Doctors have this nasty habit of asking a lot of questions, many of which make us uncomfortable or self-conscious. So we bluff. A lot. Here are 10 typical lies we tell our doctors, and why these seemingly innocuous fibs are hazardous to our health.
Illustration: Angelica Alzona/Gizmodo
(1) Yes, I'm taking my medications just like you told me
No, you're not. Sure, it's difficult to take medications routinely. It's awkward to fess up to your GP that you don't. But now, you're not just skipping out on prescribed treatment, you've given your doctor a dose of misinformation which could result in further adverse effects.
"I need to know whether the patient is taking the meds. If they aren't, and I assume the drug isn't working, it may cause me to switch to a different second choice med," Dr. David B. Agus, the Director of the Lawrence J. Ellison Institute for Transformative Medicine, told Gizmodo. A doctor might also unnecessarily adjust your dosage, since your current one (the one you're not actually taking) isn't apparently having its intended effect.
Dosage boosts come with their own set of consequences, such as increased heart rate, dizziness, and fatigue. So now you're actually undermining your health, which is the opposite outcome of why you went to the doctor in the first place.
Often, the doctor can tell if you're not taking specific medications — if you show up with elevated blood pressure, or your blood tests indicate high cholesterol. Ultimately, however, it's really on you. "Be honest about the meds you are taking or not taking," Agus says, "and then together we can make the right decisions."
(2) Nope, I'm not taking any prescription drugs or supplements right now
Oh, really? This seemingly minor omission could seriously derail your health. As Agus explains, when his patients don't tell him about all of the medications they're taking, he may miss an important interaction or potential side effect. This includes prescription drugs like blood-thinners, antibiotics, antidepressants, and heart medications, as well as supplements and over-the-counter drugs, such as aspirin, minerals, amino acids, botanicals, and vitamins.
"Supplements are drugs and need to be treated as such," he told Gizmodo. "They should be listed on a patient's record of their medications." The nature of drug-on-drug reactions depend on the particular mixture and the unique physiology of the patient, but some drugs pack a bigger punch than others.
"These may be painkillers, benzodiazepines, and so on," Dr. Gail Saltz, an associate professor of psychiatry at The New York Presbyterian Hospital Weill-Cornel School of Medicine, told Gizmodo. She says it's unfortunate when people lie to their doctor about addictive medications they're taking, or have been prescribed by another doctor. "These medications interact with others and can have an additive effect, which can be dangerous."
Problematic drug-on-drug interactions can include a dangerous drop in blood pressure, a fast-paced irregular heart beat, a build-up of toxins that damage the liver, and less serious symptoms such as nausea, upset stomach, and headache.
Patients may lie, says Saltz, because they want more of these medications, or because they feel embarrassed. They may also fail to tell their doctor that they are on antidepressants because they feel uncomfortable sharing that psychiatric treatment information with another doctor, or feel that it's not important.
"Drug interactions make it important for your doctor to know." says Saltz, "A diagnosis of depression or anxiety is also important to know because some medications can, as a side effect, cause depression or anxiety — and particularly in someone who has already been experiencing that."
(3) I didn't eat or drink anything prior to this surgery
A patient comes in for surgery and the anesthesiologists asks, "When was the last time you had anything to eat or drink?" The patient responds, "Oh doc, I haven't had anything all day." It may sound like a harmless fib, but according to Fahan Khan, assistant professor of anesthesiology at NYU Langone Medical Center, it could result in disaster.
"It is very important for patients to be honest about that last oral intake of food or drink as it can have significant consequences with regards to their anesthetic plan," he told Gizmodo. "Patients presenting for elective surgery are assumed to have an empty stomach, because they are prepped to do so."
Trouble is, when a patient is put to sleep via anesthesia, their lower esophageal sphincter (the valve that connects the esophagus to the stomach) relaxes. During this period of relaxation, says Khan, food contents from the stomach can dangerously regurgitate up into the patient's mouth and snake their way into the patient's trachea (windpipe) on their way to the lungs. Once in the lungs, this regurgitated acidic food material can start to cause inflammation and may even lead to the development of a pneumonia.
"Lying to your anesthesiologist about the last time you had anything to eat prior to surgery can have devastating consequences and in a worst case scenario can land you in the ICU," he says.
(4) I actually don't drink that much alcohol
Many of us are guilty of this one. Dr. Harriet Hall, editor of Science Based Medicine, says our failure to tell the truth about alcohol consumption is counterproductive. "Underreporting the amount of alcohol you drink will only delay diagnosis and treatment," she told Gizmodo.
Health experts say that you shouldn't have more than two-three drinks a day (10-15 per week), adding that's ok to indulge on special occasions. Health problems can arise when we exceed these limits, including raised blood pressure, abnormal blood-test results, and digestive issues. So if you lie to your doctor about your alcohol intake, and you exhibit these symptoms, you're potentially leading your doctor down the garden path. What's more, alcohol — like any other drug — may be influencing the effectiveness of medications you're taking, and your doctor needs to know.
For those with a more serious alcohol issue, this is a kind of lie that could actually kill them, according Dr. David Juurlink from Sunnybrook Health Sciences Centre in Toronto. "I'm referring specifically to patients who are admitted to hospital, and who subsequently develop alcohol withdrawal," he told Gizmodo. "It's a potentially lethal — and sometimes hard to diagnose — disorder."
In a hospital, if doctors have been truthfully told about a patient's alcohol history, they know to watch for withdrawal and treat it accordingly. But if they're not told or misled about a patient's alcohol consumption, and the patient goes into withdrawal, health practitioners often look for other disorders that can cause similar findings (e.g. fever, agitation, confusion, etc.), and may forgo what can be lifesaving treatment for alcohol withdrawal.
"Seriously, people shouldn't worry about being judged by their doctors," says Juurlink. "Plenty of doctors drink more alcohol than they should."
(5) Me, a smoker? Pfffft
Around 13 per cent of smokers keep their habit a secret from their doctors. Taken as a whole, that means about six million smokers in the United States are withholding this very important information.
"When I ask them if they're a smoker they often say they're an ex-smoker," says Dave Hepburn, a general practitioner in Victoria, British Columbia. "When I ask how long, some will admit five days or similar." Needless to say, that does not make one an ex-smoker, particularly if that person has been smoking regularly for years.
People are afraid to tell their doctors the truth because of the social stigma surrounding cigarette use, and because they're afraid to admit to themselves that they're engaging in an extremely risky health habit. What's more, patients may be hiding their habit from their families (who often share a GP) or their employers.
Nonetheless, it's important to tell the truth. If your doctor knows you smoke, they can recommend further screenings and evaluations, and assign a more stringent schedule of check-ups to catch smoking-related diseases, such as cancer, COPD (chronic obstructive pulmonary disease), and heart disease. It's also important to remember that your doctor can help you kick the habit before it's too late.
"Smoking is one of the most important lifestyle changes that can be made that affects health dramatically in many areas ranging from stroke and heart attack to cancers of all types," Hepburn told Gizmodo.
(6) Oh, I don't do drugs
Given that most recreational drugs are illegal, we're obviously uncomfortable about sharing these habits with our doctors. Dr. Ramin Manshadi, an Associate Clinical Professor at UC Davis, feels that the vast majority of people who take recreational drugs lie to their doctors about it, yet the truth often shows up in their urine.
Failure to disclose the drugs we're taking, especially hard drugs, can seriously impede a doctor's ability to diagnosis a health condition. Marijuana, an increasingly socially and legally acceptable recreational drug, can interfere with other drugs, such as antidepressants, aspirin, blood thinners (e.g. warfarin and heparin), antiplatlet drugs, and nonsteroidal anti-inflammatory drugs (e.g. ibuprofen). It can also affect blood sugar levels and cause low blood pressure.
Importantly, if you're being taken to the hospital for a drug-related reason, or if you're on some kind of drug when a health emergency happens, you should tell your doctor or the ER so they know exactly how to treat you and save you from something potentially much worse than a bad trip.
"It's very important to disclose your drug use to your doctors specially if you are having a heart attack," says Manshadi. "If a patient is having a heart attack and they have used cocaine for example, then we cannot give them some beneficial meds that we normally give heart attack patients," adding that the combination "can cause worsening of heart attack and possibly death."
(7) I exercise regularly and eat healthy foods
"If your cholesterol is up, blood glucose is high, as is your blood pressure, don't just say you've been going through a bad period when your life has been bad for as long as you can remember," says David Jenkins, professor of Nutritional Sciences and Medicine at the University of Toronto. "You need help. You need a change in lifestyle. And if that's not sufficient then you need a change in meds."
Dr. Mullen says that too many patients try to sound perfect for their doctors, but lying about exercise in particular only hurts the patients. "We all know diabetes and heart disease are major problems in developed countries," he told Gizmodo. "Exercise and diet are the best methods for beating these diseases, so don't lie about it! Overlooking the daily necessity of nutrition and exercise is a big problem. Be honest and get some helpful tips from your doctor."
(8) I don't really take a lot of over-the-counter pain relief
A patient may tell their doctor that they're only taking about 1 to 2 tablets of Tylenol once in a while, but in reality they're taking about two tablets every four hours around the clock, seven days a week. As Dr. Khan explains, acetaminophen toxicity is real and can be deadly.
"Doctors need to know an accurate record of how much over-the-counter acetaminophen a patient is actually taking in order to prescribe them a safe pain management plan," he says. "Several pain medications (i.e. Percocet, Vicodin, Norco, Ultracet) are combination pills that include a strong acting opioid medication in addition to acetaminophen."
Khan says a patient's liver doesn't know where all the acetaminophen is coming from, nor does it really care. It's just trying to figure out a way to metabolize the copious amount of medicine safely and effectively.
"The most recent guidelines for the use of acetaminophen have suggested that no more than 4,000 mg (some even cite 3,000 mg) as the upper daily limit of allowable intake," says Khan. "So now if a doctor is under the assumption that a patient is only taking a small amount of over-the-counter acetaminophen on their own, he/she may unknowingly prescribe a combination pain medication — one that that also contains acetaminophen — that will put the patient at risk for potentially developing liver failure."
(9) It doesn't hurt
Some of us go to the doctor and under-exaggerate our symptoms in hopes that the doctor won't find anything wrong with us, or to feed our inflated egos in regards to how much discomfort we can handle. This is obviously a huge no-no.
As an example, Dr. Mashadi points to patients who have had stents implanted to treat blockages in their arteries. "They downplay their symptoms because they do not want to end up getting another stent," he explains. "This is dangerous since the sooner we find out there are issues, the better the outcome."
On the other hand, Manshadi says there are patients who have financial hardships and downplay their symptoms so they don't have to pay their deductibles and/or co-pay. "This is also dangerous," he says. "The advice is to always the truth to your doctors. As much as legally possible, I would discount patients that can not afford to pay or refer them to free clinics. Health comes first."
Similarly, Dr. Mullen says he has patients who come in and downplay the amount of aches and pains they're feeling, saying they keep quiet about neck, shoulder, or low back pain. "Unfortunately, these painful areas may be more problematic than they think," he says. "Many systemic diseases refer pain to other areas (i.e. referral pain). If it isn't a referral pain, it doesn't mean it isn't serious. Regular joint pain should be addressed early and referred to a physical therapist, as pain can increase risk for joint degeneration and replacement later in life."
(10) Gotcha doc, I totally understand what you're saying
As Dr. Hall pointed out to Gizmodo, about 40 to 80 per cent of medical information provided by doctors is forgotten immediately, and much of what is remembered is remembered wrong. "Get the doctor to provide written information, read it carefully at home, and prepare questions for the next visit," she recommends.
Clearly, our ability to understand and remember our doctor's instructions and admonitions is critical to getting better and staying healthy. When we don't comprehend something our doctor says, we might not take our medications correctly, or we might engage in risky habits if we don't truly understand the implications of a concussion or an x-ray.
We need to stop pretending and nodding our heads in agreement when our doctors start talking gobbledygook. As patients, we're the non-experts, so we need to check our egos at the door. It's ok to ask your doctor for clarification. Remember — that's their job, and just like you, they want to see your health improve.