Thanksgiving and all that food are almost here. You know when to start cooking the turkey and when to put the pumpkin pie in the oven. Your family knows who’s making what and everyone is on notice about what time dinner will be served.
But have you prepared for the other holiday that takes place on the same day?
Thanksgiving is also National Family History Day. The US Surgeon General created this holiday in 2004 to encourage families to discuss and write down health issues that run in the family. It’s the perfect time to do this because the whole family is gathered in one place.
Of course, Thanksgiving is a joyous holiday, so you don’t want things to get too heavy. However, it’s an incredibly important conversation, and you might not have the chance to have the whole family’s ears anytime soon. And if you can help ensure your family’s health, it will be well worth it. (Pro tip: Save dessert or a game for after this conversation, in case it veers into depressing territory, so that everyone is in a good mood by the end of the night).
If you’ve never celebrated Family History Day, you might have some questions about this holiday. Why is knowing your family medical history important? How do you start the conversation? What if people don’t want to talk about it? What if some drama erupts?
To understand why this all matters — and how to approach this important discussion — here are answers to some common questions about discussing your family medical history.
Q: Why is getting a family medical history so important, anyway?
There are many types of diseases and medical conditions that can run in families, from high blood pressure to breast cancer. Simply knowing that you may be at a higher risk for developing these conditions yourself has several benefits. For instance:
- Risk factors for some conditions that tend to run in families — like heart disease or diabetes — can be managed. Knowing that you’re at an increased risk can cue you to take preventative measures, such as quitting smoking or cutting back on sodium. This can lower your risk of developing some of these conditions.
- If your physician knows about your risks based on your family medical history, they can be on high alert for any signs that you may be developing one of these conditions.
- Your physician may also recommend health screenings — such as colonoscopies or mammograms — more frequently or starting at an earlier age in order to detect conditions before any symptoms develop. Early detection makes treatment easier for some health conditions, such as breast cancer.
- Hereditary conditions can skip generations. Even if you don’t have a particular disease, it’s helpful to know if your parents have it so that you can look out for it in your children.
Q: If I find out that my parents have a hereditary disease, will I get it? Will I pass it down to my children?
The short answer: Not necessarily. If your family has a history of a disease, it may just mean you are at a higher risk for it. It doesn’t automatically mean that you will get it, too. The same goes for your children — you may pass down a disease, or you may just pass on a higher risk of developing it.
For example, if a woman has a first-degree female relative (mother, daughter, or sister) who has breast cancer, her risk of getting breast cancer is almost doubled. However, it’s not a guarantee that she will get it. Only about 13% of women with breast cancer have a first-degree female relative with breast cancer. If family history was a guaranteed diagnosis, that percentage would be much higher.
Family lifestyle factors can also contribute to a disease running in the family. If someone in your family has type 2 diabetes, you are at a greater risk of getting it yourself. Your risk is even higher if you are obese, eat like it’s Thanksgiving every day, or don’t get enough exercise — and eating and exercise habits are often similar among family members.
Q: I’ve been tasked with leading the whole discussion. What questions should I ask?
Don’t panic — the questions are fairly straightforward, so leading the discussion doesn’t need to be too stressful.
There are many types of questions you can ask, including:
- Do you have chronic conditions, such as heart disease or diabetes? What about rare conditions, like hemophilia, sickle cell anemia, or cystic fibrosis?
- Have you ever had a serious illness, such as stroke or cancer?
- How old were you when you were diagnosed? What were the first symptoms you noticed?
- Have you had any difficulties with pregnancies, such as miscarriage?
- Which medications are you taking?
- Do you have any allergies?
- Do you smoke?
It’s also helpful to learn about your ancestry and where your family came from. This information is important because some health problems are more common in certain ethnic groups. If you have deceased family members, find out when they passed away and what caused their deaths.
Q: Will asking about medical history be offensive?
Taking initiative to learn about your family’s medical history shouldn’t be offensive — but it can seem offensive if you don’t approach it correctly. There isn’t a one-size-fits-all approach, so you will need to think about your family’s individual needs.
Ask yourself a few questions:
Am I going to be bringing up any family drama?
Discussions about deceased relatives can easily veer from cause of death to arguments about who was supposed to get the car, quickly derailing the conversation and causing family flare-ups.
Also, getting your family medical history might uncover some skeletons in the closet. If there is any suspicion about paternity issues, an open conversation over the turkey could get quite heated.
Will this conversation be way too emotional for Thanksgiving dinner?
Learning about family medical history involves getting information about deceased relatives. If there has been a recent death in the family, or you know that your family members are still grieving from a death a while back, you might want to go for one-on-one conversations, rather than out in the open.
Is this going to sound rude?
You need to pay attention to your timing. If your uncle mentions that he has diabetes, it’s probably not a good idea to say, “Then you shouldn’t have eaten all of that dessert.” You don’t want to come off as judgy or preachy or embarrass your relatives. Afterall, it is a holiday.
If you are truly concerned, it’s okay to talk to him privately about his lifestyle habits. But again, it’s good to do it in a polite, nonjudgmental manner.
Q: So, should I always tell my family about this discussion ahead of time?
It’s a good idea. You want to give everyone time to prepare their list of medical conditions, as it can be easy to forget something on the spot.
Also, this conversation can be a bit touchy. Your family may appreciate having a heads up so they don’t feel blindsided or unprepared for a heavier conversation. And if you overlooked potential drama from having such a conversation, one of your family members might be able to warn you that a tableside discussion isn’t the best idea.
However, you know your family best. If you think you will get the best responses when your family is being candid, you can certainly bring it up once everyone’s digested their mashed potatoes.
Q: What are some of the most common hereditary diseases?
There are many types of diseases that can run in families. Here are some of the most common ones, as well as what to do if you find out your family has a history of them:
- Colorectal cancer: Don’t skip out on colonoscopies. Your physician may have you begin annual screenings at an earlier age or have you get them more frequently.
- Heart disease: Make living a healthy lifestyle a top priority. Eat a healthy diet, exercise, maintain a healthy weight, don’t smoke, and limit your alcohol use. Follow your physician’s orders for any screening tests or heart medications. Talk to a cardiologist about what you can do to keep your heart in tip-top shape.
- Breast cancer: Get your annual mammogram. Your physician might want you to start routine mammograms early on, refer you to a genetic counselor, or prescribe drugs that can reduce the risk of breast cancer in some women.
- Diabetes: Maintain a healthy weight and exercise regularly. Talk to your physician or endocrinologist about starting a healthy diet that will lower your risk of diabetes. If you are pregnant or planning to become pregnant, discuss how to prevent gestational diabetes (diabetes during pregnancy) with your physician.
- Osteoporosis: Get a bone density test to screen for osteoporosis. Your physician will be able to paint a better picture of your risk for bone fractures with the information from this test.
Q: Who needs to be involved in the discussion of our family medical history?
The most important relatives to speak with are your parents, siblings, and children.
However, anyone in your family can provide important information about medical history, which is why it’s good to talk about at a holiday when the extended family is gathered together. If your Thanksgiving consists of just your immediate family, or doesn’t include many other relatives, make sure to reach out to those other relatives separately to get their information.
You will want to talk to your extended family (grandparents, aunts and uncles, nieces and nephews, and half-siblings) and your far extended family (great aunts and uncles, and cousins) as well.
Q: What do I do if someone’s not willing to participate?
Try not to get too frustrated. If someone doesn’t want to participate, it doesn’t necessarily mean that they think the conversation is a bad idea, or that they don’t care about family health. It could very well be that they are embarrassed to discuss their own history. They could also be of the “ignorance is bliss” mindset, and not want to hear about what could be in store.
Don’t push them to share. You’re going to end up making them more upset and causing everyone to get uncomfortable. Instead, pull them aside later to ask if you can talk alone. They might be perfectly willing to share — as long as they have their privacy.
Q: How and where should I store this information?
The Surgeon General offers a tool called My Family Health Portrait. This tool prompts you to ask and answer the right questions, and gives you a space to record information. My Family Health Portrait is great because you can easily share it with everyone in the family. This means everyone at the table doesn’t need to take copious notes during the discussion, and you can make sure that family members who are not present still get the information they need.
The information you fill out is only available to you and whomever you choose to share it with — it’s not published, saved as a government record, or given to anyone else.
As you piece together your family’s medical history this Thanksgiving, stop to give yourself a pat on the back. You’re taking your family’s health into your own hands and improving everyone’s likelihood of staying healthy. And what can make you more thankful than that?
Once you’ve talked to your family about their medical history, set up an appointment with your primary care provider to discuss any health conditions you may be at risk for, and what you can do about them. Call (785) 270-4440 to make an appointment.