analytical,
you misunderstand me.
i know your children can never be SS
but if you are not AA,then they can be AS (the carrier of an S gene) and at risk of having an SS (obviously only  if they marry an AS)

but if you are AA just like your wife  that possibility is nil
i am not questioning your faith in God .I just wondered ,  being an AC woman married to an AA man and  with 2 children. abeg don't vex oh
(and yes! AC not AS-not a typo error)!

I'm a living testimony of an AS genotype married to another. To God's glory we have two beautiful girls today who are both AS's. However, I'll like to stress the point that it takes an intimate relationship with God and having faith in Him to enter into such relationships.

On the other hand, a very close friend of mine who is an AS got married to another AS. Well as things turned out it took the wife several years to conceive finally when she did, she gave birth to an SS, but to make matters worse the baby later on died. My brothers and sisters this affected their marital union they had to part ways after many years of marriage.

My advice is to please, pray and seek God's face before you enter into any relationship.

You and Your Health with Dr Caleb Bibbi Oluranti

AS, AS Case Revisited
Dear Doctor,

I was captivated by the peice that appeared on your column on Tuesday 16th December, 2003, concerniong the issue of AS vs AS MARRIAGE.

My concern comes from the fact that I am also a carrier and I face a similar problem and in all consultations I've made so far there has always been a one track response. "Please don't dare it, it is a loose loose situation".

Stories abound of the plight of carrier parents during the crises of their children. Believe me it is a nightmare. I know a girl who practically took her own life after complaining of why she couldnt live a normal life. She refused all attempts to be taken to the hospital during one of her numerous crises and she died after being forcibly carried there. The Doctor's verdict was that she had willed herself to die.

In as much I believe that a miracle can occur in such a situation, but what are the pecentages that do not suffer the the scourge of of having sickle cell children. I would also want to believe that it is God that made man to have the knowledge as a doctor to understand that such a union has the potentialities of ending in misery in the absence of absolute faith.

A doctor even told me point blank that a broken engagement under the AS-AS circumstance, is better than a broken marriage, and it would be fool hardy to go against his advise. That is why am perplexed by your write up. I have a believe that the issue of faith is gradiated so in as much as some have built up their faith to a high point, some are still cultivating it.

It will be disastrous for this couple to go in to this relationship if there faith is not even as strong as yours. Only you want us to understand that as a believer and a doctor that your faith may be enough to carry them through. In that case i will end by telling you this Chinese saying which goes like, if you save a man who is about to take his life , you have told his God that you have taken responsibilty for that life.

Doctor, pray fervently and without ceasing for them, for I have personally asked my God to interfere in my own situation and theirs too and am still waiting on him. It was my personal decision to go that route because His gift added no sorrow.

Ebube Dinmabueze, Owerri( Not real name)


Dear Ebube,

How forcible are right words!! I do not mind saying that I cannot fault your presentation and am very grateful for its insight, science and pragmatism. I can only say I was writing the answer to that question from only one angle and one only--the angle of those who have developed their faith to levels that can dare the impossible. Very grateful you pointed this out. Such, like you know can move mountains. But --like you have so pragmatically noted too, not all men have faith. And I might add no one should be crucified for this --since like you also said --medical science itself is a gift from God to help all such people also. It is inddeed very soberingly true that SS disease is a total disaster and should in no wise be courted when it can be easily avoided. Very, very true. A couple having AS AS genotype will have statistically 1 baby out of 4 who are each, AA, AS, AS and SS. However, like anyone who has ever played LUDO (dice) knows it is possile to be so very unlucky that each time he plays double zero or so lucky that he plays double six in a row -- all these things are in the hands of chance -- except of course you've a developed faith. So I do agree with you that I was carried away by the romantic and forgot to be realistic enough to explain the realitieds of the other side. For this I want to apoogise very profusely-- it was a very true oversight.
So what do we conclude?
I think we must say "Be it according to your faith". I certainly would never discourage any one who wants, on the basis of faith, to go ahead--Jesus told [Peter to come and walk on water -- and, wonder of wonders -- he did -- till he doubted. Anyone that needs help, encouragement or counselling in these areas can send to us -- it is not impossible to get even already living SS cases to become cured -- only by faith, of course. I am making a statement of categorical fact that these cures are possible and are being done--and AS, AS couples can go ahead responsibly on the basis of faith (backed up by doctors like us who do understand these dimensions) and they will not regret. However once one realises that one's faith is not at such a level as to go ahead(like you have so truly noted), no problem. It's better for AS to marry only AA so that there is absolutely no possibility that any of their kids will ever be SS.Children from such a marriage can only be AS, AA, AS AA. No SS.
For those who will be going ahead I want to still admit another area I inadvertently overlooked in my answer of the 16th December. And that is that I Counselling by the Sickle Cell Club of Nigeria will be helpful. These experts will be able to help them with what is known as Prenatal Diagnosis -- a process in which science samples blood from the baby in the womb and helps to determine if it is SS so the parents can choose to abort if necessary. I want to thank you very much for your gentle correction and I do hope nothing I have said or not said has done any damage or been seen as patronising to or by any one because the first principle of medical care is Primum non nocere -- First and foremost, do no harm.
Thank you very much and this is saying merry Xmas and a happy new year to everyone.
Cheers

Dr Caleb Bibbi Oluranti

@All,

There is actually a way out for a couple with AS genotype,the solution is genetic screening while the woman is still pregnant,its easy to determine if the fetus/baby  is AA,AS or SS and can easily abort if its SS.
An Irish friend travelled to the UK to have an abortion recently because her unborn baby was diagnosed with Downs syndrome,I doubt how many African families would agree to abortion in advance of marriage.I'm the ultimate pragmatist

The woman will spend months before she finally decides to abort, then spend the rest of her life feeling guilty about it because pastor said that abortion is murder.

SEUN,

Seun:

The woman will spend months before she finally decides to abort, then spend the rest of her life feeling guilty about it because pastor said that abortion is murder.

I agree with you,pragmatism in my view is the main difference between Whites and Africans.I'm AA but I would still insist on Genetic Screening when I get married,if my unborn child has any kind of disorder I will abort.I have no intention of marring any righteous woman who gets her pastors approval before we do any thing

Hey u cant get married. u have a chance of having an SS child. so remain as friends nd dont put your life at risk.

it is not adviseable.

cassidy

i am a medical student in the US and yes its very possible for two AS people to get married, i am sure that most o fu know that u have only a 1/4 chance of having a child iwht SICKle cell while a 50% chance of having children with the AS trait and another 1/4 chanc eof having children with AA, now evcen before people started getting tested alot of AS couples have been getting married and yet still majority of thier kids are AS. u can even have the fetus tested at an extremely early stage in pregnancy, for whether or not the child is AS, AA or SS. so u have the choice of keeping the child or not. and if u do ur reserach u realize the the mortality expectancy of SS indiiduals is about 35 now, which is a plus, so cassidy, u can hav ethe choice whetehr the keep the child or not, once u leran of its faith. and so far that is what technology can offer us. and yes do pray that u willl be in the range of 75% chance of having a non SS child. oh by the way that test is kind of expensive so if u are planning to have a million children good luck on that, but if u want to have 2 like me then its quite affordable. Good luck dear

They can marry but there will be a carrier among there children.

katherinae:

cassidy

i am a medical student in the US and yes its very possible for two AS people to get married, i am sure that most o fu know that u have only a 1/4 chance of having a child iwht SICKle cell while a 50% chance of having children with the AS trait and another 1/4 chanc eof having children with AA, now evcen before people started getting tested alot of AS couples have been getting married and yet still majority of their kids are AS. u can even have the fetus tested at an extremely early stage in pregnancy, for whether or not the child is AS, AA or SS. so u have the choice of keeping the child or not. and if u do your reserach u realize the the mortality expectancy of SS indiiduals is about 35 now, which is a plus, so cassidy, u can hav ethe choice whetehr the keep the child or not, once u leran of its faith. and so far that is what technology can offer us. and yes do pray that u willl be in the range of 75% chance of having a non SS child. oh by the way that test is kind of expensive so if u are planning to have a million children good luck on that, but if u want to have 2 like me then its quite affordable. Good luck dear

If you are a medical student and you are giving this kind of advice, I am so sorry for your patients.

egbon:

I'm a living testimony of an AS genotype married to another. To God's glory we have two beautiful girls today who are both AS's. However, I'll like to stress the point that it takes an intimate relationship with God and having faith in Him to enter into such relationships.

On the other hand, a very close friend of mine who is an AS got married to another AS. Well as things turned out it took the wife several years to conceive finally when she did, she gave birth to an SS, but to make matters worse the baby later on died. My brothers and sisters this affected their marital union they had to part ways after many years of marriage.

My advice is to please, pray and seek God's face before you enter into any relationship.

In other words "I ran across the road blindfolded like a bleeding idiot and didnt get hit, so you can do it too!". Jesus Christ. Egbon, I am sorry, I dont know you, and you may be a great person with many talents, perhaps a wonderful guy to be with or to know, but if you knew you were both AS before you married I think you deserve to be flogged.




AS + AS should never be even contemplated. It is child murder.

@Darkmanzero,

I don't get your attack on Kathernae,any doctor in a western country is bound by law to offer best advice to their patients,I really can't remember how its done in Nigeria but there is nothing wrong with her advice.I know an Irish  friend who had actually taken the step of Genetic Screening and it has saved her from the pain of seeing her child suffer from Downs Syndrome.Downs Syndrome is actually worst than Sickle Cell as it disfigures the person,leaving many disable and mentally ill.

Her Irish doctors adviced to abort and she had her abortion in Manchester,UK because abortion is illegal in Ireland.

I am not referring to the genetic screening part

I am referring to the 'go ahead and mary' part.

prevention is always BETTER and a doctor should know better than to encourage her patients to put themselves in wahala

@dakmanzero
There is nothing wrong in katherinae's opinion. A doctor explains all options available to the patient, help in guiding his choice, but the ultimate decision is taken by the patient. If your patient takes an option you don't agree with, you can always decline him your services.

There is plenty wrong with it. Read the post. It is far from an aloof description of the situation. It is an opinion that encourages the guy to go and do cr@p.

No sane doctor would say anything more than a gigantic NO to such a thing. This from a person who has had the ill fortune of listening to lifetime dinnertime conversation between a Gynaecologist and the Midwife he is married to. Before she died I could never bring myself to tell them about the SS girl I was going out with at a time. Why? My father held the professional opinion that for an AS to marry another AS was the devil's work indeed, but that NOT EVEN SS should marry!!!! ever! Personally I do not hold that view, but then *I* am not a doctor who has had to escort so many patients to their graves and watch so many families disintegrate into miserable skeletons of themselves due to some idiot not able to keep his pants zipped up.

I expect a doctor's views to be *more* extreme than mine, NOT less.

By the way, she is NOT a doctor. Not Yet. God help us if she still acts this way when she graduates.

@ Darkmanzero

I have been monitoring all ur responses ever since i started this thread, i must confess that they are a little bit too extreme. In the first instance, if you say "AS'' vs "AS" should not marry at all, i have no problems with that (even though i may not necessarily agree with you). My parents are both "AS" and they have nine children and by the grace of God, all of us are "AS". Let me quickly point out that i really do not support their action but i can't blame them either simply because they are both illiterate and i doubt whether this issue was really a factor during their time. I know you will say that what if all of us turned out to be "SS"? This is why i said that i am not making a case for them. Come to think of it, if we say "AS" pple should not get married, but "AS" can still marry "AA", it simply means that at any given time, pple will still be giving birth to carriers and by implication, we will still be having "SS" children although at a lower rate. But the truth is that the "SS" gene cannot be eradicated, i am sure you will agree with me if you do your research well. You also went too far by saying pple with "SS" gene should not marry at all. I think that is a little bit unfair too. What if they have an "AA" partner which means that they cannot have an "SS" child(ren). I have painfully agree to part with my girlfriend not because i do not have faith or because i am nursing a fear of having an "SS" but simply because my instincts told me to stop the relationship. At worst, we could have gone ahead with our plans and do genetic test for the foetus during pregnancy with the aim of getting rid of it if it turns unfavourable but i deliberately did not consider this option because if i did not do abortion for any girl at my age, i see no reason why i should do it as a legally married person. But since i took the decision, i have had to contend with a whole lot of trouble from every quarters (including my girlfriend's mother who felt i was just looking for excuses to abandon her daughter when the issue of marriage came up). There is a girl in my place of work that really do not believe my reasons for breaking the relationship, she has been searching for Mr. Right for the past few years (she is 31yrs now) and recently found a man that seem serious to ask her hand in marriage. She told me that there is no way under the sun she is gonna allow the guy to go away just because of a "flimpsy excuse" (according to her) that they are not genetically compatible. She has even vowed not to check her genotype and will not even encourage the guy to do it. The bottomline of my story is that, it is not easy to break up a two year old relationship most especially when it appears as if one has found his soulmate. Although, i do not know your marital/relationship status, but i can tell you that it is not easy to let go such a relationship. You really have to be a very strong person to be able to do it. Anyway, in spite of all what you have said, i still respect your opinion and i must admit that i have learnt some things from your postings. Thanks so much.

Hey cassidy

Sorry if i come across as a bigmouthed jerk or an overly loud a$$hole.  I'm so sorry, but sometimes you have to shout and wave your hands around to get people to listen.

points:

1.
I never said SS should never marry- I said that is my *father's* opinion, and he is a gynaecologist, a fellow of the west african college no less. I used it to point out that I expect a doctor with experience of these things to have a more severe view than mine. I believe SS should marry if they find someone they love, who is AA. At least then the kids will survive for sure.

2.
Saying AS+AS ahould never happen is NOT the same as saying AS+AA should never happen.

AS+AA will NEVER PRODUCE A SICKLER [/B] and that is the big difference.

I don't care about eradicating ss or whatnot.

There are already too many bloody illiterates and selfish, insensitive, murderous morons like that person who called AS+AS a 'flimsly excuse' (sorry if I just insulted a friend, but I have no respect for people who talk out their buttocks in an effort to trivialise a serious issue) for that to happen.

The issue is [b] WE DO NOT WANT TO PRODUCE SS CHILDREN WHO WILL SUFFER and if you go into an AS AS marriage you have shown that you think your own happiness is enough of an excuse to ruin another persons life forever.





Finally let me say I have an overflowing of respect for you and your decision- I assure you you have NO IDEA how much suffering you have just alleviated. It puts you in the same league as the most selfless heroes of our time and I am not joking or trying to patronize you. The pain of an SS child is something you had the power to prevent and you did, at the expense of your own (short term) happiness- even though you say it wasnt due to the genotype thing, it still has the same effect.

Thanks for listening and God bless you for what you have decided to do.

Well, I think you guys should be more grateful to yourselves for finding out now instead of having up to 3 or 4 sickle-cell children. although it's just a game of probability, chances are that you guys might not even have one SS child, and you might end up having as many as the number of children you guys decide to have.
The ball is in your court. I think you should have known your genotype before you get to this stage of your relationship. it is always very difficult to make a decision when things like this come up, you'll always think you didn't make the right decision in the long run because whichever option you take now, the other option will still appeal more to you.
However, in anything you do, try to be as objective as you can be taking into consideration that you guys are already thinking of marriage.
I wish you guy’s best of luck and I hope that whatever decision you take now will not come to haunt you in many years to come.

This topic is most interesting. I have a friend who is a carrier. His family has hooked him up with a girl from his tribe who is also a carrier. The girls family said that they could still get married because there is some type of medical procedure that will cure any child born with sickle cell

She and her family said that if the baby received a blood transfusion, I think, immediately after birth, the child will be cured. They also said that it isn't widely known because the procedure isn't done in the U.S. and because it costs about $50,000. I know from another friend who is a medical doctor that there are procedures that are done abroad that are not done here in the US, but I really don't believe her. I think that this girl will go to great lengths to marry my friend and warned him. He told me that even if it could be done, he doesn't want to do it because he wouldn't want her family to ever say that they "purchased" his child and hold it over his head.

What say you?

That is a stinking dirty lie and he should never believe it.

If the family cons him into murdering his own child, either immediately through 'transfusion' (yeah right) or in 20 years time due to sickle cell, he is complicit and doubly damned for not just malice but sheer stupidity. Let him research this 'procedure' and when he finds it to be a load of butt-smoke I wonder how much credibility the girl's family will have left in his eyes.

The things people will do.

i need somebody to do the whole genotype math for me.

also, is there any genotype like SC?

i wnt advice dat n pls i use God name beg u mak una no risk am o.

i would go ahead and get married. sickle cell can be managed. it seems its just in naija that it claims many. here its just any other disease like headache.

there is a genotype like SC, it is very similar to the SS but they usually have milder forms of hemolytic anaemia and they are significantly not as common as the SS forms. Although about 2% of SC patients do have severe crisis too.
SC's are sicklers with the Hemoglobin C, a variant of hemoglobin with a mutation in the beta-globin gene; a substitution of glutamate for lysine on position 6.
The S carriers have a mutation in the beta-globin gene too but on a different location.

The hemoglobin C mutation is relatively harmless.

@ibbfan

the math is simple

1 AS + 1 AS = 2 dirty stinking bastard child-murderers


Seriously:

the chance of getting a sickler is :

AA + AA: zero
AS + AA: zero
AS + AS: 25%(must NEVER HAPPEN)
AA + SS: zero
AS + SS: 75% (must NEVER EVER EVER HAPPEN)
SS + SS: 100% (no brainer)


@SPOILT:

I seriously hope you are joking.

A headache.

That statement alone, I will have to stop talking now because if I could see you face to face I'd be fighting for my LIFE against doing you some SERIOUS violence.

That kind of talk can only be justified if you are a sickler yourself. If not, may God have mercy on your soul.

@david
thank you very much for the SC clarification.

@dakman0
thanks for the math. but i don't see SC in the arithmetic table. why?

dakmanzero:

@ibbfan

the math is simple

1 AS + 1 AS = 2 dirty stinking bastard child-murderers


Seriously:

the chance of getting a sickler is :

AA + AA: zero
AS + AA: zero
AS + AS: 25%(must NEVER HAPPEN)
AA + SS: zero
AS + SS: 75% (must NEVER EVER EVER HAPPEN)
SS + SS: 100% (no brainer)


@SPOILT:

I seriously hope you are joking.

A headache.

That statement alone, I will have to stop talking now because if I could see you face to face I'd be fighting for my LIFE against doing you some SERIOUS violence.

That kind of talk can only be justified if you are a sickler yourself. If not, may God have mercy on your soul.

you want to do me violence? yawn. another woman beater in the house im so terrified of you right now. im shaking in my boots.
this coming from someone who's calling others dirty stinking bastards or what have you. he's also a verbal abuser ke? my friend, be careful.

dakmanzero:

That statement alone, I will have to stop talking now because if I could see you face to face I'd be fighting for my LIFE against doing you some SERIOUS violence.

That kind of talk can only be justified if you are a sickler yourself. If not, may God have mercy on your soul.

to be noticed no be by gra-gra.  

I'm sure spoilt isnt getting married to you neither is she thinking of making the children a burden to you. I'm sure you know there's something called freedom.

My apologies. I won't edit my post, however,  If it was in real life there would be no taking that statement back. Also let it be on record that a person belittling the suffering of a sickle cell patient caused an emotional outburst from me.

The feeling of rage you inspired in me had NOTHING to do with the fact that you are a woman. A man who beats women is an animal, but rage is natural. You can't say a man who feels angry at a woman is an animal any more than you can say a man that feels hot is a furnace- I said i would be fighting for my LIFE against it. What I would have done in real life would be to get up, walk out and refuse to see your face for the rest of the day because I would *definitely* feel that strong.

If you felt I was trying to scare you you are missing the point ENTIRELY.

Now, I apologise for the  outburst but NOT FOR MY POSITION. You HAVE to understand that what you said is far worse than careless- it is wicked. Sicklers are doomed to a painful death, one that I have witnessed twice and they spend their entire lives living in its approaching shadow. How dare you compare that to a headache? If you are a decent person at all you *will* apologise. Not to me, because I am not a sickler. I'm not holding my breath for that, anyway.




@davidylan

Letting my anger out like that was ill-advised. But freedom has limits that do not extend into the realm of evil, malice and wickedness. If she is free to be wicked then so are armed robbers and thieves. The only excuse would be ignorance but even that is invalid if she does not acknowledge it with an apology. And like I said earlier, not to me. I'm not the one that has to treat every year past 21 like its living on borrowed time.

@ dakmanzero
apology accepted. but when i said here they treat sickle cell like any other disease, i meant it. i wasnt kidding. the headache part was just to buttress the point. this disease has been successfully managed in the u.s that people hardly die from it anymore and they hardly have the crisis sef.they have good drugs and medical care. its shocking that it still kills millions in naija. belittling the disease wasnt my intention. you said sicklers are doomed to a painful death. i so dont agree with you. in naija maybe! but then again in nigeria our medical system is useless.

n.b we're friends again abi?

Dr. Kuku of EKO Hospital has been doing some research on this case and even has a foundation that caters to sicklers, being the only surviving child of about 6 kids who all died of the same sickness. hopefully, hope will be restored to the carriers and they will live normal lives.

i still dont get it, when are we going to learn?is it not wiser to break up now and experince a little pain which would go away, and i believe is temporal rather than experiece a lifetime of unhappiness.u dont need a Doc, u need wisdom.

i guess with this, there'll be more marriages out of convenience than love. shame!