So I have been more observant these days as I am trying to cleanse myself from the digital, cellphone, media word. Ironically I am on the computer writing this but felt if everybody is on their cellphone chances are they will read this and reflect upon their own behavior. 

I am writing this in LAX airport. I have walked literally from bathroom to my wife sitting about 20 feet from the bathroom and have already counted 30 people, 20 people on cell phones, 1 actually talking on the phone, and the rest reading some form of paper media, shocking I think not! 

People are obviously not emersed in their surroundings, shoot I have a baby trying to smile and giggle right in front of the guy and he doesn’t even realize my wife is breast feeding in front of him. Are we so cought up by stupid digital media. Is this the way humans are going to interact. 

We all need a digital cleanse even if it’s a few weeks. When hanging out with friends just have one bring a phone for emergencies. No phones while eating and don’t sleep by your phone. You are a slave to it, and it is consuming you, your children, and their way of expressing emotion on a most purest level. 

Even if you use your phone to wake you up just invest in a 5 dollar alarm clock. Stop the excuses and limit the digital stuff. Be more human, interact with a stranger, a wife, a husband. Increase your social network in reality. Not Facebook, instagram, etc. I believe Americans have about 1.5 friends per person. Let’s make this 10 or even 50! 

– Dr Sarela 

So tonight while I admitted a patient today I felt sorry for him. He was clearly in need of a lot of medical help and assistance. Disheveled, very sick, while having a raging cellulitis & pneumonia. He was homeless and I decided to look into homeless rate statistics. I live in Tucson, AZ and according to the Hope and Glory Ministries in “2015, DES reported 2,957 homeless in Arizona, a 18% increase from 2014. Pima county accounting for 15% of the states total population, and 16% of the states homeless population.” 1762 homeless people on Jan/2016 per the Tucson/Pima Coalition to End Homelessness (TPCH) was recorded per their information gathering. Of this population 479 had mental illness, 460 with substance disorders, 90 with HIV/AIDS, and 333 victims of domestic abuse, 281 were veterans. Obviously this is not the most accurate information, as tracking every individual can be challenging but give a rough idea.

Look up the rates in your city! You may either be shocked or not at all. Next time, when you see somebody on the street, rather than judging what could have been the cause of their homeless state – just offer them good wishes, food, etc. Count your blessings, and reflect that even you think you have it bad, somebody else is going through something 10x harder.

Proverbs 14:31 “Whoever oppresses a poor man insults his Maker, but he who is generous to the needy honors him.”

-DR SARELA

As I continue to work as a Hospitalist, I decided to ask a Nephrologist what do you think about medicine. He mentioned, “The only thing that is guaranteed in medicine is CHANGE.” Now this doesn’t mean all change is good. There have been new policies that help the hospital, and others that a detrimental. He also mentioned, that when your just getting the hang of it, it changes!  However, the consequence is staff either breaks or adapts. At this moment in time, staff is usually abandoning ship, to seek easier lifestyles, better pay, etc. In return, the hospital suffers because of lack of staff. I had a conversation with my patients mother (who also works in my hospital) and felt her frustration. She was so saddened, and embarrassed to recommend her family or friends to her own hospital for healthcare. She understands, as a nurse herself that the shortage of help, nurses, techs, secretaries makes the art of medicine very hard, and inefficient.  The shortage of staff, failure to recruit, to save money is a HUGE mistake. Hearing the mother of my patient vent about the system, I urged her to be proactive and do something about this. Hopefully she will write a letter to management and the board, advocating for change. If the general population wants better healthcare, don’t wave a flyer and complain on TV. Fight for your health care, your human right to be happy and healthy, and have healthy conversations with people who can make change!

Stop complaining, and be proactive for change!

DR SARELA.

 

I had an eye opening chat with my wife a few days ago. Apparently, work has made me a mess! I never new it was this bad but from my wife’s perspective I was a train wreck. I didn’t think work would consume me. After looking at myself and examining the past 3 months I have given a lot up. I am having longer days, so I have been taking work home, charting, billing, dictating reports – you know doctor stuff. I usually never take work home. I am finished, mentally clear, and ready to be a husband and dad for the family.

However, when I come back home I am still in “game” mode crunching the numbers, working (not getting overtime). I figured why am I killing myself for no reason. I have stopped doing the things I love. I use to play the Ukulele and watch YouTube videos, learning new notes and songs to play to the baby! This gave me joy, challenged my mind, and made the baby happy. THIS WAS TOSSED ASIDE, as I felt would impact work. I use to cook on a routine basis, watch basketball, work out at the gym, sit around the fire pit in the back yard and meditate, work on my car, play video games, talk to friends, have healthy conversations about not work, travel more, yah get the idea – ALL TOSSED ASIDE.

My whole life has become consumed with being a DOCTOR. For Lent, I have made a goal. I will not talk about work. It will be a challenge but also the thought of letting go what doesnt really matter the most is also a HUGE relief. So for the next 40 days or so, I will be working on achieving clarity, reclaiming the joys in my life!

Enjoy all

DR SARELA.

I decided to be a nurse for the week. I took off the white coat and dressed in blue scrubs. I blended in nicely, but in reality I got an awakening! I’ll share with you the highlights.

Usually when I walk the floors with a white coat, the sense of accomplishment, people saying hello, and indirectly strangers moving out of your way was over. It seems that the general populous in the hospital still respects physicians, which I am happy to say. However, when I disguised myself, I didn’t see much of the same respect! When entering the medical floors, I could command some “attention” even to the point of breaking nursing rounds, having them stop and focus on another pressing matter, nurses saying good morning. Sadly, when I entered looking like a nurse I was left to my own. No welcome greeting, can I help you, you look lost, nothing. I did deep down like the sense of being forgotten for a change. Usually when Dr Sarela enters the floor, I get ambushed with the night nurses trying to ask last minute questions, so they look prepared for the change of shift sign-outs.

As Nurse Sarela, I decided to see how it would be to pick up a patient from a post procedure. This was a wake up call. The room was still quiet, no offered assistants to the newcomer to the unit. I tried asking about a patient, <details voided to protect the involved parties>  and received the pleasant sounds of crickets. I wonder what the outcome would have been if I wore my polished shiny white coat. Do people respond as if there is a higher authority in the room. I feel this may be. Rather than working as a team people still look at the medical “team” not as equal players, but a ladder of authority/ownership/responsibility.

I now sympathize with my wife when she tells me she is burnt out from nursing. In her opinion most families/patients don’t care about the person who is by the patients side, responding to their request, helping them with their food, cleaning after them and doing all this for 12hours a day with a smile. Talk about better service than in a hotel. I see why my wife went back into school for a masters in nursing. I can understand why the burnout rates are so high for nurses. It’s tough work, dealing with patients, families, and being the first one always at the scene. Being the first to be yelled at. Being the first to be spit at. Sadly medicine has become one of patient care to consumer/customer care. Were not focusing on the aspect of medicine that makes us want to help others. Were focusing on the quality, the metrics, the length of stay, the money, the customer. The patient is seen equivalent to a mere customer at a retail store, a restaurant, an IT help line. REALLY, this is pathetic and sad.

This past week was tough. Even though disguised as a nurse I had the attitude of a physician. It’s probably why I got in trouble with administration twice during this experiment. But hey, hopefully people can wake up and realize what is occurring. Most educators, higher ups always ask, “See how it feels from the patients perspective.” I feel, another valuable vantage point is, “See how it feels to be in another colleagues shoes.” Wether it is a nurse, phlebotomist, cook, janitor, etc. Just try it, will it make you uncomfortable, sympathize, have empathy for them?

Overall, this experience has made me more pissed off than anything. I am saddened what I have learned, and observed. I am saddened that when I advocate for the patient rather than the hospital I get blamed. That nurses don’t acknowledge there own colleagues at times. That respect only comes when a white coat is on! That medicine and the way of doing things is to support the “customer” rather than the “patient.” I am saddened by a lot that is occurring. I pray for our new government, and president that we can move towards a better system.  A better way of interaction and a better way of caring for each other.

In the mean time, I can’t wait to put back the WHITE COAT on again….

-DR SARELA,

 

I finally took a long look at myself in the mirror. I did not like what I saw. I was lazy, and stressed out by the newest addition to the Sarela family. My diet went to trash, and my energy crashed. I found myself in a matter of 2 weeks lacking a goal and direction. Lost, I found some random inspiration on YouTube of all places. I decided to make a list of goals with a time frame starting from the present till the end of the year. I picked the top goals I came up with and settled on my favorite 5 to be more realistic. I now have my goals listed on my computer to remind me daily.  Now that I have direction, I feel better, have more confidence, and achieved some mental clarity.

I feel that most of my patients I interact with move along in life without a goal or purpose. I asked a gentleman aged 101 what is the “Coolest thing you have seen in life?” His response was fairly bleak, ” I wake up, I eat my breakfast, and I go to sleep.” Granted he may have had aspirations in life when he was a younger man, but this outlook on life seemed as if he was just waiting for death. I do not want to be in this position ever. It takes great self reflection to see what is missing in ones life. Even the young are guilty of this “acceptance.” Most are content with a crappy job because it pays the bills, fail to climb the social/corporate ladder because of fear, or keep unhealthy relationships because it takes effort to make new acquaintances/friends. Its this passive nature although simple and easy turns out to be very unhealthy in the long run.

All in all, when you feel lost, have no direction in life, and are caught in the mud, set up a inspiration wall, people you want to mimic in life, a goal list. Something to look up to and better yourself. This is another way of living healthier.

-DR SARELA.

Sorry viewers the posts have been slow. I have been nesting and planning to have a baby enter my life. He now is HERE and doing well. Sleeping a lot, pooping a lot, and crying a lot. Overall a big joy and pleasure to hang out with and watch grow day by day. I am embracing the challenge of being a good father and husband. Every time the baby shakes, cries, does something out of the usual I am busy researching it. Impower yourselves with knowledge about your own health, and you will better your own lives! 

-Dr Sarela. Sleep well, get rest, and enjoy your days off with the family! 

Good question! Yes doctors do recommend getting a “pneumonia shot.” Exactly what is this though? The vaccination is done to protect people specifically from Streptococcus Pneumonia, a type of bacterial pathogen. This vaccination is called the “Pneumovax.” It is created from dead bacteria to formulate the vaccine. This bacteria is one of the common causes of death in patients, and thus the creation of this vaccine. HOWEVER, people can still get pneumonia. There are many types of bacterial strains out in the world. For example the “Pneumovax 23” only covers for the 23 serotypes of Streptococcus. [Think of the serotypes as different  bumps and grooves on the surface of the Streptococcus bacteria causing different morphology recognized via microscopic evaluation.]  There are other bacteria to name a few such as Staphylococcus Aureus, Haemophilus Influenza and Klebsiella Pneumonia which can commonly cause pneumonia too. So remember, vaccines protect or reduce your chance of getting pneumonia, they are not 100% preventative.

Keep Healthy – DR SARELA.