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June offers an official welcome to summer and the height of outdoor activities in northern Nevada such as hiking, camping, days spent at the lake and embracing long days and warm evenings with friends and family. Enjoying all that the summer season has to offer may not be as easy for those living with chronic obstructive pulmonary disease, or COPD, which effects more than 15 million Americans. What is COPD? COPD is a group of lung diseases including emphysema and chronic bronchitis that result in airflow blockages from the lungs. People may experience frequent coughing and shortness of breath among other symptoms. COPD typically impacts adults ages 65 and older and is becoming increasingly more common among women. Although smoking plays a key role in the development of COPD, air pollution and indoor air quality, and respiratory infection also contribute to disease development. While there is no cure for COPD, limiting progression of disease and managing symptoms can be achieved through lifestyle changes, therapy, and medications. Tips for Living with COPD This Summer, and Always Stay Hydrated: Staying hydrated is extremely important for people with COPD, especially during the summer. Not drinking enough water can make breathing more difficult because it increases respiratory symptoms. Make sure to always keep a water bottle with you and aim to drink 8-10 glasses of water daily. Be Mindful of Temperature: COPD symptoms can be exacerbated by hot weather. It is best to participate in outdoor activities during the cooler times of day, like the morning or evening. Check Air Quality Before You Go: Before engaging in outdoor activities, be sure to check the air quality index and plan your activities accordingly. Pace Yourself: Exercising can be difficult for people who have COPD. To make the most of your summer, try not to push yourself too hard and take breaks when you need them. If you start to feel out of breath or tired, take a break in a cool, shaded area until you feel better. Take Matters Into Your Own Hands To address the needs of community members living with COPD, the Renown Health Research Office has teamed up with Pulmonary Medicine to provide patients who are former or current smokers and have a history of frequent exacerbations with an option to participate in the ARNASA study. "COPD exacerbations have a huge negative impact on patient’s lung function” states Dr. Farah Madhani-Lovely, Chief of Pulmonary Medicine at Renown Health and Assistant Dean of Clinical Research at the University of Nevada, Reno School of Medicine. “We have had inhalers and prednisone for decades but patients are still having exacerbations. Now we have a new pathway we think will prevent exacerbations which is what this clinical trial is designed to prove.” This study will evaluate the efficacy and safety of astegolimab compared with placebo in participants 40-80 years of age with COPD. “This study in particular is so exciting because of the enthusiasm from the sponsor’s end” says Katie Buckley, Lead Clinical Research Coordinator working on pulmonology studies at Renown’s Clinical Research Office. “Often times sites aren’t assigned particularly passionate or engaged personnel who aid in carrying out these studies, but you can tell Roche Genentech’s team truly cares about the success of the study, the safety of their participants, and proving the efficacy of the investigational agent. Working on a study like this takes a village, and when the individuals on all ends share similar mindsets and work towards success as a collective unit instead of as individual moving parts, it’s amazing to see everything we’re able to accomplish.” Renown’s team of expert pulmonologists and researchers are available to join patients with COPD in support of their healthcare journey. If you are interested in learning more about this clinical trial option at Renown Health, talk to your pulmonologist at your next appointment or contact us at 775-982-3646. At Renown Health, our goal is to make it easy for patients to access clinical research as a care opportunity where patients can access a variety of standard care treatment options for their health condition or choose to participate in a clinical trial. For more information about clinical trial opportunities available to you or to ask any questions, contact the Renown Research Office at Renown-CRD@renown.org or 775-982-3646.

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Lung cancer is the leading cause of cancer deaths in both men and women in the U.S. The good news is the five-year survival rate increases dramatically if lung cancer is treated before spreading to other parts of the body. Julie Locken, MD, of Renown Health Imaging, explains more. What are the signs and symptoms of lung cancer? As you might expect, most lung cancer symptoms appear in the chest and can affect your breathing. Watch for signs such as: Persistent cough Constant chest pain Shortness of breath Wheezing Bloody or rust-colored phlegm Hoarseness Swelling of the neck Pain or weakness in the shoulder, arm or hand Recurring pneumonia, bronchitis or other lung infections Loss of appetite and loss of weight can also be signs of lung cancer That said, there are usually no symptoms in the early stages of lung cancer, which means getting screened can truly be a lifesaver. If you have a history of smoking, you should get screened as a precaution.  What are the risk factors of lung cancer?  Around 80% of lung cancer cases stem from a history of smoking tobacco. But there are other known causes, such as secondhand smoke, radon, asbestos and diesel exhaust. It’s important to do what you can to eliminate exposure to all of these to reduce your lung cancer risk.  People with an immediate relative – a parent, sibling or child – diagnosed with lung cancer and people between 50 and 80 years old are also at higher risk and may need to consider screening.  People who are at the highest risk are those with a history of smoking tobacco, particularly smokers who averaged one pack of cigarettes per day for 20 years or more, as well as former heavy smokers who quit in the last 15 years.

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Dr. Nariman Rahimzadeh’s career path has been anything but typical. From humble beginnings as a shuttle bus driver for Renown Regional Medical Center, then named Washoe Medical Center, to his service as Chief of Staff for Renown South Meadows Medical Center, the steps and detours he took along the way – and the strong support from his colleagues and family members – make up a tale of perseverance, conviction, compassion and inspiration.  However, his healthcare career journey began several years before he even joined Washoe Medical Center in the 1990s.  It all began 7,446 miles away in Iran.  This is Dr. Rahimzadeh’s story.  Defining Moments  The moment Dr. Rahimzadeh knew he wanted to dedicate his career to the healthcare field started during his childhood. Growing up in Iran during the midst of the Iranian Revolution, a thought that often came to mind was, “Who is helping all the people injured in the war?”  The answer? The doctors.  “In Iranian society, doctors are extremely valued, as they are the first to help people in need,” said Dr. Rahimzadeh. “I knew I wanted to give back to society in some way, and I see my time in Iran as very formative in my future career. I just didn’t know it yet.”  After immigrating to the U.S. with his family during his preteen years, he only had one mission: to support his family. “My desires were to help my family not fall behind,” he said. “I didn’t have career aspirations at the time. All I knew is that I wanted to help my family and my community, which immediately opened its arms up to us, as well as be a good student and a good ambassador for Iran.”  Dr. Rahimzadeh remembers several influential people that helped solidify his aspiration from “helping people” to “helping people as a healthcare professional.” Their family physician and other medical professionals in the family’s lives were monumental in helping him make this decision. Coupled with his natural love for the sciences, the decision to become a doctor became clear.   But the question remained, “How do I get started in the healthcare field?”  No Links to Healthcare? No Problem  With no physicians in his immediate family and no direct connections to healthcare, Dr. Rahimzadeh set off to follow the advice he received from the influential people in his life: get a job at a healthcare facility, regardless of what the job title is.  Some of his friends had recently joined Washoe Medical Center as patient transporters and mentioned job openings that were available. He sprang into action and headed to Washoe Medical Center to apply.  Just one problem – he didn’t have the EMT certification requirement.   Enter Barry O’Sullivan, who would be Dr. Rahimzadeh’s first supervisor at Washoe Medical Center (and a friend he still speaks with to this day). Barry saw promise in Dr. Rahimzadeh immediately. As a result, Barry made a suggestion to him that would ultimately set him on the course towards medicine.  “Barry told me that he had an open position that I could work while completing the senior year of my undergraduate degree and studying for my EMT certification and eventually becoming a patient transporter. He told me Washoe Medical Center would support me in this endeavor. So, I asked what the job was and learned it was driving a shuttle bus.”  Without hesitation, Dr. Rahimzadeh responded, “I’ll take it.”  And so, his fulfilling journey with Washoe Medical Center, and eventually Renown Health, began.  While he finished up the last few months of his degree at the University of Nevada, Reno, (UNR) Dr. Rahimzadeh proudly drove the shuttle bus a few days a week. The job not only helped him pay for his degree and put food on the table, but it also allowed him to begin living out his passion for helping people in the healthcare field.  Dr. Rahimzadeh graduated with his bachelor's degree in Pre-Medicine from UNR and finished his EMT certification program. Sure enough, Barry and Washoe Medical Center lived up to their promises and helped him secure his first direct healthcare job as an EMT and Patient Transporter with REMSA. But he didn’t stop there – after several years as a ground transporter, his career literally took flight. He joined REMSA Ground Ambulance and eventually Care Flight as a Flight EMT II, caring for patients that were flying to Washoe Medical Center from nearby communities that needed lifesaving medical care.  Helping save lives every day as a member of the emergency medical team is an ultimate feat, especially when it comes to Dr. Rahimzadeh. And he didn’t stop there.  Valuing One-on-One Connections  In the 1990s, as it is today, the U.S. experienced a significant primary care provider shortage which resulted in many medical schools encouraging students to complete their residencies in a primary care specialty, like internal medicine – which is precisely what Dr. Rahimzadeh set out to do at the University of Connecticut.   However, his mind would soon change about the course of his career.   “I had a deep, introspective conversation with my residency program director, openly and honestly chatting about my future,” Dr. Rahimzadeh said. “I ended up taking a week off of my residency and wrote a long pros and cons list about what I wanted to do with my life in the medical field.”  Eventually he decided on anesthesiology because of the opportunity to have a one-on-one relationship with every surgery patient, regardless of their procedure.  “Even though it’s for a short duration of time, it is a very impactful relationship,” he said. “I feel I am making a difference in the outcomes and lives of patients every day.”  Dr. Rahimzadeh finished his internal medicine residency in three years and passed his board exam, and he went on to do the same thing for anesthesiology. He then ventured back home to Reno.  Career Progression at Its Finest  Dr. Rahimzadeh knows that people don’t always get to settle down in a place that influenced their upbringing, care and dream, yet he was able to make that vision a reality for himself.  “I feel like Renown Health and myself have this intertwined relationship that led to my growth as a person and as a physician,” he said. “For that, I feel very blessed."  Upon his arrival back to Reno with two residencies under his belt, Dr. Rahimzadeh was quickly hired at one of the two anesthesiology groups in town at the time. He started his career with Sierra Anesthesia and after working for the group for several years, he joined Associated Anesthesiologists of Reno in 2014, which went on to become one of the largest anesthesiology groups in northern Nevada. The group continuously worked very closely with Renown, taking care of all of its surgical patient needs and eventually becoming Renown Medical Group employees as of April 1, 2022, with Dr. Rahimzadeh setting up his home base at the Renown South Meadows campus.  Today, Dr. Rahimzadeh wears three “hats” at Renown. As a medical professional first and foremost, his largest “hat” is his general anesthesiologist role, where he cares for patients in the operating room. Another significant “hat” is his role as the Medical Director for Surgical Services, where he reviews surgical patient charges alongside his dedicated team of nurses and ensures optimal patient outcomes by verifying they have had the appropriate workup to proceed with surgery in a safe manner. To round out his immense responsibilities with Renown, he serves as Chief of Staff for Renown South Meadows, where he makes connections with colleagues and collaborates with leaders to review protocols, policies and address concerns that arise.  Outside of Renown, Dr. Rahimzadeh is still a contributor within his own anesthesiology practice. He also is the current President of the Nevada State Society of Anesthesiologists and the Director to the Board of Directors of the American Society of Anesthesiologists, helping bridge the gap in anesthesia concerns between his northern and southern Nevada colleagues.  He reflects on the opportunities Renown and our local community have extended to him by saying, “If you can dream big enough and continue to chase your dreams, you can make it happen right here.”  On the COVID-19 Frontlines Nothing could prepare us for the dire situation hospitals on the east coast – especially those in Livingston, New Jersey – were experiencing at the beginning of the pandemic. Livingston was known as the “second hardest hit area” by COVID-19 in April of 2020. Hospitals were overwhelmed with patients in the ICU fighting for their lives. They needed help, and they needed help now.   Unable and unwilling to sit idly by, Dr. Rahimzadeh and six of his colleagues from his practice traveled to Livingston to help. They jumped in on the frontlines alongside other anesthesiologists and intensivists to offset the sudden influx of COVID-19 patients. Many lives were saved, and Dr. Rahimzadeh was a direct part of that.  “When you care and work with people that also care, you can move the needle a lot – it doesn’t matter where you're from,” he said.  Home Means Nevada – and Renown  Renown Health is deeply rooted in the northern Nevada community. Dr. Rahimzadeh is proud to be among a diverse team who have taken responsibility for its community for generations.   "We live in a very passionate and caring community, which is often underestimated,” he said. “It’s clear to me that Renown refuses to settle. Renown is incredibly progressive in providing the best for the community. We never remain stagnant, we keep moving forward and we take care of your loved ones. This health system has never been able to sit still and settle for the status quo. That stands out to me.”  One story especially sticks out to Dr. Rahimzadeh as the moment when he knew that Renown was home. In 1997 while working as a patient transporter, his grandmother passed away on the sixth floor of the Sierra Tower at what is now Renown Regional Medical Center. At the funeral, a huge bouquet of flowers arrived. Not being especially close to anyone in Reno yet, Dr. Rahimzadeh's family had no idea who sent the beautiful arrangement. Turns out, it was Rod Callahan, the Chief Operating Officer (COO) of Washoe Medical Center at the time.   “At that point, I knew I wasn’t just a part of a workforce with thousands of employees,” said Dr. Rahimzadeh. “The COO cared so much about me that he felt compelled to send such a wonderful gift during a tragic time. That’s the value of a local, community-focused hospital; the people here know you and care about you. There’s a reason why people stay at Renown for so long – we feel that connection.”  Dr. Rahimzadeh also reflected on how far Renown South Meadows has come, from the time he immigrated to the U.S. to today. “Growing up, Renown South Meadows was kind of a ‘mom and pop shop’ primarily serving senior citizens in one wing and surgical patients in the other,” he said. “Now, I am so proud to see how far it has come. It really made its niche in the community in a great way. The future is bright!”  It’s clear that Dr. Rahimzadeh is leaving a lasting legacy with his family, from the local community to global medicine. His son is a senior at Baylor University in Texas with a strong desire to go into medicine, just like his dad. His daughter is a junior at Bishop Manogue Catholic High School in Reno and enjoys being involved in her community. His loving wife is a speech therapist in the area. The Rahimzadeh family is thriving together, and they all share the same conviction about northern Nevada and Renown:  “This is home.”

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Since the COVID-19 pandemic, more people are working from home than ever before, leading to a rise in digital screen time. Between spending eight or more hours staring at a computer screen, and some downtime hours spent looking at a smartphone or watching TV, it’s almost inevitable to feel some adverse effects at the end of a day. Blue Light Effects vs. Digital Eye Strain Blue light is all around us, and the most natural source comes primarily from sunlight. Other forms of blue light are artificial and emitted by digital screens including LED TVs, smartphones, tablets and computers. Surprisingly enough, research shows blue light can actually have health benefits such as promoting alertness, boosting memory and cognitive function, elevating mood and regulating circadian rhythm. However, studies indicate that an excess in blue light exposure can lead to depletion of melatonin production, a hormone that regulates our sleep cycles. In today’s eyewear industry, blue light glasses are one of the more popular items purchased by consumers. Companies who sell the glasses claim they help with reducing or eliminating digital eye strain, while also increasing natural melatonin secretion to get a good night’s sleep. Other than their slight yellow tint to filter out blue light, they mostly look like regular glasses and come in many different stylish frames. You can find blue light glasses through various eyewear retailers. Most adults have experienced digital eye strain. Common symptoms of digital eye strain include headaches, blurred vision, irritated eyes, and fatigue. Many believe that digital eye strain is caused by overexposure to blue light, but medical vision experts say that is not the case. “Digital eye strain is related to how we use our digital devices, not the blue light coming out of them,” says Mitchell Strominger, MD, a neuro and pediatric ophthalmologist with Renown Health. Do Blue Light Glasses Even Work? Since blue light glasses aren’t medically proven to help with digital eye strain, you’re probably wondering if they’re even worth using. “If you’re one to binge a TV show or scroll though social media before bedtime, the blue light from those digital screens can disrupt your circadian rhythm and cause you to lose sleep, which can ultimately lead to other adverse health effects,” says Dr. Strominger. “While more research is still needed, some studies have shown that blue light glasses may prevent melatonin suppression and increase quality of sleep. There is no harm in trying them out and seeing if they work for you.” As for preventing digital eye strain, Dr. Strominger shared several helpful tips: Try using the 20-20-20 rule, which entails looking away from your screen and looking at an object 20 feet away for at least 20 seconds. Sit at an arm’s length (about 25 inches) away from your screen. Adjust the brightness and contrast of your screen, especially before bedtime. There is a night mode setting on most smart phones you can use. Reduce your screen time whenever you can and give your eyes a break.

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You might think worsening eyesight is inevitable as you age. But the truth is, there are easy things you can do to keep your eyes in tiptop shape for years to come. Clear vision is an essential part of overall health and there are daily habits we can adopt to keep our eyes seeing clearly. Mitchell Strominger, M.D., a registered ophthalmologist with Renown Health specializing in pediatric ophthalmology and neuro-ophthalmology, offers some everyday tips to keep you focused on eye health. Know your family’s vision history Look to your parents and grandparents for clues about the future of your eye health. Were they near-sighted at a young age? Do they have a history of eye crossing or a lazy eye? Did they develop glaucoma or macular degeneration (AMD)? Some genes have a strong association with eye health, specifically macular degeneration. AMD is a leading cause of blindness worldwide and the top cause of vision loss and blindness for Americans over 65, according to the Centers for Disease Control and Prevention (CDC). Also be aware certain medical conditions, such as diabetes, high blood pressure and liver disease, increase the risk of long-term eye problems. Receive regular vision screening exams Children under three need vision screening examinations by their pediatrician. A medical concern or family history warrants a comprehensive eye examination by a pediatric ophthalmologist (or general ophthalmologist or optometrist who has experience with children) per the American Academy of Ophthalmology (AAO). Vision screenings should occur every two years throughout adolescence unless pain, eye crossing, difficulty seeing the board or reading, or other eye concerns occur. In adulthood the risk of eye problems increases over age 40, so the AAO recommends regular dilated exams. When your pupils are dilated it allows your eye care professional a more accurate view of your retina and optic nerve, located in the back of your eye. This allows them to look for AMD or other eye problems. Eye diseases can be caught at their earliest stages during a dilated eye exam. “It is especially important to have your child evaluated as soon as possible if there is any concern for eye crossing or lazy eye,” says Dr. Strominger. “The visual system develops in the early years so intervention, whether it be glasses, eye patching to strengthen the vision in one eye, or eye muscle surgery is critical. Children at risk include those who are born premature, have development abnormalities, genetic disorders such as Downs syndrome, or a strong family history and should be evaluated at a young age. Often small problems are not clearly evident and cannot be picked up on routine screening examinations in the pediatrician’s office.” Block the sun, improve your vision Everyone knows not to stare directly into the sun, but indirect ultraviolet (UV) sun rays can cause serious harm over time. According to the National Eye Institute, sunglasses (or a protective UV tint) are a daily must to protect your eyes from: Cataracts (a clouding of the eye’s lens causing blurred vision) AMD - macular degeneration Pterygium (a tissue growth over the white surface of the eye that can cause astigmatism) Look for sunglasses which block 99 to 100 percent of both UVA and UVB rays. You still need sunglasses if your contact lenses block UV rays. Sun rays can damage your eyelids and other tissue not covered by contact lenses. Wearing sunglasses protects your entire eye area. Eat colorful meals Your eyes need vital nutrients to keep them healthy including vitamin C, zinc, beta carotene and copper. A diet filled with citrus fruits and a variety of vegetables provide these essential nutrients. Regularly filling up on fish high in omega-3 fatty acids (salmon, tuna, sardines) may reduce your risk of AMD and help maintain your eye health. Green, leafy vegetables (kale, spinach, collard greens) containing lutein and zeaxanthin are also a must for your dinner plate. Water your eyes Eyes, like the rest of your body, need plenty of water to prevent dehydration. Make sure you stay hydrated and steer clear of smoke to avoid dry eyes and irritation. Hours staring at the computer screen can also make your eyes feel dry or tired. Try regularly refreshing them with lubricating eye drops. Taking frequent computer breaks is also important. Follow the 20/20/20 rule: every 20 minutes, look at an object 20 feet away from you for 20 seconds. Eye makeup can also lead to dry eye as the glands at the base of the eyelashes may become clogged, causing dry eye. Make sure all eye makeup is hypoallergenic and is thoroughly removed with a gentle cleanser for the delicate eye area each day. Stop Smoking (or never start) Smoking is harmful to every part of your body, including your eyes. It's not only linked to cancer and heart disease but also cataracts, AMD, dry eye, optic nerve problems and many other problems. Smoking during pregnancy can also harm the eyes of the unborn child. If you currently smoke take steps to quit and your entire body will benefit.

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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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