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For the average person, wounds aren’t an everyday worry. However, for at least eight million Americans, chronic wounds can pose a serious threat to health and well-being. From a person with diabetes experiencing painful neuropathy to a patient healing from a significant burn, caring for advanced wounds is a major part of their healthcare journey. Who do they go to get the care and guidance they need? The answer: Renown Wound Care. Serving patients in both the inpatient and outpatient settings, this department provides comprehensive, best-in-class treatments for severe and chronic wound healing and ostomy care. Our Wound Care team members have mastered the art of harnessing cutting-edge technologies and a patient-centric approach to redefine the standards of healing.  Advanced Care for the Best Repair  At Renown Health, we are fortunate to have a team full of nurses, physicians and more caring for patients with wounds caused by a wide variety of conditions. Those include:  Burns Trauma Vascular diseases Radiation therapy Pressure ulcers Diabetes and diabetic neuropathy Adding to the expert-level continuum of care, Renown is the only health system offering complete ostomy services in the entire region. The Wound Care team helps ostomy patients with the fitting of their medical bags, treatment of any skin conditions that may arise after ostomy bag placement, care coordination and much more.  With a multidisciplinary network of experts tailoring personalized treatment plans, there is never a dull moment on the floor. On the outpatient side, the team expects 50-60 patients in one day alone.  “As a clinician, wound care is a lot of ‘arts and crafts,’ so we get to use our creative and critical thinking skills to provide the best possible care,” said Samantha Moore, Advanced Wound Care Specialist RN for Outpatient Wound Care. “Each patient has an individualized plan of care – we greet them as they come into the clinic, escort them back to their treatment rooms and get their latest health updates and life situations before providing wound or ostomy care. We prepare each morning doing chart reviews to determine patient needs, wound progression and referral needs.”  “We are a highly specialized, dedicated group of professionals with a passion to treat and heal our patients’ wounds,” added Lori Conner, Advanced Wound Care Specialist RN for Outpatient Wound Care. “When a patient comes to our clinic for evaluation, they are given a dedicated appointment to thoroughly go over their medical and surgical history, medications and nature of the wound.”  Switching over to the inpatient care team, they operate like a well-oiled assembly line, navigating different daily assignments with precision and flexibility.  “On the inpatient side, our day starts in our office with triaging our consult list; after the triage process is completed, we get our assignments, which can consist of wound vacuum-assisted closure (VAC) patients, follow-up patients, ostomy education patients and new wound consults,” said Megan Uy, Advanced Wound Care Specialist RN for Inpatient Wound Care. “In the case of patients requiring wound VAC changes, we consider what kind of pre-medication for pain that they need. Although some patients may be seen on a time schedule, the day ends up flexible as patients are being seen by other specialties. This flexibility also benefits the patients, making them feel more empowered with their care.”  “Each day in the inpatient setting, we get to our office and sort through all the new consults that came in overnight, and the charge nurse makes the assignment for the day,” added Madison Arlin, Advanced Wound Care Specialist RN for Inpatient Wound Care. “After the assignment is completed, each nurse is responsible for researching their patients and organizing their day, typically by priority – wound VACs and ostomies usually take top priority.”  Now, how do these treatments actually work? This specialized field handles advanced methods of treating each condition, including:  Biological skin substitutes Surgical debridement Advanced wound dressings Negative pressure therapy Pre-ostomy markings and education Offloading techniques, such as padding or dressing “Before starting treatments, we communicate with our nurses and providers to make sure that the patient is comfortable prior to wound care,” said Dianna Seo, Advanced Wound Care Specialist RN for Inpatient Wound Care. “After we see the patient, if there is a need for escalated care, we contact the provider for additional testing or consults. We continue to follow-up on patients that have severe wounds, wound VACs and ostomies.”  In the hands of the Wound Care team, patients exit our hospital walls not only restored but also empowered, set on a trajectory for long-term healing. Your Expert Care Guides  No matter the case or the severity of the wound or condition, patient care, comfort and communication always come first – before, during and after treatment.   “Many of our patients have chronic needs, so we end up seeing them for several months, if not years in some cases; we stay up to date with their specific psychosocial needs and help remove barriers that would prevent their wounds from healing,” said Samantha Moore.  “I enjoy knowing that my positive attitude can improve our patients’ days,” added Maddie Pauley, Patient Access Representative for Outpatient Wound Care. “When they’re routinely coming to appointments they might not enjoy, hearing them praise our team and give their thanks is one of the most rewarding feelings.”  As a wound care patient, there can be a lot of unknowns when beginning their care journey. However, these team members carefully walk each patient through every step from beginning to end.  “When we go to see a wound care patient, our team is very consistent about explaining to the patients what our role is and what we plan to do with their wound, and then we continue to actively communicate throughout wound care each step that we are doing as we are doing it,” said Madison Arlin. “We also encourage some of our patients to listen to music that they enjoy during the wound care, or we will cover their eyes with a cloth if they request so that they don't have to see their wound. Sometimes, we will ask the family to stay at the bedside to hold their family member's hand.”  Education is crucial to ensuring each patient knows what to expect in order to care for their wound and understanding the stages of healing. Fortunately, this team is well-versed in the world of wound wisdom.  “A lot of education is provided on the type of dressing we are applying, and if the patient is going to be performing their own dressing changes, we will go over the entire change with them and provide supplies for discharge,” said Megan Uy. “Additionally, there will be written instructions in their discharge paperwork. In the cases of wound VAC dressing changes, each step is explained to the patient before doing it, and we also go over discharge options and expectations.”  “As a clinician who sees a lot of patients prior to having their ostomy placed (pre-surgical marking), one of the most important things we do is first sit with the patient and/or caregivers and talk about their fears, concerns, questions and goals,” said Samantha Moore. “We provide a lot of emotional support and education, helping identify community resources. For our wound patients, we spend a lot of time educating our patients/caregivers about how and why their wounds occurred. We try to connect with them on a personal level and help them identify ways to help their wounds heal.”  To see a patient’s care journey from the second they enter through our doors to the moment they return home is one of the most rewarding feelings for the Wound Care teams. In fact, they’ve had the pleasure of treating patients for years and seeing their wounds almost completely heal. The team collectively values the successful healing journeys of their patients as their proudest achievement.  “One of our team's greatest accomplishments was being able to see one of our long-term patients discharged with nearly resolved wounds,” said Megan Uy. “This patient had been in our care on-and-off for the past year with many hospitalizations and had complicated high-output enterocutaneous fistulas within his wound bed. These were incredibly hard to keep a dressing on successfully, and he often had issues with the dressing leaking. Eventually, we got a dressing that could remain intact until his next scheduled dressing change, and he was able to get surgery that fixed his fistulas. Being able to see him recover and heal his wounds was a very large accomplishment for us.”  The admiration and compassion this team has for their patients also extends to each other. The cohesive way they work together only further benefits their patients, offering the best-possible collaborative care.  “We have extremely skilled clinicians in our group that are not only incredible in the work that they do and the patient care that they provide but are also enjoyable to work with as well,” said Geane Weaver, Advanced Wound Care Specialist RN for Inpatient Wound Care. “There is something to be admired in each and every one of my coworkers.”  “Our team is very close and supportive of each other at all times,” added Madison Arlin. “I feel very lucky to work with such an amazing group of people. Our team is very proud of the work we do.” Fervently Fighting the Good Fight So, with the highly specialized nature of advanced wound care, how did these team members get inspired to join the Wound Care team in the first place?  Well, for many of these devoted employees, their first exposure to caring for wounds took place on different units – sparking their interest in making wound care their full-time career.  “Renown was the most welcoming towards me as a student nurse, and I liked that it was a teaching hospital,” said Madison Arlin. “I started in the General Surgical Unit (GSU) immediately after graduating nursing school and worked there for two years before transferring to wound care. I decided to apply to the wound team after watching the wound nurses do wound VACs and ostomy changes on the floor. I would ask them if I could watch, and I was always very fascinated by the wound healing process.”  “Prior to joining the inpatient wound team, like Madison, I was also a bedside nurse in GSU,” added Geane Weaver. “Working on that floor, I was already exposed to a lot of patients that were requiring some kind of advanced wound care in one way or another. Working in the GSU, I also cared for a lot of patients that had wound VACs and ostomies. These patients make up a huge group of the individuals that our team sees on a regular basis, and they've always been intriguing for me, so naturally, wound care has always been on my radar.”  For other team members, wound care has always been a point of curiosity throughout their education and career. From their very first exposure to this care area, they were hooked.  “I was always curious about wound care even through my nursing school experience,” said Dianna Seo. “When I was working on the floor, I would trade to do wound care for patients. When I had time, I would follow wound care and help when I could. I joined the skin team which drove me to be increasingly involved with wound care. As soon as there was a job opening, I applied for the position. I worked in outpatient wound care for approximately four years and now inpatient for another four years. I have enjoyed all aspects of wound care and patient care.”    “I had great clinical experience at Renown when I was in nursing school; I also was very interested in caring for trauma patients, and Renown being a Level II trauma center aligned with my interests,” added Megan Uy. “I began my nursing career in the GSU, but my dream job was always Wound Care. During my nursing school clinicals, I had the opportunity to watch some members of the wound team do wound VAC changes and thought it was incredibly intriguing and a great combination of utilizing the knowledge of anatomy and physiology while being creative with handicraft. A position opened on the team around the time I met the prerequisites to be eligible for the position, and luckily, I got it.”  Our Wound Care team has achieved significant employee and departmental milestones over the past year, reflecting their dedication to enhancing patient care and overall process improvement.  “We have had many accomplishments within the last year and are currently working on more to improve the hospital,” said Dianna Seo. “Madison Arlin won the DAISY Award for her great work with our patients. Megan Uy won Top Talent of the Quarter for helping a stranger. Ande Ferriera has worked tirelessly to improve our process improvement. Allie Saunders, as our leader, has worked to improve patient skin by getting new beds for Renown Regional. All our patients that have healed or are on their way to healing under our care is our greatest achievement that we as wound team is most proud of.”  “We are constantly updating protocols, notes and orders for bedside nursing so that it is a more straightforward and seamless charting process,” added Madison Arlin. “We have representatives of different supply companies come and present new products that we think may benefit our patients better. Our wonderful tech has even updated our department site on Inside Renown so that the nurses always have references available.”  Renown’s strong influence in the region – and the opportunity to give back to their community – was, and continues to be, a major draw for this team.  “Since I can remember, Renown has always been the most prevalent healthcare name for my family and has always taken the most amazing, thorough care of my loved ones,” said Maddie Pauley. “I have always wanted to work somewhere I could help people, and starting at Renown has really opened my eyes into how much of a difference each one of us can make.”  Our Wound Care department’s success stories and proactive approach not only reflect their passion for healing but also inspire a ripple effect of positive change throughout our health system. They proudly exemplify a shared commitment to enhancing the well-being of all patients under their care.  “Being part of Renown and part of this team has been my blessing; I get to do a job I love with people that love it too,” closed Dianna Seo.

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As the holiday season draws near, we find more reasons to celebrate with loved ones. At Renown Health, we are kicking off the celebrations early this November with American Diabetes Month. Approximately 37 million Americans, including 270,000 Nevadans, have been diagnosed with diabetes with as many as 95% of those diagnosed living with type 2 diabetes mellitus (T2DM). What is Type 2 Diabetes? Type 2 diabetes is a chronic health condition that occurs because your body is not using insulin (a hormone made by the pancreas to help cells use the food we eat for energy) as well as it should, resulting in high blood sugar levels. It is important to obtain a diagnosis for T2DM and ensure it is well-controlled to prevent serious health complications. Those with diabetes are at higher risk for blindness, kidney failure, heart disease, stroke and amputation. Tips for Supporting Your Health with Type 2 Diabetes Know Your Blood Sugar Levels: Work with your healthcare provider to establish target blood sugar levels, and make sure to monitor your levels regularly as advised by your healthcare provider to prevent or delay health complications associated with T2DM. Focus on Your Plate: Eating foods such as fruits and vegetables, lean meats or plant-based proteins, healthy fats and whole grains supports diabetes management. If choosing healthy foods is difficult due to your busy schedule, cost or simply because you aren’t sure where to start, talk with your healthcare provider who may refer you to a registered dietitian. Registered dietitian nutritionists are certified nutrition specialists who can provide education and practical tips for eating to support your T2DM diagnosis with visits covered by many insurance plans. Prioritize Staying Active: Engaging in regular exercise is good for everyone, especially those living with T2DM. Exercise helps your cells become more sensitive to insulin and therefore supports healthy blood sugar levels. Always check with your healthcare provider prior to beginning a new exercise plan. Support Stress Reduction: Stress is unavoidable but can be managed through regular exercise, getting enough quality sleep (7-8 uninterrupted hours per night) and practicing meditation and other mindfulness techniques. Plan Ahead for Holiday Gatherings: There’s still room for celebration while focusing on blood sugar management. Consider bringing a healthy dish to your gathering, focus on filling your plate with vegetable sides and eating those first and incorporate a family walk after dinner. If traveling, pack nutritious snacks that support your health and keep you full. Lastly, enjoy the special dishes and desserts this season has to offer in single-serving portions.

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Dr. Shipra Singh, a Pediatric Pulmonologist, outlines the challenges of diagnosing asthma in children due to symptoms resembling other respiratory issues. It's particularly difficult to identify in infants and young children, who may not clearly exhibit breathing difficulties. Asthma, often confused with bronchitis, croup, or allergies, is a significant chronic illness causing school absenteeism, as per the CDC. Risk factors include prenatal smoking and family history of allergies or asthma. Infants and toddlers are more susceptible due to smaller airways and respiratory viruses, which can exacerbate conditions like colds and bronchitis. How can I tell if my child has asthma? Unfortunately small children are unable to describe their symptoms, making asthma difficult to diagnose. Your child may even be active, playing and smiling, although they are experiencing chest tightness or labored breathing. Observe your child and let the child’s doctor know if: Your child’s breathing behavior has changed (coughing, wheezing, rapid breathing) Your child’s breathing pattern changes (day vs. night, with rest or activity, inside vs. outside) You have a family history of asthma or allergies Your child’s breathing is triggered by any foods or allergies With your help, your child’s doctor can make the best diagnosis to determine if your child has asthma. A pediatric pulmonologist (lung specialist) or pediatric allergist may also have to be consulted for special testing. Tests may include lung function testing, allergy tests, blood tests and X-rays for an accurate diagnosis. What is the treatment for infants and toddlers? Young children can use many of the same medications as older children and adults, although the way they take them and the dosage will differ. A nebulizer (or breathing machine) creating a medicated mist for your child to breathe through a mask may be used. An inhaler with a small spacer tube connected to a mask is also common to help your child breath medication into their lungs. Either of these options are effective. Asthma in children is treated with both fast-acting and long-term medicines to open up airways quickly for easy breathing and also to lessen asthma symptoms over time. Communicate with your child’s medical providers to create a personalized asthma management plan for them. How can I manage my child’s asthma? Recognize your child’s breathing habits and be aware of worsening symptoms. Consult with your child’s doctor on a daily asthma action plan to recognize worsening symptoms and track medications. Here’s an example of an asthma action plan provided by the U.S. Department of Health and Human Services’ National Institutes of Health). Be consistent with the plan and talk to your doctor before changing it. Have an emergency plan in case of a serious asthma attack. Know where the closest ER is and know who can take care of your other children. Also know what the medical treatment coverage is under your insurance plan. Dr. Singh explains, "Discussing asthma with your child may be difficult. Some kids find the subject frightening or confusing. Others, especially the older kids, may resent the treatment and may not be interested in doing it. Talk to your doctor about advice to build an open and trusting relationship regarding your child's asthma care."

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Health systems across the country recently celebrated Patient Access Week from April 2-8. Join us in recognizing our Patient Access team at Renown!  Fighting the Good Fight starts the moment a patient steps onto the grounds of our health system. When patients visit Renown on their healthcare journey, they look to the experts to not only help them navigate through the complexities of the process but also ensure their experience with us starts off on the right foot.  Renown Health’s Patient Access Representatives (also referred to as “PARs”) are the faces of this entire process. As the key links between patients, providers and insurers, they strive to create a welcoming and respectful environment for everyone. PARs are committed to providing all of Renown’s patients access to the quality care when needed. After all, it’s in their name!  A Friendly Face  PARs are the front faces of almost all clinical areas at Renown. As the starting point for much of the patient experience, the day-in-the-life of PARs can vary. Checking patients in and out, getting demographic information, verifying insurance, answering phone calls, fostering communication between patients and their care teams, scheduling patients for follow-ups, explaining financial responsibilities and our financial aid programs, creating an overall positive experience and environment, the list goes on – but they all remain united under one goal: setting patients off on the right foot as they access care through our health system.  “Each day, PARs are met with new patients who are seeking solutions to different concerns,” said Macy Betts, PAR for Renown Women’s Health. “We are the front doors to this department. We are not just checking patients in and out; we are the first step to the patients receiving the care they deserve.”  “We take pride in our work,” added Tanya Quintanilla, Shari Longley and Nancy Arroyo Garcia, PARs for Renown Pediatrics. “Usually, we are the first point of contact within Renown, so we don’t take our role lightly. For example, when we see a newborn, we must ensure the registration has been verified, which consists of patient demographics, patient preferences and insurance verification. We need to be consistent and thorough because what we do affects every point of contact a patient may have within Renown.”  “As my team’s senior PAR, my day begins with gathering the outpatient therapy work queue numbers and assigning the team to work them,” added Logan Johnson, Senior PAR in Pre-Registration at Renown. “Our goal is to contact and schedule patients for physical, occupational and/or speech therapy as soon as possible so that they have the maximum benefit and can get back to a normal life as quickly as possible. Our encounters can make or break the entire experience.”  PARs never underestimate the power of good communication and compassion. Even during the busiest of times, our PARs work diligently to ensure all patients and their care teams fully understand the administrative side of whichever part of their journey they are about to embark on, lending a helping hand and a smile.  “Whether you’re communicating with patients, leaders or coworkers, communication is key,” said Jonathan Figueroa, PAR for the Renown Institute for Heart & Vascular Health (IHVH). “We try and make sure that we do everything possible to make their visit go as smoothly as possible.”  “Communication makes the world go round,” added Keith Madrona, Sherry Riley, Erika Rios and Andie Kilpatrick, PARs at Renown Urgent Care – Ryland. “Having a friendly attitude and demeanor is very important.  “The PARs in Labor & Delivery do so much more than just registering patients – from escorting expectant parents to their rooms, welcoming newborn babies, processing pre-estimates and more – and the patience and excellent communication I receive from other teams is what keeps me going,” added Nanci Barash-Vietti, PAR for Renown Labor & Delivery (L&D). “This is critical to the success and effectiveness of the PARs in our department.”  Shift changes for PARs mimic other teams at Renown, leveraging technology and both written and spoken communication to ensure the next shift begins successfully.  "When I come in, the night shift will give me a report on what is going on and what the schedule looks like during the day; then I log in to my computer and get everything that I will need for that day up on the screen,” said Allie Boracchia, PAR for Renown L&D. “Usually around this time we have a 7-8 a.m. induction scheduled for the first patient, so I will grab the pre-made packet that the night shift put together, the unit clerk will call the nurse to get a room number, and I take the patient to the room and have them sign all the forms. After the patient has the baby, then we admit them and finish registration. This is continuous all day long.”  Our PARs all agree that regardless of the setting, whether it be emergent or routine, every patient is looking for that advocate from the moment they enter through our doors.  “Being friendly, patient and understanding is a must,” said Sheryl Lundgren, PAR for the William N. Pennington Institute for Cancer. “It is so nice being able to brighten the days of patients who are living with a cancer diagnosis.”  “In the urgent care setting, a lot of the patients we see are not feeling their best, so it is important that we show them we care and are here to help make check in go smoothly,” added Sam Deithrich, PAR at the Renown Urgent Care – Los Altos.   “Patients are relieved that they are speaking to a real person that will help set up appointments,” added Rick Jordan and Celeste Landry, PARs in Lab Services at Renown South Meadows.   PARs embrace lifelong learning at Renown, especially as their roles differ day-to-day. They are always ready to jump in and assist on tasks that might be new for them, growing their skills on the job and never hesitating to say, “How can I help?”  “As a PAR, you are always learning new things, even when it seems like you know just about everything,” said Liz Cardenas-Ramos, PAR for Renown Endocrinology. “It’s been such a positive experience.”  “Giving yourself grace to learn and grow in Patient Access is the key,” said Maggie Savoie, PAR for Renown Primary Care – Fernley. “I find myself learning every day at Renown, and if you’re learning, you’re growing. Being able to take a breath and say, ‘this is a learning opportunity for me, and tomorrow I will be better a better PAR because I’ve gained this knowledge’ is an amazing way to stay positive in the position.”  “In L&D, we are all multi-tasking, and every day I am learning something new about my department and patients, as well as how to excel in my position,” added Nanci Barash-Vietti.  Renown PARs are the front lines to health care access, and they wear that badge with pride. Jeanette Flores, PAR in the Emergency Department at Renown South Meadows, sums up the role of Patient Access well: “Talk about first impressions!”  “I am proud of our team and the excellent care we give our patients,” said Dawn Linker, PAR for the Renown IHVH. “We want them to have a good experience.”  Impactful Accomplishments  The role of our Patient Access team members goes beyond the desk. A patient’s healthcare journey begins, and sometimes even ends, with the helping hands of our PARs, leaving a lasting positive impression of Renown.  "Our interactions with the patients make a difference before they see the provider, so we always demonstrate a welcoming and helpful atmosphere for the patients to feel like their needs are being met,” said Mary Dettling, PAR for Renown Endocrinology.  “I love seeing the difference we make in peoples’ lives,” added Shannon Leone, PAR for the Stacie Mathewson Behavioral Health & Addiction Institute. “We can get patients at their toughest and worst times. Watching them overcome their fears, traumas and addictions has been very rewarding.”  Our PARs don’t just make goals for themselves – time and time again, they surpass them, all in the name of patient experience and excellence.  “We have not only met our monthly point-of-sale scores, but we also have exceeded our stretch goal for the last eight months and our scores have been in the 50th percentile or higher,” said Jeanette Flores.  “Along with being the top point-of-sale collectors, we have also been known to be some of the sweetest and most helpful staff at South Meadows,” said Katie Morrill, PAR in the Emergency Department at Renown South Meadows.  As their teams grow, so does their impact on our patients. PARs are dedicated to providing the best customer service possible, and with their expanding teams, that service goes even further, even throughout the pandemic.  “A year ago, we only had one PAR; now, we have a full and amazing team,” said Alex Bucholz, PAR for Renown Advanced Wound Care. “We have come so far in a short amount of time.”  "During the pandemic, we have maintained a core group of individuals who come in every day and help keep this office and all its parts moving smoothly,” added Shannon Leone. “We have maintained a full patient load the last three years and never had to close our office for any reason. We have even had the opportunity to start our Medicated Assisted Treatment and Transcranial Magnetic Stimulation programs.”  "We successfully operated and maintained our pediatric COVID clinic, which is the only one within our five clinics,” added Tanya Quintanilla, Shari Longley and Nancy Arroyo Garcia. “We feel proud knowing our tiny humans are protected with the COVID vaccine.”  Like many other teams at Renown, our PARs are masters at teamwork. Despite any obstacles that may happen along the way, they are always there for each other to ensure every patient gets the care and attention they deserve.  “We call ourselves the ‘A-Team’ here in Pulmonary,” said Shannon Birnberg, PAR for Renown Pulmonary & Sleep Medicine. “We have persevered through changes, additions and departures. We are most proud of bringing different personalities to the team and being super strong and effective.”  “I have noticed the team always steps up whenever needed,” added Brittany Hughes, PAR for the Renown IHVH. “Everyone has a great attitude and is very positive!”  “While our team is fairly new, we are growing together, learning our strengths and weaknesses and always pushing for stronger unity,” added Angel Freer, PAR in the Emergency Department at Renown Regional.  When our PARs find ways to simplify a process or make a workflow run more efficiently, they don’t waste any time in making that happen. They take any opportunity to enhance patient experience.  “Our team came up with a solution on how to get patients registered faster,” said Jess Castillo-Marquez, PAR in Lab Services at Renown Regional. “We came up with modalities which assign each PAR their own procedure in which they will be registering for during their scheduled shift. It has been a great success, helping our productivity and keeping our patients satisfied with our service.”  “We are proud of our successful implementation of our new therapy workflow,” added Logan Johnson. “Patients are now waiting much less to be contacted about their care.”  Our PARs know that teamwork makes the dream work, and their commitment to the patients they serve – and the goals they continue to blow out of the water – continue to inspire them daily.   “You are only as strong as your team,” said Aundie Yonker, PAR in the Emergency Department at Renown Regional.

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

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

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Millions of people across the west live in areas where air pollution can cause serious health problems. In addition, local air quality can affect our daily lives.  Who is Affected? Kouros Farro, MD, a physician with Renown Urgent Care, advises that certain people are more likely to be affected when fine particle pollution reaches an unhealthy level. People who have asthma or other breathing conditions like chronic obstructive pulmonary disease (COPD). People who have heart disease or high blood pressure. Children and older adults. People of all ages who are doing extended or heavy physical activity like playing sports or working outdoors. “Everyone should take precautions when the air quality is unhealthy. Air pollution can aggravate heart and cardiovascular disease as well as lung diseases like asthma and COPD. When the air quality is unhealthy, people with these conditions may experience symptoms like chest pain, shortness of breath, wheezing, coughing, or fatigue. If you are experiencing any of these symptoms, use your inhalers as directed and contact your health care provider,” says Dr. Farro, who is board certified in family medicine and practices at Renown Urgent Care at 975 Ryland St. in Reno. “If you do not have a health care provider, there is a Renown Urgent Care office on almost every corner, with providers ready to see you.” Dr. Farro advises the following: Take it easy and listen to your body. Limit, change or postpone your physical activity level. If possible, stay away from local sources of air pollution like busy roads and wood fires. If you have asthma or other breathing conditions like COPD, make sure you have your relief/rescue inhaler with you. People with asthma should review and follow the direction in their written asthma action plan. Make an appointment to see your health provider to be sure you have an asthma action plan. Getting Same-Day Care Renown Urgent Care provides same-day treatment for a wide range of minor injuries, illnesses and medical concerns that are urgent but not life-threatening. Avoid the long wait times and high emergency room prices at 11 convenient sites, including Reno, Sparks, Carson City, USA Parkway, Fallon and Fernley. You can walk in or book ahead online. Make an Urgent Care Appointment Community Health Resources The Washoe County Health District offers online health information on its Smoke Smart website, including fire information, daily air quality information, fire and smoke maps and how to protect yourself. In addition, an online subscription page allows you to sign up for EnviroFlash, notifying you about air quality.

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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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