University Health System Blog

Dr. John Pixley answers the question: “What tests determine whether a person has arthritis?”

There is no specific test. A medical history, physical examination, laboratory and X-ray evaluation allow for establishing both the presence of arthritis and the proper diagnosis. It’s important to determine the type of arthritis as the therapies are vastly different. Seeing with a rheumatologist for a correct diagnosis is the best course of action if patients suspect they may be developing arthritis or have arthritic symptoms.

John Pixley, M.D. is an internist and rheumatologist practicing in Reno, Nevada. Dr. Pixley has more than 30 years of medical experience.

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Dr. Kami Larsen answers the question: “Should I be concerned if my 2-year-old child can’t talk yet? She just grunts a lot.”

Absolutely! By the time a child has reached two years old, they should have a vocabulary of 50 to 100 words, and should be putting two words together to form small sentences or phrases. Anytime we see a child that has a speak delay by this age, an evaluation for the delay needs to be done.

This may involve hearing testing, evaluation by a speech pathologist, and possible evaluation for autistic spectrum disorder. Which path we, as health care providers, choose to take first depends on a number things, including the child’s ability to follow instructions, how they interact with other kids, how they ask for things, whether or not they pretend play, and various other things. The bottom line is making sure your pediatrician knows about these things and getting an evaluation started sooner rather than later.

Kami Larsen, M.D. is a pediatrician at University Health System in Las Vegas, Nevada. Dr. Larsen is assistant professor of pediatrics at the University of Nevada School of Medicine and medical director of Kids Healthcare Clinic.

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Dr. Dan Spogen answers the question: “I’ve smoked for more than 20 years. Recently I’ve had more difficulty breathing. Do I have COPD?”

COPD, or chronic obstructive pulmonary disease, is a lung disease that makes it hard to breathe. It’s caused by damage to the lungs due to time or environmental factors, such as smoking, which is the primary cause of the disease. It’s often characterized by shortness of breath, the inability to take a deep breath, and a lingering cough that brings up mucus. (More on COPD signs and symptoms.)

While some people eventually get COPD due to advanced age, smokers are the largest segment of society that contract the disease because the damage done to the air sacs in the lungs is accelerated to the point that many smokers start to feel the effects of COPD by age 50. The damage to the lungs due to smoking gets worse over time and cannot be cured, but future damage is stopped immediately if one quits using cigarettes. Exposure to second-hand smoke or smoking illegal substances also affects lung capacity and can lead to COPD.

The disease usually presents itself in one of two ways—inflammation of the airways, which also causes bronchospasm, that take air to the lungs due to the buildup of mucus, or damage to the air sacs in the lungs, making for a less efficient transfer of oxygen to the blood.

Medications, often in the form of an inhaler, are available to treat both conditions. Your family physician or internist can diagnose COPD and recommend an appropriate course of treatment.

Daniel Spogen, M.D. was named chair of the family and community medicine department at the University of Nevada School of Medicine in Reno, Nevada in October 2006. Before joining the medical school’s faculty, Dr. Spogen was in private practice for more than 20 years in northern Nevada. He helped launch fellowship programs in obstetrics and sports medicine at the medical school as well as serves as assistant student clerkship director.

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Dr. Gregory P. Brown answers the question: “What’s the difference between normal worrying and an anxiety disorder?”

Transient worry and concern over stressful situations is a normal response to life. When anxiety symptoms or worry begin to impair daily functioning, it’s possible that the normal experience of episodic worry may have progressed into an anxiety disorder.

Panic attacks, repetitive checking behavior, recurrent nightmares of trauma, or obsessive guilt, may indicate a more severe problem and should be assessed by a physician or therapist.

Gregory P. Brown, M.D. is an associate professor of psychiatry at the University of Nevada School of Medicine in Las Vegas. Dr. Brown is board certified in general psychiatry and forensic psychiatry, American Board of Psychiatry and Neurology.

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Dr. Paul Stumpf answers the question: “Is it possible to freeze a woman’s eggs for future pregnancies?” (Note: Bruce Shapiro, M.D. and Said Daneshmand, M.D. of The Fertility Center of Las Vegas, contributed to this answer. Dr. Shapiro and Dr. Daneshmand are volunteer faculty at the University of Nevada School of Medicine.)

The answer is an unequivocal yes! The ability to successfully freeze and thaw oocytes, or eggs, is a technology that has greatly improved over the last ten years. Refinements over just the past five years have transformed the process into a routine procedure at fertility centers with proven freezing techniques. The Fertility Center of Las Vegas has been freezing oocytes for the past five years with excellent success.

The ability to freeze eggs is particularly important for women who anticipate loss of ovarian function due to advancing age, disease or disease treatment. These women may have a window of opportunity to save their eggs for future use. Such women include those who must have their ovaries removed or are to be treated with radiation or chemotherapy for cancer prior to having a family. Women who, for personal reasons, plan to conceive later in life have the opportunity to preserve their eggs before the age-related decline in ovarian function.

Egg freezing is an effective option for preserving fertility in women, just as sperm freezing has been an effective option for men.

Paul Stumpf, M.D. heads the obstetrics and gynecology department at the University of Nevada School of Medicine in Las Vegas. Dr. Stumpf is a board-certified obstetrician, gynecologist and reproductive endocrinologist.

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