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    • Atención cardíaca
    • Salud de la mujer

    5 Things to Know About Women’s Heart Disease

    Heart disease is more common in women than many people think. In fact, it is the leading cause of death in the United States, ahead of cancer and stroke. However, the common signs and symptoms we often associate with men and heart disease don’t always align with women.   Thankfully, Renown Health is home to the first women’s heart center in Nevada. The Helaine Greenberg Women’s Heart Center gives women in our community the opportunity to receive exemplary care and education.   “At the Women’s Heart Center, we are proud to offer the women of our community the treatments, therapies and education they need to fight this silent killer,” Dr. Danish Atwal.  1. The warning signs for heart disease present differently in women than they do in men.   Both men and women may experience chest pain during a heart attack, but the similarity of symptoms ends there. Heart disease is especially problematic for women because more than half of women who die of heart disease have no symptoms at all. Women tend to have subtler symptoms that mimic symptoms associated with common, mild illnesses:  Fatigue or weakness Pain, pressure or tightness in the center of the chest Pain that spreads to the upper body, neck or jaw  Sweating, nausea or vomiting   Sudden dizziness   Shortness of breath  Trouble sleeping   2. Women are often not treated with the same medications as men, even when they should be.  Women are less likely to receive heart medication because their disease is often misdiagnosed or because they do not seek proper care. According to a study done by Harvard Health Publishing in 2020, “A general lack of awareness of women’s heart disease may lead to doctors or patients missing heart attacks in women or delaying their diagnosis. For example, while the frequency of cardiovascular disease tends to be lower in women before menopause than in men, the frequency dramatically increases after menopause, when it accounts for approximately one out of every three deaths in women.  3. Women who have hypertension, high cholesterol, type 2 diabetes or gestational diabetes during pregnancy are at a higher risk of a heart attack in the future.  Women who experienced complications related to developing high blood pressure or hypertension during pregnancy had a 63% increased risk for developing cardiovascular disease later in life, as stated by research funded by the National Heart, Lung, and Blood Institute.  According to that same study, researchers found that early screenings and monitoring in four target areas  – blood pressure, cholesterol levels, glucose levels and body mass index – could provide even more personalized targets to help delay or possibly prevent future cardiovascular events among women.

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  • Women's Heart Center

    Heart disease is the leading cause of death in women. According to the American Heart Association, heart disease kills more women than all forms of cancer combined and yet only 44% of women recognize that cardiovascular disease is their greatest health threat. Recognizing the urgent need for women's cardiac care, Renown Health established the Helaine Greenberg Women's Heart Center, the first of its kind in Nevada.

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    • Atención cardíaca
    • Salud de la mujer

    Las mujeres y los ataques cardíacos: signos sutiles que debe conocer

    Heart disease is the number one killer of women – claiming one life every minute – yet many women don’t know that the signs of heart attack may not be the same symptoms they’ve learned about all their lives. In women, nearly 71% experienced unusual exhaustion in the weeks before, 50% had trouble sleeping and 42% suffered shortness of breath. Most importantly, about 43% had no chest pain. Women and Heart Attacks: The Subtle Symptoms In both men and women, the most common symptom is pressure or pain in the mid chest, but there are also more subtle signs. “Women can experience a heart attack without chest pain,” explains Letitia Anderson, M.D., cardiologist with Renown Institute for Heart & Vascular Health. “It is not uncommon for women to experience extreme fatigue, shortness of breath, dizziness, lightheadedness, nausea, vomiting and pain in the abdomen or back as their primary symptom.” Other symptoms can include: Neck or jaw pain Fullness or pressure that goes away and comes back The feeling of a rope being tied around your body and squeezed Some doctors have reported seeing patients who just didn’t "feel right." One woman simply felt more tired than usual while cleaning, while another woman reported feeling winded carrying boxes to the basement. Admittedly these are symptoms many of us would shrug or sleep off versus going to the hospital for immediate care, which is why it’s important to pay close attention to the warning signs. “Women are good at being the caregiver for the rest of the family and writing off their own symptoms as something minor, like indigestion or a muscle pull,” says Dr. Anderson. “Remember that heart attacks have early warning signs, and if they are recognized and treated in time, a heart attack can be prevented and heart damage avoided.” When You Need to Call 911 Paying attention to your body is key. If you’ve experienced any unusual or flu-like symptoms, struggled to breathe or just don’t feel right – give yourself a gut check and ask if you’ve honestly felt this way before. If you’re worried at all, you need to seek emergency care. Do not wait – call 911 immediately Take an ambulance to the hospital if at all possible Try to stay calm and take deep, slow breaths until medical help arrives.

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    • Friday, Sep 29, 2023

    Renown Health Nationally Recognized for Commitment to Providing High-Quality Stroke Care With Three American Heart Association Recognitions

    The American Heart Association presents Get With The Guidelines®- Stroke Gold Plus awards for proven dedication to ensuring all stroke patients have access to best practices and life-saving care. Renown Health emergency, medical and surgical providers have received three American Heart Association’s Get With The Guidelines® awards. These awards demonstrate commitment to ensuring stroke patients receive the most appropriate treatments according to nationally recognized, research-based guidelines; reducing disabilities and increasing the number of lives saved. Every 40 seconds, someone in the U.S. has a stroke. Los derrames cerebrales son la quinta causa principal de muerte en los EE. UU. y la principal causa de discapacidades en adultos. Studies show patients recover better when providers consistently follow treatment guidelines. Get With The Guidelines puts the expertise of the American Heart Association and American Stroke Association to work for hospitals nationwide, helping ensure patient care is aligned with the latest research and evidence-based guidelines. “A stroke is an extremely serious condition that requires emergent medical treatment. The faster treatment is provided, the lower the risk of brain injury. We are proud of our thousands of physicians, nurses and clinicians who consistently practice exceptional patient care by adhering to the latest treatment guidelines,” said Brian Erling, MD, MBA, President and CEO, Renown Health. “Get With The Guidelines makes it easier for our teams to put proven knowledge and consistent protocols to work on a daily basis, which studies show can help people live longer and better lives.” “As a participant in Get With The Guidelines programs, Renown qualified for the awards by demonstrating that physicians and clinicians across our integrated health system are committed to improving quality care for stroke patients,” said Bill Plauth, MD, MMM, CPE, Chief Medical Officer for Renown Health and Associate Dean for Clinical Affairs at the University of Nevada, Reno School of Medicine. “If you or a loved one is experiencing a stroke, call 911, as you need skilled medical care immediately. Stroke care focuses on helping people recover as much function as possible and return to independent living. The Renown Neurovascular and Stroke Program and Renown Rehabilitation Hospital teams provide expert emergency stroke care and comprehensive neurovascular care and rehabilitation services.” “We are pleased to recognize Renown Health for its commitment to caring for those in their community who need cardiovascular care,” said John Warner, MD, FAHA, past president of the American Heart Association and CEO of The Ohio State University Wexner Medical Center. “Hospitals that follow the American Heart Association’s quality improvement protocols often see improved patient outcomes, fewer readmissions and lower mortality rates – a win for health care systems, families and communities.” “Renown Regional Medical Center is the only designated Comprehensive Stroke Center in northern Nevada,” says Benjamin Pence, DO, Director, Institute for Neurosciences at Renown. “This means that we have the highest level of certification to receive and treat the most complex stroke cases. Our Institute for Neurosciences team is led by the area's top neurologists, and we conduct research studies involving new ways of preventing, diagnosing, and managing neurological disorders. We care for patients suffering from nerve and brain disorders due to stroke, headache, epilepsy, and other acute causes. We also monitor and develop treatment options for patients with memory and movement disorders such as Alzheimer’s, Parkinson's Disease or Multiple Sclerosis.” Renown Health also received the American Heart Association’s Target: Stroke Honor Roll Elite award. To qualify for this recognition, hospitals must meet specific criteria that reduce the time between an eligible patient’s arrival at the hospital (within 60 minutes or less) and treatment for at least 85 percent of applicable patients. “It is an honor to be among the American Heart Association’s Stroke Honor Roll Elite award recipients,” said Bret Frey, MD, president of Northern Nevada Emergency Physicians Care teams at Renown Health. “We adhere to these rigorous guidelines daily and demonstrate our unwavering commitment to ensuring more people in northern Nevada receive leading emergency and trauma care and the gift of extended, healthier lives.” Renown Health also received the American Heart Association’s Target: Type 2 Diabetes Honor Roll - Stroke award. Target: Type 2 Diabetes aims to ensure patients with Type 2 diabetes, who might be at higher risk for complications, receive the most up-to-date, evidence-based care when hospitalized due to stroke. This award is given to hospitals that qualify for the silver level or higher achievement award within the Get With The Guidelines – Stroke program and achieve an overall Diabetes Cardiovascular Initiative Composite Score of more than 80 percent. About Renown Health Renown Health is Nevada’s largest, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination, and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the locally owned not-for-profit insurance company, Hometown Health. To join the Renown team, visit renown.org/careers. About Get With The Guidelines Get With The Guidelines® is the American Heart Association/American Stroke Association’s hospital-based quality improvement program that provides hospitals with the latest research-based guidelines. Desarrollado con el objetivo de salvar vidas y acelerar la recuperación, Get With The Guidelines ha influido en la vida de más de 12 millones de pacientes desde 2001. For more information, visit heart.org.

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    • Miércoles, 26 de julio de 2023

    Renown Health Is Nationally Recognized for Its Commitment To Providing High-Quality Heart Failure Care With Three American Heart Failure Recognitions

    Renown Health Cardiology has received the American Heart Association’s Get With The Guidelines® - Heart Failure Gold Plus quality achievement award for its commitment to improving outcomes for patients with heart failure, meaning reduced readmissions and more healthy days at home. The heart care team also received Target: Heart Failure Honor Roll and Target: Type 2 Diabetes Honor Roll. About 6 million U.S. adults are living with heart failure (HF), a number that is expected to increase to more than 8 million by 2030. Despite the name, HF doesn’t mean that the heart has stopped working – it means the heart is having a hard time pumping blood and oxygen throughout the body. While there’s no cure for HF, patients can live a quality life by working with their health care team to create and stick with a plan that may include medication, symptom monitoring and lifestyle changes. The Get With The Guidelines - Heart Failure quality achievement award is earned by hospitals that demonstrate a commitment to treating patients according to the most up-to-date guidelines as outlined by the American Heart Association. Get With The Guidelines puts the expertise of the American Heart Association to work for hospitals nationwide, helping ensure patient care is aligned with the latest research- and evidence-based guidelines. The program aims to increase healthy days at home and reduce hospital readmissions for heart failure patients. “Renown Health is committed to improving patient care by adhering to the latest treatment guidelines,” said Jayson Morgan, MD, Director of Cardiovascular Services at Renown Health. “Get With The Guidelines makes it easier for our teams to put proven knowledge and guidelines to work on a daily basis, which studies show can help patients recover better. The end goal is to ensure more people in northern Nevada can experience longer, healthier lives.” Each year, program participants qualify for the award recognition by demonstrating how their organization has committed to providing quality care for HF patients. In addition to following treatment guidelines, Get With The Guidelines participants also provide education to patients to help them manage their HF at home. “We are pleased to recognize the leaders and teams at Renown Health for a strong commitment to caring for people with heart failure,” said Clyde W. Yancy, MD, MSc, MACC, FAHA, MACP, FHFSA, national chairperson of the American Heart Association Heart Failure systems of care advisory group and chief, division of cardiology at Northwestern University, Feinberg School of Medicine. “Hospitals that participate in Get With The Guidelines quality improvement programs often see better patient outcomes, fewer readmissions and lower mortality rates – a win for health care systems, families and communities.” Renown Health is also recognized on the American Heart Association’s Target: Heart FailureSM Honor Roll. Hospitals on the Honor Roll meet specific criteria that improves medication adherence, provides early follow-up care and coordination and enhances patient education. The goal is to further reduce hospital readmissions and help patients improve their quality of life in managing this chronic condition. Renown Health additionally received the American Heart Association’s Target: Type 2 Diabetes Honor Roll™ award. Target: Type 2 Diabetes aims to ensure patients with Type 2 diabetes, who might be at higher risk for complications, receive the most up-to-date, evidence-based care when hospitalized due to heart disease or stroke. About Renown Health Renown Health is Nevada’s largest, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination, and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the locally owned not-for-profit insurance company, Hometown Health. Renown is currently enrolling participants in a community-based genetic population health study, the Healthy Nevada Project®. Acerca de Get With The Guidelines Get With The Guidelines® es el programa de mejora de calidad hospitalaria de la Asociación Estadounidense del Corazón y la American Stroke Association que proporciona a los hospitales las últimas pautas basadas en la investigación. Desarrollado con el objetivo de salvar vidas y acelerar la recuperación, Get With The Guidelines ha influido en la vida de más de 12 millones de pacientes desde 2001. For more information, visit heart.org.

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  • Atención cardíaca

    We lead the region in cardiology care with our technological expertise and patient-centered approach. Our comprehensive team diagnoses heart disease and other cardiac conditions, offering personalized treatment plans. Plus, our specialty team provides you access to the most advanced medical, surgical and minimally invasive techniques.

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    • Atención de urgencias
    • Prevención y bienestar

    Avoid Viruses, Colds and the Flu With Expert Hand-Washing Advice

    Can you really avoid colds, flu and viruses with simple hand-washing? Amy McCombs, Renown’s director of Infection Prevention, shares how to stay healthy with this very simple practice. Shaking hands, turning doorknobs, drafting emails — all regular activities of everyday life. But whenever you touch another person, or touch an object another person has touched, you’re collecting their germs on your hands. And touching your own mouth, eyes or nose also exposes you to whatever germs you’ve collected. That makes hand-washing the most important step you can take to prevent illness and disease. And while that may seem like an obvious reminder, studies have found that 85 percent of people do not practice proper hand hygiene. We asked Amy McCombs, Renown’s director of Infection Prevention, to give us some hand-washing tips for a safer, healthier life. So what are the correct hand-washing steps? Wash for at least 20 seconds. The biggest thing to remember is to wash for at least 20 seconds with soap and water. A good rule to make sure you’re washing long enough is to sing “Happy Birthday” twice through. Get a good lather of soap going. It’s also important to get a nice lather of soap and make sure you wash between your finger, both the tops and palms of your hands and your nail beds. And if you wear jewelry, you need to remove it or make sure you get lather and friction underneath. Then rinse completely and dry. Is there a wrong way to wash your hands, or is it more about making sure you do it the right way? Honestly, it’s a little bit of both. There is a wrong way since 85 percent of us don’t wash correctly. This could be for a variety of reasons. It could be because you don’t wash long enough, don’t get in between your fingers, don’t clean your palms or don’t clean the tops of your hands. How frequently should we wash our hands? Are there certain times where it is more important than others? As most of us are taught as kids, you need to wash your hands before you eat or prepare foods, after you touch raw produce and meat and after you use the restroom. You should also wash your hands after sneezing or coughing, touching your eyes, nose and mouth or coming in contact with someone who is sick. Do you recommend hand-washing over hand sanitizer? Ideally, you should wash your hands instead of using hand sanitizer, but if sanitizer is all you have, then use it. Alcohol-based hand sanitizers are best. Use about a nickel or quarter size and vigorously rub the tops of your hands, palms and in between your fingers until the sanitizer is completely dry. Remember that if your hands are physically dirty, or if you’ve come in contact with bodily fluids, you should thoroughly wash your hands with soap and water instead of hand sanitizer. Does washing your hands really prevent illnesses like the cold, the flu and viruses? Definitely. The CDC recommends hand-washing as one of the best ways to avoid getting sick and spreading illness. Hand-washing has been shown to reduce the number of people who get colds and respiratory illnesses by 21 percent. What else can I do to keep my family healthy? The annual flu vaccine is truly the best form of protection to help prevent the spread of the flu. Even if you do get the flu after being vaccinated, your symptoms will be lessened. Although they are not substitutes for the flu vaccine, simple preventative action can do a lot to help slow the spread of the virus, including these: Wash your hands often Avoid touching your eyes, nose or mouth with unwashed hands Avoid contact with people who are sick Stay home when you are sick Cough or sneeze into a tissue or your sleeve Other precautionary measures include cleaning shared spaces and avoiding shared utensils and drinks. Flu vaccines are still available in the community, including health providers at Renown Medical Group. Call 775-982-5000 to make an appointment. More Hand-Washing Information One of the best things you can do to avoid viruses, colds and the flu is to wash your hands. Protect yourself with even more hand-washing advice from the Centers for Disease Control (CDC). Roll Up Your Sleeves and Scrub Up!

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  • Renown Institute For Heart & Vascular Health - Fallon
    Renown Institute For Heart & Vascular Health - Fallon
    801 E Williams Ave
    Fallon, NV 89406
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    • Martes 26 de julio de 2022

    Renown Receives Home Health Heart Failure Certification

    American Heart Association certification recognizes Renown Health’s accomplishment in quality improvement Renown Health has earned Home Health Heart Failure certification from the American Heart Association®, the world’s leading nonprofit organization focused on heart and brain health for all. The certification provides an evidence-based framework for evaluating home health agencies against the American Heart Association’s rigorous science-based standards for heart failure patients, including program management, patient and caregiver education and support, care coordination, clinical management, and quality improvement. “This certification affirms the lifesaving mission and goal of the American Heart Association to help every person everywhere have the opportunity for a longer, healthier life,” said Kyle G. Lavergne, DNP, APRN, FNP-BC, American Heart Association volunteer and founding member of the certification standards writing committee and director of clinical programs of the LHC Group. “We’re pleased to have Renown Health join the national network of American Heart Association Home Health Heart Failure certified agencies.” Renown’s Home Health team is the oldest in northern Nevada, serving the community for 39 years, and is pleased to become the second agency in the nation to receive this American Heart Association certification for home health heart failure care. In 2016, the team began looking into how to provide care for heart failure patients at home. Through this deep dive, the team developed a method to identify heart failure patients, even if heart failure was not their primary diagnosis. The team then assessed the care pathway for this population and made changes to improve patient outcomes and readmissions. “Renown Health is proud to receive this certification from the American Heart Association,” said Philip Landis, MD, Medical Director of Renown Home Health Agency. “The tools and resources provided by the American Heart Association will help us continue to provide education and opportunities for our agencies to work toward quality improvement efforts for our patients with heart failure. This accomplishment reflects our goal to provide quality care.” The certification signifies confidence that: An agency’s heart failure program is based on standards aligned with the American Heart Association science, The agency is recognized by the American Heart Association, based on professional evaluation criteria designed by heart failure and home care experts, and Care is coordinated from pre-admission through working with the home health agency to discharge.  About Renown Health Renown Health is the region’s largest, locally governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. Con una fuerza laboral diversa de más de 7,000 empleados, Renown ha fomentado una cultura de excelencia, determinación e innovación de larga data. La organización se compone de un centro de urgencias, dos hospitales de cuidados agudos, un hospital infantil, un hospital de rehabilitación, un grupo médico y una red de atención de urgencias y Hometown Health, la compañía de seguros sin fines de lucro más grande de la región y de propiedad local, Hometown Health. Actualmente, Renown está inscribiendo participantes en el estudio genético de salud poblacional basado en la comunidad más grande del mundo, el Healthy Nevada Project®. About the American Heart Association The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

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    • Renown Health
    • Atención de urgencias

    Book Ahead to Make Urgent Care More Convenient

    How do you take the waiting game out of your Urgent Care visit? Book ahead! Here’s how this convenient service can help you schedule your appointment and see updated wait times at area urgent care facilities. We’ve all been there, done that: It’s after hours, you need to see a doc, and urgent care is slammed. Renown now offers a convenient option that will enhance your experience. Here’s How Book Ahead Works: From your phone or computer, you can check urgent care wait times around our region. This lets you see if the urgent care by your office is busier than the one closest to home — which may help your planning. Through Book Ahead, you can join the line at a specific urgent care just as you would in person. This allows you to stay home or at work as long as possible so you are more comfortable. Book Ahead When and Where to Receive Care We have many choices when it comes to our medical care. Should you visit a doctor’s office, urgent care, emergency care or make a Virtual Visit? It’s important to know which choice is right for your situation or condition. We asked Luis Palacio, M.D., with Renown Urgent Care to explain the differences and how to make your visit as smooth as possible. If you have been experiencing flu-like symptoms for less than 48 hours, call your doctor’s office. They can then determine if you can be treated with a prescription antiviral medicine. Visit urgent care or the emergency room only if you are unable to eat or drink anything and may be dehydrated, have a fever over 102.5 degrees F, or are experiencing shortness of breath. You can use Renown’s Virtual Visits videoconference service for flu-like symptoms so that you don’t need to leave the comfort of your home and you reduce the risk of spreading the virus to others. Virtual Visits allow you to see an urgent care provider from your home or office using a cellphone, computer or tablet with video capabilities. It is open from 8 a.m. to 6 p.m. Monday through Friday, and 9 a.m. to 4 p.m. Saturday and Sunday. How Do You Book Virtual Visits? Go to Virtual Visits to get started. Here, you’ll learn what virtual check-in is all about: It allows you to stay where you are and receive text notifications once a care provider is almost ready to see you. Click, join a line, and we will ask you some questions about your symptoms. This allows us to make sure you don’t need to call 911 or go to the ER. Reasons to visit the ER include stroke, chest pain, severe shortness of breath, uncontrolled bleeding, seizures and severe allergic reaction. If you answer “no,” you will see the wait times for each urgent care location. If you need to get in right away, you can select the location with the shortest wait time. Or, if time is not an issue and you’d prefer to stay closer to your home or office, you can select that location. Once you’ve selected a location, you input your cell number, name and number of patients. As your appointment gets closer, urgent care will text you with updates on timing. When you get the text message, you can choose to get “more time” and have your appointment pushed back, or tell them you’re ready to be seen and on your way. Learn more about how to Book Ahead at Renown urgent care below.

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    • Atención de urgencias
    • MyChart
    • Visita virtual
    • Telesalud

    Visitas virtuales: la atención médica que necesita en su hogar

    Virtual visits are basically secure, video conferencing visits with your health provider. Of course if you are sick, you want to avoid going outside of your house. With Renown Health’s virtual visit program, you can now see a provider from the comfort of your own home. As we work to keep all of our patients home and healthy, we’re here for any ongoing healthcare needs you have. There are two easy ways to access a virtual visit with Renown Health. If you need an urgent care visit, you can get in line using your MyChart account You can make a virtual visit with some Renown Health providers you see currently Virtual Urgent Care from a Renown Provider By using MyChart, you can now login and request to “Talk to a Doctor.” After filling in some information and confirming your healthcare concern, you will be put into a virtual line. The healthcare team will notify you by text or email when a provider is ready to talk to you virtually. Virtual urgent care visits are available for all ages. Get To Know MyChart Virtual urgent care visits are available for all ages, and can address: Common cold and cough symptoms Muscular, tendon or joint pains not caused by injury Allergy or sinus symptoms Pink eye Urinary discomfort Diarrhea without vomiting Rashes or skin sores Backache Nail problems Screening examination for sexually transmitted illness (without symptoms) Medication refills (not controlled substances) Symptoms for In-Person Urgent Care Visits Shortness of breath Chest pain Abdominal pain Numbness or weakness of any location that is new Traumatic injuries (including eye injuries or something in the eye) Severe pain of any other body location Dizziness or confusion Bleeding from any location High fever (greater than 102 degrees for all ages) Persistent vomiting Loss of vision Ear pain Substance abuse or psychiatric problems Virtual visits are open 9 a.m. through 6 p.m. Monday-Friday and 10 a.m. to 4 p.m. Saturday and Sunday for Nevada residents. Renown Provider Virtual Visits Many primary and specialty care appointments for adults and children are now available virtually. If you have a provider with Renown Medical Group, call 775-982-5000 to see if you can have a virtual appointment from the comfort of your home. MyChart Assistance If you need assistance with your MyChart account, please call 775-982-6686. For all other questions about scheduling and appointments, please call 775-982-5000.

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