Search This Blog

Thursday, June 13, 2013

Why I can’t have fights with my sister?

Everybody who has siblings knows that the relation etched out between them is very clear- a love-hate relation, a relation where a lot of things are acceptable which otherwise would not be in any other relation. Siblings can fight each other, be utterly mean to each other, wreck each other’s lives and still have that tiny ounce of bonding between them. Let us just say that siblings add the spice to each other’s lives. But, what about those siblings that are bound to each other by a very unusual kind of bond?

What if one of the siblings is the reason the other is enjoying the bliss in life? What if one of the siblings epitomizes sacrifice? Does the innate love-hate relationship still exist or does it make way for a formal obligatory relationship? When a brother and sister or two sisters fight each other, they fight as equals. Even with the age difference, there is a constant race to prove that the younger one is as tough as the older one. Given this status quo, how much would a relationship change when one sibling assumes a higher pedestal and the other a lower. When one feels indebted to the other, the dynamics of the relation change. There is no longer a friendly banter, and competitive arguments. Some awkwardness is bound to surface in this otherwise no holds barred relation.

This imbalance in the positions comes in when one of the siblings is a donor and the other the recipient, .like in the case of bone marrow transplant. Bone marrow transplant is required as an antidote for a number of fatal diseases like leukemia, neuroblastoma, severe aplastic anemia, and several immune deficiency disorders. In an Allogeneic bone marrow transplant, the donor shares the same genetic type as the patient. Stem cells are taken either by bone marrow harvest or apheresis from a genetically-matched donor, usually a brother or sister.  Before a donor is identified, it is essential for the donor to undergo genetic matching and being a sibling does not necessarily qualify a person to be a match.

Matching involves typing human leukocyte antigen (HLA) tissue. The antigens on the surface of these special white blood cells determine the genetic makeup of a person's immune system. Although there are at least 100 HLA antigens, it is believed that there are a few major antigens that determine whether a donor and recipient match. The others are considered minor and their effect on a successful transplant is not as well-defined.

Medical research is still investigating the role all antigens play in the process of a bone marrow transplant and it is not yet clear how every antigen plays a role in the transplant process. An established fact though, is that the more antigens that match, the better the engraftment of donated marrow. Most of the genes that "code" for the human immune system are on one chromosome. Since every person has only two of each chromosome, one is received from each of the parents. Hence, a full sibling of a patient (sibling that has both parents common) in need of a transplant has a one in four chance of having gotten the same set of chromosomes and being a full match for transplantation. 

The question then is, if a sibling is a full match for transplantation, is it ethical to consider him/her as a donor. We have to remember that for adult donors, there are informed consent documents that are signed, and thus, are a representation of the donor’s will to be involved in the transplantation. What happens when the donor is a child? Is it actually the child’s free will that is being exerted? It is the parents who sign the documents as guardians, and as tough a choice it is for the parents, their decision is going to be biased in favor of the ailing child. 

The most serious risk associated with donating bone marrow involves the use and effects of anesthesia during surgery. After the surgery, the donor might feel tired or weak and have trouble walking for a few days. The area where the bone marrow was taken out also might feel sore for a few days. According to Mayo Clinic, the donor is likely able to get back to their normal routine within a couple of days, but it may take a couple of weeks before they feel fully recovered. It is evident that donating bone marrow does not have any serious side effects, but the fact that the normal life of the donor sibling is disrupted, raises concern.

And although children are involved in this scenario, we forget how receptive children can be. By appointing one child as the caregiver for the other, are the parents introducing a feeling of indebtedness instead of the normal bantering relationship?  The awkwardness is just one side of the story. What if there is contempt and anger at the thought of putting your body at stake for your sibling? How long can one be a self-sacrificing martyr? What happens then?

It is essential for parents and healthcare providers to scrutinize the dynamics of this complicated relationship before selecting children as bone marrow donors. Preserving cord blood is being recommended by doctors rampantly, and may very well be the future of transplant options. The probability of finding a match from an unrelated donor is also quite high and might save families the trouble of avoiding the guilt of having to choose the welfare of one child over the other. Given that this facility of National Marrow Programs does not yet exist in India, it is an area that needs to be explored and established. With a number of Marrow Banks on the spurt, maybe that is an option which is healthier for the mental health and social dynamics of the family.

Relations never come without complications, but a donor-recipient relation is one that is innately convoluted. In such a situation, isn’t it too much to entangle two relations; that of siblings and a donor-recipient? Is it fair to rid the children of a normal childhood? Are their any laws in place for the donor sibling and how can it be ensured that the rights of the donor child are not violated? These are some issues that need to be addressed by medical rights agencies, and affected families alike, when looking at transplant options. Irrespective, a question that would remain unanswered: “Is it ever possible to have a relation, no strings attached, be it a familial relation, a medical relation, or for that matter any interaction involving humans?”


Monday, March 26, 2012

And you thought only humans cheated!

If I mention the names of a few soap operas- "Desperate Housewives", "Grey's Anatomy" or our very own Indian melodramas by Ekta Kapoor, what is the common link among all three? Infidelity, and scandals.The premise of the serial might be different in each, but human traits are personified in all of them. And being on the look out for a new mate, is definitely one of the traits on display. There are multiple theories developed by behavior analysts and scientists world over, trying to understand the impetus for this urge. What interests me more than the analyses is the fact that this trend is seen even outside of the human species. And that very much, might hold the clue to science of infidelity.

So much has been spoken about the Darwinian theories of natural selection, that it is no longer just a theory, it has become the key to much of human behavior. Recent genetic studies on birds have proven that it is very common for birds to nest with different mates over different breeding seasons. Earlier, it was thought that birds would generally mate for life and breed with the same partner over a lifetime, but more precise DNA patterns of off-springs has led researchers to conclude that each group of off-springs have some foreign DNA within them, which points to polygamous behavior of the first generation. 

Further delving into the topic has brought to the forefront, the reasons that instigate birds to "cheat" on their partners. Although, birds are known to win their mate's heart by colorful display of their plumage or mellifluous voices, these aspects seem to take a back-seat, when it comes to dealing with environmental stress. Not unlike humans, only love does not help survive the race; the pressing issues of food, shelter and security direct their mating behavior. Once a bird has nested with one partner, won over by the colorful spectrum, it does not last very long if the male bird is unable to bring home food and itself starts looking scrawny. The mother bird needs to be assured that her progeny would be safe. It is this feeling that prompts the female bird to find a different mate for the next breeding season. It is very much like in the human parallel, women look for men with stable jobs and secure careers as a life partner. 

The logical reasoning behind this effort to find different and better mates is, that at least one off-spring will have the strong genetic capability to cope up with extremes. It is with respect to this explanation, that infidelity among birds has risen over the last few years, when climate change has been so drastic. According to a study carried out by Carlos Botero of Columbia University, eggs laid by female birds, in areas that have sudden climatic changes, lacked the DNA of the spouse. Under this same study, the temperature variations and precipitation rates were plotted against the mating habits of birds, which led to the conclusion that erratic climate fluctuations push birds towards apparent promiscuity. Swapping mates is the attempt by female birds to pass on strong genes to the filial generation in hopes that when the climate gets worse, their chicks might survive. Look at it in terms of how a protective mother would want to ensure the child's best interest. I wonder if these are the same thoughts that push even humans to supposedly find a better partner!

Although infidelity seems like an unacceptable thing in the human race, for birds like geese, bluebirds, falcons, and sparrows, this is their way of making sure their species survives. Now who would have thought, that the actions of one species would affect the mating behavior of another species! This is just an indicator of how man's actions have been and continue disturbing the ecological equilibrium. Maybe next time, we invent a new CFC, we will remember that somewhere a poor bird was cheated on and left stranded because of our greed for comfort!

(Source-Scientific American)

Sunday, November 6, 2011

The workout myth!

In this busy world that we live in, we have found a way to fast-track everything. Be it instantaneous communication, information at your finger tips, fast food or speedy shopping in the express checkout lanes. We want to get a lot done in very less time and yet, we don't exert as much energy doing those things, as a few years back. All the major innovations in the recent past have been to make life easy and comfortable for everybody. The internet and its numerous applications though making everything accessible, have tied us down to the computer. The side effect to this is the drastic reduction of energy spent on performing these daily activities.

Now since, it came to our notice that the newer generations were becoming obese and unhealthy, we tried to propagate the importance of exercise. But, our busy schedules didn't stop following us. So what did we do? We came up with the brilliant ideas of power workouts. Spend 30 mins. in the gym and burn the calories. And the rest of the day, go back to being sedentary with your work. What we don't realize is that a gym workout is just that, it works up our body, in a way, that the calories are burnt. But, the other benefits derived from exercise are never attained.

A recent study boosts the same belief, by linking prolonged sitting with a higher risk of breast and colon cancer. According to Christina Friedenrich, an epidemiologist at Alberta Health Services Cancer Care in Canada, physical inactivity is linked to as many as 49,000 cases of breast cancer and 43,000 cases of colon cancer a year in the United States (Source: Scientific American). It is also established that not just these two types of cancer, but prostate, lung, endometrial and ovarian cancers could also be prevented by exercise.

Cancer cell under electron microscope

Especially, for endometrial cancer, it was noted that the level of C reactive protein (CRP) was found to be very low in women in the habit of exercising more and just being more active. This protein is a component of the acute phase immune response. The CRP levels are said to increase 50,000-fold during an inflammatory response, a type of body's defense mechanism against infection. Since chronic inflammation damages the body's own cells, it makes those cells more prone to convert into cancerous cells. Thus, the fact that CRP levels are lower when women exercise, leads us to believe that the chance of inflammation and, in turn, malignant growths are fewer.

It is not just the dreaded cancer, but a lot of other disorders that are linked to lack of exercise. The most major among them being, Type 2 Diabetes. What is generally conceived as exercise is just a short-term solution to burning calories, but what is important is to make the muscles active. This requires muscles to be in the habit of movement and exercise. When the muscles don't get the necessary activity, they do not take up the sugar from your blood after meals. Over time, this tends to put your body at a risk of having higher blood glucose levels, which is a precursor of Type 2 Diabetes.

This just means that if we really want to be healthy in its true sense and keep as far away from diseases as possible, we should have an active life! 30 mins. of gym time or jogging does help us a little with our calories issues, but what is really needed is the exercise at frequent intervals during the day. And of course, exercise during work does not mean, we start running around in sneakers. It is just implies that we get away from our desks for a little while, take a walk or just get up and do some work that can be done standing. Maybe walk up to a colleague's desk and talk about something, for which you would regularly have sent an email.

It is just the break in  the long hours of sedentary routine that goes a long way. The uninterrupted sitting is the true culprit. Just by tweaking the work schedule, so that every few hours we train our muscles to be active, we could be trading in for a longer and healthier life. It is high time that the myth of health conscious people hitting the gym should be erased. 

We need to realize that the only thing that needs to be fast-track is our steps and nothing else. Express lanes to minimize the waiting time might actually minimize the time we spend leading a healthy life! Think about it!!! Would you want to hurry to get somewhere quickly or prefer standing and let your body take care of itself? People wanting to be healthy should do it the old-school way and ditch the luxuries to actually exert some energy and lead a happier, healthier and fulfilling life.