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But when they grew older and more independent, she often wondered whether her kids were taking their medications and getting enough rest and proper nutrition. They need help with this. Parents can benefit from information on how to handle this change. To help with this in her own family, she would check in with her sons to make sure they were doing what they needed to be doing such as taking their medication and issue helpful reminders.

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For example, she would remind them of upcoming doctor appointments, as well as remind them, about a week before their medications were due to run out, that they would need to call the pharmacy to request a refill. The demands of sickle cell disease are unpredictable. Planning a vacation without travel insurance is not an option for us. Her youngest child, Mikaili, had more issues with pain crises, and eventually had to have surgery for avascular necrosis bone tissue death. Her middle child, Khari, has only had one crisis to date, which was due to lack of adequate hydration during a basketball practice, but has experienced retinopathy issues eye damage.

Our faith in God is core to everything we do. Practicing our faith keeps us grounded and focused on managing the current challenge. Our work life, our personal life, we even socialize in the arena of sickle cell disease if some [sickle cell] events are being held. Now that my boys are young men creating their own lives, I am working on defining my life and maintaining a healthy balance.

In many ways, though, sickle cell has had a positive influence in their lives. When something happens, we have an unspoken, informal process of sharing information with each other, and we work together. They do a lot through MSCDA, and have recently helped develop Maryland state guidelines recommendations for the management of sickle cell disease in schools. They are also working with major teaching institutions in their area to connect people to specialty providers. In addition, they connect people to resources, hold an annual patient and provider conference to discuss relevant sickle cell topics like eye care and the Cure Initiative, and have formed grass roots support groups.

By continuing to work very closely together as a sickle cell disease stakeholder consortia, we can get even more done. Her middle son, Khari, is an undergraduate studying theatre and acting at Towson University in Towson, Maryland. And her youngest son, Mikaili, is an undergraduate student studying clinical psychology, with an interest in sports psychology, at Hood College in Frederick, Maryland. He is also living with sickle cell disease. In , Lance was diagnosed with sickle cell SS, or sickle cell anemia, the most severe form of the disease. He was only 2 years old.

Since birth, Lance has experienced chronic pain; as an infant, he cried all the time. While hospitalized for what appeared to be a broken finger, doctors ran some blood tests; the results showed that Lance had sickle cell disease. The news came as a total surprise.

Lance was the youngest of three children. His sister, the oldest of the three siblings, did not have sickle cell disease or the trait for sickle cell disease. His brother had the sickle cell trait, but did not have any signs or symptoms of the disease, so no one even knew he had the trait until Lance was diagnosed.


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Throughout his life, Lance has had numerous health complications from sickle cell disease. He has been hospitalized more times than he can count. The doctors did not expect him to live into adulthood. In middle school, Lance developed avascular necrosis AVN , and was confined to a wheelchair for 2 years. AVN is a painful condition in which there is a loss of blood and oxygen to the bone, causing tissue in the joints to die.

As a result of this complication, Lance will need to have a hip replacement before his 32 nd birthday.

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By age 22, Lance has already suffered two lung failures. According to Lance, no one in his family knew anything about sickle cell when he was diagnosed, and it had a devastating impact on his family. My mom, a nurse at the time, lost her job because she needed to stay home and take care of me. Her career goals were gone. My parents also had a separation period because of the hardships. To them, I received special treatment because I needed it and they got less time and attention from my parents.

My parents always saw me as the sick child.


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But with my siblings, they let them spread their wings. This was especially important because Lance was one of the first sickle cell patients to take hydroxyurea, a drug that reduces pain crises in patients with severe sickle cell disease. In addition, due to a build-up of extra iron in his body called iron overload caused by monthly blood transfusions, Lance had to take a medication called Desferal at home that required an IV, which his mother taught him to use early on. As I got older, I became more knowledgeable and began to take my life and health into my own hands.

I was prepared to read the paperwork and talk to the doctors. According to Lance, the biggest way that his mom supported him in school was to make sure he was able to get the necessary accommodations and time needed to make up assignments due to missed days at school. She even arranged for tutors to come to his room when he was admitted to the hospital. Outside of school, his parents got involved in walk-a-thons and donated money for sickle cell disease research.

Lance is extremely involved in the sickle cell disease community. He is a volunteer for the Sickle Cell Disease Foundation of California and a mentor for SC Crew, a program that helps youth with sickle cell disease navigate their teen years. When both parents have sickle cell trait SCT , there is a 1 in 4 chance that each of their children will have sickle cell disease SCD. Although both Fatimah and her older sister have SCD, the disease illness affects them differently.

For me, I would be in and out of hospitals all the time. I had really bad pain crises, and I would get really bad headaches and pain in my stomach. When Fatimah was around 7 years old, she experienced a terrible pain crisis. Her pain and health continued to worsen. They took her to the emergency department ED for treatment. While in the ED, her heart rate dropped, and doctors treated her to bring her heart rate back to normal.

When I got up, the whole right side of my body gave out; I just collapsed on the floor. For Fatimah, frequent visits to the hospital and ED was a part of her childhood. If it got to that point, then I would let my team and coach know. Despite the health challenges she faced, Fatimah never wanted her SCD to influence who she was and what she could achieve. My older sister is studying to be a doctor because of me. She is studying hematology and doing sickle cell research. She told me she met a patient one day in her clinical rotations, and the patient, who also has SCD, was surprised my sister was going to school and becoming a doctor.

How do you manage take care of it? She was interested in fashion and modeling, and she wanted to take the opportunity to explore Milan, a fashion capital, and absorb the rich culture the city had to offer. Why miss out on an opportunity to live in another country? I was scared. I had to be up at 4am to be on the train and be at the hospital for my appointment. She kept her spirits up by putting her healthcare needs into perspective.

Fatimah is expected to graduate as a finance major in May She has already accepted a full-time job at JP Morgan Chase, which she will begin after graduation, but she plans to continue pursuing her dreams in travel, blogging, and fashion as well. Fatimah wants to encourage other people like her who are living with SCD to know that they can live a full life.

But, occasionally, there are problems. People with SCD are born with two sickle cell genes, but people with SCT are born with one normal gene and one sickle cell gene. However, in very extreme conditions, such as in high altitudes or when dehydrated, people with SCT can experience shortness of breath, pain crises, and other health problems related to SCD.

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In , Dr. RMC arises from the lining of the inside of the kidney. RMC is an extremely rare and aggressive type of cancer external icon , and information on RMC is still limited. Despite Holmes' remarkable reasoning abilities, Conan Doyle still paints him as fallible in this regard this being a central theme of " The Adventure of the Yellow Face ".

Though Holmes is famed for his reasoning capabilities, his investigative technique relies heavily on the acquisition of hard evidence.

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Many of the techniques he employs in the stories were at the time in their infancy for example, Scotland Yard's fingerprint bureau opened in Because of the small scale of much of his evidence, the detective often uses a magnifying glass at the scene and an optical microscope at his Baker Street lodgings. He uses analytical chemistry for blood residue analysis and toxicology to detect poisons; Holmes's home chemistry laboratory is mentioned in "The Adventure of the Naval Treaty".

Ballistics feature in "The Adventure of the Empty House" when spent bullets are recovered and matched with a suspected murder weapon.