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Number of results found: 3582
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    • Pediatric Care
    • Vaccine

    What You Need to Know About RSV

    Respiratory syncytial virus, also known as RSV, is a common respiratory virus that impacts the lungs and breathing pathways. The virus can be dangerous for infants and young children and is also concerning for older adults. While most older kids and adults only experience cold-like systems and recover in a week or two, an estimated 58,000-80,000 children younger than 5 years old are hospitalized due to RSV each year, and in 2022 healthcare organizations across the country are experiencing higher infection rates than in years past.  "We are experiencing a strong RSV season and do not expect it to go away anytime soon," said Dr. Kris Wilson, Division Chief of Renown Children's Primary Care. "Infants who are infected with RSV almost always show symptoms of runny noses and cough. Call your healthcare provider immediately if your child is having difficulty breathing, is not drinking enough fluids, or is experiencing any worsening of these symptoms.” Symptoms of RSV: Runny nose  Decrease in appetite/inability to drink Dry diapers, an indication of dehydration  Cough, which may progress to wheezing or difficulty breathing Irritability (most common in very young infants) Decreased activity (most common in very young infants) Decreased appetite (most common in very young infants) Apnea, pauses in breathing for more than 10 seconds (most common in very young infants) What to do if you think your child has RSV: Call your pediatrician! If you suspect your child might have RSV, consulting their healthcare provider is the best first line of defense. From here they will help you build an appropriate treatment plan for child. Keep in mind that many pediatrician offices offer 24/7 call lines.  If your child is experiencing retracted breathing (when the area between the ribs and in the neck sinks in when a person attempts to inhale), dehydration (not drinking and decrease in wet diapers) or apnea (pauses in breathing for more than 10 seconds) please call 911 or go to the closest emergency room.

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    • Cancer Care
    • Screening
    • Women's Health

    How Regular Cervical Cancer Screenings Can Save Lives

    According to the American Cancer Society, approximately 13,820 new cases of invasive cervical cancer will be diagnosed, and 4,360 women will die from cervical cancer. However, cervical cancer is preventable with regular screening tests and the HPV vaccine. It’s important to note that medical advances have allowed progress in diagnosing and treating cervical cancer. While it used to be one of the most common causes of cancer death for American women, the incidence of death has significantly declined. What to Know About the HPV Vaccine HPV vaccination is the best way to prevent cervical cancer and is recommended for all youth starting as early as age 9, or for teens and adults up to age 45 who didn’t start or finish the series. In Nevada, only 50.1% of teens ages 13-17 have been vaccinated for HPV.  There are 13 types of HPV, and the vaccine Gardasil 9 protects against 9 of those HPV strains, greatly reducing the incidence of cervical cancer among vaccinated individuals. What to Know About Cervical Cancer Screenings The CDC says the most important thing you can do to help prevent cervical cancer is to have regular screening tests starting at age 21. And there are two common tests that can detect early stages of cervical cancer (or precancer) and improve health outcomes. The pap test (or pap smear). This screening looks for precancers. Women should begin getting pap smears when they’re 21. The human papillomavirus (HPV) test looks for the virus that can cause these cell changes. Cervical Cancer Screening Schedule The American Cancer Society offers the following guidelines for screenings: All women should begin cervical cancer screening at 21. Women between 21 and 29 should have a pap test every three years. Beginning at 30, the preferred way to screen is with a pap test combined with an HPV test every five years. This is called co-testing and should continue until age 65. A pap test (or pap smear) is performed during a regular screening appointment to look for precancers, cell changes on the cervix that might become cervical cancer if they are not evaluated or appropriately treated. Typically outpatient procedures can reduce the risk of long-term health impacts that prevent pre-cancerous cells from becoming cancer cells. Women over 65 who have had regular screenings in the previous ten years should stop cervical cancer screening as long as they haven’t had any severe precancers found in the last 20 years. How to Get Screened Request an appointment with your primary care physician or OBGYN to schedule a screening.

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    • Renown Health
    • Clinical Trial
    • Research and Studies

    Clinical Research: Advancing Healthcare in Northern Nevada One Study at a Time

    Did you know that the Renown Research Office has partnered with the University of Nevada, Reno School of Medicine Clinical Research Office to form the Integrated Clinical Research Office? This means we are able to provide more clinical research opportunities and expertise to our northern Nevada community than ever before. Over the past two years, we have significantly expanded our clinical trial offerings from 35 to 101 studies to meet the healthcare needs of our community members and keep care options local. Currently, we offer clinical research as a care opportunity in areas such as cardiology, pulmonology, endocrinology, oncology, pediatrics, neurology and immunizations. What is Clinical Research? Clinical research is simply medical research that involves human volunteers (participants). Research studies have to be reviewed and approved by ethics committees to ensure that the questions researchers want to answer are appropriate and that research participants are protected throughout the study. Often when we talk about clinical research, we are referring to a clinical trial. Clinical trials are a type of clinical research study that places research participants into groups to study the safety and effectiveness of new medications and devices on a specific health outcome. Clinical trials follow rigorous standards and must pass four phases of testing, where each phase works progressively to understand the correct dosing and effects in larger and more diverse groups of people. Why is Clinical Research Important? Did you know that all medications, diagnostic tests and medical devices prescribed and used today by physicians and health practitioners were once tested in clinical trials? Clinical research advances medical care by helping us understand how to prevent disease and to provide new and better treatments for a wide range of health conditions. At Renown Health, we know the importance of offering the latest opportunities in healthcare, especially when standard of care options have been exhausted. What Are Some Considerations for Participating in Clinical Research? Research volunteers are often drawn to participating in studies because they are interested in accessing the latest health care treatments and/or they want to contribute to scientific discovery. If you are interested in becoming a research volunteer, you should first make sure you fully understand what the study and researcher is asking you to do and consider whether you are comfortable with the study activities and commitments to time and travel such as for required study appointments. Remember, participating in a research study is completely voluntary. That means you choose whether to participate, and you can choose to stop participating in a research study at any time, for any reason. Where Can I Find More Information About Clinical Research? There are many resources you can access if you have questions or want to learn more about clinical research. Your healthcare provider can assist you in your healthcare journey by discussing care options and exploring if participating in a clinical trial may be right for you. The Nevada Division of Public and Behavioral Health recently launched their Clinical Trials Info for Nevadans webpage which provides information on finding clinical trials in Nevada, understanding the importance of diversity in clinical trials, and linked resources to learn more about clinical trials. The U.S. Department of Health and Human Services Office for Human Research Protections provides informational videos, questions to ask researchers prior to participating and information on regulations in place to protect research participants. Finally, at the Renown Research Office, we are always here to support your clinical research journey and can be reached at Renown-CRD@renown.org or 775-982-3646. At Renown Health, our goal is to make it easy for patients to access clinical research as a care opportunity where patients can access a variety of standard care treatment options for their health condition or choose to participate in a clinical trial. For more information about clinical trial opportunities available to you or to ask any questions, contact the Renown Research Office at Renown-CRD@renown.org or 775-982-3646.

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    • Allergy
    • Primary Care

    5 Ways to Manage Seasonal Allergies

    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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    • Hospice Care
    • Caregiver

    When Should You Consider Hospice? 5 Important Signs

    Deciding on hospice care for a loved one is a deeply personal and challenging decision, balancing their wishes and medical realities. Rebecca Edwards, DNP, from Renown Hospice Care, explains the signs indicating when it might be time for hospice and offers guidance on navigating this decision with compassion and clarity. Understanding Hospice Care  Before exploring the decision-making process, it’s crucial to have a clear understanding of what hospice means. Hospice care represents a shift in how we approach living with a terminal condition, emphasizing comfort, dignity, and quality of life above all else. When there is no longer a pathway to a cure, side effects of treatment outweigh the benefits, or someone is simply tired of frequent hospital visits, then it may be time for hospice. Hospice care is mainly done in the home, where most people wish to be. It's a compassionate, team approach to care that focuses on meeting the physical, emotional, and spiritual needs, supporting their families, and honoring individual preferences. 5 Critical Signs to Be Aware Of Decline in Overall Health: When a loved one's health continues to decline despite ongoing medical interventions, this may be a sign that these treatments are no longer effective.  Increasing Pain and Symptoms: When managing symptoms such as pain, nausea, fatigue or shortness of breath becomes increasingly challenging, hospice can offer specialized support and expertise in symptom management.  Frequent Hospitalizations: Repeated hospitalizations or emergency room visits can signify that the disease has progressed to a point where managing symptoms and providing comfort at home or in a hospice setting is a more appropriate approach.  Difficulty with Daily Activities: If your loved one is experiencing difficult with activity of daily living such as dressing, bathing, or mobility, it may be a sign that they require additional support and assistance. Prognosis of Six to 12 Months: Hospice Care is typically recommended for patients with a prognosis of about one year or less if the disease follows its normal course. However, it’s important to remember that every individual is unique and prognosis can vary.

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    • Recipes
    • Food and Nutrition

    Make Your Own Trail Mix: 4 Quick and Easy Recipes

    Craving a crunchy, sweet, and nutritious snack? Try making your own trail mix! Perfect blends of nuts, dried fruits, and a touch of chocolate can be whipped up using bulk bin ingredients or pantry staples. Enjoy this delicious, healthy snack on a hike, at the office, or on your next road trip through Nevada's scenic deserts.

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    • Bone Health
    • Orthopedics
    • Physical Therapy

    A Therapist's Tips to Prevent and Manage Osteoporosis

    Want to know more about osteoporosis and osteopenia? We'll dive into these conditions and give you some handy tips on preventing future problems and taking care of your bones. What is Osteopenia? Osteopenia (low bone density) is the initial stage of bone mineral density loss, which can eventually progress to osteoporosis if steps are not taken to prevent it. What is Osteoporosis? Osteoporosis is a condition that weakens our bones. While it literally means “porous bone," it doesn’t mean that our bones are doomed to succumb to the changes that can happen to us silently over time. Our bones are living tissues that are constantly breaking down and remodeling themselves.  Osteoporosis and osteopenia are typically diagnosed by testing bone mineral density using scans that your primary care provider can easily order. This is important testing because it dictates your risk of breaking a bone in common areas like your hip, wrist or spine. It also helps set the stage for talking with your healthcare team to develop a treatment plan. Most people will reach their peak bone mass in their mid to late twenties. There are several factors that increase our risk of osteoporosis or osteopenia as we age, such as menopause, genetics and other lifestyle factors. However, there are several things you can do to mitigate this breakdown and assist your body in the constant remodeling it does to our bones. 3 Controllable Factors to Build Strong Bones 1. Talk to your primary care provider They can go over a plan and prescribe things such as vitamin D, calcium and medications that can help if you are at risk or have osteoporosis or osteopenia. 2. Maintain a healthy diet Talk to a dietician if you need further help as they can be an invaluable resource to develop a plan.  Eat foods rich in calcium, vitamin D and vitamin C. These assist with the rebuilding of bone. Examples include but aren’t limited to leafy greens, legumes, salmon and healthy dairy products.  Don’t smoke — it directly correlates with a decrease in bone mass. Smokers also take longer to heal from a fracture.  Limit alcohol to two to three beverages per week. Alcohol interferes with the production of vitamins needed to absorb calcium and the hormones that help protect bones. 3. Exercise Talk to your primary care provider to get a referral to physical therapy if you need help with exercise.  Our bones adapt to the stresses we put them through. Therefore, exercise should be tailored to putting the right stress on our bones. There is good quality research that most exercise is safe when dealing with less bone mineral density.  The exercises should be progressively challenging and increase the load for resistance and weight training at least two to three days a week. Examples include squats, step-ups, chest presses and rows.  Exercises higher in velocity will lead to more power and bone adaptation. Examples include quicker push-ups, marching and quicker walks.  Exercises that are weight-bearing will lead bones to adapt to the stress placed on them. Movements such as mini stomps, step-ups, jumping, jogging and so forth may be used depending on how your body tolerates these things to really stimulate bone adaptation. There are aspects of aging and bone health we can’t control, but we can take steps to minimize the chances of bone loss and osteoporosis. Talk to your healthcare team to determine your risk and don’t forget to show your bones a little TLC – you’re going to need them.

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    • Pulmonary and Sleep Medicine
    • Primary Care
    • Expert Advice

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

    © Africa Images via Canva.com 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.

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    • Sterling Silver Club
    • Healthy Aging
    • Senior Care

    Sterling Silver Club Shining Stars: Mark & Dana Combs

    Dana and Mark Combs met through mutual friends and had a long friendship before they became a couple in 2009. They were married in 2011 in a private ceremony at a small Reno chapel, and a few months later had a big celebration with their family and friends.   Encouraging Others to Succeed  Over the years, the happy couple has spent much of their time volunteering and giving back to others in their community. Twenty-six years ago, Mark became a bilateral lower limb amputee. For the past 10 years, he has been a prosthetic consultant, helping other amputees learn how to cope with various challenges and encouraging them to keep living life to the fullest. “Mark is great with helping people,” said Dana.   Dana also does a lot of rewarding work through a Philanthropic Educational Organization (P.E.O). She is an advocate for raising money to help women ages 18 and up gain an education. Dana also enjoys tutoring English as a second language.   Enjoying Quality Time, Hobbies & Travel When Dana and Mark aren’t helping others, they are spending time with their family and friends, their dog Mia (a 3-year-old Maltipoo) or enjoying one of their many hobbies. Some of Mark’s favorite things to do include playing Solitaire and strumming on his guitar.  “I love to garden and play crossword puzzles and word games,” said Dana. “I’m really looking forward to the springtime to spend more time in the garden.” She loves to work out and has a membership at the UFC gym in Reno through her Senior Care Plus gym benefit. Dana also has her own online Etsy store, where she sells homemade jam jars, candle holders and vintage dolls. “Last summer I sold my first edition Barbie that I got when I was 9 years old,” said Dana. “I made quite a profit on it.”

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    • Cancer Care
    • Physical Rehabilitation
    • Physical Therapy

    Life after Lymphedema Diagnosis: What to Expect

    Managing lymphedema effectively is essential for enhancing the quality of life for individuals affected by this condition. Katherine Bunker, a Physical Therapist and Certified Lymphedema Therapist (PT, DPT, CLT) at Renown, has expertise in this area and her insights offer valuable strategies for managing lymphedema.  Lymphedema is a chronic condition characterized by swelling in one or more limbs due to a blockage in the lymphatic system. This condition can result from cancer treatments, surgery, infection, or can sometimes be congenital. While it can be challenging to live with lymphedema, understanding the condition and adopting specific lifestyle changes and strategies can significantly improve the quality of life.   Understanding Lymphedema Educating yourself about lymphedema is crucial. Understanding the causes, symptoms, and potential complications can provide you with the tools to manage the condition proactively. Lymphedema can lead to discomfort, decreased mobility, and in severe cases, infections such as cellulitis. Therefore, recognizing the early signs and knowing when to seek medical advice is essential.   Medical Management  Consulting with healthcare professionals who specialize in lymphedema is critical. A physiotherapist or occupational therapist trained in lymphedema management can tailor a treatment plan for you that can include the following: Compression Therapy - Wearing prescribed compression garments can help move the lymph fluid and reduce swelling. It’s essential to get fitted by a professional and understand how to use these garments correctly.   Manual Lymphatic Drainage (MLD) a gentle massage technique that encourages the movement of lymph fluid out of the affected limb. It’s typically performed by a trained therapist but ask about self-massage techniques you can do at home.

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    • Pediatric Care

    Childproof Your Windows - 8 Tips to Avoid Falls and Ensure Safety

    Enjoying the fresh air through an open window is one of the many ways to enjoy the weather. However, open windows can pose safety risks, including injury or fatalities for young children aged two to five. We spoke with Jorge Montano-Figueroa, Pediatric Injury Prevention Specialist at Renown Children’s Hospital to understand how window falls can be prevented through safety devices and practicing careful habits. Use these tips to keep your children safe from window falls.  Supervise Young Children: Always keep an eye on young children, especially when they are near windows. Supervision is the first line of defense against accidents.   Keep Windows Closed and Locked: When possible, keep windows shut and secure. Locked windows prevent children from opening them and potentially falling out. Open Windows from the Top: If your windows allow, open them from the top down rather than the bottom up. This reduces the chance of children reaching the opening. Ensure that the opening is limited to four inches or less to prevent accidental falls. Install Child Safety Devices: For windows six feet or more above the ground, child safety devices such as window stops or guards are a must. These devices are readily available at hardware stores and for purchase online. They are designed to be easy for an adult to release in an emergency but secure enough to prevent a child from opening the window too wide. • Window Stops: These devices prevent windows from opening more than four inches, significantly reducing the risk of falls. • Window Guards: For windows that need to open more than four inches, window guards provide a barrier to prevent falls while allowing ventilation. Keep Climbing Hazards Away: Move furniture and other items that children could use to climb away from windows. Items such as chairs, beds, and couches can be stepping-stones for curious children. Establish a Safety Zone: Make it a household rule that children should play at least two feet away from windows. This safety zone helps keep them keep potential hazards out of reach. Childproof When Visiting: When visiting homes that may not be childproof, take extra precautions. Close and lock windows during your visit and watch your child closely to ensure they stay safe. Remember: Window Screens Are Not Safety Devices: Window screens are designed to keep bugs out, not children in. Screens can easily pop out if a child leans or pushes against them, leading to falls. Always use proper child safety devices instead of relying on window screens.  By taking these precautions, you can significantly reduce the risk of window falls and keep your children safe. A few simple steps and some vigilance can make a big difference in preventing these potentially tragic accidents.  For more information and to learn more, visit Pediatric Injury Prevention.

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    • Pediatric Care
    • Kid's Health

    Think Outside the Box: Healthy, Creative School Lunch Hacks

    Today's school lunch is an opportunity to create a healthy, colorful midday meal, far from the days of soggy PB&Js. Here are simple tips, a week of lunch ideas, and a shopping list to help you pack a lunch your child won't want to trade. Packing lunches ensures your child gets a well-balanced meal, and making it a team effort by having kids help can save time by packing the night before. Nutritious Ideas Main dishes Lunch meat and low-fat cheese roll ups English muffin pizzas Sandwich wraps – meat, cheese and veggies in a whole grain tortilla Pita pockets stuffed with grilled chicken and vegetables Soup Chef salad with spinach, veggies, cheese, lunch meat and dressing Tuna or chicken salad on a mini bagel Snacks and sides Fresh or dried fruit Natural apple sauce Baked tortilla chips and salsa Veggie sticks and hummus Cheese slices or string cheese with whole grain crackers Homemade trail mix with nuts, seeds and raisins Pudding Homemade fruit roll ups Popcorn (add different toppings such as salt, garlic, cinnamon, sugar or cayenne pepper) Drinks Water If you child doesn’t like plain water, try adding a few slices of fresh fruit (strawberries, lime, lemon) for more flavor. School Lunch Menu: Day-By-Day We’ve put together a week’s worth of colorful, fun and healthy school lunch ideas your kids will love. And we’ve also created a shopping list to help you easily locate all the ingredients on your weekend shopping trip. Monday: Turkey BLTA Roll-ups Roll-up Ingredients Turkey, cold cuts Bacon Avocado Tomatoes Side Dish Choices Blueberries Cucumbers Carrot sticks Tuesday: Bacon & Cucumber Sandwich Sandwich Ingredients Whole wheat English muffin Cucumber Bacon Side Dish Choices Apples slices Strawberries Vanilla yogurt mixed with sprinkled cinnamon Wednesday: DIY Lunchables  Lunchables Ingredients Crackers Turkey, cold cuts Cheese Side Dish Choices Blueberries Carrots Cucumber Thursday: Veggie Grilled Cheese Veggie Grilled Cheese Ingredients English muffin Cheese Tomato Spinach leaves Avocado Side Dish Choices Apples slices Strawberries Vanilla yogurt mixed with sprinkled cinnamon Tomatoes Friday: DIY Pizzas DIY Pizza Ingredients 2 toasted English muffins Pizza sauce Cheese Turkey pepperoni Side Dish Choices Celery Black olives Shopping List (under 20 items) Cold section: Dairy 1 large container of vanilla yogurt 1 package of your favorite cheese  Cold section: Deli meats 1 package of turkey pepperoni 1 package bacon 1 package turkey cold cuts Inside aisles Whole wheat English muffins 1 can of whole black olives 1 jar of pizza sauce 1 box of whole wheat or multigrain crackers  Produce department 1 cucumber 1 stalk of celery 2 apples 1 container of strawberries 1 avocado 2 tomatoes 1 bunch of spinach leaves 1 container of blueberries 2 carrots

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Number of results found: 3582
Use this additional navigation to go to the next pages. Use tab and enter keyboard keys to navigate the menu Navigate to previous page Page # 265 Page # 266 Page # 267 268 Page # 269 Page # 270 Page # 271 Navigate to next page Page 268 of 299
Skipped to 3582 results found. Page 268 of 299