“Family medical history is a window to your health. It is important to know that heritable factors that are embedded in our DNA put us at risk of some diseases. For example, if your relatives have diabetes, chances are high that you will also get it,” says Dr Franklin Wasswa, a general physician at Entebbe General Hospital.
Such was Ali Male’s case. “I lived such a carefree life to the point of ignoring health checkups even when they were paid for by my insurance provider. I also paid little attention to my relatives’ failing health,” he says. He thought that for some, it was simply old age while others were simply unhealthy. The walk-up call came when he started experiencing endless migraines and constant thirst.
After some prodding and pushing, Male went to hospital and one of the questions the doctor asked was whether anyone in his family had diabetes.
“That was when it hit me that almost all my father’s siblings always talked of insulin injections and whenever they visited, meals were served on time. I had only thought of them to be bossy but as the doctor explained my symptoms, I wanted to apologise to them for being unthoughtful,” he says.
Emily Lunkuse was well aware that most women in her family had died at no later than 50 after suffering from breast cancer. “I was also lucky to have a good gynaecologist that made it a point to know my family health history.
So the day I felt a lump in my breast at 34, I was quick to let her know. She suggested a mammogram which I did,” she recalls.
“Although I knew about the history, the wait was gruelling but I was better prepared when the call finally came through with the ugly news. Knowing what awaited me helped me build resilience and I had the will to live. I believe, I am only alive because the diagnosis did not get me unaware and I regularly carried out breast examination. That way, I did not find out too late,” she says.
The other use of family medical history is how family medical history is linked to our mental health. Ramathan Nsiko, at 11 years had extremely poor appetite and the answer was hidden in his family history. Nsiko had depression owing to the sudden death of his cousin with whom they practically lived like twins.
“After all medical treatment had failed, we sought the help of a psychologist, who said the boy was having silent grief that manifested as an eating disorder. The solution was in helping him cope with the situation,” his guardian shared.
Dr Wasswa says when we know what diseases we are susceptible to by our genetics, we tend to treat them or practice preventive medicine better. “This is really more of preventive medicine, which is still uncommon in Uganda yet. If my father had or died of heart disease, I will make sure I probably exercise more, or watch my diet,” he says.
The only way to know about your family health history is through observation and medical tests. Some of these tests include a regular colonoscopy if you have a family history of colon cancer or a mammogram if you have a breast cancer family history. You could also get better mental healthcare because you have a family history of depression. While predisposition is key in some of the diseases we suffer, Dr Wasswa says genetics is not the sole factor in one getting an ailment.
The environmental factor is also important. For example, if I have a diabetic genetic predisposition, I will need an environmental factor to actually make me diabetic such as poor diet habits.
Dr Wasswa says family medical or health history is important to help you prevent or deal with disease better. “Sometimes we modify treatment, for example starting one on statins (anti-cholesterol medication) early to deal with cholesterol build-up.
We also advise that one gets medical checks as these could help us to know the cause of a slow progressing infectious disease such as TB or slow progressing genetic predisposed diseases such as dementia, mental health disorders such as schizophrenia, bipolar disorder, sickle cell disease, and allergies.
More to that, family medical history can help one wisely choose who to marry, because some disorders are autosomal recessive, meaning that you need two genes to cause the disease such as sickle cells and cystic fibrosis. Dr Wasswa advises that people use special celebrations such as Easter or Christmas when families meet to get a better understanding of your family health history and act on it.
Apart from family health history, Dr Franklin Wasswa, a general physician at Entebbe General Hospital, says there are diseases that are transmitted beyond blood lines but by social reasons, such as leaving together. “I recently treated a patient with TB got as a result of taking care of a parent with TB and HIV. Family history goes beyond genetically transmitted diseases,” he shares.