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Dr. Carilyn Hoffman with Renown's Women's Health explains the symptoms, causes and treatments of Polycystic Ovary Syndrome (PCOS) (also referred to as Polycystic Ovarian Disease (PCOD)), a prevalent condition among women of reproductive age that influences hormonal balance, metabolism and fertility. Make an appointment with Renown Women's Health Click here to schedule Call to schedule: 775-982-5000 PCOS Defined PCOS is a constellation of symptoms characterized by two of the three criteria: multiple small cysts on the ovaries visible via ultrasound, irregular periods and signs of hyperandrogenism. Other symptoms include infertility, insulin resistance, and increased risk of cardiovascular disease. Symptoms of PCOS The symptoms of PCOS can vary from woman to woman, but some of the most common include: Irregular menstrual cycles: This is often one of the first signs of PCOS. Women may experience fewer than nine periods a year, more than 35 days between periods, frequent spotting, and/or abnormally heavy periods. Excess androgen levels: High levels of male hormones may result in physical signs such as excess facial and body hair (hirsutism), severe acne and male-pattern baldness. Polycystic ovaries: Enlarged ovaries containing numerous small cysts can be detected via ultrasound.     Causes and Risk Factors The exact cause of PCOS is unknown, but several factors may play a role: Genetic predisposition: A family history of PCOS increases the risk. Insulin resistance: High insulin levels might increase androgen production, causing difficulty with ovulation. Obesity: Women with elevated BMI’s are more likely to have PCOS, although 20% of women with PCOS are not obese. Diagnosis and Treatment Dr. Hoffman outlines that diagnosing PCOS requires a medical history review, a physical exam, blood work and an ultrasound to evaluate the ovaries. Treatment options can range from lifestyle modifications, like diet and exercise and weight loss, to medications for menstrual regulation, fertility assistance, and rarely surgery. Lifestyle Changes A healthy lifestyle is a cornerstone of managing PCOS. Regular exercise, a nutritious diet, and weight management can help reduce symptoms and the risk of long-term health issues. In overweight patients, weight loss as little as 5% has been shown to improve symptoms of PCOS. Medication Medications may include hormonal contraceptives to regulate menstrual cycles, anti-androgens to reduce hair growth and acne, and Metformin to address insulin resistance. Fertility Treatment For women with PCOS who are trying to conceive, ovulation induction with clomiphene or letrozole is sometimes necessary. Sometimes a referral to a reproductive endocrinologist and infertility specialist is needed for more advanced technologies like IVF. Health Implications PCOS is not just about cystic ovaries or irregular periods; it can have profound implications on a woman's overall health. Women with PCOS are at an increased risk for several conditions, including type 2 diabetes, high blood pressure, heart disease, and endometrial cancer.

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Kick off 2024 with us as we celebrate the team behind our very own Renown Health Foundation!  When you visit Renown Health, you take a look around and can’t help but notice the robust programs in place. You look left and see our thriving Children’s Miracle Network Hospital at Renown, making a lasting impact on pediatric healthcare in our region. You look right and see the advanced William N. Pennington Cancer Institute, providing leading-edge treatments right here in our community. You look around you and notice an influx of smiling nurses from the Orvis School of Nursing at the University of Nevada, Reno (UNR) who receive tuition assistance, thanks to generous donations to the Gerald “Jerry” Smith Academic Practice Partnership. Then, you think to yourself: “These programs must need a lot of money and support. So, how on earth is this all possible?”  What you may not know is that these programs are funded by the generosity of our community, all made possible by the work of Renown Health Foundation. As the largest not-for-profit health system in northern Nevada, our mission to make a genuine difference in the health and well-being of everyone we serve flourishes because of the donations, sponsorships, endowments and more that our Foundation brings in from philanthropists all over the region.  Making It Happen  The reach of Renown Health Foundation has proven to be virtually limitless, with a clear focus on supporting and raising funds for programs and initiatives that enhance the lives of our patients and their families, all for the betterment of our community for years to come.  Under their growing umbrella, the dedicated team at the Foundation makes miracles happen through administering a wide range of philanthropic programs, including: Children’s Miracle Network Hospitals (CMNH), a nonprofit organization that supports the health of 10 million children in the U.S. and Canada every year. Renown Children’s Hospital is proudly recognized as a member of CMNH. Gerald "Jerry" Smith Academic Practice Partnership, a partnership between Renown Health and the UNR Orvis School of Nursing to provide 24 nursing students a year with full-ride tuition assistance and a guaranteed career in nursing at Renown. Fianna’s Healing Garden, a healing garden bringing serenity to all at Renown Regional Medical Center, built from the vision of Fianna Dickson Combs. Miracles at Montreux Golf Tournament, an annual golf tournament that takes place at Montreux Golf & Country Club and consistently raises hundreds of thousands of dollars for Renown Children’s Hospital. A full slate of individual giving programs, including Legacy Giving, Employee Giving and Leadership Giving.  But it doesn’t stop there – the Foundation is helping our health system build more ways to care for our community by securing major gifts to fund advanced healthcare facilities and innovative healthcare solutions:  William N. Pennington Cancer Institute, the premier oncology institute in the region providing a large array of personalized cancer care services, including Medical Oncology, Infusion Services, Clinical Research and more. Renown Institute for Robotic Surgery, offering the latest advancements in surgical technology with robotic-assisted surgeries, which ensure precision, faster recovery and improved outcomes. Sophie’s Place, a state-of-the-art music therapy room currently in construction at Renown Children’s Hospital. This new space will be specially designed for children and their loved ones to enjoy the healing power of music and engage in the arts. Conrad Breast Center, the latest addition to the planned Specialty Care Center at Renown South Meadows Medical Center which will include breast imaging, infusion and surgery services along with a wellness center. Jeanne and Raymond Conrad donated a $5 million lead gift to support this important project and the Foundation team is currently working to raise an additional $6 million in 2024. It may go without saying that a day-in-the-life of these spirited team members is never a dull one. Every day brings on a new challenge to face and a goal to meet.  “A day at the Foundation is a day full of emails, calls and visits with friends of Renown,” said Abbey Stephenson, Planned Giving Officer. “Our main goal is to raise funds to support the mission of Renown, and most of our outreach efforts are to encourage philanthropy and donations. We have a very collaborative team, so we can often be found in each other’s offices strategizing about fundraising initiatives, communications and next steps with specific supporters.”  “For me, a typical day involves making sure I have a donor scheduled for coffee or lunch, working on proposals that may need research and preparing presentations,” added Jerry Cail, Major Gifts Officer. “Staying connected, I send thank you notes for any donations-usually once a week and make at least three ‘Grateful Patient’ calls to set appointments. I always make sure I am ready to contribute to any meetings I have for the Foundation."  While the scope of the Foundation’s charitable efforts goes beyond hospital walls, they also thrive right here in our own health system. Through our Grants Program, Renown’s departments and programs can leverage the connections and skills Renown Health Foundation has in order to secure funding from a multitude of grant sources.  "Grant funds from foundations, and local, state and federal governments benefit the patients and communities we serve to further our mission, vision and values,” said Pam Citrynell, Development Officer. “Past grants have supported the purchase of state-of-the-art equipment, facility development, pandemic recovery, research and clinical trials, physician and researcher recruitment, community health programs and educational training for our healthcare professionals.”  Every Foundation team member lives their passion every day while at work, frequently expressing gratitude for the immense impact they have the opportunity to make.  “I love coming to work because I get a very real opportunity to make a genuine difference and meet some fantastic people who believe in and support our mission,” said Leah Nelson, Director of Community Giving. “I have had the honor of meeting donors and the families they support. I couldn't be prouder of what our team has accomplished over the years and am excited for what is to come.”  The impact of the Foundation team’s tireless efforts extends far into the future, securing Renown’s lasting legacy in contributing to the continued health and well-being of our community.  “Philanthropy is not only a financial science but a very specific methodology where connecting resources are paramount; it requires careful intelligent management coupled with lots of hard work, patience, and vision,” said Yvonne Murphy, Development Officer. “The work that the foundation does every day makes resources available to enhance the healthcare experience for all those who seek care at Renown. Our work impacts not only this present moment but in fact is a legacy that will bless this community beyond our lifetime.”

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Nov. 12-18 is Health Care Strategy & Market Development Week. Please join us in celebrating the Marketing and Communications team at Renown Health!  When you think of the brand of Renown Health, what comes to mind? Perhaps you think about our Fight the Good Fight motto that you see integrated throughout our commercials and advertisements. Or maybe your mind drifts to our signature purple that you saw on a print design or social media post. You may even think of a local news story that showcases the essence of who we are as an organization. Or you may gravitate toward the look and feel of our patient-friendly website. Managing the brand of our health system is crucial as patients look to Renown to be the voice of not-for-profit healthcare – and it takes a wide range of expertise to solidify that voice.  The masters of our voice can be found within Renown’s Marketing and Communications (“MarComm”) team. From branding and business-to-business to content and community relations, this robust department is the minds behind our reputation within the communities we serve. This team is chock-full of expert writers, speakers, designers and marketers who craft positive and memorable communications that lead to a lifetime of patient and employee loyalty.  The Connoisseurs of Communicating  As the keyholders of Renown’s brand position and promise, our MarComm team are experts at ensuring the community at large remembers precisely who Renown is and what our health system stands for. This all-hands-on-deck department encompasses a wide variety of talents:  Marketing and creative services: Traditional and digital advertising, brand templates and collateral and brand image and awareness Communication and public relations: Employee and provider communications, intranet management, social media, media relations, photography and videography, community relations, crisis communications and strategic planning and advisement Digital specializations: Website and microsites, email marketing, customer journey mapping, blogs and chatbots  Our Marketing and Creative Services team members are the ultimate dreamers, starting diverse campaigns from the ground up.  “In marketing and creative services, we are always dreaming up something new,” said Emily MacMillan, Manager of Marketing & Creative Services. “Between our brand advertising, to service line campaigns to external partnerships, you can always find our team working on a marketing plan and creating ads, content, messaging, videos, graphics, emails, photoshoots and more.”  “From Fight the Good Fight brand work to a service line promotion or a sponsorship creative package, the variety of projects my role allows me to bring to life for Renown is almost endless,” added Chad Norton, Senior Creative Specialist. “That can make every day at my job nothing like the day before – which keeps things interesting and my creativity flowing.”  For all things storytelling and public image management, Renown looks to the Communications team for expert guidance.  “As the Manager of Communications, I get to lead the most talented group of professionals I have ever had the pleasure of working with,” said Caroline Ackerman, Manager of Communications & Public Affairs. “Sometimes there is an urgent matter to tend to, and we drop everything to support larger-scale communications. Other days, we get last-minute requests from our local media partners for TV interviews. On top of that, the communications team supports event planning and employee recognition. It’s so fun to work in this hybrid space where we can get our work done from home while also being present at meaningful Renown events.”  At Renown, we believe our external image is just as vital as our internal culture. Keeping our employees informed and engaged every step of the way is of utmost importance to MarComm.  “While most of our department supports projects that focus on our patients, guests and visitors, our employee communications team supports internal clients (our employees),” said Dani Vogel, Communications Business Partner. “Therefore, I spend a good portion of my time working with internal departments and service lines to deliver important communications across the organization using a variety of channels. In a nutshell, my day starts with the question, ‘what do our employees need to know today?’ We get to work with so many amazing internal teams.”  “I internally project manage some of the marketing campaigns, from open enrollment to our annual report, and each project is different and requires its own approach,” added Colleen McLellan, Senior Production Specialist. “I create the framework for each project, such as establishing a kickoff and ongoing meeting cadence during the project, ensuring we track lessons learned and decisions made for each, create the folder structure in Sharepoint, and opening a project and maintaining the tasks and deadlines in Workfront. I am also often part of a quality circle, proofing ads and other materials created as part of a campaign. As with all of my colleagues in MarComm, we are often resources for where to learn more or find information for other departments.”  “One of my roles is to maintain the Brand HQ site and review approval requests,” added Aurora Boles, Creative Services Specialist. “I enjoy hopping on Teams calls to assist our employees with their questions about the site or templates.”  Maintaining a high standard of digital excellence comes easy for the Marketing Technology team, who manage the complexities of Renown’s digital front door – starting with our website.  “Think about how many health service lines Renown has to offer; now, let's create an organized set of pages for that specific service line on Renown.org – that a lot of pages!” said Sarah LaBarge, Digital Specialist. “It takes time to curate the layout, work with providers and the Communications team to ensure the content is correct and create components and images for the page to give the user the best digital experience while continually updating and maintaining all our pages. We don't just have Renown.org; we have many other microsites that we maintain as well. It is a nice challenge to make both our team and users happy and have a good experience.” "The user experience is always at the forefront of whatever I do," added Tori Bowlin, Digital Content Editor. "When writing health blogs, emails, or health service web content, it's essential to attribute the information to one of our outstanding providers and link the post to a Renown Health Service or reputable source. A thoughtful workflow helps our customers make informed decisions regarding their health and well-being." As a not-for-profit health system, Renown reinvests right back into the community we serve. Our Community Benefit team serves as the overseers of this promise, ensuring our local non-profits that share our mission are able to deliver on their own goals.  “I absolutely love the role of community impact and partnership liaison and the opportunity it provides to work with so many wonderful local nonprofits,” said Melissa Dahir, Community Benefit Liaison. “Our local community is filled with so many organizations designed to help those in need, and it is an honor to be contributing to and supporting the work these amazing groups do. My work with this department involves partnering with nonprofit organizations by providing funding for program support through groups identified in our Community Health Needs Assessment, and providing grants for traditional events such as community walks, golf tournaments, dinners, galas and more.”  The MarComm team’s paramount focus on maintaining a caring and collaborative culture stems from the impact they have on patients' lives and the crucial trust placed in the organization. For this team, no project to benefit the health and well-being of Renown’s patients is too big nor too small.  “As someone holding a core leadership position on this team, I can see firsthand that our team is all about culture and retention,” said Cristal Woodley, Senior Director of Marketing, Communications and Customer Engagement. “At the end of the day, we have an impact on patients’ lives and trust in the organization. I’ve surrounded myself with such smart people.”

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At Renown Health, our commitment to the experience of all our patients and guests is not just a mission – it's a way of life. Our unwavering dedication to creating exceptional experiences for the communities we serve is what sets us apart. Every day, we strive to build a service culture of excellence, one that ensures that every person who walks through our doors has an extraordinary encounter that exceeds their expectations.  Renown’s Patient Experience department is the team that fulfills this mission and more. These passionate individuals intimately understand that top-of-the-line service involves the entire healthcare continuum, from the first phone call when scheduling an appointment to the final discharge and follow-up instructions and everything in between. With this collective dedication, Patient Experience is consistently on a journey to redefine what it means to leave a lasting impact in the minds of patients, setting a new standard for healthcare excellence in our community.  Our In-House Jack-of-All-Trades  It takes a village to ensure every patient and guest continues to have a positive experience at every Renown location and maintains trust in our providers and employees. Our Patient Experience team serves as the mayors of that village, encompassing four main aspects of healthcare service:  Service Excellence: Compiles, reviews and resolves patient complaints and concerns to help with service recovery and identify opportunities for improvement. Volunteer Services: Enhances the patient experience by leveraging dedicated youth, adult and college-aged volunteers in a variety of volunteer programs, including pet therapy, healing arts, hospice and more. Language Access: Provides qualified interpretation and translation services to assist our limited- or non-English-speaking populations. Data Management: Uses patient experience data, research and surveys to prioritize system, location and unit-specific service needs to improve clinical and quality outcomes.  “Because our department has many segments, no day is the same, which keeps the work week exciting,” said Shelbi Whitehead, Manager of Patient Experience. “Whether we are hosting a pet therapy parade for patients, de-escalating and rounding with upset patients to provide service recovery, offering interpretations for our Limited English Proficiency (LEP) patients, or managing data for the organization, we have one goal in mind: to enhance the experience for our patients and guests at Renown Health.”   Cultivating a sense of community and fostering trust in our health system, the Service Excellence team steps in to ensure no concern goes unnoticed and every opportunity to make a positive chance is addressed.  “My day consists of listening to patient concerns, connecting with different department leaders and providing support, and working on projects to improve processes,” said Julianne Revilla, Customer Experience Specialist. “To help enhance the patient experience, I round with patients on different floors to know more about their stay and experience with us. If they have any issues or concerns, I let floor staff know and do our best to resolve the issue in the moment.”  “My team and I have an amazing opportunity to work with multiple leaders throughout the organization to resolve any patient concerns and provide valuable feedback on how patients are doing while using services that we offer,” added Ricky Garcia Sanchez, Senior Patient Experience Specialist. “A typical day will involve calling patients, rounding with patients, communicating with leaders to resolve events, handling grievances and staying in compliance with Centers for Medicare and Medicaid Services (CMS) guidelines.”  “It’s all about hearing what is upsetting them and letting them know that we care about them,” added Shay Morgan, Customer Experience Specialist. “We ask ourselves, what is the main concern the patient has, and what is it they are seeking? From there, we do our internal investigation through Midas and send it to leadership, and then we find a reasonable and appropriate solution or response to let the patient know we are looking into their concern.”  As the only not-for-profit health system in the region, Renown depends on the dedicated service of our volunteers. Our Volunteer Services team deploys volunteers across many programs who make a significant difference in the lives of patients and their families.  “On a typical day, I may be going between the volunteer information desks assisting that team with anything that comes up while they are helping guests,” said Wendy Peukert, Volunteer Coordinator. “We find wheelchairs for departments, provide guest escorts, deliver flowers and mail to patients, locate doctors’ appointments or anything else that helps someone that walks in the door. We ensure all our programs go smoothly by planning ahead while also being flexible to be ready for anything that comes our way and by keeping communication open with our volunteers. Patients and guests being greeted by friendly, knowledgeable volunteers who show empathy and care is my goal!”  “Some of my best days at Renown are volunteering with my dog Moose, who is a certified therapy dog, and watching the healing he provides to patients and employees,” added Shelbi Whitehead.  At Renown, we believe that language should never be a barrier to receiving care. Our Language Access team ensures that this goal is realized through providing expert interpretation and translation services.  “Renown has many different resources we use to ensure LEP patients and visitors receive a positive, quality visit to our health system,” said Seth Rubin, Supervisor of Language Access. “With signage strategically placed at front desks and check-in areas, patients can point to their preferred language, and we can use the Language Line iPads, phone lines or a dual-role Qualified Medical Interpreter to communicate with the patient or visitor. Within EPIC, we can also set a patient’s preferred language indicating to Renown staff what language to use with the patient and prepare forms in that language. I always ensure all patients are provided with these proper language services, and I also help with employees taking our online interpreter certification course, as well as help when a department needs new Language Line equipment. Additionally, I enjoy meeting with community groups to stay informed on community updates, events and trends around language, immigration and more.”  Renown values and utilizes the opinions of our patients across all corners of our health system Maintaining service transparency is a promise, and that promise is fulfilled by our Data Management team, who use all the research and survey tools at their disposal.  “My daily work includes a lot of updating scorecards across the network, working with the tech teams to ensure the patient data is getting to the right places, training leaders, analyzing market data and maintaining the reports that go to every corner of Renown,” said Brooke Cyphers, Market Data Analyst. “Through a partnership with our patient satisfaction survey vendor, PRC, Renown ensures data integrity, neutrality and credibility in surveying patients in all our care areas. The data from completed surveys are compiled and disseminated to our providers and leadership at all levels with the goal of transparency and patient-centric practice. These surveys are incredibly important to process improvement directly targeted at addressing areas that have been mentioned by our patients. I love it when people reach out to dive into a particular initiative they want to track or an issue they want insights on.”  In their relentless pursuit of excellence in service across many programs, the Patient Experience team remains steadfast in their commitment to delivering the highest quality care and experiences.

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In today's fast-paced society, it is understandable for parents to want to take shortcuts in caring for their little ones. A s a result, It is tempting to leave a sleeping infant in a car seat or swing after a long day of errands or when you need a moment to catch your breath. But, as convenient as these devices may be, they pose a serious risk to your child's safety. Why Car Seats and Swings Pose Risks for Infant Sleep Car seats, swings, and bouncers are quick and convenient ways to feed, hold, and sleep an infant. Not out of malice or discontent, but again from the need for quick and easy access to baby care in an already busy lifestyle. However, the risks outweigh the benefits. The American Academy of Pediatrics (AAP) states that “infants should be moved to a crib, bassinet, or play yard for sleeping as soon as is practical.” If a parent must use a car seat or other sitting device, they should only do so for a short period of time and never as a substitute for a proper sleeping environment. Leaving a sleeping infant in a sitting device, such as a car seat or swing, can create unsafe sleeping conditions. The American Academy of Pediatrics (AAP) warns that doing so increases the risk of sudden infant death syndrome (SIDS) and positional asphyxia. This is because infants can easily slump over or become entangled in the straps, blocking their airway, and causing suffocation. Car seats, swings, and bouncers are quick and convenient ways to feed, hold, and sleep an infant. Not out of malice or discontent, but again from the need for quick and easy access to baby care in an already busy lifestyle. However, the risks outweigh the benefits. The AAP states: Infants should be moved to a crib, bassinet, or play yard for sleeping as soon as is practical. If a parent must use a car seat or other sitting device, they should only do so for a short period and never as a substitute for a proper sleeping environment. Leaving a sleeping infant in a sitting device, such as a car seat or swing, can create unsafe sleeping conditions. The AAP warns that doing so increases the risk of sudden infant death syndrome (SIDS) and positional asphyxia. In addition, infants can easily slump over or become entangled in the straps, blocking their airways and causing suffocation.

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If you’re expecting a new baby, you may have been given the advice to hire a doula. You may have seen statistics of improved outcomes among those who’ve had a doula attend their birth. Perhaps you’ve heard that the etymology is from the Greek word meaning “to serve.” But how does a doula serve their clients? A doula is a non-medical birth professional who will guide you through labor, birth, postpartum and beyond. Your doula can discuss your options with you so you can make informed decisions, as well as provide emotional and physical support to ease your experience. While each doula offers their own style, there are certain services that most doulas will provide for their clients. Typically, a birth doula will provide at least one prenatal visit, one postpartum visit and continuous support during active labor. A postpartum doula usually provides support during the 12 weeks immediately following birth, sometimes referred to as the “fourth trimester,” but some will continue care after that as well. Simply put, a doula provides informational, physical and emotional support during the childbearing year(s). Let’s take a closer look at these three ways a doula can support you. The Basics If you don’t know your options, you don’t have any. This is a common phrase in the world of birth work. When you’re in labor, you’re exhausted, in pain and there’s often urgency inherent or implied in any choices you make. So, when an intervention is offered, many birthing people accept it without question. One method that can help the decision-making process is to check your BRAIN: Benefits: What are the benefits of the proposed intervention? Risks: What are the risks of the proposed intervention? Alternatives: What are the alternative options? Intuition: What does your intuition tell you? Nothing: What if we do nothing? What if we wait? When you’re in active labor, you might have difficulty remembering this acronym; that’s where your doula comes in. At your prenatal visits, you can ask your doula for guidance in preparing your birth plan, which can include contingencies for certain potential interventions. And as choices arise during labor, your doula can guide you through the benefits and risks and can provide you with alternative options you might not otherwise be aware of that are available to you. Your doula can remind you to check in with your intuition and can help you quiet your mind so you can listen to your instincts. The Body Although we tend to see depictions of people giving birth on their backs with their feet in stirrups, this is only one of many ways to give birth. Walking and dancing can speed up early labor. Side-lying or hands-and-knees can prevent tearing during the pushing stage. Sometimes labor stalls, and a change of position is often helpful to get things moving again. Your doula can suggest positions depending on your stage of labor. Some labor positions might require the support of another person – your doula could fill this role or assist your partner in doing so. Some doulas also provide massage or even acupressure, and most will do the “hip squeeze” that so many laboring people swear by. If your baby is presenting posterior, or “sunny side up,” your doula can apply counter pressure to alleviate back pain during labor. Some postpartum doulas will do light housework while you rest and bond with your newborn. Others might care for your baby through the night so you can catch up on sleep. Many doulas have also gone through additional training to offer breastfeeding support and may be able to assist you with latch issues and nursing positions. The Mind Pregnancy, birth and postpartum periods can be some of the most emotional times in a person’s life. A doula will hold space for you and help you process your emotions before and after birth. It’s normal to feel apprehensive, or even fearful, about labor and birth, and discussing these feelings is the first step. A doula can help you navigate your concerns in a safe space so you can be prepared emotionally for your upcoming labor. Many doulas will also guide you through writing your birth plan, which can lessen anxiety about the unknown. If you have a history of trauma, your doula can assist in communicating this, so you don’t have to relive the experience every time you meet a new medical provider. Most people will experience some form of what’s often called the Baby Blues in the immediate postpartum period. The third day after birth tends to hit hard, as hormones attempt to regulate, but the Baby Blues can continue for weeks for some new parents. A postpartum doula’s support can be incredibly valuable during this time. When the baby blues last longer than a few weeks, it could considered a mood disorder. Most doulas will recognize signs of postpartum mood disorders and will have resources available for additional support. Choosing the Best Doula for You With so many wonderful doulas in northern Nevada, you might wonder how you could ever choose just one to attend your birth. Some expectant parents are unfortunately restricted by cost. With so many expenses related to a new baby, it can be difficult to budget doula services as well. Thankfully, Nevada Medicaid now covers doula care, and some commercial insurances are following suit. Check with your insurance company to find out if they might cover part of the cost for hiring a doula. If your insurance doesn’t cover doula services, some doulas offer a sliding scale based on income. You may want to interview multiple doulas to find the right one for you. If you’re the kind of person who wants all the information you can get, a more detail-oriented doula might be the best choice. But if you tend to feel overwhelmed by too many options, you might prefer a doula who only offers additional information as the situation calls for it. If you want massage or acupressure during labor, you might want to hire a doula with those certifications. Or maybe informational and physical support are not as important to you as emotional support, in which case your best choice could be a doula who has experience with postpartum mood disorders or trauma support. Regardless of who you hire, be sure to clearly communicate your desires and expectations – not just for your birth, but also for your doula. The most important thing when choosing your doula is trusting your gut. You need to feel comfortable with your doula, as they’ll be tending to you at one of the most vulnerable times in your life. When you find a doula that you click with, who listens to you and supports your choices, you have found the best doula for you.

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Help celebrate the end of tax season by recognizing Renown's Finance team!  The financial health of every organization is integral to their mission delivery. A health system like ours is no different – and it comes with many intricacies that require a top-notch finance team. The work of financial professionals in healthcare goes far beyond just balancing the books and ensuring bills are paid on time; their work is instrumental to the sustainability and growth of every organization.  The Finance department at Renown Health makes a genuine difference by partnering with every team across our health system to safeguard their financial vitality. From accounting and payroll to financial planning and analysis, this team manages our financial resources effectively to assure we can continue providing the highest quality of care to all patients.  Money-Minded  The team members in Renown’s robust Finance department run the gamut of financial expertise:  Accounts Payable pays all our bills to our vendors. Tax and Treasury handles our business licensing and investments. Accounting records our financial transactions, prepares financial statements and reports transactions to the public and the government. Payroll ensures all our employees are paid for their service. Financial Planning and Analysis focuses on long-range planning and evaluates projects for a positive return on investment. As our in-house finance experts, this team’s workdays are anything but ordinary. Every day – and even every month and season – looks different than the last. On top of it all, these team members know exactly what it means to represent Renown’s cultural commitment to collaboration.  “We handle a varied set of tasks daily, weekly, monthly, quarterly and yearly,” said Minty Huynh, Database Administrator for Renown Health. “We could be churning through a planning cycle involving multiple reports and leader meetings, or we could be diving into details about why a specific department has a charge that brings them over budget.”  “Given that my role is tied with a lot of other finance and accounting departments, there is a lot of variability in the role on a day-to-day, week-to-week and monthly basis,” added Michaell Poertner, Financial Systems Administrator for Renown. “Regarding cross-functional collaboration, we meet with team leaders to address any issues or concerns they have with process or data, then work to alleviate those concerns. We all work together to ensure we record and account for our businesses within established rules and regulations.”  Helping lead our leadership team through financial and strategic goals plays a major part in Renown’s success. Our Finance team has nailed this down to a science. That guidance is driven by two key aspects: data and determination.  “Our team performs specific activities around planning and budgeting, financial effectiveness of current operations and planning for the future,” said Deirdre Maurer, Director of Financial Planning and Analysis for Renown. “We analyze data and provide support for our operations teams. Additionally, we manage Axiom, our financial performance management tool used for all our financial activities: capital planning and tracking, budgeting, long-term planning, management reporting and productivity.”  The excitement of solving problems and presenting high-quality analyses drives this team to succeed. However, given the complexities of their everyday work, one may believe that they stay siloed in their own areas.  The reality is the opposite – these team members appreciate each other immensely and attribute many triumphs to their colleagues.  “I get to work on puzzles every day, such as taking capital projects and building a complete package of reports and documentation to support the many assets at Renown,” said Debra Reyes, Accountant for Renown. “I need and appreciate everyone: Accounts Payable for reclassing items, Finance for project funding, leadership for direction and departments across our health system for working with me on serial numbers and in-use information for capital items.”  Our entire Finance team is committed to providing the necessary support and guidance to everyone at Renown, ensuring our financial well-being every step of the way.  “The finance team supports business partners in managing current and future financial well-being,” said Nancy Perryman, Principal Financial Analyst for Renown. “We are here to help and work with every department that needs it.”  Change Agents  As an organization, Renown Health went through a significant change in 2022 that helped set us on a positive financial trajectory. Last year, our senior leadership decided to transition from a July 1 to June 30 fiscal year to a calendar fiscal year from Jan. 1 to Dec. 31 to link up with Hometown Health’s fiscal year and the fiscal years of most health systems nationwide. From July 1 to Dec. 31, Renown navigated through a “stub period,” which was an opportunity for our team to build upon and deeply analyze our financial health in preparation for a strong, year-long fiscal year.  This transition was accomplished with the dedicated, efficient Finance team, who led Renown through this tough time. In addition, their proactive approach to our calendar year planning during the stub period directly impacted Renown’s margin improvements and financial longevity into 2023 and beyond.   “Changing our fiscal year meant that we needed a special audit only a few months after our last audit for the six-month ‘stub’ period between the old and new fiscal years,” said Shanna Entin, CPA, Senior Accountant for Renown. “There are a lot of challenges with a smaller audit, as some are familiar while some are new, but I’m proud to say we knocked that audit out of the water.”  Despite this uniquely busy season, none of the Finance department’s additional duties fell by the wayside. They celebrated an expedited five-year plan completion, planning turnarounds and much more, all while guiding Renown through the stub period.  “I am proud of this team for finishing our rolling forecasting within two weeks and completing the five-year plan within another couple of weeks,” said Michaell Poertner. “We converted our system to a calendar fiscal year and ensured data integrity was maintained the entire time."  “We’ve had many great accomplishments involving expedited planning cycle turnarounds such as our five-year financial plans in two weeks, the calendar year 2022 finances in another two weeks and a fiscal-to-calendar year conversion,” added Minty Huynh. “We are proud of having pulled together to deliver our plans to the board on time.”  Who can forget the ramifications of the pandemic? During this trying time, our Finance team supported COVID-19 initiatives to ensure all our care teams had the resources they needed to provide the highest standard of care for our most critical patients.  “I am proud that our team was able to support the accounting team with data to reinforce the funding we received for COVID-related expenses,” said Deirdre Maurer. “Our team continues to be here to help any Renown employee, which we are happy to do.”  And the successes of our finance change agents keep on coming – full speed ahead.  “Simply put, we rock,” said Debra Reyes. “We have been able to record assets with more details than before, such as adding locations, serial numbers and more. We have had great audits because our reporting and eye for detail have been keen. We understand each other’s strengths and weaknesses, becoming friends in the process."  Falling in L.O.V.E. with Renown   Respect, reputation, relationships – this is the Finance department’s “Renown Why.” Acknowledging Renown’s community impact and giving back to the health system that provided vital support during some of their most daunting times were common themes among this team for why they joined our purple family.  “I wanted to give back to the organization that had given me so much,” said Shanna Entin. “In March 2009, the ICU team went above and beyond trying to keep my late husband alive. He was a professional ski patroller caught in an avalanche while doing snow control work in Lake Tahoe. Even though he succumbed to his injuries, I will always be grateful to them for not giving up on him. Some 21 months later, my current husband landed in the same ICU with a flailed chest and various injuries from a skiing accident. The care he received in those nine days healed him enough to continue his care at home.”  “I chose to work at Renown because we spent much time at this hospital when I was younger,” added Nancy Perryman. “My sister and I interacted with patients and delivered homemade cards to the elderly, and nurses brought us hot chocolate. Renown felt like home as much as possible when we were here with my father. Then, as an adult, when my father was in his final days, our family surrounded my father, and the amazing Renown staff surrounded us.”  “Renown is a well-known name within the Reno area, and I wanted to work with a company with a good reputation and longevity,” added Michaell Poertner.  Now, why do they stay? For this department, the answer is simple: their colleagues. Like many other departments at Renown, the encouraging and uplifting team atmosphere inspires them to continue making a difference. It helps them remain dedicated to Renown’s mission and vision.  “What keeps me at Renown is the awesome team of professionals I get to call my colleagues,” said Shanna Entin. “We take our jobs seriously. And at the same time, dealing with life is always prioritized over work. So many people are willing and able to jump in to cover you when life throws a curve ball.”  The proof “is in the pudding” – many members of this team have a 20+ year-long tenure at Renown, and they remain loyal to this day, excited for the journey ahead of them.  “I applied here in 1999 to be an Accounts Payable Clerk at Renown South Meadows while I was wrapping up my courses at Career College of Northern Nevada; I’m thankful I’m still here,” said Debra Reyes. “I have a very interesting history with Renown and have experienced a wide range of things. That’s why I stay – for what lies ahead.”  “I chose to work at Renown 20 years ago to make a ‘genuine difference,’ and I like that Renown had and still has a focus on the community and quality healthcare,” added Deirdre Maurer. “I am here today because I enjoy the people, our values and our continued commitment to our patients, community and each other. I am grateful for the opportunity to be part of a great organization.”  The gratitude among this team transcends beyond office walls, and they welcome any fellow finance experts to consider joining their department and embracing the future together.  “I’m thankful every day, even on the hard days,” closes Debra Reyes.

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Most babies weigh just one pound and are roughly the size of an eggplant when they reach 24 weeks of development inside the womb. It is a crucial stage when internal organs begin functioning, and the babies' respiratory and central nervous systems are still developing.     So, in November 2021 when Kallie Johnson experienced a premature rupture of amniotic fluid around this point in her pregnancy, her care team in Winnemucca decided to transport her via Care Flight to Renown Regional Medical Center. The team at Renown Children’s Hospital immediately began discussing the risks of delivering at 24 weeks with the Johnson family.  Moving Forward with Hope Knowing the stakes, Kallie remembers never feeling rushed to decide about delivering her baby preterm. “I felt educated and supported by my care team at Renown throughout our entire stay, starting with the education they provided about what it meant to deliver my baby early,” Kallie said. “The team really helped me make the best decision for myself and my family.”    Together, Renown employees and the Johnson family moved forward with a healthy set of nerves and a powerful feeling of hope.  Weighing in at one pound 11 ounces, Sloan entered the world on Nov. 19, 2021, via emergency Cesarean section. Her birth was classified as a micro preemie because she was born before week 26 of pregnancy and so small that she fit inside the palm of her father Sterling’s hand. A full-term pregnancy is classified as reaching 39 weeks.   A Fighting Chance  Called a fighter by many Renown Children’s Hospital care team members, Sloan spent over five months in the neonatal intensive care unit (NICU). She was placed on a ventilator, fed through a feeding tube and monitored 24/7, overcoming daily challenges with the Renown team and her family.  As a result of being born prematurely, Sloan developed a grade one brain bleed and a congenital heart defect called patent ductus arteriosus, a persistent opening between two major blood vessels, causing too much blood to flow to the lungs and heart.   To meet the oxygen needs of her tiny lungs, Sloan was intubated and developed a severe oral aversion and high-arched palate as a result. The effects would lead to difficult developmental and physical challenges that she still conquers today. Yet, with the help of her care team – including physical, occupational and speech therapists, dieticians and doctors – Sloan continues to make progress every day.

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By taking our pregnancy and birth class, you will gain the tools necessary to have a safe and empowering birth experience for both you and your baby. Chris Marlo, Childbirth Educator at Renown Health explains why birth classes are important. For questions regarding classes or tours, contact Chris Marlo: chris.marlo@renown.org 775-982-4352 What is a Certified Childbirth Educator/Doula? If you are expecting a baby, Renown has a wide variety of classes to help prepare you for birth. Classes are taught by certified childbirth educators and doulas. A certified childbirth educator is a trusted resource who has a passion for educating expecting parents about childbirth, and will provide you with non-biased, evidence-based information. A doula is a professional labor assistant who provides physical and emotional support during pregnancy, childbirth and postpartum. As you prepare for birth, our certified educators will guide you each step of the way and ensure you receive the quality care you deserve.

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Pictured above: A section of Renown’s Labor Assessment Area.  When patients expecting a new child are about to give birth, nerves can be especially heightened. Questions flood their minds: Is the baby actually on the way? What’s going to happen next? Are we ready to push?   Lucky for them, at Renown Health, the guesswork can finally end with Renown’s Labor & Delivery unit Labor Assessment Area. This unique space is a triage area that helps make more precise labor diagnoses by determining exactly what stage expectant parents are at in the labor process.  Funded by a state grant more than a decade ago, the six-bed Labor Assessment Area sees 500-600 patients per month – from patients entering the unit directly, unsure if they are in active labor, to patients who are sent over from elsewhere experiencing labor symptoms, such as high blood pressure and water breaking. The area also serves as a pre-operation space for patients getting ready for procedures such as C-sections. The six cubicles that are enclosed with doors and curtains ensure each patient gets the private, one-on-one care they need. Furthermore, rather than sitting in a waiting room, this area allows expectant parents a comfortable place to prepare for labor.  “We are a unit that prides ourselves on getting patients into beds very quickly,” said Debbie Hawley, Associate Nurse Manager in Renown’s Labor & Delivery unit. “This area has allowed us to triage more effectively and allow more patients to collaborate with their provider in a quick manner.”

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Eating a well-balanced and nutritious diet when pregnant is one of the more essential things you can do for your baby and yourself. The basic principles of what to eat when pregnant are quite similar to how we should be eating all the time. This includes focusing on fruits, vegetables, whole grains, lean protein and healthy fats. Of course, there are a few areas that you should pay close attention to when you’re pregnant and a few foods you should avoid. We consulted Renown Health’s Caitlin Bus, RD, LD, CDE to learn more about pregnancy nutrition. Foods to Eat Regularly: Veggies Vegetables of all kinds -- and in all forms -- are beneficial for you and your baby during pregnancy. Veggies ensure your body is getting the fiber, vitamins and minerals it needs. However, fresh or frozen veggies are considered best, but if you choose to eat canned veggies, make sure you choose a low sodium product. The more greens, the better! If you have an aversion to vegetables, especially in the first trimester, try sneaking them into smoothies. Healthy Proteins Protein-rich foods support your baby's growth while giving your body the nutrients to build and repair tissues, including your muscles, hair, skin and nails. Although protein requirements vary from person to person, a pregnant woman needs additional protein for her baby's growth, especially in the second and third trimesters. Regularly eating high protein foods -- like fish, chicken, turkey, eggs, peanut butter, nuts and beans –– promotes your baby's healthy brain and heart development. Grains Food like brown rice, quinoa, whole-wheat pasta and oatmeal are great to eat while pregnant. They are rich in fiber, iron, B vitamins and folic acid, which are all beneficial to physical development. Grains also help alleviate constipation and hemorrhoids. Fruits Fruit can help satisfy any sugar cravings you have when pregnant while also supplying your baby with nutrients – it's a win-win. Some people advise against fruit consumption while pregnant, but this is a myth. Like with all foods, moderation is key. Fruit can be high in sugar, so it is important to be aware of your intake. Also, make sure you are mindful of your preparation – thoroughly rinse produce under running water for 30 seconds to help avoid foodborne illness. Pasteurized Dairy Dairy products like milk, cheese and yogurt can be great sources of protein and calcium needed for the healthy development of a baby's bones, teeth and muscles. These foods also help with ensuring healthy heart function and nerve transmission. When buying these products, make sure to choose pasteurized products to avoid exposing your body to germs and bacteria. The American College of Obstetrics and Gynecology recommends 1,000mg of calcium per day for pregnant and lactating women. This equates to 4 servings of dairy or calcium-rich foods such as leafy greens, broccoli, tofu, almonds or dried figs. DHA Omega-3 Fats Omega-3s like DHA help support the health of a baby's brain and parts of their eyes. Women who are pregnant or breastfeeding should eat at least 8 ounces and up to 12 ounces of seafood each week. Ideally, food sources that offer DHA omega-3 and that are lower in mercury should be emphasized in your diet, including fish like salmon, sardines and anchovies. If you do not eat fish or omega-3 fortified foods, a DHA omega-3 supplement is recommended. Choline Did you know that 92% of pregnant women fail to meet the daily choline recommendation? Choline is crucial for an infant's brain and central nervous system development. One egg supplies 33% of the recommended daily intake. Although choline is often absent or low in prenatal vitamins, the best food sources include eggs, meats, fish, dairy, navy beans, Brussels sprouts, broccoli and spinach. Iron and Folic Acid Iron is the most common nutrient deficiency during pregnancy. Foods with high and moderate amounts of iron include red meat, chicken, fish, fortified cereals, spinach and beans. Folic acid is used to make the extra blood your body needs during pregnancy. Consuming adequate folic acid early in pregnancy reduces the risk of birth defects that affect the spinal cord. It is recommended to consume 400 micrograms (mcg) per day for pregnant women. This amount is included in your prenatal vitamins. Water Staying hydrated is one of the best things you can do for yourself and your baby when pregnant. In addition to just being good for you, hydration alleviates morning sickness and nausea, while dehydration can lead to contractions and even pre-term labor. Aim for 10 cups of fluids per day, on top of the water naturally occurring in foods. Foods to Avoid: Raw Fish and Fish with High Mercury Content Sorry sushi fans, according to the Center for Disease Control and Prevention, pregnant women are 10 times more likely to get infected by Listeria, a bacteria found in raw or undercooked fish. Also, avoid fish often found to be high in mercury, including swordfish, king mackerel, tuna and marlin. Processed or Raw Meat Similar to eating raw fish, eating undercooked or raw meat increases your risk of infection while pregnant. Hot dogs and lunch meats should also be avoided, unless they have been reheated to be steaming hot (for example, in a microwave). Alcohol Drinking alcohol when pregnant can impact your baby’s brain development and increases your risk of premature birth, low birth weight or miscarriage. Just don’t do it! Minimize Caffeine High caffeine intake during pregnancy can restrict your baby’s growth; therefore, it is recommended that pregnant people limit their caffeine intake to less than 200 mg per day – that’s roughly two cups (16 fl oz) of coffee per day. Runny Eggs Eating raw or runny eggs when pregnant increases your risk of Salmonella, which can cause fever, nausea, vomiting, stomach cramps and diarrhea. Always make sure your eggs are cooked through or use pasteurized eggs.

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“You’re gonna be a dad!” Whether you’ve been waiting years to hear those words or still think you’re too much of a kid to have a kid, the reality of impending fatherhood can be terrifying for any first-time, soon-to-be-dad. But not to worry, Best Medicine has some timely tips to help calm those bundle-of-joy fears and help you rock your new role as a brand-new, baby daddy.   Winter is Where Babies Come From Fact: More babies are born in September than any other month, with spill over (and spit-up) into October. Subtract ten months for the typical 40-week, bun-in-the-oven baking time and early winter stands out as the top baby-making part of the year. Is it the cozy nights before a fire as people avoid the snowman-friendly temperatures outside? Possibly. There could be any number of reasons, both seasonal and otherwise, for what will eventually arrive in the fall and immediately steal your heart — and untold hours of your sleep. Though moms carry most of the baby burden traditionally (and literally for three trimesters), that’s no excuse for the soon-to-be-dad not to step up to the plate and take a swing at being the best partner and father on the planet. Below is a list of tips and resources to help you do just that. So read on, daddy-o.  Tip #1: Don’t Freak Out Ok, you’re probably going to freak out even if we tell you not to. But once you calm down, consider this: human beings have been having babies for millions of years, and many of those soon-to-be-dads had it much tougher than we do today. And guess what? The human race is still going strong. Those first moms and dads did a good job — and you will too, with a little help. Tip #2: Take a Class Knowledge is power. In this case, it's diaper-changing, swaddle-wrapping, 2 a.m.-feeding power. And for you and your partner, taking a parenting class or two should be a no-brainer. You'll both learn what to expect and prepare for as you support each other and bond with your baby even before he or she arrives.   Tip #3: Learn From Other Dads If the thought of sitting in a room full of full-bellied women and their partners makes you uncomfortable, you may opt to stick with bros for your lesson plan. Dad-only classes and soon-to-be-dad support groups — taught and led by seasoned fathers with tales to tell and words of wisdom to share — are available online and in cities and communities around the country. Dad-focused sites also offer advice for new and still-learning proud papas. Here are a few options to check out:  Boot Camp for New Dads City Dads Group Wilderdad.com Fatherly.com Fathers.com  Tip #4: Babies are Required Reading Haven't read a good book lately? Well, if you're expecting a baby, now is the time to flip through a few pages that could make your life a whole lot easier in a few months. There's no such thing as being too-well-read when it comes to your fast-approaching, adorable little poop machine. The least you can do is read a book or two, or seven.  We're Pregnant! The First Time Dad's Pregnancy Handbook From Dude to Dad: The Diaper Dude Guide to Pregnancy We're Pregnant! The First Time Dad's Pregnancy Handbook  What to Expect When Your Wife Is Expanding Be Prepared: A Practical Handbook for New Dads  The New Dad's Survival Guide: Man-to-Man Advice for First-Time Fathers What to Expect When You're Expecting  Tip #5: Be a Prepared Soon-To-Be-Dad Tips 1 through 4 are meant to help alleviate some of your jittery, new-dad anxiety. And we hope they do just that. But if you really want to hold that "Best Dad Ever" coffee mug starting on day one, there are also some practical things you can do to prepare. Check these items off your list now to make life with baby more baby-, mommy- and daddy-friendly from the get-go.  Buy a baby/child car seat. Three out of four car seats are installed incorrectly. Protect your children by ensuring they are riding in a properly secured and age-appropriate car seat. Renown Children’s Hospital Car Seat Station is staffed by certified technicians who provide child vehicle safety restraint education, inspection and installation. Set up the baby's nursery early, including furniture  Stock up on diapers and baby supplies  Cook and freeze 2 weeks of food for nights when no one wants to cook  Research family healthcare  Agree upon a shared diaper-changing/feeding schedule  Ask about paternity leave from work  Get bills and finances up-to-date or pre-pay to avoid late charges   Give the home a thorough cleaning before the baby arrives

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