The glass is more than half full, is the “skinny” of this issue of The Heart of Jacksonville, from your First Coast Cardiovascular Institute “FCCI” team.
Optimism is one of the virtues we highlight at FCCI, each one of our teammates brings to work that “how can I help” compassionate attitude. We understand our patients are coming to us with many fears and ailments. We also believe in the science that says positive attitude is more than half the cure.
Being on the cutting edge of research and innovation, our doctors are able to see into the future. Many of today’s “newly approved therapies” we were very blessed to be able to introduce and test during their research phase 5-10 years prior. By the same token, the devices and drugs being currently developed offer tremendous hope for a far better and healthier future. Treatments that we only dreamed of when I went to medical school are now everyday realities. The ability to replace a heart valve without major surgery is one such example, but so is the ability to seal the area in the heart that forms the clots that cause stroke. The medications that can bring back a good bit of strength to a weak heart, and lower the highest cholesterol levels, are as exciting as the ability to perform leg bypass without surgery.
One area I continue to be concerned about is our community’s focus on prevention, which is still not where I wish it to be. Yet here too, I am very optimistic that our patients will indeed heed our advice, but also that we as doctors and nurse practitioners and physician assistants will double down on more efforts in that area.
Looking back at our legacy of over two decades and literally tens of thousands of our neighbors and friends getting treated with success here at FCCI and at our collaborating hospitals, with cutting edge technology, with compassion, dignity and yes optimism, brings me and the amazing doctors and providers and teammates a most heartwarming fulfillment.
Here’s to a bright future and improving the lives of our patients on a daily basis!
Sincerely,
Yazan Khatib, MD President of First Coast Cardiovascular Institute Interventional Cardiologist & Endovascular Specialist Board Member and Past President, American Heart Association First Coast Chapter
Expressions of the Heart
We’d like to brighten your day. Enjoy this collection of thoughtful and beautiful quotes about the most amazing organ: the heart.
“The best and most beautiful things in the world cannot be seen or even touched - they must be felt with the heart.”
~ Hellen Keller
“No beauty shines brighter than that of a good heart.”
~ Shanina Shaik
“Home is where the heart is.”
~ Pliny the Elder
“Let my soul smile through my heart and my heart smile through my eyes, that I may scatter rich smiles in sad hearts.”
~ Paramahansa Yogananda
“In the sweetness of friendship let there be laughter and sharing of pleasures. For in the dew of little things the heart finds its morning and is refreshed.”
~ Khalil Gibran
“Wherever you go, go with all your heart.”
~ Confucious
Salad Rut Be Gone!
Trying to incorporate more plant-based foods in your diet but bored with the same old salad options? There is no need to be in a salad rut! Aim for “eating the rainbow” by trying different veggies and fruits. Make it a fun weekly goal when you are shopping in the produce section to pick out something you have never eaten before.
We’ll help get you started. These two delicious salads are packed with vitamins and minerals. Enjoy as a side dish, a perfect lunch, or a light evening meal.
BEET SALAD
Ingredients
For Salad
• 4 medium beetroots
• 1/2 cup feta cheese
• 2 tablespoon roughly chopped parsley
For Lemon Vinaigrette
• 3 tablespoons lemon juice
• 3 tablespoons olive oil
• 2 garlic cloves - minced
• 1/2 teaspoon black pepper
• 1/2 teaspoon salt
Instructions
For Salad
1. Boil the beetroot on medium heat for 45 mins or until it can be easily pierced through with a knife.
2. The skin will easily peel off. After removing the skin of the beetroots, chop the beetroot into cubes and do the same with the feta cheese.
3. Roughly chop the parsley.
4. Combine beetroot, feta cheese, parsley with the lemon vinaigrette and serve.
For Lemon Vinaigrette
1. Mix all ingredients together in a bowl and whisk slightly.
12 SUPERFOODS SALAD
This salad is a feast for the senses. All of the different colors, textures, and tastes combine for a healthy and satisfying dish. Note that you can mix and match the ingredients in this recipe as you see fit.
Ingredients
For Salad
• Kale
• Blueberries
• Grapes
• Dried cherries,
• Quinoa
• Sunflower seeds,
• Walnuts
• Edamame
Instructions
For Dressing
• Yogurt
• Olive oil
• Garlic powder
• Orange juice
1. Cook the quinoa and edamame according to the package instructions.
2. Prep the rest of the ingredients (halve the grapes, chop the dried cherries, etc.).
3. Add the salad dressing ingredients to a jar and shake until creamy and combined.
4. Toss the superfood salad ingredients and dressing together and enjoy!
Image and Recipe Credit: ScrambledChefs.com
Image and Recipe credit: Averycooks.com
Behind the White Coat:
Youssef Al-Saghir, MD, FACC, FSCAI, FABVM
Director of First Coast Cardiovascular Institute Clay County Operations Cardiac & Endovascular Interventions
An interest in electrical engineering and a fascination with the physiology of the heart and the way it works with the rest of the body makes cardiology a perfect choice for Dr. Al-Saghir, who chose medicine to help people and make a difference in their lives. “There are many similarities, when you think about it – both fields require analytical thinking, and a desire to work with your hands, not just your brain. The human element is the difference, and it’s one of the things I enjoy the most about my profession.”
Dr. Al-Saghir is a graduate of the Ross University School of Medicine. He completed his cardiovascular disease fellowship and an Interventional Cardiology fellowship at the University of Utah Health Sciences Center.
In his work at the University of Utah, Dr. Al-Saghir trained in neurovascular and carotid interventions, PFO closures, and atrial septal defects. “Interventional cardiology is not just a fit-it-and-forget-it specialty”, says Dr. Al-Saghir. “It’s far more comprehensive than that. Interventional cardiology goes beyond mechanical therapy – it starts with prevention and encompasses pharmacological as well as mechanical therapy. The field has exploded so that we are now able to use interventional cardiac techniques for non-cardiac cases including peripheral vascular disease (PVD), the lower extremity peripheral arterial disease (PAD), and renal and extra cranial arteries.”
Originally from Lebanon, Dr. Al-Saghir did most of his medical training in Salt Lake City. He is happy to make Florida his home for himself and his three sons. “I always liked the beach, water, and weather here,” he says. “I am a very outdoorsy person and enjoy fishing, hiking and camping, boating, bike riding, and basketball.”
Dr. Al-Saghir also serves as cardiology chair at HCA Florida Orange Park Hospital.
Rebounding: Jumping for
Joy and Improved Cardiovascular Fitness
We have explored delicious recipes to keep you from getting stuck in a salad rut. Now let’s look at a novel and fun way to move your body. No boring workouts for you!
Rebounding
Jumping on a trampoline is not just for kids. Adults can enjoy many benefits from this fun and low-impact (easy on the joints) activity called “rebounding” including:
1. Getting your heart rate up
2. Working up a healthy sweat
3. Burning calories
4. Moving toxins out of your body by stimulating the lymphatic system
5. Strengthening your bones
6. Improved balance, coordination, and motor skills
7. Reduced blood pressure and increased blood flow
8. Stronger immune system
9. Improved digestion and elimination
10. Healthier cholesterol numbers and decreased risk of heart disease
11. Works a variety of muscle groups including the core, glutes, and legs
12. Sharper mind
HEALTHY LIVING
Trampolines or rebounders can be found at sporting goods stores or online. You can get one with a stability bar to help with balance and safety. Always make sure your rebounder is in good working condition and is on a stable surface. Also, make sure it is not too close to a wall or other pieces of furniture.
Start off gently. It might take your body a few times to get used to the feeling of this new movement. You don’t need to jump very high. There are good videos on YouTube for safety tips and ways to vary your workout. Organizations exist that offer classes online and there may be group classes in your
Play some high energy music and get moving. Jump for joy and afterwards bask in that post rebounding workout glow!
*Note, it is always a good idea to consult with your healthcare provider before starting a new form of exercise. While jumping, please stop immediately if you ever feel dizzy or experience shortness of breath.
Sources: Better Me, Leaps and Rebounds, and Healthline
Know Your Metrics: Cholesterol Numbers
Cholesterol is not all bad. Our bodies do need some cholesterol to aid in the production of vitamin D and facilitate the building of cell structures, digestive bile acids, and hormones. Too much cholesterol, however, can increase your chance of getting heart disease, a stroke, or having a heart attack.
It is important to monitor your cholesterol by getting tested and understanding your numbers.
What is cholesterol?
Cholesterol is a lipid (a waxy-like substance) fat that is made by the liver and is transported in the body through the blood.
What are the different types of cholesterol?
HDL (high-density lipoprotein) the “good” cholesterol. This is the “good” type of cholesterol because it moves cholesterol to your liver to be released from your body. HDL helps rid your body of excess cholesterol so it’s less likely to end up in your arteries. How best to remember this is you want the H (HDL) cholesterol to be High
LDL (low-density lipoprotein) “bad” cholesterol. This is the kind of cholesterol that contributes to plaque buildup in your arteries. How best to remember this is think L (LDL) cholesterol to be Low
VLDL (very low-density lipoprotein). This is another form of “bad” cholesterol that contributes to plaque buildup. It carries a kind of fat called triglycerides.
Total Cholesterol: The total of cholesterol types circulating in your blood.
Your doctor will look at the ratio of your bad (LDL) to your good (HDL) cholesterol to further refine their recommendations for your treatment goals. For example, those with very high HDL tend to have good protection even when they have high total cholesterol.
What do your cholesterol numbers mean?
Please refer to the following chart:
5 Tips to Lower Your Cholesterol
1. Eat a heart-healthy diet (give plant-based foods a high priority on your plate, choose foods low in saturated fat and eliminate trans fats). 2. Stay active. Exercise on a daily basis. Daily activity can help raise HDL (the “good” cholesterol). 3. Quit smoking 4. Maintain a
Source: Cleveland Clinic
FAST FACTS
Sumant Lamba, MD
Interventional Cardiology
The healthiest hearts in the world have been found in the Tsimane (pronounced “chee-may-nay”) people who live in the forests of Bolivia, say researchers.
Barely any Tsimane had signs of clogged up arteries - even well into old age according to a study done by The Lancet.
Dr. Lamba believes the fact that the Tsimane walk a lot and eat a simple plant-based diet could very well be the reason why they have such healthy hearts.
Sources: BBC Health and The Lancet
Pets Do Your Heart Good
While the ideal is that we spend time with other people on a regular basis, many people in our society live and/or work alone (almost 30% according to a recent Census Bureau report).
Pets provide love, joy, and companionship. Their presence helps us to de-stress and improves our physical and mental health.
The American Heart Assocation states that owning a pet reduces our chances of getting heart disease and will improve our recovery of a heart attack should we have one.
Read on to learn about the benefits of having a furry companion in your life.
5 HEALTH BENEFITS OF OWNING A DOG
1. Dogs need their walks and will make sure you get off the couch to accommodate them. You also get exercise and the bonus of fresh air and sunlight. This activity helps lower stress, cholesterol levels, and blood pressure.
2. Improved social life. Get to know your neighbors who are also out walking their dogs or children or simply taking a walk by themselves.
3. Dogs offer unconditional love.
4. Dogs and their funny and endearing antics will make you smile and laugh more.
5. Petting your dog is relaxing and helps calm anxiety.
5 HEALTH BENEFITS OF OWNING A CAT
1. A feline purring on your lap or sweetly gazing into your eyes will help release oxytocin, a hormone often called the “love” or “cuddle” hormone for its calming and joyful effects.
2. Reduced anxiety
What if You Don’t Own a Pet?
3. Low-maintenance companionship (cats are easier to take care of than dogs).
4. Help you slow down and just be in the moment more.
5. Their peaceful energy can’t help but rub off on you.
Spend time with a family member, friend, or neighbor who has a friendly pet. A visit to a nearby park or walk in the neighborhood will give you opportunities to interact with other people’s animals. You can earn an additional income by offering a dog-walking or petsitting service. Volunteering at a local shelter would be a great option as well.
Source: Dignity Health, The American Heart Association
Behind the White Coat: Ramon
Castello, MD
We would like to introduce you to Dr. Castello!
Dr. Ramon Castello is a graduate from University of Valencia School of medicine in Spain. He completed his cardiology training in Pamplona Spain, before coming to the USA. Most of his career was spent in Academic Medicine. He became Assistant Professor of Medicine at St Louis University, then Associate Professor at Case Western Reserve University in Cleveland and finally, Professor of Medicine at Mayo School of Medicine. He was the Director of the Echocardiography Laboratory at Mayo Jacksonville for 7 years. Since 2008 he has been in private practice at Memorial hospital, where he is the Director of Non-invasive cardiology.
He is a world-known echocardiographer and has over 200 scientific publications. He was the President of ICAEL, the national organization that grants accreditation to echocardiography laboratories nationwide. He has been a board member of the American Society of Echocardiography and chair of the Fellows of the American Society of Echocardiography Committee. Currently, he is a member of the National Board of Echocardiography, an organization that grants echocardiography board certifications to qualified physicians.
Dr. Castello is passionate about Cardiology and specifically echocardiography. He feels that “cardiac ultrasound can teach us almost everything about somebody’s heart”. Echocardiography is at the center of all cardiology subspecialties and is an ancillary tool to all of them. “We help everybody, but we need to provide an excellent service”. Therefore, providing high quality echocardiography is a must. He has a great interest in multiple areas of cardiology, including structural heart disease, heart failure, stroke, hypertension and autonomic dysfunction.
He is one of the few Spanish speaking cardiologists in Jacksonville. “This is an area of utmost importance”. A lot of Spanish patients are bilingual, but they feel better talking about their health in their native language. The Spanish population is growing significantly in Northeast Florida to accommodate this need and Dr. Castello has a full team of Spanish speaking providers.
Welcome, Dr. Castello!
A Grateful Heart is a Healthy Heart
“What you appreciate appreciates.” ~ Lynne Twist, Author
When we focus on our blessings, our brain releases feel-good chemicals that enhance our mood and have a calming effect on our nervous system, ultimately contributing to a lower heart rate and reduced stress levels. Studies have shown that individuals who regularly practice gratitude have lower blood pressure, better sleep quality, and improved heart rate variability—a sign of a healthy heart.
The Ripple and Boomerang Effect
Gratitude doesn’t just stay confined within us—it has a beautiful way of extending beyond ourselves. When we cultivate a heart filled with grace and gratitude, we naturally become more compassionate and empathetic. Our relationships thrive as we focus on the goodness in others and acknowledge their efforts. This, in turn, creates a positive feedback loop and that appreciation often comes back to us (like a boomerang).
5 WAYS to Infuse Gratitude into Your Daily Life
Morning Ritual: When you first wake up in the morning take a deep breath and silently give thanks for another day. Each day is truly a gift. If you believe in God or a higher power, this would be a special time to tap into the divine in whatever way is meaningful to you.
Gratitude Journaling: Keep a journal where you jot down things that you’re thankful for. Write down at least three things each day. Over time, this practice can help shift your focus from what’s lacking to what’s abundant in your life.
Express Gratitude to Others: Take a moment to thank people in your life. Make it simple but meaningful. Be specific about one thing you appreciate about them. It can be in the form of verbal words or in writing. You are guaranteed to brighten their day and yours.
Mindful Moments: Incorporate mindfulness into your daily routine. When you eat, savor each bite and appreciate the flavors. When you walk, notice the beauty around you. Being present in the moment enhances your awareness of the things you’re grateful for.
Evening Reflection: Before you go to sleep, reflect on the positive moments of your day. This practice helps you go to bed with a grateful heart and cultivates a peaceful mindset for restful sleep.
What You Need to Know About Peripheral Arterial Disease (PAD)
PAD affects millions of older adults in the U.S. Despite how relatively common it is, not many people know much about it or realize how much of a health threat it is. In one telephone survey of 2500 adults aged 50 or older, only 26% were familiar with PAD compared with 65% for coronary heart disease, stroke, and heart failure. Only 14% knew that PAD could lead to amputation and only 25% understood the connection between PAD and a higher risk of heart attack and stroke. This lack of PAD awareness results in many undiagnosed cases.
What is Peripheral Arterial Disease (PAD)?
PAD is the narrowing or blockage of the vessels that carry blood from the heart to other parts of the body including the legs. The most common form, lower extremity PAD, is primarily caused by the buildup of fatty plaque in the arteries (atherosclerosis).
PEOPLE MOST AT RISK FOR PAD
High risk groups include
Symptoms of PAD include:
• Pain, aches, cramps, or weakness in the legs, hips, glutes, or calves when walking or doing other physical activity (sometimes these symptoms exist when not exercising)
• Feet feeling cold, weak, or numb
• Change of appearance in lower extremities including shiny skin color, hair loss, and slower rate of toenail growth.
• A non-healing wound
African Americans, smokers, people with type 2 diabetes, people 60 years or older, people with kidney disease, and those with high blood pressure and/or high cholesterol levels.
Ways to Prevent PAD
• Stay active
• Do not smoke
• Manage diabetes, cholesterol, and diabetes.
• Reach and maintain a healthy weight.
• Make regular appointments with your healthcare professionals.
If you would like to learn more, or have any concerns about PAD, please contact us. First Coast Cardiovascular Institute’s accredited vascular lab offers comprehensive testing.
Lower Extremity Physiological Testing at FCCI
We can perform a lower extremity arterial physiologic study which determines whether PAD is present, what vessels are affected, and how severely blood flow is impaired. This test uses ultrasound imaging to evaluate blood flow in the arms and legs according to pressure measurements and pulse volume recordings (PVRs). Lower extremity testing also includes the ankle/brachial index (ABI) test, which measures the severity of PAD by reporting the ratio of ankle pressure to arm pressure.
How PAD is treated
A timely diagnosis is important. If diagnosed, treatment options may include a change in diet, exercise, medications to control blood pressure, cholesterol and diabetes, minimally invasive procedures, and surgery.
Clinical Trials at FCCI
Our research department is currently enrolling for a few clinical studies that may help you if you have PAD. Talk to your doctor or ask to speak with a Research Coordinator about volunteering to participate in a clinical trial. You may call 904-493-3333 or email: FCCIResearch@firstcoastcardio.com
Can Optimism Add Years to Your Life?
Being optimistic is associated with lower blood sugar and cholesterol. A review of 15 studies with over 200,000 participants found a 35% decreased chance of getting heart disease and a 14% less chance of early death in people who were optimists.
Laura Kubzansky of Harvard School of Public Health noted “It looks like there is a benefit of positive mental health that goes beyond the fact that you’re not depressed.” In a 2007 study, Kubzansky followed more than 6,000 men and women aged 25 to 74 for 20 years. The protective effect of emotional vitality was distinct and measurable, even when considering good habits such as not smoking and regular exercise. Kubzansky has found that optimism cuts the risk of coronary heart disease by half.
Researchers analyzed data from over 150,000 women ages 50–79, collected as a part of the Women’s Health Initiative (WHI). They found that the most optimistic women lived, on average, 5.4% longer (approximately 4.4 years) than the least optimistic women. The most optimistic women were also more likely to achieve exceptional longevity, defined as living over 90 years. These trends were consistent across all racial and ethnic groups.
Not everyone is a naturally born optimist. If you tend to see that glass half-empty rather than full, do not fret.
“Life is 10% what happens to you and 90% how you react to it.”
~ Charles Swindoll, Pastor, Educator, and Speaker
Here are three strategies you can employ to become more optimistic:
The Best Possible Self technique: Spend five minutes a day imagining the best possible future for yourself.
Keep a Gratitude Journal On a daily basis (nice times are first thing in the morning or at the end of the day), count your blessings. Make it a goal to jot down at least five things you are thankful for.
Spend time with happy, optimistic people. Who you spend the most time with is important because behavior and attitude can be contagious.
FASTFACTS
Mubbasher Syed, MD
Cardiac & Endovascular Interventions
Veins hold most of the blood in your body. Nearly 75% of your blood is in your veins.
Dr. Syed is among FCCI’s most passionate providers when it comes to the health of your veins.
Sources: Cleveland Clinic
How Does Light Affect Your Sleep?
Natural Sunlight: The Master Clock
Nature’s original timekeeper is the sun. The brightness and color of natural sunlight change throughout the day. In the morning, sunlight is rich in blue wavelengths, which helps signal to our body that it’s time to wake up. This blue light suppresses melatonin, a hormone that makes us feel sleepy, and boosts alertness.
As the day progresses, sunlight transitions to warmer tones with fewer blue wavelengths. This shift informs our body that it’s nearing evening and encourages the production of melatonin. This hormone prepares us for sleep and helps us wind down. This natural ebb and flow of light and melatonin is crucial for maintaining a healthy sleep pattern.
Artificial Light: The Modern Dilemma
While sunlight is our natural guide, the modern world surrounds us with artificial light sources. Fluorescent bulbs, LED lights, computer screens, smartphones, and TVs emit blue light similar to daylight. While this can be great for staying awake and alert during the day, it can disrupt our sleep at night.
Exposure to blue light in the evening can trick our body into thinking it’s still daytime. This inhibits the production of melatonin, making it harder to fall asleep and stay asleep. That’s why scrolling through social media on your phone before bed might not be the best idea—it’s like inviting the sun into your bedroom.
Sleep and Cardiovascular Health
Getting the right amount of sleep is an essential component of good heart and brain health. The American Heart Association recommends 7-9 hours of sleep per night.
Sources: American Heart Association
Creating a Sleep-Friendly Environment
To ensure a restful night’s sleep, it’s essential to manage your exposure to light:
• Limit Evening Screen Time: About an hour or two before bedtime, dim the lights and avoid screens. If you must use screens, consider using “night mode” settings that reduce blue light emissions or wear blue light blocking glasses. If you enjoy reading in bed, consider reading a paper book or magazine. Put your cell phone in another room at night and purchase an old-fashioned alarm clock to wake you up in the morning instead of using your phone.
• Invest in Warm Lighting: Choose warm-colored or dimmable bulbs in your bedroom. These emit less blue light and mimic the gradual shift in natural sunlight as the day winds down.
• Keep the Room Dark: Hang curtains that block out external light sources and create a cave-like darkness that encourages melatonin production. An inexpensive sleep mask can do the trick as well. Be mindful of nightlights: If you need to use nightlights, look for ones with red or orange hues. These colors have the least impact on melatonin production.
• Morning Sunshine: Expose yourself to natural sunlight as soon as you can upon waking up. This helps reset your internal clock, making it easier to wind down in the evening.
FCCI Sleep Lab
First Coast Cardiovascular Institute’s Sleep Lab is dedicated to the diagnosis and treatment of a range of sleep disorders. Our facility is fully accredited by the American Academy of Sleep Medicine and the only cardiology practice in our area to offer sleep evaluation and care. If you suspect you have a sleep disorder, talk to your physician about a sleep evaluation at our sleep lab.
Sources: NIH, Harvard Health
The FCCI Family is Growing!
Dr. Stephen Bagnoli, MD., F.C.C.P., who joins FCCI with 39 years of experience in his pulmonary medicine practice (yes, he started practicing when he was 15 :)). Having been recognized by Jacksonville Magazine as a top Jacksonville doctor for the last ten years, it’s an honor to have the opportunity to partner with him and offer his expertise to our patients.
Dr. Bagnoli graduated from and had his internship and residency at the University of Medicine and Dentistry of New Jersey Affiliated Hospitals. He completed a fellowship in pulmonary disease at the National Naval Medicine Center in Bethesda, Maryland.
Board certifications include Internal Medicine and Pulmonary Disease. He is a member of the Fellow of the American College of Chest Physicians and the Duval County Medical Society.
Dr. Bagnoli worked at the Naval Hospital in Jacksonville (while actively serving in the military) for five years before starting his practice in Jacksonville in 1984.
Dr. Bagnoli is married and has three children and four grandchildren.
Welcome, Dr. Bagnoli!
We are happy to announce that another esteemed colleague will be joining the FCCI family. Please help us welcome Jack J. Salah, M.D., FCCP, DABSM, who is board-certified in Sleep Medicine, Critical Care Medicine, Pulmonary Medicine, and Internal Medicine.
Dr. Salah graduated as the valedictorian and received the Dean’s Award for Outstanding Medical Graduate at the University of South Florida School of Medicine in Tampa, Florida. He received his postdoctoral training at the University of Alabama Medical Center and Affiliated Hospitals (internship and residency) and completed a Pulmonary and Clinical Research Fellowship at the University of Florida College of Medicine and Shands Teaching Hospital in Gainesville, Florida.
Dr. Salah’s comprehensive and impressive professional resume includes ten years as the Medical Director of the Florida Centers for Sleep Medicine at Ascension Health and managing his private Sleep Medicine practice since 1988. He is well-published and has been the recipient of many honors and awards over the years including earning the AMA’s Physician Recognition Award multiple times.
Dr. Salah is excited to join FCCI with the goal of cooperative efforts resulting in the highest quality of care for patients in our community in Chest (heart and lung) and Sleep Medicine.
Welcome, Dr. Salah!
3 Simple Yoga Poses to Improve Posture and Open the Heart
Yoga is a gentle and effective way to stretch your body and calm your mind. Studies from John Hopkins have shown that people who practice yoga on a regular basis benefit from lower blood pressure, a centered mind, less inflammation, and improved cardiovascular health.
If you are new to yoga, there are easy poses to do to get started. These three postures will help open your chest and heart, improve posture (great for counteracting the “desk hunch” or “text neck”), and decrease any stress you may be experiencing.
If you have injuries or if you’re concerned about exercising, please consult with your health care provider before starting a yoga program.
Bitilasana Marjaryasana (Cat Cow Pose)
This pose involves movement that both opens the chest and lengthens and stretches the spine. It serves as a good warm up as it gently activates your body.
1. Start on all fours on the mat. Your knees should be under your hips and your hands under your shoulders, arms straight at the elbows. This is the tabletop position.
2. Kneel on the floor and put your hands on the floor in front of you. Keep your hands shoulderwidth apart and your knees directly below your hips. Inhale deeply while curving your lower back and bringing your head up, let your belly drop down towards the floor, and tilt your pelvis up like a “cow.” Hold it for a breath.
3. Exhale deeply and bring your abdomen in, arching your spine and bringing your head and pelvis down like a “cat.” Hold it for a breath.
4. Alternate between cat and cow to stretch and open up the chest and spine. Repeat several times.
Bhujangasana (Cobra Pose)
This pose is a key backbend that improves spinal mobility, opens up the chest and stretches the abs and hip flexors.
1. Stretch out on your stomach with your toes pointed, hands underneath the shoulders, and elbows close to the body.
2. As you inhale, slowly lift your chest and then your head. Do not lift too high. Be gentle with yourself. With practice and experience you can test your edge a bit.
3. Hold the pose for 15 to 30 seconds.
4. Gently come back down as you exhale.
Anahatasana (Heart Melting Pose)
This pose is a great combination of opening your heart and chest area while stretching your upper and middle back.
1. Come to all fours in Bharmanasana (Tabletop Pose). Align your shoulders over your wrists and your hips over your knees.
2. Keep your hips aligned directly over your knees and walk your hands forward in space.
3. Melt your chest toward the floor, draw your shoulder blades toward each other, and rest your forehead or chin on a prop or the floor.
4. Surrender your torso down and breathe into the opening. Visualize your heart radiating a glowing light of green (a very soothing color for the body, mind, and spirit) in all directions. If you can comfortably do so, hold this pose for 1-3 minutes. Breathe normally. When you are ready to come out, do so slowly and gently.
Sources: John Hopkins Medicine, Yoga U online, Mayo Clinic, ISSA
We asked our providers... What do you love about living on the First Coast?
Chelsea Blum, APRN
“I love living near water. We have so many lakes, springs, and the beach. We have a lot of good food too.”
Shephali Patel, APRN
“Friendly people, the beach, the weather, and the fact that Jacksonville is attracting young professionals to the area.”
Andrea Richardson, APRN
“I love the beach and looking for shark’s teeth.”
The Importance of Abdominal Aortic Aneurysm (AAA) Screening
What is an Abdominal Aortic Aneurysm (AAA)?
It sounds complicated, but let’s break it down simply. The aorta is like a big pipe that carries blood from your heart to the rest of your body. An aneurysm is a weakness to the artery/tube. Now, an Abdominal Aortic Aneurysm is when this big pipe in your belly gets weak and forms a balloonlike bulge.
This bulge can be dangerous because if it gets too big, it might burst, and that can cause a lot of problems and even be life-threatening. The tricky part is you might not feel anything until it’s too late. That’s why it’s important to get screened for AAA, especially if you’re at risk.
People who smoke, have high blood pressure, are over the age of 60, or have a family history of AAA are more likely to have it. The good news is if doctors catch AAA early, they can keep an eye on it or fix it most of the time with minimally invasive special stents, but sometimes with surgery.
Getting Screened for AAA at FCCI
Ultrasound
An AAA may not be detected on routine examinations, but ultrasound imaging provides a safe way to detect the presence of an aneurysm. This exam can also assess blood flow and detect blockages or plaque buildup in the arteries.
CT Scan
This test uses X-rays to create cross-sectional images of the structures inside the belly area. It can create clear images of the aorta and serves as a good screening tool for AAA especially in patients who are overweight.
Your doctor may recommend one or both tests if you experience any of the following symptoms:
• Pulsating feeling near the abdomen
• Chronic pain in or near the abdomen
• Back pain
Knowing is better than not knowing. Getting screened for AAA can save your life and keep you safe and healthy. So, if you’re in the risk group, don’t wait. Talk to your doctor or contact First Coast Cardiovascular Insitute about getting screened for AAA. FCCI offers affordable screening packages. Your future self will thank you!
Image credit: Alila Medical Images
Behind the White Coat: Tarek Chami,
MD
Dr. Chami joins First Coast Cardiovascular Institute after completing his endovascular interventional training here at First Coast Cardiovascular Institute and interventional cardiology fellowship at Minneapolis Heart Institute in Minneapolis, Minnesota. He earned his medical education at University of Aleppo in Syria and completed his internal medicine residency and cardiovascular fellowship at Case Western Reserve University and University Hospitals Cleveland Medical Center.
Dr. Chami has been active in pursuing clinical research throughout his career. He has a great appreciation for how up-to-date medical practice impacts patients’ lives and has contributed numerous publications to research on various cardiology-related topics.
Dr. Chami has chosen to focus his compassion and skills on evaluating and managing patients in the office and hospital setting. His extensive interventional training background enables him to have the best judgement when referring patients for procedures and how best to aggressively pursue prevention efforts.
“Dr. Chami is one of the smartest and most compassionate doctors I have ever met.”
~ Yazan Khatib, MD, President of First Coast Cardiovascular Institute
In his time off, Dr. Chami loves traveling, biking, cooking, and spending time with his children and wife who is a physician as well. He looks forward to establishing a home in Jacksonville with his family and anticipates being visited often by their extended family and friends.
Aging Healthfully:
How Can We Improve our Life Expectancy?
According to the CDC, the current United States life expectancy for 2023 was 76.4 years. In the U.S., people have a 1 in 5000 chance to make it to 100 years old. 85% of those centenarians are women.
Studies from the NIH have shown that 25% of one’s longevity can be attributed to genetics. That means there is plenty of opportunity for one’s lifestyle that includes diet, exercise, sleep, and other habits to influence how long we will live.
What can we learn from the world’s centenarians to improve these numbers (and add years to our lives)?
National Geographic Fellow and best-selling author Dan Buettner discovered five regions around the globe where more people reach 100+ years in age than the general population. He called these places the “Blue Zones”: Sardinia, Italy, Okinawa, Japan, Ikaria, Greece, Nicoya, Costa Rica, and Loma Linda, California.
It was discovered that people who lived in these Blue Zones had certain lifestyle factors in common.
5 Lessons
We Can Learn from the Blue Zone’s Centenarians
Community. The Blue Zone centenarians are often members of a tight-knit community of family, friends, faith-based organizations, and neighbors. They are part of a “we culture” rather than a “me culture.” Everyone has a role to play, (giving members a sense of purpose) and loneliness is seldom a factor. Daily social interaction is the norm.
Valuing and Revering the Elderly. Older generations are respected, valued for their wisdom, remain independent, and are expected to contribute and work.
Physically Active. Most people do not sit at a desk all day. Rather, they tend to gardens, farms, perform other physical labor for work, and ride bicycles or walk rather than drive for transportation and recreation.
Simple Diet. Diets tend to be simple and plant-heavy with lunch being the largest meal of the day.
Relaxed Work Life. People from these groups are more familyfocused than career focused. They don’t let work stress them out.
FCCI is a 2023 Million Hearts® Hypertension Control Champion
We are very honored and excited about achieving these two awards.
The Centers for Disease Control and Prevention (CDC) recently designated 24 physicians and clinical practices as the 2023 Million Hearts® Hypertension Control Champions. Hypertension, or high blood pressure, is a leading cause of heart disease and stroke and a leading cause of disability for millions of adults in the United States.
Most adults diagnosed with hypertension do not have their condition under control.
The Million Hearts® Hypertension Control Challenge is a program that recognizes clinicians, practices, and health systems that achieve hypertension control rates of at least 80%.
Entrants share both verifiable patient data and insights on their successful strategies and best practices. The Champions’ stories are publicly shared to inspire other practices and health systems to improve hypertension control.
First Coast Cardiovascular Institute has joined the ranks of 167 Million Hearts® Hypertension Control Champions who have successfully improved hypertension control among their patients.
To learn more: https://millionhearts.hhs.gov/partners-progress/champions/challenge.html
We are very excited to have participated in this program recognized by the American Heart Association and the American Medical Association.
What this means for our patients:
For every 100 patients we successfully help better control their Blood Pressure, even if it is simply bringing them from 140 to 130:
We save 8 people from dying.
We save 2 people from a heart attack.
We save 3 people from stroke and its disability.
We will continue this important work. Thank you!
Walid Abdalla, MHA Director of Performance Improvement
TESTIMONIALS PATIENT
Patient reviews are the heart of our practice. Nothing is more heartwarming than seeing we have made the experience of visiting a doctor’s office just a little bit easier.
“Dr. Thielemann is doing his absolute best to figure out why I can’t sleep no more than 3-4 hrs. a night. Thank you, Dr Thielemann and staff. I know you will figure this out. I can’t wait!”
~ Google Review
“Highly recommended. Dr. Lamba is AWESOME.”
~ Google Review
“Very professional staff. Courteous and friendly. Special thank you to Dr. Syed. He explains things in an easy-to-understand way.”
~ Google Review
“Dr. Khatib and Shephali Patel, APRN are the best! They are so caring and so amazing. Their office staff is also the best!!!! They have earned my highest possible recommendation!!!
~ Google Review
“FCCI is AWESOME. The staff and Doctors are over the top with being friendly and professional. Would I recommend them for their services? 100% recommend! I was seen within moments of being referred, and then tested and treated within 3 days. I didn’t get a doctor. I acquired a TEAM of doctors and nurse practitioners at FCCI that will help keep me on this side of grass for a lot longer.”
~ Google Review
“Dr. Al-Saghir sets the example for the cardio world to look up to. He exceeds all professional expectations along with being a genuinely nice person.”
~ Verified Patient Survey.
These reviews have been edited for spelling and grammar.
Satisfy Your Sweet Tooth
WITH LESS SUGAR
Sugar is not great for the waistline or our overall health. It increases the risk of premature heart disease, diabetes, stroke, obesity, and may reduce life expectancy.
How much sugar is too much?
The American Heart Association recommends:
Men should consume no more than 9 teaspoons (36 grams or 150 calories) of added sugar per day.
For women, no more than 6 teaspoons (25 grams or 100 calories) per day. Consider that one 12-ounce can of soda contains 8 teaspoons (32 grams) of added sugar.
If you are not more mindful about sugar consumption, it is easy to go over the recommended limit.
Skinny Blueberry Muffins
INGREDIENTS
• 1 1/2 cups all-purpose flour
• 2 teaspoons baking powder
• 1 large egg
• 1/2 cup granulated sugar
• 1/2 cup unsweetened cashew milk
DIRECTIONS
• Preheat oven to 425�F. Spray a non-stick 12-cup muffin pan with cooking spray.
• In a large bowl, add all the flour, baking powder, salt, and whisk to combine; set aside.
• In a separate large bowl, add the egg, sugar, milk, canola oil, Greek yogurt, vanilla, and whisk until smooth and combined.
• Add the wet ingredients to the dry ingredients, stirring gently until smooth and combined.
• Add the blueberries and fold gently to incorporate.
• Evenly distribute the batter into the cavities of the prepared pan, filling each about 3/4-full.
• 1/4 cup canola or vegetable oil
• 1/4 cup plain Greek yogurt
• 1 teaspoon vanilla extract
• 1 and 1/2 cups fresh blueberries tossed in 2 tbsp flour to prevent sinking
Tip – Add a couple blueberries to the top of each muffin for a nice pop of color.
• Bake for 5 minutes at 425F. The short baking time at very high heat helps the muffins get a more domed top.
• Lower the temp to 375F and bake for about 19 to 20 minutes or until tops are lightly golden, springy to the touch, and a toothpick inserted in the center comes out clean or with a few moist crumbs, but no batter.
Beware of hidden sugars
Get in the habit of reading labels. Sugar is often hidden in condiments such as ketchup, barbeque sauce, salad dressing, and “healthy” breakfast cereals and granola. Look for words that end in “ose” such as glucose, sucrose, and lactose which indicate they are sugar.
Here we offer two delicious recipes that use less sugar but will satisfy your sweet tooth!
Serves 4
INGREDIENTS
• 2 very ripe bananas, peeled, chopped
• 2 ripe avocados, flesh scooped
• 2 tbs hazelnut or almond butter
• 1/2 cup raw cacao powder
• 2 tbs coconut milk
• 1/4 cup cacao nibs
• 1-2 cups raspberries
DIRECTIONS
Place the banana, avocado, nut butter, cacao powder, coconut milk and a pinch of salt in a blender and mix until smooth. Pour into a shallow serving dish, then cover and chill for 30 minutes or until set. Scatter with the cacao nibs and berries to serve.
Enjoy!
Chocolate Avocado Mousse
Image and Recipe Credit: Averiecooks.com
Image and Recipe Credit: Delicious.com
FCCI’s Vascular Interventions Fellowship
FCCI houses one of the most robust Vascular Interventions Fellowship programs in the Southeastern United States. The Vascular Medicine section is especially active in the evaluation and treatment of all forms of arterial and venous disease, as well as arteriovenous fistulas and wound care. Approximately 2,500 cardiovascular interventional procedures are performed at its state-of-the-art outpatient facility and affiliated hospitals under the leadership of Drs. Yazan Khatib and Vaqar Ali.
To learn more, please visit: Firstcoastcardio.com/vascular-interventions-fellowship/
HCA Florida Orange Park Cardiovascular Fellowship Program
The team at First Coast Cardiovascular Insitute believes in paying it forward and helping to bring up and support the next generation of cardiologists.
In partnership with HCA Florida Orange Park Cardiovascular’s Fellowship Program, we host new participants each year. Alongside dedicated attending physicians, fellows strive for excellence
in their training and provide high-quality healthcare and community-oriented service in patient-centered environments.
Active FCCI providers include Andrea DeNeen, MD, FACC, Program Director, Youssef Al-Saghir, MD Division Chief, and Core Faculty Members Ibrahim Fahdi, MD, Ashu Dhanjal, MD, and Mubbasher Syed MD, MPH, FACC, FSCAI.
Meet Two of Our Current Fellows
Dr. Jacinto received his DO at Edward Via College of Osteopathic Medicine in Spartanburg, SC. When asked what inspired him to pursue medicine, he recalls being in the second grade and enjoying visiting his pediatrician. He lost his dad to lung cancer when he was in his first year of medical school. At that time, he made a promise to his father to be the best doctor he could be.
Why cardiology? Dr. Jacinto says “The heart is at the root of everything. The heart is the center. It takes a lot of trust from the patient, and it is rewarding to help people when they are at their lowest and prevent further issues.”
Dr. Jacinto completes his fellowship in June and plans to move to the Northwest where he has accepted a position as an Invasive Cardiologist at the Pulse Heart Institute in Tacoma, Washington. He has been married for five years and he and his wife have a one-year-old daughter. When not working, Dr. Jacinto enjoys hiking, spending time with his family, eating good food, and playing the guitar.
Dr. Tran is a first-generation Vietnamese immigrant. She completed her residency at the Carolinas Healthcare System Blue Ridge in North Carolina.
What inspired her to go into medicine? “Witnessing a female cardiologist performing a left heart catheterization on my grandmother impressed upon me that I too can be a woman in cardiology.”
Dr. Tran’s plans include being a noninvasive cardiologist with an emphasis on prevention.
Outside of work, Dr. Tran enjoys spending time with her fiancé, dog, and friends.
To learn more about the HCA Florida Orange Park Cardiovascular Fellowship Program, please visit hcahealthcaregme.com
Jomel Patrick Jacinto, DO
Ly Tran, DO
QWhat was your favorite meal to eat as a child?
Dr. DeNeen: Carne Asada with rice, radish relish, cheesy refried beans (extra special with cheese empanadas)
Dr. Al-Saghir: Cereal
Dr. Lamba: Mom’s food and desserts!
Dr. Ali: French Fries
Dr. Swain: Pizza
QWhat are some items on the top of your bucket list?
Dr. Lamba: Travel to Africa, Australia, and New Zealand
Dr. Ali: Travel to Austria and New Zealand. Go see the Northern Lights. Take a train ride across Russia.
Dr. Swain: Visit all 50 USA states with my wife and kids. In the last 7 years, we have visited 40 states. When the kids are older, we would like to go backpacking in Europe.
Q & A
QWhat are your hobbies?
Dr. DeNeen: Knitting, breadmaking, starting to get into succulents (again).
Dr. Al-Saghir: Fishing, traveling, basketball
Dr. Ali: Golf and working out
Dr. Swain: Guitar playing and I’m currently learning how to play the piano
Dr. Lamba: Golf, sports, and meditation
QIf you could describe yourself as an animal, which one would it be?
Dr. DeNeen: Lioness- of course. Lol
Dr. Al-Saghir: Tiger
QWhat is a challenge you have had in your life that you have overcome?
Dr. Swain: I was born with my right foot turned 90 degrees outward and had to wear a brace to fix it. To this day, this foot is still super flexible.
