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What is Physiatry? Physiatry (fuh·zee·a·tree) encompasses the diagnosis, prevention and treatment of all disabilities related to the brain, nerves, bones and muscles.  The goal is to maximize physical functioning, significantly decrease or eliminate pain, foster independence and improve the quality of life for those with a disability, chronic pain and physical impairments.

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How We Can Help You may benefit from treatment for neuromuscular (nerve, muscle and bone) disorders – that cause pain and impair normal functions. But, first, consult your primary care physician for a referral to Renown Health's Spine, Sport & Pain Management. Dr. Keating, Medical Director and his colleagues, Dr. Su and Dr. Storm, will customize a treatment plan that best suits your needs and lifestyle while providing the most effective care possible. For more information: Call 775-982-3608 | Fax 775-982-8001

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Low back pain is not only a problem most people have at some point in life, but also the leading cause of disability in the U.S. Whether it is a sharp spasm from lifting something heavy or a daily constant ache, there are various treatments available to relieve your pain. Jessica Ryder PT, DPT, cert VRS, with Renown Health Outpatient Therapy, explains some common causes of this pain, how to treat it and ways to prevent pain flare-ups. It’s important to realize most cases of low back pain are short term. Frequently lasting only a few days or weeks. In general these cases leave no long-term damage to the spine, muscles, discs or nerves. “However, it can become episodic or chronic (lasting longer than 12 weeks) if it is not properly understood or managed by the individual, ” cautions Ryder. Causes of Pain Specifically back discomfort can be related to: Wear and tear on the spine due to age or poor movement patterns Injury to spinal discs Sprains (overstretching or tearing of ligaments) and strains (tears in tendons or muscles) Trauma Irregularities of the spine present at birth (example: scoliosis)Notably the above issues may result in a “pinched nerve” or sciatica, causing pain to extend down the leg. Risk Factors for Pain In particular, your chance of developing low back pain increases with the risk factors below: Age Being overweight Low fitness level or occasional physical activity (“weekend warrior”) Family history Pregnancy Poor posture Jobs requiring heavy physical work (landscaping, plumbers, construction, etc.)

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Meet Connor Smith Life was hectic for Connor Smith. He had just finished at the top of his class at both the fire academy and paramedic school and was looking forward to starting work in northern Nevada. It was winter 2019, and he was ready to have some fun. The plan was to ride ATVs at Sand Mountain with his brother Cody, dad Lance and some friends, but a jump would change everything. Connor’s ATV took off but landed awkwardly, and he remembers immediately knowing he was paralyzed. Connor’s mom, Dana Shugar, was at home when she received the upsetting call from Cody, who told her he had an accident. Connor was flown to Renown Regional Medical Center, the area’s only Level II Trauma Center. After a seven-hour emergency surgery, Dana learned that Connor would live but only had a slight chance of walking again due to a spinal fracture. “The surgeon saved his life. It’s amazing how your life can change in a matter of seconds,” she said. Once his condition stabilized, Connor moved to the Renown Rehabilitation Hospital and began physical rehabilitation. “Thank God for the people at rehab,” Dana said. “Dr. Pence, the therapists, nurses and all the employees were a wonderful support system, explaining everything and answering all our questions. The kindness they showed got me through.” Connor agrees, calling the Renown rehab team nothing short of amazing.

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It’s important to be aware of the risk of a concussion, which can have serious health implications. Susan Park, MD, discusses the effects of concussions and how they can be prevented. According to Susan Park, MD, a Renown Medical Group doctor who specializes in sports and family medicine, concussions are a serious issue — especially among children whose developing brains “are more susceptible to brain injury and long-term effects from concussions.” All parents, coaches and athletes, she points out, should be aware of the risks of concussions and take precautions to avoid them. What is a concussion and how does it occur? Dr. Park describes a concussion as a traumatic brain injury resulting from direct or indirect impact to the head or body, during which the brain shakes back and forth in the skull. This may cause some bruising of the brain. In severe cases, traumatic head injuries can cause bleeding, which if not treated quickly, can be fatal. What are the health implications of a concussion? Symptoms of drowsiness and confusion can be a sign of a concussion after a head injury. Some short-term effects may include headaches, dizziness and difficulty concentrating. Long-term concerns can further include mood disorders, sleep disturbance and problems with cognitive function-concentration, which may affect school performance. What sports carry the highest risk of suffering a concussion? Dr. Park notes participation in any impact sport can result in a head injury. But among school-age kids, she treats more concussions from football and soccer than any other sport. However, during the winter months, skiing and snowboarding injuries can be a common cause of concussions Any blow to your head, neck or upper body can result in a concussion with symptoms including, but not limited to, feeling dazed or confused, dizziness, nausea/vomiting or a headache. Initial treatment of concussions varies depending on severity. Rest, avoiding vigorous activity and a reduced school workload help young athletes recover after a concussion. Dr. Park notes that sometimes further imaging and an ER visit will be required. Otherwise, rest from activities is the main treatment, along with not returning to sports activities until further clearance from a healthcare provider.

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To recognize World Lymphedema Day, Katherine Bunker, Physical Therapist and Certified Lymphedema Therapist (PT, DPT, CLT) at Renown, shares her experience helping those with lymphedema and lymphatic disease thrive in their daily lives. Each year, World Lymphedema Day continues to be an advocate-driven celebration and global education opportunity on what it means to live with lymphedema and lymphatic disease. We explore why this cause deserves global recognition each year on March 6 below. Types of Lymphedema Lymphedema is an abnormal collection of protein-rich fluid that causes swelling just beneath the skin. The fluid, which is filtered through the lymph nodes, makes up a network of tissues that help the body get rid of toxins, waste and other unwanted substances. According to Katherine Bunker, PT, DPT, CLT at Renown Health, this collection of fluid causes swelling, usually in the arms or legs, but can happen in other areas too. It can also cause discomfort, restricted movement and may increase the risk of infections.

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Physiatry (fi-zahy-uh-tree), also referred to as physical medicine and rehabilitation, encompasses the diagnosis, prevention and treatment of disabilities or injuries related to the brain, nerves, bones and muscles. The goal of this specialty is to maximize physical functioning, greatly decrease or eliminate pain, foster independence and improve quality of life for those suffering with a disability, chronic pain and physical impairments. Who Is It for? Physiatry can help patients with functional deficits and secondary medical conditions as a result of the following: Amputation Brain Injury Osteoarthritis Spasticity and Movement Disorders Spinal Cord Injury Spine Pain Sports-Related Injuries Stroke Some of these medical conditions can often cause chronic pain or impede physical functioning, ultimately affecting a person’s overall well-being and making it difficult for them to sustain a desired quality of life.

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Being admitted to the hospital is never easy. Being admitted for a traumatic injury can be even harder. Whether it's learning how to walk again or powering through a new speech therapy routine, recovering from an injury that may affect the course of your life can be daunting.  But it doesn’t have to be, thanks to the Acute Care Rehab Therapy team at Renown Health.  The smiling faces of the Acute Care Rehab Therapy team at both Renown Regional Medical Center and Renown South Meadows Medical Center will make you see that there is a light at the end of the tunnel. Your dedicated physical therapists, occupational therapists and speech language pathologists are here to serve you and place you back on the right path to recovery and function.  The Role of Acute Inpatient Therapy  The Acute Care Rehab Therapy team comes in at a critical juncture in a patient’s care process after hospital admission. As one of the primary rehabilitation partners on a care team, these dedicated therapists are here to maximize every patient’s safe and independent living before they set off back home – all while reducing the risk of hospital readmission.  “As physical therapists, we address musculoskeletal deficits and assess a patient’s current function after acute injury or illness from their baseline and develop a plan for functional recovery,” said Kristie Eide-Hughes, Physical Therapist at Renown Regional. “We also use our clinical expertise to assist with the discharge process and make sure each patient has the best durable medical equipment the first time around, removing the guesswork.”   “On the occupational therapy side, we work with patients to facilitate their independence with basic life skills, such as dressing, bathing and using the restroom,” added Jeanne Clinesmith, Occupational Therapist at Renown Regional.  “In the pediatric setting, we help babies and kids get back to what they were doing before they came into the hospital,” continued Rhonda Yeager, Pediatric Occupational Therapist at Renown Regional. “In the NICU specifically, we support the development of babies, trying to prevent problems from worsening. It’s nice to be a source of positivity in an otherwise intimidating situation.”  The role of therapy in this setting reaches all ages, from babies in the neonatal intensive care unit (NICU) to adults approaching end-of-life care. Every therapeutic approach is tailored specifically to each patient.  “Therapy is more of a habilitative approach for infants in the NICU, while it is more of a rehabilitative approach for kids and adults following injury or illness,” said Sara Carolla, Physical Therapist at Renown Regional.   Each team member in the Acute Care Rehab Therapy department is dedicated to each patient, helping them make progress from start to finish and giving them the tools to succeed along the way.  “I enjoy the variety of the patients we get to see and the ability to see them make gains from the wonderful treatment they get in the hospital from my team,” said Kelly Schwarz, Occupational Therapist at Renown South Meadows.  “We provide education as each patient’s acute issues evolve,” added Nicole Leeton, Speech Language Pathologist at Renown Regional. “One of my favorite parts of my work is the patient and family education aspect, and that includes other healthcare provider education as well. It’s a moving picture.”  Moreover, every team member gives each patient tools to learn how to be themselves again and empowers them to continue striving for the best possible result of their therapy  “We get the opportunity to make a person’s bad experience in life better even by spending one session with them, giving them the keys to unlock something that they didn’t think they had the ability to do,” said Dana Robinson, Occupational Therapist at Renown Regional.  On the Road to Independence  Our dedicated therapists in the Acute Care Rehab Therapy team set the stage for a patient’s recovery process after trauma, showing them their potential for independence. With a multitude of patients coming into the hospital with many degrees of medical complexity, each day is different while the end goal is always the same: to optimize function as early as possible while overcoming any barriers and paving the way for a comfortable and effective quality of life.  “Early intervention is a big piece,” said Nicole Leeton. “Us seeing patients early can get them recovered and independent more quickly and help prevent future illness and injuries. For example, in speech therapy, getting in early and facilitating communication skills for patients with impaired speech can make a huge difference.”  Acute Care Rehab therapists dig deeply to see the whole picture of each patient’s situation to foster their independence – their history, social skills, support system and more.  “Sometimes, we are the difference between independence and dependence,” said Dana Robinson. “We are the eyes and ears because we have so much time with the patients. Our team is extremely collaborative and develops a great rapport with patients, so they feel comfortable telling us everything going on with them.”  “For kids, we teach parents ways they can help their kids by setting up their homes and the equipment they need to succeed,” added Rhonda Yeager.  According to the team, one of the biggest keys to independence is repetition. A continual flow of getting up and trying again is crucial for recovery.  “Repetition helps people regain their quality of life back sooner and control their recovery process,” said Megan Hough, Physical Therapist at Renown Health.  “Helping people continue to get stronger and more independent makes my job so rewarding,” added Sam Brown, Physical Therapist at Renown Regional.  Knowing that they have made a difference and help shape a patient’s overall development inspires each therapist to never give up, regardless of how difficult an injury presents. There is no set schedule for recovery, and the therapists are always in the patient’s corner.  “This team has the most passionate, caring and dedicated individuals that I know,” said Kendra Webber, Manager of Acute Inpatient Rehab Therapy Services at Renown Regional. They give 110 percent to every patient every time to ensure they have what they need to regain function and independence.”  “By tailoring therapy to the individual, the bounds are virtually limitless for what we can accomplish,” added Dana Robinson.  It Takes a Village  Since acute inpatient therapy is never a one-size-fits-all approach, it truly takes a village for this team to move the mountains they do for patients every day. These teams are fact-finding masters, gathering all the necessary information from the patient, their family and their care team to figure out their precise needs.  “We are a consistent presence for our patients, identifying a lot of different needs and meeting those needs to help patients grow in their treatment process,” said Kelly Schwarz. “By collaborating with each patient’s diverse care team, we are able to employ the clinical judgment to help patients overcome physical, emotional and environmental struggles and set them up with the proper resources once they leave our setting.”  “Our team has steady communication with physicians, nurses, acute care technicians, respiratory staff, physician assistants, case managers and more to ensure the best possible care,” added Jet Manzi, Physical Therapist at Renown Regional.  Constant communication and collaboration are also necessary beyond the acute treatment process. These skills are vital in order to facilitate discharge planning, and the Acute Care Rehab therapists are an essential resource in the discharge process alongside our Hospital Care Management team.  “Often times, a patient’s family needs a lot of guidance in helping their loved ones determine the next level, and we help them navigate those steps and the resources available to them,” said Mark Stumpf, Occupational Therapist at Renown Regional. “And it’s all a team effort.”  “Our therapists are the most committed, generous, hardworking people,” added Courtney Phillips-Shoda, Supervisor of Rehab Therapy Services at Renown Regional. “Despite being short-staffed, we come to work every single day and give everything to our patients. They are the priority.”  If you take away one thing, know this for certain: Renown’s Acute Care Rehab occupational, speech and physical therapists will always be there to help patients continue on a positive trajectory to physical, mental and emotional recovery.  “Whether you are a patient or a provider, if there is a problem, never hesitate to reach out to us,” said Nicole Leeton. “We are always receptive to anyone seeking our help.”  With the Acute Care Inpatient Therapy team on their side, a patient’s journey to recovery is only just beginning.

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Participating in sports and physical activities is enjoyable and beneficial for our health. However, the risk of injuries comes with the fun and excitement of sports. Sports-related injuries, including sprains, traumatic brain injuries and broken bones, are more common than we realize and can land you in the emergency room. Dr. Scott Shepherd, Emergency Medicine Physician, provides a wealth of information. Traumatic Brain Injuries: The Invisible Threat Traumatic brain injuries come in many forms. From “mild” brain injuries, concussions, to major brain injuries and bleeds. Sometimes it is very difficult to tell the difference between a major injury and a minor injury because many of the symptoms are the same. Concussions Concussions are a type of “mild” traumatic brain injury resulting from a blow to the head or a violent shaking of the body that causes a transient alteration in mental function. They are particularly prevalent in contact sports such as football, soccer and boxing. A concussion can affect memory, judgment, reflexes, speech, balance and muscle coordination. Typically, concussions are not life threatening and usually short lived. However, multiple concussions can lead to permanent disabilities. So, remember there is nothing “mild” about injuring your brain. Contusions The more serious brain injuries from brain contusions (actual bleeding in the brain material) and bleeding that presses on the brain are life threatening. These injuries are caused by the same blow to the head as a concussion and the symptoms are the same from memory deficits, loss of coordination to coma. Because of this, anyone who has a blow to the head and is not acting normal should be evaluated by a medical professional. Anyone suspected of having a severe head injury should seek immediate medical attention and follow a strict protocol for rest and a gradual return to play. It is important to note a person may not lose consciousness if they suffer a concussion; however, major consequences can occur if not properly managed. If you suspect you have an emergency that needs immediate medical attention, please call 911 or visit an emergency room near you. While it is impossible to prevent traumatic brain injuries altogether, the severity of the injury can be mitigated through proper helmet usage and knowing your skill level when participating in high-risk activities. The guidelines for picking a helmet for summer activities such as mountain biking, dirt biking and riding off highway vehicles are similar to those of picking a helmet for winter sports. Learn more about choosing the right helmet. Any blow to your head, neck or upper body can result in a major head injury Signs to watch for include the following: Headache Dizziness Blurred vision Difficulty with thinking, attention or memory Sensitivity to noise or light Ringing in the ears Changes in hearing Double vision Changes in behavior Balance issues Nausea/vomiting   Sprains: The Annoying Twist One of the most common sports injuries is a sprain, which occurs when ligaments that connect bones are stretched or torn. Sprains typically occur in joints, such as the ankle, knee or wrist, and are often caused by sudden twists or impacts. Symptoms may include: Pain Swelling Bruising Limited range of motion Rest, ice, compression and elevation (RICE) are the initial recommended treatment, followed by physical therapy to regain strength and mobility.

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