Howard Estell had to be at work by 8 a.m. and often wouldn’t get home until 10:30 p.m.

Some weeks, the hours would pile up: 65, 70, 75 at the rent-to-own store where he worked as a manager. He had to work on Saturdays. His three young daughters would plead with him to do things on the weekends, but he was often too tired to say yes.

On top of it all, Estell, 31, has sickle-cell anemia, a blood disease in which exhaustion can aggravate the condition.

His wife, Jeanette, wanted him to be home more often, too. She saw that he was unhappy.

“I’m thinking, ‘OK, this is definitely not what we envisioned … when we first got together,’ ” she said. “We wanted a family.”

After a long discussion over several months, the Estells, who live in Huntersville, decided it was time for a change.

In 2009, Howard quit his job; the next year he enrolled at Johnson C. Smith University to earn a degree in social work. The goal is to be a medical social worker.

His experiences, his disease and his family all led him to the field.

“I spend my life trying to take care of myself,” he said, “but also I’ve seen how much of a difference people can make in your life when they’re genuine, they truly care, and they want the best for you.”

‘Are you sure?’

In the early 2000s, Estell began to pursue his first degree, in business management, in western New York where he and his wife then lived. Jeanette was skeptical.

“I kept telling him, ‘Are you sure this is going to make you happy?’ ” she recalled.

He finished his first degree in 2004, and in 2006 the family moved to Charlotte where Howard had a job first at an insurance company and then at the rent-to-own store.

All the while, his family grew. His youngest daughter of three was born in late 2006.

When the work hours got long, Howard says he would get upset when he didn’t have the energy to spend time with the girls.

“Sometimes I feel selfish,” he recalled, “because I have to say ‘No, baby, I have to sit this one out.’ ”

With a chronic illness like sickle-cell anemia, he knew that if he didn’t rest, he could pay the price later with debilitating bouts of pain.

Sickle-cell anemia is a genetic disease where a person’s red blood cells are shaped like a sickle rather than a normal, round cell. The deformed red cells don’t flow through the bloodstream as easily, so they can clog small vessels. This causes pain and can lead to other serious medical problems.

“It’s a terrible disease,” said Dr. Stuart Salmon, Howard’s regular hematologist at Carolinas Medical Center-University. “I mean, it basically will color and affect their entire life.”

When Howard has one of those severe pain episodes, called “pain crises,” it usually starts from his hips then radiates throughout his body. Every joint, bone, muscle – even every tooth in his mouth – hurts. He shakes so badly it is hard to hold a glass of water when he takes medication.

Howard would have a pain crisis every three to four months when he was working normal hours. When he worked more, he could have a crisis every one or two months. Now that he is spending more time at home while taking classes, he has them maybe once a year. He says the decrease is a combination of medication and less stress.

The power of help

Howard says his life experiences led him into social work.

Growing up with sickle cell, he learned about the power of a helping hand. He saw it in the medical social worker who supported him through his first surgery when he was 11 or 12. He sees it when his wife and girls look after him when he doesn’t feel well.

“Me having my illness really sort of magnified (and) heightened my awareness to what it’s like to depend on somebody,” he said.

The Estells say Howard’s illness didn’t play the biggest part in his decision to change careers. He just wanted a job he’s more passionate about and more time at home.

“I think he’s an example of somebody that’s managed to kind of get past his illness,” said Salmon. “That’s a credit to his personality … his strength of will, more than it is to the medications he takes.”

Salmon said he wishes he could bottle some of Howard’s character and resilience and give it to his patients with incurable diseases.

Chance for healthier future

After finishing his degree next May, Estell hopes to use his social-work skills to work with cancer or hematology patients, or perhaps the elderly.

Right now the Estells make everything work financially, even though it is a struggle with one income. Jeanette is a teacher at Mallard Creek Elementary. Howard has loans and a couple of scholarships to cover his tuition.

The Estells watch their spending more than they did in previous years, and their extended families pitch in whenever they can.

“It’s a struggle, but I think it’s worth it,” Jeanette said. “… Financially, we’ll be better eventually.”

For now, though, Howard’s happy pursuing a career he’s passionate about and having more time at home with his wife and daughters.