Hosea 4: 6 (KJV)
My people perish from a lack of knowledge.
Its one thing to know your Bible, but its an other thing to KNOW the God of the Bible.

Ibn Mas`ood, radiallaahu `anhu, said: “True knowledge is not measured in relationship to how much you memorize and then narrate, but rather,true knowledge is an expression of piety [protecting oneself from what Allaah prohibited and acting upon what He mandated]. “Also, “Study and act upon what you learn.”

Some very religious people in Nigeria, always have this mindset that God will always shew mercy and forgive us our wrong deeds. While this is true, please bear in mind that forgiveness of sins and human errors doesn't mean that you will not suffer the punishment of actions or errors.
As I am typing this, there are some couples who are AS/AS or AS/SS, who are planning to go ahead with their union knowing fully well that a SS child may result from the marriage. If you are trying to advice them against their union you are most likely to hear, "It is not our portion".
If it is not your portion, why then are you tempting God?

Sickle Cell crisis can come in gradual process or it can occur suddenly. There are certain factors that trigger off these crisis which may range from very mild pains to serious and mind wrenching pains. I will list these factors below and try to explain them to the best of my ability(Please bear in mind that these factors are by no means an exhaustive list). Doctors and other care givers in the house, I wouldn't mind if you contributed. (ACM10, I believe your input will be invaluable in this thread).
The Factors
.....Dehydration
.....Eextreme Fatigue
.....Stress/ Anxiety
.....Infection (Bacterial or Fungal)
.....Trauma/ or Shock
.....Physiological Demand
..... Sudden Change in Temperature
.....Acidosis
.....Hypoxia

Dehydration
In physiology and medicine, dehydration (hypohydration) is the excessive loss of body water , with an accompanying disruption of metabolic processes . It is literally the removal of water from an object; however, in physiological terms, it entails a deficiency of fluid within an organism.
www.wikipedia.org/wiki/Dehydration
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Dehydration:
This is when your body has lost too much fluid. Losing body water makes it more likely that red blood cells will block your blood vessels. With sickle cell disease, your kidneys are not able to save as much body fluid as people who do not have the disease. This makes you more likely to get dehydrated. This can happen when it is hot outside. It can also happen if you do not drink as much liquid as your body needs. You are more likely to get dehydrated if you are at high altitude (such as in the mountains). Dehydration is also more likely if you exercise without drinking enough liquid.
www.drugs.com/cg/sickle-cell-crisis.html

I can't remember having a crisis due to dehydration (lack of fluid in my system). The only thing I know is that I love drinking water, even when I was a kid and have not known much about Sickle Cell. My mum and siblings used to tease me with that, but unknowingly water has been a kind of life saver.
It is very necessary that a Warrior keeps his/her body hydrated. The importance of water as the oxygen carrier in the human body cannot be exagerated. The good news is that water is cheap and affordable.
Mummy and Daddy, it is not too much of a task to boil your drinking water and then filter it. I know we now have "pure" water these days and we also have table/bottled water. But the old method used by mum and other mums in the neighbourhood while growing up is still advicable for that warrior child.

Extreme Fatigue
Fatigue (also called exhaustion , tiredness , lethargy , languidness, languor, lassitude , and listlessness) is a subjective feeling of tiredness which is distinct from weakness , and has a gradual onset. Unlike weakness, fatigue can be alleviated by periods of rest. Fatigue can have physical or mental causes. Physical fatigue is the transient inability of a muscle to maintain optimal physical performance, and is made more severe by intense physical exercise .
www.wikipedia.org/wiki/Fatigue_(medical)

Ok, we all understand what fatigue means. But how many of us (All genotypes) know what causes fatigue?
Common Causes of Fatigue
...Eating Junk Foods.... There is a cliche "you are what you eat". Foods that are high in saturated fat, processed foods and added sugar can really drain your energy. (Do I have any witness in the house?).
Today, our cities are littered with Fast Food Joints where gbogbo big boys and babes go for relaxation and hook ups. (I am equally guilty of this oh! afterall something must kill man....#justjoking). But some of these habits of depending on junks as food is really bad.
And for a warrior, you really need to watch what you eat. I can remember when mum first called my attention to this fact. I was like "woman, can't I even enjoy this life small... what is all this naw"
Be careful of Junk foods....that's all.

...Lack of Sleep is another cause of fatigue.
I don't know about others but I normally have insomnia (i.e is I sometimes lack thee ability to fall asleep or sleep for a long time).
Even as I am typing this, I have only had about 3 or 4 hours sleep in 24hours. I went to bed around after 12am and by 4am till now I have not been able to sleep and I hate taking sleeping tablets.

....insufficient amount of exercise...
Yeah, are you surprised? Lack of exercise or not nearly enough exercise can cause you to have Fatigue.

....Another cause of Fatigue is lost of nutirents: Minerals and vitamins.
Deficiencies in these: Solenium (important for thyroid function and metabolism), Iodine (present in salts), Vitamin D (gives us energy), Magnesium (also needed in energy production, especially in our bones and muscles) etc.

Stress /Anxiety
A certain amount of anxiety can be helpful because it motivates us to perform, but too much can trigger a sickle cell crisis and this should be avoided. In late childhood and early adulthood the most common cause of anxiety and stress relates to stresses in the educational environment for example when preparing for exams. Emotional stresses such as bullying in school can also contribute to this. In adulthood work related stresses, adult relationships, financial pressures and other challenges of adulthood can compromise the well being of someone with sickle cell disease. If these cannot be managed by the individual and their family it is be worth discussing the problem with the specialist nurse, GP, hospital doctor, social worker or psychologist.
www.sickle-thal.nwlh.nhs.uk/ForPatients/KeepingWellWithSickleCellDisease.aspx

Exam related anxiety is one of the most common triggers of crisis in warriors. In my other thread www.nairaland.com/1087596/facts- myths-sickle-cell-disease I told a story of how I fell ill just weeks before my promotional exam in JSS 2.
I use the method taught by my principal to overcome anxiety... "EVEN THIS SHALL COME TO PASS"

Infections are common and an important cause of severe complications. The most common organisms causing infection in children with sickle cell disease include: Streptococcus pneumoniae (can cause pneumonia, blood infections, or meningitis) Haemophilus influenzae (also a cause of pneumonia, blood infections, and meningitis). Such infections pose a serious threat to infants and very young children with sickle cell disease. They can progress to fatal pneumonia with devastating speed in infants, and death can occur only a few hours after onset of fever. The risk for pneumococcal meningitis, a dangerous infection of the central nervous system, is also significant.
Infections are also common in older children and adults with sickle cell disease, particularly respiratory infections such as pneumonia, kidney infections, and osteomyelitis, a serious infection in the bone. (The organisms causing them, however, tend to differ from those in young children.) Infection-causing organisms include: Chlamydia pneumoniae and Mycoplasma pneumoniae. These are the important infections in acute chest syndrome.
Gram-negative bacteria. This group of bacteria mostly infects hospitalized patients and can cause serious pneumonias and other infections.
Reference:
www.pennstatehershey.adam.com/content.aspx?productId=10&pid=10&gid=000058

I believe one can stay free of infction by taking his/her personal hygiene a little more serious. Simple things like;

washing of hands regularly (before meal, after meal, after using the conviniences etc).
Not sharing personal effects with any other person.

Practicing safe-cooking and using neat cooking utensils.

Being mindful of how you play with pet animals in you environment.
Also, getting vacinated against some virus or bacterial infections.
The list is almost endless.

Trauma/ or Shock
Trau·ma:
1. A serious injury or shock to the body, as from violence or an accident.
2. An emotional wound or shock that creates substantial, lasting damage to the psychological development of a person, often leading to neurosis.
3. An event or situation that causes great distress and disruption.
Reference:
www.encyclopedia.thefreedictionary.com/_/dict.aspx?word=trauma
__________________________
In medicine, shock may refer to any of the following:
Circulatory Shock (commonly called shock is a life-threatening medical condition that occurs due to inadequate substrate for aerobic cellular respiration . In the early stages this is generally an inadequate tissue level of oxygen .) ,
Shock or Acute stress reaction (also called acute stress disorder , psychological shock , mental shock , or simply shock is a psychological condition arising in response to a terrifying or traumatic event. A psychological condition in response to terrifying events)
Cold shock response (is a physiological response of organisms to sudden cold, especially cold water).
Reference:
www.wikipedia.org/wiki/Shock

I don't really have much to say about shock and trauma. But I have read a couple of times where Warriors complain that most times when they are woken up from sleep they will fall ill afterwards. I may be wrong, but I believe that when someone suddenly wakes up from a deep slumber there is a kind of tremor or shock waves that goes through the persons system. What I do know that whenever I am woken up by my alarm clock or someone banging on the door or a shout, I normally experience severe head ache that may last through out the day.
Again, emotional cause can even make people who are not warriors to break down not to talk of warriors. By emotional shock I mean, the death of a close relative, huge financial loss, break down in relationships....etc. But when it comes to emotional shock, I thank God for giving me the ability to *cry* my eyes out and after that I will forget about the pain (this method is my own shock absorber).

Hey my people, some of you will be wondering what has happened to this thread.
Maybe the Op does not want to complete what he started...... The truth is that, I am having a battle of my own with SCD. It wants to remind me that knowing so much about it does not stop it from attacking me from time to time...
But not to worry, the victory belongs to God. I will resume soon enough.
NB
Moreover this is the first time my girlfriend is witnessing anything close to crisis. Lookink at her frightned face, I just pity her.
Ciao.

Physiological Demand
Physiological demands such as Pregnancy and Menstruation in the female sickle cell person can also trigger off crisis. Female warriors who are pregnant may often experiences episodes of crisis. While normally monthly flows in female warriors can lead to crisis episodes if the HB level is low.
With care and patience, a female warrior will carry her pregnancy to term. But it is adviceable to religiously adhere to the doctors instruction(s) during her pregnancy.

Sudden Change in Temperature
I believe the higher the altitude the less the oxygen available for intake by human beings. So, it is safe to say that flying sometimes can lead to a crisis in a person living with sickle cell. Also mountain climbing can also induce painful crisis.
At least I have had an experience with that of mountain climbing. When I participated in endurance trek during my Service year. As we got to the top of the hill (I don't know if Nigeria has a mountain) I started having dizzy feelings as if I was going to faint, but I has some glucose and water with me so I managed to actually complete the exercise without any major incidence.
But that of airplane I don't know. Since I have flown a couple of times and did not witness any change.

Acidosis
Acidosis is a condition in which there is too much acid in the body fluids. It is the opposite of alkalosis (a condition in which there is too much base in the body fluids).
Lactic acidosis is a buildup of lactic acid which can be caused by: Alcohol
Exercising vigorously for a very long time
Liver failure
Low blood sugar (hypoglycemia)
Prolonged lack of oxygen from shock, heart failure, or severe anemia
Seizures. etc
Reference:
www.medlineplus.gov/

Hypoxia literally means "low oxygen," but is defined as a deficiency in the amount of oxygen that reaches the tissues of the body. The lack of oxygen in tissues is also known as "oxygen starvation." If a complete lack of oxygen occurs in the tissues, it is termed anoxia.
Hypoxia may affect the whole body (generalized hypoxia), or a specific organ or area of the body (tissue hypoxia). It can also be classified as acute or chronic, with acute meaning a rapid onset, and chronic meaning that hypoxia has been ongoing for some time.
Reference:
www.lungcancer.about.com/od/Respiratory-Symptoms/a/Hypoxia.htm

One of the types of hypoxia is Anemic hypoxia, which is set off by a low hemoglobin level and results in a reduced ability of the blood to carry oxygen that is breathed in, and hence, a diminished supply of oxygen available to the tissues.
Causes of Anemic Hypoxia:
Anemia of any cause – This can include iron deficiency anemia, pernicious anemia, and chemotherapy induced anemia . ~Hemorrhage
~Methemoglobinemia- also known as affinity hypoxia, is an abnormal hemoglobin that doesn't bind oxygen very well.
~Carbon monoxide poisoning - With Carbon monoxide poisoning, hemoglobin is unable to bind oxygen.
Reference:
www.lungcancer.about.com/od/ Respiratory-Symptoms/a/Hypoxia.htm

Another informative piece from the Warrior. May God continue to strengten you and enrich you with knowledge.

This thread may not be as interesting and full of comments like others by the Op, but it is by far more informative and useful especially to warriors.

I've always wondered. How is SCD symptoms detected In babies? How do the parents know their babies are having a crisis when the poor babies can't express themselves?

dominique: I've always wondered. How is SCD symptoms detected In babies? How do the parents know their babies are having a crisis when the poor babies can't express themselves?

I guess if the parent(s) has a good knowledge of the SCD it is possible to look out for those symptoms that are ever present in crisis episodes.
One of the obvious signs is painful episodes... the baby may be crying and at the same time being very restless. If the parent(s) has ruled out other physiological needs of the child.

I can't access PMs from NL.... Any PM for me can go to the email on my signature.

dominique: I've always wondered. How is SCD symptoms detected In babies? How do the parents know their babies are having a crisis when the poor babies can't express themselves?

that is because a neonate has haemoglobin F predominant in his/her blood, so a newborn baby wont have any signs or symptoms until he/she is about 6months old.....

one of the first signs a mother will notice on her child (if the child has the HbS genotype) is swelling of the hands and feet (dactyylitis) not caused by excess fluid but because the bone endings ae trying to compensate for the anaemia setting in, remember its the bone marrow that manufacture blood cells....

also, there may be frontal bossing of the forehead, gum disease, recurrent infections and the characteristic "egg on stick" appearance

a sickle cell patient gave birth in the hospital where i work, she called me and said:

"is this the pain of childbirth, is that all.... this is nothing compared to the crisis i go through..."

i also remember another lad having an EBT, doctors were busy setting line for over 6hours, a procedure that shouldnt take up to 45-60minutes....

if you are out there, and you still think of marrying the AS/AS way, then think twice, or you want your kids to curse you

^^^Lagusta, thank you for commenting on this thread. We need more people in the Medical profession to join in our discussions or threads. SCD is something that must concern all of us, be you AA, AS, SS, AC, SC, etc. It is not enough to tell us to be careful of herbal medicines and not provide an alternative in English medicines (My doctor friend is fond of giving me that warning).
I will appreciate it a lot if Doctors and other medical personnel can join our discussions once in a while and tell us their experiences in handling cases that has to do with SCD.