IMPULSE: The Summer 2014 publication, a service of ICE

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SUMMER 2014 /// THIS QUARTERLY PUBLICATION IS A SERVICE OF

The icewalk cometh Help your heart while benefitting four-footed friends

Hearts big enough to share

Mission trip changes lives — of impoverished children and ice team members

3 way tie Vision of compassionate care blossoms

contents FEATURING

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big hearts Ice team members knew the mission to Nicaragua would forever change them, but they couldn’t foresee how deeply they’d be affected.

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ice walk 2014 Popular fundraising event has new wrinkles. This year you can walk with your pet.

3-way tie 8:

DEPARTMENTS

3 : from the heart

A personal message from Dr. Asad Qamar

4 : new faces

Our patients speak from the heart

5 : nice to know

Meet the people who are at the heart of ice

15 : on ice Passion and procedures produce pleased patients

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Life is about choices, especially when we need medical care. That’s the philosophy behind ice’s three-pronged approach to wellness.

from the heart

Our heart’s in all the right places.

In this issue of IMPULSE we find our hearts reaching out to those in our own community as well as to those in a community over a thousand miles away. Our goal at the Institute of Cardiovascular Excellence has always been to help as many people as we can by spreading the messages of good health practices as well as providing treatment to those who are in immediate need.

For friends and family close to home, we are announcing ICE WALK, 2014. It’s our third ICE WALK event with more fun and participating vendors than ever before. Plus, this year, we are donating proceeds to our friends at the Marion County Humane Society and the South Lake Animal League.

In keeping with the focus on our four-legged friends, this year’s ICE WALK participants will be encouraged to share their walk with their four-legged buddies—as long as they’re well-mannered and on a leash, of course. Taking the dog for a walk means you’re out there walking, too. And what better way to do something good for your heart than to share the experience and the health benefits with that furry-faced friend that shares your heart.

Speaking of friends, this past April, a team of Institute volunteers made almost 500 new ones on a mission trip to Nicaragua. We sent out an e-mail asking for volunteers and our staff responded overwhelmingly. In a coordinated effort through Honoring the Father Ministries, our Institute team spent three days in Nicaragua, administering medical exams and treatments to families in need. After speaking with our team members, it is clear that the experience undoubtedly did more for their hearts than it did for those of our new friends in that far off country.

I am proud of the work we do at the Institute of Cardiovascular Excellence. I am even prouder of the special men and women on our staff who, every day, find it in their hearts to share their talents and their time with people far and wide. From our homes here in Ocala to the homes of families in far away places like Nicaragua, I know our hearts are in the right places.

I am so proud of the special men and women on our staff who share their time and talents with people in places far and wide.

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

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new faces

Welcome George W. Gilbert, M.D. Down-to-Earth doctor with a worldwide perspective joins the Institute of Cardiovascular Excellence

George W. Gilbert, M.D. came to a career in medicine along a path fraught with twists and turns not typical for most of today’s practicing physicians.

For one thing, he put off his pursuit of an M.D. degree for ten years while he worked construction in Florida. “I was a roofer in the Florida heat.

Needless to say, I thought there ought to be a better way and I’d always been interested in medicine as a career. The company I worked for knew that and was behind me 100%. I wouldn’t be here today if it weren’t for their support.”

Fast forward to medical school at the American University of the Caribbean where his studies were interrupted by an active volcano on the island of Montserrat. “Half an inch of ash covered the campus.” He relocated to St. Martin where a Category 5 hurricane devastated the island. “I took my daily shower from a hose.” He finally finished up his studies in Belize, located in Central America.

“I wouldn’t trade my experiences for anything.”

Dr. Gilbert topped off his world experience with seventeen months of clinical training in Ireland, before coming back to the United States to complete his residency in Ohio.

Today, after several stints at practices in Florida— from Venice to Gainesville to Belleview—Dr. Gilbert adds his unique set of skills to the family at the Institute of Cardiovascular Excellence. “I believe I relate to my patients well. They can talk to me. I’m like the guy who paints their house or mows their lawn. A lot of them tell me—You’re not just my doctor you’re somebody I can talk to. I’m proud of that.”

When asked if he has a particular philosophy about patient treatment, Dr. Gilbert says, “I imagine they’re a family member. They’ve come to me for help and I treat them exactly the way I’d want my mother or my wife to be treated.”

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nice to know

Brett Holt “It was a total surprise that snuck in the back door on me. I was in law enforcement, SWAT team, the whole bit. I had no idea. My son and I were hunting in a tree stand and the next thing I knew, I woke up and he was on top of me. He got me to the hospital and they said I’d had a heart attack some time previously and I needed to see a specialist. Dr. Qamar was the one I chose. First time I went to see him, I came home and told my wife—this is my doctor. That was ten years ago now. I’m a cardiac death survivor and every day is a blessing. Dr. Qamar is keeping me alive, doing what has to be done to keep me moving. I have a pacemaker/defibrillator. I’ve had six surgeries on my legs. A couple years ago they were purple and swollen. Today, they’re back to normal. All thanks to him. I’d tell anyone, this man is a caregiver.

He’s unique. Best word I can use; he’s unique. Not just a doctor, but also a friend. He knows how I feel. I hug him every time I see him. I love him.”

“I died and woke up with my son on top of me.”

— Brett Holt

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Join us for ICE WALK, 2014! Saturday, November 8.

Walk begins at 9:00 A.M. (with registration at 8:00 A.M.) at The Institute of Cardiovascular Excellence. Proceeds to benefit the Marion County Humane Society and the South Lake Animal League.

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ur third ICE WALK is on the calendar for Saturday morning, November 8!

Start getting in walking trim now. It’s never too late to put some miles under your feet and the walking will do you and your heart a world of good. The walk begins at 9:00 A.M. with registration at 8:00 A.M. and will begin and end at the Institute of Cardiovascular Excellence parking lot. Watch for opportunities to register even earlier on our website.

All donations go to help the Humane Society of Marion County and South Lake Animal League continue their good works on behalf of our four-footed friends. These facilities are non-profit, no-kill shelters dedicated to the care and protection of animals. The survival of these worthy organizations depends upon donations of money and time from animal lovers just like you! All monies go directly to help the animals with much needed medical care, food and facilities upkeep.

We are encouraging participants in this year’s ICE WALK to please make a donation when they register for the walk. (There is no fee to register for the ICE WALK.) We are also urging our walkers—for the first time ever—to bring along their own four-legged fur face to walk right alongside them. Pets must be well mannered around other dogs and people and of course, will be required to wear a collar and leash.

The ICE WALK is restricted to sidewalks so, no worries about traffic.

There will be water available before and after the walk and catered food ready at the end of it. Expect to spend a Saturday full of lots of fun and companionship that will do you, your heart and your community a world of good!

Why is walking so popular?

For one thing, almost everyone can do it. For another, the only equipment you need is a good pair of shoes.

And finally, the simple act of walking piles benefit upon benefit, crossing all population demographics, age groups and health categories. How can you not walk?

While not a cure-all for the ills of the world, walking can certainly keep a lot of health issues at bay. You walk every day anyway. Add a bit more focus and inject a little fun and you’ve joined the largest segment of the exercising population on the planet. According to the CDC, more than 145 million American adults—62% of the population—took at least one 10-minute or longer walk per week in 2010. That’s a 6% increase since 2005.

The American Heart Association tells us that at least thirty minutes a day of walking and/or other moderate exercise will:

Walk Right As with everything else, there is a right way to walk to derive the most benefit from the time you spend on your feet. To transform your everyday stroll into a “fitness stride” the Mayo Clinic Staff recommends that you maintain good posture: • Keep your head up.

Look forward, not at the ground.

• Relax your neck, shoulders and back.

• Swing your arms freely with a slight bend at the elbows. A little pumping with your arms is OK. • Tighten your stomach muscles and keep your back straight, not arched forward or backward.

• Walk smoothly, rolling your foot from heel to toe.

• Reduce the risk of coronary heart disease • Improve blood pressure and blood sugar levels • Improve blood lipid profile • Maintain body weight and lower the risk of obesity • Enhance mental wellbeing • Reduce the risk of osteoporosis • Reduce the risk of breast and colon cancer • Reduce the risk of noninsulin dependent (type 2) diabetes.

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A threeway tie for excellence The Institute of Cardiovascular Excellence shares its vision with two additional family members.

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innovation. compassion. excellence.

When Dr. Asad Qamar saw his dreams of a different kind of clinic take shape in Ocala, he couldn’t have known then just what that shape might resemble. But as patients responded to his compassionate approach to treatment and the medical community began to embrace his vision, it was inevitable that The Institute of Cardiovascular Excellence would grow. Today, what began as a cardiovascular practice has blossomed into a family of treatment options….

The Institute of Cardiovascular Excellence

The Institute of Medical Excellence

The Limbstitute Comprehensive

Every year, The Institute adds to its reputation as one of the finest cardiovascular resources in the entire Southeast. Licensed as a Level II Office Surgery Center by the Board of Medicine at the Florida Department of Health, The Institute maintains its equipment and technology to a constant state of state-of-the-art. Even the patient beds represent the latest developments in the field, with designs and adjustments that help Institute lab techs perform their procedures more efficiently while keeping patients as comfortable as possible. But beyond the equipment and the technology, it is the patient-centered philosophy at the core of Dr. Qamar’s vision that truly differentiates The Institute of Cardiovascular Excellence from every other medical practice. The Institute calls it ICE for short. Innovation.

Compassion. Excellence. The difference it makes is a profound one.

Every staff member, from physician to receptionist, has adopted Dr. Qamar’s vision as his or her own. As a result, patients receive a standard of personalized, compassionate care that elevates their treatment experience to one so comfortable many have compared it to a visit with an old friend.

Dr. Qamar has always been convinced that his unique patient treatment philosophy is applicable to every medical discipline. The first addition to The Institute family to test that conviction was The Institute of Medical Excellence (IME). IME is a primary care practice—family care that serves as a first line of defense for patients in need of regular checkups and medical services; everything ranging from common bumps and bruises to more serious ailments and illnesses. Just as The Institute of Cardiovascular Excellence maintains its equipment and medical technologies on the leading edge of current developments, the Institute of Medical Excellence does the same.

IME personnel also reflect the same Ice standards of excellence. Family care specialists and internists at every location lead staffs of healthcare professionals chosen for their skills as well as their demonstrated ability to carry forward the ICE standard of treatment. As a bonus for IME patients, Dr. Qamar maintains a regular schedule of rounds at each location, supplementing every clinic’s diagnostic and treatment choices with the finest cardiovascular resources in the state.

The Limbstitute is the newest addition to the Institute of Cardiovascular Excellence family and adds the highly specialized discipline of maintaining vein health to the Institute’s growing spectrum of patient care. “Save a limb. Save a life.” It’s a prescription written daily inside the Center’s 4,000 square feet of designated examination rooms, labs, testing and treatment facilities. Medical professionals at The Limbstitute form a collective team dedicated to a singular goal: treating venous diseases and abnormalities to improve limb health and even save a limb in danger of amputation. In the past, patients in danger of losing a limb traditionally have had to shuttle between various doctors, different specialists in separate facilities—a cardiologist certainly, a medical internist, phlebologist, podiatrist and if need be, specialists in infectious disease and wound care.

Today, The Limbstitute provides a better way. Now all of the tests and treatments and physicians necessary to intervene and reverse the effects of venous disease are on the same page— and under the same roof.

Vein Care and Limb Salvage

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Hearts big enough to share This past April, a group of excited, nervous members of The Institute of Cardiovascular Excellence—fourteen in all— boarded an airplane and embarked upon an adventure that would change every one of their lives forever.

Photos by Gary Skidmore

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n a joint venture with Honoring the Father Ministries, people from The Institute flew to Nicaragua to bring much needed medical help to several areas in one of Central America’s poorest countries. The climate was incredibly hot. The traveling was by bus along roads crowded with cars, bicycles, people and animals. The mission was to bring medical help to several areas in the Pacific Lowlands area of the country. And in three days the weary participants were able to bring aid and comfort to almost five hundred people.

In every location that the ministry set up operations, the conditions were primitive. No beds or exam tables, only the equipment and medicines the teams brought with them. Sheets were hung to create separate exam areas. Patients, from children to the elderly, waited quietly in the stifling heat to be seen. Once a medical assistant took down their information, noted their symptoms and ran vitals, the patients would see one of the physicians for a more in-depth examination.

At the end of the mission, when the medicines had all been dispensed and patients and medical staff parted company— often accompanied by tears and heartfelt good-byes—the real beneficiaries of the trip were the staff from the Institute. Each of them came away with a unique set of impressions and lessons learned. And to a person, they are ready to go back again, as soon as arrangements can be made for trip number two.

Mary’s Story Mary Moreno, a registered Medical Assistant for Dr. Qamar, checked her email late one night after work to find a message from Institute Administrator and CFO, K.C. It mentioned an exciting opportunity to take part in a mission trip to Nicaragua. “I was probably the first reply she got back,” says Mary. “My whole family is from Nicaragua. I am the first generation to be born here and I had never even seen the country where my family came from. I couldn’t believe it. It was an amazing opportunity.

“I was a little fearful. I had never been out of Florida before and I was terrified to get out of my comfort zone. I worried that I might get sick. I worried about the plane ride. But once there, I got over all that in a hurry. My job was to work alongside Sheila, our Physician’s Assistant, as her translator. It was overwhelming and intense at times, but we didn’t want to turn anyone away.

The hardest thing was not being able to do more for these people. We had none of the equipment we have in the States and Sheila would get emotional because of what she couldn’t do. We

were able to help a lot of people with some general care. We prescribed medications they couldn’t get or afford.

Like ibuprofen or anti-parasitics.

Because of the living conditions there, they have a lot of problems we don’t see here in Florida.

“The people, even in the conditions they were living in, sometimes with not even enough to eat, they would open their arms to us and be so sweet. Just the strength you could see in the eyes of these people. I will never forget that. And I will be going back. Next trip. Next year.

I will be there.”

“The people, even in the conditions they were living in, sometimes with not even enough to eat, they would open their arms to us and be so sweet.”

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K.C.’s Story K.C. is the Administator and CFO of The Institute of Cardiovascular Excellence and a driving force behind the trip to Nicaragua. “I can only describe it as divine intervention in a way. I have always had a passion to give back, to do missionary work and when Brock approached me with the idea, it was something I knew I had to do. His pastor from Honoring the Father Ministry came and spoke to me about it. They had never done a medical mission trip and wondered if The Institute would be interested. I asked Dr. Qamar and of course, that was all it took. I sent out an email to our staff. We had no trouble at all getting volunteers.”

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Was she surprised by any of the things she saw there? “Not really.

I knew we were going to a third world country. Outside the airport the buses with bags piled on top, the homeless people and panhandlers in the streets. Little kids who had to fend for themselves. It was sad but not so unexpected.

“My job, when we got to our destinations was to organize the medical mission. Imagine going into a building with just four walls and some chairs. No rooms. Nothing. We put bed sheets around tables to make exam rooms. We had a pharmacist and I along with others on my team helped him out. He filled prescriptions right there. I have to say, the teamwork between everyone was phenomenal.

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Everyone worked so well together. We laughed. We prayed. We cried.

“The people were what I will always take away from this trip. They were so patient, so grateful, so polite. It was 99 to 100 degrees, with no A/C or anything and they waited quietly to be seen. Even their children were quiet. I was very touched by that. The entire trip touched me deeply. To work for a boss like Dr. Qamar who encourages us in these ventures. To work with such extraordinary people like we have at ICE. So many things could have gone wrong but they didn’t.

Everything just fell into place. I said it before; to me, it was very clear that God had His hand in this. It was definitely Divine Intervention at work with us in Nicaragua.”

Sheila’s Story Sheila DePaolo is Dr. Qamar’s Physician Assistant and headed the medical team the Institute sent to Nicaragua. “I was a little nervous, but I had a strong desire to go. I knew that the trip was going to change my life and my outlook for the better.

“Right off the plane and after we got through security they loaded us on a bus. We had an hour or two to our hotel so I got to see a lot. How the houses piled up next to one another, the bars on the doors and windows. People in the road trying to sell things. No traffic rules—biggest vehicle wins.

“When we set up at our locations, I worked in a group with three other doctors. We would each pull in a patient, get symptoms, diagnose as best we could, prescribe medications.

We saw all ages from infants to elderly people in their 90’s. All the while, you want to take what time you can with them to pass on your positivity, that you care. The language barrier was difficult, but thank goodness I had Mary with me. Next time I go back, I’m hoping to have learned enough Spanish so I can communicate.

“By far the hardest thing for me was not being able to do all I needed to do.

We come from America with all our abilities. Especially working for Dr.

Qamar who keeps up to date with all the latest equipment. And yet, I had a young patient with blood in his stool. All I could tell him was to go to the hospital but I knew he probably wouldn’t. It would mean money out of his pocket. I had another patient, an elderly person who presented with angina. I knew she had coronary artery disease and needed active treatment. I couldn’t really help her.

“I would say, all of us who went came back changed. For me, daily stresses I used to have are nothing now. I’m not so stressed about things I can’t control.

I know I’m blessed and it is humbling. I pray that I can keep that humbleness.”

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Brock’s Story Brock Kreienbrink is a Cath Lab Registered Nurse and the original initiator of the mission trip to Nicaragua. “God placed it on my heart to talk to K.C. about doing a medical mission trip and one day I just walked into her office and asked her. That’s really how it all began. I got into medicine specifically so I could give back through a medical ministry and this was my first one. Honoring the Father, our partners on the trip, is a ministry that I am very familiar with.

When I talked with them about my feelings about a medical mission, they

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were very supportive, even though they had never conducted a medical ministry before either.

“The Institute and Dr. Qamar stepped up and my fellow employees volunteered and before I knew it we were on an airplane bound for Nicaragua. The country is just so beautiful and the people so wonderful.

I have been to other third world countries, so I didn’t experience the “shell shock” some of my colleagues did. But it is definitely something I think every American should experience at least once.

“We set up in churches in the villages we visited. Little electricity,

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enough for some fans. I worked triage, doing preliminary workups and assisted physicians where I could. All the while, the people were so kind and so appreciative of every little thing.

We saw quite a bit of malnutrition while we were there. Hypertension was very common.

“Next time we go—and I am absolutely going—we’ll be better prepared. I appreciate so much now; relationships, simpler things, hanging out with friends. I don’t think so much about material things.

In fact I tell people, when I got back from our trip I felt like a millionaire, I really did.”

on ice

DEPARTMENT SPOTLIGHT

imaging Julie Green is a Certified Nuclear Medicine Technologist and the Imaging Director of the Imaging Department at The Institute of Cardiovascular Excellence—and she loves her job. “I’m passionate about my job. I love waking up every day and I look forward to coming to work. ICE has done that for me….We perform various procedures to help us get a picture of a patient’s circulation. We inject radioactive isotopes into the blood stream and then take scans to see how the blood flow is. If there are any blockages and where the blockages are Dr. Qamar makes sure we have all of the latest equipment to do our job; nuclear camera and PET CT camera, a dedicated CAT scanner. It’s pretty technical and it can get overwhelming for a patient, but we’re all pretty fun and we lke to joke with our patients. If they were nervous when they came, they leave wondering

L - R: Alessandro Dell’Armi, Julie Green, and Brian Murry

what they were ever worried about….Here’s my department and Dr. Qamar in a nutshell: We use a contrast agent here called Lexiscan. It’s newer and more expensive. But it’s the best for our patients; fewer to no side effects. I’ve been to other image centers and they don’t even know about Lexiscan.

Or, they do but they don’t use it because they want to save money. Here, we are all about what is best for the patient. That’s why I recommend us to my friends, my family, and why I am so proud to work for a doctor like Dr. Qamar.”

“Our department is the best. If I sound passionate about it, it’s because I am.”

— Julie Green

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Remember when Mom used ice to make it all better?

As adults, our health issues may be more complex, but the answer is still

put ice on it.

Ocala 4730 SW 49th Rd. Tavares 2754 Dora Ave. Summerfield 10435 SE 170th Pl. Williston 412 W. Noble Ave. The Villages 1050 Old Camp Rd. The Villages 1950 Laurel Manor Dr., Bldg 240 352.854.0681 // ocalaice.com // limbstitute.com 16 \\

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