When the generations gather, it's an opportunity to share the things you all have in common -- including your genes.
As you gather around the Thanksgiving table this year, what will you talk about with your relatives? The conversation could make a difference to your health.
In 2004 the U.S. Surgeon General began encouraging families to talk about their shared genetic heritage at Thanksgiving, when relatives are likely to be together. It's a conversation that can take place anytime, of course. The important thing is to get the conversation started.
Why? Scientists have made great strides in recent years in their understanding of genetics, and of how our family histories affect the diseases we get - and don't get. That progress is likely to continue, so the more your children and grandchildren know about their health history, the better they'll be able to understand and manage the risks that apply to them.
This year I was diagnosed with a hereditary disorder called lipedema (basically, painful fat deposits in the lower body). I'd never heard of the disease before, but was able to look at pictures of my mother and grandmother and trace its symptoms. If I'd had this information earlier in my life, it might have made a big difference in my health, and also been a factor in my child-bearing decisions.
Doctors know that it's important to gather family health history information, but the nature of today's managed-care environment means very few of them can take the time to interview each patient. The more you know about your own risks, the better prepared you'll be to give your doctor useful information.
Start the conversation
Begin the process by visiting the surgeon general's family history site at http://www.hhs.gov/familyhistory/. There you'll be offered three choices for tracking your family information - a paper version, a program you can download on your PC, or a Web-based tracker which lets you save the results to your computer (the government doesn't keep any of the information you enter) or e-mail them to others.
Decide which one is best for you. The paper one may be better if you're going to be sharing this information with family members who don't feel comfortable using computers. The Web-based tracker will let you e-mail your results to relatives at a distance, including younger people who may be in a position to prevent diseases that are part of their family legacy.
The surgeon general's tool tracks heart disease, stroke, diabetes, colon cancer, breast cancer and ovarian cancer. These aren't the only diseases that have a genetic component, though they're among the most deadly. Add others to your list based on what you know about yourself and your family. I added lipedema to my list, but also depression, addictions and glaucoma.
Fill out the information you know - yourself first, then your parents, grandparents, siblings and children. Already you may be able to see some patterns - a line of heart disease, for example. The computer-based tools will let you generate reports highlighting the people in your family with a specific disease.
Fill in the blanks
When the family gathers, you may want to arrange private time with some of your older relatives, who may not wish to talk about their personal health journeys with the rest of the family. You might say something like, "My doctor recently asked me about my family health history and I realized I didn't know if there was diabetes in our family. I figured you might know some of our family health history. Would you be willing to share it with me?"
Starting these discussions before a crisis arises will enable you to present the issue and have some discussion without the stress of a crisis looming. Emphasize to them that you are not doing this to pry into their personal business, but to gather information so the children and grandchildren in the family can better understand their own risk factors. Don't forget the usual patterns of communication in your family. If some family members really don't want to talk, respect that wish and leave the door open for them to get back to you at a later time.
Other family members may treat you to a litany of medical woes right there at the Thanksgiving table. Try to focus the conversation on their relatives, not themselves, and ask them to think about what they might have done differently for their health when they were younger. Who knows? The younger generation might even listen!
If younger people in your family seem interested in this project, encourage them to help, perhaps by taking notes or running a tape recorder during your interviews, or helping to organize the family's health information.
Sharing stories
The family health conversation need not be restricted to genetically-linked diseases, of course. Along the way it is natural for family members to share stories - the silly remedies Uncle Fred tried for his asthma, how grumpy Grandma was when she quit smoking, the funny dentist who gave Mom laughing gas. This can be an enjoyable part of the process, establishing a set of family legends that relatives have in common.
You may also hear things that surprise or even shock you. One man I know went to his parents in search of genetic information, and found out for the first time that he was adopted! That's an extreme case, but be prepared to be sensitive to others' privacy concerns, and to learn unexpected things about your background. (By the way, if you are adopted, you may have to work harder to get medical information about your biological parents. The National Adoption Directory Search may be useful.)
If no one at the Thanksgiving table knows certain information, you might join forces to search for it in family Bibles, old letters, or asking your elder's friends to remember. Some information may even be found by searching in the Eons Obit section.
History is not destiny
Besides sharing stories, families often share health habits, for good or ill. As you explore your family history, you may find that you've inherited a predisposition to a certain type of illness, such as high blood pressure, diabetes, or heart disease.
Does this mean you're doomed to get this disease? No! Your own health choices have a strong effect on the length and quality of your life. (See the Eons Longevity Calculator for more information and personalized health recommendations.) Making better choices now is your right and responsibility.
Families share more than just DNA. They often share health habits, for good or ill - one family may place a shared value on exercise, while another may bond over drinking and smoking. If you share a risk factor with others in your family, work on creating experiences that bring the family together in healthy ways - slimming down the Thanksgiving menu, perhaps, or getting the relatives outside to play football instead of watching it.
As you trace the paths of your family's health, you should share this information with your health care professionals. In some cases your doctor may recommend testing to further investigate your family's health footprint.
Use this Thanksgiving conversation as a way to set the stage for other family conversations to come. Family holidays are a time when coming together offers an opportunity to gather information, make a plan, or decide who will take the lead in caring for your elders or yourself.
