As a lifetime truck mechanic I have to say that one big problem we have is customers exagerating a problem with the belief it will be more helpful in us isolating and repairing it. Nothing could be further from the truth.
I see my girlfriend do the same thing when she goes to the Dr with a complaint. I feel like it makes a diagnosis based on symptoms extremely difficult and stretches out the process. Is this a problem with patients or something you guys have just learned to allow for?
It’s a problem, and one we’ve learned to allow for.
Both symptom magnification and symptom minimization are problems, that’s why it’s important to take a good history, then confirm it with a good physical exam. That helps cut through the fog to some extent.
Getting to know the patient over time and learning whether they’re a stoic, or a histrionic, or somewhere in between helps too.
Labwork can help clarify the picture too. Or muddy the waters further.
It’s for these reasons that Medicine is still more an Art than a Science.
I’m a dermatologist. My experience is that patients create a narrative with causes and effects based on their knowledge and experiences. Often, this does not correspond to what is understood by western medicine concerning the speciific findings. Interestingly, patient anecdotes concerning their presentations take on recognizable patterns even when they are off base, so they may be useful diagnostically anyway. For example, my experience is that a history of a “spider bite” makes me strongly suspect an abscess
Oh, I agree with that one. “Doc, I’ve got a spider bite” means I’ll be draining and abscess and checking for a MRSA infection in 90% of the cases. 
I’m not a doctor, but this is why second opinions are so invaluable.
Hell, I always wonder how people know that they’ve been bitten by a spider, as opposed to some other creepy thing with too many legs. Sometimes I know when a mosquito has gotten to me, because I swatted her right after I noticed her. And I know when I’ve probably got a chigger bite, because of where it is and what I’ve been doing lately. But unless I actually see a spider on me, how can I tell if it’s a spider bite or something else?
I can recognize a cyst or boil or abscess, though. And I can also recognize when my home treatment (warm wet compresses several times a day) is not sufficient. Generally, my complaint is “I have this Lump here, it’s sore and it’s getting bigger.” Then my doctor’s complaint is “You’re allergic to most of the effective antibiotics! You’re doing that on purpose, aren’t you?”
My wife was a trauma nurse at Harbor UCLA and was bringing up a staff virus from the hospital. Dr kept telling me I was getting spider bites but I knew better.
As QtM says, we allow for this and good physicians get good at it.
Every patient filters their symptoms through their own eyes. Taking and interpreting a history is a critical skillset. One patient’s 10-rated pain is another’s “3.” One patient’s “dizzy, sometimes” is another’s “thought I was going to collapse and die.”
We don’t expect patients to be clear and concise, but it really helps when they are. Patients frequently don’t know which symptoms are important, and waste time elaborating on the wrong ones. Sometimes the really nervous ones answer “yes” or “maybe” to everything, apparently worried that if they deny a symptom, I’ll miss their diagnosis. We have some trick questions (e.g., “Are you still seeing double when I cover one eye?”) that help us a little on occasion. 
I coach my family to try and summarize their history and current complaint in a few sentences. There are folks with very complicated presentations and very subtle (but important) symptom complexes, but some of them are so bad at presenting their histories that critical diagnoses get missed, and on some occasions part of what obfuscates the presentation is the patient exaggerating everything. When such a patient goes off on too many tangents, it’s easier for the physician to miss a critical item. Beyond that, even where the diagnosis or treatment is not in question, exaggerating everything makes it very difficult to decide where to place the focus and fix.
You laugh but that is possible, I know because it happened to me. I have a pituitary gland tumor, and when it got big enough it was pushing on my optic nerves in such a way to totally screw up my vision at times, including seeing double with one eye closed.
Nearly all symptoms are possible, that’s one of the things that makes medicine challenging.
My go-to questions to try to separate wheat from chaff are “Do your teeth itch? Does your urine glow in the dark?”
Since the OP is asking for personal experience, let’s move this over to IMHO.
Thread title also edited to better indicated subject.
Colibri
General Questions Moderator
Her coworkers all had the flu? Or are you talking about a Staph. infection?
Staph infections where we would get these huge boils, mostly on my arms and sometimes stomach. Mine would resolve themselves but we had to have her on introvenious IV of antibiotics a couple of times. Her hospital at that time 1992 was having a major problem with this. I didn’t realize my spelling was off until I went back and reread your post, sorry.
I had a pilonidal cyst and I did initially assume it was either a bug bite or a topical skin infection; I had no idea what the hell a pilonidal cyst was.
Draining it was the most painful thing I have ever experienced in my entire life, and I’m–no shit–usually pretty stoic when it comes to unpleasant physical things. I don’t think it helped that the doctor was a bit of an ass; when I screamed (sorry, I couldn’t help it) he yelled over to me to say, “CAN YOU SMELL THE INFECTION? CAN YOU SMELL THAT?”
Um, not really appropriate, Doc. You get a big “F” on bedside manner.
It kept coming back and eventually I had surgery to get rid of it, but I have never forgotten that one initial doctor who was so rude and impatient and, frankly, callous. I bet he has never had one and I wished one upon him.
I love the smell of puss in the … ewwwww :eek:
I’m sure it DID smell stomach-churningly awful…but i was too busy screaming and crying to be able to breathe out of my nose and take in the aroma. I thought it was completely unprofessional and unnecessary for him to say something like that. It served no purpose, other than to humiliate me for something completely outside my control.
First do no harm my ass…she says, acknowledging the pun
I always wondered about the “On a scale of 1 to 10” question and how valuable it really is. I’m somewhat of a wuss - I get the heebie-jeebies just hearing about someone else’s cuts and such, so it’s difficult for me to evaluate my pain and filter out my emotional reaction. Plus, to be honest, I don’t think the worst pain I ever experienced was necessarily all that horrible (OK, I’ve pretty much forgotten labor.)
My husband has a pretty high pain threshold, so if he tells me he’s hurting, I know it’s pretty bad. But I always worry about him underselling it to a doctor - he hates to look wussy. And I hate coming across as a hysterical wife when I’ve had to ask for pain meds for him, but I know when he acknowledges pain, it’s pretty bad. Life would be so much simpler if we could just avoid the whole doctor/hospital thing altogether…
Of course, patients will try to “help” the doctor by “suggesting” a “likely” Dx for the doctor’s consideration.
All of my many doctors, over many years in many different cities, have trained me out of this. I’ve learned that when a patient “suggests” a Dx for the doctor’s consideration, the doctor responds by utterly, totally, irreversibly ruling out that Dx from consideration forevermore, and will adamantly NOT conduct any further examination or tests that could potentially support the “suggested” Dx.
And of course, the doctors are usually right about that. I don’t doubt that a doctor can instantly rule out various Dx’s (patient-“suggested” or otherwise). But I’m for from convinced that the doctor can always be right to rule out any such Dx so flippantly.
So I’ve learned, like a good witness under cross-examination, to keep my mouth mostly shut and just answer the doctor’s question without added editorializing, and leave it to the doc to do the doc’s work.
Except, sometimes. Sometimes, if I feel I want to “steer” the doc towards some Dx, I will think of what Dx I want to “steer” the doc away from, and suggest that instead.
Works every time, as far as I know.
I’ve had occasional vaguely similar experience, in much more minor ways. Dentists seem much more sensitive toward making the treatment passably tolerable for the patient, or at least trying. At least, they know what novocaine (or xylocaine) is, and they use it.
Next time I need a cyst or abscess drained, I’ll go to a dentist to get it done.
My interaction with doctors has been thankfully fairly minimal thus far in life, but I’m also confused about the “scale of 1 to 10” question and the couple of times I’ve had to answer it I really didn’t understand what sort of scale I’m supposed to use.
Is “10” “OMFG I can’t stand it another second or I’m going to pass out and can’t you bloody see I’m writhing on the floor in agony here” or is it “well, it’s right up there in ouchieness in my experience…”?
Too subjective a question, seems to me. And if a 1 or 2 is really a no pain/happy face, then why the heck would I be at the doctor’s office in the first place?
My psycho ex was a doctor (radiologist, so he didn’t have much patient interaction; mostly muttered into a recorder in a dark room) and I remember him saying that some people could present, say, with horribly bulging discs in their spine but be pretty much pain-free, while others claimed to be practically crippled with pain yet the films didn’t show much abnormality. And that either could be true and the films just a small part of the picture.
Anyway, I try to simply be as accurate and truthful as possible, while at the same time realising I’m probably more towards the stoic end of the spectrum. I don’t get trying to “steer” a doctor one way or another. Because when I go to the doctor, I want an accurate diagnosis, I don’t want to be prescribed uneccessary or incorrect meds or treatment, I just want whatever he or she prescribes to work.