Posted On: November 8, 2021
Family health history is one of the most important but overlooked aspects of maintaining good health. It is the single most informative data available to help you understand your risk of developing hundreds of conditions. It serves as the foundation for many preventive guidelines pointing individuals towards higher intensity screening strategies than those that apply to the general population. For example, most people know that colon cancer screening (with any of the available methods) is recommended starting at age 45. However, those who have a first-degree relative (parent, sibling, or child) or two second-degree relatives (grandparent, aunt/uncle, niece/nephew) with colon cancer or pre-cancerous colon polyps should start screening sooner at age 40, or ten years before those conditions were identified in their relative. That seems straightforward, and your doctor may be on top of this one – so why do I say it is overlooked? There are several quite complex reasons.
First, you, my dear readers, do not usually know your family history at the level of detail that is necessary to assess your risk. For example, how many of you know whether any of your relatives had pre-cancerous colon polyps? It’s a huge cultural barrier that is slowly changing, but many families do not share their personal health information. It happens for a variety of reasons including a desire for privacy and not understanding how much their health conditions affect their family’s overall risk of disease. Note that when I say family, I am limiting this to blood relatives, since they are your biologic relations.
Second, understanding health information is complicated. Our field is full of jargon and we, as doctors, often fail to ensure that our patients truly understand their diagnoses. A fitting example of this (sticking with our theme of colon cancer) is colon polyps. My patients tell me – “the doc said everything was fine, no cancer, and I’m repeating my colonoscopy in 5 years.” There is a tip off in that sentence, which is the repeat interval of 5 years. If it were truly normal the repeat test would be in 10 years, so they must have found some pre-cancerous polyps. Because polyps are not cancer, “I don’t have cancer” is what many patients hear as a takeaway from the conversation. This is just the tip of the iceberg though.
Some quite common points of confusion are:
Third, we have an increasing number and complexity of risk-based guidelines. It is often too much for your primary care physician to be able to handle collecting a large amount of family history data and running all the different risk assessments in the fleeting time they have with you in clinic. Hereditary breast and ovarian cancer recommendations alone are 80 pages long and that is just one guideline. Many physicians will focus on what they see as the most common risks, such as early heart attacks or colon cancer, and defer others due to time demands.
Which brings me to some key recommendations for you (and you may be thinking – it’s about time she got to the point!).
Hopefully, this will pique your interest and get you started on a journey towards better health. There are many more detailed resources available if you want to dig in deeper!
Dr. West is pleased to offer an extensive 90-minute health history review for each of her new practice members, including an in-depth discussion of family history. To learn more about becoming a member contact us here or simply call 571-999-9378.
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Dr. Lori A. Orlando, MD MHS MMCI is a Professor of Medicine, health services researcher, and Director of the Precision Medicine Program in the Center for Applied Genomics and Precision Medicine at Duke University. She received her MD from Tulane University in 1998, MHS from Duke in 2004, and MMCI from Duke in 2019. Her current research program focuses upon using technology to overcome barriers to family health history-based risk assessment and using high quality family health histories to guide clinical care.
The scenario plays out like this… you’re sitting at home watching reruns of Friends when your vision blurs. Minutes later your head feels like it's set in a vice, and someone is cranking the lever. With your head throbbing, the nausea kicks in. After making a bathroom stop (goodbye lunch), you climb into bed and pull the covers over your face, lying still in the dark. Can you relate? This is called migraine, and sadly this illness is all too common. ● Approximately 39 million people in the US and 1 billion people worldwide have migraines ● Most people with migraine have 1 to 2 attacks per month which can extend from 4 hours to 3 days ● 36 billion is spent each year on healthcare and loss of productivity due to migraines Add onto those staggering stats this surprise—WOMEN are at greatest risk. Studies show that 8 out of 10 people with migraine are females. While research isn’t fully conclusive as to why, the data points to women’s hormone levels changing. ➡️ If you are battling migraines, please know that you do not need to suffer alone. At Eileen West, MD, and Associates, we are here to help you find the right treatment to prevent migraines and make them less painful. You have a life to lead. We’re here to help you on that journey and provide exceptional care. ⭐️ June is National Migraine & Headache Awareness Month. Share your migraine questions below… We’d love to help. #youdeservebetter #msmedicine #fairfaxphysician #conciergemedicine #lifestylemedicine #doctorsofinstagram #femalephysician #womenshealth #fairfaxdoctor #fairfax #fairfaxva #fxva #dc #washington #loveVA #fairfaxcounty #virginia #northernvirginia #nova #dcarea #dmv #va #nham
IT’S SELF-CARE SUNDAY. We’re back this week to focus on the importance of self-care and giving you tips on how to practically care for the physical, mental, emotional, & social parts of you. Today’s self-care tip is simple but necessary: Find Ways To Relax Our American society prides itself on doing, doing, doing. Here’s the truth - busy doesn’t equal beneficial. We need a balance of work, play, and rest. Your mind, body, and emotions need periods of relaxation in order to refuel. Here are 10 Ways You Can Relax: ● Meditate ● Do Yoga ● Get a massage ● Take a nature walk or hike ● Journal ● Swim ● Listen to calming music ● Sit in the sun ● Color ● Read a book Self-care isn’t selfish, it is essential. Your brain and body need downtime. Do yourself a favor & RELAX. ➡️ What is your favorite way to relax? Tell us in the comments. #youdeservebetter #msmedicine #fairfaxphysician #conciergemedicine #lifestylemedicine #doctorsofinstagram #femalephysician #womenshealth #fairfax
More than 80% of women experience hot flashes during menopause. Hot flashes can occur during the day or night and have a range of severity. If you fall into the category of moderate to severe, here are 6 tips to help you find relief: 1. Keep the temperature in your home cool. 2. Reduce stress with yoga, tai chi, meditation, biofeedback, acupuncture & massage. 3. Eliminate hot drinks, hot foods, alcohol, caffeine, and cigarette smoking 4. Wear light, breathable clothing during the day and to bed. 5. Sleep with cooling products, including sprays, gels, and a cool-fabric pillow. Use layered bedding that can be easily removed during the night. Cool down with a bedside fan. 6. When a hot flash is starting, try “paced respiration”—slow, deep, abdominal breathing, in through your nose and out through your mouth. Breathe only 5 to 7 times per minute, much more slowly than usual. ➡️ There are some prescription treatments to help with menopausal symptoms. Talk with your primary care doctor to discuss the best path for you. If you currently are seeking a provider, we are here to advocate for your total wellbeing and provide knowledgeable and personal care. Please reach out to schedule an appointment and learn more about how we can help! References: The North American Menopause Society (mnflashes.pdf), Stat from National Library of Medicine #youdeservebetter #msmedicine #fairfaxphysician #conciergemedicine #lifestylemedicine #doctorsofinstagram #femalephysician #womenshealth #fairfaxdoctor #fairfax #fairfaxva #fxva #dc #washington #loveVA #fairfaxcounty #virginia #northernvirginia #nova #dcarea #dmv #va #menopause
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