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The board-certified rheumatologists at Renown Rheumatology provide state-of-the art care for a wide range of autoimmune rheumatic diseases such as rheumatoid arthritis, psoriatic arthritis, lupus, Sjogren syndrome, vasculitis, gout, and many more. We use the most advanced evidence-based diagnostic and therapeutic measures to restore health and enhance well-being.

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Renown Surgical Services is with you every step of the way, providing the support, guidance and information you need throughout the entire surgical process — from preparation to recovery. Whether you need same-day surgery or an advanced procedure, our team helps you find the option that provides the best possible outcome. Need help with your pre-admitting appointment or a price estimate? Call 775-982-3993.   Preparing for Your Procedure Now that you have your surgery scheduled, let’s help get you ready for your pre-admitting appointment. The following checklist provides steps for you to follow from the time it’s determined you need surgery. The checklist covers: How to prepare 1-28 days before your procedure How to prepare the night before your procedure How to prepare the day of your procedure How to take care of yourself after your procedure View the Checklist (English) Ver en Español

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Alzheimer’s disease is not normal forgetfulness as we age. Instead, it is a specific form of mental decline. And according to the Alzheimer’s Association it accounts for nearly 80 percent all dementia cases. Natasa Dragicevic, MD, PhD., behavioral neurologist and Alzheimer’s disease specialist with Renown Institute for Neurosciences, weighs in on diagnosing it and the importance of early medical action. How to Diagnose Alzheimer’s Disease In general, the signs of Alzheimer’s disease occur slowly, getting worse over time. For example, forgetfulness is a daily search – for shoes, keys and other misplaced items. Not only is memory affected, but also speech patterns and behavior. There is no single test for Alzheimer’s disease. “Specifically, a neurologist should be the one to diagnose Alzheimer’s disease given differences in presentation,” clarifies Dr. Dragicevic. “And ideally a behavioral neurologist (Alzheimer’s sub-specialist) will be managing the treatment,” she adds. Brain Imaging Diagnosing Alzheimer’s disease involves multiple approaches and medical providers. In short, medical history is reviewed along with a physical exam, lab tests and other diagnostic testing. “A medical workup includes a variety of tests. These include MRI and other brain imaging, as well as neurological and psychological testing. Furthermore, a lumbar puncture is performed to look for markers of the disease,” she states. What Causes Alzheimer’s disease? Although no one knows the cause, researchers think many factors play a role. Uncontrollable risk factors include your genetics and having a family member with the disease. However, the controllable risk factors include: reducing the risk of head injury and keeping your heart healthy. It’s important to realize that high blood pressure, high cholesterol, stroke and diabetes play a role in brain health. Blood loss to the brain causes vascular dementia, leading to long-term blood vessel damage. Symptoms of Alzheimer’s disease Generally speaking, the signs of this disease differ in each person. Yet noticeable behaviors include: • Losing the way to familiar places • Forgetting to pay bills • Trouble finding the right words when talking • Repeating questions • General confusion • Social withdrawal Alzheimer’s Disease – Benefits of Early Diagnosis Equally important, spotting Alzheimer’s disease early allows more time to benefit from medications and possible clinical trials. Likewise, nutrition and exercise changes can be made, increasing blood flow to the body, and perhaps delaying symptoms. Early diagnosis also allows for personal health decisions and quality-of-life conversations to take place.   According to the Alzheimer’s Association, these benefits include: 1. Medical advantage 2. Emotional and social comfort 3. Time to plan ahead 4. Cost savings A Brain Supporting Lifestyle “At the present time, treatment is limited,” explains Dr. Dragicevic. “Usually Alzheimer’s is a progressive ongoing disease – any management at this time is purely symptomatic.” However, she states the following lifestyle changes can help support brain health: • New hobbies such as painting, pottery, music classes or learning a new language • Crosswords, puzzles and playing games, such as Scrabble • Brain challenging mobile apps, such as Luminosity • 30-45 minutes of mild to moderate physical activity per day, such as walking • Eating a Mediterranean diet (primarily plant based foods)

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An arthritis diagnosis doesn’t mean your exercise routine has to end. In fact, a consistent routine can actually improve mobility. Although stiff and painful joints can make it difficult to keep moving, staying active is essential for easing pain. October 11 is World Arthritis Day, so we asked Michelle Higgins, MPT at Renown Physical Therapy & Rehab some advice about exercising with arthritis. According to the Arthritis Foundation, arthritis affects one in five adults and 300,000 children. As a matter of fact arthritis is the nation’s leading cause of disability. Your joints certainly don’t need to suffer when you exercise. In general exercise is actually necessary for those with arthritis. Not only does it reduce joint pain, but it also increases strength and flexibility. Furthermore those adopting a regular exercise routine also have more energy, deeper sleep and find it easier to maintain a healthy weight. “Exercise is a necessary component to managing your arthritis,” says Higgins. “Consistent participation in an exercise program has been shown to promote long-term pain relief, increased body function and an improved quality of life. Alternatively, a lack of exercise can actually increase joint pain or stiffness and eventually lead to long term disability and suffering.” Exercising With Arthritis Exercise truly is the most effective non-drug arthritis treatment available for reducing pain and improving movement. And it can even include daily activities like gardening, dancing or walking your dog. Of course talk to your doctor or physical therapist about what exercises fit into your specific treatment plan. With this is mind, the four specific components below are important to an effective arthritis exercise program: Range of motion Moving joints through their full available range of movement is important. This frequently increases function and decreases joint stiffness and pain. For this reason, aim to complete these exercises daily. Examples include bending, straightening, and rotating specific joints, or static and dynamic stretching. Strengthening These exercises target muscles supporting and protecting our joints and bones. Strengthening is also necessary for weight control, so two-to-three sessions per week are recommended. In order to allow your body to adapt, begin with light resistance and start slow. Strength exercises include weightlifting and using resistance bands. Low-impact aerobic exercise Aerobic exercise is certainly necessary for overall well-being, weight management and heart health. Aim for two-to-three sessions a week. Low-impact exercises include walking, swimming, cycling, elliptical machine exercises and water aerobics. Balance Good balance is also vital for an effective arthritis program. On the positive side, solid balance prevents falls by increasing your ability to stay upright whether you are moving or sitting still. Likewise, it improves your confidence with walking and daily activities. In order to keep excellent balance, incorporate daily balance exercises. Examples of balance exercises include the use of an exercise ball, Tai Chi and exercises such as standing on one foot. Start Slow, Finish Strong As you begin your exercise program, remember to listen to your body. Start slowly – it can take several weeks for your body to adjust to exercise. Consult your doctor, or physical therapist, if you experience increasing pain or swelling which doesn’t go away with rest. Above all, incorporate fun and motivating activities so you’ll stick to them long term and improve your results. Renown Physical Therapy & Rehab 775-982-5001 Through outpatient physical, occupational and speech therapy, Renown Physical Therapy & Rehab gives you hands-on, individualized treatment in convenient Reno/Sparks locations. We have the latest, most advanced physical therapy and rehab equipment, specialty services and treatments. Renown Physical Therapy & Rehab is now open on Robb Drive in addition to three additional locations in Reno and Sparks. Call 775-982-5001 or visit us online.

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Posture is important, but for those children diagnosed with scoliosis (spinal curvature) it can be a difficult issue. The Washoe County School District Student Health Services Department screens 7th grade students for scoliosis as growth spurts often reveal the condition and, if diagnosed early, scoliosis can stop progressing. We asked Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis to answer some frequently asked questions about scoliosis. What is scoliosis? There are many types of scoliosis: early onset (occurs before age 10), congenital scoliosis is when the bones of the spine do not form correctly, neuromuscular scoliosis which is due to children’s neurologic and muscle disease, and the most common is Adolescent Idiopathic Scoliosis. The term “idiopathic “ means the exact cause is unknown, although we do know it runs in families. This type of scoliosis occurs in 2-3 percent of adolescents and is mainly seen during their growth spurt. This is why middle school screenings are recommended. Both genders get scoliosis but girls are 8 times more likely to have their curves progress and become larger. What are the signs that my child may have scoliosis? A few signs for parents to watch for are: One shoulder might be higher than the other. One leg may seem longer. A hip may be higher or look more prominent. The waist may not look the same from side to side (asymmetry). The trunk or rib cage may be more prominent on one side or shifted. When they bend forward they may have a bump on their back. How is scoliosis diagnosed? It can be noticed by a pediatrician at a physical, school screening nurse, PE teacher or parents. Once the curve is suspected the child is usually referred to a pediatric orthopedic surgeon scoliosis expertise. At the initial visit the doctor will perform a thorough physical including a complete neurologic exam to assess the amount of curvature. Once the exam is completed the physician will determine if a spinal x-ray is needed. The curve on the x-ray is measured utilizing the cobb angle (a measurement in degrees) which helps guide the treatment. What are common treatments for scoliosis? The treatment depends on the size of the spinal curve and the amount of growth the child has remaining. An x-ray of the child’s hand is used to determine the amount of growth remaining. This allows the determination of the child’s bone age, and based on the hands growth plates it can determined if the child is in their rapid phase of growth. Treatments include: Observation - For curves less than 20-25 degrees. This entails visits every 6-9 months with a repeat scoliosis x-ray. Since scoliosis curves increase only 1-2 degrees per month, and variations in measurements can be 3-5 degrees, an x-ray is not recommended before 6 months. If the curve remains less than 25 degrees the child is followed until their growth is completed (usually age 16-18). Progressing Curve - If growth is finished and the curve is less than 40 degrees, the risk of more curvature into adulthood is small. If growth is completed and the curve is over 45 degrees, the child is followed for several years as these curves can progress into adulthood. If the patient is still growing and the curve has progressed greater than 25 degrees but still in the non-operative range (less than 45-50 degrees) bracing is used to stop the progression of the curve. Bracing - Indicated for curves over 25 degrees but less than 45 degrees. If a brace is required you will be referred to an orthotist (bracing specialist). The orthotist assesses your child, reviews the x-ray and then fits the brace. (Having a brace made usually takes 2-3 weeks.) Once the brace is fit, your child will visit the scoliosis specialist for an x-ray in the brace to ensure it fits correctly. The primary goal of bracing is to halt progression of the curve and prevent the need for surgery. The brace must be worn for about 16 hours per day to be effective. In a recent bracing study 72% of the patients who wore their braces as prescribed prevented the need for surgery compared to the group who did not wear their brace. Surgery: When a curve reaches 45-50 degrees, and a child is still growing, surgery is usually recommended because the curve is likely to continue progress. If a curve is over 50 degrees and the child is done growing surgery also may be recommended. This is because when curves are over 50 degrees they tend to increase 1-2 degrees per year for the rest of your life. As curves get larger the amount of lung function tends to decrease which could cause breathing problems later in life. The goals of surgery are to stop the progression of the curve and safely correct any misalignment. This is accomplished by attaching implants (rods, screws, hooks and bands) to the spine. Bone graft is then placed around the implants to encourage the spine to fuse (grow together). This then forms a solid column of bone with metal rods in place, preventing the curve from changing. Most patients are back to their regular sports and activities six months post surgery.

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A slobbery kiss, a wagging tail, a judgement-free smile. There are few things better than the love and attention of a canine companion. At Renown Health, we have a loyal and playful group of pet therapy teams. This volunteer program uses animal-assisted interactions (AAI) and animal-assisted therapy (AAT) to provide comfort, reduce boredom, increase social interactions, improve mood, boost general well-being and – perhaps most importantly – bring smiles to our patients’ faces. Benefits of AAT & AAI: Lowers blood pressure and heart rate by relieving anxiety Helps in pain management Eases feelings of depression, loneliness, boredom and isolation Stimulates communication Encourages physical activity For more information about the program, a complete list of our teams or to get involved, click here. Meet Keno and Linda Linda, Keno’s human, has volunteered as one-half of a therapy dog team for more than 14 years. Keno is her third Newfoundland, and he is a sweet and cuddly 2-year-old pup, who, according to Linds, thinks is a lap dog. “My mother was in assisted living for almost 10 years, and I saw what an impact a therapy dog can have,” Linda said. When she moved to Reno from Portland six years ago, she immediately contacted Renown. A Memory the Stands Out: A patient in the ICU was not responsive because of oxygen deprivation due to almost drowning. Linda and Keno went into the patient’s room at his physical therapist’s request, and the therapist asked the patient to reach out and pet the dog. After the third request, he moved his hand toward the dog, and his mother burst into tears. It was the first time the patient had moved since his accident. Linda and Keno went back several days in a row, and soon the patient was talking, sitting up and eating on his own.   Meet Madi and Clark Madi, Clark’s human, is an employee at Renown, and Clark made it a family affair by joining the team in Sept. 2021. Clark is a unique pup with an amazing demeanor who adores everyone as much as they adore him. He is a hardworking Goldendoodle who loves to be a goofball at home when he’s off the clock. Why They Became a Therapy Dog Team: Madi was inspired to get Clark trained as a therapy dog because, as an employee at Renown, she was always so happy to see dogs walking around, and she knew that I wanted to provide that same relief to others. Her favorite thing about being a Renown volunteer is the joy it spreads to those working and the patients they are caring for.   Meet Richard and Raven Raven is a four old Belgian Malinois who has been working as a therapy dog for two and a half years. She is calm, friendly and loves having her tummy rubbed. “The therapy dog teams are just one little part of Fighting the Good Fight,” Raven’s human Richard said. A Memory that Stands Out: Raven and Richard were assigned to the Sierra oncology ward one shift and visited a woman who had a picture of her dog displayed next to her bed. Raven immediately went to the bedside and the patient started petting her. As she spent more time petting Raven, Richard could see the stress disappearing from her face. He later learned that it was the patient’s first chemotherapy infusion, and Raven gave her the peace and the strength she needed to face the chemotherapy head-on.   Meet Savannah and Hallie Hallie and Savannah’s journey as a therapy dog team began in 2017 at the Morgan Stanley Children’s Hospital in New York and has also taken them to San Francisco General Hospital and Stanford Hospital. The duo moved to Reno in 2020 and immediately joined the Renown Pet Therapy Program. A friend, energetic and cuddly American Cocker Spaniel, Hallie especially loves spending time with the young children at the hospital. A Memory That Stands Out: Savannah remembers one visit to a patient in the Children’s Emergency Room who was struggling with suicidal thoughts. Having struggled with mental health herself, Savannah felt a deep connection to the patient and a need to help. She recalls placing Hallie on the patient’s bed a seeing a “very small hint of a smile.” Savannah later learned that the Renown nurses hadn’t seen the patient smile in days. It was that moment that made Savannah realize what a profound impact Hallie can have on patients.   Meet Chivas and Donna Chivas was a McNab/Border Collie mix who volunteered at Renown with her human Donna for two years. With help from Donna, Chivas was a master at reading situations in the hospital and reacting accordingly. For example, if a patient was afraid of dogs, she would sit with her back to the person so she didn’t come off as threatening. Contrarily, she would lie down on the floor when playing with young children to let them pet her on their level. Why They Became a Pet Therapy Team: This dynamic duo started out as a member of a local pet therapy group. During the height of the COVID-19 shutdown, they participated in outdoor pet therapy parades for various hospitals in the area. Donna and Chivas met Renown Volunteer Coordinator Wendy Peuket at one of the parades and she inspired Donna to pursue becoming a registered therapy dog team for Renown's Therapy Dog Program. Chivas sadly passed away unexpectedly in early December 2021, and the world is a whole lot dimmer place without Chivas’ light shining brightly.

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Excess amounts of sodium doesn’t just increase your risk of a heart attack, it can also increase your risk of a stroke. Unfortunately, avoiding that saltshaker may not be enough. Did you know that the average American consumes 3,400 milligrams of sodium each day? That’s a dangerous number considering that the American Heart Association recommends limiting daily sodium intake to 1,500 milligrams (about half the weight of a penny) to reduce the risk of heart disease and stroke. The problem is not necessarily that you’re putting too much salt on your food, it’s that salt is already in the foods you’re regularly eating. To help keep your sodium intake at a healthy level, make sure you’re aware of “The Salty Six,” six sneaky foods that are surprisingly high in sodium. Breads, Rolls and Tortillas: Although breads and tortillas may not initially appear to be high in sodium, we often consume several servings. Make sure to keep track of your total servings to see how they add up. Deli Meat, Cured Meats and Poultry: It may surprise you that six thin slices of deli meat can add up to more than half of your daily limit, so be mindful when building those sandwiches. Also, do your best to avoid cured meats, which often means the meat has been salted. Substitute uncured, skinless meats instead. Cheese: Salt is an important addition in the cheese-making process, as it prevents bacterial growth. Unfortunately, that added salt can increase your health risks. Limit the amount of cheese you add to meals to keep your sodium content down. Pizza: Take a quick look at the first three items above and it should be no surprise as to why pizza made the list. One slice and you’ve met at least half of your daily limit. Go easy on the cheese and try adding more veggies instead of meat. Canned Soup: One cup of canned soup can be as high as nearly 1,000 milligrams of sodium. When shopping for canned soup it’s important to check the label – not just on sodium content but serving size as well. Always select low-sodium options when possible or cook your own soup at home. Sandwiches and Burgers: A sandwich or burger from your favorite restaurant can contain more than 100 percent of your daily sodium limit. When dining out, it is best to select low-sodium options or eat a half portion to limit the amount of salt. If some of your favorite foods are on this Salty Six list, don’t panic. Although these foods can be high in sodium, it isn’t necessary to cut these foods out of your diet completely. It’s just important to eat them in moderation and be mindful of your daily sodium intake. Look for low-sodium options, use herbs and spices instead of table salt and do your best to stay under the recommended daily limit of 1,500 milligrams.”

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If you’ve ever spent time at Renown, you may have noticed there are some four-legged volunteers roaming the halls greeting patients, visitors, and staff. Since 1997, Renown has been fortunate enough to have its very own therapy dog program. As of today, there are 43 dogs in the program, and each of them have gone through countless hours of training to offer healing, comfort and support to those seeking treatment within our health system. Each of these therapy dogs have their own special personalities, but they all share the same mission: to make a paws-itive impact on everyone they meet.  One therapy dog that has touched many lives at Renown is Raven, a five-year old Belgian Malinois mix. Raven's Story In March of 2019, Reno residents Richard and Vickie Lange rescued Raven from an animal shelter in Portola, California. When the Langes made Raven part of their family, they immediately started her in obedience training. After seeing her do so well, they thought of an idea that would not only help Raven reach her full potential but also allow them to give back to others – they decided to train Raven to be a therapy dog.

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This holiday season, sprinkle some extra joy for your favorite furry pals by whipping up these easy, AKC-approved dog treats. With simple ingredients and quick baking times, they're the perfect last-minute surprise to show your pet some love. Turn it into a delightful gift by snagging some adorable, budget-friendly canisters (easily found at dollar or thrift stores) and fill them to the brim with these homemade goodies. It's a merry, tail-wagging gift that's sure to make this season the most pet-friendly one yet! 🎄🐾🍪

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