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

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

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Breast cancer is the leading cause of cancer deaths in women in the U.S. That’s why early detection is so important. Dr. George Krakora, a radiologist with Renown Institute for Cancer, explains what to watch for and how new technology can lead to early detection. Most women know the importance of breast health and staying current with annual breast exams, but may not know that both screening guidelines and technology is evolving. So we asked George Krakora, MD, a radiologist for the Renown Institute for Cancer, what every woman should know about breast cancer detection and which screening method is right for them. First off, when should women start getting breast exams? Generally, women should start getting breast exams using mammography or ultrasound after they turn 40 years old. But we also want women ages 18 to 39 to talk to their primary care provider and ask for what’s called a formal risk assessment to see if screening is needed sooner. And you want to make sure your care provider is giving you a breast exam starting at age 25. It’s also a good idea to be familiar with how your breasts look and feel so you can report any changes to your care provider. What are the risk factors for breast cancer? Are there any preventive steps women can take? There a few risk factors you can’t control, like your age, family history of breast or other cancers, and if you have dense breast tissue. Your risk for breast cancer increases as you get older, and most breast cancers are diagnosed after age 50. Knowing your family history is important because a history of cancer and shared lifestyle can raise your risk. Your breast density can also increase your risk: Women with high breast density are four-to-five times more likely to get breast cancer than women with low breast density. But the good news is there are quite a few things you can do to prevent breast cancer, like not smoking, watching your alcohol intake, and maintaining a healthy weight with good diet and exercise. There are a lot of newer screenings out today. What is the difference between 2-D and 3-D mammography? In a 2-D mammogram, the tech takes X-rays of the breast. These pictures can show the radiologist if there are any lumps or tumors you might not be able to feel. In 3-D mammography, the process is largely the same but more X-rays are taken and it takes a few seconds longer for each image. This kind of exam detects 41 percent more cancers and reduces the number of false-positive results given to patients. This improvement in technology is great for both patients and their care providers. 3-D mammography provides better images of the breast, which allow doctors to more clearly diagnose and avoid false positives, especially in women with dense breast tissue. And what about a whole breast ultrasound. What is that? A whole breast ultrasound uses sound waves to detect cancerous tumors in the breast without using any radiation — it’s an ultrasound just like pregnant women get to check up on their baby. And the exam only takes about 20 minutes. We recommend these exams for patients whose mammograms have shown that they have dense breast tissue. Dense breast tissue can make it harder for doctors to see any abnormalities, lumps or tumors in a mammogram, so this technology ensures better early detection.

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Thanks in part to the care provided by Renown’s award-winning team of ICU nurses, Tony Mowatt is alive, thriving and engaged. Read his story — and learn about the exclusive Beacon Award of Excellence — below.  The open road. The growl of the engine. The feeling of freedom. That’s what Oakland resident Tony Mowatt was enjoying as he drove up Highway 88 toward Reno for the semi-annual Street Vibrations event. But he wasn’t expecting to hit the diesel truck — or to fly off of his bike over 100 yards, skidding onto the side of the road. He was severely injured and in the midst of rural Nevada. He had crashed just outside Centerville, Nev., and was miles away from any critical care hospital. Having the only trauma center equipped to treat his serious injuries, Tony was flown to Renown Regional Medical Center and admitted to the intensive care unit (ICU).   ICU Nurses Treat Patient, Support Family  Tony’s girlfriend, Tasha Klubock, was notified by his friend that he had been taken to the hospital. She immediately drove from Oakland to Reno to see Tony at Renown. Her first night there was overwhelming and scary — nobody knew if Tony was going to survive. But the nurses helped Tasha cope with the initial shock. Caring for the patient isn’t their only job — they also care for the family. “They [the nurses] just kept coming in and checking on me,” she said. “Angela was so amazing that first night. I really just bonded to her, and I remember when the shift switched, I panicked thinking about who was coming on and wanting to meet the next nurse … But they all came to talk to me — I had updates from everybody. It was just amazing.” ICU Nurses Became Family Tony spent 32 days in Renown’s Sierra ICU, surviving a serious head injury, all with Tasha by his side. He and Tasha still stay in touch with Renown nurses. “Even though this was literally one of the most hideous, craziest things to go through,” Tasha said. “There was so much hope and they became such a family to me and I still think of that time fondly because of the nurses.” “I’m alive because they wanted me to be,” Tony said. And Tony and Tasha are now happily engaged and planning their wedding. Exceptional Care: Renown ICU Nurses Win Awards Renown’s ICU nurses provide care like this every day to countless patients — it’s so second nature to them that they forget how exceptional it truly is. But it’s certainly care like Tony’s that has earned them national recognition. The American Association of Critical Care Nurses awarded the Beacon Award of Excellence to the Sierra, Cardiac and Roseview ICUs. These are the only ICUs in Nevada to obtain this honor. The Beacon Award recognizes critical care nursing teams who exemplify excellence in areas like leadership, process systems, quality care, knowledge, learning and development, excellence in patient care and superior patient health outcomes. “I couldn’t have been more proud of what we’ve done to accomplish this,” said Nick Dovedot, Cardiac ICU nurse. “It represents who we are. Just a great group of individuals who all work together as a team to make our patients get better.”

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Posture is important, but for those children diagnosed with scoliosis (spinal curvature) it can be a difficult issue. The Washoe County School District Student Health Services Department screens 7th grade students for scoliosis as growth spurts often reveal the condition and, if diagnosed early, scoliosis can stop progressing. We asked Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis to answer some frequently asked questions about scoliosis. What is scoliosis? There are many types of scoliosis: early onset (occurs before age 10), congenital scoliosis is when the bones of the spine do not form correctly, neuromuscular scoliosis which is due to children’s neurologic and muscle disease, and the most common is Adolescent Idiopathic Scoliosis. The term “idiopathic “ means the exact cause is unknown, although we do know it runs in families. This type of scoliosis occurs in 2-3 percent of adolescents and is mainly seen during their growth spurt. This is why middle school screenings are recommended. Both genders get scoliosis but girls are 8 times more likely to have their curves progress and become larger. What are the signs that my child may have scoliosis? A few signs for parents to watch for are: One shoulder might be higher than the other. One leg may seem longer. A hip may be higher or look more prominent. The waist may not look the same from side to side (asymmetry). The trunk or rib cage may be more prominent on one side or shifted. When they bend forward they may have a bump on their back. How is scoliosis diagnosed? It can be noticed by a pediatrician at a physical, school screening nurse, PE teacher or parents. Once the curve is suspected the child is usually referred to a pediatric orthopedic surgeon scoliosis expertise. At the initial visit the doctor will perform a thorough physical including a complete neurologic exam to assess the amount of curvature. Once the exam is completed the physician will determine if a spinal x-ray is needed. The curve on the x-ray is measured utilizing the cobb angle (a measurement in degrees) which helps guide the treatment. What are common treatments for scoliosis? The treatment depends on the size of the spinal curve and the amount of growth the child has remaining. An x-ray of the child’s hand is used to determine the amount of growth remaining. This allows the determination of the child’s bone age, and based on the hands growth plates it can determined if the child is in their rapid phase of growth. Treatments include: Observation - For curves less than 20-25 degrees. This entails visits every 6-9 months with a repeat scoliosis x-ray. Since scoliosis curves increase only 1-2 degrees per month, and variations in measurements can be 3-5 degrees, an x-ray is not recommended before 6 months. If the curve remains less than 25 degrees the child is followed until their growth is completed (usually age 16-18). Progressing Curve - If growth is finished and the curve is less than 40 degrees, the risk of more curvature into adulthood is small. If growth is completed and the curve is over 45 degrees, the child is followed for several years as these curves can progress into adulthood. If the patient is still growing and the curve has progressed greater than 25 degrees but still in the non-operative range (less than 45-50 degrees) bracing is used to stop the progression of the curve. Bracing - Indicated for curves over 25 degrees but less than 45 degrees. If a brace is required you will be referred to an orthotist (bracing specialist). The orthotist assesses your child, reviews the x-ray and then fits the brace. (Having a brace made usually takes 2-3 weeks.) Once the brace is fit, your child will visit the scoliosis specialist for an x-ray in the brace to ensure it fits correctly. The primary goal of bracing is to halt progression of the curve and prevent the need for surgery. The brace must be worn for about 16 hours per day to be effective. In a recent bracing study 72% of the patients who wore their braces as prescribed prevented the need for surgery compared to the group who did not wear their brace. Surgery: When a curve reaches 45-50 degrees, and a child is still growing, surgery is usually recommended because the curve is likely to continue progress. If a curve is over 50 degrees and the child is done growing surgery also may be recommended. This is because when curves are over 50 degrees they tend to increase 1-2 degrees per year for the rest of your life. As curves get larger the amount of lung function tends to decrease which could cause breathing problems later in life. The goals of surgery are to stop the progression of the curve and safely correct any misalignment. This is accomplished by attaching implants (rods, screws, hooks and bands) to the spine. Bone graft is then placed around the implants to encourage the spine to fuse (grow together). This then forms a solid column of bone with metal rods in place, preventing the curve from changing. Most patients are back to their regular sports and activities six months post surgery.

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

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Award given to Truckee Meadows Health Communities, Renown Health & Washoe County Health District. Truckee Meadows Healthy Communities (TMHC), Renown Health and the Washoe County Health District received the BUILD Health Challenge® award, a $250,000 grant to support Caring For Reno’s Elders (C.A.R.E.) program. The award comes as a collaborative result of more than 30 local organizations submitting a proposal for the funding. Renown Health announced that the organization is matching the grant alongside other pledged funding from the community, bringing the current C.A.R.E. support to $580,000. Together the entities will focus on senior loneliness and the health issues it creates. The partners are honored that Truckee Meadows was selected as one of 18 communities to receive funding from BUILD in the 2019-2021 term. “C.A.R.E will be a community approach to enhance life quality for elders by reducing social isolation and loneliness, issues that seriously impact senior health,” said co-team leader Kindle Craig, Sr. Director Renown Institutes. “Loneliness is the root cause of many issues including suicide1 , chronic disease2 and a reduction in lifespan3 . Washoe County senior suicide rates are two and four times the national rate for those aged 65 and 85 years, respectively4 . That is unacceptable.” Sharon Zadra, TMHC executive director and co-team leader, said this project will tackle barriers to socialization such as access to affordable housing, transportation and healthcare.  “We’ll bring the entire community on-board, long-term, to increase social connectedness and reduce health and mortality issues associated with loneliness by starting a cross generational ‘Kindness Epidemic,’” Zadra said. The BUILD Health Challenge is a national program focused on bold, upstream, integrated, local and data driven projects that can improve community health. The award provides funding, capacity building support and access to a national peer-learning network to enhance collaborative partnerships locally to address our community’s most pressing health challenges. The C.A.R.E team expresses special thanks to the BUILD Health Challenge for its support of this initiative. “Loneliness and isolation in our senior population leads to declines in both mental and physical health, and increased mortality,” said Kevin Dick, Washoe County District Health Officer. “We are incredibly honored to join the BUILD cohort, teaming with TMHC and Renown Health to bring long-term solutions by building a cohesive social network to improve the health of our elders.”  The BUILD Health Challenge® is made possible with the support of: BlueCross BlueShield of South Carolina Foundation, the Blue Cross and Blue Shield of North Carolina Foundation, Blue Shield of California Foundation, Communities Foundation of Texas, de Beaumont Foundation, Episcopal Health Foundation, The Kresge Foundation, Methodist Healthcare Ministries of South Texas, Inc., New Jersey Health Initiatives, Robert Wood Johnson Foundation, and W.K. Kellogg Foundation. TMHC, Renown Health and WCHD have worked united for the last five years, rallying diverse partners and community leaders to influence and advocate for the region’s capacity to ensure a healthy community.

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What is an institute for cancer — and why does it matter that we have one right here in Reno? Here, a radiation oncologist answers those questions and more.  Sadly, our community health needs assessment shows cancer is the second leading cause of death in Washoe County. But many residents may not know there is an institute for cancer right here in Reno that can care for you or your loved one after diagnosis. Dr. Michael Hardacre, a radiation oncologist with Renown Institute for Cancer is here with more. What is an institute for cancer? The way I like to think of it: An Institute has healthcare providers highly trained in patient-centered care. For example, when you have cancer, many times you’ll see a lot of doctors. A program brings those doctors together — so you really have one team working together. An Institute takes that one step further. Say there are other needs beyond the doctor’s office such as nurse navigators, dietitians, physical therapists to help you get on track, etc. An Institute really proactively thinks of the need of the cancer patient. It then makes sure all those things are available to them throughout their treatment. The term “institute for cancer” identifies a cancer program that is comprehensive and multidisciplinary in nature. For Renown, that means that we have the specialists in medical oncology, surgical oncology and radiation oncology working together with other specialists to assure that a patient has coordinated care throughout the entire treatment course of cancer care. Together with cancer prevention and diagnostics, genetic assessment, supportive care, clinical trials, and cancer survivorship, the institute for cancer provides care for the community, families and patients along the entire spectrum of cancer care. What types of cancer do you treat? We’re fortunate to be able to provide cancer treatments for all types of cancers, and we’re one of the major referral centers for northern Nevada. Most commonly, just like much of the country, lung cancer, prostate cancer and breast cancer are the most frequent we see. Our care spans brain, to neck cancer and everything in between. As an accredited comprehensive community cancer program, Renown Health provides services for all cancer types. The highest volume cancers treated at Renown are breast, colorectal, lung, genitourinary, blood and gynecologic cancers. Most treatments can be done right here in Reno, but when there are specialty needs such as stem cell or bone marrow transplantation, we partner with quaternary centers, like Stanford, to assure a smooth transition of care both to and from the quaternary center. What kinds of care and treatments are offered? We offer a wide range of comprehensive care. We treat the cancer itself — surgical, radiation oncology, medical oncology in the form of chemotherapy or pills. Also addressed: dietary needs, physical therapy and navigation through this whole process. People may be surprised by the scope and scale of the Renown Institute for Cancer. For instance, our Radiation Center has the latest technologies to treat cancers. This includes the Linear Accelerators, which are machines with treatment planning software tools. In addition to the traditional external radiation treatments provided in most centers, Renown performs specialty treatments using High-Dose Brachytherapy, a treatment with an active radiation “source” and in Brain Stereotactic Radiosurgery, assuring that patients can stay right here in northern Nevada — close to home. What does that mean for the quality of care? I think it’s always great in any environment to have external people come into your program and not only share what’s happening nationally and what we could do better, but also to validate “are you doing things at the highest level you can?” That accreditation process is just one way to give us that seal of approval. We’re lucky enough this year to get the gold award by the American College of Surgeons — its highest honor. We were honored to receive it. Why is important that you’re an accredited institute? Accreditation assures our community that quality is a top priority for us. Each of the accrediting bodies has a set of standards that identify service and quality standards. Renown Institute for Cancer has the following accreditations: American College of Surgeons’ Commission on Cancer: Full Cancer Program accreditation, standards address issues from cancer prevention/diagnosis to treatment to survivorship and/or end-of-life. Renown received the Gold Level Accreditation in 2018, the highest level of accreditation possible; American College of Surgeons’ National Accreditation Program for Breast Centers: Full Breast Center/Program accreditation, standards address issues from breast cancer prevention/diagnosis to treatment to survivorship and/or end-of-life; American College of Radiology – Radiation Therapy: Full Radiation Oncology accreditation for radiation equipment, treatment planning, treatment and treatment follow-up; and American College of Radiology – Mammography Services.

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According to the American Cancer Society, approximately 14,100 new cases of invasive cervical cancer will be diagnosed, and 4,280 women will die from cervical cancer. However, cervical cancer is preventable with regular screening tests and the HPV vaccine. It’s important to note that medical advances have allowed progress in diagnosing and treating cervical cancer. While it used to be one of the most common causes of cancer death for American women, the incidence of death has significantly declined. What to Know About the HPV Vaccine HPV vaccination is the best way to prevent cervical cancer and is recommended for all youth starting as early as age 9, or for teens and adults up to age 45 who didn’t start or finish the series. In Nevada, only 50.1% of teens ages 13-17 have been vaccinated for HPV.  There are 13 types of HPV, and the vaccine Gardasil 9 protects against 9 of those HPV strains, greatly reducing the incidence of cervical cancer among vaccinated individuals. What to Know About Cervical Cancer Screenings The CDC says the most important thing you can do to help prevent cervical cancer is to have regular screening tests starting at age 21. And there are two common tests that can detect early stages of cervical cancer (or precancer) and improve health outcomes. The pap test (or pap smear). This screening looks for precancers. Women should begin getting pap smears when they’re 21. The human papillomavirus (HPV) test looks for the virus that can cause these cell changes. Cervical Cancer Screening Schedule The American Cancer Society offers the following guidelines for screenings: All women should begin cervical cancer screening at 21. Women between 21 and 29 should have a pap test every three years. Beginning at 30, the preferred way to screen is with a pap test combined with an HPV test every five years. This is called co-testing and should continue until age 65. A pap test (or pap smear) is performed during a regular screening appointment to look for precancers, cell changes on the cervix that might become cervical cancer if they are not evaluated or appropriately treated. Typically outpatient procedures can reduce the risk of long-term health impacts that prevent pre-cancerous cells from becoming cancer cells. Women over 65 who have had regular screenings in the previous ten years should stop cervical cancer screening as long as they haven’t had any severe precancers found in the last 20 years. How to Get Screened Request an appointment with your primary care physician or OBGYN to schedule a screening.

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Giving birth expends as much energy as running a marathon. And just like you would only run a marathon with training beforehand, there are exercises you can do to prepare for birth. But instead of a coach, you'll have your birth team. Your birth team exists to help you navigate pregnancy and labor and support your choices. Let's say you've never put together a birth team before and are wondering where to start. Today we'll go over the three main positions to fill for your birth team's starting lineup. Birthing Person The birthing person is the leader of the team. After all, you can't have a birth team without someone giving birth. This person could be the baby's mother, gestational surrogate, birth parent before adoption, a transgender father or a non-binary parent. If you are not the birthing person, don't presume to know what the ideal labor and birth circumstances should be. And if you are the birthing person, don't allow anyone else to tell you what you want. This is your body and your birth; you are the boss in the birth room. Doula No birth team is complete without a doula, and although doulas have increased in popularity lately, many people still don't know what a doula is. Simply put, a doula is a birth professional – not a medical provider – who offers emotional, physical and informational support during pregnancy, labor and beyond. Most doulas' services include at least one prenatal visit and one postpartum visit, as well as continuous care throughout active labor. Some doulas provide more than one prenatal/postpartum visit, so be sure to ask what is included in their fee. Even if you have a partner who will support you during labor, studies have shown that a doula can significantly increase your likelihood of a positive birth outcome. Even the most supportive partner needs to rest, and a doula can ensure that you still get the care you need while your partner gets a break. Midwife or Obstetrician Finally, you'll want to choose the medical professional who will attend your birth. Many folks choose to give birth with the OB/GYN who does their annual check-ups, but there are many reasons someone might choose a different provider for their birth. The first step to finding the best attending provider for your birth is to decide which model of care aligns closest to your values and goals: the Midwifery Model of Care or the Medical Model of Care. .tg {border-collapse:collapse;border-spacing:0;} .tg td{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; overflow:hidden;padding:10px 5px;word-break:normal;} .tg th{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; font-weight:normal;overflow:hidden;padding:10px 5px;word-break:normal;} .tg .tg-gqvw{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-weight:bold; text-align:left;vertical-align:top} .tg .tg-8vim{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-size:18px; font-weight:bold;text-align:left;vertical-align:top} .tg .tg-qm8j{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;text-align:left; vertical-align:top} .tg {border-collapse:collapse;border-spacing:0;} .tg td{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; overflow:hidden;padding:10px 5px;word-break:normal;} .tg th{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; font-weight:normal;overflow:hidden;padding:10px 5px;word-break:normal;} .tg .tg-gqvw{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-weight:bold; text-align:left;vertical-align:top} .tg .tg-8vim{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-size:18px; font-weight:bold;text-align:left;vertical-align:top} .tg .tg-2rvk{background-color:#ffffff;color:#000000;font-family:Arial, Helvetica, sans-serif !important;text-align:left; vertical-align:top} Midwifery Model of Care Medical Model of Care Philosophy Birth is physiological. Birth is potentially pathological. Interventions Medical interventions can cause more complications, and therefore are only used as needed. Medical interventions should be used, even in non-emergency situations and sometimes as preventative measures. Decisions Birthing person is the key decision maker. Medical professional is the key decision maker. Provider’s Role Providers monitor labor and will intervene or transfer to hospital if needed. Providers assess and control the birthing process.

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March is Colorectal Cancer Awareness Month, and we want you to receive the best preventative care possible. Early detection can help prevent serious illness, yet many people still choose to skip their annual exams and routine screenings. Bonnie Ferrara, MD, MPH, Section Chief for Primary Care at Renown Medical Group, further explains the importance of this simple, easy way to stay healthy. Why are annual exams so important? The benefits of early detection and prevention to save lives and reduce the impacts of disease have been proven. These exams are the perfect opportunity to get your health questions answered. “This is your chance to sit down with your provider and talk about your overall health and your family’s health history as well as your concerns for the future,” says Bonnie Ferrara, M.D., family medicine. “It’s the opportunity for your provider to talk with you about your lifestyle, tobacco use, exercise and alcohol use, all of which make a difference in your future longevity.” The annual wellness exam is also an ideal time for most adult patients to discuss health screenings. In addition, these visits are the perfect time to address issues that may not directly relate to a particular medical problem or immediate illness. A good rule of thumb is to schedule these appointments around your birthday each year to make sure you and your provider are both updated on your care. Why would you need an annual exam if you aren’t feeling sick? According to Dr. Ferrara, seeing your care provider when you aren’t sick is one of the best times. “It is better if you try to arrange this visit when you are not feeling ill,” she says. “It is an opportunity to talk about wellness. Not only how to contribute to your wellness but also the changes that you can make that will make huge dividends in the future for your wellness. In addition, it allows us to do some education about what to expect in the coming years as far as your health and lifestyle changes.” What can you expect at an annual exam? Annual exams usually check your: History – lifestyle behaviors, health concerns, vaccination status, family medical history Vitals – blood pressure, heart rate, respiration rate and temperature General appearance – your care provider can find out a lot about you just by watching and talking to you Dr. Ferrara adds, “If this is a Medicare annual wellness exam, it is an opportunity to talk to your provider about depression and dementia as well as be tested for those.” You can also leverage your annual exam to speak to your provider about managing your chronic health problems. "As a provider, these visits give us the opportunity to hear how the medications and lifestyle changes we have recommended are working and if you are having problems with these, we have the opportunity to make suggestions of how to do things better for the future," Dr. Ferrara.

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

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