Heart Healthy

As January comes to an end, the excitement of the New Year wanes slowly, we find ourselves struggling with the reality of keeping up with the new commitments and most importantly those resolutions that we made a month ago on New Year's day. Next month is going to be easy since we already have an idea on how to put our resolution into action effectively. The motto for the month of February should be "Focus on your heart". What better month than February to pay attention to the heart. With Valentine's day just around the corner, love is in the air and where does this love emanate from? The Heart of course!
This four-chambered vital organ in the chest that beats rhythmically, pumps blood and love with every beat. It beats more than 3 million times in one's lifetime supplying every cell in the body with the much-needed oxygen for survival. February is Heart Health month for a reason. Heart diseases are the leading cause of death for both men and women around the world. Raising awareness about the preventable causes of heart disease and steps that should be taken to protect the heart will go a long way in improving a person's health and life expectancy.

Here are a few heart-healthy tips:
1. Screening for silent killers: Know your Blood Pressure, Cholesterol, and Blood Sugar numbers. Yearly wellness exams shed light on the silent killers like Hypertension, Hyperlipidemia which will otherwise go unnoticed until a catastrophic event occurs.
2. Weigh in on your weight:  Maintain an ideal weight. If you are overweight, set a goal to bring it to the ideal weight. If you are already there, make sure you maintain it.
3. Say No to Nicotine: Quit smoking! Even second-hand smoking increases the risk of heart disease. According to the CDC, it is estimated that second-hand smoke caused nearly 34,000 heart disease deaths each year from 2005 to 2009 among adult nonsmokers in the United States. If you are a smoker, do your heart and the hearts of your loved ones a favor by putting out your puffing habit for good.

4. Limit the Liquor: Drinking in moderation is helpful to your heart. Health benefits of red wine are well known and well studied. Men should drink no more than 2 glasses/day and women no more than 1 glass/day.

5. Food for Heart: Go low on the salt. Too much salt increases blood pressure and risk of heart disease. Avoid Trans-fat labeled as "Partially hydrogenated oils". Even though Trans-fat was banned by FDA small amount may still be present in the cookie, cake, pizza, and frozen food. Saturated fat found in butter, cream, red meat etc. are also harmful to the heart. Eat plenty of fresh fruits, vegetables, low-fat dairy, whole grains and less of processed food. Add nuts and seeds to your diet at least  4-5 times/week.
6. FIT(T) for Fitness: Get up and move! Start with small steps and aim for 10,000 steps/day. An exercise recommendation that focuses on the following points will be highly beneficial for wellness:
The Frequency of exercise, Intensity of exercise, Type of exercise and Timing. Check with your doctor before starting any exercise regime and get professional help from an exercise therapist or personal trainer when needed.

Take care of your heart and it will take care of you until...the last beat!

Paving a new path

As 2018 comes to an end, as many others I have been pondering on the journey that I embarked this year. The journey of life enriches every soul with different emotions, it takes us up and down the roller coaster ride.When I stood at the starting point on January 1st, little did I know that the friends whom I considered as my pillar of support were indeed the road blocks. So I decided to clear those road blocks to pave my way for a productive year. As I continued my expedition alone, I found great solace in the silence around me. I started to enjoy the little things in life that I had long forgotten being caught in the cobweb of relationships.The soft touch of morning breeze or fragrance of the flowers in my garden or beauty of sunset ...all seem so much pleasurable to see,smell and feel wholeheartedly. The clarity in my vision and mind improved so did my resilience,soon I found myself discovering greater destination on this road. I started covering longer distance, enduring uphill roads to find my destination...a place filled with happiness and tranquility.
Just when I was basking in my moments of success, I found myself being engulfed in a wildfire from the "Dark Web" called Facebook .The fire that initially started as a spark to ignite my spirit soon started to burn my soul. I looked around to find many victims of this wildfire who lost their money,friends,peace of mind and mostly importantly their privacy. I was determined to extinguish it around myself which was not difficult at all. My phone and my mind was no longer cluttered with notifications about irrelevant posts or overwhelming birthday reminders or unlikable "likes"!
I have lived and formed strong friendships in pre-Facebook era and was very confident that my bond with my real friends will always stay strong,so I let go off the Facebook friends ( should we even give those acquaintances the "Friend" title?)
After the smoke from the Facebook fire cleared,the scenery around me had already changed to different shades of yellow and the air turned to crisp cold signaling the arrival of autumn. The days were getting shorter and I was afraid that I will lose my way in the dark, winding road ahead of me. I was almost close to my finish-line and was determined to make it.Then came my guardian angel in a black and tan furry bundle whose warm body and lively spirit brightened my dark gloomy days. My four legged loyal pal guided me through the path ahead, her vigilance warded off all the dangers in my way. I walked confidently knowing that I'm being protected by my paw clad pal.
By the time I saw the first snowstorm of the winter,I was experienced in walking, jogging as well as hiking in all weather conditions. The coating of white brought peace and tranquility to my mind at the same time reminded me to be cautious of the slippery path if I don't pay attention. So I slowed down and walked steadily with my mind focused only on my target. On the way I stopped by the fire build with love by my caring family and true friends to warm my body and soul. It was Christmas eve and I was almost there! There was one sharp turn which I maneuvered it by preparing my body and mind with physical as well mental exercise. I was tempted to look back but my gut feeling told me to look ahead and  move on until I reach my destination....the New Year. I finally reached the finish line...it was a picturesque place as I had imagined with relentless parade of  silvery waves to the shore telling me never to give up and the golden yellow sun rising on the horizon sending message of hope and a new beginning. I felt gratified with the lessons that this path had taught me and I'm looking forward to start another exciting expedition in the upcoming year.

New Year...New Beginning

As we put away the Christmas decorations,clear the last piece of chocolate, throw away the left-overs from the holiday party, we realize that it is already New Year. A New Year signals a new beginning. A fresh start with renewed energy to overcome our challenges, a new chance to accomplish our dreams.
Once the calendar resets to January 1st, we suddenly feel an overwhelming urge to reset our bodies to the healthiest version possible. We jot down the list of things to achieve in the new year. Weight loss being the top most priority this year again for many, we are excited at the same time overwhelmed to navigate our way through the maze of diet plans,supplements and medicines.
Here are some quick tips to reach your optimum weight this year and also to keep it off :
1. Set realistic goals. Write down your goal weight, most importantly set a date especially if you have any upcoming event. The weight did not come on overnight so do not expect it to come down easily either.
2. Track your weight weekly on the same scale in the morning without clothes and maintain a log.
3. Focus on eating healthy. Allot time for smart grocery shopping, meal planning and preparation. This will go a long way not only in weight loss but also in improving your energy level,saving you money and time. If time is in short supply,make use of the food delivery services that caters to health conscious consumers with fresh ingredients and recipes delivered right to your doorstep.
4. Exercise can be fun. Sweating it off on the treadmill is not the only way to burn calories. Choose any physical activity that you enjoy doing, be it gardening or walking the dog but maintain a regime.
5. Make use of technology. Apps like MyFitness Pal, Fitbit makes tracking easier right from the palm of your hand.
6. Clear your mind of all conflicts. Emotional instability can lead to binge eating, insomnia, depression and weight gain.
7. Partner with a pal. Having a weight loss partner can be both motivating and supportive. Friendly competition like "Biggest Loser" among girlfriends, family members or colleagues can give you the best outcome.

Let this year be the one to tip the scale in your favor. Good luck.

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.