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Vanessa Slots, MD, of Renown Medical Group – Pediatrics, explains why getting a flu shot each season can save lives—especially true for the very young and elderly. Why Kids Need Flu Shots The flu is not a passing cold. It is a serious illness that takes lives every year. And this year, flu activity is increasing late in the season.  And it happens like clockwork — the onset of an influenza epidemic as fall transitions into winter, and lasts into the spring months. This acute respiratory illness is caused by influenza A or B viruses with yearly outbreaks occurring worldwide. No one is immune, and everyone is susceptible to the flu. Flu Signs and Symptoms: Abrupt onset of fever Headache Body aches and fatigue along with respiratory-tract symptoms including cough Sore throat and an irritated nose Who’s at Risk? Once again: Everyone is susceptible, but children and the elderly are at greater risk of complication from influenza, specifically toddlers less than 2 years. At this age, immunities are underdeveloped. Seniors over 65 are also at increased risk because their immune systems have weakened with age. The severity of a child’s symptoms depend on age and prior exposure to the virus. And with young children, flu is more problematic, since they cannot verbalize certain symptoms like body aches and headaches. As a result, children often experience higher fevers, which can lead to seizures or convulsions. Coupled with gastrointestinal issues such as nausea, vomiting, diarrhea and poor appetite, children are at risk of dehydration and other complications from the virus that can require hospitalization. In fact, an average of 20,000 children are hospitalized from flu each year. Pre-Existing Health Issues Health conditions, including but not limited to asthma, cystic fibrosis, heart conditions, cerebral palsy, epilepsy or diabetes, can intensify flu symptoms. Still, a substantial number of children with none of these risk factors experience severe complications from the flu. How to Protect Your Child from the Flu The best way to guard against influenza is with a flu shot. Children and adults should get the flu vaccine before flu season kicks in — usually by the end of October. Shots are provided as long as flu viruses are circulating and the vaccine is in supply.

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What exactly is the relationship between genetics and disease? Powered by Renown Health, the Healthy Nevada Project is one of the most visible genomic studies in the United States. They are recruiting participants here in northern Nevada to understand the relationship between genetics and nonalcoholic liver disease. Joseph Grzymski, Principal Investigator at the Healthy Nevada Project and Chief Scientific Officer at Renown Health, shares why this study is so important and who should take part. Many people are aware that heavy drinking can lead to liver disease. Yet they are unaware that other types of liver disease are not caused by alcohol consumption. These types of liver disease are more difficult to diagnose but are equally dangerous. What is NASH? A build-up of fat causes nonalcoholic Fatty Liver Disease (NAFLD) in the liver. The most dangerous form is called Nonalcoholic Steatohepatitis (NASH). It causes inflammation and damages liver cells, leading to fibrosis, scarring of the liver, and decreased liver function. If NASH goes untreated, irreversible liver damage can occur, leading to cirrhosis, cancer, or liver failure. These conditions can be fatal. What’s most concerning about NASH is that the symptoms don’t typically cause pain and aren’t noticeable. The good news is that a new local study is raising awareness about this disease by recruiting at-risk people for NASH. Am I at risk for developing NASH? The following factors put you at risk: Obesity Type 2 diabetes Metabolic syndrome High blood lipids, such as cholesterol and triglycerides Does having a family member with nonalcoholic liver disease increase my risk? We do not know a lot about inheriting NASH, although a lot risk factors run in families. One goal of this study is to better understand the genetic component of NASH. There are certainly other risks too, such as environmental and behavioral risk factors. However, we don’t yet have a good grasp on how these impact NASH risk. How is NASH diagnosed? Diagnosis is traditionally done with either a liver ultrasound or biopsy. However, both procedures are expensive and the invasive biopsy has risks. Therefore doctors often use risk factors or less invasive blood tests for diagnosis. This NASH study will include a new blood test called the enhanced liver function (ELF) test. Doctors and researchers have data suggesting that the ELF test is a better diagnostic test for NASH risk. Conducting this cutting-edge test with study participants allows them to share results with their doctors to ensure the best care. What can I do to reduce my NASH risk? Limiting exposure to the risk factors of NASH often lowers risk. Eating a healthy diet, maintaining a recommended weight and exercising regularly can proactively lower your risk.

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What is the role of the child life specialist? Here are common questions and answers about how these special individuals give both parents and kids peace of mind. Let’s face it: A hospital can be an intimidating place for just about anyone. But add in being a small human with very little worldly experience — aka a child — and it’s easy to imagine how overwhelming a hospital visit can be. Enter the role of the child life specialist. Liz Winkler, a child life specialist with Renown Children’s Hospital, explains how a Renown program puts young patients and their families at ease. What does a child life specialist do? Child life specialists help young patients develop ways to cope with the anxiety, fear and separation that often accompany the hospital experience. They give special consideration to each child’s family, culture and stage of development. As professionals trained to work with children in medical settings, specialists hold a bachelor’s or master’s degree in the areas of child life, child development and special education or recreational therapy. Our child life specialists are also professionally certified and affiliated with the national Child Life Council. Child life specialists also offer tours of Renown Children’s Hospital for families whose children are scheduled to have surgery. Child life supports children and families by: Helping children cope with anxiety, fear, separation and adjustment Making doctors, needles and tests a little less scary Providing art, music and pet therapy Organizing activities Addressing your concerns Telling you what to expect Creating a therapeutic and medical plan Offering a hand to hold What else is available at the Children’s Hospital that helps ease some of the stress of a hospital visit? Whether it’s seeing a pediatrician, getting a sports physical or looking for advice, our care is centered on supporting and nurturing patients and families at our many locations. We have kid-friendly environments to help ease some of the stress of a hospital visit. These include colorful exam rooms, kid-friendly waiting and common areas, and medical equipment designed especially for children. Our children’s ER is open 24 hours a day, seven days a week. So parents and caregivers have access to emergency care tailored to little ones — anytime, day or night. We have several pediatric specialists on the Renown team in areas including diabetes, emergency medicine, neurology, pulmonology, blood diseases and cancer. How can parents start to ease their children’s mind when they know a hospital visit is in the future? As with many things in life, good preparation can help kids feel less anxious about the experience and even get through recovery faster. It’s important to provide information at your child’s level of understanding, while correcting any misunderstandings, and helping to eliminate fears and feelings of guilt. If you’re anxious and nervous, your child may reflect these feelings and behaviors. So make sure you educate yourself, feel comfortable with the process, and get your questions answered.

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As the Healthy Nevada Project expands to 50,000 study participants, researchers are sharing the health insights gleaned from the pilot phase of the project.   Air pollution is a major health factor affecting northern Nevadans, according to data gathered by researchers in the pilot phase of the Healthy Nevada Project, one of the largest population health studies in the country. Today, the project — which began 18 months ago as a partnership between Renown Health and the Desert Research Institute — is expanding to add 40,000 additional participants bringing total enrollment to 50,000 Nevadans. “We are thrilled to share the first insights from our 10,000-person pilot phase and discuss how we will begin using those results to improve patient care,” says Anthony Slonim, M.D., Dr.PH., FACHE, president and CEO of Renown Health and president of Renown Institute for Health Innovation, a collaboration between Renown and DRI. Healthy Nevada Project Pilot Phase — and What Happens Next The pilot phase of the Healthy Nevada Project proved Nevadans are excited to know more about themselves and want to contribute to research that could improve health outcomes for the entire state. The pilot phase enrolled 10,000 participants in less than 48 hours and DNA sample collection from each participant was completed in just 69 working days. Based on pilot phase data, researchers have seen increased use of regional healthcare services correlated with fluctuations in air quality and so-called “bad air events” such as wildfires and atmospheric inversions. In phase two, Renown IHI will evaluate possible links between genetics and increased susceptibility to respiratory ailments. Study researchers also announced care providers and scientists will begin working on a number of clinical programs and scientific studies focused specifically on Washoe County’s high age-adjusted death rates for heart disease, cancer and chronic lower respiratory disease. Collectively, these conditions among local residents stand at 33 percent above the national rate. In the coming months, Renown IHI will begin providing advanced calcium score screenings to pilot phase participants at higher risk for cardiovascular disease. This will allow researchers to examine the link between genetics and calcium buildup in the heart. Researchers are also evaluating future studies focused on age-related macular degeneration and breast cancer risks in northern Nevada.   Pilot Phase Insights Fifty percent of pilot study participants responded to a comprehensive, socioeconomic survey, which revealed: High rates of lower respiratory disease in northern Nevada and co-morbidities such as diabetes and hypertension suggest air pollution in northern Nevada is a confounding and significant factor in health. Study participants had parents who died from cancer and heart disease at a higher rate than the age-adjusted national average. Study participants exercised less than recommended by the American Heart Association and expressed interest in receiving help with behavior modification using diet/nutrition and weight loss tools. In phase two, if study participants choose to complete a follow-up survey, they will have the chance to pick an additional health and wellness app specific to their individual genetic results. Learn More To see if you are eligible to participate in the study, to sign up for study updates and for full details on the Healthy Nevada Project, please visit HealthyNV.org.

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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.

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