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Heart failure is a serious medical condition that occurs when the heart is unable to pump blood effectively, leading to a variety of symptoms and potential complications. Although there has been progress made in the treatment of many forms of heart disease, heart failure continues to be a prevalent and life-threatening condition – nearly 6.2. million adults in the U.S. have heart failure. Recognizing the signs of heart failure is crucial for early detection and timely intervention. We talked to Ruth Skinner, APRN at the Renown Institute for Heart & Vascular Health, about recognizing common signs and symptoms of heart failure. Heart Failure Signs and Symptoms The symptoms of heart failure may be subtle and can be mistaken for normal signs of aging. Common symptoms of heart failure are due to extra fluid or congestion – typically starting with congestion of the lungs, then moving to different parts of the body. Common heart failure symptoms include:  Breathing Difficulties (Dyspnea): One of the hallmark symptoms of heart failure is shortness of breath during daily activities and having trouble breathing when lying down.  Fatigue and Weakness: Because heart failure can lead to reduced blood flow to the body’s tissue, patients may find themselves becoming tired and weak even during routine activities.  Swelling (Edema): Fluid retention in the body can cause noticeable swelling. Weight gain along with swelling of the feet, legs, ankles or stomach is often a key sign of worsening heart failure. Rapid or Irregular Heartbeat: Heart failure can disrupt the heart's electrical signals, causing irregular heartbeats (arrhythmias) or a rapid heartbeat (tachycardia). These can be felt as palpitations or fluttering sensations in the chest. Persistent Cough or Wheezing: Fluid buildup in the lungs triggers a persistent cough, sometimes accompanied by pink or white mucus.  Loss of Appetite or Nausea: Heart failure can affect blood flow to the digestive system, leading to symptoms like loss of appetite and nausea. If you or a loved one experiences any of the above signs and symptoms, it’s important to seek medical attention promptly.

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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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February is American Heart Month. While cardiac care is crucial every time of year – especially as heart disease stays the number one killer in the United States – American Heart Month serves as a great reminder to stay on top of your heart health. We spoke with Malina Ruiz, a cardiology nurse practitioner at Renown Health, on three key ways to embrace heart-healthy living and how genetic screening can help inform you of certain genetic risks that can play a role on the cardiac life stage.  1.  Invest in a heart-healthy diet. Eating a diet that is rich in fruits, vegetables, whole grains and healthy fats (including monounsaturated fats such as avocados and polyunsaturated fats such as sunflower oil) is a key defense in protecting your cardiac health, according to Malina. While you are filling your plate with these nutritious foods, remember to keep an eye on your saturated and trans-fat intake, and try limiting foods that are high in those fats.   “No matter what age we are, maintaining a heart-healthy diet will always be important,” said Malina.    Need help finding cardiac-friendly meals? The National Heart, Lung and Blood Institute makes it easy with heart-healthy recipes and tips from experts.  2.  Do an exercise audit. “Keeping an active lifestyle during our younger years is one of the most important factors that affect heart health in future years,” said Malina. Maintaining a regular exercise regimen that allows you to raise your heart rate and break a sweat can help prevent future cardiac events.     A good rule of thumb is to aim for 150 minutes a week of moderate-intensity exercise, which averages out to 30 minutes a day on 5 days out of the week.    It’s never too late to start a regular exercise routine! Exercise doesn’t have to be something you dread – leverage American Heart Month to find activities that you enjoy. The American Heart Association can help you discover new ways to move your body. At the end of the day, as Malina emphasizes, “any movement is better than nothing!”  3. Don't skip those check-ups. Regular preventative visits with your primary care provider can help you identify possible risk factors for heart conditions before they start actively affecting your life. “Check-ups become even more important as we age, along with being aware of the signs and symptoms of heart disease, heart attack and stroke,” added Malina.     There’s no time better than the present – call our expert scheduling team today at 775-982-5000 to request a preventative check-up with your primary care provider.

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While February is recognized as American Heart Month, it’s important to prioritize your heart health 365 days a year. Cardiologists play an integral role in our overall health and wellbeing – they are the experts when it comes to preventing and treating heart and vascular diseases. Dr. Jad Al Danaf of Renown Institute for Heart & Vascular Health shares eight reasons to visit a cardiologist. 1. Abnormal EKG The American Heart Association states an electrocardiogram, abbreviated as EKG or ECG, is a recording of the heart’s electrical activity to measure the rate and rhythm of the contractions in the upper and lower chambers of the heart. An EKG detects heart problems or abnormalities. If you have an EKG that shows abnormal results, you’ll want to see a cardiologist. An abnormal EKG can mean many things, such as irregular heart rate, heart rhythm abnormalities in the shape or size of the heart, medication side effects, and more. A cardiologist is most qualified to evaluate an abnormal EKG and determine the cause. 2. Immediate family history of heart disease or sudden cardiac death Knowing your family health history is essential to identify if you’re at risk for certain health conditions such as heart disease. For example, if you’re aware of anyone in your immediate family who had or has had heart problems or passed away from sudden cardiac death. In that case, you’ll want to discuss it with a cardiologist so they can determine if screenings, medications, or lifestyle changes are needed to help lower your risk. 3. Chest pain or shortness of breath with exertion If you have chest pain or shortness of breath that starts or worsens with activity, it may indicate a heart problem, and you should schedule a visit with a cardiologist immediately. Severe chest pain might be a sign of a heart attack or other serious medical emergency. If you’re experiencing severe chest pain, shortness of breath, or any other signs of a heart attack, call 911 immediately. 4. High blood pressure Have you had a high blood pressure reading? If so, it’s recommended to consult with a cardiologist for further evaluation. High blood pressure puts you at risk for heart disease and stroke, as uncontrolled high blood pressure can damage arteries, reducing blood flow and oxygen to your heart and brain.

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An alcohol problem can affect anyone at any age. Many factors, including job stress, genetics or depression, may contribute to the start of disordered drinking.  Drinking alcohol exists on a continuum. For example, if someone feels down in the dumps for some time, it doesn’t mean they are clinically depressed. So if someone goes through a period with above-normal alcohol consumption, it doesn’t necessarily mean they abuse alcohol. Although “alcoholic” and “alcoholism” are common, they are not clinical descriptions. Alcohol use disorder is the preferred term. Symptoms are often mild but can be the start of a more significant problem. According to the National Institutes of Health (NIH), over 16 million adults live with alcohol use disorder. Symptoms of Alcohol Use Disorder Do you recognize any of the following symptoms in yourself or someone you know? Drinking more or longer than intended Trying to cut down or stop drinking but not able to Having to drink more than you once did to get the same feeling Being annoyed when family members discuss your drinking Regretting your behavior while you were drinking

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The kids are back in school and the holidays are all but a distant memory: Now what? Karen Wagner, APRN, offers specific tips about getting kids back to their routines in the post-holiday-hustle-and-bustle. Are you finding the kids struggling with bedtime routines? Having trouble getting them to tackle homework? There’s a simple reason: The holidays messed with their mojo! Here, we talk with Nurse Practitioner Karen Wagner about what to do to get them back on the straight and narrow.  Why Routines Are Important “Holidays are a fantastic time to get together with family and friends, so our routines are usually off — and this is understandable, “Wagner says. “While the holidays are exciting, they are chaotic and can put our kids out of the routines.” So how do you get kids back into those routines they crave?  “Consistency/routines are crucial for our kids,” she says. “Most people — kids and adults —  experience a let-down feeling after the holidays, and post-holiday adjustment takes time.” So what can we do, specifically? Wagner recommends the following:  Re-establish family routines, including before- and after-school programs or child care routines. Once kids are back on the regular schedule, they’ll find that sense of familiarity as the old routine returns. But keep in mind, this won’t happen overnight.  Encourage healthy eating, as the upheaval of their schedule can be offset by a balanced diet.  Make sleep time a priority: Keep in mind that it might take up to three nights of strict bedtime to get them back on track. But enforcing normal bedtime will get their bodies back on a normal schedule.  Return to usual chores and expectations. Nothing encourages a return to routine like reminding them of the basics.  Incorporate indoor and outdoor time. They likely spent lots of time outdoors during our unseasonably warm winter break — and they even had a snow day or two! So encouraging both indoor and outdoor time will help them return to a circadian rhythm and tire them out from exposure to fresh air.  “It is never too early to encourage a love for physical activity in kids by exposing them to fun fitness activities and sports,” Wagner says. “Physical activity improves bone health, cardiorespiratory and muscular fitness, decreases levels of body fat, reduces symptoms of depression, and improves cognitive skills and the ability to concentrate.”

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For the average person, detecting the signs of heart failure can be tricky, especially since people can look fairly healthy and have few symptoms. We asked Christopher Rowan, M.D., of the Renown Institute for Heart & Vascular Health, to answer our most pressing questions about heart failure. Even with more technology in medicine and a greater awareness about health today, the Centers for Disease Control and Prevention still reports that one in every four U.S. deaths is caused by heart disease. The real tragedy of heart-related deaths is that they are both common and preventable. “Heart failure can have many forms that are seen in anyone at any age," says Christopher Rowan, MD, with Renown Institute for Heart & Vascular Health. "As many forms as it has, it can also have as many causes. Although the symptoms of heart failure are numerous, people can look mostly healthy and have relatively few symptoms.” We sat down with Dr. Rowan to ask some common questions about heart failure. How can I tell if I have heart failure? What are some sure signs? "The signs and symptoms of heart failure are numerous, but the most common ones are shortness of breath when trying to walk (which differs from somebody’s normal pattern); progressive swelling in the feet, legs and ankles that does not disappear overnight; and waking up at night due to shortness of breath or waking up more than normal to urinate," Dr. Rowan says. Can heart failure be cured? "The treatment of heart failure depends on its primary cause," Dr. Rowan says. "Various forms of heart failure can be cured; however, the person is always at risk for recurrence. Some forms of heart failure have no cure but can be managed and stabilized and people can live a relatively normal life for years." What can I do to prevent heart failure? "To prevent the onset of heart failure, know your risk factors, including high blood pressure, diabetes, smoking and an unhealthy lifestyle," Dr. Rowan says. "If you have any of these risk factors, work to get them under good control and stop smoking. If you are overweight, start a daily routine where you walk at least 45 minutes per day, 5 days per week. Walking is the best exercise for your cardiovascular health." To learn more, visit the Heart Failure Program at the Renown Institute for Heart & Vascular Health. We want to hear your story! If you or a friend have been treated for a heart condition at Renown Health and are interested in chatting with us about your experience, please email your contact information to support@renown.org so we can follow up.

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How can you tell if a friend is in trouble or struggling with suicidal thoughts? And how can you support them in finding help? Are you feeling virtually exhausted? Life is always challenging, but the mental fallout of a global pandemic is real. Contributing to the loneliness epidemic is the shifting American lifestyle. More Americans live alone (28%) now than ever before, and fewer have kids. First, let’s acknowledge this is a time of anxiety and worry for everyone. Economic uncertainty, job transitions, grief, and loneliness are a perfect storm for mental stress. Even before the COVID-19 (coronavirus) pandemic mental health was a concerning issue, now it is a relevant topic of crisis. Secondly, anyone can struggle with suicidal thoughts. Those suffering from drug addiction are especially vulnerable. In particular the U.S. is currently seeing a rise in drug overdoses by almost 18% due to the pandemic. Unfortunately, suicide is responsible for one U.S. death every 11 minutes, according to the Centers for Disease Control and Prevention. Not to mention the millions who think about it, make a plan or attempt it. It is important to remember that suicidal thoughts, plans or intent must be helped immediately. Understanding Suicide Risk To clarify, depression is not a choice. No one wishes for endless days of feeling down, sleepless nights, and feeling as if you are in a dark tunnel. Currently, one in five Americans will experience a mental illness this year. This means one of your friends is struggling, right now. Specifically, consider this: When your body feels pain it talks to your mind. When your mind is suffering who does it talk to? So, how can you tell if a friend is in trouble? According to the National Institute of Mental Health be on the lookout for some depression clues below. Signs and Symptoms of Depression Persistent sad, anxious, or “empty” mood Feelings of hopelessness, or pessimism Irritability Loss of interest or pleasure in hobbies and activities Decreased energy or fatigue Moving or talking more slowly Feeling restless or having trouble sitting still Difficulty concentrating, remembering, or making decisions Signs and Symptoms of Suicide Risk Expressing feelings of hopelessness or having no purpose Talking about feeling trapped or being in unbearable pain Talking about being a burden to others Increasing the use of alcohol or drugs Sleeping too little or too much Withdrawing or isolation Displaying extreme mood swings. Talking about wanting to die or to kill oneself (Reference: Suicide Awareness Voices of Education) How to Help a Suicidal Friend It can feel awkward to approach the subject of suicide with a friend, but take any of the above warning signs seriously. Other ways you can help are by: Encouraging self-care and making sure they take care of basic needs Listen to their worries without judgement Ask them what they need from you, then follow through with action Let them know they are not a burden Don’t minimize or invalidate their feelings Point them to helpful resources Be their advocate and get them help If someone you know is in a life-threatening crisis situation, call 911 immediately. Suicide Risk Resources: National Suicide Prevention 24/7 Lifeline: 1-800-273-8255 Ayuda En Español: (Spanish National Suicide Prevention Lifeline) 1-800-628-9454 Crisis Text Line: Text HOME (or CONNECT) to 741741 to chat with a crisis counselor 24/7 free of charge. The National Alliance on Mental Health: 1-800-950-6264 Substance Abuse and Mental Health Services Administration: (SAMHSA) 24/7 helpline 1-800-662-4357

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Excess amounts of sodium doesn’t just increase your risk of a heart attack, it can also increase your risk of a stroke. Unfortunately, avoiding that saltshaker may not be enough. Did you know that the average American consumes 3,400 milligrams of sodium each day? That’s a dangerous number considering that the American Heart Association recommends limiting daily sodium intake to 1,500 milligrams (about half the weight of a penny) to reduce the risk of heart disease and stroke. The problem is not necessarily that you’re putting too much salt on your food, it’s that salt is already in the foods you’re regularly eating. To help keep your sodium intake at a healthy level, make sure you’re aware of “The Salty Six,” six sneaky foods that are surprisingly high in sodium. Breads, Rolls and Tortillas: Although breads and tortillas may not initially appear to be high in sodium, we often consume several servings. Make sure to keep track of your total servings to see how they add up. Deli Meat, Cured Meats and Poultry: It may surprise you that six thin slices of deli meat can add up to more than half of your daily limit, so be mindful when building those sandwiches. Also, do your best to avoid cured meats, which often means the meat has been salted. Substitute uncured, skinless meats instead. Cheese: Salt is an important addition in the cheese-making process, as it prevents bacterial growth. Unfortunately, that added salt can increase your health risks. Limit the amount of cheese you add to meals to keep your sodium content down. Pizza: Take a quick look at the first three items above and it should be no surprise as to why pizza made the list. One slice and you’ve met at least half of your daily limit. Go easy on the cheese and try adding more veggies instead of meat. Canned Soup: One cup of canned soup can be as high as nearly 1,000 milligrams of sodium. When shopping for canned soup it’s important to check the label – not just on sodium content but serving size as well. Always select low-sodium options when possible or cook your own soup at home. Sandwiches and Burgers: A sandwich or burger from your favorite restaurant can contain more than 100 percent of your daily sodium limit. When dining out, it is best to select low-sodium options or eat a half portion to limit the amount of salt. If some of your favorite foods are on this Salty Six list, don’t panic. Although these foods can be high in sodium, it isn’t necessary to cut these foods out of your diet completely. It’s just important to eat them in moderation and be mindful of your daily sodium intake. Look for low-sodium options, use herbs and spices instead of table salt and do your best to stay under the recommended daily limit of 1,500 milligrams.”

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To recognize World Lymphedema Day, Katherine Bunker, Physical Therapist and Certified Lymphedema Therapist (PT, DPT, CLT) at Renown, shares her experience helping those with lymphedema and lymphatic disease thrive in their daily lives. Each year, World Lymphedema Day continues to be an advocate-driven celebration and global education opportunity on what it means to live with lymphedema and lymphatic disease. We explore why this cause deserves global recognition each year on March 6 below. Types of Lymphedema Lymphedema is an abnormal collection of protein-rich fluid that causes swelling just beneath the skin. The fluid, which is filtered through the lymph nodes, makes up a network of tissues that help the body get rid of toxins, waste and other unwanted substances. According to Katherine Bunker, PT, DPT, CLT at Renown Health, this collection of fluid causes swelling, usually in the arms or legs, but can happen in other areas too. It can also cause discomfort, restricted movement and may increase the risk of infections.

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The Benefits of Being Clutter-Free Gives you a better sense of well-being. Did you know procrastination is linked to clutter? According to a recent study clutter problems led to less life satisfaction, especially among older adults. Helps you lose weight. Constantly being in cluttered room, office or car can be stressful. All the undone cleaning tasks in the back of your of mind cause stress, which is linked to obesity. Promotes mental health. Having clutter around can make you feel anxious or overwhelmed. This prevents you from truly relaxing or focusing. Saves you money. It’s not a secret that money worries cause stress. According to a Journal of Consumer Research study, you’re more likely to make a purchase when you’re sitting in a messy room compared to a tidy room. Clutter-Free Tips Start with a plan. Make a list of your clutter-improvement priorities and the tasks needed to accomplish each one. Focus on one section of your home per week, so you don’t get overwhelmed. In fact, organizational expert Peter Walsh suggests starting with the easiest room first to gain momentum. Conversely, "The Life-Changing Magic of Tidying Up" author Marie Kondo suggests organizing by category (for example clothing or books). Experiment with an organizing plan that appeals to you. There are also many helpful on-line calendars you can use as a starting point. Delegate when you can. Include your children and spouse into your plan. Is uncle Bob an electrician? Then get him to swap out your eyesore of a ceiling fan or update an old light fixture. Of course it’s ok to outsource the duties - such as window cleaning or painting - if your budget allows. Buy less. The less you purchase the less you need to store, clean, keep track of, organize or dust. Seems simple, right? Not for everyone. On average we are bombarded with over 4,000 marketing messages a day, not to mention FOMO (Fear Of Missing Out) when we see our friends posting about their newest toys on their social media feeds. Focus on quality over quantity. When in doubt, throw it out. Still on the fence about what to throw away? Use these declutter decision-making guide questions to help you. Organize Your Health Along with taking care of your surroundings, make a commitment to get up to date on your health checkup and screenings. Preventing an illness is a bargain compared to the cost of a chronic disease. It's also a good idea to go through all of your medications and check the expiration date. Remember to properly dispose of medications. DO NOT flush medications down the drain or toilet, unless the label indicates it is safe to do so.

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Some days a chat with a friend is all you need to feel better. Why? Because humans are social beings. Although we have more technology than ever at our fingertips, sometimes we may still feel left out or disconnected. Dr. Buddy Coard, Ed.D., Psychologist at the Stacie Mathewson Behavioral Health Addiction Institute at Renown, discusses the importance of social connections and tips on how to keep connecting, warning signs of loneliness and how to feel less lonely.  Why are Social Connections Important? Dr. Coard points to significant research on the topic of loneliness and social connections. He uses the findings below to detail how social connections affect our overall health. In a recent survey 40% of participants reported they sometimes or always feel that their relationships are not meaningful and that they feel isolated. Surprisingly, this survey suggests Generation Z (18-22 years old) is the loneliest generation. Another study associates loneliness as a risk factor for early death. It indicates lack of social connection heightens health risks as much as smoking 15 cigarettes a day, or having alcohol use disorder. In fact, loneliness and social isolation are twice as harmful to physical and mental health as obesity (Perspectives on Psychological Science, Vol. 10, No. 2, 2015). A 2018 study investigated several standard measures of social isolation, including marital status, frequency of religious service attendance, club meetings/group activities and number of close friends or relatives. The findings revealed race as a strong predictor of social isolation. In particular, black men and women were more likely to be lonely than were white men and women. Loneliness also switches on your body’s long-term “fight-or-flight” stress signaling system, which negatively affects your immune system. People who feel lonely have lower immunity and more inflammation than people who don’t. Dr. Coard recommends the following tips for those who feel lonely. Tips to Increase Social Connection Get outside. More and more nature prescriptions are common. In fact even a 10 minute walk can elevate your mood and get your blood flowing. Develop a schedule of activities to accomplish in a week, setting realistic goals. Monitor your technology. Of course, watching the 24/7 news cycle can be depressing. Turn off the TV and listen to music or read a book instead. Even better, use technology to connect with family members by having a virtual game night or book club discussion. Write it out. When was the last time you sent a good old-fashioned letter or card? Or even wrote in a journal? Try to brighten someone’s day with snail mail. Writing down your hopes and fears also helps you to get worries off your mind and process your emotions. With this in mind, there are also volunteer opportunities to support others by sending a handwritten letter to others battling depression. De-clutter your surroundings. Go through those old photos and put them in an album. Clean out a drawer, cupboard or closet. You will feel a sense of accomplishment and can donate items you no longer need that others can enjoy. Increase your joy by reducing your clutter. Warning Signs of Chronic Loneliness One size does not fit all when it comes to loneliness. For this reason, loneliness can be different depending on your particular situation and your unique personality. However, if you feel some (or all) of the following symptoms, chronic loneliness may be affecting you: Lack of ‘best’ or close friends. You connect with others on a surface level, but feel no one truly understands you. People are n your life, yet you are not connecting on a deep, intimate level with them. You feel lonely even when people are around. This means feeling disengaged or not part of the group when around others. You feel less than enough. You often doubt yourself or don’t feel good enough when comparing yourself to others. And social situations feel exhausting. What Can Someone Do to Feel Less Lonely? Dr. Coard offers the following suggestion for those with a lack of social connections: Talk with your doctor, psychologist or another healthcare professional. Sometimes chronic loneliness relates to longstanding negative beliefs that an individual has about themselves. Engage in behavioral activation. For example, being more active and involved in life by scheduling activities which can potentially improve your mood and decrease feelings of isolation. Initially behavioral activation can be very challenging due to lack of motivation, but setting a reasonable schedule of activities is a good start. Pay attention to your sleep. Sometimes when people become lonely they experience significant changes in their sleep cycle. Frequently they sleep too much, or too little. Make sure to maintain a normal, healthy sleep/wake cycle, following good sleep hygiene recommendations.

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