Lameck Domnic O., 15

Lameck is the second-last born in his family and lives with his mother, four siblings, and two cousins in a three-room semi-permanent house. His mother, who works as a casual laborer, is the sole provider for the family. Lameck is a calm child who prefers watching other children play rather than joining them. He is a devoted Christian, serves as an altar boy in the local church, and dreams of becoming a priest in the future. Lameck is a known sickle cell patient. One morning, Lameck complained of extreme tiredness and later went to sleep. When woken up for food, he refused to eat and only asked for water. That night, he began to have continuous nosebleeds which lasted until morning. His mother first sought help at a nearby pharmacy, where the pharmacist gave him some medicine and advised her to take him to a hospital urgently. At the local facility, his bleeding continued, and after stabilization, he was referred to Siaya County Referral Hospital for further care.

Lameck was brought to the hospital with complains of severe nose bleeds and body weakness. He was diagnosed with hemolytic crisis in SCD. This warranted admission, where he stayed for over three weeks. He was administered folic acid, and multiple blood transfusions were done, among other drugs. Lameck was tolerant to the medicine and was able to move around the hospital ward. Eventually he was discharged on orals and booked for a routine follow-up clinic after every thirty days. A call to the mother revealed that Lameck had resumed school and was going about his life and serving as an alatar boy.

Lameck, a known sickle cell disease patient presenting with haemolytic crisis and epistaxis, is at significant risk of severe anemia, hypovolemic complications, and secondary infections. Prognosis is guarded, as haemolytic crisis can rapidly lower hemoglobin levels, precipitating fatigue, tachycardia, and possible high-output cardiac failure if untreated. Epistaxis further worsens blood loss and aggravates anemia. With the timely hospitalization done at Siaya County Referral Hospital, blood transfusion support, hydration, analgesia, and monitoring for complications, the patient’s outlook is fair, and stabilization can be achieved. However, recurrent crises and complications remain a long-term risk in sickle cell disease, necessitating continuous follow-up and preventive care.