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+The patient is a 34-year-old African American man with the known history of Sickle cell disease comes to the clinic with severe bone pain. The patient had severe pain in his lower back that radiated to both thighs scored 9 out of 10. The patient has had positive history of sickle cell crises since childhood. He also had the same symptoms in past two weeks treated with oxycodone which was not beneficial to his pain. His PCP sent him to the emergency department to receive intra venous pain modulators. The patient is afebrile within the normal blood pressure. No splenomegaly was detected in the physical exam. He has no positive history of drug allergy. He won't smoke or uses any illicit drugs. The lab study is as bellow:
+Hgb: 8 g/dl
+WBC: 10000 /mm3
+Plt: 300000 /ml
+MCV: 106 fL
+Hemoglobine electrophoresis: 91% HbS 6%HbF 3%HbA2
+AST: 22 U/L
+ALT: 43 U/L
+Alk P: 53 U/L
+Ferritin: 1200 ng/ml
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