Posted On Jul 20, 2016
Fibbing to your doctor might seem harmless, but it can be outright deadly. The truth may not only set you free, but possibly add years to your life.
BY Amy Zavatto PHOTOGRAPH by Levi Brown/Trunk Archive
Honesty is always the best policy—especially when it comes to the information you offer your doctor. Unless, of course, the topics are weight, that extra glass or two of wine you have on a nightly basis, the oversized cupcake you nab weekly from your favorite bakery, the fact that you don’t actually floss every day, that you never used sunscreen in your twenties (and sometimes still don’t), you sneak a cigarette on the weekends with cocktails, you had some plastic surgery years ago, or you’re taking cholesterol medication and are embarrassed you can’t get your numbers under control. Or…
Davy Jones’ Medicine Locker
Here’s a cautionary tale: It was a routine facelift that Dr. Barry M. Weintraub was to perform on a new patient, a seemingly healthy woman in her early fifties with some sagging skin, and other issues of time and gravity that take their toll on our physical facades. The patient was very eager for a freshening up. She was re-entering the workforce and believed that shaving off some of the foibles of Father Time would give her a leg up on the younger competition. After all, she reasoned, experience plus beauty would be a lethal combination. But due to her lack of honesty with Dr. Weintraub, it was nearly deadly to her.
Dr. Weintraub, a top New York City plastic surgeon and a Fellow of theAmerican College of Surgeons, put this patient through his requisite preconsultation and testing rigors that he insists upon for each of his clients. She obtained medical clearance from her physician; everything looked good and the procedure was scheduled. “I started on the right side of the face, and as I’m working I’m noticing she’s very oozy, with more blood than normal,” says Dr. Weintraub.
“It should clot in a certain amount of time, but it was watery and slowing matters down. That’s something that caught my eye immediately. I went very carefully and gingerly, coagulating every vessel and doing the other side the same way.”
But the patient still wasn’t clotting the way she should. Dr. Weintraub was supposed to work on the patient’s eyelids, but he immediately decided to cancel that portion of the surgery because of the odd and disturbing way his patient’s body was reacting. He put in two drains, wrapped her face in compressive facial dressing, and sent her to recovery.
Dr. Weintraub kept close watch. His patient seemed to be doing well at first, but within less than 24 hours, the drains he’d put in were full of blood. The right side of her face was purple and had inflated to the size of a football. Meanwhile, her right eye was completely swollen shut. Weintraub admitted the patient to Lenox Hill Hospital for emergency surgery straightaway, where he evacuated the blood and re-cauterized blood vessels.
He thought that perhaps shehad an arterial bleeder from a clot that didn’t stick—but such was not the case. He was absolutely baffled. No sooner was the patient in the recovery ward that her drains filled again completely. “The biggest danger is uncontrollable bleeding in surgery,” he says. “You never want to see that.”
Perplexed and at a bit of a loss, he enlisted myriad consultants to lend their perspectives. Together they covered every base they could think of— from disease to possible ophthalmological issues. All came back clear. “I’m at her bedside, and a very sharp physician’s assistant assigned to that floor picked up my patient’s purse and went through her bag. In it was Plavix, one of the strongest anticoagulators you can prescribe.
With one dose, it basically takes all your platelets and makes them ineffective. I couldn’t believe my eyes,” he said. “I took it to the patient and said, ‘What is this?! You’d told me your meds, but not this. Why did you leave this out?’ She started crying and said, ‘I thought if I told you, you’d cancel my facial surgery.’ She almost died because of that lie.”
his example is extreme, but the average person can imagine it happening, no? This is especially true in instances where the dishonesty seems trivial. However, cautions dermatologist Will Richardson, M.D., of Natura Dermatology and Cosmetics in Fort Lauderdale, FL, trivial is in the eyes and ears of the beholder. “There are moments where it really can be dangerous to the patient,” he says. “I deal with a lot of skin cancer as a surgeon. Someone will say they’ve only noticed a tumor for a week, and you trust their word. Then I do the surgery and realize they’ve lost half their cheek [to cancer], and you know for sure they lied and how long it was likely there.”
While you might feel embarrassed or annoyed at perceived judgment, being honest helps your doctor to help you—from diagnosis, to pre-op disclosure, to generalwell-being. For Dr. Bruce Young, M.D., F.A.C.O.G., director of New York University Langone Medical Center’s Pregnancy Loss Prevention Center and author of Miscarriage, Medicine, and Miracles, trusting relationships with patients has been key in his practice. It does, by nature, require the discussion of intimate topics.
“If I see a patient for a while, I find they’re willing to talk to me about anything,” Young says. “I will, however, get people who might lie about their relationship with their husband because they have a hard time discussing it. Lies often cover a hidden message.
As a conscientious doctor, you have to understand that.” Young has found that asking the right questions is key to helping him not only bring problems to light, but correct them. One example he cites is patients who have lost interest in sex. “I’ll say, ‘Well, what do you think is going on?’ They’ll say, ‘I don’t know,’ or ‘I don’t care.’ Then I’ll ask specific questions: When was the last time she had sex? Did it hurt? If it’s hurting, you’ll avoid it. That’s the reason you have no libido.”
The answer can be a drying and thinning of the vagina over time, or in other patients, even endometriosis—both of which can be corrected if all the information is there to detect the issue.
THE TRUTH WILL SET YOU HEALTHY
that should you disclose? Everything. OK, you don’t have to tell your doc about your crush on your neighbor, or that you’re jealous of your best friend, but in terms of your medical present and past, put it all out there on the table. But medicine isn’t just prescriptive, and some items that you might not even think to mention are important to bring up. Aspirin is an anticoagulant, as is ibuprofen (Advil).
If you’re due in surgery, be it for a tendon or a tooth, you need to inform your surgeon, who will likely insist that you stop taking the overthe- counter meds two weeks prior to ensure that your system is clear. Homeopathic remedies are another area that can cause problems during a procedure, so disclosing those to your physician is vital as well.
“There are a slew of homeopathic remedies that people think are giving miracle health; almost all affect blood coagulation,” warns Dr. Weintraub. Always spill the beans about cigarette smoking, even if it’s only occasional.
Weintraub cautions that just one cigarette reduces peripheral circulation to the arms and legs, taking blood away from the heart at a rate of 42 percent and preventing the lungs from exchanging oxygen with your extremities, putting you at risk for out and out killing the tissue in these areas. Honesty about your consumption is another area where white lies run deep.
An informal poll we took of over 1,000 people on Facebook showed an inordinate amount lied about their drinking. “I was totally honest [about my alcohol consumption] with my acupuncturist once and the look on her face was amazing,” said one respondent. “It was what I imagine a child’s face would look like if you told her there was no Santa.” Up to two glasses of wine per day—or one spirits-based cocktail daily—is fine.
More than that is seen as excessive by the American medical community. While you might worry about disapproval from your physician, it’s directly linked to your liver’s efficacy. These are only a few examples, but the point is clear: Honesty at the doctor’s office keeps you healthy, happy, and safe. And any good physician is going to be your willing partner in that prescription. “I always confront dishonesty,” says Dr. Richardson. “I would rather lose a patient that walks out the door than dishonor myself and accept a lie.”