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Embarking on the path to bariatric surgery is a unique and deeply personal journey. Individuals like Mary Escobar choose this life-changing route for reasons ranging from improved cardiovascular health to managing diabetes or finding relief from various health complications. In Mary's case, her two-decade-long healthcare journey not only underscores the challenges she faced but also highlights the support and expertise that ultimately led to her successful transformation through bariatric surgery. Mary's Resilience: December 2002 through February 2003 More than two decades ago, Mary experienced unforeseen health complications just days after giving birth via c-section. Septic shock, hemolytic uremic syndrome, thrombocytopenia, renal failure and a blood clot in her lung plunged her into a critical state. Intensive care, plasma exchange and a long recovery followed. After being discharged with compromised kidney function, Mary faced complete renal failure two years later, leading to dialysis and a spot on the donor list. Mary's brother, a perfect match, selflessly donated his kidney on Dec. 14, 2007, marking a turning point in Mary's health. However, the post-transplant period brought new challenges, including diabetes, high blood pressure and a significant weight gain, reaching 230 pounds. Determined to regain control, Mary explored various diets without success until she consulted with a bariatric doctor. Journey to Bariatric Surgery: November 2009 - April 2021 In November 2009, Mary opted for a gastric band, shedding 40 pounds within a year. Despite initial success, issues with the gastric band arose, prompting a consultation with Dr. John Ganser at Renown Health in April 2021. Together, they decided to transition to a gastric sleeve, with comprehensive education provided to ensure long-term success.

Read More About A Transformative Journey: Mary's Bariatric Surgery Story at Renown Health

Carrie Hintz is constantly on the move. “I don’t sit well,” she said when discussing her career as an Emergency Room nurse at Renown South Meadows Medical Center. She has also earned a PhD in nursing research, a Nurse Executive DNP and an MSN in nursing and healthcare leadership, all while managing the joyful chaos of raising two toddlers under the age of four. She's always been on the move, but her journey to transformation through bariatric surgery with the da Vinci Surgical System is a testament to her determination and the vital need for cutting-edge robotic surgical tools at Renown Health. Carrie's life is non-stop, but her struggle with weight loss was a persistent challenge, compounded by the complexities of medical conditions like PCOS and a pituitary tumor, both of which made losing weight an uphill battle. It was while reading the news one night, witnessing a mother's disappointment at Disney Land due to weight restrictions, that Carrie decided to take charge of her life. She knew she had to make a change. In 2016, Carrie embarked on her bariatric surgery journey, seeking consultation with a Renown surgeon. However, her dreams of starting a family prompted her and her supportive husband to postpone surgery since one cannot have a baby within 18 months of the procedure. After welcoming two beautiful children into their lives, Carrie returned to Renown in 2022 to discuss her surgical options. Finally, in February 2023, and after six months of mandatory weight loss preparation, Carrie was ready to undergo the life-changing surgery. Dr. Alexander Ayzengart, her dedicated surgeon, had a plan that involved utilizing the da Vinci Surgical System for her bariatric procedure, coupled with repairing a hernia that had developed during her weight loss journey. The stage was finally set for Carrie's transformation. To everyone's surprise, the hernia turned out to be larger than anticipated, but miraculously, Carrie experienced no post-operative pain and minimal scarring. She reminisces about her early post-surgery days, confidently attributing her excellent outcomes to the remarkable da Vinci Surgical System. “I was up and walking around the night after the surgery,” she said. The da Vinci is no ordinary surgical tool; it's a state-of-the-art, minimally invasive robotic system skillfully operated by trained surgeons. Renown's commitment to innovation in healthcare paved the way for Carrie's remarkable journey.

Read More About A Journey of Transformation Through Robotic Surgery at Renown Health

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

Read More About A Therapist's Tips to Prevent and Manage Osteoporosis

The title of “largest nursing specialty in the country” belongs to medical-surgical nursing (commonly known as “med-surg”). Devoted to providing care for patients with a variety of health conditions and who are preparing for or recovering from surgery, this ever-popular nursing niche attracts impassioned, talented individuals who make a genuine difference in the health and well-being of every patient.  Med-surg nurses at Renown Health emulate this dedication and more. From general surgery to oncology and orthopedics, the med-surg team at Renown Regional Medical Center and Renown South Meadows Medical Center play a critical role in our care delivery for patients facing challenging diagnoses or procedures. Their ability to seamlessly juggle multiple tasks while providing the highest quality of care makes them excellent patient advocates, guiding them through the path to healing.  High-Paced with High Results Our med-surg team has the ability and willingness to provide high-caliber nursing for patients with virtually any medical condition – orthopedic injury, trauma surgery, infections, sepsis, pulmonary disease, you name it. No matter the diagnosis or procedure, med-surg has the experience and enthusiasm to handle the fast nature of the job well. Med-surg nurses are always on the go, handling a growing list of conditions together as a team. They work side by side to assess each patient’s condition and assist with both education and discharge planning for patients and families. “Med-surg is a high-paced and unpredictable environment with the largest variety of diagnoses and patient populations,” said Danyel Gish, Manager of Nursing at Renown Regional. “Every patient is everyone’s patient in med-surg. We help each other by answering each other’s call lights, communicate clear expectations and build strong trusting relationships with one another.”  “You never know what kind of disease or conditions your patient may present with,” added Brittani Manatt, Registered Nurse in the Cancer Nursing Unit at Renown Regional. “We care for patients with almost any medical diagnosis.”  Being admitted to the hospital, regardless of the reason, can be a scary and vulnerable time for anyone. However, patients can breathe a sigh of relief knowing that their competent and confident med-surg nurses are here by their side before and after they experience surgery or treatment.  “We communicate with our patients at every step of their care journey to ensure they understand what is going on and help alleviate any fears or concerns,” said Jenni Gilligan, Associate Nurse Manager at Renown South Meadows. “Some of my tips include asking the patient how they are feeling and validating those feelings; getting them and their families and friends involved in the process; and ensuring them that we are here for them and will take the best possible care of them."  “What we do as a team to reduce patients’ fears revolves around clear communication and support, whether it’s grabbing them a Starbucks drink, taking them outside for a walk or simply just listening to their concerns,” added Rose Simonian, Supervisor of Clinical Nursing at Renown Regional. “Connecting with our patients through kindness and laughter helps alleviate some of the anxiety that comes with being in the hospital.”  Jenni and Rose are exactly right – that clear communication is the “secret sauce” to success within the med-surg team. Their patients are the direct beneficiaries of this crucial skill.  “Everything we do throughout our shift focuses on teamwork and communication, making sure every piece of our plan comes together for optimal patient care,” said Cristina Vazquez, Registered Nurse at Renown Regional.  “We collaborate a lot within each healthcare team,” added Reena Clark, Registered Nurse at Renown South Meadows. “We also make sure the patients participate and are involved in their plan of care. This is important to set a common goal and help each other achieve that goal for the patient. The nurses on the floor are the eyes, ears and hands of inpatient care."  When faced with a daunting diagnosis or procedure, it’s important to have a strong support system within your personal care team, cheering you on every step of the way. Our med-surg team members are masters at this, finding new ways to connect with patients and help them feel empowered to Fight the Good Fight.  “We always try to find something that the patient loves or is passionate about that helps shift their mindset,” said Paola Espinoza-Patino, Associate Nurse Manager in the Cancer Nursing Unit at Renown Regional. “It will help them focus their attention on something that brings them joy, even if it’s for a short period of time. This helps them let their guard down and trust the team. We are here to take the best care of them as possible.”  "Med-surg provides a safe place to openly discuss any fears or anxieties a patient may be experiencing,” added Danyel Gish. “Our nurses are kind, compassionate and highly-trained professionals that work hand-in-hand with our patients to maintain their safety and wellness. We understand that being in the hospital can be a difficult experience, but we work hard to provide a calming presence and reassurance. We identify different ways to connect with our patients by holding their hands, listening, educating and providing individualized care and interventions.”  Much like many other departments across Renown, for med-surg, their patients’ accomplishments are their accomplishments. Witnessing one of their patients reach a significant milestone in their healthcare journey inspires them to continue doing what they do best: provide care driven by equal parts determination and hope.  “The biggest accomplishment for me is seeing a patient complete their last round of chemotherapy with us and getting to ring our ‘Chemo Bell,’” added Trevor Owens, Unit Clerk at the William N. Pennington Cancer Institute. “There is no greater joy than witnessing the happiness and relief of a patient completing a step in their healthcare journey."  Working tirelessly to provide exceptional care to every patient – and celebrating all their wins along the way – alongside their dedication to Renown’s cultural commitments of Caring and Collaboration are what make our med-surg nurses prosper day-in, day-out.

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As many nurses can attest, the journey they have taken to arrive at where they are today is full of twists and turns. For Zarah Jayco, an operating room nurse at Renown Regional Medical Center, her journey is nothing short of a fulfilling and exciting one. Zarah is no stranger to taking detours to find what truly makes her feel the bursts of passion she had been looking for her entire life. She found that passion in the operating room – and travel nursing led her to Renown Health. Today, she is a firm believer that she is exactly where she is supposed to be.  “I Just Want to Help People”  Throughout her life, Zarah knew she was destined for a meaningful career – but didn’t exactly know what. One day, she sat down with her mom, a nurse herself, where she asked the question that would ignite Zarah’s curiosity: What is important to you?  “That’s when I told my mom: ‘honestly, I just want to help people.’”  It was at that moment that she realized nursing could be a fit for her. Everything about venturing into the nursing field started to make sense.  So, that’s precisely what she did. Zarah went to nursing school. When she stepped into the OR during her clinical rotation, she was immediately inspired.  Zarah’s core values as a nurse were rooted from caring for her 90-year-old grandmother while she was in hospice. Her grandmother gave her some powerful lessons and words as she set off on her career: “You are in the right place.”  Upon completion of her perioperative program, Zarah the OR Nurse we know and love started her journey. She began her trek as a travel nurse, going up and down California to do exactly what she was meant to do: care for surgical patients.  “I Traded the Ocean Waves for the Mountains”  As Zarah continued to travel and find different locations for new assignments, her husband received an opportunity for work to transfer to the Biggest Little City. The duo packed up their California lives and moved to northern Nevada, where Zarah signed up for a night shift OR nurse position at Renown Regional Medical Center.  But the traveler’s mindset wouldn’t last long.  Renown embraced Zarah with open arms, and she was immediately drawn into the community-feel that our health system offered. She felt welcomed and surrounded by “loving, hardworking people” across her department and all other teams she encountered.  As Renown cares for patients across 100,000 square miles, Zarah was especially impressed with how rooted Renown is in northern Nevada, noting how it “truly feels like we are caring for the community” with our health system’s wide reach. She was inspired to live up to that mission and more.  “Reno and Renown really reeled me in, and I fell in love with the city and everything it has to offer,” said Zarah. “I traded the ocean waves for the mountains, and the more we got to know Reno, the more we realized that this change of pace and lifestyle was definitely a good fit for us.”  Zarah the OR Travel Nurse became Zarah the Renown OR Core Staff Charge Nurse. And she knew she made the right decision.  Working in the OR, according to Zarah, is challenging in the best way possible. At night, all surgery cases at Renown are emergencies. The team springs into action to answer one vital question: How do we provide the best care for this patient?  “It is essential for us to anticipate potential outcomes,” said Zarah. “When we book a surgical case, we look at everything to make sure we are absolutely prepared and ready.”  Staying at Renown was an easy choice for Zarah. To her, there is nothing like being a part of a core team that inspires her every day and ‘has each others’ back,’” Zarah stated. “During the course of my assignment at Renown, the culture harnessed a kind of environment that felt like a hardworking family. This was the hook that reeled me into considering being part of core staff. I am incredibly grateful for the opportunity to build relationships that I hold in the highest esteem.”

Read More About Zarah Path from Traveler to OR Nurse

Heading into surgery of any kind can bring along feelings of intimidation. With a best-in-class surgery team at Renown Health, patients rest assured that they are in the most capable hands for their entire procedure from start to finish – and while the physical preparation is vital, mental and emotional preparation is equally as important to ensure each patient has a smooth and comfortable experience. The Surgical Preadmission department (a.k.a. “preadmit”) at Renown Regional Medical Center and Renown South Meadows Medical Center is a dynamic and compassionate group of nurses, case managers, chart managers and more who are dedicated to guiding each patient through the surgical process. With extensive knowledge and expertise under their belt, the teams are equipped to make a genuine difference in the health and well-being of all patients, for all surgeries, at all times of the year. Surgery Starting Ground The Surgical Preadmission teams are crucial aspects in the successful outcome of every surgical procedure. Comprised of skilled healthcare professionals, this department is dedicated to providing comprehensive support and care before heading into the pre-operating room. “Our job is to prepare every patient for surgery, make sure all their pre-surgery testing is done, ensure they understand their fasting and medication instructions, have had their questions answered, have a ride home and know what to expect during surgery and after so their recovery can go smoothly and without complications,” said Debra Bennett, RN, Supervisor of Surgical Preadmission at Renown Regional. “Each patient is unique, so each experience is different.” Our preadmit nurses are the masters of communication, directing thorough assessments – including medications, tests and clearances – and addressing any questions or concerns patients may have, never missing the opportunity to inform them of exactly what they will expect in surgery. “I do a complete history on every patient while giving them detailed pre-operating instructions and helping them answer any questions to the best of my ability,” said Nancy Hilts, Surgical Preadmission RN at Renown Regional. “I am proud to be able to help allay their fears and concerns using my 30 years of pre-op experience. I offer an avenue for them to feel comfortable opening up to me.” “We always tell patients that they have great surgeons and a fantastic team that will be watching over them and taking care of them every step of the way,” added Jon Capallupo, Surgical Preadmission RN at Renown South Meadows. “We also give them plenty of educational handouts and video content, in addition to verbal instruction, to ensure they are as prepared as possible.” The nurses then pass the reigns onto the chart managers, who prepare the charts for surgery and ensure all documentation is up-to-date before sending them to the pre-operative team. The expert surgical case managers also step in to prepare a thorough discharge plan, along with reviewing pre-operation orders for status, consent, codes and more. The team does several of these initial visits virtually, and they are looking forward to soon phasing all preadmit case manager preliminary visits into a virtual model. From assisting the pre-op and post-anesthesia care unit (PACU) teams with discharge planning concerns to helping on the outpatient side with anything from oxygen equipment and catheters to transportation issues and those experiencing homelessness, our pre-admit case managers are always up to the challenge. "We are true patient advocates, alleviating concerns and fears along the way,” said Mary Carl, RN, Case Manager at Renown Regional. “Just to name a few things we do on a daily basis, we see our total joint and non-weight bearing patients during their preadmission appointment, so they are aware of the medical equipment they need and if it is covered by insurance; provide education for Aspira catheters and gastrostomy tubes; advocate to ensure tube feeding and dressing changes are set up for hospice and home health patients; and escalate concerns of patient safety to ensure a safe discharge.” In the midst of it all, there is never a dull moment in the preadmit teams. At Renown Regional alone, the preadmit professionals see more than 1,600 patients a month – and each one has a hyper-personalized experience with their very own preadmit team. “Many times, we are the first impression a patient has on our organization; after all, we touch more than 97 percent of patients that are scheduled for surgery, cardiac catheterization lab procedures or interventional radiology,” said Amy Schler, Surgical Preadmission RN at Renown Regional. “We also collaborate with many other departments in the hospital as well, from surgeons and anesthesiologists to case managers and nurse navigators. Our work in preadmit impacts the entire surgical process.” Holding a diverse array of experiences, our preadmit department plays an integral role in our commitment to providing the highest quality of care to every patient. Knowledge is Power Heading into surgery feeling fearful and worried is normal for any patient. However, how would you feel knowing that each individual member on your preadmit team has, on average, 23-25 years of experience in the field? This is the reality for our Surgical Preadmission department – and they put that vast knowledge to great use to bring a sense of calm to patients. “Our team members have worked in various departments within our organization, and they bring a wealth of knowledge that we share with each other, and most importantly, with our patients,” said Amy Schler, RN. “If you have hundreds of years of nursing experience, you can speak not only as a nurse but also as a patient. It allows you to give a more personal perspective on what patients can expect in their recovery. Being able to assess their emotions and provide feedback to our pre-op and PACU teams help the patient have a better experience.” “Many of our nurses have close to 40 years of experience each, and they have an extremely large knowledge base since we see patients from newborn to geriatric and from easy procedures to complex surgeries,” added Debra Bennett, RN. “Another great aspect of our team is the varied nursing backgrounds we all hold – surgery, pre- and post-op, labor and delivery, pediatric intensive care, cardiology, gastroenterology, urology, cardiac cath lab, home health and everything in between. Communication between departments is so important!” All members in this department, regardless of which clinical area they came from, surgical or non-surgical, can easily translate their skills into the work they do in preadmit – and they only continue to grow. “As a surgical preadmission nurse, I have used my years of experience as a nurse in surgical services,” said Terri Delatorre, Surgical Preadmission RN at Renown Regional. “I started as a floor nurse with orthopedics for 12 years, and then I worked with the PACU for 11 years. This has helped me give great understanding and care to our surgical patients.” “Because we have staff with such a vast knowledge base, we can rely on our years of working within our organization to help alleviate fears that the patient may have,” added Amy Schler, RN. We can prepare them for what to expect in pre-op and PACU and educate them on what to expect post-op, including any barriers they may face. For example, mastectomy patients may not realize they will not be able to raise their arms for 7-10 days post-op, and total knee patients have to navigate stairs and housing access. Helping patients think about barriers at home that they may not have thought about helps them prepare prior to surgery, enhances their healing and provides a better surgical experience.” The preadmit team works closely with our best-in-class surgeons and anesthesiologists, continuing to grow their expertise along the way while learning alongside our talented providers. For instance, when it comes to our Renown South Meadows preadmit department, anesthesiologist Nariman Rahimzadeh, MD provides excellent guidance for the entire team on state-of-the-art anesthesiology practices. “I am very proud of the work we do with Dr. Rahimzadeh,” said Lisa Closson, Surgical Preadmission RN at Renown South Meadows. “Together, we ensure patients are safe for both surgery and anesthesia.” Despite the challenges that come their way – whether it be changes to process and workflow to navigating support for patients after they leave the surgery floor – the preadmit team cleverly uses their collective wealth of knowledge to bring hope and comfort to all patients. “Our nurses are such warm, caring and compassionate humans that do their best to ease any fears and anxieties patients may have,” said Debra Bennett, RN. The Pride of Preadmission The pride of our preadmit team lies in their ability to make a positive impact on all patients they serve. To them, their work is not just a job – it's a calling. And they do it all while working together to elevate their team and performance. “Our team is most proud of the quality of care we provide to our patients and our abilities to troubleshoot difficult situations to ensure they have a great surgical experience here at Renown,” said Mary Carl, RN. The entire department supports each other by working collaboratively and relying on each other’s expertise to provide the best possible care for patients. They understand that their success as a team depends on their abilities to support and help each other. “Our team is awesome here at South Meadows,” said Jon Capallupo, RN. “We can turn to each other for support, and we all work very well with each other. I am glad to be a part of this team.” “I am proud of how well all of us in preadmit works with each other every day,” added Lisa Closson, RN. “We try to make patients feel comfortable from the moment they arrive to the time they leave the department.” The pride that our preadmit team expends goes beyond their departmental limits – these team members are also trusted teachers. They work closely with cancer nurse navigators to teach weekly classes for patients who have been newly diagnosed with breast cancer, coupled with lymphedema prevention and education classes. The team also encourages participation in Renown’s free smoking cessation programs to help their patients learn the risks and benefits of quitting smoking. When not serving patients or teaching classes, you can find many of these team members taking charge of multidisciplinary committees within our health system, including breast leadership, gastroenterology leadership, shared governance, infection control and recruitment and retention. On top of it all, this team certainly knows how to celebrate, with several of their members being a part of their own department-wide Celebration Committee, where they gather for retirement parties, baby showers and team get-togethers. Always active and never passing up a challenge, our preadmit department are shining examples of Renown’s Culture Commitments, especially Caring and Collaboration, and the pride in the vital work they do every day is limitless. “I am so happy my position in preadmit opened up for me at a time when I was really feeling challenged in my career,” said Nancy Hilts, RN. “The team that we have here is amazing. I am so grateful and thankful every day for the opportunity. It is an amazing place to work!”

Read More About Department Spotlight: Surgical Preadmission

Whether it’s cross-country or downhill skiing, snowboarding or snowshoeing, your off-season preparation is vital to an injury-free and healthy experience once the snow starts to fall. We’ve got you covered with expert tips that will make you the king or queen of the hill. Millions of skiers and snowboarders hit the slopes annually. So whether you’re a weekend warrior or stay active year-round, you need to prepare your body for the demands of your favorite winter sport to avoid minor aches, pains or even severe injury. Count on two to three weeks for your body to adapt to the physical challenges ahead if you’re active. Otherwise, give yourself a minimum of six weeks to gear up for the snow. Ready to shred? Here are some conditioning tips to help put you on the path to a fun, successful winter season. 1. Start With Cardio Cardiovascular exercise increases endurance as it conditions the heart, lungs and muscles and provides a solid foundation for other forms of exercise. And when you live and play at altitude, you need even more endurance. “Research shows that our maximum heart rate, cardiac output and ability to exercise are suppressed at altitudes over 5,000 feet,” explains Daniel Staffa, PT, DPT, OCS, of Renown Rehabilitation Hospital. “In the Reno-Tahoe area, altitudes can quickly rise over 8,000 feet when we exercise in the Sierras, so it’s critical to have cardiovascular fitness to avoid associated fatigue and decreased mental alertness on the slopes.” Try this: Pick an aerobic activity you enjoy — speed walking, running, hiking, biking or a cardio machine like the elliptical trainer. Build up to a minimum of 30 minutes, three days a week. 2. Increase Your Strength Your core works overtime to stabilize the body and absorb the shock of pivots and turns and variable snow conditions. Strengthen your core, lower back, hamstrings and calves and you’ll go a long way toward guarding against ligament tears and damage to other joint structures. Stronger muscles will also allow you to relax while maintaining control and making those quick adjustments that uneven terrain demands. Try this: Squats, wall sits and lunges. Work your core and lower and upper extremities with a variation of sit-ups, crunches, back extensions and planks. 3. Integrate Plyometrics Staffa explains that if your legs aren’t used to absorbing the impact of landing, severe injuries can occur. Preempt such trauma with plyometric exercises, or “explosive movements,” that simulate the movements of your favorite sport. You’ll develop greater power in your legs when you combine plyometrics with your strength training. Try this: Incorporate multi-directional drills — such as lateral jumps and forward and backward jumps — on variable surfaces like a trampoline, solid ground, or a box or step. Here’s a challenge for the more advanced: Stand in front of a bench or box (12 inches or so). Jump up and then immediately back down. Do this 10 to 30 seconds at a time, rest and repeat. Or get old school and bust out the jump rope. 4. Improve Your flexibility Flexibility is the ability to move joints through their entire range of motion, from a flexed to an extended position. Being flexible will allow you to pivot, twist and turn and navigate varying snow conditions with ease. You can increase your flexibility while maintaining bone alignment with stretching. Don’t forget to warm up and cool down. Try taking it easy the first 15 minutes of your day on the hill; try starting with a beginner’s run or walk to warm up and prepare your body. Do the same at the end of the day or go for a brisk walk to cool down. Stretching will help return muscles to their normal length. Try this: Dynamic stretches such as leg swings, arm swings and torso twists. Target your quads, hamstrings, calves, and lower back. 5. Fuel for the Hill Staffa suggests loading up on healthy complex carbohydrates the day before you go out and bring along your favorite protein snacks. Assess the slopes before making that first run — is the snow heavy, fresh or wet — and stay mindful of your fatigue level throughout the day. Don’t forget to hydrate and re-hydrate before, during and after exercise. And most important, have fun! Visit Renown Physical Therapy and Rehab for more information. Or call 775-982-5001 to consult with our sports and orthopedic experts who can help you develop an individualized training program in preparation for the winter season, including methods for overcoming previous injuries and limitations.

Read More About 5 Training Tips for an Epic Winter Season

For Michael J. Elliott, MD, a pediatric orthopedic surgeon specializing in scoliosis, it’s just another day helping patients. But to local five-year-old Makenna Christensen, her substantial spine correction is life-changing. Though her journey to body confidence was months in the making, her smiles are a reminder that a thorough, thoughtful treatment plan can yield amazing results. A Surprising Start Words don’t adequately describe the feelings you have when you unexpectedly learn your child has a birth defect. For Nicole and Nick Christensen it was a shocking surprise. During Nicole’s sonogram appointment something unusual was seen. After an amniocentesis, their baby girl was diagnosed with Noonan syndrome, which can affect a child’s height and bones. To prepare, the couple read all they could on the subject. Fortunately their daughter Makenna, was born full term and healthy. Shortly after birth, Makenna had some feeding issues and returned to the hospital. Although they resolved and she had no major complications, both parents felt unsure about their newborn’s future. With the help of Nevada Early Intervention Services , Makenna’s development was monitored until she was three years old. “Her posture has been an issue her whole life,” says Nicole. Nick also noticed when Makenna started walking her range of motion was poor. It was especially noticeable when she got dressed and raised her arms to put on clothing. Nicole observed Makenna was falling a lot in preschool. She asked Makenna’s pediatrician about physical therapy to support her coordination and muscle tone. Although physical therapy was helping Makenna, her therapist suggested Nicole seek the opinion of Dr. Michael Elliott, a pediatric specialist in orthopedics at Renown Children’s Hospital. Scoliosis Casting - A Successful Treatment Approach Dr. Elliott diagnosed Makenna with scoliosis, an abnormal curvature of the spine. While this condition is most common during a teenage growth spurt, it can also happen in early childhood. Affecting about four million people in the United States, it is estimated 20 percent of all spinal deformities in the U.S. are people living with scoliosis. Makenna’s spinal curve was significant – over 30 degrees. Through years of experience Dr. Elliott opted to put Makenna in a spinal cast, instead of multiple surgeries. “My approach is to postpone surgery as long as possible - it is tough for the patient and families,” he says. “Often excellent results can be achieved through non-invasive treatments such as, casting and bracing.” Nicole appreciated Dr. Elliott’s reassurance through the treatment plan. “It was obvious through the X-rays that there was a significant issue,” she shares. “He guided us through the timing and process and how correcting it sooner would help keep her future growth on track.” For seven months Makenna wore a cast that looked like a tank top, bracing her spine while allowing movement. Now she wears a hard plastic brace, specially fitted to her body.  “Kids tolerate casting well,” explains Dr. Elliott.  “It is a 45-minute procedure. The patient sleeps while their spine is put into traction as the cast dries.” She will continue to wear larger braces as she grows, eventually only wearing them at night. A Straight Path into the Future Dr. Elliott admits, “Not every cast is a cure. Two thirds of a child’s spinal growth happens by the age of five. Getting past the five-year mark means fewer surgeries. It’s wonderful to see Makenna’s body image improved.” Nicole agrees, “The way Makenna holds herself is completely different. She’s more confident on her feet and more balanced.” She can now play with her sister Aria, 4, and brother Lexi, 8 months, without the fear of falling. Nick is in awe of the improvements she has made, “Seeing her thrive more has been wonderful.” The Christensen’s are hopeful about the future. “Makenna is doing really good. She’s wearing her hard brace full time and her growth is consistent,” expresses Nicole. “She’s even starting swim lessons this week.” With mask wearing at every doctor visit during the COVID-19 pandemic, Makenna and Dr. Elliott look forward to seeing each other’s smiles in the future. Makenna’s story highlights the over 18 different specialty options for children locally at Renown Children’s Hospital.

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Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis, answers some common questions about bone fractures. Is there a difference between broken bones and fractures? No, these are two different names for the same injury. Of course the common term is a broken bone. Using either name will describe your concerns. Medical personnel typically describe a broken bone as a fracture to a specific bone. For example, a broken wrist is also a fractured distal radius. To clarify, this describes the injured bone and the precise location. How do I know  if my child has broken their bone? Many times children will fall and complain of their arm or leg hurting. In most cases the pain goes away and the child will return to their activities. When there is a deformity to the limb (curve in arm) and the child is complaining of pain, it is probably a fracture. If the arm or leg looks straight, look to see if there is any swelling or bruising. Both are signs of a possible fracture. Finally, if the limb looks normal but the child continues to complain, gently push on the bone. Likewise if it causes the same pain, then they likely have a fracture and should have an x-ray. My child fractured their growth plate, what does this mean? Growth comes from this area of the bone. In detail, these are located all over the body but typically at the end of the bones. With this in mind, fractures to these areas can result in the bone growing abnormally. Because of potential shortening of the arm or leg, or bones growing crooked, it is important to follow fractures closely (up to 1-2 years or longer). It is better to identify a problem early. Small problems can be treated with small surgeries. What if the bones of the x-ray do not line up? Because children are growing, unlike adults, their bones will remodel and straighten with growth. The amount of remodeling occurring depends on a child’s age, the bone fractured and the location. In many cases an angled bone will grow straight over the course of a year. For this reason, someone with experience in caring for children needs to follow bone growth. How long does it take fractures to heal? Factors deciding when a cast can come off include: Child’s age. Bone fractured. Fracture location. Young children heal faster than teens, teens heal faster than young adults, who heal faster than older adults. In young children most fractures heal in 4-6 weeks. However, teens generally take 6 weeks to heal, and adults can take much longer. Although your child  is out of their cast, it may not be healed completely to return to all activities. Placing a splint is during this time is common. This typically gives them added protection for several weeks after their cast is removed -  in case they forget their limitations. What if my child is still limping? Whether a child is in a walking or non-weight bearing cast, removing it often leaves them stiff and sore. Therefore many children will walk as though they still have a cast in place. In most cases this resolves in about three weeks. Regardless, if your child is still limping or walking abnormally after three weeks, contact the treating doctor. They may benefit from physical therapy or a repeat evaluation.  (This article was original published in the July 2019 issue of South Reno Kids & Sports.)

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A clubfoot is where the foot is turned in on itself and points toward the ground. A clubfoot diagnosis during pregnancy is surprising and challenging during any circumstance. And in the case of parents anticipating surgery during a pandemic, options can be scarce. These parents took a deep breath, and with the help of Michael J. Elliott, MD, pediatric surgeon with Renown Children’s Hospital, their baby is on the road to recovery.

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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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You’ve likely heard about bariatric surgery — and perhaps even have friends who’ve done it. But is it a potential solution for you? Here, Dawn Remme, RN, Metabolic Bariatric Surgery Program Manager, provides insight. You may have been struggling with excess weight for years. You’ve tried high-protein diets, low-carb diets and more. Most patients considering weight loss surgery have tried numerous dieting methods. The truth is, some patients who suffer with obesity are successful dieters. Unfortunately though, excess weigh often returns. This impacts their health and the quality of their life. It can be a disheartening battle. Weight loss surgery is a big decision. In making this decision, keep in mind that surgery is only one step toward your goal of achieving better health. It is neither magic, nor is it the “easy way out.” Weight loss surgery can offer you a TOOL to help you become more successful in controlling the disease of morbid obesity. By combining this tool with a lifelong commitment to important lifestyle changes, medical follow-up and nutritional modifications, you have the potential to become a healthier you. Bariatric Surgery By the Numbers Exploring the facts about obesity, how it impacts your health, and how surgery can resolve or significantly improve your chronic medical conditions is the first step to making a decision. Obesity is medically defined as “excess body fat” and is measured by a mathematical ratio known as the Body Mass Index (BMI). To calculate your BMI, we consider your height, weight, age, gender and body build. Here are the standards: “Normal” BMI: less than 25 Overweight: 25 – 29.9 Obese: BMI of 30 – 39.9 Morbid obesity: BMI of 40 or more Morbid obesity (BMI over 40) is a lifelong, progressive disease, and the prevalence of morbidly obese Americans (100 or more pounds over a healthy weight) is increasing rapidly. According to the CDC, the disease of obesity affects 78 million Americans. Further estimates indicate about 24 million have morbid obesity. Serious medical problems known as co-morbidities often occur when someone is morbidly obese. Studies tell us conditions such as type 2 diabetes, high cholesterol, sleep apnea, high blood pressure and degenerative arthritis increase in severity as the BMI is increasing in patients. When may weight loss surgery be an option? When someone has a BMI greater then 40. If a person’s BMI is 35 – 39.9 and they have significant health problems such as type 2 diabetes, high blood pressure, high cholesterol, sleep apnea, or other diagnosed health conditions related to obesity. Gastric Sleeve, Gastric Bypass Explained To resolve or significantly reduce these health conditions, bariatric surgery can be done when diet and exercise haven’t worked. Weight loss surgery makes changes to your digestive system to help you lose weight. The gastric sleeve limits how much you can eat, whereas gastric bypass limits how much you can eat and reduces the absorption of certain nutrients. Other Benefits of Surgery You can greatly increase life expectancy by resolving or significantly improving conditions like diabetes, high cholesterol, high blood pressure, sleep apnea, and obesity itself. Infertility can also be positively affected. A significant weight loss and relief from serious health conditions and diseases will greatly improve your quality of life. Studies tell us that type 2 diabetes is resolved or significantly improved in 84 percent of patients following bariatric surgery. Cholesterol levels dropped in 95 percent of patients. And hypertension and sleep apnea showed improvement in 68 and 80 percent of patients, respectively, following bariatric surgery. Bariatric Surgery at Renown In making the decision to move forward to better health, it is important to remember: Obesity is a disease, and the desire to have a healthier, longer, more fulfilling life is possible. If you are interested in learning more, please visit the Bariatric Surgery Program page to view more information about Renown Regional Medical Center’s MBSAQIP accredited bariatric program, as well as information about upcoming educational seminars. Or call 775-982-RSVP (7787) to reserve your seat. Learn More

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