The hallmark of sickle cell anemia, though, is periodic episodes of debilitating pain like the one that sent Ivor Pannell in search of Percoset. Usually referred to as crises, these episodes occur when blood flow is cut off from an area of the body, and can last for an evening or for as long as two or three weeks. But once a crisis erupts, there are few options. Predicting when episodes will occur is difficult, and patients differ greatly in how their disease manifests itself. It's very variable.
Some patients come here literally every week for a year and then nothing more.
Paige and Walter Culbreth are siblings who both have the disease. Many of these patients have been on opioids around the clock for years, a factor that complicates pain management. Many people on short-acting opioids become dependent and experience withdrawal, which often involves pain similar to that caused by the disease. Untreated pain also causes many of the conditions that precipitate a crisis in the first place. In 1989, Montefiore started an experimental day center designed for sickle cell patients in crisis.