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All photos are my personal family photos, with the exception of the family tree which was was made on Lucid Chart, by myself.

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Cafasso, J. (2016, March 16). Is Acid Reflux Genetic? Healthline. https://www.healthline.com/health/gerd/genetics#studies

Dunn, V. J. (2022, February 13). Personal Interview (S. Lewis Frasier, Interviewer) [Personal communication].

Haynie, M. (2022, February 13). Personal Interview (S. Lewis Frasier, Interviewer) [Personal communication].

Lagacy.com. (2009). Dorothy “Dottie” Butcher Obituary (2009) Courier-Journal. Legacy.com. https://www.legacy.com/us/obituaries/louisville/name/dorothy-butcher-obituary?pid=123957081

Lewis, C. V. (2022, February 7). Personal Interview (S. Lewis Frasier, Interviewer) [Personal communication].

Lewis, J. D. (2022, February 10). Personal Interview (S. Lewis Frasier, Interviewer) [Personal communication].

Lewis, P. R. (2022, February 8). Personal Interview (S. Lewis Frasier, Interviewer) [Personal communication].

Mayo Clinic. (2018). Gastroesophageal reflux disease (GERD) - Symptoms and causes. Mayo Clinic; Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940

Mayo Clinic. (2021, January 20). Type 2 diabetes - Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193

McCoy, S. (2022, February 13). Personal Interview (S. Lewis Frasier, Interviewer) [Personal communication].

Siteman Cancer Center. (2017). Your Disease Risk - Prevention - Siteman Cancer Center. Siteman Cancer Center. https://siteman.wustl.edu/prevention/ydr/

Tribute Archive. (2016). Mary Margaret Mason Obituary. Www.tributearchive.com. https://www.tributearchive.com/obituaries/902019/Mary-Margaret-Mason

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My risk assessment is much above average for GERD. I have had GERD for about as long as I can remember, but I didn't realize that it was "heartburn" until I was pregnant with my oldest daughter. While researching my family's diseases, I noticed that not only do I have "acid reflux," but my father, my sisters, and my grandmother all also listed some variety of chronic heartburn. I asked my dad about this observation and was told that he was told during a GI scope that he has some defect in his 'duodenal bulb' and that it is hereditary so I could blame him for the heartburn. Once hearing this from him, I looked for evidence to support this and found some evidence suggesting a genetic component to GERD. I also have other risk factors, such as being overweight.

To manage this condition, I take medication every day and avoid overeating, and avoid foods that I know will trigger heartburn for me. In my experience, those foods include tomato-based products, anything with fresh basil in it, large amounts of caffeine, and citrus fruits. My sisters, dad, and grandmother all take medication as well. Interestingly enough, we all take the same medication, omeprazole. My dad and grandma both take a higher dosage than me or my sisters though.

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My risk assessment for diabetes was above average. My risk factors include being overweight, not being physically active enough, and not including enough unsaturated fats in my diet. I also have several members of my family with a history of diabetes. My father was diagnosed as a type II diabetic at age 38. My sister is considered pre-diabetic. My great Aunt Mary had serious diabetic complications.

To lower my risk I can work to get to a healthier weight, increase my physical activity level and improve my diet.

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My risk assessment for melanoma also came in at much above average.
My risk factors include a family history of melanoma (paternal grandmother); I have fair skin, many freckles, and some moles and light-colored eyes (green). I have a personal history of several severe sunburns as a child growing up in the south in the 80s and 90s.

To reduce my risk, I am an avid skincare and sunscreen user. I routinely wear sunglasses, hats, and sunscreen in my everyday life. I like to layer my sunscreen products in everything that I put on my skin. I make it a goal to include sun protection factors in my makeup products, lip balms, moisturizers in addition to using a dedicated sunscreen. I don't know if that actually helps, but I feel like if I am continually adding a little bit of protection throughout the day, I will probably be protected. I also avoid going out in the hottest part of the day in the summer months, take care to stay in the shade if I have to go out in the brightest sunshine hours and I also avoid tanning of any kind.

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My personal risk assessment for hypertension is much above average.
Risk factors for hypertension include many things we can not control, such as our age, race, family history, and chronic conditions. Other risk factors can be managed, such as diet, physical activity level, and alcohol and tobacco use.

Hypertension runs in my family, with my father and paternal grandmother having hypertension and my being diagnosed with hypertension at age 24. Initially, it was thought to be related to my pre-eclampsia while pregnant; unfortunately, it did not resolve once my children were born.

I take medication daily to manage my hypertension, and I am conscious of my salt intake and dietary needs for extra potassium. I take multivitamins daily, and I try to walk as much as possible in daily life.

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My Grandfather is Winifred 'Jack' Lambert. He is my mother's adoptive father.

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My Grandma is Audrey Lou Peterson. She is my mother's adoptive mother.

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My Parents: Penny and James

My Siblings: Kali, Carley, and Jasper

My Children: Sierra and Sheridan

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Sisters: Kali Noelle, age 34 and Carley Valera, age 29
Brother: Jasper Anthony, age 27

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My sister Kali is 34 years old. She is allergic to sulfa antibiotics. Her medical history is significant for:
-Asthma
-Pre-diabetes
-GERD
-Mental illness
-History of migraines
-History of kidney stones
-Former Smoker

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My sister's medical history is significant for:
- Heart murmur
-GERD
-Alcohol abuse
-Recurrent bronchitis infections

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I am 38 years old. I am the oldest of my parents' four children. I am allergic to bee venom, sulfa antibiotics, and medical tape.
My current medical diagnoses are:
-GERD
-ADHD-I
-Hypertension
-Myofascial Pain Syndrome

My Previous Medical History Includes:
-History of severe clinical depression
-History of Pre-eclampsia/HELPP Syndrome at 27 weeks with my first pregnancy, pre-eclampsia, and IUGR at 34 weeks with my second pregnancy
-History of ruptured ectopic pregnancy at 13 weeks with my third pregnancy
-Tubal ligation at age 33
- Carpal Tunnel surgery on the right hand at age 30
-Emergent C-sections with both live births
-Emergent exploratory surgery to remove products of conception with ruptured ectopic pregnancy
-Appendectomy and cholecystectomy at age 25
-Tonsillectomy at age 21
-Removal of necrotic lymph node from the posterior neck at age 25
-History of recurrent strep throat infections
-History of Epstein-Barr virus for approximately 3 months near 21st birthday

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Diabetes is a disease in which the body either can not produce insulin or the cells can not use insulin appropriately to regulate blood sugar levels. Signs and symptoms include excessive thirst, excessive hunger, glucose in the urine, delayed healing of wounds.
Risk Factors:
Weight
Inactivity
Family history
Race and Ethnicity

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GERD stands for gastroesophageal reflux disease and occurs when stomach acid backs up into the esophagus.
Typical Risk Factors:
-Obesity
-Hiatal hernia
-Pregnancy
-Connective tissue disorders, such as scleroderma
-Delayed stomach emptying

GERD may be linked to hereditary factors and is commonly found in multi-generational family and twin studies.

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Melanoma is the most serious type of skin cancer.
Risk Factors Include:
-Fair skin and hair
-Light eye color
-History of severe sunburns during childhood
-Having many moles or unusual moles
-Family History

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Hypertension is a persistent state of high blood pressure.
Risk Factors:
*Age
*Race
*Family History
*Overweight
*Too much salt in diet
*Too little potassium in diet

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My parents and my Grammie and her husband, Dan

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My parents and my Grammie and her husband, Dan

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Sierra Renee, pictured at approximately 3 days old, March 15, 2009

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Sierra was born at 27 weeks plus 3 days gestation and weighed 1 pound 12.8 ounces at birth. She was 14.5 inches long. She spent 80 days in the NICU at St. Luke's. She was born with a Patent Ductus Arteriosus, which was closed with medication. She received multiple blood transfusions shortly after birth to replenish her red blood cells as she was not large enough to produce enough red blood cells to oxygenate her body. She was jaundiced and was treated with bili-lights, which is why she is wearing the "sunglasses" in the photo. She also has two large vascular hemangioma birthmarks on her left leg. They became ulcerated and infected shortly after she left the NICU. She underwent laser surgery to cauterize them in August of 2009 at 6 months old. She has also had laser surgery multiple times since to lighten their color and smooth them. She had her tonsils removed after multiple strep infections at age 9.
She has Sensory Processing Disorder and is incontinent of urine, but otherwise has no residual diseases of prematurity.

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Sheridan was born via cesarean at 34 weeks plus 5 days gestation due to pre-eclampsia and Intrauterine Growth Restriction. She weighed 4 pounds 1.2 ounces and was 16 inches long. She spent 14 days in the NICU at Unity Point before going home. She was jaundiced and required treatment with bili-lights. She has no residual diseases of prematurity. Sheridan has been diagnosed with depression with anxiety, at age 8 subsequent to sexual abuse by her biological father.

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James Dean, Age 57
Caucasian, of Irish and Dutch descent. He has two full biological siblings; Karen, and Michael, who is deceased. He also has two half-siblings; Ami, and Steve, who committed suicide at age 20.
My father's medical history is significant for:
-Diabetes, type II. Age 38 at the onset.
-GERD.
-Degenerative Joint Disease- vertebrae
-High blood pressure.
-Alcoholism.
-History of mental illness, but will not discuss.
My uncle Mike died at age 48 due to emphysema. He had a history of polysubstance abuse and was a lifelong smoker.
My Aunt Karen is still living. She has a history of "female problems" and is also a lifelong smoker.

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Penny Renee, age 56
Caucasian of Irish and Pennsylvania Dutch decent
My mother is adopted. She had one non-biological sibling, Scott. He is deceased. She is a former smoker, but she quit 20 plus years ago.
My mother's medical history is significant for:
-Long-haul Covid-19,  requiring oxygen use.
-History of migraines.
-History of depression.
-History of kidney stones.
-History of recurrent sinus infections.
My uncle Scott died at age 48 due to a traumatic brain injury sustained in a motor vehicle accident. He was found to have pre-cancerous cells in his liver and cirrhosis. He had a history of alcoholism and was a chewing tobacco user.

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My brother, Jasper, is 27 years old and has three sons. They are Warren Riley, age 9, Emmett Dean, age 6, and Wyatt Anthony, age 3.
My brother's medical history is significant for:
-Asthma
-Alcoholism
-Mental illness, but will not seek treatment

The boys medical histories are significant for:
Warren: dental extractions
Emmett: ASD and dental extractions
Wyatt: Undescended testicle.

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My Grammie is Valera Jeanne Highland. She is Caucasian of Irish descent. She was the oldest of her five siblings, Mary, Dottie, Judy, Patricia, and Tony.
Her medical history is significant for:
-Skin Cancer
-Hypertension
-Joint Replacement- knees
My Great Aunt Dottie died of ALS. My Great Aunt Mary died of a massive stroke.

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My grandfather was James 'Jim' Alan Lewis. He died at age 57 of brain cancer that had metastasized to other parts of his body. He had a history of alcoholism and was a lifelong smoker.