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Not all memory loss is inevitable — there are several things you can do to keep your brain nimble at any age. Find out how brain exercises, a healthy diet and daily movement can improve your brain’s focus. A modest decline in memory is to be expected as we get older. We forget someone’s name but recall it later. We find the need to make lists to remember things more pressing. Manageable? Yes. But frustrating nonetheless. The good news is we don’t have to sit back and succumb to age-related memory loss. There are concrete things we can do at any age to keep our brains sharp, nimble and engaged. Five Simple Brain Exercises 1. Volunteer or participate in meaningful activities outside of work. This engages your brain and emotions in a healthy, positive way. 2. Engage in moderate, regular exercise to tone body and mind. Overall good health is critical to brain health. Even casual daily walking can boost your mental abilities. 3. Eat the rainbow. Choose to include plenty of colorful fruits and veggies and ease up on processed foods in your daily diet. The proper nutrients can improve circulation to your brain, which will amp up your cognitive abilities. Consult your doctor for the best diet and supplement choices for your specific health needs 4. Get a blood test to determine your body’s hormonal and nutrient levels. Specific hormones and nutrients can affect cognition. Be mindful of your cholesterol levels, and if you take cholesterol medications, such as statin drugs, be aware they can also affect your mental faculties. 5. Engage in brain activities like reading, crossword puzzles, Sudoku and Trivial Pursuit. These types of activities can improve your brain’s focus and concentration and — most important — test your memory and general knowledge. You derive more benefit by engaging in these activities consistently for short amounts of time, so make a weekly appointment with yourself to build brainpower.

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Did you know: More than 2.9 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today. Prostate cancer is common, but also treatable, especially when caught early. Dr. Michael Hardacre of the Renown Institute for Cancer explains. With the exception of skin cancer, prostate cancer is the most commonly diagnosed form of cancer in American men. In fact, the American Cancer Society offers these key statistics: About 1 man in 9 will be diagnosed with prostate cancer during his lifetime. Prostate cancer develops mainly in older men and in African-American men. About 6 cases in 10 are diagnosed in men aged 65 or older, and it is rare before age 40. The average age at the time of diagnosis is about 66. The good news: This form of cancer is very treatable when also detected early. Michael Hardacre, MD, radiation oncologist with Renown Institute for Cancer, is here to explain more about prostate cancer screenings and their role in early detection. What is the prostate? The prostate is a gland that only males have, and it makes part of the seminal fluid. Prostate cancer begins when the cells in the prostate gland start growing uncontrollably due to a change in the cell’s genes. Researchers are working to find what leads to the disease. Certain types of prostate cancer are hereditary, or passed on through genes. However, most types of prostate cancer are acquired and developed later in life. What are some of the signs of prostate cancer? Common signs of prostate cancer include: Frequent urination Weak urine flow Painful urination or inability to urinate Blood in urine or semen Painful ejaculation Erectile dysfunction If you notice any of these signs, talk with your primary care doctor. Although it may be intimidating to talk about any of these signs or symptoms, the earlier prostate cancer is detected, the better the options for treatment. How can you screen for or detect prostate cancer? The good news is that prostate cancer can often be found before symptoms appear, because screening is as simple as a blood test. Your doctor will look for levels of a prostate-specific antigen in the blood. If the results come back with anything concerning, then additional testing would be recommended. A transrectal ultrasound can also be used, which is usually painless and only takes about 10 minutes to complete. This exam gives the doctor an image of the prostate to measure its size, which can help determine the density of the prostate-specific antigen. If this test comes back with any suspicious results, then your doctor may recommend a biopsy. What are the treatment options? Depending on each case, treatment options for men with prostate cancer might include: Watchful waiting or active surveillance Surgery Radiation therapy Cryotherapy (cryosurgery) Hormone therapy Chemotherapy Vaccine treatment Bone-directed treatment It’s important to discuss all of the treatment option with your doctors, including goals and possible side effects, to help make the decision that best fits your needs. Some important things to consider when choosing a treatment option also include: The stage and grade of your cancer Your age and also your expected life span Any other serious health conditions you have Your feelings (and your doctor’s opinion) about the need to treat the cancer right away The likelihood that treatment will cure your cancer (or help in some other way) Your feelings about the possible side effects from each treatment 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 also advanced treatment options allow us to tailor care to each patient. Learn about: Our Team Cancers We Treat Screening and Prevention Treatment Options

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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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You probably know testosterone (T) plays an important role in how boys physically develop into men. But is that all you know? What happens when a man's T levels are off? Are there symptoms men should look for? And what are the treatment options? Dr. Bobby Kahlon, MD, Renown Medical Group provides answers in a Testosterone Q&A.   What does testosterone do for men?  "Testosterone is known as the 'manly hormone' for a reason," says Dr. Kahlon. "Though women also naturally produce small amounts of it, men produce testosterone at much higher concentration levels. And it affects men in more physical and obvious ways. How much hair a man has on his chest, how deep his voice is, or how muscular he is are all attributable in some way to testosterone. It's also responsible in large part for sex drive and bone strength and affects how men think, learn and experience their surroundings."  Testosterone in men:   Powers virilization (male physical characteristics) and sexual function Builds muscle mass and strength  Supports bone density  Improves cognition  T Trivia: Discover Magazine reveals that “manly” testosterone and other sex hormones evolved long before we did — 500 million years ago — from the ultimate “female” hormone, estrogen. Can you have too much or too little testosterone?  Though high testosterone isn't a concern for most men, low testosterone or low T occurs more frequently and develops for two primary reasons.  Dr. Kuhadiya explains, "Subnormal testosterone concentrations occur either due to pituitary or testicular failure and the causes for each need to be discussed with your physician."  Pituitary failure: Approximately one-third of men with obesity, type 2 diabetes, or metabolic syndrome (which includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels) have low free — or "bioavailable" — testosterone. These health conditions can cause the pituitary gland to "fail" to release follicle stimulating hormone (FSH) and luteinizing hormone (LH) which are essential for triggering testosterone and sperm production. And that can cause low testosterone (hypogonadism). Testicular failure: Though less common than pituitary failure, testicular failure may also be responsible for low T. It's caused by diseases or illnesses affecting the testicles, injury or trauma to the testicles, or certain medicines and treatments such as chemotherapy or opioid pain medication. Providing your complete medical history to your doctor is always the first step toward a proper diagnosis.  What are the symptoms of low T?  The following indicators could be a sign that you have low T, say the doctors.  Lack of motivation and determination, including mild depression  Loss of physical endurance and muscle strength  Loss of or diminished early morning erections  Reduced libido (sex drive)   Erectile dysfunction (ED — difficulty achieving or maintaining an erection)   Gynecomastia (male breasts)  Small testes  T and Time: T levels in men naturally begin to decline by about 1% a year starting at age 30.  How do you test for low T?  "There are different methods for testing testosterone levels," says Dr. Kuhadiya. "Each approach uses a blood sample to evaluate total testosterone, which includes free and attached testosterone that combines with proteins albumin and sex hormone-binding globulin (SHBG). For the most accurate results, testing is based on samples collected in the morning after fasting, and from tests on two different days."  What treatment options are available?  "Well, your best natural option may be YOU," says Dr. Kahlon. "Men with pituitary failure are often able to treat their low T by losing weight to increase levels of the hormone. And even if you don't lose weight, exercise can help boost your testosterone. Unfortunately, if you have testicular failure, weight loss and exercise may not have the same effect."  So, are there other options? "You may want to consider Testosterone Replacement Therapy (TRT)," says Dr. Kuhadiya. "TRT is only available to men who are hypogonadal — with a clinical diagnosis of low T. Injection, gel, skin patch and nasal spray are available TRT options. The best option is the one that works best for the patient. Convenience, insurance coverage and cost are all factors to consider." Dr. Kahlon's TRT preference? Daily gel treatments, which are applied directly to the skin. On the other hand, Dr. Kuhadiya recommends intramuscular injections, which take place once a week or every two weeks.  But both doctors agree on this: physicians and their patients need to weigh the benefits and risks of TRT before proceeding with treatment — especially if your low T condition may require lifelong treatment. "In my clinical practice, I have seen some very good long-term results with an improved quality of life," says Dr. Kuhadiya. "However, in certain situations, TRT may increase the risk of heart disease and is not recommended for men with a history of prostate cancer." Dr. Kahlon adds, "Patients receiving any type of hormone therapy need to be closely monitored throughout the treatment process for any changes in their health."   How do you feel about steroids and T boosters?  "I don't recommend them, certainly not for hypogonadism," advises Dr. Kahlon. "There is no evidence to support anabolic-androgenic steroids or testosterone boosters as a safe or effective treatment for low T in men."  "In fact, there continues to be emerging evidence they may lead to side effects that could potentially harm the liver and the pituitary and endocrine functions of the body," warns Dr. Kuhadiya. "And that damage may be irreversible."

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“You’re gonna be a dad!” Whether you’ve been waiting years to hear those words or still think you’re too much of a kid to have a kid, the reality of impending fatherhood can be terrifying for any first-time, soon-to-be-dad. But not to worry, Best Medicine has some timely tips to help calm those bundle-of-joy fears and help you rock your new role as a brand-new, baby daddy.   Winter is Where Babies Come From Fact: More babies are born in September than any other month, with spill over (and spit-up) into October. Subtract ten months for the typical 40-week, bun-in-the-oven baking time and early winter stands out as the top baby-making part of the year. Is it the cozy nights before a fire as people avoid the snowman-friendly temperatures outside? Possibly. There could be any number of reasons, both seasonal and otherwise, for what will eventually arrive in the fall and immediately steal your heart — and untold hours of your sleep. Though moms carry most of the baby burden traditionally (and literally for three trimesters), that’s no excuse for the soon-to-be-dad not to step up to the plate and take a swing at being the best partner and father on the planet. Below is a list of tips and resources to help you do just that. So read on, daddy-o.  Tip #1: Don’t Freak Out Ok, you’re probably going to freak out even if we tell you not to. But once you calm down, consider this: human beings have been having babies for millions of years, and many of those soon-to-be-dads had it much tougher than we do today. And guess what? The human race is still going strong. Those first moms and dads did a good job — and you will too, with a little help. Tip #2: Take a Class Knowledge is power. In this case, it's diaper-changing, swaddle-wrapping, 2 a.m.-feeding power. And for you and your partner, taking a parenting class or two should be a no-brainer. You'll both learn what to expect and prepare for as you support each other and bond with your baby even before he or she arrives.   Tip #3: Learn From Other Dads If the thought of sitting in a room full of full-bellied women and their partners makes you uncomfortable, you may opt to stick with bros for your lesson plan. Dad-only classes and soon-to-be-dad support groups — taught and led by seasoned fathers with tales to tell and words of wisdom to share — are available online and in cities and communities around the country. Dad-focused sites also offer advice for new and still-learning proud papas. Here are a few options to check out:  Boot Camp for New Dads City Dads Group Wilderdad.com Fatherly.com Fathers.com  Tip #4: Babies are Required Reading Haven't read a good book lately? Well, if you're expecting a baby, now is the time to flip through a few pages that could make your life a whole lot easier in a few months. There's no such thing as being too-well-read when it comes to your fast-approaching, adorable little poop machine. The least you can do is read a book or two, or seven.  We're Pregnant! The First Time Dad's Pregnancy Handbook From Dude to Dad: The Diaper Dude Guide to Pregnancy We're Pregnant! The First Time Dad's Pregnancy Handbook  What to Expect When Your Wife Is Expanding Be Prepared: A Practical Handbook for New Dads  The New Dad's Survival Guide: Man-to-Man Advice for First-Time Fathers What to Expect When You're Expecting  Tip #5: Be a Prepared Soon-To-Be-Dad Tips 1 through 4 are meant to help alleviate some of your jittery, new-dad anxiety. And we hope they do just that. But if you really want to hold that "Best Dad Ever" coffee mug starting on day one, there are also some practical things you can do to prepare. Check these items off your list now to make life with baby more baby-, mommy- and daddy-friendly from the get-go.  Buy a baby/child car seat. Three out of four car seats are installed incorrectly. Protect your children by ensuring they are riding in a properly secured and age-appropriate car seat. Renown Children’s Hospital Car Seat Station is staffed by certified technicians who provide child vehicle safety restraint education, inspection and installation. Set up the baby's nursery early, including furniture  Stock up on diapers and baby supplies  Cook and freeze 2 weeks of food for nights when no one wants to cook  Research family healthcare  Agree upon a shared diaper-changing/feeding schedule  Ask about paternity leave from work  Get bills and finances up-to-date or pre-pay to avoid late charges   Give the home a thorough cleaning before the baby arrives

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Has a male in your life been affected by depression? It could be your father, husband, or son. Or maybe your brother, a friend – or even, your co-worker. They all have one thing in common, they’re men and they may not always be able recognize when they need help. Here’s how you can support the men in your life by understanding their unique signs of depression. Dr. Coard, Ed.D., Psychologist with Renown Behavioral Health, weighs in on the topic of depression and the warning signs. More than 6 million men are diagnosed with depression each year, and surprisingly, depression in men can differ from women. The signs of depression are not easily recognized and it’s common for men to be in denial about what they’re going through. They can demonstrate anger and aggression instead of sadness – making it difficult for loved ones, or even their providers, to recognize. Behavioral Signs of Depression in Men High levels of the hormone cortisol are released during stressful situations affecting the neurotransmitter, serotonin (a feel good hormone), contributing to depression. You can identify depression or suicidal tendencies by paying close attention to the following behavioral changes: Anger, irritability, or aggression Avoiding family or social situations Losing interest in family responsibilities, passions and hobbies Lack of sex drive Becoming controlling/abusive in relationships Risk-taking behavior such as; unsafe sex, overspending or gambling Not being able to concentrate or remember details Excessive drinking or drug use Having frequent thoughts about death Talking about suicide Attempting suicide Factors That Lead to Depression in Men Life Events Work stress or long-term unemployment can be huge contributing factors relating to depression. This type of life event can be overwhelming, making it impossible for a man to cope. Changes in Relationships The loss of a relationship can be a significant contributing factor to the emergence of depressive symptoms and past experienced physical, sexual, or emotionally abusive relationships. With this in mind, counseling can often help individual to overcome this type of trauma. Grief and Loss Overwhelming sadness due to the loss of a loved one can trigger depression. Although normal, each person goes through their own grieving period. For example, normal responses to death are insomnia, poor appetite and loss of interest in activities. Pay attention if grief seems prolonged or out of the ordinary. Health Problems In particular, depression coexists with medical conditions. As men age, this can be passed off as normal aging, but it could be more serious. In addition, illnesses such as thyroid disorders, Addison’s disease and liver disease can cause depressive symptoms. Diabetes, cancer, heart disease, or Parkinson’s disease can affect any age, thus triggering or worsening depression. Some older men also feel like they may be suffering from dementia because of difficulties with memory this may be a symptom of depression. A trip to the doctor may be in order to help alleviate concern and worry. Depression in Men and Suicide Frequently the emotional pain occurring with depression can distort a man’s ability to see a solution beyond suicide. Individuals with depression become very rigid and constricted in the way they solve problems. The statistics below speak for themselves, helping us understand the need to reach out to those who need our support. Male suicide rates are on rising – men die by suicide 3.53 times more often than women, accounting for 70% of all suicides. Sadly, every day 129 men commit suicide. White males accounted for 69.67% of suicide deaths in 2017. In 2017, firearms accounted for 50.57% of all suicide deaths. Middle aged Men who are middle aged have the highest suicide rates. 40% of those identifying as transgender have attempted suicide in their lifetime. Males who are guy or transgendered are at an increased risk for suicide attempts, especially before age 25. Veterans often suffer from post-traumatic stress disorder (PTSD) and depression, and are more likely to act on a suicide plan. How You Can Help Now that you can identify some of the warning signs of depression, here’s how you can help: Talk about your concern and communicate that you’re there to help him. Let him know depression is a medical condition and will usually get better with treatment. Suggest professional help from a Primary Care Provider, Psychologist or Therapist. Help set up appointments and offer to accompany him – let him make the decision, but make it clear you’re there for him, no matter what he decides. If you feel he is in a dire or life-threatening situation, contact 911. Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to talk to a trained counselor. Call the Veteran’s Crisis Line at 1-800-273-TALK (1-800-273-8255) and press “1”

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If you are approaching age 65, you may be starting to think about the government benefits you will soon qualify for. For example, your healthcare option to elect between Original Medicare or a Medicare Advantage plan. What’s the difference? Original Medicare comes in two parts: Part A and Part B. Part A covers a portion of hospitalization expenses, and Part B applies to doctor visits and medical expenses, such as lab tests and some preventative screenings. A Medicare Advantage plan, also known as Part C, is an “all-in-one” alternative to Original Medicare. These “bundled” plans include the benefits of Part A, Part B and Part D (prescription drugs). Some people choose a Medicare Advantage Plans over Original Medicare because these plans offer coverage like vision, hearing, dental and more. Saves You Money First and foremost, Medicare Advantage Plans save Medicare members money –and not just a little bit of money, but a lot of money. Original Medicare only pays 80% of the cost of medical care – the Medicare beneficiary is responsible for the other 20%. A Medicare Advantage Plan is different. The Medicare Beneficiary is only responsible for a small copay, typically less than 20% of a doctor visit or procedure. More importantly, Medicare Advantage Plans have a maximum out-of-pocket amount, meaning that once you reach the limit, the Plan pays 100% of all medical services. That alone can save thousands of dollars per year – particularly if there is a hospitalization involved. Dental, Vision and Hearing Coverage What sets Medicare Advantage plans apart is the additional benefits provided that Original Medicare doesn’t cover. These benefits include dental coverage, vision coverage, hearing exams and hearing aid coverage. None of these important health care benefits are included in Original Medicare. Also, most Medicare Advantage Plans include prescription drug coverage at no additional cost, while individuals with Original Medicare need to sign-up and pay extra for Part D prescription drug coverage. Medicare Advantage Plans offer more benefits than Original Medicare and they help members save on their health care costs. Focus on Accessibility, Wellness and Preventative Health Accessible healthcare coverage is key to staying on top of your health. To join a Medicare Advantage Plan you must have Part A and Part B coverage and live in the plan’s service area. It is important to remember that Original Medicare is only valid in the United States. Fortunately, many Medicare Advantage Plans offer worldwide emergency coverage. Another important healthcare consideration to keep in mind is Medicare Advantage Plans focus on your overall well-being. They offer preventative and wellness-related benefits at no cost to you. This includes important benefits like free over-the-counter medicines and free gym memberships. You won’t find those types of benefits with Original Medicare. Medicare Supplement Plans (Medigap) Some people confuse a Medicare Supplement Plan, also known as a Medigap Plan, with Medicare Advantage Plans. They are different and the biggest difference is Medicare Supplement plans come with ever-increasing premiums because they are based on your age. This means the cost of these plans increase every year. Plus, they don’t offer any supplemental benefit coverage like vision, dental or hearing. That’s not the case with a Medicare Advantage Plan. In many cases, there is no monthly premium and you receive all manner of supplemental benefits. These benefit-rich, zero-dollar premium Medicare Advantage plans are enticing people to say goodbye to pricy Medicare supplement plans and hello to Medicare Advantage Plans. Don’t worry, if you join a Medicare Advantage Plan for the first time and you aren’t happy with the plan, you’ll have special rights under federal law to buy a Medigap policy and a Medicare drug plan if you return to Original Medicare within 12 months of joining the Medicare Advantage Plan. The Flexibility to Change Your Mind A common misconception about Medicare Advantage Plans is that when you join, you are still on Medicare and are not giving up your Medicare coverage. Medicare Advantage Plans are considered “Medicare Part C.” This means they combine your Medicare Part A (hospital coverage), Part B (doctor’s coverage) and Part D (prescription drug coverage) into one convenient package that costs less and provides more. You can only join, switch or drop a Medicare Advantage Plan during the enrollment periods: Initial Enrollment Period: When you first become eligible for Medicare, you can sign up during your Initial Enrollment Period. For many, this is the seven-month period that begins three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65. General Enrollment Period: If you have Part A coverage and you get Part B for the first time during this period (between January 1 - March 31 each year), you can also join a Medicare Advantage Plan. Your coverage may not start until July 1. Annual Election Period: Between October 15 and December 7, anyone with Medicare can join, switch or drop a Medicare Advantage Plan. Your coverage will begin on January 1 (as long as the plan receives your request by December 7). Medicare Advantage Plans have been around for more than 25 years and continue to grow in popularity. In some parts of the country, more than half of all Medicare beneficiaries are enrolled in a Medicare Advantage Plan. Only 40% are enrolled here in Nevada, but that number is growing every year.

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Did you know that members of Senior Care Plus, the largest Medicare Advantage Plan in northern Nevada, have access to an exclusive, senior-focused Renown Health primary care office right here in Reno? The facility – and the Medicare plan itself – are both designed with seniors in mind; this includes specialty staff, longer appointment times, on-site services, supportive furniture and more. 4 Benefits of an Exclusive Senior Care Plus Facility Centrally Located with Senior-Focused Staff The Senior Care Plus facility, located on Del Monte Lane, is only open to members of Senior Care Plus. This exclusive access means that the bilingual staff – including doctors, medical assistants, nurses and personal assistants – works daily with aging health needs. On-Site Services and Enrollment Specialists The Senior Care Plus providers understand that seniors often require complex care management and geriatric-focused services. That is why this location offers on-site lab draws, saving travel time and stress. Another essential service this location offers is longer appointment times, ensuring members don’t feel rushed when discussing their health needs with providers. Another perk of the Del Monte location – on-site enrollment specialists. Members, and potential members, can stop by this location on weekdays between 9 a.m. and 4 p.m. to have their SCP-related questions answered. Furniture Designed with Seniors in Mind Senior Care Plus makes a doctor visit as stress-free as possible. The office has furniture that makes each visit more comfortable for members. All of the office chairs have armrests, so seniors can easily get in and out of them. Also helpful are the exam room chairs with remote controls for reclining the chair and lifting the patient’s legs. This makes exams, such as a diabetic foot exam, less of a strain. Community Rooms Social connections are an important part of health. That is why the Del Monte Lane office has community rooms used for informative seminars and as a gathering place for members to mingle. The seminars focus on many interesting topics for older adults, such as diabetes, COPD, asthma, weight loss, nutrition, yoga and chair exercises.

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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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Much like general physical and mental health, sexual health is an essential aspect of your overall well-being. Therefore, educating yourself on your sexual health is an important piece regarding your overall wellness. Secure & Private Virtual Visits Did you know that many sexually transmitted disease appointments can happen virtually, in the privacy of your own home? Our providers can perform a screening examination for sexually transmitted illness (without symptoms) when it’s convenient for you. This is a great option if the topic makes you uncomfortable during an in-person visit, or if you can’t find time to visit your primary care provider or local urgent care. After the telehealth appointment, your provider will determine the  next steps for you. Remember, in-person visits are always an option as well.   Here’s how you can take charge of your sexual health:  Get Comfortable with Getting Tested  Surprisingly, some people with STDs don't show symptoms, meaning they may not even know they have an STD unless they get tested. Even if an STD shows no symptoms, the result of non-treatment can be serious. Bret Michael Bellard, MD, with Renown Medical Group, shares that it’s important for people to get tested for STDs because if left untreated, they can cause the following health problems: Loss of fertility Pregnancy complications Other health issues  When to Visit Your Primary Care Provider  Who should get tested and how often? “The recommendations are that everyone from ages 13 to 64 should get tested at least once for HIV. All sexually active adults should also be tested for other STDs once a year, and all pregnant women should be tested at the start of their pregnancy,” says Dr. Bellard. Some STDs, like syphilis, can be passed from mother to baby, so it's important for women to get tested as soon as they know they’re pregnant.  Dr. Bellard recommends going to your primary care provider for testing. “They can also give advice on prevention and other health topics.” If you don’t have a primary care provider, this is a great reason to get established with one. Women with an established OB/GYN can have STD testing done simultaneously with their annual pelvic exam. The providers in Renown's network care for patients of all ages and specialize in family medicine, internal medicine, pediatrics and OB/GYN.   Practice Safe Sex  STDs are preventable. Practicing safe sex and getting tested routinely are your best defenses against all types of STDs.  For many, the conversation about sexually transmitted diseases is awkward and many avoid it. To lower your risk of contracting an STD, don’t wait until you’re “in the moment” to have the conversation with your partner about the last time you were both last tested. If you haven’t gotten tested in-between new partners, use latex condoms every time you have sex until you are both confirmed negative of STDs. Condoms are not 100% effective at preventing disease or pregnancy. However, they are extremely effective if used properly.   To establish Primary Care, visit renown.org/virtualvisits or call 775-982-5000

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If you and your partner are looking for a more permanent birth control method, you might consider a vasectomy. Although vasectomies are common, knowledge about them isn’t quite as common or talked about. If you are considering a vasectomy, talking with your primary care doctor is a great way to learn more and start the process. We consulted with Dr. Aurosis Reddy a primary care doctor with Renown Health – South Carson, about key topics to discuss with your doctor when considering a vasectomy. What is a vasectomy? A vasectomy – also called male sterilization – is a form of male birth control that blocks sperm from reaching semen, according to the American Urological Association (AUA). How effective and safe are vasectomies? Vasectomies are one of the most effective methods of birth control with a long-term success rate of over 99%. A vasectomy has been a safe and successful birth control method for many years. More than 500,000 men elect to have vasectomies every year in the U.S., and the number is rising. A vasectomy is also generally a low-risk procedure with a low complication rate ranging between 1-2%. What does the recovery period look like? A vasectomy is typically a quick procedure that takes under thirty minutes and can be performed in an outpatient setting under local anesthesia. Recovery from a vasectomy is also considered relatively easy. After a vasectomy, most can: Resume everyday activities within two to three days Resume normal exercise in one week Start engaging in sexual activity again in one week Your doctor can provide more details on what your individualized recovery process will look like.

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