IMPULSE: The Spring 2015 publication — a service of ICE

impulse SPRING 2015 /// THIS QUARTERLY PUBLICATION IS A SERVICE OF

12 Habits of a Healthy Heart

Do something long enough and it becomes a habit. Adopt these twelve habits and they could save your life.

contents Featuring

12 Habits of a Healthy Heart Habits get a bad rap sometimes. There are good habits, too. Even healthy ones and those are the best kind. Here we are going to share the top twelve habits you can develop that add up to one, very heart-healthy lifestyle.

Departments

3 : from the heart

A personal message from Dr. Asad Qamar

4 : ice spotlights Meet Dr. Norm Weinstein who knew he was medicine-bound at a young age. Plus, our Medical Assistants work in various specific areas—Clinical, Lab and Scribe—to keep the business of the practice running smoothly.

5 : patient spotlight

ICE patient Lisa Morgan shares her inspiring experience with our medical team and a word of encouragement.

15 : the beat

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New technologies and procedures give us fresh perspectives on the state of our health.

from the heart

Ask not what your heart can do for you…

Friends, As this first issue of IMPULSE for 2015 was being created, it occurred to me one more time just how magnificent that organ beating in the center of our chests really is. It begins beating before we are born and goes on working tirelessly (for the most part) beating 100,000 times a day, 3.6 million times a year. That is of course, if the heart is healthy and treated with the barest minimum of care.

Which brings me to the point of this IMPULSE: What have you done for your heart lately?

If you’re inclined to answer “Not enough” or even “What do you mean?” perhaps the following pages will help you out in that regard. In them, we list 12 items — including a bonus number 13 — that belong on every heart “to do” list. From exercise and eating right to taking your heart health in your own hands by keeping track of important indicators like cholesterol and stress levels.

Several items on our list have to do with the food you put into your body and how to make sure you are feeding your heart what it needs. We’ve even included a heart healthy recipe that is part of a heart-healthy meal — you’ll need to visit our website for the recipes to complete your meal!

One of my favorite sections in IMPULSE has to do with new technologies and trends in medicine. It is fascinating to see what others in the field are working on and what we may be able to expect to improve our lives in coming years. Check out the beat for a sneak peak at what we could have coming up in all our futures.

Also, I am always proud to introduce the names and faces behind the workings of our growing and thriving practice. It is because of our incredible staff that we are as successful as we are. I encourage you to read our department spotlight and meet some of the new faces at ICE. Our goal at ICE is to help as many people as we can by spreading messages of good health. We treat those who are in need. And whenever and wherever we can we make someone’s day a little brighter by opening our hearts and sharing a little of ourselves. I am proud of the men and women who lend their skills and their hearts every day to helping us achieve those goals. I am humbled and I thank you all.

“We treat those who are in need. And whenever and wherever we can we make someone’s day a little brighter by opening our hearts and sharing a little of ourselves.”

Asad U. Qamar, MD FACC, FCCP, FSGC, FACP, FSCAI Cardiologist

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employee spotlight

Dr. Norm Weinstein

From a very young age Norman Weinstein “always wanted to help people” and medicine seemed like the perfect career. Medical School at Hahnemann University in Philadelphia was followed by Residency at Northwestern University in Chicago and a Fellowship at the University of Chicago. He is Board Certified in Internal Medicine, Cardiovascular Diseases and Interventional Cardiology. After he was referred to ICE by a colleague, Dr. Weinstein was “impressed by the work ethic, the quality of care, superior technology and upbeat attitude of all the staff.” He started at ICE in April 2014. What makes him such a good fit? “I am a strong believer in Patient Rights and my role to help patients become a part of the decision-making process in their own care.”

department spotlight

Medical Assistants

Pictured are Mary Moreno and Lashanda Evans

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Medical Assistants are the front lines of ICE and serve as liaisons between patients and physicians and other departments. They are trained to work with a variety of skill sets that allow them to keep the business of the practice running smoothly. Different teams of Medical Assistants work in specific areas—Clinical, Lab and Scribe—and every one reflects the personal, compassionate vision that defines ICE. According to the Medical Assistants Supervisor, whole job it is to keep the different teams on task, “No matter how we feel, our job is to put that smile on our face and be there for our patients … From the moment we open that door and call them back to when we walk them out, it’s important that we make patients feel special— like one of our family.” Diana is not bashful either about how well she thinks her Medical Assistants do their work. “I have the best team at ICE—the Clinical, Lab and Scribe Team. We’re pretty competitive. We work hard. But we play hard, too.”

patient spotlight

Lisa Morgan Citra, FL “It all started with a dog bite when I was 16. It brought cancer out in me. Radiation and chemo cured me but probably contributed to me having a pacemaker put in when I was 29 years old. Fast forward to 10 years ago. Dr. Qamar treated my daughter for blackouts and I was impressed with his manner right away. How thorough he was. How he explained things. So, I remembered Dr. Qamar when my own doctor retired. I had shortness of breath, no energy symptoms that worried me. Dr. Qamar referred me to one doctor who said I needed a heart/lung transplant. Dr. Qamar just said, “No, I don’t think so.” He sent me to Mayo where they replaced my tricuspid valve. I don’t have shortness of breath now. I can sing again. I can walk the one-mile track in my neighborhood. Before I couldn’t walk to my Mom’s just two gates down.

I just love Dr. Qamar and all the people at ICE. I actually made friends with one of the girls at the front desk. They’re awesome people. So comforting. If I could say anything to people it would be, “Don’t give up. Put one foot in front of the other. I’ve survived cancer. They said long ago I’d never have children. Today I’m here and I have two magnificent kids.”

“It all started with a dog bite…”

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12 Habits of a Healthy Heart

They say do something long enough and it becomes a habit.

We say, adopt these twelve habits and they could become lifesavers.

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1

Move your lazy … heart.

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You knew exercise was going to be on the list.

It’s better for your body, your mind and your mood. It will dramatically lower your risk of heart disease, diabetes, cancer, and stroke. It’s one of the most significant contributors to heart health. Its No. 1 spot on our list is not random.

Got it. But which exercises should I do? And for how long? There’s a seemingly endless list of exercise choices. What you choose to do boils down to what you can do and what you enjoy as you build up to least 30 minutes of moderate physical activity five days a week.

“Build up” is key, especially for people over age 50. Start with what you can tolerate and gradually increase your time and intensity as you progress.

Walking is an excellent way to get moving again.

Thirty minutes at a time — even 15 minutes — will have a positive effect on your health.

Be sensible and keep your expectations in check. You’re not 20 or 30 any more and odds are, running a marathon is a ways off in your future. But do push yourself to improve.

Expand your exercise regimen to include activities you never considered before. Try tai chi — it’s great for improving balance and flexibility. Yoga is amazing for improving strength, flexibility and reducing stress.

Investigate classes with a mix of ages. They’ll be livelier, boost your confidence and may even be a lot more fun.

Become BFF’s with your fruits and vegetables.

Mom was right all those years ago and practically every diet program from Hollywood’s hippest new trend to the USDA’s food pyramid agrees with what she was saying. “Eat your fruits and vegetables.”

Fill half your plate with them at every meal — and eat them first. Your body will thank you, loud and clear. A recent European study concluded that eight servings of fruits and vegetables per day will cut the risk of your dying from heart disease by 22 percent. And before you balk at the “eight servings” remember what a serving really is: a carrot. Half a banana. A small apple. If you’re looking at three meals and trying to spread eight portions between them, add a couple of healthy snacks during the day. Combine portions in a meal. Soups and salads are excellent ways to double or triple up. Fruit makes for some very tasty desserts — baked apples, poached pears and even grilled nectarines can’t be beat.

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3

Add color to your life.

Nature didn’t add Her glorious rainbow of color to fruits and vegetables just for looks. The red in tomatoes, watermelon and red beans … The orange in, well, oranges, as well as carrots, sweet potatoes, squash …

Green, of course, in everything from spinach to broccoli to kiwi fruit … Purple eggplant, blueberries, black beans … All those colors are there for a reason summed up in a single word — antioxidants. The antioxidant compounds found in the colorful spectrum of Nature’s world are bioactive chemicals that provide powerful cardio-protective effects. They protect arteries and blood vessels from the damaging fats, sugar and flour in the rest of your diet — as well as some of the genetic challenges you may be facing from high cholesterol, high blood pressure and high blood sugar.

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Recipe copyright © 2015 American Heart Association. This recipe is brought to you by the American Heart Association’s Simple Cooking with Heart ® Program.

Habits

Chicken Paella

If you like Chinese fried rice, you’ll love this simple Spanish version of the dish. $2.39 per serving // Serves 6

Ingredients

Directions

Cooking spray

1. Spray a large skillet with cooking spray, add chicken and cook over medium-high heat 5-7 minutes, stirring occasionally.

• 1 lb boneless, skinless chicken breasts or tenderloins, all visible fat discarded, cut into 1-inch cubes • 2 tsp extra virgin olive oil or vegetable oil • 2 medium chopped tomatoes, lightly mashed in a bowl with a fork • 1 small onion, chopped • 1 can no-salt-added green beans

2. Remove chicken from pan.

3. Add oil, bell peppers and onions to skillet.

Stir well and cook 5 minutes until onions begin to become translucent.

4. Add tomatoes, peas, garlic, parsley and saffron or Turmeric. Stir and cook 2 minutes more.

• 1 tsp garlic from jar, minced

5. Reduce to medium low-heat, add broth and chicken, stir well and cover.

• 1/2 tsp parsley

6. Simmer for 20 minutes.

• 1/4 tsp saffron OR 1/8 tsp tumeric

7. Add rice, mix well and heat until warmed through.

Nutrient Information Calories 380 Total Fat 5.5g Saturated Fat 1.0g Trans Fat 0.0g Polyunsaturated Fat 1.5g Monounsaturated Fat 2.5g Cholesterol 48mg Sodium 113mg Potassium 628mg Carbohydrates 57g Fiber 7g Protein 24g Calcium 43mg

Hungry for more?

Try these three additional heart-healthy recipes from our website:

• 1 cup low-sodium chicken or vegetable broth

Balsamic Fish

• 2 cups long grain rice, cooked to package instructions

Asian Pork Cheese Veggie Frittata w/Fruit Salad

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Carbs—love ‘em, don’t leave ‘em.

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How many times have you heard a friend or family member brag about the amazing results they’re getting on their low carb, or even no-carb, diet? Those diets have been shown to result in short-term weight loss, but for long-term health, the truth is that carbohydrates are a necessary part of a person’s daily intake. You need them. In fact, the Institute of Medicine recommends that 45 to 65 percent of your daily calories should come from carbs (a good goal: 10 to 35 percent from protein and 20 to 35 percent in dietary fat). The key is to pick the right ones. Carbohydrates are found in a wide variety of foods, from grains, fruits and vegetables, dairy products, legumes, nuts and seeds. Better choices are fiber-rich foods like fruits, vegetables and intact whole grains and beans. Bad choices are sugary, processed, flour-based foods like bread, cereal, pasta etc. Choose well and live better as a result.

5

Be a lean, mean protein machine.

Protein can be found in every cell in the human body. It repairs cell structure. It helps grow new cells. It is literally one of your body’s main building blocks. Proteins break down into amino acids and we need lots of them to stay healthy. Trouble is, we Americans have no trouble getting enough proteins. In fact, most of us consume way too much protein for our own good. And like most things, not all protein is created equal. Think lean and mean for proteins. Put fish at the top of your list. Eat it most often — one or two palm-sized servings a week. Skinless chicken comes next.

Eggs have gotten a bad rap because of the cholesterol in their yolks, but omega-3 eggs — one whole mixed with a few egg whites — make for an excellent, heart-healthy protein breakfast. Last on the list is red meat; any red meat — beef, lamb or pork. Try to limit yourself to one serving a week of the leanest cuts. Red meat as a protein source comes with the highest risk for cancer and heart disease.

Omega Oh My!

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Omega-3 fatty acids have been lauded for improving everything from bipolar disorder and schizophrenia to bone health. But the single area most often cited as an Omega-3 benefit is heart health. And with good reason. Research shows that Omega-3s can prevent irregular heartbeat, reduce plaque inside arteries, decrease blood clotting, decrease triglycerides (blood fat), increase HDL (good cholesterol) and decrease inflammation. According to Penny Kris Etherton, professor of nutrition at Pennsylvania State University, “Omega-3 favorably affects a number of risk factors for cardiovascular disease, and at the top of the list is reducing the risk of sudden death from heart attack.” Eat at least one serving of oily fish — salmon, sardines, herring — per week to ensure you have enough Omega-3 in your diet. Eat less and you’ll need to add an Omega-3 supplement to your weekly intake.

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7

Habits

Get your head in the game.

Some studies seem to indicate that your own head can be for or against you when it comes to heart health. Certain personality traits can be key indicators of impending complications, and recognizing them could literally be the difference between life and death. Are you depressed?

Anxious? Hostile? Angry? Impatient? Competitive? Uptight? Even worse, do you display one or more of those traits? Some shrug their shoulders and say, “That’s life.” But those who use their heads and learn to cope best with “life” make better food and exercise choices and may ultimately outsmart their unhealthy personality traits to live longer and healthier.

8

Sleep on it.

Recent findings by the Chicago Medical School indicate that if you sleep less than six hours a night, you’re twice as likely to have a stroke or heart attack and one-and-a-half times more susceptible to congestive heart failure. Sleep more than eight and you’re more likely to have chest pains and coronary artery disease in your future. Why? It’s all about the hormones. Sleep too little and stress — fight or flight — hormones get released that raise blood pressure, blood sugar and heart rate. Why over-sleepers suffer is less clear, though some say it has to do with a tendency toward depression, less motivation to exercise and literally less time daily devoted to heart-healthy practices.

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9

Life goes better with chocolate.

You knew it all along didn’t you? A little bit of chocolate can go a long way toward making you feel better — as long as it’s dark chocolate and you don’t eat the whole box. Limit yourself to about 1.5 ounces a day and you’ll get all the good stuff — enough anti-oxidants to relax blood vessels, lower blood pressure and control blood sugar.

Eat more than that and you get the bad stuff — added fat, sugar and calories — that counteract all that guiltless good you thought you were doing.

10

Learn about cholesterol. Manage the levels in your body.

Know them like you know the numbers in your address.

Live and breathe the benefits of the good — HDL. Be vigilant and root out the sneaky influence of the bad — LDL. See your doctor and test for your levels regularly. Your total cholesterol should be at or below 200 mg/dL. LDL (low density lipoprotein) numbers should be at or below 100 mg/ dL. HDH (high density lipoproteins) should be 50 mg/dL or higher. Triglycerides — blood fat — should ideally be below 150 mg/dL. Consult with your doctor about dietary steps you can take to keep your numbers in line. If your cholesterol is high, ask about cholesterol lowering medications.

11

Be a pal.

Friends don’t let friends get heart attacks. A little extreme perhaps, but a 2004 study does indicate that having a close relationship with another person — a friend, lover or relative — can cut the risk of a heart attack by half in someone who’s already had one. A three-year Swedish study of more than 13,600 men and women found that having few or no close friends increased the risk of having a first-time heart attack by about 50 percent.1 Another study by the State University of New York at Oswego found that having a buddy could lower blood pressure — even if your buddy is a dog. According to the AHA, owning a pet, particularly a dog, could lower your risk of heart disease. Some studies seem to show that dog ownership benefits can be attributed in large part to taking the dog for a walk. One study concluded, “Not surprisingly, dog owners who walk their dogs are more likely to achieve the recommended level of physical activity than dog owners who do not walk their dogs.”2

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1. http://consumer.healthday.com/encyclopedia/emotional-health-17/psychology-and-mental-health-news-566/health-benefits-of-friendship-648397.html 2. http://www.heart.org/HEARTORG/GettingHealthy/Owning-a-Pet-May-Protect-You-from-Heart-Disease_UCM_453586_Article.jsp

Become a “cholesterolic.”

12 Habits

12

Weight there’s more…

Maintain a healthy weight. It’s that simple … and for many, that difficult. The proof is that fully two-thirds of adults in America are overweight or obese. Too much fat is the culprit.

Especially when it clusters around your middle. Risks for high blood pressure and diabetes go up. Cholesterol rises.

Several of the steps listed above directly relate to weight maintenance; eating habits, exercise, even sleep habits. But the point is, like your cholesterol numbers, it is healthiest to know what your ideal weight should be and be constantly on your guard to keep it there. Consult with your physician to determine where your weight needs to be and what lifestyle changes you can make to maintain it.

And 13 (To make it a bakers dozen)

Stop Smoking!

Stop smoking is at the end of our list for impact. It could have easily led it off. Smoking is the overwhelming No. 1 risk factor for heart disease, cancer, stroke, and heart attack. And what’s most ironic is that it is preventable.

Unlike genetics, environment, invisible germs and viruses, smoking is a deadly killer entirely within your control. According to the CDC, cigarette smoking kills 480,000 Americans a year — and 41,000 of those deaths are from second-hand smoke.

Smoking-related illness costs us more than $289 billion a year. There are so many groups and programs and medications to help you quit that you really have no excuse to continue smoking. Do it for yourself. Do it for your family. If nothing else, do it for your wallet. The price of cigarettes keeps going up with no end in sight. In New York, the cost exceeds $14 a pack! Stop smoking and start living heart healthy, today.

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the beat A heart disease vaccine?

Walking is good, group walking is better The benefits of getting out and stepping it around the block are well documented —weight loss, reduced depression, reduced cancer recurrences, lower blood pressure, etc. A new study led by Sarah Hanson and Professor Andy Jones from the University of East Anglia show that walking in a group has additional payoffs, including lower blood pressure, resting heart rates and better cholesterol numbers. According to Hanson, “People who walk in groups also tend to have a more positive attitude toward physical activity, a shared experience of wellness, and say they feel less lonely and isolated. Taking regular walks can also be a catalyst for adopting other healthy behaviours.”

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Wouldn’t it be great to get a shot and not have to worry about getting a heart attack?

Dr. Kiran Musunuru of Harvard University’s Department of Stem Cell and Regenerative Biology believes he is on the right track to eliminating the threat of heart disease in humans by up to 90%. Dr. Musunuru isolated a genetic mutation in a French family who maintained remarkably low LDL numbers. He spliced that gene mutation onto mice DNA, and within days lowered cholesterol in the mice by 35% to 40% — so far with no side effects.

Says Musunuru, “I think I can confidently say that with this tool, this technology will work on live, breathing human beings, but we need to figure out the safety; that’s the barrier to overcome before we can test these therapies.”

BLOOD PRESSURE BREAKTHROUGH

The Coupler A small device developed by ROX Medical called the Coupler is inserted between the artery and vein in the upper thigh. (A 40-minute procedure under local anesthetic.) No bigger than a paper clip, the Coupler helps regulate blood flow to treat hypertension in patients.

— Image of the Coupler Courtesy of leicestermercury.co.uk

Picture Perfect Heart

Our hearts are as individual as we are — different sizes, shapes, conditions — and that makes one-size-fits-all remedies like heart valves and pacemakers and defibrillators less than ideal. Researchers recently went a long way toward solving that dilemma with the use of a 3-D printer and stretchy electronics. Basically, they created 3-D images of animal hearts, printed their models, then wrapped the models with stretchy arrays of sensors, oxygenation detectors, strain gauges, electrodes, and thermometers. The models could then be unwrapped, and the electronics array wrapped around the actual heart — for a perfect fit. Once available in humans, the improvements in customtailored monitoring and treatment could be staggering.

Heart — Heal Thyself!

A new gene — called Meis1 — has been discovered that seems to be the reason that heart tissue, unlike other tissues in the body, does not regenerate.

Scientists, experimenting on mice, managed to “turn off” the Meis1 gene and when they did, healthy new heart cells were created in the mice.1 The future use in humans is uncertain, but the gene discovery may point to a way of healing heart damage caused by heart attacks in humans.

Coronary Heart Disease ­— early form of Scurvy?

Studies have revealed that vitamin C deficiency, famously the cause of scurvy among sailors in previous centuries, also affects cells in the walls of arteries. The deficiency causes a myriad of tiny cracks and lesions to form there.

The body, trying to heal the damage, rushes cholesterol, lipoproteins and other blood risk factors to “fill in the cracks.” Over time, those areas develop into atherosclerotic deposits — plaque — that can cause heart attacks and, in arteries in the brain, strokes.

— drrathresearch.org/discoveries/heart-disease.html

Which is deadlier:

French fries or car wrecks?

Not even close. When fast food restaurants tried to improve their health numbers by swearing off of saturated fats, a side effect of their new approach created trans fats instead. Trans fats are killers when it comes to heart disease. Americans have a 1-in-84 chance of dying in a car, but a 1-in-5 chance of succumbing to heart disease.

— New York Times

The Patchwork of Life Zio Patch takes Heart Monitoring to a new level.

This small 2-by-5-inch adhesive bandage may soon make the bulky heart monitor devices of today obsolete. It can capably monitor heart activity for up to 14 days.

Then, when all the data has been collected, the patient drops it in an envelope and mails it.

How do you mend a broken heart?

You patch it!

The patch is a gel-like consistency and contains periostin, a natural substance that encourages cell division. Studies conducted on rats that had suffered heart attacks showed that applying a patch to damaged areas on the heart resulted in a 100-fold increase in heart cells and a 16-percent boost in pumping ability.

This technique may one day be applicable to humans to replace the need for heart transplants, or even prevent heart attacks altogether.

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CARDIOLOGY PRIMARY CARE VEIN CARE LIMB SALVAGE PHONE 352.854.0681 FAX 352.854.8031

OCALA 3515 SE 17th St Ste 100

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