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August is National Make-a-Will Month. We talked to Abbey Stephenson, Planned Giving Officer at Renown Health Foundation, to learn more about wills, trusts and estate plans and why you should feel motivated this month to get started. Why Make a Will There are so many reasons why it is difficult to make a will or put an estate plan in place. These include: Lack of time or money to prepare a plan The misperception that “only rich people need an ‘estate plan’” How intimidating legal documents can be General discomfort with planning for the future Given the barriers to making a plan, it’s not surprising that only 32% of Americans have a will or trust in place. But having a will or trust matters because these are the documents where you can say who will inherit your assets, who will manage your assets and estate, and who should be guardian of a minor or a child with a disability. Where to Begin If you have been thinking about putting together a will and don’t know where to begin, here are some next steps you can take. 1.  Learn the terms. If you have never created a will, trust, or an estate plan, the language can be hard to get used to. A few important terms to know include: Last will and testament (also known as a will): a legal document that describes how you would like your property and other assets to be distributed after your death. This is also the document where you can nominate a guardian for a minor or disabled child. Personal representative (also known as an executor): a person named in a will responsible for collecting your assets, paying your debts and final taxes, and distributing the remaining assets to those stated in your will. Personal representatives must be formally appointed by a judge and report certain information to the judge for review and approval. Living trust (also known as a revocable or family trust): a legal arrangement set up through a document called a trust instrument or a declaration of trust that gives someone called the trustee power to make decisions about the trust creator’s money or property held in the trust. Estate plan: a collection of documents that help organize what happens to you and your assets upon your disability and death. Your estate plan is comprised of documents such as a will, trust, and advance health care directive. If you want to learn more about these terms and estate planning in general, you are invited to attend a free one-hour estate planning education session on Aug. 22, 2024, at 10 a.m. or Oct. 21, 2024, at 11 a.m., hosted by Renown Health Foundation. Click here for more information and to register. 2.  Create a list of assets. Start by creating a list of your assets including real estate, investments, bank accounts, retirement accounts, business ownership interests, vehicles, life insurance, valuable personal property like jewelry or artwork, and any other significant assets. Click here and read our free estate planning guide. 3.  Put together a list of 2-3 people you trust. When you create your will, you need to name a personal representative who will collect all your assets, pay your debts, and work with the probate court to distribute the balance to the people and charities you name in your will. If you create a trust, you need to name a trustee to manage the trust assets under the terms of the trust document. It is a good idea to include at least two people who can take on these roles in case the first person becomes unavailable. If you do not have anyone you would trust as a personal representative or trustee, there are trust companies, banks, and other professionals and institutions who may be able to assist you. If you are the parent of a child who is under 18 or has a disability, you will also nominate a guardian in your will to care for that child if you and the other parent are gone.  4.  Start a list of who you would like to inherit your assets. Which people and organizations would you like to inherit the assets you own at the time of your passing? And which assets or how much would you like them to receive? You might want to consider who relies on you for support such as family members or charities, individuals and organizations that have made a difference in your life, or those you have a special fondness for. It is important to use the legal names of individuals you include as beneficiaries and the Tax ID number for any charity you include.  If you decide to make a gift to Renown as part of your will or estate plan and notify us, you will be included in the Renown Legacy Society. Legacy Society members enjoy invitations to exclusive events, special acknowledgments, and other unique benefits. Click here to learn more about the Renown Legacy Society. 5.  Put together a list of your professional advisors and enlist their help. Write down the names and contact details for any professional advisors you work with such as your accountant, financial advisor, investment manager, attorney, insurance agent, and planned giving officer.  You may want to seek their advice on how best to proceed and which assets are best gifted to which individuals and organizations from a tax standpoint. Collaboration among the professionals with whom you work can help your plan to run more smoothly when it is needed. Depending on your circumstances, it may make sense for you to introduce your trusted individuals to these professionals. 6.  Start drafting. Once you have these items in place, you will be in a good position to begin the drafting process. There are many capable estate planning attorneys in our community who can help you with drafting. There are other drafting resources available as well, but only a licensed attorney can provide you with legal advice. Click here to attend the free Family Estate Planning Series sponsored by Renown and presented by PBS Reno and the Community Foundation of Northern Nevada.

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Chances are you or someone you know will deal with chronic pain at some point in life. In fact, in the U.S. alone, one in five adults have experienced chronic pain in recent years, according to the Centers for Disease Control and Prevention (CDC). The road to relief is a frequently traveled one that can be filled with twists and turns, so it’s important for patients to have a trusted provider by their side navigating that journey.  We interviewed Dr. Sharlene Su, a pain management physician with Renown Medical Group, who told us what patients can expect when seeking care with Renown Spine, Sports & Pain Management (RSSPM) and all about the variety of pain relief options available to patients.  What pain management treatment options are available outside of painkillers? This depends on someone’s root cause of pain. For example, for pain from arthritis of the spine or major joints, radiofrequency ablation can relieve most of the pain for six months to two years, which can be life changing. If someone is suffering from a pinched nerve in the neck or back, an epidural can be useful. Nerve stimulators can also be a great option to relieve pain for years. One of the advantages of the procedures we perform at RSSPM is that they reduce the need for painkillers, which are notorious for having side effects of their own. Physical therapy can also be a very helpful tool to treat pain.  It is an exciting time in the field of pain medicine right now because new advances are -constantly being made. At Renown, we pride ourselves on staying current with the most cutting-edge treatments to ensure our patients always have the best available to them.  What are some at-home tips and tricks that patients experiencing pain can do on their own for some relief? If pain is related to posture or physical activity, consider doing stretching and strengthening exercises. YouTube can be a great (and free) resource for this. In terms of medications, over the counter topical pain creams can be great. Tylenol is one of the safest pain medications for those without preexisting liver conditions. On a short-term basis, anti-inflammatory medications can often be used safely depending on one’s overall health. Ice and heat can both be useful for treating muscle pain.  Can you tell us more about the services Renown Spine, Sports & Pain Management offers? Our team specializes in identifying the root cause of each patient’s pain and partnering with them to develop a custom plan tailored to their individual needs, which can involve injections, physical therapy and medications. We treat patients ranging from top-level athletes, to weekend warriors, to grandparents who’d like to be able to keep up with their grandkids. Once we relieve a patient’s pain, our role then transforms into a coach, educating and guiding our patients on how to prevent their pain from coming back.  At RSSPM, you’ll see the same doctor every time, which means that your provider will get to know you very well, and you’ll receive the same high-quality consistent care whenever you come for a visit.  Renown has a unique pain management team called “Special Procedures” that not many people may realize is a great option for care. How does this team treat pain? Our Special Procedures team is crucial to the high-quality pain management care that we provide. We have an amazing staff that assists with X-ray guided procedures including epidurals, radiofrequency ablations, joint injections and nerve stimulators. Dr. Casey Keating, our division chief, and I work with this team to ensure that every procedure is done with the same precision, attention to detail and quality. The Special Procedures team regularly receives feedback from patients on how well taken care of they felt during their procedure.  If someone is experiencing pain from an injury or even an unknown reason, what should they do to get care for their concerns? Contact your primary care provider for a referral to have an evaluation with us! RSSPM accepts most insurance plans and are proud that our wait times are averaging less than one week to be seen as a new patient. Two more doctors will be joining us in the next few months, which should reduce our wait times even more.  There are so many targeted and effective ways to treat pain nowadays, and it is worth addressing to live the life you want to live.

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In the fast-paced world of healthcare, productivity is always a focus. Care teams need accurate and timely information to make decisions that directly impact our patients. However, without a reliable system to analyze and deliver complex data, noticing areas for improvement and making impactful changes can become overwhelming. This is where the power of data and analytics comes into play.  Renown Health’s Enterprise Data & Analytics (EDA) department are the leaders of this transformation. This team cares for the caregiver by delivering key data and insights with thorough analytics. Their data-driven approach ensures we are moving towards consistent progress and excellence in patient care, creating a better healthcare experience for everyone.  Dedicated Data Deliverers From patient volumes to quality-of-care metrics, our EDA department drives a lot of decisions that directly affect our patients and caregivers. A day-in-the-life as an EDA team member is where creativity meets science.  “Data is the lifeblood of the department and my role,” said Clayton Pettit, Senior Data Analyst. “Every day, I'm working with data – figuring out how to get certain pieces of data, visualizing it to provide users with clear insights and helping users of the data glean those insights and analyze the data.”  “We are builders of data tools, collaborating with team members and IT teams,” added Michelle Ebesu, Data Analyst. “We problem solve and design the most efficient way to deliver data. We work on large projects, small report requests and answer reporting related questions. We investigate and research daily.”  According to this team, every day brings a blend of exploration, engagement and discovery. Their role within our health system is central to turning data into useful ideas that drive meaningful change for all.  “A day on the Enterprise Data & Analytics team involves responding to diverse requests, some well-defined and others more open-ended, requiring exploratory collaboration with stakeholders,” said Kevin Crofton, Senior Data Analyst. “We harness the vast institutional knowledge within our organization to inform our analytics projects. This collaborative approach not only enhances our insights but also extends their impact across various groups within the organization.”  “Each day in EDA is fast paced,” added Ryan Fernandez, Manager of Data Analytics. “Our days are filled with a variety of different tasks ranging from data wrangling, building visualization to tell a meaningful story, responding to urgent business questions with analysis, training other team members on how to use analytical tools, and constantly learning more about the different clinical service lines and how to interpret their data.”  No two days are the same in EDA. In fact, every day brings a new challenge. And the best part? They’re never alone. This team thrives on working together, emulating Renown’s cultural commitment of Collaboration to a tee.  “Every day is different,” said Susan McDonald, Senior Data Analyst. “On larger projects we collaborate together, with each person taking a piece. We'll meet daily to gauge progress, exchange ideas and assist each other when needed. We'll sometimes have to troubleshoot issues that may come up with some reports. We often meet with our end users to get further details on their needs or to present their requested reports.”  “Up until the last couple of months, my day-to-day was creating, updating and fixing reports for all aspects of Hometown Health,” added Ryan Zinck, Data Analyst. “For the past two months we have begun the development of what will be an extensive reporting system in PowerBI that's intended to serve most groups within the company.”  Working with digital healthcare information that impacts how a health system operates and makes needed improvements can be complicated, since information is entered in various ways like calculations, statistics or measurements. Susan McDonald said it best: “It’s like solving puzzles every day.”   “We are Business Intelligence,” said Michele Warner, Data Analyst. “We answer questions the business proposes. We write queries and design reports/dashboards. We dig into the tables that store the data that is input by everyone at Renown through EPIC and other applications. We tell a story that will help the business be more efficient, make better decisions, solve a problem or report to government agencies.”  “We dive deeper into the front-end data and analyze it to get more detailed information and insights regarding the performance and certain project,” added Boqun Yin, Data Analyst. “Then, our colleagues working at the front line can utilize it when making strategic business decisions.”  EDA takes the definition of trendsetting to a whole new level. With the unique ability to predict future trends, this department can provide crucial information that helps care teams on the floor care for their patients to the best of their ability today, tomorrow and forever.  “I deliver data on all sorts of topics for Renown,” said Clayton Pettit. “With this data, I help Renown see where we are and where we need to improve. Beyond that, the data I provide can help us see how we can improve, what things we need to focus on and processes we need to change.”  “Our organization needs up to date robust data to ensure quality and integrity so that it’s reliable, secure and accurate,” added Uriel Duran, Data Engineer. “We also provide analytics and insights that can provide/predict patient outcomes and trends. For our patients, improving patient care is critical – and that can be done with data.”  Making Your Lives Easier As stated by Brian, Howell, Manager of Data Engineering, “we’re here to make everyone’s lives easier.” And Brian is exactly right – the EDA department’s work impacts the people who care for patients. Their data analysis and engineering skills help our care teams answer questions, give them information they can make decisions with and inform them statistically about well they are doing, along with showing opportunities for growth.  “EDA professionals like to think of themselves as the ‘wizard behind the curtain,’ a nuance from the ‘All Knowing’ Wizard of Oz; we are custodians of the company's data and we take that responsibility seriously,” said Dr. Justin Coran, Chief Analytics Officer. “When we partner with our clinical or administrative counterparts, we can help evolve decision-making from emotional to rational. The shift to rational decision-making allows the company to understand cause and effect of their business or clinical decisions.”   “I work directly with our customers on a daily basis to determine how our department can help them achieve their goals,” added Brian Howell. “I have been involved in data for over 20 years and love the technology, ever-changing landscape and challenges.”  The proof of their influence is in the numbers and the words they hear from our front-line care teams, from a significant financial impact to words of enthusiasm from providers. This reinforcement encourages the EDA team to continue going above and beyond.  “My goal is to make life easier for our clinicians and staff who do provide direct care,” said Helen Bahrke, Senior Data Analyst. “I feel accomplished if my work helps other staff reduce their time spent running reports or finding the data they need. Some providers have their own research questions they are studying in their patient population. Helping them get the data they need so they can provide better and more efficient care makes me happy.”  “Though we may not be the most visible department at Renown, the work we do and content we output drives decision making at the highest level,” added Sean Gollos, Data Analyst. “We make it easier for physicians to track patients, provide key employee data to the HR department and help ensure our organization is compliant with several requirements set by our industry.”  “I have seen my work bring in millions of dollars so that Renown can provide better care where it’s needed,” added Sean Richards, Senior Data Analyst.  Both patients and providers can lean on the EDA department for support in helping unravel data that may seem complex to the everyday eye, which has a direct impact on productivity and care quality.  “We take care of those who take care of patients,” said Mark Templeton, Manager of Data Analytics. “From descriptive analytics to measurements and dashboards, we provide a lot of support to those who manage patient care and productivity.”  “Our team provides critical datasets and insights into specific medical data that informs decision making stakeholders, which indirectly impacts patient quality of care,” added Sergio Pascutiu, Senior Data Engineer.  The impact of this team’s expertise can be felt beyond the hospital floor. Renown Health Leadership relies on the EDA to deliver data that affects important decisions at the top organizational level.  “A typical day for me revolves around data integration and extract, transfer, load (ETL) operations,” said Ken Vogel, Data Engineer. “The data and reporting that we provide to our end users and Renown leadership drive the decisions that impact the organization as a whole, which in turn impacts our patients.”  “Renown Leadership has business experience and training in order to navigate the challenges and opportunities that constantly present themselves,” added Michael Jesser, EDA Project Manager. “EDA helps them test their proposals with real data. This has been the meat and potatoes for our department if you've got a question about any process then we'll find the data that helps you form a reasonable answer.”   "We provide timely information to Renown leadership so that they may optimize our operational efficiencies that allow for improved patient outcomes,” added Todd Nicholas, Data Engineer.  This team thrives on challenges. Ryan Fernandez explains it beautifully: “I love challenges and learning new things, which is what happens almost every day being an analyst in healthcare, and that is what keeps me in this industry.”  Fighting the Good Fight for Today and Tomorrow Throughout the past year, the EDA department has been hard at work with many transformative projects that have improved several processes at Renown. What many may not know is just how large of a role these team members played in several of these endeavors, from a time-keeping platform upgrade for our employees to creating a one-stop-shop data warehouse.  As one can likely imagine, many of these projects are a large source of pride for this department, and deservedly so: “I am most proud of the Renown Regional Medical Center wall board conversion project, converting the patient lists that previously displayed to an Epic dashboard that displays data that is pertinent to the staff taking care of patients. The new wall boards provide at-a-glance information requested by nursing leadership.” - Michelle Ebesu “The last 12 months within EDA has been transformational. In May 2023, the data needed to run operations was scattered across 200 source systems and files, 20,000+ SQL tables and thousands of columns of data. Led by the vision of our executives, the team onboarded the technology (Microsoft Azure) and completed the development of a foundational Enterprise Data Warehouse (EDW) within 8 months, when the process usually takes 1.5-2 years. EDA produced Renown's first in-house developed risk stratification algorithm to optimize care for our Hometown Health members and produced a brand-new state-of-the-art reporting system for primary care.” - Dr. Justin Coran  “Our team contributed to the integration with the new UKG enterprise resource planning (ERP) system which comprises of a multi-tenant integration package that sources data from the UKG system.” - Sergio Pascutiu “I'm proud of the role our department has played in migrating from Kronos to UKG. It was a project that took over a year from planning to implementation, but our team had a key role that I think really opened people's eyes to how much they rely on the data that our team maintains.” - Sean Gollos Since this team’s work involves a large collaborative effort between the clinicians and themselves, according to them, the work that our care teams do generates “a gold mine” of health services data for them to dig through and answer crucial questions to create solutions, such as “What has happened in the past?” “What is currently happening?”  While figuring out the answers to those questions that will affect the future of healthcare at Renown, one solution often comes to the forefront: artificial intelligence.  “Under the direction of our new Chief Analytics Officer, the tool sets that EDA uses will expand into machine learning and artificial intelligence (AI),” said Michael Jesser. “We'll be answering questions about what is likely to happen or what data could influence an answer that we don't normally associate with the question. This is big – and getting bigger. EDA will put Renown at the forefront of this powerful future.”  “The new data science team that will onboard in 2025 will be able to utilize AI and machine learning (ML) applications that may impact patient care directly,” added Dr. Justin Coran. “EDA is looking forward to partnering alongside our clinicians and nurses to create the future in AI / ML healthcare products.”  Virtually everyone in the EDA department was excited about a career in high tech. To make matters even better, many of them had a passion for healthcare and the non-profit world.  “My healthcare experience led me to an understanding that there was a need for someone that understood healthcare workflows in the IT field, so I joined as an Epic analyst to help design those workflows and eventually found my way onto the EDA reporting team,” said Raffi Kilejian, Data Analyst. “The work-life balance, along with the fact that I work for a non-profit that gives back to the community are my main reasons for working for Renown.”  Other team members didn’t originally intend to use their technical talents in healthcare but are glad that they ended up taking the road to Renown. From the department’s strong culture to our health system’s impact on the community, this team consistently reports enjoying the work they do every day for Renown.  “I chose to work at Renown because of its stellar reputation as a leader in community-focused healthcare and the sense that individual contributions could genuinely drive change,” said Kevin Crofton. “Although I hadn't originally planned a career in healthcare, I've found a profound synergy in this department, where multiple disciplines converge to address diverse challenges. This welcoming and collaborative atmosphere has been key to our success. My transition into healthcare has been immensely rewarding, allowing me to apply my skills in ways that meaningfully impact our community's health and well-being.”  Finding “better ways to do things,” as the EDA team puts it, transcends the backend data. That philosophy also feeds into their departmental culture, always finding ways to bring each other together and uplift one another’s accomplishments and ambitions.  “I'm proud that we've been able to bring back some former valuable Renown employees,” added Brian Howell. “It is a testament to the culture at Renown that people recognize the meaningful work we do. I love working for a healthcare organization that makes a difference in people's lives."  “I was referred to Renown by a good friend during job hunting; since I started to work for Renown, I've seen the changes and effort that the EDA leadership has put into the development of the team,” added Boqun Yin. “I am glad to be part of this journey. That's why I choose to stay.”  “Renown also offers great benefits which I have taken advantage of, such as tuition reimbursement for my online MS in Analytics program I am currently enrolled in,” added Ryan Fernandez.  As proudly stated by Michelle Ebesu, “I believe in the values we have here at Renown.” And at the end of the day, this is what matters most to all who work in EDA.  “The opportunity to drive meaningful change and contribute to a mission that goes beyond profit—to truly focus on improving people’s lives—continues to inspire and keep me deeply committed to our cause,” closes Kevin Crofton.

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With the dangerous heat wave impacting our region, there are heightened risks of heatstroke, especially for children who cannot regulate their body temperature as efficiently as adults. Infants are particularly vulnerable and may not express discomfort, so never leave a child unattended in a vehicle. Top Tips for Preventing Heatstroke Reduce the number of deaths from heatstroke by remembering to ACT. Avoid heatstroke-related injury and death by never leaving a child alone in a car, not even for a minute. And make sure to keep your car locked when you’re not inside so kids don’t get in on their own. Create reminders. Keep a stuffed animal or other memento in your child’s car seat when it’s empty, and move it to the front seat as a visual reminder when your child is in the back seat. Or place and secure your phone, briefcase or purse in the backseat when traveling with your child. Take action. If you see a child alone in a car, call 911. Emergency personnel want you to call. They are trained to respond to these situations Keeping Your Baby Cool in the Back Seat In hot weather, it is crucial to keep your baby cool and hydrated by using a car seat cover or towel over them to reflect the sun's rays. Dress your baby in lightweight clothing that covers their arms and legs. Keep an eye on your baby's skin color. Move them to a cooler place if they look too red or flushed. Keep the temperature at a comfortable temperature for you, not for your child. Keep the windows cracked open for ventilation and ensure nothing is blocking the airflow from entering or exiting the vehicle. Dress your infant appropriately for their environment, including appropriate head and neck coverings, to keep them cool and protected from sunburns. Ensure you have enough fluids to last an hour before getting out of the car or use bottled water if possible. Never leave your child unattended in a car. Steps to Follow if You Suspect Heatstroke  Call 911 immediately.  Cool the victim – Get the person to a shady area, remove restrictive clothing and cover skin with sheets soaked in ice-water, and place ice packs in the arm pits and groin.  Have the victim drink cool fluids, preferably an electrolyte-containing sports drink.  Monitor body temperature with a thermometer but stop cooling efforts after temperature has dropped to 102 Fahrenheit. Baby Safe Classes These classes help prepare parents for emergencies that may occur in baby’s first year. Safe Kids Worldwide Did you know heatstroke is the leading cause of non-crash related fatalities in children? “On average, every 10 days a child dies from heatstroke in a vehicle. In more than half of these deaths, the caregiver forgot the child was in the car.”

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Abdominal pain is one of the most common reasons for an Emergency Room visit. The abdomen is an area that encompasses multiple organs and functions. So how would you know when the pain you are feeling is an ovarian cyst or something else, and when should you seek medical attention? Dr. Carilyn Hoffman, at Renown Women's Health, explains. Ovarian Function Defined Located on each side of the uterus, the ovaries are part of the female reproductive organs and produce eggs (ova), released during the menstrual cycle, allowing for fertilization and pregnancy. They also produce hormones such as estrogen and progesterone, which play an important role in female traits, bone health, cardiovascular health and pregnancy. Symptoms of an Ovarian Cyst Cysts are solid or fluid-filled masses. Ovarian cysts can be in the ovary or on its surface. When cysts are enlarged or rupture, they can create a dull ache or sharp pain below the belly button. Besides discomfort and pain, other symptoms of ovarian cysts may include bloating, fullness, pressure or heaviness. "Ovarian cysts are common; most are physiologic and will go away on their own. They are frequently found incidentally on ultrasound and are present in the middle of the menstrual cycle," says Dr. Hoffman. "However, if a woman experiences sudden and severe pelvic pain they should seek immediate medical attention. Sometimes ovarian cysts can become large and twist on themselves. This is called ovarian torsion and is a surgical emergency. Other times, cysts can rupture and bleed. This is called a hemorrhagic cyst and can also be a surgical emergency." Diagnosis and Treatment If an ovarian cyst is suspected, your doctor will perform a pelvic exam and order an ultrasound. There are certain ultrasound findings that suggest that the cyst is benign. There are other ultrasound findings that are concerning for cancer. Small simple cysts often resolve on their own, whereas solid or very large cysts may require surgery.

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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. © Africa Images via Canva.com

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Meet newly minted Dr. Majid Khan, PhD., a native of Reno, and current MD-PhD candidate and first-generation medical student at the University of Nevada, Reno School of Medicine, who is on his way to a career as a Neurosurgery. While most graduate students often choose between pursuing a medical degree (MD) or a doctorate in philosophy (PhD), Majid has boldly picked both. He is one of three medical students currently in the UNR Med MD-PhD Program run by Dr. Caroline Cobine, PhD and Dr. Violeta Mutafova-Yambolieva, MD, PhD. "Research is not merely an act of sitting at a computer and reading papers – it's about answering the thought-provoking questions about things we come across on a daily basis. By critically evaluating these ideas we can implement solutions to enhance various aspects of the medical field and patient care with an overall goal of improving patient outcomes," Majid said. Majid recognizes that modern research extends beyond academia and holds significant value for hospitals. “Research contributes to improving patient outcomes. By reviewing the data from peer-reviewed research studies, medical professionals can be better prepared to deliver effective care following the most up-to-date guidelines and data,” he said. Majid's journey to pursuing his MD-PhD with a goal of becoming a physician-scientist-surgeon began following a summer in the PathMaker Cancer Research Program at the Huntsman Cancer Institute at the University of Utah. "It was by fate that I stumbled into this field – ever since I saw my first brain surgery, I haven’t been able to look back," Majid said. Here are some of the valuable lessons that Majid has learned along the way. 1. Beyond the 9 to 5, Embrace both 5 to 9s To avoid burnout and nurture personal passions, make your time spent outside of work and school intentional. Harness any free time to reconnect with friends, pursue hobbies and engage with mentors and mentees. 2. Collaboration is Key Work collectively with colleagues locally, nationwide and even worldwide. Cultivate environments to share knowledge and innovation, as well as wisdom, which will evidently lead to more impactful outcomes. 3. Shine a Spotlight on Your Colleagues Acknowledge and celebrate your colleagues in group settings when you notice something outstanding that they’ve said or done – it could anything big or small. Shining the spotlight onto those who are making positive changes within the hospital can inspire a beautiful culture of academic healthcare, which ultimately improves patient outcomes. 4. Redefine Mentorship Mentorship does not need to be confined to traditional frameworks. Seek out guidance in unexpected and untraditional places; sometimes, the most enlightening lessons and opportunities emerge from the most unlikely sources. 5. Diversify Your Experiences Embracing a diverse range of experiences enriches one's medical acumen. You never know when a seemingly unrelated job or experience will help in a scenario in your career. 6. Live By the Mamba Mentality Follow the late Kobe Bryant’s approach to life and work, the Mamba Mentality. This includes planning long-term goals, placing meaning in everything, striving for constant personal growth, following your passions and focusing on the process rather than the end goal. 7. Make Time for Your Loved Ones Don’t forget who helped you get to where you are in your life, specifically your family, friends, teachers and mentors. By making time for the most important and loving people in your life, you will be surrounded by positivity which will help propel you to new heights. 8. Plan your Next Five Moves We all have the ability to come from nothing and become something. Take the time to plan out everything and execute your moves with careful precision. Majid has plans to return to the Biggest Little City after completing Neurological Surgery Residency Program. If you would like to get in touch with Majid, please reach out to him via email at majidk@med.unr.edu.

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

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Managing weight is a complicated and often difficult journey for many individuals, and obesity stands as a common and serious chronic health condition. In fact, the Center for Disease Control and Prevention reports that the prevalence of obesity in the US is greater than 40% in adults and 20% in children, and those numbers are continuing to climb. In Nevada, according to the 2020 Behavioral Risk Factor Surveillance System, 28.7% of adults reported being obese. By 2030, almost 80% of American adults may be overweight and half of them will be obese. But obesity isn't just about the numbers on the scale; it's a multifaceted, lifelong, neurobehavioral disease triggered by a combination of factors. These include abnormal eating patterns, reduced physical activity levels, environmental stressors, genetics and various other contributors. Obesity extends far beyond appearance, often leading to the development of numerous medical conditions such as diabetes, heart disease, elevated blood pressure, stroke, sleep apnea, liver disease, various cancers and infertility. Join us as we delve into the complexities of obesity and explore strategies for effective weight management available right here in northern Nevada. Why Can Losing Weight be so Difficult? The challenge behind weight loss finds its roots in the Set-Point Theory of Obesity, a concept that says our bodies have a predetermined weight, or fat mass, within a defined set-point range. In other words, when an individual's weight deviates from this set point, the body initiates mechanisms to bring it back to the established range. So, if someone loses weight below their set point, the body may respond by increasing hunger and reducing metabolism, making it challenging to sustain weight loss. There Isn’t One Right Answer, But Renown is Here to Help Various weight management strategies can be utilized by patients struggling with obesity, which may lead to substantial weight loss, resolution of associated medical conditions and improved psychosocial health. In fact, the most successful strategy involves a multidisciplinary approach under the guidance of trained specialists that includes a combination of tactics, including: Behavioral adaptations Dietary modifications Physical exercise  Anti-obesity medications  Weight loss surgery

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Ensuring a healthier and more inclusive future for LGBTQIA+ children and teens is of utmost importance to health systems in our community, especially Renown. Supporting the physical and mental health of youth in this community is key to those efforts, especially as they face unique challenges in terms of identity acceptance and social integration.   Dr. Caroline Barangan, Adolescent Medicine Physician with Renown Children’s Pediatric Specialty Care, discusses what you as a parent, caregiver, friend or support system can do to be a safe space for children and teens who identify as LGBTQIA+. 1.  Create a Safe Space at Home The most important action you can take for your LGBTQIA+ teen or child is to accept and support them for who they are, regardless of how they identify. “Being a teenager is already difficult enough, especially within the LGBTQIA+ community, which puts them at risk of being stigmatized, rejected and targets for bullying,” said Dr. Barangan.  Your supportive words and actions can make a huge difference as a profound expression of love and understanding. Being patient and willing to learn are the foundations to a healthy and loving relationship with your LGBTQIA+ teen or child.  2.  Encourage Regular Check-Ups with a Primary Care Provider (PCP)  Establishing your child or teen with a PCP is not only important when an illness occurs but also for annual preventative visits and regular check-ups. “A primary care provider can screen for high-risk behaviors that would put a patient’s health in jeopardy, such as sexual experience, substance use, suicidality and self-harm,” said. Dr Barangan. “These screenings are an opportunity to provide the education and support these kids and teens need to stay healthy.”  One of the main concerns LGBTQIA+ youth often have is that they will experience judgment from their provider, or the PCP will disclose sensitive information, including their sexuality or gender identity to their parents, when they are not ready to do so. Dr. Barangan emphatically reminds us that this legally cannot happen. “If a patient asks me to keep something confidential, unless they disclose that they have plans to harm themselves or others, I am legally not allowed to share that information with anyone without their permission,” said Dr. Barangan.  3.  Locate Local Resources  Northern Nevada is home to a variety of resources for the LGBTQIA+ community at large, including youth members of this community. "Finding resources to help them develop in a positive way and provide them with the information they need, whether it be in school, the household, the community or through a medical or mental health provider, is incredibly important,” said Dr. Barangan.  Below is a list of local LGBTQIA+ community resources open to you and your children:  Our Center LGBTQIA+ Health Services at Northern Nevada HOPES Northern Nevada Pride Festival & Community Parade (happens every July in Reno) Sassabration (happens every September in Carson City) Lake Tahoe Pride (events and resources shared on Facebook)  © alessandrobiascioli via Canva.com

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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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Heat and ice are two of the most common treatments used to relieve pain and reduce swelling in injuries. However, each one is better suited for certain types of injuries Dr. Luis Palacio, MD explores the differences between the two.  When it comes to treating aches and pains, the debate between heat and ice has been ongoing for quite some time. Both have their benefits making it crucial to understand which option is better suited for your specific needs.   Determining which method is better depends on various factors such as the type of injury or pain you are experiencing. For instance, if you have recently sprained your ankle or pulled a muscle during exercise, applying ice within the first 48 hours can help minimize swelling and alleviate discomfort.   It's worth noting that some individuals find alternating between heat and ice therapy beneficial as well. This approach combines the benefits of both methods by using heat to increase blood flow followed by ice to reduce inflammation.  Cold Therapy  Cold therapy can help to reduce inflammation after an injury, heat can have the opposite effect. Therefore, heat therapy should be reserved for those who have chronic pain issues and are not dealing with an acute injury. Cold therapy is often recommended immediately after an injury or during the initial stages of inflammation.  Cold therapy such as ice packs are especially effective in treating: Sprains  Strains Any injury that involves swelling Heat Therapy  Heat therapy is known for its ability to relax muscles, increase blood flow and soothe pain. It is often used for chronic conditions or injuries that are not inflamed. Applying heat can help alleviate stiffness, promote healing and provide a comforting sensation. This increased circulation can bring more nutrients and oxygen to the area, helping it to heal faster.  Heat therapy such as heating packs are especially effective in treating:  Stiffness with associated pain   Injuries that are not inflamed  Muscle pain

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