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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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How do you take the waiting game out of your Urgent Care visit? Book ahead! Here’s how this convenient service can help you schedule your appointment and see updated wait times at area urgent care facilities. We’ve all been there, done that: It’s after hours, you need to see a doc, and urgent care is slammed. Renown now offers a convenient option that will enhance your experience. Here’s How Book Ahead Works: From your phone or computer, you can check urgent care wait times around our region. This lets you see if the urgent care by your office is busier than the one closest to home — which may help your planning. Through Book Ahead, you can join the line at a specific urgent care just as you would in person. This allows you to stay home or at work as long as possible so you are more comfortable. Book Ahead When and Where to Receive Care We have many choices when it comes to our medical care. Should you visit a doctor’s office, urgent care, emergency care or make a Virtual Visit? It’s important to know which choice is right for your situation or condition. We asked Luis Palacio, M.D., with Renown Urgent Care to explain the differences and how to make your visit as smooth as possible. If you have been experiencing flu-like symptoms for less than 48 hours, call your doctor’s office. They can then determine if you can be treated with a prescription antiviral medicine. Visit urgent care or the emergency room only if you are unable to eat or drink anything and may be dehydrated, have a fever over 102.5 degrees F, or are experiencing shortness of breath. You can use Renown’s Virtual Visits videoconference service for flu-like symptoms so that you don’t need to leave the comfort of your home and you reduce the risk of spreading the virus to others. Virtual Visits allow you to see an urgent care provider from your home or office using a cellphone, computer or tablet with video capabilities. It is open from 8 a.m. to 6 p.m. Monday through Friday, and 9 a.m. to 4 p.m. Saturday and Sunday. How Do You Book Virtual Visits? Go to Virtual Visits to get started. Here, you’ll learn what virtual check-in is all about: It allows you to stay where you are and receive text notifications once a care provider is almost ready to see you. Click, join a line, and we will ask you some questions about your symptoms. This allows us to make sure you don’t need to call 911 or go to the ER. Reasons to visit the ER include stroke, chest pain, severe shortness of breath, uncontrolled bleeding, seizures and severe allergic reaction. If you answer “no,” you will see the wait times for each urgent care location. If you need to get in right away, you can select the location with the shortest wait time. Or, if time is not an issue and you’d prefer to stay closer to your home or office, you can select that location. Once you’ve selected a location, you input your cell number, name and number of patients. As your appointment gets closer, urgent care will text you with updates on timing. When you get the text message, you can choose to get “more time” and have your appointment pushed back, or tell them you’re ready to be seen and on your way. Learn more about how to Book Ahead at Renown urgent care below.

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National Healthcare Decision Day is forthcoming. Here’s an easy and free way to commemorate the occasion: openly discussing how we want to be cared for at the end of our lives. Join Renown Health’s experts at a workshop about making decisions about an advance directive. Among the random national holidays, this one has significance: April 16 is National Healthcare Decision Day. And experts agree that the best time to discuss your views about end-of-life care and to learn what choices are available is before a life-limiting illness or crisis occurs. By preparing in advance, you can help reduce the doubt and anxiety related to decision making for your family if you cannot speak for yourself. “Completing your advance directive is a gift you give your family,” says Mary-Ann Brown, RN, MSN, director of Palliative Care. “The stress associated with these difficult decisions is decreased if everyone knows what is important to you and what you want the end of life.” What Are Advance Directives? An advance directive is a document that states your choices about medical treatment and names another person to make medical decisions on your behalf if you are unable to. This document allows you to make legally valid decisions about future medical care. Find more information about advance directives and the form online. The Conversation The first step in completing an Advance Directive is to think about what’s important to you and talk to your loved ones. The Conversation Project provides helpful tools to guide you and your family through this challenging topic. Getting this information together will help you fill out and complete your advance directives. Some things to consider and discuss with your family include: When you think about the last phase of your life, what’s most important to you? Who do you want involved in your care? Who should make decisions on your behalf if you’re not able to? Where do you want or not want to receive care? Are there specific treatments you would or would not want? Complete Your Advance Directive Planning In order to complete an advance directive, you will need either two witnesses or a notary to sign the form. Be sure to note restrictions on the witness process. When an advance directive is complete, you should keep the original. Copies should be given to your agent named in the form, your family, your doctor(s) and the location that you receive care. Renown Health offers four advance directive workshops every month to cover the details of filling out this document. A healthcare team is available to answer questions and work through the process with you. A notary is also present to finalize the process, which means you can complete your advanced directives during this workshop. Find the workshop by calling 775-982-RSVP for more information. Advance Care Planning Workshop April 17, 1-2:30 p.m. | Free Join Renown Health’s experts for a workshop about making decisions regarding end-of-life care. You will learn how to fill out an advance directive, receive one-on-one assistance and have your documents signed by a notary. Workshops are typically held several times each month. To RSVP, call 775-982-7787

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Low back pain is not only a problem most people have at some point in life, but also the leading cause of disability in the U.S. Whether it is a sharp spasm from lifting something heavy or a daily constant ache, there are various treatments available to relieve your pain. Jessica Ryder PT, DPT, cert VRS, with Renown Health Outpatient Therapy, explains some common causes of this pain, how to treat it and ways to prevent pain flare-ups. It’s important to realize most cases of low back pain are short term. Frequently lasting only a few days or weeks. In general these cases leave no long-term damage to the spine, muscles, discs or nerves. “However, it can become episodic or chronic (lasting longer than 12 weeks) if it is not properly understood or managed by the individual, ” cautions Ryder. Causes of Pain Specifically back discomfort can be related to: Wear and tear on the spine due to age or poor movement patterns Injury to spinal discs Sprains (overstretching or tearing of ligaments) and strains (tears in tendons or muscles) Trauma Irregularities of the spine present at birth (example: scoliosis)Notably the above issues may result in a “pinched nerve” or sciatica, causing pain to extend down the leg. Risk Factors for Pain In particular, your chance of developing low back pain increases with the risk factors below: Age Being overweight Low fitness level or occasional physical activity (“weekend warrior”) Family history Pregnancy Poor posture Jobs requiring heavy physical work (landscaping, plumbers, construction, etc.)

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While the appearance of a winter wonderland in your yard can be a welcome one, an accompanying aspect is not: the idea of clearing your driveway and sidewalks. The sometimes-daunting task of snow shoveling is a repetitive activity that can cause muscle strain to the lower back and shoulders. However, by following the tips below, you will spend more time appreciating your winter wonderland -- when your sidewalk and driveway are all clear, that is. But, we all know that injuries happen, and if you do find yourself with back pain that does not resolve in a few days, contact your primary healthcare provider, or visit a Renown Urgent Care. Another way to avoid injury during strenuous activity, or help heal an injury that won't go away, is to work with a physical therapist who can offer at-home exercises to keep your body strong. 6 Tips for Safe Snow Shoveling Following these tips from the American Physical Therapy Association can help you avoid injuries: Lift smaller loads of snow, rather than heavy shovelfuls. Be sure to bend your knees and lift with your legs, rather than your back. Use a shovel with a shaft that lets you keep your back straight while lifting. A short shaft will cause you to bend more to lift the load. Using a shovel that’s too long makes the weight at the end heavier. Step in the direction where you are throwing the snow to prevent the low back from twisting to help prevent “next-day back fatigue.”  Avoid excessive twisting because the spine cannot tolerate this motion. Bend your knees and keep your back as straight as possible so that you are lifting with your legs. Take frequent breaks when shoveling. Stand up straight and walk around periodically to extend the lower back. Backward bending exercises while standing will help reverse the excessive forward bending of shoveling. Stand straight and tall, place your hands toward the back of your hips and bend slightly backward for several seconds. When in doubt, ask for help. The Reno community is a generous one and you can typically find snow shovelers for hire on local message boards like Nextdoor and Facebook. Or, if you have a kid in your neighborhood, they might be looking to make some extra money on a snow day.

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Katherine Bunker, Physical Therapist and Certified Lymphedema Therapist (PT, DPT, CLT) at Renown, discusses how patients can manage lymphedema with changes to daily routines along with diet and exercise. Lymphedema is a condition that affects millions of people around the world. It is a chronic and progressive disorder that results in swelling of the arms, legs, or other parts of the body due to an accumulation of lymph fluid. Lymphedema can occur because of cancer treatments, surgery, or other medical conditions.   Managing Lymphedema Treatments to help reduce symptoms such as pain, swelling and discomfort associated with lymphedema can include compression garments, exercise, skin care, manual lymphatic drainage and pneumatic compression.  The goal is to avoid triggering the onset of lymphedema. Lymphedema can present itself immediately after surgery or radiation. It can appear months later or even years later. There are many factors that influence the development of lymphedema which is why prevention is so important. If you have had injury or disruption to your lymphatic system, then:  Avoid injuries to the skin near the affected area. For example: wearing gloves during gardening, using bug spray to ward off mosquitos, covering your limbs while playing with pets, keeping nails clean and avoiding cutting too close to cuticle, utilizing electric razors at the armpit (instead of a traditional razor).,   Avoid blood pressure readings to the affected limb or request blood pressure to be taken manually, not by a machine.   Avoid heat like saunas, hot tubs, sunburns, hot packs, and even massages.    Avoid tight jewelry like rings or bracelets, which can be too tight.

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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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Virtual visits are basically secure, video conferencing visits with your health provider. Of course if you are sick, you want to avoid going outside of your house. With Renown Health’s virtual visit program, you can now see a provider from the comfort of your own home. As we work to keep all of our patients home and healthy, we’re here for any ongoing healthcare needs you have. There are two easy ways to access a virtual visit with Renown Health. If you need an urgent care visit, you can get in line using your MyChart account You can make a virtual visit with some Renown Health providers you see currently Virtual Urgent Care from a Renown Provider By using MyChart, you can now login and request to “Talk to a Doctor.” After filling in some information and confirming your healthcare concern, you will be put into a virtual line. The healthcare team will notify you by text or email when a provider is ready to talk to you virtually. Virtual urgent care visits are available for all ages. Get To Know MyChart Virtual urgent care visits are available for all ages, and can address: Common cold and cough symptoms Muscular, tendon or joint pains not caused by injury Allergy or sinus symptoms Pink eye Urinary discomfort Diarrhea without vomiting Rashes or skin sores Backache Nail problems Screening examination for sexually transmitted illness (without symptoms) Medication refills (not controlled substances) Symptoms for In-Person Urgent Care Visits Shortness of breath Chest pain Abdominal pain Numbness or weakness of any location that is new Traumatic injuries (including eye injuries or something in the eye) Severe pain of any other body location Dizziness or confusion Bleeding from any location High fever (greater than 102 degrees for all ages) Persistent vomiting Loss of vision Ear pain Substance abuse or psychiatric problems Virtual visits are open 9 a.m. through 6 p.m. Monday-Friday and 10 a.m. to 4 p.m. Saturday and Sunday for Nevada residents. Renown Provider Virtual Visits Many primary and specialty care appointments for adults and children are now available virtually. If you have a provider with Renown Medical Group, call 775-982-5000 to see if you can have a virtual appointment from the comfort of your home. MyChart Assistance If you need assistance with your MyChart account, please call 775-982-6686. For all other questions about scheduling and appointments, please call 775-982-5000.

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