Dumb question about acute sickle cell pain crisis

[BlueOranges8888]

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I have a pretty dumb question about sickle cell, specifically the management of acute pain crisis.

Why do we get daily labs such as LDH, retic count, etc?

Isn't retic count always going to be high in sickle cell? So what's the point of getting it? And why hemolysis labs? Wouldn't sickle cell pain crisis always hemolysis?

I had a sickle cell patient whose pain was controlled, vitals stable, no other complications (acute chest, etc), etc, so I discharged the patient but then was readmitted again in a few days. Should these labs also be used to guide decision to discharge? Wondering if I could have done something else.

 

[glorifiedresident]

the labs can help gauge severity of the crisis and ongoing vaso-occlusive disease, and may be able to help differentiate between true crisis and drug seeking behavior