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Give Thanks for Knowing Your Family’s Health History

November is a time to give thanks, a time to remember all the good that happened over the last year and it starts the holiday season for a time with family.  We all look forward to Thanksgiving and Christmas with family gatherings.  I have one special mission for you this holiday season…get to know your family and specifically your family medical history.  What do you know about your family history?

When you visit your health care provider, it is standard of care to inquire about your medical, surgical, social and family medical histories.  Each component reveals important information to guide your medical evaluation.  As a health care provider, I feel it is important to consider every facet of what makes you – you.  We are not all the same and what is normal for one person may not be for another.  I personally have an average blood pressure of 90/50; however someone else at this pressure may be passed out on the floor!  There is one commonality that I may count on to provide the best medical care for you – your family history.  I often see Patients struggle to recall this information and often some comment that it is not important for their visit today so therefore it was not completed.  I would disagree.  I consider family history just as important as your vital signs for that visit.  It tells me what I may need to consider to properly evaluate you and how I may best monitor your health and wellness.  Medical recommendations may even change based on your family history.

We have all heard the phrase, “well it runs in the family” and this is a true and wise statement.  Genetics are history and we all know if left to chance, history will most often repeat itself.  Genes refer to the map that makes each person unique, but is a compilation created by mother and father and their families.  When you inquire about your family history, you look to those who are related to you directly by blood and specifically considering your first, second and third degree relatives.  Who are they?  First-degree relatives include your biological mother and father, brothers or sisters and even your own children.  We must note and consider siblings that are from one parent only.  A half sibling’s family history is a caution as this family history is slightly different if you do not have the same parents.  Second-degree relatives are your grandparents, aunts and uncles, and nieces and nephews.  Lastly third-degree relatives are your great grandparents, first cousins and great aunts and uncles.  Each member I have listed is so important to you, and may or may not suggest a risk to you, whether it be diabetes or cancer.

So you may be thinking…okay, how would you really change what you do for me based on my listing ALL this information about my family?  I would say it could be life-changing depending on your family history.  Consider this…say if your grandmother and her sister, your maternal great aunt, both had breast cancer in their 30s, but are now alive and well in their 70s, and your mother is healthy and without cancer today.  Do you think this changes anything for you?  Do you think you should be screened the same as someone without this family history?  The answer is no, the screening for you and your mother should be entirely different than the general population.   Having an annual mammogram would be so wrong for you!  According to our knowledge of breast cancer, genetics and the best means to find breast cancer early, means that you should be having clinical breast exams with mammogram and MRI alternating every six months – not yearly!  What if I told you there is a test to see if you carry a gene that increases your risk of breast cancer?  Or any cancer for that matter?  Do you think you should be screened like someone who does not carry the gene?  What if you had a daughter and how would this information affect her?  What can we do to help her?  Simple changes like choosing a type of birth control based on this knowledge would help decrease her risk of berast or ovarian cancer and therefore protect her until she is ready to have children or have surgery to remove her breasts or ovaries.

The truth is your entire medical care and health plan should be based around your family history and medical testing.  It is the best crystal ball that we have to follow you.  Medicine is pushing the limits to not only try and find cancer early, but to do things to prevent it.  Medicine is not perfect, but we certainly must use all information we have to assure you have the appropriate and comprehensive healthcare for a healthy future.  To take this even further, we can now perform DNA testing to see if you carry the known mutations that cause many cancers, including breast, ovarian, uterine, colon, gastric, pancreatic and melanoma to name a few.  This knowledge could be life-changing and live-saving.  This is the time to become knowledgeable about you, your family medical history and if your health care is best being managed based on this information.  Talk with your health care provider about your family history.  If you do not have a health care provider, find one and assure you have an appropriate health care and wellness plan.