Sleep Center: How To Sleep Well and Wake Up Refreshed!

Your quality of sleep has a huge affect on your health.  You may notice trouble with focus, mood regulation, and even weight regulation when you aren’t sleeping well.  Sometimes, a few simple changes can get you to that good night’s sleep.  Sometimes, this can be caused by a sleep disorder, like sleep apnea.  The MacGregor Sleep Center is one component of Bariatric Specialists of North Carolina, a division of Triangle Orthopaedic Associates, P.A.  A sleep study is one of the screenings needed prior to Bariatric Surgery, although they take referrals from any source.  The staff also educate patients on good sleeping habits.  Here’s a few of the tips the MacGregor Sleep Center usually shares with patients:


The key is setting a routine, so that your body has similar cues each day for wakefulness and sleep.  Notice how you are affected by light, sound, diet, activity, and stress.  Try making small changes.  But if you believe that you may have sleep apnea or another disorder, talk to your physician.


What is OSA? OSA, or obstructive sleep apnea is a condition where you stop breathing while you sleep. Basically, your airway or throat collapses while you sleep and you don’t even know this is taking place. Some people we have tested stopped breathing over a hundred times an hour. This can lead to dangerously low levels of oxygen while causing poor sleep and increasing blood pressure. It also negatively affects your metabolism which leads to weight retention and gain. Eight out of 10 patients that Bariatric Specialists of North Carolina evaluates for weight loss surgery are unaware that they have this condition.

People who have a BMI of 35 or greater have an 80% risk of obstructive sleep apnea, or OSA. OSA is a potentially lethal condition increasing your risk of stroke, heart attack, or abnormal heart rhythm three hundred percent higher than the average population. Also, OSA can cause or worsen high blood pressure and weight gain, while also causing daytime sleepiness and fatigue. This is a disease that is no different than diabetes or low thyroid and needs to be treated. Most or all weight loss surgical programs mandate evaluation for OSA before surgery.

IMG_3259a72The MacGregor Sleep Center opened in 2009 to offer an “in-house” option for sleep studies.  Dr. Jon Bruce, medical director of the MacGregor Sleep Center, is a Bariatric Surgeon. He is Board Certified by the American Board of Surgery, a Fellow of the American College of Surgeons, and a Fellow of the American Society of Metabolic and Bariatric Surgery.

Nutrition: Meal Planning for Weight Loss

Are you working on your weight in 2016? Sometimes, the best thing you can do is eat more frequently!

Jodi McHugh, RD, LDN, a nutritionist with Bariatric Specialists of North Carolina, explains that eating on a schedule is often one of the most powerful interventions for weight loss: “We are told to eat less, eat less, eat less — and for many people, skipping meals has become an effort to eat less.  So I love it when people come in and I get to say ‘instead of eating less, let’s eat more.’”  She starts with breakfast – skipping breakfast is correlated to a higher BMI (Body Mass Index) and higher rate of obesity.  Here’s a few quick guidelines on when to eat:


Bariatric Specialists of North Carolina, a division of Triangle Orthopaedic Associates, PA, provides surgical and nonsurgical solutions for weight loss.   Dr. Paul EnochsDr. Jon BruceDr. Michael TynerDr. Scott Bovard and Dr. David Pilati are dedicated to providing patients with the highest quality care using the most advanced bariatric surgery techniques.

First Outpatient Knee Replacement Performed at Triangle Orthopaedics Surgery Center, LLC

For Immediate Release: January 8, 2016

Triangle Orthopaedic Associates, P.A.

Contact Person: Chris Adkins, CAO

Triangle Orthopaedics Surgery Center (TOSC) has performed its first outpatient knee replacement.  Instead of spending multiple nights in a hospital, the patient was able to have surgery in the morning and recover at home in the afternoon.  As a single-specialty surgery center dedicated to Orthopaedics, TOSC provides consumer-focused care with better control over the clinical environment than larger organizations such as hospitals.   TOSC is 100% physician owned, allowing physicians to personally guide innovative strategies in care delivery, such as performing joint replacements in an outpatient setting.

“National trends are moving towards performing Orthopaedic procedures, including joint replacement, in an outpatient center.  Triangle Orthopaedics is on the forefront in North Carolina by bringing this high level specialty care to our patients that require joint replacement.  We strive to provide solutions for patients in a safe and affordable surgical environment which allows them to start their recovery at home where they are most comfortable,” says Dr. William Hage.  Dr. Hage, an Orthopaedic Surgeon at Triangle Orthopaedic Associates, P.A. and the Medical Director of TOSC, performed the surgery.

“We provide superior patient care for a procedure that can sometimes require a several day hospital stay.  Our goal was to accomplish this without sacrificing patient safety while still providing pain control and maximizing early ambulation,” says Dr. Scott McCulloch, anesthesiologist.  “We are excited to soon extend this outpatient service to include total knee, hip and shoulder replacements.” McCulloch is with Regional Anesthesia, PLLC and serves on the Medical Executive Committee for TOSC.

Howard Mullins, Administrator at TOSC, states, “We take pride in patient-centered care, high quality outcomes, increased patient satisfaction, and decreased out-of-pocket costs.  As an Ambulatory Surgery Center, we offer increased flexibility based on the individual patient’s needs, including more individual control over personal postoperative recovery.”

TOSC is conveniently located near the intersection of ACC Boulevard and Brier Creek Parkway in Raleigh.  TOSC opened in February of 2013 to provide more cost-effective and efficient ambulatory surgical services than hospital-based or multidisciplinary operating rooms.  The shift from inpatient to outpatient services is pushing innovation, and many surgical procedures are less invasive than before.   Traditionally, an inpatient hospital stay was required for all joint replacement procedures.  Advances in surgical technique, implants, comprehensive blood management, and multimodal pain management have markedly reduced the hospital stay and have virtually eliminated the need for extensive formal rehabilitation. As outpatient joint replacements become possible, TOSC furthers its mission of increasing accessibility to affordable quality medical attention for North Carolinians.

For more information on Dr. Hage and Triangle Orthopaedic Associates, P.A., please visit:

For more information on Triangle Orthopaedics Surgery Center please visit:

To schedule interviews and for assistance regarding this story, please e-mail Chris Adkins at

Dr. Whitt Joins TOA Rheumatology!


Whitt (1)

Join us in welcoming a new member to our Rheumatology  team, Dr. Irene Whitt, MD!  She will be seeing patients at our Chapel Hill and our Durham locations.

Dr. Whitt’s clinical interests include: dermatomyositis/polymyositis, rheumatoid arthritis, gout, psoriatic arthritis, and connective tissue diseases. She maintains an active interest in clinical trials.

As a physician, her primary goal is to always do what is in the best interest of the patient.

To see Dr. Irene Whitt, please call 919-220-5255.

For physicians referring patients, please use our online referral form.



Bone Health: Foods for Strong Bones

Improving your diet?  It’s easy to add foods that are good for your bones.  When Dr. Stewart and his team review a bone density test, diet may be one of the first interventions prescribed.  Calcium is an important component of increasing bone density and reducing the risk of a fracture.  Aim for 1,000 to 1,200 mg of calcium a day.  Your body cannot absorb more than about 500 mg at a time, so split this up throughout the day.  Current recommendations from the National Osteoporosis Foundation emphasize whole foods first, and then supplements only as needed.  So what are some common sources of calcium?


Start checking out the nutrition facts on your food packaging – you may be getting Calcium from lots of sources already!  Some foods are fortified with calcium, like cereal, oatmeal, waffles, or almond milk.

What about Vitamin D?  It’s essential for building and maintaining strong bones, since it helps you absorb calcium.  Your skin makes Vitamin D from the sun.  You can also get it from some foods, such as fatty fish.  Cereals, dairy products, and juices are often fortified with Vitamin D – so read your labels and find ways to add Vitamin D to your diet!  Supplements are available, too.

Talk with your healthcare provider about dietary changes.  If you are diagnosed with Osteoporosis, you may also be prescribed physical therapy to improve posture and strength, prevent falls, and decrease your risk of fracture.  You may be prescribed medications – which often require Vitamin D and Calcium to work properly.

Today physicians are better to detect and treat bone loss in its earliest stages, striving to prevent disease or lessen its impact.  Triangle Orthopaedics offers bone density testing on a Hologic DEXA Scan, and a consultation to review the results and discuss any interventions needed.


Hint: Meal planning is a great way to ensure that you’re getting enough Calcium and Vitamin D each day.