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A Day in Your Life
Woke Up, fell out of bed...

Dragged a comb across your head. Then you found your way downstairs and dra...all right, you get it. One of the most time-intensive but valuable parts of your health profile is to get a detailed description of your typical day. We start by asking what time you generally wake up in the morning (and how, whether you're roused by dawn's gentle light, a rooster, an amorous mate, a lapping cat, morning smoker's cough, and so on) and how refreshed you typically feel. Next we ask about morning chores, the length and stress of the work commute, the first task (or taskmaster) to greet you at the office, and the sordid toils and pleasures of the entire A.M. journey. Then we discuss your typical lunch. You can see why this takes a while. But it's valuable in getting a full picture of your life and an accurate depiction of the suspects and scenes that affect your health, as demonstrated in these illustrations. Hopefully, this home setting won't look too much like yours.

We Double Trouble

We know you bend the truth a little when telling us the good and bad you do to yourself. That's why we at least double, up or down, the most fudged claims. For example:

Patient Says -- We Hear

I have two drinks a day. I might drink a case a week.

I exercise about twice a week. I rarely exercise.

I smoke a few cigarettes a day. I'm a pack-a-day-er.

I smoked for five years. I smoked for ten years and off and on for a few more.

My job is stressful. This job's going to give me a coronary if I don't quit or learn how to deal with it.

I hardly ever have unsafe sex. I use condoms about half the time.

I get short of breath if I run. Five porch steps leave me gasping.

I eat about two hamburgers a week. I eat cheeseburgers most of the other days.

I forget to take my medication about once a week. I remember to take my medication about twice a week.

I'll follow up with you; I won't forget. I'll stop back in when the kids are grown.

The Adopted Plan

Logging your genetic propensities is enough of a job when you have your blood relatives close at hand or accessible in your address book. But what if you're adopted? Or if you've adopted a child? Thousands face this hurdle each year in compiling a health history. Luckily, it's becoming a bit less difficult to get the information you need.

There's a trend in domestic adoptions toward openness -- in other words, the adoptee, birth parent (one or both), and adoptive family all have a degree of contact with one another and share relevant information, including health histories. Recent laws have helped unseal files too. Of course, there are still many adoptees and adoptive parents who have no such contact or any records whatsoever, for a host of different reasons, and have come up empty even after checking with the adoption agency (always the first place to contact on this mission). In this case, they should contact their state Department of Health and Human Services to see if any birth records exist, and also examine the various registries that attempt to link birth families and adopted persons. A great all-around source is the government's National Adoption Information Clearinghouse Web site at naic.acf.hhs.gov.

You can search by state for info and availability of records. Remember that there's no need for a tearful, emotional reunion if that's not wanted: these registries often connect adoptees and birth parents for the sole purpose of gathering health information.

What about international adoptions? Some countries are just beginning to open their records, and the adoption agency and country consulate's office can be a starting point for investigation.

A Ghoulish Notion?

If your parents will consent to it, consider having an autopsy performed on them when they die. Few autopsies are done today as compared with decades ago, as it's rarely thought necessary when a cause of death is clear, such as a heart attack. But there's much value in knowing if your eighty-two-year-old father had undiagnosed prostate cancer that had been advancing since his fifties, or heart disease, even though it was a stroke that did him in. This is especially useful if the death was due to an accident, of course. Reassure your living parent that this doesn't mean foul play is suspected, or that the body will be shipped to a CSI soundstage, or that there can't be an open casket.

Tip: Have a Tattle Plan

Bring your spouse to your doctor's appointment when you're giving your health history; there are a lot of questions that only he or she can answer (how many times an hour do you stop breathing while asleep?). But, please, before coming in to the office together, make sure you discuss which fibs you're going to tell the doctor. Why? Because when you tell us that you rarely tear into the Pringles after 8:00 P.M. or that you've been taking your cholesterol-lowering drugs with the discipline of a marine, your spouse will shoot you -- or us -- an involuntary look that communicates something close to Are you kidding me? We never miss it. And, hey, sometimes your spouse wants to blow your cover. It's called love -- why do you think she booked the appointment?

If you try to snow us, remember that we might try to trip you up by asking about specific dates. As in when you last did something. For example, we'll ask you if you're fit enough to climb three flights of stairs. You'll say yes, unless you're older than eighty-five or bedbound. Then we'll ask, "When was the last time you climbed three flights of stairs?" You'll think, and start to say, "Maybe a month, or..." and your spouse will shoot that never-fails look. The one that says, You haven't climbed three flights of stairs since we voted for Ike.

How embarrassing.

So please, rehearse beforehand.

Click to Access to Your Health Info

There are several Web sites that allow you to store your health records online, so you, your doctor, or any person given permission can tap them on the Internet, from any location. Some are free, and others have monthly fees that range from $30 to $80. To check out a few examples, click into the Web sites at www.ihealthrecord.org, www.personalhealthkey.com, healthmanager.webmd.com, and the Joint Commission Resources' own www.jcrinc.com. We'll update this list at the personal-health site at www.realage.com. Each site has security safeguards to protect the confidentiality of your info. Aside from the convenience factor, using these sites could make it easier to you keep your files current, because you'll have a one-stop, central place to update your info.

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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