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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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Where There is Smoke; There May Be More Headaches, Nausea and Coughing
Renown Urgent Care team prepares you to stay safe this season and is available seven days a week at 11 locations across northern Nevada Millions of people across the West live in areas where air pollution can cause serious health problems. Local air quality can affect our daily lives. Like the weather, it can change from day to day. The Northern Sierra Air Quality Management District issued an Air Quality Health Advisory for Plumas County, to notify the public of the possibility of poor air quality conditions resulting from the Beckwourth Complex Fire in addition to other wildfires in northern California. In addition, there is the potential for wind shifts to carry smoke to other parts of Plumas County from the Beckwourth and several other regional wildfires. Air quality is expected to vary greatly depending on fire behavior and weather conditions, with smoke settling in low areas at night and in the early mornings as long as these fires are active. The advisory mentions, “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, especially among sensitive individuals such as the elderly, children, people with asthma, people with heart or lung conditions, pregnant women and anyone who is exercising or working hard outdoors.” Kouros Farro, MD, a physician with Renown Urgent Care advises that there are people who are more likely to be affected when fine particle pollution reaches an unhealthy level. People who have asthma or other breathing conditions like chronic obstructive pulmonary disease (COPD). People who have heart disease or high blood pressure. Children and older adults. People of all ages who are doing extended or heavy, physical activity like playing sports or working outdoors. “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. Farro, who is board certified in family medicine and practices at Renown Urgent Care at 975 Ryland St in Reno. “If you do not have a health care provider, know we have a Renown Urgent Care office on almost every corner, with providers ready to see you.” Dr. Farro advises the following: Take it easy and listen to your body. Limit, change, or postpone your physical activity level. If possible, stay away from local sources of air pollution like busy roads and wood fires. If you have asthma or other breathing conditions like COPD make sure you have your relief/rescue inhaler with you. People with asthma should review and follow guidance in their written asthma action plan. Make an appointment to see your health provider to be sure you have an asthma action plan. “Even just one hour of smoke exposure can affect our lungs and hearts, and these consequences can reach people far beyond the direct area endangered by the fire. Children, older adults, pregnant women, people with preexisting cardiopulmonary disease, communities of color, economically disadvantaged communities, and people with preexisting chronic health conditions like asthma, diabetes, and obesity are all especially vulnerable to the air pollution that wildfires cause," says Dr. David Lemak, Division Chief of Urgent Care at Renown. 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 11 convenient sites, including Reno, Sparks, Carson City, USA Parkway, Fallon and Fernley. You can walk-in or book ahead online. You can get the latest fire and smoke information at the Washoe County Health District’s Be Smoke Smart webpage. It includes information about air pollution levels and how to protect yourself from the smoke. An on-line subscription page allows you to sign up for EnviroFlash, notifying you about air quality. 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 continually improve the care and the health of our community. For more information, visit renown.org.
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Renown and Thousands of Top U.S. Hospitals Encourage Everyone to #MaskUp
Growing numbers of COVID-19 cases and deaths are troubling; facemasks can slow the trend. 100 of the nation’s top health care systems, representing thousands of hospitals in communities across the U.S., have come together with an urgent plea for all Americans – mask up, because wearing a facemask is our best chance at slowing the surging COVID-19 pandemic now. More than 11.5 million Americans have tested positive for the virus – including an additional one million in just the past week – leading to nearly 250,000 deaths. The current trends are daunting and frightening. If the nation stays on its current course, hospital leaders are increasingly concerned that more healthcare facilities will be overwhelmed as shortages of healthy caregivers make it difficult to handle a rapidly increasing number of patients. Unfortunately, this is already happening in parts of our country. The next several months will be critical. Though there has been positive news about vaccine development, no one knows when those vaccines will be ready for widespread use. In the meantime, everyone must remain vigilant, take precautions and follow public health orders. The country has reached a tipping point. The power to do what is right is now in the hands of everyone everywhere. Beginning today, a public service message will run in The New York Times, USA Today, The Wall Street Journal, The Washington Post and The Los Angeles Times. Additionally, leading hospitals and health systems across the country will continue to unite to share these messages regionally. The message reads: “As the top nationally-ranked hospitals, we know it’s tough that we all need to do our part and keep wearing masks. But, here’s what we also know: The science has not changed. Masks slow the spread of COVID-19. So, please join us as we all embrace this simple ask: Wear. Care. Share with #MaskUp. Together, wearing is caring. And together, we are saving lives.” In an effort to reach a broader audience, the public service effort will also include messages on digital platforms, social media, online information, links to vital health resources and more. Combining resources demonstrates that these health organizations are working together, will accomplish this today and will get through this together. The U.S. Centers for Disease Control and Prevention points to recent studies that have shown facemasks successfully limit spread of the COVID-19 virus. Wearing facemasks protect in key ways: by protecting the wearer against inhalation of harmful pathogens and particulates and by preventing exposure of those around the wearer. In addition to masking, the CDC suggests that everyone minimize the number of non-household contacts, maintain a physical distance of at least six feet, and limit the amount of time around others, especially while indoors and in poorly ventilated areas. For further information about masking guidelines – how to choose a mask, how to properly wear a mask – visit the CDC website. About us: www.everymaskup.com is a collaboration of 100 leading health systems representing thousands of hospitals across the U.S. joining together to create messages for the betterment of communities they serve. The impetus for this, and other public service campaigns to follow, came from a group of health care marketing and communications executives meeting for a decade and reengaged weekly since the COVID-19 pandemic began. The goal is to share knowledge and experience, best practices, strategies and resources - knowing they can accomplish more together. Founded and led by Rhoda Weiss, Ph.D., Los Angeles-based national health care leader and consultant, the expanded coalition is partnering with Cleveland Clinic Chief Marketing and Communications Officer Paul Matsen and his team for this effort. Additionally, hospitals and health systems on a regional basis continue to come together to send messages like these of prevention and safety, hope and healing, life and death, care and caring.Media Contacts:Rhoda WeissM: 310-945-6730E: rhoda@rhodaweiss.comAngie KiskaM: 216-312-9170E: kiskaa@ccf.org The following hospitals and health systems to spread this message across the country. AdventHealth Nemours Children's Health System Adventist Health NewYork-Presbyterian Allegheny Health Network Northwell Health Atrium Health Northwestern Medicine Avera Health Norton Healthcare Banner Health Ochsner Health Baptist Health Northeast Florida OhioHealth Baylor Scott & White Health Oregon Health & Science University BJC HealthCare OSF HealthCare Bon Secours Mercy Health OU Health Boston Children's Hospital PeaceHealth Cedars-Sinai Penn Medicine Children’s Hospital Los Angeles Penn State Health Children’s Hospital of Philadelphia Providence Children's Hospital of Orange County Renown Health Children's National Hospital Roswell Park Comprehensive Cancer Center ChristianaCare Rush University System for Health Cincinnati Children’s Hospital Medical Center RWJ Barnabas Health City of Hope Saint Luke's Health System (Kansas City, MO) Cleveland Clinic SCL Health CommonSpirit Health Scripps Health Community Health Systems Sharp HealthCare Cooper University Health Care Southwestern Health Resources Dana-Farber Cancer Institute SSM Health Dartmouth-Hitchcock Health St. Elizabeth Healthcare Duke Health St. Jude Children’s Research Hospital Emory Healthcare St. Luke's Hospital (St. Louis) Geisinger Stanford Health Care Hackensack Meridian Health Sutter Health HCA Healthcare Temple Health Inspira Health Texas Health Resources Intermountain Healthcare The Christ Hospital Health Network Jefferson Health The Ohio State University Wexner Medical Center Johns Hopkins Medicine The University of Texas MD Anderson Cancer Center Kaiser Permanente ThedaCare Keck Medicine of USC TriHealth (Cincinnati) LifePoint Health Trinity Health Mass General Brigham UC Davis Health Mayo Clinic UCHealth MedStar Health UC Health CINCINNATI Memorial Hermann UC San Diego Health Memorial Sloan Kettering Cancer Center UChicago Medicine MemorialCare (Southern California) UCI Health Mercy UCLA Health Michigan Medicine UCSF Health Mount Sinai Health System UNC Health National Jewish Health University of California Health Nationwide Children's Hospital University Hospitals (Cleveland) Nebraska Medicine University of Iowa Health Care Virtua Health
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Coming Together to Make a Difference: Teens Donate Over 1,300 Face Masks to Healthcare Heros
Three Los Angeles teens rallied their high school classmates to raise funds and donate more than 1,300 face masks for Renown Health employees. While many teens reflected on missed milestones like prom and graduation that didn’t happen as a result of the COVID-19 pandemic, three high school seniors from Los Angeles felt inspired to make a difference. Friends Jessica Gestetner, Amanda Rosenthal and Katherine Konvitz organized a fundraising campaign with their classmates and purchased over 1,300 face masks for staff at Renown Health. “My friends and I wanted to help our doctors and nurses because they are out saving lives while we are all fortunate enough to remain at home and healthy,” said Gestetner “We raised over $3,500 and spent it buying KN-95 masks for the heroes at Renown. This was our way of thanking all the healthcare workers for their selfless service.” Why did these LA teens choose Renown Health for this donation? Katherine Konvitz has a family friend who works at Renown, which is how the teens first learned about the organization’s call for community support to gather face masks and other personal protective equipment. Thanks to this significant donation, Renown exceeded its goal of securing 10,000 community-donated face masks to benefit employees working on the frontline to help keep the community safe. “I can only imagine how difficult these times are for our youth, as they’re unable to go to school, spend time with their friends and experience all the activities that are seen as a rite of passage to many,” said Tony Slonim, MD, D.Ph., president and CEO of Renown Health. “I applaud the incredible act of kindness displayed by Jessica, Amanda and Katherine to give back to our staff, despite the challenging circumstances. We are extremely fortunate to have the generosity and support of northern Nevadans and people across the country as we work to improve the health and well-being of the people and communities we serve.” Aside from their face mask contribution, Ms. Gestetner, Rosenthal and Konvitz also made a financial donation to Renown’s Healthcare Workers Greatest Needs fund, where donations are directed to address the highest needs our healthcare teams are currently facing as they continue to screen, diagnose and care for patients with respiratory illness, including COVID-19. For others interested in making a tax-deductible donation of Personal Protective Equipment, Meals, Financial Donations or Thank You notes, you can go to renown.org/donations-covid-19/ or contact Renown Health Foundation, 245 E Liberty St #400, Reno, NV 89501. Phone: (775) 982-5545 Renown continues to welcome donations of masks, gowns and surgical caps and appreciates the support of our community. Donations are accepted through the main entrance at the Tahoe Tower of Renown Regional Medical Center. Please let the security staff know you are dropping off donations for the mask donation drive and these items will be marked accordingly. All handcrafted masks, gowns and surgical caps are laundered and sanitized before distribution to appropriate areas. In addition to the personal protective equipment Renown has received during these unprecedented times, people have thanked care providers through hundreds of notes and cards, as well as numerous generous meal donations for frontline staff. These donations have a tremendous impact on Renown’s ability to continue to provide quality care in northern Nevada despite the challenges brought by the COVID-19 pandemic. About Renown Health Renown Health is a locally governed and locally owned, 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, Renown Children’s Hospital, Renown 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 continually improve the care and the health of our community. For more information, visit renown.org.
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Renown Seeks Handcrafted Mask for Hospital Visitors
Need Also Exists for Handmade Gowns and Surgical Caps Renown caregivers are grateful for the community’s love and enthusiasm for sewing masks, gowns and surgical caps. We continue to need these items and appreciate your support. Masks for Patient Visitors: We are requesting that community members sew masks for loved ones visiting patients at Renown Regional Medical Center and Renown South Meadows Medical Center. All patterns and cotton or cotton-blends are welcome. Isolation Gowns: For community crafted isolation gowns, please use the Renown-approved pattern and instructions. Bouffant (Surgical Caps): The pattern we are using for community-crafted Bouffants is available here. Donations are welcome at our drive-thru, open Monday–Friday, 9 a.m.–5 p.m., located in the valet area of Tahoe Tower at Renown Regional Medical Center. All handcrafted masks, gowns and surgical caps will be laundered and sanitized before being distributed. We are so grateful for our community’s support during these unprecedented times. To address the many generous offers of assistance, we have compiled this information and hope you find it helpful. https://www.renown.org/donations-covid-19/. ### About Renown Health Renown Health is a locally governed and locally owned, 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 continually improve the care and the health of our community. For more information, visit renown.org
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Rheumatology
The board-certified rheumatologists at Renown Rheumatology provide state-of-the art care for a wide range of autoimmune rheumatic diseases such as rheumatoid arthritis, psoriatic arthritis, lupus, Sjogren syndrome, vasculitis, gout, and many more. We use the most advanced evidence-based diagnostic and therapeutic measures to restore health and enhance well-being.
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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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Stay Inside When Skies Are Smoky
Even when fires burn outside our area, the air quality in the region can reach dangerous levels. Our expert explains how to maintain your lung health when fire season strikes. It’s a sight we know all too well as northern Nevadans — a hazy or thick layer on the horizon when smoke rolls in from nearby fires. Sometimes the smoke is more evident than others, but it’s important to remember, even when the smoke may not be as visible across the valley, it still impacts our air quality. The last week or so, our air quality has been in the “unhealthy for sensitive groups” range, which can be dangerous for people who are sensitive to air pollution. Air Quality Changes: Who’s at Risk? Renown Pediatric Pulmonologist Sonia Budhecha, M.D., explains certain people are especially at risk when smoke moves in: Older people, whose lungs are not as healthy as they used to be Young children, whose lungs are still developing People with heart and lung disease including asthma, COPD and emphysema “Smoke and haze from fires carry particulates that can get into your respiratory system and eyes, which can be a danger for all ages,” Dr. Budhecha says. How You Can Protect Yourself Until the smoke clears and the air returns to the “good” range, it is best to follow these tips to protect yourself and your family: Stay indoors and keep windows closed Turn on the air conditioning to recirculate clean air Drink plenty of fluids to help your body flush out any toxins you inhale Additionally, all community members should reduce their physical activity and try to prevent heavy exertion outside. If you or a loved one has a heart or lung disease, avoid physical exertion altogether because smoke can aggravate these conditions. “People with heart disease may experience shortness of breath, chest pain, palpitations or fatigue,” Dr. Budhecha says. “People with lung disease may also have shortness of breath, chest discomfort, wheezing, phlegm or a cough.” Smoky Signs and Symptoms Smoke can also impact healthy people — irritating your eyes, nose or throat. And in some cases, inhaling smoke can lead to bronchitis. When haze moves into our area, keep an eye out for these symptoms: Burning or stinging eyes Runny nose Cough or scratchy throat Headaches Wheezing Shortness of breath Difficult taking a full breath Chest heaviness Lightheadedness Dizziness If experiencing any of the above symptoms, seek medical attention or call your doctor for advice. Sometimes, these symptoms do not appear for as long as 24 to 48 hours after smoke inhalation. For those that have pre-existing lung or heart conditions, consult with a health care provider on action or management plans. To schedule an appointment Visit Renown Pulmonary Medicine, or call 775-982-5000. Understanding Our Air Quality The Air Quality Index (AQI) is broken down by large (PM10) and small (PM2.5) particulates. According to Dr. Budhecha, large particulates are usually ones that can be seen and smelled. They can damage your eyes and nose but don’t often get deep in the lungs or blood vessels. “The more dangerous ones are PM2.5, which can’t always be seen or smelled,” Dr. Budhecha says. “Any time the AQI is above 51, children with lung or heart disease should not be outdoors.” For the latest air quality update in your area, visit AirNow.gov or call (775) 785-4110.
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Alzheimer’s Disease – How to Spot the Signs
Alzheimer’s disease is not normal forgetfulness as we age. Instead, it is a specific form of mental decline. And according to the Alzheimer’s Association it accounts for nearly 80 percent all dementia cases. Natasa Dragicevic, MD, PhD., behavioral neurologist and Alzheimer’s disease specialist with Renown Institute for Neurosciences, weighs in on diagnosing it and the importance of early medical action. How to Diagnose Alzheimer’s Disease In general, the signs of Alzheimer’s disease occur slowly, getting worse over time. For example, forgetfulness is a daily search – for shoes, keys and other misplaced items. Not only is memory affected, but also speech patterns and behavior. There is no single test for Alzheimer’s disease. “Specifically, a neurologist should be the one to diagnose Alzheimer’s disease given differences in presentation,” clarifies Dr. Dragicevic. “And ideally a behavioral neurologist (Alzheimer’s sub-specialist) will be managing the treatment,” she adds. Brain Imaging Diagnosing Alzheimer’s disease involves multiple approaches and medical providers. In short, medical history is reviewed along with a physical exam, lab tests and other diagnostic testing. “A medical workup includes a variety of tests. These include MRI and other brain imaging, as well as neurological and psychological testing. Furthermore, a lumbar puncture is performed to look for markers of the disease,” she states. What Causes Alzheimer’s disease? Although no one knows the cause, researchers think many factors play a role. Uncontrollable risk factors include your genetics and having a family member with the disease. However, the controllable risk factors include: reducing the risk of head injury and keeping your heart healthy. It’s important to realize that high blood pressure, high cholesterol, stroke and diabetes play a role in brain health. Blood loss to the brain causes vascular dementia, leading to long-term blood vessel damage. Symptoms of Alzheimer’s disease Generally speaking, the signs of this disease differ in each person. Yet noticeable behaviors include: • Losing the way to familiar places • Forgetting to pay bills • Trouble finding the right words when talking • Repeating questions • General confusion • Social withdrawal Alzheimer’s Disease – Benefits of Early Diagnosis Equally important, spotting Alzheimer’s disease early allows more time to benefit from medications and possible clinical trials. Likewise, nutrition and exercise changes can be made, increasing blood flow to the body, and perhaps delaying symptoms. Early diagnosis also allows for personal health decisions and quality-of-life conversations to take place. According to the Alzheimer’s Association, these benefits include: 1. Medical advantage 2. Emotional and social comfort 3. Time to plan ahead 4. Cost savings A Brain Supporting Lifestyle “At the present time, treatment is limited,” explains Dr. Dragicevic. “Usually Alzheimer’s is a progressive ongoing disease – any management at this time is purely symptomatic.” However, she states the following lifestyle changes can help support brain health: • New hobbies such as painting, pottery, music classes or learning a new language • Crosswords, puzzles and playing games, such as Scrabble • Brain challenging mobile apps, such as Luminosity • 30-45 minutes of mild to moderate physical activity per day, such as walking • Eating a Mediterranean diet (primarily plant based foods)
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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."
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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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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