Excerpt: 'YOU: The Smart Patient'

There's a trend in domestic adoptions toward openness -- in other words, the adoptee, birth parent (one or both), and adoptive family all have a degree of contact with one another and share relevant information, including health histories. Recent laws have helped unseal files too. Of course, there are still many adoptees and adoptive parents who have no such contact or any records whatsoever, for a host of different reasons, and have come up empty even after checking with the adoption agency (always the first place to contact on this mission). In this case, they should contact their state Department of Health and Human Services to see if any birth records exist, and also examine the various registries that attempt to link birth families and adopted persons. A great all-around source is the government's National Adoption Information Clearinghouse Web site at naic.acf.hhs.gov. You can search by state for info and availability of records. Remember that there's no need for a tearful, emotional reunion if that's not wanted: these registries often connect adoptees and birth parents for the sole purpose of gathering health information.

What about international adoptions? Some countries are just beginning to open their records, and the adoption agency and country consulate's office can be a starting point for investigation.

A Ghoulish Notion?

If your parents will consent to it, consider having an autopsy performed on them when they die. Few autopsies are done today as compared with decades ago, as it's rarely thought necessary when a cause of death is clear, such as a heart attack. But there's much value in knowing if your eighty-two-year-old father had undiagnosed prostate cancer that had been advancing since his fifties, or heart disease, even though it was a stroke that did him in. This is especially useful if the death was due to an accident, of course. Reassure your living parent that this doesn't mean foul play is suspected, or that the body will be shipped to a CSI soundstage, or that there can't be an open casket.

Tip: Have a Tattle Plan

Bring your spouse to your doctor's appointment when you're giving your health history; there are a lot of questions that only he or she can answer (how many times an hour do you stop breathing while asleep?). But, please, before coming in to the office together, make sure you discuss which fibs you're going to tell the doctor. Why? Because when you tell us that you rarely tear into the Pringles after 8:00 P.M. or that you've been taking your cholesterol-lowering drugs with the discipline of a marine, your spouse will shoot you -- or us -- an involuntary look that communicates something close to Are you kidding me? We never miss it. And, hey, sometimes your spouse wants to blow your cover. It's called love -- why do you think she booked the appointment?

If you try to snow us, remember that we might try to trip you up by asking about specific dates. As in when you last did something. For example, we'll ask you if you're fit enough to climb three flights of stairs. You'll say yes, unless you're older than eighty-five or bedbound. Then we'll ask, "When was the last time you climbed three flights of stairs?" You'll think, and start to say, "Maybe a month, or..." and your spouse will shoot that never-fails look. The one that says, You haven't climbed three flights of stairs since we voted for Ike.

How embarrassing.

So please, rehearse beforehand.

Click Access to Your Health Info

There are several Web sites that allow you to store your health records online, so you, your doctor, or any person given permission can tap them on the Internet, from any location. Some are free, and others have monthly fees that range from $30 to $80. To check out a few examples, click into the Web sites at www.ihealthrecord.org, www.personalhealthkey.com, healthmanager.webmd.com, and the Joint Commission Resources' own www.jcrinc.com. We'll update this list at the personal-health site at www.realage.com. Each site has security safeguards to protect the confidentiality of your info. Aside from the convenience factor, using these sites could make it easier to you keep your files current, because you'll have a one-stop, central place to update your info.