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Help us celebrate the holiday season by sharing joy with our Children’s Infusion Services team!  Thinking about blood can make any of us squeamish, and seeing it can be even more intimidating to the children in our lives. Being treated for a condition that requires blood transfusions or chemotherapy infusions is no easy feat, especially during the holiday season. This time of year, we are proud that we can offer our pediatric patients the power of proximity and excellence by having access to high level care close to home.  The Children’s Infusion Services (CIS) department at Renown Children’s Hospital is committed to bringing the gift of quality care to our community’s youngest patients. Whether they are caring for a child with a blood disorder or giving expert infusion care for a child battling cancer, no team does what they do better than these expert nurses, medical assistants, intake coordinators and physicians.  ‘Tis the Season to Bring Hope As the only pediatric oncology and hematology program in the region, the CIS department has a lot of responsibility on their shoulders. From inpatient chemotherapy to outpatient infusion services, this team treats a long list of pediatric blood conditions including:  Pediatric cancers Anemias Immune-mediated blood disorders Sickle-cell disease Bone marrow failure syndromes Bleeding disorders  “Our team provides a large variety of services from labs draws, sedations for procedures, infusions for diagnoses such as Crohn's disease, blood transfusions, as well as chemotherapy,” said Jen Torres, RN.  “Our team works extremely well together. We try to go above and beyond for our patients every day. It may be something as simple as a hug to comfort a parent or a special birthday gift for a patient.”  “My job allows me to work with several departments and providers when coordinating care for our littlest of patients,” added Jane Strawn, Intake Coordinator. “I assure proper authorizations are in place for the care that is needed, I communicate with our families when scheduling appointments, I organize End of Treatment Celebrations, as well as birthday shout outs and work closely with our Child Life team to help make the challenging appointment little easier.”  To best serve their patients, the team thrives on being expert multitaskers. Central line care, chemotherapy administration, blood transfusions, medication management, preventative injections, lab draws, lumbar punctures, biopsies, imaging – you name it, they do it. And they do it all with the utmost focus on safety and support.  “Our days have a lot of variation, as we perform a number of different services,” said Meagan Bertotti, RN. “We provide infusions for patients with chronic or acute medical conditions and chemotherapy/biotherapy treatment to patients undergoing cancer treatments. Overall, though, we work as a team to make these difficult procedures and treatments as easy as possible for the patients and families by providing engagement and support.”  “While we handle a lot of chemotherapy treatments for pediatric patients, we also do other infusions and transfusions as well such as blood and platelet transfusions, enzyme replacement therapies, different types of injections such as Rabies vaccine or Synagis for high-risk babies who need that extra protection during the RSV season, and lab draws,” said Chelsea Angues, RN. “We care for patients that get their therapies from outside hospitals, but the patient lives within the Reno area. We receive orders from those outside hospitals to care for those patients, so they can still be with their families and not have to travel.”  As members of the Children’s Oncology Group, a highly-regarded clinical trials group where over 90% of pediatric cancer patients across the U.S. receive treatment, teams like CIS in Renown Children’s Hospital deliver the highest standard of care. This partnership is a true testament to the devoted collaboration and relationship-building this team commits to on behalf of their patients every day.  "One of the biggest accomplishments of our team is the fact that we became a member of the Children’s Oncology Group, and the Children's Infusion Center and Pediatric Oncology became one unit,” said Shelby Nolte. "Instead of being a clinic on one side and an infusion center on the other, we really came together to make it a whole unit that collaborates on almost everything.”  “We've put much time into trying to understand other departments, their flow, their rationales and their processes so we can come to a solution that benefits our patients the greatest,” added Tiffany Macie, RN. “We've taken the last few years to really build our relationships with our pharmacy staff, our lab staff and our central supply resources. Our relationship building extends beyond the walls of the Renown building as well and out to the community providers too. In the past few years, we've been able to build relationships with the providers in the community where they trust they can send us their patients for treatment and lab draws. Finally, we've spent much time working on the relationships as a team. It's emotional work we do on our unit, and these families become our family. It's important to us that we take the time to be together outside of our shifts to enjoy one another and laugh!”  In the compassionate realm of pediatric healthcare, CIS knows that the complexities of a cancer or blood disorder diagnosis can take an emotional toll on their patients and families. The team firmly believes that emotional support can be as important as the physical and medical support throughout each patient’s unique care journey, striving to be a comforting presence during daunting times.  “The most important part of my day is collaborating with the Children's Infusion team to make life manageable for the families that are going through this experience,” added Shelby Nolte, Senior Medical Assistant. “We work as a team to make life easier for the blow of a cancer diagnosis.  We are there for our families in every way.  If they need a shoulder to cry on, an ear to listen or just someone to play cards with or tell a funny story too, we are there.”  “One of the things our team does extremely well to help our patients and their families with new diagnoses is to simply meet them where they are,” said Tiffany Macie. “That looks different for every family and every patient. We work in an environment where can build relationships with our patients and their families. This allows us the unique opportunity to really get to know them. We learn their fears, their joys, their worries, what their family lives are like, and we learn how to best meet them where they are.”  Transcending the conventional boundaries of care, the CIS department closely supports each patient, offering them solace tailored to the unique fabric of each family's life.

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It’s true there is no cure for dementia, yet studies suggest your life choices today can reduce brain decline in the future. How important is diet to brain health? Food is the foundation of your body. Fats, carbs and protein provide the energy for your cells and metabolism. So the quality and amount of food you eat directly affects your brain. Specifically, researchers are paying special attention to the link a high sugar diet and/ or an unhealthy fat diet may have on your brain. Your brain on sugar According to the Alzheimer’s Association, when too much sugar is in the bloodstream for long periods of time, it can damage the brain cells. Many people with diabetes may develop brain abnormalities, and these changes may increase chances of dementia — research is still being done to understand this connection. Many U.S. adults have prediabetes with blood sugar higher than normal. Insulin resistance often leads to diabetes. Insulin resistance has been linked to metabolic syndrome, which is a precursor for cardiovascular and cerebrovascular disease (heart attack, stroke). Some signs of metabolic syndrome include: Large waist size (40 inches or more for men, 35 inches and up for women) Low HDL (good) cholesterol level Higher than normal blood pressure — 130/85 and above Current research suggests too much sugar in the blood causes inflammation, which can damage brain cells. High carbohydrate foods, such as sweetened beverages, chips, white rice, white potatoes, bagels, cereals and desserts, have been shown to raise blood sugar. Although anyone can get diabetes, Hispanic Americans and African Americans are at greater risk.

Read More About Keeping Your Brain Healthy, No Matter Your Age

The kids are back in school and the holidays are all but a distant memory: Now what? Karen Wagner, APRN, offers specific tips about getting kids back to their routines in the post-holiday-hustle-and-bustle. Are you finding the kids struggling with bedtime routines? Having trouble getting them to tackle homework? There’s a simple reason: The holidays messed with their mojo! Here, we talk with Nurse Practitioner Karen Wagner about what to do to get them back on the straight and narrow.  Why Routines Are Important “Holidays are a fantastic time to get together with family and friends, so our routines are usually off — and this is understandable, “Wagner says. “While the holidays are exciting, they are chaotic and can put our kids out of the routines.” So how do you get kids back into those routines they crave?  “Consistency/routines are crucial for our kids,” she says. “Most people — kids and adults —  experience a let-down feeling after the holidays, and post-holiday adjustment takes time.” So what can we do, specifically? Wagner recommends the following:  Re-establish family routines, including before- and after-school programs or child care routines. Once kids are back on the regular schedule, they’ll find that sense of familiarity as the old routine returns. But keep in mind, this won’t happen overnight.  Encourage healthy eating, as the upheaval of their schedule can be offset by a balanced diet.  Make sleep time a priority: Keep in mind that it might take up to three nights of strict bedtime to get them back on track. But enforcing normal bedtime will get their bodies back on a normal schedule.  Return to usual chores and expectations. Nothing encourages a return to routine like reminding them of the basics.  Incorporate indoor and outdoor time. They likely spent lots of time outdoors during our unseasonably warm winter break — and they even had a snow day or two! So encouraging both indoor and outdoor time will help them return to a circadian rhythm and tire them out from exposure to fresh air.  “It is never too early to encourage a love for physical activity in kids by exposing them to fun fitness activities and sports,” Wagner says. “Physical activity improves bone health, cardiorespiratory and muscular fitness, decreases levels of body fat, reduces symptoms of depression, and improves cognitive skills and the ability to concentrate.”

Read More About Bye-Bye Holidays, Hello Routines! Getting Kids Back into the Groove

We’ve all been there: Your child gets sick right after urgent care closes — or worse, in the middle of the night. So do you wait it out, or do you load up and head to the Children’s ER? Pediatric Emergency Physician Joey Gassen, MD, with Northern Nevada Emergency Physicians, has insight. As parents, we often wish we had all the answers. And while a short-and-sweet comprehensive parenting guide is elusive, we can help if your questions involve whether to go to the children’s ER or wait it out. Here, a pediatric emergency physician explains when you should take your child to the Children’s ER at Renown Children’s Hospital, and what makes a children’s ER different. How do you know when it’s time to take your child to the ER? Having a sick or injured child is stressful. If you have a true emergency, you should go straight to the ER or call 911. When to go to the ER: Allergic reactions Asthma or severe shortness of breath Fever (infants less than two months old) Choking or poisoning Coughing up or vomiting blood Fainting, confusion or seizures Fractures or broken bones Head injuries Severe bleeding If you determine your child’s condition isn’t life-threatening but needs to be taken care of right away, urgent care is the best choice. Those conditions include: Cold and flu Coughs and sore throat Fevers Vomiting, diarrhea, stomach pain Cuts and severe scrapes Minor injuries and burns What is different about Renown Children’s ER compared to the adult ER? The difference starts when you first bring your child in. We have a lobby dedicated to our community’s smallest patients. The 24/7 lobby incorporates a child-friendly atmosphere with vibrant colors to help decrease anxiety that can accompany emergency situations. Our children’s ER also has equipment sized just for kids of any age. We offer a distraction machine, as well as games and movies, to help children cope with what can be a traumatic experience, like getting an IV. In addition, we have Child Life Specialists available to provide the emotional support to both children and their families. Why is it important to have an emergency room and lobby open 24/7 dedicated to children? Children aren’t just little people. They have special needs that require specialized care. Our children’s ER is staffed with skilled physicians and pediatric nurses certified in advanced pediatric emergency care to give your child the highest level of support. Renown Children’s Hospital From newborns to teens, Renown Children’s Hospital offers many different services and treatments designed specifically to take care of our community’s children. We provide a range of specialized services — from a dedicated Children’s ER and Pediatric ICU to a children’s imaging center and child’s asthma program. Explore Children’s Services

Read More About Children's ER, Urgent Care or Wait it Out? Here's Your Guide

March is Child Life Month, meaning this is the perfect time to ask: What exactly does a Child Life Specialist do? To find out, we “virtually” tagged along with one for a day. This is what a typical day looks like in this important role. For Child Life Specialist Brittany Best, play is a natural part of her work day. She approaches her role with a keen understanding of how the seemingly small tasks she performs every day — comforting children prior to a procedure, writing thank-you notes to donors, training interns — positively impact the lives of the children she serves and their families. So what does it take to work in Renown’s Child Life Program? Best shares some of the highlights from a “typical” shift. A Child Life Specialist’s Day 7:30 a.m. Clock in, put my belongings in my office, and print the patient census information. This helps me to get a sense of the day ahead, as I’m covering three areas today. 8-9 a.m. I look over the census sheets for all three areas and check in with the nurses in each area and then try to prioritize my day. 9:00 a.m. I attend Interdisciplinary Rounds for the Pediatric Intensive Care Unit, where the most critically ill or injured children are treated. Additionally, Interdisciplinary Rounds enable several key members of a patient’s care team to come together and offer expertise in patient care. 10:00 a.m. I come up to the specialty clinic/infusion center to check on the patients that have arrived already and see how things have been going since I had last seen them. We see patients frequently up here, as they are receiving treatment for cancer or other disease processes. 10:55 a.m. I’m notified by an RN that a patient needs an IV started, so I go meet with the patient and their family. I meet with a 6-year-old and mother to explain what an IV is and why it is needed. We go through an IV prep kit, looking at all the different items the nurse will use including cold stinky soap, a tight rubber band and also a flexible straw. I also teach this patient a breathing exercise to help them relax during the procedure with a simple exercise known as “smell flowers, blow out candles.” I demonstrate how to take a deep breath in through the nose — like smelling flowers — then how to blow that breath out — like blowing out birthday candles. 11:10 a.m. I walk with the patient and mom to the procedure room on the Children’s Patient Floor for an IV procedure. The Vecta distraction station is set up and running with its bright lights and water tube that bubbles with plastic fish swimming. The parent holds the patient in their lap, and with the distraction and medical preparation, we are successful! I give the patient a toy and provide emotional support to both the young patient and his mom. It’s easy to forget that these procedures can be stressful for the parents as well. 11:30 a.m. I finish rounding with staff to catch up on patients. In addition, I introduce myself to patients and put my contact number on the board in each room so the families know how to get a hold of me should they need anything. With support from volunteers, we distribute movies, games, and “All About Me” forms to patients and their families. These forms help us get to know our patients with things like their favorite foods and televisions shows. 12:45 p.m. I help with a lab draw in Children’s Specialty Care. A 3-year-old patient is very anxious about the “shot,” so I meet with the patient and parents to discuss coping techniques. The patient holds the Buzzy Bee and does well during the lab draw. The mom is relieved, and the patient is excited for a toy. The Buzzy Bee actually helps block the transmission of sharp pain on contact through icy numbing and also tingly vibration. 1 p.m. Joan, an artist with our Healing Arts Program, arrives on the Children’s Patient Floor to perform art therapy with patients. She helps two young patients who are interested in watercolor paintings. 1:15 p.m. Time for lunch and also a trip to Starbucks. 1:45 p.m. I finishing rounding and introducing myself and our services to the patients I have not met yet. 3 p.m. At this time, I meet with the parents of a newly diagnosed diabetic patient who is in intensive care. A new chronic diagnosis is always difficult, so I am there to provide emotional support. It’s instances like this that remind me every day why I love the work I do. 3:30 p.m. I meet with a new volunteer, discuss their role and also give the new volunteer a tour of the units. We are very thankful for all our volunteers on the floor, as their contributions help us provide a variety of basic services to a larger number of children. This also allows the Child Life Specialist to devote time to children who require more intense or specialized service. 4-5 p.m. I finish charting on patients and help two newly admitted families before I start to wrap up for the day. This evening we have a volunteer covering the times during shift change, which is helpful as it makes for a smooth transition for families during the meal time and change of shift. During this time, I write a note for this volunteer indicating the patients I want her to focus on. 5-5:30 p.m. Check in with critical patients and families before leaving for the day. All-in-all, it was a good day.

Read More About A Day in the Life of a Child Life Specialist

Renown’s Sterling Silver Club is honored to feature one of our more than 9,000 members each season. We thank Judith for sharing her inspirational story and all of our members for leading healthy, happy lives that inspire us all.     Mother, grandmother and eventually great-grandmother is the expected title progression as families grow and babies have babies. “Grand” and “great” usually imply roles and responsibilities have shifted from daily child-rearing duties to those of a doting grandparent – that is, unless you decide to do it all over again. At the age of 61, that’s exactly what featured Sterling Silver Club member, Judith, decided to do when she adopted four of her great-grandchildren. At the time, Alicia, Adrianna and Joey were all under five and Giancarlo, the youngest, was just a baby. “At the adoption hearing, the judge was concerned how stressful it would be for me to raise four children in my late 70s and early 80s,” recalls Judith. “But I told him I had raised my own four children and then three grandchildren for a number of years and that it would be far more stressful for me to have my great-grandchildren separated from each other and me, possibly forever. I knew I could handle the stress of raising them no matter my age, but I couldn’t survive the stress of losing them.” “That was when Giancarlo started getting fidgety,” she continues. “So I raised up his little shirt and blew a raspberry on his tummy which made him giggle and settle down. Seeing that, the judge told the recorder to “put that move in the record” and agreed I was capable of caring for my little ones.” Years later, Judith has come to realize that her great-grandchildren also want to be there to care for her. “Giancarlo always makes me smile,” says Judith. “Once during a stay in the hospital, I was awoken at 3 a.m. for blood work and found him sitting next to my bed watching the oxygen count – he was 10 years old at the time.” “The nurse asked him why he was awake and he said he heard her say the count shouldn’t go below 88, so he was watching to save me if it did,” Judith explains. “The nurse reassured him that she was also watching the count at her desk and he didn’t need to worry. Then Giancarlo looked her square in the eye and told her if it went below 88 to wake him up because he loved me and didn’t want to lose me.” “He is still my sunshine,” Judith smiles. “And I have never regretted my decision.”   Work & Play For 20 years, Judith worked at Truckee Meadows Community College (TMCC), first as an administrative assistant for the police academy before moving to a position in the president’s office. There she worked with the TMCC Foundation and on TMCC projects to raise capital funds for new buildings, off-site campuses, scholarships, college programs and more. “It felt wonderful to be able to notify a student that they had received a scholarship or tell a department that they had received the funds to purchase needed equipment for their program,” recalls Judith. For fun these days, Judith still enjoys doing something she did as a teenager: playing pool. “My mother taught me to play pool in my dad’s pool room/teen hangout space in my early 20s and I’m just getting back into the game by taking lessons to help remind me what I was taught,” says Judith. “I grew up in a small, country town on the Ohio River and my mother could beat almost all of the boys in the county. I would love to be able to emulate her ability in the game.” Judith also enjoys reading, watching Hallmark movies or Warriors basketball games, walking in nature, playing “competitive” shuffleboard with friends, all genres of music – and dancing! In fact, she’s currently taking dance lessons to learn a few new steps. Always Good for a Laugh “My great-grandchildren and I laugh a lot when I try to teach them the stroll, twist, mashed potato and old-fashioned, rock-‘n’-roll dancing,” admits Judith. “But we laugh even harder when they try to teach me their dance moves!”   Faith in What Matters Faith is something Judith celebrates and embraces for herself and others. “I truly believe that we are placed on earth exactly where God feels we are needed and that we are here to help each other through life, not to accumulate material goods for ourselves,” says Judith. “I feel deep satisfaction when I can help others either through just listening to them, advising them, helping them with specific needs or simply giving a smile to a stranger. To me, giving a smile or a helping hand to someone is like skipping a rock across the water – the ripples go on and on.” Then she adds, “And raising my great-grandchildren to be able to have wonderful lives full of love and happiness and closeness to God is the greatest gift I could give them.”   Club Talk So what does Judith appreciate most about being a member of the Sterling Silver Club? She says it’s the opportunity to just – talk. “I fully enjoyed my initial interaction with the club and other club members at the Roaring Twenties dinner dance event,” remembers Judith. “I sat at a table with the nicest ladies and had great conversations with adults and danced with one of the instructors. When you are raising four teenagers who sometimes seem to speak an entirely different language, it’s refreshing to meet and speak with others your own age.” Pictures of some of the popular Sterling Silver Club events are featured here. Judith finds club events that bring her joy. “I also like the cooking classes and recently went on a walking tour of Oxbow Park, which was very peaceful.”     What advice does Judith have to help other members live their best and fullest lives? “On a wet December morning 50 years ago,” Judith begins, “a truck coming around a curve on a country road slid into me and that split second could have made all the difference in the world to me. But God was with me and I survived, which no one expected.” “You never know when that one second that could change everything might happen, so make the most of all of your seconds,” she advises. “Do what you love with those you love. My family means the world to me and I try to think about how my decisions will reflect on the memory I will leave behind for them.” Then Judith thoughtfully adds, “I want them to remember that I truly loved them and always did my best to let them know that.”

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