By Jackie Medland President/CNO, Highlands-Cashiers Hospital
Like the explosion of green we’re seeing on the Plateau with the advent of spring (finally!), Highlands-Cashiers Hospital (HCH) is similarly poised to “blossom” again soon, in exciting ways. No one would deny that we’re living in a time of constant change for the healthcare industry – and I’m grateful that at HCH, we remain successful and continue to serve our patients’ needs through it all.
First, we’ve recently expanded our Cashiers Clinic’s hours in response to the needs of our community. On May 1st, the clinic’s hours of service changed to 7am-7pm, Monday through Friday. Saturday hours will be expanded to 9am-4pm, starting sometime in June. These newly expanded hours mean that community members can get care whenever a health issue arises, like when your child develops a fever overnight, or when a hiker unexpectedly sprains her ankle. Primary care remains the anchor of our practices, with Thomas Lindsay, MD; Thomas Duncan, MD; Rebecca Baker, FNP; and Richard Wayne, PA seeing patients throughout the week.
Change is springing forth in Highlands as well. We’ve welcomed two new primary care providers: Margaret Wadsworth, MD, who focuses her practice on the holistic care of adults, and Robyn Restrepo, MD, who has a special interest in women’s and children’s health. As an added bonus, Dr. Restrepo is fluent in Spanish. The Highlands community will also see their specialty services – both established and new – grow and change. Different specialists will be available to our community at least weekly. For example, massage therapy has recently launched on Mondays, Urology services will start every other week on Tuesdays in July, Cardiology will continue on Wednesdays, and we are hopeful that Gynecology services will return to the Plateau in the fall. To access an updated specialty services calendar at any time, call 828-526-2371.
When I’m out in the community, I consistently hear praise for our rehabilitation therapy program. The good news is that now we’re making it even better. We’re adopting an innovative program for patients suffering from Parkinson’s Disease called Big and Loud. Through it, patients receive BIG therapy, which teaches them to make the bigger movements necessary to move effectively as they perform everyday tasks, while LOUD helps them stimulate their voice box muscles for improved vocalization. The program will help Parkinson’s patients with the physical and social challenges that accompany the disease.
To learn more, plan to attend one of the two Town Hall meetings we’ll host later this month, where I’ll share more news:
Highlands’ session – Tuesday, May 29th from 12-1pm at the Jane Woodruff Clinic, Room 103,
Cashiers’ session – Wednesday, May 30th, from 5-6pm at Cashiers Recreational Park.
New services and expanded specialty care reflect our listening to your needs and our relentless desire to make our community stronger and healthier.
For more information on Highlands-Cashiers Hospital, visit hchospital.org.
By Mary Lindsey Jackson Clinical Nutritionist Educator
“Mushroom Gravy Chicken over Couscous with Lemony Arugula”; “Roasted Chickpea and Freekeh Salad with Lemon Labneh and Harissa-Glazed Carrots” – dishes from an exotic downtown restaurant, or meals that you could make easily in the comfort of your own home with the help of a meal-subscription service?
Meal delivery services such as Blue Apron and Hello Fresh have been on the rise in recent years, and are bringing both a convenience and a gourmet aspect to home-cooked meals. Most of these popular services work by sending refrigerated “meal kits” each week. These kits include the ingredients and detailed recipes for 2-4 meals each week, many with options for single, dual or multi-person households.
Most meals take 20 minutes to 45 minutes to prepare. Many companies offer heavily discounted prices for the first week or two of trying the service, which can provide an affordable option to test out the quality and value of the meals before committing. After any initial discounted weeks, costs can vary between companies but most average $9-$15 per portion (translating to $60-$90 weekly). This may be considered expensive compared to purchasing all ingredients at the store, although some would argue that it is still cheaper than going out to most restaurants for a dinner for two.
One of the main benefits of using these services is the assistance with meal planning. Outsourcing this task decreases the stress of searching for recipes every week, and can also cut down on time spent grocery shopping. Using a meal-subscription service also offers the opportunity to try a variety of cuisines or ingredients that one may not have explored otherwise, without having to purchase bottles of exotic spices or an entire bunch of herbs.
From a nutrition standpoint, offerings can vary widely. Many meals average 500-800 calories, which may provide excessive calories for a single meal depending on an individual’s needs or health goals.
However, one could cut down on oils while cooking, reduce high-calorie condiments included or split the portion in half and add more vegetables to lower overall caloric density. Different companies also cater to a variety of food preferences or dietary needs.
For example, Purple Carrot offers solely plant-based meals; Green Chef has options for vegetarian, paleo, gluten-free or vegan meals; Blue Apron and others use responsibly sourced meat and seafood; Sunbasket offers “Lean & Clean” meals that provide less than 550 calories per serving and “Mediterranean” meals for a heart-healthy diet. Almost all meals contain vegetables either incorporated into the dish or as a side, and many include whole grains or legumes.
While these meals can be a fun incentive to get back into the kitchen and reduce barriers to cooking more frequently at home, stay mindful to choose meals that incorporate lean proteins, vegetables, fruit, healthy fats and whole grains, and modify recipes as needed. Consider choosing a company that offers a variety of menus like those mentioned above; this allows for more customization of recipes depending on health goals.
Mary Lindsey Jackson, RD, LDN, is a Clinical Nutritionist Educator for Mission Weight Management.
To learn more about Mission Weight Management or to sign up for a free information session, call (828) 213-4100 or visit missionweight.org.
While angina, murmurs and heart attacks are widespread, sadly, confusion about their meanings is also common. Let’s take a closer look at six misunderstood terms.
“Since the internet can be overwhelming, your doctor is your best resource,” said Sarah Ciccotto, MD, cardiologist at Asheville Cardiology Associates, an affiliate of Mission Health.
Angina– This term refers to any heart-related symptoms including chest pressure, chest or arm pain, or shortness of breath. “Stable” angina is predictable and treated with nitroglycerin. When symptoms increase or happen with less activity, angina is “unstable” and deserves a call to your doctor.
Heart murmur – The swooshing sound of blood flowing through the heart is known as a heart murmur. Often discovered using a stethoscope, a heart murmur can be normal or it can signal something more. An echocardiogram test can reveal new information.
Heart failure – This term refers to when your heart either doesn’t pump or relax well enough to meet the body’s oxygen demands. Common symptoms are shortness of breath, and leg and ankle swelling. Symptoms can be managed and improve greatly with medicine and dietary changes.
Heart attack – A heart attack is an emergency when the heart muscle is starved of oxygen. A blocked artery prevents oxygen-rich blood from reaching the heart and causes permanent damage. “Since every minute counts, call 911, if you think you’re having a heart attack,” said Dr. Ciccotto.
Echocardiogram (echo) – An echocardiogram (echo) uses sound waves to create pictures of your heart and valves. These images provide your doctors more information about your heart and most often can be done in your doctor’s office.
Stent – A stent is a small metal scaffold inserted into an artery to prop it open and restore blood flow through blocked vessels.
“It’s important to help patients understand what’s happening with their bodies. Often I can relieve their concerns by simply answering questions,” said Dr. Ciccotto.
Sarah Ciccotto, MD, is cardiologist at Asheville Cardiology Associates, an affiliate of Mission Health.
Health clubs, gyms and organic grocery stores sell them. Exercise infomercials promote them. Smoothie detoxes and cleanses are all over Pinterest. So what’s the truth about smoothies and their impact on weight loss?
If you’re not careful, smoothies can actually promote weight gain rather than weight loss. In order to be an effective part of your weight-loss plan, you’ll need to pay careful attention to ingredient selection, portions and strategic placement of smoothies into your daily meal structure.
Avoid these ingredients
Calorie-dense ingredients to use cautiously or avoid include: nut/seed butters, plant oils like coconut or hemp oil, avocado, fruit juices, agave nectar, coconut milk, coconut water, flavored syrups, sherbet, frozen yogurt, granola and honey. These ingredients can turn a 150-200 calorie shake into a 400-500 calorie shake.
It’s also important to be mindful about portion sizes. Liquid calories can be easier to overconsume than solid food calories. Liquid meals empty more rapidly out of the stomach than solid meals, and larger volumes of liquid calories empty faster compared with smaller volumes. Avoid the 44-ounce smoothie – it could be your entire days’ worth of calories, but leave you hungry again within 1-2 hours!
Retail smoothie stores
Two popular smoothie chains, Planet Smoothie and Smoothie King, sell a wide variety of options. Review the nutritional information on their websites to make an advanced informed choice. For example, at Smoothie King, the 20-ounce Hulk Strawberry smoothie contains 910 calories, 27 grams of fat and 127 grams of sugar compared to the 20-ounce Slim-N-Trim Strawberry smoothie, which contains 240 calories, 2 grams of fat and 38 grams of sugar. The former won’t help you reach your weight-loss goals, while the latter is a healthier choice.
Some local specialty/nonchain smoothie or juice cafes do not publish their nutritional information, so it can be difficult to know what you are actually getting. Similarly to cooking at home versus eating out at restaurants, making your own smoothies can be a great way to control calories and nutrition.
Replace a meal, not a drink
To avoid weight gain, a smoothie should replace a meal or snack, not a beverage. A smoothie prepared with quality ingredients – healthy high-fiber carbohydrates like berries and leafy greens, a lean protein source like fat-free Greek yogurt or silken tofu, and a healthy fat source like a teaspoon of chia or flax seed – can support weight loss when used to replace a skipped meal or high-calorie meal.
Rachel Wyman, RD, is a Clinical Nutrition Educator at Mission Weight Management.
To learn more about Mission Weight Management and to sign up for a free information session, call (828) 213-4100 or visit missionweight.org.
Mission Hospital has served our community for more than 130 years. The new Mission Hospital for Advanced Medicine will provide care for our friends, families and neighbors for many more. Every year, decade and century, there are different people carrying on our legacy and fulfilling our mission.
Mark your legacy by signing the steel beams that will be placed on top of the new tower this summer.
Sign It and Leave Your Mark
From the first patient carried to Mission Hospital in 1885 to patients brought in by MAMA today, Mission Health continues to make medical advances as our community grows and its health needs change. By signing the steel beam or writing a dedication to a loved one, you will leave your mark as a part of our community that’s building healthcare for our future.
Don’t Wait – Now through June 28
There will be two steel beams to sign – one in each Mission Hospital campus main lobby – until the Topping Out Ceremony on June 28. All from the community are invited to sign them. The beams will be ceremonially placed at the top of the new hospital tower this summer.
Opening for Care Summer 2019
The Mission Hospital for Advanced Medicine will transform the way Mission Health cares for our patients from 21st-century technology and integrated care areas to a larger emergency department centered on patient care. This new hospital is a promise for a brighter future and a better experience for patients, families, team members and the community.
By Beverly Hopps Health Educator, Safe Kids WNC/Mission Children’s Hospital
Riding bikes is a classic kids’ pastime, and it can be lots of fun for children of all ages. But unfortunately, accidents can happen.
Some bicycle injuries are so serious that children can die, usually from head injuries. That’s one of the reasons the U.S. government and safety experts recommend wearing a helmet every time you ride a bike, even if it’s just a short ride.
Still, wearing a helmet isn’t enough. Wearing the wrong helmet or not properly fitting a helmet may not offer all the protection a helmet should provide. Below are some safety tips to ensure your child is properly protected from head injuries while riding their bike.
Bicycle helmet tips:
It should be worn level and cover your forehead.
Don’t tip it back so your forehead is showing.
The straps should always be fastened. If the straps are flying, it’s likely to fall off your head when you need it most.
Make sure the straps are adjusted so they’re snug enough that you can’t pull or twist the helmet around on your head.
Don’t throw the helmet around. That could damage the helmet, and it won’t protect you as well when you really need it.
If you do fall down and your helmet is hit, get a new one. They don’t work as well after a major crash.
Beverly Hopps is a Safe Kids Educator at Mission Children’s Hospital.
For more information or to bring your child and helmet in to have it checked out, call Safe Kids WNC at Mission Children’s Hospital at (828) 213-5548. Visit missionchildrens.org/safekids to learn more.
By Carol Wolfenbarger President, Mission Hospital McDowell
I’m delighted that moving to our new “home” – Mission Hospital McDowell (MHM) – comes at a time when we were preparing to celebrate our nurses and our hospital. May 6-12 was both National Nurses Week and National Hospital Week. As we work amidst change and help our patients and families learn their way around our new facility, I encourage everyone in our community to reflect on the significant role that health care team members play in creating a healing environment for our patients. At the same time, I want to recognize the varied and challenging work that our nurses perform in every level of healthcare, from bedside to boardroom.
Before I talk further about those we’re recognizing this month, I have some facility news to share. We’re making great strides with the demolition of our former facility, and project debris is quickly being hauled away. This will make way for the creation of our new and far more conveniently-situated parking area. We appreciate your patience as you use the temporary parking area. As you do so, please know that we offer shuttle service from the parking area to the hospital for your convenience, and volunteers and staff remain ready to help with any wayfinding needs.
Healthcare has changed dramatically over the last several decades, but nurses remain pivotal to patient safety and hospital success. A 2010 study of nursing entitled The Future of Nursing: Leading Change, Advancing Health was published through a partnership between the Institute of Medicine and the Robert Wood Johnson Foundation. It analyzed nurses’ work in a rapidly transforming healthcare industry. The report’s recommendations touched upon nursing education, increasing diversity in the field, addressing the nursing shortage, and ensuring that nurses are present at every level in healthcare – from providing patient care and serving in administration to shaping public policy. MHM employs a total of 125 RNs, 23 of whom are specialty-certified in areas such as medical-surgical, operating room, and emergency nursing. They’re also highly trained: 25 percent earned Bachelor of Science degrees, while 6 percent are Masters-prepared.
I see our RNs juggle clinical responsibilities, work in teams to make the best decisions for their patients, and compassionately deliver world-class care every day. I couldn’t be prouder. Nurses also serve in important leadership positions throughout Mission Health as well. I and all my fellow member hospital Presidents are all RNs by background, and it’s that special calling that continues to guide our work. We’re happy to celebrate National Nurses Week by highlighting the many roles our nurses play in patient care.
That said, no one in healthcare works in isolation. Every team member, from our dietary services staff to our physicians and nurse practitioners to members of our housekeeping staff, ensures that our patients receive extraordinary care that’s not just clinically excellent, but delivered with warmth and soul. Our community members serve our patients, and are our patients. Each positive patient experience at MHM results from the joint efforts of our phenomenal team members: volunteers, facilities staff, laboratory staff, therapists, imaging staff, administrators, and many more – we applaud the entire care team during National Hospital Week.
I’m humbled daily as I walk through MHM and watch our extraordinary professionals in action. Our outstanding team members prove that the most advanced technology and up-to-the-minute clinical knowledge go from “good” to “great” when accompanied by a warm smile, a gentle touch, and a listening ear.
Carol Wolfenbarger, MSN, RN, FACHE, is President of Mission Hospital McDowell. She holds both Bachelors and Masters of Science degrees in nursing administration from the University of Tennessee, is board certified in Healthcare Management and is a Fellow of the American College of Healthcare Executives (ACHE). Carol, who has served hospitals and health systems for more than three decades, has worked to add full-time cardiology services, led growth in outpatient services including imaging and surgery, and the expansion of primary care offering in Burke County since assuming her role as President at McDowell Hospital in 2015. She is an active member in Rotary and serves as a Board member for the Rutherford/Polk/McDowell Health District Board of Directors, the Corpening YMCA Board of Directors, and the McDowell County Chamber of Commerce Board of Directors.
By Becky Carter President and CNO, Blue Ridge Regional Hospital
May 6-12 was National Nurses week. I’m profoundly grateful for the nurses at Blue Ridge Regional Hospital, and I know you are too. It’s hard to find someone whose life hasn’t been positively touched by a nurse, and often, special bonds develop between patients and their nurses. As the largest group of licensed providers at BRRH, nurses play a key role in all aspects of care.
As I reflect on the influence of nurses at BRRH, I’m impressed by how engaged they are in our efforts toward quality, safety, and service. Their excellent work led us to apply for the Pathways to Excellence (PTE) designation. Created by the American Nurses Credentialing Center, hospitals that attain this designation are recognized as great places where nurses can work and grow. In turn, institutions that can attract and retain nurses have been shown to be safer, and have more satisfied patients. PTE hospitals support equitable pay for nurses and offer educational opportunities and professional development programs to nursing staff. They also have great nursing leadership, and acknowledge and appreciate nurses’ work. We’re the first Mission Health member hospital to apply for this designation. BRRH nurses are leading the way in this system goal.
The importance of nursing was highlighted prominently in 2010, when a partnership between the Institute of Medicine and the Robert Wood Johnson Foundation published the Future of Nursing Report. Its recommendations included increasing diversity, elevating educational goals for nurses, and ensuring that nurses are present in every level of healthcare. Nurses are key to transforming healthcare, and in addition to their work at the bedside, nurses must also influence care delivery by working as administrators and policy makers.
Research has repeatedly demonstrated that patient outcomes are improved when a nursing staff has a high percentage of bachelor’s degree-prepared nurses. BRRH has the highest percentage of bachelor’s degree-prepared nurses in the Mission system. Our nurses attribute this to the leadership of educators in the Mayland Community College Nursing Associate’s Degree program. The Mayland faculty maintains a strong relationship with the Lees-McCrae College Nursing Program. They emphasize, from application to graduation, that nurses must continue their education by adding a bachelor’s degree as early in their careers as possible.
Across Mission Health System, every hospital President is a nurse, which isn’t a coincidence. The nursing background shapes us throughout our careers, even when we move on to administrative roles. I’m excited to see the many roles for nurses locally, from bedside nurses who work one-on-one with patients and surgical nurses who care for patients in a way they may never remember, to clinic nurses who focus on health, wellness and prevention. Our nurses are also managers, educators, and quality and safety experts.
Everyone at BRRH values our corps of talented nurses, and we’ll continue to wholeheartedly support initiatives that support the education of nurses.
Rebecca W. Carter, MSN, RN, FACHE is President and Chief Nursing Officer of Blue Ridge Regional Hospital in Spruce Pine. Carter has served in senior hospital management for over 20 years and previously served as Chief Operating Officer and Chief Nursing Officer of Transylvania Regional Hospital in Brevard, also a part of the Mission Health system.
Ms. Carter is board certified in healthcare management and is a Fellow of the American College of Healthcare Executives (FACHE). A native of North Carolina, she holds undergraduate and graduate degrees in nursing from the University of North Carolina at Chapel Hill. Ms. Carter is currently a resident of Burnsville.
For more information on Blue Ridge Regional Hospital, visit brrhospital.org.
We’ve all heard warnings about acetaminophen’s impact on your liver, or how ibuprofen can lead to ulcers. So which one is truly your best option if you need relief from a headache, or joint or muscle pain?
Both are fine, as long as…
Either acetaminophen or ibuprofen are reasonably safe options, as long as you stay within the recommended dosage on the labels. Also, both of these over-the-counter options are equally effective, assuming you’re using them for short-term pain relief.
However, when your pain lasts long enough that you need a second dose, there are small studies suggesting in either direction as to whether alternating one and then the other is more effective.
Cautions and concerns
There are some cautions and dose limitations for both drugs. Concerns about overdosing have caused the FDA to reduce the maximum daily dose of acetaminophen from 4,000 mg/day (equal to 8 extra-strength doses) to 3,000 mg/day (6 extra-strength doses). This is to reduce the risk of acute liver failure.
For ibuprofen, the maximum dose is 6 tablets in 24 hours for a healthy adult that is not taking any blood thinners. Because of possible stomach irritation, ibuprofen should be taken with food or milk and should be avoided altogether if you have an active GI tract ulceration.
When you have a surgery, there is a suggestion in studies that ibuprofen may be more effective than acetaminophen as a premedication for tooth extraction, migraine or earache.
Is one quicker than the other?
The goal of any over-the-counter pain medication is to achieve analgesia – which simply means relief of your pain. For ibuprofen, analgesia typically takes effect within 30 to 60 minutes. With acetaminophen, you can expect to feel the effects in as little as 11 minutes.
The bottom line
When in need of pain relief, either of these over-the-counter choices are safe for short-term use if you are an otherwise healthy adult and you follow the recommendations for usage. However, if you’re ever in doubt, you should contact your pharmacist to discuss your best option based on your specific scenario. I know I always welcome calls from our patients. Whether the question is about prescriptions or over-the-counter products, your pharmacist has answers and will help you decide when it comes to medications.
Ben Lamm, PharmD, practices at the Mission Pharmacy – Lake Toxaway, a service of Transylvania Regional Hospital & Mission Health.
By Michele Pilon President/CNO, Transylvania Regional Hospital
There is a lot to celebrate at Transylvania Regional Hospital (TRH) this month. May 6-12 was National Hospital Week and National Nurses Week, and we hosted an array of appreciation events that highlight the essential work every team member provides that makes our patient care truly extraordinary.
Care teams create the patient experience, but I believe – because I witness it every day at TRH – that each and every person who touches a patient contributes to their healing. Our care teams tend to our patients’ medical and emotional needs, as well as those of their loved ones; think about the nurse who administers pre-surgery medication to a patient to calm them or the nurse who offers supportive words or a hug to a terminally ill patient’s loved ones.
But it’s also true that a patient’s hospital experience is impacted by team members who may never come into direct contact with them: the computer technology staff, the chef, our facilities staff or a housekeeping staff member, for example – yet without question they make the patient’s hospital stay safer and more comfortable. As just a few examples, pharmacists impact patient safety tremendously, the front desk volunteer is the first face a patient encounters when entering TRH, and a volunteer or nurse may be the person who wheels the patient out as they prepare to return home.
I started my career as a bedside nurse, and the care I provided was only as good as my other hospital team members – laboratory, facility management, dietary services staff, nursing assistants, housekeepers, care managers, social workers, physicians, advanced practitioners and many others – who complemented and supported my patients and me. Beyond my personal experience, our own patients’ comments clearly illustrate how powerful and impactful team collaboration is:
“The PA explained to me what tests were going to be given and what I was to expect. The dietician stopped in to make sure everyone was taking care of my food allergies. The nurses and CNA were so helpful and kind, so I felt safe. Everyone who encountered me during different tests was friendly and supportive. I felt the professionalism and human kindness wherever I was.”
“I was impressed that all, from the housekeeping staff to the charge nurses, felt that they were truly an integral part of my recovery.”
“From my first encounter with the receptionist to the final volunteer who wheeled me to the parking lot after surgery, I thought your entire staff was exemplary. Everyone I interacted with: receptionists, attendants, nurses, doctors, and volunteers all wore smiles, were encouraging and supportive, and made me feel like I was visiting a special place.”
“…received outstanding care from everyone involved – doctors, PAs, nurses, aides, local EMTs, discharge specialists, clerks and anybody else we had any dealings with….All of these folks were devoted….It was not just a job for them. It was truly a mission.”
Since my very first days as a teenaged candy striper, I knew that hospital work was for me; I never wanted to work anywhere else. I know everyone at TRH feels equally dedicated to our patients. The passion within each of our healthcare team members is visible every day throughout our halls. Thank you to our TRH “village” for providing our patients with the most advanced, yet heart-filled care possible.
Michele Pilon, MS, BSN, RN, NE-BC, is the President and CNO of Transylvania Regional Hospital. Her diverse professional experience includes service as a bedside nurse and over a decade as a leader at healthcare institutions in Virginia, Florida, and North Carolina. Ms. Pilon earned a Bachelor’s in Nursing from Ohio’s University of Akron and a Masters in Health Services Administration from the University of St. Francis in Illinois; she is also a Board-Certified Nursing Executive.
For more information on Transylvania Regional Hospital, visit trhospital.org.