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Why Am I So Tired? 9 Reasons for Your Chronic Exhaustion
© Africa Images via Canva.com Do you find yourself struggling to stay awake during the day or having no energy? You’re not alone. Whether you’re a full-time employee, a student or retiree, that “I’m tired” feeling comes in all shapes and sizes. What’s even more frustrating is not knowing the source of your exhaustion. Dr. Brandon Flores, a sleep medicine physician with Renown Medical Group, breaks down nine key reasons why you may be feeling so fatigued. You did not get enough sleep, or your quality of sleep is poor. This may seem obvious, but in today’s “rise and grind” culture, sleep can be considered a luxury rather than what it really is: a necessity. Ensuring you get adequate hours of sleep between 6-9 hours and quality sleep is essential. You may not be breathing well during sleep. Interruptions to your breathing, such as snoring, can decrease airflow at night causing your sleep to be less restorative. This is often due to Obstructive Sleep Apnea (OSA). OSA can lead to daytime fatigue and sleepiness and can also impact other chronic health conditions, such as hypertension, diabetes, acid reflux, migraines and heart rhythm. You are not getting enough regular exercise, or you are exercising too much. Incorporating at least 30 minutes a day of physical activity can help keep you energized throughout the day. It has also been shown to increase deep slow wave sleep, which is often associated with feeling rested. On the other hand, getting too much exercise can tire you out more easily and heighten stress levels. You drink too much caffeine. This one may seem counterintuitive – caffeine is supposed to keep you awake, right? Well, overdoing it with your favorite coffee or soda could affect your sleep quality. Pay attention to your caffeine limits and have a cut-off time, as most caffeine should not be consumed past noon. You have a food allergy or intolerance. If you find yourself feeling especially tired after eating a lot of a certain food, you could have an allergy or intolerance to it – and vice versa. Consider speaking with your primary care provider (PCP) about a food allergy test or being referred to an allergist. You’re drinking too many alcoholic beverages. Alcohol is a depressant, which as the word implies, can make you feel especially tired during the day. It can also affect your breathing at night and disrupt your sleep cycle. Cutting back on alcoholic drinks may be beneficial to your overall health. You are anemic. This is the leading cause of fatigue in women but can affect people of all genders. It can be associated with low iron. Eating foods high in iron, including leafy greens and many different meats, can help your iron levels. A blood test ordered by your PCP can help you understand if you are iron deficient. You are experiencing depression or anxiety. Emotional exhaustion can be just as taxing as physical exhaustion. Prolonged feelings of sadness, hopelessness, nervousness or panic can be signs and symptoms of depression or anxiety. Speak with your provider about the many resources available to help you. You have an underactive thyroid. Feeling fatigued can also be a symptom of hypothyroidism, which affects your metabolism and energy levels. Medication can help get your thyroid back to normal. Your PCP can order a blood test to determine your thyroid levels. If you experience severe exhaustion that lasts six months or longer, worsens after physical or mental exertion and does not get better after resting, it could be a sign of myalgic encephalomyelitis, otherwise known as chronic fatigue syndrome (CFS). This is a diagnosis of exclusion, and other causes must be ruled out. While there are no tests that detect CFS, your provider can order blood and urine tests to rule out other causes of your fatigue and help develop a care plan.
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Open Enrollment for Medicare Advantage Begins Oct. 15
Eligible individuals can now enroll in northern Nevada's 4-star Medicare Advantage Plan with premier access to the region's most preferred healthcare network*. Nevada is fortunate to be home to one of the over 100 provider-owned health insurance plans across the United States. Together, they cover more than 26 million enrollees, or about 8% of the population (2017). Kaiser Permanente is the most well-known nationally, but there are many other regional plans, including not-for-profit, Hometown Health based in Reno, NV. Today's dynamic health care marketplace has created an environment in which some hospitals and health care systems are operating a health plan - either on their own or in partnership - as part of their strategy to advance health in their communities. Beginning Thursday, Oct. 15, area Medicare recipients will have the opportunity to enroll in locally-owned Senior Care Plus, a 4-star Medicare Advantage Plan from Hometown Health. Senior Care Plus is available for eligible beneficiaries residing in Carson City and Washoe County during the 2021 Annual Election Period, taking place Thursday, Oct. 15 through Monday, Dec. 7. “Health policy experts celebrate the benefits of provider-owned insurers. As insurers, we have incentives to control costs and improve the health of the community we serve,” said Tony Slonim, MD, DrPH, president and CEO of Renown Health. “As an integrated provider network, we are able to work with physicians and providers, increase value by improving outcomes and better managing the total cost of care for patients.” Senior Care Plus members have access to the locally-owned and governed integrated care network, Renown Health. This network is the region’s most preferred healthcare network offering primary, specialty care and hospital and emergency services across northern Nevada. 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. Hospitals earning a high performing rating were significantly better than the national average. “We are proud to offer Hometown Health and Senior Care Plus members specialized resources, tools and services created to help them thrive,” said David Hansen, CEO of Hometown Health. “Working closely alongside the team at Renown Health, we continuously look for new and innovative ways to enhance the health and well-being of our community.” “At Senior Care Plus, we are proud to be your partners in health,” said CJ Bawden, director of government programs at Hometown Health. “Our members enjoy premier healthcare at an unmatched value, along with locally-based, world-class service from our friendly and knowledgeable team of customer service specialists. It truly is an honor to serve our members and their health as they set out to live their best lives.” Affordable Care, When and Where You Need It According to the Medicare Plan Finder, of the 22 Medicare Advantage plans available in Washoe County, Senior Care Plus plans occupy the top two spots when ranked by plans offering the lowest drug and premium costs. In addition to high-quality and affordable in-person care, members can take advantage of urgent care and medical services delivered in the comfort of their homes thanks to a partnership with Dispatch Health. Furthermore, members have convenient access to Renown care providers through virtual visits, along with Teladoc services available 24 hours a day, seven days a week. Senior Care Plus Benefits Senior Care Plus offers a wide range of plans, many of which have no monthly premiums. Plan options also offer supplemental benefits not covered by original Medicare, such as hearing, dental and vision coverage as well as $20 chiropractic visits, prescription drug gap coverage at no cost, and complimentary gym memberships. “Beginning, Wed., Oct. 14, the newest Renown Medical Group location at 1525 Los Altos Pkwy, Reno, NV, opens to provide care to primary care, lab services to patients of all ages, and will debut the first Senior Care Lounge featuring beautiful spaces to better serve members of Hometown Health’s Medicare Advantage Plan,” said Ty Windfeldt, chief operations officer for health services. “We are excited for the community to see this gorgeous space, filled with natural light, healing colors and images, as well as state-of-the-art clinical equipment. Furthermore, members with a Renown-based primary care provider have access to a personal assistant who can help with appointment scheduling and healthcare screening coordination, medication coordination, health insurance and billing questions, and more. For more details about Senior Care Plus, to attend a virtual meeting, or schedule an in-person meeting, visit SeniorCarePlus.com or call 775-982-3112. About Senior Care Plus & Hometown Health Senior Care Plus is the largest Medicare Advantage plan in northern Nevada serving more than 17,000 members. Senior Care Plus is offered by Reno-based Hometown Health, Nevada’s largest not-for-profit health insurance company and the insurance arm of Renown Health. Originally named Hospital Health Plan, Hometown Health was founded in 1988 and has grown to more than 160,000 members. The Hometown Health name reflects the organization’s commitment to the communities in which it operates and its involvement in what matters most, the people it serves. To learn more about Senior Care Plus visit SeniorCarePlus.com and to learn more about Hometown Health, please visit HometownHealth.com. *Reported by the National Research Corporation, July 1, 2018 - June 30, 2019
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6 Healthcare Action Items for the LGBTQIA+ Community
© Niyazz via Canva.com Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs. Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health. PrEP and PEP Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months. Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days. PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location. HPV Immunization All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime. The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never! STI Testing Sexually-transmitted infections form from bacteria, viruses or parasites that can be transmitted by person-to-person sexual contact through semen, vaginal, blood and other bodily fluids. According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new STI cases across the nation each year. Luckily, most STIs are preventable. Annual STI testing for HIV, gonorrhea, chlamydia and syphilis is important to stay on top of your sexual health. Because these STIs may sometimes have no symptoms, screening is recommended regularly and with any change in sexual partners. Depending on the specific condition, tests for these infections include urine, swab and blood tests. Speak with your primary care provider on a screening schedule that works best for you. Prostate Exams Prostate exams look for early signs of prostate cancer in patients who still have a prostate. The CDC recommends those who are at least 55 years old get regular prostate screenings; however, for patients with a family history of prostate cancer, screenings may be recommended as early as 45 years old. These exams are done via two common methods – a prostate specific antigen (PSA) blood test and a digital rectal examination (DRE). Your provider can help you determine your risk and when you should start getting screened. Pap Tests and Pelvic Exams Patients of all genders who have a cervix, uterus, vagina and/or ovaries will benefit from regular pelvic exams and Pap screenings. A pelvic exam consists of a provider looking inside the vagina and at the cervix for anything unusual. A Pap test, also known as a Pap smear, involves your provider using a small, soft swab to collect cervical cells to check for early signs of cancer. Generally speaking, people with these organs should have a Pap test every three years starting at age 21 through the age of 30. After age 30, patients should receive a Pap test with HPV co-testing every five years until age 65. These recommendations are changing based on new research, so it is important to have a conversation with your PCP about the current guidelines so you can make an informed choice about what schedule you should follow. A gynecologist or your primary care provider can counsel you and perform these screenings. Mammograms and Breast Exams People with breast tissue, especially dense breast tissue, are at risk for breast cancer, and regular breast screenings are your best line of defense. At-home breast self-exams are the first step – you will want to check your breasts for any lumps, changes, fluid leaks, irregular tissue thickening or anything else that feels unusual. The Breast Cancer Risk Assessment tool, provided by the National Cancer Institute, is a good place to start to identify your risk. Talk with your primary care provider about the risks and benefits of starting screening at age 40 so you can make an informed decision about when to start. If you have any family history of breast or ovarian cancer, your PCP will offer you genetic testing for BRCA 1 and 2 mutations. Nevadans over the age of 18 can also get BRCA genetic test for free by enrolling in the Healthy Nevada Project. Mammograms are important screening tools, but for a significant portion of people with breast tissue, density of the breast tissue may make mammograms less helpful in detecting cancer. Your primary care provider can help you decide what additional imaging (such as breast ultrasound) might be best for you.
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Renown Announces $469 Million in Planned Investments
A major community investment in health care facilities to transform care, improve economy and enhance the quality of life for generations to come. Renown Health announced today $469 million in planned investments, including hospital campus improvements and new health care facilities across northern Nevada to meet the growing community need over the next three years. “Renown Health has a rich 158-year history in serving northern Nevada. Continuing our bold vision and legacy, Renown is making this investment to transform care in our community and improve the quality of life for generations to come. Nothing of its kind has been imagined or currently exists in our area,” says James DeVolld, Board Chair, “The transformation of our hospital campuses represents one of the single largest investments in health care facilities, services and programs in the state, and are a result of putting people first to enhance health care access, experiences, outcomes and affordability for everyone in our community. This will improve care and it will have a tremendous, positive effect on our local and statewide economy." “Like those we serve, we have experienced many challenges in 2020,” says Tony Slonim, MD, DrPH, President and CEO, Renown Health. “These challenges confirmed the critical role that Renown plays as a locally-owned, not-for-profit integrated health network. We are passionate about stepping up to serve our community at all times, and especially when we are needed most. We are transforming to meet the needs of our growing community today- and for the future.” GROWING FOR THE COMMUNITY Over the last two years, given significant consumer demand for Renown providers and services, a master facilities planning process was undertaken to ensure that Renown has adequate bed and procedure capacity, spaces to accommodate new technology and services to meet the needs of a growing patient base and community. “Renown’s campuses will be innovative, convenient, safe and compassionate places to provide and receive care, incorporating modern efficiencies in a healing environment, says Dawn D. Ahner, DSc, FACHE, Chief Operating Officer, Acute Services at Renown. “Designed for patients, visitors and team members, these spaces will showcase state-of-the-art technology, enhance patient safety and improve the hospital experience- including adding more private rooms; having flexible areas with room for growth; and healthy, sustainable buildings and interiors.” Today, the population of Washoe County, now at 473,156 people, has experienced staggering growth of 12.28% over the last 10 years, from 2010 to 2020. According to the U.S. Census Bureau, Nevada ranks as one of the top fastest-growing states in the country, with 15.21% growth over the last ten years. BENEFITS OF MASTER FACILITY PROJECT To alleviate current capacity constraints, allow for expansion and new services, a number of aging facilities will be replaced and new patient care areas will be constructed. Overall, the master facilities project enhances the clinical care model, enhances the experience for patients, families and staff and improves the infrastructure of the physical plant. COMPONENTS: RENOWN REGIONAL TAHOE TOWER BUILD OUT & RENOVATION; REGIONAL SIERRA RENOVATION Renown Children’s Hospital at Renown Regional Medical Center, 1155 Mill St., Reno, NV An expanded Neonatal Intensive Care Unit (NICU) with increased capacity from 39 current to 49 bassinets on Level 5 of Tahoe Tower of Renown Medical Center. An expanded Pediatric Intensive Care Unit (PICU) with increased capacity from 11 to 16 private patient and family rooms on Level 5 of the Tahoe Tower of Renown Regional Medical Center. A new Renown Children's Hospital in-patient floor with improvements, upgrades and increased capacity from 33 to 38 private patient and family rooms with a total capacity of 58 pediatric beds on Level 4 of Tahoe Tower of Renown Regional Medical Center. Renown Regional Medical Center, 1155 Mill St., Reno, NV Renown Regional Tahoe Tower Build Out & Renovation A new surgical trauma Intensive Care Unit (ICU) on Level 9 in the Tahoe Tower, increasing capacity to 34 private patient rooms. Improvements and upgrades for Levels 3, 6, 7, 8, of Tahoe Tower. Improvement of 'family zone' within patient rooms; addition of USB capabilities, furnishings. New Respite room for health care team. Upgraded technology/infrastructure to improve collaboration between caregivers and family members. Improvement in lighting, with dimmable options for patient rooms and LED/sustainable improvements. Renown Regional Sierra Tower Renovation Improvements and upgrades for the Sierra Tower Intensive Care Unit (ICU) Level 1, Sierra Tower. Improvements and upgrades for an Adult Transitional Care Unit and Medical/Surgical Unit on Level 4 of Sierra Tower. Renown Regional Material Management and Kitchen Building Renown Regional CUP (Central Utility Plant) Building RENOWN SOUTH MEADOWS RENOVATION & SPECIALTY CARE CENTER Renown South Meadows Medical Center, 10101 Double R Blvd, Reno, NV A new façade, entry canopy and upgrade of lobby and public spaces, including a new Family Lounge. Improvements and upgrades for Medical Center, Levels 1, 2, 3 with private patient/family rooms, USB capabilities, furnishings. Welcome Lounges for patients and families, Respite room for health care team. Expansion of surgery minor procedures room. Operating room enhancements, technology integration and lounges. Improvement in lighting, with dimmable options for patient room areas, LED/sustainable improvements. Improvements, upgrades and new services to the South Meadows Medical Office Building including imaging, surgical pre-admission lounge and expanded Outpatient Therapy space. A new Ambulatory Center adjacent to surgery for convenient procedural care. A new Specialty Care Center. Level 1 will feature kitchen/dining facilities, expanded laboratory and diagnostic services, including Interventional Radiology and a new Cardiac Catheterization Lab. Level 2 will feature an Ambulatory Surgery Center and expanded sterile processing department. “Structural quality and resiliency are of utmost importance as we are designing our facilities for extreme weather conditions that our region may face,” says Steve Horn, Vice President, Real Estate and Facilities. “As environmental stewards, we are designing the rooms in ways that reduce energy needs, allow for natural light and comfortable temperatures. The interior design will have healing and comfort at the forefront with thoughtful places for reflection, architecture, healing art and views that inspire.” Sy Johnson, MBA, chief of staff for Renown added, “We are working tirelessly to improve the health- and the lives- of thousands of people for the better, to care for people both in sickness and in health, and to provide better quality health and healthcare services in modern, convenient and attractive facilities, at a lower cost and with improving access to services.” THE TEAM The planning and design team for the Renown master facilities project includes a number of locally-owned businesses, as well as veteran and female-owned businesses. Leading Architect: Perkins + Will, Chicago, IL For more than sixty-five years, Perkins and Will’s vision and compassion have helped shape many of the nation’s most progressive academic medical centers, research institutions, community hospitals, and clinics. The breadth and quality of their diverse, global portfolio have consistently placed them among the leading healthcare firms in the world. Leading Engineer: WSP, Montreal, CA WSP provides complete healthcare consulting services in the design of mechanical, electrical, plumbing, structural, building technology and fire protection systems; with a focus on sustainable and high performance building design. Structural Engineer: Datum, San Antonio, TX Datum has an 80-year history providing engineering services for a large variety of projects types. Datum has an experienced team whose tenures with the firm averages more than 20 years. Electrical Engineer: PK Electrical, Reno, NV, Female-Owned Business PK Electrical, Inc. is a self-performing, female-owned electrical engineering firm providing complete electrical and low voltage design for power, lighting, communications, medium voltage distribution, and emergency power systems. Mechanical Engineer: Ainsworth Associates, Reno, NV Representing a body of work spanning more than seven decades, Ainsworth Associates Mechanical Engineers has built a solid foundation for quality in design for even the most complex building requirements. Civil Engineer: Wood Rodgers, Reno, NV Wood Rodgers has a long standing history partnering with Renown Health. With just under 100 employees in their Reno office alone, they bring local expertise in land planning, civil and geotechnical engineering, surveying, and mapping to better the community we call home. Traffic Study: Headway Transportation, Reno, NV Headway Transportation was founded in 2010 to provide clients exceptional service and value across all facets of transportation planning & traffic engineering. They have extensive experience across northern Nevada. Medical Equipment: Covalus, Medical Equipment, Veteran-Owned Small Business Covalus is a veteran-owned small business (VOSB) specializing in healthcare construction management and initial outfitting and transition. In the past twenty years, Covalus has become one of the leading national firms in planning, budgeting, and executing healthcare and other facility projects, working for government, academic, and private institutions across 32 states and 5 countries. Renown has secured long-term financing for this master facilities project. Renown has engaged a firm to coordinate the bidding process in order to be transparent and unbiased in the selection process. Construction is slated to begin in spring 2021 with a majority of the project completed by fall 2023. About Renown Health Renown Health is the region’s largest, locally owned and governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health. Renown’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Health, Neurosciences and Robotic Surgery. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project® . For more information visit, www.renown.
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