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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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Providing emotional support for your children, and you.    It is undeniable that hospitals can be a daunting experience for all, but when a child is faced with a difficult diagnosis or staying in the hospital, it can be especially overwhelming. Fortunately, Renown Health has a team of experts called the Child Life team to help.   This group of devoted healthcare providers collaborate with kids who have been admitted to the hospital, as well as children whose family member is a patient at Renown, to ensure they understand every aspect of their visit, while also letting them be kids.   Child Life Specialists provide support to children and their families by:    Assessing patients developmental level and tailoring interactions to each individual family need Helping children cope with worries, fears and/or separation Making doctors, needles, and tests a little less scary by creating coping plans Organizing activities in the playroom and at bedside Addressing parent and caregiver concerns Preparing patients and families for what to expect Fostering a therapeutic environment through play opportunities Offering a hand to hold during tests, procedures, and tough stuff Offering services like art, music and pet therapy Creating special memories and mementos for children and families in times of grief and loss The Child Life Program is available seven days a week at Renown Health and the team can be reached at 775-982-5173.

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In the United States, electronic cigarettes are the most popular form of tobacco product used among high school students. Approximately 21% of Washoe County area high schoolers report current use of e-cigarettes, higher than the national average of 14% reported in the most recent national data. While often viewed as a safer alternative to traditional cigarette use, e-cigarette use, commonly referred to as vaping, exposes users to nicotine and harmful chemicals that stunt brain development, results in lung damage and harms overall health. In partnership with Reno area school principals and nurses, the Renown Health – UNR Med Clinical Research Office was able to provide this year’s World Lung Day Anti-Vaping Program to Galena High School, Robert McQueen High School and Sage Ridge School, reaching hundreds of high school students.

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With a family history of breast and other cancer, Aime′ Landaburu isn’t missing a single health screening. She recently had her first mammogram as well as a whole breast ultrasound, which detects 41 percent more cancers and reduces the number of false-positive results. Like many people, Aime′ Landaburu is busy juggling parenthood and a career. It would be easy to put health screenings on the back burner, but with a grandmother who has survived breast cancer three times and a grandmother who had ovarian cancer, Landaburu is addressing her family health history head-on. “I decided at 35 that I needed to get my screenings done because I have my family history of both grandmothers having had cancer,” Landaburu says. “In addition to the mammogram, I was really interested in doing the whole breast ultrasound. It is the same price as getting my hair done and it’s potentially something that could save my life.” Landaburu says the procedures were painless. “It was really comfortable, and the techs were all so nice and kind and gentle and explained things along the way.” Breast Screening Technology Provides Greater Insight George Krakora, MD, lead radiologist for Renown’s Breast Health Center, says the new 3D imaging for mammograms is picking up subtle cancers that would not have been seen with the previous 2D imaging. “It’s an additional tool that helps find those subtle cancers that may be missed in dense breasts,” Dr. Krakora says. With the whole breast ultrasound, the tech screens for masses — which are often obscured on the mammogram X-ray. Studies show it detects an additional 2 to 3 cancers per 1,000 women that would not have been detected with routine mammography. “Aime′ was noted to have heterogeneous dense breast tissue. That puts her at a little higher risk for cancer and also limits the sensitivity of mammography,” Dr. Krakora says. Multiple Ways to Screen for Breast Cancer However, Dr. Krakora notes, breast ultrasound is not a substitute for mammography, which can detect calcifications that can represent the earliest forms of cancer.” Surprisingly to Landaburu, her results came in just three days. “It’s so important to know what’s going on in your body. I was really nervous when I first got the paperwork, but ultimately it was negative, “ Landaburu says. “I’m thankful it was good and I have a baseline for the future.” Landaburu also advises other young women with a history of breast cancer to proactively communicate. She says it’s important to reach out to women they know who have survived breast cancer. “You have to take the first step and you want to be around for your kids and your family and yourself,” she says. “So utilize your resources, educate yourself and go get screened.” Breast Cancer Screening and Prevention Breast cancer begins when abnormal cells in the breast grow out of control. These cells form tumors that can grow into the surrounding tissue and spread to other parts of the body. Breast cancer occurs mostly in women, but men can also develop breast cancer. To schedule a mammogram or whole breast ultrasound, call 775-982-8100, or schedule an appointment online. Make an Appointment

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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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Posture is important, but for those children diagnosed with scoliosis (spinal curvature) it can be a difficult issue. The Washoe County School District Student Health Services Department screens 7th grade students for scoliosis as growth spurts often reveal the condition and, if diagnosed early, scoliosis can stop progressing. We asked Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis to answer some frequently asked questions about scoliosis. What is scoliosis? There are many types of scoliosis: early onset (occurs before age 10), congenital scoliosis is when the bones of the spine do not form correctly, neuromuscular scoliosis which is due to children’s neurologic and muscle disease, and the most common is Adolescent Idiopathic Scoliosis. The term “idiopathic “ means the exact cause is unknown, although we do know it runs in families. This type of scoliosis occurs in 2-3 percent of adolescents and is mainly seen during their growth spurt. This is why middle school screenings are recommended. Both genders get scoliosis but girls are 8 times more likely to have their curves progress and become larger. What are the signs that my child may have scoliosis? A few signs for parents to watch for are: One shoulder might be higher than the other. One leg may seem longer. A hip may be higher or look more prominent. The waist may not look the same from side to side (asymmetry). The trunk or rib cage may be more prominent on one side or shifted. When they bend forward they may have a bump on their back. How is scoliosis diagnosed? It can be noticed by a pediatrician at a physical, school screening nurse, PE teacher or parents. Once the curve is suspected the child is usually referred to a pediatric orthopedic surgeon scoliosis expertise. At the initial visit the doctor will perform a thorough physical including a complete neurologic exam to assess the amount of curvature. Once the exam is completed the physician will determine if a spinal x-ray is needed. The curve on the x-ray is measured utilizing the cobb angle (a measurement in degrees) which helps guide the treatment. What are common treatments for scoliosis? The treatment depends on the size of the spinal curve and the amount of growth the child has remaining. An x-ray of the child’s hand is used to determine the amount of growth remaining. This allows the determination of the child’s bone age, and based on the hands growth plates it can determined if the child is in their rapid phase of growth. Treatments include: Observation - For curves less than 20-25 degrees. This entails visits every 6-9 months with a repeat scoliosis x-ray. Since scoliosis curves increase only 1-2 degrees per month, and variations in measurements can be 3-5 degrees, an x-ray is not recommended before 6 months. If the curve remains less than 25 degrees the child is followed until their growth is completed (usually age 16-18). Progressing Curve - If growth is finished and the curve is less than 40 degrees, the risk of more curvature into adulthood is small. If growth is completed and the curve is over 45 degrees, the child is followed for several years as these curves can progress into adulthood. If the patient is still growing and the curve has progressed greater than 25 degrees but still in the non-operative range (less than 45-50 degrees) bracing is used to stop the progression of the curve. Bracing - Indicated for curves over 25 degrees but less than 45 degrees. If a brace is required you will be referred to an orthotist (bracing specialist). The orthotist assesses your child, reviews the x-ray and then fits the brace. (Having a brace made usually takes 2-3 weeks.) Once the brace is fit, your child will visit the scoliosis specialist for an x-ray in the brace to ensure it fits correctly. The primary goal of bracing is to halt progression of the curve and prevent the need for surgery. The brace must be worn for about 16 hours per day to be effective. In a recent bracing study 72% of the patients who wore their braces as prescribed prevented the need for surgery compared to the group who did not wear their brace. Surgery: When a curve reaches 45-50 degrees, and a child is still growing, surgery is usually recommended because the curve is likely to continue progress. If a curve is over 50 degrees and the child is done growing surgery also may be recommended. This is because when curves are over 50 degrees they tend to increase 1-2 degrees per year for the rest of your life. As curves get larger the amount of lung function tends to decrease which could cause breathing problems later in life. The goals of surgery are to stop the progression of the curve and safely correct any misalignment. This is accomplished by attaching implants (rods, screws, hooks and bands) to the spine. Bone graft is then placed around the implants to encourage the spine to fuse (grow together). This then forms a solid column of bone with metal rods in place, preventing the curve from changing. Most patients are back to their regular sports and activities six months post surgery.

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Did you know: More than 2.9 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today. Prostate cancer is common, but also treatable, especially when caught early. Dr. Michael Hardacre of the Renown Institute for Cancer explains. With the exception of skin cancer, prostate cancer is the most commonly diagnosed form of cancer in American men. In fact, the American Cancer Society offers these key statistics: About 1 man in 9 will be diagnosed with prostate cancer during his lifetime. Prostate cancer develops mainly in older men and in African-American men. About 6 cases in 10 are diagnosed in men aged 65 or older, and it is rare before age 40. The average age at the time of diagnosis is about 66. The good news: This form of cancer is very treatable when also detected early. Michael Hardacre, MD, radiation oncologist with Renown Institute for Cancer, is here to explain more about prostate cancer screenings and their role in early detection. What is the prostate? The prostate is a gland that only males have, and it makes part of the seminal fluid. Prostate cancer begins when the cells in the prostate gland start growing uncontrollably due to a change in the cell’s genes. Researchers are working to find what leads to the disease. Certain types of prostate cancer are hereditary, or passed on through genes. However, most types of prostate cancer are acquired and developed later in life. What are some of the signs of prostate cancer? Common signs of prostate cancer include: Frequent urination Weak urine flow Painful urination or inability to urinate Blood in urine or semen Painful ejaculation Erectile dysfunction If you notice any of these signs, talk with your primary care doctor. Although it may be intimidating to talk about any of these signs or symptoms, the earlier prostate cancer is detected, the better the options for treatment. How can you screen for or detect prostate cancer? The good news is that prostate cancer can often be found before symptoms appear, because screening is as simple as a blood test. Your doctor will look for levels of a prostate-specific antigen in the blood. If the results come back with anything concerning, then additional testing would be recommended. A transrectal ultrasound can also be used, which is usually painless and only takes about 10 minutes to complete. This exam gives the doctor an image of the prostate to measure its size, which can help determine the density of the prostate-specific antigen. If this test comes back with any suspicious results, then your doctor may recommend a biopsy. What are the treatment options? Depending on each case, treatment options for men with prostate cancer might include: Watchful waiting or active surveillance Surgery Radiation therapy Cryotherapy (cryosurgery) Hormone therapy Chemotherapy Vaccine treatment Bone-directed treatment It’s important to discuss all of the treatment option with your doctors, including goals and possible side effects, to help make the decision that best fits your needs. Some important things to consider when choosing a treatment option also include: The stage and grade of your cancer Your age and also your expected life span Any other serious health conditions you have Your feelings (and your doctor’s opinion) about the need to treat the cancer right away The likelihood that treatment will cure your cancer (or help in some other way) Your feelings about the possible side effects from each treatment Renown Institute for Cancer | 775-982-4000 At the Renown Health Institute for Cancer, our experienced team provides the support and care to maintain the highest quality of life and then achieve the best possible outcome, all in one location that’s close to home. Our dedicated team, clinical expertise and also advanced treatment options allow us to tailor care to each patient. Learn about: Our Team Cancers We Treat Screening and Prevention Treatment Options

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Colorectal cancer is the number two cancer killer in Nevada, only second to lung cancer, yet it is also one of the most preventable. Still, in 2020, 20.7% of Nevadans said they had never been screened for this deadly disease, according to the Nevada Cancer Coalition. At the start of the COVID-19 pandemic, unfortunately many healthcare services were halted, including colorectal cancer screenings. Those delays in screenings can lead to delays in diagnoses of colorectal cancer, resulting in poorer outcomes. Per the American Cancer Society, if colorectal cancer can be found early the relative 5-year survival rate is approximately 90%. Screening is key, and it is important to engage in preventative care. Even if you have no personal or family history of colorectal cancer, ask your doctor about colorectal risk factors and when to start screening, and if you’re up to date on your screenings, talk to loved ones and make sure they are too. According to the American Cancer Society, most colorectal cancer cases are found in those without a family history. This month let us help raise awareness for colorectal cancer and the importance of routine, life-saving screenings. To learn more, we spoke to Renown Health oncology nurse Christina Alsop, APRN. What is Colorectal Cancer Colorectal cancer is a disease in which the cells in the colon or rectum grow out of control. It usually forms from precancerous polyps, or abnormal growths, in the colon or rectum, which can become malignant without presenting any symptoms. How do Screenings Work Screening tests like stool tests, colonoscopies and others can detect these precancerous polyps, so they can be removed by a physician before turning into cancer. Screening tests can also find colorectal cancer early, resulting in better treatment outcomes. As of 2021, the U.S. Preventative Services Task Force recommends adults begin colorectal cancer screenings beginning at age 45, through 75. Screening methods include a blood stool test, which needs to take place every year or a colonoscopy, which takes place every 5-10 years. Healthy Habits Can Help Stave Off Risk Routine screenings are the only way to determine colorectal health, yet some healthy habits may reduce your risk for colorectal cancer. These factors include maintaining a healthy weight, being physically active, eating a diet rich in fresh fruits, vegetables and whole grains, limiting alcohol intake and not smoking.

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Colorectal cancer is the second-deadliest cancer in the United States – largely because it goes undiagnosed. Dr. Christi Matteoni, Division Chief of Gastroenterology at Renown Health, discusses the symptoms and key screenings used to detect this type of cancer, along with risk factors and lifestyle changes that could affect the likelihood of getting the disease. What are some of the signs and symptoms of colorectal cancer?  Many cases go undiagnosed because polyps can develop and become cancerous without any symptoms. Additionally, since colorectal cancer begins as small polyps, symptoms usually aren’t seen until later stages. This is why screenings are especially important.  For those who do experience symptoms, the signs are often tied to your bowel habits. This can include changes such as constipation or diarrhea, narrow or dark stool, rectal bleeding, abdominal cramping, weakness and fatigue or unintended weight loss.  What are some of the risk factors associated with this type of cancer?  There are risk factors that can and cannot be controlled. Uncontrollable factors include age, race, personal and family histories as well as certain genetic syndromes that are important to discuss with your provider.  This type of cancer is more common in people over the age of 50, African Americans and those of eastern European Jewish (Ashkenazi) descent. This type of cancer is also more common in those who have been diagnosed with polyps, Crohn’s disease, ulcerative colitis and long-term inflammatory bowel disease. important to discuss any of these risk factors with your provider.  There are also lifestyle factors that can help reduce your risk. Factors include being overweight, having a diet high in red and processed meat, as well as smoking and consuming excess alcohol.  Conversely, diets high in fruits and vegetables and a regular exercise routine can help lower your risk.  If someone has some of these risk factors, what should they do? Do they need to get tested?  If you are 45 or older and have any of these risk factors, we recommend you speak with your primary care provider about a formal colorectal risk assessment.  The most common form of screening is colonoscopy. This screening lets your doctor examine the length of your colon, map out any potential problem areas and remove polyps. For most people, colonoscopies are recommended every 10 years starting at age 50. However, depending on your results and risk factors, you may need to begin screening sooner or get screened more frequently.  What do diagnosis and treatment look like for this type of cancer?  There are several diagnostic options for colorectal cancer, including endoscopic ultrasound; CT, MRI and PET scans; and biopsy and pathology reports. These technologies allow your doctor to get images of your colon and evaluate what treatment is needed, as well as how the treatment is progressing.  Treatment varies for each individual working with their doctor. In the case of colorectal cancer treatment, the William N. Pennington Institute for Cancer offers chemotherapy, radiation therapy, surgery and clinical trials.

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Participating in sports and physical activities is enjoyable and beneficial for our health. However, the risk of injuries comes with the fun and excitement of sports. Sports-related injuries, including sprains, traumatic brain injuries and broken bones, are more common than we realize and can land you in the emergency room. Dr. Scott Shepherd, Emergency Medicine Physician, provides a wealth of information. Traumatic Brain Injuries: The Invisible Threat Traumatic brain injuries come in many forms. From “mild” brain injuries, concussions, to major brain injuries and bleeds. Sometimes it is very difficult to tell the difference between a major injury and a minor injury because many of the symptoms are the same. Concussions Concussions are a type of “mild” traumatic brain injury resulting from a blow to the head or a violent shaking of the body that causes a transient alteration in mental function. They are particularly prevalent in contact sports such as football, soccer and boxing. A concussion can affect memory, judgment, reflexes, speech, balance and muscle coordination. Typically, concussions are not life threatening and usually short lived. However, multiple concussions can lead to permanent disabilities. So, remember there is nothing “mild” about injuring your brain. Contusions The more serious brain injuries from brain contusions (actual bleeding in the brain material) and bleeding that presses on the brain are life threatening. These injuries are caused by the same blow to the head as a concussion and the symptoms are the same from memory deficits, loss of coordination to coma. Because of this, anyone who has a blow to the head and is not acting normal should be evaluated by a medical professional. Anyone suspected of having a severe head injury should seek immediate medical attention and follow a strict protocol for rest and a gradual return to play. It is important to note a person may not lose consciousness if they suffer a concussion; however, major consequences can occur if not properly managed. If you suspect you have an emergency that needs immediate medical attention, please call 911 or visit an emergency room near you. While it is impossible to prevent traumatic brain injuries altogether, the severity of the injury can be mitigated through proper helmet usage and knowing your skill level when participating in high-risk activities. The guidelines for picking a helmet for summer activities such as mountain biking, dirt biking and riding off highway vehicles are similar to those of picking a helmet for winter sports. Learn more about choosing the right helmet. Any blow to your head, neck or upper body can result in a major head injury Signs to watch for include the following: Headache Dizziness Blurred vision Difficulty with thinking, attention or memory Sensitivity to noise or light Ringing in the ears Changes in hearing Double vision Changes in behavior Balance issues Nausea/vomiting   Sprains: The Annoying Twist One of the most common sports injuries is a sprain, which occurs when ligaments that connect bones are stretched or torn. Sprains typically occur in joints, such as the ankle, knee or wrist, and are often caused by sudden twists or impacts. Symptoms may include: Pain Swelling Bruising Limited range of motion Rest, ice, compression and elevation (RICE) are the initial recommended treatment, followed by physical therapy to regain strength and mobility.

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