Prevent Foodborne Illness

072514_foodborne4Picnics, grilling, camping — summer was made for dining outdoors. But outdoor cooking experiences can also present unique challenges for food safety. Don’t let foodborne illness ruin your summer fun. Follow these safety tips to ensure your summer cookouts go off without a hitch.

Wash your hands and all cooking surfaces and utensils. If you are going to be camping somewhere without safe water, bring your own water and soap. Do not assume fresh water from lakes or streams is safe just because it looks clear — always disinfect water first by bringing to a rolling boil for one minute (longer if camping at high altitudes). You can also use disposable wipes for washing hands and quick cleanup.

072514_foodborne2Keep perishable food cold. Pack meats and other frozen products directly into a cooler without thawing first to keep them cold longer for picnics and camping trips. Try to pack food that will be cooked later toward the bottom of the cooler. Use a separate cooler for beverages that will be opened more often. Pack coolers as full as possible to help keep items cold, and fill extra space with large blocks of ice or frozen gel packs. Keep coolers out of the sun and covered with a blanket or tarp if possible.

Marinate the right way. To ensure your food is safe, marinate only in a refrigerated environment. Poultry and cubed meat can be marinated for up to two days. Beef, pork, steaks and lamb can be marinated for up to five days. If you plan on using the marinade in cooked food, keep a portion separate from the raw meat to use later. If you do serve marinade you’ve used to marinate the raw meat, it should be boiled first to destroy bacteria.

If you do suspect food poisoning, don’t hesitate to to go to your nearest Rex Express Care for treatment.


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Make a Splash with Water-Based Exercise

072514_swimming1If you find that activities like running or biking put too much strain on your body, or if you’re ready for a change in routine, water-based exercise may be the answer you’re looking for. From water aerobics to hydrotherapy, aquatic activities have many positive health benefits for individuals of all ages and abilities.

As a low-impact physical activity, water-based exercise allows you to reap the aerobic benefits of high-impact physical exercise without the wear and tear on your body that traditional aerobic exercises may cause. Water-based physical therapy (hydrotherapy) can help individuals with chronic diseases, such as rheumatoid arthritis or osteoarthritis, improve the use of affected joints without aggravating symptoms.

072514_swimming3Individuals dealing with chronic pain conditions, such as fibromyalgia, may find that exercising in water relieves their anxiety about being active and may even relieve pain by increasing blood flow to the muscles. If you don’t suffer from chronic disease, but still cope with joint or muscle pain, you may also see health improvements when changing from a land-based to a water-based exercise program.

Water aerobics and other water activities can also be beneficial to your mental health. Swimming can improve your mood by reducing stress and aiding relaxation. Exercising in warm water may also help relieve symptoms of depression in people with fibromyalgia.

Make it a family affair

072514_swimming2Besides being beneficial to your physical and mental health, recreational water activities are fun for the entire family and can help you forge stronger family connections. From going to the beach to playing on the water slide at your community pool, there are a variety of ways to enjoy the water with your family. Just be sure to follow safety rules and keep a sharp eye on small children and non-swimmers.

Take the plunge

Whether you’re looking for a low-impact exercise, an easy way to relax or a fun activity that can be enjoyed by the entire family, jumping in the water may be just what you need.

Float the idea by your doctor

Talk to your doctor to determine if aquatic exercises or hydrotherapy may benefit you. All five of our Wellness Centers have indoor swimming pools available for members, and all wellness centers offer a variety of aqua group exercises classes. Check them out today!

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The Benefits of My UNC Chart

072514_amyaustellbioPost by Amy Austell, UNC Health Care patient and co-worker.

I have a drawer in my office that is full of medical records.  After visit summaries, test results…some from my doctor at UNC, others from specialists at Rex and still more from my PCP in Chapel Hill.  But you know what?  It’s a mess. And when I am at an appointment and my specialist at Rex asks about a test result or procedure that my PCP had ordered, that drawer in my office is no help at all.

Three months ago, I signed up for My UNC Chart and, boom, all the information swimming around in my drawer at home was now organized in one place.  If you aren’t familiar with My UNC Chart, it’s a secure online health care patient portal that is connected to UNC Health Care’s Epic@UNC medical record system.

072514_unc2If you are a patient a Rex, UNC Medical Center or UNC Physician’s group, you can quickly and easily sign up for My UNC Chart.  Then the Epic@UNC system populates your account with all the UNC Health Care medical records electronically on file for you: medical history, prescriptions and test results.  It also tracks current and past appointments, and allows you to message your doctor.  There’s even an app for your smartphone or iPad.

The first week I had my account, I received an email that said I had a message waiting for me in My UNC Chart.  I opened the My UNC Chart app on my iPad and saw a message from my doctor’s office asking me to fill out paperwork for my visit the following week.  I clicked on the link provided, and within 10 minutes answered all the medical history and pre-visit questions.

At work, I can receive a discount on my health care premium if I complete certain health behaviors and challenges.  One option is to have your doctor check your weight, blood pressure, cholesterol, etc., but in order to get the credit, the information has to be submitted in a format that proves it came from your doctor’s office.  Not a problem with My UNC Chart.  I just went to the site, opened up my test results and printed them.  The printout was formatted with the practice information and all the data I needed.

I recently had a question about a prescription.  Through My UNC Chart, I sent a message to my doctor asking my question, and I had my answer within two hours.  It saved me multiple phone calls and possibly a visit.  Just yesterday, I paid a doctor’s bill through the My UNC Chart app.  A couple of clicks and it was paid.

Simple, easy and organized.  That’s what I love about My UNC Chart.  Last month, I changed my medical home to a UNC Health Care practice because having all my records in My UNC Chart is that important to me.  What used to be hundreds of meaningless papers in a drawer is now an organized story of my health.

This weekend, I am cleaning out my medical record drawer.  I won’t miss it at all.



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Training for the 2014 Rex Sprint Triathlon in Garner

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_tri3It 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.

708014_tri2One 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.

708014_tri4So 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.

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

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Appetite Awareness

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.

063014_hunger2Learning 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.

063014_hunger3With 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

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?

062414_bugtbite1Some 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.

062414_bugtbite3Other 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.

062414_bugtbite2Application 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

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

Number of servings: 12


  • 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)


  1. Preheat oven to 375° F.
  2. To make the crust: Cream margarine, sugar, vanilla and egg until light and fluffy.
  3. Add flour and baking powder, mixing well.
  4. Spread mixture about 1/8-inch thick on a pizza pan, baking sheet, or 9-inch by 13-inch pan.
  5. Bake for 10 to 12 minutes or until lightly browned. Cool.
  6. Mix together cream cheese and sugar. Spread on cooled cookie crust.
  7. 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.

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Preventing Cardiac Arrest in Marathon Runners

060614_running1Post 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.

060614_running2The 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.’

060614_running3Look 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

052814_grill2When 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.

052814_grill4Marinades 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.

052814_grill3Scrub 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.

052814_grill1When 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!

052714_meridethprofilePost 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_sunscreen1As 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:

  • 052714_sunscreen2The 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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