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Northern Nevada is home to some of the most gorgeous and pristine lakes in the country — but also some of the most unforgiving. Lake Tahoe water temperatures average 50 degrees in the summer, making the danger of hypothermia real and always present. Here are the signs, symptoms and ways to prevent cold water drowning. When we think of air temperature at 50 degrees Fahrenheit, it’s not all that cold. But when it comes to water that’s 50 degrees, there is no comparison. Immersion in cold water is life threatening and can happen within a minute. Taking the right precautions before entering the water can save your life. The 4 Phases of Cold Water Drowning 1. Cold Shock Response: This response affects breathing and happens within the first minute. An automatic gasp reflex occurs in response to rapid skin cooling. If the head goes below water, water may be breathed into the lungs, resulting in drowning. A life jacket will help keep your head above water during this critical phase. Additionally, hyperventilation, like the gasp reflex, is a response to the cold and will subside. Panic will make this worse, so the key is to control breathing. 2. Cold Incapacitation: This response occurs within the first five to 15 minutes in cold water. In order to preserve core heat, vasoconstriction takes place decreasing blood flow to the extremities to protect the vital organs. The result is a loss of movement to hands, feet, arms and legs. Unless a life jacket is being worn, the ability to stay afloat is next to impossible. 3. Hypothermia: Important to note, it can take 30 minutes or more for most adults to become hypothermic. So there’s time to take action and survive. Keeping panic at bay is critical, as you have more survival time than you think. Symptoms include: Shivering Slow and shallow breathing Confusion Drowsiness or exhaustion Slurred speech Loss of coordination Weak pulse 4. Circum-rescue Collapse: This experience can happen just before rescue and is not well understood. Symptoms range anywhere from fainting to death. Some experts believe an abrupt drop in blood pressure may cause this final stage of cold water drowning, post-rescue. Additional Cold Water Drowning Safety Tips and Helpful Resources Always wear a personal flotation device as well as a wetsuit or drysuit. Your personal flotation device is the most important piece of water safety gear. Try not to panic as the first phases will subside. Controlled breathing is to staying calm. Research suggests the body can withstand the cold longer than we think. The Heat Escape Lessening Posture (HELP) is a position which helps conserve energy if you’re wearing a personal flotation device. By hugging your knees to your chest, this posture helps maintain body heat for some time.

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At Renown Health, we often discuss the importance of both healthcare – how we treat people when they are sick or injured – and health – how we keep people well in their mind, body and spirit. This conversation is as important for the patients we serve as it is for our healthcare providers.   It’s well known that the medical field can impose challenging and even unhealthy expectations for healthcare workers. Long hours and physically and emotionally demanding work can lead to burnout. Yet, until recently, these issues were rarely discussed openly. Because the role of healthcare providers is to care for other people, they may feel uncomfortable asking for help themselves. The good news is that more and more physicians and professional associations are talking about burnout. Hospitals are also taking action to address concerns like mental and emotional fatigue. We need our workforce to be healthy in mind, body and spirit. That’s why we support our team by educating them on the warning signs of burnout. Renown Health also trains management-level employees to care for those who need help. We encourage employees to talk openly about these challenges and encourage them to access the many services available to our employees that can help them live well. Caring for people is central to Renown Health’s mission. We believe this applies to both our patients and our teammates.

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Winter skin alert – cold temperatures can put your skin into chaos. We asked for skin tips from Heidi Nicol, an esthetician with Renown Dermatology, Laser & Skin Care. She shares how to keep your skin glowing through the frosty months ahead. With the change from warm to cold weather, your skin can get stressed out. In fact, issues like flaky skin, irritation and chapped lips can be an everyday struggle. 5 Easy Winter Skincare Tips 1. Re-think your shower Few things feel better on a cold day than a long, hot shower. But hot showers can lead to dry skin because they strip your skin of its natural protective oils. Avoiding them altogether is best – choose a lukewarm, or warm, shower instead. If you have an occasional hot shower, the American Academy of Dermatology (AAD) suggests keeping it at five to ten minutes. Nicol recommends using a gentle cleanser and avoid using too much. Moisturizing after a shower or bath while your skin is still damp is also a must. Slathering on your favorite lotion helps your skin hold on to precious moisture. 2. Stay away from smoke and fire Although sitting close to a roaring fireplace can feel good, it is drying to your skin. Smoking and exposure to smoke also harms your skin. Smoking reduces healthy blood flow to the skin. This also causes your skin to wrinkle faster, making you looker older. Additionally your skin heals much slower if you smoke. 3. Consider a humidifier Cranking up the thermostat dries out indoor air. Skin is our largest organ, and in general, heat is very drying to your skin. To clarify, over time dry air degrades your skin’s natural moisture (lipid) barrier leading to flaking, peeling and cracking. Your skin can overcompensate for the dryness by producing even more oil. In other words it is possible for your skin to be both oily and dehydrated at the same time. Even oily skin needs a daily lightweight, non-pore clogging moisturizer. 4. Use SPF daily The sun’s rays damage your skin even on cloudy days. Sunlight contains UVB (burning) and UVA (aging) rays. Although UVB rays are less strong in the winter, the UVA rays are same strength all year. And snow can reflect almost 90% of UV radiation. With this in mind make sure you have suitable skin and eye protection when going outdoors. 5. Take care of your hands and feet Don’t forget your fingers and toes when moisturizing. These areas tend to be drier than other parts of the body. Gloves help to protect hands from winter weather and lock in moisture. Similarly, putting lotion on your feet before your socks will keep them your skin from flaking and cracking. Follow the tips above to make sure your skin is at its best, despite the winter weather. Renown Dermatology, Laser & Skin Care | 775-982-8255 Renown Dermatology, Laser & Skin Care offers a comprehensive range of treatments and products to address any skin care need. Visit our beautiful office in south Reno and browse our product lines. Experts are available to answer any questions concerning your skin care and health and wellness needs.

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Did you know that your makeup brushes are likely full of built-up dirt and bacteria? Using dirty makeup tools can lead to irritation, breakouts and even infections. The good news? It's completely preventable. An expert explains For anyone who regularly wears makeup, brushes are great tools for powdering, contouring and finishing touches. Unfortunately, these same brushes also harbor harmful bacteria that can clog pores and cause unwanted breakouts. “Brush hairs and sponges are porous, and hold on to oils, debris and bacteria,” says Heidi Nicole, medical esthetician with Renown Dermatology, Laser & Skin Care. “Also, if they are dirty, the application of makeup can be spotty and make blending more difficult." Most dermatologists suggest that you clean your makeup brushes at least once a week. Because they are used on your face, it makes sense to keep them as a clean as possible. In addition, your brushes will last longer if you stay on top of cleaning them. Six simple steps to integrate makeup brush care into your beauty routine: Wet your brush with lukewarm water. (Don’t soak your brushes, as water in the brush barrel can cause the hairs to fall out.) Place a drop of gentle cleanser or specialized brush cleaner in the palm of your hand. Gently massage the tips of the bristles on your palm. Rinse the bristles well. Blot with a clean towel and reshape the head. Let the bristles dry over the edge of a counter. Do not allow the bristles to dry on the towel, which could cause the brush to mildew. Store your brushes in a clean, dry place in between uses.

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Has a male in your life been affected by depression? It could be your father, husband, or son. Or maybe your brother, a friend – or even, your co-worker. They all have one thing in common, they’re men and they may not always be able recognize when they need help. Here’s how you can support the men in your life by understanding their unique signs of depression. Dr. Coard, Ed.D., Psychologist with Renown Behavioral Health, weighs in on the topic of depression and the warning signs. More than 6 million men are diagnosed with depression each year, and surprisingly, depression in men can differ from women. The signs of depression are not easily recognized and it’s common for men to be in denial about what they’re going through. They can demonstrate anger and aggression instead of sadness – making it difficult for loved ones, or even their providers, to recognize. Behavioral Signs of Depression in Men High levels of the hormone cortisol are released during stressful situations affecting the neurotransmitter, serotonin (a feel good hormone), contributing to depression. You can identify depression or suicidal tendencies by paying close attention to the following behavioral changes: Anger, irritability, or aggression Avoiding family or social situations Losing interest in family responsibilities, passions and hobbies Lack of sex drive Becoming controlling/abusive in relationships Risk-taking behavior such as; unsafe sex, overspending or gambling Not being able to concentrate or remember details Excessive drinking or drug use Having frequent thoughts about death Talking about suicide Attempting suicide Factors That Lead to Depression in Men Life Events Work stress or long-term unemployment can be huge contributing factors relating to depression. This type of life event can be overwhelming, making it impossible for a man to cope. Changes in Relationships The loss of a relationship can be a significant contributing factor to the emergence of depressive symptoms and past experienced physical, sexual, or emotionally abusive relationships. With this in mind, counseling can often help individual to overcome this type of trauma. Grief and Loss Overwhelming sadness due to the loss of a loved one can trigger depression. Although normal, each person goes through their own grieving period. For example, normal responses to death are insomnia, poor appetite and loss of interest in activities. Pay attention if grief seems prolonged or out of the ordinary. Health Problems In particular, depression coexists with medical conditions. As men age, this can be passed off as normal aging, but it could be more serious. In addition, illnesses such as thyroid disorders, Addison’s disease and liver disease can cause depressive symptoms. Diabetes, cancer, heart disease, or Parkinson’s disease can affect any age, thus triggering or worsening depression. Some older men also feel like they may be suffering from dementia because of difficulties with memory this may be a symptom of depression. A trip to the doctor may be in order to help alleviate concern and worry. Depression in Men and Suicide Frequently the emotional pain occurring with depression can distort a man’s ability to see a solution beyond suicide. Individuals with depression become very rigid and constricted in the way they solve problems. The statistics below speak for themselves, helping us understand the need to reach out to those who need our support. Male suicide rates are on rising – men die by suicide 3.53 times more often than women, accounting for 70% of all suicides. Sadly, every day 129 men commit suicide. White males accounted for 69.67% of suicide deaths in 2017. In 2017, firearms accounted for 50.57% of all suicide deaths. Middle aged Men who are middle aged have the highest suicide rates. 40% of those identifying as transgender have attempted suicide in their lifetime. Males who are guy or transgendered are at an increased risk for suicide attempts, especially before age 25. Veterans often suffer from post-traumatic stress disorder (PTSD) and depression, and are more likely to act on a suicide plan. How You Can Help Now that you can identify some of the warning signs of depression, here’s how you can help: Talk about your concern and communicate that you’re there to help him. Let him know depression is a medical condition and will usually get better with treatment. Suggest professional help from a Primary Care Provider, Psychologist or Therapist. Help set up appointments and offer to accompany him – let him make the decision, but make it clear you’re there for him, no matter what he decides. If you feel he is in a dire or life-threatening situation, contact 911. Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to talk to a trained counselor. Call the Veteran’s Crisis Line at 1-800-273-TALK (1-800-273-8255) and press “1”

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As we begin to enjoy the springtime weather in northern Nevada, are you finding your skin less than tip-top shape? Here’s how to add moisture back in easy, natural ways. You don’t need to be a medical aesthetician: Dry, cold climates can often wreak havoc on your body’s largest organ — your skin. These tips from Renown Dermatology, Laser & Skin Care will quickly put moisture back and relieve dry, chapped skin. 11 Miraculous Moisturizing Tips Always wear broad-spectrum sunscreen, even during winter months. Don’t forget to use an SPF lip balm, too. Heaters dry out your skin. Use a humidifier to keep moisture in the air. (And try these simple tips to make sure you’re keeping that humidifier clean.) If your skin is dehydrated, try using a nighttime moisturizer during the day. Use a hydrating mask or moisturizing mask twice a week. Don’t forget your hands and feet. Apply a rich cream to the hands and feet at night and cover them with gloves and socks to restore moisture while you sleep. Drink plenty of water to stay hydrated. Try adding a hydrating serum to your morning and nighttime skincare routine to heal the skin. Use a gentle exfoliant to remove dry skin at least once a week, which helps your skin absorb your moisturizer. Apply body oil or lotion in the shower while your skin is still damp to trap moisture. Hot water dries out your skin, so turn down the temperature in the shower and bath.   A little pampering goes a long way, and Renown’s medical aestheticians are here to help. Trained in skincare and advanced therapies, our experts can transition your skin to look healthy, youthful and rejuvenated.

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The Benefits of Being Clutter-Free Gives you a better sense of well-being. Did you know procrastination is linked to clutter? According to a recent study clutter problems led to less life satisfaction, especially among older adults. Helps you lose weight. Constantly being in cluttered room, office or car can be stressful. All the undone cleaning tasks in the back of your of mind cause stress, which is linked to obesity. Promotes mental health. Having clutter around can make you feel anxious or overwhelmed. This prevents you from truly relaxing or focusing. Saves you money. It’s not a secret that money worries cause stress. According to a Journal of Consumer Research study, you’re more likely to make a purchase when you’re sitting in a messy room compared to a tidy room. Clutter-Free Tips Start with a plan. Make a list of your clutter-improvement priorities and the tasks needed to accomplish each one. Focus on one section of your home per week, so you don’t get overwhelmed. In fact, organizational expert Peter Walsh suggests starting with the easiest room first to gain momentum. Conversely, "The Life-Changing Magic of Tidying Up" author Marie Kondo suggests organizing by category (for example clothing or books). Experiment with an organizing plan that appeals to you. There are also many helpful on-line calendars you can use as a starting point. Delegate when you can. Include your children and spouse into your plan. Is uncle Bob an electrician? Then get him to swap out your eyesore of a ceiling fan or update an old light fixture. Of course it’s ok to outsource the duties - such as window cleaning or painting - if your budget allows. Buy less. The less you purchase the less you need to store, clean, keep track of, organize or dust. Seems simple, right? Not for everyone. On average we are bombarded with over 4,000 marketing messages a day, not to mention FOMO (Fear Of Missing Out) when we see our friends posting about their newest toys on their social media feeds. Focus on quality over quantity. When in doubt, throw it out. Still on the fence about what to throw away? Use these declutter decision-making guide questions to help you. Organize Your Health Along with taking care of your surroundings, make a commitment to get up to date on your health checkup and screenings. Preventing an illness is a bargain compared to the cost of a chronic disease. It's also a good idea to go through all of your medications and check the expiration date. Remember to properly dispose of medications. DO NOT flush medications down the drain or toilet, unless the label indicates it is safe to do so.

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Some days a chat with a friend is all you need to feel better. Why? Because humans are social beings. Although we have more technology than ever at our fingertips, sometimes we may still feel left out or disconnected. Dr. Buddy Coard, Ed.D., Psychologist at the Stacie Mathewson Behavioral Health Addiction Institute at Renown, discusses the importance of social connections and tips on how to keep connecting, warning signs of loneliness and how to feel less lonely.  Why are Social Connections Important? Dr. Coard points to significant research on the topic of loneliness and social connections. He uses the findings below to detail how social connections affect our overall health. In a recent survey 40% of participants reported they sometimes or always feel that their relationships are not meaningful and that they feel isolated. Surprisingly, this survey suggests Generation Z (18-22 years old) is the loneliest generation. Another study associates loneliness as a risk factor for early death. It indicates lack of social connection heightens health risks as much as smoking 15 cigarettes a day, or having alcohol use disorder. In fact, loneliness and social isolation are twice as harmful to physical and mental health as obesity (Perspectives on Psychological Science, Vol. 10, No. 2, 2015). A 2018 study investigated several standard measures of social isolation, including marital status, frequency of religious service attendance, club meetings/group activities and number of close friends or relatives. The findings revealed race as a strong predictor of social isolation. In particular, black men and women were more likely to be lonely than were white men and women. Loneliness also switches on your body’s long-term “fight-or-flight” stress signaling system, which negatively affects your immune system. People who feel lonely have lower immunity and more inflammation than people who don’t. Dr. Coard recommends the following tips for those who feel lonely. Tips to Increase Social Connection Get outside. More and more nature prescriptions are common. In fact even a 10 minute walk can elevate your mood and get your blood flowing. Develop a schedule of activities to accomplish in a week, setting realistic goals. Monitor your technology. Of course, watching the 24/7 news cycle can be depressing. Turn off the TV and listen to music or read a book instead. Even better, use technology to connect with family members by having a virtual game night or book club discussion. Write it out. When was the last time you sent a good old-fashioned letter or card? Or even wrote in a journal? Try to brighten someone’s day with snail mail. Writing down your hopes and fears also helps you to get worries off your mind and process your emotions. With this in mind, there are also volunteer opportunities to support others by sending a handwritten letter to others battling depression. De-clutter your surroundings. Go through those old photos and put them in an album. Clean out a drawer, cupboard or closet. You will feel a sense of accomplishment and can donate items you no longer need that others can enjoy. Increase your joy by reducing your clutter. Warning Signs of Chronic Loneliness One size does not fit all when it comes to loneliness. For this reason, loneliness can be different depending on your particular situation and your unique personality. However, if you feel some (or all) of the following symptoms, chronic loneliness may be affecting you: Lack of ‘best’ or close friends. You connect with others on a surface level, but feel no one truly understands you. People are n your life, yet you are not connecting on a deep, intimate level with them. You feel lonely even when people are around. This means feeling disengaged or not part of the group when around others. You feel less than enough. You often doubt yourself or don’t feel good enough when comparing yourself to others. And social situations feel exhausting. What Can Someone Do to Feel Less Lonely? Dr. Coard offers the following suggestion for those with a lack of social connections: Talk with your doctor, psychologist or another healthcare professional. Sometimes chronic loneliness relates to longstanding negative beliefs that an individual has about themselves. Engage in behavioral activation. For example, being more active and involved in life by scheduling activities which can potentially improve your mood and decrease feelings of isolation. Initially behavioral activation can be very challenging due to lack of motivation, but setting a reasonable schedule of activities is a good start. Pay attention to your sleep. Sometimes when people become lonely they experience significant changes in their sleep cycle. Frequently they sleep too much, or too little. Make sure to maintain a normal, healthy sleep/wake cycle, following good sleep hygiene recommendations.

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You want to protect yourself and your family from the harmful rays of the sun — which are especially punishing at northern Nevada’s higher altitudes — but with so many options, how do you choose the right sunscreen? We asked our expert, Dr. Angela Walker, a dermatologist with Renown Medical Group, to shed some light on the subject. Sunscreen Application Dermatologists recommend a broad-spectrum sunscreen with a minimum SPF of 30, but keep in mind that no sunscreen protects against 100 percent of UV radiation and that reapplication is necessary. “No matter the SPF, sunscreen must be applied adequately and frequently, meaning a quarter-sized amount to cover the face and neck and a full shot glass amount for the body when wearing a bathing suit,” said Walker. “Reapplication should be every 80 minutes.” Why not use a high SPF, such as 70 or 100? According to the Skin Cancer Foundation, they don’t offer significantly more protection than SPF 30 and mislead people into thinking they have a higher level of protection. Here’s the breakdown: SPF 15 blocks 93 percent of UVB rays SPF 30 blocks 97 percent of UVB rays SPF 50 blocks 98 percent of UVB rays SPF 100 blocks 99 percent of UVB rays Do specific populations require a higher SPF? Walker explains that infants, seniors, and those with a history of skin cancer must take precautions against UV radiation, as their skin is vulnerable. Sunscreen should be an absolute priority before spending time outdoors and avoiding prolonged sun exposure, wearing a hat with wide brim (recommended 4-inch brim) and UPF (ultraviolet protection factor) clothing. Due to the sensitive nature of an infant’s skin, babies under six months should not spend time in the direct sun. For infants and toddlers six months and older, whose skin is thinner than adults, a sunscreen that contains zinc oxide or titanium dioxide (physical protectors) should be applied. Zinc and titanium are less likely to irritate because they do not penetrate the skin and instead sit on the surface and deflect UV radiation. Zinc oxide and titanium dioxide are vital ingredients to seek out in sunscreen due to their strong ability to deflect UV radiation. Sunscreen Terms Explained UVA = Long wave ultraviolet light. Penetrates deep into the dermis, the skin’s thickest layer, causing tissue damage that wrinkles and photo-aging and contributes to developing skin cancer. UVB = Short wave ultraviolet light. The biggest contributor to the development of skin cancer and are more prevalent during mid-day. SPF = Sun protection factor. Calculated by comparing the amount of time needed to burn sunscreen-protected skin vs. unprotected skin. So, SPF 15 means you can stay in the sun 15 times longer than you could without protection.

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Whether you're a parent, grandparent, caregiver or sibling, you should know drowning is the second leading cause of death among children. Yet, while we are vigilant about protecting children from water accidents and drowning, a condition known as dry drowning or delayed drowning can go unnoticed. In fact, most people aren't even aware it exists. Dry drowning defined Dry drowning is a side-effect of a near-drowning experience and includes spasms of the vocal cords and larynx — known as a laryngospasm. This occurs when the body attempts to shut down the passage of any liquid into the lungs. Unfortunately, it can also shut down the passage of air into the lungs and force fluid into the stomach and lungs. Often the condition is not discovered until it's too late — severe cases can cause death within one to 24 hours after a water incident occurs. Who is susceptible? Novice or first-time swimmers are at increased risk, as are children with asthma and known breathing issues. In addition, children who have had pneumonia or experienced acute respiratory distress syndrome are also at greater risk. To reduce these factors, caregivers should be exceptionally watchful of inexperienced swimmers. According to Leland Sullivan, MD, of Northern Nevada Emergency Physicians, children under the age of 5 are most susceptible to drowning and often drown in residential swimming pools. Infants less than 1-year-old most often drown in bathtubs. What are the signs of a dry drowning episode? If your child has a near-drowning incident, a few moments of coughing until they calm down is normal. However, you should know the more severe signs and symptoms to watch for during the 24 hours following the incident, including: Persistent coughing Difficulty breathing and/or shortness of breath Chest pains Extreme fatigue and/or lethargy Change in typical behavior Face becomes pale   What is the treatment and prognosis for dry drowning? Dr. Sullivan recommends that all victims of near-drowning incidents seek medical attention, even if they have no symptoms. If caught early, dry drowning can be treated. If you think your child is experiencing a dry drowning episode, go to the nearest emergency room as quickly as possible — do not attempt treatment at home. Healthcare professionals will work to supply oxygen to your child's lungs to restore and regulate breathing.

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Overcoming poverty is not a task of charity, it is an act of justice. Like slavery and apartheid, poverty is not natural. It is man-made and can overcome by the actions of human beings. Sometimes it falls on a generation to be great. You can be that great generation. Let your greatness bloom. – Nelson Mandela, February 2005, Make Poverty History Campaign in London Lifting away the curtain that symbolized the front door, I entered a dark, cinderblock room and instantly became overwhelmed by an unpleasant odor. Working with oncology patients as a Child Life Specialist and an Occupational Therapist for over ten years, I recognized that smell. I had arrived in Guatemala – more than 3,000 miles from Reno – and it was my first day of a week-long trip where I would be serving alongside physicians in low-income communities providing free medical care for residents. My name is Brittany Jemmoua, I am an occupational therapist at Renown, and I recently volunteered with Kalan Kuxtal, a non-profit Guatemalan organization. I served alongside physicians by providing free primary care mobile clinics and home visits. The care we provided focused on prevention, intervention, education and lifestyle/medication management as we partnered with local entities, such as fire stations, community centers and schools to transform hundreds of lives. Speaking in both English and Spanish, I collected patient intake information, performed exams, tested for diabetes, and collaborated on a diabetes research project focused on daily risk assessment. Beyond these tasks, I immersed myself in the culture and learned more from the Guatemalan people than I could have ever imagined. Similar to Renown, Kalan Kuxtal Operates with Community at its Core Kalan Kuxtal, a Mayan expression meaning “life guardian,” is different from other volunteer medical trip organizations, and I took home valuable insights and lessons from their way of life that I now consider daily in my practice at Renown. I expanded my knowledge about diabetes, hypertension, pharmacology, infectious diseases, pregnancy complication, vector-borne illness and tuberculosis. We conducted home visits for socially neglected populations rather than expecting everyone to come to our clinics. I found that being welcomed into people’s homes gives you a different lens in which to view how their medical diagnoses interact with living conditions, occupations, and quality of life. This is when I met Mercedes and her mom. Her mom, Ms. Valencia, had jaundice skin and a substantial Basal Cell Carcinoma aggressively protruding from her face that impacted eating, hearing, seeing, sleep and social interactions. This opportunity to serve within their home led to an important palliative care conversation that would have been missed had we stayed in the clinic. We combed the rural neighborhoods assessing people’s risk for diabetes, taking glucose tests and educating families about their next steps. Many individuals had uncontrolled diabetes and misunderstandings regarding basic health management strategies. At the end of the day, many people demonstrated feelings of empowerment by actively offering solutions regarding how they will manage their day-to-day glucose with diet and exercise. Small actions can lead to big changes, and in the long-term, these health actions can help them avoid medication costs and focus on affording basic life necessities, such as water and electricity. Kalan Kuxtal organized a cultural day that included going to local businesses and community leaders to learn more about how they support the people of Guatemala. For example, Valhalla Macadamia Farm’s main goal is to help communities gain access to income, employment, and improved wellbeing by donating macadamia trees to families to grow and then sell macadamia products. A Weeklong Trip with Lifelong Impacts Each patient made a lasting impact on me, both personally and professionally. One specific family I saw in the clinic had a unique situation in that their two-year-old daughter, Margareth Elizabeth Cifuentes Bautista, was laboriously diagnosed with irregular corneal syndrome associated with glaucoma of congenital origin. Due to Guatemala’s limited prenatal screens and interventions, Elizabeth is nearly blind. While highly spirited and happy, she trips, bumps and feels her way through life. One barrier to her healthcare access is that her hard-working parents remain well below the poverty line, making less than $900/month. I am working to connect them with generous US Ophthalmologists and pediatric eye specialists to explore how we might save her sight and help her family. Their biggest dream is that she could recover her eyesight. “I know that this is not a life-threatening situation, but it is still something that never stops hurting me,” Jorge Cifuentes, Elizabeth’s father, said. “Unfortunately, our situation here is very hard. This country [Guatemala], although beautiful, it is very difficult to get ahead. We are people living in underprivileged conditions which complicates our situation even more. However, we are still trying to thrive by being kind and hardworking people. Thank you for helping us.” I have had the privilege of an opportunity for education, access to healthcare, employment and am aware that inequity and injustice prevail. This experience reinforced my understanding that medicine is a physically and mentally demanding profession that requires a commitment to service, continuous learning and adaptation both on local and global scales. I encourage everyone to please join me in serving the underserved by volunteering. Brittany is an experienced Occupational Therapist at Renown and volunteers with Kalan Kuxtal and other entities, such as The Robert Unsworth Foundation and Rock Steady Boxing to elevate communities. She loves being an Occupational Therapist; however, her life experiences confirm that her true calling is to become a physician. She is currently applying to medical school. Brittany is eager to earn the responsibility to improve lives and communities as their engaged physician. Brittany is tentatively scheduled to return to Guatemala at the end of this year to continue partnering with the people for a better future. You are welcome to join!

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Want to protect yourself from skin damage from the sun’s harmful rays? Dr. Angela Walker, dermatologist with Renown Medical Group, shares what you can do to prevent skin cancer. What can people do to prevent skin cancer while enjoying the outdoors? There are several steps you can take to protect your skin from the sun. “I caution all of my patients to avoid the sun during the hours of 10 a.m. until 2 p.m. when UV rays are strongest. I also encourage people to wear sleeves on cooler days. And don’t forget that we still need to wear sunscreen on cloudy days! UV rays can still cause sun damage on cloudy days. Preventing skin cancer also entails wearing sunscreen of at least SPF 30 everyday.  Are hats also a good idea for skin protection? Yes, of course! Choose a wide-brim hat that shades the face as well as the back of the neck for extra protection against UV rays. When it comes to identifying skin cancer, what should people watch for? We use easy-to-remember letters when checking for spots on the skin; it’s called the ABCDEs: How often should people go to a dermatologist for a full-body skin check? People with a family history of melanoma or who have already had skin cancer need to be screened at least once a year. Those who are younger and use sunscreen daily don’t need to be seen as regularly. Their primary care provider can do a yearly screening. And remember to do self-screening at home to keep an eye out for unusual looking spots. Is it best to visit a care provider with an expertise in skin with questions or concerns? Absolutely. As a dermatologist, I see a lot of people coming in with a changing mole or brown spot that looks irregular. I can assure them it’s benign or get them the treatment they need. We can even use photography to monitor skin spots and have the patient take photos at home. We also perform biopsies as needed.

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