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How to Safely Give Children Over-the-Counter Medications
How can you ensure you’re giving your children safe doses of over-the-counter medications? The safest bet: Confirming dosages and recommendations with your doctor. With that in mind, here are a few answers to basic questions about OTC medications and children. It’s cold and flu season in Northern Nevada. This means you’ll find parents in the aisles of practically every drug store, wondering what will and will not work for their sick children. Over-the-counter (OTC) medications — and their dosages, side effects, interactions and more — can inspire abundant anxiety for parents. At the outset, the U.S. Food and Drug Administration offers the following warning about use of medicines for cough and colds in children: The FDA doesn’t recommend over-the-counter medicines for cough and cold symptoms in children younger than 2 years old. Prescription cough medicines containing codeine or hydrocodone are not indicated for use in children younger than 18 years old. Codeine and hydrocodone are opioids that are available in combination with other medicines, such as antihistamines and decongestants, in prescription medicines to treat cough and symptoms associated with allergies or the common cold for adults. Caregivers should also read labels on OTC cough and cold products, because some might contain codeine. So how can you feel comfortable administering any OTC medication to your children? The short answer is: Check with a doctor first. And with that in mind, here are a few common questions and answers from Kristin L. Wilson, MD, of Renown Pediatrics about children and OTC medications. Please talk about the importance of correct dosage of pediatric medications. Pediatric dosing is weight-based and unique to each medicine (and sometimes even the circumstance you are treating.) Therefore, there are no standardizations of “safe” amounts that apply to all medications. What are signs of an overdose of pediatric medications? Signs of intoxication/overdose are also unique to each medication and supplement. And to make it more confusing, mixing current prescriptions with various supplements or over-the-counter medications can cause significant adverse effects as well. Is there an age at which children take adult over-the-counter medications? Infants through adolescents can take medications that are also prescribed to adults, but only under a healthcare provider’s careful guidance. Dosing is determined by various factors dependent on child’s age and also medical history, as above. What is the takeaway about administering medications to children? When in doubt, ask a healthcare professional whether a medication or supplement is safe for your child based on his/her age and medical history as well as recommended dosing based on recent weights and other vital signs.
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5 Ways to Prevent Diabetes
November is National Diabetes Month, and with cases of the disease at an all-time high in the U.S., individuals must do everything they can to stay healthy. Learn more about diabetes prevention and also how to stop prediabetes in its tracks with these five helpful tips. Diabetes is a disease that is increasingly making its way into the public consciousness, and not in a good way. In fact, according to USA Today, diabetes has a greater health impact on Americans than heart disease, substance use disorder or COPD, with 30.3 million Americans diagnosed with the illness — and many more who are at risk for developing it. And those with prediabetes are at risk for developing type 2 diabetes in 10 years or less, according to the Mayo Clinic. The American Medical Association notes that 4 million U.S. adults have prediabetes. Check out the American Diabetes Association’s prediabetes risk test. The good news: There are ways to manage — and even reverse — prediabetes. Renown’s Certified Diabetes Educator Stephen Compston, RD, LD, CDE, shares five steps for managing blood sugar and also avoiding an eventual diagnosis. How to Prevent Diabetes Eat healthy foods. Plan meals that limit (not eliminate) foods that contain carbohydrates, which raise your blood sugar. Carbohydrates include starches, fruits, milk, yogurt, starchy vegetables (corn, peas, potatoes) and sweets. “Substitute more non-starchy vegetables into your meals to stay satisfied for fewer carbohydrates and calories,” Compston says. Exercise. Blood sugar is the body’s basic energy source. When you exercise, you are lowering your blood sugar. “People with prediabetes usually want to stay off of medication, so they must add something to their normal regimen that lowers blood sugar,” Compston says. “In this case, exercise is medicine.” Lose weight. A small decrease in your weight can drastically decrease your risk of developing diabetes in the future. The Diabetes Prevention Program study showed that a 7 percent decrease in body weight (14 pounds for a 200 pound person) can reduce a person’s risk of developing the disease by 58 percent. Get more rest. Studies link sleep issues to an increased risk of insulin resistance. It can also make it harder to lose weight. Thus, people that don’t get adequate sleep are at an increased risk for developing type 2 diabetes. See your doctor regularly. Schedule an appointment with your primary care provider at least once a year so you can track your health together. “A regular check-up and lab work can help identify what your blood sugars are doing so you and your doctor can develop a good plan for delaying the onset of diabetes,” Compston says.
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Jakob’s Journey at Renown Children’s Hospital
In August 2016, six-year-old Jakob was admitted to Renown Children's Hospital with what seemed like a common ear infection. Jakob's condition quickly progressed, and he started experiencing neurological symptoms such as difficulty speaking and a full-body shutdown. Doctors, neurologists and specialists from Renown worked with doctors from Stanford, where he was ultimately diagnosed with Bickerstaff brainstem encephalitis (BBE). BBE is a rare, autoimmune response that attacks the nerves in the body due to an acute illness such as a cold, flu or, in Jakob's case, an ear infection. Jakob could not breathe or eat and experienced paralysis on the side of his face, throat, stomach, bowels, lungs and legs. In addition, he started to rapidly lose weight as well as body function. Jakob lost half his body weight which resulted in the need for a Gastrostomy tube. This device is placed surgically and gives direct access to the stomach to give the child the nutrition needed. He also needed occupational therapy, and after three and a half months of ICU respiratory therapy, surgeries and treatments, he was released home to regain his strength. Forever Grateful Anica, Jakob's mom, said, "If it were not for the quick response and unconditional support and compassion from the team at Renown, Jakob would not be here today." Jakob's family is forever grateful to the staff, community and expertise at Renown for their unwavering commitment to their son and family during their most trying time in life. "When I met Jakob on the first day of his illness, so much was unknown. My team and I were worried, as his symptoms were very unusual. His rapid deterioration, after being a perfectly healthy child, was clearly terrifying for his parents. Handing over a child's care to a team of strangers is one of the scariest things that can happen to parents,” said Dr. Kris Deeter, Physician in Chief at Renown Children’s Hospital. “However, Anica and Jeremiah were also very clear that they did not want Jakob transferred somewhere else. So, we used all our resources to care for him, arrive at a diagnosis, and start aggressive therapies. They listened to every word we said, educated themselves, and became partners in Jakob's care. We all became part of Team Jakob, and soon, he proved to us just how strong he was." Today, Jakob is 13 years old and thriving in every aspect of his life. He is currently on the honor roll in school and finds joy in his newfound passion for the violin. He loves spending his free time learning about mixing music, making new friends and traveling to different parts of the country. This summer, he will travel to Europe to explore his passion for culture. The family says, "We owe it all to the family and staff at Renown."
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Protect Yourself and Others with the Flu Shot
Flu shots don’t just protect those who get vaccinated; they protect everyone, including your family and the community. As we continue navigating the COVID-19 (coronavirus) pandemic, Renown Health infection prevention expert Whitney Robinson explains how getting your flu shot is vital for staying healthy. 5 Ways to Schedule Your Flu Shot Call Us! 775-982-5000 Urgent Care Appointments Renown Pharmacy Vaccinations Make an Appointment via MyChart Need a Doctor? Find One Now Reasons to get the flu shot Chills, body aches, fever, congestion; getting the flu isn’t fun. But in addition to protecting yourself with a flu shot, you’re helping reduce flu cases and hospitalizations, Whitney said. Flu shots are currently available at pharmacies throughout the Reno area. Whitney says the ideal time to get your flu shot is September through October, but remain relevant throughout the winter months as it only takes two weeks for the antibodies to develop in your body. This timing allows the vaccine to provide the strongest protection during the length of flu season. Who needs a flu shot? Almost everyone. The Centers for Disease Control and Prevention recommends the yearly flu shot for everyone six months of age and older. Equally, they consider it the first and most crucial step in protecting against the flu virus.
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A Cancer Diagnosis and a Move to Reno
Michael Millman was all set to move to Reno from the Bay Area when he noticed a pimple-like growth on his forehead, and he decided to get biopsied "just in case." It was July 2020, less than six months into the COVID-19 pandemic, when Michael got the call that the biopsy came back cancerous. He was in shock. Still living in the Bay Area at the time, he immediately scheduled to have the basal cell carcinoma removed in August. After the removal, he thought he was in the clear, but a few months later, Michael noticed that his lymph nodes felt weird, and he even cut himself shaving because of some persistent swelling in the area. Given his recent history of skin cancer, Michael immediately scheduled an appointment with a specialist in the Bay Area. "I met with an ear, nose and throat doctor who suggested a fine needle biopsy of my lymph nodes, tongue and an MRI, both with and without contrast," Michael said. "I remember feeling dreadful and that I couldn't believe this was happening yet again." A Hard Decision Michael's squamous cell carcinoma, determined by the pathology report to be significantly influenced by the HPV virus, had metastasized to his lymph nodes on both sides of his neck, and his doctor said it could be stage four cancer. He remembers feeling like he was in quicksand, unsure if he should follow through with his move to Reno, or stay in the Bay Area for treatment. By now, it was early December 2020, and hospitals in the Bay Area and across the world were at limited capacity due to COVID-19. But, in what Michael describes as a positive twist of fate, the San Francisco ear, nose and throat provider he had seen about his biopsy results mentioned that he knew many providers in the oncology department at Renown, including Abhinand Peddada, MD. The San Francisco provider called Dr. Peddada's office with a referral, and Michael even remembers that Renown called him to hear more about his diagnosis before he even got the chance to call them "To be honest, I was feeling shut out in the Bay Area, and Dr. Peddada said he could help me expedite the treatment process," Michael said. "I finally felt a sense of relief." And so began Michael's 7-week chemoradiation cancer treatment program at Renown.
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Hiking Through Life After TAVR
Renown Health patient, Alden Nash, hiking Death Valley National Park just three months after a Transcatheter Aortic Valve Replacement. Alden Nash isn’t your average 80-year-old. For much of his life, he could be found outdoors enjoying nature and hiking some of the west coast’s highest elevations. A husband and father of two, Alden turned his passion into a career as a Yellowstone park ranger in 1965. Alden believes his passion for the outdoors is responsible for his many years of health – until the unavoidable happened. The Hardest Climb The number one doctor recommendation for a healthy heart – lead a healthy, active lifestyle. Any cardiologist would be thrilled to have Alden as a patient due to his robust physical activity regimen. “Don’t have a TV set or a lounge chair in your house and you’re all set,” said Alden when asked how he has remained so fit throughout his senior years. Unfortunately, many other factors come into play when it comes to heart health, one of which is the reason we are telling Alden’s story today. Familial history - it’s a hot topic in the world of medicine. Understanding your genetic risk factors can help care providers develop updated care plans based on your results. Alden’s family has a long history of high cholesterol, which he avoided for much of his life by staying active. This combined with his age resulted in his first heart attack in December 2021. Doctors later determined that Alden was suffering from a type of heart valve disease known as aortic valve stenosis. Aortic stenosis is the narrowing of your aortic valve opening that impedes normal blood flow. Over time, the leaflets of your aortic valve become stiff, reducing their ability to fully open and close. When the leaflets don’t fully open, your heart must work harder to push blood through the aortic valve of your body. Eventually, your heart gets weaker, increasing the risk of heart failure. People who are most at risk for aortic stenosis include those who have had certain heart conditions present at birth, have chronic kidney disease or have heart disease risk factors such as high cholesterol and high blood pressure. However, generally, aortic stenosis is a degenerative process of aging with no modifiable risk factors. The incidence of aortic stenosis increases rapidly with age and is very common above the age of 80 – with 1/10 having the condition and 1/50 with a problem severe enough to warrant surgery. When symptoms are present, the disease can be rapidly disabling or even deadly, often progressing over several months unless treated.
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Prestigious Honor Shines National Spotlight on Health Care in Nevada
Renown Health CEO, Dr. Tony Slonim Elected to Highest Office with American Hospital Association. Renown Health President and CEO, Anthony Slonim, M.D., DrPH, FACHE, has been elected to serve as a member of the American Hospital Association (AHA) Board of Trustees for a three-year term beginning Jan. 1, 2022. The Board of Trustees is the highest policymaking body of the AHA and has ultimate authority for the governance and management of the organization. The American Hospital Association (AHA) is the national organization that represents over 40,000 individual members and serves over 5,000 hospitals, health care networks, and their patients and communities. As a representative and advocate for those serving in the health care field, Dr. Slonim's role as a Trustee will be to ensure that members' perspectives and needs are heard and addressed in national health policy development, legislative and regulatory debates, and judicial matters. Dr. Slonim joins an elite list of CEOs from the nation’s most respected health care organizations in AHA Board service, including Yale New Haven Health (CT), Dartmouth Hitchcock Health (NH), Providence Health (WA), Henry Ford Health (MI), UMass Memorial Health (MA), Vanderbilt University Medical Center (TN), and Advocate Aurora Health (WI). The American Hospital Association was founded in 1898, the same year Marie Curie began studying uranium as a treatment for cancer. Dr. Slonim is among the first health care leaders from Nevada elected to serve on the AHA Board of Trustees. In an announcement to the national media, the AHA wrote, “Anthony Slonim, MD, DrPH, leads Renown's charitable mission of making a genuine difference in the community's health and well-being for one of the nation's most innovative and progressive health systems.” Steve Sisolak, Governor of the State of Nevada, in support of Dr. Slonim’s nomination wrote, “Both Dr. Slonim and I share a common interest for improving the health of over 3 million residents of our state. I urge you to appoint him to this position, as his national leadership would benefit the American Hospital Association, our state and our nation.” Brian Sandoval, President of the University of Nevada wrote in his nomination, “Dr. Slonim has always answered the call, and worked with me to improve health through proactive community-based prevention, to create an exceptional healthcare system for those with acute and chronic diseases, and to care for all people in our community.” Bill Welch, President and CEO of the Nevada Hospital Association, wrote in support, “I consider Dr. Anthony Slonim to be one of the most extraordinary leaders in health care today.” Dr. Slonim is recognized nationally as a thought and opinion leader who does not accept the status quo. He is a quadruple board-certified physician by training and holds a Doctorate in Public Health and Health Policy with Fellowships in the American College of Healthcare Executives (ACHE), American Association of Physician Leaders (AAPL), and the College of Critical Care Medicine. Dr. Slonim’s holds a university appointment at the University of Nevada, Reno School of Medicine, is a highly sought after speaker on healthcare trends and leadership development, holds a Six Sigma Black Belt and is a 2-time TEDx speaker. Dr. Slonim has authored more than 120 publications, 15 textbooks, and has millions of dollars in research funding to his name. Modern Healthcare has named Dr. Slonim as one of the 50 Most Influential Leaders in Healthcare. He has been named to Becker's Hospital Review's "Physician Leaders to Know" list since 2014. Before joining Renown Health in 2014, Slonim served on the senior leadership teams for Barnabas Health in New Jersey, Carilion Clinic in Virginia and Children's National Medical Center in Washington, D.C. Slonim, who was also a registered nurse, got his medical degree from New York Medical College, served four years in the U.S. Public Service Commissioned Corps as a commander, and earned both his master's and doctoral degrees in public health and health policy from The George Washington University's Center for Health Policy Studies. About Renown Health Renown Health is a locally governed, not-for-profit integrated healthcare network serving northern Nevada, Lake Tahoe and northeast California. Renown has a long tradition and commitment to improving the care and the health of our community. For more information, visit renown.org.
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Renown Cardiologist Shares Insight on Warfarin
Renown Health's Dr. Christopher Rowan recently joined a distinguished panel of experts on the "Game Changers in Medicine" podcast to discuss the science behind the discovery of warfarin. Renown Health Cardiologist Dr. Christopher Rowan was just featured on an episode of Game Changers in Medicine, a groundbreaking medical history podcast from Dramatic Health about some of the world’s most significant medical discoveries. The episode, Warfarin: How a rat poison became one of the world's most widely prescribed drugs, dives into the fascinating history of Warfarin and its life-saving effects on humans. During the episode, Dr. Rowan, whose research focus is heart disease and atherosclerosis, is joined by experts Kevin Walters, Historian and Strategic Research Coordinator at the Wisconsin Alumni Research Foundation (WARF); and Ramya M. Rajagopalan, Ph.D. of the Institute for Practical Ethics at UC San Diego. Listen to the episode now or download it wherever you listen to podcasts. History of Warfarin Warfarin prevents blood clots from forming or expanding. The drug is especially important for individuals who have experienced a heart attack or stroke, or are at risk of experiencing either. However, the backstory of the drug is rather fascinating. Beginning in the 1920s, an unknown disease was killing cattle throughout the U.S. and Canada. Desperate to find a solution, one farmer drove 200 miles to the University of Wisconsin with a dead cow, bales of spoiled hay and a milk can of unclotted blood in tow. He crossed paths with a scientist, whose team set out to determine the hemorrhagic component of the spoiled hay, resulting in a series of medical discoveries that would revolutionize medicine. After learning more about Warfarin and how Vitamin K could reverse its blood thinning properties, doctors first prescribed the drug for human use in 1954. It is perhaps most widely known for saving President Dwight D. Eisenhower after he suffered a heart attack in 1955. Today, Warfarin continues to saves millions of lives each year. “Before blood thinners like Warfarin, people would experience strokes, blood clots in their lungs, blood clots in their legs, blood clots in their hearts, along with countless other clotting disorders - these conditions likely cutting their lifespans short,” Dr. Rowan said during the podcast. “Warfarin revolutionized the treatment of patients who suffer from heart attacks and strokes, helping them to live normal and healthy lives. The drug changed medicine forever and helped make incredible innovations such as mechanical heart valves a reality.” Interview Opportunity Dr. Rowan is available for interviews to discuss the importance of this unique medical discovery and the positive impact it has on many of the patients he treats every day. Please email news@renown.org or call 775-691- 7308 to coordinate an interview. About Renown Health Renown Health is the region’s largest, locally owned and governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health. Renown’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Heath, Neurosciences and Robotic Surgery. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project® . For more information, visit renown.org. About Dramatic Health Dramatic Health, a national healthcare video company, is the producer of the six-part podcast series Game Changers in Medicine. The series premiered in July with an episode about Vitamin K and an enterprising Boston house doctor. The August episode showcased the creation of a smallpox vaccine and its parallels to today's urgent search for a COVID-19 vaccine. Game Changers in Medicine ranked #27 in Apple Podcasts: Life Sciences in the United States according to Chartable as of August 21, 2020. Both episodes, a series backgrounder, and additional material about the podcast series are available at www.gamechangersinmedicine.com and can be accessed wherever you listen to podcasts.
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Give the Gift of Health This Season with ELF Testing
Renown Health and the University of Nevada, Reno School of Medicine give the gift of early diagnosis and disease prevention this holiday season. With the season of giving upon us, give yourself the gift of health. The Renown Institute for Health Innovation (IHI) and the University of Nevada, Reno School of Medicine (UNR Med) are excited to offer a free Enhanced Liver Fibrosis (ELFTM) test to patients at risk for a common type of liver disease, e.g. metabolic and nonalcoholic steatohepatitis (M/NASH), and who enroll or are currently enrolled in the Healthy Nevada Project. The ELF Test is an FDA (Food and Drug Administration) approved non-invasive test to help identify people most at risk for liver scarring, e.g. cirrhosis, and allows doctors to intervene before irreversible damage occurs. If undetected and untreated, M/NASH can result in liver cirrhosis which could require liver transplantation or lead to death. This test is important as the symptoms of M/NASH can be silent or non-specific, making it difficult to diagnose. “There are currently more than 11,000 people across the U.S. on the national liver transplant waiting list, and with the heightened prevalence of NAFLD and M/NASH, this number is projected to keep rising; however, with research such as the ELF Test at our disposal, we are continuing to find ways to improve the health of those at risk for advanced liver disease,” said Bill Plauth, MD, Chief Medical Officer for Renown Health and Associate Dean of Clinical Affairs at UNR Med. “We encourage our community to participate in this early risk detection. Through this sophisticated, noninvasive, blood test, our physicians and Advanced Practice Providers can better evaluate liver fibrosis to help those affected and enable researchers to improve the prevention and treatment of nonalcoholic liver disease as a whole.” This liver health-focused sub-study of the Healthy Nevada Project seeks to enhance the understanding of both NAFLD and M/NASH and to help inform the development of treatment options for these conditions, as few currently exist. “Providing access to cutting-edge innovations such as the ELF Test is critical for both participants and the physicians and advanced practice providers that care for them.” said Joseph Grzymski, PhD, principal investigator of the Healthy Nevada Project and the Liver Disease Study and research professor at UNR Med. Those interested in determining their risk for M/NASH and its progression are encouraged to enroll in the Metabolic & Nonalcoholic Steatohepatitis study. Those who have consented and participated in the M/NASH research will be eligible and contacted with more information on how to receive the ELF Test. The Renown IHI is also happy to connect with physicians and Advanced Practice Providers interested in having their patients enroll in the Healthy Nevada Project and join the study. For members of the community who would like more information and learn how to enroll, please contact the Renown IHI at RenownIHI@renown.org or (775) 982-6914 to be connected to a Genomic Representative. About the ELF™ Test The ELF Test is a noninvasive blood test that can quickly identify which patients are at an elevated risk for developing cirrhosis and other liver-related clinical events (LREs). In contrast to standard liver enzyme tests that reflect liver damage that has already occurred, the ELF Test combines three serum direct biomarkers of active fibrosis. The ELF Test algorithm measures each of these biomarkers to create an ELF score, which can be used as an aid to assess the risk for future disease progression. Doctors may use this ELF score to help evaluate if a patient requires increased medical care and monitoring for their condition. Individuals interested in determining their risk for NASH and its progression are encouraged to enroll in the Nonalcoholic Steatohepatitis Liver Disease Genome Atlas study. Those who have already consented and participated in the study will be contacted with more information on how to receive an ELF blood test. For more information or to enroll, please contact RenownIHI@renown.org or (775) 982-6914. In the U.S., the ELF Testing Service is available from Brio Clinical, Inc., a CLIA-certified laboratory offering specialized testing throughout the United States. Brio Clinical is regulated under CLIA as qualified to perform high complexity testing.
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Renown Health & Cigna Reach Agreement
New contract provides Cigna members enrolled in employer-based HMO & PPO plans in-network access to Renown Medical Group and Renown hospitals Renown Health leaders have reached agreement on a new contract with Cigna that will go into effect starting today, Nov. 1, 2022. Leaders were able to work collaboratively towards a positive solution that will help further both team’s collective goals of providing expanded access to quality, affordable healthcare in northern Nevada. The agreement protects affordability and provides Cigna members with continued in-network access to all Renown hospitals and physicians. This agreement applies to Cigna consumers enrolled in employer-based HMO and PPO plans and provides continued in-network access to Renown affiliated care providers and facilities. Sy Johnson, interim President of Renown Health stated, “We appreciate the collaborative approach of both teams to reach resolution. As this community’s only not-for-profit healthcare organization, our mission is to make a genuine difference in the health and well-being of the community. As doctors, nurses and care givers, we are pleased to be able to continue to serve the healthcare needs of patients with Cigna health insurance without disruption.” Consumers with questions can contact Cigna by using the toll-free number on the back of their current Cigna identification card or by going to cigna.com/renown. In the most recent US News & World Report Best Hospital rankings, Renown Regional Medical Center was named as the number one hospital in Nevada. No other hospitals in the state met their stringent standards for the 2021 rankings. Renown is high performing, its highest rating possible, in eight procedures and conditions including heart failure, colon cancer surgery and chronic obstructive pulmonary disease, hip replacement and knee replacement. A hospital's score is based on multiple data categories, including patient outcomes, safety and volumes. Hospitals earning a high performing rating were significantly better than the national average. About Renown Health Renown Health is Nevada’s largest, locally governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 6,500 employees, Renown has fostered a longstanding culture of excellence, determination and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the locally owned not-for-profit insurance company, Hometown Health. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project®.