Navigating Life with Sickle Cell Disorder: Understanding the Unseen Struggles

Adaku was walking towards the open staff room when she heard someone mention her name. There was always one discussion or the other going on in the staff room, so she did not think it was anything spectacular. However, she paused to listen out of curiosity.

‘I told our supervisor it was a bad idea to hire her. She won’t be able to keep up with her work, and we will have to pick up her slack. I am not ready for that o!’ Adaku recognized Aisha’s voice.
‘Ah ahn! Calm down. She has worked here for six months and this is her first day off in those six months. Cut the girl some slack. Has she not been doing her work?’ Funmi replied.
‘Even though! I’m just telling you that there is more to come. Maybe she was pretending…’ Aisha stopped mid-sentence as she saw Adaku walk in.

Adaku pretended not to have heard bits of the conversation and cheerily greeted her colleagues. She was twenty-six years old and had heard quite a lot of gossip and assumptions about sickle cell all her life. She was not going to dignify any of them with a response.

For every 100 Nigerians you know or meet, about 3 of them have sickle cell disease. While for every 4 Nigerians you meet, 1 has the sickle cell trait, which means they can pass the disease to their children if they have children with another person who has the sickle cell trait also. This is according to a 2022 report by Nwabuko, O. C. et al in The Pan African Medical Journal.

Therefore, it is very likely that you have met at least 15 Nigerians in your lifetime who have sickle cell disorder. And fun fact, sickle cell no dey always show for face. The aim of this article is to help you understand the peculiarities of this demographic and help you know how to relate to them.

Two major factors that separate individuals living with Sickle Cell Disorder (SCD) and others are:
i. The shape of their red blood cells (RBCs);

ii. The rate at which these red blood cells die off.

Imagine that your veins, arteries and capillaries are like water pipes. Normal red blood cells are disc-shaped and flow easily through these pipes because they are flexible enough to go through any blood vessel. But for someone with sickle cell disease, the RBCs are sickle-shaped and inflexible. They don’t flow through the pipes easily and can lead to blockage, especially under certain conditions.

If you have icy water flowing through your water pipe, what do you think will happen? One thing is for sure, liquid water will not flow freely and it will take longer to fill your cup or bucket. Eventually, the ice will pile up and damage the pipes.

In the same way, when blood does not flow freely through the blood vessels of a person with SCD, it leads to consequences. But unlike water through your pipes, red blood cells carry oxygen and nutrients through your body.

This means that there are even more dire consequences when they do not flow freely. These consequences could include:

1. Fatigue (this is the most common because of the shortage of oxygen)
2. Crises, especially those characterised by pain
3. Leg ulcers
4. Avascular necrosis
5. Stroke
6. Acute chest syndrome
7. Vision loss, etc.

There are many more complications that could occur as a result of the sickled shape of the RBCs. The good news is that not everyone living with sickle cell disorder will experience these complications, especially with proper management.

In the next article, you will see more about the rate at which these red blood cells die off and how they affect persons living with SCD. If you enjoyed reading this, encourage someone else to read it too.