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Tuesday, March 31, 2015

HEART HEALTHY RECIPE (DINNER): BAKED SALMON WITH CUCUMBER SOUR CREAM SAUCE

·         4 (5 ounce) salmon fillets
·         Juice of 1 lemon
·         ¼ cup water
·         1 tsp. dried dill or parsley

1.      Preheat oven to 350˚
2.      Place fish fillets on large baking sheet
3.      Sprinkle fish with lemon juice and dill or parsley
4.      Place water on tray around fish
5.      Bake fish until done and fork tender, about 20 minutes
6.      Meanwhile, make the sauce by mixing the cucumber and sour cream in a small mixing bowl and serve the fillets of fish with the sauce on the side

Servings:  4
Serving size:  1 fillet

Nutritional Information
Calories:  208
Fat:  7 g
Saturated Fat: 2 g                   TIP:             
Cholesterol:  50 mg                For the best source of Omega 3 fatty acid,
Sodium:  79 mg                      choose Alaskan salmon.
Carbohydrate:  8 g              .       
Fiber:  .5 g
Protein:  26 g

"The Perfect Day"
By: Nanette Cameron, RD

Monday, March 30, 2015

MICHIGAN HEART GROUP'S PHYSICIAN LIAISON IS HERE TO HELP YOU

Michigan Heart Group has a Physician Liaison on staff to assist with questions, concerns or problems you, your staff or your patients may have with our office.

Stacie Batur is available Monday through Thursday at (248) 267-5050 (x6509). She is often between two buildings or visiting referring physician offices. If you get her voice mail, please leave a message and she will call you back shortly. If you need to speak to her immediately you can reach her on her cell phone at (248) 765-4466.

Friday, March 27, 2015

BEAUMONT HOSPITAL, ROYAL OAK AMONG FIRST TO OFFER ALTERNATIVE TO BLOOD-THINNING MEDICATIONS FOR ATRIAL FIBRILLATION

First in Midwest to use newly approved WATCHMAN left atrial appendage closure device

Cardiologists at Beaumont Hospital, Royal Oak have performed the Midwest’s first commercial implant of a device recently approved by the Food and Drug Administration for patients with non-valvular atrial fibrillation. The WATCHMAN Left Atrial Appendage Closure implant is an alternative to long-term use of blood-thinning warfarin medication to reduce the risk of stroke.

Atrial fibrillation is the most common heart rhythm disorder affecting more than five million Americans. Twenty percent of all strokes occur in patients with AF. The most common treatment to reduce their stroke risk is blood-thinning warfarin medication. Warfarin is not well tolerated by some patients and has a significant risk for bleeding complications. As a result, nearly half of those eligible for warfarin therapy are currently untreated.

“The WATCHMAN device is an excellent alternative to warfarin for patients who are not optimal candidate for oral anticoagulation. By closing the left atrial appendage, the device has been demonstrated to significantly reduce the risk of death and stroke, compared with warfarin therapy,” says George Hanzel, M.D., director of the Structural Heart program at Beaumont Hospital, Royal Oak.

Beaumont cardiologists have extensive experience with the device and were involved in initial national clinical trials testing it in 2005 that led to its FDA approval. The recently published results of these trials showed a 60 percent reduction in cardiovascular mortality and a 34 percent reduction in all-cause mortality in patients treated with the device.

”This advanced technology will be truly life-changing for many atrial fibrillation patients, freeing them from the dangers of stroke risk, and the daily challenges of long-term blood-thinning medications,” says Steven Almany, M.D., principal investigator of the WATCHMAN trial at Beaumont.

The WATCHMAN device is about the size of a quarter and shaped like a parachute. It is implanted into the heart to close off the left atrial appendage, a blind pouch of heart tissue where blood clots can form and then break off and travel in the blood stream to the brain and cause strokes. The device is inserted into the heart through a catheter placed into a vein in the leg during a one-time, minimally invasive procedure in a cardiac catheterization lab.

The first commercial implant of the device at Beaumont was performed on March 25. The patient is a 68-year old woman from River Rouge.

Developed by Boston Scientific, the WATCHMAN implant has been approved in Europe since 2005. It has been implanted in more than 10,000 patients and is approved in more than 70 countries around the world.

Thursday, March 26, 2015

HEART HEALTHY RECIPE (LUNCH): BARLEY VEGETABLE STEW

·         1 cup barley (1 cup raw= 2 cups cooked)
·         3 cups water
·         1 tsp. olive oil
·         1 cup chopped yellow onion
·         2 cloves garlic, minced
·         ½ tsp. dried rosemary
·         ¾ cup small fresh mushrooms, sliced
·         1 cup yellow bell pepper, chopped
·         2 TBSP white wine
·         1 (15.5 ounce) can white beans, rinsed and drained
·         1 (14.5 ounce) can Italian style diced tomatoes
·         2 cups fresh baby spinach
·         1 pinch red pepper flakes


1.      Bring the barley and water to a boil in a pot, cover and reduce heat to low
2.      Heat the olive oil in a large pot over medium heat and cook the onion and garlic until tender
3.      Season with rosemary; mix in the mushrooms, yellow pepper and wine and cook 5 minutes
4.      Stir in the cooked barley, beans, tomatoes and spinach
5.      Season with red pepper flakes
6.      Continue cooking for 10 minutes, or until spinach is wilted

Servings:  6
Serving size:  1¼ cups

Nutritional Information
Calories:  257
Fat:  1.7 g
Saturated Fat:  0 g             TIP:                 
Cholesterol:  0 mg              Rinse all grains in a bowl or strainer before cooking
Sodium:  172 mg                in order to take out foreign particles and keep
Carbohydrate:  51 g            the rice from being bitter.     
Fiber:  9 g
Protein:  9.4 g

"The Perfect Day"
By: Nanette Cameron, RD

Wednesday, March 25, 2015

COME JOIN OUR TEAM...

MEDICAL ASSISTANT:
Primary responsibilities include bringing patients back to be seen, taking patient vital signs, calling in prescriptions, distributing samples to patients, inputting health information into electronic medical records and other miscellaneous job related duties.

Previous medical assistant training and certification is necessary and required for consideration of this position.  Prior experience with EPIC and AllScripts Electronic Medical Record software programs is preferred.  Part time and full time positions available.  Please include salary requirements.

Please direct resumes to Mariann Graham at fax number (248) 267-5051.

MEDICAL RECEPTIONIST:
Primary responsibilities will include checking patients in and out, scheduling, answering telephones, verifying insurances, obtaining insurance authorizations collecting money and coordinating hospital procedures with testing appointments and device checks, etc. 

The Medical Receptionist will have to offer strong levels of organizational and time management. This individual will have to be comfortable independently assessing and solving operational issues. 

Please direct resumes to Ruth Moore at fax number (248) 267-5051

Tuesday, March 24, 2015

HEART HEALTHY RECIPE (BREAKFAST): BANANA FLAXSEED MUFFIN

2 cups whole wheat flour                    
1 cup ground flax-seed                    
2 cups old fashioned oats                    
¾ cup brown sugar Splenda                
1 TBSP baking powder                       
1 TBSP baking soda                           
½ tsp. cinnamon
2 eggs or 4 egg whites
1 ½ cups skim milk                     
⅓ cup canola oil
1 ¾ cup mashed banana (2-3 medium)
1 tsp. vanilla
¾ cup semi-sweet mini chocolate chips
cooking spray

1.      Preheat oven to 375˚
2.      Combine all dry ingredients in a large bowl
3.      In another bowl, slightly beat eggs
4.      Add milk, oil, mashed banana and vanilla and combine with a wire whisk until smooth
5.      Add egg mixture to the dry ingredients and stir gently- batter will be slightly thick
6.      Stir in mini chocolate chips
7.      Spray muffin tins with cooking spray and fill ⅔ full with muffin mix
8.      Bake at 375˚ for about 18 minutes

Servings:  24
Serving size:  1 muffin

Nutritional Information
Calories:  140
Fat:  5 g
Saturated Fat:  1 g                                       TIP:
Cholesterol:  15 mg                                     Wrap individual muffins and freeze
Sodium:  85 mg                                           for up to 3 months.
Carbohydrate:  20 g
Fiber:  3 g
Protein:  4 g


Serving Suggestion:
Add 14 grams of protein such as 2 turkey sausage links.

"The Perfect Day"
By: Nanette Cameron, RD


Monday, March 23, 2015

ACCESS YOUR MEDICAL INFORMATION ONLINE!!!!!

WHY YOU SHOULD SIGN UP FOR THE PATIENT
 PORTAL AT MICHIGAN HEART GROUP

·         24/7 accessibility to medical records and important health information form any computer or smart phone
·         Quicker test results online
·         You now have the ability to email the office securely for:
§  Direct messaging to your physician
§  Appointment requests
§  Prescription refill requests

                                                                                                                                                         

HOW TO SIGN UP FOR THE PATIENT PORTAL AT
 MICHIGAN HEART GROUP

·         Go to www.mhgpc.com
·         Click the link on the left hand side of the page that says “Patient Portal”
·         Click “Create an Account”
·         Fill in the necessary account information
·         You will be directed to page called “Select a Log-in Method”. Click on the logo..........

·         Create a Username and Password and enter in your email address.  Click “continue”
              **Write your username down somewhere secure, if lost we cannot 
                 recover it**
·         You will be directed to a page that says, “Request Connection to Healthcare Organization”.  Type in the zip code 48098 and hit enter, and then select “Connect” next to Michigan Heart Group.
·         Click on the “Next” button where you will be directed to ta page that says, “Sign Release of Information Authorization”.  Select “I Accept”.
·         Once your account has been matched with your health record at our office you will receive an email notification, then you are ready to use the portal and view all of your information.
                                                                                                                                                            

Friday, March 20, 2015

HIGHER ALCOHOL CONSUMPTION IN MIDDLE-AGED MEN TIED TO MEMORY DECLINE

One national news broadcast, several major newspapers, one wire source, and numerous consumer online medical sources report a study suggesting that mental decline is associated with heavy drinking in middle-aged men.
       
ABC World News (1/15, story 8, 1:40, Sawyer) reported that a study (1/16) published online Jan. 15 in the journal Neurology “shows that beer and wine speeds up memory loss, but it seems only if you drink a certain amount.”
       
The Los Angeles Times (1/15, Healy) reports, “Middle-aged men who consume an average of more than 2½ alcoholic drinks per day accelerate the rate at which their memories decline by almost six years over a 10-year span,” the study found. What’s more, “while a higher consumption of spirits such as vodka, gin, whiskey or scotch was linked to the fastest rates of mental decline in men, researchers saw little difference between the cognitive loss seen in heavy beer drinkers (who drank more than 2½ 12-ounce beers per day) and that seen in men who quaffed a half-bottle of wine or more per day.”
       
USA Today (1/15, Painter) reports that the study, which also “looked at women...found no clear results for them.” The research suggests that “lighter drinking does not contribute to cognitive decline.” The study’s lead author said, “The findings are in agreement with previous studies and suggest that moderate alcohol consumption is probably not deleterious for cognitive outcomes.”
       
MedPage Today (1/16, Gever) notes that the study received some of its funding from the National Institutes of Health.
       
Also covering the story are the AP (1/16, Ritter), the NBC News (1/16, Alexander) website, the TIME (1/15, Sifferlin) “Healthland” blog, HealthDay (1/16, Salamon), Medscape (1/16, Anderson), and the Huffington Post (1/15).
       

Alcohol tied to nearly 80,000 deaths in North and Latin America annually. The CNN (1/15, Henry) “The Chart” blog reports that according to a study published Jan. 15 in the journal Addiction, approximately “80,000 people die as a result of drinking alcohol each year in North and Latin America.” Researchers arrived at this conclusion after looking “at alcohol as the cause of death by examining death certificates over a two-year period in 16 North and Latin American countries.” The study also found that “men accounted for 84% of alcohol-related deaths.”

Posted by:  Steven Almany, MD 

Thursday, March 19, 2015

HEART HEALTHY RECIPE (DINNER): ASIAN CHICKEN STIR FRY

·         1 large onion, chopped
·         1 large bell pepper, chopped
·         ¼ cup ketchup
·         2 TBSP hosing sauce
·         2 cloves fresh garlic, minced
·         1 TBSP low sodium soy sauce
·         2/3 cup low sodium chicken broth
·         2 tsp. Splenda
·         1 TBSP garlic chili past (hot)
·         2 zucchini, chopped
·         1 yellow squash, chopped
·         6 ounces broccoli, chopped
·         8 ounces fresh mushrooms, quartered
·         2 TBSP natural peanut butter
·         1 TBSP lemon juice
·         ¼ cup toasted peanuts, crushed
·         4 skinless, boneless chicken breasts, cut into bite-size pieces
·         Cooking spray


1.      Spray the pan or wok with cooking spray, add diced chicken and onion and cook until chicken juices run clear
2.      Meanwhile, in a medium bowl combine the ketchup, oyster sauce, soy sauce, chicken broth, Splenda, peanut butter, lemon juice and chili paste and set aside
3.      When chicken and onions are done, remove and set aside
4.      Add the zucchini, squash, broccoli and mushrooms in the skillet
5.      Cook and stir 3 to 5 minutes and add the sauce and chicken
6.      Continue cooking until vegetables are tender about 5 more minutes
7.      Add 1 tablespoon of crushed peanuts to each serving

Servings:  4
Serving size:  2 cups

Nutritional Information
Calories:  370
Fat:  15 g
Saturated Fat:  2 g                          
Cholesterol:  72 mg              
Sodium:  230 mg                  
Carbohydrate:  26 g            
Fiber:  5 g
Protein:  34 g

"The Perfect Day"
By: Nanette Cameron, RD

Wednesday, March 18, 2015

COME JOIN OUR TEAM...

MEDICAL ASSISTANT:
Primary responsibilities include bringing patients back to be seen, taking patient vital signs, calling in prescriptions, distributing samples to patients, inputting health information into electronic medical records and other miscellaneous job related duties.

Previous medical assistant training and certification is necessary and required for consideration of this position.  Prior experience with EPIC and AllScripts Electronic Medical Record software programs is preferred.  Part time and full time positions available.  Please include salary requirements.

Please direct resumes to Mariann Graham at fax number (248) 267-5051.

MEDICAL RECEPTIONIST:
Primary responsibilities will include checking patients in and out, scheduling, answering telephones, verifying insurances, obtaining insurance authorizations collecting money and coordinating hospital procedures with testing appointments and device checks, etc. 

The Medical Receptionist will have to offer strong levels of organizational and time management. This individual will have to be comfortable independently assessing and solving operational issues. 

Please direct resumes to Ruth Moore at fax number (248) 267-5051

Tuesday, March 17, 2015

HEART HEALTHY RECIPE (LUNCH): AUTUMN STEW

·         1 TBSP canola oil or olive oil
·         1 large onion, chopped
·         4 cloves of garlic, chopped
·         1 large green pepper, chopped
·         2 cans (15 ounce each) diced tomatoes, no salt added
·         4 cans water
·         1 can (16 ounce) solid pack pumpkin
·         1/3 cup brown rice, dry
·         1½ TBSP chili powder
·         2 tsp. ground cumin
·         2 cans (15 ounces each) kidney beans, rinsed and drained


1.      Heat oil in a large soup pot or Dutch oven over medium-high heat
2.      Sauté onion, garlic and green pepper for 3 minutes
3.      Add the rest of the ingredients and bring to a boil
4.      Reduce to simmer and cook for 30 minutes

Servings:  6
Serving size:  2 cups

Nutritional Information
Calories:  234
Fat:  3 g
Saturated Fat:  0.5 g                       
Cholesterol:  0 mg              
Sodium:  296 mg                  
Carbohydrate:  43 g            
Fiber:  13 g
Protein:  10 g

"The Perfect Day"
By: Nanette Cameron, RD

Monday, March 16, 2015

MICHIGAN HEART GROUP'S LOCATIONS AND SATELLITE OFFICES

Michigan Heart Group has 2 main locations and 2 satellite locations.  Different physicians see patients out of different suits.  

THERE ARE TIMES, when a physician will need to SWITCH SUITES for one reason or another. It usually has to do with coverage or addition of office time.  

You will ALWAYS BE NOTIFIED of this DURING YOUR REMINDER  CALL so PLEASE pay close attention to the LOCATION when we call you. 


MAIN CAMPUS:
Beaumont Michigan Heart Group:
4600 Investment Drive, #200
Troy, MI 48098
(248) 267-5050
www.mhgpc.com
OPEN MON-FRI (7AM-4PM), Different Physicians are in on different days (see below)

Steven L. Almany, MD (Wednesday and Friday)
Steven C. Ajluni, MD (Monday and Wednesday)
William D. Devlin, MD (Tuesday and Thursday)
Terry R. Bowers, MD (Monday and Wednesday)
Michael J. Gallagher, MD (Tuesday and Friday)

Beaumont Michigan Heart Rhythm Group
4550 Investment Drive, #250
Troy, MI 48098
(248) 267-5050
OPEN MON-FRI (7AM-4PM), Different Physicians are in on different days (see below)

David R. Cragg, MD (Wednesday and Thursday)
Brian D. Williamson, MD (Tuesday and Friday)
Ilana B. Kutinsky, DO (Monday and Thursday)

SATELLITE OFFICES:
Beaumont Western Wayne Heart Group
39500 Ten Mile, #103
Novi, MI 48375
(248) 267-5050
Physicians in on certain days (see below)

Steven C. Ajluni, MD (Most Tuesdays)
William D. Devlin, MD (3rd Monday of the Month)
Ilana B. Kutinsky, DO (2nd Wednesday of the Month)

Beaumont Michigan Heart Group- Macomb
15959 Hall Road, #304
Macomb, MI 48044
(248) 267-5050
Physicians in on certain days (see below)

David R. Cragg, MD (Friday morning)
Terry R. Bowers, MD (Thursday morning)
Michael J. Gallagher, MD (Wednesday afternoon)

Friday, March 13, 2015

COME JOIN OUR TEAM...

MEDICAL ASSISTANT:
Primary responsibilities include bringing patients back to be seen, taking patient vital signs, calling in prescriptions, distributing samples to patients, inputting health information into electronic medical records and other miscellaneous job related duties.

Previous medical assistant training and certification is necessary and required for consideration of this position.  Prior experience with EPIC and AllScripts Electronic Medical Record software programs is preferred.  Part time and full time positions available.  Please include salary requirements.

Please direct resumes to Mariann Graham at fax number (248) 267-5051.

MEDICAL RECEPTIONIST:
Primary responsibilities will include checking patients in and out, scheduling, answering telephones, verifying insurances, obtaining insurance authorizations collecting money and coordinating hospital procedures with testing appointments and device checks, etc. 

The Medical Receptionist will have to offer strong levels of organizational and time management. This individual will have to be comfortable independently assessing and solving operational issues. 

Please direct resumes to Ruth Moore at fax number (248) 267-5051

Thursday, March 12, 2015

HEART HEALTHY RECIPE (BREAKFAST): APPLE PIE OATMEAL


1 cup steel cut oats
2 cups water
1 tsp. cinnamon
Dash nutmeg
1 apple, chopped with peel
1 cup soy or skim milk




1.  Place oats, water, spices and apple in a large saucepan
2.  Bring to boil
3.  Reduce heat and cook for 12-15 minutes covered
4.  Remove from heat and allow oatmeal to stand for 5 minutes
5.  Serve with milk


Servings:  4
Serving size:  3/4 cup

Nutritional Information
Calories:  252
Fat:  3 g
Saturated Fat:  0 g                                       TIP:
Cholesterol:  0 mg                                       You may substitute lit soy milk and save
Sodium:  72 mg                                            extra calories.
Carbohydrate:  47 g
Fiber:  6 g
Protein:  11 g


Serving Suggestion:
Add 11 grams of protein such as 1/2 cup cottage cheese for 90 calories

"The Perfect Day"
By: Nanette Cameron, RD

Wednesday, March 11, 2015

DO DIFFICULTIES WITH ACTIVITIES OF DAILY LIVING (ADL) PREDICT EARLY DEATH?

ROCHESTER, MN—Patients with heart failure who were seen at a major medical center commonly struggled with nine activities of daily living (ADL), which often worsened over time and were a powerful predictor of all-cause death and hospitalization during a mean follow-up of 3.2 years, according to a new study [1].

Patients who had trouble feeding themselves, using the toilet and dressing (severe difficulties with ADL) and those who had trouble taking medication, bathing, taking public transportation, and housekeeping (moderate difficulties with ADL) had a respective 2.3-fold and 1.5-fold higher risk of dying during follow-up compared with patients who had trouble walking and climbing stairs (minimal difficulties with ADL) or had no difficulties with ADL.

Even patients with no/minimal difficulties with ADL only survived a mean of 5.6 years. However, those with moderate or severe difficulties survived a mean of only 3.0 and 1.5 years, respectively.  Asking HF patients about ADL “is a relatively easy thing to assess during a routine clinical visit…[and it] certainly provides a framework to identify patients…who are at higher risk for adverse outcomes,” lead author Dr. Shannon M. Dunlay (May Clinic. Rochester, MN) told heartwire.

The study is unique in that the researchers assessed ADL, a measure used in oncology and gerontology for many years, but rarely used in cardiology,”  Dr. Kathleen Dracup (University of California, San Francisco School of Nursing), who was not involved in the study, told heartwire.

It shows that ADL “provides an important window into the daily life of the patient…and may provide a powerful tool to identify patients who might consider palliative care in the future,” she said.  Thus, at minimum, clinicians need to ask about ADLs as part of the routine clinical visit…[which] has never been part of the standard cardiac assessment.”

Do ADL Difficulties Predict Early Death?
Little is known about how functional disability affects survival and hospitalization in patients with HF, Dunlay and colleagues write.

They studied 1128 patients with HF who were seen in the Mayo Clinic from September 2003 through January 2012 and followed until January 2013 and had completed a questionnaire asking them to reply “yes” or “no” to indicate if they had difficulties with nine ADLs.

Most patients (69%) were enrolled as outpatients, while the rest were enrolled when they were hospitalized for HF.  The patients had a mean age of 75 years, and 49% were women.  About 6 in 10 patients reported having difficulty with at least one of the nine ADL’s.

The researches ranked the ADL, from easiest to hardest, as follows:  Feeding oneself, using the toilet, dressing, taking medications, bathing, taking transportation, housekeeping, walking, and climbing stairs.  After a mean follow-up of 3.2 years, 54% of the patients had died.

Risk of Outcome With Moderate and Severe vs. No/Minimal Difficulty with ADL, HR (95%CI)*
ALL-CAUSE OUTCOME
DIFFICULTY WITH ADL AT ENROLLMENT
MODERATE
SEVERE
MORTALITY
1.49 (1.22—1.82)
2.26 (1.79—2.86)
HOSPITALIZATION
1.37 (1.17—1.59)
1.22 (1.00—1.49)
*During a mean follow-up of 3.2 years; adjusted for age, sex, Charlson comorbidity index, and hospitalized vs. outpatient at enrollment ADL= activities of daily living

The 17.7% of survivors who reported more difficulty with ADL and patients with persistently severe or worsening difficulty were at increased risk for death (HR 2.10, 95% CI 1.71-2.58; P less than 0.001) and hospitalization (HR 1.51, 95% CI 1.31-17.74; P less than 0.001), Asking about ADLs can help identify which patients may need physical therapy to improve or retain their mobility, Dunlay noted.  More research is needed to identify “whether there are specific interventions, physical therapy, of types of care that can help patients who are having difficulties with ADL and potentially impact their outcomes and quality of life,” she said.

Useful Prognostic Tool         
The study has three key implications, Dr. Eldrin F. Lewis (Brigham and Women’s Hospital, Boston, MA), writes in an accompanying editorial. [2]

First, ADL in HF patients could be assessed by an online questionnaire during or prior to a clinic visit.  Second, more research is needed to better understand why certain ADL limitations are associated with earlier death and to design targeted therapies for high-risk patients.  Last, “this adds another prognostic tool that can be used by clinicians as we provide guidance into complex shared decision-making.” He said.

“Unfortunately, 50% of patients with HF will die within 5 years, [which] has not changed over the past decade despite advances in treatment,” Drakup noted.  This study—like other studies that used the 6-minute walk—shows that functional status is an important predictor of mortality, she said.

Moreover, “if high-risk and low-risk [HF patients] could be identified with any confidence, then clinicians could begin that all-important discussion about goals of treatment with high-risk patients,” she said.  “Clinicians may refer patients to hospice care earlier—currently in cardiology such referrals are infamously late (often in the last 3 days of life)—and shift the goals of treatment to comfort card vs. ‘cure’ for patients with a high risk of dying”

This work was supported by grants from the National Institutes of Health.  The authors, Lewis and Drakup have no relevant financial relationships.

POSTED by:  Steven Ajluni, MD