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World Prematurity Day is November 17

Premature birth, or birth before 37 weeks of pregnancy, is the leading cause of death among America’s newborns (source: March of Dimes). That’s why World Prematurity Day, observed on Monday, November 17, is so important.  It’s a day to raise awareness for the issue of premature birth and to gain more support for the research that is needed to help ease this global health crisis.  

The Effects of Premature Birth
For babies who do survive premature birth, there is a higher likelihood that they will experience emotional, developmental and physical challenges as a newborn and throughout childhood. Children and families that are experiencing these challenges will likely need extra support and understanding communitywide.

“Children who are born prematurely are at a higher risk for lasting childhood disabilities as well as learning disorders and behavioral disorders,” explained Jim Helm, PhD, director of the Carolina NIDCAP Training Center at WakeMed and infant-family specialist. “Additionally, there are physical challenges that can be associated with prematurity. A child may experience growth problems, and his or her lungs are more vulnerable because they are not yet completely developed. Therefore, these children are at a higher risk for respiratory illnesses and conditions such as asthma.”

By the Numbers
According to the March of Dimes, 15 million babies worldwide are born too soon each year – that’s equal to one in ten babies.  In the United States, 11.4 percent of all babies are born prematurely each year. 

Premature birth can happen to any mother and baby, regardless of preexisting health conditions – the exact cause is not always known.  More research is needed to find answers for why some babies arrive too early.

World Prematurity Day is an excellent time to garner support for this important cause and to remind women about the factors that do contribute to a healthy pregnancy, such as good prenatal care, knowing the signs and symptoms of labor, not smoking, eating a nutritious diet and getting plenty of rest.  The day also presents a perfect opportunity to remind teachers, caregivers, health care providers and others who interact with children about the issue of premature birth and how it can affect children both mentally and physically.

Care for Premature Babies at WakeMed
At WakeMed, we hold the issue of premature birth close to our hearts. Our team has been providing exceptional care to the Triangle’s premature and critically ill babies for more than 35 years.  In fact, our Level IV Neonatal Intensive Care Unit (NICU) offers the highest level of care available to premature and critically ill babies in Wake County. In February 2014, we opened a newly renovated and expanded NICU, allowing us to now offer 48 patient beds to the babies that need our care. 

Additionally, Neonatology at WakeMed is home to the Carolina Newborn Individualized Developmental Care and Assessment Program (NIDCAP) Training Center, one of only 9 training centers in the United States (19 worldwide). WakeMed is the fourth NIDCAP-certified nursery in the world. This esteemed certification is a reflection of WakeMed’s dedication to neonatal developmental care and focus on patient- and family-centered care. WakeMed has been a leader in developmentally supportive care for more than 25 years.

But the specialized care does not stop there. Our Special Infant Care Clinic follows babies born before 32 weeks gestation, or who experienced a difficult medical course after birth, until they are around 2 years old.

“The Special Infant Care Clinic allows us to closely monitor each baby’s growth and development. Especially for babies that are less than 1 year old, we can monitor their sleep patterns, ability to self-regulate, motor and emerging language skills, as well as feeding skills to ensure things are progressing normally,” said Helm. “In addition to our patients, parents can self-refer their children to this clinic or obtain a doctor’s referral.”

Community Resources
Other sources of community support for children who are experiencing challenges after premature birth include:

What Can You Do to Help?
If you are concerned about the issue of premature birth and you wish to help, you can donate to the WakeMed NICU via the WakeMed Foundation, the March of Dimes or the NIDCAP Federation International (NFI).  Help spread the word about prematurity by talking with your family and friends.

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A Veterans Day Message from Our President & CEO

Each November, we take the opportunity to honor and appreciate the sacrifices and selflessness of the men and women who serve in the American armed forces. Here at WakeMed, we are fortunate to have more than 400 active and veteran service members among our team. These employees, physicians and volunteers have made remarkable contributions to our country, and we are proud that they are part of the WakeMed family.

Having spent more than half my life in the Navy, I hold a special place in my heart for Veterans Day. I am humbled to have served alongside so many outstanding individuals throughout my career, and I am honored to continue working among so many service men and women here at WakeMed. I would be remiss if I did not acknowledge the sacrifices of my true heroes…the families of those who serve and have served in our military.

In honor of Veterans Day, I encourage you to take a moment – today, tomorrow or next week – to thank a service member for his or her dedicated service to our community, state, nation and world. Another way to honor service members is to read the proclamation the President issued in honor of Veterans Day. It eloquently describes the important contributions of our United States Armed Forces.

May God bless you all and keep you safe, and may God bless this wonderful nation.

Donald R. Gintzig is the president and chief operating officer of WakeMed Health & Hospitals. He is a retired Rear Admiral of the United States Navy. 

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Wolfpack ‘Superheroes’ Visit WakeMed Children’s

Several superheroes from the N.C. State football team, plus Mrs. Wuf, recently visited WakeMed Children’s, filled with Halloween spirit. Everyone had a great time; it was truly a visit our staff and patients will never forget. Thank you Wolfpack!

And good thing N.C. State gave us this video of the event, so we could share it with all of you!

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Banking Milk, Saving Lives

Many new mothers might think that their own breast milk and formula are the only two choices when it comes to feeding their newborn babies. But thanks to the WakeMed Mothers’ Milk Bank, and only 17 other milk banks in the United States, donated breast milk presents a third option for newborn and infant nutrition.

“Breast milk is the recommended source of nutrition for newborns, especially those who were born prematurely,” said Bonnie Gustavison, RNC, MSN, director of Women’s & Children’s Services on the WakeMed Raleigh Campus. “It contributes so much to a baby’s health and development, including a reduction in allergies, a stronger immune system, and a reduction in illness and disease.”

Formula itself cannot provide the same protection that passes to a baby from the antibodies in a mother’s milk. Additionally, human milk helps develop and seal a baby’s gastrointestinal tract for life.

“This is an especially vital form of protection for premature babies as gastrointestinal disease is often life threatening to our tiniest patients,” explained Laurie Tollens, RN, a lactation specialist at WakeMed. “Not only can donated breast milk be lifesaving for premature infants, but it can also have a profound impact on a mother who is unable to produce enough breast milk on her own. The choice to accept donated breast milk allows a mother to still provide for her baby in this way.”

The WakeMed Mothers’ Milk Bank dispenses 10,000 to 18,000 ounces of breast milk to hospitals per month. This includes WakeMed and hospitals throughout the southeast. Strictly following all guidelines mandated by the Human Milk Banking Association of North America (HMBANA), the WakeMed Milk Bank requires all of its donors to complete a rigorous screening process that includes an in-depth questionnaire and blood work that is repeated every six months while the woman is a donor. After receiving frozen milk from a donor, the Milk Bank pasteurizes, homogenizes, tests and re-freezes the milk in a highly controlled and monitored environment before sending it out for use. All milk is labelled and tracked so that a recall process can be put into place if needed. These are critical assurances that cannot be found when purchasing milk from non-Milk Bank sources.

“Our donors are healthy, generous women who desire to pay it forward and give their milk for a variety of reasons,” explained Gustavison. “Some have extra milk and want to give back, and some might have experienced a loss but still want to use their milk to help others and their fragile babies.”

Moms who need the milk might not be able to produce enough breast milk on their own or might have adopted a baby, among other reasons. Regardless, the Milk Bank gives many families a chance to feed their babies breast milk when it otherwise might not be an option.

“The WakeMed Mothers Milk Bank represents yet another way that WakeMed works to support the well-being of our community,” added Gustavison. “We strive to give our babies the healthiest start possible in life and to give parents all the support they need to raise healthy, happy kids.”

Donors are Needed
The WakeMed Mothers’ Milk Bank is always accepting new donors. For more information, visit our website or call 919-350-8599.

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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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