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Physiatry (fi-zahy-uh-tree), also referred to as physical medicine and rehabilitation, encompasses the diagnosis, prevention and treatment of disabilities or injuries related to the brain, nerves, bones and muscles. The goal of this specialty is to maximize physical functioning, greatly decrease or eliminate pain, foster independence and improve quality of life for those suffering with a disability, chronic pain and physical impairments. Who Is It for? Physiatry can help patients with functional deficits and secondary medical conditions as a result of the following: Amputation Brain Injury Osteoarthritis Spasticity and Movement Disorders Spinal Cord Injury Spine Pain Sports-Related Injuries Stroke Some of these medical conditions can often cause chronic pain or impede physical functioning, ultimately affecting a person’s overall well-being and making it difficult for them to sustain a desired quality of life.

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As the temperatures skyrocket and we return to more outdoor activity, one thing is certain: you must hydrate to stay cool, healthy, and functional. But how much water do you need, and what are some easy ways to ensure you are getting enough? Aurosis Reddy, DO a family medicine provider with Renown Medical Group, shares what you need to know.  How Much Water Is Enough?  Experts agree that recommended daily water intake can vary depending on different factors such as your weight, metabolism, location, diet, physical activity, and health. As a rule of thumb, women should aim for a daily fluid intake of 91 ounces, and men should aim for 125 ounces. It is important to listen to your body and recognize when you might need to increase your water intake. For example, if you’re partaking in strenuous exercise, or spending time outside in the heat, you’ll want to give your body more water and electrolytes to function properly.  How Can I Tell If I Am Dehydrated? Decreased coordination Fatigue Less urination Dizziness Dry, sticky lips and mouth Increased thirst Headache

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When seeking medical care, there are several different provider types and options from which to choose. For example, you may have asked yourself a common question: Should I go to my primary care provider, urgent care or the emergency room? Sarah Herbert, APRN with Renown Medical Group – South Carson, provides guidelines to help you easily make this decision. When should you go to the Emergency Room (ER)?  Making a visit to the ER should be reserved for severe symptoms and/or life-threatening conditions, including:  Chest pain Severe shortness of breath or difficulty breathing Weakness or numbness on one side Slurred speech Fainting/loss of consciousness Continuous bleeding or major open wounds Severe allergic reactions  Coughing or throwing up blood Drug or alcohol overdose Sharp pain in lower abdomen Severe dehydration and not responding to nausea medication (needing IV fluids) High fever that does not get better with medicine Serious burns Broken bones/dislocated joints Head trauma Find an Emergency Department Near You If you’re still unsure of where to go for appropriate medical care, it’s best to check with your primary care physician. And remember, for a life-threatening emergency, call 9-1-1 immediately!

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Overcoming poverty is not a task of charity, it is an act of justice. Like slavery and apartheid, poverty is not natural. It is man-made and can overcome by the actions of human beings. Sometimes it falls on a generation to be great. You can be that great generation. Let your greatness bloom. – Nelson Mandela, February 2005, Make Poverty History Campaign in London Lifting away the curtain that symbolized the front door, I entered a dark, cinderblock room and instantly became overwhelmed by an unpleasant odor. Working with oncology patients as a Child Life Specialist and an Occupational Therapist for over ten years, I recognized that smell. I had arrived in Guatemala – more than 3,000 miles from Reno – and it was my first day of a week-long trip where I would be serving alongside physicians in low-income communities providing free medical care for residents. My name is Brittany Jemmoua, I am an occupational therapist at Renown, and I recently volunteered with Kalan Kuxtal, a non-profit Guatemalan organization. I served alongside physicians by providing free primary care mobile clinics and home visits. The care we provided focused on prevention, intervention, education and lifestyle/medication management as we partnered with local entities, such as fire stations, community centers and schools to transform hundreds of lives. Speaking in both English and Spanish, I collected patient intake information, performed exams, tested for diabetes, and collaborated on a diabetes research project focused on daily risk assessment. Beyond these tasks, I immersed myself in the culture and learned more from the Guatemalan people than I could have ever imagined. Similar to Renown, Kalan Kuxtal Operates with Community at its Core Kalan Kuxtal, a Mayan expression meaning “life guardian,” is different from other volunteer medical trip organizations, and I took home valuable insights and lessons from their way of life that I now consider daily in my practice at Renown. I expanded my knowledge about diabetes, hypertension, pharmacology, infectious diseases, pregnancy complication, vector-borne illness and tuberculosis. We conducted home visits for socially neglected populations rather than expecting everyone to come to our clinics. I found that being welcomed into people’s homes gives you a different lens in which to view how their medical diagnoses interact with living conditions, occupations, and quality of life. This is when I met Mercedes and her mom. Her mom, Ms. Valencia, had jaundice skin and a substantial Basal Cell Carcinoma aggressively protruding from her face that impacted eating, hearing, seeing, sleep and social interactions. This opportunity to serve within their home led to an important palliative care conversation that would have been missed had we stayed in the clinic. We combed the rural neighborhoods assessing people’s risk for diabetes, taking glucose tests and educating families about their next steps. Many individuals had uncontrolled diabetes and misunderstandings regarding basic health management strategies. At the end of the day, many people demonstrated feelings of empowerment by actively offering solutions regarding how they will manage their day-to-day glucose with diet and exercise. Small actions can lead to big changes, and in the long-term, these health actions can help them avoid medication costs and focus on affording basic life necessities, such as water and electricity. Kalan Kuxtal organized a cultural day that included going to local businesses and community leaders to learn more about how they support the people of Guatemala. For example, Valhalla Macadamia Farm’s main goal is to help communities gain access to income, employment, and improved wellbeing by donating macadamia trees to families to grow and then sell macadamia products. A Weeklong Trip with Lifelong Impacts Each patient made a lasting impact on me, both personally and professionally. One specific family I saw in the clinic had a unique situation in that their two-year-old daughter, Margareth Elizabeth Cifuentes Bautista, was laboriously diagnosed with irregular corneal syndrome associated with glaucoma of congenital origin. Due to Guatemala’s limited prenatal screens and interventions, Elizabeth is nearly blind. While highly spirited and happy, she trips, bumps and feels her way through life. One barrier to her healthcare access is that her hard-working parents remain well below the poverty line, making less than $900/month. I am working to connect them with generous US Ophthalmologists and pediatric eye specialists to explore how we might save her sight and help her family. Their biggest dream is that she could recover her eyesight. “I know that this is not a life-threatening situation, but it is still something that never stops hurting me,” Jorge Cifuentes, Elizabeth’s father, said. “Unfortunately, our situation here is very hard. This country [Guatemala], although beautiful, it is very difficult to get ahead. We are people living in underprivileged conditions which complicates our situation even more. However, we are still trying to thrive by being kind and hardworking people. Thank you for helping us.” I have had the privilege of an opportunity for education, access to healthcare, employment and am aware that inequity and injustice prevail. This experience reinforced my understanding that medicine is a physically and mentally demanding profession that requires a commitment to service, continuous learning and adaptation both on local and global scales. I encourage everyone to please join me in serving the underserved by volunteering. Brittany is an experienced Occupational Therapist at Renown and volunteers with Kalan Kuxtal and other entities, such as The Robert Unsworth Foundation and Rock Steady Boxing to elevate communities. She loves being an Occupational Therapist; however, her life experiences confirm that her true calling is to become a physician. She is currently applying to medical school. Brittany is eager to earn the responsibility to improve lives and communities as their engaged physician. Brittany is tentatively scheduled to return to Guatemala at the end of this year to continue partnering with the people for a better future. You are welcome to join!

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Renown Health is proud to embrace the Reno-Sparks culture that makes our community stand out, which is why we sponsor the Reno Rodeo, an early summer staple with roots in the community as deep as our own. One of our many ties with the Reno Rodeo includes Renown Regional’s own emergency room nurse and Miss Rodeo Nevada 2022, Gabby Szachara. A Reno native, Gabby developed a love for the Reno Rodeo at a very young age. “I loved watching the girls on the Reno Rodeo Flag Team when I was little and knew I wanted to be part of the Reno Rodeo someday,” said Gabby. “As I got older, I started to make connections and build relationships with some people in the rodeo scene, and they generously lent me their horses so I could participate in the Reno Rodeo Flag Team.” Gabby was on the flag team for three years before being crowned Miss Rodeo Nevada 2022 last year.  Before joining the Reno Rodeo Flag Team, Gabby was a student at the University of Nevada, Reno, and a member of the women’s volleyball team. In December 2017, she graduated with a bachelor’s degree in public health. At first, Gabby was interested in a career in sports medicine – it made sense with her background in athletics. But, after working in the medical field as a certified nurse assistant and an emergency medical technician, she grew passionate about patient care and decided she wanted to become a nurse. “I’ve always loved teamwork and helping others,” said Gabby. “It’s important to me to be there for others, especially when it might be their worst day.”  In December 2021, Gabby graduated from Truckee Meadows Community College with a nursing degree and joined Renown Health this February. “I love Renown for various reasons. Everyone here is so nice and welcoming, and there is a great team dynamic,” said Gabby. “And I love that Renown’s main color is purple because that is my favorite!” When Gabby isn’t in her scrubs and caring for patients, she is in western wear and carrying out her duties as Miss Rodeo Nevada. “I do a lot of traveling across the country to attend other rodeos,” said Gabby. “I enjoy meeting so many wonderful people and experiencing the culture of different states.” Gabby’s main goals as Miss Rodeo Nevada are to promote the western way of life, agriculture, rodeo and community benefit. In addition, she visits local schools to talk with kids about how they can get involved in these areas and inspires them to turn their dreams into reality.  Gabby has a special place in her heart for the Reno Rodeo. “Reno is my home, and the Reno Rodeo is the heart and soul of summer in northern Nevada. Everyone comes together and dusts off their boots to have fun and also contribute money to important causes in our community,” said Gabby. “I love the comradery, the friendly and healthy competition and the great people.”  If you’re going to the Reno Rodeo this weekend, watch for Gabby and her horse, “Torque.”  And if you see Gabby in the halls at Renown Regional, give her a high-five for all her hard work as a nurse and Miss Rodeo Nevada!

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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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