29/08/2025
Anaemia: The Silent Killer in Sickle Cell Disease
Over the last few years, I’ve dedicated my life to writing about warriors rejecting blood transfusion in Nigeria. I know it’s a sensitive topic, but one we must confront with honesty.
Blood transfusion is not the first line of treatment in Nigeria. In fact, most warriors have already tried “boosting blood at home” before ever getting to the hospital.
But every day, we lose warriors to anaemia These are deaths that the right blood transfusion, at the right time, could have prevented.
Why Anaemia is Deadly in Sickle Cell
* Sickle cells live only 10–21 days, far shorter than normal red blood cells.
* This means most warriors live with naturally lower PCV (Packed Cell Volume)
* Each person has a Stable PCV (baseline PCV) unique to them, which doctors use to guide care.
If your stable PCV is 28%, and your hospital test shows 20%, you’re already in dangerous territory. A drop of just 3 -5% below your baseline can mean a blood transfusion is needed.
What Doctors Look For Beyond Numbers
PCV is not the only deciding factor. Symptoms matter:
* Weakness & fatigue
* Paleness
* Palpitations (fast heartbeats)
* Fever
* Loss of appetite
* Severe dehydration or crisis
When a child is too weak to eat or drink, anaemia is already severe. At that point, boosting blood with vegetables or milk will not save them because the body cannot process it anymore.
The Harsh Truth
Anaemia is the number one killer in sickle cell disease.
* Pain crises are loud, but anaemia is silent until organs start shutting down.
* The body prioritizes sending blood to the heart and brain, while other organs quietly fail.
* By the time cardiac arrest or brain shut-down happens, even a blood transfusion may come too late.
Why Rejecting Blood is Dangerous
* Some warriors lie about their stable PCV just to avoid transfusion.
* Others proudly say, “My PCV was 18% and I didn’t take blood,” then advise others to reject transfusion without knowing their baseline or how severe their case was.
* In just the last 7 days, we lost 3 warriors to anaemia 😭😭😭
The Right Time to Boost Blood
* Boosting/building blood is for everyday management , not emergencies.
* The time to eat well, hydrate, and build blood is before anaemia sets in, not when you are already weak.
* When the doctor says blood transfusion is needed, it’s not a punishment, it’s a lifesaving intervention. Even if it is one pint, get it before going to boost
I know some fear “too many transfusions.” Yes, long-term risks exist. But in that emergency moment, saving life comes first. Your hematologist will guide you on managing frequency.
Please , don’t gamble with anaemia.
Check your PCV regularly.
Know your stable PCV.
Don’t wait until weakness turns deadly.
Because every time we delay, we risk another warrior’s life.
Source: from a Warrior Kemi Oguntimehin.