The Heart of Jacksonville | Issue 6

HEART THE

OFJACKSONVILLE ISSUE 6 | 2019

SHOW ME THE

MONEY

A National Push Towards Price Transparency in Healthcare & What this Means for You IN THIS ISSUE: A PUBLICATION OF

Heart Failure: Where Are We Going?

How Income Affects Your Risk of Heart Disease Supplements: Hype or Reality?

Preventing Amputations

YOUR BEST DEFENSE BEGINS WITH KNOWING. At age 60, having type 2 diabetes and a history of a heart attack or stroke shortens life expectancy by an average of 12 years.

There are steps you can take to reduce your risk. Learn more at KnowDiabetesByHeart.org.

FOUNDING SPONSORS

NATIONAL SPONSOR

© 2019 American Heart Association, Inc. and American Diabetes Association, 501(c)(3) not-for-profits. All rights reserved. Know Diabetes by Heart is a trademark of the AHA and ADA. Unauthorized use prohibited.

ISSUE 6 2019

CONTENTS FEATURES:

SERVICE LINES:

4

Letter From The President

6

Healthcare Price Transparency

23

Patient Testimonials: What Our Patients Are Saying

17

How Income Affects Heart Disease

28

Social Media Recap: Team Pictures

18

Success Stories from Amputation Center

31

Word Search

24

The Risks of Sleep Deprivation

27

Invest in Your Employee’s Health

Back Cover Coupons For Your Health

HEALTHY LIVING:

10

Heart Failure: Where are we going?

8

What To Eat at Restaurants

12

3 Additions to Boost Heart Health

14

Recipe: Cauliflower Rice

16

Aromatherapy for Your Heart

18

Supplements for Heart Health

PROVIDER’S SPOTLIGHT: 5

Dr. Omer Zuberi Talks Diet

15

Dr. Jonathan Constantin Says Every Step Counts

19

Dr. Andrea DeNeen: Women’s Health

22

Patient Stories, as Remembered by our Team

26

Humans Of FCCI - Dr. Cary Rose

30

Doc Favorites: Q&A

PHYSICIAN’S SPOTLIGHT

Dr. Yazan Khatib

Letter from the

PRESIDENT

Let’s face it — Seeking out a doctor is not usually a pleasant experience. There are many factors to consider when choosing a physician: Is the doctor covered by your insurance? Have you heard good things about the physician? Is the facility near your home?

As all of these factors run through your head, it may be easy to forget about cost. In fact, healthcare is one of the few areas that is oftentimes overlooked when it comes to cost… at least until now.

Price transparency in healthcare is a growing movement. Consumers no longer want good care alone; they also want the right care, at the right time, and at the right price.

Price transparency isn’t just a trend. It has actually lowered overall healthcare costs, according to Health Affairs. Once the consumer becomes more aware of value, they take this on as a repeated behavior. 83% of people who have compared healthcare prices in the past say they will compare prices again when seeking another service, according to the Robert Wood Johnson Foundation. Flip over to page 6 to read more about how to shop the best value for your dollar in healthcare. The best lesson is high quality can come at a low cost, if you shop smart.

I believe we should think of healthcare from every point of view. I choose to lead this practice not only from the perspective of a physician, but also from the perspective of a patient and the loved one of a patient.

As a physician It is our responsibility to uphold our end of the job when it comes to price transparency. When you call an FCCI office and schedule an appointment, a member of our team will give you the estimated cost of your visit.

Check out more of our efforts on price transparency by flipping to page 6. We believe strongly the patient should be focused on their health, not the dollar signs.

As a patient I expect to be seen in a timely manner. When I need a doctor, I usually cannot afford a three week wait time. Our team ensures you are seen as quickly as possible so your mind can be put at ease. With convenient locations throughout Duval, Clay, St. Johns and Putnam counties, there is a good chance you will find us around the corner from your home.

As the loved one of a patient I want to ensure my loved one is treated with compassion. I expect the provider to treat my loved one the same way they would want their mother, father or friend treated. Every patient that walks through our door becomes one of our family members.

On behalf of our team, I want to say thank you for joining us for another edition of The Heart of Jacksonville. We look forward to continuing to serve Northeast Florida.

Sincerely,

Yazan Khatib, MD President of First Coast Cardiovascular Institute 4 THE HEART OF JACKSONVILLE | Issue 6 2019

PHYSICIAN’S SPOTLIGHT

New

research shows a plant-based diet can cut heart failure risk by over 40%.* You do not have to cut out meat altogether.

However, simply reducing the amount of meat you eat and filling that room on your plate with vegetables goes a long way.”

-Dr. Omer Zuberi Interventional Cardiologist and Board-Certified Heart Failure Physician Source: Journal of the American College of Cardiology Issue 6 2019 | THE HEART OF JACKSONVILLE

5

SERVICE LINE

Healthcare Price Anytime we are buying a product or a service, we scout out the best price. Take buying a car, for example. You likely visit five different dealerships, compare countless cars, and consult all of The Kaiser Family Foundation estimates that premiums have increased by 69% in the past 10 years. In fact, in the past 12 months, senior citizens have collectively withdrew $22 billion out of their savings to cover healthcare costs, according to Gallup. This leaves consumers with no choice but to shop the market. Consider the following when shopping for the best value for your dollar: 1. Higher cost does not mean higher quality. The United States spends more on healthcare than any other nation. However, we do not have the best healthcare outcomes. In a study published in The Journal of the American Medical Association comparing the healthcare outcomes of 11 countries, the US ranked last in life expectancy. According to the Institute of Medicine, up to 30% of healthcare spending is unnecessary.

2. Start with your health insurance company. If you are insured, many times, your insurance company may have a list of services and their prices at each facility in the area. Start by asking your health insurance company for prices and go from there.

3. Hospital pricing. As of January 2019, hospitals are required to post their prices online to allow consumers to shop the market. Dozens of studies show how pricing can differ by thousands of dollars for the same service at hospitals that are merely miles apart. If you are in need of a service that requires the hospital, be sure to scout the best price online.

4. Don’t be afraid to ask. Many healthcare facilities have a cost estimator tool or a price sheet readily available. Ask for an estimate of your service before scheduling an appointment.

6

THE HEART OF JACKSONVILLE | Issue 6 2019

e Transparency your family, friends, and neighbors before bargaining the best price. However, in regard to healthcare, price shopping seems to be the one area that is often overlooked—at least until now.

How First Coast Cardiovascular Institute (FCCI) Supports Value

1 2 3 We have a cost estimator tool.

When a patient calls to schedule an appointment at FCCI, they are often given the cost of the service they will have. This creates trust and transparency with the patient and ensures there will not be any surprise bills.

We strive to offer patients services in the most costeffective environment possible. As an outpatient center, we do not have the robust cost of running a hospital.

With that, we are able to offer patients a lower cost compared to hospital systems.

Despite caring for a very sick patient base, we utilize testing and other services responsibly.

Generally, we are at or below the 50th percentile in our utilization of certain tests, demonstrating a commitment to responsible usage.

Issue 6 2019 | THE HEART OF JACKSONVILLE

7

HEALTHY LIVING

WHAT to eat at

RESTAURANTS Let’s start out with the best advice there is when it comes to eating healthy:

It’s easier to implement your game plan when you are in a routine, but what happens when the routine is broken? Maybe it’s your friend’s birthday and you are all gathering at your

HAVE A GAME PLAN

favorite Mexican restaurant, or you have a lunch meeting at

Trying to eat healthy at a Mexican restaurant is like learning to walk on a tightrope — extremely hard to do but not impossible. Here are Reader’s Digest’s tips to eating healthy at a Mexican restaurant.

work and decide that Italian is everyone’s preferred choice. Or maybe you’ve had a busy workday and can’t be bothered to cook.

Below is a list of common unhealthy food spots and our tips to eating healthy at each one!

Mexican

•Swap the chips and queso for guacamole and tortillas.

Although tortilla chips can be a healthy snack, they are usually deep fried and heavily salted at Mexican restaurants. Guacamole contains the ‘good’ fats your body needs and soft tortillas reduces your sodium intake.

•Choose fajitas with lean meat. Fajitas are pretty customizable and can be made with grilled, lean meats such as chicken or shrimp, or 8 THE HEART OF JACKSONVILLE | Issue 6 2019

an assortment of grilled veggies.

It is extremely tasty, filling, and healthy for you!

•Make a healthy version of tacos and burritos. Cut out the unhealthy cheese and sour cream and substitute it with your favorite salsa. For your tacos, it’s better to choose soft tortillas rather than the deep fried hard shells.

•Add healthier side dishes to your meal. When deciding on a side dish at Mexican restaurants, it’s better to choose beans over the traditional Mexican rice. Beans are loaded with fiber and potassium, as well as other heart healthy vitamins. They are also lower in cholesterol, which aids heart health.

PASTA AND BREAD — it tastes so good, but it is also so bad for you in many ways. However, it is possible to enjoy all your favorite Italian dishes while staying true to your heart healthy diet. Try these tips from The Daily Meal the next time you are eating Italian.

Italian

•Avoid bread. This is easier said than done, especially because many Italian restaurants offer free bread as an appetizer. Try ordering a starter salad or minestrone soup, which contains fiberrich beans and veggies that are good for your heart. If your party agrees, you can ask the server to substitute the traditional bread appetizer with a healthier option, like the choices above.

•Choose red sauce. In most cases, a red tomatobased sauce is lower in calories than a whitebased sauce, which usually contains heavy cream. You can ask your server to substitute the white sauce for the red in certain dishes.

•Try fresh fish. Italians are known for their exquisite choice in seafood. Fish is an important part of your diet because it tends to be lighter, contains fewer calories and is heart healthy.

It’s best to choose fish that have been grilled, roasted, or cooked in olive oil, instead of fried.

Chinese Ordering take-out Chinese food is a cheap indulgence that everyone should enjoy, even if you’re sticking to your heart healthy diet. Try these pointers from Fit Day the next time you decide to order in.

• Browse the soup menu. Many Chinese restaurants have a range of soups that are broth based. Not only are these low calorie treats, but eating a broth-based soup before your meal will fill you up and cause you to eat less food in total, according to Livestrong.

• Choose spring rolls instead of egg rolls.

Spring rolls contain about 80 calories on average and are a lot healthier for you than deep fried egg rolls.

• Ask for sauce on the side. Chinese take-out is known for their flavorful saucy chicken such as General Tso’s Chicken, Kung Pao Chicken, and more. You can still enjoy these flavors but ask for the sauce on the side. This saves calories and is better for your heart than drenching the chicken in sauce.

• Look for steamed vegetables and lean protein. There are many different combinations of steamed veggies and lean protein when it comes to traditional Chinese food.

Try a Moo Goo Gai Pan, which is a dish with veggies, mushrooms, and chicken. This dish is full of fiber, and a whole cup is only about 275 calories.

Issue 6 2019 | THE HEART OF JACKSONVILLE

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SERVICE LINE

HEART FAILURE: Similar to other fields in medicine, heart failure is an arena with many new advancements. The treatment plan for heart failure looks vastly different now than it did 20 years ago.

What is Heart Failure?

The name of heart failure is a bit of a misnomer. Having heart failure does not mean your heart has stopped working. However, it does mean that your heart is unable to carry out one of its most important functions. In an individual with heart failure, the heart cannot pump enough blood to meet the body’s demand.

The Centers for Disease Control and Prevention (CDC) estimates that heart failure affects nearly 6 million Americans.

The American Heart Association (AHA) expects this number to grow to 8 million by 2030. Despite this unfortunate statistic, advancements in heart failure are rapidly evolving, and we are learning how to make heart failure a manageable condition.

Technology in Heart Failure

(VNS). ART is investigational and being studied in a clinical trial called ANTHEMHFrEF. This trial is currently enrolling patients who are eligible to participate to determine the long-term benefits of ART on patients suffering from heart failure. FCCI is proud to be participating in the clinical trial.

CardioMEMS We were the first healthcare provider in

First Coast Cardiovascular Institute (FCCI) has a dedicated research team performing studies to advance care for heart failure patients. Our in-house research team ensures our patients are the first to benefit from new technology in Northeast Florida.

Northeast Florida to implant the CardioMEMS

Autonomic Regulation Therapy

manage heart failure. The device works by

A new form of therapy is being evaluated for patients with heart failure. It is called Autonomic Regulation Therapy (ART) delivered through Vagus Nerve Stimulation 10 THE HEART OF JACKSONVILLE | Issue 6 2019

device. This device is the first FDA-approved heart failure monitoring device that has been proven to significantly reduce hospital admissions when used by physicians to transmitting daily sensor readings from the patient’s home to their provider, allowing for personalized and proactive management to reduce the likelihood of hospitalizations.

Where Are We Going?

Managing Heart Failure The rate at which healthcare providers are making medical advancements is incredible.

However, we should not forget about the effectiveness of the traditional treatment method for patients with heart failure: diet and exercise.

A large part of managing heart failure is diet. Many patients with heart failure are asked to follow a low sodium diet, which is often easier said than done. Here are a few tips to make following a low sodium diet a little easier.

• Be cautious of canned soups, which tend to be dangerously high in sodium.

• Consider replacing cooking salt with herbs and spices.

• When eating out, ask for your dish to be prepared without salt.

• Avoid smoked meats, which tend to be higher in sodium.

Patients with heart failure should also consider the following dietary factors: Minimize soda consumption. It’s no secret that soda is a source of empty calories and lots of sugar. However, even diet sodas are quite controversial. Some studies indicate that diet sodas may be tied to weight gain and increased appetite. It’s best to err on the side of caution and avoid both regular and diet sodas in general.

Monitor fluid intake. If you have heart failure, your body likely retains more fluid than it needs, according to the American Heart Association. Many individuals with heart failure are prescribed medication to help reduce extra water retention and reduce stress on the heart. Talk to your doctor about your fluid intake so you can develop a healthy diet that’s right for you.

Issue 6 2019 | THE HEART OF JACKSONVILLE

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3 HEALTHY LIVING

Quick Additions to Boost your Heart Health

Between the foods you are told you should be eating and the foods you are told to avoid, eating heart healthy may seem overwhelming. However, we have a way to add a heart health kick to the meals you are already eating (no life shattering changes required). Here are three examples of easy and quick additions to get you started...

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1

CHIA SEEDS. Chia seeds are packed with omega-3 fatty acids, as well as protein, fiber and calcium. Chia seeds help raise HDL cholesterol, also known as the “good” cholesterol, which helps protect your heart against heart attack and stroke, according to Medical News Today. Add these tiny seeds into yogurt, oatmeal, smoothies and more, for a nutty flavor and a punch of heart health.

3

2

SHREDDED SPINACH. Spinach has just about everything your heart needs; it is packed with omega-3 fatty acids, antioxidants, B vitamins and fiber. Spinach is also rich in folate. Folate is an important B vitamin that helps build and maintain healthy cells, such as red blood cells, that are essential for heart health, according to Everyday Health.

Chop up some spinach leaves and sprinkle them over a casserole or soup, or add to a wrap or sandwich for an extra heart healthy boost.

CHOPPED WALNUTS. Walnuts contain high levels of antioxidants, which help fight cardiovascular disease. Chopped walnuts are the only tree nut that contain a high level of omega-3 fatty acids, which keeps the “bad” cholesterol (LDL) down.

Walnuts are also a great source of protein and fiber that can be thrown on top of a salad, yogurt, or even your favorite dessert.

Issue 6 2019 | THE HEART OF JACKSONVILLE

13

PHYSICIAN’S RECIPES SPOTLIGHT

CAULIFLOWER

RICE

A HEART HEALTHY MEAL FROM THE AMERICAN HEART ASSOCIATION

White rice has been under a lot of scrutiny lately. It seems like everywhere you turn, there is a health column warning you on the dangers of carbs. Let’s face it, a bowl of steamy white rice is usually the posterchild for carbs.

Cauliflower rice is a great substitute for white rice; it’s lower in calories and healthy for your heart! Cauliflower is an amazing source of vitamin C, which can act as an antioxidant.

Antioxidants are known for their anti-inflammatory effects that can boost immune health and reduce the risk of heart disease, according to healthline.

What You Will Need

Directions

Cooking spray- use a cooking spray that is heart healthy, like olive oil.

• Cut the cauliflower into florets. In sections, add the cauliflower to a food processor or blender.

Be careful to only blend until it is the texture of rice. If you blend too much it may turn into cauliflower mush.

1 head cauliflower 1/4 tsp salt 1/4 tsp black pepper 1/4 cup chopped, fresh or dry parsley

Make it a Meal To make cauliflower rice part of a nutritious meal, consider cauliflower rice stir-fry. Just add veggies and your choice of lean meat such as chicken or shrimp.

14 THE HEART OF JACKSONVILLE | Issue 6 2019

• Coat a medium sauce pan with your favorite heart healthy spray or oil, such as olive oil, then add the blended cauliflower. Proceed to add salt, pepper and seasoning of your choice.

• Sautee over medium heat for 5 minutes until cauliflower is tender while stirring occasionally.

• Finish off by adding chopped parsley on top.

Serves 4.

PHYSICIAN’S SPOTLIGHT

It is never too late to start exercising.

New research has shown you are never too old to gain the benefits of exercise.* Even a small amount of exercise is beneficial so take the stairs, use your break to take a walk or make trips to the water fountain often.

Every bit counts!”

-Dr. Jonathan Constantin First Coast Cardiovascular Institute Source: JAMA

Issue 6 2019 | THE HEART OF JACKSONVILLE

15

HEALTHY LIVING

AROMATHERAPY FOR YOUR HEART In the past year alone, U.S. retail sales of essential oils soared 14% to $133 million, according to market research firm SPINS. Essential oils are natural plant-based oils, which are concentrated and distilled to mimic the smell of the plant it was extracted from.

While essential oils are widely known for hair and skin benefits, they can also be used to lower stress and anxiety, which may benefit your heart health.

According to the American Heart Association, physiological stress may affect major risk factors of heart disease like high blood pressure, cholesterol, overeating and more.

Although it is not scientifically proven that essential oils decrease your risk of heart disease, they could help reduce your stress levels.

Lavender, cypress, lemon and clary sage can soothe the mind and relieve stress, which lowers blood pressure and reduces the risk of heart disease. However, if you have high blood pressure, try to avoid stimulating essential oils such as rosemary, sage, and thyme, which are known to increase heart rate and blood pressure, according to Amazing Wellness Magazine.

Aromatherapists use therapeutic essential oils in various ways. Try following these tips to boost your heart health: • Mix oils together and apply directly to the skin as a lotion or massage oil. Rub a small amount on your temples or under your nose to calm your nerves.

16 THE HEART OF JACKSONVILLE | Issue 6 2019

• Pour essential oils into a diffuser. The diffuser will disperse the essential oils so their aroma will fill the room with its natural fragrance. All you have to do is breathe in and out to get a relaxing feel.

When used properly, essential oils clear the mind, calm the body, and create a soothing aroma. In addition to reducing stress, they can also relieve symptoms of anxiety, depression, and insomnia. However, be sure to always consult with your doctor before using essential oils.

SERVICE LINE

THINK YOU’VE HEARD EVERY RISK FACTOR POSSIBLE:

INCOME You have most likely heard of the more common risk factors for heart disease, like blood pressure and diet. However, a new study shows that unstable income can easily turn into a risk factor for heart disease.

A study in the journal, Circulation, found that people who experienced drops in income, have double the risk of heart disease, compared to those with a steady income.

Additionally, the study suggests that those who have lost 25% or more of their income from one assessment to another also have an increased risk of heart attack, stroke, heart failure, and even early death.

Drops in income can also impact your ability to foster a healthy lifestyle. Those with a lower income do not have the same capabilities to obtain healthy foods, ensure continuous care with a physician, and generally, upkeep a heart healthy lifestyle.

We are not always able to control our income, so this may come as unfortunate news. However, we should not forget our heart health, even in difficult financial times. If you have recently experienced a drop in income, try using the following mechanisms to cope with stress:

How Income Affects Risk of Heart Disease • Talk to your doctor. Do not shy away from telling your doctor if you are experiencing stress from a financial burden. Your physician may be able to advise you on steps you can take to reduce stress that is personalized to you.

• Maintain physical health. While it can be difficult to remember your physical health in the face of a difficult financial time, it is possibly one of the most important times to be cognizant of your health. To work on your physical health and combat stress at the same time, try exercising. A study found in the Journal of Physiology suggests that exercise can not only reduce your risk of death from heart disease, but 30 minutes of exercise 4-5 times a week can also keep your heart young.

• Practice optimism. A study published in Mayo Clinic Proceedings found that heart attack survivors who have an optimistic outlook are more likely to live longer. Let gratitude help keep you optimistic during hard times.

Issue 6 2019 | THE HEART OF JACKSONVILLE

17

HEALTHY LIVING

SUPPLEMENTS for Your Heart Health:

Hype or Reality?

18 THE HEART OF JACKSONVILLE | Issue 6 2019

You’re standing in aisle B at the pharmacy, staring at hundreds of supplements that all claim to have different health benefits. You may feel lost and confused when it comes to supplements and you are not the only one.

Supplements claim to provide a myriad of benefits, from weight loss to accelerated health and physical strength. Most American diets lack the recommended amounts of essential vitamins and minerals, so it is easy to see why over half of Americans take a supplement, according to the National Institutes of Health (NIH).

Until recently, evidence either supporting or denying supplement claims have been fairly limited. However, a study published in the Journal of the American College of Cardiology shed some light on supplements in terms of overall cardiovascular health.

also proved beneficial in stroke prevention. While this evidence is not strong, it is a starting point.

Multivitamins are one of the most common supplements used, but how does their claimed benefits measure up in reality? According to this study, multivitamins show no benefit for cardiovascular disease. The same is true for calcium, vitamin B, vitamin C, and selenium. There is also a set of supplements that show an increased risk of cardiovascular disease with its use. These supplements are antioxidant mixtures and niacin (with a statin).

The study shows that not all supplements are created equal. Certain supplements show a slight benefit for heart health, while others show no effect. Some are even detrimental to overall heart health.

Whatever claim you see on a supplement, it is important to take this with a grain of salt. The Food and Drug Administration (FDA) does not monitor these supplements or approve them as drugs before they go to the market.

Let’s start with the supplements that are beneficial: folic acid is associated with better overall heart health and stroke prevention. The study found that there is some evidence linking folic acid to this benefit. B vitamins

Remember that supplements do not substitute food.

Vitamins and minerals are better absorbed from food than supplements, so it is important to consume a balanced meal, regardless of the supplement you are taking.

PHYSICIAN’S SPOTLIGHT

Heart attack symptoms are different for women than men. You often hear chest pain as one of the key symptoms of a heart attack. While women can experience chest pain during a heart attack, they may also experience a slew of other symptoms such as shortness of breath, fatigue, or fainting. Take the time to prioritize your heart health. Establish a relationship with a cardiologist to manage your risk factors.”

-Dr. Andrea DeNeen Cardiologist

Issue 6 2019 | THE HEART OFHEART JACKSONVILLETHE HEART OF Issue 6 2019 | THE OF JACKSONVILLE 19 JACKSONVILLE | ISSUE 6 2019 19

PHYSICIAN’S SERVICE SPOTLIGHT LINE

SUCCESS STORIES TRUE or FALSE? If you have the following, then amputation is your only option:

You have a non-healing wound on your feet or legs You have chronic kidney failure You have poor circulation in your legs and have given up hope trying to improve it You are diabetic and you have a non-healing wound

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TRUE

FALSE

from the Amputation Prevention Center at FCCI ALL ANSWERS ARE FALSE. Amputation is NOT your only option.

At First Coast Cardiovascular Institute (FCCI), we pride ourselves for being pioneers in preventing unnecessary amputations.

Patients come from across the country to seek out FCCI for our endovascular services.

Endovascular medicine is a relatively new branch of medicine, treating problems affecting the blood vessels.

Below are real patients telling their real stories about their time at the Amputation Prevention Center at FCCI. “Two doctors said I was going to lose my leg.

I didn’t have blood going into either leg and I couldn’t walk. I was in California at the time and my doctor said he was going to cut off my leg. My sister told me to come down from California to Florida to see a foot doctor. The foot doctor told me I was going to lose my leg, and the only person he knew that could save it was Dr. Khatib.

After several procedures, Dr. Khatib saved both of my legs. I still cry when I think about how awful my legs and feet were until Dr. Khatib fixed them. Now I feel great. Dr. Khatib and his staff have kept on top of everything and have made my whole life wonderful. I have no problem walking around; it is like a whole

new world. When I look at my legs I thank God for Dr. Khatib and his staff, because of them I can walk again.”

- Doreen Untinen I have been seeing the wound care team at FCCI for a long time now because I was having problems with my legs. I have had three toes amputated. Because of Dr. Khatib and the wound care team, the rest of my foot and legs were saved.

I have osteomyelitis and I had it in my bones so there were many procedures like a graft for dialysis and a fistula that had to be done. Dr. Khatib guided me through every process.

I have seen plenty of doctors at FCCI and I like all of them. I have seen Dr. Swain and Dr. Lamba and I like everything about them. The staff is great too. I enjoy seeing Dee and all the women at the front desk. Jason is one of my favorites too.

After multiple procedures with Dr. Khatib I am feeling much better. I can move around and finally get the things I need to get done, done.

- Pamela Hayes

Issue 6 2019 | THE HEART OF JACKSONVILLE

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PHYSICIAN’S SPOTLIGHT

We asked our “What Patient Nurse Practitioners Story Do You and Physician Assistants…

Remember Most?”

Our physician assistants and nurse practitioners are on the front line of patient care. While every patient makes an impression, there are those special patients that stand out.

Karla Dalrymple, PA-C I have this great admiration for one of my patients.

When I first met him, he was taking care of his wife who was one of our patients.

After she passed, we started checking him out and he ended up having many heart problems and needed stents.

Afterwards, he fell from a tree while working and sustained many injuries requiring him to stop his antiplatelet medication. He ended up getting another thrombus and we had to go in and do more stenting.

With all of his injuries and heart problems, I just didn’t know if he was going to make it.

In February, we noticed his heart muscles functions went down, and we decided the best thing would be for him to be put on the heart transplant list. Being on the transplant list, you would think he would transfer his care totally, but he always wanted us to coordinate his care. Last time he came into the office was in March and he let us know he had a successful heart transplant and is doing great.

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Gina Luncan, APRN We had a patient that came in for a second opinion; he had a wound at the bottom of his foot. It was nonhealing and he was even considering amputation. He was found to have really bad arterial disease on both sides. The previous interventional cardiologist tried to fix the leg, but it was unsuccessful.

He sent the patient to a specialist in Daytona for a consult for bypass and he was turned down. Basically, he was completely out of luck. His podiatrist referred the patient to FCCI for a second opinion and we got him in to see Dr. Khatib. Dr. Khatib was able to work on both legs and open up both sides. Now, a few months later the wound is completely healed. He is walking and so happy with his care that even his wife sees us now.

PATIENT TESTIMONIALS

ONLINE TESTIMONIALS We love what we do and we love hearing that you do to. Our goal as a practice is to ensure every patient receives quality care by compassionate experts. Your testimonials, comments, reviews and positive feedback are heartwarming, and it means we are accomplishing our goal!

My dad has been a patient of Dr. Ali for several years.

We are so grateful for all the care and compassion he has shown to him. My dad is almost 91. Thank you for your commitment to my father’s health.”

~ A Healthgrades Review

(Dr. Lamba) is a first class doctor who listens and talks.

There are not that many anymore. He made me feel like he had my interests and health as a priority and I have yet to feel him lacking in making me confident in my getting better.”

My husband sees Dr. Swain for an infection. What an awesome doctor; so caring!

His staff is excellent. They are always concerned about him losing weight, they even gave him Boost to drink yesterday in the office and some to take home and coupons for it. I can’t say enough about this office staff and doctor.”

~ A Facebook Review

The

staff is great and Dr. Alnabki is very thorough and kind. He helped saved my life.

He is so nice, smiles a lot. God bless him, his staff and the patients he sees.” ~ A Facebook Review

~ A Healthgrades Review

These reviews have been edited for spelling and grammar.

Issue 6 2019 | THE HEART OF JACKSONVILLE

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SERVICE LINE

The Risks of

Sleep Dep If you are experiencing fatigue during the day due to lack of sleep, you are not alone. In fact, 35% of adults report that they do not get enough sleep, according to Centers for Disease Control and Prevention. The causes for this astonishing amount of sleep deprived Americans falls under two major categories: lifestyle/ occupation and sleep disorders, according to the National Academies of Science Engineering and Medicine. Fatigue during the day is not the only consequence to lack of sleep.

Sleep disorders are some of the most overlooked but treatable health problems.

Without treatment, sleep disorders may lead to:

OBESITY There is a direct link between obesity and sleep deprivation. The less sleep a person gets, the higher their body mass index (BMI), according to the National Academies of Science Engineering and Medicine.

This relation may be due to the amount of snacking “short sleepers� do. Lack of sleep also impairs judgment, energy intake and food choice, according to Harvard Health.

DIABETES A study called the Sleep Heart Health Study concluded that adults who reported five hours of sleep or less were more likely to have diabetes. This study also found that the weight

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of the person did not matter; sleep deprivation increased the chances of having diabetes with no relation to obesity. The lack of sleep resulted in an impaired glucose tolerance causing diabetes or becoming prediabetic.

CARDIOVASCULAR DISEASE Those who lack sleep, whether it be by choosing to stay up later on a regular basis or due to sleep disorders such as insomnia or sleep apnea, are at a higher risk of cardiovascular disease or coronary heart disease, according to the National Sleep Foundation.

When the body is short on long, deep periods of sleep, chemicals are released that

privation makes it hard for the body to naturally lower blood pressure. This will lead to high blood pressure during the day resulting in a greater risk of heart disease and stroke.

If you believe you are suffering from a sleep disorder, contact your doctor. First Coast Cardiovascular Institute’s Sleep Disorder Center treats a range of sleeping disorders.

Our sleep doctors, Drs. Thielemann & Hamdani, are board certified and dedicated to reducing your chance of heart disease due to unhealthy sleeping habits.

What you can do: • Know the difference between a bad night’s sleep and an unhealthy nighttime routine.

• If you feel you have fallen into a bad habit of staying up, try setting alarms at night and in the morning consistently so you are going to sleep and waking up at the same time every day and night.

• Make sure your bedroom is dark, (no TV, phone or computer screens on), chilly and comfortable.

Issue 6 2019 | THE HEART OF JACKSONVILLE 25

PHYSICIAN’S SPOTLIGHT

Humans of FCCI Dr. Cary Rose “I’ll never forget the first time I put a biventricular device in a patient nearly a decade ago.

The patient felt different 10 minutes after we turned the device on. The family said, ‘Look at his face, he looks like a different person.’ He did look different. Now his heart was pumping for the first time in 10 years. We gave him his life back. I looked down at my hands and thought, ‘Did I just do that?’”

Dr. Cary Rose, Electrophysiologist, shares a photo with his daughter, Josie, an aspiring physician.

26 THE HEART OF JACKSONVILLE | Issue 6 2019

Are you a local business looking to invest in your employees’ health?

Investing in your employees’ health is investing in your organization. First Coast Cardiovascular Institute (FCCI) offers three levels of wellness packages for your team.

Customizable packages also available.

Call 904.518.0532 to contact the business development team at FCCI today.

$50

Level 1: Wellness • Body mass index (BMI) • Blood pressure • Glucose check • Electrocardiogram (EKG) • Cardiovascular risk reduction education

firstcoastcardio.com

$150

$350

Level 2: Enhanced

Level 3: Executive

• Body mass index (BMI) • Blood pressure • Glucose check • Electrocardiogram (EKG) • Aortic aneurysm screening • Screening | Stroke • Ankle-brachial index (ABI) test | peripheral arterial disease

• Body mass index (BMI) • Blood pressure • Glucose check • Electrocardiogram (EKG) • Aortic aneurysm screening • Screening | Stroke • Ankle-brachial index (ABI) test | peripheral arterial disease • Cardiac consultation & risk assessment • Vein screening • Treadmill stress test

Issue 6 2019 | THE HEART OF JACKSONVILLE 27

SOCIAL MEDIA RECAP

JACKSO 28 THE HEART OF JACKSONVILLE | Issue 6 2019

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PHYSICIAN’S DOCTOR FAVORITES SPOTLIGHT

Doctor Insight

Q

What do you consider to be the highlight of your life?

Dr. Sumant Lamba – I have the rare privilege to touch hearts and this is certainly a highlight every day.

Dr. Brett Sasseen – I love the opportunity I have to teach people how to eat healthier.

Dr. Alan Schimmel – The birth of my sons & my marriage are highlights I will never forget.

Q&A

Q

What is something that lifts your spirit every day?

Dr. Yazan Khatib – When I am able to help a patient who thought nothing could be done for them, there is no better feeling.

Dr. Youssef Al-Saghir – When I can find a better way to do something, whether it is with patients or with my team, that always makes my day a little better.

Dr. Vaqar Ali – Going on a run everyday relaxes me and lifts my What is the best spirit. advice you have ever received?

Dr. Omer Zuberi – There are patients who come into the Dr. Daniel Thielemann – Always office feeling so much better get a good night’s sleep. after care they received at FCCI. Dr. Irram Hamdani – You can do That is what makes my day. everything you want, just not at Dr. Ziad Alnabki – My day is one time. made when one of my patients Dr. David Swain – Treat people refers their family member or the way you want to be treated. friend.

Q

30 THE HEART OF JACKSONVILLE | Issue 6 2019

Q

What makes you laugh no matter what?

Dr. Cary Rose – The Minions from Despicable Me & Dr. CONSTANTIN

Q

What is the best de-stressor in your life?

Dr. Andrea DeNeen – By far, knitting!

Dr. Gary Snyder – Flying to New York on the weekends with my wife to visit my daughters is always the perfect de-stressor to a busy week.

Dr. Jonathan Constantin– Seeing my daughters do something new, whether this is a new word or a new hobby, always remind me of how simple life is.

Dr. Ibrahim Fahdi – Date night with my wife!

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AMPUTATION CHOLESTEROL HEART FAILURE

CAULIFLOWER DIABETES

CHIA SEEDS ENDOVASCULAR

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COUPONS for your Health Call us at 904.493.3333 and let the staff know you have a coupon for your health you would like to redeem.

FREE

Vein Screening Venous screening is a test that takes about 20 minutes to determine your risk level for venous disease. The test involves taking an ultrasound scan of the leg to assess vein function and identify vein blockages that could lead to CVI.

FREE Blood Pressure Check

Blood pressure is one of the most important risk factors to consider when it comes to cardiovascular disease.

A blood pressure check takes just a few minutes and can help identify a possible risk factor for heart disease.

FREE

Cholesterol Check Despite being a highly prevalent risk factor for heart disease, high cholesterol usually does not have any symptoms.

Therefore, it is important to have your cholesterol levels checked. This test takes just a few minutes and can help determine plaque buildup that may narrow your arteries.

www.firstcoastcardio.com

*THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS A RIGHT TO REFUSE TO PAY, CANCEL PAYMENT, OR BE REIMBURSED FOR PAYMENT FOR ANY OTHER SERVICE, EXAMINATION, OR TREATMENT THAT IS PERFORMED AS A RESULT OF AND WITHIN 72 HOURS OF RESPONDING TO THE ADVERTISEMENT FOR THE FREE, DISCOUNTED FEE, OR REDUCED FEE SERVICE, EXAMINATION, OR TREATMENT.