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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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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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Car Seat Safety
Keeping Your Children Safe The Point of Impact Car Seat Inspection and Installation program offers checkpoints throughout the region. Renown Health is proud to partner with REMSA Health to assure the safety of our community. Nevada State Requirements Nevada state law requires those children less than 6 years of age and weighing 60 pounds or less to be secured in an appropriate child restraint system while being transported in a motor vehicle.
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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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Pool Safety: Things To Know About Drowning
The warm weather is here and pools are open. Swimming is a great way to keep your kids cool, occupied and exercised throughout summer, however pools come with their fair share of risks. Before you take your children swimming, check out these pool safety tips. Pool safety is something every parent needs to take more seriously. Why? Because drownings of young children ages one to four have increased in recent years. Unfortunately, drownings are the number one cause of death in this age group - we lose the equivalent of 10 school buses full of children to fatal drownings in the U.S. each year. With warmer temps and hopes of cooling off in a local pool, you can’t be too careful when it comes to protecting your children from the risk of drowning. Children are naturally drawn to water, so parents must be extra aware in order to protect their kids from diving in headfirst. Kris Deeter, MD, pediatric intensive care physician at Renown Children’s Hospital, offers tips to keep your littles safe in the water. Preparing Your Child for the Pool People aren’t born knowing how to swim. This means parents must teach their children about swimming and pool safety if they want them to be safe and confident around water. It can take years to develop these skills, so the key is to start when your children are very young. Here are some ground rules: Teach your child to swim starting at age one. We recommend enrolling your toddler in swim classes; there are several organizations in the Reno-Tahoe area that offer baby and toddler swim classes. Keep your kids away from plastic and inflatable pools - they’re easy for children to fall or climb into and drown. They’re also a breeding ground for bacteria. Floaties and water wings are not safe! They are not a safe substitute or “crutch” for learning how to swim and they can lead to drowning if the child is using them incorrectly or while unsupervised. Stay within arm’s reach of babies and toddlers when at the pool. Supervision alone is not enough – you must be within arm’s reach in case they fall in and need to be rescued quickly. Learn child and infant CPR. If a drowning does occur, the best course of action is to call 911, get the child onto dry land and conduct CPR until breathing is restored or the EMTs arrive. Pool Parties: A Risk for Drowning? Surprisingly, pool parties, a common summer pastime, actually increase the risk of drowning incidents. Although responsible adults are usually at pool parties, distractions ranging from alcohol to pool toys can actually make it easier for drownings to occur unnoticed. Does this mean you should RSVP “no” to the next pool party your child is invited to? Not if you follow the pool safety tips below: Attend the party with your child so you can supervise them while they swim. Remove unused floaties and toys from the pool. They can obscure visibility, making it difficult to see a child in the pool. Don’t drink alcohol while supervising a pool party. Assign an adult “water watcher” to pay constant attention to children in the pool. Pool Safety Precautions for Homeowners If you own a pool, there are several more precautions to ensure the safety of your children. Even if your kids are strong swimmers who have mastered the rules of pool safety, there may be neighbors or friends who are younger and more vulnerable to drowning. You must undertake precautions for these children too. Some of these may seem time-consuming or expensive, but they are worth it to prevent a child from a fatal drowning. To keep your pool or spa safe, please: Cover your pool or spa when not in use. Choose a pool or spa cover with safety features like locks, safety sensors or alarms. Fence in your pool or spa area. The fence should be locked and at least four feet tall. Do not leave toys in the pool area as these may attract children.
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Transitioning Your Child Out of Their Car Seat
Car seat technicians often find parents are moving their child to their next car seat stage too soon, as they get older. Here are a few reminders of when to transition your child from their booster seat to a seat belt. Moving to a booster seat too soon According to Safe Kids Worldwide, nearly 9 in 10 parents remove children from their booster before they’ve reached the recommended height, weight, or age of their car seat recommendations, which leaves the seat belt in a position on the child that could injure them. If the child is not the proper height, the seat belt can rise up on the belly, instead of the hips where it’s supposed to sit, which can lead to spinal cord damage or whiplash in the event of a car crash. Solution: You can switch from a car seat to a booster seat when your child has topped the weight allowed by the car seat manufacturer; typically 40 to 80 pounds (18 to 36 kilograms). Remember, however, that your child is safest remaining in a car seat with a harness for as long as possible. Booster seats must always be used with a lap and shoulder belt — never a lap-only belt. Transitioning to a safety belt too soon Older children need booster seats to help ensure the seat belt stays properly positioned on their body. The lap belt should lie low across the child's hips and pelvis with the shoulder belt crosses the middle of the child's chest and shoulder, so that in the event of a crash, the forces are applied to the hip bones and not the abdomen. If the lap belt is not positioned properly then it could lead to injuries to the spinal cord and abdominal organs. Solution: Most kids can safely use an adult seat belt sometime between ages 8 and 12. Always use a booster seat until the child passes the 6-step test Your child reaches a height of 4 feet, 9 inches (nearly 1.5 meters) Their back is flat against the seat back. Knees bend over the edge of the seat and feet are flat on the floor. The shoulder belt sits on their shoulder and chest (not face or neck.) The lap belt sits low on their hips and touches their upper thighs (not on their stomach.) Your child can sit comfortably this way for the entire trip. The American Academy of Pediatrics reminds us that the back seat is the safest place for children younger than age 13.
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Get Moving: How to Exercise with Arthritis
An arthritis diagnosis doesn’t mean your exercise routine has to end. In fact, a consistent routine can actually improve mobility. Although stiff and painful joints can make it difficult to keep moving, staying active is essential for easing pain. October 11 is World Arthritis Day, so we asked Michelle Higgins, MPT at Renown Physical Therapy & Rehab some advice about exercising with arthritis. According to the Arthritis Foundation, arthritis affects one in five adults and 300,000 children. As a matter of fact arthritis is the nation’s leading cause of disability. Your joints certainly don’t need to suffer when you exercise. In general exercise is actually necessary for those with arthritis. Not only does it reduce joint pain, but it also increases strength and flexibility. Furthermore those adopting a regular exercise routine also have more energy, deeper sleep and find it easier to maintain a healthy weight. “Exercise is a necessary component to managing your arthritis,” says Higgins. “Consistent participation in an exercise program has been shown to promote long-term pain relief, increased body function and an improved quality of life. Alternatively, a lack of exercise can actually increase joint pain or stiffness and eventually lead to long term disability and suffering.” Exercising With Arthritis Exercise truly is the most effective non-drug arthritis treatment available for reducing pain and improving movement. And it can even include daily activities like gardening, dancing or walking your dog. Of course talk to your doctor or physical therapist about what exercises fit into your specific treatment plan. With this is mind, the four specific components below are important to an effective arthritis exercise program: Range of motion Moving joints through their full available range of movement is important. This frequently increases function and decreases joint stiffness and pain. For this reason, aim to complete these exercises daily. Examples include bending, straightening, and rotating specific joints, or static and dynamic stretching. Strengthening These exercises target muscles supporting and protecting our joints and bones. Strengthening is also necessary for weight control, so two-to-three sessions per week are recommended. In order to allow your body to adapt, begin with light resistance and start slow. Strength exercises include weightlifting and using resistance bands. Low-impact aerobic exercise Aerobic exercise is certainly necessary for overall well-being, weight management and heart health. Aim for two-to-three sessions a week. Low-impact exercises include walking, swimming, cycling, elliptical machine exercises and water aerobics. Balance Good balance is also vital for an effective arthritis program. On the positive side, solid balance prevents falls by increasing your ability to stay upright whether you are moving or sitting still. Likewise, it improves your confidence with walking and daily activities. In order to keep excellent balance, incorporate daily balance exercises. Examples of balance exercises include the use of an exercise ball, Tai Chi and exercises such as standing on one foot. Start Slow, Finish Strong As you begin your exercise program, remember to listen to your body. Start slowly – it can take several weeks for your body to adjust to exercise. Consult your doctor, or physical therapist, if you experience increasing pain or swelling which doesn’t go away with rest. Above all, incorporate fun and motivating activities so you’ll stick to them long term and improve your results. Renown Physical Therapy & Rehab 775-982-5001 Through outpatient physical, occupational and speech therapy, Renown Physical Therapy & Rehab gives you hands-on, individualized treatment in convenient Reno/Sparks locations. We have the latest, most advanced physical therapy and rehab equipment, specialty services and treatments. Renown Physical Therapy & Rehab is now open on Robb Drive in addition to three additional locations in Reno and Sparks. Call 775-982-5001 or visit us online.
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Get to Know the Types of Car Seats
Parents often struggle with installing and choosing car seats for their children. Picking out a car seat for your child is a never-ending battle. Safe Kids Washoe County has made it simple for you to understand the types of car seats that will work for your child. Types of Car Seats Rear-Facing Only Seat. Your baby's first car seat is often used from 5 to 40 pounds. People usually buy this type of seat because it is portable. Convertible Car Seat. This seat is larger and stays in the car; it may be rear-facing until your child is two years or more. After that, it can change to a forward-facing seat. Forward-facing-only car seat. This type of seat is used in one direction and has a 5-point harness and top tether. Combination seat. This is a forward-facing seat with a 5-point harness and top tether and can change into a booster seat when you remove the harness. 3-in-1 car seat. This seat also stays in the car. You can use it rear-facing, forward-facing, and then later, as a booster seat. Booster seat. It boosts the child for a safer and more comfortable fit of the adult seat belt. Make sure your child has outgrown the weight or height limits allowed in the forward-facing car seat. The seat belt must lie flat across your child's chest, on the bony part of the shoulder, and low on the hips or upper thighs. Most children will be between the ages of 8 to 12 years old before they are ready for the seat belt alone. Have a trained car seat technician check your installation Why: 3 out of 4 car seats are installed improperly, with some studies show that the misuse rate is 90%, with the average car seat having three mistakes. Solution: Ensuring that your child's car seat is installed correctly by a certified car seat technician will ensure your child's safety.
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Ask the Expert: What is Scoliosis?
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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Tips for Coping with Smoke-Related Health Problems
Millions of people across the west live in areas where air pollution can cause serious health problems. In addition, local air quality can affect our daily lives. Who is Affected? Kouros Farro, MD, a physician with Renown Urgent Care, advises that certain people 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, there is 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 the direction in their written asthma action plan. Make an appointment to see your health provider to be sure you have an asthma action plan. Getting Same-Day Care Renown Urgent Care provides same-day treatment for a wide range of minor injuries, illnesses and medical concerns that are urgent but not life-threatening. Avoid the long wait times and high emergency room prices at 11 convenient sites, including Reno, Sparks, Carson City, USA Parkway, Fallon and Fernley. You can walk in or book ahead online. Make an Urgent Care Appointment Community Health Resources The Washoe County Health District offers online health information on its Smoke Smart website, including fire information, daily air quality information, fire and smoke maps and how to protect yourself. In addition, an online subscription page allows you to sign up for EnviroFlash, notifying you about air quality.
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