Sickle cell disease

Mention baseball and the thrill of “turning two” to Tyler Davis and you’ll get a big, beautiful smile in return. The Greene County High School rising senior covers second base for the Tigers, plays video games and loves his German shepherds, Django and Lady. And he has sickle cell disease.

Like many other children with sickle cell disease, he was diagnosed at birth through routine testing. His first year of life was filled with a number of the pain crises and episodes of chest syndrome so typical of the disease. Treatment at a local clinic had little impact and one event ultimately led to a visit to Druid City Regional Medical Center in Tuscaloosa. Doctors there referred the family to the pediatric hematologists at Children’s of Alabama.

At that time, Tyler was in the first group of sickle cell disease patients to be screened for stroke risk through then-new technology called transcranial Doppler, or TCD, which tracks the speed of blood flow through the brain. If TCD shows high stroke risk, treatment can begin immediately to, hopefully, prevent its occurrence. “Sickle cell disease is the number one cause of stroke in children,” explained hematologist-oncologist Dr. Lee Hilliard. “The faster the flow, the greater the risk of stroke. Once we implemented TCD screenings here at Children’s, the number of strokes we saw in our patients over a 10-year period went from six to .6 per year.”

Tyler’s TCD showed that he was at high risk so he was started on a regimen of monthly blood transfusions. While the transfusions have prevented a stroke, life-long transfusion causes a new problem – too much iron in the blood. So daily, 12-hour injections to eliminate the excess iron were added to Tyler’s treatment. He continued these painful injections until an oral medication became available several years later.

Fortunately, the regular treatment has been amazingly successful. Tyler once needed nine pills every day but that requirement has been reduced to one pill, once a day. The monthly transfusions have kept pain crises at bay, reduced his risk of stroke and, more importantly, have enabled the witty, outgoing young man to participate in almost all of the activities he’s wanted to—and to plan his future. After graduation, he wants to attend college and study sports medicine.

“Tyler has done a great job because it’s a partnership when you’re treating a patient with blood transfusions,” Dr. Hilliard said. “My job is to do the best I can with the blood transfusions to decrease his stroke risk. The patient’s job is to take the medication to control the iron.”

Others in the Davis family also have sickle cell disease, a not uncommon scenario. Tyler’s mother, Janie, has recommended they seek treatment at Children’s. As for Tyler, his advice to anyone fighting the disease: “If you take your medicine, everything will be okay.”