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Compassionate Care Palliative and Supportive Care provides specialized medical care for serious illnesses and diseases, including advanced kidney failure or heart disease. Palliative Care helps to: Prevent and relieve suffering to help build the best possible quality of life. Add value to standard therapies by assisting with advanced illness planning and symptom management. Palliative & Supportive Care may be needed if: You've had multiple hospital admissions for severe illness. Severe pain, nausea, fatigue or other symptoms impacting quality of life and you are reconsidering treatment plans. Treatments are no longer working. You're feeling hapless or discouraged about the future due to your serious illness. Talk to your doctor to find out if palliative care is the right choice for you or your family member.   Your Care Team Your palliative care support team comprises doctors, nurses, chaplains, social workers and other specialists who work together with you to provide extra support. Your care team can help: Facilitate close communication between you and your physician team, as well as nurses and specialists. Offer medical assessments and symptom management to help reduce pain, nausea, fatigue, shortness of breath and anxiety. Improve the ability to tolerate medical treatments and fain the strength to live a productive daily life. Explain treatment options and the decision making process regarding care. Navigate the healthcare process. Lend emotional and spiritual support.

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Compassionate Care in the Comfort of Your Home Welcome to Renown Hospice, where compassion meets comfort in life’s most tender moments. Renown Hospice is a not-for-profit hospice, founded solely on a mission to care for and support those in our community. With a dedicated team of professionals and comprehensive services provided in the comfort of your home, our hospice program is one of the highest-rated quality care and experience agencies in northern Nevada.   At Renown Hospice, we provide specialized care that focuses on providing comfort and support to individuals who are facing a life-limiting illness or nearing the end of their life. Our primary goal is to enhance quality of life by addressing physical, emotional and spiritual needs. Our hospice care emphasizes dignity and respect, empowering our patients to make choices about their care and treatment preferences.  As you embark on the journey of navigating end-of-life care for yourself or a loved one, we extend our heartfelt support and guidance. Please note our team is available 24/7 to answer any questions and schedule an evaluation with one of our Renown Hospice nurses.

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A wedding is a big day for the wedding couple, but it’s also special for loved ones. A patient at Renown, Ken, got to take part in his daughter’s special day as her wedding plans changed to accommodate his medical condition. Grab some tissues and read how Renown’s team of compassionate caregivers and chaplains planned a wedding in Fianna’s Healing Garden. Ken was hospitalized at Renown Regional Medical Center where he was battling a lung problem – which was unrelated to COVID-19 – and his condition worsened rapidly on Wednesday, Aug. 12. His family made the decision to transition him to palliative care, which helps patients near the end of their lives remain comfortable, while supporting their dignity and quality of life.  Ken’s medical condition altered wedding plans for his daughter, Chandra, and her fiancé, Tyler, who were planning to tie the knot later in 2020. Chandra wanted her father there, but knew he could not leave the hospital. That’s why Chandra’s sister, Heather, approached Ken’s care team with a request to have a small wedding ceremony at the hospital.  Planning the Wedding A member of Ken’s care team, Amy Heston, registered nurse (RN), began planning how the wedding could be held outdoors in Fianna's Healing Garden in the E. L. Wiegand Pavilion, which was donated by the E. L. Wiegand Foundation.   In 24 hours, Amy planned a wedding ceremony with the help of her colleague, Breyanna Aufiero, RN; the Renown Spiritual Care team; and nursing leaders on the coronary intensive care unit (ICU). Together, they decorated the aisle in the garden with flowers and battery-operated candles. They also made a sign for Ken’s hospital bed, which read, “Father of the Bride,” and crafted a bow tie for him to wear for the special occasion.  With visitor restrictions in place at the hospital due to coronavirus (COVID-19), having the wedding outside in the Healing Garden allowed for more members of Ken’s family to attend including his wife, Charlotte, and his dog, Bella.   Every step in planning the wedding required thoughtful and thorough care coordination so Ken could participate. His breathing was supported by oxygen and special arrangements were made to transport the oxygen tanks he needed to take part in his daughter’s wedding. Amy worked with respiratory technician, Kasey Benfield, and critical care technician, Ruben Duckworth, to ensure Ken’s oxygen needs were met using portable machines.  Celebrating Love and Life Together Ken’s team of caregivers bathed him and shaved his face so he could look and feel his best for the ceremony. They put on his bow tie, covered his bed in decorations and his favorite blue, flannel blanket, and wheeled his bed outside for the ceremony.  Renown associate chaplains Terri Domitrovich and Susan Palwick coordinated music and performed the ceremony for Chandra and Tyler on Thursday, Aug. 13, 2020. The bride and groom shared their first dance in the garden and Ken’s care team provided water and treats to give the family a full wedding experience.   Shortly after the ceremony, Ken passed away. This wedding provided Ken and his family meaningful memories for their big life-changing moments as they celebrated and said goodbye.  “Seeing Ken surrounded by family he never would have gotten to see again while in the hospital, watching him get to share a father-daughter dance with Chandra on her wedding day, and having him tell me that this day meant more to them than we would ever know were some of the most moving moments I’ve witnessed as a nurse,” Amy said. “I am so thankful for the team we have here. I know that this beautiful day wouldn’t have happened without the help of every single person who gave their time, money, creativity and passion to make it a day to remember.”

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Posture is important, but for those children diagnosed with scoliosis (spinal curvature) it can be a difficult issue. The Washoe County School District Student Health Services Department screens 7th grade students for scoliosis as growth spurts often reveal the condition and, if diagnosed early, scoliosis can stop progressing. We asked Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis to answer some frequently asked questions about scoliosis. What is scoliosis? There are many types of scoliosis: early onset (occurs before age 10), congenital scoliosis is when the bones of the spine do not form correctly, neuromuscular scoliosis which is due to children’s neurologic and muscle disease, and the most common is Adolescent Idiopathic Scoliosis. The term “idiopathic “ means the exact cause is unknown, although we do know it runs in families. This type of scoliosis occurs in 2-3 percent of adolescents and is mainly seen during their growth spurt. This is why middle school screenings are recommended. Both genders get scoliosis but girls are 8 times more likely to have their curves progress and become larger. What are the signs that my child may have scoliosis? A few signs for parents to watch for are: One shoulder might be higher than the other. One leg may seem longer. A hip may be higher or look more prominent. The waist may not look the same from side to side (asymmetry). The trunk or rib cage may be more prominent on one side or shifted. When they bend forward they may have a bump on their back. How is scoliosis diagnosed? It can be noticed by a pediatrician at a physical, school screening nurse, PE teacher or parents. Once the curve is suspected the child is usually referred to a pediatric orthopedic surgeon scoliosis expertise. At the initial visit the doctor will perform a thorough physical including a complete neurologic exam to assess the amount of curvature. Once the exam is completed the physician will determine if a spinal x-ray is needed. The curve on the x-ray is measured utilizing the cobb angle (a measurement in degrees) which helps guide the treatment. What are common treatments for scoliosis? The treatment depends on the size of the spinal curve and the amount of growth the child has remaining. An x-ray of the child’s hand is used to determine the amount of growth remaining. This allows the determination of the child’s bone age, and based on the hands growth plates it can determined if the child is in their rapid phase of growth. Treatments include: Observation - For curves less than 20-25 degrees. This entails visits every 6-9 months with a repeat scoliosis x-ray. Since scoliosis curves increase only 1-2 degrees per month, and variations in measurements can be 3-5 degrees, an x-ray is not recommended before 6 months. If the curve remains less than 25 degrees the child is followed until their growth is completed (usually age 16-18). Progressing Curve - If growth is finished and the curve is less than 40 degrees, the risk of more curvature into adulthood is small. If growth is completed and the curve is over 45 degrees, the child is followed for several years as these curves can progress into adulthood. If the patient is still growing and the curve has progressed greater than 25 degrees but still in the non-operative range (less than 45-50 degrees) bracing is used to stop the progression of the curve. Bracing - Indicated for curves over 25 degrees but less than 45 degrees. If a brace is required you will be referred to an orthotist (bracing specialist). The orthotist assesses your child, reviews the x-ray and then fits the brace. (Having a brace made usually takes 2-3 weeks.) Once the brace is fit, your child will visit the scoliosis specialist for an x-ray in the brace to ensure it fits correctly. The primary goal of bracing is to halt progression of the curve and prevent the need for surgery. The brace must be worn for about 16 hours per day to be effective. In a recent bracing study 72% of the patients who wore their braces as prescribed prevented the need for surgery compared to the group who did not wear their brace. Surgery: When a curve reaches 45-50 degrees, and a child is still growing, surgery is usually recommended because the curve is likely to continue progress. If a curve is over 50 degrees and the child is done growing surgery also may be recommended. This is because when curves are over 50 degrees they tend to increase 1-2 degrees per year for the rest of your life. As curves get larger the amount of lung function tends to decrease which could cause breathing problems later in life. The goals of surgery are to stop the progression of the curve and safely correct any misalignment. This is accomplished by attaching implants (rods, screws, hooks and bands) to the spine. Bone graft is then placed around the implants to encourage the spine to fuse (grow together). This then forms a solid column of bone with metal rods in place, preventing the curve from changing. Most patients are back to their regular sports and activities six months post surgery.

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Getting the COVID-19 booster is the best way to protect yourself from severe illness or death due to COVID-19, and both the CDC and the FDA have approved booster shots for people ages 18 and older. So, with the holidays right around the corner and infection rates on the rise both in Nevada and nationally, the best thing you can do to prevent the continued spread of this deadly virus is to get boosted today. The Basics: Who: It is recommended that everyone 18 years or older get a COVID-19 booster shot. When: At least 6 months after completing your primary COVID-19 vaccination series. What: Any of the COVID-19 vaccines authorized in the United States. The CDC allows for mix and match dosing for booster shots. How: To make an appointment for your COVID-19 vaccine booster, please visit vaccines.gov today. Appointment Reminders: Don’t forget to bring your CDC vaccination record card to your appointment. Refresh yourself on the potential side effects and remember that these are normal signs your body is building up protection. Commonly Asked Questions: Q: Does anything change if I received the Johnson & Johnson as my first COVID-19 vaccine? A: If you received the Johnson & Johnson COVID-19 vaccine, you are elidable for a booster two months after completing your primary vaccine. Q: Is the formula the same for the boosters as it was for the primary vaccine? A: COVID-19 booster shots are the same formulation as the current COVID-19 vaccines. However, in the case of the Moderna COVID-19 vaccine booster shot, it is half the dose of the vaccine people get for their primary series. Q: Am I still considered “fully vaccinated” if I don’t receive a COVID-19 booster shot. A: Yes, everyone is still considered fully vaccinated two weeks after their second dose in a two-shot series, such as the Pfizer-BioNTech or Moderna vaccines, or two weeks after a single-dose vaccine, such as the J&J/Janssen vaccine. All information courtesy of the Center for Disease Control and Prevention. All information courtesy of the Center for Disease Control and Prevention

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November is National Diabetes Month, and with cases of the disease at an all-time high in the U.S., individuals must do everything they can to stay healthy. Learn more about diabetes prevention and also how to stop prediabetes in its tracks with these five helpful tips. Diabetes is a disease that is increasingly making its way into the public consciousness, and not in a good way. In fact, according to USA Today, diabetes has a greater health impact on Americans than heart disease, substance use disorder or COPD, with 30.3 million Americans diagnosed with the illness — and many more who are at risk for developing it. And those with prediabetes are at risk for developing type 2 diabetes in 10 years or less, according to the Mayo Clinic. The American Medical Association notes that 4 million U.S. adults have prediabetes. Check out the American Diabetes Association’s prediabetes risk test. The good news: There are ways to manage — and even reverse — prediabetes. Renown’s Certified Diabetes Educator Stephen Compston, RD, LD, CDE, shares five steps for managing blood sugar and also avoiding an eventual diagnosis. How to Prevent Diabetes Eat healthy foods. Plan meals that limit (not eliminate) foods that contain carbohydrates, which raise your blood sugar. Carbohydrates include starches, fruits, milk, yogurt, starchy vegetables (corn, peas, potatoes) and sweets. “Substitute more non-starchy vegetables into your meals to stay satisfied for fewer carbohydrates and calories,” Compston says. Exercise. Blood sugar is the body’s basic energy source. When you exercise, you are lowering your blood sugar. “People with prediabetes usually want to stay off of medication, so they must add something to their normal regimen that lowers blood sugar,” Compston says. “In this case, exercise is medicine.” Lose weight. A small decrease in your weight can drastically decrease your risk of developing diabetes in the future. The Diabetes Prevention Program study showed that a 7 percent decrease in body weight (14 pounds for a 200 pound person) can reduce a person’s risk of developing the disease by 58 percent. Get more rest. Studies link sleep issues to an increased risk of insulin resistance. It can also make it harder to lose weight. Thus, people that don’t get adequate sleep are at an increased risk for developing type 2 diabetes. See your doctor regularly. Schedule an appointment with your primary care provider at least once a year so you can track your health together. “A regular check-up and lab work can help identify what your blood sugars are doing so you and your doctor can develop a good plan for delaying the onset of diabetes,” Compston says.

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Renown Health is one of the country’s first health systems to lift visitor restrictions for patients with COVID-19 and encourage the family to be at the patient’s bedside. Read Darlene and Dave’s story to understand why we’re updating our visitor policy. Dave and Darlene Randolph found joy in exploring antique shops and garage sales to find damaged or discarded vintage pieces. Dave would spend many hours scraping, cleaning, sanding, and refinishing items, transforming them into functional, beautiful pieces of furniture. Every piece in their home rekindles a memory and has a story to tell. On Thanksgiving, when Dave was too ill to gather around their antique dining room table, Darlene called the ambulance. Ailing with COVID-19 for two weeks, Dave had not been improving. When the EMTs reached her home and asked Darlene what underlying conditions he had, she said, “all of them.” David was seriously ill. Hospitalized for COVID-19, their communications options were limited. The only way Darlene could communicate with Dave was on a video call or by telephone. Dave spent 17 days hospitalized at Renown Regional Medical Center in Reno. Darlene spent 17 days waiting by the phone for more information on his condition. Darlene said he had “up days and down days,” but thought he might be home, sitting at their antique dinner table for Christmas. Sadly, Dr. David Randolph lost his battle with COVID-19 on December 13, 2020, and died as he slept in a hospital bed. When Darlene wrote his obituary for the newspaper, she gave thanks to the “tremendous nurses and doctors at Renown Regional Medical Center, for providing his care during a time when the family could not be with him.” Taking Action to Inspire Change Darlene wished she could have been there. Over their 45-year marriage, she had always been there. Darlene said, “I had always been at his bedside, as his advocate, to help communicate and straighten things out.” As a registered dietician, she worked in hospitals, knew the protocol, and knew that Renown had a restricted visitor policy to stop the virus’s spread- to other patients, staff, and their family members. Still, she wished she could have spent more time with him. On Christmas Eve, she sat down and wrote to Renown leadership. “As the wife of a COVID patient who recently passed away in your hospital, I want to express my thanks to you and your staff for the care he received in the last days of his life. I am aware that the nurses and staff are working under dangerous conditions and risking their health and lives by caring for multiple COVID patients. The staff is gracious, concerned, and doing everything they can.” She continued, “I know procedures are changing every hour to try to stay ahead of this dangerous virus, and I am sharing my experiences, hoping they will be helpful when establishing policies that impact families.” Darlene explained that despite receiving assurances that Dave’s nurse or a doctor would call daily, sometimes they would forget. She explains in her letter, “how important it is, in these times when the family cannot visit, and has only infrequent communication and is anxiously waiting at home for information about their loved one, how much it means to get a call from someone caring for him at the hospital. If there is a way you can help assure nurses have time to make calls or assist patients in making calls because it is an important part of patient care.” A Person-Centered Visitor Policy After receiving her letter, Renown leadership called Mrs. David Randolph to thank her, offer his sympathies and ask if Renown could help in any way. Darlene asked if he might reconsider allowing families to visit hospital patients during treatment for COVID-19. As the COVID-19 situation has evolved, the policy has as well. Renown hospitals and medical practices now encourage limited visitors for all patients, including those diagnosed with COVID-19. Renown also has extra safety measures to protect the health of patients, visitors and healthcare employees. Darlene is very pleased that her letter inspired this shift in visitor policies for patients with COVID-19. She says, “I have always tried to think of ways I could help other families. Especially those senior couples where one has been hospitalized and the other is home. My wish is to help others.” Renown Health Visitor Policy Renown Health patients may identify two healthy adult “patient supporters” to accompany them on their hospital stay. For more details, visit our Patient Supporter Guidelines page.

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Vaccines that provide protection against the COVID-19 virus are bringing us closer to the end of this deadly pandemic. Two different COVID-19 vaccines are currently available in the U.S. today: one from Pfizer and the other from Moderna. Kate Ward, PharmD, BCPS, Director of Clinical Pharmacy at Renown Health and Adam Porath, PharmD, Vice President of Pharmacy at Renown, share what you need to know about these vaccines. When two COVID-19 vaccines were approved by the U.S. Food & Drug Administration (FDA) in December 2020, it was cause for celebration. Why? Because according to the CDC, the vaccines are 94 percent or more effective in providing protection against the COVID-19 virus! Many people are seeking information about the new Moderna and Pfizer vaccines. Below, our pharmacy leaders provide answers to some commonly asked questions. How do the COVID-19 Vaccines Work? The Pfizer and Moderna vaccines are both mRNA vaccines that help your immune system develop antibodies against the COVID-19 virus. The vaccines use messenger RNA, or mRNA, to show our bodies’ protein-making cells how to make the spike proteins of the COVID-19 virus. Our immune system reacts to these spike proteins by creating antibodies that can recognize and destroy them. So when a person is exposed to the virus in the future, they will be less likely to get sick. What are the Differences between the Pfizer and Moderna Vaccines? The Pfizer and Moderna COVID-19 vaccines are very similar, with just a few small differences worth noting. The main difference between the two vaccines is when you should receive your follow-up dose. Patients who receive a first dose of Pfizer should receive their second dose about three weeks later. Those who receive a first dose of Moderna should receive their follow-up vaccination roughly four weeks after their first dose. People 18 years and older can receive the Moderna vaccine while people 16 years and older can receive the Pfizer vaccine. Dosage for the Moderna vaccine is 0.5 ml (100 mcg). Dosage for the Pfizer vaccine is 0.3 ml (30 mcg).

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With front-line workers receiving the first COVID-19 vaccinations, many of us are feeling hope, but also worry. As a result, we are joining with the Ad Council, the COVID Collaborative, HHS, CDC and NIAID (along with top health and medical organizations) to address your vaccine concerns and questions. Will the vaccine be available to everyone in Nevada? The Nevada Department of Health and Human Services (DHHS) is collaborating with health systems about the use of initially available, limited supplies of COVID-19 vaccines. They will provide guidance on the prioritization order of who will receive the vaccine. This will be based on available quantities, high-risk locations of work and certain other risk factors, and recommendations and guidance for public health agencies. The CDC has provided guidance to initially focus on the following groups: Healthcare personnel likely to be exposed to or treat people with COVID-19, nursing home residents and others in institutional settings; People at risk for severe illness from COVID-19 due to underlying medical conditions; People 65 years of age and older; Other essential workers. I worry the vaccine has been rushed The U.S. national vaccine safety system ensures that all vaccines are as safe as possible, and because vaccines are given to millions of healthy people to prevent serious diseases, they’re held to very high safety standards. COVID-19 vaccines are undergoing a rigorous development process that includes vaccinating tens of thousands of people who participate in a study to generate the needed clinical data. These clinical trials generate scientific data for the FDA to determine the safety and efficacy of each vaccine. It’s worth noting that the clinical studies to establish the safety and efficacy of the Covid-19 vaccines were as big and thorough as recent studies for other licensed vaccines (for example, the shingles vaccine). I'm concerned about the vaccine's side effects The most common side effects are very similar to those seen with most vaccines, such as: sore arms, fevers, and tiredness within 72 hours after the vaccine. These side effects usually mean that the vaccine is generating an immune response, indicating it is working. Short-term side effects observed in the leading COVID-19 vaccine trials include: Injection site pain and redness Fatigue Muscle aches and pains Joint pain Headache I’m afraid I’ll get COVID-19 from the vaccine None of the authorized and recommended COVID-19 vaccines, or COVID-19 vaccines currently in development in the United States, contain the live virus that causes COVID-19. This means that a COVID-19 vaccine cannot make you sick with COVID-19. Can children receive the COVID-19 vaccine? Not at the moment. In early clinical trials for various COVID-19 vaccines, only non-pregnant adults at least 18 years of age participated. However, clinical trials continue to expand those recruited to participate. The groups recommended to receive the vaccines could change in the future. As of now, it is recommended that children do not receive the vaccine. More information will be available from the vaccine manufacturers. I do not believe vaccines are effective Both this disease and the vaccine are new. We don’t know how long protection lasts for those who get infected or those who are vaccinated. What we do know is that COVID-19 has caused very serious illness and death for a lot of people. If you get COVID-19, you also risk giving it to loved ones who may get very sick. Getting a COVID-19 vaccine is a safer choice. The FDA is responsible for making sure that, just like any other medications, any FDA-authorized or approved COVID-19 vaccines are safe and they work. The EUA (Emergency Use Authorization) will not be provided if the FDA feels that the vaccine is unsafe. I can't get vaccines to due to a medical condition Adults of any age with certain underlying medical conditions are at increased risk for severe illness from the virus that causes COVID-19. mRNA COVID-19 vaccines may be administered to people with underlying medical conditions provided they have not had a severe allergic reaction to any of the ingredients in the vaccine. The following information aims to help people in the groups listed below make an informed decision about receiving the mRNA COVID-19 vaccine. It is extremely important to speak with your doctor regarding your specific medical condition, and always follow their strict advice regarding the COVID-19 vaccine, or any other vaccines. Sources: Renown COVID-19 Ad Council COVID Collaborative U.S. Department of Health & Human Services Centers for Disease Control and Prevention National Institute of Allergy and Infectious Disease

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Type 2 diabetes, formerly known as adult-onset diabetes, is on the rise for adults and children in the United States. Although genetics play a role, you can take steps today to lower your risk of developing this life-altering condition. Michael Raymund Gonzales, MD with Renown Endocrinology answered our questions about Type 2 diabetes and gave us some useful tips for prevention. What effect does diabetes have on the body? And who’s most at risk? First, it’s important to know the difference between the two most common types of diabetes: Type 1 diabetes is the result of the body’s inability to make insulin, which is a hormone your body needs to be able to use sugar, or glucose, for energy. Type 1 is not preventable, and people who have it were either born with it or they developed it later in life due to an autoimmune process that attacked the pancreas that went unrecognized. Type 2 diabetes occurs when the body makes the insulin hormone, but it might not make enough or work well enough for the body to use sugar for energy. This is called insulin resistance. This condition usually develops later in life but is preventable with proper diet, exercise and weight loss. However, due to the obesity epidemic, type 2 diabetes is occurring more often in younger individuals.  Diabetes hurts the body’s ability to break down glucose, so rather than it being used for energy, glucose stays in the bloodstream, which can cause problems. But with early detection and the help of your doctor, diabetes can be managed so that complications are avoided. Left unmanaged, however, diabetes can affect major organs and lead to heart and blood vessel disease, nerve damage, kidney damage, eye damage, skin conditions and more. Type 2 diabetes also results from risk factors that you can’t control, including your family history, race and age. However, there are a few risk factors that you can watch out for, such as being overweight, inactivity, diet choices, having high blood pressure and high cholesterol and triglycerides.

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