Not-so-sweet little lies
Small fibs can have big consequences for your health. Why you should come clean
Why lie?
It's normal to fib about some things. "So sorry we won't make
the potluck — can't find a sitter." You promise your mother
you'll call. But the one person you should never, ever lie to is your
doctor. Yet we do. All the time...
The danger
A national survey recently revealed that 52 percent of women routinely
stretch the truth when they talk to their doctors — exaggerating
how much exercise they get, lowballing how much they smoke or drink,
even hiding sexual behavior. We lie, mainly, because we know we're
not being as dedicated as we should and we don't want to feel judged
or endure a lecture we've heard before. (Hey, we're not stupid. Lazy,
perhaps, but not stupid!)
Other lies just...slip out. It can be hard in a short visit to bring
up behavior we might be ashamed of (even if there's no reason to be
— docs have seen and heard it all before, and worse). We figure,
what's the harm in omitting a few minor details — like that
STD we had in college, or that one time we forgot to take our birth
control?
In fact, more than a quarter of the women in the survey didn't believe
their lies were a big deal. But lying to the one person who really
needs to know the truth — and is bound by doctor/patient privilege
and federal law to keep that info private — can be a very big
deal. When you tell even a fib, your doctor can't diagnose you correctly,
which wastes your time and money and may keep her from giving treatment
that could save your life. So the next time you're tempted to make
like Pinocchio with one of the following falsehoods, here's the truth
about why you should tell nothing but.
Flossing
The lie: "Of course I floss!"
"When I was in practice, I heard this lie every day," laughs
Paula Jones, D.D.S., now president of the Academy of General Dentistry.
"I'd ask, 'How often?'" And the truth would start to come
out. "They'd say, 'Oh, a couple of times a week' or 'I only do
this one tooth where food gets caught.'"
Why you should come clean: Neglecting to floss leads directly to tooth
decay, gum inflammation, and gum disease — and a growing body
of research suggests that gum disease may contribute to cardiovascular
disease. Some studies also suggest a link between gum disease and
a life-threatening pregnancy complication called preeclampsia. If
you cop to being a non-flosser, your dentist can make doubly sure
to watch for and help you prevent these dangerous conditions.
STDs
The lie: "I've never had an STD."
"Many women are embarrassed about having had a sexually transmitted
disease," says Dimino. Jessica, 37, never let on that she'd had
chlamydia and HPV in college because she was afraid she'd be denied
health insurance when setting up her own business. But she also believed
it wasn't anyone else's affair. "My feeling was: That was then;
it's taken care of, so they don't need to know," says the Littleton,
CO, Web designer.
Why you should come clean: The ghosts of STDs past can come back to
haunt you later. Hiding that you had HPV may put you at higher risk
for cervical cancer if your gyno doesn't think you need annual Pap
tests. Keeping quiet may also put you at risk for pregnancy complications.
For instance, if your doctor knows you've had gonorrhea or chlamydia
— especially if you also developed pelvic inflammatory disease
— she'll watch more carefully for ectopic pregnancy, since both
can scar the fallopian tubes, preventing a fertilized egg from reaching
the uterus. And telling your ob that you have genital herpes when
you're pregnant may help you avoid a predelivery flare-up —
and a C-section as a result. "If you tell me you have it, even
if your last flare-up was ages ago, I can put you on medication to
suppress an outbreak before delivery," says Dimino.
Drinking
The lie: "I'm not a big drinker."
Doctors have an unspoken rule: Whatever you tell them you drink, they
double it. "Lots of women claim, 'I drink once a week,'"
says Rakhi Dimino, M.D., an ob/gyn at the Woman's Hospital of Texas
in Houston. "But then they drink six or seven cocktails in an
evening."
"I always lie about drinking," admits Amanda, 33, an entertainment
coordinator from Orlando, FL. "My doctor prescribed me the antidepressant
Zoloft and told me not to drink any alcohol while taking it. Then
I went to a wine tasting and drank anyway." That night, she awoke
in a cold sweat with heart palpitations. "At the emergency room,
the doctor asked me which drugs I was on. When I said Zoloft, he asked
if I'd taken any drugs or drunk any alcohol. I flat-out lied and said
that I'd had not a drop."
The ER staff tried to sleuth out what else could be making Amanda
ill; then her blood alcohol test came back. "The doctor said,
'The test shows you've been drinking, and this is a common reaction
with Zoloft and alcohol.' He told me that I would have saved a lot
of time and money if I'd been honest. I didn't say a thing. I just
wanted to get out of there with my tail between my legs."
Why you should come clean: Drug and alcohol interactions are very
common. If your doctor knows that you imbibe, even a little, she can
prescribe meds that won't mix badly with a glass of wine. She can
also counsel you on alcohol's risks for women. For starters, having
one to two drinks a day can raise your risk for breast cancer; heavy
consumption is linked to liver disease, brain damage, and stroke and
can put you at risk for assault and car accidents.
Concealing what you drink may signal another disease: "Denial
is part of addiction," says Brenda Iliff, clinical director of
Hazelden Women's Recovery Center in Center City, MN.
Sex
The lie: "I'm monogamous."
Cheryl, 48, went to see her gyno for what she thought was a yeast
infection — and was shocked to learn she actually had trichomoniasis,
an STD. She didn't want to admit she was juggling four guys, so when
the doctor asked how many partners she had, "I said one, of course,"
recalls the accountant from Knoxville, TN. The doctor gave Cheryl
enough medication for her and her partner. But Cheryl kept seeing
the other guys too.
"I went back for my checkup, and my gyno says, 'You still have
this. You haven't told me the whole truth, have you?' I said, 'Yes,
I have.' She didn't want to call me a liar, but she said, 'You have
to treat everyone you're seeing, or quit seeing the ones you don't
want and treat the one you do. Otherwise, you'll never get rid of
this.'" Cheryl dumped the other guys and continued treatment
with her main man. "But afterward, I changed doctors," she
admits. "I couldn't face her anymore."
Why you should come clean: Your doctor doesn't ask about your sex
life to judge your morals. What does concern her is that sleeping
with more than one person may increase your risk for STDs. Delayed
STD treatment can mean a more entrenched pelvic infection, fertility
problems — even cervical cancer. "If your gyno knows you
have several partners, she may recommend you have an annual Pap test
and get screened more frequently for STDs," says Dimino.
Exercise
The lie: "I watch what I eat and exercise."
"I have patients who swear they're exercising and sticking to
the calorie count," says Bonnie Davis, an advanced registered
nurse practitioner in Largo, FL, who helps administer a weight-management
program. "Yet they've put on 5 pounds while taking an appetite
suppressant three times a day. That's impossible."
Meredith, 26, sticks with the purposely vague "sometimes"
when asked how often she exercises. "I wouldn't feel right saying
'regularly,'" says the writer from Forest Hills, NY. "But
when I say, 'Sometimes,' I consider that I walk to the subway every
day, and if I'm not wearing heels, I walk fairly briskly." In
other words, she's not lying outright — just bending the truth
enough to spare herself the inevitable lecture. "I know that
losing 10 pounds could lower my risk for heart disease and diabetes,
and diabetes does run in my family," Meredith says. "But
I don't want to hear it. I'd rather doctors think that I take it seriously
than give them the opportunity to tell me what I already know but
still am not paying attention to."
Why you should come clean: If your blood pressure and cholesterol
are high or you're borderline diabetic — all factors that can
boost your risk for cardiovascular disease — diet and exercise
can help, which is why your doctor asks about them. But if you're
not really making either lifestyle change and your numbers don't get
lower, your doc may put you through a battery of pricey medical tests
and/or prescribe a range of medications to lower them for you.
And while taking a pill may sound easier than counting calories and
hitting the gym, it actually "opens up a Pandora's box of inconvenience,"
says Nora Tossounian, M.D., an internist at the Women's Health Center
at Hackensack University Medical Center in New Jersey. Start with
the nuisance of remembering to take medication once or twice a day;
add to that the high cost of those meds. Then there are the side effects:
muscle aches on statins; bloating, cramping, and diarrhea on diabetes
medications; a plunging sex drive with certain blood pressure drugs.
The truth hurts less.
Smoking
The lie: "I don't smoke."
When Pamela Douglas, M.D., a cardiologist at Duke University Medical
Center in Durham, NC, asks women if they smoke, she often hears a
little moment of hesitation before they say no. "They believe
you need to smoke two packs a day to be at risk," she explains.
"They say they don't smoke them all the way down or they're not
really inhaling. If they've only been smoking a year or two or they
don't smoke every day, they think they're not really smokers."
Why you should come clean: Reality check: If you light up, even if
it's only one on the weekends, even if you just bum a drag from your
friend, you smoke. Beyond an increased risk for sinus and upper respiratory
infections, emphysema, cardiovascular disease, and, yes, lung cancer,
lighting up — even occasionally — raises your risk for
blood clots and stroke if you're also using hormone-based contraceptives
(pills, patches, rings).
"If there's a pause when I ask them if they smoke and they say,
'No' or 'Maybe once a month,' I'm hesitant to give that woman a prescription
for the Pill" to help clear up her skin, says David Bank, M.D.,
medical director of the Center for Dermatology, Cosmetic and Laser
Surgery in Mount Kisco, NY. Tell the truth so you and your doc can
figure out a safe option together.
Sunscreen
The lie: "I use sunscreen every day."
"Along with 'I'm not tan — this is my natural skin color,'
this one's at the top of the list of lies we hear all day," chuckles
Bank. "We ask every patient whether they use sunscreen every
day, and about 10 percent to 20 percent of the responses we get are
false or exaggerated."
Why you should come clean: Skin cancer is the most common cancer in
the United States; since 1980, the rate of melanoma (the most serious
form of skin cancer) has jumped by 50 percent for women between the
ages of 15 and 39, according to new research from the National Cancer
Institute. If you admit you're not slathering on sunscreen (SPF 30
or higher, applied liberally to exposed areas), your doctor may schedule
more frequent screenings — this way, if skin cancer does develop,
it'll be caught early.
Being truthful about sunscreen use can also help him decide whether
to prescribe certain meds, like Retin-A for acne and wrinkles, that
can make you more sensitive to the sun.
Prescription medicines
The lie: "I'm taking my medication the way you prescribed it."
Alicia, 31, often used her asthma inhaler up to five times a day,
despite her doctor's warnings. When he noted her trembling hands and
pallid face, "I swore I wasn't abusing it, because I was afraid
he'd take it away," says the Orlando, FL, day-care teacher. "I
didn't care about the risks as long as I could breathe."
Why you should come clean: If you tell your doctor your medication
isn't working, or has side effects, he can find one that suits you
better (which is what Alicia's new doc eventually did). But if you
don't use it correctly, you could end up even sicker.
Take a typically misused drug like a routine antibiotic: "If
you lie and say you finished your antibiotics, but you're still sick,
the doctor will assume the first drug didn't work," says Maurice
A. Ramirez, D.O., Ph.D., an emergency-room physician at Florida Hospital-Flagler
Division in Palm Coast. "So he'll change the antibiotic. Meanwhile,
the bacteria become resistant to the drug we normally use, and they
crank along unimpeded, and you can go from a bladder infection to
a kidney inflection to a blood infection."
OTC medicines
The lie: "I'm not taking any medication."
This one's told so often, doctors say, that they always dig deeper
when they hear it. Sometimes it's an honest mistake: "People
don't classify over-the-counter drugs like Tylenol, herbal supplements,
or vitamins as medication," says Gillian Stephens, M.D., an assistant
professor of community and family medicine at Saint Louis University
in St. Louis. "But they are." Women also keep mum, though,
when they've "borrowed" an Ambien from a friend or bought
Hoodia online to lose weight.
Why you should come clean: Your doctor may adjust your dosage of a
drug if he knows you're taking something else that could alter its
effects. "Hearing that someone's taking ibuprofen, which is a
weak blood thinner, is useful if you're adding other thinners,"
says John H. Alexander, M.D., a cardiologist at Duke University Medical
Center.
Not to mention, what he doesn't know could kill you. It's not unusual
for doctors to realize that you've taken something you didn't tell
them about only after they've given you another medication--and the
combination has caused you to stop breathing, have a seizure, or go
into cardiac arrest.
Contraception
The lie: "I always use birth control."
"The lie I hear day after day is, 'The condom broke,'" says
Millicent Comrie, M.D., vice chair of obstetrics and gynecology at
Long Island College Hospital in Brooklyn, NY. "Women often say
that when they get pregnant by accident and don't want to admit that
they didn't use a condom." Sound familiar? How about this: "Women
fudge the truth about whether they put their diaphragms in or took
them out and whether they take their pills every day at the same time,"
says Bruce Rosenzweig, M.D., director of urogynecology at Rush University
Medical Center in Chicago. "They're embarrassed because they
know they should be able to handle these things."
Why you should come clean: There are tons of contraception options
out there these days. If you fess up to messing up with birth control,
your gyno can suggest one that might suit you better. "If you
hate to swallow pills, you have oily skin and the patch keeps falling
off, or the ring comes out when your partner pulls out, I can give
you something else," says Rosenzweig. "But if you don't
tell me, I can't make the appropriate recommendations."
Coming clean with your doctor only stands to help you in the long
run, as difficult as it may be in the moment. So answer her questions
honestly — and even bring up issues that she may be forgetting
to ask about. When it comes to your health, there's no such thing
as TMI.
