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A Therapist's Tips to Prevent and Manage Osteoporosis
Want to know more about osteoporosis and osteopenia? We'll dive into these conditions and give you some handy tips on preventing future problems and taking care of your bones. What is Osteopenia? Osteopenia (low bone density) is the initial stage of bone mineral density loss, which can eventually progress to osteoporosis if steps are not taken to prevent it. What is Osteoporosis? Osteoporosis is a condition that weakens our bones. While it literally means “porous bone," it doesn’t mean that our bones are doomed to succumb to the changes that can happen to us silently over time. Our bones are living tissues that are constantly breaking down and remodeling themselves. Osteoporosis and osteopenia are typically diagnosed by testing bone mineral density using scans that your primary care provider can easily order. This is important testing because it dictates your risk of breaking a bone in common areas like your hip, wrist or spine. It also helps set the stage for talking with your healthcare team to develop a treatment plan. Most people will reach their peak bone mass in their mid to late twenties. There are several factors that increase our risk of osteoporosis or osteopenia as we age, such as menopause, genetics and other lifestyle factors. However, there are several things you can do to mitigate this breakdown and assist your body in the constant remodeling it does to our bones. 3 Controllable Factors to Build Strong Bones 1. Talk to your primary care provider They can go over a plan and prescribe things such as vitamin D, calcium and medications that can help if you are at risk or have osteoporosis or osteopenia. 2. Maintain a healthy diet Talk to a dietician if you need further help as they can be an invaluable resource to develop a plan. Eat foods rich in calcium, vitamin D and vitamin C. These assist with the rebuilding of bone. Examples include but aren’t limited to leafy greens, legumes, salmon and healthy dairy products. Don’t smoke — it directly correlates with a decrease in bone mass. Smokers also take longer to heal from a fracture. Limit alcohol to two to three beverages per week. Alcohol interferes with the production of vitamins needed to absorb calcium and the hormones that help protect bones. 3. Exercise Talk to your primary care provider to get a referral to physical therapy if you need help with exercise. Our bones adapt to the stresses we put them through. Therefore, exercise should be tailored to putting the right stress on our bones. There is good quality research that most exercise is safe when dealing with less bone mineral density. The exercises should be progressively challenging and increase the load for resistance and weight training at least two to three days a week. Examples include squats, step-ups, chest presses and rows. Exercises higher in velocity will lead to more power and bone adaptation. Examples include quicker push-ups, marching and quicker walks. Exercises that are weight-bearing will lead bones to adapt to the stress placed on them. Movements such as mini stomps, step-ups, jumping, jogging and so forth may be used depending on how your body tolerates these things to really stimulate bone adaptation. There are aspects of aging and bone health we can’t control, but we can take steps to minimize the chances of bone loss and osteoporosis. Talk to your healthcare team to determine your risk and don’t forget to show your bones a little TLC – you’re going to need them.
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Steve Shell Joins Renown to Lead the Stacie Mathewson Behavioral Health & Addiction Institute
Under Steve Shell's leadership, the Institute will continue to expand community access to prevention and intervention services for mental health disorders and alcohol and drug addiction. Renown Health is excited to announce Steve Shell is joining the Stacie Mathewson Behavioral Health & Addiction Institute at Renown as its vice president. In this role, Shell will oversee the Institute, which provides intensive outpatient treatment, partial hospitalization programs and medication-assisted treatment to serve those struggling with mental illness and addiction in our community. “We are pleased to welcome such an experienced and talented leader like Steve to our organization,” said Tony Slonim, MD, DrPH, president and CEO, Renown Health. “As vice president of the Stacie Mathewson Behavioral Health & Addiction Institute at Renown, Steve will continue the Institute’s work to change the status of mental health and addiction in northern Nevada.” Shell comes to Renown after opening and serving as chief executive officer of Nevada’s two newest behavioral health hospitals since 2013. He was instrumental in establishing Reno Behavioral Healthcare Hospital in 2016 and helped to design, set up and manage operations for the 124-bed psychiatric and addiction treatment facility for all ages. He also launched the 152- bed Desert Parkway Behavioral Healthcare Hospital in Las Vegas in 2013, a psychiatric and addiction treatment facility for all ages. “Nevada has the highest prevalence of mental illness and substance use in the nation combined with limited access to treatment and a shortage of care providers,” said Steve Shell. “I am passionate about improving the health of our community and have dedicated my career to advocating for mental health, working diligently to further elevate the care offered in our state.” Renown Health and Charles N. and Stacie L. Mathewson established the Stacie Mathewson Behavioral Health & Addiction Institute at Renown in to expand community access to prevention and intervention services for mental health disorders and alcohol and drug addiction. The Institute is working to expand intensive outpatient treatment, partial hospitalization programs and medication-assisted treatment to better serve those struggling with mental illness and addiction and is working to decrease stigma and encourage more people to seek help. “Moving the needle and improving the heartbreaking statistics of our state is a key focus for the Institute,” said Stacie Mathewson, executive director at the Stacie Mathewson Foundation. “I believe Steve’s leadership will have a positive impact on our efforts to improve the care and treatment of mental illness and addiction.” 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 Heath, Neurosciences and Robotic Surgery. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project®.
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Takesha Cooper, M.D., Appointed Chair of Psychiatry & Behavioral Sciences
Takesha Cooper, MD, has joined the University of Nevada, Reno School of Medicine and Renown Health as Department Chair of Psychiatry and Behavioral Sciences. Dr. Cooper comes to the area from the University of California, Riverside School of Medicine where she served for seven years as clinical associate and then full professor in the Department of Psychiatry and Neurosciences, and associate training director for Child and Adolescent Psychiatry. Dr. Cooper previously served as associate medical director for the Riverside University Health System and Riverside County Department of Mental Health providing clinical and operational oversight for four regional psychiatric county clinics, and as an adjunct instructor of psychiatry at Stanford University School of Medicine. As a double board-certified child, adolescent, and adult psychiatrist, she also established a successful solo private practice serving patients from diverse backgrounds. At UC Riverside, Dr. Cooper held significant academic and leadership roles including vice chair of education, residency program director, chair of the Admissions Committee and equity advisor. Dr. Cooper will now build on the strong foundation established by Dr. Josh Fitzgerald, interim chair of the department, who will now serve as director of research for the department. Dr. Cooper will be responsible with Steve Shell, vice president of the Stacie Mathewson Behavioral Health & Addiction Institute at Renown Health, for leading the Behavioral Health Program at the Institute where a team of nine psychiatrists, nurse practitioners and licensed professionals and counselors provide intensive outpatient treatment, partial hospitalization programs, Transcranial Magnetic Stimulation, Esketamine, hospital-based assessment and medication-assisted treatment to serve those struggling with mental illness and addiction across northern Nevada, Lake Tahoe and northern California. “We are delighted to have Dr. Cooper join the UNR Med/Renown team,” said Paul J. Hauptman, MD, dean of UNR Med and chief academic officer for Renown Health. “She brings a wealth of experience in multiple clinical settings, and we are confident that she will have a significant impact at a time of great need for mental health services, education, and research in northern Nevada. Dr. Cooper will do much to advance the mission of UNR Med which includes a commitment by the Department of Psychiatry to train the next generation of psychiatrists through a Psychiatry Residency and Child & Adolescent Psychiatry Fellowship training program. Education and training are provided in both urban and rural areas of northern Nevada.” Dr. Cooper earned her Doctor of Medicine Degree from the Keck School of Medicine at the University of Southern California and completed her residency at San Mateo County and fellowship at Stanford University. Prior to medical school, she obtained a Master of Science degree in Biochemistry and Molecular Biology from UC Riverside and her bachelor’s degree in Biochemistry and Molecular Biology from UC Santa Barbara. Dr. Cooper’s research explores the impact of Adverse Childhood Experiences on mental health outcomes in children and adults. She served as a clinical co-PI on a U54 funded grant aimed at reducing health disparities by engaging in community-based participatory research partnerships. “Dr. Cooper is an energetic, collaborative physician, researcher and mentor who cares deeply about improving the mental health and well-being of adults and children,” said Brian Erling, MD, MBA, President and CEO, Renown Health. “This is an exceptionally exciting time to advance health equity and to help improve mental health outcomes for people and communities across northern Nevada. We are excited that Dr. Cooper is joining our team. I know her talent, energy and leadership will further elevate our mission of outstanding care, exceptional training, innovative research, impactful advocacy and innovative community partnerships in mental health and addiction medicine.” Dr. Cooper is recognized for her passion for high-quality patient care and supports future practitioners through rigorous and culturally informed undergraduate and graduate medical education, research, and community collaboration. A 2022 graduate of the Executive Leadership in Academic Medicine (ELAM) program offered through Drexel University, she also maintains active involvement in national and state committees and journal editorial boards. The University of Nevada, Reno School of Medicine (UNR Med), Nevada’s first public medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Since 1969, UNR Med has trained more than 3,900 students, residents and fellows. UNR Med continues to improve the health and well-being of all Nevadans and their communities through excellence in student education, postgraduate training and clinical care, research with local, national and global impact and a culture of diversity and inclusion. For more information, visit med.unr.edu. Renown Health is the region’s largest, locally 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 locally owned not-for-profit insurance company, Hometown Health. For more information, visit renown.org.
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Department Spotlight: Acute Care Rehab Therapy
Being admitted to the hospital is never easy. Being admitted for a traumatic injury can be even harder. Whether it's learning how to walk again or powering through a new speech therapy routine, recovering from an injury that may affect the course of your life can be daunting. But it doesn’t have to be, thanks to the Acute Care Rehab Therapy team at Renown Health. The smiling faces of the Acute Care Rehab Therapy team at both Renown Regional Medical Center and Renown South Meadows Medical Center will make you see that there is a light at the end of the tunnel. Your dedicated physical therapists, occupational therapists and speech language pathologists are here to serve you and place you back on the right path to recovery and function. The Role of Acute Inpatient Therapy The Acute Care Rehab Therapy team comes in at a critical juncture in a patient’s care process after hospital admission. As one of the primary rehabilitation partners on a care team, these dedicated therapists are here to maximize every patient’s safe and independent living before they set off back home – all while reducing the risk of hospital readmission. “As physical therapists, we address musculoskeletal deficits and assess a patient’s current function after acute injury or illness from their baseline and develop a plan for functional recovery,” said Kristie Eide-Hughes, Physical Therapist at Renown Regional. “We also use our clinical expertise to assist with the discharge process and make sure each patient has the best durable medical equipment the first time around, removing the guesswork.” “On the occupational therapy side, we work with patients to facilitate their independence with basic life skills, such as dressing, bathing and using the restroom,” added Jeanne Clinesmith, Occupational Therapist at Renown Regional. “In the pediatric setting, we help babies and kids get back to what they were doing before they came into the hospital,” continued Rhonda Yeager, Pediatric Occupational Therapist at Renown Regional. “In the NICU specifically, we support the development of babies, trying to prevent problems from worsening. It’s nice to be a source of positivity in an otherwise intimidating situation.” The role of therapy in this setting reaches all ages, from babies in the neonatal intensive care unit (NICU) to adults approaching end-of-life care. Every therapeutic approach is tailored specifically to each patient. “Therapy is more of a habilitative approach for infants in the NICU, while it is more of a rehabilitative approach for kids and adults following injury or illness,” said Sara Carolla, Physical Therapist at Renown Regional. Each team member in the Acute Care Rehab Therapy department is dedicated to each patient, helping them make progress from start to finish and giving them the tools to succeed along the way. “I enjoy the variety of the patients we get to see and the ability to see them make gains from the wonderful treatment they get in the hospital from my team,” said Kelly Schwarz, Occupational Therapist at Renown South Meadows. “We provide education as each patient’s acute issues evolve,” added Nicole Leeton, Speech Language Pathologist at Renown Regional. “One of my favorite parts of my work is the patient and family education aspect, and that includes other healthcare provider education as well. It’s a moving picture.” Moreover, every team member gives each patient tools to learn how to be themselves again and empowers them to continue striving for the best possible result of their therapy “We get the opportunity to make a person’s bad experience in life better even by spending one session with them, giving them the keys to unlock something that they didn’t think they had the ability to do,” said Dana Robinson, Occupational Therapist at Renown Regional. On the Road to Independence Our dedicated therapists in the Acute Care Rehab Therapy team set the stage for a patient’s recovery process after trauma, showing them their potential for independence. With a multitude of patients coming into the hospital with many degrees of medical complexity, each day is different while the end goal is always the same: to optimize function as early as possible while overcoming any barriers and paving the way for a comfortable and effective quality of life. “Early intervention is a big piece,” said Nicole Leeton. “Us seeing patients early can get them recovered and independent more quickly and help prevent future illness and injuries. For example, in speech therapy, getting in early and facilitating communication skills for patients with impaired speech can make a huge difference.” Acute Care Rehab therapists dig deeply to see the whole picture of each patient’s situation to foster their independence – their history, social skills, support system and more. “Sometimes, we are the difference between independence and dependence,” said Dana Robinson. “We are the eyes and ears because we have so much time with the patients. Our team is extremely collaborative and develops a great rapport with patients, so they feel comfortable telling us everything going on with them.” “For kids, we teach parents ways they can help their kids by setting up their homes and the equipment they need to succeed,” added Rhonda Yeager. According to the team, one of the biggest keys to independence is repetition. A continual flow of getting up and trying again is crucial for recovery. “Repetition helps people regain their quality of life back sooner and control their recovery process,” said Megan Hough, Physical Therapist at Renown Health. “Helping people continue to get stronger and more independent makes my job so rewarding,” added Sam Brown, Physical Therapist at Renown Regional. Knowing that they have made a difference and help shape a patient’s overall development inspires each therapist to never give up, regardless of how difficult an injury presents. There is no set schedule for recovery, and the therapists are always in the patient’s corner. “This team has the most passionate, caring and dedicated individuals that I know,” said Kendra Webber, Manager of Acute Inpatient Rehab Therapy Services at Renown Regional. They give 110 percent to every patient every time to ensure they have what they need to regain function and independence.” “By tailoring therapy to the individual, the bounds are virtually limitless for what we can accomplish,” added Dana Robinson. It Takes a Village Since acute inpatient therapy is never a one-size-fits-all approach, it truly takes a village for this team to move the mountains they do for patients every day. These teams are fact-finding masters, gathering all the necessary information from the patient, their family and their care team to figure out their precise needs. “We are a consistent presence for our patients, identifying a lot of different needs and meeting those needs to help patients grow in their treatment process,” said Kelly Schwarz. “By collaborating with each patient’s diverse care team, we are able to employ the clinical judgment to help patients overcome physical, emotional and environmental struggles and set them up with the proper resources once they leave our setting.” “Our team has steady communication with physicians, nurses, acute care technicians, respiratory staff, physician assistants, case managers and more to ensure the best possible care,” added Jet Manzi, Physical Therapist at Renown Regional. Constant communication and collaboration are also necessary beyond the acute treatment process. These skills are vital in order to facilitate discharge planning, and the Acute Care Rehab therapists are an essential resource in the discharge process alongside our Hospital Care Management team. “Often times, a patient’s family needs a lot of guidance in helping their loved ones determine the next level, and we help them navigate those steps and the resources available to them,” said Mark Stumpf, Occupational Therapist at Renown Regional. “And it’s all a team effort.” “Our therapists are the most committed, generous, hardworking people,” added Courtney Phillips-Shoda, Supervisor of Rehab Therapy Services at Renown Regional. “Despite being short-staffed, we come to work every single day and give everything to our patients. They are the priority.” If you take away one thing, know this for certain: Renown’s Acute Care Rehab occupational, speech and physical therapists will always be there to help patients continue on a positive trajectory to physical, mental and emotional recovery. “Whether you are a patient or a provider, if there is a problem, never hesitate to reach out to us,” said Nicole Leeton. “We are always receptive to anyone seeking our help.” With the Acute Care Inpatient Therapy team on their side, a patient’s journey to recovery is only just beginning.
Read More About Department Spotlight: Acute Care Rehab Therapy
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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.
Read More About Renown Now Offering rTMS Treatment for Major Depression
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Child Life Program
Providing emotional support for your children, and you. It is undeniable that hospitals can be a daunting experience for all, but when a child is faced with a difficult diagnosis or staying in the hospital, it can be especially overwhelming. Fortunately, Renown Health has a team of experts called the Child Life team to help. This group of devoted healthcare providers collaborate with kids who have been admitted to the hospital, as well as children whose family member is a patient at Renown, to ensure they understand every aspect of their visit, while also letting them be kids. Child Life Specialists provide support to children and their families by: Assessing patients developmental level and tailoring interactions to each individual family need Helping children cope with worries, fears and/or separation Making doctors, needles, and tests a little less scary by creating coping plans Organizing activities in the playroom and at bedside Addressing parent and caregiver concerns Preparing patients and families for what to expect Fostering a therapeutic environment through play opportunities Offering a hand to hold during tests, procedures, and tough stuff Offering services like art, music and pet therapy Creating special memories and mementos for children and families in times of grief and loss The Child Life Program is available seven days a week at Renown Health and the team can be reached at 775-982-5173.
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Physiatry NEURO-REHABILITATION CLINIC
What is Physiatry? Physiatry (fuh·zee·a·tree) encompasses the diagnosis, prevention and treatment of all disabilities related to the brain, nerves, bones and muscles. The goal is to maximize physical functioning, significantly decrease or eliminate pain, foster independence and improve the quality of life for those with a disability, chronic pain and physical impairments.
