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Keeping Your Brain Healthy, No Matter Your Age
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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Generic Drugs – What You Need to Know About Them
Without a doubt, taking medications can not only be expensive, but also confusing. In the United States, generic prescriptions are widely used, with 9 out of 10 people choosing them over a name brand. Pharmacists are a great resource to help us understand the benefits and side effects of any medication. We asked Adam Porath, PharmD, Vice President of Pharmacy at Renown Health, to answer some common questions about generic drugs. What is a generic drug? A generic drug has the same active ingredients of brand-name drugs. Brand-name drugs have a patent (special license) protecting them from competition to help the drug company recover research and development costs. When the patent expires other manufacturers are able to seek approval for a generic drug. However, the color, shape and inactive elements may be different. Per the U.S. Food & Drug Administration (FDA), a generic medicine works in the same way and provides the same clinical benefit as its brand-name version. Why do they cost less? Generic drug makers do not have the expense of costly development, research, animal and human clinical trials, marketing and advertising. This savings is passed on to the public. Also after a patent expires, several companies will compete on a generic version of a drug, further driving down prices.
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Exceptional Talent Joins William N. Pennington Cancer Institute at Renown; Dr. Kate Ward Brings Expertise and Vision as Vice President of Oncology Division
Renown Health is pleased to announce that Kate A. Ward, Pharm.D., BCPS, has been promoted to serve as Vice President, Oncology for Renown Regional Medical Center. Dr. Ward has over fourteen years of service to the organization, most recently as Director of Clinical Pharmacy responsible for the oversight of all clinical pharmacy activities at Renown Regional Medical Center, Renown South Meadows Medical Center, and Renown Rehabilitation Hospital. Additionally, Dr. Ward is the Residency Director of the Post-Graduate Year 1 (PGY1) Pharmacy Practice Residency at Renown. Over the last decade at Renown, Dr. Ward has served as Pharmacy Clinical Manager, Pharmacy Clinical Coordinator and Clinical Pharmacist. Dr. Ward will bring her pharmacy clinical service experience (including ICU, Outpatient Infusion, Pediatrics, Oncology and Emergency Services), Inpatient Care, Clinical Research, and Hospital Formulary Management, Electronic Medical Record Integration and Optimization to this important new role. As a dyad partner with Max J. Coppes, MD, PhD, MBA, Director of the William N. Pennington Cancer Institute at Renown, she will bring her clinical, operational, regulatory, and administrative experience to lead the oncology division. Dr. Ward, Dr. Coppes and the dedicated team will advance Renown’s mission to expand care, prevention, screening, research, and education with the goal of establishing the first National Institutes of Health, NCI designated Cancer Center for our State. “We are thrilled to welcome Dr. Ward as our new Vice President of Oncology. She brings a wealth of experience and a passion for advancing patient care. Dr. Ward will play a pivotal role in sharing the future our oncology division and furthering our commitment to providing exceptional care,” said Chris Nicholas, CEO of Renown Regional Medical Center. As a licensed pharmacist, Dr. Ward holds a Doctor of Pharmacy degree from the University of Colorado, Health Sciences Center. The Pharm.D. is a professional degree like a Doctor of Medicine (MD) or Doctor of Dental Surgery (DDS). As a doctorate, it represents the increasing responsibility pharmacists have in healthcare systems and the high trust Americans have in pharmacists. Dr. Ward completed her residency at Stanford Hospital and Clinics. She graduated from the University of Nevada, Reno with her bachelor’s degree in Nutritional Sciences. Dr. Ward is active in several professional associations and currently serves as a Pharmacy Board member for HealthTrust; Vice Chair of the American Society of Health System Pharmacists® Council on Therapeutics; and Vice Chair for the Silver State Scripts Board for the State of Nevada. Dr. Ward was the 2022 recipient of the Nevada Society of Health System Pharmacists (NVSHP) President’s Award. About Renown Health 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. To join the Renown Health team, visit renown.org/careers.
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Department Spotlight: Pharmacy
When it comes to each patient’s healthcare journey, medication is often a key chapter. After all, medication is one of the most common treatment methods to help patients on the road back to health. In 2023, 4.83 billion prescriptions were filled in the U.S., and with this number only anticipated to rise annually, having an expert pharmacy team on your side to make certain you are prescribed the ideal dosage to treat your condition, prepare your prescriptions on time and help you manage your medications responsibly is important. Fortunately, at Renown Health, we have best-in-class inpatient and outpatient pharmacy teams to fill both prescriptions and promises for excellent care. Renown Pharmacy plays a vital role in helping us foster a health system that prioritizes patient well-being above all else. This department exemplifies the impact that a unified, expert pharmacy team can have on patient outcomes now and in the future. The Masters of Medication Spanning three hospitals plus ambulatory locations across the health system, Renown’s growing pharmacy team – full of dedicated pharmacists, pharmacy technicians and even medical assistants – manages medications in a wide variety of patient settings, touching nearly every aspect of the healthcare continuum: Outpatient Retail Pharmacies Renown Regional Medical Center – 75 Pringle Way The Healthcare Center – 21 Locust Street Renown South Meadows Medical Center – 10101 Double R Blvd Inpatient Pharmacies Renown Rehabilitation Hospital Renown Regional Medical Center (including Renown Children’s Hospital) Renown South Meadows Medical Center COMING SOON: Conrad Breast Center Pharmacy (in honor of Kristina Ferrari) in the Specialty Care Center at Renown South Meadows Ambulatory Pharmacies Anticoagulation Services – Institute for Heart & Vascular Health (IHVH) Pharmacotherapy Program – IHVH and Renown Medical Group Locations Congestive Heart Failure Pharmacotherapy Program – Center for Advanced Medicine B at Renown Regional Chronic Obstructive Pulmonary Disease (COPD) Pharmacotherapy Program – Renown South Meadows Endocrinology Pharmacotherapy Program – Renown South Meadows Additional Pharmacy Programs Medical Reconciliation Pharmacy Residency Clinical pharmacists at Renown bridge the gap between medicine and compassionate support, making sure each patient receives personalized care one prescription at a time. “There are various roles pharmacists play within Renown,” said Clarissa Munoz, Clinical Pharmacist in the Renown Regional Inpatient Pharmacy. “Staff pharmacists work diligently to ensure correct medications are dispensed, and if compounded, make sure they were prepared properly. They also work hard to answer medication messages and phone calls, help verify orders and make sure ode trays/RSI kits are appropriately stocked and ready when needed. Clinical pharmacists work from satellite pharmacies on the floor and focus on reviewing patient charts and aim to provide additional interventions to the providers to optimize treatment strategies. We also serve as a resource for nursing staff and help answer medication questions.” “My role in the pharmacy is pretty expansive,” added Chanelle Ajimura, Clinical Pharmacist in the Renown Regional Outpatient Pharmacy. “I maintain inventory to confirm patients can receive their medications in a timely manner both for our discharge and retail patients while balancing the Meds to Beds program, which offers medication delivery to the bedside and bedside medication counseling; collaborating with an interdisciplinary team to find the most affordable price for patients; and verifying that the dose, strength, indication, etc. is appropriate for the patient from start to finish.” “In the pharmacy, I make sure patients are receiving appropriate drug therapy by checking for major drug interactions and ensuring appropriate dosing,” added Courtney Church, Clinical Pharmacist in the Renown Regional Outpatient Pharmacy. “I also make recommendations to providers so patients can get cost-effective therapy.” Our pharmacy technicians work behind-the-scenes ensuring efficient medication management, making a difference in the lives of patients every day. “A pharmacy technician is responsible for making sure the patient gets their medications on time and at the lowest price possible,” said Nate Graham, Pharmacy Technician in the Renown Regional Outpatient Pharmacy. “This is done by working with patients, insurance companies and case workers. We fill prescriptions, enter prescriptions into our system, receive and send orders for medications and maintain a clean pharmacy with an accurate inventory.” “We do a variety of things; the task people probably know the most is counting out the medications and putting them in the amber vials,” added Rachel Vallin, Pharmacy Technician in the Renown Regional Outpatient Pharmacy. “We also help patients at the front of the pharmacy, ring out their prescriptions, answer some basic questions (deferring to a pharmacist as necessary) and billing insurance. Meds to Beds is my favorite part because I feel the most involved. I take medications to patients who are discharging up to their hospital rooms so they have it with them when they leave.” “As a technician, I confirm that all medications of new admissions are available in our machines prior to admitting and then maintain stock during each patient’s stay,” added Tammara Axtman, Pharmacy Technician at Renown Rehabilitation Hospital. "I also assist our nurses when needed in regard to any of their questions with both EPIC and Omnicell.” Our pharmacy team is also on the move all across our health system, thanks to our Ambulatory Pharmacy programs. For patients experiencing a serious heart, lung, or endocrine condition that requires ongoing drug therapy maintenance and guidance, our ambulatory pharmacies step in to carefully monitor how their medications impact their health and well-being. “Our role as pharmacists in this department is non-traditional because we actually see patients in the exam rooms face-to-face,” said Cory Lankford, Ambulatory Care Clinical Pharmacist for Renown’s Anticoagulation Services. “We modify their medication regimens and drug recommendations under collaborative practice agreements.” “Because our role is so unique, we have a lot of opportunities to make a positive impact on patients,” added Janeen Abe, Ambulatory Care Clinical Pharmacist for Renown’s Anticoagulation Services. “We do a lot of direct patient interaction, including counseling patients on their medications and helping them navigate through their disease state.” “As a medical assistant in this department, we’re called the patient ‘liaisons’ to orchestrate who they should go to whether it’s a nurse, a provider or a pharmacist,” added Kiara Scruggs, Medical Assistant for Renown’s Anticoagulation Services. “We look at each patient’s medications and help with the Warfarin blood thinner monitor. We get to do a lot with patients." A key resource within the Pharmacy department and the emergency admission process, our Medical Reconciliation ("Med Rec") team stays on top of each patient's medication records. By ensuring each medication regimen is accurately reflected in each patient's chart and that patients continue to take their at-home medications while admitted to the hospital, this team provides vital insight into medications that could be a contributing factor to each patient's symptoms, including drug interactions. “Our medication reconciliation pharmacy technician team are true detectives,” said Heather Townsend, Clinical Pharmacy Supervisor. “When a patient arrives to the hospital, Med Rec works with patients, families, caregivers and outpatient pharmacies to compile a list of medications the patient has been taking a home. This list is used to make sure medications are not contributing to the patient’s symptoms and to assure medications are continued throughout the hospital stay. The addition of the medication reconciliation team has been one of the greatest advancements in medication safety.” “As a Med Rec Tech, we interview patients and family members and call pharmacies, skilled nursing facilities, etc. to obtain an accurate and complete medication list/history to outline what the patient is currently taking on a daily basis,” added Kara McGee, Medical Reconciliation Pharmacy Technician. “We make sure that we document the correct medication, dose, route, frequency and directions. This information is crucial because the nurses, pharmacists and physicians look at our work to figure out if any medications are contributing to the patient's health condition, and for the continuation of home medications on admission.” “Even though the Med Rec Tech might seem small in the hospital realm, it is very vital for patient information and beneficial to the patient's health,” added Brizza Villafan, Medical Reconciliation Pharmacy Technician. “There is never a dull moment in this work.” No matter the diagnosis, having Renown Pharmacy as an integral part of your healthcare team is a win-win situation for both you and them: you receive access to medication to help you heal, delivered to you with precision and care, and the pharmacy team has the opportunity to care for you and make a positive impact, a role they take seriously.
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Name-Brand Medication vs. Generic: What's the Difference?
Most prescriptions meds are available in generic form. Find out the similarities and differences between the two and how to determine whether a generic is right for you. Approximately 80 percent of prescriptions sold today are generics. If you’re taking a prescription medication, chances are it’s a generic form of the brand-name drug. But are you getting the same quality in a generic medication? Do generics measure up? The answer in most cases is yes — generics, just like branded products, are regulated by the Food and Drug Administration. “To have a generic product approved by the FDA, the generic manufacturer must prove that its product is bioequivalent to the branded product,” explains Adam Porath, PharmD, BCPS AQ-Cardiology, BCACP and Vice President of Pharmacy Services. Basically, it has to function the same. “Generic products are extremely well tolerated and will provide the same results as using a branded product,” Porath says. Here’s how generics are the same as name-brand prescriptions: Generic products contain the same active ingredients. They produce the same desired clinical effect and accompanying side effects. Generics come in the same form as their branded counterparts: pill, liquid or inhaler, for example. Release into the bloodstream matches the name brand in timing and strength. Here’s how they differ: Generics generally cost less. Federal law requires generics have different names and look different: shape, size, markings and color. Generics contain different inactive ingredients, like binders, fillers and artificial colors. Different side effects with generics can usually be attributed to these additions. Why do generics cost less? When pharmaceutical companies develop a new drug, they are paying for research, development, clinical studies, marketing — in some cases it can cost more than $800 million and take 10 to 15 years to develop a new drug. “The manufacturers of branded medication products have to recoup their research and development costs,” Porath says. So companies are granted a limited patent to sell their drug without the competition of generic counterparts. “When patent exclusivity ends, the market is open for any generic manufacturer to make a competing product with FDA approval.” Without the same startup costs, companies can sell generics at 80 to 85 percent less. And because more than one company can produce the same generics, competition drives prices even lower.
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Renown Health Welcomes New Vice President, Pharmacy
Adam D. Porath, Pharm.D., BCACP, BCPS-AQ Cardiology is promoted to serve future generations and improve the health and well-being of Nevadans. Renown Health is excited to announce Dr. Adam Porath has been promoted to vice president, pharmacy to lead clinical pharmacy and pharmacy operations and ensure excellent care for patients and families. “We are pleased to promote an experienced and talented leader like Dr. Adam Porath,” said Dawn D Ahner, DSc, FACHE, Chief Operating Officer, Acute Services. “Adam will continue to foster a culture of caring and excellence, while ensuring the highest level of pharmacy practice and experience for both care providers and patients.” Dr. Porath has served in roles within pharmacy at Renown since 2006. Since June 2020, he has served as Interim Director of Pharmacy where he has led strategic planning for pharmacy operations, precepted students and residents, identified business growth opportunities, developed novel clinical pharmacy services and oversaw quality assurance of pharmacy operations. He began his career as a pharmacy practice resident at Renown Regional Medical Center in Reno. “I am honored to be given the opportunity to serve the medical community and patients of Renown Health,” said Dr. Porath. “What a source of pride it is to be able to deliver the high-quality, compassionate patient care Renown is known for, and to help serve and lead in the pharmacy profession.” Dr. Porath received his doctor of pharmacy degree from Idaho State University. He is a board certified pharmacotherapy specialist with added qualifications in cardiology and board certified ambulatory care pharmacist. Dr. Porath has a BS in Biology from the University of Nevada, Reno. Dr. Porath serves as adjunct clinical faculty for several colleges of pharmacy including the University of New England, Oregon State University, University of New Mexico, Idaho State University and University of Wyoming. He has been published in several peer-reviewed journals including CHEST, Clinical Infectious Diseases, and the Canadian Medical Association Journal. Here in Nevada, Dr. Porath successfully lobbied the Nevada Legislature on behalf of the Nevada Society of Health System Pharmacists (NVSHP) to pass Collaborative Drug Therapy Management (CDTM) legislation in 2011, permitting Nevada pharmacists to adjust drug therapy per physician-signed protocol in any practice setting, as long as the pharmacist is under a physician’s direct supervision. Currently, 48 states permit some degree of CDTM. In 2017, Adam helped to pass further expansion of the pharmacy practice act. He is currently serving as a director at large of the NVSHP board. Dr. Porath has served as a state of Nevada delegate to the American Society of Health System Pharmacists (ASHP) House of Delegates since 2012. In 2018, Dr. Porath was appointed to the Nevada Attorney General’s statewide partnership on the opioid crisis. In 2019, he was appointed to the ASHP Council on Public Policy. In U.S. News and World Report Best Hospital rankings, Renown South Meadows Medical Center was listed #1 in the State of Nevada. Renown Regional Medical Center was named #2 Best Hospital in Nevada. 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. 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® . For more information, visit renown.org.
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Renown's Dr. Kate Ward Honored with Nevada Society of Health System Pharmacists (NVSHP) President's Award
The award is given annually to a member of the Nevada pharmacy community making significant and sustained contributions to the field Kate Ward, Pharm.D., BCPS Director of Clinical Pharmacy at Renown Health is the 2022 recipient of the Nevada Society of Health System Pharmacists (NVSHP) President’s Award. Dr. Ward has been with Renown for over a decade, starting as a Clinical Pharmacist in 2009. As the Director of Clinical Pharmacy, she is responsible for the oversight of all clinical pharmacy activities at Renown Regional, South Meadows and Rehab. Additionally, Dr. Ward is the Residency Director of the Post-Graduate Year 1 (PGY1) Pharmacy Practice Residency at Renown Regional Medical Center. “We are so proud that Kate has been recognized by the Nevada Society of Health System Pharmacists with the President’s Award and for her many accomplishments as a member of our Renown Pharmacy team. With 66% of adults taking five or more drugs per day and 27% taking 10 or more per day, a pharmacist’s review is critical in supporting patient safety and well-being,” says Tom Graf, MD, interim CEO, Renown Health. “Beyond that, pharmacists have the ability to suggest methods for accurately and effectively taking prescribed medications, discuss medication safety, identify and manage side effects and assist patients and families in managing chronic health conditions.” As a licensed pharmacist, Dr. Ward holds The Doctor of Pharmacy degree (abbreviated Pharm.D. or PharmD) from the University of Colorado. The Pharm.D. is a professional degree similar to a Doctor of Medicine (MD) or Doctor of Dental Surgery (DDS). As a doctorate, it represents the increasing responsibility pharmacists have in healthcare systems and the high trust Americans have in pharmacists. The Doctor of Pharmacy degree takes three to four years of undergraduate pre-professional (prerequisite) coursework, followed by four academic years in a professional program. Most students need four years to complete their prerequisite courses. Thus, it usually takes eight years of college study to earn a Pharm.D. and become a pharmacist. Pharmacists working in hospitals and health systems often complete additional post-graduate training after a Pharm.D. degree. Dr. Ward completed a PGY1 Residency at Stanford prior to joining the Pharmacy Department at Renown. “Dr. Ward is such an asset to Renown and our community. Her incredible perseverance to reach for and achieve higher aspirations has resulted in this important recognition by our peers across the state. She consistently contributes her pharmacy expertise to patients, physicians, clinicians and healthcare students and volunteers her time to advance the profession at both the state and national level through pharmacy professional organization participation. It is wonderful to have her efforts recognized by NVSHP,” says Adam Porath, Pharm.D., BCACP, BCPS, FASHP, Vice President, Pharmacy. On Sept. 24, NVSHP and the Nevada Pharmacy Alliance held their annual joint meeting at Renown Regional Medical Center. During this meeting, Dr. Ward was awarded the NVSHP President’s Award. The President’s Award is awarded annually at NVSHP President's discretion to a member making significant and sustained contributions to NVSHP. Dr. Ward was specifically recognized for representing the State of Nevada at the American Society Health System Pharmacists House of Delegates for several consecutive years, as well as her continuous contributions to the annual NVSHP Student Symposium. Established in October 2006, NVSHP has diligently worked on continuing the strong foundation developed to better meet the needs of health-system pharmacists in Nevada. The organization was established on a strong mission statement that enables Nevada's pharmacists to be heard, from all regions of the state and in one collective voice to advocate for patient care. Are you interested in working with this award-winning team? The Renown Health Pharmacy is hiring for multiple roles, including pharmacy technician and clinical pharmacist. For more information, visit careers.renown.org. About Renown Health 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 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 region’s largest, 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®.
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Pharmacists Answer Questions about the COVID-19 Vaccines
Vaccines that provide protection against the COVID-19 virus are bringing us closer to the end of this deadly pandemic. Two different COVID-19 vaccines are currently available in the U.S. today: one from Pfizer and the other from Moderna. Kate Ward, PharmD, BCPS, Director of Clinical Pharmacy at Renown Health and Adam Porath, PharmD, Vice President of Pharmacy at Renown, share what you need to know about these vaccines. When two COVID-19 vaccines were approved by the U.S. Food & Drug Administration (FDA) in December 2020, it was cause for celebration. Why? Because according to the CDC, the vaccines are 94 percent or more effective in providing protection against the COVID-19 virus! Many people are seeking information about the new Moderna and Pfizer vaccines. Below, our pharmacy leaders provide answers to some commonly asked questions. How do the COVID-19 Vaccines Work? The Pfizer and Moderna vaccines are both mRNA vaccines that help your immune system develop antibodies against the COVID-19 virus. The vaccines use messenger RNA, or mRNA, to show our bodies’ protein-making cells how to make the spike proteins of the COVID-19 virus. Our immune system reacts to these spike proteins by creating antibodies that can recognize and destroy them. So when a person is exposed to the virus in the future, they will be less likely to get sick. What are the Differences between the Pfizer and Moderna Vaccines? The Pfizer and Moderna COVID-19 vaccines are very similar, with just a few small differences worth noting. The main difference between the two vaccines is when you should receive your follow-up dose. Patients who receive a first dose of Pfizer should receive their second dose about three weeks later. Those who receive a first dose of Moderna should receive their follow-up vaccination roughly four weeks after their first dose. People 18 years and older can receive the Moderna vaccine while people 16 years and older can receive the Pfizer vaccine. Dosage for the Moderna vaccine is 0.5 ml (100 mcg). Dosage for the Pfizer vaccine is 0.3 ml (30 mcg).
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Testosterone, Men and Health: What You Need to Know
You probably know testosterone (T) plays an important role in how boys physically develop into men. But is that all you know? What happens when a man's T levels are off? Are there symptoms men should look for? And what are the treatment options? Dr. Bobby Kahlon, MD, Renown Medical Group provides answers in a Testosterone Q&A. What does testosterone do for men? "Testosterone is known as the 'manly hormone' for a reason," says Dr. Kahlon. "Though women also naturally produce small amounts of it, men produce testosterone at much higher concentration levels. And it affects men in more physical and obvious ways. How much hair a man has on his chest, how deep his voice is, or how muscular he is are all attributable in some way to testosterone. It's also responsible in large part for sex drive and bone strength and affects how men think, learn and experience their surroundings." Testosterone in men: Powers virilization (male physical characteristics) and sexual function Builds muscle mass and strength Supports bone density Improves cognition T Trivia: Discover Magazine reveals that “manly” testosterone and other sex hormones evolved long before we did — 500 million years ago — from the ultimate “female” hormone, estrogen. Can you have too much or too little testosterone? Though high testosterone isn't a concern for most men, low testosterone or low T occurs more frequently and develops for two primary reasons. Dr. Kuhadiya explains, "Subnormal testosterone concentrations occur either due to pituitary or testicular failure and the causes for each need to be discussed with your physician." Pituitary failure: Approximately one-third of men with obesity, type 2 diabetes, or metabolic syndrome (which includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels) have low free — or "bioavailable" — testosterone. These health conditions can cause the pituitary gland to "fail" to release follicle stimulating hormone (FSH) and luteinizing hormone (LH) which are essential for triggering testosterone and sperm production. And that can cause low testosterone (hypogonadism). Testicular failure: Though less common than pituitary failure, testicular failure may also be responsible for low T. It's caused by diseases or illnesses affecting the testicles, injury or trauma to the testicles, or certain medicines and treatments such as chemotherapy or opioid pain medication. Providing your complete medical history to your doctor is always the first step toward a proper diagnosis. What are the symptoms of low T? The following indicators could be a sign that you have low T, say the doctors. Lack of motivation and determination, including mild depression Loss of physical endurance and muscle strength Loss of or diminished early morning erections Reduced libido (sex drive) Erectile dysfunction (ED — difficulty achieving or maintaining an erection) Gynecomastia (male breasts) Small testes T and Time: T levels in men naturally begin to decline by about 1% a year starting at age 30. How do you test for low T? "There are different methods for testing testosterone levels," says Dr. Kuhadiya. "Each approach uses a blood sample to evaluate total testosterone, which includes free and attached testosterone that combines with proteins albumin and sex hormone-binding globulin (SHBG). For the most accurate results, testing is based on samples collected in the morning after fasting, and from tests on two different days." What treatment options are available? "Well, your best natural option may be YOU," says Dr. Kahlon. "Men with pituitary failure are often able to treat their low T by losing weight to increase levels of the hormone. And even if you don't lose weight, exercise can help boost your testosterone. Unfortunately, if you have testicular failure, weight loss and exercise may not have the same effect." So, are there other options? "You may want to consider Testosterone Replacement Therapy (TRT)," says Dr. Kuhadiya. "TRT is only available to men who are hypogonadal — with a clinical diagnosis of low T. Injection, gel, skin patch and nasal spray are available TRT options. The best option is the one that works best for the patient. Convenience, insurance coverage and cost are all factors to consider." Dr. Kahlon's TRT preference? Daily gel treatments, which are applied directly to the skin. On the other hand, Dr. Kuhadiya recommends intramuscular injections, which take place once a week or every two weeks. But both doctors agree on this: physicians and their patients need to weigh the benefits and risks of TRT before proceeding with treatment — especially if your low T condition may require lifelong treatment. "In my clinical practice, I have seen some very good long-term results with an improved quality of life," says Dr. Kuhadiya. "However, in certain situations, TRT may increase the risk of heart disease and is not recommended for men with a history of prostate cancer." Dr. Kahlon adds, "Patients receiving any type of hormone therapy need to be closely monitored throughout the treatment process for any changes in their health." How do you feel about steroids and T boosters? "I don't recommend them, certainly not for hypogonadism," advises Dr. Kahlon. "There is no evidence to support anabolic-androgenic steroids or testosterone boosters as a safe or effective treatment for low T in men." "In fact, there continues to be emerging evidence they may lead to side effects that could potentially harm the liver and the pituitary and endocrine functions of the body," warns Dr. Kuhadiya. "And that damage may be irreversible."
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Community Recognizes 2020 Northern Nevada Nurses of Achievement Winners
Renown Health nurses are being celebrated for going above and beyond for their patients and care team colleagues. Every year, the Northern Nevada Nurses of Achievement Committee recognizes registered nurses (RNs) from across the community to celebrate their accomplishments and further the nursing profession. The committee just announced the 2020 award winners, including seven high-performing nurses from Renown Health. Nurses are at the forefront of the care teams working through the COVID-19 pandemic and 2020 has been fittingly declared the “International Year of the Nurse and Midwife” by the World Health Organization. Celebrating our nurses is more important this year than ever, and Renown is proud to be home to seven of the 2020 Northern Nevada Nurses of Achievement winners in the following categories: Clinical Leadership: Jenny Garcia, RN, BSN, supervisor of nursing in the orthopedics unit at Renown Regional Medical Center; Critical Care: Olivia Cartwright, RN, BSN, bedside nurse in the intensive care unit at Renown Regional Medical Center; Lifetime Achievement: Cheryl Jameson, RN, bedside nurse in the general surgical unit at Renown South Meadows Medical Center; Office & Outpatient: Kathleen Neilan, RN, BCN, OCN, cancer nurse navigator at Renown Institute for Cancer; Oncology and Infusion Services: Paola Espinoza, RN, BSN, supervisor of nursing in the cancer nursing unit at Renown Regional Medical Center; Rookie of the Year: Tamara Slater, RN, BSN, bedside nurse in the general surgical unit at Renown Regional Medical Center;Renown Facility Winner: Chelsea Zielinski, RN, MSN, clinical nurse educator in the neonatal intensive care unit at Renown Regional Medical Center. From a pool of over 400 publicly-nominated nurses who provide care across northern Nevada’s care facilities and hospitals, the Committee announced a total of 14 award winners during a virtual awards celebration on Friday, Aug. 28. Anthony D. Slonim, RN, MD, DrPH, FACHE; President and CEO of Renown, who worked as a registered nurse in an Emergency Department earlier in his career says, “We appreciate the work that every nurse does every day, not only for the patient in the hospital, but in all of the other settings where people come to learn how to live healthier lives. Nurses have direct influence on the outcomes of every patient, and I congratulate all 14 nurses for their exceptional achievements.” He adds, “The real winners are those patients, families, colleagues and community members who are cared for by these exceptional nursing professionals.” “We’re proud to celebrate our community’s nurses and all they do to care for patients and their loved ones,” said Jana Elliott, Associate Chief Nursing Officer, Acute Care Services. “Nursing is a true calling to serve others and there are so many incredible ways nurses go beyond their duty to provide the best care despite the intense nature of the pandemic.” “Nurses are at the core of our care teams; they provide compassionate care and advocate for patients and their loved ones in a time of need,” said Melodie Osborn, Chief Nursing Officer, Health Services. “The Northern Nevada Nurses of Achievement awards are a longstanding way of honoring our community’s most compassionate nurses.” Interview Opportunities A 2020 Nurses of Achievement winner and a representative from Renown’s nursing leadership are happy to speak on this prestigious honor, as well as what it means to be a nurse during these unprecedented times. Please email news@renown.org or call 775-691-7308 to schedule an interview. 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®. For more information, visit renown.org. About Northern Nevada Nurses of Achievement Shining a spotlight on the nursing profession since 1999, the Northern Nevada Nurses of Achievement Committee works to honor their colleagues and to increase awareness of nursing as a profession. The committee also supports the growth of the profession in awarding scholarships for nursing students.
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Renown Recognized for Quality Care for Heart Attack & Failure
American Heart Association awards shine national spotlight on care offered in northern Nevada. Renown Regional Medical Center has been honored once again by the American Heart Association (AHA) for high quality heart care. Renown’s focus on quality and applying the most up-to-date, evidenced-based treatment guidelines improves patient outcomes, getting people home sooner and back to doing what they love. “We are pleased to recognize Renown for their commitment to heart failure care,” said Lee H. Schwamm, M.D., national chairperson of the Quality Oversight Committee and Executive Vice Chair of Neurology, Director of Acute Stroke Services, Massachusetts General Hospital, Boston, Massachusetts. “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 importance to us at Renown,” says Tony Slonim, M.D., DrPH, FACHE, president and CEO, Renown Health. “We are proud of our incredible team for providing the highest-quality clinical care, and thank the American Heart Association for this national recognition.” Renown Regional was awarded The Get with the Guidelines – Heart Failure Gold Plus Quality Achievement award for continually ensuring heart failure patients receive the most appropriate treatment according to nationally recognized, research-based guidelines, as well as AHA’s Mission: Lifeline Gold Receiving honor for the treatment of patients who suffer severe heart attacks. “Renown offers the most highly-skilled and experienced heart and vascular team and the most advanced heart center in the region. Having national recognition for being the region’s heart care leader is critical to a Destination Health strategy,” said Josiah "Sy" Johnson, MBA, chief of staff for Renown Health. “We at Renown are proud to bring a high level of world-class care providers, leading-edge care and new delivery approaches to meet the needs of people in northern Nevada through our Institute for Heart & Vascular Health.” Why This Recognition Matters to You - Heart Attack Care Every year, more than 250,000 people experience an ST elevation myocardial infarction (STEMI), the deadliest type of heart attack, caused by a blockage of blood flow to the heart that requires timely treatment. Renown earned the award by meeting specific criteria and standards of performance for quick treatment to re-establish blood flow to blocked arteries in heart attack patients. “Our expert staff treat problems that extend from mild to the most critical of emergencies,” said Christopher M. Kozlowski, MD, MHA, vice president and medical director of Renown Institute for Heart & Vascular Health. “Specialized physicians including cardiologists, interventional radiologists, heart and vascular surgeons, emergency medicine and trauma surgeons, 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 care team whether they should undergo formal screening for early heart disease.” Why This Recognition Matters to You - Heart Failure Care According to the AHA, more than 6.5 million adults in the United States are living with heart failure. Heart failure patients can lead full, enjoyable lives when their condition is managed with proper medications or devices and with healthy lifestyle changes. “Renown’s reputation as the region’s heart 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,” said Erik Olson, 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. Renown is among the nation’s top-performing hospitals for heart attack treatment and one of only 105 hospitals nationwide to receive the American College of Cardiology ACTION Registry Silver Performance Achievement Award recognizing success in implementing a higher standard of care for heart attack patients. Renown’s Roseview, Sierra and Cardiac Intensive Care Units (ICUs) are the only ICUs in Nevada to receive the Beacon Award of Excellence from the American Association of Critical Care Nurses. U.S. News and World Report’s Best Hospital rankings recently named Renown hospitals as best in the state of Nevada. Patients in need of advanced heart care can speak with their care provider about Renown Medical Group – Specialty Care, which can be reached at 775-982-6270 or visit renown.org/HeartCare. 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®. For more information, visit renown.org. About Mission: Lifeline The American Heart Association’s Mission: Lifeline program helps hospitals and emergency medical services develop systems of care that follow proven standards and procedures for STEMI patients. The program works by mobilizing teams across the continuum of care to implement American Heart Association/American College of Cardiology Foundation clinical treatment guidelines. For more information, visit heart.org. About Get With The Guidelines Get With The Guidelines® is the American Heart Association/American Stroke Association’s hospital-based quality improvement program that provides hospitals with the latest research-based guidelines. Developed with the goal of saving lives and hastening recovery, Get With The Guidelines has touched the lives of more than 9 million patients since 2001. For more information, visit heart.org.
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Renown Pharmacy Introduces New Program: Medications to Go
Renown's Medications to Go program offers time-savings and convenience for patients and their families. It can be difficult leaving the hospital after a stay. Learning and understanding detailed care instructions and settling in to a new routine, can be an overwhelming experience for both patients and their caregivers. Plus, there’s the added inconvenience of visiting the pharmacy to pick up prescribed medications. Because it is so inconvenient, one-third of these prescriptions never reach the patient, and remain in a basket at the pharmacy, awaiting pick-up. Because the patient never takes their medication, recovery time can take longer, and in some cases, the patient goes without the needed medications and may be readmitted to the hospital. To make the process more convenient for patients and their families, Renown Pharmacy now offers a new Medications to Go program. Patients can now receive Medications to Go at Renown hospitals. Opting in when they arrive, and the day they leave, their medication will be hand-delivered to them in their room by a member of Renown’s pharmacy team, along with medication counseling by a Renown pharmacist. There is no additional cost for patients to use this service aside from their normal medication copays. “Medications to Go is another example of how we are using new approaches to deliver an excellent patient and customer experience, and helping people choose, access, experience and prefer Renown Health providers and hospitals,” said Tony Slonim, MD, DrPH, president and CEO of Renown. “We want to help our patients on their journey to health and wellness.” The Renown Pharmacy team has been recognized for several national best practice programs. A similar pilot program showed a 25 percent reduction in hospital readmission rates for patients with Medicaid insurance, emphasizing the need for the service for all patients at all Renown hospital locations. Since June 1, 2020, Medications to Go has been available to every patient at Renown Regional Medical Center, Renown South Meadows Medical Center and Renown Rehabilitation Hospital. “We’ve filled more than 1,600 prescriptions through the program to date,” said Adam Porath, Doctor of Pharmacy, and Renown’s interim director. “Patients are very happy – especially new moms and parents of our youngest patients at Renown Children’s Hospital.” 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®. For more information, visit renown.org.
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