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Seven Tips to Deal with Baby Backache

Probably the biggest symptom my pregnant patients complain about is the achy back, otherwise known as “baby backache.”  And it’s certainly understandable why.  Your body is gaining weight, mostly in the front, and preparing for childbirth. Those pesky hormones, estrogen and progesterone, are relaxing your joints and softening muscles. 

Just because a backache is normal, it’s important to discuss your symptoms with your healthcare provider. The first thing we’ll do is rule out a bladder infection, preterm labor, muscle injury and other problems. If need be, we can prescribe Tylenol. But there are other things that will help.
 
#1 – Stay hydrated. Your body is made up of about 60 percent water, so drinking water is especially important while you’re going through these changes. About six to eight glasses are all you need.  If you are retaining water and have swelling in your feet and hands, don’t stop drinking water. Talk with your provider.
 
#2 – Improve your posture. Most of us slouch over a computer, hunch over in chairs, and don’t make a conscious effort to stand or sit straight when we aren’t pregnant. When you’re pregnant, this can easily lead to back pain. Watch your posture throughout the day – while sitting, sleeping, standing, walking and driving.
 
#3 – Exercise. We need 30 to 60 minutes of exercise most days of the week for a healthy heart.  This makes for a healthy you and a healthy pregnancy. Exercise will release endorphins, elevate your mood and alleviate signs of depression.
 
#4 – Support your back. Your provider may suggest a maternity belt for back pain or physical therapy so you can learn how to keep your muscles strong and your back huting less.
 
#5 – Watch your weight.  Your healthcare provider has given you guidelines on how much weight is appropriate for you to gain based on your body frame and overall health. Following his or her advice will lead to a healthier, happier pregnancy and reduce the risk of having a cesarean section.
 
#6 – Wear low-heeled shoes. Not only will this help improve your posture, but wearing low heeled shoes lowers your center of gravity and keeps you safer while you walk. As your body changes, you’ll have to learn to balance going down stairs and other hard-to-maneuver places.
 
#7 – Warm baths. Warm baths are a great way to relax and get comfortable. Be sure your tub is outfitted with a suitable bath mat or non-slip strips placed inside. You may even find a shower gripper bar especially useful.
 
And an added bonus… ask your partner for a massage!

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.

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

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Preparing for a Marathon

In many ways, preparing for a marathon or a half marathon is the same as preparing for a 5K or 10K.  When getting ready for any running event, the focus is always on hydration and nutrition.  The difference comes in when you start prepping and what and how much you eat.  The reasoning is simple; the longer the race the earlier you need to start preparing and adding in the right kind of calories.

What to do before a marathon:
Hydrate:
  Three to four days before a race, begin adding two to four cups more water per day than you would normally drink.  In total, men need to consume approximately 13 cups per day and women need to consume 9 cups per day when preparing for a long run. 

Being dehydrated at the start of a race can lead to poor performance, so carry that water bottle with you everywhere you go in the days leading up to the race.  It’s probably also a good idea to limit drinks that will dehydrate you like caffeinated soda, coffee and alcohol. 

About four hours before the marathon start, drink an additional one to two cups of water every hour until one hour prior to the race  and then another cup 15 minutes before the race start.

Eat: If you’re able, eat a full meal of low glycemic index carbohydrates, protein and fat (i.e, oatmeal and eggs) about 3 to 4 hours before the race start.  In the 15 to 30 minutes right before the race, eat something light like peanut butter or a piece of fruit that will give you a boost of energy and stick with you but will not weigh you down.

During the marathon:
Hydrate: Take advantage of those water stations!  During the race, be sure to hydrate every 15 to 30 minutes with water, sports drink or a carbohydrate source (at least 25 grams). 

Listen to Your Body: Spring in Raleigh means warmer temperatures and often pollen!  These two factors can put even the most fine-tuned body under additional respiratory stress.  If at any time you feel dizzy, have cramps, are nauseous or feel faint slow down to a stop and take a break.  And, never be embarrassed to try intervals of jogging and walking.

After the marathon:
Hydrate:
After the race, you’ll want to replace the fluid you sweated out during the race, so be sure to drink plenty of water. You may also want to consider drinking a sports drink like Gatorade.

Eat: Ingest a snack that has a 3 to 1 carbohydrate to protein ratio that will get into your system quickly (i.e., bagel with cream cheese, fruit and peanut butter).  Bananas and apples also help you replenish your electrolytes.  Every 1 to 2 hours after the race, you’ll want to continue eating mixed meals with a 3 to 1 or 4 to 1 carbohydrate to protein ratio to replenish your body.

Celebrate: Running a marathon or a half marathon is no small feat.  Make sure to take some time to celebrate your accomplishments!

Hailee Wingfield, MA, CISSN, ACSM EP-C, GFI, AHC, is a Fitness Specialist with WakeMed Healthworks.

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“Baby Maybe?” Seminar Helps Curious Couples Learn More

Thinking about having a baby?  Starting or expanding your family is a big decision. There are so many things to consider. So, where do you start?

During this FREE health seminar, hear from our expert physicians in the field of pregnancy and child birth, and learn more about preconception planning, prenatal health, fertility, diet and fitness, what to expect during pregnancy and child birth, and more. They will answer your questions and help prepare you mentally and physically for this important decision.

Tuesday, April 21
6 to 7:30 pm – Dinner Discussion
North Ridge Country Club
6612 Falls of Neuse Road, Raleigh

Our physician experts will include:


Karen Bash, MD
OB/GYN, WakeMed Physician Practices

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Amantia Kennedy, MD
OB/GYN, WakeMed Physician Practices

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Avick Mitra, MD
Maternal-Fetal Medicine Specialist, WakeMed Physician Practices 

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Registration is required. Learn more.

This seminar is brought to you by the women’s hospital at WakeMed North, opening May 2015. Learn more and follow our progress.

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Healthy Weight Gain in Pregnancy

A patient once asked me if she could eat a piece of chocolate every day while she was pregnant. At about 75 calories each for a Lindt chocolate truffle, well, technically she could.

The key to a healthy pregnancy is exercise and nutritious eating… there’s no surprise there. But there is also a third factor to consider – metabolism – over which you really have no control.

Women of all shapes and sizes have different experiences when they are pregnant. On average, a pregnant woman only needs about 300 extra calories a day.

A balanced diet includes about 5 to 6 ounces of protein, 6 to 8 servings of whole grains (1/3 c to ½ cup); 2 to 3 servings of fruits, 2 to 3 servings of vegetables and 2 to 3 cups of milk. While too much fat can cause heart disease and other health problems, it’s essential to your intestinal function. Olive oil – no more than 2 tablespoons each day – is the best option.

Pregnant women need fiber – about 25 to 35 grams each day – to stay regular and reduce the chance of hemorrhoids. Good sources of fiber include whole grains, beans, fruits and vegetables. Add calcium every day with low-fat dairy products such as 1% milk, yogurt and low-fat cheeses. Keep in mind that intestinal gas and bloating are also common with pregnancy, so you may want to find less gassy foods to reduce discomfort.

Dark, leafy green vegetables are a good choice because they have natural vitamins such as A, B, C, K and folic acid. Salmon is also a great source of omega-3 fatty acids. And if you must have that chocolate truffle, buy the darkest chocolate with the least amount of sugar for antioxidant benefits.

Overall weight gain depends on your frame and size before pregnancy. Healthcare providers generally recommend a person who is underweight should gain between 28 to 40 pounds; a person at average weight, 25 to 35 pounds; and overweight, only 15 to 25 pounds throughout the pregnancy. Managing the weight gain is especially important to minimize risks of gestational diabetes or cesarean section, for example. Guidelines we use for weight gain are as follows:

  • Underweight: 20 to 40 pounds
  • Normal weight: 25-35 pounds
  • Overweight: 15-25 pounds
  • Obese: 11-20 pounds

Everyone is different, and there is no magic number. The most sound advice is to stay as balanced as possible and talk with your healthcare provider when you have specific questions.

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.

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

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Facts About Gluten-Free Labeling

Celiac disease is an autoimmune disorder that can occur in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine. When people with celiac disease eat gluten (a protein found in wheat, rye and barley), their body mounts an immune response that attacks the small intestine. These attacks lead to damage on the villi, small fingerlike projections that line the small intestine, that promote nutrient absorption. When the villi get damaged, nutrients cannot be absorbed properly into the body.  This is why it is so important for people with gluten sensitivity to avoid gluten, but gluten-free labeling can be confusing.

Facts about gluten-free labeling

There is no treatment for Celiac other than strictly following a gluten-free diet. So it becomes imperative for people with Celiac to find gluten-free foods that are free of any contamination. On August 2, 2013, the Food and Drug Administration (FDA) announced its long-awaited gluten-free food labeling rule.

According to the rule, when a manufacturer chooses to put “gluten-free” on food packaging, the item must comply with the new FDA definition of the term – less than 20 parts per million (ppm) of gluten. All FDA regulated foods, drinks, and dietary supplements are subject to the rule. Foods not covered under the rule are meat, poultry and unshelled eggs, and any other products regulated by the USDA. Imported products or any foods not regulated by FDA are not covered. Distilled spirits, wine and malted beverages are not covered. Medications are not regulated by FDA hence they are not covered under this rule, but there is work going on to create a Medicine Disclosure Act to include gluten-free labeling. Restaurants are encouraged to label the foods but there is no way to enforce the requirement.

No symbol has been approved by the FDA to identify foods that meet the definition of ‘gluten-free’. The FDA has determined that consumers favor the label “gluten-free” to communicate that a food is free of gluten. Manufacturers are allowed to include a symbol as long as it is truthful and not misleading.

Since there are a wide variety of foods that are not covered, it becomes important to learn how to read ingredient labels and avoid cross contamination.

If you suffer from gluten sensitivity and follow a gluten free diet, please join us for our new Celiac Disease support group.  This group meets the 3rd Tuesday of each month starting today, March 17 from 6 to 8 pm at Cary Hospital.  The support group is a great resource to keep up with latest research, most current and accurate news and information about celiac disease and other gluten-related disorders.

If you have questions about the WakeMed Cary Hospital Celiac Disease Support Group, please contact me, Parul Kharod, RD, in WakeMed Cary Hospital’s Food & Nutrition Services department at 919-350-2358 or email at pkharod@wakemed.org

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Free Women’s Health Seminar & Lunch on March 30

Ladies – you’re busy. Growing kids, aging parents, not to mention work, inside the home and out. But where do YOU fall on that priority list?  You need to take a little time to focus on your own health and well-being.

As we age, our bodies change, and we can face different health challenges. No matter what you’re experiencing – changes in menstrual cycle, bladder problems, hot flashes, interest in a new contraceptive, or a desire to learn more about cancer prevention and women’s health screenings – we have the answers. Our panel of physicians who are women’s health experts are here to provide guidance and give you tools to help maintain health at every age.

This FREE seminar will include an informal discussion and a free boxed lunch.  Join us by registering today!

Monday, March 30
Noon to 1:30 pm
Finley YMCA: 9216 Baileywick Rd, Raleigh

About the panel:

Ann Becker, MD
WakeMed Physician Practices – Urology
Dr. Ann Becker is a board-certified urologist with WakeMed Physician Practices – Urology. She has been practicing in the Raleigh area since 2009 and has clinical interests in both women’s and men’s urological health conditions, including urinary incontinence, bladder health, kidney and prostate disease, kidney stones and pelvic disorders. 

Andrea Crane, MD
WakeMed Physician Practices – Urogynecology
Dr. Andrea Crane is a urogynecologist with WakeMed Physician Practices – Women’s Center. She is board certified in OB/GYN, and her specialties include evaluation and treatment of childbirth trauma, advanced pelvic organ prolapse, urinary and fecal incontinence, vesicovaginal and rectovaginal fistulae, and mesh complications. 

Lisa Roberts, MD
Gynecology & Laparascopic Surgeons
Dr. Roberts is a practicing physician and president and CEO of Gynecology & Laparoscopic Surgeons, PC. Dr. Roberts is a Fellow of the American College of Obstetricians and Gynecologists (FACOG), and she is a specialist in advanced laparoscopy and advanced hysteroscopy techniques.

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New! Celiac Disease Support Group

WakeMed is partnering with the Celiac Disease Foundation to start a new local support group at Cary Hospital.  In fact, our first meeting is Tuesday, March 17 from 6 to 8 pm.   This is great news for people in our area who must follow a gluten-free diet.

Why a support group for celiac disease?

Celiac disease is about much more than just a gluten-free diet. It has physical, psychological and social implications. One in 100 people worldwide have Celiac disease and many more have gluten sensitivity. It is estimated that about 2.5 million people are undiagnosed.  Celiac disease is an auto immune disorder.  If left untreated, it can lead to other autoimmune conditions such as Type I diabetes and multiple sclerosis (MS), anemia and other vitamin and mineral deficiencies, osteoporosis, infertility and miscarriage, neurological conditions like epilepsy and migraines, growth issues, and intestinal cancers.  Celiac is a hereditary disease.  People with a first degree relative have a 1 in 10 risk of developing Celiac disease.  That is why a support group is necessary for education and awareness.

Learn more about our celiac disease support group, and please plan on joining us to help us build a community that offers a caring environment where participants can help each other with ideas and guidance for coping and managing daily struggles.  Expect to benefit from the assistance, encouragement, comfort and reassurance of others dealing with similar issues.

If you have any questions, please contact me, Parul Kharod, RD, in WakeMed Cary Hospital’s Food & Nutrition Services department at 919-350-2351 or by email at pkharod@wakemed.org.

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Rock the Rock ‘n Roll Marathon

Rock ‘n’ Roll Marathoners, help us help you run your very best race by consulting these resources.

FREE 15 Minute Physical Therapy Consultation

If you have a specific physical therapy question, we encourage you to take advantage of our FREE, 15 minute physical therapy consultation offered at multiple locations around the Triangle up until race day.  Schedule your free screening today by calling (919)350-3800 and mention “Rock ‘n’ Roll Marathon.”   Also feel free to Ask the PT via email.

WakeMed is proud to be the co-medical sponsor of the Rock ‘n’ Roll Marathon, along with Wake Emergency Physicians, and we wish you all a great race day!

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Prenatal Genetic Counseling & Preparing to Have a Baby

Many people have never heard the term “genetic counseling.”  Some people have heard about genetic counseling and associate it with hearing bad or scary news.  In reality, genetic counseling is about conversation, education, guidance and support.  It is about helping a woman feel empowered when it comes to her pregnancy and her health, as well as the health of her baby.  

What is a genetic counselor?
A genetic counselor is a healthcare provider who has advanced educational training in medical genetics and counseling. Prenatal genetic counselors specialize in helping women and their families understand medical genetic information as it relates to the health of a pregnancy or a future pregnancy.  There are many reasons that a woman might visit or be referred to a genetic counselor, such as:

  • Having questions about available genetic testing options
  • Having a prior child with, or a family history of, a genetic condition or birth defect
  • Having a medical condition or an exposure (i.e. medication, radiation, etc.) that may increase the risk for pregnancy complications
  • Having an abnormal genetic screening test result or ultrasound finding
  • Having experienced several pregnancy losses

The Benefits of Genetic Counseling
After gathering information about family and medical history, a genetic counselor can help a woman decide what type of prenatal genetic testing is best for her, or if she needs testing at all.  While genetic tests can provide information about the health of a current or future pregnancy, genetic counselors are uniquely trained to discuss the benefits, risks and limitations of genetic testing.  They are also trained to help women determine whether or not the information from genetic testing will be helpful to them.  When a woman decides to undergo testing, a genetic counselor explains the results and discusses if additional tests are needed.

In most cases, genetic counselors offer reassurance that a current or future pregnancy will be healthy. However, when complications arise, the information and perspective received from a genetic counselor can be invaluable as expectant parents prepare for the birth of their child. With the help of the genetic counselor, parents can use the rest of the time before their baby’s birthday to:

  • Learn more about the complication faced by their unborn child
  • Meet with other specialists who may be involved with their child’s care after birth, such as neonatologists, cardiologists, pediatric surgeons, etc.
  • Talk with family members and friends to help them prepare for their child’s birth
  • Reach out to other parents who have been in a similar situation for support and guidance
  • Contact a support group for parents of children who have the same complication
  • Select a pediatrician
  • Arrange for childcare

The goal of the genetic counseling team at WakeMed Physician Practices (WPP) – Maternal Fetal Medicine is to ensure parents feel supported when it comes to welcoming and caring for their child by connecting them with the appropriate information, specialists and resources.

Things to Think about Before Becoming Pregnant
The genetic counseling team at WPP – Maternal Fetal Medicine provides consultation to women who are pregnant, and we are also happy to meet with women who have experienced recurrent pregnancy loss or who have concerns about a future pregnancy.

Before becoming pregnant, it is important to think about your health and any factors that might affect a baby’s development.  Therefore, consider these things first before attempting to conceive:

  • Know your family medical history and that of your partner as well.  Learn more by asking questions of your family members and doing research on conditions that may not be familiar to you.
  • If you have a chronic medical condition, such as diabetes or epilepsy, ensure that it is well controlled before trying to conceive.
  • If you take medication, talk to your doctor about the possibility of reducing the dosage and/or stopping use of unnecessary medication.
  • If you are a smoker, get on a path toward quitting.
  • Stop use of alcohol and illicit drugs.
  • Ensure you are up-to-date with all vaccinations.
  • Talk with your doctor about taking a prenatal vitamin that contains folic acid.

For more information on the genetic counseling services available through WakeMed Physician Practices – Maternal Fetal Medicine, visit our website or call 919-350-6002 (Raleigh Campus location) or 919-235-6433 (North Campus location).

Cheryl Dickerson, MS, CGC, is a genetic counselor at WakeMed Physician Practices – Maternal Fetal Medicine.

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February 2015 Daisy Award Winner

Congratulations Cheryl Palmer for being recognized as the February 2015 DAISY Award Recipient!

4 month old Braylen’s Mom wrote this about you:   

“The professionalism and compassion that she showed all of our family was a huge blessing.  The care she shared with us in teaching us how to take care of a premature infant was and is so much appreciated.  She truly is an amazing nurse.” 

A co-worker shared this about you in her nomination:

“The mother of one of our infant patients shared that she was unable to get her 3 older children school supplies.  Cheryl purchased a bag full of school supplies and left a card addressed to “Emma’s brothers and sister” in the patient’s room.  Cheryl is always a kind and loving person – both to families and co-workers.”

Thank you Cheryl “We are Proud You Are a WakeMed Nurse”!

Each month one outstanding WakeMed nurse is awarded a DAISY Award.  This award recognizes the super-human work that nurses do every day.  These nurses are nominated by their patients, patient’s families and their peers.  Nominate a deserving nurse today.  Please nominate nurses who have demonstrated superior clinical skill and compassionate care so they can be recognized as an outstanding role model.

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