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Transparency about our addiction with doctors

Old 01-15-2021, 06:06 AM
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Transparency about our addiction with doctors

I've been making big changes in how honest I am about my addiction and other things during the last ~2 months of what's a very different approach to sobriety and recovery for me, now almost 4 weeks sober. In this thread, I would like to ask specifically how you all deal with medical providers in recovery, whether it's relatively new sobriety or well-cemented. I never told a doctor about my alcohol abuse yet and plan to see one soon just to get a comprehensive physical, with complete transparency regarding everything about my alcoholism and recent sobriety. I plan to ask that doctor to run tests specifically to investigate issues that might be related to it and more, with the goal to have a good picture of my current state and optimizing my health more. I definitely won't have an issue with declaring everything to a GP like that, no fear of judgment or learning about the reality of my physical state that I can't overcome now. My question is more how people handle it with all kinds of medical attention we seek and receive, including any specialist we see for routine preventative exams, dentists, and so on.

What inspired this question: I just had yesterday one of the routine exams yesterday that I neglected for a long time. I was a new patient so there was a quite thorough intake of my medical history, including a question about alcohol drinking. Unfortunately, I answered the questions quickly on an autopilot and missed a few things that I regretted later, especially because the doctor and team seemed very nice, thorough and knowledgeable (not always easy to find a good doctor). Said I don't drink at all, but didn't mention it's quite recent (let alone the huge history of it) even when the doctor expressed some surprise and said "not at all, that's not so common" (but no other questions). The drinking is probably not too relevant to the specific exams and tests I had done yesterday, but in biology/physiology everything is literally or potentially connected, so it's not a very accurate approach to exclude something that was still all over my life just 2 months ago.

I'm thinking that from now on, will at least briefly declare I had a problem with alcohol to every medical provider at start (especially when they ask about alcohol). I'll just need to be more aware and not let myself switch to minimalist autopilot mode during those discussions as though I'm still hiding things. Then we can decide if it's more relevant and needs more attention/discussion. I don't really have any concern about how this information going into my medical records would affect me, especially now that I'm quitting a job that still pushed me to maintain a lot of facade. I'm on a holistic kind of health and fitness kick now that still needs a lot of improvement - part of why I have a bunch of doctor appointments on my agenda early this year.

So I'm interested in how you all deal with these things - just please keep the "no medical advice" rule in mind while discussing
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Old 01-15-2021, 06:18 AM
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I’ve never lied fudged or auto piloted the issue in recovery. I can’t see the point.

Full frank disclosure for me. They’re always way less interested than I expect them to be.

One little omission from me means my doctor or other health care professional doesn’t have all the facts and that could mean a disastrous outcome down the track.

I get being circumspect. My addictive past isn’t on the medical card in my wallet - it’s not that big a card...
But my doctors number is and it’s on medical file.

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Old 01-15-2021, 06:28 AM
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My perspective on this is that it is completely counter-productive to see a medical professional and obscure my drinking history from them. This is a vital piece of information for any provider; it impacts (or should impact) how they can best support your sobriety and could also have an impact on your care.

For instance, the last time I went to the dentist, the anesthesia barely worked even though they'd given me quite a large dose. If I'd told them at some point that I was a heavy drinker, they may have been able to better avoid the enormous pain I was in during that procedure. Imagine the consequences if I'd needed surgery during that period and hadn't told my surgeon!

For another instance, my primary (who is absolutely an amazing find and was so worth the hunt!) knew from the beginning of our relationship three years ago that I was alcoholic. Knowing this, and in seeking to know something about the "causes and conditions" of my illness, her care has been tailored to where I've been at each step of this journey. She knows I can become overwhelmed with anxiety, so she's careful about which procedures/test to suggest and when. During this past year, she has respectfully but enthusiastically suggested 3-month follow ups. (As if she didn't want to trouble me! In fact, I didn't want to appear too "needy.")

Every provider should be doing a "social history" with you that includes asking about your alcohol use. This is a standard of care that is required in the US. When they ask, tell em - don't brush over it; really tell em. I work with providers for a living and believe me, they've heard it all and will appreciate your honesty. (The one provider I saw for awhile was honest that she didn't really know how to help me as she had no expertise in the area of addiction. And while that was disappointing, it was a pretty good clue that I needed to find someone who could.)

Good question, Aellyce.

O
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Old 01-15-2021, 06:54 AM
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I have been afraid of being denied coverage of future care, due to the destruction of my body from alcohol. I try to come clean about my situation, but don't want my charts to reflect it. A couple of days ago, I just decided I need to own up to it all. I told my doctor that I am a full blown alcoholic, and I need help. Future denial of benefits and stigma be damned. The doctor helped me realize my fears were irrational. To get the help I need, I have to give full disclosure. Good luck Aellyce2
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Old 01-15-2021, 06:58 AM
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There really isn't anything to be gained by giving less than the full situation to all of your health care providers. First, they all know bs when they hear it. They've heard it a million times and with their own two eyes and common shared experiences, they have a general idea of what the situation is regardless of what we tell them. Second, they just don't care in any sort of judgmental way in my experience. Again, they've heard it all and we cannot shock them. Finally, you are seeing health care providers of various sorts because you lack the medical training to treat yourself in those ways. So how do you know what they need to know to keep you safe and treat you effectively? Being cavalier about any info could put your health at risk and be at cross-purposes of what you are trying to accomplish with your holistic health approach.
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Old 01-15-2021, 07:17 AM
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Lots of good advice here already, and my thoughts on the subject are also that honesty is the best policy. The only person that is harmed by withholding information about my medical/health past is me. Medical records are private, as are the conversations between my physician and myself and also with the mental health professionals around me.
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Old 01-15-2021, 04:27 PM
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I came to the conclusion to be upfront with doctors early on. I had blood pressure issues and other things creep up and I wanted them to know. I was very shaky once and the nurse asked what was going on. Now in non-medical situations I might lie and say I'm nervous or lots of caffeine. I told her. She told me they could help even it if took a long time. They were treating someone for a couple of years who kept trying. I was thankful but declined - because I had no intentions of quitting yet. Liver tests were started to be done at my request because I feared the damage and thought if I could stop when damage started - I could see it happening.

They really have seen it all - and no big deal. I mean it's a big part of your overall medical picture -so its a very big deal in that regards - but I didn't feel judged. When I got sick 3 months sober and was in the hospital I told them everything as well. Do you drink? No - but it's only been 3 months and I had X amount of drinks daily for X years before that. I was met with a congratulations and a motivating keep it up.

During Covid, I decided to redo my life insurance, and I had to go through insurance screens. That's a grey area. If you are lying you could be denied your claim the first two years. So I did do as best as I could without completely marking a scarlet letter A on myself. I didn't mention I've gone to AA meetings or any of that. I did give them authorization to 5 years of medial records and interviews with my doctors. After their research (I'm a little over 1 year sober at this point) my premiums came back like a little higher than quoted but not ludicrous crazy. So that fear/anxiety also appeared to be bigger in my head than what ended up happening. I do think if I relapsed and died from something alcohol related in the first two years of the policy - they could probably dig up more in depth about my drink history and deny a claim. A risk I thought is low and worth it versus giving them every itty bitty detail up front.

I will absolutely give all itty bitty details to my docs or ER docs, dentists and psych docs.

Those are my experiences - for better or for worse.
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Old 01-15-2021, 04:42 PM
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I'm always upfront. Two reasons:

True and accurate reading of my health.

I want to see 'alcoholism' destigmatised and believe every honest and authentic voice will help achieve this end.
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Old 01-15-2021, 06:18 PM
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I began my journey into sobriety by making a Dr appointment and telling my GP the truth about my drinking. She was brilliant, no judgment, just practical advice and support. She ordered blood tests which revealed some liver damage and we made a plan. I found it really helped me especially in those early days.

I now always tell any Dr I see about my drinking and length of time sober, it is a really important piece of the puzzle. I know I put my body through a lot and while my liver results are great now, I also know alcohol damage is something the professionals need to rule out. I recently had a serious health scare that fortunately had a benign cause, knowing my history with alcohol helped them find the cause a lot faster even though ultimately the problem was unrelated to it.

My feeling about it is, if a health provider ever made me feel ashamed about my drinking then they are not the right professional for me to see.
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Old 01-15-2021, 07:44 PM
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Hi Alleyce, I am also making changes. I’ve had a problem for years with alcohol and lied through my teeth on how much I drank and the frequency with everyone, especially doctors. I had intended to always continue on that route. The closest I ever came to being more honest was a few years ago when I was concerned about something and as I was walking out the door after the visit with the doc I said I was a little concerned because recently I had drank a little more than usual. I was too scared earlier in the appointment to admit it to him. We were already done with the appointment when I admitted it and I’m sure it never even made it into my file.

And here we are a few years later. I’ve had a chronic issue and finally got medical care after avoiding it the last few years (the ONLY reason for avoidance is because I was afraid my liver enzymes would be high and they would “figure me out“. And that it would be a permanent part of my medical record). I’ve avoided the routine medical appointments for a long time and have started scheduling them recently. Reason being, it’s time for a change and all that.

Saw two docs this week. The first doc I saw is the first I‘ve told that I haven’t always been honest with docs and wanted to change that and I’ve been a daily drinker but had recent cut down significantly with the goal of quitting for good. I said I knew it wouldn’t help me or my doctors if I wasn’t honest about it. I’m one of those people who swore to myself I’d never be honest about my drinking to doctors. And even when I started to think maybe I could, I thought I would be sick with worry about their judgement and ridicule. When the appointment came, I wasn’t that nervous about it because I was finally ready to be open so the doc could do his job better for my medical care. This doc was really nonchalant and didn’t cast any judgement on me or admonish me. I didn’t feel weird or ashamed or embarrassed or overly anxious as I thought I would. I walked out proud of myself that I was honest because I’m trying to change my life for the better. In the check out notes it did state alcohol abuse. It bothered me for a second but then I had to tell myself - it is true! It’s a part of my past and I do not want it to be part of my future. I’ve had to let my damn pride go.

I saw another doctor today. Honestly, I did think about minimizing my alcohol use (abuse). This was a new doctor and I had never dealt with this nurse before, who really was just kind of snooty or in a foul mood or something and it just rubbed me the wrong way. But the doc came in and I mentioned some concerns and then said there’s something I’ve never been totally honest about with my doctors and I want to change that and he said drinking? I said yes. I’d never seen this doctor before. I don’t know if he reviewed my chart before coming into the room and assumed (his questions seemed as if he had not reviewed my chart). But again, there was no judgement. It felt like he said drinking just based on his experience as a doctor and someone saying they hadn’t been honest versus what I had previously been talking about. It was kind of like, eh another person who drinks too much. I didn’t feel the shame I thought I would. I felt good about being honest so he could have all the information. He did say that quitting can really make you feel like garbage for awhile, as I already knew from personal experience and all the wise voices here. Of all my issues, he said it was key to quit and I told him I’m working on it and that I’m not perfect but I’m trying. It made me feel better to continue fighting on.
I say all this as someone who always wanted to keep up the facade. But I’m tired of having certain health issues and want to figure them out. The docs can‘t figure it all out if I don’t tell them one very important piece of the puzzle!
I recently had labs and they were all normal. I was incredibly shocked and grateful. Surprisingly, it was those good labs instead of bad labs that prompted me to be honest. Because I thought even though the liver numbers were okay, I could still have something else going on related to my drinking. I was tired of hiding and being ashamed. I figured, hey I drink at home alone - I’m sure they’ve heard worse than that! I’m sure even at everyone’s worst, most docs have heard “worse than that”.
In order to be honest with my docs, I’ve had to let go of my pride. I’ve held on to this damn pride as long as I could. What’s the goal here? Be sober, be healthy? Let’s do everything we can to get there!!
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Old 01-15-2021, 07:47 PM
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having told my gp and practiced being up front about it came in really handy when i needed surgery a couple of years after getting sober and then was on IV morphine, in lots if pain, and the nurses kept telling me i wasn’t using enough of the drip.
i could have an honest conversation about my fears about the drug, and got a different and useful understanding.
last time some healthcare person asked about my drinking, i had some fun and said “i’m an alcoholic, so i don’t drink”.
took her a good long time of puzzlement

used to lie about it before i got sober.
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Old 01-15-2021, 08:01 PM
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When it was my time to leave Rehab it was strongly suggested I see my doctor. To get tests to check on my liver, heart etc.

On my first doctor’s visit, I told her a very brief history of my decades of alcoholism. Whew!!! My body organs were fine too 😄. I had always lied to the question, How many times a week do you drink? I still get a kick when I’m asked by the check-in nurse if I drink or smoke ... NADA 😍😍

🌌💙📘
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Old 01-16-2021, 05:25 AM
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Thanks for the detailed and thoughtful responses. Reading these inspires me further to be transparent about my drinking history with my medical providers in the future. I especially liked the comment that not doing so would defeat the purpose of my so-called holistic approach. It's interesting how the old habits of secrecy can be hard to shred even when I am otherwise very determined and motivated to turn my life around in many ways now, but glad I've made this post because it will help keep my awareness up in the future and prepare to my appointments differently. All this is also kinda weird, because I've worked in medical research, and often closely with various physicians, in my whole career - just another good example for how addiction can twist values and acts with no exemptions.

Other elements showing how alcoholism (and maybe psych feature that predispose to addiction) keeps us in a self-neglecting, self-destructive bubble: in spite of working for a large hospital system, with great insurance, and having easy access to some of the best providers in the country, the only kind of medical care I have kept up reasonably well most of my adult life is the dental. But even that had several years of break a while ago. Ironically, that wasn't even primarily inspired by a desire for health in the past, more vanity, and that I paid a lot of money especially on cosmetic procedures in the past and wanted to maintain the result in a good shape. I also probably have bad genetics for teeth knowing my parents, plus only learned to properly care for my mouth after I turned ~18, and then didn't have the funds to fix things properly until my mid-20s. Meaning that a lot of damage was done by a young age, so it's a life-long task to maintain the good restorative and cosmetic work.

Speaking of the dentist, I definitely experienced becoming less responsive to local anesthetics at the dentist. I had a good idea why that might be, especially because I never had similar high tolerance to dental anesthetics in my youth, before alcoholism. I have a good and empathetic dentist now and am in the middle of a treatment plan. Will mention the drinking history next time and ask his opinion on potential link to the high anesthetic tolerance. It'll be a bit challenging emotionally with this dentist as he is very friendly and tends to talk to me more like a medical colleague (we work for the same institution) than a patient, which I like of course, but the reality is that I am a patient and he is a provider. Will probably get a chance to observe if the tolerance decreased at all after a couple months sober as I'll have a procedure requiring locals in about 3 weeks. I did think about running into similar issues with more serious surgeries in the future - terrifying thought and most definitely don't want to experience that.

Thanks for all the shares and advice again. I'll do what y'all do and suggest in the future. I am actually not afraid of judgment in general and do not expect it in a medical setting - I know they have seen addictions of all kinds a million times and won't have misconceptions about it. I avoided it more in the past, I think, for the same reasons I was lying so long here on SR: didn't really want to give up my drinking. And during the times I thought I did, there was still mostly laziness and no real recovery action associated with it but made a whole world pretending, where revealing anything real would have interfered with that system of fake competence and success, primarily poking holes on my own walls and denial. I think avoiding being a patient in the medical system I have been part of as a professional (meaning I am a science person and respect that profession) was also a manifestation of either not wanting to change, or not wanting to feel vulnerable.

I easily recognized, with some delay, after my doctor appointment this week that I was still running on the same habit in the moment. Next time will prepare more for these appointments mentally, and then I think it will be easy to be transparent, because I don't actually feel ashamed at all now. A bit afraid of what we might find, but my desire for knowing and wanting to solve problems is much stronger now than any fear. Maintaining false images of success was apparently so important for me in the past - I think with a different approach and effort now, I may actually achieve the competency and success I've wanted, probably much more easily.

After all this, I have booking a comprehensive physical with a primary care doctor on my schedule for today, so will get to it now
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Old 01-16-2021, 05:57 AM
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Rigorous honesty serves me well each day in recovery 🙏
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Old 01-16-2021, 06:09 AM
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Originally Posted by Aellyce2 View Post
So I'm interested in how you all deal with these things - just please keep the "no medical advice" rule in mind while discussing
We do keep embarrassing things to ourselves, even with doctors, and it was humiliating for me to let a doctor or even others know I was having a problem with my drinking for fear of getting a long useless lecture condemning my behavior. And there are some doctors who would rather lecture and pass judgement than help (big difference between lecturing and helping).

But does it matter that much? People pass judgement all the time. Just find help. Help is out there. And that's what you need... or you do it all on your own, something I was unable to do on my own.

I've had both types of reactions from doctors, but most of them are willing to help a little, even though doctors are rushed to get you in and out because they always have a line of patients waiting, and they are more geared to diagnosing and referral. My current doctor understood that I didn't drink, although I never went into detail about why, but my last visit, he commented about my health, and said that it was good that I didn't drink or smoke, especially at my age. For some reason, I was feeling an unusual level of self pride, and I told him that on Jan 3rd, it would be 25 years from my last drink. He stopped and turned around to look at me with obvious interest, and asked if I did it on my own, or if I had help, and we talked some more. He said, "The reason I want to know how you did it was so that I can pass information like that onto others who need it." This guy is the busiest doctor I have known, but he obviously wants to help, and he can make referrals and direct people to others who have the time and the skills to help.

The thing is, you may get less disapproval from your doctor than you think, especially if he understands that you are asking for help. And if he doesn't, well you took a risk. Don't be disheartened by that. If someone is quitting and is worried about the real dangers of withdraw, a doctor can help a whole bunch by getting you to a place where withdrawal can be supervised, and emergency help will be readily available.

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Old 01-16-2021, 06:43 AM
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Okay, just booked the appointment for the physical, yay! It will be in mid-February as none of the doctors I considered had an earlier appointment. It's fine, I don't need anything urgent right now from a GP, just want a general exam with comprehensive bloodwork and all, and will ask for some things specific to the alcoholism and new sobriety. Even though I don't feel I need medical help right now to maintain my sobriety, will ask what they usually recommend, if for nothing else, out of curiosity. I will just tell them what I said here, that I am trying to take a holistic approach and any opinion/advice is welcomed, including on mental health.

I forgot to mention earlier today that, sadly, many of the doctors even in this apparently prestigious institution don't do a comprehensive intake at all. Primary care doctors usually do, and the specialist I saw this week did (part of what gave me a good impression on him), but no one else, including the dentist. Most of them usually ask basic questions about past and current physical illnesses, allergies etc, and sometimes if I have anything else I want to tell them (that's the room for disclosing the alcoholism I think), but typically nothing about mental health unless the patient brings up taking psychiatric medications or that the purpose of the visit is mental health. I understand the shortage of time and that it's a delicate balance/strategy not to intrude upon a patient, but it's definitely a weakness of this whole system still. I think more patients would be more open and honest about mental health issues, including substance abuse, if the team showed more interest (assuming a non-judgmental attitude).

Anyhow, need to work with we what we've got and take initiative in receiving the care we want - much like we need to make the efforts to get sober and then in every step of recovery.
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Old 02-05-2021, 02:05 PM
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Just wanted to update this thread because I received two of my routine medical test results today that are abnormal and discussed them with my doctors. One of them is of no real concern, just means I'll have to get it done again in a year (instead of 3 years, if it was completely normal). The other one needs further evaluation more urgently and I've already made an appointment for next week, so we'll see. These are not blood tests or anything related to alcoholism, so no reason to discuss them further here, just posting to share that while getting these results causes some anxiety of course, it is so much better mentally to do these preventive screens that can catch potential problems early than the avoidance of doctors I was doing for many years. I feel more mental peace knowing the test results today than still uncertain yesterday and happy that I have a chance to investigate further before any symptoms, if necessary. I think I'll never avoid doctors again in the future, it is a blessing that we have all the great medical technology that can detect and treat issues more effectively. I think I avoided them not because of fear of judgment. I work in the medical field and know that most doctors don't care about judging and, if anything, they are curious and interested if they have a less than completely normal case - I would be the same in their position. It was probably more driven by the same thing that made me lie about sobriety: simply didn't truly want to stop drinking until last November and didn't want anyone to find out anything potentially associated with it and suggest a real change.

And I'm very excited about the second COVID vaccine dose that I'm getting tomorrow. It may make me a bit sick for a day but it's the weekend and I'm so lucky to be fully vaccinated soon!
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Old 02-05-2021, 03:10 PM
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Hope the urgent condition resolves with a minimum of fuss Aellyce

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Old 02-06-2021, 04:50 AM
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I avoid the doctors for years because of drinking. Once I stopped I gave myself 6 months to stack the deck in my favor before going in to be checked out.

I was proud to say I didn't drink but did tell them about my past drinking.


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Old 02-06-2021, 06:00 AM
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If you're cool with "alcoholic" / "addict" being in your medical records, then disclose away. For me, our "rigorous honesty" has to include room for personal privacy. Obviously, reasonable minds can differ on where that line gets drawn.
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