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When Tabitha Cox received a diagnosis of multiple sclerosis (MS), she was in shock, denial and felt that she was too strong for something like this to be happening to her. As the disease progressed, Tabitha realized she needed to do what she could to stay as healthy as possible. “I heard, ‘You have a quarter-size lesion on your brain,'” recalls Tabitha Cox. “At that moment, that was literally all I heard come out of her mouth.” Tabitha’s official diagnosis was multiple sclerosis (MS), an unpredictable, often disabling disease of the central nervous system that slowly debilitated her mom. “I was numb,” says Tabitha. After her diagnosis, Tabitha went on with her life as if the disease was nothing more than a doctor’s diagnosis. However two years later, Tabitha realized something wasn’t right and sought care at Renown Institute for Neurosciences – Brain and Nerve Care. Her form of MS was aggressive, and her doctor recommended treatment right away.

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Did you know certain medications can interact with everyday food and drink? We asked VP of Pharmacy Services Adam Porath how to take these important medications safely. One in five Americans between the ages of 40 and 75 are currently taking a statin drug to reduce their cholesterol level or to prevent atherosclerosis (hardening of the arteries). Many others also take anticoagulants (blood thinners) to prevent blood clots from forming, which can increase the risk of stroke. Adam Porath, VP of Pharmacy Services at Renown Health, explains how to safely take these medications. What is a statin? A statin is a drug that can lower cholesterol by helping your body absorb cholesterol or by blocking a substance your body needs to make it. The American Heart Association cites a global study reporting the benefit of statins to help reduce heart attacks and strokes. Common statins include atorvastatin (Lipitor), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor). Which foods or drinks should be avoided while taking statin drugs? Grapefruit juice is the only food or drink that has a direct interaction with statins. Statins do not directly interact with any food but people taking statins should moderate their intake of saturated fats to help lower their LDL cholesterol and overall risk of cardiovascular disease. What is a blood thinning drug? Blood thinning drugs, such as warfarin, rivaroxaban (Xarelto), apixiban (Eliquis), dabigatran (Pradaxa) and edoxaban (Savaysa), are used to prevent stroke. Which foods or drugs should be avoided while taking blood thinning drugs? If taking warfarin, alcohol and cranberries (including juice) should be avoided. Patients taking warfarin should be aware of foods that contain Vitamin K (green leafy vegetables) and try to maintain a consistent diet of these foods. Warfarin interacts with many over the counter and prescription medications. Patients should consult a pharmacist when starting, stopping, or changing doses of any medication when taking warfarin. Also, patients taking any blood thinning medication should avoid over-the-counter pain relievers (i.e. aspirin, ibuprofen, etc.) How do I know whether to take my medication with food or not? Consulting with a pharmacist is the best resource to determine if a medication should be taken with or without food. In general, all statins and blood thinners can be taken with or without food. The only exception is Xarelto (rivaroxaban), which should be taken with the largest meal of the day If you are a Renown patient you can also review your prescriptions online, request a refill or ask a question via MyChart. With MyChart, you can access all your healthcare information securely 24/7.

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© 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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Whether it’s cross-country or downhill skiing, snowboarding or snowshoeing, your off-season preparation is vital to an injury-free and healthy experience once the snow starts to fall. We’ve got you covered with expert tips that will make you the king or queen of the hill. Millions of skiers and snowboarders hit the slopes annually. So whether you’re a weekend warrior or stay active year-round, you need to prepare your body for the demands of your favorite winter sport to avoid minor aches, pains or even severe injury. Count on two to three weeks for your body to adapt to the physical challenges ahead if you’re active. Otherwise, give yourself a minimum of six weeks to gear up for the snow. Ready to shred? Here are some conditioning tips to help put you on the path to a fun, successful winter season. 1. Start With Cardio Cardiovascular exercise increases endurance as it conditions the heart, lungs and muscles and provides a solid foundation for other forms of exercise. And when you live and play at altitude, you need even more endurance. “Research shows that our maximum heart rate, cardiac output and ability to exercise are suppressed at altitudes over 5,000 feet,” explains Daniel Staffa, PT, DPT, OCS, of Renown Rehabilitation Hospital. “In the Reno-Tahoe area, altitudes can quickly rise over 8,000 feet when we exercise in the Sierras, so it’s critical to have cardiovascular fitness to avoid associated fatigue and decreased mental alertness on the slopes.” Try this: Pick an aerobic activity you enjoy — speed walking, running, hiking, biking or a cardio machine like the elliptical trainer. Build up to a minimum of 30 minutes, three days a week. 2. Increase Your Strength Your core works overtime to stabilize the body and absorb the shock of pivots and turns and variable snow conditions. Strengthen your core, lower back, hamstrings and calves and you’ll go a long way toward guarding against ligament tears and damage to other joint structures. Stronger muscles will also allow you to relax while maintaining control and making those quick adjustments that uneven terrain demands. Try this: Squats, wall sits and lunges. Work your core and lower and upper extremities with a variation of sit-ups, crunches, back extensions and planks. 3. Integrate Plyometrics Staffa explains that if your legs aren’t used to absorbing the impact of landing, severe injuries can occur. Preempt such trauma with plyometric exercises, or “explosive movements,” that simulate the movements of your favorite sport. You’ll develop greater power in your legs when you combine plyometrics with your strength training. Try this: Incorporate multi-directional drills — such as lateral jumps and forward and backward jumps — on variable surfaces like a trampoline, solid ground, or a box or step. Here’s a challenge for the more advanced: Stand in front of a bench or box (12 inches or so). Jump up and then immediately back down. Do this 10 to 30 seconds at a time, rest and repeat. Or get old school and bust out the jump rope. 4. Improve Your flexibility Flexibility is the ability to move joints through their entire range of motion, from a flexed to an extended position. Being flexible will allow you to pivot, twist and turn and navigate varying snow conditions with ease. You can increase your flexibility while maintaining bone alignment with stretching. Don’t forget to warm up and cool down. Try taking it easy the first 15 minutes of your day on the hill; try starting with a beginner’s run or walk to warm up and prepare your body. Do the same at the end of the day or go for a brisk walk to cool down. Stretching will help return muscles to their normal length. Try this: Dynamic stretches such as leg swings, arm swings and torso twists. Target your quads, hamstrings, calves, and lower back. 5. Fuel for the Hill Staffa suggests loading up on healthy complex carbohydrates the day before you go out and bring along your favorite protein snacks. Assess the slopes before making that first run — is the snow heavy, fresh or wet — and stay mindful of your fatigue level throughout the day. Don’t forget to hydrate and re-hydrate before, during and after exercise. And most important, have fun! Visit Renown Physical Therapy and Rehab for more information. Or call 775-982-5001 to consult with our sports and orthopedic experts who can help you develop an individualized training program in preparation for the winter season, including methods for overcoming previous injuries and limitations.

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Did you know that 80 percent of all strokes are preventable? Learn which foods should be eaten in moderation to reduce your family's risk of stroke. Stroke is the fifth leading cause of death in the nation and a major cause for disability, killing 130,000 people each year. But did you know that 80 percent of all strokes are preventable, according to the American Stroke Association? Several stroke risk factors -- high blood pressure, smoking, diabetes, physical activity level, obesity, high cholesterol and heart and artery disease -- can be controlled, treated and improved, right down to the foods we choose to consume each day. Diets high in sodium can increase blood pressure, putting you at greater risk for stroke. A high-calorie diet can lead to obesity -- another risk factor. And foods high in saturated fats, trans fat and cholesterol will raise your blood cholesterol levels causing blood clots, which -- you guessed it -- can lead to a stroke. The “not-so-fab” five foods listed below play a large role in damaging your body and causing vascular disease, stroke and heart disease and should be avoided on a regular basis. However: Moderation is the key to life, in my opinion. Sure, everyone is going to have a soda here and there or a steak off the grill, but keep it off the main menu.  1. Packaged and Fried Food Have you noticed foods like hot dog buns and bottled salad dressings rarely go bad? Ever asked yourself why? This is due to the use of hydrogenated oils, which are trans fats. Hydrogenated oils stay solid at room temperature and do not require refrigeration. Convenient? Yes. Healthy? No. Unfortunately, many frozen foods and meals also fall into this category, except for frozen fruits and veggies. So here’s the lowdown on trans fats: They’re considered by many experts as the worst type of fat you can consume, raising your LDL (“bad”) cholesterol and lowering your HDL (“good”) cholesterol. While some meat and dairy products contain small amounts of naturally occurring trans fat, most dietary sources are formed through an industrial process adding hydrogen to vegetable oil, causing the oil to solidify at room temperature.  The FDA is in the process of restricting or possibly banning trans-fats from food in the U.S. A study published in JAMA Cardiology compared data from counties with and without trans-fat restrictions and the findings were substantial: There was a 6 percent decline in hospitalizations for heart attack and stroke in counties with trans-fat restrictions.  Bottom line: Ideally no processed food should pass your lips, but realistically, aim for less than 2 grams of trans fat per day. Skip the store-bought treats at the office and fries at lunch. Also avoid crackers, regardless of what you are dipping them in. Choose to eat fruits to satisfy your sweet cravings and veggies and hummus to satisfy the savory.  2. Lunch meat Processed meats, including bacon, smoked meats and hot dogs, are all on the DNE (Do Not Eat) list, unless you want to play with fire. Processed meats are a no-go if you want to keep your arteries clear of plaque buildup. So what is the alternative to your salami sandwich?  Try a healthy alternative like a tuna sandwich with avocado (a great alternative to mayo) or a veggie sandwich. 3. Diet soft drinks First of all, when a drink is sweeter than a candy bar but it contains zero sugar and zero calories, buyer beware. Many consumers think because a soda is labeled “diet” it’s a better choice, but studies have linked diet soft drink consumption with an increased risk of stroke and vascular disease. In a nine-year study of more than 2,500 people, those who drank diet soda daily were 48 percent more likely to have a heart attack or stroke or die from those events, compared with those who rarely or never drank soda. What else are you supposed to drink? If you must drink soda, break the everyday habit and drink it on special occasions; otherwise water rules. And if you don’t like water, try flavoring your water with fruit slices. 4. Good-old red meat So is there ANY good meat out there you ask? The answer is yes, but it’s not red. In the journal Stroke, an article showed women who consumed large servings of red meat regularly had a 42 percent higher incidence of stroke. Red meat is high in saturated fat, which clogs arteries with plaque. The alternative to red meat is a heart-healthy protein like poultry or fish, or even non-animal products like beans, nuts and tofu.  5. Canned foods Steer clear of factory processed soups, beans and sauces. Canned items all have incredible amounts of sodium or MSG or baking soda/powder to maintain their freshness and shelf life. One study showed if you consume more than 4,000 mg of salt per day, you more than double the risk of stroke compared to diets with less than 2,000 mg. Another tip: When possible, plan and make meals from scratch. Making the wrong meal or snack choices is one of the biggest contributing risk factors for stroke and heart disease. Most people know what good food choices are, but they don’t realize the serious impact the bad choices have on overall health. Learn what is most beneficial to your body to consume. It will be a life changer – literally.

Read More About The Not-So-Fab-Five: Foods That Increase Stroke and Heart Disease Risk

Over the past couple of years, pickleball has become the fastest-growing sport among people of all ages.  It’s a combination of tennis, ping-pong and badminton that originated in 1965. This sport can be played indoors or outdoors on a pickleball court where two players (singles) or four (doubles) hit a perforated hollow plastic ball over a 36-inch-high net using solid-faced paddles. A pickleball court is the same size as a double’s badminton court and measures 20×44 feet.  Pickleball is a fun, low-impact game that keeps people healthy and active. Kaitlyn Jacobson, Physician Assistant at Renown Urgent Care – Ryland, plays pickleball herself and is a big fan of the sport. Here she shares the top five health benefits of playing pickleball.

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