Picture this — the doctor sits down with their clipboard and starts to go down their checklist. Do you drink or smoke? Do you use any substances or on any chronic medication? How many sexual partners do you have? Do you use condoms?
Yep, it can end up feeling like an interrogation room at a police station. You look down in shame, clutch your sweaty hands and instinctively lie to soften your reply. “Sexual partners? About three.” (More like three times three times three, maybe). “Alcohol? Occasionally.” (Four bottles of wine this week already sounds worse than it is). “No, I’m not on any drugs.” (It was only five lines of coke last Saturday. Oh, and the week before. Whatever).
Because your doctor is there to help, lying about these types of things can cause a huge disservice to yourself and your health. Here are five things you should ALWAYS tell your doctor, no matter how ‘embarrassing’ you think they are.
“There’s a weird smell down there, and behind.”
Sex and other things that go on with your private parts are already embarrassing enough to talk about, now imagine having to show someone else that blister or discharge your saw earlier on. We get it; it’s hard. But it’s important to be open with your doctor. Think about it this way, your doctor has seen, heard and smelled it all, so whether or not you use condoms, any weird itchiness or smells you’ve got, or any concerns you have about STIs, be open.
“I am on anti-depressants”
Mental illness is still one of the most taboo and difficult things to talk about. The good part is, your doctor will never judge you and you opening up about is a win-win situation, especially if you’re on ARVs. According to Dr Kevin Rebe, one of Anova Health Institute’s specialists in infectious diseases, there are potential drug interactions between some ARV’s and some types of anti-depressants. “The current first-line recommended ARVs can usually be used safely with anti-depressants. One of the ARVs in the current first-line regimen (Efavirenz) is well known for causing psychiatric side effects, including depression, anxiety and insomnia. So that drug should be avoided whenever there is another good ARV option for a patient with mental illness including depression.”
“I smoke, I drink and I do drugs”
Regardless of whether you use drugs, alcohol or smoke, recreationally or regularly, it’s still not easy to disclose to your doctor. Dr Rebe says a patient does NOT HAVE to disclose this to a health provider, but it is advisable and important to do so. “Many ARVs are safe to use in the context of alcohol or other drugs. However, some ARVs are used which can have severe interactions. For example, efavirenz might increase the effects of psychoactive drugs and protease inhibitors such as alluvia have the effect of dramatically increasing the effects and dangers of some recreational drugs. Alcohol and drugs may also impair your ability to adhere to your medication schedule.”
“I’ve swapped my ARVs for alternative medication.”
We live in South Africa after all, and we have all types of healers that are at our fingertips. So, it’s no surprise that when you feel like you’re experiencing side effects from ARV’s, you might rethink your treatment and swap your them for an alternative medication. Dr Rebe advises disclosing this ASAP. “Your doctor will be able to give an evidence-based opinion on whether the alternative medication is likely to be effective. Some alternative medications can have side effects and even be harmful. Going back onto ARVs is a very wise choice as they are the only product that has consistently been shown to be effective in managing HIV infection.” Concludes Dr Rebe.
“This may sound stupid but…”
Ever heard of the phrase “there’s no such thing as a stupid question”? The same applies when you’re with your doctor. We know it’s easier to hide behind your smartphone and google instead of asking, but nothing beats a professional health caregiver. Google will probably scare you anyway, so why not just ask someone who is trained to keep healthy.
You can find a list of our un-freak-out-able doctors here https://www.yellowdotdoctor.co.za/ Remember, staying alive and healthy generally beats the brief wrench of embarrassment.