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

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It’s true there is no cure for dementia, yet studies suggest your life choices today can reduce brain decline in the future. How important is diet to brain health? Food is the foundation of your body. Fats, carbs and protein provide the energy for your cells and metabolism. So the quality and amount of food you eat directly affects your brain. Specifically, researchers are paying special attention to the link a high sugar diet and/ or an unhealthy fat diet may have on your brain. Your brain on sugar According to the Alzheimer’s Association, when too much sugar is in the bloodstream for long periods of time, it can damage the brain cells. Many people with diabetes may develop brain abnormalities, and these changes may increase chances of dementia — research is still being done to understand this connection. Many U.S. adults have prediabetes with blood sugar higher than normal. Insulin resistance often leads to diabetes. Insulin resistance has been linked to metabolic syndrome, which is a precursor for cardiovascular and cerebrovascular disease (heart attack, stroke). Some signs of metabolic syndrome include: Large waist size (40 inches or more for men, 35 inches and up for women) Low HDL (good) cholesterol level Higher than normal blood pressure — 130/85 and above Current research suggests too much sugar in the blood causes inflammation, which can damage brain cells. High carbohydrate foods, such as sweetened beverages, chips, white rice, white potatoes, bagels, cereals and desserts, have been shown to raise blood sugar. Although anyone can get diabetes, Hispanic Americans and African Americans are at greater risk.

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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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Has a male in your life been affected by depression? This could be your father, husband, son, brother, friend, or co-worker. Men often struggle to recognize when they need help. Learn how to support them by understanding their unique signs of depression. Psychologist Dr. Herbert Coard discusses depression in men and its often-overlooked warning signs. Every year, over 6 million men are diagnosed with depression, which can manifest differently than in women. Commonly misread, the signs can include anger and aggression rather than sadness, leading to challenges for loved ones and healthcare providers in recognizing the condition. 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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You probably know testosterone (T) plays an important role in how boys physically develop into men. But is that all you know? What happens when a man's T levels are off? Are there symptoms men should look for? And what are the treatment options? Dr. Bobby Kahlon, MD, Renown Medical Group provides answers in a Testosterone Q&A.   What does testosterone do for men?  "Testosterone is known as the 'manly hormone' for a reason," says Dr. Kahlon. "Though women also naturally produce small amounts of it, men produce testosterone at much higher concentration levels. And it affects men in more physical and obvious ways. How much hair a man has on his chest, how deep his voice is, or how muscular he is are all attributable in some way to testosterone. It's also responsible in large part for sex drive and bone strength and affects how men think, learn and experience their surroundings."  Testosterone in men:   Powers virilization (male physical characteristics) and sexual function Builds muscle mass and strength  Supports bone density  Improves cognition  T Trivia: Discover Magazine reveals that “manly” testosterone and other sex hormones evolved long before we did — 500 million years ago — from the ultimate “female” hormone, estrogen. Can you have too much or too little testosterone?  Though high testosterone isn't a concern for most men, low testosterone or low T occurs more frequently and develops for two primary reasons.  Dr. Kuhadiya explains, "Subnormal testosterone concentrations occur either due to pituitary or testicular failure and the causes for each need to be discussed with your physician."  Pituitary failure: Approximately one-third of men with obesity, type 2 diabetes, or metabolic syndrome (which includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels) have low free — or "bioavailable" — testosterone. These health conditions can cause the pituitary gland to "fail" to release follicle stimulating hormone (FSH) and luteinizing hormone (LH) which are essential for triggering testosterone and sperm production. And that can cause low testosterone (hypogonadism). Testicular failure: Though less common than pituitary failure, testicular failure may also be responsible for low T. It's caused by diseases or illnesses affecting the testicles, injury or trauma to the testicles, or certain medicines and treatments such as chemotherapy or opioid pain medication. Providing your complete medical history to your doctor is always the first step toward a proper diagnosis.  What are the symptoms of low T?  The following indicators could be a sign that you have low T, say the doctors.  Lack of motivation and determination, including mild depression  Loss of physical endurance and muscle strength  Loss of or diminished early morning erections  Reduced libido (sex drive)   Erectile dysfunction (ED — difficulty achieving or maintaining an erection)   Gynecomastia (male breasts)  Small testes  T and Time: T levels in men naturally begin to decline by about 1% a year starting at age 30.  How do you test for low T?  "There are different methods for testing testosterone levels," says Dr. Kuhadiya. "Each approach uses a blood sample to evaluate total testosterone, which includes free and attached testosterone that combines with proteins albumin and sex hormone-binding globulin (SHBG). For the most accurate results, testing is based on samples collected in the morning after fasting, and from tests on two different days."  What treatment options are available?  "Well, your best natural option may be YOU," says Dr. Kahlon. "Men with pituitary failure are often able to treat their low T by losing weight to increase levels of the hormone. And even if you don't lose weight, exercise can help boost your testosterone. Unfortunately, if you have testicular failure, weight loss and exercise may not have the same effect."  So, are there other options? "You may want to consider Testosterone Replacement Therapy (TRT)," says Dr. Kuhadiya. "TRT is only available to men who are hypogonadal — with a clinical diagnosis of low T. Injection, gel, skin patch and nasal spray are available TRT options. The best option is the one that works best for the patient. Convenience, insurance coverage and cost are all factors to consider." Dr. Kahlon's TRT preference? Daily gel treatments, which are applied directly to the skin. On the other hand, Dr. Kuhadiya recommends intramuscular injections, which take place once a week or every two weeks.  But both doctors agree on this: physicians and their patients need to weigh the benefits and risks of TRT before proceeding with treatment — especially if your low T condition may require lifelong treatment. "In my clinical practice, I have seen some very good long-term results with an improved quality of life," says Dr. Kuhadiya. "However, in certain situations, TRT may increase the risk of heart disease and is not recommended for men with a history of prostate cancer." Dr. Kahlon adds, "Patients receiving any type of hormone therapy need to be closely monitored throughout the treatment process for any changes in their health."   How do you feel about steroids and T boosters?  "I don't recommend them, certainly not for hypogonadism," advises Dr. Kahlon. "There is no evidence to support anabolic-androgenic steroids or testosterone boosters as a safe or effective treatment for low T in men."  "In fact, there continues to be emerging evidence they may lead to side effects that could potentially harm the liver and the pituitary and endocrine functions of the body," warns Dr. Kuhadiya. "And that damage may be irreversible."

Read More About Testosterone, Men and Health: What You Need to Know

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

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© 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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If Sterling Silver Club member Ann had an official motto, it would be, “I love to learn new things.” Ann has been a Reno resident for about 25 years after making her way to the Silver State from Arizona and before that, her birth state of Indiana. All along the way, she’s been growing, exploring and learning. Meet Ann From her days as a Girl Scout to her cherished roles as mother and grandmother and her time spent working for the federal government, Ann has enjoyed the adventures she’s had, the people she’s met and the learning opportunities that continue to be an important part of her life’s journey. “Learning never has to end,” Ann says wisely. Today, Ann lives a life full of learning — and giving. She is a member of the Osher Lifelong Learning Institute (OLLI) at UNR, which offers classes and events for people who are 50 and older. She has also been a foster grandparent for Seniors in Service and has tutored troubled teens at the Jan Evans Juvenile Detention Center and helped out at Title 1 schools. Volunteer Extraordinaire Her volunteer résumé continues with work for the Reno Police Department’s SAVE program through Retired Senior Volunteer Program (RSVP) for Sanford Center for Aging and time spent with VISTA for AmeriCorps, helping victims of domestic violence and refugees. And with her recent appearance in Ky’s Kab, a segment of Aging & Awesome — the popular 55+ show airing Saturdays at 7 p.m. on local CBS affiliate, KTVN Channel 2 — she’s a bit of a celebrity to boot! Through all of her experiences, Ann has learned something about herself and others. She looks forward to the new memories and friendships her latest membership to the Sterling Silver Club will bring. “I love being a member of the Sterling Silver Club because it’s another opportunity for me to grow, have fun, learn and socialize,” she says. And everyone at Renown is thrilled to help her do those things — and live a happy, healthy life. Please join us in welcoming Ann, one of our first members of the Sterling Silver Club. Today we have more than 2,800 members and we’re happy to be featuring members and getting to know you all along the way!

Read More About Meet Ann Sterling Silver Club Member