Once upon a time, people only visited doctors when they were sick, hospitals were primarily a place for the terminally ill, and premature deaths were treated with secrecy and even shame. Doesn't sound like a tale with a happy ending, right? Fortunately, advances in medicine and increased patient education have helped rewrite how we think about medical care.
Today, the focus is on prevention. Appointments for routine visits and health screenings should be on everyone's calendar. Every family should create a medical history and update it regularly. And a plan should be in place based on the genetic predispositions that the family history reveals.
"The whole concept of medicine has changed dramatically," says Carla Germinario, M.D., an internist on the medical staff at Holy Name Medical Center, Teaneck. "It is much easier to prevent disease than it is to treat disease. It is much easier [for example] to lower someone's blood pressure or cholesterol than it is to treat someone for a heart attack."
According to Dr. Germinario, even the most common forms of cancer -- breast, prostate, color and cervical -- do not have to be a death sentence if they are caught early enough.
"There's an age-appropriate screening for all of those [cancers]," says Germinario. "People do not need to die from those four cancers nowadays if people follow the proper screenings and guidelines."
The following pages will walk you through creating a medical history and comprehensive health plan for your family. Follow these guidelines and you will improve the chances that you and those you care about most will remain in good health. Now that's a story you can feel good about.
Your Family Health Tree
Knowing your family medical history is perhaps the most important tool you have for preventing disease.
A family medical history should include information on any major physical and mental health illnesses of grandparents, parents, aunts, uncles, siblings, cousins and children, as well as the causes of death and ages at death of any of these relatives. It is important to include lifestyle factors that may have played a role; make sure to note, for instance, that the uncle who died at the age of 40 of a heart attack also weighed 300 pounds and smoked heavily. Finally, include information about what country relatives were born in since certain diseases are linked with specific ethnic groups.
Keep your family medical history in a safe place with your family's other health records. Bring it with you when seeing a doctor for the first time and make copies for relatives.
Parents of newborns will no doubt want to present a family history tree to their pediatricians. According to Dr. Harry Banschick, a pediatrician on staff at Holy Name, when a newborn or new patient enters his practice important questions are asked about the child's family medical history: "You go back as far as the grandparents. Is there any history or premature death or premature chronic illness?"
"If you know that someone has a predisposition to severe obesity, then you know that their children will too," explains Banschick. "You check these children more carefully for these particular problems."
A Family with a Plan
You have your family health history recorded, now what? The following three scenarios are examples of how knowledge about your family history can be used to create life-saving action plans. Talk to your doctors about what actions, such as genetic testing, you and your family members should take based on your own family's history.
A 50-year-old male knows his mother had breast cancer. It's possible that he inherited a harmful mutation of the BRCA1 or BRCA2 gene that has been linked to breast and ovarian cancer. Genetic testing can determine whether or not he has the gene and has potentially passed it down to his daughter or son.
Colon cancer is generally diagnosed in men and women over the age of 50. If somebody in the family developed colon cancer prior to age 50, screenings can be done earlier in family members. Genetic testing is also available for colon cancer.
Type II diabetes is linked to both a genetic tendency and poor eating habits. By modifying eating habits and getting adequate physical activity, a person with a history of diabetes in his or her family can prevent developing the disease.
If you have an aging parent, or another family member that you could potentially become a caregiver for, it's important to get involved in their health care sooner than later.
Plan to accompany your parent on doctor visits as often as possible so that you can ask and help answer questions. You can also assist in making sure that your parent is being compliant with his or her medications. Consider having test results explained to you, instead of, or in addition to, your parent.
Ultimately, you might need to obtain a power of attorney, which is the legal authorization to give or refuse consent on behalf of someone else. This could apply to any medical care, treatment, service or procedure. Some states require that you sign a separate document appointing you as the health care proxy, or health care agent. Health care proxy forms are available at doctors' offices and hospitals.
Most importantly, know the end-of-life wishes of your parents. "Have that uncomfortable discussion in front of the doctor," recommends Germinario. "The worst thing I see for a family is that somebody is on a ventilator and the family is in distress because they don't know what the patient's wishes would be. It's better to have a plan of action."
Managing Your Meds
An important part of managing your health is to keep track of the medications you are taking or have taken in the past. This applies to everything from herbal medicine to over-the-counter and prescription drugs to vitamins and supplements.
When tracking your daily medications, it is useful to note the start date and stop date for each medication, as well as the dosages and any special directions. It's a good idea to use a chart that lets you manage your daily medication schedule, or you can purchase a handy pill organizer that sorts your medications by days of the week. The best ones let you sort further by which pills you should be taking in the morning, noon, evening and at bedtime.
Drugs.com's MedNotes is a free online tool with some useful interactive features. MedNotes lets you access FDA alerts, consumer information and news about your medications, offers detailed warning and interaction information, sends you e-mail notifications of new warnings and new drugs that are coming on the market, and allows you to print your reports to bring to your doctor or pharmacist. You can also manage multiple profiles for yourself, as well as family members, and physicians can use the tool to manage their patients' medications.
Keeping all your medical information in one place -- as well as that of family members -- is a healthy habit. Many types of medical organizers are available for sale and you might want to pick one up before attempting to get organized on your own.
Organizers generally include pre-printed forms that track your health care professionals' contact information, medications, appointments, family history and test results. They may also include spaces to keep appointment cards, storage pockets for important documents, and health information and resources.
If you prefer to keep digital records, there are various Internet-based tools from which to choose. The Surgeon General's My Family Health Portrait and the Mayo Clinic Health Manager are two options that are free and easy to use. They both work with Microsoft's HealthVault software to make accessing your information convenient, private and secure.
My Family Health Portrait focuses strictly on family history and takes about 20 minutes to complete. It can be easily shared and updated by family members who might not live near you.
The Mayo Clinic Health Manager has many features, such as a "family dashboard" that keeps each individual's information organized and has the ability to make tailored recommendations based on each health profile. With Microsoft's HealthVault, you can access your records at any time and anywhere you have an Internet connection, which makes it especially useful if you are going on a family trip, or travel often for work.