Doctors once told Richard Mitchell he wouldn’t live past age 40. This week, he blew out the candles on his 70th birthday cake.
Mitchell has sickle cell disease, an inherited blood disorder that used to kill people before age 20. Even with today’s medical advances, the average life expectancy in the U.S. is 42 years for men and 48 for women.
“You just take it one day at a time,” Mitchell said during a birthday party thrown for him Thursday at Mount Sinai Hospital.
Mitchell’s doctors at Mount Sinai aren’t sure exactly why he’s been so lucky, but they hope he can teach them about surviving to a ripe old age with the genetic disease, which affects an estimated 100,000 people in the U.S.
Dr. Jeffrey Glassberg, the hospital’s director ofsickle cell disease research, calls Mitchell “amazing. He’s the oldest patient I’ve ever known with sickle cell disease, and as far as I can tell the oldest patient who’s currently living.”
SCD results from a genetic mutation that causes red blood cells to be misshapen. The sickle-shaped cells inhibit blood flow throughout the body, causing pain and fatigue.
“What it really boils down to is, your blood behaves differently than people without those mutations,” Glassberg said.
“Every single organ from the skin to the brain needs oxygen, so you get manifestations in every single organ system.”
SCD takes a progressive toll on the body, raising the risk of infection, organ damage and stroke, and of acute chest syndrome, a life-threatening event in which the lungs fill rapidly with fluid. People with the disease experience regular pain crises that are treated with oxygen therapy and blood transfusions.
Mitchell, who has the most severe form of the disease, “lives with a lot of pain” and ends up in the ER a few times a year, Glassberg said.
To beat the odds, Mitchell says, he learned to take his condition in stride. He was diagnosed at age 20, shortly after moving to Fort Greene, Brooklyn.
He credits his grandparents, who raised him on a farm in South Carolina, and his father, a minister, for keeping him “on the straight and narrow.”
“They were very strict about hanging out and partying and drinking,” Mitchell recalled.
Though his disease kept him at home for long stretches, he worked throughout his adulthood in factories and as a mailroom clerk at a Manhattan law firm. But in the past two decades he’s made an effort to slow down in order to preserve his health.
“The main thing to worry about is dehydration and stress,” he said. “Those two really take a toll on sickle cell people. No stress, drink a lot of fluid, eat right, and go for exercise.”
He cut out fast food and alcohol in favor of home-cooked meals at his assisted living center in Yorkville.
“The good days are when I can go out and walk and do my own shopping,” he said.
“The bad days are when I come out of a crisis. I have to stay in and get my energy back.”
Now that Mitchell is 70, “his age is beginning to show a little more,” said Dr. Nisha Rughwani, assistant professor of geriatrics at Mount Sinai, who is Richard’s primary care physician. “Any kind of an infection, even if mild, for him it’s a big deal because he has a sickle crisis. But most of the time he’s actually a pretty fit and well man.”
Even as they celebrate success stories like Mitchell’s, experts are concerned that mortality in young adults with sickle cell is rising. This may be because young adults lose access to medical care when they become too old for a pediatric sickle cell clinic, Glassberg said.
“We know there are thousands of young adults with sickle cell in New York who are not under the care of a comprehensive sickle cell center, or any hematologist, for that matter,” Glassberg said.
“It’s really helpful to have a guy like Richard to help inspire the patients and give them someone to look up to.”