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Help WakeMed Grow

According to the latest census, Raleigh added 127,799 residents and Cary added 40,698 in just the past 10 years.  In fact, an Associated Press story today named Raleigh as the second fastest growing market in the United States.   This tremendous pace of growth requires continued investment in the health care services available to our community.

WakeMed Health & Hospitals, the only hospital system based in Wake County, is committed to meeting the growing health care needs of our community – as we have been doing for the past 50 years.  On April 15, WakeMed will submit two applications to the state to add 101 acute care beds divided between WakeMed Raleigh Campus and WakeMed Cary Hospital.

The Need

While WakeMed has continued to expand over the years, it hasn’t been enough to keep pace with the community’s growth, and our beds remain full. Both WakeMed Raleigh Campus and WakeMed Cary Hospital currently operate at occupancy levels far above any other Wake County hospital. With occupancy levels this high, patients often must wait for care due to the limited availability of inpatient beds.  WakeMed is proposing the addition of new beds in the most heavily populated areas of the county such as Raleigh and Cary where we already have the existing infrastructure to support added services. This will allow us to grow quickly and efficiently to better meet the community’s needs.

WakeMed’s Value to the Community

WakeMed offers the highest level of health care services in Wake County, including many services exclusively offered by WakeMed.  These unique offerings include Wake County’s only: Level 1 Trauma Center, Children’s Emergency Department and Children’s Hospital, Level IV Neonatal Intensive Care Unit and the area’s only inpatient rehabilitation hospital. We are the largest private employer in Wake County, with more than 7,600 employees, nearly 1,000 physicians and over 1,000 volunteers. 

How You Can Help

To continue meeting the growing health care needs of this community, we need your help to win this competitive application process.

WakeMed supporters are invited to submit a letter of support for the addition of acute care beds at the WakeMed Raleigh Campus and WakeMed Cary Hospital. Sample support letters can be found online at here. You can also express your support by sending a letter to:

Dr. Bill Atkinson
President & CEO
WakeMed Health & Hospitals
3000 New Bern Ave.
Raleigh, North Carolina 27610

or emailing: CONsupport@wakemed.org

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Tooting Our Horn

Over the past week, several WakeMed specialties and providers have been praised for being the best. 

First and foremost, WakeMed was recognized for having a strong record of high performance by U.S. News & World Report for most conditions and procedures in nine different specialties.  These specialties include gastroenterology, geriatrics, gynecology, heart & heart surgery, kidney disorders, neurology & neurosurgery, orthopedics, pulmonology, rehabilitation and urology. 

WakeMed is also pleased to have three of its own honored by the Triangle Business Journal as being Healthcare Heroes.  Here are a few excerpts from their nominations, so you too can see why we are so proud to have them on our team.

Dr. Graham Snyder, Emergency Department Physician & Medical Director WakeMed Center for Innovative Learning, Rising Star

Not long began working in WakeMed Emergency Departments in 2002, Dr. Graham Snyder approached WakeMed CEO Dr. Bill Atkinson about getting a human simulator to help train his 30 residents.

“You can,” Snyder recalls Atkinson telling him, “as long as you also train the doctors, the nurses, the EMTs … .” Instead of getting just one human simulator, Snyder found himself creating a virtual university, the Center for Innovative Learning, which today occupies 3,800 square feet on WakeMed’s Raleigh Campus. Last year the Center trained more than 4,900 medical personnel from 30 states.

The Center plays a key role letting medical professionals get hands-on experience minus the life-and-death consequences. That’s especially important for fledgling residents with little hands-on experience, especially with tricky procedures such as intubation.

The Center has a fully equipped emergency room with four “patients.” The set-up resembles the real thing, with one exception: Behind a windowed wall in one corner is a control room where Snyder controls the patients’ symptoms and reactions via computer. Video cameras placed strategically throughout the room capture the action. Afterward, Snyder, a facilitator who is in the ER, and the students review the session —they typically last 20 minutes — in an adjoining classroom.

Lil Galphin, Interim Director of WakeMed’s Spritual Care – Community Outreach

It is a very special role the spiritual caregiver provides in the health care setting.  While the majority of patients and their families count their blessings as WakeMed physicians and staff ease their pain and send them on the road to recovery, others must cope with loss of life, loss of independence and other hardships.  Hospital spiritual caregivers like Lil Galphin give families and patients the tools to begin to cope with often life-changing hardships.

Galphin’s life’s work has been dedicated to patients and families healing from crisis and/or loss.  She first came to WakeMed Health & Hospitals as part of a grant program in the Intensive Care Nursery (ICN) in 1977 and has been with the system ever since.  The WakeMed ICN, now a Level IV Neonatal Intensive Care Unit (NICU), is where neonatal physician and nurse specialists care for premature and critically ill infants.  Level IV is the highest designation a NICU facility and staff can achieve.  Therefore, the area’s sickest and tiniest babies as well as their families are often cared for at WakeMed.  

Galphin works with the families of our tiniest patients, helping them cope with the minute-to-minute stresses of being a parent of a premature newborn.  Given the exceptional care and technology that is available to these babies, many of them thrive and go on to lead vibrant lives. Unfortunately some premature infants are too sick and do not survive. Galphin’s work with these parents and the NICU staff led her to help fulfill a very important community need. She helped form Parentcare Inc., a group established for the care and support of parents whose infant (from conception to age 1) has died.  Galphin’s role in Parentcare has been vital.  She is one of the authors of the Parentcare educational booklet, which serves as a resource for parents seeking the organization’s services. That completed, Galphin, in addition to her full-time duties with WakeMed, took over as facilitator of the Parentcare support group in 1978.  She has been the group’s loyal facilitator and coordinator ever since. 

Dr.  Patrick O’Brien, Medical Director WakeMed Rehab, Physician Carolina Back Institute - Physician/Physician Group

Dr. O’Brien is an extraordinary physician who not only treats patients who have had catastrophic, unplanned, sudden spinal cord and brain injuries but he also manages the business aspect of taking care of these patients with life-long care needs.

He is instrumentally involved in the day to day operations and administration at WakeMed Rehabilitation that is invested in the care of patients with disabilities.

Dr. O’Brien cares for patients with stroke, spinal cord and brain injuries at the most challenging time in their lives and continues to follow and encourage these patients throughout their life.  He understands what it is like to age with a disability and the health issues that go along with these disabilities.  He looks at the patient realizing what their life-long needs will be.

 There is no doubt, Dr. O’Brien would walk through fire to help one of his patients or team members whether that is in a clinic, rehab facility, or in the boardroom.

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Is That Cold RSV in Disguise?

Before you dismiss your baby’s sniffles as merely a common cold, consider this: What often appears to be a common cold may in fact be a very common virus called RSV in disguise.

Respiratory syncytial virus (RSV) is a virus that leads to mild, cold-like symptoms in adults and older, healthy children. Unfortunately, RSV can be more serious in young babies, especially to those in certain high-risk groups, and it spreads easily by physical contact.

Premature babies, infants with chronic lung disease, those with weakened immune systems, and those with certain forms of heart disease are most susceptible.  And time of year is notorious for RSV – outbreaks of infections usually begin in the fall and run into the spring. True to form, RSV, which tends to rise every third year, has shown to have infected larger numbers this year than the past two.

This is no reason to panic. In fact, most infants have had this infection by age two.

Be on the lookout, however, for certain symptoms. If a baby isn’t able to feed, is acting lethargic or abnormal, is wheezing, or if their breathing is labored, requiring use of their chest muscles to breathe, the baby should be taken to a primary care physician. At home, RSV can be treated like a regular cold. Use a humidifier, encourage fluids, make use of a bulb suction nasal aspirator to clear mucus before feeding, and make feedings smaller and more frequent, as their appetite may lessen.

In severe RSV cases, an infant may need to be hospitalized in order to receive oxygen, humidified air, and fluids by IV. A ventilator may also be needed.

It is important that RSV is addressed promptly, as it can lead to ear infections, lung failure, and pneumonia.

But of course, an ounce of prevention is worth a pound of cure. Wash your hands—RSV can live for a half an hour or more on hands, keep babies away from those who are sick, and be an advocate for your child—don’t allow strangers to touch your child.

Do not smoke inside your house, car, or anywhere near your baby. Exposure to tobacco smoke increases the risk of RSV illness. Additionally, try to keep young children away from your baby. RSV is very common among young children and easily spreads from child to child. Finally, common household cleaners can keep the virus, which can also live for up to 5 hours on countertops and for several hours on used tissues, from spreading.

Dr. Karen Chilton, MD, is a WakeMed pediatric intensivist.

WakeMed Children’s is dedicated to providing answers to common questions parents have about children’s health and wellbeing.   Learn more by subscribing to WakeMed’s Families First newsletter.  Have a specific question you would like answered?  Post a comment or email us directly.

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Debunking Detox Diets

While the idea behind them is catchy—cleanse, start anew, and drop weight fast—detox diets are just another popular, ineffective, and yet harmful form of fad dieting. The sciences do not offer any peer-reviewed research that attests to the safety or effectiveness of these often extreme diets. When considering any strict diet that encourages excessive consumption of water, yellow foods, meat, syrup with juice mixed with strange combinations of spices, remember that any diet that is not balanced should be avoided.

There are healthier, more effective ways to lose weight. Aim for a well-balanced diet. Focus on drinking water and adding fiber. Calorie reduction will come naturally. In addition, getting sufficient amounts of sleep, between 7 and 8 hours a night, is crucial for effective dieting and maintaining energy levels.

Moreover, watch your portions. People often spend more time analyzing what they’re eating with little regard to how much but it’s these little things, done every day that can sabotage a diet. Try to make small changes with a big impact—ones that can be carried out over the long term, very unlike the typical 7-day detox diet that does not offer stable, permanent change. Record your meals and track your progress in a diet diary for 3 days. If you’re honest with yourself, you’ll see where you’re frequently led astray, making self correction easier – whether it’s Friday night alcohol or dessert after dinner that’s adding up for you. iPhone applications and the internet can make calorie-counting and recording very easy. Some of these inlcude caloriecount.about.com, my-calorie-counter.com and livestrong.com/thedailyplate/.

Detox diets are unhealthy and unnecessary because your body detoxes itself every day. In fact, a large role of the kidneys and liver is detoxification. Take care of yourself – limit alcohol, drink plenty of water, have a diet based on fruits and vegetables, lean protein, and whole grains, and get regular exercise to boost weight loss and increase energy levels. While a positive aspect of some detox diets are to promote eating fruits and vegetables and drink ample amounts of water, eating a balanced diet, getting enough sleep, and exercising will provide a foundation for a healthier lifestyle. The end result will be a more satisfying diet plan, and a more confident you.

Interested in learning more about a healthy, sustainable diet? Some insurance plans will pay for visits with a dietitian. Review your specific plan and make an appointment today. To make an appointment with a WakeMed Dietitian, call (919) 350-2358.

Ilsy Chappell, RD, is a clinical dietitian at WakeMed Cary Hospital.

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WTVD Troubleshooter: Rear Facing Seats Until Age 2

Yesterday Rosy Rosenthal, WakeMed Raleigh Campus car seat technician, offered WTVD’s Troubleshooter Diane Wilson information on the new car seat recommendations recently sanctioned by the American Academy of Pediatricians along with the National Highway Traffic Administration.

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Operation Medicine Drop: Clean Out Your Cabinets

This week is Poison Prevention Week and it is also your chance to safely dispose of old or unneeded prescriptions and over-the-counter medications during North Carolina’s second annual Operation Medicine Drop.

Operation Medicine Drop is a statewide blitz of events where the public is invited to drop off medications for safe and secure disposal. A partnership of Safe Kids North Carolina, the North Carolina Department of Insurance, the U.S. Drug Enforcement Agency, the State Bureau of Investigation and other local agencies, Operation Medicine Drop retrieved and destroyed over two million dosages of medications at nearly 200 take-back events in 2010.

Why should you participate in Operation Medicine Drop?

To prevent poisonings: Poisoning from prescription medications is on the rise in North Carolina. Since 1999, approximately 4,500 people in North Carolina have died from prescription drug poisoning, according to the North Carolina Division of Public Health.

To fight drug abuse: Many people think prescription and over-the-counter drugs are safe because they have legitimate uses, but when used improperly, they can be just as dangerous and addictive as illegal substances.

To protect our waterways: Throwing medicines in the garbage or flushing them down the toilet or sink leads to water contamination and harms aquatic life.

There are more than 215 Operation Medicine Drop events scheduled in communities across North Carolina.
Find an Operation Medicine Drop near you by clicking here.

Lynn Eschenbacher is a manager in the Pharmacy on WakeMed Raleigh Campus.

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Uninsured patients and WakeMed

This past weekend Janice Frohman, administrative director of emergency services at WakeMed Health & Hospitals, and Jim Palombaro, M.D., president of Wake Emergency Physicians and of the medical staff at the WakeMed Raleigh Campus, submitted the following op ed about the care of the uninsured to the News & Observer.

Uninsured patients and WakeMed

Almost daily in newspapers across the country, you can find articles, editorials, letters to the editor and op-ed articles written by health policy experts, academics, caregivers and consumers discussing health care reform. When you get to the heart of each of these articles, it all comes down to who is caring for and paying for the un- and underinsured.

The reason for this continued conversation is that there is a significant difference between the services available to the insured and to the underinsured and uninsured. Yet, the uninsured and underinsured, whose ranks continue to grow, remain drastically underserved and misunderstood.

The reality for far too many members of our community is that WakeMed’s five emergency departments serve as the default front door to the health care system. Each day we see heartbreaking situations. For example, uninsured patients who lack access to primary care and who must choose between purchasing medications to manage chronic conditions or putting food on the table. Beyond the obvious tragedy of the dilemma, this dangerous combination frequently lands patients in the hospital with acute, life-threatening illnesses.

The uninsured do not fit a specific mold. They are usually not homeless, do not always have mental illness or substance abuse problems, and increasingly are not exceptionally poor. The uninsured today are more frequently middle-class individuals who have always worked hard and have always been insured, but due to the recession and job loss, extenuating circumstances or the simple inability to afford insurance due to pre-existing conditions, they find themselves uninsured or uninsurable.

At WakeMed, our mission since our founding in 1961 has not changed; for the past 50 years we have been dedicated to providing care to all who seek our services regardless of the ability to pay. Last year WakeMed’s investment in treating the un- and underinsured was $103 million, including $68 million in charity care plus $35 million in unreimbursed Medicaid costs.

As a private not-for-profit, we cover this investment without direct funding from taxpayers, the county or the state, other than Medicaid (which doesn’t come close to covering the cost of care). In fact, not all hospitals receive the same Medicaid reimbursement, and WakeMed currently receives a significantly lower Medicaid reimbursement rate than state-supported hospitals.

Although the cost of delivering on our mission may seem staggering, we take great pride in delivering this care, and we are proud to provide it without discrimination or bias. In fact, up until discharge, when they need to make a referral, the majority of our emergency department physicians and staff do not know or care to determine a patient’s insurance status.

WakeMed continues to serve more than 80 percent of our community’s Medicaid, uninsured and underinsured residents, and we fully anticipate the amount of charity care we provide will continue to increase for the foreseeable future. Insurance status is not and never will be a barrier to care in our emergency departments, but the need in our community is great and growing.

It is therefore time for all of our hospitals to provide their fair share of services to the un- and underinsured. In addition, all of our community hospitals and physicians should receive the same reimbursement from Medicaid and other government-funded programs. It is imperative that Gov. Beverly Perdue and members of the General Assembly work to level the playing field to ensure that all hospitals and physicians that treat Medicaid patients are reimbursed appropriately and in an equitable manner. A level playing field will enable fair competition, ensure appropriate and timely access to care for all members of our community and allow WakeMed to deliver upon its mission and service.

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New pacemaker can take MRI scans

WRAL interviewed Dr. Marc Silver with WakeMed Faculty Physicians – Raleigh Cardiology  about the new Revo pacemaker that is MRI compatible.  This is the first pacemaker that is MRI compatible.  Missed it last night, check it out below.

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Bed Bugs in NC

Last Thursday, Jung Wook Kim, PhD, bed bug specialist with the Division of Environment and Natural Resources presented to hospital staff about the reemerging problem of bed bugs.  Chemicals like DDT virtually eradicated bed beds in the United States but since DDT’s banning in 1972 bed bugs are slowly but surely making a comeback across North America.

While bed bugs are not as prevalent here in North Carolina as they are in New York or other large cities where there are many multi-dwelling apartment complexes, it is important to be aware of this emerging issue.  Bed bugs have been found in our area, and once you have them in your home, they are very difficult to eliminate especially if the infestation become severe.

Bed bugs are aptly named.  They generally live in or around bedding because they are nocturnal and feed on blood.  These traits make the bed the most likely place to find this bug.  A few more fun facts included in Dr. Kim’s presentation about bed bugs include:

  • Bed bugs are initially tiny, but can still be seen with the naked eye.
  • Fed bed bugs are reddish brown and unfed bed bugs are yellow
  • Bed bugs can sometimes travel more than 10 feet to feed
  • Feeding only takes place every three days and lasts for about 10 minutes
  • Female bed bugs lay approximately 500 eggs in their lifetime. Eggs hatch every 7 – 12 days
  • If you have 1 bed bug, you will be bitten 90 times per year
  • Bed bugs have been known to survive 6 to 12 months without feeding

Unlike other insects, both male and female bed bugs bite. Bites are painless because the bed bug administers an anesthetic to its victim. On most people, the bite causes a red bump and can itch.  In severe infestations, anemia can occur as a result of multiple bites. However, people react differently to bed bugs; 54 percent people will have no red, itchy bumps after being bitten, and many bites will not emerge for 7-11 days.  Bites also tend to be in linear groups of three or four.

Although bed bugs are commonly associated with unsanitary conditions, the fact is that despite the best preventive efforts, almost any property can become home to these hitch-hiking pests.  Additionally, contrary to popular belief, bed bugs do NOT carry disease. Check out North Carolina State University’s Department of Entomology web site for more information about bed bug identification and prevention. 

 Also, it might be useful to search the Bed Bug Registry, a free, public database of user-submitted bed bug reports from across the United States and Canada before you travel. This site has collected about 20,000 reports covering 12,000 locations.

Dominique Godfrey-Johnson is a WakeMed Public Health Epidemiologist.

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Whirlwind Tour of an Aortic Aneurysm

What do Lucille Ball, Albert Einstein and John Ritter have in common?  They all died from a ruptured aortic aneurysm

Like peripheral vascular disease, most physicians do not routinely screen for aortic aneurysms.  And for most people this is OK, because they do not have the risk factors for having an aortic aneurysm, making their chances for aortic rupture quite slim.  But for those few individuals who have an aortic aneurysm, it is like walking around with a ticking time bomb in your chest or abdomen because if it ruptures, the result is overwhelmingly death.

Your aorta is the primary blood vessel coming out of the heart.  It is about the size of a garden hose.  Aortic aneurysm affects approximately 6-7 percent of people over age 60.  It is the 10th leading cause of death in men over age 65, but unlike peripheral artery disease, an aortic aneurysm is generally symptom free, making a physical exam almost worthless and diagnosis difficult.  If you have any of the following risk factors, then you are a candidate for screening.

-Are over age 60
-Have ever smoked or used tobacco (the longer you have smoked or used tobacco, the greater the risk)
-Have high blood pressure and/or high cholesterol
-Have been diagnosed with atherosclerosis, which is the build-up of plaque in the arteries
-Are male
-Are white
-Are overweight
-Have a family history of aortic disease
-Have certain rheumatologic conditions like ankylosing spondylitis
-Or a family member were born with an abnormal, or bicuspid, aortic valve

In a physician’s mind if you have an aortic aneurysm, it is similar to having heart disease.  The most important part of treating or preventing aneurysm is to make sure you are living right; eat well, exercise, manage your cholesterol and blood pressure and limit alcohol consumption.  Smoking is the biggest risk factor, and if you have an aortic aneurysm and you continue to smoke, then you may be igniting the bomb in your belly.

Aortic aneurysms are treatable and if they are severe enough can be repaired surgically or in the cath lab using an endovascular repair.  The most important thing is to be screened if you have risk factors for the disease.

Dr. Chris Gring, MD, is an interventional cardiologist with Wake Heart & Vascular Associates.

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