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Medical emergencies like strokes and heart attacks still happen, even in a pandemic. That’s why Renown Health is always ready to provide emergency care to patients in need, and being admitted at Renown does not put patients at risk of getting COVID-19. When to Get Emergency Care Resources like Renown Virtual Visits have allowed us to stay home while making routine visits with our primary care physician. But, if you are feeling any of the following symptoms, please call 911 or have someone you know take you to the emergency room. Symptoms that may require emergency care: Heart attack Stroke symptoms Difficulty breathing Chest pain Seizure Sudden loss of consciousness Severe abdominal pain Serious allergic reaction Fighting the Good Fight for Our Patients Renown Health provides a clean and safe environment 365 days of the year, 24 hours a day. Alongside regular sanitation practices, Renown is dedicated to protecting patients from infectious disease while providing emergency care. Staff, Care Providers and Visitors Wear Masks Every staff member, care provider and visitor is wearing a mask. Additionally, providers are following guidelines from the Centers for Disease Control (CDC) on wearing protective equipment, such as masks and gloves. Respiratory Illness Screenings for Everyone Care providers and staff members are participating in respiratory illness screenings. Therefore, any care provider or staff member with a fever, cough, difficulty breathing or severe respiratory illness is not on a Renown campus. Visitor Restrictions are in Place Visitor restrictions are in place to prevent the spread of infectious disease by practicing physical distance. Because of these restrictions, Renown is only allowing one visitor per patient for with extenuating circumstances. Staying healthy and safe means caring for yourself in emergency situations, too. Please do not hesitate to call 911 when you or a loved one are in need of emergency medical care. Virtually Visit a Renown Urgent Care Login to MyChart to “get in line” for a virtual urgent care visit between 8:30 a.m. to 10:30 p.m. Monday-Friday and 9:30 a.m. to 4:30 p.m. Saturday and Sunday. Login to MyChart

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Something wasn’t right. Even though it was the holiday season, on December 23, 2018, Mondo Corona didn’t feel good…not to mention his sudden earache. Although Christmas was a happy celebration with his family. He still felt tired. Was it the flu? And that darn earache wouldn’t go away. On that cool winter day, Mondo could not imagine he was near death. Or that he would become a heart attack survivor. Know Your Heart A few days later, on December 27, he wasn’t feeling any better. He decided to go to the emergency room at Renown Regional Medical Center. That’s when a simple blood test revealed shocking results. “I thought about death a lot. I was calling people to ask them to help take care of my family if I wasn’t going to be here anymore,” he emotionally confesses. Although Mondo loves his job as a railroad engineer, it involves on-call shifts and an erratic sleep schedule. At that time his exercise and eating habits weren’t the best either. Yet he never imagined he would have a massive, often lethal, type of heart attack called ‘the widowmaker.’ In fact, his family had been concerned about his health for awhile. “He worked so much and he didn’t take care of himself and he didn’t exercise – he was burning the candle at both ends,” shares his wife, Alison. His daughter Justice, an avid exerciser, was always encouraging him to join her at the gym, but could never quite convince him. Mondo remembers the time before he became a heart attack survivor. “I didn’t have any exercise whatsoever in my life. At that point my eating habits were just terrible,” he shares. He went to the emergency room due to his earache, but nothing was found until one of the doctors ordered some tests. Specifically blood work showed high troponin levels. Troponin is a blood protein often released in large amounts when the heart muscle has damage, sometimes by a heart attack. Heart Attack Survivor “My surgeon came in and told us that it was going to be a triple bypass – that three of the four…major arteries were clogged 100 percent,” Mondo explains. Amazingly his heart was pumping on only 10 percent blood flow. Heart surgeon, Joseph Brandl, MD, told him he survived a widowmaker heart attack. This type of heart attack happens when there is a 100 percent blockage in the critical left anterior descending artery (LAD) of the heart. Frequently the symptoms can often be mistaken for the flu. According to the Centers for Disease Control and Prevention (CDC), every 40 seconds a person in the U.S. has a heart attack. And 1 in 5 heart attacks are “silent” – meaning you can be a heart attack survivor, but not know it. For Mondo’s children, seeing their strong father struggle after heart surgery was difficult. Justice tearfully shares, “It was really hard seeing him so vulnerable. He really needed anybody’s and everybody’s help at that point.” A Heart Attack Survivor Program After leaving the hospital on January 5, 2019, he was extremely weak. On February 12, Mondo began Renown Health’s Intensive Cardiac Rehabilitation (ICR) Program called the Healthy Heart Program. This program, requiring a doctor referral, includes 12 weeks of supervised exercise along with nutrition education and stress management skills. In spite of heart disease being the leading cause of death in the U.S. – more than all cancers combined, the risk can be lessened with daily lifestyle habits. Mondo credits the ICR program with motivating him and getting his focus back on his health. He saw the team members setting an example and also caring about his health. He describes one of his favorite recipes, “In ICR Sara showed us how to make this incredible fruit salad, with jicama, watermelon, grapes, oranges, red onion, and ginger!” Of course, the recovery process was not overnight. “It did take a long time to really realize that he was going to be back to normal, that he was going to be okay and that he was going to be that strong provider for me and my children,” Alison reflects. “Mondo’s had an amazing outcome and he’s not limited in his activities at all and should hopefully have a life that’s not limited at all from heart disease as we’re monitoring everything and everything’s looking good,” reports his heart doctor Jayson Morgan, MD. Mondo describes his care experience being a heart attack survivor as life-changing. “The care teams at both Renown and ICR were incredible. There wasn’t a single person we came across who didn’t immediately become a part of the family. They truly cared for us, all of us, including the extended family that came to visit. They were informative and supportive. I felt like I created lasting bonds with so many of them, especially the gang in ICR. What amazing people.” Lynice Anderson, Director of Intensive Cardiac Rehab, Healthy Heart Program, shares,” Mondo is one of the most genuine, thoughtful and humble people I have ever met. His love for his family is palpable. His impact on me personally and our team is forever.” She acknowledges family support is key to his success, “Mondo’s family is his rock and they are his. I have never met a family that was so ‘all in’ in the support of their loved one. His new heart healthy lifestyle is modeled through his family every day.” Fighting The Good Fight Of course, Mondo may look familiar to you. That’s because he is featured in Renown Health’s “Fight The Good Fight” brand campaign. For this reason, you may have seen him in advertising working out on a treadmill, shirtless, with his open heart surgery scar in full view. When asked how he feels about showing his scar he confidently says, “I don’t mind showing it to people. I don’t. I earned that scar.” He is a proud heart attack survivor. Today, he’s grateful to be alive and takes his health commitment seriously. “Things have a different feel now. The skies and lakes are bluer and the trees greener. My family is so much more a part of my day. We go on so many more outdoor adventures, trying to incorporate a little exercise into our fun. We watch what we eat more and are trying to teach our children and loved ones about healthy choices. And I think with a few we’ve even been successful!” he observes. “Don’t take life for granted.” “Unconditional love. I get nothing but support from my family without them I wouldn’t be where I’m at. What happened to me definitely makes me a fighter for sure. I’m fighting for my life – the good fight – I think life is good,” he adds.

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Even when fires burn outside our area, the air quality in the region can reach dangerous levels. Our expert explains how to maintain your lung health when fire season strikes. It’s a sight we know all too well as northern Nevadans — a hazy or thick layer on the horizon when smoke rolls in from nearby fires. Sometimes the smoke is more evident than others, but it’s important to remember, even when the smoke may not be as visible across the valley, it still impacts our air quality. The last week or so, our air quality has been in the “unhealthy for sensitive groups” range, which can be dangerous for people who are sensitive to air pollution. Air Quality Changes: Who’s at Risk? Renown Pediatric Pulmonologist Sonia Budhecha, M.D., explains certain people are especially at risk when smoke moves in: Older people, whose lungs are not as healthy as they used to be Young children, whose lungs are still developing People with heart and lung disease including asthma, COPD and emphysema “Smoke and haze from fires carry particulates that can get into your respiratory system and eyes, which can be a danger for all ages,” Dr. Budhecha says. How You Can Protect Yourself Until the smoke clears and the air returns to the “good” range, it is best to follow these tips to protect yourself and your family: Stay indoors and keep windows closed Turn on the air conditioning to recirculate clean air Drink plenty of fluids to help your body flush out any toxins you inhale Additionally, all community members should reduce their physical activity and try to prevent heavy exertion outside. If you or a loved one has a heart or lung disease, avoid physical exertion altogether because smoke can aggravate these conditions. “People with heart disease may experience shortness of breath, chest pain, palpitations or fatigue,” Dr. Budhecha says. “People with lung disease may also have shortness of breath, chest discomfort, wheezing, phlegm or a cough.” Smoky Signs and Symptoms Smoke can also impact healthy people — irritating your eyes, nose or throat. And in some cases, inhaling smoke can lead to bronchitis. When haze moves into our area, keep an eye out for these symptoms: Burning or stinging eyes Runny nose Cough or scratchy throat Headaches Wheezing Shortness of breath Difficult taking a full breath Chest heaviness Lightheadedness Dizziness If experiencing any of the above symptoms, seek medical attention or call your doctor for advice. Sometimes, these symptoms do not appear for as long as 24 to 48 hours after smoke inhalation. For those that have pre-existing lung or heart conditions, consult with a health care provider on action or management plans. To schedule an appointment Visit Renown Pulmonary Medicine, or call 775-982-5000. Understanding Our Air Quality The Air Quality Index (AQI) is broken down by large (PM10) and small (PM2.5) particulates. According to Dr. Budhecha, large particulates are usually ones that can be seen and smelled. They can damage your eyes and nose but don’t often get deep in the lungs or blood vessels.   “The more dangerous ones are PM2.5, which can’t always be seen or smelled,” Dr. Budhecha says. “Any time the AQI is above 51, children with lung or heart disease should not be outdoors.” For the latest air quality update in your area, visit AirNow.gov or call (775) 785-4110.

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It seemed like a normal Wednesday, except Kimi Woolsey was feeling really stressed. On Sept. 4, 2019 she was rushing to get ready for an appointment when suddenly, she could not feel her legs. Kimi immediately knew something was wrong and called out to her fiancé, Paul, for help. After seeing a bright light in her right eye, she felt a severe, sharp pain in her head traveling down into her leg. Paul quickly called 911, the EMT’s arrived and her stroke survival journey began. At first the medical team thought she had a complicated migraine, but one of them suspected a stroke. On the way to the hospital Kimi felt numbness and her face drooping, then instantly, no pain. For a moment she thought she was dying, going from pain to numbness and realizing she couldn’t move or speak. Kimi didn’t know she was having another massive stroke in transit. Each year nearly 800,000 people in the U.S. suffer a stroke, or “brain attack” – that’s one every 40 seconds. Of those, about 75% occur in people over age 65. However, at only 45 years old, Kimi is proof that a stroke can happen at any age. Stroke Survival Begins for Kimi Upon arriving at the emergency department of Renown Regional Medical Center the Certified Comprehensive Stroke Center team went into action. Kimi received a brain MRI, then was wheeled into surgery for a thrombectomy (clot removal). She was in the intensive care unit for 11 days. She remembers someone telling her, “Generally people don’t survive this magnitude of stroke.” And a doctor saying, “You are here for a reason.” Kimi’s comeback journey began with the comprehensive care team at Renown Rehabilitation Hospital. “Literally I had the best day of my life that first day there…I was so happy because I couldn’t imagine being in a safer place with people that literally live for you,” she recalls. During her 41 days there, her biggest milestone was being able to get out of bed and walk. For Kimi the support she felt at the rehab hospital was key to her progress, ”I still feel loved and appreciated and they’re rooting for me still and I can feel it.” Although she left the rehab hospital on Oct. 18, 2019, she is still working on improving the left side of her body. Currently Kimi works with therapists in outpatient physical rehabilitation sessions, continuing to see improvement in both her hand and leg. Her advice to those currently in a rehab hospital setting is, “Stay as long as you can to get the most out of it and push, push, push.” Kimi’s Stroke Survival as a Warrior “Having a stroke is not for the faint of heart,” says Kimi. She experienced despair and felt discouraged. Many days she would ask herself, “Why am I here?” Today she proudly calls herself a stroke warrior and refuses to be a victim of her stroke. Alongside her tenacious spirit, Kimi actively helps others on their stroke survival journey. Before her stroke she never dreamed of starting a non-profit foundation. Now, each day you’ll find her texting inspiration to others, offering advice and connecting with other struggling stroke survivors on her Facebook page, Stroke Warrior Recovery Coach. Her goal is to become the person she needed to talk to after her stroke; she currently coaches several stroke survivors. “Stroke survivors need to know that they aren’t alone. Mental support and encouragement are so important for each person’s stroke journey,” Kimi said. Along with the physical changes, Kimi feels the stroke magnified her empathy. “I was always in a hurry in my life. People didn’t go fast enough for me – on the road, at the grocery store, in a line. Now I have more patience with myself and others." Kimi realizes most people cannot wrap their brain around the concept of a stroke. In fact, the brain fog, physical challenges and frustration are hard to explain… unless you’ve experienced them. “You need to find your tribe,” she explains. “I have a passion for helping people through this process.” Most of all, she encourages people to keep going and never stop. After her stroke, Kimi has a greater appreciation for her family, health and life. She is one of the patients featured in the current “Fight The Good Fight” trauma and physical rehab advertising campaign. “I wake up every day and fight,” she asserts. “Each day you have to fight for your recovery and fight for yourself.”

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In recent years, healthcare has undergone many important transitions. One of the greatest changes has been the transition from a fee-for-service model to a value-based care model. Historically, healthcare organizations were paid for the amount of services they performed. This payment model resulted in more tests and procedures ordered, which, in turn, increased our country’s health care costs. However, now our government incentivizes health systems to provide the highest quality of care at the lowest cost possible. This new payment model is called value-based purchasing or value-based care. In this model, providers focus on delivering more coordinated and effective care. Additionally, healthcare organizations track important metrics like patient engagement, population health, and hospital readmissions. At Renown Health, we know that progress on these metrics represents real improvements in our patients’ lives. Shifting Focus from Illness to Wellness Healthcare organizations have traditionally viewed a hospital stay as the center of a patient’s wellness journey. At Renown Health, we believe a key part of our job is to help people live well every day. This means we focus not only on treating illness and injury but also on prevention efforts to keep people out of the hospital. For example, our employees help patients hazard-proof their homes to prevent falls, as falls are the leading cause of injuries in older adults. We also provide affordable health screenings to catch disease in its early stages, when it is more treatable. Renown Health also recognizes that many of the diseases our patients face – from diabetes to cancer – have social and environmental origins. We know that creating a healthier community will have a positive impact on their physical and mental health. Renown Health partners with local organizations to address community-based issues like addiction, pedestrian safety, air and water quality, climate change, and nutrition. Working together, we can lower the number of people who need care and improve the health and wellbeing of our community. Creating healthier environments and communities will help us prevent disease, which in turn will help us decrease spending and improve health. Most importantly, it will help people live up to their full potential. Dr. Slonim on Twitter | @RenownCEOTonyMD Interested in hearing more of Dr. Slomin’s thoughts on health and healthcare? Engage with him on Twitter. Follow Tony

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Can you really avoid colds, flu and viruses with simple hand-washing? Amy McCombs, Renown’s director of Infection Prevention, shares how to stay healthy with this very simple practice. Shaking hands, turning doorknobs, drafting emails — all regular activities of everyday life. But whenever you touch another person, or touch an object another person has touched, you’re collecting their germs on your hands. And touching your own mouth, eyes or nose also exposes you to whatever germs you’ve collected. That makes hand-washing the most important step you can take to prevent illness and disease. And while that may seem like an obvious reminder, studies have found that 85 percent of people do not practice proper hand hygiene. We asked Amy McCombs, Renown’s director of Infection Prevention, to give us some hand-washing tips for a safer, healthier life. So what are the correct hand-washing steps? Wash for at least 20 seconds. The biggest thing to remember is to wash for at least 20 seconds with soap and water. A good rule to make sure you’re washing long enough is to sing “Happy Birthday” twice through. Get a good lather of soap going. It’s also important to get a nice lather of soap and make sure you wash between your finger, both the tops and palms of your hands and your nail beds. And if you wear jewelry, you need to remove it or make sure you get lather and friction underneath. Then rinse completely and dry. Is there a wrong way to wash your hands, or is it more about making sure you do it the right way? Honestly, it’s a little bit of both. There is a wrong way since 85 percent of us don’t wash correctly. This could be for a variety of reasons. It could be because you don’t wash long enough, don’t get in between your fingers, don’t clean your palms or don’t clean the tops of your hands. How frequently should we wash our hands? Are there certain times where it is more important than others? As most of us are taught as kids, you need to wash your hands before you eat or prepare foods, after you touch raw produce and meat and after you use the restroom. You should also wash your hands after sneezing or coughing, touching your eyes, nose and mouth or coming in contact with someone who is sick. Do you recommend hand-washing over hand sanitizer? Ideally, you should wash your hands instead of using hand sanitizer, but if sanitizer is all you have, then use it. Alcohol-based hand sanitizers are best. Use about a nickel or quarter size and vigorously rub the tops of your hands, palms and in between your fingers until the sanitizer is completely dry. Remember that if your hands are physically dirty, or if you’ve come in contact with bodily fluids, you should thoroughly wash your hands with soap and water instead of hand sanitizer. Does washing your hands really prevent illnesses like the cold, the flu and viruses? Definitely. The CDC recommends hand-washing as one of the best ways to avoid getting sick and spreading illness. Hand-washing has been shown to reduce the number of people who get colds and respiratory illnesses by 21 percent. What else can I do to keep my family healthy? The annual flu vaccine is truly the best form of protection to help prevent the spread of the flu. Even if you do get the flu after being vaccinated, your symptoms will be lessened. Although they are not substitutes for the flu vaccine, simple preventative action can do a lot to help slow the spread of the virus, including these: Wash your hands often Avoid touching your eyes, nose or mouth with unwashed hands Avoid contact with people who are sick Stay home when you are sick Cough or sneeze into a tissue or your sleeve Other precautionary measures include cleaning shared spaces and avoiding shared utensils and drinks. Flu vaccines are still available in the community, including health providers at Renown Medical Group. Call 775-982-5000 to make an appointment. More Hand-Washing Information One of the best things you can do to avoid viruses, colds and the flu is to wash your hands. Protect yourself with even more hand-washing advice from the Centers for Disease Control (CDC). Roll Up Your Sleeves and Scrub Up!

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With more than 29 million adult Americans having high cholesterol, it’s important to know the facts. We asked Jayson Morgan, MD, a cardiologist with Renown Institute for Heart and Vascular Health, explains the numbers, the risk factors and how to maintain healthy levels. What is cholesterol? There are two types: Low-density lipoprotein (LDL) cholesterol, also known as the “bad” variety, because it can eventually build up within the walls of your blood vessels and narrow the passageways. High-density lipoprotein (HDL), also known as the “good” variety, because it helps remove other forms of cholesterol from the bloodstream. In adults, total cholesterol is considered high if it is more than 200 mg/dL. If the total is more than 200 or if high-density lipoprotein (HDL) levels are less than 40, your heart and brain may not be getting as much oxygen-rich blood as they need. This puts you at greater risk of heart attack and stroke. HDL levels greater than 60 mg/dL can actually lower your risk. What are the risk factors for high levels? Diet high in saturated fat Excess body weight Lack of exercise Smoking Family history Age (as people age, they are more prone to high levels) How often should someone get their numbers checked, and what kind of test is done? The American Heart Association recommends all adults age 20 or older have their cholesterol checked every four to six years. Those with cardiovascular disease or who are at higher risk of it may need their levels and other risk factors assessed more often. Your primary care provider can perform the test, along with assessing your other risk factors to help determine a treatment plan if necessary. The test will likely be one you will need to fast for, meaning no food, beverages or medications for around nine to 12 hours. Your healthcare provider will let you know if, and for how long, to fast. A simple blood test is all that’s needed to get your levels. What are some ways to lower “bad” cholesterol and raise “good” cholesterol? To achieve healthier levels, people should: Eat a heart-healthy diet: Choose healthier fats, eliminate trans fats, eat foods rich in omega-3 fatty acids and increase soluble fiber. Increase physical activity: Exercise on most days of the week. Quit smoking: If you smoke, it’s time to stop. Quitting smoking will improve HDL “good” cholesterol levels. Lose weight: Losing as little as five to 10 percent of your weight can improve cholesterol levels. Drink alcohol only in moderation. And finally, if lifestyle changes aren’t enough, your care provider might recommend medication to help lower your numbers. Renown Institute for Heart & Vascular Health For optimal heart health, the American Heart Association encourages you to “Know Your Numbers” which include: blood pressure, body mass index (BMI), cholesterol and fasting blood sugar, by scheduling a visit with your doctor. These numbers are critical in assessing your current risk for heart disease and stroke. Find a Cardiologist

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At Renown Health, we often discuss the importance of both healthcare – how we treat people when they are sick or injured – and health – how we keep people well in their mind, body and spirit. This conversation is as important for the patients we serve as it is for our healthcare providers.   It’s well known that the medical field can impose challenging and even unhealthy expectations for healthcare workers. Long hours and physically and emotionally demanding work can lead to burnout. Yet, until recently, these issues were rarely discussed openly. Because the role of healthcare providers is to care for other people, they may feel uncomfortable asking for help themselves. The good news is that more and more physicians and professional associations are talking about burnout. Hospitals are also taking action to address concerns like mental and emotional fatigue. We need our workforce to be healthy in mind, body and spirit. That’s why we support our team by educating them on the warning signs of burnout. Renown Health also trains management-level employees to care for those who need help. We encourage employees to talk openly about these challenges and encourage them to access the many services available to our employees that can help them live well. Caring for people is central to Renown Health’s mission. We believe this applies to both our patients and our teammates.

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