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Pulmonary and Sleep Medicine
Pulmonary Medicine Our expert pulmonary medicine team diagnoses and cares for patients with lung and breathing challenges. Serious breathing problems and long-term conditions, such as COPD and emphysema, are treated by our extensively trained providers. Our board-certified care team has the experience and clinical judgment to ensure the strongest possible patient outcomes. If you have a chronic lung condition diagnosis, you may also benefit from Renown Pulmonary Rehab. Conditions We Treat Asthma Bronchitis (acute and chronic) Chest infections Chronic obstructive pulmonary disease (COPD) Cystic fibrosis Emphysema Lung cancer Lung transplant Pulmonary fibrosis Pulmonary hypertension Pulmonary tuberculosis (TB) Other chronic lung diseases Pulmonary Services
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Lung Cancer Screening and Early Detection
Lung cancer is the leading cause of cancer deaths in both men and women in the U.S. The good news is the five-year survival rate increases dramatically if lung cancer is treated before spreading to other parts of the body. Julie Locken, MD, of Renown Health Imaging, explains more. What are the signs and symptoms of lung cancer? As you might expect, most lung cancer symptoms appear in the chest and can affect your breathing. Watch for signs such as: Persistent cough Constant chest pain Shortness of breath Wheezing Bloody or rust-colored phlegm Hoarseness Swelling of the neck Pain or weakness in the shoulder, arm or hand Recurring pneumonia, bronchitis or other lung infections Loss of appetite and loss of weight can also be signs of lung cancer That said, there are usually no symptoms in the early stages of lung cancer, which means getting screened can truly be a lifesaver. If you have a history of smoking, you should get screened as a precaution. What are the risk factors of lung cancer? Around 80% of lung cancer cases stem from a history of smoking tobacco. But there are other known causes, such as secondhand smoke, radon, asbestos and diesel exhaust. It’s important to do what you can to eliminate exposure to all of these to reduce your lung cancer risk. People with an immediate relative – a parent, sibling or child – diagnosed with lung cancer and people between 50 and 80 years old are also at higher risk and may need to consider screening. People who are at the highest risk are those with a history of smoking tobacco, particularly smokers who averaged one pack of cigarettes per day for 20 years or more, as well as former heavy smokers who quit in the last 15 years.
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Living with COPD? How to Maximize Your Summer Experience
June offers an official welcome to summer and the height of outdoor activities in northern Nevada such as hiking, camping, days spent at the lake and embracing long days and warm evenings with friends and family. Enjoying all that the summer season has to offer may not be as easy for those living with chronic obstructive pulmonary disease, or COPD, which effects more than 15 million Americans. What is COPD? COPD is a group of lung diseases including emphysema and chronic bronchitis that result in airflow blockages from the lungs. People may experience frequent coughing and shortness of breath among other symptoms. COPD typically impacts adults ages 65 and older and is becoming increasingly more common among women. Although smoking plays a key role in the development of COPD, air pollution and indoor air quality, and respiratory infection also contribute to disease development. While there is no cure for COPD, limiting progression of disease and managing symptoms can be achieved through lifestyle changes, therapy, and medications. Tips for Living with COPD This Summer, and Always Stay Hydrated: Staying hydrated is extremely important for people with COPD, especially during the summer. Not drinking enough water can make breathing more difficult because it increases respiratory symptoms. Make sure to always keep a water bottle with you and aim to drink 8-10 glasses of water daily. Be Mindful of Temperature: COPD symptoms can be exacerbated by hot weather. It is best to participate in outdoor activities during the cooler times of day, like the morning or evening. Check Air Quality Before You Go: Before engaging in outdoor activities, be sure to check the air quality index and plan your activities accordingly. Pace Yourself: Exercising can be difficult for people who have COPD. To make the most of your summer, try not to push yourself too hard and take breaks when you need them. If you start to feel out of breath or tired, take a break in a cool, shaded area until you feel better. Take Matters Into Your Own Hands To address the needs of community members living with COPD, the Renown Health Research Office has teamed up with Pulmonary Medicine to provide patients who are former or current smokers and have a history of frequent exacerbations with an option to participate in the ARNASA study. "COPD exacerbations have a huge negative impact on patient’s lung function” states Dr. Farah Madhani-Lovely, Chief of Pulmonary Medicine at Renown Health and Assistant Dean of Clinical Research at the University of Nevada, Reno School of Medicine. “We have had inhalers and prednisone for decades but patients are still having exacerbations. Now we have a new pathway we think will prevent exacerbations which is what this clinical trial is designed to prove.” This study will evaluate the efficacy and safety of astegolimab compared with placebo in participants 40-80 years of age with COPD. “This study in particular is so exciting because of the enthusiasm from the sponsor’s end” says Katie Buckley, Lead Clinical Research Coordinator working on pulmonology studies at Renown’s Clinical Research Office. “Often times sites aren’t assigned particularly passionate or engaged personnel who aid in carrying out these studies, but you can tell Roche Genentech’s team truly cares about the success of the study, the safety of their participants, and proving the efficacy of the investigational agent. Working on a study like this takes a village, and when the individuals on all ends share similar mindsets and work towards success as a collective unit instead of as individual moving parts, it’s amazing to see everything we’re able to accomplish.” Renown’s team of expert pulmonologists and researchers are available to join patients with COPD in support of their healthcare journey. If you are interested in learning more about this clinical trial option at Renown Health, talk to your pulmonologist at your next appointment or contact us at 775-982-3646. At Renown Health, our goal is to make it easy for patients to access clinical research as a care opportunity where patients can access a variety of standard care treatment options for their health condition or choose to participate in a clinical trial. For more information about clinical trial opportunities available to you or to ask any questions, contact the Renown Research Office at Renown-CRD@renown.org or 775-982-3646.
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Three Emergency Room Options for You and Your Family
Renown Health has three emergency rooms open 24 hours a day, seven days a week, ready to serve our community. We checked in with Amy Hawkins, Manager of Clinical Nursing at Renown South Meadows, to learn more about the emergency room experience and how each can accommodate your emergency care needs. 1. Renown Regional Emergency Room The emergency room at Renown Regional Medical Center is the only Level II Trauma Center between Sacramento and Salt Lake City, treating more than 80,000 ER and trauma patients annually. Services Offered: This location offers immediate emergency care covered by general surgeons and coverage by the specialties of orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology and critical care. In addition, tertiary care needs include cardiac surgery, hemodialysis and microvascular surgery. (Patients may be referred to a Level I Trauma Center.) Renown Regional ER Location 2. Renown South Meadows Emergency Room South Reno is expanding, and so is Renown South Meadows ER! Exciting transformations are happening across this campus, including the new 121,000-square-foot specialty care center and upgrades to the existing medical center—expanding care to our patients. Added benefits to the more intimate setting at South Meadows: Smaller ER also means more personal experience. The team traditionally has more time to spend with each patient at the bedside. A smaller campus means convenient parking, as the ER is just outside the front entrance; however, patients are reminded to follow marked road signs when approaching the campus during construction. Most patients arrive by private vehicle versus an ambulance, so we are very accustomed to thinking quickly on our feet. Benefits to new construction: A new Cath lab will allow us to treat patients experiencing a heart attack and needing immediate intervention to open vessels in their hearts. Additional lab and imaging capabilities for our patients Services Offered: This location offers immediate emergency care staffed with board-certified emergency physicians. Patients can expect one-on-one interactions with trusted providers and shorter wait times. All emergency room services are open during construction, and patients are reminded to follow marked road signs when approaching the campus. South Meadows ER Location 3. Renown Children's Hospital Emergency Room This location offers immediate emergency care, with pediatric specialists always on staff. In addition, the Children's ER lobby is ideal for our littlest patients, with a child-friendly atmosphere and vibrant colors to help decrease the anxiety accompanying emergencies. Medical equipment is sized just for kids, and we offer a distraction machine, games and movies to help children cope with what can be a traumatic experience, like getting an IV. In addition, we have Child Life Specialists available to provide emotional support to both children and their families. When to Bring Your Child to the ER: Allergic reactions Asthma attacks Baby under three months old with a temperature higher than 100.4 degrees Fahrenheit Broken bones Burns Choking or poisoning Difficulty breathing Eye injuries Fainting, dizziness and confusion Head injuries Heart attack Rashes Seizures Severe bleeding Severe headache Severe pain Skin infections Stitches Stroke Venomous stings and bites Renown Children's Hospital Location
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As 70,000+ People Congregate for Burning Man, 100 Miles Northeast of Reno, Renown Health’s Emergency Teams and Hospitals Prepare to Serve
Burning Man is an annual event inspired by the values reflected in the Ten Principles and united in the pursuit of a more creative and connected existence in the world. As over 70,000 congregate this week, between Aug. 27 to Sept. 4, in the high altitudes of the hot and windy Black Rock Desert, Renown Health’s emergency and clinical care teams are ready to care for Burners who may find themselves ill and in need of additional urgent, emergent care or hospitalization. This year, people from across the world are expected to make the journey in RVs and cars brimming with tents, food, water, artwork, and costumes, temporarily turning Black Rock into the state’s third largest city. “The Burning Man Project has done an excellent job preparing participants to have a safe, healthy, and wonderful time building Black Rock City and living on the playa for nine days to nurture the distinctive culture emerging from that experience. However, bringing over 70,000 people together in a high altitude, desert environment with limited access to water, food, and sanitary conditions- always presents a challenge,” says Brian Erling, MD, MBA, president and CEO of Renown Health and an experienced emergency medicine physician. “Having excellent care on the playa and plans in place back here in Reno helps to mitigate that risk and ensure the health and safety of all participants.” “We welcome every Burner to northern Nevada,” says Bret Frey, MD, the board-certified emergency medicine physician who heads up the largest Emergency Department at Renown Regional Medical Center; which has the highest-level trauma center for 100,000 miles, located in Reno, NV. Dr. Frey has 23 years of experience in the medical field, and 23 years of experience treating people who have experienced Burning Man. “Burning Man is a fascinating event, and most people have a great time. However, if things go wrong, they are fortunate to have the BlackRock City Emergency Services Department, 24/7, to help. Back here in Reno, we serve as their ‘back up,’ providing care as needed, for the ill and injured and supporting clinical teams when they’re feeling overwhelmed.” Renown Health is home to three 24/7 Emergency Rooms that provide the highest level of emergency and trauma care in the region: Renown Regional Medical Center is the only Level II Trauma Center between Sacramento and Salt Lake City. Located near downtown Reno, this Emergency Room has several helipads and ambulance banks for patients requiring emergency and trauma care. Renown Children’s Hospital at Renown Regional Medical Center is home to the only Pediatric Emergency Room in the region designed just for kids. This location is staffed by pediatric specialists and provides child-sized equipment and family-friendly areas. Renown South Meadows Medical Center includes South Reno’s first 24/7 Emergency Room. Located just off I580, this location is designed to treat patients who need immediate attention for emergencies. These locations are designed to assess and care for emergency situations, including: Heart attack symptoms Stroke symptoms Broken bones Shortness of breath Seizures Severe bleeding Head injuries Chest pains Severe pain Venomous stings and bite All of Renown’s emergency rooms are staffed by Northern Nevada Emergency Physicians, including pediatric specialists and physicians who have completed fellowship training in specialty areas such as sports medicine, ultrasound and emergency medical services. A few interesting medical conditions (Playa Foot and Playa Lung), are associated with Burning Man. The Black Rock Desert in northwestern Nevada is part of the lakebed of the ancient Lake Lahontan, a deep lake that existed 15,000 years ago. Lake Lahontan left fine sediments on the lake bottom to form the extremely flat surface. Playa dust is made of both larger and smaller particulate matter. The Playa dust is in the air, on the ground, and on everything in Black Rock City. People combat the dust with masks, bandannas, and colorful respirators to keep the chalky dust out of their mouths and nostrils, but the effort is often futile. Playa Foot is a malady unique to the Black Rock Desert caused by the alkali dust that makes up the desert. It is, in essence, a chemical burn. The best prevention is keeping feet covered as much as possible, applying a moisturizing skin lotion before bed and wearing socks and closed shoes each day on the playa. “Playa Lung, where the particulate is breathed into the lungs, may cause coughing, throat pain and loss of voice in the short-term,” says William Graham, MD, a specialist in Pulmonary Medicine and Critical Care Medicine at Renown Health. “The dust can cause health issues for smokers, children and elderly and people with pre-existing conditions like asthma and COPD. The best prevention is to get a mask that’s comfortable with n99 filters, wear the mask as much as possible and change the filters often. Be sure to drink lots of water and take protection from windstorms. A doctor visit is recommended if any effects of breathing in dust persist beyond a week or two.” Dr. Derek Beenfeldt is the Chief Medical Officer for Renown’s not-for-profit insurance arm HometownHealth, and has been a frequent participant in the Burning Man experience over the years. In the interest of wanting every person to have a wonderful experience while here- especially since over half of the participants live outside the U.S. health care system, he reminds people of the number of free and low-cost on-site health care and testing resources provided on the playa at Black Rock City. “It is important for Burning Man participants to know that without US health care insurance coverage, the costs can be significant for transportation off the playa for a medical evacuation, hospital emergency department care or hospitalization. Even for people who have insurance, in the past, some have faced some significant out-of-pocket expenses for the flight or transportation to Reno-area hospitals or emergency departments.” He shares the following information; On Site Medical Response A community of EMTs, paramedics, nurses, medical students, and physicians are on site at Black Rock City in RVs to provide emergency response and urgent care to participants as needed. Local Hospital Response Since 2011, the Burning Man organization, has contracted with Humboldt General Hospital in Winnemucca, Nev., to staff and equip Rampart Urgent Care, a field hospital that offers X-rays, ultrasounds, a hand-held head scanner, lab tests and a pharmacy. The single-room wooden structure is easily seen- it is painted pink and yellow. The hospital’s 40 beds are located in adjoining tents. At Rampart, when possible, patients are treated on site. EMTs, medics and nurses are empowered to practice medicine to the fullest ability their licensing and credentialing allow. Patients are not charged for Rampart Urgent Care services, which is covered as part of their ticket fee. The Nevada State Health Division, Bureau of Health Protection Services is also on the playa. You will know them by the Nevada State Health Division logo on their shirts. All Renown’s physicians remind people that if they are experiencing symptoms of a heart attack or stroke, they should go to the closest emergency room (ER) to get needed medical care. Delaying care for a medical emergency, such as a heart attack or stroke, can be life threatening or lead to serious complications. About Renown Health Renown Health is the region’s largest, locally governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination, and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health. For more information, visit renown.org.
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Thomas S. Dolan Pulmonary Rehabilitation Program Receives Esteemed Certification by Industry Leader
The program becomes first of its kind to be accredited in Nevada. Renown Health is pleased to announce the certification of the Thomas S. Dolan Pulmonary Rehabilitation program at Renown South Meadows Medical Center by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). AACVPR certification demonstrates that an organization's Pulmonary Rehabilitation Program is aligned with current guidelines set by the American Association of Cardiovascular and Pulmonary Rehabilitation for appropriate and effective early outpatient care of patients with cardiac or pulmonary issues. Certification offers peace of mind, so that patients can feel confident in knowing that staff has the experience and skills necessary to coordinate the many issues faced by people receiving a life-changing cardiac or pulmonary diagnosis. Pulmonary rehabilitation programs help people with health issues such as asthma, chronic bronchitis, pulmonary fibrosis, or chronic obstructive pulmonary disease (COPD) recover faster and live healthier. “Having access to quality pulmonary rehabilitation services so close to home, staffed by a highly-skilled group of compassionate care providers, truly is a gift to our community,” said Tony Slonim, MD, DrPH, president and CEO of Renown. “We are extremely proud of the work being done in our pulmonary rehabilitation program, and also forever grateful for Tom Dolan’s donation to the program in 2019, which empowers Nevadans to improve both their health and quality of life.” “Thomas S. Dolan Pulmonary Rehabilitation is the only accredited pulmonary rehabilitation program in the state of Nevada,” said Renown South Meadows Medical Center and Rehabilitation Hospital Vice President Chris Nicholas. “We take pride in this distinguished honor from the AACVPR as it acknowledges and amplifies the life-changing work happening here. Our dedicated caregivers provide support to our patients every step of the way, helping them lead vibrant and fulfilling lives despite their health conditions.” The comprehensive pulmonary rehabilitation program at Renown South Meadows Medical Center offers treadmills, stationary bicycles, strength training and an education classroom to help patients achieve health goals. To earn accreditation, Renown’s pulmonary rehabilitation program participated in an application process requiring extensive documentation of the program’s practices. AACVPR Program Certification is the only peer-review accreditation process designed to review individual programs for adherence to standards and guidelines developed and published by AACVPR and other related professional societies. In November 2019, Tom Dolan, owner and founder of Dolan Auto Group, donated to the Pulmonary Rehabilitation at Renown South Meadows Medical Center after his personal experience thriving in pulmonary rehabilitation brought northern Nevada’s capabilities, and needs, to his attention. His generous donation has allowed Renown to double the number of patients who receive treatment and increase the access to pulmonary rehab in our community. “As a former patient myself, I found so much benefit in my pulmonary rehab,” said Dolan. “I have always wanted to support this program and increase the number of people it serves. It’s great to see that we now have the only certified pulmonary rehab in Nevada.” “The most essential component of lung health is breaking the cycle of inactivity associated with lung disease,” said Lung Critical Care Physician Dr. Farah Madhani-Lovely. “Our community is fortunate to have an accredited program like this to empower our patients.” About Renown Health Renown Health is the region’s largest, locally owned and governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health. Renown’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Heath, Neurosciences and Robotic Surgery. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project® . For more information, visit renown.org. About AACVPR Founded in 1985, the American Association of Cardiovascular and Pulmonary Rehabilitation is a multidisciplinary organization dedicated to the mission of reducing morbidity, mortality and disability from cardiovascular and pulmonary disease through education, prevention, rehabilitation, research and disease management. Central to the core mission is improving the quality of life for patients and their families. Learn more about AACVPR at www.aacvpr.org.
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Wildfire Smoke More Dangerous Than Other Air Pollution for People With Asthma
Stage 2 Air Quality Index and alarming research studies from DRI, Renown Health and the Washoe County Health District leads to public health advisory- seek care if needed For people who suffer from asthma, wildfire smoke is more hazardous than other types of air pollution, according to a study from the Desert Research Institute (DRI), the Renown Institute for Health Innovation (Renown IHI) and the Washoe County Health District (WCHD). The study published in the journal Environmental Health examined associations between airborne particulate matter (PM) from sources such as wildfire, transportation and industry, and medical visits for asthma at Renown Health’s emergency departments and urgent care centers in Reno, Nev. during the six-year period from 2013-2018. In places like Reno, where wildfire events occur regularly during parts of the year and are expected to become more frequent in the future, an accurate understanding of the impacts of wildfire smoke on population health is critical. We have an exceptional process in place through our urgent care sites, Renown Medical Group offices and hospital emergency departments to screen, diagnose and treat members of our community who come to us for care related to asthma, chronic obstructive pulmonary disease (COPD), chronic bronchitis, emphysema, and other upper respiratory diseases that may be exacerbated by wildfire smoke. At the same time, we continue to develop and refine, in real-time, the data that supports our predictive analytic models. We are using every tool and resource-including scientific data and clinical reporting, to ensure that we are meeting both the health and healthcare needs of the people we serve. In the study, researchers found that air quality in the Reno area was affected by wildfire smoke on a total of 188 days during the study period. A total of 18,836 asthma-related emergency room and urgent care visits occurred over the same five-year period of time, indicating that the influences of wildfire smoke and other types of air pollution on this medical condition are important to understand. The Washoe County Health District – Air Quality Management Division (AQMD) has issued a Stage 2 Air Pollution Warning due to smoke from area wildfires. Air quality in the Reno-Sparks area is now “Very Unhealthy” with an Air Quality Index of 247. The Stage 2 warning means that all residents should stay indoors and reduce activity levels due to the susceptibility of increased health risks. To see current air quality in Reno-Sparks, click here. Brion Hill, MD who practices at the Renown Urgent Care - Los Altos location warns, “This is an important health advisory, exposure to elevated PM2.5 (fine particulate matter in smoke) concentrations can result in eye and throat irritation, headaches, nausea, shortness of breath, congestion, coughing, impaired lung function and chest pain. Everyone should take precautions when the air quality is unhealthy. Air pollution can aggravate heart and cardiovascular disease as well as lung diseases like asthma and COPD. When the air quality is unhealthy, people with these conditions may experience symptoms like chest pain, shortness of breath, wheezing, coughing, or fatigue. If you are experiencing any of these symptoms, use your inhalers as directed and contact your health care provider,” says Dr. Hill. “If you do not have a health care provider, we have 11 conveniently located Renown Urgent Care offices with providers ready to see you 7 days a week." Dr. Joseph Grzymski, a research professor at Desert Research Institute, a corresponding author on the study and Chief Scientific Officer, Renown Health, says, “This air is very bad for your health. Given today’s Air Quality Index in Reno, being outside and breathing this air for a day equals about smoking half a package of cigarettes.” Additional Information: The full text of the article “Particulate matter and emergency visits for asthma: a time-series study of their association in the presence and absence of wildfire smoke in Reno, Nevada, 2013–2018,” is available from Environmental Health: https://ehjournal.biomedcentral.com/articles/10.1186/s12940-020-00646-2 To learn more about the Renown Institute for Health Innovation, please visit: https://www.dri.edu/renown-ihi/ Renown Urgent Care provides treatment for a wide range of minor injuries, illnesses and medical concerns that are urgent but not life-threatening, that require same-day medical attention and avoid the long wait times and high prices of the emergency room at 13 convenient sites, including Reno, Sparks, Carson City, USA Parkway, Fallon and Fernley. You can walk-in or book ahead online. The Washoe County Health District offers online health information on its Be Smoke Smart website, including fire information, daily air quality information, fire and smoke maps and how to protect yourself. About the Desert Research Institute The Desert Research Institute (DRI) is a recognized world leader in basic and applied interdisciplinary research. Committed to scientific excellence and integrity, DRI faculty, students, and staff have developed scientific knowledge and innovative technologies in research projects around the globe. Since 1959, DRI’s research has advanced scientific knowledge, supported Nevada’s diversifying economy, provided science-based educational opportunities, and informed policymakers, business leaders, and community members. With campuses in Reno and Las Vegas, DRI serves as the non-profit research arm of the Nevada System of Higher Education. For more information, visit www.dri.edu. About Renown Health Renown Health is a locally governed, not-for-profit integrated healthcare network serving northern Nevada, Lake Tahoe and northeast California. Renown is one of the region’s largest private employers with a workforce of more than 7,000. It comprises three acute care hospitals, a rehabilitation hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown has a long tradition and commitment to improve the care and the health of our community. For more information, visit renown.org.
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