381. Getting Better: A Doctor's Story of Resilience, Recovery and Renewal with Dr. Andrew Kadar

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Dr. Andrew Kadar: 

If you're having symptoms, the best way to deal with them is to take it away from yourself.

Dr. Richard Shuster: 

Hello and welcome to The Daily Helping with Dr. Richard Shuster, food for the brain, knowledge from the experts, tools to win at life. I'm your host, Dr. Richard. Whoever you are, wherever you're from, and whatever you do, this is the show that is going to help you become the best version of yourself. 

Each episode, you will hear from some of the most amazing, talented, and successful people on the planet who followed their passions and strive to help others. Join our movement to get a million people each day to commit acts of kindness for others. Together, we're going to make the world a better place. Are you ready? Because it's time for your Daily Helping.

Thanks for tuning into this episode of the Daily Helping Podcast. I'm your host, Dr. Richard. And our guest today is as fascinating from a story perspective as he is brilliant. We're going to be talking to Dr. Andrew Kadar. He's an anesthesiologist, world renowned anesthesiologist. He graduated from the Yale University, School of Medicine and completed his residency at Stanford and Harvard Universities. He served on faculties of the UCLA School of Medicine, and Charles Drew University and Cedars Sinai Medical Center. 

He's been everywhere in the media from Good Morning America and NBC Nightly News to countless other outlets. He studied in the UCLA Writer's Program and his writing has appeared in the Atlantic, the LA Times, the New York Daily News, the Philadelphia Inquirer, and the San Francisco Chronicle, among others.

He's here to talk to us today about his story in which he faced a life-threatening experience and describe that in his new book that's available everywhere, Getting Better, A Doctor's Story of Resilience, Recovery, and Renewal. Dr. Andrew, I've been excited about this interview for a while. Welcome to The Daily Helping. It is so fantastic to have you with us today. 

Dr. Andrew Kadar: 

Thank you very much, Dr. Richard. I'm very happy to be here. 

Dr. Richard Shuster: 

Well, we're excited you're here. And so what I love to do is I love to go back in time with people who join us on the show and find out the inspiration, the spark, the antithesis of what put them on their journey. I know we're going to talk about a health scare you have and how that resulted in you writing this incredible book. But talk to us about what puts you on the path you're on today, and let's start there. 

Dr. Andrew Kadar: 

I guess that the path that put me on was having an unexpected illness. I thought I was perfectly healthy. In fact, I thought I was better than average healthy. I'd been a gymnast, competed for the UCLA gymnastics team. I ran 10Ks. I was active. Didn't have the usual risk factors like high blood pressure, never been overweight, never smoked. Had a great family history. My father lived to be 94. We hiked together in the Canadian Rockies when he was 86. 

So when I suddenly came down with heart disease, I think I started a minor run on cardiac workups in West L.A. because all the people that knew me were pretty shocked. I thought I was perfectly healthy. I presented as perfectly healthy. And then suddenly I was facing open heart surgery for a condition that's known as the widowmaker. 

Now, I knew how coronary artery disease presented. The most common presentation is chest pain that comes on with exercise right under the breastbone and it goes away promptly with rest. I also knew about illness denial, which is people say, oh, what I'm feeling is nothing. It's just minor. I'll forget about it, and it will go away. And yet, despite everything I knew about heart disease, when I had chest pain in the middle of the chest, that went away probably with exercise, my reaction was the typical denial. I knew I didn't have heart disease, so disregarded it. 

Basically, I was working out in the gym. I was doing a pretty intense workout on the elliptical. And about nine minutes into it, I started having this chest pain. And I thought, okay, well, I don't feel so well. It's probably nothing. I'll just go -- it will go away. I'll stop working out today. Three days later, I'm back in the gym, exact same thing happened. So this time I wait a little bit, goes away. I start exercising again. In about two minutes, I have the same burning right under the sternum. It's not particularly severe, but it's there. 

So I kind of thought to myself, okay, I know I don't have heart disease, but what would I tell somebody else who came to me with the same set of symptoms? At that point, the answer became obvious. And I think that was sort of the first lesson to me was that the best way to figure out what to do with an illness that you have is to take it away from yourself. It's difficult to be objective about yourself. But as soon as I said, okay, what would I tell somebody else, then the answer became obvious. And I called my doctor. And in his office, they told me, oh, we have our next appointment available is 18 days. 

Now, I knew that this was a little more urgent and I didn't want to wait 18 days. And so the second lesson I have in this is that when you have something that's more urgent, you need to get to somebody who can make a triage decision. And when you call a doctor's office, the secretary, they set their appointments on a first come first serve basis. So when you have more urgency, you need to talk to somebody who can cut through that and get you a more urgent appointment. 

And so I had, a few days later, I had a stress test. And that showed that there was abnormalities everywhere with exercise. It was nor -- my electrocardiogram was normal at rest, but once I started exercising, I started having abnormalities in pretty much every lead. So then I was set up for an angiogram. 

And that, now at that point, even if you have coronary artery disease, it can be solved with angioplasty, which is putting a catheter, a plastic tubing up from the groin usually, up to the heart, and dilating the blood vessel, and then putting in a scaffold, and then in a day you can go back to work. When I woke up from the procedure, the angiographer was there, and I asked him, did you do an angioplasty and how many vessels? And his answer was, I'm going to get a surgeon to talk to you. So then I knew that I had some bad news happening. 

And the next day I was having open heart surgery for a blockage, well actually three blockages, but the one that was most serious is the one in the largest artery that supplies the heart. And it was in a spot that often causes sudden death. So it was a fairly urgent situation. I had the surgery, had lots and lots of setbacks. 

Now, when I first had the surgery scheduled, I figured that I would get back to work and get back to normal about as rapidly as anybody has after this surgery. Before I went to medical school, I thought that doctors routinely exaggerated the amount of time it takes to heal. The reason for that was, my friends on the UCLA gymnastics team, they'd get an injury and they'd be told it would take two months to get back to the gym. In a month, they were flipping around and doing all kinds of routines on the equipment. And so, I thought that that was an exaggeration. 

Once I got to medical school, I realized that I didn't have a typical sample. The young, very healthy athletes who are highly motivated tend to recover somewhat faster. But in my mind, I was still that young gymnast, so I thought everything would go very smoothly for me. In fact, I ended up staying in the ICU longer than average. I ended up staying in the hospital longer than average. I ended up having more initial complications more than average. 

So, everything didn't turn out perfectly at that point, but ultimately, I did get back to my normal health, was able to get back to work, and continued full time work thereafter. So the outcome of the story is a happy story. 

Dr. Richard Shuster: 

I'm listening to this, and I have to add my little PSA because for those of you listening who are younger, 25 to 35 ish, heart disease is on the rise for young people. There's a lot of reasons why. And that's a show for another time. But listen to your bodies because these are things that can happen to us at any age. 

So obviously, you had the warning signs. They call that procedure the widow maker for a reason. How much longer after that you recovered, you went back to work, why now? Why did you decide to write this book Getting Better now? And how long was that kind of percolating in you?

Dr. Andrew Kadar: 

I really started thinking about it as I was recuperating, but I had a fairly busy schedule at work. And so it took quite a few years to fully write it and get it to the point where I was ready to have it go out. So it's really been 14 years. And by the way, I've had no cardiac symptoms since recovering from my surgery. So I've been able to live my life as I had before, which was my goal from the beginning. 

Dr. Richard Shuster: 

Fantastic. So take us through then the tenets of the book. What is a reader going to get out of this book? And let's go high level overview through it. Because I'm obviously, as I said in the intro here, you describe your experience of what you went through with the heart surgery and the risks and all of the things. So we know that's in the book. But in terms of the other piece of this, that a reader is going to get out of this, what are they going to learn in your book, Dr. Andrew? 

Dr. Andrew Kadar: 

Well, I think -- well, several things. One is that expect the unexpected when you have a major illness. And I had a number of unexpected things happen along the way. And some of them were complications that I knew about, but they were sort of the known unknowns in the sense that I didn't know how severe they were going to be. And some were complications that I wasn't aware of, so they were the unknown unknowns to me.

And one of the things that happened was, after I woke up, I had difficulty swallowing. I wasn't aware that this was a problem after heart surgery, but once I found out from the ENT specialist that came in and consulted on me, that it does happen and he reassured me that it tends to go away in less than a month, then I was much more reassured. But initially, I was quite dismayed because every meal turned out to be sort of an ugly ordeal. 

So I think one of the things I learned in that part, is that you've got to communicate what's bothering you the most. And at every stage, a different thing tended to bother me the most. And at one point, it was the inability to swallow. Now, after that, there were drains that were in my body from surgery. Basically, let fluids out, the drainage from surgery. And as each of them came out, I started to have more and more hiccups. Now, I knew that hiccups were a possibility after having surgery in the chest or the upper abdomen. But once the last drain came out, I started having hiccups like you can't believe. It was hiccups on top of hiccups on top of hiccups. 

Now, when I was in medical school, I learned that hiccups are usually just a minor nuisance, but some people have had hiccups for years and months and years, and some people have even died from intractable hiccups because the diaphragm would get exhausted, and they'd have respiratory failure. And today we put him on a ventilator, but nevertheless, it can be a severe problem. 

There's one guy, the world record is, I think, 68 years of hiccups, and I think he was estimated to have over 430 million hiccups in his life. And I didn't expect to die from hiccups, but it was hic, hic, hic, hic, hic, hic, hic, and it was a sequence that would just slow down and then speed up, slow down and speed up. And it was just totally miserable to me. So these were sort of the unexpected things that were happening along the way. 

So I think that the lesson number one is there is to expect the unexpected. And then I think you also have to relay what your desires are and what's bothering you the most at each stage. So when it was a swallowing, I really needed to emphasize to my doctors that this was a serious problem for me because I think initially they did write a note in the chart and go on their way. But as it was making me miserable every time I tried to swallow anything, it became very important to me at that time. There were some other things along the way

Now, one of the things that you have to be appreciative of your caretakers, and also be aware of what's happening to them. Now, once I got to my regular room, patients are allowed to have one person stay with them overnight. And so my wife decided she was going to stay with me the first night. And so she got this very narrow, not so very comfortable cot, and during the night, they take my blood pressure, they draw blood samples. And with the noise of the hospital and people coming in and out, basically she got no sleep at all. And there's a thing called caretaker exhaustion syndrome where people who want to take care of you, just get worn out and burned out. 

And so after that one night we decided she'd be better off going home and getting some better rest, not only for her sake, but also for my sake, because she'd be better able to help me if she was alert and not so worn out. So those are some of the things that I talk about. I think some of the things that can happen is now patients are given a certain amount of slack for their behavior during the hospital, but I think you do need to be as patient centered as possible, as humane as possible and as kind as possible to everybody who's around you. 

And there was one time when, when I think after about a week or so in the hospital, I did have an episode that was somewhat atypical of me. I woke up one day and I noticed that there was a wristband on me that said fall risk. Now, I'm a gymnast. I have great balance. So a band that said fall risk was, what are you talking about? I'm not a fall risk. 

So then, so I asked the nurses about it. I thought somebody put it on me in the middle of the night when I wasn't aware of it. And they told me that I should be careful. And I said, no, I'm not at fall risk. I can stand on my toes. I can stand on one leg. I was demonstrating it to him. And I said, no, no, no. And later on, and most people wouldn't -- would look at this band and say, okay, it does no harm, what's the big deal, but it would be like putting a band on a musician that said he was tone deaf. 

And I think when you're in the hospital and you're a patient, you lose a fair amount of autonomy and a lot of decision making over your life. And so, this seemed to me like a gratuitous insult. And so I think my reaction to it was overblown. And at the time, well, at the time I didn't think it was overblown, but in retrospect it was. And then I actually found out that shortly before my hospitalization, the hospital decided to put a fall risk on anybody who went into surgery, and mine had probably been on or had been on ever since my surgery and I just hadn't been aware of it. And about a week later, one day I noticed it and that's when it upset me. 

So that was another episode that I recall. And in a normal time, I would have handled it differently. So I think the lesson in that is just be aware of how you come across to your caretakers and be kind to them because they're being kind to you. After all, everybody has the same purposes. There's a perfect confluence between what you want and what your caretakers want. They want you to get well and you want to get well and it's everybody's best interest. 

Dr. Richard Shuster: 

Absolutely. Just kind of summarizing what we've talked about so far. Expecting the unexpected. You talked about advocating for yourself. People aren't going to know what's wrong with you if you don't express, hey, I'm having trouble swallowing, something else that's going on. Appreciate your caretaker, your caregiver, which is important. 

I want to call your attention, and have you talk about something that from chapter nine in the book, because I think this not only holds true to recovering from illness or injury, but also life itself. So talk to us about Chapter 9, which is entitled, Small Pains, Big Gains, The Lost Art of Patience.

Dr. Andrew Kadar: 

So one of the frustrating things that can happen during hospitalization deals with starting IVs. And Michael Jordan said that in his how many thousands of shots has missed in his career. And for IVs, even the best IV starter occasionally misses. Now, there are more difficult IVs and more difficult and easier IVs, just like there are more difficult shots in basketball. You can have a layup, or you can have a mid-court shot. 

And people with large veins have the easy shot. Those are the easy ones. And people with small, deep veins, not so much. Now I had large, easy to start veins usually. But when on, I think day four, when nurses came to start my IVs, a new IV on me, she decided, she looked at it and said, oh, these are very small. 

Now, they didn't look that tiny to me, but she had a great deal of difficulty, and she stuck me once. Okay, that can happen that it doesn't work. Did it a second time, by now, I was getting a little frustrated. My wife, who's there was getting a lot more frustrated, and angry at her. And, but I knew that she was suffering as I was because she wanted to start this IV and her pride was hurt in not being able to do it well. The third time she finally did get it. 

I think that IV start starting is kind of an art. Not this is similar to any other skill, and you have to learn how to do it. And there are people, if you do it a lot, you're going to get good at it eventually. Now, some people are a little more skilled to begin with, but if you practice shooting baskets, you're eventually going to be able to do it and you're going to be able to do it proficiently. 

And in this case, I had much more frustration in my situation because I expected my IV starts to be easy and they turned out to be difficult. But you have to understand that it's a two-way street and the person who's trying to start your IV is also having a struggle with it, not just you. 

Dr. Richard Shuster: 

Well, and I know we're talking about IVs, but again, this is, and you mentioned Michael Jordan, this is really an analogy for almost anything that's challenging, right? Whether it's managing a business or being in a relationship or trying to get your kid to do their homework, right? It's the perseverance story. And even though you're frustrated, it's probably true that the other person on the other side of this is frustrated as well. 

And so, this is a neat book, Dr. Andrew, because if somebody might be listening to this saying “I'm perfectly healthy, I'm not going to be in a hospital”, you just never know right? And so I'm grateful that a book is out there like this because I think people need to know what their experience should be, if they're going to be, God forbid, in a hospital, what their recovery might look like and what might happen on the back end. And this is knowledge that not only makes it easier for the person experiencing it, but for the loved ones around, because as you know, when you get ill, it doesn't just affect you. It affects everybody around you. 

So the book again, it's called Getting Better: A Doctor Story of Resilience, Recovery, and Renewal, which is available everywhere. Dr. Andrew, our time together has flown by. I'm happy that your open-heart surgery wasn't indeed a widow maker because it is for so many people. 

But as you know, I love to wrap up my shows by asking my guests a question, just this one question, what is your biggest helping, that one most important piece of information you'd like somebody to walk away with after hearing our conversation today?

Dr. Andrew Kadar: 

Can I just insert one thing before I answer that? And that's that when you're having a situation like this, it can strengthen your relationship, or it can make it worse. And if you take, if you're not appreciative of your caretakers, particularly your family members, it can make your relationship introduce resentment into your relationship. But if you treat your caretaker well, I think it can bring you closer together. And I think for my wife and myself, I learned to admire her more. And I think she learned to admire me more, and we had a better relationship at the end of all this than when we began. 

And as far as the question that you asked most recently, I think that the easiest and number one thing I would say is that if you're having symptoms, the best way to deal with them is to take it away from yourself. And there are twin dangers here. One is denial, which is you disregard something that's important. The other is becoming a hypochondriac and thinking everything is horrible. 

And if, by taking it away from yourself, you're likely to be more realistic. You're not going to interpret a headache as a brain tumor. And you're not going to disregard chest pain that comes up with exercise and goes away with rest. So I think that's one thing that I would like people to remember is that if they're having some symptoms, think about how you would advise your best friend or anybody else who came to you with the same set of symptoms and what you think they should do as the wise course of action.

Dr. Richard Shuster: 

Sagely advice, Dr. Andrew, sagely advice. Dr. Andrew, this has been a treat for me. I think your book is going to help a lot of people. Tell us where people can learn more about you online. 

Dr. Andrew Kadar: 

Well, I have a website and that's similar to the title of the book. It's gettingbetterdoc.com. That's Getting Better and D-O-C at the end .com.

Dr. Richard Shuster: 

Perfect. And we will have links to everything Dr. Andrew, including his newest book in the show notes at drrichardschuster.com. Well, I have loved our time together. Dr. Andrew, thank you so much for joining us today and sharing your wisdom with the audience. 

Dr. Andrew Kadar: 

Thank you very much, Dr. Richard. It's been a pleasure.

Dr. Richard Shuster: 

Absolutely. And to each and every one who took time out of your day to listen to this, thank you for spending a little bit of time with us today. If you liked it, if you're inspired, if you think you're going to get the book so you can have a better understanding of how to help everybody in your circle, God forbid, if there's an illness that you experienced that requires care, go give us a follow on a five star review on your podcast app of choice, because this is what helps other people find the show. 

But most importantly, go out there today and do something nice for somebody else, even if you don't know who they are and post in your social media feeds using the hashtag #MyDailyHelping because the happiest people are those that help others.