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Obstetrician-gynecologists (OBGYNs) see patients from menses (the monthly menstrual cycle that occurs as a part of the female reproductive system), pregnancy and childbirth through menopause and play a pivotal role in managing reproductive health and overall wellness. Dr. James Alexander with Renown Women's Health explains. "As experts in women's health, we are uniquely positioned to recognize subtle changes or symptoms that might indicate broader health issues. This comprehensive approach allows us to serve as a valuable first touchpoint for various health concerns." Preventive Screenings: A Proactive Approach One key aspect is an OBGYN's ability to recommend preventive screenings based on your symptoms, age, lifestyle and medical history. For instance, lipid screenings are critical for monitoring cholesterol levels, which can be a significant factor in women’s heart disease. An OBGYN keeps up with the current guidelines for routine screening as well as in women with risk factors such as high blood pressure, diabetes, or a family history of heart disease during your visit. By identifying risks and abnormal screening early, they can collaborate with you to implement lifestyle changes or treatments to reduce your risk of heart conditions. Schedule Your Screening Appointment Make an Appointment by Phone: 775-982-5000

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While menstrual cycles can be an annoying inconvenience for many women, heavy bleeding (menorrhagia) is not normal and can disrupt your life. A few days of heavy flow at the start of your period is usually nothing to worry about. However, if you’re frequently experiencing very heavy periods, you should discuss it with your gynecologist or primary care provider.  Dr. Megan Fish, an OB-GYN with Renown Women’s Health, discusses various reasons, evaluation and treatment methods when it comes to heavy menstrual cycles.  What is classified as heavy menstrual bleeding?  The American College of Obstetricians and Gynecologists considers heavy bleeding to be any of the following signs: Bleeding that lasts more than 7 days. Bleeding that soaks through one or more tampons or pads every hour for several hours in a row. Needing to wear more than one pad at a time to control menstrual flow. Needing to change pads or tampons during the night. Menstrual flow with blood clots that are as big as a quarter or larger. What are the most common reasons for heavier periods?  A variety of reasons why someone might have heavy periods. Fortunately, most of these problems are treatable. Because each woman's period is unique, only a doctor can definitively determine the cause of your heavy periods. Some of the most common issues that cause heavy periods include: Hormone imbalances such as anovulation, thyroid disease and Polycystic Ovary Syndrome (PCOS). Structural abnormalities in your uterus such as polyps or fibroids.  Precancer and cancer such as uterine, cervical, vaginal, ovarian or endometrial hyperplasia.  Infections such as chlamydia, gonorrhea, endometritis or vaginitis. Other medical conditions such as liver disease, kidney disease or Pelvic Inflammatory Disease. Medications such as blood thinners and aspirin, hormone replacement therapy, Intrauterine devices (IUDs), birth control pills and injectables. Pregnancy-related problems such as a miscarriage or ectopic pregnancy.

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Dr. Carilyn Hoffman with Renown's Women's Health explains the symptoms, causes and treatments of Polycystic Ovary Syndrome (PCOS) (also referred to as Polycystic Ovarian Disease (PCOD)), a prevalent condition among women of reproductive age that influences hormonal balance, metabolism and fertility. Make an appointment with Renown Women's Health Click here to schedule Call to schedule: 775-982-5000 PCOS Defined PCOS is a constellation of symptoms characterized by two of the three criteria: multiple small cysts on the ovaries visible via ultrasound, irregular periods and signs of hyperandrogenism. Other symptoms include infertility, insulin resistance, and increased risk of cardiovascular disease. Symptoms of PCOS The symptoms of PCOS can vary from woman to woman, but some of the most common include: Irregular menstrual cycles: This is often one of the first signs of PCOS. Women may experience fewer than nine periods a year, more than 35 days between periods, frequent spotting, and/or abnormally heavy periods. Excess androgen levels: High levels of male hormones may result in physical signs such as excess facial and body hair (hirsutism), severe acne and male-pattern baldness. Polycystic ovaries: Enlarged ovaries containing numerous small cysts can be detected via ultrasound.     Causes and Risk Factors The exact cause of PCOS is unknown, but several factors may play a role: Genetic predisposition: A family history of PCOS increases the risk. Insulin resistance: High insulin levels might increase androgen production, causing difficulty with ovulation. Obesity: Women with elevated BMI’s are more likely to have PCOS, although 20% of women with PCOS are not obese. Diagnosis and Treatment Dr. Hoffman outlines that diagnosing PCOS requires a medical history review, a physical exam, blood work and an ultrasound to evaluate the ovaries. Treatment options can range from lifestyle modifications, like diet and exercise and weight loss, to medications for menstrual regulation, fertility assistance, and rarely surgery. Lifestyle Changes A healthy lifestyle is a cornerstone of managing PCOS. Regular exercise, a nutritious diet, and weight management can help reduce symptoms and the risk of long-term health issues. In overweight patients, weight loss as little as 5% has been shown to improve symptoms of PCOS. Medication Medications may include hormonal contraceptives to regulate menstrual cycles, anti-androgens to reduce hair growth and acne, and Metformin to address insulin resistance. Fertility Treatment For women with PCOS who are trying to conceive, ovulation induction with clomiphene or letrozole is sometimes necessary. Sometimes a referral to a reproductive endocrinologist and infertility specialist is needed for more advanced technologies like IVF. Health Implications PCOS is not just about cystic ovaries or irregular periods; it can have profound implications on a woman's overall health. Women with PCOS are at an increased risk for several conditions, including type 2 diabetes, high blood pressure, heart disease, and endometrial cancer.

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Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs.  Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health.  PrEP and PEP  Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months.  Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days.  PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location.   HPV Immunization  All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime.  The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never!  STI Testing  Sexually-transmitted infections form from bacteria, viruses or parasites that can be transmitted by person-to-person sexual contact through semen, vaginal, blood and other bodily fluids. According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new STI cases across the nation each year.   Luckily, most STIs are preventable. Annual STI testing for HIV, gonorrhea, chlamydia and syphilis is important to stay on top of your sexual health. Because these STIs may sometimes have no symptoms, screening is recommended regularly and with any change in sexual partners. Depending on the specific condition, tests for these infections include urine, swab and blood tests. Speak with your primary care provider on a screening schedule that works best for you.  Prostate Exams  Prostate exams look for early signs of prostate cancer in patients who still have a prostate. The CDC recommends those who are at least 55 years old get regular prostate screenings; however, for patients with a family history of prostate cancer, screenings may be recommended as early as 45 years old.  These exams are done via two common methods – a prostate specific antigen (PSA) blood test and a digital rectal examination (DRE). Your provider can help you determine your risk and when you should start getting screened.  Pap Tests and Pelvic Exams  Patients of all genders who have a cervix, uterus, vagina and/or ovaries will benefit from regular pelvic exams and Pap screenings. A pelvic exam consists of a provider looking inside the vagina and at the cervix for anything unusual. A Pap test, also known as a Pap smear, involves your provider using a small, soft swab to collect cervical cells to check for early signs of cancer.  Generally speaking, people with these organs should have a Pap test every three years starting at age 21 through the age of 30. After age 30, patients should receive a Pap test with HPV co-testing every five years until age 65. These recommendations are changing based on new research, so it is important to have a conversation with your PCP about the current guidelines so you can make an informed choice about what schedule you should follow. A gynecologist or your primary care provider can counsel you and perform these screenings.  Mammograms and Breast Exams  People with breast tissue, especially dense breast tissue, are at risk for breast cancer, and regular breast screenings are your best line of defense. At-home breast self-exams are the first step – you will want to check your breasts for any lumps, changes, fluid leaks, irregular tissue thickening or anything else that feels unusual.  The Breast Cancer Risk Assessment tool, provided by the National Cancer Institute, is a good place to start to identify your risk. Talk with your primary care provider about the risks and benefits of starting screening at age 40 so you can make an informed decision about when to start. If you have any family history of breast or ovarian cancer, your PCP will offer you genetic testing for BRCA 1 and 2 mutations. Nevadans over the age of 18 can also get BRCA genetic test for free by enrolling in the Healthy Nevada Project.  Mammograms are important screening tools, but for a significant portion of people with breast tissue, density of the breast tissue may make mammograms less helpful in detecting cancer. Your primary care provider can help you decide what additional imaging (such as breast ultrasound) might be best for you.

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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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This Department Spotlight is dedicated to Jason Simpson, Manager of Respiratory Services at Renown Children’s Hospital.  Take a moment to breathe deeply. Inhale in, exhale out. We rely on our lungs to provide us with the air we need to live a healthy life – and this essential bodily function is something that many of us don’t think twice about since it comes easily for us. Now, imagine yourself as someone who is living with severe asthma, chronic obstructive pulmonary disease (COPD) or someone who was recently diagnosed with a frightening respiratory condition like COVID-19 or pneumonia. The simple act of breathing can prove to be an intimidating venture requiring the care of a professional. Who are the people that take on the challenge?  Meet Renown Health’s Respiratory Care Services department. Serving patients across 13 service lines, three acute facilities, outpatient locations and telehealth, our respiratory specialists – including respiratory therapists, respiratory care aides, inpatient COPD respiratory therapy navigators and educators and more – use their expertise to help restore the vitality of all their patients with every inhale and exhale, shaping a healthier livelihood one lung at a time.  The Guardians of Respiratory Wellness  Whether they are managing lifelong respiratory conditions or offering crucial support in emergencies, the Respiratory Care team strives to enhance the quality of life for every patient. As an indispensable member of the clinical team at Renown, our respiratory therapists work collaboratively with doctors and nurses to tackle a wide range of tasks, tailoring care for each patient’s unique needs.  “Respiratory care is involved with all stages of life, from beginning to end,” said Sarah Kurtz, Respiratory Therapist. “We work closely with nurses and doctors and perform arterial punctures, breathing treatments, weaning maneuvers for patients on life support, intubations and much more. We assess patients constantly to see if their care needs to be upgraded or if they can be weaned to get them back home with their families.”  “You start your morning researching your assigned patients,” added Tim Start, Respiratory Specialist. “We go over lab values and chest radiographs and decide the best plan of care for each patient. Our objective is to improve their respiratory status by giving them medications and doing breathing exercises. We participate in other forms of care with nurses, such as activities of daily living (ADLs) and mobilization. We work as a team, and that enables us to provide great patient care.”  For patients living with COPD, enjoying all that life has to offer comes with a separate set of obstacles. According to the Centers for Disease Control and Prevention (CDC), over 200,000 people across the Silver State are living with this chronic condition. Luckily for them, Renown has a specialized team to help these patients optimize their life and manage their condition with individualized treatment and education.  “We run a report every morning to identify all the patients currently admitted who have a history of COPD, take respiratory medications or smoke,” said Amber Beck, Inpatient COPD RT Navigator. “After looking through their charts, we visit with the patient (and possibly their family) at the bedside to help them better understand how to manage their breathing issues.”  As a vital part of the Respiratory Care team, Renown’s respiratory care aides help ensure the seamless operation of our respiratory care services. These dedicated professionals provide essential support to respiratory therapists not only during intricate procedures but also outside of face-to-face patient care by transporting equipment, restocking supplies, assisting in the mobilization of patients and more.  “We are responsible for the maintenance of unit supplies and making decisions regarding levels of stock to be maintained,” said Dia Ramos, Respiratory Care Aide. “We also transport equipment, refill the oxygen tanks on the floors and intensive care units (ICUs), order and stock respiratory care supplies, mobilize patients and assist the respiratory therapists during bronchoscopies in the ICUs. In addition, we clean respiratory equipment like mechanical ventilators, continuous positive airway pressure (CPAP) and bilateral positive airway pressure (BiPAP) machines, high flows and aerosol poles.”  Once the COVID-19 pandemic hit, a special spotlight shined upon respiratory care teams across the country for the heroic care they provided patients in respiratory distress. While their roles in health systems have gained a better understanding nationwide, this team understands it is vital for them to educate the community about the important jobs they hold for our patients.  “Respiratory care can be under the radar,” said Pam Umek, Respiratory Specialist. “Once, when I told someone that I am a Respiratory Therapist, they said, ‘Oh, like a yoga breathing instructor?’ I then explained all the things we do: intubation, extubation, bronchoscopies, transports, traumas, codes, rapid responses, pediatrics/NICU, breathing medications/therapies, open heart rapid ventilator weaning … needless to say, that individual walked away with a better understanding of not just Respiratory Care Services but also the enormous effort it takes to care for our community.”  The accolades and achievements continue to pour in, from national awards and certifications to implementing different jobs in care units to optimize the patient care experience.  “We have earned and continue to maintain the Joint Commission Disease-Specific Certification for COPD,” said Amber Beck. “We are well below national averages for 30-day readmissions, lengths of stay and mortality due to COPD. Sandy, one of our COPD Coordinators, was a recipient of a patient advocacy award from the American Association of Respiratory Care and FACES Foundation.”  “We have started implementing Respiratory Care Aides in the critical units, starting with the Cardiac ICU,” added Dia Ramos. “We work as one team and are always helping each other with their tasks.”  Education and mentorship are at the core of Renown’s mission to make a genuine difference in the health and well-being of every patient. Nurturing the next generation of medical professionals – including respiratory care professionals – is a task that the Respiratory Care team takes seriously.  “It has been great being able to help educate students in different disciplines,” added Pam Umek. “We have been able to offer shadow shifts to students in emergency medical services (EMS), nursing and medical school. These opportunities help students entering the medical field have a better understanding of the many ways we can help care for our respiratory patients.”  From the moment of birth to the final stages of life, Renown is fortunate to have a Respiratory Care team that tirelessly ensures every breath counts, safeguarding their role as a trusted partner within our health system.  A Tribute to Jason Simpson, Healthcare Hero

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In today's fast-paced society, it is understandable for parents to want to take shortcuts in caring for their little ones. A s a result, It is tempting to leave a sleeping infant in a car seat or swing after a long day of errands or when you need a moment to catch your breath. But, as convenient as these devices may be, they pose a serious risk to your child's safety. Why Car Seats and Swings Pose Risks for Infant Sleep Car seats, swings, and bouncers are quick and convenient ways to feed, hold, and sleep an infant. Not out of malice or discontent, but again from the need for quick and easy access to baby care in an already busy lifestyle. However, the risks outweigh the benefits. The American Academy of Pediatrics (AAP) states that “infants should be moved to a crib, bassinet, or play yard for sleeping as soon as is practical.” If a parent must use a car seat or other sitting device, they should only do so for a short period of time and never as a substitute for a proper sleeping environment. Leaving a sleeping infant in a sitting device, such as a car seat or swing, can create unsafe sleeping conditions. The American Academy of Pediatrics (AAP) warns that doing so increases the risk of sudden infant death syndrome (SIDS) and positional asphyxia. This is because infants can easily slump over or become entangled in the straps, blocking their airway, and causing suffocation. Car seats, swings, and bouncers are quick and convenient ways to feed, hold, and sleep an infant. Not out of malice or discontent, but again from the need for quick and easy access to baby care in an already busy lifestyle. However, the risks outweigh the benefits. The AAP states: Infants should be moved to a crib, bassinet, or play yard for sleeping as soon as is practical. If a parent must use a car seat or other sitting device, they should only do so for a short period and never as a substitute for a proper sleeping environment. Leaving a sleeping infant in a sitting device, such as a car seat or swing, can create unsafe sleeping conditions. The AAP warns that doing so increases the risk of sudden infant death syndrome (SIDS) and positional asphyxia. In addition, infants can easily slump over or become entangled in the straps, blocking their airways and causing suffocation.

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

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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.

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Most babies weigh just one pound and are roughly the size of an eggplant when they reach 24 weeks of development inside the womb. It is a crucial stage when internal organs begin functioning, and the babies' respiratory and central nervous systems are still developing.     So, in November 2021 when Kallie Johnson experienced a premature rupture of amniotic fluid around this point in her pregnancy, her care team in Winnemucca decided to transport her via Care Flight to Renown Regional Medical Center. The team at Renown Children’s Hospital immediately began discussing the risks of delivering at 24 weeks with the Johnson family.  Moving Forward with Hope Knowing the stakes, Kallie remembers never feeling rushed to decide about delivering her baby preterm. “I felt educated and supported by my care team at Renown throughout our entire stay, starting with the education they provided about what it meant to deliver my baby early,” Kallie said. “The team really helped me make the best decision for myself and my family.”    Together, Renown employees and the Johnson family moved forward with a healthy set of nerves and a powerful feeling of hope.  Weighing in at one pound 11 ounces, Sloan entered the world on Nov. 19, 2021, via emergency Cesarean section. Her birth was classified as a micro preemie because she was born before week 26 of pregnancy and so small that she fit inside the palm of her father Sterling’s hand. A full-term pregnancy is classified as reaching 39 weeks.   A Fighting Chance  Called a fighter by many Renown Children’s Hospital care team members, Sloan spent over five months in the neonatal intensive care unit (NICU). She was placed on a ventilator, fed through a feeding tube and monitored 24/7, overcoming daily challenges with the Renown team and her family.  As a result of being born prematurely, Sloan developed a grade one brain bleed and a congenital heart defect called patent ductus arteriosus, a persistent opening between two major blood vessels, causing too much blood to flow to the lungs and heart.   To meet the oxygen needs of her tiny lungs, Sloan was intubated and developed a severe oral aversion and high-arched palate as a result. The effects would lead to difficult developmental and physical challenges that she still conquers today. Yet, with the help of her care team – including physical, occupational and speech therapists, dieticians and doctors – Sloan continues to make progress every day.

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By taking our pregnancy and birth class, you will gain the tools necessary to have a safe and empowering birth experience for both you and your baby. Chris Marlo, Childbirth Educator at Renown Health explains why birth classes are important. For questions regarding classes or tours, contact Chris Marlo: chris.marlo@renown.org 775-982-4352 What is a Certified Childbirth Educator/Doula? If you are expecting a baby, Renown has a wide variety of classes to help prepare you for birth. Classes are taught by certified childbirth educators and doulas. A certified childbirth educator is a trusted resource who has a passion for educating expecting parents about childbirth, and will provide you with non-biased, evidence-based information. A doula is a professional labor assistant who provides physical and emotional support during pregnancy, childbirth and postpartum. As you prepare for birth, our certified educators will guide you each step of the way and ensure you receive the quality care you deserve.

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If you're not taking safety precautions during mountain sports, you could be at risk for a spinal cord injury. Dr. Benjamin Pence of Renown Rehabilitation Hospital explains the best way to prevent this serious injury. Mountain sports are a big part of the winter season here in our area, but if you’re not practicing all the proper safety techniques, you could end up with a serious spinal cord injury. Benjamin Pence, MD, Renown Rehabilitation Hospital, is here to offer tips to prevent this serious injury while you’re out enjoying what the Truckee Meadows has to offer. What is the spinal cord? The spine stretches from the base of your skull to the coccyx (commonly referred to as the tailbone). Your spine is made up of 24 vertebrae—seven cervical, which are in your neck, 12 thoracic, which are in your chest, and five lumbar, which are in your lower back. There are ligaments and muscles attached to each vertebra. These facilitate back movement and protect the bones from damage. There is cartilage between each vertebra which acts as a shock absorber for your spine. Finally, the spinal cord is a long, thin, tubular bundle of the nervous tissue and support cells that is enclosed in the spinal canal and send signals from the brain to everything from your arm and leg muscles to bowel and bladder function. The brain and spinal cord together make up the central nervous system.

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