Head, Clinical Psychology
Lagos University Teaching Hospital, Idi-Araba, Lagos
Sickle cell disorder is an inherited blood disorder that can cause debilitating pain crises, and patients will be at increased risk for infection and other symptoms.
Pain was said to be the most common debilitating symptom of sickle cell disorder. These pains tend to contribute to fatigue, which is a common symptom of anaemia and, at times, leads to poor sleep and other psychological problems. Hydroxyurea may reduce the frequency of pain crises in some patients, while analgesics and other pain management methods work perfectly for others.
The limitations experienced by sickle cell disorder patients include acute chest syndrome, jaundice, priapism (i.e., persistent and painful erections), leg ulcers, gallstones, and stroke. It could also hurt the mental health of patients, which may lead to depression, anxiety, and other psychological problems.
Every patient needs to understand the common triggers of sickle cell disorder. The most common triggers include dehydration, extreme temperatures like cold weather, overexertion, substance abuse like pentazocine and other prescribed drugs for addiction, and stress-related issues in the patient’s immediate environment.
In the area of management, the patient needs to be knowledgeable about the dos and don’ts of the management of sickle cell disorder and the use of this knowledge for effective management of the illness conditions. Patients should take their routine drugs for their illness condition regularly, and the intake of water should be taken very seriously. Any other serious symptoms of sickle cell disorder should be adequately managed to avoid serious complications.
COUNSELING IMPLICATION FOR PATIENT THAT MAY NOT WANT TO MARRIED AS A RESULT OF SICKLE CELL DISORDER.
- If you are a man, as a patient, ensure that you don’t marry a lady who has the same genotype as you.
- Sickle cell disorder did not reduce the chance of marriage for both males and females.
- It does not affect sperm production hence, a male patient can be as productive as their other male counterpart in the society.
- Sickle cell anaemia does not reduce a woman’s chance of pregnancy, but she will need increased monitoring by medical experts to prevent any form of complications. During pregnancy, the patient should avoid the use of hydroxyurea, as it might be harmful to the fetus.
- The idea of patients not willing to marry because of sickle cell disorder is an erroneous belief that should be avoided by people living with sickle cell disorder.
- The patient who does not want to marry as a result of sickle cell disorder should rethink, as only the precautionary measure must be taken very seriously (i.e., the patient should not marry a lady with the same genotype as him).
- The belief that women and sex, spell trouble is an erroneous belief by any male patient; hence, there is a need for such patients to take responsibility and forge ahead in life. His major concern should be the effective management of sickle cell disorder.
- The belief that no woman will like you because of sickle cell disorder is also erroneous, as there are reported cases of people living with sickle cell disorder who live happy married lives and are also, able to manage their conditions perfectly.
- People living with sickle cell disorder should know that they are not the only ones living with this condition, and that is why they should register in any sickle cell disorder club of their choice in their immediate environment.
- People living with sickle cell disorder should believe that the disorder is not a death sentence, but a disease condition that could be managed effectively by being proactive towards the care of sickle cell disorder by following the dos and don’ts of the illness condition.
- People who experience abnormal sexual desire as a result of sickle cell disorder should try to build up a lasting relationship with the lady concerned through a change of attitude towards the lady.
- People living with sickle cell disorder should have confidence in themselves, as it will tend to boost their self-esteem.
- Sex should not be seen as a crime but for reproductive purposes hence, the need for sickle cell disorder patient to settle down with the lady of his choice for a fruitful relationship.
- It is important to note that if your genotype is SS and you marry someone who is SS, you will have sickle cell disorder children; hence, the need for genotype SS to marry genotype AA for a better result.
- Couples need to be counselled on the need to do their genotypes before marriage. For example, an AA genotype person marrying an SS can result in AS children, while someone with genotype AS should only marry someone with genotype AA because if he/she marries another genotype SS, it could result in the birth of sickle cell disorder children.
- SS and SS must not marry to avoid giving birth to SS children because, with this relationship, there is no chance of escaping having a child with sickle cell disease. Presently, the only way that can change the genotype in the literature is a bone marrow transplant (BMT), which is very expensive for the average Nigerian to bear, except with the support of the state or federal government and other humanitarians in society.
- Another situation where SS and SS can get married is when the marriage is for companionship; that is, the couple might decide not to give birth to children of their own, as is practiced in some advanced countries of the world.
- A situation where SS searches for AA for marriage but fails to work out. In this situation, when SS get married to SS, the couple might decide to go for pre-implantation genetic diagnosis, as reported by Akinade and Akinsete in 2021. The IVF treatment is used to select an embryo’s genotype before it is inserted into the woman. The procedure would make it easy for the woman concerned to have a chance of giving birth to a child with an AA, AS, or AC genotype and not an SS genotype.
- Another option, as reported in the literature, is prenatal diagnosis. The diagnosis is carried out before birth, and if there is any genetic disorder, including genotype, the couple might make a decision that will favour them before the birth of the baby. It is important to note that, the machine for the above procedure is available at LUTH and other medical facilities in Nigeria.
- People with genotypes SS and SS should endeavour to go through genetic counselling whenever they think about marital relationships. The services of genetic counsellors cannot be overemphasized, as they make it possible for couples to make reasonable choices as regards their future partner.
In conclusion, any individual who lives with sickle cell disorder and does not want to get married or have a relationship with the opposite sex should re-think about his illness condition and replace all the distorted thoughts about his relationship with the opposite sex with positive ones. He should also not see sickle cell disorder as a death sentence, as highlighted above by the writer. However, individuals should look at the disease condition so that it can be managed with effective use of one’s medication, know the dos and don’ts of the condition, and use psychological management for milder pain. The individual concerned should change his attitude towards ladies and settle down with a lady of his choice, as expected from his parents.
References
- Akinyanju O. and Adebayo O. (2007) How to live with sickle cell disorder: A handbook for affected people, their families and health workers. Ibadan, Book Builder Edition Africa.
- Your Genotype should not stop you from getting married, say sickle cell expert. The Sun June 2021. Retrieved 12th March 2024 from Genotype Archives- Genomix Nigeria.ng>category> genotype
- Genotype compatibility- American university of Nigeria. Retrieved 10th March 2024 from www.aun.edu.ng>index.php> health tip cans.
- Danger of marrying without checking genotype. Retrieved 12th March 2024 from Puncng.com> dangers of marrying with ….
NB The author is a clinical and counselling psychologist. He is also an expert in genetic counselling and a drug and mental health rehabilitation specialist at the above hospital. He can be reached at suleiman.folorunsho@yahoo.com
