Author Archives: Rex Healthcare

Recipe: Sunshine Salad

Brighten up your day with a salad that’s colorful and sweet—and good for you!

Ingredients

  • 032714_sunshinesalad5 cups spinach leaves, packed, washed and dried well
  • ½ red onion, sliced thin
  • ½ red pepper, sliced
  • 1 whole cucumber, sliced
  • 1 whole tomato, slided
  • 2 oranges, peeled and chopped into bite-size pieces
  • ⅓ cup of bottle light vinaigrette dressing

Directions
Toss all ingredients together in a large bowl. Add dressing and toss again. Serve immediately.

Makes 5 servings. Per serving: cholesterol: 0 mg, fiber: 8 g, sodium: 200 mg, calories from protein: 18 percent, calories from carbohydrate: 62 percent, calories from fat: 20 percent.

Recipe courtesy of U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion

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What you need to know about AEDs

Post Glenn W. Barham, EMT-P and Coordinator for the Emergency Response Team at Rex Healthcare.

032714_AED1Automated external defibrillators (AEDs) are literal lifesavers, delivering a shock to restore a heart’s normal rhythm following sudden cardiac arrest. But would you know how to use one in an emergency situation?

AEDs are available in many public places, including malls, grocery stores and airports, and are actually very user-friendly. While there are several AED brands on the market, they all work similarly.  The first thing to do is turn it on, and then just follow the voice and visual prompts.  They are designed to be used by untrained lay people.

Here are some pointers, courtesy of the National Heart, Lung, and Blood Institute, to keep in mind if you ever find yourself in an emergency situation requiring an AED:

  • 032714_AED2Before using an AED, check the person to make sure there is no response (shout at or shake him or her; if the person is a child, pinch instead).
  • Call 911; if more than one person is present, have one person call emergency services and get the AED while the other person begins CPR.
  • Check the breathing and pulse. If breathing and pulse are irregular or not present, get ready to use the AED as soon as possible.
  • Turn on the defibrillator, which will give you step-by-step instructions via voice and screen prompts.
  • 032714_AED3Make sure the wires from the electrodes are connected to the AED, and that no one is touching the person, then press the “analyze” button, which will allow the machine to check the person’s heart rhythm.
  • If the machine tells you a shock is needed, stand clear of the person before pressing the “shock” button.
  • Start or resume CPR until help arrives or the person begins moving. Stay with the person.

The residents of Raleigh and Wake County enjoy one of the best out-of-hospital cardiac arrest resuscitation rates in the country. Early CPR and defibrillation are cornerstones of that success. Every Emergency Response Team that works an event in our community is equipped with an AED, and their use has been instrumental, along with rapid CPR, in several successful resuscitations. While we don’t have to use them often, we realize they are one of the most vital pieces of equipment we have.

I encourage everyone to take a CPR class which includes the AED training. Do it for your family, your friends, and your neighbors.

If your company,  church, or other facility outside of Rex has an AED, please make sure that the local 911 center is aware. In cases of emergency, they can instruct the caller on its location. If you have a heart condition that puts you at risk for sudden cardiac arrest, talk with your health care provider about purchasing one for home use.

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25 Years of Cardiac Surgery at Rex

Written by Betsy Kelley RN, MS, GNC; Cardiovascular Clinical Nurse Specialist at Rex then (1989) and now (2014).

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CTRU and OR5 staff, March 1989

March 15, 2014 will mark 25 years since the first cardiac surgical procedure at Rex Hospital was performed. After months of preparation and planning by physicians, nurses, administrators, and a host of other disciplines, our first patient left OR5 after a “rolling call” to the new Cardiothoracic Recovery Unit (CTRU) on March 15, 1989.

Many things have changed at Rex since that day, including Rex becoming a part of the UNC Health Care system, CTRU’s name (now the CTICU) the length of time our heart patients are hospitalized, the variety of procedures performed, and most of the faces associated with the program. However, there are a few Rex co-workers who were part of that auspicious day, that are still working in their heart-related service areas at Rex.

As the first Clinical Nurse Specialist hired at Rex, and the person charged with educating and orienting all CTRU and 4W nurses, I was nervous on 3/15/89, hoping for a smooth start to our program, and a successful outcome for our patient.

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Nurses tending to the first heart patient, March 1989

Our first patient did extremely well, but our CNO at the time, Patti Fralix, wanted to make sure he continued to do well post-discharge and asked me to make a “home visit” to him. I met him at his bait and tackle shop in Fuquay-Varina, where I was pleased to see he was progressing satisfactorily. I’m sure such a visit by a non home-health nurse would never be allowable in this day and age!

My office was in the current Room 8 in CTRU, so I was close at hand for support of the staff. I slept in CTRU several nights in the first couple years of our program. The Clinical Manager Cheryl Batchelor and I were not both allowed to be on vacation at the same time during the first year. I worked with the cardiac surgery program for 11 years, and then left Rex.

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Doctors operate on the first heart patient, March 1989

Two years ago I had the opportunity to again work with the cardiothoracic surgeons and staff. One of my first tasks was helping our physicians and support staff to get our TAVR program up and running. It was a “mini” revisit to the excitement of 1989! Our heart program has outdone every expectation I ever had for it. The original open heart OR staff called our group “pioneers.” We are proud to have cleared a path for others to follow.

For those of us that were a part of the events that day, it is gratifying to see the growth of our heart services and cardiac surgery program, and there is much anticipation for our new North Carolina Heart and Vascular Hospital scheduled to open its doors by the end of 2016. We never would have imagined such a culmination to our work back in 1989. We are so proud of our program’s history, and our contributions to the excellent care provided to cardiac surgery patients at Rex.

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RNs Patricia Sloan, Betsy Kelly, and Vickie Alston, some of the original nurses still at Rex since the first heart surgery, March 2014

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The Best Plate Scenario

012414_AnnaGraceRotskoAnna Grace Rotsko is a Dietetic Intern at Rex Wellness Center through North Carolina Central University. She is passionate about delicious foods that are also good for your health.

012414_faddiet1It can be hard to know if you are getting enough of the right foods to give you the right nutrition so you feel your best. Though understanding nutrition can be difficult, it doesn’t have to be. A simple trick to getting the nutrition you need is to follow “The Plate Method.”

This method consists of eating lean proteins (poultry, fish, pork, beans, tofu), whole grains (brown rice, whole grain breads, corn, sweet potatoes), and an assortment of vegetables (cooked in small amounts of plant based oils if necessary) with a side of low-fat dairy and/or fruit.

Try baking, grilling, or sautéing your lean protein, for example, and include three different colors of vegetables on your plate. A quarter of your plate should be lean meat or other protein of your choice, a quarter of your plate should be a carbohydrate of your choice, and the rest of your plate should be vegetables (try not to drown them in butter or cheese sauce)! Don’t forget your side of fruit or low fat dairy of choice with your meal.

This is how your plate should look:030314_foodplate

If you get tired of monotony, do not fear! You can still follow the plate method with sandwiches, pastas, salads, tacos, and almost anything. Just make sure you are getting about the same portions of lean protein, whole grains, and vegetables that you would if they were simply on your plate. You can also add the  low-fat dairy or fruit to your meal (reduced fat cheese, non-fat yogurt) but keep it in the quantity of a side dish… don’t let it take over the meal.

By following the plate method you will be getting the protein, carbohydrates, fiber, fats, vitamins and minerals you need for your body to function optimally!

If you are interested in learning more about bettering your nutrition, you can schedule a private nutrition consultation with one of our registered dietitians at the Rex Wellness Centers. Visit our site for more information!

Caution:  If you gain weight while following the plate method, start using a smaller plate and re-evaluate your cooking methods to find hidden fats that can add up quickly.

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New Stroke Guidelines Target Women

For the first time, the American Heart Association and the American Stroke Association have issued guidelines aimed at reducing stroke risk in women. Each year, 55,000 more strokes occur in women than in men and represent the third leading cause of death for women (they’re the fifth leading cause for men).

Highlights of the guidelines include:

  • Pregnancy: Women with high blood pressure before pregnancy or a history of preeclampsia (pregnancy-related high blood pressure) should be considered for a low-dose aspirin regimen to decrease the risk of preeclampsia; aspirin should be taken from the 12th week of gestation until delivery.
    Women with a systolic blood pressure of 150 to 159 mm Hg and a diastolic reading of 100 to 109 mm Hg should be considered for blood pressure medication. Pregnant women with blood pressure of 160/110 mm Hg should be treated.
  • History of preeclampsia: This condition should be considered a risk factor for stroke later in life.
  • Hormonal contraceptives: Having high blood pressure and taking birth control pills raise the risk of stroke, so women should be screened before taking the pill.
  • Migraines: Women who experience migraines with aura should avoid smoking to avoid further increasing risk.
  • Atrial fibrillation: Women older than 75 should be screened for this heart arrhythmia.

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Gluten-Free Baked Lemon Chicken

The lemon and garlic give this gluten-free dish a tasty zing.

Ingredients
3½ pounds chicken (skinned and cut into 10 pieces)
¼ teaspoon salt
¼ teaspoon pepper
1½ cloves of garlic (thinly sliced, or 1 tsp. garlic powder)
4 thyme sprigs (fresh, or 1 tsp. dried thyme)
3 cups onion (thinly sliced)
1½ cup gluten-free chicken stock (or water)
¼ cup lemon juice
1 lemon (sliced into 10 slices, seeds removed)

Directions

  • Combine salt, pepper, garlic and thyme. Lay chicken pieces into 11×13 baking pan. Sprinkle seasonings over chicken.
  • Combine onions, stock and lemon juice in a saucepan. Heat to a boil. Pour hot lemon mixture around chicken. Top each chicken piece with a lemon slice.
  • Bake for 30 minutes at 400°F until golden brown and juices are clear-colored.

Makes 5 servings. Per serving: 450 calories, 11g total fat, 3g saturated fat, 225mg cholesterol, 470mg sodium, 15g carbohydrates, 3g dietary fiber, 6g sugar, 71g protein.

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Recipe courtesy of the U.S. Department of Agriculture.

 

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D-I-Y Relaxation

Through the ages, people have turned to calm and quiet meditation to draw tension from their bodies. And studies done by Harvard Medical School say relaxation techniques really work when done correctly. Two worth trying:

Relaxation response. Every day, go alone to a quiet place. Sit with eyes closed and focus your thoughts on your breathing until it becomes even and slow. Use four counts to inhale, pause, then exhale four counts. At the same time, repeat one word to yourself such as “calm” or “slow.” Practice daily; soon it will become effortless.

Progressive muscle relaxation. Find a quiet spot and sit or lie comfortably with eyes closed. One by one, tense your muscle groups for 10 seconds, and then release them. Start by scrunching your cheeks, eyes and eyebrows into a knot, hold for 10 seconds, then release. Next, shrug your shoulders, hold and release. Then tense and release your fists, arms, stomach, buttocks, legs and toes. As you release, feel the warmth from your muscles. Imagine “seeing” your stress evaporate.

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S.M.A.R.T. Goals

012414_AnnaGraceRotskoAnna Grace Rotsko is a Dietetic Intern at Rex Wellness Center through North Carolina Central University. She is passionate about delicious foods that are also good for your health.

It is now several weeks into the New Year. How are your resolutions going? If you are having trouble keeping them, try setting them as S.M.A.R.T. goals! What’s a S.M.A.R.T. goal you might ask?

A S.M.A.R.T. goal is Specific, Measurable, Attainable, Realistic, and Timely.

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Specific: Write as much information as you can about your goals. Is there anyone else involved besides you? What exactly do you want to accomplish? What are the precise steps that you need take to make this goal a reality?

Measurable: Give yourself goals that have numbers or values to make it easier to track how you are doing and how close you are getting to reaching your goal. Use benchmarks or milestones if this will help you stay motivated.

Attainable: Are your goals actually in your power to change? Keep in mind finances, body shape, what is going to be good for your health etc. Make sure your goals do not go against the things you cannot change. Visualize the change you want to make and stick to it.

Realistic: Try not to set outlandish goals. Don’t be afraid to take baby steps. It is better to set a smaller goal and then set a new goal once you’ve accomplished the first one than set a large goal that seems/is impossible to reach.

Timely: Put your goals in a time frame to help you keep your focus. Does this time frame give you enough time to safely complete your goals? Where do your milestones fit into the time frame you have set?

Once you have set your S.M.A.R.T. goals, write them down on paper and keep them in a place where you can review them. Place notes around your house as motivation, especially in places where you are more likely to not follow your goals. Write down accomplishments and milestones that you have achieved alongside your original goal and pat yourself on the back!

Here is an example:

Goal – Eat five homemade dinners a week at home.

  1. 020514_smart3Ask my family for help and support of my goal
  2. Set aside time for and complete meal planning and grocery shopping on Saturday
  3. Set aside time for and complete as much cooking and preparation of dinner meals for the upcoming week over the weekend, leaving minimal work to do at night
  4.  Do not stop at fast food on my way home from work! Even if I am tired.
  5. Complete the rest of the cooking process when I get home as needed per night and ENJOY!

This could even be one step in several steps to a long term goal of weight loss. What are some changes that you will make to make your goals S.M.A.R.T.?

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Can protecting your heart also help ward off Alzheimer’s?

Many conditions that damage the heart or blood vessels also appear to increase the risk of developing Alzheimer’s disease or another type of dementia, called vascular dementia. That’s a decline in thinking skills caused by blocked or reduced blood flow to the brain, which deprives brain cells of vital oxygen and nutrients.

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Lifestyle factors that raise your risk of heart disease and may also increase your chance of developing Alzheimer’s or vascular dementia include:

  • smoking
  • high blood pressure
  • high cholesterol
  • poorly controlled diabetes
  • a diet lacking in fruits and vegetables
  • lack of social engagement

What’s the connection?

Although researchers are still working to understand Alzheimer’s disease, studies suggest that many people who have features in the brain that are a hallmark of Alzheimer’s may not develop symptoms unless they also have vascular (blood vessel) disease. So, researchers theorize, controlling cardiovascular disease risk factors may be helpful in protecting brain health. If you can prevent vascular disease, there may be potential for also preventing Alzheimer’s in some cases.

Protect heart and brain health

You can take steps to protect your heart and brain health with these guidelines:

  1. Use up as many calories as you take in to maintain your weight. If you need to lose weight, use up more calories than you eat. Also, choose your calories wisely. The American Heart Association (AHA) suggests that every day, you aim for at least 4½ cups of fruits and vegetables, three one-ounce servings of whole-grain products and less than1,500 mg of sodium. Every week, eat at least two 3½-ounce servings of fish and four servings of nuts, legumes and seeds. Limit sugar-sweetened beverages to no more than 36 ounces and processed meats to no more than two servings per week. Keep saturated fats to no more than 7 percent of your total calories.
  2. Get at least a half-hour of physical activity most days. The AHA suggests at least 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise. You don’t have to exercise 30 minutes at a time. Two or three 10 to 15 minute segments a day are also beneficial. Include moderate to high intensity muscle-strengthening activity at least two days a week.
  3. Quit smoking if you currently smoke. Knowing why you want to quit and getting assistance with quitting can help you stick to your plan. That may include counseling, education or medications. Visit the American Lung Association for help with smoking cessation.]
  4. Control your blood pressure, cholesterol and blood sugar. Good diet and exercise habits can help keep all of these in check. In addition, working closely with your health care provider can help you keep your levels under control.
  5. Scientists don’t have all the answers about how to prevent Alzheimer’s or other types of dementia. But living a heart-healthy lifestyle is certainly good for your heart, and it may benefit your brain, too!

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Banana Walnut Oatmeal

This heart-healthy recipe is high in fiber and low in cholesterol. A great way to start your day!

013014_BananaOatmealIngredients
⅔ cup milk (nonfat, dry)
1 pinch salt
2¾ cups water
2 cups oats (quick cooking)
2 bananas (very ripe, mashed)
2 Tbsp. maple syrup
2 Tbsp. walnuts (chopped)
Optional: Substitute 2 cups water or 2 cups skim milk for the reconstituted nonfat dry milk.

Directions

  • In a small saucepan, combine reconstituted nonfat dry milk, salt and water.
  • Heat over medium heat until steaming hot, but not boiling.
  • Add oats and cook, stirring until creamy, 1 to 2 minutes.
  • Remove the pan from heat and stir in mashed banana and maple syrup.
  • Divide between four bowls, garnish with walnuts and serve.

Makes 4 servings. Per serving: 340 calories, 6g total fat, 0g saturated fat, 5mg cholesterol, 190mg sodium, 60g carbohydrates, 6g dietary fiber, 25g sugar, 14g protein.

Recipe courtesy of the U.S. Department of Agriculture.

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