Medical Advice: How to Talk with Your Doctor about Embarrassing Medical Problems
Vicki Rackner MD


The realization hit Natalie like a ton of bricks.  Her mother,
Joann, had literally died of embarrassment! Joann had noticed
blood in her stool almost a year before she was diagnosed with
colon cancer.  At first she told herself it must have been those
beets she ate.  Then she thought it was most likely her
hemorrhoids, although she had not had a flair-up of hemorrhoids
since Natalie's birth 52 years earlier.

The truth was that Joann was embarrassed to talk with her doctor
about private topics such as her bowel habits.  She didn't raise
the concern with her doctor until she had bloating, cramping and
abdominal pain.  This led to the diagnosis of colon cancer that
ultimately took her life.  Natalie's brother-in-law, who was a
nurse, wondered whether Joann would still be alive if she had
told her doctor about the blood in her stool when she first
noticed it.

Let's face it; certain topics are embarrassing to talk about
with your doctor.  I call them the 5 P's:

1. Peeing

2. Pooping

3. Paying

4. Procreating

5. Psychic moaning


Although at first blush the challenge of talking with your doctor
about embarrassing medical topics seems simple enough, for some
people, it can cause significant suffering.

Hillary, for example, had what's now called a shy bladder.  She
had not used a public restroom in over 20 years.  She was too
embarrassed to talk with her doctor about this; instead, she
remained a prisoner to her bladder.

Ed was laid off from work and could no longer afford his asthma
medications.  Instead of talking with his doctor about it, he
decided to do without   He wound up in the emergency room with an
asthma attack that could have been avoided with regular
medication.

Tom had some sexual side effects from his blood pressure
medicine.  Instead of talking with his doctor and getting a
different medicine, he just stopped taking it.  The doctors
wonder if this might have contributed to his heart attack.

Jerry noticed his loss of appetite and sleeping problems as his
caregiver responsibilities for his aging father mounted.  He
wondered if he might be depressed, but dismissed the thought
because real men don't get depressed.

Imagine how each of these stories might have been different if
these individuals who suffered in silence could have talked with
their doctors.

Here are 6 tips that can help you talk with your doctor about
embarrassing medical topics:

1. Own the embarrassment.

Say to your doctor, "This is a taboo topic in our family, so
it's hard for me to ask.  Is it normal to have a funny smell
coming from your belly button?"

2. Find the words.

Your doctor speaks a specialized language acquired through years
of training.  Sometimes patients are embarrassed because they
don't know the "right words" or have a hard time describing the
problem.

Remember that your job is to communicate.  You don't need to
know the fancy words to do that.  If a patient said to me, "Dad
had an operation on the dingle-ball thing at the back of his
throat", I would know just what he meant. And, the patient would
seem relieved when I said, "Oh, you mean the uvula."

The best way to make sure you and your doctor understand each
other is to use anatomically correct words.  Get a basic anatomy
atlas.    Use anatomically correct words with your children.

3. Practice saying the words.

Sometimes embarrassing words can be hard to get out of your
mouth.  Gertrude, a 90-year-old patient said to me, "You
youngsters don't understand how much things have changed.  When
I got breast cancer in the 1962, the words 'breast' and
'cancer' were not uttered in polite company."  Some words are
still embarrassing to say.  Practice saying these words out loud
when you're alone!  That will make it easier to say them at the
doctor's office

4. Find the right person to ask.

You may have an easy rapport with the nurse or physician's
assistant at your doctor's office.  You can bring up the
sensitive topic with them.  Say, "Trish, could you please give
the doctor a heads up.  I want to know why I should say no to
those steroids my buddies at the gym are offering me.  I would
love to look like they do."

5. Find the right way to ask.

Maybe it's easier for you to drop a note or a cartoon to your
doctor rather than ask in person.  Find the style that works best
for you.

6. Remember that your doctor is there to help you, not to judge
you.

Your doctor has heard it all before.  I promise!  Your doctor
will not think less of you for asking an embarrassing medical
question; in fact, your doctor with think more of you for
overcoming your fear and helping you take charge of your
health.





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Dr. Vicki Rackner is a board-certified surgeon who left the
operating room to help families take the most direct path
from illness to optimal health. Her book, "The Personal
Health Journal", can save your life today by helping you
understand your health story. Empower yourself with the
tips and tools that will help you direct your story and
partner with your doctor more effectively at:
http://www.drvicki.org/drvicki-store-health-journal.html