Dr Roger Henderson shares his experiences as a GP…
There are many reasons why people visit their GPs – some extremely serious, some totally trivial. But whatever the reason, there are always things we need to know. The problem is, a lot of the time, people are very reluctant to share important details.
In an ideal world, your doctor should know pretty much everything about you, even if it makes you uncomfortable. Leaving out crucial facts can make diagnosis very difficult and can also put you at risk.
Everything can affect your health, and thus should be discussed with your doctor if you have any concerns. The most common secrets people keep from me which I wish they wouldn’t are:
1. You’ve stopped taking your medication
Non-compliance is a massive problem in general practice with some estimates revealing up to 70% of people don’t take a course of treatment correctly, either because they forget or think they’re ‘better’ because symptoms have stopped. This can have a large impact on things like blood pressure or cholesterol levels, and can even mean unnecessary extra medication gets prescribed because a doctor thinks a condition is not responding to treatment – when it would be correctly treated if the original treatment was taken properly. Your doctor will understand if this is the case – we’re all human! However, if you’re not able to take medication as prescribed, don’t lie and say you are, as this only cause problems further down the line.
2. How much you REALLY drink or smoke
Doctors will not arrest you if you smoke or drink too much. But we do need to have an accurate idea as to whether your lifestyle could be causing problems. The same principle applies for recreational drugs – your doctor is not going to report you to the police! The doctor-patient rules of confidentiality means exactly that – whatever you say will be in the strictest confidence unless it is felt that you are in immediate and present danger to yourself or others. Doctors need to know about your lifestyle in order to diagnose accurately, run the right tests and protect your health.
3. You’re incredibly stressed, depressed or abused
If you are in any kind of abusive relationship, try to find the strength to speak up about it and your doctor will be able to help. If you have the symptoms of an early depressive illness, then the sooner this is treated the better. Your doctor can offer the best advice, refer you for counselling or advise whether medication may be needed to help with your symptoms. Once you have broken the ice, you will find it gets easier to talk about these kinds of problems. Remember that depression is too big a problem to keep secret.
4. You take herbal supplements or over-the-counter medicines
Most people believe that, because herbal supplements are natural, they can have no interaction with prescription medication, but unfortunately this is not the case. So-called ‘weight loss supplements’ can be harmful to the heart, excessive doses of vitamins and minerals can be risky, and Chinese herbal supplements may have the potential to damage your health too. If in doubt, ask your doctor first – ‘natural’ does not always mean harmless or safe.
5. You have financial issues
Every day I speak with someone whose symptoms are being triggered by major financial stresses. This can sometimes be due to a gambling addiction, bipolar disorders or anxiety and depression, but can also have simply built up over time due to the current financial climate. Your doctor doesn’t need to know your bank balance, but does need to have a sense of how deep the problem is so they can give you the correct advice and understand whether there is an associated psychological or psychiatric consequence to it.
6. You’re not sleeping
Sleep problems can have many causes and if left unexplored, can become chronic and hard to treat. Possible causes include stress, depression or anxiety, menopausal changes and obstructive sleep apnoea (a potentially dangerous condition). Possible advice here usually includes avoiding exercise too close to bedtime, keeping a strict bedtime ritual and time, avoiding drinking alcohol or caffeine in the evening and sensible dietary advice.
7. You have bowel or bladder problems
Here in the UK we can be notoriously embarrassed about our bowel function or if we are having problems peeing. Unfortunately, in the case of both bowel and bladder cancer, it really is possible to die of embarrassment. As children we are often taught not talk about our bowels because ‘it’s rude’ but unfortunately this can make adults reluctant to mention if they see blood in their stools or if their usual bowel routine changes. The same can apply to people who see blood in their urine and simply hope it will go away and not say anything about it. The advice here could not be simpler – if in doubt, always get checked out. Your GP will see several patients each day with bowel problems and they are quite used to it, believe me!
8. Your tiredness is extreme
Although age is the most common cause of fatigue, there are a huge number of other possible medical causes including diabetes, depression, anaemia, thyroid problems and heart disease, to name just a few. If you don’t mention this to your doctor they can’t assess whether it is just due to getting older or if there may be a more serious potential problem going on.
9. You’re having issues with sex
If there’s one thing us Brits are worse at talking about than our bowels, it’s our sex life. Your sexuality might not be a topic you want to discuss with your GP, but erectile dysfunction can be an early indicator of conditions such as diabetes or heart disease, and painful sex or post-sex bleeding in women can reflect hormonal difficulties or womb problems, all of which need investigating. Again, your doctor will have this type of conversation many times each day so don’t be embarrassed.
10. You have a strong family history of any medical condition
A family history of heart disease, for example, is always worth mentioning to your doctor. As is cancer, stroke, diabetes, etc. This can mean that you can be screened for these and start early preventive treatment, if need be. Don’t worry about thinking if something is worth mentioning or not – your GP can reassure you or talk about whether any investigations may be warranted. Either way, your mind can be put at rest.
Remember – the key to any relationship, including one with your doctor, is honesty. Hiding something may seem the easy option sometimes, but if you don’t mention something that is potentially harmful to your health, serious problems can occur. Open up, tell the whole truth, and get the best help and advice that you can get as a result.
