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Every cancer journey is different — and so are the ways individuals deal with a cancer diagnosis. So if you’re a close friend or family member, how can you help? Bobbi Gillis, manager of cancer support services with Renown Institute for Cancer, explains more. Just as we are all unique, we all also have our own ways of dealing with difficult news. For some, receiving a cancer diagnosis is devastating, and they want family members rallying around them in support; for others, they want to be left completely alone. So how do you know what is helpful and what is hurtful? For advice, we reached out to Bobbi Gillis, manager of cancer support services with Renown Institute for Cancer. Support, Defined What are some ways to support a loved one when they find out they have cancer? First and foremost, let them know you are there for them. As we can all imagine, a cancer diagnosis is scary, and it’s helpful just to know you have support if and when you need it. Second, try to listen and give advice only when you are asked. In trying to help as much as possible, many family and friends take on the role of “researcher” to find out more treatment options, but it’s best to avoid saying “you should try this” or “you ought to do that.” Patients are already dealing with a lot of information at once from care providers and their own research. You don’t want to make them feel overwhelmed or question the treatment they’re planning. What are some words of encouragement or support people can use? Just as you would in any difficult situation, speak from the heart and be genuine. But also be careful not to show false optimism or to tell them to just stay positive; saying these things may discount their fears and concerns. Here are some ideas to get you started: “We’re going to get through this together.” “Count me in to help out.” “I’m not sure what to say, but I want you to know I care and I’m here.” What resources are available to patients? What about their families? For patients with cancer, we offer support groups in-person or online. There are also support groups specific to the type of cancer you or your loved one have. You can check these out on our website, renown.org, or ask your care provider. There are also support groups and emotional support services available for family and friends. How can family and friends help throughout cancer treatment? It’s great to offer help, but it’s important to be specific when you offer. Saying “call me if you need something” is very general, and people may feel like they’re putting you out when they do ask for something specific. Instead, offer help with certain tasks — like driving them to treatment, babysitting, making them dinner or buying groceries. As much as possible, keep things normal. For some patients, being able to do everyday things like walking the dog helps them feel better. Loved ones can try to do too much for a patient, and while well-intentioned, this can make them feel less useful after being diagnosed. Renown Institute for Cancer | 775-982-4000 At the Renown Health Institute for Cancer, our experienced team provides the support and care to maintain the highest quality of life and then achieve the best possible outcome, all in one location that’s close to home. Our dedicated team, clinical expertise and advanced treatment options allow us to tailor care to each patient. Learn about: Our Team Cancers We Treat Screening and Prevention Treatment Options Find a Doctor

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Becoming a caregiver or playing a more active role in another’s healthcare is a big responsibility. At some point, almost all adults will support an aging parent or a loved one in need. Keeping track of their needs and wellbeing, while also prioritizing your own can become overwhelming. It’s important to know: you are not alone, and help is available. Read on for 11 tips to help you manage your time, your own wellbeing and your loved one’s care. Self-care comes first. When your main priority is the person in your life who needs care, it’s easy for your own needs to take the backseat. Give yourself time each day to focus on your personal wellbeing. It’s hard to give a loved one the care they need if your own needs are not met. Prioritize the Activities of Daily Living (ADL). Make a note of what ADLs your loved one can do alone, what they need help with and what activities require the most help. This will help you work through the day with them, as well as plan out how the day’s activities will go. Do a home safety audit. Do showers, bathtubs and steps have safety grab bars? Look around the house for additional tripping hazards, like rugs or electrical cords. If your loved one struggles with day-to-day navigation of the home, consider scheduling an occupational therapy appointment. This type of therapy helps a person develop or maintain the motions required to accomplish daily tasks. You might also qualify for a referral to in-home healthcare, such as Home Care. Have the hard conversation. The best time to discuss views about end of life care and to learn what choices are available is before a life-limiting illness or crisis occurs. With advance care planning, you can help reduce the doubt and anxiety related to decision making at the end of life. Completing an Advance Directive is a great tool to sort out all these decisions before they’re needed. Attend a free workshop to learn more and complete this important document. Identify when you need respite. Respite care involves receiving a short-term break from caregiving. Organizing in-home care for your loved one will allow you to step away and tend to your needs. By identifying what kind of respite care you are seeking, you can find the right person to provide you with that much-needed break. Don’t wait until you feel overwhelmed, plan ahead. Write down insurance contact information. Have a direct connection to the right insurance professional for support and advice. If your loved one is eligible Medicare, this is a good opportunity to review their current selections and if they would benefit from a Medicare Advantage Plan or Medicare Supplement Insurance. Seeking out expert advice or information on Medicare options is a great way to navigate this. Consider calling a broker, or attend a free educational seminar with Senior Care Plus. Gather legal and financial information. Make a list of all existing legal documents and financial accounts that your loved one has. These might include a will, advance directive, power of attorney, bank accounts or investment accounts. If you have questions about how to manage them, or need assistance in setting up additional framework, reach out to a lawyer, legal service, financial adviser or bank representative. Create an inventory of medical information. Identify where all of your loved one’s medical records are, as well as a list of providers or healthcare practices where they have received care. Consider if you should have your loved one give you Proxy Access in MyChart, which allows you to access all the features in MyChart on their behalf, including viewing upcoming appointments, viewing test results and emailing a doctor on their behalf. Make a list of what others can do. Think about all the little (and big) things that need to happen, and write down tasks that others could take care of you. When someone says “let me know what I can do” you’ll be ready with a pre-written list of items they may be able to assist with. Tasks could include tackling around-the-house repairs, scheduling lawn work, helping to walk the dog, taking a car for an oil change and cleaning. Find programs and events for social enjoyment. If and when possible, seek an activity outside of the home. Look for community centers that have programs for seniors, recreational activities or meals that you can patriciate in together. If leaving the home is not an option, arrange for visits or in-home activities, such as movie nights, card games or time to visit with family. Research long-term options. If you will be considering a nursing home or assisted living, make a list of amenities that you and the person you are caring for would like. Take this list with you when visiting potential locations to make sure you don’t forget to ask about each item.

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It seemed like a normal Wednesday, except Kimi Woolsey was feeling really stressed. On Sept. 4, 2019 she was rushing to get ready for an appointment when suddenly, she could not feel her legs. Kimi immediately knew something was wrong and called out to her fiancé, Paul, for help. After seeing a bright light in her right eye, she felt a severe, sharp pain in her head traveling down into her leg. Paul quickly called 911, the EMT’s arrived and her stroke survival journey began. At first the medical team thought she had a complicated migraine, but one of them suspected a stroke. On the way to the hospital Kimi felt numbness and her face drooping, then instantly, no pain. For a moment she thought she was dying, going from pain to numbness and realizing she couldn’t move or speak. Kimi didn’t know she was having another massive stroke in transit. Each year nearly 800,000 people in the U.S. suffer a stroke, or “brain attack” – that’s one every 40 seconds. Of those, about 75% occur in people over age 65. However, at only 45 years old, Kimi is proof that a stroke can happen at any age. Stroke Survival Begins for Kimi Upon arriving at the emergency department of Renown Regional Medical Center the Certified Comprehensive Stroke Center team went into action. Kimi received a brain MRI, then was wheeled into surgery for a thrombectomy (clot removal). She was in the intensive care unit for 11 days. She remembers someone telling her, “Generally people don’t survive this magnitude of stroke.” And a doctor saying, “You are here for a reason.” Kimi’s comeback journey began with the comprehensive care team at Renown Rehabilitation Hospital. “Literally I had the best day of my life that first day there…I was so happy because I couldn’t imagine being in a safer place with people that literally live for you,” she recalls. During her 41 days there, her biggest milestone was being able to get out of bed and walk. For Kimi the support she felt at the rehab hospital was key to her progress, ”I still feel loved and appreciated and they’re rooting for me still and I can feel it.” Although she left the rehab hospital on Oct. 18, 2019, she is still working on improving the left side of her body. Currently Kimi works with therapists in outpatient physical rehabilitation sessions, continuing to see improvement in both her hand and leg. Her advice to those currently in a rehab hospital setting is, “Stay as long as you can to get the most out of it and push, push, push.” Kimi’s Stroke Survival as a Warrior “Having a stroke is not for the faint of heart,” says Kimi. She experienced despair and felt discouraged. Many days she would ask herself, “Why am I here?” Today she proudly calls herself a stroke warrior and refuses to be a victim of her stroke. Alongside her tenacious spirit, Kimi actively helps others on their stroke survival journey. Before her stroke she never dreamed of starting a non-profit foundation. Now, each day you’ll find her texting inspiration to others, offering advice and connecting with other struggling stroke survivors on her Facebook page, Stroke Warrior Recovery Coach. Her goal is to become the person she needed to talk to after her stroke; she currently coaches several stroke survivors. “Stroke survivors need to know that they aren’t alone. Mental support and encouragement are so important for each person’s stroke journey,” Kimi said. Along with the physical changes, Kimi feels the stroke magnified her empathy. “I was always in a hurry in my life. People didn’t go fast enough for me – on the road, at the grocery store, in a line. Now I have more patience with myself and others." Kimi realizes most people cannot wrap their brain around the concept of a stroke. In fact, the brain fog, physical challenges and frustration are hard to explain… unless you’ve experienced them. “You need to find your tribe,” she explains. “I have a passion for helping people through this process.” Most of all, she encourages people to keep going and never stop. After her stroke, Kimi has a greater appreciation for her family, health and life. She is one of the patients featured in the current “Fight The Good Fight” trauma and physical rehab advertising campaign. “I wake up every day and fight,” she asserts. “Each day you have to fight for your recovery and fight for yourself.”

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A wedding is a big day for the wedding couple, but it’s also special for loved ones. A patient at Renown, Ken, got to take part in his daughter’s special day as her wedding plans changed to accommodate his medical condition. Grab some tissues and read how Renown’s team of compassionate caregivers and chaplains planned a wedding in Fianna’s Healing Garden. Ken was hospitalized at Renown Regional Medical Center where he was battling a lung problem – which was unrelated to COVID-19 – and his condition worsened rapidly on Wednesday, Aug. 12. His family made the decision to transition him to palliative care, which helps patients near the end of their lives remain comfortable, while supporting their dignity and quality of life.  Ken’s medical condition altered wedding plans for his daughter, Chandra, and her fiancé, Tyler, who were planning to tie the knot later in 2020. Chandra wanted her father there, but knew he could not leave the hospital. That’s why Chandra’s sister, Heather, approached Ken’s care team with a request to have a small wedding ceremony at the hospital.  Planning the Wedding A member of Ken’s care team, Amy Heston, registered nurse (RN), began planning how the wedding could be held outdoors in Fianna's Healing Garden in the E. L. Wiegand Pavilion, which was donated by the E. L. Wiegand Foundation.   In 24 hours, Amy planned a wedding ceremony with the help of her colleague, Breyanna Aufiero, RN; the Renown Spiritual Care team; and nursing leaders on the coronary intensive care unit (ICU). Together, they decorated the aisle in the garden with flowers and battery-operated candles. They also made a sign for Ken’s hospital bed, which read, “Father of the Bride,” and crafted a bow tie for him to wear for the special occasion.  With visitor restrictions in place at the hospital due to coronavirus (COVID-19), having the wedding outside in the Healing Garden allowed for more members of Ken’s family to attend including his wife, Charlotte, and his dog, Bella.   Every step in planning the wedding required thoughtful and thorough care coordination so Ken could participate. His breathing was supported by oxygen and special arrangements were made to transport the oxygen tanks he needed to take part in his daughter’s wedding. Amy worked with respiratory technician, Kasey Benfield, and critical care technician, Ruben Duckworth, to ensure Ken’s oxygen needs were met using portable machines.  Celebrating Love and Life Together Ken’s team of caregivers bathed him and shaved his face so he could look and feel his best for the ceremony. They put on his bow tie, covered his bed in decorations and his favorite blue, flannel blanket, and wheeled his bed outside for the ceremony.  Renown associate chaplains Terri Domitrovich and Susan Palwick coordinated music and performed the ceremony for Chandra and Tyler on Thursday, Aug. 13, 2020. The bride and groom shared their first dance in the garden and Ken’s care team provided water and treats to give the family a full wedding experience.   Shortly after the ceremony, Ken passed away. This wedding provided Ken and his family meaningful memories for their big life-changing moments as they celebrated and said goodbye.  “Seeing Ken surrounded by family he never would have gotten to see again while in the hospital, watching him get to share a father-daughter dance with Chandra on her wedding day, and having him tell me that this day meant more to them than we would ever know were some of the most moving moments I’ve witnessed as a nurse,” Amy said. “I am so thankful for the team we have here. I know that this beautiful day wouldn’t have happened without the help of every single person who gave their time, money, creativity and passion to make it a day to remember.”

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Eating healthy is a daily challenge for many, but for those with cancer it is an even harder struggle. A cancer diagnosis not only impacts those diagnosed, but family members and friends too. One key area of concern is making sure your loved one stays well by eating healthy food every day. Here are some essential cancer nutrition tips from Renown Health registered dietitians Jessica Blauenstein and Amy Laster. Help to Prepare Meals and Snacks for Daily Cancer Nutrition Make it grab and go. Easy-to-make meals help reduce the burden of having to cook and prepare food. Having easy to grab snacks on the counter or in the fridge can help ensure your loved one has access to those nutrients when needed. Sit outside of the kitchen. This allows your loved one to avoid cooking smells which can make them feel sick as a side effect of cancer treatments. Also try serving them cold foods such as sandwiches, cheese and crackers, or shakes which have a mild scent. Try drinkable meals. Some people with cancer find it easier to sip their calories over the course of 30 minutes to an hour. Consider smoothies or supplemental shakes such as Ensure Enlive or Boost Plus as snacks not meal replacements. A great foundation for a smoothie is a protein source (Greek yogurt, protein powder, nut butters or milk) with a carbohydrate (fruits, juice or berries). Add other ingredients as desired, such as spinach, kale, and ground flaxseed or chia seeds to give it more vitamins, minerals, and fiber. Snack Ideas for Those Undergoing Cancer Treatment The following ideas are both quick and easy to make for your loved one. Chicken or tuna salad with whole grain crackers or as a sandwich on whole grain bread Greek yogurt mixed with cereal, fruit and/or nuts Cottage cheese with banana, cinnamon and/or peanut butter Favorite fruit with 100% natural peanut or almond butter spread - Try peanut butter with bananas, apples, or even celery Their favorite veggies dipped in a salad dressing of your choice - For example, carrots with hummus or ranch dressing Cheese and whole grain crackers - Add tomato slices with a dash of oregano on top for more flavor Eggs scrambled with cheese, vegetables and/or salsa Peanut butter and jelly sandwich on whole grain bread A baked sweet potato with some favorite toppings Hard boiled eggs and/or egg salad with whole grain crackers, or as a sandwich on whole grain bread Oatmeal or cream of wheat prepared with milk, fruit and/or nuts Sometimes your loved one may not feel like eating or refuse to eat. If treatment side effects are impacting your loved one’s ability to eat, please visit the websites below containing recipes tailored to treat side effects. Cook for Your Life ELLICSR Of course you may also consult a registered dietitian and/or the patients care team, if you have more cancer nutrition concerns. No Appetite? Assisting with Cancer Taste Changes Taste changes are common during cancer treatment. Patients experiencing these changes may not feel like eating, which can negatively impact their nutrition. Help your loved one overcome taste changes with these cancer nutrition strategies: Metallic or bitter taste in food - add something sweet such as maple syrup, honey or jelly. You may also try adding fat, such as a nut butter, avocado or regular butter. Pickles or vinegar could help with this too. A taste like cardboard - try adding salt and extra flavor to foods with seasonings and spices. Some examples are onion, garlic, chili powder, basil, oregano, rosemary, tarragon, barbecue sauce, mustard, ketchup, or mint. Lemon juice, citrus, vinegar, or pickles may also help with this as well Food tastes too sweet - try adding six drops of lemon or lime juice. Add small amounts until the sweetness is gone. Very salty taste - try adding ¼ teaspoon of lemon juice. Try plastic utensils instead of metal, especially if your loved one is struggling with foods tasting metallic. Dipping small bites of food into either lemon juice or vinegar can have a “palate cleansing” feel and may improve taste perception. This helps avoid getting tired of the flavor after a few bites. Try marinating food or meats in sweet fruit juices, salad dressings, or sweet-and-sour sauce. Other “palate cleansing” foods are lime juice, orange juice, mangos, lemongrass, parsley, cilantro, mint, ginger, basil, and pickled foods. Use aroma to make foods appealing, avoiding any smells that may cause nausea. In particular, cinnamon, nutmeg, cloves, coriander, cumin, ginger, and black pepper can add an aromatic flavor. Also include herbs such as oregano, rosemary and thyme. Think texture. Consider trying wafers, crunchy nut butters, carrots, celery, cucumbers, chips, rice crispies, corn flakes, crackers, panko crumbs, nuts, or seeds if you are able to chew and swallow them safely. Remember that patience with your loved one's changing appetite and tastes can be the strongest form of support you can provide. Nutrition Tips for Cancer Survivorship and Beyond If eating large meals is difficult for your loved one, encourage them to snack throughout the day. Aim for 4-6 snacks or small meals per day. Focus on consuming 2-3 protein-rich foods each day such as lean animal meats, fish, eggs, soy or a protein supplement with 20-30 grams of protein per serving. Eat a variety of brightly colored fruits and veggies. Aim to make half of each meal fruits and vegetables. Eat less than 18 oz. (cooked weight) of red meat per week. Limit cold cuts, bacon, sausage, and hot dogs. Avoid excess salt and saturated fats. Cut back on simple carbs. (i.e. desserts, candies, white bread/pastas, french fries, packaged foods, chips) Drink in moderation- if at all- one drink per day for women, two for men. Get enough vitamin D (through diet and/or supplement) Avoid tobacco of any kind. Keep a healthy weight and stay up on exercise. Other Ways to Help a Loved One with Cancer Assist with Chores Allow your loved one to relax as you help take care of chores around the house, such as cleaning, cooking and grocery shopping. This may reduce overall stress and can be helpful for those that get tired after their treatments. Physical activity can still be beneficial, so be sure to do an activity together that they enjoy and is approved by their doctor. Be Patient It can be very difficult to see a loved one go through cancer treatment. Remember to be patient with your loved one. There may be things we want them to do or eat that we know would be good for them, however, meet your loved one with grace and understanding. It is ultimately their decision on what to do, just be there to support and assist them as they go through this challenging time. Additionally, Renown hosts free “Eating Well After Cancer Treatment” nutrition classes for cancer survivors.  Our next cancer nutrition class series starts Thursday, June 3, 2021, and will be hosted virtually. It is open to anyone in the community. For more information or to register please click here.

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Whether watching a 4th of July celebration from her father’s boat on the Saint Johns River or sneaking a peek at a post-game display over Gator Bowl Stadium from her parents’ bedroom window, the fondest childhood memories of Sterling Silver Club featured member are of fireworks. “I love watching fireworks,” says Rhogenia. “And I get just as excited by them now as I did then.” Well, fireworks are certainly a fitting introduction to this Sterling Silver Club member who shines with a spectacular collection of accomplishments, adventures and interests. A Passion for Teaching Rhogenia remembers herself as a happy, carefree child “who read all the time” while growing up in Jacksonville, Florida with her younger sister, Rosemary, and her father and mother, who was a public school teacher. It’s easy to see how this natural enthusiasm for reading (and learning), along with her mother’s influence, would spark Rhogenia’s calling – and passion – for teaching. After earning her bachelor’s degree in education, Rhogenia spent the first 2 years of her career as a kindergarten teacher in a “one traffic light” town in her home state. She then moved to Oakland, California where she taught kindergarten and first grade classes at various schools for 4 years. The Biggest Little City in the World came next, and her stay there would last much longer. In Reno, Rhogenia added a master’s degree to her credits and found a home for her teaching career at Grace Warner Elementary School – where she taught first and second grade for 20 years! During that time, she also took on the additional role of adjunct professor, teaching graduate students for the University of Phoenix, College of Education.   “A great teacher never stops learning,” explains Rhogenia. “I believe the art of teaching is the act of facilitating discovery, for students and also for myself.” In recognition of her efforts, Rhogenia received the Reno Gazette Journal’s Best of Education Award, the Washoe County Teachers Association Distinguished Performance Award, and was also awarded a grant from Learn and Serve America to help her support student programs that gave back to the community. Rhogenia’s favorite quote: “One hundred years from now it will not matter what my bank account was, the sort of house I lived in, or the kind of car I drove. But the world may be a little better, because I was important in the life of a child.” – Adapted from an essay by Forest Witcraft Commissions, Councils & Space Camp Life outside the classroom also kept Rhogenia busy – and inspired – throughout her career. In 1998, she was selected to participate in an educator externship, and in 1999, was chosen to be a teacher consultant to the Alliance Summer Geography Institute. These opportunities allowed Rhogenia to return to her students with exciting lessons to share about different types of industries and the importance of geography, respectively. In 2002, the governor appointed her commissioner for the state of Nevada’s Commission on Professional Standards in Education. And Rhogenia followed that up with an appointment to the National Council for Accreditation of Teacher Education in 2004. She also got to travel. Rhogenia was one of two teachers from Nevada chosen to participate in the Japan Fulbright Memorial Fund Teacher program on its 50th anniversary. Originally established in 1946 to foster mutual understanding between the U.S. and Japan, the trip allowed Rhogenia to represent her state, her country and her race to Japanese dignitaries, business people and students alike. For over three weeks, she toured schools, universities, factories, temples, art galleries and museums, and stayed in the home of a Japanese family for a few days – which she calls the highlight of her trip.  Oh, and then there was the time she went to space camp! The Nevada Teacher in Space Program sent Rhogenia to join teachers from across the county at the out-of-this-world camp in Huntsville, Alabama. On “Team Endeavor,” she learned what it would be like to deliver payloads and perform experiments at the International Space Station, and took a seat in flight simulators and an antigravity chair. The goal of the program was to inspire teachers to help their students learn about the infinite possibilities of math and science. Time for What Matters These days, Rhogenia enjoys spending time on the things that matter most to her. Personally, that means diving into hobbies like genealogy, music, reading, writing, cooking and the occasional card or board game. She also continues to learn and broaden herself through Osher Life Long Institute (OLLI) classes and Retired Living Truth Series seminars. But her greatest joy comes from spending time with family – four generations of her own family, her church family, retired teachers from Warner Elementary and the many acquaintances and friends she’s come to know over the years. Other things worthy of Rhogenia’s time: Giving back to the community, rainbows, sunsets and sometimes, just watching the clouds roll by. Membership & Senior-ship What does Rhogenia think about being a Sterling Silver Club member and a senior? She told us. “Before COVID, it was the face-to-face club events that I liked most,” recalls Rhogenia. “At the Silver Stars Gala, I had such a wonderful time chatting with old and new friends… the fashions, decorations and the food were delightful.” Over the past year, she also found things to love about the club’s virtual events and regularly attends lectures, cooking and yoga classes and weekly meditation sessions – from her home! It Starts with Hello offers some of her favorite club events. “It reminds me of the television show, Cheers, where everybody knows your name!” she grins. “We meet at noon on Tuesdays and Thursdays. There are a variety of topics and guest speakers, and with the virtual events, I feel like the presenters are talking directly to me… I have the best seat in the house.” As far as being a senior goes, Rhogenia is living her best life and has some advice to help others do the same. “As a senior, I have the time to explore and take advantage of the many opportunities available out there,” she says. “I live life in the present and to the fullest. I make the most of each day because tomorrow, it will be the past.” Rhogenia feels that the biggest challenges for seniors today are health and isolation, and wants people to know there’s help if they need it. “Sometimes we need a little help to make everyday activities a little easier, or just need a person to talk with,” she explains. “My advice is never be too proud to ask for help with anything! Most people are glad to help or guide you to someone who will.” “Lastly, to seniors, I would like to say this: Love yourself and make peace with who you are and where you are at this moment in time,” Rhogenia continues. “And give yourself a big hug!” The Sterling Silver Club thanks Rhogenia for dazzling us with her story, her friendship and her collaboration – and we send her and all of our members a “BIG hug.”

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Standing at the top of the stairs to the basement Sharon Sturtevant was chatting with her grandson in the kitchen. Suddenly, Sharon stumbled and fell down the stairs. “The last thing I remember was my head hitting the floor before everything went black,” she recalls. Her grandson, Oliver, quickly called 911 and paramedics arrived on the scene, taking her by ambulance to Renown Regional Medical Center where she was diagnosed with a broken collarbone and a neck fracture that would require complex surgery involving fusion of her neck. Fall Recovery Begins After her surgery, Sharon was transported to the Renown Rehabilitation Hospital and her recovery process began. Sharon smiles as she describes the rehab hospital team “They are fabulous here, I learned so much about how my body moves, and the proper way to move it. At home I wouldn’t have known what to do,” she confesses. “They set me up for success to return home and not get injured again.” At Renown Rehabilitation Hospital, different therapists coordinated a custom plan to help Sharon recover from her injuries. Ultimately, the goal of her physical therapy was to help restore and improve her strength, reduce pain and increase her mobility for stamina and balance. Physical Therapy Key to Successful Treatment of Falls “My recovery after the operation was an eye-opener,” Sharon declares. “I had no idea how much went into regaining everyday moment.” During her rehabilitation hospital stay, she had to re-learn how to swallow, go up and down stairs, as well as successfully get in and out of a wheelchair, which involved transferring her body weight safely. Due to hormonal changes after menopause women are 50% more at risk for falls than men, according to research. Sharon now has a greater awareness of how to move her body and is significantly stronger than before entering her physical rehabilitation sessions. Not everyone knows that everyday mobility is impacted by four basic skills: stepping, trunk flexibility, upright posture and weight shifting. “I don’t know how I could have gotten this far without the wonderful therapists here,” she shares. “They are so thorough. Proper alignment was encouraged helping me to walk and stand correctly. They were all so nice and patient with me,” she states. “I actually had less pain because I didn’t hurt myself moving the wrong way.” Falls Are Common Among Aging Adults As we age balance becomes more important. Unfortunately falls are common among older adults with negative quality of life effects, even fatalities. According to the Centers for Disease Control and Prevention (CDC), one in four seniors fall each year in the U.S. A comprehensive physical therapy plan for sudden falls or chronic conditions is a safe, effective alternative treatment to medication such as opioids. Today Sharon is back at home with a new banister installed on the basement stairs. As a music lover she is enjoying her musical grandchildren Oliver and Eliana who play instruments. She looks forward to attending their upcoming school concerts. Sharon remembers the staff at Renown Rehabilitation Hospital fondly, “They were unfailingly patient, supportive, informative and understanding.” Her advice to those unexpectedly finding themselves in the rehabilitation hospital is, “Listen to your therapists carefully and follow their instructions.”

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Stroke is unfortunately common, with 1 in 5 American women experiencing it each year. When it comes to a stroke the phrase “time is brain” speaks to the urgency of getting rapid care. In fact, a woman may lose nearly 2 million neurons per minute of oxygen loss to the brain. The Renown Health Comprehensive Stroke Center experts share the importance of timely treatment and how stroke symptoms can differ in women. Women and Stroke – Surprising Symptoms  Each year stroke affects more women than men. Even more concerning, women are less likely to recover from a stroke. The following non-traditional, less common, warning signs can be common in women: Hiccups with chest pain Sudden disorientation, drowsiness, confusion or a general altered mental status Nausea or vomiting A sudden headache that feels like the ‘worst headache of your life’ Unusual chest pain (especially with hiccups) Body numbness or weakness, such as an arm or leg suddenly ‘falling asleep’ Fainting or loss of consciousness Stroke Diagnosis The first step is neuroimaging by CT scan. This allows for rapid identification of any bleed, and also assists in determining candidacy for the early clot busting medication. MRI brain imaging is much higher resolution, and can better determine the core stroke size, assisting in prognosis and recovery. Since strokes have several different origins, an inpatient workup is essential to determine the underlying cause. Whether the stroke is secondary to plaque in the large vessels, clots being thrown in the setting of atrial fibrillation (an abnormal heart rhythm), or small vessel disease from years of uncontrolled vascular risk factors (high blood pressure, smoking, high cholesterol, diabetes), determining the cause is essential to implementing a management plan to reduce risk for further strokes. Quick Treatment for Stroke is Key Early recognition of stroke symptoms and seeking prompt attention is paramount. There are interventions that can be instituted to minimize the stroke and increase likelihood of recovery, but only if a patient presents to the hospital early. A clot busting medication, called tPA, can be given to patients with stroke if given within 4-5 hours from time of onset. Renown Regional Health Center is designated as a Comprehensive Stroke Center, the highest level of stroke certification available. To earn the designation of comprehensive stroke center, a hospital has to meet stringent requirements, including biannual on-site evaluations. This includes care for ischemic stroke patients (lack of blood flow), hemorrhagic stroke patients (bleeds), and determining the underlying cause to guide secondary stroke management prevention. Stroke Symptoms Remember “B.E.F.A.S.T.” to recognize the symptoms of a stroke below: B – Balance Being off balance or dizzy, is common. E – Eyes An eyesight change such as blurring or double vision may occur. F – Face droop One side of the face, or lip, droops A – Arm weakness Does one arm drift down? S – Speech Talking may slur or sound strange. T – Time Time to call 911. Call an ambulance immediately if you or anyone else, experiences any of these symptoms.

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Millions suffer from urinary incontinence (urine leakage). Often people feel as if their bladders control their lives. But this doesn't have to be your story. Bladder control issues are treatable and you can take steps to help control your bladder. What is urinary incontinence? Men and women of all ages can have difficulty controlling their bladders. Urinary incontinence occurs when the muscles in the bladder that control the flow of urine contract or relax involuntarily. Is there more than one type of urinary incontinence? Yes, there are three main types: Stress incontinence is when the bladder leaks small amounts of urine as a result of physical stress or pressure on the muscles supporting the bladder caused by coughing, sneezing, laughing, lifting or any sudden physical exercise such as running or jumping. Urge incontinence is the inability to control a strong urge to go without advance warning, limiting the time needed to get to the bathroom. Overflow incontinence occurs when the bladder does not empty properly. As a result, over time, large quantities of urine are stored, causing the bladder to overflow (this is more common in men and is often the result of an enlarged prostate blocking the bladder opening). Are there any tests that can determine the cause and type of incontinence? Your doctor may have you track your fluid intake and output in a Bladder Diary. A urinalysis can be checked for infection, traces of blood, or other abnormalities. Blood tests can look for chemicals or substances that may relate to contributing causes. Other testing may be an ultrasound, cystogram or post voiding residual measurement. How is urinary incontinence treated? Exercises to strengthen the pelvic floor muscles or restrain the bladder to hold on for longer. Medication can relieve and control the troublesome symptoms. If there is an infection an antibiotic is used. Surgery can repair weakened muscles or remove blockage. Special products such as pants, pads, collection devices, and chair and bed protection may be needed if the problem cannot be controlled. How do you strengthen your pelvic floor muscles? To make your pelvic floor muscles stronger, alternate between squeezing and relaxing them. Following the steps below may help: Squeeze your muscles for one second and hold. Relax your muscles for two seconds. Each time you squeeze and relax, it counts as one set. Complete five sets. When you can do the exercises easily, increase to doing them 10 times per day. When that gets easy, try to squeeze and hold the muscles for three seconds and then relax the muscles for three seconds. As your pelvic muscles get stronger, you can progress to longer squeezes for about 10 seconds. Be sure to relax between squeezes so that your muscles can rest before squeezing again. You should do these exercises in three different positions. Do 10 sets lying down, 10 sitting and 10 standing. It is important that you develop the habit of doing the exercises every day. You may want to exercise just after you get up in the morning and right before you go to bed at night. What can I do to help control incontinence? Watch your weight, practice pelvic floor muscle exercises, eat plenty of fresh fruits, vegetables and fiber to prevent constipation. Most importantly, talk to your doctor regarding incontinence issues, don’t be embarrassed!

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According to the Centers for Disease Control and Prevention (CDC), one out of four adults aged 65 or older, fall each year. But less than half of those who fall talk to their healthcare provider about it. What’s more, among older adults, falls are the leading cause of both fatal and nonfatal injuries. Senior Care Plus, a Medicare Advantage Plan by Hometown Health, and Renown Health Nurse Educator, Nicholas Mannering, worked together to provide a list with simple tips to help you prevent falls.  1. Exercise Exercise strengthens both your muscles and bones and improves balance which is a key factor to preventing falls. The stronger you are, the less likely you are to fall. And, if you do fall, you are less likely to be injured.   2. Vision Check Vision is an import part of fall prevention, have your eyes check by an eye doctor at least once a year. Update your vision prescription and replace your eyeglasses as needed.   3. Install Safety Equipment in Your Bathroom Installing grab bars in your home bathroom provides a way for you to help yourself in and out of challenging situations. It also provides support if you suddenly feel week or unstable. Having a grab bar to lean on or hold onto when you feel yourself falling or slipping can help prevent falls. Rubber mats eliminate slick surfaces that increase your risk of falling.   4. Helpful Items in Your Bedroom A light within reaching distance is an important item to have in your bedroom. One reason adults fall is because they wander through a dark room, often to get to the bathroom at night, and can’t see where they are walking. Having a light within reach that is quick and easy to turn on before walking around a room can make it safer and decrease your risk of falling. Having a bedroom that is organized and furnished in a way that is easy to navigate is also important. If your bedroom is cluttered and hard to walk around without tripping or running into things, it might be worth reorganizing the area to define a clear walking path.   5. Helpful Items in Your Living Room Similar to your bedroom, your living room should have a light that is easily accessible. Sofas with armrests are helpful for support when getting up and sitting down. Avoiding clutter in your walkways, rugs that are not secured down and unstable furniture are important to consider when preventing falls.   6. Actions to Avoid in Your Home There are other ways to fall besides slipping or tripping while walking. Never stand on chairs, boxes or other unstable items in your home. Walkways should be tidy and free of objects that you could trip on. Spills should be cleaned up right away to prevent slipping.   7. Wear Appropriate Footwear Wearing shoes with non-slip soles and closed toes can help prevent you from falling.  Having shoes that fit properly, are made from hard rubber (like tennis shoes) and provide good support help prevent tripping and falling. Shoes with a collar that support the ankle and a well-padded tongue for the top of your foot can also help prevent injury to your feet.   8. Review Your Health & Medications at your Annual Health Check-Up It is important to review your health and medications with your healthcare provider so they can assess if you are at risk for falls. You should discuss your vision, heart health and blood pressure at your annual health check-up. These things can play a role in the risk of falling. Reviewing your current medications is also important. If medications are making you dizzy, talk to your provider about adjusting the dosage so you can feel more stable and balanced. When talking to your doctor about medications be sure to include your vitamins and supplements. Finally, Have your healthcare provider check your feet and discuss proper footwear yearly.   9. Avoid Smoking and Alcohol Balance is important in preventing falls. Alcohol consumption negatively affects balance and increases your risk for falls and fractures. It also increases your risk for cancer, liver damage, osteoporosis, high blood pressure and strokes. Smoking is connected to frailty in older adults. It prevents the development of muscle tissue and breaks down healthy muscle tissue due to the lack of oxygen in your body.

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Often, when we think of Italian dishes, we think of pasta. In fact, there are more than 600 different pasta shapes, each holding the task of delivering Italy’s flavors.  While we all crave pasta, according to the U.S. Department of Agriculture (USDA), a cup of pasta shells contains about 166 calories, 6 grams of protein and 32 grams of carbohydrates. When you add all the other comforting ingredients that comes with cooking Italian, it’s nearly impossible to keep it healthy.  Caitlin Bus, Registered Dietitian with the Renown Healthy Heart Program shares a healthier version of an Italian favorite –deconstructed manicotti using zucchini as a substitute for noodles. If you’re looking for a healthier Italian dish and wondering how to use a spiralizer to turn vegetables into noodles, this recipe is for you.

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As we enter the holiday season, many of us are beginning to plan and partake in festivities such as shopping, cooking, baking, holiday parties and family gatherings. While the holidays often bring joy and cheer, the hustle and bustle can also lead to fatigue, stress, anxiety and sometimes depression. To avoid holiday burnout, it’s important to find ways to care for yourself mentally and physically. Galen Gorelangton, the facilitator of Renown’s Heartfulness Meditation program, discusses how yoga and meditation can benefit you. What is yoga and meditation?  Yoga is defined as performing a series of postures and controlled breathing exercises to promote a more flexible body and a calm mind. As you move through poses that require balance and concentration, you're encouraged to focus less on your busy day and more on the moment. Meditation involves focusing or clearing your mind using a combination of mental and physical techniques. While there are many different types of meditation and yoga practices, they both share similar benefits including: Reduced stress Lower blood pressure Decreased anxiety and depression Increased energy Better sleep Lower inflammation and pain levels Improved strength, balance and flexibility  Better focus and concentration  And much more!

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