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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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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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There are a few simple ways to encourage healthy aging that can translate to an improved quality of life. Here are some expert tips.  What does healthy aging mean to you? If you’re like most people, you’re looking forward to removing the negative from your life — negative energy, thoughts, people and activities that don’t contribute to your best life.  And while that’s a noble goal, too often we forget about ways to strengthen the positive parts of our lives. Expert Herbert “Buddy” Coard III, Ed.D, psychologist with Renown Behavioral Health, provides us with five positive behaviors to focus on to improve happiness and life satisfaction. Healthy Aging in 5 Easy Steps: 1. Connect – Make connections with friends, family, colleagues and neighbors. When you build strong connections, they can help enrich your life with new experiences and opportunities. Besides, having a support system to call upon when you need a favor is valuable as you age. 2. Be Active – Make time to get moving and work those muscles. Being active can include walking, practicing yoga, playing a game of pickleball or dancing. Exercise makes you feel good and keeps you health. Pick a physical activity that you enjoy, and don’t make excuses. Not only will being active help you build stronger muscles, it also helps you build strong connections with others. If you need a workout buddy, Meetup is a great resource to find like-minded people that share common exercise goals. 3. Take Notice – Be mindful and become more curious. Like a child, see the wonder and beauty of the world. Notice the things around you — the weather, the landscape, the mood and feelings of the people around you. By taking notice, it’s easier to learn to appreciate the things that matter. 4. Keep Learning – We never stop learning. Keep trying something new — a new course you’ve always wanted to try or a more challenging task someone has solicited for your help. Challenges keep us on our toes and increase our confidence and excitement in our day. OLLI (Osher Lifelong Learning Institute at the University of Nevada, Reno), brings diverse educational and social opportunities to active older adult learners (50+). EPIC (Educational Programs Inspiring the Community), offers a divers curriculum ranging from art classes to Accelerated training certificate courses. 5. Give – Be generous with your time, your knowledge and your talents by giving to friends, family and even strangers. Some easy ways to give is to show thankfulness, smile at people and volunteer. Sharing of yourself to a wider audience gives you a greater reward than just doing things for yourself. Nevada Volunteers Volunteer at Renown Health Practice these five tips to improve happiness and quality of life at any age.

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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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Some people drive for hundreds of miles just to pitch a tent in what we're fortunate enough to call our backyard. From alpine hiking trails and miles of remote forest to desert lakes and spectacular night skies, there's no better way to unwind and explore the outdoors than camping. If you've been daydreaming of hiking trails and swimming holes or looking for a tranquil and adventurous family vacation,  it's time to clear your schedule, pack up the car and venture into the Great Outdoors.  We've got six fun and beautiful camping getaways you need to experience this summer that will leave you feeling relaxed and rejuvenated. And best of all, they're just a short drive away.  Emerald Bay State Park South Lake Tahoe, Calif. Highway 89 Summer Boat-In Camping: Available by reservation. Accessible by boat or foot.  Cost: $35 per night Dogs? Allowed in campground on a 6 foot leash. They cannot be on trails or roads into Emerald Bay or on the beach.  Information/Reservations: 530-525-7232 or www.reserveamerica.com To say this camping location is stunning is an understatement. If you're seeking a view from your campsite of blue lake waters, thick forest and jutting rocks, than this is the spot for you. This campsite is located on the north side of Emerald Bay, at old Emerald Bay Resort, and offers hiking and walking trails and easy access to Lake Tahoe. There are also large rocks you can jump from into the lake.   Davis Creek Regional Park West Side of Washoe Valley US 395 South  Cost: $20, cash only Dogs? Yes. $1 per night fee per pet and they must be leashed. Information/Reservations: (775) 823-6501 or www.washoecounty.us/parks Located in the foothills of the Carson Range 20 miles south of Reno, Davis Creek campground offers over 60 overnight sites along with equestrian trailheads that provide access to the Toiyabe National Forest. The campsite is well-known for outstanding views of Washoe Valley and Slide Mountain and includes picnic areas, a small pond and nature trails. Showers are also available.  Donner Memorial State Park Truckee, Calif.  12593 Donner Pass Road Cost: $35 per night Dogs? Contact for information. Information/Reservations: (530) 582-7892 or www.parks.ca.gov If you're looking for a little more to your camping adventure than what nature has to offer, Donner Memorial State Park may be the ideal campground for you. The park includes the Emigrant Trail Museum, with historical and regional exhibits including the Donner Party tragedy during the severe winter of 1846, as well as hiking trails, Donner Lake swimming and picnic areas. Fallen Leaf Campground South Lake Tahoe, Calif. 2165 Fallen Leaf Road Cost: $33 to $84/day Dogs? Allowed at tent and RV sites (a maximum of two pets per site); prohibited on beaches. Information/Reservations: (530) 544-0426 Nestled among pine and aspen trees and wildflower meadows, Fallen Leaf offers campers the best of both worlds: mountain landscapes and lake recreation. Located less than a mile away from the south shore of Lake Tahoe, the campground features more than 200 camping sites including tent, RV and several yurt rentals.   There are many shady campsites for campers to choose from, as well as food lockers, toilets, showers and a general store. The lake is only a short walk from the sites and features views of Cathedral Peak (8,200 feet) and Mount Tallac (9,738 feet) and there are several trails for hikers. Pyramid Lake Marina & Beach Camping Pyramid Lake Pyramid Lake Store, 29555 Pyramid Lake Road Cost: $9 per day Dogs? Allowed without restrictions. Information/Reservations: 775-476-0555 or www.pyramidlake.us The largest natural lake in Nevada, just 40 miles from Reno, is located between the Virginia and Lake Mountains on Paiute Indian land -- the Pyramid Lake Reservation. It's an ideal locale for boating and fishing and for those who are looking for remote beach camping and easy access to swimming. There are multiple camping spots around the lake -- including an RV park and designated and open camping -- but campers must obtain a tribal camping permit prior to settling in. Note: This is a desert lake and therefore, has limited shade. Campers should plan accordingly with shade sails and pop up shade tents.  Camp Richardson Resort South Lake Tahoe, Calif.  1900 Jameson Beach Road Cost: Contact for specifics.  Dogs? No.   Information/Reservations: 800-544-1801, reservations@camprichardson.com  Whether you're seeking the solace of a shaded forest or craving lazy beach days, Camp Richardson offers a wide variety of camping and lodging needs. Located on the south shore of Lake Tahoe, Camp Richardson features over 30 cabins, 26 lodge hotel rooms, a beachside inn, duplex and house, as well as 200 tent camping sites and 100 RV sites.  The resort campground offers year-round camping and a wide variety of services, including a marina, sports center, restaurant and a store.

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