If you're worried about how to begin the conversation, try making a list of the things you want to discuss at your next visit. Preparation might make you feel more comfortable. Bring the list with you so you won't forget anything, and if you get tongue-tied, you can always hand the paper to your doctor.
So, how do you know if your query is worth bringing up and could be indicative of a serious problem or if it's a nonissue you should ignore? It's always better to be safe than sorry, as there will never be any penalty for asking a seemingly silly question. Here are five common issues people worry about discussing with a doctor, and why they are worth raising.
1. Sometimes I urinate a little when I laugh and/or sneeze.
This type of urinary incontinence, called stress incontinence, is most common in women. It happens when the pelvic floor muscles can no longer properly support the bladder. When you're experiencing a sudden leak during a cough, sneeze, laugh, or exercise, the bladder is dropping down and pushing against the vagina, but the muscles that close off the urethra aren’t tightening quickly enough. Though this is common if you've recently given birth or gained weight, it is definitely a topic to bring up with your physician. He or she will want to make sure you don't have a urinary tract infection and may be able to recommend treatment or strategies to help with the leaking. This could include pelvic floor muscle exercises, called Kegels, which can strengthen your urinary sphincter, or examining your lifestyle to identify a medication or vitamin that may be exacerbating the condition. It is unlikely that you'll require surgery, but there are surgical options. Be prepared for your doctor to ask questions about your typical fluid and caffeine intake, frequency of urination, and your bowels.
2. I frequently have very bad breath.
If you practice good dental hygiene, including brushing, flossing, and using an antibacterial mouth wash, and still have persistent bad breath, this is definitely a topic to raise with your physician. Bad breath, called halitosis, doesn't just carry a social stigma; it can indicate a variety of other medical conditions including gum disease, yeast infection of the mouth, diabetes, liver or kidney problems, and more. You could also be experiencing halitosis because of dry mouth, which can be a side effect of various medications. When you're going to an appointment to have your breath evaluated by your doctor, avoid wearing perfume, scented lotions, or lipstick, as the type of smell you're emitting can actually help the physician identify what could be causing it. Expect to answer questions about your dental routine, diet, allergies, and your sleeping/snoring habits.
3. My medication/treatment/test is too expensive for me.
No one likes to admit when they can't afford something, but with the rising costs of healthcare, this is an increasingly common problem. If you question whether a test is necessary, you may also be worried that your physician may perceive you as not valuing his or her opinion. Be honest with your doctor about your financial limitations. It's possible there may be an alternative to an expensive medical test, as research is always providing new evidence and less invasive alternatives. You may even be able to enroll in a clinical trial. If a medication has gone up in price, ask your doctor if there is an available generic – or even an over-the-counter – product available that might work for you. Together, you can decide over time if this is an effective enough alternative. Lastly, depending on the drug you’re taking, your physician may have a patient assistance program application from a pharmaceutical company that could help you. It never hurts to ask.
4. I think I noticed blood in my stool.
Though you most likely aren't excited to talk to your doctor about your bowel movements, avoiding discussing this issue could be dangerous. If you think you see blood in the bowl or on the toilet paper, head straight your primary care physician, as this is never considered normal. One of the worst case scenarios could be colorectal cancer, though there are a variety of other less serious causes including hemorrhoids, anal fissures, peptic ulcers, and more. Your doctor will very likely ask you about the color of the blood you saw, as different shades of red can indicate varying conditions. He or she may also want you to have a test such as an endoscopy, colonoscopy, or fecal occult test, which checks for blood (even hidden blood) in stool. Be sure to share any other symptoms you may be having, even if you don’t think they seem relevant. Rest assured that there are many available treatments, ranging from small things you can do at home to medications and surgeries that can address the problems associated with blood in stool.
5. I sweat excessively.
Excessive sweating, called hyperhidrosis, does not refer to the exhilarating and satisfying dampness you feel after an intense workout, but rather to bodily wetness when you aren't physically exerting yourself at all. If you're sweating profusely and you're just sitting around, or if you feel the need to wipe your hands before every handshake, this is not normal. Hyperhidrosis is potentially a warning sign of thyroid problems, diabetes, infection, or drug interaction, though not necessarily. While it isn't medically risky, it can certainly interfere with the quality of your life and is a legitimate medical condition you should raise with you doctor. Be prepared to be asked about which body parts are sweating, medications you're taking, and whether or not members of your family experience the same issue. There are drugs that can stop your sweat glands from activating and treatments that stop your nerves from triggering too much sweat, so don't be afraid to raise this issue.
A good way to overcome your nerves or anxiety about a doctor's visit is to remind yourself that you can't afford to take chances with your health. It's unlikely you will shock your doctor with your symptom(s), and you will feel much better once your problem is in professional hands, even if it is nothing. “Your doctor will not laugh at you or mock your symptoms. Instead, he or she will address your concerns and help determine the best plan of action,” says Dr. Motter-Mast.
By being proactive about attending routine physicals and mentioning all new symptoms (even if you find them embarrassing!) you may even help your doctor catch a health condition before it becomes serious. Click here to find a primary care physician who is right for you.
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