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The Recreation Therapy Alumni Program is a new addition to Renown Rehabilitation Hospital’s current programs. After daily hospital physical therapy ends, it is an opportunity for other adventures. Shaun Stewart, CTRS (Ceritified Therapeutic Recreation Specialist), tells us about the new Renown Alumni Recreation Therapy Program, its partnership with the City of Reno and upcoming events. It’s no secret that being active and social supports a satisfying, happy life. With this in mind, the Renown Alumni Recreation Therapy Program reinforces this idea. Its goal is to help patients experience the energy, teamwork and commitment that sports and recreation provide beyond the hospital walls. “We are happy to partner with the City of Reno’s adaptive and inclusion programming to create an active community of adaptive sports participants. There are many options for outdoor recreation in our area. This program looks to share these opportunities with those with a traumatic spinal cord injury,” says Shaun. April Wolfe, CTRS, with the City of Reno adds, “The program’s main objective is to empower individuals living with spinal cord injury to live and recreate independently in the community. We also want them to enjoy the activities, improving their emotional and physical well-being by taking part in the Renown Alumni Recreation Therapy program.” First Successful Therapy Event On Aug. 27, 2020, the recreation therapy program’s first event was an introduction to adaptive mountain biking. Eight participants enjoyed a morning of adaptive biking thanks to a grant in partnership with the City of Reno. “Getting back to an active leisure lifestyle following injury can increase your quality of life both socially and physically,” explains Shaun. “It was great to be outside with people of all abilities enjoying the beautiful Nevada sunshine.” We encourage patients of all abilities to develop active skills, make lasting friendships and, of course, have a blast. Certainly any activity is possible with adaptive equipment and a motivated attitude. Future Recreation Therapy Events Below are the details for the next event. Event: Introduction to Wheelchair Rugby Learn the rules of the sport and play with local athletes. When: Sunday, Nov. 1, from 2 – 5 p.m. Where: Evelyn Mount Northeast Community Center, 1301 Valley Rd., Reno, NV 89512 Cost: Free RSVP: Shaun.Stewart@renown.org or 775-982-3612 by Tuesday, October 26, 2020 This event has a 10 participant limit, following six feet distancing guidelines. Please bring a mask to wear. In particular, this will be a learning event and no scrimmages will occur Rugby wheelchairs will be provided. Please RSVP, to ensure the reservation of the appropriate equipment. In case you cannot attend this event, please look for upcoming events which will include adaptive archery, skiing and scuba diving. Renown Rehabilitation Hospital | 775-982-3500 Renown Rehabilitation Hospital is the region’s only hospital with certification by the Commission on Accreditation of Rehabilitation Facilities (CARF). It is certified for: Comprehensive Integrated Inpatient Rehabilitation Program Stroke Specialty Program Medical Rehabilitation Case Management Take a Virtual Tour

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Renown’s team of nurses and respiratory therapists discuss what you need to know before undergoing surgery, including fasting guidelines and how to improve recovery. There are several things to know before you undergo surgery, including steps to prepare at home in advance of your procedure.   Fasting Guidelines: No solid foods eight hours prior to surgery You may have clear liquids three hours before your surgery. Clear liquids include water, apple juice and lemon or lime-flavored soda water (not cola). In addition, do not chew or smoke tobacco (regular or e-cigarettes) after midnight the night before your surgery, unless instructed by your doctor or anesthesiologist.

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University of Nevada, Reno student Khoa Le was paralyzed in 2010 after a longboarding accident. Through physical therapy, a positive attitude and sheer will, Le is walking again. This weekend, Le will walk across the commencement stage to accept his college diploma. “Walking around on my own power is just the greatest feeling,” says Khoa Le, a senior at the University of Nevada, Reno. Just after finishing summer school at the university in July 2010, his whole life changed within seconds after stepping on a longboard skateboard for the first time. He lost control of the board and hit the curb, causing paralysis on the left side of his body. His journey to recovery began at Renown Health Physical Therapy & Rehab. His physical therapist, Dina Barry, says he never complained once in four years. “I started seeing Khoa in April 2011, and we worked for four years together,” says Barry, a lead physical therapist at Renown. “Everything I’ve ever asked him to do, he does. Le is a hard worker, is continuously optimistic and smiling, and I think that is why he’s accomplished what he has.” Le plans to pursue a career as an information systems manager.

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You’ve likely heard about bariatric surgery — and perhaps even have friends who’ve done it. But is it a potential solution for you? Here, Dawn Remme, RN, Metabolic Bariatric Surgery Program Manager, provides insight. You may have been struggling with excess weight for years. You’ve tried high-protein diets, low-carb diets and more. Most patients considering weight loss surgery have tried numerous dieting methods. The truth is, some patients who suffer with obesity are successful dieters. Unfortunately though, excess weigh often returns. This impacts their health and the quality of their life. It can be a disheartening battle. Weight loss surgery is a big decision. In making this decision, keep in mind that surgery is only one step toward your goal of achieving better health. It is neither magic, nor is it the “easy way out.” Weight loss surgery can offer you a TOOL to help you become more successful in controlling the disease of morbid obesity. By combining this tool with a lifelong commitment to important lifestyle changes, medical follow-up and nutritional modifications, you have the potential to become a healthier you. Bariatric Surgery By the Numbers Exploring the facts about obesity, how it impacts your health, and how surgery can resolve or significantly improve your chronic medical conditions is the first step to making a decision. Obesity is medically defined as “excess body fat” and is measured by a mathematical ratio known as the Body Mass Index (BMI). To calculate your BMI, we consider your height, weight, age, gender and body build. Here are the standards: “Normal” BMI: less than 25 Overweight: 25 – 29.9 Obese: BMI of 30 – 39.9 Morbid obesity: BMI of 40 or more Morbid obesity (BMI over 40) is a lifelong, progressive disease, and the prevalence of morbidly obese Americans (100 or more pounds over a healthy weight) is increasing rapidly. According to the CDC, the disease of obesity affects 78 million Americans. Further estimates indicate about 24 million have morbid obesity. Serious medical problems known as co-morbidities often occur when someone is morbidly obese. Studies tell us conditions such as type 2 diabetes, high cholesterol, sleep apnea, high blood pressure and degenerative arthritis increase in severity as the BMI is increasing in patients. When may weight loss surgery be an option? When someone has a BMI greater then 40. If a person’s BMI is 35 – 39.9 and they have significant health problems such as type 2 diabetes, high blood pressure, high cholesterol, sleep apnea, or other diagnosed health conditions related to obesity. Gastric Sleeve, Gastric Bypass Explained To resolve or significantly reduce these health conditions, bariatric surgery can be done when diet and exercise haven’t worked. Weight loss surgery makes changes to your digestive system to help you lose weight. The gastric sleeve limits how much you can eat, whereas gastric bypass limits how much you can eat and reduces the absorption of certain nutrients. Other Benefits of Surgery You can greatly increase life expectancy by resolving or significantly improving conditions like diabetes, high cholesterol, high blood pressure, sleep apnea, and obesity itself. Infertility can also be positively affected. A significant weight loss and relief from serious health conditions and diseases will greatly improve your quality of life. Studies tell us that type 2 diabetes is resolved or significantly improved in 84 percent of patients following bariatric surgery. Cholesterol levels dropped in 95 percent of patients. And hypertension and sleep apnea showed improvement in 68 and 80 percent of patients, respectively, following bariatric surgery. Bariatric Surgery at Renown In making the decision to move forward to better health, it is important to remember: Obesity is a disease, and the desire to have a healthier, longer, more fulfilling life is possible. If you are interested in learning more, please visit the Bariatric Surgery Program page to view more information about Renown Regional Medical Center’s MBSAQIP accredited bariatric program, as well as information about upcoming educational seminars. Or call 775-982-RSVP (7787) to reserve your seat. Learn More

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Renown Surgical Services is with you every step of the way, providing the support, guidance and information you need throughout the entire surgical process — from preparation to recovery. Whether you need same-day surgery or an advanced procedure, our team helps you find the option that provides the best possible outcome. Need help with your pre-admitting appointment or a price estimate? Call 775-982-3993.   Preparing for Your Procedure Now that you have your surgery scheduled, let’s help get you ready for your pre-admitting appointment. The following checklist provides steps for you to follow from the time it’s determined you need surgery. The checklist covers: How to prepare 1-28 days before your procedure How to prepare the night before your procedure How to prepare the day of your procedure How to take care of yourself after your procedure View the Checklist (English) Ver en Español

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If you’re having surgery on your shoulder, why does it matter what’s in your stomach? We asked Dr. Matthew Hoberg to explain more about pre-surgery directives, including fasting. If you have an upcoming surgery, your care team likely gave you instructions to fast before your procedure. But why? We asked Matthew Hoberg, M.D., medical director of Renown Surgical Services, to explain why it’s important to forgo food and drinks before surgery. Why are patients instructed to fast before surgery? Regardless of surgery type or site, we want the stomach to be empty before having anesthesia, because anesthesia can reduce your body’s ability to protect and prevent food or acids from the stomach from entering the lungs. Normally, your body is able to prevent this, but anesthesia medicines make it harder for your body to do so. When food or liquids from the stomach get into the lungs, doctors call it “aspiration.” This is rare, but can be dangerous if it does happen. Solid foods and liquids leave the stomach at different rates too. Solid food takes longer to empty from the stomach than liquids, so the time to stop eating solids (eight hours) is longer than that for clear liquids (two hours). The body has energy reserves to produce needed nutrients and fuel during fasting. Recently, studies have shown it is important to stay hydrated and have some carbohydrates in clear liquids up to two hours before surgery, so clear liquids are allowed until two hours before surgery. There are also special rules for babies and young children who need surgery. For example, you may give breast milk up to four hours before surgery. If your baby drinks formula, you should stop six hours before surgery, and all solid foods you should stop eight hours before. Your child’s doctor or nurse will give you exact instructions. What if you show up for surgery and have broken the no-eating rule? Will surgery be re-scheduled? If patients have not followed the fasting guidelines, surgery will be postponed or rescheduled due to the possible increased risk associated with not having an empty stomach. The exception would be emergency surgery that cannot be delayed in which case special precautions are taken to help prevent anything from getting into the lungs. What other pre-operative rules should be followed to the letter? All instructions given to patients before their surgery or procedure should be followed. There are specific medical reasons behind all the instructions and they are designed for safety — to minimize risks, lower complications like infections and enhance the recovery process to help patients get back to normal as quickly as possible. Also, many patients ask if they should continue taking medications before surgery. The answer is: It depends. Your doctor or nurse will tell you which medicines you should take and when. Some medicines need to be stopped before surgery. But for others, it’s important you keep taking them as usual. You may also get new medicines to take before surgery. You may be asked to take some medications before surgery as part of advanced pain management protocols. If you need to take medicine right before your surgery, you can take it with a sip of water.

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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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After having a heart attack, a Mammoth resident travels to Reno to complete rehab. He’s already lost 15 pounds and gained a healthier outlook on life.  Eric Smith travels from his home in Mammoth Lakes, Calif., to Reno twice a week to participate in Renown Health’s Healthy Heart Program.   “Living in Mammoth, it’s a three hour drive for me up here. Well, it’s my life or it’s a drive,” says Healthy Heart Program participant Eric Smith. The Mammoth Lakes, Calif., resident travels to Reno twice a week to participate in the 72-session program. which includes heart-healthy classes, exercise sessions and cooking demonstrations. “The cardiac rehab program here is excellent,” Smith says. “It is the only program that I am aware of that combines nutrition and exercise together. What’s the point of exercising to get your heart strong if you are still eating poorly and not educating yourself on that?” Smith’s heart issues began when he was 46-years-old. He received an angioplasty, which is a stent to hold a coronary artery open. Two years later, Smith had a heart attack and was flown to Renown Regional Medical Center for emergency bypass surgery on four arteries to allow blood to flow to his heart more freely. An avid skier, ski racing coach and tile setter, Smith admits that it is sometimes difficult to eat right when you’re on the go in a tourist town. Since starting the cardiac rehab program, Smith says he is feeling more optimistic on making lasting lifestyle changes after meeting other people who are going through the same challenges, like food cravings and trying to get stronger. “The big thing is getting educated on food,” says Smith, who has swapped out heavy breakfasts for whole grains and fruit, and steak dinners for baked fish. In just a few months of starting the program, Smith lost 15 pounds. He looks forward to passing along what he’s learned to his friends.  “Everybody benefits from this program, especially if you have experienced a heart attack,” Smith says. “But if you don’t have those issues, you can still get the benefits from eating healthier.”

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