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Renown Health is one of the country’s first health systems to lift visitor restrictions for patients with COVID-19 and encourage the family to be at the patient’s bedside. Read Darlene and Dave’s story to understand why we’re updating our visitor policy. Dave and Darlene Randolph found joy in exploring antique shops and garage sales to find damaged or discarded vintage pieces. Dave would spend many hours scraping, cleaning, sanding, and refinishing items, transforming them into functional, beautiful pieces of furniture. Every piece in their home rekindles a memory and has a story to tell. On Thanksgiving, when Dave was too ill to gather around their antique dining room table, Darlene called the ambulance. Ailing with COVID-19 for two weeks, Dave had not been improving. When the EMTs reached her home and asked Darlene what underlying conditions he had, she said, “all of them.” David was seriously ill. Hospitalized for COVID-19, their communications options were limited. The only way Darlene could communicate with Dave was on a video call or by telephone. Dave spent 17 days hospitalized at Renown Regional Medical Center in Reno. Darlene spent 17 days waiting by the phone for more information on his condition. Darlene said he had “up days and down days,” but thought he might be home, sitting at their antique dinner table for Christmas. Sadly, Dr. David Randolph lost his battle with COVID-19 on December 13, 2020, and died as he slept in a hospital bed. When Darlene wrote his obituary for the newspaper, she gave thanks to the “tremendous nurses and doctors at Renown Regional Medical Center, for providing his care during a time when the family could not be with him.” Taking Action to Inspire Change Darlene wished she could have been there. Over their 45-year marriage, she had always been there. Darlene said, “I had always been at his bedside, as his advocate, to help communicate and straighten things out.” As a registered dietician, she worked in hospitals, knew the protocol, and knew that Renown had a restricted visitor policy to stop the virus’s spread- to other patients, staff, and their family members. Still, she wished she could have spent more time with him. On Christmas Eve, she sat down and wrote to Renown leadership. “As the wife of a COVID patient who recently passed away in your hospital, I want to express my thanks to you and your staff for the care he received in the last days of his life. I am aware that the nurses and staff are working under dangerous conditions and risking their health and lives by caring for multiple COVID patients. The staff is gracious, concerned, and doing everything they can.” She continued, “I know procedures are changing every hour to try to stay ahead of this dangerous virus, and I am sharing my experiences, hoping they will be helpful when establishing policies that impact families.” Darlene explained that despite receiving assurances that Dave’s nurse or a doctor would call daily, sometimes they would forget. She explains in her letter, “how important it is, in these times when the family cannot visit, and has only infrequent communication and is anxiously waiting at home for information about their loved one, how much it means to get a call from someone caring for him at the hospital. If there is a way you can help assure nurses have time to make calls or assist patients in making calls because it is an important part of patient care.” A Person-Centered Visitor Policy After receiving her letter, Renown leadership called Mrs. David Randolph to thank her, offer his sympathies and ask if Renown could help in any way. Darlene asked if he might reconsider allowing families to visit hospital patients during treatment for COVID-19. As the COVID-19 situation has evolved, the policy has as well. Renown hospitals and medical practices now encourage limited visitors for all patients, including those diagnosed with COVID-19. Renown also has extra safety measures to protect the health of patients, visitors and healthcare employees. Darlene is very pleased that her letter inspired this shift in visitor policies for patients with COVID-19. She says, “I have always tried to think of ways I could help other families. Especially those senior couples where one has been hospitalized and the other is home. My wish is to help others.” Renown Health Visitor Policy Renown Health patients may identify two healthy adult “patient supporters” to accompany them on their hospital stay. For more details, visit our Patient Supporter Guidelines page.

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

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With front-line workers receiving the first COVID-19 vaccinations, many of us are feeling hope, but also worry. As a result, we are joining with the Ad Council, the COVID Collaborative, HHS, CDC and NIAID (along with top health and medical organizations) to address your vaccine concerns and questions. Will the vaccine be available to everyone in Nevada? The Nevada Department of Health and Human Services (DHHS) is collaborating with health systems about the use of initially available, limited supplies of COVID-19 vaccines. They will provide guidance on the prioritization order of who will receive the vaccine. This will be based on available quantities, high-risk locations of work and certain other risk factors, and recommendations and guidance for public health agencies. The CDC has provided guidance to initially focus on the following groups: Healthcare personnel likely to be exposed to or treat people with COVID-19, nursing home residents and others in institutional settings; People at risk for severe illness from COVID-19 due to underlying medical conditions; People 65 years of age and older; Other essential workers. I worry the vaccine has been rushed The U.S. national vaccine safety system ensures that all vaccines are as safe as possible, and because vaccines are given to millions of healthy people to prevent serious diseases, they’re held to very high safety standards. COVID-19 vaccines are undergoing a rigorous development process that includes vaccinating tens of thousands of people who participate in a study to generate the needed clinical data. These clinical trials generate scientific data for the FDA to determine the safety and efficacy of each vaccine. It’s worth noting that the clinical studies to establish the safety and efficacy of the Covid-19 vaccines were as big and thorough as recent studies for other licensed vaccines (for example, the shingles vaccine). I'm concerned about the vaccine's side effects The most common side effects are very similar to those seen with most vaccines, such as: sore arms, fevers, and tiredness within 72 hours after the vaccine. These side effects usually mean that the vaccine is generating an immune response, indicating it is working. Short-term side effects observed in the leading COVID-19 vaccine trials include: Injection site pain and redness Fatigue Muscle aches and pains Joint pain Headache I’m afraid I’ll get COVID-19 from the vaccine None of the authorized and recommended COVID-19 vaccines, or COVID-19 vaccines currently in development in the United States, contain the live virus that causes COVID-19. This means that a COVID-19 vaccine cannot make you sick with COVID-19. Can children receive the COVID-19 vaccine? Not at the moment. In early clinical trials for various COVID-19 vaccines, only non-pregnant adults at least 18 years of age participated. However, clinical trials continue to expand those recruited to participate. The groups recommended to receive the vaccines could change in the future. As of now, it is recommended that children do not receive the vaccine. More information will be available from the vaccine manufacturers. I do not believe vaccines are effective Both this disease and the vaccine are new. We don’t know how long protection lasts for those who get infected or those who are vaccinated. What we do know is that COVID-19 has caused very serious illness and death for a lot of people. If you get COVID-19, you also risk giving it to loved ones who may get very sick. Getting a COVID-19 vaccine is a safer choice. The FDA is responsible for making sure that, just like any other medications, any FDA-authorized or approved COVID-19 vaccines are safe and they work. The EUA (Emergency Use Authorization) will not be provided if the FDA feels that the vaccine is unsafe. I can't get vaccines to due to a medical condition Adults of any age with certain underlying medical conditions are at increased risk for severe illness from the virus that causes COVID-19. mRNA COVID-19 vaccines may be administered to people with underlying medical conditions provided they have not had a severe allergic reaction to any of the ingredients in the vaccine. The following information aims to help people in the groups listed below make an informed decision about receiving the mRNA COVID-19 vaccine. It is extremely important to speak with your doctor regarding your specific medical condition, and always follow their strict advice regarding the COVID-19 vaccine, or any other vaccines. Sources: Renown COVID-19 Ad Council COVID Collaborative U.S. Department of Health & Human Services Centers for Disease Control and Prevention National Institute of Allergy and Infectious Disease

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