Sunday, April 4, 2010

Genetically, You're Screwed

Genetically, you're screwed.

That's what a distant relative said to me the day my father returned from the hospital after having two stints surgically put in following a heart attack.

The relative, of course, was referring to my genetic health history (at least I hope so, otherwise, that's quite rude!).

There are some health issues that run in my family. My father has heart disease and has already suffered a heart attack. A few months prior, his brother, who is in his late forties, also had a heart attack. My grandfather died from heart disease.

My mother is in remission from breast cancer. She's had a mastectomy. I have three aunts that have also had breast cancer. My mother was told by her doctor that the cancer she has was not caused by lifestyle or diet, but by genetic predisposition.

High blood pressure and diabetes also run in my family.

So, yeah... Outlook not looking really rosy.

Then, for me, there's the UC twist. Forget that I have a disease that may or may not have genetic involvement but when I got my diagnosis, I was also told "There is a significantly increased risk of colorectal cancer in patients with ulcerative colitis." And while I am not sure if these numbers are accurate my gastro. doc. said my risk is 10% above the general population for colon cancer and increases by 1% each year I have UC.

That's great.

So when one is "genetically screwed", what are they to do?

Here's what I think my options are:

1. Eat, drink, and be merry, for tomorrow we die! This approach is basically assume that my future is bleak and so I might as well make the most of my life now. Today is all about having fun and worrying about the consequences later. Eat what you want, when you want it. Take the big risks now. Forget about the check-ups, have to squeeze in the living while you can.

2. Fight for your right to party. This approach is to take things in stride. Sure, we can live a little but there's also going to have to be sacrifices. You want to enjoy that hot dog? That's fine, but you better make up for it by eating your veggies and going on a bike ride. This option takes into consideration my potential health risks, but let's me do the things I want to as long as I am making efforts (through diet and exercise) to minimize my risks. I want to be around for a long time, but I want to be happy and enjoying life while I have it.

3. Ignorance is bliss. This approach is to basically plug my ears and go "Na-na-na-na" whenever someone talks about my family's health history. It ignores my family's health history and basically says to make no changes to my lifestyle. Live life as I would if I didn't know I had an increased risk for illness.

4. Be institutionalized. This approach gives in to the hysteria that basically I am doomed. I spend all my time worrying about the future and obsessing over little health hiccups, convincing myself it is the beginning of the end. Ultimately, this option ends with a peaceful rest at a mental institution.

5. Convert to "wholeness". This approach treats life style as a religion. What I eat, how much I exercise is strict and studied. Most of my time will be spent making sure I consume only the healthiest things and exercising. Good-bye sugar, fat and nitrates. Green smoothies become like the holy grail. Strict rule-following is mandatory.

What option did I pick for myself? I picked number 2. I have the great advantage of knowing there is a bit more risk to my health, but I also know there are no guarantees. My mother was told there was nothing she could have done to prevent her breast cancer. I could obsess and worry about it, but it won't guarantee anything. A good diet and exercise are the only things shown to reduce the risk of cancer and heart disease, but even then there's no guarantee. On the flip side, people who do everything wrong and have a genetic disposition for a disease still may not end up with it.

I'm going to make careful and balanced choices. For some people, going the whole foods route is a perfect match for them. It's not for me. At least not right now. I'm trying to exercise regularly and include more fruits and vegetables in my diet. I'm also making great efforts on how I handle my stress. But if I am at a summer barbecue and they are serving hot dogs, (they have nitrates which have been linked inconclusively to colon cancer), I'm going to eat one. I'm not going to deprive myself of things I would like.

Why? Because I don't just want to live, I want to live now.