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Want to know more about osteoporosis and osteopenia? We'll dive into these conditions and give you some handy tips on preventing future problems and taking care of your bones. What is Osteopenia? Osteopenia (low bone density) is the initial stage of bone mineral density loss, which can eventually progress to osteoporosis if steps are not taken to prevent it. What is Osteoporosis? Osteoporosis is a condition that weakens our bones. While it literally means “porous bone," it doesn’t mean that our bones are doomed to succumb to the changes that can happen to us silently over time. Our bones are living tissues that are constantly breaking down and remodeling themselves.  Osteoporosis and osteopenia are typically diagnosed by testing bone mineral density using scans that your primary care provider can easily order. This is important testing because it dictates your risk of breaking a bone in common areas like your hip, wrist or spine. It also helps set the stage for talking with your healthcare team to develop a treatment plan. Most people will reach their peak bone mass in their mid to late twenties. There are several factors that increase our risk of osteoporosis or osteopenia as we age, such as menopause, genetics and other lifestyle factors. However, there are several things you can do to mitigate this breakdown and assist your body in the constant remodeling it does to our bones. 3 Controllable Factors to Build Strong Bones 1. Talk to your primary care provider They can go over a plan and prescribe things such as vitamin D, calcium and medications that can help if you are at risk or have osteoporosis or osteopenia. 2. Maintain a healthy diet Talk to a dietician if you need further help as they can be an invaluable resource to develop a plan.  Eat foods rich in calcium, vitamin D and vitamin C. These assist with the rebuilding of bone. Examples include but aren’t limited to leafy greens, legumes, salmon and healthy dairy products.  Don’t smoke — it directly correlates with a decrease in bone mass. Smokers also take longer to heal from a fracture.  Limit alcohol to two to three beverages per week. Alcohol interferes with the production of vitamins needed to absorb calcium and the hormones that help protect bones. 3. Exercise Talk to your primary care provider to get a referral to physical therapy if you need help with exercise.  Our bones adapt to the stresses we put them through. Therefore, exercise should be tailored to putting the right stress on our bones. There is good quality research that most exercise is safe when dealing with less bone mineral density.  The exercises should be progressively challenging and increase the load for resistance and weight training at least two to three days a week. Examples include squats, step-ups, chest presses and rows.  Exercises higher in velocity will lead to more power and bone adaptation. Examples include quicker push-ups, marching and quicker walks.  Exercises that are weight-bearing will lead bones to adapt to the stress placed on them. Movements such as mini stomps, step-ups, jumping, jogging and so forth may be used depending on how your body tolerates these things to really stimulate bone adaptation. There are aspects of aging and bone health we can’t control, but we can take steps to minimize the chances of bone loss and osteoporosis. Talk to your healthcare team to determine your risk and don’t forget to show your bones a little TLC – you’re going to need them.

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As we enter the holiday season, many of us are beginning to plan and partake in festivities such as shopping, cooking, baking, holiday parties and family gatherings. While the holidays often bring joy and cheer, the hustle and bustle can also lead to fatigue, stress, anxiety and sometimes depression. To avoid holiday burnout, it’s important to find ways to care for yourself mentally and physically. Galen Gorelangton, Renown's Spiritual Center Volunteer, discusses how yoga and meditation can benefit you. What is yoga and meditation?  Yoga is defined as performing a series of postures and controlled breathing exercises to promote a more flexible body and a calm mind. As you move through poses that require balance and concentration, you're encouraged to focus less on your busy day and more on the moment. Meditation involves focusing or clearing your mind using a combination of mental and physical techniques. While there are many different types of meditation and yoga practices, they both share similar benefits including: Reduced stress Lower blood pressure Decreased anxiety and depression Increased energy Better sleep Lower inflammation and pain levels Improved strength, balance and flexibility  Better focus and concentration  And much more!

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Reviewed by: Jessica Blauenstein, a Board-Certified Specialist in Oncology Nutrition and Registered Dietitian at Renown Health. As the temperatures continue to rise around northern Nevada, our farmer’s markets and home gardens are bursting with produce – making this the perfect time to prepare a fresh summer salad for you and your family. American salads have come a long way. No longer must we settle for iceberg lettuce topped with pale tomatoes and store-bought salad dressing. Fresh fruits, exotic vegetables and aromatic herbs are proudly taking up residence as entrees on menus around the globe. These refreshing Pritikin salad recipes are chocked full of phytonutrients – plant compounds that provide a host of anti-bacterial and anti-inflammatory benefits while supporting the body’s natural detoxification process. When it comes to ingredients, freshness counts! Try to use local and unsprayed produce in your salads whenever possible for added nutritional value. Already thinking of ways you can put your own personal touch on these recipes? Andria Herron, dietary educator with Renown’s Healthy Heart Program, encourages you to experiment. “Salads are the perfect recipes to substitute, omit and add in additional ingredients based on your personal preferences,” said Andria.

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If you and your partner are looking for a more permanent birth control method, you might consider a vasectomy. Although vasectomies are common, knowledge about them isn’t quite as common or talked about. If you are considering a vasectomy, talking with your primary care doctor is a great way to learn more and start the process. We consulted with Dr. Aurosis Reddy a primary care doctor with Renown Health – South Carson, about key topics to discuss with your doctor when considering a vasectomy. What is a vasectomy? A vasectomy – also called male sterilization – is a form of male birth control that blocks sperm from reaching semen, according to the American Urological Association (AUA). How effective and safe are vasectomies? Vasectomies are one of the most effective methods of birth control with a long-term success rate of over 99%. A vasectomy has been a safe and successful birth control method for many years. More than 500,000 men elect to have vasectomies every year in the U.S., and the number is rising. A vasectomy is also generally a low-risk procedure with a low complication rate ranging between 1-2%. What does the recovery period look like? A vasectomy is typically a quick procedure that takes under thirty minutes and can be performed in an outpatient setting under local anesthesia. Recovery from a vasectomy is also considered relatively easy. After a vasectomy, most can: Resume everyday activities within two to three days Resume normal exercise in one week Start engaging in sexual activity again in one week Your doctor can provide more details on what your individualized recovery process will look like.

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Renaissance Don   The Sterling Silver Club is honored to have thousands of members who’ve led and continue to lead incredibly vibrant and diverse lives. And we’re absolutely thrilled when those members volunteer to share their stories and experiences so we can all appreciate and learn from them.   This issue’s featured member is no exception. From his love of cooking, travel and music to his drive to learn new languages, take on new hobbies and keep himself active and fit, Don is an aspiring Renaissance man who may already be deserving of the title.    Revolutionary Family Roots   Don’s father, who was born in Beijing, China, earned a master’s degree in metallurgical engineering from the University of California, Berkeley and was working on his PhD there on a full scholarship from his home country when the Chinese Communist Revolution occurred. In order to stay in the United States and avoid potentially being thrown into prison by the new communist regime (a fate that befell some of his family members), his father married Don’s mother, who was a U.S. citizen and also a student at Berkeley. Together, they started a family.   “My father met my mother in a class and received his green card by marrying her,” says Don. “They proceeded to have six kids in nine years, I was number three. Dad never finished his PhD, but clearly earned what we like to call his “PSK” degree – Papa with Six Kids.”  Proud (of) Papa: Don’s father was a professor of metallurgy and a brilliant research scientist who was responsible for virtually every breakthrough in the development of titanium in the 1960s.

Read More About Meet Multifaceted Member Don Chang

Men are generally less likely to visit their doctor for exams, screenings, and consults compared to women. To address this, we've collaborated with Dr. Bonnie Ferrara of Renown Health, to compile a list of eight essential screenings that can help men maintain their health. 1. Blood Pressure Tests Ages 20+ Blood Pressure tests measure the pressure in your arteries as your heart pumps. Biennial (every two years) checks are recommended if you have normal blood pressure or more frequently if you have high blood pressure (hypertension) or low blood pressure (hypotension). The United States Preventative Services Taskforce cites normal blood pressure below 120 systolic (top number) and 80 diastolic (bottom number). 2. Cholesterol Screening Ages 20+ High levels of cholesterol increase your risk of stroke and heart disease. A simple blood test will help your healthcare provider determine your numbers and if you're at risk. If you have a family history of diabetes or heart disease, you may need yearly screenings. But, again, your doctor can provide the best course of action.

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Did you know an estimated 1.9 million neurons and 14 billion synapses are lost per minute during a stroke? That’s why every second counts. Anyone can have a stroke, but your chances increase if you have certain risk factors. That’s why the best way to protect yourself or your loved ones from a stroke is to know the risks and how to manage them. You can make changes to your lifestyle to lower your risk of stroke by asking yourself the following questions: 1. Is my blood pressure normal? High blood pressure is the leading cause of stroke and the most important controllable risk factor. If you’ve had a stroke, lowering your blood pressure can help prevent future strokes. 2. Can I quit smoking? Smoking damages blood vessels, clogs arteries and raises blood pressure — doubling your risk of stroke. If you want to reduce your risk of stroke and heart attack, quitting smoking is the first step — and Renown can help you with this. Learn more: Renown Health Quit Tobacco Program. 3. Do I make time to exercise 30 minutes a day? Many studies link consistent exercise habits with lower stroke risk. Also, being overweight contributes to high cholesterol, high blood pressure, heart disease and diabetes, all increasing your stroke risk. You don’t need to run a marathon — just commit to making time to move each day. 4. Do I regularly eat processed food and sugar? Eating less cholesterol and fat, especially saturated and trans fats, may reduce the fatty deposits (plaque) in your arteries. Also, eating five or more servings of fruits and vegetables per day may reduce your stroke risk. If you are diabetic, follow recommendations to get your diabetes under control.

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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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Often, when we think of Italian dishes, we think of pasta. In fact, there are more than 600 different pasta shapes, each holding the task of delivering Italy’s flavors.  While we all crave pasta, according to the U.S. Department of Agriculture (USDA), a cup of pasta shells contains about 166 calories, 6 grams of protein and 32 grams of carbohydrates. When you add all the other comforting ingredients that comes with cooking Italian, it’s nearly impossible to keep it healthy.  Caitlin Bus, Registered Dietitian with the Renown Healthy Heart Program shares a healthier version of an Italian favorite –deconstructed manicotti using zucchini as a substitute for noodles. If you’re looking for a healthier Italian dish and wondering how to use a spiralizer to turn vegetables into noodles, this recipe is for you.

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There are a few simple ways to encourage healthy aging that can translate to an improved quality of life. Here are some expert tips.  What does healthy aging mean to you? If you’re like most people, you’re looking forward to removing the negative from your life — negative energy, thoughts, people and activities that don’t contribute to your best life.  And while that’s a noble goal, too often we forget about ways to strengthen the positive parts of our lives. Expert Herbert “Buddy” Coard III, Ed.D, psychologist with Renown Behavioral Health, provides us with five positive behaviors to focus on to improve happiness and life satisfaction. Healthy Aging in 5 Easy Steps: 1. Connect – Make connections with friends, family, colleagues and neighbors. When you build strong connections, they can help enrich your life with new experiences and opportunities. Besides, having a support system to call upon when you need a favor is valuable as you age. 2. Be Active – Make time to get moving and work those muscles. Being active can include walking, practicing yoga, playing a game of pickleball or dancing. Exercise makes you feel good and keeps you health. Pick a physical activity that you enjoy, and don’t make excuses. Not only will being active help you build stronger muscles, it also helps you build strong connections with others. If you need a workout buddy, Meetup is a great resource to find like-minded people that share common exercise goals. 3. Take Notice – Be mindful and become more curious. Like a child, see the wonder and beauty of the world. Notice the things around you — the weather, the landscape, the mood and feelings of the people around you. By taking notice, it’s easier to learn to appreciate the things that matter. 4. Keep Learning – We never stop learning. Keep trying something new — a new course you’ve always wanted to try or a more challenging task someone has solicited for your help. Challenges keep us on our toes and increase our confidence and excitement in our day. OLLI (Osher Lifelong Learning Institute at the University of Nevada, Reno), brings diverse educational and social opportunities to active older adult learners (50+). EPIC (Educational Programs Inspiring the Community), offers a divers curriculum ranging from art classes to Accelerated training certificate courses. 5. Give – Be generous with your time, your knowledge and your talents by giving to friends, family and even strangers. Some easy ways to give is to show thankfulness, smile at people and volunteer. Sharing of yourself to a wider audience gives you a greater reward than just doing things for yourself. Nevada Volunteers Volunteer at Renown Health Practice these five tips to improve happiness and quality of life at any age.

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Stroke is unfortunately common, with 1 in 5 American women experiencing it each year. When it comes to a stroke the phrase “time is brain” speaks to the urgency of getting rapid care. In fact, a woman may lose nearly 2 million neurons per minute of oxygen loss to the brain. The Renown Health Comprehensive Stroke Center experts share the importance of timely treatment and how stroke symptoms can differ in women. Women and Stroke – Surprising Symptoms  Each year stroke affects more women than men. Even more concerning, women are less likely to recover from a stroke. The following non-traditional, less common, warning signs can be common in women: Hiccups with chest pain Sudden disorientation, drowsiness, confusion or a general altered mental status Nausea or vomiting A sudden headache that feels like the ‘worst headache of your life’ Unusual chest pain (especially with hiccups) Body numbness or weakness, such as an arm or leg suddenly ‘falling asleep’ Fainting or loss of consciousness Stroke Diagnosis The first step is neuroimaging by CT scan. This allows for rapid identification of any bleed, and also assists in determining candidacy for the early clot busting medication. MRI brain imaging is much higher resolution, and can better determine the core stroke size, assisting in prognosis and recovery. Since strokes have several different origins, an inpatient workup is essential to determine the underlying cause. Whether the stroke is secondary to plaque in the large vessels, clots being thrown in the setting of atrial fibrillation (an abnormal heart rhythm), or small vessel disease from years of uncontrolled vascular risk factors (high blood pressure, smoking, high cholesterol, diabetes), determining the cause is essential to implementing a management plan to reduce risk for further strokes. Quick Treatment for Stroke is Key Early recognition of stroke symptoms and seeking prompt attention is paramount. There are interventions that can be instituted to minimize the stroke and increase likelihood of recovery, but only if a patient presents to the hospital early. A clot busting medication, called tPA, can be given to patients with stroke if given within 4-5 hours from time of onset. Renown Regional Health Center is designated as a Comprehensive Stroke Center, the highest level of stroke certification available. To earn the designation of comprehensive stroke center, a hospital has to meet stringent requirements, including biannual on-site evaluations. This includes care for ischemic stroke patients (lack of blood flow), hemorrhagic stroke patients (bleeds), and determining the underlying cause to guide secondary stroke management prevention. Stroke Symptoms Remember “B.E.F.A.S.T.” to recognize the symptoms of a stroke below: B – Balance Being off balance or dizzy, is common. E – Eyes An eyesight change such as blurring or double vision may occur. F – Face droop One side of the face, or lip, droops A – Arm weakness Does one arm drift down? S – Speech Talking may slur or sound strange. T – Time Time to call 911. Call an ambulance immediately if you or anyone else, experiences any of these symptoms.

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Has a male in your life been affected by depression? This could be your father, husband, son, brother, friend, or co-worker. Men often struggle to recognize when they need help. Learn how to support them by understanding their unique signs of depression. Psychologist Dr. Herbert Coard discusses depression in men and its often-overlooked warning signs. Every year, over 6 million men are diagnosed with depression, which can manifest differently than in women. Commonly misread, the signs can include anger and aggression rather than sadness, leading to challenges for loved ones and healthcare providers in recognizing the condition. Behavioral Signs of Depression in Men High levels of the hormone cortisol are released during stressful situations affecting the neurotransmitter, serotonin (a feel good hormone), contributing to depression. You can identify depression or suicidal tendencies by paying close attention to the following behavioral changes: Anger, irritability, or aggression Avoiding family or social situations Losing interest in family responsibilities, passions and hobbies Lack of sex drive Becoming controlling/abusive in relationships Risk-taking behavior such as; unsafe sex, overspending or gambling Not being able to concentrate or remember details Excessive drinking or drug use Having frequent thoughts about death Talking about suicide Attempting suicide Factors That Lead to Depression in Men Life Events Work stress or long-term unemployment can be huge contributing factors relating to depression. This type of life event can be overwhelming, making it impossible for a man to cope. Changes in Relationships The loss of a relationship can be a significant contributing factor to the emergence of depressive symptoms and past experienced physical, sexual, or emotionally abusive relationships. With this in mind, counseling can often help individual to overcome this type of trauma. Grief and Loss Overwhelming sadness due to the loss of a loved one can trigger depression. Although normal, each person goes through their own grieving period. For example, normal responses to death are insomnia, poor appetite and loss of interest in activities. Pay attention if grief seems prolonged or out of the ordinary. Health Problems In particular, depression coexists with medical conditions. As men age, this can be passed off as normal aging, but it could be more serious. In addition, illnesses such as thyroid disorders, Addison’s disease and liver disease can cause depressive symptoms. Diabetes, cancer, heart disease, or Parkinson’s disease can affect any age, thus triggering or worsening depression. Some older men also feel like they may be suffering from dementia because of difficulties with memory this may be a symptom of depression. A trip to the doctor may be in order to help alleviate concern and worry. Depression in Men and Suicide Frequently the emotional pain occurring with depression can distort a man’s ability to see a solution beyond suicide. Individuals with depression become very rigid and constricted in the way they solve problems. The statistics below speak for themselves, helping us understand the need to reach out to those who need our support. Male suicide rates are on rising – men die by suicide 3.53 times more often than women, accounting for 70% of all suicides. Sadly, every day 129 men commit suicide. White males accounted for 69.67% of suicide deaths in 2017. In 2017, firearms accounted for 50.57% of all suicide deaths. Middle aged Men who are middle aged have the highest suicide rates. 40% of those identifying as transgender have attempted suicide in their lifetime. Males who are guy or transgendered are at an increased risk for suicide attempts, especially before age 25. Veterans often suffer from post-traumatic stress disorder (PTSD) and depression, and are more likely to act on a suicide plan. How You Can Help Now that you can identify some of the warning signs of depression, here’s how you can help: Talk about your concern and communicate that you’re there to help him. Let him know depression is a medical condition and will usually get better with treatment. Suggest professional help from a Primary Care Provider, Psychologist or Therapist. Help set up appointments and offer to accompany him – let him make the decision, but make it clear you’re there for him, no matter what he decides. If you feel he is in a dire or life-threatening situation, contact 911. Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to talk to a trained counselor. Call the Veteran’s Crisis Line at 1-800-273-TALK (1-800-273-8255) and press “1”

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