Episode Transcript
[00:00:00] Speaker A: Foreign.
[00:00:11] Speaker B: Welcome to the Comeback with Boomerang Healthcare, your podcast for relief, recovery and restoration. I'm Dr. Peter Abachi.
[00:00:20] Speaker C: And I'm Dr. Sarah Guzet. As doctors, we know healing isn't just about treatment. It's about having the right tools for mindset and support to move forward.
[00:00:30] Speaker B: You can have pain, you might be injured or even hurting on the inside, but with all that you got going on, you can still have a really great life. And that is what we are here for. This is the Comeback. Let's get started.
[00:00:45] Speaker C: Joining us today is Dr. Anu Navani, Chief medical officer at Boomerang Healthcare and a leading expert in pain medicine. She's board certified in anesthesiology and pain medicine. Dr. Navani has authored national guidelines on opioids and interventional spine procedures. Angie serves on multiple national boards, shaping the future of pain care. We are so excited to have you here with us today, Dr. Navani.
[00:01:09] Speaker A: It is really exciting to be here. Thanks, Dr. Bachi and Dr. Gouzet.
[00:01:14] Speaker C: We have so many questions for you. So tell us a little bit. How did you get started and interested in medicine?
[00:01:22] Speaker A: Well, you know, it's really an interesting question and I don't often talk about it, but let me tell you first off how truly blessed and honored I feel to, to be a physician. It gives me the ability to help people and make a difference in other people's lives. And I'm sure you both can relate to that.
But truly, I got interested in medicine because I saw firsthand what happens when people don't have access to quality care.
My mom actually didn't keep very good health and she lived in a small town in India and there weren't enough resources or providers who could help her.
And just watching her go through that made me realize how much of a difference compassionate, competent care, medical care can make.
And I wanted to be that difference for people. You know, I wanted to make that difference for someone, someone else, someone else's family.
And so I was fortunate to study medicine. I actually happened to study medicine in one of the first schools of Asia. I found out later after I already was in the med school. It's called Calcutta Medical College. Calcutta, the same place in India that Mother Teresa used to be.
And it so turned out it was the first med school of Asia.
[00:02:34] Speaker B: You went from a small town, maybe not a lot of doctors. Sounds like not a lot of health care.
How did you, how did you get into med school? How did. I mean, was that hard in India or was it accessible?
[00:02:49] Speaker A: Or, you know, I get asked that question a lot. But if you know India and Indian parents, there's a lot of focus on academics there. Right.
And in this town that I grew up among great work ethics that my dad showed me, and the discipline that my mom brought to the table, and the fact that there were not too many distractions growing up, I just followed my sister's footsteps. She happened to be a great student. She actually was 13th all over India and first in our state. And those were big shoes to fill. But I enjoyed. I had some amazing mentors and teachers along the way.
I was truly inspired by my sister who I followed in med school. Not the same med school, but in medicine. And, you know, I just met the right people and, you know, the right teachers in the school that guided me in the right direction. And once I was in that med school, my gosh, the training was phenomenal. And it was a government school, so a lot of access to care and lot of seeing very varied cases and taking care of care of some rare conditions as well as very commonly the common conditions. So it was an amazing journey. And I think India is very strong when it comes to academics. So, you know, that foundation really came in handy in shaping my future and getting into med school.
[00:04:22] Speaker C: And of all the various fields of medicine, how did you find yourself in pain medicine? Tell us about that journey.
[00:04:31] Speaker A: Yeah, you know, when I started anesthesiology residency and I was fortunate to go to Medical College of Wisconsin, Milwaukee, where they started me off here because I was finishing up a research project at UCSF that was going to end later in the year.
I realized that very first year, although I was very encouraged and excited about anesthesia, I really felt I needed that patient interaction. It wasn't me to put the people to sleep and then not talk to them for hours on end. Surgery was going on. I wanted like a two way communication and being there to make a difference in their lives and so on. I'm like, okay, I got to do something where I can really talk to awake people.
So I knew that in my first year of residency and accordingly, I took a lot of electives all through that would shape my career in pain medicine.
And I was really intrigued and inspired by what I saw throughout my journey.
Although it started from something that I really wanted in terms of, of managing pain in people, but it really became more profound and more paradigm as I saw how poorly managed or mismanaged chronic pain really was.
The story of pain is often untold. A lot of pains don't surface and show on the physical appearance.
And that's why they're commonly misdiagnosed or overlooked or misunderstood. And I really felt I wanted to be that person that read in between lines and really understood that physical and emotional, emotional pain people had that was not on the surface and make a difference if I could. So that kind of transpired my journey in pain medicine.
[00:06:13] Speaker B: You know, Dr. Navani, I remember when I was doing my anesthesia residency and you would spend hours taking care of people sometimes in an intense way, right? An acute intense way. And they're asleep, but you're, you know, working hard. And then you finish, you take them to the recovery room and everything's good.
And then the next day they want you to go back and you know, check in on them, say hello, make sure everything is going okay. You kind of make these post op rounds and you walk in the room and you say, hey, Mr. Smith, Mrs. Smith, how's it going? And they look at you like, who are you? Do I know you?
[00:06:53] Speaker A: Totally, totally.
[00:06:55] Speaker B: You realize that you don't. Even though you've invested a lot of your mental and intellectual capacity and energy and trying to take good care of somebody, you don't have that connection in the same way as you do when they are seeing you in a clinic in an outpatient setting for pain management or chronic pain.
So I totally get that. And I think, interesting you and I kind of coming into it on the anesthesia side. We're one of the first people, one of the early ones, into what was a new specialty at the time.
Maybe you could speak to a little bit about what it was like as a new specialty at that time for you and for what was going on in the country.
[00:07:41] Speaker A: Yeah, absolutely. You know, although, you know, if you think about the history of pain, it dates back to like 3000 BC, you know, when it was thought, of course, of gods. Right, Gods to have pain. But we've come a long way and even in 1900s or 2000s that we really stepped into the field in a serious way, it was a whole lot different than it is now.
The access to care was a big issue as well as the technologies that we currently have that we didn't have then.
And so much has changed, Right.
If you just look at the chronology of differences that pain has seen in United States as well as overseas, starting from the definition of who that International studies. I'm sorry, definition of pain that came out from the International association for the Study of Pain, which was very subjective and really nobody knew what was being talked about to pain being the fifth vital sign and the Rise and fall of the opioid crisis. I mean, we have seen it all, right? We've also gone from a single electrode to now the capacity of neurostimulating people, any nerve, anywhere, anytime, with any type of parameters that we want. So we have really come a long way. But I think one thing that has really stuck on, and I think we all three here could relate to that, is the multidisciplinary integrated care that we take a lot of pride in. You know, the concept of functional restoration programs or helping people with rehab care came about in 1950s or 1960s, predating our coming into pain medicine, thankfully. So, because that was already there.
But really bringing it out to the people at the point of care was something that we all are proud to do because we have so many locations that administer multidisciplinary care.
As you know, it came out in University of Washington and Mayo Clinic to start with. But I think that is such a strong biopsychosocial model of addressing people with pain and not just giving them a pill or not just doing a procedure on them and saying bye. It's just hand holding them through the whole process and making people out of patients, as we commonly say. Right. In our practice. So that has been truly gratifying, I think, of all the things that are out there, you know, and there's so much technology change, and I'm sure we'll hit on some of those now.
But I mean, one thing that really, truly stands out is that whole multidisciplinary aspect of pain where we really take the patients from, you know, where they started and bring them right back. And rightfully so. Boomerang healthcare. Right.
You know, we're taking functional patients and boomeranging them back to functionality again.
[00:10:36] Speaker B: So when you, when you say multidisciplinary, what is that? What do you, when you, what do you. How does that, what does that mean to you?
[00:10:43] Speaker A: Well, I feel like it's multi specialties working under one roof in a comprehensive, integrated fashion. I mean, it's the medical doctors like you and me, as well as mental health physicians like Dr. Gouzet, right. That make a huge impact in patients care. Our physical rehab experts, physical therapists, chiropractors, and even ancillary providers, acupuncturists, nutritionists, vocational counselors. I mean, if you really look at chronic pain and how that impacts people's lives and how that gets them into variety of mental health and emotional behavioral conditions, as well as lack of job, lack of family, social interactions, I mean, it just takes them for A really vicious cycle ride. And just to get them out of it can be a huge endeavor. And I don't think any of us alone could do that if we didn't have all the specialties working together as a team.
[00:11:35] Speaker C: That's fantastic. And I think it's so important, as you kind of stated, that there is a bit of a history with multidisciplinary programs. And I'm wondering if you can speak to some of the other programs that you've seen that are not just for single diagnosis of chronic pain, but some of the other conditions that are commonly correlated with that.
[00:11:54] Speaker A: Yeah, of course. I mean, we talked about functional restoration program that's for chronic pain. But then other conditions like post traumatic stress disorder, one can actually release benefit getting those patients out of what they're feeling and what they're experiencing into functionality and normal life through a program called Trauma Recovery Program that boomerang takes a lot of pride in administering and that is mental health. Strong program, but it also incorporates other aspects of functionality and getting back to work and getting reintegrated back to society as well as if you have brain injuries. Right, Traumatic brain injuries. There is traumatic brain injury program that's out there that can really get people from not functional state and being highly depressed and dysfunctional to getting back to work, getting back onto their families, getting back to having a normal life or as close to normal life as they can.
[00:12:51] Speaker B: So it's interesting you mentioned about the progress that's been made in technology from when you started to where we are today.
But you also, I think, appreciate that the human side of it, the per, you know, the psychological and social parts along with the biological parts are still critical and maybe how did you, you know, I remember talking to patients early on about, hey, we want to bring a psychologist into the treatment plan. And them looking at me like, well, I'm not crazy. It's not in my head. And it's like, no, it's not about that. It's about helping. This is a, this is such a whole person problem and we need such a whole person approach.
And I, and I feel like people are a lot more open to that today than they were, you know, when, at least, you know, when I started. And maybe how do you feel about that? Do you feel like, you know, we're coming around as a society more towards being more connected to our psychological selves and how it impacts our physical health and our physical bodies?
[00:14:05] Speaker A: Yeah, I think so. You said it right, Peter. I feel people are getting more self aware. People are getting More health conscious. And people are really wanting to drive all the treatments that will get them better as a whole.
They have realized that it's not that one pill or one injection or one surgery that's gonna get them to the finish.
It's really addressing all aspects of what's happening with them. So I think they have become more open to accepting mental health issues or seeing a mental health provider. And, you know, also, I think the burden falls on us as practitioners to be able to relate to patients in the right way.
And, you know, there is a way of approaching chronic pain patients and saying, listen, I mean, we totally understand what's going on with you, and that's why we want to bring the team of doctors who are. And providers who are expert in their field to help you as a whole. Like, you brought up the concept of whole person approach. And that really is the key, rather than saying, hey, I think you have depression, and, you know, let's get you to a psychiatrist. I mean, that doesn't sit very well. I mean, as physician, our first oath is do no harm. But then also alongside that, I believe should be be compassionate and confident and competent.
And with all of those three in place, I think there has to be a way in which we learn how to speak well with our patients and really offer them truly comprehensive care in a compassionate fashion.
So telling them, listen, let's bring the team of doctors in a multidisciplinary setting to help you as a whole. And it is, you know, the chronic pain that we are treating, but we are treating from multiple aspects. I mean, I don't think mental health is any different than physical rehab, you know, and I don't think it's any different than diabetes or hypertension, so to speak, as we need medication for that. We need, you know, we need treatments for our emotionality or behavioral issues or, you know, be it PTSD or be it depression or be it anxiety that go hand in hand and they're chemically triggered because of chronic pain. So, you know, just bringing that forth. And I think people are now at a point where they understand, or at least try to understand the science. They take interest in that. And I think we do a pretty good job. I think we have all come a long way also in how we approach our patients. And I think that's led to them being more accepting of these services.
[00:16:23] Speaker C: I think what you said was really important there about how you kind of, instead of telling them you have this condition, it has depression, you know, associated with it. And we know the research shows that you know, estimates are between 80 to 95% of people with chronic pain have some level of depressive symptoms. And we also understand that from the biology of what's happening in the brain. But to educate them and let them kind of identify, like, yeah, you know what, I could use some more support as opposed to putting a label on them. And so I think, you know, patients are more accepting of that message from their provider and more likely to try one of these great rehab programs.
I am curious, where do you see the future of chronic pain treatment?
[00:17:06] Speaker A: Oh, I feel like we are at the right place at the right time and the technology is really getting us to amazing places where we would have personalized medicine and, you know, a lot of focus on really identifying what the issues are and connecting those etiologies or those causes to real solutions that are personally tailored to people. From pharmacology standpoint, there are lots of new drugs that are in the pipeline or have come to the market.
Heard about suzitrogine, right? That just came into market. It's a non opioid nav 1.8 sodium channel blocker which actually helps with nerve pain and has been studied in acute setting, post surgical patients and has shown to be giving comparable relief as pain medications do, but definitely better than placebo and don't have that addictive component attached to it.
There are several other very exciting medications in the pipeline. One that actually will also change. International pain management.
There is a product called SP102 that is viscous dexamethasone. Now international pain physicians can relate to dexamethasone as being one of the safe injectable steroids that we use for nerve blocks and so on. And the fact that it is non particulated, it's a huge advantage and actually recommended by many pain societies as a safe medication because it doesn't cause clotting of the arteries and strokes and heart attacks and you know, spinal cord damage.
Now one of the issues that we have with that is that it free flows and it doesn't stick to the site of injury.
So now there is a production of viscous dexamethasone, which is a non particulate steroid that we can actually inject at the site of issue that's in the pipeline. And then there are other medications like TRP1V1 which is transient receptor potential banaloid, which will block those receptors which are involved with the sensation of pain and heat.
Other selective sodium channel blockers. So much is that's coming our way from pharmacology. Standpoint. But then when you add technology to it, I mean, there's virtual reality. We know it's FDA approved for chronic low back pain, AI neurostimulation. There is so much that's happening there.
Someday I want to write a book on emerging technologies because I really feel like not only us as clinicians need to be familiar with it, but also patients need to know about it and be empowered to be able to discuss this at their doctor's appointments and bring all these treatments to themselves. So that's a dream one day going.
[00:19:45] Speaker B: Back to Suzetragine, which I think the company calls it Journavax.
[00:19:52] Speaker A: Yes.
[00:19:53] Speaker B: And you mentioned the sodium channel blocker, and you know that there's several different types of, of sodium channel blockers, and this works on a specific one.
Nice lady in my church brought me an article about it and I thought it was kind of interesting how it got discovered. Originally, a researcher from Canada was studying a genetic disease of some kind and wanted to do more research on it. And so a lot of the patients that he or she was, was studying were from Pakistan. So he went to Pakistan, to the same town that these people had come from, to learn more about the genetics of this disease. And when the researcher got there, they realized that there was these other people in this town who felt no pain, and they were doing things like walking on fire and hot coals and doing these things. And so they started doing research to find that there's a rare genetic disorder mutation for some people that don't feel any pain. And tragically, these people, typically, by the time they're 20 or so, they die from bad accidents because they don't. They don't, you know, feel things and they're not protected by that.
And so that was where they discovered that there was a sodium channel defect in these people, that they had no, no pain at all. And then that sort of led down a road many years later to people trying to discover a, hey, how can we invent a medication that can work on a sodium channel like that so that when we need it, we can make the pain go away or stop it versus when we can?
And interesting with that is, you know, it's been approved for acute pain, but the whole chronic pain side of it might be very different. And it may not end up because it's, as you were talking about, it's so complex.
You know, where is it going to really fit in?
It's going to be interesting, I think, to see, to see how that unfolds.
And maybe you're going to see a lot of new interesting things come out. But it sounds like that's what kind of excites you the most is the new technology and some of the hope and promise of the future.
[00:22:06] Speaker A: Absolutely. And I think, you know, people are really investing a lot in say, biomarkers for longevity or, you know, trying to identify if, you know, or epigenetic clock age and things like that as well. As you know, there are folks, both you and I, Peter, know from Stanford days who actually have found transcription factors that will help them identify, you know, which people are more predisposed to based on their genetic makeup to say, neurodegenerative conditions, Alzheimer's or, you know, cardiovascular risk or rare diseases and so on. So there's so much happening in the field of genomics that, you know, the more you read about it, the more intrigued you get as to, you know, will we in this era see cure of lot of conditions that we don't currently have cure for, such as ALS or Alzheimer's? And is there going to be really a way to prevent it? Rather than just coming in as reactive doctors, can we really be proactive doctors?
So, yeah, I mean, I think the technology is moving fast and AI is definitely helping us get there faster. So it's very, very intriguing as to where we are in the timeline of this whole history of pain that we talked about. And just a quick note on history pain management. You know, you brought that up.
You know, I, along with some others, we thought just seeing some of the pain leaders of our times on podium. In fact, it happened in one of the meetings. I saw Gabor Rax up on the podium and he is really old and he's, you know, he's a pioneer of interventional pain management, a giant in the field. He was speaking and he seemed really frail and old and he's the inventor of rags catheter that we all use and so on. And I'm thinking, I don't know how long these guys are going to be around.
Let's capture them. So we actually, a few of us in interventional pain came up with a video of giants of pain management of the past. Whosoever is still here and able to speak to us as well as current leaders of our times.
So hopefully that'll come about next year. We'll be releasing international meetings. But, you know, it's nice for the future generation to know what's really happening in our field at this time.
[00:24:14] Speaker B: That's really cool. I love that. That's great.
[00:24:19] Speaker C: And you know, speaking of the History and where we're going. I am curious if there's any other inter interventions or procedures that you specifically are really excited about or interested about or we might be, you know, you wouldn't be surprised to see come out in the next decade.
[00:24:36] Speaker A: Yeah, no, absolutely sarat.
I'm biased towards boomerang, as you can tell. I lead that group and I simply admire the talent we have there. So I'm going to just speak from that standpoint.
You know, I just love the talent we have starting from interventional pain procedures that we have starting from even basic simple ones, but the way those are administered in a safe and effective fashion to minimally invasive surgeries that we actually perform. You know, we talked about the spinal cord stimulation, peripheral nerve stimulation with all possible parameters that will actually not even make you feel the paresthesias because oftentimes when to control the pain, we have to feel a strong tingling. But now the technologies that our doctors are engaging in that eliminate that tingling sensation, but also eliminate pain and then there are minimally invasive surgeries where we can actually modify the condition. Right. We can do discectomies, we can actually do procedures that are same day surgeries for spinal stenosis. Our doctor is also doing regenerative medicine with platelet rich plasma injections where we are using our own growth factors and injecting and healing the tissues. And there is so much more endoscopic procedures that we are doing. We are doing decompressive procedures and so on and so forth forth. This goes on and on. And that along with orthopedic surgery that we have combined with multidisciplinary approach of that biopsychosocial model is what leads us to be at the forefront of medicine. Right. I mean, having all of that in one place and I think that's what I take maximum pride in in boomerang healthcare. Because we have interventions, we have medication management, we have all the rehab programs, something for everybody who walks in through the doors.
So. And I think that's how the pain medicine needs to be practiced this day and age. So we are complete and thorough in our evaluation and treatment of our patients and give them the best possible outcomes.
[00:26:32] Speaker B: Dr. Navani, you mentioned regenerative medicine, which is I think a really growing area and we're seeing it, you know, used for more and more conditions.
Are there a few special injuries or problems that you think it works particularly well with? Because patients often have questions about hey, would that help my situation? And if there are a few you that you think it works really great for?
[00:26:57] Speaker A: Yeah, Absolutely. You know, if you look at the level one indication for platelet rich plasma lateral epicondylitis is one tennis elbow, which we see a lot of, as well as knee osteoarthritis. These are level one indications. There's enough high level randomized control trials done all around the world to qualify them as that. And then there's a good amount of research that's been done with meniscal injuries, ACL tears, other soft tissue injection injuries, as well as for the spine. You know, facet arthropathy has been studied. SI joint arthropathy as well as discs have been studied and we do some of those studies here in Boomerang as well. So as regards level one indication is lateral epicondylitis and knee oa. But there are a variety of indications. The problems we run into is that it's not considered to be mainstream treatment still and it's not covered by insurance. So there is a little access issue there which I hope in course of time legislators will see the benefit of it and a benefit of avoiding surgeries and being able to have a better and more functional life in a natural, organic way. And hopefully that will shift so more patients can avail the treatment.
[00:28:05] Speaker C: I hear about your advocating for increased coverage of medically appropriate interventions. Can you tell us a little bit about your role as Chief Medical Officer and doing all this advocacy work on behalf of all the patients?
[00:28:19] Speaker A: Yeah, absolutely. So we take a lot of pride at Boomerang Healthcare in serving industrial injuries compensation patients that have very limited access to care.
And we are that solution for them with our comprehensive, integrated solutions that we talked about.
So there is a fair amount of advocacy that we do with multiple stakeholders in terms of getting these people the treatment they need and then ultimately driving them back to functionality and back to their lives and back to work and so on. But in general in pain management, you know, we also do quite a bit of advocacy. I'm going to be the president of American Society of Interventional pain physician in 2026 next year.
And there is a lot of legislation, advocacy work that we do at Capitol Hill where we have a legislative day, we meet with the congressmen and senators and talk about access to pain management for general people.
And that translates both to workers comp and non workers comp population. So there is a lot of advocacy that happens through Boomerang at the state level as well as a national level through ACIP that I'm part of. And I'm really excited because I think we really need to solve the comprehensive impact the Scalability and that will solve the problem of access.
[00:29:39] Speaker B: So when you're, when you're advocating for access, I'm sure listeners would be interested.
You walk into a room, you're going to sit down with an insurance executive or a health care executive and have a discussion.
What's that like? And what, what kind of questions do they ask and what information are they looking for and how do you work through that process, which I'm sure is pretty high level.
[00:30:03] Speaker A: Yeah, it's really great. I mean we meet with multiple stakeholders. The insurance companies, their medical directors, senior leadership, employers and the same there, senior leadership of employers and then even like legislators and so on. One thing that we really have to understand is what is that will help drive the care forward?
On one hand in terms of the injured worker or the patient getting the care to completion and access, but also what's needed on the other side to be able to make that happen. Because I think all stakeholders do want people to get better, unquestionably, but they also have their own interests in mind, such as maybe cost effectiveness or clinical effectiveness and understanding where they're coming from and how we can offer solutions that will get them the most expedited care. Care in a cost effective fashion is really something. If we can offer that to them, then I think all bodies are happy. And I think, you know, just in general, healthcare in this country needs that at this point. Effective solutions that are clinically great but also cost effective.
So I think our drive at boomerang Healthcare is towards that. What can we do to compress the patient journey? Every single time we get a patient coming in through the door, the clock starts ticking. What can we do to get them treatments faster? Not just to save costs, but also to give them the best possible outcome. Right. Because the longer we wait, statistics show that if we don't get people back to work in three months, their return to work rate drops by 50% and then it becomes chronic unemployment and disability and nobody's happy with that. We want to kind of expedite those treatments, get them back to functionality, get them into rehab programs if they need to, and get them back to their own lives, whether or not that has work associated with it or not. But making them functional so then they can be independent human beings and productive members of the society.
[00:31:57] Speaker B: Because the patients want to get through this process quick too. They don't want to drag out yet. There's so many barriers sometimes. So we appreciate you trying to speed people through a process that often slows them down and the slower it goes Sometimes the worse the problems they get.
When I went into this, which was a little bit before you did, it was mostly men going into anesthesia and then specializing in pain. And it's not that way anymore. You know, I think we've seen in. In healthcare and in medicine, we've seen, you know, a lot of women now becoming leaders, raising the bar of excellence in healthcare.
And certainly in the world of treating pain, we're seeing a lot of not just men anymore, but a lot of brilliant, dynamic female specialists like yourself.
Was it hard, Was it hard at first to break in or what was that like?
[00:33:00] Speaker A: Yeah, well, you know, I think taking on a career in medicine, being a mother, daughter, and a wife taught me really the importance of balance and boundaries. Boundaries. You know, I often remind myself of those days when I had really young kids and I was working long hours.
But it's the drive and the love for the field that keeps you going. Right. These roles were not separate from each other. You know, they were part of my identity, all at the same time, same place. Right.
So they gave me empathy, they gave me time management skills. I had to be efficient to be able to do it all, and a very strong sense of responsibility.
They made me understand what it meant to care for others, to be cared for, and, you know, have that happen not only in the clinical setting, but also at home and in everyday life. So, you know, medicine is demanding, but so is family. So I've learned a lot. I should say I'm much smarter person now, having all of those things happen in my life and having to juggle through it. But it's been a beautiful journey. I can't complain. But it's taught me to be faster, smarter, sharper, just following the boundaries and the balance.
[00:34:11] Speaker C: Well, any advice you would give to young physicians, whether it be, you know, female or male, anybody considering entering the field of medicine or pain medicine, any wisdom you'd like to share? Anything you've learned along the way?
[00:34:27] Speaker A: Yeah, plenty. I mean, don't do the mistakes I did. But on a larger note, keep. Keep being there for your patients. Keep reading and keep being the doctor you want to be. And first, do no harm, but then also push yourself to the boundaries of getting the right care for the right patient. It's really important and just not getting disappointed. There are times that the days are really long and they're tiring, and sometimes you request a treatment and it gets denied or your patients don't get better.
But if you take a step back and think about all the other people you have really helped. I think it goes a long way in reinforcing why in the first place you choose this career, which is definitely a long drawn career. And if you are in it, I'm sure you really wanted to be in it. And for patients, stay with it, be with your doctor, talk about what your issues are. Don't hold back and be empowered and be strong and be aware of getting the right treatments for yourself.
It's not always that one injection or one surgery that will heal you. But if you are aware and you know what's happening, including the newer technologies that are coming your way, ask your doctor about it and be your best health advocate.
[00:35:42] Speaker B: Going back to your, your point about the work life balance too, are there any like special tips or tricks that you found for yourself that kind of helps you manage your wellness? You know, keeps your, your cup full while you're helping everybody else?
[00:36:01] Speaker A: Yeah, you know, Peter, you bring up, you know, a memory that I had from before and you know, I often that with my friends as well as with my family. And of course I'm not going to bring any identifiers, but I had a patient who actually turned 90 and she came to me asking for a shot in her back because she wanted to go and celebrate her 90th birthday. She said, do an epidural injection, please, because she had been getting that intermittently for her back condition.
And when I asked her what was her plan for her 90th birthday, she told me that she was going to go skydiving, diving. And I was like, oh my God, doesn't that seem a little extreme for your birthday? I mean, you know, are you sure?
And she, then she told me that, oh yeah, my family said the same thing. So I think I'm not going to go for skydiving. I'll go for ziplining instead.
I chuckled in my mind, but I said, okay. And I did the injection for her and she went and celebrated her 90th birthday and came back back.
And as I was reviewing her medication list, I saw that she was only on multivitamins.
And so I asked her, hey, listen. What? Tell me the secret of how you've stayed so well for so long. There are not too many 90 years old who can go ziplining on their birthdays and yet you're just on multivitamins.
And she told, she taught me one thing that I've always stuck with myself. And I've told my family and my kids too.
So she told me, doc, let me tell you a thing, right? Every morning I get up and I make a choice. I think about, should I be really happy about all that I have or be unhappy about that one thing that I don't have? And I choose to be happy.
So that really stuck on with me. And I've kind of tried to make that a thing that I like to live by.
And I'll admit not every time does it happen, but I try to kind of always remember her and what she taught me as my patient.
She taught a doctor that. Right? So I feel, you know, I think that is the key to balance and happiness. If you love what you do, you'll make time for it no matter what. And then be satisfied with what we have. We have so much. I mean, we have ability to be able to live every day, breathe, take that first breath in the morning, be able to walk.
You know, some people are dealing with disabilities. We are able to live a free life and practice medicine in a country that has so much to offer us. So I feel like we are really uniquely privileged to be able to help others. And that's a gift.
And, you know, I couldn't be happier doing what I do. So, you know, that's a little tip, if that helps.
[00:38:44] Speaker B: That's beautiful.
[00:38:45] Speaker C: I love that positive perspective.
[00:38:47] Speaker A: Wonderful.
Thank you.
[00:38:50] Speaker C: I think that wraps it up for today. Thank you so much, Dr. Navani, for joining us. And for everyone, everyone who's tuned in, thank you for joining us on the Comeback with Boomerang Healthcare. We're grateful to have you all here. And if you've enjoyed today's episode, be sure to subscribe so you never miss an update. You can follow us on social media for more tips, information, and inspiration. Until next time, keep moving forward. Your comeback is just getting started.
