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With allergy season’s extended stay and cold and flu season having just begun, you may soon find yourself seeking relief through several different kinds of over-the-counter medications. Know what precautions you need to take when fighting multiple symptoms with multiple medications. When you’re too sick to go to work but not sick enough for a doctor’s visit, over-the-counter medicines are a welcome relief to help alleviate that fever, runny nose or allergies. But because those medicines aren’t signed off on or managed by your doctor and pharmacist, it’s crucial that you’re especially mindful of what you put into your body. Whenever you pop a pill, you want to make sure you’re taking the right dosage, waiting the right amount of time before taking another dose and not mixing certain medicines together. Recent stories like this one detail dangerous over-the-counter medicine combinations, and we’re following suit: Here is a quick go-to guide about potentially harmful over-the-counter combinations. Too Much Tylenol/Acetaminophen Tylenol — or acetaminophen — is a popular pain reliever for many, but too much can be bad for your liver. “Our bodies have a finite ability to metabolize Tylenol,” says Andy Wright, clinical pharmacist at Renown Rehabilitation Hospital. “When too much builds up in the liver, it becomes toxic. In patients with medical conditions like cirrhosis of the liver or hepatitis, this could be disastrous.” Remember, acetaminophen is in more than just Tylenol and generic pain relievers. You may also see acetaminophen in flu, cold and cough medicines, like Nyquil, and some prescription medications including Norco and Percocet. Keep a list of the medications you take, and limit daily acetaminophen use to 3,000 mg per day. When you’re scanning medicine bottle contents, remember acetaminophen is also referred to as APAP, AC, acetam or paracetamol. Mixing Painkillers When you’re dealing with pain and not getting any relief, taking a different medication may seem like the easy solution. Maybe you take some Aleve — a form of naproxen — for a headache, but it isn’t working, so you switch to Motrin, an over-the-counter form of ibuprofen. Not a smart idea. Ibuprofen and naproxen along with aspirin are known as nonsteroidal anti-inflammatory drugs (NSAIDS). Because these medicines work in similar ways, they should never be combined or used in larger doses or more frequently than directed. Otherwise your risk of side effects can increase, which range from mild nausea to severe gastrointestinal bleeding. It’s also important to consider your family history when taking NSAIDs because, “recent studies have shown NSAIDs may have greater cardiovascular risks for people taking blood thinners or those with hypertension,” explains Andy. “A good example is ibuprofen: It has a relatively low gastrointestinal bleed risk while it has a moderate to high cardiovascular risk. The opposite is true for naproxen.” Rather than experimenting with multiple medicines, figure out which drug works best for you. You may find muscle soreness improves with aspirin, whereas when a headache hits, naproxen is best. Keep in mind that these medications aren’t always best for everyone in the family. “Aspirin in children and teens is not recommended unless under the supervision of a doctor,” Andy says. And pregnant and lactating women should generally avoid NSAIDS due to risk of birth defects and bleeding. “In both of these cases, acetaminophen or Tylenol are preferred but only if approved by an OB/GYN.” Fighting Allergies Over-the-counter antihistamines like Claritin, Zyrtec and Allegra have made fighting itchy eyes and runny noses a little easier. But these daily medicines — when taken inappropriately or in the wrong combinations — can also have an adverse effect. Similar to acetaminophen, you need to watch for antihistamines in other products. Sleep aids — like Tylenol PM and Unisom — commonly use an antihistamine known as diphenhydramine, which may increase your risk of overdose. “Combining antihistamines, or overdosing, can cause many adverse effects including dry mouth, blurred vision — even arrhythmias,” Andy says. “Only take these medications on their own.” If you’re still struggling with symptoms, you can talk to your doctor about adding an over-the-counter nasal steroid. Andy confirms the importance of closely following the directions listed on antihistamine (and all medicine) bottles. He has seen extended release nasal decongestants cause significant arrhythmias requiring medical care after a patient took the medicine with warm fluids. “The decongestant in question is designed to slowly release, but it can dissolve suddenly in the presence of warm liquids like coffee,” Andy explains. “This can cause the pill to deliver 12 to 24 hours of medication all at once.” Taking an Antidiarrheal with Calcium Calcium supplements and antidiarrheal medicines are another harmful combination. Calcium firms up your stool, but if taken with an antidiarrheal, can cause severe constipation. If you need to take an antidiarrheal, take a break from your calcium for a few days until you’re back to normal. Another consideration when taking calcium supplements or calcium-based antacids is gas. “I’ve had several patients report cases of excessive gas using Tums or calcium carbonate-based supplements.” Andy suggests instead “trying Maalox or Mylanta for indigestion and Citracal as a supplement.” Talk with Your Doctor or Pharmacist About Your Medications If over-the-counter drugs aren’t providing the relief you need, it’s time to see your doctor. And remember, for your safety it is important to keep your doctor and pharmacist up-to-date with any medications — prescribed or over-the-counter — that you are taking.

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In honor of International Women’s Day, we’re working to spread the word about taking care of your breast health and encouraging the women in your life to do the same.  Heather Reimer is on a mission — a mission to educate women everywhere about breast tissue type. For women with dense breasts, knowing your breast tissue type is absolutely critical, as cancers embedded in dense breast tissue are not always detectable with a mammogram alone. Dense breast tissue requires a breast ultrasound screening to get a complete breast health picture. Whole Breast Ultrasound for Dense Breast Tissue Heather knows this firsthand. She has dense breasts, and in this video she shares her story about finding breast cancer during a breast ultrasound screening — cancer that went undetected with her mammogram screening alone. As a result of that experience, Heather founded Each One. Tell One. — a movement to encourage women to pass along this information to others and to prompt those with dense breast and implants to consult with their doctor to schedule a whole breast ultrasound screening. To schedule a mammogram or a whole breast ultrasound, call 775-982-8100.

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Menopause is something that every woman experiences at some point in her lifetime. Learn what to expect and how you can help manage the symptoms and health risks. Most women don’t experience menopause until their 50s, but certain factors such as chromosomal abnormalities, glandular problems and chemotherapy can cause early menopause before the age of 40. No matter what your age, it’s a good idea be aware of the risks and treatments available to maintain a comfortable and healthy lifestyle. Health Risks of Menopause Two of the biggest health risks posed to women who have gone through menopause are bone density loss and risk of cardiovascular disease. Bone loss can be treated with bisphosphonate and estrogens. “Calcium with vitamin D and weight bearing exercise will also limit bone loss,” says Vickie Tippett, MD and OB/GYN at Renown Health. For cardiovascular risk, a healthy lifestyle is key. Discontinuing tobacco use, getting regular exercise and maintaining a healthy weight and diet all help reduce a woman’s risk of cardiovascular disease. Managing Discomforts of Menopause One of the most common complaints about menopause is the discomfort of hot flashes. “Hot flashes can be treated with systemic estrogen alone or in combination with progesterone or another agent similar to estrogen,” Dr. Tippett says. “Non-hormonal medications such as SSRIs and antidepressants also work.” Vaginal dryness, another common symptom of menopause, can also be treated with estrogen, estrogen-like compounds and personal lubricants. Pills, patches, creams and many other formulations are available to help alleviate discomfort. Knowing when, why and what to expect when it comes to menopause can help make the transition easier. Learn the facts about menopause in the infographic below.

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Breast cancer is the leading cause of cancer deaths in women in the U.S. That’s why early detection is so important. Dr. George Krakora, a radiologist with Renown Institute for Cancer, explains what to watch for and how new technology can lead to early detection. Most women know the importance of breast health and staying current with annual breast exams, but may not know that both screening guidelines and technology is evolving. So we asked George Krakora, MD, a radiologist for the Renown Institute for Cancer, what every woman should know about breast cancer detection and which screening method is right for them. First off, when should women start getting breast exams? Generally, women should start getting breast exams using mammography or ultrasound after they turn 40 years old. But we also want women ages 18 to 39 to talk to their primary care provider and ask for what’s called a formal risk assessment to see if screening is needed sooner. And you want to make sure your care provider is giving you a breast exam starting at age 25. It’s also a good idea to be familiar with how your breasts look and feel so you can report any changes to your care provider. What are the risk factors for breast cancer? Are there any preventive steps women can take? There a few risk factors you can’t control, like your age, family history of breast or other cancers, and if you have dense breast tissue. Your risk for breast cancer increases as you get older, and most breast cancers are diagnosed after age 50. Knowing your family history is important because a history of cancer and shared lifestyle can raise your risk. Your breast density can also increase your risk: Women with high breast density are four-to-five times more likely to get breast cancer than women with low breast density. But the good news is there are quite a few things you can do to prevent breast cancer, like not smoking, watching your alcohol intake, and maintaining a healthy weight with good diet and exercise. There are a lot of newer screenings out today. What is the difference between 2-D and 3-D mammography? In a 2-D mammogram, the tech takes X-rays of the breast. These pictures can show the radiologist if there are any lumps or tumors you might not be able to feel. In 3-D mammography, the process is largely the same but more X-rays are taken and it takes a few seconds longer for each image. This kind of exam detects 41 percent more cancers and reduces the number of false-positive results given to patients. This improvement in technology is great for both patients and their care providers. 3-D mammography provides better images of the breast, which allow doctors to more clearly diagnose and avoid false positives, especially in women with dense breast tissue. And what about a whole breast ultrasound. What is that? A whole breast ultrasound uses sound waves to detect cancerous tumors in the breast without using any radiation — it’s an ultrasound just like pregnant women get to check up on their baby. And the exam only takes about 20 minutes. We recommend these exams for patients whose mammograms have shown that they have dense breast tissue. Dense breast tissue can make it harder for doctors to see any abnormalities, lumps or tumors in a mammogram, so this technology ensures better early detection.

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Some people drive for hundreds of miles just to pitch a tent in what we're fortunate enough to call our backyard. From alpine hiking trails and miles of remote forest to desert lakes and spectacular night skies, there's no better way to unwind and explore the outdoors than camping. If you've been daydreaming of hiking trails and swimming holes or looking for a tranquil and adventurous family vacation,  it's time to clear your schedule, pack up the car and venture into the Great Outdoors.  We've got six fun and beautiful camping getaways you need to experience this summer that will leave you feeling relaxed and rejuvenated. And best of all, they're just a short drive away.  Emerald Bay State Park South Lake Tahoe, Calif. Highway 89 Summer Boat-In Camping: Available by reservation. Accessible by boat or foot.  Cost: $35 per night Dogs? Allowed in campground on a 6 foot leash. They cannot be on trails or roads into Emerald Bay or on the beach.  Information/Reservations: 530-525-7232 or www.reserveamerica.com To say this camping location is stunning is an understatement. If you're seeking a view from your campsite of blue lake waters, thick forest and jutting rocks, than this is the spot for you. This campsite is located on the north side of Emerald Bay, at old Emerald Bay Resort, and offers hiking and walking trails and easy access to Lake Tahoe. There are also large rocks you can jump from into the lake.   Davis Creek Regional Park West Side of Washoe Valley US 395 South  Cost: $20, cash only Dogs? Yes. $1 per night fee per pet and they must be leashed. Information/Reservations: (775) 823-6501 or www.washoecounty.us/parks Located in the foothills of the Carson Range 20 miles south of Reno, Davis Creek campground offers over 60 overnight sites along with equestrian trailheads that provide access to the Toiyabe National Forest. The campsite is well-known for outstanding views of Washoe Valley and Slide Mountain and includes picnic areas, a small pond and nature trails. Showers are also available.  Donner Memorial State Park Truckee, Calif.  12593 Donner Pass Road Cost: $35 per night Dogs? Contact for information. Information/Reservations: (530) 582-7892 or www.parks.ca.gov If you're looking for a little more to your camping adventure than what nature has to offer, Donner Memorial State Park may be the ideal campground for you. The park includes the Emigrant Trail Museum, with historical and regional exhibits including the Donner Party tragedy during the severe winter of 1846, as well as hiking trails, Donner Lake swimming and picnic areas. Fallen Leaf Campground South Lake Tahoe, Calif. 2165 Fallen Leaf Road Cost: $33 to $84/day Dogs? Allowed at tent and RV sites (a maximum of two pets per site); prohibited on beaches. Information/Reservations: (530) 544-0426 Nestled among pine and aspen trees and wildflower meadows, Fallen Leaf offers campers the best of both worlds: mountain landscapes and lake recreation. Located less than a mile away from the south shore of Lake Tahoe, the campground features more than 200 camping sites including tent, RV and several yurt rentals.   There are many shady campsites for campers to choose from, as well as food lockers, toilets, showers and a general store. The lake is only a short walk from the sites and features views of Cathedral Peak (8,200 feet) and Mount Tallac (9,738 feet) and there are several trails for hikers. Pyramid Lake Marina & Beach Camping Pyramid Lake Pyramid Lake Store, 29555 Pyramid Lake Road Cost: $9 per day Dogs? Allowed without restrictions. Information/Reservations: 775-476-0555 or www.pyramidlake.us The largest natural lake in Nevada, just 40 miles from Reno, is located between the Virginia and Lake Mountains on Paiute Indian land -- the Pyramid Lake Reservation. It's an ideal locale for boating and fishing and for those who are looking for remote beach camping and easy access to swimming. There are multiple camping spots around the lake -- including an RV park and designated and open camping -- but campers must obtain a tribal camping permit prior to settling in. Note: This is a desert lake and therefore, has limited shade. Campers should plan accordingly with shade sails and pop up shade tents.  Camp Richardson Resort South Lake Tahoe, Calif.  1900 Jameson Beach Road Cost: Contact for specifics.  Dogs? No.   Information/Reservations: 800-544-1801, reservations@camprichardson.com  Whether you're seeking the solace of a shaded forest or craving lazy beach days, Camp Richardson offers a wide variety of camping and lodging needs. Located on the south shore of Lake Tahoe, Camp Richardson features over 30 cabins, 26 lodge hotel rooms, a beachside inn, duplex and house, as well as 200 tent camping sites and 100 RV sites.  The resort campground offers year-round camping and a wide variety of services, including a marina, sports center, restaurant and a store.

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Most prescriptions meds are available in generic form. Find out the similarities and differences between the two and how to determine whether a generic is right for you. Approximately 80 percent of prescriptions sold today are generics. If you’re taking a prescription medication, chances are it’s a generic form of the brand-name drug. But are you getting the same quality in a generic medication? Do generics measure up? The answer in most cases is yes — generics, just like branded products, are regulated by the Food and Drug Administration. “To have a generic product approved by the FDA, the generic manufacturer must prove that its product is bioequivalent to the branded product,” explains Adam Porath, PharmD, BCPS AQ-Cardiology, BCACP and Vice President of Pharmacy Services. Basically, it has to function the same. “Generic products are extremely well tolerated and will provide the same results as using a branded product,” Porath says. Here’s how generics are the same as name-brand prescriptions: Generic products contain the same active ingredients. They produce the same desired clinical effect and accompanying side effects. Generics come in the same form as their branded counterparts: pill, liquid or inhaler, for example. Release into the bloodstream matches the name brand in timing and strength. Here’s how they differ: Generics generally cost less. Federal law requires generics have different names and look different: shape, size, markings and color. Generics contain different inactive ingredients, like binders, fillers and artificial colors. Different side effects with generics can usually be attributed to these additions. Why do generics cost less? When pharmaceutical companies develop a new drug, they are paying for research, development, clinical studies, marketing — in some cases it can cost more than $800 million and take 10 to 15 years to develop a new drug. “The manufacturers of branded medication products have to recoup their research and development costs,” Porath says. So companies are granted a limited patent to sell their drug without the competition of generic counterparts. “When patent exclusivity ends, the market is open for any generic manufacturer to make a competing product with FDA approval.” Without the same startup costs, companies can sell generics at 80 to 85 percent less. And because more than one company can produce the same generics, competition drives prices even lower.

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