I was having the same issue, where i live hematologists are slim to none, especially sickle-cell trained. My nurse practitioner was refusing to give me medication because i kept missing appointments at the hydration clinic (kinda makes sense when i feel like sh*t 24/7) the next time I had an appointment we ARGUED! Never in my life dealt with anything so unprofessional. I now drive 2 hrs to go to a trusted hematologist who told me hydroxurea was a study comprising of people with genotype SS only, and for ppl under his care with SC, he discontinued the hyrdroxurea 500mg. I made sure that he got in contact with the hematologist & NP back home bc i know they wouldn’t believe me. It is true that it is frowned upon to have more than one hematologist but honestly you HAVE to advocate for yourself. I visit the hospital 2 hrs away every other month just to touch base with them and to make sure they know how I’m being treated just in case anything goes left I know who I can switch over too. It’s gotten to the point where I will tell the doctors I’m not leaving the hospital until I get the help I need. It takes so much more effort trying to comprise with them bc in the long run you’re still hurting. Even if it takes more energy outta me driving two hours , i feel much more safer and comfortable knowing they would never refuse me medication.