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Heart disease is the leading cause of death in women. According to the American Heart Association, heart disease kills more women than all forms of cancer combined and yet only 44% of women recognize that cardiovascular disease is their greatest health threat. Recognizing the urgent need for women's cardiac care, Renown Health established the Helaine Greenberg Women's Heart Center, the first of its kind in Nevada.

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When medical treatments no longer offer a cure, Hospice Care offers a special way to care for you and your family who are faced with a life-limiting illness. Serving Washoe, Lyon, Storey and Carson Counties, our team is available 24 hours a day, seven days a week.   Hospice staff receive special training to care for all types of physical and emotional symptoms that cause pain, discomfort and distress. When considering your options for end-of-life transition, our team is available to answer questions and discuss if Renown Hospice Care will meet your needs.  Your hospice care team includes Medical Director Registered Nurses Certified Nursing Aides Medical Social Workers Chaplains Registered Dietitians Trained Volunteers

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Feelings of grief can take on many forms and can occur in reaction to many situations, including the death of a loved one or a medical diagnosis for yourself or someone close to you. It is important to remember that this reaction is entirely natural, and many people who experience grief find outside help to be a valuable part of the healing process. Below is a list of both local and national grief and bereavement resources for all ages and specificities. If you or someone you know is experiencing grief, the trained professionals below are here to help. Solace Tree Support groups for children and teens (ages 3 to 18), young adults and their family members. For more information visits solacetree.org/grief-programs or call 775-324-7723. Healing Minds Counseling services for those coping with the loss of a loved one or major life change. For more information visit healingminds.com/grief-counseling-reno-nv or call 775-448-9760. Circle of Life Hospice Support groups open to the community held the first and third Tuesday of every month. Fore more information visits colhospice.com/bereavement-and-spiritual-care or call 775-827-2298. Summit View Hospice Grief and bereavement support open to the community-groups, memorials and by mail. For more information visit summitviewhospice.com or call 775-636-9598. The Compassionate Friends Monthly support group on the second Monday of each month for families after a child dies. Fore more information visit facebook.com/TheCompassionateFriendsofReno, compassionatefriends.org or call 775-750-7005. Healing for Survivors of Suicide Links and resources for those who have lost a loved one to suicide. For more information visit survivingsuicide.com GriefShare Grief recovery support groups meeting weekly both in-person and online with options in Reno/Sparks, Carson City and rural cities. For more information www.griefshare.org National Alliance for Grieving Children Resources for parents and caregivers to help children navigate the challenges of bereavement and grow into healthy adults. For more information visit nacg.org/resources-and-support/ Mourning Hope Grief Center Grief support groups, counseling, resources and COVID-19 support for children, adults and families before and after a death loss. For more information visit mourninghope.org Crisis Support Services of Nevada 24/7, free, confidential and caring support to people in crisis across Nevada and the U.S. For more information visit cssnv.org, call 775-784-8090 or text CARE to 839863 National Alliance on Mental Illness-Warmline A stigma-free, non-crisis phone service you can call or text that is staffed by trained peers in recovery. For more information visit namiwesternnevada.org/resources/ or call 775-241-4212. Vitas Healthcare Grief and bereavement resources and support groups both virtual and phone-in. For more information visit vitas.com/family-and-caregiver-support or call 866-489-0583. St. Mary’s - Hospice We Promise Resources on grief for all groups including children to adults, trauma, caregivers and more. For more information visit hospicewepromise.com/topics/grief or call 775-525-6700. Mountain View Mortuary Grief support and tools available to assist you in your healing journey including “365 Days of Healing” email list for daily support and comfort. For more information visit mountainviewmortuary.net/resources/grief-support or call 775-788-2199 Sesame Street – Helping Kids Grieve Discover games, videos and more on topics important to you and your child. For more information visit sesamestreetincommunities.org/topics/grie Trauma Intervention Program-Northern NV A national non-profit organization of volunteers dedicated to ensuring those emotionally traumatized receive assistance. For more information visit tipnnv.org/about-tip/resources Pregnancy & Infant Loss Support Organization A non-profit organization dedicated to the support of families who have lost a baby through miscarriage, stillbirth or neonatal death. For more information visit pilsos.org Caring Info A program of the National Hospice & Palliative Care Organization providing free resources to help people make decisions about end-of-life. For more information visit nhpco.org/patients-and-caregivers/

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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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Although going to the bathroom is not a typical conversation among women and their doctors, it’s an important one. It is a topic you may want to discuss with a urogynecologist, a physician who diagnoses, manages and treats pelvic health conditions in women. Kerac Falk, MD, a urogynecologist and assistant professor at the University of Nevada, Reno and Renown Health discusses overactive bladder in women and how to treat it. According to the National Institutes of Health, about 1 in 4 women struggle with pelvic health conditions, with over 40 percent of women over age 60 experiencing problems. While these conditions may be common, they shouldn’t just be accepted as a normal part of getting older. In fact, many women don’t think of urine leakage as a medical problem, and only 1 in 3 women with incontinence seek care. So, while these conditions may be common, they shouldn’t just be accepted as a normal part of getting older. There are excellent treatment options that can significantly improve the quality of life. Overactive Bladder Symptoms in Women: As your body changes and ages, so does your pelvic health. Whether you just had a baby, are experiencing urgency issues or find you cannot go about your daily routine, sneeze or laugh without leaking urine – you’re not alone. An overactive bladder, also known as OAB, is more than feeling an urgent need to go to the bathroom. It can also include the following: Incontinence or lack of control over urination Waking up in the middle of the night to empty your bladder Going to the bathroom often, even every 30 to 60 minutes Symptoms of OAB can lead to a decreased quality of life, feeling as if you cannot go about your normal daily routine, or even become hazardous, increasing the risk of trips, falls, and bone fractures. Various Treatments are Available: Behavioral management (eliminating coffee, soda and alcohol which irritate your bladder) Pelvic floor physical therapy to optimize nerve and muscular function and coordination to prevent leakage Medications including tablets and local estrogen replacement Pelvic nerve stimulation and reprogramming treatments Botox to relax the bladder muscle Solutions for an Overactive Bladder: Simply put, OAB is a nerve and muscle problem, so the bladder needs to calm down. Although there is no underlying reason for OAB, some underlying conditions may exist, such as: High blood pressure Recent trauma Neurological conditions (such as stroke and multiple sclerosis) Lifestyle and non-invasive measures can usually reduce symptoms by as much as 50%, significantly improving quality of life. However, if these measures do not help your OAB, further bladder testing may be needed. Dr. Falk notes that “every patient has a unique situation and set of symptoms. My job as a urogynecologist and pelvic floor subspecialist is to work as a team with each individual to figure out what’s going on and design the best treatment approach that fits your needs and goals, whether that is conservative or with more advanced procedures. The outcome we are working towards is improved quality of life.” If you are bothered by your bladder, the best thing you can do is bring this up with your primary care doctor or gynecologist to begin to discuss solutions

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A mammogram may not be on the top of your to-do list when you turn 40, but it needs to be. The American College of Obstetrics and Gynecology recommends a first mammogram at age 40, however you may need one earlier, so talk with your provider about your breast cancer risk. The purpose of a first time or baseline breast screening, is to get an accurate image of your breasts for future comparisons. Amber Snow, Supervisor of Renown Health Imaging, tells us why it’s important to get a baseline mammogram and what to expect during your visit. Mammogram Screenings Save Lives Simply put, a mammogram is a low-dose x-ray image of your breast from two views: top to bottom and side to side. A yearly screening reduces your risk of dying from breast cancer. Mammograms can detect signs of breast cancer even before you can see or feel it. That’s why it’s important to get a first- time mammogram. About 85% of breast cancers happen to those with no family history of it and in the U.S., one in eight women will develop breast cancer. Unfortunately, the two main risk factors for breast cancer: being female and aging. “Your baseline screening is important when you’re young, so that we know when changes occur,” explains Snow. “We compare your current mammogram to all your previous ones to know if anything changes year to year.” If you are under 40, talk to your provider about getting a formal risk assessment to see if a screening is right for you. If you have a family history of breast cancer a mammogram before age 40 or additional testing may be recommended for you. 3D Mammogram Technology Renown Health uses the latest 3D mammogram technology allowing our radiologists to see early changes in your breast tissue. This also reduces the number of false readings compared to traditional mammograms. While breast screening technology has improved, it is not uncommon to get called back after your first mammogram. According to the American Cancer Society, fewer than 10% of women called back for further testing have been found to have cancer. Reasons for being called back for further imaging include: Dense breast tissue, which can make it hard to see tumors A cyst, mass or unusual tissue is seen A possible area of concern needing another, closer look Preparing for Your Mammogram For an accurate image of your breasts do not wear deodorant, powders or lotions, as they can make it difficult to read your breast images. This is what will happen during your breast screening: A gown will be given to you and you will go to a private area to undress from the waist up, putting on the gown. You will then be escorted to the imaging room and a care team member will place one of your breasts between two plates. The plates will flatten to allow the most breast tissue to be seen and you will feel a firm pressure. You will be asked to hold your breath while the image is taken. An adjustment will be made to the plates to get a side view of the breast. The plate adjustments and images will be done on your other breast. Typically, a mammogram appointment is quick – only lasting about 15 minutes. Be Your Breast Friend While breast screenings are important, it’s also key that you know how your breasts normally look and feel. A monthly self-exam to check for lumps is essential, as breast cancers are often found during a routine self-exam. Remember your hormone levels change monthly, with your breast feeling tender and swollen right before your period. It’s best to perform a breast exam the week after your period after the swelling is gone. To avoid breast tenderness, this is also the best time for a mammogram.

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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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Parents welcoming their new bundles of joy into the world might be overcome with emotions. They're exhausted yet excited to meet their new baby and hold them in their arms. That’s where Renown Health’s Labor & Delivery (L&D) department comes in. When patients arrive at the L&D unit in Renown Regional Medical Center, they are embraced with caring, compassionate nurses, surgical technicians and physicians ready to serve their family. As they get ready for the big moment in their private L&D room or family suite, you can be certain that you, they can be certain that they will receive the excellent care they deserve. Unpredictable, but Never Unprepared  Ushering in new life can bring a lot of surprises for parents, but the L&D department is prepared for any challenge. Whether the unit is helping with a routine or high-risk delivery, every patient and newborn are treated with personalized care that is uniquely tailored to their own individual needs and birth preferences, from labor evaluation and birth to post-birth lactation consultation and navigating the nursery.  “Our floor is never predictable,” said Bri Goode, Renown L&D nurse. “Our nurses and our staff work as a team to ensure the best care for our patients. I commonly say that we are all 'nurses’ for each patient!”  The state-of-the-art technology at their fingertips – including advanced 3D ultrasound machines – coupled with the love and passion the team has for their patients allows them to create an optimal environment for every mother and baby. The unit is also equipped with a Labor Assessment Area, where expectant mothers are evaluated to determine what stage of labor they are in, removing the guesswork and allowing providers to treat the patient and unborn child more efficiently and meet them exactly where they are at in the labor process.  Nothing can replace the careful guidance and words of encouragement a patient needs in the delivery room. The L&D department are true patient advocates and firmly believe in the power of listening and the power of staying calm and collected.  “To help our patients and ease their fears and anxieties, we always ensure them that our biggest goal is to have a healthy mom and healthy baby,” said Lindsay Strowmatt, Renown L&D nurse. “We constantly reinforce that they are strong and capable. Empowerment goes a long way!”  “We always take the time to actually sit down and listen to the patient, no matter how busy we are,” added Krystie Mortensen, Renown L&D nurse and DAISY Award winner. “It’s important for us to understand where their nerves are stemming from and address any changes in plan of care along the way.”  While the L&D unit is seen as a “happy place,” as described repeatedly by the members of the team, a seemingly low-risk patient can also turn into an emergency in a matter of seconds.   "Our line of work can involve high-stakes emergency care,” said April Tucker, Renown L&D nurse. “We view change as a necessary part of growth, and we save lives.”  These steps result in high patient outcome scores, which can be attributed directly to the unit.  “We have continually great outcomes from hard work and consistency in care,” said Roya Galata, Renown L&D nurse and Nursing Organizations Alliance (NOA) Lifetime Achievement awardee. “I have tremendous love for my patients and the type of work I do.”  Awards Without End  With patient safety and experience always top of mind, and with the team continually going above and beyond for all parents and their newborns, it’s no wonder why the L&D department has achieved a long and growing list of both local and national awards and accolades.   This year, U.S. News & World Report ranked the L&D unit at Renown Regional as "High Performing in Maternity Care – Uncomplicated Pregnancy.” This award is only the latest in this department’s “Best Of” accolades list, as the unit also achieved a win as the Best Place to Have a Baby in the 2022 Best of Reno Awards.  Not only is the department continually recognized, but individual team members also receive coveted awards within their professional associations. As previously mentioned, Krystie Mortensen is a DAISY Award winner, which means that she has been recognized for the “super-human work” she has done throughout her career. Additionally, three team members, including Roya Galata, have received NOA awards, celebrating their contributions to the nursing profession as a whole.  Many nurses in this department also choose to pursue lifelong learning by taking advantage of the educational benefits that Renown offers. Several team members have completed their continuing education in midwifery and advanced practice, reaffirming their dedication to delivering healthy babies and helping parents manage their first few days with their newborns.  “The teamwork on this unit is phenomenal, and the energy and commitment that the staff comes in with every single day amazes me,” said Lora Carlson, Renown L&D Manager of Nursing.  Internally, the L&D department loves to show their spirit at Renown. In December, they received the Best Holiday Decoration award during the 2021 holiday season. The team also enjoys participating (and scoring well) in Renown-sponsored Halloween costume contests.  In 2023, the L&D department will only pursue greater heights to continue producing patient outcomes.  A Work Family  “I stay here because this is my family. My work family.”  These strong words were proudly stated by Jeanne Bufkin, Renown L&D Surgical Technician, and echoed by virtually every L&D employee. Having each other’s backs during both times of need and times of celebration is a must in this department, and they do so proudly.  “Our staff constantly back each other up,” added Lora Carlson. “They display a lot of adaptability and flexibility. That’s why our unit functions as well as it does.”  Several team members in this department experienced the care of the L&D unit at Renown before they became fully-fledged employees.  “I had two of my babies here and had wonderful experiences both times,” said Judy McBride, Unit Clerk. “I love being a part of the reason why the next woman can say the same!”  Bri Goode also delivered her child at Renown and loved her experience so much that she was also inspired to join the team. “I chose to work at Renown because when I had such a positive experience during my delivery while I was in nursing school, I knew it was a team I wanted to be a part of.”  Coming to Renown was clearly an easy decision for this team; staying at Renown is even easier.  “I stay here because I love what I do and who I do it with,” said Judy McBride. “I truly feel like I am treated as an asset to this department, and it makes me want to come to work every day and make a difference in these mothers’ lives.”  The closeness of this department and the top-of-the-line collaboration displayed by every provider can be felt by the patients during their entire stay at Renown.   “We have an amazing collaborative team of physicians, nurses, scrub techs, unit clerks, patient access representatives and environmental services personnel that strive to provide our patients with the best possible care,” said April Tucker.  The labor and delivery process is a team effort – and those interested in jumping in on this team effort are welcome to join. Delivering healthy babies and supporting new mothers are cornerstone acts in meeting Renown’s mission of making a genuine difference in the communities we serve. Our L&D department does precisely this and more, never giving up in Fighting the Good Fight.

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