UCSF Fresno Sickle Cell Clinic Provides Timely Preventative Care

UCSF Fresno Sickle Cell Clinic is Providing Patients with Timely Preventative Care

In 2020, UCSF Fresno opened a comprehensive adult sickle cell disease care clinic at the Community Cancer Institute in Clovis to provide comprehensive care, including screening for complications of the blood disease, and coordination of care with other specialties such as genetics, counseling, pain management, orthopedics, surgery and obstetrics/gynecology.  

Mohammed Sani Bukari, MD, associate clinical professor and a UCSF Fresno oncologist who is board certified in Hematology, Oncology, Internal Medicine and Pediatrics, wrote the grant proposal for the only operating sickle cell disease clinic for adults in the greater Fresno area.  

“Having this clinic in the Central Valley is important because it reduces the time that families and patients have to travel to neighboring counties or cities to get comprehensive care and it allows patients to get care closer to home,” said Dr. Bukari. It also serves as a transitioning of care clinic for children receiving care in Valley Children’s Hospital (VCH) hemoglobinopathies and sickle cell clinic.  

Sickle cell disease is an inherited blood disorder that causes red blood cells to become misshapen (sickle cell) and undergo premature breakdown. The misshaped blood cells block blood flow through the vessels leading to tissue death and or acute pain episodes. The shortened lifespan of red blood cells causes anemia and associated symptoms like fatigue and weakness.  

Other symptoms of sickle cell include increased risk of infection, strokes, kidney, lungs, and liver failures leading to shortened life spans of affected individuals compared to the general population. 

Available treatments include medications, blood transfusions, bone marrow transplant and evolving novel therapies like gene therapy.

Now, in its third year of operation, Dr. Bukari runs the clinic along with physician assistant Stephanie Harris Mercado, DMSc, MBA, PA-C, who has a doctorate in medical science with an emphasis in sickle cell disease.  

“Sickle cell patients here, have access to the hematologist, a medical assistant or me, 24 hours a day, seven days a week. They have access to texting, and we will answer even on the weekends and get them taken care of,” said Dr. Harris Mercado.  

The clinic also provides same day pain management at an ambulatory infusion center in the Community Cancer Institute, helping reduce the utilization of the emergency department for acute mild to moderate pain episodes.  

Calvin Mays is one of those patients. He is 50 years old and grateful to be alive because he has surpassed the life expectancy of an adult male with the disease. He was diagnosed with sickle cell at the age of 12 when he began having excruciating back pain. He remembers the only way to deal with it was by going to the emergency room.  

In 2018, he moved from Illinois to Fresno to be close to family, and the emergency hospital visits continued. Unbeknownst to him, he would soon find preventative care.  

After much struggle and dealing with pain, Mays found the sickle cell clinic before one of his worst health episodes. In July 2022, he experienced excruciating knee and elbow pain that sent him to the emergency department. It turned into a one month stay at the hospital. He was bedridden for more than two weeks until he began to regain his strength under the care of Drs. Bukari and Harris Mercado.   

“They figured out everything and worked with me. At first it seemed like nothing was working, but they kept at it, and I started getting better. All my organs were shutting down and then everything turned around,” Mays said.  

Now, Mays is living a better lifestyle and receives preventative care at the sickle cell clinic every three to four months. “I have never had that kind of experience before. It was always pain meds, fill you with fluids, drink plenty of water. That was about it,” he said.  

According to Dr. Bukari, getting treatment from a comprehensive center has several advantages including seeing physicians who provide care for sickle cell patients daily, access to all associated sub-specialist care affiliated with the clinic and focused treatment for patients.  

As the only sickle cell disease clinic for adults in the region, UCSF Fresno cooperates with the children’s sickle cell disease clinic at Valley Children’s Hospital to help teens transition from the pediatric clinic to the adult clinic.   

“Our clinic is still growing, and we are hoping that all patients who are transitioning from Valley Children’s Hospital who remain in the Central Valley will become our patient and those patients moving into the Valley will also have the opportunity to get comprehensive care from our clinic,” Dr. Bukari said.  

The clinic is also part of Networking California for Sickle Cell Care, Pacific Sickle Cell regional collaborative network and is in the process of joining national alliance of sickle cell clinics.  

For information on receiving sickle cell disease care, call 559-387-1900.  

Part of Newsletter: Focus on UCSF Fresno, Spring 2023