In early June (2007) I got a frantic phone call from a lady in Geneva saying her brother “SC” was in hospital in Colorado with Sickle Cell Crisis, and had been on Morphine for 3 days, not getting better. Could I ring and advise? The patient, a professional pianist, was glad to talk to me. Within minutes, I discovered 5 precipitating causes of his crisis:
(1) Alcohol prior to illness
(2) Criss-crossing America flying
(3) Lack of sleep for 2 days
(4) Working too hard without a hoiliday
(5) Dehydration from not drinking enough water [He needed at least 2 Litres water daily]
I asked to speak to the Doctor and I told him (politely):
(1) Take him off the Morphine AT ONCE
(2) Hydrate him with 3 Litres of Normal Saline over 24 hours
(3) Injection Ketorolac subcutaneously 30 milligrams six hourly for just 3 times
(4) Get him out of bed as soon a possible
(5) Treat respiratory infection (if any).
(6) Oxygen to counteract the chest syndrome produced by the Morphine.
“And he will be out of hospital in 48 hours”. He was out of hospital in 48 hours. Alive.
Prof F Konotey-Ahulu.