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The month of September recognizes several cancer-related health observances. Join us in celebrating our Medical Oncology team at Renown!  No person ever wants to hear the words, “You have cancer.” Those three short yet impactful words immediately change the course of someone’s life. As these patients Fight the Good Fight against cancer, there are a lot of intimidating unknowns that can take over their minds. What happens next? What will my treatment be like? What is my prognosis? How will I be able to handle this physically and emotionally? What will it take for me to beat this?  Who is better to be by their side than the devoted team members at the William N. Pennington Cancer Institute at Renown Health? From helping patients manage the process of complex paperwork and referrals to delivering personalized oncology and hematology treatment options tailored to each individual diagnosis, those fighting virtually any type of cancer are never alone, thanks to this team. The William N. Pennington Cancer Institute always lives up to that promise, guiding patients through the daunting journey of cancer treatment ahead, one step at a time.  Courageous Against Cancer Our exceptional Medical Oncology department inherently understands that each moment in life is precious, especially for patients battling cancer. This team is dedicated to orchestrating the most comprehensive plan for each patient, seamlessly weaving together diagnoses and treatments, oral chemotherapy, medication management, clinical trials, radiation oncology and more.   With the many patients they impact, there’s no question that there is never a dull moment in the day of the life of a healing hero like those in this department.  “No day is the same in Medical Oncology,” said Hollyann Dehm, Registered Nurse. “As a nurse, we wear many hats in the clinic. Our role is to educate patients on their treatment plans and specific drugs they are receiving, triage symptom calls from patients, refill medications and implement our oral chemotherapy program.  We help provide direct patient care by accessing ports, drawing labs and giving IV hydration when needed.  We also help fill out family and medical leave (FMLA)/disability paperwork, help with physician orders, help obtain prior authorizations for prescribed medications and treatments.”  “We do our best to let our patients know that they will not be going through this alone,” added Danielle Say, Physician Scheduling Coordinator. "We will be here for them every step of the way, guiding them and making sure their treatment is as smooth as possible and making ourselves available to them as much as we can. We end up getting to know many of our patients on a very close, personal level, and this helps to build that trust.”  “Our day-to-day activities include seeing patients and helping to manage their therapies as well as their toxicities,” added Dr. Harry Menon, DO, Oncology Physician. “We work closely with our infusion room staff and have a robust team to help us deal with these complex patients. We also work very closely with our surgical and radiation oncology colleagues in a multidisciplinary fashion to provide comprehensive care for our patients.”  The Medical Oncology team excels not only in providing cutting-edge cancer care but also in their compassionate approach to helping patients reduce the anxieties they understandably feel. Recognizing that a cancer diagnosis can be an emotionally overwhelming experience, this dedicated team combines medical expertise with unwavering support to create a healing environment.  “When patients are referred to our department, a lot of them have many fears and questions,” said Heather Cortez, Medical Assistant. “A majority of what our team does is focused on the mental support that our patients require to help them have the most successful outcomes. One thing I have learned about cancer care is that positivity in the face of adversity is everything. Just being there to listen to our patient’s concerns can make all the difference. Helping them to navigate their many appointments and taking the time to explain things in a patient and compassionate way, is part of how our team serves this vulnerable population.”  “The uncertainty is one of my patients' biggest fears: How far has my cancer progressed? How long will I have left? Is treatment even an option?” added Mary Wilson, Senior Medical Assistant. “The best advice that I can give my patients is that they are not alone. While this battle is going to be one of the hardest parts of their lives, they are surrounded by constant support to try and help with any burdens they may be facing. I also tell my patients that we have to take the little wins no matter how small they may be, because while cancer treatment is a physical battle, it is also a large mental battle."  “While we don’t have answers to all the questions patients and their family members may have, we do our best to listen to their questions and concerns regarding their cancer diagnosis and treatment and guide them through their cancer journey," added Hollyann Dehm. “We provide emotional support and education on their type of cancer, managing their pain and side effects of their treatment.  We also connect them to nurse navigators and our social worker who also help identify barriers to care and provide the patient with resources.”  Whether it's explaining treatment options in understandable terms or offering emotional support through difficult moments, this department is committed to empowering patients on their journey toward healing. Their holistic approach not only treats the disease but also nurtures the spirit, all while being a strong advocate on each patient’s behalf.  “Getting a cancer diagnosis can be the worst news that a person can hear; what we try to do is focus on improving quality life and focus on goals that help to promote quality of life,” said Dr. Harry Menon. “If the option for a cure is on the table, we try and focus on that goal in concert with promoting quality life. I try and have our patients focus on what they can control, with the understanding that even if some things are out of our control, the way we approach and manage those things, including our mindset, is still within our control.”  “In our clinic, we truly value our patients and how they are cared for,” added Mary Wilson. “The amount of compassion our team shows is incredible. Patients constantly commend our team on how much they feel like the provider's care. Our providers and staff are not afraid to advocate for patients and that truly is an accomplishment in and of itself.”  “We know patients are only hearing a small amount of the immense volume of information we provide them, so we encourage them to ask questions until it makes sense because the timeframe is different for every patient,” said Lillian Morton, APRN of Medical Oncology. “Cancer is an anxiety inducing lack of control whirlwind – if we can help by being responsive to patient calls and messages, we do so.”  With their harmonious and integrated approach, each patient’s treatment journey progresses uninterrupted, bringing them closer to a brighter and healthier future.

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Do it for the patient. That’s the motto that each employee in the Customer Engagement Center (CEC) lives by every single day. This team spins all the existing stereotypical thoughts about call centers on their side by empowering and partnering with patients to achieve their best health. Being transferred around several times just isn’t in this team’s DNA – being a one-stop-shop for patient scheduling, referrals, insurance matters and more is how they proudly operate. Through elevating the customer engagement experience, the CEC closes care gaps to ensure patients get the right care at the right time. From employees who work from our home base in Reno, all the way to the southeastern corner of Florida, this primarily remote team stays firmly connected and collaborative to make patient care possible for all Renown Health patients and Hometown Health and Senior Care Plus members.  The “Make It Happen” Department  Back-to-back phone calls about a wide variety of patient needs? They make it happen. Referrals that need to go directly to the provider? They make it happen. Complex insurance questions that need to be resolved? They make it happen. The CEC is the keeper of all things customer service and all things patient satisfaction, leveraging technology to improve engagement and accessibility – and they wear that badge with pride.  “Patient care is our first priority,” said Cindy Arevalo, Supervisor of Customer Engagement. “Even though we aren’t face-to-face with them, we are always there to help them over the phone with whatever their needs are.”  The CEC has a lot of different sub-departments under its umbrella: scheduling, referrals, insurance, patient outreach, personal assistants, MyChart customer service and more. Each team handles calls for a different section of our health system, including the hospitals, imaging, primary care and specialty care. While their individual teams may be different, one aspect of their jobs remains the same: they care. Deeply.  “We advocate for the patient, especially when they can’t advocate for themselves,” said Amanda Ishii, Referral Specialist.  “We are the first people that patients speak to, and we all have empathy to listen to them, help them solve their problems and take as much time as they need to care for their needs,” added Susana Arroyo Garcia, Supervisor of Customer Engagement.  Customer loyalty is key to the CEC. Every CEC team member builds strong relationships with patients and members. Whether they manage patient outreach or manage back-to-back inbound calls, each employee feels a special connection to the helpful work they do to solve a variety of patient concerns.  “As Senior Care Plus Personal Assistants, for instance, we help guide our members through complex situations, and we eliminate the process of transferring them to different departments, becoming a ‘one-stop-shop' for them,” said Stephanie Perez Campbell, Senior Care Plus (SCP) Health Coordinator. “While every day is different, we are constantly learning new things and helping members navigate through the health system."  With the 4.5 million calls the CEC handles per year, the nature of their jobs is undoubtedly fast paced. However, this does not intimidate the CEC team members; instead, it inspires them to continue reaching new milestones, helping thousands of patients and members every year by handling all the scheduling and referral work on the backend so that they can receive the care needed.  “I never find myself sitting around asking, ‘what should I do next,’” said Gina Briles, Supervisor of Customer Engagement. “We always support each other to stay on top of it all in order to take care of our patients.”  By wearing a lot of hats and managing many different work queues all while staying engaged with each patient, the CEC is full of natural problem-solvers, helping our healthcare network run smoothly.  “The Engagement Center is the front door for the community; serving as the voice of the customer, we ensure patients do not fall through the cracks of the complex healthcare system and are able to easily access the right care at the right time through an exceptional experience,” said Candace Dietrich, Director of Customer Engagement.   Consistently Connected  With thousands of referrals to process and millions of calls to field, the ways the CEC stays connected to patients and members as well as each other can be related closely to magic. No concern goes unnoticed, and no problem is too complicated.  “The sheer volume of patients we engage with is incredible,” said Rene Jacinto, Manager of Customer Engagement. “We processed nearly 200,000 referrals and authorizations last year.”  “We expect a steady increase of calls year-over-year. My team processed 1,259 referrals in one day alone recently,” added Arielle Gomes, Referral Specialist.  A superpower that every CEC team member holds is the ability to listen. According to this department, active listening is key when problem-solving with every patient and member, as that skill helps them anticipate patient needs and resolve their issues quickly and efficiently.  “I’ll always listen,” said Alex Gomez, Customer Engagement Representative. “I want them to know that they are in good hands, especially when they are feeling scared or frustrated.”  Team members like Alex help carefully guide customers through the Hometown Health and Senior Care Plus enrollment process, increasing membership and engaging patients to find the perfect plan for them.  One of the largest challenges the CEC faces is the departures and arrivals of providers. The ebbs and flows of all hospital systems include provider departures and shifting provider availabilities. Despite this challenge, the CEC staff work hard to ensure communication with all patients regarding provider changes is consistent and that all patients are scheduled in a slot that works for both their schedule and the provider’s schedule.  “It’s important for us to be flexible, because things can change at a moment’s notice,” said Gina Briles. “This is more than just a job – we are here for our patients. What we are doing impacts everyone.”  Throughout all times of transition, the CEC builds robust relationships with both patients and providers within our organization and community, a skill that this team emphasizes as “fundamentally important.” For example, SCP Personal Assistants like Stephanie Perez Campbell will coordinate care with community resources and offices, giving members one less call to make and one less hurdle to cross in order to get the care they need.  On top of it all, even though this team has the ability to work from all 50 states (and many of them work outside of Nevada!), every employee feels connected to their colleagues and their work.  “This is the best group of people I’ve ever worked with,” said Riley Petro, Manager of Customer Engagement – Imaging. “I am super lucky for this job and am so thankful for these people.”  Proud and Powerful  The proof is in the pudding – or rather, the proof is in the numbers. Within the 4.5 million calls they successfully field every year, approximately 1.6 million of those calls route through the private branch exchange (PBX) team – the team that oversees the main operator lines – under the guidance of Jess Nater, Supervisor of Customer Engagement. The CEC is also on track to handle nearly 300,000 referrals this year alone. Additionally, the Hometown Health CEC team was recognized nationally this year with a five-star rating from Medicare.  “We all have the initiative to grow, and because of this, we are always learning something new,” said Cindy Arevalo. “Our leaders also support our growth, especially if we want to skill-build or advance in our careers.”  The CEC is frequently the first stop on the career ladder for many employees as they start their journey in healthcare, and CEC leadership is committed to the growth and development of their teams to reach their career goals at Renown.  The secret formula for all this success can be in part attributed to the pride each CEC employee has for their team, their work and Renown.  “We have a very supportive team,” said Holly Coffey, Supervisor of Customer Engagement. “I’ve seen our leaders support their teams tremendously.”  “We rely on each other,” added Ashleigh Carty, Customer Engagement Representative. "I love the relationships we create with one another.”  Employees in the CEC come from many walks of life, choosing to work at Renown and Hometown Health for a variety of different reasons, many related to the positive power our health system holds. Team members in this department hold a myriad of different career backgrounds, including pharmacy technicians, medical assistants, population health professionals, community health workers and more.  Some team members, like Nikki Clifford, Customer Engagement Representative Lead, heard wonderful things about Renown from her mother, who also works for Renown. According to Nikki, “seeing how happy my mom has been in her career made me want to join too. I’ve loved it here ever since.”   Katie Lunau, Supervisor of Customer Engagement, also grew up in a family involved in healthcare, and she wanted to follow in their footsteps. Choosing Renown as the place to follow her family path was a simple one, because “Renown stood out as the company that was actively involved in the community helping others.”  For other team members, like Susana Arroyo Garcia, Ashleigh Carty and Stephanie Perez Campbell, Renown and Hometown Health’s impact on the local healthcare landscape was their primary driver for choosing a career here and in the CEC specifically.  “Renown is very well-known in the area,” said Stephanie Perez Campbell. “I went to school in Reno for public health, so Renown came up all the time in my schooling. I knew Renown had a lot of different opportunities available for career growth, and with the friendly environment I always experienced here, it was an easy decision.”  “Once I went through the interview process and joined the team, I immediately realized that there are outstanding managers, support systems and communication skills here. People genuinely care,” added Ashleigh Carty.  Ashleigh is exactly right. As emphasized by every team member, employees in the CEC care. Their heightened levels of care and empathy set the bar high for all at Renown and Hometown Health, and their impact will be felt for years to come.

Read More About Department Spotlight: Customer Engagement Center

November is National Alzheimer’s Disease Awareness Month. At Renown Health, we know that Alzheimer's safety for your loved one is a priority, as the symptoms can sometimes lead to unsafe situations. We asked Dr. Jonathan Artz – a neurology physician with Renown Health and an assistant professor of clinical neurology at the University of Nevada, Reno School of Medicine – for tips on keeping loved ones safe and secure.  According to the Alzheimer’s Association, Alzheimer’s disease affects safety in various ways, specifically due to body and brain adjustments. These changes can include: Judgment, including forgetfulness  Sense of place – getting lost on the way home  Behavior – being suspicious or fearful  Body difficulty – losing balance Sensing ability – noticeable sensitivity in hearing, seeing or temperature  Dr. Artz gives us four major tips to ensure your loved one’s safety as you both navigate this disease together.  Watch for Wandering  Those experiencing Alzheimer’s disease tend to wander and get lost. Try the following tips to reduce the risk of wandering:  Get your loved one an ID bracelet and have them wear it at all times. You can also enroll your loved one in “Wandering Support.”  Install door chimes so you know when exterior doors are open.  Ask neighbors to call you if they see your loved one out alone. Go with your loved one when they insist on leaving the house. Don’t argue or yell. Instead, use distraction or gentle hints to get them to return home.  Discourage Driving  Driving can be unsafe for someone with this disease. With this in mind, ask a doctor whether it’s safe for your loved one to drive. For example, on a case-by-case basis, there are certain situations where doctors are required to report individuals with particular cognitive impairments, wherein a form of a driving assessment will be recommended.  Limit access to the car. Keep the keys with you or lock them away.  Ask an authority figure, such as an insurance agent or a doctor, to tell them not to drive.  Adult-Proof Your Abode  A simple living space is a safe living space. This means reducing clutter and removing any issues that may pose a safety concern. You may also want to get advice from an occupational therapist (home safety expert). Keep in mind that some changes may not be needed right away. Focus on major safety concerns first.  Try the following tips:  Add lighting (or glow-in-the-dark tape) to brighten dark areas, including stairways and halls.  Use color contrast or texture indicators for dials, knobs and appliance controls.  Remind your loved one not to carry items while walking to avoid a fall.  Remove sharp objects from drawers and countertops.  Avoid using small throw rugs or doormats, as they are easy to trip on.  Move frequently used items so that they are easy to reach.  Lock away alcohol and tobacco products, as they are not recommended for dementia patients.  Install handrails in the shower, tub and near the toilet. Bathroom falls are especially common.  Adjust the setting on your hot water heater so water does not scald. Those with Alzheimer’s can lose their sensitivity to temperature.  Move and lock up hazardous chemicals and cleaning supplies, such as bleach and insecticides.  Disable and remove guns or any weapons. Supervise any medication taken by your loved one.  Promote a Positive & Healthy Lifestyle  Continually emphasize the strengths of your loved one by promoting participation in meaningful activities, wellness visits and healthy habits to help them improve their well-being. Here are some ways to keep them physically and mentally active:   Maintain regular vision and hearing screenings and make necessary adaptations.  Establish a routine for daily activities.  Encourage participation in self-care and leisure activities.  Work with your loved one’s doctor to establish a healthy diet.  Ensure proper hydration. It may help to set reminders for your loved one to drink fluids.  Encourage regular exercise. Exercise delivers oxygen to the brain, improving brain health. Promote good sleep habits. Good quality sleep can increase overall brain health and has been associated with improving memory, attention and concentration.  Resources and support are available with the Renown Memory Disorders Program. Providers within this program are specifically dedicated to treating several different memory-related disorders. Memory Disorders Resources & Support.

Read More About Alzheimer's Safety Tips for Caregivers to Know

Renown Health is proud to embrace the Reno-Sparks culture that makes our community stand out, which is why we sponsor the Reno Rodeo, an early summer staple with roots in the community as deep as our own. One of our many ties with the Reno Rodeo includes Renown Regional’s own emergency room nurse and Miss Rodeo Nevada 2022, Gabby Szachara. A Reno native, Gabby developed a love for the Reno Rodeo at a very young age. “I loved watching the girls on the Reno Rodeo Flag Team when I was little and knew I wanted to be part of the Reno Rodeo someday,” said Gabby. “As I got older, I started to make connections and build relationships with some people in the rodeo scene, and they generously lent me their horses so I could participate in the Reno Rodeo Flag Team.” Gabby was on the flag team for three years before being crowned Miss Rodeo Nevada 2022 last year.  Before joining the Reno Rodeo Flag Team, Gabby was a student at the University of Nevada, Reno, and a member of the women’s volleyball team. In December 2017, she graduated with a bachelor’s degree in public health. At first, Gabby was interested in a career in sports medicine – it made sense with her background in athletics. But, after working in the medical field as a certified nurse assistant and an emergency medical technician, she grew passionate about patient care and decided she wanted to become a nurse. “I’ve always loved teamwork and helping others,” said Gabby. “It’s important to me to be there for others, especially when it might be their worst day.”  In December 2021, Gabby graduated from Truckee Meadows Community College with a nursing degree and joined Renown Health this February. “I love Renown for various reasons. Everyone here is so nice and welcoming, and there is a great team dynamic,” said Gabby. “And I love that Renown’s main color is purple because that is my favorite!” When Gabby isn’t in her scrubs and caring for patients, she is in western wear and carrying out her duties as Miss Rodeo Nevada. “I do a lot of traveling across the country to attend other rodeos,” said Gabby. “I enjoy meeting so many wonderful people and experiencing the culture of different states.” Gabby’s main goals as Miss Rodeo Nevada are to promote the western way of life, agriculture, rodeo and community benefit. In addition, she visits local schools to talk with kids about how they can get involved in these areas and inspires them to turn their dreams into reality.  Gabby has a special place in her heart for the Reno Rodeo. “Reno is my home, and the Reno Rodeo is the heart and soul of summer in northern Nevada. Everyone comes together and dusts off their boots to have fun and also contribute money to important causes in our community,” said Gabby. “I love the comradery, the friendly and healthy competition and the great people.”  If you’re going to the Reno Rodeo this weekend, watch for Gabby and her horse, “Torque.”  And if you see Gabby in the halls at Renown Regional, give her a high-five for all her hard work as a nurse and Miss Rodeo Nevada!

Read More About Meet Gabby, Renown Regional ER Nurse and Miss Rodeo Nevada

You may recognize her from billboards around town or the cover of Renown's latest annual report, but what you might not know is the story behind the now-familiar face. Paola Espinoza-Patino is the oncology unit's associate nurse manager at Renown Regional, and she grounds her work in hope and determination daily. Meet Paola:

Read More About Paola’s Story: Bringing Hope and Determination to Patient Care

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)

Read More About Alzheimer’s Disease – How to Spot the Signs

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.

Read More About Ask the Expert: What is Scoliosis?