Sickle Cell Anaemia Symptom #3 - Leg Ulcers

I decided to speak about leg ulcers this week because of my very good friend Rachel. Rachel has had leg ulcers for a couple of year now and finally today, she got the opportunity to have a grafting procedure done on the leg ulcers.

What are Leg Ulcers?

Like many other Sickle Cell warriors, leg ulcers are a big pain, physically and visually. Leg ulcers are acute or chronic wounds that occur on the lower extremities around the ankle, in areas with less subcutaneous fat, thin skin, and with decreased blood flow. They are open sores marked by a complete loss of the top layer of the skin (epidermis); which does not tend to heal quickly. Leg ulcers are a chronic complication for people living with sickle cell disease. Ulcers tend to be difficult to treat successfully, healing slowly over months or years. They can severely disrupt quality of life, increase disability, require extended absence from the workplace, and place a high burden of care on healthcare systems.

They may be classified as acute or chronic according to their duration, however, there is no consensus as to a specific length of time to define chronicity. An acute ulcer usually should heal in less than a month. Among chronic ulcers, a duration of six months seems to define the most recalcitrant ulcers. It is not uncommon for ulcers to last many years, often closing and re-opening repeatedly. Leg ulcers are painful and often disabling complications of SCD. They tend to be indolent, intractable and heal slowly over months to years. The pain may be severe, excruciating, penetrating, sharp and stinging in nature. In most patients, opioid analgesics are needed to achieve some pain relief.

In the case of Rachel, her leg ulcers prevented her from doing a number of things including walking and/or standing for long hours. Aside from the fact that both of her legs were in bangages, the severe pain during the night was one of the many things she endured. The physiological manifestations of leg ulcers prevents many warriors from living normal pain free lives. I can only imagine what having a persistent wound does to someone's psyche.

Causes of Leg Ulcers

Most of the causes of leg ulcers in Sickle Cell Warriors especially is the lack of blood flow to the skin in the lower extremeties of the legs. Another huge fact is the problem of low immunity which prevents wounds to heal properly and timely. Other major causes are listed below.

• Obstruction by dense sickled red cells
• Venous incompetence (impaired blood flow)
• Bacterial infections, trauma and inflammation
• Abnormal autonomic control with excessive vasoconstriction when in the dependent position
• Localized blood clots
• Anemia with decrease in oxygen carrying capacity
• Decreased nitric oxide bioavailability leading to impaired endothelial function
• Arteriovenous shunting that deprives the skin of oxygen
• Lower musculoskeletal exercise tolerance and oxygen consumption due to the lowered oxygen supply to the exercising muscles in SCD patients

#10003 Sickle Cell Symptom #3 - Leg Ulcers

Management of Leg Ulcers

Management can only be advised depending on how severe the leg ulcer is. This is usually determined by the size, depth and duration of the particular leg ulcer manifestation. The management of chronic leg ulcers in sickle cell patients can be difficult and protracted. It often results in significant pain, limits physical activity and potential employment, and reduces the quality of life for these patients.

Coming back to Rachel, her leg ulcer was chronic. It was deep, relatively large and had persisted for a couple of years. In her case, the option given by the doctors was to administer a skin graft on the wound to help in the healing process. This is because it is a much better option for her since the wound has not been able to heal on itself. However, with the help of a skin graft, healing and closing up of the wound is possible.

With regards to pharmaceutical intervention, studies show that arginine butyrate, RGD peptide, L-cartinine report change in ulcer size However, RGD peptide significantly reduces ulcer size and has reported incidences of complete wound closure. Local treatment with either surgical or sharp debridement, hydrogels, enzymatic digestion, or topical gm-CSF have been recommended but responses are slow and often incomplete. 

1. Systemic therapies with zinc replacement that help with wound healing and use of antibiotics to prevent and control bacterial growth and infection of the ulcer.
2. Regular cleaning and dressing of the wound is highly recommended. This helps greatly to improve circulation and treat any rising infections on the wound. Weekly cleaning to remove debris and dressing with clean bandages help to heal the wound quickly.
3. Transfusion therapy has been used to improve oxygen carrying capacity as well as to decrease levels of hemoglobin S. It has also been used in preparation for surgery, and in the treatment of non-healing leg ulcers. However, it is associated with significant alloimmunization and iron overload which requires aggressive chelation therapy.
4. Bed rest and elevation to reduce edema (accumulation of fluid) could be beneficial in the treatment of lower extremity wounds. This helps prevent collection of fluid and bring it back to the heart. Elevation also reduces pressure to the blood vessels on the extremities and reduces swelling of the leg around the affected area.
5. The use of compression for sickle cell ulcers with reference to the use of either Unna's boot or elastic compression bandages and absorbent dressings. This helps keep the blood pressure regulated but not stopped.
6. And then of course the use of skin grafts to influence wound healing and wound closure.

The use of aggressive medical, wound, and physical therapeutic management is recommended for the successful healing of a chronic wound and leg ulceration in patients with SCD.

Prevention of Leg Ulcer

Since it is clear that leg ulcers are majorly caused by poor circulation and immunity, we can easily be able o prevent their occurrence especially among Sickle Cell Warriors.

Regular light exercise that is comfortable for the warrior is recommended. This may include but not limited to, walking, yoga, swimming or anything that promotes movement and circulation of oxygenated blood within the body.

Increasing intake of nutritional foods especially those that promote body detox and promotes wound healing such as green vegetables and fruits. These foods help build one's immune system to keep off bacteria and infection, improve wound healing and increases overall body energy.

Vitamin C helps in the healing process and increase in blood circulation. Vitamins E, B complex, Zinc and amino acids also help in healing and circulation. For blood clotting, Vitamin K is a huge factor. Being vigilant in your diet will help quicken the healing process. Dark green vegetables and fruits have a dense wealth of nutrition that help oxygenate blood among other things. Do stay away from sweets, refined sugars/carbs and animal protein that reduce and even stop the healing process.

As far as Rachel is concerned, we wish her a full recovery post-surgery and healing that will give her back a full life that she deserves.

All the best Rachel.

Love Life!

Lea

Ref

Pathophysiology and Multidisciplinary Management of Leg Wounds in Sickle Cell Disease: A Case Discussion and Literature Review 

Leg Ulcers in Sickle Cell Disease 

Treatments for leg ulcers in people with sickle cell disease 

SICKLE CELL SYMPTOMS & CLINICAL MANIFESTATIONS

How do you know one has Sickle Cell just by looking at them? How does Sickle Cell Disease look like?

I could say, jaundiced (yellow) eyes/skin, small physical stature, swollen abdomens etc. . But to truthfully answer your question, there is no particular way to tell if someone has Sickle Cell by just looking at them. Unless you're a keen observer and are very versed in the knowledge of Sickle Cell and its symptoms. Sickle Cell has no particular face.

Well, since it has no particular identifier, like any disease, there are definitely certain symptoms to look out for if you have Sickle Cell. Granted that human beings are different in there physiological make-up, these symptoms vary from one individual to the next. This means that, not everyone with Sickle Cell will exhibit the same symptoms. Different people may only experience a few or even in some cases none at all. In very rare cases does one person exhibit all of the symptoms.

Sickle Cell Symptoms

These clinical manifestations and symptoms result from changes of red blood cell deformability and fragility, increases in blood viscosity with blockage of small blood vessels, and red cell membrane changes contributing to hemoglobin polymerization(clumping), adherence of red blood cells to interior surface of blood vessels, and ingestion of foreign material by white blood cells. The end result is a hemolytic anemia, increased incidence of serious infection, and ischemic damage (damage caused by restriction of blood supply) throughout the body. In individuals with Sickle syndromes, there is a life-long risk of having complications,  however, there are specific ages when many of the manifestations develop. The more common problems in Sickle Cell syndromes will be presented by the age usual onset.

Early Symptoms
The majority of infants are being diagnosed at birth by newborn screening. The symptoms occurring in the first few months of life in infants with sickle cell syndromes are non-specific and include jaundice, irritability, colic, failure to thrive, fever, nausea, and vomiting. Findings include hepatosplenomegaly (simultaneous enlargement of live and spleen), pallor (unhealthy pale appearance), and heart murmurs. Unfortunately, undiagnosed infants may present with overwhelming infection as the first manifestation of the illness in the first few months of life.

Other Symptoms

• Anemia
• Sequestration Episode
• Aplastic Episode
• Infections
• Dactylitis : The Hand-Foot Syndrome
• Strokes
• Priapism
• Growth & Development
• Pain : Acute and Chronic Pain
• Retinopathy
• Nephropathy
• Pulmonary Complications
• Leg Ulcers 

In the next couple of weeks we will discuss each of the different symptomatic expressions of Sickle Cell. We will go into the causes of said symptom and how to manage the symptom.These are the most common symptoms which occur in many recorded cases. Personally, I have experienced very few of the symptoms above and also other symptoms that are not on the list. I'll be sure to give a brief on my experiences as we go through each of the symptom.

Sickle Cell Clinical Manifestations 

Have you experienced any of the symptoms above? Let me know your experience and how you were able to manage it. And if you feel I have missed something, comment below and let me know what I need to add onto the list.


Love Life!
Lea

Sickle Cell Warrior #10

10003 SICKLE CELL WARRIOR #10

Donna. A
27 Warrior Years

I am a lady, 27 years of age. My parents died in 2002 and before that we were all unaware I had Sickle Cell. I later discovered it when I collapsed in school and was taken for a checkup. From then on that’s when I started with my medication and checkups. I was 14years old when it was discovered.  I faced negative perceptions from people around me. Never believed I would reach 18. I also stopped going for checkups due to financial problems. I only go to the hospital when in crisis. After 20 years people started seeing my determination and always want to hear my story. So far God has brought me and further will he take me.

Catch up with me on my facebook HERE to find oud more about how i conquer Sickle Cell everyday.

Love Life

Donna

YOU NEED TO LEARN ABOUT SICKLE CELL TRAIT

On January 18th this year, Shanice Clark 21 a college basketball star of California University of Pennsylvania was found unresponsive in her dorm room. She was rushed to Monongahela Valley Hospital but she could not be revived and was pronounced dead. California borough police said that a preliminary report from medical personnel indicated the death appeared to be accidental and there were suggestions she had choked on gum while sleeping.

On Monday this week a Washington coroner Tim Warco’s report blamed the death of the college star on sickle cell trait.

Sickle cell trait means having one gene for a condition called sickle cell disease (SCD). This in itself does not normally cause problems and sickle cell trait is not considered as a disease. It is extremely rare for it to cause problems or complications, which mainly occur under conditions of severe physical stress.

There has been a long term discussion on whether sickle cell trait can cause pain and other complications or not except under extreme conditions. Their debate has existed for more than 50 years and some professors who have managed sickle cell cases for long time have refused to accept that sickle cell trait can cause complications despite the fact that they have come across many cases of trait carriers who get complications like haematuria.

I remember a review written by a professor in sickle cell about a research that had been done and published in Journal of American Forensics by Charis Kepron M.D, Gino R. Somers M.B.B.S, Ph.D and Michael S. Pollanen, Ph.D titled Sickle Cell Trait Mimicking Multiple Inflicted Injuries in a 5-Year-Old Boy (September 2009), in his review he argued that a person with the trait cannot get complications. In their research they had described a case of sudden unexpected death in a 5-year-old child with undiagnosed Sickle Cell Trait due to the Acute Chest Syndrome.

The boy’s story according to the paper was “5-year-old boy of Ghanaian origin was reportedly well except for a dry cough that was initially noted on the morning of the day he died. He had been given a single dose of an over-the-counter cough medication in the early evening, and on his way to bed began to vomit. His parents described copious vomiting from the nose and mouth, and EMS was called. Paramedics arrived to find the child with no vital signs and it appeared to them at the time of initial assessment that he had aspirated. Intubation attempts in the field were unsuccessful; therefore, the boy was bag-ventilated until his arrival at the nearest Emergency Department (ED) 30 min after the onset of vomiting. He was successfully incubated in the ED, and during the resuscitation efforts it was noted that his abdomen appeared distended, a sign that appeared to worsen over the course of treatment. The anaesthetist involved reported thick secretions in the airway and high airway resistance. The resuscitation attempt was unsuccessful and the boy was declared dead 30 min after arriving in the ED. There were no signs of injury, and the child appeared well cared for.”

The issue of sickle cell trait complications has remained controversial as the complications experienced themselves. No body seems to explain why the complications exist.

In both cases of Shanice and the 5 years old boy the preliminary investigations always focus on the soft points.

With the rampant increase in the number of people with the trait in the world there is a need to educate everybody concerned.

There is a need to have comprehensive education and awareness programs for everyone with a major emphasis on coaches, healthcare professionals, parents, and student-athletes on sickle cell trait and the prevention of sudden death. Sickle cell trait should not prevent anyone from participating in athletic activity; however, recent deaths from exertional sickling events in the athlete setting have demonstrated the need for more education. Education and prevention programs are the key to preventing an exertional sickling event.

Sickle cell trait is a generally benign condition in red blood cells sometimes causing them to carry oxygen differently. Athletes with sickle cell trait run the risk of experiencing exertional sickling events that may have injurious outcomes. Complications from sickle cell trait while exercising are mostly preventable.

There is also a need to have population screening for the sickle cell trait. A population unaware of the sickle cell trait (SCT) has resulted in a large population of individuals entering childbearing age with no knowledge of their risk.

Love life!

Lea.

 

Sickle Cell Warrior #9

10003 Sickle Cell Warrior #9

Mercy A

19 Warrior Years

I don't know what it is with girls and their fathers', perhaps a father can give us a bit of introspect into this subject.

When i first met Mercy, she like many other younger warriors were very keen to participate in the project. To speak out about a very sensitive issue that affects numerous young girls in Kenya takes a great deal of courage.

Courage is the one thing that i was reminded of when i talked to Mercy. She has faced great hardship in her daily battle with Sickle Cell disease. Many times she has had to stay in one class as her classmates advanced to the next level, as she tries to catch up on the missed lessons. In a system that doesn't quite cater for special needs students with SCD, many of them are shunned by teachers and deemed not good enough or just another non-performing cliche. 

Mercy however rose above those mental models society knowingly or unknowingly bestows on us. The biggest one being, Sickle Cell Warriors are lazy, dumb and sickly. 

 Here's how Mercy sees things

“Being a warrior does not make you different from others. Most of us have been told a lot about our lives but in all I have built my faith on hope and faith. I have ignored the voices of doctors and anyone who pulls my hope down, that’s why I’m still moving on. In all I've trusted in God.”

Love Life!

Lea

GENETICS IN SCD AND NUTRITION

We’re back once again with a very complicated yet simple topic –Genetics!

Relax; this won’t be a recap of your high school biology class. It will be more of the kind of table talk that leaves you feeling like you just left here with a doctorate.  So, let’s get started!

By the time you got to this section, you knew that all types of Sickle Cell Disease (SCD) are caused by a genetic change in hemoglobin, the oxygen-carrying protein inside the red blood cells. Yes, I reassure you, it’s purely a genetic change or mutation that causes SCD –not bad luck or curses or other diseases or even poor nutrition. It’s just the genes you have on. But really, how and why do these mutations occur? I mean, it must have had a cause, right?

Well, according to a widely accepted theory, the genetic mutation associated with the Sickle Cell Trait occurred thousands of years ago (yeah, they just didn't pop up this millennium). You see, it’s believed that SCD began with a single carrier. Carriers of the sickle cell gene are said to have Sickle Cell Trait. Unlike SCD, Sickle Cell Trait does not cause health problems. In fact, sickle cell trait is protective against malaria, a disease caused by blood-borne parasites transmitted through mosquito bites. So the sickle cell trait actually began as a survival tactic for our red blood cells; it was and believed to still be, a DEFENSE MECHANISM against malaria!

You can imagine that cavemen didn't have any anti-malarial drugs and so Mother Nature simply increased the likelihood that carriers could survive malaria infection. Survivors then passed the mutation on to their offspring, and the trait became established throughout areas where Malaria was common –primarily tropical regions. This is why sickle cell disease largely affects people of African, Mediterranean, Middle Eastern and Asian Indian ancestry. As populations migrated, so did the Sickle Cell Trait. Here’s where the big BUT comes in, we had to multiply. Where the first two carriers went ahead to get an offspring which then began the Sickle Cell Disease history. This defense mechanism had this one unpredictable flaw.

Genetics in Sickle Cell Disease 

Research has not yielded any evidence of nutrition reversing the gene mutation in Sickle Cell Disease let alone any other genetic disorder, but as we have & will continue learning, nutrition plays a big role in management of SCD symptoms.

A silver lining has been seen in this cloud of gene mutation. Scientists say that replacing the gene that produces the defective hemoglobin in Sickle Cell patients, with one that makes normal hemoglobin, could be a possible treatment. According to a 1998 report in Science, researchers studied the blood cells from people who carry the Sickle Cell Gene. By using an enzyme called a ribosome, the study was able to alter Sickle Cells into normal cells. The ribosome cut out the mutated instructions in the cells' genetic pattern and replaced them with the correct instructions. Researchers hope that this will allow the cells to make normal hemoglobin—leading to the ultimate treatment for those with Sickle Cell Disease.

Until this research is considered full-proof in humans, we recommend genetic counselling which is just as important of nutritional counselling. A genetics counselor meets with families to review your family history, the inheritance of SCD, and the chances of having children with SCD and provide more education to people with SCD.

When will you visit your nearest genetic counselor? We’ll talk more on what to expect from them in the next article. Also we have some homework for you (so this is actually ending up like a biology class, sorry J) –leave comments below on any questions you have or any myths you've heard on genetics in SCD. We’ll keep you posted. Later!

Love Life!

Sharlene Mule

IS SICKLE CELL OVER 1003 YEARS OLD?!

Have you ever wondered where diseases originate from?

Why does disease arise and how do they come about?

How in the world did Sickle Cell Anaemia come about?

Sickle Cell Disease is a very old disease. It is older than you, me and the next two readers combined.  How do I know this you ask? Well, I connected the dots.   And as our good friend Steve Jobs put it, “You cannot connect the dots looking forward; you can only connect them looking backwards.”  So let’s go back in history.

The Discovery

In the annals of medical history, 1910 is regarded as the date of the discovery of Sickle Cell Disease, making 2010 the 100th anniversary of that discovery, but just what does it mean to say the disease was “discovered”? The disorder we call “Sickle Cell Disease” often abbreviated as SCD, had been present in Africa for at least five thousand years and has been known by many names in many tribal languages. What we call its “discovery” in 1910 occurred, not in Africa, but in the United States.

Enough about that, let’s go further back in time before 1910.

I’m sure we all know that Sickle Cell Disease comes about when two individuals with the Sickle Cell Trait/Gene come together; they pass down the gene and give birth to an individual with Sickle Cell Disease.  If this is new to you, go back and learn the basics HERE. The key word we need to note is Sickle Cell Trait. And since Sickle Cell Trait is the cause of Sickle Cell Disease, let’s look into the cause and origin of the Sickle Cell Trait.

Sickle cell trait occurred as a natural mutation of the haemoglobin gene. Sickle trait served and still serves as a protective mechanism against Malaria. Malaria is a deadly disease found in countries along the equator. People with Sickle Cell Trait are protected from Malaria while those with Sickle Cell Anaemia and normal haemoglobin are susceptible to it. Over the years people with Sickle Trait migrated to other continents to parts of the Middle East, Central India, and countries bordering the Mediterranean Sea, especially Italy and Greece.

So we now know the cause of the Sickle Cell Trait, Malaria resistance, what next? Yes, you got it; let’s have a look into the origins of Malaria.

King Tut's Golden Mask from Ancient Egypt

Malaria

The first evidence of malaria parasites was found in mosquitoes preserved in amber approximately 30 million years old. Human malaria likely originated in Africa and coevolved with its hosts, mosquitoes and non-human primates. About 10,000 years ago, Malaria started having a major impact on human survival, coinciding with the start of agriculture in the agricultural revolution. Consequences included natural selection for Sickle Cell Disease, Thalassaemias etc, because such blood disorders confer a selective advantage against Malaria infection (balancing selection). The major types of inherited genetic resistance (Sickle Cell Disease, Thalassaemias, etc) were present in the Mediterranean world by the time of the Roman Empire, about 2000 years ago.

To dilute it down, the information simply means that Sickle Cell Trait came about as a way to resist Malaria. Darwin's theory of 'survival of the fittest' is demonstrated well as individuals developed stronger genes to prevent from Malaria. The stronger gene is Sickle Cell Trait. However since there was no knowledge of this back then, people went about their business as usual. Intermarrying within gene families was not uncommon then which increased the chance of intermarriage between people who developed the Malaria resistant Sickle Trait, therefore bringing about Sickle Cell Disease.

King Tut of Egypt

Tutankhamun, is the world’s best known pharaoh. There are many speculations about the death of King Tutankhamun at the ripe age of 19 years. Why I bring this up is to show and demonstrate the age of Sickle Cell and how far back the disease had been existing.  Since the discovery of Tutankhamun's mummy, there has been a lot of speculation and theories on the exact cause of death, which until recent studies had been hard to prove with the evidence and data available.  One of the theories that caught my eye was one by Christian Timmann and Christian Meyer. They came to the conclusion that Tutankhamun did not die from a combination of bone disease and malaria, but instead had Sickle Cell Disease. Dr. Timmann and Dr. Meyer believed the Sickle Cell Disease turned fatal when Tutankhamun also contracted severe Malaria that was rampant in Ancient Egypt during his era. Tutankhamen's parents are thought to be related, boosting the chance that they both carried the Sickle Cell Gene. He is expected to have been homozygous recessive for the Sickle Cell Gene, thus making him not immune to severe malaria, which would have been fatal. So tell me, Is King Tut the oldest recently recorded Sickle Cell Warrior/patient?!

Wow isn't it all so surreal! The Sickle Cell Gene has survived millennial, centuries and decades of time up to this day and age. Sickle Cell Warriors such as myself can trace their gene back to the likes of King Tut.  Imagine a family tree that can be traced back in time to the beginning of ancient civilizations and evolution of mankind!

Coming back to the present moment, with the dots hopefully connected, do you feel you have a bit of understanding on the origins of Sickle Cell? I feel this brings everything into perspective and helps me understand why Sickle Cell Disease is. And not to mention the great need a couple thousand years and 115 years later, when humanity is still looking for sustainable solutions on Sickle Cell disease management.  

I say Knowledge is the Key! 

Love Life!

Lea

IMPORTANCE OF NUTRITION IN SICKLE CELL DISEASE

Nutrition! What has food got to do with my red blood cells? I’m sure you’re probably wondering what the big fuss is all about, but nutrition plays a very significant role in our lives. It is important for growth and development and a strong immunity against infections. In patients with Sickle Cell Disease, appetite and immunity are greatly affected which results in poor growth, poor sexual maturation and increased susceptibility to infections. This affects the quality of their lives and will often be sickly if basic proper care is not given.

Therefore dear warrior, keep in mind that you have extra requirements for nutrients such as energy, protein, water, folate & zinc. It is recommended that you take extra vitamins and minerals in order to replenish those being lost or those on higher demand by your body due to the nature of the disease. Extra protein and energy are required to promote growth & maturation especially if you are a child or adolescent with Sickle Cell Disease. Folic acid is needed in extra amounts so that it can aid in the increased production of red blood cells needed to replace the destroyed ones, while zinc is needed to increase oxygen affinity and perform its functions in skeletal & muscle growth and sexual maturation. While these are important we will also discuss other nutrients whose increased intake aid in management of Sickle Cell Disease. These include Vitamin A, Vitamin E and Vitamin C.

Hearty Nutrition for Sickle Cell

Food choices in Sickle Cell Disease have great health benefits to you and even go beyond providing nutrients only –they can affect how frequent your symptoms occur, imagine that! Most foods that have been implicated with triggering crises are animal protein sources due to iron overload and their complexity in digestion. Vegan diets have been associated with less frequent and severe episodes (yes contrast to common thought, being a VEGAN aids in much more than just weight loss). Your dietary intake may be low because of abdominal pain crises caused by some certain foods, but at the same time you need a high caloric intake because of hyper metabolism caused by the constant inflammation. Therefore, it is very essential for a healthy Sickle Cell diet to avoid trigger foods. Your diet should be low in:

• Sodium –a component of salt. If you’re one of those people who grab the salt shaker right away before tasting your food, keep note! Salt leads to dehydration by ‘sucking’ the water out of our body cells leading to painful crises episodes.

• Added sugars –such as those found in sodas, processed juices, sweets & candies cause dehydration in the same way as salt does.

• Solid fats – include saturated fat and trans fatty acids which adversely raise the levels of low-density lipoprotein (LDL)/ bad cholesterol and lower the levels of high-density lipoprotein (HDL)/ good cholesterol in the body. They cause abdominal obesity, inflammation and insulin resistance. In the long term, consumption of trans fats raises the risk of obesity, diabetes, heart disease, stroke, depression and many more diseases.

• Refined grains and products –such as white baked foods (bread, cake, mandazi and donuts), white rice and white refined flour are easily digestible & release glucose quickly. This causes a rapid spike in blood sugar, followed by a surge of insulin in the blood, typically followed by reactive hypoglycemia –a low energy feeling caused by over-secretion of insulin. This is why we feel so hungry & weak after eating such foods. Such foods also lack some nutrients present in their counterparts –whole unrefined grains.

Watch Importance of Nutrition Video , a short pictorial on cheap available foods that are easy to source within Kenya

Nutrition is irrefutably very important in managing Sickle Cell Disease. Don’t you agree? And this is just a tiny drop from an ocean of health benefits. Log on to see the nitty gritty details of how each nutrient we have talked about helps in managing Sickle Cell Disease & discover their richest sources. But before you do that remember that power is gained by sharing knowledge, feel free to comment below on how nutrition is so important to you. Until then, eat healthy & stay strong.

Love Life!

Sharlene Mule

Healthy Food Pyramid & Healthy Eating Plate

Have you ever wondered how the food you eat affects your body? What food makes us healthier, smarter or stronger, especially when you have a condition such as Sickle Cell Disease? How do we make the right choices in eating healthy with all the billions of food types in the world? You are not alone in asking these questions & fortunately, nutritionists & other health experts have come up with a universal guide to making decisions in eating healthy –the Healthy Pyramid and Healthy Eating Plate.

Healthy Food Pyramid & Eating Plate courtesy of Harvard University

Sickle Cell Warrior #6

10003 Sickle Cell Warrior #6

Donald O..24 Warrior years

It is difficult to put in words that which deserves more than words.
In such a situation when one is rendered speechless, silence is best observed.

Well., most of you who have the pleasure to know Donald may be familiar with his "larger than life" persona and his very eccentric ways of doing things.

I had the pleasure to interact with Donald a couple of years back at a Sickle Cell community meeting in Agakhan. Back then (2012) my Sickle Cell circle of friends wasn't as diverse as it is now and the few people who spoke out about Sickle Cell disease were considered to be brave and mighty titans. Donald was one of these titans.

True to the title, Donald has surpassed various perceived "limitations",mind and body. As sickle cell warriors, we are conditioned to restrict ourselves within the lines of the coloring box. We take what we are told we cant do as gospel truth and many of us live miserable unfulfilled lives. Donald seeks to break those barriers and create new ones, on his own terms. He has been working out and building body mass for almost 2 years now and still going strong. He started slow and grew and he continued to learn and understand his body. He takes care not to over exert himself and stress his body. Aside from his physical body; i believe that in order to see change in the physical, one has to first shift his mindset from the old conditioning of the mind to a mindset that makes everything possible. A warrior needs to have the knowledge on what works for him/her  and the wisdom to apply that knowledge in their daily lives.

Donalds words
"Inability and Disability is all in the mind. What you conceive in your mind comes to be. Pray daily because its the source of power and have faith because everything happens for a reason."

On a lighter note, Donald is a hit with the ladies though fortunately or unfortunately he only holds dear one lucky lady in his heart. Catch up with Donald on his Facebook and continue the conversation on Sickle Cell.

Love Life!
Lea

Sickle Cell Warrior #4

10003 Sickle Cell Warrior #4

Hi

My name is Frida Odee and i'm 25 years old. I am an independent social researcher also studying media, culture and society. Most importantly, I am a Sickle Cell Warrior and I hope to eventually become an accomplished social scientist. I did not know that I had a form of Sickle Cell until four years ago. I was relieved to find out what had been bothering me after years of being sickly. I am a warrior because I hope to inspire and spread awareness on Sickle Cell Disease and let other people know they are not alone.”

Talk to me on  TWITTER and lets continue the conversation as we create awareness of Sickle Cell Disease on 10003 Warrior Project .

Love Life!
Freda

Sickle Cell Warrior #3

10003 Sickle Cell Warrior #3

Hey there, my name is Catherine Odenyo and I am 29 years old. For all those years, I have lived with pain that can’t be explained in words, but each and every moment I have gotten to learn my body more. I didn't know I was a Warrior until I was 18, it was a difficult moment. Now that I know, I have to keep moving forward with hope and joy. And YES! I am a Warrior because I’m still here fighting and haven’t given up.

Love Life!

Catherine

Sickle Cell Warrior #2

10003 Sickle Cell Warrior #2

Hey there, my name is Fredrick Oywer and I am a 22 year old business Information Technology student. I have lived with the disease my whole life and despite the challenges it comes with, I have not let it be a hindrance to my life or even the way I live it. Growing up, I always participated in the same activities that my school mates engaged in and I truly enjoyed my childhood. Now, as a young adult, I still live my life to the fullest and certainly am thankful to God for all my friends and family who have been with me throughout.

Catch up with me on Facebook and let's keep the sickle cell awareness conversation going.

Love Life!
Freddy.

International Day of the Girl Child

Attempting to take selfies with Lady Laimani (top), Hon. Wamalwa (left) and Hon. Odinga (right).

This day was commemorated at the Hilton Hotel, Nairobi. The guest speakers included Hon. Ida Odinga, Lady Laimani Bidali and Caroline Mutoko among others. The Standard Group, Eve Sisters, Mothers & Daughters, Alabastron, Coca Cola and The Kenya Dairy Association are among the partners who made this day a success.

The purpose of the event was to celebrate the girl child in Kenya. This was seen through the invitation of different girls’ schools: primary and secondary. Different women university leaders were in attendance. Filled with pomp, colour and the splash of pink and purple, it was certain that this indeed was a girl’s event. The seating arrangement was strategically organized in dinner tables where 6 young girls from primary or secondary sat together with 4 ladies. I think the main aim for this was to encourage conversation between the different age sets.

The MC, Njeri Karuoya open the event by inviting performances from the different schools that were 

represented. The schools showcased pieces of song, poetry and choral verses that speak of the plight of the girl child in Africa. From poetry about FGM, abortion and sexual abuse to songs appreciating the beauty and the brains of the girl child.

As the speakers took the floor, their main emphasis was motivation creation and the importance of speaking out about issues affecting the girls; for example, the loss of value in the Kenyan girl child and the need for older, more successful role models to come up and guide the girl child. A lot was emphasized on the lack of priorities with regards to the superficial achievements seen in skin color and the size of the behind. This has become a rampant trend in our society,where the pressure to stand on a pedestal of perceived beauty for the acquisition of depreciating assets rather than acquisition of appreciating assets.

Another thing that was mentioned by the very candid Caroline Mutoko, was the message that the media was pumping out to the masses. What is considered attractive is what the media says it is. This creates a sort of cognitive dissonance that sets a high bar for the society especially the females who have to keep up with the likes of Kim Kardashian. The conversation hence shifted to the older woman: mothers, aunts, grandparents, guardians and teachers, the ones who have an obligation to teach and guide. They have supposedly failed in educating the young girl on the challenges of youth, and gifts of motherhood. Many young girls look up to disgruntled mothers and learn from them how lackluster life is which leads to an increased number of children with absentee mothers. The older women were urged to listen to their younger girls. After all, how are the girls to grow into their best selves without support and guidance?

There are instances where we are told we can be anything we want in the world but we fail to get an audience from our "well-off "mothers in the society to help mould our ideas or even mentor us. Young girls seek audience sometimes and they fail to get their mothers attention for one reason or another: goes to show the disparity in communication and information. Older more successful women  in the society refuse to take up responsibility in developing the younger generation, but are quick to point out their evils when they get this information from the media.

I enjoyed the event immensely and managed to get an audience with the guest speakers and VIP to talk about the 10003 Warrior Project. I got advice on who I could approach with regards to propelling the project. I must admit it was quite intimidating sitting and having lunch with the likes of Hon. Yvonne Wamalwa, Hon. Ida Odinga, Lady Laimani Bidali, Doreen Mbaya and Njeri Karuoya.

On my end, the event was a success. Not only because I got to speak to the big “wigs” (pun intended), but because I got to surround myself with young girls from different high schools and learn more about the challenges they are facing. Being able to connect and recall my high school and primary days was invaluable experience. How far I have come from being that shy soft spoken girl, to a very confident out spoken young woman, is such an amazing journey. Of course all has not happened overnight. Instead, I have cultivated simple daily steps and experiences that have helped to expand and grow me to the blooming flower I am.

More selfies, now with the young girls.

However I feel it will only be remembered by the large turn out and beautiful choral verses. I feel the 

young girls, those in my age group especially, still cannot bring themselves to ask for assistance from the older well established woman. A serious case of the fear of being inadequate and the worry of possible rejection. Moreover I also feel the more established woman maybe a little unapproachable to the young woman. Not because they are, but because that’s how they carry themselves, in my opinion. This gap between the two women maybe our undoing. I’m afraid if each of us don’t play our roles and meet each other halfway, we will always have events of commemoration without actionable objectives that will see the Kenyan woman bogged down instead of being uplifted.

Love Life!

Lea.

Progress Report

This past week has been so busy for the team and I. On Friday the 3^rd of October we got officially accepted to the PAWA254 open membership and on Monday the 6^th we were officially welcomed. It was a great opportunity for us as we got free working space sponsored by PAWA254. In addition, we will be guided through our project and the myriad of people and talent that exists there is so impressive. It certainly does make for an amazing working space.

Fast forward to Friday the 10^th, we went for a Crowd Funding BootCamp at iHub* from 9am to 6pm. We were introduced to the 1% Club and The Cheetah Fund. Here we learnt about the importance of crowd funding, how to pitch ideas successfully, social media platforms to use, creative crowd funding and how to plan and present a crowd funding campaign. At the end of the day, we took home a successful campaign online and started getting some funds from supporters of the project.

And lastly, on Saturday the 11^th I attended the International day of the girl child at Nairobi’s Hilton hotel. Read more on it HERE.