1. healthyFocus
Urgent Care
WhenYouNeedIt
Page 4
Giving Patients
Maximum Relief
Page 3
Dale’s Recovery Story
Page 6
Rally to Beat
Lung Cancer
Page 7
Fall 2009
Find the hidden acorn and
you could win an iPod
shuffle. Details on page 2.
2. healthy
Focus
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dukeraleighhospital.org
Closer to You
Dear Friends:
We are pleased to continue to bring you
Healthy Focus and hope that it provides
useful information to you and your family
about opportunities for improving health
and adding to your enjoyment of life.
In this issue, consistent with our
“Closer to You” theme, Duke Medicine
is expanding its Urgent Care presence in
Wake County at Morrisville and Knight-
dale. We have made a major
commitment to have a greater
presence in Wake County, and
these are two recent examples
of improving access and
convenience for the community.
Similarly, we are also com-
mitted to hiring practitioners
in specialty areas that have not previously
been available in Wake County. In this
issue, we feature the Duke Urogynecol-
ogy Program and Dr. David White, the
first board-certified thoracic oncologic
surgeon to establish a practice in Wake
County. We are proud and excited to
offer these specialists and anticipate that
we will continue to bring new services
to Wake County.
We hope that you enjoy this publication
and find that it helps broaden your aware-
ness of what’s happening at Duke Raleigh
Hospital and with Duke Medicine’s
expanded presence in Wake County.
Sincerely,
Douglas B. Vinsel
Chief Executive Officer
Duke Raleigh Hospital
From the CEO
Fill out and mail the business reply card found in this issue to submit your entry. All entries must be received
by November 30, 2009. Must be 18 years or older to enter. Duke University Health System employees and their
immediate family members are not eligible to win.
Find the hidden acorn and be entered to win an iPod Shuffle!
Physician Focus: Meet Dr. White
The Duke Medical Plaza Brier Creek offers primary care, urgent care and specialty
care, including OB/GYN, physical therapy and occupational therapy, all under one roof.
Patients can also benefit from rapid access to appointments, on-site laboratory and X-ray
services, and free and convenient parking. Duke Gastroenterology of Brier Creek remains
in its same location in Brierdale.
DUKE MEDICAL PLAZA BRIER CREEK
10211 Alm St., Raleigh, NC 27617
Primary Care and OB/GYN Hours: Monday–Friday, 8 a.m. to 5 p.m.
Physical Therapy and Occupational Therapy: Monday–Friday,
8 a.m. to 5 p.m., and Saturday 8 a.m. to 3 p.m.
Urgent Care Hours: Seven days a week, 365 days a year,
no appointment necessary, 8 a.m. to 8 p.m.
Office: 919-484-8345
DUKE GASTROENTEROLOGY OF BRIER CREEK
10441 Moncreiffe Road, Suite 101, Raleigh, NC 27617
Hours: Monday–Friday, 8:30 a.m. to 5 p.m.
Office: 919-405-2341
This past July, Duke Medicine in Brier Creek moved into its larger location
on Alm Street, located off Brier Creek Parkway.
A New Location for Duke Medicine in Brier Creek
David C. White, MD, general thoracic surgeon at Duke Thoracic Surgery of Raleigh
and on the medical staff at Duke Raleigh Hospital, enjoys being part of a specialty that
provides a wide spectrum of care for the community. He performs surgery for both benign
and malignant diseases of the lungs, esophagus, pleura and mediastinum.
Dr. White graduated from University of Virginia School of Medicine in 1996 and completed
his general surgery residency at Duke University Medical Center in 2003, where he became
interested in a thoracic surgery specialization.
“At Duke, I observed minimally invasive chest surgery, which sparked an interest in the
thoracic surgery fellowship—of which I had the privilege of participat-
ing in from 2003 to 2006,” says Dr. White. “I believe there is a huge
need for specialized surgical care of lung and chest diseases, in partic-
ular lung cancer. Lung cancer kills far more men and women than any
other type of cancer. In addition, there is a great need for minimally
invasive chest surgery, as it allows us to offer surgery to more patients
in a manner that reduces pain and disability and hastens recovery.”
To schedule an appointment with Dr. White, call 919-862-5970. Dr. WHITE
Free to Breathe
5K Lung Cancer Run/Walk Rally
Saturday, Nov. 7 • 9 a.m.
NCSUCentennial Campus, Raleigh, NC
Duke Raleigh Cancer Center is honored
to partner for a third year with the North
Carolina Lung Cancer Partnership for such
an amazing and important event to raise
awareness and funds for lung cancer.
3. Fall 2009
healthy
Focus 3
Few people want to talk about urinary incontinence, but it is a surprisingly
common problem. While the condition is more prevalent in women, millions
of Americans live with urinary incontinence every day.
End the Embarrassment
The blanket term urinary incontinence
actually covers two distinct types: stress
incontinence, the inability to control the
bladder when it is put under pressure such
as when coughing or exercising, and urge
incontinence, the sudden urge to empty
the bladder.
For patients with urge incontinence, or
overactive bladder, skilled urogynecologists
at Duke Raleigh Hospital are spearheading
leading-edge clinical trials designed to give
patients maximum relief.
“We are using a minimally invasive
procedure involving Botox®
injections as a new
option for patients whose incontinence cannot
be relieved through behavioral therapy and oral
medications,” explains Cindy Amundsen, MD,
associate professor at Duke University in the
division of urogynecology and urology. “The
new procedure has been shown to relax the
bladder muscles, giving patients better control.”
Understanding the Procedure
The Botox procedure is performed at the
physician’s office—patients do not have to visit
the hospital or worry about admitting processes
or paperwork beforehand. No sedatives are
used, but patients are generally given
a gel solution, which successfully
numbs the urethra and bladder.
A physician uses a small
needle to inject Botox into
the bladder wall. Generally,
several injections are given
at points across the
bladder wall to ensure
maximum results
for patients.
“Patients
generally report
results that last
as long as six
months,” Dr. Amundsen says. “Side effects
may occur in a small percentage of patients
and include difficulty emptying the bladder.
Since the injections only take a few minutes
and can be completed during the course of
an appointment, most patients don’t object
to having the procedure repeated
once the initial treatment
begins to wear off.” Beyond Botox
The Botox®
procedure is just one
of several clinical trials being
performed at Duke UROGYNE-
COLOGY CONSULTANTS OF Raleigh.
Some of the procedures being
performed are designed to offer
relief to patients with stress
incontinence, including a trial
that combines the efforts of
physical therapy sessions with
surgical treatments.
In addition to these trials,
physicians are also delving
deeper into the actual causes of
incontinence, including efforts
to find genetic markers that
might help researchers prevent
incontinence before its onset.
“It is rewarding to know these
studies may one day offer
permanent relief to urinary
incontinence sufferers, so many
studies are currently being
performed,” says Cindy Amund-
sen, MD, associate professor at
Duke University in the division
of urogynecology and urol-
ogy. “Patients have more options
now than ever before.”
Cindy Amundsen, MD,
associate professor
at Duke University
in the division of
urogynecology
and urology
Dr. Amundsen practices at Duke
Urogynecology Consultants of Raleigh.
To learn more, call 919-783-4299
or visit dukehealth.org.
4. healthy
Focus
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dukeraleighhospital.org
Urgent Care for Our Community
Sprained ankles, stomach viruses and ear infections are rarely limited to between 9 a.m. and 5 p.m.
on weekdays. Minor illnesses and injuries can occur anytime, and when they’re not serious enough
for the emergency room, urgent care facilities step into the role of providing primary care services
outside of regular business hours.
Urgent care facilities provide
healthcare services similar to what’s
available in your physician’s office, but
they remain open nights, weekends and
holidays when your doctor’s office is
usually closed.
“In the urgent care center, we see
mostly the same conditions that primary
care physicians see in their offices,”
says Kevin Broyles, MD, senior medical
director of Duke Urgent Care Services.
“In addition, we can sew a laceration,
splint a broken bone, perform X-rays and
do minor lab work.”
What sets Duke Urgent
Care apart?
One of the biggest differences between
Duke Urgent Care and other facilities is
that we use evidence-based medicine.
“Our goal is to do the right thing
for each individual patient,” says
Dr. Broyles. “That means that we use
medical knowledge from research and
evidence to guide us in treating patients.”
An example of the way urgent
care clinicians apply evidence-based
medicine is the way they talk with
patients to determine what might
be causing pain or concern rather
than simply ordering a battery
of expensive medical tests.
“Some urgent care facilities
will look at a patient who has
chest pain and instantly order
an electrocardiogram, tests and
medications without really talking
with the patient,” says Dr. Broyles.
“We pride ourselves on the way
that we take time to really talk to
patients to try to determine the
cause of the problem without
wasting anyone’s time or money.”
Another important aspect
of the quality of care available
at Duke Urgent Care is the fact that a
physician is always on site at every center.
“There is always a Duke physician
present who is credentialed to see
urgent care patients of every age,”
says Dr. Broyles. “Some centers have
physicians on site who are not trained or
credentialed in urgent care, which means
they aren’t prepared to see everyone
who might walk through the door.”
We also ensure that only qualified
professionals perform specific tasks.
“At some facilities, a nurse or a
medical office assistant might take
X-rays, and while they may have
on-the-job training, they aren’t
actually certified as a radiologic
technologist,” says Dr. Broyles. “At
Duke Urgent Care, X-rays are taken
by a trained radiologic technologist.”
Registered nurses also maintain
a presence at each facility—other
than physicians, physician assistants
or nurse practitioners, they are the
team members who are trained
to assess patients for triage, make
assessments and give medical advice.
Accreditation and Feedback
Duke Urgent Care facilities have
earned an accreditation from The
Joint Commission.
“The Joint Commission ensures
every aspect of patient safety, from hand
washing to preventing medical errors,”
says Dr. Broyles. “What the accreditation
Where to Go When
In the midst of a health problem, it can be hard
to figure out where to go—should you wait
until your regular physician’s office is open or
do you need urgent or emergency care? Here
are some tips to help you make a decision.
•
Your primary care physician’s office should
be your destination for routine health exams,
common illnesses such as cold, flu and sore
throat, as well as minor illnesses and injuries.
•
If your regular physician’s office is closed,
an urgent care facility can treat common
illnesses like colds in addition to sprains, minor
fractures, urinary tract infections, cuts and
minor burns, ear infections and eye injuries.
•
An emergency department is best-
equipped to treat heart attacks, seizures,
strokes, severe bleeding, poisoning,
broken bones and head injuries.
Kevin Broyles, MD,
senior medical
director of Duke
Urgent Care Services
5. Fall 2009
healthy
Focus 5
Urgent Care in Five Locations
Urgent care is available at five easily accessible locations throughout Durham, Knightdale, Morrisville and Raleigh.
• Duke Urgent Care Hillandale, 1901 Hillandale Road, Suite D, 919-383-4355
• Duke Urgent Care South, 5716 Fayetteville Road, 919-572-1868
• Duke Urgent Care Morrisville, 10950 Chapel Hill Road, 919-327-1630
• Duke Urgent Care Brier Creek, 10211 Alm Street, 919-206-4889
• Duke Urgent Care Knightdale, 162 Legacy Oaks Drive, 919-232-5205
“If you have a primary care physician and a healthcare concern,
we always recommend contacting that physician. Even if it’s after
business hours at your physician’s office, there’s usually someone
on call who can help you, and that person is going to give you the
best advice about whether to wait to come into the office or to
seek urgent or emergency care.
”
—Kevin Broyles, MD, senior MEDICAL director of Duke Urgent Care Services
means to our patients is that we care
a whole lot about their safety.”
Another important facet of
Duke Urgent Care’s commitment to
providing excellent patient care is our
utilization of feedback from patients.
“We have a very robust
performance improvement and
peer review process,” says
Dr. Broyles. “From administrative
issues to clinical matters, we take
feedback from patients and make
improvements based on that.”
Recently, Duke Urgent
Care improved their
management of migraines
and patient wait times based
on patient feedback.
Collaboration
Urgent care facilities act as
a part of the continuum of the
healthcare services you receive in
your primary physician’s office.
Because of the nature of urgent
care facilities, and the fact that you
may see a different physician every
time you go, urgent care can’t and
shouldn’t replace regular visits
with your primary care physician.
“We’re here to work with you
and your primary care physician
to provide the care you want
and need,” says Dr. Broyles.
“We’re grateful to be able to
care for patients when they
need us, and we’re grateful to
our community’s physicians
for allowing us to be guests in
the lives of their patients.”
Every Duke Urgent Care location is
open from 8 a.m. until 8 p.m., 365 days
a year. For more information, visit
dukehealth.org/Services/UrgentCare.
6. healthy
Focus
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dukeraleighhospital.org
Dale’s orthopAedic
problems began in 1971 when
a drunk driver struck the car he
was driving. While preventing him
from serving in the Vietnam War,
the injury also has since required
seven surgeries and left Dale with a
limited range of motion in his right
knee. Almost 38 years later, this in-
jury would come back to haunt him.
While helping his son move
away to college late last year,
Dale took one awkward step off
the front porch and wound up
in the emergency room.
“I stepped on a stick that slid on some loose leaves. My knee bent as
far as it could, but the pressure caused my tibia and fibula to break right
above my ankle and my femur broke just above my knee,” says Dale.
After the fall, Dale had to lay in the yard in excruciating pain
until emergency responders arrived. Once in the ambulance, the
only pain medicine available was morphine, to which Dale is
allergic. Still in pain, Dale waited two and a half hours before
receiving any medication.
A Place to Turn
Once emergency services transported Dale to Duke Raleigh
Hospital, he underwent surgery to fix the fractures using steel
plates and 16 screws. Following a six-day hospital stay,
Dale returned to work with the help of a cane. Courtesy
of an intensive physical therapy regimen and a custom-fitted
knee brace, Dale began to recover and his movement
steadily improved.
“Dale has responded extremely well to his surgery,”
says Hardy Singh, MD, orthopaedic surgeon on staff
at Duke Raleigh and a part of Southeastern Orthopedics
Sports Medicine and Shoulder Center. “Over the course
of his rehabilitation, he worked very hard to regain motion
in his knee and his dedication certainly paid off.”
A Miraculous Recovery
Just months after his accident, Dale, although still wearing
his brace, now walks normally without the help of a cane. Dale
credits his speedy recovery to the quality, focused treatment
he received from Dr. Singh at Duke Raleigh.
“I was truly blessed to have had talented physicians
and compassionate staff members taking care of me over
the course of my surgery and recovery,” he says. “Dr. Singh
assured me throughout the entire process that I would
recover and, thanks to his encouragement and surgical
ability, I have.”
For more information about Duke Raleigh’s orthopaedic
services, visit dukeraleighhospital.org, click the “Services”
tab and select “Orthopaedic Center.”
Dale Smith has never been a quitter. When an accident
in November 2008 left him with a severely broken leg,
Dale knew he would have to fight to overcome the injury.
The Power of
Perseverance
7. Fall 2009
healthy
Focus 7
community calendar
Community Profile:
Make-A-Wish Foundation®
of Eastern North Carolina
healthy RECIPE:
Fall Squash Soup
Granting the wishes
of children with life-threatening
medical conditions to enrich the
human experience with hope,
strength and joy is the mission of
the Make-A-Wish Foundation®
of Eastern North Carolina. This
independently incorporated local
chapter of the Make-A-Wish
Foundation grants wishes to chil-
dren in 49 counties in the eastern
part of the state, including Wake
County. These grassroots efforts
allow local donors to help their
neighbors and people they know.
The foundation offers four
types of wishes: to have, to go, to
be or to meet.
“While those are the general
categories of wishes, each child’s
imagination brings a unique
perspective to his or her wish,”
says Ziva Starr Raney, director of
development for the Make-A-
Wish Foundation.
The foundation has granted
many unique wishes, such as a
trip to Sea World to see dolphins,
a visit to Mattel®
to design a
Hot Wheels®
car, and a wish for
professional grade reptile cages.
The most common wish among
our children is to go to Walt
Disney World®
to meet their
favorite characters.
The Make-A-Wish Foundation
relies on the generosity of com-
munity members to grant wishes
and fulfill its mission. Volunteer
opportunities range from working
directly with the child or family,
assisting in the office and at events,
or serving on a committee.
To learn more about the Make-A-
Wish Foundation, its volunteer
opportunities, fundraising
events or to make a donation,
please visit eastncwish.org or
call 919-821-7111.
3. Roast vegetables and fruit 40
to 45 minutes or until very tender,
stirring occasionally. Remove from
the oven and let cool.
4. Purée the roasted ingredients
in a food processor until smooth.
Add broth as needed.
5. Transfer the purée to a large
saucepot and stir in rest of broth.
Warm over medium heat until soup
is hot. Garnish with fresh parsley.
Nutritional Information
(per serving) Serves 6
Calories: 234.9 Fat: 5.1g
Saturated Fat: 0.8g Total Sugars: 15.2g
Cholesterol: 0mg Sodium: 754.9mg
Protein: 7.8g Dietary Fiber: 5.1g
Carbohydrates: 46.1g
Source: recipes.prevention.com
Ingredients
1 large butternut squash,
peeled, halved and seeded
3 medium cooking apples,
peeled, cored and quartered
1 large onion, chunked
3 cloves of garlic, peeled
2 tablespoons extra virgin
olive oil
½ teaspoon salt
½ teaspoon ground pepper
6 cups reduced sodium, fat-free
chicken or vegetable broth
fresh parsley
Directions
1. Preheat oven to 400 degrees
Fahrenheit. Coat large roasting
pan with olive oil spray.
2. Cut squash into 1–inch chunks.
Place squash, apples, onion and
garlic in the pan. Drizzle with oil
and sprinkle with salt and pepper.
Toss to mix well.
SEPTEMBER
American Lung Association Walk
Saturday, Sept. 19 • 9 a.m.
NC State Centennial Campus
Join Duke Medicine in helping raise
funds to fight lung disease and help
improve the quality of life for those
who struggle to breathe. Visit the
events calendar at dukehealth.org
to learn more.
Gail Parkins Memorial Ovarian
Cancer Awareness Walk
Saturday, Sept. 26
Come join us in this event to raise money
to benefit Duke Medicine’s gynecologic/
oncology programs and awareness
of ovarian cancer. To register for
more information, please visit
www.ovarianawareness.org.
American Heart Association’s
Start! Triangle Heart Walk
Sunday, Sept. 27
Duke Medicine is a sponsor of the 2009
Start! Triangle Heart Walk through the
American Heart Association. The funds
from the race support the prevention of
cardiovascular disease and stroke. Visit
starttriangle.org for more information.
OCTOBER
Raleigh Chamber Executive
Women’s Luncheon
Thursday, Oct., 15
11:30 a.m. until 1:30 p.m.
Hilton North Raleigh
Duke Raleigh Hospital invites you to join
us for the Raleigh Chamber Executive
Women’s Luncheon series. These quar-
terly luncheons include dynamic speakers
who provide valuable information on a
variety of topics for women in business.
$40.00 per employee of member firms
and $55.00 per non-member. Register at
raleighchamber.org.
NOVEMBER
North Carolina Lung Cancer Partnership’s
Free to Breathe
®
5K Lung Cancer Run/Walk
Saturday, Nov. 7
NCSU Centennial Campus
Duke Raleigh Cancer Center is the presenting
sponsor for the Free to Breathe 5K Lung Cancer
Run/Walk Rally. The race raises funds in
support of lung cancer research and awareness.
Visit FreetoBreathe.org for registration, volunteer
and sponsorship information.
8. non-profit
org
US Postage
Paid
Duke Raleigh
Hospital
3400 Wake Forest Road
Raleigh, NC 27609-7373
dukeraleighhospital.org
This publication in no way seeks to serve as a substitute for professional medical care. Consult your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.
Duke Raleigh Hospital is proud to announce recent recognition for two
health education programs: RAH for Rolesville and Wholesome Routines.
These programs were honored on July 25 at the annual American Hospital
Association (AHA) Health Forum Leadership Summit in San Francisco
with the AHA NOVA Award. The award recognizes hospitals and health
systems for their collaborative efforts toward improving community health.
Established with a
collaboration between Duke
Raleigh Hospital, the Alice
Aycock Poe Center for Health
Education and Rolesville
Elementary School in 2000,
RAH for Rolesville served as a
model program for the larger
initiative Wholesome Routines.
The goal of RAH is to provide
health education to kindergarten
through second graders with
the hopes of preventing illness,
increasing preventive health
screenings and developing life-
long healthy habits. In a partner-
ship with the Poe Center, Wake
County Public School System
and The Duke Endowment,
Celebrating Children’s
Health Education Programs
Wholesome Routines evolved
and took health education one
step further. The school-based
comprehensive nutrition and
physical activity program is
designed for third and fifth
graders in local counties.
Wholesome Routines provides
assistance to approximately 700
students. Some successes include
a decreasing prevalence of over-
weight children from 43 percent
to 34 percent; 28 percent of
participants reporting having
fewer servings of fried snacks;
and 39 percent of students
reporting an increase in their
weekly physical activity
by an hour.
“Duke Raleigh is extremely
proud to have been a part of
the RAH program at Roles-
ville Elementary School and to
watch that model evolve into the
Wholesome Routines program,”
says Doug Vinsel, CEO of Duke
Raleigh Hospital. “As an area
healthcare provider, part of our
responsibility to look for ways
to support the health of children
and families in our community.
RAH and Wholesome Routines
are impactful because of the col-
laboration with classroom teach-
ers and the hands-on, unique
approach the Poe Center educa-
tors use to teach lessons that will
affect lifelong health habits.”
