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Bariatric Surgery – How to become a winner at losing

Bariatric surgery is a surgical procedure to help patients lose weight, reduce the risk of life threatening conditions like diabetes and high blood pressure, and improve the overall quality of life.

Weight loss surgery is not a cure for obesity.  It is, however, a powerful tool to help you jump-start your weight loss and begin your journey to improved health and fitness.  It involves commitment, support, and the determination to succeed.

Here are eight tips to help you become successful at losing weight with bariatric surgery and keeping it off, courtesy of some of our most successful patients at Wake Specialty Physicians – General Surgery Bariatric Surgery Program.

1.      Family support is key to keeping the weight off. Be clear about your weight loss goals and desire for better health and talk to your family about it. Help them help you by requesting that dinners out have several, tasty healthy options on the menu or inviting your kids to join you as you walk for exercise.

2.      Motivation is more than willpower. It’s the engine that drives you toward success. Find something that motivates you to reconnect to the purpose of your weight loss journey. It could be as simple as carrying a photo of your children in your wallet or listening to an empowering song.

3.      Start eating healthy foods before surgery. It’s tempting to wait until after surgery to incorporate healthy foods in your diet. But adding a small salad to a meal or discovering whether you like yogurt vs. cottage cheese now will help you make better food choices later.

4.      Meal planning helps you avoid the temptations that come during the day like the tray of doughnuts that magically appear in the break room or the four o’clock snack attacks. Plan ahead for small meals during the day and stick to your grocery list when shopping.

5.      Lose as much weight as possible before surgery. Some programs will require you lose weight before the surgery to demonstrate your commitment. But more importantly there is a medical reason for the pre-operative diet.  Pre-surgical weight loss reduces the amount of fat stored in the liver making surgery easier for your surgeon and safer for you.

6.      Join a support group. While the help of family and friends is essential in maintaining your weight loss, nothing beats getting together on a regular basis with people who share your experiences. Support groups offer educational information, peer support, and nutritional, fitness and medical advice.  In this comfortable forum, members have an opportunity to ask questions as well as share experiences, tips, and advice.

7.      Continue with eating habits and exercise. Remember, it’s not about the surgery. It’s about developing a healthy lifestyle that includes eating right and exercising. Doing both will ensure your success on your weight loss journey.

8.      Count the cost. If bariatric surgery is covered by your health insurance, you may only need to pay the required co-payment or deductible.  If you are paying out-of-pocket, the surgery can cost between $17,000 and $35,000 depending on the type of surgery (lap band vs. gastric bypass), geographic location of the treatment center, the bariatric surgeon’s experience, and level of post-op treatment. Make sure you have a clear picture of all of the costs and what your insurance covers before deciding to have surgery.

For more tips and information, attend the “Bariatric Challenge Breakthrough” this Saturday from 9 a.m. to 4 p.m. at the Embassy Suites at Crabtree, 4700 Creedmoor Road in Raleigh.  Interested participants can register online.  The registration fee is $59 and includes lunch and your take-home challenge kit.  This event is sponsored by Wake Specialty Physicians – General Surgery Bariatric Surgery program.

Erin Akey and the Bariatric Guru Team will motivate and educate you in addition to making you laugh and think. Working closely with others who have similar goals, you will spend a motivational day addressing important topics such as nutrition, cooking, commitment to success, and emotional considerations.

Carol F. Kunkel, BA, BSN, RN is the Bariatric Program Coordinator at Wake Specialty Physicians Bariatric Surgery.

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Thinking Through Car Seat Placement

How do we put more than one car seat in the back of the car? …. Our car is small.

Let’s start to answer this question by sharing that statistics show 73 percent of crashes are from either the front or rear or the vehicle and the other 27 percent are equally dispersed between the left and the right.

So, for safety sake, many parents choose to place the baby in the middle of the back seat.  The rationalization is that the center of the vehicle is away from either side in case of an impact, and is a good choice if you only have one child and your car can accommodate a seat in the middle safely.

Others choose to place the car seat on right passenger side.  This is a good choice because the driver can easily turn around and see the baby. 

If you have two children in the car, many moms place the new baby in the center of the back seat and the older brother or sister on either side.  There are several pros to this configuration, especially if you choose the right side.  If the toddler is on the right side, mom can see her/him just by looking around while stopped at a light or sign.  It is important to note that if the toddler is placed on the left passenger side, they will be more likely to be on the traffic side of a street when exiting the vehicle.  If the toddler is on the right/passenger side, they will always get out on the curb side and are more likely to be away from moving traffic.

Furthermore, if you choose to place your toddler next to the baby, remember toddlers like to share things, food, toys, sippy cups, etc. and also like to touch and point.  Many toddlers do not yet fully understand why brother or sister does not or cannot have their things.  If the baby is placed on the passenger side and the toddler is placed on the driver’s side, they are separated and you may be less likely to have undesirable attention or food placed into your new baby’s mouth, ear or nose.

In all cases, when there is an unused seat belt in the back seat, it should be hooked together to prevent it from flying around in case of a crash.

Regardless of where you decide to place your baby, remember car seat techs never recommend those little mirrors that (sometimes) strap on the rear seat so mom can look in her rear view mirror to catch a look at the baby.  If there is an impact, the first person the mirror will hit is YOUR baby.  As a retired police officer, I would much prefer your attention be on the road and not on the rear view mirror while driving. 

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

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WakeMed Cary Hospital Breastfeeding Support Group

WakeMed Cary Hospital is pleased to announce it is now home to a breastfeeding support group. 

The support group will meet weekly beginning Monday, February 12 and will be led by our certified lactation consultants who can answer questions and facilitate an open forum where moms can discuss common challenges with breastfeeding. This support group will be especially good for brand new moms and for breastfeeding moms preparing to return to work.

Often, breastfeeding moms have concerns that their baby is not growing enough or getting enough milk. This is why at each support group we will offer weekly weight checks for the babies.  The weekly weight checks will help build mom’s confidence and prove they are doing the right thing.  The weekly weigh-ins will also help identify issues early so moms can find solutions to breastfeeding challenges and ultimately be successful.

It is our hope too that the support group also helps new moms connect with each other and eventually develop friendships between moms and babies. 

Bring a snack and water. This class is for moms and breastfeeding babies only.

WakeMed Cary Hospital
Points West Café
1900 Kildaire Farm Road
February 12, 2012
2:00 – 3:30 pm

For questions, please call 919-350-5831.

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Which car seat is best for my baby?

Which is the best seat for my baby?

Unfortunately, car seat technicians are not allowed to answer this popular question with a product name or model, because we are prohibited from saying one seat is better than the other implying endorsement.

Our biggest concern is that you have a car seat you can use correctly 100 percent of the time. 

All seats sold on today’s market are tested to provide your baby with a safe ride within the confines of our government’s standards, so the best way to select a seat for you and your baby is to answer the following questions:

  • Can I use the seat correctly?
  • Can I install it correctly?
  • Are the directions easy to follow?
  • Does it have the features that I want?  e.g. the straps are easy to secure around my child.
  • Will my child be comfortable in this seat?
  • Will the seat fit in my car?
  • Is the seat expired?
  • If I get the seat from a friend or someone else, do I know the history of the seat?
  • Has the seat been involved in a crash? (If so, do not use it.)
  • Will my child outgrow the seat too quickly?
  • Can I afford the seat?
  • Does my baby cry every time I place her/him in the seat?  (If so, your child may be uncomfortable and you may want to consider replacing the seat.)
  • Has the car seat recalled?

If you are comfortable with the answers to these questions, then you are probably moving in the right direction selecting a car seat for your baby.

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

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WakeMed Offers CPR Training During Heart Month

WakeMed Heart Center is hosting a series of education programs and events to mark February as National Heart Month and to help North Carolinians lead healthy, heart-filled lives.

We are teaming up with Wake County EMS to teach the basics of CPR and the warning signs and symptoms of a heart attack in our “Feel the Beat – CPR Anytime” program. 

CPR was selected as a primary focus for education events because according to the American Heart Association, effective bystander CPR provided immediately after sudden cardiac arrest can double or triple a victim’s chance of survival, but only 32 percent of cardiac arrest victims get CPR from a bystander. Today, less than eight percent of people who suffer cardiac arrest outside a hospital survive.

Locations and date include:
Cary – Wednesday, February 8
Adult CPR Anytime
WakeMed Cary Hospital Conference Center, Cary
6:30 to 8 p.m.
Presented by: Jimmy Locklear, MD, WakeMed Faculty Physicians – Raleigh Cardiology; and Wake County EMS

Raleigh – Thursday, February 16
Infant/Child CPR Anytime and Handling Pediatric Emergencies
Andrews Conference Center at WakeMed Raleigh Campus, Raleigh
6:30 to 8 p.m.
Presented by Courtney Mann, MD, Wake Emergency Physicians

Garner – Tuesday, February 21
Adult CPR Anytime
White Deer Park Nature Center, Garner
10:30 a.m. to noon
Presented by: George Hamrick, MD, FACC, WakeMed Faculty Physicians – Carolina Cardiology; and Wake County EMS

Raleigh – Thursday, February 23
Adult CPR Anytime
Heart Center Conference Center at WakeMed Raleigh Campus
6:30 to 8 p.m.
Presented by John Sinden, MD, FACC, WakeMed Faculty Physicians – Raleigh Cardiology; and  Wake County EMS

Brier Creek – Wednesday, February 29
Adult CPR Anytime
WakeMed Brier Creek Healthplex, Raleigh
10:30 a.m. to noon
Presented by: John Kelly, MD, FACC, WakeMed Faculty Physicians, and Wake County EMS

Participants will receive one free CPR Anytime for Family & Friends kit per household. However, donations to the WakeMed Foundation – Heart Education Fund are encouraged and make it possible for WakeMed to continue heart health education programs in the community. Register online at www.wakemed.org

Additionally, February 14- 19 we’re also pleased to sponsor the classic musical adaptation of Victor Hugo’s Les Miserables, a timeless story of love, dreams, and redemption. Les Miserables will be staged at the Raleigh Memorial Auditorium at the Progress Energy Center for the Performing Arts.  For tickets, call 1-800-745-3000 or visit www.ProgressEnergyCenter.com

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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.

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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.

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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.

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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.

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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.

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