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

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

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There are nearly 1 million adults living with MS in the United States alone. For comparison, that is roughly the entire population of the Reno/Sparks and Las Vegas areas combined. MS is a neurological autoimmune condition which means that the immune system of patients with MS attacks the body’s myelin, a protective substance that covers your nerves. When this happens, the unprotected nerves can be damaged. Patients with MS may experience many different symptoms ranging from mild to severe, such as mobility and vision problems, fatigue and difficulty thinking. MS is usually diagnosed between the ages of 20-50, but late onset MS can occur in patients over 50 years old. While there is no cure for MS, there are effective treatments that can help reduce the burden of patients’ symptoms and create a positive quality of life. At Renown Health, we have joined the fight against MS through a partnership between advanced neurology programs and providers and our research office. We are proud to offer newly diagnosed MS patients the opportunity to choose between standard care treatment options or participating in an open label clinical trial, the AGNOS study. This study is assessing the impact of a new medication, ofatumumab, as the first disease modifying therapy participants receive for managing relapsing remitting MS, the most common form of MS.

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Many millennials are fortunate to have good health, but it’s important to be prepared for your next doctor’s visit. Here are three things that millennials should stay on top of for tracking and maintaining their health. For many millennials, doctor visits and preventive healthcare fall by the wayside. Alison Lynch, MD, a family medicine provider with Renown Medical Group says there are a few key things you can do now to set yourself up for a healthy future. 1. Establish with a Primary Care Provider Millennials are more likely to go to urgent care or consult the internet when a healthcare issue arises. While these are helpful tools, here’s a better one: a primary care provider. The benefit of establishing with a primary care provider is that your medical records, history and a baseline for your health will be documented. That means that when a problem or question comes up, your doctor will already have helpful information on file and can help you navigate your needs. Having a primary care provider is often required for prescription refills and referrals to a specialist. By establishing now, you’ll be able to get what you need in the future much faster. Make an Appointment Today 2. Protect Yourself and Your Community There are a few vaccinations and screenings that Dr. Lynch recommends for millennials. Flu Shots: These are available every year and are recommended for protecting not only yourself against the flu but also others you may come into contact with. Flu shots are usually available from August through December through your healthcare provider, pharmacies and pop-up events. Tetanus or Tdap: Most people receive a tetanus shot as a child, but it’s recommended that everyone get a booster every 10 years. If you are overdue, talk to your primary care provider or pharmacist about getting updated. Pap smear: If you’re a woman, a pap smear is recommended every three years in your 20s and every five years in your 30s. HPV vaccine: This vaccine helps prevent the virus that causes cervical cancer as well as the majority of head and neck cancers and warts. The HPV vaccine is recommended for all genders up until age 45. STD screening: Consider an STI/STD screening if you’re sexually active.

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Excess amounts of sodium doesn’t just increase your risk of a heart attack, it can also increase your risk of a stroke. Unfortunately, avoiding that saltshaker may not be enough. Did you know that the average American consumes 3,400 milligrams of sodium each day? That’s a dangerous number considering that the American Heart Association recommends limiting daily sodium intake to 1,500 milligrams (about half the weight of a penny) to reduce the risk of heart disease and stroke. The problem is not necessarily that you’re putting too much salt on your food, it’s that salt is already in the foods you’re regularly eating. To help keep your sodium intake at a healthy level, make sure you’re aware of “The Salty Six,” six sneaky foods that are surprisingly high in sodium. Breads, Rolls and Tortillas: Although breads and tortillas may not initially appear to be high in sodium, we often consume several servings. Make sure to keep track of your total servings to see how they add up. Deli Meat, Cured Meats and Poultry: It may surprise you that six thin slices of deli meat can add up to more than half of your daily limit, so be mindful when building those sandwiches. Also, do your best to avoid cured meats, which often means the meat has been salted. Substitute uncured, skinless meats instead. Cheese: Salt is an important addition in the cheese-making process, as it prevents bacterial growth. Unfortunately, that added salt can increase your health risks. Limit the amount of cheese you add to meals to keep your sodium content down. Pizza: Take a quick look at the first three items above and it should be no surprise as to why pizza made the list. One slice and you’ve met at least half of your daily limit. Go easy on the cheese and try adding more veggies instead of meat. Canned Soup: One cup of canned soup can be as high as nearly 1,000 milligrams of sodium. When shopping for canned soup it’s important to check the label – not just on sodium content but serving size as well. Always select low-sodium options when possible or cook your own soup at home. Sandwiches and Burgers: A sandwich or burger from your favorite restaurant can contain more than 100 percent of your daily sodium limit. When dining out, it is best to select low-sodium options or eat a half portion to limit the amount of salt. If some of your favorite foods are on this Salty Six list, don’t panic. Although these foods can be high in sodium, it isn’t necessary to cut these foods out of your diet completely. It’s just important to eat them in moderation and be mindful of your daily sodium intake. Look for low-sodium options, use herbs and spices instead of table salt and do your best to stay under the recommended daily limit of 1,500 milligrams.”

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Alzheimer’s disease is not normal forgetfulness as we age. Instead, it is a specific form of mental decline. And according to the Alzheimer’s Association it accounts for nearly 80 percent all dementia cases. Natasa Dragicevic, MD, PhD., behavioral neurologist and Alzheimer’s disease specialist with Renown Institute for Neurosciences, weighs in on diagnosing it and the importance of early medical action. How to Diagnose Alzheimer’s Disease In general, the signs of Alzheimer’s disease occur slowly, getting worse over time. For example, forgetfulness is a daily search – for shoes, keys and other misplaced items. Not only is memory affected, but also speech patterns and behavior. There is no single test for Alzheimer’s disease. “Specifically, a neurologist should be the one to diagnose Alzheimer’s disease given differences in presentation,” clarifies Dr. Dragicevic. “And ideally a behavioral neurologist (Alzheimer’s sub-specialist) will be managing the treatment,” she adds. Brain Imaging Diagnosing Alzheimer’s disease involves multiple approaches and medical providers. In short, medical history is reviewed along with a physical exam, lab tests and other diagnostic testing. “A medical workup includes a variety of tests. These include MRI and other brain imaging, as well as neurological and psychological testing. Furthermore, a lumbar puncture is performed to look for markers of the disease,” she states. What Causes Alzheimer’s disease? Although no one knows the cause, researchers think many factors play a role. Uncontrollable risk factors include your genetics and having a family member with the disease. However, the controllable risk factors include: reducing the risk of head injury and keeping your heart healthy. It’s important to realize that high blood pressure, high cholesterol, stroke and diabetes play a role in brain health. Blood loss to the brain causes vascular dementia, leading to long-term blood vessel damage. Symptoms of Alzheimer’s disease Generally speaking, the signs of this disease differ in each person. Yet noticeable behaviors include: • Losing the way to familiar places • Forgetting to pay bills • Trouble finding the right words when talking • Repeating questions • General confusion • Social withdrawal Alzheimer’s Disease – Benefits of Early Diagnosis Equally important, spotting Alzheimer’s disease early allows more time to benefit from medications and possible clinical trials. Likewise, nutrition and exercise changes can be made, increasing blood flow to the body, and perhaps delaying symptoms. Early diagnosis also allows for personal health decisions and quality-of-life conversations to take place.   According to the Alzheimer’s Association, these benefits include: 1. Medical advantage 2. Emotional and social comfort 3. Time to plan ahead 4. Cost savings A Brain Supporting Lifestyle “At the present time, treatment is limited,” explains Dr. Dragicevic. “Usually Alzheimer’s is a progressive ongoing disease – any management at this time is purely symptomatic.” However, she states the following lifestyle changes can help support brain health: • New hobbies such as painting, pottery, music classes or learning a new language • Crosswords, puzzles and playing games, such as Scrabble • Brain challenging mobile apps, such as Luminosity • 30-45 minutes of mild to moderate physical activity per day, such as walking • Eating a Mediterranean diet (primarily plant based foods)

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