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One of the best things about living in the Reno area is the beautiful mountain range that surrounds our city. Many families take advantage of the activities the mountains have to offer or travel over them to visit friends and family in neighboring areas. However, for parents of infants there is often angst over your baby’s ears and altitude changes and the associated potential for ear pain and/or “popping.” Fortunately, there are things you can do to protect your infant’s ears the next time you drive over the mountain or hop on a plane with your little one. Baby’s Ears and Altitude Changes: What Causes Them to “Pop” The simple answer is pressure. The problem originates in the middle ear where there is an air pocket that is vulnerable to changes in pressure. The Eustachian tube, which runs behind the nose to the middle ear, is constantly absorbing and resupplying air to this pocket to keep it balanced. When the pressure is not balanced, your ears feel “clogged” or like they need to “pop.” In some cases this sensation can cause significant ear pain and even temporary hearing loss. Rapid changes in elevation or altitude, like driving over a mountain, or ascending or descending on an airplane, can cause rapid changes in pressure. In order to avoid problems, the Eustachian tube needs to open widely and frequently to equalize those pressure changes. The problem often intensifies during descents as you go from an area of lower atmospheric pressure to an area of higher atmospheric pressure. This is why you hear babies screaming on planes during descent or why your infant is wailing in the car seat as you head down the mountain. What can you do to make it a more comfortable trip for your child? First, be prepared. Babies cannot intentionally “pop” their ears like adults can, but we can help them by encouraging them to swallow. Offer your baby a pacifier or bottle while making ascents and descents. If possible, it may be helpful to have an adult ride in the back seat with baby if you’re in the car to ensure this can happen. Don’t let your baby sleep during descent on a plane. Help your little traveler out by offering him or her a pacifier during this process, as descent is the most likely time for pain associated with altitude changes. If your baby is congested prior to travel involving altitude changes, seek the advice of your pediatrician since they may have other solutions, including medications such as decongestants. If you return from a trip and notice your infant is still fussy and uncomfortable, contact your child’s doctor for a thorough ear evaluation. Safe travels!

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Not all memory loss is inevitable — there are several things you can do to keep your brain nimble at any age. Find out how brain exercises, a healthy diet and daily movement can improve your brain’s focus. A modest decline in memory is to be expected as we get older. We forget someone’s name but recall it later. We find the need to make lists to remember things more pressing. Manageable? Yes. But frustrating nonetheless. The good news is we don’t have to sit back and succumb to age-related memory loss. There are concrete things we can do at any age to keep our brains sharp, nimble and engaged. Five Simple Brain Exercises 1. Volunteer or participate in meaningful activities outside of work. This engages your brain and emotions in a healthy, positive way. 2. Engage in moderate, regular exercise to tone body and mind. Overall good health is critical to brain health. Even casual daily walking can boost your mental abilities. 3. Eat the rainbow. Choose to include plenty of colorful fruits and veggies and ease up on processed foods in your daily diet. The proper nutrients can improve circulation to your brain, which will amp up your cognitive abilities. Consult your doctor for the best diet and supplement choices for your specific health needs 4. Get a blood test to determine your body’s hormonal and nutrient levels. Specific hormones and nutrients can affect cognition. Be mindful of your cholesterol levels, and if you take cholesterol medications, such as statin drugs, be aware they can also affect your mental faculties. 5. Engage in brain activities like reading, crossword puzzles, Sudoku and Trivial Pursuit. These types of activities can improve your brain’s focus and concentration and — most important — test your memory and general knowledge. You derive more benefit by engaging in these activities consistently for short amounts of time, so make a weekly appointment with yourself to build brainpower.

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Getting the COVID-19 booster is the best way to protect yourself from severe illness or death due to COVID-19, and both the CDC and the FDA have approved booster shots for people ages 18 and older. So, with the holidays right around the corner and infection rates on the rise both in Nevada and nationally, the best thing you can do to prevent the continued spread of this deadly virus is to get boosted today. The Basics: Who: It is recommended that everyone 18 years or older get a COVID-19 booster shot. When: At least 6 months after completing your primary COVID-19 vaccination series. What: Any of the COVID-19 vaccines authorized in the United States. The CDC allows for mix and match dosing for booster shots. How: To make an appointment for your COVID-19 vaccine booster, please visit vaccines.gov today. Appointment Reminders: Don’t forget to bring your CDC vaccination record card to your appointment. Refresh yourself on the potential side effects and remember that these are normal signs your body is building up protection. Commonly Asked Questions: Q: Does anything change if I received the Johnson & Johnson as my first COVID-19 vaccine? A: If you received the Johnson & Johnson COVID-19 vaccine, you are elidable for a booster two months after completing your primary vaccine. Q: Is the formula the same for the boosters as it was for the primary vaccine? A: COVID-19 booster shots are the same formulation as the current COVID-19 vaccines. However, in the case of the Moderna COVID-19 vaccine booster shot, it is half the dose of the vaccine people get for their primary series. Q: Am I still considered “fully vaccinated” if I don’t receive a COVID-19 booster shot. A: Yes, everyone is still considered fully vaccinated two weeks after their second dose in a two-shot series, such as the Pfizer-BioNTech or Moderna vaccines, or two weeks after a single-dose vaccine, such as the J&J/Janssen vaccine. All information courtesy of the Center for Disease Control and Prevention. All information courtesy of the Center for Disease Control and Prevention

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Millions suffer from urinary incontinence (urine leakage). Often people feel as if their bladders control their lives. But this doesn't have to be your story. Bladder control issues are treatable and you can take steps to help control your bladder. What is urinary incontinence? Men and women of all ages can have difficulty controlling their bladders. Urinary incontinence occurs when the muscles in the bladder that control the flow of urine contract or relax involuntarily. Is there more than one type of urinary incontinence? Yes, there are three main types: Stress incontinence is when the bladder leaks small amounts of urine as a result of physical stress or pressure on the muscles supporting the bladder caused by coughing, sneezing, laughing, lifting or any sudden physical exercise such as running or jumping. Urge incontinence is the inability to control a strong urge to go without advance warning, limiting the time needed to get to the bathroom. Overflow incontinence occurs when the bladder does not empty properly. As a result, over time, large quantities of urine are stored, causing the bladder to overflow (this is more common in men and is often the result of an enlarged prostate blocking the bladder opening). Are there any tests that can determine the cause and type of incontinence? Your doctor may have you track your fluid intake and output in a Bladder Diary. A urinalysis can be checked for infection, traces of blood, or other abnormalities. Blood tests can look for chemicals or substances that may relate to contributing causes. Other testing may be an ultrasound, cystogram or post voiding residual measurement. How is urinary incontinence treated? Exercises to strengthen the pelvic floor muscles or restrain the bladder to hold on for longer. Medication can relieve and control the troublesome symptoms. If there is an infection an antibiotic is used. Surgery can repair weakened muscles or remove blockage. Special products such as pants, pads, collection devices, and chair and bed protection may be needed if the problem cannot be controlled. How do you strengthen your pelvic floor muscles? To make your pelvic floor muscles stronger, alternate between squeezing and relaxing them. Following the steps below may help: Squeeze your muscles for one second and hold. Relax your muscles for two seconds. Each time you squeeze and relax, it counts as one set. Complete five sets. When you can do the exercises easily, increase to doing them 10 times per day. When that gets easy, try to squeeze and hold the muscles for three seconds and then relax the muscles for three seconds. As your pelvic muscles get stronger, you can progress to longer squeezes for about 10 seconds. Be sure to relax between squeezes so that your muscles can rest before squeezing again. You should do these exercises in three different positions. Do 10 sets lying down, 10 sitting and 10 standing. It is important that you develop the habit of doing the exercises every day. You may want to exercise just after you get up in the morning and right before you go to bed at night. What can I do to help control incontinence? Watch your weight, practice pelvic floor muscle exercises, eat plenty of fresh fruits, vegetables and fiber to prevent constipation. Most importantly, talk to your doctor regarding incontinence issues, don’t be embarrassed!

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The summer is here, and it is time to take action. The heat can be dangerous for kids, so make sure that you are aware of the signs of heatstroke and know how to prevent it.  Did you know heatstroke is the leading cause of non-crash related fatalities in children? “On average, every 10 days a child dies from heatstroke in a vehicle. In more than half of these deaths, the caregiver forgot the child was in the car.” (Safe Kids Worldwide,” 2022, para.1)  Babies are at higher risk for heatstroke than adults, as they cannot regulate their body temperature as well as adults can. They also do not have the same understanding of how hot the environment is and may not be able to communicate that they need to be taken out of the car.   Here are eight simple tips to keep your baby cool in the back seat:  In hot weather, it is important to keep your baby cool and hydrated by using a car seat cover or towel over them to reflect the sun's rays. It is important to dress your baby in lightweight clothing that covers their arms and legs. Make sure that your car is well ventilated and use a towel or blanket to create an air gap between your baby and the seat. This will help with air circulation, as well as provide insulation from hot surfaces. Keep an eye on your baby's skin color. If it starts looking too red or flushed, it may be time to get somewhere cooler. Keep the temperature at a comfortable temperature for you, not for your child. Keep windows cracked open for ventilation and make sure that there is nothing blocking the flow of air from entering or exiting the vehicle. Dress your infant appropriately for their environment with appropriate head and neck coverings, keeping them cool as well as protected from sunburns. Ensure that you have enough fluids on hand to last an hour before getting out of the car or use bottled water if possible. Never leave your child unattended in a car.    If you suspect heatstroke in someone, especially a child, take the following measures:  Call 911 immediately.  Cool the victim – Get the person to a shady area, remove restrictive clothing and cover skin with sheets soaked in ice-water, and place ice packs in the arm pits and groin.  Have the victim drink cool fluids, preferably an electrolyte-containing sports drink.  Monitor body temperature with a thermometer, but stop cooling efforts after temperature has dropped to 102.   Additional Resources:  Baby Safe Class  This class helps prepare parents for emergencies that may occur in baby’s first year. Along with car seat safety and basic baby proofing, discussion will include prevention and treatment of common injuries.

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Renown Health is closely following the national outbreak of the monkeypox virus and urging healthcare providers to be alert for patients with illnesses associated with a rash. In working with the Washoe County Health District (WCHD), Renown is closely monitoring the spread of monkeypox in the community and looking to prevent and reduce the spread of monkeypox. To help to ease worries, we consulted with Paul De Leon, Infection Preventionist at Renown Health. What Exactly is Monkeypox? Monkeypox is a rare viral illness caused by the monkeypox virus — the same family of viruses that causes Smallpox. Although symptoms are similar to Smallpox, monkeypox symptoms are milder and rarely fatal. However, it's important to mention that this virus can be more severe for these susceptible groups: Immunocompromised Pregnant women A fetus or newborn baby Women who are breastfeeding Young children Those with severe skin diseases such as eczema How is Monkeypox Transmitted? The monkeypox virus is not easily transmitted but occurs through sustained person to person close contact with an infected individual. Monkeypox can also be transmitted through direct contact with infectious rash, scabs, or body fluids. Monkeypox can also be spread through prolonged intimate physical contact, such as kissing, cuddling or sex. Lastly, monkeypox can be spread through contaminated linens or bedding. Transmission through respiratory secretions is uncommon but has been reported after prolonged face-to-face contact with symptomatic individuals. In addition, pregnant women can spread the virus to their fetuses through the placenta. Monkeypox Testing If you think you have monkeypox, contact your primary care physician or other medical providers to obtain testing. Notify the provider ahead of time before entering the physical office. Signs & Symptoms This current outbreak of West African monkeypox does not have the typical presentation of classic monkeypox. Symptoms usually appear one to three weeks after infection and include: Pimple-like rash or blisters on the face, inside the mouth, and on other areas of the body, like the hands, feet, chest, genitals, or anus. The rash will go through serval stages, including scabs, before healing and may be painful or itchy. Other symptoms of monkeypox can include: Fever Headache Muscle aches and backache Swollen lymph nodes Chills Exhaustion Respiratory symptoms such as sore throat, nasal congestion, or cough Symptoms of monkeypox may occur before or after a rash with some individuals only report experience a rash. Individuals with monkeypox are infectious once symptoms begin and remain infectious until lesions form scabs, scabs fall off, and a fresh layer of skin forms. The illness typically lasts 2-4 weeks.

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Renown Health recently announced that it has contracted with the Centers for Medicare and Medicaid Services (CMS) on a new program that offers enhanced Medicare benefits for Medicare beneficiaries. This new direct contracting Medicare program is designed specifically for patients with Original Medicare. Here are three things to know about Renown’s new program: The goal of the program is to help care providers work together to improve patients’ health by better coordinating patient care and reducing costs. Medicare beneficiaries who choose to sign up will have peace of mind knowing that they are in a program that ensures coordinated care along with potential cost-sharing assistance for chronic care management. Signing up for this program is easy – and it does not affect your existing Medicare benefits in any way. Simply click the button below, select either your current Renown Health or Geriatric Specialty Care provider from the drop down menu, complete the form and click “Submit Form.” It only takes a minute or two to fill out the form. You will be asked to provide the name of your primary care provider and be sure have your red, white, and blue Medicare card handy. Sign Up for Renown’s Enhanced Medicare Benefit Program Voluntary Alignment Sign Up Note: Participation in this program is voluntary. If you choose to sign up, your benefits will NOT change, and you can visit any doctor, other health care professional, or hospital. Learn more about Renown’s Direct Contracting Entity for Medicare Beneficiaries here. The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.

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Becoming a parent for the first time means lots of new unknowns – from learning to breastfeed and swaddle to buckling your newborn into the car seat for the first time. But when it comes to putting them to bed safely, it’s important to remember it really can mean life or death. It’s something we’re taught before our little one is even here: the correct way to put your baby to bed safely. Sadly though, the number of infant deaths continues to climb. The main culprit of sleep-related infant death continues to be all the items parents leave in the crib with their babies. According to the Center for Disease Control and Prevention, there are about 3,500 sleep-related deaths among babies each year. “The best advice is ‘bare is best.’ Keep your infant’s sleep space clutter free – no blankets, bumpers, toys or pillows,” said Karen Wagner, Pediatric Nurse Practitioner. Follow the ABCs for Safe Sleep Remembering the ABCs is an easy way to remember how to put your little one to bed safely. A: Alone No blankets, toys or pillows. “We do recommend using a sleep sack as a blanket alternative,” said Karen. “It prevents the risk of suffocation and keeps your baby warm.” Keep in mind, the greatest risk for suffocation happens when babies are under 1 year of age, so it’s best to save the toys, blankets and pillows for their “big kid bed,” or around 18 months old. B: Back The slogan “back is best” is another good reminder. Keeping your baby on their back until they’re old enough to rollover helps reduce the risk of Sudden Infant Death Syndrome (SIDS). C: Crib It is best to have your baby sleep alone in their crib. While co-sleeping may be enticing, especially after a late-night feed, it increases the risks of possible suffocation. However, “having your child in your room, in their own crib or bassinet, is protective for SIDS,” Karen said. “In fact, we think co-rooming reduces SIDS risk by almost 50 percent.” Co-rooming allows parents to keep new babies in close reach and helps parents oversee their baby’s sleep, just in case something happens.

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