Health Education

Exercising Safely with Asthma

More than 20 million people in the United States suffer from asthma, the lung disease caused by narrow or blocked airways. The Asthma and Allergy Foundation of America estimates that 80 to 90 percent of people with allergic asthma also experience symptoms of exercise-induced asthma, such as coughing, wheezing, chest tightness and shortness of breath during physical activity. But that doesn’t mean you should avoid exercise—quite the opposite!


Regular activity can help strengthen your heart and lungs, relieving asthma symptoms. Follow these steps to exercise safely:

1. Take your medication. Your doctor may prescribe two types of inhalers: one that’s used just before exercise and one for long-term asthma control. Medication is one of the best ways to treat an asthma attack. Long-term-control medicines control asthma by reducing inflammation that are taken every day. The quick-relief medicines relax and open your airways at the first sign of an attack. Discuss treatment options with your doctor to keep your asthma under control.


2. Warm up. Take about 10 minutes to warm up before working out.

3. Exercise in moist air. Breathe through your nose to humidify air before it enters your lungs. If it’s cold and dry, wear a mask or scarf over your nose and mouth.

4. Avoid allergy triggers. For instance, exercise indoors when pollen counts are high. Find out what things make your asthma worse and do your best to avoid them. Asthma cannot be cured, but is manageable with the right treatment. Knowing what triggers your asthma can help keep your symptoms under control.
Common triggers include:

  • Cold air
  • Perfumes and other strong smells
  • Smoke
  • Pet dander
  • Dust
  • Mold
  • Pollen
  • Pollution

To learn more about treatment options for your asthma symptoms or other pulmonary conditions, visit:

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Managing Diabetes Together

diabetes medicine

If a spouse, partner or other immediate family member has diabetes; it can be beneficial for everyone to learn more about the condition. Diabetes can have a substantial impact on individuals and their partners, facing complex reactions to the condition.

Here are some ideas to help you and your loved one make healthy lifestyle changes together.

  1. Be active. Exercise plays an essential role in managing or preventing diabetes. Whether it’s riding a tandem bicycle around town or kayaking on a lake, find a fun, social activity that you both enjoy. This will allow the two of you to get fit in a healthy, happy manner. In addition, physical activity can be spread throughout the day. Try taking regular walks together. Moderate workouts can help control your blood sugar, lower blood pressure and reduce stress.
  1. Eat well. Eating healthy starts at the grocery store. By shopping together you both may be more prone to select healthy foods than when shopping by yourself. Fill up on whole grains, fiber-rich foods, veggies and nuts. Aim to reduce the consumption of foods high in saturated fats and trans fats, such as fried foods, cakes, cookies, crackers and fatty cuts of meat.
  1. Support each other. Living with diabetes has its ups and downs with monitoring blood glucose and making changes to your diet and/or medications. Research shows that partners who provide social support for one another enables positivity. Having someone on your side makes it easier to manage diabetes, staying on track along with relieving stress.
  • couple with diabetesRemind each other to check your blood sugar levels and take your medications at recommended times.
  • Discuss how to handle a diabetes-related emergency or complications a head of time. Having a prepared emergency plan can reduce the amount of physical and emotional stress for you and your loved one.

Not only is it important to seek support from each other, but finding help from a professional outside source will ensure that you’re making the best health decisions. Try joining a diabetes support group or a diabetes education program.

diabetesTake a free online diabetes health assessment and receive a report of your risk factors and recommendations for improving and maintaining a healthy lifestyle.

For more information on how you and your loved one can manage diabetes together, ask your physician for a referral to UNC REX Diabetes Education Center.


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Mental and Behavioral Health in Wake County

In Wake County alone, more than 65,000 people suffer from serious mental illness. Families, friends and communities are also affected.

shutterstock_212336449May is National Mental Awareness Month and UNC Health Care and UNC REX Healthcare continue to lead the way with mental and behavioral health initiatives in Wake County.

UNC WakeBrook, a behavioral health facility located in Raleigh, offers a continuum of services for people dealing with mental health and/or substance abuse disorders.

WakeBrook’s campus, at 107 Sunnybrook Road, Raleigh, provides a wide range of services for patients: crisis and assessment services, inpatient services, facility-based crisis services, alcohol and drug detoxification and primary care. Our leadership continues to work with Alliance Behavioral Health and representatives from area hospital emergency departments, crisis centers and other mental health providers to better serve the growing number of behavioral health patients in Emergency Departments. Some behavioral health patients have a multitude of additional needs, and are often in crisis.

One of Wake County’s strongest advocates is the National Alliance on Mental Health (NAMI) of Wake County. Its leaders Gerry and Ann Akland continue to shine the spotlight on mental and behavioral health needs. Last week, NAMI hosted its 10th Annual Celebration of Courage luncheon as well as a Gala of Hope and Courage. These events offer other advocates, health providers and loved ones an outlet of support and hope, and help to raise crucial funding. NAMI works diligently to reduce the stigma surrounding mental health. “No blame, no shame,” is a common, heart-felt phrase echoed by advocates. NAMI’s continued support offers education, awareness and hope to those who struggle with mental illness.

A visual reminder of Irises, the flower symbol for mental health awareness, graced UNC REX’s front lawn last week.


Our commitment to providing access to the health care services those with mental illness need continues. In addition to WakeBrook opening an on-site primary care and dental clinic in last year, which has helped provide behavioral health patients with basic medical and preventative care, additional beds are set to open this summer.

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Stepping Outside with Seasonal Allergies

Brett E. Dorfman, MD, at Rex Ear Nose and Throat Specialists at Wakefield is board certified in Otolaryngology-Head and Neck Surgery. Dr. Dorfman is also a member of the American Academy of Otolarygology and American Academy of Otoloaryngologic Allergy. The Rex ENT Specialists at Wakefield provide allergy testing and immunotherapy treatments in office or at home.

Are you experiencing constant sneezing, sniffling, stuffiness, or irritated eyes? Many people look forward to enjoying the fresh spring air, but not the common allergens that come with it. But, with proper preparation you can enjoy the great outdoors even if you suffer from seasonal allergies.

shutterstock_267288281An inhalant allergy occurs when your immune system overreacts to a normal substance that gets into your nose. Your body overreacts, creating a chemical response to attack the allergen. This chemical response then causes symptoms like watery or dry eyes, constant sneezing, and/or a runny nose. The common inhalant allergens are pollen dust mites, pet dander, and naturally occurring molds.

Follow these steps suggested by Dr. Dorfman before going outside. With these tips, you can learn how to enjoy the fresh air while keeping your allergies under control.

  1. Know what you are allergic to and when. When taking precautions for your allergies, the first thing to figure out is which seasons are you might be allergic to. Typically allergies tend to be caused by:
  • Trees in the spring
  • Grass in the summer
  • Weeds in the fall
  • Mold in the winter

If you can identify which season your symptoms flare up, then there are a number of things you can do. For example, if you’re allergic to tree pollen, you can visit and find daily reports on the levels of pollen and for which specific trees.

  1. shutterstock_197035589Find the best times to go outside. The pollen count tends to be highest around dawn and dusk, try to avoid being outside during those times of day. During days when it’s raining or shortly after rain showers, pollen gets pulled to the ground and the levels aren’t as high. And on nice sunny days, you’re going to have pretty consistently high levels of pollen.
  1. Take your recommended medications. If you plan to be outside for a long period of time, and you know you’re going to be symptomatic, be sure to take the appropriate medications beforehand. There’s not a perfect allergy medicine that resolves everyone’s symptoms, however, different types of medication are best for different things.
  • Oral antihistamines are best for treating sneezing and itching
  • Nasal steroids help control running noses and congestion
  • Newer medications such as nasal antihistamines and antihistamine eye drops help manage itchy or runny eyes
  1. Flush out pollen afterwards. After you come in from being outside, using salt water (nasal saline) will help flush out and dilute any excess pollen that’s sitting in your nose. Change into clean clothes and wash any attire that accumulated pollen from being outdoors. Scrub and rinse hands and face with soap and water to wash off pollen on your skin.shutterstock_332413589

You can learn more on which seasons cause allergy symptoms by taking an allergy test with Rex ENT Specialists at Wakefield.


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Aging well: 4 simple ways to stay fit

Getting and staying physically active doesn’t mean becoming a superstar athlete. It can mean just moving around a little more throughout the week. Staying fit becomes especially important as you get older because it can help you stay healthy and independent.

Health experts point to various long-term benefits of exercise, including:


  • Enhanced focus, planning and working memory
  • Improved conditions in those with diseases and disabilities such as arthritis and diabetes
  • Prevention or delay of many diseases and disabilities. For example, exercising may lead to lower blood pressure, which can help you avoid damage to your brain, eyes, heart and kidneys.
  • Reduced stress and improved mood

You might understand why it’s important to exercise, but feel like you’re physically unable or don’t have the time. But there are ways you can fit activity into your day.


  1. Start slow and easy. You can always work your way up to more difficult activities.
  2. Exercise when you wake up. This creates a habit and prevents other distractions from getting in the way.
  3. Break it into chunks. If you can’t dedicate much time at once, get 10 minutes of exercise several times throughout the day.
  4. Find something you enjoy. It’s easier to make exercise a habit if you enjoy it.
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How to Stay Young (At Heart)

12092Ashley Lewis, MD, FACC, RPVI, is a cardiologist at UNC REX Healthcare. She is board certified in general cardiology and is registered in vascular imaging. She is a general cardiologist with interventional training and has specific interests in coronary artery disease, valvular heart disease, congestive heart failure, peripheral artery disease and heart disease in women. She is a fellow of the American College of Cardiology.

Have you seen the recent news about heart age? Do you know your heart’s age? Learning about your heart age will give you a general indication of your current heart health and of what lifestyle-related factors may affect your heart health.

According to a study conducted by the Center for Disease Control and Prevention, if your predicted heart age is older than your actual age, you may be at a higher risk for a heart attack or stroke.


How can you prevent your heart from aging too fast? UNC REX Cardiologist Dr. Ashley Lewis names the most common risk factors to look for when it comes to protecting yourself from heart disease.

Your age and gender: “Though women are at a lower risk for heart disease than men, their chances increase after the age of 55,” says Dr. Lewis. “Once men reach the age of 45, they are at risk for heart disease.”

Your family history: You are at a greater risk of developing heart disease if you have a first-degree relative (i.e. mother, father, brother or sister) who’s suffered from heart disease before the age of 55 for males or before the age of 65 for females.

“Family history is a significant risk factor, so we always take that into account when it comes to our patients’ heart health,” Dr. Lewis says.

High Blood Pressure: According to the American Heart Association, about 80 million U.S. adults have been diagnosed with high blood pressure, also called hypertension.

“For adults, a healthy blood pressure is a systolic blood pressure less than 140 and a diastolic blood pressure less than 90. There are some populations, like people with diabetes or kidney disease, where the goal blood pressure is even lower,” says Dr. Lewis.

High Cholesterol: Cholesterol is found in your blood and the food that you eat. Elevated levels of cholesterol in your blood leads to build-up of a soft, waxy substance along the walls of your heart arteries called plaque and this can form a blockage, making it difficult for your heart to circulate blood appropriately. This can cause a heart attack.

Smoking: Tobacco abuse is one of the top two leading risk factors for cardiovascular disease.

“Second-hand smoke exposure does not come without risk as well, and is often overlooked,” says Dr. Lewis.

Weight: A normal body mass index is anywhere between 18 and 24. Controlling your weight decreases your risk of developing high blood pressure, diabetes, and high cholesterol.

“Obesity contributes to a domino effect; once you develop high blood pressure, diabetes or high cholesterol you’re at risk for developing heart disease, kidney disease, and/or stroke,” Dr. Lewis says.

Diabetes: Diabetes is a disorder that disrupts the way your body uses glucose (sugar). Type 1 diabetes develops in children or young adults and is a condition that occurs when the pancreas makes little or no insulin. Whereas, Type 2 diabetes more often occurs in adults and is a disorder where the cells of the body do not respond to insulin; this is called insulin resistance. Type 2 diabetes is often associated with obesity and abnormalities in cholesterol levels.

The only benefit in having Type 2 diabetes is that if patients choose to make drastic changes in their lifestyle including exercise, weight loss and good blood sugar management, they are actually able to resolve their condition,” says Dr. Lewis.

Are you young or old at heart? Determine your heart age with this simple quiz.
Take a free, confidential online heart risk assessment with Heart Aware and you may be eligible for a free follow-up screening by a physician from UNC REX Healthcare.

Learn more about UNC REX heart and vascular care

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4 Everyday Things to Keep Your Heart Healthy

12092Ashley Lewis, MD, FACC, RPVI, is a cardiologist at UNC REX Healthcare. She is board certified in general cardiology and is registered in vascular imaging. She is a general cardiologist with interventional training and has specific interests in coronary artery disease, valvular heart disease, congestive heart failure, peripheral artery disease and heart disease in women. She is a fellow of the American College of Cardiology.

For many of us, we start our days off with a casual morning routine that is usually shaped by the habits we adapt over time. When it comes to improving your health, Dr. Ashley Lewis says the first step is to make healthy lifestyle choices every day. In honor of Heart Health Awareness Month, Dr. Lewis explains four important habits we should focus on to maintain our heart heath.


  1. Get up and move! – Studies show that sitting for long periods of time increases your risk for heart disease. The Statistic Brain Research Institute reveals that 49 percent of Americans watch up to five hours of television a day. However, by getting the right amount of physical activity, you can reduce your risk of coronary heart disease by about 30 percent. Dr. Lewis recommends that you exercise 30 minutes a day for five days a week (a total of 150 minutes per week) with a moderate-intensity aerobic workout. Some examples of moderate-intensity activities include, brisk walking, jogging, biking or swimming.

    “Five days per week of moderate-intensity aerobic exercise in addition to light weight lifting or resistance training two times per week leads to weight loss, lower blood pressure, decreased blood sugars, decreased cholesterol levels, and stress,” Dr. Lewis says.
  1. Eat a healthy diet – Along with exercising, limiting the amount of salt in your everyday meals has proven to decrease your blood pressure by 5 to 10 points. Pay close attention to eating good fats in your everyday diet. Saturated fats and trans fat are the types of fats you should try to avoid and monounsaturated fats and polyunsaturated fats are good fats to add to your diet. The most well-known heart healthy nutrition plan is often referred as the Mediterranean diet. Many of the foods included in this diet provide various benefits to your heart and consist of items such as fruits, vegetables, whole grains, beans, nuts, seeds as well as monounsaturated fats like olive oil and canola oil and polyunsaturated fats such as fish.
  1. Try a stress relieving activity – When you’re under stress, your body releases adrenaline into your blood stream, making your heart rate speed up and blood pressure rise temporarily. Living a stressful life can cause your body to change the way it behaves by increasing your resting blood pressure and heart rate, potentially contributing to blockages and reduced blood flow within the heart. Some ways to reduce stress include daily exercise and 7 to 8 hours each night.

    “If you exercise daily and get enough rest at night, you are contributing to a lower stress level and therefore having less of an impact on your blood pressure, reducing your risk of developing heart disease,” Dr. Lewis says.
  1. Quit smoking and avoid secondhand smoke – Cigarette smoking is the leading preventable cause of mortality. Nicotine which is found in tobacco damages the structure and function of your heart’s blood vessels. The effects of smoking can cause plaque to develop within the arteries which can form blockages leading to heart attack. Non-smokers are also at risk for heart disease. Second-hand smoke exposure has been shown to increase the risk for heart disease by 25-30 percent.

To learn more about UNC REX heart and vascular care, visit

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5 Things You Need to Know About the Zika Virus


The Zika virus (pronounced zee-ka) has been in the national news a lot lately due, in part, to a travel alert related to its spread. In Brazil, it was recently linked to a rise in cases of microcephaly — a birth defect characterized by an undersized skull and brain. Scientists are still trying to better understand the possible connection between the increase in Zika virus infections and the increase in microcephaly cases. But concern is strong enough that in January 2016, the Centers for Disease Control and Prevention (CDC) issued a Zika virus travel alert recommending pregnant women not travel to areas of virus transmission.

While experts currently think the virus poses a small risk to people in the United States, it’s important to learn more about this mosquito-borne virus:

  1. What is Zika?
    Zika is a virus originally discovered in Africa. People infected with the virus may have no symptoms at all, or may experience a rash, fever, joint pain and redness in the eyes. The illness is usually mild, with symptoms lasting a few days to a week.
  1. How is Zika transmitted?
    The virus is primarily spread through bites from a mosquito species commonly found in the countries where Zika is present.
  1. Where has Zika been found?
    Active transmission of Zika has been found in more than 25 countries, mostly in Central and South America.
  1. Who is at risk?
    Anyone who hasn’t previously had the virus can be infected. While there’s no evidence pregnant women are more susceptible to the virus than others, their infections are of greatest concern because the virus can be transferred to babies still in the womb.
  1. How can I avoid being infected?shutterstock_339870569
    A Zika vaccine isn’t currently available, but scientists are working to develop one. For now, the CDC recommends that pregnant women avoid travel to countries where active Zika virus transmission is present. Women who may become pregnant should talk with their health care provider before traveling to these areas. Precautions recommended for anyone who travels to an area where Zika virus is spreading include using EPA-approved insect repellents; wearing clothing treated with permethrin that covers your arms and legs; and spending time in air-conditioned spaces or those with window and door screens that keep out mosquitoes.
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8 Helpful Ways to Communicate Effectively with the Hearing Impaired

12145Genevieve Spiliopoulos of Rex Ear, Nose & Throat Specialists at Wakefield is board-certified in audiology. She is a member of the American Speech and Hearing Association, American academy of Audiology Fellow and is also a licensed Fast ForWord® provider.

It is estimated that one out of every three individuals over the age of 65 have some degree of hearing loss. The onset of hearing loss due to aging is typically gradual over the course of several years. Once hearing loss has been diagnosed, hearing aids are typically recommended. There are various types and styles of hearing aids that should be discussed with your audiologist to fit your individual hearing and lifestyle needs. Hearing aids are not a one size fits most, but rather individually customized to maximize hearing and communication.

shutterstock_134283248Hearing aids are the first step to better communication, but it is not the only one. Hearing aids alone may not let a person with hearing loss communicate successfully. Remember, communication involves at least two individuals: a talker, who sends the message, and a listener, who receives the message.


As a family member or friend of a person with hearing loss, you can help improve communication by following eight simple suggestions.

1. Gain attention
Gain the listener’s attention before you begin talking, for example, by saying his or her name. If the person with hearing loss hears better from one ear, move to that side of the person. If necessary, lightly touch the listener’s hand, arm or shoulder. This simple gesture will prepare the listener to listen and allow him or her to hear the first part of the conversation.

2. Maintain eye contact
Face the person with hearing loss. Make eye contact. Your facial expressions and body language add vital information to the communication. For example, you can “see” a person’s anger, frustration and excitement by watching the expression on his or her face.

3. Keep hands away from face
When talking, try to keep your hands away from your face. You will produce clearer speech and allow the listener to use those visual cues.

4. Avoid covering or changing the shape of your lips and mouth
Most listeners lip-read. Lip-reading helps improve recognition of some sounds that are more difficult, especially in difficult listening situations. To help with lip-reading, do not overdo or create odd lip shapes when applying lipstick, do not talk with food in your mouth and do not chew gum. Keep in mind that heavy beards and moustaches can also hide your mouth.

5. Speak naturally
Speak distinctly, but without exaggeration. You do not need to shout. Shouting actually distorts the words. Try not to mumble, as this is very hard to understand, even for people with normal hearing. Speak at a normal rate, not too fast or too slow. Use pauses rather than slow speech to give the person time to process.

6. Rephrase rather than repeat
If the listener has difficulty understanding something you said, find a different way of saying it. If he or she did not understand the words the first time, it’s likely he or she will not understand them a second time. So, try to rephrase it.

7. Converse away from background noise
Try to reduce background noise when conversing. Turn off the radio or television. Move to a quiet space away from the noise source. When dining out, ask for a table away from the kitchen, server stations or large parties.

8. Move to an area with good lighting
When at a social gathering, sit where there is good lighting so that your face can be more easily seen. Also, avoid strong lighting coming from behind you, such as through a window. Writing, texting, using visual media (such as pictures, diagrams and charts) and finger spelling are other methods of effective communication. If the person with whom you are speaking is deaf and uses sign language, communicating by using sign language would be the most ideal.

To learn more about effectively communicating with someone with hearing loss, use the following links:

For more information or to schedule an appointment, please call 919-570-5900.

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Dispelling 5 Myths of Learning CPR


North Carolina Heart & Vascular and UNC REX Healthcare are sponsoring a booth at the North Carolina State Fair this year to offer free CPR training. Over 130 instructors will come together to volunteer more than 500 hours and train as many people as possible.

It’s easy, quick and can help you save a life, but every year we find people reluctant to stop and get trained. We asked why, and here are our Top 5 CPR Training Myths dispelled. If you think of any other reasons you may be reluctant to stop by, reply and let us know.

  1. Myth: I will look silly

    Fact: Everyone at our booth will be doing the same thing, so even if it does look silly, you won’t be the only one. If you are, our instructors will do the compressions with you, so you’re not alone.

  2. Myth: I will have to do mouth to mouth breathing on a dummy.

    Fact: We teach “Hands-Only” CPR, which is just chest compressions, not mouth to mouth breathing.

  3. Myth: Hands-only CPR is ineffective, so why learn it?

    Fact: By simply recognizing cardiac arrest, calling 9-1-1 and starting chest compressions, a loved one’s odds of survival can be doubled or even tripled.

  4. Myth: It will take too much time

    Fact: In about the same amount of time it takes to spin our prize wheel and get your prize, you can learn CPR. It takes 2 – 3 minutes to learn, and it’s time well spent.

  5. Myth: It will be difficult.

    Fact: Our great instructors take you through everything step by step, and show you just how easy it can be. Check out the simple CPR steps before you stop by.

Stop by and see us in the Education Building, booth 37-38, this week at the Fair. Spin the prize wheel, and find out how quick and easy it can be to learn how to save a life!


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