It's very frustrating for the child and family. Dr. Glass explained there might not be any obvious signs during a pain crisis. Vital signs and physical exams are not as effective as asking the patient. School-age children are asked to rate their pain on a scale of one to 10. If they say their pain is an eight, Dr. Glass administers medicine to reduce the pain to what the patient says is a tolerable level.
Most patients identify a pain score of two to three as something they can manage.
Commonly, oral narcotics are recommended, and when that is no longer effective they are admitted through the emergency room. If the pain is in the lower extremities or the lower back, we can use an epidermal analgesia. Morphine and other agents have replaced Demerol, which accumulates in the body and places the patient at risk for seizures. Dr. Glass notes that sickle cell patients do not use or ask for narcotics when they are pain-free and are not at a greater risk for developing opiate addiction than the general population.