Tuesday 8 September 2015

THE SS GENOTYPE …BRIDGING THE GAP BETWEEN FAITH, SCIENCE AND MORALITY (SEASON 2 EPISODE 9)

“Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort, who comforts us in all our tribulation that we may be able to comfort those who are in any trouble, with the comfort with which we ourselves are comforted by God”. 2 Corinthians 1:3-4

Today is the 13th July, 2015. Remember I had mentioned in Season 1 Episode 4 that my youngest sister was married? Yeah. And she has the sweetest lil two year old on earth. His name is Zinachidi. She informed the family today (My parents and siblings) that she was expecting her second child. My joy knew no bound. God was enlarging our coast.

Now back to my sister.

My sister got married in 2012 to a pleasant gentleman. Prior to their marriage, they had dated for about four years. Now my parents had told my sister that she was born with the AA genotype and this we had all believed over the years. Shortly before their wedding, they had to undergo the regular medical checks required by their local church. The result of the test was devastating…apparently, my sister and her would-be husband had the AS genotypes.

Now, when two people with the AS genotypes procreate, they stand the risk of producing children with the SS genotype. The SS genotype is responsible for the Sickle Cell Disease. The Sickle cell Disease is a genetic condition that is present at birth. It is inherited when a child receives two sickle cell genes—one from each parent. It is the most common form of haemoglobinopathy in Nigeria affecting 1-3% of the population and it is associated with physical, psychosocial and emotional suffering.

At this time, my would be brother in-law was already very much a part of the family and marriage plans were in full gear. But we were not novices to the sickle cell scourge. My family knows only too well about the disease. My elder sister who passed on in 2014 to complications from the sickle cell disease was born with the SS genotype so the associated crises and mental torture was not new to my family. Despite our fore-knowledge of this issue, we were now faced with a grave decision and when one is faced with such, you need to weigh your options and not rush in. There is no hard and fast rule and quitting is just one of many solutions. When faced with such and armed with all possible solutions, it becomes necessary to find a meeting point. Do we opt for faith? Do we opt for science? Do we opt for morality?

We opted for all three.

By faith, we agreed that the marriage would go on as planned even as we prayed to God that he would bless them with a child who didn’t carry the disease. And oh yes we prayed. By science, we opted for Amniocentesis and based on morality, we decided that if faced with the heavy decision associated with the test results, we would opt to save the couple from the turmoil of raising a child with the SS genotype.

Now one can proffer a million and one arguments against induced abortion but that’s going to be story for another day. I share this here today to let you know the decision my family took when faced with that dilemma, I share this to educate couples who are also facing the same heartache and I share it here to let you guys know that I do not think that terminating a pregnancy which would have resulted in a child with a TERMINAL condition is murder. No it isn’t. It is sanctified common sense. It is just and it is right.

I believe everyone should seek to know their genotypes long before courtship and then purposefully find someone they are compatible with. This would prevent the heartache or indecision that comes with making some hard choices. However, if all else fails or somehow, the details are left out and one finds themselves in this dilemma and one earnestly believe they has reached the point of no return, then such couple and all affected parties should necessarily agree on the necessary precautions in moving forward. One of such precautions is Amniocentesis.

Prenatal diagnosis is the process of ruling in or out fetal anomalies or genetic disorders, to provide expecting parents with information and the opportunity to modify pregnancy management and/or postnatal care. The availability of prenatal diagnosis (PND) for the disease has opened a window of opportunity for expectant couples to have information about the haemoglobin (Hb) genotype of their unborn child. This gives them the option of termination of the pregnancy in case of positive result and to prepare them psychologically, financially and medically for the arrival of the new child when abortion is not an option.

Prenatal diagnosis began to improve with the development of Amniocentesis in the 1950s. In the 1960s the ability to culture cells from amniotic fluid was developed. Beginning in 1968, cells from amniotic fluid could be analyzed for chromosome disorders like Down's syndrome. Today, Amniocentesis permits the diagnosis of a wide range of disorders. The type of test done depends on the stage of pregnancy and the position of the placenta. The test can be done between 10 and 22 weeks of pregnancy, but obviously the earlier, the better. An early test is less upsetting than a later test, because termination is easier and more acceptable than a later one. Test results are usually available to the patient in one week.

Since this is a test that is done on the fetus before it is born to see whether it is affected by a particular disease or not; if it is affected, the couple may decide to terminate the pregnancy and try again for an unaffected child or may choose to continue with the pregnancy and prepare their minds for its birth. If the baby is not affected, then the pregnancy can continue normally. It carries less than a 1 in 100 risk of miscarriage and virtually no risk at all to the mother.

And so when my sister took in sometime in 2012, we were all agreed on the necessary steps to take. She underwent the test and when the results came, we were relieved… Zinachidi was born in 2013 with the AS genotype.

Hopefully with proper counselling and guidance, he would learn to restrict his potential circle to ladies with the AA genotype and thus prevent his loved ones from having to take some hard decisions.

Now my sister is pregnant again. We all know the routine so we are joining our faith with hers even as we call on heaven for mercy and the miraculous.
It is well.

The Amniocentesis procedure costs between N180k to N250k and it can be carried out at the Sickle Cell Foundation Nigeria, National Sickle Cell Centre, Opposite Lagos University Teaching Hospital (LUTH), Ishaga Road, Idi-araba, Lagos. Nigeria.



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