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Early detection is a significant piece of the breast cancer puzzle. Susan Cox, Renown Health Senior Director of Cancer Operations, discusses what you need to watch for and how the latest technology can help detect potential cancer sooner. When should women start getting breast exams? It depends on risk factors: Average-risk women: Most medical organizations recommend the first mammogram between 40 and 44. Higher-risk women: Dependent on their high risk, which will dictate when they start screening, but generally around the age of 30 and not before 25 years old.

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Mammograms are an effective means for early detection of breast cancer. Still, many women shy away from them for fear of pain or discomfort. Let us debunk a few mammogram myths that will remove your worries and encourage proactive breast health. Reviewed by Dr. Colleen O'Kelly-Priddy, MD, FACS, breast surgical oncologist at Renown Women's Health. Myth 1: Mammograms Are Painful Reality: Although some women experience discomfort during a mammogram, most say it is not painful. Breast compression, which is important to get a clear image, can cause a sensation of pressure, but this lasts for a few seconds. Let your technician know how much pressure you can handle so you're not uncomfortable. Myth 2: Discomfort Persists Long After the Procedure Reality: The sensation of pressure developed through the compression process diminishes quickly after the procedure. Most women go about their day afterward without experiencing any residual pain.

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Cancer can develop at any age, and that’s why the experts at Renown are ready to help you stay ahead of breast cancer, especially if you're in your 20s or 30s. We're talking about early detection, signs to be aware of, and why being proactive is a big deal. Studies show there has been an increase in breast cancer in younger women. Although breast cancer is rare in women under 40, when it occurs, it tends to be aggressive. The tricky part? Many young women don't think it can happen to them, so they don't check for the signs as often as they should. Reviewed by Dr. Colleen O'Kelly-Priddy, MD, FACS, breast surgical oncologist at Renown Women's Health. Early Signs and Symptoms New or Different Lump in the Breast: A lump is probably the most well-known symptom. Breast cancer is usually painless and firm, but it can also be soft. If you find a new lump, don't panic, but don't ignore it either. Changes in Breast Size or Shape: Have you noticed that one breast looks a little different? Whether it's swelling, shrinking, bulging, dimpling, or seems off, it's worth mentioning to your doctor. Skin Changes: If the skin on your breast starts to thicken or turn red, it's time to pay attention. If your skin starts looking like an orange peel (thickened, with prominent pores), that warrants evaluation. Nipple Discharge: Spontaneous drainage coming from your nipple that isn't breast milk—especially if it's clear or bloody—should be checked out. Nipple Changes: If your nipple starts to invert, flatten, or look different, call your doctor. Breast Pain: Continuous pain in your breast or nipple that isn't linked to your menstrual cycle is another symptom to note. However, breast pain is very common and is only rarely a sign of cancer, so don’t panic. Swelling or Lumps in the Armpit: When it spreads, breast cancer usually first goes to the lymph nodes in the armpit, so swelling or lumps under your arm should be on your radar.

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One of the most crucial aspects of maintaining health and wellness is staying proactive about regular cancer screenings. Early cancer detection significantly increases the chances of successful treatment and survival. The multidisciplinary care team at the William N. Pennington Cancer Institute at Renown Health provides compassionate care and support to the community for early detection and diagnoses. This comprehensive guide outlines the various cancer screenings available for breast, colorectal, lung, cervical, prostate and skin cancer. Breast Cancer Screening Who Should Get Screened? Mammograms are recommended starting age 40 for those considered at average risk for breast cancer. Women with a family history or other risk factors should discuss appropriate screening options with their healthcare provider. Women under 40 with a family history should discuss risk factors with a healthcare provider. Screening Methods Mammogram: This provides an X-ray of the breast and can detect tumors that are not yet palpable. Breast MRI: This type of scan is recommended for women at high risk for breast cancer due to genetic factors or family history. Screening Breast Ultrasound: This scan can help in identifying masses in denser breast tissue that might not be visible on mammogram. It is recommended in addition to a mammogram for patients at a higher risk for breast cancer. What to Expect During a mammogram, the breast is compressed between two plates to capture X-ray images. Some pressure or discomfort may be felt, but the procedure is brief and critical for early detection. Colorectal Cancer Screening Who Should Get Screened? Adults aged 45 to 75 should undergo regular colorectal screenings. Some adults under 45 may need to be screened earlier depending on family history or other genetic risks. Those over 75 should consult with their healthcare provider to determine if continued screening is necessary. Screening Methods Colonoscopy: This procedure uses a flexible tube with a camera to examine the entire colon. Fecal Immunochemical Test (FIT): A non-invasive test that detects hidden blood in the stool. CT Colonography (Virtual Colonoscopy): Uses Computed tomography (CT) imaging to provide detailed views of the colon. What to Expect A colonoscopy can detect changes or abnormalities in the large intestine (colon) and rectum. Screening is usually advised every ten years, but if you are at risk, screening may be recommended every 3 to 5 years after your initial colonoscopy. Colonoscopy preparation includes bowel cleansing the day before and sedation during the procedure. FIT is a simple at-home test requiring no special preparation. Lung Cancer Screening Who Should Get Screened? Adults aged 50 to 80 with a significant smoking history (20 pack years or more) and who currently smoke or have quit within the past 15 years. Screening Methods Low-dose Computed Tomography (LDCT): A CT scan with low radiation doses to create detailed images of the lungs. What to Expect LDCT is a non-invasive scan that requires you to hold your breath for a few seconds. Cervical Cancer Screening Who Should Get Screened? Women aged 21 to 65 should undergo regular screenings. Women aged 21 to 29 should have a Pap test every three years. Women aged 30 to 65 should have a Pap test and HPV test every five years, or a Pap test alone every three years. Screening Methods Pap Test (sometimes called a Pap Smear): Collects cells from the cervix to detect precancers. HPV Test: Identifies high-risk human papillomavirus (HPV) types that can cause cervical cancer. What to Expect The Pap test involves collecting cells from the cervix using a small brush. Some discomfort may be felt, but the procedure is brief and crucial for early detection. Prostate Cancer Screening Who Should Get Screened? Men aged 50 and older should discuss screening options with their healthcare provider. Men at higher risk (African American men and those with a family history of prostate cancer or are a BRCA2 gene carrier) should begin discussing screenings  at age 40. Screening Methods Prostate-Specific Antigen (PSA) Test: Measures PSA levels in the blood. Digital Rectal Exam (DRE): A physical examination where the provider feels the prostate through the rectum to detect abnormalities. What to Expect The PSA test is a simple blood test. The DRE may cause slight discomfort but is quick and essential for early detection. Skin Cancer Screening Who Should Get Screened? Anyone with a suspicious lesion or abnormal area on their skin. Individuals with more than 50 moles or dysplastic moles. Those with a personal history of melanoma or history of other skin cancers. Those who have more than one member of immediate family with a history of cancers (melanoma, breast cancer, pancreatic cancer) or a family member who was diagnosed with melanoma before they were 50 years old. Positive gene testing for BRACA2, Lynch syndrome genes (MLH1, MSH2, MSH6, PMS2 or EPCAM). Screening Methods Skin Exam: A visual examination by your provider to check for unusual moles, birthmarks, or other skin changes. Biopsy: Removal of a small sample of skin for testing if an abnormal area is identified. What to Expect A skin exam is non-invasive and visual. A biopsy involves minor discomfort and local anesthesia if needed. Expert Advice Although the cadence of these skin screenings may or may not be annual, as one's age increases, the risk of many cancers rises. Everyone benefits from attentive sun protection, including avoiding direct sun between 10 a.m. and 4 p.m. by seeking shade and wearing hats, clothing and sunscreen. When purchasing sunscreen, look for SPF 50, UVA/UVB broad spectrum. Questions to Discuss with Your Healthcare Provider What is my risk level for different types of cancer? Which screening tests do you recommend for me and why? What are the potential risks and benefits of each test? How often should I get screened? What steps to follow if a test result is abnormal? Importance of Cancer Screenings Regular cancer screenings are vital for maintaining your health and catching cancer early, when it is most treatable. Renown Health is dedicated to guiding you through the process and providing the highest quality of care. Consult with your healthcare provider to determine the appropriate screenings for your specific needs and to take proactive steps toward a healthier future.

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Deciding on hospice care for a loved one is a deeply personal and challenging decision, balancing their wishes and medical realities. Rebecca Edwards, DNP, from Renown Hospice Care, explains the signs indicating when it might be time for hospice and offers guidance on navigating this decision with compassion and clarity. Understanding Hospice Care  Before exploring the decision-making process, it’s crucial to have a clear understanding of what hospice means. Hospice care represents a shift in how we approach living with a terminal condition, emphasizing comfort, dignity, and quality of life above all else. When there is no longer a pathway to a cure, side effects of treatment outweigh the benefits, or someone is simply tired of frequent hospital visits, then it may be time for hospice. Hospice care is mainly done in the home, where most people wish to be. It's a compassionate, team approach to care that focuses on meeting the physical, emotional, and spiritual needs, supporting their families, and honoring individual preferences. 5 Critical Signs to Be Aware Of Decline in Overall Health: When a loved one's health continues to decline despite ongoing medical interventions, this may be a sign that these treatments are no longer effective.  Increasing Pain and Symptoms: When managing symptoms such as pain, nausea, fatigue or shortness of breath becomes increasingly challenging, hospice can offer specialized support and expertise in symptom management.  Frequent Hospitalizations: Repeated hospitalizations or emergency room visits can signify that the disease has progressed to a point where managing symptoms and providing comfort at home or in a hospice setting is a more appropriate approach.  Difficulty with Daily Activities: If your loved one is experiencing difficult with activity of daily living such as dressing, bathing, or mobility, it may be a sign that they require additional support and assistance. Prognosis of Six to 12 Months: Hospice Care is typically recommended for patients with a prognosis of about one year or less if the disease follows its normal course. However, it’s important to remember that every individual is unique and prognosis can vary.

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© Arthon Meekodong via Canva.com Breast cancer screening has long been a cornerstone of women's healthcare. With 1 in 8 women diagnosed with breast cancer in their lifetime1, the United States Preventive Services Task Force (USPSTF) has developed screening recommendations to help detect early-stage cancer. Notably in 2023, the USPSTF revised the recommended age for biennial mammogram screenings for women with average risk to start at age 40 instead of 502, estimated to result in 19% more lives being saved3 by starting screening earlier. While initiating screening at an earlier age offers advantages to a wide demographic, concerns about the potential of over-screening prompted research into the feasibility of identifying women with lower breast cancer risk who could safely delay mammograms. While guidelines address high-risk individuals, a notable gap exists in providing recommendations tailored to those at lower risk. To gain insight into a patient's risk level, physicians are able to utilize genetic testing to understand an individual's genetic makeup, providing precise insights into their predisposition to various health conditions, including breast cancer. Armed with this genetic information, healthcare providers could craft tailored screening strategies that align with an individual’s specific risk profile. This genetic risk-based approach underscores the value of genetics in individualizing the onset of screening to help avoid over-screening and its associated costs. Surprisingly, genetic information is not currently being widely utilized to identify women at risk of breast cancer or other diseases in clinical practice, despite its potential to make a significant positive impact for patients. A recent retrospective analysis of 25,591 women from the Healthy Nevada Project4 sheds light on the potential benefits of this genetic risk-based approach. The study classified 2,338 (9.1%) of these women as having a low genetic risk for breast cancer. What's remarkable is that these women exhibited a significantly lower and later onset of breast cancer compared to their average or high-risk counterparts. This finding suggests that it might be safe for low-risk women to delay mammogram screening by 5 to 10 years without compromising their health.

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Becoming a caregiver or playing a more active role in another’s healthcare is a big responsibility. At some point, almost all adults will support an aging parent or a loved one in need. Keeping track of their needs and wellbeing, while also prioritizing your own can become overwhelming. It’s important to know: you are not alone, and help is available. Read on for 11 tips to help you manage your time, your own wellbeing and your loved one’s care. Self-care comes first. When your main priority is the person in your life who needs care, it’s easy for your own needs to take the backseat. Give yourself time each day to focus on your personal wellbeing. It’s hard to give a loved one the care they need if your own needs are not met. Prioritize the Activities of Daily Living (ADL). Make a note of what ADLs your loved one can do alone, what they need help with and what activities require the most help. This will help you work through the day with them, as well as plan out how the day’s activities will go. Do a home safety audit. Do showers, bathtubs and steps have safety grab bars? Look around the house for additional tripping hazards, like rugs or electrical cords. If your loved one struggles with day-to-day navigation of the home, consider scheduling an occupational therapy appointment. This type of therapy helps a person develop or maintain the motions required to accomplish daily tasks. You might also qualify for a referral to in-home healthcare, such as Home Care. Have the hard conversation. The best time to discuss views about end of life care and to learn what choices are available is before a life-limiting illness or crisis occurs. With advance care planning, you can help reduce the doubt and anxiety related to decision making at the end of life. Completing an Advance Directive is a great tool to sort out all these decisions before they’re needed. Attend a free workshop to learn more and complete this important document. Identify when you need respite. Respite care involves receiving a short-term break from caregiving. Organizing in-home care for your loved one will allow you to step away and tend to your needs. By identifying what kind of respite care you are seeking, you can find the right person to provide you with that much-needed break. Don’t wait until you feel overwhelmed, plan ahead. Write down insurance contact information. Have a direct connection to the right insurance professional for support and advice. If your loved one is eligible Medicare, this is a good opportunity to review their current selections and if they would benefit from a Medicare Advantage Plan or Medicare Supplement Insurance. Seeking out expert advice or information on Medicare options is a great way to navigate this. Consider calling a broker, or attend a free educational seminar with Senior Care Plus. Gather legal and financial information. Make a list of all existing legal documents and financial accounts that your loved one has. These might include a will, advance directive, power of attorney, bank accounts or investment accounts. If you have questions about how to manage them, or need assistance in setting up additional framework, reach out to a lawyer, legal service, financial adviser or bank representative. Create an inventory of medical information. Identify where all of your loved one’s medical records are, as well as a list of providers or healthcare practices where they have received care. Consider if you should have your loved one give you Proxy Access in MyChart, which allows you to access all the features in MyChart on their behalf, including viewing upcoming appointments, viewing test results and emailing a doctor on their behalf. Make a list of what others can do. Think about all the little (and big) things that need to happen, and write down tasks that others could take care of you. When someone says “let me know what I can do” you’ll be ready with a pre-written list of items they may be able to assist with. Tasks could include tackling around-the-house repairs, scheduling lawn work, helping to walk the dog, taking a car for an oil change and cleaning. Find programs and events for social enjoyment. If and when possible, seek an activity outside of the home. Look for community centers that have programs for seniors, recreational activities or meals that you can patriciate in together. If leaving the home is not an option, arrange for visits or in-home activities, such as movie nights, card games or time to visit with family. Research long-term options. If you will be considering a nursing home or assisted living, make a list of amenities that you and the person you are caring for would like. Take this list with you when visiting potential locations to make sure you don’t forget to ask about each item.

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November is National Alzheimer’s Disease Awareness Month. At Renown Health, we know that Alzheimer's safety for your loved one is a priority, as the symptoms can sometimes lead to unsafe situations. We asked Dr. Jonathan Artz – a neurology physician with Renown Health and an assistant professor of clinical neurology at the University of Nevada, Reno School of Medicine – for tips on keeping loved ones safe and secure.  According to the Alzheimer’s Association, Alzheimer’s disease affects safety in various ways, specifically due to body and brain adjustments. These changes can include: Judgment, including forgetfulness  Sense of place – getting lost on the way home  Behavior – being suspicious or fearful  Body difficulty – losing balance Sensing ability – noticeable sensitivity in hearing, seeing or temperature  Dr. Artz gives us four major tips to ensure your loved one’s safety as you both navigate this disease together.  Watch for Wandering  Those experiencing Alzheimer’s disease tend to wander and get lost. Try the following tips to reduce the risk of wandering:  Get your loved one an ID bracelet and have them wear it at all times. You can also enroll your loved one in “Wandering Support.”  Install door chimes so you know when exterior doors are open.  Ask neighbors to call you if they see your loved one out alone. Go with your loved one when they insist on leaving the house. Don’t argue or yell. Instead, use distraction or gentle hints to get them to return home.  Discourage Driving  Driving can be unsafe for someone with this disease. With this in mind, ask a doctor whether it’s safe for your loved one to drive. For example, on a case-by-case basis, there are certain situations where doctors are required to report individuals with particular cognitive impairments, wherein a form of a driving assessment will be recommended.  Limit access to the car. Keep the keys with you or lock them away.  Ask an authority figure, such as an insurance agent or a doctor, to tell them not to drive.  Adult-Proof Your Abode  A simple living space is a safe living space. This means reducing clutter and removing any issues that may pose a safety concern. You may also want to get advice from an occupational therapist (home safety expert). Keep in mind that some changes may not be needed right away. Focus on major safety concerns first.  Try the following tips:  Add lighting (or glow-in-the-dark tape) to brighten dark areas, including stairways and halls.  Use color contrast or texture indicators for dials, knobs and appliance controls.  Remind your loved one not to carry items while walking to avoid a fall.  Remove sharp objects from drawers and countertops.  Avoid using small throw rugs or doormats, as they are easy to trip on.  Move frequently used items so that they are easy to reach.  Lock away alcohol and tobacco products, as they are not recommended for dementia patients.  Install handrails in the shower, tub and near the toilet. Bathroom falls are especially common.  Adjust the setting on your hot water heater so water does not scald. Those with Alzheimer’s can lose their sensitivity to temperature.  Move and lock up hazardous chemicals and cleaning supplies, such as bleach and insecticides.  Disable and remove guns or any weapons. Supervise any medication taken by your loved one.  Promote a Positive & Healthy Lifestyle  Continually emphasize the strengths of your loved one by promoting participation in meaningful activities, wellness visits and healthy habits to help them improve their well-being. Here are some ways to keep them physically and mentally active:   Maintain regular vision and hearing screenings and make necessary adaptations.  Establish a routine for daily activities.  Encourage participation in self-care and leisure activities.  Work with your loved one’s doctor to establish a healthy diet.  Ensure proper hydration. It may help to set reminders for your loved one to drink fluids.  Encourage regular exercise. Exercise delivers oxygen to the brain, improving brain health. Promote good sleep habits. Good quality sleep can increase overall brain health and has been associated with improving memory, attention and concentration.  Resources and support are available with the Renown Memory Disorders Program. Providers within this program are specifically dedicated to treating several different memory-related disorders. Memory Disorders Resources & Support.

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Dr. Nariman Rahimzadeh’s career path has been anything but typical. From humble beginnings as a shuttle bus driver for Renown Regional Medical Center, then named Washoe Medical Center, to his service as Chief of Staff for Renown South Meadows Medical Center, the steps and detours he took along the way – and the strong support from his colleagues and family members – make up a tale of perseverance, conviction, compassion and inspiration.  However, his healthcare career journey began several years before he even joined Washoe Medical Center in the 1990s.  It all began 7,446 miles away in Iran.  This is Dr. Rahimzadeh’s story.  Defining Moments  The moment Dr. Rahimzadeh knew he wanted to dedicate his career to the healthcare field started during his childhood. Growing up in Iran during the midst of the Iranian Revolution, a thought that often came to mind was, “Who is helping all the people injured in the war?”  The answer? The doctors.  “In Iranian society, doctors are extremely valued, as they are the first to help people in need,” said Dr. Rahimzadeh. “I knew I wanted to give back to society in some way, and I see my time in Iran as very formative in my future career. I just didn’t know it yet.”  After immigrating to the U.S. with his family during his preteen years, he only had one mission: to support his family. “My desires were to help my family not fall behind,” he said. “I didn’t have career aspirations at the time. All I knew is that I wanted to help my family and my community, which immediately opened its arms up to us, as well as be a good student and a good ambassador for Iran.”  Dr. Rahimzadeh remembers several influential people that helped solidify his aspiration from “helping people” to “helping people as a healthcare professional.” Their family physician and other medical professionals in the family’s lives were monumental in helping him make this decision. Coupled with his natural love for the sciences, the decision to become a doctor became clear.   But the question remained, “How do I get started in the healthcare field?”  No Links to Healthcare? No Problem  With no physicians in his immediate family and no direct connections to healthcare, Dr. Rahimzadeh set off to follow the advice he received from the influential people in his life: get a job at a healthcare facility, regardless of what the job title is.  Some of his friends had recently joined Washoe Medical Center as patient transporters and mentioned job openings that were available. He sprang into action and headed to Washoe Medical Center to apply.  Just one problem – he didn’t have the EMT certification requirement.   Enter Barry O’Sullivan, who would be Dr. Rahimzadeh’s first supervisor at Washoe Medical Center (and a friend he still speaks with to this day). Barry saw promise in Dr. Rahimzadeh immediately. As a result, Barry made a suggestion to him that would ultimately set him on the course towards medicine.  “Barry told me that he had an open position that I could work while completing the senior year of my undergraduate degree and studying for my EMT certification and eventually becoming a patient transporter. He told me Washoe Medical Center would support me in this endeavor. So, I asked what the job was and learned it was driving a shuttle bus.”  Without hesitation, Dr. Rahimzadeh responded, “I’ll take it.”  And so, his fulfilling journey with Washoe Medical Center, and eventually Renown Health, began.  While he finished up the last few months of his degree at the University of Nevada, Reno, (UNR) Dr. Rahimzadeh proudly drove the shuttle bus a few days a week. The job not only helped him pay for his degree and put food on the table, but it also allowed him to begin living out his passion for helping people in the healthcare field.  Dr. Rahimzadeh graduated with his bachelor's degree in Pre-Medicine from UNR and finished his EMT certification program. Sure enough, Barry and Washoe Medical Center lived up to their promises and helped him secure his first direct healthcare job as an EMT and Patient Transporter with REMSA. But he didn’t stop there – after several years as a ground transporter, his career literally took flight. He joined REMSA Ground Ambulance and eventually Care Flight as a Flight EMT II, caring for patients that were flying to Washoe Medical Center from nearby communities that needed lifesaving medical care.  Helping save lives every day as a member of the emergency medical team is an ultimate feat, especially when it comes to Dr. Rahimzadeh. And he didn’t stop there.  Valuing One-on-One Connections  In the 1990s, as it is today, the U.S. experienced a significant primary care provider shortage which resulted in many medical schools encouraging students to complete their residencies in a primary care specialty, like internal medicine – which is precisely what Dr. Rahimzadeh set out to do at the University of Connecticut.   However, his mind would soon change about the course of his career.   “I had a deep, introspective conversation with my residency program director, openly and honestly chatting about my future,” Dr. Rahimzadeh said. “I ended up taking a week off of my residency and wrote a long pros and cons list about what I wanted to do with my life in the medical field.”  Eventually he decided on anesthesiology because of the opportunity to have a one-on-one relationship with every surgery patient, regardless of their procedure.  “Even though it’s for a short duration of time, it is a very impactful relationship,” he said. “I feel I am making a difference in the outcomes and lives of patients every day.”  Dr. Rahimzadeh finished his internal medicine residency in three years and passed his board exam, and he went on to do the same thing for anesthesiology. He then ventured back home to Reno.  Career Progression at Its Finest  Dr. Rahimzadeh knows that people don’t always get to settle down in a place that influenced their upbringing, care and dream, yet he was able to make that vision a reality for himself.  “I feel like Renown Health and myself have this intertwined relationship that led to my growth as a person and as a physician,” he said. “For that, I feel very blessed."  Upon his arrival back to Reno with two residencies under his belt, Dr. Rahimzadeh was quickly hired at one of the two anesthesiology groups in town at the time. He started his career with Sierra Anesthesia and after working for the group for several years, he joined Associated Anesthesiologists of Reno in 2014, which went on to become one of the largest anesthesiology groups in northern Nevada. The group continuously worked very closely with Renown, taking care of all of its surgical patient needs and eventually becoming Renown Medical Group employees as of April 1, 2022, with Dr. Rahimzadeh setting up his home base at the Renown South Meadows campus.  Today, Dr. Rahimzadeh wears three “hats” at Renown. As a medical professional first and foremost, his largest “hat” is his general anesthesiologist role, where he cares for patients in the operating room. Another significant “hat” is his role as the Medical Director for Surgical Services, where he reviews surgical patient charges alongside his dedicated team of nurses and ensures optimal patient outcomes by verifying they have had the appropriate workup to proceed with surgery in a safe manner. To round out his immense responsibilities with Renown, he serves as Chief of Staff for Renown South Meadows, where he makes connections with colleagues and collaborates with leaders to review protocols, policies and address concerns that arise.  Outside of Renown, Dr. Rahimzadeh is still a contributor within his own anesthesiology practice. He also is the current President of the Nevada State Society of Anesthesiologists and the Director to the Board of Directors of the American Society of Anesthesiologists, helping bridge the gap in anesthesia concerns between his northern and southern Nevada colleagues.  He reflects on the opportunities Renown and our local community have extended to him by saying, “If you can dream big enough and continue to chase your dreams, you can make it happen right here.”  On the COVID-19 Frontlines Nothing could prepare us for the dire situation hospitals on the east coast – especially those in Livingston, New Jersey – were experiencing at the beginning of the pandemic. Livingston was known as the “second hardest hit area” by COVID-19 in April of 2020. Hospitals were overwhelmed with patients in the ICU fighting for their lives. They needed help, and they needed help now.   Unable and unwilling to sit idly by, Dr. Rahimzadeh and six of his colleagues from his practice traveled to Livingston to help. They jumped in on the frontlines alongside other anesthesiologists and intensivists to offset the sudden influx of COVID-19 patients. Many lives were saved, and Dr. Rahimzadeh was a direct part of that.  “When you care and work with people that also care, you can move the needle a lot – it doesn’t matter where you're from,” he said.  Home Means Nevada – and Renown  Renown Health is deeply rooted in the northern Nevada community. Dr. Rahimzadeh is proud to be among a diverse team who have taken responsibility for its community for generations.   "We live in a very passionate and caring community, which is often underestimated,” he said. “It’s clear to me that Renown refuses to settle. Renown is incredibly progressive in providing the best for the community. We never remain stagnant, we keep moving forward and we take care of your loved ones. This health system has never been able to sit still and settle for the status quo. That stands out to me.”  One story especially sticks out to Dr. Rahimzadeh as the moment when he knew that Renown was home. In 1997 while working as a patient transporter, his grandmother passed away on the sixth floor of the Sierra Tower at what is now Renown Regional Medical Center. At the funeral, a huge bouquet of flowers arrived. Not being especially close to anyone in Reno yet, Dr. Rahimzadeh's family had no idea who sent the beautiful arrangement. Turns out, it was Rod Callahan, the Chief Operating Officer (COO) of Washoe Medical Center at the time.   “At that point, I knew I wasn’t just a part of a workforce with thousands of employees,” said Dr. Rahimzadeh. “The COO cared so much about me that he felt compelled to send such a wonderful gift during a tragic time. That’s the value of a local, community-focused hospital; the people here know you and care about you. There’s a reason why people stay at Renown for so long – we feel that connection.”  Dr. Rahimzadeh also reflected on how far Renown South Meadows has come, from the time he immigrated to the U.S. to today. “Growing up, Renown South Meadows was kind of a ‘mom and pop shop’ primarily serving senior citizens in one wing and surgical patients in the other,” he said. “Now, I am so proud to see how far it has come. It really made its niche in the community in a great way. The future is bright!”  It’s clear that Dr. Rahimzadeh is leaving a lasting legacy with his family, from the local community to global medicine. His son is a senior at Baylor University in Texas with a strong desire to go into medicine, just like his dad. His daughter is a junior at Bishop Manogue Catholic High School in Reno and enjoys being involved in her community. His loving wife is a speech therapist in the area. The Rahimzadeh family is thriving together, and they all share the same conviction about northern Nevada and Renown:  “This is home.”

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If you’re a parent, you’ve probably been there — the sometimes-nightly struggle to get your little ones off to bed. Elaina Lantrip, an APRN with Renown Pediatrics, offers some tips and explains how your child’s electronics may be getting in the way of a good night’s sleep. These days, kids are consuming media from a very early age on all types of devices — from tablets and phones to TVs. While they can benefit from some media use, it can have a negative impact on bedtime. We asked Elaina Lantrip, an advanced nurse practitioner with Renown Pediatrics, for some advice on downloading a better bedtime routine. What are the most important practices for parents to establish for their children’s bedtime routines? I often have parents tell me that their child won’t go to bed — or to sleep. Parents frequently ask for tips on bedtime routines that work. My first question is whether their regular bedtime routine involves television, iPad, tablet, phone or anything with a screen. It’s very important that bedtime includes a bath, reading a story, talking, singing and bonding with young ones, rather than using any devices. Why shouldn’t children have a device at bedtime? A growing body of research supports that screen time at bedtime contributes to delays in a child’s falling to sleep; overall inability to reach the important REM, or deep sleep; waking up during the night; nightmares and night terrors. For older youth, engaging with social media before bedtime can bring up stresses, emotions and relationship issues with peers that don’t exactly create peaceful bedtime thoughts. Bedtime should be a screen-free, stress-free, peaceful time of day. It’s a great time for parents to promote self-esteem, talk through things going on in the child’s life, to encourage and build them up. Children grow up fast — bedtime is a great the opportunity with younger children to cuddle up and read a story or sing a lullaby. What are other major considerations in making bedtime smooth and relaxing for kids and their parents? Another factor that contributes to positive sleep habits includes children getting enough activity during the the day so they’re genuinely tired at night. Also helpful are ambient noise makers, peaceful music, avoiding sugar two hours prior to bedtime, consistency in bedtime routine, comfortable pajamas and comfortable temperature in the home. Is it important to keep the child’s bedroom dark? Dimming the lights is important, regardless of the time of year. This is another reason to ban screens, as they emit light that stimulates wakefulness.

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Unfortunately, many in our community go to bed hungry. Thanks to the support of the Food Bank of Northern Nevada and other local partners, Renown’s food pantry is helping meet the food needs of homeless and low-income individuals in our community. Patients who qualify for the “Food is Medicine Prescription” can receive a bag of food for themselves and each member of their immediate family every week through a free assistance program. This project started last year when Renown began giving food support to hospital and emergency room patients who expressed the need. Food is also given out at the Healthcare Center, which provides affordable access to care for anyone in our community. Those who receive care at the Healthcare Center are also eligible for food assistance. Working Alongside the Community After receiving food deliveries from the Food Bank of Northern Nevada, Renown’s community health team collects an assortment of fresh produce, donated from local grocery stores and other community organizations. Then they put together one bag for each family filled with healthy foods, such as: Whole grain cereals Shelf stable milk Kid-friendly snacks (granola bars, popcorn, graham crackers Proteins (low-salt soups, stews, peanut butter) Seasonal produce Food is Medicine Prescriptions Continue Amidst the Pandemic Throughout the COVID-19 (coronavirus) pandemic, Renown’s community health workers have been working remotely. They continue to reach out to patients who need groceries from the Food is Medicine Prescription program. With this in mind, the food pantry staff is currently coordinating outpatient deliveries to those with a Food is Medicine Prescription. At present, Renown is working to get more refrigeration, shelving and staffing to expand the service to more Renown Medical Group patients in need of food.

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Dr. Max J. Coppes, Physician-in-Chief Renown Children’s Hospital, and Nell J. Redfield Chair of Pediatrics, UNR Med, talks about how much is too much when it comes to teens and social media. Social apps (Facebook, Instagram, Twitter, WhatsApp, Snapchat, TikTok, etc.) have become an integral part of most people’s lives. In contrast to traditional media — where one source goes to many receivers — social media operates in a dialogic transmission system. Many sources interact, sometimes simultaneously, with many receivers and provide for superior interactivity between its users. Not surprisingly, it also plays a significant role in our children’s lives once they are old enough to understand how to access and use these apps. On average, children start exploring social media at around ages 10 to 12. They rapidly discover that electronic communication allows for unique and personalized ways to make and keep friendships. They also use it to develop and expand family ties, get help with homework, share music, art, and experiences, and learn and discover the world. Social Media and Teens Surveys suggest that more than 90 percent of teenagers use social media. Additionally, approximately 75 percent have at least one active profile by age 17. Access to social media is greatly facilitated because more than two-thirds of teens have their own mobile devices with internet capabilities, a substantial change relative to previous generations. The use of social apps can have many positive aspects. But we now also recognize that it can also have negative impacts. The use of hazardous sites or the inherent risks of using social media (identity theft, being hacked, cyber-bullying, etc.) are indeed damaging to children. Any use of hazardous social apps is too much and carries serious hazards. But what about the use of “normal” and/or “safe” social media? Well, data suggest that too much use of “non-hazardous” apps can indeed affect health. How Much Do Teens Use Social Media? First, some basic data. For example, how much do normal teenagers use social media? A study from Pew Research found that more than 50 percent of 13- to 17 year-olds go online several times a day. This quickly increases during the teenage years to more than 70 minutes per day. Teenage girls have the highest usage at just over 140 minutes per day. It is important to recognize that non-school related use of the internet and social media is often beheld by teenagers as important for developing their self-esteem, their acceptance among peers, and their mental health in general. As parents, we recognize that the use of social media can indeed contribute, in many positive ways, to our children’s growth. At the same time, we also worry about them spending too much time online. We worry about their ability to communicate effectively in face-to-face settings or in writing. Many of us also feel and/or worry that our children are addicted. Social Media and Addiction Recent studies suggests that the overuse of social media indeed mirrors addiction. Reports now show that teenagers and college kids experience anxiety when deprived from their connected devices and consequently feel a compulsion to access their social applications. The emotional symptoms they experience are very similar to those seen in substance abuse. In fact, the American Psychiatric Association is considering making internet addition a bonafide diagnosis. Pediatricians therefore encourage limits on the use of social media, a recommendation more easily suggested than accomplished. So when should a parent consider seeking help? Aside from unhealthy use of these apps (cyber-bullying, sexting, online users asking for sexual relations, etc.), which should always trigger concern, the use of social media for more than 120 minutes per day should trigger parental concern. If you feel unable to address the overuse of social media, contact your pediatrician for help and guidance. Renown Children’s Hospital Whether it’s seeing a pediatrician, getting a sports physical or looking for advice, our care is centered around supporting and nurturing patients and families at our many locations. We have pediatricians dedicated to children who have experience recognizing children’s illnesses. They also have knowledge about tests and treatments for young ones to ensure your child gets the best care possible. Explore Children’s Services

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