Q: As a sickle cell anaemia patient, which type of exercises am I supposed to do on a daily basis for a healthy living? I take 500 mg hydrea (Hydroxyurea) daily for the past 9 months, and since then I am living a healthy life with fewer incidents of pain and crisis. Is it safe to take hydrea for longer periods of time?

A:Exercise regularly but not so much that you become really tired. When you exercise, drink lots of fluids, at least 8 glasses of water a day, especially during warm weather. Due to anaemia, you may have less stamina than haematologically normal individuals and therefore exercise should be at your own pace. Aerobic exercises like running, swimming, walking and biking are recommended. Avoid swimming in cold water. You should acclimatise gradually to heat and humidity and condition carefully and gradually for several weeks before engaging in strenuous work-out. If going to an altitude, acclimatise to it over an appropriate period of time. A lot of research is on to identify drugs that interfere with the sickling process and prevent many of the complications of sickle cell disease. Till date, the only drug approved is hydroxyurea as it has shown a decrease in incidence and severity of pain. Its mechanism of action is thought to be due to the induction of fetal haemoglobin synthesis. The dose of hydrea is 20 mg/kg/d orally and this can be increased by 5 mg/kg/d every 12 weeks to maximal acceptable toxicity, usually considered to be a total leukocyte count (TLC) above 4000/µl. Till such time that a stable dose is established, a TLC should be done fortnightly and liver & kidney functions should be monitored every month.