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With more than 3 million cases in the United States each year, human papillomavirus (HPV) is a common sexually transmitted disease and can lead to the risk of several cancer diagnoses. Fortunately, a vaccine can prevent more than 90% of HPV cancers when given at the recommended ages. We talked to Renown Pediatrician Vanessa Slots, M.D., to learn more about HPV and the importance of getting your child fully vaccinated.   What is HPV?   Talking about sexually transmitted infections can be uncomfortable, but learning how HPV is spread is important for prevention. HPVs are spread via skin-to-skin contact. According to the National Cancer Institute, there are low/medium-risk HPVs that can cause warts and cervical dysplasia (abnormal cells on the cervix), and there are high-risk HPVs that can cause various cancers. HPV is perhaps most known for causing cervical cancer. Other cancers related to HPV are anal, vaginal, vulvar, penile and oropharyngeal cancers. In fact, men are four times more likely than women to suffer from HPV-associated oropharyngeal (mouth and throat) cancer. HPV is so common that nearly all sexually active people will be exposed at some point in their lifetime, with around half of infections being a high-risk virus.  Benefits of the HPV vaccine   Immunizations are safe and effective and have successfully reduced the transmission of many deadly diseases. The CDC (Centers for Disease Control and Prevention) states the HPV vaccine protects against infections that can lead to HPV related cancers and abnormal cells that can lead to cancer (precancers), as well as genital warts.   The recommended HPV vaccine schedule   The American Cancer Society states that the HPV vaccine is most effective when two doses are given to girls and boys between the ages of 9 to 12. There should be at least 6 months between the first and second dose. “You might be asking why your child needs to get the HPV vaccine at this young age when they are not sexually active,” says Dr. Slots. “Research shows that people have a better immune response to the vaccine when younger than in their late teens and early 20s.”   For teens and young adults ages 13 through 26 who have not been vaccinated, getting the HPV vaccine is still highly effective in preventing cancers and genital warts.   CDC recommended HPV vaccination suggestions:  2-dose schedule for people who get their first dose before their 15th birthday.  3-dose schedule for people who get their first dose on or after their 15th birthday.   “By following the recommended HPV vaccine schedule and getting your child the correct number of doses, this will ensure they have adequate protection against HPV associated diseases including cancer,” says Dr. Slots.

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Dr. Derek Beenfeldt first joined the Renown family in 2014 as a family medicine physician after graduating from University of Nevada, Reno, School of Medicine (UNR Med) in 2011. His son Davis was only 10 years old when Dr. Beenfeldt decided to change careers and attend medical school. Ten years later, Davis is following in his dad’s footsteps as a third year student at UNR Med. “I am proud of Davis for taking on the challenges and the commitment that I know goes along with attending medical school,” Dr. Beenfeldt said. “I also feel lucky that we have a medical school with such a great reputation and resources close to home.” The affiliation is a great source of pride for Dr. Beenfeldt. Not just because two important organizations in his life are joining forces, but he also sees it as both entities taking on an immense responsibility – the challenge to be better for incoming students, and subsequently to improve healthcare in Nevada. Davis is currently going through his rotations and spending countless hours a week at Renown Regional. His dad is right there by his side supporting him along the way. “It has been really interesting to have discussions about the UNR medical school with Davis, I recognize the names of many of the professors and courses from when I was a student,” Dr. Beenfeldt said. “I tried to be empathetic, as I can relate to how difficult and stressful this time is for him. Dr. Beenfeldt currently works as chief medical officer for Renown’s insurance arm Hometown Health, and Davis is still browsing specialties. “I don’t know what kind of medicine I want to focus on yet, but I feel lucky that I can attend medical school so close to home and have the option to continue helping my fellow Nevadans after I graduate.” UNR Med at a Glance UNR’s Medical School was established in 1969 Over the last 50 years, UNR Med has educated 3,900+ physicians More than 30% of UNR Med physician graduates continue to practice in Nevada UNR Med is the state’s oldest medical school

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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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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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COPD (chronic obstructive pulmonary disease) is a progressive lung condition often mistaken for typical aging signs, like shortness of breath and coughing. While smoking and pollution can contribute to its development, lifestyle changes and medications can help manage its progression. Diagnosis typically involves lung function tests, chest X-rays, or CT scans, with treatments available through a pulmonologist or primary care provider. Renown’s Pulmonary Rehabilitation Program offers insights into living with COPD. What is COPD? According to the COPD Foundation, it is an umbrella term used to describe progressive lung diseases including: Emphysema: Damage to the small air sacs in the lungs (alveoli). Chronic Bronchitis: Irritation and swelling of bronchial tubes, causing shortness of breath and coughing for long periods of time. Asthma (non-reversible): When asthma medications cannot reduce swelling in the airways. COPD Risk Factors Smoking is the most significant COPD risk factor, and the American Lung Association (ALA) says it accounts for nearly 90 percent of cases. If you are a smoker, it is essential to seek help and quit. Other COPD risk factors include: Air pollution Genetics Second-hand smoke Chemical, fumes or dust in the workplace How Can You Protect Yourself?  Stop smoking Renown Health provides support offering 4-week Smoking Cessation Virtual Classes, free of charge! Sign up today. Use natural cleaning products Many household chemicals, especially those containing bleach, can irritate the lungs – a condition called, chemical pneumonitis. Stay away from all types of smoke This includes smoke from fireplaces. Likewise, plan to stay indoors when it is smoky outside, or air quality is poor. Get active Of course, it’s never too late to start an exercise program. When exercising your heart pumps, circulating your blood and sending oxygen to every part of your body. Notably it strengthens your lungs, making it easier to breath. Talk to your doctor to see if you are healthy enough to begin exercising. Eat a healthy diet Surprisingly what you eat can affect your breathing. The American Lung Association encourages those with COPD to watch their sodium intake, eat smaller, more frequent meals (instead of three large ones), limit high fat foods and drink plenty of water. Avoid scented products Perfumes, aerosol sprays and plug-in air fresheners can trigger flare-ups. Get a flu shot Did you know chronic lung conditions, as well as, heart disease, cancer and diabetes, can be made even worse by the flu? Now is the time to get your flu shot for the season if you haven’t already. Renown’s Pulmonary Rehab staff is certified through the American Association for Cardiovascular and Pulmonary Rehabilitation (AACVPR).  Recently, Renown Regional Medical Center successfully completed a disease specific COPD certification survey by The Joint Commission. For two accreditation cycles in a row, the COPD Program has had zero findings during the rigorous survey.

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It’s important to be aware of the risk of a concussion, which can have serious health implications. Susan Park, MD, discusses the effects of concussions and how they can be prevented. According to Susan Park, MD, a Renown Medical Group doctor who specializes in sports and family medicine, concussions are a serious issue — especially among children whose developing brains “are more susceptible to brain injury and long-term effects from concussions.” All parents, coaches and athletes, she points out, should be aware of the risks of concussions and take precautions to avoid them. What is a concussion and how does it occur? Dr. Park describes a concussion as a traumatic brain injury resulting from direct or indirect impact to the head or body, during which the brain shakes back and forth in the skull. This may cause some bruising of the brain. In severe cases, traumatic head injuries can cause bleeding, which if not treated quickly, can be fatal. What are the health implications of a concussion? Symptoms of drowsiness and confusion can be a sign of a concussion after a head injury. Some short-term effects may include headaches, dizziness and difficulty concentrating. Long-term concerns can further include mood disorders, sleep disturbance and problems with cognitive function-concentration, which may affect school performance. What sports carry the highest risk of suffering a concussion? Dr. Park notes participation in any impact sport can result in a head injury. But among school-age kids, she treats more concussions from football and soccer than any other sport. However, during the winter months, skiing and snowboarding injuries can be a common cause of concussions Any blow to your head, neck or upper body can result in a concussion with symptoms including, but not limited to, feeling dazed or confused, dizziness, nausea/vomiting or a headache. Initial treatment of concussions varies depending on severity. Rest, avoiding vigorous activity and a reduced school workload help young athletes recover after a concussion. Dr. Park notes that sometimes further imaging and an ER visit will be required. Otherwise, rest from activities is the main treatment, along with not returning to sports activities until further clearance from a healthcare provider.

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According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new sexually transmitted infection (STI) cases in the United States each year, with rates continuing to increase.  What you may not know is most STIs are preventable. We talked with Renown Adolescent Medicine Specialist, Caroline Barangan, MD to learn more about STIs.  How Can You Get an STI?  The CDC (Center for Disease Control) says that STIs are acquired through sexual contact. There are bacteria, viruses or parasites that can cause an STI which may pass from person to person in blood, semen, vaginal and other bodily fluids.  How Do You Know if You Have an STI?  STIs can have a range of signs and symptoms such as:  Warts, bumps or sores on or near the penis, vagina, mouth or anus Swelling, redness or severe itching near the penis or vagina Discharge from the penis Vaginal bleeding that’s not your period Painful or uncomfortable sex Vaginal discharge that has an unpleasant odor, causes irritation or is a different color or amount than usual  Weight loss, diarrhea or night sweats Aches, pains, fever and chills Jaundice (yellowing of the skin and whites of the eyes) Painful or frequent urination  Sore throat if you engage in oral sex It’s important to know that the majority of people who have an STI commonly have no symptoms at all, which is why it’s important to get regularly tested once you have had any sexual activity. Young people less than 25 years of age should be screened on a yearly basis at minimum.

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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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Grab your skis, goggles, coat – and don’t forget that helmet. Skiing and snowboarding are fun activities for all ages but come with the risk of injury. Read on for tips to make it a safe day on the mountain. Daydreaming about your next trip to the slopes? We talked to Jared Worchel, DO, about his top tips for gearing up. Get the Gear Before you head out to ski or snowboard, make sure you have all your gear ready and in good condition. Everything should fit correctly so that it keeps you as safe as possible. Wearing proper gear will also help keep you warm. Items to check on before you head out include: Boots Bindings Goggles Poles Helmet Outwear Gloves Pack water and snacks in case the drive takes longer than you except due to weather or traffic. You’ll also want to make sure that your cell phone is fully charged before you head out in case you need to contact friends of staff for help while on the mountain.  Helmet, Helmet, Helmet Having a helmet that fits correctly is the most important thing you can do to prepare for a safe day on the mountain. According to a National Ski Areas Association study, helmet use has increased over the last 15 years, with 80 percent of skiers and snowboarders using helmets. Schubert would like to see that number increase to 100 percent. “If you have a head injury it could take you out for the rest of your life,” Dr. Worchel said. “The most important things to think about when fitting a helmet are making sure that it really fits you appropriately. You want to go into a store and try on as many different helmets as they have available. I know it’s tempting to buy one online, but you’re never going to know if it fits correctly.” If you are in an accident, your helmet’s fit can help protect you. Dr. Worchel has some tips on fitting: A helmet should fit low and snug over the head. Make sure that the helmet doesn’t wiggle or feel loose. Look for a model that has adjustability in the back, which will help you make sure it fits snugly. F ind a helmet with a chin strap that will help it stay in place throughout the day.

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As our community grows, so does the need for specialized care. Thanks to a generous gift, there’s a healthier future for families in the region as a $7.5 million gift to the Renown Health Foundation is helping keep care close to home. Being in the hospital is often a stressful experience, especially for a child and their caregivers. If you add the need to travel out-of-state for care into the mix, unnecessary anxiety and financial burdens can be placed on a family that is already worried about a sick child. With our quickly growing community and close to 100,000 children under the age of 18 in Washoe County alone, the need for local specialty care is needed. The William N. Pennington Foundation recognized this need and donated $7.5 million to the Renown Health Foundation – the largest gift the health system has received – to keep care close to home and establish the William N. Pennington Fund for Advanced Pediatric Care. Thanks to this gift, Renown Children’s Hospital has hired more than 15 pediatric specialists who provide care for children in our community. Below, we introduce you to three key specialized pediatricians in northern Nevada: Joseph A. Gassen, M.D. “Having pediatric specialists in the community is invaluable,” says Joseph A. Gassen, M.D., pediatric emergency medicine. “It allows families and patients to stay in Reno and not have to travel far distances to get quality care.” Gassen, the only doctor specializing in pediatric emergency medicine in the region, moved to Reno to provide care in the emergency room at Renown Children’s Hospital. “The hospital is dedicated to improving the care of children in northern Nevada, and I wanted to be a part of this amazing vision," Dr. Gassen says. I would not have been able to relocate to Reno without the support from the hospital and the William N. Pennington gift.” Working with children and their families are what Dr. Gassen finds most rewarding. "I get to provide care for a child, which in turn makes the parent feel better,” he says. “Essentially, I get to treat the whole family, even though I only directly care for the kids.”   Colin Nguyen, M.D. Also among the first new specialists is Pediatric Neurologist Colin Nguyen, M.D., who has done extensive work with epilepsy and epilepsy surgery. “In any growing and expanding community, we need the multitude of social, financial, political and well-being services to sustain that growth and progress,” Dr. Nguyen says. “The ability to offer more breadth of medical services to our local population allows families to spend more time together and fulfill work obligations, without the need to travel long distances to obtain that specialized care.” Dr. Nguyen says he enjoys caring for children because they are honest in their emotions and reactions, as well as simple in their intentions. “It is the overall joy and unique sadness that comes in working with children, which drives many of us to continue our work -- I am no exception.” Jacob Zucker, M.D. The third pediatric specialist providing care thanks to the Pennington gift has close ties to northern Nevada. Jacob Zucker, M.D., pediatric hematologist-oncologist, was born and raised in Reno and attended medical school at the University of Nevada, Reno School of Medicine before moving to the Midwest for his residency and fellowship. Dr. Zucker feels fortunate to have been offered the opportunity to return home and give back to the community that has given so much to him. “I can say with absolute resolve that northern Nevada is an exceptional community to practice medicine in. The care offered here at home is top rate and the providers that live and practice here truly understand the purpose of community.” The addition of these three specialists and the future specialists that will be coming to our area will impact thousands of children and their families. “With a growing population, the vision of leadership at Renown, and with the generosity of the William N. Pennington Foundation, northern Nevada is in position for the first time to make local pediatric subspecialty care a reality and to keep our families at home in their community,” Dr. Zucker says.

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When you have an ill child in the hospital, it is a stressful event. And Panda Express is helping local families support children who need special care. Their generous donation provides much-needed equipment, programs, and resources via the new Panda Cares Center of Hope, Renown Children’s Specialty Center. Their partnership directly benefits patients and their families! The ‘Panda Cares Center of Hope, Renown’s Children’s Specialty Center’ In fact, this new center provides care to not only children, but also comprehensive support to the entire family. Similarly, it creates an environment that reduces stress, promotes healing, and provides a superior patient and family experience. This facility upholds Panda Express’ mission, vision, and values and its four pillars: to directly help fund the emotional, mental, physical, and spiritual needs of children. This center, the first-ever in northern Nevada, will provide care for children who have chronic conditions. In particular, it offers ongoing treatment, health management, and specialty medical services, including: Nephrology Endocrinology Neurology Pulmonary Infectious Diseases Medical Genetics Adolescent Medicine How You Can Help! When you order from Panda Express, you can opt to round up your change, which will help support programs and services, such as the Center of Hope for Renown Children’s Hospital. Order Online A Partnership for Health & Education of Underserved Youth This partnership allows Renown Children’s Hospital to continue to strengthen regional services and increase Panda’s visibility within our growing community. Last year, 21,930 sick children received care from Renown Children’s Hospital. To date, Panda Express has raised $449,200 in financial support to assist us in providing health and education to every child, regardless of illness, injury, insurance, or ability to pay. Panda Express funds have already supported: Giraffe omni beds for the NICU Ultrasound machine for the Children’s ER Panda warmers and a hand held Accuvein machine Child Life Program to support sick patients and families Meeting room in the Children’s Specialty Center In kind donations, volunteer time and support of local events such as the University of Nevada Reno, Wolf Pack Dance Marathon

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How can you ensure you’re giving your children safe doses of over-the-counter medications? The safest bet: Confirming dosages and recommendations with your doctor. With that in mind, here are a few answers to basic questions about OTC medications and children. It’s cold and flu season in Northern Nevada. This means you’ll find parents in the aisles of practically every drug store, wondering what will and will not work for their sick children. Over-the-counter (OTC) medications — and their dosages, side effects, interactions and more — can inspire abundant anxiety for parents. At the outset, the U.S. Food and Drug Administration offers the following warning about use of medicines for cough and colds in children:   The FDA doesn’t recommend over-the-counter medicines for cough and cold symptoms in children younger than 2 years old. Prescription cough medicines containing codeine or hydrocodone are not indicated for use in children younger than 18 years old. Codeine and hydrocodone are opioids that are available in combination with other medicines, such as antihistamines and decongestants, in prescription medicines to treat cough and symptoms associated with allergies or the common cold for adults. Caregivers should also read labels on OTC cough and cold products, because some might contain codeine. So how can you feel comfortable administering any OTC medication to your children? The short answer is: Check with a doctor first. And with that in mind, here are a few common questions and answers from Kristin L. Wilson, MD, of Renown Pediatrics about children and OTC medications. Please talk about the importance of correct dosage of pediatric medications. Pediatric dosing is weight-based and unique to each medicine (and sometimes even the circumstance you are treating.) Therefore, there are no standardizations of “safe” amounts that apply to all medications. What are signs of an overdose of pediatric medications? Signs of intoxication/overdose are also unique to each medication and supplement. And to make it more confusing, mixing current prescriptions with various supplements or over-the-counter medications can cause significant adverse effects as well. Is there an age at which children take adult over-the-counter medications? Infants through adolescents can take medications that are also prescribed to adults, but only under a healthcare provider’s careful guidance. Dosing is determined by various factors dependent on child’s age and also medical history, as above. What is the takeaway about administering medications to children? When in doubt, ask a healthcare professional whether a medication or supplement is safe for your child based on his/her age and medical history as well as recommended dosing based on recent weights and other vital signs.

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