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Leslie Michelson featured in the Chicago Tribune

Posted by Levine Communications Office on January 9, 2012

Resolve to chart family’s medical history

Improved records could help you, others in your family

Leslie Michelson, Special to the Tribune

January 11, 2012

As we all know, the typical New Year’s resolution can be summed up like this: “Feel like a failure by February.” Are you well on your way to keeping that one?

If so, how about a second chance? How about a “new” New Year’s resolution you can actually keep and feel good about the rest of your life — because you’ll live longer if you keep it?

Here it is: Resolve to chart your family medical history — for your good and theirs.

This simply requires illuminating your own records with a medical history of your family tree, then securely archiving the results. You can set this resolution into motion through a few hours’ effort, and the results will be permanent and priceless.

Here’s how, starting with the step that’s most fun.

•Collect your family health history. Genetics play an enormous role in determining health risks and treatment. That’s why tens of thousands of scientists around the world are working to develop new insights on how to use this information to prevent, detect early and treat a host of diseases. Progress can be seen practically daily. Individual genomic mapping is already a reality, and someday — maybe soon — widespread, affordable DNA testing will reveal insights to improve your health and even save your life. But until then, the collective memories of your extended family are the best source of information on what may be latent in your genetic code. Your physicians can use that knowledge to optimize your preventive care and, if you develop a health problem, to dramatically reduce the time it takes to diagnose and start treating it.

So resolve to be an anecdotal sleuth. What were great-grandpa’s physical and mental health like just before he died of “old age”? Any unusual health symptoms with aunts, uncles, cousins — including estranged, distant or otherwise unfamiliar relatives? Is there an unsolved medical mystery in the family closet? There probably is. I see examples every day.

One of our patients, a 12-year-old boy, recently developed unusual abdominal symptoms. After ruling out the most common diagnoses, his primary-care physician sent him to a hematologist to review some potentially worrisome blood work results. But the blood work wasn’t reviewed in a vacuum. First, the hematologist did due diligence on the boy’s medical history, including the extended family’s. He learned that the mother suffered a rare anemia when she was about the boy’s age, but it was never fully diagnosed or understood. With that single clue, the physician focused immediately on an obscure but specific blood disorder that he knew to be hereditary. He not only diagnosed the young man’s condition but also finally solved the medical puzzle his mother had wondered about for 40 years.

We can’t learn from what we don’t know. Harvest your health history with the closest members of your gene pool. If you don’t, that irreproducible information might be lost forever. If you do, it’s also a good bet you’ll unearth some great stories.

Gather your records. Your medical history is likely spread out among specialists you’ve consulted over the years — also possibly spread out geographically if you’ve moved around — and your primary-care physician isn’t certain to have all the details. But referrals are probably noted in your chart, and a review of your calendar archives can help you fill in the blanks.

If you’re lucky to find a volunteer willing to help with legwork, you can authorize access to your far-flung records with a standard release form: bit.ly/yTCiJt. Compile a list of every doctor you remember seeing. They’re required by law to comply with your records request — or your proxy’s.

Ideally, when your medical records arrive, scan and put them in an electronic file. Then distribute them right back to all the doctors who contributed, or at least to your primary-care physician. Once you establish this database — better than any doctor’s — you can set up a schedule to update it regularly — such as quarterly — or in the event of any major medical development. Always keep backup digital copies.

Let your records speak for you. Carry one of those digital copies when you travel, especially outside of the country. We provide our patients a portable digital medical history through a credit card-size USB device. At a minimum, carry a laminated wallet card that lists medications, diagnoses, allergies, insurance coverage, family contacts and the name and phone number of your primary-care physician.

If, far from home, you suddenly find yourself in an ambulance — and these things are always sudden — having your full medical history on a memory card, or at least the name and number of your doctor prominently in your wallet, can save your life. A voice that can urgently speak for you when you cannot is the most valuable gift you can give yourself.

It does not take an emergency for this entire exercise to be valuable. Routine medical errors harm and even kill patients every day, on an astonishing scale. The casualties of misdiagnoses or drug errors in this country add up to roughly the equivalent of a daily 747 crash with no survivors. Clarity in your past and present medical status can help keep you off those flights. At the very least, it can help you avoid unnecessary or duplicative tests, which are a waste of time and money at best — and at worst can muddy the diagnostic and treatment processes.

By all means, make and keep resolutions to lose weight, eat better, stop smoking, exercise more and imbibe less. All these will extend and improve your life. But becoming your own medical historian may actually save it — and possibly your relatives’.

And it’s a lot easier than trying to be perfect for the next 11 months and two weeks.

Leslie Michelson, former special assistant to the general counsel of the U.S. Department of Health and Human Services is chairman and CEO of Los Angeles-based Private Health Management Inc.

Copyright © 2012, Chicago Tribune

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