Love and Sickle Cell

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Black couple hugging

Shortly after my internship, I got a job at the staff clinic of a polytechnic. My job entailed medical fitness tests and treatment of minor ailments for ths staff and students twice a week. This was before I was drafted for the mandatory one year NYSC (National youth service corp is a scheme where fresh graduates are posted to different locations to serve the nation as deemed fit. A kind of paramilitary programme).

I found it quite boring except for the few occassions some of the students who had never met a female doctor of my age, came just to peer at me. To cure the boredom, I engaged those I had to see in health talks, career talk and so on. For this reason, I made quite a number of friends. Rather than just rattle off your blood group and genotype, I would spend a few minutes discussing its implications on your health. I also advised on love, relationships and what not.

One day, a young lady came in for her test results. I informed her that her genotype was found to be AS.

“I hope you know what that means?” I asked, distracted.

“I don’t believe it’s my portion in Jesus name”, she replied.

I was surprised.  Sickle cell disease is quite common in West Africa and for years there has been a campaign for people to be aware of their genotype and marry accordingly. It is one of the few diseases we can easily prevent. The probability that one will bear children with the SS gene is higher when he or she and her partner carry the gene. Therefore, people who both have AS genotype are not advised to marry.

“Why do you not believe the result?  I hope you know it does not have any effect on your health?” I asked. “In fact, AS gene is thought to confer a kind of immunity to malaria parasite. It is only that you should marry a man who has AA as his genotype”

“I just don’t believe it”, she insisted, biting her nails nervously.

“Have you done the test before?”

She replied that she had and had even repeated it. Both results were the same.

“So why are you insisting it is not right? Are you in a relationship with a man who has the AS genotype?”

“My boyfriend has Sickle cell disease”, she whispered.

“What! You mean you are dating and planning to marry a man suffering sickle cell? Your genotype is AS! Do you plan to have children? ” I was shocked to say the least.

She went on to tell me how she had dated this young man for 3 years and now she had a year to go, they were so close that he was often talking about marrying her. The few times she had tried to extricate herself from the relationship, he threatened to kill himself. It was she who nursed him through his frequent crises, taking care of him in hospital, cooking for him, even bathing him. His family was not ready to go that far. I could see that she really loved him and since she could not leave him, the only option was to pray that her genotype would change mysteriously.

I scratched my head, wondering how to deliver her.

“Just start withdrawing from him now that you are in your final year”, I advised. “When you graduate, tell him it’s over. Change your address, phone number and other contacts so that he cannot continue to blackmail you with suicide. Let him find someone whose genotype is AA”

She left not fully convinced. I have often wondered since then whether I gave her the right counsel. What do you think? Should she have stayed with him or not?

Too all those who suffer sickle cell disease, you can live free of crises by eating nutritious food, drinking lots of water (more than 2 litres daily), exercising moderately, and treating minor ailments immediately. God loves you and will provide you with all you need to have fruitful relationships.

For all my readers who do not know their genotype, book an appointment with your doctor to get tested. Make that call today. God bless you.

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7 thoughts on “Love and Sickle Cell

    sandy said:
    November 11, 2013 at 12:55 pm

    I love Dr N’s blog

    Gaile Uka said:
    November 12, 2013 at 12:18 pm

    Sis, even though I believe that God can do all things, i know you gave her a good advice. She is already emotionally attached to the guy so it may not have been that easy for her to breakup.It is one thing to have your advice taken when you give it.

    Ngwanma Onuoha said:
    November 12, 2013 at 2:47 pm

    God gave us doctors and medical science for a reason! some of us need to know the difference between faith, foolishness and presumptuousness!

    Femmetotale said:
    November 15, 2013 at 2:04 pm

    I couldn’t find the love button…would have clicked it at once. Please there is a big difference btw faith and foolishness. My worry is the kids that may suffer for the foolishness of the parents.

    Mo said:
    March 11, 2014 at 12:23 pm

    I rarely comments on blogs… I felt it needed a counteracting opinion

    I felt you did not provide the patient with appropriate information regardless of which decision she makes, however illogical it might have been. Providing information about options available if she did consider to carry on with the relationship. You explain the risks fully I.e. 50% chance of having a child with the AS or SS genotype. Also prenatal testing and possible termination of pregnancy. It is left to her and her partner to make an INFORMED decision. I always say life is what you make of it, knowing well the risks and consequences. Being a doctor, you will need to put your own personal beliefs and choices aside. We all have to consciously make the effort to do that to provide people with the best care possible.

      drnsmusings responded:
      March 11, 2014 at 4:34 pm

      Thank you for your “counteracting” opinion. Genetic counselling while great was of no use to a girl wwho was being manipulated. Abortion is illegal in Nigeria, so what would she do with SS babies? My faith and personal beliefs enhance rather than take away from my care of patients. I narrated it as it happened but that does not mean it was verbatim. If you have met a sickle cell patient before, you would not advice anyone to intentionally go into such an relationship. While I hail such patients, I know the quality of their lives leave much to be desired.

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