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When it comes to each patient’s healthcare journey, medication is often a key chapter. After all, medication is one of the most common treatment methods to help patients on the road back to health. In 2023, 4.83 billion prescriptions were filled in the U.S., and with this number only anticipated to rise annually, having an expert pharmacy team on your side to make certain you are prescribed the ideal dosage to treat your condition, prepare your prescriptions on time and help you manage your medications responsibly is important.  Fortunately, at Renown Health, we have best-in-class inpatient and outpatient pharmacy teams to fill both prescriptions and promises for excellent care. Renown Pharmacy plays a vital role in helping us foster a health system that prioritizes patient well-being above all else. This department exemplifies the impact that a unified, expert pharmacy team can have on patient outcomes now and in the future.  The Masters of Medication Spanning three hospitals plus ambulatory locations across the health system, Renown’s growing pharmacy team – full of dedicated pharmacists, pharmacy technicians and even medical assistants – manages medications in a wide variety of patient settings, touching nearly every aspect of the healthcare continuum: Outpatient Retail Pharmacies Renown Regional Medical Center – 75 Pringle Way The Healthcare Center – 21 Locust Street Renown South Meadows Medical Center – 10101 Double R Blvd  Inpatient Pharmacies Renown Rehabilitation Hospital Renown Regional Medical Center (including Renown Children’s Hospital) Renown South Meadows Medical Center COMING SOON: Conrad Breast Center Pharmacy (in honor of Kristina Ferrari) in the Specialty Care Center at Renown South Meadows Ambulatory Pharmacies Anticoagulation Services – Institute for Heart & Vascular Health (IHVH) Pharmacotherapy Program – IHVH and Renown Medical Group Locations Congestive Heart Failure Pharmacotherapy Program – Center for Advanced Medicine B at Renown Regional Chronic Obstructive Pulmonary Disease (COPD) Pharmacotherapy Program – Renown South Meadows Endocrinology Pharmacotherapy Program – Renown South Meadows Additional Pharmacy Programs Medical Reconciliation Pharmacy Residency Clinical pharmacists at Renown bridge the gap between medicine and compassionate support, making sure each patient receives personalized care one prescription at a time.  “There are various roles pharmacists play within Renown,” said Clarissa Munoz, Clinical Pharmacist in the Renown Regional Inpatient Pharmacy. “Staff pharmacists work diligently to ensure correct medications are dispensed, and if compounded, make sure they were prepared properly. They also work hard to answer medication messages and phone calls, help verify orders and make sure ode trays/RSI kits are appropriately stocked and ready when needed. Clinical pharmacists work from satellite pharmacies on the floor and focus on reviewing patient charts and aim to provide additional interventions to the providers to optimize treatment strategies. We also serve as a resource for nursing staff and help answer medication questions.”  “My role in the pharmacy is pretty expansive,” added Chanelle Ajimura, Clinical Pharmacist in the Renown Regional Outpatient Pharmacy. “I maintain inventory to confirm patients can receive their medications in a timely manner both for our discharge and retail patients while balancing the Meds to Beds program, which offers medication delivery to the bedside and bedside medication counseling; collaborating with an interdisciplinary team to find the most affordable price for patients; and verifying that the dose, strength, indication, etc. is appropriate for the patient from start to finish.”  “In the pharmacy, I make sure patients are receiving appropriate drug therapy by checking for major drug interactions and ensuring appropriate dosing,” added Courtney Church, Clinical Pharmacist in the Renown Regional Outpatient Pharmacy. “I also make recommendations to providers so patients can get cost-effective therapy.”  Our pharmacy technicians work behind-the-scenes ensuring efficient medication management, making a difference in the lives of patients every day.  “A pharmacy technician is responsible for making sure the patient gets their medications on time and at the lowest price possible,” said Nate Graham, Pharmacy Technician in the Renown Regional Outpatient Pharmacy. “This is done by working with patients, insurance companies and case workers. We fill prescriptions, enter prescriptions into our system, receive and send orders for medications and maintain a clean pharmacy with an accurate inventory.”  “We do a variety of things; the task people probably know the most is counting out the medications and putting them in the amber vials,” added Rachel Vallin, Pharmacy Technician in the Renown Regional Outpatient Pharmacy. “We also help patients at the front of the pharmacy, ring out their prescriptions, answer some basic questions (deferring to a pharmacist as necessary) and billing insurance. Meds to Beds is my favorite part because I feel the most involved. I take medications to patients who are discharging up to their hospital rooms so they have it with them when they leave.”  “As a technician, I confirm that all medications of new admissions are available in our machines prior to admitting and then maintain stock during each patient’s stay,” added Tammara Axtman, Pharmacy Technician at Renown Rehabilitation Hospital. "I also assist our nurses when needed in regard to any of their questions with both EPIC and Omnicell.”  Our pharmacy team is also on the move all across our health system, thanks to our Ambulatory Pharmacy programs. For patients experiencing a serious heart, lung, or endocrine condition that requires ongoing drug therapy maintenance and guidance, our ambulatory pharmacies step in to carefully monitor how their medications impact their health and well-being.  “Our role as pharmacists in this department is non-traditional because we actually see patients in the exam rooms face-to-face,” said Cory Lankford, Ambulatory Care Clinical Pharmacist for Renown’s Anticoagulation Services. “We modify their medication regimens and drug recommendations under collaborative practice agreements.”  “Because our role is so unique, we have a lot of opportunities to make a positive impact on patients,” added Janeen Abe, Ambulatory Care Clinical Pharmacist for Renown’s Anticoagulation Services. “We do a lot of direct patient interaction, including counseling patients on their medications and helping them navigate through their disease state.”  “As a medical assistant in this department, we’re called the patient ‘liaisons’ to orchestrate who they should go to whether it’s a nurse, a provider or a pharmacist,” added Kiara Scruggs, Medical Assistant for Renown’s Anticoagulation Services. “We look at each patient’s medications and help with the Warfarin blood thinner monitor. We get to do a lot with patients." A key resource within the Pharmacy department and the emergency admission process, our Medical Reconciliation ("Med Rec") team stays on top of each patient's medication records. By ensuring each medication regimen is accurately reflected in each patient's chart and that patients continue to take their at-home medications while admitted to the hospital, this team provides vital insight into medications that could be a contributing factor to each patient's symptoms, including drug interactions. “Our medication reconciliation pharmacy technician team are true detectives,” said Heather Townsend, Clinical Pharmacy Supervisor. “When a patient arrives to the hospital, Med Rec works with patients, families, caregivers and outpatient pharmacies to compile a list of medications the patient has been taking a home. This list is used to make sure medications are not contributing to the patient’s symptoms and to assure medications are continued throughout the hospital stay. The addition of the medication reconciliation team has been one of the greatest advancements in medication safety.” “As a Med Rec Tech, we interview patients and family members and call pharmacies, skilled nursing facilities, etc. to obtain an accurate and complete medication list/history to outline what the patient is currently taking on a daily basis,” added Kara McGee, Medical Reconciliation Pharmacy Technician. “We make sure that we document the correct medication, dose, route, frequency and directions. This information is crucial because the nurses, pharmacists and physicians look at our work to figure out if any medications are contributing to the patient's health condition, and for the continuation of home medications on admission.” “Even though the Med Rec Tech might seem small in the hospital realm, it is very vital for patient information and beneficial to the patient's health,” added Brizza Villafan, Medical Reconciliation Pharmacy Technician. “There is never a dull moment in this work.” No matter the diagnosis, having Renown Pharmacy as an integral part of your healthcare team is a win-win situation for both you and them: you receive access to medication to help you heal, delivered to you with precision and care, and the pharmacy team has the opportunity to care for you and make a positive impact, a role they take seriously.

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It’s July 23, 2022, and I am arriving in Downtown Reno to walk in my first-ever Pride Parade. Even more amazing, I am going to be walking with a group of my coworkers, announcing to our entire community that our employer supports us being our full and truest selves. I arrived alone, but in the staging area I met new people who worked in other departments of Renown, coworkers I might never have met if not for Pride. I even took a selfie with one of these new friends. Someone passed around flags for us to hand out to the audience as we marched by. I took a rainbow-striped temporary tattoo in the shape of the Renown “R” and used my water bottle to apply it. There was an overwhelming atmosphere of excitement and joy that can only come from gathering with other human beings who are overflowing with love. We started the Parade waving handfuls of Pride flags high and gave those flags out to the audience as we passed. By the time we were done walking, our hands were empty, but our hearts were full. I couldn’t have stopped smiling if I’d tried. I’d joined the parade as a single person, but as we walked, I became part of a community. Not only the Renown community, but a community of Proud queer people across northern Nevada. And by extension, the LGBTQIA+ community all around the world – past, present and future.  With the multiple recent state laws proposing to strip away the rights of LGBTQIA+ people, many of us have felt a noticeable decline in our mental health and feelings of personal safety.  As a member of the queer community, I have felt these mental health effects too. I am fortunate and privileged enough to not have experienced workplace discrimination in my current position. But before Renown, I – like so many others in the LGBTQIA+ community – had a negative experience at a previous job, and afterwards I was hesitant to share my full self while at work. To be able to walk in a Pride Parade with my current employer, healed a little bit of that past pain inflicted by my former employer.  When our liberties are under attack, Pride is more important than ever. We must remind ourselves, especially when others cannot seem to remember, that we are loved and worthy of love. I am grateful to work for an organization that is willing and able to fight this good fight with us.  I will certainly be back to walk in this year’s Pride Parade, and I sincerely hope to see you there too! Be sure to wear comfortable walking shoes, sunglasses and of course keep your skin safe with sunscreen. Whether you’re part of the LGBTQIA+ community, or just an ally, you are welcome.

Read More About Employee Blog: Team Renown at Northern Nevada Pride

June offers an official welcome to summer and the height of outdoor activities in northern Nevada such as hiking, camping, days spent at the lake and embracing long days and warm evenings with friends and family. Enjoying all that the summer season has to offer may not be as easy for those living with chronic obstructive pulmonary disease, or COPD, which effects more than 15 million Americans. What is COPD? COPD is a group of lung diseases including emphysema and chronic bronchitis that result in airflow blockages from the lungs. People may experience frequent coughing and shortness of breath among other symptoms. COPD typically impacts adults ages 65 and older and is becoming increasingly more common among women. Although smoking plays a key role in the development of COPD, air pollution and indoor air quality, and respiratory infection also contribute to disease development. While there is no cure for COPD, limiting progression of disease and managing symptoms can be achieved through lifestyle changes, therapy, and medications. Tips for Living with COPD This Summer, and Always Stay Hydrated: Staying hydrated is extremely important for people with COPD, especially during the summer. Not drinking enough water can make breathing more difficult because it increases respiratory symptoms. Make sure to always keep a water bottle with you and aim to drink 8-10 glasses of water daily. Be Mindful of Temperature: COPD symptoms can be exacerbated by hot weather. It is best to participate in outdoor activities during the cooler times of day, like the morning or evening. Check Air Quality Before You Go: Before engaging in outdoor activities, be sure to check the air quality index and plan your activities accordingly. Pace Yourself: Exercising can be difficult for people who have COPD. To make the most of your summer, try not to push yourself too hard and take breaks when you need them. If you start to feel out of breath or tired, take a break in a cool, shaded area until you feel better. Take Matters Into Your Own Hands To address the needs of community members living with COPD, the Renown Health Research Office has teamed up with Pulmonary Medicine to provide patients who are former or current smokers and have a history of frequent exacerbations with an option to participate in the ARNASA study. "COPD exacerbations have a huge negative impact on patient’s lung function” states Dr. Farah Madhani-Lovely, Chief of Pulmonary Medicine at Renown Health and Assistant Dean of Clinical Research at the University of Nevada, Reno School of Medicine. “We have had inhalers and prednisone for decades but patients are still having exacerbations. Now we have a new pathway we think will prevent exacerbations which is what this clinical trial is designed to prove.” This study will evaluate the efficacy and safety of astegolimab compared with placebo in participants 40-80 years of age with COPD. “This study in particular is so exciting because of the enthusiasm from the sponsor’s end” says Katie Buckley, Lead Clinical Research Coordinator working on pulmonology studies at Renown’s Clinical Research Office. “Often times sites aren’t assigned particularly passionate or engaged personnel who aid in carrying out these studies, but you can tell Roche Genentech’s team truly cares about the success of the study, the safety of their participants, and proving the efficacy of the investigational agent. Working on a study like this takes a village, and when the individuals on all ends share similar mindsets and work towards success as a collective unit instead of as individual moving parts, it’s amazing to see everything we’re able to accomplish.” Renown’s team of expert pulmonologists and researchers are available to join patients with COPD in support of their healthcare journey. If you are interested in learning more about this clinical trial option at Renown Health, talk to your pulmonologist at your next appointment or contact us at 775-982-3646. At Renown Health, our goal is to make it easy for patients to access clinical research as a care opportunity where patients can access a variety of standard care treatment options for their health condition or choose to participate in a clinical trial. For more information about clinical trial opportunities available to you or to ask any questions, contact the Renown Research Office at Renown-CRD@renown.org or 775-982-3646.

Read More About Living with COPD? How to Maximize Your Summer Experience

Lung cancer is the leading cause of cancer deaths in both men and women in the U.S. The good news is the five-year survival rate increases dramatically if lung cancer is treated before spreading to other parts of the body. Julie Locken, MD, of Renown Health Imaging, explains more. What are the signs and symptoms of lung cancer? As you might expect, most lung cancer symptoms appear in the chest and can affect your breathing. Watch for signs such as: Persistent cough Constant chest pain Shortness of breath Wheezing Bloody or rust-colored phlegm Hoarseness Swelling of the neck Pain or weakness in the shoulder, arm or hand Recurring pneumonia, bronchitis or other lung infections Loss of appetite and loss of weight can also be signs of lung cancer That said, there are usually no symptoms in the early stages of lung cancer, which means getting screened can truly be a lifesaver. If you have a history of smoking, you should get screened as a precaution.  What are the risk factors of lung cancer?  Around 80% of lung cancer cases stem from a history of smoking tobacco. But there are other known causes, such as secondhand smoke, radon, asbestos and diesel exhaust. It’s important to do what you can to eliminate exposure to all of these to reduce your lung cancer risk.  People with an immediate relative – a parent, sibling or child – diagnosed with lung cancer and people between 50 and 80 years old are also at higher risk and may need to consider screening.  People who are at the highest risk are those with a history of smoking tobacco, particularly smokers who averaged one pack of cigarettes per day for 20 years or more, as well as former heavy smokers who quit in the last 15 years.

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Whether you're a parent, grandparent, caregiver or sibling, you should know drowning is the second leading cause of death among children. Yet, while we are vigilant about protecting children from water accidents and drowning, a condition known as dry drowning or delayed drowning can go unnoticed. In fact, most people aren't even aware it exists. Dry drowning defined Dry drowning is a side-effect of a near-drowning experience and includes spasms of the vocal cords and larynx — known as a laryngospasm. This occurs when the body attempts to shut down the passage of any liquid into the lungs. Unfortunately, it can also shut down the passage of air into the lungs and force fluid into the stomach and lungs. Often the condition is not discovered until it's too late — severe cases can cause death within one to 24 hours after a water incident occurs. Who is susceptible? Novice or first-time swimmers are at increased risk, as are children with asthma and known breathing issues. In addition, children who have had pneumonia or experienced acute respiratory distress syndrome are also at greater risk. To reduce these factors, caregivers should be exceptionally watchful of inexperienced swimmers. According to Leland Sullivan, MD, of Northern Nevada Emergency Physicians, children under the age of 5 are most susceptible to drowning and often drown in residential swimming pools. Infants less than 1-year-old most often drown in bathtubs. What are the signs of a dry drowning episode? If your child has a near-drowning incident, a few moments of coughing until they calm down is normal. However, you should know the more severe signs and symptoms to watch for during the 24 hours following the incident, including: Persistent coughing Difficulty breathing and/or shortness of breath Chest pains Extreme fatigue and/or lethargy Change in typical behavior Face becomes pale   What is the treatment and prognosis for dry drowning? Dr. Sullivan recommends that all victims of near-drowning incidents seek medical attention, even if they have no symptoms. If caught early, dry drowning can be treated. If you think your child is experiencing a dry drowning episode, go to the nearest emergency room as quickly as possible — do not attempt treatment at home. Healthcare professionals will work to supply oxygen to your child's lungs to restore and regulate breathing.

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Renown Health has long supported northern Nevada’s LGBTQ+ community Pride events with sponsorship, and we’ve collaborated with local and regional LGBTQ+ organizations as an ally. Renown’s Pride Committee works to deepen and broaden our external and internal efforts around LGBTQ+ community engagement, advocacy, and healthcare issues related to sexual and gender minorities, which is part of the greater Diversity, Equity and Inclusion efforts Renown is undertaking. According to Harvard Chan School, data shows that nearly a sixth of LGBTQ+ adults feel they were discriminated against based on their sexual orientation and gender identity. As a result, this brings to light the important need for education within the healthcare setting. Renown Health is bridging the gap for our LGBTQ+ population, and we know more work needs to take place in order to become an inclusive organization. Below are a few ways we’re working on improving our response to LGBTQ+ needs, and celebrate, respect and honor our diversity by being inclusive. Diversity, Equity and Inclusion The Diversity, Equity and Inclusion subcommittee was formed to heighten the awareness and develop a plan on how to better serve all of our diverse populations, including our LGBTQ+ patients. As the largest healthcare provider in northern Nevada, we knew that we could do a better job. The subcommittee provides us a forum to discuss ideas and develop plans to provide better care to these populations. Updated Medical Records with Preferred Name and Pronouns Of course healthcare is personal. We meet patients at their most vulnerable states. And relating to every person by the correct pronoun shows we respect their gender identity. A new medical records update supports our doctors, nurses and care team in capturing this vital information. We are now able to capture every person’s preferred name, sex and sexual orientation to better care for them. Kathleen Zaski BSN, RN, Manager of Clinical Informatics and IT Applications at Renown explains why this is so important. “Your name and identity are core to who you are as a person, and here at Renown, we aim to take care of you as a whole person and to provide the highest level of quality care to our community – all while ensuring the experience is exceptional and tailored to the individual. In other words, having the patient’s preferred name and pronoun in the medical record is important to validate their identity, and show we care, in an already high stress environment. Specifically, giving our providers easy access to the patients preferred name and pronoun in the medical record, allows them to properly address their health concerns. This also helps the health care provider foster a closer relationship with the patient. Studies have found this actually increases the quality of care by creating a more open and comfortable environment.” Gender Neutral Restrooms Mitch Harper, Senior Program Development Manager at Renown, recognizes there’s still so much more to improve upon in becoming an inclusive organization. “At the end of the day, it’s about creating a safe and welcoming environment for our community and our employees. Access to basic human services shouldn’t be contingent on an individual’s skin color, ethnicity, sex, gender identity, sexual orientation, age, disability, or beliefs. Ensuring that private restrooms are equally available to everyone on our campus is just one way we can provide a more inclusive, caring space for the people we serve.” Updated restroom locations: Roseview Tower: 10 Sierra Tower: 14 Tahoe Tower: 14 Helping to Lead and Influence Change Sean Savoy, Manager of Spiritual Care at Renown "The foundation of spiritual care is compassion – being with people in need by caring, supporting, and showing empathy, and promoting a sense of well-being. Being a member of the LGBTQ+ community informs that deep sense of compassion and empathy in a very special and unique way. Our human value, social validity, the very reality of who and what we are, even our right to exist, love and just be, are often called into question. This, in turn, can cause many of us to question ourselves and wonder about our self-worth. This experience should engender compassion and empathy so that we can better recognize, listen to and meet others’ needs to help them achieve inner peace, explore coping strategies to overcome obstacles during illness or crisis, and even find new balance by re-conceptualizing themselves in the context of health and illness. I have found that the intersectionality of my gay and spiritual selves has been a blessing in my life." Matthew Maloy, Team Lead Applications Specialist at Renown “I am a Team Lead Epic analyst in the IT department that is responsible for clinical based workflows for ED, Trauma, and Critical Care and have worked at Renown for 15 years. Being a part of the LGBTQ+ community influences my daily work by ensuring the Electronic Health Record reflects best practices such as giving clinicians the ability to document a preferred name, and displaying that throughout the medical record for consistency. Having the ability to influence decisions that move our community toward human value for all of us is a priority in my daily work.” Our Mission Renown Health’s mission is to make a genuine difference in the health and well-being of the people and communities we serve, including the LGBTQ+ community. We continue to build relationships to improve care, fostering better health outcomes for ALL of our patients by creating a more inclusive health system.

Read More About Supporting LGBTQ+ Community Health – Why it Matters

Without a doubt, taking medications can not only be expensive, but also confusing. In the United States, generic prescriptions are widely used, with 9 out of 10 people choosing them over a name brand. Pharmacists are a great resource to help us understand the benefits and side effects of any medication. We asked Adam Porath, PharmD, Vice President of Pharmacy at Renown Health, to answer some common questions about generic drugs. What is a generic drug? A generic drug has the same active ingredients of brand-name drugs. Brand-name drugs have a patent (special license) protecting them from competition to help the drug company recover research and development costs. When the patent expires other manufacturers are able to seek approval for a generic drug. However, the color, shape and inactive elements may be different. Per the U.S. Food & Drug Administration (FDA), a generic medicine works in the same way and provides the same clinical benefit as its brand-name version. Why do they cost less? Generic drug makers do not have the expense of costly development, research, animal and human clinical trials, marketing and advertising. This savings is passed on to the public. Also after a patent expires, several companies will compete on a generic version of a drug, further driving down prices.

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Even when fires burn outside our area, the air quality in the region can reach dangerous levels. Our expert explains how to maintain your lung health when fire season strikes. It’s a sight we know all too well as northern Nevadans — a hazy or thick layer on the horizon when smoke rolls in from nearby fires. Sometimes the smoke is more evident than others, but it’s important to remember, even when the smoke may not be as visible across the valley, it still impacts our air quality. The last week or so, our air quality has been in the “unhealthy for sensitive groups” range, which can be dangerous for people who are sensitive to air pollution. Air Quality Changes: Who’s at Risk? Renown Pediatric Pulmonologist Sonia Budhecha, M.D., explains certain people are especially at risk when smoke moves in: Older people, whose lungs are not as healthy as they used to be Young children, whose lungs are still developing People with heart and lung disease including asthma, COPD and emphysema “Smoke and haze from fires carry particulates that can get into your respiratory system and eyes, which can be a danger for all ages,” Dr. Budhecha says. How You Can Protect Yourself Until the smoke clears and the air returns to the “good” range, it is best to follow these tips to protect yourself and your family: Stay indoors and keep windows closed Turn on the air conditioning to recirculate clean air Drink plenty of fluids to help your body flush out any toxins you inhale Additionally, all community members should reduce their physical activity and try to prevent heavy exertion outside. If you or a loved one has a heart or lung disease, avoid physical exertion altogether because smoke can aggravate these conditions. “People with heart disease may experience shortness of breath, chest pain, palpitations or fatigue,” Dr. Budhecha says. “People with lung disease may also have shortness of breath, chest discomfort, wheezing, phlegm or a cough.” Smoky Signs and Symptoms Smoke can also impact healthy people — irritating your eyes, nose or throat. And in some cases, inhaling smoke can lead to bronchitis. When haze moves into our area, keep an eye out for these symptoms: Burning or stinging eyes Runny nose Cough or scratchy throat Headaches Wheezing Shortness of breath Difficult taking a full breath Chest heaviness Lightheadedness Dizziness If experiencing any of the above symptoms, seek medical attention or call your doctor for advice. Sometimes, these symptoms do not appear for as long as 24 to 48 hours after smoke inhalation. For those that have pre-existing lung or heart conditions, consult with a health care provider on action or management plans. To schedule an appointment Visit Renown Pulmonary Medicine, or call 775-982-5000. Understanding Our Air Quality The Air Quality Index (AQI) is broken down by large (PM10) and small (PM2.5) particulates. According to Dr. Budhecha, large particulates are usually ones that can be seen and smelled. They can damage your eyes and nose but don’t often get deep in the lungs or blood vessels.   “The more dangerous ones are PM2.5, which can’t always be seen or smelled,” Dr. Budhecha says. “Any time the AQI is above 51, children with lung or heart disease should not be outdoors.” For the latest air quality update in your area, visit AirNow.gov or call (775) 785-4110.

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According to a National Center for Health Statistics survey, about 8% of U.S. adults are not taking their medications because they can’t afford them. This means millions of adults aren’t taking their medication due to the high cost. Virtual Event with pharmacist, Adam Porath Thursday, July 23, 11 a.m. to Noon Attend Virtual Lecture 5 Ways to Cut Medication Costs Safely Cost might not be affecting your medication plan, but the following ways to save money on medication can help: 1. Questions to ask your prescribing provider Do I have to take this medication? This is particularly a good question when you’ve been taking a pill for some time and not sure if you should continue. Is there a way to combine my medications? A good example of this is for those who are taking blood pressure medications. Do I have to take this particular pill? Often there are generic choices in the same medication class. Can I get a larger supply? Basically, knowing the cost of a 30- vs 90-day supply is always a good idea. In other words, it could save you time and money. This generally works for medications you take long-term. Remember, asking questions can help you save money on medication, so communicate your concerns. 2. Research online Find the website for the medication and look to see if there are savings and support available through the drug company. 3. Consider a co-pay card Co–pay card programs offered by drug manufacturing companies are a direct way to lower out-of-pocket costs for prescription drugs for eligible patients. The cards can patients pay for the medications they, or their doctors, prefer. If you don’t qualify for a co-pay card, then you can look into patient assistance programs. 4. Consider patient assistance programs Drug companies sponsor these programs by income and they are often hard to find. The best way to find a patient assistance program is by asking your pharmacist. 5. If you’re on Medicare, consider updating your plan Medicare plans can change from year to year, which often times includes the medication they cover and the co-payments or deductible amounts. Annual Enrollment takes place October 15 – December 7, 2020. Most important, review the options and shop around for the best plan. Visit Senior Care Plus for information on Medicare Advantage Plans available to you. Want to ask a pharmacist more questions on how to save on medication? Join us for a Sterling Silver Club virtual event on Saving Money on Medication. To learn more about the Sterling Silver Club, visit our club website.

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Northern Nevada is home to some of the most gorgeous and pristine lakes in the country — but also some of the most unforgiving. Lake Tahoe water temperatures average 50 degrees in the summer, making the danger of hypothermia real and always present. Here are the signs, symptoms and ways to prevent cold water drowning. When we think of air temperature at 50 degrees Fahrenheit, it’s not all that cold. But when it comes to water that’s 50 degrees, there is no comparison. Immersion in cold water is life threatening and can happen within a minute. Taking the right precautions before entering the water can save your life. The 4 Phases of Cold Water Drowning 1. Cold Shock Response: This response affects breathing and happens within the first minute. An automatic gasp reflex occurs in response to rapid skin cooling. If the head goes below water, water may be breathed into the lungs, resulting in drowning. A life jacket will help keep your head above water during this critical phase. Additionally, hyperventilation, like the gasp reflex, is a response to the cold and will subside. Panic will make this worse, so the key is to control breathing. 2. Cold Incapacitation: This response occurs within the first five to 15 minutes in cold water. In order to preserve core heat, vasoconstriction takes place decreasing blood flow to the extremities to protect the vital organs. The result is a loss of movement to hands, feet, arms and legs. Unless a life jacket is being worn, the ability to stay afloat is next to impossible. 3. Hypothermia: Important to note, it can take 30 minutes or more for most adults to become hypothermic. So there’s time to take action and survive. Keeping panic at bay is critical, as you have more survival time than you think. Symptoms include: Shivering Slow and shallow breathing Confusion Drowsiness or exhaustion Slurred speech Loss of coordination Weak pulse 4. Circum-rescue Collapse: This experience can happen just before rescue and is not well understood. Symptoms range anywhere from fainting to death. Some experts believe an abrupt drop in blood pressure may cause this final stage of cold water drowning, post-rescue. Additional Cold Water Drowning Safety Tips and Helpful Resources Always wear a personal flotation device as well as a wetsuit or drysuit. Your personal flotation device is the most important piece of water safety gear. Try not to panic as the first phases will subside. Controlled breathing is to staying calm. Research suggests the body can withstand the cold longer than we think. The Heat Escape Lessening Posture (HELP) is a position which helps conserve energy if you’re wearing a personal flotation device. By hugging your knees to your chest, this posture helps maintain body heat for some time.

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SOGI stands for sexual orientation and gender identity. Being a SOGI-inclusive medical facility means regardless of our differences, we treat others with dignity and respect. Sean Savoy, Renown Health Manager of Spiritual Care, explains SOGI terms and their importance in a healthcare setting below. SOGI History Although the UN passed a historic resolution on SOGI in 2016, it is still a relatively new term for some. Above all, an inclusive environment where every patient feels safe and valued, improves the quality of care in our community. In reality, defining gender and sexuality can be confusing. However, the terms we use to define gender and sexuality are an important influence on how we relate to each other. Generally, "sex" refers to the biological differences between males and females. Still the term “sex” doesn’t fully capture the complex biological, anatomical and chromosomal variations that can occur. Accordingly, having only two (binary) options – biological male or biological female – might not describe what’s going on inside a person’s body. In essence, assigned sex (also called "biological sex) is given at birth based on medical factors. These include your hormones, chromosomes and genitals. Most people are assigned male or female, and this is what’s put on their birth certificate. When someone’s sexual and reproductive anatomy isn’t clearly female or male, that person may be described as “intersex.”  However, a person’s biological or assigned sex may be different from a person’s actual or perceived gender identity or expression. The word “gender,” therefore, is more difficult to define. It could refer to the gender or sex role society determines is acceptable, desirable or appropriate based on a person’s perceived sex. Likewise, it could refer to an individual’s own gender identity or preferred gender expression. What is Gender Identity? To summarize, gender identity is one's innermost concept of self as male, female, a blend of both or neither. To clarify - how individuals perceive themselves and what they call themselves. Of course sometimes a person's genetically assigned sex does not line up with their gender identity. These individuals might refer to themselves as transgender, non-binary, or gender-nonconforming, for example. Another key point is the process of gender transition. This specifically refers to more closely aligning your internal knowledge of gender with your outward appearance. According to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), the term – which replaces Gender Identity Disorder – "is intended to better capture the experiences of affected children, adolescents, and adults." What is Sexual Orientation? Sexual orientation is an internal or enduring emotional, romantic or sexual attraction to other people. For example, you could be heterosexual (straight), gay, lesbian, bisexual or even pansexual. SOGI Terms to Know Below are some common SOGI terms according to the National LGBT Health Education Center and the Human Rights Campaign. The following list is not meant to represent every term (or definition) used by the LGBTQ+ community. LGBTQ+ Stands for lesbian, gay, bisexual, transgender and queer (or questioning). The plus encompasses other identities that fall under the queer umbrella with one common theme: they are not strictly straight or cisgender. Queer An umbrella term used by some to describe people who think of their sexual orientation or gender identity as outside of societal norms. Some people view the term “queer” as more fluid and inclusive than traditional SOGI identities. Due to its history as a derogatory term, the term is not always embraced or used by all members of the LGBTQ+ community. Sexual Orientation Terms Asexual (adj.) – Describes a person who experiences little or no sexual attraction to others. Asexuality is not the same as celibacy. Bisexual (adj.) – A sexual orientation that describes a person who is emotionally and sexually attracted to people of their own gender and people of other genders. Gay (adj.) – A sexual orientation that describes a person who is emotionally and sexually attracted to people of their own gender. It can be used regardless of gender identity, but is more commonly used to describe men attracted to other men. Heterosexual or Straight (adj.) – A sexual orientation that describes a person whose sexual or emotional attractions and behaviors focus exclusively or mainly on members of the opposite sex or gender identity. Lesbian (adj., noun) – A sexual orientation that describes a woman who is emotionally and sexually attracted to other women. Pansexual or Omnisexual (adj.) – A sexual orientation that describes a person who is sexually and emotionally attracted to people of any sex or gender identity. Pansexual people may refer to themselves as gender-blind, asserting that gender and sex are insignificant or irrelevant in determining whether they will be sexually attracted to others. Gender Identity Terms Bigender or Binary (adj.) – Describes a person whose gender identity is a combination of two genders. Cisgender (adj.) – A person whose gender identity aligns with the assigned sex at birth or biological sex. Gender non-conforming (adj.) – Describes a gender expression that differs from a given society’s norms for males and females. Gender transition (noun) - The process by which some people strive to more closely align their internal knowledge of gender with its outward appearance. Some people socially transition, whereby they might begin dressing, using names and pronouns and/or be socially recognized as another gender. Others undergo physical transitions in which they modify their bodies through medical interventions. Intersex (adj.) - A variation in sex characteristics including chromosomes, gonads, or genitals that do not allow an individual to be distinctly identified as male or female. Non-binary Alternate terms are gender queer and gender non-conforming. Transgender (adj.) – Describes a person whose gender identity and assigned sex at birth do not correspond. Also used as an umbrella term to include gender identities outside of male and female. Sometimes abbreviated as trans. SOGI Awareness Again, not all people use the above terms in the same way, so respect and sensitivity are key. And the healthcare setting is an especially vulnerable one. Maintaining the dignity and humanity of every individual during a medical interaction is essential. The U.S. Department of Health and Human Services requires all Electronic Health Record (EHR) systems be able to collect SOGI information from patients. This promotes better understanding of health treatment outcome disparities in order to reduce them. Renown Health’s mission is to make a genuine difference in the health and well-being of the people and communities we serve.

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Watch as two dads look back on their newborn adoption process. They reminisce about discovering their newborn was on his way — and how Renown Health subsequently helped them navigate the process.  During Memorial Day weekend, Chris Mulhern and his husband, Jeffrey Bodimer, learned a set of birth parents chose them to parent their unborn baby boy. After writing a letter to the birth parents, they were chosen over other applicants in a private adoption. The adoption agency took care of many details, like connecting Mulhern and Bodimer to the birth mother and dad. In fact, they could participate in nearly all the phases of the pregnancy. The mother's prenatal care and delivery took place at Renown Health, where Mulhern and Bodimer attended her appointments and took childbirth classes. "Our experience was wonderful at Renown," says Mulhern. "We thought it was absolutely incredible how nice and accepting everyone was." The Nuances of Newborn Adoption Their son, Bradley, was born via cesarean section. And the adoptive parents got to see him an hour after he came into the world. The labor and delivery nurses even helped coordinate everything between them and the birth mom. Mulhern and Bodimer stayed in a room at The Inn at Renown. The closeness of the facility on the Renown campus made it possible to feed Bradley every two hours. Incredible Nurses "They were great, the nursing staff. If we weren't sure about doing something right, about burping him right they would say 'It's okay. He's not going to blow up. He will eventually do it'," says Mulhern. The nurses also made arrangements for the two dads to participate in skin-to-skin contact with their newborn baby. Experts agree parents and babies should be in direct contact for at least the first 1–2 hours after the birth. Taking Baby Home Chris and Jeffery took Bradley home after three days at Renown. “It was the most joyful thing to be chosen as his parents, even before we met him,” says Chris.

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