Genetic conditions

Genetic conditions

What is Genetic conditions?

Thousands of Australians have genetic conditions that cause physical or intellectual disabilities. Some of these conditions are inherited, while others are caused by random alteration in one or more genes in the person’s body.

Some babies are born with obvious signs of a genetic condition, such as a physical deformity or a neurological problem. However, many genetic conditions only start showing as the child is growing up, or in the teenage or adult years.

Some of these conditions have little effect, while others have a significant effect on someone’s life, having an impact on their independence, their family, their closest relationships, their work, their sexual lives and their daily activities.

But with the right treatment, therapy, services and support, many people find that the issues raised by their genetic condition can be managed, and their quality of life improved. For babies and children with genetic conditions, early intervention therapies can be vital in allowing them to make the most of their abilities.

 

What is a gene

A gene is a part of a cell in your body that provides instructions for life. When you are growing as a fetus, it provides instructions to tell you what colour eyes to develop, whether your hair should be straight or curly, and how your heart should develop. They do this by telling your cells to produce proteins that are used throughout the body to help with growth, development and repair.

Once you are born, your genes continue to provide instructions, and do so all through your life. They don’t switch off once you are born. But those instructions now have to compete with all the other influences around you, such as what you eat, what you drink, your environment and more.

You have more than 20,000 genes in you. A whole lot of genes together form what is known as a strand of DNA. Two strands of DNA twisted together form what is known as a chromosome, which is found in the centre of almost every cell in your body. Most people have 46 chromosomes in nearly every cell – 23 inherited from each

Types & Severity

There are dozens of different genetic disorders, most of which are rare. They can be classified like this.

  • Single gene disorders, where the person inherits a single altered or mutated gene. Examples are Huntington’s disease and cystic fibrosis.
  • Complex gene disorders, where the person inherits two or more mutated genes which sometimes combine with environmental or lifestyle factors to cause a disease. These diseases tend to run in families, but there is no clear pattern of inheritance. Examples are Alzheimer’s disease, type 2 diabetes and some cancers.
  • Chromosomal disorders, where the person has damaged, missing or extra chromosomes. Examples are Turner syndrome, cri-du-chat syndrome and Klinefelter syndrome.

 

Impact of genetic conditions

The impact varies from person to person. Everybody has faulty genes – that is part of life. Some cause trouble, and some don’t.

At their mildest, genetic conditions can have minimal effect on an individual, perhaps with some minor health issues, and perhaps not. Other people are significantly affected by their genetic conditions  and need consistent support throughout life. 

The impact of the genetic condition/s on the individual may  also affect others around them, especially in the family.

Causes

Genetic conditions can come about in three ways:

  • you can have a faulty gene or chromosome passed on by one or both of your parents, or
  • you can have a gene develop a fault in the process of being passed down by a parent, or
  • you can have a gene or chromosome develop a fault while inside your body.

These faulty genes or chromosomes then give faulty instructions throughout your body. It might not give the right instructions to stop a cancer developing, or it might not give instructions to develop pigment in your skin. It might give instructions to make a certain protein, and that protein interferes with how your brain develops. There is a lot of variety in genetic conditions. 

Usually it is impossible to say why any one person has a faulty gene or chromosome in the first place. It is thought that some genetic or chromosomal mutations are influenced by things like:

  • radiation from the sun, from X-rays and CT scans, from nuclear explosions
  • some pesticides and toxins.

Diagnosis

When a genetic condition begins in infancy, the signs that something is wrong are often first noticed by the baby’s parents. Their fears may be confirmed during routine checks of whether the child is meeting typical developmental milestones. With other genetic disorders, the first signs may appear anywhere from childhood to middle age.

The child or adult often sees a general practitioner, before being referred to a relevant specialist, such as a paediatrician or neurologist. Some people will see a geneticist or a genetic counsellor. The health professionals will take a family and medical history and examine the person. They will order tests, which might include:

  • genetic tests, including DNA sampling, that can be used to confirm or rule out particular conditions
  • blood tests
  • computer tomography (CT) scans of the brain
  • nerve conduction studies and electromyography (EMG) to assess nerve damage
  • nerve or muscle biopsies, where a small sample of nerve or muscle is removed and tested in a laboratory
  • X-rays.

Some genetic conditions can be picked up fairly easily, but rarer conditions may take many months or even years to diagnose.

About testing for genetic conditions

Some genetic conditions can be tested for, and it can be good to know what’s going on. But you should not have genetic testing without thinking it through carefully.

There are many issues to think about. What is the effect of a test on other family members? Do they have a right to be part of a family decision about testing? Would a genetic test affect your working conditions or your chances of getting insurance?

If you want to discuss testing, it is worth starting with your family doctor or a  genetic counsellor. A genetic counsellor works with families to discuss genetic conditions. You can discuss with them whether or not testing is available, how reliable it is, the risks and benefits of testing, your privacy and the privacy of others, and about work and insurance. You can discuss your family with them, and how to talk to your family, and when. They generally work with other experts in genetics.

Living with Genetic conditions

Having a genetic condition might or might not have a significant impact on the life of the person affected, and on the lives of people around them.

If they have just been diagnosed, it will take some time to get used to. They might be shocked, and they might feel a lot of different emotions, sometimes at the same time, like anger, denial, fear, grief and depression. Having a genetic condition might mean the future is looking less certain, and there might be effects on work, relationships, family and independence.

Parents of children with a serious genetic condition face many problems, including psychological, emotional and financial difficulties in caring for their child.

Finding out as much as possible about the genetic condition and the therapies, services and treatments available can be very helpful. Talk to your doctors. See a genetic counsellor. Use reliable sites such as Healthdirect and Genetic Alliance Australia as a starting point. American sites such as GARD and the Rare List have a lot of information on rare genetic conditions.

Healthdirect and Genetic Alliance Australia also provide starting points for finding out about services and support available near you.

Psychological and emotional support

It’s a good time to look for psychological and emotional support. There is a lot to think about, and a lot to deal with. You might be able to get the support you need from your partner, your family and your friends, but you can also look for support from a professional such as a psychologist, counsellor or social worker.

 

Treatment

The treatment the person affected needs will depend on the particular condition and how it affects them.

Ideally, they will be cared for by a multidisciplinary team that changes as their needs change. It should be led by a GP that you get to know and trust, and who acts as a guide to the services and supports available. Other members of the team could include:

  • a medical specialist such as a neurologist or geneticist, supported by others as required like surgeons
  • a physiotherapist who can provide advice on movement and mobility
  • an occupational therapist who can help with advice around mobility and independence
  • a social worker or a psychologist or counsellor to help manage both the practical and the emotional aspects of the condition
  • and more.

There is no cure for genetic conditions. But there is often a lot that can be done to manage symptoms, keep disability to a minimum, prevent complications and improve quality of life.

Often early intervention programs are recommended for babies and young children with genetic conditions.

Male carer, Anthony shares his insights as a male carer to mark National Carers Week. 


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