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Pedia Pain Focus

Oct 29, 2018

Nothing sums up the challenges of sickle cell pain better than what our guest, Dr. Zempsky, quotes in the interview, "like having a thousand heart attacks". Anyone who's been involved in taking care of a sickle cell patient in pain, knows that this expression can easily describe the experience of patients and healthcare providers alike! Todays episode is focused on understanding the nature of pain in sickle cell disease, simplifying and improving the care of these patients, resulting in better outcomes.  

Takeaways in This Episode:

  • The most common types of pain presentations in Sickle cell patients and how to differentiate them.
  • What challenges do clinicians face in taking care of sickle cell patients
  • There's more to sickle cell pain than what we've long believed (Hint:It's not just sickling)
  • Do the the inflammatory markers play  any role in sickle cell?
  • Why are sickle cell disease patients having “heart attacks”?
  • Should we treat sickle cell crisis pain like post-operative pain?
  • The added challenges with improved sickle cell disease care and increased life expectancy of sickle cell patients.
  • What specific benefits does aggressive early management of vaso-occlusive episodes offer?
  • Are there early changes or signs that indicate transition from acute to chronic sickle cell pain? 
  • What our ethical mandate as clinicians is, for our pain patients.
  • Where does the evidence for non-opioid analgesics in management of sickle cell pain fall?
  • Should sickle cell patients be following any particular dietary and nutritional supplements guidelines?
  • What he says about the role of vitamin D or glutamine and other supplements in sickle cell pain
  • What advice have we, as medical community, given our sickle cell patients and their parents that we are having to reverse the course on that now?
  • What his recommendations on activity for hospitalized sickle cell patients are.
  • What should our goal(s) be for sickle cell patients?
  • What crucial steps in care of sickle cell patients when presenting to the urgent care or emergency room lead to improved healthcare outcomes.
  • Quality care indicators for care of sickle cell patients in ER.
  • Utility of Individualized Care Plans in the care of sickle cell patients

Links Mentioned:

A Parent’s Pain Relief Toolkit


William Zempsky, MD

AAPT Diagnostic Criteria for Chronic Sickle Cell Disease Pain.

Evaluation and Treatment of Sickle Cell Pain in the Emergency Department