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Some risk factors associated with osteoporosis are out of your control. But you’re in luck, because some can be lessened by following simple tips. Below, Orthopedic Nursing Manager Katie McCarthy discusses the signs, symptoms and preventive measures. By Katie McCarthy, BSN, RN, ONC, Orthopedic Nursing Manager, Renown Health Osteoporosis is often called the silent disease, because it develops gradually for years with no clear signs or symptoms. And while some bone loss is expected as we age, osteoporosis is not a normal part of aging. So it’s important to start thinking about your bone health early.  Bone is not just a lifeless scaffold for the body. It is living tissue that regenerates continually. Once we reach peak bone mass around age 25, we begin losing more bone than we produce, increasing the risk of developing osteoporosis — which literally means porous bone and points to a loss in bone density. In severe cases, normal everyday activities or movements, like hugging, can cause a fracture. After the first fracture you’re at higher risk for more, which can lead to a life of chronic pain and immobility. Bone fractures in the spine or hip are the most serious. Hip fractures can result in disability and even death — especially in older adults. Spinal fractures can even occur without falling. The vertebrae weaken to the point that they simply crumple, which can result in back pain, lost height and a hunched-forward posture.   Osteoporosis: Uncontrollable Risk Factors Women are at greater risk of developing osteoporosis than men, and white and Asian women are at higher risk than black and Hispanic women. Other uncontrollable risk factors include: age; a family history of osteoporosis; certain genetic conditions; medications and medical treatments; eating disorders; a low body weight and small, thin frame; ethnicity; menopause: In fact, the lack of estrogen produced during menopause is largely responsible for a woman’s increased risk. Poor diet, tobacco use, excessive alcohol consumption, lack of exercise and an unhealthy weight also contribute to bone loss. Fortunately, those risk factors are in your control. Without symptoms, you can’t know if you’ve developed osteoporosis unless you get a bone density test or suffer a fracture. If you fall into a high-risk group, are over age 50 or have any concerns about your bone health, consult your doctor and find out if you need to be evaluated. Additionally, if either of your parents sustained hip fractures, you experienced early menopause or took corticosteroids for several months — a steroid often prescribed to relieve inflammation and arthritis — you’ll want to talk to your doctor about your bone health. If you test positive, your doctor will devise a treatment plan to match your needs, which will include lifestyle changes surrounding diet and exercise to build and strengthen weak bones. Medication to slow bone breakdown and build new bone may be prescribed, depending on the severity of your bone loss. If you’ve sustained a spinal fracture that is causing severe pain, deformity or is not responding to non-surgical treatment, your doctor may recommend surgery. Reduce Your Risk of Osteoporosis You can strengthen your bones now to prevent osteoporosis from starting. Here are some tips: Eat a diet rich in fruits and vegetables and low in caffeine, sodium and protein. Avoid soda, and talk to your doctor to make sure you’re getting enough calcium and vitamin D. Don’t smoke — it directly correlates with a decrease in bone mass. Smokers also take longer to heal from a fracture. Limit alcohol to two to three beverages per day. It interferes with the production of vitamins needed to absorb calcium and the hormones that help protect bones. Exercise three to four times each week — it’s key to healthy bones. Weight-bearing exercises like jogging, hiking and especially weight lifting build bone mass and density. There are aspects of the aging process we can’t control, but we can do something about bone loss and osteoporosis. Find out your risk, and show your bones a little TLC — you’re going to need them. This story was also published in the Reno Gazette-Journal’s Health Source on April 24, 2016.

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Experiencing knee pain during exercise or while undertaking daily activities? The knee is the largest joint in our body, so it goes without saying a lot hinges on its functionality. Here are a few exercises to help.   Is exercise a real pain in the knee for you? Does getting up in the morning require a few minutes for your knees to adjust to walking around? As it turns out, knee pain is common, and it can result from injury, overuse or the breakdown of cartilage over time. Often, this pain is a result of faulty mechanics in your body, according to Jessica Ryder, a physical therapist with Renown Physical Therapy and Rehab. “We see weakness at the hips causing a lot of stresses at the knee,” she says. Exercises that Alleviate Knee Pain Try these three exercise to strengthen your glute muscles and maintain proper alignment in your knees. Hip Lift Lie flat on your back with your knees bent and feet flat against the floor. Lift your hips into the air until your body is in a neutral position, then lower your hips back down. Repeat this motion several times until you feel a gentle burn in your glute muscles. Step Down Stand with one foot on a stair or step. Slowly bend your knee and drop the other foot toward the floor. Slowly extend back up to your starting position. While doing this exercise, it’s important to move slowly, maintain control and ensure that your knee is in line with your toes. Do as many reps as needed until you feel a small fatigue in your muscles. Repeat this exercise on the opposite leg. Side Step with Exercise Band Place an exercise band around your ankles. Stand in a slight squat and then take several steps to the side until you feel a small fatigue on the outside of your hips. While doing this exercise, keep your upper body still and focus the exercise to your hips. The band will try to move your knees toward each other Repeat in both directions. Hometown Health and Renown Health are proud to be the official insurance plan and healthcare partners of the Nevada Wolf Pack. Renown Physical Therapy and Rehab | 775-982-5001 Through outpatient physical, occupational and also speech therapy, Renown Physical Therapy and Rehab gives patients hands-on, individualized treatment. Our therapists use evidence-based methods to help patients return to an active, productive lifestyle. Learn More About PT

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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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In this article reprinted with permission from the Galena Times,  Dr. Max J Coppes, Physician-in-Chief, Renown Children’s Hospital, and Nell J. Redfield, Chair of Pediatrics, UNR Med, talk about adolescents vaping, and how an estimated additional 10 million teens are at risk to start using e-cigarettes. What are E-cigarettes? E-cigarettes are battery-operated devices heating a liquid (e-juice) into an aerosol to be inhaled. Breathing in this flavor vapor, which usually contains nicotine, anti-freeze or other cancer-causing chemicals is called ‘vaping.’  There are many forms of these electronic nicotine delivery devices - and they're not always obvious. They not only appear to be cigarettes, cigars, or pipes, but also pass for everyday items, such as flashlights, flash drives or pens.   The Effects of Vaping and E-cigarettes Regardless of the nicotine delivery, vaping is addictive and is quickly becoming a public health concern. Nicotine levels in e-cigarettes vary greatly, and they may also contain toxic chemicals. Currently there is a wide range of variability among vaping products. In other words - they deliver different ingredients, hardware, levels of nicotine, and possible toxic chemicals to the user. This makes it challenging to create an overall public health recommendation on their use. Nevertheless, there is no confusion about the harmful effects of the chemicals used in e-cigarettes to the young brain, which develops until age 25. Studies show e-cigarette use serves as an introductory product for teens to go on using ‘regular’ tobacco products. The American Academy of Pediatrics has several recommendations on their use. Such as increasing the minimum age to buy tobacco products, including e-cigarettes, to age 21 nationwide. (Update: nationwide the age as of January 2, 2020 is now 21.) A common misunderstanding with teenagers is the belief e-cigarettes are less harmful than other tobacco products. Moreover, there is a wide range of flavor choices, from mint, mango, crème brûlée to cucumber to attract users. As of September 6, 2019, The Centers for Disease Control and Prevention is reporting over 450 possible cases of lung illness associated with the use of e-cigarette products in 33 states.    What Should Parents Know about Vaping? Parents and teachers should know JUUL is a very popular e-cigarette among teenagers, capturing about 68% of the market. JUUL is sleek, small, hides easily, and resembles a flash drive. Surprisingly it charges in an USB port, and can also instantly be mistaken for a real flash drive. One JUUL cartridge contains twice the nicotine found in other e-cigarette cartridges. This roughly equals the amount of nicotine in an entire pack of cigarettes. To repeat, the use of JUUL in young people continues to grow, and this is why parents and teachers need to be aware. Be alert, teach, communicate, and talk to your child about the serious risks of smoking in all forms, whether at home or parties. Tell them how difficult it is to quit and why they should not start. Loving your children is caring; caring for their current and future health and well-being.

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Without a doubt, taking medications can not only be expensive, but also confusing. In the United States, generic prescriptions are widely used, with 9 out of 10 people choosing them over a name brand. Pharmacists are a great resource to help us understand the benefits and side effects of any medication. We asked Adam Porath, PharmD, Vice President of Pharmacy at Renown Health, to answer some common questions about generic drugs. What is a generic drug? A generic drug has the same active ingredients of brand-name drugs. Brand-name drugs have a patent (special license) protecting them from competition to help the drug company recover research and development costs. When the patent expires other manufacturers are able to seek approval for a generic drug. However, the color, shape and inactive elements may be different. Per the U.S. Food & Drug Administration (FDA), a generic medicine works in the same way and provides the same clinical benefit as its brand-name version. Why do they cost less? Generic drug makers do not have the expense of costly development, research, animal and human clinical trials, marketing and advertising. This savings is passed on to the public. Also after a patent expires, several companies will compete on a generic version of a drug, further driving down prices.

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Vaccines that provide protection against the COVID-19 virus are bringing us closer to the end of this deadly pandemic. Two different COVID-19 vaccines are currently available in the U.S. today: one from Pfizer and the other from Moderna. Kate Ward, PharmD, BCPS, Director of Clinical Pharmacy at Renown Health and Adam Porath, PharmD, Vice President of Pharmacy at Renown, share what you need to know about these vaccines. When two COVID-19 vaccines were approved by the U.S. Food & Drug Administration (FDA) in December 2020, it was cause for celebration. Why? Because according to the CDC, the vaccines are 94 percent or more effective in providing protection against the COVID-19 virus! Many people are seeking information about the new Moderna and Pfizer vaccines. Below, our pharmacy leaders provide answers to some commonly asked questions. How do the COVID-19 Vaccines Work? The Pfizer and Moderna vaccines are both mRNA vaccines that help your immune system develop antibodies against the COVID-19 virus. The vaccines use messenger RNA, or mRNA, to show our bodies’ protein-making cells how to make the spike proteins of the COVID-19 virus. Our immune system reacts to these spike proteins by creating antibodies that can recognize and destroy them. So when a person is exposed to the virus in the future, they will be less likely to get sick. What are the Differences between the Pfizer and Moderna Vaccines? The Pfizer and Moderna COVID-19 vaccines are very similar, with just a few small differences worth noting. The main difference between the two vaccines is when you should receive your follow-up dose. Patients who receive a first dose of Pfizer should receive their second dose about three weeks later. Those who receive a first dose of Moderna should receive their follow-up vaccination roughly four weeks after their first dose. People 18 years and older can receive the Moderna vaccine while people 16 years and older can receive the Pfizer vaccine. Dosage for the Moderna vaccine is 0.5 ml (100 mcg). Dosage for the Pfizer vaccine is 0.3 ml (30 mcg).

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Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis, answers some common questions about bone fractures. Is there a difference between broken bones and fractures? No, these are two different names for the same injury. Of course the common term is a broken bone. Using either name will describe your concerns. Medical personnel typically describe a broken bone as a fracture to a specific bone. For example, a broken wrist is also a fractured distal radius. To clarify, this describes the injured bone and the precise location. How do I know  if my child has broken their bone? Many times children will fall and complain of their arm or leg hurting. In most cases the pain goes away and the child will return to their activities. When there is a deformity to the limb (curve in arm) and the child is complaining of pain, it is probably a fracture. If the arm or leg looks straight, look to see if there is any swelling or bruising. Both are signs of a possible fracture. Finally, if the limb looks normal but the child continues to complain, gently push on the bone. Likewise if it causes the same pain, then they likely have a fracture and should have an x-ray. My child fractured their growth plate, what does this mean? Growth comes from this area of the bone. In detail, these are located all over the body but typically at the end of the bones. With this in mind, fractures to these areas can result in the bone growing abnormally. Because of potential shortening of the arm or leg, or bones growing crooked, it is important to follow fractures closely (up to 1-2 years or longer). It is better to identify a problem early. Small problems can be treated with small surgeries. What if the bones of the x-ray do not line up? Because children are growing, unlike adults, their bones will remodel and straighten with growth. The amount of remodeling occurring depends on a child’s age, the bone fractured and the location. In many cases an angled bone will grow straight over the course of a year. For this reason, someone with experience in caring for children needs to follow bone growth. How long does it take fractures to heal? Factors deciding when a cast can come off include: Child’s age. Bone fractured. Fracture location. Young children heal faster than teens, teens heal faster than young adults, who heal faster than older adults. In young children most fractures heal in 4-6 weeks. However, teens generally take 6 weeks to heal, and adults can take much longer. Although your child  is out of their cast, it may not be healed completely to return to all activities. Placing a splint is during this time is common. This typically gives them added protection for several weeks after their cast is removed -  in case they forget their limitations. What if my child is still limping? Whether a child is in a walking or non-weight bearing cast, removing it often leaves them stiff and sore. Therefore many children will walk as though they still have a cast in place. In most cases this resolves in about three weeks. Regardless, if your child is still limping or walking abnormally after three weeks, contact the treating doctor. They may benefit from physical therapy or a repeat evaluation.  (This article was original published in the July 2019 issue of South Reno Kids & Sports.)

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