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It's all in the family: Why your family's genetic history matters to you and your physician

Posted by Nina Hamza, MD on Nov 27, 2018 1:30:00 PM

HamzaBlogPhotoMy dad is my favorite person in the entire world. Even if it’s his fault I have this unruly frizzy hair. Growing up, I railed against the injustice over being the one to get his hair, while my sister got his incredible work ethic and unshakeable will power. Unfortunately, when it comes to family, you can’t pick and choose what you get.

So when your doctor asks you about your family history and you go through that long list of who had what “Was it your maternal or paternal grandfather that had a heart attack? And how old were they?” it’s not simple curiosity that drives us. We want to know because it’s another tool to help keep you healthy.

Most diseases are not caused by just one thing. Many chronic illnesses are caused by a combination of genetic predisposition and lifestyle. And how do we know what your genetic predisposition is? We ask about your Uncle Max and your Aunt Irene. And since we can’t control Uncle Max and Aunt Irene (who can?) we work on screening you for those diseases and controlling your lifestyle.

With this in mind, we ask you about who had diabetes in your family. The combination of genetics and lifestyle, in diabetics, causes insulin resistance. This means your body doesn’t use insulin as well as it should. Say your mom has diabetes, and her sister has it, too. That means, darn it, you’re predisposed. We can’t decrease that predisposition but we can make sure to screen your blood, and advise you to follow a healthy lifestyle.

I had colon cancer a few years ago, which means I’m now the Uncle Max and Aunt Irene for my family. They can’t do anything about being related to me. Believe me, they’ve tried. But I’ll make sure they have their colonoscopies 10 years before the age at which I was diagnosed. I’ll try to make sure they don’t eat too much red meat, and they stay at a healthy weight. In our family, we’ll focus a little more on these because I know my kids are predisposed.

The pink ribbons and walks have been great in raising awareness about breast cancer. Almost everyone knows to inform us about family members who’ve been unfortunate enough to have it. Knowing that history helps me make the case for screening mammograms, helps me talk about their ideal weight, and discuss the role of hormone replacement therapy and smoking cessation.

My father-in-law had a heart attack when he was in his early 50s. You’ve never met my father-in-law, because if you had, you’d be shocked. Everyone who heard about it at the time, was. This man exercises every day, is a vegetarian, and doesn’t have an ounce of body fat. My husband’s doctor now pays a little more attention to his blood pressure, started him on cholesterol medication, and tries to get him to exercise more.

So the bottom line is that you can’t get away from your family no matter how many miles you put between them. But that doesn’t mean you have to be them. You can work with your doctor to see what screening tests may be available to you and what changes should be made to your life.

In our family we speak about death lightly, and I tell my father that when he dies I won’t get a chance to miss him because my youngest son is a carbon copy – down to the way they cross their legs when they sit, and walk pigeon toed. If I could just get him hooked on Gene Hackman movies, I may not even be able to tell them apart.

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Medical and health information presented here is intended to be general in nature, and should not be viewed as a substitute for professional advice. Please consult with a health care professional for all matters relating to personal medical and health care issues. In case of an emergency, please call 911. 

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