Rex Connects

Training for the 2014 Rex Sprint Triathlon in Garner

by Rodney Jenkins on July 8, 2014

Post by Rodney Jenkins, a Group Exercise Instructor at the Rex Wellness Center of Garner. He is also a business teacher, a soccer coach and an athletic trainer with the Wake County Public School system.

708014_tri3 It is hard to believe, but the Rex Sprint Triathlon in Garner is just a few days away! This year I was given the privilege of preparing Kristey Evans and Keshia Best to participate in their first sprint triathlon.

Kristey has a full time job and children but thanks to a supportive husband (thanks Jason), has made time for training. Keshia works late hours so our meetings have for the most part been by cell phone and e-mail. Proof positive that carving out time to train can be done in spite of work and family obligations! Last year’s winner, Theresa Pearce, easily met her goal to complete the inaugural Rex Sprint Triathlon and continues to compete. I have no doubt that Kristey and Keshia will also be successful.

One of the best things about Rex Wellness of Garner is that we have a very active group of triathletes. As was the case last year, I recruited a number of Rex Triathletes to work with our trainees and all agreed to return, including Theresa who has excelled from trainee to trainer. Theresa and Shannon Thomsen, a seasoned cyclist, have spent valuable time getting Kristey comfortable with cycling in vehicular traffic which is always a challenge for both experienced and novice cyclist.

For people training for their first triathlon, It has been my experience that concerns vary from one triathlete to another. If you come from a swimming background, your greatest concern might be with the cycling or run. If you come from a running background, you may be worried about the cycling and swimming. Regardless of your background, there is always a concern about endurance.

So how do we overcome these challenges? We train. As a triathlete, you are not simply training to swim 250 yards, ride a bike 10 miles or run 2 miles. You are training to ride a bike 10 miles after swimming 250 yards and training to run 2 miles after swimming and cycling.

Thus, we must brick train. Brick training is a training session in which you train on two disciplines during the same workout, one after the other with minimal to no interruption. Kristey and Keshia have been brick training for several weeks. On July 6, one week before the triathlon, we held a mock triathlon. Keshia could not attend but Kristey was able to participate. My wife Angie, Theresa, Keith Manning, Charlie and Carrie Frey all seasoned triathletes swam, cycled and ran the entire course with Kristey. She did great and in the minds of all of her trainers, she is ready.

On July 13, we will all be at Rex Wellness Center in Garner to cheer Kristey and Keshia on and I can’t wait!

From L to R: Charlie, Theresa, Carrie, Rodney, Kristey, Angie, and Keith.

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Appetite Awareness

by Diane Danchi on June 30, 2014

Post by Diane Danchi, R.D., L.D.N. Diane is a Registered Dietitian at Rex Wellness Center of Cary and Rex Wellness Center of Knightdale.

Summer is here and many are faced with a desire to lose some weight for summer styles. For so many people, this is a common life theme and success this time may not mean a permanent change in weight. The common approach is to start skipping meals or restricting and depriving of specific foods. Sometimes this restriction and deprivation feels empowering, but it often leads to some kind of rebound eating or a full blown binge. Some may believe that they cannot lose weight unless they are totally miserable, which in turn is not sustainable.

Learning how to key into your body’s true hunger and satiety is a balanced and effective approach which is helpful in weight management. We are trained from the time we are small children to ignore hunger and satiety signals, “eating for the kids in China,” being members of the “clean plate” club, being taught to never “waste” food regardless of the impact it has on our own “waist!” A new perspective on hunger and satiety could revamp your relationship with food and get your weight moving down

There is great beauty and pleasure in eating when we are truly hungry. It means we have burned off all the fuel from the previous meal, our palate / taste buds are rejuvenated and ready to enjoy food, and it is the time food will taste best, giving us the most pleasure for the calories spent. This is the purpose of the Hunger Scale, a tool to call us back to eating when hungry and stopping when satisfied (never “full” or uncomfortable). Eat at “3” when your stomach is growling; stop at “7” when satisfied.

With the Hunger Scale as a guide, train yourself to eat regular meals and snacks at regular times. A meal should last at least 20 minutes (so your appetite control center has time to get the “we have fuel” message). If you eat faster, you will still be hungry after you eat the right amount of food and head for seconds. At the end of the meal you should be satisfied and always COMFORTABLE. Never eat to discomfort. That meal should get you 4-5 hours, then you are hungry for the next meal or snack.

With the availability of food in our culture, we are constantly exposed to challenging food cues. Recognizing these cues and effective ways to deal with them can help greatly with weight management. Most of the time we should eat when hungry and stop when satisfied. If you see an advertisement, smell something cooking, are offered something with pressure, are with other people, get stressed, bored, angry or feel lonely, you might want to eat even though you aren’t hungry at all. “Is my stomach growling?” is the question to ask before grabbing that fork. If you are not hungry, learn to skip the eating event and wait until true hunger presents. Plan ahead to focus on something else like taking a walk, striking up a conversation with someone, playing an instrument, cleaning a closet, calling a friend, or planning your next vacation!

Experienced dieters will often create a list of foods to avoid when “dieting.” This eventually results in feelings of deprivation with a rebound binge-eating event, accompanied by guilt and frustration. Rather than restrict food, listen to your body. If the craving is strong, honor it in the smallest portion you can without guilt, then move on. This is a life strategy and is sustainable.

A couple more tools to help management appetite are fiber and water from whole grains, fruits, veggies. They both fill you up with no calories, and a high fiber meal takes longer to digest. Dehydration can make you think you are hungry when what you really need is fluid, so intentionally hydrating wards off “fuzzy hunger.”

There are lots of ways to honor yourself and manage weight through understanding your appetite, so use it to your advantage and don’t let your appetite be the saboteur of your health and weight management.

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Keep Bugs at Bay

by Rex Healthcare on June 24, 2014

If the warm temperatures and sunshine beckon you outdoors this summer, don’t let biting bugs drive you back inside. Wearing insect repellent is one way to help protect you and your loved ones from the bite of pesky — and sometimes dangerous — bugs.

Why repellent?

Some mosquitoes and ticks transmit viruses or bacteria that may cause diseases like Lyme disease, West Nile virus and St. Louis encephalitis when they bite you. In addition to wearing long sleeves and long pants and avoiding bug-friendly habitats like tall grass and standing water, applying insect repellent to skin can keep bugs from landing on you. To choose the best repellent for you, consider the insects you’ll be exposed to, the length of protection you need and the active ingredient. The higher the concentration of the active ingredient, the longer the protection.

Active ingredients

The most common and effective active ingredient is DEET. An EPA data review in 1998 confirmed that when users follow product label instructions, DEET poses no health concerns to humans. Many products promise protection of about two and a half hours, depending on concentration. Experts suggest that a concentration higher than 30 percent offers no additional protection.

Other EPA-approved active ingredients include picaridin and several plant-based oils. Picaridin may be as effective as DEET according to recent studies, but there is no data showing long-term safety results. Further research is needed to understand how well the active ingredient repels ticks, as well. Plant-based insect repellents are made from the essential oils of citronella, cedar, eucalyptus and soybeans, with oil of lemon eucalyptus being the most effective. These products may offer protection for up to two hours. There are also citronella-scented candles that you can put outside of your home to make sitting outdoors more enjoyable.

Application safety

Always read the product label and follow the directions.
Use just enough to cover exposed skin. Do not apply under clothing.
Avoid applying on or near eyes, mouth, ears and open sores.
Do not spray directly to face or in an enclosed area.
Wash skin and clothing with soap and water once you return indoors.

If you do get a bug bite that needs to be treated, Rex Express Care Centers are the perfect place to go. Check out our list of locations to find the nearest Rex Express Care to your home.

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Recipe: Fruit Pizza

by Rex Healthcare on June 24, 2014

Are you a pizza lover? Add more fresh fruit to your day with this fruit-inspired dessert pizza.

Number of servings: 12

Ingredients

½ cup margarine
½ cup sugar
1 teaspoon vanilla extract
1 egg (large)
1 teaspoon vanilla extract
2 cups flour
2 teaspoons baking powder
8 ounces cream cheese, nonfat or light
½ cup sugar
1 cup strawberries, sliced (or kiwi, bananas, pears, peaches or blueberries)

Directions

Preheat oven to 375° F.
To make the crust: Cream margarine, sugar, vanilla and egg until light and fluffy.
Add flour and baking powder, mixing well.
Spread mixture about 1/8-inch thick on a pizza pan, baking sheet, or 9-inch by 13-inch pan.
Bake for 10 to 12 minutes or until lightly browned. Cool.
Mix together cream cheese and sugar. Spread on cooled cookie crust.
Arrange fruit on top of pizza. Refrigerate until serving time.

Serves 12. Per serving: 240 calories, 8 g fat, 15 mg cholesterol, 310 mg sodium, 36 g total carbohydrate, 1 g fiber, 19 g sugar, 6 g protein, 8 percent vitamin A, 15 percent vitamin C, 10 percent calcium, 6 percent iron.

recipefinder.nal.usda.gov

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Preventing Cardiac Arrest in Marathon Runners

by Deepak Pasi, M.D. on June 16, 2014

Post by Deepak Pasi, M.D., F.A.C.C., NC Heart & Vascular.

Cardiac arrest in marathon runners is a very uncommon event. However, occurrences at recent race events have heightened the awareness of this dramatic and unexpected tragedy.

The chance of suffering cardiac arrest during marathons is about 1 in 184,000, and the likelihood of dying from the arrest is about 1 in 259,000. Men are more likely to be a victim than women. The good news is that the chance of surviving the arrest is higher than in the usual out-of-the-hospital cardiac arrest. The reason for the arrest is dependent on age. If one suffers cardiac arrest before the age of 35, usually it is related to a congenital defect (from birth) and hereditary diseases. After the age of 35, it is usually related to early coronary artery disease.

There are numerous congenital heart diseases that can cause cardiac arrest. Here are a few:

Hypertrophic Cardiomyopathy in which the muscular wall or septum between the two ventricles abnormally thickens.
Anomalous Coronary Anatomy in which one of the heart arteries originates from a different location.
Arrhythmogenic Right Ventricular Dysplasia (ARVD) in which the wall of the ventricle is replaced by fatty tissue.
Long QT syndrome: Prolongation of the QT interval on the EKG.

The only way to prevent the cardiac arrest from happening is to detect the abnormality before the event happens. The athlete should heed the symptoms and body warnings and seek medical attention promptly. It is wrong to be under the impression that because one is an athlete then he or she is invincible or saying that ‘I have a good diet and exercise a lot, so I cannot have a heart problem.’

Look for the following:

chest pain, burning, ache or discomfort
palpitations
shortness of breath
dizziness
family history of heart problem or sudden death

One should see a physician should you have any of the above symptoms or if you have any unexplained symptoms or concerns. It is also important to participate in this activity only after adequate training. You should make sure you are well hydrated before and after the marathon. You should never push for completion of the marathon if you are having any of the above symptoms.

There is much controversy on how to prevent the incidence of cardiac arrest for marathon runners. One school of thought is that the marathon runner or athlete should undergo a complete evaluation by a physician which may include an electrocardiogram (EKG), echocardiogram (echo) and/or stress testing. Opponents of that thought suggest that it would be very expensive and we do not have the money or the resources. Most would agree to seek medical attention for above symptoms, as well as encourage athlete and physician education.

In the end, there are many preventable causes of cardiac arrest in athletes. The marathon runner should listen to his or her body and report any unusual symptoms instead of ignoring the body’s warnings. If you have any of the above mentioned symptoms or have risk factors, you should seek medical attention before starting or continuing the sport.

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Get Fired Up about Safe Grilling

by Rex Healthcare on May 28, 2014

When summer winds come blowing in, you can bet the aroma of grilling will be in the air. According to the Hearth, Patio & Barbecue Association, three out of four households own grills. Ensure your backyard barbecues are safe for your family and friends by sparking your knowledge about food and grill safety.

Make sure frozen meat, poultry or seafood is thawed before grilling so that it cooks evenly. The refrigerator works best for slow, safe defrosting. You may also place sealed packages of frozen meat in cold water to thaw. Never defrost meat at room temperature, as this can promote bacteria growth and foodborne illness.

Marinades can boost the flavor of meat and help keep it moist. You can marinate meat for several hours or a day or two in the refrigerator. As with defrosting, the kitchen counter is no place to marinate meat. If you plan to use a portion of the marinade for cooked food, make sure to boil the marinade for at least three minutes to kill any bacteria.

Marinade bonus: Not only can marinades enhance flavor, they may provide health benefits. Marinating meats before grilling may reduce cancer-causing substances that occur when meat is charred over high heat. In addition, some marinades contain antioxidants and vitamins that may offer protection against heart disease and cell and tissue damage.

Scrub the grilling surface with a wire grill brush to remove any charred food. Have plenty of clean grilling utensils and platters on hand, and prevent the spread of harmful bacteria by using different platters and utensils for raw meat and cooked meat. Thoroughly wash your hands with warm, soapy water after handling raw meat.

Instruct children to stay away from the grill, and keep pets away from the grilling area. Set up your barbecuing station in a well-ventilated area and only use approved fire starters with a charcoal grill. Let the starter fluid burn off before putting food on the grill, and keep a squirt bottle of water nearby to douse any flare-ups. When heating up the grill and flipping food, wear flameproof mitts and use cooking utensils with long handles.

Heat meat to a safe internal temperature to kill bacteria. Use a food thermometer and place it in the deepest part of the meat to determine if it’s done (see chart). Turn meat at least once during the cooking process, and make sure it is no longer pink inside.

When food has reached a safe temperature, remove the meat with clean tongs and place it on a clean platter. Serve food as soon as possible after cooking. In hot weather, food should never sit out for more than one hour. Immediately refrigerate any leftovers in shallow containers.

Now you’re ready to make grilling season a breeze! By following these health and safety tips, you’ll know your grill has the sweet smell of success.

Ready to Serve?

Food Cook to at Least…

Whole poultry and thighs 180°F

Poultry breasts 170°F

Ground poultry 165°F

Pork (all cuts), ground beef hamburgers 160°F

Beef, veal, lamb steaks, roasts and chops, fish and seafood 145°F

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The Sun’s Out: Seek Protection and Be Sun Smart!

by Rex Healthcare on May 27, 2014

Post by Meredith Brown, Rex Wellness Centers intern for the Summer of 2014. Meredith is a senior at East Carolina University majoring in Public Health with a concentration in Community Health.

The summer is just around the corner and for most of us that means weekend trips to the beach, hanging by the pool, evening walks, and grilling out with family and friends. While the summer brings fun in the sun it can also bring some not so fun times – SUNBURN.

052714_sunscreen1 As a child, my mom would apply the sunscreen every hour. I was taken care of and had no need to worry. As I reached my teenage years, sitting by the pool or beach getting bronzed became fun and something I loved about summer months. In high school, I went on a beach trip with friends. At this age, I rarely bothered with using sunscreen because I only wanted darker skin and I thought sunscreen was blocking the sun from me altogether-I was very wrong! Needless to say, I got burned. Severely burned! Sitting out in the sun for 7 hours with no protection in my cute bikini was not the best idea.

I still love being in the sun as it gives me time to relax and read – two things I rarely have time for these days! Although now, I have learned from many severe sunburns that not using sunscreen all can be very damaging to my skin and my future.

Here are some helpful tips for beach trips, pool days, and days out in the sun during the summertime:

The experts say that using the ridiculously high SPF sunscreens are useless. Instead, go for a SPF between 15 and 60.
Remember to reapply every 2-3 hours. Many sunscreens rub off and fade away after periods of time so continue to reapply throughout the day, especially when jumping in and out of water.
Pay attention to the ingredients in your sunscreen products.
Always protect your face. Apply sunscreen and pack a hat or umbrella to seek coverage when you need an escape from the sun.
Each sunburn can double your chance of skin cancers, especially sunburns in your youth.

Always remember to be responsible when enjoying the sun this summer. Use sunscreen and have fun!

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The Latest on Nutrition and Heart Disease

by Diane Danchi on May 13, 2014

Post by Diane Danchi, R.D., L.D.N. Diane is a Registered Dietitian at Rex Wellness Center of Cary and Rex Wellness Center of Knightdale.

Keeping your ears to the nutrition news wire is a good thing these days, as research is turning up some new information that will hopefully be a great addition to what we already know about nutrition and heart disease.

We have known for years that a high intake of red meat was connected to heart disease. Avoiding the high amounts of saturated fat and cholesterol, both abundant in red meat, has been a cornerstone of heart-healthy eating for decades. We know now, however, that it isn’t just the saturated fat and cholesterol in red meat that leads to blocked arteries. There is another player in red meat that is connected to heart disease, and Cleveland Clinic has discovered it.

In the spring of 2013, the journal of Nature Medicine published a study about carnitine done by Cleveland Clinic. They found that certain bacteria in the gut of both mice and humans metabolize carnitine into a substance called TMAO that promotes atherosclerosis, or thickening of the arteries. This culprit, carnitine, is abundant in red meat (beef, pork, veal and lamb), is sold as a dietary supplement, and is in found in some energy drinks.

Most interestingly, the study found that the gut of a vegan loses the ability to make the TMAO. The reported ended by saying that we don’t know how long it takes for the gut to stop making TMAO. They suspect it is longer than a week and less than a year. So, we do not yet know the bottom line on frequency of red meat, but the Mediterranean Diet gives us a good guideline for now. The Mediterranean Pyramid limits red meat to 2-3 times a month. Using fish, boneless skinless poultry and beans for protein are good choices, along with low-fat dairy like Greek yogurt, cottage cheese and string cheese.

Another player in heart disease that just hit the news wire is ADDED SUGARS. Studies have revealed that sugar raises blood cholesterol levels like saturated and trans fat do. People who had 25% of their calories from sugar had double the risk of developing heart disease, and one regular soda per day may increase risk by as much as 30%, independent of other risk factors. The average American diet contains enough added sugar to increase the risk of heart-related death by nearly 20 percent, the researchers said. The current recommendation for added sugars is no more than 9 teaspoons for men and no more than 6 teaspoons for women.

So, for that heart healthy diet, add these powerful tools of limited red meat and avoiding added sugars. As research continues, hopefully the years will bring us more detailed information about red meat and added sugars as well other new and effective tools for heart-healthy living.

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Rex Encourages the Breastfeeding Journey

by Rex Healthcare on May 9, 2014

Jennifer Majors, IBCLC, RN, is a Lactation Consultant at Rex Healthcare. Prior to being an IBCLC, she was a Pediatric RN. Jennifer and her husband have three boys.

Breastfeeding is a hot topic these days, from the rise of milk banks to Gieselle Bundchen’s instagram photo that shows that supermodels can breastfeed too. There was also a recent report that announced that only 16.4% of U.S. mothers exclusively breastfeed for at least 6 months.

At Rex, our most important goal is that your baby is getting the nutrition he or she needs. We want to support EVERY Mom (and dad) and their feeding goals no matter what they are- as long as the baby is getting fed!

With that being said, we do encourage breastfeeding as much as possible. Here are some things we at Rex do to help moms reach their breastfeeding goals:

Automatic visit from an IBCLC (International Board Certified Lactation Consultant) for all first time moms, moms with multiples, and moms with late preterm or small for gestational age newborns. Any routine experienced mom can easily request a consult with an IBCLC.
The staff nurses go through yearly training and check-offs on basic breastfeeding skills that are relevant to their working area
There are numerous IBCLC’s staffed during the day, and Rex even offers night shift IBCLC’s every night of the week!
Rex is working on protocols to help specific groups of babies based on gestational age
We have developed a protocol for supplementation if it happens to be needed and will speak with the parents at length regarding any need for supplementation
We absolutely do not give out goodie bags stuffed with formula
We try to encourage rooming in with the baby for better reading of baby’s hunger cues
If you are having difficulty once you go home, call Rex Lactation at 919-784-3224, for any questions/concerns, or to schedule an outpatient visit with one of our IBCLCs
We can give you info on additional services as well that can improve the breastfeeding relationship. We have a list of support groups such as Le Leche League, and Nursing Mothers of Raleigh. We also have lists of private practice IBCLC’s in the area that can come to your home and spend a lot of focused one on one time with and mom/baby.
We have an office down on the first floor that handles pump rentals and sales. It also carries nursing bras and other breastfeeding necessities and gizmos. They are open 9-12 Monday-Friday.

The bottom line is that Rex is happy to support all moms who feed their babies! We hope our new moms and dads will use our resources to help them as much as possible on their new journey.

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Rex turns 120: Co-Worker Ginny Martin Reflects

by Rex Healthcare on May 1, 2014

Post by Ginny Martin, Application Coordinator and Project Analyst at Rex Healthcare. In honor of Rex’s 120 Anniversary on May 1, Ginny reflects on her 34-year career at Rex.

Rex Hospital at it’s ‘new’ location at Lake Boone Trail, 1981

I was born at Rex in the St. Mary’s street hospital, and I started working at Rex in 1979. My records would show that I have been with Rex since 1980- my first son was born before I had been an employee for a year, and I was re-hired after a 4-week maternity leave.

I was back at Rex by September 1980 when we moved from the St. Mary’s street location to the ‘new’ hospital on Lake Boone Trail. I remember that when we moved here, everyone was amazed how big it was- we thought there was no way we would use all the space!

All of my children, and now both of my grandchildren, were also born at Rex. Over my 30+ year career here, I have loved my family and friends at Rex so much that I wanted my youngest son Jason to be a part of Rex family as well. Jason joined Rex a few years ago as a Project Coordinator- my former title- and it is such a joy to share this experience with him.

Another blessing I’ve had in my long career at Rex is that I’ve been able to watch so many of my friends grow their careers here. Not only am I blessed with my family, but I am blessed with an extended family here at Rex. I’ve watched friends date, get married, have kids, and then become grandparents!

Rexie with friends at the Wakefield Open House, 2009

Rex has always encouraged me to fulfill my dreams and offered me the opportunity to make them come true. I’ve worked in the same department my entire career. I’ve never even transferred to another position within my department. I’ve been blessed that my job evolved like it has. I started out using a number 2 pencil, abstracting general demographics and ICD codes in block formation for statistics to building a second EMR, and now I am working on the EPIC implementation. Talk about a technology jump!

Six years ago I was given the opportunity to be Rexie, and it has enabled me to meet other mascots and share my love for Rex. Working with kids as a mascot is one of the most amazing and rewarding experiences that a person could ever imagine. I will tell you that everyone that meets Rexie is convinced that it is a guy in the suit. I’m constantly getting chest bumps which is an experience all by itself! My husband has also been a major part of the Rex experience. He has been by my side for every event that I’ve done as Rexie.

From 1979 to 2014, a lot has changed at Rex, but the caring and compassion of its co-workers has remained steadfast. It is an honor to work for an organization that takes care of its community as well as we do. Happy anniversary, Rex!