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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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We get it – the entire world has been overwhelmed with COVID-19 vaccine information, questions and celebrations around vaccines developed to combat COVID-19 induring the past several months. It’s hard to know where to start in digesting all this news and information. But one thing is clear: healthcare experts agree that the authorized COVID-19 vaccines are safe, effective and recommended to help end this pandemic. If you are passionate about stepping up in your community to encourage the vaccination efforts, we’re offering a few ideas on how you can be an ambassador. Find the Facts Content on the vaccine is abundant, but and there’s a few resources that we can all rely on to help digest the information: The Centers for Disease Control (CDC) updates its website content around the vaccine regularly, and also offerings information in Spanish. Health departments across the U.S. are leading the way in distribution logistics planning, and partnering with other providers, like such as hospitals and pharmacies, to distribute give people doses. Their websites are great resources to understand options where you live. Locally, check out washoecounty.gov/health/programs-and-services/environmental-health/covid-19-guidance for vaccine updates in Washoe County. Many providers like Renown Health and other providers are sharing content around their recommendations for the vaccine. Get answers about the vaccine types from one of our pharmacists, read common concerns addressed by experts and view videos from many doctors and other specialists on our YouTube Channel.

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Immunizations (vaccines) save the lives of thousands of children and adults annually, protecting us from illnesses that can lead to disease, hospital stays, life-long complications and even death. Not only do immunizations protect the persons receiving the vaccine, but through herd immunity, vaccines protect children that are unable to get vaccines due to illness or age and our elderly community members whose immunities may have declined. Vanessa Slots, M.D., offers insight on the importance of immunizations. Immunizations Your Child Needs (and when) Birth to 6 Months Hepatitis B: Shortly after birth, first vaccine dose Diphtheria, Tetanus, and Pertussis (DTaP), Polio, Haemophilus Influenza (HiB), Pneumonia, Hepatitis B and Rotavirus: Ages 2, 4 and 6 months, boosters and vaccines One Year to 18 Months MMR and Varicella (chickenpox) vaccine: Age 1, first vaccine dose Hepatitis A, HiB and Pneumonia: Age 1, booster DTaP: 15 months, fourth vaccine dose Hepatitis, second dose: 18 months Flu Vaccine: 6 months and older, annually* *In the year after receiving their first dose, an infant will need a booster one month later. Four Years Old MMRV, DTaP and Polio, final dose: Four years of age Pre-Teen and Beyond Tdap and Meningitis: Before starting middle school, children receive these vaccines. They are also old enough to start the HPV vaccine, an essential vaccine for all young adults to protect against cancer, genital warts and cervical dysplasia.

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According to the Centers for Disease Control (CDC), e-cigarette use isn’t just up among adults, but it has also tripled in usage for teens. Dr. Jose Cucalon Calderon, a Pediatrics Physician at Renown Health and an Assistant Professor of Pediatrics at the University of Nevada, Reno School of Medicine, provides helpful insight into e-cigarettes and the dangers it poses to kids and teens.   What Are E-Cigarettes? E-cigarettes are electronic nicotine delivery devices. e-cigarettes use liquid nicotine as an alternative to traditional smoked cigarettes. e-cigarettes contain nicotine which is an addictive substance with known toxic side effects that, when released in very high doses, that can have health consequences and causes addiction. Nicotine is described as “toxic,” but the most "toxic" part of e-cigarettes' is everything else within the E-juice. Nicotine mainly keeps people coming back for more. According to the CDC, e-cigarettes are also advertised using the same themes and tactics that have been shown to increase youth use of other tobacco products, including cigarettes. In 2021, approximately 76% of students reported exposure to tobacco product marketing through traditional sources, and approximately 74% of students who used social media had seen e-cigarette–related content. What Does This Mean for the Health My Teen? We know that nicotine can affect brain development in kids and teens, so it is important to educate your teen on the risks of exposure. If you have young children in the home, it is important to be vigilant as well. One teaspoonful of liquid nicotine can be fatal for a young child. How Do I Monitor My Teen for E-Cigarette Use? Monitoring your children can be tricky for parents. E-cigarettes can be harder to detect, unlike traditional cigarettes that were easy to detect by smell and residual odor. E-cigarette use, or “vaping,” is often associated with a dry cough or chronic throat/mouth irritation. Overall, increasing research shows strong links between mental health conditions and posterior combustible tobacco use along with increased risk of marijuana use. Nicotine is addictive, but it does not cause altered mental status like the other drugs of abuse can. All parents are strongly encouraged to talk to their children about the potential dangers of e-cigarettes.   What are the health risks of vaping? Vaping devices have been on the market for a relatively short period of time, with evidence-based health effects and complications still being discovered. Vaping effects poses many harmful risks to children and teens. The risks of vaping include: Chest pain Difficulty breathing Dizziness Headaches Impaired response to infection in the airway Inflammatory problems of the airway Nausea Nicotine addiction Seizures Vomiting   For more information for both parents and teens about quitting smoking or vaping, you can click here. Parents can also use this tip sheet from the U.S. Surgeon General to talk to their child about vaping. The Substance Abuse and Mental Health Services Administration free national helpline number is 1-800-662-4357 (HELP). It is available 24/7, 365 days a year offering confidential treatment referral and information (in English and Spanish). If you or someone you know is facing a substance (or mental health) problem, please reach out to them.

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Bacterial meningitis is probably the last thing on your mind as you help your child prepare for college. Buying books and stocking up on necessities may top your list, but it’s a good idea to ensure your student is up-to-date on their meningitis vaccine. How Bacterial Meningitis Spreads According to the Centers for Disease Control and Prevention, people living in close quarters are more likely to spread this illness to one another. For example, you may have heard about the higher risk of meningococcal (or bacterial) meningitis for new college students. The risk is so serious that many colleges and universities require proof of a vaccine for new students moving into campus housing. This includes the University of Nevada, Reno. To clarify, all incoming freshmen under 23 years of age must show proof of their up-to-date meningitis shot. “Bacterial meningitis is considered a medical emergency, and anyone with the signs and symptoms should be evaluated in the emergency room immediately,” says Vanessa Slots, MD, Renown pediatrician. Symptoms of Bacterial Meningitis Fever Nausea Vomiting Irritability Headache Confusion Back pain Stiff or painful neck Leg pain Light sensitivity Rash on the torso or lower extremities It’s important to know many of these symptoms for both bacterial and viral meningitis are the same. However, the viral type is more common, often clearing up in seven to 10 days without complications. Nonetheless, you should go to the emergency room to be looked at, as the signs are similar for both illnesses. Why is Bacterial Meningitis Dangerous? This illness moves quickly, and in some cases, it can seem like the flu or severe strep throat and take a few days to develop. Or, it can hit in just hours. “Bacterial meningitis has an overall death rate of 10 to 15 percent despite treatment with antibiotics,” Dr. Slots warns. Another critical point is problems after recovery can also be severe. Frequently these include brain damage, amputations, infections around the heart, seizures and shock.

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Respiratory syncytial virus, also known as RSV, is a common respiratory virus that impacts the lungs and breathing pathways. The virus can be dangerous for infants and young children and is also concerning for older adults. While most older kids and adults only experience cold-like systems and recover in a week or two, an estimated 58,000-80,000 children younger than 5 years old are hospitalized due to RSV each year, and in 2022 healthcare organizations across the country are experiencing higher infection rates than in years past.  "RSV typically peaks in the winter, but this season we are seeing an earlier surge in cases,” said Dr. Vanessa Slots, the Division Chief of General Pediatrics at Renown. “Infants who are infected with RSV almost always show symptoms. Call your healthcare provider immediately if your child is having difficulty breathing, is not drinking enough fluids or is experiencing worsening symptoms.” Symptoms of RSV: Runny nose  Decrease in appetite/inability to drink Dry diapers, an indication of dehydration  Cough, which may progress to wheezing or difficulty breathing Irritability (most common in very young infants) Decreased activity (most common in very young infants) Decreased appetite (most common in very young infants) Apnea, pauses in breathing for more than 10 seconds (most common in very young infants) What to do if you think your child has RSV: Call your pediatrician! If you suspect your child might have RSV, consulting their healthcare provider is the best first line of defense. From here they will help you build an appropriate treatment plan for child. Keep in mind that many pediatrician offices offer 24/7 call lines.  If your child is experiencing retracted breathing (when the area between the ribs and in the neck sinks in when a person attempts to inhale), dehydration (not drinking and decrease in wet diapers) or apnea (pauses in breathing for more than 10 seconds) please call 911 or go to the closest emergency room.  Treating RSV from home: Clear your child's nasal pathway with a bulb syringe or saline spray/drops Stay home and rest Drink plenty of fluids to prevent dehydration Manage fever with fever reducers such as acetaminophen or ibuprofen Preventing the spread of RSV:  Good news! The biggest RSV prevention tips are almost identical to what we’ve already been doing to prevent COVID-19 – so hopefully, these actions are already second nature.   If you have young children or regularly encounter younger children, remember to:  Wash your hands often  Keep your hands off your face  Avoid close contact with sick people  Cover your coughs and sneezes Clean and disinfect surfaces  Stay home when you are sick  Get vaccinated against the flu and COVID-19 to prevent more serious co-infections RSV is dangerous for older adults, Too Older adults – especially those over 65 years old, have chronic heart or lung disease or a weakened immune system – also need to be hyper-vigilant about RSV.  If you or your loved one is in the older adult at-risk group, remember to follow the above prevention measures and talk to your healthcare provider immediately if you suspect you have RSV.  *Data courtesy of the Center for Disease Control and Prevention.

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According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new sexually transmitted infection (STI) cases in the United States each year, with rates continuing to increase.  What you may not know is most STIs are preventable. We talked with Renown Adolescent Medicine Specialist, Caroline Barangan, MD to learn more about STIs.  How Can You Get an STI?  The CDC (Center for Disease Control) says that STIs are acquired through sexual contact. There are bacteria, viruses or parasites that can cause an STI which may pass from person to person in blood, semen, vaginal and other bodily fluids.  How Do You Know if You Have an STI?  STIs can have a range of signs and symptoms such as:  Warts, bumps or sores on or near the penis, vagina, mouth or anus Swelling, redness or severe itching near the penis or vagina Discharge from the penis Vaginal bleeding that’s not your period Painful or uncomfortable sex Vaginal discharge that has an unpleasant odor, causes irritation or is a different color or amount than usual  Weight loss, diarrhea or night sweats Aches, pains, fever and chills Jaundice (yellowing of the skin and whites of the eyes) Painful or frequent urination  Sore throat if you engage in oral sex It’s important to know that the majority of people who have an STI commonly have no symptoms at all, which is why it’s important to get regularly tested once you have had any sexual activity. Young people less than 25 years of age should be screened on a yearly basis at minimum.

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