Bryony,
I'm late as usual in getting around to posting. While I wholly agree with PattiJT's advice to you, there may be a few more points worth adding.
While I have appreciated your concern for frankness, particularly with those immediately affected by one’s actions, one must also appreciate that undiluted truth may be damaging, distracting, counterproductive, even cruel or deceptive, and there may be legitimate occasions to 'protect' people from the truth, or being 'careful' in presenting it. From your postings in this thread it strikes me that you may be standing into danger of providing your doctor with TMI (thank you for introducing me to that acronym). In the course of my career (not in medicine) I found that most people interacting with clients (or in the present case, patients) develop techniques directed to having you, the patient, tell them what they need to know, rather than your telling them what you want them to know or think they want to know. This can result in odd-ball questions (not perhaps as much off the wall as those Lenneth has told us about, although even those could be interpeted as singularly inept attempts to find out “Am I dealing with a transexual?”), but a good general rule is not to volunteer information unless it is information that it is essential for the doctor to know in order to address specific concerns that you yourself want addressed. Of course, patients also learn interview techniques to manipulate doctors
From what you say it sounds as if you are going for a routine checkup (after a considerable time lapse?), in which case any observable or detectable abnormality is fair game for questions by the doctor. Your concern is directed to one particular abnormality (for a male), but even so there is a good chance that it may not excite comment. Gynecomastia is so common among males of your age that it may not merit comment, particularly since many with the condition are known to be very sensitive about it. We had one doctor that weighed his patients routinely but was notorious for never telling them that they were overweight since he found that too many were oversensitive about being told this.
If the subject is raised, admit you are aware of it, and perhaps ask whether it could have been caused by something you are taking. You could say that you have wondered whether it could have been caused by a herbal remedy you are taking and which seems to be effective in relieving your (unspecified) anxiety problems, and that you can accept the breast enlargement if it allows you to avoid use of the pharmaceutical sledgehammers conventionally used for such problems. I would emphasize that these kinds of interviews rarely go forward in the ways that one agonizes over and rehearses for in advance and you’ll probably emerge wondering what you were worrying about. As for doctor’s attitudes to self medication, most just don’t believe in herbs anyway but are more or less resigned to their patients dosing themselves with them, some just don’t want to know, and the few that take an intelligent interest don’t give one much grief. As a class they seem much more antagonistic to self diagnosis than self medication!
As a patient with heart failure in my medical history, my heart and lung functions are fairly closely monitored. When I first went to the clinic I presently attend, I expressed concern at the effects some of the drugs I was then taking were having, including severe erectile disfunction and (by gesture) breast development. None of the doctors and NPs that have since examined me have raised the subject themselves although they must be aware of it, with the exception of one radiologist who wanted my chest X-rays redone with radio-opaque markers on my nipples, because of uncertainty whether something that showed up was breast tissue (mentioned specifically) or something on my lungs (it wasn’t). The NP’s comment was that it should have been done that way in the first place. It really doesn’t make much difference whether the examination is made shirt on or shirt off since my development is just as likely to be felt as seen. Not only am I now unworried by being ‘noticed’ in medical contexts, but I have managed to reduce by half the number of drugs that I am on, as well as greatly reducing the dosage and total cost of those that remain (certainly by enough to pay for quite a lot of PM). So getting myself noticed may have contributed to this.
As for being risk averse, this is something where everyone has a different threshold. Almost everything carries a risk, and everyone has to make their own decisions as to what is acceptable risk - after taking reasonable steps to inform themselves. Some times of course, and I don’t think this applies to you, risk aversion is used as a convenient excuse for not doing what one doesn’t want to do, and the aversion conveniently evaporates in respect of things one does want to do. A favourite among my wife’s collection of fridge magnets is the one that says “Housework won’t kill you - but why take the risk?” There is also the issue of personal as against public risk. If a certain treatment carries a one in a thousand risk of serious adverse consequences, that may be a risk one is prepared to take on a personal basis, but in a mass marketed drug it may constitute a public health disaster and a massive potential liability. I imagine that big pharma must use some very sophisticated risk management techniques. I don’t know whether your own concerns are public as well as personal but they obviously extend not only to yourself and your family but also the members of this forum. In a way you act as our collective conscience, and when you seemed to disappear for a while I for one was anxious. You recently expressed the same concern about Isabelle - happily both of you resurfaced. Carry on the good work and good luck with your doctor visit
