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Renown Recognized for Quality Care for Heart Attack & Failure
American Heart Association awards shine national spotlight on care offered in northern Nevada. Renown Regional Medical Center has been honored once again by the American Heart Association (AHA) for high quality heart care. Renown’s focus on quality and applying the most up-to-date, evidenced-based treatment guidelines improves patient outcomes, getting people home sooner and back to doing what they love. “We are pleased to recognize Renown for their commitment to heart failure care,” said Lee H. Schwamm, M.D., national chairperson of the Quality Oversight Committee and Executive Vice Chair of Neurology, Director of Acute Stroke Services, Massachusetts General Hospital, Boston, Massachusetts. “Recognizing the significance of preventing, diagnosing and caring for people with heart and vascular disease, which continues to be on the rise and taking far too many lives, is of critical importance to us at Renown,” says Tony Slonim, M.D., DrPH, FACHE, president and CEO, Renown Health. “We are proud of our incredible team for providing the highest-quality clinical care, and thank the American Heart Association for this national recognition.” Renown Regional was awarded The Get with the Guidelines – Heart Failure Gold Plus Quality Achievement award for continually ensuring heart failure patients receive the most appropriate treatment according to nationally recognized, research-based guidelines, as well as AHA’s Mission: Lifeline Gold Receiving honor for the treatment of patients who suffer severe heart attacks. “Renown offers the most highly-skilled and experienced heart and vascular team and the most advanced heart center in the region. Having national recognition for being the region’s heart care leader is critical to a Destination Health strategy,” said Josiah "Sy" Johnson, MBA, chief of staff for Renown Health. “We at Renown are proud to bring a high level of world-class care providers, leading-edge care and new delivery approaches to meet the needs of people in northern Nevada through our Institute for Heart & Vascular Health.” Why This Recognition Matters to You - Heart Attack Care Every year, more than 250,000 people experience an ST elevation myocardial infarction (STEMI), the deadliest type of heart attack, caused by a blockage of blood flow to the heart that requires timely treatment. Renown earned the award by meeting specific criteria and standards of performance for quick treatment to re-establish blood flow to blocked arteries in heart attack patients. “Our expert staff treat problems that extend from mild to the most critical of emergencies,” said Christopher M. Kozlowski, MD, MHA, vice president and medical director of Renown Institute for Heart & Vascular Health. “Specialized physicians including cardiologists, interventional radiologists, heart and vascular surgeons, emergency medicine and trauma surgeons, primary care providers, nurses and other clinicians work as a team to determine the best treatment plan for each patient. We encourage all patients to discuss with their care team whether they should undergo formal screening for early heart disease.” Why This Recognition Matters to You - Heart Failure Care According to the AHA, more than 6.5 million adults in the United States are living with heart failure. Heart failure patients can lead full, enjoyable lives when their condition is managed with proper medications or devices and with healthy lifestyle changes. “Renown’s reputation as the region’s heart care leader has been built over many years. We performed the area’s first open-heart surgery, angioplasty, stent and valve replacements decades ago. Renown Regional offers incredible advancements like trans-catheter aortic valve replacement (TAVR) and trans-catheter mitral valve repair (TMVr) with MitraClip therapy, lifesaving alternatives to open-heart surgery for patients considered high-risk or inoperable,” said Erik Olson, chief executive officer of Renown Regional Medical Center. “Offering the highest level of comprehensive care for patients experiencing cardiac and vascular disease, Renown developed its first division of cardiothoracic surgery dedicated to heart surgery patients in 2019.” The Renown Institute for Heart & Vascular Health program now offers a Diagnostic Electrophysiology Lab; a Chest Pain Center using the D-SPECT® heart camera; multiple Interventional Labs; Heart Failure Program; several Cardiac Catheterization Labs; Interventional Cardiology and Cardiac Surgery when necessary; and the only Pritikin-certified Healthy Heart Program in the West, creating individualized rehabilitation plans tailored to each patient’s needs, so they can exercise safely, eat healthy, manage stress and cook nourishing, balanced meals, all while gaining a healthy mindset. Renown is among the nation’s top-performing hospitals for heart attack treatment and one of only 105 hospitals nationwide to receive the American College of Cardiology ACTION Registry Silver Performance Achievement Award recognizing success in implementing a higher standard of care for heart attack patients. Renown’s Roseview, Sierra and Cardiac Intensive Care Units (ICUs) are the only ICUs in Nevada to receive the Beacon Award of Excellence from the American Association of Critical Care Nurses. U.S. News and World Report’s Best Hospital rankings recently named Renown hospitals as best in the state of Nevada. Patients in need of advanced heart care can speak with their care provider about Renown Medical Group – Specialty Care, which can be reached at 775-982-6270 or visit renown.org/HeartCare. About Renown Health Renown Health is the region’s largest, locally owned and governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health. Renown’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Heath, Neurosciences and Robotic Surgery. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project®. For more information, visit renown.org. About Mission: Lifeline The American Heart Association’s Mission: Lifeline program helps hospitals and emergency medical services develop systems of care that follow proven standards and procedures for STEMI patients. The program works by mobilizing teams across the continuum of care to implement American Heart Association/American College of Cardiology Foundation clinical treatment guidelines. For more information, visit heart.org. About Get With The Guidelines Get With The Guidelines® is the American Heart Association/American Stroke Association’s hospital-based quality improvement program that provides hospitals with the latest research-based guidelines. Developed with the goal of saving lives and hastening recovery, Get With The Guidelines has touched the lives of more than 9 million patients since 2001. For more information, visit heart.org.
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Snakes! 3 Safety Tips for Outdoor Adventures
Seeing a snake while exploring northern Nevada’s trails is somewhat rare and the chance of a snakebite is even less common. However, it’s important to make sure you’re ready for snakes and know what to do in case of a snakebite. Hiking the rugged, stunning and varied landscapes of northern Nevada is a huge draw for many who live here. But it’s important to stay alert and be prepared while you’re out exploring the natural habitats of wildlife, especially if you encounter a snake or get a snakebite. As you prep for your next outdoor adventure, remember these three tips to stay safe in Nevada’s wilderness. 1. Leave snakes alone In general, if you don’t mess with snakes, they won’t mess with you. Seeing a snake is fairly uncommon because of their body camouflage and secretive nature, which are their first defenses in evading predators. According to the Nevada Department of Wildlife (NDOW), most snakebites happen when a person tries to capture or kill the snake. Nevada is home to 52 species of snakes and reptiles, according to NDOW. Only six can be dangerous to people and pets: Western Rattlesnake (this is the most common type of venomous snake in northern Nevada, especially around Yerington and Fallon) Sidewinder Mohave Rattlesnake Speckled Rattlesnake Western Diamondback Gila Monster (these live in southern Nevada’s Mojave Desert) Venomous snakes, like the rattlesnakes, have a wide head and thick body. Non-venomous snakes are usually more slender and have a narrow head. If you see a snake on the trail and you aren’t sure if it’s venomous or not, it’s best to be safe and leave it alone by moving away slowly. 2. Wear the right gear and take care where you walk NDOW and the U.S. Department of Agriculture suggest doing the following to decrease your chances of a snakebite: Wear over-the-ankle boots, thick socks and loose-fitting long pants. Stick to trails and stay out of the bushes or tall grass. Don’t step where you can’t see. If going over a fallen tree or large rock, step on it. Don’t jump over it. A snake might be lying on the other side. Always check stumps or logs for snakes if you’re going to sit on it. If you see one or hear a rattle, move away from the area slowly. Don’t run or make any sudden movements. Don’t handle or move a recently-killed snake as it can still inject venom. And for your dog, the best way to prevent a snake bite is to keep it on a leash. 3. Know what to do (and not do) if you get a snakebite Renown Health primary care physician Aaron A. Bertalmio, MD, reminds us the odds of getting a snakebite are very low. Roughly 7,000 to 8,000 people get bitten annually and only 5 percent die according to the U.S. Food and Drug Administration. But in the event of a snakebite, here’s what to do: Get medical help as soon as possible Stay calm to help keep your heart-rate low Remove constrictive clothing or jewelry Clean the wound with soap and water if available Cover the snakebite with dry, sterile cloth or adhesive bandage if available Keep the bite snakebite area level and below your heart if possible WHAT NOT TO DO IF YOU GET A SNAKEBITE: Apply a tourniquet (a tool used to stop arm or leg blood flow) Ice the bitten area Suck out the venom You’re now prepped and ready on what you need to know about Nevada’s slithery friends so you can stay safe and enjoy the outdoors!
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Testosterone, Men and Health: What You Need to Know
You probably know testosterone (T) plays an important role in how boys physically develop into men. But is that all you know? What happens when a man's T levels are off? Are there symptoms men should look for? And what are the treatment options? Dr. Bobby Kahlon, MD, Renown Medical Group provides answers in a Testosterone Q&A. What does testosterone do for men? "Testosterone is known as the 'manly hormone' for a reason," says Dr. Kahlon. "Though women also naturally produce small amounts of it, men produce testosterone at much higher concentration levels. And it affects men in more physical and obvious ways. How much hair a man has on his chest, how deep his voice is, or how muscular he is are all attributable in some way to testosterone. It's also responsible in large part for sex drive and bone strength and affects how men think, learn and experience their surroundings." Testosterone in men: Powers virilization (male physical characteristics) and sexual function Builds muscle mass and strength Supports bone density Improves cognition T Trivia: Discover Magazine reveals that “manly” testosterone and other sex hormones evolved long before we did — 500 million years ago — from the ultimate “female” hormone, estrogen. Can you have too much or too little testosterone? Though high testosterone isn't a concern for most men, low testosterone or low T occurs more frequently and develops for two primary reasons. Dr. Kuhadiya explains, "Subnormal testosterone concentrations occur either due to pituitary or testicular failure and the causes for each need to be discussed with your physician." Pituitary failure: Approximately one-third of men with obesity, type 2 diabetes, or metabolic syndrome (which includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels) have low free — or "bioavailable" — testosterone. These health conditions can cause the pituitary gland to "fail" to release follicle stimulating hormone (FSH) and luteinizing hormone (LH) which are essential for triggering testosterone and sperm production. And that can cause low testosterone (hypogonadism). Testicular failure: Though less common than pituitary failure, testicular failure may also be responsible for low T. It's caused by diseases or illnesses affecting the testicles, injury or trauma to the testicles, or certain medicines and treatments such as chemotherapy or opioid pain medication. Providing your complete medical history to your doctor is always the first step toward a proper diagnosis. What are the symptoms of low T? The following indicators could be a sign that you have low T, say the doctors. Lack of motivation and determination, including mild depression Loss of physical endurance and muscle strength Loss of or diminished early morning erections Reduced libido (sex drive) Erectile dysfunction (ED — difficulty achieving or maintaining an erection) Gynecomastia (male breasts) Small testes T and Time: T levels in men naturally begin to decline by about 1% a year starting at age 30. How do you test for low T? "There are different methods for testing testosterone levels," says Dr. Kuhadiya. "Each approach uses a blood sample to evaluate total testosterone, which includes free and attached testosterone that combines with proteins albumin and sex hormone-binding globulin (SHBG). For the most accurate results, testing is based on samples collected in the morning after fasting, and from tests on two different days." What treatment options are available? "Well, your best natural option may be YOU," says Dr. Kahlon. "Men with pituitary failure are often able to treat their low T by losing weight to increase levels of the hormone. And even if you don't lose weight, exercise can help boost your testosterone. Unfortunately, if you have testicular failure, weight loss and exercise may not have the same effect." So, are there other options? "You may want to consider Testosterone Replacement Therapy (TRT)," says Dr. Kuhadiya. "TRT is only available to men who are hypogonadal — with a clinical diagnosis of low T. Injection, gel, skin patch and nasal spray are available TRT options. The best option is the one that works best for the patient. Convenience, insurance coverage and cost are all factors to consider." Dr. Kahlon's TRT preference? Daily gel treatments, which are applied directly to the skin. On the other hand, Dr. Kuhadiya recommends intramuscular injections, which take place once a week or every two weeks. But both doctors agree on this: physicians and their patients need to weigh the benefits and risks of TRT before proceeding with treatment — especially if your low T condition may require lifelong treatment. "In my clinical practice, I have seen some very good long-term results with an improved quality of life," says Dr. Kuhadiya. "However, in certain situations, TRT may increase the risk of heart disease and is not recommended for men with a history of prostate cancer." Dr. Kahlon adds, "Patients receiving any type of hormone therapy need to be closely monitored throughout the treatment process for any changes in their health." How do you feel about steroids and T boosters? "I don't recommend them, certainly not for hypogonadism," advises Dr. Kahlon. "There is no evidence to support anabolic-androgenic steroids or testosterone boosters as a safe or effective treatment for low T in men." "In fact, there continues to be emerging evidence they may lead to side effects that could potentially harm the liver and the pituitary and endocrine functions of the body," warns Dr. Kuhadiya. "And that damage may be irreversible."
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