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Expectant and Postpartum Moms
Reply to "Husband has Sickle Cell gene and didn't tell me"
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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]Shocked by these responses. This is a serious big deal. Just like it would be to hide infertility. This might not be a big deal for some but is for OP so one should be dismissing her concerns. [/quote] No, it’s not even close to hiding infertility. [b]It should have been mentioned to make sure that the partner is not a carrier as well, but being a carrier doesn’t affect quality of life.[/b] SCD develops when inherited from both parents.[/quote] According to a previous poster, this is incorrect. See quote below. [b]"It's a widespread myth that sickle cell trait is always asymptomatic. Sickle cell trait is an intermediate phenotype, not a true asymptomatic carrier state. A proportion of individuals with SCT WILL have pain crises and other symptoms. Think of the trait as a less severe version of the disease. OP, I can't decide for you if you're in the right to be angry. I can only provide you with scientific facts."[/b][/quote] This is true. Having the trait means that we inherited a normal allele from one of our parents and an abnormal (sickle cell) allele from the other parent. We have both normal (round) and abnormal (sickle-shaped) red blood cells in our bodies. [b]If you look at our blood under a microscope, you will see both shapes of red blood cells present[/b]. The abnormally shaped red blood cells that are present can cause health issues for us. The trait is just considered less problematic than the disease because we do have some normal (round) red blood cells. People with sickle cell disease have NO normal red blood cells. [b]All of their red blood cells are sickle shaped[/b].[/quote] No. That is not how it works. The variant hemoglobin cells LOOK normal under the microscope UNLESS they are "sickled" -- it's not a default shape. They undergo "sickling" and change shape, which is what causes the crises in those that have them. Otherwise the blood flows normally. If they were always in sickled shape, people with SCA would always be in crisis. [quote]Sickle hemoglobin is not like normal hemoglobin. [b]Under low oxygen conditions, hemoglobin S transforms into stiff strands[/b] within red blood cells. These stiff strands change the shape of the cell, causing the “sickled,” or crescent-shaped, red blood cell that gives the disease its name. Sickled red blood cells are not flexible and can stick to vessel walls, which can block or slow blood flow. NIH webpage https://www.nhlbi.nih.gov/health/sickle-cell-disease/ [/quote][/quote] The red blood cells aren’t always sickled (as they have to undergo sickling), but there are [b]always[/b] [b]SOME[/b] sickled red blood cells that are present in the bodies of those with sickle cell disease at any given moment. If you looked at their blood under a microscope, you would always see [b]SOME[/b] amount of sickled red blood cells [b](whether they’re in a crisis or not)[/b]. The number of sickled red blood cells present in the body [b]INCREASES[/b] under certain conditions (like low levels of oxygen in the body). A sickle cell crisis happens when those sickled red blood cells clump together. Those sickled red blood cells build up and become stuck in blood vessels as they’re attempting to travel throughout the body (as normal red blood cells do). This happening is what sets off a crisis. “The sickle-shaped cells [b]become more numerous[/b] when people have infections or low levels of oxygen in the blood.” - https://www.merckmanuals.com/home/blood-disorders/anemia/sickle-cell-disease[/quote] [quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]Shocked by these responses. This is a serious big deal. Just like it would be to hide infertility. This might not be a big deal for some but is for OP so one should be dismissing her concerns. [/quote] No, it’s not even close to hiding infertility. [b]It should have been mentioned to make sure that the partner is not a carrier as well, but being a carrier doesn’t affect quality of life.[/b] SCD develops when inherited from both parents.[/quote] According to a previous poster, this is incorrect. See quote below. [b]"It's a widespread myth that sickle cell trait is always asymptomatic. Sickle cell trait is an intermediate phenotype, not a true asymptomatic carrier state. A proportion of individuals with SCT WILL have pain crises and other symptoms. Think of the trait as a less severe version of the disease. OP, I can't decide for you if you're in the right to be angry. I can only provide you with scientific facts."[/b][/quote] This is true. Having the trait means that we inherited a normal allele from one of our parents and an abnormal (sickle cell) allele from the other parent. We have both normal (round) and abnormal (sickle-shaped) red blood cells in our bodies. [b]If you look at our blood under a microscope, you will see both shapes of red blood cells present[/b]. The abnormally shaped red blood cells that are present can cause health issues for us. The trait is just considered less problematic than the disease because we do have some normal (round) red blood cells. People with sickle cell disease have NO normal red blood cells. [b]All of their red blood cells are sickle shaped[/b].[/quote] No. That is not how it works. The variant hemoglobin cells LOOK normal under the microscope UNLESS they are "sickled" -- it's not a default shape. They undergo "sickling" and change shape, which is what causes the crises in those that have them. Otherwise the blood flows normally. If they were always in sickled shape, people with SCA would always be in crisis. [quote]Sickle hemoglobin is not like normal hemoglobin. [b]Under low oxygen conditions, hemoglobin S transforms into stiff strands[/b] within red blood cells. These stiff strands change the shape of the cell, causing the “sickled,” or crescent-shaped, red blood cell that gives the disease its name. Sickled red blood cells are not flexible and can stick to vessel walls, which can block or slow blood flow. NIH webpage https://www.nhlbi.nih.gov/health/sickle-cell-disease/ [/quote][/quote] The red blood cells aren’t always sickled (as they have to undergo sickling), but there are [b]always[/b] [b]SOME[/b] sickled red blood cells that are present in the bodies of those with sickle cell disease at any given moment. If you looked at their blood under a microscope, you would always see [b]SOME[/b] amount of sickled red blood cells [b](whether they’re in a crisis or not)[/b]. The number of sickled red blood cells present in the body [b]INCREASES[/b] under certain conditions (like low levels of oxygen in the body). A sickle cell crisis happens when those sickled red blood cells clump together. Those sickled red blood cells build up and become stuck in blood vessels as they’re attempting to travel throughout the body (as normal red blood cells do). This happening is what sets off a crisis. “The sickle-shaped cells [b]become more numerous[/b] when people have infections or low levels of oxygen in the blood.” - https://www.merckmanuals.com/home/blood-disorders/anemia/sickle-cell-disease[/quote] Yep. Medical examiners see some sickled RBC present in specimens taken from every person with sickle cell trait and sickle cell disease. This is one of the ways that they’re able to determine that someone had SCT or SCD (even if it didn’t contribute to the person’s death). You don’t need to be in a crisis or to have ever experienced a crisis (in the case of those with SCT) for sickled RBC to be present.[/quote] My apologies, but just to clarify -- are both of you claiming that you can rely on a peripheral blood smear to rule out sickle cell anemia and/or sickle cell trait, because there will always be visible sickle cells? Is that what you each are saying?[/quote] I’m not sure about the other poster, but that’s what I’m saying. I will never claim that any diagnostic test is 100% accurate, but I will say that peripheral blood smears are highly accurate at detecting sickle cell in the vast majority of people. (Infants are the exception to the rule.) https://imagebank.hematology.org/image/3958/sickle-cell-disease-ndash-rbc-morphology--1 https://academic.oup.com/labmed/article-abstract/31/8/445/2657125 https://www.rmj.org.pk/fulltext/27-1594051429.pdf[/quote]
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