A crescent moon is always the first and last phase before or after a new moon. Whenever we look at the sky, it’s always with the hope that it’s going to be a full moon. But there are some people out there who will never get to experience the full glow of the moon. Knowing the moon only in its crescent form. Even without its light fully on display, there is still so much beauty the moon possesses. Dr. James Herrick made the first official report on a patient with a mysterious disease in 1910. Notably recognizing how, instead of full circles, the patient’s red blood cells were sickle or crescent shaped. Over time, it was found that there were abnormalities in the patient’s hemoglobin, the protein responsible for transporting oxygen. This was then compared to the blood of the parents, and from there, a genetic link was hypothesized. It was not until 1922 that the name “Sickle Cell Anemia” was finally used regarding this ailment.
The veins and arteries are like our body’s highway, working overtime to make sure that every cell receives the molecules that it needs to make sure things run smoothly. The most vital molecule is oxygen as it allows for cellular respiration. In patients with sickle cell anemia, the molecule responsible for this transport, hemoglobin, is mutated and called hemoglobin S. This causes the normally round and red blood cells to adopt a sickle, crescent moon-like shape. The abnormality makes it so that the transport of oxygen is much less efficient. The red blood cells are less flexible and durable which is why “anemia”, or lack of red blood cells, is also included in the disease title as people with this disease often don’t have enough blood. This disorder is activated based on the genes passed on from parents. Specifically, it’s autosomal recessive, a copy of the gene must be received from each parent. This means that if the parents each have a copy, there is a 25% chance that a child will end up with both copies, and it is equally as likely that the child ends up with neither. If only one copy is received, then the person has the sickle cell trait, in most cases this won’t mean anything to their physical health. From there, a copy can be passed on to the next generation.
On its own it is not fatal; however, certain conditions can bring about serious complications. Most symptoms are caused by potential blockages. The vessels behind the eyes are a common area that becomes plugged, which can cause complications with vision. Another dangerous blockage that could occur is one to the brain, which causes a stroke. There may also be swelling of the hands and feet. The worst of these symptoms is called a crisis. Lack of flexibility causes some red blood cells to get stuck in a vessel, meaning vital tissues are not getting the oxygen that they need. This causes a tremendous amount of pain that often requires a hospital visit to be able to manage. Atmosphere, pressure, and hydration can also trigger this event. So, people with this condition need to pay attention before performing any high-impact activities. Staying hydrated allows for the blood cells to stay more lubricated, so consistently drinking water is vital to health. Avoiding the cold can also be helpful to derail crises, as heat widens blood vessels and improves their circulation. Making efforts to minimize obstructions helps keep crises at bay. It’s also important to note that people with the trait should still be mindful of their habits as they can also have some symptoms manifest physically.
When my brother was born, a series of tests were done to assess his health as a newborn. It was then that doctors realized that he was my parents’ 25% chance. My mom has a background in medicine, so she was totally prepared to help my brother with whatever he needed. We had long conversations about what the disease was and how it would affect him. I needed to know this information too as I carry the trait. We would have an abundance of water bottles with us whenever we left the house. Making sure my brother downed tons of water a day. When he started school, it was instilled in him that drinking water should be a part of his routine. His teachers didn’t appreciate the frequent interruptions, and my brother had to ask to go to the bathroom so much that he needed to give his teachers a note at the beginning of the school year explaining his condition.
My brother has always been my best friend in this world. I got to mold him growing up as I’d force him to watch all of my favorite shows. Our family moved around a lot and with our parents getting divorced, the only thing that was constant in our lives was each other. We learned French and saw Africa together. I have so many memories in this life that wouldn’t be as fulfilling if he wasn’t part of them. It’s why I’m heartbroken that as he’s grown up some things have become harder for him, like flying. Something that I paid no mind to was causing my brother so much pain. As a surprise, we flew to New York for his thirteenth birthday, and in the most wonderful city in the world, my brother was bedridden. After that last trip, we realized that it just didn’t make sense for him to go through that again. A selfish part of me was mad about this. I love to travel and go on adventures. I hated that I would have to explore the world on my own now and translate the world through pictures to him. He’s always said that he doesn’t care, but I’m mad at the world for him. All those adventures we could’ve had together were just taken away from us.
One night, in the summer of 2019, the TV was on blast with the Descendant’s music videos as the third movie had just been released. Toy swords in hand, and we were the mightiest warriors in the land. Then out of nowhere, my brother collapses on the couch clutching his side. I was confused because there was no way I had hurt him during the song. I told him to stop faking, saying I know when he does. But I looked at his face again and I realized that something was wrong. I cannot count the number of conversations we had about crises, yet when one finally hit, I was so lost. Yelling for our mom, I tried comforting him as she jumped into action. We carried him into the car and rushed him to the hospital. I had never been more scared; I’d have done anything to take his pain away and give it to myself. Those couple of days when he was in the hospital were so hard, but I was so proud of him for being so strong. When he had been released it was right before our trip to Orlando’s Volcano Bay. Unfortunately, he wasn’t feeling up for it, so it was just my cousin and me. Don’t get me wrong, I had a blast there, but anytime my mind wandered off a bit I would immediately think about how much fun we’d have if we were together. There was a lazy river that launched water sometimes, and I know he would have been happy there. No chance he’d have let me go home without making fun of me for getting caught in the water. It’s just not the same having to tell him that it happened instead of him being able to witness it.
Starting college was always going to be a challenge, it’s the first time in our lives that we would be living without each other. Whenever I thought about what I’d miss the most during this transition, the answer was him every time without a doubt. I hated the fact that it would be so hard to see each other because my family relocated to Canada, and the most efficient way to get there is by flying. I have to wait for long weekends to see him now, but what hurts me is the fact that he can’t occasionally come down and say hi to his friends that he left behind in Florida. Even some of the simple pleasures in this world have been taken away from him. We used to love getting Wingstop together, and he hasn’t had that in over a year now. His favorite chips, Takis, are also something that he has a hard time finding in Canada. I hate that he feels so limited as to what his options are in this world. I hate waiting months to see my best friend. I hate seeing him in pain knowing I can’t do anything about it, but I make sure that he knows I’ll be the strongest pillar in the world for him. So even if he can’t get to see all the world has to offer, I’m going to do it for him. Every night I’ll look at the sky and be just as, if not more, excited to see a crescent moon in the sky.