SICKLE CELL RAPPER
Summer 2002, The Children's Sickle Center, San Antonio, Texas
When the weather begins to get hot the problem of dehydration increases. It is important that patients with sickle cell maintain an adequate fluid intake.
Dehydration is a lack of adequate body water. Sometimes this lack of water is the result of body losses such as vomiting, diarrhea and increased perspiration during hot weather.
In each person with sickle cell, there are normal red blood cells and irreversibly sickled cells. In a number of the sickled cells, the sickling process may be reversed and the cells return to normal shape. These cells require adequate amounts of fluid to return to normal.
What to do?
- Insure that your child drinks a lot of fluid on hot days.
- If vomiting persists more than 24 hours bring your child to the hospital. Intravenous fluids may be required.
- On very hot days, have your child play in a shaded or other cool place.
- Monitor above signs for beginning dehydration.
- If child has a high fever, give Tylenol or Motrin to reduce fever.
If in doubt call the Children's Regional Sickle Cell Center at (210) 704-3110.
Howard A. Britton, M.D.
Children's Regional Sickle Cell Center
From the Editor
Hot Tips for Keeping Children Cool
During the hotter days of summer, children are at higher risk for dehydration, which occurs when the body's fluid loss is greater than fluid intake. Drinking enough fluid throughout the day is the best way to avoid dehydration.
Normally, children need six 8-ounce glasses of fluid per day. But that need can double with increased activity and length of exposure to high outdoor temperatures.
Because children are more susceptible to dehydration than adults, they should be observed for any signs of mild to moderate dehydration, such as dry mouth, drowsiness, dizziness, disorientation, nausea, and decreased urination.
Parents should be aware of the symptoms of mild dehydration and monitor their children. If children do not receive replacement fluid, severe dehydration can occur, causing unconsciousness and other serious complications.
To protect children from dehydration, encourage parents to make water easily accessible to their children. Suggest that parents:
- Place children's cups and drinking glasses near the home's water cooler.
- Keep refrigerated water and water-abundant fruits (watermelon, cantaloupe, grapes) available.
- Dilute fruit juice with water, or alternate offerings of full-strength juice with offerings of water.
- Avoid soft drinks amd iced tea that includes caffeine, which is a diuretic. A diurectic increases urine output, and thus increases fluid loss, which increases the risk of dehydration.
- Plan ahead on hot days by bringing water bottles on outings, and reminding children to take water breaks during the day.
- Encourage children to drink before they go outside to play.
Infants are at a greater risk for dehydration than older children because their smaller bodies tend to loose fluid faster, and they cannot clearly ask for something to drink.
Parents of infants should be encouraged to monitor their baby's wet diapers. Several dry diapers in a row may indicate dehydration. If an infant needs more fluid than it has been receiving, the baby's body conserves its fluids by decreasing urine output. Monitoring diapers can provide an important warning of dehydration.
During hot weather, exclusively breastfed infants receive enough water from breast milk alone. Whan a breastfed infant starts eating solid foods or formula, it may be appropriate each day to offer about 4 to 8 ounces of water in hot or normal weather.
Formula-fed infants should be offered about 4 to 6 ounces of water per day during hot weather, and formula-fed babies already eating solid foods should be offered about 4 to 8 ounces of water each day.
- Keep infants in the shade, avoiding long exposures to direct sunlight.
- Dress infants in light clothing and keep their heads covered.
To make it a safe summer for everyone, remind parents about the dangers of dehydration through bulletin boards, individual counseling sessions, and nutrition education classes.
[Reprinted with permission from Texas WIC News]
For Your Information (FYI)
Information and educational resources are available for families and individuals with sickle cell.
Texas Department of Health - http://www.tdh.state.tx.us/newborn/sickle.htm
Comprehensive Sickle Cell Centers - http://www.rhofed.com/sickle
My name is Esther Lares, and I have been assigned the responsibility of case management for the Sickle Cell Clinic. Many of you may remember me, as this is not a new task for me. I would like to get to know you and your child. My office is in the outpatient clinic, Room C825. If you have any questions, please feel free to stop by. No appointment is necessary.
I would like to review your funding situation as well as traveling expenses to and from the clinic. My main goal is to help improve the quality of care for sickle cell patients by controlling the cost of care through adequate funding for your child. I will also assist you to access needed services.
Esther Lares, MSW Case Manager
Sickle Cell Clinic
Parent Support Network For Sickle Cell Children
Hello, let me begin by introducing myself. My name is Latesia Umblance and I, like you, am a concerned parent who has a child with sickle cell disease. I have often found myself alone without any outside support. With this in mind, I have decided that we need a support group. There have been several attempts to start groups, but for various reasons they grew apart. As a parent, I did not understand that because there are still many parents who need the support. This is where I have stepped in. I want to be able to develop a strong, supportive organization that will stand.
In order to make this happen, we need concerned parents like you. If you would like to be a part of the Parent Support Network of Sickle Cell Children (PSN), I would love to hear from you. Please send your questions, concerns, or comments to the address below.
Together, we can make a difference
Parent Support Network for Sickle Cell CHildren
7019 Solver Canyon
San Antonio, TX 78244
The Importance of Fluids
Children with sickle cell disease will always have a special need for adequate fluids. These children demonstrate this by being thirsty more often than other children. During the summer, when the temperatures soar and activities are often held outdoors, a loss of fluids can easily occur through increased sweating. To maintain normal body functioning, it is important to keep a balance of body fluids. Whenever there is a loss of body fluids, the child should drink more water and juices and eat such things as soup and ice chips.
Your child needs more fluid when:
- He has a fever.
- He has pain.
- It is hot outside.
- He is very activie.
Signs of dehydration:
- Decreased urination.
- Dry skin and mouth.
- Increased heart rate.
- Thirst with loss of appetite.
- Pale skin.
- Weight loss.
If you notice any of these signs of dehydration, contact your pediatrician or the Regional Sickle Cell Center immediately.
Amount of Clear Fluids Your
Child Needs Each Day
||Number of 8 oz. Cups per day
|Over 60 lbs.
||10 or more cups
Coming Events of Interests
30th Anniversary Combined Meeting September 17-21, 2002.
The NIH (National Institutes of Health) Comprehensive Sickle Cell Centers will combine with the Sickle Cell Disease Association for a National Sickle Cell meeting in Washington, D.C.
CHRISTUS SANTA ROSA
The Children's Sickle Cell Center
519 West Houston Street
San Antonio, Texas 78307-3198
(210) 704-2187 (800) 227-3618
(After hours, call 704-2011 and ask for Hematologist on call.)
Anne-Marie Langevin, MD
Chief, Division of Pediatric Hematology/Oncology-UTHSC-SA
Howard A Britton, MD, FAAP
Medical Director, Pediatric Hematologist/Oncologist
Reginald Moore, MD
Associate Medical Director, Pediatric Hematologist/Oncologist
Javier R. Kane, MD
Anthony Infante, MD, PhD
Pediatric Hematologist/Oncologist Immunologist
Paul J. Thomas, MD, FAAP
Director, Pediatric Oncology Clinical Services
Shafqat Shah, MD
Leanne Embry, PhD
Psychology Fellow/Assistant Professor
Elisa Ornelas, LSW
Sickle Cell Social Worker
Yvonne Shannon, RN, MSN
Sickle Cell Disease Nurse Coordinator
Editor of the Sickle Cell Rapper