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Clínica de Fisiatría y Neurorrehabilitación
What is Physiatry? Physiatry (fuh·zee·a·tree) encompasses the diagnosis, prevention and treatment of all disabilities related to the brain, nerves, bones and muscles. The goal is to maximize physical functioning, significantly decrease or eliminate pain, foster independence and improve the quality of life for those with a disability, chronic pain and physical impairments.
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What is Disordered Drinking?
An alcohol problem can affect anyone at any age. Many factors, including job stress, genetics or depression, may contribute to the start of disordered drinking. Drinking alcohol exists on a continuum. For example, if someone feels down in the dumps for some time, it doesn’t mean they are clinically depressed. So if someone goes through a period with above-normal alcohol consumption, it doesn’t necessarily mean they abuse alcohol. Although “alcoholic” and “alcoholism” are common, they are not clinical descriptions. Alcohol use disorder is the preferred term. Symptoms are often mild but can be the start of a more significant problem. According to the National Institutes of Health (NIH), over 16 million adults live with alcohol use disorder. Symptoms of Alcohol Use Disorder Do you recognize any of the following symptoms in yourself or someone you know? Drinking more or longer than intended Trying to cut down or stop drinking but not able to Having to drink more than you once did to get the same feeling Being annoyed when family members discuss your drinking Regretting your behavior while you were drinking
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Takesha Cooper, M.D., Appointed Chair of Psychiatry & Behavioral Sciences
Takesha Cooper, MD, has joined the University of Nevada, Reno School of Medicine and Renown Health as Department Chair of Psychiatry and Behavioral Sciences. Dr. Cooper comes to the area from the University of California, Riverside School of Medicine where she served for seven years as clinical associate and then full professor in the Department of Psychiatry and Neurosciences, and associate training director for Child and Adolescent Psychiatry. Dr. Cooper previously served as associate medical director for the Riverside University Health System and Riverside County Department of Mental Health providing clinical and operational oversight for four regional psychiatric county clinics, and as an adjunct instructor of psychiatry at Stanford University School of Medicine. As a double board-certified child, adolescent, and adult psychiatrist, she also established a successful solo private practice serving patients from diverse backgrounds. At UC Riverside, Dr. Cooper held significant academic and leadership roles including vice chair of education, residency program director, chair of the Admissions Committee and equity advisor. Dr. Cooper will now build on the strong foundation established by Dr. Josh Fitzgerald, interim chair of the department, who will now serve as director of research for the department. Dr. Cooper will be responsible with Steve Shell, vice president of the Stacie Mathewson Behavioral Health & Addiction Institute at Renown Health, for leading the Behavioral Health Program at the Institute where a team of nine psychiatrists, nurse practitioners and licensed professionals and counselors provide intensive outpatient treatment, partial hospitalization programs, Transcranial Magnetic Stimulation, Esketamine, hospital-based assessment and medication-assisted treatment to serve those struggling with mental illness and addiction across northern Nevada, Lake Tahoe and northern California. “We are delighted to have Dr. Cooper join the UNR Med/Renown team,” said Paul J. Hauptman, MD, dean of UNR Med and chief academic officer for Renown Health. “She brings a wealth of experience in multiple clinical settings, and we are confident that she will have a significant impact at a time of great need for mental health services, education, and research in northern Nevada. Dr. Cooper will do much to advance the mission of UNR Med which includes a commitment by the Department of Psychiatry to train the next generation of psychiatrists through a Psychiatry Residency and Child & Adolescent Psychiatry Fellowship training program. Education and training are provided in both urban and rural areas of northern Nevada.” Dr. Cooper earned her Doctor of Medicine Degree from the Keck School of Medicine at the University of Southern California and completed her residency at San Mateo County and fellowship at Stanford University. Prior to medical school, she obtained a Master of Science degree in Biochemistry and Molecular Biology from UC Riverside and her bachelor’s degree in Biochemistry and Molecular Biology from UC Santa Barbara. Dr. Cooper’s research explores the impact of Adverse Childhood Experiences on mental health outcomes in children and adults. She served as a clinical co-PI on a U54 funded grant aimed at reducing health disparities by engaging in community-based participatory research partnerships. “Dr. Cooper is an energetic, collaborative physician, researcher and mentor who cares deeply about improving the mental health and well-being of adults and children,” said Brian Erling, MD, MBA, President and CEO, Renown Health. “This is an exceptionally exciting time to advance health equity and to help improve mental health outcomes for people and communities across northern Nevada. We are excited that Dr. Cooper is joining our team. I know her talent, energy and leadership will further elevate our mission of outstanding care, exceptional training, innovative research, impactful advocacy and innovative community partnerships in mental health and addiction medicine.” Dr. Cooper is recognized for her passion for high-quality patient care and supports future practitioners through rigorous and culturally informed undergraduate and graduate medical education, research, and community collaboration. A 2022 graduate of the Executive Leadership in Academic Medicine (ELAM) program offered through Drexel University, she also maintains active involvement in national and state committees and journal editorial boards. The University of Nevada, Reno School of Medicine (UNR Med), Nevada’s first public medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Desde 1969, UNR Med ha capacitado a más de 3,900 estudiantes, residentes y becarios. UNR Med continues to improve the health and well-being of all Nevadans and their communities through excellence in student education, postgraduate training and clinical care, research with local, national and global impact and a culture of diversity and inclusion. For more information, visit med.unr.edu. 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. 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. Visite renown.org para obtener más información.
Leer más About Takesha Cooper, M.D., Appointed Chair of Psychiatry & Behavioral Sciences
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Cinco consejos para mantener la salud mental mientras busca empleo
It is no secret that looking for a new job can be stressful and overwhelming. Yet a record number of Americans are quitting their jobs to look for new opportunities, a trend also known as the “Great Resignation.” While there are many reasons why someone might be on the hunt for new work, it’s important for all job hunters to check in with their mental health regardless of their job hunting circumstances. To learn more about maintaining your mental health while looking for a new job, we spoke to Dr. Mavis Major, a Licensed Clinical Social Worker and Behavioral Health Therapist at Renown Health. 1. Identify Goals When beginning your job-hunting journey, your first step should be to make a plan that focuses on quality over quantity. Make lists of companies you would like to work for and, if you’re looking to change fields or industries, make a list of careers that interest you. At this stage in the process, it’s also important to determine what salary range you’re looking for, what type of work environment you want (in-person, remote or hybrid) and understand what benefits are important to you. Identifying goals makes it easier to narrow down the list of jobs you apply for so you can produce quality applications rather than frantically applying for jobs without putting thought into the process. 2. Set Boundaries It does not matter if you are working full-time while applying for jobs or if applying is your job right now; it can be easy to get lost in the stress of it all. For that reason, it is essential to set intentional boundaries throughout the process. This can look like scheduling days that you fully take off from the job search or going for a walk before a big interview to clear your head. Setting boundaries will make you more productive overall and hopefully help you get your mind off the process. 3. Ask For Help Do not try and tackle this undertaking on your own. Once you have identified goals (see tip #1) make lists of people you know within those industries, and do not be afraid to reach out. Of course, never be afraid to reach out to a mental health professional to talk through why this process might be making you feel anxious. Talking to someone who is not your friend or family can give you a different perspective.
Read More About Five Tips for Maintaining Your Mental Health While Job Hunting
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Departamento destacado: Acute Care Rehab Therapy
Being admitted to the hospital is never easy. Being admitted for a traumatic injury can be even harder. Whether it's learning how to walk again or powering through a new speech therapy routine, recovering from an injury that may affect the course of your life can be daunting. But it doesn’t have to be, thanks to the Acute Care Rehab Therapy team at Renown Health. The smiling faces of the Acute Care Rehab Therapy team at both Renown Regional Medical Center and Renown South Meadows Medical Center will make you see that there is a light at the end of the tunnel. Your dedicated physical therapists, occupational therapists and speech language pathologists are here to serve you and place you back on the right path to recovery and function. The Role of Acute Inpatient Therapy The Acute Care Rehab Therapy team comes in at a critical juncture in a patient’s care process after hospital admission. As one of the primary rehabilitation partners on a care team, these dedicated therapists are here to maximize every patient’s safe and independent living before they set off back home – all while reducing the risk of hospital readmission. “As physical therapists, we address musculoskeletal deficits and assess a patient’s current function after acute injury or illness from their baseline and develop a plan for functional recovery,” said Kristie Eide-Hughes, Physical Therapist at Renown Regional. “We also use our clinical expertise to assist with the discharge process and make sure each patient has the best durable medical equipment the first time around, removing the guesswork.” “On the occupational therapy side, we work with patients to facilitate their independence with basic life skills, such as dressing, bathing and using the restroom,” added Jeanne Clinesmith, Occupational Therapist at Renown Regional. “In the pediatric setting, we help babies and kids get back to what they were doing before they came into the hospital,” continued Rhonda Yeager, Pediatric Occupational Therapist at Renown Regional. “In the NICU specifically, we support the development of babies, trying to prevent problems from worsening. It’s nice to be a source of positivity in an otherwise intimidating situation.” The role of therapy in this setting reaches all ages, from babies in the neonatal intensive care unit (NICU) to adults approaching end-of-life care. Every therapeutic approach is tailored specifically to each patient. “Therapy is more of a habilitative approach for infants in the NICU, while it is more of a rehabilitative approach for kids and adults following injury or illness,” said Sara Carolla, Physical Therapist at Renown Regional. Each team member in the Acute Care Rehab Therapy department is dedicated to each patient, helping them make progress from start to finish and giving them the tools to succeed along the way. “I enjoy the variety of the patients we get to see and the ability to see them make gains from the wonderful treatment they get in the hospital from my team,” said Kelly Schwarz, Occupational Therapist at Renown South Meadows. “We provide education as each patient’s acute issues evolve,” added Nicole Leeton, Speech Language Pathologist at Renown Regional. “One of my favorite parts of my work is the patient and family education aspect, and that includes other healthcare provider education as well. It’s a moving picture.” Moreover, every team member gives each patient tools to learn how to be themselves again and empowers them to continue striving for the best possible result of their therapy “We get the opportunity to make a person’s bad experience in life better even by spending one session with them, giving them the keys to unlock something that they didn’t think they had the ability to do,” said Dana Robinson, Occupational Therapist at Renown Regional. On the Road to Independence Our dedicated therapists in the Acute Care Rehab Therapy team set the stage for a patient’s recovery process after trauma, showing them their potential for independence. With a multitude of patients coming into the hospital with many degrees of medical complexity, each day is different while the end goal is always the same: to optimize function as early as possible while overcoming any barriers and paving the way for a comfortable and effective quality of life. “Early intervention is a big piece,” said Nicole Leeton. “Us seeing patients early can get them recovered and independent more quickly and help prevent future illness and injuries. For example, in speech therapy, getting in early and facilitating communication skills for patients with impaired speech can make a huge difference.” Acute Care Rehab therapists dig deeply to see the whole picture of each patient’s situation to foster their independence – their history, social skills, support system and more. “Sometimes, we are the difference between independence and dependence,” said Dana Robinson. “We are the eyes and ears because we have so much time with the patients. Our team is extremely collaborative and develops a great rapport with patients, so they feel comfortable telling us everything going on with them.” “For kids, we teach parents ways they can help their kids by setting up their homes and the equipment they need to succeed,” added Rhonda Yeager. According to the team, one of the biggest keys to independence is repetition. A continual flow of getting up and trying again is crucial for recovery. “Repetition helps people regain their quality of life back sooner and control their recovery process,” said Megan Hough, Physical Therapist at Renown Health. “Helping people continue to get stronger and more independent makes my job so rewarding,” added Sam Brown, Physical Therapist at Renown Regional. Knowing that they have made a difference and help shape a patient’s overall development inspires each therapist to never give up, regardless of how difficult an injury presents. There is no set schedule for recovery, and the therapists are always in the patient’s corner. “This team has the most passionate, caring and dedicated individuals that I know,” said Kendra Webber, Manager of Acute Inpatient Rehab Therapy Services at Renown Regional. They give 110 percent to every patient every time to ensure they have what they need to regain function and independence.” “By tailoring therapy to the individual, the bounds are virtually limitless for what we can accomplish,” added Dana Robinson. It Takes a Village Since acute inpatient therapy is never a one-size-fits-all approach, it truly takes a village for this team to move the mountains they do for patients every day. These teams are fact-finding masters, gathering all the necessary information from the patient, their family and their care team to figure out their precise needs. “We are a consistent presence for our patients, identifying a lot of different needs and meeting those needs to help patients grow in their treatment process,” said Kelly Schwarz. “By collaborating with each patient’s diverse care team, we are able to employ the clinical judgment to help patients overcome physical, emotional and environmental struggles and set them up with the proper resources once they leave our setting.” “Our team has steady communication with physicians, nurses, acute care technicians, respiratory staff, physician assistants, case managers and more to ensure the best possible care,” added Jet Manzi, Physical Therapist at Renown Regional. Constant communication and collaboration are also necessary beyond the acute treatment process. These skills are vital in order to facilitate discharge planning, and the Acute Care Rehab therapists are an essential resource in the discharge process alongside our Hospital Care Management team. “Often times, a patient’s family needs a lot of guidance in helping their loved ones determine the next level, and we help them navigate those steps and the resources available to them,” said Mark Stumpf, Occupational Therapist at Renown Regional. “And it’s all a team effort.” “Our therapists are the most committed, generous, hardworking people,” added Courtney Phillips-Shoda, Supervisor of Rehab Therapy Services at Renown Regional. “Despite being short-staffed, we come to work every single day and give everything to our patients. They are the priority.” If you take away one thing, know this for certain: Renown’s Acute Care Rehab occupational, speech and physical therapists will always be there to help patients continue on a positive trajectory to physical, mental and emotional recovery. “Whether you are a patient or a provider, if there is a problem, never hesitate to reach out to us,” said Nicole Leeton. “We are always receptive to anyone seeking our help.” With the Acute Care Inpatient Therapy team on their side, a patient’s journey to recovery is only just beginning.
Read More About Department Spotlight: Acute Care Rehab Therapy
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Renown Now Offering rTMS Treatment for Major Depression
Treatment offers patients safe, non-drug and non-invasive repetitive transcranial magnetic stimulation (rTMS) therapy to treat symptoms of major depression. Renown Health is committed to improving access to vital mental health services in northern Nevada. Today, clinical leaders at the Stacie Mathewson Behavioral Health & Addiction Institute at Renown announced they will offer repetitive transcranial magnetic stimulation (rTMS) therapy for people experiencing Major Depressive Disorder (MDD) under the guidance of a Renown psychiatrist. According to the National Institute of Mental Health, major depression is one of the most common mental disorders in the U.S. The disease causes people to experience sadness and helplessness, and in some cases, may prevent people from carrying out their daily routines. “We at Renown are proud of our national reputation as an innovator in implementing new models, technology and systems of care for our community,” said Tony Slonim, MD, DrPH, President and CEO. “We are working to transform care and demonstrate value in a way that appeals to patients and helps clinicians improve outcomes and reduce costs. There is now a sufficient body of evidence to accept the analgesic and antidepressant effect of high-frequency rTMS, and we are pleased to offer this promising therapy.” rTMS is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. It is typically used when other depression treatments haven't been effective. This treatment for depression involves delivering repetitive magnetic pulses, so it's called repetitive TMS or rTMS. “Depression can be treated; however, for some people, medications and talking with a behavioral health expert may not be enough,” said Renown’s Division Chief of Behavioral Health, Richard A. Charlat, M.D., M.P.H. “We are pleased to offer rTMS therapy for people looking for a new way to fight depression and for whom other treatments may not have given them relief. We are committed to working closely with our patients to find the treatment that works best for them, so they can live their best lives.” “Nevada has the highest prevalence of mental illness and substance use in the nation,” said Steve Shell, vice president of the Stacie Mathewson Behavioral Health & Addiction Institute. “Combine that with the added stress and isolation many are feeling with the COVID-19 pandemic, and we know that offering patients safe, non-drug and non-invasive treatments- as well as essential mental health and addiction services are more important than ever.” How rTMS Works During an rTMS session, an electromagnetic coil is placed against the person’s scalp near their forehead. The electromagnet painlessly delivers a magnetic pulse that stimulates nerve cells in the region of the person’s brain involved in mood control and depression. It's thought to activate regions of the brain that have decreased activity in depression. Though the biology of why rTMS works isn't completely understood, the stimulation appears to impact how the brain is working, which in turn seems to ease depression symptoms and improve mood. There are different ways to perform the procedure, and techniques may change as experts learn more about the most effective ways to perform treatments. En promedio, los pacientes se someten a tratamientos de EMTr durante cuatro a seis semanas, cinco días a la semana, durante unos 40 minutos al día. In all cases, a patient’s doctor will determine a treatment plan that’s best for the patient. This video shows what patients can expect during rTMS therapy. What Does rTMS Feel Like? rTMS therapy is an easy, in-office experience designed to be positive for patients. During treatment, people are awake, alert, and comfortably reclined in a spa-like chair. Los primeros tratamientos pueden causar molestias en la zona de tratamiento o cerca de ella; sin embargo, es poco probable que esto dure más allá de la primera semana de tratamiento.1, 2 “Los efectos de la depresión pueden ser devastadores para las personas que luchan contra ella, así como para sus seres queridos”, afirmó Stacie Mathewson. “No importa cuán oscura pueda parecer la vida, siempre tenga en cuenta que hay increíbles expertos en salud conductual en Renown dispuestos a apoyarlo y empoderarlo mientras busca la ayuda que se merece”. Charles N. y Stacie L. Mathewson crearon el Stacie Mathewson Behavioral Health & Addiction Institute en Renown en 2018 para ampliar el acceso de la comunidad a los servicios de prevención e intervención de los trastornos de la salud mental y la adicción al alcohol y las drogas. Renown is working to expand intensive outpatient treatment, partial hospitalization and medication-assisted treatment programs to better serve those struggling with mental illness and addiction. The Renown team is also passionate about prevention, mental wellness and is actively working to decrease stigma and encourage more people to seek the help they need. TMS therapy is cleared by the FDA and available by prescription only. It is commonly covered by most insurance plans. Patients must be referred by a behavioral expert to seek rTMS treatment. Para obtener más información y para referir a un paciente, llame al Stacie Mathewson Behavioral Health & Addiction Institute al 775-982-5318. About Renown Health Renown Health is the region’s largest, locally owned and 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. Renown’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Health, Neurosciences and Robotic Surgery. Actualmente, Renown está inscribiendo participantes en el estudio genético de salud poblacional basado en la comunidad más grande del mundo, el Healthy Nevada Project®. Sources Trivedi MH, et al. (2006). Evaluation of Outcomes with Citalopram for Depression Using Measurement-Based Care in STAR*D Implications for Clinical Practice. Am J Psychiatry, 163(1):28-40 Rush AJ, et. al. (2006) Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry, 163(11):1905-1917.
Leer más About Renown Now Offering rTMS Treatment for Major Depression
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Steve Shell se une a Renown para dirigir el Stacie Mathewson Behavioral Health & Addiction Institute
Under Steve Shell's leadership, the Institute will continue to expand community access to prevention and intervention services for mental health disorders and alcohol and drug addiction. Renown Health is excited to announce Steve Shell is joining the Stacie Mathewson Behavioral Health & Addiction Institute at Renown as its vice president. In this role, Shell will oversee the Institute, which provides intensive outpatient treatment, partial hospitalization programs and medication-assisted treatment to serve those struggling with mental illness and addiction in our community. “We are pleased to welcome such an experienced and talented leader like Steve to our organization,” said Tony Slonim, MD, DrPH, president and CEO, Renown Health. “As vice president of the Stacie Mathewson Behavioral Health & Addiction Institute at Renown, Steve will continue the Institute’s work to change the status of mental health and addiction in northern Nevada.” Shell llega a Renown luego de inaugurar y dirigir los dos hospitales de salud conductual más nuevos de Nevada desde 2013. Fue fundamental en la creación del Reno Behavioral Healthcare Hospital en 2016 y ayudó a diseñar, establecer y gestionar las operaciones de este centro de tratamiento psiquiátrico y de adicciones con 124 camas para personas de todas las edades. También inauguró en 2013 el Desert Parkway Behavioral Healthcare Hospital, en Las Vegas, un centro de tratamiento psiquiátrico y de adicciones que cuenta con 152 camas para personas de todas las edades. “Nevada has the highest prevalence of mental illness and substance use in the nation combined with limited access to treatment and a shortage of care providers,” said Steve Shell. “I am passionate about improving the health of our community and have dedicated my career to advocating for mental health, working diligently to further elevate the care offered in our state.” Renown Health and Charles N. and Stacie L. Mathewson established the Stacie Mathewson Behavioral Health & Addiction Institute at Renown in to expand community access to prevention and intervention services for mental health disorders and alcohol and drug addiction. The Institute is working to expand intensive outpatient treatment, partial hospitalization programs and medication-assisted treatment to better serve those struggling with mental illness and addiction and is working to decrease stigma and encourage more people to seek help. “Moving the needle and improving the heartbreaking statistics of our state is a key focus for the Institute,” said Stacie Mathewson, executive director at the Stacie Mathewson Foundation. “I believe Steve’s leadership will have a positive impact on our efforts to improve the care and treatment of mental illness and addiction.” About Renown Health Renown Health is the region’s largest, locally owned and 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. Renown’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Heath, Neurosciences and Robotic Surgery. Actualmente, Renown está inscribiendo participantes en el estudio genético de salud poblacional basado en la comunidad más grande del mundo, el Healthy Nevada Project®.