There seems to be a lot of misconceptions about almost everything in life, this is however not surprising as no one is all knowing. Misconceptions are raised due to the different perspectives individuals have on issues. CrimsonBow will be bringing to you a new series that will discuss and educate you on the popular misconceptions that are related to the Sickle Cell condition.

This first write-up on misconceptions relating to the sickle cell condition will be about the yellowing of the white part of the pupil (sclera). While some of you know the implications of the yellowing of the eyes in human beings, a lot of people in this country Nigeria do not know. I remember while I was growing up, my eyes were predominantly yellow. This didn’t mean anything to me till I started working. There were lots of embarrassing questions and comments directed at me. I remember some people saying that my yellow eyes could kill me. Some were right to say that I had jaundice but their idea of jaundice was wrong, I felt at that time that they were ludicrous to assume I will go insane or die due to the yellowing of my eyes as it had been part of me for so long, it meant absolutely nothing to me anymore.

Recently, while my partner (Greg) and I were preparing for a radio interview with two doctors (shout out to Doctor Julz and Doctor Sanda), one of the doctors mentioned a case of a Nigerian woman who didn’t know why her child’s eyes were yellow. She felt the need to correct this, so within her means, she took her child to “wash” his eyes using traditional methods. Her child became blind as a result. This saddened me greatly as I realised that so many people don’t know the implications of yellowing of the eyes in Sickle Cell Warriors, hence, will not know how to handle it.

Yes, the yellowing of the sclera is as a result of jaundice. This, however, is a result of the breaking and dying of the red blood cells in the body. Once this happens, the body is supposed to recycle or get rid of them through excretion. A special protein called haemoglobin inside the red blood cells is converted to bilirubin at this stage so that it can be passed out by the body. However, bilirubin is not yet disposable and must be mixed with other things from the liver that will modify it into bile. This then goes into the intestines and converted by bacteria to urobilirubin (I hope you are not confused yet, lol). Urobilirubin is then excreted in stool (this is what makes poop brown) or in urine. Isn’t the human body amazing?

The average red blood cells live about 90-120 days, but the red blood cells in the case of a person with Sickle Cell Disease (SCD) only lives 10-12 days. This implies that the volume of red blood cells that will go through the process of excretion I just explained will be a lot more. This ensures that the body becomes overworked. Sometimes, the bilirum will just keep floating around until the liver can convert it for excretion. This is what reflects in the white part of the eyes and make them yellow. Apart from the eyes, the fingernails might also turn yellow. The skin might also portray a tinge of yellow in light-skinned people. The more yellow the white part of the eyes are, the more susceptible a Sickle Cell Warrior is to crisis.

The main advice a Doctor will give at this point is to drink lots of water and take folic acid. However, every SCD carrier is to ensure that his or her liver is functioning properly. Go for regular liver enzyme level tests (AST/ALT), do not consume excess vitamin A & D, as the liver produces this on its own. Be careful about the pain medications you use. Stay away from alcohol, fatty foods, over processed foods and herbal remedies, please.

Timi Edwin

Note: I realise I used a lot of medical jargons in this write-up. To simplify this, in summary, the yellow eyes in Sickle Sell warriors is as a result of their bodies being unable to pass out the red blood cells as quickly as they die. The residue of these red blood cells is what causes the discoloration of the eyes.

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