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WakeMed Wins Approval to Add 14 Rehab Beds

The NC Division of Health Service Regulation recently awarded 14 inpatient beds to WakeMed Rehabilitation Hospital after a competitive Certificate of Need (CON) process. 

Our rehab hospital – the only inpatient rehab hospital in Wake County – will grow from 84 beds to 98 once the beds are operational by the end of the year.  In North Carolina, WakeMed Rehab Hospital is second only to Carolinas Medical Center in the number of inpatient rehab beds.


Hand Sanitizing Gel Not Effective Against Norovirus

The News &  Observer reported this morning that norovirus is on the rise in North Carolina, including in Wake and Orange counties. 

Highly contagious, this virus can infect someone who ingests only 10 particles of virus.  That is smaller than the head of a pin.  For example, it usually takes about 100,000 colonies of a bacteria to quantify an infection.

Norovirus begins suddenly and causes nausea, vomiting, diarrhea and stomach cramping. Sometimes, people may also feel tired and experience a low fever, chills, headache and muscle aches. It is contracted in areas of close contact, most commonly in long-term care facilities, schools and restaurants, especially those with buffets. This has commonly been referred to as the “cruise-ship” virus.

Norovirus is spread by direct person-to-person contact or the ingestion of fecally contaminated food or water.

Protection is relatively easy, but you must be diligent. Strict hand washing with warm water and soap remains the number one way to avoid norovirus.

Alcohol-based hand sanitizers are not effective against norovirus. Wash your hands frequently with soap and warm water, especially after using the restroom and before eating.  Additionally, norovirus is not killed with regular household cleaners.  A solution of bleach and water is the best defense.


Young Woman Adopts a Healthy Lifestyle

The following is republished from the Advocates for Health in Action (AHA) blog and is a story about a young woman learning to be healthy by exercising and eating right through WakeMed’s Energize! program.  Her exciting results and new outlook on life are detailed below.   Thank you AHA for allowing us to share this inspirational story as well.

“We were talking about making good food choices and portion control, but it just wasn’t sinking in,” said Yuri Brown, Essence Lee’s foster mother. Then Brown contacted WakeMed’s Energize! program last spring, and she set in motion what became a major lifestyle change for this Fuquay-Varina teenager. As a result of her Energize! participation, Essence lost 44 pounds from March to August, discovered how fun Zumba can be, learned what a healthy portion is, and according to her foster mother, became a more confident person.

Energize! is a 12-week program dedicated to helping children aged 6 to 18 reduce their risk of developing type 2 diabetes. Energize! teaches young people and their families how to build lifelong healthy attitudes about food and fitness through three classes a week, including a family night. In addition to classes held at WakeMed Health park, Energize! partners with the YMCA of the Triangle to hold  classes at five Triangle YMCAs throughout the year.

Quiet but friendly, Essence does not seem to be aware of all her positive changes, Brown said. Nonetheless, Lee did learn this: “You can have fun while exercising. It may not always be fun while you’re doing it, like cycling and pushing yourself hard, but you feel good afterwards. And Zumba is fun while you’re doing it,” Lee said.

She also said that exercise was a little dull before, such as getting on a treadmill and walking. Energize! showed her a lot of options though, with the group playing games, mixing up their routines, doing cheer dancing and other activities.

Essence and her foster family joined in an Energize! program at the Kraft Family YMCA three nights a week. The curriculum for children aged 12-18 involves an hour of fitness, plus a 30-minute discussion on healthy lifestyles, ranging from nutrition to fast food facts, behaviors to positive body image and healthy snacks to reading nutrition labels.  (For children ages 6-11, Energize! meets three nights a week with one hour of fitness.)

“With the teens, we focus on positive thinking and how they feel about their own health and body, and giving positive messages to each other. We also do a class with just parents about role modeling to help  parents discover their role in helping their child grow up healthy,” said Energize’s Program Coordinator Julie Paul, MS, RD, CDE.

Paul continued, “The Energize curriculum starts with walking activities and then builds to different activities each week like outdoor sports and recreation, group fitness, plus two weeks of cooperative games—all kinds of activities that are group and family-based,” Paul said. The goal is to expose families to many different ways to be active that do not require expensive equipment or a gym membership. Fitness measures are also taken before and after the program so participants can see the difference that exercise makes in their overall fitness level.

She also said that WakeMed trains YMCA staff in the Energize! curriculum and provides direction to help them in turn help these inactive children and teens in a very different way than many who enter the Y to get fit. Motivation and adapting fitness ideas for them is really important. 

Brown sees a huge change in Lee’s attitude from the beginning of the Energize program to now; not only is she healthier and fit, but she is more outgoing, participating more and more confident in who she is. Lee won the Youth Lifestyle Change Award from the Y this year for her efforts. Lee’s foster mother says she stumbled a bit after the program ended, but that she is back on track now.

“When I was with my mom, I wanted to work out and be healthy, but I didn’t really know how. I would get a salad with all the meat and eggs and bacon bits and lots of dressing, and work out for a few days and then stop,” Lee said. Now when she outs, she makes better choices, she’s not at the snack table at parties and she drinks a gallon of water a day!

Lee even sets a positive example now for her 2-year-old sister and her foster family. “She’ll say, ‘I was out walking. What were you doing?’” Brown said.

Energize! follows its participants for two years after the formal 12-week program ends; there are four appointments over two years with lab work repeated, blood pressure, height, weight and BMI check, as well as counseling and discussion about exercise and nutrition patterns, behaviors, eating out and more.

“A good number of kids in Energize lose weight, but Essence lost a substantial amount of weight. Her foster family wanted to help her and took a lot of initiative to get healthier foods at home and at school. for her. Essence’s success in the program is a testament to her perseverance,” Paul said.


Honoring the Longview House Legacy

Earlier this week we announced that the family of Clarence and Alice Aycock Poe generously gifted the historic Longview House, or Poe House as it is often referred to, and two acres of land upon which it sits to the WakeMed Foundation.

The Longview House is very close to many people’s hearts both as a historic property and as the place where many a wedding reception and anniversary party has been held over the years.  After our announcement, we heard concerns about the future of the home. 

Although we are still finalizing land use plans for 14 acres we purchased adjacent to the home, we promise to honor the legacy that is the Longview House and not tear it down.  Our intent is to develop the land surrounding the Longview House.

According to the ancestors of Clarence Poe, he used to sit on porch of the Longview House, survey his farm, and comment on how you need to look at life and health with a long view.  We commit to honor this perspective in the future development of the property adjacent to the home.


Ladder Safety – Or Lack There Of

Last week, the News & Observer included a picture on the front page of its Triangle section of a man balancing precariously on the top of a step ladder trimming trees.  This picture could be used as a great example of what not to do because falls from height remain the most common cause of workplace fatality.  In fact, most falls (79%) are a result of excessive reaching or incorrect ladder placement.

Ladder injuries are most common in adult males aged > 18 years (mean 42.9 +/- 16.2 years), from a distance of 1-15 feet. Other primary injuries include fractures or dislocations to the extremities, spine injuries, bleeding in the brain and even death.  

In the United States, injuries due to a fall from a ladder results in an average one week hospital stay and six weeks of disability and unemployment. For the sake of your health, please be very careful when doing anything on a ladder.

And, if you are a photographer who is thinking of taking a picture of someone misusing a ladder, please print the picture in the paper with a list ladder use of dos and don’ts.  Better yet, refrain from taking the picture and intervene in consideration of the health of the ladder user.

Post provided by Dr. Okechukwu Nwoko, MD, an orthopaedic surgeon with Wake Orthopaedics.


Liquid Tylenol Dosage Change

The U.S. Food and Drug Administration and manufacturers of over-the-counter liquid acetaminophen products recently agreed to move toward a single concentration for all liquid acetaminophen. 

All pediatric liquid acetaminophen for infant and children will be 160 milligrams per 5ml (or one teaspoon).  The hope is the single liquid concentration product will reduce dosing errors and create less confusion for parents and caregivers.

Acetaminophen, which is available both generically and under the brand name Tylenol, is a medication used to reduce fever and control pain.  Historically, it has been available as infant drops, 80milligram per 0.8ml, and for children 2 years and older as a liquid, 160milligrams per 5ml (or one teaspoon). 

Acetaminophen is generally safe when given in reasonable doses, however, each year children are treated at WakeMed Children’s Hospital for acetaminophen overdoses.   An overdose has the potential to cause liver toxicity and liver damage if taken over a long period of time or given at too high of a dose.    

The reason for changing to a single concentration is to help reduce and prevent medication errors.  The change was voluntarily agreed upon by the over-the-counter manufacturers.   Therefore, for a period of time both the concentrations will continue to be available in retail stores.   Parents and caregivers should be aware of the various products and to only use the dosing recommendations included with the purchased product.  

The new infant 160milligram per 5ml (or one teaspoon) product will now come with a dosing syringe rather than a dropper and for children the liquid acetaminophen will come with a dosing cup to assist with measuring doses.   Always contact a healthcare provider such as your pharmacist, nurse or physician if unsure of the appropriate dose.      

It is critically important for parents to fully understand any medication they are giving to their children and that they communicate clearly with their pharmacist or physician as to how much to administer and how often.  This way both caregiver and baby will feel better.

Interested in learning more about the change?

NC Poison Center

Rhonda Zillmer is a WakeMed pediatric pharmacist.


Expiring Car Seats

Few parents are aware that car seats, like milk, actually expire.  But, many who are aware that car seats expire often believe that it is a marketing ploy by manufacturers to get parents to purchase new seats – an expensive endeavor. 

The truth is, car seats are made out of a special kind of plastic that over time develop hairline cracks that you cannot see.  These cracks can cause serious weaknesses in a car seat and eventually cause the seats to not properly protect the baby. 

Additionally, extended exposure to sunlight has been shown to deteriorate the straps of a car seat, potentially making it unsafe for the child in the event of a crash. 

Most car seats expire in five to seven years, and in most cases, the expiration dates are clearly marked on the seat.  So, for the health and safety of your baby or child make sure to replace these seats as they expire. 

When choosing a new seat do mom, dad and baby a favor and make sure the seats are comfortable for infants and convertible/forward facing seats have at least two cup holders – one for sippy cups and one for snacks.

Other quick tips when choosing a car seat:
-Never purchase a car seat second-hand because you do not know the history of the seat.
-If you have been in an accident, replace the seat your child was riding in.  The accident may have caused hairline cracks in the seat that are not visible to the naked eye.
-If your infant seat is expired, so is the base.  Replace both and make sure not to use expired bases.
-Keep your child in a rear-facing car seat until they are at least two years old.
-Always stay informed about car seat recalls and safety issues.
-Make sure your car seat is installed correctly and your baby is strapped in snuggly

Rosy Rosenthal is a certified car seat specialist and works with WakeMed Campus Police.


Emergency Department with the Shortest Wait Time

January, February and March mark the peak of respiratory and flu season. As a result, physician offices, emergency departments and hospitals are busier than other times of the year.  Unfortunately, this also means that it can be very difficult to get an appointment with your physician and can result in extended emergency department wait times. 

As of last week with the opening of Brier Creek Healthplex, WakeMed now has six emergency departments in Wake County – making it more possible than ever to find an emergency department with reasonable wait times.  

For your convenience, we provide up-to-date emergency department wait times on both and on our Smartphone App for both iPhones and Droids.  For less-urgent medical needs WakeMed also has two urgent care locations, but of course, if you are experiencing a life-threatening emergency and need immediate assistance, please dial 9-1-1.

Average Door to Doc Time* (Jan. 9 through Jan. 15)
Emergency Department Average Time to See a Doctor
Raleigh Adult Emergency Department 1:43
Raleigh Children’s Emergency Department 0:53
Cary Hospital Emergency Department 0:59
North Healthplex Emergency Department 0:58
Apex Healthplex Emergency Department 0:32
Brier Creek Healthplex Emergency Department 0:16

*Average time it took for a patient to enter the emergency department door and be seen by a physician in each of WakeMed’s six emergency departments over the past week (Jan. 9 through Jan. 15)


Orthopaedic Surgeon: Everyday Items that Cause Serious Injuries

Dr. Robert Howard

Having been an orthopaedic surgeon for the past 11 years specializing in trauma surgery, I have treated many different types of injuries – some of which still amaze me.  However, I have come to expect the cause of the many severe injuries.

The biggest injury offenders are:

Trampolines are notorious for causing injures, including fractures of the wrist and elbow. These injuries are mostly seen in children and rarely adults.  However, there is a great potential for serious neck and head injuries as well.  My recommendation: never have a trampoline at home, and if you do have one follow the safety rules closely.  Make sure it is on level ground with an intact safety net, supervise children at all times and make sure there is only one person on the trampoline at a time.   

Ladders are another pretty common cause of severe injury – primarily to the foot and ankle, and occasionally the spine.  Always follow safety recommendations for ladder use.  Do not exceed the maximum load for the ladder, ensure it is the proper size for the job, and always use the ladder on level ground with your body centered on it.  And, never step on the top – it really is not a step!

Table Saws cause severe injuries like amputations.  Always use safety precautions because it is not easy to reattach a finger – I guarantee that reattached finger will never work exactly the same. 

Playground Equipment is fun, but it is also a common cause of injury in children.  Both public and home playground equipment can be dangerous, however home playground swings are often the most dangerous because children are not as closely supervised and use them in unconventional ways.  Ensure that there is a soft landing surface, the equipment is well maintained and adults supervise play.

Bicycles: Last year alone, emergency departments across the U.S. treated more than 500,000 injuries that resulted from riding a bike.  Children are at a particularly high risk.  Always wear a helmet, check the brakes, make sure the bike is well maintained, don’t bike at night, and  always obey traffic laws

Skateboards or wheelie shoe accidents often cause injuries to the head, neck and upper extremities.  Make sure your child always wears a helmet when riding anything with wheels, understands the danger of vehicle collisions, never ride in the middle of the street, only have one person per skateboard and never hitch a ride on a car or bicycle.

Lawnmowers can cause serious injuries to feet – both the users and innocent bystanders like children.  Lawnmowers have also been known to cause cardiac arrest.   Be aware of where children are at all times and that they are a safe distance from the lawnmower.  Always wear ear and eye protection.  And, if you have cardiac disease let someone else do the mowing.  

Pets:  Dog and cat bites can cause infections usually in the hand.  Additionally, dogs or cats get caught up in feet and cause falls, which can be especially dangerous for folks who have difficulty walking or seeing.  Pools cause slips and falls and drowning accidents.  Exercise caution when in and around water all the time.

Area rugs and bath mats cause a surprising number of very bad falls, especially in the elderly where the fall often results in hip fractures.  Make sure all area rugs, including bath mats, are secured to the floor.  

Dr. Robert Howard is an orthopaedic surgeon with Wake Orthopaedics.


Winter Chill Tennis Challenge

Tennis players of all ages are invited to participate in the third annual Winter Chill Tennis Challenge being held on Saturday, January 28, 2012. 

Sponsored by Raleigh Racquet Club Indoor Tennis Facility, the event will benefit the WakeMed Children’s Hospital and will feature round robin doubles, quick start tennis, entertainment, contests, prizes and dinner.

$40 per player ages 15 and up

$10 per child ages 5 to 14 for quick start tennis

$15 dinner only, ages 5 and up

January 28, 2012 (Snow date February 4), 4 – 9 pm

Raleigh Racquet Club Indoor Tennis Facility

Register by January 25 at or call 919-350-4596.