Family History: After the Fact

The thing about family history is that you have to know it exists. I was sixteen when I was diagnosed with asthma in 2008. I had no known family history of asthma—I had a “sort of” family history of allergies: a smattering of inconsistent “seasonal allergies”, perhaps, among one or two family members, and one relative with a food allergy to one item.

I have a friend who, whenever he hears asthma on the news, he texts me to share what he’s heard or when they’re going to be talking asthma on what channel—which is super cool of him. Sometimes the news is related to treatment; last night it was the less-hopeful news of four asthma-related deaths in Australia due to a thunderstorm. He mentioned that in the 80s, his grandfather died from asthma when he was 74. Which started the wheels turning in my head...

A handful of years after my own asthma diagnosis, my grandma learned she had asthma. BOOM, family history after the fact, after I'd likely told several medical people I didn’t have any family history—because I didn’t think I did! I also learned at this point her dad, my great grandfather, also had asthma, although it was more commonly referred to as bronchial asthma at the time, and my grandma didn’t realize that this was the exact same thing. Interesting is that my friend who messaged me last night does not have asthma, but he does have eczema, which is related to asthma and allergies. When he mentioned his grandfather having asthma, I said jokingly, “You can blame him for your eczema then!"

I went on to explain about my own family history I’d learned after the fact, and that my dad now has some type of eczema I’m pretty sure. “Between that and prematurity and being born tiny, I was screwed,” I told him.

Asthma, Eczema and Allergies are Connected

I explained that asthma, eczema, and allergies are all connected conditions: there is a “plausible” theory of how eczema in childhood may be an indicator that a child is at higher risk of developing asthma later in life, referred to as the “atopic march”—a progression where eczema ‘leads to’ other conditions, specifically asthma.1

This “triad” likely has a genetic (hereditary) component, although they haven’t determined exactly how or why, only that it is probably based on specific combinations of genes, rather than just a single gene.2,3

He hadn’t been aware of the probable genetics of his eczema—he laughed and said, “Then I was screwed, too."

I laughed and replied, “Yeah, it’s like you learn of these things after the fact and it all makes sense."

Does family history make a difference? No, not really. I’d still have asthma, he’d still have eczema either way, even if we both hadn’t discovered that we were probably genetically predisposed to them—and in my case, other factors like prematurity, low birth weight, and c-section birth could also play a role4. But I’m super inquisitive and generally curious, so if I can find any nuggets that make any of this make a bit more sense, then hey, I’m game. Even if it requires reading medical journals.

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