Sizing Up Boo-Boos Big and Small


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When kids get hurt, parents and caregivers are first responders. They clean and bandage cuts and scrapes, apply ice to bumps and bruises, and remove painful splinters while drying tears and offering hugs of reassurance. For the most part, parents are confident in their role as first-aid providers for minor injuries. It's the more complicated or emergent situations that can create a sense of uncertainty or panic. We asked area experts for advice on evaluating and treating common childhood injuries.

Skin injuries

From the missteps of toddlers to the bike wrecks of teens, bandaging cuts is part of parenting. But not all cuts are created equal. How can parents tell if stitches are needed?

Dr. Nicole Parkerson, a pediatrician at Raleigh Pediatrics, advises parents to call their provider first if they are unsure. "We can do most stuff in the office," Parkerson says, "but wounds that won't stop bleeding after four to five minutes of applying pressure or wounds that are gaping should be seen at the E.R. to err on the side of caution."

Raleigh parent Kristen Shelton opted to head straight to the emergency room after her 3-year-old son fell. "I thought he was just upset until he took his hand off of his forehead and blood went everywhere." It only took 15 minutes to sew up the wound, but "he cried during the procedure because he was scared, so it felt more like 15 hours to me," she recounts. "But afterward they gave him a lollipop and he was fine. I didn't recover from the experience nearly as quickly as he did."

Burns are another common childhood injury, especially for toddlers and preschoolers. Kids are frequently scalded by coffee, irons and curling irons, according to Dr. Lisa Ferrari at Durham Pediatrics.

"Wash the burn with soap and water, but don't dress the wound without it being looked at first," Ferrari says. "If the burn is blistering, see a doctor within 24 hours." She also suggests giving the child acetaminophen or ibuprofin as soon as possible since burns can be painful.

Bites also call for soap and water. If your child is bitten by a dog, find out the animal's rabies status or call animal control. Cat bites are actually more dangerous than dog or human bites.
"Children who are bitten by a cat will definitely need to be seen by their doctor and given antibiotics," according to Ferrari.

Breaks and sprains

Sprains and broken bones are common injuries for all age groups. Because bones and ligaments are internal, deciding whether an injury requires rest and ice or an X-ray and a cast can be difficult for parents. Obvious deformity or cuts near the site of the injury may indicate a break, according to Dr. Keith P. Mankin of Raleigh Orthopaedic Clinic.

"Make sure the limb is the same color as the rest of the skin to see if the blood supply is intact," Mankin says. "If any of these things are abnormal, the child should be seen immediately."

Some breaks are fairly easy to detect. Chatham County parents Paula and Erik Butler knew right away their 8-year-old daughter's arm was broken after she fell from a tree house. "Her arm looked like a tepee," Paula says. "She looked pale, almost in shock."

Anne and Geoff Krouse of Raleigh also could easily tell that their 2-year-old daughter had suffered a break when her foot slipped while walking down a set of stairs with her dad.
"She fell into his arms screaming a scream we had never heard from her," Anne says. "Even after we calmed her down, she didn't want to put any weight on the affected ankle."

But not all breaks share the same telltale signs. Jenny and Darrin Bryan of Chapel Hill cared for their 11-year-old immediately after his fall from a Rip Stick in front of their home.

"We iced his shoulder, gave him Motrin, and he was much better that night and the following morning," Jenny explains. It wasn't until their son called from school the next day complaining of increased pain that the extent of the injury became obvious. "We took him to an urgent care orthopedic clinic and discovered he had fractured his humerus," Jenny says.

It is not uncommon for a broken bone to be detected after the first few days, Mankin says. "If a child still has significant pain on the bone after two or three days, there is a good possibility that the bone may be broken," he says.
The lining of children's bones is very sturdy, according to Mankin. "Children may still be able to walk or use a limb, even with a break in it," he says. Six weeks is an average healing time for most breaks, while mild sprains and strains can often be iced, rested and healed within days.

An ounce of prevention

Being aware of risks is the first step in preventing childhood injury. Dr. Courtney Mann, medical director for WakeMed Children's Emergency Department, urges parents to closely monitor use of protective gear and equipment.

"You never outgrow the need for seatbelts and helmets," Mann says. "We can fix a broken bone, but you only have one brain, and it doesn't heal well."

Knee pads and wrist guards are also useful, but Parkerson at Raleigh Pediatrics reminds parents to be sure gear fits properly each season. "If equipment is the wrong size or worn out, it won't protect a child from injury," she says.

Periods of rest between sports seasons can help children avoid overuse injuries, according to Dr. William Hage of Triangle Orthopaedic Associates in Durham. "As kids are growing, their growth plates are fairly prone to injuries like stress fractures and inflammation," Hage says. "After an injury, it's important to ease back into sports and have coaches ensure proper techniques to avoid further injury."

Some parents may be concerned about exposing children to radiation when a child's injury requires diagnostic equipment. Dr. Margaret Douglas at Wake Radiology says that current imaging guidelines make it easy for providers to minimize exposure for children. "The vast majority of X-rays, like those taken for suspected wrist or ankle fractures, expose children to only a very small dose of radiation," Douglas says.

Mann also stresses staying keenly alert when kids are swimming. "Parents can listen closely for most signs of injury like a crash or a plea for help," she says, "but drownings are silent."

Even if children are competent swimmers, panic can set in when they find themselves in difficult situations. "Never overestimate your child's ability to swim," Mann says. "Constant supervision is a must."

Focusing on prevention and being prepared for first-aid situations can help parents stay calm when their children get hurt. List important phone numbers like the pediatrician's office, Poison Control (800-222-1222) and 9-1-1 next to a fully stocked first-aid kit and rest assured that medical professionals are just one phone call away.

Mary Parry is a freelance writer and mother of three from Chapel Hill.

Understanding Head Injuries

Signs of Concussion:
Head injuries that result in any of the following symptoms should be evaluated, according to Dr. Courtney Mann, medical director at WakeMed Children's Emergency Department.

* Loss of consciousness
* Persistent headache or vomiting
* Unusual behavior
* Significant bruising on the head, particularly on areas other than the forehead

If not managed appropriately, concussions can lead to problems for children, ranging from subtle to severe, such as persistent headaches, mood disturbances, coma and even death.

When to Resume Play:
"Recovery time is linked to the severity of the injury, so it's important for parents to seek the advice of their pediatrician before resuming active play," Mann says.

Top Childhood injuries

* FALLS - Falls are the leading cause of nonfatal injuries for all children from birth to 19. Every day, approximately 8,000 children are treated in U.S. emergency rooms for fall-related injuries. This adds up to almost 2.8 million children each year.
* ROAD TRAFFIC INJURIES - Every hour, 150 children from birth to 19 are treated in emergency departments for injuries from motor vehicle crashes. More children ages 5 to 19 die from crash-related injuries than from any other type of injury.
* DROWNINGS - Drownings are the leading cause of injury death for young children ages 1 to 4, and three children die every day as a result of drowning.
* BURNS - Every day, 435 children birth to 19 are treated in emergency rooms for burn-related injuries, and two children die as a result of being burned.
* POISONINGS - Every day, 374 children in the U.S. from birth to 19 are treated in an emergency department, and two children die, as a result of being poisoned. It's not just chemicals in your home marked with clear warning labels that can be dangerous to children.
* SPORTS INJURIES - More than half of the 7 million sports and recreation-related injuries that occur each year are sustained by youth between ages 5 and 24.

Source: U.S. Centers for Disease Control and Prevention, www.cdc.gov/safechild

Be prepared

Maintaining a first-aid kit at home helps parents be ready for an assortment of childhood injuries. Most ready-made kits come with bandages, tweezers and antibiotic creams. "Add Steri-Strips to your kit," suggests Dr. Nicole Parkerson of Raleigh Pediatrics. "Those can close a lot of really mild lacerations."

Benadryl is also helpful to keep around, according to Dr. Lisa Ferrari of Durham Pediatrics. "I recommend keeping it at home and bringing it with you when traveling," she says. "It can be a lifesaver."

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Calendar

December 2019

Wear your favorite holiday attire and dine with Santa Claus. Enjoy a delicious brunch, stories and crafts, and take pictures with the jolly man from the North Pole. 

Cost: $10/child. Free for ages 2 and younger

Where:
Joyner Park Community Center
701 Harris Rd.
Wake Forest, NC  27587
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Participants develop their naturalist skills and understanding of local nature. Ages 5-8 with parent. Register online. 

Cost: $8/resident, $10/nonresident

Where:
Stevens Nature Center/Hemlock Bluffs
2616 Kildaire Farm Rd.
Cary, NC
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Telephone: 919-387-5980
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Girls ages 5-12 take their favorite doll and have a creative time together preparing for the holidays. Register by emailing llpolkhouse2@gmail.com.

Cost: $22/attendee, $20/sister

Where:
Historic Polk House
537 N. Blount St.
Raleigh, NC  27604
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Telephone: 919-676-6368
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See dancers and a guitarist from Flamenco Carolina perform a Spanish style of music and dance.

Cost: $3/person

Where:
Century Center
100 N. Greensboro St.
Carrboro, NC  27510
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Ebeneezer Scrooge was visited by three spirits, but what about the next Christmas? With heartwarming excitement, discover how the Cratchit family has fared in the year that has passed since old...

Cost: Free

Where:
Wake Forest Renaissance Centre
405 S. Brooks St.
Wake Forest, NC  27587
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The Durham Medical Orchestra performs with special guest Joseph Alessi, principal trombone, New York Philharmonic.

Cost: Free

Where:
Baldwin Auditorium, Duke University
1336 Campus Dr.
Durham, NC  27705
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As a Christmas gift to our community and surrounding area, Wake Forest Presbyterian Church delivers the true Christmas story in a stirring virtual “walk” through Bethlehem to the stable...

Cost: Free

Where:
Wake Forest Presbyterian Church
12605 Capital Blvd
Wake Forest, NC  27587
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Sponsor: Wake Forest Presbyterian Church
Telephone: 919-556-7777
Contact Name: Meghan Reynolds
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Fun for the entire family, enjoy this wonderful, witty retelling of a classic fairy-tale. With a score consisting of well-known pop songs, follow Snow White and her Seven Dwarves as they try to...

Cost: $10-$60/person

Where:
Duke Energy Center for the Performing Arts
2 East South Street
Raleigh, NC  27601
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Sponsor: Duke Energy Center for the Performing Arts
Telephone: 919-996-8700
Contact Name: Blake Jones
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The choir presents its 49th performance on Handel's "Messiah."

Cost: Free

Where:
White Plains United Methodist Church
313 S.E. Maynard Rd.
Cary, NC  27513
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The first day of winter is right around the corner! Help us welcome the season by making a snow globe to take home. We will bring the materials if you bring the imagination! For all ages (adult...

Cost: For all ages (adult accompaniment required for all children); FREE. Registration

Where:
Crowder County Park
4709 Ten-Ten Rd
Apex, NC  27529
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Telephone: 919-662-2850

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Children will enjoy this wonderful book written by John Denver reminding us not to forget about the wildlife this holiday season. We will make a craft then take a walk to look for our wildlife...

Cost: Free

Where:
Harris Lake County Park
2112 County Park Dr.
New Hill, NC  27562
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Sponsor: Harris Lake County Park
Telephone: 919-387-4342
Contact Name: Joanne St. Clair
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Join RTOOT as it performs the music of great Italian composers as well as beloved Christmas classics. Purchase tickets online. 

Cost: $9/adult, $3 ages 12 and younger

Where:
Cary Arts Center
101 Dry Ave.
Cary, NC  27511
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Dan the Animal Man brings some of his animals from his vast collection to entertain all ages. 

Cost: $3/person

Where:
Century Center
100 N. Greensboro St.
Carrboro, NC  27510
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Help find candy canes hidden in Bond Park before the Grinch turns them green. Ages 6-12. Registration required online. Choose course #127871. 

Cost: $10/child

Where:
Bond Park
801 High House Rd.
Cary, NC
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Embark on a wild ride with favorite Disney characters Mickey, Minnie, Goofy and many others in this fun-filled getaway featuring unexpected hijinks and character interaction. Purchase tickets...

Cost: $15 and up

Where:
PNC Arena
1400 Edwards Mill Rd.
Raleigh, NC  27607
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Website »

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Ages 1-5 and caregiver delight in the discoveries of nature. Register online. 

Cost: $8/resident, $10/nonresident

Where:
Stevens Nature Center/Hemlock Bluffs
2616 Kildaire Farm Rd.
Cary, NC
View map »


Telephone: 919-387-5980
Website »

More information

Get into the holiday spirit by decorating cooking, making a craft and enjoying a holiday children's show.

Cost: Free

Where:
Century Center
100 N. Greensboro St.
Carrboro, NC  27510
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The Wake Forest Abilities Choir will present an evening of holiday music under the direction of director.

Cost: Free

Where:
Wake Forest Renaissance Centre
405 S. Brooks St.
Wake Forest, NC  27587
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Website »

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Embark on a wild ride with favorite Disney characters Mickey, Minnie, Goofy and many others in this fun-filled getaway featuring unexpected hijinks and character interaction. Purchase tickets...

Cost: $15 and up

Where:
PNC Arena
1400 Edwards Mill Rd.
Raleigh, NC  27607
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Website »

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Celebrate pecans at the State Farmers Market.

Cost: Free

Where:
State Farmers Market
1201 Agriculture St.
Raleigh, NC  27603
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Join us to learn about how Habitat for Humanity helps build houses, hear a Christmas tale and then build a graham cracker house of your own. Call to, 919-245-2532. Best for ages 4 and up with a...

Cost: free

Where:
Orange County Main Library
137 W Margaret Ln
Hillsborough, NC  27278
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Sponsor: Orange County Public Library
Telephone: 919-245-2539
Contact Name: Libbie Hough
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Is there a man in the moon, and is the moon made of cheese? Sip on some hot cocoa and listen to some of the stories people have told about the moon and find out if there is truth to them. Then...

Cost: For all ages; FREE. Registration is required for everyone, and adult accompanime

Where:
Crowder County Park
4709 Ten-Ten Rd
Apex, NC  27529
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Telephone: 919-662-2850
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Discover family traditions from North Carolina and around the globe. Create art, enjoy free access to Frida Kahlo, Diego Rivera, and Mexican Modernism, and have a special visit with Santa.

Cost: Free

Where:
North Carolina Museum of Art East Building and Museum Plaza
Raleigh, NC


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Bundle up and enjoy an evening around the campfire learning about creatures of the night and listen to Native American tales about some of our favorite nocturnal animals. Roast marshmallows and go...

Cost: Free

Where:
Harris Lake County Park
2112 County Park Dr.
New Hill, NC  27562
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Sponsor: Harris Lake County Park
Telephone: 919-387-4342
Contact Name: Joanne St. Clair
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Kids ages 5-12 enjoy indoor activities while parents enjoy a night out. Register online. 

Cost: $30/resident, $45/nonresident

Where:
Halle Cultural Arts Center
237 N. Salem St.
Apex, NC  27502
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Wear white clothing and play games, tumble and dance. Enjoy pizza, drinks and more. Ages 5-10. Registration required online. Choose course #127487.

Cost: $18/child; $28 for two children per family

Where:
Middle Creek Community Center
125 Middle Creek Ave.
Apex, NC  27539
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Friday, December 13, 6:00pm, at both the Millbrook and Wake Forest Campuses. Put on your Christmas jammies, grab a blanket and come out for a  festive night to watch the classic animated...

Cost: Free

Where:
Crossroads Fellowship
2721 E Millbrook Road
Raleigh, NC  27604
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Sponsor: Crossroads Fellowship
Telephone: 919-981-0222
Contact Name: Lorraine Entwisle
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Have some fun and make something great at the Clay studio (and parents can sneak away and grab a bite or do some shopping at Northgate Mall). Each kid will complete and paint a piece of pottery...

Cost: $18 per child per workshop

Where:
1058 West Club Blvd
Durham, NC  27701
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Telephone: 919-560-2726
Contact Name: Lauren Tannenbaum
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Embark on a wild ride with favorite Disney characters Mickey, Minnie, Goofy and many others in this fun-filled getaway featuring unexpected hijinks and character interaction. Purchase tickets...

Cost: $15 and up

Where:
PNC Arena
1400 Edwards Mill Rd.
Raleigh, NC  27607
View map »


Website »

More information

Sing along with the band as they perform holiday favorites of Christmas, Hanukkah, the winter solstice and more. 

Cost: Free

Where:
Cary Senior Center
120 Maury O'Dell Place
, NC  27513
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Celebrate the love and joy that this season brings by creating art inspired by a Christmas tree. Register online. Choose course #126761.

Cost: $32/resident, $42/nonresident

Where:
Cary Arts Center
101 Dry Ave.
Cary, NC  27511
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Website »

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Give rugby a try. Take part in tag rugby pick-up games every Saturday morning at Baileywick Road Park, near the Second Shelter.  No experience necessary. All ages. 

Cost: Free

Where:
Baileywick Road Park
9501 Baileywick Rd
Second Shelter Field
Raleigh, NC  27615
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Sponsor: Raleigh Redhawks Rugby
Contact Name: denise travis
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Our Reindeer Romp is open to the entire community and our Girls on the Run families. So join us! Celebrate as nearly 1,000 girls reach their end-of-season goals – the finish line is only the...

Cost: $30 - $35

Where:
Koka Booth Amphitheater
8003 Regency Pkwy
Cary, NC  27518
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Sponsor: Girls on the Run of the Triangle
Telephone: 919-401-6307
Contact Name: Jamie Botta
Website »

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Ages 5-12 make a picture frame for the holidays. Snack provided. Register online. 

Cost: $30/resident, $45/nonresident

Where:
Halle Cultural Arts Center
237 N. Salem St.
Apex, NC  27502
View map »


Website »

More information

Ages 1-5 and caregiver delight in the discoveries of nature. Register online. 

Cost: $8/resident, $10/nonresident

Where:
Stevens Nature Center/Hemlock Bluffs
2616 Kildaire Farm Rd.
Cary, NC
View map »


Telephone: 919-387-5980
Website »

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Travel with us to Puerto Rico with books, games and arts and crafts!  Join the staff of ISLA (Immersion for Spanish Language Acquisition) for a fun filled hour! Best for ages 3 and up with a...

Cost: Free Gratis

Where:
Orange County Main Library
137 W Margaret Ln
Hillsborough, NC  27278
View map »


Sponsor: Orange County Public Library
Telephone: 919-245-2539
Contact Name: Libbie Hough
Website »

More information

Embark on a wild ride with favorite Disney characters Mickey, Minnie, Goofy and many others in this fun-filled getaway featuring unexpected hijinks and character interaction. Purchase tickets...

Cost: $15 and up

Where:
PNC Arena
1400 Edwards Mill Rd.
Raleigh, NC  27607
View map »


Website »

More information

One ticket admits the entire family to decorate a special gingerbread house. Supplies provided. Workshops available at 2 p.m. and 4:30 p.m. Allergy-free workshop available at 11 a.m....

Cost: $40

Where:
Family Preschool
4907 Garrett Rd
Durham, NC  27707
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Sponsor: Family Preschool
Telephone: 919-402-1500
Contact Name: Sue Henson
Website »

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Family Wildlife Series: Holiday Habitat Helpers Saturday, December 14, 2-3 Attract winter wildlife to your backyard by providing or improving their habitat.  Create simple outdoor decorations...

Cost: Free

Where:
Blue Jay Point County Park
3200 Pleasant Union Church Rd
Raleigh, NC  27614
View map »


Website »

More information

Embark on a wild ride with favorite Disney characters Mickey, Minnie, Goofy and many others in this fun-filled getaway featuring unexpected hijinks and character interaction. Purchase tickets...

Cost: $15 and up

Where:
PNC Arena
1400 Edwards Mill Rd.
Raleigh, NC  27607
View map »


Website »

More information

Embark on a wild ride with favorite Disney characters Mickey, Minnie, Goofy and many others in this fun-filled getaway featuring unexpected hijinks and character interaction. Purchase tickets...

Cost: $15 and up

Where:
PNC Arena
1400 Edwards Mill Rd.
Raleigh, NC  27607
View map »


Website »

More information

Join us as we watch for meteors during the Gemenids Meteor Shower. Local astronomers will help us observe these shooting stars and other phenomena in the night sky. As a bonus we may see or hear...

Cost: Free

Where:
American Tobacco Trail
1309 New Hill-Olive Chapel Rd.
Apex, NC  27502
View map »


Sponsor: Harris Lake County Park and the American Tobacco Trail
Telephone: 919-387-4342
Contact Name: Joanne St. Clair
Website »

More information

Favorite Christmas songs are presented in authentic Nashville country style with dazzling guitars and fiddles along with soaring harmonies. Purchase tickets online. 

Cost: $25/person

Where:
Wake Forest Renaissance Centre
405 S. Brooks St.
Wake Forest, NC  27587
View map »


Website »

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See the choir perform beloved Christmas songs with guest vocal group AVANTE. Purchase tickets online. 

Cost: See website for fees

Where:
Cary Arts Center
101 Dry Ave.
Cary, NC  27511
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