Does your state Medicaid pay for family caretakers? I found it ALL...Pt 1

2017 Medicaid Home Care Benefits - State by State


State Medicaid Policy on Home Care 

Other Options Can Help Residents


In Alabama, there are two waivers help with home care.  These are the Elderly and Disabled and the SAIL Waiver.   Both waivers offer a Personal Choices option which allows self-direction of home care.


Other Financial Assistance
Affordable Care Options in AL



Alaska Medicaid helps residents with home care through Personal Care Assistance.  Participants have the option of choosing their own care providers or having the state manage that process on their behalf.  A new option is the Alaskans Living Independently Waiver which provides many supports for the participants in their homes but does not pay for personal care directly. Finally, the Adults with Physical & Developmental Disabilities Waiver is another option.



Senior Benefits Program
Senior Access Program
Other Financial Assistance
Senior In-Home (SIH) Services
Affordable Care Options in AK



Medicaid in Arizona is delivered on a managed care model.  Participants approved for Long Term Care Services can receive assistance at home.  A second option is the SDAC Program which allows participant to self-direct their personal care.  Lastly, a new program called Agency With Choiceoffers considerable flexibility for participants.


Arizona NMHCBS
Other Financial Assistance
Affordable Care Options in AZ


DAAS ElderChoices is a program that provide supports to help individuals remain living in their homes but not personal care.  Arkansas' sister program, which does provide personal care, is called Independent Choices.  Another option is Medicaid Personal Care.


Other Financial Assistance
Affordable Care Options in AR



In California there are multiple Medicaid (Medi-Cal) programs that provide assistance at home. The NF/AH Waiver, for individuals with more severe needs, the MSSP Waiver for persons with lower levels of impairment. The popular In Home Supportive Services program and finally, the CBAS Program provides for adult day care (which is not home care but can help seniors remain living at home).


Alzheimer's Day Care
Other Financial Assistance
Affordable Care Options in CA



Colorado's Elderly, Blind and Disabled Medicaid Waiver pays for both personal care assistance at home as well as other supports to help individuals remain living at home.  These include modifications to improve the access and safety of the residence.  The CDASS Program is an option for waiver participants which allows them to self-direct these services.


Home Care Allowance
Other Financial Assistance
Affordable Care Options in CO



In Connecticut, Medicaid has a program called the Home Care Program for Elders (CHCPE).  This program is somewhat unique in that it is also open to non-Medicaid eligible residents.  The state also offers the Personal Care Assistance program which is available to residents under 65 years of age.  Lastly, a new option called Community First Choice has eliminated wait lists for home care.


Choices at Home
Statewide Respite Care Program

Other Financial Assistance
Affordable Care Options in CT



Delaware recently switched from a waiver model to a Medicaid managed care model.  As such, the Amended Elderly and Disabled Waiver is no longer an option.  However, home care is still provided under the Diamond State Health Plan Plus.


DE RX Assistance Program
Other Financial Assistance
Adult Day & Alzheimer's Day Care
CARE Delaware
Affordable Care Options in DE



Washington DC offers an Elderly and Disabled Waiver that helps local residents with home care. 


The Caregivers’ Institute

Other Financial Assistance

Affordable Care Options in DC



Florida's recently converted from HCBS Waivers to Managed Long Term Care.  Under SMMC LTC, home care is a covered benefit.  The following waivers are no longer active: Nursing Home DiversionAged and DisabledAlzheimer's DiseaseConsumer Directed Care Plus Waiver


Project R.E.L.I.E.F.
Alzheimer’s Disease Initiative

Local Services Program

Home Care for the Elderly
Other Financial Assistance
Affordable Care Options in FL



Georgia Medicaid offers two waiver options that help with home care; CCSP and SOURCE.  Both waivers offer very similar benefits and have similar eligibility requirements but they are available in different geographic areas of the state.


Non-Medicaid, HCB Services

Other Financial Assistance
Affordable Care Options in GA



In the years during the economic downturn, Hawaii converted its Medicaid waiver programs, Nursing Homes without Walls and Residential Alternative Community Care into managed care.  Home care may still be covered for Hawaii Medicaid beneficiaries but it will be at the discretion of the managed care provider.  Learn more about Hawaii managed Medicaid, now called Med QUEST. 


Kupuna Care
Chore Services Program
Other Financial Assistance
Affordable Care Options in HI



Through the Medicaid Aged and Disabled Waiver, Idaho residents can receive a variety of home care services including personal care, adult day care and respite.  Idaho also has a Personal Care Services Programwhich allows participants to self-direct their care.


Idaho Senior Respite
Other Financial Assistance
Idaho Homemaker Services
Affordable Care Options in ID



In Illinois, the state Medicaid program offers a HCBS Waiver.  Under that waiver, participants can receive services at home.  However, the range of approved services is more limited than in many states.  Another option is the My Choices Project. Unfortunately, My Choices is not statewide.  Unfortunately, My Choices is not statewide, it is only in approximately 10 counties.


Illinois Community Care
Illinois Cares Rx Assistance
Other Financial Assistance
Affordable Care Options in IL



Indiana Medicaid's Aged and Disabled Waiver offers a very wide range of support services to help individuals remain living at home such as home modifications, respite care, meals, supplies and non-emergency transportation.  Unfortunately, personal care is not included.  However, the Indiana Caregiver Homes / Structured Family Caregiving benefit under that waiver does enable personal care through a home sharing arrangement.


Indiana Choice
Hoosier Rx Assistance
Other Financial Assistance
Affordable Care Options in IN



Medicaid in Iowa, through the HCBS Elderly Waiver covers many services to help the elderly remain living in the homes.  These includes personal or attendant care, which can be self-directed.  Another option is the Health and Disability Waiver. Note that this second option is only available to persons under 65 years of age. 


Other Financial Assistance
Affordable Care Options in IA



Kansas offers the Frail and Elderly Medicaid Waiver intended to prevent or at least delay the placement of frail elderly individuals in nursing homes. By providing home care and home support services, the waiver accomplishes this goal.


Kansas Senior Care Act
Other Financial Assistance
Affordable Care Options in KS



Personal care at home as well as other supports to help individuals remain living in their homes are covered by Medicaid in Kentucky.  The program is called the Waiver for the Aged and it is also known as the HCB Services Waiver.  A second waiver called Supports for Community Living Waiver offers support but is intended for the developmentally disabled.


Hart-Supported Living

Homecare Program

Personal Care Attendant
Other Financial Assistance
Affordable Care Options in KY



Louisiana has several Medicaid programs that will provide assistance to residents living outside of nursing homes. These are the PCS Waiver and the new Community Choices Waiver.  The EDA Waiver has been phased out and is no longer an option.


Other Financial Assistance
Affordable Care Options in LA



Maine has two Medicaid programs that provide assistance to elderly and disabled individuals in their homes.  The first is the Older Adults and Adults with Disabilities Waiver which covers a broader set of services and the second is called Consumer Directed Attendant Services.  Although a more limited range of services are available under the second option, it allows the participants to self-direct or choose their own service providers.


Home-Based Care Program

Caregiver Respite Program

DEL and RX Plus
Other Financial Assistance
Affordable Care Options in ME



The Community First Choice Program is now the primary option.  Playing a reduced role is Medicaid Waiver for Older Adults which pays for personal care at home as well as covers the cost of some home modifications to increase the safety and accessibility of the home.  Two other programs also provide help at home.  These are Community Pathways and Community Personal Assistance.


Senior Care Program
In Home-Aide Services
Other Financial Assistance
Affordable Care Options in MD



Massachusetts Medicaid (Mass-Health) has three programs that provide assistance to individuals outside of nursing homes.  The Frail Elder HCBS Waiver provides for a wide range of home care and health services.  The Personal Care Attendant program is more limited in scope but covers most or all of the participant's personal care needs.  Finally, the unique Caregiver Homesprogram allows an elderly individual to move into the home of a caregiver.  In this situation, care is not provided in the beneficiary's home but it is still offered in a home in place of institutional care.


HCP and ECOP Programs
Prescription Advantage
Other Financial Assistance
Affordable Care Options in MA



Medicaid in Michigan has two programs that provide assistance at home.  The Choice Waiver provides for a broad range of services at home, although it is open to only those aged 65 and older.  The Home Help Program is open to younger individuals but covers a more limited range of services. 


Other Financial Assistance
Affordable Care Options in MI



Minnesota has five Medicaid programs that help individuals living at home to receive care or support services.  The Elderly Waiver offers broad-based support, Personal Care Assistance offers personal care and the Consumer Support Grant provides cash assistance to individuals to select and retain their own care providers.  This grant can also be allocated towards home modifications which decrease the participant's reliance on other persons.  Another option is the CADI Waiver.  Finally, the state now offers two managed Medicaid programs that offer home care: Senior Health Options & Senior Care Plus.


Alternative Care Program

Essential Community Supports

Other Financial Assistance
Affordable Care Options in MN



Mississippi Medicaid's Elderly and Disabled Waiver provides a variety of supports and care services to individuals in their homes including personal care and adult day care.  Serving a different audience in their homes in the Independent Living Waiver.


Other Financial Assistance
MS In Home Care Services / Homemaker
Affordable Care Options in MS



In Missouri, Medicaid offers the Aged and Disabled Waiver that helps seniors to receive care support in their homes as does the Independent Living Waiver.  While 24/7 personal care at home is not included, adult day care and homemaker services are.  Also of note are Home and Community Based Services.  Finally, Personal Care is available under the Medicaid State Plan.


Missouri Rx Plan
Other Financial Assistance
Affordable Care Options in MO



Montana, through Medicaid, pays for home care using two programs or waivers.  First, the HCBS Waiver includes assistance with personal care, homemaker services and in several other areas.  The second option, Personal Assistance Services, can be self-directed allowing the participant to select their own care providers.  


Big Sky Rx Program
Other Financial Assistance
Affordable Care Options in MT



Nebraska has a single Medicaid waiver targeting the elderly called the Aged and Disabled Waiver.  This waiver provides some support for assisted living, adult day care and home care services though notably absent from its benefits list is personal care provided at home.  Another option through the regular Medicaid program is called simply Personal Assistance Services.


Lifespan Respite
Other Financial Assistance
SSAD Program
DPFS Program
Affordable Care Options in NE



Medicaid in Nevada offers the HCB Elderly Waiver for non-nursing home care. It also provides adult day care, homemaker/chore services as well as several other supports to help the elderly age in place.  Under the Medicaid State Planpersonal care is also provided at home.



Nevada COPE
NV Homemaker Program
Other Financial Assistance
Affordable Care Options in NV


New Hampshire

New Hampshire’s Choices For Independence Program is a Medicaid waiver that offers a very broad range of support services including personal care and assistance with the activities of daily living in one's home. 


Transitions in Caregiving
Other Financial Assistance
Affordable Care Options in NH


New Jersey

New Jersey recently changed from HCBS Waivers to a statewide Medicaid managed care program called Managed Long Term Services and Supports (MLTSS).  Under this program home care is provided. It can also be consumer directed under the Personal Preferences sub-program. The Global Options Waiver is no longer an option.


Alzheimer's Adult Day Care
Statewide Respite Care
Assistance for Community Caregiving
Other Financial Assistance
Affordable Care Options in NJ


New Mexico

New Mexico recently switched from HCBS Waivers to a Medicaid managed care program called Centennial Care Community Benefitwhich offers home care.  The CoLTS C Waiver and the Mi Via Program are no longer valid options.



Older Americans Act
Other Financial Assistance

Affordable Care Options in NM


New York

In the State of New York there are two very different Medicaid programs that cover home care.  The Managed Long Term Care Program covers a very wide suite of care services and supports but gives the participant very little flexibility or control.   Consumer-Directed Personal Assistance is the opposite.  While it will only pay for a limited range of services to help aging in place, it does offer the participant great choice in who provides them with care.


Expanded EISEP Program

Community Services for the Elderly

EPIC Rx Assistance
Other Financial Assistance
Affordable Care Options in NY


North Carolina

North Carolina Medicaid offers the Community Alternatives Programwhich covers many services that help families to manage the process of caring for a loved one at home.  CAP, as the program is referred to, has a Consumer Choice option that permits the self-direction of certain care services.  However, the Choice option may not be available statewide.  Personal Care Services are available statewide and are a Medicaid entitlement, so no waiting lists exist. Also of note is the Special Assistance In-Home Program for Adults.


In-Home Aide Services

Other Financial Assistance
Affordable Care Options in NC


North Dakota

In North Dakota there is an Aged and Disabled Medicaidwaiver that offers homemaker services, respite care, help for home accessibility modifications and adult day care.  Under the Medicaid State Plan personal care is also provided at home.



Other Financial Assistance
Affordable Care Options in ND
Older Americans Act Services



Ohio offers a Medicaid Waiver that address the challenges of caring for a loved one at home.  Under the PASSPORT Waiver, a broad set of in-home services are available.  Newly available in 29 counties is the managed Medicaid program called MyCare Ohio.


Older American Act Services

Other Financial Assistance

Affordable Care Options in OH



In Oklahoma, home care from Medicaid is available both as a waiver and through the Medicaid state plan.  The waiver program is called Oklahoma ADvantageand it offers many support and care services delivered to the individual in their home.  The Personal Care Program is limited service-wise to only personal care but offers the participant the option of self-directing their care.


Respite Resource
Other Financial Assistance
OK In Home Assistance for the Elderly
Affordable Care Options in OK



Of all the states, Oregon Medicaid offers the most options with regards to home care.  Four different programs cover nearly all services that an elderly individual living at home may require.  The Aged and Disabled Waiver is the most traditional of the four, Independent Choices offers great flexibility in allowing the beneficiary to determine their own care needs and Client-Employed Providerallows participants to hire their own service providers with the state managing the administrative tasks.  Finally, a unique program called Spousal Pay will pay spouses to help care for each other. 


Project Independence
Other Financial Assistance
Affordable Care Options in OR



Pennsylvania offers two Medicaid programs to help with home care.  The Pennsylvania Department of Aging (PDA) Waiver is the more traditional of the two covering a wide range of home care and support services.  Services My Way, the other option, allows great flexibility for the participant to determine their care needs and from whom they receive services.  


PACE Rx Assistance

Options Program

Other Financial Assistance
Affordable Care Options in PA


Rhode Island

Rhode Island has a Medicaid program called Personal Choice that covers personal care at home as well as various other supports as does the Global Consumer Choice Compact Waiver.  RI also has a unique program called RIte@Home.  Although RIte@Home does not provide care in one's home, it allows the participant to move into the home of another individual who provides care, thereby avoiding nursing home placement. 


RIPAE Rx Assistance

Caregiver Insurance Program

Other Financial Assistance
Affordable Care Options in RI


South Carolina

The Community Choice Waiver from South Carolina Medicaid covers home care and other support services for eligible individuals in the state.  The Waiver will also pay for home accessibility modifications to allow an individual greater independence and reduce their need for care services.  Another option is Community Supports.


Older Americans Act

Other Financial Assistance

Affordable Care Options in SC


South Dakota

In South Dakota there are two Medicaid programs relevant to the elderly that cover home care services.  The HCBS Waiver for the Elderly will pay for adult day care, home chore services and home modifications to decrease the participant's reliance on others.  It should be noted that 24/7 personal care at home is not an included benefit.  There is also SD Medicaid Personal Care Services.


Other Financial Assistance
Homemaker, Chore Services & Respite
Affordable Care Options in SD



Tennessee recently replaced its Elderly and Disabled HCBS Waiver which covered home care with the CHOICES in Long Term Care program.  The new program also covered home care in lieu of nursing home placement.


Other Financial Assistance

Homemaker & Adult Day Care

OPTIONS for Community Living
Affordable Care Options in TN



Texas now offers a statewide, comprehensive Medicaid program called the STAR Plus Waiver that helps elderly individuals remain living outside of nursing homes and helps families with caregiving activities.  Also new is the Community First Choice Program.  The former programs titled Primary Home Care, the CBA Waiver and Day Activity and Health Services program are no longer valid options.


CCAD Program
Community Attendant Services
DADS Services to Assist Independent Living
In-Home and Family Support Program 
Other Financial Assistance
Affordable Care Options in TX



The Aging Waiver for Individuals 65 and Older is a Utah Medicaid waiver that covers a very wide range of services that support the elderly participant directly or support their primary caregivers to help them remain living in their home.  Services include personal care, home delivered meals, respite care, home accessibility modifications and other supports. The New Choices Waiverhelps the elderly move from nursing homes into private homes.  Finally, under the Medicaid State Planpersonal care services are provided.



The Alternatives Program 
Other Financial Assistance
Affordable Care Options in UT



In Vermont, Medicaid (or Green Mountain Care) has 4 programs that help with home care.  The Choices for Care program is a Medicaid waiver that covers personal care, adult day care but has largely been replaced by the more comprehensive Global Commitment to Health Medicaid Waiver.  Also available is Attendant Services.  This option is more focused on providing direct support to the individual and less to their caregivers. Finally, for technology dependent persons, there is the High Technology Home Care Program.


Rx Assistance

Dementia Care Respite Grants

Other Financial Assistance
Affordable Care Options in VT



In Virginia there is a Medicaid waiver called the Elderly or Disabled Waiver with Consumer Direction.  Under this program participants can receive a variety of home care services such as personal care, adult day care, respite care as well as other forms of assistance.  Most of these services can be self-directed should the participant choose to do so.  Also worth mentioning is the Technology Assisted Waiver as it helps to pay for technology that enables an individual to continue living independently at home. 


Virginia Adult Services
Other Financial Assistance
Affordable Care Options in VA



The State of Washington has several Medicaid program that help seniors in their homes.  COPES and the Medically Needy In-Home Waiverprovide similar services such as personal care and adult day care as well as other supports.  The Medicaid Personal Care option offers a more narrow range of care options but allows for a degree of consumer choice in care providers.  The New Freedom Program combines the best of both options but is only available in King County.  Lastly, a new program in 2015 is the Community First Choice Option.


Volunteer Chore Services
Other Financial Assistance
Nurse Delegation Program
Affordable Care Options in WA


West Virginia

West Virginia has two Medicaid programs that provide assistance at home.  The Aged and Disabled Waiverprovides personal care and home maintenance services as well as transportation assistance and other minor supports.  Medicaid Personal Care is limited to assistance with the activities of daily living.


Ron Yost Program
Family Alzheimer’s In-Home 
Lighthouse Program
WV In Home Services (for the elderly)
Other Financial Assistance
Affordable Care Options in WV



Wisconsin offers a variety of programs intended to provide help to the elderly in their homes. These are designed to reduce nursing home placements.  The first two are called CIP-II and COP-W  Another option is the IRIS Program which encourages participants to self-direct their care.  However, the IRIS Program may not be available statewide. The Medicaid State Plan offers Personal Care.  Lastly, there is Family Care and Partnership. Note that in 2017, CIP-II and COP-W will be discontinued, thereby leaving Family Care as the primary option.


Community Options Program
Alzheimer's Family & Caregiver Support

Other Financial Assistance
Affordable Care Options in WI



The Wyoming Home and Community Based Services Waiver, whose objective is to lower the number of nursing home placements, offers home care services for eligible participants.  These include personal care, adult day care, transportation, meals and other supports. 

And THIS is why I KEEP yelling!


This baby lost his life because of the STIGMAS that are connected to our illness! How many more people are going to lose their lives bc of this LACK OF RESPECT that Sickle Cell is given? The TRUTH of the matter is that the illness is a blood disorder! So I am going to yell #BLOODISBLOOD SICKLE CELL DON'T DISCRIMINATE AND #SICKLECELL IS #NOJOKE UNTIL MY LAST BREATH! 

Patients RIGHTS 101

Your Health Information, Your Rights.

Get it. Check it. Use it.

The Health Insurance Portability and Accountability Act, or HIPAA, gives individuals the right to see and get copies of their health information or share it with a third party, like a family member or a mobile device application. Having easy access to their health information empowers individuals to be more in control of decisions regarding their health and well-being.  Individuals can monitor chronic conditions better, understand and stay on track with treatment plans, find and fix errors, and contribute information to research if they choose.  

To help explain this important right to individuals and health care providers, ONC and OCR have developed easy-to-understand educational tools in English and Spanish.

HIPAA Access Videos

A series of short educational videos to help individuals better understand their right to see and get their health information and to have that information sent to others of their choosing (including family members, caregivers, or a mobile device application).

Video 1 - Individual's Rights under HIPAA to Access their Health Information: Video 1 provides a high-level overview of the HIPAA access rights and introduces  the topics of fees, timing and sharing health information with a third party. Length 3:27

Video 2 – HIPAA Access Associated Fees and Timing: Video 2 tells the story of Hannah, who is moving across the country.  At her last visit with her current doctor, Hannah asks to have a copy of her records to take with her.  The video helps explain the associated fees, forms and the time it may take for Hannah to get a copy of her records. Length 5:14

Video 3 – HIPAA Access and Third Parties: Video 3 tells the story of Martin who would like to share the health information in his medical record with a heart health application on his smartphone.  The video provides information on the right to provide access to a third party including a mobile application device.  Length 3:16

To learn more about your rights, visit OCR's Rights to Access Health Information under HIPAA Page


HIPAA Access Infographic

This infographic, titled Your Health Information, Your Rights, was created by the Office of the National Coordinator for Health Information Technology and the U. S. Department of Health and Human Services Office for Civil Rights.  The infographic includes facts pertaining to an individual's right to accessing their medical records, a demonstration of how to obtain medical records and tips for protecting health information.

To learn more about your rights, visit OCR's Rights to Access Health Information under HIPAA Page

We've provided an easy way for you to share this HealthIT infographic. Copy and paste this code to your company website or blog.


SickleCell need to know....

Lung function, transfusion, pulmonary capillary blood volume and sickle cell disease.

Lung function abnormalities occur in children with sickle cell disease (SCD) and may be associated with elevated pulmonary blood volume. To investigate that association, we determined whether blood transfusion in SCD children acutely increased pulmonary capillary blood volume (PCBV) and increased respiratory system resistance (Rrs5). Measurements of Rrs5 and spirometry were made before and after blood transfusion in 18 children, median age 14.2 (6.6-18.5) years. Diffusing capacity for carbon monoxide and nitric oxide were assessed to calculate the PCBV. Post transfusion, the median Rrs5 had increased from 127.4 to 141.3% predicted (p<0.0001) and pulmonary capillary blood volume from 39.7 to 64.1ml/m2 (p<0.0001); forced expiratory volume in one second (p=0.0056) and vital capacity (p=0.0008) decreased. The increase in Rrs5 correlated with the increase in PCBV (r=0.50, p=0.0493). Increased pulmonary capillary blood volume may at least partially explain the lung function abnormalities in SCD children.






Being in pain is quite

uncomfortable for most

people. Even minor pain, such

as a stubbed toe or a paper

cut, is unpleasant but that pain

fades relatively quickly.

Imagine being in pain that

never fades, or that fades only

to come back a few hours later.

What would that do to a

person? This is what people

with chronic pain have to deal

with every day.

Chronic pain, a diagnosis

including arthritis, back pain,

and recurring migraines, can

have a profound effect on a

person’s day to day life when it

goes untreated. People dealing

with ongoing or long-term pain

can become irritable, short-

tempered, and impatient, and

with good reason. Constant

pain raises the focus threshold

for basic functioning, which

leaves the pained person with

a greatly reduced ability to find

solutions or workarounds to

even relatively mundane

problems. Something like a

traffic jam, which most people

would be mildly annoyed by

but ultimately take in stride,

could seriously throw off the

rhythm of someone who is

putting forth so much effort

just to get through the day.

After a while, pain wears a

person down, draining their

energy and sapping their

motivation. They sometimes

attempt to limit social contact

in an effort to reduce stress

and to decrease the amount of

energy they have to spend

reacting to their environment.

Eventually, many people with

chronic pain develop

depression-like symptoms: lack

of interpersonal interaction,

difficulty concentrating on

simple tasks, and the desire to

simplify their life as much as

possible, which often manifests

as seeking isolation and quiet.

Sleeping often makes the pain

less intrusive, and that

combined with the exhaustion

that pain induces means that it

isn’t uncommon for a person to

start sleeping upwards of ten

hours a day.

Some recent studies have also

shown that chronic pain can

actually affect a person’s brain

chemistry and even change the

wiring of the nervous system.

Cells in the spinal cord and

brain of a person with chronic

pain, especially in the section

of the brain that processes

emotion, deteriorate more

quickly than normal,

exacerbating many of the

depression-like symptoms. It

becomes physically more

difficult for people with chronic

pain to process multiple things

at once and react to ongoing

changes in their environment,

limiting their ability to focus

even more. Sleep also

becomes difficult, because the

section of the brain that

regulates sense-data also

regulates the sleep cycle. This

regulator becomes smaller

from reacting to the pain,

making falling asleep more

difficult for people with chronic


In addition to making some

symptoms more profound, the

change in brain chemistry can,

create new ones, as well. The

most pronounced of these are

anxiety and depression. After

enough recurring pain, the

brain rewires itself to anticipate

future bouts, which makes

patients constantly wary and

causes significant anxiety

related to pain. Because

chronic pain often mimics

depression by altering how a

person’s brain reacts to

discomfort and pain, chronic

pain often biologically creates

a feeling of hopelessness and

makes it more difficult to

process future pain in a healthy

way. In fact, roughly one third

of patients with chronic pain

develop depression at some

point during their lifetime.

Untreated pain creates a

downward spiral of chronic

pain symptoms, so it is always

best to treat pain early and

avoid chronic pain. This is why

multidisciplinary pain clinics

should be involved for accurate

diagnosis and effective

intervention early in the course

of a painful illness – as soon as

the primary care provider runs

out of options that they can do

themselves such as physical

therapy or medications.

However, even if the effects of

chronic pain have set in,

effective interdisciplinary

treatment may significantly

reduce the consequences of

pain in their lives. There are

any number of common

treatments, which include

exercise, physical therapy, a

balanced diet, and prescription

pain medication. Ultimately,

effective treatment depends on

the individual person and the

specific source of the pain.

One thing is very clear,

however: the earlier a person

begins effective treatment, the

less the pain will affect their

day-to-day life.


What Causes
Sickle Cell

Abnormal hemoglobin, called hemoglobin
S, causes sickle cell disease (SCD).

The problem in hemoglobin S is caused
by a small defect in the gene that directs
the production of the beta globin part of
hemoglobin. This small defect in the beta
globin gene causes a problem in the beta
globin part of hemoglobin, changing the
way that hemoglobin works. (See

How Is Sickle Cell Disease

When the hemoglobin S gene is inherited
from only one parent and a normal
hemoglobin gene is inherited from the
other, a person will have sickle cell trait.
People with sickle cell trait are generally

Only rarely do people with sickle cell trait
have complications similar to those seen
in people with SCD. But people with sickle
cell trait are carriers of a defective
hemoglobin S gene. So, they can pass it
on when they have a child.

If the child’s other parent also has sickle
cell trait or another abnormal hemoglobin
gene (like thalassemia, hemoglobin C,
hemoglobin D, hemoglobin E), that child
has a chance of having SCD.

Example of an Inheritance

The image shows how sickle hemoglobin genes
are inherited. Aperson inherits two hemoglobin
genes—one from each parent. A normal gene will
make normal hemoglobin (A). A sickle hemoglobin
gene will make abnormal hemoglobin (S).

In the image above, each parent has one
hemoglobin A gene and one hemoglobin
S gene, and each of their children has:

A 25 percent chance of inheriting two
normal genes: In this case the child does
not have sickle cell trait or disease. (Case
A 50 percent chance of inheriting one
hemoglobin A gene and one hemoglobin
S gene: This child has sickle cell trait.
(Cases 2 and 3)
A 25 percent chance of inheriting two
hemoglobin S genes: This child has sickle
cell disease. (Case 4)

It is important to keep in mind that each
time this couple has a child, the chances
of that child having sickle cell disease
remain the same. In other words, if the
first-born child has sickle cell disease,
there is still a 25 percent chance that the
second child will also have the disease.
Both boys and girls can inherit sickle cell
trait, sickle cell disease, or normal

If a person wants to know if he or she
carries a sickle hemoglobin gene, a
doctor can order a blood test to find out,


What Are the Symptoms?

TMD often causes severe pain and
discomfort. It can be temporary or last
many years. It might affect one or both
sides of your face. More women than men
have it, and it’s most common among
people between the ages of 20 and 40.

Common symptoms include:

Pain or tenderness in your face, jaw
joint area, neck and shoulders, and in or
around the ear when you chew, speak,
or open your mouth wide
Problems when you try to open your
mouth wide
Jaws that get "stuck" or "lock" in the
open- or closed-mouth position
Clicking, popping, or grating sounds in
the jaw joint when you open or close
your mouth or chew. This may or may
not be painful.
A tired feeling in your face
Trouble chewing or a sudden
uncomfortable bite -- as if the upper
and lower teeth are not fitting together
Swelling on the side of your face

You may also have toothaches, headaches,
neck aches, dizziness, earaches, hearing
problems, upper shoulder pain, and ringing
in the ears (tinnitus).

11 things that you did not know about sickle cell food

Sickle cell disease affects approximately 100,000 people in the United States and millions worldwide. It occurs in about 1 out of every 500 Black or African-American births and 1 out of every 36,000 Hispanic-American births. Let’s review some facts about sickle cell disease that you may not know as well as dispel a few common myths about this blood disorder.

1.Sickle Cell Awareness Month

September is National Sickle Cell Awareness Month. The Sickle Cell Disease Association of American was instrumental in this proposal and it was officially recognized in 1983.

2.Sickle cell disease can occur in any race or ethnic group

Although sickle cell disease has long been associated with people of African descent, it can be found in many races and ethnic groups including Spanish, Brazilian, Indian, Africans and even Caucasians.

3.Sickle cell disease is inherited

It is not contagious like a cold. People with sickle cell disease inherited this condition from their parents and are born with it. Additionally, people with sickle cell trait cannot develop sickle cell disease.

4.Sickle cell disease is diagnosed at birth

In the United States, every baby is tested for sickle cell disease. This is part of the newborn screen performed shortly after birth. Identifying children with sickle cell disease in infancy can prevent serious complications.

5.Sickle cell trait and malaria

Sickle cell trait can protect an individual from becoming infected with malaria. This doesn’t mean a person with sickle cell trait cannot be infected with malaria, but it is less common than a person without sickle cell trait.

6.Not all types are created equal


There are different types of sickle cell disease. The most common is hemoglobin SS but there are also hemoglobin SC and sickle beta thalassemia. The type of sickle cell disease a person inherits determines the severity of the disease.

7.It is more than just pain

There is a lot more to sickle cell disease than just painful crises. Sickle cell disease is a disorder of the red blood cells, which supply oxygen to all the organs. Because sickle cell disease occurs in the blood, every organ can be affected. Patients with SCD are at risk for stroke, eye disease, gallstones, serious bacterial infections, and anemia, to name a few.

8.Children with sickle cell disease can have strokes

People don’t think about strokes occurring in children but children with sickle cell disease have a higher risk than the general population. Physicians who treat children with sickle cell disease use an ultrasound of the brain to screen patients to determine who is at highest risk of stroke and start treatment to prevent stroke.

9.A simple antibiotic changed life expectancy

Penicillin is life-saving. Patients with sickle cell disease are at increased risk of serious bacterial infections. Starting penicillin twice a day for the first 5 years of life has changed the life expectancy from childhood to adulthood.

10.There are treatments available

There is more than pain medications for treating sickle cell disease. Today blood transfusions and medicine called hydroxyurea are changing the lives of people with SCD. These therapies are allowing people with sickle cell disease to live longer lives with fewer complications.


11.There is a cure

Bone marrow transplantation is the only cure. The best success has come from donors who are matched-siblings to the patient with sickle cell disease, but there are trials ongoing looking at other possible donors. In the coming years, gene therapy looks like a promising treatment.

Dispelling Myths about Sickle Cell Disease

Hopefully the above information gave you more information about sickle cell disease and clarified some commonly heard myths about this disease.