Patients with sickle cell disease receive their routine care at the outpatient Hematology/Oncology clinics.
Pediatric Sickle Cell Clinic
Pediatric clinics are held on Mondays. Both check-in and clinic are located on the first floor of the North Carolina Cancer Center Hospital at 101 Manning Drive in Chapel Hill.
Adult Sickle Cell Clinic
Adult clinics are held on Fridays. Both check-in and clinic are located on the second floor at the UNC – Carolina Pointe II Comprehensive Cancer Support Program at 6011 Farrington Road in Chapel Hill.
Patient and family education is provided at the time of clinic visits and is a part of comprehensive care.
Sickle cell disease affects just about every organ in the body. As a result, we provide a multitude of specialty services to meet the needs of patients with the disease. We, at the Sickle Cell Program, work very closely with our colleagues in ophthalmology, nephrology, general surgery, hepatology, pulmonology and orthopedic surgery to provide preventive and treatment services.
Access to state-of-the-art imaging techniques plays a major role in the care of patients with sickle cell disease. Imaging modalities available at our center include transcranial Doppler studies for stroke prevention in children, abdominal ultrasound for gallstones, imaging of the bones to evaluate avascular necrosis, and magnetic resonance imaging of the brain for detection of silent infarcts and strokes.
Neuropsychological screening is available to help identify problems, which if not adequately addressed, can affect a child’s ability to learn. Consultations with a psychiatrist are arranged as needed. Pulmonary hypertension is common in patients with sickle cell disease. Because the majority of patients have no specific symptoms, particularly at the early stages of this complication, we routinely screen all our adult patients for this complication.
Patients who are admitted to the inpatient services are routinely followed by the sickle cell team, in consultation with the admitting service.
Blood transfusion is an important treatment modality in patients with sickle cell disease. Chronic blood transfusions, usually every 3 to 4 weeks, are provided to prevent recurrence of stroke in a child who has already experienced stroke or to avoid stroke in a child who has been determined to be 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.
However, blood transfusions may occasionally be associated with life-threatening complications. As a result, we work very closely with the Blood Bank at UNC, Chapel Hill, as well as the American Red Cross to ensure that when patients are transfused, they 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 is a social worker at the Sickle Cell Program who provides a wide range of services related to psychosocial needs in coping with this chronic illness, as well as navigation through hospital and insurance systems. Assistance is also provided for school, employment and financial issues and in referrals to community-based and support agencies. When needed, our social worker helps to coordinate psychiatric and psychological consultations with specialists within the Hospital.