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#TraumaSurvivorsDay

Today is #TraumaSurvivorsDay. As Wake County’s only Level 1 Trauma Center, our patients hold a special place in our hearts.  Read messages from members of our trauma team to their patients.

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What’s New at WakeMed North?

I’m so glad you asked. For WakeMed, what’s new is a women’s hospital in north Raleigh! This is a big deal for our system and for the community, especially since it is the first new hospital opening in Wake County since WakeMed Cary Hospital opened its doors in 1991.

The Women’s Hospital at WakeMed North is more than just a new, beautiful building offering a warm, inviting, hotel-like environment. This new hospital is the first women’s hospital in our community, exclusively focusing on childbirth and inpatient gynecological services. Although we welcome your private doctor at all times, WakeMed North will be the first hospital in this area to employ OB hospitalists, which means that an experienced, board-certified doctor will be on-site 24/7, ready to assist with your care. If your doctor is unavailable, the OB hospitalist will take excellent care of you and will deliver your baby when you go into labor, which we all know is as likely to happen at 3 am as it is at 3 pm. Our OB hospitalists can partner with your community physician and focus exclusively on providing a positive birth experience either all the way through delivery or until your physician arrives to take over.

What’s not new are our highly experienced doctors and nurses. Our team of healthcare providers, including our OB hospitalists, offer a wealth of experience and have delivered tens of thousands of babies during their careers. The majority of the nurses working at WakeMed North have transferred to the hospital from the other two hospitals within our system or from other hospitals in our area. Our maternal fetal medicine specialists have an office at WakeMed North and work with women throughout the system, providing seamless, top-notch care for high-risk pregnancies or complicated deliveries, regardless of where they initially enter the system. The neonatologists staffing our Level III Special Care Nursery are the same highly experienced physicians who provide care at our Level IV Neonatal Intensive Care Unit (NICU) on the Raleigh Campus, where the highest level of neonatal care is delivered in all of Wake County. Additionally, we will continue to deliver exceptional healthcare to the entire family through our physician offices, emergency department, imaging services and lab, just like always.

So, although there is a lot new about the Women’s Hospital at WakeMed North, the things that really matter from a patient care perspective are not new at all. We invite you to tour our new hospital and meet our healthcare providers during our community open house event, being held tomorrow (Saturday, May 9, from 10 am to 2 pm).  I look forward to meeting you there.

Dr. Seth Brody is the executive medical director of the Women’s Hospital at WakeMed North.

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Every Pitch Counts in Youth Baseball

An estimated 282,000 baseball-related injuries per year require treatment in hospitals, doctors’ offices or emergency rooms for players 18 years of age and younger.  Injuries are a part of all sports, however, many overuse injuries are preventable.

Little League Baseball and other youth baseball programs have made an effort to save young arms from overuse — but the rule may not protect pitchers when they participate on other travel teams, school teams and baseball leagues, in special show-case events or other throwing activities. The rule limits the number of pitches but only affects one specific team. While many baseball programs are governed, there may be different pitching rules and oversight is often lacking for pitchers who play on more than one team or in different leagues at the same time.  The term “Little League” is often used generically, but the official league doesn’t govern all leagues such as Babe Ruth, Pony or other school and local community specific leagues.

The key is to limit the amount of pitches thrown, rather than limiting the number of innings, in order to gain more control over how often kids throw in a game.  The ultimate goal is to prevent young, developing arms, elbows and shoulders from ending up on the operating table. 

Overuse is the Issue
Orthopedic surgeons are seeing more injuries due to overuse; young arms throwing too many pitches at a time when their bones are growing and more vulnerable.  An estimated 50 percent of youth sport injuries are due to overuse, and kids are getting injured at younger ages as they specialize in one year-round sport and/or position.  Research indicates that there has been a five to seven fold increase in throwing arm injuries since 2000.  Rest and recovery are essential for injury prevention, but may be overlooked.  This often leads to pain and injury that may go unrecognized.

Young bones are immature and have growth plates (the region of bones where growth and length occurs and where tendons attach) at their ends.  Growth plates are the weak link and are more vulnerable, especially when overused and not allowed proper healing with rest and recovery.

Exponential increased risk of injury is correlated directly with the amount of pitching.  Studies have shown that pitching greater than 80 pitches per game carries a 380 percent increased risk, pitching for greater than eight months per year leads to a 500 percent increased risk, and pitching with a fatigued arm leads to a 3,600 percent increased risk of injury.

Just Stop Throwing
When a baseball player experiences pain or injury to the shoulder or elbow, the solution is simple…just stop throwing.  The treatment for an overuse injury is underuse (rest). However, that’s easier said than done. It’s not always the kid you have to worry about; it may be the expectations from the coaches or parents.  Surgery is the extreme consequence for throwing too much and is avoidable if pain is recognized early and proactively treated with rest.  Modern techniques are very effective in rehabilitating these types of injuries for a safe return to throwing and to enable many years of baseball participation. 

Injuries can also be associated with:

  • An abrupt increase in pitching distance when a player advances to a new league or level
  • Inappropriate throwing mechanics
  • Unidentified muscle imbalance or weaknesses
  • A growth spurt, which could make the growth plate more susceptible to injury

The take home message is that not all baseball injuries can be prevented, but most can be significantly reduced.  Research confirms that if a young pitcher throws with a fatigued arm, he has a 36 to 1 times risk of injury.  By closely monitoring pitch counts, multi-team participation, year-round sport specialization and early recognition and treatment of pain, coaches and parents can be the difference between a young athlete’s long-term baseball participation and the inability to play due to a secondary to serious injury.

Dr. Mark Wood is an orthopaedic surgeon with Wake Orthopaedics.

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Meet Our OB Hospitalist Team at WakeMed North

Opening in early May, WakeMed North Family Health & Women’s Hospital will be the result of the transformation of our WakeMed North Healthplex into a brand new campus dedicated to labor and delivery services as well as other specialized services for women. Not only that, we will continue to offer the same superior services for the entire family that North Healthplex offered, including a 24/7 emergency department, imaging services, same-day surgery, outpatient laboratory services and physician offices.

Importantly, WakeMed North will feature six labor and delivery rooms in a hotel-like environment that incorporates beauty, tranquility and personalized service as well as an unmatched level of care and support. The hospital will also incorporate the obstetric (OB) hospitalist concept of care, meaning it will offer the around-the-clock services of board certified obstetrician/gynecologists (OB/GYNs).

Our OB/GYN hospitalists are a valuable extension to your own obstetrician. They provide an added level of safety because they only see patients who are in the hospital and are 100 percent focused on those patients throughout the entire birth experience, from labor through post-partum care. And being able to respond immediately to obstetrical emergencies can improve outcomes for both mother and baby.

Our hospital-based physicians are available 24/7/365 to deliver your baby should you not have a regular doctor, if you’re visiting from out of town and go into labor, or if your own doctor is not available in time. Of course, if your regular OB/GYN has privileges, he or she can deliver your baby at WakeMed North, just like at any other acute care hospital. We ensure all of this because we know your safety, comfort, and confidence are critical during this special life event.

Learn more about the OB Hospitalist program at WakeMed North from Dr. Seth Brody (right), executive medical director of the Women’s Hospital at WakeMed North. He explains all the details about the program and why it is so beneficial for patients as well as OB/GYNs throughout our community. Plus, learn more about each of the hospitalists that will be a part of the OB Hospitalist team at WakeMed North:

Dr. Karen Bash, Director of the OB Hospitalist Service at WakeMed North

Dr. Stacy Boulton

Dr. Lindsey Deschamps

Dr. Elizabeth Kim

Dr. Gary Wilson

Dr. Matthew Zerden

Community Grand Opening for WakeMed North
Join us for our community open house event on May 9 – learn more! We hope to see you there.

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Three from WakeMed Receive TBJ 40 Under 40 Leadership Award

WakeMed congratulates Dr. Bryon Boulton of WakeMed Physician Practices – Carolina Cardiovascular Surgical Associates, Dr. Islam Othman of WakeMed Physician Practices – Raleigh Cardiology and Blair Reynolds of the WakeMed Foundation for being named to the Triangle Business Journal’s elite list of “40 Under 40” for 2015.  According to the TBJ, the 40 Under 40 leadership awards recognize outstanding professionals under the age of 40 for their contributions to their organizations and to the community.  This year, five judges from TBJ and the local business community reviewed nearly 300 nominations to determine the 40 winners.

Dr. Bryon Boulton

Dr. Bryon Boulton is board certified in both general surgery and cardiothoracic surgery, which requires 10 years of additional training after medical school.  In 2012, he joined WakeMed Physician Practices – Carolina Cardiovascular Surgical Associates, bringing with him expertise in transcatheter aortic valve replacement (TAVR).  This minimally invasive surgical procedure repairs the valve without having to open and stop the heart.  Dr. Boulton co-leads the TAVR program at WakeMed with Dr. Walter Tan.

Part of why Dr. Boulton has become one of the leading cardiac surgeons in minimally invasive procedures is research. At WakeMed, he is currently one of two principal investigators involved with an atrial fibrillation (AFib) study called the Converge Trial, a clinical trial that compares two minimally invasive procedures for treating persistent AFib.

As surgical director of the Structural Heart Program at WakeMed, Dr. Boulton is responsible for the surgical portion of the transcatheter valve team and developing other therapies for specific structural heart issues as an alternative to traditional open-heart surgery.  He also serves on WakeMed’s Surgical Quality Improvement committee to ensure that all patients receive safe, high quality surgical care.

Apart from WakeMed, Dr. Boulton is a youth soccer coach, a participant in the YMCA’s Y Guides program and an active member of the Church of the Apostles in Raleigh. He and his wife also volunteer with “Pride for Parents,” a ministry to help underprivileged families purchase Christmas gifts. Globally, Dr. Boulton places medical mission trips high on his list of priorities. His next trip is planned for a missionary hospital in Kenya where he can serve as both a general surgeon and a cardiac surgeon.

Dr. Islam Othman

At 39, Dr. Islam Othman has quickly risen to the top of the interventional cardiology field and leads one of the most successful heart disease programs on the East Coast. He is director of the Complex PCI/ Chronic Total Occlusion (CTO) Program at WakeMed, where he pioneered  new, minimally invasive techniques using state-of-the-art equipment to restore blood flow to completely blocked coronary arteries that otherwise would be deemed too risky or would require a patient to undergo open heart surgery.  To date, Dr. Othman has performed the most CTO procedures in North Carolina with a 97 percent success rate and excellent patient outcomes.

Dr. Othman stands firmly on the forefront of invasive cardiovascular skill in this state and is among a small but growing number of American physicians specially trained to safely and successfully restore blood flow in blocked heart arteries. Dr. Othman also serves as medical director for WakeMed’s Cardiac Intensive Care Unit and chairman of the Peripheral Vascular Committee.

Apart from WakeMed, Dr. Othman is actively involved with the Mariam Clinic, a Raleigh non-profit organization that provides free health care to uninsured individuals, and he serves on community boards to address the needs of the uninsured. Dr. Othman also works with the local pharmaceutical industry to ensure that area patients have access to the heart medications they need.  He even challenged pharmaceutical representatives to ensure that the national program, Lilly Cares, was available here in the Triangle so that indigent patients could receive free life-saving medicine for the duration of their required treatment.

Dr. Othman also publicly advocates for prevention of disease through speaking engagements and various community and hospital events.

Blair Reynolds

Blair Reynolds joined the WakeMed Foundation in 2010 as a Major Programs & Gifts specialist.  Her effect on fundraising and ability to build and nurture relationships, as well as her ability to establish processes for more efficiency in her department, led her to become the Foundation’s director of Annual Giving & Stewardship.

As director, Reynolds works with the executive director and Board of Directors to set Annual Campaign goals and identify/implement new annual giving approaches. She also plans and directs Annual Campaign segments for all divisions. One of Reynolds’ crowning achievements with the Foundation is the establishment of “Friends of WakeMed,” a volunteer group designed to create and sustain future leaders while supporting community projects and fundraisers.

Apart from WakeMed, Reynolds has served as vice chair of the Greater Raleigh Chamber of Commerce’s Young Professionals Network (YPN) (next year, she will be chair) as well as leader of the YPN Programs Committee. Under her leadership, the YPN programming evolved and received superior reviews. In addition, Reynolds made notable contributions as a leader in the Chamber’s total resource campaign, and she was selected to participate in the Chamber’s 2013 Leadership Raleigh program.

Prior to joining WakeMed, Blair worked for InterAct, a private, non-profit United Way agency that provides support for victims and survivors of domestic violence and rape/sexual assault. At the time, she became the youngest director at InterAct, and she led efforts to establish the first stand-alone rape crisis center in this state, now located at InterAct’s main office.  In the community, Reynolds served on the Board for Bailey’s Fine Jewelry from 2013-2015, and she is currently participating in the Leukemia & Lymphoma Society’s Woman of the Year Campaign.

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Pregnancy Cravings…on the Wild Side

While not a common side effect of pregnancy, cravings for non-food items are neither unheard of nor surprising. The desire to eat ice, chalk, dirt, ashes, starch, soap – even matches – is called pica. 

If this happens to you, don’t panic. We see patients many times who are too embarrassed or afraid to admit they have these cravings. It’s a real concern, and it’s important to discuss your symptoms and the specific items you’re craving with your physician or provider.  Together, we’ll work to stop this eating disorder as soon as possible so you don’t wind up with a serious health issue.

Risks associated with pica include intestinal blockage, malnutrition, toxicity, and weight gain. When eaten, earth, clay or other non-digestible substances can collect in your bowels and make it difficult or even impossible to expel. If your cravings are for bulkier items, ruptured intestines are a possibility. The items you ingest may contain parasites, chemicals or toxins that could harm the fetus as well as your own body. And, these substances, or what’s in them, can interfere with your body’s ability to absorb the nutrients in the healthy foods you’re eating. Depending on what you’re consuming (corn starch is full of empty calories), you could even gain weight.

Your doctor will check your iron level to ensure you don’t have an iron deficiency. He or she may prescribe an iron pill or potentially iron infusion to get you back on track. It may also be suggested that you increase the protein or iron-enriched foods you are eating each day. Adding a vitamin C supplement in between meals might help as well. If there is a deficiency in your diet, your doctor will recommend you eat plenty of low-fat protein, complex carbohydrates, and fresh fruits and vegetables daily. He or she may even prescribe some counseling sessions from a therapist or dietitian.

While there is no definitive reason for the cause of pica, it’s suspected that it could be physical, psychological, cultural, and even a learned behavior. If you have unusual cravings, don’t justify them by saying your baby is hungry for what you are craving. Talk to your doctor, and he or she will help you decide what to do next.

Ginny Wolf is a registered dietitian with the WakeMed Diabetes Program.

New WakeMed Women’s Hospital Opening May 2015
We’re counting down the weeks until the May 2015 grand opening of Wake County’s fifth full-service hospital, WakeMed North Family Health & Women’s Hospital. WakeMed North Healthplex at 10000 Falls of Neuse Road in Raleigh is currently being transformed into a 248,800-sq. ft., full-service women’s hospital designed with the unique needs of women in mind. It will feature a tranquil environment as well as amenities tailored to our patients’ needs. This includes spacious and comfortable labor and delivery rooms. Learn more.

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Happy, Happy Baby Story

We are pleased to share that WakeMed has become the first hospital in the U.S. to successfully correct esophageal atresia – a rare condition in which a baby is born without part of his or her esophagus – without surgery. Traditionally, this condition is corrected by a difficult surgery, requiring lengthy hospitalization and an extensive recovery process. This non-invasive, breakthrough procedure was performed at Raleigh Campus last week on a seven-week-old baby girl who has been a patient in the NICU since birth.

Led by pediatric surgeon David Hoover, MD, a team of WakeMed’s interventional radiologists, neonatologists and others were able to use magnets placed by a catheter to repair the patient’s esophagus. The procedure, which was developed at the University of Chicago Medicine, was a complete success and thanks to the exceptional work of the WakeMed team, this baby girl who had been unable to swallow for the first seven weeks of her life is now eating normally and almost ready to go home.

Watch the story on WRAL.

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Pregnant Women Beware of a Different Kind of Labor Pain

As a midwife, I understand the labor pains pregnant women face nowadays. Hormones are raging, they are not getting enough sleep, and their bodies are changing.  It’s normal to experience sensory overload, but sometimes pregnant women feel pain and discomfort that has nothing to do with the actual baby. They might be hurt by comments made by those closest to them or even by strangers.

It’s a funny thing, when people see a pregnant woman…their verbal filters and personal barriers magically disappear. Everyone becomes an expert – or a comedian.  So, here is what I tell my pregnant patients to be aware of when it comes to facing the world:

1. The Baby Babble: Don’t be surprised if people ask you some inappropriate questions such as “Do you know who the daddy is?” or “Are you carrying twins in there?”  or “I can’t believe you’re still here at work. You’re huge!”  And don’t read too much into a well-intentioned compliment about how small you look. It doesn’t mean something is wrong with your baby. When you’re pregnant, people often wind up babbling and putting a foot in their mouth. They will share their childbirth experience with you whether it was wonderful or difficult. They will offer you opinions on whether you should have a natural birth or C-section.  This is your experience, and you know what’s best for you. If you have questions, talk with your healthcare provider.

2. The Grocery Store Grab: Strangers grab your stomach to feel the baby kick – “Um, hello? You’re touching ME, not my baby!”  Don’t be afraid to back up, turn away or respond with a comment such as, “I’m sorry, but please don’t touch. The baby’s ticklish.”

For those people around a pregnant woman, the best advice I can give: support her in any way you can with positive encouragement and help.  You know she can’t bend over, so help with some chores around the house. If she’s a stranger at a store, ask her if you can help her with her bags or get something off a shelf.  If she is past the morning sickness, deliver a healthy meal for her family. But most importantly be kind and remember, there is really only ONE thing to say to a pregnant woman… “YOU LOOK FABULOUS!”

Julie Stembridge, RN, MSN, CNM, is a certified nurse midwife with WakeMed Physician Practices – Women’s Center.

New WakeMed Women’s Hospital Opening May 2015
We’re counting down the weeks until the May 2015 grand opening of Wake County’s fifth full-service hospital, WakeMed North Family Health & Women’s Hospital. WakeMed North Healthplex at 10000 Falls of Neuse Road in Raleigh is currently being transformed into a 248,800-sq. ft., full-service women’s hospital designed with the unique needs of women in mind. It will feature a tranquil environment as well as amenities tailored to our patients’ needs. This includes spacious and comfortable labor and delivery rooms. Learn more.

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Pregnancy & Heart Trouble

When a typically healthy pregnant woman is asked about her heart, she is probably only thinking about it being full of love for her unborn baby.  However, pregnancy can cause cardiac problems for some women, and Dr. Sahar Amery of WakeMed Physician Practices – Raleigh Cardiology helps us learn more.  Dr. Amery is skilled in evaluating and treating women who experience heart trouble during pregnancy.

What Causes Heart Trouble during Pregnancy?
During pregnancy, the heart is impacted by the excess weight and fluid carried by a woman’s body as well as hormonal changes.  All of these factors are potential precursors to certain cardiac issues.

Know the Symptoms
Symptoms of discomfort that may be part of the normal pregnancy can also be related to potential cardiac conditions, including:

  • Easy fatigability
  • Shortness of breath
  • Chest pain
  • Rapid heart beat
  • Overly swollen feet and ankles

Most of the time, these symptoms are benign, however, talk to your OB/GYN openly about what you are feeling.  If there are concerns, he or she will refer you to a cardiologist for further evaluation. 

Common Cardiac Issues for Pregnant Women
The most common cardiac-related problems faced by pregnant women include:

  • Heart palpitations: Racing heart
  • Shortness of breath: Sometimes an underlying cause of heart failure
  • High blood pressure: Blood pressure reaches greater than 140/90 mm Hg
  • Peripartum or Postpartum cardiomyopathy: The heart weakens and cannot pump enough blood to support the body (occurs during pregnancy or right after delivery)
  • Supraventricular Tachycardia (SVT): Abnormally fast heart beat

The prognosis is good for most of these conditions.  However, medication, follow-up, a healthy diet, exercise and the avoidance of caffeine are often indicated. 

What to Expect from the Cardiologist Appointment
If you are referred to a cardiologist as a pregnant woman, you can expect a physical exam and a comprehensive review of your health history and symptoms.  In some cases, you may undergo additional diagnostic testing to identify potential cardiac problems that could be causing your discomfort. This testing will help the cardiologist determine if you have a heart condition and what treatment plan is needed.

Who’s at Risk?
While women with obesity are at a greater risk for heart complications during pregnancy, any healthy pregnant woman could develop symptoms.  Therefore, being aware of your heart health and open communication with your doctor will help ensure the delivery of a happy, healthy baby. 

Dr. Amery sees patients at WPP-Raleigh Cardiology on the WakeMed Raleigh Campus and at the WakeMed North Campus, where the WakeMed North Family Health & Women’s Hospital will open in May 2015.

New WakeMed Women’s Hospital Opening May 2015
We’re counting down the weeks until the May 2015 grand opening of Wake County’s fifth full-service hospital, WakeMed North Family Health & Women’s Hospital. WakeMed North Healthplex at 10000 Falls of Neuse Road in Raleigh is currently being transformed into a 248,800-sq. ft., full-service women’s hospital designed with the unique needs of women in mind. It will feature a tranquil environment as well as amenities tailored to our patients’ needs. This includes spacious and comfortable labor and delivery rooms. Learn more.

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Are Women Athletes More Likely to Tear their ACL?

It is true that we see an increasing number of knee injuries in female athletes, especially in those who participate in basketball, soccer and volleyball. The ACL is one of the four major ligaments of the knee and acts as a stabilizer between the thigh (femur) and the shin (tibia), restraining forward motion of the shin.

Females who perform jumping, cutting and pivoting sports are 3 to 8 times more likely to tear the ACL than their male counterparts. The majority of ACL injuries occur without contact or a direct blow. Athletes often report landing awkwardly and the sensation of the knee giving out with an associated “pop”. When there is significant knee pain and swelling after this type of sports injury, there is a 75% chance the ACL has been torn. 

Females have multiple unique factors that increase their risk for ACL tears. Women have weaker hamstrings relative to their quadriceps muscles, which may affect the knee stability and the stress on the ACL. Other theories include differences in anatomy and hormones. Some studies have indicated that a female’s body mechanics move differently than males. For instance females jump and land with the hip and knee less flexed than males. Research has shown that specialized training programs in female athletes that focus on these factors will significantly reduce the risk of ACL tears. Conditioning and training are the keys to preventing ACL injuries. In general, all athletes should:

  • Always warm up correctly before playing sports or working out – especially stretching the hamstrings, quadriceps, calves and hip flexors.
  • Strengthen leg and core muscles with correct techniques.
  • Add speed and flexibility training to your program.
  • Learn proper landing, pivoting and jumping techniques.
  • Cross-train between sports and allow time for rest to avoid overuse injuries.
  • Contact an Orthopaedic Sports Medicine Doctor or Physical Therapist for further assistance.

Dr. Mark Wood is an orthopedist at Wake Orthopaedics who specializes in sports medicine.

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