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Medical advice: how to talk with your doctor about embarrassing medical problems
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Medical advice: how to talk with your doctor about embarrassing medical problems

By 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 flare-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 diagnosis of the colon cancer that ultimately took her life. Natalie's brother-in-law, a nurse, wondered whether Joann would still be alive had she 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 Ps:

• peeing
• pooping
• paying
• procreating
• 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 whether 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 whether he might be depressed but dismissed the thought because real men don't get depressed.

Imagine how each of these stories might have had a different outcome had these individuals who suffered in silence talked with their doctors.

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

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?"

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.

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 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.

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."

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.

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 taking charge of your health.

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