Last Friday my brother (The World’s Best Uncle – TWBU) and I took AM and his siblings 50 Cedis, G Ketewa and Treasure to the beach. It was a gorgeous day, the waves were just right, the water was sparkling, translucent and a perfect temperature, we had fish and chips for lunch, ice creams on the way home, and everyone had a fantastic time. Except for TWBU, when he had to eat the Bart Simpson ice cream that Treasure licked once and then rejected.
AM took to the waves at the back for five hours, 50 Cedis showed surprising confidence and competence in the smaller waves at the front, and G Ketewa and Treasure grew more and more bold in the shallows.
I mostly left AM to himself – he’s safe in the deep water. The World’s Best Uncle watched the littlies, and I was able to get very wet splashing about in the smaller waves making sure that 50 Cedis didn’t get over-confident and drown himself.
It was a happy day, and since then Treasure has demanded a return to the beach every time she sees me. She may get lucky, I’m hoping to take her on a few excursions once her brothers are all back at school this week. And it’s very hopeful that she didn’t show any signs of sickle cell pain afterwards (she’ s never been tested for it). She certainly got cold enough to have brought on a crisis, if she had it.
The following day I took Abrantie to a heated indoor pool. This was his compensation for missing out on the beach. We hadn’t taken him because we knew it would be hard to keep him out of the cold water and also because we felt that having responsibility for four non-swimmers at once was a bit too much. Plus I think his frustration at not being allowed to boogie board with 50 Cedis would have far exceeded his disappointment about being left at home.
The pool excursion was a mixed success. Abrantie loved playing in the water and had a great time. But he was very much aware that the friends we went with would really have preferred to go in the big, cold outdoor pool right beside it. Being good friends though, they mostly stayed and played with him in the warm, small pool and one of them even tried to teach him to swim – what a hero.
To a non-sickler on a scorching day (42 degrees C) the water in both pools felt pretty tepid, but Abrantie’s red blood cells obviously felt differently about it because by the end of the afternoon he was complaining of pain in his leg. Either he’d spent too long in the water or the water wasn’t quite as warm as usual. I felt terrible: guilty that I’d let it happen, sad that it seemed like taking him to the pool was just too big a risk.
Fortunately, the pain didn’t develop into a major crisis. On the way home in the car I encouraged him to yell and scream and moan as much as he could. I joined in the yelling myself, in Twi and English. Ow, ow ow! Omigod, the pain! Na me adom, awurade, adjee adjee (forgive the spelling, no idea how to write some of these words). He seemed to enjoy this, perhaps because making a fuss about his pain is not really alllowed at home. But I believe in expressing it loudly, providing you don’t frighten other people. It’s not the noise of yelling that’s hurting you, after all.
Once we got back I cuddled him for a while, then massaged his leg with a hot ointment and gave him some nurofen. His mum, Obaapa is in Ghana at the moment – for Nana’s funeral and also the one year celebration for her own mother’s death – so I reckon he needed a bit of mothering.
Well, one or all of the above strategies worked. I was very relieved the next morning to find out that he had slept ok and the pain had receded. Phew.
I’ve had another look around the web and rediscovered the Sickle cell information centre. This site is a fantastic resource which answers a wide range of questions about sickle cell. Here is some of what they have to say about why swimming in cold water causes sickling crises:
“Cold increases the use of oxygen by the muscles and this reduces the amount in the red cells. Shivering is an example of the extreme of this effect. Cold also causes the blood vessels to contract down and become smaller to preserve body heat. This directly reduces blood flow and any sickling of red cells causes further slowing of flow. The slower blood flow also reduces further oxygen in the blood and low oxygen causes increased sickling.”
This is good information. However what I’d really like to read is stories from people about their swimming experiences. Is it something people have given up on doing? Or have people found the optimum indoor pool temperature? Can you swim in tropical seas, which are so warm? Perhaps a trip to North Queensland is in order. Sickle cell is bound to become more of a problem in Australia as more Africans migrate here (It’s most common in people of African descent). Perhaps it’s here, where swimmimg is a national obsession, that we’ll come up with some solutions for swimming with sickle cell? Or perhaps I just have to accept that this is one pleasure Abrantie may have to always forego. It’s not easy. For either of us.