Susan Evans

The Triangle Business Journal (TBJ) honored 25 local professionals this year with Health Care Hero Awards, including four from WakeMed.

All four WakeMed finalists – Susan Evans, Rosemary Kenny, Dr. Duncan Phillips and Tiffany Young – won in their respective categories. The winners were announced on Thursday, March 22 at a special dinner at the Raleigh Marriott City Center.

Dr. Duncan Phillips

Winners were nominated by their peers and selected by a TBJ-appointed committee. All winners have made significant contributions to health care in this community.

“Our winners this year represent another class of exceptional heroes,” said Bryan Hamilton, publisher of Triangle Business Journal. “Whether serving those in need or working on breakthrough innovation in health care, these winners are changing people’s lives.  We thank each of our finalists for their years of hard work and passion to make a difference.”

Susan Evans, RN, IBCLC, is the coordinator for WakeMed Mothers’ Milk Bank. It is one of only 10 milk banks in the country, and for several years, was the only one on the east coast. Evans admits to getting teary-eyed when she talks to a mom who wants to donate her milk after her baby has died.

Rosemary Kenny

Rosemary Kenny is a volunteer in the Neonatal Intensive Care Unit (NICU), where she conducts hearing tests for premature babies. Kenny says she is motivated by the importance of identifying babies who need hearing assistance, so that “we can give them the very best possible start in life.”

Dr. Duncan Phillips is a pediatric surgeon who also helps to coordinate care delivered by other surgical subspecialists within the WakeMed system. If Dr. Phillips could change one thing about health care in America, he says it would be to guarantee all children equal access to specialty medical care, no matter where they live, the language they speak, or what their parents do for a living.

Tiffany Young

Tiffany Young works as a triage, charge, and trauma nurse in the Children’s Emergency Department. Her work has taken her around the globe, including to Haiti, where in 2010 she led a team in providing mobile medical clinics to rural areas. She also trained 50 Haitian doctors and nurses and opened a Cholera Treatment Center, which treated more than 10,000 people.

American Diabetes Association Alert Day on Tuesday, March 27 is a one-day “wake up” call that encourages everyone to take the Diabetes Risk Test to find out if they are at risk for developing type 2 diabetes.

In addition to taking the test, signs and symptoms of diabetes include:

• Extreme thirst or hunger
• Frequent urination
• Blurred vision
• Drowsiness or dizziness
• Headache
• Irritability

However, only your doctor can tell for sure if you have Prediabetes or type 2 diabetes.

Pre-diabetes is diagnosed when fasting blood sugar measures between 100-126 on 2 different occasions or the A1C is between 5.7% and 6.5%

Diabetes is diagnosed when fasting blood sugars measure over 126 on 2 different occasions or the A1C is over 6.5%

Early diagnosis is critical to successful treatment, delaying or preventing some complications of diabetes such as heart disease, blindness, kidney disease, stroke, amputation, and death.

A serious disease

Diabetes is a serious disease that strikes nearly 26 million children and adults in the United States. A quarter of them, roughly 7 million, do not even know they have it.

An additional 79 million, or 1 in 3 American adults, have pre-diabetes, which puts them at a high risk for developing type 2 diabetes.

Unfortunately, diagnosis often comes 7 to 10 years after the onset of the disease, after disabling and even deadly complications have had time to develop.

While everyone should be aware of the risk factors for type 2 diabetes, people who are overweight, live a sedentary lifestyle, and over the age of 45 should consider themselves at risk for the disease. African Americans, Hispanics/Latinos, Native Americans, Asian Americans, Pacific Islanders, and people who have a family history of the disease are also at an increased risk.

What you can do

Studies have shown that type 2 diabetes can often be prevented or delayed by losing just 7 percent of body weight through regular physical activity and healthy eating. By understanding your risk, you can take the necessary steps to help prevent pre-diabetes or the onset of type 2 diabetes.

WakeMed can help. Our Diabetes Management Program pairs you with a caring, experienced staff of diabetes nurse clinicians and dietitians who can help you learn to control your diabetes by eating healthy, exercising and taking your medications properly. This education and support is offered through our Outpatient Program, and if you need to be in the hospital, through our Inpatient Services. Services are available at WakeMed’s Raleigh campus and Wake Med Cary Hospital.

Carol V. White, BSN, RN-BC, CDE is a Diabetes Patient Educator at WakeMed’s Adult Diabetes Management Program.

By Amy Bowen, RD, LDN and Lindsey Hurd, Dietetic Intern, MS

With sensible management through diet, exercise, and medication, individuals diagnosed with diabetes can live a long healthy life. Diabetes is a lifelong disease that cannot be cured. Luckily, risks for complications and accompanying diseases such as heart disease can be reversed or avoided by following a healthful lifestyle.

When we eat carbohydrates (starches), our body digests them to make glucose (sugar), the primary source of energy in the body. The glucose is then stored in our liver and in our muscles for use when we need energy. For people with diabetes, this process may not happen as it normally would, causing the amount of sugar in the blood to rise above a normal level.

Signs and Symptoms of Diabetes:

• Extreme thirst or hunger
• Frequent urination
• Blurred vision
• Drowsiness or dizziness
• Headache
• Irritability

Diabetes is diagnosed when:

• Fasting blood sugar rises over 126mg/dL on consecutive occasions.
• A test called oral glucose tolerance test is given and blood sugar levels are above or equal to 200mg/dL when measured 2 hours after the test.
• Blood sugar levels are above 200mg/dL when tested at the time hyperglycemic (high blood sugar) symptoms occur.

Four categories:  Pre-Diabetes, Type I Diabetes, Type II Diabetes, or Gestational Diabetes

Pre-diabetes is a new term used to describe the period of time when individuals have a high blood sugar, but do not meet the criteria of diabetes. Pre-diabetes is diagnosed when:

• Fasting blood sugar levels fall between 100mg/dL and 126mg/dL
• After an oral glucose tolerance test, blood sugar levels fall between 140mg/dL and 200mg/dL
• In Type I Diabetes, the body no longer produces insulin, causing these individuals to require insulin injections to process the sugar from digesting foods normally.

In Type I Diabetes, the body no longer produces insulin, causing these individuals to require insulin injections to process the sugar from digesting foods normally. Type I Diabetes is often diagnosed in children.

Type II Diabetes is most often caused by lifestyle choices such as inactivity, overweight/obesity, smoking, hypertension (blood pressure of ≥ 140/90), and high cholesterol. Other factors include age greater than 45 and African American or Hispanic ethnicities.

Gestational Diabetes occurs in pregnant women, usually toward the end of pregnancy. Soon after birth, Gestational Diabetes resolves itself without further need for treatment. Women with a history of Gestational Diabetes are considered at an increased risk for Type II Diabetes later in life.

Moving Toward a Healthier Lifestyle

1. Eat a consistent amount of carbohydrates at each meal.  Eating the same amount of carbohydrates at your meals and snack (s) each day will help keep your blood sugar from going too high or too low.
2. Avoid cutting out all carbohydrate foods from your diet. Carbohydrates are your body’s best form of energy and your body needs some carbohydrates every day.
3. Do not skip meals.
4. Control Portion Sizes.  Portion control is the most important aspect of nutrition management in diabetes. Follow the link to Choose My Plate and learn more about how to fill your body with tasty nutrient dense foods that fall within a healthy diet.
5. Move More

Lastly, to achieve or maintain a healthy weight, activity and movement is an essential component to the equation*. Work toward accomplishing 30-60 minutes of moderate intensity exercise most days of the week. *Check with your physician prior to starting any exercise program.

Achieving a healthy lifestyle takes time and effort. As you progress toward your goals, follow the 80/20 rule, 80 percent of the time, maintain a healthy active lifestyle, and follow the points above. This leaves 20 percent for enjoying foods and activities you enjoy, keeping in mind portion control is key. No food is completely off limits. Find a healthful balance that you can maintain for life and you will find success in achieving your goals.

Need Guidance?

The Outpatient Nutritional Services Department at WakeMed Cary Hospital offers nutritional counseling. A registered dietitian can talk to you about making healthier food choices and tailor a diet that’s right for you. Individual counseling is also offered for weight management, diabetes, heart health, and food allergies.

For more information, or to schedule an appointment, please call or have your physician fax a referral. Phone: (919) 350-2358; Fax (919) 350-2319. Insurance coverage and costs vary.

Editor’s Note: In the fight against chronic conditions, what you eat can be just as important as taking your medicine as prescribed, exercising, and having a support system. In a series of blog posts, Parul Kharod, a clinical dietitian at WakeMed Cary Hospital, will explore the best diet for common conditions such as high blood pressure, diabetes, and high cholesterol.

Chances are you or someone you know has high blood pressure.

High blood pressure, also known as hypertension, usually has no symptoms and affects 1 in 3 American adults.  This occurs when your blood presses too hard against the walls of your blood vessels.  High blood pressure by itself rarely produces symptoms, but over time, if left untreated, can cause some serious health problems.  High blood pressure can cause your blood vessel walls to thicken, increasing the risk of heart attack, stroke, and damage to other organs such as eyes and kidneys.

Maintaining a diet that is low in sodium, total fat, saturated fat, and cholesterol, while high in potassium, calcium, magnesium, fiber and protein can be a great way to manage high blood pressure. Small tweaks to your diet such as eating out less, cooking more at home, and buying fresh fruits and vegetables can be very effective.

Supported by the National Lung, Heart, and Blood Institute, the Dietary Approach to Stop Hypertension or D.A.S.H. eating plan is clinically proven to successfully reduce your blood pressure.

To D.A.S.H. your way to better health:

Add or Increase:

• Whole fruits
• Colorful vegetables
• Low-fat dairy products such as milk, cheese, or yogurt
• Whole grains such as oats, barley, bulgur, quinoa, rye, and whole wheat bread and pasta
• Nuts such as almonds, pistachios, walnuts, and cashews
• Omega-3 fats found in walnuts and fish oil
• Water
• Exercise (after clearance from your doctor)

Reduce or Avoid:

• Fruit Juices
• Sodium
• Alcohol
• Saturated and trans fats
• Added sugar

The Outpatient Nutrition Services Department at WakeMed Cary Hospital offers nutrition counseling. A registered dietitian can talk to you about making healthier food choices and tailor a diet that’s right for you. Individual counseling is also offered for weight management, diabetes, heart health, and food allergies.

For more information, or to schedule an appointment, please call or have your physician fax a referral. Phone: (919) 350-2358; Fax (919) 350-2319. Insurance coverage and costs vary.

Parul Kharod, MS, R.D, LDN is a clinical dietitian at WakeMed Cary Hospital.

Fever is one of the most common childhood encounters. Yet, despite its frequency, the very thought of a child having a fever can fill even normally composed parents with worry and anxiety.

Parents often have questions like:  “When should I worry?”  “How high is too high?”  “Will my child have a seizure?” “Does my child need antibiotics?” “If I use ibuprofen or acetaminophen will that mask a serious illness?”

First of all, let me reassure you, it’s a great time to be a child. Modern vaccine advances have led to staggering protection from previously deadly and debilitating illnesses. For a healthy, vaccinated child the chances that a fever represents a life-threatening illness are much, much lower than years ago.

How a fever works

Fever is a healthy child’s normal response to an infection. By raising the body’s temperature, fever helps activate certain enzymes needed to fight infection and may also have some direct effect in killing the causative virus or bacteria.

However, a healthy child’s temperature will not just continue to rise unabated. The body has a very sophisticated thermostat, much like that in your house.  The upper limit of the body’s thermostat is around 106.  So even if your child’s temperature seems to be climbing (101… 102…103…104) it will not continue at that pace until your child spontaneously combusts.  The healthy brain will tell the body not to take the temperature over 106 and no brain damage will occur at temperatures of 106 and below.

Likewise, seizures are not a direct result of a high fever.  There is a phenomenon in children called a “febrile seizure.”  However, these seizures result from a rapid rise in fever that typically occurs even before the parents know the child is ill.  These seizures are usually benign and never cause any long -term problems.

When to see a doctor

Although I always advocate that parents should trust their parental instincts and seek care when they are concerned, below is some additional guidance.

See a doctor when:

1. The fever associated is with other symptoms such as: trouble breathing, abdominal pains, persistent vomiting, sore throat, severe headache, neck pains, extreme body aches, or rash.
2. A fever lasts for more than two days since hard- to-detect infections such as urinary tract infections can be the cause of fever particularly in children less than 2 years old.
3. Any fever (defined as more than 100.4 on rectal temp) occurs in a child less than 3 months old.
4. A fever occurs in children with other serious medical problems or immune deficiencies.

Dr. Courtney Mann is an emergency physician at WakeMed Health & Hospitals.

WakeMed is on track to open a health care complex on U.S. 70 in Garner, scheduled to open in April 2013.

The Garner Town Council approved this week a special use permit for the facility and agreed to rezone the 20-acre site across from the Agri-Supply store, according to the Raleigh News & Observer.

The 50,000-square-foot facility will feature a 14-bed emergency department and lab services, and include physicians’ offices. It will also serve as the base for medical helicopter operations and create about 150 jobs.

An estimated 12,000 to 15,000 people could be treated in the emergency department in the first year. That number could jump to 27,000 by the end of the facility’s first decade in operations.

Learn more.

For many toddlers and young children, home is a place of discovery.

The adventure of learning to stand, walk, and reach that shiny object way on the top shelf can prove irresistible. But these adventures can be dangerous and even downright deadly if the proper precautions are not taken.

The U.S. Consumer Product Safety Commission (CPSC) estimates that between 2000 and 2010 there were at least 245 deaths related to tip-overs of furniture, televisions or appliances among children ages 8 years and under. Most of these deaths, 90 percent of them, involved children younger than age 6. In 2011, the CPSC identified this issue as one of the top hidden home hazards.

Kids can be seriously injured or killed as a result of climbing onto, falling against or pulling themselves up on shelves, bookcases, dressers, TV tables, and other furniture.

Here are some tips for keeping your home safe:

• Fasten top-heavy or unstable furniture to a wall using brackets, screws or wall straps.
• Keep heavier items on lower shelves or in lower drawers.
• Don’t keep remote controls, candy or other tempting items on unstable stands or tables.
• Teach children not to climb or jump on furniture.
• Push the television as far back as possible from the front of its stand.

Kids are also in danger of suffocation if they become accidentally trapped in a cabinet, toy chest or laundry machine. In 2007 alone, there were 3,270 injuries to children ages 2 to 14 involving toy chests. Always supervise children around any confined space and keep the doors closed and locked.

Toy chests that meet voluntary standards set by the CPSC are equipped with lid supports that hold the lid open in any position. The standards also call for ventilation holes to prevent suffocation. If you have a toy chest with a lid that doesn’t stay open, the CPSC recommends you remove the lid or install a spring-loaded lid support.

Safe Kids Wake County works to prevent unintentional childhood injury, the leading cause of death and disability to children ages 1 to 14. Safe Kids Wake County is a member of Safe Kids Worldwide, a global network of organizations dedicated to preventing unintentional injury. Safe Kids Wake County was founded in 1996 and is led by WakeMed Health & Hospitals.

For more information about home safety, call 919-350-8364 or visit www.safekids.org.

Siobhan Davis is the WakeMed Injury Prevention Representative and Safe Kids Wake County Coordinator.

WakeMed’s Mother’s Milk Bank was recently featured in a news story by Fox Wilmington about the increasing demand for “human milk for human babies”. The milk bank is one of the most established on the East Coast and one of only 10 in the country. Thousands of babies have benefited from the program. WakeMed collects nearly 24,000 ounces a month and ships out about 20,000 ounces. While the demand for milk is high, WakeMed’s priority is helping babies with special needs.

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Both WRAL and NBC 17 did stories this week featuring WakeMed Physician Dr. Michele Casey about the importance of getting the whooping cough vaccine.

Eighty-two cases of the contagious disease were recently confirmed in Alamance County.

Whooping cough, also known as pertussis, is a bacterial disease which leads to severe coughing that can cause people to make a whooping sound as they gasp for breath.

The Tdap vaccine, which protects against tetanus, diphtheria, and whooping cough, lasts for about 10 years and is recommended for all adults, but especially for those who are around vulnerable populations such as young children and the elderly.

As they grab their uniforms, cleats, rackets, helmets, sneakers, etc… make sure your kids grab healthy snacks to keep their energy high and their minds nourished.

And, if you’re the parent in charge of snacks, it’s important to bring something that will keep all the kids moving!

Here’s a list of go-to snacks that will surely be team-pleasers. Be sure to offer at least two options – a carb and a protein.

• Low-fat cheese, string cheese
• Greek yogurt
• Apples, bananas, pears, oranges (fresh or dried)
• Carrots, sugar snap peas, cucumbers
• Hummus and pita
• Trail mix (be aware of nut allergies)
• Plain popcorn, pretzels, baked chips
• Granola bars (watch the sugar and fat)
• Almond butter or peanut butter mini-sandwiches (again, be allergy aware)
• WATER

With all of the on-the-go packaging available these days, providing these healthy options is not only good for them – it’s easy to keep stocked! If you’re feeding the team, going to membership stores (Costco, Sam’s, BJs) is a great place to find favorite snacks in bulk at great prices.

Julie Paul is a program coordinator with WakeMed Children’s Diabetes and Endocrinology.