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Use Caution: Mixing Over-the-Counter Medications Can Be Harmful
With allergy seasonâs extended stay and cold and flu season having just begun, you may soon find yourself seeking relief through several different kinds of over-the-counter medications. Know what precautions you need to take when fighting multiple symptoms with multiple medications. When youâre too sick to go to work but not sick enough for a doctorâs visit, over-the-counter medicines are a welcome relief to help alleviate that fever, runny nose or allergies. But because those medicines arenât signed off on or managed by your doctor and pharmacist, itâs crucial that youâre especially mindful of what you put into your body. Whenever you pop a pill, you want to make sure youâre taking the right dosage, waiting the right amount of time before taking another dose and not mixing certain medicines together. Recent stories like this one detail dangerous over-the-counter medicine combinations, and weâre following suit: Here is a quick go-to guide about potentially harmful over-the-counter combinations. Too Much Tylenol/Acetaminophen Tylenol â or acetaminophen â is a popular pain reliever for many, but too much can be bad for your liver. âOur bodies have a finite ability to metabolize Tylenol,â says Andy Wright, clinical pharmacist at Renown Rehabilitation Hospital. âWhen too much builds up in the liver, it becomes toxic. In patients with medical conditions like cirrhosis of the liver or hepatitis, this could be disastrous.â Remember, acetaminophen is in more than just Tylenol and generic pain relievers. You may also see acetaminophen in flu, cold and cough medicines, like Nyquil, and some prescription medications including Norco and Percocet. Keep a list of the medications you take, and limit daily acetaminophen use to 3,000 mg per day. When youâre scanning medicine bottle contents, remember acetaminophen is also referred to as APAP, AC, acetam or paracetamol. Mixing Painkillers When youâre dealing with pain and not getting any relief, taking a different medication may seem like the easy solution. Maybe you take some Aleve â a form of naproxen â for a headache, but it isnât working, so you switch to Motrin, an over-the-counter form of ibuprofen. Not a smart idea. Ibuprofen and naproxen along with aspirin are known as nonsteroidal anti-inflammatory drugs (NSAIDS). Because these medicines work in similar ways, they should never be combined or used in larger doses or more frequently than directed. Otherwise your risk of side effects can increase, which range from mild nausea to severe gastrointestinal bleeding. Itâs also important to consider your family history when taking NSAIDs because, ârecent studies have shown NSAIDs may have greater cardiovascular risks for people taking blood thinners or those with hypertension,â explains Andy. âA good example is ibuprofen: It has a relatively low gastrointestinal bleed risk while it has a moderate to high cardiovascular risk. The opposite is true for naproxen.â Rather than experimenting with multiple medicines, figure out which drug works best for you. You may find muscle soreness improves with aspirin, whereas when a headache hits, naproxen is best. Keep in mind that these medications arenât always best for everyone in the family. âAspirin in children and teens is not recommended unless under the supervision of a doctor,â Andy says. And pregnant and lactating women should generally avoid NSAIDS due to risk of birth defects and bleeding. âIn both of these cases, acetaminophen or Tylenol are preferred but only if approved by an OB/GYN.â Fighting Allergies Over-the-counter antihistamines like Claritin, Zyrtec and Allegra have made fighting itchy eyes and runny noses a little easier. But these daily medicines â when taken inappropriately or in the wrong combinations â can also have an adverse effect. Similar to acetaminophen, you need to watch for antihistamines in other products. Sleep aids â like Tylenol PM and Unisom â commonly use an antihistamine known as diphenhydramine, which may increase your risk of overdose. âCombining antihistamines, or overdosing, can cause many adverse effects including dry mouth, blurred vision â even arrhythmias,â Andy says. âOnly take these medications on their own.â If youâre still struggling with symptoms, you can talk to your doctor about adding an over-the-counter nasal steroid. Andy confirms the importance of closely following the directions listed on antihistamine (and all medicine) bottles. He has seen extended release nasal decongestants cause significant arrhythmias requiring medical care after a patient took the medicine with warm fluids. âThe decongestant in question is designed to slowly release, but it can dissolve suddenly in the presence of warm liquids like coffee,â Andy explains. âThis can cause the pill to deliver 12 to 24 hours of medication all at once.â Taking an Antidiarrheal with Calcium Calcium supplements and antidiarrheal medicines are another harmful combination. Calcium firms up your stool, but if taken with an antidiarrheal, can cause severe constipation. If you need to take an antidiarrheal, take a break from your calcium for a few days until youâre back to normal. Another consideration when taking calcium supplements or calcium-based antacids is gas. âIâve had several patients report cases of excessive gas using Tums or calcium carbonate-based supplements.â Andy suggests instead âtrying Maalox or Mylanta for indigestion and Citracal as a supplement.â Talk with Your Doctor or Pharmacist About Your Medications If over-the-counter drugs arenât providing the relief you need, itâs time to see your doctor. And remember, for your safety it is important to keep your doctor and pharmacist up-to-date with any medications â prescribed or over-the-counter â that you are taking.
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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 sheâs not wearing scrubs in her role as a trauma nurse in the intensive care unit of Renown Regional Medical Center, sheâs wearing fatigues as a first lieutenant in the Nevada Air National Guard. âService is huge,â says Becca Gilbert, RN, of her role in the Air Guard. âItâs 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.â Renown Health was named one of 15 recipients across the nation â and the only health system in the U.S. â for the Department of Defenseâs 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 sheâs able to relate to the veterans and their families and create a quick bond with them. âIâve been assigned patients who are guard members with traumatic injuries â itâs good but hard,â Gilbert explains. âBut I really love working with patients who are veterans.â Gilbertâs first career was as a veterinarian technician. Then enlisted in the Nevada Air National Guard in August 2008 â following in her fatherâs footsteps â and trained to serve as an EMT. While she was a medic, she went to nursing school for her second bachelorâs 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 sheâs worked for four years. âAt Renown, we are really a team and rely on each other to make sure there are good outcomes,â she says. âIn the guard, officers are often put in charge, which teaches you a lot of things â 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.â Gilbertâs responsibilities in the guard vary, including training for disaster relief missions and ensuring service members are fit and healthy enough to perform their jobs. âTraining is a large part of the military â trauma training, physical fitness training and staying current on certifications,â 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. âThe women who work at the Women and Children Crisis Centre are pioneers,â she says. âThey 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 isnât accepted, but they continue to help the women and children of Tonga. They are helping so many people.â Renown Health salutes Gilbert for her tireless service to her country and her community here at home.
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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. âAfter Travis passed, the community did some amazing things for me,â Walker says. âI got really motivated to do the same thing and to give back, so thatâs when I came up with starting The Journey Within.â 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. âShe thought of creating this foundation in the darkest time of her familyâs life,â Goff says. âShe 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.â 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 Walkerâs 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 âLetâs Toast to Travis Fundraiserâ 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 nonprofitâs 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. âShe is strong and resilient and cares a lot about people,â says Jen Richards, chief nursing officer, acute care services. âShe never settles for the status quo and is always pushing our team to do better.â In navigating her own loss and starting a nonprofit to give back, Walker has learned a lot about the community. âIâve gained a tremendous amount of respect for the community as a whole, but especially for the young community,â she says. âSeeing the young people in the community who have been willing to give back and live really selflessly has been amazing to me.â 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 doesnât stop her â it fuels her. âThatâs one of the hardest parts about doing this â it takes you back a little bit,â she says. âBut itâs just a very good reminder of âwhy.â 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 theyâre talking to someone whoâs been through something similar.â
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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.â 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. âI have a lot of compassion for animals,â Payne explains. âAnd some of the things I saw while working at the vet â like people bringing in their cat saying, âIâm moving, you need to put this cat downâ â wasnât OK with me, and wasnât what I wanted to do.â 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 â 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. âI overheard all of this and thought, âthis is the most horrible thing Iâve ever heard,ââ 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 â her day off â Payne and her young daughter picked up the ashes and brought them to the patient at the hospital. âHe couldnât even talk because he was crying so much,â Payne says. âHe said âI canât thank you enough for all youâve done. Youâre a wonderful person.â There was a friend in the room who asked what my daughterâs name was, and I said âEstelle.â The friend said, âEstelle, your mother is an angel.ââ Payne, who has a golden retriever of her own, says she knows what itâs like to have âfur babies,â and she could see how important this dog was to the patient. âIt was great to be able to do this for him,â 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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Name-Brand Medication vs. Generic: What's the Difference?
Most prescriptions meds are available in generic form. Find out the similarities and differences between the two and how to determine whether a generic is right for you. Approximately 80 percent of prescriptions sold today are generics. If youâre taking a prescription medication, chances are itâs a generic form of the brand-name drug. But are you getting the same quality in a generic medication? Do generics measure up? The answer in most cases is yes â generics, just like branded products, are regulated by the Food and Drug Administration. âTo have a generic product approved by the FDA, the generic manufacturer must prove that its product is bioequivalent to the branded product,â explains Adam Porath, PharmD, BCPS AQ-Cardiology, BCACP and Vice President of Pharmacy Services. Basically, it has to function the same. âGeneric products are extremely well tolerated and will provide the same results as using a branded product,â Porath says. Hereâs how generics are the same as name-brand prescriptions: Generic products contain the same active ingredients. They produce the same desired clinical effect and accompanying side effects. Generics come in the same form as their branded counterparts: pill, liquid or inhaler, for example. Release into the bloodstream matches the name brand in timing and strength. Hereâs how they differ: Generics generally cost less. Federal law requires generics have different names and look different: shape, size, markings and color. Generics contain different inactive ingredients, like binders, fillers and artificial colors. Different side effects with generics can usually be attributed to these additions. Why do generics cost less? When pharmaceutical companies develop a new drug, they are paying for research, development, clinical studies, marketing â in some cases it can cost more than $800 million and take 10 to 15 years to develop a new drug. âThe manufacturers of branded medication products have to recoup their research and development costs,â Porath says. So companies are granted a limited patent to sell their drug without the competition of generic counterparts. âWhen patent exclusivity ends, the market is open for any generic manufacturer to make a competing product with FDA approval.â Without the same startup costs, companies can sell generics at 80 to 85 percent less. And because more than one company can produce the same generics, competition drives prices even lower.
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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 â 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. âI wanted to honor the memory of my mother, who was a registered nurse in a small-town hospital in Iowa.,â said Stephanie. âI 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.â 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. Stephanieâs 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. âAs nurses, we are entrusted with our patientsâ lives,â said Melodie Osborn, Chief Nurse Executive at Renown Health. âWe have the privilege of caring for people in their most vulnerable time and helping those who cannot help themselves. Stephanieâs 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.â 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. âI have a soft spot in my heart for organizations who strive against all odds to help those with the greatest needs,â said Stephanie.
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Free Virtual Event! Saving Money on Medications
According to a National Center for Health Statistics survey, about 8% of U.S. adults are not taking their medications because they canât afford them. This means millions of adults arenât taking their medication due to the high cost. Virtual Event with pharmacist, Adam Porath Thursday, July 23, 11 a.m. to Noon Attend Virtual Lecture 5 Ways to Cut Medication Costs Safely Cost might not be affecting your medication plan, but the following ways to save money on medication can help: 1. Questions to ask your prescribing provider Do I have to take this medication? This is particularly a good question when youâve been taking a pill for some time and not sure if you should continue. Is there a way to combine my medications? A good example of this is for those who are taking blood pressure medications. Do I have to take this particular pill? Often there are generic choices in the same medication class. Can I get a larger supply? Basically, knowing the cost of a 30- vs 90-day supply is always a good idea. In other words, it could save you time and money. This generally works for medications you take long-term. Remember, asking questions can help you save money on medication, so communicate your concerns. 2. Research online Find the website for the medication and look to see if there are savings and support available through the drug company. 3. Consider a co-pay card Coâpay cardâŻprograms offered by drug manufacturing companies are a direct way to lower out-of-pocket costs forâŻprescriptionâŻdrugs for eligible patients. TheâŻcardsâŻcan patients pay for the medications they, or their doctors, prefer. If you donât qualify for a co-pay card, then you can look into patient assistance programs. 4. Consider patient assistance programs Drug companies sponsor these programs by income and they are often hard to find. The best way to find a patient assistance program is by asking your pharmacist. 5. If youâre on Medicare, consider updating your plan Medicare plans can change from year to year, which often times includes the medication they cover and the co-payments or deductible amounts. Annual Enrollment takes place October 15 â December 7, 2020. Most important, review the options and shop around for the best plan. Visit Senior Care Plus for information on Medicare Advantage Plans available to you. Want to ask a pharmacist more questions on how to save on medication? Join us for a Sterling Silver Club virtual event on Saving Money on Medication. To learn more about the Sterling Silver Club, visit our club website.
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Parkinson's Disease Know The Important Symptoms
Parkinsonâs disease â you may have heard of it because Neil Diamond and Ozzy Osbourne were recently diagnosed with it. Or perhaps you know Michael J. Fox is a strong advocate and funds research through his foundation. Neurologist Jonathan Spivack, MD, discusses this disease, while physiatrist Stephanie Jones, DO, explains how physical therapy can help as a supplemental treatment. According to the Parkinsonâs Foundation about ten million people worldwide currently have this disease. What is Parkinsonâs Disease? âParkinsonâs disease is a neurodegenerative disease that progresses slowly and definitely, though at variable rates,â explains Dr. Spivack. âSymptoms go beyond the classic motor changes. It results from a loss of specific dopamine-producing brain cells. Specifically, this loss is likely due to a mix of genetic and environmental factors,â he adds. Dopamine allows communication between particular nerve cells responsible for movement. If you have Parkinsonâs dopamine levels gradually drop, causing a loss of motor skills. Generally, most patients with the disease are over age 65. Early Signs and Symptoms Diagnosing Parkinsonâs can be difficult as some of the symptoms happen during the natural aging process. The Parkinsonâs Foundation identifies the following 10 early signs of PD: Tremors or shaking of your hand, fingers or chin Small handwriting Loss of smell Sudden movements during sleep Stiffness when walking or moving Constipation Softer or lower voice volume Mad facial expression Feeling dizzy or faint Hunching or stooping posture A single sign may not point to the disease, but if you (or a loved one) has multiple signs, talk to your healthcare provider.
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Addressing the Threat of Workplace Violence in Hospitals
In recent years, workplace violence against healthcare workers has been on the rise. According to the Occupational Safety and Health Administration (OSHA), about 75 percent of nearly 25,000 reported annual workplace assaults occur in healthcare and social service settings. Those who donât work in healthcare may be surprised to learn that violent altercations are so common in our field. Hospital settings can create fear and stress for patients and their families. Pain, mind-altering medications and drugs, and difficult prognoses can amplify these feelings. While inappropriate responses may be understandable, violence cannot be tolerated. As the leader of a health system, protecting our employees is an issue that I take seriously. Reporting Workplace Violence Unfortunately, sometimes employees donât report dangerous incidents fearing they might be blamed, or not realizing itâs a reportable offense. At Renown Health, we take these events seriously. We have clear, mandatory policies and protocols for reporting and investigating violent incidents. Each incident is investigated to ensure follow through and accountability. We also teach de-escalation skills to our hospital security teams, clinicians, and other frontline employees. As an added layer of protection, Renown Health has a first-rate security team that closely monitors activity on our campuses, addressing potential issues before they escalate. Our organization values our partnerships with community organizations including local law enforcement agencies like the Washoe County Sheriffâs Office and the Reno Police Department. Renown Health maintains a close relationship with these partners, and we alert them when our care teams experience an increase in violent incidents. I also recognize that workplace violence is a national problem that demands collaborative solutions. Thatâs why I am also proud to serve as a member of the American Hospital Associationâs Hospitals Against Violence Advisory Committee. Nurses, doctors, paramedics, and frontline health workers care for us every day. Itâs our responsibility to support them by ensuring they feel safe at work.
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Generic Drugs â What You Need to Know About Them
Without a doubt, taking medications can not only be expensive, but also confusing. In the United States, generic prescriptions are widely used, with 9 out of 10 people choosing them over a name brand. Pharmacists are a great resource to help us understand the benefits and side effects of any medication. We asked Adam Porath, PharmD, Vice President of Pharmacy at Renown Health, to answer some common questions about generic drugs. What is a generic drug? A generic drug has the same active ingredients of brand-name drugs. Brand-name drugs have a patent (special license) protecting them from competition to help the drug company recover research and development costs. When the patent expires other manufacturers are able to seek approval for a generic drug. However, the color, shape and inactive elements may be different. Per the U.S. Food & Drug Administration (FDA), a generic medicine works in the same way and provides the same clinical benefit as its brand-name version. Why do they cost less? Generic drug makers do not have the expense of costly development, research, animal and human clinical trials, marketing and advertising. This savings is passed on to the public. Also after a patent expires, several companies will compete on a generic version of a drug, further driving down prices.
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3,000 Miles Away But Close to Home
Overcoming poverty is not a task of charity, it is an act of justice. Like slavery and apartheid, poverty is not natural. It is man-made and can overcome by the actions of human beings. Sometimes it falls on a generation to be great. You can be that great generation. Let your greatness bloom. â Nelson Mandela, February 2005, Make Poverty History Campaign in London Lifting away the curtain that symbolized the front door, I entered a dark, cinderblock room and instantly became overwhelmed by an unpleasant odor. Working with oncology patients as a Child Life Specialist and an Occupational Therapist for over ten years, I recognized that smell. I had arrived in Guatemala â more than 3,000 miles from Reno â and it was my first day of a week-long trip where I would be serving alongside physicians in low-income communities providing free medical care for residents. My name is Brittany Jemmoua, I am an occupational therapist at Renown, and I recently volunteered with Kalan Kuxtal, a non-profit Guatemalan organization. I served alongside physicians by providing free primary care mobile clinics and home visits. The care we provided focused on prevention, intervention, education and lifestyle/medication management as we partnered with local entities, such as fire stations, community centers and schools to transform hundreds of lives. Speaking in both English and Spanish, I collected patient intake information, performed exams, tested for diabetes, and collaborated on a diabetes research project focused on daily risk assessment. Beyond these tasks, I immersed myself in the culture and learned more from the Guatemalan people than I could have ever imagined. Similar to Renown, Kalan Kuxtal Operates with Community at its Core Kalan Kuxtal, a Mayan expression meaning âlife guardian,â is different from other volunteer medical trip organizations, and I took home valuable insights and lessons from their way of life that I now consider daily in my practice at Renown. I expanded my knowledge about diabetes, hypertension, pharmacology, infectious diseases, pregnancy complication, vector-borne illness and tuberculosis. We conducted home visits for socially neglected populations rather than expecting everyone to come to our clinics. I found that being welcomed into peopleâs homes gives you a different lens in which to view how their medical diagnoses interact with living conditions, occupations, and quality of life. This is when I met Mercedes and her mom. Her mom, Ms. Valencia, had jaundice skin and a substantial Basal Cell Carcinoma aggressively protruding from her face that impacted eating, hearing, seeing, sleep and social interactions. This opportunity to serve within their home led to an important palliative care conversation that would have been missed had we stayed in the clinic. We combed the rural neighborhoods assessing peopleâs risk for diabetes, taking glucose tests and educating families about their next steps. Many individuals had uncontrolled diabetes and misunderstandings regarding basic health management strategies. At the end of the day, many people demonstrated feelings of empowerment by actively offering solutions regarding how they will manage their day-to-day glucose with diet and exercise. Small actions can lead to big changes, and in the long-term, these health actions can help them avoid medication costs and focus on affording basic life necessities, such as water and electricity. Kalan Kuxtal organized a cultural day that included going to local businesses and community leaders to learn more about how they support the people of Guatemala. For example, Valhalla Macadamia Farmâs main goal is to help communities gain access to income, employment, and improved wellbeing by donating macadamia trees to families to grow and then sell macadamia products. A Weeklong Trip with Lifelong Impacts Each patient made a lasting impact on me, both personally and professionally. One specific family I saw in the clinic had a unique situation in that their two-year-old daughter, Margareth Elizabeth Cifuentes Bautista, was laboriously diagnosed with irregular corneal syndrome associated with glaucoma of congenital origin. Due to Guatemalaâs limited prenatal screens and interventions, Elizabeth is nearly blind. While highly spirited and happy, she trips, bumps and feels her way through life. One barrier to her healthcare access is that her hard-working parents remain well below the poverty line, making less than $900/month. I am working to connect them with generous US Ophthalmologists and pediatric eye specialists to explore how we might save her sight and help her family. Their biggest dream is that she could recover her eyesight. âI know that this is not a life-threatening situation, but it is still something that never stops hurting me,â Jorge Cifuentes, Elizabethâs father, said. âUnfortunately, our situation here is very hard. This country [Guatemala], although beautiful, it is very difficult to get ahead. We are people living in underprivileged conditions which complicates our situation even more. However, we are still trying to thrive by being kind and hardworking people. Thank you for helping us.â I have had the privilege of an opportunity for education, access to healthcare, employment and am aware that inequity and injustice prevail. This experience reinforced my understanding that medicine is a physically and mentally demanding profession that requires a commitment to service, continuous learning and adaptation both on local and global scales. I encourage everyone to please join me in serving the underserved by volunteering. Brittany is an experienced Occupational Therapist at Renown and volunteers with Kalan Kuxtal and other entities, such as The Robert Unsworth Foundation and Rock Steady Boxing to elevate communities. She loves being an Occupational Therapist; however, her life experiences confirm that her true calling is to become a physician. She is currently applying to medical school. Brittany is eager to earn the responsibility to improve lives and communities as their engaged physician. Brittany is tentatively scheduled to return to Guatemala at the end of this year to continue partnering with the people for a better future. You are welcome to join!
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A Renown Anesthesiologist's Unique Journey
Dr. Nariman Rahimzadehâs career path has been anything but typical. From humble beginnings as a shuttle bus driver for Renown Regional Medical Center, then named Washoe Medical Center, to his service as Chief of Staff for Renown South Meadows Medical Center, the steps and detours he took along the way â and the strong support from his colleagues and family members â make up a tale of perseverance, conviction, compassion and inspiration. However, his healthcare career journey began several years before he even joined Washoe Medical Center in the 1990s. It all began 7,446 miles away in Iran. This is Dr. Rahimzadehâs story. Defining Moments The moment Dr. Rahimzadeh knew he wanted to dedicate his career to the healthcare field started during his childhood. Growing up in Iran during the midst of the Iranian Revolution, a thought that often came to mind was, âWho is helping all the people injured in the war?â The answer? The doctors. âIn Iranian society, doctors are extremely valued, as they are the first to help people in need,â said Dr. Rahimzadeh. âI knew I wanted to give back to society in some way, and I see my time in Iran as very formative in my future career. I just didnât know it yet.â After immigrating to the U.S. with his family during his preteen years, he only had one mission: to support his family. âMy desires were to help my family not fall behind,â he said. âI didnât have career aspirations at the time. All I knew is that I wanted to help my family and my community, which immediately opened its arms up to us, as well as be a good student and a good ambassador for Iran.â Dr. Rahimzadeh remembers several influential people that helped solidify his aspiration from âhelping peopleâ to âhelping people as a healthcare professional.â Their family physician and other medical professionals in the familyâs lives were monumental in helping him make this decision. Coupled with his natural love for the sciences, the decision to become a doctor became clear.  But the question remained, âHow do I get started in the healthcare field?â No Links to Healthcare? No Problem With no physicians in his immediate family and no direct connections to healthcare, Dr. Rahimzadeh set off to follow the advice he received from the influential people in his life: get a job at a healthcare facility, regardless of what the job title is. Some of his friends had recently joined Washoe Medical Center as patient transporters and mentioned job openings that were available. He sprang into action and headed to Washoe Medical Center to apply. Just one problem â he didnât have the EMT certification requirement.  Enter Barry OâSullivan, who would be Dr. Rahimzadehâs first supervisor at Washoe Medical Center (and a friend he still speaks with to this day). Barry saw promise in Dr. Rahimzadeh immediately. As a result, Barry made a suggestion to him that would ultimately set him on the course towards medicine. âBarry told me that he had an open position that I could work while completing the senior year of my undergraduate degree and studying for my EMT certification and eventually becoming a patient transporter. He told me Washoe Medical Center would support me in this endeavor. So, I asked what the job was and learned it was driving a shuttle bus.â Without hesitation, Dr. Rahimzadeh responded, âIâll take it.â And so, his fulfilling journey with Washoe Medical Center, and eventually Renown Health, began. While he finished up the last few months of his degree at the University of Nevada, Reno, (UNR) Dr. Rahimzadeh proudly drove the shuttle bus a few days a week. The job not only helped him pay for his degree and put food on the table, but it also allowed him to begin living out his passion for helping people in the healthcare field. Dr. Rahimzadeh graduated with his bachelor's degree in Pre-Medicine from UNR and finished his EMT certification program. Sure enough, Barry and Washoe Medical Center lived up to their promises and helped him secure his first direct healthcare job as an EMT and Patient Transporter with REMSA. But he didnât stop there â after several years as a ground transporter, his career literally took flight. He joined REMSA Ground Ambulance and eventually Care Flight as a Flight EMT II, caring for patients that were flying to Washoe Medical Center from nearby communities that needed lifesaving medical care. Helping save lives every day as a member of the emergency medical team is an ultimate feat, especially when it comes to Dr. Rahimzadeh. And he didnât stop there. Valuing One-on-One Connections In the 1990s, as it is today, the U.S. experienced a significant primary care provider shortage which resulted in many medical schools encouraging students to complete their residencies in a primary care specialty, like internal medicine â which is precisely what Dr. Rahimzadeh set out to do at the University of Connecticut.  However, his mind would soon change about the course of his career.  âI had a deep, introspective conversation with my residency program director, openly and honestly chatting about my future,â Dr. Rahimzadeh said. âI ended up taking a week off of my residency and wrote a long pros and cons list about what I wanted to do with my life in the medical field.â Eventually he decided on anesthesiology because of the opportunity to have a one-on-one relationship with every surgery patient, regardless of their procedure. âEven though itâs for a short duration of time, it is a very impactful relationship,â he said. âI feel I am making a difference in the outcomes and lives of patients every day.â Dr. Rahimzadeh finished his internal medicine residency in three years and passed his board exam, and he went on to do the same thing for anesthesiology. He then ventured back home to Reno. Career Progression at Its Finest Dr. Rahimzadeh knows that people donât always get to settle down in a place that influenced their upbringing, care and dream, yet he was able to make that vision a reality for himself. âI feel like Renown Health and myself have this intertwined relationship that led to my growth as a person and as a physician,â he said. âFor that, I feel very blessed." Upon his arrival back to Reno with two residencies under his belt, Dr. Rahimzadeh was quickly hired at one of the two anesthesiology groups in town at the time. He started his career with Sierra Anesthesia and after working for the group for several years, he joined Associated Anesthesiologists of Reno in 2014, which went on to become one of the largest anesthesiology groups in northern Nevada. The group continuously worked very closely with Renown, taking care of all of its surgical patient needs and eventually becoming Renown Medical Group employees as of April 1, 2022, with Dr. Rahimzadeh setting up his home base at the Renown South Meadows campus. Today, Dr. Rahimzadeh wears three âhatsâ at Renown. As a medical professional first and foremost, his largest âhatâ is his general anesthesiologist role, where he cares for patients in the operating room. Another significant âhatâ is his role as the Medical Director for Surgical Services, where he reviews surgical patient charges alongside his dedicated team of nurses and ensures optimal patient outcomes by verifying they have had the appropriate workup to proceed with surgery in a safe manner. To round out his immense responsibilities with Renown, he serves as Chief of Staff for Renown South Meadows, where he makes connections with colleagues and collaborates with leaders to review protocols, policies and address concerns that arise. Outside of Renown, Dr. Rahimzadeh is still a contributor within his own anesthesiology practice. He also is the current President of the Nevada State Society of Anesthesiologists and the Director to the Board of Directors of the American Society of Anesthesiologists, helping bridge the gap in anesthesia concerns between his northern and southern Nevada colleagues. He reflects on the opportunities Renown and our local community have extended to him by saying, âIf you can dream big enough and continue to chase your dreams, you can make it happen right here.â On the COVID-19 Frontlines Nothing could prepare us for the dire situation hospitals on the east coast â especially those in Livingston, New Jersey â were experiencing at the beginning of the pandemic. Livingston was known as the âsecond hardest hit areaâ by COVID-19 in April of 2020. Hospitals were overwhelmed with patients in the ICU fighting for their lives. They needed help, and they needed help now.  Unable and unwilling to sit idly by, Dr. Rahimzadeh and six of his colleagues from his practice traveled to Livingston to help. They jumped in on the frontlines alongside other anesthesiologists and intensivists to offset the sudden influx of COVID-19 patients. Many lives were saved, and Dr. Rahimzadeh was a direct part of that. âWhen you care and work with people that also care, you can move the needle a lot â it doesnât matter where you're from,â he said. Home Means Nevada â and Renown Renown Health is deeply rooted in the northern Nevada community. Dr. Rahimzadeh is proud to be among a diverse team who have taken responsibility for its community for generations.  "We live in a very passionate and caring community, which is often underestimated,â he said. âItâs clear to me that Renown refuses to settle. Renown is incredibly progressive in providing the best for the community. We never remain stagnant, we keep moving forward and we take care of your loved ones. This health system has never been able to sit still and settle for the status quo. That stands out to me.â One story especially sticks out to Dr. Rahimzadeh as the moment when he knew that Renown was home. In 1997 while working as a patient transporter, his grandmother passed away on the sixth floor of the Sierra Tower at what is now Renown Regional Medical Center. At the funeral, a huge bouquet of flowers arrived. Not being especially close to anyone in Reno yet, Dr. Rahimzadeh's family had no idea who sent the beautiful arrangement. Turns out, it was Rod Callahan, the Chief Operating Officer (COO) of Washoe Medical Center at the time.  âAt that point, I knew I wasnât just a part of a workforce with thousands of employees,â said Dr. Rahimzadeh. âThe COO cared so much about me that he felt compelled to send such a wonderful gift during a tragic time. Thatâs the value of a local, community-focused hospital; the people here know you and care about you. Thereâs a reason why people stay at Renown for so long â we feel that connection.â Dr. Rahimzadeh also reflected on how far Renown South Meadows has come, from the time he immigrated to the U.S. to today. âGrowing up, Renown South Meadows was kind of a âmom and pop shopâ primarily serving senior citizens in one wing and surgical patients in the other,â he said. âNow, I am so proud to see how far it has come. It really made its niche in the community in a great way. The future is bright!â Itâs clear that Dr. Rahimzadeh is leaving a lasting legacy with his family, from the local community to global medicine. His son is a senior at Baylor University in Texas with a strong desire to go into medicine, just like his dad. His daughter is a junior at Bishop Manogue Catholic High School in Reno and enjoys being involved in her community. His loving wife is a speech therapist in the area. The Rahimzadeh family is thriving together, and they all share the same conviction about northern Nevada and Renown: âThis is home.â