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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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Every cancer journey is different — and so are the ways individuals deal with a cancer diagnosis. So if you’re a close friend or family member, how can you help? Bobbi Gillis, manager of cancer support services with Renown Institute for Cancer, explains more. Just as we are all unique, we all also have our own ways of dealing with difficult news. For some, receiving a cancer diagnosis is devastating, and they want family members rallying around them in support; for others, they want to be left completely alone. So how do you know what is helpful and what is hurtful? For advice, we reached out to Bobbi Gillis, manager of cancer support services with Renown Institute for Cancer. Support, Defined What are some ways to support a loved one when they find out they have cancer? First and foremost, let them know you are there for them. As we can all imagine, a cancer diagnosis is scary, and it’s helpful just to know you have support if and when you need it. Second, try to listen and give advice only when you are asked. In trying to help as much as possible, many family and friends take on the role of “researcher” to find out more treatment options, but it’s best to avoid saying “you should try this” or “you ought to do that.” Patients are already dealing with a lot of information at once from care providers and their own research. You don’t want to make them feel overwhelmed or question the treatment they’re planning. What are some words of encouragement or support people can use? Just as you would in any difficult situation, speak from the heart and be genuine. But also be careful not to show false optimism or to tell them to just stay positive; saying these things may discount their fears and concerns. Here are some ideas to get you started: “We’re going to get through this together.” “Count me in to help out.” “I’m not sure what to say, but I want you to know I care and I’m here.” What resources are available to patients? What about their families? For patients with cancer, we offer support groups in-person or online. There are also support groups specific to the type of cancer you or your loved one have. You can check these out on our website, renown.org, or ask your care provider. There are also support groups and emotional support services available for family and friends. How can family and friends help throughout cancer treatment? It’s great to offer help, but it’s important to be specific when you offer. Saying “call me if you need something” is very general, and people may feel like they’re putting you out when they do ask for something specific. Instead, offer help with certain tasks — like driving them to treatment, babysitting, making them dinner or buying groceries. As much as possible, keep things normal. For some patients, being able to do everyday things like walking the dog helps them feel better. Loved ones can try to do too much for a patient, and while well-intentioned, this can make them feel less useful after being diagnosed. Renown Institute for Cancer | 775-982-4000 At the Renown Health Institute for Cancer, our experienced team provides the support and care to maintain the highest quality of life and then achieve the best possible outcome, all in one location that’s close to home. Our dedicated team, clinical expertise and advanced treatment options allow us to tailor care to each patient. Learn about: Our Team Cancers We Treat Screening and Prevention Treatment Options Find a Doctor

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Parents often struggle with installing and choosing car seats for their children. Picking out a car seat for your child is a never-ending battle. Safe Kids Washoe County has made it simple for you to understand the types of car seats that will work for your child. Types of Car Seats Rear-Facing Only Seat. Your baby's first car seat is often used from 5 to 40 pounds. People usually buy this type of seat because it is portable. Convertible Car Seat. This seat is larger and stays in the car; it may be rear-facing until your child is two years or more. After that, it can change to a forward-facing seat. Forward-facing-only car seat. This type of seat is used in one direction and has a 5-point harness and top tether.  Combination seat. This is a forward-facing seat with a 5-point harness and top tether and can change into a booster seat when you remove the harness.  3-in-1 car seat. This seat also stays in the car. You can use it rear-facing, forward-facing, and then later, as a booster seat. Booster seat.  It boosts the child for a safer and more comfortable fit of the adult seat belt. Make sure your child has outgrown the weight or height limits allowed in the forward-facing car seat. The seat belt must lie flat across your child's chest, on the bony part of the shoulder, and low on the hips or upper thighs. Most children will be between the ages of 8 to 12 years old before they are ready for the seat belt alone. Have a trained car seat technician check your installation Why: 3 out of 4 car seats are installed improperly, with some studies show that the misuse rate is 90%, with the average car seat having three mistakes. Solution: Ensuring that your child's car seat is installed correctly by a certified car seat technician will ensure your child's safety.

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Car seat technicians often find parents are moving their child to their next car seat stage too soon, as they get older. Here are a few reminders of when to transition your child from their booster seat to a seat belt. Moving to a booster seat too soon According to Safe Kids Worldwide, nearly 9 in 10 parents remove children from their booster before they’ve reached the recommended height, weight, or age of their car seat recommendations, which leaves the seat belt in a position on the child that could injure them. If the child is not the proper height, the seat belt can rise up on the belly, instead of the hips where it’s supposed to sit, which can lead to spinal cord damage or whiplash in the event of a car crash. Solution: You can switch from a car seat to a booster seat when your child has topped the weight allowed by the car seat manufacturer; typically 40 to 80 pounds (18 to 36 kilograms). Remember, however, that your child is safest remaining in a car seat with a harness for as long as possible. Booster seats must always be used with a lap and shoulder belt — never a lap-only belt.  Transitioning to a safety belt too soon Older children need booster seats to help ensure the seat belt stays properly positioned on their body. The lap belt should lie low across the child's hips and pelvis with the shoulder belt crosses the middle of the child's chest and shoulder, so that in the event of a crash, the forces are applied to the hip bones and not the abdomen. If the lap belt is not positioned properly then it could lead to injuries to the spinal cord and abdominal organs.  Solution: Most kids can safely use an adult seat belt sometime between ages 8 and 12. Always use a booster seat until the child passes the 6-step test Your child reaches a height of 4 feet, 9 inches (nearly 1.5 meters) Their back is flat against the seat back. Knees bend over the edge of the seat and feet are flat on the floor. The shoulder belt sits on their shoulder and chest (not face or neck.) The lap belt sits low on their hips and touches their upper thighs (not on their stomach.) Your child can sit comfortably this way for the entire trip.   The American Academy of Pediatrics reminds us that the back seat is the safest place for children younger than age 13.

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The warm weather is here and pools are open. Swimming is a great way to keep your kids cool, occupied and exercised throughout summer, however pools come with their fair share of risks. Before you take your children swimming, check out these pool safety tips. Pool safety is something every parent needs to take more seriously. Why? Because drownings of young children ages one to four have increased in recent years. Unfortunately, drownings are the number one cause of death in this age group - we lose the equivalent of 10 school buses full of children to fatal drownings in the U.S. each year. With warmer temps and hopes of cooling off in a local pool, you can’t be too careful when it comes to protecting your children from the risk of drowning. Children are naturally drawn to water, so parents must be extra aware in order to protect their kids from diving in headfirst. Kris Deeter, MD, pediatric intensive care physician at Renown Children’s Hospital, offers tips to keep your littles safe in the water. Preparing Your Child for the Pool People aren’t born knowing how to swim. This means parents must teach their children about swimming and pool safety if they want them to be safe and confident around water. It can take years to develop these skills, so the key is to start when your children are very young. Here are some ground rules: Teach your child to swim starting at age one. We recommend enrolling your toddler in swim classes; there are several organizations in the Reno-Tahoe area that offer baby and toddler swim classes. Keep your kids away from plastic and inflatable pools - they’re easy for children to fall or climb into and drown. They’re also a breeding ground for bacteria. Floaties and water wings are not safe! They are not a safe substitute or “crutch” for learning how to swim and they can lead to drowning if the child is using them incorrectly or while unsupervised. Stay within arm’s reach of babies and toddlers when at the pool. Supervision alone is not enough – you must be within arm’s reach in case they fall in and need to be rescued quickly. Learn child and infant CPR. If a drowning does occur, the best course of action is to call 911, get the child onto dry land and conduct CPR until breathing is restored or the EMTs arrive.   Pool Parties: A Risk for Drowning? Surprisingly, pool parties, a common summer pastime, actually increase the risk of drowning incidents. Although responsible adults are usually at pool parties, distractions ranging from alcohol to pool toys can actually make it easier for drownings to occur unnoticed. Does this mean you should RSVP “no” to the next pool party your child is invited to? Not if you follow the pool safety tips below: Attend the party with your child so you can supervise them while they swim. Remove unused floaties and toys from the pool. They can obscure visibility, making it difficult to see a child in the pool. Don’t drink alcohol while supervising a pool party. Assign an adult “water watcher” to pay constant attention to children in the pool.   Pool Safety Precautions for Homeowners If you own a pool, there are several more precautions to ensure the safety of your children. Even if your kids are strong swimmers who have mastered the rules of pool safety, there may be neighbors or friends who are younger and more vulnerable to drowning. You must undertake precautions for these children too. Some of these may seem time-consuming or expensive, but they are worth it to prevent a child from a fatal drowning. To keep your pool or spa safe, please: Cover your pool or spa when not in use. Choose a pool or spa cover with safety features like locks, safety sensors or alarms. Fence in your pool or spa area. The fence should be locked and at least four feet tall. Do not leave toys in the pool area as these may attract children.

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Car seat mistakes can have very serious consequences. Misuse of a car seat can injure your child, or fail to keep them safe in the event of a crash. A lot goes into finding the right car seat for your child. With so many factors to consider (including age, weight and height of the child, type and brand of a car seat, cost of the car seat, etc.) it can be easy to forget critical factors. Here are two common mistakes that certified technicians often find when speaking with parents. Mistake #1: Getting a used car seat without knowing its history Why: A used or secondhand car seat can pose several factors that can compromise its safety in a crash. First, car seats expire six to ten years after their date of manufacture, so refer to the car seat's manual for recommended car seat longevity. The safety mechanisms can be compromised if a car seat has been in a crash. So it's crucial to replace your car seat following a collision. Solution: Only use a car seat if you know its history. A new car seat is your best bet, as they are up to date on the latest safety guidelines, and safety mechanisms are up to standard. However, if you are considering a used car seat for your child, please ensure the following: The car seat has never been in a car crash. The car seat isn't expired or outside the manufacturer's recommended longevity. It comes with the car seat manual and has all safety labels, including manufacture date, model number, and use instructions and restrictions. The car seat or any of its parts have not been recalled. The overall state and integrity of the car seat and its parts are undamaged. The carseat or any of its parts have not been recalled and are present and in working order.

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Becoming a caregiver or playing a more active role in another’s healthcare is a big responsibility. At some point, almost all adults will support an aging parent or a loved one in need. Keeping track of their needs and wellbeing, while also prioritizing your own can become overwhelming. It’s important to know: you are not alone, and help is available. Read on for 11 tips to help you manage your time, your own wellbeing and your loved one’s care. Self-care comes first. When your main priority is the person in your life who needs care, it’s easy for your own needs to take the backseat. Give yourself time each day to focus on your personal wellbeing. It’s hard to give a loved one the care they need if your own needs are not met. Prioritize the Activities of Daily Living (ADL). Make a note of what ADLs your loved one can do alone, what they need help with and what activities require the most help. This will help you work through the day with them, as well as plan out how the day’s activities will go. Do a home safety audit. Do showers, bathtubs and steps have safety grab bars? Look around the house for additional tripping hazards, like rugs or electrical cords. If your loved one struggles with day-to-day navigation of the home, consider scheduling an occupational therapy appointment. This type of therapy helps a person develop or maintain the motions required to accomplish daily tasks. You might also qualify for a referral to in-home healthcare, such as Home Care. Have the hard conversation. The best time to discuss views about end of life care and to learn what choices are available is before a life-limiting illness or crisis occurs. With advance care planning, you can help reduce the doubt and anxiety related to decision making at the end of life. Completing an Advance Directive is a great tool to sort out all these decisions before they’re needed. Attend a free workshop to learn more and complete this important document. Identify when you need respite. Respite care involves receiving a short-term break from caregiving. Organizing in-home care for your loved one will allow you to step away and tend to your needs. By identifying what kind of respite care you are seeking, you can find the right person to provide you with that much-needed break. Don’t wait until you feel overwhelmed, plan ahead. Write down insurance contact information. Have a direct connection to the right insurance professional for support and advice. If your loved one is eligible Medicare, this is a good opportunity to review their current selections and if they would benefit from a Medicare Advantage Plan or Medicare Supplement Insurance. Seeking out expert advice or information on Medicare options is a great way to navigate this. Consider calling a broker, or attend a free educational seminar with Senior Care Plus. Gather legal and financial information. Make a list of all existing legal documents and financial accounts that your loved one has. These might include a will, advance directive, power of attorney, bank accounts or investment accounts. If you have questions about how to manage them, or need assistance in setting up additional framework, reach out to a lawyer, legal service, financial adviser or bank representative. Create an inventory of medical information. Identify where all of your loved one’s medical records are, as well as a list of providers or healthcare practices where they have received care. Consider if you should have your loved one give you Proxy Access in MyChart, which allows you to access all the features in MyChart on their behalf, including viewing upcoming appointments, viewing test results and emailing a doctor on their behalf. Make a list of what others can do. Think about all the little (and big) things that need to happen, and write down tasks that others could take care of you. When someone says “let me know what I can do” you’ll be ready with a pre-written list of items they may be able to assist with. Tasks could include tackling around-the-house repairs, scheduling lawn work, helping to walk the dog, taking a car for an oil change and cleaning. Find programs and events for social enjoyment. If and when possible, seek an activity outside of the home. Look for community centers that have programs for seniors, recreational activities or meals that you can patriciate in together. If leaving the home is not an option, arrange for visits or in-home activities, such as movie nights, card games or time to visit with family. Research long-term options. If you will be considering a nursing home or assisted living, make a list of amenities that you and the person you are caring for would like. Take this list with you when visiting potential locations to make sure you don’t forget to ask about each item.

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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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A wedding is a big day for the wedding couple, but it’s also special for loved ones. A patient at Renown, Ken, got to take part in his daughter’s special day as her wedding plans changed to accommodate his medical condition. Grab some tissues and read how Renown’s team of compassionate caregivers and chaplains planned a wedding in Fianna’s Healing Garden. Ken was hospitalized at Renown Regional Medical Center where he was battling a lung problem – which was unrelated to COVID-19 – and his condition worsened rapidly on Wednesday, Aug. 12. His family made the decision to transition him to palliative care, which helps patients near the end of their lives remain comfortable, while supporting their dignity and quality of life.  Ken’s medical condition altered wedding plans for his daughter, Chandra, and her fiancé, Tyler, who were planning to tie the knot later in 2020. Chandra wanted her father there, but knew he could not leave the hospital. That’s why Chandra’s sister, Heather, approached Ken’s care team with a request to have a small wedding ceremony at the hospital.  Planning the Wedding A member of Ken’s care team, Amy Heston, registered nurse (RN), began planning how the wedding could be held outdoors in Fianna's Healing Garden in the E. L. Wiegand Pavilion, which was donated by the E. L. Wiegand Foundation.   In 24 hours, Amy planned a wedding ceremony with the help of her colleague, Breyanna Aufiero, RN; the Renown Spiritual Care team; and nursing leaders on the coronary intensive care unit (ICU). Together, they decorated the aisle in the garden with flowers and battery-operated candles. They also made a sign for Ken’s hospital bed, which read, “Father of the Bride,” and crafted a bow tie for him to wear for the special occasion.  With visitor restrictions in place at the hospital due to coronavirus (COVID-19), having the wedding outside in the Healing Garden allowed for more members of Ken’s family to attend including his wife, Charlotte, and his dog, Bella.   Every step in planning the wedding required thoughtful and thorough care coordination so Ken could participate. His breathing was supported by oxygen and special arrangements were made to transport the oxygen tanks he needed to take part in his daughter’s wedding. Amy worked with respiratory technician, Kasey Benfield, and critical care technician, Ruben Duckworth, to ensure Ken’s oxygen needs were met using portable machines.  Celebrating Love and Life Together Ken’s team of caregivers bathed him and shaved his face so he could look and feel his best for the ceremony. They put on his bow tie, covered his bed in decorations and his favorite blue, flannel blanket, and wheeled his bed outside for the ceremony.  Renown associate chaplains Terri Domitrovich and Susan Palwick coordinated music and performed the ceremony for Chandra and Tyler on Thursday, Aug. 13, 2020. The bride and groom shared their first dance in the garden and Ken’s care team provided water and treats to give the family a full wedding experience.   Shortly after the ceremony, Ken passed away. This wedding provided Ken and his family meaningful memories for their big life-changing moments as they celebrated and said goodbye.  “Seeing Ken surrounded by family he never would have gotten to see again while in the hospital, watching him get to share a father-daughter dance with Chandra on her wedding day, and having him tell me that this day meant more to them than we would ever know were some of the most moving moments I’ve witnessed as a nurse,” Amy said. “I am so thankful for the team we have here. I know that this beautiful day wouldn’t have happened without the help of every single person who gave their time, money, creativity and passion to make it a day to remember.”

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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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Eating healthy is a daily challenge for many, but for those with cancer it is an even harder struggle. A cancer diagnosis not only impacts those diagnosed, but family members and friends too. One key area of concern is making sure your loved one stays well by eating healthy food every day. Here are some essential cancer nutrition tips from Renown Health registered dietitians Jessica Blauenstein and Amy Laster. Help to Prepare Meals and Snacks for Daily Cancer Nutrition Make it grab and go. Easy-to-make meals help reduce the burden of having to cook and prepare food. Having easy to grab snacks on the counter or in the fridge can help ensure your loved one has access to those nutrients when needed. Sit outside of the kitchen. This allows your loved one to avoid cooking smells which can make them feel sick as a side effect of cancer treatments. Also try serving them cold foods such as sandwiches, cheese and crackers, or shakes which have a mild scent. Try drinkable meals. Some people with cancer find it easier to sip their calories over the course of 30 minutes to an hour. Consider smoothies or supplemental shakes such as Ensure Enlive or Boost Plus as snacks not meal replacements. A great foundation for a smoothie is a protein source (Greek yogurt, protein powder, nut butters or milk) with a carbohydrate (fruits, juice or berries). Add other ingredients as desired, such as spinach, kale, and ground flaxseed or chia seeds to give it more vitamins, minerals, and fiber. Snack Ideas for Those Undergoing Cancer Treatment The following ideas are both quick and easy to make for your loved one. Chicken or tuna salad with whole grain crackers or as a sandwich on whole grain bread Greek yogurt mixed with cereal, fruit and/or nuts Cottage cheese with banana, cinnamon and/or peanut butter Favorite fruit with 100% natural peanut or almond butter spread - Try peanut butter with bananas, apples, or even celery Their favorite veggies dipped in a salad dressing of your choice - For example, carrots with hummus or ranch dressing Cheese and whole grain crackers - Add tomato slices with a dash of oregano on top for more flavor Eggs scrambled with cheese, vegetables and/or salsa Peanut butter and jelly sandwich on whole grain bread A baked sweet potato with some favorite toppings Hard boiled eggs and/or egg salad with whole grain crackers, or as a sandwich on whole grain bread Oatmeal or cream of wheat prepared with milk, fruit and/or nuts Sometimes your loved one may not feel like eating or refuse to eat. If treatment side effects are impacting your loved one’s ability to eat, please visit the websites below containing recipes tailored to treat side effects. Cook for Your Life ELLICSR Of course you may also consult a registered dietitian and/or the patients care team, if you have more cancer nutrition concerns. No Appetite? Assisting with Cancer Taste Changes Taste changes are common during cancer treatment. Patients experiencing these changes may not feel like eating, which can negatively impact their nutrition. Help your loved one overcome taste changes with these cancer nutrition strategies: Metallic or bitter taste in food - add something sweet such as maple syrup, honey or jelly. You may also try adding fat, such as a nut butter, avocado or regular butter. Pickles or vinegar could help with this too. A taste like cardboard - try adding salt and extra flavor to foods with seasonings and spices. Some examples are onion, garlic, chili powder, basil, oregano, rosemary, tarragon, barbecue sauce, mustard, ketchup, or mint. Lemon juice, citrus, vinegar, or pickles may also help with this as well Food tastes too sweet - try adding six drops of lemon or lime juice. Add small amounts until the sweetness is gone. Very salty taste - try adding ¼ teaspoon of lemon juice. Try plastic utensils instead of metal, especially if your loved one is struggling with foods tasting metallic. Dipping small bites of food into either lemon juice or vinegar can have a “palate cleansing” feel and may improve taste perception. This helps avoid getting tired of the flavor after a few bites. Try marinating food or meats in sweet fruit juices, salad dressings, or sweet-and-sour sauce. Other “palate cleansing” foods are lime juice, orange juice, mangos, lemongrass, parsley, cilantro, mint, ginger, basil, and pickled foods. Use aroma to make foods appealing, avoiding any smells that may cause nausea. In particular, cinnamon, nutmeg, cloves, coriander, cumin, ginger, and black pepper can add an aromatic flavor. Also include herbs such as oregano, rosemary and thyme. Think texture. Consider trying wafers, crunchy nut butters, carrots, celery, cucumbers, chips, rice crispies, corn flakes, crackers, panko crumbs, nuts, or seeds if you are able to chew and swallow them safely. Remember that patience with your loved one's changing appetite and tastes can be the strongest form of support you can provide. Nutrition Tips for Cancer Survivorship and Beyond If eating large meals is difficult for your loved one, encourage them to snack throughout the day. Aim for 4-6 snacks or small meals per day. Focus on consuming 2-3 protein-rich foods each day such as lean animal meats, fish, eggs, soy or a protein supplement with 20-30 grams of protein per serving. Eat a variety of brightly colored fruits and veggies. Aim to make half of each meal fruits and vegetables. Eat less than 18 oz. (cooked weight) of red meat per week. Limit cold cuts, bacon, sausage, and hot dogs. Avoid excess salt and saturated fats. Cut back on simple carbs. (i.e. desserts, candies, white bread/pastas, french fries, packaged foods, chips) Drink in moderation- if at all- one drink per day for women, two for men. Get enough vitamin D (through diet and/or supplement) Avoid tobacco of any kind. Keep a healthy weight and stay up on exercise. Other Ways to Help a Loved One with Cancer Assist with Chores Allow your loved one to relax as you help take care of chores around the house, such as cleaning, cooking and grocery shopping. This may reduce overall stress and can be helpful for those that get tired after their treatments. Physical activity can still be beneficial, so be sure to do an activity together that they enjoy and is approved by their doctor. Be Patient It can be very difficult to see a loved one go through cancer treatment. Remember to be patient with your loved one. There may be things we want them to do or eat that we know would be good for them, however, meet your loved one with grace and understanding. It is ultimately their decision on what to do, just be there to support and assist them as they go through this challenging time. Additionally, Renown hosts free “Eating Well After Cancer Treatment” nutrition classes for cancer survivors.  Our next cancer nutrition class series starts Thursday, June 3, 2021, and will be hosted virtually. It is open to anyone in the community. For more information or to register please click here.

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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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