“You were concerned today because [his] eyes were darker
than normal?” Dr. David Goo asks Schenequa Norfleet, “And
you said that he had a low-grade fever of 100.4?” A fever
for her son, two-year-old Quest Norfleet, could mean trouble. He
has sickle cell anemia.

The doctor explains, “they get a minor infection, something
that’s minor in you or me, their body doesn’t fight
it off well and they can get an overwhelming infection.” And
that, he says, could lead to pneumonia.

X-rays are taken of his chest but, “looking at his lungs,
they look normal,” says Goo, “I don’t see any
evidence of pneumonia.”

As for the discoloration in his eyes, “when the eyes get
dark, it means the blood is undergoing what we call hemolysis,
or breakdown,” the doctor explains to Schenequa. In other
words, in a sickle cell crisis, blood cells die when they don’t
get enough oxygen.

A blood test is performed but, “we were able to look at
his biliruben, and the biliruben is the substance that I said when
your blood breaks down, makes your blood turn yellow and your skin
turn yellow,” explains Goo, “and his was less than
.2 which is very low, meaning that it’s not related to the
sickle cell.”

“And that made me think he might have what we call muddy
sclera,” says the doctor, “Muddy sclera is just the
terminology [used] when the whites of the eyes turn really brown,
muddy.”

Among Asians and African-Americans especially, time in the sun
can darken the whites of the eyes. It’s as harmless as a
suntan.

Still, “we’re very happy that you came in today, because
the temperature was low-grade, and any child with sickle cell and
fever, you know, you’re supposed to come in and we’re
supposed to do the work-up,” says the doctor.

Sickle cell anemia is an inherited disease of the red blood cells
that can cause attacks of pain. It can also damage vital organs, cause
serious infections and lead to early death.

Why is it called “sickle?” Unlike normal blood cells,
which are round like doughnuts, sickle cells become hard, sticky and
shaped like sickles used to cut wheat. When these hard and pointed
red cells pass through small blood tubes, they clog the flow and break
apart. This can cause pain, damage and a low blood count or anemia.

Most cases of sickle cell disease occur among African-Americans and
Hispanics of Caribbean ancestry. About one in every 400 African-Americans
has sickle cell disease. It also affects people of Arabian, Greek,
Maltese, Italian, Sardinian, Turkish and Indian ancestry. There are
several forms of sickle cell disease. According to the March of Dimes,
the most common forms include the following:

• SS – The child inherits two sickle cell genes.
• SC – The child inherits one sickle cell gene and one gene
  for another abnormal type of hemoglobin celled “C.”
• S
  beta thalassemia – The child inherits one sickle cell gene
  and one gene for a type of thalassemia, another inherited anemia.

The symptoms of sickle cell disease
vary greatly from one person to the next. Some affected people have
few symptoms, while others are frequently hospitalized. One of the
most serious complications of sickle cell anemia is stroke (bleeding
or blockage of blood vessels in the brain). The March of Dimes says 10 percent
of children with sickle cell anemia have a stroke, which can lead to lasting
disabilities by age 20. The risk is highest between the ages of 4 and 6. Recent
research has found that regular blood transfusions greatly reduce the risk
of a first stroke in children with sickle cell disease. Unfortunately, regular
transfusions pose some major risks, including a potentially fatal buildup of
iron in the body, infections and other problems. Other treatments to prevent
sickle-cell anemia are being tested and studied, with various results.

The Georgia Comprehensive Sickle Cell Center (GCSCC) reports that
most states now perform the sickle cell test when babies are born.
The simple blood test will detect sickle cell disease or sickle sell
trait. Other types of traits that may be discovered include Hemoglobin
C trait, Hemoglobin E trait and Hemoglobin Barts, which indicates
an alpha thalassemia trait.

The GCSCC recommends the following general guidelines to help keep
a sickle cell patient healthy:

• Take the vitamin folic acid (folate) daily to help make new red
  cells.
• Take daily penicillin until age 6 to prevent serious infection.
• Drink plenty of water daily (eight to 10 glasses for adults).
• Avoid too hot or too cold temperatures.
• Avoid overexertion and stress.
• Get plenty of rest.
• Get regular checkups from knowledgeable health-care providers.

Parents of sickle cell patients should watch for the following conditions
that need an urgent medical evaluation:

• Fever
• Chest pain
• Shortness of breath
• Increased tiredness
• Abdominal swelling
• Unusual headache
• Any sudden weakness or loss of feeling
• Pain that will not go away with home treatment
• Priapism (painful erection that will not go down)
• Sudden vision change

In addition to the conditions listed above, the GCSCC suggests
familiarizing yourself with the following complications from which
your child may suffer:

• Pain episodes
• Strokes
• Increased infections
• Leg ulcers
• Bone damage
• Yellow eyes or jaundice
• Early gallstones
• Lung blockage
• Kidney damage and loss of body water in urine
• Blood blockage in the spleen or liver (sequestration)
• Eye damage
• Low red blood cell counts (anemia)
• Delayed growth

Right after school, 18-year-old Patrick Ferrell gets in his car and gets on the phone…

“I talk on my cell phone all the time when I’m driving but I don’t consider it a big deal because, I mean, you just got to watch for the roads,” he says.

But researchers from the University of Utah found that even when watching the road… a 20-year-old talking on a cell phone has the reaction time of a 70-year-old.

“The center of the brain that we call upon for decision making, like in driving, and also communicating is pretty much the same center,” says Psychologist Cathy Blusiewicz, Ph.D., “So it’s as is talking on the cell phone and driving… both of those activities put demands on the same center of the brain.”

“Yea I get really, like if my friend’s telling me an exciting story, I’ll get really really excited and if someone pulls out in front of me,” says 18-year-old Kendra Rasmussen, “I’ll be like, I’ll slam on the brakes or whatever. Because I’ll be paying more attention to my friends than to the road.”

The Utah study found that on average, reaction time was reduced by 18-percent.

“I think it’s very significant,” says Dr. Blusiewicz, “Because when you think of it, I think teenagers are more prone to be risky drivers to begin with. One of the saving graces is they have excellent reaction time… and this is one of the strengths and we’re taking it away with them being on the phone.”

She says parents need to set an example… and as much as possible stay off the phone while driving. And then, just as kids need constant reminders to wear a seatbelt… they will need to hear over and over again: driving while on the phone is dangerous.

“At least planting that seed in their mind that it’s not o-k to do both,” says Dr. Blusiewicz, “Much like we’ve talked to them so much about drinking and driving. Don’t do it, find somebody else to drive. If you have an important call to make, make it ahead of the getting in the car or starting the car up.”

A major committee in the Virginia State House approved a recent bill that would ban anyone under the age of 18 from using cell phones while driving. The approval is significant because the committee has a reputation for being hostile toward any driver restrictions. While the committee did amend the proposal, its approval paves the way for the bill’s passage into law. The bill, which would apply to hands-fee devices as well, would make Virginia the third state to target teenage driving and cell phone usage. The bill stems from a recent wave of teenage driving fatalities in the Washington, D.C. area, including 18 deaths since the beginning of this school year alone.

It is very likely that your teenager will pick up the majority of his/her driving habits from watching you. According to a recent survey by Liberty Mutual and Students Against Destructive Decisions (SADD), nearly two-thirds of teenagers polled say their parents talk on the cell phone while driving, almost half say their parents speed, and just under one-third say their parents don’t wear seatbelts. The following statistics, therefore, shouldn’t be very surprising:

• Sixty-two percent of high school drivers say they talk on a cell phone while driving, and approximately half of high school teens who do not yet drive (52 percent) and middle school students (47 percent) expect they will engage in this behavior when they begin driving.
• Sixty-seven percent of high school drivers say they speed.
• Thirty-three percent of high school drivers say they do not wear their seatbelt while driving.

Cell phones have been transformed from status symbols into everyday accessories. In fact, cell phones are so prevalent among teenagers that a recent study found that they viewed talking on the phone nearly the same as talking to someone face-to-face. And with the latest studies showing that at least 56 percent of 13- to 17-year-olds own cell phones, the issue of cell phone usage is more pertinent than ever.

If you believe your teen should have a cell phone, it is important to lay down a few ground rules. The National Institute on Media and the Family suggests the following guidelines for setting limits on your teen’s cell phone use:

• Choose a plan that puts some reasonable limits on your teen’s phone time. Make sure he or she knows what the limits are so he or she can do some budgeting.
• Let your teen know that the two of you will be reviewing the bill together so you will have some idea of how the phone is being used.
• If use exceeds the plan limits, the charges can mount very quickly. Make sure your teen has some consequences, financial or otherwise, if limits are exceeded.
• Teach your child about the dangers of using the cell phone while driving and the distractions it can cause.
• Find out what the school’s policies are regarding cell phone use and let your teen know that you will completely support the school’s standards.
• Agree on some cell phone etiquette. For example, no phone calling during meals or when it is bothersome or rude to other people.
• Conversely, let your teen know that any “phone bullying” or cheating via text messaging will not be tolerated.
• Let your teen know that his or her use of the cell phone is contingent on following the ground rules. No compliance, no phone.

Washington Post
Liberty Mutual
SADD
Road and Travel
Wired News
National Institute on Media and the Family