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    • Community Partnerships
    • Nursing

    Air Guard RN Makes an Impact in Community and Beyond

    Everyday, Renown salutes its more than 150 active military and veterans on staff. Becca Gilbert, a Renown trauma nurse, is an example of the many outstanding service members at Renown who are serving both their country and their community. Becca Gilbert, BSN, RN, wears many uniforms. When she’s not wearing scrubs in her role as a trauma nurse in the intensive care unit of Renown Regional Medical Center, she’s wearing fatigues as a first lieutenant in the Nevada Air National Guard. “Service is huge,” says Becca Gilbert, RN, of her role in the Air Guard. “It’s something that is ingrained in me and a big part of who I am as a person. I find a lot of pride in being a part of something that is bigger than what is going on in my world.” Renown Health was named one of 15 recipients across the nation — and the only health system in the U.S. — for the Department of Defense’s highest employer award, the Secretary of Defense Employer Support Freedom Award, for exceptional support of its military employees. The Employer Support of the Guard and Reserves and Renown held a ceremony June 29 to recognize the award and to honor representatives of Renown who currently serve in the Guard and Reserves. With her Air Guard background, Gilbert is preassigned veteran patients at the Renown ICU. She says she’s able to relate to the veterans and their families and create a quick bond with them. “I’ve been assigned patients who are guard members with traumatic injuries — it’s good but hard,” Gilbert explains. “But I really love working with patients who are veterans.” Gilbert’s first career was as a veterinarian technician. Then enlisted in the Nevada Air National Guard in August 2008 — following in her father’s footsteps — and trained to serve as an EMT. While she was a medic, she went to nursing school for her second bachelor’s degree and was able to commission as an officer after graduation. Serving Our Community Gilbert says her work in the guard offers benefits that help with her job responsibilities at Renown, where she’s worked for four years. “At Renown, we are really a team and rely on each other to make sure there are good outcomes,” she says. “In the guard, officers are often put in charge, which teaches you a lot of things — organization, decision making and thinking of others. I think all of those things go hand-in-hand with my role as a nurse, especially in the ICU. People in the guard count on you as an officer and leader, and that is really important in the ICU when patients are counting on you for a positive outcome.” Gilbert’s responsibilities in the guard vary, including training for disaster relief missions and ensuring service members are fit and healthy enough to perform their jobs. “Training is a large part of the military — trauma training, physical fitness training and staying current on certifications,” she says. Locally she also leads the Self Aid Buddy Care program, a United States Air Force program that encompasses basic life support and limb-saving techniques to help wounded or injured personnel survive in medical emergencies until medical help is available. With the guard, Gilbert has also been involved in a bleeding-control program for volunteers in the community. She teaches community groups how to stop bleeding if they are a bystander to a car accident or other type of event, and is working with Renown trauma surgeon Marty Bain, M.D. to implement the program at Renown as well. Making a Difference Abroad In January, Gilbert was presented with an opportunity through the Nevada Guard State Partnership Program to travel outside the United States to the Kingdom of Tonga in the South Pacific and work at the Women and Children Crisis Centre, which assists families who are dealing with domestic violence. Gilbert praised the women who work at the center for their efforts towards change, as she says domestic violence is common in Tonga. “The women who work at the Women and Children Crisis Centre are pioneers,” she says. “They are trying to make changes by documenting what is going on and providing statistics to the lords and kings of Tonga. Some of it still isn’t accepted, but they continue to help the women and children of Tonga. They are helping so many people.” Renown Health salutes Gilbert for her tireless service to her country and her community here at home.

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    • Renown Health
    • Nursing

    The Journey Within: Helping Others Through Grief

    Learn more about a Renown Health nurse who formed a nonprofit to help other families through loss. After the unexpected loss of her young husband, a Renown Health nurse turned her grief into helping other families navigate the loss of a family member. Jen Walker, RN, MSN, director of clinical excellence, lost her high school sweetheart and husband of eight years when he passed away in October 2015, while their two boys, age 7 and 9, lost their father. Walker, a nurse at Renown since 2003, was overwhelmed by the outpouring of support she received from the Reno community. It inspired her to want to help others in the same situation. “After Travis passed, the community did some amazing things for me,” Walker says. “I got really motivated to do the same thing and to give back, so that’s when I came up with starting The Journey Within.” The Journey Within organization provides support and resources for young families who have lost a close family member. Before officially starting her organization, Walker used some of the money she received after her husband passed and personally donated to three families. And with the help of four board members, Jen officially started The Journey Within in February 2017, and they have helped six families so far. One of the board members is her sister, Anny Goff. “She thought of creating this foundation in the darkest time of her family’s life,” Goff says. “She knew there would be other families that would need help and support and immediately wanted to help others. It showed incredible strength and courage to keep moving forward.” Nursing Careers at Renown Health Nurses at Renown Health demonstrate a commitment to patients and their families through the integration of care, clinical expertise, education, evidence-based practice and the pursuit of quality patient outcomes. Learn more about our mission, vision and values and the benefits of a career in nursing at Renown Health today. Explore Nursing at Renown Walker’s organization supports families through financial donations, which she funds through two yearly fundraisers. The Travy Tourney is a golf tournament held in memory of Travis, and the “Let’s Toast to Travis Fundraiser” event raffles prizes and merchandise. Along with financial support, The Journey Within helps families connect with other community resources, such as counseling and grief therapy services. Walker hopes to expand her nonprofit’s fundraising and support for families beyond the Reno-Tahoe community. Because of her outstanding work at Renown and in the community, Walker recently received a 20 Under 40 award from the Reno-Tahoe Young Professionals Network. She has also received a Women of Achievement award, a Leader of the Quarter award and has been nominated four times for Northern Nevada Nurses of Achievement. “She is strong and resilient and cares a lot about people,” says Jen Richards, chief nursing officer, acute care services. “She never settles for the status quo and is always pushing our team to do better.” In navigating her own loss and starting a nonprofit to give back, Walker has learned a lot about the community. “I’ve gained a tremendous amount of respect for the community as a whole, but especially for the young community,” she says. “Seeing the young people in the community who have been willing to give back and live really selflessly has been amazing to me.” As someone who lost her husband, helping young families who have gone through the loss of a close loved one can hit close to home for Walker, but that doesn’t stop her — it fuels her. “That’s one of the hardest parts about doing this — it takes you back a little bit,” she says. “But it’s just a very good reminder of ‘why.’ Because when I get to talk with these families, I realize that now I am that person who is there to listen. I just want them to know that they’re talking to someone who’s been through something similar.”

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    • Women's Health
    • Pregnancy and Childbirth

    What is a High-Risk Pregnancy?

    You can still have a healthy pregnancy and baby if your pregnancy is high-risk. Learn what steps you can take to give your baby the best start possible. A “high-risk” pregnancy is one that threatens the health or life of the mother or her fetus. Women with high-risk pregnancies should receive care health care specialists to ensure the best possible outcomes. Some examples of a high-risk pregnancy include: Maternal age, women 35 and higher or 17 and younger Lifestyle choices, including smoking, drinking alcohol and illegal controlled substances Existing medical history, chronic hypertension, diabetes and breathing issues Multiple gestation, pregnancy with twins or triplets Overweight and underweight  Remember: You can still have a healthy pregnancy and baby if your pregnancy is high-risk. Some ways to promote a healthy pregnancy: Schedule an appointment with your OBGYN Eat a balanced diet Avoid substances Prenatal care Healthy weight gain Reduce stress Exercise  Pregnancy & Childbirth at Renown | 775-982-KIDS (5437) When you are expecting a new baby, you can depend on Renown Children’s Hospital for all your mom and baby healthcare needs. We can help you find the right doctor and tell you what to expect during your stay. We offer childbirth education classes and tours to help you prepare. Be sure to check out our virtual tours of our Labor Assessment Area.

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    • Women's Health
    • Pregnancy and Childbirth

    You're Ready to Start a Family! Now What?

    Deciding you’re ready to start a family is a big decision for any couple. So once you’ve decided – what are the next steps for both moms and dads-to-be? And what should you know if you’re struggling to conceive? Dr. Myron Bethel, OB/GYN with Renown Women’s Health, offers key insights about fertility. What’s the first thing couples should do when they decide to start a family? For the mom-to-be, it’s important to meet with your obstetrician before you get pregnant. This appointment gives you an opportunity to discuss your family medical history, any past or current health problems, immunization history, medications you’re taking and any issues with previous pregnancies. Your doctor can also provide helpful tips to ensure your body is ready for a healthy pregnancy and help guide you on how to monitor your period, basal resting body temperature and other important factors to help you get pregnant more quickly. How can couples who are trying to get pregnant make sure they’re healthy to conceive? Of course it’s important to maintain a healthy lifestyle all the time, but it’s especially important if you’re trying to get pregnant. There’s no magic pill or single food, but women should start focusing on nutrients they’ll need during pregnancy. Before trying to conceive, start taking folate and folic acid to help prevent birth defects. You can get good sources of these nutrients from cereal, spinach, beans, asparagus, oranges and peanuts. Lifestyle changes can also help improve fertility. For both men and women, extra weight can reduce fertility. Both sexes can increase their chances of conception by not smoking, not drinking alcohol and exercising regularly. And for men specifically, take a daily vitamin containing zinc and selenium to support healthy sperm. What is the average timeline for conception, and what do you suggest for couples who may be struggling to conceive and start a family? First, remember getting pregnant can take longer than you expect. Do not to get stressed out about it or place blame. Seventy percent of couples conceive within six months and 85 percent within one year of trying to get pregnant. To help improve your chances of pregnancy, monitor your ovulation closely. You can do this by tracking your period, watching your body closely and logging symptoms, logging your basal body temperature or using ovulation kits. If you still aren’t sure when you’re ovulating, try to have sex every other day to improve your chances of conception. If you’ve been trying for nine months to a year, you can talk to your OB about options and discuss meeting with a fertility specialist.

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    • Cancer Care
    • Men's Health

    Prostate Cancer: Symptoms, Treatments and Screenings

    Did you know: More than 2.9 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today. Prostate cancer is common, but also treatable, especially when caught early. Dr. Michael Hardacre of the Renown Institute for Cancer explains. With the exception of skin cancer, prostate cancer is the most commonly diagnosed form of cancer in American men. In fact, the American Cancer Society offers these key statistics: About 1 man in 9 will be diagnosed with prostate cancer during his lifetime. Prostate cancer develops mainly in older men and in African-American men. About 6 cases in 10 are diagnosed in men aged 65 or older, and it is rare before age 40. The average age at the time of diagnosis is about 66. The good news: This form of cancer is very treatable when also detected early. Michael Hardacre, MD, radiation oncologist with Renown Institute for Cancer, is here to explain more about prostate cancer screenings and their role in early detection. What is the prostate? The prostate is a gland that only males have, and it makes part of the seminal fluid. Prostate cancer begins when the cells in the prostate gland start growing uncontrollably due to a change in the cell’s genes. Researchers are working to find what leads to the disease. Certain types of prostate cancer are hereditary, or passed on through genes. However, most types of prostate cancer are acquired and developed later in life. What are some of the signs of prostate cancer? Common signs of prostate cancer include: Frequent urination Weak urine flow Painful urination or inability to urinate Blood in urine or semen Painful ejaculation Erectile dysfunction If you notice any of these signs, talk with your primary care doctor. Although it may be intimidating to talk about any of these signs or symptoms, the earlier prostate cancer is detected, the better the options for treatment. How can you screen for or detect prostate cancer? The good news is that prostate cancer can often be found before symptoms appear, because screening is as simple as a blood test. Your doctor will look for levels of a prostate-specific antigen in the blood. If the results come back with anything concerning, then additional testing would be recommended. A transrectal ultrasound can also be used, which is usually painless and only takes about 10 minutes to complete. This exam gives the doctor an image of the prostate to measure its size, which can help determine the density of the prostate-specific antigen. If this test comes back with any suspicious results, then your doctor may recommend a biopsy. What are the treatment options? Depending on each case, treatment options for men with prostate cancer might include: Watchful waiting or active surveillance Surgery Radiation therapy Cryotherapy (cryosurgery) Hormone therapy Chemotherapy Vaccine treatment Bone-directed treatment It’s important to discuss all of the treatment option with your doctors, including goals and possible side effects, to help make the decision that best fits your needs. Some important things to consider when choosing a treatment option also include: The stage and grade of your cancer Your age and also your expected life span Any other serious health conditions you have Your feelings (and your doctor’s opinion) about the need to treat the cancer right away The likelihood that treatment will cure your cancer (or help in some other way) Your feelings about the possible side effects from each treatment Renown Institute for Cancer | 775-982-4000 At the Renown Health Institute for Cancer, our experienced team provides the support and care to maintain the highest quality of life and then achieve the best possible outcome, all in one location that’s close to home. Our dedicated team, clinical expertise and also advanced treatment options allow us to tailor care to each patient. Learn about: Our Team Cancers We Treat Screening and Prevention Treatment Options

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    • Diversity
    • Pregnancy and Childbirth

    Two Dads and a Newborn Adoption: "Our Experience Was Wonderful"

    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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    • Renown Health
    • Nursing

    Caring for the Whole Family: Renown Nurse Helps Patient with Ailing Pet

    Registered Nurse Tori Tembey (left) shared how her co-worker and fellow RN Jennifer Payne helped a patient with his pet's end-of-life arrangements. "It was such a selfless act that Jennifer took the time to do this for the patient.” Tembey says. Pets become members of our own family, and when they are ill or at the end of their lives, it can be devastating for their owners. During a hospital stay, a Renown patient was faced with the difficult decision to euthanize their terminally ill pet. A Renown registered nurse stepped in to help in some pretty remarkable ways. Back in high school, Jennifer Payne wanted to be a veterinarian. She worked in a veterinary hospital and planned to attend veterinary school, but struggled with some of the situations she faced. “I have a lot of compassion for animals,” Payne explains. “And some of the things I saw while working at the vet — like people bringing in their cat saying, ‘I’m moving, you need to put this cat down’ — wasn’t OK with me, and wasn’t what I wanted to do.” She changed course and went into nursing, but recently drew upon her early experiences working with pets and their owners to help a Renown patient in an extraordinary way. Payne now works in the trauma intensive care unit at Renown Regional Medical Center, where she recently observed a county animal control officer visiting a patient. The patient was visibly upset — they learned their dog was terminally ill and in poor health, and a veterinarian was recommending euthanasia. The patient had lost another dog just before Christmas. The patient hoped to have his ill dog similarly cremated, but animal control does not perform cremation. “I overheard all of this and thought, ‘this is the most horrible thing I’ve ever heard,’” Payne says. She offered to pick up the dog, have him cremated and bring the ashes to the patient. She also took up a collection with her Renown colleagues to pay for the cremation. The next day — her day off — Payne and her young daughter picked up the ashes and brought them to the patient at the hospital. “He couldn’t even talk because he was crying so much,” Payne says. “He said ‘I can’t thank you enough for all you’ve done. You’re a wonderful person.’ There was a friend in the room who asked what my daughter’s name was, and I said ‘Estelle.’ The friend said, ‘Estelle, your mother is an angel.’” Payne, who has a golden retriever of her own, says she knows what it’s like to have “fur babies,” and she could see how important this dog was to the patient. “It was great to be able to do this for him,” she says. Renown salutes nurses like Jennifer Payne, who are making a genuine difference everyday in the lives of patients and in the community.

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    • Women's Health
    • Pregnancy and Childbirth

    Why Didn't You Tell Me? 10 Pregnancy Surprises, Revealed

    We asked, you answered: Moms and dads who have been there, done that offer up 10 pregnancy surprises. These are the things they wish they knew before, during and after their pregnancy. Check out these real examples of insights that would have proved helpful and enlightening to these parents and parents-to-be. When you’re pregnant or considering becoming pregnant, it seems the unsolicited advice runs rampant. You’ll hear people tell you what kind of Boppy Pillow to buy. You’ll have people tell you that you should “definitely” have a natural birth or a pool birth or a doula or a therapy dog present. And you’ll definitely hear about what kinds of foods to induce labor, what kind of tea to drink to reduce nausea during your pregnancy and what kind of underwear for less “chafing.” But something you might not hear as often: Some of the symptoms and side effects, both before and after giving birth, that were totally unexpected. These are the ultimate pregnancy surprises. So we asked the question of moms and dads who have been there, done that: What do you wish you had known would happen during your pregnancy — you know, during the time you were supposed to be all sweet and beautiful and glowing? Here is Part 1, featuring 10 real-life, crowdsourced pregnancy surprises from parents. And yes, there are multiple parts to this post, because people are passionate about sharing their wisdom! We’ll publish the second part later this month. Pregnancy surprises: What do you wish you had known about pregnancy? “The only symptom I never heard anyone talk about is extra blood flow making me feel all sorts of weird feelings in my head. I feel like I’m in a dream half the time. I looked it up online when it started happening, and tons of women have the same symptom.” — Anna K. “For me it was an after-birth surprise. I had no clue your tummy doesn’t just spring back to where it was pre-pregnancy. It was a rude awakening in the hospital when I had to have my husband go home and get a pair of maternity sweatpants to get dressed to go home in. I’d hoped to dress in my old cute jeans…. nope!” — Suzanne M. “I didn’t know that while you’re pregnant, friends and strangers would tell you their nightmare delivery stories. Oh — and that complete strangers will, uninvited, touch your baby bump. I didn’t know that you’re in the safety zone while pregnant and that men and women openly adore you. I didn’t know that besides the mother, the nurses do most of the work. I didn’t know that even though they’ve obviously seen hundreds of deliveries, nurses and doctors cry too once your baby is out. I didn’t know even though I thought they must be crazy to send a tiny human home with me, that you instinctively know how to parent. I didn’t know what it meant to love something more than myself and how that changes everything.” — Cathy B. “I had no idea the weird things that it does to hair. My bangs stuck straight out for months, and I just had to go with it. There wasn’t enough product that would make them lie down.” — Heidi P. “That you may not go home with your child if there are any complications. That was a sad day. But 22 years later, we are blessed, because everything turned out fine.” — Kristine F. “I didn’t know people would opine out loud to you, that you must not have purposely gotten pregnant with Baby #2 or 3, etc., implying you failed basic high school biology and that you should have known better than to have more than one kid.” — Jessica L. “I didn’t know that near the pregnancy’s end, as the hips widen, that those bones could begin to separate. I was sore and achy. And I wish I’d slowed down and rested more in the last few weeks.” — April C. “I had heard about food cravings, but no one told me food aversions were also a thing. I bought a whole load of groceries for the week, and by the time I got home, I suddenly couldn’t even look at the ground turkey (that’s not an exaggeration), let alone cook it and eat it. I didn’t throw up necessarily, but my body told me to avoid most meats and vegetables. I pretty much lived on plain bagels and cereal for half my pregnancy.” — Danielle S. “Morning sickness is SO not just in the morning! All-the-time sickness is what I experienced. And why didn’t anyone warn me about butthole pain during and after birth?” — Stephanie C. “The juiciness. Every possible secretion was in hyper drive.” — Jane F. Giving Birth at Renown At Renown Regional Medical Center we have the skill, expertise and technology — along with a friendly environment — to make your experience a memorable one. Pre-register for childbirth, take virtual tours of our rooms and facilities, and learn more about our labor and delivery offerings at the link below. Explore Our Services

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    • Breastfeeding
    • Baby Health
    • Lactation

    How to Safely Store Breast Milk

    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.

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    • Men's Health
    • Active Living

    Testosterone, Men and Health: What You Need to Know

    You probably know testosterone (T) plays an important role in how boys physically develop into men. But is that all you know? What happens when a man's T levels are off? Are there symptoms men should look for? And what are the treatment options? Dr. Bobby Kahlon, MD, Renown Medical Group provides answers in a Testosterone Q&A.   What does testosterone do for men?  "Testosterone is known as the 'manly hormone' for a reason," says Dr. Kahlon. "Though women also naturally produce small amounts of it, men produce testosterone at much higher concentration levels. And it affects men in more physical and obvious ways. How much hair a man has on his chest, how deep his voice is, or how muscular he is are all attributable in some way to testosterone. It's also responsible in large part for sex drive and bone strength and affects how men think, learn and experience their surroundings."  Testosterone in men:   Powers virilization (male physical characteristics) and sexual function Builds muscle mass and strength  Supports bone density  Improves cognition  T Trivia: Discover Magazine reveals that “manly” testosterone and other sex hormones evolved long before we did — 500 million years ago — from the ultimate “female” hormone, estrogen. Can you have too much or too little testosterone?  Though high testosterone isn't a concern for most men, low testosterone or low T occurs more frequently and develops for two primary reasons.  Dr. Kuhadiya explains, "Subnormal testosterone concentrations occur either due to pituitary or testicular failure and the causes for each need to be discussed with your physician."  Pituitary failure: Approximately one-third of men with obesity, type 2 diabetes, or metabolic syndrome (which includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels) have low free — or "bioavailable" — testosterone. These health conditions can cause the pituitary gland to "fail" to release follicle stimulating hormone (FSH) and luteinizing hormone (LH) which are essential for triggering testosterone and sperm production. And that can cause low testosterone (hypogonadism). Testicular failure: Though less common than pituitary failure, testicular failure may also be responsible for low T. It's caused by diseases or illnesses affecting the testicles, injury or trauma to the testicles, or certain medicines and treatments such as chemotherapy or opioid pain medication. Providing your complete medical history to your doctor is always the first step toward a proper diagnosis.  What are the symptoms of low T?  The following indicators could be a sign that you have low T, say the doctors.  Lack of motivation and determination, including mild depression  Loss of physical endurance and muscle strength  Loss of or diminished early morning erections  Reduced libido (sex drive)   Erectile dysfunction (ED — difficulty achieving or maintaining an erection)   Gynecomastia (male breasts)  Small testes  T and Time: T levels in men naturally begin to decline by about 1% a year starting at age 30.  How do you test for low T?  "There are different methods for testing testosterone levels," says Dr. Kuhadiya. "Each approach uses a blood sample to evaluate total testosterone, which includes free and attached testosterone that combines with proteins albumin and sex hormone-binding globulin (SHBG). For the most accurate results, testing is based on samples collected in the morning after fasting, and from tests on two different days."  What treatment options are available?  "Well, your best natural option may be YOU," says Dr. Kahlon. "Men with pituitary failure are often able to treat their low T by losing weight to increase levels of the hormone. And even if you don't lose weight, exercise can help boost your testosterone. Unfortunately, if you have testicular failure, weight loss and exercise may not have the same effect."  So, are there other options? "You may want to consider Testosterone Replacement Therapy (TRT)," says Dr. Kuhadiya. "TRT is only available to men who are hypogonadal — with a clinical diagnosis of low T. Injection, gel, skin patch and nasal spray are available TRT options. The best option is the one that works best for the patient. Convenience, insurance coverage and cost are all factors to consider." Dr. Kahlon's TRT preference? Daily gel treatments, which are applied directly to the skin. On the other hand, Dr. Kuhadiya recommends intramuscular injections, which take place once a week or every two weeks.  But both doctors agree on this: physicians and their patients need to weigh the benefits and risks of TRT before proceeding with treatment — especially if your low T condition may require lifelong treatment. "In my clinical practice, I have seen some very good long-term results with an improved quality of life," says Dr. Kuhadiya. "However, in certain situations, TRT may increase the risk of heart disease and is not recommended for men with a history of prostate cancer." Dr. Kahlon adds, "Patients receiving any type of hormone therapy need to be closely monitored throughout the treatment process for any changes in their health."   How do you feel about steroids and T boosters?  "I don't recommend them, certainly not for hypogonadism," advises Dr. Kahlon. "There is no evidence to support anabolic-androgenic steroids or testosterone boosters as a safe or effective treatment for low T in men."  "In fact, there continues to be emerging evidence they may lead to side effects that could potentially harm the liver and the pituitary and endocrine functions of the body," warns Dr. Kuhadiya. "And that damage may be irreversible."

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    • Pediatric Care
    • Women's Health
    • Baby Health
    • Pregnancy and Childbirth

    Get Ready for Baby with Childbirth Classes

    By taking our pregnancy and birth class, you will gain the tools necessary to have a safe and empowering birth experience for both you and your baby. Chris Marlo, Childbirth Educator at Renown Health explains why birth classes are important. For questions regarding classes or tours, contact Chris Marlo: chris.marlo@renown.org 775-982-4352 What is a Certified Childbirth Educator/Doula? If you are expecting a baby, Renown has a wide variety of classes to help prepare you for birth. Classes are taught by certified childbirth educators and doulas. A certified childbirth educator is a trusted resource who has a passion for educating expecting parents about childbirth, and will provide you with non-biased, evidence-based information. A doula is a professional labor assistant who provides physical and emotional support during pregnancy, childbirth and postpartum. As you prepare for birth, our certified educators will guide you each step of the way and ensure you receive the quality care you deserve. Why Should I Take Pregnancy and Birth Classes? For expecting parents, taking a childbirth education course is an important step in preparing for their new arrival. We cover topics such as labor and delivery, postpartum care, breastfeeding, nutrition, pain management techniques, and more. Our experienced instructors will provide you with the information you need to make informed decisions during your pregnancy and childbirth. With our classes, you can be sure that you have all the knowledge necessary to have a positive experience before, during, and after your baby’s arrival. Our classes will help ease your fears as we practice breathing, relaxation and the many tools you can utilize for birth. At Renown we understand that there is no right way to give birth, and our educators will offer a supportive environment where questions are encouraged, and everyone is respected. Childbirth Class Options: Baby and Family Suites Tour & Virtual Tour Breastfeeding Basics and Beyond Class Breathing & Relaxation Techniques for Birth Pregnancy and Birth – 5 & 7 Week Series Pregnancy and Birth Class Additional Resources: Baby Safe Class Babysitter Class Grandparents Virtual Class Infant CPR & Choking Class Newborn Care Nurturing Your Newborn Preparing for Postpartum Virtual Class

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    • Renown Health Foundation
    • Nursing

    Getting to Know Stephanie Kruse

    There are a lot of impressive titles you can use to describe Stephanie Kruse: entrepreneur, marketer, philanthropist, leader, adventurer, nurse. And now with her planned gift to the Renown Health Nursing Excellence Endowment, she can add one more to the list: a member of the Renown Legacy Society – a group of visionary supporters who have chosen to make a lasting commitment to the future health and wellbeing of northern Nevadans. This generous planned gift comes on the heels of a significant cash gift made to the Nursing Education Fund last summer. Stephanie is an inspiring example of someone who has dedicated her life to helping others. The daughter of a nurse and a retired nurse herself, Stephanie knows the hard work, selflessness and dedication it takes to create a successful business and community. As Chair of the Renown Health Foundation Board of Directors, she also understands the importance of attracting and retaining nurses within a healthcare system. As a way to contribute to a cause near and dear to her heart, she decided to include the Renown Nursing Excellence Endowment as a beneficiary of her retirement plans. “I wanted to honor the memory of my mother, who was a registered nurse in a small-town hospital in Iowa.,” said Stephanie. “I was always very conscious of her passion for providing great care to her patients, and I wanted to provide funding for others interested in nursing.” Across the nation, health systems are facing a shortage of nurses and nursing-related professionals. Renown is proactively implementing programs to build our pipeline of potential future nurses and keep those already in the field. Stephanie’s generous gift will help the endowment provide programs such as training, scholarships, loan repayment and professional development to increase retention and recruitment of prospective nurses. “As nurses, we are entrusted with our patients’ lives,” said Melodie Osborn, Chief Nurse Executive at Renown Health. “We have the privilege of caring for people in their most vulnerable time and helping those who cannot help themselves. Stephanie’s generous gift to the Nursing Excellence Endowment Fund will help us develop new nurses for the future so we can continue to provide care to those in need for generations to come.” No Stranger to Healthcare Long before she found herself leading the Renown Health Foundation Board, Stephanie learned the ins and outs of healthcare. She graduated from nursing school and became a part-time nurse in a Sioux Falls, South Dakota nursing home while attending Augustana College to obtain a degree in journalism and a minor in theater. As part of her journalism program, Stephanie completed an internship in the public relations department of a Sioux Falls hospital, and that led to her accepting a position as director of public relations at a sister hospital. She later was recruited by Saint Mary's Hospital and moved to Reno to be the director of marketing in 1981. She stayed at Saint Mary's for almost 10 years before starting her own company in pursuit of her passion for marketing strategy. Since launching her brand, Stephanie has grown KPS3 to a multi-million-dollar firm with more than 60 staff members. Somehow, she is still able to find time to serve on six (!) volunteer boards, most of which are dedicated to improving access to better health and human services. “I have a soft spot in my heart for organizations who strive against all odds to help those with the greatest needs,” said Stephanie.

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