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How Do I Prepare for Surgery?
Renown’s team of nurses and respiratory therapists discuss what you need to know before undergoing surgery, including fasting guidelines and how to improve recovery. There are several things to know before you undergo surgery, including steps to prepare at home in advance of your procedure. Fasting Guidelines: No solid foods eight hours prior to surgery You may have clear liquids three hours before your surgery. Clear liquids include water, apple juice and lemon or lime-flavored soda water (not cola). In addition, do not chew or smoke tobacco (regular or e-cigarettes) after midnight the night before your surgery, unless instructed by your doctor or anesthesiologist.
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Understanding and Managing Childhood Asthma
Dr. Shipra Singh, a Pediatric Pulmonologist, outlines the challenges of diagnosing asthma in children due to symptoms resembling other respiratory issues. It's particularly difficult to identify in infants and young children, who may not clearly exhibit breathing difficulties. Asthma, often confused with bronchitis, croup, or allergies, is a significant chronic illness causing school absenteeism, as per the CDC. Risk factors include prenatal smoking and family history of allergies or asthma. Infants and toddlers are more susceptible due to smaller airways and respiratory viruses, which can exacerbate conditions like colds and bronchitis. 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. Dr. Singh explains, "Discussing asthma with your child may be difficult. Some kids find the subject frightening or confusing. Others, especially the older kids, may resent the treatment and may not be interested in doing it. Talk to your doctor about advice to build an open and trusting relationship regarding your child's asthma care."
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Ovarian Cancer Survivor Shares Decision to Try Clinical Trial
While there used to be three basic treatment options for cancer -- surgery, radiation and chemotherapy, or a combination of the three -- there's a fourth option: clinical trials. Here, a Renown patient shares her successful battle with ovarian cancer, aided by a clinical trial. Shari Flamm's battle with ovarian cancer began in 2011. She was experiencing prolonged bleeding, irregular thyroid levels and anemia and was scheduled to undergo a hysterectomy. Before the surgery, her gynecologist ran routine tests to check for cancer as a precautionary measure. All tests were negative for cancer, expect her CA 125 test. A CA 125 test measures the amount of the protein CA 125 (cancer antigen 125) in the blood. In some cases, a CA 125 test may be used to look for early signs of ovarian cancer in women with a very high risk of the disease. In most laboratories, the normal level is 0 to 35 units/ml. Flamm's CA 125 level was 121. As Flamm can attest, early diagnosis played a key role in her battle with ovarian cancer. September is Gynecologic Cancer and Ovarian Cancer Awareness Month – an important time to learn the signs, symptoms and risk factors of this type of cancer so your doctor can diagnosis the disease as early as possible. Ovarian Cancer: Round One Despite the elevated CA 125 results, her doctor recommended they move forward with the hysterectomy. But when surgery began, doctors discovered a mass. She had stage 4 cancer. The procedure was halted, the mass was biopsied and she was immediately seen by Dr. Peter Lim of the The Center of Hope. Following diagnosis, Flamm underwent surgery with Dr. Lim to remove the cancer, which had spread to part of diaphragm, spleen, colon and other organs. Three months after surgery, Flamm had recovered enough to start six rounds of chemotherapy in her hometown of Carson City. She continued working at a doctor's office during her treatment, and was grateful for Dr. Lim’s ability to co-manage her care so she could stay close to work and family. “To me, chemo was the scariest part because I didn’t like feeling sick,” Flamm says. Thankfully, her body responded well to the treatments and she was back to the things she loved. “I stated working out at the gym, even if it was only for 10 minutes,” she says. She also stayed positive by spending time with her grandchildren, attending a San Jose Sharks hockey game, going for walks and enjoying concerts. Ovarian Cancer: Round Two In November 2014, Flamm had a cancer check-up. That’s when doctors discovered three cancerous tumors. For this round, Flamm choose another treatment option -- clinical trials at Renown Institute for Cancer. Clinical trials are the studies that test whether drugs work, and inform doctors' decisions about how to treat their patients. Flamm participated in a clinical trial that featured oral-targeted therapy stronger than IV chemotherapy. The hope was for the drug to shrink her tumors, however the result was stabilization -- meaning the lumps weren’t growing or spreading. The best part of the clinical trial, Flamm says, was the constant monitoring. Between the CT scans every six weeks, a heart scan every three months and monthly doctor visits, she was confident that if the cancer started growing or spreading, her healthcare team would catch it right away. For Flamm, the benefits of the clinical trial included less hair loss, less fatigue and more time to focus on what’s important in her life -- her family. “I decided I wasn’t going to be that sick grandma on the couch with cancer,” Flamm says. After taking the oral medication for one year, Flamm developed a rash and discontinued treatment due to discomfort. Clinical Trials, Setbacks and Survival In June 2016, two of the three tumors began to grow and had to be surgically removed. Despite the setback, Flamm was determined to maintain a positive outlook. "You have to stay positive because cancer feeds off anger, depression and stress," Flamm says. Flamm was released to go home with clear margins, meaning the tumors were removed and are surrounded by a rim of normal tissue that does not have cancerous cells. Flamm says her outlook on life has changed drastically since her first cancer diagnosis. “Your whole mentality changes when cancer disturbs your life," Flann says. "The things that weren’t important, are now ever so important. I’m a lot calmer now,” Flamm says.
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Use Caution: Mixing Over-the-Counter Medications Can Be Harmful
When you’re too sick to go to work but not sick enough for a doctor’s visit, over-the-counter medicines are a welcome relief to help alleviate that fever, runny nose or allergies. But because those medicines aren’t signed off on or managed by your doctor and pharmacist, you must be especially mindful of what you put into your body. Whenever you pop a pill, you want to ensure you’re taking the correct dosage, waiting the right amount of time before taking another dose and not mixing certain medicines. Too Much Tylenol/Acetaminophen Tylenol — or acetaminophen — is a popular pain reliever for many, but too much can be bad for your liver. “Our bodies have a finite ability to metabolize Tylenol,” says Andy Wright, clinical pharmacist at Renown Rehabilitation Hospital. “When too much builds up in the liver, it becomes toxic. In patients with medical conditions like cirrhosis of the liver or hepatitis, this could be disastrous.” Remember, acetaminophen is in more than just Tylenol and generic pain relievers. You may also see acetaminophen in flu, cold and cough medicines, like Nyquil, and some prescription medications including Norco and Percocet. Keep a list of the medications you take, and limit daily acetaminophen use to 3,000 mg per day. When you’re scanning medicine bottle contents, remember acetaminophen is also referred to as APAP, AC, acetam or paracetamol. Mixing Painkillers When you’re dealing with pain and not getting any relief, taking a different medication may seem like the easy solution. Maybe you take some Aleve — a form of naproxen — for a headache, but it isn’t working, so you switch to Motrin, an over-the-counter form of ibuprofen. Not a smart idea. Ibuprofen and naproxen along with aspirin are known as nonsteroidal anti-inflammatory drugs (NSAIDS). Because these medicines work in similar ways, they should never be combined or used in larger doses or more frequently than directed. Otherwise your risk of side effects can increase, which range from mild nausea to severe gastrointestinal bleeding. It’s also important to consider your family history when taking NSAIDs because, “recent studies have shown NSAIDs may have greater cardiovascular risks for people taking blood thinners or those with hypertension,” explains Andy. “A good example is ibuprofen: It has a relatively low gastrointestinal bleed risk while it has a moderate to high cardiovascular risk. The opposite is true for naproxen.” Rather than experimenting with multiple medicines, figure out which drug works best for you. You may find muscle soreness improves with aspirin, whereas when a headache hits, naproxen is best. Keep in mind that these medications aren’t always best for everyone in the family. “Aspirin in children and teens is not recommended unless under the supervision of a doctor,” Andy says. And pregnant and lactating women should generally avoid NSAIDS due to risk of birth defects and bleeding. “In both of these cases, acetaminophen or Tylenol are preferred but only if approved by an OB/GYN.” Fighting Allergies Over-the-counter antihistamines like Claritin, Zyrtec and Allegra have made fighting itchy eyes and runny noses a little easier. But these daily medicines — when taken inappropriately or in the wrong combinations — can also have an adverse effect. Similar to acetaminophen, you need to watch for antihistamines in other products. Sleep aids — like Tylenol PM and Unisom — commonly use an antihistamine known as diphenhydramine, which may increase your risk of overdose. “Combining antihistamines, or overdosing, can cause many adverse effects including dry mouth, blurred vision — even arrhythmias,” Andy says. “Only take these medications on their own.” If you’re still struggling with symptoms, you can talk to your doctor about adding an over-the-counter nasal steroid. Andy confirms the importance of closely following the directions listed on antihistamine (and all medicine) bottles. He has seen extended release nasal decongestants cause significant arrhythmias requiring medical care after a patient took the medicine with warm fluids. “The decongestant in question is designed to slowly release, but it can dissolve suddenly in the presence of warm liquids like coffee,” Andy explains. “This can cause the pill to deliver 12 to 24 hours of medication all at once.” Taking an Antidiarrheal with Calcium Calcium supplements and antidiarrheal medicines are another harmful combination. Calcium firms up your stool, but if taken with an antidiarrheal, can cause severe constipation. If you need to take an antidiarrheal, take a break from your calcium for a few days until you’re back to normal. Another consideration when taking calcium supplements or calcium-based antacids is gas. “I’ve had several patients report cases of excessive gas using Tums or calcium carbonate-based supplements.” Andy suggests instead “trying Maalox or Mylanta for indigestion and Citracal as a supplement.” Talk with Your Doctor or Pharmacist About Your Medications If over-the-counter drugs aren’t providing the relief you need, it’s time to see your doctor. And remember, for your safety it is important to keep your doctor and pharmacist up-to-date with any medications — prescribed or over-the-counter — that you are taking.
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Now It's Fast and Easy to Schedule a Primary Care or Pediatric Appointment Online with Renown Medical Group
You can now schedule a new patient appointment 24/7 from your computer or cell phone, with no need to call. You get home from work, look at the note on the refrigerator and remember for the third day in a row, you failed to make an appointment with a new primary care doctor or schedule that pediatrician visit for your toddler. You tried to do it on your lunch hour but got distracted with other things. Frustrating! Now, one health system is making it easy for people to schedule their primary care and pediatrics doctor appointments online, and 24 hours a day, 7 days a week. Over 3,000 new appointments are available with Renown Children’s pediatricians. “I booked an appointment that way and I thought it worked great,” said Daryl Hendery, a returning patient who just scheduled his annual check- up with his Renown physician. “It was very easy to use. I just clicked on my doctor’s name and booked an appointment for next week. I was kind of surprised at how easy it was to schedule.” Hendery says he’ll book online again, instead of calling. Many people like Daryl love the ability to set an appointment without ever needing to speak to an actual person. Patients Encouraged to Use Online Scheduling With Renown’s new online scheduling feature, you can now book your primary care and pediatric primary care appointments with Renown Medical Group without making a phone call to the office. Our dedicated team of primary care physicians and pediatricians offer a full range of services—including annual checkups, complete physicals, immunizations, lab work, and referrals to specialists—at multiple locations across northern Nevada. “One of the biggest advantages is that you can set an appointment when and where it’s convenient for you to do so,” said Sierra Kelly-Martinez, MPH, director of the Customer Engagement Center at Renown. “You can schedule that appointment whenever you want, at 9 o’clock at night, while waiting in line at the grocery store or during after school pick up, or whenever you think of doing it.” “It’s really quite easy and empowering to have control of your own scheduling,” she adds. “Anyone wanting a new Renown primary care physician or provider, or a Renown Children’s pediatrician, can schedule through the www.renown.org website. If you’re a new patient or don’t have your MyChart profile set up, visit www.renown.org and click on the ONLINE APPOINTMENTS button or the Find A Doctor tab. Under the New Primary Care or New Pediatric Patients tab, click on “Book Your Appointment.” Select your insurance provider, click the Location you’re looking for- Or “Any Location.” You can then choose the time and provider and schedule your appointment. Renown accepts most insurances including Hometown Health, Senior Care Plus, Anthem Blue Cross, Cigna, United, Medicare, and Medicaid. If you’re a Returning Patient, you can schedule a primary care or pediatrics appointment by clicking on Book Your Appointment through the www.renown.org website which will automatically take you to your MyChart account. You will be asked a few questions about your visit to ensure To schedule an appointment using MyChart, you can: 1. Log in to your MyChart account 2. Select “Schedule an Appointment” from the main menu or “Visits” from the top menu 3. Select a provider or reason for your visit 4. Answer decision questions on visit 5. Select a date and time from the available options 6. Enter the reason for your visit 7. Verify the appointment information and click Schedule You can also schedule an appointment by selecting the name icon in the top right corner, selecting the name of the child you're scheduling for, and then selecting “Schedule an Appointment.” If you don't see a date and time that works for you, you can click the Search for additional available appointments link to view available appointments at all locations. MyChart MyChart is a convenient, online portal where patients can communicate with their doctors, view your medications, request prescription refills, access test results, message your doctor, pay your bill, and now schedule appointments online. Benefits of Online Appointment Scheduling Though the new online, scheduling tool is new, it’s easy to use and not much different than making an online reservation at a restaurant. Benefits include: · 24/7 Access: Patients can book appointments at any time, from anywhere. · Real-Time Availability: View real-time appointment slots and select a time that fits your schedule. · Appointment Management: Patients can easily cancel or reschedule appointments with just a few clicks. · Appointment Reminders: Receive automated reminders via email or text to avoid missed appointments. Renown is committed to enhancing patient care and improving the healthcare experience. With the launch of the online scheduling option, patients have more control and flexibility over their healthcare journey. “We are always looking for ways to improve the patient experience and make access to our physicians and advanced practice providers easier and faster” said Rahul Mediwala, MD, MBA, CEO of Renown Medical Group. “Our new online scheduling tool is just one of the many ways we’re working to make healthcare more convenient for our patients. Over the next year, we will be increasing the number of Renown physicians and medical providers who have online appointment availability, as we look to improve the health of our community.” For more information or to schedule an appointment, visit www.renown.org. Renown Health is the region’s largest, locally governed, not-for-profit integrated health care network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 7,500 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. For more information, visit renown.org.
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Pediatric Care
It's both a joy and an incredible responsibility to care for your child. Our pediatric care specialists look forward to working with you as a team to provide the highest level of pediatric health care from birth — and beyond. Our family-centered care approach gives you an active role alongside our specialists to deliver the best possible care and outcome for your child.
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Breast Health
The William N. Pennington Cancer Institute at Renown is a dedicated hub for breast health. We strive to empower individuals with knowledge, support and leading-edge resources to navigate the journey towards breast wellness. Whether you seek preventative measures, early detection strategies or comprehensive treatment options, our expert team is committed to guiding you every step of the way.