How to Tell Your Doctor the Stuff You've Been Avoiding

You sat in the waiting room for forty minutes, rehearsed what you were going to say, and then when the doctor walked in, you said, "I'm fine, just here for my blood pressure refill." That thing you actually needed to talk about? You took it home with you.

I hear some version of that story at least three times a week.

Patients hold back all kinds of things — changes in their sex life, how much they're actually drinking, the chest heaviness they've been explaining away for six months, the way their mood shifted since they hit menopause. Sometimes it's embarrassment. Sometimes it's cultural — in many families, you just don't discuss certain things out loud, especially with someone you've only seen a few times. Sometimes people are simply afraid of what I might say.

I understand. But I also need you to tell me. Here's how to make it easier.

Write it down before you come in. Physically write it on a piece of paper. "I need to talk about my energy and my mood." "I've been having pain during sex." "I'm worried I'm drinking too much." When you get to the room, hand it to my nurse or put it face up on the table. You don't even have to say it out loud at first.

Use the words that feel least awkward to you. There is no wrong vocabulary in my exam room. You can say "down there," you can describe things in Spanish if that's easier — a lot of my Orlando patients prefer that, and I do too. My goal is to understand what's happening, not to grade your medical terminology.

Try starting with the word "embarrassing." Seriously. "I have something embarrassing to ask" lowers the temperature immediately. It tells me you're aware it's uncomfortable, and I'll slow down, sit closer, and give you the space to get it out.

Whatever you're about to tell me — the thing you think is uniquely shameful — I've probably heard it from three people this same week. You are not going to shock me. I've practiced primary care in Central Florida long enough to have seen every combination of symptoms, habits, and circumstances.

Here's what patients most commonly avoid telling me, and why it matters.

Mental health changes. Florida has some of the least-funded mental health resources in the country, and here in Orlando, the waitlist to see a psychiatrist can stretch six months. Your primary care doctor can screen you, prescribe a first-line antidepressant or anxiety medication, and connect you to the right specialist faster — but only if you say something.

Sexual health. Irregular bleeding, pain, discharge, changes in libido since starting a new medication — these are medical symptoms, full stop. If you've been staying quiet because it feels awkward, you may be sitting on an early sign of something very treatable.

Substance use. I don't ask because I want to lecture you. Alcohol, cannabis, and other substances interact with every medication I prescribe and affect every lab value I interpret. If you're drinking more than you think you should — especially if it's become a way to manage anxiety or pain — that's something we can work on together, without judgment.

Financial barriers to your medications. This is Central Florida. Many of my patients are uninsured or working with a high-deductible plan. If you've been skipping doses or splitting pills because of cost, tell me. I can prescribe lower-cost alternatives, connect you to patient assistance programs, and sign the paperwork on the spot. I cannot help if I don't know.

When to see a doctor right away: chest tightness that comes and goes, shortness of breath on a walk you normally handle fine, blood in your stool or urine, unexplained weight loss over a few weeks, a new lump anywhere on your body, or new thoughts of hurting yourself. Any of those deserves a same-week visit, not a wait-and-see. Call us at (407) 378-6686. We take walk-ins and same-day appointments at both our Orlando and Lake Nona locations — no referral needed, no weeks of waiting.

There is no version of "too small" or "too embarrassing" in a primary care clinic. I need the whole picture to do my job right, and the thing you've been holding back might be exactly the piece that matters most.

If you've been putting something off, come in. When you check in, you can simply say you want to talk about something personal. That's it. We'll take it from there together.

Lake Nona Medical Services is located at 12609 Narcoossee Rd in Lake Nona and 115 E Lancaster Rd in Orlando. Dr. Catherine Arevalo and our team see patients in English and Spanish. Call (407) 378-6686 or just walk in.

This article is for general informational purposes only and does not constitute medical advice. Please consult a qualified healthcare provider for personalized guidance.