Saturday, July 5, 2008

Do You Have A Family Medical History Tree?

Family Medical History

Did you know that like the color of your eyes, tendencies from many health conditions are genetically passed from one family member to another? If you have a blood relative with heart disease, your risk for developing it significantly increases. Heart disease can be passed along to younger generations, but so can healthy habits that will help you and others avoid health risks. The more you know about your family’s health history, the more you can do to reduce your risk of heart disease.

My sister and I were talking the other week about family health history. With aging parents, and our own health problems we want to be more informed on our possible genetic health risks. As we were talking, Marsha had told me that she had gone through genealogy information that our brother had prepared. As she was looking she found some very distressing news. Our great-grandmother died from breast cancer. Neither one of us knew the kind of cancer she had when she died. My sister said that she asked our cousin, who has battled and won breast cancer twice, if she knew about this; our cousin screamed on the other end of the phone… ‘NO one said a word!” My sister and cousin both asked their mothers and their response, “Well, it’s just not something you talk about or discuss. It’s private.”

Have you received the same response from your mothers when you ask about family health history? Are you coming up with road blocks when you ask your family about their medical history or past relative’s medical history?

Here are some things that might be helpful in acquiring family health history:

  1. Share with your loved one that you want to give your family doctor all the correct medical information on your health as well as the family health so that he can be better informed so he can treat you properly now and in the future. Do this in a way that you are asking for yourself and your children. Not to be prying, but informed for better health care. Consider the following strategies for addressing the issue with your relatives:
    a. Explain your purpose. Emphasize that your purpose is to create a record that will help you determine whether you and your relatives have a family history of certain diseases or health conditions. Offer to make the medical history available to other family members, so that they can share the information with their doctors.
    b. Provide several ways to answer questions. Some people may be more willing to share health information in a face-to-face conversation. Others may prefer answering your questions by phone, mail or e-mail.
    c. Word questions carefully. Don't start with personal questions. Begin your interview by asking questions about the whole family. When you begin discussing personal medical history, keep your questions short and to the point.
    d. Be a good listener. As your relatives talk about their health problems, let them speak without interruption. Listen without judgment or comment.
    e. Respect privacy. As you collect information about your relatives, respect their right to confidentiality. Some people may not want to share any health information with you. Or they may not want this information revealed to anyone other than you and your doctor

  2. What type of health issues do your family members suffer from or have suffered from? What did Aunt Maude really die from? Old age or heart disease?

  3. Map out your family’s health history. Make a family tree diagram to record your blood relatives who live or lived with heart disease or other diseases. Update this often.

  4. Listen to the terminology or word usage your family members’ uses when describing how a family member died. My older Aunts would say, “Mother was told she was hormonal and needed to have more children and then she would feel better. But she never did, her mood got worse with each child.” Do you hear what I hear here? She mostly likely had post-partum depression! What did they do with her? They put her in a mental institution until she died! How would that help you? If you are planning on having children, you may want the doctor to know that other female family members have suffered from PPD.

  5. Ask your parents once in a while how their check ups are with their doctors. Ask them what their numbers are: blood pressure, cholesterol, thyroid, etc. Besides wanting to be more informed on their health, this knowledge is helpful for your doctor. I have thyroid disease; it would have been most helpful years ago to know I had aunts with this problem as well.

  6. If you have a family genealogy, look it over. Most of the time it will tell you what they died from and their age of death. Look at death certificates. That’s where my sister found out that great-grandmother died from breast cancer.

  7. Make use of casual conversations with family members and slowly bring in health questions or concerns. This may generate some informative information.

  8. Family health history cannot be changed, but it can be managed by having information.

What information should you include in a family medical history?

Your goal is to gather as much accurate information as possible. Don't expect to find answers to all your questions, and don't worry if some details are missing.

If possible, your family medical history should include at least three generations. Compile information about your grandparents, parents, uncles and aunts, siblings, cousins, children, nieces and nephews, and grandchildren. For each person, gather the following information:

  • Sex

  • Date of birth

  • For deceased relatives, age at the time of death and cause of death

  • Diseases or other medical conditions

  • Age of disease onset

  • Diet, exercise habits, smoking habits or history of weight problems

Ask about the occurrence of the following diseases and medical conditions often associated with genetic risk:
  • Cancer

  • Heart disease

  • Diabetes

  • Asthma

  • Arthritis

  • Mental illness

  • High blood pressure

  • High cholesterol

  • Stroke

  • Kidney disease

  • Alcoholism or other substance abuse

  • Birth defects

  • Vision loss

  • Hearing loss

  • Learning disabilities

  • Mental retardation

  • Miscarriages or stillbirths

Also include information about race and ethnicity because the risk of a particular disorder may be greater in one population group than in others.

Here is a handy family history site:

Review your family health history with each of your doctors. Each time the family health history changes make sure you make the necessary changes with your doctor’s records as well.

Why Is it important that we have a Family Medical History?

Your doctor and other health care professionals may use your family medical history to:
  • Assess your risk of certain diseases

  • Recommend changes in diet or other lifestyle habits that can lower disease risk

  • Recommend treatments that can modify disease risk

  • Determine what diagnostic tests to order

  • Determine the type and frequency of appropriate disease screening tests

  • Determine whether you or family members should get a specific genetic test

  • Identify a condition that might not otherwise be considered by your doctor

  • Identify other family members who are at risk of developing a certain disease

  • Assess your risk of passing conditions on to your children

A family medical history can't predict your future health. With few exceptions, it only provides information about risk. Other factors — such as your diet, weight, exercise routine, other lifestyle habits, and exposure to pollutants or environmental factors — will also raise or lower your risk of developing certain diseases.

If you are adopted, ask your adoptive parents if they received any medical information about your biological parents at the time of your adoption. Adoption agencies may also have family medical information on file. If you were adopted through an open adoption process, you may be able to discuss your family's medical history directly with members of your biological family.

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