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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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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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Becoming a Hometown Health plan member opens you up to the largest provider network in our region. As northern Nevada’s only not-for-profit health insurance company, the hometown advantage goes beyond your health coverage – and you may not be using all the perks available to you. Here are three benefits that Hometown Health is proud to offer all members to enhance wellbeing and connect the dots between healthcare and technology.  MyChart  MyChart is Renown Health's and Hometown Health’s secure online member portal that gives you direct access to your health and benefit information. From 24/7 access to your benefits and important documents to scheduling an appointment with your provider, this free tool is a great way to keep track of your family’s health. If you have a Renown primary care provider, you can use MyChart to:  Securely email your healthcare provider. Get your test results faster and view your After Visit Summaries. Request prescription refills. Schedule and check-in for appointments. Pay your bill. Request your medical records and review immunization records. Manage designated health care agents and upload end-of-life documents, such as advance directives and a living will. View or download your documents: Member ID Card, Summary of Care, Explanation of Benefits, Referrals and Authorizations. Get in touch with our Customer Engagement Center.  Telehealth  Virtual visits have never been easier thanks to Renown Telehealth and Teladoc. These two tools are convenient options that allow members to be seen by a qualified doctor via phone or video chat who can diagnose, recommend treatment and prescribe medication for many non-emergent medical conditions – no matter where you are. Some of the health issues your virtual provider can treat include:   Cold and flu Allergies Sore throat Sinus infection Respiratory infection Stomach bug Ear infection Urinary tract infection  Both Renown Telehealth and Teladoc are also staffed with specialists in behavioral health, where you can speak with a therapist or psychiatrist on a wide variety of issues, including:  Stress and anxiety Depression Trauma Grief Burnout Medication management  Renown is also proud to offer access to top-level specialty care to address your ongoing condition and help guide you through illness maintenance and education. Through Renown Telehealth, Hometown Health members have access to a variety of specialties, including (but not limited to):  Adolescent Medicine Cardiology Hematology, Oncology and Pediatric Oncology Nephrology Pediatric Endocrinology Pediatric Neurology Pulmonary and Pediatric Pulmonary Sleep Medicine  New in recent years, Teladoc is now proud to offer both dermatology and nutrition visits. Teladoc dermatologists can treat conditions like acne, rosacea and rashes, while their registered dieticians can help you manage your nutrition and weight goals.  Booking an appointment with Renown Telehealth is easy by heading over to MyChart and selecting “Schedule an Appointment.” To book an appointment with a Teladoc provider, visit teladoc.com or download the Teladoc app.  Renown Telehealth is available within the state of Nevada, and Teladoc is available in all 50 states. Your copay can be as low as $0 for each visit; check your plan documents for more information.  Doctoroo  The house call has returned – avoid long urgent care waits with Doctoroo. Through Doctoroo, Hometown Health members have access to in-home urgent care services at the same price as your regular urgent care copay. A call to Doctoroo will dispatch a fully equipped medical team consisting of an EMT and either a nurse practitioner or physician assistant to your home within a few hours. Whether you need treatment or testing, each team is ready to provide care in the comfort of your own home with their over 60 medications and antibiotics, EKGs, wound dressings, IVs, catheters and more.  Doctoroo care teams can address and treat many non-emergent care areas and conditions, including (but not limited to): Respiratory Ear, Nose, Throat Eye Wound Care Cardiac Care Musculoskeletal Gastroenterology  Doctoroo is open year-round from 7 a.m. to midnight. Book a house call in minutes in the Doctoroo app or by calling (888) 888-9930.

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Your provider wants to send you to a specialist. Now what?  You are about to enter the referral process. A referral is your provider’s recommendation for you to see a specialist or receive specialized treatment. When it comes to referrals, the process can seem like the wild west for people not familiar with it. At Hometown Health and Senior Care Plus, we make the process simple for all our members. We know that access to specialists is a vital aspect of total health, and our goal is to break down those barriers to care at every level.   Here is a step-by-step guide to how the referral process with your Hometown Health or Senior Care Plus provider works:  1.   Your primary care provider (PCP) or urgent care provider will send a referral to the specialist’s office. A referral can also be sent from another specialist or after discharge from the hospital. This is usually done via email or fax.   2.   As your referral is sent, now would be the ideal time to discuss with your provider’s office how the specialist will receive your medical records prior to your appointment. Your provider’s office will most likely send these records to the specialist for you, but it is always a good idea to double-check with them directly.  At Renown, the referrals team will send the following items to your specialist’s office when available:  ID Insurance card Most recent and relevant office notes to support the referral The referral order Any relevant labs or imaging pertaining to the referral Demographics information  3.   The specialist’s office will call you to schedule the appointment after they receive the referral. Each office processes the referrals they receive in a slightly different time frame, so if you have any questions about the status of your referral, it is best to call their office directly. At Renown, if you are enrolled in MyChart, you can access the phone number for your specialist as soon as the team processes the referral. Those not enrolled MyChart will receive a letter in the mail with scheduling information.  4.   The specialist will start to develop a course of treatment. That may include procedures, diagnostic tests or medications. Some of these treatments may require prior authorization from your insurance plan, so don’t forget to discuss how and when your specialist will receive the authorizations before you begin your course of care to avoid any surprise bills.  What can I expect if I have a Renown specialist?  At Renown, we handle a lot of the behind-the-scenes nitty-gritty so you don’t have to. After the referral is placed, it routes to Renown’s centralized referrals team and triaged to make sure you are scheduled with one of our providers with the right specialization for your specialty care needs. This team will also obtain the prior authorization you need and will you to a specialist that is in your network and based on you and/or your provider’s preference and continuity of care. The referrals team will attempt to find you a Renown provider first if you are not yet established elsewhere.   For Hometown Health and Senior Care Plus members, prior authorization is not required for certain services if you are being referred to a Renown provider. This makes the scheduling process go quicker for both the provider and the patient.   Our referrals team strives to keep their turnaround time for referrals within three business days, not including prior authorization wait times. If your referral is marked as ‘urgent,’ it will be reviewed within one business day so you are seen as soon as possible based on the needs of your medical condition, and you will receive a direct phone call with scheduling information.   After prior authorization is obtained, the Renown scheduling team will call you through an automated phone system or via a message in MyChart with a direct link to schedule your appointment. To speak with a Renown scheduler or if you have any questions, please call 775-982-5000.  What does prior authorization mean?  Prior authorization isn’t as scary as it sounds! Essentially, prior authorization is your provider “going to bat” for you to receive this specialty level of care. Some medical services, including many specialists, are covered only if your ordering provider (usually your PCP) submits an authorization request to your insurance plan. They will include specific details about the type and duration of treatment they would like you to receive and any medical records that support your need for the specialist.  After your insurer receives the request, a licensed medical professional will review the request, your records and your plan benefits. They will decide whether the specialty treatment is considered medically necessary based on recognized standards of care.  Where can I go for more information?  Your referrals and authorizations can be viewed in MyChart. To view them, navigate to Your Menu in the upper left corner of the page, scroll to the Insurance section and click on “Referrals.”   The Renown referrals team is available to answer your questions and address any concerns. Give them a call at 775-982-2707 Monday through Friday from 8 a.m. to 5 p.m.  Any questions you may have related to referrals and authorizations, including outside-of-Renown providers, can be directed to our expert Hometown Health or Senior Care Plus customer engagement representatives.

Read More About How Referrals Work at Hometown Health and Senior Care Plus

As we enter the holiday season, many of us are beginning to plan and partake in festivities such as shopping, cooking, baking, holiday parties and family gatherings. While the holidays often bring joy and cheer, the hustle and bustle can also lead to fatigue, stress, anxiety and sometimes depression. To avoid holiday burnout, it’s important to find ways to care for yourself mentally and physically. Galen Gorelangton, Renown's Spiritual Center Volunteer, discusses how yoga and meditation can benefit you. What is yoga and meditation?  Yoga is defined as performing a series of postures and controlled breathing exercises to promote a more flexible body and a calm mind. As you move through poses that require balance and concentration, you're encouraged to focus less on your busy day and more on the moment. Meditation involves focusing or clearing your mind using a combination of mental and physical techniques. While there are many different types of meditation and yoga practices, they both share similar benefits including: Reduced stress Lower blood pressure Decreased anxiety and depression Increased energy Better sleep Lower inflammation and pain levels Improved strength, balance and flexibility  Better focus and concentration  And much more!

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Reviewed by: Jessica Blauenstein, a Board-Certified Specialist in Oncology Nutrition and Registered Dietitian at Renown Health. As the temperatures continue to rise around northern Nevada, our farmer’s markets and home gardens are bursting with produce – making this the perfect time to prepare a fresh summer salad for you and your family. American salads have come a long way. No longer must we settle for iceberg lettuce topped with pale tomatoes and store-bought salad dressing. Fresh fruits, exotic vegetables and aromatic herbs are proudly taking up residence as entrees on menus around the globe. These refreshing Pritikin salad recipes are chocked full of phytonutrients – plant compounds that provide a host of anti-bacterial and anti-inflammatory benefits while supporting the body’s natural detoxification process. When it comes to ingredients, freshness counts! Try to use local and unsprayed produce in your salads whenever possible for added nutritional value. Already thinking of ways you can put your own personal touch on these recipes? Andria Herron, dietary educator with Renown’s Healthy Heart Program, encourages you to experiment. “Salads are the perfect recipes to substitute, omit and add in additional ingredients based on your personal preferences,” said Andria.

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If you and your partner are looking for a more permanent birth control method, you might consider a vasectomy. Although vasectomies are common, knowledge about them isn’t quite as common or talked about. If you are considering a vasectomy, talking with your primary care doctor is a great way to learn more and start the process. We consulted with Dr. Aurosis Reddy a primary care doctor with Renown Health – South Carson, about key topics to discuss with your doctor when considering a vasectomy. What is a vasectomy? A vasectomy – also called male sterilization – is a form of male birth control that blocks sperm from reaching semen, according to the American Urological Association (AUA). How effective and safe are vasectomies? Vasectomies are one of the most effective methods of birth control with a long-term success rate of over 99%. A vasectomy has been a safe and successful birth control method for many years. More than 500,000 men elect to have vasectomies every year in the U.S., and the number is rising. A vasectomy is also generally a low-risk procedure with a low complication rate ranging between 1-2%. What does the recovery period look like? A vasectomy is typically a quick procedure that takes under thirty minutes and can be performed in an outpatient setting under local anesthesia. Recovery from a vasectomy is also considered relatively easy. After a vasectomy, most can: Resume everyday activities within two to three days Resume normal exercise in one week Start engaging in sexual activity again in one week Your doctor can provide more details on what your individualized recovery process will look like.

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Renaissance Don   The Sterling Silver Club is honored to have thousands of members who’ve led and continue to lead incredibly vibrant and diverse lives. And we’re absolutely thrilled when those members volunteer to share their stories and experiences so we can all appreciate and learn from them.   This issue’s featured member is no exception. From his love of cooking, travel and music to his drive to learn new languages, take on new hobbies and keep himself active and fit, Don is an aspiring Renaissance man who may already be deserving of the title.    Revolutionary Family Roots   Don’s father, who was born in Beijing, China, earned a master’s degree in metallurgical engineering from the University of California, Berkeley and was working on his PhD there on a full scholarship from his home country when the Chinese Communist Revolution occurred. In order to stay in the United States and avoid potentially being thrown into prison by the new communist regime (a fate that befell some of his family members), his father married Don’s mother, who was a U.S. citizen and also a student at Berkeley. Together, they started a family.   “My father met my mother in a class and received his green card by marrying her,” says Don. “They proceeded to have six kids in nine years, I was number three. Dad never finished his PhD, but clearly earned what we like to call his “PSK” degree – Papa with Six Kids.”  Proud (of) Papa: Don’s father was a professor of metallurgy and a brilliant research scientist who was responsible for virtually every breakthrough in the development of titanium in the 1960s.

Read More About Meet Multifaceted Member Don Chang

Unfortunately, men are less likely to visit their doctor for exams, screenings, and consults than women. So with the help of Bonnie Ferrara, MD of Renown Health, we've put together a list of eight screenings to help men stay on top of their health game. 1. Blood Pressure Tests Ages 20+ Blood Pressure tests measure the pressure in your arteries as your heart pumps. Biennial (every two years) checks are recommended if you have normal blood pressure or more frequently if you have high blood pressure (hypertension) or low blood pressure (hypotension). The United States Preventative Services Taskforce cites normal blood pressure below 120 systolic (top number) and 80 diastolic (bottom number). 2. Cholesterol Screening Ages 20+ High levels of cholesterol increase your risk of stroke and heart disease. A simple blood test will help your healthcare provider determine your numbers and if you're at risk. If you have a family history of diabetes or heart disease, you may need yearly screenings. But, again, your doctor can provide the best course of action.

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Flu shots don’t just protect those who get vaccinated; they guard everyone, including your family and the community. Renown Health experts help us understand why everyone should get a flu shot, including children, pregnant women and older adults. Ways to Schedule Your Flu Shot Call Us! 775-982-5000 Urgent Care Appointments Renown Pharmacy Vaccinations Make an Appointment via MyChart Need a Doctor? Find One Now Flu Shot Information Whitney Robinson, Renown Health Infection Prevention Expert Chills, body aches, fever and congestion; getting the flu isn’t fun. When you get a flu shot, you’re not just protecting yourself, you’re also helping reduce the total flu cases and hospitalizations. The ideal time to get your flu shot is September through October. This timing allows the vaccine to provide the strongest protection during the length of flu season. However, getting the vaccine later is better than not at all as it's still flu season well into spring. Flu Symptoms In general, influenza (flu) is worse than the common cold and shares symptoms with COVID-19, causing mild to severe illness, and at times can lead to death. Symptoms include: Fever or feeling feverish/chills (not everyone will have a fever) Cough and/or sore throat Runny or stuffy nose Headaches, muscle or body aches Fatigue (tiredness) Vomiting and diarrhea, though this is more common in children than adults Who Needs a Flu Shot? Almost everyone. The Centers for Disease Control and Prevention (CDC) considers it the first and most crucial step in protecting against the flu virus. Therefore, they recommend the yearly flu shot for those six months of age and older. Does the Flu Shot Help with COVID-19? The short answer is no. However, flu vaccines can reduce the risks of flu illness and hospitalization. Therefore, it is crucial for you to get your flu shot to not only protect yourself and the community, but also to help conserve vital, local healthcare resources. CDC Resource: Who Needs a Flu Vaccine and When Kids, the Elderly and Flu Shots  Vanessa Slots, M.D., Renown Medical Group The flu is not a passing cold. It is a serious illness that takes lives every year and it happens like clockwork. The onset of flu season is fall and lasts through winter into the spring months. This lung illness is caused by viruses, with yearly outbreaks occurring worldwide. No one is immune, and anyone can catch  to the flu. Flu Signs and Symptoms Quick onset of fever Headache Body aches and fatigue along with respiratory symptoms including cough Sore throat and nose Who's at Risk for the Flu? Children and the elderly are at greater risk of complications from the flu, specifically toddlers less than two years old. At this age, their immunity is still developing. Seniors over 65 are also at increased risk because their immune systems have weakened with age. The severity of a child’s symptoms depends on age and prior exposure to the virus. With young children, for example, the flu is more problematic since they cannot talk and communicate their symptoms. As a result, children often experience higher fevers, which can lead to seizures or convulsions. This can be coupled with issues such as nausea, vomiting, diarrhea and poor appetite, all of which put children at risk of dehydration and other complications that can require hospitalization. An average of 20,000 children are hospitalized for flu each year. Pre-Existing Health Issues Ongoing health conditions including asthma, heart conditions, diabetes and more can intensify flu symptoms. Still, many children without risk factors can experience severe flu complications. CDC Resource: Flu Information for Parents Pregnant Moms and Flu Shots Tamsen Carson, PAC, Surgical First Assistant, OB/GYN, Renown Medical Group “During pregnancy, your immune system wards off infection for your baby, leaving you more susceptible to infection and adverse health conditions,” Tamsen explains. She   highly recommends flu shots for ALL women during pregnancy. You must receive the injected vaccine versus the live vaccine, a nasal spray, which can cause the flu to occur. Passing Flu Immunity on to Your Baby Also, remember that you will also be able to pass the immunity onto your baby if you breastfeed, which will protect your baby from the flu. CDC Resource: Flu Safety and Pregnancy

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What is Proxy Access? Proxy access allows parents, legal guardians and caregivers to log into their personal MyChart account and connect to the health information of a patient they represent. As a proxy, you can view upcoming appointments, request appointments, view lab results, email a doctor on the patient’s behalf, view medications, request prescription refills and view health reminders. How Do I Establish Proxy Access? Login to your MyChart account with your username and password Go to the Profile menu at the top of the screen, then select Personalize From this screen you can see whose records you currently have access to Click Request Access to a minor’s chart Complete all of the fields When finished click Submit Request What if I Don’t Have a Renown MyChart Account? If you don’t have a Renown MyChart account, call 775-982-2781 and someone from the Renown Health MyChart team can help you set up proxy access. Keep in mind, the ability to request proxy access is only available on the MyChart website and not via the mobile app. However, the website can be accessed with your smartphone or tablet by using the web browser and going to mychart.renown.org.

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Much like general physical and mental health, sexual health is an essential aspect of your overall well-being. Therefore, educating yourself on your sexual health is an important piece regarding your overall wellness. Secure & Private Virtual Visits Did you know that many sexually transmitted disease appointments can happen virtually, in the privacy of your own home? Our providers can perform a screening examination for sexually transmitted illness (without symptoms) when it’s convenient for you. This is a great option if the topic makes you uncomfortable during an in-person visit, or if you can’t find time to visit your primary care provider or local urgent care. After the telehealth appointment, your provider will determine the  next steps for you. Remember, in-person visits are always an option as well.   Here’s how you can take charge of your sexual health:  Get Comfortable with Getting Tested  Surprisingly, some people with STDs don't show symptoms, meaning they may not even know they have an STD unless they get tested. Even if an STD shows no symptoms, the result of non-treatment can be serious. Bret Michael Bellard, MD, with Renown Medical Group, shares that it’s important for people to get tested for STDs because if left untreated, they can cause the following health problems: Loss of fertility Pregnancy complications Other health issues  When to Visit Your Primary Care Provider  Who should get tested and how often? “The recommendations are that everyone from ages 13 to 64 should get tested at least once for HIV. All sexually active adults should also be tested for other STDs once a year, and all pregnant women should be tested at the start of their pregnancy,” says Dr. Bellard. Some STDs, like syphilis, can be passed from mother to baby, so it's important for women to get tested as soon as they know they’re pregnant.  Dr. Bellard recommends going to your primary care provider for testing. “They can also give advice on prevention and other health topics.” If you don’t have a primary care provider, this is a great reason to get established with one. Women with an established OB/GYN can have STD testing done simultaneously with their annual pelvic exam. The providers in Renown's network care for patients of all ages and specialize in family medicine, internal medicine, pediatrics and OB/GYN.   Practice Safe Sex  STDs are preventable. Practicing safe sex and getting tested routinely are your best defenses against all types of STDs.  For many, the conversation about sexually transmitted diseases is awkward and many avoid it. To lower your risk of contracting an STD, don’t wait until you’re “in the moment” to have the conversation with your partner about the last time you were both last tested. If you haven’t gotten tested in-between new partners, use latex condoms every time you have sex until you are both confirmed negative of STDs. Condoms are not 100% effective at preventing disease or pregnancy. However, they are extremely effective if used properly.   To establish Primary Care, visit renown.org/virtualvisits or call 775-982-5000

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