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Virtual visits are basically secure, video conferencing visits with your health provider. Of course if you are sick, you want to avoid going outside of your house. With Renown Health’s virtual visit program, you can now see a provider from the comfort of your own home. As we work to keep all of our patients home and healthy, we’re here for any ongoing healthcare needs you have. There are two easy ways to access a virtual visit with Renown Health. If you need an urgent care visit, you can get in line using your MyChart account You can make a virtual visit with some Renown Health providers you see currently Virtual Urgent Care from a Renown Provider By using MyChart, you can now login and request to “Talk to a Doctor.” After filling in some information and confirming your healthcare concern, you will be put into a virtual line. The healthcare team will notify you by text or email when a provider is ready to talk to you virtually. Virtual urgent care visits are available for all ages. Get To Know MyChart Virtual urgent care visits are available for all ages, and can address: Common cold and cough symptoms Muscular, tendon or joint pains not caused by injury Allergy or sinus symptoms Pink eye Urinary discomfort Diarrhea without vomiting Rashes or skin sores Backache Nail problems Screening examination for sexually transmitted illness (without symptoms) Medication refills (not controlled substances) Symptoms for In-Person Urgent Care Visits Shortness of breath Chest pain Abdominal pain Numbness or weakness of any location that is new Traumatic injuries (including eye injuries or something in the eye) Severe pain of any other body location Dizziness or confusion Bleeding from any location High fever (greater than 102 degrees for all ages) Persistent vomiting Loss of vision Ear pain Substance abuse or psychiatric problems Virtual visits are open 9 a.m. through 6 p.m. Monday-Friday and 10 a.m. to 4 p.m. Saturday and Sunday for Nevada residents. Renown Provider Virtual Visits Many primary and specialty care appointments for adults and children are now available virtually. If you have a provider with Renown Medical Group, call 775-982-5000 to see if you can have a virtual appointment from the comfort of your home. MyChart Assistance If you need assistance with your MyChart account, please call 775-982-6686. For all other questions about scheduling and appointments, please call 775-982-5000.

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If CPR (cardiopulmonary resuscitation) is performed in the first few minutes of cardiac arrest, a person’s chance of survival can double or even triple. Troy Wiedenbeck, MD, cardiologist with the Renown Institute for Heart & Vascular Health, explains how you can be ready to perform it in case of an emergency. According to the American Heart Association, over 350,000 out-of-hospital cardiac arrests occur in the U.S. This highlights the importance of CPR to everyone, not just medical personnel. Most people do not have heart trouble at a hospital or fire station, they have it going about their everyday lives. And when someone has a heart attack outside of a hospital, their survival often depends on receiving help from a bystander. Signs of Heart Trouble First, how do you know when someone is experiencing cardiac arrest? The signs and symptoms of cardiac arrest are immediate and drastic, including: Sudden collapse No pulse Not breathing Loss of consciousness And sometimes, patients can experience symptoms beforehand, such as fatigue, fainting, blackouts, dizziness, chest pain, shortness of breath or vomiting. CPR Change Many of us know CPR as both mouth-to-mouth and pumps to the chest, but the rule now is hands-only. Can you explain the change? Hands-only CPR is exactly what the name says -- it's CPR without mouth-to-mouth. The American Heart Association recommends using only your hands. So if you see someone suddenly collapse, it’s recommended to call 9-1-1 and push hard and fast in the center of their chest. Doing this will get blood flowing back to the brain, lungs and other organs for someone having heart problems. Performing CPR on Adults vs. Children Hands-only CPR is just as effective as mouth-to-mouth and chest compressions for teens and adults who may have gone into cardiac arrest. Remember, it’s important to act fast. First, call 9-1-1 and then start chest compressions right away. If you perform CPR on someone within the first few minutes, it can double or triple their chance of survival. Keep in mind, for infants and children younger than 12 years old, regular CPR with mouth-to-mouth, as well as chest compressions, is still recommended. Two Steps to Save a Life If you see a teen or adult suddenly collapse follow these two steps: Call 911 so care providers can begin to respond. When calling 911, be specific about your location, especially if you are calling from a cell phone. Knowing the street address, building, floor and closest entry point can save precious time for first responders. Answering the dispatcher’s questions will make sure help arrives fast, and at the correct location. Push hard and fast in the center of the chest. The goal during CPR is 100 to 120 compressions per minute, about the same tempo as the song “Stayin’ Alive,” or “Thriller.”  For hand placement, it’s also important to put the heel of your hand on the center of their chest and place the other hand on top. Push down on their chest at least two inches. It may seem severe at the time, but pushing this hard can truly save a life. Continue performing compressions as long as possible. If you tire, have someone take over compressions, if possible, and take turns until medical help arrives. For information on a CPR course in Reno, please contact REMSA at 775-858-5700.

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A clubfoot is where the foot is turned in on itself and points toward the ground. A clubfoot diagnosis during pregnancy is surprising and challenging during any circumstance. And in the case of parents anticipating surgery during a pandemic, options can be scarce. These parents took a deep breath, and with the help of Michael J. Elliott, MD, pediatric surgeon with Renown Children’s Hospital, their baby is on the road to recovery.

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If you’ve been putting off care for your child, know that Renown Health is prepared with updated processes and procedures to ensure safety for you and your little ones.   Doctor Max Coppes, MD, PhD, MBA, Physician-in-Chief of Renown Children’s Hospital, is concerned there could be an outbreak of serious illnesses if parents continue to delay getting their children immunized. Dr. Coppes and team understand your anxieties when it comes to visiting your pediatrician, and would like you to know; not only are well visits important to assess your child’s overall health, crucial vaccinations are administered to guard your little ones against disease. Immunizations Immunizations protect children from communicable diseases. Other benefits include: Children that are unable to have vaccines due to age or illness are protected through herd immunity Vaccinations are at given at specific intervals, and missing an appointment may put your child behind schedule Elderly populations are protected where immunity may be decreased Dr. Coppes states, “What we have noticed nationwide, and also in Washoe County, is that the number of kids immunized has gone down by about two-thirds. If that goes on, we’re just waiting for chickenpox, measles, any of those childhood diseases that were eradicated to come up again.” 4 Easy Ways to Schedule an Appointment: Call Us: 775-982-KIDS (5437) Request Appointment Online MyChart Virtual Visits In-Person Wellness Visits/Checkups Maintaining your child’s health is important! Contact your pediatrician to schedule an in-office visit. When you call to make an appointment, you’ll talk to a specialist at our Customer Care Center who will screen you to make sure you and your child have not been exposed to someone with COVID-19, and ensure symptoms of a respiratory illness are not present. Virtual Visits When appropriate, many pediatric appointments are available through virtual visits. Please call 775-982-KIDS (5437) to request a visit with your child’s established provider. All virtual visits require a MyChart account. Don’t have a MyChart account? You can easily sign up online. If you need assistance with your MyChart account, please call 775-982-6686. Virtual visits are able to connect to an ASL interpreter (sign language interpreter), and 37 languages including Spanish.

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In this article reprinted with permission from the Galena Times,  Dr. Max J Coppes, Physician-in-Chief, Renown Children’s Hospital, and Nell J. Redfield, Chair of Pediatrics, UNR Med, talk about adolescents vaping, and how an estimated additional 10 million teens are at risk to start using e-cigarettes. What are E-cigarettes? E-cigarettes are battery-operated devices heating a liquid (e-juice) into an aerosol to be inhaled. Breathing in this flavor vapor, which usually contains nicotine, anti-freeze or other cancer-causing chemicals is called ‘vaping.’  There are many forms of these electronic nicotine delivery devices - and they're not always obvious. They not only appear to be cigarettes, cigars, or pipes, but also pass for everyday items, such as flashlights, flash drives or pens.   The Effects of Vaping and E-cigarettes Regardless of the nicotine delivery, vaping is addictive and is quickly becoming a public health concern. Nicotine levels in e-cigarettes vary greatly, and they may also contain toxic chemicals. Currently there is a wide range of variability among vaping products. In other words - they deliver different ingredients, hardware, levels of nicotine, and possible toxic chemicals to the user. This makes it challenging to create an overall public health recommendation on their use. Nevertheless, there is no confusion about the harmful effects of the chemicals used in e-cigarettes to the young brain, which develops until age 25. Studies show e-cigarette use serves as an introductory product for teens to go on using ‘regular’ tobacco products. The American Academy of Pediatrics has several recommendations on their use. Such as increasing the minimum age to buy tobacco products, including e-cigarettes, to age 21 nationwide. (Update: nationwide the age as of January 2, 2020 is now 21.) A common misunderstanding with teenagers is the belief e-cigarettes are less harmful than other tobacco products. Moreover, there is a wide range of flavor choices, from mint, mango, crème brûlée to cucumber to attract users. As of September 6, 2019, The Centers for Disease Control and Prevention is reporting over 450 possible cases of lung illness associated with the use of e-cigarette products in 33 states.    What Should Parents Know about Vaping? Parents and teachers should know JUUL is a very popular e-cigarette among teenagers, capturing about 68% of the market. JUUL is sleek, small, hides easily, and resembles a flash drive. Surprisingly it charges in an USB port, and can also instantly be mistaken for a real flash drive. One JUUL cartridge contains twice the nicotine found in other e-cigarette cartridges. This roughly equals the amount of nicotine in an entire pack of cigarettes. To repeat, the use of JUUL in young people continues to grow, and this is why parents and teachers need to be aware. Be alert, teach, communicate, and talk to your child about the serious risks of smoking in all forms, whether at home or parties. Tell them how difficult it is to quit and why they should not start. Loving your children is caring; caring for their current and future health and well-being.

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Need fresh hiking trails? These hiking trails offer new views, a different route or the motivation you need to get outside. Of course, whatever you’re looking for this summer, these trails were made for sunshine in Reno-Tahoe. Easy Hiking Trails Oxbow Nature Study Area Nature Trail Location: 3100 Dickerson Road, at the Truckee River. Parking: There is a parking lot onsite. Time Out and Back: 30 minutes Items to Bring: Water, sunscreen and a hat. Although this loop is just under one mile, it’s the perfect escape in the heart of Reno. And this riverside trail is accessible for all skill levels. Bird watcher? Certainly, keep an eye out for black-crowned night herons, red-shouldered hawks, mule deer, beavers and more wildlife in the area. Tahoe-Pyramid Bikeway – Sections 2 to 4 Location: West Reno to Sparks Parking: Woodland Drive, Crissie Caughlin Park, Idlewild Park, 1st Street, Rock Park and Spice Island Drive. Time Out and Back: 2-4 hours (each section, out and back) Items to Bring: Water, sunscreen and a hat. From west Reno to Sparks, this paved portion of the trail stretches more than 8 miles. And it is easy to find as it runs along the Truckee River. As one of the easiest hiking trails in the region, it includes numerous parking access points and you can walk as long or short as you desire. In particular, one great route is from Rock Park on S. Rock Boulevard to Cottonwood Park on Spice Island Drive in Sparks. It’s an easy walk for all hiking levels. Notably many evening hikers explore this area to view the bats living under the McCarran Bridge. Additionally, an array of birds and river views can also be found along this enjoyable path. For maps for sections of this path, visit Tahoe-Pyramid Bikeway’s website. Cave Rock Hiking Trail Location: South Lake Tahoe; turn right on Cave Rock Drive from Highway 50, just prior to the tunnel. Parking: Park on Cave Rock Drive. Time Out and Back: 30 minutes Items to Bring: Water and sunscreen. Not only does this short trail have breathtaking views of Lake Tahoe, but it is also meaningful. Chiefly the rock was created more than three million years ago. Equally important, it is still considered sacred to the Washoe Native Americans. Also, leashed dogs are welcome on the trail. Moderate Hiking Trails Steamboat Ditch Trail Location: To get to the trailhead, take Mayberry Drive in west Reno. Then turn south on Plateau Road and right onto Woodchuck Circle. Parking: There is a dirt area for limited parking. Time Out and Back: 3-5 hours Items to Bring: Water, layers, sunscreen and a hat. Of all the hiking trails listed, this one offers some of the best views of downtown Reno and the surrounding hillsides. Built by Chinese laborers in the late 1870s, the Steamboat Ditch is the longest ditch in the Truckee Meadows region. In fact, the water serves as a vital source for ranchers and farmers south of Reno. First, start behind the Patagonia in northwest Reno at the Tom Cooke Trail or park off of Woodchuck Circle. Next head west to find the “Hole in the Wall.” Surprisingly this is a tunnel engineered through the hill, so the ditch could supply water to the Truckee Meadows. This hike is a little over 8 miles with the halfway point just under 4½ miles. With this in mind, if you’re thinking of hiking with your four-legged friend, remember to bring your leash because rattlesnakes can be spotted. Usually there’s also little shade, so plan accordingly by bringing a hat and dressing in layers. Thomas Creek Trail Location: Head out on Mt. Rose Highway going west to Timberline Road. Then drive 1.3 miles past the end of the pavement, stay on Timberline and you will see the trail head on your left shortly after you cross the bridge. Parking: There is a paved parking area on Timberline Drive. Time Out to Back: 2-6 hours Items to Bring: Water, layers, food and a phone with GPS or map. Definitely put he Thomas Creek Trail on your hiking trails list. Located off of Mt. Rose Highway, it is a very scenic hike winding along Thomas Creek into a Jeffrey pine forest. You may choose to hike to what appears to be the end of the trail (where it meets the road) or continue further up for 1/8 of a mile into the Mt. Rose Wilderness. Hiking up the trail to the creek crossing, and then taking the dirt road back down is a great way to see the entire canyon. While this hiking trail is closer to 5 miles, it can be shortened by turning around at any point. Another option is to look for signs to turn off the Thomas Creek Trail at the junction for Dry Pond Loop. Dry Pond is a 4½-mile, out and back hiking trail from the Timberline parking lot. Ultimately you may see a pond or hilltop meadow, depending on the season and weather. Overall it is possible to go anywhere from 2 to 6 miles (or more), based on what you choose to hike. The gain along the creek is minimal, with an 800-foot gain at the top part of the trail. In particular, watch for mountain bikers, as this is also a very popular biking trail. Hunter Creek Trail Location: Go west on Mayberry Drive to Plateau Road. Then turn left and go up the hill to Woodchuck Drive. Lastly, turn right and follow Woodchuck to the hiking trail head. Parking: Paved parking on Woodchuck Drive with a bathroom and benches. Time Out and Back: 2-5 hours Items to Bring: Water, layers, a snack, sturdy shoes and sunscreen. The Hunter Creek trail is about a 7-mile day hike with a little over 1,000 feet of overall gain leading to a waterfall. Ultimately it’s totally worth the trip! This hiking trail winds up Hunter Canyon through sagebrush, Jeffrey pines and interesting rock formations. The waterfall is a great place to sit on shaded logs and enjoy lunch. This trek is very rocky and narrow at times, so good trail shoes are recommended. Furry friends should also be leashed, as rattlesnakes and wildlife are common along the trail. Difficult Hiking Trails Hidden Valley Loop Location: Hidden Valley Regional Park; drive east on Pembroke Drive and turn left on Parkway Drive. The park is at the end of the road. Parking: Park on the east side of the park, closest to the hills. Time Out and Back: 3-6 hours Items to Bring: Water, sunscreen, shoes with good traction and a lunch or snack. Overall this 6-mile loop has about 1,800 feet of gain and is located east of Hidden Valley. We recommend starting the hike from Hidden Valley Regional Park. First, head southeast on a dirt road and then turn east onto a very steep trail that winds over red dirt for about a half mile. In fact, this is the steepest part and it’s a leg burner. Once you get past the climb, the trail gradient decreases. Then you wind along the south side of a big bowl lined with pinyon pine and juniper trees. The hiking trail continues up to the ridge line where there are incredible views of the Truckee Meadows and Mt. Rose. You can hike back down from this point, but it is best to continue on the trail along the ridge line to where it isn’t as steep with incredible views. Frequently you may see wild horses while hiking in this area. Mount Tallac Location: Southwestern side of Lake Tahoe, between Emerald Bay and Camp Richardson. Turn south on Mt. Tallac Road from Highway 89. Parking: Follow Mt. Tallac Road to the parking lot. Time Out and Back: 6 hours Items to Bring: Water, layers, lunch or snacks, sunglasses, hat, sturdy shoes and sunscreen. Definitely a big hike with an even bigger reward — an incredible view of the Desolation Wilderness and Lake Tahoe. This hiking trail is 10.5 miles out and back with a 3,500-foot elevation gain. If you’d like to explore the area without the 6-hour commitment, hike 1.7 miles out to Floating Island Lake or 2.3 miles out to Cathedral Lake. Day use permits are required and you can fill one out for free at the trailhead.

Read More About 8 Local Hiking Trails You Need to Explore

Alzheimer’s disease is not normal forgetfulness as we age. Instead, it is a specific form of mental decline. And according to the Alzheimer’s Association it accounts for nearly 80 percent all dementia cases. Natasa Dragicevic, MD, PhD., behavioral neurologist and Alzheimer’s disease specialist with Renown Institute for Neurosciences, weighs in on diagnosing it and the importance of early medical action. How to Diagnose Alzheimer’s Disease In general, the signs of Alzheimer’s disease occur slowly, getting worse over time. For example, forgetfulness is a daily search – for shoes, keys and other misplaced items. Not only is memory affected, but also speech patterns and behavior. There is no single test for Alzheimer’s disease. “Specifically, a neurologist should be the one to diagnose Alzheimer’s disease given differences in presentation,” clarifies Dr. Dragicevic. “And ideally a behavioral neurologist (Alzheimer’s sub-specialist) will be managing the treatment,” she adds. Brain Imaging Diagnosing Alzheimer’s disease involves multiple approaches and medical providers. In short, medical history is reviewed along with a physical exam, lab tests and other diagnostic testing. “A medical workup includes a variety of tests. These include MRI and other brain imaging, as well as neurological and psychological testing. Furthermore, a lumbar puncture is performed to look for markers of the disease,” she states. What Causes Alzheimer’s disease? Although no one knows the cause, researchers think many factors play a role. Uncontrollable risk factors include your genetics and having a family member with the disease. However, the controllable risk factors include: reducing the risk of head injury and keeping your heart healthy. It’s important to realize that high blood pressure, high cholesterol, stroke and diabetes play a role in brain health. Blood loss to the brain causes vascular dementia, leading to long-term blood vessel damage. Symptoms of Alzheimer’s disease Generally speaking, the signs of this disease differ in each person. Yet noticeable behaviors include: • Losing the way to familiar places • Forgetting to pay bills • Trouble finding the right words when talking • Repeating questions • General confusion • Social withdrawal Alzheimer’s Disease – Benefits of Early Diagnosis Equally important, spotting Alzheimer’s disease early allows more time to benefit from medications and possible clinical trials. Likewise, nutrition and exercise changes can be made, increasing blood flow to the body, and perhaps delaying symptoms. Early diagnosis also allows for personal health decisions and quality-of-life conversations to take place.   According to the Alzheimer’s Association, these benefits include: 1. Medical advantage 2. Emotional and social comfort 3. Time to plan ahead 4. Cost savings A Brain Supporting Lifestyle “At the present time, treatment is limited,” explains Dr. Dragicevic. “Usually Alzheimer’s is a progressive ongoing disease – any management at this time is purely symptomatic.” However, she states the following lifestyle changes can help support brain health: • New hobbies such as painting, pottery, music classes or learning a new language • Crosswords, puzzles and playing games, such as Scrabble • Brain challenging mobile apps, such as Luminosity • 30-45 minutes of mild to moderate physical activity per day, such as walking • Eating a Mediterranean diet (primarily plant based foods)

Read More About Alzheimer’s Disease – How to Spot the Signs

Breast milk. It's often referred to as liquid gold. And fortunately, it can be safely refrigerated or frozen for later use, which can allow you to be a bit more flexible in your new routine with baby. Whether you're getting ready to return to work, planning for the chance date night out or just exclusively pumping, it's crucial to understand the guidelines for proper breast milk storage. Storing Breast Milk Use clean bottles with screw caps, hard plastic cups that have tight caps or nursing bags (pre-sterilized bags meant for breast milk). Be sure to label each container with the date the milk was pumped and your baby's name if the milk is going to childcare providers. You can add fresh, cooled milk to milk that is already frozen, but add no more than is already in the container. For example, if you have two ounces of frozen milk, then you can add up to two more ounces of cooled milk. For healthy full-term infants, milk can be stored as follows: Room temperature - six to eight hours (no warmer than 77°F, or 25°C). Refrigerator - up to five days at 32°-39°F (0°-3.9°C). Freezer– Varies depending on freezer type. Up to two weeks in a freezer compartment located within the refrigerator. Three to six months in a freezer that is self-contained (standard kitchen fridge/freezer combination) and kept at 0°F (-18°C). Breast milk should be stored in the back of the freezer and not in the door. Six to 12 months in a deep freezer that is kept at -4°F (-20°C). Be sure to leave about an inch of space at the top of the container or bottle to allow for expansion of the milk when it freezes. Thawing Breast Milk Place frozen breast milk in the refrigerator to thaw (about 24 hours) then warm by running warm water over the bag or bottle of milk and use it within the next 24 hours. If you need it immediately, remove it from the freezer and run warm water over it until it's at room temperature. Never microwave breast milk and do not refreeze it. Once your baby has started to drink from the bottle, you should use it within one hour. You may find that different resources provide different recommendations about the amount of time you can store breast milk at room temperature, in the refrigerator and in the freezer. Talk to your doctor or lactation consultant if you have any concerns or questions.

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SOGI stands for sexual orientation and gender identity. Being a SOGI-inclusive medical facility means regardless of our differences, we treat others with dignity and respect. Sean Savoy, Renown Health Manager of Spiritual Care, explains SOGI terms and their importance in a healthcare setting below. SOGI History Although the UN passed a historic resolution on SOGI in 2016, it is still a relatively new term for some. Above all, an inclusive environment where every patient feels safe and valued, improves the quality of care in our community. In reality, defining gender and sexuality can be confusing. However, the terms we use to define gender and sexuality are an important influence on how we relate to each other. Generally, "sex" refers to the biological differences between males and females. Still the term “sex” doesn’t fully capture the complex biological, anatomical and chromosomal variations that can occur. Accordingly, having only two (binary) options – biological male or biological female – might not describe what’s going on inside a person’s body. In essence, assigned sex (also called "biological sex) is given at birth based on medical factors. These include your hormones, chromosomes and genitals. Most people are assigned male or female, and this is what’s put on their birth certificate. When someone’s sexual and reproductive anatomy isn’t clearly female or male, that person may be described as “intersex.”  However, a person’s biological or assigned sex may be different from a person’s actual or perceived gender identity or expression. The word “gender,” therefore, is more difficult to define. It could refer to the gender or sex role society determines is acceptable, desirable or appropriate based on a person’s perceived sex. Likewise, it could refer to an individual’s own gender identity or preferred gender expression. What is Gender Identity? To summarize, gender identity is one's innermost concept of self as male, female, a blend of both or neither. To clarify - how individuals perceive themselves and what they call themselves. Of course sometimes a person's genetically assigned sex does not line up with their gender identity. These individuals might refer to themselves as transgender, non-binary, or gender-nonconforming, for example. Another key point is the process of gender transition. This specifically refers to more closely aligning your internal knowledge of gender with your outward appearance. According to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), the term – which replaces Gender Identity Disorder – "is intended to better capture the experiences of affected children, adolescents, and adults." What is Sexual Orientation? Sexual orientation is an internal or enduring emotional, romantic or sexual attraction to other people. For example, you could be heterosexual (straight), gay, lesbian, bisexual or even pansexual. SOGI Terms to Know Below are some common SOGI terms according to the National LGBT Health Education Center and the Human Rights Campaign. The following list is not meant to represent every term (or definition) used by the LGBTQ+ community. LGBTQ+ Stands for lesbian, gay, bisexual, transgender and queer (or questioning). The plus encompasses other identities that fall under the queer umbrella with one common theme: they are not strictly straight or cisgender. Queer An umbrella term used by some to describe people who think of their sexual orientation or gender identity as outside of societal norms. Some people view the term “queer” as more fluid and inclusive than traditional SOGI identities. Due to its history as a derogatory term, the term is not always embraced or used by all members of the LGBTQ+ community. Sexual Orientation Terms Asexual (adj.) – Describes a person who experiences little or no sexual attraction to others. Asexuality is not the same as celibacy. Bisexual (adj.) – A sexual orientation that describes a person who is emotionally and sexually attracted to people of their own gender and people of other genders. Gay (adj.) – A sexual orientation that describes a person who is emotionally and sexually attracted to people of their own gender. It can be used regardless of gender identity, but is more commonly used to describe men attracted to other men. Heterosexual or Straight (adj.) – A sexual orientation that describes a person whose sexual or emotional attractions and behaviors focus exclusively or mainly on members of the opposite sex or gender identity. Lesbian (adj., noun) – A sexual orientation that describes a woman who is emotionally and sexually attracted to other women. Pansexual or Omnisexual (adj.) – A sexual orientation that describes a person who is sexually and emotionally attracted to people of any sex or gender identity. Pansexual people may refer to themselves as gender-blind, asserting that gender and sex are insignificant or irrelevant in determining whether they will be sexually attracted to others. Gender Identity Terms Bigender or Binary (adj.) – Describes a person whose gender identity is a combination of two genders. Cisgender (adj.) – A person whose gender identity aligns with the assigned sex at birth or biological sex. Gender non-conforming (adj.) – Describes a gender expression that differs from a given society’s norms for males and females. Gender transition (noun) - The process by which some people strive to more closely align their internal knowledge of gender with its outward appearance. Some people socially transition, whereby they might begin dressing, using names and pronouns and/or be socially recognized as another gender. Others undergo physical transitions in which they modify their bodies through medical interventions. Intersex (adj.) - A variation in sex characteristics including chromosomes, gonads, or genitals that do not allow an individual to be distinctly identified as male or female. Non-binary Alternate terms are gender queer and gender non-conforming. Transgender (adj.) – Describes a person whose gender identity and assigned sex at birth do not correspond. Also used as an umbrella term to include gender identities outside of male and female. Sometimes abbreviated as trans. SOGI Awareness Again, not all people use the above terms in the same way, so respect and sensitivity are key. And the healthcare setting is an especially vulnerable one. Maintaining the dignity and humanity of every individual during a medical interaction is essential. The U.S. Department of Health and Human Services requires all Electronic Health Record (EHR) systems be able to collect SOGI information from patients. This promotes better understanding of health treatment outcome disparities in order to reduce them. Renown Health’s mission is to make a genuine difference in the health and well-being of the people and communities we serve.

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Flu shots don’t just protect those who get vaccinated; they guard everyone, including your family and the community. Renown Health experts help us understand why everyone should get a flu shot, including children, pregnant women and older adults. 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 Flu Shot Information Whitney Robinson, Renown Health Infection Prevention Expert Chills, body aches, fever and congestion; getting the flu isn’t fun. When you get a flu shot, you’re not just protecting yourself, you’re also helping reduce the total flu cases and hospitalizations. The ideal time to get your flu shot is September through October. This timing allows the vaccine to provide the strongest protection during the length of flu season. However, getting the vaccine later is better than not at all as it's still flu season well into spring. Flu Symptoms In general, influenza (flu) is worse than the common cold and shares symptoms with COVID-19, causing mild to severe illness, and at times can lead to death. Symptoms include: Fever or feeling feverish/chills (not everyone will have a fever) Cough and/or sore throat Runny or stuffy nose Headaches, muscle or body aches Fatigue (tiredness) Vomiting and diarrhea, though this is more common in children than adults Who Needs a Flu Shot? Almost everyone. The Centers for Disease Control and Prevention (CDC) considers it the first and most crucial step in protecting against the flu virus. Therefore, they recommend the yearly flu shot for those six months of age and older. Does the Flu Shot Help with COVID-19? The short answer is no. However, flu vaccines can reduce the risks of flu illness and hospitalization. Therefore, it is crucial for you to get your flu shot to not only protect yourself and the community, but also to help conserve vital, local healthcare resources. CDC Resource: Who Needs a Flu Vaccine and When Kids, the Elderly and Flu Shots  Vanessa Slots, M.D., Renown Medical Group The flu is not a passing cold. It is a serious illness that takes lives every year and it happens like clockwork. The onset of flu season is fall and lasts through winter into the spring months. This lung illness is caused by viruses, with yearly outbreaks occurring worldwide. No one is immune, and anyone can catch  to the flu. Flu Signs and Symptoms Quick onset of fever Headache Body aches and fatigue along with respiratory symptoms including cough Sore throat and nose Who's at Risk for the Flu? Children and the elderly are at greater risk of complications from the flu, specifically toddlers less than two years old. At this age, their immunity is still developing. Seniors over 65 are also at increased risk because their immune systems have weakened with age. The severity of a child’s symptoms depends on age and prior exposure to the virus. With young children, for example, the flu is more problematic since they cannot talk and communicate their symptoms. As a result, children often experience higher fevers, which can lead to seizures or convulsions. This can be coupled with issues such as nausea, vomiting, diarrhea and poor appetite, all of which put children at risk of dehydration and other complications that can require hospitalization. An average of 20,000 children are hospitalized for flu each year. Pre-Existing Health Issues Ongoing health conditions including asthma, heart conditions, diabetes and more can intensify flu symptoms. Still, many children without risk factors can experience severe flu complications. CDC Resource: Flu Information for Parents Pregnant Moms and Flu Shots Tamsen Carson, PAC, Surgical First Assistant, OB/GYN, Renown Medical Group “During pregnancy, your immune system wards off infection for your baby, leaving you more susceptible to infection and adverse health conditions,” Tamsen explains. She   highly recommends flu shots for ALL women during pregnancy. You must receive the injected vaccine versus the live vaccine, a nasal spray, which can cause the flu to occur. Passing Flu Immunity on to Your Baby Also, remember that you will also be able to pass the immunity onto your baby if you breastfeed, which will protect your baby from the flu. CDC Resource: Flu Safety and Pregnancy

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Renown Health has long supported northern Nevada’s LGBTQ+ community Pride events with sponsorship, and we’ve collaborated with local and regional LGBTQ+ organizations as an ally. Renown’s Pride Committee works to deepen and broaden our external and internal efforts around LGBTQ+ community engagement, advocacy, and healthcare issues related to sexual and gender minorities, which is part of the greater Diversity, Equity and Inclusion efforts Renown is undertaking. According to Harvard Chan School, data shows that nearly a sixth of LGBTQ+ adults feel they were discriminated against based on their sexual orientation and gender identity. As a result, this brings to light the important need for education within the healthcare setting. Renown Health is bridging the gap for our LGBTQ+ population, and we know more work needs to take place in order to become an inclusive organization. Below are a few ways we’re working on improving our response to LGBTQ+ needs, and celebrate, respect and honor our diversity by being inclusive. Diversity, Equity and Inclusion The Diversity, Equity and Inclusion subcommittee was formed to heighten the awareness and develop a plan on how to better serve all of our diverse populations, including our LGBTQ+ patients. As the largest healthcare provider in northern Nevada, we knew that we could do a better job. The subcommittee provides us a forum to discuss ideas and develop plans to provide better care to these populations. Updated Medical Records with Preferred Name and Pronouns Of course healthcare is personal. We meet patients at their most vulnerable states. And relating to every person by the correct pronoun shows we respect their gender identity. A new medical records update supports our doctors, nurses and care team in capturing this vital information. We are now able to capture every person’s preferred name, sex and sexual orientation to better care for them. Kathleen Zaski BSN, RN, Manager of Clinical Informatics and IT Applications at Renown explains why this is so important. “Your name and identity are core to who you are as a person, and here at Renown, we aim to take care of you as a whole person and to provide the highest level of quality care to our community – all while ensuring the experience is exceptional and tailored to the individual. In other words, having the patient’s preferred name and pronoun in the medical record is important to validate their identity, and show we care, in an already high stress environment. Specifically, giving our providers easy access to the patients preferred name and pronoun in the medical record, allows them to properly address their health concerns. This also helps the health care provider foster a closer relationship with the patient. Studies have found this actually increases the quality of care by creating a more open and comfortable environment.” Gender Neutral Restrooms Mitch Harper, Senior Program Development Manager at Renown, recognizes there’s still so much more to improve upon in becoming an inclusive organization. “At the end of the day, it’s about creating a safe and welcoming environment for our community and our employees. Access to basic human services shouldn’t be contingent on an individual’s skin color, ethnicity, sex, gender identity, sexual orientation, age, disability, or beliefs. Ensuring that private restrooms are equally available to everyone on our campus is just one way we can provide a more inclusive, caring space for the people we serve.” Updated restroom locations: Roseview Tower: 10 Sierra Tower: 14 Tahoe Tower: 14 Helping to Lead and Influence Change Sean Savoy, Manager of Spiritual Care at Renown "The foundation of spiritual care is compassion – being with people in need by caring, supporting, and showing empathy, and promoting a sense of well-being. Being a member of the LGBTQ+ community informs that deep sense of compassion and empathy in a very special and unique way. Our human value, social validity, the very reality of who and what we are, even our right to exist, love and just be, are often called into question. This, in turn, can cause many of us to question ourselves and wonder about our self-worth. This experience should engender compassion and empathy so that we can better recognize, listen to and meet others’ needs to help them achieve inner peace, explore coping strategies to overcome obstacles during illness or crisis, and even find new balance by re-conceptualizing themselves in the context of health and illness. I have found that the intersectionality of my gay and spiritual selves has been a blessing in my life." Matthew Maloy, Team Lead Applications Specialist at Renown “I am a Team Lead Epic analyst in the IT department that is responsible for clinical based workflows for ED, Trauma, and Critical Care and have worked at Renown for 15 years. Being a part of the LGBTQ+ community influences my daily work by ensuring the Electronic Health Record reflects best practices such as giving clinicians the ability to document a preferred name, and displaying that throughout the medical record for consistency. Having the ability to influence decisions that move our community toward human value for all of us is a priority in my daily work.” Our Mission Renown Health’s mission is to make a genuine difference in the health and well-being of the people and communities we serve, including the LGBTQ+ community. We continue to build relationships to improve care, fostering better health outcomes for ALL of our patients by creating a more inclusive health system.

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Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis, answers some common questions about bone fractures. Is there a difference between broken bones and fractures? No, these are two different names for the same injury. Of course the common term is a broken bone. Using either name will describe your concerns. Medical personnel typically describe a broken bone as a fracture to a specific bone. For example, a broken wrist is also a fractured distal radius. To clarify, this describes the injured bone and the precise location. How do I know  if my child has broken their bone? Many times children will fall and complain of their arm or leg hurting. In most cases the pain goes away and the child will return to their activities. When there is a deformity to the limb (curve in arm) and the child is complaining of pain, it is probably a fracture. If the arm or leg looks straight, look to see if there is any swelling or bruising. Both are signs of a possible fracture. Finally, if the limb looks normal but the child continues to complain, gently push on the bone. Likewise if it causes the same pain, then they likely have a fracture and should have an x-ray. My child fractured their growth plate, what does this mean? Growth comes from this area of the bone. In detail, these are located all over the body but typically at the end of the bones. With this in mind, fractures to these areas can result in the bone growing abnormally. Because of potential shortening of the arm or leg, or bones growing crooked, it is important to follow fractures closely (up to 1-2 years or longer). It is better to identify a problem early. Small problems can be treated with small surgeries. What if the bones of the x-ray do not line up? Because children are growing, unlike adults, their bones will remodel and straighten with growth. The amount of remodeling occurring depends on a child’s age, the bone fractured and the location. In many cases an angled bone will grow straight over the course of a year. For this reason, someone with experience in caring for children needs to follow bone growth. How long does it take fractures to heal? Factors deciding when a cast can come off include: Child’s age. Bone fractured. Fracture location. Young children heal faster than teens, teens heal faster than young adults, who heal faster than older adults. In young children most fractures heal in 4-6 weeks. However, teens generally take 6 weeks to heal, and adults can take much longer. Although your child  is out of their cast, it may not be healed completely to return to all activities. Placing a splint is during this time is common. This typically gives them added protection for several weeks after their cast is removed -  in case they forget their limitations. What if my child is still limping? Whether a child is in a walking or non-weight bearing cast, removing it often leaves them stiff and sore. Therefore many children will walk as though they still have a cast in place. In most cases this resolves in about three weeks. Regardless, if your child is still limping or walking abnormally after three weeks, contact the treating doctor. They may benefit from physical therapy or a repeat evaluation.  (This article was original published in the July 2019 issue of South Reno Kids & Sports.)

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