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Want to know more about osteoporosis and osteopenia? We'll dive into these conditions and give you some handy tips on preventing future problems and taking care of your bones. What is Osteopenia? Osteopenia (low bone density) is the initial stage of bone mineral density loss, which can eventually progress to osteoporosis if steps are not taken to prevent it. What is Osteoporosis? Osteoporosis is a condition that weakens our bones. While it literally means “porous bone," it doesn’t mean that our bones are doomed to succumb to the changes that can happen to us silently over time. Our bones are living tissues that are constantly breaking down and remodeling themselves.  Osteoporosis and osteopenia are typically diagnosed by testing bone mineral density using scans that your primary care provider can easily order. This is important testing because it dictates your risk of breaking a bone in common areas like your hip, wrist or spine. It also helps set the stage for talking with your healthcare team to develop a treatment plan. Most people will reach their peak bone mass in their mid to late twenties. There are several factors that increase our risk of osteoporosis or osteopenia as we age, such as menopause, genetics and other lifestyle factors. However, there are several things you can do to mitigate this breakdown and assist your body in the constant remodeling it does to our bones. 3 Controllable Factors to Build Strong Bones 1. Talk to your primary care provider They can go over a plan and prescribe things such as vitamin D, calcium and medications that can help if you are at risk or have osteoporosis or osteopenia. 2. Maintain a healthy diet Talk to a dietician if you need further help as they can be an invaluable resource to develop a plan.  Eat foods rich in calcium, vitamin D and vitamin C. These assist with the rebuilding of bone. Examples include but aren’t limited to leafy greens, legumes, salmon and healthy dairy products.  Don’t smoke — it directly correlates with a decrease in bone mass. Smokers also take longer to heal from a fracture.  Limit alcohol to two to three beverages per week. Alcohol interferes with the production of vitamins needed to absorb calcium and the hormones that help protect bones. 3. Exercise Talk to your primary care provider to get a referral to physical therapy if you need help with exercise.  Our bones adapt to the stresses we put them through. Therefore, exercise should be tailored to putting the right stress on our bones. There is good quality research that most exercise is safe when dealing with less bone mineral density.  The exercises should be progressively challenging and increase the load for resistance and weight training at least two to three days a week. Examples include squats, step-ups, chest presses and rows.  Exercises higher in velocity will lead to more power and bone adaptation. Examples include quicker push-ups, marching and quicker walks.  Exercises that are weight-bearing will lead bones to adapt to the stress placed on them. Movements such as mini stomps, step-ups, jumping, jogging and so forth may be used depending on how your body tolerates these things to really stimulate bone adaptation. There are aspects of aging and bone health we can’t control, but we can take steps to minimize the chances of bone loss and osteoporosis. Talk to your healthcare team to determine your risk and don’t forget to show your bones a little TLC – you’re going to need them.

Read More About A Therapist's Tips to Prevent and Manage Osteoporosis

When you meet Poeth Kilonzo, Director of Oncology Nursing at Renown Health, you are immediately greeted with a warm smile that puts your mind at ease. Within the William N. Pennington Cancer Institute, Poeth enjoys a strong reputation among her employees and patients as someone they can always rely on, no matter how rough the tides may flow.   As an incredibly humble oncology professional, you may not realize that behind that smile is the power of a best-in-class nurse and leader holding a 20+ year career of diverse nursing experience and leadership excellence – dedicating the majority of her service to Renown Health.  Join us as we dive into Poeth’s unique journey through Renown.  Finding Her Passion  Ever since she could remember, Poeth has been a “people person.” Above all else, she cared for people – and she cared a lot. What better place for her to be than healthcare?  After moving to northern Nevada from Kenya, she began working in private patient care working with home health and dementia patients while taking classes at Truckee Meadows Community College (TMCC) in 2000. One day, a patient asked her a question that would change the course of her career journey: Did you ever think about becoming a nurse?  Driven by not only the words of encouragement of her patients and supervisors in home health but also the rallying support from her family and friends, including her husband and high school friend, who both have decades of experience interacting with nurses in healthcare (with her husband spending many of those years at Renown), Poeth knew this was the path she was meant to take.  “That was it; it was like a light switch had flipped,” said Poeth. “I switched to nursing overnight.”  According to Poeth, TMCC’s nursing program offered her an incredibly supportive environment, which was especially important as she was a young mom at the time. Working in healthcare, going to nursing school and raising a family all at the same time is no easy task, but to Poeth, this was her calling.  “Regardless of my path, I knew I wanted to be a nurse that was close to patients, sitting with them and holding their hand throughout their treatment,” said Poeth.  During nursing school, Poeth completed clinicals at several hospitals in Reno – three of them were at Renown Health (known as Washoe Medical Center at the time). What immediately stood out to her was the passion of the pediatrics unit, especially in the neonatal intensive care unit (NICU).  “While I knew that pediatrics wasn’t going to be my arena, some of the best times in my life were during my pediatrics clinical,” said Poeth. “It opened me up to how welcoming Renown is.”  While doing her rotations, nursing leaders helped Poeth and her fellow classmates discover Renown’s Nurse Apprentice program, an apprenticeship designed exclusively for local northern Nevada nursing students. One of those leaders asked her, “have you considered doing a rotation in oncology?”  And another light switch flipped.  “Bingo. I am becoming an oncology nurse apprentice,” Poeth recalls. And that’s exactly what she did.   After her four-month apprenticeship ended in February 2002, she walked into her interview with Joanna Gold, who would end up being her supervisor and one of her greatest mentors until she passed away in recent years. With her experience and enthusiastic spirit on her side, Poeth fervently expressed her passion and interest in working in oncology. And Joanna saw all of that and more.  In June 2002, Poeth was presented with a two-year oncology RN contract, which she easily signed – however, she knew right then and there but she was not going anywhere. Renown was her home, and oncology ignited the fire within her.  “The nurses in this unit are part of what kept me here,” Poeth remembers. “These nurses would really do anything for their patients. The commitment and love they all had for one another truly was like family. It inspired me to learn more and give even better care to my patients."  To Poeth, it didn’t feel like she was coming to work just to do a job – she was following her dreams.  “You don’t think about the work you do; you think about the service,” said Poeth.  From there, Poeth spent three years on the floor as an oncology RN and became a night shift supervisor in 2005. She was thriving.  But this part of her journey was only the beginning.  When Opportunity Arises, Take It  In March 2007, Poeth and her husband welcomed their third child – and for her, working a day shift position would serve her the best at her current stage of life. This revelation led her down to Renown South Meadows Medical Center, where she became a staff nurse in Medical Telemetry.  It was in the telemetry unit where Poeth contributed to one of the largest digital transformations Renown would ever go through: transitioning from paper records to electronic records on EPIC.  From there, Poeth was inspired to get back into leadership in 2012 as the Supervisor of Clinical Nursing overseeing nurses, clinical outcomes and payroll in the medical/telemetry unit and intensive care unit (ICU). The timing of her leadership role lined up perfectly with her decision to take her skills to the next level, achieving a bachelor’s degree from Nevada State College in 2016. The timing of her degree lined up perfectly with what was about to come; she embarked on her first leadership role at Renown  This is where she would happily stay for 11 years, eventually becoming the Manager of Nursing in telemetry and the ICU, noting that Renown South Meadows felt like a second home to her.  “I wore many hats at South Meadows,” Poeth recalls. “From piloting back coding and handling compliance work to being on the patient floor and heading up South Meadows’ first high school hospital volunteer program, I got very involved. We had seven years without having a single nurse traveler in our unit."  It wasn’t long before Poeth was inspired to expand her education even further, and she graduated in January 2018 with a master’s degree in nursing clinical leadership from Western Governors University. Thanks to Renown’s educational assistance programs, our health system invested directly in Poeth’s education with tuition reimbursement and a $1,000 nursing scholarship.  Soon after celebrating her achievement, Jennifer Allen Fleiner – who was the Director of Nursing at Renown South Meadows at the time – asked Poeth yet another question that would bring her to the precipice of another career detour: “Have you ever considered transferring from South Meadows to Renown Regional?”   Moments later, Alicia Glassco, Director of Nursing for Renown Regional, asked her the same question, noting that the hospital’s neurosurgery unit needed the leadership of someone just like Poeth.  “It took me a whole week to make a decision, because this was one of the toughest decisions I’ve ever made in my life,” said Poeth. “I truly loved South Meadows. After that week, my leader told me, ‘you know what, Poeth? You’ve reached your pinnacle. You need and deserve a new challenge. Learn from this new team and teach them something. I think you have a huge opportunity for growth.”  So, Poeth decided to apply for the position and shadow the neurosurgery team, where unlike her unit, the majority of the team at the time were travelers. But this was a challenge Poeth was up to – so she was accepted into the role.  “At the end of the day, these patients deserved consistent care,” Poeth emphasized. “I knew I had to take this position for the patients – they were the ones who sold me on this job. They are the reason why we are all here. It was important for me to be an advocate for them.”  The big hills to climb didn’t slow down Poeth; in fact, the exact opposite happened. Within her first year in the neurosurgery unit, her team onboarded 18 new graduates and replaced travelers.  “We were hiring like crazy,” said Poeth. “My standing agenda at all section meetings focused on hiring and our quality metrics. I started having a relationship with our doctors. Once we created a strong doctor/nurse collaboration, our nurses started staying with us longer.”  Everything on the unit was going great.  Then, COVID-19 hit.   “Since we had private patient rooms, our unit became the first COVID unit at Renown Regional,” Poeth recalls. “My whole staff that I had built up had to be distributed elsewhere. I started caring for COVID patients. We relied on our Infection Prevention team a lot. And at the same time, I was worried about my family in Africa.”  Despite the stressful nature that the pandemic brought upon health systems everywhere, according to Poeth, she knew she had to continue on.  “The neurosurgery team ended up merging with orthopedic trauma, which was very difficult,” said Poeth. “We went from 28 beds to 58 beds. The key to success here was training. Nurses are very resilient, and through training, we were able to stabilize the unit.”  Noticing the opportunity for virtual demonstrations that were previously offered only in-person, Poeth spearheaded online trainings for nursing, physical therapy, mobility, head injuries and more, allowing teams across Renown to upskill in safe spaces.  These programs continued throughout the pandemic, and Poeth was proud to be a figurehead through it all, helping to stabilize the unit while creating strong relationships with the entire team, many of whom followed her from Renown South Meadows to Renown Regional.  Then, she gets another visitor – her Chief Nursing Executive – in her office with yet another opportunity.  Have You Considered...  In September 2022, Chief Nursing Executive Melodie Osborn walked into Poeth’s office with those three words that Poeth has heard for decades: “Have you considered...”  “Before Melodie could even finish, I thought, ‘I have considered A LOT in my career!’” said Poeth.  Melodie told Poeth that the William N. Pennington Cancer Institute was looking for a Director of Oncology Nursing, noting that this could be yet another growth opportunity for her and a chance for her to go back to her roots.  “I had just celebrated my twentieth year at Renown; I knew this was going to be a decision I really had to think about,” said Poeth. “Everyone believed in me. Alicia Glassco told me, ‘Poeth, you are ready for this. Go for it.’ Once I applied for the position and started getting my updated chemotherapy certifications, I thought, ‘they are right; I got this.’”  At this point in her career, Poeth had been hyper-focused on inpatient care, and this role would be her first time caring for patients in the outpatient setting. After going through the interview process, however, Poeth knew that this was where she was meant to be yet again – and colleagues she hadn’t seen in years reaffirmed that commitment.  “I felt the most excited about the job when I toured the facility,” Poeth recalls. “I’ll never forget what one of the infusion nurses told me on my tour. She told me, ‘I don’t know if you remember me, but I remember you; I came from Renown South Meadows, and you were so nice to me as I was precepting as a new nurse. Your kindness was unforgettable to me.’ The fact that people like her wanted me in the unit so badly inspired me to come back.”  Soon enough, Poeth became the Director of Oncology Nursing, a position she still proudly holds to this day. Once she was hired, she immediately went into deep learning mode, mastering skills such as revenue integrity, credentialing and the insurance process. She attributes Supervisor of Infusion Kaitlin Hildebrand and Director of Radiation Oncology Services Susan Cox for helping her succeed.  Shortly after assuming the position, Poeth noticed yet another opportunity for cross-training within the organization to combat short staffing – training nurses from the Float Pool to care for patients in Infusion Services.  “Between May and July of this year, we trained six nurses from Float Pool to do infusion therapy services, which offered so much relief to my team; I am so thankful to Rendee Perry, the Manager of Nursing in our Float Pool unit, and her team for their support,” said Poeth. “My mission in outpatient oncology is to serve the staff and patient population and create those strong relationships."  Poeth's efforts to circumvent nurse burnout go beyond cross-training – as a director, she is always there for her team members no matter what, leading with kindness every step of the way.  “I never miss a 7:45 a.m. huddle unless I am in a ‘cannot miss’ commitment; I want my employees to always know that I am there for them and that they are cared for both on and off the job,” Poeth emphasizes. “I want them to feel like they are valued, their families are valued and their mental health is valued; after all, without my team, we cannot care for patients. It’s important for them to know that I am here to be a security blanket and that there is always something we can do to solve a problem."  Today, Poeth enjoys a full team of core Renown staff members whom patients look forward to seeing – and the high patient satisfaction scores to prove it.  “Our team is so established that patients feel comfort in knowing they are always going to know exactly who they are being treated by,” said Poeth. “We will always work to maintain that consistency.”  Staying True to the Mission  Renown’s mission of making a genuine difference in the health and well-being of our community resonates closely with Poeth. Before she arrives at the infusion unit every day, she asks herself: What can I do to make it easier for my team to deliver care?  “It takes a village to deliver the care we do,” said Poeth. “Our nurses are priceless. You can’t place a monetary value on dealing with life and death every day. This is what inspires me. It’s all about helping each other out and keeping those relationships strong.”  Maintaining those relationships on the floor, according to Poeth, requires one main ingredient: work-life balance.  “I want my nurses to be able to balance sending their kids to kindergarten and giving their patients their first chemotherapy treatments,” Poeth emphasizes. “I genuinely care about their lives. It’s nice when you get to know your team’s children, grandkids, spouse and hobbies. I’m grateful that Renown has given us the autonomy to foster that flexible environment within our teams. It is so rewarding to have such a strong impact on these employees.”  To Poeth, it’s all about doing and then duplicating. Luckily for her team and infusion patients in northern Nevada, a new infusion center at Renown South Meadows is planned to open in the coming years as part of our commitment to expanding care. Her team is excited to grow their expertise down to south Reno – Poeth's original home hospital.  “I strongly believe that as nurses, we are meant to be where we are meant to be at the time,” said Poeth. “Be kind to yourself and remember your ‘why.’ Take advantage of the opportunity you have.”  To all nurses (and future nurses) out there, Poeth wants you to know that you are welcomed and valued. You are saving lives every day, and to her, that is worth everything.  “Always remain focused, even throughout all the challenges. Never forget why you got into nursing. And lastly, always stay true to your own mission,” closes Poeth.

Read More About 20 Years of Compassion and Dedication

Health systems across the country recently celebrated Patient Access Week from April 2-8. Join us in recognizing our Patient Access team at Renown!  Fighting the Good Fight starts the moment a patient steps onto the grounds of our health system. When patients visit Renown on their healthcare journey, they look to the experts to not only help them navigate through the complexities of the process but also ensure their experience with us starts off on the right foot.  Renown Health’s Patient Access Representatives (also referred to as “PARs”) are the faces of this entire process. As the key links between patients, providers and insurers, they strive to create a welcoming and respectful environment for everyone. PARs are committed to providing all of Renown’s patients access to the quality care when needed. After all, it’s in their name!  A Friendly Face  PARs are the front faces of almost all clinical areas at Renown. As the starting point for much of the patient experience, the day-in-the-life of PARs can vary. Checking patients in and out, getting demographic information, verifying insurance, answering phone calls, fostering communication between patients and their care teams, scheduling patients for follow-ups, explaining financial responsibilities and our financial aid programs, creating an overall positive experience and environment, the list goes on – but they all remain united under one goal: setting patients off on the right foot as they access care through our health system.  “Each day, PARs are met with new patients who are seeking solutions to different concerns,” said Macy Betts, PAR for Renown Women’s Health. “We are the front doors to this department. We are not just checking patients in and out; we are the first step to the patients receiving the care they deserve.”  “We take pride in our work,” added Tanya Quintanilla, Shari Longley and Nancy Arroyo Garcia, PARs for Renown Pediatrics. “Usually, we are the first point of contact within Renown, so we don’t take our role lightly. For example, when we see a newborn, we must ensure the registration has been verified, which consists of patient demographics, patient preferences and insurance verification. We need to be consistent and thorough because what we do affects every point of contact a patient may have within Renown.”  “As my team’s senior PAR, my day begins with gathering the outpatient therapy work queue numbers and assigning the team to work them,” added Logan Johnson, Senior PAR in Pre-Registration at Renown. “Our goal is to contact and schedule patients for physical, occupational and/or speech therapy as soon as possible so that they have the maximum benefit and can get back to a normal life as quickly as possible. Our encounters can make or break the entire experience.”  PARs never underestimate the power of good communication and compassion. Even during the busiest of times, our PARs work diligently to ensure all patients and their care teams fully understand the administrative side of whichever part of their journey they are about to embark on, lending a helping hand and a smile.  “Whether you’re communicating with patients, leaders or coworkers, communication is key,” said Jonathan Figueroa, PAR for the Renown Institute for Heart & Vascular Health (IHVH). “We try and make sure that we do everything possible to make their visit go as smoothly as possible.”  “Communication makes the world go round,” added Keith Madrona, Sherry Riley, Erika Rios and Andie Kilpatrick, PARs at Renown Urgent Care – Ryland. “Having a friendly attitude and demeanor is very important.  “The PARs in Labor & Delivery do so much more than just registering patients – from escorting expectant parents to their rooms, welcoming newborn babies, processing pre-estimates and more – and the patience and excellent communication I receive from other teams is what keeps me going,” added Nanci Barash-Vietti, PAR for Renown Labor & Delivery (L&D). “This is critical to the success and effectiveness of the PARs in our department.”  Shift changes for PARs mimic other teams at Renown, leveraging technology and both written and spoken communication to ensure the next shift begins successfully.  "When I come in, the night shift will give me a report on what is going on and what the schedule looks like during the day; then I log in to my computer and get everything that I will need for that day up on the screen,” said Allie Boracchia, PAR for Renown L&D. “Usually around this time we have a 7-8 a.m. induction scheduled for the first patient, so I will grab the pre-made packet that the night shift put together, the unit clerk will call the nurse to get a room number, and I take the patient to the room and have them sign all the forms. After the patient has the baby, then we admit them and finish registration. This is continuous all day long.”  Our PARs all agree that regardless of the setting, whether it be emergent or routine, every patient is looking for that advocate from the moment they enter through our doors.  “Being friendly, patient and understanding is a must,” said Sheryl Lundgren, PAR for the William N. Pennington Institute for Cancer. “It is so nice being able to brighten the days of patients who are living with a cancer diagnosis.”  “In the urgent care setting, a lot of the patients we see are not feeling their best, so it is important that we show them we care and are here to help make check in go smoothly,” added Sam Deithrich, PAR at the Renown Urgent Care – Los Altos.   “Patients are relieved that they are speaking to a real person that will help set up appointments,” added Rick Jordan and Celeste Landry, PARs in Lab Services at Renown South Meadows.   PARs embrace lifelong learning at Renown, especially as their roles differ day-to-day. They are always ready to jump in and assist on tasks that might be new for them, growing their skills on the job and never hesitating to say, “How can I help?”  “As a PAR, you are always learning new things, even when it seems like you know just about everything,” said Liz Cardenas-Ramos, PAR for Renown Endocrinology. “It’s been such a positive experience.”  “Giving yourself grace to learn and grow in Patient Access is the key,” said Maggie Savoie, PAR for Renown Primary Care – Fernley. “I find myself learning every day at Renown, and if you’re learning, you’re growing. Being able to take a breath and say, ‘this is a learning opportunity for me, and tomorrow I will be better a better PAR because I’ve gained this knowledge’ is an amazing way to stay positive in the position.”  “In L&D, we are all multi-tasking, and every day I am learning something new about my department and patients, as well as how to excel in my position,” added Nanci Barash-Vietti.  Renown PARs are the front lines to health care access, and they wear that badge with pride. Jeanette Flores, PAR in the Emergency Department at Renown South Meadows, sums up the role of Patient Access well: “Talk about first impressions!”  “I am proud of our team and the excellent care we give our patients,” said Dawn Linker, PAR for the Renown IHVH. “We want them to have a good experience.”  Impactful Accomplishments  The role of our Patient Access team members goes beyond the desk. A patient’s healthcare journey begins, and sometimes even ends, with the helping hands of our PARs, leaving a lasting positive impression of Renown.  "Our interactions with the patients make a difference before they see the provider, so we always demonstrate a welcoming and helpful atmosphere for the patients to feel like their needs are being met,” said Mary Dettling, PAR for Renown Endocrinology.  “I love seeing the difference we make in peoples’ lives,” added Shannon Leone, PAR for the Stacie Mathewson Behavioral Health & Addiction Institute. “We can get patients at their toughest and worst times. Watching them overcome their fears, traumas and addictions has been very rewarding.”  Our PARs don’t just make goals for themselves – time and time again, they surpass them, all in the name of patient experience and excellence.  “We have not only met our monthly point-of-sale scores, but we also have exceeded our stretch goal for the last eight months and our scores have been in the 50th percentile or higher,” said Jeanette Flores.  “Along with being the top point-of-sale collectors, we have also been known to be some of the sweetest and most helpful staff at South Meadows,” said Katie Morrill, PAR in the Emergency Department at Renown South Meadows.  As their teams grow, so does their impact on our patients. PARs are dedicated to providing the best customer service possible, and with their expanding teams, that service goes even further, even throughout the pandemic.  “A year ago, we only had one PAR; now, we have a full and amazing team,” said Alex Bucholz, PAR for Renown Advanced Wound Care. “We have come so far in a short amount of time.”  "During the pandemic, we have maintained a core group of individuals who come in every day and help keep this office and all its parts moving smoothly,” added Shannon Leone. “We have maintained a full patient load the last three years and never had to close our office for any reason. We have even had the opportunity to start our Medicated Assisted Treatment and Transcranial Magnetic Stimulation programs.”  "We successfully operated and maintained our pediatric COVID clinic, which is the only one within our five clinics,” added Tanya Quintanilla, Shari Longley and Nancy Arroyo Garcia. “We feel proud knowing our tiny humans are protected with the COVID vaccine.”  Like many other teams at Renown, our PARs are masters at teamwork. Despite any obstacles that may happen along the way, they are always there for each other to ensure every patient gets the care and attention they deserve.  “We call ourselves the ‘A-Team’ here in Pulmonary,” said Shannon Birnberg, PAR for Renown Pulmonary & Sleep Medicine. “We have persevered through changes, additions and departures. We are most proud of bringing different personalities to the team and being super strong and effective.”  “I have noticed the team always steps up whenever needed,” added Brittany Hughes, PAR for the Renown IHVH. “Everyone has a great attitude and is very positive!”  “While our team is fairly new, we are growing together, learning our strengths and weaknesses and always pushing for stronger unity,” added Angel Freer, PAR in the Emergency Department at Renown Regional.  When our PARs find ways to simplify a process or make a workflow run more efficiently, they don’t waste any time in making that happen. They take any opportunity to enhance patient experience.  “Our team came up with a solution on how to get patients registered faster,” said Jess Castillo-Marquez, PAR in Lab Services at Renown Regional. “We came up with modalities which assign each PAR their own procedure in which they will be registering for during their scheduled shift. It has been a great success, helping our productivity and keeping our patients satisfied with our service.”  “We are proud of our successful implementation of our new therapy workflow,” added Logan Johnson. “Patients are now waiting much less to be contacted about their care.”  Our PARs know that teamwork makes the dream work, and their commitment to the patients they serve – and the goals they continue to blow out of the water – continue to inspire them daily.   “You are only as strong as your team,” said Aundie Yonker, PAR in the Emergency Department at Renown Regional.

Read More About Department Spotlight: Patient Access

Renown Health is closely following the national outbreak of the monkeypox virus and urging healthcare providers to be alert for patients with illnesses associated with a rash. In working with the Washoe County Health District (WCHD), Renown is closely monitoring the spread of monkeypox in the community and looking to prevent and reduce the spread of monkeypox. To help to ease worries, we consulted with Paul De Leon, Infection Preventionist at Renown Health. What Exactly is Monkeypox? Monkeypox is a rare viral illness caused by the monkeypox virus — the same family of viruses that causes Smallpox. Although symptoms are similar to Smallpox, monkeypox symptoms are milder and rarely fatal. However, it's important to mention that this virus can be more severe for these susceptible groups: Immunocompromised Pregnant women A fetus or newborn baby Women who are breastfeeding Young children Those with severe skin diseases such as eczema How is Monkeypox Transmitted? The monkeypox virus is not easily transmitted but occurs through sustained person to person close contact with an infected individual. Monkeypox can also be transmitted through direct contact with infectious rash, scabs, or body fluids. Monkeypox can also be spread through prolonged intimate physical contact, such as kissing, cuddling or sex. Lastly, monkeypox can be spread through contaminated linens or bedding. Transmission through respiratory secretions is uncommon but has been reported after prolonged face-to-face contact with symptomatic individuals. In addition, pregnant women can spread the virus to their fetuses through the placenta. Monkeypox Testing If you think you have monkeypox, contact your primary care physician or other medical providers to obtain testing. Notify the provider ahead of time before entering the physical office. Signs & Symptoms This current outbreak of West African monkeypox does not have the typical presentation of classic monkeypox. Symptoms usually appear one to three weeks after infection and include: Pimple-like rash or blisters on the face, inside the mouth, and on other areas of the body, like the hands, feet, chest, genitals, or anus. The rash will go through serval stages, including scabs, before healing and may be painful or itchy. Other symptoms of monkeypox can include: Fever Headache Muscle aches and backache Swollen lymph nodes Chills Exhaustion Respiratory symptoms such as sore throat, nasal congestion, or cough Symptoms of monkeypox may occur before or after a rash with some individuals only report experience a rash. Individuals with monkeypox are infectious once symptoms begin and remain infectious until lesions form scabs, scabs fall off, and a fresh layer of skin forms. The illness typically lasts 2-4 weeks.

Read More About Monkeypox: A Renown Expert Weighs In

If you’re a parent, you’ve probably been there — the sometimes-nightly struggle to get your little ones off to bed. Elaina Lantrip, an APRN with Renown Pediatrics, offers some tips and explains how your child’s electronics may be getting in the way of a good night’s sleep. These days, kids are consuming media from a very early age on all types of devices — from tablets and phones to TVs. While they can benefit from some media use, it can have a negative impact on bedtime. We asked Elaina Lantrip, an advanced nurse practitioner with Renown Pediatrics, for some advice on downloading a better bedtime routine. What are the most important practices for parents to establish for their children’s bedtime routines? I often have parents tell me that their child won’t go to bed — or to sleep. Parents frequently ask for tips on bedtime routines that work. My first question is whether their regular bedtime routine involves television, iPad, tablet, phone or anything with a screen. It’s very important that bedtime includes a bath, reading a story, talking, singing and bonding with young ones, rather than using any devices. Why shouldn’t children have a device at bedtime? A growing body of research supports that screen time at bedtime contributes to delays in a child’s falling to sleep; overall inability to reach the important REM, or deep sleep; waking up during the night; nightmares and night terrors. For older youth, engaging with social media before bedtime can bring up stresses, emotions and relationship issues with peers that don’t exactly create peaceful bedtime thoughts. Bedtime should be a screen-free, stress-free, peaceful time of day. It’s a great time for parents to promote self-esteem, talk through things going on in the child’s life, to encourage and build them up. Children grow up fast — bedtime is a great the opportunity with younger children to cuddle up and read a story or sing a lullaby. What are other major considerations in making bedtime smooth and relaxing for kids and their parents? Another factor that contributes to positive sleep habits includes children getting enough activity during the the day so they’re genuinely tired at night. Also helpful are ambient noise makers, peaceful music, avoiding sugar two hours prior to bedtime, consistency in bedtime routine, comfortable pajamas and comfortable temperature in the home. Is it important to keep the child’s bedroom dark? Dimming the lights is important, regardless of the time of year. This is another reason to ban screens, as they emit light that stimulates wakefulness.

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Renown Health has long supported northern Nevada’s LGBTQ+ community Pride events with sponsorship, and we’ve collaborated with local and regional LGBTQ+ organizations as an ally. Renown’s Pride Committee works to deepen and broaden our external and internal efforts around LGBTQ+ community engagement, advocacy, and healthcare issues related to sexual and gender minorities, which is part of the greater Diversity, Equity and Inclusion efforts Renown is undertaking. According to Harvard Chan School, data shows that nearly a sixth of LGBTQ+ adults feel they were discriminated against based on their sexual orientation and gender identity. As a result, this brings to light the important need for education within the healthcare setting. Renown Health is bridging the gap for our LGBTQ+ population, and we know more work needs to take place in order to become an inclusive organization. Below are a few ways we’re working on improving our response to LGBTQ+ needs, and celebrate, respect and honor our diversity by being inclusive. Diversity, Equity and Inclusion The Diversity, Equity and Inclusion subcommittee was formed to heighten the awareness and develop a plan on how to better serve all of our diverse populations, including our LGBTQ+ patients. As the largest healthcare provider in northern Nevada, we knew that we could do a better job. The subcommittee provides us a forum to discuss ideas and develop plans to provide better care to these populations. Updated Medical Records with Preferred Name and Pronouns Of course healthcare is personal. We meet patients at their most vulnerable states. And relating to every person by the correct pronoun shows we respect their gender identity. A new medical records update supports our doctors, nurses and care team in capturing this vital information. We are now able to capture every person’s preferred name, sex and sexual orientation to better care for them. Kathleen Zaski BSN, RN, Manager of Clinical Informatics and IT Applications at Renown explains why this is so important. “Your name and identity are core to who you are as a person, and here at Renown, we aim to take care of you as a whole person and to provide the highest level of quality care to our community – all while ensuring the experience is exceptional and tailored to the individual. In other words, having the patient’s preferred name and pronoun in the medical record is important to validate their identity, and show we care, in an already high stress environment. Specifically, giving our providers easy access to the patients preferred name and pronoun in the medical record, allows them to properly address their health concerns. This also helps the health care provider foster a closer relationship with the patient. Studies have found this actually increases the quality of care by creating a more open and comfortable environment.” Gender Neutral Restrooms Mitch Harper, Senior Program Development Manager at Renown, recognizes there’s still so much more to improve upon in becoming an inclusive organization. “At the end of the day, it’s about creating a safe and welcoming environment for our community and our employees. Access to basic human services shouldn’t be contingent on an individual’s skin color, ethnicity, sex, gender identity, sexual orientation, age, disability, or beliefs. Ensuring that private restrooms are equally available to everyone on our campus is just one way we can provide a more inclusive, caring space for the people we serve.” Updated restroom locations: Roseview Tower: 10 Sierra Tower: 14 Tahoe Tower: 14 Helping to Lead and Influence Change Sean Savoy, Manager of Spiritual Care at Renown "The foundation of spiritual care is compassion – being with people in need by caring, supporting, and showing empathy, and promoting a sense of well-being. Being a member of the LGBTQ+ community informs that deep sense of compassion and empathy in a very special and unique way. Our human value, social validity, the very reality of who and what we are, even our right to exist, love and just be, are often called into question. This, in turn, can cause many of us to question ourselves and wonder about our self-worth. This experience should engender compassion and empathy so that we can better recognize, listen to and meet others’ needs to help them achieve inner peace, explore coping strategies to overcome obstacles during illness or crisis, and even find new balance by re-conceptualizing themselves in the context of health and illness. I have found that the intersectionality of my gay and spiritual selves has been a blessing in my life." Matthew Maloy, Team Lead Applications Specialist at Renown “I am a Team Lead Epic analyst in the IT department that is responsible for clinical based workflows for ED, Trauma, and Critical Care and have worked at Renown for 15 years. Being a part of the LGBTQ+ community influences my daily work by ensuring the Electronic Health Record reflects best practices such as giving clinicians the ability to document a preferred name, and displaying that throughout the medical record for consistency. Having the ability to influence decisions that move our community toward human value for all of us is a priority in my daily work.” Our Mission Renown Health’s mission is to make a genuine difference in the health and well-being of the people and communities we serve, including the LGBTQ+ community. We continue to build relationships to improve care, fostering better health outcomes for ALL of our patients by creating a more inclusive health system.

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Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis, answers some common questions about bone fractures. Is there a difference between broken bones and fractures? No, these are two different names for the same injury. Of course the common term is a broken bone. Using either name will describe your concerns. Medical personnel typically describe a broken bone as a fracture to a specific bone. For example, a broken wrist is also a fractured distal radius. To clarify, this describes the injured bone and the precise location. How do I know  if my child has broken their bone? Many times children will fall and complain of their arm or leg hurting. In most cases the pain goes away and the child will return to their activities. When there is a deformity to the limb (curve in arm) and the child is complaining of pain, it is probably a fracture. If the arm or leg looks straight, look to see if there is any swelling or bruising. Both are signs of a possible fracture. Finally, if the limb looks normal but the child continues to complain, gently push on the bone. Likewise if it causes the same pain, then they likely have a fracture and should have an x-ray. My child fractured their growth plate, what does this mean? Growth comes from this area of the bone. In detail, these are located all over the body but typically at the end of the bones. With this in mind, fractures to these areas can result in the bone growing abnormally. Because of potential shortening of the arm or leg, or bones growing crooked, it is important to follow fractures closely (up to 1-2 years or longer). It is better to identify a problem early. Small problems can be treated with small surgeries. What if the bones of the x-ray do not line up? Because children are growing, unlike adults, their bones will remodel and straighten with growth. The amount of remodeling occurring depends on a child’s age, the bone fractured and the location. In many cases an angled bone will grow straight over the course of a year. For this reason, someone with experience in caring for children needs to follow bone growth. How long does it take fractures to heal? Factors deciding when a cast can come off include: Child’s age. Bone fractured. Fracture location. Young children heal faster than teens, teens heal faster than young adults, who heal faster than older adults. In young children most fractures heal in 4-6 weeks. However, teens generally take 6 weeks to heal, and adults can take much longer. Although your child  is out of their cast, it may not be healed completely to return to all activities. Placing a splint is during this time is common. This typically gives them added protection for several weeks after their cast is removed -  in case they forget their limitations. What if my child is still limping? Whether a child is in a walking or non-weight bearing cast, removing it often leaves them stiff and sore. Therefore many children will walk as though they still have a cast in place. In most cases this resolves in about three weeks. Regardless, if your child is still limping or walking abnormally after three weeks, contact the treating doctor. They may benefit from physical therapy or a repeat evaluation.  (This article was original published in the July 2019 issue of South Reno Kids & Sports.)

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Dr. Max J. Coppes, Physician-in-Chief Renown Children’s Hospital, and Nell J. Redfield Chair of Pediatrics, UNR Med, talks about how much is too much when it comes to teens and social media. Social apps (Facebook, Instagram, Twitter, WhatsApp, Snapchat, TikTok, etc.) have become an integral part of most people’s lives. In contrast to traditional media — where one source goes to many receivers — social media operates in a dialogic transmission system. Many sources interact, sometimes simultaneously, with many receivers and provide for superior interactivity between its users. Not surprisingly, it also plays a significant role in our children’s lives once they are old enough to understand how to access and use these apps. On average, children start exploring social media at around ages 10 to 12. They rapidly discover that electronic communication allows for unique and personalized ways to make and keep friendships. They also use it to develop and expand family ties, get help with homework, share music, art, and experiences, and learn and discover the world. Social Media and Teens Surveys suggest that more than 90 percent of teenagers use social media. Additionally, approximately 75 percent have at least one active profile by age 17. Access to social media is greatly facilitated because more than two-thirds of teens have their own mobile devices with internet capabilities, a substantial change relative to previous generations. The use of social apps can have many positive aspects. But we now also recognize that it can also have negative impacts. The use of hazardous sites or the inherent risks of using social media (identity theft, being hacked, cyber-bullying, etc.) are indeed damaging to children. Any use of hazardous social apps is too much and carries serious hazards. But what about the use of “normal” and/or “safe” social media? Well, data suggest that too much use of “non-hazardous” apps can indeed affect health. How Much Do Teens Use Social Media? First, some basic data. For example, how much do normal teenagers use social media? A study from Pew Research found that more than 50 percent of 13- to 17 year-olds go online several times a day. This quickly increases during the teenage years to more than 70 minutes per day. Teenage girls have the highest usage at just over 140 minutes per day. It is important to recognize that non-school related use of the internet and social media is often beheld by teenagers as important for developing their self-esteem, their acceptance among peers, and their mental health in general. As parents, we recognize that the use of social media can indeed contribute, in many positive ways, to our children’s growth. At the same time, we also worry about them spending too much time online. We worry about their ability to communicate effectively in face-to-face settings or in writing. Many of us also feel and/or worry that our children are addicted. Social Media and Addiction Recent studies suggests that the overuse of social media indeed mirrors addiction. Reports now show that teenagers and college kids experience anxiety when deprived from their connected devices and consequently feel a compulsion to access their social applications. The emotional symptoms they experience are very similar to those seen in substance abuse. In fact, the American Psychiatric Association is considering making internet addition a bonafide diagnosis. Pediatricians therefore encourage limits on the use of social media, a recommendation more easily suggested than accomplished. So when should a parent consider seeking help? Aside from unhealthy use of these apps (cyber-bullying, sexting, online users asking for sexual relations, etc.), which should always trigger concern, the use of social media for more than 120 minutes per day should trigger parental concern. If you feel unable to address the overuse of social media, contact your pediatrician for help and guidance. Renown Children’s Hospital Whether it’s seeing a pediatrician, getting a sports physical or looking for advice, our care is centered around supporting and nurturing patients and families at our many locations. We have pediatricians dedicated to children who have experience recognizing children’s illnesses. They also have knowledge about tests and treatments for young ones to ensure your child gets the best care possible. Explore Children’s Services

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Experiencing knee pain during exercise or while undertaking daily activities? The knee is the largest joint in our body, so it goes without saying a lot hinges on its functionality. Here are a few exercises to help.   Is exercise a real pain in the knee for you? Does getting up in the morning require a few minutes for your knees to adjust to walking around? As it turns out, knee pain is common, and it can result from injury, overuse or the breakdown of cartilage over time. Often, this pain is a result of faulty mechanics in your body, according to Jessica Ryder, a physical therapist with Renown Physical Therapy and Rehab. “We see weakness at the hips causing a lot of stresses at the knee,” she says. Exercises that Alleviate Knee Pain Try these three exercise to strengthen your glute muscles and maintain proper alignment in your knees. Hip Lift Lie flat on your back with your knees bent and feet flat against the floor. Lift your hips into the air until your body is in a neutral position, then lower your hips back down. Repeat this motion several times until you feel a gentle burn in your glute muscles. Step Down Stand with one foot on a stair or step. Slowly bend your knee and drop the other foot toward the floor. Slowly extend back up to your starting position. While doing this exercise, it’s important to move slowly, maintain control and ensure that your knee is in line with your toes. Do as many reps as needed until you feel a small fatigue in your muscles. Repeat this exercise on the opposite leg. Side Step with Exercise Band Place an exercise band around your ankles. Stand in a slight squat and then take several steps to the side until you feel a small fatigue on the outside of your hips. While doing this exercise, keep your upper body still and focus the exercise to your hips. The band will try to move your knees toward each other Repeat in both directions. Hometown Health and Renown Health are proud to be the official insurance plan and healthcare partners of the Nevada Wolf Pack. Renown Physical Therapy and Rehab | 775-982-5001 Through outpatient physical, occupational and also speech therapy, Renown Physical Therapy and Rehab gives patients hands-on, individualized treatment. Our therapists use evidence-based methods to help patients return to an active, productive lifestyle. Learn More About Physical Therapy

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Many factors are contributing to the rise of early onset puberty in girls. Learn what they are below and how you can support your daughter. The number of girls experiencing early puberty has increased dramatically over the last few years and continues to grow. More and more girls in the U.S. are starting to show signs of development before the age of 8. Recent studies show that up to 10 percent of Caucasian girls and 23 percent of African American girls are showing signs of puberty by age 7. What’s Contributing to Early Puberty in Girls? Determining the exact cause is difficult. But experts agree that several factors may be contributing to these growing numbers. Increasing rates of childhood overweight and obesity. Excess body fat alters the levels of hormones responsible for the acceleration of pubertal timing. Physical inactivity may decrease melatonin levels, which can also trigger pubertal development. Increased animal protein intake. Higher total protein, animal protein and meat intake in children ages 3 to 7 have been associated with earlier onset of menstruation. High protein intake elevates IGF-1 levels and promotes growth, which could accelerate the onset of puberty. Poor diet. Children with lower-nutrient diets tend to enter puberty earlier. A diet rich in processed foods and meats, dairy, and fast food is disruptive to normal physical development. Exposure to EDCs (endocrine-disrupting chemicals). EDCs are synthetic chemicals found in plastics, pesticides, fuels and other industrial chemicals that inhibit or alter the action of natural hormones. Because EDCs accumulate in the fatty tissues of animals, animal foods contain higher levels of these chemicals than plant foods. Exposure to BPA (bisphenol A). BPA is an industrial petrochemical found in a variety of products including plastics, tin-can linings and even cash register receipts. Because it acts as a synthetic estrogen it may speed up pubertal development. Soy products. Soy contain isoflavones which are converted to phytoestregens in the body, and are similar to the hormone estrogen, Dr. Chelsea Wicks says. “Soy consumed from natural food sources is likely safe and will not cause abnormal hormones levels. However, when consumed in large amounts, such as with soy supplements or in more processed foods, there have been links to chronic medical problems due to elevated estrogen levels. I feel a good answer to this is to continue working on eating fresh foods and trying to avoid the processed, packaged foods as this will be best for overall general nutrition as well,” she adds. What You Can Do While some genetic factors play a role in the early onset of puberty, parents can help lessen environmental causes of the condition. Encourage and help your child to maintain a healthy weight with proper nutrition and exercise. Avoid exposure to hormones such as estrogen and testosterone that may be found in hair products, medications and nutritional supplements. Avoid exposure to EDCs and BPA. Offer your child a diet centered around whole plant foods rather than animal foods, which will help keep protein intake within a safe range and reduce consumption of EDCs. Create a supportive environment for your daughter. Avoid commenting on her appearance and instead focus on her achievements, academic successes or artistic talents. Speak to her openly and honestly about the physical changes she’s experiencing — that although these changes are normal, she’s simply developing early — and that ultimately her peers will undergo the same changes. Encourage your daughter to continue participating in social activities and pursuing her interests, and reassure her you are always open to discuss any questions or worries. If you are concerned that your child may be going through these changes before expected, speak with your pediatrician. Sources: Early Puberty: Causes and Consequences When Is Puberty Too Early? Precocious Puberty (Early Puberty) Precocious Puberty

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