There is a lot of confusion regarding when to start blood pressure medication. I will try to explain it very simply so that you don’t have a headache! The latest recommendations for blood pressure management are found in the JNC 8 guidelines. Essentially a lot of the information is obtained and adapted from European studies.  The quick and simple is outlined below:

Now and days people are consumed with work, money, and how many hours they work. Get a hobby and dedicate some of your time and energy to this. It will distract you from the daily work hustle and allow your mind to detox. For example, I created this blog, but I have realized putting my energy into this is also quite relaxing. I am able to voice out my opinions, even if nobody may listen or read it. Its cathartic! I also watch basketball, even though my Lakers did not accomplish anything besides the NBAs worst record performance. But it still allows me to vent, and get some stress of when cheering for a team. At the end of the day find an outlet besides your daily routine and your mind and body will rejoice!

Happy living – DR SARELA.

An A1C is a blood test physicians use to check if your a diabetic. A level greater than 6.5 indicates that your a diabetic, and your sugars have been elevated for over a three month time frame. It is always a great idea to remember your A1C levels. The lower the A1C the better your sugar control. The higher the A1C the worse your sugar control. Ideally by eating more healthy, eliminating simple sugars, and exercises will lower your A1C. You just need to be motivated! By remembering your A1C trends you can determine if your improving or heading on a downward spiral.  

Above is a rough diagram that can help you understand the A1C level. If your PCP tells you that you’re A1C is 9.0, this means on a daily basis your sugars are hovering around 215. This is high! Ideally optimal sugar ranges should be in the 115 – 150s. If your not at that level, your primary care doctor needs to adjust your current diabetic regimen and make it tighter to bring you into the more optimal range.

On the flip side, a A1C of 5.0 means your diabetic regimen is to strict. Your medications are to high, and need to be backed off. The reason why, if your current regimen is to strict it can lower your sugars and cause the body to be lethargic, confused, or worse potential death if sugars are to low.

Happy eating, DR SARELA

 

 

 

So the common question of the day while working was, “How do I prevent CHF from happening?” Sadly, patients diagnosed with CHF lack the simple tips to prevent getting into trouble. I am amazed that even patients that have been diagnosed with CHF in the past and have lived with this for years are not even educated by their cardiologist or primary care doctors. Below I have outlined simple rules to follow;

1. Always weigh yourself every day usually in the morning when you have not eaten anything. Any change in weight by 5 pounds or more despite eating the same routine diet is concerning for retaining fluid in your body.
2. If your legs are becoming more swollen, your abdomen more firm, or if your having trouble laying flat there is a high likely hood that you’re retaining fluid.
3. Remember, sodium is not your friend. Patients should read nutrition labels. A max of 2 grams of sodium should be consumed in a day. Any higher than this the salt will cause you to retain fluid. Think of salt like a magnet for fluid.
4. Always be complaint with your cardiac medications. Even missing a few days if you have a weak heart can put you into congestive heart failure.
5. Remember fluid restriction, fluid restriction, fluid restriction. I like to imagine a 2 liter pepsi soda bottle. You should only be consuming about 75% of the bottle in fluid on a daily basis. This includes, coffee, milk used for cereal, soups, water, juices, gravy. Essentially anything in your diet that has a liquid form. One should always document how much they have consumed so you don’t go over the limit

Hope this helps, to clarify a simple way to understand and live with Congestive Heart Failure. – DR SARELA.

I have heard a lot from my patients on how to get healthy, and what to do. The magical advice really is to just start doing something! For example, I decided today that I would buy an exercise stationary bike. In my mind, I always made excuses to not go to the gym even though I am paying for a trainer, a membership for my wife and myself. However, after buying the bike I decided to do 30 minutes a day if I did not go to the gym. Just this simple act has eliminated my excuse for not doing cardio on a daily basis. As of now, I have increased my cardio, feel more energized, and have a better wellbeing. At the end of the day just start something, even if its simple like eating a apple a day.

As a physician sometimes I take for granted that my patients understand what I am saying. Granted I try to speak very simply, and use analogies to convey my point, however, it is not a fool proof method. I understand when a family member is going through a tough time they become overwhelmed that even common sense goes out the window. Take for example, a patient of mine who I consider quite smart, (a engineer with a masters, and a MBA) could not comprehend that his blood pressure was linked to his stress at work. The most simple logical conclusions for an engineer did not make sense anymore. Granted the patient was occupied with a newly diagnosis of cardiomyopathy, a recent heart attack, and coming to terms that his ability to run a 5K would be severely hampered.

Knowing that common sense can be lost in a setting of confusion, I feel taking the time to listen, answer questions thoroughly and honestly is the utmost priority. The purpose of this blog will fill that void.

Welcome to my blog/website page. It’s in the early phase of design, but this will be the virtual birth of my personal company Sarela Medical PLLC. A slow but steady dream and vision to provide medical services to the community. The aim of this company is to provide concierge medicine, and an overall different doctor-patient interaction.

-DR. SARELA.