After FutureMed this year, I sent my spit to 23andme to have my DNA sequenced. They told me that my mom had Tibetan origins and my dad had Andamanese origins - fascinatingly I've traveled to both these regions. They told me stuff I knew - that my eyes were brown and hair curled a little. The most discomforting (at least initially) was my disease risks that varied from atrial fibrillation to prostate cancer to Alzheimer's.
I was skittish when I first logged on to find out my results (it took six weeks after I shipped my spit). There was a prompt that asked something like, Do you really want to see it? What the heck, I thought and clicked on ahead. Then I went through a phase of omg, how could I have all this going on inside? And then I realized this had to be everyone's story. All our bodies are likely to have something broken inside with the kind of mutations our DNA has been through (consider, interbreeding with Neanderthals). We just didn't have a means of learning about it, up until now. For a long time, I did nothing about these results. I was busy preparing for a trek and work - I just let it lie.
Around my 21st birthday, because of a chance incident, I was diagnosed with genetic hypertension and put on a 50mg daily dosage of Atenolol. I simply took the tablet for several years and life went on. More recently, I started exploring ways to get over hypertension to give me the flexibility to trek more freely. Interestingly, my DNA didn't talk of hypertension as a risk factor. I decided to show my data to doctors and see what they say.
What doctors say when they see DNA data
I met two types of doctors - one is an allopathic doctor who originally diagnosed me with hypertension and the other a natural therapist who works on the body systemically.
The natural therapist (also a physician) studied my entire history (family, medical and lifestyle) and over an hour long discursive diagnosis told me that I had what might be essential hypertension. He explained that when a body has essential hypertension, its systems simply rev faster - it's not a disease but more an internal behavior. He fixed my diet - from cutting out milk and wheat to other food that made my intestines work harder, therefore requiring the heart to pump more blood. He curiously looked at my DNA results for a long time and said that it reaffirmed his thinking - I need to fix what I put in my mouth. He kept reiterating that the essential systems of our body are interconnected - a problem in one area sooner or later affects another - for e.g. the liver affects the lungs that affect the heart. Our general understanding was to explore getting me off medications slowly to curtail the toxins accumulating in my liver.
In the interim, I had mild wheezing that wouldn't go and a lung doctor suggested I shouldn't be taking Atenelol that may have side effects. When I met my allopathic doctor (a well experienced general practitioner who also thinks systemically), I told him that - interestingly, he felt the same and took me off the medication altogether. It's been over 10 days now and when I check my blood pressure daily - the readings are very normal. Looking at my DNA results (I'm sure I was his first patient to show him that), his alerts went off on the risks it pointed to (e.g. prostate cancer) and he prescribed tests that I must do every two years to keep a watch on my insides.
What I think as a patient
When doctors see patients in episodes of time and make decisions, they can be flawed. As with everything, the body is changing all the time and so is its data. DNA data provides very basic clues on where the problems might be - these are flaws in our machines. Lab data (such a Lipid profile) only provide data at specific points in time. What we really need is data that constantly flows - similar to what a cockpit in a plane gets when it flies. This isn't possible yet but will in the future.
As patients, we see doctors (and specialists) for specific medical problems. Each doctor fixes his side of the story, often adding problems to other systems of the body. There are very few doctors who are able to think (and have the patience to think) of the body as a whole and see the interconnectedness of systems. But we do so as patients (our body is talking to us all the time) and therefore it becomes our responsibility to channel the care our body needs.
I wonder now if I really ever had hypertension or was that an episode in time. Or did it gradually go away because I took control of it (I eat moderately, exercise, meditate)? Or is this an episode in time and would it recur? I'll never really know the answers to these questions. My job is to track my data continuously - just as a pilot does for his plane.
I realize that I need both the types of doctors that I see - I need to fix the symptoms when they occur through medication but I also need to fix the system. Systemic problems require systemic correction - largely involving diet, activity and state of mind that mere medication will not fix.
Should you sequence your DNA?
The answer is yes. Every other disease becomes a symptom as we learn more about it. In the past, fever was possibly a disease requiring various cures. We now know that it's actually a symptom - an indicator that our body is showing to let us know that something is not alright inside. You can fix the fever by popping Tylenol but you gotto fix the systemic problem for the fever to really go away. Just as a thermometer gives us insight into fever, our sequenced DNA gives us insight into few other indicators that our body is talking about.
It took me a few hours, after I first saw my results, to accept that health risks exist for me and for everyone and I'd rather know than not know about them. If anything these results have helped me give focus to areas that need attention - for e.g. what I eat, how I eat, when I eat (I still haven't fixed it but am more aware). It also helped me prioritize things in general and be more conscious of how I spend my time. I worry less about what other people think and focus more on doing things that I really want to do. I was usually reticent about my health in the past but have surprised myself now by being open about it - thinking that if I talk, it'll help other people.
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But the human DNA is just 10% of us. 90% of our body is the microbiome - bacteria and other microorganisms that reside in us. Sequencing the microbiome (startup ubiome does it) will tell a whole new story. Now, I just can't wait to ship my poop.
