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© Africa Images via Canva.com Do you find yourself struggling to stay awake during the day or having no energy? You’re not alone. Whether you’re a full-time employee, a student or retiree, that “I’m tired” feeling comes in all shapes and sizes. What’s even more frustrating is not knowing the source of your exhaustion.  Dr. Brandon Flores, a sleep medicine physician with Renown Medical Group, breaks down nine key reasons why you may be feeling so fatigued.  You did not get enough sleep, or your quality of sleep is poor. This may seem obvious, but in today’s “rise and grind” culture, sleep can be considered a luxury rather than what it really is: a necessity. Ensuring you get adequate hours of sleep between 6-9 hours and quality sleep is essential. You may not be breathing well during sleep. Interruptions to your breathing, such as snoring, can decrease airflow at night causing your sleep to be less restorative. This is often due to Obstructive Sleep Apnea (OSA). OSA can lead to daytime fatigue and sleepiness and can also impact other chronic health conditions, such as hypertension, diabetes, acid reflux, migraines and heart rhythm. You are not getting enough regular exercise, or you are exercising too much. Incorporating at least 30 minutes a day of physical activity can help keep you energized throughout the day. It has also been shown to increase deep slow wave sleep, which is often associated with feeling rested. On the other hand, getting too much exercise can tire you out more easily and heighten stress levels. You drink too much caffeine. This one may seem counterintuitive – caffeine is supposed to keep you awake, right? Well, overdoing it with your favorite coffee or soda could affect your sleep quality. Pay attention to your caffeine limits and have a cut-off time, as most caffeine should not be consumed past noon. You have a food allergy or intolerance. If you find yourself feeling especially tired after eating a lot of a certain food, you could have an allergy or intolerance to it – and vice versa. Consider speaking with your primary care provider (PCP) about a food allergy test or being referred to an allergist. You’re drinking too many alcoholic beverages. Alcohol is a depressant, which as the word implies, can make you feel especially tired during the day. It can also affect your breathing at night and disrupt your sleep cycle. Cutting back on alcoholic drinks may be beneficial to your overall health. You are anemic. This is the leading cause of fatigue in women but can affect people of all genders. It can be associated with low iron. Eating foods high in iron, including leafy greens and many different meats, can help your iron levels. A blood test ordered by your PCP can help you understand if you are iron deficient. You are experiencing depression or anxiety. Emotional exhaustion can be just as taxing as physical exhaustion. Prolonged feelings of sadness, hopelessness, nervousness or panic can be signs and symptoms of depression or anxiety. Speak with your provider about the many resources available to help you. You have an underactive thyroid. Feeling fatigued can also be a symptom of hypothyroidism, which affects your metabolism and energy levels. Medication can help get your thyroid back to normal. Your PCP can order a blood test to determine your thyroid levels.  If you experience severe exhaustion that lasts six months or longer, worsens after physical or mental exertion and does not get better after resting, it could be a sign of myalgic encephalomyelitis, otherwise known as chronic fatigue syndrome (CFS). This is a diagnosis of exclusion, and other causes must be ruled out. While there are no tests that detect CFS, your provider can order blood and urine tests to rule out other causes of your fatigue and help develop a care plan.

Read More About Why Am I So Tired? 9 Reasons for Your Chronic Exhaustion

Hygiene in healthcare is an essential backbone to providing the safest, most optimal care to every patient. From everyday handwashing techniques and getting all necessary vaccinations to surveilling our health system before the onset of outbreaks, at Renown Health, creating and maintaining a low-infection environment is a group effort. From ensuring fundamental infection prevention practices are carried out to identifying process improvement opportunities, Renown’s Infection Prevention (IP) department is here to help care teams be successful in their role. This effort is led by members who are devoted in sharing evidence-based best practices to our patients, employees, healthcare organization partners and community. Making “Zero” A Reality Reducing healthcare-associated infections is possible when core infection prevention practices are incorporated into the daily care of our patients. These team members are dedicated to Renown’s commitment to creating a culture of Excellence, caring for our healthcare environment, and our care teams. “Often times, when asked what we do in our work it can be a challenge to answer because unpredictability is built into almost every day; and in that, we as a team must divide and conquer,” said Susanne James, Manager of Infection Prevention. Every day, each team member is assigned a day to perform required surveillance activities. Whether they are reviewing patients’ infections and isolation and evaluating lab orders for possible infectious processes or reporting communicable diseases to the local health authorities and the CDC, every Infection Preventionist participates in improvement projects and address issues as they arise. The Infection Prevention team plans, organizes, manages and evaluates the Infection Prevention Program and ensures IP policies reflect current best practice. They work closely with all departments at Renown in order to achieve high levels of standards that are implemented to reduce transmission of infection. “As a team, we perform ‘Infection Prevention Environment of Care Rounding’ on all units and departments to ensure our environment complies with regulatory requirements,” said Erika Clark, Operations Analyst at Renown Health. "We work together with Facilities and Site Practice Leaders to ensure a safe environment.” The pandemic challenged all Renown teams to find creative solutions for issues no one ever imagined. Our Infection Prevention department worked tirelessly alongside Renown's Hospital Incident Command Structure (HICS) and care teams in creating several lines of defense against COVID-19, including: Launching Renown's Alternate Care Site to meet the need for critical patients. Bringing on the new lab tests and specimen collection criteria. Managing demand for personal protective equipment (PPE). Bringing vaccines to staff and then to the community. Managing ill employees and our visitors. Keeping all locations informed on pandemic status and changes (which were occurring at breakneck speed). These initiatives enabled Renown's care teams to focus on providing the safest care possible to patients saving countless lives. This solidified the fact that together, the team can accomplish anything. “Infection Prevention is proud to be a valued and respected member of the care team,” said Susanne James. “We appreciate being a trusted resource and take this responsibility seriously as this enables us to provide staff the best possible tools to be successful.” Fight the Good Fight Against the Spread of Disease Educating patients and providers plays a huge part on the Infection Prevention stage. This team provides educational materials on a range of topics, some of the most important are, proper hand hygiene and the use of PPE. All these materials can be found throughout our health system and serve as an important reminder – infection prevention starts with all of us. “We partner with every aspect of the health system – environmental services, nutrition services, lab services, facilities, pharmacy, physical therapy and occupational therapy, respiratory care, patient access, security, nurses, providers and quality...just to name a few!” said Susanne James. Our Infection Prevention team also partners with Washoe County Health District and other public health agencies to report – and in turn, stop the spread of – diseases and exposures. These close partnerships poise our team to do what we do best: Fight the Good Fight. “I greatly appreciate everyone in the IP department for sharing their expertise as I learned a new position,” said Erika Clark. “I love working with my team and how closely we work with other departments to ensure excellence in all we do.” Our health system is ever-changing. But according to the experts in our Infection Prevention department, the three main ways to prevent illness and disease that remain the same time and time again are to: Clean your hands. Hand hygiene is the most effective way of preventing the spread of infections. The CDC recommends washing your hands with warm soap and water for 15-20 seconds or using an alcohol-based hand sanitizer. Clean your hands often and assist our patients to do the same. Learn expert hand-washing advice here. Get vaccinated. Immunizations are one of the top methods you can embrace the fight against preventable diseases, such as COVID-19, flu, measles, tetanus and more. Discover how you can get vaccinated with Renown. Keep germs from spreading. Practice good hygiene by covering your cough or sneeze or wearing a mask and sanitizing frequently touched spaces. Stay home if you feel ill to prevent the spread of illness and infection. Be sure to bring up any illness concerns with your primary care provider. “Every aspect of our health system has an infection prevention component, and we work daily to ensure our staff, patients and visitors are providing and receiving care free from potential harm or infections,” said Susanne James. “We are often the first call staff make when they have questions, concerns or just need someone to help improve process or outcomes.” Reveling with Renown Proudly defining themselves as a “small but mighty” team, the six-person Infection Prevention department moves mountains to ensure the safety of anyone who walks through Renown’s doors. The tight-knit nature of this team can be felt from miles away, and to them, being “small but mighty” is not a hindrance, as they have the support of the IP Champions and the entire health system.   “I originally came to Renown in 2018 as a nurse traveler, the facility and people I worked with immediately made an impact on me,” said Brian Stroud, Infection Preventionist at Renown Health. “My wife and I chose Renown and Reno due to the positive impact the people had on us. Everyone is welcoming, helpful and caring. Now, I am a full-time employee, and the team has made my transition into infection prevention trouble-free." Renown’s mission of providing a genuine difference for the health and wellbeing of the community is heightened and echoed by the Infection Prevention team. “I chose Renown because of the reputation Renown has earned in the community because of the excellent care and level of services provided,” said Shannon Oriola, Infection Preventionist at Renown Health. “I absolutely love this team and my Renown family!” “What brought me to Renown was the opportunity to acquire diverse skills which then motivated me to pursue my master’s degree,” added Paul DeLeon, Infection Preventionist at Renown Health. “What keeps me here is the people – Renown attracts hard working, ethical and caring people.” "My wife and I loved coming out to the Nevada mountains on vacations," added Russ Laarman, Infection Preventionist at Renown Health. "After being in Michigan for 47 years, we took the plunge and made NV our home. The experience has been great! I work with a great team that is very knowledgeable and works hard to ensure positive outcomes for our patients and colleagues at Renown.” Their pride shines through with their own individual accolades, both inside and outside of work. This past year: Shannon Oriola received a scholarship from the Association for Professionals in Infection Control and Epidemiology (APIC) for “improving outcomes through knowledge and practice,” which provided her with a $1,000 scholarship to attend the annual APIC conference in Indianapolis. Paul DeLeon earned his Certification in Infection Control and Prevention from APIC. Erika Clark completed Renown’s High Potential program, a six-month program that gives employees hands-on learning experience with several competencies, including emotional intelligence, effective communication, building successful relationships and organizational knowledge. Brian Stroud and his wife Charla became official Nevada residents. Russ Laarman scaled Mount Whitney. ...And the list keeps growing! Charged with the goal of keeping disease spread at bay, our Infection Prevention team remains vigilant and dedicated to their mission. Their commitment to Renown and to keeping our health system clean and healthy proves the age-old saying true: not all heroes wear capes. “I’m so very proud of the work Infection Prevention does every day, working with the vast teams throughout the health system to improve lives,” said Susanne James. “We would like to thank all of you for protecting the health and safety of your colleagues, our patients and the community.”

Read More About Department Spotlight: Infection Prevention

Abdominal pain is one of the most common reasons for an Emergency Room visit. The abdomen is an area that encompasses multiple organs and functions. So how would you know when the pain you are feeling is an ovarian cyst or something else, and when should you seek medical attention? Dr. Carilyn Hoffman, at Renown Women's Health, explains. Ovarian Function Defined Located on each side of the uterus, the ovaries are part of the female reproductive organs and produce eggs (ova), released during the menstrual cycle, allowing for fertilization and pregnancy. They also produce hormones such as estrogen and progesterone, which play an important role in female traits, bone health, cardiovascular health and pregnancy. Symptoms of an Ovarian Cyst Cysts are solid or fluid-filled masses. Ovarian cysts can be in the ovary or on its surface. When cysts are enlarged or rupture, they can create a dull ache or sharp pain below the belly button. Besides discomfort and pain, other symptoms of ovarian cysts may include bloating, fullness, pressure or heaviness. "Ovarian cysts are common; most are physiologic and will go away on their own. They are frequently found incidentally on ultrasound and are present in the middle of the menstrual cycle," says Dr. Hoffman. "However, if a woman experiences sudden and severe pelvic pain they should seek immediate medical attention. Sometimes ovarian cysts can become large and twist on themselves. This is called ovarian torsion and is a surgical emergency. Other times, cysts can rupture and bleed. This is called a hemorrhagic cyst and can also be a surgical emergency." Diagnosis and Treatment If an ovarian cyst is suspected, your doctor will perform a pelvic exam and order an ultrasound. There are certain ultrasound findings that suggest that the cyst is benign. There are other ultrasound findings that are concerning for cancer. Small simple cysts often resolve on their own, whereas solid or very large cysts may require surgery.

Read More About What is an Ovarian Cyst, and How is it Treated?

On March 19, 2020, Renown Regional admitted the first patient in need of care while sick with COVID-19. Our providers navigated two years of a pandemic and overcame many challenges while providing the best care for our patients and the community. Anicia Beckwith’s series “The Art of Healing” captured Renown Health during this time. Let's take a look back on the last two years. February 2020: Standing Up the Hospital Incident Command System (HICS) On February 25, 2020, leaders at Renown Health stood up Renown’s Hospital Incident Command System (HICS), a standardized system used to organize response personnel and resources and manage response operations during emergencies and crises. March 2020: Temporary Deployable Medical Structure Placed Outside Renown Regional Emergency Department On March 12, 2020, Renown set up a deployable medical facility to serve as a respiratory illness screening center for emergency room patients at Renown Regional. A similar tent was also set up outside the emergency room at South Meadows Medical Center. This proactive measure helped our teams care for community members with respiratory illness symptoms while protecting patients and staff in the emergency department and other areas of the hospital. Check out photos of the tent here. Read the Reno Gazette Journal Article about the tent here. April 2020: Alternate Care Site at Mill Street Parking Structure at Renown Regional Renown’s HICS team decided to create an Alternate Care Site (ACS) in the Renown Regional Medical Center Mill Street parking structure. The ACS served additional hospitalized patients and allowed caregivers to remain on campus and still have access to existing hospital infrastructure such as lab, pharmacy, imaging, food services and other critical services. After just 10 days of construction, the ACS was completed on April 3, 2020 with space to hold up to 1,400 patients. Check out photos of the ACS under construction here. On Nov. 12, 2020, Renown opened the ACS to serve additional hospitalized patients diagnosed with COVID-19 who were clinically stable or improving. Healthcare workers at Renown cared for hundreds of patients at this site. In early Jan. 2021, the remaining patients returned home. Check out the video of Connie, a patient who received care in the ACS. April and July 2020: The LOVE Sculpture Placed at Renown Regional On April 16, 2020, during a time of darkness and uncertainty, Artown loaned Renown the LOVE sculpture, a one-ton aluminum piece of art created by artist Laura Kimpton and fabricated by Jeff Schomberg. The structure, which originally debuted at Burning Man, was lit up Renown Regional's main entrance on Mill St. Watch a video about the LOVE sculpture’s debut at Renown Regional. On July 13, 2020, thanks to the support of former board chair and community supporter Blake Smith and the Keyser Foundation, the LOVE sculpture is now a permanent fixture at Renown Health. Throughout the pandemic, it has served as a source of inspiration, hope and positivity for our community and care providers. Check out a video of the LOVE is Here to Stay celebration. June 2020: Renown Offers In-House COVID Testing In June 2020, the Renown laboratory team sprang into action to help meet the growing demand for COVID-19 testing amongst Washoe County residents and businesses. Renown invested in expanded staffing and in-house testing capabilities that ensured our teams could swab and process up to 1,000 COVID-19 tests for patients each day. All with results returning within hours. November 2020: Renown Introduces “Hospital At Home” Remote Monitoring In November 2020, six patients at Renown Regional Medical Center and Renown South Meadows Medical Center diagnosed with COVID-19 were outfitted with a remote Hospital at Home monitoring system. Renown clinicians plan to continue using this system to monitor upwards of 1,000 hospitalized patients and lower acuity patients from their homes. December 2020: Renown Administers COVID-19 Vaccines to Health Care Employees On Dec. 17, 2020, Renown began to vaccinate its healthcare workers. Among those receiving the first vaccines was Luis Martinez, a technician on Renown’s Clinical Decision Unit who cared for patients recovering from COVID-19 in the Alternate Care Site field hospital. Read the Reno Gazette Journal article about the COVID-19 vaccine rollout at Renown. January 2021: Renown Administers COVID-19 Vaccines to Community After several weeks of successful employee and volunteer drive-thru vaccination events, Renown supported the Washoe County Health District and the state in vaccinating Washoe County community members. Click here for a playlist of videos featuring Renown Health employees and patients talking about the importance of the COVID-19 vaccine. February 2021: Local Widow Inspires Renown to Change Visitor Supporter Policy Darlene Randolph’s husband Dave spent 17 days hospitalized at Renown Regional Medical Center before losing his battle with COVID-19 on December 13, 2020. Darlene wrote a passionate letter to Renown Health asking for the visitor policy that allowed patients with COVID-19 to receive visitors. In February 2021, Renown hospitals were among the first in the country to lift visitor restrictions for patients with COVID-19 to encourage families to be at the patient's bedside. Read Darlene’s full story here. May 2021: Renown Celebrates Volunteers, Partners and Community Who Aided in Vaccine Efforts In May 2021, Renown administered the last dose of COVID-19 vaccines to community members in Renown’s drive-thru clinic. Between January and May 2021, over 80,000 doses were administered at the drive-thru. View drone footage of this effort here. Click here to see pictures of vaccine volunteers and employees. November 2021: Renown Offers Vaccine for Children Ages 5+ In November 2021, Renown vaccinated children in the Reno-Sparks community with the 2-dose series in a limited round of weekend clinics. The vaccine clinics featured therapy dogs, local mascots and donuts donated by Doughboy’s Donuts. Click here to see pictures of the children’s vaccine clinics and watch a video about the clinics here.

Read More About Two Years We Won't Forget: COVID-19 at Renown Health