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“You’re gonna be a dad!” Whether you’ve been waiting years to hear those words or still think you’re too much of a kid to have a kid, the reality of impending fatherhood can be terrifying for any first-time, soon-to-be-dad. But not to worry, Best Medicine has some timely tips to help calm those bundle-of-joy fears and help you rock your new role as a brand-new, baby daddy.   Winter is Where Babies Come From Fact: More babies are born in September than any other month, with spill over (and spit-up) into October. Subtract ten months for the typical 40-week, bun-in-the-oven baking time and early winter stands out as the top baby-making part of the year. Is it the cozy nights before a fire as people avoid the snowman-friendly temperatures outside? Possibly. There could be any number of reasons, both seasonal and otherwise, for what will eventually arrive in the fall and immediately steal your heart — and untold hours of your sleep. Though moms carry most of the baby burden traditionally (and literally for three trimesters), that’s no excuse for the soon-to-be-dad not to step up to the plate and take a swing at being the best partner and father on the planet. Below is a list of tips and resources to help you do just that. So read on, daddy-o.  Tip #1: Don’t Freak Out Ok, you’re probably going to freak out even if we tell you not to. But once you calm down, consider this: human beings have been having babies for millions of years, and many of those soon-to-be-dads had it much tougher than we do today. And guess what? The human race is still going strong. Those first moms and dads did a good job — and you will too, with a little help. Tip #2: Take a Class Knowledge is power. In this case, it's diaper-changing, swaddle-wrapping, 2 a.m.-feeding power. And for you and your partner, taking a parenting class or two should be a no-brainer. You'll both learn what to expect and prepare for as you support each other and bond with your baby even before he or she arrives.   Tip #3: Learn From Other Dads If the thought of sitting in a room full of full-bellied women and their partners makes you uncomfortable, you may opt to stick with bros for your lesson plan. Dad-only classes and soon-to-be-dad support groups — taught and led by seasoned fathers with tales to tell and words of wisdom to share — are available online and in cities and communities around the country. Dad-focused sites also offer advice for new and still-learning proud papas. Here are a few options to check out:  Boot Camp for New Dads City Dads Group Wilderdad.com Fatherly.com Fathers.com  Tip #4: Babies are Required Reading Haven't read a good book lately? Well, if you're expecting a baby, now is the time to flip through a few pages that could make your life a whole lot easier in a few months. There's no such thing as being too-well-read when it comes to your fast-approaching, adorable little poop machine. The least you can do is read a book or two, or seven.  We're Pregnant! The First Time Dad's Pregnancy Handbook From Dude to Dad: The Diaper Dude Guide to Pregnancy We're Pregnant! The First Time Dad's Pregnancy Handbook  What to Expect When Your Wife Is Expanding Be Prepared: A Practical Handbook for New Dads  The New Dad's Survival Guide: Man-to-Man Advice for First-Time Fathers What to Expect When You're Expecting  Tip #5: Be a Prepared Soon-To-Be-Dad Tips 1 through 4 are meant to help alleviate some of your jittery, new-dad anxiety. And we hope they do just that. But if you really want to hold that "Best Dad Ever" coffee mug starting on day one, there are also some practical things you can do to prepare. Check these items off your list now to make life with baby more baby-, mommy- and daddy-friendly from the get-go.  Buy a baby/child car seat. Three out of four car seats are installed incorrectly. Protect your children by ensuring they are riding in a properly secured and age-appropriate car seat. Renown Children’s Hospital Car Seat Station is staffed by certified technicians who provide child vehicle safety restraint education, inspection and installation. Set up the baby's nursery early, including furniture  Stock up on diapers and baby supplies  Cook and freeze 2 weeks of food for nights when no one wants to cook  Research family healthcare  Agree upon a shared diaper-changing/feeding schedule  Ask about paternity leave from work  Get bills and finances up-to-date or pre-pay to avoid late charges   Give the home a thorough cleaning before the baby arrives

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Much like general physical and mental health, sexual health is an essential aspect of your overall well-being. Therefore, educating yourself on your sexual health is an important piece regarding your overall wellness. Secure & Private Virtual Visits Did you know that many sexually transmitted disease appointments can happen virtually, in the privacy of your own home? Our providers can perform a screening examination for sexually transmitted illness (without symptoms) when it’s convenient for you. This is a great option if the topic makes you uncomfortable during an in-person visit, or if you can’t find time to visit your primary care provider or local urgent care. After the telehealth appointment, your provider will determine the  next steps for you. Remember, in-person visits are always an option as well.   Here’s how you can take charge of your sexual health:  Get Comfortable with Getting Tested  Surprisingly, some people with STDs don't show symptoms, meaning they may not even know they have an STD unless they get tested. Even if an STD shows no symptoms, the result of non-treatment can be serious. Bret Michael Bellard, MD, with Renown Medical Group, shares that it’s important for people to get tested for STDs because if left untreated, they can cause the following health problems: Loss of fertility Pregnancy complications Other health issues  When to Visit Your Primary Care Provider  Who should get tested and how often? “The recommendations are that everyone from ages 13 to 64 should get tested at least once for HIV. All sexually active adults should also be tested for other STDs once a year, and all pregnant women should be tested at the start of their pregnancy,” says Dr. Bellard. Some STDs, like syphilis, can be passed from mother to baby, so it's important for women to get tested as soon as they know they’re pregnant.  Dr. Bellard recommends going to your primary care provider for testing. “They can also give advice on prevention and other health topics.” If you don’t have a primary care provider, this is a great reason to get established with one. Women with an established OB/GYN can have STD testing done simultaneously with their annual pelvic exam. The providers in Renown's network care for patients of all ages and specialize in family medicine, internal medicine, pediatrics and OB/GYN.   Practice Safe Sex  STDs are preventable. Practicing safe sex and getting tested routinely are your best defenses against all types of STDs.  For many, the conversation about sexually transmitted diseases is awkward and many avoid it. To lower your risk of contracting an STD, don’t wait until you’re “in the moment” to have the conversation with your partner about the last time you were both last tested. If you haven’t gotten tested in-between new partners, use latex condoms every time you have sex until you are both confirmed negative of STDs. Condoms are not 100% effective at preventing disease or pregnancy. However, they are extremely effective if used properly.   To establish Primary Care, visit renown.org/virtualvisits or call 775-982-5000

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One of the most pressing issues in modern medicine is the need to improve rural healthcare. This challenge hits particularly close to home, as Renown Health is the only provider covering 100,000 square miles in northern Nevada, an area that’s mostly rural. People in rural areas suffer from chronic diseases such as heart disease, cancer and respiratory disease, at higher rates than the general population. One of the largest contributors to these health disparities is a lack of access to health services. Many rural communities have fewer providers and care facilities. This forces residents to travel farther to receive preventive care and medical treatment. We must identify ways to better support the health needs of the millions of Americans who live in rural communities. Ideas for improving rural healthcare Health systems must identify innovative ways to leverage existing resources and new technologies to care for patients in these communities. For example, telehealth can help diminish a person’s need to travel long distances to receive specialty care. Similarly, online classes can help educate patients about preventive behaviors. Remote monitoring technology also allows patients to track their health conditions from home. Additionally, we can address physician shortages by empowering health professionals such as nurse practitioners, physician assistants and technologists to care for patients. These providers receive excellent training and have demonstrated success in improving health outcomes. Renown Health cares for people from diverse backgrounds and we are dedicated to caring for patients in every community we serve. Renown Telehealth We’re leading the region in using video conferencing technology to provide the best care possible – no matter where you are. Renown Telehealth is telemedicine that gives you access to top-level care and better outcomes with less stress and fewer travel costs. Learn More

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You probably know testosterone (T) plays an important role in how boys physically develop into men. But is that all you know? What happens when a man's T levels are off? Are there symptoms men should look for? And what are the treatment options? Dr. Bobby Kahlon, MD, Renown Medical Group provides answers in a Testosterone Q&A.   What does testosterone do for men?  "Testosterone is known as the 'manly hormone' for a reason," says Dr. Kahlon. "Though women also naturally produce small amounts of it, men produce testosterone at much higher concentration levels. And it affects men in more physical and obvious ways. How much hair a man has on his chest, how deep his voice is, or how muscular he is are all attributable in some way to testosterone. It's also responsible in large part for sex drive and bone strength and affects how men think, learn and experience their surroundings."  Testosterone in men:   Powers virilization (male physical characteristics) and sexual function Builds muscle mass and strength  Supports bone density  Improves cognition  T Trivia: Discover Magazine reveals that “manly” testosterone and other sex hormones evolved long before we did — 500 million years ago — from the ultimate “female” hormone, estrogen. Can you have too much or too little testosterone?  Though high testosterone isn't a concern for most men, low testosterone or low T occurs more frequently and develops for two primary reasons.  Dr. Kuhadiya explains, "Subnormal testosterone concentrations occur either due to pituitary or testicular failure and the causes for each need to be discussed with your physician."  Pituitary failure: Approximately one-third of men with obesity, type 2 diabetes, or metabolic syndrome (which includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels) have low free — or "bioavailable" — testosterone. These health conditions can cause the pituitary gland to "fail" to release follicle stimulating hormone (FSH) and luteinizing hormone (LH) which are essential for triggering testosterone and sperm production. And that can cause low testosterone (hypogonadism). Testicular failure: Though less common than pituitary failure, testicular failure may also be responsible for low T. It's caused by diseases or illnesses affecting the testicles, injury or trauma to the testicles, or certain medicines and treatments such as chemotherapy or opioid pain medication. Providing your complete medical history to your doctor is always the first step toward a proper diagnosis.  What are the symptoms of low T?  The following indicators could be a sign that you have low T, say the doctors.  Lack of motivation and determination, including mild depression  Loss of physical endurance and muscle strength  Loss of or diminished early morning erections  Reduced libido (sex drive)   Erectile dysfunction (ED — difficulty achieving or maintaining an erection)   Gynecomastia (male breasts)  Small testes  T and Time: T levels in men naturally begin to decline by about 1% a year starting at age 30.  How do you test for low T?  "There are different methods for testing testosterone levels," says Dr. Kuhadiya. "Each approach uses a blood sample to evaluate total testosterone, which includes free and attached testosterone that combines with proteins albumin and sex hormone-binding globulin (SHBG). For the most accurate results, testing is based on samples collected in the morning after fasting, and from tests on two different days."  What treatment options are available?  "Well, your best natural option may be YOU," says Dr. Kahlon. "Men with pituitary failure are often able to treat their low T by losing weight to increase levels of the hormone. And even if you don't lose weight, exercise can help boost your testosterone. Unfortunately, if you have testicular failure, weight loss and exercise may not have the same effect."  So, are there other options? "You may want to consider Testosterone Replacement Therapy (TRT)," says Dr. Kuhadiya. "TRT is only available to men who are hypogonadal — with a clinical diagnosis of low T. Injection, gel, skin patch and nasal spray are available TRT options. The best option is the one that works best for the patient. Convenience, insurance coverage and cost are all factors to consider." Dr. Kahlon's TRT preference? Daily gel treatments, which are applied directly to the skin. On the other hand, Dr. Kuhadiya recommends intramuscular injections, which take place once a week or every two weeks.  But both doctors agree on this: physicians and their patients need to weigh the benefits and risks of TRT before proceeding with treatment — especially if your low T condition may require lifelong treatment. "In my clinical practice, I have seen some very good long-term results with an improved quality of life," says Dr. Kuhadiya. "However, in certain situations, TRT may increase the risk of heart disease and is not recommended for men with a history of prostate cancer." Dr. Kahlon adds, "Patients receiving any type of hormone therapy need to be closely monitored throughout the treatment process for any changes in their health."   How do you feel about steroids and T boosters?  "I don't recommend them, certainly not for hypogonadism," advises Dr. Kahlon. "There is no evidence to support anabolic-androgenic steroids or testosterone boosters as a safe or effective treatment for low T in men."  "In fact, there continues to be emerging evidence they may lead to side effects that could potentially harm the liver and the pituitary and endocrine functions of the body," warns Dr. Kuhadiya. "And that damage may be irreversible."

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Renown Health strongly supports and advocates for innovative medical technology. Our diverse lineup of medical equipment enables our care leaders to provide quality care to every patient. But what if a piece of technology breaks down? What happens when our care teams are ready for technological upgrades? Where do employees go when they have a question about a complicated piece of equipment?  Enter the Clinical Engineering department. This sophisticated team is staffed with intelligent, science-minded individuals who are ready to jump in and help at any given second. From newborn incubators to robots that clean the hospital floors, these team members are the med-tech masters that keep our health system running.  Equipment Experts  Upon entering the Clinical Engineering department’s workshop, you are welcomed with an abundance of high-tech equipment undergoing repairs and upgrades. The department takes care of more than 26,000 pieces of equipment throughout the entire healthcare network, including the technologies at the University of Nevada, Reno School of Medicine, which they just took over this past year. To the average person, this may seem overwhelming; however, for this team, this is the exact environment they thrive in to make the technology magic happen.  “I am motivated and engaged every day at work,” said Tony Martinez, Supervisor of Clinical Engineering for Renown. “Our department is fast-paced and rewarding, and that’s a big plus.”  While some team members enter the department as equipment generalists, this team offers training to develop their skills on certain pieces of equipment, eventually becoming specialists.   “Every month, we encourage our colleagues to undergo specific training on more delicate equipment,” said Tony. “Once we get to that point in their training, we assign different equipment to our team members every month. They pick up the experience very quickly.”  As a Clinical Engineering Technician for Renown, Rylie Nickerson took advantage of the training and educational opportunities offered to her and is now a ventilator specialist especially for Renown’s neonatal intensive care unit (NICU). “Regardless of whether I’m working on ventilators or on another piece of equipment I’m assigned to, I’m always thinking about how I can help the patients, nurses and doctors,” said Rylie.  Raul Hernandez, a Clinical Engineering Specialist for Renown, is the go-to person for anesthesia, heart-lung bypass, red cell saver and life support equipment. He embraces the fact that, regardless of whether you are a specialist or a generalist, there is no typical day working in this department. “Every day brings different challenges,” said Raul. “I really enjoy the mental exercises I do every day. They keep me grounded and focused.”  On top of their day-to-day work and any special projects or emergencies that come up, the team is on an ongoing preventative maintenance schedule. Think of this work like your car’s oil change – routine maintenance to prevent something from breaking down in the future. “At any point, we might have 100-200 extra pieces of equipment to handle during preventative maintenance,” said Taylor Gray, a Clinical Engineering Technician for Renown. “We are always helping each other through any issues.”  Our Clinical Engineering team shows exactly what it means to be collaborative. Even though their to-do lists are ever-growing, this team never feels alone. They know they can always lean on each other for support, regardless of the workload.  “We always have each other’s backs,” said Taylor. “I feel so happy and satisfied in my job, and my coworkers are a large part of that.”  Celebrating the Genuine Difference  The Clinical Engineering department is driven by their desire to help and take care of the entire health system, and in turn, make a genuine difference for the communities we serve, from the medical staff to the patients.   “The satisfaction you get in our field when we impact patients’ lives and their healing process is so motivating and engaging,” said Tony Martinez. “It’s a great feeling.”  The team knows the common saying ‘Walk a mile in someone’s shoes’ very well; so well, in fact, that they take it to the next level, doing everything they can to prevent frustrations and extended down times. “We try to walk a mile in someone’s shoes before they get angry,” said Reagan Jordan, Director of Clinical Engineering for Renown. “Your satisfaction is our mission, and our team continually works to improve their outcomes every day.”  This department is where the entrepreneurial spirit and science-focused mind meet. For people like Raul Hernandez, who came from a business background as well as decades of medical technology experience, Renown helps him bring both his personal and business skills into focus. “This environment is very beneficial for Renown, me, and of course, the patients,” added Raul.  Being members of a team that is committed to excellence and purpose inspires them to reach new heights in patient care.  “I am constantly reminded of the positive impact we have by witnessing the individual experiences we have and hearing the enthusiasm and thankfulness in their voices,” said Raul. “It gives me a great sense of pride to work at Renown.”  "There is a strong feeling of mutual respect here,” added Ed Trejo, a Clinical Engineering Technician at Renown. “We are always here to help.”  The proof is in the data. The Clinical Engineering team scored as one of the top departments in the recent Renown employee engagement survey, with their results sitting at more than 94 percent.   “This speaks to not only our department leadership but also the team as a whole,” said Reagan. “I am extremely proud of them. Despite the pandemic, they are knocking it out of the park.”  For this department, coming to Renown is easy; staying at Renown is even easier.  “Staying at Renown is the easy choice,” said Raul. “And this team is only going to grow.”  Workflow Whizzes and Kindness Champions  “Rolling with the punches,” as Tony Martinez says, comes naturally to the Clinical Engineering team. With the constant workflow of equipment coming into the shop, every team member has learned how to be experts at prioritizing, especially based on the needs of our organization.  Even though their jobs can bring a lot of intensity, this department’s positive attitude radiates throughout the hospital. Upon entering the workshop, everyone is greeted with a smile from every team member, along with an immediate willingness to dive into the complex world of engineering.  “The experience of helping other people with their unique needs is invaluable,” said Taylor Gray.  If this work environment sounds enticing, great news – the Clinical Engineering team is growing. Motivated, aspiring engineers with a passion for healthcare and an associate’s degree in a related field are welcome.   Military experience is also valued very highly in this team. As many of our military servicemen and servicewomen gain specialized engineering experience while enlisted, the military-to-engineer career ladder at Renown is especially strong. In fact, according to Paul Joseph, a Clinical Engineering Technician at Renown, the majority of their teammates come from a military background.   Above all, being capable of prioritizing on the fly, thinking critically, having an open-mined outlook and being self-driven are the top skills that this department values. As Ed Trejo states, “If you’re willing to wear different hats, you will do very well here."  “Go with the flow, and expect the unexpected,” added Rylie Nickerson.  Those who join this team feel at home. The warm embrace of the team’s kind nature and the supportive environment they all foster inspires an efficient workflow that helps our entire hospital system function at the top of its game. At the end of the day, everyone who joins the team, or anyone who even interacts with the team in any capacity, will be in good hands.  Mandy Noriega, a Clinical Engineering Technician for Renown, closes these thoughts with a great reminder to each and every one of us: “After all, teamwork makes the dream work.”

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Renown TeleHealth is improving the health of everyone – even our most distant neighbors. That’s why we’re leading the region in using video conferencing technology to give you the best care possible – no matter where you are. Be it an emergency, an ongoing condition, or even the need for convenient health and wellness education and support, we are always just a connection away. Renown TeleHealth is telemedicine that gives you access to top-level care and better outcomes with less stress and fewer travel costs.

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