What happens when you try to talk to your spouse's doctor?
December 23, 2013 11:10 AM   Subscribe

My husband gets a clean bill of health from his doctor every time he goes for a checkup, which makes no sense to me if she knew his habits. He seems to like and respect his doctor, and is inclined to listen to her. I've been considering calling her up and informing her of what she's been missing. Have you ever done this? Have you ever been the doctor on the receiving end of this information? I welcome your thoughts and experience.

So, my husband is diabetic (Type 1) as well as an alcoholic. Doctor is well aware of his diabetes and he is more or less compliant with those medications. However, I find it very hard to believe that she would give him a "keep up the good work" if she knew he was drinking 40+ drinks per week. I have seen the required form for a check-up at the office (I am in the same medical group, though not with his practice), and it specifically asks for how many drinks consumed in a week. It is unlikely that he fills this out truthfully and gets a clean bill of health from his doctor.

I have a lot of conflicting motivations here; many are selfish and I'm not going to lie to myself and say this is all for him. His alcoholism is tough to cope with and I am in Al-Anon. I know I can't control it, I didn't cause it, and I can't cure it. But I also know that he is going to die, and soon, if he does not get some help. Hiding his drinking from his doctor is not only harming his health, but the positive reinforcement he gets from his doctor (as a result of lying about his drinking to her) just keeps him drinking because of the "clean bill of health." I think it is possible that a wake-up call from his doctor might give him the motivation he needs to acknowledge his alcoholism and seek to arrest it.

So I've arrived at the possibility that I could call up his doctor and tell her. Obviously I know she can't actually discuss his health with me; there's patient-doctor confidentiality there for a reason. But I'm wondering if I can get her on the phone, if she might just listen to me when I tell her how much he drinks and how dependent he is on alcohol, because it affects his health care. Would a doctor even take a call from the wife of a patient? Listen to a call like this and acknowledge it but not volunteer any other information about his care? (This is what I'm hoping?) Or would she be obligated to tell him when he came in that his wife called about his drinking?

Also, thanks for your inevitable concern and suggestions that I leave him, those of you who are considering offering that advice. That's not what I'm asking for here. I am seeking specific advice on the above topic.
posted by anonymous to Human Relations (22 answers total) 1 user marked this as a favorite
I can't imagine her taking the phone call, but I can imagine her listening if you bring it up at your next appointment. I've spoken on behalf on an ill member of my family to the doctor, but generally while they were in the room.

I can't speak to whether she'd tell him that he told her, but I imagine that wouldn't be a far guess on his part. I'd assume he'd be told or figure it out and be ready for the consequences, if any, within your relationship with him.

Good luck.
posted by tilde at 11:14 AM on December 23, 2013 [2 favorites]

Have you asked him if he has discussed his alcohol consumption with his doctor? That seems like a pretty important first step to me.
posted by Big_B at 11:14 AM on December 23, 2013 [6 favorites]

To be a type 1 diabetic and get an A+ on your check up you need to keep your blood glucose under control; which can be really tricky. It requires discipline with your diet and monitoring your blood sugar.

I would bet all my insulin on he is not under control. Any competent doctor would have him take an A1C test every three months which gives you a generally idea of what your blood sugar was over that period. His doctor isn't overlooking his bad habits. He is lying to you about his health.
posted by munchingzombie at 11:18 AM on December 23, 2013 [42 favorites]

Would he be open to you going with him on the next appointment? You could discuss it then.
posted by bleep at 11:26 AM on December 23, 2013 [6 favorites]

Your husband's doctor may be able to listen to you, but she won't be able to comment on your husband's health or contradict that she's told him to "keep up the good work."

I think it is possible that a wake-up call from his doctor might give him the motivation he needs to acknowledge his alcoholism and seek to arrest it.

I do want to address your idea that if only your husband knew that his drinking was negatively affecting his health, that he'd be more serious about quitting alcohol. No, not going to happen.

I don't know how much Al-Anon you've been to, but even this kind of controling behavior can't help your husband.

Ask yourself, "how likely is it that my husband's test results are coming back great, if he's an alcoholic?"

Do not trust your husband on this issue. Do trust that his doctor IS telling him the truth about his health, and he still choses to use.

Make your decisions accordingly.
posted by Ruthless Bunny at 11:27 AM on December 23, 2013 [30 favorites]

Did he tell you that his doctor gives him "a clean bill of health?" Or did his doctor somehow tell you directly that he's healthy? Because if it's the former, the most likely situation is that, regardless of what he is telling her, he is lying to you about her response. I suspect that he's telling you that his doctor says he's fine because he's hoping that it will get you to stop nagging him about his drinking. I suspect that his doctor already knows that something is up because his numbers are not likely coming back normal if he is diabetic and drinking six drinks a day. In other words, you can try telling the doctor about the drinking specifically. A letter, in writing, might be a good method. (And yes, she will probably tell him about it, and no, she will not be able to acknowledge it to you. It would violate his rights for her to even acknowledge to you that she is his doctor.) But I suspect that it will not make a difference, because I suspect that she has already told him that he has health problems, and he is ignoring her and lying to you about her response, and all of that is tied up in the same avoidance and mental health issues and everything else that feeds into his alcoholism in the first place.

Just as you know that you can't control it and can't cure it, know that his doctor can't control or cure it either, and that you can't use his doctor as a method to control or cure it. I'm not bashing Al-Anon, but it appears that those meetings are not enough support for you right now. I would suggest individual therapy or more support groups. You need to start preparing yourself to lose your husband, either because you realize that you need to leave him, or because you lose him to his alcoholism. Because this plan to intervene through his doctor and give him a wake-up call that leads him to a cure is simply an attempt to control and cure him by proxy, and it is highly unlikely to work. You need to get in place the support you're going to need for yourself when you lose him to this disease.
posted by decathecting at 11:32 AM on December 23, 2013 [17 favorites]

Can you go with him to his next appointment?

If not, to strictly answer your question, I think it is possible for you to call or email the doctor and give her more information if you think it will help.

However I think you know even without the above answers that there's a lot more to it.
posted by radioamy at 11:35 AM on December 23, 2013 [1 favorite]

The greater likelihood is that your husband is lying to you about going to his doctor. If he is still drinking, he is more likely lying to you than it is likely that his doctor is giving him a clean bill of health. Ask to tag along with your husband the next time he goes in for a check-up. See how amenable he is. If you really aren't trying to control him and really, really understand that you can't control his behavior, you will back off and let him suffer the consequences of his own actions.

With due respect, as a person who comes from a massively dysfunctional background full of addictive personalities, this sounds like an attempt on your part to triangulate against your husband with your husband's doctor. You're not doing this on purpose; you're doing this because you are programmed to do this kind of thing.

Work your Al-Anon program. Go to a meeting and tell them what you've written here. See what people say.

Best of luck.
posted by TryTheTilapia at 11:37 AM on December 23, 2013 [5 favorites]

Are you sure he's getting an actual clean bill of health? Or, is that just what he's telling you so that the discussion is closed? I doubt that the doctor is aware of his drinking habits and has given him a gold star and encouragement to continue drinking. It's far more likely that his tests are coming back looking not-so-great and he's telling you they're fine so that you leave it alone.

If you've discussed the reality of your husband's alcoholism with him and he refuses treatment, that's about the end of it. You can call her or write to her telling her about his drinking habits, but be aware that she won't keep it in confidence and that it probably won't change your husband's behavior. The effective and transformative wake-up call delivered by the doctor is probably a bit of a fantasy.
posted by quince at 11:47 AM on December 23, 2013

Do you really think that even if his doctor told him that this wasn't healthy that he would do anything different? He's an alcoholic. Part of him knows it's not healthy, that's why he's hiding it or soft-pedaling it...he just chooses to ignore the consequences.

But honestly, if you think he's lying to her about his health, what makes you think he's not lying to you about his results?

So call or don't, the end result will likely be the same.
posted by inturnaround at 11:49 AM on December 23, 2013 [2 favorites]

Everyone's already spoken to the fact that he's probably lying to you about his 'clean bill of health'. But he may just be fudging the details - his doctor really may not be aware that he is an alcoholic. There are plenty of alcoholics out there who have not yet developed complications from their drinking. Maybe he figures that as long as his doctor doesn't tell him he's in liver failure, that he must be doing OK. Anyway, there are alcoholics who don't have any health complications (YET) and there are some who are on death's door due to alcohol, but that's all beside the point.

The point is that you and your husband don't have adequate communication about this issue. You could call his doctor and let them know about his drinking. I'm a doctor and I certainly welcome that sort of information from family members since it is often relevant to the care I'm providing. But I work in an emergency department and therefore the provision of relevant information is a lot more pressing - I would not recommend that a family member provide this sort of information apropos of nothing in a non-emergent situation, it would come off as trying to punish them or ambush them and would certainly be detrimental to the marital relationship, which would be a very important thing for my patient to have (a supportive spouse) if they wanted to get help for their drinking.

I would much prefer that the spouse try to engage the husband about drinking and not go behind their back trying to pressure them into stopping drinking through me. That's unlikely to be effective for a person who is what we call "pre-contemplative" about quitting alcohol. If your husband's drinking is a problem is his life and in your marriage, you ought to try to address it directly first - through discussion, through counseling. If he remains resistant to change, you probably need to get out rather than trying tactics like this.
posted by treehorn+bunny at 11:50 AM on December 23, 2013 [9 favorites]

Pardon me for trying to read between the lines, but it sounds like he's functioning fairly well for an alcoholic diabetic. As you say, he's managing the medication and you don't mention any low sugar scares, trips to the ER, passing out, etc. He's certainly never showed up with extremely high or low sugar or else he would have been hospitalized. All the organs are apparently intact and his kidneys and liver are still working. The sad truth is that a prudent adult man, even a diabetic, can drink 40 a week and avoid most of the short-term problems (for now, and he's still killing himself.)

And, doctors typically do not advocate diabetes make drastic lifestyle changes. The conventional advice is to medicate to match the lifestyle and to advise low to moderate lifestyle changes over time (because people don't usually change, and doing something drastic without feedback can alter glucose levels too rapidly.) Of course, the doctor does not want your husband to be alcoholic, but they probably are telling him that a little every day is fine, and he is mentally inflating that number to convince himself he isn't damaging his body.

So, I think that even if the doctor was surprised by your information and delivered a sober warning to your husband, he would not listen. He will probably have to suffer an acute scare before he changes. Hopefully it will only be near-death and not lethal.
posted by michaelh at 12:42 PM on December 23, 2013 [3 favorites]

I assume you've talked with your husband (plenty of times) about how he's not looking after his own health. You can mention it to the doctor next time you go for a check-up yourself, but what's the likelihood that he'll change what he's doing after advice from the doc? He's an alcoholic; he lies to himself.

If you have a sponsor, talk with her about it. I don't have to tell you that you can't control what your husband does, only what you do. Please take good care of yourself.
posted by wryly at 1:01 PM on December 23, 2013 [1 favorite]

I attend my husband's appt.'s with him. He is not alcoholic but is stoical and will not tell the doctor when he is suffering nor how much.

However, I have called another doctor to give details about a friend's son's drug-taking. The son was having medical problems and the mother, my friend, was in denial and would certainly not have welcomed this info from me. But I felt compelled to share it with his doctor. The doctor was very grateful for the info and of course could not say anything else which was fine. I only wanted him to listen.

The boy is now a successful man, happily married father of two.

I will never know if that call made any difference, but then I don't need to know. I suggest that you examine your intentions and then do as your conscience guides you to do. Outcomes are impossible to predict many times.
posted by claptrap at 1:04 PM on December 23, 2013

I think you should call. I'm type 1, and I hope that my wife would do the same. Even if that is kind of overriding your husband's wishes in some sense, assuming that he has been concealing the drinking from his doctor, there is a medical necessity here.

As others have said, I am also curious to know if you have seen the actual papers with your husband's a1C test results on them - or have you seen actual results on his glucometer? It's hard enough to achieve decent control, below 6 or 7, even in the best of circumstances - but with consuming that much alcohol, I just don't know how that would be possible. I do not agree with the comment that, just because he hasn't been hospitalized, that means he must not have extremely high or low sugar. Perhaps he has not had any severe lows, but it is certainly possible for someone to live with high sugars for weeks or months that inflict irreversible damage on the body yet never rise to the level of needing hospitalization.

Good luck.
posted by chinston at 1:24 PM on December 23, 2013 [2 favorites]

His alcoholism is tough to cope with and I am in Al-Anon. I know I can't control it, I didn't cause it, and I can't cure it. But I also know that he is going to die, and soon, if he does not get some help.

By calling his doctor you are hoping to gain some control over it and move him closer to a cure. That's completely understandable but it's at odds with the reality and acceptance you're facing in Al-Anon.

Call, or write, and express your concerns, but leave off all expectation that it will have any effect. I'm sorry, what a difficult situation.
posted by headnsouth at 1:31 PM on December 23, 2013 [4 favorites]

Do you know if your husband has authorized the physician to share his personal health information with you? He would have likely checked a box and listed your name on his intake paperwork. If so, she'll likely be a lot more receptive to talking with you.
posted by kelegraph at 2:05 PM on December 23, 2013 [1 favorite]

I debated posting, but I've unfortunately been where you are Anon; I don't know anything about diabetes but it's a sure bet that his doctor knows something isn't right. Chronic alcoholism isn't something that is easily hidden, many alcoholics feel that they can hide the signs and this may be your husbands case.

The first step in recovery is coming out of the denial you are currently in - you recognize the alcoholism as the amount he is drinking but not the lying, the deceit, the broken promises. Honestly, I get it - I truly do but before you can help your husband, you need to help yourself. You say you're not ready to leave him, then I ask you - what's his rock bottom? What reason does he have to get sober? I would wager it being that you hope one day he wakes up and realizes that you love him so much and want a full life with him, maybe there are children, I don't know but what I do know is you will lose to the drink. I've met many along the way who have been where you are, they all thought that with enough love, prayer, and understanding - one day their love ones would make up and realize what an ass they've been all along and everything will be fine... sunshine, rainbows, puppy dogs, and all those pipe dreams. Well guess what, it's a lie - you're husband is an alcoholic and you sound like an enabler. You're going to Al-Anon but just because you're going doesn't mean you've excepted the reality of the situation - there is a small portion of you that hopes one day you'll wake from this bad dream. Everyone who has been through this has been there, and we all eventually realize that holding on to hope that our loved ones will get sober on their own isn't enough and we need to make our own hope by getting ourselves healthy.

You posed this question as how can I help my husband expecting an answer that makes it all ok and will help him sober up but I promise you this, he won't hit rock bottom until HE is ready to. Why do some people get sober when they lose their job while others only get sober when they are living under an underpass in the middle of winter while others never get sober? Everyone has a different rock bottom, his is not yours. The true answer to your question is to get help yourself, recognize the signs of codependency, and make the plans accordingly. Either he's going to fight and live from this disease (alcoholism, not diabetes) or he's going to die from it but either way, as long as you're by his side - you're an enabler and they are just as bad as the alcoholic themselves. I don't doubt you love him, but you're love is misplaced. The hardest thing I had to learn in my journey was learning to love from a distance and that sometimes, love isn't enough and love doesn't mean we're a doormat and put up with all the shit they do.

Get yourself some serious help, look into codependency therapy and only then, once YOU'RE healthy, can you even attempt to help your husband. I ask you as someone who has been down this road, face the denial for what it is and figure out the next moves but you're original question; yes, you can call the office and relay the information but like others have said before, unless the doctor is incompetent, they have a good understanding of what's up.

Your husband is lying to you about his health and he has chosen the drink over you.
posted by lpcxa0 at 2:18 PM on December 23, 2013 [2 favorites]

Is he telling you she gave him a clean bill of health, or have you seen actual test results? If you're taking his word for what she told him, he's probably lying. If you've seen the results of a blood panel that includes A1C, liver panel, cholesterol and the rest and it's ok, maybe he's one of those rare people who can live like shit and be just fine, or possibly just for awhile til it catches up to them.

My ex's grandfather was a type 2 diabetic who drank like a fish, smoked like a chimney and ate whatever the fuck he wanted. He eventually died of kidney failure... in his late 80s. Sometimes it happens like that. (Personally I think he lived on pure meanness, but I'm not a doctor, so...)
posted by Serene Empress Dork at 2:27 PM on December 23, 2013 [2 favorites]

I've meddled in a third party's medical affairs by talking to their doctor. What happens is that the doctor can listen to you but cannot say anything to you. In my own instance, this meant the doctor sat stony-faced while I talked and then said, "OK, I have heard what you're saying." Literally. It felt like a very weird interaction, but I felt an obligation to say something and am not sorry I did.

This was my children's pediatrician, who was also the pediatrician for an acquaintance's children, and I felt he needed to know something about this acquaintance that might have affected his care for his patient. I have no idea if he cared what I said, or if it affected his care, or thought I was overreacting, or what, which is exactly as it should be. So if you want to say something to the doctor, that's how -- just say it, and know that you will get zero feedback if the doctor is professional and respectful of your husband's privacy, which he should be.
posted by palliser at 3:39 PM on December 23, 2013

Maybe the doctor can't talk to you, but he can listen. Frankly, I can't imagine what kind of medicine a physician could be practicing if they limit their input on a patient's habits by refusing to listen to such important information from the patient's spouse.

Sorry, that's just crazy.

I called my father's doctor and told them I was his daughter and he'd just been diagnosed with lung cancer with mets to the brain and I wanted to talk to his doctor about what to expect. They made an appointment for me with the doctor, who told me he couldn't share any of what my father had shared with him, but - he told me my father was very likely beyond any serious hope of cure and that I should prepare myself to help him, to be there for him, and to support him in whatever choices he made. Ahh .... what a blessed relief it was to receive such an honest, straightforward answer - and it helped me to help my father without all the extraneous nonsense.

My friend, 45 years old, whose husband was out of work pretty much all the time, who lived on whatever they could scrounge up, asked me to take a look at her breast because it was very painful. Ye gods - it was an open, vicious sore, oozing and smelling and horrible. They "couldn't afford" mammograms, they said. I took her that day to a local surgeon who didn't know me but I knew him to be the best in town because I was in medical transcription at the hospital and I knew my doctors. I told his nurse the situation and had my friend expose just a small amount of the mess to the nurse. We were shown into an exam room, and I went with her because she was incredibly shy and could hardly squeak in response to a question from a doctor. He removed her breast within a few days and then, later, her thyroid. She lived for another six years, fairly comfortably. When I saw this doctor in the hospital after that, he always stopped to say hello and be friendly.

I went to Tucson to visit my mother, who was in her 80s, to help her learn to use a computer. I had no idea she was desperately ill. She hadn't been off the sofa in over a week, couldn't walk, was barely coherent. It started with abdominal pain and constipation. I called an ambulance, went with her to the hospital and talked to the ED physicians. When it was obvious that she had to have immediate surgery, I talked to some people in the Transcription Dept - without getting any names - and called their most recommended surgeon, who operated the next day on my mother, literally saving her life. It took seven months before she could function on her own again and during that time I went to every office visit.

I have always, always, offered to leave the room so the patient and doctor could speak privately - very rarely has this been accepted.

I have a friend right now who lives in another state. He's been on Ambien for 15 years and is having unbelievable side effects from it - complete amnesia, sleep walking and sleep driving, has been arrested for DUI but charges were dropped because he had no alcohol in his system, and more. My pharmacist says it's absolutely the Ambien, but he's afraid of going off the Ambien because he'll "never get to sleep" and his wife thinks whatever the doctor (VA) says is what they should do. I'm honestly afraid I won't have my friend for much longer. I guess his "rights" are being honored, though, so there's that.

Every single patient needs an advocate - someone to step up there and do what has to be done. If the person is fortunate enough to have a spouse, you're damn right they should get in touch with the doctor and give him/her the information that may indeed save their spouse's life! Any doctor who won't even see the spouse, who has no interest in the whole story behind what their patient is going through, should be cleaning floors instead of practicing medicine. I can't believe that the word "rights" should overrule the words "save his life"!!

I hope my kids stand up and push their way through to get the attention of a doctor whose care matters to my quality of life, let alone to my very existence. Jeez.
posted by aryma at 8:03 PM on December 23, 2013 [12 favorites]

Saw this Carolyn Hax article today...

"I often wish advice columnists would counsel neighbors, family and friends who are concerned about someone to send a letter to the patient’s doctor."

As a transcriptionist, I often type notes for the charts of patients whose friends/family take a nurse aside or call and leave a message saying they are concerned because the patient drinks more than they claimed at the visit, etc. When it comes to something like alcohol intake, the doctor can then ask specific questions (i.e., how many drinks do you have per night? What kind? What size glass? Do you drink alone?) rather than general ones (i.e., do you drink alcohol?).

Don't expect acknowledgement (from anyone) or different results after you say something. Doctors can't force change on anyone, they can only point out better options and the reasons for them.
posted by AllieTessKipp at 8:37 AM on December 27, 2013

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