The sickle cell disease is an inherited health disorder, which causes red blood cells that are naturally disc-shaped and pliable, to become misshapen, stiff and sticky. Severe pain crises occur periodically in people living with the disease when these sickled red blood cells hinder proper blood flow. Instead of donut appearance, red blood cells are sickle shaped; and this makes sufferers more fragile, resulting in lowered supply of oxygen to the body and disrupted healthy blood flow.
KNOW YOUR GENE BEFORE MARRIAGE The days of ignorance as a result of little medical research and public awareness are over. Society holds everyone responsible to guard against uninformed relationships leading to marriage or child bearing outside wedlock. While delivering a lecture on SCD – ‘Know Your Gene Before Marriage’ in Lagos recently, Dr. Martins Irhoeze told the workshop that with medical research and public awareness embarked upon by the health ministry and religious bodies, there is no excuse for anyone to fall victim to the disease or procreate children with sickle cell anaemia. Just as the antidote to HIVAIDS is abstinence, the fool-proof cure for SCD is complete prevention; and, like HIV-AIDS, it is easy to avoid the SCD because all a sensible adult needs to do is not to attempt to ‘acquire’ the virus that causes AIDS; acquiring is a decision and that is where individual responsibility comes in. “Similarly, a sensible adult going into a relationship can easily avoid the problem of SCD by ensuring the genotype of his or her partner before marriage is contemplated.” Martins praised some religious organizations that created marital counseling departments where intending couples are made to present their genotype test results; some even go the extra mile to oversee the test themselves before the intending couples arecounselled on other areas preparatory for marriage. “The foundation of marriage today must be based on a thorough knowledge of what sickle cell disease is as well as the necessity to know and ensure your genotype compatibility with your partner. The distinction between AA, AS and SS must be clearly understood by both partners before marriage is embarked upon.” Martins painted graphic pictures of the consequences of ignoring the genotype pre-marriage test. “People with incompatible genotype combination should not get married and those who are already in relationships, must call off such relationships.”
DIETARY CONTROL In the long failed battle by medical science to find a cure for the condition, a healthy diet is advised to control the condition and minimize symptoms in sufferers. Dietician and nutrition expert in a sickle cell emergency response team, Kayode Oguntimehintold Daily Times that good dieting or nutrition can help safeguard healthy growth in people with sickle cell disease and may reduce the risk of complications. “Any registered dietitian can advise the patient and family on how to meet macronutrient and micronutrient needs. Though it is important for everyone to eat a healthy, balanced diet, it is especially significant for those with sickle cell anemia. “A good balanced diet filled with iron-rich foods is highly recommended. Research has it that high-protein foods such as red meat, liver, tuna fish, shellfish, egg yolks, beans and peas contain iron and are highly recommended for sickle cell patients. “Other foods include iron-fortified cereals, oatmeal, cream of wheat, leafy green vegetables, dried fruits, prune juice and molasses.”
WHAT NOT TO EAT “But while meat is recommended for sufferers of Sickle Cell anemia, care should be taken in the consumption of chicken and egg. This, according to him, is not unconnected with the fact that chicken and egg are the main source of salmonella, which can easily lead to bone infection, which also can be very difficult to treat in, especially, Sickle Cell patients.”
DANGERS TO AVOID Not eating for long periods can trigger a sickle cell crisis due to not having enough nutrients in the body for maintaining normal bodily functions. Considering nutritional requirements of sickle cell patients, sufferers, especially children, may need more calories than others their age to assis the body in fighting off infection and replace damaged blood cells. During a sickle cell crisis, energy intake can be especially low, which leads to increased symptoms and increased fatigue. A diet containing up to three times the normal recommended nutrients can help to prevent nutrient deficiency and help to prevent severe and frequent crises. Eating snacks between meals during the day can help in meeting these caloric needs. Such snacks can include fruit, peanut butter or hummus with vegetables or whole-grain crackers, nuts, small amounts of cheese and smoothies or prepared drinks. A doctor or nutritionist can help determine an individual’s caloric need. On the needed level of vitamins and minerals, blood vitamin levels in sickle cell disease patients tend to be lower than normal, with deficiencies in vitamin A, carotenoids, vitamin B6, C, E, magnesium and zinc. These deficiencies can result in lower levels of antioxidants in the blood, which in turn leads to oxidative stress and can lead to vaso-occlusion-related acute chest syndrome. On the basis of this, foods such as citrus fruit, oranges and grapefruit, tomatoes and tomato juice, strawberries, cantaloupe, kiwi fruit, green peppers, broccoli and cauliflower are highly advised. The water content in these foods also decreases dehydration, a condition that causes pain in sickle cell anemia sufferers. The place of fluid in the lives of sickle cell patients can never be over-emphasized. Research shows that sickling red blood cells is increased in SCD patients who have low hydration levels. Insufficient amount of water in the body (dehydration) is one of the most common causes of a sickle cell crisis. In this situation the blood becomes thicker, and sickled shaped red blood cells are more likely to stick together and cause a blockage in the blood circulation. Therefore, it is important for an adult to drink at last 3 – 4 litres of water daily; this is apart from the water contained in the food they eat. The water can be in the form of plain water, diluted fruit squash, tea and other fluids. Alcoholic drinks should be avoided and if taken it should be consumed in very small quantities because alcohol increases dehydration and can lead to other complications. Below is fruit and food chart guide for the benefit of sickle cell disease sufferers.