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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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COPD (chronic obstructive pulmonary disease) is a progressive lung condition often mistaken for typical aging signs, like shortness of breath and coughing. While smoking and pollution can contribute to its development, lifestyle changes and medications can help manage its progression. Diagnosis typically involves lung function tests, chest X-rays, or CT scans, with treatments available through a pulmonologist or primary care provider. Renown’s Pulmonary Rehabilitation Program offers insights into living with COPD. What is COPD? According to the COPD Foundation, it is an umbrella term used to describe progressive lung diseases including: Emphysema: Damage to the small air sacs in the lungs (alveoli). Chronic Bronchitis: Irritation and swelling of bronchial tubes, causing shortness of breath and coughing for long periods of time. Asthma (non-reversible): When asthma medications cannot reduce swelling in the airways. COPD Risk Factors Smoking is the most significant COPD risk factor, and the American Lung Association (ALA) says it accounts for nearly 90 percent of cases. If you are a smoker, it is essential to seek help and quit. Other COPD risk factors include: Air pollution Genetics Second-hand smoke Chemical, fumes or dust in the workplace How Can You Protect Yourself?  Stop smoking Renown Health provides support offering 4-week Smoking Cessation Virtual Classes, free of charge! Sign up today. Use natural cleaning products Many household chemicals, especially those containing bleach, can irritate the lungs – a condition called, chemical pneumonitis. Stay away from all types of smoke This includes smoke from fireplaces. Likewise, plan to stay indoors when it is smoky outside, or air quality is poor. Get active Of course, it’s never too late to start an exercise program. When exercising your heart pumps, circulating your blood and sending oxygen to every part of your body. Notably it strengthens your lungs, making it easier to breath. Talk to your doctor to see if you are healthy enough to begin exercising. Eat a healthy diet Surprisingly what you eat can affect your breathing. The American Lung Association encourages those with COPD to watch their sodium intake, eat smaller, more frequent meals (instead of three large ones), limit high fat foods and drink plenty of water. Avoid scented products Perfumes, aerosol sprays and plug-in air fresheners can trigger flare-ups. Get a flu shot Did you know chronic lung conditions, as well as, heart disease, cancer and diabetes, can be made even worse by the flu? Now is the time to get your flu shot for the season if you haven’t already. Renown’s Pulmonary Rehab staff is certified through the American Association for Cardiovascular and Pulmonary Rehabilitation (AACVPR).  Recently, Renown Regional Medical Center successfully completed a disease specific COPD certification survey by The Joint Commission. For two accreditation cycles in a row, the COPD Program has had zero findings during the rigorous survey.

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In the United States, electronic cigarettes are the most popular form of tobacco product used among high school students. Approximately 21% of Washoe County area high schoolers report current use of e-cigarettes, higher than the national average of 14% reported in the most recent national data. While often viewed as a safer alternative to traditional cigarette use, e-cigarette use, commonly referred to as vaping, exposes users to nicotine and harmful chemicals that stunt brain development, results in lung damage and harms overall health. In partnership with Reno area school principals and nurses, the Renown Health – UNR Med Clinical Research Office was able to provide this year’s World Lung Day Anti-Vaping Program to Galena High School, Robert McQueen High School and Sage Ridge School, reaching hundreds of high school students.

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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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June offers an official welcome to summer and the height of outdoor activities in northern Nevada such as hiking, camping, days spent at the lake and embracing long days and warm evenings with friends and family. Enjoying all that the summer season has to offer may not be as easy for those living with chronic obstructive pulmonary disease, or COPD, which effects more than 15 million Americans. What is COPD? COPD is a group of lung diseases including emphysema and chronic bronchitis that result in airflow blockages from the lungs. People may experience frequent coughing and shortness of breath among other symptoms. COPD typically impacts adults ages 65 and older and is becoming increasingly more common among women. Although smoking plays a key role in the development of COPD, air pollution and indoor air quality, and respiratory infection also contribute to disease development. While there is no cure for COPD, limiting progression of disease and managing symptoms can be achieved through lifestyle changes, therapy, and medications. Tips for Living with COPD This Summer, and Always Stay Hydrated: Staying hydrated is extremely important for people with COPD, especially during the summer. Not drinking enough water can make breathing more difficult because it increases respiratory symptoms. Make sure to always keep a water bottle with you and aim to drink 8-10 glasses of water daily. Be Mindful of Temperature: COPD symptoms can be exacerbated by hot weather. It is best to participate in outdoor activities during the cooler times of day, like the morning or evening. Check Air Quality Before You Go: Before engaging in outdoor activities, be sure to check the air quality index and plan your activities accordingly. Pace Yourself: Exercising can be difficult for people who have COPD. To make the most of your summer, try not to push yourself too hard and take breaks when you need them. If you start to feel out of breath or tired, take a break in a cool, shaded area until you feel better. Take Matters Into Your Own Hands To address the needs of community members living with COPD, the Renown Health Research Office has teamed up with Pulmonary Medicine to provide patients who are former or current smokers and have a history of frequent exacerbations with an option to participate in the ARNASA study. "COPD exacerbations have a huge negative impact on patient’s lung function” states Dr. Farah Madhani-Lovely, Chief of Pulmonary Medicine at Renown Health and Assistant Dean of Clinical Research at the University of Nevada, Reno School of Medicine. “We have had inhalers and prednisone for decades but patients are still having exacerbations. Now we have a new pathway we think will prevent exacerbations which is what this clinical trial is designed to prove.” This study will evaluate the efficacy and safety of astegolimab compared with placebo in participants 40-80 years of age with COPD. “This study in particular is so exciting because of the enthusiasm from the sponsor’s end” says Katie Buckley, Lead Clinical Research Coordinator working on pulmonology studies at Renown’s Clinical Research Office. “Often times sites aren’t assigned particularly passionate or engaged personnel who aid in carrying out these studies, but you can tell Roche Genentech’s team truly cares about the success of the study, the safety of their participants, and proving the efficacy of the investigational agent. Working on a study like this takes a village, and when the individuals on all ends share similar mindsets and work towards success as a collective unit instead of as individual moving parts, it’s amazing to see everything we’re able to accomplish.” Renown’s team of expert pulmonologists and researchers are available to join patients with COPD in support of their healthcare journey. If you are interested in learning more about this clinical trial option at Renown Health, talk to your pulmonologist at your next appointment or contact us at 775-982-3646. At Renown Health, our goal is to make it easy for patients to access clinical research as a care opportunity where patients can access a variety of standard care treatment options for their health condition or choose to participate in a clinical trial. For more information about clinical trial opportunities available to you or to ask any questions, contact the Renown Research Office at Renown-CRD@renown.org or 775-982-3646.

Read More About Living with COPD? How to Maximize Your Summer Experience

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.

Read More About Your Top 5 Questions about TAVR Answered

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!”

Read More About Department Spotlight: Surgical Preadmission

According to the Centers for Disease Control (CDC), e-cigarette use isn’t just up among adults, but it has also tripled in usage for teens. Dr. Jose Cucalon Calderon, a Pediatrics Physician at Renown Health and an Assistant Professor of Pediatrics at the University of Nevada, Reno School of Medicine, provides helpful insight into e-cigarettes and the dangers it poses to kids and teens.   What Are E-Cigarettes? E-cigarettes are electronic nicotine delivery devices. e-cigarettes use liquid nicotine as an alternative to traditional smoked cigarettes. e-cigarettes contain nicotine which is an addictive substance with known toxic side effects that, when released in very high doses, that can have health consequences and causes addiction. Nicotine is described as “toxic,” but the most "toxic" part of e-cigarettes' is everything else within the E-juice. Nicotine mainly keeps people coming back for more. According to the CDC, e-cigarettes are also advertised using the same themes and tactics that have been shown to increase youth use of other tobacco products, including cigarettes. In 2021, approximately 76% of students reported exposure to tobacco product marketing through traditional sources, and approximately 74% of students who used social media had seen e-cigarette–related content. What Does This Mean for the Health My Teen? We know that nicotine can affect brain development in kids and teens, so it is important to educate your teen on the risks of exposure. If you have young children in the home, it is important to be vigilant as well. One teaspoonful of liquid nicotine can be fatal for a young child. How Do I Monitor My Teen for E-Cigarette Use? Monitoring your children can be tricky for parents. E-cigarettes can be harder to detect, unlike traditional cigarettes that were easy to detect by smell and residual odor. E-cigarette use, or “vaping,” is often associated with a dry cough or chronic throat/mouth irritation. Overall, increasing research shows strong links between mental health conditions and posterior combustible tobacco use along with increased risk of marijuana use. Nicotine is addictive, but it does not cause altered mental status like the other drugs of abuse can. All parents are strongly encouraged to talk to their children about the potential dangers of e-cigarettes.   What are the health risks of vaping? Vaping devices have been on the market for a relatively short period of time, with evidence-based health effects and complications still being discovered. Vaping effects poses many harmful risks to children and teens. The risks of vaping include: Chest pain Difficulty breathing Dizziness Headaches Impaired response to infection in the airway Inflammatory problems of the airway Nausea Nicotine addiction Seizures Vomiting   For more information for both parents and teens about quitting smoking or vaping, you can click here. Parents can also use this tip sheet from the U.S. Surgeon General to talk to their child about vaping. The Substance Abuse and Mental Health Services Administration free national helpline number is 1-800-662-4357 (HELP). It is available 24/7, 365 days a year offering confidential treatment referral and information (in English and Spanish). If you or someone you know is facing a substance (or mental health) problem, please reach out to them.

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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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In this article reprinted with permission from the Galena Times,  Dr. Max J Coppes, Physician-in-Chief, Renown Children’s Hospital, and Nell J. Redfield, Chair of Pediatrics, UNR Med, talk about adolescents vaping, and how an estimated additional 10 million teens are at risk to start using e-cigarettes. What are E-cigarettes? E-cigarettes are battery-operated devices heating a liquid (e-juice) into an aerosol to be inhaled. Breathing in this flavor vapor, which usually contains nicotine, anti-freeze or other cancer-causing chemicals is called ‘vaping.’  There are many forms of these electronic nicotine delivery devices - and they're not always obvious. They not only appear to be cigarettes, cigars, or pipes, but also pass for everyday items, such as flashlights, flash drives or pens.   The Effects of Vaping and E-cigarettes Regardless of the nicotine delivery, vaping is addictive and is quickly becoming a public health concern. Nicotine levels in e-cigarettes vary greatly, and they may also contain toxic chemicals. Currently there is a wide range of variability among vaping products. In other words - they deliver different ingredients, hardware, levels of nicotine, and possible toxic chemicals to the user. This makes it challenging to create an overall public health recommendation on their use. Nevertheless, there is no confusion about the harmful effects of the chemicals used in e-cigarettes to the young brain, which develops until age 25. Studies show e-cigarette use serves as an introductory product for teens to go on using ‘regular’ tobacco products. The American Academy of Pediatrics has several recommendations on their use. Such as increasing the minimum age to buy tobacco products, including e-cigarettes, to age 21 nationwide. (Update: nationwide the age as of January 2, 2020 is now 21.) A common misunderstanding with teenagers is the belief e-cigarettes are less harmful than other tobacco products. Moreover, there is a wide range of flavor choices, from mint, mango, crème brûlée to cucumber to attract users. As of September 6, 2019, The Centers for Disease Control and Prevention is reporting over 450 possible cases of lung illness associated with the use of e-cigarette products in 33 states.    What Should Parents Know about Vaping? Parents and teachers should know JUUL is a very popular e-cigarette among teenagers, capturing about 68% of the market. JUUL is sleek, small, hides easily, and resembles a flash drive. Surprisingly it charges in an USB port, and can also instantly be mistaken for a real flash drive. One JUUL cartridge contains twice the nicotine found in other e-cigarette cartridges. This roughly equals the amount of nicotine in an entire pack of cigarettes. To repeat, the use of JUUL in young people continues to grow, and this is why parents and teachers need to be aware. Be alert, teach, communicate, and talk to your child about the serious risks of smoking in all forms, whether at home or parties. Tell them how difficult it is to quit and why they should not start. Loving your children is caring; caring for their current and future health and well-being.

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Watch what happens when a family’s matriarch finds out she has to have heart valve replacement surgery. Thanks to supportive cardiac care, she is now back to health and enjoying her extended family with a healthy heart.  Marilyn O’Gorman has a full heart full of love: Just ask her six children, 15 grandchildren and six great grandchildren. However, in 2009, tests showed that same heart had medical issues. So her close family was by her side when she underwent heart valve replacement surgery. O’Gorman says her heart doctor, Athan Roumanas, MD, FACS, put her at ease about the surgery. “You’re very nervous — you’re scared,” says O’Gorman. “You don’t know: Are you going to come out of it? Is it going to work?”  Heart Valve Replacement Surgery Comes with an Unexpected Question O’Gorman was asked to choose whether she’d prefer a pig or a cow valve — ultimately inquiring of Dr. Roumanas which one he’d choose for his own mother.  “And he said, ‘Well, probably pig,'” she recalls. “And I said, ‘OK, I’ll oink for you.’ And that’s how I got that, and he did a wonderful job.”  O’Gorman continues her care at the Renown Institute for Heart and Vascular Health, so she can stay heart healthy and spend her free time with the many generations of family in her life.

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To be on the move is a scary concept when you’re recovering from surgery. But did you know getting up and at ’em could be the key to a quicker recovery, post-surgery? Here’s some expert insight from Renown Surgical Services. The team at  has some news for you: Rest and movement are important to prevent serious complications. Here are some tips about how to get mobile after your procedure — and why it’s fundamentally important. Tip 1: Start Simple While you’re in bed, move your legs and feet up and down. Be sure to ask the nurses to help you get out of bed and into the chair for all your meals, or walk to the bathroom when needed. If you feel up to it, take a walk in the hallways with the nursing staff. Tip 2: The Sooner, the Better This may be surprising, but too much rest is not necessarily a good thing. The old saying “You use it, or you lose it” rings very true to maintaining the strength needed to get yourself out of bed. Beginning the mobility process early in your hospital stay will not only help you maintain strength and function, it may also help you get home sooner. Though it may seem counter intuitive, lying in bed all day can delay your healing time and cause serious complications to arise, including pneumonia, deep vein thrombosis or blood clots, pressure ulcers and sometimes constipation. Tip 3: Mobilize Your Support System Getting out of bed, sitting in a chair for meals and walking around your room or hospital unit can help reduce your risk of complications. The nursing staff will help you out of bed the same day of your surgery if it’s cleared by your doctor. Tip 4: Safety First The nursing staff is here to keep you safe, so make sure you call them for assistance getting out of bed. Even if you think you can do it yourself, use your call light to notify the nursing staff you are ready to get up and move. In addition, new medications can sometimes impair our judgment, balance and safety, so it’s always better to have help even though you may not need it. This is also why you may have a “bed alarm” on, to remind you to call for help and keep you safe while you are recovering. Tip 5: Move, But Manage Your Pain Many people find that getting up and moving actually helps their pain, rather than making it much worse. Taking the right amount of medication at the right times will minimize your pain and help you to get moving. Your care team will work with you on how much pain medication is right to manage any postoperative pain, with the goal for you to be comfortable enough to be able to move and gradually increase your activity each day. Tip 6: Maintain that Momentum at Home Mobility doesn’t end once you’re discharged from the hospital. It’s key to keep moving to maintain health and function. When you first arrive home, it’s crucial to take frequent movement breaks throughout the day. Increase activity as it becomes more comfortable, and be sure to ease back into an active daily routine. If you have concerns about your mobility once home, be sure to discuss this with your doctor at your follow-up appointment. Renown Surgical Services | 775-982-3993 Ask your doctor if you have any questions about your medical condition or the specific surgical procedure planned, or contact the team at Renown Surgical Services. Learn More

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