Podcast transcript

INTRO
Welcome to Docs in a Pod, presented by WellMed. Over the next half hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts Dr. Rajay Seudath and former television broadcaster Gina Galaviz will share information to improve your health and well-being. And now here are Gina Galaviz and Dr. Rajay Seudath.

GINA GALAVIZ EISENBERG
Welcome to the award winning Docs in a Pod presented by WellMed. I'm your host, Gina Galaviz Eisenberg. Ron Aaron is on special assignment today. He loves those special assignments. I'm so pleased to have you with us. Our program is available on podcast wherever you get your podcasts. We're also on the radio in several Texas cities and in Florida as well. Each week, we talk about a variety of health and wellness issues that impact Medicare-eligible seniors and others. Drumroll, we welcome our Docs in a Pod co-host, Dr. Rajay Seudath. Welcome.

DR. RAJAY SEUDATH
Thank you so much for having me.

GINA GALAVIZ EISENBERG
You are also our guest today. We're going to talk about an interesting topic of morning routines to reduce stress and start your day. But before we start talking, I just want to toot your horn just a bit. You're a board certified family medicine physician. You're a Tampa native and currently a physician for Optum, and you're at the university location in Tampa. So, folks, go say hi to him. Dr. Seudath received his medical degree from the University of South Florida Morsni College of Medicine, and he has a passion for primary care and for guiding your patients to meet their health care goals. In fact, you even inspire me every time we get to visit. But before his career in medicine, he had many, many jobs, like most of us did, and he was working as an English teacher. I always feel a little bit of pressure when we're here visiting. Without further ado, Dr. Seudath, take it away. Tell us about these morning routines and how to reduce the stress before we even walk out the door.

DR. RAJAY SEUDATH
The most important thing on that prompt of morning routine is that word routine. I think for all stages of life, having a healthy routine is the number one thing to A, making sure you're ready for the rest of the day. B, making sure that you're using it to reduce stress and C, so that you're more productive throughout the day. So, that word there routine, routine, routine. Getting into a routine and sticking by it, that's really the first step when it comes to what are we doing. Because you want to stay consistent. When you don't have a routine, it's kind of chaos, and that can increase your stress levels. That in itself, not having order in your life can increase your stress levels. Because again, if you don't know what you're going to be doing, that can make you more anxious. It can worsen mental health disease That sort of thing. And again, this is for all age groups. All spectrums. So, if we're talking about patients who are retired or patients who have dementia, we often talk about having a routine is good for their brain. So, reinforcing that. Even if you've got children. What's the day of the week? What's the month? TheyÕre learning to use the time. They're learning to use the calendar. They're learning to manipulate time and master time. As we get into our elder years and we retire, we kind of stop manipulating time. Sunday could fall on a Monday, and IÕd never know. When you get rid of manipulating time, your brain kind of stops doing that over time. And that's one of the skills we want to make sure that we're continuing to keep. So, one of the things that you can do is just have a calendar, check what day it is, check the month, check the year. If we look at a dementia test , we're looking for a memory test. There's 30 points in those tests. The first three questions are what's the day of the week? What's the year? What's the date? That's 10% of that memory test if you think about it. Three out of 30 points is 10%. So, just by having that routine where I'm checking my time, I'm checking what am I doing today. I'm checking this kind of plan for the rest of the week or the rest of the month. That is ensuring that you are already decreasing your stress level, improving your memory. So, that's one thing. The word routine.

GINA GALAVIZ EISENBERG
And it's that simple.

DR. RAJAY SEUDATH
Yes.

GINA GALAVIZ EISENBERG
You're not talking about hiring a coach or a life coach or anything. It's just something you still have some control.

DR. RAJAY SEUDATH
Absolutely. I think that's the first step towards having a good morning routine. Then we kind of ask, to eat or not to eat is the question. You hear so many people say, well, I don't eat breakfast. I don't have time. Or I'm going to sit down. I'm going to have a three-course meal in the morning. What's the right thing? What's the right thing for your situation? As always in medicine, it depends. Breakfast in general, if we're having a lower saturated fat breakfast. Breakfast with more fruits and vegetables, more fresh, less processed things in the morning, like a dash diet or a mediterranean diet, that's going to give you more energy throughout the day as opposed to simply skipping breakfast.

GINA GALAVIZ EISENBERG
Right.

DR. RAJAY SEUDATH
That's one of the things. Now, again, do we have a specific goal that we're trying to reach with our diet? That's another question that brings into another element.

GINA GALAVIZ EISENBERG
Before we go into the next element, I just want to check in with the folks who may have just joined us right now. You're listening to the award winning Docs in a Pod with our co-host, Dr. Rajay Seudath, who's talking about, morning routines and stress. Just a reminder, our podcast is available wherever you get your podcasts. All right. Take it away. What is the next step? We're talking about diet. Do we eat first thing in the morning? What comes next?

DR. RAJAY SEUDATH
What comes next is we have to choose what you're eating. That's often dependent on your disease, depending on your goals. Are we trying to lose weight? Are we trying to lower blood pressure and cholesterol? Are we trying to stick to a low-carb diet for a diabetic person? There are many different diets that we can use, but like we said before, having a diet that's low in saturated fats, that has fresh vegetables or fresh fruits is going to be on the whole better for you. So, if we're talking about a diabetic diet, yes, we want to have low carbs, more lean fibers, complex carbohydrates. Things that are going to be better for you in terms of your sugars. Now, when we talk about breakfast, we talk about the morning, it always comes up intermittent fasting.

GINA GALAVIZ EISENBERG
Tell us, what is that?

DR. RAJAY SEUDATH
Intermittent fasting kind of goes two different ways. One of the ways to do intermittent fasting is I have an 8-to-10-hour block where I eat, and I don't eat the other times. Another type of intermittent fasting is I will have no restrictions on my caloric intake. Every other day I'll have a stricter caloric intake. So, one day I got nothing. I could eat whatever I want. The next day, I have 1,500 calories. No ifs, ands or buts. That's different from intermittent fasting where it's kind of a timed fasting. Timed restrictive fasting. So, I'm only going to eat for an eight-hour span. A person can do that and still have breakfast. So, the idea is, well, what's breakfast for you? If I'm on a night shift, breakfast might be at 9 p.m. So, I would say instead of using the word breakfast, we could use the word first meal of the day. So, your first meal of the day can still be within that guideline. Dash diet, low-carb diet, weight loss, lean proteins. Those kinds of things. It shows that when you do have fresh fruits, fresh vegetables, low-fat breakfast items, those do give you more energy. Those do give you less stress and less crash later on in the day. That's definitely been shown with multiple studies. That's one of the things that I would say is breakfast. I would say to eat or not to eat. The answer is yes, do eat.

GINA GALAVIZ EISENBERG
Eat.

DR. RAJAY SEUDATH
The second thing would be medications. If you have a routine, are you routinely taking your medications? That gets back into it, well, when should I take my medications again? The answer is that it depends. It depends on what's the disease. Some diseases it's better to take your medicines in the morning. Some diseases it's better to take it at night. Some medicines you have to take it 2 or 3 times a day.

GINA GALAVIZ EISENBERG
Right. Are you spreading it out depending on your schedule?

DR. RAJAY SEUDATH
Right. Exactly. Having that routine where you are staying consistent, that is the major thing is staying consistent. We were just talking about before we started airing, pill organizers. Having your bottles very clearly labeled. So, it's got a very small pit, but I would say a great majority of people are writing with a large Sharpie, AM, PM, twice a day, three times a day.

GINA GALAVIZ EISENBERG
WhereÕs my Sharpie?

DR. RAJAY SEUDATH
Yes, that's exactly right. Those are the things that we can do to stay consistent with our routine, which, again, can help to lower our stress by keeping our diseases under control, can help to give us more energy by making sure that we're not having our body become in some sort of derangement because our medicines aren't being taken correctly. There's different ways to do that. You can have different reminders. You can have checklists. For patients with dementia, I often tell the caregivers, I suggest you put a camera in the kitchen. So, when it's time for grandma to take her medicines and you call her and say, grandma, take your blood pressure medicines, you can watch her actually take them or not.

GINA GALAVIZ EISENBERG
ThatÕs very smart.

DR. RAJAY SEUDATH
Because she'll say, I'll do it, and then, lo and behold, you come back and the pillbox is still full. Oh, I guess I didn't take them. Well, why didn't you go and check them? I forgot. So, if you're a person who's going to be keeping a person accountable, you don't have to be there in person, but you can watch them take it and say, okay, you took your medicine. Great. Let's go and have your breakfast now. Or they have their breakfast and then they have their pills. I think that's one of the things you can do. Taking it with breakfast. If you have breakfast every day, link those together. Then the other thing is, if you have a partner, if you're married, if you're living with a roommate, if you have people in your house, make it so you all take your medicines at the same time.

GINA GALAVIZ EISENBERG
Right.

DR. RAJAY SEUDATH
That's a really good thing.

GINA GALAVIZ EISENBERG
The family who takes her medicines together stays together.

DR. RAJAY SEUDATH
That's correct. They stay healthy together. Absolutely. The other thing, and this is more for health care providers, more for people who are caring for people who have disease. What are the barriers to taking those medicines? If you can unlock what is preventing a person from taking their medicines and address that, that can allow them to keep to a healthy routine taking their medicines. Some people feel that there's a stigma with their illness. If they're a newly diagnosed diabetic, they may feel that, I just hate the idea that my body is betraying me.

GINA GALAVIZ EISENBERG
Right.

DR. RAJAY SEUDATH
Sometimes just talking about that can help them to work through that. Sometimes a person can feel helpless for their disease. A new cancer diagnosis, and they have to take their chemotherapy, and all of a sudden, they don't want to take it anymore. So, if you feel helpless for your disease, talking about that, working through that. If you really don't gel with your health care team, if you mistrust your doctor, maybe you need to come and see an Optum or WellMed doctor.

GINA GALAVIZ EISENBERG
Exactly.

DR. RAJAY SEUDATH
We have pretty good scores, but that's thing, if you're not trusting your health care team, that can make it, so you don't want to take what they give you. So, that's another barrier.

GINA GALAVIZ EISENBERG
That's a red flag.

DR. RAJAY SEUDATH
Yes. Absolutely. Then, making a regimen. If you have a medication regimen, the people who are prescribing that to you or giving that to you, it should be acceptable. You should accept the plan. It should be understandable. Do you understand how to do it? And it should be manageable. If I'm telling you to take this medicine five times a day and you've got really bad arthritis and you can't get the bottle open, that's a problem.

GINA GALAVIZ EISENBERG
That's a big problem. And that does happen a lot.

DR. RAJAY SEUDATH
Absolutely. Working to make sure that you're able to actually take the medicines and have them in a routine. I think that's one of the things that can definitely lead to a healthy stress reduction, improve your energy, and make sure that your diseases are controlled.

GINA GALAVIZ EISENBERG
We're talking about a morning routine to reduce stress and start your day. We're going to continue the discussion in just a moment. I'm Gina Galaviz Eisenberg, along with Dr. Rajay Seudath. We'll be right back.

AD
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GINA GALAVIZ EISENBERG
Thanks so much for staying with us on the award winning Docs and a Pod. Our podcast is available wherever you get your podcasts. I'm Gina Galaviz Eisenberg. Let's continue our discussion on morning routines to reduce stress and start your day. Dr. Seudath, you said something just a little while ago before the break about maybe it's hard to open your medication. I heard something about blister packages. What is that? And is that something that can help?

DR. RAJAY SEUDATH
Yes. For people who may have difficulty taking their medicines and have difficulty opening bottles, you can get blister packages. So, your medicines will come in a sealed package with blisters for each of the 30 days. You just go down the line and every day you open up your package and take your medicine. That's for each individual medication. It's not childproofed, so if there is a small child in the house, that may not be a good option. But for someone who may have dementia or bad arthritis, that's something that can help them to easily take their medications. One, they can see did they take their medicine for that day, and two, it's easy to get out. So, I think those are two very beneficial things for that.

GINA GALAVIZ EISENBERG
It is. I'm going to keep that in the back of my mind. Thank you.

DR. RAJAY SEUDATH
Moving along, what are the things we can do in our routine for the day? Exercise, exercise, exercise. That's a hard one, because if you're a working person, you've got kids to take care of, where do you find the time to exercise in the morning? Oftentimes when I say that to patients they say, doc, you're squeezing blood from a stone. How am I going to fit that in? And my response to them is often, you don't have to exercise for an hour.

GINA GALAVIZ EISENBERG
Right.

DR. RAJAY SEUDATH
When we think of exercise, we're thinking of this monolithic chunk of time.

GINA GALAVIZ EISENBERG
Driving to the gym.

DR. RAJAY SEUDATH
Right. I've got to get my socks on and my sweatband and change.

GINA GALAVIZ EISENBERG
Brush my teeth.

DR. RAJAY SEUDATH
Right. I've got to do all of this stuff. But to be honest, even if it's something as simple as stretching. Just a few yoga poses, and you could do them on your bed. There's a reason why one of the flows of yoga is called the Sun Salutation. It's because you do it in the morning and it makes you feel great the rest of the day.

GINA GALAVIZ EISENBERG
I've started doing this thing in the morning where to wake up, and it maybe takes three minutes. I'll start doing bicycles in bed. Forwards and backwards. Then sort of like chair aerobics. I'll sit up and I start doing some crunches, and then maybe I will even do some arm things just to stretch. Then that's when I get up. For me, psychologically, I feel like, oh, I did something.

DR. RAJAY SEUDATH
Yes. That something is absolutely beneficial. I tell patients, every little bit helps. There is no wasted effort when it comes to exercise. Sometimes what we can do is we can mix different types of exercises. So, sitting on your back and doing the leg bicycle, that's more of an Arabic type of thing, right?

GINA GALAVIZ EISENBERG
Right.

DR. RAJAY SEUDATH
If you had bottles of water and you wanted to over your head do some small curls. Now you're getting anaerobic resistance training into it. Then if you wanted to add on some stretching while you're in the bed or youÕre at the edge of the bed, you're getting one of each three parts of that exercise routine. Even if it's only for five minutes or ten minutes, that certainly adds up if it's part of your routine. We recommend 90 minutes of exercise per week. So, if you're doing ten minutes every day in the morning, if you only do it Monday through Friday, that's 50 minutes. You're already halfway to the goal. That's just in the mornings. The amount of energy it gives you, your flexibility, you will feel a difference when you do that, and feeling better, that lowers your stress levels. Then if we're talking about weight loss, if a person is using their breakfast to lose weight, more activity burns calories. That kind of pushes you further towards that weight loss routine, which again, makes you feel lighter, gives you more energy, helps to lose stress. So, those are all great things.

GINA GALAVIZ EISENBERG
Even doing squats in the kitchen because you're able to hold on to something and you're not going to fall.

DR. RAJA
Y SEUDATH
Yes.
GINA GALAVIZ EISENBERG
IsnÕt the mind frame also so you can keep your balance?

DR. RAJAY SEUDATH
Yes.

GINA GALAVIZ EISENBERG
Because if you don't use it, you're going to lose it.

DR. RAJAY SEUDATH
Absolutely. Those are very easily part of the daily routine. Then you can have your formal exercise days. So, if you're a retired person, you're over 65, use those Silver Sneakers if you have that as part of your benefits. If not, go to a group exercise. Morning tai-chi is a really cool thing to learn.

GINA GALAVIZ EISENBERG
That sounds cool.

DR. RAJAY SEUDATH
It's amazing to see that group fitness of everybody doing those movements and motions all at the same time. And as you do it, it's like there's a synergy between organisms and people, and you really feel connected. It's a cool feeling. That's one of the things that in most cities, in most towns, there's usually a tai-chi society or something like that where people can go and join. So, that's a cool thing to do. We talked about breakfast, medication, exercise, daily planning. We talked about that at the beginning. Daily planning, planning your day. I talked about how that's very good for memory preservation when it comes to dementia. You're developing a therapeutic environment, but it's also good for mental health. We're talking about stress reduction, how to kick start your day, how to make sure that we're having a good start of our day so we're good throughout the entire day. One of the things you can do as part of your morning routine, if you have anxiety, depression, PTSD, agoraphobia, problems where getting out and starting your day, even depression. People who are clinically depressed, you don't want to get out of bed, right? You don't want to do anything. You don't want to face the music so to speak. You don't want to be a part of society because you're depressed, because you're having this mental health change. So, I say your morning routine is a good time to start your coping strategies. Regardless of whatever the mental health disease that you're dealing with is, use your coping strategy for your particular disease. Start with that in the morning. You may reinforce it throughout the day. But getting that under your belt, getting that mindset set for the rest of the day can really give you a boost to your productivity, to your energy level, and lower your stress. So, I think those are some of the cool things. And there's many different coping strategies for many different types of diseases. One of the ones is for anxiety post-traumatic stress disorder. So, let's say a person has PTSD. They wake up in the morning. They had a really bad nightmare for whatever was the traumatic event. And they're still feeling their hearts racing. They're sweating. One of the exercises is called grounded. I was just pulled back into my traumatic memory. So, I need to ground myself in reality. The wall is white. My bed linens are red. My alarm clock is blinking. I can hear the birds outside. The sun is shining a bright orange red. So, you're just describing the things around you to ground yourself back into reality. That's one of the coping strategies for anxiety. So, for the many different types of mental health that we may have that your health care team may direct you to use in the morning is a great way to start off your day with that coping strategy.

GINA GALAVIZ EISENBERG
It's okay if you didn't do everything you needed to do the day before. A new day, a new beginning.

DR. RAJAY SEUDATH
Absolutely. That's actually one of the things that I think is great that you brought up. A new day, a new beginning. You didn't finish everything that you needed the night before. The night before can play into your morning. So, how good was your sleep the night before? Are you on night shift? Do you have insomnia? Are we doing things to ensure that you're having good sleep? That's another way to prepare for your morning, to prepare for your next day is as you're winding down to go to sleep, are we doing the things to ensure we're having good sleep? Dark rooms, making sure that we're not watching screens an hour before we go to sleep, making the room nice and cool, no loud sounds. Those are the kind of things that we can do to make sure that we're having good sleep so that we wake up, we're going to have a nice, good morning.

GINA GALAVIZ EISENBERG
WeÕre going to wrap up because we have about 20 seconds.

DR. RAJAY SEUDATH
Oh my gosh. If you didn't have a good night, one of the things you can do is eye drops. You can make sure that you're having nice flavorful things in the morning. Then the exercise. Those are the best ways to wake up. My gosh, the time went so quickly.

GINA GALAVIZ EISENBERG
I know. And if you didn't catch all this, you'll just have to go and listen to the podcast when it comes out. Thanks for joining us today on the award winning Docs in the Pod. I'm Gina Galaviz Eisenberg, along with Dr. Rajay Seudath. In the words of the late Charles Osgood, I'll see you on the radio. We'll see you next time.

DR. RAJAY SEUDATH
Bye-bye.

OUTRO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.

DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.

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