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It’s true there is no cure for dementia, yet studies suggest your life choices today can reduce brain decline in the future. How important is diet to brain health? Food is the foundation of your body. Fats, carbs and protein provide the energy for your cells and metabolism. So the quality and amount of food you eat directly affects your brain. Specifically, researchers are paying special attention to the link a high sugar diet and/ or an unhealthy fat diet may have on your brain. Your brain on sugar According to the Alzheimer’s Association, when too much sugar is in the bloodstream for long periods of time, it can damage the brain cells. Many people with diabetes may develop brain abnormalities, and these changes may increase chances of dementia — research is still being done to understand this connection. Many U.S. adults have prediabetes with blood sugar higher than normal. Insulin resistance often leads to diabetes. Insulin resistance has been linked to metabolic syndrome, which is a precursor for cardiovascular and cerebrovascular disease (heart attack, stroke). Some signs of metabolic syndrome include: Large waist size (40 inches or more for men, 35 inches and up for women) Low HDL (good) cholesterol level Higher than normal blood pressure — 130/85 and above Current research suggests too much sugar in the blood causes inflammation, which can damage brain cells. High carbohydrate foods, such as sweetened beverages, chips, white rice, white potatoes, bagels, cereals and desserts, have been shown to raise blood sugar. Although anyone can get diabetes, Hispanic Americans and African Americans are at greater risk.

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Help us celebrate the holiday season by sharing joy with our Children’s Infusion Services team!  Thinking about blood can make any of us squeamish, and seeing it can be even more intimidating to the children in our lives. Being treated for a condition that requires blood transfusions or chemotherapy infusions is no easy feat, especially during the holiday season. This time of year, we are proud that we can offer our pediatric patients the power of proximity and excellence by having access to high level care close to home.  The Children’s Infusion Services (CIS) department at Renown Children’s Hospital is committed to bringing the gift of quality care to our community’s youngest patients. Whether they are caring for a child with a blood disorder or giving expert infusion care for a child battling cancer, no team does what they do better than these expert nurses, medical assistants, intake coordinators and physicians.  ‘Tis the Season to Bring Hope As the only pediatric oncology and hematology program in the region, the CIS department has a lot of responsibility on their shoulders. From inpatient chemotherapy to outpatient infusion services, this team treats a long list of pediatric blood conditions including:  Pediatric cancers Anemias Immune-mediated blood disorders Sickle-cell disease Bone marrow failure syndromes Bleeding disorders  “Our team provides a large variety of services from labs draws, sedations for procedures, infusions for diagnoses such as Crohn's disease, blood transfusions, as well as chemotherapy,” said Jen Torres, RN.  “Our team works extremely well together. We try to go above and beyond for our patients every day. It may be something as simple as a hug to comfort a parent or a special birthday gift for a patient.”  “My job allows me to work with several departments and providers when coordinating care for our littlest of patients,” added Jane Strawn, Intake Coordinator. “I assure proper authorizations are in place for the care that is needed, I communicate with our families when scheduling appointments, I organize End of Treatment Celebrations, as well as birthday shout outs and work closely with our Child Life team to help make the challenging appointment little easier.”  To best serve their patients, the team thrives on being expert multitaskers. Central line care, chemotherapy administration, blood transfusions, medication management, preventative injections, lab draws, lumbar punctures, biopsies, imaging – you name it, they do it. And they do it all with the utmost focus on safety and support.  “Our days have a lot of variation, as we perform a number of different services,” said Meagan Bertotti, RN. “We provide infusions for patients with chronic or acute medical conditions and chemotherapy/biotherapy treatment to patients undergoing cancer treatments. Overall, though, we work as a team to make these difficult procedures and treatments as easy as possible for the patients and families by providing engagement and support.”  “While we handle a lot of chemotherapy treatments for pediatric patients, we also do other infusions and transfusions as well such as blood and platelet transfusions, enzyme replacement therapies, different types of injections such as Rabies vaccine or Synagis for high-risk babies who need that extra protection during the RSV season, and lab draws,” said Chelsea Angues, RN. “We care for patients that get their therapies from outside hospitals, but the patient lives within the Reno area. We receive orders from those outside hospitals to care for those patients, so they can still be with their families and not have to travel.”  As members of the Children’s Oncology Group, a highly-regarded clinical trials group where over 90% of pediatric cancer patients across the U.S. receive treatment, teams like CIS in Renown Children’s Hospital deliver the highest standard of care. This partnership is a true testament to the devoted collaboration and relationship-building this team commits to on behalf of their patients every day.  "One of the biggest accomplishments of our team is the fact that we became a member of the Children’s Oncology Group, and the Children's Infusion Center and Pediatric Oncology became one unit,” said Shelby Nolte. "Instead of being a clinic on one side and an infusion center on the other, we really came together to make it a whole unit that collaborates on almost everything.”  “We've put much time into trying to understand other departments, their flow, their rationales and their processes so we can come to a solution that benefits our patients the greatest,” added Tiffany Macie, RN. “We've taken the last few years to really build our relationships with our pharmacy staff, our lab staff and our central supply resources. Our relationship building extends beyond the walls of the Renown building as well and out to the community providers too. In the past few years, we've been able to build relationships with the providers in the community where they trust they can send us their patients for treatment and lab draws. Finally, we've spent much time working on the relationships as a team. It's emotional work we do on our unit, and these families become our family. It's important to us that we take the time to be together outside of our shifts to enjoy one another and laugh!”  In the compassionate realm of pediatric healthcare, CIS knows that the complexities of a cancer or blood disorder diagnosis can take an emotional toll on their patients and families. The team firmly believes that emotional support can be as important as the physical and medical support throughout each patient’s unique care journey, striving to be a comforting presence during daunting times.  “The most important part of my day is collaborating with the Children's Infusion team to make life manageable for the families that are going through this experience,” added Shelby Nolte, Senior Medical Assistant. “We work as a team to make life easier for the blow of a cancer diagnosis.  We are there for our families in every way.  If they need a shoulder to cry on, an ear to listen or just someone to play cards with or tell a funny story too, we are there.”  “One of the things our team does extremely well to help our patients and their families with new diagnoses is to simply meet them where they are,” said Tiffany Macie. “That looks different for every family and every patient. We work in an environment where can build relationships with our patients and their families. This allows us the unique opportunity to really get to know them. We learn their fears, their joys, their worries, what their family lives are like, and we learn how to best meet them where they are.”  Transcending the conventional boundaries of care, the CIS department closely supports each patient, offering them solace tailored to the unique fabric of each family's life.

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March is Child Life Month, meaning this is the perfect time to ask: What exactly does a Child Life Specialist do? To find out, we “virtually” tagged along with one for a day. This is what a typical day looks like in this important role. For Child Life Specialist Brittany Best, play is a natural part of her work day. She approaches her role with a keen understanding of how the seemingly small tasks she performs every day — comforting children prior to a procedure, writing thank-you notes to donors, training interns — positively impact the lives of the children she serves and their families. So what does it take to work in Renown’s Child Life Program? Best shares some of the highlights from a “typical” shift. A Child Life Specialist’s Day 7:30 a.m. Clock in, put my belongings in my office, and print the patient census information. This helps me to get a sense of the day ahead, as I’m covering three areas today. 8-9 a.m. I look over the census sheets for all three areas and check in with the nurses in each area and then try to prioritize my day. 9:00 a.m. I attend Interdisciplinary Rounds for the Pediatric Intensive Care Unit, where the most critically ill or injured children are treated. Additionally, Interdisciplinary Rounds enable several key members of a patient’s care team to come together and offer expertise in patient care. 10:00 a.m. I come up to the specialty clinic/infusion center to check on the patients that have arrived already and see how things have been going since I had last seen them. We see patients frequently up here, as they are receiving treatment for cancer or other disease processes. 10:55 a.m. I’m notified by an RN that a patient needs an IV started, so I go meet with the patient and their family. I meet with a 6-year-old and mother to explain what an IV is and why it is needed. We go through an IV prep kit, looking at all the different items the nurse will use including cold stinky soap, a tight rubber band and also a flexible straw. I also teach this patient a breathing exercise to help them relax during the procedure with a simple exercise known as “smell flowers, blow out candles.” I demonstrate how to take a deep breath in through the nose — like smelling flowers — then how to blow that breath out — like blowing out birthday candles. 11:10 a.m. I walk with the patient and mom to the procedure room on the Children’s Patient Floor for an IV procedure. The Vecta distraction station is set up and running with its bright lights and water tube that bubbles with plastic fish swimming. The parent holds the patient in their lap, and with the distraction and medical preparation, we are successful! I give the patient a toy and provide emotional support to both the young patient and his mom. It’s easy to forget that these procedures can be stressful for the parents as well. 11:30 a.m. I finish rounding with staff to catch up on patients. In addition, I introduce myself to patients and put my contact number on the board in each room so the families know how to get a hold of me should they need anything. With support from volunteers, we distribute movies, games, and “All About Me” forms to patients and their families. These forms help us get to know our patients with things like their favorite foods and televisions shows. 12:45 p.m. I help with a lab draw in Children’s Specialty Care. A 3-year-old patient is very anxious about the “shot,” so I meet with the patient and parents to discuss coping techniques. The patient holds the Buzzy Bee and does well during the lab draw. The mom is relieved, and the patient is excited for a toy. The Buzzy Bee actually helps block the transmission of sharp pain on contact through icy numbing and also tingly vibration. 1 p.m. Joan, an artist with our Healing Arts Program, arrives on the Children’s Patient Floor to perform art therapy with patients. She helps two young patients who are interested in watercolor paintings. 1:15 p.m. Time for lunch and also a trip to Starbucks. 1:45 p.m. I finishing rounding and introducing myself and our services to the patients I have not met yet. 3 p.m. At this time, I meet with the parents of a newly diagnosed diabetic patient who is in intensive care. A new chronic diagnosis is always difficult, so I am there to provide emotional support. It’s instances like this that remind me every day why I love the work I do. 3:30 p.m. I meet with a new volunteer, discuss their role and also give the new volunteer a tour of the units. We are very thankful for all our volunteers on the floor, as their contributions help us provide a variety of basic services to a larger number of children. This also allows the Child Life Specialist to devote time to children who require more intense or specialized service. 4-5 p.m. I finish charting on patients and help two newly admitted families before I start to wrap up for the day. This evening we have a volunteer covering the times during shift change, which is helpful as it makes for a smooth transition for families during the meal time and change of shift. During this time, I write a note for this volunteer indicating the patients I want her to focus on. 5-5:30 p.m. Check in with critical patients and families before leaving for the day. All-in-all, it was a good day.

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Shining Brightly We all carry a light inside of us. Some people seem to have a constant glow while others flicker brightly here or there depending on what they’re doing or who they’re with. But for another select group, the light they embody is closer to a sunrise, illuminating and embracing everything and everyone it touches. Do you think that’s a bit heavy-handed or just a writer’s poetic exaggeration? Well, that’s because you haven’t met this issue’s featured Sterling Silver Club member, Tami, yet. But that’s about to change…  This Little Light of Mine  As an infant, Tami’s adoptive parents were drawn to her light, even though the couple had come to an orphanage in Washington state hoping to find an older child to add to their family.  “My parents always said that after seeing and holding me, they had to take me home,” Tami remembers and then smiles. “They also liked to tell the story of how they sold their prize baby bull, Johnny Apollo, to pay my adoption fees!”  Tami has fond memories of making mud pies and climbing trees as a child and feels privileged to have been raised by older parents.  “They both lived through the Great Depression and my dad proudly served in the U.S. Navy in World War ll,” says Tami. “I certainly attribute learning to love and give unconditionally through their humble ways. I had the honor of taking care of them both for about 10 years before their passing. When asked who my heroes are, though I have several, they are at the top of that list for sure.”  Today, Tami is married to her high school sweetheart, Richard. They’ve been together for 43 years and have five children – and 10 grandchildren – of their own.  Helping Others Through Darkness Tami started a highway construction business with her family in 2000, but focused 18 years of her career around her love of teaching, with seven years spent as Vice Principal of Academics at Reno Christian Academy. One of her greatest joys during that time was implementing Prime Time, a program that set aside special time for students who had experienced recent traumatic events. “I used puppets, sewing, crafts – any activity the students would respond to,” explains Tami. “But mostly, I listened.” And when one of her students shared, “I just want someone to listen to me for an hour today” – that’s what she did. “We sat on the sidewalk and ate Fudgsicles and giggled at the silliest things,” Tami recalls with some emotion. “And when we both left smiling, I was reminded that the most beautiful moments are when we are simply present with an open heart.”

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