If you have been following my blogposts, I put up a write up on Genotype and Love issues recently. The response I received was amazing and I was even encouraged to speak more about it, as it seemed a lot of people that are assumed to be aware about this issue are not, while some others who claim to be aware do not really put it to heart until, it becomes a really deep matter.
My first post on genotype just gave an introduction to what it really is about and encouraged us to be on the guard about it as young people. (If you have not read it, you can do so here)
This post would go deeper, answering some practical questions and giving some advice.
But before we continue, let me just quickly explain some things:
People with the AS genotype are said to have the sickle cell trait, while people with the SS genotype, are said to have sickle cell disease.
The AS guys have some blood cells sickled, (distorted shape) but are mostly asymptomatic (do not show symptoms, in case you are struggling!), while the SS genotype has every cell sickled.
Note that the shape and size of a Red Blood cell is very important to its function, just like a key and its key hole. Distort the shape of the key, it cannot open. In the same way, once the shape and size of the Red Blood cell is affected, the lifespan is reduced and its major function of transporting oxygen is markedly affected.
From our first post, remember we said this would affect:
Oxygen transport and Blood flow, which could lead to a host of other complications; the crises, anemia, priapism, gallstones, pulmonary hypertension, leg ulcers that do not heal and a host of other things.
A lot of these complications are what make them present to hospitals many times, and they are worsened by illiteracy and poverty.
Now that you have more understanding of what we ar talking about
So let us delve into answering some questions:
Does genotype change?
Now, WITHIN THE BOUNDARIES OF MEDICAL practice, your HB type is genetically determined. From our last post, I explained that there are certain codes that determine the type of Haemoglobin found in your body. These codes would not change, and you would keep on producing the same type of HB under normal conditions.
I have heard of some people saying that there was a disparity in their results in different health facilities.
This is possible, because of the type of chemicals used in the testing. I would not bore you with details, but in some health facilities, especially in low resource settings, some of the chemicals used to ‘determine’ the genotype might actually be ‘expired’ or less effective.
Again, there could be human error in determination. I must say however that in many standard facilities in Nigeria, these are rare occurrences, so you can have the confidence to believe whatever results you get. Most of us even already have our HB genotypes checked at birth. However, I do not see any reason why you cannot go on your own to a standard health facility closest to you to recheck (if you have not done so recently). It costs next to nothing and is even free in some centres.
Medically speaking, your genotype does not change
What genotypes are compatible?
You know folks always talk about compatibility in terms of personality types and ideologies, his jokes, her laughs; his swag, her ‘slay,’ talkative/quiet, tall/short, and all those other things that we match in our heads.
Now, let us talk about the real compatibility: Genotype compatibility!
For marriage with an aim of bearing children (I have to add this because we now have couples who are not interested), the best advice your doctor or health worker would give you is as follows:
AA + AA = Excellent
AA + AS = Good
AS + AS = Bad
AS + SS = Very Bad
SS + SS = Terrible (Village people might be involved)
The same rule for the AS applies to the AC genotype, while for the SS applies to the SC genotype.
What are my chances if AS marries AS?
I have also seen a lot of people put up different arguments, citing various examples of their cousins or friends or relations that got married but did not have any children with sickle cell disease (SS).
I believe very strongly in knowledge and information. Some people also do not know how to correctly calculate the chances they have, so we would deal with that here.
Now a little biology, nothing hard, in Mendelian inheritance, you have one two alleles (variations of a trait, in this case A, or S and so on) coding for a particular trait. Notice the HB comes in pairs ,
For instance, Hb AA would be ‘A’ and ‘A’, Hb AS would be ‘A’ and ‘S’ while Hb SS would be ‘S’ and ‘S’.
So let us say two people with AS and AS marry, here is what we have:
So from the image, we know now the possibilities of having an AS and and AS,
We could have one AA, AS, AS, or SS.
PLEASE!! NOTE THAT THE POSSIBILITY IS PER CHILD BORN FROM THE PARENTS, NOT FOR ALL THE CHILDREN AT ONCE.
It means that for the first child, it could be AS,AS, AA or SS.
For the second child, the same thing, and so on.
So, the same way your cousin was lucky to have AA for all his four kids, you could have SS for all of yours!
Now, do you understand?
You really would not want to take that chance. For the AS vs SS I think you can do the maths yourself and find that is even entirely ridiculous.
That is 50%.
No try am!
No even think say you go think am!
We are both AS. Can we take the 75% chance?
I already know someone is thinking this way. The thing about love is that sometimes we can decide to close our eyes to a lot of things because of the one we love.
Let Genotype matters not be one of the things that we close our minds to, except we have no intention of bearing children. The issue with the 75% is that it could very well be the other 25%, and there is really nothing you could do about it. Once you make that decision, you leave everything entirely up to chance and random assortment.
Would you really leave a child’s life up to fate? And luck? When you have a chance to make a decision?– think about it
It is not wise, and not fair.
We now know better, we now understand things clearly. We know it is not an ‘abiku’. We know it is not someone doing it from one calabash in the village.
Genes. That’s what they are! We have the knowledge now. We can and would use it!
We can avoid all of that, please do.
But we really love each other, what do we do?
Well, love is a decision. Think about the person you love and how much stress they would have to go through if there is a child with an illness. The energy expended from both of you could even make you so tired and bitter at each other. It is not for a year or two, it is a lifelong issue, you both would have to keep battling.
You have always fantasized your marriage to be paradise and enjoyment and peaceful. This is certainly not in the way of that. I encourage you to seek counsel from doctors or informed counsellors to help you go about this in the best and right way.
We are already married, what do we do?
It is simple, please seek counsel from a health facility closest to you.
CALL TO ACTION
Please let us spread the word. Chances are you know at least one person that is in that kind of relationship, or you might even be the one and you have been ignoring it..
Nothing would happen, please do something about it before you go further.
For those who have not entered at all, please, do not enter.
Always ask the G-QUESTION:
What is your Genotype?
Before you start hanging out, calling, texting, loving up and your head starts turnionion
Parents, drum this into the ears of your kids as much as possible.
Siblings, sing it into each other’s ears.
Friends, talk about it among yourselves.
We can organize campaigns to discuss among people who are not informed, go to marketplaces and shops to sensitize them on this issue.
Everyone in a position of influence should also counsel their members. Look, we can end this as a generation. I honestly believe it!
We can get some things out of our community, by taking deliberate steps. We want to have a healthier community and nation.
Our future is determined by the steps that we take today!
I believe you have learnt one or two things!
Have a great day!