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Navigating Pain with Renown Spine, Sports & Pain Management
Chances are you or someone you know will deal with chronic pain at some point in life. In fact, in the U.S. alone, one in five adults have experienced chronic pain in recent years, according to the Centers for Disease Control and Prevention (CDC). The road to relief is a frequently traveled one that can be filled with twists and turns, so it’s important for patients to have a trusted provider by their side navigating that journey. We interviewed Dr. Sharlene Su, a pain management physician with Renown Medical Group, who told us what patients can expect when seeking care with Renown Spine, Sports & Pain Management (RSSPM) and all about the variety of pain relief options available to patients. What pain management treatment options are available outside of painkillers? This depends on someone’s root cause of pain. For example, for pain from arthritis of the spine or major joints, radiofrequency ablation can relieve most of the pain for six months to two years, which can be life changing. If someone is suffering from a pinched nerve in the neck or back, an epidural can be useful. Nerve stimulators can also be a great option to relieve pain for years. One of the advantages of the procedures we perform at RSSPM is that they reduce the need for painkillers, which are notorious for having side effects of their own. Physical therapy can also be a very helpful tool to treat pain. It is an exciting time in the field of pain medicine right now because new advances are -constantly being made. At Renown, we pride ourselves on staying current with the most cutting-edge treatments to ensure our patients always have the best available to them. What are some at-home tips and tricks that patients experiencing pain can do on their own for some relief? If pain is related to posture or physical activity, consider doing stretching and strengthening exercises. YouTube can be a great (and free) resource for this. In terms of medications, over the counter topical pain creams can be great. Tylenol is one of the safest pain medications for those without preexisting liver conditions. On a short-term basis, anti-inflammatory medications can often be used safely depending on one’s overall health. Ice and heat can both be useful for treating muscle pain. Can you tell us more about the services Renown Spine, Sports & Pain Management offers? Our team specializes in identifying the root cause of each patient’s pain and partnering with them to develop a custom plan tailored to their individual needs, which can involve injections, physical therapy and medications. We treat patients ranging from top-level athletes, to weekend warriors, to grandparents who’d like to be able to keep up with their grandkids. Once we relieve a patient’s pain, our role then transforms into a coach, educating and guiding our patients on how to prevent their pain from coming back. At RSSPM, you’ll see the same doctor every time, which means that your provider will get to know you very well, and you’ll receive the same high-quality consistent care whenever you come for a visit. Renown has a unique pain management team called “Special Procedures” that not many people may realize is a great option for care. How does this team treat pain? Our Special Procedures team is crucial to the high-quality pain management care that we provide. We have an amazing staff that assists with X-ray guided procedures including epidurals, radiofrequency ablations, joint injections and nerve stimulators. Dr. Casey Keating, our division chief, and I work with this team to ensure that every procedure is done with the same precision, attention to detail and quality. The Special Procedures team regularly receives feedback from patients on how well taken care of they felt during their procedure. If someone is experiencing pain from an injury or even an unknown reason, what should they do to get care for their concerns? Contact your primary care provider for a referral to have an evaluation with us! RSSPM accepts most insurance plans and are proud that our wait times are averaging less than one week to be seen as a new patient. Two more doctors will be joining us in the next few months, which should reduce our wait times even more. There are so many targeted and effective ways to treat pain nowadays, and it is worth addressing to live the life you want to live.
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Department Spotlight: Point-of-Care
When you visit your provider for your annual exam or to address a health concern, or if you’re admitted to the hospital for any reason, lab draws – including blood tests, urine samples and saliva swabs – are common. When it comes to lab draws when you’re sick with a virus, such as strep, flu, RSV or COVID, or routine tests for chronic conditions, such as blood glucose or hemoglobin A1C, the last thing you’d want to do as a patient is wait a long time to get your results back. You’re focused on getting your results, receiving the proper medication and feeling better as soon as possible. Luckily for patients at Renown Health, we have a talented team to meet that need. Meet the Point-of-Care team at Renown, an important subset of the larger Core Laboratory department. With decades of collective experience in the field and some of the finest point-of-care technology at their fingertips, this team works with our healthcare teams to ensure you have access to fast, accurate test results to help you on a quicker road to recovery. Pointed Towards Efficient Solutions Point-of-care testing can be defined as exactly how it sounds – lab testing at or near the patient or their care area, otherwise known as “at the point-of-care.” While our clinicians utilize this specialized equipment every day for point-of-care testing on patients, they rely on the Point-of-Care department for training, everyday guidance, quality checks, audits and leadership. At Renown, Point-of-Care testing is used in nearly every nursing unit across our hospitals and 53 outpatient care locations, including primary care, urgent care, pediatrics and women’s health – alleviating some of the workload of our central lab. Because so many teams rely on this crucial technology and test processes, this team accomplishes a great deal each day, from checking equipment to ensuring test accuracy. “Our day starts early, with our first team member opening the department at 5 a.m. and circulating on the nursing units to address broken point-of-care equipment issues or supply shortages that could impact patient testing,” said Joni Boury, Lab Program Coordinator. “Once the point-of-care scientists arrive, they will address any charting issues that arose overnight and ensure all test results are correctly charted in Epic. After critical issues are addressed, we visit the testing locations and performing audits to ensure all testing equipment is functioning, clean and being appropriately maintained.” In order to provide these efficient tests – in minutes! – to patients anxiously awaiting their results, our first step is to make sure our equipment and processes are up-to-code. Point-of-care testing is regulated at both the state and federal levels, and this team never leaves a checkbox unmarked when it comes to testing regulations. “As a part of the ambulatory side of the Point-of-Care team, I make sure that state and federal licensing is maintained so the practices that perform these tests can continue to perform in-office testing for patients,” said Wende Lane, Clinical Lab Assistant Lead. “I also round in these practices to make sure they are adhering to state and federal guidelines, as well as Renown policies.” And it’s not just existing equipment that needs oversight – the Point-of-Care department also implements new equipment and processes across Renown. These team members are expert jugglers when it comes to this effort, handling training, collaborating with leaders, recommending the proper placement of equipment and much more. "Each day, we work on our many deployments scheduled throughout the hospital and outpatient locations,” said Joni Boury. “That work includes meeting with leaders to ensure new spaces are correctly built to accommodate the point-of-care devices, configuring new equipment, training new leaders and device operators and ensuring appropriate ordering and charting of the test results.” “In being able to perform these tests in the outpatient setting instead of having to send them somewhere else for a test, providers can begin treating their patients within a matter of a few minutes, rather than hours,” added Wende Lane. For a small-but-mighty team of six employees, the heights this team reaches knows no bounds. They’ve celebrated many achievements and expansions this year, including offering new-and-improved PCR testing across various outpatient practices. “Our team has had several notable accomplishments over the past year,” said Breanna Van Dyck, Medical Lab Scientist and Lab Program Coordinator. “We successfully rolled out a massive Cepheid PCR testing initiative to over 30 Renown outpatient locations within the community. This expansion significantly improved our testing capacity and accessibility and will help ensure timely and accurate diagnostic tests for respiratory viruses and strep to a broader patient population, including our rural practices.” By combining cutting-edge technology with compassionate patient care, our Point-of-Care team members are essential to contributing to Renown’s goal of providing efficient, high-quality care tailored to each patient’s individual needs. Take a Point-of-Care Tour! The Point-of-Care department covers a lot of ground around Renown, reaching Reno, Sparks, Carson City, Fernley and Fallon. Take a glance at the photo carousel below to put yourself in the shoes of our Point-of-Care team members on a regular day!
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Tariqs Journey of Resilience at Renown Rehab
Pictured above are members of the interdisciplinary team at Renown Rehabilitation Hospital, representing the diverse array of caregivers who supported Tariq's recovery journey. For Tariq Kuraishy and his wife Melissa, the focus is on his journey and getting back to life as he knew it rather than the stroke he experienced in June 2024, which led him to Renown Regional Medical Center and later to Renown Rehabilitation Hospital (otherwise known as “Renown Rehab”). From the swift assessment by first responders to the immediate treatment at Renown Emergency Room and the critical care received in Renown's Intensive Care Unit (ICU), Tariq’s journey has been marked by resilience and exceptional support beyond the couple’s expectations. Navigating the First Moments After Stroke Melissa shared how Tariq’s care team’s calm demeanor and expertise eased the initial shock of his diagnosis, treatment and plan of care. For Melissa, staying informed during crucial care discussions was vital. She noted that the team's professionalism and reassurance gave her the confidence to let go of some of the mental and emotional burden she felt during the immediate period after the stroke, allowing her to focus on both her and Tariq's physiological and emotional needs. “I felt very safe being at Renown, knowing that we were being cared for to the greatest extent,” said Melissa. Rising to His Personalized Rehabilitation Plan Tariq began the Renown Rehab program on June 19 with one goal in mind: to regain 70% of his brain function within 30 days. To achieve this, he spends four to five hours per day participating in physical, occupational, speech and recreational therapies as part of a comprehensive rehabilitation program tailored to his specific needs. If that sounds like a rigorous schedule, it's because it is, but Tariq prefers it that way because it means he’s actively working towards regaining his sense of normalcy with his care team alongside him every step of the way. “Unlike other places that might take a more lenient approach, the responsibility for progress not only lies with the Renown Rehab team but also the patient. If you are prepared to do the work, Renown Rehab is prepared to get you there,” Tariq said. Melissa emphasizes that Renown Rehab provides comprehensive, whole-person care with a variety of innovative, individualized therapies. These therapies keep patients engaged and busy throughout the day, addressing not just the affected areas but also the entire body and mind, ensuring holistic recovery and facilitating progress in unique ways. Activities like catching a ball or putting a ball in a hole help restore function, much like restoring power to a building that has lost electricity. It’s All About the Support and the Team’s Know-How From the moment he arrived, the Renown Rehab team has been continuously assessing Tariq’s abilities and tailoring his rehabilitation plan to propel him to the next level. Melissa, who spends up to 12 hours a day at the facility supporting her husband, highlighted the daily therapeutic sessions as an impressive way the care team evaluates Tariq’s readiness for more challenging tasks. Communication between the couple and Tariq’s team of doctors, nurses, therapists, techs and certified nursing assistants is constant as they actively involve them in decisions. As Tariq put it, they don’t cater to his comfort zone but instead push for progress, understanding it may not always be linear. It’s a true collaboration. “It doesn’t feel like it's being done to us but being done with us,” Melissa said. Looking Ahead Tariq and Melissa feel immensely fortunate to be at Renown Rehabilitation Hospital, which offers an exceptional blend of equipment, technology and expert care teams. “The Rehab facility is a treasure,” Tariq said. “Every member of the care team has displayed the utmost level of professionalism and expertise, and there hasn't been a single person who hasn't shown compassion and competence,” Melissa added. “I feel I will get the most out of being at Renown Rehab. I plan to take full advantage of the services and use every bit of the team’s talent, training and expertise. I will not leave anything on the table,” Tariq said. As Tariq continues to progress, he and Melissa are optimistic about the future. Tariq continues to receive physical, occupational and speech therapy at Renown Rehab. Their journey, marked by determination and strong support from Renown, offers hope to others facing similar challenges.
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Pediatric Sepsis: Causes, Symptoms and Treatment
Sepsis happens when a person's body reacts too strongly to an infection. Usually, our bodies fight infections with help from our immune system. But with sepsis, the body fights too hard, and that can be dangerous. Dr. Julianne Wilke, Pediatrics and Critical Care Medicine, examines pediatric sepsis's causes, symptoms and treatments and provides tips on preventing this potentially fatal condition. Most Common Causes Pediatric sepsis is a particularly concerning form of sepsis that can occur in children and infants. Therefore, it is vital for parents and caregivers to be aware of the indications of pediatric sepsis and to understand the causes. Bacterial infections are the most common cause of pediatric sepsis, accounting for over 80% of cases. Common Bacterial Causes: Staphylococcus infections (including Methicillin Resistant Staphylococcus Aureas - MRSA) Streptococcal infections (including those causing pneumonia and group B strep) Escherichia coli, or more commonly; E. coli Klebsiella and Pseudomonas infections Viral Infection Causes: Respiratory syncytial virus (RSV) Influenza Parainfluenza Adenovirus Human metapneumovirus Coronaviruses (including COVID-19) Other Causes: Fungal infections (but are relatively rare) Parasites, such as Giardia lamblia Pediatric Sepsis Symptoms Parents and caregivers need to be observant of sepsis symptoms in children and can include: Fever Extremely fast heart rate Rapid breathing Lethargy Pale or discolored skin Low blood pressure Confusion Slurred speech Abdominal pain Diarrhea & Vomiting Decreased urination Difficulty breathing Use the acronym SEPSIS: S – Slurred speech and confusion E – Extreme shivering or muscle pain/fever P – Passing no urine all day S – Severe breathlessness I – “I feel like I might die.” S – Skin mottled or discolored If any of these symptoms are present, seeking immediate medical attention is imperative.
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Know when to visit an ER: Top 5 concerns
When a sudden illness or injury occurs, the emergency room (ER) provides immediate medical attention to those in need. Understanding the top reasons for visiting the ER can help people make informed decisions about seeking emergency care. Here are the five most common reasons people in Nevada visited an ER in 2023. 1. Abdominal pain One of the top reasons people visit the ER is abdominal pain. The abdomen has many organs, including the stomach, liver, small and large intestines, gallbladder and pancreas. Significant pain in this area can be a cause of concern. Warning signs of a serious problem include abdominal pain with fever, vomiting, and not being able to move or perform everyday tasks due to pain. Seeking medical attention when experiencing these symptoms is essential. Emergency physicians can perform abdominal exams, assess the condition and rule out significant threats. 2. Fever High fevers that do not get better with medicine and are accompanied by other symptoms can cause concern. This can indicate that the body is fighting off an infection or illness. Fever with symptoms like vomiting, pain, altered mental status, shortness of breath or inability to perform daily functions are warning signs to watch out for. Adults and children should visit an ER, where the team can assess the causes of the fever. 3. Chest pain and shortness of breath Chest pain and discomfort, or pain in the upper body can suggest warning signs of a heart attack. If a person is experiencing signs of a heart attack, call 911 immediately to ensure timely treatment or assessment by a medical professional. Heart attack symptoms include: Chest pain, including pain that can be described as chest pressure, heaviness or squeezing Discomfort in the chest, arms, back, neck, shoulders and jaw Difficulty breathing Sweating with any of the above symptoms When visiting a Renown ER for chest pain, a trained medical professional will promptly perform an Electrocardiogram (EKG) in an area where preliminary assessments, also known as triage, take place. Individuals experiencing shortness of breath or trouble breathing, whether from a respiratory infection, asthma complications or other pre-existing conditions should not ignore symptoms as these can signify more serious issues. Warning signs of respiratory distress may include: A significant change in breathing rate A significant change in the amount of energy used to inhale or exhale when breathing Changing of the skin color to blue, gray or paleness, which can indicate a lack of oxygen Nasal flaring Chest retractions, which can suggest difficulty bringing air into the lungs What this looks like: the chest sinking in just below the neck, breastbone or rib cage while breathing 4. Neurological symptoms Sudden and severe headaches or seizures may prompt individuals to visit the ER if symptoms are extremely disorientating or debilitating. These symptoms could be indicative of various conditions, including strokes or neurological disorders that require prompt evaluation. If a person is experiencing signs of stroke, call 911 immediately to ensure timely treatment. Stroke symptoms include: Numbness, weakness or loss of movement in the face, leg or arm, especially on one side Confusion, including trouble speaking or understanding Trouble with vision or loss of balance When choosing emergency care for signs and symptoms of stroke, a Comprehensive Stroke Center can provide patients with immediate intervention, including evaluation, treatment and education. 5. Cough/flu-like symptoms Emergency departments are staffed by medical professionals trained to prioritize and treat emergency and trauma situations. Receiving care at an ER should be reserved for severe symptoms and life-threatening conditions. It’s best to schedule a visit with a primary care physician for mild cold and flu symptoms. Most urgent care locations are equipped with rapid testing options, including RSV, COVID-19, influenza, mononucleosis, urinary issues and strep throat. It is critical to distinguish between common respiratory infections and more severe cases, such as pneumonia or complications from the flu. Symptoms that may warrant a visit to the ER include: Rapid decline in the ability to perform regular daily activities Coughing or throwing up blood Severe dehydration and inability to drink fluids High fever not responsive to medication Understanding top ER visits in Nevada While these ER complaints are common reasons for emergency room visits in Nevada, it's important to remember that emergency care is available for all immediate medical needs. Do not hesitate to seek help at an emergency room if someone experiences a sudden or severe health concern. Quick and appropriate action can make a significant difference in keeping you and your loved ones healthy. Renown Health is the largest locally governed, not-for-profit healthcare network in northern Nevada, providing leading emergency and trauma care by board-certified emergency physicians 24/7 at three locations, including the region’s only pediatric emergency department. Renown Health emergency rooms prioritize swift assessments, advanced diagnostic tools and compassionate care, providing leading emergency and trauma care. Trust Renown ER for not just emergency care but exceptional care. Learn more at renown.org/ER.
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Dr. Carilyn Hoffman's Guide to Menopause Medication & Relief
Women undergo multiple hormonal changes throughout their lives, leading to different physical and emotional experiences. Dr. Carilyn Hoffman, at Renown Women's Health, explains these confusing life stages and helps decode menopause. Perimenopause: Transitioning Towards Menopause Defined as the time "around menopause," perimenopausal symptoms are caused by hormonal fluctuations that occur as the ovarian function declines. Levels of estrogen and progesterone decrease, and follicle stimulating hormone increases. These hormonal fluctuations may cause a range of symptoms including: Irregular or abnormal periods: Initially cycles intervals vary in length by greater than 7 days, then in later stages the interval increases to greater than 60 days between cycles Hot flashes and night sweats: This is the most common symptom and 50-82% of women will have vasomotor symptoms Mood swings and memory problems Anxiety or insomnia Heart palpitations Decreased libido and vaginal dryness Weight gain and thinning hair Increased risk of urinary tract infections Decreased bone density Menopause Menopause is defined as year without a menstrual cycle and marks the timeframe when the ovaries stop making estrogen. This signifies the end of the reproductive years. The average age of menopause is 51; however, the menopausal transition can last about 8 years. This means that women in their late 30’s and 40’s may start to have symptoms of perimenopause. The worst vasomotor symptoms are typically experienced at the one-year mark since the last period. Unfortunately, some women experience symptoms throughout the entire menopausal transition. Postmenopausal After 12 months without a menstrual cycle, a woman is confirmed to be postmenopausal. This is sometimes difficult to define, as women may have had procedures that cause menstrual suppression such as a uterine ablation or hysterectomy or they may still be on contraception. Sometimes, lab work may be recommended to help determine menopausal status. However, due to the broad time period that the menopausal transition occurs and the variations in normal hormone levels throughout a cycle, lab work is not always helpful. Dr. Hoffman explains the importance of thorough counseling for patients seeking to "check their hormone levels." She emphasizes that menopause is diagnosed clinically, focusing more on the individual's symptoms rather than lab values. This approach ensures that patients understand the implications of the test results and the treatment strategy. Menopause Medical Management Medical management of symptoms should be tailored to the individual’s concerns. Abnormal Bleeding: There are a range of medications, IUDs and procedures available if the main concern is irregular or prolonged menstrual bleeding during perimenopause. Hot Flashes and Night Sweats: Hormone Replacement Therapy (HRT): HRT is currently the most effective method for relieving vasomotor symptoms. However, it's important to discuss potential risks with a healthcare provider, as HRT can increase your risk of blood clots and breast cancer. If improperly prescribed, it can also increase the risk of uterine cancer. The American College of Obstetricians and Gynecologists recommends the lowest dose for the shortest duration. Low-dose antidepressants: SSRIs/SSNIs may mitigate hot flashes and mood disorders for those who are not candidates or prefer to avoid HRT. Currently, only Paroxetine is FDA-approved for this use. Fezolinetant: This is a newly FDA-approved non-hormonal medication that works at the brain's level to treat vasomotor symptoms. Gabapentin: This is an anticonvulsant medication that has been shown in several studies to be helpful for vasomotor symptoms, but it is not currently FDA-approved. Genitourinary Symptoms of Menopause: Vaginal estrogen: Vaginal dryness and pain with intercourse due to thinning vaginal tissue is a common symptom of menopause. Vaginal estrogen is highly effective at decreasing these symptoms and has fewer side effects than systemic HRT. Ospemifene: This is a selective estrogen receptor modulator that is a non-hormonal FDA-approved medication for severe vaginal dryness. Natural Symptom Relief Strategies: Nutrition: Incorporate calcium, vitamin D, and high-quality protein to support bone health and muscle maintenance. There are limited studies on phytoestrogens (found in soy and tofu) and vasomotor symptoms. While the data doesn’t necessarily support that these phytoestrogens relieve symptoms, no detrimental effects were found and these tend to be high quality and healthy proteins. Exercise: Regular physical activity can ease menopausal symptoms and support weight management. Data doesn’t support that this reduces vasomotor symptoms, but it can be helpful in weight management and sleep quality. Beverage choices: Limiting alcohol and caffeine can help decrease the frequency of vasomotor symptoms and may also improve sleep quality. Alternative remedies: One study shows that Chinese herbal medicine and acupuncture are effective at relieving vasomotor symptoms. There is not enough evidence to recommend Black Cohosh, and it is associated with liver toxicity in high doses. Studies don’t show that St. John’s Wart or Gingko Balboa are any better than placebo. Always mention your alternative medical therapies to your provider as some do interact with other prescribed medications. By understanding and recognizing that the symptoms of menopause are real and treatable, women are empowered to manage this transition better and can maintain their well-being and quality of life. Please schedule an appointment with Renown Women’s Health if you’d like to discuss your menopause symptoms with a provider.
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Healthy Potato Salad A Creamy Dreamy and Light Picnic Favorite
Potato salad is the superstar of summer picnics, a delightful sidekick at backyard BBQs, and a tasty everyday treat! Our friends at Renown's Health Improvement Programs whipped up a fabulous, health-conscious version that doesn't skimp on the creamy dreaminess we crave. This salad features purple potatoes for a dash of delightful color. It's also easy to make, with protein-rich Greek yogurt and egg whites. This simple but classic dish will indeed become your circle's new favorite—talk about a tasty transformation!
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Nourishing Your Loved One Through Cancer Treatment
Eating healthy is a daily challenge for many, but for those with cancer, it is an even harder struggle. A cancer diagnosis affects not only those diagnosed but family members and friends, too. One key area of concern is making sure your loved one stays well by eating healthy food every day. Here are some vital cancer nutrition tips from Jessica Blauenstein, a Board Certified Specialist in Oncology Nutrition and Registered Dietitian at Renown Health. Help to Prepare Meals and Snacks for Daily Cancer Nutrition Make it grab and go. Easy-to-make meals help reduce the burden of having to cook and prepare food. Having easy to grab snacks on the counter or in the fridge can help ensure your loved one has access to those nutrients when needed. Sit outside of the kitchen. This allows your loved one to avoid cooking smells which can make them feel sick as a side effect of cancer treatments. Also try serving them cold foods such as sandwiches, cheese and crackers, or shakes which have a mild scent. Try drinkable meals. Some people with cancer find it easier to sip their calories over the course of 30 minutes to an hour. Consider smoothies or supplemental shakes such as Ensure Complete, Fairlife shakes, Orgain shakes, or Boost Plus to name a few. A great foundation for a smoothie is a protein source (Greek yogurt, protein powder, nut butters or milk) with a carbohydrate (fruits, juice or berries). Add other ingredients as desired, such as spinach, kale, and ground flaxseed or chia seeds to give it more vitamins, minerals, and fiber. Snack Ideas for Those Undergoing Cancer Treatment The following ideas are both quick and easy to make for your loved one. Chicken or tuna salad with whole grain crackers or as a sandwich on whole grain bread Greek yogurt mixed with cereal, fruit and/or nuts Cottage cheese with banana, cinnamon and/or peanut butter Favorite fruit with 100% natural peanut or almond butter spread - Try peanut butter with bananas, apples, or even celery Their favorite veggies dipped in a salad dressing of your choice - For example, carrots with hummus, tahini, or ranch dressing Cheese and whole grain crackers - Add tomato slices with a small amount of avocado, and a dash of oregano on top for more flavor Eggs scrambled with cheese, vegetables and/or salsa Peanut butter and jelly sandwich on whole grain bread A baked sweet potato with some favorite toppings Hard boiled eggs and/or egg salad with whole grain crackers, or as a sandwich on whole grain bread Oatmeal or cream of wheat prepared with milk, fruit and/or nuts Sometimes your loved one may not feel like eating or refuse to eat. If treatment side effects are impacting your loved one’s ability to eat, please visit the websites below containing recipes tailored to treat side effects. Cook for Your Life ELLICSR Of course, you may also consult a registered dietitian and/or the patients care team, if you have more cancer nutrition concerns.
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Department Spotlight: Pharmacy
When it comes to each patient’s healthcare journey, medication is often a key chapter. After all, medication is one of the most common treatment methods to help patients on the road back to health. In 2023, 4.83 billion prescriptions were filled in the U.S., and with this number only anticipated to rise annually, having an expert pharmacy team on your side to make certain you are prescribed the ideal dosage to treat your condition, prepare your prescriptions on time and help you manage your medications responsibly is important. Fortunately, at Renown Health, we have best-in-class inpatient and outpatient pharmacy teams to fill both prescriptions and promises for excellent care. Renown Pharmacy plays a vital role in helping us foster a health system that prioritizes patient well-being above all else. This department exemplifies the impact that a unified, expert pharmacy team can have on patient outcomes now and in the future. The Masters of Medication Spanning three hospitals plus ambulatory locations across the health system, Renown’s growing pharmacy team – full of dedicated pharmacists, pharmacy technicians and even medical assistants – manages medications in a wide variety of patient settings, touching nearly every aspect of the healthcare continuum: Outpatient Retail Pharmacies Renown Regional Medical Center – 75 Pringle Way The Healthcare Center – 21 Locust Street Renown South Meadows Medical Center – 10101 Double R Blvd Inpatient Pharmacies Renown Rehabilitation Hospital Renown Regional Medical Center (including Renown Children’s Hospital) Renown South Meadows Medical Center COMING SOON: Conrad Breast Center Pharmacy (in honor of Kristina Ferrari) in the Specialty Care Center at Renown South Meadows Ambulatory Pharmacies Anticoagulation Services – Institute for Heart & Vascular Health (IHVH) Pharmacotherapy Program – IHVH and Renown Medical Group Locations Congestive Heart Failure Pharmacotherapy Program – Center for Advanced Medicine B at Renown Regional Chronic Obstructive Pulmonary Disease (COPD) Pharmacotherapy Program – Renown South Meadows Endocrinology Pharmacotherapy Program – Renown South Meadows Additional Pharmacy Programs Medical Reconciliation Pharmacy Residency Clinical pharmacists at Renown bridge the gap between medicine and compassionate support, making sure each patient receives personalized care one prescription at a time. “There are various roles pharmacists play within Renown,” said Clarissa Munoz, Clinical Pharmacist in the Renown Regional Inpatient Pharmacy. “Staff pharmacists work diligently to ensure correct medications are dispensed, and if compounded, make sure they were prepared properly. They also work hard to answer medication messages and phone calls, help verify orders and make sure ode trays/RSI kits are appropriately stocked and ready when needed. Clinical pharmacists work from satellite pharmacies on the floor and focus on reviewing patient charts and aim to provide additional interventions to the providers to optimize treatment strategies. We also serve as a resource for nursing staff and help answer medication questions.” “My role in the pharmacy is pretty expansive,” added Chanelle Ajimura, Clinical Pharmacist in the Renown Regional Outpatient Pharmacy. “I maintain inventory to confirm patients can receive their medications in a timely manner both for our discharge and retail patients while balancing the Meds to Beds program, which offers medication delivery to the bedside and bedside medication counseling; collaborating with an interdisciplinary team to find the most affordable price for patients; and verifying that the dose, strength, indication, etc. is appropriate for the patient from start to finish.” “In the pharmacy, I make sure patients are receiving appropriate drug therapy by checking for major drug interactions and ensuring appropriate dosing,” added Courtney Church, Clinical Pharmacist in the Renown Regional Outpatient Pharmacy. “I also make recommendations to providers so patients can get cost-effective therapy.” Our pharmacy technicians work behind-the-scenes ensuring efficient medication management, making a difference in the lives of patients every day. “A pharmacy technician is responsible for making sure the patient gets their medications on time and at the lowest price possible,” said Nate Graham, Pharmacy Technician in the Renown Regional Outpatient Pharmacy. “This is done by working with patients, insurance companies and case workers. We fill prescriptions, enter prescriptions into our system, receive and send orders for medications and maintain a clean pharmacy with an accurate inventory.” “We do a variety of things; the task people probably know the most is counting out the medications and putting them in the amber vials,” added Rachel Vallin, Pharmacy Technician in the Renown Regional Outpatient Pharmacy. “We also help patients at the front of the pharmacy, ring out their prescriptions, answer some basic questions (deferring to a pharmacist as necessary) and billing insurance. Meds to Beds is my favorite part because I feel the most involved. I take medications to patients who are discharging up to their hospital rooms so they have it with them when they leave.” “As a technician, I confirm that all medications of new admissions are available in our machines prior to admitting and then maintain stock during each patient’s stay,” added Tammara Axtman, Pharmacy Technician at Renown Rehabilitation Hospital. "I also assist our nurses when needed in regard to any of their questions with both EPIC and Omnicell.” Our pharmacy team is also on the move all across our health system, thanks to our Ambulatory Pharmacy programs. For patients experiencing a serious heart, lung, or endocrine condition that requires ongoing drug therapy maintenance and guidance, our ambulatory pharmacies step in to carefully monitor how their medications impact their health and well-being. “Our role as pharmacists in this department is non-traditional because we actually see patients in the exam rooms face-to-face,” said Cory Lankford, Ambulatory Care Clinical Pharmacist for Renown’s Anticoagulation Services. “We modify their medication regimens and drug recommendations under collaborative practice agreements.” “Because our role is so unique, we have a lot of opportunities to make a positive impact on patients,” added Janeen Abe, Ambulatory Care Clinical Pharmacist for Renown’s Anticoagulation Services. “We do a lot of direct patient interaction, including counseling patients on their medications and helping them navigate through their disease state.” “As a medical assistant in this department, we’re called the patient ‘liaisons’ to orchestrate who they should go to whether it’s a nurse, a provider or a pharmacist,” added Kiara Scruggs, Medical Assistant for Renown’s Anticoagulation Services. “We look at each patient’s medications and help with the Warfarin blood thinner monitor. We get to do a lot with patients." A key resource within the Pharmacy department and the emergency admission process, our Medical Reconciliation ("Med Rec") team stays on top of each patient's medication records. By ensuring each medication regimen is accurately reflected in each patient's chart and that patients continue to take their at-home medications while admitted to the hospital, this team provides vital insight into medications that could be a contributing factor to each patient's symptoms, including drug interactions. “Our medication reconciliation pharmacy technician team are true detectives,” said Heather Townsend, Clinical Pharmacy Supervisor. “When a patient arrives to the hospital, Med Rec works with patients, families, caregivers and outpatient pharmacies to compile a list of medications the patient has been taking a home. This list is used to make sure medications are not contributing to the patient’s symptoms and to assure medications are continued throughout the hospital stay. The addition of the medication reconciliation team has been one of the greatest advancements in medication safety.” “As a Med Rec Tech, we interview patients and family members and call pharmacies, skilled nursing facilities, etc. to obtain an accurate and complete medication list/history to outline what the patient is currently taking on a daily basis,” added Kara McGee, Medical Reconciliation Pharmacy Technician. “We make sure that we document the correct medication, dose, route, frequency and directions. This information is crucial because the nurses, pharmacists and physicians look at our work to figure out if any medications are contributing to the patient's health condition, and for the continuation of home medications on admission.” “Even though the Med Rec Tech might seem small in the hospital realm, it is very vital for patient information and beneficial to the patient's health,” added Brizza Villafan, Medical Reconciliation Pharmacy Technician. “There is never a dull moment in this work.” No matter the diagnosis, having Renown Pharmacy as an integral part of your healthcare team is a win-win situation for both you and them: you receive access to medication to help you heal, delivered to you with precision and care, and the pharmacy team has the opportunity to care for you and make a positive impact, a role they take seriously.
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Optimizing Mammogram Screenings: A Genetic Approach to a Personalized Screening Schedule
© Arthon Meekodong via Canva.com Breast cancer screening has long been a cornerstone of women's healthcare. With 1 in 8 women diagnosed with breast cancer in their lifetime1, the United States Preventive Services Task Force (USPSTF) has developed screening recommendations to help detect early-stage cancer. Notably in 2023, the USPSTF revised the recommended age for biennial mammogram screenings for women with average risk to start at age 40 instead of 502, estimated to result in 19% more lives being saved3 by starting screening earlier. While initiating screening at an earlier age offers advantages to a wide demographic, concerns about the potential of over-screening prompted research into the feasibility of identifying women with lower breast cancer risk who could safely delay mammograms. While guidelines address high-risk individuals, a notable gap exists in providing recommendations tailored to those at lower risk. To gain insight into a patient's risk level, physicians are able to utilize genetic testing to understand an individual's genetic makeup, providing precise insights into their predisposition to various health conditions, including breast cancer. Armed with this genetic information, healthcare providers could craft tailored screening strategies that align with an individual’s specific risk profile. This genetic risk-based approach underscores the value of genetics in individualizing the onset of screening to help avoid over-screening and its associated costs. Surprisingly, genetic information is not currently being widely utilized to identify women at risk of breast cancer or other diseases in clinical practice, despite its potential to make a significant positive impact for patients. A recent retrospective analysis of 25,591 women from the Healthy Nevada Project4 sheds light on the potential benefits of this genetic risk-based approach. The study classified 2,338 (9.1%) of these women as having a low genetic risk for breast cancer. What's remarkable is that these women exhibited a significantly lower and later onset of breast cancer compared to their average or high-risk counterparts. This finding suggests that it might be safe for low-risk women to delay mammogram screening by 5 to 10 years without compromising their health.
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What You Need to Know About RSV
Respiratory syncytial virus, also known as RSV, is a common respiratory virus that impacts the lungs and breathing pathways. The virus can be dangerous for infants and young children and is also concerning for older adults. While most older kids and adults only experience cold-like systems and recover in a week or two, an estimated 58,000-80,000 children younger than 5 years old are hospitalized due to RSV each year, and in 2022 healthcare organizations across the country are experiencing higher infection rates than in years past. "We are experiencing a strong RSV season and do not expect it to go away anytime soon," said Dr. Kris Wilson, Division Chief of Renown Children's Primary Care. "Infants who are infected with RSV almost always show symptoms of runny noses and cough. Call your healthcare provider immediately if your child is having difficulty breathing, is not drinking enough fluids, or is experiencing any worsening of these symptoms.” Symptoms of RSV: Runny nose Decrease in appetite/inability to drink Dry diapers, an indication of dehydration Cough, which may progress to wheezing or difficulty breathing Irritability (most common in very young infants) Decreased activity (most common in very young infants) Decreased appetite (most common in very young infants) Apnea, pauses in breathing for more than 10 seconds (most common in very young infants) What to do if you think your child has RSV: Call your pediatrician! If you suspect your child might have RSV, consulting their healthcare provider is the best first line of defense. From here they will help you build an appropriate treatment plan for child. Keep in mind that many pediatrician offices offer 24/7 call lines. If your child is experiencing retracted breathing (when the area between the ribs and in the neck sinks in when a person attempts to inhale), dehydration (not drinking and decrease in wet diapers) or apnea (pauses in breathing for more than 10 seconds) please call 911 or go to the closest emergency room.
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Department Spotlight: Special Procedures
Chronic pain can be one of the most distressing feelings someone may encounter – and more likely than not, you know someone who is managing their pain as a part of their healthcare journey. In fact, according to the Centers for Disease Control and Prevention, about 1 in 5 U.S. adults have experienced chronic pain in recent years. One of the most common methods of treating pain is through prescription pain medications; however, with the rise of the opioid epidemic across the country, leveraging other interventions to help patients manage their chronic pain has become increasingly more important. What if there was a way to treat pain directly without the automatic need for pain medication? Luckily for patients in northern Nevada, our Special Procedures department at Renown Rehabilitation Hospital specializes in exactly that: interventional pain mitigation sans painkillers. With nearly 95% of their patients who come in with pain-related mobility issues being able to physically walk out of the hospital after their treatment, much-needed relief is clearly in store. Tight-knit and forever-caring, the Special Procedures team knows how to transform the purpose of pain management. A Penchant for Pain Alleviation Renown's Special Procedures team offers a wide variety of pain management solutions that are uniquely tailored to each individual patient’s needs. With the help of a team of 14 attentive nurses, interventional radiology technologists and a surgical technician – plus a dedicated patient access representative ensuring everything goes smoothly behind-the-scenes – these lifechanging interventions include: Epidurals (including steroid epidurals) Nerve blocks Ablations Tenotomies Spinal cord stimulator trials Peripheral nerve stimulator trials The nurses on this specialized team guide patients before, during and after their procedures, making sure they are at ease throughout the entire process. Each nurse emulates both expertise and empathy to help light the path towards healing. “Before each procedure, we get the patient’s vitals, health history and work with the doctor to answer any questions they may have about what is going to happen in the procedure room,” said Michon Edgington, RN. “After they’re all done, they come back to me, and I make sure they are ready to go home by educating them on their discharge. Our goal is to get them back to their families very quickly.” “In the actual procedure room, we perform safety checks, do charting, prepare the sterile tray for the doctor and give medication for conscious sedations, all while consistently monitoring the patient and helping the doctor out along the way to help the procedure go well,” added Shannon Boelow, RN. This team’s dedicated imaging professionals harness expertise that goes beyond capturing images. Their skillful utilization of X-ray technology serves as a guide for doctors administering treatments for pain – and according to our own physicians, our imaging technologists are some of the best in the business. “Our X-ray skills here are specialized,” said Julie Smith, Imaging Lead. “Visually, the doctor needs to see what’s going on inside the body so they can accurately place needles and steroids. We all work together collectively and work with each doctor to accommodate their preferences, helping the treatments go much faster and minimizing the patient’s exposure to radiation.” Serving as the ideal representation of both precision and support, the surgical technician on this team is an important collaborator in the procedure room, helping to ensure the success of every interventional procedure with a meticulous eye for detail. “As the Special Procedures surgical technician, I get the room ready with all the necessary instruments, including making sure everything is sterile,” said Carrie Crow, Surgical Technician. “I enjoy keeping the team organized.” Overseeing it all are the physicians, who are eternally grateful for the team for the life-changing interventions they offer every day. “Our physicians are so phenomenal,” said Brittney Summerfield, Manager of Nursing. “They are very supportive and collaborative, and they always do the right thing. They have total confidence in us.” Seeing patients walk out of the hospital happy and healthy is a driving motivator for this team. Whether they had significant experience in pain management or were ready for a completely new challenge, each team member comes to work every day inspired to move mountains. “I had worked in pain management in other facilities, and I was extremely excited to come here and solely focus on pain,” said Jodi Eldridge, Supervisor of Special Procedures. “I enjoy seeing the patients so happy when they leave no longer in pain. I feel immediate gratification, because you truly feel like you’re doing something big for the patient. It’s very rewarding.” “I decided to come work here because I worked in the inpatient setting for a long time, and I was ready to see a different side of healthcare and provide a different type of care to our community; plus, my coworkers are the best,” added Lisa Dunnivant, RN. There’s no question that the realm of pain management is a delicate one – and there is no team better suited to take on that challenge than Special Procedures, working harmoniously to bring relief and a renewed sense of livelihood for every patient they serve. “Some people believe pain management is just all about pills, and that is simply not true,” said Carrie Crow. “Our procedures are yet another way to help them manage their pain and find relief.”