSLY LOW LEVELS of Hb such as 1 or 2 (since normal is above 12). But that’s why you need to have a track record and an SCD SPECIALISED DOCTOR to know what is “normal” for you, not everyone else.
Many patients are mishandled due to misdiagnosis. Save yourself and the child the trouble if you can by knowing exactly what you have.
Aluta Continua?! Viva Mandela!?