Are You Keeping Embarrassing Symptoms From Your Doctor? | Rounds With Dr. E

Do you ever feel like wearing a Groucho Marx disguise when visiting your doctor? After all, you need to broach an embarrassing symptom and what if you run into him/her at a later date at the supermarket? Whether it be sexual dysfunction, profuse sweating, bloating, diarrhea, or bad breath, I'm sure your physician has heard it all before (possibly from me).

Although seemingly safe and in the comfort of your own home, googling your symptoms can lead you down a dangerous path, one generating even more anxiety and possibly providing you with misinformation. Nothing can replace an actual doctor's visit. Perhaps, take a deep breath (even if your complaint is having bad breath), and make an appointment. In the meantime, here are some common symptoms which many people find uncomfortable to divulge.


Vaginal Dryness

Vaginal dryness, also known as atrophic vaginitis (in case you want to impress your physician), is an extremely common problem in women with low estrogen levels, whether it be due to menopause, surgical removal of the ovaries or breastfeeding. Several medications can also cause vaginal dryness. In fact, many of the over-the-counter antihistamines, which 'dry out' your nasal passages, can be the culprit. Vaginal dryness can cause burning and itching, pain during intercourse, and can, unfortunately, increase your risk of developing a urinary tract infection. As there are many effective treatments, whether it be lubricants, moisturizers, or estrogen-containing preparations, there is no reason why you should endure vaginal dryness.

Excessive Sweating

If you tell your doctor that you 'sweat like a pig,' your doctor may go off on a tangent (making the visit seem even more protracted) and let you know that pigs do not actually sweat. Hyperhidrosis, or excessive sweating, occurs in at least 5% of people. Sweating is considered excessive when it is not clearly related to body temperature or exercise and it causes significant social anxiety. If you have been an excessive sweater since your 20s (or earlier) and your sweating does not occur during your sleep, you likely have the inherited condition called primary hyperhidrosis (always blame the parents). Apart from an increased risk of skin infections, this condition isn't dangerous. Aluminum-based antiperspirants, applied at night for maximum benefit, prescription deodorants, and Botox injections may alleviate your symptoms. Menopause, an overactive thyroid gland, episodes of low blood sugar, reflux, panic attacks, and certain medications such as anti-inflammatory pain medications and antidepressants can cause excessive sweating. You should schedule a visit with your physician if your symptoms are new, as infection and some cancers such as lymphoma (sorry to scare you) can present this way.

Gas

For you Latin language lovers out there, the word flatulence is derived from the word flatus: the act of blowing or the act of breaking wind. Although many children find this act of blowing funny, most adults do not; in fact, not only can gas and bloating be uncomfortable, but it can be a source of self-consciousness (especially if you are stuck in an elevator with your boss). It turns out that even the most prim and proper of us pass wind at least 20 times a day. There are two main sources of gas: air that is swallowed (perhaps you should cut back on chewing gum or drinking carbonated beverages, especially through a straw) and gas that is produced in our intestines by the normal bacteria feasting on and processing our food. This gas is either belched or, as the Latins say, passed as wind. Legumes and vegetables such as cauliflower, cabbage and kale are common gas-generating foods (although don't be so quick to give them up as they are very healthy). Dairy products can produce uncomfortable gas in people who are lactose intolerant and unable to digest lactose, the primary sugar in milk. Keeping a food diary to see which foods are to blame can be useful. A trial of an over-the-counter medication that contains Simethicone or Beano may improve your symptoms. If your symptoms do not improve with dietary changes, have become more severe, or are associated with nausea, vomiting, diarrhea, constipation or pain, please schedule a doctor's visit. In addition, if you have bloating and abdominal pain that improves after a bowel movement, you should see your doctor as you may have irritable bowel syndrome and prescription medications can be very effective. It turns out that patients with irritable bowel syndrome do not generate more gas than normal but, instead, are very sensitive to the gas they produce.

Bad Breath

Bad breath, or halitosis, plagues many people (and the people who live with them). Curiously, there is a condition called pseudo-halitosis in which a person is convinced that he/she has bad breath without objectively having bad breath. In the majority of cases, bad breath is caused by poor dental hygiene (make sure to also brush your tongue) or the foods and drinks we enjoy such as garlic, onions, certain cheeses, alcohol, coffee, and orange juice. Halitosis can also be the result of a medical problem such as a periodontal infection, sinusitis, postnasal drip, certain stomach problems, and dry mouth in which there is not enough saliva to neutralize the acids and wash away the particles. Of note, certain medications such as diuretics and antihistamines can contribute to dry mouth. Remaining well-hydrated and chewing sugar-free gum may help increase your saliva production and improve your breath. If brushing twice daily, flossing, using mouthwash before bedtime, changing your toothbrush often, and adjusting your diet do not improve your halitosis, you should schedule an appointment with your dentist.



By Dr. Marc Eisenberg

Dr. Marc Sabin Eisenberg, M.D., F.A.C.C. is an associate professor of medicine at Columbia University Medical Center. He is co-author of the book "Am I Dying?!: A Complete Guide to Your Symptoms and What to Do Next" and co-host of the "Am I Dying?!" podcast, which provides light-hearted advice for the hypochondriac in all of us. Listen to an episode below!

Have you ever had a symptom that you felt was so embarrassing you could not even tell your doctor? Well, you are not alone. In this episode, the doctors assure us that your physician has seen most everything before and stress the importance of being honest and candid with your doctor. It's also fun to hear Chris embarrass mark with the details of some symptoms.

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Follow security Expert Bill Staton's important advice to keep yourself safe.

Have you ever had a tense interaction with a stranger in public? Perhaps your shopping carts accidentally knocked into each other or there was a misunderstanding in communication and the other person gets angry. You may wonder how you can de-escalate the aggression and exit the situation safely. So security expert Bill Stanton has your go-to advice for staying alert and protecting yourself in the face of verbal aggression and physical attacks.

THE INITIAL INTERACTION

Bill Stanton: "It always starts with something small, like someone being too close to you, or even more common, you get bumped by a shopping cart. You want to look at their eyes first -it may reveal emotional changes. But you can't rely on just that. Look at what their trunk is doing; a person's torso will reveal their intent. Body language like raising hands, heightened expression, tense shoulders — these are natural responses to a person who is feeling threatened and will escalate. They may begin to zero in on the space between you and them, and their voice will get louder and louder. You want to read this before it gets further and becomes explosive."

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