Nina's Clinic

Amara is 6 years old and is being carried into the ER by her dad because she can't walk—her legs hurt too much. She's screaming and clutching her shins. Her dad says this has happened before, but never this bad. Amara's history: She's had episodes of severe pain in her arms, legs, and back since she was a toddler. Last year, she was hospitalized for pneumonia that took weeks to clear. She gets tired easily. Her spleen was removed last year after it stopped working. Looking at Amara, you notice: her skin has a slight yellowish tint (jaundice, yellowing of skin from a buildup of bilirubin, a yellow pigment released when red blood cells break down), the whites of her eyes are yellow too, and she looks pale—her nail beds and inner eyelids are almost white instead of pink. Her dad mentions: "Both my wife and I carry the trait. We knew Amara might get the full disease."