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Do you find yourself struggling to stay awake during the day or having no energy? You’re not alone. Whether you’re a full-time employee, a student or retiree, that “I’m tired” feeling comes in all shapes and sizes. What’s even more frustrating is not knowing the source of your exhaustion.  Dr. Brandon Flores, a sleep medicine physician with Renown Medical Group, breaks down nine key reasons why you may be feeling so fatigued.  You did not get enough sleep, or your quality of sleep is poor. This may seem obvious, but in today’s “rise and grind” culture, sleep can be considered a luxury rather than what it really is: a necessity. Ensuring you get adequate hours of sleep between 6-9 hours and quality sleep is essential. You may not be breathing well during sleep. Interruptions to your breathing, such as snoring, can decrease airflow at night causing your sleep to be less restorative. This is often due to Obstructive Sleep Apnea (OSA). OSA can lead to daytime fatigue and sleepiness and can also impact other chronic health conditions, such as hypertension, diabetes, acid reflux, migraines and heart rhythm. You are not getting enough regular exercise, or you are exercising too much. Incorporating at least 30 minutes a day of physical activity can help keep you energized throughout the day. It has also been shown to increase deep slow wave sleep, which is often associated with feeling rested. On the other hand, getting too much exercise can tire you out more easily and heighten stress levels. You drink too much caffeine. This one may seem counterintuitive – caffeine is supposed to keep you awake, right? Well, overdoing it with your favorite coffee or soda could affect your sleep quality. Pay attention to your caffeine limits and have a cut-off time, as most caffeine should not be consumed past noon. You have a food allergy or intolerance. If you find yourself feeling especially tired after eating a lot of a certain food, you could have an allergy or intolerance to it – and vice versa. Consider speaking with your primary care provider (PCP) about a food allergy test or being referred to an allergist. You’re drinking too many alcoholic beverages. Alcohol is a depressant, which as the word implies, can make you feel especially tired during the day. It can also affect your breathing at night and disrupt your sleep cycle. Cutting back on alcoholic drinks may be beneficial to your overall health. You are anemic. This is the leading cause of fatigue in women but can affect people of all genders. It can be associated with low iron. Eating foods high in iron, including leafy greens and many different meats, can help your iron levels. A blood test ordered by your PCP can help you understand if you are iron deficient. You are experiencing depression or anxiety. Emotional exhaustion can be just as taxing as physical exhaustion. Prolonged feelings of sadness, hopelessness, nervousness or panic can be signs and symptoms of depression or anxiety. Speak with your provider about the many resources available to help you. You have an underactive thyroid. Feeling fatigued can also be a symptom of hypothyroidism, which affects your metabolism and energy levels. Medication can help get your thyroid back to normal. Your PCP can order a blood test to determine your thyroid levels.  If you experience severe exhaustion that lasts six months or longer, worsens after physical or mental exertion and does not get better after resting, it could be a sign of myalgic encephalomyelitis, otherwise known as chronic fatigue syndrome (CFS). This is a diagnosis of exclusion, and other causes must be ruled out. While there are no tests that detect CFS, your provider can order blood and urine tests to rule out other causes of your fatigue and help develop a care plan.

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At Renown Health, our nationally recognized Heart Failure Program provides best-in-class diagnoses, treatment and management of heart failure. Patients receive specialized care from our dedicated team of experts which includes nurse navigators, clinical coordinators and highly trained cardiologists. We are proud to serve our community and lead the region in heart failure care.

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In Nevada, we are so fortunate to have a number of not-for-profits and philanthropists who are supporting our mission at Renown Health; we couldn’t do it without them. In the world of healthcare, we are doing well in driving community benefit programming through operations. However, the things our communities need investments in are so much broader than we might be able to afford on our own. That is why it is essential for us to be supported by the people who are so in love with this community and want to assure we get the kinds of services and care for those who can’t afford it or add new services that are contemporary and leading edge that have not been offered here before. Establishing Behavioral Health & Addiction Institute We are so excited to receive a very generous donation from Chuck and Stacie Mathewson for the Stacie Mathewson Behavioral Health & Addiction Institute. This institute is so sorely needed in northern Nevada. Renown Health has a very important role in being able to bring attention to this important problem of mental health and addiction challenges in northern Nevada. Keeping Pediatric Care Close to Home One of the most important areas where philanthropy comes in handy for us at Renown Health is by assuring that we have the foundational programs that we would not be able to afford with operations alone. For example, the William N. Pennington Foundation’s generous gift has allowed us to create 15 pediatric specialty areas here in northern Nevada so children who have an illness or injury no longer need to leave town. The William N. Pennington Foundation supported Renown Children’s Hospital in a way that we never would have been able to support on our own. We are eternally grateful, and their gift — that 100,000 children are assured access to contemporary health and healthcare services — is beyond comprehension.

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As our community grows, so does the need for specialized care. Thanks to a generous gift, there’s a healthier future for families in the region as a $7.5 million gift to the Renown Health Foundation is helping keep care close to home. Being in the hospital is often a stressful experience, especially for a child and their caregivers. If you add the need to travel out-of-state for care into the mix, unnecessary anxiety and financial burdens can be placed on a family that is already worried about a sick child. With our quickly growing community and close to 100,000 children under the age of 18 in Washoe County alone, the need for local specialty care is needed. The William N. Pennington Foundation recognized this need and donated $7.5 million to the Renown Health Foundation – the largest gift the health system has received – to keep care close to home and establish the William N. Pennington Fund for Advanced Pediatric Care. Thanks to this gift, Renown Children’s Hospital has hired more than 15 pediatric specialists who provide care for children in our community. Below, we introduce you to three key specialized pediatricians in northern Nevada: Joseph A. Gassen, M.D. “Having pediatric specialists in the community is invaluable,” says Joseph A. Gassen, M.D., pediatric emergency medicine. “It allows families and patients to stay in Reno and not have to travel far distances to get quality care.” Gassen, the only doctor specializing in pediatric emergency medicine in the region, moved to Reno to provide care in the emergency room at Renown Children’s Hospital. “The hospital is dedicated to improving the care of children in northern Nevada, and I wanted to be a part of this amazing vision," Dr. Gassen says. I would not have been able to relocate to Reno without the support from the hospital and the William N. Pennington gift.” Working with children and their families are what Dr. Gassen finds most rewarding. "I get to provide care for a child, which in turn makes the parent feel better,” he says. “Essentially, I get to treat the whole family, even though I only directly care for the kids.”   Colin Nguyen, M.D. Also among the first new specialists is Pediatric Neurologist Colin Nguyen, M.D., who has done extensive work with epilepsy and epilepsy surgery. “In any growing and expanding community, we need the multitude of social, financial, political and well-being services to sustain that growth and progress,” Dr. Nguyen says. “The ability to offer more breadth of medical services to our local population allows families to spend more time together and fulfill work obligations, without the need to travel long distances to obtain that specialized care.” Dr. Nguyen says he enjoys caring for children because they are honest in their emotions and reactions, as well as simple in their intentions. “It is the overall joy and unique sadness that comes in working with children, which drives many of us to continue our work -- I am no exception.” Jacob Zucker, M.D. The third pediatric specialist providing care thanks to the Pennington gift has close ties to northern Nevada. Jacob Zucker, M.D., pediatric hematologist-oncologist, was born and raised in Reno and attended medical school at the University of Nevada, Reno School of Medicine before moving to the Midwest for his residency and fellowship. Dr. Zucker feels fortunate to have been offered the opportunity to return home and give back to the community that has given so much to him. “I can say with absolute resolve that northern Nevada is an exceptional community to practice medicine in. The care offered here at home is top rate and the providers that live and practice here truly understand the purpose of community.” The addition of these three specialists and the future specialists that will be coming to our area will impact thousands of children and their families. “With a growing population, the vision of leadership at Renown, and with the generosity of the William N. Pennington Foundation, northern Nevada is in position for the first time to make local pediatric subspecialty care a reality and to keep our families at home in their community,” Dr. Zucker says.

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When it comes to our heart, keeping this vital source of life in tip-top shape is of utmost importance. Echo technologists or echocardiographers, otherwise known as "echo-techs," are charged with that mission, providing critical information that leads to life-saving interventions to keep our hearts beating strong.  Adrianne Little, echocardiographer at Renown Health, breaks down the echo-tech's role in the health system, the educational path it takes to get there and the unique perks that come with the profession.  What does an echo tech do?  “Echo techs play a key role in the diagnosis and treatment of patients,” said Adrianne. “We are members of the cardiovascular imaging team that perform ‘heart ultrasounds’ or echocardiograms. Although we are most commonly known as echo techs, our official title is either ‘cardiac sonographer’ or ‘echocardiographer.’”  Echo techs use imaging technology and sophisticated ultrasound equipment to produce images of the heart. These images show how well the heart functions, as well as the valves, chambers and blood flow. Echocardiograms are used to diagnosis and treat a variety of heart conditions such as murmurs, arrhythmias and heart failure.   At the end of the day, the main goal of echo techs is to help our cardiovascular team provide the quickest and most accurate diagnoses to help with patient management and help them receive the highest standard of care.  “When it comes to looking at the heart, we are part of the front-line team," said Adrianne. “We provide real time critical information that leads to life saving interventions down the road.”

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At Renown Health, we're dedicated to providing exceptional care to patients with a wide range of cardiac conditions. Our General Cardiology Program specializes in assessing heart diseases, identifying existing conditions and developing personalized treatment plans for each patient.

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Renown's William N. Pennington Cancer Institute offers comprehensive medical oncology services designed to provide compassionate care and personalized treatment for individuals battling cancer. We understand that a cancer diagnosis can be a challenging and life-changing experience. That's why our team of board-certified medical oncologists, nurses, and support staff provide you with the highest level of care and support throughout your cancer journey.  Our approach to medical oncology is patient-centered and multidisciplinary. We believe in treating the whole person, not just the disease, and work closely with other specialists, including surgeons, radiation oncologists, and supportive care providers, to develop comprehensive treatment plans tailored to each individual's unique needs and goals.  Services Offered  Diagnosis and Treatment: Comprehensive Evaluation: Our team conducts thorough evaluations, including diagnostic imaging and laboratory tests, to accurately diagnose your condition and determine the most appropriate treatment plan.  Chemotherapy: We offer a wide range of chemotherapy options, including traditional intravenous infusions, oral medications, and targeted therapies, tailored to target your specific type of cancer.  Immunotherapy: Immunotherapy harnesses the power of the immune system to fight cancer and has shown promising results in treating various types of cancer. Our oncologists are experienced in administering and monitoring immunotherapy treatments.  Clinical Trials: As a leading cancer research institute, we offer access to cutting-edge clinical trials exploring new treatment approaches and investigational therapies.

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Early detection plays a crucial role in effectively managing cancer. By undergoing regular cancer screening tests, you can identify the presence of cancerous cells or tumors even before symptoms manifest. It provides an opportunity for timely intervention and increases the chances of successful treatment and recovery. At the William N. Pennington Cancer Institute, your care team is essential in determining which screenings are most appropriate for you and your family based on your medical history, age, and risk factors. They can guide you through the various screening options available and address any concerns or questions you may have. Cancer screening tests encompass a range of examinations, including imaging techniques such as X-rays, CT scans, MRI scans, as well as specific tests like mammograms, Pap smears, colonoscopies, and prostate-specific antigen (PSA) tests. These screenings aim to detect breast, lung, prostate, colorectal, cervical, and other types of cancers. By prioritizing cancer screenings and preventive measures, you take an active role in safeguarding your health. Detecting cancer early significantly increases the chances of successful treatment and improves overall outcomes. Prevention Cancer prevention is a vital aspect of maintaining overall health and well-being. One significant preventive measure is the administration of HPV (human papillomavirus) vaccines. HPV is a common sexually transmitted infection that can lead to several types of cancers, including cervical, vaginal, vulvar, anal, penile, and oropharyngeal cancers. HPV vaccines are designed to protect against high-risk HPV strains responsible for the majority of these infections. By getting vaccinated, individuals can significantly reduce their risk of developing HPV-related cancers. These vaccines are most effective when administered before exposure to the virus through sexual activity. Therefore, early vaccination, ideally during adolescence or early adulthood, is crucial for long-term protection. By prioritizing HPV vaccination as part of comprehensive cancer prevention strategies, individuals can take proactive steps towards reducing the risk of these preventable cancers.

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Planning Your Care at Renown Your care is a team effort, combining the skill and expertise of doctors, nurses, and other support staff who specialize in cancer diagnosis and treatment. This collaboration happens on multiple levels so that you receive the best possible care and treatment specific to your needs. Multidisciplinary Care “Multidisciplinary” refers to the collaboration between providers from different backgrounds or disciplines and can include doctors, advanced practice nurses, registered nurses, therapists, dietitians and social workers. These teams meet regularly to discuss patient care so that each patient benefits from the professional opinion of a wide range of experts.   Multispecialty Treatment Depending on your diagnosis, several different specialists may be involved in your treatment. Pathologists study tissue samples in the lab to confirm the diagnosis. Radiologists diagnose and track cancer with various imaging techniques. Medical oncologists treat cancer with chemotherapy and other medications. Radiation oncologists treat cancer with radiation therapy. Surgical oncologists treat cancer through surgery. Medical Geneticists diagnose cancer through genetic counseling. Gynecologic Oncologists treat cancers of the female reproductive system. These specialists meet to discuss your care plan and coordinate to make sure you’re receiving proven evidence-based care.   Center of Excellence A Center of Excellence is recognized for having a multidisciplinary, multispecialty team that provides leadership in research, training and best practices. Renown has three Centers of Excellence that focus on site-specific cancers. These include: Breast Cancer Gastrointestinal Cancer (colon, rectum, liver, pancreas, and stomach) Thoracic Cancer (lung and esophagus) These teams regularly meet to develop and update clinical guidelines, identify quality initiatives, evaluate clinical trials, and assess new technology and processes.   Cancer Conferences (Tumor Boards) Multidisciplinary, multispecialty cancer conferences (also called tumor boards) allow cancer specialists, genetic specialists, nurse navigators, nurses, social workers, dietitians, physical therapy specialists, and other providers the opportunity to review new and open cancer cases together and provide expertise from several different viewpoints. This collaboration allows them to develop a comprehensive treatment plan for each patient early in diagnosis or changes to a patient’s clinical status.   Who is my point of contact? Having multiple doctors who are working with even more doctors can become confusing for patients. Your Nurse Navigator will guide you through your care, provide you with the resources you need and answer your questions. Nurse Navigators

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The Renown Health Structural Heart Program was the first integrated program of its kind in northern Nevada. Since the beginning, we've been dedicated to providing specialized care to patients with complex and progressive structural heart and valve disease. Our team of experts offer comprehensive diagnostics, advanced treatment options, leading-edge technologies and top-level expertise.

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Raquel was 33 when she was diagnosed with breast cancer. It was April 2023, when she found a lump in her breast and was referred to the William N. Pennington Cancer Institute. After comprehensive imaging, she was diagnosed with invasive lobular carcinoma, which is a type of breast cancer that begins in the milk-producing glands of the breast. Between June 2023 and January 2024, she received a total mastectomy, chemotherapy and radiation at Renown Health. “Breast cancer is uncommon in women under 40, but any woman with a mass or lump in her breast should have an exam by a physician and imaging at any age,” said Dr. Lee Schwartzberg. In fact, according to the Centers for Disease Control and Prevention (CDC), only 9% of all new cases of breast cancer in the U.S. are found in women younger than 45. “It was a pretty scary diagnosis, but I’ve been led by great people through the process,” she said. “They were so helpful and there for me throughout the chemo and radiation.” Raquel's journey through breast cancer treatment at the William N. Pennington Cancer Institute was marked by the exceptional care provided by the Renown Health team, including nurses, nurse navigators, therapists, support teams and providers. Among the dedicated professionals, Dr. Michelle Chu and Dr. Lee Schwartzberg played pivotal roles in Raquel's diagnosis and subsequent treatment plan. Their expertise, compassion and commitment to patient care left an indelible impact on Raquel's experience. Their thorough examination and comprehensive approach ensured that Racquel received the best possible care for her invasive lobular carcinoma. In addition to the care provided at Renown, Raquel greatly benefitted from being connected with a mentor by Dr. Chu. This mentor, Kayla, had undergone a similar diagnosis and treatment plan, and at the same age Raquel. They texted and called each other throughout Raquel’s treatment, providing additional support through a challenging time. As of January 2024, Raquel is done with her treatment and continues to see her care team for follow-up appointments. “I’m through the worst and ready to rebuild my life,” Raquel said. To help celebrate this milestone, Nevada Athletics invited Raquel to receive the game ball at a Nevada Men’s Basketball game. She was joined on the basketball court for this special recognition by her husband, Raul; mother, Arlene; and two daughters, Ryleigh and Rhiannon. Racquel's journey is not only a testament to her resilience but also a tribute to the invaluable contributions of Dr. Chu and Dr. Schwartzberg in guiding her towards triumph over breast cancer.

Read More About Celebrating Resilience: Raquel's Remarkable Journey Through Breast Cancer Treatment