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Tall Tale Lies You Tell Your Doc

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Your doctor is supposed to be your medical confidante. The information you share is used to make or keep you healthy. Still, many of you omit critical details, distort the truth, or outright lie when questioned by your doctors.  However, make no mistake, what you don't tell your doctor can hurt or kill you.

For many, the exam room feels like a courtroom. The doctor, a detective, judge, and jury all wrapped up in a single white lab coat, making it less than appealing to tell the whole truth and nothing but the truth about their health.

"Hiding their medical history, social history, or social functioning could actually retard their treatment," Usman Siddiqui, MD, Cardiologist at Florida Hospital Orlando, told Ivanhoe.

"Withholding information is actually dangerous. We might be prescribing some medications that could be harmful for the patient," Swathy Kolli, MD, Cardiologist at Dr. P. Phillips Hospital, Orlando, told Ivanhoe.

Surveys say one of the most common lies patients tell their doctors are about drinking.

Too much alcohol leads to liver disease, high blood pressure, heart disease, and increases the risk of certain cancers. Also, drinking while using drugs, or taking prescription meds, can kill you.

"Sometimes you'll ask the patient, ‘Do you do any drugs?' and they'll go, ‘No.' Then you conduct a urine drug screen and it turns out to be positive," Dr. Kolli said.

Another common habit patients lie about is smoking. 

Smokers typically pay 15 to 20 percent more for health insurance than non-smokers, but they also have a higher risk of developing diseases that are expensive to treat.

Another taboo topic for patients is sex partners.

"Sometimes the patients may not realize that it is important information for the doctor," Dr. Kolli explained.

The more partners you have, the more likely you are to have a STD, which means proper screenings are critical for you and your partners.

In the end, it's your choice, silence or solutions, but keep in mind, "we leave the judging behind," Dr. Siddiqui said.

Remember, doctors are bound by doctor-patient confidentiality and federal law to keep your info private. If you're still not comfortable, find a new doctor.

BACKGROUND:  It's normal to tell a lie about some things.  You promise your mom you will call; you tell your friend you can't make it to lunch because you can't find a sitter. However, the one person you should never lie to is your doctor, but people do often.  A national survey recently revealed that 52 percent of women routinely stretch the truth when they talk to their doctors, like hiding sexual behavior.  Patients lie mainly because they are not being as dedicated as they should be and don't need another lecture, and sometimes the lies just slip out. In fact, more than 25 percent of the women in the survey didn't believe their lies were a big deal, but when even a little white lie is told to your doctor, they can't make an accurate diagnosis.  So, here are some examples of why you should tell nothing but the truth. (Source: http://www.redbookmag.com)

THE LIE: "I'm not taking any medications." 

 

  • THE TRUTH: You are really taking vitamins and herbal supplements without giving them much thought. 
  • CONSEQUENCES:  When the doctor asks, "what drugs are you taking?" some patients would lie about any illegal drugs they may be taking.  Some will list any and all medications, legal or illegal.  However, even those honest patients could neglect to mention that they are taking vitamins and herbal supplements because they don't think of them as powerful, but they can be.  For example, patients may be trying out kava for relaxation, biotin for strong hair and nails, or acai for weight loss, without really understanding how it impacts their body. In reality, herbs like kava can damage the liver.  Vitamin E can cause bruising and bleeding.  Also, mixing supplements with medication could end up making them weaker or stronger.  (Source: www.shine.yahoo.com)   

 

THE LIE:  "I don't have digestive issues."

 

  • THE TRUTH: You are embarrassed to admit that you have intestinal trouble, like gas, constipation, or bloating, on a regular basis.
  • THE CONSEQUENCES:  One in four Americans suffer with gastrointestinal distress and out of that number, 70 percent are women.  "Our colons are longer, and they twist and turn like a slinky, which makes it harder for food to get through," Robynne Chutkan, MD, founder of the Digestive Center for Women and assistant professor at Georgetown Hospital in Washington, D.C., was quoted as saying.  This could explain why women are more prone to IBS, a condition that can often be controlled with dietary changes.  So, by omitting these issues, patients are missing out on information their doctor can give to help correct the problem.  Also, sometimes these symptoms could mean that a patient needs further testing for a more serious condition.  For example, bloating could signal ovarian cancer and persistent stomach cramps could mean an autoimmune disorder like Crohn's disease.  (Source: www.shine.yahoo.com

·         Usman Siddiqui, MD, Cardiac Electrophysiologist at Florida Hospital a new treatment for cardiovascular care.

·         I don't know if you watch the Sopranos but James died at fifty one years old with a heart attack, what did you think?

·         Dr.Siddiqui:  It's unfortunate but it's a very common. In fact, from recent cardiology guidelines there have been almost more than five hundred thousand deaths associated with, what is called sudden cardiac death. In most cases this sudden cardiac death is associated with blockages in arteries. If we adopt unhealthy lifestyles, don't take care our blood pressure, our blood sugar; we tend to develop these blockages in arteries, which can progress and subsequently present as either acute heart attack. Most cases patients have time to present with chest pain, jaw pain, neck pain, and non-specific shortness of breath or even passing out. However, there are times where this would present as one episode or what is called sudden cardiac death and cardiac arrest.

·         How does the body not give you the warning?

·         Dr.Siddiqui: In some cases if you have a blockage in the artery, which is in the range up around fifty percent, that blockage may not be critical to produce symptoms. If there's plaque it may suddenly rupture, which causes acute thrombosis; a shutdown of flow in that vessel. So let's take an example, it was an interior artery, there was a plaque sitting there for fifty percent. It never produced any symptoms, but it could have been diagnosed or screened if you would have routinely done cardiac checkups or done stress testing, or a CT scan of the heart. Some type of testing like that we could have routinely screened them. Or if you would have had treatment for high cholesterol, high blood pressure we would have been able to prevent the progression or maybe even regress those blockages. Now so in that particular phenomena which does happen, it happen rarely, but it does happen is that fifty percent blockage that there was all of a sudden get acutely thrombosed, now there's no blood flow. So the heart is hungry there is no blood going in so the whole electrical system gets confused and it creates an abnormal circuit, which leads to what is called ventricular tachycardia or ventricle fibrillation; this is basically a lethal arrhythmia. The blockage is so critical and involves such a big area the heart goes in to a dangerous arrhythmia because there's no blood going to the area and the whole electrical circuit gets confused. This is called ventricle tachycardia or ventricle fibrillation. And—and that leads to what is called cardiac arrest. So there are two separate entities, one is heart attack. The heart attack is a common name that we use for acute blockage in a main artery, but if this blockage is severe enough it could lead to what is called cardiac arrest, which is the heart electrical activity gets all confused. The heart is not able to pump any blood and people can die within seconds. And this is the phenomena that happened. You can label this as Sudden Cardiac Death and then we can talk about Ablation and what we can do for prevention of that. So in cases where people do end up getting a big heart attack they usually develop a scar inside the heart. After a heart attack we usually recommend implanting defibrillators prophylactically even though they didn't have a documented arrest we'll still put the defibrillators in.  A lot of the times since the disease has become so advanced and people are living longer now that they're able to open arteries up at a good time we've seen a lot of people who are getting shocks from these defibrillators which saves their life. They live longer but it affects their quality of life because you can feel those shocks. And to treat those we've developed a technology to actually go inside the heart and modify that scar that has developed. To do those one of the new technologies that we have over here at Florida Hospital is called a stereotaxis robotic navigation system. What it does is this is a spaghetti like very soft catheter has holes on the tips where you can actually profuse saline through them so that it doesn't shower out and then you have electrical holes at the tip where you can apply heat energy to that abnormal circuit to modify it. We usually get inside the heart through one of the veins in the legs and enter the heart through this vein which is called inferior vena cava, through one of these veins. Once we're inside the heart we can perform detailed mapping of these electrical chambers. So the catheter can prolapse in here and take points, electrical points, in a three dimensional space to identify where the normal voltage is which is the normal muscle and the abnormal voltage which represents the diseased or damaged tissue from the infarct. We can do this on the right side of the heart and we can also cross over from this side in to the left side of the heart and map it that way. And this is all without opening up the chest, this is all through the leg. Years and years ago, up to twenty five years ago we used to do this procedure by open heart. And whenever people would have a heart attack and they had a big scar it was a very invasive bloody procedure. There was a very high mortality, mortality means death rate, associated with that procedure. Now with these navigation techniques and mapping techniques and doing this procedure through uhpercutaneous, through the leg, we have been able to reduce the morbidity mortality of these cases to less than five percent.

·         You're moving that through the heart with the use of the magnet?

·         Dr. Siddiqui: There are two ways to do this. One is for a long time we used to use manual techniques to do this and which actually became quite cumbersome for us because these are very trabeculated structures, the ventricles. It takes a lot of time and effort to manually use your hands to map these structures. The advantage of using this specific type of catheter is that it has rotors associated with it and it has a magnet in it which is driven by two big magnets sitting on the side of the patient, which drives this catheter forward and backwards. It's called magnetic navigation or robotic navigation. So what we do is we actually sit in the booth, use a joy stick to move the catheter back and forth, right and left, in all directions. The other advantage of this is being able to use this magnetic catheter this is much softer than what a manual catheter is. So the risk of damaging any adjacent structures is very low with this. And obviously you can create a much detailed map using this technology as compared to manual technology.

·         So the benefits are less risk?

·         Dr. Siddiqui: Definite, that's the top less risk because the catheter tip is much softer as compared to a catheter tip of a manual. So the chances of damaging adjacent structure or making a hole while ablation in the heart is very low. The second advantage is these procedures can be long and cumbersome so if an operator is standing manually by the patient he may be get more fatigue; a phenomena of doctor fatigue while doing this procedure as compared to using this irrigated catheter, where you can actually sit down and focus on the arrhythmia rather than having to deal with a fatigue associated with it.

·         For you personally was that a big deal?

·         Dr. Siddiqui: Yes, it has changed the way I treat ventricular tachycardia now, I mean I'm switched hundred percent. I trained under manual for a long time, but with this technology and the success rates we have seen we have switched hundred percent of ablation, ventricle tachycardia ablation to stereotaxis robotic. The patients are happy we're getting patients from all over the state, which who have had failed ablations before come to us and we're able to address it. And partially because we have a nice team set up and support set up at this hospital.

·         And you're not worried being in the other room with the joy stick, you don't need to be like right on top of the patient?

·         Dr. Siddiqui: That's a good question. We usually do all our cases with anesthesiology, there's an anesthesiology person watching it. We have monitors which portray everything that is on the bedside in to that booth so we're able to use that.

 


For More Information, Contact:

 

                Jennifer Roberts

                Manager, Media Relations

Florida Hospital

407-303-8217