Shaking Out Your Family Medical Tree

Excerpted from
Dr. Ro's Ten Secrets to Livin' Healthy : America's Most Renowned African American Nutritionist Shows You How to Look Great, Feel Better, and Live Longer by Eating Right
By Rovenia Brock, Ph.D.

My self-assessment test is only the first step toward figuring out your healthy living picture. A family assessment could help, too, because while you may have your dad's big brown eyes, your mom's gorgeous legs, or Aunt Mamie's curvy hips, you could also have inherited a tendency toward a whole host of ailments from your family. Breast and colon cancer, heart disease, osteoporosis, and diabetes all have a genetic component to them, so it is wise to know your family medical history. A family medical history is a record of important medical information about your relatives. Knowing your family medical history can help you and your doctor determine potential health problems as well as allow you to take preventive measures to reduce your risk. You can begin your family history by talking with your immediate family-grandparents, parents, and siblings. Their health provides you with the most important information about genetic risks you may run.

If some of these relatives are deceased, it may take some real detective work to find the desired information. Medical records, death certificates, newspaper obituaries, and old letters can be valuable sources of information for you to tap. I've also found that looking through old baby books, photo albums, or scrapbooks can provide visual clues to conditions such as obesity and osteoporosis. You might consider working on the medical history at the next family reunion, when many of your family members are all in the same place at one lime. Every family has an unofficial historian who knows about the health and habits of previous generations. You might run into some resistance; you and I know that black people, especially members of the older generations, are often reluctant to discuss sensitive issues. If your family is like mine and many other African American families, medical secrets are tantamount to family secrets.

Take the example of Rosetta, my guardian, who lived with the painful secret of breast cancer for two years without telling anyone except her sister and without getting any treatment. She couldn't share such intimate information with anyone. I was a student at Virginia State University when I got a call from my uncle that I should come home that weekend, because Rosetta was in the hospital and in trouble. The ride to Hadley Memorial Hospital was completely silent; you really could hear a pin drop. All the while I was worried sick I'd already lost one mother-how could this be happening to me again? Once we arrived at the hospital, Rosetta greeted me as she always did, with a broad smile. But I could see the pain radiating over her face. When we began to embrace, the nurse cautioned me, "Don't squeeze her." She had had a radical mastectomy. And because losing her breast was such a blow to her sense of womanhood, I'm sure that if my uncle hadn't called me, she would never have let me know.

Don't let the reluctance of your relatives to discuss their health problems prevent you from getting this information. Tell them how important it could be to your own health and that of future generations, too. Rosetta, of course, was not a blood relation of mine, so I tell this story only because I think her sense of secrecy is typical of the problems you may face trying to get a family medical history. But be persistent. Once you do get the facts, the picture they may paint could be all the encouragement you need to make potentially life-altering, health-enhancing changes in your lifestyle.

In my own case, there are factors of heredity that place me at a higher risk for hypertension, vascular problems (poor circulation), cancer, and weight problems, as you will see in the family medical tree I did tracing the illnesses and causes of death on my mother's side of the family (going back only as far as her parents). To create this tree, I used any sources of information I could get. For example, although I didn't know my mother's father, who died before I was born, I was able to

recall stories that I had heard told over and over during many a family gathering, of my granddad, who suffered a massive stroke and as a result was barely able to carry on an audible conversation. And from personal observation I knew what had happened to two of my uncles, Linwood and Ben, strong, vibrant, independent men who took care of their families but who were later rendered almost helpless as a result of becoming amputees. For information about other aunts and uncles whom I hadn't known I had to rely on relatives, who were not always able to remember everything about the illnesses and causes of death among my mother's siblings. Still, I was able to create a complete enough family medical history to show me that I have good reason to maintain my weight at a normal level, get plenty of exercise, and pay particular attention to my diet. You may want to use the occasion of your next family reunion to start finding out your own reasons for making lifesaving changes.

Be as specific as you can when you gather this information. If possible, health histories should note the date of birth and the date and cause of death, as well as any serious medical diseases such as heart disease, stroke, diabetes, cancer, or glaucoma. Try to learn the age of onset of any diseases, because this can be a vital clue about your genetic predisposition. If, for example, your grandmother developed breast cancer at age 35, this information is much more of a warning sign than learning that she developed the disease at age 77. It may help if you draw a genealogical chart. This will let you track whether a disease has passed from generation to generation. If you notice the same diseases in different generations or a pattern developing, branch out and start obtaining information about cousins, aunts, and uncles; this will make your family medical history a more complete picture.

You can't change your genes, but you can present this information to your physician, and he or she can tailor your health plan or perform tests or screenings for diseases for which you are at risk earlier than he or she would have without this information.