Warm weather and sunshine are finally here, allowing more kids the freedom to play outside in their warm weather clothes. While shorts, short-sleeved shirts and tank tops are a lot more comfortable than sweaters and jeans, they expose little legs, arms, elbows and knees, leaving them susceptible to cuts and scrapes. 

However, minor injuries can be safely treated at home – just follow this trusted advice from Dr. Sasha Avery of WakeMed Physician Practices – Garner Primary Care.

Stock Your Medicine Cabinet
Always stock your medicine cabinet with bandages and an antibiotic ointment such as Neosporin® or Bacitracin. Ensure soap, water and clean towels are always accessible. 

Treating an Injury at Home

• Stop any bleeding with persistent pressure to the wound. This could take up to 10 minutes.
• Wash the wound with warm water and soap for about five minutes and carefully remove any dirt or debris that might be in the wound. Alcohol and hydrogen peroxide are not recommended as they can irritate the wound tissues and are quite painful.
• Blot dry the area around the wound with a clean towel; then apply an antibiotic ointment such as Neosporin.  
• Cover the wound with a bandage. Check and change the bandage once a day until the wound is healed.
• For minor pain, administer Tylenol® or Ibuprofen according to the age-related dosage instructions on the package.

When to See a Doctor
If your child’s wound is infected, it is definitely time to see a doctor. Signs of infection include:

• Redness or streaking around the wound
• Pus or a foul smell from the wound
• Significant pain, swelling or warmth around the area
• Fever

Additionally, if the wound is open and has been exposed to dirt, your child may need a tetanus shot. Call your doctor’s office to schedule an appointment.

If your child’s wound is bleeding profusely, and the bleeding cannot be stopped with pressure or if the wound is deep, head to your nearest emergency department as stitches may be required. The WakeMed Children’s Emergency Department is located at 3000 New Bern Avenue in Raleigh. Continue to hold pressure on an actively bleeding wound until you are seen by a medical professional.

Let Your Kids Play!
Outside play is important to a child’s health and development. Just keep in mind that knowing the appropriate way to handle childhood injuries and having the right supplies on hand will make the spring and summer a lot more enjoyable for your entire family.

Twinkle, the WakeMed Children's mascot, visits with event participants.

WakeMed was proud to help sponsor Wake County’s Safe Kids Day 2014, hosted by Safe Kids Wake County in Apex on Saturday, April 5. Over 750 people attended to enjoy activities related to fire safety, pedestrian safety, drunk driving awareness, teen driving, poison prevention and sports safety.

Also on hand were car seat safety displays as well as a hot car display that emphasized how hot a car can get when parked outside. S’mores were even cooked in the car!

Several WakeMed employees volunteered at this important community safety event. Thank you to Safe Kids Wake County for allowing us to be a part of all the fun! See more event photos here.

Every year the Triangle Business Journal (TBJ) recognizes individuals in our area who are true heroes within the healthcare profession.

While the TBJ includes a nice profile and picture of each award winner (available online only to subscribers), we thought you might want to see their actual nominations and read first-hand what makes these individuals so special.

Our third highlighted winner is Elizabeth Penny, LRT/CTRS, RYT, a recreational therapist at the WakeMed Rehabilitation Hospital. She deals primarily with patients who have experienced spinal cord injuries and is known for doing “whatever the patient needs.” From moving furniture and yoga, to miniature golf and pet therapy via her trusty canine companion Scully, Penny is whole-heartedly dedicated to her patients and getting them back on their feet again.

Following is her nomination.

Elizabeth Penny
Recreational Therapist
WakeMed Rehabilitation Therapist

It’s a telling moment when one of Elizabeth Penny’s coworkers stops by and asks where the hot sauce is.

If there’s anything to be known about recreational therapy at WakeMed, from the effectiveness of chair yoga for spinal cord injuries to the location of staff condiments, Penny will likely know. Since she started as a recreational therapist 18 years ago, there’s little she hasn’t attempted to help her patients get back on their feet and living their lives.

Elizabeth deals primarily with patients coming off spinal cord injuries. Working with inpatients, she typically has no more than nine sessions to help them start to regain basic functions before they are discharged. Each patient is different and requires a unique approach.

“What do I do to help people?” she says, repeating the question put to her.

“I’ve helped patients move furniture, I’ve arranged to purchase a wheelchair off Craigslist, I’ve taken people to the dentist, I took a pediatric patient to play Putt-Putt,” she begins, rattling off the numerous and tasks she has performed under the rec therapy umbrella. She pauses, realizing the list could go on for quite some time, and says, “I do whatever the patient needs.”

Her arsenal of skills and services is constantly growing. Several years ago she turned to yoga to help with her own pain management. It worked, so she figured it would work for her patients. She became a yoga instructor, recently became certified in chair yoga (she spends every other Sunday conducting a class at a local nursing home), and is working on becoming a certified yoga therapist, which requires 1,000 hours of study and a 10-day practicum in India.

She’s also certified in HeartMath, a biofeedback system aimed at helping patients with stress management, and is in the processes of becoming a certified personal trainer.

“It couldn’t hurt,” she says of the latter.

But the biggest weapon in her arsenal is her partner of more than five years, Scully. Scully is a black lab/golden retriever mix, a therapy dog trained by Canine Companions International who makes Elizabeth’s patients forget the sometimes difficult and challenging work of therapy.

Elizabeth has a set caseload, generally seeing seven to 10 assigned patients three times a week. But she and Scully may help twice that many patients at the request of fellow therapists whose patients need a little something extra. A little Scully therapy.

On a Tuesday morning, Elizabeth and Scully spend a half hour with a patient recovering from an aneurysm. Scully hops up on a table before the seated patient as Elizabeth begins asking a range of questions, from “So tell me why you’re here?” to “Do you have a dog?”

“I try to find something important to them,” she says. “It helps get their mind off the challenges of therapy.”

Elizabeth has the patient brush Scully, first with her left hand and then with her right hand, which is weaker. There’s physical therapy at work, to be sure; there’s emotional therapy as well. The patient starts to talk about her dog, who she hasn’t seen since she entered the hospital. Her strokes become more pronounced. She kisses Scully on the nose. Then she does something no one has seen her do since she entered WakeMed.

“You smiled!” beams an assistant who has been working with the woman.

A few minutes later, Elizabeth and Scully are flagged down by another therapist. Her patient had surgery for a brain tumor, and she’s been trying to get him more comfortable leaning forward.

She cuts up an apple, puts it on a towel, and places it on a stool to the man’s left. Scully lies in front of him, about four feet away. Penny instructs the man to reach across his body with his right hand, pick up a piece of apple, then lean forward and give it to Scully, who takes the apple upon the release word: “OK.” At first, Scully reaches to meet the patient half way. Then, Scully stays put, making the man come all the way to him. At one point, the towel drops to the floor.

“Can you pick that up?” Elizabeth asks. “No,” he replies. “I think you can,” she answers. The man looks at Scully, reaches down with his right hand and retrieves the towel.

“People are funny,” Elizabeth says later. “They think they’re doing it for the dog, but they’re really doing it for themselves. They’ll do things for Scully that they’ll never do for a therapist.”

Chair yoga, moving furniture, playing Putt-Putt, employing the wiles of man’s best friend.

Recently, the Asthma and Allergy Foundation of America ranked the top 100 cities in the United States that cause trouble for people who suffer from spring allergies. See list here. Scores were based on the prevalence of certain types of pollens and molds, pharmacy data for prescription allergy medicines in the area and the number of board-certified allergy and immunology specialists per 10,000 estimated patients. Our own capital city of Raleigh ranked number 64 – not terrible, but not good either. 

So, what can you do if you live in one of these top 100 cities and you suffer from spring allergies?  Several specialists from WakeMed Physician Practices ENT – Head & Neck Surgery have recently spoken with the news media to offer advice on the treatment and management of allergy symptoms. We’ve included these news stories below so you can learn more and hopefully find some relief.

Itchy Eyes, Runny Nose – What Works for Allergy Season? – WTVD-ABC 11, April 4 – Dr. Mike Ferguson, director of WakeMed Physician Practices ENT – Head & Neck Surgery, was interviewed for this segment that provided helpful tips for treating seasonal allergy symptoms.

Allergy Season Well Underway in North Carolina – WTVD-ABC 11, April 1 – Dr. Brett Dorfman of WakeMed Physician Practices ENT – Head & Neck Surgery was interviewed for this story about the start of spring allergy season.

Suffering from Sinusitis? New Implant May be the Answer – WRAL.com, March 13 – Dr. Brett Dorfman of WakeMed Physician Practices ENT – Head & Neck Surgery discusses a new Propel implant that works like a stent and may be the answer for those who suffer from allergies and sinus disease.

Combat Spring Allergies – Wake Living magazine, Spring 2014 – Dr. Allen Marshall of WakeMed Physician Practices ENT – Head & Neck Surgery discusses spring allergies and how to manage them.

Back in 1961, WakeMed Health & Hospitals (then the Wake County Hospital System Inc.) was established by the community to care for the people of the community.  In other words, the community has been the most vital supporter of WakeMed since its beginnings.

A special segment of our community – providing a very special service to WakeMed and the community – came into existence and immediate relevance just five years after the WakeMed Raleigh Campus opened.  Back then, they were known as The Auxiliary to the Wake County Hospital System Inc.  Today, they are The Volunteers at WakeMed Raleigh Campus.

The Volunteers at WakeMed Raleigh Campus’ counterparts to the West, The Volunteers at Western Wake Medical Center, also got their start soon after Western Wake (now WakeMed Cary Hospital) opened.  They began their service to patients, families and staff in 1992 – just one year after Western Wake’s official ribbon-cutting ceremony. 

WakeMed Volunteer Services reports that more than 1,500 men and women serve the WakeMed mission as either members of The Volunteers at WakeMed Cary Hospital or The Volunteers at WakeMed Raleigh Campus.  In fiscal year 2013, they provided 135,432 hours of service.  That is an astounding number. 

When you walk through either WakeMed hospital, you will see a volunteer in a red or gray vest escorting patients and families to their destination, providing hearing screenings for babies, helping staff with clerical duties and even bringing their proud pooches in to visit dog-loving patients. 

Through their sales (uniform, shoe, jewelry, etc.) programs (Blossoms for Life) and events (the annual Volunteers at WakeMed Cary Hospital Golf Outing), they raise funds to purchase important items like scales for heart failure patients, prescriptions for immediate-need patients, distraction toys, books and music, and infant care items and car seats. 

Through their scholarships, the volunteers help staff members achieve higher levels of learning to better their skills.  A highly skilled health care team benefits the entire community. 

And a large group of volunteers from throughout the community work tirelessly as groups and individuals to produce knitted, sewn and crocheted Huggables (small, stuffed animals for pediatric patients), baby hats and baby blankets.  These items are treasured by recipients, who greatly appreciate the stress relief these distractions bring.

While National Health Care Volunteer Week was April 6-12, we invite you, every week, to tell a WakeMed volunteer how much you appreciate all they do for our mission and our community.  They are the best!

Here are some of our awesome volunteers in action!

Every year the Triangle Business Journal recognizes individuals in our area who are true healthcare heroes. 

While the Journal includes a nice profile and picture of the award winners (available online only to subscribers), we thought you might want to see their actual nominations and read first-hand what makes these individuals so special.

Our second  highlighted winner is Jim Helm.   Jim is a long-time employee who has helped our tiniest patients grow to be big, happy babies.  He also helps families adjust to the special needs of babies born a little earlier than expected.  Although Jim’s patients might be tiny, his passion for his job is huge.  Read a little bit about what makes Jim special in this nomination submitted to Triangle Business Journal.

James Helm
Infant-Family Specialist, WakeMed Neonatology

For more than 30 years, WakeMed and its Neonatal ICU Department have been at the forefront of specialized care for premature babies. In part, that’s because it was an early proponent of a pioneering neonatal treatment called NIDCAP — Newborn Individualized Development Care & Assessment Program. At WakeMed, the NIDCAP approach has been advocated and promoted since the 1980s by Infant-Family Specialist James Helm, whose efforts helped the hospital’s Neonatal Intensive Care Unit (NICU) become one of only four such facilities in the world to earn certification from the NIDCAP Federation International (NFI).

“A lot of neonatal nurseries embrace elements of the NIDCAP approach,” says Helm, who holds a PhD in Special Education from UNC-CH. “What makes WakeMed’s different is that it covers everything, it’s a comprehensive program. Developmental care is integrated into all aspects of the nursery.”

The road to WakeMed’s certification has been a long one for Helm, who started at WakeMed as a consultant in 1984 and became full time in Neonatology in 1988. He became a NIDCAP certified trainer a year later.

As the number of NIDCAP certified trainers began to grow in the 1990s, Helm said more hospitals began to ask, “Well, we have a NIDCAP Certified Professional, does that make our nursery a “NIDCAP nursery”?”

That set the NFI, founded in 2001, to develop a nursery certification process. In 2008, the first hospitals, WakeMed among them, began going through the process. After a two-year review, WakeMed was told that it was doing well in most areas, but needed work in others. And in 2012, WakeMed’s NICU nursery received the coveted NIDCAP certification. It joins a hospital in France and two others in the US as the only facilities so certified.

The NIDCAP approach covers four main areas: infant care, working with the families of the infants, staff support, and the environment. It’s an ongoing and evolving process in a field that’s changed dramatically since he first joined the hospital. “There was a time when our goal was to simply keep the babies alive,” says Helm. “We’ve gotten a lot better at that.”

That’s still the overriding goal, he adds. But increasing emphasis is placed on minimizing developmental problems that a premature birth could cause. “At 24, 25 weeks, the brain is essentially smooth.  It changes dramatically over that last trimester. The environment plays a huge role in how the brain develops.”

For a premature baby, that means a brain plucked from the protective embrace of the womb and subjected to an onslaught of stimuli it may not be ready to handle. “Our goal is to try and eliminate or dramatically decrease that added stress,” says Helm.

Certified NIDCAP observers look for signs of stress, some subtle, some not so, and to see how each baby attempts to manage then work with staff and the family to try and minimize that stress and help the baby be successful.

One strategy NIDCAP adopted early on is called “Kangaroo Care,” which involves frequent skin-to-skin contact between infant and parent. “It makes sense,” Helm says, “because the baby is expecting that contact in the uterine environment.”

A big change from Helm’s early days involves the infant’s exposure to family. “Access used to be severely restricted to premature infants because of the fear of infection. Now, with antibiotics, that’s less of a concern and there’s been mounting evidence of the healing power of family and friends.”

As a certified NIDCAP trainer, Helm spends time working with staff at other hospitals, but mostly works with staff at WakeMed. The certification process isn’t easy. 

“It takes about 18 to 24 months to get certified,” he says. “It’s about the same as a master’s.”

The bulk of his time, though, is spent observing infants in the NICU. He shares his assessment with staff and family to help customize the least stressful treatment for each baby.

Every six months as a part of “nursery blitzes” (intensive training for staff on new procedures), he and colleagues share the latest findings from the trenches, which the staff use to further tweak treatment.

Those findings also helped shape remodeled and expanded NICU, which opens next month (February 18, 2014). One of the big changes reflecting the NIDCAP approach are the individual patient rooms versus the original set up of semi-private, four-bed corrals. “The private rooms make it easier for families to spend more time with their babies,” says Helm.

March was Colorectal Cancer Month, and even though the month has come and gone, the importance of colorectal cancer awareness is always here.  Colorectal cancer is the third most common cancer diagnosed in men and women in the United States. Overall, the lifetime risk of developing colorectal cancer is about one in 20 (five percent). The risk is slightly more for men. Every year, about 140,000 Americans are diagnosed with colorectal cancer, and more than 50,000 people do not survive it.

Symptoms of Colon Cancer
When it comes to colon cancer, many patients have no symptoms; however, some may notice rectal bleeding, abdominal pain or cramps that won’t go away, a change in bowel habits, unintentional weight loss or a condition called anemia that causes weakness and fatigue.  If a person has any of these symptoms, he or she should contact their primary care doctor for an evaluation and/or referral to a gastroenterologist (a physician trained to diagnose/treat diseases related to the gastrointestinal tract).

Early Detection is Key
Colonoscopy helps in early detection of cancer, when the disease is easier to cure.  In fact, studies have shown that colonoscopies and increased colon cancer awareness have decreased colon cancer rates by two to three percent per year over the last 15 years. A colonoscopy is a test that looks at the inner lining of the large intestine (medically known as a colon) to check for polyps or cancer. Polyps are growths in the colon that can turn into cancer over time. 

What is a Colonoscopy?
A colonoscopy is typically performed as an outpatient procedure at an endoscopy suite.  A day before the procedure, patients are advised to eat a special diet and drink a “bowel prep” liquid to clean the colon. Each patient must also have a designated driver to and from the procedure.  For the procedure, patients are given medication to help them relax as well as a sedative.  A colonoscope is then carefully inserted into the anus and up into colon.  Used to examine the lining of the colon, the colonoscope is a thin tube with a camera and light attached to its tip. The procedure usually takes 20 to 60 minutes, although patients should plan on two to three hours for waiting, preparation and recovery. After the procedure, most patients can eat as normal. 

How Often Does One Need a Colonoscopy?
Once a person turns 50, he or she should receive a colonoscopy every 10 years.  However, patients with certain medical conditions (such as inflammatory bowel disease), family history of colon cancer, prior history of polyps or certain hereditary syndromes (such as FAP or lynch syndrome) should receive them more frequently.
Anyone over 50 who has never had a colonoscopy should talk to their doctor today about getting one.  After all, an ounce of prevention is worth a pound of cure.

Dr. Deepa Reddy is a gastroenterologist with WakeMed Physician Practices (WPP) – Gastroenterology. WPP – Gastroenterology performs 25 to 30 colonoscopies per week – learn more about the practice.

As the parent of a pre-teen or teenager, you might notice that your child’s weight fluctuates frequently.  You might wonder if this is normal or worry that something is wrong.  In most cases, weight fluctuation is completely normal during childhood and can be attributed to growth spurts or puberty during the adolescent years.

Many parents say they can tell their child is about to go through a growth spurt when he or she becomes a little “pudgy.”  While no scientific evidence shows that this is true, increases in weight and height do tend to parallel each other.  A larger growth spurt is associated with a larger increase in body weight.  Additionally, excess fat helps promote growth.  This is why children who are overweight or obese also tend to be tall. 

Another thing to consider when your adolescent child’s weight is fluctuating is puberty. As a child experiences puberty, his or her body fat distribution changes. Girls develop more fatty tissue in the hips, thighs and buttocks. Because this can happen quickly, it can cause stretch marks in these areas, even in normal-weight kids. One study suggests that stretch marks can occur in as much as 70 percent of girls and 40 percent of boys.

During puberty, boys commonly experience gynecomastia, or the development of fatty breast tissue. This happens in up to 70 percent of boys and usually occurs during mid-puberty. The predominance of estrogen during puberty as compared to testosterone is said to be the cause. However, gynecomastia does tend to disappear within two years and typically does not require treatment.

While frequent changes in height and weight can make dressing your child challenging, rest assured that this is a normal part of life. As a parent, your role is to help make your child feel as comfortable as possible, even though they may feel frustrated or self-conscious. Help your child understand these physical changes and continue to encourage a healthy diet, plenty of sleep, and lots of exercise and activity.  However, when weight loss or gain is extreme and sudden, talk with your child’s doctor to ensure there is no underlying condition to consider.

Hillary Lockemer, MD, is a pediatric endocrinologist with WakeMed Children’s Endocrinology & Diabetes.

Marian Uy a True Healthcare Hero

Every year the Triangle Business Journal recognizes individuals in our area who are true healthcare heroes. 

While the Journal includes a nice profile and picture of the award winners (available online only to subscribers), we thought you might want to see their actual nominations and read first-hand what makes these individuals so special.

Our first highlighted winner is Marian Uy.   Marian is a long-time employee who has touched the hearts and minds countless cardiac patients and their families during her tenure at WakeMed.  Her profile truly shows that Marian has one of the biggest hearts in the business. 

Marian Uy’s Healthcare Heroes Nomination

Manager, Heart Failure and Structural Heart Programs
WakeMed Health & Hospitals
TBJ Healthcare Heroes Award Winner – Category: Medical Professional

It was the late 1990s and Marian Uy had been a staff nurse in the Cardiac Care Unit (CCU) at WakeMed for 15 years. She loved her work, especially working with patients recovering from the trauma of heart failure. But one thing had long puzzled her: Why do we see so many patients back in the CCU so soon after they’re discharged?

On average, figures nationwide show that about 1 in 4 cardiac patients – primarily those suffering congestive heart failure – are readmitted to the hospital within 30 days of initial treatment.

It also bothered Marian that once a patient checked out, she had no idea how they were doing. Except, of course, the 25% who returned within 30 days. “Follow-up care was an unexplored area at the time.”

“My boss in the CCU at the time, Betsy Gaskins-McClaine, was very open to new ideas and innovation,” says Uy, who started working at WakeMed in 1984. “So I went to her and asked if we could study the problem and come up with a solution.

Turned out Gaskins-McClaine had similar concerns. Together, she and Uy conducted a study and their solution — the Congestive Heart Failure Program — was launched in 1999. Its goal: to not only do a more thorough job of educating heart patients about how to manage their condition while in the hospital, but to follow-up once they were released to make sure their recovery continued.

“Studies show that patients take in about 15% of the information they are given while they are in the hospital,” says Uy. “On our first follow-up call, which we do within 48 hours of discharge, we go over everything again.”

Previously, the education process consisted of a quick visit from a doctor just before discharge. “Basically, they were told what meds to take and to eat better.” Then they were on their own.

Under the Congestive Heart Failure (CHF) Program, patients have an extended visit with one of 5 nurses now in the CHF Program prior to discharge. Patients are also given a 24-page booklet that Uy was instrumental in creating, which explains the various types of heart failure and how the patient can manage – and recover from – their affliction.

After that initial 48-hour follow-up call, patients are contacted once a week for 6 weeks.

“We ask about their weight,” says Uy. “If they’ve gone up more than 2 pounds, that’s a sign that they’re retaining water – a red flag. We ask about their diet, their activity level. And we listen to hear if they’re short of breath, or if they pause between words and sentences. More red flags.”

After 6 weeks, patients are called every other week for 3 months. “And we tell them that if they have any problems to call us immediately.”

Since its inception in 1999, more than 4,000 patients have benefited from WakeMed’s CHF Program. About 1,300 CHF patients are currently active. “We make between 100 and 150 calls a day.” And the patients are listening.

Uy says for the latest reporting period, the percentage of CHF patients returning within 30 days was 14%. “And we’ve been as low as 10%,” she says.

A native of the Philippines, Marian earned her nursing degree from Velez College of Nursing in Cebu City. She loved the coursework, but she discovered that the rewards of nursing in her home country were limited. “The doctor made the decisions about patient care, and the nurse followed those instructions.”

Shortly after graduating, a recruiter visited her hospital in 1979 looking for candidates to ease a nursing shortage in the U.S. “We thought we were going to New York or Chicago,” Uy says with a laugh. She wound up in West Virginia.

But within the walls of Wyoming General Hospital in tiny Mullens, W. Va, the doctors would turn to Marian and say, “What do you think?” And Marian has been thinking and sharing her medical opinion ever since.

Her analytic and critical thinking skills were not only instrumental in the creation of WakeMed’s Congestive Heart Failure Program, they’ve also helped fuel the hospital’s Transcatheter Aortic Valve Replacement (TAVR) program – an option for patients who can’t undergo heart surgery – which launched in 2013.

She’s also the program coordinator for the American College of Cardiology’s Patient Navigator Program, which has adopted the CHF Program concept for patients suffering from heart attacks and heart failure.

Uy has dedicated the past 30 years to matters of the heart, an organ she became intrigued by in college.

“The heart is the organ of love, the organ of emotion, the organ of life. To me, the heart is life. That has always captivated me.”

According to the Center for Disease Control, 5.1 million people in the United States have congestive heart failure (CHF), characterized by the heart’s inability to pump enough blood to meet the body’s needs. A history of coronary artery disease, heart attack, high blood pressure and heart valve problems increases the risk of CHF.

The key to preventing heart failure is to reduce your risk factors. You can control or eliminate many of the risk factors for heart disease — high blood pressure and coronary artery disease, for example — by making lifestyle changes along with the help of any needed medications.

Lifestyle changes you can make to help prevent heart failure include:

• Not smoking
• Staying physically active
• Eating healthy foods
• Maintaining a healthy weight
• Reducing and managing stress

Many people with CHF can live normal lives with proper nutrition and medical management. If you have been diagnosed with heart failure, a good management plan includes these steps:

• Weigh yourself each day. If you notice a weight gain of around two to three pounds overnight, fluid might be building up in your body. This could be a sign that CHF is getting worse. Talk with your doctor if you have noticed recent changes in your weight.
• Maintain a healthy weight. Extra pounds can be hard on your heart. Getting enough exercise (about 30 minutes per day) can help keep your weight stable.
• Limit sodium. Sodium increases fluid in your body. Limiting sodium to <2,000 mg/day will prevent risks of CHF, high blood pressure, and stroke.
• Limit fluid intake to 6- 8 cups per day. It is important to stay hydrated, but a high fluid intake can increase risk of fluid retention.
• Control blood pressure. Smoking, stress and alcohol can increase blood pressure and create extra work for the heart.
• Stay on track with medications. Research shows that people who are compliant with medications live longer, have fewer CHF symptoms, and are less likely to be admitted to the hospital.

WakeMed’s CHF program works in conjunction with primary care physicians and cardiologists to provide patients with education on managing CHF. For more information about the WakeMed CHF Program, including support groups, contact Marian Uy, RN, CHF Program manager, at 919-350-5732, or visit our website.

Amy Bowen is a clinical dietitian at WakeMed Cary Hospital, and Kelli Wood is a dietetic intern from Meredith College. With questions for the dietitians, e-mail askadietitian@wakemed.org. For individual nutrition counseling, call WakeMed Cary Hospital Outpatient Nutrition Services at 919-350-2358.