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Managing lymphedema effectively is essential for enhancing the quality of life for individuals affected by this condition. Katherine Bunker, a Physical Therapist and Certified Lymphedema Therapist (PT, DPT, CLT) at Renown, has expertise in this area and her insights offer valuable strategies for managing lymphedema.  Lymphedema is a chronic condition characterized by swelling in one or more limbs due to a blockage in the lymphatic system. This condition can result from cancer treatments, surgery, infection, or can sometimes be congenital. While it can be challenging to live with lymphedema, understanding the condition and adopting specific lifestyle changes and strategies can significantly improve the quality of life.   Understanding Lymphedema Educating yourself about lymphedema is crucial. Understanding the causes, symptoms, and potential complications can provide you with the tools to manage the condition proactively. Lymphedema can lead to discomfort, decreased mobility, and in severe cases, infections such as cellulitis. Therefore, recognizing the early signs and knowing when to seek medical advice is essential.   Medical Management  Consulting with healthcare professionals who specialize in lymphedema is critical. A physiotherapist or occupational therapist trained in lymphedema management can tailor a treatment plan for you that can include the following: Compression Therapy - Wearing prescribed compression garments can help move the lymph fluid and reduce swelling. It’s essential to get fitted by a professional and understand how to use these garments correctly.   Manual Lymphatic Drainage (MLD) a gentle massage technique that encourages the movement of lymph fluid out of the affected limb. It’s typically performed by a trained therapist but ask about self-massage techniques you can do at home.

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For the average person, wounds aren’t an everyday worry. However, for at least eight million Americans, chronic wounds can pose a serious threat to health and well-being. From a person with diabetes experiencing painful neuropathy to a patient healing from a significant burn, caring for advanced wounds is a major part of their healthcare journey. Who do they go to get the care and guidance they need? The answer: Renown Wound Care. Serving patients in both the inpatient and outpatient settings, this department provides comprehensive, best-in-class treatments for severe and chronic wound healing and ostomy care. Our Wound Care team members have mastered the art of harnessing cutting-edge technologies and a patient-centric approach to redefine the standards of healing.  Advanced Care for the Best Repair  At Renown Health, we are fortunate to have a team full of nurses, physicians and more caring for patients with wounds caused by a wide variety of conditions. Those include:  Burns Trauma Vascular diseases Radiation therapy Pressure ulcers Diabetes and diabetic neuropathy Adding to the expert-level continuum of care, Renown is the only health system offering complete ostomy services in the entire region. The Wound Care team helps ostomy patients with the fitting of their medical bags, treatment of any skin conditions that may arise after ostomy bag placement, care coordination and much more.  With a multidisciplinary network of experts tailoring personalized treatment plans, there is never a dull moment on the floor. On the outpatient side, the team expects 50-60 patients in one day alone.  “As a clinician, wound care is a lot of ‘arts and crafts,’ so we get to use our creative and critical thinking skills to provide the best possible care,” said Samantha Moore, Advanced Wound Care Specialist RN for Outpatient Wound Care. “Each patient has an individualized plan of care – we greet them as they come into the clinic, escort them back to their treatment rooms and get their latest health updates and life situations before providing wound or ostomy care. We prepare each morning doing chart reviews to determine patient needs, wound progression and referral needs.”  “We are a highly specialized, dedicated group of professionals with a passion to treat and heal our patients’ wounds,” added Lori Conner, Advanced Wound Care Specialist RN for Outpatient Wound Care. “When a patient comes to our clinic for evaluation, they are given a dedicated appointment to thoroughly go over their medical and surgical history, medications and nature of the wound.”  Switching over to the inpatient care team, they operate like a well-oiled assembly line, navigating different daily assignments with precision and flexibility.  “On the inpatient side, our day starts in our office with triaging our consult list; after the triage process is completed, we get our assignments, which can consist of wound vacuum-assisted closure (VAC) patients, follow-up patients, ostomy education patients and new wound consults,” said Megan Uy, Advanced Wound Care Specialist RN for Inpatient Wound Care. “In the case of patients requiring wound VAC changes, we consider what kind of pre-medication for pain that they need. Although some patients may be seen on a time schedule, the day ends up flexible as patients are being seen by other specialties. This flexibility also benefits the patients, making them feel more empowered with their care.”  “Each day in the inpatient setting, we get to our office and sort through all the new consults that came in overnight, and the charge nurse makes the assignment for the day,” added Madison Arlin, Advanced Wound Care Specialist RN for Inpatient Wound Care. “After the assignment is completed, each nurse is responsible for researching their patients and organizing their day, typically by priority – wound VACs and ostomies usually take top priority.”  Now, how do these treatments actually work? This specialized field handles advanced methods of treating each condition, including:  Biological skin substitutes Surgical debridement Advanced wound dressings Negative pressure therapy Pre-ostomy markings and education Offloading techniques, such as padding or dressing “Before starting treatments, we communicate with our nurses and providers to make sure that the patient is comfortable prior to wound care,” said Dianna Seo, Advanced Wound Care Specialist RN for Inpatient Wound Care. “After we see the patient, if there is a need for escalated care, we contact the provider for additional testing or consults. We continue to follow-up on patients that have severe wounds, wound VACs and ostomies.”  In the hands of the Wound Care team, patients exit our hospital walls not only restored but also empowered, set on a trajectory for long-term healing. Your Expert Care Guides  No matter the case or the severity of the wound or condition, patient care, comfort and communication always come first – before, during and after treatment.   “Many of our patients have chronic needs, so we end up seeing them for several months, if not years in some cases; we stay up to date with their specific psychosocial needs and help remove barriers that would prevent their wounds from healing,” said Samantha Moore.  “I enjoy knowing that my positive attitude can improve our patients’ days,” added Maddie Pauley, Patient Access Representative for Outpatient Wound Care. “When they’re routinely coming to appointments they might not enjoy, hearing them praise our team and give their thanks is one of the most rewarding feelings.”  As a wound care patient, there can be a lot of unknowns when beginning their care journey. However, these team members carefully walk each patient through every step from beginning to end.  “When we go to see a wound care patient, our team is very consistent about explaining to the patients what our role is and what we plan to do with their wound, and then we continue to actively communicate throughout wound care each step that we are doing as we are doing it,” said Madison Arlin. “We also encourage some of our patients to listen to music that they enjoy during the wound care, or we will cover their eyes with a cloth if they request so that they don't have to see their wound. Sometimes, we will ask the family to stay at the bedside to hold their family member's hand.”  Education is crucial to ensuring each patient knows what to expect in order to care for their wound and understanding the stages of healing. Fortunately, this team is well-versed in the world of wound wisdom.  “A lot of education is provided on the type of dressing we are applying, and if the patient is going to be performing their own dressing changes, we will go over the entire change with them and provide supplies for discharge,” said Megan Uy. “Additionally, there will be written instructions in their discharge paperwork. In the cases of wound VAC dressing changes, each step is explained to the patient before doing it, and we also go over discharge options and expectations.”  “As a clinician who sees a lot of patients prior to having their ostomy placed (pre-surgical marking), one of the most important things we do is first sit with the patient and/or caregivers and talk about their fears, concerns, questions and goals,” said Samantha Moore. “We provide a lot of emotional support and education, helping identify community resources. For our wound patients, we spend a lot of time educating our patients/caregivers about how and why their wounds occurred. We try to connect with them on a personal level and help them identify ways to help their wounds heal.”  To see a patient’s care journey from the second they enter through our doors to the moment they return home is one of the most rewarding feelings for the Wound Care teams. In fact, they’ve had the pleasure of treating patients for years and seeing their wounds almost completely heal. The team collectively values the successful healing journeys of their patients as their proudest achievement.  “One of our team's greatest accomplishments was being able to see one of our long-term patients discharged with nearly resolved wounds,” said Megan Uy. “This patient had been in our care on-and-off for the past year with many hospitalizations and had complicated high-output enterocutaneous fistulas within his wound bed. These were incredibly hard to keep a dressing on successfully, and he often had issues with the dressing leaking. Eventually, we got a dressing that could remain intact until his next scheduled dressing change, and he was able to get surgery that fixed his fistulas. Being able to see him recover and heal his wounds was a very large accomplishment for us.”  The admiration and compassion this team has for their patients also extends to each other. The cohesive way they work together only further benefits their patients, offering the best-possible collaborative care.  “We have extremely skilled clinicians in our group that are not only incredible in the work that they do and the patient care that they provide but are also enjoyable to work with as well,” said Geane Weaver, Advanced Wound Care Specialist RN for Inpatient Wound Care. “There is something to be admired in each and every one of my coworkers.”  “Our team is very close and supportive of each other at all times,” added Madison Arlin. “I feel very lucky to work with such an amazing group of people. Our team is very proud of the work we do.” Fervently Fighting the Good Fight So, with the highly specialized nature of advanced wound care, how did these team members get inspired to join the Wound Care team in the first place?  Well, for many of these devoted employees, their first exposure to caring for wounds took place on different units – sparking their interest in making wound care their full-time career.  “Renown was the most welcoming towards me as a student nurse, and I liked that it was a teaching hospital,” said Madison Arlin. “I started in the General Surgical Unit (GSU) immediately after graduating nursing school and worked there for two years before transferring to wound care. I decided to apply to the wound team after watching the wound nurses do wound VACs and ostomy changes on the floor. I would ask them if I could watch, and I was always very fascinated by the wound healing process.”  “Prior to joining the inpatient wound team, like Madison, I was also a bedside nurse in GSU,” added Geane Weaver. “Working on that floor, I was already exposed to a lot of patients that were requiring some kind of advanced wound care in one way or another. Working in the GSU, I also cared for a lot of patients that had wound VACs and ostomies. These patients make up a huge group of the individuals that our team sees on a regular basis, and they've always been intriguing for me, so naturally, wound care has always been on my radar.”  For other team members, wound care has always been a point of curiosity throughout their education and career. From their very first exposure to this care area, they were hooked.  “I was always curious about wound care even through my nursing school experience,” said Dianna Seo. “When I was working on the floor, I would trade to do wound care for patients. When I had time, I would follow wound care and help when I could. I joined the skin team which drove me to be increasingly involved with wound care. As soon as there was a job opening, I applied for the position. I worked in outpatient wound care for approximately four years and now inpatient for another four years. I have enjoyed all aspects of wound care and patient care.”    “I had great clinical experience at Renown when I was in nursing school; I also was very interested in caring for trauma patients, and Renown being a Level II trauma center aligned with my interests,” added Megan Uy. “I began my nursing career in the GSU, but my dream job was always Wound Care. During my nursing school clinicals, I had the opportunity to watch some members of the wound team do wound VAC changes and thought it was incredibly intriguing and a great combination of utilizing the knowledge of anatomy and physiology while being creative with handicraft. A position opened on the team around the time I met the prerequisites to be eligible for the position, and luckily, I got it.”  Our Wound Care team has achieved significant employee and departmental milestones over the past year, reflecting their dedication to enhancing patient care and overall process improvement.  “We have had many accomplishments within the last year and are currently working on more to improve the hospital,” said Dianna Seo. “Madison Arlin won the DAISY Award for her great work with our patients. Megan Uy won Top Talent of the Quarter for helping a stranger. Ande Ferriera has worked tirelessly to improve our process improvement. Allie Saunders, as our leader, has worked to improve patient skin by getting new beds for Renown Regional. All our patients that have healed or are on their way to healing under our care is our greatest achievement that we as wound team is most proud of.”  “We are constantly updating protocols, notes and orders for bedside nursing so that it is a more straightforward and seamless charting process,” added Madison Arlin. “We have representatives of different supply companies come and present new products that we think may benefit our patients better. Our wonderful tech has even updated our department site on Inside Renown so that the nurses always have references available.”  Renown’s strong influence in the region – and the opportunity to give back to their community – was, and continues to be, a major draw for this team.  “Since I can remember, Renown has always been the most prevalent healthcare name for my family and has always taken the most amazing, thorough care of my loved ones,” said Maddie Pauley. “I have always wanted to work somewhere I could help people, and starting at Renown has really opened my eyes into how much of a difference each one of us can make.”  Our Wound Care department’s success stories and proactive approach not only reflect their passion for healing but also inspire a ripple effect of positive change throughout our health system. They proudly exemplify a shared commitment to enhancing the well-being of all patients under their care.  “Being part of Renown and part of this team has been my blessing; I get to do a job I love with people that love it too,” closed Dianna Seo.

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It’s true that a road trip can change your life, and it did for Sergeant Brandon Ott, just not in the way he was expecting. For nine years, Brandon worked alongside his friend, Denton Tipler, at the police department in Florence, Oregon. To break the monotony of the COVID-19 lockdown, they planned a ‘guy’s trip’ - a pandemic safe, motorcycle adventure traveling through Idaho and Washington. On the morning of July 22, 2020, they set out on their journey. But by 8 p.m., they ran into rough weather - with wind, poor visibility and heavy rain as they rode into Nevada. Four miles from their destination, on a desolate stretch of Highway 140, a gust of wind hit Brandon. Denton watched in disbelief as his friend bounced, tumbled and ultimately came to a stop after sliding over 100 yards. He flagged down the next vehicle, a semi-truck, and the driver did traffic control while another passerby drove to get cell service and call 911.  A Distressing Call  About 10 p.m. the same night, Angie Brog, Brandon’s partner, picked up her phone at the Florence police station. A Nevada highway patrolman let her know Brandon was in a motorcycle accident and had been taken to a hospital in Winnemucca, NV. From there he took a life flight to Renown Regional Medical Center.  Angie immediately called Brandon’s parents and told Addison, their 9-year-old daughter, the news. They quickly packed their bags and drove to Nevada. On the drive to Reno, an ER doctor called Angie to give her Brandon’s status, “I can’t thank him enough. I was so worried. He even gave me his personal cell phone number.”   Upon arrival, she ran to see Brandon in the trauma ICU. “His face was shattered, he had a collapsed lung, a tube was down his throat and something was in his head to relieve pressure from his swelling brain,” she remembers. “He was not expected to live.”  While Brandon was in a coma for three days, Angie was by his side, trying to come to grips with a new normal. “The doctors did not sugarcoat it,” she recalls. “They told me to prepare myself if he pulled through.”  It was a rough week in the ICU with Brandon heavily sedated, so he could heal. From there he was transferred to the neurology floor, where he slowly improved. While there, his daughter Addison got to see him for the first time. Angie says, “When Addison saw her daddy for the very first time, she was relieved, happy she could hug him, and that he was alive.” Miraculously his legs were not broken and he was able to hold simple conversations and walk a few steps.    As the days went on, Brandon’s dad returned to Oregon, and the Inn at Renown became the family’s new home. “It was such a blessing to be so close to Brandon,” Angie observes. “It allowed us to relax a little being in the same building and let us settle in.”  The Comeback Brandon’s first memory after the accident was waking up in the Renown Rehabilitation Hospital, 16 days after his accident, not knowing where he was. (Brandon experienced amnesia due to his brain injury and doesn’t remember the days prior to his rehab stay.) He recalls looking around the hospital room and seeing the photos Angie posted of their family on the walls and wondering, “How did they get pictures of my family?” Immediately after learning that Brandon was awake, Angie raced back to the hospital, went outside his window and talked to Brandon on the phone, reassuring him that they were there for him and everything was going to be ok.  The next morning, he saw Addison for the first time that he remembered since his accident. They each put their hands to the hospital window “touching” each other in an emotional reunion. During the pandemic, each rehab hospital room was designated with an animal, so family and friends could visit outside safely.  Brandon was in the ‘moose’ room. “Whoever thought of that was a genius,” notes Brandon.  A new phase of Brandon’s recovery began at the rehab hospital. "He worked so hard while he was there,” Angie shares. With a minimum of three hours of daily therapy sessions, including speech, occupational and physical therapy. Angie participated in every aspect of his therapy, “I learned so much from the therapists; they included me in everything,” she recalls. “The compassion and patience they have is amazing. It takes a special type of person to do this job. I cannot say enough good things about the Renown Rehabilitation Hospital staff. If he would have been anywhere else, I’m not sure he would be alive,” she says.  It wasn’t easy. Brandon had a brain injury that required a bolt in his skull to relieve the pressure, and a broken left collar bone and left eye socket. His entire face had to be reconstructed. He remembers his face hurting and thinking he looked like Freddy Krueger. When he saw himself in the mirror for the first time, he was surprised to find he only looked thinner, with a gauze pad on his temple.   Prior to the accident, Brandon weighed 300 pounds, but had just finished a year-long fitness journey losing 119 pounds, by doing CrossFit and overhauling his diet. During rehab his weight dropped to 160 pounds and he was known as “the double portion” guy, eating extra food to gain weight.   Shaun Stewart, Therapeutic Recreational Therapist, recalls Brandon riding the recumbent cycle during his recovery. “I remember him saying he didn’t know if he was ever going to be able to ride a bike again and was appreciative when adaptive sports were discussed. He was very willing to participate and excited to be able to get on a bike again. He had a positive attitude and always was willing to get up and get back on the bike.”  Better Together Although Angie and Brandon were in a committed relationship for almost 11 years, they were not legally married at the time of his accident. “In our minds, our lives were perfect,” Angie asserts. “We had lived together for so long and have a child together.” However, because of COVID-19 restrictions, Angie had to lie and tell the medical staff that they were married so she could be by his side. When Brandon woke up from a coma, she told him, “No matter what I’m your wife.” He asked, “What do you mean, you are my wife?” After hearing Angie’s explanation, Brandon said, “Then, let’s do it.”   “We realized when faced with death that the benefits far outweighed the negatives in becoming husband and wife,” Angie discloses. “The rest is history.”  On Tuesday, August 18, 2020, Brandon and Angie were married underneath the trees behind the rehab hospital. Their family, friends and several staff members attended the ceremony. “I think that’s a first for us,” declares Dr. Gavin Williams. “I cleared him for capacity to make decisions, and we had a COVID-friendly wedding on our back lawn before he went back home to Oregon.”  The next day, Brandon officially left the hospital. “I felt good. Like ‘he’s gonna make it,’ but I was also scared,” mentions Angie. The family stayed in town for a couple of days to make sure everything was ok and then traveled home to Oregon.

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Katherine Bunker, Physical Therapist and Certified Lymphedema Therapist (PT, DPT, CLT) at Renown, discusses how patients can manage lymphedema with changes to daily routines along with diet and exercise. Lymphedema is a condition that affects millions of people around the world. It is a chronic and progressive disorder that results in swelling of the arms, legs, or other parts of the body due to an accumulation of lymph fluid. Lymphedema can occur because of cancer treatments, surgery, or other medical conditions.   Managing Lymphedema Treatments to help reduce symptoms such as pain, swelling and discomfort associated with lymphedema can include compression garments, exercise, skin care, manual lymphatic drainage and pneumatic compression.  The goal is to avoid triggering the onset of lymphedema. Lymphedema can present itself immediately after surgery or radiation. It can appear months later or even years later. There are many factors that influence the development of lymphedema which is why prevention is so important. If you have had injury or disruption to your lymphatic system, then:  Avoid injuries to the skin near the affected area. For example: wearing gloves during gardening, using bug spray to ward off mosquitos, covering your limbs while playing with pets, keeping nails clean and avoiding cutting too close to cuticle, utilizing electric razors at the armpit (instead of a traditional razor).,   Avoid blood pressure readings to the affected limb or request blood pressure to be taken manually, not by a machine.   Avoid heat like saunas, hot tubs, sunburns, hot packs, and even massages.    Avoid tight jewelry like rings or bracelets, which can be too tight.

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If you're not taking safety precautions during mountain sports, you could be at risk for a spinal cord injury. Dr. Benjamin Pence of Renown Rehabilitation Hospital explains the best way to prevent this serious injury. Mountain sports are a big part of the winter season here in our area, but if you’re not practicing all the proper safety techniques, you could end up with a serious spinal cord injury. Benjamin Pence, MD, Renown Rehabilitation Hospital, is here to offer tips to prevent this serious injury while you’re out enjoying what the Truckee Meadows has to offer. What is the spinal cord? The spine stretches from the base of your skull to the coccyx (commonly referred to as the tailbone). Your spine is made up of 24 vertebrae—seven cervical, which are in your neck, 12 thoracic, which are in your chest, and five lumbar, which are in your lower back. There are ligaments and muscles attached to each vertebra. These facilitate back movement and protect the bones from damage. There is cartilage between each vertebra which acts as a shock absorber for your spine. Finally, the spinal cord is a long, thin, tubular bundle of the nervous tissue and support cells that is enclosed in the spinal canal and send signals from the brain to everything from your arm and leg muscles to bowel and bladder function. The brain and spinal cord together make up the central nervous system.

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Grab your skis, goggles, coat – and don’t forget that helmet. Skiing and snowboarding are fun activities for all ages but come with the risk of injury. Read on for tips to make it a safe day on the mountain. Daydreaming about your next trip to the slopes? We talked to Jared Worchel, DO, about his top tips for gearing up. Get the Gear Before you head out to ski or snowboard, make sure you have all your gear ready and in good condition. Everything should fit correctly so that it keeps you as safe as possible. Wearing proper gear will also help keep you warm. Items to check on before you head out include: Boots Bindings Goggles Poles Helmet Outwear Gloves Pack water and snacks in case the drive takes longer than you except due to weather or traffic. You’ll also want to make sure that your cell phone is fully charged before you head out in case you need to contact friends of staff for help while on the mountain.  Helmet, Helmet, Helmet Having a helmet that fits correctly is the most important thing you can do to prepare for a safe day on the mountain. According to a National Ski Areas Association study, helmet use has increased over the last 15 years, with 80 percent of skiers and snowboarders using helmets. Schubert would like to see that number increase to 100 percent. “If you have a head injury it could take you out for the rest of your life,” Dr. Worchel said. “The most important things to think about when fitting a helmet are making sure that it really fits you appropriately. You want to go into a store and try on as many different helmets as they have available. I know it’s tempting to buy one online, but you’re never going to know if it fits correctly.” If you are in an accident, your helmet’s fit can help protect you. Dr. Worchel has some tips on fitting: A helmet should fit low and snug over the head. Make sure that the helmet doesn’t wiggle or feel loose. Look for a model that has adjustability in the back, which will help you make sure it fits snugly. F ind a helmet with a chin strap that will help it stay in place throughout the day.

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Meet Dave Pierson and his Wife Kathy Dave Pierson, 73, and his wife Kathy were just ten days away from a celebratory retirement trip to Africa in May 2021 when severe leg pain and discomfort landed Dave in the Veterans Administration (VA) Hospital. Unbeknownst to the couple, they would not be making the trek to Africa, and it would be several weeks before Dave would be back home with his wife in Carson City, their life drastically different than before.   It all happened so fast. After a prompt referral from the VA Hospital to Renown Regional Medical Center, Dave received treatment for a bacteremia infection and underwent emergency spine surgery due to an epidural abscess. However, once his surgeon Edward Perry, MD completed the emergency procedure at Renown Health, Dave learned there was still a long road ahead. He had extremely limited body function and would need to learn to walk again.  A Husband, Baseball Fan and Veteran  Until this emergency spinal cord surgery, Dave had lived an especially healthy life in his retirement, traveling the world with Kathy, taking photographs along the way and attending ball games for their beloved team, the Reno Aces. Dave, a Vietnam veteran, and Kathy planted their roots in Carson City surrounded by countless friends and family, eagerly awaiting Kathy’s retirement.   The Long Road Ahead  It was those same friends and family who remained by Dave’s side throughout his recovery process.   At the advice of the Renown team, Dave began a personalized physical rehabilitation plan at Renown Rehabilitation Hospital just days after his initial surgery. It was with the help of Charles Krasner, MD, an Infectious Disease Specialist that Dave made a smooth transition to be cared for at the Rehabilitation Hospital. Dave spent six weeks of inpatient treatment relearning fundamental occupational skills and motor functions such as eating and drinking, getting dressed, using a wheelchair and eventually taking his first steps, aided by a walker.   The couple proudly remembers a day at the Rehabilitation Hospital when Dave successfully buttoned up his shirt using a small apparatus designed to aid in the task. "It was a little thing, but it was a monumental thing," Kathy shared.  Dave achieved physical and cognitive victories, both on a small and large scale, over the next six weeks. Kathy visited every day she could, always prepared with a photo of the couple's past travels to encourage Dave.   The Rehabilitation Hospital staff grew close with the Piersons, sharing stories and photos of their dogs, travels and life. The nurses kept Kathy updated about her husband’s condition and prepared her for the journey to come, this included extensive education related to Dave’s future at-home care.   Benjamin Pence, MD, Dave’s lead rehabilitation doctor and the Director of the Institute for Neurosciences, always seemed to know just how to motivate Dave on his most challenging days. As a ranger in Vietnam, the phrase, “drive on ranger” meant a lot to the veteran when it came to determination and perseverance. So, the phrase was used as encouragement by Dr. Pence and the Rehabilitation Hospital team throughout Dave’s journey, becoming a fond memory about hope and determination during recovery.

Read More About Dave's Story: How One Ranger Drove On

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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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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Standing at the top of the stairs to the basement Sharon Sturtevant was chatting with her grandson in the kitchen. Suddenly, Sharon stumbled and fell down the stairs. “The last thing I remember was my head hitting the floor before everything went black,” she recalls. Her grandson, Oliver, quickly called 911 and paramedics arrived on the scene, taking her by ambulance to Renown Regional Medical Center where she was diagnosed with a broken collarbone and a neck fracture that would require complex surgery involving fusion of her neck. Fall Recovery Begins After her surgery, Sharon was transported to the Renown Rehabilitation Hospital and her recovery process began. Sharon smiles as she describes the rehab hospital team “They are fabulous here, I learned so much about how my body moves, and the proper way to move it. At home I wouldn’t have known what to do,” she confesses. “They set me up for success to return home and not get injured again.” At Renown Rehabilitation Hospital, different therapists coordinated a custom plan to help Sharon recover from her injuries. Ultimately, the goal of her physical therapy was to help restore and improve her strength, reduce pain and increase her mobility for stamina and balance. Physical Therapy Key to Successful Treatment of Falls “My recovery after the operation was an eye-opener,” Sharon declares. “I had no idea how much went into regaining everyday moment.” During her rehabilitation hospital stay, she had to re-learn how to swallow, go up and down stairs, as well as successfully get in and out of a wheelchair, which involved transferring her body weight safely. Due to hormonal changes after menopause women are 50% more at risk for falls than men, according to research. Sharon now has a greater awareness of how to move her body and is significantly stronger than before entering her physical rehabilitation sessions. Not everyone knows that everyday mobility is impacted by four basic skills: stepping, trunk flexibility, upright posture and weight shifting. “I don’t know how I could have gotten this far without the wonderful therapists here,” she shares. “They are so thorough. Proper alignment was encouraged helping me to walk and stand correctly. They were all so nice and patient with me,” she states. “I actually had less pain because I didn’t hurt myself moving the wrong way.” Falls Are Common Among Aging Adults As we age balance becomes more important. Unfortunately falls are common among older adults with negative quality of life effects, even fatalities. According to the Centers for Disease Control and Prevention (CDC), one in four seniors fall each year in the U.S. A comprehensive physical therapy plan for sudden falls or chronic conditions is a safe, effective alternative treatment to medication such as opioids. Today Sharon is back at home with a new banister installed on the basement stairs. As a music lover she is enjoying her musical grandchildren Oliver and Eliana who play instruments. She looks forward to attending their upcoming school concerts. Sharon remembers the staff at Renown Rehabilitation Hospital fondly, “They were unfailingly patient, supportive, informative and understanding.” Her advice to those unexpectedly finding themselves in the rehabilitation hospital is, “Listen to your therapists carefully and follow their instructions.”

Read More About Fall Recovery Gets Patient Back to Life and Movement

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.

Read More About The Road to Recovery Close to Home

Despite the challenges of a pandemic, the Renown Rehabilitation Hospital continues to help their patients thrive outside of the hospital walls. On July 31, 2021, they hosted the first-ever Renown Alumni Sports Extravaganza, or RASE, a day focused on adaptive sports for all abilities. “Sports and recreation have a unique way of breaking down emotional barriers,” states Jared Worchel, DO, MS. The alumni used their skills on a climbing wall, Frisbee golf, archery, an obstacle course and bag toss. Over 20 people spent the day cruising the first adaptive mountain biking trail in the Tahoe region. “Having old friends meet up and seeing new friendships form had to be the highlight of the weekend,” says Shaun Stewart Certified Therapeutic Recreation Specialist (CTRS) with Renown Rehabilitation Hospital. “RASE was a great way to learn new methods to improve outdoor recreation engagement from both participants and the many programs involved.” Dr. Worchel agrees, “The smiles really make it worth it, and we even saw several touching moments with tears of joy when participants completed a task and finally felt like they were getting past their injury, mentally, after years of being so focused on recovery.” Adaptive Climbing and Camping One touching moment came on the adaptive climbing wall. Cassie Firchau, an occupational therapist at Renown, recalls a rehab alumni who had never been on a climbing wall (pre or post injury) conquering the wall. “Everyone was cheering him on. I was impressed with how he used the ascending pull up bar to get up the wall,” she remembers. Mark Wellman, the founder of No Limits, provided the climbing wall. “I had heard of Mark, but I had no idea that he climbed El Capitan only a few years after his spinal cord injury,” says Cassie. “Having him at the event was a great opportunity to learn how to stay active and enjoy the things you love, no matter the circumstance.” After dark, the event continued with a DJ spinning hits followed by overnight camping. That evening Shaun Stewart had the chance to talk to one of the alumni. “He spoke on how he was nervous about camping and how it would go in a new campground. He said that he was happy for an opportunity to practice with our group prior to going out on his own,” remarks Stewart. “Knowing that this event can help create opportunities even outside our events is great to know.” Adaptive camping activities allow all abilities to not only enjoy nature, but also connect. “We also saw a lot of interaction between the participants themselves, sharing their journeys with each other during the down times which was possible with the extended format,” explains Dr. Worchel. “Overall it was an overwhelming success and we are already looking forward to next year.” Northern Nevada's Adaptive Sports Community Not only did the Renown Rehab alumni come together at RASE, but so did the greater northern Nevada community. Along with the hard work of the Renown Rehabilitation employees, the City of Reno Adaptive and Inclusion Programs, Wasting Arrows, Disable Sports Eastern Sierra, No Limits, and High Fives Foundation, provided support and equipment for the alumni. “It was so great to see multiple groups, volunteers and non-profits collaborating to support alumni participants to live life to the fullest, and to experience outdoor recreation in such a dynamic way,” states Josh Patterson, Supervisor of Rehab Therapy Services at Renown Health. "The City of Reno is so grateful for this sponsorship to bring together new and old Renown alumni to learn and encourage each other. There were many firsts this weekend, and we look forward to future participation in City of Reno Adaptive programs,” says April Wolfe, CTRS, City of Reno Parks and Recreation. For more information on future alumni adaptive events, please email: shaun.stewart@renown.org.

Read More About Renown Hosts Adaptive Sports Day for All Abilities at Sky Tavern RASE Event