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University of Nevada, Reno student Khoa Le was paralyzed in 2010 after a longboarding accident. Through physical therapy, a positive attitude and sheer will, Le is walking again. This weekend, Le will walk across the commencement stage to accept his college diploma. “Walking around on my own power is just the greatest feeling,” says Khoa Le, a senior at the University of Nevada, Reno. Just after finishing summer school at the university in July 2010, his whole life changed within seconds after stepping on a longboard skateboard for the first time. He lost control of the board and hit the curb, causing paralysis on the left side of his body. His journey to recovery began at Renown Health Physical Therapy & Rehab. His physical therapist, Dina Barry, says he never complained once in four years. “I started seeing Khoa in April 2011, and we worked for four years together,” says Barry, a lead physical therapist at Renown. “Everything I’ve ever asked him to do, he does. Le is a hard worker, is continuously optimistic and smiling, and I think that is why he’s accomplished what he has.” Le plans to pursue a career as an information systems manager.

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Read about Jordan Stiteler, a local mom who says the Healthy Nevada Project provided insights into her family’s genetic makeup — and the likely cause of her dad and great grandfather’s deaths. Now she is changing her life due to her new diagnosis of familial hypercholesterolemia, which will allow her to take steps toward preventing the same fate. Jordan Stiteler’s dad died suddenly of a stroke nearly ten years ago — at only 45 years old. His grandfather died at age 40. Now through the Healthy Nevada Project’s no-cost genetic testing, she is closer to understanding why that may have happened. And she can take proactive steps to prevent the unhealthy symptoms that often lead to a stroke and heart problems. After getting her Geno 2.0 by National Geographic ancestry report, Stiteler got a call from Renown Institute for Heart & Vascular Health Cardiologist and Renown IHI Director of Research, Dr. Christopher Rowan. “They told me that I have FH, which is familial hypercholesterolemia,” she said. “I have genetically very high cholesterol because I have a non-functioning gene that doesn’t get rid of my cholesterol like a normal body would.” Familial Hypercholesterolemia: Simple Life Changes Dr. Rowan told Stiteler it is curable with medication and a change in lifestyle. Stiteler has embraced healthy lifestyle changes by exercising more and eating healthier. “It is so important. Being a mom, I think you have so much more to live for. Having this information has changed my life.” Stiteler feels confident FH affected her Dad. “It is helping my family realize that we need to get tested,” she said. “There were big milestones that my Dad missed. He didn’t get to see either of us get married or have our children. That was huge.” She has become passionate about sharing the need to join the Healthy Nevada Project as her way of helping to prevent other families from possibly going through what she and her family did with the early loss of her Dad. In addition to FH results, the Healthy Nevada Project is returning clinical results on BRCA 1/2 (hereditary breast and ovarian cancer) and Lynch syndrome (colorectal and endometrial cancer) to consenting study participants. To sign up for the Healthy Nevada Project, go to HealthyNV.org. Join the Healthy Nevada Project Recruitment for phase two is still open. In addition to opting in to receive clinical results, participants receive National Geographic’s Geno 2.0 ancestry app at no cost. They also have the chance to pick an additional app for health and wellness after completing a follow-up survey. Learn More or Sign Up

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

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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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In August 2016, six-year-old Jakob was admitted to Renown Children's Hospital with what seemed like a common ear infection. Jakob's condition quickly progressed, and he started experiencing neurological symptoms such as difficulty speaking and a full-body shutdown. Doctors, neurologists and specialists from Renown worked with doctors from Stanford, where he was ultimately diagnosed with Bickerstaff brainstem encephalitis (BBE). BBE is a rare, autoimmune response that attacks the nerves in the body due to an acute illness such as a cold, flu or, in Jakob's case, an ear infection. Jakob could not breathe or eat and experienced paralysis on the side of his face, throat, stomach, bowels, lungs and legs. In addition, he started to rapidly lose weight as well as body function. Jakob lost half his body weight which resulted in the need for a Gastrostomy tube. This device is placed surgically and gives direct access to the stomach to give the child the nutrition needed. He also needed occupational therapy, and after three and a half months of ICU respiratory therapy, surgeries and treatments, he was released home to regain his strength. Forever Grateful Anica, Jakob's mom, said, "If it were not for the quick response and unconditional support and compassion from the team at Renown, Jakob would not be here today." Jakob's family is forever grateful to the staff, community and expertise at Renown for their unwavering commitment to their son and family during their most trying time in life. "When I met Jakob on the first day of his illness, so much was unknown. My team and I were worried, as his symptoms were very unusual. His rapid deterioration, after being a perfectly healthy child, was clearly terrifying for his parents. Handing over a child's care to a team of strangers is one of the scariest things that can happen to parents,” said Dr. Kris Deeter, Physician in Chief at Renown Children’s Hospital. “However, Anica and Jeremiah were also very clear that they did not want Jakob transferred somewhere else. So, we used all our resources to care for him, arrive at a diagnosis, and start aggressive therapies. They listened to every word we said, educated themselves, and became partners in Jakob's care. We all became part of Team Jakob, and soon, he proved to us just how strong he was." Today, Jakob is 13 years old and thriving in every aspect of his life. He is currently on the honor roll in school and finds joy in his newfound passion for the violin. He loves spending his free time learning about mixing music, making new friends and traveling to different parts of the country. This summer, he will travel to Europe to explore his passion for culture. The family says, "We owe it all to the family and staff at Renown."

Read More About Jakob’s Journey at Renown Children’s Hospital