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Some risk factors associated with osteoporosis are out of your control. But you’re in luck, because some can be lessened by following simple tips. Below, Orthopedic Nursing Manager Katie McCarthy discusses the signs, symptoms and preventive measures. By Katie McCarthy, BSN, RN, ONC, Orthopedic Nursing Manager, Renown Health Osteoporosis is often called the silent disease, because it develops gradually for years with no clear signs or symptoms. And while some bone loss is expected as we age, osteoporosis is not a normal part of aging. So it’s important to start thinking about your bone health early.  Bone is not just a lifeless scaffold for the body. It is living tissue that regenerates continually. Once we reach peak bone mass around age 25, we begin losing more bone than we produce, increasing the risk of developing osteoporosis — which literally means porous bone and points to a loss in bone density. In severe cases, normal everyday activities or movements, like hugging, can cause a fracture. After the first fracture you’re at higher risk for more, which can lead to a life of chronic pain and immobility. Bone fractures in the spine or hip are the most serious. Hip fractures can result in disability and even death — especially in older adults. Spinal fractures can even occur without falling. The vertebrae weaken to the point that they simply crumple, which can result in back pain, lost height and a hunched-forward posture.   Osteoporosis: Uncontrollable Risk Factors Women are at greater risk of developing osteoporosis than men, and white and Asian women are at higher risk than black and Hispanic women. Other uncontrollable risk factors include: age; a family history of osteoporosis; certain genetic conditions; medications and medical treatments; eating disorders; a low body weight and small, thin frame; ethnicity; menopause: In fact, the lack of estrogen produced during menopause is largely responsible for a woman’s increased risk. Poor diet, tobacco use, excessive alcohol consumption, lack of exercise and an unhealthy weight also contribute to bone loss. Fortunately, those risk factors are in your control. Without symptoms, you can’t know if you’ve developed osteoporosis unless you get a bone density test or suffer a fracture. If you fall into a high-risk group, are over age 50 or have any concerns about your bone health, consult your doctor and find out if you need to be evaluated. Additionally, if either of your parents sustained hip fractures, you experienced early menopause or took corticosteroids for several months — a steroid often prescribed to relieve inflammation and arthritis — you’ll want to talk to your doctor about your bone health. If you test positive, your doctor will devise a treatment plan to match your needs, which will include lifestyle changes surrounding diet and exercise to build and strengthen weak bones. Medication to slow bone breakdown and build new bone may be prescribed, depending on the severity of your bone loss. If you’ve sustained a spinal fracture that is causing severe pain, deformity or is not responding to non-surgical treatment, your doctor may recommend surgery. Reduce Your Risk of Osteoporosis You can strengthen your bones now to prevent osteoporosis from starting. Here are some tips: Eat a diet rich in fruits and vegetables and low in caffeine, sodium and protein. Avoid soda, and talk to your doctor to make sure you’re getting enough calcium and vitamin D. 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 day. It interferes with the production of vitamins needed to absorb calcium and the hormones that help protect bones. Exercise three to four times each week — it’s key to healthy bones. Weight-bearing exercises like jogging, hiking and especially weight lifting build bone mass and density. There are aspects of the aging process we can’t control, but we can do something about bone loss and osteoporosis. Find out your risk, and show your bones a little TLC — you’re going to need them. This story was also published in the Reno Gazette-Journal’s Health Source on April 24, 2016.

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Did you know that 80 percent of all strokes are preventable? Learn which foods should be eaten in moderation to reduce your family's risk of stroke. Stroke is the fifth leading cause of death in the nation and a major cause for disability, killing 130,000 people each year. But did you know that 80 percent of all strokes are preventable, according to the American Stroke Association? Several stroke risk factors -- high blood pressure, smoking, diabetes, physical activity level, obesity, high cholesterol and heart and artery disease -- can be controlled, treated and improved, right down to the foods we choose to consume each day. Diets high in sodium can increase blood pressure, putting you at greater risk for stroke. A high-calorie diet can lead to obesity -- another risk factor. And foods high in saturated fats, trans fat and cholesterol will raise your blood cholesterol levels causing blood clots, which -- you guessed it -- can lead to a stroke. The “not-so-fab” five foods listed below play a large role in damaging your body and causing vascular disease, stroke and heart disease and should be avoided on a regular basis. However: Moderation is the key to life, in my opinion. Sure, everyone is going to have a soda here and there or a steak off the grill, but keep it off the main menu.  1. Packaged and Fried Food Have you noticed foods like hot dog buns and bottled salad dressings rarely go bad? Ever asked yourself why? This is due to the use of hydrogenated oils, which are trans fats. Hydrogenated oils stay solid at room temperature and do not require refrigeration. Convenient? Yes. Healthy? No. Unfortunately, many frozen foods and meals also fall into this category, except for frozen fruits and veggies. So here’s the lowdown on trans fats: They’re considered by many experts as the worst type of fat you can consume, raising your LDL (“bad”) cholesterol and lowering your HDL (“good”) cholesterol. While some meat and dairy products contain small amounts of naturally occurring trans fat, most dietary sources are formed through an industrial process adding hydrogen to vegetable oil, causing the oil to solidify at room temperature.  The FDA is in the process of restricting or possibly banning trans-fats from food in the U.S. A study published in JAMA Cardiology compared data from counties with and without trans-fat restrictions and the findings were substantial: There was a 6 percent decline in hospitalizations for heart attack and stroke in counties with trans-fat restrictions.  Bottom line: Ideally no processed food should pass your lips, but realistically, aim for less than 2 grams of trans fat per day. Skip the store-bought treats at the office and fries at lunch. Also avoid crackers, regardless of what you are dipping them in. Choose to eat fruits to satisfy your sweet cravings and veggies and hummus to satisfy the savory.  2. Lunch meat Processed meats, including bacon, smoked meats and hot dogs, are all on the DNE (Do Not Eat) list, unless you want to play with fire. Processed meats are a no-go if you want to keep your arteries clear of plaque buildup. So what is the alternative to your salami sandwich?  Try a healthy alternative like a tuna sandwich with avocado (a great alternative to mayo) or a veggie sandwich. 3. Diet soft drinks First of all, when a drink is sweeter than a candy bar but it contains zero sugar and zero calories, buyer beware. Many consumers think because a soda is labeled “diet” it’s a better choice, but studies have linked diet soft drink consumption with an increased risk of stroke and vascular disease. In a nine-year study of more than 2,500 people, those who drank diet soda daily were 48 percent more likely to have a heart attack or stroke or die from those events, compared with those who rarely or never drank soda. What else are you supposed to drink? If you must drink soda, break the everyday habit and drink it on special occasions; otherwise water rules. And if you don’t like water, try flavoring your water with fruit slices. 4. Good-old red meat So is there ANY good meat out there you ask? The answer is yes, but it’s not red. In the journal Stroke, an article showed women who consumed large servings of red meat regularly had a 42 percent higher incidence of stroke. Red meat is high in saturated fat, which clogs arteries with plaque. The alternative to red meat is a heart-healthy protein like poultry or fish, or even non-animal products like beans, nuts and tofu.  5. Canned foods Steer clear of factory processed soups, beans and sauces. Canned items all have incredible amounts of sodium or MSG or baking soda/powder to maintain their freshness and shelf life. One study showed if you consume more than 4,000 mg of salt per day, you more than double the risk of stroke compared to diets with less than 2,000 mg. Another tip: When possible, plan and make meals from scratch. Making the wrong meal or snack choices is one of the biggest contributing risk factors for stroke and heart disease. Most people know what good food choices are, but they don’t realize the serious impact the bad choices have on overall health. Learn what is most beneficial to your body to consume. It will be a life changer – literally.

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Renown Health President and CEO Tony Slonim, MD, DrPH, discusses efforts nationwide to develop a more effective and efficient way to deliver care. explains the benefits of Renown Health’s population health study with the Desert Research Institute and 23andMe.

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Craving a snack with crunch, sweet flavor and a powerful nutritious punch? These healthy, homemade variants of this make-it-and-take-it super snack are sure to satisfy your sweet tooth and your healthy lifestyle. Who says healthy snacks and bland taste go together? We say you can have it all — nutritious and delicious snack foods that taste great and satisfy — and trail mix fits the bill. Your homemade batch can be as healthy as you like. The nuts provide fiber, protein and a whole lot of crunchy goodness; dried fruit and touches of chocolate infuse the mix with just the right amount of sweetness. We’ve compiled some simple-to-make and hard-to-resist recipes so you can easily pick up a few items from the grocery store’s bulk bins, or your kitchen cupboard, and put together a snack for your kiddos lunches or the office. Better yet, grab your mix and head out for a stroll or hike, or take along on your next road trip or adventure in Nevada’s rugged, desert locales.

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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 PT

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Friday, April 12 is National Grilled Cheese Sandwich Day! So Let us help you create a healthier melt-in-your-mouth version to this popular cheesy sandwich. Ah, the grilled cheese. It’s the quintessential comfort food that not only pairs easily with a cup of soup, but it’s easy to whip together with just a few ingredients. There are many reasons to celebrate the gooey cheesiness of this toasted sandwich, but at nearly 700 calories, it’s definitely an occasional treat. But with just a few ingredient swaps — think light mayonnaise or toasting the bread in a toaster instead of slathering it in butter — you can remake your grilled cheese into a mouth-watering and nutritious meal. We’ve compiled a couple of easy substitutions, and some of our favorite healthy twists, so you can try a new variation of an old favorite. Be Choosy with Your Cheese It’s the star of your sandwich, but do you need to always grab the yellow slices? Try to opt for stronger flavors, like blue cheese or extra-sharp cheddar, to help you retain flavor while using less cheese on your sandwich. Better Bread Goes A Long Way Plain old white bread might be your toast of choice, but by choosing a whole wheat or multi-grain bread for your sandwich you’re not only adding in new crunch and flavor, you can also increase your fiber and nutrient intake. Hold the Butter Your mom, and maybe even your grandmother, probably spread a layer of butter on your grilled cheese throughout your childhood. But know this: It isn’t necessary. While butter helps crisp the crust, it doesn’t add too much in the way of flavor. Instead, brush the bread with olive oil, or try using a thin layer of reduced-fat mayonnaise or a creamy spread. Or skip grilling altogether by toasting your bread and then baking your sandwich open faced in the oven for a few minutes at 350 degrees. Healthier Options Looking for a new twist? Here are three incredibly tasty (and healthier) versions of the traditional grilled cheese sammy. 1. Baby Swiss And Tomato Grilled Cheese 2. Green Grilled Cheese 3. Spinach, Pesto & Havarti Grilled Cheese

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In recent years, healthcare has undergone many important transitions. One of the greatest changes has been the transition from a fee-for-service model to a value-based care model. Historically, healthcare organizations were paid for the amount of services they performed. This payment model resulted in more tests and procedures ordered, which, in turn, increased our country’s health care costs. However, now our government incentivizes health systems to provide the highest quality of care at the lowest cost possible. This new payment model is called value-based purchasing or value-based care. In this model, providers focus on delivering more coordinated and effective care. Additionally, healthcare organizations track important metrics like patient engagement, population health, and hospital readmissions. At Renown Health, we know that progress on these metrics represents real improvements in our patients’ lives. Shifting Focus from Illness to Wellness Healthcare organizations have traditionally viewed a hospital stay as the center of a patient’s wellness journey. At Renown Health, we believe a key part of our job is to help people live well every day. This means we focus not only on treating illness and injury but also on prevention efforts to keep people out of the hospital. For example, our employees help patients hazard-proof their homes to prevent falls, as falls are the leading cause of injuries in older adults. We also provide affordable health screenings to catch disease in its early stages, when it is more treatable. Renown Health also recognizes that many of the diseases our patients face – from diabetes to cancer – have social and environmental origins. We know that creating a healthier community will have a positive impact on their physical and mental health. Renown Health partners with local organizations to address community-based issues like addiction, pedestrian safety, air and water quality, climate change, and nutrition. Working together, we can lower the number of people who need care and improve the health and wellbeing of our community. Creating healthier environments and communities will help us prevent disease, which in turn will help us decrease spending and improve health. Most importantly, it will help people live up to their full potential. Dr. Slonim on Twitter | @RenownCEOTonyMD Interested in hearing more of Dr. Slomin’s thoughts on health and healthcare? Engage with him on Twitter. Follow Tony

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As a clinician and a cancer survivor, I know that hope is an essential force that drives people to work through difficult situations. I also believe there’s a strong correlation between hope and wellness. Hope inspires us to make healthy choices today with the understanding that these behaviors will benefit us in the future.   In addition, an optimistic outlook helps patients face illness and injury with strength and confidence. While it’s easy for some people to maintain a positive outlook, it’s common to feel hopeless on a bad day. An important part of our job as healthcare providers is to help patients cultivate hope and build a strong foundation that carries them through their medical journey. The Importance of Family A common source of hope, for me and many others, is family. My family has recently welcomed our newest member, my first granddaughter, Emory. Becoming a grandparent has inspired me to reflect on the many blessings in my life. It’s not only been a opportunity to reflect, but also look ahead to the future. I often dream about the things Emory will accomplish one day, the kind of person she will become, and the world I want her to live in. These aspirations have renewed my determination to work hard and lead by example. At Renown Health, we know that hope and resilience are just as important in the recovery process as excellent medical care. That’s why we work with our patients to find sources of strength and inspiration in their own lives. We’re committed to helping our patients keep fighting the good fight for a healthier tomorrow.

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Hospital food gets a bad rap and maybe it’s deserved. However, at Renown Health we strive to serve patients, visitors and staff meals that are both nutritious and delicious. In this video and blog post, Renown Health President and CEO, Tony Slonim, M.D., Dr.PH., FACHE, shares his thoughts on hospital food and modeling healthy lifestyles.   Everyone knows that what we eat matters for almost every aspect of our health. Eating well can prevent chronic disease, control weight, improve our mood and even strengthen our bonds with loved ones as we come together to enjoy a family meal. Yet despite this knowledge, balancing work or school responsibilities, family life and everything in between can make eating healthy feel like an uphill battle. Recognizing this challenge, Renown Health invests in programming to help our community embrace healthy lifestyle habits – starting with our own employees. Knowing that people often look to their healthcare providers to model healthy behavior, we are deliberate in our efforts to help our employees and their families live well. We also provide healthy dining options in our on-campus restaurants and through our food and nutrition services team. We believe that providing nutritious, appetizing meals helps patients to recuperate from illness or injury, helps their families recharge, and helps our staff fulfill their promise of providing outstanding care. We hope that by serving as models of healthy behaviors, our employees will inspire others to join us in this journey. Dr. Slonim on Twitter | @RenownCEOTonyMD Interested in learning more of Dr. Slomin’s thoughts on health and healthcare? Engage with him on Twitter. Follow Tony

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I am regularly amazed by medical advancements and innovation in the United States. However, even as we make significant progress in many areas of medicine, there is still much more work to be done in others. One such area is patient safety.   What is Patient Safety? When we talk about patient safety, we are discussing how hospitals and healthcare organizations protect patients from errors, injuries and infections. Anyone can make a mistake at work, but in healthcare these mistakes can result in serious outcomes. In 1999, the Institute of Medicine released a report that estimated 98,000 deaths per year result from medical examination or treatment. The most recent study in 2013 suggested these numbers could range from 210,000 to 440,000 deaths per year. Many of these deaths result from preventable medical errors. This is inexcusable and shows how much more work our industry still needs to do to improve patient safety. Making Patient Safety a Priority Patient Safety is our number one priority at Renown Health. We dedicate a lot of time to establishing, reviewing, and revising our processes to prevent errors. Despite the obvious importance of patient safety, this issue is largely left to individual hospitals and health systems to manage. There is a surprising lack of national attention around this truly important issue. However, a silver lining of the COVID-19 pandemic is that it is igniting interest in hygiene and infection prevention. Patients want to learn more about the processes that are in place to prevent the spread of infections. In addition to the many protocols that guide our treatment of injuries and illness, Renown Health has implemented the following measures to prevent the spread of communicable diseases: Requiring everyone entering Renown sites to wear a mask or face covering. Establishing new processes to help patients and visitors practice social distancing. Limiting the number of visitors in our facilities. Screening all employees and patients for symptoms. Enhancing our already-thorough cleaning and disinfection processes. I hope patient safety and infection prevention remain in the national spotlight long after the COVID-19 pandemic has ended. The healthcare industry must come together to develop stronger systems and regulations to minimize preventable medical errors. We have a responsibility to our patients to do better.

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There are many lenses through which to view health. As you would expect, medical providers typically focus on the health of individual patients. For example, doctors consider a person’s symptoms, their current lifestyle, their past medical history, and their family’s history to diagnose medical conditions and recommend treatments. The Public Health Perspective Public health professionals look beyond the health of an individual and instead focus on the health of an entire community or population of people. They strive to achieve “the greatest good for the greatest number.” As the CEO of a health system, I feel fortunate to have education and training in both medicine and public health. As Renown Health’s leader, it is my responsibility to care for the people and communities we serve. That involves bringing world-class staff and innovative medical care to northern Nevada. We also focus on prevention by looking for ways to improve health outside of our facilities. That means partnering with local organizations to address the social, economic, and environmental factors that shape our health. Or working with local government to create policies that help to prevent disease and injury. In order to make a genuine and long-lasting impact on health, we must foster a community that helps our neighbors live well. Public health is especially important during times of crisis, such as the COVID-19 pandemic that we’re experiencing now. During these times, health systems must be able to swiftly shift focus from prioritizing the needs of individual patients to considering what is best for our local population. For example, we may need to temporarily limit hospital visitors or educate the public about how to socially distance in order to stop the spread of disease. Being prepared to make this shift and having strong relationships with our local health department and community organizations help us better serve the public. In both good times and bad, I am thankful that my public health background provides me with the perspective to look beyond our health system and embrace the health our community.

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At Renown Health, we often discuss the importance of both healthcare – how we treat people when they are sick or injured – and health – how we keep people well in their mind, body and spirit. This conversation is as important for the patients we serve as it is for our healthcare providers.   It’s well known that the medical field can impose challenging and even unhealthy expectations for healthcare workers. Long hours and physically and emotionally demanding work can lead to burnout. Yet, until recently, these issues were rarely discussed openly. Because the role of healthcare providers is to care for other people, they may feel uncomfortable asking for help themselves. The good news is that more and more physicians and professional associations are talking about burnout. Hospitals are also taking action to address concerns like mental and emotional fatigue. We need our workforce to be healthy in mind, body and spirit. That’s why we support our team by educating them on the warning signs of burnout. Renown Health also trains management-level employees to care for those who need help. We encourage employees to talk openly about these challenges and encourage them to access the many services available to our employees that can help them live well. Caring for people is central to Renown Health’s mission. We believe this applies to both our patients and our teammates.

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