The causes and treatment of sickle cell anemia

Healthcare has recently become a very polarizing and contentious issue within the United States. Healthcare expenditures as a percentage of GDP are currently percent. Over the next decade these expenditures are expected to be 20% of GDP or roughly $6.2 Billion. COVID-19 has only exacerbated many of the prevailing trends surrounding healthcare and its subsequent treatment. For one, the government has passed the affordable care act which attempts to lower healthcare costs through a series of legislative efforts. In addition, governments are attempting to redirect healthcare expenditures to focus primarily on outcomes as oppose to simply treatment. This quality over quantity approach is very apparent when revieing sickle cell anemia and its overall complications. Sickle cell treatment typically costs $1,389 per month.

Sickle Cell Anemia is actually a group of interrelated disorders that are often inherited at birth. Here, the disorder results from not having enough healthy red blood cells to carry oxygen throughout the body. Normally, red blood cells are round and circular shaped to allow for seamless passage through various blood vessels. However, with sickle cell anemia, the red blood cells are shaped like a crescent moon and are much more rigid. Due to their shape, these blood cells are much more likely to clog small arteries within the body. This can cause complications as blook flow is restricted to various parts of the body. This could potentially cause a litany of disorders and complications. A number of these complication can have severe adverse effects on the individual. A list of symptoms is provided below. Unfortunately, there is no cure for sickle cell anemia, which means people must incur treatment for the remainder of there life. As noted in the introductory paragraph, these costs can be very large and can often result in financial hardship or difficulty (Murayama, 1973)

1. Adverse Vision Problems – Due to the nature and curvature of the sickle cell, blood vessel within the eyes can potentially become clogged. This can potentially lead to vision impairment as the retina within the eye becomes damaged.

2. Higher probability of infections – Sickle cells have a large probability of damaging the spleen, which is directly responsible of healing infections within the body. As the spleen is damages or impaired, the body is much more vulnerable to infections. Depending on the overall nature of the infection, this could cause still further complications within the individual depending on their diet and nutrition habits

3. Frequent episodes of pain – A very common symptom of sickle cell anemia is short but frequent episodes of pain. This again occurs to the ability of sickle cells to block, clog, or otherwise restrict blood flow to major arteries within the body. This frequently occurs in many of the small blood vessels located in the check, abdomen or joints. The length and frequency of these episodes can vary dramatically. Some individuals may only experience these episodes a few times a year. Other may experience these episodes much more frequently. Depending on the severity, individuals may also need to go to the hospital for extended period of time

4. Anemia – The symptom is what characterizes sickle cell anemia. Anemia is rapid degradation of red blood cells within the body. Typically, red blood cells last for roughly 120 days. Sickle cells, in contrast, live for only 20 days, causing a severe shortage of red blood cells within the body.

As noted above, sickle cell anemia can cause varying degree of complications for an individual. These complications are often inherited with no full cure for the disease. As a result, individuals suffering from sickle cell must deal with it for their entire life.

The cause of sickle cell anemia is a gene mutation. Typically, the gene communicates with the body, telling it to make the iron-rich compound that makes blood red called hemoglobin. This ultimately allows red blood cells to carry oxygen throughout the body, thus enabling general bodily functions such as running or sprinting. With sickle cell anemia, the gene mutates. Here the gene still communicates with the body causing it to make hemoglobin. However, the hemoglobin that is produced creates abnormal red blood cells shaped like a crescent moon as described earlier. These blook cells are rigid and sticky causing a high likelihood of clogging an artery in the body and restricting blood flow. Unfortunately, both the mother and the father can pass this gene onto their children at birth, but the likelihood of doing so is currently unknown. Thankfully, if one parent passing the gene onto the child and the other doesn’t the child will have both the normal and defective hemoglobin gene. This will result in the possibility of the blood containing a fraction of its red blood cells as sickle cells, but the child will not exhibit any symptoms. Here due to having the normal gene, the child may not develop symptoms, but they can still pass the defective gene on to their children. This defective gene heavily impacts African American communities and is much less frequent in other communities. Due to abnormal shape of the cell many complications can arise which are detailed below (Beutler. 1960).

1. Stroke – Due to the ability of sickle cells to clog arteries and block blood flow, they can cause a stroke. In this instance oxygen flow to the brain is restricted causing complications such as seizures, numbness of the arm and legs, speech difficulties and more

2. Chest Pain and Hypertension – As noted above, African Americans are overwhelming the victims of sickle cell. In many instances, the diet of African Americans is high in fat and sodium. This causes further complications as both elements are heavily related to hypertension. Here fat and sodium deposits can clog arteries and blood vessels. This is compounded by sickle cell anemia which can also clog arteries. The combination of both factors can cause hypertension which is high blood pressure. Shortness of breath and fatigue are common complications

3. Chest pain and organ damage – As noted above, as oxygen is deprived from vital organs, this can cause further complication to nerves and organs. This includes organs such the kidneys, liver, and spleen. In certain instances, the lack of oxygen can be fatal for those who don’t take preventative action