Beyond ADHD A Physician‘s Perspective Ep 3 with Dr. Arun Rao (Bariatric Surgeon, Medical Director of Sarasota Memorial’s Bariatric and Metabolic Health Center)

Dr. Arundathi (Arun) Rao is a medical director of Sarasota Memorial’s Bariatric and Metabolic Health Center, she oversees the full range of medical, surgical and support services provided by Sarasota Memorial Hospital and its bariatric team. She has 3 kids, and into photograph; just like our previous guests, who have ADHD, she’s also overachieving in her career, and life in general.

Dr. Diana Mercado-Marmarosh: Hi, welcome to beyond ADHD, a physician's perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers or three and four years of age. And in the past year, I have undergone radical transformation after discovering ADHD, coaching, and life coaching for the past decade, my typical day consisted of having 300 charts, backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own. I was running on fumes the last year. I figured out the secret learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back, like I have.

So today what we have is a very special guest, but before we go to all of that, I need to give you some pointers. So as we know, this podcast is to explain awareness of ADHD and how it's a lifelong disease. And I will be sharing with you physicians who will share their wins and their challenges along with any tips that they've learned to over achieve with ADHD. My aim is to stop mental stigma associated with this condition. Most people think of ADHD. Sometimes they think of a hyperactive child running around, but I want to bring to you that perspective that sometimes it could be adult mom, a teacher, a physician.

With this in mind, I want to show you that ADHD is an infinite and it's presented in many different ways with different people. So we will talk about the latest scientific data. We'll talk about different books and resources that have helped us. And like I said, I will bring you amazing physicians to share their life stories.

And just like I've shared with you guys before, I need to give you a disclaimer while me and my guests are medical doctors, we are not your medical doctors, meaning that, anything you learned here is not meant to replace or substitute any advise of your own physician therapists or coaches. In addition, anything you hear here doesn't mean that it is being represented by other people.

Meaning it's our views. It's our opinion. It's not represented by the people that we work for. The employers, the hospital, or any particular healthcare organization. I know I have. Say that my lawyer is proud when I say this part. So I have to get that out of the way. But today we have a very special guest Dr. Arun Rao, and I want to introduce her. She is in Florida. And so let's talk to her today. Tell us about yourself.

Dr. Arun Rao: Hi. So incredibly thankful to be a part of this podcast. I am a bariatric surgeon in, , Florida, , actually in Sarasota. I'm the director for bariatrics of a major hospital. And, I'm also a general surgeon, but my passion is truly, , bariatrics and I've got three little kids, seven, seven and 11, but me through my paces when I'm not at my paces at work.

Okay. I am blessed with three ADHD children that I have had to manage along the way, but they teach me more and more about this every day. They, they show me that every day that the, basically there are different versions of ADHD and how they present symptom-wise things that happen during the day. It's very much an individual thing. It's not a blanket statement if you will. So, but I am blessed to be their mom and they're amazing kids. And yeah, those are my big things. So I'm excited to be here.

Dr. Diana Mercado-Marmarosh: So you have twins cause you said seven and seven.

Dr. Arun Rao: Yeah, they're a handful, but interestingly enough, the way that their ADHD manifests is completely different. I mean, they're boy, girl twins, and my son is he's. He is, gosh, he's a joy. But he is probably my biggest challenge, a lot more issues with temper and, you know, early on, I could just tell something was going on when even when he was young, young, where he couldn't communicate. And I think initially a lot of his problems came from the fact that he.

Communicate, but he is very much someone who with medication can accomplish a lot. And I have to maneuver my way around things when he's not medicated. And, , my seven-year-old daughter is amazing, but she does require a very low dose of something in order to really get, get things accomplished in a meaningful way.

So amazing kids. And my 11 year old was my first dip in the ADHD pool or when it came to kids. So we've grown through the process. And while there are difficulties here and there overall, it's been such a blessing to just have amazing kids that do amazing things.

Dr. Diana Mercado-Marmarosh: Now, can you tell me about your diagnosis? Like how did that come about?

Dr. Arun Rao: I gotta be honest. I wasn't, I was younger at a time when ADHD was not really something people were looking at. And the first time as an adult that I can look back and go, well, that explains, that was, I was thinking it was like in the second grade, I think my teacher's name was Ms.

Gretchen, and she was this, she might've been an amazing teacher, but I knew she was gunning for me, and I can see it in my head where I was at a desk and it was one of those. Tiled floors, vinyl, tiled floors. And I kept tapping my feet, like the whole time, just tapping my feet. And I just, she would say stop and I would keep doing it.

And eventually she got so angry with me that she moved the table, my desk, and my chair in one fell swoop. They weren't attached. And she just pushed me all the way to the back of the room up against the wall. Like, because I, so you know, it wasn't, I didn't want to listen to. It's that was what was going on then.

And you know, of course all the report cards. Oh, she's really smart. But if she could just focus or she could just, you know, it just, all of these report cards fell into line. Unfortunately, I didn't figure this out until right before my surgical boards. And so, oh yes. You want to talk about. It was it my whole life.

I mean, high school was no big deal college. I tanked, I completely tanked in college. There was nothing I could do. I just felt so helpless and I felt really dumb. I felt like everybody could get it, but me and why did I need to read it eight times? And I really just kind of, I kind of gave up and I was actually told my mom, pre-med counselor.

I needed to find something else to do with my life because there was no way I was ever going to get into medical school. So heartache after heartache, after heartache. And, you know, after talking with a number of people about just my frustrations and wanting to share that with somebody, which was really difficult, you know, they said, you know, you have all of these symptoms, have you looked into this?

And then I started doing my own research and, then I finally like, literally I was studying, I had got like six weeks of studying for surgical boards. And I just had basically hit the ceiling on this and went and discussed it with somebody and sat down and teased it out. And, and that was the tipping point for me.

But I went through a lot of bad stuff before I got to that point.

Dr. Diana Mercado-Marmarosh: So in college, you said you tanked. Like where you, I understand you said you were reading and like trying to do everything as much as best as you could, but you felt like frustrated and they told you, forget it. There's no way you can be a physician.

You need to do something else. Like, what were you trying at that point? Like, were you trying like extra tutors? Were you talking it out to people to like, understand how to learn different things? What did you do?

Dr. Arun Rao: So I, you know, I basically tried to isolate myself in my room and I had all of these grandiose plans and it would always end up like I would read the same page.

Like I would get to a certain point cause I, I wouldn't be able to tolerate to a certain point and then there'd be this huge gap and I would read it over and over and, and, and it just, it never penetrated. If there was nothing at a certain point. Now I will tell you the other thing that I didn't realize is that the majority of meaningful studying occurred after 11 o'clock at night, which is not great.

Right. I mean, it's not great, but when I talk about that with like the therapist and. You know, people that I had spoken to, they said, you know, a lot of times ADHD, people do better when they're exhausted because they don't have the ability to tolerate all the noise that usually gets in the way on a regular basis.

So the fact that I was exhausted or I was tired or sleepy actually led my lent itself to doing better learning, because any time before 10 or 11, Nothing was getting in the door, nothing. And so I actually, I really did very poorly in undergraduate and I took time off. So I basically, I did research at a hospital.

I waited tables. I was, you know, I was always doing multiple jobs because my parents were furious. I've got those typical Indian parents that are like, what are you talking about? You know, you know, they didn't understand me. They didn't understand. They thought I was just this goof-off that just wasn't ready to be serious.

And so it made it even more difficult. And then I just said, you know, I can't. After having such a bad experience with college after really trying to give it my all and not getting anywhere with it. I said, I just need a break. It doesn't mean I don't want to still do this, but I need a mentor for like two years or so.

I basically just, I did some research at a hospital. I, you know, kind of, and finally, one day I was like, now I'm ready. I really need to get back to it. This is what I was meant to do. And I went to, I went to a program up in Boston for a year. It was, I definitely engaged in more ways and I did much better.

But I, again, I kind of overloaded myself with work and the majority of studying came at night and because I lived in an apartment by myself, there was no other influences really, but that time became my golden hour was late, late nights studying and. I still took a lot for me to do, but eventually I was able to kind of bring up my GPA, bring up my science GPA and I applied and I didn't get in, in the states.

And so I ended up going to a foreign medical school and, you know, again proved to be harder. But this time I had a roommate who really helped with the process of learning because I started incorporating multiple other ways of getting the information. So it was like, I would sit and we would discuss it with them when I had more.

It was almost weird when I had more distraction and more conversation going on. It also absorbed better. I did more study groups. I did more, there was definite I'm a more visual learner. I figured that out a little bit better. So it was multiple things that allowed me to kind of get through the process in medical school.

And I think as I got older, you know, it just became a little bit easier, but I think it was because I had people in my life who lived with me, who were all going through the same process. And, you know, we worked together a lot to get things like that done.

Dr. Diana Mercado-Marmarosh: So did you ever think like in college or in medical school, like, it shouldn't be this hard.

Like, did you ever think there was something wrong with you or did you just think, well, this is just the way I am.

Dr. Arun Rao: I just basically got to the point where I'm like, you're just not smart enough to do this. Like, that's what, it never ever dawned on me. I mean, at some point when you go through the stuff, like you go through psych and you go through these different things and, you know, it's kind of, you're like, this sounds awfully familiar, you know?

Like, why does this sound so familiar? But I first went to the point where I just wasn't smart and I was just going to have to work harder, but I wasn't smart enough and I wasn't going to do it. Like my roommate in medical school was, she was like a book. Like she could just read something and it would be in her head.

She didn't have to, you know, work as hard obviously. I mean, she just, she could absorb it like, that. And so even more. So I was like, and now I was blaming it on age because of course all my med school people were younger. So I was like, You know, it's just not coming. So for the majority of my life and even now, and it's one of the things that really pushes me to get my kids treated and to have the therapy they need, as I never want them to think that this diagnosis equals loss intelligence, it really does.

It's quite the opposite if you know how to reign it in and control it in a productive way. And so. I mean, I think my kids have really taught me so much more about this than I ever got as an adult child, et cetera. It really, through my kids, I'm learning so much about how this works.

Dr. Diana Mercado-Marmarosh: And so finally, somebody told you, okay, maybe you have ADHD.

So you went to, was it a general doctor or did you go straight to a psychiatrist? Do you remember what that was like?

Dr. Arun Rao: I went to a general doctor and the workup is not, obviously is not as thorough as if you were to go to a therapist or a psychologist or psychiatrist rather. And the only reason I know that now is because my kids see a psychiatrist and he really teases it out.

I'm like, oh, okay. That makes sense. You know, but I went to a general doctor. I almost felt like the diagnosis was too easy. Like they're like, oh yeah, here it is. You know, because quite honestly, I do think that there are people that aren't really ADHD that take the medications because it gives you hyper-focused.

If you're not really. You know what I mean? If the diagnosis is really isn't there, it can give you that hyper focus, but it's not the right way to go, obviously. So I just felt initially I was like, this is too good to be true. This can't be working the way it is. I mean, it was like, I mean, just the tables flipping the way that they did and me sitting there going wait, did I just studied for an hour straight and actually not have to read something three times?

Get it. Like I had to almost, it was so funny cause I did all these no cards. Like I was trying to sell hard for surgical boards to just get it into my brain. I wrote it, I looked at it, I drew it. I, everything that worked in medical school, I really was trying to just cram into my brain and it just wasn't going. And then I got this medicine, I was like, this can't be right. So I would go back to the flashcards and like quiz myself to make sure I didn't just read it and was focused, but that I actually was absorbing it. And it was just. I mean a light bulb went off and I mean, it was just amazing. It was just amazing.

So yeah, I mean, it was definitely, it was a life changer, really?

Dr. Diana Mercado-Marmarosh: So, you know, I don't know if you heard of this book, ADHD, 2.0, it's by Dr. Hallowell, on there, I read it in the last year, maybe in the last six months. And for me it was also life changing. Like I finally understood like myself and the diagnosis and like a lot how I treat my patients because I'm a family medicine doc, and I do see patients with ADHD and I finally got what he was saying.

He was saying that, you know, adults that are diagnosed, that we've had it all along, but we tend to compensate because either something's interesting or we just, you know, Some people call a stubborn or some people call it as determined. We like find ways to get to it, but then you reach a point to where either you have the birth of a child or you have, you get to college or you get to like medical school, law school, something that really challenges you, or you get like, you become like the boss, or something where you, your executive function just tips over, even though everything you were doing before you were finding ways, it's like gets oversaturated. There's doesn't matter what you do, how many more hours, whatever it, you just can't. And that's why it's so hard sometimes because they're like, I see you doing all these other things and you do it so well, but you can't do like something simple sometimes it's really weird because. What might be simple to you is complicated for somebody else, but first something complicated for somebody else, it's like a walk in the park. So that book, if you haven't heard about it or read about it, you might want to look into, it might help you tease out a lot of this stuff.

And he talks about like, How in the last five years, they realized that they can use MRIs to pick up the different areas in the people with ADHD versus not ADHD and how they light up in different, right. Versus the left side of the brain. As we know, some of us are like, we think, and we are creative. Right.

Okay. So it lights up differently for ADHD. So now there's a lot more evidence and, it's just not like you're saying how some people are like, oh, I just can't concentrate. Give me a pill. No, but like now they're finding all these other way. Of course they're not using that to diagnose right now, but at least it's really cool to see scientific data coming out and all that. Are your, are you a first generation here or you always been here?

Dr. Arun Rao: So I was born in India. Moved when I was three. So I've lived here most of my life.

Dr. Diana Mercado-Marmarosh: The reason I questioned that is my I'm Mexican American and my, and I was born here, but, I lived in Mexico. Tele was 10. I was born in Texas and I lived in Mexico. I was 10, but there are studies that show that ADHD is genetic.

And it's also, it shows that the immigrant parents usually, you know, because it takes Coronas right. To like, move out of your country to go somewhere else, to start a whole new life, not even knowing how, but the belief that you're going to do it. Like. So there's a lot of information that is showing that immigrant people, and it's usually genetic because you have to really like it. Make sense. You have to be the Explorer and be creative and figure out. When you don't know how you're going to figure it out, but you're going to figure it out. So, I asked that because you know, I've been interviewing different physicians and some of them like, you know, they come from Egypt, they come from all over.

Right. So it's just, it's so interesting. How ADHD is a spectrum. Like you said, you can see it in your own kids, how it presents differently. And at the same time, how there are certain things that are. Our traits and it's not like a character flaw. It's just, that's the way it is. You know, you take the med and then, like you said, it's not like you were not smart.

You were it's just that the way your brain was functioning was not letting you. Do it all at once. It's like having 25 tabs open and you're trying really hard, but we all know how slow the computer can be. If you have 25 tabs open, lower it down to one or two, it's so much better, right?

Dr. Arun Rao: Yes. And you know, my three kids, I think my oldest is more like I was as a kid.

And when I speak with her, it's interesting. Cause I can almost see it happening. She'll have something to tell me, but she'll have four sentences and they're all trying to get out at one time. So, you know what I'm saying? Like, she, she knows what she wants to say, but because they're all trying to cram out at one time, it just comes out as this kind of like, well, I, and you could just see it all working.

So yeah, I a hundred percent get that. And interestingly, my dad ADHD, my sister is a physician. Mom's a physician. She doesn't seem to have this issue, but I'll tell you, I mean, it is just, I mean, it's crazy. And I think that. Understanding the fact that it is not a sign of intelligence or lack of intelligence in fact it's a sign of higher intelligence that even the product or the ability to get there. And I will tell you with my oldest, one of the things that confused me for a while is if I put her in front of a television set, she has focused, like there could be a bomb next to this child will not notice it at all.

I mean, if that's the way it is when I told the therapist, I'm like, I don't get it. I mean, I think that she just doesn't want to focus. I think she just he's like, that's not how this works. There can be things that will focus you like that. It's the majority of other stuff that you just can't seem to bring yourself to.

So that's also was a part of me that felt like I couldn't be ADHD. Cause there were some things that could hold my focus. Like surgery could hold my foot, you know what I mean? Like it can hold my focus, but.

Dr. Diana Mercado-Marmarosh: Because you're so interested in it. You love it. It's aligned with your passion.

Right. But how about you? But I'm not like, Ooh, I can't wait to do my dishes and my laundry. Like, those are just things that I'm just like, ah, you know what you're doing them. Right. But it's not like it's in the area where your passion is aligned. Right.

Dr. Arun Rao: Yes. A hundred percent. So, but that was the confusing piece for me, especially with her.

And it explained also for me, cause for, you know, after. Training. And I say in training and when I had my kids, I wasn't medicated. After, after my exam, I was for a little bit. And then I was like, do I really need it? And honestly, I don't know that I needed it because I was in surgery all the time and I was good.

I was focused. I didn't feel like I didn't feel like there was anything specific that required that much attention that I couldn't give it. And then things kind of changed, you know, like I, as I get older and I was like, what I realized is that the piles on my desk were piling up. Because I wasn't finishing things completely.

So my ADHD issues led to significant anxiety, lack of sleep at night because I just could not finish things unless it was specific to, so I mean, even at night when I'm like in bed and we're watching TV, I'm into what we're watching, but I'm playing games at the same time on my phone and texting, you know, it's just this constant drive. I don't know. It's crazy.

Dr. Diana Mercado-Marmarosh: Looking for dopamine from different places so you don't get bored.

Dr. Arun Rao: Gosh, I mean, it's, it's crazy and there's, there's very rarely a time. I'm not doing two and three things. And I feel like sometimes I actually feed off of that, which isn't great. You know, so I've had to go back to the medicine in order. Cause now I'm a director, I've got more responsibility outside of the surgery suite.

And so. Not only that, but even just being a parent, who's a surgeon and having to schedule and keep organized. And I don't know how I would do it at this point without having the medication that's necessary to be able to, you know, get me through that day.

Dr. Diana Mercado-Marmarosh: That's what was going to bring me to this question is like, how do you think your diagnosis impacts or affects those around you?

Like your family and your friends? Like, so you notice when you take the med your. A lot more there

Dr. Arun Rao: and I'll tell you, my sister is not medicated, but she'll like, she makes fun of me all the time. Cause we'll be in the car and she's, she'll be having a conversation with me and we're talking and she's like, it's like, you're sitting in the car, you're talking the next thing you go in depth in a conversation, you'll be like, squirrel.

Completely unrelated, not even close to what we're discussing and I'll sit there and I'll go. But when you said this, it made me think of this, which may lead me to this. And she's like, you just need to stop.

Oh, well, hers is not as difficult to manage as mine has been. And I think the more stuff I've got to juggle actually feeds into it and makes it more difficult to focus, you know, in life in general. So yeah, it, it makes a difference. Yeah.

Dr. Diana Mercado-Marmarosh: So I'm in that book that I was telling you about, they talk about how ADHD has two times.

It's now not right now. And usually the not right now, like we forget about it. So unless we write it down or we keep a, like a little nugget somewhere that's. Like you said, like, if you were doing a paper, , filling out some work and then you didn't have all that information. Right. Then you're like, oh, I'll do it later.

But then later, like you just it's out of your mind that you forgot. So like, oh, dang. And then it could be months by the time, like, oh, there are, the papers are still there. It's almost like you become blind to them, even though they're right there, right in front of you.

Dr. Arun Rao: Oh my gosh. It's so true. You know, the other thing is like I carry a patient phone, I carry a personal phone and the patients are like texting me throughout the day, or if I'm in the operating room and I'll be like, okay, I'm going to answer that phone.

And sometimes I actually have to do something physically to my phone or have them wrap it a certain way. So it triggers me after the case to make that phone call or communicate with that person. So you do kind of compensate that and that's even with the medication. So it's not always going to be a perfect scenario, but it's definitively better.

You know then that, and I'm gonna also say that recently I took up photography. Like it's always been something I've enjoyed, always something that like in the, like, I try to take these interesting pictures and I never, I sat down. I'm like, Hey, I don't have any hobbies. Like I'm either a hundred percent doctor, a hundred percent wife and mother there's like literally nothing in between.

And I'm like, I really want to be more three-dimensional with my own, you know, with me. And I was thinking about it and photography popped up. I honestly think that I would not get to a point where I want to think about a hobby for myself. If I didn't have good control over the things in my life right now, I would feel overwhelmed and incapable of adding anything.

But this, that, this allows me to be far more dedicated to things, because I know I can accomplish them as opposed to adding things to a list that you know is going to be forever growing.

Dr. Diana Mercado-Marmarosh: Right. And, and I think that's a very important trick or technique. Really, I call it self care because when you are doing things that, again, go back to what brings you passion or something that intrigues you because it's different, or you're wanting to learn about it.

Then you are prioritizing what needs to stay on your schedule and what can be delegated right. Making sure that you do make a commitment to yourself to have that specific time to do that, that, that photography, right. Or for some people is running or sleeping or different things. But it's important because, I don't know about you, but with me before learning how ADHD work in the last year, I had no time for me.

Like, it was always like kids, you know, or work or whatever. And like, I didn't know. I could ask my husband, Hey, can you watch them for 30 minutes so that I can actually go for a run or like, I can meditate or I can journal or something. I just. Like, you know, that's not something I can ask for because I haven't done all my other jobs, but like now I'm like, okay, well, if I have to prioritize me, because when I prioritize me, then I feel my own cup and then I can show up more mindful and more present with whatever I am doing.

So, like you said, it's kind of like having a structure for the thing that you love. Can do everything else more efficiently.

Dr. Arun Rao: That's the thing is like, I don't want to be like, I don't want my career to define who I am. Like I see this all the time. I see people wanting to retire, but especially there are some older surgeons, older doctors in the community that are trying to retire and I see them come back after a retirement party.

What are you doing? They never develop that side of themselves. And, you know, as ADHD folks, I'm sorry, we are creative. Like that is definitely one of the traits. And I see it in my kids, my son, oh my gosh. He's got a million Legos, Amelia. My daughter loves to draw my seven year old will get on the computer and draw amazing things just from a little tutorial.

And Maya's always been like taking pictures or, you know, painting. They love it. I, you know, I dropped them off. You know, one of the local art places and make for two hours, there are good. So I feel like I want to foster my own growth. And, one of the things I've realized about ADHD is it doesn't even in a particular person, it changes as you get older, as you move into other parts of your life, it's not a black and white.

It's not like here's your diagnosis, here's your stuff. This is how you fix it. Go ahead. There are different aspects to this, even as an individual that you go through. Based on how you manage before you ever figured out something was, was not right. You know, so,

Dr. Diana Mercado-Marmarosh: And just like you've said, like, based on whatever's going on in your life can lead to anxiety and depression, in addition to you having your ADHD right.

Or life sometimes happens, you know, we're grieving something, you know, so. Take us in different places. And like recently I've been learning about like hormones and stuff. So like menopause, like can really affect people with ADHD. So it's, unfortunately, some people don't get diagnosed until then, which, you know, it's hard, but it's also important as we're learning more things to keep an open mind and to be curious, because.

Even then people are like, well, they're 50. Why do they need their meds for you're like, dude, some of us lived to be 90, like 40 of them, like being able to do like a productive life. Like I still have some people that I've diagnosed like later in age and they still tell me, doc, this was life changing.

I can't like finally write my music or like do all these things that you just that's the thing with our brain. Like, we're still curious. I feel like we're long term students, like we are constantly learning because we're curious.

Dr. Arun Rao: Yes. And that's the thing is adds quality to life in retirement, right? Like I know, I remember I can clearly remember my dad taking like a glass class when we were, we lived in like Arizona and he had this little work bench and, but he would never finish.

Any of his product. I don't recall ever seeing a finished product and you now he's older. He doesn't really want to do it. And I'm like, when, you know, you can finish something to completion the impetus to want to start both so much higher and you know, your desires improve. Quite honestly, the directorship here has led to so many cool developments because they've given me kind of a cart launch to develop things.

And I kind of made a mental list when I first got here, what I wanted to accomplish. I've literally in four years I have, I actually have created two other clinics. I've been able to hire, dietician, just different things to make the clinic better, to give the patients things that can support them. I mean, by making.

By giving myself the opportunity to use that creativity and see the need and fill the need. It gives me the opportunity to be a better doctor to fulfill the needs of my patients. I mean, it's just, it's awesome. And I go forth with that and I become even more persistent when I know it's a good thing. And it allows me to accomplish so much more on a regular basis.

Really. It does.

Dr. Diana Mercado-Marmarosh: Yeah, that's a wonderful that you're bringing that up. Cause that's what I was going to ask you. Like what are some, , reflecting, like what characteristics make you a great doctor? And like you just said, it's your ability to see the big picture. You don't know how it's going to get there, but you just, we are dreamers.

Right? And we are changers and it doesn't matter how long it take, but this is how I want it to look. I don't care how the details don't tell me what the details, just make it happen.

Dr. Arun Rao: That's ahundred percent because it's all, it all starts with vision. Right. And maybe the vision isn't what the final, but usually the final picture is better than the vision because all of these pieces just start to come together.

And so, I see when I first came here, I begged, four years ago, please get me telemedicine, get me telemedicine. Because one of the things in bariatrics that ends up happening is the patients just disappear. They feel like either they feel overly confident. They've got it. They don't have to worry, dah, dah, dah, dah, or it's just too hard or they've moved somewhere and they can't find the person that will help take care of them and keep them going.

So I begged for telemedicine for four years every year. Oh no, we're not ready. We're not ready. And then, and the funny thing is they gave me telemedicine before COVID hit. So it was really that just persistence of look, neurology's got it. Why can't we, I really think this is important. And the next thing you know, I'm helping to spearhead the initiative when COVID hits, you know what I'm saying?

It's just, it's crazy. So, yeah, it's pretty crazy. It's awesome.

Dr. Diana Mercado-Marmarosh: What are your goals for the next five years? Have what are you envisioning like in terms of traveling with your family maybe, or, , anything in your career or any new hobbies that you would like to do?

Dr. Arun Rao: So, you know, I literally, I mean, when I say I just started with the photography thing, I mean, my camera came in the mail last week.

So it's like really new. And I met an amazing PMG with, you know, with our process that has actually mentored me in the process of photography. Cause she's a photographer, so it's been great. But I really, for me, the, the key is to make sure that I am, assisting my kids because of course with children, you know, it's an ever-changing situation in terms of the meds.

Is this working? Is this not? And as a parent, you know, I can honestly say I've had a parent in my office, boo hooing. I mean the big tears telling me that she just found out her child has ADHD. Why are you crying? She's just looking at me like you're crazy. And so I started saying, listen, your child is probably well above average intelligence, do not take this as a negative thing.

You're you need to empower your child to use this diagnosis to do great, great things. So, you know, I mean, I really, that. Journey with my kids right now and really making sure they're on the right meds and the right dosage. It doesn't change their personality. They're getting the most out of school.

They're pushing ahead. Like those things are going to be critical in the next five years for me, as they move forward in their education. And as far as work is concerned, oh my gosh, sky's the limit. So I opened a medical weight loss clinic. Designed to help patients who already had surgery. I take all comers.

It's been an incredible experience already, but my last goal, which I haven't quite accomplished, but I'm starting to kind of step towards that is I wanted to create a family program. You know, I wanted to develop a program where it isn't just the one family member who has diabetes and has the issues coming to me for surgery.

And then I'm putting them back into a situation with an entire family that has a similar problems or headed in that direction. But have no guidance. So my goal is to start very small, maybe five families a year where we take the entire family and change their thoughts about nutrition and lifestyle changes and their thoughts on how food works.

So that maybe the next generation won't find themselves in my office, you know? Yeah. That's and I'm actually, you know, I've actually got a book that I'm contemplating and it's interesting. Cause it's one of my patients, is I've been thinking about it forever, but my patient came to me and said, I he's a well-known person, so he's come to me.

And he said, I want to write a book with you. And so although pieces are starting to slowly kind of come together, but I mean, man, I'm just excited. You know, ADHD did not bring the excitement for a very long time, but, I don't look at the climb anymore. I look at what the view's going to look like at the top, because I finally feel like I'm going to get through the climb and I'm going to be able to see at the top, whereas before I did not feel that way I could only see the obstacles.

Dr. Diana Mercado-Marmarosh: It's so wonderful. How you, you just described the mind shift that has happened. That has. Instead of feeling like, man, I have this, what the hell? It's not like I have it. Yeah. Guess what's going to happen. Right. And start to just visualize the possibility of being able to do whatever you want to do.

And having people around you to support you in doing what you're doing, because it does take a village, right. To be able to help us with our kids, to help us with, um, the vision of, of empowering the whole family. Like you just said, not just that one person that came and was your patient, but the culture so that, like you said, going forth, this is just not something that happens again, because your culture, that's how you eat or that's how you share the love with each other. Right. Learnings at the, excitement should be from the activities that we do, not the culture of eating, because like, I don't know about your family, but I'm sure it's like my family, we eat. Cause clearly we're happy.

We're sad. Like somebody was born, somebody died, like, you know, our everything, right? Yeah. And, so you celebrate other people's like holidays, not even your holiday. right. And so you just have to learn like being in a family, like together, playing board games or different things. It doesn't have to entail all the foods.

Dr. Arun Rao: It engaging. I tell people all the time, the people, you know, it's not the food that's on your table. It's the people around your table exactly. To change that focus. And when it comes to ADHD, you go from being. You know, over basically overwhelmed and overpowered to be, to being empowered, which is such a huge shift.

Dr. Diana Mercado-Marmarosh: Yes. Awesome. So tell me if my listeners wanted to get in touch with you to either ask you something about your kids or just to ask you about how do I get in touch with his family thing that you're doing or to become one of your patients?. Where can they email you somewhere or do you have a website to share with us where they go?

Dr. Arun Rao: You know, my practice is at Sarasota Memorial hospital. It is the public hospital. It is the biggest hospital in Sarasota. And, I, if you just Google my name, the, page, all the pages kind of come up and we're still in the midst of developing these pages, but you know, the beautiful thing is with telemedicine the reach just grows and I'm not here to say I am the best out there. But it's imperative that people. Fight for themselves and their, for their life. And the interesting thing about Sarasota has changed my thoughts on obesity and bariatrics and health in general, because I went from a population that was really 50 and under to a population.

The majority of my patients are 65 to 80 years old. I'm talking about going into surgery at 79 and 80 years of age. Doing just phenomenal, phenomenal things. And so I encourage patients no matter where you are in your life to fight for your life, fight for that quality. And if it means, having the conversation starting the discussion, you know, you can always sit there and be discouraged where you're at or realize that if you don't move, you're going to be here in the same spot for years to come.

It's a big journey. I'm not going to lie no matter which way you go, this is a big dream, but it's going to be worth it. And if you start that journey, You're going to be so much further along and then you get to look back and go, oh my gosh, I'm so glad I started. So definitely, you know, there are great providers, great bariatric surgeons in every community.

You certainly want to search for somebody who has an ASMBS certification. That is a quality designation. Our program is meant to help as many people as possible. We are, by the way, very excited because in October, we were initially doing that one clinic for three days a week, we went from two days to three days administration just called them and said, we want you up to five days by October.

Dr. Diana Mercado-Marmarosh: That's amazing. Awesome. Well, there you have it. Is there one final piece of advice you might want to share right before we close? I know you dropped all kinds of amazing, you know, advise already. And especially what you just said, like that can be applied for anything, like fight for your life, whether it's for exercise, for getting an ADHD coach for, getting a family physician or a cardiologist or some therapist, anybody who really understands you. And if you don't like what happens, go get a second opinion, right? Like that's the part that is really important until you find somebody that understand where you're going and both together work as a team to get there, because I mean, you are great and I am great as a physician, but that doesn't matter if the patient is not ready.

Right. And so when the patient is ready, the teacher shows up. So, so that's how that happens. So, thank you so much, but anything else you want to share really quick with us?

Dr. Arun Rao: I mean, I just think that, you know, the power of the mind is something that is just, and I tell people all the time, even as a bariatric surgeon and I say, you know, we have people who gain their weight back definitively true.

But if I operated up here, Nobody would ever gain their weight back. And that goes for everything in life. And you know what nobody's going to fight for you. You have to fight for you and you only get one life. Don't say you're too old. Don't say you're too young. Those are just excuses. You've got to find the right doctors to help you to be the best you at every stage in your life.

And so I encourage people to just be advocates for themselves. And if you're not happy, that is so critical. I can't tell you how many people I've met that have seen another physician who was. Oh, oh, I don't know. And I'm like, whoa, my goodness. If it doesn't feel right. Don't give up, go find somebody. You, everybody has that sixth sense.

You got to listen. So, you just, you gotta fight for yourself. And, I'm so glad that I had a chance to talk with you. I hope that, you know, our, our discussion today helps somebody make a better choice or, you know, search for something better in their life. I think that's critical.

Dr. Diana Mercado-Marmarosh: Yes, you so much, Dr. Rao. It was a pleasure to talk to you. You're such a delight and there you have it kids, and adults, as you see, we're all kids at heart, we all always want to be, empowering ourselves to try new things and challenge yourselves. But just like that, you have to remember that new things are new for a reason.

So don't be so hard on yourself. Start with a beginner's mind and explore it and have fun with it and keep trying to empower yourself because that's the only way we improve. It's not to compare ourselves to others, but to compare ourselves with ourselves so that we improve. Our own quality of life so that we then show up better for everybody else because we are happy.

So thank you again for listening to this week's episode with the overachieving ADHD physicians. I really enjoyed, my awesome physician today that I got to share with. And if you guys have any topics you all want to talk about, or any feedback you want to share with me, send me an email at overachievewithadhd@gmail.com and y'all have a good one.

As someonewho understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.