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- Neurology
- Stroke
Are You At Risk For Stroke?
Did you know an estimated 1.9 million neurons and 14 billion synapses are lost per minute during a stroke? That’s why every second counts. Anyone can have a stroke, but your chances increase if you have certain risk factors. That’s why the best way to protect yourself or your loved ones from a stroke is to know the risks and how to manage them. You can make changes to your lifestyle to lower your risk of stroke by asking yourself the following questions: 1. Is my blood pressure normal? High blood pressure is the leading cause of stroke and the most important controllable risk factor. If you’ve had a stroke, lowering your blood pressure can help prevent future strokes. 2. Can I quit smoking? Smoking damages blood vessels, clogs arteries and raises blood pressure — doubling your risk of stroke. If you want to reduce your risk of stroke and heart attack, quitting smoking is the first step — and Renown can help you with this. Learn more: Renown Health Quit Tobacco Program. 3. Do I make time to exercise 30 minutes a day? Many studies link consistent exercise habits with lower stroke risk. Also, being overweight contributes to high cholesterol, high blood pressure, heart disease and diabetes, all increasing your stroke risk. You don’t need to run a marathon — just commit to making time to move each day. 4. Do I regularly eat processed food and sugar? Eating less cholesterol and fat, especially saturated and trans fats, may reduce the fatty deposits (plaque) in your arteries. Also, eating five or more servings of fruits and vegetables per day may reduce your stroke risk. If you are diabetic, follow recommendations to get your diabetes under control.
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- Physical Rehabilitation
- Neurology
Love Endures - A Remarkable Recovery Leads To A New Future
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.”
Read More About Love Endures - A Remarkable Recovery Leads To A New Future
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- Neurology
- Active Living
- Fitness
Keeping Your Brain Healthy, No Matter Your Age
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. MIND your diet The Alzheimer’s Association recommends both the Mediterranean diet and DASH (Dietary Approach to Stop Hypertension) diet. The brain friendly MIND diet is a combination of the two eating plans. MIND stands for the MediterraneanDASH Intervention for Neurodegenerative Delay. This diet tries to prevent dementia and age-related brain decline. To some, this eating plan is common sense — basically eating plants while limiting meat, saturated fat and sugar in your diet. Foods to eat on a MIND diet include: Fish: omega-3 fatty acids are found in fish and some seafood Olive oil: both for cooking and drizzling on salad Vegetables of all kinds: especially green leafy vegetables such as spinach and kale (do not overcook) Berries: the more color the better Fiber-rich foods: this includes oatmeal and beans Unsalted nuts There’s no need to change your diet all at once. One or two changes a week is key for long-term success. Keep in mind, frozen vegetables and berries are just as nutritious as fresh, and often more budgetfriendly. Notably, this diet limits alcohol. Although wine is permitted, it is a modest serving of no more than five ounces per day, no matter the size of your glass. Once you make changes to your diet, it is important to stay consistent. Keep active It’s no secret that a brisk walk is good for your heart and lungs. And it’s good for your brain too. Exercising for 30 minutes a day is also recommended to keep the blood flowing to your brain. Make sure you are getting adequate rest and also challenging you brain with a new hobby, learning a new language, reading books, playing an instrument or even completing word or number puzzles. Sleep A structured sleep pattern, while adhering to overnight sleep of around 7-8 hours, has shown to also diminish risk for dementia. Certainly, your lifestyle affects your brain. With this in mind, we recommend you visit your primary care provider to discuss specific concerns such as diabetes, weight, cholesterol or blood pressure, which affect your brain health. — Rolando Ania, MD, is Division Chief of the Renown Institute for Neurosciences.
Read More About Keeping Your Brain Healthy, No Matter Your Age
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- Neurology
- Stroke
- Women's Health Care
Women And Stroke Surprising Signs To Know
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. Preventing a stroke Although a stroke can happen at any age, the good news is you can prevent it. Unfortunately African American and Hispanic women are more likely to have a stroke than other women, according to the Centers for Disease Control and Prevention. The following lifestyle changes are recommended to prevent strokes: Control your blood pressure Manage your cholesterol Don’t smoke or quit smoking Maintain a healthy weight by eating healthy and exercising regularly Get screened for diabetes Diagnosing sleep apnea and seeking treatment While May is national stroke awareness month, it’s important to know the signs and symptoms of a stroke all year. Especially the non-traditional stroke symptoms in women. You could save the life of your mother, sister, aunt, co-worker, friend, or even your own life. The Renown Regional Medical Center is a Comprehensive Stroke Center, receiving the Gold Plus Achievement award by the American Stroke Association. Our Stroke Program provides primary stroke care including evaluation, treatment and education to patients who arrive at a Renown facility with the signs and symptoms of a stroke.
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- Neurology
- Awards and Accreditations
- Renown Health
Renown Neuro Diagnostic Laboratory Nationally Recognized
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.
Read More About Renown Neuro Diagnostic Laboratory Nationally Recognized
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- Neurology
- Parkinson's Disease
- Renown Health
Parkinson's Disease Know The Important Symptoms
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. Diagnosing Parkinson’s Disease “It is a clinical diagnosis, based on symptoms that evolve over the course of the disease,” says Dr. Spivack. “There is no diagnostic test that can establish the disease.” There are three cardinal symptoms, though only two need be present Tremor Rigidity: stiffness of muscles Bradykinesis: slowness of movements Not all symptoms are present at the outset, but develop over the course of the disease. Diagnosing Parkinson’s disease can be difficult as some of the symptoms happen during the natural aging process. tests are not done for a diagnosis, but to rule out other illnesses than can mimic it. Cause of Parkinson’s Currently the cause of Parkinson’s is unknown, although scientists are researching three main factors. Genetics The environment – Several studies also suggest extended exposure to chemicals and environmental factors may play a part in developing Parkinson’s disease. Aging – Most people develop Parkinson’s at the age of 50 or older, although a small percentage develop Young Onset Parkinson’s disease. Treatment for Parkinson’s “Treating Parkinson’s involves both medication and non-medication based modalities, along with surgery in specific cases,” observes Dr. Spivack. “The mainstay is medication based; all patients with the disease require their use. It is in advanced cases where surgery can be considered.” “Treatments are symptom-based, variable in efficacy, and there is still controversy about when to start. Symptoms are controlled to a degree, the benefit(s) still lost over time, but life span is prolonged. With this comes significant functional disabilities at home, work, etc., all of which need to be addressed,” adds Dr. Spivack. A neurologist is essential in the care of a Parkinson’s patient. “Because the disease has so many different symptoms, the treatments are multifaceted, so must be adjusted patient by patient,” says Dr. Spivack. “With all of these complexities, non-pharmacologic interventions like physical, occupational, speech, and nutritional therapies are critical to maintaining quality of life.” Physical Therapy for Parkinson’s “In addition to medication management of Parkinson’s, physical therapy is an important supplemental treatment of symptoms,” says Dr. Jones. “Continuing to participate in formal physical therapy sessions and maintaining a baseline level of physical activity can preserve, and even improve, a patient’s function, which includes their capability to walk and their balance.” “Physical therapy can also help reduce negative secondary complications such as decreased range of motion of the joints and hardening (or shortening) of tissue,” adds Dr. Jones. “Lastly, it is important to follow a home exercise program, as prescribed by the physical therapist, to continue rehabilitation daily at home.”
Read More About Parkinson's Disease Know The Important Symptoms
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- Neurology
- Multiple Sclerosis
- Fitness
Powerlifting Through MS Diagnosis
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. Shortly after treatment, Tabitha’s father passed away from heart disease and not long after, Tabitha lost her mom. “A turning point in my life to take better care of myself was not a very pretty thing,” she says. “It was losing my parents.” She knew it was time to take her treatment a step further and follow her doctor’s recommendations of following an anti-inflammatory diet and losing weight. She committed herself to being healthy for her family and began powerlifting. “I started training and started really feeling the strength that I was getting.” Tabitha competed in her first United Powerlifting Association Meet and despite her body fighting her as the weight got heavier, Tabitha didn’t give up. “I tried my hardest and I came in third place.” Finding her strength and not letting MS define who she is has been the best part of Tabitha accepting her diagnosis.