Know your history
When it comes to our health, one of the most essential pieces of information we can give to our doctor is our medical history. However, many people have an incomplete history. They may not know if their parents had high blood pressure or heart problems. If you’re lucky to still have one or both of your parents in your life today, it’s absolutely essential that you take the time to sit down and ask them about their own medical history. Being forewarned is being forearmed and the best thing you can do for your own health (and for your family’s) is to take the time to educate yourself about your medical history.
“The family history is something doctors will ask about when they meet a patient first. The presence of medical conditions in a family can help doctors determine what illnesses the patient may be at risk of developing in the future,” says Dr Brian McManus, the Medical Director of Irish online GP service VideoDoc.
“It should be borne in mind that having a family history does not mean you will get a condition, but you may be at a higher risk of developing the condition and this will allow your doctor to watch for signs of the condition. For example, regular mammograms for someone with a family history of breast cancer or checking the blood pressure and cholesterol in patients with a family history of heart disease.”
A family history will also allow your doctor to discuss any lifestyle factors contributing to your potential risk and, as Dr McManus notes, allow your doctor to “discuss modifying lifestyle factors [such as] smoking cessation, diet and exercise in those at risk of coronary artery disease.”
While you’re not guaranteed to suffer from a condition if it tends to run in your family, there are some common health issues that can have an impact the older you get. Dr McManus talks us through the most common culprits.
Cardiovascular disease can come from your mum’s or your dad’s side of the family and if you have a relative who developed it below a certain age, this is something you need to be aware of.
“Cardiovascular disease is a serious condition that runs in families and it puts patients at risk of heart attacks, angina, heart failure and stroke. You are considered to have a family history of cardio vascular disease if your father or brother was under the age of 55 when they were diagnosed with cardiovascular disease or your mother or sister was under the age of 65 when they were diagnosed with cardiovascular disease.”
We are likely to know whether our parents have had cancer or not, but it’s still absolutely essential that we speak to them about it.
“Many cancers have genetic links. The one most people have heard about are the inherited mutations of the BRCA genes which are associated with breast and ovarian cancer. As the public are aware, some women at high risk have chosen to have their ovaries and breasts removed to manage the increased risk. The faulty BRCA gene can also increase the risk of prostate cancer. Other cancers with genetic links are; pancreatic cancer, bowel cancer, kidney cancer, melanoma and thyroid cancer. It is important that the public is aware this is all about risk. Having a family history of a cancer may increase your risk of developing the cancer, but it doesn’t mean you will develop cancer. In addition, having no family history doesn’t mean you won’t develop a cancer and it is still important to get regular check-ups with your GP and inform them of any symptoms like a change in bowel habit.”
While you may feel your medical history is complete once you find out about the ‘major’ health issues in your family, it’s important not to overlook other health concerns notes Dr McManus, as many of these can have strong hereditary links too.
“Many other conditions have hereditary links like autoimmune disease, deep vein thrombosis (DVT/clots), eye disease (for example, macular degeneration), inflammatory bowel disease, osteoporosis and depression. It is best to discuss any family history of chronic conditions with your GP and they can determine whether you are at an increased risk.”
HAVING THE CONVERSATION
Sitting down and having a frank and honest conversation about health with your parents may not be an easy thing to do, but this information could go on to save your life one day in the future. It can be very helpful to record the conversation (if your parents are comfortable with you doing so) or keep a notepad with you and jot down notes as you go. Dr McManus says that it’s important to be honest with your reasons for having the conversation in the first place.
“It’s best to start the conversation by being open and letting your family know you are trying to gather health information about the family. While parents and siblings are the most important, it is also ideal to get information about grandparents, uncles and aunts, and nieces and nephews in order to get a complete picture,” says Dr McManus.
Family medical histories can be complex and given that there will be a lot of ground to cover, where should you begin?
“Asking about major medical illnesses (for example, heart attacks, strokes and cancer) and chronic diseases (for example osteoporosis, depression, inflammatory bowel disease) helps acquire the right information. The age of onset is also important because some hereditary conditions manifest at a younger age. While it might be difficult to discuss, asking about the cause of death and the age of death of relatives is very important,” says Dr McManus.
“[Other] important areas to identify are diseases that occur at a much earlier age than in the normal population for examples, cardiovascular disease in the 30s or 40s, conditions in more than one family member, combinations of diseases (for example, breast cancer and ovarian cancer), and ethnicity. Some conditions are more common certain ethnic groups.”
KEEP A RECORD
While our GP has our official medical record on file, it is important that we, as patients, are proactive about our health and create and maintain our own medical records. Not only are our own personal records a golden source of information for doctors, they can also help us to feel empowered as patients as we can answer the questions that a doctor is likely to ask us and be able to give essential information such as dates and the names of prescribed medication etc.
“Patient information remains confidential even after death. Your GP can’t discuss their patient’s medical history without consent from the patient. Because of this, it is important for everyone to be aware of their own family history of medical conditions,” says Dr McManus.
To sum it up, the earlier you can schedule a family health related conversation with your parents, the better. But what should you do if your parents have already passed? Your childhood medical records (if you can access them) will provide a host of information. By law, you have a legal right to view your own medical records, so a good place to start would be to get in touch with your childhood GP or with the records departments of hospitals where you may have spent time as a child.
Dr Brian McManus is the Medical Director of Irish online GP service VideoDoc. VideoDoc is Europe’s fastest growing online doctor service offering consultations anywhere you can access the internet. For more information log on to www.videodoc.ie