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Embarking on the path to bariatric surgery is a unique and deeply personal journey. Individuals like Mary Escobar choose this life-changing route for reasons ranging from improved cardiovascular health to managing diabetes or finding relief from various health complications. In Mary's case, her two-decade-long healthcare journey not only underscores the challenges she faced but also highlights the support and expertise that ultimately led to her successful transformation through bariatric surgery. Mary's Resilience: December 2002 through February 2003 More than two decades ago, Mary experienced unforeseen health complications just days after giving birth via c-section. Septic shock, hemolytic uremic syndrome, thrombocytopenia, renal failure and a blood clot in her lung plunged her into a critical state. Intensive care, plasma exchange and a long recovery followed. After being discharged with compromised kidney function, Mary faced complete renal failure two years later, leading to dialysis and a spot on the donor list. Mary's brother, a perfect match, selflessly donated his kidney on Dec. 14, 2007, marking a turning point in Mary's health. However, the post-transplant period brought new challenges, including diabetes, high blood pressure and a significant weight gain, reaching 230 pounds. Determined to regain control, Mary explored various diets without success until she consulted with a bariatric doctor. Journey to Bariatric Surgery: November 2009 - April 2021 In November 2009, Mary opted for a gastric band, shedding 40 pounds within a year. Despite initial success, issues with the gastric band arose, prompting a consultation with Dr. John Ganser at Renown Health in April 2021. Together, they decided to transition to a gastric sleeve, with comprehensive education provided to ensure long-term success.

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When you meet Poeth Kilonzo, Director of Oncology Nursing at Renown Health, you are immediately greeted with a warm smile that puts your mind at ease. Within the William N. Pennington Cancer Institute, Poeth enjoys a strong reputation among her employees and patients as someone they can always rely on, no matter how rough the tides may flow.   As an incredibly humble oncology professional, you may not realize that behind that smile is the power of a best-in-class nurse and leader holding a 20+ year career of diverse nursing experience and leadership excellence – dedicating the majority of her service to Renown Health.  Join us as we dive into Poeth’s unique journey through Renown.  Finding Her Passion  Ever since she could remember, Poeth has been a “people person.” Above all else, she cared for people – and she cared a lot. What better place for her to be than healthcare?  After moving to northern Nevada from Kenya, she began working in private patient care working with home health and dementia patients while taking classes at Truckee Meadows Community College (TMCC) in 2000. One day, a patient asked her a question that would change the course of her career journey: Did you ever think about becoming a nurse?  Driven by not only the words of encouragement of her patients and supervisors in home health but also the rallying support from her family and friends, including her husband and high school friend, who both have decades of experience interacting with nurses in healthcare (with her husband spending many of those years at Renown), Poeth knew this was the path she was meant to take.  “That was it; it was like a light switch had flipped,” said Poeth. “I switched to nursing overnight.”  According to Poeth, TMCC’s nursing program offered her an incredibly supportive environment, which was especially important as she was a young mom at the time. Working in healthcare, going to nursing school and raising a family all at the same time is no easy task, but to Poeth, this was her calling.  “Regardless of my path, I knew I wanted to be a nurse that was close to patients, sitting with them and holding their hand throughout their treatment,” said Poeth.  During nursing school, Poeth completed clinicals at several hospitals in Reno – three of them were at Renown Health (known as Washoe Medical Center at the time). What immediately stood out to her was the passion of the pediatrics unit, especially in the neonatal intensive care unit (NICU).  “While I knew that pediatrics wasn’t going to be my arena, some of the best times in my life were during my pediatrics clinical,” said Poeth. “It opened me up to how welcoming Renown is.”  While doing her rotations, nursing leaders helped Poeth and her fellow classmates discover Renown’s Nurse Apprentice program, an apprenticeship designed exclusively for local northern Nevada nursing students. One of those leaders asked her, “have you considered doing a rotation in oncology?”  And another light switch flipped.  “Bingo. I am becoming an oncology nurse apprentice,” Poeth recalls. And that’s exactly what she did.   After her four-month apprenticeship ended in February 2002, she walked into her interview with Joanna Gold, who would end up being her supervisor and one of her greatest mentors until she passed away in recent years. With her experience and enthusiastic spirit on her side, Poeth fervently expressed her passion and interest in working in oncology. And Joanna saw all of that and more.  In June 2002, Poeth was presented with a two-year oncology RN contract, which she easily signed – however, she knew right then and there but she was not going anywhere. Renown was her home, and oncology ignited the fire within her.  “The nurses in this unit are part of what kept me here,” Poeth remembers. “These nurses would really do anything for their patients. The commitment and love they all had for one another truly was like family. It inspired me to learn more and give even better care to my patients."  To Poeth, it didn’t feel like she was coming to work just to do a job – she was following her dreams.  “You don’t think about the work you do; you think about the service,” said Poeth.  From there, Poeth spent three years on the floor as an oncology RN and became a night shift supervisor in 2005. She was thriving.  But this part of her journey was only the beginning.  When Opportunity Arises, Take It  In March 2007, Poeth and her husband welcomed their third child – and for her, working a day shift position would serve her the best at her current stage of life. This revelation led her down to Renown South Meadows Medical Center, where she became a staff nurse in Medical Telemetry.  It was in the telemetry unit where Poeth contributed to one of the largest digital transformations Renown would ever go through: transitioning from paper records to electronic records on EPIC.  From there, Poeth was inspired to get back into leadership in 2012 as the Supervisor of Clinical Nursing overseeing nurses, clinical outcomes and payroll in the medical/telemetry unit and intensive care unit (ICU). The timing of her leadership role lined up perfectly with her decision to take her skills to the next level, achieving a bachelor’s degree from Nevada State College in 2016. The timing of her degree lined up perfectly with what was about to come; she embarked on her first leadership role at Renown  This is where she would happily stay for 11 years, eventually becoming the Manager of Nursing in telemetry and the ICU, noting that Renown South Meadows felt like a second home to her.  “I wore many hats at South Meadows,” Poeth recalls. “From piloting back coding and handling compliance work to being on the patient floor and heading up South Meadows’ first high school hospital volunteer program, I got very involved. We had seven years without having a single nurse traveler in our unit."  It wasn’t long before Poeth was inspired to expand her education even further, and she graduated in January 2018 with a master’s degree in nursing clinical leadership from Western Governors University. Thanks to Renown’s educational assistance programs, our health system invested directly in Poeth’s education with tuition reimbursement and a $1,000 nursing scholarship.  Soon after celebrating her achievement, Jennifer Allen Fleiner – who was the Director of Nursing at Renown South Meadows at the time – asked Poeth yet another question that would bring her to the precipice of another career detour: “Have you ever considered transferring from South Meadows to Renown Regional?”   Moments later, Alicia Glassco, Director of Nursing for Renown Regional, asked her the same question, noting that the hospital’s neurosurgery unit needed the leadership of someone just like Poeth.  “It took me a whole week to make a decision, because this was one of the toughest decisions I’ve ever made in my life,” said Poeth. “I truly loved South Meadows. After that week, my leader told me, ‘you know what, Poeth? You’ve reached your pinnacle. You need and deserve a new challenge. Learn from this new team and teach them something. I think you have a huge opportunity for growth.”  So, Poeth decided to apply for the position and shadow the neurosurgery team, where unlike her unit, the majority of the team at the time were travelers. But this was a challenge Poeth was up to – so she was accepted into the role.  “At the end of the day, these patients deserved consistent care,” Poeth emphasized. “I knew I had to take this position for the patients – they were the ones who sold me on this job. They are the reason why we are all here. It was important for me to be an advocate for them.”  The big hills to climb didn’t slow down Poeth; in fact, the exact opposite happened. Within her first year in the neurosurgery unit, her team onboarded 18 new graduates and replaced travelers.  “We were hiring like crazy,” said Poeth. “My standing agenda at all section meetings focused on hiring and our quality metrics. I started having a relationship with our doctors. Once we created a strong doctor/nurse collaboration, our nurses started staying with us longer.”  Everything on the unit was going great.  Then, COVID-19 hit.   “Since we had private patient rooms, our unit became the first COVID unit at Renown Regional,” Poeth recalls. “My whole staff that I had built up had to be distributed elsewhere. I started caring for COVID patients. We relied on our Infection Prevention team a lot. And at the same time, I was worried about my family in Africa.”  Despite the stressful nature that the pandemic brought upon health systems everywhere, according to Poeth, she knew she had to continue on.  “The neurosurgery team ended up merging with orthopedic trauma, which was very difficult,” said Poeth. “We went from 28 beds to 58 beds. The key to success here was training. Nurses are very resilient, and through training, we were able to stabilize the unit.”  Noticing the opportunity for virtual demonstrations that were previously offered only in-person, Poeth spearheaded online trainings for nursing, physical therapy, mobility, head injuries and more, allowing teams across Renown to upskill in safe spaces.  These programs continued throughout the pandemic, and Poeth was proud to be a figurehead through it all, helping to stabilize the unit while creating strong relationships with the entire team, many of whom followed her from Renown South Meadows to Renown Regional.  Then, she gets another visitor – her Chief Nursing Executive – in her office with yet another opportunity.  Have You Considered...  In September 2022, Chief Nursing Executive Melodie Osborn walked into Poeth’s office with those three words that Poeth has heard for decades: “Have you considered...”  “Before Melodie could even finish, I thought, ‘I have considered A LOT in my career!’” said Poeth.  Melodie told Poeth that the William N. Pennington Cancer Institute was looking for a Director of Oncology Nursing, noting that this could be yet another growth opportunity for her and a chance for her to go back to her roots.  “I had just celebrated my twentieth year at Renown; I knew this was going to be a decision I really had to think about,” said Poeth. “Everyone believed in me. Alicia Glassco told me, ‘Poeth, you are ready for this. Go for it.’ Once I applied for the position and started getting my updated chemotherapy certifications, I thought, ‘they are right; I got this.’”  At this point in her career, Poeth had been hyper-focused on inpatient care, and this role would be her first time caring for patients in the outpatient setting. After going through the interview process, however, Poeth knew that this was where she was meant to be yet again – and colleagues she hadn’t seen in years reaffirmed that commitment.  “I felt the most excited about the job when I toured the facility,” Poeth recalls. “I’ll never forget what one of the infusion nurses told me on my tour. She told me, ‘I don’t know if you remember me, but I remember you; I came from Renown South Meadows, and you were so nice to me as I was precepting as a new nurse. Your kindness was unforgettable to me.’ The fact that people like her wanted me in the unit so badly inspired me to come back.”  Soon enough, Poeth became the Director of Oncology Nursing, a position she still proudly holds to this day. Once she was hired, she immediately went into deep learning mode, mastering skills such as revenue integrity, credentialing and the insurance process. She attributes Supervisor of Infusion Kaitlin Hildebrand and Director of Radiation Oncology Services Susan Cox for helping her succeed.  Shortly after assuming the position, Poeth noticed yet another opportunity for cross-training within the organization to combat short staffing – training nurses from the Float Pool to care for patients in Infusion Services.  “Between May and July of this year, we trained six nurses from Float Pool to do infusion therapy services, which offered so much relief to my team; I am so thankful to Rendee Perry, the Manager of Nursing in our Float Pool unit, and her team for their support,” said Poeth. “My mission in outpatient oncology is to serve the staff and patient population and create those strong relationships."  Poeth's efforts to circumvent nurse burnout go beyond cross-training – as a director, she is always there for her team members no matter what, leading with kindness every step of the way.  “I never miss a 7:45 a.m. huddle unless I am in a ‘cannot miss’ commitment; I want my employees to always know that I am there for them and that they are cared for both on and off the job,” Poeth emphasizes. “I want them to feel like they are valued, their families are valued and their mental health is valued; after all, without my team, we cannot care for patients. It’s important for them to know that I am here to be a security blanket and that there is always something we can do to solve a problem."  Today, Poeth enjoys a full team of core Renown staff members whom patients look forward to seeing – and the high patient satisfaction scores to prove it.  “Our team is so established that patients feel comfort in knowing they are always going to know exactly who they are being treated by,” said Poeth. “We will always work to maintain that consistency.”  Staying True to the Mission  Renown’s mission of making a genuine difference in the health and well-being of our community resonates closely with Poeth. Before she arrives at the infusion unit every day, she asks herself: What can I do to make it easier for my team to deliver care?  “It takes a village to deliver the care we do,” said Poeth. “Our nurses are priceless. You can’t place a monetary value on dealing with life and death every day. This is what inspires me. It’s all about helping each other out and keeping those relationships strong.”  Maintaining those relationships on the floor, according to Poeth, requires one main ingredient: work-life balance.  “I want my nurses to be able to balance sending their kids to kindergarten and giving their patients their first chemotherapy treatments,” Poeth emphasizes. “I genuinely care about their lives. It’s nice when you get to know your team’s children, grandkids, spouse and hobbies. I’m grateful that Renown has given us the autonomy to foster that flexible environment within our teams. It is so rewarding to have such a strong impact on these employees.”  To Poeth, it’s all about doing and then duplicating. Luckily for her team and infusion patients in northern Nevada, a new infusion center at Renown South Meadows is planned to open in the coming years as part of our commitment to expanding care. Her team is excited to grow their expertise down to south Reno – Poeth's original home hospital.  “I strongly believe that as nurses, we are meant to be where we are meant to be at the time,” said Poeth. “Be kind to yourself and remember your ‘why.’ Take advantage of the opportunity you have.”  To all nurses (and future nurses) out there, Poeth wants you to know that you are welcomed and valued. You are saving lives every day, and to her, that is worth everything.  “Always remain focused, even throughout all the challenges. Never forget why you got into nursing. And lastly, always stay true to your own mission,” closes Poeth.

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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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Renown Health is proud to debut our newest commercial spot, Days, on Thanksgiving Day 2022. This commercial features members of the greater northern Nevada community, former Renown patients and employees. Chris and Ann Cook are some of these community members, and we are grateful we get to tell their story. Family is everything for Chris and Ann Cook. Their loved ones span across the United States and even farther to Germany, so time spent with their children and grandchildren means the world to them. When Chris went to the emergency room for a persistent headache and drooping eye over twenty years ago, they could have never predicted the number of hours their family would spend at Renown care facilities in the coming years. “Whenever we step inside a building with that purple logo, we know right away we will be supported by friends, family and Renown staff. Our family has turned countless hours inside hospital walls into memories of gratitude for the care we receive.” Chris Cook said. “It is these memories that make us appreciate the health of our family today.”   A Relationship with Renown that Spans Decades The Cooks can remember a time before Renown Regional Medical Center’s inception when Washoe Medical Center (Washoe Med) stood in its place. It was at Washoe Med that Chris received emergency brain surgery after a visit to the emergency room over 20 years ago. Immediately following a CT scan, Chris was transported to Washoe Med, now Renown Health, for emergency brain surgery and eventually to treat a hematoma. Doctors close to his case were amazed by his survival, considering Chris’ divergent situation resulting from a raisin-size colloid cyst and dissected corotated artery. He spent three weeks in the ICU recovering at the hospital, his spirits lifted by the amazing staff who brightened his day with gestures of kindness. From there, he was supported by countless friends and family members over the next three months while recovering at home. A Home Away from Home Later, the Cooks’ daughter received cancer care at Renown at the William N. Pennington Cancer Institute. Ann, Chris and their daughter found small comforts when running into the familiar faces of their daughters' past schoolmates, who are now Renown employees, in the hallways. The family became well-acquainted with the food options at Renown Regional’s Sierra Café, even finding favorites like the sushi bar. Reliable Care, Close to Home  The Cooks have also experienced many happy and comforting memories at Renown and Washoe Med over the past twenty years, including the births of three of their seven grandchildren. And when Chris needed an emergency appendectomy on a Friday night four years ago, they felt confident that the best care would be received at Renown Regional Medical Center.    From lab work to routine procedures or visits to urgent care, the Cooks feel rest-assured knowing Renown will be the place they can consistently trust for care with many locations close to their home in Sparks, Nevada.  After spending many hours within Renown walls, Chris and Ann remarked how impressed they were by Renown Regional Medical Center’s growth in the past decade from their first encounter over twenty years ago. With a deep appreciation for the care received at Renown facilities and the technology used to help treat patients, Chris and Ann said, “We really feel confident that if something bad were to happen, you’d want to be in the care of Renown.”  Family, Health and The Future "Our care at Renown has changed the course of our family’s lives and led to the success of who we are today. So, when the team at Renown approached us about participating in the commercial shoot, we knew this was meant to be the next piece in our Renown story." Chris and Ann said. "Of course, it was nice to be back at Renown, not as a patient this time, but to help the team create something great."

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You’ve likely heard about bariatric surgery — and perhaps even have friends who’ve done it. But is it a potential solution for you? Here, Dawn Remme, RN, Metabolic Bariatric Surgery Program Manager, provides insight. You may have been struggling with excess weight for years. You’ve tried high-protein diets, low-carb diets and more. Most patients considering weight loss surgery have tried numerous dieting methods. The truth is, some patients who suffer with obesity are successful dieters. Unfortunately though, excess weigh often returns. This impacts their health and the quality of their life. It can be a disheartening battle. Weight loss surgery is a big decision. In making this decision, keep in mind that surgery is only one step toward your goal of achieving better health. It is neither magic, nor is it the “easy way out.” Weight loss surgery can offer you a TOOL to help you become more successful in controlling the disease of morbid obesity. By combining this tool with a lifelong commitment to important lifestyle changes, medical follow-up and nutritional modifications, you have the potential to become a healthier you. Bariatric Surgery By the Numbers Exploring the facts about obesity, how it impacts your health, and how surgery can resolve or significantly improve your chronic medical conditions is the first step to making a decision. Obesity is medically defined as “excess body fat” and is measured by a mathematical ratio known as the Body Mass Index (BMI). To calculate your BMI, we consider your height, weight, age, gender and body build. Here are the standards: “Normal” BMI: less than 25 Overweight: 25 – 29.9 Obese: BMI of 30 – 39.9 Morbid obesity: BMI of 40 or more Morbid obesity (BMI over 40) is a lifelong, progressive disease, and the prevalence of morbidly obese Americans (100 or more pounds over a healthy weight) is increasing rapidly. According to the CDC, the disease of obesity affects 78 million Americans. Further estimates indicate about 24 million have morbid obesity. Serious medical problems known as co-morbidities often occur when someone is morbidly obese. Studies tell us conditions such as type 2 diabetes, high cholesterol, sleep apnea, high blood pressure and degenerative arthritis increase in severity as the BMI is increasing in patients. When may weight loss surgery be an option? When someone has a BMI greater then 40. If a person’s BMI is 35 – 39.9 and they have significant health problems such as type 2 diabetes, high blood pressure, high cholesterol, sleep apnea, or other diagnosed health conditions related to obesity. Gastric Sleeve, Gastric Bypass Explained To resolve or significantly reduce these health conditions, bariatric surgery can be done when diet and exercise haven’t worked. Weight loss surgery makes changes to your digestive system to help you lose weight. The gastric sleeve limits how much you can eat, whereas gastric bypass limits how much you can eat and reduces the absorption of certain nutrients. Other Benefits of Surgery You can greatly increase life expectancy by resolving or significantly improving conditions like diabetes, high cholesterol, high blood pressure, sleep apnea, and obesity itself. Infertility can also be positively affected. A significant weight loss and relief from serious health conditions and diseases will greatly improve your quality of life. Studies tell us that type 2 diabetes is resolved or significantly improved in 84 percent of patients following bariatric surgery. Cholesterol levels dropped in 95 percent of patients. And hypertension and sleep apnea showed improvement in 68 and 80 percent of patients, respectively, following bariatric surgery. Bariatric Surgery at Renown In making the decision to move forward to better health, it is important to remember: Obesity is a disease, and the desire to have a healthier, longer, more fulfilling life is possible. If you are interested in learning more, please visit the Bariatric Surgery Program page to view more information about Renown Regional Medical Center’s MBSAQIP accredited bariatric program, as well as information about upcoming educational seminars. Or call 775-982-RSVP (7787) to reserve your seat. Learn More

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