WEBVTT 1 00:00:00.090 --> 00:00:01.130 I'm Tara Schmidlen, 2 00:00:01.130 --> 00:00:03.610 I'm a genetic counselor and clinical investigator 3 00:00:03.610 --> 00:00:06.300 at Geisinger Health System in Pennsylvania. 4 00:00:06.300 --> 00:00:09.220 I'll back up and say a genetic counselor to start with 5 00:00:09.220 --> 00:00:13.580 line:15% is a person who helps individuals understand, 6 00:00:13.580 --> 00:00:17.990 line:15% act on, and adapt to genetic risk information for a disease. 7 00:00:17.990 --> 00:00:19.760 line:15% So most genetic counselors work 8 00:00:19.760 --> 00:00:21.890 in a hospital or clinic setting, 9 00:00:21.890 --> 00:00:24.770 line:15% talking to patients or families with a risk for 10 00:00:24.770 --> 00:00:28.030 line:15% disease either in the setting of pregnancy. 11 00:00:28.030 --> 00:00:30.030 line:15% They may also work in the cancer setting, 12 00:00:30.030 --> 00:00:32.640 line:15% might work in pediatric care, 13 00:00:32.640 --> 00:00:36.050 line:15% just trying to understand genetic causes for disease 14 00:00:36.050 --> 00:00:39.040 and contributions to disease risk for families. 15 00:00:39.040 --> 00:00:41.470 So we meet with patients and take 16 00:00:41.470 --> 00:00:43.430 a family and medical history, 17 00:00:43.430 --> 00:00:45.530 we do a risk assessment. 18 00:00:45.530 --> 00:00:49.170 We share with them what the potential causes for the disease 19 00:00:49.170 --> 00:00:51.090 or condition of interest may be, 20 00:00:51.090 --> 00:00:52.220 what their options are, 21 00:00:52.220 --> 00:00:54.583 if genetic testing should be warranted. 22 00:00:55.430 --> 00:00:58.340 line:15% We coordinate that genetic testing if that's necessary. 23 00:00:58.340 --> 00:01:00.530 line:15% We help them understand the results of the testing, 24 00:01:00.530 --> 00:01:02.390 line:15% and then we also talk them through 25 00:01:02.390 --> 00:01:03.880 line:15% who else in their family might be 26 00:01:03.880 --> 00:01:06.550 line:15% impacted by this genetic information. 27 00:01:06.550 --> 00:01:10.050 So I work in the cancer and cardiology setting 28 00:01:10.050 --> 00:01:11.300 at Geisinger Health Systems. 29 00:01:11.300 --> 00:01:15.710 So we have patients with strong family histories of cancer, 30 00:01:15.710 --> 00:01:17.230 so people with breast cancer 31 00:01:17.230 --> 00:01:19.000 or ovarian cancer in their family, 32 00:01:19.000 --> 00:01:21.658 cancers happening before the age of 50. 33 00:01:21.658 --> 00:01:24.110 So we look for different patterns of cancer, 34 00:01:24.110 --> 00:01:26.210 ages of onset are another red flag 35 00:01:26.210 --> 00:01:28.500 that we would look at to determine 36 00:01:28.500 --> 00:01:30.150 who might have a greater risk, 37 00:01:30.150 --> 00:01:32.090 who might benefit from additional screening 38 00:01:32.090 --> 00:01:35.596 line:15% or earlier intervention to lower their risk. 39 00:01:35.596 --> 00:01:37.740 line:15% On the cardiology side of things, 40 00:01:37.740 --> 00:01:39.990 line:15% you know, people, we look at people 41 00:01:39.990 --> 00:01:43.470 line:15% who've had a history of early heart attack, 42 00:01:43.470 --> 00:01:45.560 people who have really high cholesterol. 43 00:01:45.560 --> 00:01:46.940 That's a red flag for something called 44 00:01:46.940 --> 00:01:48.920 familial hypercholesterolemia, 45 00:01:48.920 --> 00:01:50.590 it's a very common disease. 46 00:01:52.420 --> 00:01:55.230 So we look at, you know, people's medical history 47 00:01:55.230 --> 00:01:56.350 and their family history to try and see 48 00:01:56.350 --> 00:01:58.074 do they meet that picture because they might need 49 00:01:58.074 --> 00:02:00.160 more than just a statin drug. 50 00:02:00.160 --> 00:02:01.780 They might need some additional medications, 51 00:02:01.780 --> 00:02:02.700 and they might need to be followed 52 00:02:02.700 --> 00:02:04.280 a little bit more closely. 53 00:02:04.280 --> 00:02:05.880 In addition to connecting them to 54 00:02:05.880 --> 00:02:07.760 sort of the medical next steps, 55 00:02:07.760 --> 00:02:10.080 we also try to connect them as much as we can 56 00:02:10.080 --> 00:02:11.490 to other patients or other families 57 00:02:11.490 --> 00:02:14.034 line:15% who might have been sort of down this road before. 58 00:02:14.034 --> 00:02:16.790 line:15% Because we understand that getting this information 59 00:02:16.790 --> 00:02:18.890 line:15% has a psychological impact, 60 00:02:18.890 --> 00:02:20.750 line:15% so we want to make sure people are taken care of 61 00:02:20.750 --> 00:02:23.913 line:15% both physiologically and psychologically.