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Bad news for those of us who love spending summer days lazing in the grass: The number of people getting diseases transmitted by mosquito, tick and flea bites has more than tripled in the United States from 2004 to 2016. Those critters cause what are called “vector-borne diseases”—the bug is the vector spreading the germ—including dengue virus, West Nile virus, malaria, Lyme disease, Zika virus, Rocky Mountain spotted fever and plague. Yikes.

The problem is growing in part because of our more interconnected world, the CDC says, as international trade moves goods, and bugs along for the ride, from place to place and infected travelers spread germs. Warmer weather also amplifies the threat.

So what are you supposed to do about it? No, you don’t have to stay inside. Just take some precautions to lower your risk.

Here are some recommendations, compiled from the CDC and an interview David Weber, MD, MPH gave to The New York Times. Dr. Weber is medical director of UNC Hospitals’ Departments of Hospital Epidemiology and Occupational Health Services and an infectious diseases expert.

1. Wear an EPA-approved insect repellent whenever you’re outside.

Make sure your kids are covered, too, with a few caveats: babies younger than 2 months shouldn’t wear any insect repellent, and children under 3 years old shouldn’t use products containing oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD). Read labels carefully to make sure your repellent is effective against both mosquitoes and ticks.

2. Cover your skin, especially if you’re going to be in the woods or outdoors for a long period of time.

That means long sleeves, long pants and closed shoes with socks. You can even tuck your pants into your socks for added protection. You can also buy clothes that has been pre-treated with an insecticide called permethrin, or you can treat the clothes yourself.

3. Avoid tall grassy fields, where ticks live.

“Ticks don’t fly and they don’t jump,” Dr. Weber told The Times. “They live on grasses, and when a human goes by, they leave the grass and attach themselves to the human.”

4. After you come inside, check for ticks on yourself, your kids and your pets.

The CDC has instructions on how to safely remove a tick. Make sure to give your pets their flea and tick medicine as recommended.

Dr. Weber offered this advice: “Do a full body check by looking in a mirror, and check hidden spots: behind the knees, the waist area, the bellybutton. That’s where they like to hide.”

5. Minimize entry points.

Check your screens on windows and doors for small holes that bugs could enter through, and don’t leave doors and windows open without a screen. Dump out standing water that may collect in your yard in planters, toys, birdbaths or trash containers—that’s where mosquitoes lay eggs. If you have air-conditioning, use it.

Talk to a doctor about summer health. Find one here.

Click to find more articles like this at UNC Health Talk.

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Having a woman’s body is wonderful—but it isn’t easy. As women grow and age, it’s important to be aware of health issues and risks that are unique to women.

So much changes over a lifetime, from adolescence to the childbearing years, to menopause and beyond. Women start, and then stop, menstruating. They navigate pregnancy and childbirth and the joys and challenges of having children—or not. They may struggle with sexually transmitted infections, infertility, postpartum depression or pelvic floor disorders. Along the way, women must consider their risks for cancer and know when to be screened.

Need an OB-GYN? Find one near you.

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After a long winter, we’re all ready for these warmer, sunnier days. Whether it’s on the beach, at a lake or in your own backyard, plans for soaking up some rays should include sunscreen.

Turns out there’s more to the white goop than you think—ingredients, SPF ratings and application instructions matter when picking out your protection. We took our questions about sunblock to Megan Evans, MD, a fellow in the Department of Dermatology at the UNC School of Medicine. Here are her answers.

What are some common ingredients in sunscreen and how do they work?

Most sunscreens contain multiple active ingredients to protect against both kinds of harmful ultraviolet rays—UVA and UVB. Those ingredients fall into two main categories: physical blockers and chemical absorbers. The common physical blockers are titanium dioxide and zinc oxide. They create a physical barrier between the skin and UV rays. Examples of chemical absorbers include oxybenzone, avobenzone, homosalate, and octinoxate. These absorbers do just that—absorb UV rays so that our skin doesn’t absorb them. Aside from the active ingredients, sunscreens contain many additional inactive ingredients. These may vary based on the brand and type of sunscreen, as in baby vs. sport, and may include antioxidants, vitamins, such as vitamin E, preservatives, fragrances and emollients.

What’s the difference between UVA and UVB rays?

UVA and UVB rays are both types of ultraviolet rays from the sun that reach the earth’s surface. While UVB rays do not penetrate quite as deeply as UVA rays, they cause sunburn and also play the biggest role in causing skin cancer. UVA rays also contribute to the formation of skin cancer, but their penetration into the deeper portions of the skin also leads to premature aging and wrinkling of the skin. UVA rays make up 95 percent of the UV rays that reach the earth’s surface.

What do different SPF ratings mean?

The SPF (sun protection factor) listed for a particular sunscreen reflects the degree of protection against UVB rays. Dermatologists generally recommend using a sunscreen with an SPF of at least 30, which correlates to protection against 97 percent of the sun’s UVB rays. Ultrahigh ratings of 100 or above actually aren’t that much more protective than an SPF 50, which blocks 98 percent of UVB rays. To make sure you’re using a sunscreen that offers sufficient protection against UVB and UVA rays, you should look for the term “broad-spectrum.”

How and when should I apply sunscreen?

Your first application of sunscreen should happen about 15 minutes before you go outside, and it should always be applied to dry skin. All areas of skin not covered by clothing should have sunscreen on them. Sunscreen should be reapplied every two hours, or more often if you’re swimming or sweating. To get the full protection of your sunscreen’s SPF, you need to apply it generously. Most people only apply about 25 to 50 percent of the recommended amount of sunscreen, which is one ounce (or one shot glass) of sunscreen with each application.

Do I need to pay attention to the expiration date?

Many, but not all, sunscreens have a listed expiration date. The FDA requires all sunscreens to maintain their protection for at least three years. If your sunscreen has either passed the listed expiration date or is over three years old, you should not use it. Also, do not use your sunscreen if the color or consistency has changed.

Are there chemicals or certain ingredients to avoid in my sunscreen?

I recommend avoiding sunscreens that also contain insect repellents, as sunscreen should be applied more often and more generously than insect repellent.

Should people with certain skin tones use more or less sunscreen?

It’s recommended that all people, regardless of skin color, use sunscreen. Skin cancer can develop even in people with darker skin types. Though some people are more prone to sunburns than others, sun damage occurs even in the absence of sunburn. That means even someone who never gets sunburned should still wear sunscreen.

Is sunscreen enough protection from the sun on its own?

No. Even the highest SPF sunscreens don’t protect against 100 percent of the sun’s harmful rays. In addition to sunscreen, I recommend sunglasses, wide-brimmed hats, protective clothing and seeking shade when possible. Also, keep in mind that sitting under a canopy doesn’t offer enough protection because the sun’s rays reflect easily off the sand and water.

Are there instances in which I should use sunscreen differently?

You may prefer to use a facial moisturizer containing SPF for the face, but make sure you follow the same application guidelines we discussed: SPF 30 or higher and reapply every two hours.  Also, many people often forget to protect their lips. Lip balms containing SPF are a good idea, as skin cancer can develop on the lips, too. Never use spray sunscreens on the face, as you should avoid inhaling the chemicals. Finally, you should avoid sunscreen on your infant’s skin until he or she is 6 months old. If your infant is younger than that and must be out in the sun, use protective clothing and shade to protect him or her.

Click to find more articles like this at UNC Health Talk.

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The thank-you came in the form of an email.

An outpatient who was the sole caregiver for his wife came to the hospital for two six-week stints to receive antibiotics through an IV. And while he was being treated, the nurses and CNAs on the floor took turns caring for his wife, who had late-stage Alzheimer’s.

“Every nurse treated me like family,” he wrote. “They truly made me feel special. I’m also grateful for how they treated my wife. They looked out for her as much as they did me. Please tell them how awesome they are! ”

It’s among the many uplifting stories that arrive weekly in cards and letters, and captured in phone calls by surveyors. All are treasured, sometimes posted on bulletin boards, and oftentimes read aloud at the start of meetings throughout the hospital.

Why are they important?

They show that Johnston Health is committed to putting patients and families first, says Amber Stanley, who is the patient experience specialist for Johnston Health. “We work with our heads, hands and our hearts.”

And the results speak for themselves.

In May, Johnston Health received the Healthgrades 2018 Outstanding Patient Experience Award, placing the hospital among the top 15 percent in the nation.

In April, Johnston Health earned its third consecutive “A” safety grade from the Leapfrog Group, a national nonprofit. The rating highlights the health care system’s commitment to reducing errors, infections and accidents that can harm patients.

In March, Johnston Health made Business North Carolina’s top 25 list for hospitals in the state. The magazine looks at information provided by CMS, including patient-satisfaction surveys, infection rates, and readmission and death rates for common conditions and procedures.

Chuck Elliott, CEO and president of Johnston Health, says every employee, volunteer and physician play a vital role in quality and the patient experience. “These awards truly reflect their hard work, dedication and commitment,” he adds. “I’m so proud of what they do every day to give our patients and families the best possible care and treatment.”

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Pop quiz, just for men: What’s your doctor’s name?

Wait, you do have a doctor, right?

Too many men don’t have a family physician and don’t get regular checkups, says Culley Carson, MD, a urologist with UNC Medical Center in Chapel Hill. This problem is especially bad among younger men, he says.

Between ages 18 and 30, healthy men should see a doctor every two to three years. Men 30 and older should go annually.

“The majority [of men] don’t [see a physician] until they get sick or have some significant problem in their 40s, 50s or 60s,” he says. “To some extent, there’s a denial of their need for physicians. That’s part of the problem—a macho feeling that there’s nothing a physician can do for you.”

On the contrary, well-patient visits are critical to a healthy life, mostly because they are a chance to catch health issues early.

For example, discovering hypertension in your 30s or 40s might allow your doctor to intervene and decrease the chances of sudden death or cardiac issues later.

“Even if you’re not sick, if you’re a male in your 30s or 40s, you absolutely should have annual visits,” Dr. Carson says.

With health, many things are connected. Issues such as sleep apnea and erectile dysfunction can signal a high risk of future cardiac problems. If you experience these conditions, you should tell your doctor during a regular checkup. Heart disease is the leading cause of death for both men and women in the U.S. In fact, 1 in 4 people die of heart disease every year.

The primary reasons for having checkups change as you get older. Even when you’re under 18 and seeing a pediatrician, well-patient visits can help doctors assess things like early onset diabetes, risk-taking behavior and substance abuse.

These issues never become irrelevant for men. “Men are much more likely to die from accidents resulting from risk-taking behavior than women,” Dr. Carson says. “Men are much more likely to die from suicide, for example, although women are more likely to try it.”

So what are the key health issues men should address at different ages? Use this timeline as a guide.

All Ages
  • During regular checkups, your doctor will evaluate you for:
  • Heart and vascular health (including checking your blood pressure, cholesterol and family history of heart disease)
  • Risk-taking behavior
  • Substance abuse
  • Depression
  • Weight issues
  • Your doctor may also recommend routine vaccines, including:
  • Tetanus and diphtheria booster
  • Shingles vaccine
  • Pneumonia vaccine
  • Flu shot
Your 20s
  • Talk to your doctor about how to start managing your weight, heart health and stress now, while you’re young.
  • Get screened for sexually transmitted infections.
Your 30s
  • Your doctor will become more concerned with your cardiovascular risk factors; now is the time to make lifestyle choices to set yourself up for a healthy middle age.
  • Many people are raising families and dealing with hectic careers in their 30s. Be sure to talk to your doctor if you feel overwhelmed with stress; he or she can refer you to a therapist or prescribe medication.
Your 40s
  • Your cardiovascular risk factors are now more important than ever to check: blood pressure, cholesterol and smoking.
  • If you’re an African-American man or have a close relative who has had colon cancer, talk to your doctor about a colonoscopy. If your doctor thinks your risk is heightened, he or she may have you begin screening at age 40 or 45.
  • This is the time when erectile dysfunction can start. Make sure to tell your doctor, because early erectile dysfunction is associated with an increased risk of heart issues. It can be treated, and there’s no reason to be embarrassed.
Your 50s and 60s
  • At this stage of life, your risk factors for disease—especially heart disease and cancer—continue to rise. Keep getting your blood pressure and cholesterol checked, and ask your doctor about prostate cancer screening.
  • Get screened for colon cancer, regardless of your family history. If you’re at average risk, get your first colonoscopy at age 50 and repeat every 10 years.
  • If you smoke or have smoked, talk to your doctor about lung cancer screening. Lung cancer is the leading cause of cancer death among men (and women).
  • Erectile dysfunction is more common in your 50s and 60s. Let your doctor know if you’re having a problem; it can be treated.
  • Get screened for diabetes.
  • Have your weight assessed, and ask about weight control methods.
Your 70s and Beyond
  • Continue to be screened for diabetes.
  • Have your weight assessed, and inquire about weight control methods.
  • Talk to your doctor about whether to continue screening for colon and prostate cancers.
  • If you’re interested, talk to your doctor about sexuality and how to maintain intimacy during the aging process.
  • Bring a list of your prescriptions and doses, or the prescription bottles themselves, to each appointment. This will help your doctor assess any drug interactions or side effects.
  • Make sure your doctor is evaluating your mental health; older adults are especially prone to depression.

Have a question about your health? Find a doctor near you and get answers.

Click to find more articles like this at UNC Health Talk.

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Johnston Health - Blog by Erin Bailey - 1M ago

Have you ever had trouble remembering what day of the week it was? Or finding your keys? Maybe you forgot to pay a bill on time and got an overdue notice in the mail.

First, take a deep breath. Most adults, no matter what age, have had experiences like these. But it’s understandable that these moments can be alarming for older adults, as the risk of Alzheimer’s disease and other types of dementia rises as we age.

Maureen Dale, MD, a geriatrician at the UNC Hospitals Geriatrics Specialty Clinic, helps us recognize early signs of Alzheimer’s and offers advice on what to do if you’re concerned about yourself or a loved one.

Alzheimer’s Disease vs. Typical Aging

“It’s not always easy to tell the difference between early signs of Alzheimer’s and normal aging,” Dr. Dale says. “That’s why it’s important when you have concerns to see your doctor and consider seeing a specialist, such as a geriatrician or neurologist.”

At that first visit with the doctor, bring all the medications that you take, including common over-the-counter drugs such as aspirin and dietary supplements such as vitamins. That’s because some medications can cause confusion and other symptoms that might suggest Alzheimer’s but really aren’t related to the disease.

Although Alzheimer’s disease can occur in younger adults, it’s much more common in people older than 60. Many people in this age group experience occasional incidents of forgetfulness, but people with early Alzheimer’s have memory loss problems much more consistently, to the point that it interferes with their ability to function in daily life and carry out normal activities.

“In normal aging, it would not be uncommon for a person to forget someone’s name from time to time. What we see in Alzheimer’s is more consistent trouble remembering people’s names,” Dr. Dale says. “In normal aging, it’s also not unusual for a person to make an error from time to time and forget to pay a bill. In contrast, people with Alzheimer’s are consistently forgetting to pay their bills, whereas previously they had been able to pay their bills without any problems.”

Other examples of memory loss related to Alzheimer’s can include having trouble coming up with the right words, forgetting which room in the house is your bedroom, or getting lost while driving to or from familiar places.

Lesser-Known Signs

People think of Alzheimer’s as a memory disease, and it is. But some early signs have little to do with memory loss. Some people experience personality and mood changes. They become more reckless or impulsive than they used to be or make quick decisions without thinking through the consequences first.

Others go in the opposite direction, toward social withdrawal. “They stop doing a lot of the activities that they used to do, and that may look more like depression than the memory loss that people traditionally think of when they think of Alzheimer’s,” Dr. Dale says.

The Alzheimer’s Association has a checklist of 10 early signs of Alzheimer’s. Dr. Dale says it’s a good idea to familiarize yourself with the list ahead of time, and then take it with you when you see your doctor. The 10 signs are:

  1. Memory loss that disrupts daily life.
  2. Challenges in planning or solving problems.
  3. Difficulty completing familiar tasks at home, at work or at leisure.
  4. Confusion with time or place.
  5. Trouble understanding visual images and spatial relationships.
  6. New problems with words in speaking or writing.
  7. Misplacing things and losing the ability to retrace steps.
  8. Decreased or poor judgment.
  9. Withdrawal from work or social activities.
  10. Changes in mood and personality.
Why Early Diagnosis Matters

There is no cure for Alzheimer’s disease, but treatments are available to help manage the symptoms and provide a better quality of life. For that reason, getting a diagnosis as early as possible is extremely important.

“The biggest benefit of early diagnosis is that it gives patients and their families time to plan for the future,” says Dr. Dale.

In the early stages, most patients still have a good understanding of their disease process and what’s going on, and they understand the decisions they face going forward. They typically will have more control in designating who will make medical decisions on their behalf and what those decisions might be.

“It also gives us time to talk about some of the things that we can do to help people function better for longer,” Dr. Dale says. “I talk to people about staying active after diagnosis. That means having regular activities, whether it’s exercise or walking or enrolling in a balance and strength class, and also keeping their mind active.”

What to Do if You’re Concerned About Alzheimer’s Disease

If you have experienced any of the 10 early signs of Alzheimer’s and are concerned, talk to your primary care doctor. He or she can evaluate you and refer you to a specialist if needed.

If you’re concerned because someone in your family is showing possible signs of Alzheimer’s, then it’s important to talk to your loved one about it. This can be difficult, Dr. Dale says, because people who experience these symptoms may be in denial and are likely frightened. But it’s important for you to speak with your family member openly and honestly, and for the individual to see a doctor for an evaluation as soon as possible.

Click to find more articles like this at UNC Health Talk.

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We are a society of planners. We plan for marriage, children, college and even retirement, yet many do not prepare for end of life or unexpected circumstances in our health.

Advance care planning helps your loved ones and health care providers know your goals of care so that they can honor your wishes when you are unable to speak for yourself. Imagine if you ever had an accident, stroke, surgery, or are diagnosed with a serious illness, you may need someone to advocate for your wishes, have you told anyone your wishes and have you put it in writing?

What is advance care planning?

To put it simply, advance care planning is a process where you discuss and plan for the care you would want to receive if you are unable to make decisions for yourself.

Advance care directives are the actual documents a person completes to ensure their wishes are carried out. This can include:

  • A living will
  • Healthcare Power of Attorney (HPOA)
  • Five wishes document
  • MOST form
  • DNR form

The living will, healthcare power of attorney, and five wishes document can all be completed with the signature of the individual completing the document, a notary, and two non- family witnesses. The MOST form and DNR form are considered a Physicians order and only require MD signature.

In North Carolina the living will allows you to state your desire to not receive life prolonging measures in any or all of the following situations:

  1. You have an incurable condition that will likely result in death within a short period of time
  2. You are unconscious, and your doctors are confident that you will not regain consciousness
  3. You have advanced dementia or other substantial and irreversible loss of mental function.
Healthcare Power of Attorney (HPOA)

A HPOA is a legal document in which you name another person (known as a health care agent) to make decisions for you when you are no longer able to make decisions yourself.

A HPOA only becomes effective when your physician determines that you lack the capacity to make informed decisions.

It is important to put great thought into who you choose to be your health care agent. Consider that it needs to be someone who knows you well and understands what quality of life means to you, is available and accessible when needed, and someone who is not afraid to stand up for you in the event your wishes differ from other family members.

It’s completed…now what?

Once you have completed your advance care directives put the original in a safe place, make copies for health care providers (Physicians, Home Health, Hospice, hospital etc…) and make sure to give a copy to your HPOA.

We also recommend putting one in the glove compartment of your car or creating a wallet card that tells that you have an advance directive and the phone number of your HPOA.

It is a fact that most people do not make the best most informed decisions in the middle of a crisis. It is better to speak up now and talk about your wishes with your family and put them in writing so that you can make a decision with a level head. If for no other reason consider this, when you state your wishes and complete an advance care directive you have removed that decision making burden from your family. It is much easier to advocate and honor those wishes when they are in writing and made by the individual than it is if your family has to decide without any knowledge of what you would want.

Advance care planning is not just for our elderly it is for all adults. It is never too soon to start planning for the unexpected. Speak up and talk with your family. Now is the best time.

Article written by April Barbour-Matthews, social worker at the SECU Hospice House.

In my career as a Social Worker in end of life care I have encountered numerous families who have struggled with whether or not they made the right decision or actually can’t make a decision because they did not have any prior knowledge of their loved one wishes. Care enough to speak up.

View April’s powerpoint presentation for our Advance Planning event.

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For many people, certain foods and drinks should come with a giant yellow hazard label: WARNING—RUN AWAY! Depending on the individual, seemingly harmless ingredients, such as milk, egg, soy and wheat, can wreak havoc.

So if this misery happens when you eat a certain food, are you allergic to it or just intolerant?

Important Differences Between Allergies and Intolerances

First, some definitions: A food allergy is an immediate, hypersensitive response to a food triggered by the body’s immune system.

“In patients with food allergy, even ingesting a tiny amount of the culprit food can cause an allergic reaction. This exposure causes the immune system to produce histamine and other factors that can cause symptoms ranging from itching and hives to a severe, life-threatening reaction known as anaphylaxis,” says Saira Sheikh, MD, an allergist/immunologist and rheumatologist with the UNC Allergy and Immunology Clinic and UNC Hospitals Rheumatology Specialty Clinic.

The symptoms of a food allergy can include but are not limited to:

  • Itchy, watery eyes
  • Runny nose
  • Hives
  • Swelling of the lips and throat
  • Abdominal pain, nausea and vomiting
  • Difficulty breathing and wheezing
  • Drop in blood pressure and heart rate

Food intolerance, on the other hand, occurs when you have difficulty tolerating particular foods. This results in gastrointestinal symptoms such as gas, abdominal pain or diarrhea. It’s not life-threatening, but it can be very uncomfortable.

“In the majority of people with these symptoms, it ends up being a sensitive GI tract. Either on the upper side, which causes nausea, feeling full or heartburn-type symptoms, or lower, causing diarrhea or cramping,” says  Evan Dellon, MD, MPH, a gastroenterologist with UNC Gastrointestinal Medicine.

The takeaway? “Food allergy is mediated by the immune system and can involve various organ systems in the body, whereas food intolerance primarily involves the digestive system,” Dr. Sheikh says.

Other important differences between food allergies and food intolerances include:

  • Time: Symptoms of a true allergic reaction often occur immediately after exposure to even a miniscule amount of the food. A food intolerance generally takes longer to emerge and can last for hours or days after you’ve eaten the food. (One exception is the alpha-gal allergy to red meat, which can take hours to manifest.)
  • Severity: Food allergies can kill you, whereas food intolerances just make you feel bad. People with food allergies should avoid their trigger foods no matter what. Some people with intolerance can have smaller amounts of that food.

Take milk, for example. People with a milk allergy can have a severe allergic reaction to even a small amount of milk. This could include gastrointestinal problems as well as skin and respiratory symptoms. On the other hand, those who are lactose intolerant primarily experience gastrointestinal symptoms and often can tolerate small amounts of dairy. The allergy is the immune system responding to protein in milk; the intolerance is because the person’s gut is missing an enzyme that is meant to help digest lactose, which is a sugar found in milk.

Diagnosing Food Allergies and Food Intolerances

Knowing whether you have an allergy or intolerance is important because food allergies are potentially life-threatening. People with food allergies should carry emergency lifesaving medications, such as epinephrine in an injectable form.

The diagnosis of a food allergy is made based on a history of a reaction to a food and a positive skin or blood test that confirms the allergy.

For example, “if you eat shrimp and you develop hives on your skin and swelling of your lips immediately afterwards, there is a strong clinical suspicion for shrimp allergy, so we would confirm this diagnosis with allergy testing by skin prick method or by blood test,” Dr. Sheikh says.

A positive skin or blood test alone, without symptoms suggestive of an allergic reaction, means your body may be sensitized but not necessarily that you’re allergic.

Food intolerance is sometimes difficult to diagnose because there’s no accurate, validated test to identify food intolerance.

“A good way to identify if a food is causing intolerance is to keep a food diary to track and recognize what regularly eaten food may be causing an adverse reaction,” Dr. Sheikh says.

“Symptoms associated with a food intolerance that we worry about and say see a doctor as soon as possible would be sudden weight loss, blood in the stool, throwing up blood and having food stick when you swallow,” Dr. Dellon says. Those could indicate a more serious condition.

Treating Food Allergies and Food Intolerances

Whether you’re allergic to a food or intolerant of it, you’ll want to avoid it. If that fails, your treatment options are:

  • Food allergy: The drug of choice is epinephrine, which comes in an injectable pen. “Basically, it jump-starts your heart,” Dr. Sheikh says. During a severe allergic reaction, your blood pressure can drop. “Epinephrine causes tightening or constriction of blood vessels, which increases blood pressure and helps to reverse or prevent cardiovascular collapse. It also relaxes the muscles in the airways and lungs, which helps the airways to open up.” If symptoms are mild, it is reasonable to take an antihistamine. For severe symptoms, if in doubt about whether to use epinephrine or an antihistamine, always go with epinephrine, Dr. Sheikh says. “It is the main therapy that should be used in the management of anaphylaxis.”
  • Food intolerance: Unfortunately, you’ll probably have to wait out the discomfort with the help of over-the-counter gut soothers. Food intolerance is often tied to irritable bowel syndrome (IBS), which can be treated with dietary changes such as the low-FODMAP diet; FODMAPs are compounds that aggravate IBS.

Whatever you think the problem is, you don’t have to figure it out on your own, Dr. Dellon says. “Talk to your doctor about what’s going on, and then together you can decide if you need to see a gastroenterologist or an allergist for further diagnosis and treatment.”

Looking for a gastroenterologist? Click here.

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Johnston CORE is the new employee engagement advisory council led and managed by Johnston Health Employees. CORE stands for “Creating Opportunities. Recognizing Employees.” Meet our CORE members with our weekly profiles and fun facts.

Meet Samantha Barbour


If she’s having a crummy day, Samantha Barbour says coming to work as a health and wellness specialist at HealthQuest Fitness and Wellness Center always makes her feel better.

In her personal life and on the job, it’s her goal to promote physical activity and healthy living in the community. Toward that end, she’s led shopping tours to the grocery store for healthful foods, demonstrated healthful cooking techniques in the HealthQuest kitchen, and given tips to employees on how to fit in exercise while at work.

“I’m constantly looking for new information and cutting-edge ideas to help me shape objectives and strategies,” she says.

For her hard work and dedication, Barbour was recognized last April as a Johnston Health Ambassador. “I’m so proud that I was chosen by my organization for such an honor,” she says. “And I’m doubly proud when HealthQuest members tell us that they’re healthier, happier or more knowledgeable because of our services.”

Barbour has worked with HealthQuest for the past five years. She started out working at the reception desk and coaching the swim team. “I give 100 percent every time I clock in,” she adds. “I believe excellent customer service goes a long way, and I try to show that through my work.”

She and her husband, Rodney, live in Selma.

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For National Doctors’ Day, Johnston Health would like to recognize the doctors on our medical staff providing care in our hospitals and practices across the county. Their expertise, dedication and commitment shine through to help save the day, every day. On Friday, please take a moment to thank a doctor that’s provided you excellent care.

Our staff were recently asked who their favorite doctor was and what qualities they have that they admire? Below are a few of their answers.

We have a lot of emergency situations in labor and delivery, and Dr. Brandon Woodard handles these so smoothly. He is always so calm and collected, which helps put the patient, family and even the nurses at ease.
Amy Simpson, RN

Dr. Mark Bowling and I worked together years ago at the clinics that were owned by the hospital. He is now one of the primary care physicians with UNCPN in Clayton. He has a great bedside manner and working relationship with the staff. He is down to earth, and keeps it real. He provides excellent patient care.
Robin Schwartz, IT business analyst

Prior to working in the emergency department, I was a floor nurse for eight years. Dr. Devang Gujarathi was one of the hospitalists I always felt comfortable approaching. He’s great with answering questions. He’s willing to help you learn. He doesn’t mind answering the “why” questions, and explaining processes for procedures.  He has a wonderful bedside manner.
Elizabeth Robertson, RN

I have three favorite doctors. Dr. Cary Bizzell, a radiologist, is passionate about the early prevention of cancer. He was a natural fit to lead our campaign for the 3D mammography systems. Dr. Eric Janis, a cardiologist, gives a lot back to the community. Last year, he launched our heart fund, and a few years earlier, led the campaign to equip our cath lab. In his work at the SECU Hospice House, Dr. Dennis Koffer is passionate about helping patients and sharing information about hospice with our community. He and his wife, Gayle, are volunteers at our fundraising events.
Sol Halliburton, director of the Johnston Health Foundation

If I had to choose just one favorite, it would be Dr. Rick Alioto, an orthopedic surgeon who is so relatable. He is informative with his patients, respectful to his staff, and he employs a great physician assistant, Chetan Kapat. Together they make a great team, and provide great care to our patients in the community!
Lisa Williamson, RN, OR

Dr. John Adams is caring and always willing to listen. He goes the extra mile without enough recognition!
Jessica Toole, RN, peer review nurse

Dr. Daree Russell is always approachable, pleasant and friendly.  She takes the time to listen to staff, patients and families. She is open to professional input, and usually seeks it out. She spends time with patients and families, answers questions and provides support. She is extremely knowledgeable and a fantastic doctor!
Jennifer Kraus, speech language pathologist

Dr. Pamela Blakely is a caring, compassionate hospitalist who always has the patient’s best interest. She takes the time to find out what’s going on with a patient’s health. She listens to our concerns and findings. When we have a patient who passes on from this world, Dr. Blakely truly takes the loss to heart. I feel honored to work alongside her.
Dawn Simone, RN, ICU

Dr. John Adams is the director of our hospitalist service. He takes time to listen in order to understand the needs from both the staff and patients’ perspective. He does what he can to engage his team to be supportive in order to create a safer place for our patients.
Christy C. Davis, Operational Excellence improvement advisor

I like Dr. Kimberly Willis because she is spunky, down to earth and compassionate yet straightforward with her patients. These are all qualities I would want to have in my hospital physician. I also love that she takes the time to dress up and wear heels to work.
Kelli Wallace, registered dietitian

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