Adult Specialty Care
Thanks to advances in sickle cell research and great care by pediatricians, many people with sickle cell are living well into their adulthood. Adults with sickle cell will need specialty care. Rather than referring patients to another clinic, we offer the convenience of appointments with specialty providers at the same time and in the same place.
Barbara Levarge, MD, Pulmonologist (lungs/respiratory system/hypoxia)
Vimal Derebail, MD, Nephrologist (kidneys and blood pressure)
Kim Malloy, MD, Gynecologist (women’s health)
Kim Kasow, DO, Curative Therapies (bone marrow transplant and gene therapy)
Jama Darling, MD, Hepatology Provider (liver)
Specialty Clinics
We provide accessible and comprehensive services to our patients all in one place. You can see your sickle cell provider and a specialty provider with expertise in sickle cell all in one appointment. See our specialty clinic descriptions below.
Psychiatry and Psychotherapy (Mental Health)
Our psychiatrists and psychotherapist see patients for the diagnosis and treatment of mental health disorders such as depression, anxiety, and mood disorders. Living with sickle cell disease can be hard on your mental health at times. Our psychiatrists will listen to what is going on, provide empathetic feedback and help you make a plan to feel better. Our psychiatrists can also recommend and manage medications for mental health. Dr. Scheidler and Dr. Goodman are our clinic psychiatrists. Caroline Hale, LCSW is our clinic psychotherapist.
Chronic Pain
Some patients with sickle cell may experience chronic pain, or everyday pain, in addition to vaso-occulsive crisis pain. Chronic pain may result from avascular necrosis, bone infarcts, osteomyelitis, or a variety of other issues. In this clinic you will see your sickle cell provider, a psychiatrist, a pharmacist, and a psychotherapist to create a plan to better manage your pain.
Nephrology (Kidney)
Sickle cell can affect the organs in your body, in particular your kidneys. Dr. Derebailsees patients (with a sickle cell provider) to treat chronic kidney disease, acute kidney injury, and other kidney issues.
Pulmonology (Lungs and hypoxia)
Sickle cell causes a shortage of red blood cells carrying oxygen to the body. Some patients may experience breathing problems such as hypoxia, sleep apnea, or asthma. Dr. Levarge treats patients with hypoxia or other pulmonary issues, with a sickle cell provider.
Curative Therapies (bone marrow transplant and gene therapy)
There are exciting curative therapies available to some sickle cell patients and many more on the horizon. Dr. Kasow meets with patients to discuss their eligibility for bone marrow transplant or gene therapy studies.
Gynecology (women’s health)
Our gynecology provider, Dr. Malloy, provides regular preventive care to patients as well as contraceptive counseling, fertility counseling, and treatment of gynecologic complications like PCOS and endometriosis. If you are pregnant, she may possibly deliver your baby at UNC Medical Center!
Iron
Sickle cell and thalassemia patients who receive blood products regularly may have a buildup of iron in their organs. This can cause damage to your organs but there are ways to treat this overload. Dr. Wilsonspecializes in the treatment of iron overload.
Transition
Moving your care from the pediatric to the adult clinic can be a big change. That is why our adult providers begin seeing patients at 16 to prepare for this transition.
Transfusion services
Blood transfusion is an important treatment for patients with sickle cell disease. Chronic blood transfusions, usually every 3 to 4 weeks, are provided to prevent new or recurrent strokes in children and adults who are at risk for stroke.
Less commonly, some people with sickle cell disease receive chronic transfusions to reduce the number of painful episodes or the risk of recurrent acute chest syndrome and other complications. Blood transfusions for sickle cell patients require specialized matching. As a result, we work very closely with the Blood Bank at UNC and the American Red Cross to ensure patients receive blood that is closely matched with their own. Automated exchange transfusion, given on the Apheresis Unit, is the preferred method of transfusion for those on chronic transfusions to avoid iron overload.
Social Work Services
There are two social workers with the Sickle Cell Program who provide a wide range of services related to psychosocial needs in coping with this chronic illness, as well as navigation through hospital and insurance systems. They also offer assistance for school, work and financial issues and referrals to community-based and support agencies.