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Winter is a season that is loved by many. It is the time of year when families get to enjoy outdoor activities such as snow and ice-skating and indoor activities such as cooking or playing board games with family. But because the temperature outside is a little more frightful, it can make us need to think a little more creatively about what activities the kids in our lives might enjoy. We have you covered, here are 10 ways to keep children entertained and enriched even when the weather is not sunny Reno, we all know and love. 1. Ice Skating Enjoy the family fun of gliding and twirling around at The Ice Rink at Grand Sierra Resort or check out Reno Ice. Both ice rinks offer public skating sessions for all ages. 2. Movies Watching movies has always been a great activity. Check your local listings to find a theater convenient to your location. 3. Snow Play The Winter is a time that many people use to take advantage of all the snow and ice our area has to offer. People enjoy snowball fights and rolling downhills. It is a great time for kids to have fun in the snow with their friends. 4. Scrap-Booking Being crafty is a great way for the whole family to have fun. Scrapbooking can be done with most of the supplies lying around the house. 5. Write Letters to Our Troops Operation Gratitude sends letters from civilians thanking troops, veterans, and first responders for their service. Recipients say these letters, notes, and drawings are the most cherished items they receive all year. Check out Operation Gratitude for a downloadable guide on how to write a letter to a service member. 6. Nevada Museum of Art Channel your inner Picasso and have fun exploring your artistic side in this monthly HandsONatHome, a family fun experience with different projects and ideas inspired by the collection. Plan your visit. 7. Homemade Activities Create homemade playdough using a handful of ingredients in your pantry. It takes about 10 minutes to make and is sure to get their creativeness flowing. Here is an easy recipe to follow. 8. Cooking Cooking can be fun, especially when you can involve the kids. Pick a recipe that is fun and easy to make and pull the kids in for some help in the kitchen. 9. Discover The Discovery Museum The museum has over 10 permanent exhibitions and a calendar full of activities that families can explore throughout the year. Let's Discover!  10. Who’s Got Talent? This is an activity with so many possibilities, and it's great for all ages, including grown-ups. If you are working, the kids might put together a show and perform for you later. Or the whole family could show off their talents to visiting guests. Click here for ideas.

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Overcoming poverty is not a task of charity, it is an act of justice. Like slavery and apartheid, poverty is not natural. It is man-made and can overcome by the actions of human beings. Sometimes it falls on a generation to be great. You can be that great generation. Let your greatness bloom. – Nelson Mandela, February 2005, Make Poverty History Campaign in London Lifting away the curtain that symbolized the front door, I entered a dark, cinderblock room and instantly became overwhelmed by an unpleasant odor. Working with oncology patients as a Child Life Specialist and an Occupational Therapist for over ten years, I recognized that smell. I had arrived in Guatemala – more than 3,000 miles from Reno – and it was my first day of a week-long trip where I would be serving alongside physicians in low-income communities providing free medical care for residents. My name is Brittany Jemmoua, I am an occupational therapist at Renown, and I recently volunteered with Kalan Kuxtal, a non-profit Guatemalan organization. I served alongside physicians by providing free primary care mobile clinics and home visits. The care we provided focused on prevention, intervention, education and lifestyle/medication management as we partnered with local entities, such as fire stations, community centers and schools to transform hundreds of lives. Speaking in both English and Spanish, I collected patient intake information, performed exams, tested for diabetes, and collaborated on a diabetes research project focused on daily risk assessment. Beyond these tasks, I immersed myself in the culture and learned more from the Guatemalan people than I could have ever imagined. Similar to Renown, Kalan Kuxtal Operates with Community at its Core Kalan Kuxtal, a Mayan expression meaning “life guardian,” is different from other volunteer medical trip organizations, and I took home valuable insights and lessons from their way of life that I now consider daily in my practice at Renown. I expanded my knowledge about diabetes, hypertension, pharmacology, infectious diseases, pregnancy complication, vector-borne illness and tuberculosis. We conducted home visits for socially neglected populations rather than expecting everyone to come to our clinics. I found that being welcomed into people’s homes gives you a different lens in which to view how their medical diagnoses interact with living conditions, occupations, and quality of life. This is when I met Mercedes and her mom. Her mom, Ms. Valencia, had jaundice skin and a substantial Basal Cell Carcinoma aggressively protruding from her face that impacted eating, hearing, seeing, sleep and social interactions. This opportunity to serve within their home led to an important palliative care conversation that would have been missed had we stayed in the clinic. We combed the rural neighborhoods assessing people’s risk for diabetes, taking glucose tests and educating families about their next steps. Many individuals had uncontrolled diabetes and misunderstandings regarding basic health management strategies. At the end of the day, many people demonstrated feelings of empowerment by actively offering solutions regarding how they will manage their day-to-day glucose with diet and exercise. Small actions can lead to big changes, and in the long-term, these health actions can help them avoid medication costs and focus on affording basic life necessities, such as water and electricity. Kalan Kuxtal organized a cultural day that included going to local businesses and community leaders to learn more about how they support the people of Guatemala. For example, Valhalla Macadamia Farm’s main goal is to help communities gain access to income, employment, and improved wellbeing by donating macadamia trees to families to grow and then sell macadamia products. A Weeklong Trip with Lifelong Impacts Each patient made a lasting impact on me, both personally and professionally. One specific family I saw in the clinic had a unique situation in that their two-year-old daughter, Margareth Elizabeth Cifuentes Bautista, was laboriously diagnosed with irregular corneal syndrome associated with glaucoma of congenital origin. Due to Guatemala’s limited prenatal screens and interventions, Elizabeth is nearly blind. While highly spirited and happy, she trips, bumps and feels her way through life. One barrier to her healthcare access is that her hard-working parents remain well below the poverty line, making less than $900/month. I am working to connect them with generous US Ophthalmologists and pediatric eye specialists to explore how we might save her sight and help her family. Their biggest dream is that she could recover her eyesight. “I know that this is not a life-threatening situation, but it is still something that never stops hurting me,” Jorge Cifuentes, Elizabeth’s father, said. “Unfortunately, our situation here is very hard. This country [Guatemala], although beautiful, it is very difficult to get ahead. We are people living in underprivileged conditions which complicates our situation even more. However, we are still trying to thrive by being kind and hardworking people. Thank you for helping us.” I have had the privilege of an opportunity for education, access to healthcare, employment and am aware that inequity and injustice prevail. This experience reinforced my understanding that medicine is a physically and mentally demanding profession that requires a commitment to service, continuous learning and adaptation both on local and global scales. I encourage everyone to please join me in serving the underserved by volunteering. Brittany is an experienced Occupational Therapist at Renown and volunteers with Kalan Kuxtal and other entities, such as The Robert Unsworth Foundation and Rock Steady Boxing to elevate communities. She loves being an Occupational Therapist; however, her life experiences confirm that her true calling is to become a physician. She is currently applying to medical school. Brittany is eager to earn the responsibility to improve lives and communities as their engaged physician. Brittany is tentatively scheduled to return to Guatemala at the end of this year to continue partnering with the people for a better future. You are welcome to join!

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Don’t worry, there’s still time to enroll in a Medicare plan! You’ve probably noticed all the advertisements lately encouraging Medicare beneficiaries to enroll before AEP ends on Dec. 7. But what is AEP, and how can you ensure the best decision for Medicare enrollment? If you’ve been asking yourself this same question, you’re in the right place. Here we’ll explore some of the most important things you need to know before you choose your Medicare plan for 2023. What is AEP? AEP stands for Annual Enrollment Period, and for Medicare this takes place Oct. 15 – Dec. 7 every year. You might hear people refer to AEP as Open Enrollment or the Fall Enrollment Period. All Medicare beneficiaries can enroll during this time, and their new policy will take effect on Jan. 1 of the following year. If you’re already enrolled in Medicare Parts A & B, you can use AEP to enroll in a Medicare Supplemental or Advantage Plan. You can also choose to drop your Supplement or Advantage Plan and revert to traditional Medicare.

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Shining Brightly We all carry a light inside of us. Some people seem to have a constant glow while others flicker brightly here or there depending on what they’re doing or who they’re with. But for another select group, the light they embody is closer to a sunrise, illuminating and embracing everything and everyone it touches. Do you think that’s a bit heavy-handed or just a writer’s poetic exaggeration? Well, that’s because you haven’t met this issue’s featured Sterling Silver Club member, Tami, yet. But that’s about to change…  This Little Light of Mine  As an infant, Tami’s adoptive parents were drawn to her light, even though the couple had come to an orphanage in Washington state hoping to find an older child to add to their family.  “My parents always said that after seeing and holding me, they had to take me home,” Tami remembers and then smiles. “They also liked to tell the story of how they sold their prize baby bull, Johnny Apollo, to pay my adoption fees!”  Tami has fond memories of making mud pies and climbing trees as a child and feels privileged to have been raised by older parents.  “They both lived through the Great Depression and my dad proudly served in the U.S. Navy in World War ll,” says Tami. “I certainly attribute learning to love and give unconditionally through their humble ways. I had the honor of taking care of them both for about 10 years before their passing. When asked who my heroes are, though I have several, they are at the top of that list for sure.”  Today, Tami is married to her high school sweetheart, Richard. They’ve been together for 43 years and have five children – and 10 grandchildren – of their own.  Helping Others Through Darkness Tami started a highway construction business with her family in 2000, but focused 18 years of her career around her love of teaching, with seven years spent as Vice Principal of Academics at Reno Christian Academy. One of her greatest joys during that time was implementing Prime Time, a program that set aside special time for students who had experienced recent traumatic events. “I used puppets, sewing, crafts – any activity the students would respond to,” explains Tami. “But mostly, I listened.” And when one of her students shared, “I just want someone to listen to me for an hour today” – that’s what she did. “We sat on the sidewalk and ate Fudgsicles and giggled at the silliest things,” Tami recalls with some emotion. “And when we both left smiling, I was reminded that the most beautiful moments are when we are simply present with an open heart.”

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It’s July 23, 2022, and I am arriving in Downtown Reno to walk in my first-ever Pride Parade. Even more amazing, I am going to be walking with a group of my coworkers, announcing to our entire community that our employer supports us being our full and truest selves. I arrived alone, but in the staging area I met new people who worked in other departments of Renown, coworkers I might never have met if not for Pride. I even took a selfie with one of these new friends. Someone passed around flags for us to hand out to the audience as we marched by. I took a rainbow-striped temporary tattoo in the shape of the Renown “R” and used my water bottle to apply it. There was an overwhelming atmosphere of excitement and joy that can only come from gathering with other human beings who are overflowing with love. We started the Parade waving handfuls of Pride flags high and gave those flags out to the audience as we passed. By the time we were done walking, our hands were empty, but our hearts were full. I couldn’t have stopped smiling if I’d tried. I’d joined the parade as a single person, but as we walked, I became part of a community. Not only the Renown community, but a community of Proud queer people across northern Nevada. And by extension, the LGBTQIA+ community all around the world – past, present and future.  With the multiple recent state laws proposing to strip away the rights of LGBTQIA+ people, many of us have felt a noticeable decline in our mental health and feelings of personal safety.  As a member of the queer community, I have felt these mental health effects too. I am fortunate and privileged enough to not have experienced workplace discrimination in my current position. But before Renown, I – like so many others in the LGBTQIA+ community – had a negative experience at a previous job, and afterwards I was hesitant to share my full self while at work. To be able to walk in a Pride Parade with my current employer, healed a little bit of that past pain inflicted by my former employer.  When our liberties are under attack, Pride is more important than ever. We must remind ourselves, especially when others cannot seem to remember, that we are loved and worthy of love. I am grateful to work for an organization that is willing and able to fight this good fight with us.  I will certainly be back to walk in this year’s Pride Parade, and I sincerely hope to see you there too! Be sure to wear comfortable walking shoes, sunglasses and of course keep your skin safe with sunscreen. Whether you’re part of the LGBTQIA+ community, or just an ally, you are welcome.

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Giving birth expends as much energy as running a marathon. And just like you would only run a marathon with training beforehand, there are exercises you can do to prepare for birth. But instead of a coach, you'll have your birth team. Your birth team exists to help you navigate pregnancy and labor and support your choices. Let's say you've never put together a birth team before and are wondering where to start. Today we'll go over the three main positions to fill for your birth team's starting lineup. Birthing Person The birthing person is the leader of the team. After all, you can't have a birth team without someone giving birth. This person could be the baby's mother, gestational surrogate, birth parent before adoption, a transgender father or a non-binary parent. If you are not the birthing person, don't presume to know what the ideal labor and birth circumstances should be. And if you are the birthing person, don't allow anyone else to tell you what you want. This is your body and your birth; you are the boss in the birth room. Doula No birth team is complete without a doula, and although doulas have increased in popularity lately, many people still don't know what a doula is. Simply put, a doula is a birth professional – not a medical provider – who offers emotional, physical and informational support during pregnancy, labor and beyond. Most doulas' services include at least one prenatal visit and one postpartum visit, as well as continuous care throughout active labor. Some doulas provide more than one prenatal/postpartum visit, so be sure to ask what is included in their fee. Even if you have a partner who will support you during labor, studies have shown that a doula can significantly increase your likelihood of a positive birth outcome. Even the most supportive partner needs to rest, and a doula can ensure that you still get the care you need while your partner gets a break. Midwife or Obstetrician Finally, you'll want to choose the medical professional who will attend your birth. Many folks choose to give birth with the OB/GYN who does their annual check-ups, but there are many reasons someone might choose a different provider for their birth. The first step to finding the best attending provider for your birth is to decide which model of care aligns closest to your values and goals: the Midwifery Model of Care or the Medical Model of Care. .tg {border-collapse:collapse;border-spacing:0;} .tg td{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; overflow:hidden;padding:10px 5px;word-break:normal;} .tg th{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; font-weight:normal;overflow:hidden;padding:10px 5px;word-break:normal;} .tg .tg-gqvw{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-weight:bold; text-align:left;vertical-align:top} .tg .tg-8vim{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-size:18px; font-weight:bold;text-align:left;vertical-align:top} .tg .tg-qm8j{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;text-align:left; vertical-align:top} .tg {border-collapse:collapse;border-spacing:0;} .tg td{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; overflow:hidden;padding:10px 5px;word-break:normal;} .tg th{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; font-weight:normal;overflow:hidden;padding:10px 5px;word-break:normal;} .tg .tg-gqvw{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-weight:bold; text-align:left;vertical-align:top} .tg .tg-8vim{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-size:18px; font-weight:bold;text-align:left;vertical-align:top} .tg .tg-2rvk{background-color:#ffffff;color:#000000;font-family:Arial, Helvetica, sans-serif !important;text-align:left; vertical-align:top} Midwifery Model of Care Medical Model of Care Philosophy Birth is physiological. Birth is potentially pathological. Interventions Medical interventions can cause more complications, and therefore are only used as needed. Medical interventions should be used, even in non-emergency situations and sometimes as preventative measures. Decisions Birthing person is the key decision maker. Medical professional is the key decision maker. Provider’s Role Providers monitor labor and will intervene or transfer to hospital if needed. Providers assess and control the birthing process.

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If you’re expecting a new baby, you may have been given the advice to hire a doula. You may have seen statistics of improved outcomes among those who’ve had a doula attend their birth. Perhaps you’ve heard that the etymology is from the Greek word meaning “to serve.” But how does a doula serve their clients? A doula is a non-medical birth professional who will guide you through labor, birth, postpartum and beyond. Your doula can discuss your options with you so you can make informed decisions, as well as provide emotional and physical support to ease your experience. While each doula offers their own style, there are certain services that most doulas will provide for their clients. Typically, a birth doula will provide at least one prenatal visit, one postpartum visit and continuous support during active labor. A postpartum doula usually provides support during the 12 weeks immediately following birth, sometimes referred to as the “fourth trimester,” but some will continue care after that as well. Simply put, a doula provides informational, physical and emotional support during the childbearing year(s). Let’s take a closer look at these three ways a doula can support you. The Basics If you don’t know your options, you don’t have any. This is a common phrase in the world of birth work. When you’re in labor, you’re exhausted, in pain and there’s often urgency inherent or implied in any choices you make. So, when an intervention is offered, many birthing people accept it without question. One method that can help the decision-making process is to check your BRAIN: Benefits: What are the benefits of the proposed intervention? Risks: What are the risks of the proposed intervention? Alternatives: What are the alternative options? Intuition: What does your intuition tell you? Nothing: What if we do nothing? What if we wait? When you’re in active labor, you might have difficulty remembering this acronym; that’s where your doula comes in. At your prenatal visits, you can ask your doula for guidance in preparing your birth plan, which can include contingencies for certain potential interventions. And as choices arise during labor, your doula can guide you through the benefits and risks and can provide you with alternative options you might not otherwise be aware of that are available to you. Your doula can remind you to check in with your intuition and can help you quiet your mind so you can listen to your instincts. The Body Although we tend to see depictions of people giving birth on their backs with their feet in stirrups, this is only one of many ways to give birth. Walking and dancing can speed up early labor. Side-lying or hands-and-knees can prevent tearing during the pushing stage. Sometimes labor stalls, and a change of position is often helpful to get things moving again. Your doula can suggest positions depending on your stage of labor. Some labor positions might require the support of another person – your doula could fill this role or assist your partner in doing so. Some doulas also provide massage or even acupressure, and most will do the “hip squeeze” that so many laboring people swear by. If your baby is presenting posterior, or “sunny side up,” your doula can apply counter pressure to alleviate back pain during labor. Some postpartum doulas will do light housework while you rest and bond with your newborn. Others might care for your baby through the night so you can catch up on sleep. Many doulas have also gone through additional training to offer breastfeeding support and may be able to assist you with latch issues and nursing positions. The Mind Pregnancy, birth and postpartum periods can be some of the most emotional times in a person’s life. A doula will hold space for you and help you process your emotions before and after birth. It’s normal to feel apprehensive, or even fearful, about labor and birth, and discussing these feelings is the first step. A doula can help you navigate your concerns in a safe space so you can be prepared emotionally for your upcoming labor. Many doulas will also guide you through writing your birth plan, which can lessen anxiety about the unknown. If you have a history of trauma, your doula can assist in communicating this, so you don’t have to relive the experience every time you meet a new medical provider. Most people will experience some form of what’s often called the Baby Blues in the immediate postpartum period. The third day after birth tends to hit hard, as hormones attempt to regulate, but the Baby Blues can continue for weeks for some new parents. A postpartum doula’s support can be incredibly valuable during this time. When the baby blues last longer than a few weeks, it could considered a mood disorder. Most doulas will recognize signs of postpartum mood disorders and will have resources available for additional support. Choosing the Best Doula for You With so many wonderful doulas in northern Nevada, you might wonder how you could ever choose just one to attend your birth. Some expectant parents are unfortunately restricted by cost. With so many expenses related to a new baby, it can be difficult to budget doula services as well. Thankfully, Nevada Medicaid now covers doula care, and some commercial insurances are following suit. Check with your insurance company to find out if they might cover part of the cost for hiring a doula. If your insurance doesn’t cover doula services, some doulas offer a sliding scale based on income. You may want to interview multiple doulas to find the right one for you. If you’re the kind of person who wants all the information you can get, a more detail-oriented doula might be the best choice. But if you tend to feel overwhelmed by too many options, you might prefer a doula who only offers additional information as the situation calls for it. If you want massage or acupressure during labor, you might want to hire a doula with those certifications. Or maybe informational and physical support are not as important to you as emotional support, in which case your best choice could be a doula who has experience with postpartum mood disorders or trauma support. Regardless of who you hire, be sure to clearly communicate your desires and expectations – not just for your birth, but also for your doula. The most important thing when choosing your doula is trusting your gut. You need to feel comfortable with your doula, as they’ll be tending to you at one of the most vulnerable times in your life. When you find a doula that you click with, who listens to you and supports your choices, you have found the best doula for you.

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