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From anxiety issues to bad breath, bowel movements and a lack of sex drive, your primary care provider has seen it all. But just in case you’re still worried about what your doc may think, we asked some of the hard questions for you.

1. I Feel Down. Could I Be Depressed?

Talking about depression and anxiety is becoming easier with increased acceptance of mental illness. Primary care providers are on the front lines of mental health and are wonderful resources for patients. We all struggle with moments of sadness and fear, but feelings that persist in spite of our best efforts can become a problem. Depression affects one out of every six adults at some point in their lives and can happen at any age. Anxiety is common for everyone and often goes hand-in-hand with depression.  

If you or a loved one notices that your depression or anxiety is starting to affect your home life, work or relationships, then that is a good indicator that it is time to talk to your doctor. Many wonderful treatment options are available these days, including psychotherapy, medication and exercise programs, which can give us hope and joy about the future.

— Meredith Stanton, M.D.
FirstHealth Behavioral Services

2. I Just Peed While Jumping on the Trampoline With My Kids. Is This Normal?

If you’re hella embarrassed about this, know that you don’t have to talk to your primary doc — you can speak with a board certified urologist (or urogynecologist) without a referral anytime. First, here’s some things you should know:

  • *Urinary incontinence is the unwanted loss of urine occurring with activity (laughing, coughing, exercise or even during sexual intercourse) or the sudden urgency to urinate without the ability to timely reach the restroom.
  • * Urinary incontinence is NOT a normal part of aging.
  • Urinary incontinence results from injury to the muscles and nerves of the pelvic floor often as a result of pregnancy, obesity, chronic hypertension, diabetes or lower back injuries.
  • *Urinary leakage is COMMON, occurring in 1:4 women in the United States.

Now, here’s a questionnaire. If you answer yes to any of the below, you are suffering from something that’s likely treatable.

  • I have frequent urination.
  • I leak urine with a sense of urgency.
  • I leak urine with physical activity such as laughing, coughing or sneezing.
  • I have small amounts of leakage.
  • I have difficulty emptying my bladder.
  • I have pain or discomfort in my lower abdomen or pelvic area.

Many treatment options exist including physical therapy of the pelvic floor muscles and minimally invasive procedures performed under local anesthesia with return to normal activity in one day.

— Janet E. Harris-Hicks, MD, FACOG, FPMRS I
FirstHealth Urogynecology

3. I Can’t Poop in Public Places. Will Holding in a Bowel Movement Cause Any Problems?

I would suggest that you break down why you may feel anxious about passing a movement in a public restroom, and see if one or all of those factors cannot be mitigated. Are you afraid of the “public” aspect of the toilet (i.e. cleanliness)? Making sounds? Leaving a smell in the bathroom? Or something else?

In general, holding in stool is unavoidable from time to time and will not cause any lasting effects. Doing so will likely firm up one’s stool, creating constipation, so making this a habit can lead to the ill effects of chronic constipation (hemorrhoids and diverticulosis, among others). So while holding your stool in from time to time should be no problem, making it a habit can lead to problems down the road.

— Reid Vegeler, M.D.
FirstHealth Colorectal Surgeon

4. I Sweat So Much That Siri Doesn’t Recognize Me. What’s Up with That?

Don’t be afraid to simply ask your healthcare provider “is my sweating normal?”  There are certain medical conditions or even medications that can cause excessive sweating. Bacterial overload can also cause extra smelly sweat called bromhidrosis, a smell that happens when sweat contacts bacteria on the skin. We can help! Be sure to let your provider know that it is on your mind.

— Laura Martin, PA-C
FirstHealth Family Medicine — Pinehurst

5. I Just Brushed, But My Breath Could Melt My Partner’s Eyebrows Off. How Can I Fix It?

The most common causes of bad breath are poor oral hygiene, sinus/allergy problems including post-nasal drip, and acid reflux from the stomach.

Poor Oral Hygiene: Floss in addition to brushing.  Bad breath can often be caused by meat that was lodged in between the teeth from last night’s meal. Lightly brushing the tongue will also remove food debris and lead to fresher breath.

Post-Nasal Drip:  See your doctor for medicine or treatment for sinus or allergy aliments.

Acid Reflux from stomach:  If you burp a lot, have frequent stomach pain, or eat a lot of spicy foods, acid reflux may be the culprit. The acid coming from the stomach into the mouth can cause bad breath. Ask your dentist to check if there is any evidence of acid erosion of the teeth and whether a referral to a medical doctor is needed.

— Sharon Nicholson Harrell, DDS, MPH, FAGD,
Director, FirstHealth Dental Care

6. Why Has My Sex Drive Decreased?

If you’re experiencing a difference in the bedroom (or out of it, you do you), one of the following might be the culprit:

  • Vaginal issues (such as dryness)
  • Previous history of trauma or emotional/psychological roadblocks
  • Hormone Imbalance
  • Busy schedule and stress: It’s hard to focus on a connection between yourself and your partner when you’re busy with a full or part-time job, kids, or other life stressors.

If you are experiencing pain with intercourse, know that it should be enjoyable. The culprit could be some type of irritation or not enough lubrication. Definitely speak to your OB-GYN if you have questions — you deserve a healthy sex life!

— Lourdes M. Castano, M.D.
Southern Pines Women’s Health Center, A FirstHealth Clinic

For more specific questions on lung health, see our Q&A with Pulmonologist Dr. Michael Pritchett, here, or for heart health questions see our Q&A with Cardiologist Dr. William Harris, here.

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