Doctor-Patient Relationship: Building Trust, Communication, and Empowering Yourself in Healthcare with Dr. William T. Choctaw, MD, JD

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Coming up on this episode of the
Healthy, Wealthy, and Wise podcast.

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Let me say before we finish about
recovery, uh, what is relatively unique

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about stroke is.

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Welcome to the Healthy, Wealthy,
and Wise podcast with Dr.

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William T.

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Choctaw, MD, JD.

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This podcast will provide you with
tools and actionable information

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to You can use to help live a more
healthy, wealthy, and wise life.

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It's powered by the over 50 years
of medical experience of this Yale

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university medical school trained
surgeon, who is also a Western

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state law school trained attorney
with executive experience being a.

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Former Mayor of Walnut, California,
as well as the current chairman of the

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Nonprofit Servants Arms, and as president
of Choctaw Medical Group Incorporated.

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This is the Leadership Masterclass
edition already in progress.

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Now, a lot of you are
probably familiar with this.

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This is the fast.

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nomenclature that's put out by the
American Heart Association and the

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American Stroke Association so people
can remember to how to spot a stroke.

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Um, face, uh, FAST, F stands for
face, uh, frequently these individuals

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will have drooping of one side
of their face, uh, certainly a

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change in the side of the face.

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You're talking to them and you're
just saying, you know what, you know,

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you, you look a little different.

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Different.

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Um, and you might see that arm weakness.

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Uh, sometimes when they, if they
lift their arms or move their arms,

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you'll notice they aren't moving.

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One side of their body is equally
with the other speech difficulty.

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Therefore, whatever reason,
their speech is not clear.

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And many times that can
be a sign of stroke.

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And then the T and FAST is for time.

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You want to call 9 1 1, get them to
the hospital as fast as possible.

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Uh, and because as we
said, uh, time is brain.

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Again, just the same
thing but with pictures.

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F for face drooping, A for
arm weakness, S for speech

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difficulty, and the T is for time.

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Um, and remember as I said before,
when I say time, I'm talking

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about minutes, not hours, in terms
of getting them to a hospital.

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Ideally, you want to get them to a
hospital that has a stroke center.

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Now if you call 911, the
paramedics will know in the area

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who has a stroke center or not.

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And if, uh, they take them to that
hospital, if they come to pick up,

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pick you up a family member, they'll
know who has the stroke center.

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Why is it that you want a
hospital with a Stroke Center?

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Because there are hospitals with
Stroke Centers have, uh, methodology

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or equipment or staff or expertise
to immediately treat the stroke.

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If it's a stroke that's caused by a
clot, they can give you medication

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that can dissolve the clot.

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within minutes.

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If it's treated by a bleed, they can do
procedures, uh, diagnostically that can

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plug the hole and stop the bleeding.

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And again, time is brain, time is brain.

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So ideally you don't want to
waste your time in a certain, in

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an urgent, urgent care center.

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for that little, um, 10 bed
hospital down the street.

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Ideally, you want to be able
to go to the street center.

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Most places with cities will have
hospitals that have stroke centers.

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It becomes more of an issue when you're
out in very, very large rural areas.

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where there are not a lot of hospitals.

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I would advise you, particularly you
young people who are in the 50s and 60s,

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when you get that second and third house,
and you want this huge house and this

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huge area with this huge yard, check the
community and see where the hospitals are.

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You know, like you're going to check
on the schools cause you got kids,

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but also check and see where the
hospitals are and make sure, make sure

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that you have good quality hospitals
that are close by to wherever you go.

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There's another example of, um, you
can see the, um, angiogram, um, of the

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blood vessel going up to the brain.

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Um, and they can identify, Bleeds
or clots just by doing that.

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The beauty of this is it's non invasive.

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Back in the 70s when I was assisting with
heart surgery, we had to go in on stuff.

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You know, that's amazingly traumatic.

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And one of the biggest changes
in healthcare, particularly

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surgery, is non invasive surgery.

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The things that radiologists can do,
the things that cardiologists can do

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that are non invasive is just amazing.

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Yes.

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Yeah, patients can be awake.

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And that's the question was that I
should notice that the patient in the

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picture that I'm showing was awake.

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Yes.

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And that's one of the advantages
of non invasive surgery is

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that you avoid anesthesia.

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One of the things that my surgical
colleagues and I about anesthesiologists

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that we work with every day, but
we've always, you know, teasing them.

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We said surgery is good, but anesthesia
is bad, you know, which is not

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true, but we used to say it anyway.

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Uh, so, but my point is
that if you can avoid

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If you can avoid invasive types
of stuff, that's a good thing.

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If you can avoid anesthesia,
that's a good thing.

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And still have done what
you need to have done.

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Most times the surgery is
shorter, which is good, and most

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times the recovery is faster.

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There's less pain post op, um, and
all that leads to a faster recovery.

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Again, um, ways to prevent stroke,
exercise we talked about, um, social

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determinants we talked about, drugs and
alcohol we mentioned, um, you want to take

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any medication that you're prescribed.

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Sometimes you may be on aspirin,
um, some patients put on aspirin

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by their doctor, some are not.

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Use just 8 or 1 milligrams, uh, I
would advise you to do that if that's

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what your doctor has recommended, uh,
avoiding tobacco, um, and good nutrition.

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Again, same thing, um, I like this
slide because one of the things

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that helps me, uh, when I look at
eating well is that you want to eat.

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Foods that have a lot of color, this
is my thing, um, so, when you sit down

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for your dinner or whatever, look at
the amount of vegetables on your plate.

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If your food is black and white or brown
and white, chances are you may not have

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a lot of vegetables, uh, in, in your
diet, uh, so you want a lot of color,

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and it's one of the things that I, We
give my, my loving wife a hard time, but

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I say, you know, there's a lot of color
in this meal, you know, uh, but actually

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it's a good thing because what she's
doing is giving me stuff that's healthy.

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Uh, again, going back to that
doctor patient relationship, um,

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uh, it is extremely important,
um, to follow your doctor's

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suggestions and, and recommendations.

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Um, but again, uh, I'm a
strong believer in patient.

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Empowerment.

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And so if it is not
working for you with Dr.

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X or Dr.

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Y or Dr.

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Z, do not hesitate to get a second
opinion or tell your primary care

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physician, your PCP, uh, that
you want to get a second opinion.

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Do not hesitate to do that.

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Again just finishing up about
prevention, staying healthy, you want

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to keep your good cholesterol, your
HDL high and your bad cholesterol, your

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LDL low, blood pressure control and
heart rate and hypertension control.

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Don't smoke, eliminate alcohol,
stay at a healthy rate, eat

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healthy foods and be active.

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Uh, let me say before we finish about
recovery, uh, what is relatively unique,

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uh, about stroke is that usually it
involves a lot of recovery, uh, and

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let me give a shout out to all those,
um, uh, home health family members who

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are taking care of family people who
have had strokes and heart attacks.

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It is a tremendous task because
frequently those, those family

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members that you're taking care of.

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are going to either be husband or wife,
mother or father, brother or sister.

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It is a tremendous task, because a lot
of times, particularly as they get older,

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And these things happen to them, they,
they won't help you take care of them.

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It will give you a hard time and
you feel guilty on and on and on.

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Um, so recovery is important, uh,
nursing care, physical therapy,

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speech therapy, very important.

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Um, going back to this 50 year
old, he had a small stroke, but

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he did have some speech issues.

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So he had a post op, I mean a post,
um, discharge speech therapist and

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his speech is back to normal now.

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Let me go back.

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There will be some, maybe
some cognitive there.

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Cognitive.

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issues, a cognitive main thinking,
you know, they said, you know, I,

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I, I, I think I understand what
you're saying, but tell me again

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and again, that's a part of it.

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That's a part of it.

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It's also a part of age, you
know, whether it's dementia or

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Alzheimer's on and on and on.

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And we will have another, excuse
me, discussion about that.

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Uh, and uh, behavioral and home therapy.

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And behavioral therapy particularly,
it may have to do with attitude.

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Attitude.

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Attitude may not necessarily be physical.

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Uh, you know, it's just that they
may not be that happy go lucky type

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person that you grew up with, or
you've been with for a long time.

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Um, uh, my point is be more patient.

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This many times is a part of the
illness, um, and, uh, as challenging

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as it is just to be more patient.

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And it goes to the mental health support.

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And a lot of times that
mental health support is not

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necessarily seen in psychiatrists.

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It's just that home health care person,
that home care person being more tolerant.

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Now that's hard.

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That is very difficult.

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And I saw a lot of patients in my
practice who were sons and daughters,

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who were caregivers of mom and dad.

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And I would many times try to get
them to do things to help themselves

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so they can be even more effective
in terms of helping their loved one.

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But you do have to persevere.

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You do have to persevere,
and it takes time.

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It takes time.

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I will clearly admit, I'm one of those
people who does not like to waste time.

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I tell people, particularly when
I was doing surgery, I said, time

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is the only commodity that I have.

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It's the only commodity I can control,
and I do not like to waste time.

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I'm one of those people, if you tell me to
be somewhere at 8 o'clock, I'll get there

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at 7 30, because I don't like to be late.

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You know people like that.

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Some of you may be like
that, I don't know.

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But my point is But I have to
be patient with stuff like this,

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and you will have to be patient.

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It means that you just take a step back
and say, okay, you know, as I mentioned,

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what always helps me, uh, in my patience,
hi, welcome, come on in, what always

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helps me in my patience, yeah, in
being patient is the serenity prayer.

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You know, I say that to myself, God
help me, God give me the serenity to

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accept the things I cannot change.

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Uh, uh, and, and to get through there.

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Uh, and so, but you have to be patient
to be a good home health person.

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Particularly when that person is a
family, it is difficult, it is difficult.

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And so as a result of that, it's
important that you take care of yourself.

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Give yourself permission, give
yourself permission to go out and

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have dinner with a friend or go to
the movies or whatever it is you like.

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Because you need to strengthen
yourself to take care of that

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person who is depending on you.

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In summary, there are two types of
stroke, ischemic and hemorrhagic.

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The important thing is you want
to get to the hospital quick.

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Um, time is brain, time is brain.

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Um, and when, when, you know,
you'd want to ideally go to a

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hospital that has strokes in them.

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Um, and why is that important?

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Because those hospitals have particular
expertise to maybe do thrombectomies

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that we have a plug that, that bleed
if necessary, very, very quickly.

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Um, and, um, you need to take care, have
this happen in minutes and not hours.

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Sometimes surgery is necessary, uh, and
that can also be done because the Strokes

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Center has surgeons, neurosurgeons,
cardiac surgeons who are on call.

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Um, one of my specialties at Queen
of the Valley Atlantic Community, in

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addition to being a general surgeon,
I was on the trauma surgery team.

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And we want a 24 7 call, um, and as
we saw, they said traumas don't come

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at four o'clock in the afternoon.

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They do not.

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They come on the weekends, in the middle
of the night, when people are coming

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from the clubs, coming from the clubs.

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That's frequently when
a lot of stuff happens.

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So finally, my basic principles,
I, I say this all the time for the

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last two years, but I, I think it's
important for me to tell you what

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I believe and what's helped me.

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Now, this may or may not help you.

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Uh, but, uh, number one, my
first principle, which is

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obvious, God is in charge.

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And again, uh, when, when
I'm going through my issues.

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about time or whatever it is.

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Um, I repeat my serenity prayer
or whatever prayer you want

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to repeat that works for you.

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Um, but about recognizing, um,
uh, that God really is in charge,

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that that really does help me.

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Second thing, I don't have bad days.

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I've said this before.

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Um, I figured out about 30 years
ago now, um, about 30 years ago

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now, That days were good or bad.

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I said they were.

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I said they were.

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Example, if I get up in the morning
and it's raining cats and dogs outside.

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And I said, Oh my God, it's raining, you
know, I'm going to get wet, you know,

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I may shrivel up and disappear, but you
know, Oh no, no, no, no, then that's true.

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But if I get up and say, Oh
my God, it's raining cats and

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dogs, how beautiful is that?

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It's going to clean up everything
and everything will be bright

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when the sun comes out.

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That is all in my attitude.

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So I said, gee whiz, if I have the
control of whether I have a good or bad

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day, guess what I'm going to choose.

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So I got rid of him.

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I got rid of them.

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I said, I've had enough bad
days, don't want any more.

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So I have good days and great days.

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But it's always a good day.

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Always a good day.

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Don't sweat the small
stuff, most stuff is small.

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Learn this.

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I've learned this.

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When I would get upset with somebody or
she said X to me or he said Y to me And

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then I think about it's two or three
hours and I said, you know, I don't think

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she really meant that I think that's
really me, you know, and then I sort

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of figured out, took me a while, I'm a
little slow, took me a while, I figured

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out You know what, let's just let that go.

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You don't even know whether
that was what she meant or not.

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So is it really worth all this?

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And so then what I learned, which the
next one is, forgiveness is therapy.

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Forgiveness is therapy.

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Forgive her whether it's true or not.

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It doesn't matter, is my point.

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Because it goes back to about
that small stuff, types of stuff.

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If I can't figure out whether it's good
or bad, it's probably not worth it anyway.

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And the very last thing, and I say
this all the time, and I really

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believe it, everything, everything,
everything is relationship.

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I don't care what kind it is.

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Whether you work in the food bank,
or you're in Sunday school, or

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you're, Husband, wife, boyfriend,
girlfriend, daughter, son, um, uh,

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whatever, uh, it's a relationship.

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Relationships are based on three
things, mutual respect, mutual

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trust, good communication.

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I would argue that the good
communication is most important because

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if we're in a relationship and we
can't communicate, means when she

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talks to me, I'm, I'm not listening.

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I'm looking at her, but I'm not listening.

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You know, I'm thinking about
something over here, we're not

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communicating, then you never get to
that mutual respect and mutual trust.

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Does that make sense?

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Because it means that
I don't even know her.

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I'm not listening to her, so
how can I understand what it

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is she's trying to tell me?

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She's trying to tell me something,
but I'm, you know, on a different

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planet, uh, or a different world.

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So, I get it.

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These are the lessons that I've learned.

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These are my lessons learned.

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You may have all this down pat and
that's great, God bless you, but if

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you don't, uh, you can get better
because I got this, you know, therapy.

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And finally, as I was mentioning to
Claudette, if a lot of this material

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you want to go back and review, it is
available to you through the graciousness

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of Shelley Shaw, who created, true story,
created two different ways to do it.

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One, if you go to the church
website, go to the events, scroll

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down, you'll see masterclass.

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Click on masterclass, it'll
take you to the subject matter

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for the next masterclass.

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Stay on that page, go down to the bottom,
there's a PowerPoint, it'll say PPT,

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and click on it, and it'll give you
the PowerPoint that I presented today.

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You know, I said, we've been
doing this for two years and

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she's got everyone there.

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Secondly, if you just want to see
some additional, you just want to

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hear parts of it yourself, go to
the church website instead of going

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to events, go to, uh, ministries.

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Thank you, sir.

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I'll say that.

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Let me say, the reason why he's here.

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He's, he's like, he's the director
of production, uh, and we call

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him a podcast professor, you know.

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But his job is to keep me straight,
that was what he was doing.

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Thank you, sir.

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God bless you.

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Uh, but you, you go to ministries
and scroll down and you'll see my

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00:18:31,524 --> 00:18:33,035
pictures, see podcasts, whatever.

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Click on that and there's what's called
an embeddable player, which are bite

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00:18:37,745 --> 00:18:41,945
sizes of presentations we call podcasts.

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Of every single podcast we've
done, we've done close to about

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130 in the last two years.

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Every single subject.

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Uh, so you can always go back, you
can always go back, um, and certainly

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feel free to email me a Jessie or
grab us in the church or whatever, ask

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us a question, that's not a problem.

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And finally, and I
always like to say this.

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How are we doing on time?

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See, you've got five minutes left.

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Five minutes left.

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Uh, be the change that you
want to see in the world.

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What's my point?

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00:19:12,500 --> 00:19:15,709
My point is, if you're frustrated
and if you're sick and tired of

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being sick and tired, do something.

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Don't whine and complain.

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Do something, uh, and you'll be
amazed how you can championed.

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Thank you.

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00:19:24,500 --> 00:19:27,710
Thank you for listening to the Healthy,
wealthy, and Wise Podcast with Dr.

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00:19:27,710 --> 00:19:30,230
William t Choctaw, MDJD.

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You can listen again to this and
any of the previous episodes.

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00:19:34,790 --> 00:19:42,650
Leave a comment or pose questions to
the doctor by going to www.thwwp.com.

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00:19:43,010 --> 00:19:48,379
That's www.thwwp.com and you've got it.

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00:19:49,010 --> 00:19:49,760
It's also available.

340
00:19:49,760 --> 00:19:54,980
Wherever you get your podcast, be
sure to follow, like, share, and

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00:19:54,980 --> 00:19:56,750
subscribe if you haven't already.

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00:19:56,990 --> 00:20:01,534
Then tune in for the next episode of the
Healthy, wealthy and Wise podcast with Dr.

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00:20:01,534 --> 00:20:07,580
William t Choctaw, M-D-J-D-A, production
of Change Makers Communications, LLC.