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On This Day 50 Years Ago

On April 9, 1961, a dedication ceremony was held for Wake Memorial Hospital, and a legacy of care and caring for the Wake County community began.
In 1955, the Wake County Board of Commissioners had asked the voters to authorize a $5 million bond issue to supply funds for construction of a general hospital system that would provide health care services for all Wake County citizens. An additional $3.2 million grant from the federal government was approved, and work began on a central facility in Raleigh and four division hospitals to be located in Apex, Fuquay-Varina, Wake Forest, and Zebulon.

Today, WakeMed Health & Hospitals features two hospitals (with a third on the way in North Raleigh), two stand alone emergency departments (and another opening in Brier Creek in late 2011), 870-beds, more than 1,000 physicians on staff, 7,600 employees, 1,000 volunteers and more than 600,000 patient contacts each year.

As the only hospital system based in Wake County and the county’s largest employer, we are proud to have called Wake County home for the past 50 years and look forward to the next 50 and beyond.

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Alternating Fever Reducers

Fever is a word that most parents dread.  Just the first hint of a fever sends the worried parent to the medicine cabinet to find the fever and pain reliever. In many cases this is an appropriate response, but not for the reasons parents think. 

Fever in and of itself is not dangerous to the vast majority of children. Fever actually has the beneficial effect of fighting infection.  A pediatrician’s goal in recommending treating a child with acetaminophen or ibuprofen is actually to simply improve the child’s overall comfort and be in a better position to assess the child’s wellbeing.

It also surprises many parents to learn that pediatricians only define a fever as anything over 100.4° F for a rectal temperature.  In recent years, many pediatricians have been recommending alternating acetaminophen and ibuprofen as a treatment for fever as it has been shown that they may work better to lower fever when used together.  But this is not a practice that parents should regularly employ without a visit or call to a pediatrician.  The reason is simple; errors in dosing are very common and you may be accidentally over-medicating your child.

So, what is a parent to do?  The best thing to do if your child has fever is to give them a dose of acetaminophen or ibuprofen to make them more comfortable and monitor their intake, activity level, and for resolution of the fever.  The exact temperature really doesn’t matter or tell you anything about the illness, but monitoring temperature shows the response (or lack of response) to acetaminophen/ibuprofen and presence or absence of a temperature is helpful to know when deciding it an illness is resolving.  It does not matter whether you choose acetaminophen or ibuprofen because they have both been proven equally effective in treating fever in children.

Never wake a child from a slumber to give them a dose of fever/pain reliever.  Since the primary reason for the medicine is to improve overall comfort, by definition if they are sleeping then they are comfortable.

Always consult your primary care physician if your child is less than two months old (because we always evaluate every infant less than 2 months old if they have a fever), if the fever persists for more than several days, your child has trouble feeding, seems exceptionally lethargic, has a febrile seizure, or if you have specific concerns or questions.  It is also important to note, that although very scary for the parent, a febrile seizure is not in and of itself dangerous, but by all means if you feel your child is having an emergency, never hesitate to bring your child to an emergency department.

Dr. Betty Witman is a WakeMed pediatrician and Medical Director of the SAFEchild Advocacy Center.

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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WakeMed Stroke Centers Receive Quality Awards

WakeMed Raleigh Campus and WakeMed Cary Hospital. the only Joint Commission certified Stroke Centers in Wake County, have received quality awards from the American Heart Association/American Stroke Association. 

WakeMed Raleigh Campus received the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Gold Performance Achievement and Gold Plus Quality Achievement Awards for exceptional performance for 24 months.  WakeMed Cary Hospital received the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Silver Performance Achievement Award for exceptional performance for 12 consecutive months.   

Award quality measures include aggressive use of medications, such as t-PA, antithrombotics, anticoagulation therapy, DVT prophylaxis, cholesterol reducing drugs and smoking cessation, all aimed at reducing death and disability and improving the lives of stroke patients.

The press release announcing this exciting news can be found here.

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Drug Shortages and You

Did you know that currently if a manufacturer decides to stop making a drug, they can just stop without alerting anyone? Additionally there are no rules dictating when companies have to tell the FDA that there is an issue found in the manufacturing process.

This often leaves patients, pharmacies, and clinical providers in tight spots. Frequently, there are substitute medications available, but for some medically necessary drugs these shortages can mean the difference between life and death.

For example, over the past year we have had shortages of medically necessary drugs like dexamethasone that reduces inflammation when a breathing tube is removed and it helps reducing swelling in the brain. And there are hundreds of other prescription drugs that are currently shorted.

The American Society of Health System Pharmacists is hoping that a bill working its way through Congress will require manufacturers to notify the FDA of any discontinuance, interruption or adjustment in the manufacture of a drug that may result in a shortage. If manufacturers are required to alert the FDA of potential problems sooner or discontinuation of certain medications, then the FDA could give advance notice to other companies making the drug to ramp up.

Read more about the issue here, and take this opportunity to encourage Congress to regulate drug makers to ensure that patients always have access to the lifesaving medications they need by sending a letter to your Senator.

Lynn Eschenbacher is manager of WakeMed Raleigh Campus inpatient pharmacy and is a member of the American Society of Health System Pharmacists.

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Orthopedic surgeon stresses stretching benefits

Wake Orthopaedics physician Dr. Jonathan Chappell shared information with WRAL about whether or not stretching is beneficial before or after exercise.  This story was an expansion of a previous blog posted on this site by Dr. Chappell.

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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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