The Heart and Wellness Center
A Cardiology Practice with a focus on Health and Wellness!
The Heart and Wellness Center
A Cardiology Practice with a focus on Health and Wellness!
About The Heart and Wellness Center
Meet Dr.Makki!
Dr. Hassan S Makki came to the United States with his family as a child and grew up in Michigan. He graduated from the University Of Michigan with a Bachelor’s degree in Biochemistry. He then did research in blood coagulation before completing course work in the Masters of Public Health at the University of Michigan. He then attended and graduated with Honors from A.T. Still University with his Osteopathic Medical degree in 2004.
He then completed his Internal Medicine residency and Cardiovascular Medicine fellowship in Garden City Michigan in 2010.
Dr. Makki practiced General Cardiology for several years before completing his Interventional Fellowship in Macomb Michigan in 2016.
Dr. Makki, after over two decades of education, training and practice, believes that the secrets to great health and vitality are quite simple; regular Exercise, proper Nutrition and the judicious use of well established Medical Therapies. Dr. Makki believes that our current healthcare system incentivizes people, doctors and hospitals to keep people in a perpetual state of disease by focusing most of our efforts and resources After disease has set in. Billions of healthcare dollars are used to "save people's" lives, by preforming expensive procedures and utilizing overpriced medications, only to return them to same state of health where these therapies found them. This insanity is akin to catching someone as they fall of the cliff and putting them right back on that edge after! The Heart and Wellness Center seeks to reverse this trend and extend the area before the patient even reaches the cliff!
Our goal is not merely to extend the Lifespan of our patients, but also to improve and increase the HEALTHSPAN!
Our Philosophy
The Heart and Wellness Center seeks to flip the paradigm of our current healthcare system, which focuses on disease and reactivity, to one that focuses on Health, Nutrition and Social Support with only judicious use of Medication and Testing.
The Mediterranean Dish!
The HWC believes that great health starts at home and mainly in the kitchen! Dr. Makki advocates the Mediterranean Diet as it is easy to follow and has been well validated in multiple studies across many disciplines as one of the most effective methods of reducing cardiovascular risk (by upwards of 30-40%!).That is more powerful than any medication alone or any particular therapy or surgery. The basic idea is to center your food around a base of whole greens and vegetables that should be consumed daily as a large salad or healthy bowl. Ideally, the staple protein should be plant based or fish with occasional poultry and only rarely, red meat. Generally, healthier oils like Olive oil or Avocado oils can be used for cooking and for salads, with a general avoidance of all things fried. To that end, an air fryer should be the main cooking instrument in the kitchen! The HWC will be partnering with Registered Dieticians and with meal prep service providers in the area to help keep our patients on track!
Our Services
The HWC is a fully functioning Cardiology Practice offering all the services of a traditional Cardiology Practice including;
Stress Testing, EKG, Echocardiography, Remote Monitoring and comprehensive Vascular testing.
At the HWC, every patient is encouraged to participate in our Exercise Assessment and Enhancement Program designed to find you where you are and help guide you to your health and fitness goals!
Echocardiography
The HWC offers Echocardiography, which uses ultrasound to look at the heart muscle, size and function and the Valves of the heart. This non invasive test is quick (less than 30 minutes) and allows us not only diagnose, but to surveil and treat people with problems with the Heart Valves, Heart Muscle (Cardiomyopathy) and Chamber Enlargements. These “enlarged hearts” increase the patient’s chances of having a Heart Attack or Stroke. Echocardiography is also a beautiful visual discipline that allows us to see the Patient Heart's Story before treatment and can be quite gratifying to see the heart return to normal with excellent blood pressure management and lifestyle modification!
Rhythm Monitoring and Management
The HWC offers the standard EKG and Extended Day Monitoring required for the detection and management of virtually all cardiac dysrhythmias including: Bradycardias or slow heart rates including Heart Blocks and Tachycardias or fast heart rates including Atrial Fibrillation, a very common cause of stroke. We also have Extended Day Monitors that require no wires or significant training to operate and can be used to monitor a patient for almost a full month if necessary. Should longer surveillance be required, such as in cases of unknown cause of stroke or unexplained Syncope (passing out), we also offer a simple procedure that places a thumb-drive-sized device called an Implantable Loop Recorder (ILR, pictured above). This device can be placed in the clinic in under 5 minutes and can monitor the Heart's Rhythm for over 2 years!
Stress Testing
The HWC offers Treadmill and Nuclear Stress Testing to help us diagnose Coronary Artery Disease (CAD), the remaining number one cause of Heart Attack, Heart Failure, and death in the US.
A Stress Test is one of the Cardiologist's tools to assess a patient's Heart's Fitness. It typically, takes 15-20 minutes and uses a treadmill or stationary bike to incrementally increase the workload on the heart (by varying the incline and speed of the treadmill). The patient's EKG is monitored for signs of heart strain indicating a possible blockage of blood flow (CAD) with even the length of the patient study is usually very prognostic of the patient risk of future cardiac events. It is also often used to asses a patients risk for upcoming major surgery. When coupled with imaging (above picture showing the heart muscle taking up a Nuclear isotope to varying degrees), the Nuclear Stress Test can very accurately detect significant blockages in the Coronary Arteries, often the precursor to having a Heart Attack, or MI (Myocardial Infarction).
VascularTesting
At the HWC , we specialize in treating both Arterial (blood coming from the heart to the body) and Venous (blood returning to the heart) disorders. These disorders are often diagnosed with symptoms and Ultrasound Testing.
The Ultrasound Testing we offer:
- ABDOMINAL AORTA
- CAROTID ARTERIES
- RENAL ARTERIES
- ARTERIAL AND VENOUS ULTARSOUNDS of the lower extremities.
Arterial blockages in the legs or arms is known as Peripheral Arterial Disease (PAD). It’s often diagnosed with symptoms of pain with ambulation called Claudication and is usually confirmed with ultrasound (Arterial Doppler pictured here). Since vascular disease is a Systemic disorder, finding PAD in any vascular area, places the patient at higher risk for Cardiovascular Events. Conversely, a patient identified as having Coronary Artery Disease (CAD) ie "heart disease" is more than 40% more likely to have PAD of significance.
Luckily, most Atherosclerosis (hardening of the arteries, plaque build up) whether it be in the extremities or in the heart is amendable to the treatment philosophy and modalities advocated by the Heart and Wellness Center!
The Vein Clinic
The HWC offers a complete Vein Clinic Service!
Dr. Makki has been treating vein disease for over 10 years and has had hundreds of excellent outcomes with his previous vein clinics. He has partnered up with the industry leaders and experts in the field to help provide his patients with complete venous care!
Vein Disease affects millions of people worldwide and is often considered minor issue. The reality is it can very debilitating with a myriad of presenting signs and symptoms.
Symptoms, can be as mild as small varicose veins (Reticular Veins) to large Varicosities, to swelling, aching and generalized discoloration and discomfort to full blown Venous Stasis Ulcers.
Treating Vein problems usually involves identifying the poorly functioning veins with a specialized Venous Ultrasound. The ultrasound study can identify the poorly functioning veins or Insufficient Veins that cause swelling, pain and varicose veins.
Weight loss, leg elevation and Graduated Compression Therapy (stockings) are the mainstay first steps to treatment.
If the patient continues to have symptoms due to these faulty or Insufficient Veins, they are then treated in the office with a minimally invasive Vein Ablation procedure (pictured here). The patient will usually require Sclerotherapy to follow the ablation procedures. This therapy utilizes medications injected directly in the remaining (smaller) veins to close them to prevent their recurrence. The patient can usually go back to normal activities a day or so later!
Medications we use
The HWC understands that one of the greatest fears of a patient is the feeling of constantly being barraged with more and more medications! Most of the time the patient does not truly understand why they are on or even for how long they are to be on these medications. This is why Dr. Makki has simplified and refined his approach to medical therapy to limit their use to only the most essential, effective and clinically validated medical therapies.
In Cardiology, there are literally hundreds of drugs that can be prescribed regularly, but in each category there are always the standout medication that works best or is best tolerated by patients. It is these medications, about 15-20 total, that can achieve the most "bang for the buck".
Cardiology Medications Categories:
- Vasodilators
- Diuretics or "water pills"
- Betablockers (BB) or Calcium channel blockers (CCB's)
- Lipid or "cholesterol" Lowering
- Blood Thinners
- Platelet Inhibitors
- Rhythm Management
- Heart Failure Meds
With each individual category, there are "best in class" medications which work really well and are well tolerated; those would be the only medications we use at the HWC. If the desired goal is not being achieved by adding more medications, especially from multiple classes, then rather that keep adding more medications, we advocate re-focusing on Wellness!
A great illustration of this the principle is treatment of Hypertension. (see our Blog Post!)
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Meet Dr Burke!
The HWC is excited to Welcome Dr. Elizabeth Burke, PT!
Mobility is Life!
Dr. Burke believes that a lot of things can fall under the "wellness" category.
"To me it basically means anything physically therapeutic that insurance does not cover. Medicare technically just covers what is required to live independently and safely in the home;
things like independently dressing, walking, reaching overhead, squatting, stair negotiation, transfers etc.. It covers basic things that disease, injury or pain prevents. It does not technically cover any kind of hobby, sport, gardening or even physically able to play with grandkids"
These are exactly the activities that we hope to cultivate at the HWC!
Dr. Elizabeth Burke graduated from James Madison University and then completed her Doctor of Physical Therapy at Virginia Commonwealth University in 2006. While in Virginia she was a Clinical Director at an outpatient physical therapy clinic, primarily treating orthopedic conditions.
She is trained in a variety of joint and soft tissue mobilization techniques she utilizes to help patients recover from joint pain, muscle pain, injury or surgery.
During her time in Virginia, she noticed a connection between patients who had prolonged mobility limitations and an impaired vestibular system, adversely affecting their spatial awareness and balance. She developed a Fall Prevention and Vestibular Rehab program and began incorporating these techniques to improve her patients' stability and quality of life. In 2014, she moved to Arizona and continues to care for patients with orthopedic needs, vestibular conditions, and integrating the two specialties when needed.
Elizabeth founded Focus Physical Therapy to better put the focus on her patients. Her business model is not traditional, which allows her to give you better care. With visits dedicated to applying advanced training and 1-1 treatment, care and outcomes are optimized.
Her specialties include:
Orthopedic Rehab, Vestibular Rehab, Balance and Fall Prevention, Dry Needling, and Wellness.
She looks forward to empowering you on your journey to better health!
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