Central Carolina Health & Life Winter 2010

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Central Carolina Hospital

Winter 2010

health&life T H E G O O D

L I V I N G

M A G A Z I N E

f r o m

C E N T R A L

C A R O L I N A

H O S P I TA L

A baby boomer’s exercise guide 10 WAYS TO BEAT HEADACHES RELIEF FROM

incontinence

Plus

QUIZ: How ’green’ is your diet?

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health&life

Contents

THE GOOD LIVING MAGAZINE from CENTRAL CAROLINA HOSPITAL

Central Carolina Hospital Staff CEO DOUG DORIS CFO

KERRY TOLLESON COO

KEVIN ZACHARY CNO

URSULA LAWRENCE CMO

RICK EBKEN, M.D. CHRO

TOM MACKLIN compliance & privacy officer

MISHELLE FRIAS director of business development

DANYL BUTLER director of marketing & public relations/editor

MARGARET MINUTH

Central Carolina Hospital 1135 Carthage Street Sanford, NC 27330 Main Phone: 919-774-2100 Physician Referrals: 1-800-483-6385 www.centralcarolinahospital.com www.breastnavigator.com

WAINSCOT STAFF

Central Carolina Hospital

health&life

winter 2010

editor in chief RITA GUARNA

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art director

Thanks to a simple procedure used to treat urinary incontinence, an active woman no longer needs to plan her day around bathroom visits.

SARAH LECKIE

senior editor TIMOTHY KELLEY

CLINICAL FOCUS: Freedom restored

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Don’t suffer in silence

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WELLNESS: 10 ways to beat headaches

managing editor JENNIFER CENICOLA

Doctors say most urinary difficulties can be relieved.

Read about the four kinds of incontinence and an innovative treatment.

assistant editor KRISTIN COLELLA

Central Carolina Hospital Health & Life is published by Wainscot Media, 110 Summit Avenue, Montvale, NJ 07645, in association with Central Carolina Hospital. This is Volume 2, Issue 1. © 2010 by Central Carolina Hospital.

All rights reserved.

Material contained herein is intended for informational purposes only. If you have medical concerns, seek the guidance of a healthcare professional.

CORRECTION: Our Fall 2009 issue inadvertently misquoted cardiologist Lukas Jantac, M.D., in the article on sodium. It should have read: "Normal blood pressure is 120/80 millimeters of mercury (mm Hg)."

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Medications can help, but so can changes in your routine.

FOOD: How green is your diet?

Take our quick quiz to assess how eco-friendly your food choices are.

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FITNESS: Your aging ‘boomer’ body

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HEALTHY KIDS: News you can use

A few smart precautions can help this age group stay active while avoiding injuries.

Items from research about asthma, househould safety, depression and stuttering COVER IMAGE : DON MCKENZIE

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CLINICAL FOCUS

Freedom restored THANKS TO AN OUTPATIENT PROCEDURE, AN ACTIVE WOMAN NO LONGER PLANS HER DAY AROUND BATHROOM VISITS

A simple procedure helped Connie Dean banish fears about straying too far from the bathroom.

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DON MCKENZIE

FOR CONNIE DEAN, A QUICK SURGICAL PROcedure known as a single-incision sling instantly improved the quality of her life and eliminated years of embarrassment. A very active person, Dean is always on the go—whether she’s camping in the mountains with her family, jog-walking her daily two or three miles, gardening at home, or singing in her church choir.

Dean knew that the birth of her child 32 years ago might eventually contribute to urinary incontinence, and about three years ago, it did. At first, it was just a nuisance. Laughing and sneezing were obvious activities that would cause alarm for her. Then, getting out of a chair and bumping into things would become problems.

When she sang in the church choir, she would have to

reposition herself to keep bladder control. “I had to retrain myself and plan my posture when getting up and moving around,” she recalls. As the first soprano, she also found it difficult to hit the high notes.

Eventually it worsened to where her days had to be planned around finding a bathroom. Needing a bathroom break three or more times an hour became the norm. “It was interfering with my life,” says Dean.

“Whenever we’d go somewhere, I’d have to plan the trip so that I would always be near a bathroom.” On trips to the lakes or mountains with her family, she would often withhold fluids so that her family didn’t have to be disrupted too.

During her annual physicals, she had talked about the issue with her gynecologist, Paul Heimbecker, M.D. “When I first talked to Dr. Heimbecker about it, we discussed surgery as an option, but I wasn’t ready for that,” she says. “I just hadn’t reached that point.”

Instead, they tried Kegel exercises (contracting and relaxing the muscles that form the pelvic floor) and medications, but with no success. After two years of planning her life around an uncontrolled bladder, with embarrassment and a considerably changed lifestyle, she decided to have surgery and scheduled her singleincision sling for November 2008 at Central Carolina Hospital.

With the “A less invasive approach to MiniArc, a correcting urine leakage, the strip of mesh helps MiniArc Single-Incision Sling is prevent urine an outpatient procedure that is leakage. used on patients who have incontinence due to stress such as sneezing or coughing,” Dr. Heimbecker says. “When Kegel exercises alone don’t work, this is a viable option for many women.”

Unlike other procedures, the MiniArc requires just one

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incision to surgically place a small narrow strip of mesh material— called a sling—under the urethra to give it more support and prevent accidental urine leakage. In Paul Heimbecker, M.D. women with stress urinary incontinence, pelvic muscles and tissue have been weakened by pregnancy, childbirth, trauma, prior surgery, radiation, muscle damage or hormonal changes. “The sudden added pressure from coughing, sneezing, laughing or simple lifting can cause accidental loss of urine,” Dr. Heimbecker says. (For women who have urge incontinence, an unstable bladder while sleeping or sitting still, a different procedure called sacral nerve stimulator may be an option. See page 7 for more information.)

“My recovery was very quick,” Connie says. “I was in surgery at CCH on Friday morning, and back at work on Monday. I was even able to get up and do things

around home the day after surgery.”

A year after surgery, Connie is well pleased with the results. “I’m so happy I had this. If I had realized it would be so quick and immediate, I would have done it much sooner. It was the best thing I’ve done for myself.”

Connie is back to her daily two- to three-mile jogwalks, and she’s now able to bike, swim and even sneeze with no problems. But best of all, during the Christmas Cantata at her church over the holidays, when Connie sang “O Holy Night” she was able to hit all the high notes with a confident smile. ■

To locate a physician in Lee County who performs the single-incision sling procedure for treating stress incontinence, please call Central Carolina Hospital’s physician referral line at 800-483-6385 or visit us online at www.centralcarolinahospital.com.

Turn the page for more information on incontinence . . .

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CLINICAL FOCUS

DON’T SUFFER in Silence

IF YOU’RE TROUBLED BY URINARY INCONTINENCE, SEEK TREATMENT

APPROXIMATELY 25 MILLION ADULTS in the United States experience loss of bladder or bowel control. About 10 percent of people over age 65 have this potentially embarrassing problem; and women are twice as likely as men to experience incontinence. According to the National Association for Continence, 80 percent of those affected by urinary incontinence can be cured or significantly helped.

Incontinence is a symptom, not a disease. On a temporary basis, it can be caused by infections, constipation or certain medications.

Persistent urinary incontinence may be caused by weakness of the bladder or the muscles supporting it, overactive bladder muscles or urinary tract blockage. Hiding incontinence can lead to rashes, sores, and skin or urinary tract infections. For many people, incontinence can seriously impair quality of life.

THERE ARE FOUR TYPES OF URINARY

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INCONTINENCE: • Stress incontinence happens when certain activities such as coughing, sneezing or laughing cause increased abdominal pressure on the bladder.

• Urge incontinence (“overactive bladder”) occurs when the need to urinate develops too quickly for the person to be able to get to the bathroom in time.

• Overflow incontinence involves small amounts of urine leaking from a bladder that never empties completely.

• Functional incontinence affects individuals who have normal bladder control, but cannot get to the bathroom quickly enough because of physical limitations that make it difficult for them to move.

It’s possible to have more than one type of urinary incontinence. Once the cause of urinary incontinence has been identified, the course of treatment may include behavioral techniques, physical therapy, medications, the use of medical devices and even surgery. ■

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A TREATMENT FOR OVERACTIVE BLADDER: the sacral nerve stimulator implant If you have been diagnosed with urge incontinence, urgency-frequency or non-obstructive urinary retention, and behavioral techniques and medications have been unsuccessful, you may be a candidate for a sacral nerve stimulator. With this procedure, a small pacemakerlike device is surgically placed under the skin, usually in the buttock. A thin, electrode-tipped wire is then passed under the skin to carry impulses to the sacral nerve.

Board-certified gynecologist Paul Heimbecker, M.D., explains, “The sacral nerves control the bladder and urinary function muscles.

If the brain and the sacral nerves don’t communicate correctly, leakage and bladder-control problems may occur. The InterStim device stimulates the nerves with mild electrical puls-

If the nerves on the pelvic floor (above) aren’t communicating properly with the brain, incontinence can result. When behavior modifications and medications don’t relieve the problem, doctors may suggest a sacral nerve stimulator (below). It can be worn externally for a trial period to see if surgical implantation is appropriate.

es to aid in communication back to the brain.”

Because this method isn’t appropriate for everyone with urge incontinence, patients can try out the device first by wearing the stimulator externally. Dr. Heimbecker says, “We do a trial assessment for 3 to 7 days to determine if this therapy is a viable option for a patient. If symptoms improve and the patient has more control over her bladder, we’ll discuss a longer commitment through a surgical implant.”

Appropriate for both women and men, the sacral nerve stimulator implant is performed by gynecologists and urologists in a hospital on an outpatient basis. Once implanted, the device can last for several years and can be removed at any time. To find a Central Carolina Hospital surgeon who can help you determine if the sacral nerve stimulator is right for you, please call our physician referral line at 800-483-6385.

C E N T R A L C A R O L I N A H O S P I TA L H E A LT H & L I F E

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WELLNESS

10 ways to beat headaches MEDICATIONS CAN HELP, BUT SO CAN KEY CHANGES IN YOUR ROUTINE

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IN THE MIDDLE AGES, THE ARAB SURGEON Ease muscle tension. Sometimes soreness and and medical writer Albucasis recommended one of two tension are caused by sitting in the same position for an treatments for severe headaches: applying a hot iron to extended period—even if you don’t feel particularly the site of the pain or inserting a piece of garlic into an uncomfortable. If you spend a large part of your day seated incision on the temple! Thankfully, today’s treatments at a computer, for example, schedule a five-minute break at are a lot easier to take—and a great deal more effective. least once every 40 minutes: Take a brief walk or give stiff A doctor may recommend a prescription medicamuscles a mini-workout by tensing and relaxing different tion to treat migraines, and a number of over-themuscle groups. And remember to maintain good posture. counter remedies are available to relieve occasional Avoid foods that trigger headaches. If headache pain. But if you’re having frequent headaches, you’ve noticed that indulging in a chocolate bar freyou should make an effort to find and address their quently leaves you with a pounding head, blame it on tyraunderlying cause. Try these suggestions: mine, an organic substance linked to Reduce stress. Do you headaches. If you think you may When to call the doctor tend to keep your anger botbe tyramine-sensitive, stay away “Not all headaches require medical attentled up? No wonder you’re feelfrom aged cheeses, vinegar, organ tion,” says the National Institute of ing stressed—and headachy. If meats, sour cream, soy sauce, Neurological Disorders and Stroke, “but some confronting the source of your yogurt and yeast extracts—they types of headaches are signals of more serious anger is out of the question, try also contain the substance. Two disorders.” Contact your physician, advises venting your feelings by writing a other nutritional culprits to avoid the NINDS, if you begin having frequent letter. Make it as vehement as are nitrites (preservatives found headaches that interfere with your routine, or you like. You won’t be mailing it; in smoked fish, bologna, pepperif a particular headache: the idea is to express your emooni, bacon, hot dogs, corned beef, • is sudden and severe tions. Exercise, massage, meditapastrami and canned ham and • is accompanied by confusion tion and biofeedback are other sausages), and monosodium glu• is accompanied by fever or eye or ear pain proven ways to manage stress. tamate, or MSG (a flavor

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POLKA DOT IMAGES; SHUTTERSTOCK

• follows a blow to the head

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FOR MORE INFORMATION ON HEADACHE RELIEF • AMERICAN HEADACHE SOCIETY COMMITTEE FOR HEADACHE EDUCATION

19 Mantua Road

havoc with blood-sugar levels, drienhancer included in dry-roasted Mt. Royal, NJ 08061 856-423-0043; www.achenet.org ving them down and causing blood nuts, potato chips, Chinese food, • NATIONAL HEADACHE FOUNDATION vessels to dilate or expand—a naturprocessed or frozen foods, prepared 820 N. Orleans, Suite 217 al setup for developing a headache. soups and sauces, diet foods, salad Chicago, IL 60610-3132 In fact, researchers have found that dressings and mayonnaise).

1-888-643-5552; www.headaches.org not eating for five hours or more can Drink plenty of water. It’s even trigger a migraine. the simplest strategy for keeping headaches at bay, Avoid overusing pain relievers. Ironically, since dehydration is a common culprit. To supply your too much reliance on pain relievers can cause more body with all the water it needs to function properly, distress than relief, triggering chronic headaches doctors drink several glasses of water a day. And if you’re exercall “analgesic-rebound” headaches. Several studies cising on a hot afternoon, traveling by air, fighting a bout have shown that giving up pain medication can help freof diarrhea or running a fever, you’d do well to boost quent headache sufferers get back on an even keel— your intake. although they may have to survive two weeks of daily Avoid alcohol. Alcohol inflicts a double whammy headaches first. when it comes to a pounding head: Besides causing Get a good night’s sleep. Too little—or too dehydration, many alcoholic beverages, particularly red much—sleep can trigger a common, everyday wine and brandy, contain tyramine. headache, or even bring on a migraine. That’s why bedTake a coffee break. Too much caffeine can time routines are not just for babies. Try establishing a give you a headache, but so can going without it if nighttime ritual by going to sleep and waking up at your body’s used to getting its daily ration. (That’s why about the same time each day. It’s not a bad idea to take some people get early-morning headaches before their a warm bath beforehand or drink a cup of herbal tea to first cup of coffee.) Try eliminating it from your diet, or help you unwind. cut back significantly, even if that means enduring withTake care of your eyes. Few activities are drawal headaches for a few days. Enjoy a cup of cocoa as relaxing as reading—unless you’re doing it in (less than half as much caffeine as brewed coffee) or, betsemidarkness or for hours on end. In that case, you’re ter yet, decaffeinated coffee. making yourself vulnerable to eyestrain, a leading cause Don’t go hungry. Letting more than five wakeof headache. Use common sense when it comes to lightful hours go by between meals or snacks can wreak ing conditions, take frequent breaks if you’re on a long drive or reading for an extended period, and if you wear Try keeping a headache diary glasses or contacts, get regular eye exams to make sure If your headaches become a chronic problem, it may help your prescription is up-to-date. ■

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to gather some information about them. For a couple of weeks, try keeping a written record, answering the questions below about each headache. Then show your report to your physician; it may offer clues to what’s triggering your pain—and how to stop it.

1. Did you eat anything shortly before the headache’s onset?

2. Did any symptoms precede the headache?

3. Where did the pain begin?

4. Did the pain come on slowly or suddenly?

5. Describe the pain. Is it throbbing?

6. Are you experiencing nausea or vomiting?

7. Were you under any special stress before the headache occurred?

8. At what time of day did the headache begin?

C E N T R A L C A R O L I N A H O S P I TA L H E A LT H & L I F E

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FOOD

HOW GREEN IS YOUR DIET? What’s eco-friendly can be good for you too.

Take our quiz to see how your choices fare.

1. What food source does the majority of your protein come from? a) red meat

b) prepared snacks with organic or natural ingredients c) a handful of nuts or seeds d) a cup of yogurt

b) poultry c) legumes, nuts, leafy greens and whole grains

2. How often do you eat cheese? a) every day

6. When you eat out, what do you do with the leftovers? a) I rarely take them home and when I do, I usually wind up throwing them out.

b) a couple of times a week

b) I split meals or order small portions in restaurants so I rarely have leftovers.

c) rarely

c) I always eat my leftovers the next day.

3. When you buy seafood, you look for: a) fresh and regional fish b) fresh, but I’m not sure where it’s from

7. How much of the food you buy at the grocery store is actually consumed?

c) fish that’s been processed and frozen at sea

a) I often end up throwing out produce and other perishable items.

d) I don’t eat seafood.

b) I occasionally throw things out.

4. What’s your starch of choice?

c) I’m really good about using all of the products I buy.

a) bread

8. Breakfast is usually:

b) pasta

a) cereal with milk

c) rice

b) yogurt and fruit

a) prepared snacks like pretzels, chips or popcorn

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c) scrambled eggs and toast

9. In the winter, which of these fruits do you

MASTERFILE

5. When you’re hungry for a snack, you usually reach for:

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buy most often? a) apples b) pineapples c) oranges and grapefruit d) fresh berries e) frozen berries

10. How often do you buy packaged, prepared foods? a) Often, but I look for “eco-friendly” boxes or companies that buy renewable energy credits. b) Often, but I don’t pay attention to packaging. c) I buy packaged foods occasionally, some in “green” packaging, some not. d) I try to avoid packaged food.

11. When you prepare food at home, you usually: a) consolidate items to be baked in the oven, when possible. b) bake items one at a time.

12. How often do you drive your car to pick up groceries, buy prepared food or go to a restaurant? a) Rarely: I bicycle commute or use public transportation. b) no more than once a week

d) 4 or more times a week

13) Which of the following types of sandwiches would you most commonly order at a restaurant (or make for yourself)? b) cheeseburger c) chicken d) grilled vegetable and hummus

Green machine! You’re doing a great job of maintaining a diet that’s good for you and for the planet.

Next task? Share your strategies with others.

19–29 POINTS: Eco-admirable. You’re making respectable choices, but a few tweaks could dramatically alter the impact your diet has on the environment. Believe it or not, you may hardly even notice the changes.

c) 2–3 times a week

a) grilled cheese

10–18 POINTS:

30–38 POINTS: Earth shattering. You need a green makeover, pronto! Read on to find out how your diet is affecting our planet—and tips for making it more environmentally friendly.

For a more customized assessment of your diet’s global warming effect (and suggestions for change), check out the online calculator at www.eatlowcarbon.org.

SCORING: 1) a = 3 points; b = 2 points; c = 1 point

LEIGH BEISCH

2) a = 3; b = 2; c = 1 3) a = 1; b = 3; c = 2; d = 0 4) a = 1; b = 2; c = 3

5) a = 3; b = 3; c = 1; d = 2

10) a = 2; b = 2; c = 1; d = 0

6) a = 3; b = 1; c = 1

11) a = 1; b = 2

7) a = 3; b = 2; c = 1

12) a = 0; b = 1; c = 2; d = 3

8) a = 3; b = 1; c = 2

13) a = 3; b = 4; c = 1; d = 1

9) a = 1; b = 3; c = 2; d = 3; e = 1 C E N T R A L C A R O L I N A H O S P I TA L H E A LT H & L I F E

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FITNESS

Your aging ‘boomer’ body TIPS FOR KEEPING IT IN TIP-TOP SHAPE WHILE YOU STAY ACTIVE

“WILL YOU STILL NEED ME,” THE BEATLES sang decades ago, “when I’m 64?”

starting to catch up with them.

The

American

Academy

of

Orthopaedic

The 78 million Americans born from 1946 to

Surgeons (AAOS) has noted a significant increase in the

1964—the baby boomers—will start finding out the

number of overuse injuries in the baby boomer genera-

answer to that question in January, when the first of them reach that age milestone. That generation has ture, but they haven’t rewritten the rules of biology: Time and age are 12

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With a few smart precautions, you can lower your risk of injury.

coined a new term—“boomeritis”— to describe the growing number of sports injuries in this demographic.

These injuries range from tendonitis to bursitis and arthritis. The suffix

GETTY IMAGES

changed the face of American cul-

tion. In fact, the AAOS has actually

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“-itis” refers to inflammation.

Baby boomers are staying more active and are racking up more injuries along the way. In 1998, they accounted for more than 1 million sports injuries. From 1991 to 1998, baby boomers experienced a 33 percent increase in sports injuries, which resulted in more than 365,000 hospital emergency room visits.

PREVENTING INJURIES Doctors and physical therapists say that staying active doesn’t have to mean getting hurt more. “Most injuries are related to overuse,” says Kim Widrick, director of rehab services at Central Carolina Hospital. “You need to learn to listen to your body and learn about ways to prevent injuries.”

Here are some pointers for staying active and injury-free with an aging body: • Get checked out. If you haven’t been physically active, consult with your doctor before starting a new exercise routine.

• Stretch! Include stretching in your exercise routine

Kim Widrick, director of rehab services at Central Carolina Hospital, tells baby boomers: “Listen to your body.”

to maintain joint flexibility. Once your muscles have warmed up, do some gentle stretching exercises.

• Mix it up. Your exercise routine should include a combination of cardiovascular exercise, strength training and flexibility exercises.

• Listen to your pain. Exercise doesn’t have to hurt.

You may experience muscle soreness, but true pain is telling you something. Talk to your doctor, physical therapist or trainer if you are experiencing pain with exercise.

• Don’t try to add too much at one time. Work up towards your goal. If you want to be able to work out for 60 minutes a day and haven’t been physically active, start with a smaller objective, such as 20 minutes a day for a week, and then add 10 percent more the next week and so on until you reach your goal.

strength-training program, start light. Go for lighter weights and gradually increase as the routine becomes easy. Remember the “10 percent” rule for adding weights —don’t add more than about 10 percent each time. If you’ve been using a 2-pound free weight, don’t step up to a 10-pound weight the next week!

One study of wheelchair-bound nursing home residents who were in their 80s and 90s found that lifting light weights helped improve their strength and overall fitness level. “It’s never too late to start an exercise program that can help you age in a more healthy manner,” says Widrick. “So lace up your walking shoes and start moving toward your fitness goals.” ■

• Invest in the right equipment. Wear a helmet for bicycling and buy good walking or running shoes that fit you properly.

• Add variety to your routine. Walking on a treadmill day after day can get boring. Take your walk outside or go for a bike ride. Take up dancing or join a gym class.

To schedule an appointment for physical therapy, call Central Carolina Hospital’s Rehab Services Department at 919-774-2255. If you need a referral to an orthopedic surgeon, please call our free physician referral number at 800-483-6385.

• Don’t overdo the weights. When starting a C E N T R A L C A R O L I N A H O S P I TA L H E A LT H & L I F E

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H E A LT H Y K I D S

NEWS YOU CAN USE TO HELP YOUR CHILD GET THE BEST CARE

B E S U R E T H AT T V I S S A F E LY I N S TA L L E D

Family harmony is good for asthma Scientists knew that family tensions can aggravate kids’ asthma. Now, thanks to a Canadian study, they know one reason why. It seems emotional stress called beta-2-adrenergic receptors that regulate airway response and inflammation. This finding followed a study of asthmatic children ages 9 to 18, which showed that those with more stress in their lives from things like abrasive family relationships produced less of this beneficial protein. Says Maurice Elias, M.D., of Saint Clare’s Hospital in Denville, N.J.: “The finding seems reasonable, because an asthmatic patient under chronic stress tends to be less responsive to treatment.”

Fish oil may ease depression in kids A small Israeli study hints that supplements containing omega-3 fatty acids of the type found in fish oils might ease depression in children. When 20 children were tracked for 16 weeks, scores on a standard depression test improved for seven of the 10 kids getting omega-3, but for none of the children in a placebo group.

Making life better for children who stutter When a child stutters, can psychological help ease the problem?

Stuttering’s cause is unknown, but it appears to stem from an interlocking of genes and environment. Now a study links the phenomenon to emotional volubility. Comparing 65 preschool stutterers with 56 nonstutterers of similar age, the study found that kids who stuttered showed more emotional “reactivity”—that is, tendency to react emotionally in both positive and negative ways—than their peers. Study authors believe their findings show that helping kids regulate their emotions “is something we should look at.”

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inhibits the body’s production of certain proteins

Television can be hazardous to kids, says the Consumer Product Safety Commission—and it’s not talking about violent program content. Each year in the U.S., the agency estimates, some 2,300 children are injured by falling television sets. With today’s “home theater” TVs getting bigger, there’s an increasing danger, say researchers writing in the journal Academic Emergency Medicine. They looked closely at the experience of 26 children ages 1 to 7 who visited an ER from November 2003 to October 2004 for TV-related injuries. Their conclusion: Families need to make a better effort to secure their television sets firmly and safely—in a stable display area with a balanced distribution of weight— and manufacturers need to make installation of their sets more mistake-proof.

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