Our basic premise is that your body is amazing. You get a do over. It doesn’t take that long, and it isn’t that hard if you know what to do. In these notes, we give you a short course on what to do so it becomes easy for you and for you to teach others. We want you to know how much control you have over both the quality and length of your life.
Question: Every time I see a medical professional, I am asked about my parents’ diseases. I even see ads on TV about getting my genes tested to know my family history. Why the attention to family, and don’t the diseases they have stay the same? Can’t they just get that from the record? And why would they ask me about my spouse since she’s not a blood relative?—Craig, from Dallas
Answer: Let’s first deal with why we care about your family history and why your spouse counts. And although November is Family Health History Month, any holiday (Labor Day, Thanksgiving, Christmas, President’s Day, even a party on a non-holiday) is the perfect time to gather the information you and your healthcare team need to craft a roadmap for preventing disease. Your doctor asks about family history repeatedly because your family may have developed new problems (especially living brothers and/or sisters) or you may have remembered other ones you didn’t tell them about. And they ask about your spouse because your spouse lives with you (at least we hope so) and thus shares the same environmental exposures and likely, similar risks. Yes, she or he is a non-blood relative, but you serve as each other’s personal coal mine canary. Also, even though you don’t share DNA, your spouse influences your health far more than your aunt Sadie in Perth Amboy. Auntie may have a cholesterol count that would bring a Guinness World Records rep to her door, but she isn’t filling your day-to-day life with cigarette smoke, bacon, beer, and lost-sock arguments. The only thing worse for your health and longevity than having a spouse is not having one, in fact.
Knowing funny stories about your relatives makes for great fun at family gatherings — but knowing that three of your ancestors had diabetes or that your grandmother had breast cancer at an early age may help you and your children live longer healthier lives. That is right: When you know what you are most likely to get, you can tailor preventive care for conditions such as diabetes, osteoporosis, and cancers of the breast, colon, and prostate.
The Surgeon General’s My Family Health Portrait website (familyhistory.hhs.gov) helps you here. Start with the info you know off-hand. You want to record each relative’s birth date and (if applicable) death date, the jobs they performed (as certain occupations can strongly affect health), and—most important—any diseases they had that may have a genetic link. Your doctor can clarify this if you aren’t certain about the disease or if it was never diagnosed. Just list the symptoms the person had (memory loss, for example). While you’re at it, you might as well jot down any other interesting tidbits in case your kids get curious about their roots one day.
If you’re like most people, it’ll be about 14 percent complete when your brain is tapped. You’ll need to do some investigating, Columbo-style, so see the ideas (below) for the family interrogation protocol. Hopefully, you won’t have to interrogate more than a handful of relatives in this manner.
If you hail from a litter of fourteen and have more aunts than a cartoon picnic, however, just remember to keep your radar sharp for two factors: serious illness or death before age sixty and potentially fatal conditions. Either can be more important than how close you and your relative are in the bloodline. For example, your uncle’s pancreatic cancer at age fifty-three would likely be more alarming to us than your mother’s heart fibrillations at age seventy. At a bare minimum, you need to know why your parents and grandparents died, if they’re now gone.
No family picnic or Thanksgiving bash? No problem. First search for your family’s historian. Most families have at least one great storyteller—a grandfather or an aunt who knows all about the family’s past. Identify that person, and ask him or her to give you details about medical conditions that are common in your family.
No family historian and no bash? Still no problem. Shaking down family for health details needn’t always be a horribly awkward task. Remember that half will always talk about the other half, so go the gossip route if it’s easier. If you want to be direct, just grab your reporter’s pad and pen, dial the phone or meet the relative at the early-bird diner, and repeat this checklist (feel free to ad-lib). You might consider an opener like this:
“Hello, (relative). I know you haven’t heard from me since (year), but I’m putting my family health history together to see if I’m at risk for anything genetic, and I thought you could tell me a few things I just can’t find anywhere else. (Another relative he or she dislikes) said you probably wouldn’t help me or wouldn’t be able to remember, but I thought I’d try anyway.”
- When were you born?
- Have you been diagnosed with any diseases? When?
- What kind of treatment did you get?
- Any cancers? Diabetes? Heart problems? High blood pressure? Do you take any medications or supplements? If so, why?
- Any surgeries? When, and for what?
- Ever have a bout of depression, anxiety, or other emotional health problems? (Ask relative this family member dislikes for an immediate answer.)
- Any miscarriages, stillbirths, or infant deaths?
- Any heart attacks or strokes? (Pretend you suddenly remember and ask if the flowers made it.)
- How’s your hearing? (Whispered.)
- Do you or did you smoke or drink?
- What jobs did you have?
- Has your memory deteriorated?
- So, that thing growing on (another relative)—is that skin cancer or what?
Once you have a good family history in place, don’t keep it to yourself—talk to your healthcare team about it—it is a springboard for discussions about your and your family members’ health. In the old days, you couldn’t do much about your family health history but wring your hands and worry. Now, because of research, you can take action. Genetic counselors and genetic physicians can evaluate you for risks, diagnose diseases early and seek appropriate treatments or preventive measures. Family health history can and should be empowering.
And your bottom-line question to your doctor is always the same: If there’s a genetic link associated with this condition, how can I prevent it? Genetic testing will get more accurate but isn’t there yet. Until it is, a robust and accurate family history can help, but remember it is you that have to do the work to prevent the potential problem. But believe us, prevention works, and it is fun.
Thanks for reading. Feel free to send questions—to AgeProoflife@gmail.com.
Dr. Mike Roizen
NOTE: You should NOT take this as medical advice.
This article is of the opinion of its author.
Before you do anything, please consult with your doctor.
You can follow Dr Roizen on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week). The YOU docs have two newly revised books: The patron saint “book” of this column YOU Staying Young—revised and YOU: The Owner’s Manual…revised —yes a revision of the book that started Dr Oz to being Dr Oz. These makes great gifts—so do YOU: ON a Diet and YOU: The Owner’s Manual for teens.
Michael F. Roizen, M.D., is chief wellness officer and chair of the Wellness Institute at the Cleveland Clinic. His radio show streams live on http://www.radioMD.com Saturdays from 5-7 p.m. He is the co-author of 4 #1 NY Times Best Sellers including: YOU Staying Young.
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