IMPULSE: The Fall 2015 publication — a service of ICE

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Walk the (ice)walk It’s healthy. It’s easy. It’s free— and it’s an upcoming event!

We got the beat

The wildest new developments in fitness and healthcare.

Sweet ‘n’ Spicy

This salsa chicken is secretly good for you. Don’t tell your taste buds!

FALL 2015 /// A QUARTERLY PUBLICATION BY

Sometimes all it takes is putting one foot in front of the other, and before you know it, you’re exercising!

Make your


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F E AT U R I N G

Make our move! Learn how and why even the smallest commitment to exercise consistently can yield huge rewards. Move it and lose it!

Walking the (ice)walk

If you walk—you’re helping yourself. If you ice walk—you’re helping yourself, your community and the American Heart Association!

D E PA R T M E N T S

3 from the heart

A personal message from Dr. Asad Qamar.

4 the beat

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

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10 heart-healthy recipe

You have never tasted grilled chicken with this kind of zing. If your taste buds had hands they’d applaud.

15 ice spotlights

Meet our dedicated staff, an outstanding department, and a featured patient.

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FROM THE HEART

A PERSONAL NOTE FROM OUR FOUNDER

It’s your move… Friends, In this issue of IMPULSE we are looking at the how and why of being on the move. We all know that exercise is something we need to do. But we may not be quite sure of the benefits and how they could apply to our own lives. Then again, sometimes it just does us good to be reminded of something we think we already know…. Our first article — Make Our Move — looks at some of the benefits of exercise and how just moving a little more every day can help those add up over time. One of the benefits that may surprise you is how exercise works not just our muscles and joints, but our brains as well. And who doesn’t want to look better, feel better and even think better? All we have to do is move!

“We see even more people enjoying a walk in the fresh air with friends and family — even new friends they just met at ICE Walk — than the year before.”

Our second article is all about one of my favorite days of the year. ICE WALK is just around the corner, and we’re giving you a heads-up to be ready. All of us at ICE are thrilled, proud even, of how our participation has grown each year. We see even more people enjoying a walk in the fresh air with friends and family — even new friends they just met at ICE WALK — than the year before. As always, we’ve filled our issue of IMPULSE with lots of information and fun facts about your health. We have spotlighted some important people on our staff and programs we have in place to help keep our patients healthy and their lives fulfilled. I am so very proud of the men and women who contribute their talents daily to the operations of ICE and I continue to be amazed by their commitment to the company, and most of all, to our patients. It is because of you that we keep moving forward to provide the very best medical care possible. Sincerely,

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

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the beat T H E L A T E S T T I P S , T I D B I T S A N D T E C H I N H E A LT H C A R E

Treadmills are wonderful tools for getting fit, burning calories and keeping track of the calories while we burn them. According to Harvard Health Letter, “A 155-pound person can burn approximately 600 calories in one hour of running at a moderate pace, and a 185-pound person can burn well over 1,000 calories running vigorously.”

So how long does it take to burn off that cheeseburger lunch? Based on the 155- pound model of ten calories per minute, it’s easy to calculate how much treadmill time you’ll need to put in by simply removing the last digit from the calorie count. Take a look at how many minutes you’ll need to run just to burn the calories from any of these fast foods: FAST FOOD ITEM

MINUTES ON TREADMILL

Big Mac ...................................................... 53 mins Cheeseburger ............................................ 29 mins Medium Fries ............................................. 34 mins Coke Classic Can........................................ 9 mins 8oz Starbucks Chai Tea Soy Latte ............. 12 mins Taco Bell Crunchy Taco .............................. 17 mins 6” Subway Italian BMT on Wheat ............... 41 mins KFC Original Recipe Chicken Breast ......... 32 mins Pizza Hut Personal Pepperoni Pizza .... 1 hr 2 mins

A jump rope without the rope!

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Jumping rope burns more calories in an allotted time than almost any other exercise. JumpSnap takes the old standby exercise to another lever — by eliminating the rope. source: JumpSnap.com and coolest-gadgets.com

Doing the Clothes really Walk the Electric Stride. do make the walk. Work man. the work. InStep NanoPower has developed a device that fits inside a shoe and harvests the energy expended while walking to charge a battery — that’s up to 20 watts of power. More than enough to power up many electronic mobile devices.

Athos fitness apparel uses electromyography (EMG) to look inside your body as you work out, measuring muscle involvement, muscle intensity, heart rate and more. Gear is available for preorder now and will ship in the fall.

source: www.InStepNanoPower.com

source: www.liveathos.com

TrekDesk is a treadmill desk that fits almost any treadmill. Answer the phone, email, compose letters, write reports, work the computer — while you walk. Lose 50–70 pounds a year! Reduce stress. Increase productivity. Do your heart some good while you do your job! source: www.TrekDesk.com

Starbucks photo via weedezign / Shutterstock.com

The Journey of 10,000 Steps


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A ONE-MINUTE KISS BURNS

Have a seat. Have a ball.

Eliminate backaches, energize your day, and strengthen your core — get fit while you sit at your desk — on a Balance Ball Chair by Gaiam. Align your spine and support your back while you deal with your daily grind. Fitness has never been so comfortable. source: www.gaiam.com.

Get a leg up with LEO The LEO legband reads you, advises you, diagnoses you, analyzes your form, improves your performance and keeps you safe. It measures lactic acid buildup and hydration breakdown and is ideal for elite athletes and weekend warriors alike. source: www.indiegogo.com/projects/leo-fitness-intelligence

Stick a calories HAPI fork in it.

THE HUMAN BODY HOUSES

650 muscles

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HAPIfork counts your “forkfulls,” how fast you eat and the intervals between bites. It even warns you if you’re eating too fast. Why is that important? Eating too fast causes weight gain, digestive problems, gastric reflux and more. source: www.hapi.com

percent OF AMERICANS HAVE GYM MEMBERSHIPS

That’s about 45.3 million people out of 321 million.

10 MINUTES OF EXERCISE IS EQUAL TO LAUGHING OUT LOUD

100 times

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After hundreds of studies conducted by hospitals and universities all over the world and too many not-so-casual hints by our doctors to stop thinking about exercise and actually try doing it once in awhile; we give up. We get it. We know its time to

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A Body of Proof

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Let’s go right for our vanity bones and hit the number one motivator that fills gyms night after night — weight control. Exercise burns calories, period. The more we move, the more calories we lose. Burn more in a day than we take in and voila, we’re burning fat, losing weight, and eyeing a new wardrobe. The number two reason — and the one people give when refuse to own up to number one­— is health. Exercise for the health of it. The benefits are staggering. Heart disease, high blood pressure, type-2 diabetes, arthritis, some cancers, stroke, metabolic syndrome — regular exercise gives us a fighting chance at keeping these things out of our lives for good. Plus, exercise makes us feel better. Whether it’s the chemicals and hormones we release during a run on the treadmill, or the steam we vented after a stressful day, or simply the knowledge that we’re looking better every day and are proud of our accomplishment, exercise relaxes us and lifts our spirits. It just does. Stronger muscles, greater endurance, heart and lungs working together like they were made to — they all add up to more

Exercise is the single best thing you can do for your brain in terms of mood, memory, and learning.

energy. We’ll feel it in the grocery aisle and going up and down the stairs at home. When we do yard work, play sports, or walk the dog, the boost in energy we get from exercising will improve every facet of our lives. Not a bad trade off for a few minutes a day of doing something we need to do anyway. Better sleep and better sex. That got your attention didn’t it? Exercise helps us with both of those, not necessarily in that order. When we’re more active, we get to sleep faster, sleep deeper and stay asleep longer. Studies show we’ll also enjoy better sex lives. It’s true. Not just because we’ll be in better shape and feeling better about ourselves. But women who exercise regularly can experience greater arousal. Men can stave off problems with erectile dysfunction. Makes that treadmill look like a smart investment after all, doesn’t it? What’s it all mean, really? The more we stay active, the more ways our bodies will find to thank us for it. Simple — and simply amazing — as that.

Fit Body, Fit Brain The tendency is to think that all that running, weight lifting, tennis, bike riding and beach volleyball benefits our hearts and lungs, muscles and joints exclusively. But


health and medical experts have known for over a decade that one of the most important beneficiaries of all that exercise lies in the space between our ears. Our brains derive a long list of benefits from a consistently active lifestyle — starting with stress reduction. Put in the time on a treadmill or weight training. Bend and twist in a yoga class. Learn a new dance move. Our brains respond by releasing chemicals — serotonin, dopamine, and norepinephrine — and the reward is significant. According to a 2010 study at UCSF, we could actually be reversing the aging effects of stress on a cellular level. Plus, we’ll feel good about it. Research has shown that exercising enough to burn off just 350 calories three times a week can counter the effects of depression almost as well as taking a prescription antidepressant. Want to get smarter? Exercise. According to Harvard Medical School psychiatrist John Ratey, “Exercise is the single best thing you can do for your brain in terms of mood, memory, and learning. Even 10 minutes of activity changes your brain.” Why is that? Exercise releases brain chemicals called growth factors that help grow new brain cells and increase cell-to-cell connections. If the exercise is more complicated — like playing tennis or participating in a dance class — the effects are enhanced. It seems, if we have to think about being coordinated, so much the better. Even going for a walk can have a powerful effect on our brain health. Canadian researchers studied elderly adults over a two to five-

year period and found that mild activity — walking, gardening, cleaning — helped mitigate memory loss and keep skills like vocabulary retrieval more robust. The Alzheimer’s Research Center has even said that exercise may be one of our best tools to help stave off the disease. The hippocampus is one of the first targets of Alzheimer’s and exercise appears to help protect that region of our brain, thus lowering the risk or lessening the impact of this terrible disease.

The Results Add Up We can mark the benefits of exercise by our watches and our calendars. In the first hour after a strenuous bout of exercise, our immune system gets a boost from an elevated immunoglobulin level — proteins that fight infection. Our brains are flooded with happy chemicals like serotonin, dopamine and norepinephrine. Stress dissipates and even at rest, we’re burning calories. Strength train at least twice a week and the “after burn” is especially pronounced. A study at Ohio University shows that our metabolisms continue to burn calories up to thirty-eight hours after we work out. Within a day of exercising, we’re already adding lean muscle. Strength training routines make our bodies rev up the metabolism to repair the micro-tears weight training causes in our muscles. (Interestingly, preliminary research shows that women respond and recover from weight training faster than men.) Our hearts will be healthier. Any exercise session that breaks a sweat will lower our blood

Any exercise session that breaks a sweat will lower blood pressure for up to 16 hours.

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and our clothes will fit better. Within one year of adopting a regular schedule of exercise that includes cardio and weight training, our endurance and aerobic fitness will skyrocket. In fact, endurance can more than double in that time. Our hearts

Longer life. Easier life. Happier life. are working much more efficiently. Our cells will have become micro factories, burning fat 24/7. Cancer risk will plummet — a study of more than 14,800 women with superior aerobic fitness showed them to be 55% less likely to die from breast cancer than women who did nothing. Women with medium fitness still improved their odds by 33%.

We’ll also live longer and happier lives. People who exercise regularly and who attain a higher level of fitness have “better telomeres.” Telomeres are the DNA strands on the ends of our chromosomes that protect against damage. Better protection means slower aging. Our mood will be enhanced; as much by the knowledge of how we’re taking control of our own health as by the chemical reactions we’re creating in our brains. The simple fact is that our bodies were created and evolved to move. They want to move; on every level, from muscle and bone to hormones and brain. We ignore that genetic imperative at our peril. “Use it or lose it” comes to mind. If we start out slow — discuss exercise with a physician beforehand to be safe — the benefits are guaranteed to be amazing. Longer life? Easier life? Happier life? What more incentive do we really need than that?

40 65 percent

percent

OF ADULTS OVER 55 DO NO LEISURE EXERCISE WHATSOEVER

OF ALL ADULTS ARE OBESE OR OVERWEIGHT

INACTIVITY IS THE TOP RISK FACTOR FOR HEART DISEASE, AFFECTING

LESS THAN

percent

percent

OF ADULTS, COMPARED TO OBESITY (34%) AND HYPERTENSION (32%)

OF ALL ADULTS MEET THE PHYSICAL ACTIVITY GUIDELINES FOR AEROBIC AND ANAEROBIC ACTIVITY

53 20

source: The American Heart Association and the CDC

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The Exercist

pressure for up to sixteen hours. A vigorous session will do more than an average one. LDL levels will be more reduced, improving our cholesterol numbers. After one week of exercise we will have reduced our risk of diabetes. As we maintain a consistent workout schedule, we increase sensitivity to insulin, lowering our blood sugar levels and decreasing the threat of type-2 diabetes. Our ability to take in oxygen — VO2 max — will have increased by five percent. Long-term benefits will continue to accumulate as we get stronger and increase endurance. We’ll see it in the amount of weight we can move and the number of reps we can accomplish. It’s also in the increased speed and length of time we can maintain a jog or run. We’ll feel it in a general feeling of wellbeing and an enhanced selfimage. We’ll have dropped body fat


H E A R T- H E A LT H Y R E C I P E S

DISHES SO GOOD AND SO GOOD FOR YOU!

Grilled Chicken with Strawberry and Pineapple Salsa INGREDIENTS

• 1 tsp canola or corn oil

Salsa • 2 slice pineapples, each 1/2 inch thick, patted dry • 1 cup whole strawberries, diced • 1/4 cup finely chopped red onion • 3–4 Tbsp chopped, fresh mint leaves • 1–2 tsp sugar • 1/8 tsp crushed red pepper flakes • 1 medium lemon

Chicken • 4 boneless, skinless chicken breast halves (about 4 ounces each), all visible fat discarded • 2 tsp salt-free steak seasoning • 1/4 tsp salt

1. Preheat grill on medium high. Brush a grill pan or grill rack with the oil. Heat the grill pan/ rack on the grill for about 2 minutes, or until hot. Grill the pineapple for 2 minutes on each side. Transfer to a cutting board and let cool slightly — about 2 minutes — before chopping. 2. Meanwhile, in a medium bowl, stir together the remaining salsa ingredients except the lemon.

Grate 1 tsp lemon zest, reserving the lemon. Stir zest and chopped pineapple into the strawberry mixture and set aside. 3. Sprinkle both sides of the chicken with the seasoning blend and salt. Grill for 5 minutes on each side, or until no longer pink in the center. Transfer to plates. Squeeze the reserved lemon over the chicken. Serve with salsa on the side.

Serving Size: 3oz chicken & 1/2 cup salsa Serves 4 Calories 320 Total Fat 10g Saturated Fat 2g Trans Fat 0g Polyunsaturated Fat 1g Monounsaturated Fat 3g Cholesterol 8mg Sodium 453mg Carbohydrates 38g Fiber 9g Sugars 6g Protein 21g

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by the American Heart Association’s Simple Cooking with Heart ® Program.

DIRECTIONS

Recipe copyright © 2015 American Heart Association. This recipe is brought to you

NUTRIENT INFORMATION


Walking th

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Name an exercise you can do that requires no formal training, can be done anywhere, needs no specialized equipment, improves your cholesterol, lowers blood pressure, wards off diabetes, burns fat, tones you up, makes you happier — and comes without a price tag…you probably already guessed — it’s walking. Of all exercises, walking is the great equalizer. It’s accessible to practically everyone. It’s safe, simple, and you’ve been doing it your whole life. By now, you ought to be pretty good at it. Estimates put the number of Americans who walk for exercise at about 110 million — far ahead of any other reported activity. The reasons are obvious. No matter what your fitness level, walking is an easy habit to work into. Both time and distance are easy

to judge and can be increased gradually as fitness improves. The exercise itself is low impact. So, there’s no stress on muscles and joints. And the benefits are numerous. People who walk regularly as a part of an active lifestyle put up much better health numbers than their non-walking counterparts. By percentages, 59.5% of those who walk each week got in enough exercise to reduce the risk of early death, heart disease, type II diabetes, stroke, colon and breast cancer. Of non-walkers, only 29.5% got enough exercise. According to a 2010 CDC report, one third of Americans reported no physical activity at all during their leisure time. Just under half of people overall — 48% — achieve the recommended amount of exercise, up from 42.1% to

48.0% in the last five years. But on the other side of the equation, that means that more than half faced increased health risks. Walking is an excellent way to defy the percentages and break into the habit of exercise. When it is done right, with a good warmup, adequate stretching, proper form and gradual cool down, walking is very hard to beat. Which brings us to ICE WALK 2015.

Join Us for ICE WALK 2015 What better way to get in a little cardiovascular fitness than an easy walk in the fresh air and sunshine with friends and family! Our 4th Annual ICE WALK happens Saturday, November 14th. Registration is at 8:00 A.M. The walk steps off at 9:00 A.M.


he (ice)walk The accent this year, like every year, is on fun. Yes, it’s a great way to meet people. Yes, it’s good to get out and do a little walking. But, one big reason most people lace up their sneakers and join us is simply for the fun of it! And the fun will begin early with the traditional ICE WALK warmup. The music starts and the stretching begins! We want you good and loose and ready when the Walk starts. Be sure to wear your ICE WALK t-shirt — free for everyone who registers — comfortable clothes and a good-fitting pair of shoes. The walk itself is a leisurely four miles. Bring a stroller if you like — it’s that leisurely — and maybe even your furry-faced BFF. On a leash, of course. If you can’t quite make the whole four miles don’t

worry. Some only do half of the walk. Some even less. The point is not to finish. The point is to get out in the fresh air, do what you can and have a blast doing it. After the walk, the fun continues with lots more music. We’ll all get together for some delicious catered food and refreshments. Vendors will be exhibiting by the big tent. And if you feel lucky we’ll have a raffle for some very impressive Gift Baskets to tempt you! Last year, all donations went to help our four-legged friends at both the Marion County Animal Shelter and the South Lake Animal League. This year, we’re back on two legs. The proceeds from this 4th Annual ICE WALK are slated for the American Heart Association, a

very worthwhile charity that is literally close to all our hearts. The AHA is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. Founded by six cardiologists in 1924, the organization now includes more than 22.5 million volunteers and supporters.* After this year’s ICE WALK, and all your donations and our raffle ticket dollars, we’ll be in some very good company. We set a record last year for donations and participants and we expect this year’s numbers to surpass even those. So, mark your calendars and start getting ready. Our 4th Annual ICE WALK will be here before you know it. See you in November! *According to the American Heart Association’s website

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I CSEPSOPTOLTI L GIH GTHST S

P R O F I L E S O F PAT I E N T S A N D C A R E P R O V I D E R S

EMPLOYEE

Adam Bryniarski Cath Lab Assistant Adam followed a varied and colorful path on his way to a career with ICE, starting with professional wrestling in England. He began as a teenager in Britain and traveled the world for ten years putting on shows. He parlayed that into a job as President and Director of Operations for a major gym franchise, before deciding to further his education. Health and fitness is where his passions lay, and so Adam studied to become a licensed Paramedic. Then, on the job in the ER one day, he met a doctor who worked with ICE. Adam’s skills and temperament impressed the doctor enough to recommend Adam seek a position with ICE. He met Dr. Qamar and the pieces fell into place. Adam says,“ICE is the most fulfilling job I have ever had. The direct patient contact… working with patients and having them return weeks later pain-free and happy… it’s a wonderful job that I do.” PROGRAM

Strides

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STRIDES is a special program at ICE created expressly for patients who have symptomatic PAD. Its goal is to thwart the looming specter of amputation and return PAD sufferers to an active, pain-free life. By all measures, STRIDES is working. The national average for people with PAD is 5,790 amputations per 100,000 patients. STRIDES has reduced that number to 100 for every 100,000 and ICE continues to work to improve those odds. Patients who enter the program are interviewed, measured, and evaluated during an initial visit before receiving an individualized plan. Their recommended treatment protocol may require specific diagnostic tests—PVR/ABI, arterial ultrasound, CT angiogram, angiography—to get a clearer picture of the extent of their PAD. Surgical intervention may even be necessary before the STRIDES patient begins an individualized plan that may include: Medication, Smoking Cessation, Home Exercise Program, Supervised Vascular Rehab, and ongoing education and support.


PAT I E N T

James & Nancy Hernandez “In September 2011, my wife Nancy had double bypass surgery, from which she recovered remarkably well. Since then, under the continued care and supervision of the ICE staff, my wife has had four stents in her legs. We are also monitoring an abdominal aortic aneurysm detected on an earlier ultrasound to prevent an emergency situation.

“Then, earlier this year, we thought my wife might need a pacemaker because her heart rate had been very slow for several months. She was referred to Dr. Ali—an excellent cardiologist at ICE that specializes in the electrical functioning of the heart. After some tests, he suspected one of Nancy’s medications was causing her heart to beat more slowly. He changed the medication and her heart rate began to return to normal. Dr. Ali gave us the great news that she didn’t need a

pacemaker after all! “One thing that is important to both of us is to have doctors that listen to you, gain your trust and treat you like family. Both of our primary care doctors—who are also part of the staff at ICE— do all of that as well. We feel by now that the staff of ICE is practically a part of our family. We are extremely lucky and are very grateful for the care we have received from all the folks at ICE.”

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Tavares

Ocala

Williston

Summerfield

The Villages

CARDIOLOGY PRIMARY CARE VEIN CARE LIMB SALVAGE PHONE 352.854.0681 FAX 352.854.8031 OCALA 4730 SW 49th Rd OCALA 3515 SE 17th St Ste 100 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

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