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Seasonal Affective Disorder (SAD) is a form of depression linked to seasonal changes. Learn to recognize the symptoms of SAD in your kids (or yourself) should they appear. We checked in with Dr. Vanessa Slots, the Division Chief of General Pediatrics at Renown to help us understand this condition. 1. Blame SAD on the sun—or the lack of it Seasonal Affective Disorder is a more severe form of the “winter blues. Over-sleeping, feeling irritable or unhappy, and withdrawing from people are classic symptoms of SAD. Approximately 90 percent of people with SAD experience depressive symptoms yearly in the fall and winter, while about 10 percent have depression in the spring and summer. The causes of SAD aren’t explicitly known. Still, researchers believe it’s related to a change in circadian rhythms, with differences in the amount of sunlight during different times of the year as one factor. 2. The further north you live, the more common SAD becomes While Seasonal Affective Disorder is predominantly an adult condition, estimates are that one million children in North America have it. Interestingly, SAD does not occur in the tropics. 3. SAD is more recognizable in adults than in children Common symptoms include feeling “empty,” pessimistic, hopeless, short-tempered, restless and not knowing what to do with oneself. Symptoms vary greatly from one individual to the next. SAD is more common in women than in men. When symptoms are severe, physical examinations are required to rule out other medical causes and determine whether antidepressant medication is needed. 4. In teenagers, symptoms tend to revolve around school-related issues Schoolwork suffers, students have difficulty getting up in the morning and arriving late for class, homework is incomplete, and grades may plummet. Afflicted students have difficulty concentrating, remembering details and making decisions. They lose interest in activities that they previously enjoyed. Some teenagers tend to overeat, crave carbohydrates such as pasta and gain weight. Many teachers, school counselors and therapists should be more familiar with Seasonal Affective Disorder.

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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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In this article reprinted with permission from the Galena Times,  Dr. Max J Coppes, Physician-in-Chief, Renown Children’s Hospital, and Nell J. Redfield, Chair of Pediatrics, UNR Med, talk about adolescents vaping, and how an estimated additional 10 million teens are at risk to start using e-cigarettes. What are E-cigarettes? E-cigarettes are battery-operated devices heating a liquid (e-juice) into an aerosol to be inhaled. Breathing in this flavor vapor, which usually contains nicotine, anti-freeze or other cancer-causing chemicals is called ‘vaping.’  There are many forms of these electronic nicotine delivery devices - and they're not always obvious. They not only appear to be cigarettes, cigars, or pipes, but also pass for everyday items, such as flashlights, flash drives or pens.   The Effects of Vaping and E-cigarettes Regardless of the nicotine delivery, vaping is addictive and is quickly becoming a public health concern. Nicotine levels in e-cigarettes vary greatly, and they may also contain toxic chemicals. Currently there is a wide range of variability among vaping products. In other words - they deliver different ingredients, hardware, levels of nicotine, and possible toxic chemicals to the user. This makes it challenging to create an overall public health recommendation on their use. Nevertheless, there is no confusion about the harmful effects of the chemicals used in e-cigarettes to the young brain, which develops until age 25. Studies show e-cigarette use serves as an introductory product for teens to go on using ‘regular’ tobacco products. The American Academy of Pediatrics has several recommendations on their use. Such as increasing the minimum age to buy tobacco products, including e-cigarettes, to age 21 nationwide. (Update: nationwide the age as of January 2, 2020 is now 21.) A common misunderstanding with teenagers is the belief e-cigarettes are less harmful than other tobacco products. Moreover, there is a wide range of flavor choices, from mint, mango, crème brûlée to cucumber to attract users. As of September 6, 2019, The Centers for Disease Control and Prevention is reporting over 450 possible cases of lung illness associated with the use of e-cigarette products in 33 states.    What Should Parents Know about Vaping? Parents and teachers should know JUUL is a very popular e-cigarette among teenagers, capturing about 68% of the market. JUUL is sleek, small, hides easily, and resembles a flash drive. Surprisingly it charges in an USB port, and can also instantly be mistaken for a real flash drive. One JUUL cartridge contains twice the nicotine found in other e-cigarette cartridges. This roughly equals the amount of nicotine in an entire pack of cigarettes. To repeat, the use of JUUL in young people continues to grow, and this is why parents and teachers need to be aware. Be alert, teach, communicate, and talk to your child about the serious risks of smoking in all forms, whether at home or parties. Tell them how difficult it is to quit and why they should not start. Loving your children is caring; caring for their current and future health and well-being.

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Sepsis happens when a person's body reacts too strongly to an infection. Usually, our bodies fight infections with help from our immune system. But with sepsis, the body fights too hard, and that can be dangerous. Dr. Julianne Wilke, Pediatrics and Critical Care Medicine, examines pediatric sepsis's causes, symptoms and treatments and provides tips on preventing this potentially fatal condition. Most Common Causes Pediatric sepsis is a particularly concerning form of sepsis that can occur in children and infants. Therefore, it is vital for parents and caregivers to be aware of the indications of pediatric sepsis and to understand the causes. Bacterial infections are the most common cause of pediatric sepsis, accounting for over 80% of cases. Common Bacterial Causes: Staphylococcus infections (including Methicillin Resistant Staphylococcus Aureas - MRSA) Streptococcal infections (including those causing pneumonia and group B strep) Escherichia coli, or more commonly; E. coli Klebsiella and Pseudomonas infections Viral Infection Causes: Respiratory syncytial virus (RSV) Influenza Parainfluenza Adenovirus Human metapneumovirus Coronaviruses (including COVID-19) Other Causes: Fungal infections (but are relatively rare) Parasites, such as Giardia lamblia Pediatric Sepsis Symptoms Parents and caregivers need to be observant of sepsis symptoms in children and can include: Fever Extremely fast heart rate Rapid breathing Lethargy Pale or discolored skin Low blood pressure Confusion Slurred speech Abdominal pain Diarrhea & Vomiting Decreased urination Difficulty breathing Use the acronym SEPSIS: S – Slurred speech and confusion E – Extreme shivering or muscle pain/fever P – Passing no urine all day S – Severe breathlessness I – “I feel like I might die.” S – Skin mottled or discolored If any of these symptoms are present, seeking immediate medical attention is imperative.

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When you’re too sick to go to work but not sick enough for a doctor’s visit, over-the-counter medicines are a welcome relief to help alleviate that fever, runny nose or allergies. But because those medicines aren’t signed off on or managed by your doctor and pharmacist, you must be especially mindful of what you put into your body. Whenever you pop a pill, you want to ensure you’re taking the correct dosage, waiting the right amount of time before taking another dose and not mixing certain medicines. Too Much Tylenol/Acetaminophen Tylenol — or acetaminophen — is a popular pain reliever for many, but too much can be bad for your liver. “Our bodies have a finite ability to metabolize Tylenol,” says Andy Wright, clinical pharmacist at Renown Rehabilitation Hospital. “When too much builds up in the liver, it becomes toxic. In patients with medical conditions like cirrhosis of the liver or hepatitis, this could be disastrous.” Remember, acetaminophen is in more than just Tylenol and generic pain relievers. You may also see acetaminophen in flu, cold and cough medicines, like Nyquil, and some prescription medications including Norco and Percocet. Keep a list of the medications you take, and limit daily acetaminophen use to 3,000 mg per day. When you’re scanning medicine bottle contents, remember acetaminophen is also referred to as APAP, AC, acetam or paracetamol. Mixing Painkillers When you’re dealing with pain and not getting any relief, taking a different medication may seem like the easy solution. Maybe you take some Aleve — a form of naproxen — for a headache, but it isn’t working, so you switch to Motrin, an over-the-counter form of ibuprofen. Not a smart idea. Ibuprofen and naproxen along with aspirin are known as nonsteroidal anti-inflammatory drugs (NSAIDS). Because these medicines work in similar ways, they should never be combined or used in larger doses or more frequently than directed. Otherwise your risk of side effects can increase, which range from mild nausea to severe gastrointestinal bleeding.  It’s also important to consider your family history when taking NSAIDs because, “recent studies have shown NSAIDs may have greater cardiovascular risks for people taking blood thinners or those with hypertension,” explains Andy. “A good example is ibuprofen: It has a relatively low gastrointestinal bleed risk while it has a moderate to high cardiovascular risk. The opposite is true for naproxen.” Rather than experimenting with multiple medicines, figure out which drug works best for you. You may find muscle soreness improves with aspirin, whereas when a headache hits, naproxen is best. Keep in mind that these medications aren’t always best for everyone in the family. “Aspirin in children and teens is not recommended unless under the supervision of a doctor,” Andy says. And pregnant and lactating women should generally avoid NSAIDS due to risk of birth defects and bleeding. “In both of these cases, acetaminophen or Tylenol are preferred but only if approved by an OB/GYN.” Fighting Allergies Over-the-counter antihistamines like Claritin, Zyrtec and Allegra have made fighting itchy eyes and runny noses a little easier. But these daily medicines — when taken inappropriately or in the wrong combinations — can also have an adverse effect. Similar to acetaminophen, you need to watch for antihistamines in other products. Sleep aids — like Tylenol PM and Unisom — commonly use an antihistamine known as diphenhydramine, which may increase your risk of overdose. “Combining antihistamines, or overdosing, can cause many adverse effects including dry mouth, blurred vision — even arrhythmias,” Andy says. “Only take these medications on their own.” If you’re still struggling with symptoms, you can talk to your doctor about adding an over-the-counter nasal steroid.  Andy confirms the importance of closely following the directions listed on antihistamine (and all medicine) bottles. He has seen extended release nasal decongestants cause significant arrhythmias requiring medical care after a patient took the medicine with warm fluids. “The decongestant in question is designed to slowly release, but it can dissolve suddenly in the presence of warm liquids like coffee,” Andy explains. “This can cause the pill to deliver 12 to 24 hours of medication all at once.” Taking an Antidiarrheal with Calcium Calcium supplements and antidiarrheal medicines are another harmful combination. Calcium firms up your stool, but if taken with an antidiarrheal, can cause severe constipation. If you need to take an antidiarrheal, take a break from your calcium for a few days until you’re back to normal. Another consideration when taking calcium supplements or calcium-based antacids is gas. “I’ve had several patients report cases of excessive gas using Tums or calcium carbonate-based supplements.” Andy suggests instead “trying Maalox or Mylanta for indigestion and Citracal as a supplement.” Talk with Your Doctor or Pharmacist About Your Medications If over-the-counter drugs aren’t providing the relief you need, it’s time to see your doctor. And remember, for your safety it is important to keep your doctor and pharmacist up-to-date with any medications — prescribed or over-the-counter — that you are taking.

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Whether it’s cross-country or downhill skiing, snowboarding or snowshoeing, your off-season preparation is vital to an injury-free and healthy experience once the snow starts to fall. We’ve got you covered with expert tips that will make you the king or queen of the hill. Millions of skiers and snowboarders hit the slopes annually. So whether you’re a weekend warrior or stay active year-round, you need to prepare your body for the demands of your favorite winter sport to avoid minor aches, pains or even severe injury. Count on two to three weeks for your body to adapt to the physical challenges ahead if you’re active. Otherwise, give yourself a minimum of six weeks to gear up for the snow. Ready to shred? Here are some conditioning tips to help put you on the path to a fun, successful winter season. 1. Start With Cardio Cardiovascular exercise increases endurance as it conditions the heart, lungs and muscles and provides a solid foundation for other forms of exercise. And when you live and play at altitude, you need even more endurance. “Research shows that our maximum heart rate, cardiac output and ability to exercise are suppressed at altitudes over 5,000 feet,” explains Daniel Staffa, PT, DPT, OCS, of Renown Rehabilitation Hospital. “In the Reno-Tahoe area, altitudes can quickly rise over 8,000 feet when we exercise in the Sierras, so it’s critical to have cardiovascular fitness to avoid associated fatigue and decreased mental alertness on the slopes.” Try this: Pick an aerobic activity you enjoy — speed walking, running, hiking, biking or a cardio machine like the elliptical trainer. Build up to a minimum of 30 minutes, three days a week. 2. Increase Your Strength Your core works overtime to stabilize the body and absorb the shock of pivots and turns and variable snow conditions. Strengthen your core, lower back, hamstrings and calves and you’ll go a long way toward guarding against ligament tears and damage to other joint structures. Stronger muscles will also allow you to relax while maintaining control and making those quick adjustments that uneven terrain demands. Try this: Squats, wall sits and lunges. Work your core and lower and upper extremities with a variation of sit-ups, crunches, back extensions and planks. 3. Integrate Plyometrics Staffa explains that if your legs aren’t used to absorbing the impact of landing, severe injuries can occur. Preempt such trauma with plyometric exercises, or “explosive movements,” that simulate the movements of your favorite sport. You’ll develop greater power in your legs when you combine plyometrics with your strength training. Try this: Incorporate multi-directional drills — such as lateral jumps and forward and backward jumps — on variable surfaces like a trampoline, solid ground, or a box or step. Here’s a challenge for the more advanced: Stand in front of a bench or box (12 inches or so). Jump up and then immediately back down. Do this 10 to 30 seconds at a time, rest and repeat. Or get old school and bust out the jump rope. 4. Improve Your flexibility Flexibility is the ability to move joints through their entire range of motion, from a flexed to an extended position. Being flexible will allow you to pivot, twist and turn and navigate varying snow conditions with ease. You can increase your flexibility while maintaining bone alignment with stretching. Don’t forget to warm up and cool down. Try taking it easy the first 15 minutes of your day on the hill; try starting with a beginner’s run or walk to warm up and prepare your body. Do the same at the end of the day or go for a brisk walk to cool down. Stretching will help return muscles to their normal length. Try this: Dynamic stretches such as leg swings, arm swings and torso twists. Target your quads, hamstrings, calves, and lower back. 5. Fuel for the Hill Staffa suggests loading up on healthy complex carbohydrates the day before you go out and bring along your favorite protein snacks. Assess the slopes before making that first run — is the snow heavy, fresh or wet — and stay mindful of your fatigue level throughout the day. Don’t forget to hydrate and re-hydrate before, during and after exercise. And most important, have fun! Visit Renown Physical Therapy and Rehab for more information. Or call 775-982-5001 to consult with our sports and orthopedic experts who can help you develop an individualized training program in preparation for the winter season, including methods for overcoming previous injuries and limitations.

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According to the Skin Cancer Foundation, higher altitude increases the risk of sun-induced skin damage. UV radiation exposure rises 4 to 5 percent every 1,000 feet above sea level. In addition, snow reflects up to 80 percent of the UV light from the sun, meaning that you are often hit by the same rays twice. This only increases the risk of damage. If you're among the 58 percent of adult Americans who choose not to wear sunscreen, you may be even less likely to apply sunscreen during the fall and winter. Experts at the William N. Pennington Cancer Institute, explain that exposure to the sun happens when we least expect it, like during our daily commute. The ultraviolet A (UVA) rays can penetrate the windows of your car, office or home and get deep into the dermis, the thickest layer of our skin. So what’s the solution to preventing skin damage — or even worse, skin cancer — in the colder months? Apply, then Re-apply Sunscreen "There are a million sunscreens, so find one that feels good on your skin. Hydrating formulas are great for the drier months, so use a broad spectrum UVA and UVB lotion with a mix of ingredients to ensure you are fully protected." Still not sure which sunscreen to use? Look for the Skin Cancer Foundation Seal of Recommendation next time you’re out shopping for your sun protection products. A good rule of thumb is to use about one ounce (a shot glass full) and re-apply every two hours, or more often if sweating. Also, make sure to: Follow directions and shake the bottle before using. Make sure all skin is covered (including neck, ears and lips). For people with thin or thinning hair, apply to the scalp as well. Carry your favorite bottle of sunscreen with you at all times. Skiers, snowboarders, snowshoers, sledders, snow shovelers and winter enthusiasts take note: When spending time out the snow, we recommend a sport sunscreen with an SPF of at least 30.

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Unfortunately, men are less likely to visit their doctor for exams, screenings, and consults than women. So with the help of Bonnie Ferrara, MD of Renown Health, we've put together a list of eight screenings to help men stay on top of their health game. 1. Blood Pressure Tests Ages 20+ Blood Pressure tests measure the pressure in your arteries as your heart pumps. Biennial (every two years) checks are recommended if you have normal blood pressure or more frequently if you have high blood pressure (hypertension) or low blood pressure (hypotension). The United States Preventative Services Taskforce cites normal blood pressure below 120 systolic (top number) and 80 diastolic (bottom number). 2. Cholesterol Screening Ages 20+ High levels of cholesterol increase your risk of stroke and heart disease. A simple blood test will help your healthcare provider determine your numbers and if you're at risk. If you have a family history of diabetes or heart disease, you may need yearly screenings. But, again, your doctor can provide the best course of action.

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