Sickle Cell and Pool Safety

Source: Worakit Sirijinda,

This year my family will take a trip to Great Wolf lodge, a family friendly resort and water park. I am excited about the trip and the break, but also concerned about my daughter’s Sickle Cell Disease (SCD) and pool safety. As many of you may know, one of my daughters is living with Sickle Cell Disease, a genetic blood disorder. For many Sickle Cell Patients, they are advised not to swim in public swimming pools or cold-water pools.

Why does cold water pools affect Sickle Cell Patients?

Cold water pools can cause a person living with SCD to be in pain as a result of their blood sickling. Unfortunately, the cold water causes patients to need more oxygen in their muscles, which also decreases the amount of red blood cells the person has because cold temperatures  slows their blood flow and reduces oxygen from traveling throughout the person’s body. Additionally, this decrease in blood flow, causes their blood vessels to become smaller in order to preserve body heat. The lack of blood flowing throughout the SCD patient’s extremities triggers sickle cell pain.Therefore, it is recommended that people with SCD swim in warm indoor pools.

“Warm temperature causes reflexes to open (dilate) blood vessels and send more blood to the skin and extremities to shed heat. This re-distributes blood flow and may shunt blood flow away from parts of the body that need oxygen or need to clear the chemical waste of metabolism. Those parts of the body might then develop sickle cell pain. Sweating helps the body lose heat, but also may lead to dehydration, and dehydration is a common trigger for sickle cell pain. People can adapt to hot weather by keeping to the shade or air conditioning, by drinking a lot of fluids to avoid dehydration, and avoiding excessive exertion while taking frequent rest breaks” (source).

How warm does an indoor pool need to be?

At least 80 degrees. Patients with SCD can swim in indoor pools “if the water temperature is 80 degrees Fahrenheit or above. He/she should dry off immediately when leaving the pool and have a dry robe or towel on at all times. Sudden chills or temperature changes can trigger sickle cell pain. The student should be allowed to stop swimming on request. He/She should [always] be well hydrated before and during swimming” (source).

Do patients living with Sickle Cell always have sickled cells?

In sickle cell patients some cells will always remain sickled, but not all. Thus, extremely cold temperatures should be avoided because cold temperatures increase sickling which causes pain. Currently, research is being conducted by hematologists to understand and come to a consensus about the cause of pain that may continually occur in some sickle cell patients.

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