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Is a man in your life struggling with depression? Many men find it difficult to acknowledge when they need help. Recognize their unique warning signs of depression with insights from psychologist Dr. Herbert Coard. Over 6 million men are diagnosed annually, often displaying symptoms like anger and aggression instead of sadness. Learn how to support them and understand these often-misinterpreted indicators. Behavioral Signs of Depression in Men High levels of the hormone cortisol are released during stressful situations affecting the neurotransmitter, serotonin (a feel-good hormone), contributing to depression. You can identify depression or suicidal tendencies by paying close attention to the following behavioral changes: Anger, irritability, or aggression Avoiding family or social situations Losing interest in family responsibilities, passions and hobbies Lack of sex drive Becoming controlling/abusive in relationships Risk-taking behavior such as; unsafe sex, overspending or gambling Not being able to concentrate or remember details Excessive drinking or drug use Having frequent thoughts about death Talking about suicide Attempting suicide Factors That Lead to Depression in Men Life Events Work stress or long-term unemployment can be huge contributing factors relating to depression. This type of life event can be overwhelming, making it impossible for a man to cope. Changes in Relationships The loss of a relationship can be a significant contributing factor to the emergence of depressive symptoms and past experienced physical, sexual, or emotionally abusive relationships. With this in mind, counseling can often help individual to overcome this type of trauma. Grief and Loss Overwhelming sadness due to the loss of a loved one can trigger depression. Although normal, each person goes through their own grieving period. For example, normal responses to death are insomnia, poor appetite and loss of interest in activities. Pay attention if grief seems prolonged or out of the ordinary. Health Problems In particular, depression coexists with medical conditions. As men age, this can be passed off as normal aging, but it could be more serious. In addition, illnesses such as thyroid disorders, Addison’s disease and liver disease can cause depressive symptoms. Diabetes, cancer, heart disease, or Parkinson’s disease can affect any age, thus triggering or worsening depression. Some older men also feel like they may be suffering from dementia because of difficulties with memory this may be a symptom of depression. A trip to the doctor may be in order to help alleviate concern and worry. Depression in Men and Suicide Frequently the emotional pain occurring with depression can distort a man’s ability to see a solution beyond suicide. Individuals with depression become very rigid and constricted in the way they solve problems. The statistics below speak for themselves, helping us understand the need to reach out to those who need our support. Male suicide rates are on rising – men die by suicide 3.53 times more often than women, accounting for 70% of all suicides. Sadly, every day 129 men commit suicide. White males accounted for 69.67% of suicide deaths in 2017. In 2017, firearms accounted for 50.57% of all suicide deaths. Middle aged Men who are middle aged have the highest suicide rates. 40% of those identifying as transgender have attempted suicide in their lifetime. Males who are guy or transgendered are at an increased risk for suicide attempts, especially before age 25. Veterans often suffer from post-traumatic stress disorder (PTSD) and depression, and are more likely to act on a suicide plan. How You Can Help Now that you can identify some of the warning signs of depression, here’s how you can help: Talk about your concern and communicate that you’re there to help him. Let him know depression is a medical condition and will usually get better with treatment. Suggest professional help from a Primary Care Provider, Psychologist or Therapist. Help set up appointments and offer to accompany him – let him make the decision, but make it clear you’re there for him, no matter what he decides. If you feel he is in a dire or life-threatening situation, contact 911. Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to talk to a trained counselor. Call the Veteran’s Crisis Line at 1-800-273-TALK (1-800-273-8255) and press “1”

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Summer is around the corner, bringing heightened risks of heatstroke, especially for children who cannot regulate their body temperature as efficiently as adults. Infants are particularly vulnerable and may not express discomfort, so never leave a child unattended in a vehicle. Top Tips for Preventing Heatstroke Reduce the number of deaths from heatstroke by remembering to ACT. Avoid heatstroke-related injury and death by never leaving a child alone in a car, not even for a minute. And make sure to keep your car locked when you’re not inside so kids don’t get in on their own. Create reminders. Keep a stuffed animal or other memento in your child’s car seat when it’s empty, and move it to the front seat as a visual reminder when your child is in the back seat. Or place and secure your phone, briefcase or purse in the backseat when traveling with your child. Take action. If you see a child alone in a car, call 911. Emergency personnel want you to call. They are trained to respond to these situations Keeping Your Baby Cool in the Back Seat In hot weather, it is crucial to keep your baby cool and hydrated by using a car seat cover or towel over them to reflect the sun's rays. Dress your baby in lightweight clothing that covers their arms and legs. Keep an eye on your baby's skin color. Move them to a cooler place if they look too red or flushed. Keep the temperature at a comfortable temperature for you, not for your child. Keep the windows cracked open for ventilation and ensure nothing is blocking the airflow from entering or exiting the vehicle. Dress your infant appropriately for their environment, including appropriate head and neck coverings, to keep them cool and protected from sunburns. Ensure you have enough fluids to last an hour before getting out of the car or use bottled water if possible. Never leave your child unattended in a car. Steps to Follow if You Suspect Heatstroke  Call 911 immediately.  Cool the victim – Get the person to a shady area, remove restrictive clothing and cover skin with sheets soaked in ice-water, and place ice packs in the arm pits and groin.  Have the victim drink cool fluids, preferably an electrolyte-containing sports drink.  Monitor body temperature with a thermometer but stop cooling efforts after temperature has dropped to 102 Fahrenheit. Baby Safe Classes These classes help prepare parents for emergencies that may occur in baby’s first year. Safe Kids Worldwide Did you know heatstroke is the leading cause of non-crash related fatalities in children? “On average, every 10 days a child dies from heatstroke in a vehicle. In more than half of these deaths, the caregiver forgot the child was in the car.”

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For the average person, wounds aren’t an everyday worry. However, for at least eight million Americans, chronic wounds can pose a serious threat to health and well-being. From a person with diabetes experiencing painful neuropathy to a patient healing from a significant burn, caring for advanced wounds is a major part of their healthcare journey. Who do they go to get the care and guidance they need? The answer: Renown Wound Care. Serving patients in both the inpatient and outpatient settings, this department provides comprehensive, best-in-class treatments for severe and chronic wound healing and ostomy care. Our Wound Care team members have mastered the art of harnessing cutting-edge technologies and a patient-centric approach to redefine the standards of healing.  Advanced Care for the Best Repair  At Renown Health, we are fortunate to have a team full of nurses, physicians and more caring for patients with wounds caused by a wide variety of conditions. Those include:  Burns Trauma Vascular diseases Radiation therapy Pressure ulcers Diabetes and diabetic neuropathy Adding to the expert-level continuum of care, Renown is the only health system offering complete ostomy services in the entire region. The Wound Care team helps ostomy patients with the fitting of their medical bags, treatment of any skin conditions that may arise after ostomy bag placement, care coordination and much more.  With a multidisciplinary network of experts tailoring personalized treatment plans, there is never a dull moment on the floor. On the outpatient side, the team expects 50-60 patients in one day alone.  “As a clinician, wound care is a lot of ‘arts and crafts,’ so we get to use our creative and critical thinking skills to provide the best possible care,” said Samantha Moore, Advanced Wound Care Specialist RN for Outpatient Wound Care. “Each patient has an individualized plan of care – we greet them as they come into the clinic, escort them back to their treatment rooms and get their latest health updates and life situations before providing wound or ostomy care. We prepare each morning doing chart reviews to determine patient needs, wound progression and referral needs.”  “We are a highly specialized, dedicated group of professionals with a passion to treat and heal our patients’ wounds,” added Lori Conner, Advanced Wound Care Specialist RN for Outpatient Wound Care. “When a patient comes to our clinic for evaluation, they are given a dedicated appointment to thoroughly go over their medical and surgical history, medications and nature of the wound.”  Switching over to the inpatient care team, they operate like a well-oiled assembly line, navigating different daily assignments with precision and flexibility.  “On the inpatient side, our day starts in our office with triaging our consult list; after the triage process is completed, we get our assignments, which can consist of wound vacuum-assisted closure (VAC) patients, follow-up patients, ostomy education patients and new wound consults,” said Megan Uy, Advanced Wound Care Specialist RN for Inpatient Wound Care. “In the case of patients requiring wound VAC changes, we consider what kind of pre-medication for pain that they need. Although some patients may be seen on a time schedule, the day ends up flexible as patients are being seen by other specialties. This flexibility also benefits the patients, making them feel more empowered with their care.”  “Each day in the inpatient setting, we get to our office and sort through all the new consults that came in overnight, and the charge nurse makes the assignment for the day,” added Madison Arlin, Advanced Wound Care Specialist RN for Inpatient Wound Care. “After the assignment is completed, each nurse is responsible for researching their patients and organizing their day, typically by priority – wound VACs and ostomies usually take top priority.”  Now, how do these treatments actually work? This specialized field handles advanced methods of treating each condition, including:  Biological skin substitutes Surgical debridement Advanced wound dressings Negative pressure therapy Pre-ostomy markings and education Offloading techniques, such as padding or dressing “Before starting treatments, we communicate with our nurses and providers to make sure that the patient is comfortable prior to wound care,” said Dianna Seo, Advanced Wound Care Specialist RN for Inpatient Wound Care. “After we see the patient, if there is a need for escalated care, we contact the provider for additional testing or consults. We continue to follow-up on patients that have severe wounds, wound VACs and ostomies.”  In the hands of the Wound Care team, patients exit our hospital walls not only restored but also empowered, set on a trajectory for long-term healing. Your Expert Care Guides  No matter the case or the severity of the wound or condition, patient care, comfort and communication always come first – before, during and after treatment.   “Many of our patients have chronic needs, so we end up seeing them for several months, if not years in some cases; we stay up to date with their specific psychosocial needs and help remove barriers that would prevent their wounds from healing,” said Samantha Moore.  “I enjoy knowing that my positive attitude can improve our patients’ days,” added Maddie Pauley, Patient Access Representative for Outpatient Wound Care. “When they’re routinely coming to appointments they might not enjoy, hearing them praise our team and give their thanks is one of the most rewarding feelings.”  As a wound care patient, there can be a lot of unknowns when beginning their care journey. However, these team members carefully walk each patient through every step from beginning to end.  “When we go to see a wound care patient, our team is very consistent about explaining to the patients what our role is and what we plan to do with their wound, and then we continue to actively communicate throughout wound care each step that we are doing as we are doing it,” said Madison Arlin. “We also encourage some of our patients to listen to music that they enjoy during the wound care, or we will cover their eyes with a cloth if they request so that they don't have to see their wound. Sometimes, we will ask the family to stay at the bedside to hold their family member's hand.”  Education is crucial to ensuring each patient knows what to expect in order to care for their wound and understanding the stages of healing. Fortunately, this team is well-versed in the world of wound wisdom.  “A lot of education is provided on the type of dressing we are applying, and if the patient is going to be performing their own dressing changes, we will go over the entire change with them and provide supplies for discharge,” said Megan Uy. “Additionally, there will be written instructions in their discharge paperwork. In the cases of wound VAC dressing changes, each step is explained to the patient before doing it, and we also go over discharge options and expectations.”  “As a clinician who sees a lot of patients prior to having their ostomy placed (pre-surgical marking), one of the most important things we do is first sit with the patient and/or caregivers and talk about their fears, concerns, questions and goals,” said Samantha Moore. “We provide a lot of emotional support and education, helping identify community resources. For our wound patients, we spend a lot of time educating our patients/caregivers about how and why their wounds occurred. We try to connect with them on a personal level and help them identify ways to help their wounds heal.”  To see a patient’s care journey from the second they enter through our doors to the moment they return home is one of the most rewarding feelings for the Wound Care teams. In fact, they’ve had the pleasure of treating patients for years and seeing their wounds almost completely heal. The team collectively values the successful healing journeys of their patients as their proudest achievement.  “One of our team's greatest accomplishments was being able to see one of our long-term patients discharged with nearly resolved wounds,” said Megan Uy. “This patient had been in our care on-and-off for the past year with many hospitalizations and had complicated high-output enterocutaneous fistulas within his wound bed. These were incredibly hard to keep a dressing on successfully, and he often had issues with the dressing leaking. Eventually, we got a dressing that could remain intact until his next scheduled dressing change, and he was able to get surgery that fixed his fistulas. Being able to see him recover and heal his wounds was a very large accomplishment for us.”  The admiration and compassion this team has for their patients also extends to each other. The cohesive way they work together only further benefits their patients, offering the best-possible collaborative care.  “We have extremely skilled clinicians in our group that are not only incredible in the work that they do and the patient care that they provide but are also enjoyable to work with as well,” said Geane Weaver, Advanced Wound Care Specialist RN for Inpatient Wound Care. “There is something to be admired in each and every one of my coworkers.”  “Our team is very close and supportive of each other at all times,” added Madison Arlin. “I feel very lucky to work with such an amazing group of people. Our team is very proud of the work we do.” Fervently Fighting the Good Fight So, with the highly specialized nature of advanced wound care, how did these team members get inspired to join the Wound Care team in the first place?  Well, for many of these devoted employees, their first exposure to caring for wounds took place on different units – sparking their interest in making wound care their full-time career.  “Renown was the most welcoming towards me as a student nurse, and I liked that it was a teaching hospital,” said Madison Arlin. “I started in the General Surgical Unit (GSU) immediately after graduating nursing school and worked there for two years before transferring to wound care. I decided to apply to the wound team after watching the wound nurses do wound VACs and ostomy changes on the floor. I would ask them if I could watch, and I was always very fascinated by the wound healing process.”  “Prior to joining the inpatient wound team, like Madison, I was also a bedside nurse in GSU,” added Geane Weaver. “Working on that floor, I was already exposed to a lot of patients that were requiring some kind of advanced wound care in one way or another. Working in the GSU, I also cared for a lot of patients that had wound VACs and ostomies. These patients make up a huge group of the individuals that our team sees on a regular basis, and they've always been intriguing for me, so naturally, wound care has always been on my radar.”  For other team members, wound care has always been a point of curiosity throughout their education and career. From their very first exposure to this care area, they were hooked.  “I was always curious about wound care even through my nursing school experience,” said Dianna Seo. “When I was working on the floor, I would trade to do wound care for patients. When I had time, I would follow wound care and help when I could. I joined the skin team which drove me to be increasingly involved with wound care. As soon as there was a job opening, I applied for the position. I worked in outpatient wound care for approximately four years and now inpatient for another four years. I have enjoyed all aspects of wound care and patient care.”    “I had great clinical experience at Renown when I was in nursing school; I also was very interested in caring for trauma patients, and Renown being a Level II trauma center aligned with my interests,” added Megan Uy. “I began my nursing career in the GSU, but my dream job was always Wound Care. During my nursing school clinicals, I had the opportunity to watch some members of the wound team do wound VAC changes and thought it was incredibly intriguing and a great combination of utilizing the knowledge of anatomy and physiology while being creative with handicraft. A position opened on the team around the time I met the prerequisites to be eligible for the position, and luckily, I got it.”  Our Wound Care team has achieved significant employee and departmental milestones over the past year, reflecting their dedication to enhancing patient care and overall process improvement.  “We have had many accomplishments within the last year and are currently working on more to improve the hospital,” said Dianna Seo. “Madison Arlin won the DAISY Award for her great work with our patients. Megan Uy won Top Talent of the Quarter for helping a stranger. Ande Ferriera has worked tirelessly to improve our process improvement. Allie Saunders, as our leader, has worked to improve patient skin by getting new beds for Renown Regional. All our patients that have healed or are on their way to healing under our care is our greatest achievement that we as wound team is most proud of.”  “We are constantly updating protocols, notes and orders for bedside nursing so that it is a more straightforward and seamless charting process,” added Madison Arlin. “We have representatives of different supply companies come and present new products that we think may benefit our patients better. Our wonderful tech has even updated our department site on Inside Renown so that the nurses always have references available.”  Renown’s strong influence in the region – and the opportunity to give back to their community – was, and continues to be, a major draw for this team.  “Since I can remember, Renown has always been the most prevalent healthcare name for my family and has always taken the most amazing, thorough care of my loved ones,” said Maddie Pauley. “I have always wanted to work somewhere I could help people, and starting at Renown has really opened my eyes into how much of a difference each one of us can make.”  Our Wound Care department’s success stories and proactive approach not only reflect their passion for healing but also inspire a ripple effect of positive change throughout our health system. They proudly exemplify a shared commitment to enhancing the well-being of all patients under their care.  “Being part of Renown and part of this team has been my blessing; I get to do a job I love with people that love it too,” closed Dianna Seo.

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As the holiday season draws near, we find more reasons to celebrate with loved ones. At Renown Health, we are kicking off the celebrations early this November with American Diabetes Month. Approximately 37 million Americans, including 270,000 Nevadans, have been diagnosed with diabetes with as many as 95% of those diagnosed living with type 2 diabetes mellitus (T2DM). What is Type 2 Diabetes? Type 2 diabetes is a chronic health condition that occurs because your body is not using insulin (a hormone made by the pancreas to help cells use the food we eat for energy) as well as it should, resulting in high blood sugar levels. It is important to obtain a diagnosis for T2DM and ensure it is well-controlled to prevent serious health complications. Those with diabetes are at higher risk for blindness, kidney failure, heart disease, stroke and amputation. Tips for Supporting Your Health with Type 2 Diabetes Know Your Blood Sugar Levels: Work with your healthcare provider to establish target blood sugar levels, and make sure to monitor your levels regularly as advised by your healthcare provider to prevent or delay health complications associated with T2DM. Focus on Your Plate: Eating foods such as fruits and vegetables, lean meats or plant-based proteins, healthy fats and whole grains supports diabetes management. If choosing healthy foods is difficult due to your busy schedule, cost or simply because you aren’t sure where to start, talk with your healthcare provider who may refer you to a registered dietitian. Registered dietitian nutritionists are certified nutrition specialists who can provide education and practical tips for eating to support your T2DM diagnosis with visits covered by many insurance plans. Prioritize Staying Active: Engaging in regular exercise is good for everyone, especially those living with T2DM. Exercise helps your cells become more sensitive to insulin and therefore supports healthy blood sugar levels. Always check with your healthcare provider prior to beginning a new exercise plan. Support Stress Reduction: Stress is unavoidable but can be managed through regular exercise, getting enough quality sleep (7-8 uninterrupted hours per night) and practicing meditation and other mindfulness techniques. Plan Ahead for Holiday Gatherings: There’s still room for celebration while focusing on blood sugar management. Consider bringing a healthy dish to your gathering, focus on filling your plate with vegetable sides and eating those first and incorporate a family walk after dinner. If traveling, pack nutritious snacks that support your health and keep you full. Lastly, enjoy the special dishes and desserts this season has to offer in single-serving portions.

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© alessandrobiascioli via Canva.com Ensuring a healthier and more inclusive future for LGBTQIA+ children and teens is of utmost importance to health systems in our community, especially Renown. Supporting the physical and mental health of youth in this community is key to those efforts, especially as they face unique challenges in terms of identity acceptance and social integration.   Dr. Caroline Barangan, Adolescent Medicine Physician with Renown Children’s Pediatric Specialty Care, discusses what you as a parent, caregiver, friend or support system can do to be a safe space for children and teens who identify as LGBTQIA+. 1.  Create a Safe Space at Home The most important action you can take for your LGBTQIA+ teen or child is to accept and support them for who they are, regardless of how they identify. “Being a teenager is already difficult enough, especially within the LGBTQIA+ community, which puts them at risk of being stigmatized, rejected and targets for bullying,” said Dr. Barangan.  Your supportive words and actions can make a huge difference as a profound expression of love and understanding. Being patient and willing to learn are the foundations to a healthy and loving relationship with your LGBTQIA+ teen or child.  2.  Encourage Regular Check-Ups with a Primary Care Provider (PCP)  Establishing your child or teen with a PCP is not only important when an illness occurs but also for annual preventative visits and regular check-ups. “A primary care provider can screen for high-risk behaviors that would put a patient’s health in jeopardy, such as sexual experience, substance use, suicidality and self-harm,” said. Dr Barangan. “These screenings are an opportunity to provide the education and support these kids and teens need to stay healthy.”  One of the main concerns LGBTQIA+ youth often have is that they will experience judgment from their provider, or the PCP will disclose sensitive information, including their sexuality or gender identity to their parents, when they are not ready to do so. Dr. Barangan emphatically reminds us that this legally cannot happen. “If a patient asks me to keep something confidential, unless they disclose that they have plans to harm themselves or others, I am legally not allowed to share that information with anyone without their permission,” said Dr. Barangan.  3.  Locate Local Resources  Northern Nevada is home to a variety of resources for the LGBTQIA+ community at large, including youth members of this community. "Finding resources to help them develop in a positive way and provide them with the information they need, whether it be in school, the household, the community or through a medical or mental health provider, is incredibly important,” said Dr. Barangan.  Below is a list of local LGBTQIA+ community resources open to you and your children:  Our Center LGBTQIA+ Health Services at Northern Nevada HOPES Northern Nevada Pride Festival & Community Parade (happens every July in Reno) Sassabration (happens every September in Carson City) Lake Tahoe Pride (events and resources shared on Facebook)

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

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The back-to-school season is here, and ensuring your child's successful transition involves more than just school supplies and schedules. At Renown Children’s Hospital, and in collaboration with Nevada Pediatric Psychiatry Solutions, we understand the vital role that mental health plays in a child's overall well-being and academic performance. Below we'll guide you through essential tips for a smooth back-to-school experience, with a special focus on nurturing your child's mental health. How to Support Your Child’s Mental Health from Home Remember, the below strategies can be adapted to align with your child's personality, learning style and household dynamics. Flexibility and understanding are key in tailoring these tips to suit your child's unique needs. 1. Be Open to Communication: Recognize that effective communication is the cornerstone of understanding your child's feelings and concerns. Create a safe space where your child feels comfortable expressing their thoughts. Listen to learn, without judgment. Make it a point to validate their emotions and ensure they are heard. Encourage sharing experiences,worries, friends and challenges they may be facing. Having open conversations about sensitive topics opens the door for discussion and understanding. Make yourself available. 2. Establish a Routine: A consistent routine can offer a sense of stability and predictability for your child, and anticipation helps to decrease anxiety and establish a sense of control. Join forces and design a daily schedule that includes time for schoolwork, play, physical activity, meals and relaxation. Be flexible about the structure to allow room for last-minute changes including extra activities based on that day’s needs as well. Always add time for play and bonding. 3. Practice Compassion: Back-to-school can come with big emotions. Listening reflexively and acknowledging these feelings can help you and your child act positively on these big emotions. 4. Get Involved: Actively engage in your child's school life by participating in school events, meetings and discussions. Show interest in their educational journey, ask about their experiences and provide guidance when needed. Being present in their academic pursuits not only boosts their confidence but also strengthens the parent-child bond. 5. Use Positive Reinforcement: Celebrate your child's achievements, no matter how small they may seem. This allows for a sense of accomplishment and boosts self-esteem. Praise efforts, progress and perseverance, whether it's completing an assignment, making a new friend or overcoming a challenge. This positivity encourages a growth mindset and resilience. 6. Organize a Schoolwork Zone: Create a comfortable workspace at home dedicated to school-related tasks. Customize the area based on your child's preferences and needs. Having a designated space for studying and completing assignments promotes focus, reduces distractions and enhances their overall learning experience.

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In today's fast-paced society, it is understandable for parents to want to take shortcuts in caring for their little ones. A s a result, It is tempting to leave a sleeping infant in a car seat or swing after a long day of errands or when you need a moment to catch your breath. But, as convenient as these devices may be, they pose a serious risk to your child's safety. Why Car Seats and Swings Pose Risks for Infant Sleep Car seats, swings, and bouncers are quick and convenient ways to feed, hold, and sleep an infant. Not out of malice or discontent, but again from the need for quick and easy access to baby care in an already busy lifestyle. However, the risks outweigh the benefits. The American Academy of Pediatrics (AAP) states that “infants should be moved to a crib, bassinet, or play yard for sleeping as soon as is practical.” If a parent must use a car seat or other sitting device, they should only do so for a short period of time and never as a substitute for a proper sleeping environment. Leaving a sleeping infant in a sitting device, such as a car seat or swing, can create unsafe sleeping conditions. The American Academy of Pediatrics (AAP) warns that doing so increases the risk of sudden infant death syndrome (SIDS) and positional asphyxia. This is because infants can easily slump over or become entangled in the straps, blocking their airway, and causing suffocation. Car seats, swings, and bouncers are quick and convenient ways to feed, hold, and sleep an infant. Not out of malice or discontent, but again from the need for quick and easy access to baby care in an already busy lifestyle. However, the risks outweigh the benefits. The AAP states: Infants should be moved to a crib, bassinet, or play yard for sleeping as soon as is practical. If a parent must use a car seat or other sitting device, they should only do so for a short period and never as a substitute for a proper sleeping environment. Leaving a sleeping infant in a sitting device, such as a car seat or swing, can create unsafe sleeping conditions. The AAP warns that doing so increases the risk of sudden infant death syndrome (SIDS) and positional asphyxia. In addition, infants can easily slump over or become entangled in the straps, blocking their airways and causing suffocation.

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If you’re expecting a new baby, you may have been given the advice to hire a doula. You may have seen statistics of improved outcomes among those who’ve had a doula attend their birth. Perhaps you’ve heard that the etymology is from the Greek word meaning “to serve.” But how does a doula serve their clients? A doula is a non-medical birth professional who will guide you through labor, birth, postpartum and beyond. Your doula can discuss your options with you so you can make informed decisions, as well as provide emotional and physical support to ease your experience. While each doula offers their own style, there are certain services that most doulas will provide for their clients. Typically, a birth doula will provide at least one prenatal visit, one postpartum visit and continuous support during active labor. A postpartum doula usually provides support during the 12 weeks immediately following birth, sometimes referred to as the “fourth trimester,” but some will continue care after that as well. Simply put, a doula provides informational, physical and emotional support during the childbearing year(s). Let’s take a closer look at these three ways a doula can support you. The Basics If you don’t know your options, you don’t have any. This is a common phrase in the world of birth work. When you’re in labor, you’re exhausted, in pain and there’s often urgency inherent or implied in any choices you make. So, when an intervention is offered, many birthing people accept it without question. One method that can help the decision-making process is to check your BRAIN: Benefits: What are the benefits of the proposed intervention? Risks: What are the risks of the proposed intervention? Alternatives: What are the alternative options? Intuition: What does your intuition tell you? Nothing: What if we do nothing? What if we wait? When you’re in active labor, you might have difficulty remembering this acronym; that’s where your doula comes in. At your prenatal visits, you can ask your doula for guidance in preparing your birth plan, which can include contingencies for certain potential interventions. And as choices arise during labor, your doula can guide you through the benefits and risks and can provide you with alternative options you might not otherwise be aware of that are available to you. Your doula can remind you to check in with your intuition and can help you quiet your mind so you can listen to your instincts. The Body Although we tend to see depictions of people giving birth on their backs with their feet in stirrups, this is only one of many ways to give birth. Walking and dancing can speed up early labor. Side-lying or hands-and-knees can prevent tearing during the pushing stage. Sometimes labor stalls, and a change of position is often helpful to get things moving again. Your doula can suggest positions depending on your stage of labor. Some labor positions might require the support of another person – your doula could fill this role or assist your partner in doing so. Some doulas also provide massage or even acupressure, and most will do the “hip squeeze” that so many laboring people swear by. If your baby is presenting posterior, or “sunny side up,” your doula can apply counter pressure to alleviate back pain during labor. Some postpartum doulas will do light housework while you rest and bond with your newborn. Others might care for your baby through the night so you can catch up on sleep. Many doulas have also gone through additional training to offer breastfeeding support and may be able to assist you with latch issues and nursing positions. The Mind Pregnancy, birth and postpartum periods can be some of the most emotional times in a person’s life. A doula will hold space for you and help you process your emotions before and after birth. It’s normal to feel apprehensive, or even fearful, about labor and birth, and discussing these feelings is the first step. A doula can help you navigate your concerns in a safe space so you can be prepared emotionally for your upcoming labor. Many doulas will also guide you through writing your birth plan, which can lessen anxiety about the unknown. If you have a history of trauma, your doula can assist in communicating this, so you don’t have to relive the experience every time you meet a new medical provider. Most people will experience some form of what’s often called the Baby Blues in the immediate postpartum period. The third day after birth tends to hit hard, as hormones attempt to regulate, but the Baby Blues can continue for weeks for some new parents. A postpartum doula’s support can be incredibly valuable during this time. When the baby blues last longer than a few weeks, it could considered a mood disorder. Most doulas will recognize signs of postpartum mood disorders and will have resources available for additional support. Choosing the Best Doula for You With so many wonderful doulas in northern Nevada, you might wonder how you could ever choose just one to attend your birth. Some expectant parents are unfortunately restricted by cost. With so many expenses related to a new baby, it can be difficult to budget doula services as well. Thankfully, Nevada Medicaid now covers doula care, and some commercial insurances are following suit. Check with your insurance company to find out if they might cover part of the cost for hiring a doula. If your insurance doesn’t cover doula services, some doulas offer a sliding scale based on income. You may want to interview multiple doulas to find the right one for you. If you’re the kind of person who wants all the information you can get, a more detail-oriented doula might be the best choice. But if you tend to feel overwhelmed by too many options, you might prefer a doula who only offers additional information as the situation calls for it. If you want massage or acupressure during labor, you might want to hire a doula with those certifications. Or maybe informational and physical support are not as important to you as emotional support, in which case your best choice could be a doula who has experience with postpartum mood disorders or trauma support. Regardless of who you hire, be sure to clearly communicate your desires and expectations – not just for your birth, but also for your doula. The most important thing when choosing your doula is trusting your gut. You need to feel comfortable with your doula, as they’ll be tending to you at one of the most vulnerable times in your life. When you find a doula that you click with, who listens to you and supports your choices, you have found the best doula for you.

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A well-child checkup is a great opportunity to monitor your child’s growth and development, and it's also a chance to establish a trusting relationship with your child’s pediatrician and have your questions answered. What to Expect at Each Checkup At every checkup, a comprehensive physical examination will be conducted to assess your child's growth parameters, including height, weight and head circumference. A developmental assessment will evaluate the progress of your infant or young child in achieving age-appropriate milestones, encompassing language skills, motor development, problem-solving abilities and psycho-social skills. In addition, your pediatrician will address common concerns such as feeding, sleep patterns, oral health and general infant care. Unless there are specific needs or concerns for your baby, routine laboratory tests are typically unnecessary. Your pediatrician will provide guidance on immunization schedules, post-vaccination expectations and when to seek medical attention. Furthermore, during each visit, you will receive age-specific guidance to help you anticipate your child's expected growth and development, along with essential safety precautions and illness prevention measures. Your pediatrician will discuss various topics, such as placing your baby to sleep on their back, utilizing rear-facing infant car seats until around age two, maintaining home water thermostats below 120 degrees Fahrenheit, ensuring dangerous objects and poisonous substances are out of sight and reach, emphasizing dental health and promoting the use of bike helmets, among other things. Preparing for Your Visit It is recommended that, as a parent, you write down any questions beforehand, so you don’t forget them in the moment. Most importantly, feel comfortable asking your pediatrician about anything that might seem unusual, as you are the parent, and you know best! Before leaving the pediatrician’s office, be sure that you fully understand any instructions given to you and ask for clarification if needed. From your child’s birth through young adulthood, you will be visiting your pediatrician regularly. The American Academy of Pediatrics provides what a regular schedule might look like. Well-Child Checkup Schedule Two to three days after birth and at one month Two months Four months Six months Nine months One year 15 months 18 months 24 months 30 months Three years, and yearly after

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Taking a few minutes to prepare for your child's pediatrician visit helps ensure that all your child's medical needs are met. Knowing the right questions to ask your provider can help you get the most out of your visit and ensure you and your child feel comfortable and informed. It is essential to base your questions on your child's specific health needs, but the ten options below are a great place to start. How is my child's overall health and development progressing? Is my child meeting their developmental milestones, and are there any areas where they may need extra support? What vaccinations does my child need, and are they up to date on all required immunizations? Are there any nutritional recommendations or concerns for my child's age and stage of development? What are some strategies for promoting healthy habits and physical activity for my child? Are there any warning signs I should look out for regarding my child's health or behavior? What can I do to help prevent common childhood illnesses like colds, flu strains or ear infections? What should I do if my child gets sick, and when should I seek medical attention? Are there any changes to my child's medication or dosage that I should be aware of? Is there anything else I should know or be aware of regarding my child's health or development?

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Bringing in new life is an exciting and beautiful occasion. The possibilities for the newest members of our world are endless – what will the child grow up to become? What will they achieve in their lifetime? Anyone will agree that a new life is precious and protecting that life by any means possible is a necessity.  Sometimes, however, a baby’s journey into our world brings along obstacles. Prematurity, congenital defects and other complications can accompany a birth and the baby’s first few moments of life. But what happens when these complications happen outside of a fully-functioning Labor & Delivery unit, or if the complications need a special level of intervention with a health system capable of caring for their unique needs?  Enter the NICU Transport team at Renown Health. As the only Neonatal Intensive Care Unit (NICU) Transport team in northern Nevada, these dedicated nurses, respiratory therapists and neonatal nurse practitioners – who have normal unit duties of their own at Renown Regional Medical Center – step up to the plate to take on this extra duty to support members of their community facing some of the scariest moments of their lives. To them, transporting babies in critical condition and giving them the best chance of life isn’t just a responsibility; it’s a calling.  The NICU on Wheels  When the Saint Mary’s maternity unit, which was Renown’s partner in NICU transport duties, made the decision to close, our dedicated NICU nurses and respiratory therapists diligently rose to the occasion to fill the demand. Dubbed the “NICU on Wheels,” Renown’s team went from taking on transport duties every other day to 365 days a year – and they are always ready to go at a moment’s notice, whether it’s by ambulance or by fixed-wing aircraft.  “When we learned about the closure we knew it was our calling and knew we had to step up,” said Rachel D., Neonatal Transport RN at Renown. “We still have regular days on the floor, and we each switch off being on-call for transport. Once we get a distress call, we have 30 minutes to get to the hospital, grab our gear and go. We have to essentially put a whole room’s worth of portable equipment in one bag.”  “I really enjoy being a part of the transport team and making a difference from northern Nevada to northern California,” added Sam V., Supervisor of Respiratory Care at Renown. “We are able to practice at the top of our skill level and use autonomy that not every practitioner gets to use.”  Each NICU Transport unit works in teams of three when heading out into the field: one nurse (our bedside experts), one nurse practitioner (our education experts) and one respiratory therapist (our lung and breathing experts). With several years – and in many cases, decades – of experience in NICU nursing, NICU transport duties and respiratory therapy, this team is poised to provide state-of-the-art lifesaving care en route to the hospital. This diverse array of experiences among the team especially comes in handy as they continue to face the increased transport workload.  “We are so thankful to have Saint Mary’s employees come over and work on our team after their maternity ward closed,” said Melyssa H., RN, NICU Transport Coordinator at Renown. “Helping the babies, as well as helping the scared families, will always be our top priority.”  “I love the complexity that babies provide in the NICU,” added Jennifer J., Neonatal Transport RN at Renown. “Providing hands-on care right at the bedside along other members of the team is such a rewarding experience.”  Education is also a crucial tool in NICU care, especially in the field. The nurse practitioners on this team make it their mission to outreach to the community, including our rural health partners, and help them build the tools and skills they need to care for our smallest and most critical patients.  “I have been on a few transports where we went out and did not have to bring the baby over to the hospital, and we were able to provide lots of education instead,” said Shiela A., Respiratory Specialist at Renown. “For instance, I was called out to Fallon for a baby that was in respiratory distress. When we arrived, we saw the baby was awake and active although intubated. The tube came out, and we retaped it. While we stayed to observe the baby to make sure everything was okay, the nurse practitioner on the team provided educational tools to the family on what they can improve on regarding their baby’s tubing. Our nurses do such a great job with these teachings.”  “When I started, I quickly noticed that more education was needed in the field,” added Jennifer J., RN. “Now I see the momentum we’ve had in these communities really take full force. Because of this education, and the confidence we instill in our patients’ families, each baby’s transition to our team has become so much easier. It has been awesome to watch this progress over the years.”  With immense experience, education and a strong commitment to their community under their wing, the NICU on Wheels is only just getting started.  Teamwork Makes the Dream Work  Running a successful NICU Transport operation, especially as the sole health system participating, takes a village. With only three professionals out in the field, the team leans on their fellow nurses, physicians, surgeons and specialists to make the operation run as smoothly as possible.  From REMSA and Care Flight helping load patients in and get them to the hospital safely, to Renown’s Clinical Engineering team who are first on the scene when machines need repairs and troubleshooting, everyone rises to the occasion to achieve the best-possible outcome for our youngest patients at some of the most challenging moments of the beginning of their lives – and they are fully trusted to move those mountains.  “Being a part of the NICU Transport team has given us the opportunity to facilitate a deeper, meaningful relationship with providers and a patient’s entire care team,” said Rachel D., RN. “They entrust us with our assessment skills, opinions and skill levels. There is an equal layer of trust between us and them.”  Despite the pressure they feel every day, the NICU Transport team never let it overtake them and instead let it empower them.  “We are under a lot of pressure and stress regardless of the case, and yet, we all work so well together; the teamwork really is incredible,” said Lisa A., Respiratory Specialist at Renown. “I am very proud of how our team steps up and is very intricate, even down to organization. For example, team members like Shiela arrange all the respiratory bags and make sure they are laid out in a way that makes the procedure as simple as possible to ensure there are no complications.”  The nurses and respiratory therapists also partner together on the NICU floor and are always ready to provide coverage when their transport colleagues get a call. Committed to collaboration and ready to jump into action, the NICU Transport team works together to elevate each other and the bottom line for each patient.  “This is a full-time gig, and the group works together to make sure everyone is covered; we are all very collaborative,” said Sarah K., Respiratory Specialist at Renown. “We all think of our patients as extra special, and it’s nice to know that you can make a difference in the baby’s life and the lives of the family. We all have a sense of purpose in giving back to the community.”  “I am just so thankful to be a part of this team,” added Marcia A., Neonatal Transport RN at Renown. “We really have developed a strong bond.”  A Track Record of Success  The life-saving measures that each member of the NICU Transport team take surpass hospital walls. The impact they have on each baby are remembered and celebrated for years, and they often develop lifelong relationships with patients and their families after their stay in the NICU.  One prime example of this can be found in an impassioned letter from Tess, the mother of a young boy who was in the midst of respiratory distress and needed immediate intervention. Because of the valiant efforts of Renown’s NICU Transport team, her child, Warren, is a healthy and happy baby to this day. She recalls the experience: Warren had stopped breathing while getting routine blood work. He was resuscitated twice while at an area hospital. We made the decision to transfer him to Renown for him to be admitted into the NICU. Within an hour and a half of this decision, Renown had sent a team consisting of a respiratory therapist, nurse and nurse practitioner to come and get him. As soon as the team entered the room, we immediately felt safe and comforted. The team made sure we knew exactly what was going on and what was going to happen in the following hours, and they let us know they would do everything for Warren. He was resuscitated two more times by the respiratory therapist while getting ready for transport. At that time, the decision was made to intubate for a smoother ride to Renown. We knew you all had his best interest in mind, and of course, we trusted you with everything. The intubation went well, and he was packed up and ready to drive. Today, Warren is hitting all of his developmental milestones and is a normal, happy baby in everyone’s eyes. We can’t thank the NICU Transport team enough for taking such good care of Warren and helping him Fight the Good Fight.  “This success wasn’t just due to our three-person unit – our manager, Jason, also jumped in and drove all the way to Carson City to stabilize the child,” said Shiela A. “This just goes to show that no matter our title, we are always here to help and make a huge difference in the lives of our patients.”  Success stories of children like Warren describe the common mission of the NICU Transport team in detail, and while there are more of these stories to come, the team is always ready to make the necessary sacrifices for the greater good of their patients.  “Sarah K. is like Warren’s guardian angel,” said Tess. “We call her ‘Auntie Sarah’ now. He wouldn’t be here if it weren’t for her and the entire NICU Transport team. It takes a special kind of person to work in the NICU. I can never repay this team for what they’ve done for Warren and our family.”  “I am proud of this team, their flexibility and the sacrifices they have made to do transport 365 days a year,” added Melyssa H., RN.”  The remarkable success of the NICU Transport team serves as proof of the unwavering and tireless commitment of each and every team member, bringing hope to families during their most difficult moments.  “NICU Transport forces you to be confident in yourself and your abilities and to push yourself a step further,” said Rachel D., RN. “I am a better nurse because I joined the transport team.”

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