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Want to protect yourself from skin damage from the sun’s harmful rays? Dr. Angela Walker, dermatologist with Renown Medical Group, shares what you can do to prevent skin cancer. What can people do to prevent skin cancer while enjoying the outdoors? There are several steps you can take to protect your skin from the sun. “I caution all of my patients to avoid the sun during the hours of 10 a.m. until 2 p.m. when UV rays are strongest. I also encourage people to wear sleeves on cooler days. And don’t forget that we still need to wear sunscreen on cloudy days! UV rays can still cause sun damage on cloudy days. Preventing skin cancer also entails wearing sunscreen of at least SPF 30 everyday.  Are hats also a good idea for skin protection? Yes, of course! Choose a wide-brim hat that shades the face as well as the back of the neck for extra protection against UV rays. When it comes to identifying skin cancer, what should people watch for? We use easy-to-remember letters when checking for spots on the skin; it’s called the ABCDEs: A - Asymmetry: One half of the mole or lesion doesn't match the other half. B - Border irregularity: The edges of the mole are irregular, blurred, or notched. C - Color variation: The mole has different shades of color or uneven color distribution. D - Diameter: The diameter of the mole is larger than the size of a pencil eraser (about 6 millimeters) or is increasing in size. E - Evolution: Any changes in the mole over time, such as size, shape, color, itching, bleeding, or crusting. These guidelines can help in identifying potentially suspicious skin lesions, but it's important to consult a dermatologist for proper evaluation and diagnosis. Early detection is crucial for successful treatment of skin cancer.

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Snowshoeing is an excellent winter workout that can help burn calories, strengthen muscles and boost cardiovascular health. Explore the top 8 snowshoeing spots and experience this ultimate workout adventure! Significant Health Benefits: Exceptional cardiovascular workout – burn up to 1,000 calories per hour! Low-impact muscle building Endurance building Balance strengthening and agility Improves your sense of well-being by connecting to nature Prepping for Your Adventure There are some crucial details to think about when it comes to snowshoeing, especially if you are a beginner. Make sure to pick the right kind of footwear to go on top of your snowshoes; a pair of comfortable waterproof boots are a great choice and remember to wear lots of layers. Several local places rent snowshoes if you aren’t sure about spending money on a pair. Check out Bobos Ski and Board Patio or our local REI Co-Op. Check out REI’s Beginner’s Guide to Snowshoeing for reference. 8 Cool Snowshoeing Spots 1. Galena Creek Park Close to Reno, this beautiful, low-altitude park offers several trails. You’ll find various creeks and streams under cover of pristine ponderosa pines. From beginner to advanced, the differing trail systems provide a challenge for everyone! Head west on State Route 431 (Mt. Rose Highway) for about seven miles until you see the park sign on the right side of the highway. 2. Tahoe Meadows – Chickadee Ridge This local favorite not only gives fantastic views of Lake Tahoe but the best part? – friendly little chickadees will eat seeds right out of your hand! Be sure to pack plenty of sunflower birdseed, as that seems to be their favorite. From the trailhead parking lot, head southeast into the open meadow. Then follow the ridgeline to your right (southwest). Continue southwest up toward the top of the ridgeline to the west, and you’ll get to Chickadee Ridge in just under two miles. 3. Spooner Lake Trail The easy 2.5-mile loop around Spooner Lake is excellent for all skill levels. This alpine lake is surrounded by aspen trees which house varied bird species, so bring your binoculars! Dogs are allowed on a leash, and all-day parking is $10. 4. Kirkwood Ski Resort You’ll need a trail pass, but this South Lake Tahoe resort has various routes from beginner to advanced, with roughly 50 miles of terrain. Nighttime snowshoe treks during the full moon are also available throughout the winter. Kirkwood is located on Highway 88, close to Carson Pass. 5. Camp Richardson Heading north, you can find this well-established and favorite local snowshoeing spot. If you’re up for an adventure, you can trek up to Fallen Leaf Lake. It’s located off Highway 89 and near Fallen Leaf Road. 6. Dry Pond Loop This moderate, 6.5-mile loop near Washoe Valley has impressive views of Carson Valley, Washoe Lake, and the Mt. Rose Wilderness. If you like the sound of rushing water, most of the trail meanders along White’s Creek. This area is dog-friendly and kid-friendly, which makes it a family favorite. 7. Royal Gorge Soda Springs is home to this resort, which is well known for its cross-country skiing trails. Enjoy extensive trails leading deep into the trees with spectacular views. Find Royal Gorge from the Soda Springs exit on West Interstate 80. 8. Ash Canyon Creek Tucked away in the Carson Valley, these trails are filled with mountain bikes in the spring and provide excellent snowshoeing trails in the winter. Find it from Interstate 580 by taking the Highway 395 Business exit to Winnie Lane.

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September is National Healthy Aging Month, which is described by Healthy Aging Magazine as a “month designed to focus national attention on the positive aspects of growing older.”   What does healthy aging mean to you? If you're like most people, you're looking forward to removing the negative from your life – negative energy, thoughts, people and activities that don't contribute to your best life.   While we remain focused on ridding ourselves of the negatives, we can forget about ways to strengthen the positive parts of our lives. Dr. Shruti Basho, a family medicine physician at Renown Health’s senior-focused medical group, provides us with five positive behaviors to focus on to improve happiness and life satisfaction.  Healthy Aging in 5 Easy Steps  Connect – Humans are naturally social creatures! Build connections with friends, family, colleagues and neighbors. Strong interpersonal connections help enrich your life with new experiences and opportunities. Having a support system to call upon in both times of need and times of celebration is priceless, especially as you age. Forming these bonds helps you stay healthier and happier well into your aging journey. Joining the Sterling Silver Club is a great place to meet more people in the community who want to live a healthy, fulfilled life just like you. Be Active – Regular exercise, particularly as you grow older, is vital to increase and maintain your endurance, strength and balance. But exercise doesn’t have to be a chore! Pick a physical activity that you enjoy – whether it be enjoying a nature walk, taking a power weightlifting class or anything in between. Being active will also help you build strong connections with others. If you need a workout buddy in your neighborhood, Nextdoor is a great resource to find people who live right around the block from you and may be looking for their next exercise partner.   Take Notice – Curiosity and mindfulness can be an impactful motivator in positive cognition and behavior as you age. Like a child, see the wonder and beauty of the world. Notice the things around you – the weather, the landscape, the mood and the feelings of people. According to Harvard Medical School, changes in the aging brain "enable us to become better at detecting relationships between diverse sources of information, capturing the big picture, and understanding the global implications of specific issues.” By taking notice, it’s easier to learn to appreciate the things that matter.  Keep Learning – Engaging with lifelong learning is one of the best ways to keep your mind active. Keep trying something new! Challenges keep you on your toes and increase your confidence and excitement in your day. Don’t know where to start? EPIC (Educational Programs Inspiring the Community) offers a diverse personal enrichment and professional development curriculum at Truckee Meadows Community College ranging from art classes to accelerated training certificate courses.  Give – Be generous with your time, your knowledge and your talents by giving to friends, family and the community when you have the capacity. Lending yourself to others doesn’t have to be taxing – saying thank you and even just giving someone a smile can change the course of someone’s day. If you’re looking for a hands-on way to give back, Nevada Volunteers is a great place to find volunteer opportunities near you. Renown Health is also always looking for volunteers who are passionate about making an unforgettable difference to the people and communities we serve.   Practice these five tips to improve happiness and quality of life at any age.

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Renaissance Don   The Sterling Silver Club is honored to have thousands of members who’ve led and continue to lead incredibly vibrant and diverse lives. And we’re absolutely thrilled when those members volunteer to share their stories and experiences so we can all appreciate and learn from them.   This issue’s featured member is no exception. From his love of cooking, travel and music to his drive to learn new languages, take on new hobbies and keep himself active and fit, Don is an aspiring Renaissance man who may already be deserving of the title.    Revolutionary Family Roots   Don’s father, who was born in Beijing, China, earned a master’s degree in metallurgical engineering from the University of California, Berkeley and was working on his PhD there on a full scholarship from his home country when the Chinese Communist Revolution occurred. In order to stay in the United States and avoid potentially being thrown into prison by the new communist regime (a fate that befell some of his family members), his father married Don’s mother, who was a U.S. citizen and also a student at Berkeley. Together, they started a family.   “My father met my mother in a class and received his green card by marrying her,” says Don. “They proceeded to have six kids in nine years, I was number three. Dad never finished his PhD, but clearly earned what we like to call his “PSK” degree – Papa with Six Kids.”  Proud (of) Papa: Don’s father was a professor of metallurgy and a brilliant research scientist who was responsible for virtually every breakthrough in the development of titanium in the 1960s.

Read More About Meet Multifaceted Member Don Chang

A Gallery-Worthy Member Artistry usually refers to a person’s ability to express their unique creativity in powerful and surprising ways. But there is also an art to living your life in ways that celebrate who you are, your limitless potential, the people you love and the community you care about. So imagine our delight to discover a Sterling Silver Club member and artist whose artistry of life reaches far beyond gallery walls.  An Early Love of Art Born in Chicago, Illinois, Debbie arrived as the last of her parents’ three children and has two older siblings, Cynthia and Henry (a.k.a. Skip). As is usually the case, school played an important role in their shared childhood and Debbie remembers being drawn to art assignments in class from an early age.   “When I was a young girl, I loved working on various art projects at school,” she recalls. “I always found myself learning something new and then teaching it to everyone I knew.”  Later, Debbie would play violin in the school orchestra, join the swim team, and to continue to learn about art and its broader influence.  “I remember taking a class and learning about color theory,” recounts Debbie. “I was so impressed with how colors relate to one another and also discovered how primary and secondary colors can be used together to make everything from products and advertising to what we wear more pleasing to the eye.”  Expression-ism. “Art allows you to express yourself,” says Debbie. “And I’ve always been quite happy being expressive.” Though Debbie’s affinity for art was obvious, it wasn’t destined to be her career… at least initially.  After earning degrees in marketing and public relations at North Central College in Naperville, Illinois and George Williams College of Aurora University in Williams Bay, Wisconsin, respectively, Debbie began what turned out to be a career in technology.  In the Chicago area, she held positions as a systems analyst and computer programmer and a role in marketing and public relations for a computer software company. Then it was off to Los Angeles, California with her new husband, David, where she worked in sales and education for another software company.  The couple returned to Elmhurst, Illinois to start their family but eventually moved to and settled in Minden, Nevada where David had an insurance business for 23 years and their children grew to become the adults their grandparents dreamed of. “My mom and dad would be most proud of our children,” beams Debbie. “They (her parents) always hoped for the best for them and would be over the moon that they are doing what they want to do, two of them in the field of medicine.”  Debbie and David now live in Carson City, Nevada and their three children have established lives of their own. Jeffrey, the oldest, is a pastor and holds two master’s degrees. Rachael is an OB/GYN provider in Southern California and a graduate of University of Nevada, Reno School of Medicine (UNR Med). And their youngest, John-Henry, is finishing up his medical training and will soon be a trauma surgeon.  Furry Family Members Debbie’s other “kids” are of the four-legged variety. “Mercedes and Bentley are really our luxury pugs,” she admits. “But are named after famous characters from books, not luxury cars.” She also says they are goofy, much-loved and simply melt the hearts of everyone they meet – “always!”

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Renown Health recently announced that it has contracted with the Centers for Medicare and Medicaid Services (CMS) on a new program that offers enhanced Medicare benefits for Medicare beneficiaries. This new direct contracting Medicare program is designed specifically for patients with Original Medicare. Here are three things to know about Renown’s new program: The goal of the program is to help care providers work together to improve patients’ health by better coordinating patient care and reducing costs. Medicare beneficiaries who choose to sign up will have peace of mind knowing that they are in a program that ensures coordinated care along with potential cost-sharing assistance for chronic care management. Signing up for this program is easy – and it does not affect your existing Medicare benefits in any way. Simply click the button below, select either your current Renown Health or Geriatric Specialty Care provider from the drop down menu, complete the form and click “Submit Form.” It only takes a minute or two to fill out the form. You will be asked to provide the name of your primary care provider and be sure have your red, white, and blue Medicare card handy. Sign Up for Renown’s Enhanced Medicare Benefit Program Voluntary Alignment Sign Up Note: Participation in this program is voluntary. If you choose to sign up, your benefits will NOT change, and you can visit any doctor, other health care professional, or hospital. Learn more about Renown’s Direct Contracting Entity for Medicare Beneficiaries here. The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.

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Renown’s Sterling Silver Club is honored to feature members of our club each season. We thank Mary and Dave for sharing their fun-loving story and all of our members for leading healthy, happy lives that inspire us all.     Rock On! Rhyolite almost sounds like a rock band, but it’s not (at least not one that we are aware of). It is a ghost town near the eastern boundary of Death Valley National Park, the most silica-rich of volcanic rock – and the magma-based spark for what has become a very special relationship of our featured Sterling Silver Club member couple, Mary and Dave.  “May I carry those for you?” Mary and Dave first met back in January of 2015 when they sat near each other at a financial seminar in Reno. Though friendly banter was exchanged at the time, contact information was not. It wasn’t until later that year in July when “rock karma” intervened. The two reunited unexpectedly when they joined friends on an excursion to Wonder Mountain near Fallon, Nevada to gather… Rhyolite!  “I remember I enjoyed meeting Mary at the seminar and thought she was pretty, but didn’t get her phone number,” recalls Dave.  “But that day in the desert, Dave asked if he could carry my rocks,” Mary smiles, “and we got each other’s numbers and began dating after that.”  Since then, they’ve gone “rockhounding” all over the state. Smokey quartz brought them to Mt. Peterson, north of Reno. Daisy agates were worth a trip to Austin, Nevada. They’ve hunted for Larsonite, a rare, petrified bog wood found only in McDermott, and also venture out with the Comstock Gold Prospectors Club in search of that precious metal.  Hiking, exploring and searching for interesting and colorful “finds” together make rock hunting one of the couple’s favorite hobbies.  “I’m especially fascinated with petrified wood that’s been lying in the desert for millions of years until I dig it up,” says Dave. “Pretty cool!” The Pre-Rock Years Mary and her four siblings are first generation Chinese Americans. Her parents who emigrated from Malaysia to the U.S. by way of Canada after World War II and raised the family in Northern Virginia. After earning a bachelor’s degree from the College of William and Mary, our Mary started a career in software training and project management. Now retired, she occasionally goes to work helping friends and family with travel reservations.  Dave and his three siblings were born and raised in Southern California. He remembers his parents taking the family camping in the Sierra Nevada mountains a couple times a year and trips out to the sand dunes in San Filipe, Mexico where they’d stay for weeks at a time. Dave began his career in the restaurant industry right out of high school and was eventually recruited to run a developer’s hotel restaurant and be his personal chef. Dave wrapped up his career in 2012 when he stepped down as executive chef at Circus Circus Reno Hotel & Casino.  More recently on the non-work front, Dave’s son, Cameron, and his wife, Rebecca, have blessed grandpa Dave with a granddaughter, Madison – and there’s a grandson on the way!  Getting to Know You   Mary and Dave also use their time to collect travel experiences that have allowed their relationship to deepen and their appreciation of each other to grow. They’ve camped at Death Valley and locations throughout the Nevada desert and admit to more civilized stays in hotels and resorts in Ireland, Mexico, Portugal, Spain and the United States. They also spend a week every fall paddling their canoe along the shores of Lake Tahoe, which they call the most beautiful place in the world.  Well, when you travel that much with someone, you really get to know them.  “Mary has the clever wit to keep things interesting,” says Dave. “Plus she has the patience to put up with my little quirks and idiosyncrasies, and the gumption to keep me out of trouble!”    And Dave’s cooking skills have found a fan in Mary, who’s a bit of a cook herself. “My favorite dish of his is roast duck,” says Mary. “I offered a little coaching and showed him the traditional way of serving it with steamed rice pancakes, hoisin sauce and spring onions.”  Mary also enjoys spending time bulldog spotting, restoring her 1992 Mazda Miata, playing the ukulele, crocheting and knitting – and she’s teaching herself Spanish!  Member-to-Member Advice Mary and Dave enjoy socializing with other Sterling Silver Club members and learning how to better care for their health at different club events. As for their advice to other members? That’s simple: “Live the best life you can by taking care of yourself and your family and friends.” The Sterling Silver Club thanks Mary and Dave for giving us a glimpse inside their ROCKIN’ relationship and appreciates all of our members for being passionate about living their best lives.

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As we begin to enjoy the springtime weather in northern Nevada, are you finding your skin less than tip-top shape? Here’s how to add moisture back in easy, natural ways. You don’t need to be a medical aesthetician: Dry, cold climates can often wreak havoc on your body’s largest organ — your skin. These tips from Renown Dermatology, Laser & Skin Care will quickly put moisture back and relieve dry, chapped skin. 11 Miraculous Moisturizing Tips Always wear broad-spectrum sunscreen, even during winter months. Don’t forget to use an SPF lip balm, too. Heaters dry out your skin. Use a humidifier to keep moisture in the air. (And try these simple tips to make sure you’re keeping that humidifier clean.) If your skin is dehydrated, try using a nighttime moisturizer during the day. Use a hydrating mask or moisturizing mask twice a week. Don’t forget your hands and feet. Apply a rich cream to the hands and feet at night and cover them with gloves and socks to restore moisture while you sleep. Drink plenty of water to stay hydrated. Try adding a hydrating serum to your morning and nighttime skincare routine to heal the skin. Use a gentle exfoliant to remove dry skin at least once a week, which helps your skin absorb your moisturizer. Apply body oil or lotion in the shower while your skin is still damp to trap moisture. Hot water dries out your skin, so turn down the temperature in the shower and bath.   A little pampering goes a long way, and Renown’s medical aestheticians are here to help. Trained in skincare and advanced therapies, our experts can transition your skin to look healthy, youthful and rejuvenated.

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Renown’s Sterling Silver Club is honored to feature one of our more than 9,000 members each season. We thank Judith for sharing her inspirational story and all of our members for leading healthy, happy lives that inspire us all.     Mother, grandmother and eventually great-grandmother is the expected title progression as families grow and babies have babies. “Grand” and “great” usually imply roles and responsibilities have shifted from daily child-rearing duties to those of a doting grandparent – that is, unless you decide to do it all over again. At the age of 61, that’s exactly what featured Sterling Silver Club member, Judith, decided to do when she adopted four of her great-grandchildren. At the time, Alicia, Adrianna and Joey were all under five and Giancarlo, the youngest, was just a baby. “At the adoption hearing, the judge was concerned how stressful it would be for me to raise four children in my late 70s and early 80s,” recalls Judith. “But I told him I had raised my own four children and then three grandchildren for a number of years and that it would be far more stressful for me to have my great-grandchildren separated from each other and me, possibly forever. I knew I could handle the stress of raising them no matter my age, but I couldn’t survive the stress of losing them.” “That was when Giancarlo started getting fidgety,” she continues. “So I raised up his little shirt and blew a raspberry on his tummy which made him giggle and settle down. Seeing that, the judge told the recorder to “put that move in the record” and agreed I was capable of caring for my little ones.” Years later, Judith has come to realize that her great-grandchildren also want to be there to care for her. “Giancarlo always makes me smile,” says Judith. “Once during a stay in the hospital, I was awoken at 3 a.m. for blood work and found him sitting next to my bed watching the oxygen count – he was 10 years old at the time.” “The nurse asked him why he was awake and he said he heard her say the count shouldn’t go below 88, so he was watching to save me if it did,” Judith explains. “The nurse reassured him that she was also watching the count at her desk and he didn’t need to worry. Then Giancarlo looked her square in the eye and told her if it went below 88 to wake him up because he loved me and didn’t want to lose me.” “He is still my sunshine,” Judith smiles. “And I have never regretted my decision.”   Work & Play For 20 years, Judith worked at Truckee Meadows Community College (TMCC), first as an administrative assistant for the police academy before moving to a position in the president’s office. There she worked with the TMCC Foundation and on TMCC projects to raise capital funds for new buildings, off-site campuses, scholarships, college programs and more. “It felt wonderful to be able to notify a student that they had received a scholarship or tell a department that they had received the funds to purchase needed equipment for their program,” recalls Judith. For fun these days, Judith still enjoys doing something she did as a teenager: playing pool. “My mother taught me to play pool in my dad’s pool room/teen hangout space in my early 20s and I’m just getting back into the game by taking lessons to help remind me what I was taught,” says Judith. “I grew up in a small, country town on the Ohio River and my mother could beat almost all of the boys in the county. I would love to be able to emulate her ability in the game.” Judith also enjoys reading, watching Hallmark movies or Warriors basketball games, walking in nature, playing “competitive” shuffleboard with friends, all genres of music – and dancing! In fact, she’s currently taking dance lessons to learn a few new steps. Always Good for a Laugh “My great-grandchildren and I laugh a lot when I try to teach them the stroll, twist, mashed potato and old-fashioned, rock-‘n’-roll dancing,” admits Judith. “But we laugh even harder when they try to teach me their dance moves!”   Faith in What Matters Faith is something Judith celebrates and embraces for herself and others. “I truly believe that we are placed on earth exactly where God feels we are needed and that we are here to help each other through life, not to accumulate material goods for ourselves,” says Judith. “I feel deep satisfaction when I can help others either through just listening to them, advising them, helping them with specific needs or simply giving a smile to a stranger. To me, giving a smile or a helping hand to someone is like skipping a rock across the water – the ripples go on and on.” Then she adds, “And raising my great-grandchildren to be able to have wonderful lives full of love and happiness and closeness to God is the greatest gift I could give them.”   Club Talk So what does Judith appreciate most about being a member of the Sterling Silver Club? She says it’s the opportunity to just – talk. “I fully enjoyed my initial interaction with the club and other club members at the Roaring Twenties dinner dance event,” remembers Judith. “I sat at a table with the nicest ladies and had great conversations with adults and danced with one of the instructors. When you are raising four teenagers who sometimes seem to speak an entirely different language, it’s refreshing to meet and speak with others your own age.” Pictures of some of the popular Sterling Silver Club events are featured here. Judith finds club events that bring her joy. “I also like the cooking classes and recently went on a walking tour of Oxbow Park, which was very peaceful.”     What advice does Judith have to help other members live their best and fullest lives? “On a wet December morning 50 years ago,” Judith begins, “a truck coming around a curve on a country road slid into me and that split second could have made all the difference in the world to me. But God was with me and I survived, which no one expected.” “You never know when that one second that could change everything might happen, so make the most of all of your seconds,” she advises. “Do what you love with those you love. My family means the world to me and I try to think about how my decisions will reflect on the memory I will leave behind for them.” Then Judith thoughtfully adds, “I want them to remember that I truly loved them and always did my best to let them know that.”

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Millions suffer from urinary incontinence (urine leakage). Often people feel as if their bladders control their lives. But this doesn't have to be your story. Bladder control issues are treatable and you can take steps to help control your bladder. What is urinary incontinence? Men and women of all ages can have difficulty controlling their bladders. Urinary incontinence occurs when the muscles in the bladder that control the flow of urine contract or relax involuntarily. Is there more than one type of urinary incontinence? Yes, there are three main types: Stress incontinence is when the bladder leaks small amounts of urine as a result of physical stress or pressure on the muscles supporting the bladder caused by coughing, sneezing, laughing, lifting or any sudden physical exercise such as running or jumping. Urge incontinence is the inability to control a strong urge to go without advance warning, limiting the time needed to get to the bathroom. Overflow incontinence occurs when the bladder does not empty properly. As a result, over time, large quantities of urine are stored, causing the bladder to overflow (this is more common in men and is often the result of an enlarged prostate blocking the bladder opening). Are there any tests that can determine the cause and type of incontinence? Your doctor may have you track your fluid intake and output in a Bladder Diary. A urinalysis can be checked for infection, traces of blood, or other abnormalities. Blood tests can look for chemicals or substances that may relate to contributing causes. Other testing may be an ultrasound, cystogram or post voiding residual measurement. How is urinary incontinence treated? Exercises to strengthen the pelvic floor muscles or restrain the bladder to hold on for longer. Medication can relieve and control the troublesome symptoms. If there is an infection an antibiotic is used. Surgery can repair weakened muscles or remove blockage. Special products such as pants, pads, collection devices, and chair and bed protection may be needed if the problem cannot be controlled. How do you strengthen your pelvic floor muscles? To make your pelvic floor muscles stronger, alternate between squeezing and relaxing them. Following the steps below may help: Squeeze your muscles for one second and hold. Relax your muscles for two seconds. Each time you squeeze and relax, it counts as one set. Complete five sets. When you can do the exercises easily, increase to doing them 10 times per day. When that gets easy, try to squeeze and hold the muscles for three seconds and then relax the muscles for three seconds. As your pelvic muscles get stronger, you can progress to longer squeezes for about 10 seconds. Be sure to relax between squeezes so that your muscles can rest before squeezing again. You should do these exercises in three different positions. Do 10 sets lying down, 10 sitting and 10 standing. It is important that you develop the habit of doing the exercises every day. You may want to exercise just after you get up in the morning and right before you go to bed at night. What can I do to help control incontinence? Watch your weight, practice pelvic floor muscle exercises, eat plenty of fresh fruits, vegetables and fiber to prevent constipation. Most importantly, talk to your doctor regarding incontinence issues, don’t be embarrassed!

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Once upon a time … in Incline  This issue’s featured member began writing the latest chapter of her life story by retiring on Lake Tahoe’s north shore in Incline Village, NV.  “I had several criteria when selecting a place to retire,” says MaryBeth. “And a healthy lifestyle was number one. The people who have settled in Incline are very active with both their minds and their bodies. It’s not a stagnant population, it is unusually robust. I’ve made wonderful friendships here and we really watch out for each other, which means the world to me.” “I also wanted four seasons a year,” she continues. “And most importantly, I wanted a place that my son, Addison, would love to visit and share with me – and world-class skiing just minutes away scored extra points with both of us!” Zürich and Beyond  Skiing was something MaryBeth and Addison took to with a passion while living in Zürich, Switzerland. A business move to the land of the Alps (and Swiss chocolate) provided the perfect opportunity for an international education for her son and a culturally eye-opening experience for the family.  “I was unprepared for what it was going to be like living in a foreign place, and I learned a lot about empathy as a non-native and the kindness of strangers, or not. Our seven years there gave us many easily available travel adventures on the other side of the globe, and the friendships I made with people around the world have been lifelong.” “Divas” of the Garden  “Tall and showy” is how MaryBeth lovingly describes the “Divas” of her garden, aka the delphiniums. Located in the sunny part of her yard, the plants explode in a variety of colors that accentuate her home’s landscaping and are a well-earned reward for her mountain gardening challenges. “The very first thing you must do when creating a new garden is amend the soil,” explains MaryBeth. “It’s not sexy, but it’s necessary! And that’s when you learn that every shovelful of “mountain” dirt is loaded with rocks of every size – it’s fantastic exercise!” And her neighbors appreciate the hard work. “I’ve made so many friends of all ages in the neighborhood while working outside in my garden,” shares MaryBeth. “They stop, chat, inquire about the plants and take photos all the time.” Then with a smile, she adds, “You could call it my art.” Aging-In to Life with Medicare At 64 and on the cusp of Medicare eligibility, MaryBeth recently tasked herself with learning what she could about the plans and options that would soon be available to her and was overwhelmed. “I made the mistake of entering my phone number on a Medicare website for “wanting more information” and had no less than 15 calls a day from health insurance brokers – from all over the country!” she exclaims. “What one person would tell me would then be questioned by the next. I eventually quit answering the phone.” However, finding a Medicare plan that meets all of her needs is still a priority. “First and foremost, since I am a traveler (at least before the pandemic) I want to have a healthcare plan that will cover me in any state,” MaryBeth explains. “I would also like a policy that allows for alternative treatments, such as acupuncture – which I’ve had great success with in the past. I know that getting a good Rx plan now will save me money down the line, and I also want to be able to see a specialist without seeing a provider first for a referral.”

Read More About A Tale of Life Done Right

You probably know testosterone (T) plays an important role in how boys physically develop into men. But is that all you know? What happens when a man's T levels are off? Are there symptoms men should look for? And what are the treatment options? Dr. Bobby Kahlon, MD, Renown Medical Group provides answers in a Testosterone Q&A.   What does testosterone do for men?  "Testosterone is known as the 'manly hormone' for a reason," says Dr. Kahlon. "Though women also naturally produce small amounts of it, men produce testosterone at much higher concentration levels. And it affects men in more physical and obvious ways. How much hair a man has on his chest, how deep his voice is, or how muscular he is are all attributable in some way to testosterone. It's also responsible in large part for sex drive and bone strength and affects how men think, learn and experience their surroundings."  Testosterone in men:   Powers virilization (male physical characteristics) and sexual function Builds muscle mass and strength  Supports bone density  Improves cognition  T Trivia: Discover Magazine reveals that “manly” testosterone and other sex hormones evolved long before we did — 500 million years ago — from the ultimate “female” hormone, estrogen. Can you have too much or too little testosterone?  Though high testosterone isn't a concern for most men, low testosterone or low T occurs more frequently and develops for two primary reasons.  Dr. Kuhadiya explains, "Subnormal testosterone concentrations occur either due to pituitary or testicular failure and the causes for each need to be discussed with your physician."  Pituitary failure: Approximately one-third of men with obesity, type 2 diabetes, or metabolic syndrome (which includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels) have low free — or "bioavailable" — testosterone. These health conditions can cause the pituitary gland to "fail" to release follicle stimulating hormone (FSH) and luteinizing hormone (LH) which are essential for triggering testosterone and sperm production. And that can cause low testosterone (hypogonadism). Testicular failure: Though less common than pituitary failure, testicular failure may also be responsible for low T. It's caused by diseases or illnesses affecting the testicles, injury or trauma to the testicles, or certain medicines and treatments such as chemotherapy or opioid pain medication. Providing your complete medical history to your doctor is always the first step toward a proper diagnosis.  What are the symptoms of low T?  The following indicators could be a sign that you have low T, say the doctors.  Lack of motivation and determination, including mild depression  Loss of physical endurance and muscle strength  Loss of or diminished early morning erections  Reduced libido (sex drive)   Erectile dysfunction (ED — difficulty achieving or maintaining an erection)   Gynecomastia (male breasts)  Small testes  T and Time: T levels in men naturally begin to decline by about 1% a year starting at age 30.  How do you test for low T?  "There are different methods for testing testosterone levels," says Dr. Kuhadiya. "Each approach uses a blood sample to evaluate total testosterone, which includes free and attached testosterone that combines with proteins albumin and sex hormone-binding globulin (SHBG). For the most accurate results, testing is based on samples collected in the morning after fasting, and from tests on two different days."  What treatment options are available?  "Well, your best natural option may be YOU," says Dr. Kahlon. "Men with pituitary failure are often able to treat their low T by losing weight to increase levels of the hormone. And even if you don't lose weight, exercise can help boost your testosterone. Unfortunately, if you have testicular failure, weight loss and exercise may not have the same effect."  So, are there other options? "You may want to consider Testosterone Replacement Therapy (TRT)," says Dr. Kuhadiya. "TRT is only available to men who are hypogonadal — with a clinical diagnosis of low T. Injection, gel, skin patch and nasal spray are available TRT options. The best option is the one that works best for the patient. Convenience, insurance coverage and cost are all factors to consider." Dr. Kahlon's TRT preference? Daily gel treatments, which are applied directly to the skin. On the other hand, Dr. Kuhadiya recommends intramuscular injections, which take place once a week or every two weeks.  But both doctors agree on this: physicians and their patients need to weigh the benefits and risks of TRT before proceeding with treatment — especially if your low T condition may require lifelong treatment. "In my clinical practice, I have seen some very good long-term results with an improved quality of life," says Dr. Kuhadiya. "However, in certain situations, TRT may increase the risk of heart disease and is not recommended for men with a history of prostate cancer." Dr. Kahlon adds, "Patients receiving any type of hormone therapy need to be closely monitored throughout the treatment process for any changes in their health."   How do you feel about steroids and T boosters?  "I don't recommend them, certainly not for hypogonadism," advises Dr. Kahlon. "There is no evidence to support anabolic-androgenic steroids or testosterone boosters as a safe or effective treatment for low T in men."  "In fact, there continues to be emerging evidence they may lead to side effects that could potentially harm the liver and the pituitary and endocrine functions of the body," warns Dr. Kuhadiya. "And that damage may be irreversible."

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