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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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When Tabitha Cox received a diagnosis of multiple sclerosis (MS), she was in shock, denial and felt that she was too strong for something like this to be happening to her. As the disease progressed, Tabitha realized she needed to do what she could to stay as healthy as possible. “I heard, ‘You have a quarter-size lesion on your brain,'” recalls Tabitha Cox. “At that moment, that was literally all I heard come out of her mouth.” Tabitha’s official diagnosis was multiple sclerosis (MS), an unpredictable, often disabling disease of the central nervous system that slowly debilitated her mom. “I was numb,” says Tabitha. After her diagnosis, Tabitha went on with her life as if the disease was nothing more than a doctor’s diagnosis. However two years later, Tabitha realized something wasn’t right and sought care at Renown Institute for Neurosciences – Brain and Nerve Care. Her form of MS was aggressive, and her doctor recommended treatment right away.

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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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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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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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Earning its third five-year accreditation, Renown’s neuro-diagnostic lab remains Nevada’s only accredited ABRET facility. The Renown Institute for Neurosciences is pleased to announce that the neuro-diagnostic lab at Renown Regional Medical Center has been re-accredited by the American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET). ABRET’s lab accreditation process evaluates technical standards, the quality of a laboratory’s output, and lab management. “Renown Health is a leader and a destination for health in treating neurological disorders and advancing innovations in neurology. The specialists at the Renown Institute for Neurosciences provide comprehensive brain, nerve and surgical support along with a full range of diagnostic and additional procedures and a disease-specific, patient-focused approach to care,” says Tony Slonim, MD, DrPH, FACHE, President and CEO, Renown Health. “This prestigious honor from ABRET means Renown’s Electroencephalogram (EEG) Laboratory has met strict standards and is recognized as a place where patients and physicians can confidently receive quality diagnostics.” “In addition to re-accreditation from ABRET, the Institute for Neurosciences has earned a Gold Seal of Approval by the Joint Commission and offers advanced treatment options including t-PA (Tissue Plasminogen Activator) and biplane angiography. The Level III accredited Epilepsy laboratory implements some of the newest treatments available,” said Renown’s Chief Medical Officer, Paul Sierzenski, MD, MSHQS, CPE, FACEP. “Renown patients also have access to the most promising new therapies through national clinical trials, which have been shown to significantly improve patients’ health and well-being.” “I am proud to recognize our dedicated team of caregivers for their continued passion and excellence in maintaining the highest standards in patient care,” said Renown Institute for Neurosciences’ Division Chief, Dr. Rolando Ania. “It is all thanks to their tremendous efforts that we remain the only ABRET accredited laboratory, as well as the only nationally accredited epilepsy center (NAEC Level III), in the state of Nevada.” Using a collaborative approach, specialists at the Renown Institute for Neurosciences use leading-edge diagnostic tools to identify neurological conditions and treat patients with the most effective techniques available. What is a Neuro-diagnostic Lab? A neuro-diagnostic lab allows care teams the technology to evaluate how a patient’s peripheral, autonomic, and central nervous systems function, and aid in diagnosing and treating conditions such as epilepsy, multiple sclerosis, Parkinson’s disease, stroke, and other diseases of the nervous system. What is an Electroencephalogram (EEG)? An Electroencephalogram (EEG) is a test that measures and records the electrical activity of the brain. During the test, special sensors called electrodes are attached to the patient’s head and hooked by wires to a computer. The computer then records the brain’s electrical activity on the screen. Using a collaborative approach, specialists at the Renown Institute for Neurosciences use leading-edge diagnostic tools to identify neurological conditions and treat patients with the most effective techniques available. Renown Health hospitals are ranked as Nevada’s top hospitals by U.S. News & World Report.

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It’s true there is no cure for dementia, yet studies suggest your life choices today can reduce brain decline in the future. How important is diet to brain health? Food is the foundation of your body. Fats, carbs and protein provide the energy for your cells and metabolism. So the quality and amount of food you eat directly affects your brain. Specifically, researchers are paying special attention to the link a high sugar diet and/ or an unhealthy fat diet may have on your brain. Your brain on sugar According to the Alzheimer’s Association, when too much sugar is in the bloodstream for long periods of time, it can damage the brain cells. Many people with diabetes may develop brain abnormalities, and these changes may increase chances of dementia — research is still being done to understand this connection. Many U.S. adults have prediabetes with blood sugar higher than normal. Insulin resistance often leads to diabetes. Insulin resistance has been linked to metabolic syndrome, which is a precursor for cardiovascular and cerebrovascular disease (heart attack, stroke). Some signs of metabolic syndrome include: Large waist size (40 inches or more for men, 35 inches and up for women) Low HDL (good) cholesterol level Higher than normal blood pressure — 130/85 and above Current research suggests too much sugar in the blood causes inflammation, which can damage brain cells. High carbohydrate foods, such as sweetened beverages, chips, white rice, white potatoes, bagels, cereals and desserts, have been shown to raise blood sugar. Although anyone can get diabetes, Hispanic Americans and African Americans are at greater risk.

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It’s true that a road trip can change your life, and it did for Sergeant Brandon Ott, just not in the way he was expecting. For nine years, Brandon worked alongside his friend, Denton Tipler, at the police department in Florence, Oregon. To break the monotony of the COVID-19 lockdown, they planned a ‘guy’s trip’ - a pandemic safe, motorcycle adventure traveling through Idaho and Washington. On the morning of July 22, 2020, they set out on their journey. But by 8 p.m., they ran into rough weather - with wind, poor visibility and heavy rain as they rode into Nevada. Four miles from their destination, on a desolate stretch of Highway 140, a gust of wind hit Brandon. Denton watched in disbelief as his friend bounced, tumbled and ultimately came to a stop after sliding over 100 yards. He flagged down the next vehicle, a semi-truck, and the driver did traffic control while another passerby drove to get cell service and call 911.  A Distressing Call  About 10 p.m. the same night, Angie Brog, Brandon’s partner, picked up her phone at the Florence police station. A Nevada highway patrolman let her know Brandon was in a motorcycle accident and had been taken to a hospital in Winnemucca, NV. From there he took a life flight to Renown Regional Medical Center.  Angie immediately called Brandon’s parents and told Addison, their 9-year-old daughter, the news. They quickly packed their bags and drove to Nevada. On the drive to Reno, an ER doctor called Angie to give her Brandon’s status, “I can’t thank him enough. I was so worried. He even gave me his personal cell phone number.”   Upon arrival, she ran to see Brandon in the trauma ICU. “His face was shattered, he had a collapsed lung, a tube was down his throat and something was in his head to relieve pressure from his swelling brain,” she remembers. “He was not expected to live.”  While Brandon was in a coma for three days, Angie was by his side, trying to come to grips with a new normal. “The doctors did not sugarcoat it,” she recalls. “They told me to prepare myself if he pulled through.”  It was a rough week in the ICU with Brandon heavily sedated, so he could heal. From there he was transferred to the neurology floor, where he slowly improved. While there, his daughter Addison got to see him for the first time. Angie says, “When Addison saw her daddy for the very first time, she was relieved, happy she could hug him, and that he was alive.” Miraculously his legs were not broken and he was able to hold simple conversations and walk a few steps.    As the days went on, Brandon’s dad returned to Oregon, and the Inn at Renown became the family’s new home. “It was such a blessing to be so close to Brandon,” Angie observes. “It allowed us to relax a little being in the same building and let us settle in.”  The Comeback Brandon’s first memory after the accident was waking up in the Renown Rehabilitation Hospital, 16 days after his accident, not knowing where he was. (Brandon experienced amnesia due to his brain injury and doesn’t remember the days prior to his rehab stay.) He recalls looking around the hospital room and seeing the photos Angie posted of their family on the walls and wondering, “How did they get pictures of my family?” Immediately after learning that Brandon was awake, Angie raced back to the hospital, went outside his window and talked to Brandon on the phone, reassuring him that they were there for him and everything was going to be ok.  The next morning, he saw Addison for the first time that he remembered since his accident. They each put their hands to the hospital window “touching” each other in an emotional reunion. During the pandemic, each rehab hospital room was designated with an animal, so family and friends could visit outside safely.  Brandon was in the ‘moose’ room. “Whoever thought of that was a genius,” notes Brandon.  A new phase of Brandon’s recovery began at the rehab hospital. "He worked so hard while he was there,” Angie shares. With a minimum of three hours of daily therapy sessions, including speech, occupational and physical therapy. Angie participated in every aspect of his therapy, “I learned so much from the therapists; they included me in everything,” she recalls. “The compassion and patience they have is amazing. It takes a special type of person to do this job. I cannot say enough good things about the Renown Rehabilitation Hospital staff. If he would have been anywhere else, I’m not sure he would be alive,” she says.  It wasn’t easy. Brandon had a brain injury that required a bolt in his skull to relieve the pressure, and a broken left collar bone and left eye socket. His entire face had to be reconstructed. He remembers his face hurting and thinking he looked like Freddy Krueger. When he saw himself in the mirror for the first time, he was surprised to find he only looked thinner, with a gauze pad on his temple.   Prior to the accident, Brandon weighed 300 pounds, but had just finished a year-long fitness journey losing 119 pounds, by doing CrossFit and overhauling his diet. During rehab his weight dropped to 160 pounds and he was known as “the double portion” guy, eating extra food to gain weight.   Shaun Stewart, Therapeutic Recreational Therapist, recalls Brandon riding the recumbent cycle during his recovery. “I remember him saying he didn’t know if he was ever going to be able to ride a bike again and was appreciative when adaptive sports were discussed. He was very willing to participate and excited to be able to get on a bike again. He had a positive attitude and always was willing to get up and get back on the bike.”  Better Together Although Angie and Brandon were in a committed relationship for almost 11 years, they were not legally married at the time of his accident. “In our minds, our lives were perfect,” Angie asserts. “We had lived together for so long and have a child together.” However, because of COVID-19 restrictions, Angie had to lie and tell the medical staff that they were married so she could be by his side. When Brandon woke up from a coma, she told him, “No matter what I’m your wife.” He asked, “What do you mean, you are my wife?” After hearing Angie’s explanation, Brandon said, “Then, let’s do it.”   “We realized when faced with death that the benefits far outweighed the negatives in becoming husband and wife,” Angie discloses. “The rest is history.”  On Tuesday, August 18, 2020, Brandon and Angie were married underneath the trees behind the rehab hospital. Their family, friends and several staff members attended the ceremony. “I think that’s a first for us,” declares Dr. Gavin Williams. “I cleared him for capacity to make decisions, and we had a COVID-friendly wedding on our back lawn before he went back home to Oregon.”  The next day, Brandon officially left the hospital. “I felt good. Like ‘he’s gonna make it,’ but I was also scared,” mentions Angie. The family stayed in town for a couple of days to make sure everything was ok and then traveled home to Oregon.  Not Today Dr. Williams set Brandon’s recovery in the range of six months to two years. Brandon set the six-month mark as his goal and returned to work full time in just under that time. Then, in March 2021, he and Denton completed the David Goggins challenge run -- running 4 miles, every 4 hours for 48 hours. He completed the run with “not today” on the front of his shirt – a new motto.  After the race we wrote a letter of thanks to the Renown Rehabilitation Hospital staff. “I have learned doing ‘hard’ things on purpose is so important. I’ve said this a few times over the past few months after my crash, but I maintain it is the only reason I am still alive. When you do ‘hard’ things, your body (and more importantly your mind) is much better prepared for those unplanned times you face hardships. Maybe even a conversation with death itself, where I somehow had the strength to answer with a firm ‘not today’.”   Brandon describes the rehab hospital as, “A phenomenal facility. Everyone is happy to be there from the doctors, nurses and therapists, to the cleaning staff. Everyone was helpful and nice. They reinforced the positive aspects of my recovery and kept my head in a good spot.”    “Brandon was a great patient and he has made excellent recovery from his brain injury and multiple fractures,” Dr. Williams observes.  Life Goes On These days you can find the Ott family happily spending time with Addison’s new German Shepard puppy Density, camping at Crater Lake for Father’s Day and planning future adventures. Angie reflects, “Life is so precious and tomorrow is never promised.”  Since his crash, Brandon sold all of his motorcycles and now prefers biking on his own power. He even completed a 50-mile ride on July 8, 2021.  “Before this happened, I was on the judgmental side,” Brandon confesses. “This recovery led me to a place of compassion realizing everyone has their own struggles. I’m a much more caring person and am aware how fragile life is. I appreciate life a lot more.”

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Parkinson’s disease – you may have heard of it because Neil Diamond and Ozzy Osbourne were recently diagnosed with it. Or perhaps you know Michael J. Fox is a strong advocate and funds research through his foundation. Neurologist Jonathan Spivack, MD, discusses this disease, while physiatrist Stephanie Jones, DO, explains how physical therapy can help as a supplemental treatment. According to the Parkinson’s Foundation about ten million people worldwide currently have this disease. What is Parkinson’s Disease? “Parkinson’s disease is a neurodegenerative disease that progresses slowly and definitely, though at variable rates,” explains Dr. Spivack. “Symptoms go beyond the classic motor changes. It results from a loss of specific dopamine-producing brain cells. Specifically, this loss is likely due to a mix of genetic and environmental factors,” he adds. Dopamine allows communication between particular nerve cells responsible for movement. If you have Parkinson’s dopamine levels gradually drop, causing a loss of motor skills. Generally, most patients with the disease are over age 65. Early Signs and Symptoms Diagnosing Parkinson’s can be difficult as some of the symptoms happen during the natural aging process. The Parkinson’s Foundation identifies the following 10 early signs of PD: Tremors or shaking of your hand, fingers or chin Small handwriting Loss of smell Sudden movements during sleep Stiffness when walking or moving Constipation Softer or lower voice volume Mad facial expression Feeling dizzy or faint Hunching or stooping posture A single sign may not point to the disease, but if you (or a loved one) has multiple signs, talk to your healthcare provider.

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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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Meet Connor Smith Life was hectic for Connor Smith. He had just finished at the top of his class at both the fire academy and paramedic school and was looking forward to starting work in northern Nevada. It was winter 2019, and he was ready to have some fun. The plan was to ride ATVs at Sand Mountain with his brother Cody, dad Lance and some friends, but a jump would change everything. Connor’s ATV took off but landed awkwardly, and he remembers immediately knowing he was paralyzed. Connor’s mom, Dana Shugar, was at home when she received the upsetting call from Cody, who told her he had an accident. Connor was flown to Renown Regional Medical Center, the area’s only Level II Trauma Center. After a seven-hour emergency surgery, Dana learned that Connor would live but only had a slight chance of walking again due to a spinal fracture. “The surgeon saved his life. It’s amazing how your life can change in a matter of seconds,” she said. Once his condition stabilized, Connor moved to the Renown Rehabilitation Hospital and began physical rehabilitation. “Thank God for the people at rehab,” Dana said. “Dr. Pence, the therapists, nurses and all the employees were a wonderful support system, explaining everything and answering all our questions. The kindness they showed got me through.” Connor agrees, calling the Renown rehab team nothing short of amazing.

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Renown Health has always been on the frontlines of technological advancement, and that innovation remained unwavering during the COVID-19 pandemic. Our telehealth teams heeded the call to provide home monitoring for our patients, transforming how we provide care. The care providers at Renown successfully monitored lower acuity COVID-19 patients from the comfort of their own homes. Bernard Lee was diagnosed with COVID-19 and pneumonia, and was able to return home to continue his recovery with a home monitoring system. While at home, Bernard’s health took a turn for the worse while he was sleeping, but thanks to the continuous monitoring of Health at Home, his worsening vitals did not go unnoticed. “This monitoring system really saved my life,” Bernard said. “It was telling me that my sats were low, but I didn’t even feel the common COVID symptoms; I just felt tired.” Because of his low oxygen saturation (sats) and the continuous monitoring, he woke up to providers calling to check on him in the early morning. He was immediately transferred to the Renown Intensive Care Unit to be cared for and monitored by our expert care teams. Today Bernard is recovering, feeling great and continuously refers to the team and the home monitoring system as his guardian angels.

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