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Abdominal pain is one of the most common reasons for an Emergency Room visit. The abdomen is an area that encompasses multiple organs and functions. So how would you know when the pain you are feeling is an ovarian cyst or something else, and when should you seek medical attention? Dr. Carilyn Hoffman, at Renown Women's Health, explains. Ovarian Function Defined Located on each side of the uterus, the ovaries are part of the female reproductive organs and produce eggs (ova), released during the menstrual cycle, allowing for fertilization and pregnancy. They also produce hormones such as estrogen and progesterone, which play an important role in female traits, bone health, cardiovascular health and pregnancy. Symptoms of an Ovarian Cyst Cysts are solid or fluid-filled masses. Ovarian cysts can be in the ovary or on its surface. When cysts are enlarged or rupture, they can create a dull ache or sharp pain below the belly button. Besides discomfort and pain, other symptoms of ovarian cysts may include bloating, fullness, pressure or heaviness. "Ovarian cysts are common; most are physiologic and will go away on their own. They are frequently found incidentally on ultrasound and are present in the middle of the menstrual cycle," says Dr. Hoffman. "However, if a woman experiences sudden and severe pelvic pain they should seek immediate medical attention. Sometimes ovarian cysts can become large and twist on themselves. This is called ovarian torsion and is a surgical emergency. Other times, cysts can rupture and bleed. This is called a hemorrhagic cyst and can also be a surgical emergency." Diagnosis and Treatment If an ovarian cyst is suspected, your doctor will perform a pelvic exam and order an ultrasound. There are certain ultrasound findings that suggest that the cyst is benign. There are other ultrasound findings that are concerning for cancer. Small simple cysts often resolve on their own, whereas solid or very large cysts may require surgery.

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Up to half of all men and one-third of all women will face a cancer diagnosis in their lifetime, according to the Nevada Cancer Coalition. Chances are, you or someone you care about has been affected by cancer and has witnessed the ultimate fight for life. More than likely, your loved one’s cancer journey involved radiation therapy – and in fact, more than half of cancer diagnoses are treated in whole or in part with radiation. At first glance, this treatment plan can sound scary to any person. With a cancer care journey, it takes a village, and at Renown Health, we have top-notch leaders of the village roads that lead to radiation.  Meet our Radiation Oncology team at the William N. Pennington Cancer Institute. From intake to inpatient, this department of passionate physicians, radiation therapists, registered nurses, medical assistants, intake coordinators, schedulers and more are here to help every patient dealing with the intimidating diagnosis of cancer. Any patient that needs radiation as a part of their treatment is in the best of hands with this team, who will stop at nothing to ensure each patient under their care knows that they have a village Fighting the Good Fight right alongside them.  Teamwork in Tackling Tumors One of the most common forms of cancer treatment, radiation therapy uses high-energy X-rays to minimize cancerous cells. But with Renown’s Radiation Oncology department, the impressive cancer care doesn’t stop there – this team leverages advanced technology right at their fingertips. In fact, our cancer institute has the most state-of-the-art radiation therapy system of its kind – the ultra-precise Varian TrueBeam radiation therapy system – and is the very first program holding American College of Radiology accreditation in the entire region.  Given the advanced nature of their jobs and the high standard of care their patients expect them to uphold, it’s no question that the days-in-the-life of each team member is complex and can continually change every day.  “There are many moving parts in radiation oncology on any given day,” said Sandra Bailey, Manager of Radiation Oncology Services. “The radiation oncologists consult newly diagnosed patients, follow up with previously treated patients and oversee daily treatments for patients actively receiving treatments. Nurses and medical assistants move around the clinic to support the physicians with patients and provide education and other supportive care.”  The physics and dosimetry teams work diligently alongside the physicians to design the most beneficial treatment plan for each patient. Once a patient begins their treatments, the radiation therapists administer the daily treatments with the utmost precision. Intake coordinators, schedulers and patient access representatives make surethe patients have their insurance authorization and are processed through the system appropriately. Like any well-oiled machine, each part is necessary for the other to function at peak performance to ensure our patients receive the quality care they deserve and expect. Like many other clinical departments at Renown, teamwork coupled with education is crucial to best serve radiation therapy patients. Our nurses on this team are experts at exactly that, serving as a reminder of the transformative power of care in the face of a daunting disease.  “Radiation oncology is a unique world,” said Kristen Reed, Registered Nurse. “We have many different team members that play a role in how we function as a department. We all work together in some aspect to provide care for our patients. As a nurse, I provide patient education to all my patients before starting treatment to go over potential side effects and expectations on their treatment. Daily, we see new patients and follow-ups, plan simulations to start patients for radiation treatments and provide radiation treatments, among many other daily tasks.”  The unique role of our radiation therapists, the team members who are on the frontlines of giving radiation treatments, helps this department stand out from the rest with their tireless dedication to fighting against cancer with compassion and expertise. Not only are they armed with technology, but they are also armed with hands that deliver healing rays of radiation.  “As a radiation therapist, our daily tasks can vary pretty widely,” said Casey Johnson, Radiation Therapist. “We rotate between three radiation treatment machines called linear accelerators – one of which we use for stereotactic radiosurgery, a minimally invasive form of surgical intervention. We also staff the CT simulation room where we construct all the patients' treatment devices and perform their ‘mapping’ scan. We then coordinate with the dosimetrists and physicians to determine the specifics of the patients’ course of treatment. The most important parts of our job are patient care and education. Even though our job is very technical and requires tremendous attention to detail, the critical part is remembering that our average workday could be a monumental day for a new patient.”  “Our day-in-the-life in Radiation Oncology is centered around patient care,” added Haley Longfield, Radiation Therapist. “Although we do not spend a ton of time with our patients, we see them every day. We are able to build a wonderful rapport with our patients that is top-notch. We set up the room with their treatment devices, get them set up appropriately and administer their radiation treatment. On average, our patients are here for about 15 minutes.”  The bottom line: our Radiation Oncology team’s unified commitment to both excellence and innovation promises a brighter future for those battling cancer. No one is ever alone in their fight, and this team makes sure of that, no matter what.  Radiating Excellence in Cancer Care The Pennington Cancer Institute boasts a stellar reputation in our community for offering best-in-class, evidence-based care and cutting-edge research, improving outcomes for patients battling cancer. This fact is what inspired many Radiation Oncology team members to take their talents to this department in the first place.   “I chose to work at the Cancer Institute because I believe we offer the best patient care experience, along with the most advanced radiation treatments in the area,” said Casey Johnson.  "I am a fifth generation Reno resident, and I am part of this community through and through,” added Haley Longfield. “I always knew that I wanted to work here.” The success of our cancer institute starts with our people – and many members of the Radiation Oncology team witnessed this firsthand upon their arrival in this department. “I was initially inspired to move across the country to work in the Cancer Institute by the vision of the senior leaders and the future growth plans for the entire institute; once I arrived, I quickly realized what a great team I am now leading,” said Sandra Bailey. “The compassion and care the Radiation Oncology team provides our patients is second to none. Medical errors are rare in our department, and this can be attributed to not only the processes in place to prevent them, but everyone working together to deliver radiation treatments safely. Each day I witness a patient relationship being nurtured and developed. I am truly honored to be part of this team.”  Inspired by Renown's integral role in the northern Nevada community, several team members were drawn to this department because of the opportunity to make a meaningful impact on patients' lives in a quiet healing environment.  “As a student nurse, I had clinical and practicum on the cancer nursing unit here at Renown; I noticed the quiet, healing environment and a patient population enduring some of life’s most challenging hurdles,” said Rachel Bales, Registered Nurse. “It is in these moments that you can really make a difference as a nurse. After pursuing critical care as a new grad and working in Interventional Radiology with cancer patients, I knew that I had to find my way back to oncology. I applied to Radiation Oncology, and I am working towards my third year in this department. I have always known that I enjoy helping others, and the fulfillment that comes from working with this patient population is unmatched.”  “Renown is a huge part of the community in northern Nevada, and I knew while I was in nursing school that I wanted to have a career here,” added Kristen Reed. “I ended up joining the Cancer Institute about two years ago. My patients are a huge part of why I stay. We really get to know these patients and their families well, especially because they come in from Monday through Friday for up to six weeks for treatments. Building connections and being able to support these patients during a difficult time in their life makes my job fulfilling.”  From the initial consultation to the administration of therapy, the staff's commitment to personalized care remains strong. Patients and their families develop profound connections with these team members as they navigate through the challenges of treatment.  “We have knowledgeable and caring staff that help guide our patients through treatment,” said Kristen Reed. “This starts on the day of their consultation and continues even after completion of treatment. The patients and families get to know the staff through their treatment, and having a familiar face can be reassuring to them. We also take time every week to see how they are doing physically and mentally while undergoing treatment and we give them a chance to check in with their doctor. Taking this time helps reassure patients and allows them to ask questions, and in turn, reduce some anxiety and worry.”

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Do you find yourself struggling to stay awake during the day or having no energy? You’re not alone. Whether you’re a full-time employee, a student or retiree, that “I’m tired” feeling comes in all shapes and sizes. What’s even more frustrating is not knowing the source of your exhaustion.  Dr. Brandon Flores, a sleep medicine physician with Renown Medical Group, breaks down nine key reasons why you may be feeling so fatigued.  You did not get enough sleep, or your quality of sleep is poor. This may seem obvious, but in today’s “rise and grind” culture, sleep can be considered a luxury rather than what it really is: a necessity. Ensuring you get adequate hours of sleep between 6-9 hours and quality sleep is essential. You may not be breathing well during sleep. Interruptions to your breathing, such as snoring, can decrease airflow at night causing your sleep to be less restorative. This is often due to Obstructive Sleep Apnea (OSA). OSA can lead to daytime fatigue and sleepiness and can also impact other chronic health conditions, such as hypertension, diabetes, acid reflux, migraines and heart rhythm. You are not getting enough regular exercise, or you are exercising too much. Incorporating at least 30 minutes a day of physical activity can help keep you energized throughout the day. It has also been shown to increase deep slow wave sleep, which is often associated with feeling rested. On the other hand, getting too much exercise can tire you out more easily and heighten stress levels. You drink too much caffeine. This one may seem counterintuitive – caffeine is supposed to keep you awake, right? Well, overdoing it with your favorite coffee or soda could affect your sleep quality. Pay attention to your caffeine limits and have a cut-off time, as most caffeine should not be consumed past noon. You have a food allergy or intolerance. If you find yourself feeling especially tired after eating a lot of a certain food, you could have an allergy or intolerance to it – and vice versa. Consider speaking with your primary care provider (PCP) about a food allergy test or being referred to an allergist. You’re drinking too many alcoholic beverages. Alcohol is a depressant, which as the word implies, can make you feel especially tired during the day. It can also affect your breathing at night and disrupt your sleep cycle. Cutting back on alcoholic drinks may be beneficial to your overall health. You are anemic. This is the leading cause of fatigue in women but can affect people of all genders. It can be associated with low iron. Eating foods high in iron, including leafy greens and many different meats, can help your iron levels. A blood test ordered by your PCP can help you understand if you are iron deficient. You are experiencing depression or anxiety. Emotional exhaustion can be just as taxing as physical exhaustion. Prolonged feelings of sadness, hopelessness, nervousness or panic can be signs and symptoms of depression or anxiety. Speak with your provider about the many resources available to help you. You have an underactive thyroid. Feeling fatigued can also be a symptom of hypothyroidism, which affects your metabolism and energy levels. Medication can help get your thyroid back to normal. Your PCP can order a blood test to determine your thyroid levels.  If you experience severe exhaustion that lasts six months or longer, worsens after physical or mental exertion and does not get better after resting, it could be a sign of myalgic encephalomyelitis, otherwise known as chronic fatigue syndrome (CFS). This is a diagnosis of exclusion, and other causes must be ruled out. While there are no tests that detect CFS, your provider can order blood and urine tests to rule out other causes of your fatigue and help develop a care plan.

Read More About Why Am I So Tired? 9 Reasons for Your Chronic Exhaustion

Meet newly minted Dr. Majid Khan, PhD., a native of Reno, and current MD-PhD candidate and first-generation medical student at the University of Nevada, Reno School of Medicine, who is on his way to a career as a Neurosurgery. While most graduate students often choose between pursuing a medical degree (MD) or a doctorate in philosophy (PhD), Majid has boldly picked both. He is one of three medical students currently in the UNR Med MD-PhD Program run by Dr. Caroline Cobine, PhD and Dr. Violeta Mutafova-Yambolieva, MD, PhD. "Research is not merely an act of sitting at a computer and reading papers – it's about answering the thought-provoking questions about things we come across on a daily basis. By critically evaluating these ideas we can implement solutions to enhance various aspects of the medical field and patient care with an overall goal of improving patient outcomes," Majid said. Majid recognizes that modern research extends beyond academia and holds significant value for hospitals. “Research contributes to improving patient outcomes. By reviewing the data from peer-reviewed research studies, medical professionals can be better prepared to deliver effective care following the most up-to-date guidelines and data,” he said. Majid's journey to pursuing his MD-PhD with a goal of becoming a physician-scientist-surgeon began following a summer in the PathMaker Cancer Research Program at the Huntsman Cancer Institute at the University of Utah. "It was by fate that I stumbled into this field – ever since I saw my first brain surgery, I haven’t been able to look back," Majid said. Here are some of the valuable lessons that Majid has learned along the way. 1. Beyond the 9 to 5, Embrace both 5 to 9s To avoid burnout and nurture personal passions, make your time spent outside of work and school intentional. Harness any free time to reconnect with friends, pursue hobbies and engage with mentors and mentees. 2. Collaboration is Key Work collectively with colleagues locally, nationwide and even worldwide. Cultivate environments to share knowledge and innovation, as well as wisdom, which will evidently lead to more impactful outcomes. 3. Shine a Spotlight on Your Colleagues Acknowledge and celebrate your colleagues in group settings when you notice something outstanding that they’ve said or done – it could anything big or small. Shining the spotlight onto those who are making positive changes within the hospital can inspire a beautiful culture of academic healthcare, which ultimately improves patient outcomes. 4. Redefine Mentorship Mentorship does not need to be confined to traditional frameworks. Seek out guidance in unexpected and untraditional places; sometimes, the most enlightening lessons and opportunities emerge from the most unlikely sources. 5. Diversify Your Experiences Embracing a diverse range of experiences enriches one's medical acumen. You never know when a seemingly unrelated job or experience will help in a scenario in your career. 6. Live By the Mamba Mentality Follow the late Kobe Bryant’s approach to life and work, the Mamba Mentality. This includes planning long-term goals, placing meaning in everything, striving for constant personal growth, following your passions and focusing on the process rather than the end goal. 7. Make Time for Your Loved Ones Don’t forget who helped you get to where you are in your life, specifically your family, friends, teachers and mentors. By making time for the most important and loving people in your life, you will be surrounded by positivity which will help propel you to new heights. 8. Plan your Next Five Moves We all have the ability to come from nothing and become something. Take the time to plan out everything and execute your moves with careful precision. Majid has plans to return to the Biggest Little City after completing Neurological Surgery Residency Program. If you would like to get in touch with Majid, please reach out to him via email at majidk@med.unr.edu.

Read More About Eight Lessons from an MD-PhD Candidate at UNR Med

Managing weight is a complicated and often difficult journey for many individuals, and obesity stands as a common and serious chronic health condition. In fact, the Center for Disease Control and Prevention reports that the prevalence of obesity in the US is greater than 40% in adults and 20% in children, and those numbers are continuing to climb. In Nevada, according to the 2020 Behavioral Risk Factor Surveillance System, 28.7% of adults reported being obese. By 2030, almost 80% of American adults may be overweight and half of them will be obese. But obesity isn't just about the numbers on the scale; it's a multifaceted, lifelong, neurobehavioral disease triggered by a combination of factors. These include abnormal eating patterns, reduced physical activity levels, environmental stressors, genetics and various other contributors. Obesity extends far beyond appearance, often leading to the development of numerous medical conditions such as diabetes, heart disease, elevated blood pressure, stroke, sleep apnea, liver disease, various cancers and infertility. Join us as we delve into the complexities of obesity and explore strategies for effective weight management available right here in northern Nevada. Why Can Losing Weight be so Difficult? The challenge behind weight loss finds its roots in the Set-Point Theory of Obesity, a concept that says our bodies have a predetermined weight, or fat mass, within a defined set-point range. In other words, when an individual's weight deviates from this set point, the body initiates mechanisms to bring it back to the established range. So, if someone loses weight below their set point, the body may respond by increasing hunger and reducing metabolism, making it challenging to sustain weight loss. There Isn’t One Right Answer, But Renown is Here to Help Various weight management strategies can be utilized by patients struggling with obesity, which may lead to substantial weight loss, resolution of associated medical conditions and improved psychosocial health. In fact, the most successful strategy involves a multidisciplinary approach under the guidance of trained specialists that includes a combination of tactics, including: Behavioral adaptations Dietary modifications Physical exercise  Anti-obesity medications  Weight loss surgery

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National Radiologic Technology Week is from Nov. 5-11, 2023. Join us in celebrating Renown's Interventional Radiology department!Try to put yourself in the shoes of someone who is told that they have a massive blood clot in their lung, someone who needs a biopsy to determine the next steps of their care, someone facing a stroke or brain aneurysm or someone who needs a catheter to receive treatment such as chemotherapy. You may immediately think that an intense and intimidating surgery is on the horizon. What if, instead of surgery, your care teams were able to use the necessary tools to treat your blockage or administer your medicine with an image-guided procedure?  That’s precisely what the Interventional Radiology (IR) team at Renown Health does. Behind the doors of this department is where you’ll find a team of highly skilled individuals who operate like a well-oiled machine, ensuring that each procedure is executed with precision and care. Their commitment to excellence knows no bounds as they provide essential interventions to patients of all ages, from the tiniest newborns to the elderly. Their mission extends beyond diagnostic and therapeutic procedures; they are experts in understanding and serving the ever-evolving needs of their patients.  Minimally Invasive, Maximally Impactful  With their advanced expertise, our IR teams at both Renown Regional Medical Center and Renown South Meadows Medical Center harness the power of X-ray, CT and ultrasound technologies to navigate their way through life-saving minimally invasive procedures, such as thrombectomies, angioplasties, stent placements, embolizations, catheter and drain insertions and needle biopsies. In the world of medicine, Interventional Radiology often offers an alternative to traditional surgical methods, reducing the risk of hospitalization and helping patients embrace recovery more quickly.  Our IR teams have a diverse and busy daily work life in order to make these complex and life-saving interventions happen – and they all have each other’s backs to ensure that every patient gets the care they deserve.  “Every day is different, and no two days are alike,” said Ryan Nunes, Specialty Procedure IR Technologist at Renown Regional. “The day can start off first thing in the morning with several emergent cases, such as ruptured brain aneurysms to brain blockages. We all work really well together; we help each other out and come together to do things as a team.”   Like every other team at Renown, patient well-being is always a number one priority. The IR department takes this commitment seriously, upholding the highest standards of ethics and safety.  “We start the day by preparing rooms and making sure they are well-stocked, checking that all devices are working, performing safety checks and making sure the entire team is well-prepared for whatever cases come through the door,” said Aubrey Goldsmith, Supervisor of Clinical Nursing in IR at Renown Regional. “We have routine cases like drain placements, biopsies, line placements and more, and we also have life-threatening cases that come at a moment’s notice. Our nurses are responsible for monitoring patients throughout the procedure to make sure they are doing well the entire time and are there to respond if the patient has a decline.”  "After completing the prior assessment of each patient, we look for any medical problems the patient may have before confirming it is safe for the patient to have procedure done,” said Brandon Hartwig, Interventional Radiology RN at Renown South Meadows. “We work closely with the physicians on all our cases while assessing each patient, going through labs and vitals and personalizing the procedure for each patient.”  Even though the procedures they oversee are minimally invasive, the IR team understands that any procedure, regardless of the severity, can be incredibly frightening for any patient. Their best tool for handling patient anxieties? Communication.  "The best thing we can do to reduce anxieties and fears in patients is to have communication with them to ensure they know what is going on and what to expect,” said Megan Rios, IR Technologist at Renown Regional. "We set clear expectations for the patients and give reassurance throughout the entire procedure.”  "All of our team members are very attentive to our patients when it comes to potential fears and anxieties that they may have,” added Jazmynn Kimsey, IR Technologist at Renown Regional. “We always take the extra time to listen to our patients and break things down, explaining every step before, during and after the procedure.”  Knowledge sharing is also a crucial part of the IR process. No patient will ever have to wonder, “what exactly is going on here?”  “We provide each patient with education and advocacy throughout the process,” said Blaire Henderson, Interventional Radiology RN at Renown Regional. “We ensure every patient is as comfortable as possible at all times.”  “When it comes to procedures, patients tend to be scared and nervous,” added Ryan Nunes. “The silver lining to what we do is that it is all done through very small openings of the skin, and we all explain this to patients. Most procedures we do are done under moderate sedation which helps put the patient more at ease.”  In a world where advanced medical care meets the human touch, the IR team exemplifies Renown’s commitment to making a genuine difference in the health and well-being of everyone they serve.

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Ensuring a healthier and more inclusive future for LGBTQIA+ children and teens is of utmost importance to health systems in our community, especially Renown. Supporting the physical and mental health of youth in this community is key to those efforts, especially as they face unique challenges in terms of identity acceptance and social integration.   Dr. Caroline Barangan, Adolescent Medicine Physician with Renown Children’s Pediatric Specialty Care, discusses what you as a parent, caregiver, friend or support system can do to be a safe space for children and teens who identify as LGBTQIA+. 1.  Create a Safe Space at Home The most important action you can take for your LGBTQIA+ teen or child is to accept and support them for who they are, regardless of how they identify. “Being a teenager is already difficult enough, especially within the LGBTQIA+ community, which puts them at risk of being stigmatized, rejected and targets for bullying,” said Dr. Barangan.  Your supportive words and actions can make a huge difference as a profound expression of love and understanding. Being patient and willing to learn are the foundations to a healthy and loving relationship with your LGBTQIA+ teen or child.  2.  Encourage Regular Check-Ups with a Primary Care Provider (PCP)  Establishing your child or teen with a PCP is not only important when an illness occurs but also for annual preventative visits and regular check-ups. “A primary care provider can screen for high-risk behaviors that would put a patient’s health in jeopardy, such as sexual experience, substance use, suicidality and self-harm,” said. Dr Barangan. “These screenings are an opportunity to provide the education and support these kids and teens need to stay healthy.”  One of the main concerns LGBTQIA+ youth often have is that they will experience judgment from their provider, or the PCP will disclose sensitive information, including their sexuality or gender identity to their parents, when they are not ready to do so. Dr. Barangan emphatically reminds us that this legally cannot happen. “If a patient asks me to keep something confidential, unless they disclose that they have plans to harm themselves or others, I am legally not allowed to share that information with anyone without their permission,” said Dr. Barangan.  3.  Locate Local Resources  Northern Nevada is home to a variety of resources for the LGBTQIA+ community at large, including youth members of this community. "Finding resources to help them develop in a positive way and provide them with the information they need, whether it be in school, the household, the community or through a medical or mental health provider, is incredibly important,” said Dr. Barangan.  Below is a list of local LGBTQIA+ community resources open to you and your children:  Our Center LGBTQIA+ Health Services at Northern Nevada HOPES Northern Nevada Pride Festival & Community Parade (happens every July in Reno) Sassabration (happens every September in Carson City) Lake Tahoe Pride (events and resources shared on Facebook)

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Did you know certain medications can interact with everyday food and drink? We asked VP of Pharmacy Services Adam Porath how to take these important medications safely. One in five Americans between the ages of 40 and 75 are currently taking a statin drug to reduce their cholesterol level or to prevent atherosclerosis (hardening of the arteries). Many others also take anticoagulants (blood thinners) to prevent blood clots from forming, which can increase the risk of stroke. Adam Porath, VP of Pharmacy Services at Renown Health, explains how to safely take these medications. What is a statin? A statin is a drug that can lower cholesterol by helping your body absorb cholesterol or by blocking a substance your body needs to make it. The American Heart Association cites a global study reporting the benefit of statins to help reduce heart attacks and strokes. Common statins include atorvastatin (Lipitor), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor). Which foods or drinks should be avoided while taking statin drugs? Grapefruit juice is the only food or drink that has a direct interaction with statins. Statins do not directly interact with any food but people taking statins should moderate their intake of saturated fats to help lower their LDL cholesterol and overall risk of cardiovascular disease. What is a blood thinning drug? Blood thinning drugs, such as warfarin, rivaroxaban (Xarelto), apixiban (Eliquis), dabigatran (Pradaxa) and edoxaban (Savaysa), are used to prevent stroke. Which foods or drugs should be avoided while taking blood thinning drugs? If taking warfarin, alcohol and cranberries (including juice) should be avoided. Patients taking warfarin should be aware of foods that contain Vitamin K (green leafy vegetables) and try to maintain a consistent diet of these foods. Warfarin interacts with many over the counter and prescription medications. Patients should consult a pharmacist when starting, stopping, or changing doses of any medication when taking warfarin. Also, patients taking any blood thinning medication should avoid over-the-counter pain relievers (i.e. aspirin, ibuprofen, etc.) How do I know whether to take my medication with food or not? Consulting with a pharmacist is the best resource to determine if a medication should be taken with or without food. In general, all statins and blood thinners can be taken with or without food. The only exception is Xarelto (rivaroxaban), which should be taken with the largest meal of the day If you are a Renown patient you can also review your prescriptions online, request a refill or ask a question via MyChart. With MyChart, you can access all your healthcare information securely 24/7.

Read More About Foods to Avoid When Taking Heart Medications

Heat and ice are two of the most common treatments used to relieve pain and reduce swelling in injuries. However, each one is better suited for certain types of injuries Dr. Luis Palacio, MD explores the differences between the two.  When it comes to treating aches and pains, the debate between heat and ice has been ongoing for quite some time. Both have their benefits making it crucial to understand which option is better suited for your specific needs.   Determining which method is better depends on various factors such as the type of injury or pain you are experiencing. For instance, if you have recently sprained your ankle or pulled a muscle during exercise, applying ice within the first 48 hours can help minimize swelling and alleviate discomfort.   It's worth noting that some individuals find alternating between heat and ice therapy beneficial as well. This approach combines the benefits of both methods by using heat to increase blood flow followed by ice to reduce inflammation.  Cold Therapy  Cold therapy can help to reduce inflammation after an injury, heat can have the opposite effect. Therefore, heat therapy should be reserved for those who have chronic pain issues and are not dealing with an acute injury. Cold therapy is often recommended immediately after an injury or during the initial stages of inflammation.  Cold therapy such as ice packs are especially effective in treating: Sprains  Strains Any injury that involves swelling Heat Therapy  Heat therapy is known for its ability to relax muscles, increase blood flow and soothe pain. It is often used for chronic conditions or injuries that are not inflamed. Applying heat can help alleviate stiffness, promote healing and provide a comforting sensation. This increased circulation can bring more nutrients and oxygen to the area, helping it to heal faster.  Heat therapy such as heating packs are especially effective in treating:  Stiffness with associated pain   Injuries that are not inflamed  Muscle pain

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Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs.  Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health.  PrEP and PEP  Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months.  Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days.  PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location.   HPV Immunization  All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime.  The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never!  STI Testing  Sexually-transmitted infections form from bacteria, viruses or parasites that can be transmitted by person-to-person sexual contact through semen, vaginal, blood and other bodily fluids. According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new STI cases across the nation each year.   Luckily, most STIs are preventable. Annual STI testing for HIV, gonorrhea, chlamydia and syphilis is important to stay on top of your sexual health. Because these STIs may sometimes have no symptoms, screening is recommended regularly and with any change in sexual partners. Depending on the specific condition, tests for these infections include urine, swab and blood tests. Speak with your primary care provider on a screening schedule that works best for you.  Prostate Exams  Prostate exams look for early signs of prostate cancer in patients who still have a prostate. The CDC recommends those who are at least 55 years old get regular prostate screenings; however, for patients with a family history of prostate cancer, screenings may be recommended as early as 45 years old.  These exams are done via two common methods – a prostate specific antigen (PSA) blood test and a digital rectal examination (DRE). Your provider can help you determine your risk and when you should start getting screened.  Pap Tests and Pelvic Exams  Patients of all genders who have a cervix, uterus, vagina and/or ovaries will benefit from regular pelvic exams and Pap screenings. A pelvic exam consists of a provider looking inside the vagina and at the cervix for anything unusual. A Pap test, also known as a Pap smear, involves your provider using a small, soft swab to collect cervical cells to check for early signs of cancer.  Generally speaking, people with these organs should have a Pap test every three years starting at age 21 through the age of 30. After age 30, patients should receive a Pap test with HPV co-testing every five years until age 65. These recommendations are changing based on new research, so it is important to have a conversation with your PCP about the current guidelines so you can make an informed choice about what schedule you should follow. A gynecologist or your primary care provider can counsel you and perform these screenings.  Mammograms and Breast Exams  People with breast tissue, especially dense breast tissue, are at risk for breast cancer, and regular breast screenings are your best line of defense. At-home breast self-exams are the first step – you will want to check your breasts for any lumps, changes, fluid leaks, irregular tissue thickening or anything else that feels unusual.  The Breast Cancer Risk Assessment tool, provided by the National Cancer Institute, is a good place to start to identify your risk. Talk with your primary care provider about the risks and benefits of starting screening at age 40 so you can make an informed decision about when to start. If you have any family history of breast or ovarian cancer, your PCP will offer you genetic testing for BRCA 1 and 2 mutations. Nevadans over the age of 18 can also get BRCA genetic test for free by enrolling in the Healthy Nevada Project.  Mammograms are important screening tools, but for a significant portion of people with breast tissue, density of the breast tissue may make mammograms less helpful in detecting cancer. Your primary care provider can help you decide what additional imaging (such as breast ultrasound) might be best for you.

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This Department Spotlight is dedicated to Jason Simpson, Manager of Respiratory Services at Renown Children’s Hospital.  Take a moment to breathe deeply. Inhale in, exhale out. We rely on our lungs to provide us with the air we need to live a healthy life – and this essential bodily function is something that many of us don’t think twice about since it comes easily for us. Now, imagine yourself as someone who is living with severe asthma, chronic obstructive pulmonary disease (COPD) or someone who was recently diagnosed with a frightening respiratory condition like COVID-19 or pneumonia. The simple act of breathing can prove to be an intimidating venture requiring the care of a professional. Who are the people that take on the challenge?  Meet Renown Health’s Respiratory Care Services department. Serving patients across 13 service lines, three acute facilities, outpatient locations and telehealth, our respiratory specialists – including respiratory therapists, respiratory care aides, inpatient COPD respiratory therapy navigators and educators and more – use their expertise to help restore the vitality of all their patients with every inhale and exhale, shaping a healthier livelihood one lung at a time.  The Guardians of Respiratory Wellness  Whether they are managing lifelong respiratory conditions or offering crucial support in emergencies, the Respiratory Care team strives to enhance the quality of life for every patient. As an indispensable member of the clinical team at Renown, our respiratory therapists work collaboratively with doctors and nurses to tackle a wide range of tasks, tailoring care for each patient’s unique needs.  “Respiratory care is involved with all stages of life, from beginning to end,” said Sarah Kurtz, Respiratory Therapist. “We work closely with nurses and doctors and perform arterial punctures, breathing treatments, weaning maneuvers for patients on life support, intubations and much more. We assess patients constantly to see if their care needs to be upgraded or if they can be weaned to get them back home with their families.”  “You start your morning researching your assigned patients,” added Tim Start, Respiratory Specialist. “We go over lab values and chest radiographs and decide the best plan of care for each patient. Our objective is to improve their respiratory status by giving them medications and doing breathing exercises. We participate in other forms of care with nurses, such as activities of daily living (ADLs) and mobilization. We work as a team, and that enables us to provide great patient care.”  For patients living with COPD, enjoying all that life has to offer comes with a separate set of obstacles. According to the Centers for Disease Control and Prevention (CDC), over 200,000 people across the Silver State are living with this chronic condition. Luckily for them, Renown has a specialized team to help these patients optimize their life and manage their condition with individualized treatment and education.  “We run a report every morning to identify all the patients currently admitted who have a history of COPD, take respiratory medications or smoke,” said Amber Beck, Inpatient COPD RT Navigator. “After looking through their charts, we visit with the patient (and possibly their family) at the bedside to help them better understand how to manage their breathing issues.”  As a vital part of the Respiratory Care team, Renown’s respiratory care aides help ensure the seamless operation of our respiratory care services. These dedicated professionals provide essential support to respiratory therapists not only during intricate procedures but also outside of face-to-face patient care by transporting equipment, restocking supplies, assisting in the mobilization of patients and more.  “We are responsible for the maintenance of unit supplies and making decisions regarding levels of stock to be maintained,” said Dia Ramos, Respiratory Care Aide. “We also transport equipment, refill the oxygen tanks on the floors and intensive care units (ICUs), order and stock respiratory care supplies, mobilize patients and assist the respiratory therapists during bronchoscopies in the ICUs. In addition, we clean respiratory equipment like mechanical ventilators, continuous positive airway pressure (CPAP) and bilateral positive airway pressure (BiPAP) machines, high flows and aerosol poles.”  Once the COVID-19 pandemic hit, a special spotlight shined upon respiratory care teams across the country for the heroic care they provided patients in respiratory distress. While their roles in health systems have gained a better understanding nationwide, this team understands it is vital for them to educate the community about the important jobs they hold for our patients.  “Respiratory care can be under the radar,” said Pam Umek, Respiratory Specialist. “Once, when I told someone that I am a Respiratory Therapist, they said, ‘Oh, like a yoga breathing instructor?’ I then explained all the things we do: intubation, extubation, bronchoscopies, transports, traumas, codes, rapid responses, pediatrics/NICU, breathing medications/therapies, open heart rapid ventilator weaning … needless to say, that individual walked away with a better understanding of not just Respiratory Care Services but also the enormous effort it takes to care for our community.”  The accolades and achievements continue to pour in, from national awards and certifications to implementing different jobs in care units to optimize the patient care experience.  “We have earned and continue to maintain the Joint Commission Disease-Specific Certification for COPD,” said Amber Beck. “We are well below national averages for 30-day readmissions, lengths of stay and mortality due to COPD. Sandy, one of our COPD Coordinators, was a recipient of a patient advocacy award from the American Association of Respiratory Care and FACES Foundation.”  “We have started implementing Respiratory Care Aides in the critical units, starting with the Cardiac ICU,” added Dia Ramos. “We work as one team and are always helping each other with their tasks.”  Education and mentorship are at the core of Renown’s mission to make a genuine difference in the health and well-being of every patient. Nurturing the next generation of medical professionals – including respiratory care professionals – is a task that the Respiratory Care team takes seriously.  “It has been great being able to help educate students in different disciplines,” added Pam Umek. “We have been able to offer shadow shifts to students in emergency medical services (EMS), nursing and medical school. These opportunities help students entering the medical field have a better understanding of the many ways we can help care for our respiratory patients.”  From the moment of birth to the final stages of life, Renown is fortunate to have a Respiratory Care team that tirelessly ensures every breath counts, safeguarding their role as a trusted partner within our health system.  A Tribute to Jason Simpson, Healthcare Hero

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When thinking about taking care of your total health, what comes to mind? Perhaps participating in your annual check-ups, taking your prescribed medication, eating a nutritious diet, checking in with your mental health, the list goes on and on.   Now, put yourselves in the shoes of someone who may not know where their next meal may come from, someone who may be homebound and not have access to transportation, someone who may be on a fixed income, someone facing homelessness or even someone who may be struggling with substance abuse issues. Getting healthy – and staying healthy – comes with a unique set of obstacles, or social determinants of health, for these patients to overcome. Inequities around social determinants and health behaviors have an outsized impact on patient outcomes, and social and economic factors make up 40 percent of those inequities.  This is where the caring and compassionate community health workers, social workers and registered nurses that make up Renown’s Community Care Management (CCM) department rise to the occasion. As the need for resources grows in northern Nevada, these dedicated team members fill those gaps and ensure every patient feels prepared, educated and equipped with everything they need to continue their care journey and live a healthy, fulfilling life.  Defying Disparities  When our community at risk faces healthcare disparities, it can create complications in each patient’s life that may keep them from addressing their healthcare needs and affect the likelihood of them being admitted or readmitted to the hospital or continuing to struggle with their care management – but not on CCM’s watch. Whenever possible, the CCM team steps in to provide critical resources, education and care journey guidance for any patient that finds themselves in need.  “In the simplest terms, we do outpatient case management with vulnerable populations,” said Barb Mader-Scherrer, Director of Community Care Management. “It may be anyone from elderly people who need help managing chronic diseases, to patients experiencing homelessness who are being discharged from the hospital. We work with folks who are facing all sorts of challenges.”  Several roles make up the CCM department, including Community Health Workers. These team members are the resource experts, on the front lines of helping educate patients and supporting them as they navigate through the facets of their care. Their main goals? Avoid admissions and readmissions to the hospital and continue to meet their unique goals.  “I have the pleasure of working with patients who may need financial help, transportation help or even help utilizing the food pantries in our community," added Steve Arm, Community Health Worker. “We help patients navigate healthcare and social services, address social determinants of health, encourage self-efficiency and provide general health education for many chronic conditions. We also provide home visits for our patients who need extra support.”  “The day in the life of a Transitional Community Health Worker is to outreach to the patient while being admitted, do a bedside assessment, complete the social determinants of health evaluation and provide any resources needed to avoid readmission,” added Sherrie Skaggs, Community Health Worker. “Our main population is Medicaid, and many are homeless and financially challenged. As needed, we continue to ensure that follow-up is completed, and all needs and goals are met.”  For those learning to cope with their condition and needing hands-on help especially after discharge, the CCM Social Work Care Coordinators take on this complex aspect of the healthcare journey. These individuals provide support and intervention for Renown patients facing a chronic, behavioral health or substance dependency condition to improve their overall quality of life beyond hospital walls, developing a strong framework to build a long-term healthcare plan.   “As social work care coordinators, we help connect patients with mental health resources, welfare programs, community support, caregiver burnout resources, placement for loved ones with terminal illnesses and much more,” said Irina Osmolovska, Social Work Care Coordinator. “Requests that come to us run the gamut of homelessness, family crisis, food insecurity and even situations where a patient has no electricity for their life-saving medical equipment. We receive challenging requests and are always ready to go above and beyond to advocate for our patients.”  Possessing a profound understanding of the delicate balance between medicine and the patient spirit, the CCM RNs help bridge the gaps between the hospital or primary care practice and post-discharge settings, ensuring a smooth transition for patients as they move from one healthcare setting to another. With their expertise in care coordination and patient education, these RNs help enhance patient outcomes and promote continuity of care.  “Our group is responsible for making discharge follow-up calls to patients who have Medicare, as well as scheduling their hospital follow-up visit if needed,” said Vanessa Alford, Consulting RN. “The goal is to have every patient see their primary care physician within 14 days of discharge for continuity of care and to prevent readmissions. We also screen patients for eligibility for Chronic Care Management or Personal Care Management. In addition to setting up the patient for follow up, I review each patient's medications, answer any questions they may have about their medications and health conditions.”  As another important part of unpacking the intricate web of social determinants impacting health, CCM RN Care Coordinators have the extraordinary opportunity to extend this department’s compassionate care beyond the boundaries of the traditional in-office environment. Whether it be through virtual connections, heartfelt conversations over the phone or in-person encounters outside the hospital, RN Care Coordinators create holistic and enduring plans of care for individuals facing chronic challenges – including behavioral health issues and chemical dependency struggles – at every stage of life.  All in all, the CCM department recognizes the interconnectedness of physical, emotional and social well-being for all patients, fostering a sense of wholeness and empowerment to ensure they continue to meet their goals and live healthier, happier lifestyles.  “Our team has a holistic approach to our work,” said Barb Mader-Scherrer. “We look at the whole picture. What are the medical things we can do for this person? What education do they need to help them manage their condition? Do they have food in their house? Do they have a safe living environment? Are there substance abuse issues? Do they need help in managing their medications?”  “My 18 years of experience in various areas of hospital nursing and home health have given me the knowledge to serve patients in our community holistically, and I feel good about what I do,” added Vanessa Alford. “I hope that I am able to lessen the load on the medical assistants and providers in the clinics so they can focus on their patients on site.”

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