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Help us celebrate the holiday season by sharing joy with our Children’s Infusion Services team!  Thinking about blood can make any of us squeamish, and seeing it can be even more intimidating to the children in our lives. Being treated for a condition that requires blood transfusions or chemotherapy infusions is no easy feat, especially during the holiday season. This time of year, we are proud that we can offer our pediatric patients the power of proximity and excellence by having access to high level care close to home.  The Children’s Infusion Services (CIS) department at Renown Children’s Hospital is committed to bringing the gift of quality care to our community’s youngest patients. Whether they are caring for a child with a blood disorder or giving expert infusion care for a child battling cancer, no team does what they do better than these expert nurses, medical assistants, intake coordinators and physicians.  ‘Tis the Season to Bring Hope As the only pediatric oncology and hematology program in the region, the CIS department has a lot of responsibility on their shoulders. From inpatient chemotherapy to outpatient infusion services, this team treats a long list of pediatric blood conditions including:  Pediatric cancers Anemias Immune-mediated blood disorders Sickle-cell disease Bone marrow failure syndromes Bleeding disorders  “Our team provides a large variety of services from labs draws, sedations for procedures, infusions for diagnoses such as Crohn's disease, blood transfusions, as well as chemotherapy,” said Jen Torres, RN.  “Our team works extremely well together. We try to go above and beyond for our patients every day. It may be something as simple as a hug to comfort a parent or a special birthday gift for a patient.”  “My job allows me to work with several departments and providers when coordinating care for our littlest of patients,” added Jane Strawn, Intake Coordinator. “I assure proper authorizations are in place for the care that is needed, I communicate with our families when scheduling appointments, I organize End of Treatment Celebrations, as well as birthday shout outs and work closely with our Child Life team to help make the challenging appointment little easier.”  To best serve their patients, the team thrives on being expert multitaskers. Central line care, chemotherapy administration, blood transfusions, medication management, preventative injections, lab draws, lumbar punctures, biopsies, imaging – you name it, they do it. And they do it all with the utmost focus on safety and support.  “Our days have a lot of variation, as we perform a number of different services,” said Meagan Bertotti, RN. “We provide infusions for patients with chronic or acute medical conditions and chemotherapy/biotherapy treatment to patients undergoing cancer treatments. Overall, though, we work as a team to make these difficult procedures and treatments as easy as possible for the patients and families by providing engagement and support.”  “While we handle a lot of chemotherapy treatments for pediatric patients, we also do other infusions and transfusions as well such as blood and platelet transfusions, enzyme replacement therapies, different types of injections such as Rabies vaccine or Synagis for high-risk babies who need that extra protection during the RSV season, and lab draws,” said Chelsea Angues, RN. “We care for patients that get their therapies from outside hospitals, but the patient lives within the Reno area. We receive orders from those outside hospitals to care for those patients, so they can still be with their families and not have to travel.”  As members of the Children’s Oncology Group, a highly-regarded clinical trials group where over 90% of pediatric cancer patients across the U.S. receive treatment, teams like CIS in Renown Children’s Hospital deliver the highest standard of care. This partnership is a true testament to the devoted collaboration and relationship-building this team commits to on behalf of their patients every day.  "One of the biggest accomplishments of our team is the fact that we became a member of the Children’s Oncology Group, and the Children's Infusion Center and Pediatric Oncology became one unit,” said Shelby Nolte. "Instead of being a clinic on one side and an infusion center on the other, we really came together to make it a whole unit that collaborates on almost everything.”  “We've put much time into trying to understand other departments, their flow, their rationales and their processes so we can come to a solution that benefits our patients the greatest,” added Tiffany Macie, RN. “We've taken the last few years to really build our relationships with our pharmacy staff, our lab staff and our central supply resources. Our relationship building extends beyond the walls of the Renown building as well and out to the community providers too. In the past few years, we've been able to build relationships with the providers in the community where they trust they can send us their patients for treatment and lab draws. Finally, we've spent much time working on the relationships as a team. It's emotional work we do on our unit, and these families become our family. It's important to us that we take the time to be together outside of our shifts to enjoy one another and laugh!”  In the compassionate realm of pediatric healthcare, CIS knows that the complexities of a cancer or blood disorder diagnosis can take an emotional toll on their patients and families. The team firmly believes that emotional support can be as important as the physical and medical support throughout each patient’s unique care journey, striving to be a comforting presence during daunting times.  “The most important part of my day is collaborating with the Children's Infusion team to make life manageable for the families that are going through this experience,” added Shelby Nolte, Senior Medical Assistant. “We work as a team to make life easier for the blow of a cancer diagnosis.  We are there for our families in every way.  If they need a shoulder to cry on, an ear to listen or just someone to play cards with or tell a funny story too, we are there.”  “One of the things our team does extremely well to help our patients and their families with new diagnoses is to simply meet them where they are,” said Tiffany Macie. “That looks different for every family and every patient. We work in an environment where can build relationships with our patients and their families. This allows us the unique opportunity to really get to know them. We learn their fears, their joys, their worries, what their family lives are like, and we learn how to best meet them where they are.”  Transcending the conventional boundaries of care, the CIS department closely supports each patient, offering them solace tailored to the unique fabric of each family's life.

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Managing weight is a complicated and often difficult journey for many individuals, and obesity stands as a common and serious chronic health condition. In fact, the Center for Disease Control and Prevention reports that the prevalence of obesity in the US is greater than 40% in adults and 20% in children, and those numbers are continuing to climb. In Nevada, according to the 2020 Behavioral Risk Factor Surveillance System, 28.7% of adults reported being obese. By 2030, almost 80% of American adults may be overweight and half of them will be obese. But obesity isn't just about the numbers on the scale; it's a multifaceted, lifelong, neurobehavioral disease triggered by a combination of factors. These include abnormal eating patterns, reduced physical activity levels, environmental stressors, genetics and various other contributors. Obesity extends far beyond appearance, often leading to the development of numerous medical conditions such as diabetes, heart disease, elevated blood pressure, stroke, sleep apnea, liver disease, various cancers and infertility. Join us as we delve into the complexities of obesity and explore strategies for effective weight management available right here in northern Nevada. Why Can Losing Weight be so Difficult? The challenge behind weight loss finds its roots in the Set-Point Theory of Obesity, a concept that says our bodies have a predetermined weight, or fat mass, within a defined set-point range. In other words, when an individual's weight deviates from this set point, the body initiates mechanisms to bring it back to the established range. So, if someone loses weight below their set point, the body may respond by increasing hunger and reducing metabolism, making it challenging to sustain weight loss. There Isn’t One Right Answer, But Renown is Here to Help Various weight management strategies can be utilized by patients struggling with obesity, which may lead to substantial weight loss, resolution of associated medical conditions and improved psychosocial health. In fact, the most successful strategy involves a multidisciplinary approach under the guidance of trained specialists that includes a combination of tactics, including: Behavioral adaptations Dietary modifications Physical exercise  Anti-obesity medications  Weight loss surgery

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© MikeSaran via Canva.com Hair is often considered a symbol of identity and self-expression, from scalps and eyebrows to beards and bodies. But what happens when this symbol starts to fall out? The 6.7 million people across the country living with alopecia know this feeling all too well. Alopecia, or hair loss, is a medical condition with variable causes, presentations and treatments. Experts at Renown Health dive into the world of alopecia, its causes and how to address it – especially as we embrace National Alopecia Awareness Month this September.   Types of Alopecia  The term “alopecia” is a broad umbrella term that encompasses many different forms of hair loss that can present itself at any age, no matter your gender or ethnicity. The most common types include:  Alopecia Areata: An autoimmune disorder where the immune system targets hair follicles, typically resulting in patches of hair loss on the scalp and/or other body parts. More severe forms of alopecia areata also exist, such as alopecia totalis and alopecia universalis. Androgenetic (or Androgenic) Alopecia: A disorder also known as male or female pattern baldness that causes gradual hair thinning and loss often around the temples and crown. Unlike alopecia areata, this form of alopecia is usually hereditary. Telogen Effluvium: A condition resulting in hair shedding, typically after high-stress or infectious events, such as after giving birth or after a COVID-19 infection. This usually resolves itself within a few months to a year. Traction Alopecia: Hair loss resulting from the effects of tight braiding or styling of the hair, which can cause permanent loss over time. Scarring and Inflammation-Mediated Hair Loss: Patterns of hair loss related to lupus, lichen planus or other autoimmune conditions that can unfortunately be permanent and progressive.  Options to Treat Alopecia  While there isn’t a cure for most types of alopecia, some treatments are available to help minimize the effects of the condition and promote hair growth. Treatment varies depending on the type of alopecia. Potential options can include:  Topical Minoxidil: An FDA-approved over-the-counter medication available in foam or liquid form and applied directly to the scalp, which helps stimulate hair growth by increasing blood flow to hair follicles. Hormone Therapies: A hormone regimen that can help minimize the resulting hair thinning and balding. Corticosteroids: A topical cream or ointment – or an injection for severe cases – that help reduce inflammation and re-grow hair. Low-Level Laser Therapy: A therapeutic, non-invasive intervention involving wearing special caps or combs that release painless, low-level lasers to stimulate hair follicles. Healthy Diets and Nutritional Supplements: A diet rich in vitamins and minerals essential for hair health, such as biotin and collagen, can aid in recovery. Vitamin D and iron are also important hair growth nutrients. Stress Management: Stress can impact the speed and frequency of hair loss. Managing your stress can help mitigate the effects of alopecia.  Treatment for alopecia is not a one-size-fits-all approach. A scalp skin biopsy may help determine a cause for hair loss and help guide the best management strategies with your provider.  Addressing the Emotional Impacts  Even though alopecia isn’t life-threatening, the impacts of the condition can affect your self-esteem and self-image. The most powerful tool to help you manage alopecia is knowledge. Keeping yourself educated about your condition, and encouraging your loved ones to do the same, can help arm yourself with the acceptance and self-compassion you need and help combat misconceptions.  With the rise in awareness in the mainstream media for alopecia and other hair conditions, beauty standards and fashion are shifting to become more inclusive for those experiencing hair loss. Celebrating the many diverse hairstyles and fashion statements can help you regain your confidence. There are many options you can advantage of to help style your hair and protect your scalp:  Hairpieces: Wigs, extensions and other hairpieces can help cover up balding or thinning patches and add volume to your hair. Hairpieces have come a long way in the past few decades, and many use real human hair. Hats: Hats serve a dual purpose – a fun fashion accessory to help boost your confidence and a method of protecting your scalp from the sun. As someone with alopecia, your scalp is more exposed, and hats can provide that extra layer of protection you need. Scalp Sunscreens: While regular body sunscreens can provide good scalp sun protection, they can result in oily scalp and hair appearance. Sunscreens that are specifically designed for the scalp are available at most beauty stores or online. Remember, patience is fundamental, as many treatments require consistent use over time to see noticeable results. Stay resilient, and don’t give up – you are not alone in your alopecia journey.

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According to the Global Sepsis Alliance, 1 in 5 deaths worldwide are associated with sepsis. If not recognized early and treated promptly, sepsis is the final common pathway to death from most infectious diseases worldwide, including viruses such as COVID-19. We spoke with Jeremy Gonda, MD, a critical care physician from Renown Health’s Sepsis Committee to increase public awareness of this preventable medical emergency. What is sepsis? Sepsis is a response to infection—bacterial, viral or fungal—and can start anywhere in the body and spread into the bloodstream. The body is trying so hard to fight an infection that it begins releasing chemicals into the bloodstream that cause inflammation and the shutdown of multiple organ systems. “It carries a very poor prognosis in general unless you catch and treat it very early,” said Dr. Gonda. “Any infection can lead to sepsis. Typically your immune system takes care of the infection. It doesn’t progress, but in cases where the infection becomes severe, or the immune system doesn’t function properly, people can certainly die. So there’s, unfortunately, a very high mortality rate associated with sepsis.” According to the Centers for Disease Control and Prevention, each year at least 1.7 million adults in America develop sepsis. While you can recover from sepsis if caught early, many sepsis survivors suffer from long-term physical and psychological effects. What are the signs of sepsis? One way to spot sepsis is to use the acronym SEPSIS: S – Slurred speech and confusion E – Extreme shivering or muscle pain/fever P – Passing no urine all day S – Severe breathlessness I – “I feel like I might die” S – Skin mottled or discolored Keep in mind that sepsis symptoms can vary depending on where the infection starts. “Patients may experience urinary burning if they have a urinary tract infection or a cough and shortness of breath if they have pneumonia first,” said Dr. Gonda. “However, often symptoms are more generalized or subtle such as fevers, confusion and malaise.” How do you develop sepsis? When germs enter your body, they can cause an infection. If you don’t stop that infection, it can cause sepsis. Areas of infection that more commonly result in sepsis include: Lungs, such as pneumonia Kidney, bladder and other parts of the urinary system Digestive system Bloodstream (bacteremia) Catheter sites Wounds or burns Who is most at risk? People with compromised immune systems are at greater risk for sepsis, such as “The very young, the elderly and any people who may have conditions that suppress your immune system,” said Dr. Gonda. “For instance, if you have diabetes or if you’re an organ transplant patient who is on immunosuppressant therapy, you’re at somewhat higher risk.” Sepsis is often considered a hospital-acquired infection, but a study in The Journal of American Medical Association found that 80% of sepsis cases occur outside of a hospital. That’s why it’s especially important to remember any infection can lead to sepsis, and anyone can develop sepsis from an infection. What do I do? Timing is critical in the case of sepsis and septic shock. According to a study on septic shock patients, there is a 7.6 percent decrease in survival for each hour treatment is delayed. On the other end, if treatment is given within an hour of the first drop in blood pressure, the survival rate is 80 percent. Because sepsis can be so deadly, it’s important to seek medical attention as soon as possible. “If you’re not getting any better, if you think symptoms are progressively worsening – you should definitely be evaluated by a doctor,” said Dr. Gonda. You can help #StopSepsis by getting involved at worldsepsisday.org.

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Your heart is the muscle in charge of pumping blood to your entire body. This vital organ is made up of chambers, valves and blood vessels. Your heart valves work similarly to a one-way door: they open and close, controlling blood flow in the correct direction through the heart chambers.   For patients who have been diagnosed with a heart-related condition like aortic valve stenosis (narrowing), it is important to know treatment options. Most might think open-heart surgery is the only way to treat a heart valve, but many hospitals, including Renown, also offer a minimally invasive procedure called a Transcatheter Aortic Valve Replacement (TAVR). Dr. Abhilash Akinapelli of Renown Institute for Heart & Vascular Health shares his answers to the top five TAVR questions:  1. What causes aortic valve stenosis?  Aortic valve stenosis can be caused by a variety of factors. The main reasons being wear and tear of the valve due to aging; genetically abnormal heart valve (bicuspid aortic valve); long-standing high blood pressure; and other reasons like radiation exposure.   2. Am I a candidate for TAVR?  Renown’s heart care teams are made up of your primary care provider, cardiologist and cardio thoracic surgeon. They will evaluate if patients are a good candidate for the TAVR procedure by performing a variety of screenings and tests. Some of these include:   Echocardiogram  Electrocardiogram (ECG or EKG)  Chest X-ray Exercise tests or stress tests  Cardiac computerized tomography (CT) scan  Cardiac catheterization  3. What are the advantages of the TAVR procedure?  The Transcatheter Aortic Valve Replacement (TAVR) procedure is much less invasive than open heart surgery, otherwise known as a Surgical Aortic Valve Replacement (SAVR). Patients can typically return to their normal lifestyles within a week after leaving the hospital.   During the TAVR procedure, a stent valve mounted on a balloon is advanced to the heart through the blood vessels in the groin without any incision. Once in position, the balloon will be inflated to firmly expand the new valve inside the diseased old valve, pushing it away to the sides. Once the new valve is in place, it begins working immediately and the deflated balloon is removed. The surgical procedure is approximately one hour long. Patients can get up and walk after four hours and will be discharged the following day if no complications arise. Compared to a SAVR, recovery time is much shorter and less risky for patients above the age of 75. A big advantage for anyone who fits under the criteria for a TAVR.  4. Is the procedure painful?  The TAVR procedure is not surgery, but you will still be asleep during the procedure. Since no incision is made, it is essentially a painless procedure. Patients may experience slight discomfort such as aches and pains at the entry site of the catheter.   5. Can I have an MRI and X-rays done after having a TAVR valve?  Yes, patients can have MRI scans and X-rays after TAVR.   For further questions and information about the TAVR procedure, please consult with your Renown heart care team at 775-982-2452 or through MyChart.

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Heading into surgery of any kind can bring along feelings of intimidation. With a best-in-class surgery team at Renown Health, patients rest assured that they are in the most capable hands for their entire procedure from start to finish – and while the physical preparation is vital, mental and emotional preparation is equally as important to ensure each patient has a smooth and comfortable experience. The Surgical Preadmission department (a.k.a. “preadmit”) at Renown Regional Medical Center and Renown South Meadows Medical Center is a dynamic and compassionate group of nurses, case managers, chart managers and more who are dedicated to guiding each patient through the surgical process. With extensive knowledge and expertise under their belt, the teams are equipped to make a genuine difference in the health and well-being of all patients, for all surgeries, at all times of the year. Surgery Starting Ground The Surgical Preadmission teams are crucial aspects in the successful outcome of every surgical procedure. Comprised of skilled healthcare professionals, this department is dedicated to providing comprehensive support and care before heading into the pre-operating room. “Our job is to prepare every patient for surgery, make sure all their pre-surgery testing is done, ensure they understand their fasting and medication instructions, have had their questions answered, have a ride home and know what to expect during surgery and after so their recovery can go smoothly and without complications,” said Debra Bennett, RN, Supervisor of Surgical Preadmission at Renown Regional. “Each patient is unique, so each experience is different.” Our preadmit nurses are the masters of communication, directing thorough assessments – including medications, tests and clearances – and addressing any questions or concerns patients may have, never missing the opportunity to inform them of exactly what they will expect in surgery. “I do a complete history on every patient while giving them detailed pre-operating instructions and helping them answer any questions to the best of my ability,” said Nancy Hilts, Surgical Preadmission RN at Renown Regional. “I am proud to be able to help allay their fears and concerns using my 30 years of pre-op experience. I offer an avenue for them to feel comfortable opening up to me.” “We always tell patients that they have great surgeons and a fantastic team that will be watching over them and taking care of them every step of the way,” added Jon Capallupo, Surgical Preadmission RN at Renown South Meadows. “We also give them plenty of educational handouts and video content, in addition to verbal instruction, to ensure they are as prepared as possible.” The nurses then pass the reigns onto the chart managers, who prepare the charts for surgery and ensure all documentation is up-to-date before sending them to the pre-operative team. The expert surgical case managers also step in to prepare a thorough discharge plan, along with reviewing pre-operation orders for status, consent, codes and more. The team does several of these initial visits virtually, and they are looking forward to soon phasing all preadmit case manager preliminary visits into a virtual model. From assisting the pre-op and post-anesthesia care unit (PACU) teams with discharge planning concerns to helping on the outpatient side with anything from oxygen equipment and catheters to transportation issues and those experiencing homelessness, our pre-admit case managers are always up to the challenge. "We are true patient advocates, alleviating concerns and fears along the way,” said Mary Carl, RN, Case Manager at Renown Regional. “Just to name a few things we do on a daily basis, we see our total joint and non-weight bearing patients during their preadmission appointment, so they are aware of the medical equipment they need and if it is covered by insurance; provide education for Aspira catheters and gastrostomy tubes; advocate to ensure tube feeding and dressing changes are set up for hospice and home health patients; and escalate concerns of patient safety to ensure a safe discharge.” In the midst of it all, there is never a dull moment in the preadmit teams. At Renown Regional alone, the preadmit professionals see more than 1,600 patients a month – and each one has a hyper-personalized experience with their very own preadmit team. “Many times, we are the first impression a patient has on our organization; after all, we touch more than 97 percent of patients that are scheduled for surgery, cardiac catheterization lab procedures or interventional radiology,” said Amy Schler, Surgical Preadmission RN at Renown Regional. “We also collaborate with many other departments in the hospital as well, from surgeons and anesthesiologists to case managers and nurse navigators. Our work in preadmit impacts the entire surgical process.” Holding a diverse array of experiences, our preadmit department plays an integral role in our commitment to providing the highest quality of care to every patient. Knowledge is Power Heading into surgery feeling fearful and worried is normal for any patient. However, how would you feel knowing that each individual member on your preadmit team has, on average, 23-25 years of experience in the field? This is the reality for our Surgical Preadmission department – and they put that vast knowledge to great use to bring a sense of calm to patients. “Our team members have worked in various departments within our organization, and they bring a wealth of knowledge that we share with each other, and most importantly, with our patients,” said Amy Schler, RN. “If you have hundreds of years of nursing experience, you can speak not only as a nurse but also as a patient. It allows you to give a more personal perspective on what patients can expect in their recovery. Being able to assess their emotions and provide feedback to our pre-op and PACU teams help the patient have a better experience.” “Many of our nurses have close to 40 years of experience each, and they have an extremely large knowledge base since we see patients from newborn to geriatric and from easy procedures to complex surgeries,” added Debra Bennett, RN. “Another great aspect of our team is the varied nursing backgrounds we all hold – surgery, pre- and post-op, labor and delivery, pediatric intensive care, cardiology, gastroenterology, urology, cardiac cath lab, home health and everything in between. Communication between departments is so important!” All members in this department, regardless of which clinical area they came from, surgical or non-surgical, can easily translate their skills into the work they do in preadmit – and they only continue to grow. “As a surgical preadmission nurse, I have used my years of experience as a nurse in surgical services,” said Terri Delatorre, Surgical Preadmission RN at Renown Regional. “I started as a floor nurse with orthopedics for 12 years, and then I worked with the PACU for 11 years. This has helped me give great understanding and care to our surgical patients.” “Because we have staff with such a vast knowledge base, we can rely on our years of working within our organization to help alleviate fears that the patient may have,” added Amy Schler, RN. We can prepare them for what to expect in pre-op and PACU and educate them on what to expect post-op, including any barriers they may face. For example, mastectomy patients may not realize they will not be able to raise their arms for 7-10 days post-op, and total knee patients have to navigate stairs and housing access. Helping patients think about barriers at home that they may not have thought about helps them prepare prior to surgery, enhances their healing and provides a better surgical experience.” The preadmit team works closely with our best-in-class surgeons and anesthesiologists, continuing to grow their expertise along the way while learning alongside our talented providers. For instance, when it comes to our Renown South Meadows preadmit department, anesthesiologist Nariman Rahimzadeh, MD provides excellent guidance for the entire team on state-of-the-art anesthesiology practices. “I am very proud of the work we do with Dr. Rahimzadeh,” said Lisa Closson, Surgical Preadmission RN at Renown South Meadows. “Together, we ensure patients are safe for both surgery and anesthesia.” Despite the challenges that come their way – whether it be changes to process and workflow to navigating support for patients after they leave the surgery floor – the preadmit team cleverly uses their collective wealth of knowledge to bring hope and comfort to all patients. “Our nurses are such warm, caring and compassionate humans that do their best to ease any fears and anxieties patients may have,” said Debra Bennett, RN. The Pride of Preadmission The pride of our preadmit team lies in their ability to make a positive impact on all patients they serve. To them, their work is not just a job – it's a calling. And they do it all while working together to elevate their team and performance. “Our team is most proud of the quality of care we provide to our patients and our abilities to troubleshoot difficult situations to ensure they have a great surgical experience here at Renown,” said Mary Carl, RN. The entire department supports each other by working collaboratively and relying on each other’s expertise to provide the best possible care for patients. They understand that their success as a team depends on their abilities to support and help each other. “Our team is awesome here at South Meadows,” said Jon Capallupo, RN. “We can turn to each other for support, and we all work very well with each other. I am glad to be a part of this team.” “I am proud of how well all of us in preadmit works with each other every day,” added Lisa Closson, RN. “We try to make patients feel comfortable from the moment they arrive to the time they leave the department.” The pride that our preadmit team expends goes beyond their departmental limits – these team members are also trusted teachers. They work closely with cancer nurse navigators to teach weekly classes for patients who have been newly diagnosed with breast cancer, coupled with lymphedema prevention and education classes. The team also encourages participation in Renown’s free smoking cessation programs to help their patients learn the risks and benefits of quitting smoking. When not serving patients or teaching classes, you can find many of these team members taking charge of multidisciplinary committees within our health system, including breast leadership, gastroenterology leadership, shared governance, infection control and recruitment and retention. On top of it all, this team certainly knows how to celebrate, with several of their members being a part of their own department-wide Celebration Committee, where they gather for retirement parties, baby showers and team get-togethers. Always active and never passing up a challenge, our preadmit department are shining examples of Renown’s Culture Commitments, especially Caring and Collaboration, and the pride in the vital work they do every day is limitless. “I am so happy my position in preadmit opened up for me at a time when I was really feeling challenged in my career,” said Nancy Hilts, RN. “The team that we have here is amazing. I am so grateful and thankful every day for the opportunity. It is an amazing place to work!”

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Being diagnosed with a chronic heart condition like atrial fibrillation (A-fib) can shift the course of your entire life. Embracing heart medications and lifestyle changes become your norm, and thanks to advancements in medicine and medical technology, managing the condition can bring you to a new sense of normalcy.  But what if a different option was possible – one that would make medications and activity limits a thing of the past?  This became the reality for Renown Health patient Richard Preyer after receiving a hybrid catheter ablation. Thanks to the vigilant surgical care of Shining Sun, MD, a cardiologist at the Renown Institute for Heart & Vascular Health, and his compassionate team, Richard has a new lease on life.  Minimally Invasive with Maximal Results  An A-fib patient since 2010 who had been living with an unfinished ablation, the 59-year-old Carson City resident turned to the internet to look for alternate solutions. He had heard that the Renown Institute for Heart & Vascular Health was a top-tier location for cardiovascular care. “I changed health insurance plans through Nevada Health Link to ensure I could see a Renown cardiologist,” said Richard.   Choosing a cardiologist was an even easier decision for Richard. Dr. Sun’s introductory Find a Doctor video on Renown’s YouTube channel, where he displayed his expertise and determination, was more than enough for Richard to choose him as his cardiac care leader.  At his first visit, Dr. Sun reviewed Richard’s records, and noted his prior unfinished ablation. The nine-hour procedure had been performed several years ago. With the enhanced technologies at Dr. Sun's disposal, Richard was excited at the thought of his life potentially being changed for good – with a minimally-invasive solution.  Dr. Sun collaborated closely with Richard’s previous and current care teams – including a surgeon who performed a maze operation on him right before his surgery at Renown, to ensure his hybrid ablation was tailored uniquely to him. “Dr. Sun is clearly a very powerful cardiologist with many connections, and the coordination between his team and my other doctors was great,” said Richard.   After working on the exterior of the heart in the first phase of the surgery and the interior of the heart during the second phase, Richard’s hybrid ablation was successful, completing the unfinished portion of his previous ablation.   “Fixing A-fib can take one to three ablations, and sometimes it never holds,” said Richard. “That is one of the largest reasons why I am so thankful for this procedure and how it ended up.”  Life After A-fib  Now comes the long, arduous healing process, right? Not for Richard. With only eight incisions (four on each side of his chest), he was able to remove his bandages after two days, and he healed completely in one week.  “I was even back to taking three-mile walks within a week of my operation,” said Richard.  No more blood thinners.  No more activity limits. And most importantly for Richard, no more heart-stabilizing medications that came with side effects he didn’t enjoy. He attributes his enhanced life to Dr. Sun and his team.   “I highly recommend Dr. Sun and everyone that works with him,” he said. “Everyone in the group, from the nurses and anesthesiologists going above-and-beyond to the schedulers who helped me navigate the appointment process, made me have a lot of confidence. Their calm demeanors made so much difference.”  Today, Richard now enjoys elongated walks in the northern Nevada outdoors, exotic vacations with his wife and, as he describes, “feeling like I’m in my 40’s again.” Learn more about the region's leader in cardiac health, heart and vascular care here.

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Since the COVID-19 pandemic, more people are working from home than ever before, leading to a rise in digital screen time. Between spending eight or more hours staring at a computer screen, and some downtime hours spent looking at a smartphone or watching TV, it’s almost inevitable to feel some adverse effects at the end of a day. Blue Light Effects vs. Digital Eye Strain Blue light is all around us, and the most natural source comes primarily from sunlight. Other forms of blue light are artificial and emitted by digital screens including LED TVs, smartphones, tablets and computers. Surprisingly enough, research shows blue light can actually have health benefits such as promoting alertness, boosting memory and cognitive function, elevating mood and regulating circadian rhythm. However, studies indicate that an excess in blue light exposure can lead to depletion of melatonin production, a hormone that regulates our sleep cycles. In today’s eyewear industry, blue light glasses are one of the more popular items purchased by consumers. Companies who sell the glasses claim they help with reducing or eliminating digital eye strain, while also increasing natural melatonin secretion to get a good night’s sleep. Other than their slight yellow tint to filter out blue light, they mostly look like regular glasses and come in many different stylish frames. You can find blue light glasses through various eyewear retailers. Most adults have experienced digital eye strain. Common symptoms of digital eye strain include headaches, blurred vision, irritated eyes, and fatigue. Many believe that digital eye strain is caused by overexposure to blue light, but medical vision experts say that is not the case. “Digital eye strain is related to how we use our digital devices, not the blue light coming out of them,” says Mitchell Strominger, MD, a neuro and pediatric ophthalmologist with Renown Health. Do Blue Light Glasses Even Work? Since blue light glasses aren’t medically proven to help with digital eye strain, you’re probably wondering if they’re even worth using. “If you’re one to binge a TV show or scroll though social media before bedtime, the blue light from those digital screens can disrupt your circadian rhythm and cause you to lose sleep, which can ultimately lead to other adverse health effects,” says Dr. Strominger. “While more research is still needed, some studies have shown that blue light glasses may prevent melatonin suppression and increase quality of sleep. There is no harm in trying them out and seeing if they work for you.” As for preventing digital eye strain, Dr. Strominger shared several helpful tips: Try using the 20-20-20 rule, which entails looking away from your screen and looking at an object 20 feet away for at least 20 seconds. Sit at an arm’s length (about 25 inches) away from your screen. Adjust the brightness and contrast of your screen, especially before bedtime. There is a night mode setting on most smart phones you can use. Reduce your screen time whenever you can and give your eyes a break.

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Visiting a Renown Urgent Care location is an excellent option when you have a non-severe condition, such as a skin rash or sore throat, can't get in to see your primary care provider in a timely manner or if you need an appointment after regular business hours. To learn more about the ins and outs of Urgent Care, we spoke to David Lemak, MD, Division Chief Urgent Care, who let us know some reasons to visit Urgent Care, how to make your visit as efficient as possible, and more. Remember, for a life-threatening emergency, call 911 immediately! Urgent Care is similar to a Primary Care provider Urgent Care providers can do most of the things your Primary Care provider can do, with visits billed the same as an office visit. If you could put the word “severe” in front of your reason for visiting Urgent Care, please go to the emergency department right away For a list of what is an appropriate visit for Urgent Care click here. Also, we recommend that babies 2 months old and younger should go to the Renown Children’s Emergency Department, not Urgent Care.  Renown Health has 10 Urgent Care locations across northern Nevada There are five locations in Reno, two in Sparks, one in Carson City, one in Fernley and one in Fallon. For a complete list of Renown Urgent Care locations, click here.  Many of your Urgent Care needs can be accomplished via a virtual visit, from the comfort of your home or office Conditions Appropriate for a Virtual Visit Included:   - Common cold and cough symptoms - Muscular, tendon or joint pain not cause by injury  - Allergy or sinus symptoms   - Pink eye  - Urinary discomfort  - Backache  - Sexually transmitted illness screening   - Rashes or skin sores - Medication refills (no controlled substances) Some conditions are not appropriate for a virtual visit. They include:  - Chest or abdominal pain   - Shortness of breath  - Traumatic injuries  - Dizziness or confusion   - Bleeding    - High fever   - Persistent vomiting  - Loss of vision   - Substance abuse or psychiatric problems Book ahead for shorter wait times, but remember walk-ins are always available. Click here to make your appointment. This booking page conveniently shows the next available appointment at each location. Typically, mornings and late afternoon (right before dinner time) have the shortest wait times if you plan on walking in.   You will be asked to wait in your car when you arrive at a Renown Urgent Care facility. While you wait (or even before you arrive), patients are encouraged to complete all registration paperwork and co-pay information online.  Urgent Care is great for visits such as back-to-school physicals, camp physicals, commercial motor vehicle exams and more. Sometimes you cannot get in to see your primary care provider to meet the last-minute deadlines for certain school or work-related physicals. Many of these appointments can be completed at Urgent Care; we just recommend you call ahead and confirm that our facility offers what you need.  An Urgent Care provider can virtually order a PCR COVID-19 test.  Whether you have a possible exposure, are not feeling quite like yourself or need a negative test for upcoming travel, a COVID-19 test can be ordered for you. The cost for a visit to Urgent Care is dependent on your benefits, but the visit is billed the same as a standard office visit. If you don’t have insurance, a basic visit to a Renown Urgent Care will cost $125.

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Much like general physical and mental health, sexual health is an essential aspect of your overall well-being. Therefore, educating yourself on your sexual health is an important piece regarding your overall wellness. Secure & Private Virtual Visits Did you know that many sexually transmitted disease appointments can happen virtually, in the privacy of your own home? Our providers can perform a screening examination for sexually transmitted illness (without symptoms) when it’s convenient for you. This is a great option if the topic makes you uncomfortable during an in-person visit, or if you can’t find time to visit your primary care provider or local urgent care. After the telehealth appointment, your provider will determine the  next steps for you. Remember, in-person visits are always an option as well.   Here’s how you can take charge of your sexual health:  Get Comfortable with Getting Tested  Surprisingly, some people with STDs don't show symptoms, meaning they may not even know they have an STD unless they get tested. Even if an STD shows no symptoms, the result of non-treatment can be serious. Bret Michael Bellard, MD, with Renown Medical Group, shares that it’s important for people to get tested for STDs because if left untreated, they can cause the following health problems: Loss of fertility Pregnancy complications Other health issues  When to Visit Your Primary Care Provider  Who should get tested and how often? “The recommendations are that everyone from ages 13 to 64 should get tested at least once for HIV. All sexually active adults should also be tested for other STDs once a year, and all pregnant women should be tested at the start of their pregnancy,” says Dr. Bellard. Some STDs, like syphilis, can be passed from mother to baby, so it's important for women to get tested as soon as they know they’re pregnant.  Dr. Bellard recommends going to your primary care provider for testing. “They can also give advice on prevention and other health topics.” If you don’t have a primary care provider, this is a great reason to get established with one. Women with an established OB/GYN can have STD testing done simultaneously with their annual pelvic exam. The providers in Renown's network care for patients of all ages and specialize in family medicine, internal medicine, pediatrics and OB/GYN.   Practice Safe Sex  STDs are preventable. Practicing safe sex and getting tested routinely are your best defenses against all types of STDs.  For many, the conversation about sexually transmitted diseases is awkward and many avoid it. To lower your risk of contracting an STD, don’t wait until you’re “in the moment” to have the conversation with your partner about the last time you were both last tested. If you haven’t gotten tested in-between new partners, use latex condoms every time you have sex until you are both confirmed negative of STDs. Condoms are not 100% effective at preventing disease or pregnancy. However, they are extremely effective if used properly.   To establish Primary Care, visit renown.org/virtualvisits or call 775-982-5000

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You might think worsening eyesight is inevitable as you age. But the truth is, there are easy things you can do to keep your eyes in tiptop shape for years to come. Clear vision is an essential part of overall health and there are daily habits we can adopt to keep our eyes seeing clearly. Mitchell Strominger, M.D., a registered ophthalmologist with Renown Health specializing in pediatric ophthalmology and neuro-ophthalmology, offers some everyday tips to keep you focused on eye health. Know your family’s vision history Look to your parents and grandparents for clues about the future of your eye health. Were they near-sighted at a young age? Do they have a history of eye crossing or a lazy eye? Did they develop glaucoma or macular degeneration (AMD)? Some genes have a strong association with eye health, specifically macular degeneration. AMD is a leading cause of blindness worldwide and the top cause of vision loss and blindness for Americans over 65, according to the Centers for Disease Control and Prevention (CDC). Also be aware certain medical conditions, such as diabetes, high blood pressure and liver disease, increase the risk of long-term eye problems. Receive regular vision screening exams Children under three need vision screening examinations by their pediatrician. A medical concern or family history warrants a comprehensive eye examination by a pediatric ophthalmologist (or general ophthalmologist or optometrist who has experience with children) per the American Academy of Ophthalmology (AAO). Vision screenings should occur every two years throughout adolescence unless pain, eye crossing, difficulty seeing the board or reading, or other eye concerns occur. In adulthood the risk of eye problems increases over age 40, so the AAO recommends regular dilated exams. When your pupils are dilated it allows your eye care professional a more accurate view of your retina and optic nerve, located in the back of your eye. This allows them to look for AMD or other eye problems. Eye diseases can be caught at their earliest stages during a dilated eye exam. “It is especially important to have your child evaluated as soon as possible if there is any concern for eye crossing or lazy eye,” says Dr. Strominger. “The visual system develops in the early years so intervention, whether it be glasses, eye patching to strengthen the vision in one eye, or eye muscle surgery is critical. Children at risk include those who are born premature, have development abnormalities, genetic disorders such as Downs syndrome, or a strong family history and should be evaluated at a young age. Often small problems are not clearly evident and cannot be picked up on routine screening examinations in the pediatrician’s office.” Block the sun, improve your vision Everyone knows not to stare directly into the sun, but indirect ultraviolet (UV) sun rays can cause serious harm over time. According to the National Eye Institute, sunglasses (or a protective UV tint) are a daily must to protect your eyes from: Cataracts (a clouding of the eye’s lens causing blurred vision) AMD - macular degeneration Pterygium (a tissue growth over the white surface of the eye that can cause astigmatism) Look for sunglasses which block 99 to 100 percent of both UVA and UVB rays. You still need sunglasses if your contact lenses block UV rays. Sun rays can damage your eyelids and other tissue not covered by contact lenses. Wearing sunglasses protects your entire eye area. Eat colorful meals Your eyes need vital nutrients to keep them healthy including vitamin C, zinc, beta carotene and copper. A diet filled with citrus fruits and a variety of vegetables provide these essential nutrients. Regularly filling up on fish high in omega-3 fatty acids (salmon, tuna, sardines) may reduce your risk of AMD and help maintain your eye health. Green, leafy vegetables (kale, spinach, collard greens) containing lutein and zeaxanthin are also a must for your dinner plate. Water your eyes Eyes, like the rest of your body, need plenty of water to prevent dehydration. Make sure you stay hydrated and steer clear of smoke to avoid dry eyes and irritation. Hours staring at the computer screen can also make your eyes feel dry or tired. Try regularly refreshing them with lubricating eye drops. Taking frequent computer breaks is also important. Follow the 20/20/20 rule: every 20 minutes, look at an object 20 feet away from you for 20 seconds. Eye makeup can also lead to dry eye as the glands at the base of the eyelashes may become clogged, causing dry eye. Make sure all eye makeup is hypoallergenic and is thoroughly removed with a gentle cleanser for the delicate eye area each day. Stop Smoking (or never start) Smoking is harmful to every part of your body, including your eyes. It's not only linked to cancer and heart disease but also cataracts, AMD, dry eye, optic nerve problems and many other problems. Smoking during pregnancy can also harm the eyes of the unborn child. If you currently smoke take steps to quit and your entire body will benefit.

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Virtual visits are basically secure, video conferencing visits with your health provider. Of course if you are sick, you want to avoid going outside of your house. With Renown Health’s virtual visit program, you can now see a provider from the comfort of your own home. As we work to keep all of our patients home and healthy, we’re here for any ongoing healthcare needs you have. There are two easy ways to access a virtual visit with Renown Health. If you need an urgent care visit, you can get in line using your MyChart account You can make a virtual visit with some Renown Health providers you see currently Virtual Urgent Care from a Renown Provider By using MyChart, you can now login and request to “Talk to a Doctor.” After filling in some information and confirming your healthcare concern, you will be put into a virtual line. The healthcare team will notify you by text or email when a provider is ready to talk to you virtually. Virtual urgent care visits are available for all ages. Get To Know MyChart Virtual urgent care visits are available for all ages, and can address: Common cold and cough symptoms Muscular, tendon or joint pains not caused by injury Allergy or sinus symptoms Pink eye Urinary discomfort Diarrhea without vomiting Rashes or skin sores Backache Nail problems Screening examination for sexually transmitted illness (without symptoms) Medication refills (not controlled substances) Symptoms for In-Person Urgent Care Visits Shortness of breath Chest pain Abdominal pain Numbness or weakness of any location that is new Traumatic injuries (including eye injuries or something in the eye) Severe pain of any other body location Dizziness or confusion Bleeding from any location High fever (greater than 102 degrees for all ages) Persistent vomiting Loss of vision Ear pain Substance abuse or psychiatric problems Virtual visits are open 9 a.m. through 6 p.m. Monday-Friday and 10 a.m. to 4 p.m. Saturday and Sunday for Nevada residents. Renown Provider Virtual Visits Many primary and specialty care appointments for adults and children are now available virtually. If you have a provider with Renown Medical Group, call 775-982-5000 to see if you can have a virtual appointment from the comfort of your home. MyChart Assistance If you need assistance with your MyChart account, please call 775-982-6686. For all other questions about scheduling and appointments, please call 775-982-5000.

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