Family History Can Be Key To Maintaining Your Health
Maintaining Your Health
on Mackinac
By Yvan Silva, M.D.

The concept of the “family tree” is quite appealing. To chart one’s ancestral origins, the chronology of members of the tree, and their life histories, can be collectively a source of curiosity, pride, and a theme of belonging. The quest to acquire this information has become very popular, more so with the availability of computer-based programs.

Many people are seeking their family’s health history for the benefits that may accrue to their own health and to that of their family members. As we begin to age, it’s important to diagnose early on, and when possible, pre-empt, the onset of heart disease, diabetes, cancer, and other conditions possibly transmitted through our genes.

The first and most important interaction between a physician and patient is the “history and physical,” the traditional way to establishing a diagnostic impression, obtaining tests, and elaborating a treatment plan. The “history taking” consists of a detailed identification of a chief complaint and related symptoms, including the initiation of the symptoms, the duration, the progression, and related issues. Past medical history, social history, and family history taking follows. It is here, in the area of family history, that there may be clues to consider and steps to follow in the problem solving process. The physical examination that follows takes into account the abnormal findings and relates them to the symptoms and other clues obtained in the history taking.

When you visit a doctor, you’re asked to fill out a form including questions on illnesses that you, your immediate family, and previous generations have been known to have. Usually, that’s where it ends, and most people don’t get past that to talk to relatives and record the overall family history, which is important to themselves as well as generations to come. The information contained in the family history can be vital to individuals as well as to the family as a whole.

A family health history is known to geneticists as a “pedigree,” an important tool in diagnosing conditions passed on to individuals in families. Groups of genes are often linked to many such familial diseases.

A good way to reconstruct your family history would be to go back three generations when possible. So-called first degree relatives comprise your parents, siblings, and children; grandparents and grandchildren are considered second degree. Aunts, uncles, and cousins, upwards, downwards, and laterally are also important.

Information about all health issues are important to record even if you don’t think there may be a genetic linkage. Ages at which the diagnosis was made should be included. Obesity, high blood pressure, diabetes, heart disease, cancer, alcoholism, depression and mental illness, and other major conditions should be noted. It is also relevant to know of habits that could have played a role in the overall health of the individuals, such as smoking, drinking, drugs, overeating, and lack of exercise, and the cause of death of family members, as well as secondary diagnoses. Death certificates, especially older ones, may be misleading; there have been changes in terminology.

Some general impressions to look for include members who died at an early age (before 55 years), a pattern of the same cancer in relatives or a relative with multiple cancers, or the same illness recurring in more than one generation. When you find certain patterns, such as two or more female relatives with breast cancer, or relatives with diabetes not all associated with obesity, these may be important clues for your own health surveillance.

For Type 2 diabetes, the risk increases with the number of relatives affected and with earlier age of onset. There is twice the risk for stroke if parents or siblings have been affected. There is an increased risk for heart disease when parents or their siblings have been affected, especially if there is a history of coronary artery angioplasty or bypass surgery before the ages of 55 in males and 65 in females. Colorectal cancer is a risk for those who have a close relative with the disease. The risk for cancer for hormone-related organ cancers such as prostate, breast, uterus, and ovaries could be related to maternal as well as paternal family histories.

The compilation of a family health tree is surely worth the effort. This brings into focus the many things we can do for ourselves in our own preventive health maintenance.

Dr. Silva is a professor of surgery at Wayne State University and a resident of Woodbluff on Mackinac Island.