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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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Nationally Recognized Vascular Surgeons Join Renown Health
Two vascular surgeons bring a quarter of a century of experience to patients and community. As part of a continuing focus to bring comprehensive care to patients experiencing cardiac and vascular disease across northern Nevada, Renown Health Department of Surgery and Renown Institute for Heart & Vascular announce that vascular surgeons, John C. Hansen, MD, FACS and Benjamin P. Jaquish, MD, FACS have joined Renown Health. "Recognizing the significance of preventing, diagnosing and caring for people with heart and vascular disease, which continues to be on the rise and taking far too many lives, is of critical important to us at Renown," says Christos A. Galanopoulos, MD, MBA, MSc, FACS, VP, Chairman Department of Surgery at Renown Health. "Both Drs. Hansen and Jaquish are superb clinicians, skilled investigators, and effective educators. We are fortunate to have them helping to lead the growth of both the department and the Division of Vascular and Endovascular Surgery." Together, the vascular surgeons have more than 26 years of combined experience caring for northern Nevadans. Dr. Hansen has 20 years of experience in northern Nevada. He is a clinical associate professor of surgery at the University of Nevada, Reno School of Medicine (UNR Med) and currently serves as medical director of vascular and endovascular surgery for Renown Regional Medical Center. "Since 2002, Dr. Hansen has led our region with his expertise and knowledge of aortic stents, grafting for abdominal aortic aneurysms and thoracic aneurysms, as well as treating patients with carotid disease," says Jayson Morgan, MD, FACC, Director, Cardiovascular Services. "Dr. Hansen specializes in the comprehensive management of vascular disorders, including open and endovascular surgeries. He is meticulous, thorough, and compassionate in the extraordinary care he provides to patients. We are thrilled that he has joined the Institute for Heart & Vascular Health team at Renown." Dr. Hansen completed his fellowship in Vascular Surgery at the Mayo Clinic in Rochester, MN, and completed his residency in General Surgery at the University of South Carolina, Greenville. He graduated with his Doctor of Medicine from the University of North Carolina School of Medicine, Chapel Hill, and is board certified in both Surgery and Vascular Surgery from the American Board of Surgery and a Fellow of the American College of Surgeons. Dr. Hansen has an interest in complex and acute vascular surgery and is committed to expanding access to qualified vascular care in the region. His mission is to further develop and establish Renown as a premier vascular center in northern Nevada. "Dr. Jaquish has extensive experience in carotid artery disease, carotid endarterectomy, aortic aneurysm and dissection, and peripheral vascular disease," says Sam Obilie-Mante, MBA, MIS, RDCS, RVT, LBBP, VP Administrator, Cardiovascular Services. "Dr. Jaquish is intelligent, professional, conscientious, and always perseveres on behalf of his patients. How proud we are to have him bringing his time and talent to patients across Renown Health." Dr. Jaquish received both his B.S. in Biochemistry (2005), graduating Magna Cum Laude with his Doctor of Medicine (2009) from the University of Nevada, Reno School of Medicine. Dr. Jaquish completed his fellowship in General Surgery at Ascension St. John Hospital and Medical Center in Detroit and a fellowship in Vascular Surgery at Texas A&M at Baylor, Scott & White Hospitals in Temple, TX. He is board certified in both General Surgery and Vascular Surgery. Dr. Jaquish currently serves as Assistant Professor of Clinical Surgery for UNR Med. Dr. Jaquish is bilingual in Spanish, proficient in American Sign Language and serves as an instructor for Advanced Trauma Life Support. Why Vascular and Endovascular Care Matters to You People with complex and serious conditions of the blood vessels and lymph system (vascular diseases) often find the help they need from Renown Health's vascular and endovascular surgical team. Renown's experts provide coordinated and comprehensive treatment to people of all ages. Renown's surgeons use advanced technology to perform vascular and endovascular surgery, including complex stenting procedures, blood clot removal and bypass surgery. Conditions treated include peripheral artery disease, aortic disease, mesenteric disease, nutcracker syndrome and carotid artery disease. "Our expert vascular and endovascular surgeons and staff treat problems that extend from mild to the most critical of emergencies," says Adnan Akbar, MD, Chief Medical Officer for Renown Acute Care. "Specialized physicians including cardiologists, interventional radiologists, heart and vascular surgeons, emergency medicine and trauma surgeons, neurologists, radiologists, physical medicine and rehabilitation specialists, primary care providers, nurses and other clinicians work as a team to determine the best treatment plan for each patient. We encourage all patients to discuss with their primary care providers whether they should undergo formal screening for early vascular disease." "Renown's reputation as the region's vascular and endovascular care leader has been built over many years. We performed the area's first open-heart surgery, angioplasty, stent and valve replacements decades ago. Renown Regional offers incredible advancements like trans-catheter aortic valve replacement (TAVR) and trans-catheter mitral valve repair (TMVr) with MitraClip therapy, lifesaving alternatives to open-heart surgery for patients considered high-risk or inoperable," says Chris Nicholas, FACHE, Chief Executive Officer of Renown Regional Medical Center. "Offering the highest level of comprehensive care for patients experiencing cardiac and vascular disease, Renown developed its first division of cardiothoracic surgery dedicated to heart surgery patients in 2019." The Renown Institute for Heart & Vascular Health program now offers a Diagnostic Electrophysiology Lab; a Chest Pain Center using the D-SPECT® heart camera; multiple Interventional Labs; Heart Failure Program; several Cardiac Catheterization Labs; Interventional Cardiology and Cardiac Surgery when necessary; and the only Pritikin-certified Healthy Heart Program in the West, creating individualized rehabilitation plans tailored to each patient's needs, so they can exercise safely, eat healthy, manage stress and cook nourishing, balanced meals, all while gaining a healthy mindset. In the most recent US News & World Report Best Hospital rankings, Renown Regional Medical Center was named as the number one hospital in Nevada. No other hospitals in the state met their stringent standards for the 2021 rankings. Renown Health is High Performing, its highest rating possible, in eight procedures and conditions including Heart Failure, Colon Cancer Surgery and Chronic Obstructive Pulmonary Disease, Hip Replacement and Knee Replacement. A hospital's score is based on multiple data categories, including patient outcomes, safety and volumes. Hospitals earning a High Performing rating were significantly better than the national average. The 2021-22 Best Hospitals rankings are drawn from a universe of 4,523 facilities, representing nearly all U.S. hospitals providing inpatient care. Hospitals are evaluated across a wide range of conditions and procedures, including 16 medical specialty areas of care. US News & World Report evaluated 58 hospitals in Nevada. Renown Health is Nevada's largest, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 6,500 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. Renown is currently enrolling participants in a community-based genetic population health study, the Healthy Nevada Project®. For more information, visit renown.org. 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.
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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.
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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.
