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Finding your balance as a doctor: Tips from David Samadi

As a very successful doctor, David Samadi has made lots of sacrifices on the road of becoming one of the leading urological oncologists, specializing in robotics and minimally invasive surgery for prostate cancer. It is a well known fact that at the age of 15 he was forced to leave his parents and little sister Heidi in Iran and flee the country with his younger brother Dan. During the eight years of living among strangers, in Belgium, the UK and, finally, the US, the only motivation for the two was the goal to succeed. After this lonely period, their parents and little sister were finally able to fly to the US and the Samadi family was reunited.

Dr. Samadi’s ambition to succeed was motivated by the sacrifices his parents were making back home in Iran. After they came to the US, his drive didn’t stop. He went on to complete his master’s degree, his training in urology and fellowships in proctology and robotic radical prostatectomy. His professional life has been on the rise ever since. He has performed over 7000 robotic prostate surgeries, pioneered the SMART technique that managed to achieve the Trifecta for most of his patients, has written many publications and held speeches internationally. More than that, he is often called a “celebrity doctor” due to his repeated appearances in Fox’s Sunday Housecall, on Fox and Friends, frequent articles in media publications, podcasts and videos on his personal sites. He even had a guest cameo on Law&Order: Criminal Intent, playing a prostate cancer doctor, raising awareness on the issue. These might appear hectic for the ordinary person, but Dr. Samadi enjoys every single facet of his professional life: “It’s a very exciting life that takes me from surgery, to broadcast news, to the Emmy Awards and then, the next day, I meet people from different countries, who I’d never meet if didn’t do what I do.”

 

David Samadi’s wife has been alongside him for 18 years now

In 2000, David Samadi met his wife, Sarah Danielpour, at Cedars Sinai Medical Center in Los Angeles, where she worked in Hospital Management. “I’m fortunate to have a wife who is a superb mom and a great partner,” Samadi says of his wife, who, like him, is from Iran. Together, they have two children, a daughter and a son. David Samadi’s family is a large and atypical one. Him, his brother, sister and 20 cousins are all doctors. He has 5 nephews only from his brother’s and sister’s side, so when the entire family comes together, Samadi and his wife have a full table.

His professional work does sometimes put a strain on his personal life: “My immediate family has paid the price. They would like to see much more of me”, Samadi says. Even though the thousands of patients he has had all these years have taken up a big part of the time spent in family, Samadi insists that all doctors must try to disconnect once in a while from their hospital lives and enjoy valuable time spent with their loved ones.

 

David Samadi’s tips for work-life balance

  • Find a favorite physical activity – Dr. Samadi was captain of the soccer team back in Iran and has always been a competitive person. He is an active person and still plays tennis, golf and other sports. Practicing sports can help reduce stress, clear the thinking, increase self-confidence. Any doctor should have a physical activity that gives him 1 or 2 hours weekly of time out from his/her medical practice.
  • Focus on your spirituality – Dr. Samadi was raised Jewish by his family and remembers how his dad taught him about Judaism on their 45 minutes drive to school. After all these years, even when apart from his parents, he maintained a close relationship to his spirituality: “I practice my religion every time I raise a scalpel. Taking care of all people regardless of religion and using my God-given talent to help others and save lives is what is imprinted on me from my faith.” David Samadi and his wife are active members of Temple Beth Shalom in Roslyn, NYC. Focusing on your religion or on whatever your inner motivation for helping people is, will give you purpose through the hard times and keep you going.
  • Go on holidays – Even though your schedule might be booked throughout the entire year, your patients won’t benefit from you if you’re tired, overworked, stressed out, on the verge of a physical or emotional breakdown from all the stress and responsibility. Try to empty your schedule at least once every six months and go on a trip with your family, for 7-10 days. When you’ll return, everything will seem more bearable.
  • Get enough sleep – This might feel like a dream to you, especially if you’re a surgeon, but the lack of sleep will, in time, lead to fatigue, daytime sleepiness, clumsiness and can affect the brain and cognitive functions. It could also affect your mood, your patience and overall well-being. Not sleeping enough will affect both your professional and personal life, so make sure you allow yourself to rest for as long as possible.
  • Delegate tasks whenever possible – Assigning some tasks, especially administrative ones, such as scheduling, filling up forms, ordering supplies and medication, to members of your team, will clean up your plate from not so important tasks. You will be able to dedicate yourself to the important issues of your patients and will be able to leave the practice once every appointment has been met.

Balancing work and personal life is a struggle for the modern man and woman, which increases in complexity, especially for those practicing medicine. Doctors are generous persons who, more often than usual, will sacrifice their personal lives for the wellbeing of their patients. Even though this shows dedication and passion towards the profession, being one-sided helps no one: not the patient, not the doctor and not his/her family. “Balance is not something you find. It’s something you create”. In other words, you need to make continuous efforts to be happy in both areas of your life.

 

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A second opinion for cancer can save your life. This is how you ask for it.

second opinion from doctors

Asking for a second opinion from a doctor can be intimidating, but that doesn’t mean you shouldn’t do it anyway. There may be several factors that refrain you from doing so, such as: the fear of seeming demanding, of being impolite by not granting him/her full confidence, feeling scared and wanting to commence treatment as soon as possible, not wanting to go through the hassle of finding another experienced doctor. Although these might feel legitimate to you, we believe that the reasons you should proceed with asking for a second opinion from a doctor, especially in the case of a life-threatening or serious disease, are much more compelling:

  • if you feel your doctor isn’t really listening to you or was hasted in making a decision;
  • if the treatment proposed is especially risky or toxic;
  • if you feel you’re being rushed inexplicably into making a decision;
  • if the procedure that is recommended involves the use of experimental instruments or devices;
  • if the recovery process for the initial procedure is especially long;
  • if you feel like your doctor isn’t interested in your case;
  • if he explains your disease using only medical terms which you don’t fully understand and refuses to be more explanatory;
  • if you’re in line for receiving experimental or trial drugs;
  • if the medical analysis or diagnosis isn’t 100% clear or accurate;
  • if the FDA hasn’t established a consensus or an approved treatment for your disease.

Doctor David B. Samadi says: “As a rule of thumb with most diagnosis, it’s always recommended to seek out a second opinion. This is especially true when you are diagnosed with prostate cancer, specifically before you have decided on a course of treatment. Seeking a second opinion is an invaluable way for a patient to verify certain facts about prostate cancer, such as the stage of cancer or location of the cancerous growth. Patients generally look for a second opinion because they feel an inability to communicate effectively with their current doctor. Some patients are also confused as to what is the best treatment and course of action for their scenario.”

If you decide on getting a second opinion, make sure to write down any question you want to ask or that you feel weren’t answered in your initial consultation. Regardless of your choice, just be sure not to take too long for deciding. While your disease can be slow growing, in most cases you don’t want to delay any treatment you may require, to prevent future  complications.

What’s the best way to ask doctors for a second opinion?

Even tough it might seem awkward, you should tell your first doctor you intend on looking for a second opinion. Doctors don’t need to feel threatened by this and they should encourage you to follow all the steps that might make you feel more comfortable with your diagnosis. A doctor who doesn’t support your need for a second opinion will lose your confidence. Telling him/her that you are interested in looking for a different opinion is an act of exercising your right to be in control of your body and your treatment and the first step in building a relationship with your doctor, based on respect, honesty and trust.

How to reach out for a second opinion?

One of the easiest ways of finding a new doctor is asking your current one for a referral. Most physicians located in the same area know each other from university, conferences or other sorts of gatherings, so they should have a broad reach in the field. However, if for some reason he/she refuses to provide some referrals, there are multiple sites you can access in order to find reputable experts in your ailment, near your location.

It is preferable that your first doctor will be on board with you asking for a 2nd opinion for one simple reason: you need to provide medical records from the moment you started making appointments to your first doctor, all test results, scans, treatments and medication you might have taken up until that moment. Cooperating with your first doctor will make it a lot easier for you to have access to these.

How should you approach the doctor giving the second opinion?

As in the case of the first doctor, honesty is at the essence. Being fair with your doctor, letting him know what your first diagnosis was and the specific steps you had to go through up until that moment, will be very useful and will save you a lot of time. Just be frank: “These are my test results, I have been diagnosed with X and given this medication. What is your opinion about this course of action?”.

Key to the conversation is trying to be as objective as possible when presenting your case: exhibit the battery of tests you’ve taken until then, all your medical history and your current diagnosis and treatment, without expressing doubt or overconfidence in your initial physician, or your expectancy to hear a certain answer. This way, his judgement won’t be influenced by the first opinion and he’ll be able to decide unbiased what will the next steps for uncovering your diagnosis be.

Find out if your insurance covers second opinions

Insurance companies handle second opinions in different manners. Before deciding who you should get a second opinion from, find out who your plan covers in terms of medical professionals and institutions you can approach free of charge. You may have to advocate for yourself quite loudly if there are better opportunities for your treatment at other facilities, outside your healthcare network.

 

Doctors are human too and sometimes they can make mistakes. You don’t want to go through with excessively long treatment or invasive surgery if you’re not 100% sure it’s the right way to go. Better safe than sorry!

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Preparing for Surgery – Patient guide

Preparing for Surgery

From the patient’s perspective, the period before surgery can be very stressful and full of unknowns. This is why it is crucial to prepare both mentally and physically for the big day.
Of course, you will need to follow your doctor’s instructions before anything else, but there are a couple of things you can do to prepare yourself on a personal level:

Surgery isn’t a passive event in your life. A highly cooperative patient, disciplined and ready before the surgery will always recover faster and have decreased risks towards complications.

  • Even if the surgery itself probably has the goal to reduce pain, you should try to diminish the number of painkillers you take before surgery; it will be easier to manage the pain after surgery. Please ask your doctor before dropping any kind of medication.
  • You need to make you home post-surgery proof, make sure you prepare your house for the period after the surgery, remove rugs and other objects that may cause you to trip over and fell or harm yourself in any way.
  • If you are a smoker, it would be for the best to quit smoking before surgery as well as after surgery, at least until you are fully recovering. You need to understand that smoking reduces healing by 25%.
  • Don’t take aspirins and anti-inflammatory drugs or other similar meds ten days before surgery because such drugs may have a negative effect and can influence the normal blood coagulation.
  • Keep in mind that there aren’t special meds you can take to recover more quickly; the recovery needs to be natural.
  • Most of the times you need to avoid food as well as liquids for at least 8 hours before surgery.

These were the general notes on preparing for a general surgery, but what do you need to do to prepare yourself for prostate cancer surgery?

  • First of all, you need to make sure this is the decision you want to make. Otherwise, prostate cancer surgery is a relatively simple operation.
  • You need to make sure you flush out any blood thinning medication before the surgery. Bleeding is a risk for any kind of surgery, and this is especially true for prostate cancer surgery, which involves operating around a lot of blood vessels.
  • The day before surgery you will probably need to drink only liquids and drop food intake altogether. Expect a ball-prep with magnesium something similar to an enema but done for the bladder by drinking a special liquid that contains magnesium. Also, expect your doctor not to allow you to drink anything after this prep as well as giving you nothing to eat at least a few hours before your prostate cancer surgery.
  • No matter the surgical technique used (open or robotic) as I said, are relatively simple and painless for most of the patient cases.

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Follow these 7 steps to prepare for surgery

Dealing with surgery is a fact of life. Most people go through at least one during their lifetime, be it dental surgery, appendectomies, cardiac surgery or transplants. Supposing it isn’t an emergency intervention, but a planned one, you should take your time to prepare yourself both mentally and physically. This step is important and a key factor in determining the speediness of the recovery, how to handle the pain and how quickly you’ll be able to return to your old life.
We have put together a checklist you need to go through in order to make the entire process as easier and hassle free as possible. Surgery isn’t a walk in the park, but following these steps can make you feel in control and more confident of the outcome.

1. Learn everything about the surgery – Asking your doctor all the questions regarding your intervention, such as dietary plan, risks, healing time and a detailed explanation of the steps involved and staff that will participate, will give you a clean perspective on what to expect and will make you feel less anxious.
Try not to get your information from the internet or other shady sources. Every person’s experience is different and you could be influenced in a negative way. The safest source of information is your doctor.

2. Follow a pre-surgery diet – Surgeries usually require dietary restrictions a few days before. Try to eat as healthy as possible to ensure nutrients, enhance your immune system and shorten the recovery time. You should avoid foods that increase the inflammatory response.
There are a couple of general rules you need to apply to your pre-surgery diet, a few weeks in advance:

  • Drink plenty of fluids that are easily digested by your body: water, black coffee (no added milk or sugar), lemon/lime juice, apple juice. Avoid cola, juice with pulp, milk, dairy beverages. These require lots of time to be processed by your body. In most cases, your anesthesiologist will recommend not drinking anything 8-12h before surgery, not even water.
  • Avoid foods with high-fiber content: meals that contain whole-wheat pasta, whole-grain bread, beans, oatmeal take longer to be digested. Your bowel needs to be clear before surgery, so your doctor will recommend a low-fiber diet.
  • Avoid medication and supplements that could interfere with the surgery: aspirin, vitamin E, vitamin C can increase blood flow.
  • Restrict foods that increase inflammatory response: sugar, white flour, refined carbohydrates, saturated fats, pastries, alcohol. They make your body susceptible to tissue swelling from bacteria and toxins, during the surgery or the hospital stay.

Each type of surgery may have additional restrictions. This is why you have to consult with your doctor and anesthesiologist at least a week before the intervention.

3. Strengthen your body – Being fit, flexible and strong is generally a good thing. You might consider getting in shape a few weeks before (if you have the notice of your surgery), which will help your body heal faster and you get around easier while in recovery.

4. Learn what to expect after surgery – You need to be aware of several aspects you’ll be facing after the surgery: how long after it will you be able to go home, how much pain will you be in, what pain-medication will the doctor recommend, will you need a rehabilitation program or somebody to stay with you. Make arrangements for someone to pick you up from the hospital and drive you home.

care after surgery

5. Find out the care you’ll need after surgery – The more complicated your intervention will be, the more days you’ll need to stay submitted. Information such as what machines you’ll be connected to when you wake up, what intravenous treatments you’ll receive, what assistants you can call on when you need something, what are the visiting hours, or the food you’ll receive, will help everything go smoothly.

6. Make arrangements in your home – When you’ll get home from the hospital, it’s likely you won’t be able to put on new sheets, arrange your pillows, or start cooking a light meal. Prepare everything beforehand and arrange with someone to cook for you or bring you some food. Make yourself a cozy spot, stack up on relaxing music, some movies, books and get a lot of rest.

7. Pack your bag – If you’re going to be submitted in the hospital for a few days, you will want to bring some items. A pajama, robe, slippers, your toiletries, your telephone and charger, books, even your favorite pillow and blanket. Pack anything that will make your stay more comfortable.

Nobody goes to surgery with a full smile on their face. As simple as it might be, you will likely feel a bit scared, intimidated and confused. Preparing for the intervention will reduce a big part of these feelings, especially if you know you are in the hands of an experienced doctor and his/her staff. The most important thing to anticipate is having supportive people around you, family and friends that will be with you throughout the entire process.

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The Surgical Team: Meet the 5 superheroes of the OR

Being a part of a surgical team is much like being in the army: it requires preparation, discipline and cooperation.

Surgical team operating room

We all see surgeons as rock stars – VIPs of medical care, all-knowing gods that walk among us and see over our well-being. Doctors usually have this effect over us: you often feel intimidated around them, because disease makes you vulnerable. But this shouldn’t be the case and you should consider surgeons more like frontmen of their bands, not solo artists. They may be the ones that do the talking, diagnose and prescribe treatment, but they also have a team of professionals that tend to the patient’s every need and make sure the surgery goes smoothly.

As with any other professional lineup, the surgical team also relies on the technical competence and preparation of each member. The level of stress can be much higher than that of other jobs out there. This is why it’s important that each member cooperates, knows their role and behaves appropriately. Leadership is of high-value and the chief surgeon is regarded as a pillar of moral and ethical grounds. His or her behaviour and interpersonal relations have a high influence on the overall environment, performance and cooperation between each member of the team.

This is the surgical team structure:

1. The surgeon – Surgeons are medical school graduates that complete surgery residency and receive all certifications required for practicing general or specialised surgery. They often specialise in a particular area of study such as trauma surgery, colorectal surgery, breast, vascular, endocrine, transplant, oncology. Key requirements are the full knowledge of the instruments required, on-going training in new procedures, the ability to make close call decisions to save a patient’s life and the overall management of the OR.

2. Anaesthesiologist – Similar to surgeons, anaesthesiologists complete 4 years of medical school and 4 years of anaesthesia residency. There are certain areas of anaesthesia that require special certification and training, such as cardiac anaesthesia. They are present before, during and after the surgery. It’s necessary that they’re informed about the entire medical condition and history of the patient before the procedure, in order for them to choose the best anaesthetic option. During the surgery, he/she will monitor the critical life functions – breathing, heart rate, blood pressure – and take any necessary precautions.

3. Certified registered nurse anaesthetist (CRNA) – the nurse anaesthetist is an advanced practice registered nurse (APRN). In order to become one, he/she has to complete one year of full-time nursing experience in a medical or surgical intensive care unit, followed by a master’s degree in anaesthesia and/or nursing, with a post-masters certification in anaesthesia. Nurse anaesthetists work under the supervision of a licensed physician, dentist or podiatrist and assist in anaesthesia care before, during and after surgery, labour and delivery.

4. Operating room nurse – The OR nurses have various responsibilities in making sure everything is well organised and the surgery can be performed under the highest operating standards.
• Scrub nurses ensure that all instruments are sterilised and layered out for the operation. They provide care for the patient before and during the surgery, attach equipment and monitors and pass instruments to the surgeon.
• Circulating nurses take care of all the documents required before the surgery and handle the procurement of instruments and surgical supplies.
• Registered nurse first assistants play a higher role in assisting the surgeons during the operation: they administer medication, control the bleeding, suture incisions, monitor vital signs, perform CPR.

5. Surgical technologist – The surgeon needs to concentrate on the patient, not on finding instruments. This is where the surgical techs chime in: they’re trained in hundreds of types of surgery and are able to anticipate next steps in the procedure, in order to provide the surgeon with the required instruments and equipment. In the US, they are graduates of surgical technology programs and can specialise in a vast array of surgeries.

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