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Let Those Ears Breathe! Increased Headphone and Ear Bud Use Leads to Ear Wax Build Up; Renown Urgent Cares Offer Relief
Wearing headphones or earbuds is a daily activity for many of us. Listening to music, podcasts, meetings, phone calls; there are endless reasons to stick them in or on your ears. However, if your ears start to feel plugged, full; or you feel dizzy, lightheaded or hear ringing in your ears; you may be experiencing ear wax build up where your ear canals become blocked and affect your hearing. If you’ve tried to clean your ears (please don’t use Q-Tips®), but still have symptoms, pain, or hearing loss, it’s time to see your physician, nurse practitioner, physician assistant or visit Renown Urgent Care. “Ear wax isn’t dirty. It’s normal,” says Ryan Bristol, APRN, Advanced Practitioner of Nursing at Renown Urgent Care. “Ears are self-cleaning miracles, and naturally clean themselves with the help of jaw movement and skin migration. However, wearing headphones or earbuds for hours blocks earwax from naturally draining from the ear. Additionally, the dirt and bacteria that these headphones often carry can cause an infection on their own, and earwax buildup can trap dirt in the ear and block the canal completely. The snug fit of headphones can create a conducive environment for the accumulation of ear wax. It's crucial for individuals to be mindful of this and take necessary precautions to prevent complications." “Individuals experiencing symptoms such as ear pain, decreased hearing, or a sensation of fullness in the ears are encouraged to seek evaluation and treatment at their nearest urgent care facility,” says Rahul Mediwala, MD, CEO of Renown Medical Group. “By addressing ear wax build-up promptly, individuals can mitigate the risk of complications and maintain optimal ear health. Fortunately, prompt, pain-free and effective treatment is available at Renown Urgent Care. We offer professional ear wax removal procedures performed by trained staff, providing relief to those experiencing discomfort or hearing impairment due to excessive ear wax build-up.” The experts at Renown Health gave us some background. What is ear wax and why is it healthy? Ear wax is a protective substance called sebum made of fat, skin cells and sweat. Ear wax is produced by glands in the ear canal. It helps protect the ear from germs and dirt and prevents the sensitive skin of the ear canal from becoming irritated. It is normal and healthy to have a thin lining of ear wax on the canal. Ear wax will sometimes accumulate and move to the outer ear canal, where it would typically fall out or be wiped away. This is also normal. When should I seek care? An ear canal has too much wax if the ear feels plugged or hearing is affected. The accumulation of wax happens very gradually, so ears do not necessarily feel waxy. The problem is usually noticed because of changes in hearing. Over the counter remedies may offer relief. However, in some cases, the earwax has built up or become impacted, and ears need to be treated. What is the treatment? At Renown Urgent Care, we offer professional ear wax removal procedures performed by trained staff, providing relief to those experiencing discomfort or hearing impairment due to excessive ear wax build-up. Wax is flushed from the ear canal using a syringe filled with warm water and saline or diluted hydrogen peroxide. Most patients find the procedure is fast, pain free and effective. How can I prevent earwax buildup from headphones and ear buds? Most people who wear headphones or use earbuds occasionally or intermittently don’t have difficulties with excessive ear wax. Wax accumulation also depends on the size of the ear canals and the productivity of the oil glands in the ear canal. You can choose to use over the ear headphones. If you prefer to use in-ear headphones, the best modes of excess ear wax prevention are to: Clean headphones and earbuds regularly with a cloth or disinfectant wipes; Avoid sharing headphones or earbuds with other people; Take breaks from headphones and earbuds so ears can breathe and get back to normal; Pay attention to your ear health. Should we talk about Q-tips? Yes! Q-tips (and similar products) are rarely helpful for managing ear wax. The cotton on the end of the Q-tip is usually unable to pull the wax out of the canal. Worse, they can push the wax deep inside the ear canal, and it can end up impacted. Where should I seek care? Individuals experiencing symptoms such as ear pain, decreased hearing, or a sensation of fullness in the ears are encouraged to seek evaluation and treatment at a medical facility. By addressing ear wax build-up promptly, individuals can mitigate the risk of complications and maintain optimal ear health. Renown Urgent Care sees patients 365 days a year for medical concerns that are urgent but not life-threatening at many locations across northern Nevada. Book ahead to reserve a time slot at one of our ten urgent care locations. If you do not see time slots that work for you, you can still go to any location that has "walk-ins available" listed. For more information, or to book an appointment, go to renown.org/Health-Services/Urgent-Care. Renown Health is the region’s locally governed, not-for-profit integrated health care network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 7,200 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 locally owned not-for-profit insurance company, Hometown Health.
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Researchers at Renown Seek Convalescent Plasma Study Participants
Physician researchers seek to understand how the immune system responds to COVID-19 and create a healthier Nevada. During the early stages of the pandemic, convalescent plasma was considered the only viable treatment option available for patients with COVID-19. Convalescent plasma is the component of the blood from recovered patients that may contain COVID-19 antibodies that help fight the infection. The National Institutes of Health has since developed treatment guidelines for COVID-19 based on clinical trial data and many studies are still underway worldwide assessing various additional treatment options. Convalescent plasma was in high demand but difficult to locate for COVID-19 patients in the northern Nevada area. A 24-year-old nursing assistant, Austin Meegan, was hospitalized and spent weeks staving off kidney and lung failure before learning he was eligible for an experimental blood transfusion that showed promise in treating COVID-19. Doctors estimated Meegan had only about a 3% chance of tracking down a donor to match his rare blood type. A COVID-19 survivor, Thomas Gibson, a Texas resident with the same blood type, traveled to Reno to donate his viral antibodies and a convalescent plasma donation credited with helping to save Meegan’s life. Physician clinical researchers and scientists at Renown and the University of Nevada, Reno School of Medicine (UNR Med) knew they needed to create better options for patients and physicians. Clinical researchers developed a study to help other patients like Austin, and pleaded for donations from recovered COVID-19 patients to donate their convalescent plasma. The researcher teams looked to understand how the body’s immune system responds to the virus over time, to aid them in developing new treatments for COVID-19. “The world’s capacity to get through the COVID crisis will depend on four things — science, technology, innovation and partnerships, says Tony Slonim, MD, DrPH, President and CEO of Renown Health. “Taking lab bench discoveries to the bedside of patients in an efficacious and timely manner is not easy, but with UNR Med and our partners, we are making great strides in advancing clinical research which has the power to save lives and to create a healthier Nevada.” “It’s tremendously promising to partner on clinical research that will not only help us better understand the disease, but help inform treatment for those combatting COVID-19 that has had such a devastating impact on Nevadans, our nation and the world,” says UNR Med Dean Thomas L. Schwenk, MD. Renown, UNR Med and other area health care partners collaborated with Vitalant to collect plasma from recovered donors for a study on the treatment's efficacy. Eligible donors are at least 18 years old, weigh more than 110 pounds and are healthy. Donors had fully recovered from a confirmed diagnosis of COVID-19. Project coordinators at the Renown Research Office were overwhelmed by the community’s support and plasma blood donations. Additional partnerships with the Washoe County Health District, the State of Nevada and the Governor’s office, Saint Mary’s Medical Center, Northern Nevada Medical Center, Carson Tahoe Health and the VA Sierra Nevada Health Care System, along with many area health care providers helped the team meet their goals of enrolling 120 eligible participants in the study. “Our success in this study rests heavily on the support of our great community, as well as the innovation and collaboration demonstrated by Renown and UNR Med,” said Sara Healy, MD, MPH, principal investigator of the study and a pediatric infectious disease physician at Renown Children’s Hospital and UNR Med. “We are proud to be at the forefront of conducting essential research during such a pivotal time in history, and look forward to our continued partnership as we continue this important work.” “The control of COVID-19 in our communities relies on testing. The study that is being launched to develop a sensitive, specific and easier way to collect specimens (blood) is advancing the field and brings promise towards getting to our common goal of having the right diagnostic test for the right clinical situation at the right time,” says Mark Riddle, MD, DrPH, FISTM, associate investigator of the study and associate dean for clinical research and professor at UNR Med's Department of Internal Medicine and Medical Research. The research team is now asking area residents to participate in a study to analyze the efficacy of two COVID-19 tests. Participants will undergo two blood tests: one being a finger stick to provide results for a rapid test, and the other is a traditional venipuncture draw confirming the presence or absence of COVID-19 antibodies. This study is a collaboration with InBios International, Inc., a leading biotechnology company based in Seattle. Researchers are seeking: Individuals who have confirmed positive for COVID-19 and who have recently recovered from the virus. Study participants must be within 7-28 days from the onset of their symptoms. Individuals who have recently tested negative for COVID-19 and have never tested positive. Those who are interested in participating in the study may contact project coordinators at the Renown Research Office at (775) 982-3646, or via e-mail at covidplasmascreening@renown.org, 7:30 A.M. – 5:00 P.M., Monday through Friday. Individuals aged 18-75 in general good health are encouraged to consider participating in this ongoing study. There is no cost to participate in this study and participation is voluntary. An individual’s decision to participate will not affect their current or future relations with their health care provider(s), health district, or the community. Those who decide to participate are free to withdraw at any time. “Time is of the essence with COVID. If we can get test results to people and their clinicians in a more timely way, we can make a faster diagnosis of a patient's condition, says Christopher M. Kozlowski, MD, MHA, Renown's institutional research officer and Medical Director/VP of Renown Institute for Heart & Vascular Health. “As we refine the accuracy of our testing; we are applying sensitivity and specificity testing for true negative and true positive results. This provides people with more timely and accurate results and better quality care.” 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. About the University of Nevada, Reno School of Medicine The University of Nevada, Reno School of Medicine (UNR Med), Nevada’s first medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Established in 1969, UNR Med is improving the health and well-being of all Nevadans and their communities through excellence in student education, postgraduate training and clinical care, research with local, national and global impact and a culture of diversity and inclusion. For more information, visit med.unr.edu.
Read More About Researchers at Renown Seek Convalescent Plasma Study Participants
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Newly Expanded Clinical Research Center at UNR Med Fosters Collaboration and Research with Renown Health
Renown Health and the University of Nevada, Reno School of Medicine (UNR Med) are proud to announce a newly integrated and expanded research space called the Clinical Research Center (CRC). This space offers a dynamic physical location on the University of Nevada, Reno campus that supports the UNR Med and Renown Health research enterprise. "The partnership between Renown Health and UNR Med truly knows no bounds, and this Clinical Research Center is an incredible example of that endless possibility,” said Thomas Graf, MD, interim CEO of Renown Health. “This new space will only continue to expand our community’s access to clinical research as part of patient care while providing the necessary resources to engage our students and support a healthy Nevada.” This space’s capabilities include experienced staff with knowledge and skills in operationalizing FDA and non-FDA regulated clinical and translational research studies in a centralized 5,470-square foot research clinic housed in the Center for Molecular Medicine (CMM) at the University. This CRC space provides resources including: A centralized location next to the laboratory space that allows for strategic interdisciplinary collaboration between clinicians and basic scientists. Eleven private outpatient rooms for research clinic visits. Two blood draw stations. Physician consultation areas. Conference room for trial monitoring and consulting. Secure Investigational Product storage and preparation. Sample processing and storage, including countertop refrigerated centrifuges, 4°, -20° and -80° C refrigerators and freezers. Operations around clinical research are becoming more complex so growing clinical research in our community will require expertise and dedicated space where clinical research can be conducted in a learning environment first,” said Danielle Eaton, Director of Clinical Research with UNR Med and Renown Health. “This Clinical Research Center provides such space and experienced staff where these research studies can be successfully completed. The CRC provides a training environment for students, residents, faculty and clinical research professional work-force that will be needed to bring cutting edge diagnostics, therapeutics and preventatives to our community.” Meet the Team: Danielle Eaton, UNR Med Director of Clinical Research Kristen Gurnea, Renown Health Manager of Clinical Research Amber Emerson, UNR Med Project Manager Valerie Smith, UNR Med Center Administrative Manager Annie Beach-Hills, Gina Castro, Michelle Mejia and Amil Trujillo-King, UNR Med Study Coordinators Dr. John Westhoff, UNR Med Chair of Internal Medicine, Emergency Medicine physician Dr. Sean Kandel, UNR Med Associate Program Director for Resident Research, Associate Professor of Internal Medicine Dr. Amneet Rai, UNR Med Clinical research pharmacist Dr. Kellie Watkins, UNR Med Clinical Epidemiologist/Data Manager/Statistician As part of the affiliation between UNR Med and Renown Health, the Clinical Research Office is part of an integrated Office of Clinical Research, which allows both entities to collaborate on shared research program objectives. This effort allows colleagues to partner on clinical research, and to leverage bench-to-bedside research and delivery of leading-edge healthcare to northern Nevadans. 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. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project®. About UNR Med The University of Nevada, Reno School of Medicine (UNR Med), Nevada’s first public medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Since 1969, UNR Med has trained more than 3,900 students, residents and fellows. UNR Med continues to improve the health and well-being of all Nevadans and their communities through excellence in student education, postgraduate training and clinical care, research with local, national and global impact and a culture of diversity and inclusion. For more information, visit med.unr.edu.
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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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Testosterone, Men and Health: What You Need to Know
You probably know testosterone (T) plays an important role in how boys physically develop into men. But is that all you know? What happens when a man's T levels are off? Are there symptoms men should look for? And what are the treatment options? Dr. Bobby Kahlon, MD, Renown Medical Group provides answers in a Testosterone Q&A. What does testosterone do for men? "Testosterone is known as the 'manly hormone' for a reason," says Dr. Kahlon. "Though women also naturally produce small amounts of it, men produce testosterone at much higher concentration levels. And it affects men in more physical and obvious ways. How much hair a man has on his chest, how deep his voice is, or how muscular he is are all attributable in some way to testosterone. It's also responsible in large part for sex drive and bone strength and affects how men think, learn and experience their surroundings." Testosterone in men: Powers virilization (male physical characteristics) and sexual function Builds muscle mass and strength Supports bone density Improves cognition T Trivia: Discover Magazine reveals that “manly” testosterone and other sex hormones evolved long before we did — 500 million years ago — from the ultimate “female” hormone, estrogen. Can you have too much or too little testosterone? Though high testosterone isn't a concern for most men, low testosterone or low T occurs more frequently and develops for two primary reasons. Dr. Kuhadiya explains, "Subnormal testosterone concentrations occur either due to pituitary or testicular failure and the causes for each need to be discussed with your physician." Pituitary failure: Approximately one-third of men with obesity, type 2 diabetes, or metabolic syndrome (which includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels) have low free — or "bioavailable" — testosterone. These health conditions can cause the pituitary gland to "fail" to release follicle stimulating hormone (FSH) and luteinizing hormone (LH) which are essential for triggering testosterone and sperm production. And that can cause low testosterone (hypogonadism). Testicular failure: Though less common than pituitary failure, testicular failure may also be responsible for low T. It's caused by diseases or illnesses affecting the testicles, injury or trauma to the testicles, or certain medicines and treatments such as chemotherapy or opioid pain medication. Providing your complete medical history to your doctor is always the first step toward a proper diagnosis. What are the symptoms of low T? The following indicators could be a sign that you have low T, say the doctors. Lack of motivation and determination, including mild depression Loss of physical endurance and muscle strength Loss of or diminished early morning erections Reduced libido (sex drive) Erectile dysfunction (ED — difficulty achieving or maintaining an erection) Gynecomastia (male breasts) Small testes T and Time: T levels in men naturally begin to decline by about 1% a year starting at age 30. How do you test for low T? "There are different methods for testing testosterone levels," says Dr. Kuhadiya. "Each approach uses a blood sample to evaluate total testosterone, which includes free and attached testosterone that combines with proteins albumin and sex hormone-binding globulin (SHBG). For the most accurate results, testing is based on samples collected in the morning after fasting, and from tests on two different days." What treatment options are available? "Well, your best natural option may be YOU," says Dr. Kahlon. "Men with pituitary failure are often able to treat their low T by losing weight to increase levels of the hormone. And even if you don't lose weight, exercise can help boost your testosterone. Unfortunately, if you have testicular failure, weight loss and exercise may not have the same effect." So, are there other options? "You may want to consider Testosterone Replacement Therapy (TRT)," says Dr. Kuhadiya. "TRT is only available to men who are hypogonadal — with a clinical diagnosis of low T. Injection, gel, skin patch and nasal spray are available TRT options. The best option is the one that works best for the patient. Convenience, insurance coverage and cost are all factors to consider." Dr. Kahlon's TRT preference? Daily gel treatments, which are applied directly to the skin. On the other hand, Dr. Kuhadiya recommends intramuscular injections, which take place once a week or every two weeks. But both doctors agree on this: physicians and their patients need to weigh the benefits and risks of TRT before proceeding with treatment — especially if your low T condition may require lifelong treatment. "In my clinical practice, I have seen some very good long-term results with an improved quality of life," says Dr. Kuhadiya. "However, in certain situations, TRT may increase the risk of heart disease and is not recommended for men with a history of prostate cancer." Dr. Kahlon adds, "Patients receiving any type of hormone therapy need to be closely monitored throughout the treatment process for any changes in their health." How do you feel about steroids and T boosters? "I don't recommend them, certainly not for hypogonadism," advises Dr. Kahlon. "There is no evidence to support anabolic-androgenic steroids or testosterone boosters as a safe or effective treatment for low T in men." "In fact, there continues to be emerging evidence they may lead to side effects that could potentially harm the liver and the pituitary and endocrine functions of the body," warns Dr. Kuhadiya. "And that damage may be irreversible."
Read More About Testosterone, Men and Health: What You Need to Know
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How to Spot Depression in Men
Has a male in your life been affected by depression? This could be your father, husband, son, brother, friend, or co-worker. Men often struggle to recognize when they need help. Learn how to support them by understanding their unique signs of depression. Psychologist Dr. Herbert Coard discusses depression in men and its often-overlooked warning signs. Every year, over 6 million men are diagnosed with depression, which can manifest differently than in women. Commonly misread, the signs can include anger and aggression rather than sadness, leading to challenges for loved ones and healthcare providers in recognizing the condition. Behavioral Signs of Depression in Men High levels of the hormone cortisol are released during stressful situations affecting the neurotransmitter, serotonin (a feel good hormone), contributing to depression. You can identify depression or suicidal tendencies by paying close attention to the following behavioral changes: Anger, irritability, or aggression Avoiding family or social situations Losing interest in family responsibilities, passions and hobbies Lack of sex drive Becoming controlling/abusive in relationships Risk-taking behavior such as; unsafe sex, overspending or gambling Not being able to concentrate or remember details Excessive drinking or drug use Having frequent thoughts about death Talking about suicide Attempting suicide Factors That Lead to Depression in Men Life Events Work stress or long-term unemployment can be huge contributing factors relating to depression. This type of life event can be overwhelming, making it impossible for a man to cope. Changes in Relationships The loss of a relationship can be a significant contributing factor to the emergence of depressive symptoms and past experienced physical, sexual, or emotionally abusive relationships. With this in mind, counseling can often help individual to overcome this type of trauma. Grief and Loss Overwhelming sadness due to the loss of a loved one can trigger depression. Although normal, each person goes through their own grieving period. For example, normal responses to death are insomnia, poor appetite and loss of interest in activities. Pay attention if grief seems prolonged or out of the ordinary. Health Problems In particular, depression coexists with medical conditions. As men age, this can be passed off as normal aging, but it could be more serious. In addition, illnesses such as thyroid disorders, Addison’s disease and liver disease can cause depressive symptoms. Diabetes, cancer, heart disease, or Parkinson’s disease can affect any age, thus triggering or worsening depression. Some older men also feel like they may be suffering from dementia because of difficulties with memory this may be a symptom of depression. A trip to the doctor may be in order to help alleviate concern and worry. Depression in Men and Suicide Frequently the emotional pain occurring with depression can distort a man’s ability to see a solution beyond suicide. Individuals with depression become very rigid and constricted in the way they solve problems. The statistics below speak for themselves, helping us understand the need to reach out to those who need our support. Male suicide rates are on rising – men die by suicide 3.53 times more often than women, accounting for 70% of all suicides. Sadly, every day 129 men commit suicide. White males accounted for 69.67% of suicide deaths in 2017. In 2017, firearms accounted for 50.57% of all suicide deaths. Middle aged Men who are middle aged have the highest suicide rates. 40% of those identifying as transgender have attempted suicide in their lifetime. Males who are guy or transgendered are at an increased risk for suicide attempts, especially before age 25. Veterans often suffer from post-traumatic stress disorder (PTSD) and depression, and are more likely to act on a suicide plan. How You Can Help Now that you can identify some of the warning signs of depression, here’s how you can help: Talk about your concern and communicate that you’re there to help him. Let him know depression is a medical condition and will usually get better with treatment. Suggest professional help from a Primary Care Provider, Psychologist or Therapist. Help set up appointments and offer to accompany him – let him make the decision, but make it clear you’re there for him, no matter what he decides. If you feel he is in a dire or life-threatening situation, contact 911. Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to talk to a trained counselor. Call the Veteran’s Crisis Line at 1-800-273-TALK (1-800-273-8255) and press “1”
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Ovarian Cancer Survivor Shares Decision to Try Clinical Trial
While there used to be three basic treatment options for cancer -- surgery, radiation and chemotherapy, or a combination of the three -- there's a fourth option: clinical trials. Here, a Renown patient shares her successful battle with ovarian cancer, aided by a clinical trial. Shari Flamm's battle with ovarian cancer began in 2011. She was experiencing prolonged bleeding, irregular thyroid levels and anemia and was scheduled to undergo a hysterectomy. Before the surgery, her gynecologist ran routine tests to check for cancer as a precautionary measure. All tests were negative for cancer, expect her CA 125 test. A CA 125 test measures the amount of the protein CA 125 (cancer antigen 125) in the blood. In some cases, a CA 125 test may be used to look for early signs of ovarian cancer in women with a very high risk of the disease. In most laboratories, the normal level is 0 to 35 units/ml. Flamm's CA 125 level was 121. As Flamm can attest, early diagnosis played a key role in her battle with ovarian cancer. September is Gynecologic Cancer and Ovarian Cancer Awareness Month – an important time to learn the signs, symptoms and risk factors of this type of cancer so your doctor can diagnosis the disease as early as possible. Ovarian Cancer: Round One Despite the elevated CA 125 results, her doctor recommended they move forward with the hysterectomy. But when surgery began, doctors discovered a mass. She had stage 4 cancer. The procedure was halted, the mass was biopsied and she was immediately seen by Dr. Peter Lim of the The Center of Hope. Following diagnosis, Flamm underwent surgery with Dr. Lim to remove the cancer, which had spread to part of diaphragm, spleen, colon and other organs. Three months after surgery, Flamm had recovered enough to start six rounds of chemotherapy in her hometown of Carson City. She continued working at a doctor's office during her treatment, and was grateful for Dr. Lim’s ability to co-manage her care so she could stay close to work and family. “To me, chemo was the scariest part because I didn’t like feeling sick,” Flamm says. Thankfully, her body responded well to the treatments and she was back to the things she loved. “I stated working out at the gym, even if it was only for 10 minutes,” she says. She also stayed positive by spending time with her grandchildren, attending a San Jose Sharks hockey game, going for walks and enjoying concerts. Ovarian Cancer: Round Two In November 2014, Flamm had a cancer check-up. That’s when doctors discovered three cancerous tumors. For this round, Flamm choose another treatment option -- clinical trials at Renown Institute for Cancer. Clinical trials are the studies that test whether drugs work, and inform doctors' decisions about how to treat their patients. Flamm participated in a clinical trial that featured oral-targeted therapy stronger than IV chemotherapy. The hope was for the drug to shrink her tumors, however the result was stabilization -- meaning the lumps weren’t growing or spreading. The best part of the clinical trial, Flamm says, was the constant monitoring. Between the CT scans every six weeks, a heart scan every three months and monthly doctor visits, she was confident that if the cancer started growing or spreading, her healthcare team would catch it right away. For Flamm, the benefits of the clinical trial included less hair loss, less fatigue and more time to focus on what’s important in her life -- her family. “I decided I wasn’t going to be that sick grandma on the couch with cancer,” Flamm says. After taking the oral medication for one year, Flamm developed a rash and discontinued treatment due to discomfort. Clinical Trials, Setbacks and Survival In June 2016, two of the three tumors began to grow and had to be surgically removed. Despite the setback, Flamm was determined to maintain a positive outlook. "You have to stay positive because cancer feeds off anger, depression and stress," Flamm says. Flamm was released to go home with clear margins, meaning the tumors were removed and are surrounded by a rim of normal tissue that does not have cancerous cells. Flamm says her outlook on life has changed drastically since her first cancer diagnosis. “Your whole mentality changes when cancer disturbs your life," Flann says. "The things that weren’t important, are now ever so important. I’m a lot calmer now,” Flamm says.
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Take Charge of Your Sexual Health
Much like general physical and mental health, sexual health is an essential aspect of your overall well-being. Therefore, educating yourself on your sexual health is an important piece regarding your overall wellness. Secure & Private Virtual Visits Did you know that many sexually transmitted disease appointments can happen virtually, in the privacy of your own home? Our providers can perform a screening examination for sexually transmitted illness (without symptoms) when it’s convenient for you. This is a great option if the topic makes you uncomfortable during an in-person visit, or if you can’t find time to visit your primary care provider or local urgent care. After the telehealth appointment, your provider will determine the next steps for you. Remember, in-person visits are always an option as well. Here’s how you can take charge of your sexual health: Get Comfortable with Getting Tested Surprisingly, some people with STDs don't show symptoms, meaning they may not even know they have an STD unless they get tested. Even if an STD shows no symptoms, the result of non-treatment can be serious. Bret Michael Bellard, MD, with Renown Medical Group, shares that it’s important for people to get tested for STDs because if left untreated, they can cause the following health problems: Loss of fertility Pregnancy complications Other health issues When to Visit Your Primary Care Provider Who should get tested and how often? “The recommendations are that everyone from ages 13 to 64 should get tested at least once for HIV. All sexually active adults should also be tested for other STDs once a year, and all pregnant women should be tested at the start of their pregnancy,” says Dr. Bellard. Some STDs, like syphilis, can be passed from mother to baby, so it's important for women to get tested as soon as they know they’re pregnant. Dr. Bellard recommends going to your primary care provider for testing. “They can also give advice on prevention and other health topics.” If you don’t have a primary care provider, this is a great reason to get established with one. Women with an established OB/GYN can have STD testing done simultaneously with their annual pelvic exam. The providers in Renown's network care for patients of all ages and specialize in family medicine, internal medicine, pediatrics and OB/GYN. Practice Safe Sex STDs are preventable. Practicing safe sex and getting tested routinely are your best defenses against all types of STDs. For many, the conversation about sexually transmitted diseases is awkward and many avoid it. To lower your risk of contracting an STD, don’t wait until you’re “in the moment” to have the conversation with your partner about the last time you were both last tested. If you haven’t gotten tested in-between new partners, use latex condoms every time you have sex until you are both confirmed negative of STDs. Condoms are not 100% effective at preventing disease or pregnancy. However, they are extremely effective if used properly. To establish Primary Care, visit renown.org/virtualvisits or call 775-982-5000
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If You're a Soon-To-Be-Dad, We've Got Tips for You
“You’re gonna be a dad!” Whether you’ve been waiting years to hear those words or still think you’re too much of a kid to have a kid, the reality of impending fatherhood can be terrifying for any first-time, soon-to-be-dad. But not to worry, Best Medicine has some timely tips to help calm those bundle-of-joy fears and help you rock your new role as a brand-new, baby daddy. Winter is Where Babies Come From Fact: More babies are born in September than any other month, with spill over (and spit-up) into October. Subtract ten months for the typical 40-week, bun-in-the-oven baking time and early winter stands out as the top baby-making part of the year. Is it the cozy nights before a fire as people avoid the snowman-friendly temperatures outside? Possibly. There could be any number of reasons, both seasonal and otherwise, for what will eventually arrive in the fall and immediately steal your heart — and untold hours of your sleep. Though moms carry most of the baby burden traditionally (and literally for three trimesters), that’s no excuse for the soon-to-be-dad not to step up to the plate and take a swing at being the best partner and father on the planet. Below is a list of tips and resources to help you do just that. So read on, daddy-o. Tip #1: Don’t Freak Out Ok, you’re probably going to freak out even if we tell you not to. But once you calm down, consider this: human beings have been having babies for millions of years, and many of those soon-to-be-dads had it much tougher than we do today. And guess what? The human race is still going strong. Those first moms and dads did a good job — and you will too, with a little help. Tip #2: Take a Class Knowledge is power. In this case, it's diaper-changing, swaddle-wrapping, 2 a.m.-feeding power. And for you and your partner, taking a parenting class or two should be a no-brainer. You'll both learn what to expect and prepare for as you support each other and bond with your baby even before he or she arrives. Tip #3: Learn From Other Dads If the thought of sitting in a room full of full-bellied women and their partners makes you uncomfortable, you may opt to stick with bros for your lesson plan. Dad-only classes and soon-to-be-dad support groups — taught and led by seasoned fathers with tales to tell and words of wisdom to share — are available online and in cities and communities around the country. Dad-focused sites also offer advice for new and still-learning proud papas. Here are a few options to check out: Boot Camp for New Dads City Dads Group Wilderdad.com Fatherly.com Fathers.com Tip #4: Babies are Required Reading Haven't read a good book lately? Well, if you're expecting a baby, now is the time to flip through a few pages that could make your life a whole lot easier in a few months. There's no such thing as being too-well-read when it comes to your fast-approaching, adorable little poop machine. The least you can do is read a book or two, or seven. We're Pregnant! The First Time Dad's Pregnancy Handbook From Dude to Dad: The Diaper Dude Guide to Pregnancy We're Pregnant! The First Time Dad's Pregnancy Handbook What to Expect When Your Wife Is Expanding Be Prepared: A Practical Handbook for New Dads The New Dad's Survival Guide: Man-to-Man Advice for First-Time Fathers What to Expect When You're Expecting Tip #5: Be a Prepared Soon-To-Be-Dad Tips 1 through 4 are meant to help alleviate some of your jittery, new-dad anxiety. And we hope they do just that. But if you really want to hold that "Best Dad Ever" coffee mug starting on day one, there are also some practical things you can do to prepare. Check these items off your list now to make life with baby more baby-, mommy- and daddy-friendly from the get-go. Buy a baby/child car seat. Three out of four car seats are installed incorrectly. Protect your children by ensuring they are riding in a properly secured and age-appropriate car seat. Renown Children’s Hospital Car Seat Station is staffed by certified technicians who provide child vehicle safety restraint education, inspection and installation. Set up the baby's nursery early, including furniture Stock up on diapers and baby supplies Cook and freeze 2 weeks of food for nights when no one wants to cook Research family healthcare Agree upon a shared diaper-changing/feeding schedule Ask about paternity leave from work Get bills and finances up-to-date or pre-pay to avoid late charges Give the home a thorough cleaning before the baby arrives
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Keeping Kids Safe on Halloween
Halloween is around the corner. So while you're prepping pumpkins for carving, putting together creative costumes and coordinating trick-or-treating plans, safety is one more detail to remember. Masks, haunted houses, witches, ghosts and ghouls — it all spells Halloween, and what could be more frighteningly fun, right? For children, however, Halloween can indeed be frightening and not so fun. According to Dr. Kristina Deeter, Physician-in-Chief of Renown Children’s Hospital and Chair of Pediatrics for the University of Nevada, Reno School of Medicine, it is common for younger children to express Halloween fears — being afraid of monsters, the dark or really anything out of the norm. “It's normal for children to struggle with separating reality from fantasy,” she explains. For children who fall into this category, the month of October can be traumatizing. Halloween may not come until the end of the month. Still, in the weeks building up to the spookiest night of the year, little ones are bombarded on all sides with decorations — mummies, skeletons, coffins, vampires, you name it. For a child with a blossoming imagination who, as Dr. Deeter said, is still learning to differentiate real from pretend, this can cause additional fears and anxieties. In commemoration of Halloween Safety Month, Dr. Deeter shares safety tips for the spooky holiday from the American Academy of Pediatrics: Dressing Up & Heading Out Plan costumes that are bright and reflective. Ensure shoes fit well and that costumes are short enough to prevent tripping, tangling or coming into contact with flames. Consider adding reflective tape or striping to costumes and trick-or-treat bags and baskets for greater visibility. Masks can limit or block eyesight. Instead, consider non-toxic makeup and hats, which should fit properly to prevent them from sliding over the eyes. Test makeup ahead of time on a small patch of skin to test for allergies before full application. When shopping for costumes, wigs and accessories, look for and purchase those with a label clearly indicating they are flame resistant. If a sword, cane or stick is a part of your child's costume, make sure it is not sharp or long. A child may be easily hurt by these accessories if he stumbles or trips. Do not use decorative contact lenses without an eye examination and a prescription from an eye care professional. While the packaging on decorative lenses will often make claims such as "one size fits all," or "no need to see an eye specialist," obtaining decorative contact lenses without a prescription is both dangerous and illegal. This can cause pain, inflammation, serious eye disorders and infections, which may lead to permanent vision loss. Review with children how to call 9-1-1 (or their local emergency number) if they ever have an emergency or become lost. Carving Pumpkins Leave the carving to the grownups. Have children draw the pumpkin design with markers, but keep knives away. Consider using a flashlight or glow stick instead of a candle to light your pumpkin. If you do use a candle, a votive candle is safest. Candlelit pumpkins should be placed on a sturdy table, away from curtains and other flammable objects, and not on a porch or any path where visitors may pass close by. They should never be left unattended. Prepping Your Home Keep your entryway safe for trick-or-treaters by removing all items from the porch or front yard that a child could trip over, like garden hoses, toys, bikes and lawn decorations. To ensure visibility, check outdoor lights and replace burned-out bulbs. Sweep leaves (or snow) from sidewalks and steps. If there are dogs in the home, take steps to ensure they don't jump on trick-or-treaters. Hunting for Treats Young children should always be accompanied by a parent or responsible adult. Give each child and adult a flashlight (with fresh batteries). If older children are heading out to trick-or-treat alone, plan and review a route you can agree on, as well as a specific time they are supposed to return home. Only visit homes with a lit porch light. Never enter a home or a car for a treat. Notify law enforcement authorities of any suspicious or unlawful activity immediately. Since pedestrian injuries are the most common injuries to children on Halloween, remind youngsters to take crosswalk safety precautions. For more key tips regarding Halloween safety for your young trick-or-treaters, visit our partners at Safe Kids Worldwide for a variety of spooky safety resources.
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Take a Stand Against Domestic Violence
October is Domestic Violence Awareness Month in the United States. We spoke with Renown Health experts and local domestic violence prevention organizations who gave us a deeper look into understanding the warning signs of abuse and the many proactive and reactive resources in our community that you can reach out to today. Domestic violence, also referred to as domestic abuse, is an everyone issue. Whether you identify as male or female, an adult or a child, single or partnered – domestic violence can affect anyone. In fact, it may be closer to home than you might think. According to the Nevada Quality Parenting Initiative, in Nevada, 43.8% of women and 32.8% of men experience domestic violence in their lifetime, and the risk of that figure rising is imminent. This year alone, the Domestic Violence Resource Center (DVRC) in Reno experienced a 55% increase in overnight emergency stays, according to the Reno Gazette-Journal. This problem also, unfortunately, extends to children. More than 5,000 children in Nevada were reportedly primary or secondary victims of domestic abuse in 2021, as stated by the Nevada Coalition to End Domestic and Sexual Violence. “Domestic violence can manifest in many different ways,” said Kami Price, Supervisor of Social Services for Renown Health. “Abuse isn’t always strictly physical. It can also be emotional, verbal, sexual and even digital. Understanding those differences can help you prepare accordingly and respond safely if you or a loved one are experiencing domestic violence.” Knowing what to look out for is crucial in protecting yourself and others against the effects of domestic abuse and taking action when warning signs appear. The National Domestic Violence Hotline shares the common signs of an abusive partner, no matter how old they are or what gender they identify as: Telling you that you never do anything right. Showing extreme jealousy of your friends or time spent away from them. Preventing or discouraging you from spending time with friends, family members or peers. Insulting, demeaning or shaming you, especially in front of other people. Preventing you from making your own decisions, including about working or attending school. Controlling finances, including taking your money or withholding money for needed expenses. Pressuring you to perform sexual acts you’re not comfortable with. Pressuring you to use drugs or alcohol. Intimidating you through threatening looks or actions. Threatening to harm or take away your children or pets. Intimidating you with weapons. Destroying your belongings or your home. "People experiencing domestic violence may feel as though they are trapped,” said Kami Price. “The reality is – this often couldn’t be further from the truth, especially with the resources we have at our disposal in northern Nevada.” Respected Resources Ending the Silence on Domestic Violence While these facts and figures might be staggering, those experiencing domestic violence at any age are not alone. There is hope at the end of the tunnel, especially here locally. Devoted to meeting the growing needs of the communities we serve, Renown Health proudly supports and sponsors several organizations in our community that are committed to educating children and adults on the signs and symptoms of domestic violence, along with what each child and family member can do today to prevent abuse in the household. These essential organizations are on the frontlines of shifting attitudes from “I don’t want to get involved” to “How can I help?” Serving children across northern Nevada, the Child Assault Prevention (CAP) Project offers “education and prevention programs designed to increase children’s safety from bullying, abuse and assault” and break the cycle of domestic abuse. During 2021 and the first half of 2022, CAP led about 500 different workshops, teaching 10,000 second-grade and fourth-grade children in Washoe, Storey, Lyon and Churchill Counties how to keep themselves safe from domestic violence. “As domestic violence is on the rise, open communication, early intervention and education are key to protecting children from the effects of domestic violence," said Rebecca LeBeau, Executive Director of the CAP Project. “That’s why I begin speaking about child assault prevention and stranger danger to kids as young as six years old. It's important to explain the true reality of domestic violence to both children and adults, tailoring language specifically to whatever age they are, and allowing them to process it. Kids of all ages will learn how to deal with extremely dangerous situations this way.” According to Rebecca, common symptoms of abuse to be on the lookout for at school include grades dropping, a lack of focus and feelings of not wanting to return home after the school day ends. If someone in a child’s home is being hurt or abused, children are always encouraged to speak with a trusted adult or school counselor. From there, organizations like the CAP Project develop a safety plan moving forward. Adults and family units aren’t alone either. The DVRC provides a wide variety of services to Washoe County residents experiencing domestic abuse. To date, the DVRC has helped more than 100,000 victims of domestic violence, and with the recent launch of their crisis text line, they are poised to serve many more. Like the CAP Project, the DVRC also believes that education is one of the first lines of defense against domestic violence. “Education on what domestic violence looks like is so much more than talking about physical violence,” said Aria Overli, Volunteer Coordinator at the DVRC. “Educating the community, and particularly youth, about what healthy relationships look like is a major factor in preventing abuse. Understanding the intersection of how other issues – such as race, mental illness and immigration status – affect domestic violence risk factors is key to addressing those issues.” The list doesn’t stop there. Renown Health Foundation has provided financial support for many more organizations that are dedicated to ending the silence on domestic violence, sexual violence and family abuse, including: The Children’s Cabinet – A child-focused organization offering many support services for youths and families, including Safe Place, a program that partners with local businesses to offer safe locations for children to seek help if they feel threatened at school or at home. The organization also provides free family counseling, providing a pathway to better communication for families experiencing a myriad of issues ranging from domestic violence to substance abuse. Awaken – A nonprofit committed to increasing awareness and education regarding sex trafficking and providing housing and healing to all survivors. Safe Embrace – The largest and most inclusive safe house in Reno-Sparks for survivors of domestic and sexual violence, offering a wide range of resources including counseling, emergency transportation, court support and more. Eddy House – A safe space for at-risk individuals aged 18-24 recovering from the effects of domestic abuse, unsafe housing conditions, homelessness and more. Being an advocate starts with us – if you see something, say something. Keeping a transparent line of communication is key to preventing, noticing and combating domestic violence. “The more you reach out and talk about the issues, the better,” closed Kami Price. “No one has to go through their struggles alone.”