Obesity Care Week

 

As America's waistline increases so do the medical conditions and healthcare costs associated with the disease state causing this expanding phenomenon...Obesity. Obesity, unlike other disease conditions, was not recognized as a disease until a few years back. A medical condition that is the root cause of about 230 diseases was buried under social stigmatization, body shaming, prejudice, and most importantly misconception even among medical providers. 

About 33% of Americans are obese, the percentage of children affected by overweight has increased from 15% to 32% in the past 30 years. If we do not take action now, it is predicted that about 50% of adults will be obese by 2030. Obesity is not just a national problem but a global one. According to WHO, the prevalence of obesity nearly tripled between 1975 and 2016 worldwide.
 . What does it really mean? This means that time to take action is now! 

Take the NOCW Pledge

National Obesity Care Week (NOCW) is going to be observed September 15th-21st to raise awareness, to provide educational tools, to remove bias and to give access to health care.

Here is what you can do :

• Schedule a wellness exam with your Primary Care Provider. A wellness exam is always a good time to start the dialogue about your weight issue.
• Have a set goal weight, weight loss plan, and most importantly realistic expectation.
• Track your caloric intake. There are many smartphone apps that are user-friendly and free.
• Have a calorie-conscious eating plan. Find out the calorie content of every food before you place it in your mouth.
• Follow smart grocery shopping tips. Never go to the grocery store hungry, shop only in the periphery of the store that has the fresh produce and stays away from the free samples.
• Incorporate physical activity and fitness into your routine.
• If you follow all the above steps but still struggle with your weight, consult a professional. There are physicians certified to treat obesity called Bariatric Physician for medical weight loss options. Bariatric surgery may be suitable for patients who are morbidly obese and/or those patients who failed medical treatment. Dietitians/nutritionist, a health coach can provide additional help.
• Talk to your health insurance company and your employer about coverage for weight loss treatment be it Rx medications or surgery. There are a few health insurance companies with good plans for unlimited preventive service coverage whereas with some plan "obesity" is an exclusion.
• Do not blame yourself. Poor self-esteem, depression, anxiety, substance abuse are closely linked to obesity and have a poor outcome. Never be a silent spectator for weight bias..speak up!
• Beware of those fad diets and over-the-counter diet pills. 

There has been a significant advancement in the field of obesity medicine, so there is hope. As we see more medications in the market as well as more in the pipeline, there is definitely a surge of optimism. Also groups like Obesity Medicine Association, the STOP obesity alliance are constantly interacting with law-makers in Capitol Hill to bring about a positive change in healthcare, research, and education. So, this week, let's all join hands and take a pledge to spread the word about obesity, focus on healthy behavior, help those in need gain access to healthcare and remove weight bias. Together, we can tip the scale in our favor!

Body Mass IndexIs it Reliable Indicator of Obesity

Body Mass IndexIs it Reliable Indicator of Obesity

Cyberspace slandering

" Pen is mightier than sword" that's the old saying, nowadays " Social media is more powerful than any nuclear weapon. Disgruntled patients often resort to cyberspace to get the steam off. We as physicians do not have the luxury of time to follow their posts, blogs or bursts of tweets. The cause of dissatisfaction may range from long wait time to lack of Wifi in the waiting room. What gives them the right to lash out on us when we don't have an opportunity to defend ourselves?Seldom does a satisfied patient run home to give a 5 star rating for us. If patients treat medical office like hospitality service then we should not be asked to write off their copays or deductibles. Fallacious review online will tarnish an otherwise impeccable reputation of a committed physician. If only we get a chance to tweet about our temperamental patients or post a review about our abusive patients,I'm sure they will think twice about putting baseless accusation online.
        There were many instances in my office recently of patients threatening us openly about posting bad reviews in social media... the reason always seem to be with a statement for services provided. Their reluctance to pay or their lack of understanding of the insurance coverage gets twisted into a take of vulnerable patients caught in the hands of professional predators. Now where would I blog,report or post this?!Patients are now abusing this powerful tool in their palm to exploit, extort and defame us.
While I understand that every individual has the freedom of speech in this country, no one should be given the freedom of abusive speech. If medical offices are going to put in the same platform as pizzeria, then patient must be ready to keep their wallet out as soon as they step in. How often do they get to leave a pizzeria with a slice of pizza for free ?!   I feel that we all must join hands in curbing this culture of social media slandering of doctors. We can’t let anyone stain our white coat online with their dirty digital finger prints.
 Responding to your negative review is key. This ensures that you are taking every comment/review seriously. Short, crisp and assertive response always makes the best impression.
Secondly, one can try contacting Google, Yelp directly and flag it as abusive but it may or may not work.
If that doesn’t work, some physicians have penned their views to the patient asking them politely to delete those derogatory reviews. Finally, if Google gives you the run around, patients turns a deaf ear the last resort is to seek Legal services for a defamatory lawsuit. After all your reputation is worth it!

How I achieve work-life balance as a physician

When I set my eyes on stethoscope and my mind on white coat, the warnings about personal life was endless. "It is a 24/7 job. Think about becoming a professor with lots of vacation time" said my dad. "Be prepared to miss parties, holidays and family functions" said my mom. More skeptical comments poured in from many others that made me a little edgy. We physicians have a stereotypical image of work mongers with no reprieve. White coat workers dealing with disease and death. It is an irony that we as health care professional who give lectures to our patients about eating right, sleeping tight, are the ones who are often running from offices to hospitals missing many meals and spending sleepless nights.

I, like many others juggle with personal and professional responsibilities. Planning, preparing and most importantly unwinding has helped me keep those adrenaline rush under control.
➤Prudent Planning: Being a typical "Type A" personality I have always planned my days well ahead. I usually go through my week's schedule on Sunday to give me an idea on how to prepare myself for both personal and professional demands. If there is any conflicts I try to fix it then and there.
➤Practical preparation: Putting the planning to action requires a lot of co-ordination and time management. I pack lunch, set clothes for my kids and myself the night before so that we waste little time in the morning searching for a pair of socks or belt. I have a set schedule for dinner during the week days that is simple and easy to follow. I finish most of the chores like laundry, grocery shopping during the weekend so that weekday evenings are spent entirely with kids.
➤Modus operandi: Most important change I did with my work schedule is to start early and finish early. This way I not only waste time in traffic but also give my patient the flexibility of scheduling their doctor's visit before they hit work. I keep my office hours strictly for patient care and try to get as much work as possible while at office. We have a office policy of not allowing lunches from any salesperson. I limit my interaction with drug reps to a quick hello and signature at the waiting room. All my staff members are encouraged to communicate with me through our EHR messaging system. Monthly face to face meeting with my staff gives me the dedicated time to discuss about their concerns and come up with a plan . I also log in every night to check labs, send messages and do Rx refills which saves me tremendous amount of time during the work day. I allot specific to-do list for my staff so that work flow is streamlined. I keep one day a week as an administrative day when my staff catch up with those lengthy phone calls with insurance companies or carry out those ever frustrating "PA" process while I do my nursing home rounds.

➤Power naps: Do not underestimate the "Power of power naps". I have always been a big advocate of power naps and cannot stress enough how much it has helped me to be very productive in the evening. Since I come home with my boys I do get ( rather make) time for a quick 20 minute nap that seem to revitalize me.The rest of the evening until their bed time is exclusively for my children which is as fulfilling to me as my white coat job.

➤ I have a discovered a few ways to unwind after work which is both relaxing as well as purposeful like cooking, gardening. I not only get my quota of physical activity but also get my chores done. Another new hobby I very much enjoy is blogging. My personal blog covers a wide range of topics from real life events to abstract narrative which helps me connect with friends with all walks of lives.On the other hand I maintain my grounds in the field of medicine through my health blog that constantly pushes me to be up-to-date.

➤Splendid Saturdays: Most of us would prefer a golf course to an examination room on Saturdays.Meeting friends will make more sense on Saturdays than meeting the "Meaningful use criteria"! I beg to differ.  I have a short but a packed schedule on Saturdays which has helped my practice tremendously. Working on Saturdays has been very fulfilling to me for many reasons, less traffic on the street, empty parking spaces, gratified patients and laid back atmosphere. By the time my family finishes their brunch, I'm home for some quality family time.

How do we find balance between a personal and professional life? Some would even ask is there a perfect balance ? The answer is in our hands. Physicians belong to the society of high achievers. We have always pushed us to go beyond what it is expected from us. So it is only natural that we continue set our goals higher. There is nothing wrong in aiming big and working hard but not at the cost one's piece of mind. Of late physician burnout has increased exponentially, suicide rate and sudden cardiac death continue to raise among us. We need to fix it,before this Stress syndrome sucks out the life from us.

Being in this noble profession has opened my eyes to the world. I learnt that key to happiness is being yourself, to pursue your heart's desire. The simple joys of life cannot be measured in dollar amount. I get up every morning eager to put on my white coat knowing that I can make a difference in someone's life and I come home with same enthusiasm knowing that I'm going to have personally gratifying time with my loved ones. 

Color blind

It was heart breaking to hear about the killing of a young Indian man in Kansas last week. A senseless act of violence brought the life of a 32 year old loving husband, a caring brother and adorable son to an abrupt end. His American dream turning into a nightmare! Until that day I have always felt safe in American soil. My brown skin, unpronounceable Indian name or my desi accent did not alienate me from others. I felt a part of the multicultural American fabric as many other immigrants. This incident wiped off all securities in my mind in an instant!The country that welcomed immigrants from all over the world with open arms is now closing its doors. Shall I say is made to close its doors! Fear swept across the Indian diaspora as we look for an answer. What shall we tell our children? How do we prepare ourselves from these racist attacks? Crippling fear, overwhelming sadness and above all precarious future are the dark clouds above of our heads.  As law abiding Americans we all take pride in everything American irrespective of the color of our skin, country of origin or religious affiliation.
 Martin Luther King's famous speech says " I have a  dream that my four little children will one day live in a nation where they will not be judged by the color of their skin, but by the content of their character". It is about time to create a color blind society. We all need to unite under one common goal of protecting human life. Human life, irrespective of race, religion, etc is precious and we all can do our part in spreading the message of seeing every human being as our own, to feel their pain and appreciate their differences. 

The realm of relationship

Let's admit it, we all have felt jealous of someone at some point or other. May be he/she is better looking, endowed with great skills or just the type who outsmarts everyone. Recent article in a local newspaper titled " Friends you don't want your partner to meet"triggered a series of interesting discussions that led me to ponder on these lines. Feeling of jealously when in a relationship as much as it reflects one's insecurity it also reflects one's love for their partner. There is that hidden pleasure in knowing that our significant other is feeling jealous and within limits being possessive also means that boundless love for someone special. That love that you don't want it to share it with anyone else!
 
One of my friend from college days had a super possessive boyfriend who would go to her college and punch her seniors for merely ragging her. May be they flirted a little in the name of ragging! We used to tease her saying  " He has sign on your back - My property, no trespassing allowed strictly!" It is okay if done within limits like many other things but that special person in your life should not feel suffocated. Feeling of suffocation even with love can be detrimental to a relationship.

Another very interesting category is your "Ex" who is your friend currently. That category is too complicated for many partners to digest even if one swears that they have erased any such feeling. This reminds me of the award winning malayalum movie called "Olangal". In that movie the hero Amul Palekar brings in a child home,telling his wife Ambika that the little girl is the daughter of his friend who had died in an accident. Ambika showers her motherly love on that girl until one day she finds out that the child was in fact her husband's love child from another women. All hell breaks loose from then on...If someone cannot accept a child think about an adult. It will be a topic that would be best avoided for known reasons. The society does not give any "Ex" a second chance to put the differences and animosity behind, even if that person is willing. There are outlier to the garden variety group of "ex" who are able to filter that hatred for each other, untangle the relationship web, turn a deaf ear to the gossip mongers....and maintain a blissful relationship with their ex-partners.

Ladies often feel intimidated by that "Super hot" friend who steals everyone's attention and would possibly steal their man too. If you are teenager that attractive friend of yours could be a threat as boys usually carry their hearts in their pocket... and would easily lose it to a good looking dame! The more they know about our insecurities more will be the drooling episodes. As we grow up we realize( I mean both the genders) that beauty is skin deep and we need more than a pretty face to establish a long lasting relationship.

Everyone is quite cautious about that flirtatious group of men and women. Boy! I hate them like many others. Their agenda is to create havoc in a serious relationship and nothing else. In one of our hospital parties I witnessed one such act. This young male doctor Sanjay had his eyes on his female colleague Anjali and he made sure that he announced it to the world that evening! Anjali was getting introduced to a senior physician in the hospital Dr.Singh and poor Dr.Singh happened to hold her hand a little longer than the usual brief hand shake. Our Casanova walks into the middle of that formal introduction and puts his hand around her. He did not stop there...he went ahead to the chief " Take your hands off of her, I know about you oldies too well". Everyone in that group had their mouth open...he gave this sermon with his hands firmly placed on her hip !! The entire evening he followed her everywhere and flirted to his heart's content. so much so that, some even thought that he was Anjali's husband. Now did Sanjay has any serious feelings for Anjali, to my knowledge "no" but he is that carefree Casanova whom you would never introduce to your partner!

Next group of people are the "Smartie pants" type. They think that they know it all and make sure that they rub it on everyone else. They are out spoken, loud and do not think twice about bragging about themselves. They impress people in the first meeting and make everyone around them feel like "nobody". A good friend of mine has this natural instinct of showing off her knowledge, materialistic possession, her awards from kindergarten to Medical college on her very first encounter. She can talk hours about treating a common cold and make every non medical person in the room open their mouth wide in an awe and every medical person roll their eyes and walk away. These self proclaimed Nobel laureate can be very annoying and it can also damage a fragile self -esteem. They are harmless, annoyance who can trigger small fights in a relationship but nothing more!

That secret admirer of yours...can be exciting, daunting and often perplexing. That gut feeling that he/she likes you but can't be sure. Very tricky group to deal with since we do not know for sure where we stand. Should I introduce him/her to my significant other? What if he/she drops the "admiration bomb" in front of my possessive partner?  What if  he/she acts indifferently out of jealously ? There lot more questions that would come to one's mind in dealing with these puzzling persona.

Good relationship as such is very difficult to establish. I feel that there is some super natural power to bring like-minded people together..." Rab ne bana di jodi" Out of the thousands of eyes we see there is one pair that strikes a chord. And out of the hundreds we have spoken to, there is one voice that speaks our heart's language. If you have that person in your life, cherish every moment with your loved one and do not worry about whom you partner gets introduced to. 

Heart warming Holidays

                                                           

Having lived in North America for almost two decades,I have added a few more holidays to my list.Easter,July 4th,Thanksgiving and Christmas to name a few. Spring brings in colorful flowers and delightful Easter bunny.Who could escape the Easter egg hunt if you have small children?As the Easter bunny jumps away,our next major holiday break comes in a snail's pace after 3 long months. As soon the school closes in the North eastern part of US, we kick off the summer vacation with American Independence day. July 4th fireworks reminds us all of "Diwali".I would never say no to lighting those sparklers under the clear summer sky.Then comes September,which not only summons a new school year but also our Indian festive season.The season starts with "Navarathri" which got a new platform in US lately. South Indians still enthusiastically bring their authentic "Golu"dolls from back home and proudly display it in their living room.The nine day celebration is usually cut down to the weekends.While the Golu goers in Chennai went door to door without an invitation that open door policy does not seem to exist anywhere these days.Dates are fixed in advance and attendance strictly by invitation only! In the past few years most of the towns with sizable Indian population in US have launched electrifying "Dandiya" nights in a mega scale.The event is marked by heavily packed halls,ear splitting music,ladies and men in the best Indian attire dancing to the beats of Dandiya music until daybreak.

Before we could recover from Navarathri, Diwali follows.Did I forget to mention about the spooky festival of Halloween? I have gone from designing my son's warrior costume to carving a pumpkin like many parents.While we fight hard to get over the sugar rush from Halloween candies our willpower is put to another test by the mouth watering Diwali delicacies.The North American Diwali includes grand Diwali melas to elaborate week long festivities in our temples to small scale neighborhood parties.We are lucky to have some school districts declare it as a holiday here.It has been a tradition for many desi families in New Jersey to make a quick trip to our local "Sivakaasi" in a town named Easton in Pennsylvania to get the fireworks.While "Diyas" brighten our dark fall nights, Diwali sweets help us beat those Fall blues.As our folks in India wrap up their holiday season soon after Diwali, we start another session of "Adopted Holidays".What's interesting about them is the Indian touch the Thanksgiving and Christmas celebration gets in our desi families.Indian Thanksgiving meals gets Americanized longer you stay here but I still frequently find our Tandoori dishes next to Turkey on Thanksgiving dinner table.No one cares as long it satiates your holiday appetite! Anyway we have come a long way from what the pilgrims ate.I absolutely love the way we first generation immigrants have added a new flavor to the American holidays.We bring in the Christmas cheers by following the rituals of an American Christmas as closely as possible so that our kids too can share their holiday stories with their friends, be it taking them to "Radio City Christmas Spectacular" or merely giving them a spectacular icicle lighting at the house.We show the same enthusiasm in putting the Christmas tree as we do for lighting the Diyas on Diwali.Every Indian mom puts on her best culinary effort to make the gingerbread house as they do for making "Laddos"during Diwali.

Holidays in any culture has one meaning,that's bringing the families and friends together.Of course food is an integral part of any celebration.It's a time to break the monotonous daily chores and add a little excitement to otherwise mundane lives of many.It's time to clean up the clutter,embellish the house,and to adorn oneself.We immigrants seem to have assimilated the quality of bringing the best out of both cultures.While our motherland inculcated outstanding hospitality, our adopted motherland polished it with an international touch but both taught us the importance of the family and friends.Holidays celebrated with kith and kin has a special meaning.They not only kindle childhood memories but also create new ones with no expiration date.Holidays are heart warming and emotionally uplifting.As we step into this holiday season let's all be thankful for the loved ones in our lives who make our everyday special and our holidays extra special.Happy Holidays!!