Often called the stomach bug or the stomach flu, viral gastroenteritis is an illness that is quite common throughout the year, but especially throughout the winter months. Symptoms include nausea, watery diarrhea, vomiting, sometimes a fever and malaise, or a general feeling of discomfort.  Most symptoms last for about 24 to 48 hours, but sometimes they may last for up to 72 hours.

Viral gastroenteritis is very contagious.  If someone in your family has it, it is likely others will get it, especially those who are caring for a sick person or cleaning up after them.  The illness is spread through contact with vomit or stool, contaminated food or water, direct contact with an infected person, and contact with surfaces touched by an infected person, such as doorknobs, faucet handles or toilet flush handles.

A person may be contagious before showing symptoms of the virus, though onset of symptoms is very quick, within one to two days. Patients may continue to be contagious for two to three weeks, but the virus is more likely to be spread during the active phase of vomiting or diarrhea.

Prevention & Cleaning
Viral gastroenteritis is often resistant to hand sanitizers. The best method of prevention is washing your hands frequently and thoroughly with warm water and soap. Cleaners with bleach are best for killing these particular viruses, and gloves may be worn to make clean-up easier and to decrease risk of exposure to the virus.

Treatment
The best method of treatment is to drink, drink, drink.  Lots of fluids are key, especially water, but also some sports drinks or broths can be tolerated. The sugar in juice or soda could make your stomach feel worse and cause more diarrhea, so if drinking these, water them down significantly.    

Additionally, get lots of rest to help restore your energy level, and slowly introduce foods back into your diet. Start with bland foods such as toast, applesauce or chicken noodle soup. Eliminate milk and dairy from your diet initially, and slowly introduce it back after several days. Also try to avoid food heavy in fat until you are feeling better, as these can cause more difficulty with digestion.

Risk of Dehydration
Especially in children, gastroenteritis can cause dehydration.  This is why it is so important to keep drinking. Signs of dehydration include:

• No tears when crying
• Decreased urination
• A dry tongue
• Listlessness

If your child is sick and refuses to drink, you can feed him or her very small amounts of water or Pedialyte via a syringe every 10 minutes over the course of an hour or two until he or she feels good enough to drink more. Concern about dehydration is definitely a reason to call your doctor’s office for advice and next steps. Depending on the severity of illness, your child may need to go to the emergency room for an IV of fluids.

Other Reasons to Call the Doctor
If symptoms last for more than 72 hours and are getting worse or not improving, if abdominal pain is severe, if you are unable to tolerate fluids by mouth, or if you are otherwise concerned about your symptoms, call your doctor’s office for further advice.

Dr. Laura Ekka is a physician with WakeMed Physician Practices – Garner Primary Care. Learn more about the primary care and urgent care services offered by WakeMed Physician Practices.

There are many things you can do to help prevent illness, hand washing being one of the top strategies. However, it is also important to be aware of the objects that are considered “high-touch” – objects that people frequently touch and are agents in spreading a lot of germs. WakeMed’s Melinda Cooper, RN, BSN, CIC, infection preventionist and public health epidemiologist, and Lance Hoover, manager of WakeMed Environmental Services, helped us identify these objects and learn more about how to appropriately manage use of them.

High-touch objects are found everywhere, such as public places, offices, hospitals, hotels, churches, and even your home. These objects include, but are not limited to:

• Remote control
• Door knobs, especially bathroom door knobs
• Doors
• Refrigerator door handle
• Toilet flush handle
• Sink faucet handles
• Light switches
• Toilet seat
• Phone
• Staircase and escalator railing
• Computer keyboard/mouse
• Copier/printer buttons 
• Gas pump handle
• Shopping cart handle
• Elevator buttons
• Money – dollars and coins

Illnesses that are commonly spread via high-touch objects include MRSA, cough and cold viruses, flu virus, rhinoviruses, staph infections, and germs that cause diarrheal illnesses such as norovirus. Some illnesses can live on these objects for days, and even weeks.  Touching them is often unavoidable but there are things you can do both at home and in public to help avoid infection.

• Clean them! Use a bleach-based disinfectant mixed at the appropriate concentration to clean high-touch objects in your home.  Be sure to check the label and read instructions for proper use.  For example, many cleaning agents need time to dry (i.e. 10 minutes) before effectively killing germs.
• Don’t inoculate yourself. When in public, avoid touching your eyes, nose and mouth.
• Use a barrier, such as a shirt sleeve, paper towel or scarf, when opening door handles or using other high-touch objects.
• Wash your hands with warm water and soap or use an alcohol-based hand gel whenever and wherever possible, especially before eating and drinking or putting anything in your mouth.

Simple strategies like these can help combat illness and keep a lot of germs at bay. Here’s hoping everyone out there is staying as healthy and well as possible!

Everybody knows the first thing you do when the meteorologist calls for winter weather – like they are tonight and tomorrow – is to run to the grocery store (along with the rest of the city) to buy staples to get you through the storm.

The list of staples includes the obligatory milk, eggs and bread.  The most popular thing to make with this combination of ingredients is of course French toast, which we can all agree is not the healthiest of breakfasts.  We asked Café 3000 Chef Rob Newmeyer to help us make French toast that is a little better for you but still delicious.

This is the same recipe that will be featured tomorrow morning (January 14) in Café 3000 in celebration of this winter’s first frozen precipitation.

Thanks Chef Rob for the healthy inspiration!

Healthier French Toast

• 2 large egg whites
• 1 large egg
• 3/4 cup low-fat (1-percent) milk
• 1/2 teaspoon salt
• 1/4 teaspoon ground cinnamon
• 1/4 teaspoon ground nutmeg
• 1/4 teaspoon vanilla extract
• 2 teaspoons butter or trans-fat-free margarine
• 8 slices firm whole-wheat bread

Beat the egg whites, egg, milk, salt, cinnamon, nutmeg and vanilla with a whisk until blended.  In a nonstick skillet or a well-seasoned cast iron skillet, melt a teaspoon of butter or trans-fat-free margarine over medium heat.

Dip bread slices one at a time in the egg mixture, pressing the bread lightly to coat well on both sides. Place 1 to 2 slices into the skillet to cook until lightly browned.  This will take about 3 to 4 minutes. Flip the toast and cook until lightly browned on the second side, again this will take about 3 to 4 minutes.

Cut strawberries and fresh blueberries make a nice healthy topping for French toast!

Did you know that WakeMed has one of the very few human milk banks in the United States?  Neither did Kelli Russell until the birth of her second baby resulted in a significant oversupply of breast milk.

Happy First Birthday, Holden!

Even when her son was sleeping through the night, Kelli still had to pump due to an oversupply.  This extra pumping resulted in more than 3,000 ounces of milk over the course of a year.

Instead of letting all of that hard-earned liquid gold go to waste, Kelli began researching human milk banks.  She learned that there was one just down the road from her home in Washington, North Carolina at WakeMed.

Kelli’s extra effort and big heart has provided access to life-giving milk for fragile, premature infants in more than 44 hospitals thus far.

For tiny premature infants, having a steady supply of human milk can make all the difference for their immature gastrointestinal systems.  Many moms of premature babies have difficulty establishing a supply of breast milk due to the early birth of their babies.  Human breast milk banking helps to fill the gap from birth to when the milk supply is established.  Sometimes mom of premature babies are unable to breastfeed and donor milk provides the sole source of nourishment.

Today, Kelli’s son turns one – Happy Birthday Holden - and in addition to celebrating, Kelli will be mailing off her last donation to the Milk Bank.  Thank you Kelli and to all of the other moms who have shared their gift with babies other than their own.

If you find yourself with an oversupply of milk like Kelli, please do not throw it away.  Consider donating it to the WakeMed Mother’s Milk Bank to help other babies grow and thrive.  Learn more about donating today.

Due to the widespread outbreak of flu in this area, WakeMed is restricting visitation in all patient care facilities in an effort to protect patients, visitors and employees from illness.  Effective Friday, January 9, the following visitation restrictions apply to all WakeMed patient care facilities:

• No visitors under the age of 12 are permitted without prior approval from a WakeMed health care provider.  (Any limited exceptions to the restrictions may be considered on a case-by-case basis, after the risk to the patient has been fully evaluated and discussed with the patient and their family or significant other.)
• Each patient is limited to two adult visitors at a time.
• WakeMed staff asks all visitors not to visit patients if they are ill. Symptoms of concern include: fever, cough, sneezing, runny nose, sore throat, vomiting or diarrhea within the past 24 hours. WakeMed staff will direct any ill family members or visitors to please return home.

For more information about flu, visit our Flu Resource Center and read these blogs:

• Flu-Like Symptoms? What to Expect from the Doctor’s Visit
• In the Season of Flu, Help Boost Your Immunity
• Dispelling Flu Myths

Also, read a special message for our expectant moms and families about the visitation restrictions.

The flu is running rampant in our community.  In fact, it is “widespread” in our community and the vast majority of the country according to the U.S. Centers for Disease Control.
 
We have received several emails from patients and family members expressing concern about their experience in the emergency department not being what they expected.  We asked Dr. David Dubow, an emergency department physician with Wake Emergency Physicians, to help us understand what patients visiting a healthcare provider with flu-like symptoms can expect.  Here are his answers to our questions:

Should I seek medical care if I think I have been EXPOSED to the flu?
The flu is a highly contagious virus, but exposure to a sick person does not mean you will get the flu.  The best thing to do if you have been exposed to the flu is to watch and wait for symptoms to appear and then treat the symptoms.  Of course, if you have an underlying chronic health condition like COPD, asthma or are very old or very young, it never hurts to consult your primary care physician for advice.

Should I seek medical care if I think I HAVE the flu?
Since the flu is a virus there is very little doctors can do to help you through.   In other words, if you have the flu, we can’t fix the problem or make you feel better quickly.   We’ll probably mostly recommend rest, hydration, and a healthy diet to help get you well as soon as possible.  There are a few things we can do, however:

• We Can Confirm You Have the Flu
  We can confirm that you actually have the flu using a swab test, which is fast but not very accurate.  Many doctor’s offices and urgent care offices use this kind of fast antigen test.  In the hospital emergency department, we use a much more accurate test but it takes about 3 to 4 hours to receive the results, so often we opt not to run the test if the patient is at low risk for complications and is not being admitted into the hospital.  As physicians, we often diagnose the flu based on prevalence in the community and symptoms (If it looks like the flu, smells like the flu and acts like the flu, it probably is the flu and there is no reason to make patients wait hours for a result that won’t change the treatment plan.)

 

• We Can Recommend Medications to Control the Symptoms
  We can recommend medications and medication dosages to help manage the symptoms of flu.  We may also prescribe a medication called Tamiflu, which is an antiviral that may reduce the symptoms of the flu on the back end by about a ½ a day.  There are catches with Tamiflu.  The side effects can be bad – nausea, vomiting and diarrhea.  Add these side effects to the symptoms of the flu itself and you may wish you just had the flu for a little longer instead of suffering through the combined misery. Tamiflu is right for some people, however, who have chronic medical conditions and are likely to develop complications from the flu.  These patients include those with COPD, asthma, emphysema, cancer, heart disease, other chronic health conditions or those who are very old or very young.Please do not be disappointed if your doctor does not offer you a prescription for Tamiflu – instead rejoice.  No prescription means you are healthy enough to fight the illness on your own and the side effects are not worth the few benefits Tamiflu may deliver.

When should I come to the emergency department?
As always, come to the emergency department if you think you are having a medical emergency.  The American College of Emergency Physicians (ACEP) offers a list of warning signs that indicate a medical emergency.  These warning signs include:
 
•         Difficulty breathing, shortness of breath
•         Chest or upper abdominal pain or pressure
•         Fainting, sudden dizziness, weakness
•         Changes in vision
•         Confusion or changes in mental status
•         Any sudden or severe pain
•         Uncontrolled bleeding
•         Severe or persistent vomiting or diarrhea
•         Coughing or vomiting blood
•         Suicidal feelings
•         Difficulty speaking
•         Shortness of breath
•         Unusual abdominal pain

If you have a question about the flu you would a physician to answer, please either comment here or email us at info@wakemed.org.

Blueberries contain antioxidants which are helpful in boosting the immune system.

Flu season is officially here. In fact, the Centers for Disease Control & Prevention (CDC) has confirmed that the illness is widespread throughout 43 states, including North Carolina. For the week of December 29 through January 5, WakeMed reported 240 cases of positive flu diagnosis.

This year, the influenza A H3N2 strain of the virus is particularly prevalent and has mutated or changed since being included in the flu vaccine. In past seasons during which this occurred, decreased vaccine effectiveness was observed. However, it is still critically important to receive your flu vaccine. The flu vaccine still provides protection against other strains of flu, such as H1N1 and Influenza B, and it also essentially “teaches” your body how to make the antibodies needed to fight the flu, which is paramount.

In addition to receiving the flu vaccine, there are some things you can do to help protect your body from illness and give your immune system an added boost. WakeMed Cary Hospital clinical dietitian Parul Kharod offered this helpful advice:

• If you are a smoker, try to stop smoking.
• Make sure you are getting regular exercise.
• Get an adequate amount of sleep; 7 to 8 hours a night for adults and a few hours more for children.
• Reduce your stress level through such practices as meditation or yoga.

“Anything that you can do to help reduce infammation in your body will be beneficial to your immune system,” explained Kharod.

In terms of nutrition and diet, Kharod said that these elements are key:

• Reduce or eliminate the amount of sugars and trans-fats that you eat.  This includes processed and fast foods.
• Increase the amount of antioxidants that you eat.  Antioxidants can be found in berries and any fruit or vegetable that has natural color. Many herbs and spices also contain antioxidants, such as ginger, cinnamon and turmeric. 
• Eat fruits and vegetables that include vitamin C, such as citrus fruits and red peppers.
• Eat more whole grains, such as oats, barley and rye.  Processed grains introduce more starch which leads to more sugar.
• Get your fill of omega-3 fatty acids, which are found in fish, flaxseed, pumpkin seeds and sunflower seeds.
• Nuts and beans include lots of minerals and vitamins.  Eat more of them!
• The greater variety of food that you eat, the better as you will introduce more minerals and vitamins into your diet.

“More and more research has shown that you should get your immune-boosting vitamins and minerals directly from food, as opposed to taking a daily vitamin or other supplement,” added Kharod.

And of course regular and thorough hand washing is always strongly recommended when it comes to avoiding germs.

Learn more about the flu and strategies for helping to prevent illness on our website.  We hope you and your family are able to stay healthy and well!

For our posts on WakeMed Voices, we regularly consult with WakeMed experts – doctors, nurses, nutritionists, chefs and other highly skilled specialists – for advice and insider information on a wide variety of health-related topics. Today, we pull from 15 of our past blogs to create a list of things you can do in 2015 to promote better health and improve your personal well-being, as well as the health and well-being of those around you.  We hope this advice will help you jumpstart a healthier and safer year ahead.  Best wishes for a great 2015!

• Eat more fruits and vegetables that are locally grown and in-season.
• Consider the Mediterranean Diet, which involves centering your meals around fruits, vegetables, whole grains, nuts and beans.
• Manage your stress by knowing your limits and practicing relaxation techniques such as mediation, yoga or walking. 
• Be more mindful and pay closer attention when driving, especially in neighborhoods where kids are waiting for or getting off the school bus.
• Wash your hands often and learn how to wash your hands more effectively.
• Drink more water and remember not to drink your sugar and calories.
• Incorporate more superfoods into your diet, such as the aronia berry and the blueberry.
• If you don’t know how, learn how to swim and ensure your kids learn how to swim as well. 
• Protect your skin from the sun’s harmful rays by using sunscreen and other methods of sun protection, such as hats and visors.
• Think more carefully about your hearing and how to protect it.
• If you are a parent, grandparent or caregiver, teach children about health and wellness from an early age.
• Educate yourself on the dangers of heat stroke and learn strategies that will remind you never to forget to leave a child behind in a hot car. 
• Learn how to recognize and properly react to the signs of a stroke.
• Eat healthy and stay active, especially if you suffer from congestive heart failure or another heart condition. 
• Always remember to celebrate life and be thankful!

In 2014, we opened our newly renovated and expanded neonatal intensive care unit.

As one year ends and another is set to begin, we feel thankful to have the physicians, specialists, nurses, staff, volunteers, resources and community support that allow us to continue working toward our mission of improving the health and well-being of our community by providing outstanding and compassionate care to all. Looking back at 2014, we are proud of all that has been accomplished and all that has changed at WakeMed: 

• In May, we officially welcomed our new president and chief operating officer, Donald R. Gintzig. Our entire organization has been re-energized in the wake of his enthusiasm, ideas, and devotion to WakeMed’s mission and vision.
• We also started construction on WakeMed North Hospital, located on our North Healthplex campus.  The new hospital is scheduled to open in May 2015 and will be a 61-bed, full-service women’s hospital designed with the unique needs of women in mind. North Hospital will feature amenities tailored to our patients and will offer women of every age throughout northern Wake County, and the surrounding communities, access to a wide variety of exceptional health services.
• In February, we opened our newly renovated and expanded neonatal intensive care unit (NICU). Our NICU now offers 48 patient beds, including 27 private rooms. Single-room care in the NICU represents an extension of WakeMed’s focus on patient- and family-centered care to our tiniest patients.
• This year we also implemented the WakeMed MyChart electronic patient record system, a method for our patients to track their medical records, communicate with their doctors, view test results, and request prescription refills and appointments online.
• Throughout the year, our organization and employees were honored with a multitude of awards including, but not limited to, top honors from the American Heart Association and the American Stroke Association for a higher standard of care for our heart and stroke patients; one of our nurses being named to The Great 100 Nurses of North Carolina; the 2014 BEST Award for Commitment to Employee Learning; the Triangle Business Journal’s Women in Business, Healthcare Heroes and Healthiest Employers of the Triangle awards; the Gold Star Award for Implementing Tobacco-Free Best Practices from N.C. Prevention Partners; and the American College of Cardiology’s NCDR ACTION Registry-Get With the Guidelines Platinum Performance Achievement Award for 2014.
• In light of the international Ebola crisis, we trained many employees on Ebola preparedness and readied our hospitals with detailed plans and protocols should the virus come through our doors. In fact, representatives from the North Carolina Division of Public Health, the Centers for Disease Control & Prevention (CDC) and the North Carolina Office of EMS (NCOEMS) traveled to WakeMed and assessed our Ebola plans. They gave us high compliments for the extensive work and planning that has been completed within our organization and expressed that they feel we are in a very good place with our preparations.
• This summer, we opened the first installment of the WakeMed Farmers’ Market on our Raleigh Campus to employees and local residents. Each summer, the market will offer fruits, vegetables and other locally made goodies in an effort to help promote health and wellness throughout the community.
• Also this summer, we successfully hosted our third WakeMed Scrub Run, a 5K/10K race and community event benefiting WakeMed Children’s.
• And much, much more…

WakeMed North Hospital is scheduled to open in May 2015.

However, during this time, we do not only look back. We look forward to all that 2015 will allow us to offer our patients and this community. We look forward to the opening of the new North Women’s Hospital and to the renovation and expansion of the Women’s Pavilion & Birthplace on our Raleigh Campus. We look forward to another Scrub Run, another Farmers’ Market, and more community events and health screenings. We look forward to helping more parents welcome their new babies into the world and to offering each and every one of our patients outstanding and compassionate care. During this time, we wish you all a happy and healthy 2015 and hope you will remember that we are always here if you need us.

Let’s all follow Dr. Alexander’s lead and take a stand against child abuse – together as a community!  We can start by sharing this article as often as possible.

Read Dr. Alexander’s Thoughts Here

Tristan Blue