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Did you know that about one in four adults and one out of every ten kids in the U.S. might have a liver problem called non-alcoholic fatty liver disease (NAFLD)? This happens when too much fat builds up in the liver, and it's not because of drinking alcohol. The most serious type of this liver problem is called metabolic and non-alcoholic steatohepatitis (M/NASH). It means there's damage and can be scarring in the liver. About 20% of people with fatty liver disease have M/NASH. What's worrying is that many people don't even know they have it. Dr. Catherine McCarthy, a family medicine doctor at the University of Nevada, Reno School of Medicine, talks about the main risks of M/NASH and how you can check your risk for liver disease during Liver Health Matters Month, or anytime.  Who Might Get M/NASH?  Doctors aren't sure exactly why some people get fatty liver or M/NASH. While anyone can get M/NASH, people who might be more at risk include those with:  Type 2 diabetes Insulin resistance or prediabetes High body mass index (BMI) or obesity High cholesterol or other fats in the blood High blood pressure Signs of liver problems from tests or biopsies A family member living with M/NASH How Do Doctors Find Out If You Have M/NASH? Doctors can do different checks and tests to see if someone has fatty liver or M/NASH. They might look at your liver health through non-invasive tests such as blood work, ultrasounds or MRIs. They might also suggest a special blood test called an Enhanced Liver Fibrosis (ELF) test– offered at no-cost through the Healthy Nevada Project – to check your risks of advancing liver disease.  How Can You Treat Fatty Liver Disease or M/NASH?  Patients with moderate to advanced liver scarring may also be prescribed a recently approved therapy called Rezdiffra. However, prevention of advancing disease is still the best option.  Actions you can take to improve your liver health and reduce your risk include: Eating healthy, especially low-carb foods Exercising regularly Losing weight if needed Not drinking alcohol Keeping an eye on blood sugar if you have diabetes No-Cost Liver Screening Through the Healthy Nevada Project  If you live in Nevada and are 18 or older, you can qualify for a no-cost liver health screening by enrolling in the Healthy Nevada Project, one of the largest community-based population health studies in the entire country. This study helps doctors understand your liver health better and plan early treatments to stop liver disease from getting worse.  By joining the Healthy Nevada Project, you can: Get the FDA-approved ELF test to check your risks for liver disease See your test results in your medical record to help your doctor plan your care better Help doctors and researchers learn more about M/NASH and work on future treatments Participate in genetic sequencing for high-risk conditions linked to heart disease and certain cancers, including breast and ovarian cancer Gain high-level health insights, including food sensitivities, and ancestry information. Enrolling in the study is easy: Schedule a Virtual Consent Appointment through MyChart where a study representative will answer any questions, confirm your eligibility and sign you up. Once you’re signed up, your representative will schedule your blood test. Go to your blood draw appointment. By taking part in this study, you're helping to make a difference in liver health research!

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As we approach the warmer months, many plants bloom in northern Nevada, leading some to deal with the bothersome symptoms of seasonal allergies. Dr. Michael Babcock, a family medicine physician at Renown Medical Group—North Hills, discusses the effects of seasonal allergies and how to manage them. 1. Reduce your exposure to allergy triggers: Stay indoors on dry and/or windy days. Avoid outdoor tasks like weeding or gardening. If you must do chores outside, wear a face mask. After being outside, shower to rinse off pollen and change into a new pair of clothes. 2. When there's a lot of pollen in the air, seasonal allergies can flare up. These steps can help you reduce your exposure: Check your local newscast or search online for pollen forecasts and current pollen levels. If pollen counts are high, start taking allergy medications before your symptoms start. Close doors and windows at night if possible or any other time when pollen counts are high. Avoid or reduce outdoor activity in the early morning when pollen counts are highest. 3. Reduce allergy triggers by keeping your indoor air clean. Use air conditioning in both your house and car. Replace your home’s HVAC air filters and follow regular maintenance schedules. Use both a dehumidifier in combination with a portable high-efficiency particulate air (HEPA) filter in your bedroom. Routinely clean your home to remove dust and dirt.

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Do you find yourself struggling to stay awake during the day or having no energy? You’re not alone. Whether you’re a full-time employee, a student or retiree, that “I’m tired” feeling comes in all shapes and sizes. What’s even more frustrating is not knowing the source of your exhaustion.  Dr. Brandon Flores, a sleep medicine physician with Renown Medical Group, breaks down nine key reasons why you may be feeling so fatigued.  You did not get enough sleep, or your quality of sleep is poor. This may seem obvious, but in today’s “rise and grind” culture, sleep can be considered a luxury rather than what it really is: a necessity. Ensuring you get adequate hours of sleep between 6-9 hours and quality sleep is essential. You may not be breathing well during sleep. Interruptions to your breathing, such as snoring, can decrease airflow at night causing your sleep to be less restorative. This is often due to Obstructive Sleep Apnea (OSA). OSA can lead to daytime fatigue and sleepiness and can also impact other chronic health conditions, such as hypertension, diabetes, acid reflux, migraines and heart rhythm. You are not getting enough regular exercise, or you are exercising too much. Incorporating at least 30 minutes a day of physical activity can help keep you energized throughout the day. It has also been shown to increase deep slow wave sleep, which is often associated with feeling rested. On the other hand, getting too much exercise can tire you out more easily and heighten stress levels. You drink too much caffeine. This one may seem counterintuitive – caffeine is supposed to keep you awake, right? Well, overdoing it with your favorite coffee or soda could affect your sleep quality. Pay attention to your caffeine limits and have a cut-off time, as most caffeine should not be consumed past noon. You have a food allergy or intolerance. If you find yourself feeling especially tired after eating a lot of a certain food, you could have an allergy or intolerance to it – and vice versa. Consider speaking with your primary care provider (PCP) about a food allergy test or being referred to an allergist. You’re drinking too many alcoholic beverages. Alcohol is a depressant, which as the word implies, can make you feel especially tired during the day. It can also affect your breathing at night and disrupt your sleep cycle. Cutting back on alcoholic drinks may be beneficial to your overall health. You are anemic. This is the leading cause of fatigue in women but can affect people of all genders. It can be associated with low iron. Eating foods high in iron, including leafy greens and many different meats, can help your iron levels. A blood test ordered by your PCP can help you understand if you are iron deficient. You are experiencing depression or anxiety. Emotional exhaustion can be just as taxing as physical exhaustion. Prolonged feelings of sadness, hopelessness, nervousness or panic can be signs and symptoms of depression or anxiety. Speak with your provider about the many resources available to help you. You have an underactive thyroid. Feeling fatigued can also be a symptom of hypothyroidism, which affects your metabolism and energy levels. Medication can help get your thyroid back to normal. Your PCP can order a blood test to determine your thyroid levels.  If you experience severe exhaustion that lasts six months or longer, worsens after physical or mental exertion and does not get better after resting, it could be a sign of myalgic encephalomyelitis, otherwise known as chronic fatigue syndrome (CFS). This is a diagnosis of exclusion, and other causes must be ruled out. While there are no tests that detect CFS, your provider can order blood and urine tests to rule out other causes of your fatigue and help develop a care plan. © Africa Images via Canva.com

Read More About Why Am I So Tired? 9 Reasons for Your Chronic Exhaustion

Ensuring a healthier and more inclusive future for LGBTQIA+ children and teens is of utmost importance to health systems in our community, especially Renown. Supporting the physical and mental health of youth in this community is key to those efforts, especially as they face unique challenges in terms of identity acceptance and social integration.   Dr. Caroline Barangan, Adolescent Medicine Physician with Renown Children’s Pediatric Specialty Care, discusses what you as a parent, caregiver, friend or support system can do to be a safe space for children and teens who identify as LGBTQIA+. 1.  Create a Safe Space at Home The most important action you can take for your LGBTQIA+ teen or child is to accept and support them for who they are, regardless of how they identify. “Being a teenager is already difficult enough, especially within the LGBTQIA+ community, which puts them at risk of being stigmatized, rejected and targets for bullying,” said Dr. Barangan.  Your supportive words and actions can make a huge difference as a profound expression of love and understanding. Being patient and willing to learn are the foundations to a healthy and loving relationship with your LGBTQIA+ teen or child.  2.  Encourage Regular Check-Ups with a Primary Care Provider (PCP)  Establishing your child or teen with a PCP is not only important when an illness occurs but also for annual preventative visits and regular check-ups. “A primary care provider can screen for high-risk behaviors that would put a patient’s health in jeopardy, such as sexual experience, substance use, suicidality and self-harm,” said. Dr Barangan. “These screenings are an opportunity to provide the education and support these kids and teens need to stay healthy.”  One of the main concerns LGBTQIA+ youth often have is that they will experience judgment from their provider, or the PCP will disclose sensitive information, including their sexuality or gender identity to their parents, when they are not ready to do so. Dr. Barangan emphatically reminds us that this legally cannot happen. “If a patient asks me to keep something confidential, unless they disclose that they have plans to harm themselves or others, I am legally not allowed to share that information with anyone without their permission,” said Dr. Barangan.  3.  Locate Local Resources  Northern Nevada is home to a variety of resources for the LGBTQIA+ community at large, including youth members of this community. "Finding resources to help them develop in a positive way and provide them with the information they need, whether it be in school, the household, the community or through a medical or mental health provider, is incredibly important,” said Dr. Barangan.  Below is a list of local LGBTQIA+ community resources open to you and your children:  Our Center LGBTQIA+ Health Services at Northern Nevada HOPES Northern Nevada Pride Festival & Community Parade (happens every July in Reno) Sassabration (happens every September in Carson City) Lake Tahoe Pride (events and resources shared on Facebook)  © alessandrobiascioli via Canva.com

Read More About 3 Ways to Foster the Wellbeing of LGBTQIA+ Kids and Teens

Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs.  Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health.  PrEP and PEP  Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months.  Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days.  PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location.   HPV Immunization  All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime.  The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never!

Read More About 6 Healthcare Action Items for the LGBTQIA+ Community

The back-to-school season is here, and ensuring your child's successful transition involves more than just school supplies and schedules. At Renown Children’s Hospital, and in collaboration with Nevada Pediatric Psychiatry Solutions, we understand the vital role that mental health plays in a child's overall well-being and academic performance. Below we'll guide you through essential tips for a smooth back-to-school experience, with a special focus on nurturing your child's mental health. How to Support Your Child’s Mental Health from Home Remember, the below strategies can be adapted to align with your child's personality, learning style and household dynamics. Flexibility and understanding are key in tailoring these tips to suit your child's unique needs. 1. Be Open to Communication: Recognize that effective communication is the cornerstone of understanding your child's feelings and concerns. Create a safe space where your child feels comfortable expressing their thoughts. Listen to learn, without judgment. Make it a point to validate their emotions and ensure they are heard. Encourage sharing experiences,worries, friends and challenges they may be facing. Having open conversations about sensitive topics opens the door for discussion and understanding. Make yourself available. 2. Establish a Routine: A consistent routine can offer a sense of stability and predictability for your child, and anticipation helps to decrease anxiety and establish a sense of control. Join forces and design a daily schedule that includes time for schoolwork, play, physical activity, meals and relaxation. Be flexible about the structure to allow room for last-minute changes including extra activities based on that day’s needs as well. Always add time for play and bonding. 3. Practice Compassion: Back-to-school can come with big emotions. Listening reflexively and acknowledging these feelings can help you and your child act positively on these big emotions. 4. Get Involved: Actively engage in your child's school life by participating in school events, meetings and discussions. Show interest in their educational journey, ask about their experiences and provide guidance when needed. Being present in their academic pursuits not only boosts their confidence but also strengthens the parent-child bond. 5. Use Positive Reinforcement: Celebrate your child's achievements, no matter how small they may seem. This allows for a sense of accomplishment and boosts self-esteem. Praise efforts, progress and perseverance, whether it's completing an assignment, making a new friend or overcoming a challenge. This positivity encourages a growth mindset and resilience. 6. Organize a Schoolwork Zone: Create a comfortable workspace at home dedicated to school-related tasks. Customize the area based on your child's preferences and needs. Having a designated space for studying and completing assignments promotes focus, reduces distractions and enhances their overall learning experience.

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Abdominal pain is one of the most common complaints that brings individuals to the emergency room. We spoke with emergency physician Bret Frey, MD, to ask about when and where to seek care for abdominal pain.   Dr. Frey advises that any time you feel something is developing inside your body that is substantially different from what is normal for you, understand that something is wrong. He further explains that warning signs of an acute medical situation include fever, vomiting or a rapid change in function and ability to move due to pain. These symptoms indicate that one needs to be evaluated by a medical professional.   This evaluation will include the care team conducting an examination and asking a series of questions to determine if additional diagnostics, such as lab work or imaging, are needed. Be prepared to discuss where the pain is and what it feels like, in addition to how long it’s been bothering you and if it’s constant or intermittent.  While appendicitis often comes to mind when thinking about abdominal pain, Dr. Frey says that this is not the bulk of cases that the Emergency Department sees. In fact, often the pain does not have a specific diagnosis, but our team of board-certified emergency physicians are experienced in assessing and caring for those experiencing the acute symptoms he described.   “We often don’t come away with an answer about exactly what it is, but we substantially rule out life threats in a very methodical and systematic way,” said Frey.  The abdomen includes many organs, including the stomach, liver, small and large intestines, gallbladder and pancreas. In addition, pain stemming from your chest, pelvis or back may be felt in the abdominal area.  If you are experiencing abdominal issues that are persistent but not an emergency, talk to your primary care doctor about what you are experiencing, and be prepared to review the history of this pain, medications, allergies and diet. He or she will be a good partner to review conditions such as gas, heartburn, constipation, diarrhea, inflammation or menstrual and ovulation pain. Drinking plenty of water is always an important part of supporting your health.

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Vitamin D, often hailed as the sunshine vitamin, plays a crucial role in our health by helping the body absorb calcium and promoting bone and teeth strength. However, despite its importance, Vitamin D deficiency is widespread, contributing to various health issues ranging from osteoporosis to type 2 diabetes. We asked Alexandra Westover, APRN for Renown Health, for more information. Understanding Vitamin D and Sun Exposure How Vitamin D is Synthesized Vitamin D functions like a pro-hormone produced when our skin is exposed to sunlight. It's vital for bone health and immune function and can even reduce the risk of type 2 diabetes by 15%. Challenges in Vitamin D Synthesis Achieving adequate Vitamin D levels is more complex than basking in the sun. The vitamin breaks down quickly; during winter in northern latitudes, UVB rays are often too weak to contribute to its production. Expert Insight Alexandra shares, "Vitamin D deficiency is linked to multiple health concerns, including cancer and depression. Unfortunately, deficiency rates are high in the U.S., partly due to limited dietary sources and the increasing prevalence of obesity." Dietary Sources of Vitamin D Foods High in Vitamin D: Fatty fish like salmon and tuna Fortified milk and orange juices Mushrooms Eggs Cod Liver Oil Alexandra's Advice on Supplements "While foods and over-the-counter supplements can help, they often fail to correct deficiencies. Many individuals need prescription-strength doses of Vitamin D."

Read More About The Essential Guide to Vitamin D: The Sunshine Vitamin

March is Colorectal Cancer Awareness Month, and we want you to receive the best preventative care possible. Early detection can help prevent serious illness, yet many people still choose to skip their annual exams and routine screenings. Bonnie Ferrara, MD, MPH, Section Chief for Primary Care at Renown Medical Group, further explains the importance of this simple, easy way to stay healthy. Why are annual exams so important? The benefits of early detection and prevention to save lives and reduce the impacts of disease have been proven. These exams are the perfect opportunity to get your health questions answered. “This is your chance to sit down with your provider and talk about your overall health and your family’s health history as well as your concerns for the future,” says Bonnie Ferrara, M.D., family medicine. “It’s the opportunity for your provider to talk with you about your lifestyle, tobacco use, exercise and alcohol use, all of which make a difference in your future longevity.” The annual wellness exam is also an ideal time for most adult patients to discuss health screenings. In addition, these visits are the perfect time to address issues that may not directly relate to a particular medical problem or immediate illness. A good rule of thumb is to schedule these appointments around your birthday each year to make sure you and your provider are both updated on your care. Why would you need an annual exam if you aren’t feeling sick? According to Dr. Ferrara, seeing your care provider when you aren’t sick is one of the best times. “It is better if you try to arrange this visit when you are not feeling ill,” she says. “It is an opportunity to talk about wellness. Not only how to contribute to your wellness but also the changes that you can make that will make huge dividends in the future for your wellness. In addition, it allows us to do some education about what to expect in the coming years as far as your health and lifestyle changes.” What can you expect at an annual exam? Annual exams usually check your: History – lifestyle behaviors, health concerns, vaccination status, family medical history Vitals – blood pressure, heart rate, respiration rate and temperature General appearance – your care provider can find out a lot about you just by watching and talking to you Dr. Ferrara adds, “If this is a Medicare annual wellness exam, it is an opportunity to talk to your provider about depression and dementia as well as be tested for those.” You can also leverage your annual exam to speak to your provider about managing your chronic health problems. "As a provider, these visits give us the opportunity to hear how the medications and lifestyle changes we have recommended are working and if you are having problems with these, we have the opportunity to make suggestions of how to do things better for the future," Dr. Ferrara.

Read More About Why are Annual Exams & Routine Screenings Important?

When seeking medical care, there are several different provider types and options from which to choose. For example, you may have asked yourself a common question: Should I go to my primary care provider, urgent care or the emergency room? Sarah Herbert, APRN with Renown Medical Group – South Carson, provides guidelines to help you easily make this decision. When should you go to the Emergency Room (ER)?  Making a visit to the ER should be reserved for severe symptoms and/or life-threatening conditions, including:  Chest pain Severe shortness of breath or difficulty breathing Weakness or numbness on one side Slurred speech Fainting/loss of consciousness Continuous bleeding or major open wounds Severe allergic reactions  Coughing or throwing up blood Drug or alcohol overdose Sharp pain in lower abdomen Severe dehydration and not responding to nausea medication (needing IV fluids) High fever that does not get better with medicine Serious burns Broken bones/dislocated joints Head trauma Find an Emergency Department Near You If you’re still unsure of where to go for appropriate medical care, it’s best to check with your primary care physician. And remember, for a life-threatening emergency, call 9-1-1 immediately!

Read More About Primary Care vs. Urgent Care vs. The ER

An alcohol problem can affect anyone at any age. Many factors, including job stress, genetics or depression, may contribute to the start of disordered drinking.  Drinking alcohol exists on a continuum. For example, if someone feels down in the dumps for some time, it doesn’t mean they are clinically depressed. So if someone goes through a period with above-normal alcohol consumption, it doesn’t necessarily mean they abuse alcohol. Although “alcoholic” and “alcoholism” are common, they are not clinical descriptions. Alcohol use disorder is the preferred term. Symptoms are often mild but can be the start of a more significant problem. According to the National Institutes of Health (NIH), over 16 million adults live with alcohol use disorder. Symptoms of Alcohol Use Disorder Do you recognize any of the following symptoms in yourself or someone you know? Drinking more or longer than intended Trying to cut down or stop drinking but not able to Having to drink more than you once did to get the same feeling Being annoyed when family members discuss your drinking Regretting your behavior while you were drinking

Read More About What is Disordered Drinking?

Approximately 476,000 Americans are diagnosed and treated for Lyme disease every year. Lyme disease is an infection that is transmitted to humans through the bite of infected black-legged or “deer” tick. It’s the most common and fastest-growing vector-borne disease in the United States. This bacterial infection, if left untreated, can cause serious pain, fatigue and other crippling symptoms. Keeping an eye out for early signs of Lyme disease, implementing prevention techniques and understanding testing and treatment options can go a long way in maintaining your health. We consulted with Peter O’Reilly, PA-C at Renown Medical Group – South Carson to learn more. 1. Recognizing the Signs of Lyme Disease Lyme disease is extremely easy to misdiagnose, given that most of its early signs and symptoms mimic those of other conditions, such as COVID-19. Common Lyme Disease symptoms include: Fever Chills Joint or muscle pain Swollen glands Extreme fatigue Headache  The primary initial symptom that occurs in about 80 percent of Lyme disease cases is a “bulls-eye” rash that spreads around the site of the tick bite – called “erythema migrans.” Tick bites can be hard to find and not everyone gets the classic bullseye rash, making Lyme disease difficult to self-diagnose. O’Reilly suggests talking to either your primary care doctor or infection doctor as soon as possible if you’re concerned about Lyme disease.

Read More About Lyme Disease: 3 Things You Should Know