Wednesday, June 23, 2010

Family history

It's funny--there are so many things in life that I take for granted or ignore completely. For instance, take my family medical history. I took histories on every patient I ever saw at my VA clinic, and yet I know only bare bones basics about my own.

My GI system has a long standing history of not cooperating. Things have been acting up again recently, and it wasn't until I was talking to my mom that I realized how much of a history I have. I don't want to put all the gory details out on the internet, but one of my immediate family members had their first precancerous lesion found by colonoscopy at age 35. By the CDC/American Cancer Society guidelines, I should have been screened ten years before the age at which the first precancerous polyp was found, or age 25. I'm now 30.

It was suggested that I get a colonoscopy in 2002 after I spent three days in the hospital with GI issues. However, with the insurance we had at the time, it would have been extremely expensive. So I didn't get one.

The GI issues I have seem to come and go, and I know the scary symptoms (melena, hematochezia, etc), but I also know things can happen quietly. I do not think the current issues I have are at all related to cancer (and I've had the same issues for decades), but maybe it's time to get checked.

I don't know why I am so hesitant to see the doctor, and when I do go, why I'm not more proactive. I ask when I have questions, but I am not a fan of medication or procedures on myself if I can help it.

I guess part of me is happier not thinking about my own chance for disease. I know there are some things I need to watch for. Breast cancer is one: my great grandmother died of it, and my grandmother had it as well. Thyroid disease is another: it is very prevalent on my mom's side of the family. And I know things like heart disease, high blood pressure, high cholesterol, diabetes, and obesity are also fairly common on both sides of my family.

Knowing all this, why am I not more concerned with preventable factors like losing weight and getting more active? I guess the answer is that I am concerned, but I am also overwhelmed. I have so much mental and emotional baggage tied up with my weight and body image that it isn't as easy as just going on a diet and starting a serious exercise program. I start making steps in the right direction, but in a very short period of time, I start sabotaging myself without even realizing it.

I need to make progress in that area. I need to make it more about my health than a number on the scale. And I think I need to find out if I'd be covered by insurance for a colonoscopy. It's probably something I need to do sooner rather than later.

First, I need to sit down with both of my parents and do an extensive family history. It's time to find out what other surprises are out there. And I'm the oldest--if I do this now, when the time comes for my sibs to start getting screened, they'll have all the information they need to be informed.

1 comment:

  1. Family Member10:39 AM

    I'm the family member that Bridgette talked about -- the one that had pre-cancerous polyps removed at age 35.

    I have had countless (literally) numbers of colonoscopies since then (I've over 50 now) and I don't regret a single one of them. I make jokes about the prep being worse than the procedure, but this is one case where it is worth ANY amount of discomfort to find the truth. If I would not have had that procedure almost 20 years ago, I shudder to think of where I would be today. By the new ACS standards, I would have just had my first procedure only a few years ago -- that would have allowed the cancer to grow for more than FIFTEEN YEARS!! What would the size of a 15-year-old tumor be? Yeah, chances are I would have had other symptoms before then, but why go under the knife if you don't have to?

    I have become an evangelist for early colon screening. I know, the prep is nasty and unnatural. Many people also have "issues" regarding how invasive it is. It's a medical procedure, not a violation of your privacy. We all have these hang-ups about certain areas of our bodies. Those hang-ups can kill us if we don't put them in the right perspective. My MD told me the last time I had a prostate exam: "If you think it's uncomfortable for you, rest assured the view from here isn't that great either." I get a prostate check once a year. I wonder how many checks he performs EACH DAY!

    I have also heard from many people that they don't know how they would handle bad news if their doctor found something. Well DUH!! Finding a wee tiny little polyp thru early screening is bad news, but it's nothing compared to finding a grape-sized tumor that will require major surgery, chemo and an ostemy bag.

    Let's just get over ourselves and do the right thing for a change. Bad news doesn't get any better with age, only worse.

    As for insurance coverage, more insurance companies are covering colonoscopies and flexible sygmoidoscopies as preventive care (like mammograms and annual physicals). If your insurance company does NOT, then talk to your doctor about how he/she can code the diagnosis to make the test eligible for coverage. A family history certainly moves you to the top of the list.

    Finally, I don't think of myself as a cancer survivor. I know quite a few people who are, and what they went through was horrific. Rather, I think of myself as a cancer "Evader" because my doctor removed polyps BEFORE they could turn into cancer. I feel like the guy who was right behind the 12-car pileup on the expressway who did NOT get caught in the chain reaction but was able to maneuver past the carnage by driving on the berm and getting past the wreckage.

    Don't be a survivor -- be an evader.

    End of sermon -- now go call your doctor before you wimp out.