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Did you know certain medications can interact with everyday food and drink? We asked Pharmacy Manager Adam Porath how to take these important medications safely. One in five Americans between the ages of 40 and 75 are currently taking a statin drug to reduce their cholesterol level or to prevent atherosclerosis (hardening of the arteries). Many others also take anticoagulants (blood thinners) to prevent blood clots from forming, which can increase the risk of stroke. Adam Porath, pharmacy manager with the Renown Institute for Heart and Vascular Health’s Anticoagulation Program, explains how to safely take these medications. What is a statin? A statin is a drug that can lower cholesterol by helping your body absorb cholesterol or by blocking a substance your body needs to make it. The American Heart Association cites a global study reporting the benefit of statins to help reduce heart attacks and strokes. Common statins include atorvastatin (Lipitor), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor). Which foods or drinks should be avoided while taking statin drugs? Grapefruit juice is the only food or drink that has a direct interaction with statins. Statins do not directly interact with any food but people taking statins should moderate their intake of saturated fats to help lower their LDL cholesterol and overall risk of cardiovascular disease. What is a blood thinning drug? Blood thinning drugs, such as warfarin, rivaroxaban (Xarelto), apixiban (Eliquis), dabigatran (Pradaxa) and edoxaban (Savaysa), are used to prevent stroke. Which foods or drugs should be avoided while taking blood thinning drugs? If taking warfarin, alcohol and cranberries (including juice) should be avoided. Patients taking warfarin should be aware of foods that contain Vitamin K (green leafy vegetables) and try to maintain a consistent diet of these foods. Warfarin interacts with many over the counter and prescription medications. Patients should consult a pharmacist when starting, stopping, or changing doses of any medication when taking warfarin. Also, patients taking any blood thinning medication should avoid over-the-counter pain relievers (i.e. aspirin, ibuprofen, etc.) How do I know whether to take my medication with food or not? Consulting with a pharmacist is the best resource to determine if a medication should be taken with or without food. In general, all statins and blood thinners can be taken with or without food. The only exception is Xarelto (rivaroxaban), which should be taken with the largest meal of the day If you are a Renown patient you can also review your prescriptions online, request a refill or ask a question via MyChart. With MyChart, you can access all your healthcare information securely 24/7.

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Sometimes, children’s asthma masks itself in symptoms that can be similar to other common respiratory problems. Dr. Shipra Singh of Renown Medical Group – Pediatrics discusses some diagnoses and treatments for asthma in children. Adults can easily recognize when we are out of breath or struggling to breathe, but what if you noticed this regularly happening to your infant or child during their daily play? Would you think they might have asthma? It may be difficult to tell if your small child has asthma because the symptoms can be similar to other common respiratory problems (bronchitis, croup, pneumonia) or even allergies. Read on to learn how to spot and manage asthma in your infant or child with advice from Shipra Singh, M.D., MPH, Pediatric Pulmonologist at Renown Medical Group – Pediatrics. According to the Centers for Disease Control, asthma in children is a leading chronic illness and cause of school absenteeism in the U.S. Asthma is a multi-factorial disease. Smoking during pregnancy or a family history of allergies or asthma has been linked to a greater chance of developing childhood asthma. Asthma is usually on a spectrum and not a single disease. It can range from mild to severe. Because an infant’s or toddler’s airway is smaller than in older children and adults, even a slight blockage caused by mucus or a restricted airway due to swelling can make breathing hard for them. In children five and younger, one of the most common causes of asthma symptoms is a respiratory virus, which narrows the airways in the lungs. These include a cold, the flu, bronchitis, pneumonia and other illnesses. How can I tell if my child has asthma? Unfortunately small children are unable to describe their symptoms, making asthma difficult to diagnose. Your child may even be active, playing and smiling, although they are experiencing chest tightness or labored breathing. Observe your child and let the child’s doctor know if: Your child’s breathing behavior has changed (coughing, wheezing, rapid breathing) Your child’s breathing pattern changes (day vs. night, with rest or activity, inside vs. outside) You have a family history of asthma or allergies Your child’s breathing is triggered by any foods or allergies With your help, your child’s doctor can make the best diagnosis to determine if your child has asthma. A pediatric pulmonologist (lung specialist) or pediatric allergist may also have to be consulted for special testing. Tests may include lung function testing, allergy tests, blood tests and X-rays for an accurate diagnosis. What is the treatment for infants and toddlers? Young children can use many of the same medications as older children and adults, although the way they take them and the dosage will differ. A nebulizer (or breathing machine) creating a medicated mist for your child to breathe through a mask may be used. An inhaler with a small spacer tube connected to a mask is also common to help your child breath medication into their lungs. Either of these options are effective. Asthma in children is treated with both fast-acting and long-term medicines to open up airways quickly for easy breathing and also to lessen asthma symptoms over time. Communicate with your child’s medical providers to create a personalized asthma management plan for them. How can I manage my child’s asthma? Recognize your child’s breathing habits and be aware of worsening symptoms. Consult with your child’s doctor on a daily asthma action plan to recognize worsening symptoms and track medications. (Here’s an example of an asthma action plan provided by the U.S. Department of Health and Human Services’ National Institutes of Health). Be consistent with the plan and talk to your doctor before changing it. Have an emergency plan in case of a serious asthma attack. Know where the closest ER is and know who can take care of your other children. Also know what the medical treatment coverage is under your insurance plan. We asked Dr. Singh about asthma in children: “Discussing asthma with your child may be a difficult subject. Some kids find the subject frightening or confusing. Others, especially the older kids, may be resentful of the treatment and may not be interested in doing the treatment. Talk to your doctor about advice to build an open and trusting relationship regarding your child’s asthma care.” What can I do to reduce my child’s asthma? Know your child’s asthma triggers (dust, pets, pollen, etc.) Follow your asthma action plan Keep your child away from smoke Can my child outgrow their asthma? Asthma symptoms change day to day and year to year. An older child can better recognize and manage their symptoms, so asthma episodes may lessen. However asthma is a life-long condition of the airways, so it is important to always have an asthma action plan, even with occasional asthma events. Renown Health Pediatric Care | Same-Day Appointments: 775-982-KIDS Our team of pediatricians, specialists and nurse practitioners have specialized training in children’s healthcare needs. We see children from birth to age 18 for the following pediatric needs: Wellness and preventive visits Sick visits Immunizations Behavioral health Allergy Asthma Common cold Diabetes  Asthma resources for parents: Asthma and Allergy Foundation of America Centers for Disease Control and Prevention

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Even when fires burn outside our area, the air quality in the region can reach dangerous levels. Our expert explains how to maintain your lung health when fire season strikes. It’s a sight we know all too well as northern Nevadans — a hazy or thick layer on the horizon when smoke rolls in from nearby fires. Sometimes the smoke is more evident than others, but it’s important to remember, even when the smoke may not be as visible across the valley, it still impacts our air quality. The last week or so, our air quality has been in the “unhealthy for sensitive groups” range, which can be dangerous for people who are sensitive to air pollution. Air Quality Changes: Who’s at Risk? Renown Pediatric Pulmonologist Sonia Budhecha, M.D., explains certain people are especially at risk when smoke moves in: Older people, whose lungs are not as healthy as they used to be Young children, whose lungs are still developing People with heart and lung disease including asthma, COPD and emphysema “Smoke and haze from fires carry particulates that can get into your respiratory system and eyes, which can be a danger for all ages,” Dr. Budhecha says. How You Can Protect Yourself Until the smoke clears and the air returns to the “good” range, it is best to follow these tips to protect yourself and your family: Stay indoors and keep windows closed Turn on the air conditioning to recirculate clean air Drink plenty of fluids to help your body flush out any toxins you inhale Additionally, all community members should reduce their physical activity and try to prevent heavy exertion outside. If you or a loved one has a heart or lung disease, avoid physical exertion altogether because smoke can aggravate these conditions. “People with heart disease may experience shortness of breath, chest pain, palpitations or fatigue,” Dr. Budhecha says. “People with lung disease may also have shortness of breath, chest discomfort, wheezing, phlegm or a cough.” Smoky Signs and Symptoms Smoke can also impact healthy people — irritating your eyes, nose or throat. And in some cases, inhaling smoke can lead to bronchitis. When haze moves into our area, keep an eye out for these symptoms: Burning or stinging eyes Runny nose Cough or scratchy throat Headaches Wheezing Shortness of breath Difficult taking a full breath Chest heaviness Lightheadedness Dizziness If experiencing any of the above symptoms, seek medical attention or call your doctor for advice. Sometimes, these symptoms do not appear for as long as 24 to 48 hours after smoke inhalation. For those that have pre-existing lung or heart conditions, consult with a health care provider on action or management plans. To schedule an appointment Visit Renown Pulmonary Medicine, or call 775-982-5000. Understanding Our Air Quality The Air Quality Index (AQI) is broken down by large (PM10) and small (PM2.5) particulates. According to Dr. Budhecha, large particulates are usually ones that can be seen and smelled. They can damage your eyes and nose but don’t often get deep in the lungs or blood vessels.   “The more dangerous ones are PM2.5, which can’t always be seen or smelled,” Dr. Budhecha says. “Any time the AQI is above 51, children with lung or heart disease should not be outdoors.” For the latest air quality update in your area, visit AirNow.gov or call (775) 785-4110.

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Millions of people across the west live in areas where air pollution can cause serious health problems. In addition, local air quality can affect our daily lives.  Who is Affected? Kouros Farro, MD, a physician with Renown Urgent Care, advises that certain people are more likely to be affected when fine particle pollution reaches an unhealthy level. People who have asthma or other breathing conditions like chronic obstructive pulmonary disease (COPD). People who have heart disease or high blood pressure. Children and older adults. People of all ages who are doing extended or heavy physical activity like playing sports or working outdoors. “Everyone should take precautions when the air quality is unhealthy. Air pollution can aggravate heart and cardiovascular disease as well as lung diseases like asthma and COPD. When the air quality is unhealthy, people with these conditions may experience symptoms like chest pain, shortness of breath, wheezing, coughing, or fatigue. If you are experiencing any of these symptoms, use your inhalers as directed and contact your health care provider,” says Dr. Farro, who is board certified in family medicine and practices at Renown Urgent Care at 975 Ryland St. in Reno. “If you do not have a health care provider, there is a Renown Urgent Care office on almost every corner, with providers ready to see you.” Dr. Farro advises the following: Take it easy and listen to your body. Limit, change or postpone your physical activity level. If possible, stay away from local sources of air pollution like busy roads and wood fires. If you have asthma or other breathing conditions like COPD, make sure you have your relief/rescue inhaler with you. People with asthma should review and follow the direction in their written asthma action plan. Make an appointment to see your health provider to be sure you have an asthma action plan. Getting Same-Day Care Renown Urgent Care provides same-day treatment for a wide range of minor injuries, illnesses and medical concerns that are urgent but not life-threatening. Avoid the long wait times and high emergency room prices at 11 convenient sites, including Reno, Sparks, Carson City, USA Parkway, Fallon and Fernley. You can walk in or book ahead online. Make an Urgent Care Appointment Community Health Resources The Washoe County Health District offers online health information on its Smoke Smart website, including fire information, daily air quality information, fire and smoke maps and how to protect yourself. In addition, an online subscription page allows you to sign up for EnviroFlash, notifying you about air quality.

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Young children under 4 and adults over 65 are especially vulnerable to heat exhaustion. Avoid heat exhaustion this summer with some expert tips. Northern Nevada summers can be downright hot, and although the balmy temperatures can feel great, they may cause heat-related illness, also known as heat exhaustion. Infants and children under 4 and adults over 65 are particularly vulnerable to heat exhaustion because their bodies adjust to heat more slowly. Without proper intervention, heat exhaustion can progress to heat stroke, which can damage the brain and other vital organs and even cause death. The Warning Signs of Heat Exhaustion Heavy sweating Elevation of body temperature Paleness Muscle cramps Tiredness, weakness, dizziness Headache Fainting Nausea or vomiting Cool and moist skin Fast and weak pulse Fast and shallow breathing Heat stroke happens when the body’s temperature rises rapidly and the body loses its ability to sweat. The Symptoms of Heat Stroke Body temperatures rising to 106 degrees or higher within 10 to 15 minutes Red, hot and dry skin (no sweating) Rapid, strong pulse Throbbing headache Dizziness or nausea Prevention and Treatment Make sure your air conditioner works Stay indoors and drink plenty of fluids Limit strenuous outdoor activities to mornings and evenings Drink plenty of water throughout the day Avoid caffeine and alcohol Do outdoor activities in the shade and wear light, loose clothing Take plenty of breaks and drape a wet bandanna around your shoulders to cool down If you suspect you or someone else is headed toward heat exhaustion or heat stroke, call 911 immediately.

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Halloween is around the corner. So while you're prepping pumpkins for carving, putting together creative costumes and coordinating trick-or-treating plans, safety is one more detail to remember.   Masks, haunted houses, witches, ghosts and ghouls — it all spells Halloween, and what could be more frighteningly fun, right? For children, however, Halloween can indeed be frightening and not so fun.  According to Dr. Kristina Deeter, Physician-in-Chief of Renown Children’s Hospital and Chair of Pediatrics for the University of Nevada, Reno School of Medicine, it is common for younger children to express Halloween fears — being afraid of monsters, the dark or really anything out of the norm. “It's normal for children to struggle with separating reality from fantasy,” she explains.   For children who fall into this category, the month of October can be traumatizing. Halloween may not come until the end of the month. Still, in the weeks building up to the spookiest night of the year, little ones are bombarded on all sides with decorations — mummies, skeletons, coffins, vampires, you name it. For a child with a blossoming imagination who, as Dr. Deeter said, is still learning to differentiate real from pretend, this can cause additional fears and anxieties. In commemoration of Halloween Safety Month, Dr. Deeter shares safety tips for the spooky holiday from the American Academy of Pediatrics:  Dressing Up & Heading Out  Plan costumes that are bright and reflective. Ensure shoes fit well and that costumes are short enough to prevent tripping, tangling or coming into contact with flames.   Consider adding reflective tape or striping to costumes and trick-or-treat bags and baskets for greater visibility.  Masks can limit or block eyesight. Instead, consider non-toxic makeup and hats, which should fit properly to prevent them from sliding over the eyes. Test makeup ahead of time on a small patch of skin to test for allergies before full application.  When shopping for costumes, wigs and accessories, look for and purchase those with a label clearly indicating they are flame resistant.  If a sword, cane or stick is a part of your child's costume, make sure it is not sharp or long. A child may be easily hurt by these accessories if he stumbles or trips.  Do not use decorative contact lenses without an eye examination and a prescription from an eye care professional. While the packaging on decorative lenses will often make claims such as "one size fits all," or "no need to see an eye specialist," obtaining decorative contact lenses without a prescription is both dangerous and illegal. This can cause pain, inflammation, serious eye disorders and infections, which may lead to permanent vision loss.  Review with children how to call 9-1-1 (or their local emergency number) if they ever have an emergency or become lost.  Carving Pumpkins  Leave the carving to the grownups. Have children draw the pumpkin design with markers, but keep knives away.  Consider using a flashlight or glow stick instead of a candle to light your pumpkin. If you do use a candle, a votive candle is safest.  Candlelit pumpkins should be placed on a sturdy table, away from curtains and other flammable objects, and not on a porch or any path where visitors may pass close by. They should never be left unattended.  Prepping Your Home  Keep your entryway safe for trick-or-treaters by removing all items from the porch or front yard that a child could trip over, like garden hoses, toys, bikes and lawn decorations.  To ensure visibility, check outdoor lights and replace burned-out bulbs.  Sweep leaves (or snow) from sidewalks and steps.  If there are dogs in the home, take steps to ensure they don't jump on trick-or-treaters. Hunting for Treats  Young children should always be accompanied by a parent or responsible adult.   Give each child and adult a flashlight (with fresh batteries).  If older children are heading out to trick-or-treat alone, plan and review a route you can agree on, as well as a specific time they are supposed to return home.   Only visit homes with a lit porch light. Never enter a home or a car for a treat.  Notify law enforcement authorities of any suspicious or unlawful activity immediately.  Since pedestrian injuries are the most common injuries to children on Halloween, remind youngsters to take crosswalk safety precautions.  For more key tips regarding Halloween safety for your young trick-or-treaters, visit our partners at Safe Kids Worldwide for a variety of spooky safety resources.

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October is Domestic Violence Awareness Month in the United States. We spoke with Renown Health experts and local domestic violence prevention organizations who gave us a deeper look into understanding the warning signs of abuse and the many proactive and reactive resources in our community that you can reach out to today.  Domestic violence, also referred to as domestic abuse, is an everyone issue. Whether you identify as male or female, an adult or a child, single or partnered – domestic violence can affect anyone. In fact, it may be closer to home than you might think.   According to the Nevada Quality Parenting Initiative, in Nevada, 43.8% of women and 32.8% of men experience domestic violence in their lifetime, and the risk of that figure rising is imminent. This year alone, the Domestic Violence Resource Center (DVRC) in Reno experienced a 55% increase in overnight emergency stays, according to the Reno Gazette-Journal.   This problem also, unfortunately, extends to children. More than 5,000 children in Nevada were reportedly primary or secondary victims of domestic abuse in 2021, as stated by the Nevada Coalition to End Domestic and Sexual Violence.  “Domestic violence can manifest in many different ways,” said Kami Price, Supervisor of Social Services for Renown Health. “Abuse isn’t always strictly physical. It can also be emotional, verbal, sexual and even digital. Understanding those differences can help you prepare accordingly and respond safely if you or a loved one are experiencing domestic violence.”   Knowing what to look out for is crucial in protecting yourself and others against the effects of domestic abuse and taking action when warning signs appear. The National Domestic Violence Hotline shares the common signs of an abusive partner, no matter how old they are or what gender they identify as:  Telling you that you never do anything right.  Showing extreme jealousy of your friends or time spent away from them.  Preventing or discouraging you from spending time with friends, family members or peers.  Insulting, demeaning or shaming you, especially in front of other people.  Preventing you from making your own decisions, including about working or attending school.  Controlling finances, including taking your money or withholding money for needed expenses.  Pressuring you to perform sexual acts you’re not comfortable with.  Pressuring you to use drugs or alcohol.  Intimidating you through threatening looks or actions.  Threatening to harm or take away your children or pets.  Intimidating you with weapons.  Destroying your belongings or your home.  "People experiencing domestic violence may feel as though they are trapped,” said Kami Price. “The reality is – this often couldn’t be further from the truth, especially with the resources we have at our disposal in northern Nevada.”  Respected Resources Ending the Silence on Domestic Violence  While these facts and figures might be staggering, those experiencing domestic violence at any age are not alone. There is hope at the end of the tunnel, especially here locally.  Devoted to meeting the growing needs of the communities we serve, Renown Health proudly supports and sponsors several organizations in our community that are committed to educating children and adults on the signs and symptoms of domestic violence, along with what each child and family member can do today to prevent abuse in the household. These essential organizations are on the frontlines of shifting attitudes from “I don’t want to get involved” to “How can I help?”  Serving children across northern Nevada, the Child Assault Prevention (CAP) Project offers “education and prevention programs designed to increase children’s safety from bullying, abuse and assault” and break the cycle of domestic abuse. During 2021 and the first half of 2022, CAP led about 500 different workshops, teaching 10,000 second-grade and fourth-grade children in Washoe, Storey, Lyon and Churchill Counties how to keep themselves safe from domestic violence.   “As domestic violence is on the rise, open communication, early intervention and education are key to protecting children from the effects of domestic violence," said Rebecca LeBeau, Executive Director of the CAP Project. “That’s why I begin speaking about child assault prevention and stranger danger to kids as young as six years old. It's important to explain the true reality of domestic violence to both children and adults, tailoring language specifically to whatever age they are, and allowing them to process it. Kids of all ages will learn how to deal with extremely dangerous situations this way.”  According to Rebecca, common symptoms of abuse to be on the lookout for at school include grades dropping, a lack of focus and feelings of not wanting to return home after the school day ends. If someone in a child’s home is being hurt or abused, children are always encouraged to speak with a trusted adult or school counselor. From there, organizations like the CAP Project develop a safety plan moving forward.  Adults and family units aren’t alone either. The DVRC provides a wide variety of services to Washoe County residents experiencing domestic abuse. To date, the DVRC has helped more than 100,000 victims of domestic violence, and with the recent launch of their crisis text line, they are poised to serve many more. Like the CAP Project, the DVRC also believes that education is one of the first lines of defense against domestic violence.  “Education on what domestic violence looks like is so much more than talking about physical violence,” said Aria Overli, Volunteer Coordinator at the DVRC. “Educating the community, and particularly youth, about what healthy relationships look like is a major factor in preventing abuse. Understanding the intersection of how other issues – such as race, mental illness and immigration status – affect domestic violence risk factors is key to addressing those issues.”   The list doesn’t stop there. Renown Health Foundation has provided financial support for many more organizations that are dedicated to ending the silence on domestic violence, sexual violence and family abuse, including:  The Children’s Cabinet – A child-focused organization offering many support services for youths and families, including Safe Place, a program that partners with local businesses to offer safe locations for children to seek help if they feel threatened at school or at home. The organization also provides free family counseling, providing a pathway to better communication for families experiencing a myriad of issues ranging from domestic violence to substance abuse.  Awaken – A nonprofit committed to increasing awareness and education regarding sex trafficking and providing housing and healing to all survivors.  Safe Embrace – The largest and most inclusive safe house in Reno-Sparks for survivors of domestic and sexual violence, offering a wide range of resources including counseling, emergency transportation, court support and more.  Eddy House – A safe space for at-risk individuals aged 18-24 recovering from the effects of domestic abuse, unsafe housing conditions, homelessness and more.  Being an advocate starts with us – if you see something, say something. Keeping a transparent line of communication is key to preventing, noticing and combating domestic violence.   “The more you reach out and talk about the issues, the better,” closed Kami Price. “No one has to go through their struggles alone.”

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Pulmonary Medicine Our expert pulmonary medicine team diagnoses and cares for patients with lung and breathing challenges. Serious breathing problems and long-term conditions, such as COPD and emphysema, are treated by our extensively trained providers. Our board-certified care team has the experience and clinical judgment to ensure the strongest possible patient outcomes. If you have a chronic lung condition diagnosis, you may also benefit from Renown Pulmonary Rehab. Conditions We Treat Asthma Bronchitis (acute and chronic) Chest infections Chronic obstructive pulmonary disease (COPD) Cystic fibrosis Emphysema Lung cancer Lung transplant Pulmonary fibrosis Pulmonary hypertension Pulmonary tuberculosis (TB) Other chronic lung diseases Pulmonary Services

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