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CAROLINA DOCTORS MED CARE Sports Physicals 1024 S. Horner Blvd., Sanford, NC

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Saturday, April 20, 2013

Whitney Wilkinson enjoys a morning of yoga on the Endor Trail.



2 / Saturday, dategoeshere April 20, 2013

Health & Wellness

Central Carolina hospital

Research reveals migraines have various triggers M

any things can cause migraine headaches. Some seem harmless enough, like a glass of red wine or change in your daily routine. But if enough triggers add up, you may find yourself suffering the familiar migraine symptoms of intense throbbing, pulsing in one area of the head, nausea, vomiting, and extreme sensitivity to light. All you want to do now is find a dark, quiet place where you can lie down. Instead of being miserable with these headaches, you can try to limit how often you get migraines and their intensity by finding and avoiding your migraine triggers. Certain factors that can make people more prone to developing migraines include having a family history of migraines, being a woman, experiencing the first migraine during adolescence, and undergoing hormonal changes due to estrogen fluctuations during menstruation, pregnancy and menopause. Food, stress and changes in your daily routine also can set off migraines. Common triggers include: Certain foods, including blue and aged cheeses (Roquefort, Stilton, Gorgonzola or Parmesan), as well as some Asian

foods made with monosodium glutamate, chocolate, aspartame, salty or processed foods, citrus (oranges, lemons, limes, grapefruits and pineapples), nitrates found in cured meats (hot dogs, bacon or cold cuts), and foods that contain tyramines, such as soy, marinated or pickled products. • Too much caffeine.

• Skipping meals or fasting for too long. • Certain odors, such as perfumes, paint or certain flowers. • Bright lights or sun glare. • Getting too much or too little sleep. • Changes in the weather or high humidity. • Stress. • Loud noises.

Harnett Health systems

down the time of day and what you were doing when the headache started, what you ate or drank 24 hours before it began, and how long it lasts. Be sure to record any unusual stress and overall state of health. It is important to remember that less than 30 percent of migraine sufferers identify food as triggers. To be recognized as a migraine trigger, the food must start a headache within one day of the time it is consumed for more than half the time that it is eaten. Over time, you may notice a pattern to your headaches. Once the triggers are identified, it will be easier to take steps to avoid them. You won’t be able to control all your triggers, but you can limit them so they don’t add up and start a migraine. In addition to managing triggers, other ways to reduce the number and severity of migraines include exercising regularly, getting a • Certain medications, such good night’s rest, watching what as oral contraceptives or ones you eat, drinking plenty of fluids, that expand the blood vessels. eating on a regular schedule, and • Intense exercise. managing stress through relax• Smoking or being around ation exercises or biofeedback. someone who smokes. For more information about • Strong emotions, such as migraine triggers, talk with your anxiety or depression. Keeping a diary can help iden- doctor or visit the American tify your migraine triggers. Each College of Physicians website at time you have a migraine, write

FirstHealth of the Carolinas

Radiosurgery greatly reduces number of cancer treatments


hen listing the benefits of a new cancer treatment at FirstHealth Moore Regional, Stephen King, M.D., and his colleagues in the hospital’s Radiation Oncology department get excited by what it means for their patients. Since October of last year, the new Trilogy Stereotactic Radiosurger y Linear Accelerator has made highly effective cancer care possible for some people who previously would not have been candidates for traditional cancer surger y. It allows others to avoid weeks of radiation treatments but with the same positive results. “Some cancers are inoperable because of their location, in the brain or spine, for example, and some patients are too weak for surger y,” says Dr. King, a radiation oncologist. “This treatment provides results that are just as pring and Summer them. Products containoffer any extra protection are seasons for fun ing DEET currently are according to the American good as traditional suroutdoor activities, available to the public in a Academy of Pediatrics, and ger y and better than but also seasons for bug variety of liquids, lotions should especially be avoid- other types of radiation treatment.” bites and using insect and sprays, and products ed for use on children. Previously, patients repellent. Bug bites, registered for direct appliFor all insect repellents, for the most part, are cation to human skin conthe EPA recommends that and their families spent hours on the road travelnot harmful, but can tain from 4 percent to 100 you: be irritating, itchy and percent DEET. •Do not allow children ing elsewhere for the same therapy. Today, unpleasant. Insects can Is DEET Safe? to handle…product with they can get this powertransmit diseases like After completing a com- DEET and do not apply yellow fever and malaria, prehensive re-assessment such products to children’s ful treatment at Moore Regional. but those diseases are of DEET, the EPA conhands. When using on mainly a risk for travelers cluded that, as long as children, apply to your own outside the U.S. consumers follow label hands and then put it on Precise and powerful Do the following to help directions and take proper the child. prevent insect bites and precautions, insect repel•Apply sparingly FirstHealth’s Trilogy their complications: lents containing DEET do around ears. According Stereotactic Radiosur•Don’t bother insects not present a health conto the EPA Reregistration •Use insect repellant cern. Based on extensive Eligibility Decision report gery Linear Accelerator is used primarily for •Wear protective cloth- toxicity testing, the Agency on DEET, absorption of ing believes that the normal pesticides through the skin smaller lung and brain cancers and may be used •Be careful when you use of DEET does not is, “…approximately four in the future to treat the eat outside because food present a health concern times greater around the spine, liver and pancreas. attracts insects to the general population. ears than the forearm.” During stereotactic •If you know you have If you do rely upon Prefer not to use severe allergic reactions to products that contain DEET? procedures, physiinsect bites, carry an emer- DEET, remember these To help you find the cians use computers gency epinephrine kit tips: right Bug Repellent for and advanced images Many people choose • Do not use you, visit the EPA’s online to position the patient to use insect repellent to DEET/ sunscreen comsearch tool at http://cfpub. accurately, so they can help ward off bug bites. bination products. The or precisely focus the radiaThe repellent may contain frequent reapplication of discuss your options with tion. Radiosurgery refers the chemical DEET as an sunscreen will, “…pose your physician or pharma- to the use of a very high active ingredient and is unnecessary exposure to cist. dose of radiation in a used to repel biting pests DEET,” according to the Your health and wellsingle treatment session such as mosquitoes and U.S. Environmental Protec- ness is important so be to destroy a tumor. The ticks, including ticks that tion Agency. DEET is not sure to take appropriate linear accelerator is the may carry Lyme disease. water-soluble and will last precautions against bug machine that generates According to the U.S. up to eight hours, while bites when you are outthe radiation. Environmental Protection sunscreen washes off and doors. Key advances of the Agency (EPA), DEET is may only last a few hours. Learn more about Har- new equipment are designed for direct applica• Do not use nett Health and use our its ability to focus an tion to human skin to repel products with more than Physician Finder online at extremely powerful insects, rather than kill 30% DEET. They do not

Warm weather means the return of biting bugs


Stephen King, M.D.

radiation beam on a very Regional Hospital on a par with some of the small area— and do so best available anywhere. with great accuracy. The Trilogy Stereotactic “Because we can direct the beam so preRadiosurgery Linear Accelerator is one of the cisely, we’re able to protect healthy tissue next most precise and powerto the cancerous tissue,” ful radiation treatments for certain cancers. Dr. King says. “And so, during every “The leadership at treatment, “Some cancers are FirstHealth we’re able to inoperable has been use signifibecause of their extremely cantly higher supportive doses of radia- location, in the bringing tion aimed brain or spine, for of this cuttingdirectly at the example, and edge cancer cancer.” treatment to With other some patients are residents of radiation ther- too weak for our region, apies, patients surgery. This and we’re all might need very excited up to 35 treat- treatment provides results about it,” ments—35 says Margie visits back that are just as and forth from good as traditional Thomas, BSRT, (R) home and days of recov- surgery and better (T), Moore than other types of Regional’s ery between. clinical “Now we radiation director of can accomtreatment.” Radiation plish the Oncology. same results “Between in one or two — Dr. Stephen king our specialsuper-focused radiation oncologist ists and all treatments,” the treatDr. King says, ment options we offer, “and patients remain plus clinical trials, our here near their family patients can now remain and friends. Those are here to get the same huge benefits for our quality of care that they community.” This latest would get at almost any addition to the cancer major medical center in experts’ toolbox puts the country.” cancer care at Moore

Health & Wellness

Saturday, April dategoeshere 20, 2013 /

A New Choice In Healthcare Is Closer Than You Think

Central Harnett Hospital in Lillington

215 Brightwater Drive · Lillington, NC 27546 (910) 892-1000 · HOSPITAL SERVICES 24/7 Emergency Department · Board-Certified Emergency Medicine Physicians DIAGNOSTIC SERVICES MRI · CT Scan · Digital Mammography · Ultrasound · Nuclear Medicine · X-Ray Diagnostic Cardiology · Cardiopulmonary Services · Lab SURGICAL SERVICES Orthopedics · Gynecology · General Surgery · Ophthalmology · Urology · Podiatry Laparoscopic & Minimally Invasive Procedures · Anesthesiology 50 PRIVATE INPATIENT ROOMS Med/Surg Nursing Unit · Special Care Unit Hospitalists provided by WakeMed Faculty Physicians

Drive Times* to Central Harnett Hospital From: Anderson Creek Angier Broadway Buffalo Lakes Carolina Trace Fuquay Varina Holly Springs Sanford Spout Springs Spring Lake Willow Spring

Mileage: 12.0 8.1 16.5 21.2 25.1 12.3 18.0 23.9 23.0 20.5 17.0

Time: 18 minutes 11 minutes 20 minutes 30 minutes 33 minutes 15 minutes 24 minutes 29 minutes 29 minutes 28 minutes 24 minutes

*GoogleMaps 12-11-12: from hospital coordinates to town centers.


4 / Saturday, dategoeshere April 20, 2013

Health & Wellness

Bright Audiology

How to prevent noise-induced hearing loss By Dr. Angela Bright Pearson


the tiny hairs “bend over” and are unable to deliver the sounds appropriately to the brain.

ne shot is all it takes to make a hole in one -- to sink the Some of the warning winning basket -- or to signs of excessive permanently destroy your noise exposure hearing forever. are as follows: Noise induced hearing • Being unable to hear loss (NIHL) is hearing someone three feet away loss resulting from over• Having pain, ringing, exposure to noise and or buzzing (tinnitus) after can happen leaving a instantly or When a loud noise noisy area gradually • Expestrikes the eardrum, riencing over time. difBecause it causes the middle ficulty underour society ear bones to deliver standing has become so much force to the speech; hearaccustomed ing people inner ear that the to living, talk but not and even tiny hairs “bend understandenjoying, ing them. over” and are unable loud events sevto deliver the sounds eralAfter our daily hours or “dose” of appropriately to the even a few noise expobrain. days, these sure often symptoms exceeds usually go safe limits. away as the hair cells Because noise exposure recover. Howgenerally occurs without ever, after any pain or obvious injury repeated (bleeding) to the ear, expoindividuals are not alerted sures when damage is occuror one ring. very When we hear, loud sounds, in the form of vibrations, strike our eardrum and are delivered to our inner ear by the chain of three tiny, middle ear bones. Our inner ear, or cochlea (pronounced COKE-lee-uh) is a small, snail shaped structure that contains 15,000 to 20,000 hair cells that are responsible for detecting sounds. When a loud noise strikes the eardrum, it causes the middle ear bones to deliver so much force to the inner ear that

exposure, hair cells remain permanently damaged. How loud is too loud? Both the loudness of sound (called the intensity; measured in decibels) and the amount of time you hear the noise are important. The louder the sound, the less time one can safely be exposed to it.

Some examples are as follows:

Motorcycle, Lawn mower: 90-95 decibels = 4 hours Personal music players: 100 decibels = 2 hours Farm machinery: 110 decibels = 30 minutes Chain saw: 115 decibels = 15 minutes Music concert (regardless of type of music!): 120 decibels = 7.5 minutes Firearms, Firecrackers, Explosives: 140 -170 decibels = seconds NIHL is preventable. To protect yourself, take these precautions: 1) Have your hearing tested by an audiologist to obtain a baseline. If you already have existing hearing loss,

take medications that can be damaging to the ear, or have hereditary hearing loss, it is important that you monitor your hearing on an annual basis, and be especially protective of your hearing from noise. 2) Pay attention to the noises around you. Whenever possible, turn down the volume. If you are in a public place and cannot carry on a normal

conversation because of loud background noise, ask for it to be turned down. Take hearing protection with you for loud places such as movie theatres. 3) Alternate a noisy activity with a quiet one to give your ears a rest. 4) Wear adequate hearing protection when exposed to loud noise at work or play. Disposable,

foam ear can be purchased at hardware stores and sporting good stores. Purchase protectors with the highest Noise Reduction Rating (NRR) possible. If over the counter protectors do not fit your ear canals, your audiologist can order custommade devices to fit your ears. 5) Turn down the volume on personal music devices. Specialized earbuds, such as “KidzSafe” buds limit the amount of damaging noise to the ears, no matter how loud the device is turned. 6) When purchasing power tools or even children’s toys, check the decibel ratings (the smaller, the better). Hearing damaged by noise is a permanent loss and cannot be repaired. Hearing aids amplify sound for remaining hearing, but they do not restore hearing to normal. Do yourself a favor for years to come and practice Hearing Loss Prevention now.

Sanford Dermatology

Experience Counts.

Enjoy summer fun in the sun, without the burn Molly Speight Roberts MS, PA-C

The award-winning FirstHealth Orthopaedics program features board certified, fellowship-trained surgeons focused on one goal– maximizing your quality of life. You and your orthopaedic specialist will decide on the best treatment for your condition. If surgery is necessary, feel confident in knowing FirstHealth Orthopaedics ranks in the top 10 in the state for surgeries performed.

FirstHealth Orthopaedics. Excellent Care. Close to Home.

(800) 213-3284 370-70-13

As warm weather rapidly approaches and those nice sunny days beckon us to go outdoors, here are a few things you should know before that much anticipated spring break or summer vacation. The harmful effects from the sun come in the form of ultraviolet radiation.  UV radiation is the main cause of nonmelanoma skin cancers and also plays a key role in melanoma, the deadliest form of skin cancer which kills more than 8,000 Americans every year.  These rays also cause eye damage, (i.e. cataracts) and suppress our immune system, limiting the body’s ability to fight off infections and cancers.  So since we are consistently being exposed to these scary electromagnetic rays everyday, it is extremely important to know how to pick the right sunscreen to protect your skin! In June of 2011, the FDA announced a new rule to regulate the labeling and effectiveness testing of sunscreens.  Since December, it’s starting to show up on the shelves.  The hope was to make buying sunscreens a little easier for consumers and to cut out some confusion when it comes to SPF values and sunscreen terminology.  The following are key changes to look for this summer: 1) We will no longer be seeing sunscreens with extremely high SPF values.  SPF will now be “maxed out” at 50, since research has shown that sunscreens with any higher SPFs are not that much more protective, and tend to be extra pricey.  Any sunscreens with these high SPF factors will fit into the category of “SPF 50+.”

2) The two main forms of UV radiation are Ultraviolet A and Ultraviolet B (UVA and UVB rays, respectfully). In the past, SPF onlyindicated protection against UVB rays, but now, the FDA is forcing all sunscreen manufacturers to have some UVA protection as well, and to be considered “broad spectrum.”  As the SPF number increases, so does the proportion of UVA and UVB protection.  Although, at this point the UVA proportion does not have to be as high as the UVB, this is a great move in the right direction to better overall sun protection. 3) The FDA has also decided to ban companies from using the terms“waterproof” or “sweat proof,” (since this was false advertising to begin with), and instead they will designate sunscreens that are“water resistant” and whether the protection lasts for 40 or 80 minutes. 4) And sunscreens with an SPF 15 or higher will now get to claim that they prevent skin cancer and signs of premature aging,

whereas those with any lower values can claim only that they help protect against sunburn It is possible to enjoy the outdoors, but still protect yourself from all the negative effects of the sun. Make sure you are wearing abroad spectrum SPF 15+ sunscreen when outdoors, (I usually recommend SPF 30+ and daily protection on sun exposed areas with sunscreencontaining moisturizers).  Broad brimmed hats and sunglasses are not only in style, but also a must for the sun savvy outdoorsman or beach goer.  When having fun in the sun, always reapply sunscreen every two to three hours, especially after swimming or excessive sweating.  Avoid tanning booths and instead opt for self tanner or a spray-on tan, (these have been perfected over the years!).  And the most important rule of all, have a blast!  If you follow these simple tips and make sure to read sunscreen labels carefully, your skin will surely thank you over the upcoming years!

Health & Wellness

Saturday, April dategoeshere 20, 2013 /


Central carolina hospital

More than 320,000 Americans suffer hip fractures anually


hile hip fractures can be treated, the injur y can lead to severe health problems and reduced quality of life. Approximately 20 percent of hip fracture patients die within one year of their injur y. Most hip fractures occur because of a fall, especially among adults over the age of 65. Women are more likely than men to experience hip fractures due to a higher rate of osteoporosis. In addition to advanced age and osteoporosis, other risk factors associated with hip fractures include being Caucasian or Asian, lack of calcium and vitamin D in the diet when younger, physical inactivity, tobacco and alcohol use, and certain medications. Environmental factors, such as loose rugs or a cluttered living space, also could increase the chance of falling. A hip fracture causes pain in the outer upper thigh or groin area, as well as the inability to bear weight on the side of the injur y. The hip area may become stiff, show signs of bruising or swelling, and a significant level of discomfort could occur after any attempt to rotate or flex the hip. Most hip fractures are diagnosed following an X-ray, which also shows where the fracture occurred in the hip. Treatment is determined based on the patient’s overall health and age, as well as the location and severity of the fracture. Most hip fractures are treated surgically using one of three methods: Inserting metal screws into the bone, if it is properly aligned, to hold it together as it heals. This is called internal fixation. Replacing part of the femur, the long bone that extends from the pelvis to the knee. This method, called hemiarthroplasty, calls for removing the head and neck of the femur and replacing them with a metal prosthesis. Replacing the upper femur and pelvic bone socket with a prosthesis. This is called a total hip replacement. Patients typically do better if they undergo surger y soon after the hip fracture occurs. They may be encouraged to get out of bed the day after surger y with help from a physical therapist, who also will work with patients to help them regain strength and start walking again. After a hip fracture, most patients are hospitalized for approximately one week1d and may then be either discharged home or referred to a nursing home if they are unable to live independently. Physical therapy rehabilitation usually takes approximately three months. People at risk for hip fractures can take steps to reduce their chances of falling. Women should have a bone density test to

measure bone mass and make sure they get enough vitamin D and calcium in their diet. Engage in weight-bearing exercise to help strengthen bones and prevent falls. Avoid excessive amounts of alcohol and do not smoke. Take medications as prescribed to treat osteoporosis. Wear shoes with non-skid soles and avoid high heels and shoes like sandals and bedroom slippers that flop when you walk. Check your home for trip hazards like throw rugs, electrical cords and clutter. Make sure your home and outside walkways are well-lit so you can see where you are walking. Talk to your doctor or physical therapist about whether assistive devices may be needed to help you keep your balance. For more information about hip fractures, talk with your doctor or call (800)483-6385 for a free referral to a specialist near you.

Carolina Eye Associates

Eyelid rejuvenation a surprisingly common procedure


ne of the most common eye procedures performed today is blepharoplasty, or eyelid lift of the upper and lower eyelids. As we age, the skin of the eyelids loses its elasticity and can start to rest on or overhang the eyelashes. This redundant tissue is often accompanied by protruding fat pockets in the upper and lower lids that can give a tired Dr. Jeffrey White or excessively aged appearance. and need a surgical plan To rejuvenate the tailored to their desires upper eyelids, a and their particublepharoplasty lar anatomy. Patients are procedure can Prior to decidunique and remove this ing on surgery, need a excess skin and patients should give a more alert, surgical plan have a complete youthful appeareye examination tailored to ance, leaving to identify any only a minimally their desires other conditions. and their noticeable scar. It’s important The lower lids to discuss your particular may often be cor- anatomy. goals and expecrected through tations with your an internal physician. After approach leaving no scarsurgery, patients are able ring. Patients are unique to use their eyes with only

minimal discomfort. Typically, patients need to avoid strenuous activity for one to two weeks, but may return to work in this timeframe. The final results are usually apparent in two to three months. The ideal patient for eyelid rejuvenation is someone with excess tissue around the eyes, is healthy enough for surgery, and has realistic expectations. The goal is to correct the sagging of the upper lids and the bulging fat pockets of the lower lids that give a tired appearance. The vast majority of patients notice an improvement in the appearance of the eyes. Jeffrey White, MD, an oculoplastic and aesthetic surgery specialist at Carolina Eye Associates performing cosmetic, functional and reconstructive procedures around the eyes and face, can be reached at (910)295-2100 or (800)SEE-WELL (733-9355) or

Compass House Counseling Center Pamela Parker, MS, LMFT Psychotherapy Services Offered: Individual, Couples & Family Therapy ADHD, ODD & Conduct Disorder Depression & Anxiety Disorders Bipolar Disorder Grief Counseling Comprehensive Diagnostic Assessment

Let Us Help You Find Your Way Call Today 919-774-8790 Most Insurance Plans Accepted

Celebrates... 18th International Noise Awareness Day Wednesday, April 24th, 2013 9 am – 5 pm • Dr. Angela Bright Pearson will be presenting an informative seminar at 11:00 a.m. on how noise affects our precious hearing and what you can do to protect yours • Free hearing screenings to identify whether hearing loss is present- school age and up • Free earplugs (one pair per attendee) • Refreshments and a chance to ask our staff questions about noise and hearing protection devices

REGISTER TO WIN! ($20.00 value) The new KidsSafe Earbuds allows your child (or you) to enjoy your music without fear of damaging your hearing. No matter how loud they “crank it up”, these new buds keep damaging sounds to a safe level!

REGISTER TO WIN! One free pair of noise blocking earmolds, made to fit your ears. Good for target shooting, mowing, car races, and even snoring spouses! ($120 value)

1620 South Third Street 919-774-3277

6 / Saturday, dategoeshere April 20, 2013

Health & Wellness

Sanford Specialty Clinic

Chronic kidney disease – what you need to know By Drs. Roger Lamanna and Edwin Fuller, III

Nephrologists Sanford Specialty Clinics a member of the UNC Physicians Network


ore than 20 million people in the United States suffer from Chronic Kidney Disease (CKD), and it is estimated that

one in every nine people in North Carolina has CKD. Chronic kidney disease is the slow loss of kidney function over time. The main function of

the kidneys is to remove wastes and excess water from the body. In most instances, chronic kidney disease (CKD) slowly gets worse over time. In the

Healthcare for the entire family!

From the cradle... Newborn Care • Pediatric Care • Teen Care • Adult Care • Seasoned Citizen Care the golden years! James B. Holt, M.D. Family Practice

Leah Beynon, P.A. Physician Assistant

Erik Butler, D.O. Family Practice

Cindy Julich, F.N.P. Family Nurse Practitioner, Certified

Dawn Erikson, F.N.P. Family Nurse Practitioner, Certified

Roxanne Bryant, F.N.P. Family Nurse Practitioner, Doctorate

Michael J. Tyler, M.D. Family Practice

• On-Site Laboratory • On-Site X-Ray • Diabetic Management & Education • Audiometry • Pulmonary Function Testing • Pre-Employment Physicals

• Same Day Appointments Available • Complete Physical Exams • Occupational Medicine • Minor Surgical Procedures • Injury Care

Visit our NEW PATIENT PORTAL at 75 Old Graham Road Pittsboro, NC 27312 919.542.2731

2412 Wilkins Drive Sanford, NC 27330 919.776.6000


early stages, there may be no symptoms. The primary risk factors for CKD are diabetes, hypertension, heart disease and a family history of kidney disease.  More than 35% of people aged 20 years or older with diabetes have CKD. Diabetes is the most common cause of kidney failure. Poorly controlled diabetes can damage the small blood vessels in the kidneys and prevent the removal of waste and excess fluid from the body. Diabetes results from problems converting sugars from food (carbohydrates) into energy (insulin) in one of the following ways: • too little insulin in the body (Type 1 diabetes), or • the body’s inability to use insulin (Type 2 diabetes). More than 20% of people aged 20 years or older with hypertension (high blood pressure) have CKD. Hypertension is the second leading cause of kidney failure. Blood pressure beyond the normal range (>120/80) makes the heart work harder and can damage blood vessels. If the kidneys’ blood vessels are damaged, they may stop removing waste and extra fluid from the body through urine. The extra fluid in the blood vessels may then raise blood pressure even more. Less common kidney diseases and infections can result in CKD, as well. Initial CKD symptoms are often subtle but can include: fatigue, puffy eyes or swelling of legs, metallic taste in mouth, itching or easy bruising

of skin, changes in volume or appearance of urine, and high blood pressure. Screening for CKD based on risk factors is one way to avoid a delayed diagnosis -- when kidney function is already severely diminished and clinical symptoms are apparent. Screening for persons with risk factors is recommended to delay or avoid its complications. When kidneys fail, their important work (blood pressure control, removal of extra fluid and waste, making red blood cells, and maintaining healthy bones) must be completed another way. When CKD reaches advanced stages, it is important to select the treatment that best matches your lifestyle and medical condition. There are three options for replacing the kidneys’ important work: transplant, hemodialysis, and peritoneal dialysis. To decrease your risk of developing CKD, persons with diabetes mellitus should strive to keep their hemoglobin A1C (a 3-6 month blood sugar average) less than 7. Your endocrinologist or primary care physician will determine the appropriate therapy and self-management strategies. If you suffer from hypertension, take your blood pressure medication as prescribed to achieve a blood pressure of 130/80. Finally, if you have heart disease, you should have your kidney function monitored. If you have any questions or would like to learn more, please contact Sanford Specialty Clinics at (919)718-9512.

The quality health care you need, the compassion you deserve...

Personalized, local adult specialty care Easy access to world-renowned healthcare... We offer an inter-disciplinary team approach in the following specialties:

Cardiology, Endocrinology, Nephrology, Pulmonology, and Rheumatology Highlights of on-site services include: s Bone density studies s Joint injections s Rheumatic disease infusions

s ADA-certified diabetes education program s Insulin pump management s Continuous glucose monitoring s Medical nutrition therapy

s s s s

Pulmonary function tests Alphi - 1 therapy & infusions Allergy injections Cardiopulmonary exercise testing s Arterial blood gas testing

s s s s s

s Thyroid ultrasounds & biopsies

ECHO cardiograms Stress ECHO Arterial & venous ultrasound Pacemaker services Vein clinic including endovenous ablation & Sclerotherapy

s X-ray services s Lab services

To schedule an appointment at one of our specialty clinics, please call (919) 718-9512





We are accepting new patients and welcome all your family members!
































At Dr. Hall's practice, we pride ourselves on taking the time to listen to our patients and learn about each patient's personal needs. Our commitment is to state-of-the-art, quality medical services in a caring environment.





We are pleased to announce Chassidy Young, PA-C has joined our healthcare team.

To schedule an appointment, please call (919) 775-1000 1911 K.M. WICKER DIVE, SANFOD, NC 27330

Health & Wellness

We create smiles!

At Sanford Pediatric Dentistry we make your child‛s dental experience a pleasant and comfortable one. We treat infants, children, adolescents and patients with special needs. The entire Sanford Pediatric Dentistry family looks forward to meeting you and your child!

Se Habla Espanol

919-718-5561 New Location!

1013 Spring Lane, Sanford, NC 27330

New Location!

We are located in the Riverbirch shopping complex behind McDonalds.

Antonio S. Braithwaite DDS, MPH, PA

Board-Certified Pediatric Dentist

Most Insurances Accepted Including: United Concordia, Delta Dental, NC Medicaid, & NC Health Choice

8 / Saturday, dategoeshere April 20, 2013

Health & Wellness

Harnett Health systems

FirstHealth of the Carolinas

Wound care of particular Post-surgical diabetes concern to diabetics remission an innovation


iabetes is a disease where the body does not make enough insulin. The body needs insulin to break down sugar. Too much sugar will stay in the blood stream and can harm the body. There are 25.8 million people in the United States, or 8.3% of the population, who have diabetes according to the American Diabetes Association (ADA). There are two types of diabetes. The ADA identifies the following symptoms for T ype 1 and Type 2.

of their body. Diabetic ulcers are of great concern. A diabetic ulcer is a wound that appears on the feet of people with diabetes. The skin may appear nor mal and be war m Type 1 Diabetes like usual, but the ulcer • Frequent urination may exist. Many times • Unusual thirst there is little to no feel• Extreme hunger • Unusual weight ing in the feet or at the site of the ulcer. Even if loss • Extreme fatigue the ulcer doesn’t hur t, it should be checked by and irritability a healthcare professional because ulcers can result in infections and Type 2 Diabetes • Any of the type 1 in extreme circumstances can lead to death. symptoms If a diabetic person • Frequent infechas a wound, like a foot tions ulcer, and it doesn’t • Blurred vision • Cuts/bruises that heal completely within six weeks then receivare slow to heal • T ingling/numb- i n g t r e a t m e n t a t a wound care center may ness in the hands/feet be appropriate. Wound • Recurcare centers ring skin, of fer stategum, or blad- There are 25.8 of-the-ar t d e r i n f e c - million people in tions the United States, t r e a t m e n t and protoIf n o t or 8.3% of the cols to treat t r e a t e d , chr onic d i a b e t e s population, who wounds. c a n l e a d t o have diabetes Such treatother health according to the issues. One American Diabetes m e n t a n d protocols of the comAssociation. i n c l u d e mon conhyperbaric cer ns faced by people with diabetes oxygen therapy, negais slow wound healing. tive pressure therapies, Untreated wounds can bioengineered tissues lead to other complica- a n d b i o s y n t h e t i c s . tions like infection and Patients may also have amputation, especially the oppor tunity to parin lower limbs. Foot ticipate in clinical trials ulcers, wound infec - and multi-center studtion and tissue loss are ies. Hyperbaric oxygen sources of morbidity and mortality in diabet- t h e r a p y t a k e s p l a c e ics, so it is critical for in a chamber that you them to take good care can see out of as you

recline on a stretcher. Treatments typically take about two hours, so patients undergoing treatments often watch television or a movie. A trained staff member is always in the room with the patient and the patient can communicate with the staff member at anytime. During treatment, the chamber is pressurized, and the patient breathes one hundred per cent oxygen. The patient’s blood carries the oxygen to the injured area to help the wound heal faster. The therapy is pain free. Patients may experience a bit of pr es sure in their ears at the beginning of treatment, much like when you fly in a plane or drive into higher altitudes. Hyperbaric oxygen therapy is used not only for diabetic patients with wounds, but for many types of wound healing. Talk with your healthcare provider on the benefits of using a wound care center. Har nett Health now has a wound care center in Dunn, across the street from Betsy Johnson Hospital. We welcome new patients and look for ward to ser ving your healthcare needs. Contact the Har nett H e a l t h Wo u n d C a r e Center at (910)8921000. Also, visit to learn more about Har nett Health and to use our Physician Finder.

PINEHURST – Raeford resident Rick Sousa knew there was a chance his Type 2 diabetes would go into remission once he’d had weight-loss surgery. Or that he would see enough of an improvement in the disease that he would no longer need medication to control it. He also knew there was no guarantee of either outcome, but he hoped for the best and got it. Less than a month after his surger y at FirstHealth Moore Regional Hospital, the 45-year-old FirstHealth paramedic star ted to notice an encouraging change in his blood sugar levels.

“They were slowly going down,” he says.

Except for the two multivitamins he takes daily, Sousa no longer needs any kind of medication. He is completely off his oral diabetes medicine as well as the medication he took to lower his cholesterol and to prevent problems with his blood pressure and kidneys.

“I’m feeling fantastic,” he says.

Since his surger y, Sousa has enjoyed the benefit of what one of the foremost health care systems in the country calls “the top medical innovation for 2013” or, according to the Cleveland Clinic, research showing that bariatric surgery can help control diabetes even when medicine cannot. In fact, said a recent Cleveland Clinic press release, “many diabetes experts now believe that weight-loss surgery should be offered much earlier as a reasonable treatment option for patients with poorly controlled diabetes – not as a last resort.” Weight-loss surgeons at Moore Regional Hospital have observed this remission phenomenon (disappearance or lessening of symptoms) time and time again in their patients with

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Raymond G. Washington, M.D.

Type 2 diabetes. In the 43 bariatric procedures performed at Moore Regional between August 2011 and November 2012, 13 patients had Type 2 diabetes. According to recent clinic records, 12 are now off all of their diabetes medications. “Bariatric surgery can have a profound ef fect on diabetes, and many published studies have looked at the effect,” says bariatric surgeon Raymond Washington, M.D. “Surger y can account for almost an 80 percent remission of diabetes. Oftentimes, patients with non-insulin-dependent diabetes will leave the hospital off of their oral medications after only a few days.” While it isn’t known exactly why bariatric surgery can have this effect on diabetes, two American Diabetes Associationsponsored researchers have discovered clues that might explain it. In his research, Christopher Newgard, Ph.D. of North Carolina’s Duke University Medical Institute and the Sara W. Stedman Nutrition and Metabolism Center, found a link between increased circulating concentrations of certain kinds of amino acids (the building-blocks of proteins) and insulin resistance. (Insulin is the hormone that delivers sugar to cells to give them energy. In diabetes, the body does not use insulin properly.) More recently, Blan-

dine Laferrere, M.D., of St. Luke’s Roosevelt Institute for Health Sciences in New York, observed that patients undergoing bariatric surgery have greatly reduced levels of these amino acids, indicating that the changes are somehow involved in post-surgical diabetes remission. “Removing the lateral aspect of the stomach induces hormonal and metabolic changes that have a profound ef fect on insulin and blood glucose,” Dr. Washington says. “This occurs before any significant weight loss and is notable in both gastric bypass and sleeve gastrectomy.” According to published reports, Dr. Newgard and Dr. Laferrere plan to focus on the ef fect of amino acids in diabetes in their future research and are hopeful that their preliminary findings could even lead to advancements in diabetes treatments. Diabetes remission is just one of several benefits that Rick Sousa has experienced since his surgery. “Always a big kid,” he had reached 330 pounds by the time of his surger y. By December 2012, about four months after the operation, he was down to 237 and sporting extra-large T-shirts instead of the quadruple Xes that had been part of his wardrobe. He can also par ticipate in activities that used to leave him huffing and puffing – like backpacking with his 13-year-old son’s Boy Scout troop. “They don’t have to wait for me anymore,” Sousa says. “I’m usually in front of them. They have to catch up with me. Depending on how good I feel, I have to wait for them once in a while.” FirstHealth of the Carolinas offers two information sessions each month on its weight-loss surgery program. For more information, call (800) 213-3284 or visit www.

Pinehurst Surgical

Pinehurst offers newest in breast implant surgery


r. Russell Stokes, plastic and reconstructive surgeon with Pinehurst Surgical Plastic and Reconstructive Center, is now offering his patients another option in breast augmentation. The FDA approved Sientra® “Gummy Bear” breast implants are known for their highly cohesive gel, as well as their natural shape and look. Until recently, breast implants were only round in shape. The Sientra® implants will offer a variety of sizes and profiles to fit each individual patient. “This advancement in breast implants will offer women more choices in breast profile, proportion and projection,” according to Dr. Stokes. The implants are form stable, which means each implant has a shape, and no matter what position it is in it will retain it’s natural shape. It is made from a highly cohesive soft gel that helps to maintain the natural shape and prevents folds and wrinkles.

Russell B. Stokes M.D., F.A.C.S.

“Another unique feature of the Sientra® implants is that they are only sold to Board Certified Plastic surgeons, which is in the best interest of patients for outcome results and patient safety,” according to Dr. Stokes. The implants can be used for women over the age of 22 for primary and revision augmentation, as well as reconstructive surgery. If you would like more information you may call our office at (910)235-2949 or toll free at (855)294-2639 to schedule a consultation.

Health & Wellness

Saturday, April dategoeshere 20, 2013 /


Central Carolina Hospital

Joint replacement surgery increasingly common


oint replacement surgery involves replacing a damaged joint with a new one called a prosthesis. These new joints usually are made of special metals, such as stainless steel or titanium, and durable, wear-resistance plastic. Prostheses are designed to be accepted by the body and resist corrosion, degradation and wear so they can last at least 10 to 15 years. Hips and knees are the joints replaced most often, but shoulders, fingers, ankles and elbows can be replaced as well. Joint replacement is usually considered after exercise, walking aids, physical therapy or medications cannot relieve pain and improve mobility. Surgery for hip replacement patients, for example, can help lessen problems walking up and down stairs or make it easier to stand from a seated position. Joint damage is caused by osteoarthritis, injuries, other diseases, joint wear caused by years of use, bone tumor or blood loss due to insufficient blood supply. Symptoms of joint problems include pain, stiffness and swelling. Before surgery, the surgeon evaluates the patient’s range of motion and joint strength, takes a medical history and reviews medications currently being taken. Blood tests and X-rays also can be ordered. The doctor may put a small, lighted tube called an arthoscope into the joint to check for damage. In some cases, only the damaged parts would be replaced, not the entire joint. During a hip

replacement surgery, diseased or damaged bone and tissue is removed and a metal stem and attached ball is then inserted into healthy bone and tissue that are left intact. New joints can be cemented into place to hold the new joint to the bone, or the prosthesis can be placed without cement so bone can grow and attach to it. A prosthesis is designed to duplicate the mechanical properties of the joint being replaced. A prosthetic knee, for example, will be flexible

enough to bend without breaking and strong enough to bear weight. Most hip and knee replacement patients are discharged from the hospital three to five days after surgery. Patients will be encouraged to stand and start walking soon after surgery with a walker or crutches. Pain from sore muscles or surgery can be helped with medication and usually disappears in a few weeks or months. Physical therapy exercises will help

regain motion in the joint. More than 90 percent of joint replacement surgeries are successful. However, if problems do arise, most can be treated. Possible complications from joint replacement surgery include infections, blood clots, loosening, dislocation or wear of the new joint, or nerve and blood vessel injury. Hip replacement patients also may experience a change in leg length or joint stiffening. Following hip replacement surgery, most

patients eventually will be able to swim, play golf or bike ride comfortably, but high-impact sports such as basketball and running would not be possible. Joint replacement surgery is becoming more common in the United States, with more than 773,000 Americans having a hip or knee replaced annually. For more information about joint replacement, check with your doctor or call (800)483-6385 for a free referral to a physician near you.

William E. Hall Family Practice

Keep your Springtime allergies from blooming this year


clothes you wore outside that may be covered with pollen. • Shower to remove pollen from your skin and hair. • Do not hang laundr y outside. • Wear a dust mask if you do outside chores. • Check for local pollen forecasts and current pollen levels. If high pollen counts are forecast, start taking allergy medications before your symptoms start. • Close doors and windows at night or any other time when pollen Reduce your exposure counts are high. Use the air conditioning in your to allergy triggers house and car. To reduce your • Avoid spending exposure to anything time outside in the early that may trigger your morning when pollen allergy symptoms, tr y counts are highest. the following: • Use high-efficiency • Stay inside on dr y, air conditioner filters windy days. • Have someone else and follow regular maintenance schedules. handle yard work. • Keep indoor • As soon as you air dr y with a come inside, dehumidifier. remove Use a the portable pring has sprung and with the longer days, warmer nights, and flowers blooming comes the onslaught of seasonal allergies. Millions of people suffer from seasonal allergies. The sneezing, congestion, and runny nose can make life miserable. But before you resign yourself to staying indoors on a gorgeous spring day, tr y these simple strategies to keep seasonal allergies under control.

help ease allergy symptoms include: • Oral antihistamines. Antihistamines such as Benadr yl, Loratadine, Fexofenadine, or Zyrtec can help relieve Try an over-the-counter sneezing, itching, runny nose and water y eyes. remedy • Decongestants. Nonprescription Oral decongestants can medications that can

high-efficiency particulate air (HEPA) filter in your bedroom. • Clean floors often with a vacuum cleaner that has a HEPA filter.

provide temporar y relief from nasal stuffiness. Decongestants also come in nasal sprays. Only use nasal decongestants for short-term relief. Long-term use of decongestant nasal sprays actually can make your symptoms worse.

• NOTE: RSVP is required for this event • Talk individually with the physicians. See before and after examples. • Book 1/2 price cosmetic consultations the night of the event. (All consults are 100% credited to any cosmetic surgeries that are performed.)

When all else fails

If these measures don’t help, contact your primary care physician. There are medications available by prescription. When all else fails, immunotherapy allergy shots) may help. We hope these tips will help you to have a ver y Happy Spring!

Call (910) 235-2949 or 1-855-294-BODY (2639)

5 First Village Drive • Pinehurst

10 / Saturday, dategoeshere April 20, 2013

Health & Wellness




Central Carolina Hospital’s board certified orthopedists are fortunate to have an exciting development in the treatment of early to mid-stage osteoarthritis. MAKOplasty® Robotic Surgery is changing the way our surgeons help patients:

If you experience these symptoms, MAKOplasty® may be right for you: • Pain when weight bearing • Start up pain or stiffness after prolonged sitting or after getting out of bed

• Restore range of motion • Reduce or eliminate joint pain

• A grating sensation or crunching feeling

• Return quickly to the lives they love

in your knee or hip

Contact us to see how MAKOplasty® can help you reach a new level of orthopedic health.


Health & Wellness

Saturday, April dategoeshere 20, 2013 /


Stroke survivor group reaps rewards of yoga By Will Doran

One audience member agreed, saying she learned yoga as a young girl and any had replacement has always used it for pain joints. Most were management, even when she afflicted with aches was battling cancer. Several and pains. All were stroke others volunteered tips and survivors, and all of them personal anecdotes while practiced yoga. Shareff was available to assist A typical group of 15-20 — helping make sure they had people came to the Enrichment the best posture possible. Center for the monthly That type of self-confidence Sanford/Lee County Stroke is exactly what group facilitator Support Group meeting, Joy Phillips Murphy, herself a featuring a special presentation 30-year stroke survivor, said by Raleigh-based yoga she loves to see in the group instructor Howie Shareff. although she never expected Shareff, an energetic former it when she started these dentist in his 50s, taught the meetings in January 2012. Will Doran | The Sanford Herald mostly elderly crowd "chair Stroke survivors, their loved Raleigh-based yoga instructor Howie Shareff (right) bows to memyoga," which he said he took bers of the Sanford/Lee County Stroke Support Group at the Enrich- ones and caregivers are invited up himself several years ago ment Center after teaching them "chair yoga" tips to help improve to the regular gatherings, after having a multitude of which take place on the second posture and breathing. health problems including a Thursday of each month at 1 stroke, arthritis, hip surgery intake, line of sight, alertness, situations like long waits at the p.m. at the Enrichment Center and neck surgery. It can be back pain and core strength. doctor. He also noted that yoga of Lee County done sitting down, and it He also taught the and meditation only require The group is quickly mostly focuses on improved participants how to use long participants to change how approaching another posture and breathing, which breaths and backward counting they act and react. milestone this spring with the he said can improve confidence — key tenets of meditation — "Yoga is not a religion, it's a observance of National Stroke and mood as well as impact to help them fall asleep easier, health practice," he said, also Awareness Month in May physiological factors like blood regain composure under calling it a type of self-preser— a time public education to pressure, nerves, oxygen stress or take their mind off of vation. increase awareness of different



aspects of stroke. "A stroke is a lifelong journey, mild or severe," said Murphy, who had a trauma-induced stroke at the young age of 27 that left her whole left side paralyzed for a time. "You have quite a lot of mental things to deal with, as well as the physical. ... Being with other people going through the same things you're going through really helps. You say, 'They're doing it. I can, too.' It gives you courage." Those wanting more information about the stroke support group can contact the Enrichment Center at (919) 776-0501, ext. 2230. Those wanting more information about Shareff, the book and DVD he made about chair yoga, or the schedule of classes he teaches in North Raleigh, can email him at or call (919) 522-2646. Free instructional videos of his techniques are also posted at howie1055.

harnett Health systems

Osteoarthritis a potentially debilitating ailment


rthritis is a disease that destroys joints, bones, muscles, car tilage and other connective tissues in the body. Osteoarthritis (OA) is one of the most common forms of ar thritis and is a joint disorder where the joint’s car tilage breaks down causing bones to r ub against each other leading to pain, stiffness and loss of movement in the joint. Close to 27 million adults have OA according to the National Arthritis

Foundation. The disease can hinder a person’s quality of life and limit daily activities while also complicating other diseases such as diabetes and heart disease. OA is generally considered a normal result of aging and is common in people of all races and backgrounds. It usually appears after age 45, and overall more women have OA than men. There are many factors that are possible causes of OA: • OA tends to run in families.

• Being over weight increases the risk of OA in the hip, knee, ankle, and foot joints because extra weight causes more wear and tear. • Fractures or other joint injuries can lead to OA later in life. This includes injuries to the cartilage and ligaments in your joints. • Jobs that involve kneeling or squatting for more than an hour a day put you at the highest risk. Jobs that involve lifting, climbing stairs, or walking also put you at risk.

• Playing sports that involve direct impact on the joint (such as football), twisting (such as basketball or soccer), or throwing also increase the risk of arthritis. Medical conditions that can lead to OA include: • Bleeding disorders that cause bleeding in the joint, such as hemophilia. • Disorders that block the blood supply near a joint and lead to avascular necrosis. • Other types of arthritis, such as chronic gout, pseudogout, or

rheumatoid arthritis. Symptoms Pain and stif fness in the joints are the most common symptoms of OA. The pain is often worse after exercise and when you put weight or pressure on the joint. If you have osteoarthritis, your joints probably become stif fer and harder to move over time. You may notice a r ubbing, grating, or crackling sound when you move the joint. The phrase "morning stif fness" refers to the pain and stif fness you

may feel when you first wake up in the morning. Stiffness usually lasts for 30 minutes or less. It is improved by mild activity that "warms up" the joint. Or thopedic surgeons on staff at Harnett Health are accepting patients and ready to talk with you about Osteoarthritis and can perform diagnostic procedures at Central Harnett Hospital in Lillington or Betsy Johnson Hospital in Dunn. Find an orthopedic surgeon with our Physician Finder Tool at www.myharnetthealth. org.


Invites you to visit our friendly office & staff


general surgery...

ALL ABOUT THE specifics When it comes to surgery the term, “General Surgeon” can be a little confusing. It refers to an expertise in a number of areas including the abdominal organs as well as breasts and certain skin disorders. At CCH we have a team of General Surgeons ready to help.

• Adult & Pediatric Dermatology • Diagnosis & Treatment Of Moles & Skin Cancer • Spider Veins

from left to right: Roger Ernest, DO; Michael Gordon, MD; Steven Jurisich, MD

Diseases & Surgery Of The Skin, Hair & Nails SERVING LEE COUNTY FOR 30 YRS.

John D Cheesborough, MD • Tiffany J. Mills, PA-C Molly E. Roberts, PA-C Three full time providers. RENOVATIONS ARE COMPLETE. COME BY AND SEE OUR NEW OFFICE! New Patients welcome!

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919-542-2731 919-775-7926

827 S. Horner Boulevard Old Graham Road Sanford Pittsboro

100 S 10th Street Lillington


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Health & Wellness

Bobbyker Wal

I chose Central Carolina Hospital for my cardiovascular health

Bud Marchant

I chose Central Carolina Hospital for my health


John Sauls I chose Central Carolina Hospital for surgical services

Margaret Murchison I chose Central Carolina Hospital for emergency services

Choose us for your health, too:

800-483-6385 or

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