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DOES IT RUN IN MY FAMILY?
A GUIDE TO FAMILY HEALTH HISTORY, GENETICS AND HEALTH
GENETIC ALLIANCE -- A FREE PATIENT EDUCATION BOOK
This ebook is given at no charge.
This patient education book was created as an open source ebook
by Genetic Alliance, Inc. (501c3).
Lucid Genetics, Corp. a telegenetics medical practice, updated
the artwork and layout but the content has not been altered.
We encourage you to share this book with family and friends; the
book is free and not copyrighted. We hope this beneļ¬ts those who
are looking for answers and offers an understanding to this new
era of medicine -- genetics. This book is the beginning, please
keep researching and learning about this ļ¬eld because it involves
all of us.
Leigh J Mack, MD, PhD, FAPCR, CPI
President
Lucid Genetics, Corp.
970 Lake Carillon Drive, Suite 300
St. Petersburg, FL 33716
888-935-8676
ljmackmd@lucidgenes.com
DEDICATION
i
Information to collect
How to collect
How to ask questions
Sample questions
1
FAMILY HEALTH
HISTORY
What is family health history?
Family health history is information about diseases that run in
your family, as well as the eating habits, activities, and environ-
ments that your family shares. Knowing about the diseases that
run in your family can help you make healthy choices.
Your familyā€™s health is one part of the history of your family. While
collecting your family health history, pay attention to events, sto-
ries, and experiences as well. Gathering your family history helps
you share your family stories and health information with your fam-
ily members and children.
ā€œ Family health history can be found in the choices you make, the
stories your family shares, and the culture of your community. Dis-
cover it and improve your health!ā€
ā€“ Sharon F. Terry President & CEO Genetic Alliance
COLLECT
3Free Patient Education from Lucid Genetics
Carloā€™s Story
Every man in my family
has dropped dead
before the age of 50ā€”
my father, my
grandfather, and my
uncles. I always
assumed that I wouldnā€™t
make it to 50.
A few years ago my
cousin told me that he
told his doctor about
our family health
history.
How can family health history affect my health?
You inherit many things from your parents and grandparents. They pass
on culture and values through photos, recipes, stories, spiritual prac-
tices, and music. You also inherit how you lookā€”for example, how tall
you are and the color of your eyes. Small structures in cells called
genes carry information for these characteristics and how your body
works. Your genes were passed on to you from your parents.
Some genes can make it more likely that you will get certain diseases.
When members of your family share health problems, you might be at
risk for getting the same health problems in the future. This is because
family members can have genes, lifestyle, and environment in common.
However, you may be able to prevent illness by knowing your family
health history and by making healthy choices.
4
His doctor did some tests
and found out that my
cousin was at risk for
heart diseaseā€”maybe
even a heart attack.
He put my cousin on
medication to lower his
cholesterol and told him
to stop eating so many
fried foods.
I talked to my doctor and
got the same tests and
advice. Last year, I threw
the biggest 50th birthday
party ever!
Free Patient Education from Lucid Genetics
Kathleenā€™s Story
Iā€™ve always known that some of the
relatives on my fatherā€™s side of the
family died in early adulthood. At
23, I started to experience heart
problems. I worried that I would
die young like my aunt Kathleen,
after whom I was named. Like
many of my relatives who died, I
was unusually tall, and everyone
said I was Aunt Kathleenā€™s ā€œspitting
image.ā€
I was in medical school at the time
and drew a family tree. When I
shared my family health history
with a few specialists, they did
some tests and diagnosed me with
Marfan syndrome. I contacted all
of the members of the family who I
feared were affected, and they
were able to get lifesaving
treatment.
Now I donā€™t live in fear that I might
die suddenly like my aunt. I donā€™t
worry for my daughter Marissa,
who also has Marfan syndrome.
We take the proper medication,
get checkups regularly, and can
get on with our lives. Our
ancestors did not die in vain. Their
story was heard and saved many.
To find out more about Marfan
syndrome, visit www.marfan.org.
How can my choices affect my health?
Many things shape your health. Some
thingsā€”such as your genesā€”are outside
of your control. Other thingsā€”such as
what you eat, if you smoke or exercise,
and what you do for a livingā€”can be inļ¬‚u-
enced by the choices you make. To make
healthy choices, you need to understand
your current health, your risk for getting
certain diseases, and your environment.
Family health history is the ļ¬rst step
on the road to better health. ! !
! ! ! ! !
5Free Patient Education from Lucid Genetics
Collect stories about
your ancestry and
culture. This is a great
chance to preserve
your familyā€™s memories.
What information should I collect?
Who to collect information on:
ā€¢ Yourself
ā€¢ Your parents
ā€¢ Your brothers and sisters
ā€¢ Your children
Then move on to aunts, uncles cousins and grandparents.
Basic information to collect:
ā€¢ Name and how you are related (myself, parent, child, etc.)
ā€¢ Ethnicity, race, and/or origins of family
ā€¢ Date of birth (or your best guessā€”for example ā€œ1940sā€)
ā€¢ Place of birth
ā€¢ If deceased, age and cause of death
6Free Patient Education from Lucid Genetics
Be sure to record age at onset of symptoms
Health history:
ā€¢ Alzheimerā€™s disease
ā€¢ Asthma and allergies
ā€¢ Birth defects (such as cleft lip, heart defects,
spina biļ¬da)
ā€¢ Blindness/vision loss
ā€¢ Cancer (such as breast, ovarian, colon, pros-
tate)
ā€¢ Current and past medications
ā€¢ Deafness/hearing loss at a young age
ā€¢ Developmental delay/ learning disorders
ā€¢ Diabetes/sugar disease
ā€¢ Heart disease
ā€¢ High blood pressure
ā€¢ High cholesterol
(when the disease started)
ā€¢ History of surgeries
ā€¢ Immunizations
ā€¢ Mental health disorders (such as depression,
schizophrenia)
ā€¢ Obesity
ā€¢ Pregnancy (such as number of children, miscar-
riages, complications)
ā€¢ Stroke
ā€¢ Substance abuse (such as alcohol, drugs)
Lifestyle:
ā€¢ Exercise
ā€¢ Habits (such as smoking, drinking, regular doc-
tor/ dentist checkup)
ā€¢ Hobbies and activities
ā€¢ Nutrition and diet
ā€¢ Occupation
7Free Patient Education from Lucid Genetics
How do I collect family health history?
Talk to your family
Your relatives are the best source of information about your fam-
ily. Family history is often shared while talking at family events like
birthday parties, weddings, reunions, religious gatherings, holi-
day dinners, and funerals. These events provide a chance to ask
family members about their lives.
Use what you have
Check ļ¬rst to see if your family has family trees, charts, or listings
of family members. This information may be written in baby
books, photo albums, birthday date books, a family bible or other
religious records. Review your own medical history with your doc-
tor to make sure you are not forgetting anything.
8Free Patient Education from Lucid Genetics
Consider explaining to
family members that
you are collecting the
information to learn
more about possible
medical conditions you
or your children might
have in the future.
Plan an individual conversation
After you have brought up the idea of collecting your family health his-
tory, you may want to talk with certain family members to get a more
complete record of what they know. If possible, record these talks so
you can go over them later. This guide includes questions to ask.
Send a survey
You may wish to send out a survey asking for health information from
relatives. One quick and easy way to collect this information is to put it
in a holiday newsletter. Not everyone will feel comfortable ļ¬lling out a
survey. Be sure to explain exactly why you are asking questions.
9Free Patient Education from Lucid Genetics
Lisaā€™s Story
When I became pregnant, I
talked with my parents about
diseases that run in our family.
I wanted to be prepared for
anything that could affect my
child. My parents told me
that, before I was born, my
aunt had a baby boy who
seemed healthy. A few weeks
later, however, he became
very ill with vomiting and
wasnā€™t eating. The doctor
diagnosed him with a genetic
disorder called MCADD
(Medium Chain Acyl-
CoADehydrogenase
Deficiency)
and put him on a special diet
and medication.
Unfortunately, some damage
had already been done.
Tips for collecting family health history
ā€¢ Start with your parents if they are still living. Often, older relatives
are good sources of information and can be the ā€œfamily histo-
rian.ā€
ā€¢ If you are adopted, you may be able to learn some of your family
history through your adoptive parents. You may also ask to see
the adoption agency records.
ā€¢ It is important to respect others. Some relatives may not want to
share their medical histories. Some may not know their family his-
tory.
ā€¢ It can be scary to ļ¬nd out about a health concern in your family.
Sharing family history with your healthcare provider can help you
understand if you are at risk.
ā€¢ Family members may not clearly identify all diseases. For exam-
ple, someone who suffered from ā€œthe bluesā€ may have had de-
pression. Ask family members to talk about how relatives acted.
10Free Patient Education from Lucid Genetics
When I told my doctor this, she
checked to see if MCADD was
included in our stateā€™s
newborn screening program.
Luckily, it was. When my
daughter was born, we paid
close attention to her newborn
screening results. She too has
MCADD, but we were able to
start treatment right away.
Now she is a healthy, active
three-year-old. By learning
about my family health history,
I was able to ensure that my
baby stayed as healthy as
possible from the moment she
was born.
To find out more about
MCADD, visit
www.fodsupport.org.
How do I ask my family members about family history?
On the next page is a list of questions that will help you talk with your family members. These
questions will help you learn about your family stories, as well as health patterns and any impact
environment, lifestyle, and family history may have on family health. Add your own questions that
relate to your family.
Prepare ahead of time
ā€¢ Write down what you knowā€”such as family membersā€™ names, where they were born, or how
many children they have.
ā€¢ Pick the questions you will ask ahead of time.
ā€¢ Record the interviews on a tape recorder or video camera.
11Free Patient Education from Lucid Genetics
During the conversation
ā€¢ Write down health-related information given by
your relative.
ā€¢ Try to keep the questions short. Avoid ques-
tions that can be answered with a simple ā€œyesā€
or ā€œno.ā€
ā€¢ Use follow-up questions such as ā€œwhy,ā€ ā€œhow,ā€
and ā€œcan you give me an example.ā€
ā€¢ Do not expect people to know the answers to
all of your questions.
ā€¢ Respect a personā€™s wishes not to talk about cer-
tain topics.
ā€¢ Ask your family member to show you pictures,
recipes, letters, and other family keepsakes.
These can help people remember details and
lead to more family stories.
	 	 	 	 	
Michaelā€™sā€™s Story
Since I am adopted, I thought there was no way
for me to put together a family health history.
Even though my adopted family and the
adoption agency tried to help, they didnā€™t have
the answers I needed about my birth familyā€™s
health. How can I have a family health history
without having my questions answered?
There is something I can do. I am starting my
family health history with me and my health
issuesā€”like the fact that I started wearing glasses
when I was 12 years old. I will pass the
information on to my children, and they will be
able to add to our family history.
12Free Patient Education from Lucid Genetics
These questions are examples. You should change them to ļ¬t
your conversation.
Questions about childhood
ā€¢ Where were you born?
ā€¢ Where did you grow up?
ā€¢ Did you experience any health problems (for example, aller-
gies) as a child?
ā€¢ Do you have any brothers or sisters? Are they living? How old
are they?
ā€¢ Questions about adulthood
ā€¢ What jobs have you had? Can you tell me about a normal day?
ā€¢ What was your work environment like?
ā€¢ Do you have children? What are their names? When were they
born? Did they have any health problems?
ORGANIZE
13Free Patient Education from Lucid Genetics
ā€¢ What habits (sun exposure, physical activity,
smoking, etc.) have you had that could have
affected your health?
ā€¢ Did you have any health problems as an adult?
At what age? How was this treated (e.g. medi-
cine, surgery)?
Questions about parents and grandparents
ā€¢ When and where were your parents born?
What do you know about them (for example,
their jobs and hobbies)?
ā€¢ When and where were your grandparents
born? What do you remember about them?
ā€¢ Did your parents or grandparents have any
health problems?
ā€¢ Do you know if your parents or grandparents
took medicine on a regular basis? If so, for
what? Did they use home remedies? What
kinds and for what?
Questions about family life
ā€¢ Has your family lived anywhere that caused
them health problems (e.g. disaster areas,
waste sites)?
ā€¢ What foods does your family usually eat? De-
scribe a typical family breakfast or dinner. Do
you eat special foods for special occasions?
ā€¢ Has anyone had problems in pregnancy or
childbirth? What kinds of problems?
ā€¢ Are there any diseases that you think might run
in our family?
ā€¢ Is there anything else you would like to tell me
about your life or health concerns in our family?
How can I organize my family health history?
The family health history information you collect
can be written down or typed into the computer.
It is important to write down all of the information
so it makes sense to you, your family, and your
healthcare provider. We have included some
ideas below to help you organize your informa-
tion.
Family health portrait
A family health portrait is like a family tree show-
ing family members and their health. Because it
is a simple picture of your family health history, it
can be easily shared with your healthcare pro-
vider. Turn to page 18 for more information.
Healthcare Provider Card
Online (www.geneticalliance.org/ccfhh), you will
ļ¬nd a card to ļ¬ll out and bring to your provider.
The card focuses on concerns you have about
your family health history. It also gives your pro-
vider more information on how to best use your
family health history to ļ¬gure out your risk for get-
ting a disease.
14Free Patient Education from Lucid Genetics
Isabelā€™s Story
My grandmother died of a massive heart attack
when she was 39 years old. Even though my
mother was so careful about healthcare for our
family, she did not know that she had a very
serious heart condition. She felt just fine, but
during a routine checkup two years ago, a
doctor discovered my motherā€™s uncontrollable
heart arrhythmia. Mom was taken to the hospital
immediately, and a cardiac pacemaker was
implanted the following day. Since the doctors
knew my grandmother had died of a heart attack
at a young age, they took my motherā€™s symptoms
very seriously.
This knowledge about my motherā€™s and
grandmotherā€™s health scares me, but I feel it is
good to know. I know you can feel healthy but
have a serious health condition. Whenever I go
for my checkups, I always talk to my doctor
about my grandmotherā€™s and motherā€™s heart
conditions. She checks my heart thoroughly and
always runs a special test on it because of my
family health history.
Though I canā€™t change what happened to my
mom and grandmother, I can use the
information to manage my health better and
lower my risk of heart disease.
15Free Patient Education from Lucid Genetics
How can I draw a family health portrait?
If you have access to the Internet, you can use the U.S. Surgeon
Generalā€™s My Family Health Portrait to create a family health his-
tory tree on your computer.
Visit www.familyhistory.hhs.gov.
You can also draw your own family health portrait. Use the exam-
ple on the next page to help guide you.
Instructions for drawing a family health portrait
ā€¢ Write your name and the date at the top of a large piece of pa-
per.
ā€¢ Draw yourself at the center using a square if you are a man or a
circle if you are a woman.
ā€¢ Draw your parents above you and label each symbol with his or
her name and birth date (or approximate age).
UNDERSTAND
16Free Patient Education from Lucid Genetics
ā€¢ Draw a line between them and then draw a line
down to you.
ā€¢ When possible, draw your brothers and sisters
and your parentsā€™ brothers and sisters from old-
est to youngest, going from left to right across
the paper.
ā€¢ Add the health information you collected for
each individual.
ā€¢ Add the ancestry and any other information
you have collected.
Kimā€™s Story
1. To start my family health portrait, I added
myself. Any women on the portrait are
drawn with a circle. Under my name, I wrote
my birth date.
2. Next, I drew in my mother and father. Any
men in the portrait are drawn as squares. I
connected my parents to each other using
one line and drew another line that
connected to me.
3. Next, I added my brother and sister and
their birthdates. I connected each of them to
the line that connects my parents.
4. For my fatherā€™s parents, I put their names
above his and drew one line connecting
them to each other and another line
connected to my father. I also added my
familyā€™s ancestry. Finally, I drew a line
diagonally through my grandmotherā€™s circle
to show that she died at age 42.
Me (Kim) b 1975
_____________________________________
Mark b. 1950 Helen b. 1952
Jon b. 1974 Me(Kim) 1975 Rebecca b. 1979
_____________________________________
Mexico
	
Ana b. 1930 Luis b.1929
Died Heart attack
	 age 42
	
	 	 Mark b. 1950
	 	 	 	 	 Me(Kim) b. 1975
	 	 	 	 	 High Blood Pressure
17Free Patient Education from Lucid Genetics
What now?
ā€¢ Save your family health history and update it with new informa-
tion you learn about your family.
ā€¢ Find out more about the diseases that run in your family and
how to stay healthy.
ā€¢ Share information with your family.
ā€¢ Take your family health history to your healthcare provider.
Resources
Genetic Alliance Family Health History Resources
www.geneticalliance.org/familyhealthhistory
The Smithsonian Folklife and Oral History Interviewing Guide
www.familyoralhistory.us/news/view/the_smithsonian_folklife_and_
oral_history_interviewing_guide/
and visit the American Folklife Center website:
www.loc.gov/folklife/ļ¬eldwork
18Free Patient Education from Lucid Genetics
Why is genetics important to my family and me?
Genetics helps to explain:
ā€¢ What makes you unique, or one of a kind
ā€¢ Why family members look alike
ā€¢ Why some diseases like diabetes or cancer run in families
ā€¢ How learning your family health history can help you stay healthy
ā€¢ Why you should bring your family health history to your healthcare provider
2
GENETICS AND HEALTH
19Free Patient Education from Lucid Genetics
Taking time to learn about health and diseases
that run in your family is worth it! It will help you
understand your own health and make healthy
choices.
What makes me unique?
Every person is unique. Part of what makes you
unique is your genes. Genes are the instructions
inside each of your cells. They control how you
look and how your body works. Since everyone
has slightly different genes, everyone has a differ-
ent set of instructions. Genes are one reason
why you are unique!
Tell me more about my genes
ā€¢ A person has two copies of each gene, one
from the mother and one from the father.
ā€¢ Genes carry instructions that tell your cells how
to work and grow.
ā€¢ Cells are the building blocks of the body. Every
part of your body is made up of billions of cells
working together.
ā€¢ Genes are arranged in structures called chro-
mosomes. Humans have 23 pairs of chromo-
somes. Copies of the chromosomes are found
in each cell.
ā€¢ Chromosomes are made up of DNA. DNA is
the special code in which the instructions in
your genes are written
20Free Patient Education from Lucid Genetics
You share a lot with
your familyā€”including
what can make you
sick.
Common Disease:
Diabetes
Changes in your genes
passed on by your
parents may make you
more likely to develop
type 2 diabetes. If you
are active and eat a
healthy diet, you may
be able to lower your
risk.
Why do family members have things in common?
Children inherit pairs of genes from their parents. A child gets one set
of genes from the father and one set from the mother. These genes can
match up in many ways to make different combinations. This is why
many family members look a lot alike and others donā€™t look like each
other at all. Genes can also increase the risk in a family for getting cer-
tain health conditions.
Families also share habits, diet, and environment. These inļ¬‚uence how
healthy we are later in life.
Why do some diseases run in families?
Some diseases are caused when there is a change in the instructions
in a gene. This is called a mutation. Every person has many mutations.
Sometimes these changes have no effect or are even slightly helpful.
But sometimes they can cause disease.
Most common diseases are caused by a combination of mutations, life-
style choices, and your environment. Even people with similar genes
21Free Patient Education from Lucid Genetics
Single Gene Disorder:
Sickle Cell Anemia
Sickle cell anemia is
caused by a mutation in
a single gene passed
from each parent.
may or may not get an illness if they make different choices or live in a
different environment.
Thousands of diseases are caused by a speciļ¬c change in the DNA of
a single gene. Many of these diseases are rare. These conditions usu-
ally develop when an individual is born with a mutated gene.
If a rare disease runs in your family, be sure to write it down. Do not for-
get to learn about common conditions that affect your familyā€™s health.
22Free Patient Education from Lucid Genetics
How can knowing my family health history help me stay healthy?
Your family health history tells you which diseases run in your family.
Health problems that develop at a younger age than usual can be a
clue that your family has a higher risk. Though you cannot change your
genes, you can change your behavior.
Knowing your family health history will help you:
ā€¢ Identify risks due to shared genes.
ā€¢ Understand better what lifestyle and environmental factors you share
with your family.
ā€¢ Understand how healthy lifestyle choices can reduce your risk of de-
veloping a disease.
ā€¢ Talk to your family about your health.
ā€¢ Tell your healthcare provider about diseases that run in your family.
Why should I take my family health history to my
healthcare provider?
Your healthcare provider (doctor, nurse, or physicianā€™s assistant) may
use your family health history and current health to ļ¬gure out your risk
for developing a disease. Your provider can then help decide which
screenings you get and which medicines you might take.
Based on your family health history, a healthcare provider may order a
genetic test or refer you to a genetic counselor or geneticist. Genetic
tests can show if you have a gene change that increases your risk for
disease. They can also tell if you have a gene change that you might
pass on to your children. Your healthcare provider can help you:
ā€¢ Understand the results of your tests.
ā€¢ Learn of any treatments for a disease found by the test.
All newborn babies born in the U.S. and many other countries are
tested for certain genetic diseases that may make them sick. This is
called newborn screening. If the screening test ļ¬nds a problem, a
healthcare provider will help you understand what can be done to help
the baby.
Remember
1. Share your family
health history with
your healthcare
provider.
2. Ask if you can be
screened for a
disease that runs in
your family.
23Free Patient Education from Lucid Genetics
In the rest of this booklet, we give you examples of some com-
mon diseases that affect our communities and families. For each
disease, we include information under the following headings:
ā€¢ What is the disease?
ā€¢ Who is at risk?
ā€¢ Hints for health
DISEASES THAT
RUN IN THE
FAMILY
24Free Patient Education from Lucid Genetics
Heart disease
Heart disease is the main cause of death in America in both men and
women. There are many types of heart disease. Two of the most com-
mon types are coronary artery disease (CAD) and high blood pressure
(hypertension).
What is Coronary Artery Disease (CAD)?
ā€¢ In CAD the arteries that supply blood to the heart muscle can get
hard and narrow. The arteries narrow, or get smaller, because plaque
and cholesterol build up on the inner walls.
ā€¢ CAD gets worse over time. As the arteries get smaller, less blood
gets to the heart, and less oxygen gets to the heart muscle. Very low
levels of oxygen can cause chest pain or a heart attack.
ā€¢ CAD is the most common cause of heart attacks among Americans.
Who is at risk?
ā€¢ About 13 million Americans have CAD.
ā€¢ Everyone has some risk for developing heart disease.
ā€¢ CAD is caused by a combination of genes, lifestyle choices, and envi-
ronment.
ā€¢ For some people, a healthier diet and more activity can change cho-
lesterol level and lower risk.
ā€¢ Since your genes cannot be changed, some people need medicine
to lower their risk of having a heart attack.
Hints for health
ā€¢ Eat healthy meals.
ā€¢ Get active and exercise regularly. Obesity increases your risk.
ā€¢ Take your prescribed medications to control high cholesterol, high
blood pressure, and diabetes.
ā€¢ If you smoke, talk with your healthcare provider about quitting.
For more information,
visit
www.nhlbi.nih.gov/
health/dci
and click on ā€œCoronary
Artery Diseaseā€ or call
the American Heart
Association at 800-
AHA-USA-1
(800-242-8721).
25Free Patient Education from Lucid Genetics
What is High Blood Pressure?
ā€¢ Blood pressure is a measure of how hard your heart is working to push the blood through your arter-
ies, the blood vessels leaving your heart.
ā€¢ There are two numbers in a blood pressure reading. A normal reading is about 120/80 (read as
ā€œ120 over 80ā€). The ļ¬rst number is the force your heart uses to pump the blood. The second num-
ber is the pressure between heartbeats.
ā€¢ High blood pressure means that your heart is working too hard. Over time, high blood pressure can
cause kidney failure, heart attacks, strokes, and other health problems.
Who is at risk?
ā€¢ About one in three adults has high blood pressure. Many do not even know it because there are no
clear symptoms.
ā€¢ A family history of high blood pressure increases your risk for getting it at a younger age.
ā€¢ Risk increases with age, being overweight, or having a family history of hypertension.
Hints for health
ā€¢ Eat less salt.
ā€¢ Maintain a healthy weight.
ā€¢ Manage your stress.
ā€¢ Get active and exercise regularly.
ā€¢ Limit the alcohol you drink.
ā€¢ Get screening regularly.
For more information, visit www.nhlbi.nih.gov/health/dci and click on ā€œHigh Blood Pressureā€ or call the
American Heart Association at 800-AHA-USA-1 (800-242-8721)
Heart disease symptoms may not appear until the damage is already done. Talk to your family about
heart disease today.
26Free Patient Education from Lucid Genetics
What is Asthma?
ā€¢ Asthma is a lung disease that causes repeated episodes of breath-
lessness, wheezing, coughing, and chest tightness. The episodes
can range from mild to life threatening.
ā€¢ Asthma episodes are caused by tirggers. These are things like dust
mites, animal dander, mold, pollen, cold air, exercise, stress, viral
colds, allergies, tobacco smoke, and air pollutants.
ā€¢ Some people have genes that control their response to these asthma
triggers.
Who is at risk?
ā€¢ Asthma affects about one in 10 children and one in 12 adults.
ā€¢ Asthma is the main reason children end up in the emergency room
and miss days of school.
ā€¢ If you have parents, siblings, or children with asthma or allergies, you
are more likely to get it.
Hints for health
ā€¢ Avoid exposure to triggers.
ā€¢ Use medication correctly.
Diabetes (sugar disease)
Diabetes is a serious, chronic disease in which blood sugar levels are
above normal. Many people learn about their diabetes after problems
develop. According to the American Diabetes Association, one out of
three people who have type 2 diabetes do not know that they have the
disease.
Symptoms occur when the body fails to change sugar and other food
into energy. This happens when the body cannot make or use a hor-
mone called insulin. Serious problems from diabetes can include blind-
ness, kidney failure, and death. Diabetes can be detected early and
treatment can prevent or delay these serious health problems.
For more information,
visit
www.nhlbi.nih.gov/
health/dci and click on
ā€œAsthmaā€ or call the
American Lung
Association at
800-548-8252.
For more information,
visit www.ndep.nih.gov
or call 800-860-8747.
27Free Patient Education from Lucid Genetics
Both genetic and environmental factors such as
diet and exercise plays an important role in get-
ting the disease.
What isType 1 Diabetes?
ā€¢ Type 1 diabetes usually develops in young chil-
dren or young adults.
ā€¢ People with type 1 diabetes stop making their
own insulin.
What isType 2 Diabetes?
ā€¢ Type 2 diabetes usually develops in people
over 30 years of age. In recent years, more
young people are getting it due to poor diet.
ā€¢ Scientists are learning more about the speciļ¬c
genes involved in this type of diabetes.
ā€¢ Who is at risk?
ā€¢ Diabetes affects about one in 13 people in the
United States.
ā€¢ Five to 10 percent of Americans with diabetes
have type 1 diabetes.
ā€¢ Children or siblings of people with diabetes are
more likely to get diabetes.
ā€¢ Obese people are more likely to get type 2 dia-
betes.
ā€¢ Women who had a baby that weighed more
than 9 pounds or who had gestational diabetes
while pregnant are at risk.
ā€¢ Hints for health
ā€¢ Eat more fruits and vegetables, less sugar and
fat.
ā€¢ Get active and exercise regularly.
ā€¢ Lose weight if necessary.
28Free Patient Education from Lucid Genetics
For more information,
visit www.cancer.gov/
cancertopics and click
on ā€œBreast Cancerā€ or
call 800-4-CANCER
(800-422-6237).
Cancer
There are many types of cancer. Cancer is caused by the growth and
spread of abnormal cells. Though your risk of getting cancer increases
as you get older, genetic and environmental factors also cause people
to be at a higher risk for certain types of cancer. Some of the most com-
mon cancers are breast cancer, lung cancer, and prostate cancer.
What is Breast Cancer?
ā€¢ Breast cancer is a type of cancer that forms in the tissues of the
breast, usually the ducts.
ā€¢ Breast cancer is one of the most common cancers among women.
ā€¢ Although it is rare, men can also get breast cancer.
29Free Patient Education from Lucid Genetics
ā€¢ Most breast cancer can be treated if found
early.
Who is at risk?
ā€¢ One out of eight American women will develop
breast cancer in her lifetime.
ā€¢ Among Hispanic/Latina women, breast cancer
is the most common type of cancer.
ā€¢ Breast cancer risk is higher if a women has
close blood relatives who have had this dis-
ease. Both your motherā€™s and fatherā€™s family his-
tory of breast cancer is important.
Hints for health
ā€¢ Women should do monthly breast self-exams.
ā€¢ After age 40, women should get annual mam-
mograms.
ā€¢ Ask about genetic testing for high-risk families.
ā€¢ Eat a healthy, balanced diet.
ā€¢ Get active and exercise regularly.
ā€¢ Limit the alcohol you drink.
What is Lung Cancer?
ā€¢ Lung cancer is the uncontrolled growth of ab-
normal cells in one or both of the lungs.
Who is at risk?
ā€¢ Lung cancer is the leading cause of cancer
death for both men and women.
ā€¢ About 160,000 people died in the United
States from lung cancer in 2007.
ā€¢ Nearly 87 percent of lung cancer cases in the
United States are smoking-related.
Hints for health
ā€¢ Do not smoke.
ā€¢ Avoid secondhand smoke.
ā€¢ Find out about testing for radon and asbestos
in your home and at work.
What is Prostate Cancer?
ā€¢ Prostate cancer develops in the male reproduc-
tive system. The prostate is a small gland near
the bladder.
ā€¢ Scientists do not yet know what causes pros-
tate cancer.
ā€¢ Doctors have a test to ļ¬nd out whether a man
might have prostate cancer.
Who is at risk?
ā€¢ Men of all ages can develop prostate cancer.
However, more than eight out of 10 cases oc-
cur in men over the age of 65.
ā€¢ Prostate cancer is the most common type of
cancer diagnosed in Hispanic/Latino and Afri-
can American men.
ā€¢ Having a father or brother with prostate cancer
more than doubles a manā€™s risk for getting pros-
tate cancer. The risk goes up with the number
of relatives who have it, especially if the rela-
tives were less than 50 years old when they got
it.
Hints for health
ā€¢ Follow a healthy diet.
ā€¢ Exercise regularly.
ā€¢ After age 50, have your prostate checked.
30Free Patient Education from Lucid Genetics
What are Single Gene Disorders?
ā€¢ Earlier in this booklet, you read about conditions caused by mu-
tations in a single gene. These conditions are called single
gene disorders.
ā€¢ There are more than 6,000 single gene disorders. Combined,
they occur in about 1 in 300 births.
ā€¢ The symptoms of single gene disorders vary widely, but many
of them run in families.
ā€¢ Collecting your family health history for these conditions is im-
portant for diagnosis and management of the condition and for
making reproductive choices.
Who is at risk?
ā€¢ Every person is born with mutations. Most of these mutations
will not cause disease on their own, but it is important to iden-
tify any that do.
SINGLE GENE
DISORDERS
31Free Patient Education from Lucid Genetics
ā€¢ Depending on which gene is affected, single
gene disorders can be passed down even
when the mother and father do not show any
symptoms.
ā€¢ Some single gene disorders are identiļ¬ed dur-
ing a pregnancy or soon after a child is born.
Others will not be diagnosed until adulthood.
ā€¢ The most harmful mutations may lead to a mis-
carriage or stillbirth. If you have a family history
of miscarriages, this may be related to a ge-
netic mutation.
Picture courtesy of CureAHC Inc.
Hints for health:
ā€¢ If you have a family history of a single gene dis-
order, discuss it with your healthcare provider.
Your provider may refer you to a specialist.
ā€¢ Know which newborn screening tests are per-
formed in your state.
ā€¢ For thousands of conditions, advocacy organi-
zations provide support services, information,
and ways to get involved in the discovery of
treatment options.
Visit Disease InfoSearch at
www.geneticalliance.org to ļ¬nd out more.
For more information on single gene disorders,
contact the Genetic and Rare Diseases (GARD)
Information Center at gardinfo@nih.gov or 888-
205-2311.
32Free Patient Education from Lucid Genetics
Resources
The ā€œDoes It Run In the Family?ā€ toolkit includes two pieces that can help you summarize your health
information for your providerā€”the family health portrait and healthcare provider card. You may also
hear your healthcare provider call a Family Health Portrait a ā€œpedigree.ā€
Each family and individual is unique and may have genetic
diseases other than the major diseases listed here.
For more information visit:
Disease Info Search
www.geneticalliance.org
National Library of Medicine
www.nlm.nih.gov/services/genetics_resources.html
33Free Patient Education from Lucid Genetics
www.geneticalliance.org www.lucidgenes.com
4301 Connecticut Ave. NW, Suite 404 970 Lake Carillon Drive, Suite 300
Washington, D.C. 20008-2369 St. Petersburg, FL 33716
Phone: 202-966-5557 Fax: 202-966-8553 888-935-8676
info@geneticalliance.org info@lucidgenes.com
Genetic Alliance transforms health through genetics. We promote an environment of openness cen-
tered on the health of individuals, families, and communities. We bring together diverse stakeholders
that create novel partnerships in advocacy; integrate individual, family, and community perspectives
to improve health systems; and revolutionize access to information to enable translation of research
into services and individualized decision making.
Funded in part by a cooperative agreement (U33 MC06836) from the Maternal and Child Health Bu-
reau, Health Resources and Services Administration.
34Free Patient Education from Lucid Genetics

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Does It Run In My Family

  • 1. DOES IT RUN IN MY FAMILY? A GUIDE TO FAMILY HEALTH HISTORY, GENETICS AND HEALTH GENETIC ALLIANCE -- A FREE PATIENT EDUCATION BOOK
  • 2. This ebook is given at no charge. This patient education book was created as an open source ebook by Genetic Alliance, Inc. (501c3). Lucid Genetics, Corp. a telegenetics medical practice, updated the artwork and layout but the content has not been altered. We encourage you to share this book with family and friends; the book is free and not copyrighted. We hope this beneļ¬ts those who are looking for answers and offers an understanding to this new era of medicine -- genetics. This book is the beginning, please keep researching and learning about this ļ¬eld because it involves all of us. Leigh J Mack, MD, PhD, FAPCR, CPI President Lucid Genetics, Corp. 970 Lake Carillon Drive, Suite 300 St. Petersburg, FL 33716 888-935-8676 ljmackmd@lucidgenes.com DEDICATION i
  • 3. Information to collect How to collect How to ask questions Sample questions 1 FAMILY HEALTH HISTORY
  • 4. What is family health history? Family health history is information about diseases that run in your family, as well as the eating habits, activities, and environ- ments that your family shares. Knowing about the diseases that run in your family can help you make healthy choices. Your familyā€™s health is one part of the history of your family. While collecting your family health history, pay attention to events, sto- ries, and experiences as well. Gathering your family history helps you share your family stories and health information with your fam- ily members and children. ā€œ Family health history can be found in the choices you make, the stories your family shares, and the culture of your community. Dis- cover it and improve your health!ā€ ā€“ Sharon F. Terry President & CEO Genetic Alliance COLLECT 3Free Patient Education from Lucid Genetics
  • 5. Carloā€™s Story Every man in my family has dropped dead before the age of 50ā€” my father, my grandfather, and my uncles. I always assumed that I wouldnā€™t make it to 50. A few years ago my cousin told me that he told his doctor about our family health history. How can family health history affect my health? You inherit many things from your parents and grandparents. They pass on culture and values through photos, recipes, stories, spiritual prac- tices, and music. You also inherit how you lookā€”for example, how tall you are and the color of your eyes. Small structures in cells called genes carry information for these characteristics and how your body works. Your genes were passed on to you from your parents. Some genes can make it more likely that you will get certain diseases. When members of your family share health problems, you might be at risk for getting the same health problems in the future. This is because family members can have genes, lifestyle, and environment in common. However, you may be able to prevent illness by knowing your family health history and by making healthy choices. 4 His doctor did some tests and found out that my cousin was at risk for heart diseaseā€”maybe even a heart attack. He put my cousin on medication to lower his cholesterol and told him to stop eating so many fried foods. I talked to my doctor and got the same tests and advice. Last year, I threw the biggest 50th birthday party ever! Free Patient Education from Lucid Genetics
  • 6. Kathleenā€™s Story Iā€™ve always known that some of the relatives on my fatherā€™s side of the family died in early adulthood. At 23, I started to experience heart problems. I worried that I would die young like my aunt Kathleen, after whom I was named. Like many of my relatives who died, I was unusually tall, and everyone said I was Aunt Kathleenā€™s ā€œspitting image.ā€ I was in medical school at the time and drew a family tree. When I shared my family health history with a few specialists, they did some tests and diagnosed me with Marfan syndrome. I contacted all of the members of the family who I feared were affected, and they were able to get lifesaving treatment. Now I donā€™t live in fear that I might die suddenly like my aunt. I donā€™t worry for my daughter Marissa, who also has Marfan syndrome. We take the proper medication, get checkups regularly, and can get on with our lives. Our ancestors did not die in vain. Their story was heard and saved many. To find out more about Marfan syndrome, visit www.marfan.org. How can my choices affect my health? Many things shape your health. Some thingsā€”such as your genesā€”are outside of your control. Other thingsā€”such as what you eat, if you smoke or exercise, and what you do for a livingā€”can be inļ¬‚u- enced by the choices you make. To make healthy choices, you need to understand your current health, your risk for getting certain diseases, and your environment. Family health history is the ļ¬rst step on the road to better health. ! ! ! ! ! ! ! 5Free Patient Education from Lucid Genetics
  • 7. Collect stories about your ancestry and culture. This is a great chance to preserve your familyā€™s memories. What information should I collect? Who to collect information on: ā€¢ Yourself ā€¢ Your parents ā€¢ Your brothers and sisters ā€¢ Your children Then move on to aunts, uncles cousins and grandparents. Basic information to collect: ā€¢ Name and how you are related (myself, parent, child, etc.) ā€¢ Ethnicity, race, and/or origins of family ā€¢ Date of birth (or your best guessā€”for example ā€œ1940sā€) ā€¢ Place of birth ā€¢ If deceased, age and cause of death 6Free Patient Education from Lucid Genetics
  • 8. Be sure to record age at onset of symptoms Health history: ā€¢ Alzheimerā€™s disease ā€¢ Asthma and allergies ā€¢ Birth defects (such as cleft lip, heart defects, spina biļ¬da) ā€¢ Blindness/vision loss ā€¢ Cancer (such as breast, ovarian, colon, pros- tate) ā€¢ Current and past medications ā€¢ Deafness/hearing loss at a young age ā€¢ Developmental delay/ learning disorders ā€¢ Diabetes/sugar disease ā€¢ Heart disease ā€¢ High blood pressure ā€¢ High cholesterol (when the disease started) ā€¢ History of surgeries ā€¢ Immunizations ā€¢ Mental health disorders (such as depression, schizophrenia) ā€¢ Obesity ā€¢ Pregnancy (such as number of children, miscar- riages, complications) ā€¢ Stroke ā€¢ Substance abuse (such as alcohol, drugs) Lifestyle: ā€¢ Exercise ā€¢ Habits (such as smoking, drinking, regular doc- tor/ dentist checkup) ā€¢ Hobbies and activities ā€¢ Nutrition and diet ā€¢ Occupation 7Free Patient Education from Lucid Genetics
  • 9. How do I collect family health history? Talk to your family Your relatives are the best source of information about your fam- ily. Family history is often shared while talking at family events like birthday parties, weddings, reunions, religious gatherings, holi- day dinners, and funerals. These events provide a chance to ask family members about their lives. Use what you have Check ļ¬rst to see if your family has family trees, charts, or listings of family members. This information may be written in baby books, photo albums, birthday date books, a family bible or other religious records. Review your own medical history with your doc- tor to make sure you are not forgetting anything. 8Free Patient Education from Lucid Genetics
  • 10. Consider explaining to family members that you are collecting the information to learn more about possible medical conditions you or your children might have in the future. Plan an individual conversation After you have brought up the idea of collecting your family health his- tory, you may want to talk with certain family members to get a more complete record of what they know. If possible, record these talks so you can go over them later. This guide includes questions to ask. Send a survey You may wish to send out a survey asking for health information from relatives. One quick and easy way to collect this information is to put it in a holiday newsletter. Not everyone will feel comfortable ļ¬lling out a survey. Be sure to explain exactly why you are asking questions. 9Free Patient Education from Lucid Genetics
  • 11. Lisaā€™s Story When I became pregnant, I talked with my parents about diseases that run in our family. I wanted to be prepared for anything that could affect my child. My parents told me that, before I was born, my aunt had a baby boy who seemed healthy. A few weeks later, however, he became very ill with vomiting and wasnā€™t eating. The doctor diagnosed him with a genetic disorder called MCADD (Medium Chain Acyl- CoADehydrogenase Deficiency) and put him on a special diet and medication. Unfortunately, some damage had already been done. Tips for collecting family health history ā€¢ Start with your parents if they are still living. Often, older relatives are good sources of information and can be the ā€œfamily histo- rian.ā€ ā€¢ If you are adopted, you may be able to learn some of your family history through your adoptive parents. You may also ask to see the adoption agency records. ā€¢ It is important to respect others. Some relatives may not want to share their medical histories. Some may not know their family his- tory. ā€¢ It can be scary to ļ¬nd out about a health concern in your family. Sharing family history with your healthcare provider can help you understand if you are at risk. ā€¢ Family members may not clearly identify all diseases. For exam- ple, someone who suffered from ā€œthe bluesā€ may have had de- pression. Ask family members to talk about how relatives acted. 10Free Patient Education from Lucid Genetics
  • 12. When I told my doctor this, she checked to see if MCADD was included in our stateā€™s newborn screening program. Luckily, it was. When my daughter was born, we paid close attention to her newborn screening results. She too has MCADD, but we were able to start treatment right away. Now she is a healthy, active three-year-old. By learning about my family health history, I was able to ensure that my baby stayed as healthy as possible from the moment she was born. To find out more about MCADD, visit www.fodsupport.org. How do I ask my family members about family history? On the next page is a list of questions that will help you talk with your family members. These questions will help you learn about your family stories, as well as health patterns and any impact environment, lifestyle, and family history may have on family health. Add your own questions that relate to your family. Prepare ahead of time ā€¢ Write down what you knowā€”such as family membersā€™ names, where they were born, or how many children they have. ā€¢ Pick the questions you will ask ahead of time. ā€¢ Record the interviews on a tape recorder or video camera. 11Free Patient Education from Lucid Genetics
  • 13. During the conversation ā€¢ Write down health-related information given by your relative. ā€¢ Try to keep the questions short. Avoid ques- tions that can be answered with a simple ā€œyesā€ or ā€œno.ā€ ā€¢ Use follow-up questions such as ā€œwhy,ā€ ā€œhow,ā€ and ā€œcan you give me an example.ā€ ā€¢ Do not expect people to know the answers to all of your questions. ā€¢ Respect a personā€™s wishes not to talk about cer- tain topics. ā€¢ Ask your family member to show you pictures, recipes, letters, and other family keepsakes. These can help people remember details and lead to more family stories. Michaelā€™sā€™s Story Since I am adopted, I thought there was no way for me to put together a family health history. Even though my adopted family and the adoption agency tried to help, they didnā€™t have the answers I needed about my birth familyā€™s health. How can I have a family health history without having my questions answered? There is something I can do. I am starting my family health history with me and my health issuesā€”like the fact that I started wearing glasses when I was 12 years old. I will pass the information on to my children, and they will be able to add to our family history. 12Free Patient Education from Lucid Genetics
  • 14. These questions are examples. You should change them to ļ¬t your conversation. Questions about childhood ā€¢ Where were you born? ā€¢ Where did you grow up? ā€¢ Did you experience any health problems (for example, aller- gies) as a child? ā€¢ Do you have any brothers or sisters? Are they living? How old are they? ā€¢ Questions about adulthood ā€¢ What jobs have you had? Can you tell me about a normal day? ā€¢ What was your work environment like? ā€¢ Do you have children? What are their names? When were they born? Did they have any health problems? ORGANIZE 13Free Patient Education from Lucid Genetics
  • 15. ā€¢ What habits (sun exposure, physical activity, smoking, etc.) have you had that could have affected your health? ā€¢ Did you have any health problems as an adult? At what age? How was this treated (e.g. medi- cine, surgery)? Questions about parents and grandparents ā€¢ When and where were your parents born? What do you know about them (for example, their jobs and hobbies)? ā€¢ When and where were your grandparents born? What do you remember about them? ā€¢ Did your parents or grandparents have any health problems? ā€¢ Do you know if your parents or grandparents took medicine on a regular basis? If so, for what? Did they use home remedies? What kinds and for what? Questions about family life ā€¢ Has your family lived anywhere that caused them health problems (e.g. disaster areas, waste sites)? ā€¢ What foods does your family usually eat? De- scribe a typical family breakfast or dinner. Do you eat special foods for special occasions? ā€¢ Has anyone had problems in pregnancy or childbirth? What kinds of problems? ā€¢ Are there any diseases that you think might run in our family? ā€¢ Is there anything else you would like to tell me about your life or health concerns in our family? How can I organize my family health history? The family health history information you collect can be written down or typed into the computer. It is important to write down all of the information so it makes sense to you, your family, and your healthcare provider. We have included some ideas below to help you organize your informa- tion. Family health portrait A family health portrait is like a family tree show- ing family members and their health. Because it is a simple picture of your family health history, it can be easily shared with your healthcare pro- vider. Turn to page 18 for more information. Healthcare Provider Card Online (www.geneticalliance.org/ccfhh), you will ļ¬nd a card to ļ¬ll out and bring to your provider. The card focuses on concerns you have about your family health history. It also gives your pro- vider more information on how to best use your family health history to ļ¬gure out your risk for get- ting a disease. 14Free Patient Education from Lucid Genetics
  • 16. Isabelā€™s Story My grandmother died of a massive heart attack when she was 39 years old. Even though my mother was so careful about healthcare for our family, she did not know that she had a very serious heart condition. She felt just fine, but during a routine checkup two years ago, a doctor discovered my motherā€™s uncontrollable heart arrhythmia. Mom was taken to the hospital immediately, and a cardiac pacemaker was implanted the following day. Since the doctors knew my grandmother had died of a heart attack at a young age, they took my motherā€™s symptoms very seriously. This knowledge about my motherā€™s and grandmotherā€™s health scares me, but I feel it is good to know. I know you can feel healthy but have a serious health condition. Whenever I go for my checkups, I always talk to my doctor about my grandmotherā€™s and motherā€™s heart conditions. She checks my heart thoroughly and always runs a special test on it because of my family health history. Though I canā€™t change what happened to my mom and grandmother, I can use the information to manage my health better and lower my risk of heart disease. 15Free Patient Education from Lucid Genetics
  • 17. How can I draw a family health portrait? If you have access to the Internet, you can use the U.S. Surgeon Generalā€™s My Family Health Portrait to create a family health his- tory tree on your computer. Visit www.familyhistory.hhs.gov. You can also draw your own family health portrait. Use the exam- ple on the next page to help guide you. Instructions for drawing a family health portrait ā€¢ Write your name and the date at the top of a large piece of pa- per. ā€¢ Draw yourself at the center using a square if you are a man or a circle if you are a woman. ā€¢ Draw your parents above you and label each symbol with his or her name and birth date (or approximate age). UNDERSTAND 16Free Patient Education from Lucid Genetics
  • 18. ā€¢ Draw a line between them and then draw a line down to you. ā€¢ When possible, draw your brothers and sisters and your parentsā€™ brothers and sisters from old- est to youngest, going from left to right across the paper. ā€¢ Add the health information you collected for each individual. ā€¢ Add the ancestry and any other information you have collected. Kimā€™s Story 1. To start my family health portrait, I added myself. Any women on the portrait are drawn with a circle. Under my name, I wrote my birth date. 2. Next, I drew in my mother and father. Any men in the portrait are drawn as squares. I connected my parents to each other using one line and drew another line that connected to me. 3. Next, I added my brother and sister and their birthdates. I connected each of them to the line that connects my parents. 4. For my fatherā€™s parents, I put their names above his and drew one line connecting them to each other and another line connected to my father. I also added my familyā€™s ancestry. Finally, I drew a line diagonally through my grandmotherā€™s circle to show that she died at age 42. Me (Kim) b 1975 _____________________________________ Mark b. 1950 Helen b. 1952 Jon b. 1974 Me(Kim) 1975 Rebecca b. 1979 _____________________________________ Mexico Ana b. 1930 Luis b.1929 Died Heart attack age 42 Mark b. 1950 Me(Kim) b. 1975 High Blood Pressure 17Free Patient Education from Lucid Genetics
  • 19. What now? ā€¢ Save your family health history and update it with new informa- tion you learn about your family. ā€¢ Find out more about the diseases that run in your family and how to stay healthy. ā€¢ Share information with your family. ā€¢ Take your family health history to your healthcare provider. Resources Genetic Alliance Family Health History Resources www.geneticalliance.org/familyhealthhistory The Smithsonian Folklife and Oral History Interviewing Guide www.familyoralhistory.us/news/view/the_smithsonian_folklife_and_ oral_history_interviewing_guide/ and visit the American Folklife Center website: www.loc.gov/folklife/ļ¬eldwork 18Free Patient Education from Lucid Genetics
  • 20. Why is genetics important to my family and me? Genetics helps to explain: ā€¢ What makes you unique, or one of a kind ā€¢ Why family members look alike ā€¢ Why some diseases like diabetes or cancer run in families ā€¢ How learning your family health history can help you stay healthy ā€¢ Why you should bring your family health history to your healthcare provider 2 GENETICS AND HEALTH 19Free Patient Education from Lucid Genetics
  • 21. Taking time to learn about health and diseases that run in your family is worth it! It will help you understand your own health and make healthy choices. What makes me unique? Every person is unique. Part of what makes you unique is your genes. Genes are the instructions inside each of your cells. They control how you look and how your body works. Since everyone has slightly different genes, everyone has a differ- ent set of instructions. Genes are one reason why you are unique! Tell me more about my genes ā€¢ A person has two copies of each gene, one from the mother and one from the father. ā€¢ Genes carry instructions that tell your cells how to work and grow. ā€¢ Cells are the building blocks of the body. Every part of your body is made up of billions of cells working together. ā€¢ Genes are arranged in structures called chro- mosomes. Humans have 23 pairs of chromo- somes. Copies of the chromosomes are found in each cell. ā€¢ Chromosomes are made up of DNA. DNA is the special code in which the instructions in your genes are written 20Free Patient Education from Lucid Genetics
  • 22. You share a lot with your familyā€”including what can make you sick. Common Disease: Diabetes Changes in your genes passed on by your parents may make you more likely to develop type 2 diabetes. If you are active and eat a healthy diet, you may be able to lower your risk. Why do family members have things in common? Children inherit pairs of genes from their parents. A child gets one set of genes from the father and one set from the mother. These genes can match up in many ways to make different combinations. This is why many family members look a lot alike and others donā€™t look like each other at all. Genes can also increase the risk in a family for getting cer- tain health conditions. Families also share habits, diet, and environment. These inļ¬‚uence how healthy we are later in life. Why do some diseases run in families? Some diseases are caused when there is a change in the instructions in a gene. This is called a mutation. Every person has many mutations. Sometimes these changes have no effect or are even slightly helpful. But sometimes they can cause disease. Most common diseases are caused by a combination of mutations, life- style choices, and your environment. Even people with similar genes 21Free Patient Education from Lucid Genetics
  • 23. Single Gene Disorder: Sickle Cell Anemia Sickle cell anemia is caused by a mutation in a single gene passed from each parent. may or may not get an illness if they make different choices or live in a different environment. Thousands of diseases are caused by a speciļ¬c change in the DNA of a single gene. Many of these diseases are rare. These conditions usu- ally develop when an individual is born with a mutated gene. If a rare disease runs in your family, be sure to write it down. Do not for- get to learn about common conditions that affect your familyā€™s health. 22Free Patient Education from Lucid Genetics
  • 24. How can knowing my family health history help me stay healthy? Your family health history tells you which diseases run in your family. Health problems that develop at a younger age than usual can be a clue that your family has a higher risk. Though you cannot change your genes, you can change your behavior. Knowing your family health history will help you: ā€¢ Identify risks due to shared genes. ā€¢ Understand better what lifestyle and environmental factors you share with your family. ā€¢ Understand how healthy lifestyle choices can reduce your risk of de- veloping a disease. ā€¢ Talk to your family about your health. ā€¢ Tell your healthcare provider about diseases that run in your family. Why should I take my family health history to my healthcare provider? Your healthcare provider (doctor, nurse, or physicianā€™s assistant) may use your family health history and current health to ļ¬gure out your risk for developing a disease. Your provider can then help decide which screenings you get and which medicines you might take. Based on your family health history, a healthcare provider may order a genetic test or refer you to a genetic counselor or geneticist. Genetic tests can show if you have a gene change that increases your risk for disease. They can also tell if you have a gene change that you might pass on to your children. Your healthcare provider can help you: ā€¢ Understand the results of your tests. ā€¢ Learn of any treatments for a disease found by the test. All newborn babies born in the U.S. and many other countries are tested for certain genetic diseases that may make them sick. This is called newborn screening. If the screening test ļ¬nds a problem, a healthcare provider will help you understand what can be done to help the baby. Remember 1. Share your family health history with your healthcare provider. 2. Ask if you can be screened for a disease that runs in your family. 23Free Patient Education from Lucid Genetics
  • 25. In the rest of this booklet, we give you examples of some com- mon diseases that affect our communities and families. For each disease, we include information under the following headings: ā€¢ What is the disease? ā€¢ Who is at risk? ā€¢ Hints for health DISEASES THAT RUN IN THE FAMILY 24Free Patient Education from Lucid Genetics
  • 26. Heart disease Heart disease is the main cause of death in America in both men and women. There are many types of heart disease. Two of the most com- mon types are coronary artery disease (CAD) and high blood pressure (hypertension). What is Coronary Artery Disease (CAD)? ā€¢ In CAD the arteries that supply blood to the heart muscle can get hard and narrow. The arteries narrow, or get smaller, because plaque and cholesterol build up on the inner walls. ā€¢ CAD gets worse over time. As the arteries get smaller, less blood gets to the heart, and less oxygen gets to the heart muscle. Very low levels of oxygen can cause chest pain or a heart attack. ā€¢ CAD is the most common cause of heart attacks among Americans. Who is at risk? ā€¢ About 13 million Americans have CAD. ā€¢ Everyone has some risk for developing heart disease. ā€¢ CAD is caused by a combination of genes, lifestyle choices, and envi- ronment. ā€¢ For some people, a healthier diet and more activity can change cho- lesterol level and lower risk. ā€¢ Since your genes cannot be changed, some people need medicine to lower their risk of having a heart attack. Hints for health ā€¢ Eat healthy meals. ā€¢ Get active and exercise regularly. Obesity increases your risk. ā€¢ Take your prescribed medications to control high cholesterol, high blood pressure, and diabetes. ā€¢ If you smoke, talk with your healthcare provider about quitting. For more information, visit www.nhlbi.nih.gov/ health/dci and click on ā€œCoronary Artery Diseaseā€ or call the American Heart Association at 800- AHA-USA-1 (800-242-8721). 25Free Patient Education from Lucid Genetics
  • 27. What is High Blood Pressure? ā€¢ Blood pressure is a measure of how hard your heart is working to push the blood through your arter- ies, the blood vessels leaving your heart. ā€¢ There are two numbers in a blood pressure reading. A normal reading is about 120/80 (read as ā€œ120 over 80ā€). The ļ¬rst number is the force your heart uses to pump the blood. The second num- ber is the pressure between heartbeats. ā€¢ High blood pressure means that your heart is working too hard. Over time, high blood pressure can cause kidney failure, heart attacks, strokes, and other health problems. Who is at risk? ā€¢ About one in three adults has high blood pressure. Many do not even know it because there are no clear symptoms. ā€¢ A family history of high blood pressure increases your risk for getting it at a younger age. ā€¢ Risk increases with age, being overweight, or having a family history of hypertension. Hints for health ā€¢ Eat less salt. ā€¢ Maintain a healthy weight. ā€¢ Manage your stress. ā€¢ Get active and exercise regularly. ā€¢ Limit the alcohol you drink. ā€¢ Get screening regularly. For more information, visit www.nhlbi.nih.gov/health/dci and click on ā€œHigh Blood Pressureā€ or call the American Heart Association at 800-AHA-USA-1 (800-242-8721) Heart disease symptoms may not appear until the damage is already done. Talk to your family about heart disease today. 26Free Patient Education from Lucid Genetics
  • 28. What is Asthma? ā€¢ Asthma is a lung disease that causes repeated episodes of breath- lessness, wheezing, coughing, and chest tightness. The episodes can range from mild to life threatening. ā€¢ Asthma episodes are caused by tirggers. These are things like dust mites, animal dander, mold, pollen, cold air, exercise, stress, viral colds, allergies, tobacco smoke, and air pollutants. ā€¢ Some people have genes that control their response to these asthma triggers. Who is at risk? ā€¢ Asthma affects about one in 10 children and one in 12 adults. ā€¢ Asthma is the main reason children end up in the emergency room and miss days of school. ā€¢ If you have parents, siblings, or children with asthma or allergies, you are more likely to get it. Hints for health ā€¢ Avoid exposure to triggers. ā€¢ Use medication correctly. Diabetes (sugar disease) Diabetes is a serious, chronic disease in which blood sugar levels are above normal. Many people learn about their diabetes after problems develop. According to the American Diabetes Association, one out of three people who have type 2 diabetes do not know that they have the disease. Symptoms occur when the body fails to change sugar and other food into energy. This happens when the body cannot make or use a hor- mone called insulin. Serious problems from diabetes can include blind- ness, kidney failure, and death. Diabetes can be detected early and treatment can prevent or delay these serious health problems. For more information, visit www.nhlbi.nih.gov/ health/dci and click on ā€œAsthmaā€ or call the American Lung Association at 800-548-8252. For more information, visit www.ndep.nih.gov or call 800-860-8747. 27Free Patient Education from Lucid Genetics
  • 29. Both genetic and environmental factors such as diet and exercise plays an important role in get- ting the disease. What isType 1 Diabetes? ā€¢ Type 1 diabetes usually develops in young chil- dren or young adults. ā€¢ People with type 1 diabetes stop making their own insulin. What isType 2 Diabetes? ā€¢ Type 2 diabetes usually develops in people over 30 years of age. In recent years, more young people are getting it due to poor diet. ā€¢ Scientists are learning more about the speciļ¬c genes involved in this type of diabetes. ā€¢ Who is at risk? ā€¢ Diabetes affects about one in 13 people in the United States. ā€¢ Five to 10 percent of Americans with diabetes have type 1 diabetes. ā€¢ Children or siblings of people with diabetes are more likely to get diabetes. ā€¢ Obese people are more likely to get type 2 dia- betes. ā€¢ Women who had a baby that weighed more than 9 pounds or who had gestational diabetes while pregnant are at risk. ā€¢ Hints for health ā€¢ Eat more fruits and vegetables, less sugar and fat. ā€¢ Get active and exercise regularly. ā€¢ Lose weight if necessary. 28Free Patient Education from Lucid Genetics
  • 30. For more information, visit www.cancer.gov/ cancertopics and click on ā€œBreast Cancerā€ or call 800-4-CANCER (800-422-6237). Cancer There are many types of cancer. Cancer is caused by the growth and spread of abnormal cells. Though your risk of getting cancer increases as you get older, genetic and environmental factors also cause people to be at a higher risk for certain types of cancer. Some of the most com- mon cancers are breast cancer, lung cancer, and prostate cancer. What is Breast Cancer? ā€¢ Breast cancer is a type of cancer that forms in the tissues of the breast, usually the ducts. ā€¢ Breast cancer is one of the most common cancers among women. ā€¢ Although it is rare, men can also get breast cancer. 29Free Patient Education from Lucid Genetics
  • 31. ā€¢ Most breast cancer can be treated if found early. Who is at risk? ā€¢ One out of eight American women will develop breast cancer in her lifetime. ā€¢ Among Hispanic/Latina women, breast cancer is the most common type of cancer. ā€¢ Breast cancer risk is higher if a women has close blood relatives who have had this dis- ease. Both your motherā€™s and fatherā€™s family his- tory of breast cancer is important. Hints for health ā€¢ Women should do monthly breast self-exams. ā€¢ After age 40, women should get annual mam- mograms. ā€¢ Ask about genetic testing for high-risk families. ā€¢ Eat a healthy, balanced diet. ā€¢ Get active and exercise regularly. ā€¢ Limit the alcohol you drink. What is Lung Cancer? ā€¢ Lung cancer is the uncontrolled growth of ab- normal cells in one or both of the lungs. Who is at risk? ā€¢ Lung cancer is the leading cause of cancer death for both men and women. ā€¢ About 160,000 people died in the United States from lung cancer in 2007. ā€¢ Nearly 87 percent of lung cancer cases in the United States are smoking-related. Hints for health ā€¢ Do not smoke. ā€¢ Avoid secondhand smoke. ā€¢ Find out about testing for radon and asbestos in your home and at work. What is Prostate Cancer? ā€¢ Prostate cancer develops in the male reproduc- tive system. The prostate is a small gland near the bladder. ā€¢ Scientists do not yet know what causes pros- tate cancer. ā€¢ Doctors have a test to ļ¬nd out whether a man might have prostate cancer. Who is at risk? ā€¢ Men of all ages can develop prostate cancer. However, more than eight out of 10 cases oc- cur in men over the age of 65. ā€¢ Prostate cancer is the most common type of cancer diagnosed in Hispanic/Latino and Afri- can American men. ā€¢ Having a father or brother with prostate cancer more than doubles a manā€™s risk for getting pros- tate cancer. The risk goes up with the number of relatives who have it, especially if the rela- tives were less than 50 years old when they got it. Hints for health ā€¢ Follow a healthy diet. ā€¢ Exercise regularly. ā€¢ After age 50, have your prostate checked. 30Free Patient Education from Lucid Genetics
  • 32. What are Single Gene Disorders? ā€¢ Earlier in this booklet, you read about conditions caused by mu- tations in a single gene. These conditions are called single gene disorders. ā€¢ There are more than 6,000 single gene disorders. Combined, they occur in about 1 in 300 births. ā€¢ The symptoms of single gene disorders vary widely, but many of them run in families. ā€¢ Collecting your family health history for these conditions is im- portant for diagnosis and management of the condition and for making reproductive choices. Who is at risk? ā€¢ Every person is born with mutations. Most of these mutations will not cause disease on their own, but it is important to iden- tify any that do. SINGLE GENE DISORDERS 31Free Patient Education from Lucid Genetics
  • 33. ā€¢ Depending on which gene is affected, single gene disorders can be passed down even when the mother and father do not show any symptoms. ā€¢ Some single gene disorders are identiļ¬ed dur- ing a pregnancy or soon after a child is born. Others will not be diagnosed until adulthood. ā€¢ The most harmful mutations may lead to a mis- carriage or stillbirth. If you have a family history of miscarriages, this may be related to a ge- netic mutation. Picture courtesy of CureAHC Inc. Hints for health: ā€¢ If you have a family history of a single gene dis- order, discuss it with your healthcare provider. Your provider may refer you to a specialist. ā€¢ Know which newborn screening tests are per- formed in your state. ā€¢ For thousands of conditions, advocacy organi- zations provide support services, information, and ways to get involved in the discovery of treatment options. Visit Disease InfoSearch at www.geneticalliance.org to ļ¬nd out more. For more information on single gene disorders, contact the Genetic and Rare Diseases (GARD) Information Center at gardinfo@nih.gov or 888- 205-2311. 32Free Patient Education from Lucid Genetics
  • 34. Resources The ā€œDoes It Run In the Family?ā€ toolkit includes two pieces that can help you summarize your health information for your providerā€”the family health portrait and healthcare provider card. You may also hear your healthcare provider call a Family Health Portrait a ā€œpedigree.ā€ Each family and individual is unique and may have genetic diseases other than the major diseases listed here. For more information visit: Disease Info Search www.geneticalliance.org National Library of Medicine www.nlm.nih.gov/services/genetics_resources.html 33Free Patient Education from Lucid Genetics
  • 35. www.geneticalliance.org www.lucidgenes.com 4301 Connecticut Ave. NW, Suite 404 970 Lake Carillon Drive, Suite 300 Washington, D.C. 20008-2369 St. Petersburg, FL 33716 Phone: 202-966-5557 Fax: 202-966-8553 888-935-8676 info@geneticalliance.org info@lucidgenes.com Genetic Alliance transforms health through genetics. We promote an environment of openness cen- tered on the health of individuals, families, and communities. We bring together diverse stakeholders that create novel partnerships in advocacy; integrate individual, family, and community perspectives to improve health systems; and revolutionize access to information to enable translation of research into services and individualized decision making. Funded in part by a cooperative agreement (U33 MC06836) from the Maternal and Child Health Bu- reau, Health Resources and Services Administration. 34Free Patient Education from Lucid Genetics