Richmond Leader

How to start a family conversation about medical history this holiday season

The holiday season is a time for sharing big meals and seeing family. It’s when people gather around for conversations about the local sports team or see how much the grandchildren have grown. Being together for the holidays is also an excellent time for you to collect information about your family medical history to prepare for your next doctor’s visit.

When assessing a person, doctors often rely on family medical history. Certain types of cancer, heart disease and other illnesses have a genetic component.Physicians, like Jeffrey T. Kushinka, M.D., believe this information can help provide better care. Kushinka, who is a primary care doctor and the chair of General Internal Medicine in the VCU School of Medicine, talks about the importance of gathering your family medical history and offers tips for how to bring it up with relatives .What is family medical history?It’s a listing of or understanding of medical conditions that affect family members. The most significant would be first-degree relatives, such as parents and siblings. Their medical histories are the ones most directly relevant to clinical practice.Why is knowing your family medical history important?There are instances where knowledge of family history allows us to be more proactive in managing a patient’s current medical conditions. There are instances where knowing your parent’s medical history, knowing your sibling’s medical history can translate into better care for the individual. But also, there are instances where it might not be helpful. For example, knowing that something happened to your second cousin or that your older grandparent died of heart disease in her 90s might be less relevant. I understand people want to be complete and informative, but often doctors have to filter out extra details to focus on the key elements that most directly affect one’s health.What role does genetics play in disease?We do believe that genetics plays a large role in disease, but it can be hard to quantify how large. You can do everything right in terms of leading a healthy lifestyle and still have bad things happen to you. Where we pay attention to it is where we think genetics plays a role. Having a first-degree relative with a certain medical condition, particularly when that condition develops earlier than we would otherwise expect, is a much stronger influence on a patient’s future health. For example, having a father who had a heart attack or heart disease at age 48 is a much more relevant family history than having a grandmother who had a stroke at age 86. It shows a much stronger genetic predisposition.What diseases do you pay particular attention to with family medical history?Cancer and heart disease are the two biggest. We pay attention to diabetes and some neurologic diseases, like multiple sclerosis and Alzheimer’s.When families gather over the holidays, how would you suggest they approach asking about family medical history?From my experience as a physician and someone sitting around the holiday dinner table over the years, people who are older and have health issues are more likely to discuss them. These issues are more likely to come up more naturally as part of the conversation. It can be more challenging to start the conversation with younger parents or siblings.Here are a few suggestions:Be sensitive: A person’s medical history can be difficult to discuss. You need to be careful how you phrase questions and be wary of upsetting the person. You just want to learn the basic information. Let them know that understanding your family medical history is important to your health.Try not to have the conversation at the dinner table: While it can be easy to talk around the dinner table, your relatives might feel more comfortable talking in quieter settings. This is especially true for people who do not like to discuss their problems in a group situation.Write down what you learn: You do not want to rely on your memory when relaying the information to your physician. Write down the information so you will have it available the next time you visit your doctor.Ask about specific health issues: You need to make sure that your relatives tell you about the specific diagnosis and the time. That will help your physician understand if you are at greater risk for certain types of diseases.How do you let your medical provider know about what you have learned?It usually comes up during a routine visit. Physicians pay the most attention to family medical history during a first visit with the patient. It is always something that can be revisited when a patient comes in for a routine visit.

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