February is Heart Month, and in our most recent issue of Heart to Heart we included interviews with a few of our cardiologist about how they stay heart healthy. 

Brian Go, MD, FACC

Raleigh Cardiology Associates

Heart to Heart: What motivates you to exercise?

Dr. Go: Routine exercise is an essential part of my life. It’s like the “perfect drug” for me. It decreases my stress level, and I sleep better at night. It helps me focus mentally and improves my overall mood and disposition. For me, there is no substitute.

Tonia Fehr is the manager of WakeMed Cary Hospital’s new 12-bed Chest Pain Unit.

Dick Cheney has a long history with heart disease, suffering his first heart attack at age 37.  Yesterday he was admitted to the hospital again with complaints of chest pain.

Chest pain should always be taken seriously.  It can be a primary symptom of a STEMI (better known as a heart attack) and speedy treatment can save valuable heart muscle, preventing death and ensuring a good quality of life after the event.  It also matters where you are treated.  Certain hospitals have undergone stringent surveys by the Society of Chest Pain Centers, certifying that they are following protocols proven to offer the best possible outcome for patients presenting with chest pain. Raleigh Campus, Cary Hospital, North Healthplex and Apex Healthplex are all Certified Chest Pain Centers, and Raleigh Campus and Cary Hospital (as of today) both have dedicated 12-bed chest pain units.

Patients presenting with chest pain to any WakeMed Emergency Department are cared for by specially trained nurses who are passionate about cardiac care. Using standardized protocols, each patient on arrival will immediately have a 12 lead EKG, receive the appropriate medications, cardiac monitoring and have serial cardiac enzymes checked. These steps help physicians rule out a STEMI ( the most dangerous of heart attacks).

If a STEMI is ruled in, patients are immediately whisked to an interventional cath lab to open the affected coronary artery thereby restoring circulation to the heart muscle. If a STEMI is ruled out, patients are admitted to the Chest Pain Unit for continuous cardiac monitoring with additional diagnostic tests to determine the cause of the chest pain. 

Regardless of the cause, chest pain should never be ignored.

Update, February 23 2:30 pm: This just in, Dick Cheney did have a mild heart attack.  Visit MSNBC for more information.

February is Heart Month, and in our most recent issue of Heart to Heart we included interviews with a few of our cardiologists about how they stay heart healthy.  

Dr. Michael Zellinger

Michael Zellinger, MD, FACC 

Wake Heart & Vascular Associates 

Heart to Heart: What’s the best heart-healthy advice? 

Dr. Zellinger: I think the most important heart healthy advice is to stop smoking. The next would be to stop eating so much. We take in too many calories each day. Cutting calories, especially carbohydrates, helps in weight loss. My favorite heart-healthy food advice is to use olive oil instead of butter or margarine. 

Heart Healthy Cooking Demonstration 

Speaking of eating heart healthy, tomorrow WakeMed Heart Center is hosting a Heart Healthy Cooking Demonstration in the Heart Center Conference Center.   

Executive Chef Adam Jones of Michael Dean’s Seafood Grill will demonstrate how to prepare a heart healthy meal that’s tasty, too.  Registration is full, but don’t fret if you aren’t able to make it to the event.  Here are the recipes Chef Jones will prepare. 

Grilled Honey Glazed Shrimp Cocktail with Pineapple Sauce
Servings: 3 oz shrimp with 3 oz pineapple sauce
6 oz large shrimp, peeled, deveined
2 tbsp honey
1 tbsp olive oil
1 lemon, juiced
In small bowl, combine honey and lemon juice. Set aside. Brush shrimp with oil and grill until just done or 1 minute per side. Toss shrimp in honey mixture and place in refrigerator to cool. 

Pineapple Sauce
1 cup fresh pineapple, peeled
Pinch cayenne pepper
1 lemon, juiced
1 tbsp honey
In food processor or blender combine all ingredients and puree until smooth. Pour into small bowl and “dip” shrimp in sauce to taste preference.
Calories: 280, Total Fat: 8 g, Saturated Fat: 1 g, Monounsaturated Fat: 5 g, Polyunsaturated Fat: 1 g, Sodium: 127 mg, Total Carbohydrate: 35 g, Dietary Fiber: 0 g, Sugars: 30 g, Protein: 17 g 

Wood Grilled Salmon with Black Bean and Artichoke Salad
Servings: 3 oz salmon with ¼ salad mixture
2, 3oz portions salmon
1 cup dried black beans, cooked without salt and drained
1 chopped tomato
1 diced red onion
1 diced green bell pepper
1 jalapeno, seeded, small dice
2 cups chopped artichoke hearts, fresh, cooked without salt
½ cup chopped cilantro
2 tbsp chili powder
1 tbsp cumin
¼ cup extra virgin olive oil
½ cup red wine vinegar
Grill or broil salmon for 6-7 minutes or until done. Combine remaining ingredients and mix well. Spoon a quarter of bean mixture over salmon. Enjoy!
Calories: 445, Total Fat: 26 g, Saturated Fat: 4.5 g, Monounsaturated Fat: 13 g, Polyunsaturated Fat: 5 g, Sodium: 146 mg, Total Carbohydrate: 28 g, Dietary Fiber: 14 g, Sugars: 4 g, Protein: 25 g

If an object can fit through a toilet paper roll, then it is a possible choking hazard.

WakeMed’s Trauma Program Director Sylvia Scholl shares tips to identify choking hazards for children.

Today on MSNBC, one of the lead stories is Choking warning urged for food labels, which highlights the death of a 4 year old boy after he choked on a hot dog.  This story discusses a true public health issue – airway obstruction in children. 

Each year, approximately 890 children ages 14 and under die from airway obstruction injuries, which include unintentional choking, strangulation or suffocation. Nearly all of these incidents, 8 out of every 10, involved children under 4 years of age.

Most choking incidents in children involve food. To avoid this, parents and caregivers should always supervise young children while they’re eating and never give children under age 3 small, round foods such as hot dogs, candies, nuts, grapes, carrots and popcorn. Other common choking hazards include coins, buttons, small balls and toys with small parts. 

Keep small objects that are potential choking hazards out of your child’s reach.  Literally get down on your hands and knees and crawl around to see what your child can reach. You’ll be surprised at how much is at your child’s eye level.

Here are some tips to help prevent choking that all parents should know:

• If an object can fit through a standard toilet paper tube or a store-bought small parts tester, do not let your child play with it.
• All parents and caregivers should learn CPR and first aid for airway obstruction. Infant and child CPR classes are available from the American Red Cross or the American Heart Association. Parents can learn effective skills that can make the difference between life and death.

For more information about preventing choking and other airway obstruction, visit Safe Kids USA.

Dr. Ben Alexander, WakeMed’s chief medical information officer and pediatric intensivist, weighs in on the new Apple iPad and its application in a health care setting.

News of Apple’s innovative iPad has the technology world abuzz,  but what is the heath care community saying? The responses are, in fact, varied. Some have lauded the device as a “health care revolution,” while others are hesitant about how fast software creators will fashion usable health care applications.

On the surface, the device may seem an upgrade from its smaller screened relative, the iPhone. The 9.7 inch touch screen iPad boasts enough space to view health care data in detail. Though that’s too big for the lab coat pocket, it still beats the size of most paper files.

But obstacles for health care applications may lay behind the sleek façade. Currently organizations, such as the Office of the National Coordinator for Health Information Technology (ONC), are trying to define the health information technology standards that could address data transferring and security issues. Stimulus money from the federal government could also advance this cause.

With all the hype surrounding the device, the iPad could be the impetus to speed this process. If this occurs, companies could create compatible and affordable software to optimize the device’s health care capabilities. It seems it will take these efforts (and some time) before we see just how revolutionary the iPad will be.

Update February 23: The American Medical Association also recently posted an article on the possibilities of the iPad in health care. Check out their thoughts here.

February is Heart Month, and in our most recent issue of Heart to Heart we included interviews with a few of our cardiologists about how they stay heart healthy. 

Christian Gring, MD, FACC

Wake Heart & Vascular Associates

Heart to Heart: Do you ever fall off the heart-healthy wagon?

Dr. Gring: I am the poster child for it. Before entering practice, I had a pretty good diet, and I had plenty of time to exercise. Then, reality hit, and I entered cardiology practice. I face the same challenges as everybody else, balancing ever-increasing time commitments— work, family and other priorities.

My diet remained good, with the exception of lunchtime when I would graze on the constant supply of cookies at the office.  But I stopped exercising routinely, which made all the difference. It took a while for the weight to creep on, which allowed me to deny that I had fallen off the wagon. When the time came for me to establish care with an internal medicine physician, I found out that I was not only 15-20 pounds overweight, but that I also had high blood pressure. Now, I’m applying my own advice, and my New Year’s resolution is to practice what I preach. I walk 30 minutes a day, five days a week, and have started to run again. Some days are not pretty: I struggle with excuses, willpower and those cookies. To stay motivated, I set a goal of running in the City of Oaks Marathon next fall. Everyone is welcome to join me!  I’ll see you on race day!

Laura Aiken is a community health specialist with WakeMed and the director for Advocates for Health in Action, a group of over 50 organizations working together to shape a community where healthful eating and physical activity is the way of life in Wake County.

Upon hearing Michelle Obama announce her new initiative to reverse the obesity epidemic within a generation through the Let’s Move Campaign, I could not help but feel proud of Wake County’s very own partnership, Advocates for Health in Action (AHA).

Like the First Lady, our goal is to ensure affordable access to healthful foods, work with school and parents to create a healthier school environment, increase the number of safe places for children to play, and to offer tools and resources to help our community make healthy choices. Through trainings such as the Brains and Bodies Workshops, we are providing parents with the tools they need to create healthier environments.

AHA recognizes the importance of understanding the needs of our community as it relates to access to food and places to be active.  Using GIS technology, middle and high school students are evaluating access to physical activity and healthful food and working in their communities to advocate for healthier options. In Fuquay-Varina, young people recognized that the convenience store that serves as a popular student hangout near school didn’t have many healthy food options.

They began working with the store manager to make positive changes such as placing healthier snacks and drinks in a more prominent locations and is looking into the possibility of adding healthier items that students want.  After this project made the front page of the News & Observer, an interested community member volunteered to create an iPhone app that will make it quick and easy for Wake County residents to determine what healthy food options are nearby. Similarly, the Let’s Move website features a Food Environment Atlas that provides the same type of information about our nation.

Working to reverse childhood obesity is not easy. At times it feels as if we are fighting the entire American culture! To see the work we have been doing is completely in line with plan launched by the White House provides motivation and validation to stay the course.

We applaud Michelle Obama for shining the spotlight on the issues we are passionate about in Wake County and we are excited to be a part of the change that will come from this movement.

Tomorrow marks the first of three free events we are hosting at our facilities throughout the county over the next few weeks.  These free comprehensive events will cover the basics of chest pain, from the warning signs and early diagnosis and treatment to activation of the 9-1-1 emergency system.

In addition, all participants will be led through the CPR Anytime for Family & Friends program. CPR Anytime for Family & Friends is the quick and easy way to learn CPR, a life-saving skill that everyone should know.  Each participants will receive a free CPR Anytime kit to share with family and friends, valued at $35. 

Tuesday, February 16 - Additional spots now available!  Sign up today!
WakeMed North Healthplex
6:30 – 8 pm

Presented by Dr. Brent Myers, Medical Director, Wake County EMS and Dr. Mark Leithe, Raleigh Cardiology Associates

Thursday, February 18 – Registration Full
WakeMed Cary Hospital
6:30 – 8 pm

Presented by Dr. Brent Myers, Medical Director, Wake County EMS and Dr. Richard Daw, Wake Heart & Vascular Associates

Thursday, March 11
WakeMed Heart Center 

Presented by Dr. Brent Myers, Medical Director, Wake County EMS and Dr. John Sinden, Raleigh Cardiology Associates

Click here to register for these events.

Today the State Auditor released an audit of the Department of Correction’s prisoner medical costs.  WakeMed is a primary provider of hospital care for Central and Women’s Prisons due to close proximity, and the audit indicates that WakeMed’s reimbursement for these patients is significantly higher than Medicare/Medicaid reimbursement.  As a result of the audit, WakeMed received numerous requests from the media to explain the seemingly higher charges. So, we thought we would share the same information with you. 

The study was based on Medicare/Medicaid reimbursement rates that do not cover our cost of providing care. Additionally, prisoners are more expensive to care for because of their higher acuity levels.  (In other words, they tend to be much sicker and tend not have had consistent access to health care or preventative medicine.) Caring for prisoners also requires significantly increased numbers of clinical staff and additional security.

WakeMed is a highly efficient hospital, and we are proud to provide high quality health care to everyone.  But the reality is that as a private not-for-profit, we receive no funds from the state, county or city and provide the majority of the charity care in Wake County.  We also incur the additional costs of caring for a large number of prisoners – who are very expensive to care for.

Over the past 18 months, WakeMed and the North Carolina Hospital Association have been working on a solution that would distribute the prisoner population evenly to hospitals throughout the state.  This solution would also ensure reasonable reimbursement for caring for this unique population of patients. Additionally, we have  been working with the Department of Correction to help them provide more care within the prison system hospitals, so that prisoner health care costs can be even further reduced.

Stacy Moretz, a dietitian in Corporate and Community Health, offers up some tips for Valentine’s Day to lavish your loved one with heart healthy gifts.  These are great ways to really show that you love their heart.

Planning a romantic dinner?

Start the meal with a salad using heart-healthy fats such as avocado or an olive oil vinaigrette. Include fatty fish, such as mackerel, herring, or salmon, which contains omega-3 fatty acids, in your entrée. Pair your meal with a glass (5 oz.) of antioxidant-rich red wine or red grape juice.

Healthy gift giving

Give a delicious display with a bouquet of fruit. Fruits contain many healthy components, such as vitamins, fiber, and antioxidants. 

Valentine’s Day treat

Include healthy ingredients into a traditional treat, such as oatmeal cookies with dried cherries or dried cranberries for a touch of festive color.

Chocolate

Indulge in this Valentine’s Day staple with a small portion of pure dark chocolate, which contains catechins (heart-healthy flavonoid compounds).

Get your heart pumping

Take a Valentine’s Day stroll with a loved one. Strengthen your and your partner’s hearts while spending quality time together. 

Laugh

Hit the movies or snuggle up for a comedy. Some research suggests a good hearty laugh is in fact good for the heart. This could be due to the relief of stress, which can contribute to factors such as high blood pressure and cholesterol.