Latest Entries

NC Seasonal Sensation – The Pecan

In a week, North Carolinians across our state will gather around the dinner table and give thanks for our blessings in life. We’ll indulge in all the holiday favorites that make Thanksgiving a meal to remember. And if I have it my way, those favorites will be as healthy as they are delicious.

Just in time for the holidays, North Carolina’s Seasonal Sensation is the pecan. Pecans are packed with antioxidants, like Vitamin E that may protect against heart disease. Pecans also contain plant sterols, fiber and heart healthy monounsaturated and polyunsaturated fats, all of which may help lower cholesterol levels. Now that’s something to be thankful for.

This Thanksgiving, try a healthy pecan dish in place of one that’s loaded with unwanted fat and calories, like sweet potato pecan casserole or spiced pecans, both perfectly delicious for the holiday season. Or take it from EatingWell.com, which shares great tips on how to cut 150 calories and five grams of fat from a traditional pecan pie. 

Healthy Eating for a Happy Thanksgiving

Healthy eating is all about balance. This Thanksgiving, remember to eat in moderation by practicing proper portion control. Make smart decisions about what you put on your plate with these healthy tips from www.myplate.gov. Here are the highlights:

  • Enjoy your food, but eat less; eat slowly and savor every bite
  • Make half of your plate fruits and vegetables
  • Make sure at least half of your grains are whole grains
  • Use a smaller plate to help control portion sizes

Also, on Thanksgiving morning, eat breakfast. Don’t skip meals to “save up” calories only to gorge yourself at dinner. Remember, you’re giving thanks for what you appreciate most. Your body is at the top of that list, right? Instead of stuffing yourself, enjoy a well-balanced breakfast with a nutritious meal like oatmeal topped with two tablespoons of toasted, chopped pecans. Add fruit for extra fiber and sweetness.

 Lastly, after the holiday feast, head outside for a breath of fresh air. Go on a walk or a hike. Start a friendly game of flag football, basketball or soccer. Build a fire, fly a kite, go for a bike ride. Grab your family and friends and enjoy a little post-Thanksgiving exercise with these family friendly fall activities.

Here’s to a happy and healthy Thanksgiving!

Amy Bowen is a clinical dietitian at WakeMed Cary Hospital.

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Type 1 & Type 2 Diabetes Q&A

Throughout the month of November in celebration of American Diabetes Month, we will bring you facts about the prevention and the management of prediabetes and diabetes.  We started last week with prediabetes and have now progressed to type 1 and type 2 diabetes.

According to the American Diabetes Association in 2011 a total of 25.8 million children and adults in the United States—8.3% of the population—have diabetes.
Diagnosed: 18.8 million people
Undiagnosed: 7.0 million people
Prediabetes: 79 million people

What is type 1 diabetes?
People with type 1 diabetes do not make any insulin at all. They require insulin injections to provide the insulin they need to allow the sugar from the blood to enter the cells to produce energy (remember, insulin is the key that opens the cells and allows the glucose to enter). Only about 5% to 10% of people with diabetes have type 1.

What is type 2 diabetes?
In type 2 diabetes, the body does not make enough insulin, or the cells ignore the insulin that the body does make (insulin resistance).Therefore, all the sugar does not enter the cells, but stays in the blood. About 90% to 95% of people with diabetes have type 2.

What can I do if I have type 2 diabetes?
There is no cure for type 2 diabetes, but it can be managed by 7 self –care behaviors identified by the American Association of Diabetes educators,(AADE) that work together to influence your overall health.

The 7 self –care behaviors are:
1. Healthy Eating
2. Being Active
3. Monitoring
4. Taking Medication
5. Problem Solving
6. Reducing Risks
7.  Healthy Coping.

However, the most frequently asked question by a person with newly diagnosed diabetes is;

What can I eat now that I have diabetes?
The body’s primary source of energy is sugar (glucose). Sugar comes from breaking down carbohydrate foods such as fruit, milk and yogurt, sweets, and starches. Foods that contain carbohydrates contribute to increased blood sugar levels. We need to learn to recognize the foods that contain carbohydrates and limit the intake of these foods to maintain blood sugars within the target range set by your doctor. Remember meats, fish, and poultry do not contain carbohydrates. (If you have to kill it to eat it, it’s not a carbohydrate.)

Portion sizes also factor into the overall affect of carbohydrate intake on blood sugars. We have become accustomed to exaggerated portions when eating out and are frequently surprised at what a “true portion size” really is.

Learn about carbohydrates so you can be comfortable reading nutrition labels and knowing what they mean.

Next week we’ll cover the Truths and Myths of Diabetes.”

Carol V. White, BSN, RN-BC is a Patient Educator in the Adult Diabetes Management Program with WakeMed Health & Hospitals

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Honoring Those Who Serve

Tomorrow WakeMed will host a special Veterans Day program honoring nearly 300 staff, physicians and volunteers who have proudly served in the United States Armed Services. And, we are cordially inviting all Veterans in our community to join us for this event.

Program will include remarks by WakeMed President & CEO Dr. Bill Atkinson, General Gerald A. Rudisill, Jr., N.C. Department of Crime Control & Public Safety, and Chief Deputy Secretary – Office of the Secretary
 
FRIDAY, NOVEMBER 11
12:30 – 1:30 pm
Andrews Conference Center
WakeMed Raleigh Campus
3000 New Bern Avenue
Raleigh, NC

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Flu or Cold?

You’re sick and you figure it’s probably just a cold so you don’t need to go see your doctor, right? Well, the flu and the common cold are both caused by viruses and they have similar symptoms. The flu is usually more severe and can cause death in certain vulnerable populations like the immunocompromised, elderly and young children.  Here are the symptoms of the common cold and of the flu so you can tell which illness you or your loved one is up against:

What’s the difference? :

Characteristic Flu Cold
Onset 3-6 hours of exposure Gradual over a few days
Fever Common – range 101 – 103 Less common – low grade possible
Chills Common Less Common
Chest Discomfort Common Less Common
Headache Common Less Common
Aches Severe Milder
Cough Dry Productive
Tiredness Extreme Less Intense
Stuffy Nose Less Common Common
Sore Throat Less Common Common
Sneeze Less Common Common

It is always a good idea to call your doctor if you exhibit two or more of the flu symptoms listed. And, if you are lucky enough not to be sick, remember your best defense against most illnesses is frequent hand washing.  For flu, everyone six months of age and older should also get extra protection with a flu vaccine.

More information about the flu can be found at http://flu.gov

Michele Roberts Casey, MD, Wake Specialty Physicians – Falls Point Medical Group

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Drug shortages at critical levels in Triangle

WakeMed Pharmacist Lynn Eschenbacher, a frequent contributor to this blog, was interviewed by WRAL for a story about managing drug shortages.

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Prediabetes Q&A

Throughout the month of November in celebration of American Diabetes Month, we will bring you facts about the prevention and the management of prediabetes and diabetes – starting with prediabetes.

According to the American Diabetes Association more than 79 million Americans have prediabetes.  In other words, their blood sugar levels are elevated, but not high enough to be considered diabetes.

How do you get prediabetes? 
The body’s primary source of energy is sugar (glucose). Sugar comes from breaking down carbohydrate foods such as fruit, milk and yogurt, sweets, and starches. Once the carbohydrates are broken down into sugar (glucose), the body produces insulin which acts as a key to allow the sugar to enter the cells and produce energy. 

Before people develop Type 2 diabetes, they almost always have prediabetes. Prediabetes is the inability of the body to use all the insulin it produces (insulin resistance). With insulin resistance all the cells do not easily recognize the insulin as insulin and will not allow the sugar to move from the blood to the cell. As a result, sugar remains in the blood leading to higher than normal blood sugars.

What can contribute to prediabetes?
Family history of type 2 diabetes, weight gain, being over 45 years old, a history of gestational diabetes or of delivering a baby weighing more than 9 lbs, elevated blood pressure and an inactive lifestyle can increase your insulin resistance.

Is there a test for prediabetes?
Yes, there are three different tests for prediabetes. (All results within these ranges are considered prediabetes.)

  • A1C test does not require fasting. It gives us an average of blood sugars over a three month period and is measured in percent. An A1C result is between 5.7%-6.4%
  • Fasting blood sugar between 100-125 mg/dl
  • Blood sugar after a 2 hour oral glucose tolerance test between 140-199 mg/dl or

Why is having prediabetes a concern?
People with prediabetes almost always develop Type 2 diabetes, and already have higher than normal blood sugar levels. People with prediabetes have a 1.5-fold higher risk of developing cardiovascular disease compared to those with a normal blood sugar.

High blood sugar damages artery walls and over time allows the buildup of fatty materials such as cholesterol (plaque) in the arteries. This damage can lead to stroke, heart attack, kidney damage, blindness, nerve damage and amputation of limbs.

Does prediabetes always develop into Type 2 diabetes?  
NO! Studies have shown that people with prediabetes can delay or prevent the development of Type 2 diabetes by up to 58% through changes to their lifestyle. Under a doctor’s care, overweight patients who have a modest weight loss (5% to 7% of body weight) and participate in a regular exercise like brisk  walking, cut their risk of Type 2 diabetes by 58%.

For those over individuals over 60, their risk is cut by 71%. For some people with prediabetes , being diagnosed early and taking preventative measures can actually return elevated blood sugar levels to normal.

In the next few weeks, watch for our blogs on Type 1 and Type 2 diabetes and the skills to manage diabetes.

Carol V. White, BSN, RN-BC is a Patient Educator in the Adult Diabetes Management Program with WakeMed Health & Hospitals

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WakeMed Opens New Retail Pharmacy and Gift Shop

WakeMed recently opened a new retail pharmacy and gift shop on Raleigh Campus for added shopping convenience for patients, guests and staff.

The beautiful new Gift Shop welcomes guests into an open and bright atrium filled with unexpected treasures including jewelry, fashion accessories and thoughtful gifts for every occasion. 

The Pharmacy, WakeMed’s first true retail pharmacy, is located beside the Gift Shop just off the main entrance hallway.  Their professional and knowledgeable staff provides efficient full pharmacy services for their customers without leaving the hospital.

Interested in Visiting?

Tuesday, November 8 would be a great time to visit the Gift Shop for an Exotic Maharaja trunk show featuring an unparalleled selection of semi-previous gemstones in sterling silver.  The hours of the show are 8:30 am – 7 pm.

The Pharmacy at WakeMed is open from 8 am – 11 pm M-F, Saturday 8 am – 4 pm and closed on Sunday.

The Gift Shop is open Monday through Friday 8:30 am – 8 pm and 10 am – 7 pm on Saturday and Sunday.

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Staying Safe in the Hospital

About two weeks ago The News & Observer printed an article all about Joe and Terry Graedon’s experiences with the health care system and what they learned about what patients can do to help prevent medical errors from happening to them while in the hospital.  The entire article can be read here and is enlightening, but if you read nothing else, the checklists they created were particularly helpful.

Ways to Prevent Medical Errors

  1. Expect mistakes and have an advocate with you in the hospital.
  2. Be assertive. “Being nice can get you killed.”
  3. Check every medicine to make sure the dose is right.
  4. When in doubt, “say No.” Demand and explanation.
  5. Be vigilant during transitions, from one floor to another, or when shift changes.
  6. Alert the nurse or rapid response team if something seems wrong.
  7. When discharged from the hospital, get detailed instructions and contact information.  Know what symptoms might signal a worsening situation or infection.
  8. Hospital doctors may never speak to your primary care physician.  Take your records and don’t assume doctors already know what’s in them.
  9. Double-check everything.  Don’t assume no news is good news or that test results are always correct.  Get copies of lab results in a timely fashion.  If something seems wrong, request a repeat.
  10. Take a friend or family member to doctor’s visits.  Nearly every error made in the hospital can be also be made in the outpatient setting.  A second pair of eyes and ears can be useful in getting instructions and spotting problems.

Patient Checklist

  • Take a list of your top health concerns/symptoms
  • Ask your doctor for a recap to make sure you’ve been heard.
  • Take notes or record the conversation so you can remember.
  • Carry a list of all your medicines and supplements.
  • Find out about the most common and serious side effects your medicines may cause.
  • Ask the doctor how confident he is about your diagnosis.  Find out what else could be causing your symptoms.
  • Get a second opinion.
  • Ask health care providers to wash their hands before they examine you.
  • Keep track of your progress: keep a diary of relevant measurements such as weight, blood pressure, blood sugar
  • Be vigilant when moving from one health care setting to another.  Mistakes and oversights are especially common during transitions.
  • Ask how to get in touch with healthcare providers.  Get phone numbers or email address and learn when to report problems.
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Dr. Graham Snyder Honored as Tarheel of the Week

Dr. Graham Snyder is an emergency department physician and the medical director of WakeMed's Center for Innovative Learning.

WakeMed’s own Dr. Graham Snyder was recognized yesterday by the News & Observer at Tarheel of the Week.   

Read all about the Raleigh native’s path to becoming an emergency department physician, his love of medical simulation and the role medical simulation plays in improving patient safety by clicking here.

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Playing it Straight: Chest & Spine Issues in Teens

The teen years can be tough. Scoliosis or a chest wall deformity can make them even tougher. But the symptoms should not be ignored.

Diagnosing Scoliosis

All spines have a natural curve that extends from the neck to the base of the spine, helping the body maintain balance and alignment. Too much side-to-side or lateral curve in the spinal column results in scoliosis. Here are some red flags that your child might have scoliosis:
• Shoulders are asymmetrical, with one shoulder blade protruding out more than the other
• Head is not centered above the pelvis
• One hip appears to be raised
• Rib cages are different heights
• Waist is uneven
• Skin covering the spine shows changes in appearance or texture (dimples, discoloration or excessive hair)

Diagnosing a Chest Wall Deformity

Chest wall deformities – pectus excavatum (sunken chest) or pectus carinatum (pigeon chest) – most commonly occur in teenagers. Patients can experience symptoms such as:
• Exercise intolerance
• Shortness of breath
• Chest pain
• Embarrassment over body image
• Cannot keep up with peers while playing sports.

Spine Camp

To educate children and parents about scoliosis, chest wall deformities and treatment options, WakeMed Rehab and Children’s Surgical Services, along with Raleigh Orthopaedics, are hosting a half-day spine camp.

Saturday, October 29 – 9 am to Noon
WakeMed Raleigh CampusRehab Health Park

Learn more and register online at events.wakemed.org or by calling 919-350-4179.

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