Search

Stepping into the Renown Transfer and Operations Center (RTOC) means stepping into a transformative hub of excellence where lives are saved and healthcare is reimagined. As a cornerstone of Renown Health's commitment to exceptional patient care, the RTOC serves as a dynamic nerve center that seamlessly coordinates medical resources, ambulance rides, hospital bed space, remote home systems, hospital transfers and emergency preparedness. In this best-in-class facility, the boundaries of what is possible in healthcare are constantly pushed, and new horizons of patient care are discovered.   Staffed with a dedicated team of skilled professionals, the RTOC harnesses the power of advanced technology and compassionate expertise to ensure that patients receive the highest level of care and support, no matter where they are. Through a synchronized network of communication, coordination, and compassionate care, the RTOC team ensures that patients receive the critical support they need when it matters most, working tirelessly to redefine what it means to deliver world-class healthcare.   A National Standard  Charged with the goal of overseeing the placement and transportation for every patient, the RTOC officially launched in 2021 as northern Nevada’s first and only transfer center of its kind and a nationally celebrated facility. As Renown’s highly coordinated care logistics system, this team uses the cutting-edge technology at their fingertips to customize healthcare to the needs of every patient, manage patient flow and drive healthcare innovation.  “Compared to where we’ve started to where we are now, it’s a 180-degree difference,” said Kelli McDonnell, Manager of RTOC. “When we first started building our facility right before the pandemic happened, we took what was six conference rooms and classrooms and turned it into a command center that organizations across the country admire and come to Reno to see what we do. Mel Morris, the Director of RTOC, was recruited exclusively to build our facility with her history of building successful hospital command centers. Many people didn’t realize what a transfer center was or that Renown was the only center in the region – and we only continue to grow.”  This best-in-class facility, and the masterful team behind it, handles:  Coordinating all incoming patients transferred from neighboring hospitals and 27 counties across northern Nevada, Lake Tahoe, northeast California and neighboring states. Matching patients to the most appropriate bed placement using diagnostic, triage and Epic electronic medical record clinical information in conjunction with medical staff expertise to outline a plan of care that determines the best bed assignment given the patient’s needs.  Coordinating video-enabled Telehealth monitoring capabilities for Renown’s four Intensive Care Units (ICUs), as well as Renown patient Telehealth and virtual visits. Monitoring Remote Home systems with Masimo during the COVID-19 pandemic, where some patients received hospital-level care in the comfort of their own homes while Renown clinicians monitored and evaluated their data and plan of care.  Serving emergency and disaster management for area hospitals, first-responders and the community with local, regional and statewide emergency and disaster management for sudden-onset emergencies.  The RTOC is home to many different critical roles for our health system, including Transfer Center Nurses, Ride Line Coordinators, RTOC Coordinators and more, many duties of which each team member cross-trains on to be able to fill in whenever needed. While their roles may differ, their commitment to their patients remains the same – and they all work together to achieve the same outcome: delivering the right care, at the right time and place.  “As an RTOC Coordinator, we do a variety of different things,” said Anna Schaffer, RTOC Coordinator. “We do triage coordination to help our nurses and hospitalists get patients in the emergency department admitted, and we also do bed control to find patients appropriate bed placement. Communication is important, so we always make sure to stay closely connected with the charge nurses on those floors.”  “We start with a basic ‘need to know’ and place patients accordingly,” added Karly Brown, RTOC Coordinator. “We get surgery numbers, ICU capacity and discharges and find beds for all patients as quickly as possible. We have the advantage of being able to see the entire hospital.”  “I primarily schedule transportation for patients at the hospital who are either going home or going to a skilled nursing facility,” said Sarah Clark, Ride Line Coordinator. “I get requests from case managers to schedule rides, and I work with REMSA and other ambulance services to schedule them. It relies a lot on appropriate and efficient communication and critical thinking.”  Patients in facilities across northern Nevada and northeastern California, especially the rural communities, look to the RTOC to help guide ambulances, bed coordinators and hospital staff in finding care for our rural patients.  “As a transfer center nurse, I facilitate incoming patients from rural facilities in Nevada and surrounding areas in California,” added Meg Myles, Transfer Center Nurse Specialist. “There are days we may take up to 30 direct admissions from these areas.”  “We are the point of contact for inter-facility transfers, whether we are sending patients out or bringing them into Renown,” said Lisa Lac, Transfer Center Nurse Specialist. “We take phone calls from those rural areas, identify what services are needed, connect them to the appropriate provider and coordinate any transfers.”  “Simply put, we are the bed wizards,” said Addison Rittenhouse, RTOC Coordinator.  The RTOC team continues to break barriers and push the boundaries of medical excellence through leveraging the technology at their fingertips and their unwavering dedication to the health of our community. Inspiring a new era of medical possibilities, these team members have achieved a multitude of accomplishments for both their department and their patients since the birth of the center.  “We have significantly reduced the time it takes to get patient admit orders in, thanks in part to the new Triage Coordinator role, and we provide easier access for patients to transfer to us from other facilities,” said Beth Rios, RTOC Coordinator. “We have taken a bigger role in helping the smaller hospitals in our area in caring for patients and improve patient throughput.”  “As a team, we’ve done a lot of work in creating an engaging and positive environment, and our internal morale committee has been a huge help with that,” said Kelli McDonnell. “We’ve been working tremendously over the last year and taking all the feedback that we received from the Employee Engagement Survey to make improvements. We had 100 percent survey participation within five days, which is incredible.”  “I am so proud of our escalation and problem-solving skills,” said Becca Dietrich, RTOC Coordinator. “When an issue is raised to us, we will always find a timely solution on our end so our care teams can focus on the issue in front of them. We are the eyes in the sky, seeing movement everywhere.”  Each day in the life of our RTOC team members is a testament to their commitment, resilience and timework, making a profound impact on countless lives.

Read More About Department Spotlight: Renown Transfer and Operations Center

Want to know more about osteoporosis and osteopenia? We'll dive into these conditions and give you some handy tips on preventing future problems and taking care of your bones. What is Osteopenia? Osteopenia (low bone density) is the initial stage of bone mineral density loss, which can eventually progress to osteoporosis if steps are not taken to prevent it. What is Osteoporosis? Osteoporosis is a condition that weakens our bones. While it literally means “porous bone," it doesn’t mean that our bones are doomed to succumb to the changes that can happen to us silently over time. Our bones are living tissues that are constantly breaking down and remodeling themselves.  Osteoporosis and osteopenia are typically diagnosed by testing bone mineral density using scans that your primary care provider can easily order. This is important testing because it dictates your risk of breaking a bone in common areas like your hip, wrist or spine. It also helps set the stage for talking with your healthcare team to develop a treatment plan. Most people will reach their peak bone mass in their mid to late twenties. There are several factors that increase our risk of osteoporosis or osteopenia as we age, such as menopause, genetics and other lifestyle factors. However, there are several things you can do to mitigate this breakdown and assist your body in the constant remodeling it does to our bones. 3 Controllable Factors to Build Strong Bones 1. Talk to your primary care provider They can go over a plan and prescribe things such as vitamin D, calcium and medications that can help if you are at risk or have osteoporosis or osteopenia. 2. Maintain a healthy diet Talk to a dietician if you need further help as they can be an invaluable resource to develop a plan.  Eat foods rich in calcium, vitamin D and vitamin C. These assist with the rebuilding of bone. Examples include but aren’t limited to leafy greens, legumes, salmon and healthy dairy products.  Don’t smoke — it directly correlates with a decrease in bone mass. Smokers also take longer to heal from a fracture.  Limit alcohol to two to three beverages per week. Alcohol interferes with the production of vitamins needed to absorb calcium and the hormones that help protect bones. 3. Exercise Talk to your primary care provider to get a referral to physical therapy if you need help with exercise.  Our bones adapt to the stresses we put them through. Therefore, exercise should be tailored to putting the right stress on our bones. There is good quality research that most exercise is safe when dealing with less bone mineral density.  The exercises should be progressively challenging and increase the load for resistance and weight training at least two to three days a week. Examples include squats, step-ups, chest presses and rows.  Exercises higher in velocity will lead to more power and bone adaptation. Examples include quicker push-ups, marching and quicker walks.  Exercises that are weight-bearing will lead bones to adapt to the stress placed on them. Movements such as mini stomps, step-ups, jumping, jogging and so forth may be used depending on how your body tolerates these things to really stimulate bone adaptation. There are aspects of aging and bone health we can’t control, but we can take steps to minimize the chances of bone loss and osteoporosis. Talk to your healthcare team to determine your risk and don’t forget to show your bones a little TLC – you’re going to need them.

Read More About A Therapist's Tips to Prevent and Manage Osteoporosis

Becoming a parent for the first time means lots of new unknowns – from learning to breastfeed and swaddle to buckling your newborn into the car seat for the first time. But when it comes to putting them to bed safely, it’s important to remember it really can mean life or death. It’s something we’re taught before our little one is even here: the correct way to put your baby to bed safely. Sadly though, the number of infant deaths continues to climb. The main culprit of sleep-related infant death continues to be all the items parents leave in the crib with their babies. According to the Center for Disease Control and Prevention, there are about 3,500 sleep-related deaths among babies each year. “The best advice is ‘bare is best.’ Keep your infant’s sleep space clutter free – no blankets, bumpers, toys or pillows,” said Karen Wagner, Pediatric Nurse Practitioner. Follow the ABCs for Safe Sleep Remembering the ABCs is an easy way to remember how to put your little one to bed safely. A: Alone No blankets, toys or pillows. “We do recommend using a sleep sack as a blanket alternative,” said Karen. “It prevents the risk of suffocation and keeps your baby warm.” Keep in mind, the greatest risk for suffocation happens when babies are under 1 year of age, so it’s best to save the toys, blankets and pillows for their “big kid bed,” or around 18 months old. B: Back The slogan “back is best” is another good reminder. Keeping your baby on their back until they’re old enough to rollover helps reduce the risk of Sudden Infant Death Syndrome (SIDS). C: Crib It is best to have your baby sleep alone in their crib. While co-sleeping may be enticing, especially after a late-night feed, it increases the risks of possible suffocation. However, “having your child in your room, in their own crib or bassinet, is protective for SIDS,” Karen said. “In fact, we think co-rooming reduces SIDS risk by almost 50 percent.” Co-rooming allows parents to keep new babies in close reach and helps parents oversee their baby’s sleep, just in case something happens.

Read More About Top Safe Sleep Tips for Your Baby

Renown Health strongly supports and advocates for innovative medical technology. Our diverse lineup of medical equipment enables our care leaders to provide quality care to every patient. But what if a piece of technology breaks down? What happens when our care teams are ready for technological upgrades? Where do employees go when they have a question about a complicated piece of equipment?  Enter the Clinical Engineering department. This sophisticated team is staffed with intelligent, science-minded individuals who are ready to jump in and help at any given second. From newborn incubators to robots that clean the hospital floors, these team members are the med-tech masters that keep our health system running.  Equipment Experts  Upon entering the Clinical Engineering department’s workshop, you are welcomed with an abundance of high-tech equipment undergoing repairs and upgrades. The department takes care of more than 26,000 pieces of equipment throughout the entire healthcare network, including the technologies at the University of Nevada, Reno School of Medicine, which they just took over this past year. To the average person, this may seem overwhelming; however, for this team, this is the exact environment they thrive in to make the technology magic happen.  “I am motivated and engaged every day at work,” said Tony Martinez, Supervisor of Clinical Engineering for Renown. “Our department is fast-paced and rewarding, and that’s a big plus.”  While some team members enter the department as equipment generalists, this team offers training to develop their skills on certain pieces of equipment, eventually becoming specialists.   “Every month, we encourage our colleagues to undergo specific training on more delicate equipment,” said Tony. “Once we get to that point in their training, we assign different equipment to our team members every month. They pick up the experience very quickly.”  As a Clinical Engineering Technician for Renown, Rylie Nickerson took advantage of the training and educational opportunities offered to her and is now a ventilator specialist especially for Renown’s neonatal intensive care unit (NICU). “Regardless of whether I’m working on ventilators or on another piece of equipment I’m assigned to, I’m always thinking about how I can help the patients, nurses and doctors,” said Rylie.  Raul Hernandez, a Clinical Engineering Specialist for Renown, is the go-to person for anesthesia, heart-lung bypass, red cell saver and life support equipment. He embraces the fact that, regardless of whether you are a specialist or a generalist, there is no typical day working in this department. “Every day brings different challenges,” said Raul. “I really enjoy the mental exercises I do every day. They keep me grounded and focused.”  On top of their day-to-day work and any special projects or emergencies that come up, the team is on an ongoing preventative maintenance schedule. Think of this work like your car’s oil change – routine maintenance to prevent something from breaking down in the future. “At any point, we might have 100-200 extra pieces of equipment to handle during preventative maintenance,” said Taylor Gray, a Clinical Engineering Technician for Renown. “We are always helping each other through any issues.”  Our Clinical Engineering team shows exactly what it means to be collaborative. Even though their to-do lists are ever-growing, this team never feels alone. They know they can always lean on each other for support, regardless of the workload.  “We always have each other’s backs,” said Taylor. “I feel so happy and satisfied in my job, and my coworkers are a large part of that.”  Celebrating the Genuine Difference  The Clinical Engineering department is driven by their desire to help and take care of the entire health system, and in turn, make a genuine difference for the communities we serve, from the medical staff to the patients.   “The satisfaction you get in our field when we impact patients’ lives and their healing process is so motivating and engaging,” said Tony Martinez. “It’s a great feeling.”  The team knows the common saying ‘Walk a mile in someone’s shoes’ very well; so well, in fact, that they take it to the next level, doing everything they can to prevent frustrations and extended down times. “We try to walk a mile in someone’s shoes before they get angry,” said Reagan Jordan, Director of Clinical Engineering for Renown. “Your satisfaction is our mission, and our team continually works to improve their outcomes every day.”  This department is where the entrepreneurial spirit and science-focused mind meet. For people like Raul Hernandez, who came from a business background as well as decades of medical technology experience, Renown helps him bring both his personal and business skills into focus. “This environment is very beneficial for Renown, me, and of course, the patients,” added Raul.  Being members of a team that is committed to excellence and purpose inspires them to reach new heights in patient care.  “I am constantly reminded of the positive impact we have by witnessing the individual experiences we have and hearing the enthusiasm and thankfulness in their voices,” said Raul. “It gives me a great sense of pride to work at Renown.”  "There is a strong feeling of mutual respect here,” added Ed Trejo, a Clinical Engineering Technician at Renown. “We are always here to help.”  The proof is in the data. The Clinical Engineering team scored as one of the top departments in the recent Renown employee engagement survey, with their results sitting at more than 94 percent.   “This speaks to not only our department leadership but also the team as a whole,” said Reagan. “I am extremely proud of them. Despite the pandemic, they are knocking it out of the park.”  For this department, coming to Renown is easy; staying at Renown is even easier.  “Staying at Renown is the easy choice,” said Raul. “And this team is only going to grow.”  Workflow Whizzes and Kindness Champions  “Rolling with the punches,” as Tony Martinez says, comes naturally to the Clinical Engineering team. With the constant workflow of equipment coming into the shop, every team member has learned how to be experts at prioritizing, especially based on the needs of our organization.  Even though their jobs can bring a lot of intensity, this department’s positive attitude radiates throughout the hospital. Upon entering the workshop, everyone is greeted with a smile from every team member, along with an immediate willingness to dive into the complex world of engineering.  “The experience of helping other people with their unique needs is invaluable,” said Taylor Gray.  If this work environment sounds enticing, great news – the Clinical Engineering team is growing. Motivated, aspiring engineers with a passion for healthcare and an associate’s degree in a related field are welcome.   Military experience is also valued very highly in this team. As many of our military servicemen and servicewomen gain specialized engineering experience while enlisted, the military-to-engineer career ladder at Renown is especially strong. In fact, according to Paul Joseph, a Clinical Engineering Technician at Renown, the majority of their teammates come from a military background.   Above all, being capable of prioritizing on the fly, thinking critically, having an open-mined outlook and being self-driven are the top skills that this department values. As Ed Trejo states, “If you’re willing to wear different hats, you will do very well here."  “Go with the flow, and expect the unexpected,” added Rylie Nickerson.  Those who join this team feel at home. The warm embrace of the team’s kind nature and the supportive environment they all foster inspires an efficient workflow that helps our entire hospital system function at the top of its game. At the end of the day, everyone who joins the team, or anyone who even interacts with the team in any capacity, will be in good hands.  Mandy Noriega, a Clinical Engineering Technician for Renown, closes these thoughts with a great reminder to each and every one of us: “After all, teamwork makes the dream work.”

Read More About Department Spotlight: Clinical Engineering

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.

Read More About What Foods to Eat and What to Avoid When Pregnant

If you think sore nipples are just a normal part of breastfeeding, think again. Robin Hollen, APRN, and Breastfeeding Medicine Specialist, says that nursing can be an enjoyable experience for mom and baby without pain and discomfort. A top concern of nursing moms within the first week after delivery is how to prevent sore nipples. Even moms who’ve nursed before struggle with this common issue. While many women think it is a regular part of the nursing experience, it is actually a sign that something isn’t quite right. “Nursing your baby should be enjoyable,” says Robin Hollen, Breastfeeding Medicine Specialist with Renown Health. For over 30 years Robin has been supporting moms to breastfeed. Below she shares some valuable information and tips, helping you create a happy and healthy breastfeeding experience for you and your baby. What causes sore nipples? The most common cause of sore nipples involves incorrect latching. For a proper latch, a baby’s mouth takes in the entire nipple and some of the breast, so that the nipple rests at the back of the mouth where the palate is soft. With an improper latch, the mouth may slip down to the tip of the nipple while the baby nurses. This constant pressure on your sensitive skin may cause discomfort and pain. A board-certified lactation consultant can help assess if your baby is latched correctly and troubleshoot your breastfeeding concerns. Less common causes of sore nipples include: • Improper tongue placement of baby • Clenching • Incorrect breast pump use How can a mother prevent sore nipples from an improper latch? Breastfeeding is a learning experience for both mom and baby. Ask for help with the latch so your baby learns it correctly and maintains its depth. In the past, new mothers were surrounded by a community of women — their own mothers, grandmothers, or other family and friends — to provide assistance and guidance with every latch at the beginning of an infant’s life. In today’s culture, new moms can find themselves on their own with no extended family to lend their knowledge. Nurses, pediatricians and lactation consultants now fill that role; they are the eyes and hands along with the much-needed experience to guide new mothers. Our Breastfeeding Medicine experts assist nursing moms with latch every day. Even a single visit with a lactation consultant observing your breastfeeding baby can provide valuable insight on achieving, and maintaining, the proper latch - preventing future nipple soreness and discomfort. How to heal sore nipples from breastfeeding To heal sore nipples, you must first fix the cause, and correcting the latch prevents further damage. A lactation consultant can also help you address the pain. Below are some breast healing tips: • Your own expressed breast milk is excellent to rub into the nipple for anti-bacterial protection. • For those moms who need more lubricant or fat than breast milk offers, use a lanolin or a cream that is labeled safe for the baby. • Soothies are a gel pads providing comfort in between feedings, but should not be used with lanolin products. • Breast shells, not to be confused with shields, can guard the nipples from irritation or pressure in between feedings. If you have more questions about preventing and healing sore nipples or general breastfeeding concerns, talk to your pediatrician or a Renown Health Breastfeeding Medicine specialist at 775-982-6365.

Read More About Breast Feeding Doesn't Have To Mean Sore Nipples

While breastfeeding is natural, it's not always easy. We asked Certified Lactation Counselor Sarah Mitchell for some tips to help make the process easier for mom and baby. From increased infant immunity to improved maternal health and well-being, the benefits of breastfeeding are many. Still, only 60 percent of U.S. moms in the United States continue to breastfeed past their baby's first six months. There are for many reasons for why moms stop, including the mother's their need to return to work. We reached out spoke to Sarah Mitchell, a certified lactation counselor at The Lactation Connection at Renown, for some expert advice. Tip 1 At first, it's normal to expect obstacles. Even in cultures where close to 100 percent of moms breastfeed, they can experience issues, including getting the baby to "latch on," sore nipples, and milk production. In addition, it sometimes can take several weeks for mom and baby to get comfortable. Tip 2 Line up a coach, even before the baby is born. This can be a professional lactation coach, family member, or friend who is experienced and encouraging. While online videos can be helpful, most new moms need the one-on-one guidance that a coach can provide. Renown offers outstanding resources in its Lactation Connection center, including expert consultants, products, and support. Tip 3 Well ahead of the due date, set up a support network of friends, family members, or community groups such as La Leche League. Women historically have relied on extended support systems to help them with raising children, and breastfeeding is one of those areas that, while natural, still needs encouragement from the women who’ve been there. Tip 4 Don’t get discouraged if you need to supplement at times with formula. This, too, as it turns out, is not uncommon in other cultures. In other parts of the world, babies are given beverages and foods such as tea, broth, soup, juice, mashed bananas, and papaya. The American Academy of Pediatrics recommends supplementation only with approved formula -- but the point is, it’s ok to supplement if you need to. Finally, don’t forget the importance of breastfeeding for connecting with your baby. It’s essential to maintain breastfeeding over the weekends, preferably “on-demand,.” and will keep that special bond strong after you have returned to your job.

Read More About 4 Breastfeeding Tips for New Moms

Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis, answers some common questions about bone fractures. Is there a difference between broken bones and fractures? No, these are two different names for the same injury. Of course the common term is a broken bone. Using either name will describe your concerns. Medical personnel typically describe a broken bone as a fracture to a specific bone. For example, a broken wrist is also a fractured distal radius. To clarify, this describes the injured bone and the precise location. How do I know  if my child has broken their bone? Many times children will fall and complain of their arm or leg hurting. In most cases the pain goes away and the child will return to their activities. When there is a deformity to the limb (curve in arm) and the child is complaining of pain, it is probably a fracture. If the arm or leg looks straight, look to see if there is any swelling or bruising. Both are signs of a possible fracture. Finally, if the limb looks normal but the child continues to complain, gently push on the bone. Likewise if it causes the same pain, then they likely have a fracture and should have an x-ray. My child fractured their growth plate, what does this mean? Growth comes from this area of the bone. In detail, these are located all over the body but typically at the end of the bones. With this in mind, fractures to these areas can result in the bone growing abnormally. Because of potential shortening of the arm or leg, or bones growing crooked, it is important to follow fractures closely (up to 1-2 years or longer). It is better to identify a problem early. Small problems can be treated with small surgeries. What if the bones of the x-ray do not line up? Because children are growing, unlike adults, their bones will remodel and straighten with growth. The amount of remodeling occurring depends on a child’s age, the bone fractured and the location. In many cases an angled bone will grow straight over the course of a year. For this reason, someone with experience in caring for children needs to follow bone growth. How long does it take fractures to heal? Factors deciding when a cast can come off include: Child’s age. Bone fractured. Fracture location. Young children heal faster than teens, teens heal faster than young adults, who heal faster than older adults. In young children most fractures heal in 4-6 weeks. However, teens generally take 6 weeks to heal, and adults can take much longer. Although your child  is out of their cast, it may not be healed completely to return to all activities. Placing a splint is during this time is common. This typically gives them added protection for several weeks after their cast is removed -  in case they forget their limitations. What if my child is still limping? Whether a child is in a walking or non-weight bearing cast, removing it often leaves them stiff and sore. Therefore many children will walk as though they still have a cast in place. In most cases this resolves in about three weeks. Regardless, if your child is still limping or walking abnormally after three weeks, contact the treating doctor. They may benefit from physical therapy or a repeat evaluation.  (This article was original published in the July 2019 issue of South Reno Kids & Sports.)

Read More About Bone Fractures in Children Honest Expert Advice

One of the most pressing issues in modern medicine is the need to improve rural healthcare. This challenge hits particularly close to home, as Renown Health is the only provider covering 100,000 square miles in northern Nevada, an area that’s mostly rural. People in rural areas suffer from chronic diseases such as heart disease, cancer and respiratory disease, at higher rates than the general population. One of the largest contributors to these health disparities is a lack of access to health services. Many rural communities have fewer providers and care facilities. This forces residents to travel farther to receive preventive care and medical treatment. We must identify ways to better support the health needs of the millions of Americans who live in rural communities. Ideas for improving rural healthcare Health systems must identify innovative ways to leverage existing resources and new technologies to care for patients in these communities. For example, telehealth can help diminish a person’s need to travel long distances to receive specialty care. Similarly, online classes can help educate patients about preventive behaviors. Remote monitoring technology also allows patients to track their health conditions from home. Additionally, we can address physician shortages by empowering health professionals such as nurse practitioners, physician assistants and technologists to care for patients. These providers receive excellent training and have demonstrated success in improving health outcomes. Renown Health cares for people from diverse backgrounds and we are dedicated to caring for patients in every community we serve. Renown Telehealth We’re leading the region in using video conferencing technology to provide the best care possible – no matter where you are. Renown Telehealth is telemedicine that gives you access to top-level care and better outcomes with less stress and fewer travel costs. Learn More

Read More About Improving the Way we Deliver Quality Rural Healthcare

Breast milk. It's often referred to as liquid gold. And fortunately, it can be safely refrigerated or frozen for later use, which can allow you to be a bit more flexible in your new routine with baby. Whether you're getting ready to return to work, planning for the chance date night out or just exclusively pumping, it's crucial to understand the guidelines for proper breast milk storage. Storing Breast Milk Use clean bottles with screw caps, hard plastic cups that have tight caps or nursing bags (pre-sterilized bags meant for breast milk). Be sure to label each container with the date the milk was pumped and your baby's name if the milk is going to childcare providers. You can add fresh, cooled milk to milk that is already frozen, but add no more than is already in the container. For example, if you have two ounces of frozen milk, then you can add up to two more ounces of cooled milk. For healthy full-term infants, milk can be stored as follows: Room temperature - six to eight hours (no warmer than 77°F, or 25°C). Refrigerator - up to five days at 32°-39°F (0°-3.9°C). Freezer– Varies depending on freezer type. Up to two weeks in a freezer compartment located within the refrigerator. Three to six months in a freezer that is self-contained (standard kitchen fridge/freezer combination) and kept at 0°F (-18°C). Breast milk should be stored in the back of the freezer and not in the door. Six to 12 months in a deep freezer that is kept at -4°F (-20°C). Be sure to leave about an inch of space at the top of the container or bottle to allow for expansion of the milk when it freezes. Thawing Breast Milk Place frozen breast milk in the refrigerator to thaw (about 24 hours) then warm by running warm water over the bag or bottle of milk and use it within the next 24 hours. If you need it immediately, remove it from the freezer and run warm water over it until it's at room temperature. Never microwave breast milk and do not refreeze it. Once your baby has started to drink from the bottle, you should use it within one hour. You may find that different resources provide different recommendations about the amount of time you can store breast milk at room temperature, in the refrigerator and in the freezer. Talk to your doctor or lactation consultant if you have any concerns or questions.

Read More About How to Safely Store Breast Milk

Experiencing knee pain during exercise or while undertaking daily activities? The knee is the largest joint in our body, so it goes without saying a lot hinges on its functionality. Here are a few exercises to help.   Is exercise a real pain in the knee for you? Does getting up in the morning require a few minutes for your knees to adjust to walking around? As it turns out, knee pain is common, and it can result from injury, overuse or the breakdown of cartilage over time. Often, this pain is a result of faulty mechanics in your body, according to Jessica Ryder, a physical therapist with Renown Physical Therapy and Rehab. “We see weakness at the hips causing a lot of stresses at the knee,” she says. Exercises that Alleviate Knee Pain Try these three exercise to strengthen your glute muscles and maintain proper alignment in your knees. Hip Lift Lie flat on your back with your knees bent and feet flat against the floor. Lift your hips into the air until your body is in a neutral position, then lower your hips back down. Repeat this motion several times until you feel a gentle burn in your glute muscles. Step Down Stand with one foot on a stair or step. Slowly bend your knee and drop the other foot toward the floor. Slowly extend back up to your starting position. While doing this exercise, it’s important to move slowly, maintain control and ensure that your knee is in line with your toes. Do as many reps as needed until you feel a small fatigue in your muscles. Repeat this exercise on the opposite leg. Side Step with Exercise Band Place an exercise band around your ankles. Stand in a slight squat and then take several steps to the side until you feel a small fatigue on the outside of your hips. While doing this exercise, keep your upper body still and focus the exercise to your hips. The band will try to move your knees toward each other Repeat in both directions. Hometown Health and Renown Health are proud to be the official insurance plan and healthcare partners of the Nevada Wolf Pack. Renown Physical Therapy and Rehab | 775-982-5001 Through outpatient physical, occupational and also speech therapy, Renown Physical Therapy and Rehab gives patients hands-on, individualized treatment. Our therapists use evidence-based methods to help patients return to an active, productive lifestyle. Learn More About Physical Therapy

Read More About A True Joint Effort: Exercises to Prevent Knee Pain