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New 3D Mammography Offered at WakeMed Cary Hospital

This October, as we observe Breast Cancer Awareness Month, WakeMed has begun offering 3D mammography at Cary Hospital. While traditional 2D screening mammography is a valuable tool in the early detection and diagnosis of breast cancer, 3D mammography has been shown to improve breast cancer detection by providing a more detailed, complete view of the breast tissue. Doctors and scientists agree that early detection is the best defense against breast cancer, and 3D mammography (also called breast tomosynthesis) is the newest technology in the fight against this disease. 

What is 3D Mammography?
The breast is a three-dimensional body part composed of different structures, such as blood vessels, milk ducts, fat and ligaments. All of these structures can overlap and cause confusion or create the illusion of an abnormality when the breast is viewed as a two-dimensional, flat image.

Performed in conjunction with a traditional 2D digital mammogram, the 3D mammogram uses high-powered computing to convert digital breast images into a stack of very think layers or slices. The 3D technology creates a more complete picture of the breast that allows radiologists to see inside the breast with a more accurate, layer-by-layer view.

“In the past, if the radiologist saw an area that was questionable, the patient would have to return for additional imaging,” said Libby Dore, director (Imaging Services – Cary Hospital). “With 3D mammography, the breast tissue can be seen in smaller, thinner sections, often making the ‘second look’ unnecessary.”

It has been proven that 3D mammography finds cancers earlier than 2D mammography alone, with a 27 percent increase in cancer detection and a 40 percent increase in invasive cancer detection. It is recommended for all breast types but is especially beneficial for patients who have dense or very dense breasts.

What to Expect During a 3D Mammography Exam
A 3D mammography exam is very similar to a traditional mammography exam. The technologist will position the patient, compress the breast under a paddle and take images from different angles. There is no additional compression required with 3D mammography, and it only takes a few seconds longer for each view. Very low X-ray energy is used during the exam.

The technologist will view the images on a computer to ensure adequate information has been captured for the radiologist to review.  The results will either be reported to the patient directly or to the patient’s physician.

Screening mammography does not require a physician order.  Call Cary Hospital at 919-350-7000 to schedule an appointment.  Insurance rates vary, so check with your provider for your plan’s specific coverage.

For more information on breast health, visit the American Cancer Society or Women’s Services at WakeMed.  And remember, early detection is key!

Resources

  • American Cancer Society, Facts and Figures 2012.
  • Rafferty EA, Park JM, Philpotts LE, et al. Assessing Radiologist Performance Using Combined Digital Mammography and
    Breast Tomosynthesis Compared with Digital Mammography Alone: Results of a Multicenter, Multireader Trial. Radiology.
    2013 Jan; 266(1):104-13. Epub 2012 Nov 20.
  • Philpotts L, Raghu M, Durand M, et al. Initial Experience With Digital Breast Tomosynthesis in Screening Mammography.
    Presented at the ARRS 2012, Scientifi c Session 22 – Breast Imaging: Screening/Emerging Technologies.
  • Haas B et al. Performance of Digital Breast Tomosynthesis Compared to Conventional Digital Mammography for Breast
    Cancer Screening. Radiological Society of North America annual meeting. Chicago, Il, 2012.
  • Skaane P, Bandos A, Gullien R, et. al. Comparison of Digital Mammography Alone and Digital Mammography Plus
    Tomosynthesis in a Population-based Screening Program. Radiology. 2013 Jan 7 [Epub ahead of print].
     

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Make it a Hauntingly Healthy Halloween

This Friday is Halloween, the black and orange, candy-filled holiday that brings out the festively spooky side in many of us.  If you are planning to participate in trick-or-treating festivities this Friday, help your children and the children in your neighborhood make better choices by offering healthier snacks and fun giveaways instead of sweets that are full of sugar and fat.

Julie Paul, a registered dietitian with WakeMed Children’s Endocrinology & Diabetes, commented that no candy is really great for you. “You do not get nutritional value out of candy. This Halloween, focus on the experience instead of the candy. Seek out special Trunk-or-Treat events in your community, visit a pumpkin patch or farm, decorate your house, dress up your pets, carve a spooktakular pumpkin, or make a really creative costume.”

And when considering the candy that is collected while trick-or-treating, do not allow children to go on a candy binge on Halloween night or the day after. Ask them to pick out a few treats and put the rest away for later. Better yet, give them the option to trade the candy in for a special toy or privilege. Most children eventually forget about the candy, and parents, this is also not an open invitation to take care of the leftovers yourself, advised Paul.

Non-candy giveaways that kids enjoy include:

  • Glow sticks, bracelets, necklaces
  • Gel pens
  • LED finger lights
  • Bracelet- or necklace-beading kits
  • Coloring pages or coloring books
  • Wind-up toys
  • Silly straws
  • Pencils or crayons
  • Stickers

If food is your preference, these treats are better choices than candy:

  • Animal crackers
  • Small packages of Goldfish or other crackers
  • Individually wrapped granola bars
  • Sugar-free hot chocolate packages
  • Microwave popcorn 100-calorie packs
  • Pre-packaged apple slices
  • Scarrots – Baby carrots repackaged for Halloween

The Teal Pumpkin Project
For some children and parents, no candy is the only option due to a child’s food allergies and sensivities. While out trick-or-treating on Friday, these families will be looking for a teal-colored pumpkin on their neighbors’ front porches or outside the front door. A teal pumpkin – teal being the color of food allergy awareness – is a sign that a neighbor is giving out safe, non-food treats for children. Examples of non-food treats are included above. 

For more information about The Teal Pumpkin Project, visit www.foodallergy.org/teal-pumpkin-project. The Teal Pumpkin Project helps keep Halloween a fun, safe and positive experience for all.  The project also accepts donations toward their mission of finding a cure and keeping individuals with food allergies feeling safe and included.

Pediatric Gastroenterology Services at WakeMed
WakeMed now offers pediatric gastroenterology services, providing care for children with GI conditions related to food allergies. Whether it’s a gluten allergy/sensitivity, lactose intolerance or another food-related GI problem, our team, led by Sachin Kunde, MD, MPH, at WakeMed Physician Practices – Pediatric Gastroenterology, can help your child avoid the uncomfortable and sometimes dangerous symptoms associated with food allergies. Call for an appointment today! 919-235-6435

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The Truth about Antibiotics

It is common for people to think that their doctor will prescribe them an antibiotic to “cure” a cold, influenza (flu) or bronchitis, and they are surprised when their doctor does not. The truth is health care providers should not and usually do not prescribe antibiotics. Antibiotics only work against bacterial infections. Almost all colds and bronchitis infections are caused by viruses, not bacteria.

So why not at least give antibiotics a try? For years, health care providers have admittedly over-prescribed antibiotics for colds and bronchitis. Many patients have had experiences where they were prescribed an antibiotic and felt much better in a few days. But studies have consistently shown that people who were prescribed a sugar pill got better at the same speed as those patients on antibiotics – the body simply healed itself, although the patients were giving credit to the antibiotics.

Doctors are becoming much more careful about prescribing antibiotics because they are powerful medicines that can actually cause harm, both to the individual patient and to society. Antibiotics have many potential side effects such as diarrhea (including episodes caused by a potentially life-threatening strand of bacteria, clostridium difficile), vaginal yeast infections, allergic skin rashes and anaphylaxis (swelling of the airways). Any time a medication is prescribed, the physician and patient need to review if the benefits of a certain medication outweighs its risk.

A recent study helped to clarify the risks and benefits of antibiotic use for upper respiratory tract infections. The study found there is about a 1 in 4,000 chance an antibiotic will prevent a serious complication, a 5 to 25 percent chance it will cause diarrhea, and about a 1 in 1,000 chance a person will wind up in an emergency room from a bad reaction to the antibiotic. The risks simply do not justify the benefit.

Resistance is another very important reason for not prescribing an antibiotic for a virus. We all have bacteria that we naturally carry in our bodies (such as in our nose and throat). This bacteria is “good” bacteria that protect us from infection and illness. When you take antibiotics for a virus, the bacteria in your body becomes resistant to the antibiotics. What can this mean? In the future, if you have an actual bacterial infection, the antibiotic may not work. And, you can spread antibiotic-resistant bacteria to the people around you. In fact, there now exist bacteria such as methicillin-resistant staphylococcus aureus (MRSA) that are resistant to antibiotics and pose a concern for communities at large. There are serious concerns that, in the future, we will be unable to treat certain bacterial infections due to resistance that has developed from inappropriate use of antibiotics.

There are times when symptoms of a potential bacterial infection are present and antibiotics are appropriate. Your doctor can guide you through the decision process. If an antibiotic isn’t the right medication for you, talk to your doctor about over-the-counter and home remedies that may help. If your symptoms continue for a week or two, or suddenly get worse, go back to your doctor for help.

If you do not already have a primary care physician, visit www.wakemedphysicians.com and learn more about our primary care physicians located throughout Wake County.

Dr. John Holly is a primary care physician with WakeMed Physician Practices – Brier Creek Medical Group.

Dr. Brian Klausner is a primary care physician with WakeMed Physician Practices – City Center Medical Group.

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Why Do I Get Sinus Headaches When the Weather Changes?

Your sinus headache could be caused by changes in the weather or more precisely changes in environmental pressure.  Most often, sinus headaches are associated with low pressure weather systems.
 
Your sinuses are an extensive network of tiny tubes leading to the nasal cavity.  These tubes, when your sinuses are healthy, are filled with air and have a clear opening into your nose.  If the opening to these tubes is obstructed and a low pressure system rolls in, there is a pressure differential between the air inside your sinuses and the air in the outside environment.  This pressure differential can result in a sinus headache.
 
For those of you reading this blog who already have a headache, I’ll cut straight to the chase.  Your best course of treatment is to take an over-the-counter oral decongestant like Sudafed® and use an over-the-counter saline or medicated nasal spray.  The goal is to reopen the sinuses and relieve the pressure differential.
 
If you do not currently have a headache, you can take some precautionary measures to help prevent future pain by regularly using a saline nasal spray or irrigation system.  We, in the ENT community, are big fans of saline washes because they can help keep the sinuses healthy by flushing out the allergens and pathogens that can cause swelling of the nasal passages.  Saline nasal sprays can also thin mucus secretions, lessening the chances of a blocked sinus opening or tube.  
 
If you find that your sinus headaches persist even after taking these steps, you may want to consult a physician as you may be a candidate for prescription medication. 
 
Dr. Michael Ferguson is specialist with WakeMed Physician Practices – Ear, Nose & Throat.  He treats adults and children of all ages for a range of ear nose and throat issues including sinus disease, thyroid problems and cancers of the head and neck.

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WakeMed’s Cardiac Rehab Program Receives Generous Gift

Michael Dean Chadwick (third from left) with caregivers from the WakeMed Cardiac Rehab Program

WakeMed would like to thank former cardiac patient Michael Dean Chadwick and Advancing the Heart for the generous gift of 25 wristwatch-style heart monitors that will be used by patients of the WakeMed Cardiac Rehab Program. Valued at $50 each, the monitors will remain with the program so that multiple patients can use and benefit from them. The monitors will allow staff to receive an exact reading on a patient’s heart rate while he or she is exercising, in addition to allowing the patient to monitor him/herself during exercise. 

WakeMed Cardiac Rehab offers a safe, monitored environment where patients can gain the strength, confidence, camaraderie and nutritional knowledge needed to live a heart-healthy lifestyle. Patients of this program have experienced or are managing a recent heart attack, cardiac bypass surgery, an angioplasty or stent placement, valve repair or replacement surgery, a heart transplant, stable angina or heart failure. 

Chadwick himself graduated from the WakeMed Cardiac Rehab Program on Friday, October 10, after about five months of participation. Through his experience, he was inspired to make a donation and spoke with nurse Lynne Boyd about what he could do to help support the program and the many cardiac patients it serves. Chadwick’s donation was made possible through Advancing the Heart, a 501 (c) (3) organization that works to positively impact lives through innovation in cardiac technology, education and advocacy.

“Sometimes you want to say thank you, and flowers just don’t do it,” commented Chadwick. “These monitors will offer very powerful information and can be used to help many [cardiac rehab patients] for years to come.”

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Safety at the Bus Stop – Critical Advice for Parents & Morning Commuters

No child should ever have to fear for his or her safety while waiting for the school bus.  But in recent weeks, too many children have ended up in the emergency room instead of their school building due to a preventable accident at the bus stop.

“We’ve seen multiple children here at WakeMed after bus stop accidents in the past few weeks – in fact, four in the past month,” said Dr. Amy Griffin, an emergency physician with the WakeMed Children’s Emergency Department.  “Drivers are whizzing past school buses, ignoring school bus lights or driving too fast to stop when children are making their way to the bus.”

Dr. Griffin offered the following tips for parents:

  • Educate your children about bus stop safety – never step into the street while waiting for the bus, always assume that the passing car does not see you, always be on the defensive and pay attention when it comes to passing cars, and always look both ways before crossing the street to enter the bus.
  • Because many children wait for the bus in the dark, dress your children in reflective clothing and even put reflective tape on their backpacks.
  • Supervise your children at the bus stop yourself or ensure that an adult is always at the bus stop to provide supervision.

Additionally, Dr. Griffin offered critical advice to morning commuters:

  • Be aware that school bus stops are everywhere these days, not just in residential neighborhoods.  Always drive the speed limit and with extreme caution, especially in the morning when kids are out waiting for the bus.
  • Always be aware of an upcoming school bus and slow down, even if the bus is not stopped or does not have its lights on.
  • Always be observant of your surroundings, and slow down when you see children nearby.
  • Never assume that a child who is waiting for the bus sees you.

If the unthinkable should happen and a child is hit at the bus stop, “Call 9-1-1 immediately. Bend down to comfort the child but do not attempt to move the child, and leave his or her head on the ground.  This is important in helping to avoid spinal injury,” said Dr. Griffin.

Caution, speed and awareness are all important factors when it comes to driver and bus stop safety.  Please heed this advice, and help make our community a safer place.  The WakeMed Children’s Emergency Department is located at 3000 New Bern Avenue in Raleigh.

For more information about school bus safety, read these past blogs:

Bus Stop Teachable Moment

Wake County Schools Bus Routes & A Few Safety Tips

Danger at the Bus Stop Comes a Little Too Close to Home

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October is a Time to Think About Hearing Protection

October is National Audiology Awareness Month & National Protect Your Hearing Month. If you have concerns about your hearing, now is the time to receive a complete audiological evaluation through WakeMed Physician Practices (WPP) – ENT, Head & Neck Surgery.  Our experienced ASHA-certified audiologists will make the appropriate recommendations for hearing amplification, and if necessary, they will help you obtain, fit and learn to use hearing aids while considering your personal needs and lifestyle.
 
“It’s important to get an evaluation if you have a concern. Untreated hearing loss has been linked to depression, isolation and withdrawal. Your ability to understand speech can also deteriorate over time. Sensorineural  hearing loss (hearing loss in the inner ear) is permanent, and over time, it can get worse,” advised Genevieve Spiliopoulos, MS, CCC-A, F-AAA, a board-certified audiologist with WPP – ENT, Head & Neck Surgery.  “The more access you have to sound, the more connected you are to the world around you.”
 
She added, “Many people have the misunderstanding that hearing aids are only for older people, but this is not true.  A lot of young professionals use hearing aids. They are much smaller now in addition to being sleek, modern and discreet.  You can even stream music, your phone or your TV through them.”   

Protect Your Hearing 
Even if you do not have any concerns about your hearing, this month is a good opportunity to think about ways you can protect your hearing and help avoid any future loss.  According to the American Academy of Audiology, approximately 36 million Americans have hearing loss and one in three developed this loss as a result of noise exposure.
 
Many familiar sounds can put you at greater risk for noise-induced hearing loss, such as:

  • Recreational sports
  • Mowing the lawn
  • Attending a concert
  • Gun shots
  • Car races
  • Fireworks
  • Car stereos or iPods® at full blast
  • Sirens
  • Planes taking off
  • Playing in a band (especially kids!) or orchestra 

It is important to know that sounds can become harmful if they are too loud and last too long or if they are very loud and sudden. Noise should never be painful or make your ears ring, and you should never have to shout over background noise to be heard. Additionally, if you have decreased or muffled hearing for several hours after exposure, there is reason for concern.
 
Luckily, there are ways you can help protect your hearing if you are ever in a situation that presents loud noise.

  • Wear hearing protection, such as ear plugs. If ear plugs are something you think you may need for your daily life, work and/or hobbies, you can have them custom-fitted through WPP – ENT, Head & Neck Surgery.
  • Turn down the volume on your car stereo, iPod/MP3 player, radio and TV to a reasonable level.
  • Walk away from the noise! Keep as much distance as possible between you and any loud source of noise.
  • Never put anything in your ear, with the exception of hearing protection.

For more information on hearing loss and how to protect your hearing, visit www.HowsYourHearing.org. Learn more about WPP – ENT, Head & Neck Surgery, and find a location near you, by visiting our website.  We evaluate and treat all ages, including infants, children and geriatric adults.  And remember, if you have concerns about your hearing, don’t wait another minute to schedule a hearing evaluation.
 
Resources:
 
“Facts About Noise-Induced Hearing Loss” handout by the American Academy of Audiology

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WakeMed Employees Train for Ebola Preparedness

As hospitals across the country ready themselves for a possible outbreak of Ebola in the United States, WakeMed is pulling staff together to learn more about handling the deadly virus in a health care setting. Trainings, organized and led internally by the WakeMed Emergency Services Institute (ESI), began in September and will continue throughout October for employees of the Adult Emergency Department, pediatrics, the critical care departments, Infection Prevention & Control, Occupational Health, the hospital intensivist team, Labor & Delivery, the Neonatal Intensive Care Unit (NICU) and Respiratory Therapy, among others.
 
These trainings have allowed WakeMed’s health care providers to get better acquainted with using more extensive personal protective equipment (PPE), such as thicker gowns, three sets of gloves and powered air purifying respirators (PAPRs), while performing patient care and to gain insight on other necessary protective procedures should Ebola ever come to WakeMed. Several select employees, from areas such as Environmental Health & Safety, CapRAC, Infection Prevention, Occupational Health, Materials Processing & Distribution, Environmental Services, the Adult Emergency Department and others, will be trained to be part of a Support Team that can assist the Clinical Team with things such as the correct donning and doffing of PPE, managing specimens and waste correctly, and managing the traffic into and out of a controlled area.
 
Additionally, WakeMed ESI is actively working with other internal hospital departments to assess and enhance the current PPE available for staff and to develop long-term plans for the handling of infectious diseases that we may not be used to dealing with or have never dealt with before. Recently, Dr. Barb Bisset, executive director of WakeMed ESI, told The News & Observer that none of the preparations are particularly tricky, as the hospital frequently has to set up protocols for contagious diseases that haven’t appeared here, but they are necessary.
 
Learn more about what WakeMed and other area hospitals are doing to prepare for the possibility of Ebola in this recent News & Observer article.

See a photo gallery from a recent employee training class below:

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WakeMed Highlights Family, Fun & Safety this Fall

This October is going to be a big month for WakeMed in the community!  We are excited to be hosting events that are geared toward family fun and safety, including Operation Pumpkin, the Families First Fun Fest and CPR Anytime for Infant & Pediatric Emergencies.

Dr. Duncan Phillips of WakeMed Physician Practices - Pediatric Surgery helps carve at Operation Pumpkin.

Operation Pumpkin
On Saturday, October 11, join us for a pumpkin carving event (free with museum admission) from 11 am to 2 pm at Marbles Kids Museum in downtown Raleigh.  WakeMed pediatric surgeons will be on hand to help carve pumpkins with the kids!  And all participants will receive a free pumpkin.

WakeMed Families First Fun Fest at the SAS Championship Tournament
Also on October 11, SAS Championship tournament ticket holders can enjoy free, family-friendly activities at the WakeMed Families First Fun Fest. The fun includes rounds of the Operation game with WakeMed Cary Hospital’s Operative Services staff, arts & crafts, a visit from Twinkle, the WakeMed Children’s mascot, and more!  Join us from 9:30 am to 1:30 pm at Prestonwood Country Club in Cary.

CPR Anytime for Infant & Pediatric Emergencies
CPR Anytime for Infant & Pediatric Emergencies is FREE to the public, but registration is required.  From fevers to falls, rashes to earaches and everything in between, it’s no laughing matter when your child is injured or ill. Hear what the experts have to say about how to handle common pediatric emergencies. Plus, learn hands-on CPR for Infants using the American Heart Association’s CPR Anytime for Family & Friends training kit.

Thursday, October 23
6:30 to 8 pm
A.E. Finley YMCA – 9216 Baileywick Road, Raleigh
Register here.

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Thank You, First Responders!

On Friday, Sept. 19, the Greater Raleigh Chamber will recognize and celebrate Wake County first responders by hosting the sixth annual Greater Raleigh Chamber/Wells Fargo First Responders Appreciation Breakfast. In light of this event, WakeMed would also like to recognize and thank the courageous men and women who selflessly dedicate their lives to helping make our community a safer place.

Several local businesses, known as Friends of the First Responders, have also decided to honor our local first responders by offering special discounts to those who are either in uniform or who have identification. If you are a first responder, remember to take advantage of these great deals any time you are out and about.

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