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Construction Begins on Brier Creek Healthplex

Exciting news for the Brier Creek community. Construction has officially begun on the WakeMed Brier Creek Healthplex located at the corner of US-70 and TW Alexander Blvd.

Like WakeMed’s other stand-alone emergency departments located in North Raleigh and Apex, the Brier Creek Emergency Department will be staffed by the same board certified physicians that serve WakeMed’s five additional emergency departments and Level 1 Trauma Center.

The Brier Creek Healthplex will be the county’s third 24/7 full-service, stand-alone emergency department with 12 private treatment rooms. And laboratory and imaging services, including CT and X-ray, will be available for emergency department patients and outpatient visits.

Construction is slated to be completed by November 2011 and the building will be operational by January 2012. Find more information about Brier Creek Healthplex here.

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NC Seasonal Sensation: Lettuce Recipes

Once again, here are a few recipes straight from the NC’s No Diet Diet – all featuring North Carolina-grown seasonal veggies. Lettuce varieties sprout in early spring and are packed with tons of nutrients like vitamins A, C and K, beta-carotene and folic acid. Not all lettuce is created equal, however, so look for dark green varieties like Romaine, Butter Crunch, Royal Red and even spinach.

Spring Greens

Lettuce varieties sprout in early spring and are packed with tons of nutrients like vitamins A, C and K, beta-carotene and folic acid. Not all lettuce is created equal, however, so look for dark green varieties like Romaine, Butter Crunch, Royal Red and even spinach.

Walnut Vinaigrette Salad
From WakeMed’s HeartSmart Cooking Series, 2009 Serves 8, vinaigrette serving size 1 ½ Tbsp

For the salad
12 cups seasonal lettuce
1 medium tomato or two roma tomatoes, cut into wedges
5 sprigs Italian flat leaf parsley, lightly chopped ½ cup dried cranberries or currant (unsweetened) ½ cup walnuts
Clean and chop the lettuce and place in a large salad bowl. Add the tomato wedges and chopped parsley and toss to combine.
Preheat oven to 325°F. Spread walnuts on a baking sheet and toast in the oven for 5 to 10 minutes or until golden, being careful not to burn them. Remove from oven and let cool.

For the vinaigrette
¼ cup white wine or champagne vinegar
Zest of a lemon
2 Tbsp lemon juice
2 Tbsp walnut oil (Use extra virgin olive oil if walnut oil is unavailable.)
2 Tbsp water
4 Tbsp extra virgin olive oil
Pinch of salt and cracked pepper to taste
Optional: herbs, 1 tsp honey, ½ tsp Dijon mustard, 1 clove garlic

Place vinegar, lemon juice, salt, pepper and optional ingredients in a blender or food processor. Pulse until well combined. With the blender running, slowly add the oil in a thin stream. Pour the vinaigrette into a bowl and wisk in the lemon zest. Drizzle the vinaigrette over the salad and top with the toasted nuts and dried fruit. Try garnishing the salad with a few tablespoons of freshly grated parmesan cheese.

Per serving: 165 calories; 13 g fat; 1 g sat; 6 g monounsaturated fat; 4 g polyunsaturated fat; 0 mg cholesterol; 9 g carbohydrates; 2 g protein; 2.6 g fiber; 90 mg sodium

Grilled Asparagus & Spinach Salad
From WakeMed’s HeartSmart Cooking Series, 2009 Serves 4 to 6
1 large bunch of asparagus
4 cups fresh spinach (preferably baby spinach)
1 Tbsp pine nuts
2 Tbsp extra virgin olive oil plus more for drizzling
2 Tbsp balsamic vinegar
Pinch sea salt
Fresh cracked pepper to taste
½ cups roasted red peppers, chopped
1 cup button or cermini mushrooms

Preheat oven to 325°F. Spread pine nuts on a baking sheet and toast in the oven for 5 to 10 minutes or until golden. Remove from oven and let cool.
Drizzle a small amount of olive oil over asparagus and toss well. Season with a pinch of sea salt and a few grinds of black pepper. Toss well to combine. Place asparagus on a hot grill and cook until lightly charred or to preferred doneness.

Place spinach, mushrooms and roasted red peppers in a large salad bowl. Drizzle about two tablespoon of olive oil, followed by two tablespoons of balsamic vinegar over the salad. Toss well to combine. Top the salad with grilled asparagus and toasted pine nuts.
Per serving: 184 calories; 2.5 g fat, 0 g saturated fat; 1.5 g monounsaturated fat; 120 mg sodium; 12 g carbohydrates

For a complete list of farmers markets, CSA’s, veggie boxes, farm stands and groceries carrying locally grown sources, visit the Community Gardens & Local Foods section of Advocates for Health in Action’s website

Tina Schwebach is a clinical dietician, R.D., at WakeMed Cary Hospital.

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Parents should monitor CT radiation exposure for children

Pediatric radiologist Dr. Margaret Douglas discussed pediatric radiation exposure with the WRAL Health Team.

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Don’t Forgo the Stretch

Several patients have asked me over the past week about a study that was released by the American Academy of Orthopaedic Surgeons that found that stretching before running may not prevent injuries. 

This is just one study of many looking at sports and injury prevention.  With every study the findings are slightly different and since each study examines a different segment of the population, my advice is to always take each piece of new information in stride.

This study, for example, examined 3,000 long-distance runners and found that they were more likely to get hurt if they were overweight or switched routines, but stretching before or after exercise didn’t appear to matter.  This group, overweight or not, was obviously very active and in decent shape, since they were all categorized as “long distance runners.”   Regular exercise naturally stretches your tendons and muscles and gets them used to moving and extending.

However, if you are a weekend warrior who has never seen a yoga matt and you do no exercise all week long then that Saturday morning run is more likely to result in injury. If you are a weekend warrior, then you would likely benefit from a warm up and a good stretch before you embark and after you return. 

And everyone, whether you are in great shape or not, participating in activities that require a lot of sudden stops and starts like soccer or basketball would also benefit from a warm up and a stretch.

Stretching is an important component of overall health and flexibility.  People typically start to lose flexibility and become more prone to injury as they age simply because they become less active and more sedentary. 

The good news is that flexibility lost can be regained.  Yoga is surprisingly not difficult and people of all ages, activity levels, and flexibility can participate and benefit from this type of stretching activity. But, if you work out regularly and incorporate activities like yoga into your fitness routine, then stretching before or after running or other aerobic exercise likely will not make you more prone to injury. 

Jonathan Chappell, MD, is an orthopaedic physician with Wake Orthopaedics.

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Community Garden Tool Drive

Schools, churches, neighborhoods, community groups and other nonprofits are capitalizing on the excitement around sustainable food systems by connecting people with where their food comes from and promoting environmentally friendly living through community gardens.

However, one of the biggest hurdles community gardeners face is funding for all the supplies needed to maintain the gardens. Many of us have old shovels and tools tucked in the corners of our garages. Why not donate those unused tools for others in our community growing local foods?

Triangle area residents who dig gardening and giving are invited to donate spare gardening tools for Advocates for Health in Action’s (AHA) Garden Tool Drive.

Garden Tool Drive Locations

Sat., March 5 at AHA’s Dig In at Marbles Kids Museum in Raleigh, 8:30 am-12 pm;

Tues., March 15 at the Alexander Family YMCA at 1603 Hillsborough St. in Raleigh in the WakeMed Rehabilitation office, 11 am-1 pm;

Mon., March 21 outside the main entrance of WakeMed Cary Hospital, 1900 Kildaire Farm Rd. in Cary, 11 am-1 pm.

Wheel barrows, hoes, shovels, pick axes and other useful gardening tools are in great demand at many area community gardens. AHA will arrange for any donated tools to go to gardens in need.

AHA expects over 235 beginner and veteran gardeners at Dig In on Saturday; registration is now closed for this community garden summit, but gardening resources, presentations and handouts will be posted on the AHA web site, www.advocatesforhealthinaction.org, after the event.

Laura Aiken is a community health specialist with WakeMed Health & Hospital and is the director of Advocates for Health in Action.

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Are Video Games and Computers Causing Injuries?

Since 80 percent of kids ages 8 through 18 today regularly use computers, I thought it might be helpful to expand on last Friday’s post and provide a few additional resources to help encourage healthy computing and offer resources for individuals who have already been impacted by monitor misery.

Video Games
The American Society of Hand Therapists issued a national alert regarding the potential for musculoskeletal injuries or disorders in people who use video games.  Here’s what parents can do to help prevent repetitive motion injuries:

• Read the warnings that come with your child’s video games.
• Monitor you child’s usage on video games and computers.
• Make sure he stops and takes a break every 20 to 30 minutes.
• Encourage your child to go outside and engage in a physical activity.
• Don’t let him sit too close to the video game/monitor and make sure he doesn’t hunch over or tense up his muscles.

Computers
Help your child avoid stresses and injuries by working their muscles in a relaxed and efficient manner.

• Provide support for your child’s back, especially the lower back.  A supportive chair is ideal, but a pillow or rolled up towel will suffice.  A pillow behind a small child’s back can also help to shorten a seat depth that is too long.
• Show your child the proper arm position when using the keyboard or mouse, which is slightly greater than a 90-degree angle.  Your child should not be reaching up and/or forward, as it places a lot of tension on muscles.  Consider an adjustable keyboard tray.  Child-sized keyboards and various designs are available.
• Adjust the chair so your child is looking straight at the monitor, not tilting her head back or twisting to get a good view.  Make sure her feet are supported, with the knees at the same level or slightly lower than the hips.  If a footrest is not available, use phone books or a box.
• Provide built-in adjustability as your child grows or if your family shares a computer.  You can purchase adjustable keyboard trays in height and tilt, adjustable chairs, and an adjustable height monitor.  These will allow each family member to customize the station for comfort and safety.
• Place a light source to the side, preferably at a 90-degree angle.
• Most importantly, you can lead by example.  These same guidelines should apply to mom and dad.

For step-by-step information on how to properly set up a computer workstation visit the U.S. Department of Labor Occupational Health & Safety Administration’s web site.

Think your child has a gaming related injury?

If so, remember that WakeMed Rehab is available to assist at multiple outpatient locations throughout the Triangle, including your local YMCA. Physical Therapy evaluations and treatments are available with a physician referral and free physical therapy screenings are available for YMCA members. For information or to schedule a screening, call 350-3800.

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Spring Fever

Spring is quickly approaching and the doldrums of winter are ending as the days are getting noticeably longer. Adults and children alike are getting excited to go outside and be more physically active, especially on the occasional 70 or 80 degree sunny day.  This shorts and t-shirts weather builds excitement that can sometimes be interpreted (or misinterpreted) as Spring Fever. 

Spring Fever is not a virus and it is not contagious, although it might be catchable.  Spring Fever is simply the desire to be outside and be physically active. 

My advice to parents, no matter the weather, is to balance the need to get homework done and the need for physical activity.  Dress children appropriately and send them out to play.  Bundle them up on cold days, shed some layers on warmer afternoons, and take advantage of this new-found energy to run away the winter blues.  Limiting screen time in front a TV, computer or video game is important too.  In fact, this is all generally good advice for kids and parents alike.

Melissa Johnson, PhD, is a pediatric psychologist with WakeMed’s Pediatric Development Team.

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Watch Your Posture

For those of you who missed it Monday, WakeMed Physical Therapist Amy Howes provided tips in a News & Observer article about how parents can encourage healthy computing.  Here’s what she said:

Watch Your Posture

Sitting up straight can do a lot to prevent posture problems or pain in the back and neck, said Amy Howes, a physical therapist for WakeMed, who works in a clinic in the Kerr Family YMCA. She offered these tips for parents and kids.

Find a chair that supports your lower back. Your feet should be on the floor and should be in line with your knees. If your child’s feet do not reach the floor, use a footrest or other booster.

Use a desk. Do not use a computer or laptop sitting on the couch. “That sort of makes you want to slouch and bend over, and that’s not always best,” she said. “Plus, if you’re sitting on a couch, you’re much more likely to not be doing your work and to get distracted.”

Keep your ears in line with your shoulders and your shoulders in line with your hips. In other words – sit up straight!

If you find that you have soreness or pain in your back or neck, try these three simple stretching exercises.

1. Sit up straight, put your arms at your sides and try to squeeze your shoulder blades together. Hold for 5 to 10 seconds, relax and then repeat.

2. Tilt your ear toward your shoulder to stretch your neck, hold for 5 to 10 seconds, then look straight ahead and then repeat for the other shoulder.

3. Bring your shoulders up toward your ears like you are shrugging, hold for a few seconds and then relax.

Read the article and learn more about computer user ergonomics and eye health here.

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Peripheral vascular screening anyone?

Everyone is screened for high blood pressure, high cholesterol, diabetes, some cancers and obesity each year during your physical with your primary care physician. 

Have you ever wondered why you are not screened for peripheral artery disease, carotid artery disease, or an aortic aneurysm?  The answer is likely that you are not in the risk group and you do not have symptoms.

On this blog over the next couple of weeks, I will share with you the risk factors for each of these diseases, so you better understand if you are at risk and if you are a good candidate for screening. 

For starters lets talk about peripheral artery disease. It is important to be aware of peripheral artery disease because it is a significant marker for premature death, so identifying issues early is important. 

If you answer yes to most of these, then it would be a good idea to speak with your physician about peripheral artery disease screening.

Are you obese?
Do you exercise less than three times per week?
Do you have heart disease?
Do you eat a poor diet?
Do you consume an excessive amount of alcohol?
Do you smoke?
Do you have high cholesterol?
Do you have high blood pressure?
Are you a diabetic?

The primary benefit of peripheral artery disease identification is to reduce the risk of heart, stroke, limb loss and even death. The good news is that if it is identified early, you receive treatment, and aggressively modify the amount of exercise you get, improve your diet, etc., peripheral artery disease is quite treatable in most cases. 

Note too that you, as a patient, may need to ask additional questions to your caregiver because most physicians and nurses are not great at following through to follow up on potential peripheral artery disease. And if you have leg pain, make sure the doctor nurse examines your feet and legs because peripheral artery disease is easily and often overlooked.

Matt Hook is an interventional cardiologist with Wake Heart & Vascular Associates, with an office located in the WakeMed Heart Center.

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WakeMed Milk Bank Donations Down, Need Up – Mirrors National Trend

WakeMed Mothers’ Milk Bank, one of nine, not-for-profit human milk banks in the United States, continues to experience increased demand and significantly reduced donations as indicated in last month’s blog

The lack of donations and increased need is not isolated to North Carolina. Human milk banks across the country are experiencing a similar trend, leading the Human Milk Banking Association of North America (HMBANA) to distribute the following press release.

Non-Profit Human Milk Banks Submit Urgent Call for Donations

Nationwide supply is inadequate to meet demand for premature and ill infants in need

The Human Milk Banking Association of North America (HMBANA) is asking healthy lactating mothers to consider donating to a milk bank so that fragile babies will be fed this life-giving and sustaining nutrition.

HMBANA announced that the non-profit milk banks in North America have reached critically low levels of screened donor human milk for fragile babies in relation to demand.

Neonatologists who care for the tiniest and most fragile patients use DHM because it provides immunologic and growth factors as well as optimal nutrition. “For these babies, it is truly life-saving. In many cases, the mother does not have a full supply of her own milk, and in some cases mothers cannot provide any milk to their fragile babies,” states Kathleen Marinelli MD, IBCLC, FABM, neonatologist at Connecticut Children’s Medical Center, where human milk (mothers’ own and donor milk) is standard of care for premature babies.

 HMBANA asks every healthy lactating mom to consider donating milk for a fragile infant by contacting the milk bank closest to them.

Click here to learn more about donation to WakeMed Mothers’ Milk Bank.

Sue Evans is a lactation specialist and director of the WakeMed Mothers’ Milk Bank.

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