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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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Heat and ice are two of the most common treatments used to relieve pain and reduce swelling in injuries. However, each one is better suited for certain types of injuries Dr. Luis Palacio, MD explores the differences between the two.  When it comes to treating aches and pains, the debate between heat and ice has been ongoing for quite some time. Both have their benefits making it crucial to understand which option is better suited for your specific needs.   Determining which method is better depends on various factors such as the type of injury or pain you are experiencing. For instance, if you have recently sprained your ankle or pulled a muscle during exercise, applying ice within the first 48 hours can help minimize swelling and alleviate discomfort.   It's worth noting that some individuals find alternating between heat and ice therapy beneficial as well. This approach combines the benefits of both methods by using heat to increase blood flow followed by ice to reduce inflammation.  Cold Therapy  Cold therapy can help to reduce inflammation after an injury, heat can have the opposite effect. Therefore, heat therapy should be reserved for those who have chronic pain issues and are not dealing with an acute injury. Cold therapy is often recommended immediately after an injury or during the initial stages of inflammation.  Cold therapy such as ice packs are especially effective in treating: Sprains  Strains Any injury that involves swelling Heat Therapy  Heat therapy is known for its ability to relax muscles, increase blood flow and soothe pain. It is often used for chronic conditions or injuries that are not inflamed. Applying heat can help alleviate stiffness, promote healing and provide a comforting sensation. This increased circulation can bring more nutrients and oxygen to the area, helping it to heal faster.  Heat therapy such as heating packs are especially effective in treating:  Stiffness with associated pain   Injuries that are not inflamed  Muscle pain

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Seeking specialized care for your teen from a sports medicine doctor is essential. Like a coach fine-tunes a player's skills, our experts fine-tune your teen's health, ensuring they stay at the top of their game. Luis Palacio, MD, a sports medicine physician with Renown Health, shares information to help young athletes safely push their boundaries and achieve their personal best. The Role of Sports Medicine Sports medicine is a specialized branch of healthcare that focuses on preventing, diagnosing and treating injuries related to physical activity and sports. Renown's Sports Medicine team consists of skilled professionals passionate about keeping young athletes performing at their peak while minimizing the risk of injury. With a comprehensive approach to care, our sports medicine doctors provide tailored guidance and solutions to help your teen reach their full potential. Injury Prevention and Education Prevention is the key to maintaining a long and successful athletic journey. Our sports medicine doctors collaborate with young athletes to educate them about proper warm-up techniques, body mechanics, and techniques to prevent overuse injuries. From understanding the importance of rest days to practicing correct form, our experts empower teen athletes with the knowledge they need to stay in the game.

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Injuries happen to everyone. They are caused by participating in sports, recreational activities like hiking, and even by accidentally stepping off a curb wrong. If you experience a sprain or strain, the first few days are often the most painful. Renown Sports Medicine physicians Luis Palacio, MD and Brandon Hockenberry, MD walked us through what to do after an injury.  Listen to Your Body See a medical professional right away if: You know or suspect that a bone is broken You are having difficulties putting full weight on a joint of the leg Pain or swelling is severe There is a sign of an infection, such as redness and warmth in the joint  The First 24-72 Hours Joint sprains tend to swell more than muscle strains. You can use ice as needed for comfort and to relieve any pain, but do not use ice for more than 15-20 minutes at a time. Ice and NSAIDs (such as ibuprofen) can help prevent excessive swelling and mask the pain, but they do not speed recovery. Some research shows that overuse of ice actually delays recovery.    During the first 24-72 hours, your injury will go through an inflammation phase. Inflammation is your body’s natural way to dispose of dead tissue cells, build new healthy structures, and hopefully heal even stronger than before.

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Tendonitis occurs when a tendon in your body is inflamed or irritated. This painful condition can impact your day-to-day activities, but can be managed and prevented. Luis Palacio, MD, shared some insights into how to manage tendonitis. Overuse and Repetitive Motion Tendons are complex tissues in our body that connect muscles to bones, allowing us to move. Unfortunately, sometimes these tendons become inflamed, worn down or injured, a condition called tendonitis. Symptoms of tendonitis include pain or dull ache, tenderness and mild swelling at the site. While tendonitis can be caused by a sudden injury, it is more commonly seen in frequent motions, including: Repetitive motions in exercise, work or other physical activities. Awkward positions in a movement, including poor posture. Forced movements that strain your body. Sudden increase in frequency of movement or level of difficulty, including little to no recover time between new activity. Shoes without proper support or hard surfaces, such as concrete floors. Evaluation is Key If you suspect that you have tendonitis and it does not resolve on its own after a few days, you should get it evaluated by a primary care or sports medicine doctor. They can make recommendations to aid your recovery and refer you to the right sub-specialist if needed. With some intentional actions, you can help reduce the risk of tendonitis with the following suggestions: Add variety: Mixing up the type of exercise you do will help prevent repetitive motions that can result in overuse. Stretch and condition: Make sure the keep up with proper stretching and muscle strengthening to support your physical activities. Do it right: Make sure that the way you are completing exercise or work-related physical activities is correct. Seek out a professional for lessons or guidance if you are unsure.

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Concussions are an unfortunate occurrence in youth sports and other physical activities. Learning the signs now will help you respond if you suspect that someone near you has suffered a concussion. A concussion is a mild type of traumatic brain injury (TBI) that can occur after any injury to the head/neck area. It’s important to seek the appropriate level of care if they occur. Brandon Hockenberry, MD with Renown Sports Medicine shares tips on concussion signs to look for and what to do next. Look for these Dangerous Signs First Call 911 or visit an ER right away if you notice one of the following in the person who suffered a blow to the head or body: One pupil is larger than the other Severe or worsening headaches Drowsiness or inability to wake up, including any period of unconsciousness Slurred speech, weakness, numbness or decreased coordination Multiple episodes of vomiting Convulsions, shaking or twitching Monitor for Concussion Signs and Symptoms If someone suffers a bump, blow or other jolt, it’s important to look out for changing symptoms. Symptoms can continue to evolve for up to 24 hours after the injury. Seek care from your primary care provider, an urgent care or a sports medicine provider if you notice any of the following: Cannot recall events prior to or after the incident Appears confused or disoriented Clumsy movements Slow reaction, including movements and speech Changes to normal behavior or mood You should also question the person about how they are feeling. If they report any of the following symptoms, seek care: Headache or feelings of pressure in their head Nausea or vomiting Dizziness or balance issues Problems with eyesight, such as blurriness or double vision Increase sensitivity to light or sound Sluggishness, or feelings described as “hazy” or “foggy” Struggles with remembering or concentration Just “not feeling right”

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November is National Alzheimer’s Disease Awareness Month. At Renown Health, we know that Alzheimer's safety for your loved one is a priority, as the symptoms can sometimes lead to unsafe situations. We asked Dr. Jonathan Artz – a neurology physician with Renown Health and an assistant professor of clinical neurology at the University of Nevada, Reno School of Medicine – for tips on keeping loved ones safe and secure.  According to the Alzheimer’s Association, Alzheimer’s disease affects safety in various ways, specifically due to body and brain adjustments. These changes can include: Judgment, including forgetfulness  Sense of place – getting lost on the way home  Behavior – being suspicious or fearful  Body difficulty – losing balance Sensing ability – noticeable sensitivity in hearing, seeing or temperature  Dr. Artz gives us four major tips to ensure your loved one’s safety as you both navigate this disease together.  Watch for Wandering  Those experiencing Alzheimer’s disease tend to wander and get lost. Try the following tips to reduce the risk of wandering:  Get your loved one an ID bracelet and have them wear it at all times. You can also enroll your loved one in “Wandering Support.”  Install door chimes so you know when exterior doors are open.  Ask neighbors to call you if they see your loved one out alone. Go with your loved one when they insist on leaving the house. Don’t argue or yell. Instead, use distraction or gentle hints to get them to return home.  Discourage Driving  Driving can be unsafe for someone with this disease. With this in mind, ask a doctor whether it’s safe for your loved one to drive. For example, on a case-by-case basis, there are certain situations where doctors are required to report individuals with particular cognitive impairments, wherein a form of a driving assessment will be recommended.  Limit access to the car. Keep the keys with you or lock them away.  Ask an authority figure, such as an insurance agent or a doctor, to tell them not to drive.  Adult-Proof Your Abode  A simple living space is a safe living space. This means reducing clutter and removing any issues that may pose a safety concern. You may also want to get advice from an occupational therapist (home safety expert). Keep in mind that some changes may not be needed right away. Focus on major safety concerns first.  Try the following tips:  Add lighting (or glow-in-the-dark tape) to brighten dark areas, including stairways and halls.  Use color contrast or texture indicators for dials, knobs and appliance controls.  Remind your loved one not to carry items while walking to avoid a fall.  Remove sharp objects from drawers and countertops.  Avoid using small throw rugs or doormats, as they are easy to trip on.  Move frequently used items so that they are easy to reach.  Lock away alcohol and tobacco products, as they are not recommended for dementia patients.  Install handrails in the shower, tub and near the toilet. Bathroom falls are especially common.  Adjust the setting on your hot water heater so water does not scald. Those with Alzheimer’s can lose their sensitivity to temperature.  Move and lock up hazardous chemicals and cleaning supplies, such as bleach and insecticides.  Disable and remove guns or any weapons. Supervise any medication taken by your loved one.  Promote a Positive & Healthy Lifestyle  Continually emphasize the strengths of your loved one by promoting participation in meaningful activities, wellness visits and healthy habits to help them improve their well-being. Here are some ways to keep them physically and mentally active:   Maintain regular vision and hearing screenings and make necessary adaptations.  Establish a routine for daily activities.  Encourage participation in self-care and leisure activities.  Work with your loved one’s doctor to establish a healthy diet.  Ensure proper hydration. It may help to set reminders for your loved one to drink fluids.  Encourage regular exercise. Exercise delivers oxygen to the brain, improving brain health. Promote good sleep habits. Good quality sleep can increase overall brain health and has been associated with improving memory, attention and concentration.  Resources and support are available with the Renown Memory Disorders Program. Providers within this program are specifically dedicated to treating several different memory-related disorders. Memory Disorders Resources & Support.

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Millions of people across the west live in areas where air pollution can cause serious health problems. In addition, local air quality can affect our daily lives.  Who is Affected? Kouros Farro, MD, a physician with Renown Urgent Care, advises that certain people are more likely to be affected when fine particle pollution reaches an unhealthy level. People who have asthma or other breathing conditions like chronic obstructive pulmonary disease (COPD). People who have heart disease or high blood pressure. Children and older adults. People of all ages who are doing extended or heavy physical activity like playing sports or working outdoors. “Everyone should take precautions when the air quality is unhealthy. Air pollution can aggravate heart and cardiovascular disease as well as lung diseases like asthma and COPD. When the air quality is unhealthy, people with these conditions may experience symptoms like chest pain, shortness of breath, wheezing, coughing, or fatigue. If you are experiencing any of these symptoms, use your inhalers as directed and contact your health care provider,” says Dr. Farro, who is board certified in family medicine and practices at Renown Urgent Care at 975 Ryland St. in Reno. “If you do not have a health care provider, there is a Renown Urgent Care office on almost every corner, with providers ready to see you.” Dr. Farro advises the following: Take it easy and listen to your body. Limit, change or postpone your physical activity level. If possible, stay away from local sources of air pollution like busy roads and wood fires. If you have asthma or other breathing conditions like COPD, make sure you have your relief/rescue inhaler with you. People with asthma should review and follow the direction in their written asthma action plan. Make an appointment to see your health provider to be sure you have an asthma action plan. Getting Same-Day Care Renown Urgent Care provides same-day treatment for a wide range of minor injuries, illnesses and medical concerns that are urgent but not life-threatening. Avoid the long wait times and high emergency room prices at 11 convenient sites, including Reno, Sparks, Carson City, USA Parkway, Fallon and Fernley. You can walk in or book ahead online. Make an Urgent Care Appointment Community Health Resources The Washoe County Health District offers online health information on its Smoke Smart website, including fire information, daily air quality information, fire and smoke maps and how to protect yourself. In addition, an online subscription page allows you to sign up for EnviroFlash, notifying you about air quality.

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Even when fires burn outside our area, the air quality in the region can reach dangerous levels. Our expert explains how to maintain your lung health when fire season strikes. It’s a sight we know all too well as northern Nevadans — a hazy or thick layer on the horizon when smoke rolls in from nearby fires. Sometimes the smoke is more evident than others, but it’s important to remember, even when the smoke may not be as visible across the valley, it still impacts our air quality. The last week or so, our air quality has been in the “unhealthy for sensitive groups” range, which can be dangerous for people who are sensitive to air pollution. Air Quality Changes: Who’s at Risk? Renown Pediatric Pulmonologist Sonia Budhecha, M.D., explains certain people are especially at risk when smoke moves in: Older people, whose lungs are not as healthy as they used to be Young children, whose lungs are still developing People with heart and lung disease including asthma, COPD and emphysema “Smoke and haze from fires carry particulates that can get into your respiratory system and eyes, which can be a danger for all ages,” Dr. Budhecha says. How You Can Protect Yourself Until the smoke clears and the air returns to the “good” range, it is best to follow these tips to protect yourself and your family: Stay indoors and keep windows closed Turn on the air conditioning to recirculate clean air Drink plenty of fluids to help your body flush out any toxins you inhale Additionally, all community members should reduce their physical activity and try to prevent heavy exertion outside. If you or a loved one has a heart or lung disease, avoid physical exertion altogether because smoke can aggravate these conditions. “People with heart disease may experience shortness of breath, chest pain, palpitations or fatigue,” Dr. Budhecha says. “People with lung disease may also have shortness of breath, chest discomfort, wheezing, phlegm or a cough.” Smoky Signs and Symptoms Smoke can also impact healthy people — irritating your eyes, nose or throat. And in some cases, inhaling smoke can lead to bronchitis. When haze moves into our area, keep an eye out for these symptoms: Burning or stinging eyes Runny nose Cough or scratchy throat Headaches Wheezing Shortness of breath Difficult taking a full breath Chest heaviness Lightheadedness Dizziness If experiencing any of the above symptoms, seek medical attention or call your doctor for advice. Sometimes, these symptoms do not appear for as long as 24 to 48 hours after smoke inhalation. For those that have pre-existing lung or heart conditions, consult with a health care provider on action or management plans. To schedule an appointment Visit Renown Pulmonary Medicine, or call 775-982-5000. Understanding Our Air Quality The Air Quality Index (AQI) is broken down by large (PM10) and small (PM2.5) particulates. According to Dr. Budhecha, large particulates are usually ones that can be seen and smelled. They can damage your eyes and nose but don’t often get deep in the lungs or blood vessels.   “The more dangerous ones are PM2.5, which can’t always be seen or smelled,” Dr. Budhecha says. “Any time the AQI is above 51, children with lung or heart disease should not be outdoors.” For the latest air quality update in your area, visit AirNow.gov or call (775) 785-4110.

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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)

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