There is a phrase healthcare providers use so often that it almost becomes background noise:

“Make sure you tell your provider everything you’re taking.”

Prescription medications. Over-the-counter medications. Vitamins. Supplements. Herbal products. Recreational or illicit substances.

Everything.

I spent years telling patients this.

Then I managed not to follow my own advice.

There’s an uncomfortable lesson for you.

Your Provider Needs the Whole Picture

Before my strokes, I already had a fairly extensive medication regimen. Fortunately, I had adapted to it over the years, and adding new medications didn’t create major interaction problems for me.

But new medications can cause new symptoms, and medications can interact with other prescriptions, over-the-counter drugs, supplements, and substances.

This is why communication with your healthcare provider matters.

If something changes after you start a medication, tell them. If you’re dizzy, tell them. If you’re falling, tell them. If you’re having symptoms you didn’t have before, tell them.

Don’t simply stop an important medication because you don’t like what you’re experiencing without talking with the clinician managing it. At the same time, don’t assume you have to quietly tolerate every new symptom because someone prescribed the medication.

Your provider can’t troubleshoot a problem they don’t know exists.

That also means telling them about changes in your lifestyle, new prescriptions from other clinicians, over-the-counter medications, vitamins, herbal products, and supplements.

“Natural” does not mean pharmacologically inactive.

Some supplements can interact with prescription medications, sometimes increasing their effects and sometimes reducing them. Something being sold without a prescription doesn’t magically make it irrelevant to your healthcare.

Your provider needs the whole picture.

And yes, that includes the things you may not particularly want to talk about.

Tell Them About the Drugs, Too

If you’re using illicit substances, your healthcare provider needs to know that too.

I’m not saying that from some imaginary moral high ground.

I’m saying it from firsthand experience.

Your provider may be able to help you access treatment for substance use. They may also need that information to make safer decisions about medications, symptoms, testing, and treatment.

Ultimately, they’re probably going to recommend reducing or stopping substances that are negatively affecting your health.

You probably already know that.

I certainly did.

Knowing something isn’t always the problem.

Sometimes the problem is being ready to do something about it.

And sometimes we convince ourselves that if we don’t tell the person sitting across from us, we don’t really have to confront it.

I Should Have Known Better

It embarrasses me now to admit that I didn’t trust my own provider enough to use them as a resource for everything I was going through.

And remember:

I was a healthcare provider.

I knew why medication reconciliation mattered. I knew why providers asked about substances. I knew about interactions. I knew how incomplete information could affect clinical decision-making.

I knew better.

And I still didn’t do better.

That’s probably one of the most valuable things I’ve learned from ending up on the other side of the exam room.

Patients aren’t textbooks.

Knowing that something is harmful doesn’t automatically make someone stop doing it. Knowing that information is medically important doesn’t automatically overcome shame, embarrassment, denial, fear of judgment, or simply not being ready to change.

Perhaps I understood that before.

I understand it differently now.

If I were still practicing, I think I would spend considerably less time asking myself why a patient hadn’t told me something and considerably more time asking what made them feel they couldn’t.

That doesn’t eliminate personal responsibility. Ultimately, we are responsible for the information we provide and the decisions we make.

But healthcare works considerably better when the person sitting on the exam table believes they can tell the truth without first passing a morality test.

You Can Lead a Horse to Water

I don’t want to harp on these things. I don’t want this blog to become one long lecture telling people what they’re supposed to do.

I’d rather be a resource.

Sometimes you can give someone advice and it lands exactly when it should. They take it to heart, their situation improves, and everyone wins.

That’s the best outcome.

I also know that at certain points in my life, you could have told me exactly what I’m telling you now and I probably would have looked at you and said:

“Okay. Whatever.”

Unfortunately, even when you love and care for someone very much, you can lead a horse to water, but you can’t make it drink.

Eventually the horse has to decide it’s thirsty.

There are things I wish I had done differently. There are conversations I wish I had been more honest about. There were resources available to me that I didn’t use because I wasn’t ready to use them.

I can’t change that now.

What I can do is talk about it.

Maybe somebody reading this is sitting in an exam room telling their provider 90 percent of the story because the remaining 10 percent is embarrassing.

Tell them the other 10 percent.

Maybe you’re taking something you didn’t mention because you don’t think it’s important.

Mention it.

Maybe something changed after a new medication and you’ve convinced yourself you just have to tolerate it.

Tell them.

Give the person trying to help you the information they need to actually help you.

I say that as someone who spent years on one side of the exam room and then discovered, rather spectacularly, how difficult it can be to sit on the other.

Thankfully, my mom didn’t have to see the worst of the negative impact on my health.

Unfortunately, my dog did.

He didn’t understand what was happening.

He just knew something was wrong.

Maybe that’s another kind of medicine worth remembering.

No matter where you are with your health, your mistakes, your recovery, or whatever particular corner of the Wasteland you’re trying to crawl out of:

Be the kind of person your dog and your mom hope you are.