Wellness Change Your Outlook -- Change Your Life

How To Be A Smart Patient

By DR. MICHAEL ROIZEN AND DR. MEHMET OZ
Continued from Page 1

In addition to those mentioned above, here are a few more examples of conditions that are significant:

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    • Anemia

    • Heart disease

    • Heart murmur, or any other

    • heart irregularity

    • HIV

    • Herpes

    • Multiple sclerosis

    • Nerve paralysis

    • Cancer of any form

    • Diabetes

    • Gingivitis (gum or periodontal disease)

    • Hemophilia

    • Kleptomania (just making sure you're paying attention)

    • Epilepsy

    • Gulf War syndrome

    • Alcohol or other addictions

    • Vertigo

    • Sexual dysfunction

    • Paraplegia or quadriplegia

    • Sleep apnea

    • Vision or hearing loss

    • Glaucoma

    • Parkinson's disease

    • Amputation

    • Liver disease

    • Post-traumatic stress disorder

    • Dementia or frequent memory loss (for example, can't recall name of close friend or relative) • Multicythemia veragis (just kidding)

    Here are some that are probably not significant:

    • Astigmatism

    • Dental cavities

    • Sore lower back after shoveling heavy snow

    • Rosacea

    • Varicose veins

    • Toenail fungus infection or athlete's foot

    • Forgetfulness (for example, can't remember where keys are, or where you were when Luke and Laura married on General Hospital)

    • Sunburn prone or can't tan

    • Insomnia before job interviews or court sentencings

    • Cat allergy

    • Hangover

    • Irritability

    • Disorganization

    • C-SPAN addiction

    • Turkey neck

    • Repeatedly date or marry losers

    Now list your past significant ailments and conditions in the next section, noting when you were diagnosed and what happened. Then list all the details about the medications you're taking (all pills or tablets or anything that you regularly ingest, inject, insert, or otherwise consume regularly, whether it's prescription or over-the-counter (OTC) drugs, herbal supplements, vitamins, etc.). We'll say this again, but in addition to having this form handy when you see your doctor (in your pocket or the office file cabinet), always bring the actual bottles of all those medicinal consumables, too. It's important.

    Checklist: We Ask, You Answer

    For any condition or ailment you include on your list that you're still dealing with, write down and be prepared to tell the doc the following:

    • What caused this?

    • When was it diagnosed?

    • How are you treating it?

    • Has it gotten better or worse?

    • When did it first begin to noticeably improve or worsen?

    • What makes it better?

    • What makes it worse?

    Don't Know Much about Genealogy

    On pages 52 and 53, you'll also find the Smart Patient Family Tree. Flip to it and sharpen a pencil. This Smart Patient Family Tree is designed to bring joy (and longevity) to your life. The solid lines sprouting outward from you to your siblings, and downward to your parents, aunts and uncles, and grandparents represent blood-relative connections (not by marriage). You'll notice a dashed line going to your spouse, which represents a non-blood relationship. The reason you need to include your spouse is that he or she lives with you (at least we hope so). That means you share the same environmental exposures and, likely, similar risks. You serve as each other's personal coal-mine canary. One of you may get nauseous from the toxic waste buried under your house years before the other one. (Just kidding! You'd likely be afflicted simultaneously.) Also, even though you don't share DNA (at least not on most school nights, anyway), your spouse influences your health far more than your aunt Sadie in Perth Amboy. Auntie may have a cholesterol count that would bring a Guinness World Records rep to her door, but she isn't filling your day-to-day life with cigarette smoke, bacon, Pabst Blue Ribbon, and lost-sock arguments. The only thing worse for your health and longevity than having a spouse is not having one, in fact. No one likes being nagged, but being nagged into eating broccoli pays dividends.

    Start filling out the Smart Patient Family Tree by adding your spouse's info, if you have one. You'll notice that the tree reaches only to your grandparents, not back to your Viking ancestors like some other family trees you may have seen. Why? Of course you recall the genetic Mendel grid from biology class, and how a fruit fly's ability to pass his tiny wings to his great-grandson was so genetically diluted, it was practically nil. Alas, the apple never falls far from the tree, but the fruit fly must at least be in the orchard -- that is, at least as genetically close as a grandparent -- before you go blaming him for any shortcomings.

    Are there any exceptions? Sure. It's biology. None of us would be our particularly unique and endearing selves if not for a whole gang of exceptions. Include great-gramps and any other distant forebear if they had a disease or condition that is especially rare and deadly (even a small risk may warrant vigilance or gene testing). For example, Baron von Munchausen VI is still at extreme risk, but he knows that.

    Thicken your family tree with all the info you know offhand. You want to record each relative's birth date and (if applicable) death date, the jobs they performed (as certain occupations can strongly affect health), and -- most important -- any diseases they had that may have a genetic link. Your doctor can clarify this if you aren't certain about the disease or if it was never diagnosed. Just list the symptoms the person had (memory loss, for example). While you're at it, you might as well jot down any other interesting tidbits in case the kids get curious about their roots one day. If you're like most people, it'll be about 14 percent complete when your brain is tapped. You'll need to do some investigating, Columbo style (Remember? Smart cop?), so see the checklist (on page 54) for the family interrogation protocol.

    Test: Just How Likely Are You to Inherit This Relative's Condition

    To better assess your risk, answer these questions for each relative who has (or had) a disease that might be genetically transmissible to you:

    Y / N Is this an immediate, full-blood relative? Circle yes if it is your mother or father or a sibling (if a stepsibling, circle no)

    Y / N Did this relative get the disease with a suspected genetic link before age sixty-five?

    Y / N Did this relative die from this disease before age sixty-five?

    Y / N Was this disease likely caused by a genetic link, and not caused by environmental or lifestyle factors? (If the relative was a heavy smoker, a heavy drinker, or had a toxic or hazardous exposure at work, and these likely caused or contributed to the disease, circle no)

    Y / N Is there at least one other blood relative who also has or had any of these same diseases?

    Y / N Do you look like this relative, either inside or out? Meaning, do you have the same body type, same cholesterol problem, same bad temper, etc.?

    If you circled one or two Ys, you may be at risk for inheriting this condition, so monitor it with your doctor. You circled three or more Ys? You're likely at very high risk of inheriting the disease, so keep a watchful eye on it.

    Hopefully, you won't have to interrogate more than a handful of relatives in the above manner. If you hail from a litter of fourteen and have more aunts than a cartoon picnic, however, just remember to keep your radar sharp for two factors: serious illness or death before age sixty-five, and potentially fatal conditions. Either can be more important than how close you and your relative are in the bloodline. For example, your uncle's pancreatic cancer at age fifty-three would likely be more alarming to us than your mother's heart fibrillations at age seventy. At a bare minimum, you need to know why your parents and grandparents died, if they're now gone. And your bottom-line question to your doctor is always the same: If there's a genetic link associated with this condition, how can I prevent it?

    Checklist: Gastritis, Aunt Gertrude?

    Shaking down family for health details needn't always be a horribly awkward task. Remember that half will always talk about the other half, so go the gossip route if easier. If you want to be direct, just grab your reporter's pad and pen, dial the phone or meet the relative at the early-bird diner, and repeat this checklist (feel free to ad-lib). You might consider an opener like this:

    "Hello, [relative]. I know you haven't heard from me since [year], but I'm putting my family health history together to see if I'm at risk for anything genetic, and I thought you could tell me a few things I just can't find anywhere else. [Another relative he or she dislikes] said you probably wouldn't help me or wouldn't be able to remember, but I thought I'd try anyway."

    • When were you born? (Or "Who was the first president you remember?" if the relative won't say. If it's Franklin Delano Roosevelt, ask if he or she voted for him.)

    • Have you been diagnosed with any diseases? When?

    • What kind of treatment did you get?

    • Any cancers? Diabetes? Heart problems? High blood pressure? Do you take any drugs (not those kind) or supplements? If so, why?

    • Any surgeries? When, and for what?

    • Ever have a bout of depression, anxiety, or other emotional health problems? (Ask relative this family member dislikes for immediate answer.)

    • Any miscarriages, stillbirths, or infant deaths?

    • Any heart attacks or strokes? (Pretend you suddenly remember and ask if the flowers made it.)

    • How's your hearing? (Whispered.)

    • Do you or did you smoke or drink?

    • What jobs did you have?

    • Still lead in the pencil?

    • Has your memory deteriorated? Do you still remember my name?

    • So, that thing growing on [another relative] -- is that skin cancer or what?

    Excerpted from 'YOU: The Smart Patient An Insider's Handbook for Getting the Best Treatment' by Michael F. Roizen, M.D. and Mehmet C. Oz, M.D.

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