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    • Wednesday, Nov 25, 2020

    Renown Now Offering rTMS Treatment for Major Depression

    Treatment offers patients safe, non-drug and non-invasive repetitive transcranial magnetic stimulation (rTMS) therapy to treat symptoms of major depression. Renown Health is committed to improving access to vital mental health services in northern Nevada. Today, clinical leaders at the Stacie Mathewson Behavioral Health & Addiction Institute at Renown announced they will offer repetitive transcranial magnetic stimulation (rTMS) therapy for people experiencing Major Depressive Disorder (MDD) under the guidance of a Renown psychiatrist.  According to the National Institute of Mental Health, major depression is one of the most common mental disorders in the U.S. The disease causes people to experience sadness and helplessness, and in some cases, may prevent people from carrying out their daily routines.  “We at Renown are proud of our national reputation as an innovator in implementing new models, technology and systems of care for our community,” said Tony Slonim, MD, DrPH, President and CEO. “We are working to transform care and demonstrate value in a way that appeals to patients and helps clinicians improve outcomes and reduce costs. There is now a sufficient body of evidence to accept the analgesic and antidepressant effect of high-frequency rTMS, and we are pleased to offer this promising therapy.” rTMS is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. It is typically used when other depression treatments haven't been effective. This treatment for depression involves delivering repetitive magnetic pulses, so it's called repetitive TMS or rTMS. “Depression can be treated; however, for some people, medications and talking with a behavioral health expert may not be enough,” said Renown’s Division Chief of Behavioral Health, Richard A. Charlat, M.D., M.P.H. “We are pleased to offer rTMS therapy for people looking for a new way to fight depression and for whom other treatments may not have given them relief. We are committed to working closely with our patients to find the treatment that works best for them, so they can live their best lives.” “Nevada has the highest prevalence of mental illness and substance use in the nation,” said Steve Shell, vice president of the Stacie Mathewson Behavioral Health & Addiction Institute. “Combine that with the added stress and isolation many are feeling with the COVID-19 pandemic, and we know that offering patients safe, non-drug and non-invasive treatments- as well as essential mental health and addiction services are more important than ever.”   How rTMS Works During an rTMS session, an electromagnetic coil is placed against the person’s scalp near their forehead. The electromagnet painlessly delivers a magnetic pulse that stimulates nerve cells in the region of the person’s brain involved in mood control and depression. It's thought to activate regions of the brain that have decreased activity in depression. Though the biology of why rTMS works isn't completely understood, the stimulation appears to impact how the brain is working, which in turn seems to ease depression symptoms and improve mood. There are different ways to perform the procedure, and techniques may change as experts learn more about the most effective ways to perform treatments. On average, patients undergo rTMS treatments for four to six weeks, five days a week for about 40 minutes a day. In all cases, a patient’s doctor will determine a treatment plan that’s best for the patient. This video shows what patients can expect during rTMS therapy.    What Does rTMS Feel Like? rTMS therapy is an easy, in-office experience designed to be positive for patients. During treatment, people are awake, alert, and comfortably reclined in a spa-like chair. The first few treatments may cause discomfort at or near the treatment site, however, this is unlikely to last beyond the first week of treatment.1, 2  “The effects of depression can be devastating for the people battling it, as well as for those who love them,” said Stacie Mathewson. “No matter how dark life may seem, always know, there are incredible behavioral health experts at Renown ready to support and empower you as you seek the help you deserve.”  Charles N. and Stacie L. Mathewson established the Stacie Mathewson Behavioral Health & Addiction Institute at Renown in 2018 to expand community access to prevention and intervention services for mental health disorders and alcohol and drug addiction. Renown is working to expand intensive outpatient treatment, partial hospitalization and medication-assisted treatment programs to better serve those struggling with mental illness and addiction. The Renown team is also passionate about prevention, mental wellness and is actively working to decrease stigma and encourage more people to seek the help they need. TMS therapy is cleared by the FDA and available by prescription only. It is commonly covered by most insurance plans. Patients must be referred by a behavioral expert to seek rTMS treatment. For more information and to make a patient referral, please call the Stacie Mathewson Behavioral Health & Addiction Institute at 775-982-5318.   About Renown Health Renown Health is the region’s largest, locally owned and governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health. Renown’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Health, Neurosciences and Robotic Surgery. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project®.   Sources Trivedi MH, et al. (2006). Evaluation of Outcomes with Citalopram for Depression Using Measurement-Based Care in STAR*D Implications for Clinical Practice. Am J Psychiatry, 163(1):28-40 Rush AJ, et. al. (2006) Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry, 163(11):1905-1917.

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    • Pediatric Care
    • Kid's Health
    • Behavioral Health

    What Is the Role of a Child Life Specialist?

    What is the role of the child life specialist? Here are common questions and answers about how these special individuals give both parents and kids peace of mind. Let’s face it: A hospital can be an intimidating place for just about anyone. But add in being a small human with very little worldly experience — aka a child — and it’s easy to imagine how overwhelming a hospital visit can be. Enter the role of the child life specialist. Liz Winkler, a child life specialist with Renown Children’s Hospital, explains how a Renown program puts young patients and their families at ease. What does a child life specialist do? Child life specialists help young patients develop ways to cope with the anxiety, fear and separation that often accompany the hospital experience. They give special consideration to each child’s family, culture and stage of development. As professionals trained to work with children in medical settings, specialists hold a bachelor’s or master’s degree in the areas of child life, child development and special education or recreational therapy. Our child life specialists are also professionally certified and affiliated with the national Child Life Council. Child life specialists also offer tours of Renown Children’s Hospital for families whose children are scheduled to have surgery. Child life supports children and families by: Helping children cope with anxiety, fear, separation and adjustment Making doctors, needles and tests a little less scary Providing art, music and pet therapy Organizing activities Addressing your concerns Telling you what to expect Creating a therapeutic and medical plan Offering a hand to hold What else is available at the Children’s Hospital that helps ease some of the stress of a hospital visit? Whether it’s seeing a pediatrician, getting a sports physical or looking for advice, our care is centered on supporting and nurturing patients and families at our many locations. We have kid-friendly environments to help ease some of the stress of a hospital visit. These include colorful exam rooms, kid-friendly waiting and common areas, and medical equipment designed especially for children. Our children’s ER is open 24 hours a day, seven days a week. So parents and caregivers have access to emergency care tailored to little ones — anytime, day or night. We have several pediatric specialists on the Renown team in areas including diabetes, emergency medicine, neurology, pulmonology, blood diseases and cancer. How can parents start to ease their children’s mind when they know a hospital visit is in the future? As with many things in life, good preparation can help kids feel less anxious about the experience and even get through recovery faster. It’s important to provide information at your child’s level of understanding, while correcting any misunderstandings, and helping to eliminate fears and feelings of guilt. If you’re anxious and nervous, your child may reflect these feelings and behaviors. So make sure you educate yourself, feel comfortable with the process, and get your questions answered.

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    • Pediatric Care
    • Behavioral Health
    • Kid's Health

    Bye-Bye Holidays, Hello Routines! Getting Kids Back into the Groove

    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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    • Behavioral Health
    • Pediatric Care
    • Primary Care
    • Kid's Health
    • Mental Health

    Nurturing Your Child's Back-to-School Mental Health

    The back-to-school season is here, and ensuring your child's successful transition involves more than just school supplies and schedules. At Renown Children’s Hospital, and in collaboration with Nevada Pediatric Psychiatry Solutions, we understand the vital role that mental health plays in a child's overall well-being and academic performance. Below we'll guide you through essential tips for a smooth back-to-school experience, with a special focus on nurturing your child's mental health. How to Support Your Child’s Mental Health from Home Remember, the below strategies can be adapted to align with your child's personality, learning style and household dynamics. Flexibility and understanding are key in tailoring these tips to suit your child's unique needs. 1. Be Open to Communication: Recognize that effective communication is the cornerstone of understanding your child's feelings and concerns. Create a safe space where your child feels comfortable expressing their thoughts. Listen to learn, without judgment. Make it a point to validate their emotions and ensure they are heard. Encourage sharing experiences,worries, friends and challenges they may be facing. Having open conversations about sensitive topics opens the door for discussion and understanding. Make yourself available. 2. Establish a Routine: A consistent routine can offer a sense of stability and predictability for your child, and anticipation helps to decrease anxiety and establish a sense of control. Join forces and design a daily schedule that includes time for schoolwork, play, physical activity, meals and relaxation. Be flexible about the structure to allow room for last-minute changes including extra activities based on that day’s needs as well. Always add time for play and bonding. 3. Practice Compassion: Back-to-school can come with big emotions. Listening reflexively and acknowledging these feelings can help you and your child act positively on these big emotions. 4. Get Involved: Actively engage in your child's school life by participating in school events, meetings and discussions. Show interest in their educational journey, ask about their experiences and provide guidance when needed. Being present in their academic pursuits not only boosts their confidence but also strengthens the parent-child bond. 5. Use Positive Reinforcement: Celebrate your child's achievements, no matter how small they may seem. This allows for a sense of accomplishment and boosts self-esteem. Praise efforts, progress and perseverance, whether it's completing an assignment, making a new friend or overcoming a challenge. This positivity encourages a growth mindset and resilience. 6. Organize a Schoolwork Zone: Create a comfortable workspace at home dedicated to school-related tasks. Customize the area based on your child's preferences and needs. Having a designated space for studying and completing assignments promotes focus, reduces distractions and enhances their overall learning experience.

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