Buscar

Michael Millman was all set to move to Reno from the Bay Area when he noticed a pimple-like growth on his forehead, and he decided to get biopsied "just in case." It was July 2020, less than six months into the COVID-19 pandemic, when Michael got the call that the biopsy came back cancerous. He was in shock. Still living in the Bay Area at the time, he immediately scheduled to have the basal cell carcinoma removed in August. After the removal, he thought he was in the clear, but a few months later, Michael noticed that his lymph nodes felt weird, and he even cut himself shaving because of some persistent swelling in the area. Given his recent history of skin cancer, Michael immediately scheduled an appointment with a specialist in the Bay Area. "I met with an ear, nose and throat doctor who suggested a fine needle biopsy of my lymph nodes, tongue and an MRI, both with and without contrast," Michael said. "I remember feeling dreadful and that I couldn't believe this was happening yet again." A Hard Decision Michael's squamous cell carcinoma, determined by the pathology report to be significantly influenced by the HPV virus, had metastasized to his lymph nodes on both sides of his neck, and his doctor said it could be stage four cancer. He remembers feeling like he was in quicksand, unsure if he should follow through with his move to Reno, or stay in the Bay Area for treatment. By now, it was early December 2020, and hospitals in the Bay Area and across the world were at limited capacity due to COVID-19. But, in what Michael describes as a positive twist of fate, the San Francisco ear, nose and throat provider he had seen about his biopsy results mentioned that he knew many providers in the oncology department at Renown, including Abhinand Peddada, MD. The San Francisco provider called Dr. Peddada's office with a referral, and Michael even remembers that Renown called him to hear more about his diagnosis before he even got the chance to call them "To be honest, I was feeling shut out in the Bay Area, and Dr. Peddada said he could help me expedite the treatment process," Michael said. "I finally felt a sense of relief." And so began Michael's 7-week chemoradiation cancer treatment program at Renown.

Read More About A Cancer Diagnosis and a Move to Reno

June offers an official welcome to summer and the height of outdoor activities in northern Nevada such as hiking, camping, days spent at the lake and embracing long days and warm evenings with friends and family. Enjoying all that the summer season has to offer may not be as easy for those living with chronic obstructive pulmonary disease, or COPD, which effects more than 15 million Americans. What is COPD? COPD is a group of lung diseases including emphysema and chronic bronchitis that result in airflow blockages from the lungs. People may experience frequent coughing and shortness of breath among other symptoms. COPD typically impacts adults ages 65 and older and is becoming increasingly more common among women. Although smoking plays a key role in the development of COPD, air pollution and indoor air quality, and respiratory infection also contribute to disease development. While there is no cure for COPD, limiting progression of disease and managing symptoms can be achieved through lifestyle changes, therapy, and medications. Tips for Living with COPD This Summer, and Always Stay Hydrated: Staying hydrated is extremely important for people with COPD, especially during the summer. Not drinking enough water can make breathing more difficult because it increases respiratory symptoms. Make sure to always keep a water bottle with you and aim to drink 8-10 glasses of water daily. Be Mindful of Temperature: COPD symptoms can be exacerbated by hot weather. It is best to participate in outdoor activities during the cooler times of day, like the morning or evening. Check Air Quality Before You Go: Before engaging in outdoor activities, be sure to check the air quality index and plan your activities accordingly. Pace Yourself: Exercising can be difficult for people who have COPD. To make the most of your summer, try not to push yourself too hard and take breaks when you need them. If you start to feel out of breath or tired, take a break in a cool, shaded area until you feel better. Take Matters Into Your Own Hands To address the needs of community members living with COPD, the Renown Health Research Office has teamed up with Pulmonary Medicine to provide patients who are former or current smokers and have a history of frequent exacerbations with an option to participate in the ARNASA study. "COPD exacerbations have a huge negative impact on patient’s lung function” states Dr. Farah Madhani-Lovely, Chief of Pulmonary Medicine at Renown Health and Assistant Dean of Clinical Research at the University of Nevada, Reno School of Medicine. “We have had inhalers and prednisone for decades but patients are still having exacerbations. Now we have a new pathway we think will prevent exacerbations which is what this clinical trial is designed to prove.” This study will evaluate the efficacy and safety of astegolimab compared with placebo in participants 40-80 years of age with COPD. “This study in particular is so exciting because of the enthusiasm from the sponsor’s end” says Katie Buckley, Lead Clinical Research Coordinator working on pulmonology studies at Renown’s Clinical Research Office. “Often times sites aren’t assigned particularly passionate or engaged personnel who aid in carrying out these studies, but you can tell Roche Genentech’s team truly cares about the success of the study, the safety of their participants, and proving the efficacy of the investigational agent. Working on a study like this takes a village, and when the individuals on all ends share similar mindsets and work towards success as a collective unit instead of as individual moving parts, it’s amazing to see everything we’re able to accomplish.” Renown’s team of expert pulmonologists and researchers are available to join patients with COPD in support of their healthcare journey. If you are interested in learning more about this clinical trial option at Renown Health, talk to your pulmonologist at your next appointment or contact us at 775-982-3646. At Renown Health, our goal is to make it easy for patients to access clinical research as a care opportunity where patients can access a variety of standard care treatment options for their health condition or choose to participate in a clinical trial. For more information about clinical trial opportunities available to you or to ask any questions, contact the Renown Research Office at Renown-CRD@renown.org or 775-982-3646.

Read More About Living with COPD? How to Maximize Your Summer Experience

Read about Jordan Stiteler, a local mom who says the Healthy Nevada Project provided insights into her family’s genetic makeup — and the likely cause of her dad and great grandfather’s deaths. Now she is changing her life due to her new diagnosis of familial hypercholesterolemia, which will allow her to take steps toward preventing the same fate. Jordan Stiteler’s dad died suddenly of a stroke nearly ten years ago — at only 45 years old. His grandfather died at age 40. Now through the Healthy Nevada Project’s no-cost genetic testing, she is closer to understanding why that may have happened. And she can take proactive steps to prevent the unhealthy symptoms that often lead to a stroke and heart problems. After getting her Geno 2.0 by National Geographic ancestry report, Stiteler got a call from Renown Institute for Heart & Vascular Health Cardiologist and Renown IHI Director of Research, Dr. Christopher Rowan. “They told me that I have FH, which is familial hypercholesterolemia,” she said. “I have genetically very high cholesterol because I have a non-functioning gene that doesn’t get rid of my cholesterol like a normal body would.” Familial Hypercholesterolemia: Simple Life Changes Dr. Rowan told Stiteler it is curable with medication and a change in lifestyle. Stiteler has embraced healthy lifestyle changes by exercising more and eating healthier. “It is so important. Being a mom, I think you have so much more to live for. Having this information has changed my life.” Stiteler feels confident FH affected her Dad. “It is helping my family realize that we need to get tested,” she said. “There were big milestones that my Dad missed. He didn’t get to see either of us get married or have our children. That was huge.” She has become passionate about sharing the need to join the Healthy Nevada Project as her way of helping to prevent other families from possibly going through what she and her family did with the early loss of her Dad. In addition to FH results, the Healthy Nevada Project is returning clinical results on BRCA 1/2 (hereditary breast and ovarian cancer) and Lynch syndrome (colorectal and endometrial cancer) to consenting study participants. To sign up for the Healthy Nevada Project, go to HealthyNV.org. Join the Healthy Nevada Project Recruitment for phase two is still open. In addition to opting in to receive clinical results, participants receive National Geographic’s Geno 2.0 ancestry app at no cost. They also have the chance to pick an additional app for health and wellness after completing a follow-up survey. Learn More or Sign Up

Read More About The Healthy Nevada Project Changed My Life: A Local Mom's Story

This Department Spotlight is dedicated to Jason Simpson, Manager of Respiratory Services at Renown Children’s Hospital.  Take a moment to breathe deeply. Inhale in, exhale out. We rely on our lungs to provide us with the air we need to live a healthy life – and this essential bodily function is something that many of us don’t think twice about since it comes easily for us. Now, imagine yourself as someone who is living with severe asthma, chronic obstructive pulmonary disease (COPD) or someone who was recently diagnosed with a frightening respiratory condition like COVID-19 or pneumonia. The simple act of breathing can prove to be an intimidating venture requiring the care of a professional. Who are the people that take on the challenge?  Meet Renown Health’s Respiratory Care Services department. Serving patients across 13 service lines, three acute facilities, outpatient locations and telehealth, our respiratory specialists – including respiratory therapists, respiratory care aides, inpatient COPD respiratory therapy navigators and educators and more – use their expertise to help restore the vitality of all their patients with every inhale and exhale, shaping a healthier livelihood one lung at a time.  The Guardians of Respiratory Wellness  Whether they are managing lifelong respiratory conditions or offering crucial support in emergencies, the Respiratory Care team strives to enhance the quality of life for every patient. As an indispensable member of the clinical team at Renown, our respiratory therapists work collaboratively with doctors and nurses to tackle a wide range of tasks, tailoring care for each patient’s unique needs.  “Respiratory care is involved with all stages of life, from beginning to end,” said Sarah Kurtz, Respiratory Therapist. “We work closely with nurses and doctors and perform arterial punctures, breathing treatments, weaning maneuvers for patients on life support, intubations and much more. We assess patients constantly to see if their care needs to be upgraded or if they can be weaned to get them back home with their families.”  “You start your morning researching your assigned patients,” added Tim Start, Respiratory Specialist. “We go over lab values and chest radiographs and decide the best plan of care for each patient. Our objective is to improve their respiratory status by giving them medications and doing breathing exercises. We participate in other forms of care with nurses, such as activities of daily living (ADLs) and mobilization. We work as a team, and that enables us to provide great patient care.”  For patients living with COPD, enjoying all that life has to offer comes with a separate set of obstacles. According to the Centers for Disease Control and Prevention (CDC), over 200,000 people across the Silver State are living with this chronic condition. Luckily for them, Renown has a specialized team to help these patients optimize their life and manage their condition with individualized treatment and education.  “We run a report every morning to identify all the patients currently admitted who have a history of COPD, take respiratory medications or smoke,” said Amber Beck, Inpatient COPD RT Navigator. “After looking through their charts, we visit with the patient (and possibly their family) at the bedside to help them better understand how to manage their breathing issues.”  As a vital part of the Respiratory Care team, Renown’s respiratory care aides help ensure the seamless operation of our respiratory care services. These dedicated professionals provide essential support to respiratory therapists not only during intricate procedures but also outside of face-to-face patient care by transporting equipment, restocking supplies, assisting in the mobilization of patients and more.  “We are responsible for the maintenance of unit supplies and making decisions regarding levels of stock to be maintained,” said Dia Ramos, Respiratory Care Aide. “We also transport equipment, refill the oxygen tanks on the floors and intensive care units (ICUs), order and stock respiratory care supplies, mobilize patients and assist the respiratory therapists during bronchoscopies in the ICUs. In addition, we clean respiratory equipment like mechanical ventilators, continuous positive airway pressure (CPAP) and bilateral positive airway pressure (BiPAP) machines, high flows and aerosol poles.”  Once the COVID-19 pandemic hit, a special spotlight shined upon respiratory care teams across the country for the heroic care they provided patients in respiratory distress. While their roles in health systems have gained a better understanding nationwide, this team understands it is vital for them to educate the community about the important jobs they hold for our patients.  “Respiratory care can be under the radar,” said Pam Umek, Respiratory Specialist. “Once, when I told someone that I am a Respiratory Therapist, they said, ‘Oh, like a yoga breathing instructor?’ I then explained all the things we do: intubation, extubation, bronchoscopies, transports, traumas, codes, rapid responses, pediatrics/NICU, breathing medications/therapies, open heart rapid ventilator weaning … needless to say, that individual walked away with a better understanding of not just Respiratory Care Services but also the enormous effort it takes to care for our community.”  The accolades and achievements continue to pour in, from national awards and certifications to implementing different jobs in care units to optimize the patient care experience.  “We have earned and continue to maintain the Joint Commission Disease-Specific Certification for COPD,” said Amber Beck. “We are well below national averages for 30-day readmissions, lengths of stay and mortality due to COPD. Sandy, one of our COPD Coordinators, was a recipient of a patient advocacy award from the American Association of Respiratory Care and FACES Foundation.”  “We have started implementing Respiratory Care Aides in the critical units, starting with the Cardiac ICU,” added Dia Ramos. “We work as one team and are always helping each other with their tasks.”  Education and mentorship are at the core of Renown’s mission to make a genuine difference in the health and well-being of every patient. Nurturing the next generation of medical professionals – including respiratory care professionals – is a task that the Respiratory Care team takes seriously.  “It has been great being able to help educate students in different disciplines,” added Pam Umek. “We have been able to offer shadow shifts to students in emergency medical services (EMS), nursing and medical school. These opportunities help students entering the medical field have a better understanding of the many ways we can help care for our respiratory patients.”  From the moment of birth to the final stages of life, Renown is fortunate to have a Respiratory Care team that tirelessly ensures every breath counts, safeguarding their role as a trusted partner within our health system.  A Tribute to Jason Simpson, Healthcare Hero

Read More About Department Spotlight: Respiratory Care

Most babies weigh just one pound and are roughly the size of an eggplant when they reach 24 weeks of development inside the womb. It is a crucial stage when internal organs begin functioning, and the babies' respiratory and central nervous systems are still developing.     So, in November 2021 when Kallie Johnson experienced a premature rupture of amniotic fluid around this point in her pregnancy, her care team in Winnemucca decided to transport her via Care Flight to Renown Regional Medical Center. The team at Renown Children’s Hospital immediately began discussing the risks of delivering at 24 weeks with the Johnson family.  Moving Forward with Hope Knowing the stakes, Kallie remembers never feeling rushed to decide about delivering her baby preterm. “I felt educated and supported by my care team at Renown throughout our entire stay, starting with the education they provided about what it meant to deliver my baby early,” Kallie said. “The team really helped me make the best decision for myself and my family.”    Together, Renown employees and the Johnson family moved forward with a healthy set of nerves and a powerful feeling of hope.  Weighing in at one pound 11 ounces, Sloan entered the world on Nov. 19, 2021, via emergency Cesarean section. Her birth was classified as a micro preemie because she was born before week 26 of pregnancy and so small that she fit inside the palm of her father Sterling’s hand. A full-term pregnancy is classified as reaching 39 weeks.   A Fighting Chance  Called a fighter by many Renown Children’s Hospital care team members, Sloan spent over five months in the neonatal intensive care unit (NICU). She was placed on a ventilator, fed through a feeding tube and monitored 24/7, overcoming daily challenges with the Renown team and her family.  As a result of being born prematurely, Sloan developed a grade one brain bleed and a congenital heart defect called patent ductus arteriosus, a persistent opening between two major blood vessels, causing too much blood to flow to the lungs and heart.   To meet the oxygen needs of her tiny lungs, Sloan was intubated and developed a severe oral aversion and high-arched palate as a result. The effects would lead to difficult developmental and physical challenges that she still conquers today. Yet, with the help of her care team – including physical, occupational and speech therapists, dieticians and doctors – Sloan continues to make progress every day.

Read More About A Fighting Chance at 24 Weeks Sloans Story