Rooted in Intention
A holistic self-development podcast to grow the life you want, from the roots up. We go into healing, relationships, health, money, and community. Listen to connect through stories and learn practical tools.
Rooted in Intention
Sleep, Aging Parents & Your Future: How to Care and Plan More Intentionally with Dr. Luis E. Chug
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In this episode, I'm joined by Dr. Luis E. Chug, MD, a quadruple board-certified physician in internal, pulmonary, critical care and sleep medicine, in addition to being a mission-driven entrepreneur. Dr. Chug wears multiple hats, so this episode covers an array of topics.
Tune in to learn:
- What it can look like to navigate burnout within healthcare and reinvent yourself;
- What conversations to have with aging parents before an emergency happens;
- How residential assisted living can be an option for aging parents, as well as an investment option; and
- Why it's so important to care for your sleep.
Want to dive even deeper? You can connect with and/or work with Dr. Chug through:
- Website
- If you are a healthcare worker interested in learning more about residential assisted living (RAL) investing, join the Facebook group.
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Life can sometimes feel like a lot, but you don't have to do it alone. I strongly believe that we're stronger together. Here we're going to slow down, have real talks, make sense of things together, and explore ways to intentionally grow the life you love. We're going to talk about mental and physical health relationships, money, work, and community. Welcome to Rooted in Intention with me, Getty Nagelman. Hi everyone. Thank you for tuning in to another episode. Today I'm joined by a special guest, Dr. Luis Chug, who is a sleep and pulmonary doctor and a mission-driven investor in residential assisted living. So, Dr. Chugg, thank you for joining me today.
SPEAKER_00So thank you for the invitation. Very excited to be here.
SPEAKER_02Yeah. And I usually like starting off with people's stories, but I have a question before jumping into that. How is the doctor doing?
SPEAKER_00Oh well, I'm doing good. Thank you. Uh, things have been doing well for me. Appreciate it.
SPEAKER_02Wonderful. We have to check in on our doctors as well.
SPEAKER_00Yes. Yes, no, that's true. Especially nowadays, we know and recognize that there's a lot of burnout from our from not only doctors, but nurses and other healthcare providers.
SPEAKER_02I imagine, especially after COVID. So I actually have a public health background, worked with, I don't know if you're familiar with community health centers, but worked very closely with that. And burnout was definitely a big thing that I would say healthcare systems are trying to address.
SPEAKER_00So it's real and it has to be addressed not only of the healthcare providers, but also for the patients.
SPEAKER_02Because we're all interconnected and we influence each other. Okay. So with that, I would love to hear a little bit more about your story and what first got you interested in medicine. And how did you then become interested in investing in residential assisted living spaces as well?
SPEAKER_00Sure. So basically, I am originally from Peru. Uh, my family is from there, and that's that's the place where I grew up and uh finished my medical school. I got interested. My family has a background on medicine. My my dad was a pediatrician analogist, and my mom um she is a nurse. Uh and right there I got interested. Uh, I always liked science and I decided to help people. My training was challenging but uh also very satisfying. And then I decided that uh US uh was a place for me to continue my training. Um my dad did some years of training here, and he always motivated me to come here. So I decided to apply and do all the testing and all the training that is required, interviews, etc. And I ended up in uh residence in New York, which was a great experience. I I did three years of internal medicine, and after that, I decided to follow also one of my passions, which was uh lung disease and ICU. So I did uh that in Kansas City for three years more, pulmonary and critical care. And then not satisfied on all this studying and training, I decided to do another year in Houston doing sleep medicine, which ties up very well with uh my specialty of pulmonary and critical care. So I am quadruple board certified on these specialties, and I have been in Houston for the last 10 years serving the community, and now after COVID, and we can talk more, I'm pretty sure. Before that, I joined a practice and I was working for a hospital, and after COVID, there was a lot of burnout because I was covering ICU a lot, and I was just having my second baby, and my wife is a nurse too, and but she unfortunately uh had to stop working at the time. And after COVID, I spoke with her and I told her that I was very burnout, something has to change, and we decided to open my own practice and become an entrepreneur because obviously being my own boss uh requires a different mindset shift. And I decided that I trained myself, I educated myself to also reinvent myself to do other things beside medicine, and that's where my entrepreneurial journey started, and actually it went well. So I'm very glad that we took that leap of faith, and now um we are in a position where also I want to decide where to invest, not only my financially, but also my time. And one of my focus uh with my wife, a partner, uh a business partner, is to help our seniors. And one of my focus has been senior leaving now.
SPEAKER_02That's quite a story, especially because I imagine that there's so much difficulty in moving countries, plus the training around you said you are quadruple board certified. And then I would say on top of that, you made the pivot into entrepreneurship. And I imagine that was a big change. Can you share a little bit more of what that looked like at the beginning? What were some of the things that you really had to change about the way that you viewed things?
SPEAKER_00Something that I I tell my colleagues when they hear my story is that we as doctors uh we are trained to be very stoic, that we can do everything by ourselves. And one thing that is very hard is to try to uh change that chip where we can do everything and try to bring up that we can use help too, and try to get the right teams for the things that we don't know, and that mindset shift is what is important for being an entrepreneur, in addition to having an abundant mindset where you want to provide the service to people that need your service and try to find out what are the pain points of your customer, and and from there try to bring that uh service that you can provide, and also try to help people in your own team to see how how you can help them as well. I think that's the main mindset that I had to really change, and that's where I started. Besides starting my practice, I also invested in real estate and I did a lot of seminars and masterminds that really helped me with that mindset. And I think that's the main shift that I did, and that really helped me not only with those, but also in my personal life, where I found myself that teaching or reinventing myself and changing my mindset could help also in my personal life with my kids, with my wife, with my friends. And I think like nowadays I'm really more proud sometimes from that mindset shift than my all my medical career. So but things I'm achieving now because reinventing at this age, after going through all what I went through, is not easy, and not only for me, for a lot of people in my position.
SPEAKER_02Yeah, I would say my mom, she's like, oh, like it's too, I'm too old to learn new things, and I'm just like very forgetful, but it's just recognizing the power that we do have to make those changes. And I think that's what I really appreciate about you saying, is just like, oh, I actually had to do like more learning and change my mindset. And I was talking to someone that is a neuroscience coach, and that's one of the things that she was just saying as well is the neuroplasticity that we have within our brain. And I think it's a message that so many more people need to hear is that we can mold our mind and we can make pivots in life.
SPEAKER_00Yes, I'm glad that you mentioned that because that's one of the things I try to work with my patients that is exactly what they how they they talk to back to themselves. Like they cannot do it because they have been doing it for so many times. Oh, I've been smoking for so many years, oh, I have been eating this way for that many years, and that's exactly where I'm more successful is to talk to them first, that they can do it and change that chip that it's a matter of baby steps, but those small changes and the way you talk to yourself is very important to switch, otherwise, uh we're not gonna, no matter what I do as a doctor, they are going to continue doing what is harming them. So I think that that's that's very key on on seeing my patients.
SPEAKER_02So for the patients that you see, do you see two different types of patients? One for sleep pulmonary issues and the other one for the residential assisted living?
SPEAKER_00Uh good question. So the good thing about my specialty is that it connects uh with other with different settings. I get to see the patients in the hospital when they're sick, the senior adults in the ICU uh also on the floors and in my office, but I also uh go beyond that in my practice and see these patients in other settings like nursing homes and assistant livings, and I get to uh observe firsthand that continuity of of their living because most of our seniors uh they are going to end require some sort of senior placement at some point on their life. I think that's the percentage, if I'm I'm wrong, is more than 70% of seniors are gonna require some sort of uh senior uh living requirements. And that's huge. That's why I promote my videos and my social media education on how to discuss this caregivers, ask as caregivers, uh, if you have uh your mom, your dad, to discuss this situation earlier, because a lot of time what I see when I'm rounding around and in the ICU that these conversations happen very late on the stage and when there is a really need, rather than be prepared earlier and have more time for the senior, the elderly or loved ones to uh process the information.
SPEAKER_02And I know me and many others have parents that are aging. Can you share a little bit more of the things that you find helpful to have in those conversations with our aging parents? And what are some of the things that you see that work and some of the things that aren't as helpful and make the process harder?
SPEAKER_00Oh, sure. Thanks for bringing that up. And uh again, I think like one is to try to discuss things earlier and bring those issues, try to focus on the problem more than oh, you have to we have to talk about sending you to this place. It's better to bring the problem, like for example, I've mom, I have noticed that you are having you're missing your medications, or is how are you doing? Are you able to come down the stairs? I've been noticing that you have been falling more often. So focusing on the problem is a second recommendation. Another recommendation is if there is some sort of uh defensive, which is normal approach, is the sentiment from our loved one, we should um instead of avoid it, try to recognize that there is going to be and something like uh mom, I see that you are distressed, you are you are sad, so I just wanted to let you know that I'm here for you to support you, and then maybe take a break. And and if things uh get a little bit more challenging, uh try to bring some experts. For example, if there's too much tension to bring a doctor or a social worker to kind of uh help with these conversations. The other thing is important, and that happened to me actually, I'll tell a story that sometimes it's good to bring the other family members and recognize that you are as a caregiver, that there is a burnout because sometimes family members that are outside they don't realize how much care and time our loved one requires. And once they realize maybe we can have a family meeting and support each other. That happened to me with my dad. Like I was finishing my training and he was unfortunately getting sick, and we was living with my sister and my mom, and I vively remember that they uh they keep telling me the stories of what he's going through until I took a break, and one weekend I went there to help. And I remember I stay with him, he had a heart heart condition, and I couldn't sleep. I was like helping all the time, even at night, and actually I fell asleep at some point, and and it was so hard for me to keep up. And I then I realized like how much work the my mother and my sister were doing for him. So I think that's very important to also talk with all the other family members so they are in the same page. Um, because that's where I see a lot of drama, unfortunately in the ICUs when someone, when there is a fire, uh, I mean, it's not the perfect time to discuss this situation. So, yeah, those are some of the recommendations that I will give to people to do that to how to approach this. I hope that helps.
SPEAKER_02Yeah, thank you for sharing about your experience with your dad. And I imagine that that was a lot for the family. And yeah, I think caregiving I is one of those other parts where there could be a lot of burnout as well. And recognizing, especially if someone has health issues, I imagine that could last over years. That's someone that needs a lot of help and attention and being able to, if there are siblings, hopefully, luckily that people have, or other family members, I imagine that it would be super helpful to what you were saying, being like, hey, like all of this can't fall on one person. And I'm curious if you can share a little bit more about the different options that people might not be aware of in caregiving for someone that needs support. And I imagine this might look a little bit different depending on like the states where people live. But what are some things for people to consider?
SPEAKER_00Sure. So obviously it will depend on the level of care that a particular patient might need. And obviously, there are also the financial aspect. But in general, depending again on those factors, you can have a home health or a visiting nurse at home to help, and you can have also an assisted living, uh, where assisted livings are a senior living where the caregivers they can help basic daily activities and uh they can help with uh medication, they can help with feeding, maybe mobilizing. Nothing more extends than that, no medical care. Some doctors can come and nurses to help, obviously, but that's basically what assisted living. In between, also you have independent living, but that's less you support from a caregiver. And this could be uh pay at some some part from a private or sometimes insurance will not cover this for most of the time. That I have to say that medical insurance. Sometimes people that have uh insurance for senior living, I forgot the name, that can cover some of the costs, and there are some BA benefits that might help. Then after that, you have obviously skilled nursing facility where the level of care is higher, and then obviously other I think that those are the main ones. And I just want to mention that for the those caregivers listening, and that always is good to realize that not to feel guilty of making decisions because there is data actually that supports that uh assisted living or or some sort of senior living actually has is more beneficial for the loved one because you don't have that social isolation, there is better outcomes because you have a more of a 24-hour caregiving where they can support with activities and moving the patients. Because you can imagine sometimes patients can, and I've seen it a lot, can be incontinent, and you need that constant change, otherwise, they develop uh wounds. Um, also patients with dementia uh they sometimes wander wander at night, and they need that special support 24-7 to redirect, otherwise it can be dangerous for them and for others. So there is research. My point is that actually uh senior living is has improved outcomes and more not only hospitalizations and entering into ERs, but also improved quality of life. Um obviously you can see people interacting more with other people, so that social isolation is important to keep our loved ones um more active.
SPEAKER_02I'm curious if you've thought about this. So when you reach that older age, senior living something that you've considered for yourself, or what are your thoughts on what your life might look like when you're older?
SPEAKER_00Sure. Um yes, and more that I have been into this space. Uh my mind has been my goals has been to obviously try to support myself and and have uh a financial question so that me and my wife we can like have that decision of choosing where we want to spend our our days, right? Um, and don't leave my kids with that tough decision. But at the same time, obviously try to save so that we can have a comfortable retirement. And that might include to live in a senior care.
SPEAKER_02Yeah. I think what appeals to me about being in a, I don't know if it's a senior living or I haven't looked at all the retirement options, but is really the sense of community. And I think you were talking a little bit about what the research shows in terms of like reducing hospitalizations and having the support when there's health issues. But I think one of the pieces too is just having that sense of community. And it's something that I've talked about with my college friends is wouldn't it just be nice for all of us to buy like one big plot of land? And we all still have our own separate houses because we still appreciate like our privacy and our own space, but still knowing that we're close to each other and creating that sense of community. And I imagine that that's one of the things that's helpful. Because in the US, not only is there's like the loneliness epidemic that we have, but then there's the like additional loneliness when someone might be growing old and their kids might be off like in a different state or in a different area, and they're not having as much of that like human interaction. So yeah, interesting things, I guess, to think about for both our parents that are growing older and for ourselves as well. Of what is the society that we're creating and in what direction are we going? And where's community left with all of that?
SPEAKER_00Yeah, and I think that's a good question to to start asking ourselves. I think in US, we don't ask that. We think like, oh, we'll sort it out later on, or our social security will help us, and actually will not, because it's not gonna cover senior living. The sense of community is very important, and I think that's one of the attractive parts of senior living, like assisted living. And we see that a lot more in in Europe. I've seen that people take that more into consideration than here, but definitely very important. And just to going back to your questions, when I started uh entertaining this idea was a few years ago before I started uh looking to senior living. I remember a patient that he was very young, actually. I mean, he was probably on his late 50s, but he was by himself and he was telling me he was pretty pretty healthy. But he told me already, like he told me that he already put money down for to live in an independent community. I was like, wow, but you are so independent. But he brought that to my attention. Like, actually, there's not a lot of places, and he is by himself. Like, if something happens, he would like something secure. And I it did make sense to start thinking, made me think more about that option.
SPEAKER_02Yeah, that is interesting because it kind of reminds me of one of my friends. This was in high school, but she was telling me that she her mom already purchased her like grave or her like space for her body. And I was just like, what? And I was just like, people were thinking so ahead of that. And then later on, I ended up learning that they're actually very expensive. So there's, I guess, plans that come up where people could pay over the course of years, and then so by the time that someone does die, it doesn't fall back on the family to pay for that. And I was just like, that's so how would I say productive? Like really thinking ahead. But I was just like, I don't know, it's interesting.
SPEAKER_00But I mean I I'm I'm Hispanic too, so you don't get to in our culture, you don't get to think about those things. I guess like more on the Cauchitian uh culture, that's probably more common, but oh no, they Hispanic, Hermong.
SPEAKER_02Oh, really? Yeah, good as well. But anyways, I imagine that you have a lot of conversations with patients as well, and you see a lot of the things that come up in elderly age. And I think prevention is like one of the top tools that we have as humans. And I'm curious from things that you see come up that people end up needing help with, what are some tips that you might have for people to help? I guess like age like fine wine and reduce some of the things that come up in what you see?
SPEAKER_00Sure. What a great question. And uh, it's one of those questions uh as I personally have age, I've also been researching more and and trying to educate myself. But not only that, I get to see a lot of healthy older adults in my job. And I always ask them, like, what do you do to be so healthy at this age, right? 70, 80s, I see like minimal uh chronic conditions, great quality of life, walking, enjoying the things that they like to do, enjoying family time, not with oxygen or not able to even like do one step, but actually participating on activities. And what I have on my personal research, what I found on those patients is mobility exercise. They walk four, six miles, eight miles every day. That's the number one thing that I notice a lot of my healthy patients, and there are patients because they get to have a little bit of allergies or things like that. So it's not like my more sick patients. So, yes, um, mobility. And we see it a lot also in my in my practice, like those patients that don't move and they get in the ICU, and one day that my elderly patients don't move actually, it's like seven days that they get deconditioned. Meaning, like just every day that passes and they don't move, it's like a lot for them to get the condition, get back to their baseline. So that's one of the number one priorities for in the critical care world, uh, is to and pulmonary to get them out of the bed as soon as possible. Sometimes it's not possible, but that's the goal. And and other than that, I think like the regular uh recommendations, which is uh have a healthy diet, kind of like my favorite is a Mediterranean diet, sleep well is very important as a sleep doctor. Uh, we know all the benefits from sleep, and you name it, improve, especially in the elderly, improve memory, improve cognitive function, decrease fall risk, decrease diabetes, high blood pressure. So sleep is very important, not only in the elderly, in all ages, and different quantities for different people, yes, for different ages. Uh, adults, usually seven to nine hours, uh, seniors usually around uh six to seven, and obviously for kids is longer more than that. Yeah, so basically, I think those are the main main uh recommendations.
SPEAKER_02Okay, thank you, Dr. Chuck.
SPEAKER_00You're welcome.
SPEAKER_02And speaking of sleep, what does the research show are some key things to consider for your own sleep hygiene? And I guess like sleep best practices, yeah, great question.
SPEAKER_00So we know that by science that sleep before centuries before, we thought like, oh, sleep is just a passive time where we just turn off and nothing is going on during sleep. And actually, in the recent centuries, we started to know that sleep is very important for our health. We we pass a long, long time of our life also sleeping. And actually, sleep is very important, like I mentioned, for your memory, is where uh your metabolism regulates our blood pressure, or our blood sugar comes down. It's a matter, it's like recharging our batteries, and it's good for our immune system. We have studies that have shown, for example, that people that uh are sleep deprived and they get vaccinated, and people that they sleep regular hours, those that receive a vaccine during regular hours of sleep, they get a better immune response. Um we know there is less accidents uh and more accidents actually on people that are sleep deprived. That's why we have to we know that we have to start uh recommending that, for example, uh residents or interns or doctors, there's a maximum of hour shifts that they work, otherwise, there's more accidents. Um, same like driving. If you are sleep deprived, uh, have seen uh there's a paper I think that showed that it's like drinking alcohol. So, yeah, for those reasons and more, not only is important the time of sleep, but also the quality of sleep. Sometimes people have uh some conditions or sleep problems that can predispose you to have a poor sleep quality. For example, sleep apnea, where you sleep, but uh your respiration is limited due to a narrowing of your throat, and that causes you to arouse very frequently and don't sleep well, and that can predispose to diabetes, high blood pressure, strokes, heart problems, etc. And there so one of the recommendations if you try to sleep and you have bad sleep and you try everything, obviously, sleep hygiene is very important, and we can talk about that. But if you still have issues, don't just uh blame it of that's how I am or all my life I had poor sleep. Try to talk with your doctors and also for maybe to get you referred to a sleep doctor because you might have a sleep condition that you are not aware of. And for the sleep hygiene, I'm sorry, um, to I forgot that question. So obviously, sleep hygiene is very important, and mostly is obviously we know that light is very important to keep us awake, and also less light is important to regulate our internal clock, our circadian rhythm. So basically, get you exposed to a lot of light during the morning, very important, and decrease that light exposure at night, especially with an hour that we are with our cell phones and TVs and and all that. We have to minimize that, especially in kids. In kids, I see a lot of unfortunately parents that they give cell phones. No, nothing wrong to give cell phones, but at night, there's no need to have our kids having cell phones at nine o'clock, ten o'clock, and and that should be taken away from them. Uh, that's my recommendation, at least. That's why I do I don't give cell phones to my kids. Um, so so light exposure early in the morning, uh decreased caffeine. If you're having sleep problems, definitely you have to cut down because even though you drink all your life, your metabolism changes, and we cannot the metabolism of coffee, for example, it varies and it's not very predictable. And also other best practices, naps to try to limit those. If you need to take a nap, take it less than 30 minutes.
SPEAKER_02I thought you were gonna encourage people to take naps. I was like, I love naps.
SPEAKER_00I mean, if you have to take it, nothing wrong, but try to limit those less than 30 minutes and not too close to bed because when you it's too close to bed, it causes a vicious circle because your sleep drive is gonna decrease and you're not gonna sleep until one or two or three o'clock in the morning, and then wake up early because of your social duties, responsibilities, and then you're gonna take more naps. And also, if you need to take naps, maybe there is a reason why. So, again, talk to your doctors if you are needing to you're tired or sleepy during the day, and yeah, cool temperature at night, uh not too cold, not too hot, and try to minimize the light.
SPEAKER_02The cold dilox amount. I love it. Going back a little bit to the maybe not getting restful sleep if you're waking up tired, and I know people should talk to their doctors about that, but what are some things that could potentially be getting in the way of someone having good quality sleep?
SPEAKER_00Sure, there's many there could be many reasons from insomnia, uh, where um people have difficulty to initiate sleep, usually. That could be many reasons: stress, uh health issues, menopause, uh, psychiatric issues. So definitely that's number one. Another, like I mentioned, sleep apnea, very frequent, very prevalent, especially high risk on obese patients, but not you don't necessarily have to be obese to have this. So we have uh several conditions that can cause that. So insomnia, sleep apnea, restless leg syndrome, narcolepsy, less frequent, but possible, and health issues. Uh, some people have health issues like heart, heart failure, COPD that can cause them um heart problems at night to sleep.
SPEAKER_02I'm curious, does snoring impact sleep quality?
SPEAKER_00Actually, snoring is a symptom of something going on, possibly. 70% of people or close to 70%, they might have some degree of sleep apnea. So it's very important if you do snore to maybe get you screamed first because sleep apnea can actually impact your health.
SPEAKER_02Interesting. Because I feel like a lot of my family members tend to snore on the male side. I don't know if that is it a common gender thing, not really.
SPEAKER_00Most likely they have some degree of sleep apnea and they need to get checked.
SPEAKER_02Okay, so maybe it runs in the family.
SPEAKER_00Yeah, and it's it's usually the case. I kind of funny story, I diagnose sleep apnea not only in my side of my family to all my family, but also my wife's family.
SPEAKER_02So okay.
SPEAKER_00It's very prevalent, it's very common.
SPEAKER_02Yeah, and okay, so you obviously wear multiple hats. What advice would you give to people from someone that wears multiple hats?
SPEAKER_00I think the most important advice is not to be afraid to pivot and always why you're doing things. And if there's going to be always problems, barriers, people that will tell you not to do this and disappoint you. But as long as you know why you're doing things, and that really clears that path and makes things a little bit more like easier.
SPEAKER_02Thank you for sharing that. Dr. Chug, I know you are in the digital social media space. How can folks connect with you?
SPEAKER_00You can follow me on my Instagram, Facebook, LinkedIn, and also I have a Facebook group for healthcare workers investing on assisted living. If you want to have more education about this investment and with purpose, please go ahead.
SPEAKER_02Okay, and all of those details will be included in the show notes. Thank you everyone for tuning in. If you liked today's episode, go ahead and leave a review and let us know what you thought. Okay, bye. Thank you for joining me for another episode of Rooted intention. Until next time, and remember to keep showing up for the life, relationship, and community you want. Now go grow the life you want from the roots up.
