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2 / dategoeshere 2 / Saturday, April 20, 2013 Health & Wellness

Many things can cause migraine headaches. Some seem harmless

enough, like a glass of red wine or change in your daily routine. But if enough triggers add up, you may find yourself suffering the familiar migraine symptoms of intense throbbing, pulsing in one area of the head, nausea, vomiting, and extreme sensitivity to light. All you want to do now is find a dark, quiet place where you can lie down. Instead of being miserable with these headaches, you can try to limit how often you get migraines and their intensity by finding and avoiding your migraine triggers.

Certain factors that can make people more prone to developing migraines include having a fam-ily history of migraines, being a woman, experiencing the first migraine during adolescence, and undergoing hormonal changes due to estrogen fluc-tuations during menstruation, pregnancy and menopause. Food, stress and changes in your daily routine also can set off migraines. Common triggers include:

Certain foods, including blue and aged cheeses (Roquefort, Stilton, Gorgonzola or Parme-san), as well as some Asian

foods made with monosodium glutamate, chocolate, aspartame, salty or processed foods, citrus (oranges, lemons, limes, grape-fruits and pineapples), nitrates found in cured meats (hot dogs, bacon or cold cuts), and foods that contain tyramines, such as soy, marinated or pickled prod-ucts.

• Too much caffeine.

• Skipping meals or fasting for too long.

• Certain odors, such as per-fumes, paint or certain flowers.

• Bright lights or sun glare. • Getting too much or too

little sleep.• Changes in the weather or

high humidity.• Stress.• Loud noises.

• Certain medications, such as oral contraceptives or ones that expand the blood vessels.

• Intense exercise.• Smoking or being around

someone who smokes.• Strong emotions, such as

anxiety or depression.Keeping a diary can help iden-

tify your migraine triggers. Each time you have a migraine, write

down the time of day and what you were doing when the head-ache started, what you ate or drank 24 hours before it began, and how long it lasts. Be sure to record any unusual stress and overall state of health. It is impor-tant to remember that less than 30 percent of migraine sufferers identify food as triggers. To be recognized as a migraine trigger, the food must start a headache within one day of the time it is consumed for more than half the time that it is eaten.

Over time, you may notice a pattern to your headaches. Once the triggers are identified, it will be easier to take steps to avoid them. You won’t be able to control all your triggers, but you can limit them so they don’t add up and start a migraine. In addi-tion to managing triggers, other ways to reduce the number and severity of migraines include exercising regularly, getting a good night’s rest, watching what you eat, drinking plenty of fluids, eating on a regular schedule, and managing stress through relax-ation exercises or biofeedback. For more information about migraine triggers, talk with your doctor or visit the American College of Physicians website at www.acponline.org.

Research reveals migraines have various triggers

Spring and Summer are seasons for fun outdoor activities,

but also seasons for bug bites and using insect repellent. Bug bites, for the most part, are not harmful, but can be irritating, itchy and unpleasant. Insects can transmit diseases like yellow fever and malaria, but those diseases are mainly a risk for travelers outside the U.S.

Do the following to help prevent insect bites and their complications:

•Don’t bother insects•Use insect repellant •Wear protective cloth-

ing •Be careful when you

eat outside because food attracts insects

•If you know you have severe allergic reactions to insect bites, carry an emer-gency epinephrine kit

Many people choose to use insect repellent to help ward off bug bites. The repellent may contain the chemical DEET as an active ingredient and is used to repel biting pests such as mosquitoes and ticks, including ticks that may carry Lyme disease. According to the U.S. Environmental Protection Agency (EPA), DEET is designed for direct applica-tion to human skin to repel insects, rather than kill

them. Products contain-ing DEET currently are available to the public in a variety of liquids, lotions and sprays, and products registered for direct appli-cation to human skin con-tain from 4 percent to 100 percent DEET.

Is DEET Safe? After completing a com-

prehensive re-assessment of DEET, the EPA con-cluded that, as long as consumers follow label directions and take proper precautions, insect repel-lents containing DEET do not present a health con-cern. Based on extensive toxicity testing, the Agency believes that the normal use of DEET does not present a health concern to the general population.

If you do rely upon products that contain DEET, remember these tips:

• Do not use DEET/ sunscreen com-bination products. The frequent reapplication of sunscreen will, “…pose unnecessary exposure to DEET,” according to the U.S. Environmental Protec-tion Agency. DEET is not water-soluble and will last up to eight hours, while sunscreen washes off and may only last a few hours.

• Do not use products with more than 30% DEET. They do not

offer any extra protection according to the American Academy of Pediatrics, and should especially be avoid-ed for use on children.

For all insect repellents, the EPA recommends that you:

•Do not allow children to handle…product with DEET and do not apply such products to children’s hands. When using on children, apply to your own hands and then put it on the child.

•Apply sparingly around ears. According to the EPA Reregistration Eligibility Decision report on DEET, absorption of pesticides through the skin is, “…approximately four times greater around the ears than the forearm.”

Prefer not to use DEET?

To help you find the right Bug Repellent for you, visit the EPA’s online search tool at http://cfpub.epa.gov/oppref/insect/ or discuss your options with your physician or pharma-cist.

Your health and well-ness is important so be sure to take appropriate precautions against bug bites when you are out-doors.

Learn more about Har-nett Health and use our Physician Finder online at myharnetthealth.org.

Warm weather means the return of biting bugs

When listing the benefits of a new cancer

treatment at FirstHealth Moore Regional, Stephen King, M.D., and his colleagues in the hospital’s Radiation Oncology department get excited by what it means for their patients.

Since October of last year, the new Trilogy Stereotactic Radiosur-gery Linear Accelerator has made highly effec-tive cancer care possible for some people who previously would not have been candidates for traditional cancer sur-gery. It allows others to avoid weeks of radiation treatments but with the same positive results.

“Some cancers are inoperable because of their location, in the brain or spine, for example, and some patients are too weak for surgery,” says Dr. King, a radiation oncologist. “This treatment provides results that are just as good as traditional sur-gery and better than other types of radiation treatment.”

Previously, patients and their families spent hours on the road travel-ing elsewhere for the same therapy. Today, they can get this power-ful treatment at Moore Regional.

Precise and powerful

FirstHealth’s Trilogy Stereotactic Radiosur-gery Linear Accelerator is used primarily for smaller lung and brain cancers and may be used in the future to treat the spine, liver and pancreas.

During stereotactic procedures, physi-cians use computers and advanced images to position the patient accurately, so they can precisely focus the radia-tion. Radiosurgery refers to the use of a very high dose of radiation in a single treatment session to destroy a tumor. The linear accelerator is the machine that generates the radiation.

Key advances of the new equipment are its ability to focus an extremely powerful

radiation beam on a very small area— and do so with great accuracy.

“Because we can direct the beam so pre-cisely, we’re able to pro-tect healthy tissue next to the cancerous tissue,” Dr. King says. “And so, during every treatment, we’re able to use signifi-cantly higher doses of radia-tion aimed directly at the cancer.”

With other radiation ther-apies, patients might need up to 35 treat-ments—35 visits back and forth from home and days of recov-ery between.

“Now we can accom-plish the same results in one or two super-focused treatments,” Dr. King says, “and patients remain here near their family and friends. Those are huge benefits for our community.” This latest addition to the cancer experts’ toolbox puts cancer care at Moore

Regional Hospital on a par with some of the best available anywhere. The Trilogy Stereotactic Radiosurgery Linear Accelerator is one of the most precise and power-ful radiation treatments for certain cancers.

“The leadership at FirstHealth has been extremely supportive of bringing this cutting-edge cancer treatment to residents of our region, and we’re all very excited about it,” says Margie Thomas, BSRT, (R)(T), Moore Regional’s clinical director of Radiation Oncology.

“Between our special-ists and all the treat-

ment options we offer, plus clinical trials, our patients can now remain here to get the same quality of care that they would get at almost any major medical center in the country.”

Radiosurgery greatly reduces number of cancer treatments

StePhen King, M.D.

“Some cancers are inoperable because of their location, in the brain or spine, for example, and some patients are too weak for surgery. This treatment provides results that are just as good as traditional surgery and better than other types of radiation treatment.”

— Dr. Stephen kingradiation oncologist

Central Carolina hospital

harnett health systems Firsthealth oF the Carolinas


Drive Times* to Central Harnett Hospital From: Mileage: Time:Anderson Creek 12.0 18 minutesAngier 8.1 11 minutesBroadway 16.5 20 minutesBuffalo Lakes 21.2 30 minutesCarolina Trace 25.1 33 minutesFuquay Varina 12.3 15 minutesHolly Springs 18.0 24 minutesSanford 23.9 29 minutesSpout Springs 23.0 29 minutesSpring Lake 20.5 28 minutesWillow Spring 17.0 24 minutes*GoogleMaps 12-11-12: from hospital coordinates to town centers.

HOSPITAL SERVICES24/7 Emergency Department · Board-Certified Emergency Medicine Physicians

DIAGNOSTIC SERVICESMRI · CT Scan · Digital Mammography · Ultrasound · Nuclear Medicine · X-Ray

Diagnostic Cardiology · Cardiopulmonary Services · Lab

SURGICAL SERVICESOrthopedics · Gynecology · General Surgery · Ophthalmology · Urology · Podiatry

Laparoscopic & Minimally Invasive Procedures · Anesthesiology

50 PRIVATE INPATIENT ROOMSMed/Surg Nursing Unit · Special Care Unit

Hospitalists provided by WakeMed Faculty Physicians

Central Harnett Hospitalin Lillington

215 Brightwater Drive · Lillington, NC 27546(910) 892-1000 · www.HarnettHealth.org

A New Choice In Healthcare Is Closer Than You Think

dategoeshere / 3Saturday, April 20, 2013 / 3Health & Wellness


By Dr. AngelA Bright PeArSon

One shot is all it takes to make a hole in one -- to sink the

winning basket -- or to permanently destroy your hearing forever.

Noise induced hearing loss (NIHL) is hearing loss resulting from over-exposure to noise and can happen instantly or gradually over time. Because our society has become accustomed to living, and even enjoying, loud events our daily “dose” of noise expo-sure often exceeds safe limits. Because noise exposure generally occurs without any pain or obvious injury (bleeding) to the ear, individuals are not alerted when damage is occur-ring.

When we hear, sounds, in the form of vibrations, strike our eardrum and are delivered to our inner ear by the chain of three tiny, middle ear bones. Our inner ear, or cochlea (pronounced COKE-lee-uh) is a small, snail shaped structure that contains 15,000 to 20,000 hair cells that are responsible for detecting sounds. When a loud noise strikes the eardrum, it causes the middle ear bones to deliver so much force to the inner ear that

the tiny hairs “bend over” and are unable to deliver the sounds appropriately to the brain.

Some of the warning signs of excessive

noise exposure are as follows:

• Being unable to hear someone three feet away

• Having pain, ringing, or buzzing (tinnitus) after

leaving a noisy area

• Expe-riencing dif-ficulty under-standing speech; hear-ing people talk but not understand-ing them.

After sev-eral hours or even a few days, these symptoms usually go

away as the hair cells recover. How-

ever, after repeated

expo-sures or one

very loud

exposure, hair cells remain permanently dam-aged.

How loud is too loud? Both the loudness of

sound (called the inten-sity; measured in deci-bels) and the amount of time you hear the noise are important. The louder the sound, the less time one can safely be exposed to it.

Some examples are as follows:

Motorcycle, Lawn mower: 90-95 decibels = 4 hours

Personal music play-ers: 100 decibels = 2 hours

Farm machinery: 110 decibels = 30 minutes

Chain saw: 115 deci-bels = 15 minutes

Music concert (regard-less of type of music!): 120 decibels = 7.5 minutes

Firearms, Firecrack-ers, Explosives: 140 -170 decibels = seconds

NIHL is preventable. To protect yourself, take these precautions:

1) Have your hearing tested by an audi-ologist to obtain a baseline. If you already have existing hear-ing loss,

take medications that can be damaging to the ear, or have hereditary hearing loss, it is important that you monitor your hearing on an annual basis, and be especially protective of your hearing from noise.

2) Pay attention to the noises around you. When-ever possible, turn down the volume. If you are in a public place and cannot carry on a nor-mal

conversation because of loud background noise, ask for it to be turned down. Take hearing pro-tection with you for loud places such as movie theatres.

3) Alternate a noisy activity with a quiet one to give your ears a rest.

4) Wear adequate hearing protection when exposed to loud noise at

work or play. Dispos-

able,

foam ear can be pur-chased at hardware stores and sporting good stores. Purchase protectors with the highest Noise Reduc-tion Rating (NRR) pos-sible. If over the counter protectors do not fit your ear canals, your audi-ologist can order custom-made devices to fit your ears.

5) Turn down the vol-ume on personal music devices. Specialized ear-buds, such as “KidzSafe” buds limit the amount of damaging noise to the ears, no matter how loud the device is turned.

6) When purchasing power tools or even chil-dren’s toys, check the decibel ratings (the

smaller, the better). Hearing damaged

by noise is a perma-nent loss and cannot be repaired. Hearing

aids amplify sound for remaining hearing, but they do not restore hearing to normal. Do yourself a favor for years to come and practice

Hearing Loss Prevention now.

How to prevent noise-induced hearing loss

Molly SPeight roBertS MS, PA-C

As warm weather rapidly approaches and those nice sunny days beckon us to go outdoors, here are a few things you should know before that much antici-pated spring break or sum-mer vacation. The harmful effects from the sun come in the form of ultraviolet radiation. UV radiation is the main cause of non-melanoma skin cancers and also plays a key role in melanoma, the deadliest form of skin cancer which kills more than 8,000 Ameri-cans every year. These rays also cause eye damage, (i.e. cataracts) and suppress our immune system, limiting the body’s ability to fight off infections and cancers. So since we are consistently being exposed to these scary electromagnetic rays everyday, it is extremely important to know how to pick the right sunscreen to protect your skin!

In June of 2011, the FDA announced a new rule to regulate the labeling and effectiveness testing of sun-screens. Since December, it’s starting to show up on the shelves. The hope was to make buying sunscreens a little easier for consumers and to cut out some confu-sion when it comes to SPF values and sunscreen termi-nology. The following are key changes to look for this summer:

1) We will no longer be seeing sunscreens with extremely high SPF values. SPF will now be “maxed out” at 50, since research has shown that sunscreens with any higher SPFs are not that much more protective, and tend to be extra pricey. Any sunscreens with these high SPF factors will fit into the category of “SPF 50+.”

2) The two main forms of UV radiation are Ultraviolet A and Ultraviolet B (UVA and UVB rays, respect-fully). In the past, SPF only-indicated protection against UVB rays, but now, the FDA is forcing all sunscreen manufacturers to have some UVA protection as well, and to be considered “broad spectrum.” As the SPF number increases, so does the proportion of UVA and UVB protection. Although, at this point the UVA pro-portion does not have to be as high as the UVB, this is a great move in the right direction to better overall sun protection.

3) The FDA has also decided to ban com-panies from using the terms“waterproof” or “sweat proof,” (since this was false advertising to begin with), and instead they will designate sunscreens that are“water resistant” and whether the protection lasts for 40 or 80 minutes.

4) And sunscreens with an SPF 15 or higher will now get to claim that they prevent skin cancer and signs of premature aging,

whereas those with any lower values can claim only that they help protect against sunburn

It is possible to enjoy the outdoors, but still protect yourself from all the negative effects of the sun. Make sure you are wearing abroad spectrum SPF 15+ sunscreen when outdoors, (I usually recom-mend SPF 30+ and daily protection on sun exposed areas with sunscreen-containing moisturiz-ers). Broad brimmed hats and sunglasses are not only in style, but also a must for the sun savvy outdoorsman or beach goer. When hav-ing fun in the sun, always reapply sunscreen every two to three hours, especial-ly after swimming or exces-sive sweating. Avoid tan-ning booths and instead opt for self tanner or a spray-on tan, (these have been per-fected over the years!). And the most important rule of all, have a blast! If you follow these simple tips and make sure to read sun-screen labels carefully, your skin will surely thank you over the upcoming years!

Enjoy summer fun in the sun, without the burn

sanFord dermatology

Bright audiology

When a loud noise strikes the eardrum, it causes the middle ear bones to deliver so much force to the inner ear that the tiny hairs “bend over” and are unable to deliver the sounds appropriately to the brain.


The award-winning FirstHealth Orthopaedics

program features board certified, fellowship-trained

surgeons focused on one goal– maximizing your quality of life.

You and your orthopaedic specialist will decide on the best treatment for your condition.

If surgery is necessary, feel confident in knowing FirstHealth Orthopaedics

ranks in the top 10 in the state for surgeries performed.

FirstHealth Orthopaedics. Excellent Care. Close to Home.

(800) 213-3284

www.firsthealth.org/ortho370-70-13

Experience Counts.


One of the most common eye procedures

performed today is blepharoplasty, or eyelid lift of the upper and lower eyelids. As we age, the skin of the eyelids loses its elasticity and can start to rest on or overhang the eyelashes. This redundant tissue is often accompanied by protruding fat pockets in the upper and lower lids that can give a tired or excessively aged appearance.

To rejuvenate the upper eyelids, a blepharoplasty procedure can remove this excess skin and give a more alert, youthful appear-ance, leaving only a minimally noticeable scar. The lower lids may often be cor-rected through an internal approach leaving no scar-ring. Patients are unique

and need a surgical plan tailored to their desires

and their particu-lar anatomy.

Prior to decid-ing on surgery, patients should have a complete eye examination to identify any other conditions. It’s important to discuss your goals and expec-tations with your physician. After

surgery, patients are able to use their eyes with only

minimal discomfort. Typi-cally, patients need to avoid strenuous activity for one to two weeks, but may return to work in this time-frame. The final results are usually apparent in two to three months.

The ideal patient for eyelid rejuvenation is someone with excess tissue around the eyes, is healthy enough for surgery, and has realistic expectations. The goal is to correct the sagging of the upper lids and the bulging fat pockets of the lower lids that give a tired appear-ance. The vast majority of patients notice an improve-ment in the appearance of the eyes.

Jeffrey White, MD, an oculoplastic and aesthetic surgery specialist at Carolina Eye Associates performing cosmetic, functional and reconstructive procedures around the eyes and face, can be reached at (910)295-2100 or (800)SEE-WELL (733-9355) or www.carolinaeye.com

Eyelid rejuvenation a surprisingly common procedure

Carolina eye assoCiates

Dr. Jeffrey White

Patients are unique and need a surgical plan tailored to their desires and their particular anatomy.

While hip fractures can be treated, the injury can lead to severe health problems and reduced quality of life. Approximately

20 percent of hip fracture patients die within one year of their injury.

Most hip fractures occur because of a fall, especially among adults over the age of 65. Women are more likely than men to experience hip fractures due to a higher rate of osteoporosis. In addition to advanced age and osteoporosis, other risk factors associated with hip fractures include being Caucasian or Asian, lack of calcium and vitamin D in the diet when younger, physical inactivity, tobacco and alcohol use, and certain medications. Environmental factors, such as loose rugs or a cluttered living space, also could increase the chance of falling.

A hip fracture causes pain in the outer upper thigh or groin area, as well as the inability to bear weight on the side of the injury. The hip area may become stif f, show signs of bruising or swelling, and a significant level of discomfort could occur after any attempt to rotate or flex the hip. Most hip fractures are diagnosed following an X-ray, which also shows where the fracture occurred in the hip.

Treatment is determined based on the patient’s overall health and age, as well as the location and severity of the fracture. Most hip fractures are treated surgically using one of three methods:

Inserting metal screws into the bone, if it is properly aligned, to hold it together as it heals. This is called internal fixation.

Replacing part of the femur, the long bone that extends from the pelvis to the knee. This method, called hemiarthroplasty, calls for removing the head and neck of the femur and replacing them with a metal prosthesis.

Replacing the upper femur and pelvic bone socket with a prosthesis. This is called a total hip replacement.

Patients typically do better if they undergo surgery soon after the hip fracture occurs. They may be encouraged to get out of bed the day after surgery with help from a physical therapist, who also will work with patients to help them regain strength and start walking again. After a hip fracture, most patients are hospitalized for approximately one week1d and may then be either discharged home or referred to a nursing home if they are unable to live independently. Physical therapy rehabilitation usually takes approximately three months.

People at risk for hip fractures can take steps to reduce their chances of falling.

Women should have a bone density test to

measure bone mass and make sure they get enough vitamin D and calcium in their diet.

Engage in weight-bearing exercise to help strengthen bones and prevent falls.

Avoid excessive amounts of alcohol and do not smoke.

Take medications as prescribed to treat osteoporosis.

Wear shoes with non-skid soles and avoid high heels and shoes like sandals and bedroom slippers that flop when you walk.

Check your home for trip hazards like throw rugs, electrical cords and clutter.

Make sure your home and outside walkways are well-lit so you can see where you are walking.

Talk to your doctor or physical therapist about whether assistive devices may be needed to help you keep your balance.

For more information about hip fractures, talk with your doctor or call (800)483-6385 for a free referral to a specialist near you.

More than 320,000 Americans suffer hip fractures anuallyCentral Carolina hospital


Compass House Counseling CenterPamela Parker, MS, LMFT

Psychotherapy Services Offered:

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Comprehensive Diagnostic Assessment

Let Us Help You Find Your WayCall Today 919-774-8790

Most Insurance Plans Accepted

• Dr. Angela Bright Pearson will be presenting an informative seminar at 11:00 a.m. on how noise affects our precious hearing and what you can do to protect yours

• Free hearing screenings to identify whether hearing loss is present- school age and up

• Free earplugs (one pair per attendee)• Refreshments and a chance to ask our staff

questions about noise and hearing protection devices

REGISTER TO WIN!

($20.00 value)

The new KidsSafe Earbuds allows your child (or you) to enjoy your music without fear of damaging your hearing. No matter how loud they “crank it up”, these new buds keep damaging sounds to

a safe level!

REGISTER TO WIN! One free pair of noise blocking earmolds, made to fi t your ears. Good

for target shooting, mowing, car races, and even snoring spouses! ($120 value)

1620 South Third Street919-774-3277

www.brightaudiology.com

Celebrates...18th International

Noise Awareness DayWednesday, April 24th, 2013

9 am – 5 pm


By DrS. roger lAMAnnA AnD eDWin fuller, iii

NEPhroLogiStS

SANForD SPECiALty CLiNiCSA MEMbEr oF thE UNC PhySiCiANS

NEtWork

More than 20 million people in the United

States suffer from Chronic Kidney Disease (CKD), and it is estimated that

one in every nine people in North Carolina has CKD. Chronic kidney disease is the slow loss of kidney function over time. The main function of

the kidneys is to remove wastes and excess water from the body. In most instances, chronic kidney disease (CKD) slowly gets worse over time. In the

early stages, there may be no symptoms.

The primary risk factors for CKD are diabetes, hypertension, heart disease and a family history of kidney disease. More than 35% of people aged 20 years or older with diabetes have CKD. Diabetes is the most common cause of kidney failure. Poorly controlled diabetes can damage the small blood vessels in the kidneys and prevent the removal of waste and excess fluid from the body. Diabetes results from problems converting sugars from food (carbohydrates) into energy (insulin) in one of the following ways:

• too little insulin in the body (Type 1 diabetes), or

• the body’s inability to use insulin (Type 2 diabetes).

More than 20% of people aged 20 years or older with hypertension (high blood pressure) have CKD. Hypertension is the second leading cause of kidney failure. Blood pressure beyond the normal range (>120/80) makes the heart work harder and can damage blood vessels. If the kidneys’ blood vessels are damaged, they may stop removing waste and extra fluid from the body through urine. The extra fluid in the blood vessels may then raise blood pressure even more. Less common kidney diseases and infections can result in CKD, as well.

Initial CKD symptoms are often subtle but can include: fatigue, puffy eyes or swelling of legs, metallic taste in mouth, itching or easy bruising

of skin, changes in volume or appearance of urine, and high blood pressure. Screening for CKD based on risk factors is one way to avoid a delayed diagnosis -- when kidney function is already severely diminished and clinical symptoms are apparent. Screening for persons with risk factors is recommended to delay or avoid its complications.

When kidneys fail, their important work (blood pressure control, removal of extra fluid and waste, making red blood cells, and maintaining healthy bones) must be completed another way. When CKD reaches advanced stages, it is important to select the treatment that best matches your lifestyle and medical condition. There are three options for replacing the kidneys’ important work: transplant, hemodialysis, and peritoneal dialysis.

To decrease your risk of developing CKD, persons with diabetes mellitus should strive to keep their hemoglobin A1C (a 3-6 month blood sugar average) less than 7. Your endocrinologist or primary care physician will determine the appropriate therapy and self-management strategies. If you suffer from hypertension, take your blood pressure medication as prescribed to achieve a blood pressure of 130/80. Finally, if you have heart disease, you should have your kidney function monitored.

If you have any questions or would like to learn more, please contact Sanford Specialty Clinics at (919)718-9512.

Chronic kidney disease – what you need to know sanFord speCialty CliniC


James B. Holt, M.D.Family Practice

Leah Beynon, P.A.Physician Assistant

Erik Butler, D.O.Family Practice

Cindy Julich, F.N.P.Family Nurse Practitioner, Certifi ed

Dawn Erikson, F.N.P.Family Nurse Practitioner, Certifi ed

Roxanne Bryant, F.N.P.Family Nurse Practitioner, Doctorate

Michael J. Tyler, M.D. Family Practice

• On-Site Laboratory• On-Site X-Ray• Diabetic Management & Education• Audiometry• Pulmonary Function Testing• Pre-Employment Physicals

• Same Day Appointments Available• Complete Physical Exams• Occupational Medicine• Minor Surgical Procedures• Injury Care

Healthcare for the entire family!

From the cradle...

...to the golden years!

Visit our NEW PATIENT PORTAL at www.cfmodoc.com

Newborn Care • Pediatric Care • Teen Care • Adult Care • Seasoned Citizen Care

75 Old Graham RoadPittsboro, NC 27312919.542.2731

2412 Wilkins DriveSanford, NC 27330

919.776.6000

FIELLDS DRIVE

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CENTRAL CAROLINAHOSPITAL

SANFORD SPECIALTY CLINICS

We offer an inter-disciplinary team approach in the following specialties:

Cardiology, Endocrinology, Nephrology, Pulmonology, and Rheumatology

Highlights of on-site services include:

S A N F O R D S P E C I A LT Y C L I N I C S

Bone density studies Joint injections Rheumatic disease infusions

Pulmonary function tests Alphi - 1 therapy & infusions Allergy injections Cardiopulmonary exercise

testing Arterial blood gas testing

Thyroid ultrasounds & biopsies

X-ray services Lab services

ADA-certified diabetes education program

Insulin pump management Continuous glucose

monitoring Medical nutrition therapy

ECHO cardiograms Stress ECHO Arterial & venous ultrasound Pacemaker services Vein clinic including

endovenous ablation & Sclerotherapy

Personalized, local adult specialty careEasy access to world-renowned healthcare...

1301 CENTRAL DRIVE, SANFORD, NC 27330

To schedule an appointment at one of our specialty clinics, please call (919) 718-9512

We are pleased to announce Chassidy Young, PA-C has joined our healthcare team.

At Dr. Hall's practice, we pride ourselves on taking the time to listen to our patients and learn about each patient's personal needs. Our commitment is

to state-of-the-art, quality medical services in a caring environment.

We are accepting new patients and welcome all your family members!

The quality health care you need, the compassion you deserve...

To schedule an appointment, please call (919) 775-10001911 K.M. WICKER D IVE, SANFO D, NC 27330

William E. Hall, MDFAMILY P ACTICE

Health & WellnessC7 HEALTH & WELLNESS

We create smiles!At Sanford Pediatric Dentistry we make your child‛s dental

experience a pleasant and comfortable one. We treat infants, children, adolescents and patients with special needs.

The entire Sanford Pediatric Dentistry family looks forward to meeting you and your child!

Most Insurances Accepted Including: United Concordia, Delta Dental, NC Medicaid,

& NC Health Choice

Antonio S. Braithwaite DDS, MPH, PA

1013 Spring Lane, Sanford, NC 27330

www.sanfordpediatricdentistry.com

919-718-5561Se Habla Espanol

Board-Certified Pediatric Dentist

New Location! New Location!We are located in the Riverbirch shopping complex behind McDonalds.

8 / dategoeshere 8 / Saturday, April 20, 2013 Health & Wellnessharnett health systems

Di a b e t e s i s a d isease wher e the body does not

make enough insulin. The body needs insulin to break down sugar. Too much sugar will stay in the blood stream and can harm the body.

There are 25.8 mil-lion people in the Unit-ed States, or 8.3% of the population, who have diabetes according to the American Diabetes Association (ADA).

There are two types of diabetes. The ADA identifies the following symptoms for Type 1 and Type 2.

type 1 Diabetes • Frequent urination • Unusual thirst • Extreme hunger • Unusual weight

loss • Extreme fatigue

and irritability

type 2 Diabetes • Any of the type 1

symptoms • Frequent infec-

tions • Blurred vision • Cuts/bruises that

are slow to heal • T ingling/numb-

ness in the hands/feet • Recur-

r i n g s k i n , gum, or blad-d e r i n f e c -tions

I f n o t t r e a t e d , d i a b e t e s can lead to other health issues. One of the com-m o n c o n -cer ns faced by people with diabetes is slow wound healing. Untreated wounds can lead to other complica-tions like infection and amputation, especially in lower l imbs. Foot ulcers, wound infec-tion and tissue loss are sources of morbidity and mortality in diabet-ics, so it is critical for them to take good care

of their body.Diabetic ulcers are

of great concern. A dia-betic ulcer is a wound that appears on the feet of people with diabetes. The skin may appear normal and be warm like usual, but the ulcer may exist. Many times there is little to no feel-ing in the feet or at the site of the ulcer. Even if the ulcer doesn’t hur t, it should be checked by a healthcare profession-al because ulcers can result in infections and in extreme circumstanc-es can lead to death.

If a diabetic person has a wound, like a foot ulcer, and i t doesn’t heal completely within six weeks then receiv-i n g t r e a t m e n t a t a wound care center may be appropriate. Wound

care centers of fer state-o f - t h e - a r t t r e a t m e n t and proto -cols to treat c h r o n i c w o u n d s . Such treat-m e n t a n d p r o t o c o l s i n c l u d e hyperbar ic

oxygen therapy, nega-tive pressure therapies, bioengineered tissues a n d b i o s y n t h e t i c s . Patients may also have the opportunity to par-ticipate in clinical trials and multi-center stud-ies.

Hyperbaric oxygen therapy takes p lace in a chamber that you can see out of as you

recline on a stretcher. T reatments typical ly take about two hours, so patients undergoing treatments often watch television or a movie. A trained staf f member is always in the room with the patient and the patient can communi-cate with the staff mem-ber at anytime.

During treatment , the chamber is pres-surized, and the patient breathes one hundred percent oxygen. The pa t ien t ’ s b lood car -ries the oxygen to the injured area to help the wound heal faster.

The therapy is pain free. Patients may expe-rience a bit of pres-sure in their ears at the beginning of treatment, much like when you fly in a plane or drive into higher altitudes.

Hyperbaric oxygen therapy is used not only for diabet ic pat ients with wounds, but for many types of wound healing. Talk with your healthcare provider on the benefits of using a wound care center.

Harnett Health now has a wound care cen-ter in Dunn, across the street from Betsy John-son Hospital. We wel-come new patients and look forward to serving your healthcare needs. Contact the Har nett Hea l th Wound Car e Center a t (910)892 -1000. Also, visit myhar-netthealth.org to learn more about Har net t Health and to use our Physician Finder.

Wound care of particular concern to diabetics

There are 25.8 million people in the United States, or 8.3% of the population, who have diabetes according to the American Diabetes Association.


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For a Limited Time Free LipiView® Testing with Your Office Evaluation!

$125 Dry Eye Disease Value! Dr. Russell Stokes,

plastic and reconstructive

surgeon with Pinehurst Surgical Plastic and Reconstructive Center, is now offering his patients another option in breast augmentation. The FDA approved Sientra® “Gummy Bear” breast implants are known for their highly cohesive gel, as well as their natural shape and look.

Until recently, breast implants were only round in shape. The Sientra® implants will offer a variety of sizes and profiles to fit each individual patient. “This advancement in breast implants will offer women more choices in breast profile, proportion and projection,” according to Dr. Stokes.

The implants are form stable, which means each implant has a shape, and no matter what position it is in it will retain it’s natural shape. It is made from a highly cohesive soft gel that helps to maintain the natural shape and prevents folds and wrinkles.

“Another unique feature of the Sientra® implants is that they are only sold to Board Certified Plastic surgeons, which is in the best interest of patients for outcome results and patient safety,” according to Dr. Stokes.

The implants can be used for women over the age of 22 for primary and revision augmentation, as well as reconstructive surgery. If you would like more information you may call our office at (910)235-2949 or toll free at (855)294-2639 to schedule a consultation.

Pinehurst offers newest in breast implant surgery

pinehurst surgiCal

ruSSell B. StoKeS M.D., f.A.C.S.

PINEHURST – Raeford resident Rick Sousa knew there was a chance his Type 2 diabetes would go into remission once he’d had weight-loss surgery. Or that he would see enough of an improve-ment in the disease that he would no longer need medication to control it.

He also knew there was no guarantee of either outcome, but he hoped for the best and got it. Less than a month after his surger y at FirstHealth Moore Regional Hospital, the 45-year-old FirstHealth paramedic star ted to notice an encouraging change in his blood sugar levels.

“they were slowly going down,” he says.

Except for the two mul-tivitamins he takes daily, Sousa no longer needs any kind of medication. He is completely off his oral dia-betes medicine as well as the medication he took to lower his cholesterol and to prevent problems with his blood pressure and kidneys.

“i’m feeling fantastic,” he says.

Since his surger y, Sousa has enjoyed the benefit of what one of the foremost health care sys-tems in the country calls “the top medical innova-tion for 2013” or, accord-ing to the Cleveland Clinic, research showing that bariatric surgery can help control diabetes even when medicine cannot.

In fact, said a recent Cleveland Clinic press release, “many diabe-tes experts now believe that weight-loss surgery should be offered much earlier as a reasonable treatment option for patients with poorly con-trolled diabetes – not as a last resort.”

Weight-loss surgeons at Moore Regional Hospital have observed this remis-sion phenomenon (disap-pearance or lessening of symptoms) time and time again in their patients with

Type 2 diabetes. In the 43 bariatric procedures per-formed at Moore Regional between August 2011 and November 2012, 13 patients had Type 2 diabe-tes. According to recent clinic records, 12 are now off all of their diabetes medications.

“Bariatric surgery can have a profound ef fect on diabetes, and many published studies have looked at the effect,” says bariatric surgeon Ray-mond Washington, M.D. “Surger y can account for almost an 80 percent remission of diabetes. Oftentimes, patients with non-insulin-dependent dia-betes will leave the hospi-tal off of their oral medi-cations after only a few days.”

While it isn’t known exactly why bariatric sur-gery can have this effect on diabetes, two Ameri-can Diabetes Association-sponsored researchers have discovered clues that might explain it.

In his research, Chris-topher Newgard, Ph.D. of North Carolina’s Duke University Medical Insti-tute and the Sara W. Stedman Nutrition and Metabolism Center, found a link between increased circulating concentrations of certain kinds of amino acids (the building-blocks of proteins) and insulin resistance. (Insulin is the hormone that delivers sugar to cells to give them energy. In diabetes, the body does not use insulin properly.)

More recently, Blan-

dine Laferrere, M.D., of St. Luke’s Roosevelt Insti-tute for Health Sciences in New York, observed that patients undergoing bar-iatric surgery have greatly reduced levels of these amino acids, indicating that the changes are some-how involved in post-surgi-cal diabetes remission.

“Removing the lateral aspect of the stomach induces hormonal and metabolic changes that have a profound ef fect on insulin and blood glu-cose,” Dr. Washington says. “This occurs before any significant weight loss and is notable in both gas-tric bypass and sleeve gas-trectomy.”

According to published reports, Dr. Newgard and Dr. Laferrere plan to focus on the ef fect of amino acids in diabetes in their future research and are hopeful that their prelimi-nary findings could even lead to advancements in diabetes treatments.

Diabetes remission is just one of several benefits that Rick Sousa has expe-rienced since his surgery. “Always a big kid,” he had reached 330 pounds by the time of his surgery. By December 2012, about four months after the oper-ation, he was down to 237 and sporting extra-large T-shirts instead of the qua-druple Xes that had been part of his wardrobe.

He can also par tici-pate in activities that used to leave him huffing and puffing – like backpacking with his 13-year-old son’s Boy Scout troop.

“They don’t have to wait for me anymore,” Sousa says. “I’m usually in front of them. They have to catch up with me. Depending on how good I feel, I have to wait for them once in a while.”

Firsthealth of the Carolinas offers two information sessions each month on its weight-loss surgery program. For more information, call (800) 213-3284 or visit www.ncweightlosssurgery.org.

Post-surgical diabetes remission an innovation

Firsthealth oF the Carolinas

rAyMonD g. WAShington, M.D.


Spring has sprung and with the longer days, warmer

nights, and flowers blooming comes the onslaught of seasonal allergies. Millions of people suffer from seasonal allergies. The sneezing, congestion, and runny nose can make life miserable. But before you resign yourself to staying indoors on a gorgeous spring day, try these simple strategies to keep seasonal allergies under control.

reduce your exposure to allergy triggersTo reduce your

exposure to anything that may trigger your allergy symptoms, try the following:

• Stay inside on dry, windy days.

• Have someone else handle yard work.

• As soon as you come inside, remove the

clothes you wore outside that may be covered with pollen.

• Shower to remove pollen from your skin and hair.

• Do not hang laundry outside.

• Wear a dust mask if you do outside chores.

• Check for local pollen forecasts and current pollen levels. If high pollen counts are forecast, start taking allergy medications before your symptoms start.

• Close doors and windows at night or any other time when pollen counts are high. Use the air conditioning in your house and car.

• Avoid spending time outside in the early morning when pollen counts are highest.

• Use high-efficiency air conditioner filters and follow regular maintenance schedules.

• Keep indoor air dry with a

dehumidifier. Use a

portable

high-efficiency particulate air (HEPA) filter in your bedroom.

• Clean floors often with a vacuum cleaner that has a HEPA filter.

try an over-the-counter remedy

Nonprescription medications that can

help ease allergy symptoms include:

• oral antihistamines. Antihistamines such as Benadryl, Loratadine, Fexofenadine, or Zyrtec can help relieve sneezing, itching, runny nose and watery eyes.

• decongestants. Oral decongestants can

provide temporary relief from nasal stuf finess. Decongestants also come in nasal sprays. Only use nasal decongestants for short-term relief. Long-term use of decongestant nasal sprays actually can make your symptoms worse.

When all else failsIf these measures

don’t help, contact your primary care physician. There are medications available by prescription. When all else fails, immunotherapy allergy shots) may help.

We hope these tips will help you to have a very Happy Spring!


Call (910) 235-2949 or1-855-294-BODY (2639)

• NOTE: RSVP is required for this event• Talk individually with the physicians. See before and after examples.

• Book 1/2 price cosmetic consultations the night of the event.(All consults are 100% credited to any cosmetic surgeries that are performed.) 5 First Village Drive • Pinehurst

Joint replacement surgery involves replacing a damaged joint with a

new one called a prosthesis. These new joints usually are made of special metals, such as stainless steel or titanium, and durable, wear-resistance plastic. Prostheses are designed to be accepted by the body and resist corrosion, degradation and wear so they can last at least 10 to 15 years. Hips and knees are the joints replaced most often, but shoulders, fingers, ankles and elbows can be replaced as well.

Joint replacement is usually considered after exercise, walking aids, physical therapy or medications cannot relieve pain and improve mobility. Surgery for hip replacement patients, for example, can help lessen problems walking up and down stairs or make it easier to stand from a seated position. Joint damage is caused by osteoarthritis, injuries, other diseases, joint wear caused by years of use, bone tumor or blood loss due to insufficient blood supply. Symptoms of joint problems include pain, stiffness and swelling.

Before surgery, the surgeon evaluates the patient’s range of motion and joint strength, takes a medical history and reviews medications currently being taken. Blood tests and X-rays also can be ordered. The doctor may put a small, lighted tube called an arthoscope into the joint to check for damage. In some cases, only the damaged parts would be replaced, not the entire joint. During a hip

replacement surgery, diseased or damaged bone and tissue is removed and a metal stem and attached ball is then inserted into healthy bone and tissue that are left intact.

New joints can be cemented into place to hold the new joint to the bone, or the prosthesis can be placed without cement so bone can grow and attach to it. A prosthesis is designed to duplicate the mechanical properties of the joint being replaced. A prosthetic knee, for example, will be flexible

enough to bend without breaking and strong enough to bear weight.

Most hip and knee replacement patients are discharged from the hospital three to five days after surgery. Patients will be encouraged to stand and start walking soon after surgery with a walker or crutches. Pain from sore muscles or surgery can be helped with medication and usually disappears in a few weeks or months. Physical therapy exercises will help

regain motion in the joint. More than 90 percent of

joint replacement surgeries are successful. However, if problems do arise, most can be treated. Possible complications from joint replacement surgery include infections, blood clots, loosening, dislocation or wear of the new joint, or nerve and blood vessel injury. Hip replacement patients also may experience a change in leg length or joint stiffening. Following hip replacement surgery, most

patients eventually will be able to swim, play golf or bike ride comfortably, but high-impact sports such as basketball and running would not be possible.

Joint replacement surgery is becoming more common in the United States, with more than 773,000 Americans having a hip or knee replaced annually. For more information about joint replacement, check with your doctor or call (800)483-6385 for a free referral to a physician near you.

Joint replacement surgery increasingly commonCentral Carolina hospital

Keep your Springtime allergies from blooming this yearWilliam e. hall Family praCtiCe

10 / dategoeshere 10 / Saturday, April 20, 2013 Health & WellnessC10 HEALTH & WELLNESS

CENTRAL CAROLINA HOSPITAL INTRODUCES

MAKOplasty® ROBOTIC SURGERY

orthopedic healthA NEW LEVEL OF

Y

CENTRAL CAROLINA HOSPITAL

855-44-J-O-I-N-T centralcarolinahospital.com

Central Carolina Hospital’s board certified orthopedists

are fortunate to have an exciting development in the

treatment of early to mid-stage osteoarthritis.

MAKOplasty® Robotic Surgery is changing the way

our surgeons help patients:

• Restore range of motion

• Reduce or eliminate joint pain

• Return quickly to the lives they love

If you experience these symptoms,

MAKOplasty® may be right for you:

• Pain when weight bearing

• Start up pain or stiffness after prolonged

sitting or after getting out of bed

• A grating sensation or crunching feeling

in your knee or hip

Contact us to see how MAKOplasty®

can help you reach a new level of

orthopedic health.

By Will DorAn

S A N F o r D

Many had replacement joints. Most were afflicted with aches

and pains. All were stroke survivors, and all of them practiced yoga.

A typical group of 15-20 people came to the Enrichment Center for the monthly Sanford/Lee County Stroke Support Group meeting, featuring a special presentation by Raleigh-based yoga instructor Howie Shareff. Shareff, an energetic former dentist in his 50s, taught the mostly elderly crowd "chair yoga," which he said he took up himself several years ago after having a multitude of health problems including a stroke, arthritis, hip surgery and neck surgery. It can be done sitting down, and it mostly focuses on improved posture and breathing, which he said can improve confidence and mood as well as impact physiological factors like blood pressure, nerves, oxygen

intake, line of sight, alertness, back pain and core strength.

He also taught the participants how to use long breaths and backward counting — key tenets of meditation — to help them fall asleep easier, regain composure under stress or take their mind off of

situations like long waits at the doctor. He also noted that yoga and meditation only require participants to change how they act and react.

"Yoga is not a religion, it's a health practice," he said, also calling it a type of self-preser-vation.

One audience member agreed, saying she learned yoga as a young girl and has always used it for pain management, even when she was battling cancer. Several others volunteered tips and personal anecdotes while Shareff was available to assist — helping make sure they had the best posture possible.

That type of self-confidence is exactly what group facilitator Joy Phillips Murphy, herself a 30-year stroke survivor, said she loves to see in the group although she never expected it when she started these meetings in January 2012. Stroke survivors, their loved ones and caregivers are invited to the regular gatherings, which take place on the second Thursday of each month at 1 p.m. at the Enrichment Center of Lee County

The group is quickly approaching another milestone this spring with the observance of National Stroke Awareness Month in May — a time public education to increase awareness of different

aspects of stroke."A stroke is a lifelong

journey, mild or severe," said Murphy, who had a trauma-induced stroke at the young age of 27 that left her whole left side paralyzed for a time. "You have quite a lot of mental things to deal with, as well as the physical. ... Being with other people going through the same things you're going through really helps. You say, 'They're doing it. I can, too.' It gives you courage."

Those wanting more information about the stroke support group can contact the Enrichment Center at (919) 776-0501, ext. 2230. Those wanting more information about Shareff, the book and DVD he made about chair yoga, or the schedule of classes he teaches in North Raleigh, can email him at [email protected] or call (919) 522-2646. Free instructional videos of his techniques are also posted at www.youtube.com/user/howie1055.


Stroke survivor group reaps rewards of yoga

Will Doran | the Sanford heraldRaleigh-based yoga instructor Howie Shareff (right) bows to mem-bers of the Sanford/Lee County Stroke Support Group at the Enrich-ment Center after teaching them "chair yoga" tips to help improve posture and breathing.


SERVING LEE COUNTY FOR 30 YRS.John D Cheesborough, MD • Tiffany J. Mills, PA-C

Molly E. Roberts, PA-CThree full time providers.

RENOVATIONS ARE COMPLETE. COME BY AND SEE OUR NEW OFFICE!New Patients welcome!

Invites you to visit our friendly offi ce & staff

Diseases & Surgery Of The Skin, Hair & Nails

We Accept Assignment On MedicareMost Insurance Claims Filed

NOW ACCEPTING UNITED HEALTHCARE & TRICARE INSURANCE

Offi ce Hours:Monday - Thursday 8am-5pm Friday 8am-Noon

• Adult & Pediatric Dermatology• Diagnosis & Treatment Of Moles & Skin Cancer

• Spider Veins

919-542-2731Old Graham Road

Pittsboro

919-775-7926827 S. Horner Boulevard

Sanford

919-775-7926100 S 10th Street

Lillington855-966-3633

centralcarolinahospital.com

When it comes to surgery the term, “General

Surgeon” can be a little confusing. It refers to

an expertise in a number of areas including the

abdominal organs as well as breasts and certain

skin disorders. At CCH we have a team of

General Surgeons ready to help.

CCH general surgery...

ALL ABOUT THE specifics

from left to right:

Roger Ernest, DO; Michael Gordon, MD;

Steven Jurisich, MD

harnett health systems

Osteoarthritis a potentially debilitating ailmentArthritis is a disease

that destroys joints, bones, muscles,

ca r t i l age and o ther connective tissues in the body. Osteoarthritis (OA) is one of the most c o m m o n f o r m s o f ar thritis and is a joint d i s o r d e r w h e r e t h e joint’s car tilage breaks down causing bones to rub against each other leading to pain, stiffness and loss of movement in the joint.

Close to 27 million adults have OA according to the National Arthritis

Foundation. The disease can hinder a person’s quality of life and limit daily activities while also complicating other dis-eases such as diabetes and heart disease.

OA is generally con-sidered a normal result of aging and is common in people of all races and backgrounds. It usually appears after age 45, and overall more women have OA than men.

There are many factors that are possible causes of OA:

• OA tends to run in families.

• Being over weight increases the risk of OA in the hip, knee, ankle, and foot joints because extra weight causes more wear and tear.

• Fractures or other joint injuries can lead to OA later in life. This includes injuries to the cartilage and ligaments in your joints.

• Jobs that involve kneeling or squatting for more than an hour a day put you at the high-est risk. Jobs that involve lifting, climbing stairs, or walking also put you at risk.

• Playing sports that involve direct impact on the joint (such as foot-ball), twisting (such as basketball or soccer), or throwing also increase the risk of arthritis.

Medical conditions that can lead to OA include:

• Bleeding disorders that cause bleeding in the joint, such as hemophilia.

• Disorders that block the blood supply near a joint and lead to avascular necrosis.

• Other types of arthritis, such as chron-ic gout, pseudogout, or

rheumatoid arthritis.SymptomsPain and stif fness in

the joints are the most common symptoms of OA. The pain is often worse after exercise and when you put weight or pressure on the joint.

If you have osteoar-thritis, your joints prob-ably become stif fer and harder to move over time. You may notice a rub-bing, grating, or crackling sound when you move the joint.

The phrase "morning stif fness" refers to the pain and stif fness you

may feel when you first wake up in the morning. Stiffness usually lasts for 30 minutes or less. It is improved by mild activity that "warms up" the joint.

Orthopedic surgeons on staff at Harnett Health are accepting patients and ready to talk with you about Osteoarthritis and can perform diagnos-tic procedures at Central Harnett Hospital in Lill-ington or Betsy Johnson Hospital in Dunn. Find an orthopedic surgeon with our Physician Finder Tool at www.myharnetthealth.org.


I CHOOSECENTR AL CAROLINA HOSPITAL

Margaret MurchisonI chose Central Carolina Hospital

for emergency services

John SaulsI chose Central Carolina Hospital

for surgical services

Choose us for your health, too:

800-483-6385 or centralcarolinahospital.com

BobbyWalkerI chose Central Carolina Hospital

for my cardiovascular health

Bud Marchant I chose Central Carolina Hospital

for my health

health and wellness

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