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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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Use Caution: Mixing Over-the-Counter Medications Can Be Harmful
When you’re too sick to go to work but not sick enough for a doctor’s visit, over-the-counter medicines are a welcome relief to help alleviate that fever, runny nose or allergies. But because those medicines aren’t signed off on or managed by your doctor and pharmacist, you must be especially mindful of what you put into your body. Whenever you pop a pill, you want to ensure you’re taking the correct dosage, waiting the right amount of time before taking another dose and not mixing certain medicines. Too Much Tylenol/Acetaminophen Tylenol — or acetaminophen — is a popular pain reliever for many, but too much can be bad for your liver. “Our bodies have a finite ability to metabolize Tylenol,” says Andy Wright, clinical pharmacist at Renown Rehabilitation Hospital. “When too much builds up in the liver, it becomes toxic. In patients with medical conditions like cirrhosis of the liver or hepatitis, this could be disastrous.” Remember, acetaminophen is in more than just Tylenol and generic pain relievers. You may also see acetaminophen in flu, cold and cough medicines, like Nyquil, and some prescription medications including Norco and Percocet. Keep a list of the medications you take, and limit daily acetaminophen use to 3,000 mg per day. When you’re scanning medicine bottle contents, remember acetaminophen is also referred to as APAP, AC, acetam or paracetamol. Mixing Painkillers When you’re dealing with pain and not getting any relief, taking a different medication may seem like the easy solution. Maybe you take some Aleve — a form of naproxen — for a headache, but it isn’t working, so you switch to Motrin, an over-the-counter form of ibuprofen. Not a smart idea. Ibuprofen and naproxen along with aspirin are known as nonsteroidal anti-inflammatory drugs (NSAIDS). Because these medicines work in similar ways, they should never be combined or used in larger doses or more frequently than directed. Otherwise your risk of side effects can increase, which range from mild nausea to severe gastrointestinal bleeding. It’s also important to consider your family history when taking NSAIDs because, “recent studies have shown NSAIDs may have greater cardiovascular risks for people taking blood thinners or those with hypertension,” explains Andy. “A good example is ibuprofen: It has a relatively low gastrointestinal bleed risk while it has a moderate to high cardiovascular risk. The opposite is true for naproxen.” Rather than experimenting with multiple medicines, figure out which drug works best for you. You may find muscle soreness improves with aspirin, whereas when a headache hits, naproxen is best. Keep in mind that these medications aren’t always best for everyone in the family. “Aspirin in children and teens is not recommended unless under the supervision of a doctor,” Andy says. And pregnant and lactating women should generally avoid NSAIDS due to risk of birth defects and bleeding. “In both of these cases, acetaminophen or Tylenol are preferred but only if approved by an OB/GYN.” Fighting Allergies Over-the-counter antihistamines like Claritin, Zyrtec and Allegra have made fighting itchy eyes and runny noses a little easier. But these daily medicines — when taken inappropriately or in the wrong combinations — can also have an adverse effect. Similar to acetaminophen, you need to watch for antihistamines in other products. Sleep aids — like Tylenol PM and Unisom — commonly use an antihistamine known as diphenhydramine, which may increase your risk of overdose. “Combining antihistamines, or overdosing, can cause many adverse effects including dry mouth, blurred vision — even arrhythmias,” Andy says. “Only take these medications on their own.” If you’re still struggling with symptoms, you can talk to your doctor about adding an over-the-counter nasal steroid. Andy confirms the importance of closely following the directions listed on antihistamine (and all medicine) bottles. He has seen extended release nasal decongestants cause significant arrhythmias requiring medical care after a patient took the medicine with warm fluids. “The decongestant in question is designed to slowly release, but it can dissolve suddenly in the presence of warm liquids like coffee,” Andy explains. “This can cause the pill to deliver 12 to 24 hours of medication all at once.” Taking an Antidiarrheal with Calcium Calcium supplements and antidiarrheal medicines are another harmful combination. Calcium firms up your stool, but if taken with an antidiarrheal, can cause severe constipation. If you need to take an antidiarrheal, take a break from your calcium for a few days until you’re back to normal. Another consideration when taking calcium supplements or calcium-based antacids is gas. “I’ve had several patients report cases of excessive gas using Tums or calcium carbonate-based supplements.” Andy suggests instead “trying Maalox or Mylanta for indigestion and Citracal as a supplement.” Talk with Your Doctor or Pharmacist About Your Medications If over-the-counter drugs aren’t providing the relief you need, it’s time to see your doctor. And remember, for your safety it is important to keep your doctor and pharmacist up-to-date with any medications — prescribed or over-the-counter — that you are taking.
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Research Shows Genetic Approaches to Breast Cancer Screenings Yield More Accurate Results
Clinical researchers with the Healthy Nevada Project co-author research paper with findings that emphasize the need for a comprehensive approach to breast cancer risk assessment – including a focus on genetic medicine – to help ensure that individuals at high risk are identified and supported proactively rather than reactively. Breast cancer is a leading cause of cancer death among women in the United States. According to the American Cancer Society, about 1 in 8 women will develop breast cancer and about 1 in 39 women will die from breast cancer. Breast cancer is associated with increased age, hereditary factors, obesity, and alcohol use. Since 1990, breast cancer death rates have declined progressively due to advancements in treatment and detection. In Nevada there are an estimated 2,310 new breast cancer cases a year, and genetic mutations such as in the genes BRCA1 or BRCA2 remain a top risk factor for this prevalent disease. Recognizing the urgency for progress in breast cancer research, a collaborative effort between physicians, advanced practice providers and scientists from the Healthy Nevada Project® (HNP) and Helix have unveiled groundbreaking research. This study explores how genetic screenings are a necessary supplement to traditional testing methods, together offering more accurate insights into a patient's likelihood of developing breast cancer in the future. HNP is operated by Renown Genomic Medicine and the Institute for Health Innovation and is one of the largest community-based population health studies in the country. Their team works in collaboration with Helix, a leader in precision health that delivers comprehensive genomic solutions. Together, this dynamic partnership aims to understand breast cancer risk factors and pave the way for more effective preventative measures. The combined research team studied 25,591 female HNP participants to evaluate the performance of different genetic screening approaches to identify women at high risk of breast cancer. The results of this research suggest that a combined monogenic, or single-gene, and polygenic, or multi-gene, approach to breast cancer screenings helped produce more accurate results and more closely identify study participants who have a high genetic risk of developing the disease. "Based on this research, we are advocating a shift in approach which would improve breast cancer risk assessment through a combination of effective family history ascertainment and genetic screening,” said Joseph Grzymski, PhD, principal investigator of the Healthy Nevada Project, research professor at the University of Nevada, Reno School of Medicine and co-author of the breast cancer research paper. “This tailored approach, founded on the assessment of individual genetic risk, not only intends to elevate patient well-being but also will improve efficiency and equity in healthcare." Complementing the team’s research on leveraging genetics to identify women at low genetic risk of breast cancer that could safely defer mammogram screenings by five to 10 years that was released in late 2023 in JAMA Oncology, the study suggests that incorporating genetic information can assist in personalizing breast cancer screenings and optimizing the use of screening resources. "Existing disparities persist across various facets of breast cancer screening and treatment; however, genetic screening is clearly a powerful tool to help facilitate early intervention for those at higher risk,” said Jamie Schnell Blitstein, APRN, a primary care nurse practitioner at Renown Health and co-author of the breast cancer research paper. “By placing a heightened focus on risk, we underscore the pivotal role of preventative breast cancer screening.” Despite the availability of effective methods for early screening, co-authors of this research found that 78 percent of women with a family history of breast cancer had their risk ascertained only after a breast cancer diagnosis. The findings emphasize the need for a comprehensive approach to breast cancer risk assessment – including a focus on genetic medicine – to help ensure that individuals at high risk are identified and supported proactively rather than reactively. “These findings that can profoundly impact how healthcare is delivered were only made possible by all the participants who were willing to consent to research,” said Alex Bolze, PhD from Helix and co-author of the publication. “Broad-scale collaboration projects like these between Renown Health and UNR that engage large populations where participants share both their genetic information as well as electronic health records drive advancements in preventative medicine, as well as fundamental biological research.” The research paper was officially accepted on Jan. 29, 2024, and will be published by Elsevier, Inc. on behalf of the American College of Medical Genetics and Genomics. The contents of the paper will appear in the international journal Genetics in Medicine Open. Read the full article by visiting sciencedirect.com. The Healthy Nevada Project is currently recruiting new study participants. Free to all Nevadans with a saliva sample or blood draw, participants and their referring providers receive access to whole-exome sequencing and clinical grade results that help provide insight into their unique genetic risks tied to heart disease and certain cancers. If you are interested in enrolling in the study, schedule a Virtual Consent Appointment through MyChart or contact the Renown Institute for Health Innovation at RenownIHI@renown.org or (775) 982-6914 to be connected to a Genomic Representative. About Renown Health Renown Health is the region’s largest, 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 is currently enrolling participants in the largest community-based genetic population health study, the Healthy Nevada Project®. To join the Renown Health team, visit renown.org/careers. About Helix Helix is the leading population genomics and viral surveillance company operating at the intersection of clinical care, research, and data analytics. Helix enables health systems, life sciences companies, payers, and government partners to accelerate the integration of genomic data into patient care and public health decision-making. Learn more at helix.com.
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COVID-19 Vaccines to be Administered to Those 75 and Older by Renown Health
Beginning Thursday, January 14, 2021, in order to quickly vaccinate additional residents of Washoe County age 75 and older, Renown Health is pleased to partner with the Washoe County Health District to help distribute the initially available, limited supplies of COVID-19 vaccines. Those who are 75 years or older interested in joining the waiting list for an appointment at Renown’s Drive Thru COVID19 vaccination clinic, will need to download Renown MyChart, if they currently do not have an account. Residents do not need to have a Renown Health provider to enroll. Residents will be notified through their MyChart account when appointments are available. The vaccine clinic is operating by appointment only. Due to limited resources and the limited vaccine available, initially the Renown COVID-19 Vaccination Program will concentrate on vaccinating those 75 and older at this time in Washoe County. Per Governor Sisolak, and the state’s vaccine rollout plan, once those 75 and older have the opportunity to receive the vaccine, the next general population priority group is those who are 70 and older. In addition, Renown Health patients and members of Senior Care Plus/Hometown Health aged 75 and older are will be notified through their Renown MyChart accounts as appointments become available. Once an appointment is confirmed, instructions are given on how to obtain the vaccine. “We remain steadfast in our determination to fight the good fight for our community. Being able to administer COVID19 vaccines is incredibly gratifying. The tragedy of COVID-19 is that the mortality rates, or the risk of dying, is highest in this generation,” said Tony Slonim, MD, DrPH, President & CEO of Renown Health. “We are pleased to be part of the solution, to bring hope and to make a genuine difference in the health and well-being of others.” Age increases risk for severe illness & hospitalization According to the CDC, the risk for severe illness with COVID-19 increases with age, with older adults at highest risk. The greatest risk for severe illness from COVID-19 is among those aged 85 or older. Severe illness means that a person with COVID-19 may require hospitalization, intensive care, or a ventilator to help them breathe, or they may even die. In Washoe County alone, there are 29,034 people 75 years or older and Renown is only receiving limited supplies of the vaccine. Older adults are at greater risk of requiring hospitalization or dying if diagnosed with COVID-19. As you get older, your risk of being hospitalized for COVID-19 increases. For those aged 75 and older, the risk of hospitalization is eight to 13x higher, with deaths 220-630 percent higher than for younger adults. Compounding the risk for COVID-19 for older adults is a weakened immune system. “Because the immune system generally weakens with age, it’s important that older adults get a vaccine to help their bodies form a defense against COVID-19” says Derek Beenfeldt, MD, Chief Medical Officer for Hometown Health, the insurance division of Renown. “Please get vaccinated, unless you are sick or have significant allergic reactions to vaccines." You are advised not to receive the vaccine if: You are ill at the time of vaccination (fever, shortness of breath, vomiting, diarrhea or acute illness). You have been diagnosed with COVID-19 in the previous 14 days. You have received any other vaccination in the last 14 days. You have a history of significant allergic reaction to this vaccine or any of its ingredients. Due to unprecedented demand, Renown is coordinating with local and state agencies to ensure every person has an opportunity to receive the vaccine over time. Downloading MyChart is not a guarantee of an appointment. Register for MyChart to be notified when you are eligible to make an appointment to receive the vaccine Renown Health will contact residents when it is time for them to receive their vaccine. Please do not contact a Renown doctor/health care provider at this time to schedule a vaccine appointment. Instead, all are encouraged to register for a Renown MyChart account if you have not already. The intricacies of vaccine administration Renown Health has been able to distribute and administer the COVID-19 vaccine to a record number of people in the shortest possible time. Much of this success is due to the use of a convenient patient electronic medical record, called Epic MyChart, which allows people to be notified that the vaccine is available, schedule their appointments online, complete the consent form and have full documentation. In addition, the information automatically posts to Web IZ Nevada’s Statewide Immunization Information System. Stay Up-to-date on COVID-19 Renown Health is prepared to safely screen, diagnose and care for patients with respiratory illness, including COVID19. To stay up-to-date on communications regarding Renown’s distribution of the COVID-19 vaccine, FAQs and the scientific evidence behind the vaccine, visit https://renown.org/covid/ Join the Renown team Renown Health remains committed to hiring key roles in our organization to support the health and well-being of our community. To join the Renown family to Fight the Good Fight, apply online at https://careers.renown.org/ 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 notfor-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®.
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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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As Community COVID-19 Cases Rise, Renown Prepares
Alternate Care Site opens today in Renown Regional Mill St. Parking Structure to serve additional hospitalized patients diagnosed with COVID-19 who are clinically stable or improving. Across the country, there is an increase in COVID-19 cases including significant increases in hospitalized patients. As Nevadans experience the impact of the pandemic, the Renown Health team continues to be prepared to serve the community. At this time, based on the number of patients hospitalized for COVID-19 and seasonal fluctuations, Renown Regional Medical Center and Renown South Meadows Medical Center are experiencing inpatient hospital capacity challenges. Being prepared for these patient census increases and the need to serve an increased level of hospital patients, Renown Regional Medical Center has now opened the ground floor of the Alternate Care Site (ACS) created within the Mill Street parking structure to serve additional hospitalized patients diagnosed with COVID-19 who are clinically stable or improving. Staff, technology, supplies, equipment and services are in place to meet the needs of patients and assure the safety of Renown’s care teams. This measure allows Renown to enact the emergency preparedness plans that have been in place over the past year, creating additional capacity for inpatients while allowing Renown to continue to deliver high quality care as the number of patients hospitalized for COVID-19 increases in northern Nevada. This ACS location allows patients and caregivers to remain on campus, and still have accessibility to existing hospital infrastructure such as lab, pharmacy, imaging, food services and other critical services. Staff, technology, supplies, equipment and services are in place to meet the needs of patients and the safety of care teams. The Ground Floor has accommodation for 711 beds. “These challenges presented to our community this year by COVID-19 have confirmed the critical role that Renown plays as a locally-owned, not-for-profit integrated health network,” says Tony Slonim, MD, DrPH, President and CEO, Renown Health. “We are passionate about stepping up to serve our community at all times, and especially when we are needed most. We are transforming and implementing creative approaches to ensure patient care needs can be addressed and that we can meet the needs of our community.” “Every community member can feel confident that Renown has a specialty-trained team of physicians, nurses, respiratory therapists, medical assistants, care managers, and physical and occupational therapists around the clock, every day to ensure that, no matter the illness or injury, every patient will be treated with compassion and the appropriate degree of care,” says Paul Sierzenski, MD, MSHQS, CPE, FACEP, Chief Medical Officer, Acute Services. “News about the coronavirus disease 2019 (COVID-19) pandemic may be making you feel anxious about going to the emergency room (ER) or getting the medical care you need,” said Bret W. Frey, MD, emergency medicine physician at Renown. “Please remember it's important to seek emergency care if you have serious non-COVID-19 symptoms and COVID-19 symptoms. Delaying care for a medical emergency, such as a heart attack or stroke, can be life-threatening or lead to serious complications. We are here for you around the clock and have taken all precautions to be sure that visits to the ER and hospital are as safe as possible.” The Renown Alternate Care Site was built within a 10-day period last April by local partners including Clark/Sullivan Construction, Curtis Bros. Construction, PK Electrical, Ainsworth Associates Mechanical Engineers, Intermountain Electric, Mt. Rose Heating & Air Conditioning and Frank Lepori Construction. (Alternate Care Site B-Roll). In U.S. News and World Report Best Hospital rankings, Renown South Meadows Medical Center was listed #1 in the State of Nevada. Renown Regional Medical Center was named #2 Best Hospital in Nevada. A hospital's score is based on multiple data categories, including patient outcomes, safety and volumes. Hospitals earning a high performing rating were significantly better than the national average. Renown Regional Medical Center has also been awarded the Joint Commission’s Gold Seal of Approval® for Hospital Accreditation based on compliance with hospital standards related to emergency management, environment of care, infection prevention and control, leadership and medication management. Renown’s Roseview, Sierra and Cardiac Intensive Care Units have each been awarded a Beacon Award of Excellence from the American Association of Critical Care Nurses (AACN) based on patient outcomes that exceed national benchmarks. Renown has the only intensive care units awarded this distinction in Nevada. For up-to-date information on Renown’s approach to keeping our community safe, visit our website at www.renown.org/covid-19/. We are so grateful for our community’s support during these unprecedented times. If you are able to assist with handcrafted mask covers, financial donations, PPE & other supplies or restaurant meal delivery for staff, please visit https://www.renown.org/donations-covid-19/. 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 Health, 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, www.renown.org.
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Renown and Thousands of Top U.S. Hospitals Encourage Everyone to #MaskUp
Growing numbers of COVID-19 cases and deaths are troubling; facemasks can slow the trend. 100 of the nation’s top health care systems, representing thousands of hospitals in communities across the U.S., have come together with an urgent plea for all Americans – mask up, because wearing a facemask is our best chance at slowing the surging COVID-19 pandemic now. More than 11.5 million Americans have tested positive for the virus – including an additional one million in just the past week – leading to nearly 250,000 deaths. The current trends are daunting and frightening. If the nation stays on its current course, hospital leaders are increasingly concerned that more healthcare facilities will be overwhelmed as shortages of healthy caregivers make it difficult to handle a rapidly increasing number of patients. Unfortunately, this is already happening in parts of our country. The next several months will be critical. Though there has been positive news about vaccine development, no one knows when those vaccines will be ready for widespread use. In the meantime, everyone must remain vigilant, take precautions and follow public health orders. The country has reached a tipping point. The power to do what is right is now in the hands of everyone everywhere. Beginning today, a public service message will run in The New York Times, USA Today, The Wall Street Journal, The Washington Post and The Los Angeles Times. Additionally, leading hospitals and health systems across the country will continue to unite to share these messages regionally. The message reads: “As the top nationally-ranked hospitals, we know it’s tough that we all need to do our part and keep wearing masks. But, here’s what we also know: The science has not changed. Masks slow the spread of COVID-19. So, please join us as we all embrace this simple ask: Wear. Care. Share with #MaskUp. Together, wearing is caring. And together, we are saving lives.” In an effort to reach a broader audience, the public service effort will also include messages on digital platforms, social media, online information, links to vital health resources and more. Combining resources demonstrates that these health organizations are working together, will accomplish this today and will get through this together. The U.S. Centers for Disease Control and Prevention points to recent studies that have shown facemasks successfully limit spread of the COVID-19 virus. Wearing facemasks protect in key ways: by protecting the wearer against inhalation of harmful pathogens and particulates and by preventing exposure of those around the wearer. In addition to masking, the CDC suggests that everyone minimize the number of non-household contacts, maintain a physical distance of at least six feet, and limit the amount of time around others, especially while indoors and in poorly ventilated areas. For further information about masking guidelines – how to choose a mask, how to properly wear a mask – visit the CDC website. About us: www.everymaskup.com is a collaboration of 100 leading health systems representing thousands of hospitals across the U.S. joining together to create messages for the betterment of communities they serve. The impetus for this, and other public service campaigns to follow, came from a group of health care marketing and communications executives meeting for a decade and reengaged weekly since the COVID-19 pandemic began. The goal is to share knowledge and experience, best practices, strategies and resources - knowing they can accomplish more together. Founded and led by Rhoda Weiss, Ph.D., Los Angeles-based national health care leader and consultant, the expanded coalition is partnering with Cleveland Clinic Chief Marketing and Communications Officer Paul Matsen and his team for this effort. Additionally, hospitals and health systems on a regional basis continue to come together to send messages like these of prevention and safety, hope and healing, life and death, care and caring.Media Contacts:Rhoda WeissM: 310-945-6730E: rhoda@rhodaweiss.comAngie KiskaM: 216-312-9170E: kiskaa@ccf.org The following hospitals and health systems to spread this message across the country. AdventHealth Nemours Children's Health System Adventist Health NewYork-Presbyterian Allegheny Health Network Northwell Health Atrium Health Northwestern Medicine Avera Health Norton Healthcare Banner Health Ochsner Health Baptist Health Northeast Florida OhioHealth Baylor Scott & White Health Oregon Health & Science University BJC HealthCare OSF HealthCare Bon Secours Mercy Health OU Health Boston Children's Hospital PeaceHealth Cedars-Sinai Penn Medicine Children’s Hospital Los Angeles Penn State Health Children’s Hospital of Philadelphia Providence Children's Hospital of Orange County Renown Health Children's National Hospital Roswell Park Comprehensive Cancer Center ChristianaCare Rush University System for Health Cincinnati Children’s Hospital Medical Center RWJ Barnabas Health City of Hope Saint Luke's Health System (Kansas City, MO) Cleveland Clinic SCL Health CommonSpirit Health Scripps Health Community Health Systems Sharp HealthCare Cooper University Health Care Southwestern Health Resources Dana-Farber Cancer Institute SSM Health Dartmouth-Hitchcock Health St. Elizabeth Healthcare Duke Health St. Jude Children’s Research Hospital Emory Healthcare St. Luke's Hospital (St. Louis) Geisinger Stanford Health Care Hackensack Meridian Health Sutter Health HCA Healthcare Temple Health Inspira Health Texas Health Resources Intermountain Healthcare The Christ Hospital Health Network Jefferson Health The Ohio State University Wexner Medical Center Johns Hopkins Medicine The University of Texas MD Anderson Cancer Center Kaiser Permanente ThedaCare Keck Medicine of USC TriHealth (Cincinnati) LifePoint Health Trinity Health Mass General Brigham UC Davis Health Mayo Clinic UCHealth MedStar Health UC Health CINCINNATI Memorial Hermann UC San Diego Health Memorial Sloan Kettering Cancer Center UChicago Medicine MemorialCare (Southern California) UCI Health Mercy UCLA Health Michigan Medicine UCSF Health Mount Sinai Health System UNC Health National Jewish Health University of California Health Nationwide Children's Hospital University Hospitals (Cleveland) Nebraska Medicine University of Iowa Health Care Virtua Health
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Renown Now Offering rTMS Treatment for Major Depression
Treatment offers patients safe, non-drug and non-invasive repetitive transcranial magnetic stimulation (rTMS) therapy to treat symptoms of major depression. Renown Health is committed to improving access to vital mental health services in northern Nevada. Today, clinical leaders at the Stacie Mathewson Behavioral Health & Addiction Institute at Renown announced they will offer repetitive transcranial magnetic stimulation (rTMS) therapy for people experiencing Major Depressive Disorder (MDD) under the guidance of a Renown psychiatrist. According to the National Institute of Mental Health, major depression is one of the most common mental disorders in the U.S. The disease causes people to experience sadness and helplessness, and in some cases, may prevent people from carrying out their daily routines. “We at Renown are proud of our national reputation as an innovator in implementing new models, technology and systems of care for our community,” said Tony Slonim, MD, DrPH, President and CEO. “We are working to transform care and demonstrate value in a way that appeals to patients and helps clinicians improve outcomes and reduce costs. There is now a sufficient body of evidence to accept the analgesic and antidepressant effect of high-frequency rTMS, and we are pleased to offer this promising therapy.” rTMS is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. It is typically used when other depression treatments haven't been effective. This treatment for depression involves delivering repetitive magnetic pulses, so it's called repetitive TMS or rTMS. “Depression can be treated; however, for some people, medications and talking with a behavioral health expert may not be enough,” said Renown’s Division Chief of Behavioral Health, Richard A. Charlat, M.D., M.P.H. “We are pleased to offer rTMS therapy for people looking for a new way to fight depression and for whom other treatments may not have given them relief. We are committed to working closely with our patients to find the treatment that works best for them, so they can live their best lives.” “Nevada has the highest prevalence of mental illness and substance use in the nation,” said Steve Shell, vice president of the Stacie Mathewson Behavioral Health & Addiction Institute. “Combine that with the added stress and isolation many are feeling with the COVID-19 pandemic, and we know that offering patients safe, non-drug and non-invasive treatments- as well as essential mental health and addiction services are more important than ever.” How rTMS Works During an rTMS session, an electromagnetic coil is placed against the person’s scalp near their forehead. The electromagnet painlessly delivers a magnetic pulse that stimulates nerve cells in the region of the person’s brain involved in mood control and depression. It's thought to activate regions of the brain that have decreased activity in depression. Though the biology of why rTMS works isn't completely understood, the stimulation appears to impact how the brain is working, which in turn seems to ease depression symptoms and improve mood. There are different ways to perform the procedure, and techniques may change as experts learn more about the most effective ways to perform treatments. On average, patients undergo rTMS treatments for four to six weeks, five days a week for about 40 minutes a day. In all cases, a patient’s doctor will determine a treatment plan that’s best for the patient. This video shows what patients can expect during rTMS therapy. What Does rTMS Feel Like? rTMS therapy is an easy, in-office experience designed to be positive for patients. During treatment, people are awake, alert, and comfortably reclined in a spa-like chair. The first few treatments may cause discomfort at or near the treatment site, however, this is unlikely to last beyond the first week of treatment.1, 2 “The effects of depression can be devastating for the people battling it, as well as for those who love them,” said Stacie Mathewson. “No matter how dark life may seem, always know, there are incredible behavioral health experts at Renown ready to support and empower you as you seek the help you deserve.” Charles N. and Stacie L. Mathewson established the Stacie Mathewson Behavioral Health & Addiction Institute at Renown in 2018 to expand community access to prevention and intervention services for mental health disorders and alcohol and drug addiction. Renown is working to expand intensive outpatient treatment, partial hospitalization and medication-assisted treatment programs to better serve those struggling with mental illness and addiction. The Renown team is also passionate about prevention, mental wellness and is actively working to decrease stigma and encourage more people to seek the help they need. TMS therapy is cleared by the FDA and available by prescription only. It is commonly covered by most insurance plans. Patients must be referred by a behavioral expert to seek rTMS treatment. For more information and to make a patient referral, please call the Stacie Mathewson Behavioral Health & Addiction Institute at 775-982-5318. 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 Health, Neurosciences and Robotic Surgery. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project®. Sources Trivedi MH, et al. (2006). Evaluation of Outcomes with Citalopram for Depression Using Measurement-Based Care in STAR*D Implications for Clinical Practice. Am J Psychiatry, 163(1):28-40 Rush AJ, et. al. (2006) Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry, 163(11):1905-1917.
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Surgery Center of Reno To Offer Option for Outpatient Surgery
Brings a new level of convenience, access and affordability to surgical care in northern Nevada. In a collaboration designed to offer consumers additional convenient and affordable options for outpatient surgery, Surgery Center of Reno (SCOR) and Renown Health today announced a new partnership. “We are thrilled to bring a new level of convenience in surgical care to patients and providers in the Reno community and outlying areas, to deliver superior clinical quality and service, and make health care more affordable,” said James Lynch, MD, President, and Chairman of the Board of Directors for the Surgery Center of Reno. “We trust and value the Surgery Center of Reno and its team of surgeons, clinicians and administrators and the excellent quality of care and compassion they provide to their patients,” said Tony Slonim, MD, DrPH, Renown’s President & CEO. “Given our mutual interests in advancing high-quality and high-value care, this partnership expands capabilities, enhances access and affordability for patients and physicians, improves the health of our community and establishes Renown and the Surgery Center of Reno as the premier destination for surgery in northern Nevada.” This joint venture for outpatient surgery care is the result of the unique collaborative relationship between Renown Health, Reno’s only not-for-profit health care system; and the Surgery Center of Reno, an independent physician owned ambulatory surgery center with Regent Surgical Health as the managing partner. The SCOR and Renown partnership brings together three key elements to serve patients and our community with enhanced outpatient surgery care that includes: Out-of-pocket cost savings for patients. Ambulatory Surgical Centers (ASCs) like Surgery Center of Reno, offer a high-quality, low-cost alternative for many surgical procedures. Patient preference and the desire to decrease healthcare costs continue to fuel Renown’s interest in transitioning appropriate surgeries from hospitals to freestanding ambulatory surgery centers. Significant innovations in minimally-invasive surgical procedures along with advances in anesthesia techniques, reduced complications and recovery times for selected procedures, have helped to make ambulatory surgery centers popular. Renown is focused on creating options for high quality, affordable care for patients and insurance providers by having selected surgical procedures occur in the ASC setting. Comfort and convenience for patients. Surgery Center of Reno offers an upscale experience and has some of the most advanced technology for Ambulatory Surgical Centers in the state. Since all surgeries at SCOR are pre-scheduled, a patient’s procedure is never bumped or delayed by an emergency or trauma case. Surgery is scheduled at ideal times for the patient and family. After surgery, the patient has time to wake up in the recovery room, and then recuperate in their own home. The same high-quality physicians who work in the operating rooms at Renown hospitals also work as part of the Surgery Center of Reno, including surgeons specializing in Spine, Orthopedics, General Surgery, Ear, Nose & Throat, Pain management, Urology/Lithotripsy, Gynecology, Ophthalmology; Dental/ Oral Surgery, Podiatry and Weight Loss Surgery. Since their inception more than forty years ago, Ambulatory Surgical Centers have demonstrated an ability to deliver quality and customer service while simultaneously reducing costs. The Surgery Center of Reno and all Ambulatory Surgical Centers are highly regulated, adhere to stringent quality and safety guidelines, are certified by Medicare and the Nevada State Department of Health, accredited with accrediting agencies such as the Accreditation Association for Ambulatory Health Care or The Joint Commission, and have adopted extensive patient safety procedures. Of course, if complications or an emergency were to develop, patients have immediate access to Renown’s hospitals. “Renown has used our experience through COVID-19 to emerge better and stronger, and we are realigning to meet new consumer demands for health and healthcare services that are convenient, accessible and affordable,” said Bethany Sexton, Chief Transformation Officer. “We are excited to partner with SCOR to exceed people’s expectations and to delight our community with smart, innovative approaches to care. As our nation struggles with how to improve a troubled health care system, the experience of ASCs is a great example of a successful transformation in health care delivery.” Each year, millions of procedures are performed in outpatient centers. The Surgery Center of Reno has been in operation for 14 years, with an excellent track record and reputation in our community. According to a July 2017 report from the Centers for Medicare & Medicaid Services (CMS), about 70 percent of all surgeries in the U.S. occur in an outpatient or ambulatory setting. Outpatient and ambulatory surgery centers can save money and improve the efficiency and convenience of care for patients and health care providers alike. ASCs are at the center of today’s most pressing healthcare initiatives- value based care and risk-sharing models. Nic Towle, RN, Administrator at SCOR says, “We are dedicated to providing excellent care in a safe environment and want all of our patients and their families to be comfortable and receive the highest quality surgical care. Not all procedures can take place in an outpatient setting and may require a hospital stay regardless of your preference. We suggest you speak with your doctor to ensure you qualify as a candidate, to learn about all the options and what is best for you.” About SCOR SCOR is a well-established, Medicare certified, AAAHC accredited, multidisciplinary ambulatory surgery center in Reno. The ASC is partnered with a leader in development and management of ASCs, Regent Surgical Health based in Westchester, Illinois. SCOR has been an integral provider in the market in offering out-patient services to northern Nevada and northeastern California since 2006. SCOR has proven to be a leader in expanding services that include minimally invasive techniques in spine and general surgery. The surgery center has one of the strongest group of fellowship-trained and board-certified specialists and has won multiple awards for clinical excellence. 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.
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Renown Health Announces Cancer Program Leadership Team
Dr. Max J. Coppes announced as Cancer Center Directory, Larry Duncan as Cancer Center Administrator for Renown's Institute for Cancer, with goal to improve the health and well-being of Nevadans. Renown Health is excited to announce that effective today, Max J. Coppes, MD, PhD, MBA has been appointed to a new leadership role as the Cancer Center Director for Renown’s Institute for Cancer. Dr. Coppes, a pediatric oncologist by training, has experience in leading large-scale, nationally-recognized academic adult and pediatric cancer center teams in both the U.S. and Canada. “If you know Dr. Coppes, you know he has the passion, dedication and commitment to build and foster the partnerships needed to create a leading comprehensive cancer center and program that spans the spectrum for patients and their families; from prevention to treatment to survivorship to palliative care,” said Tony Slonim, MD, DrPH, President and CEO, Renown Health. Also effective today, Larry Duncan, MS, has been appointed as Cancer Center Administrator for Renown Health, working in dyad partnership with Dr. Coppes to support the development of this important service line. Larry will also continue his service as Vice President of Pediatrics and Surgery & Administrator of Renown Children's & Women’s Services “Together, as they have done so successfully for Renown Children’s Hospital, Dr. Coppes and Larry Duncan will be responsible for the strategic direction, operations, fiscal management and recruitment of professionals to the Renown Institute for Cancer,” said Sy Johnson, MBA, chief of staff for Renown Health. “As one of Renown’s ‘Destination Health’ service lines, Dr. Coppes and Larry will continue to support an integrated leadership model that puts the patient at the center of all that we do.” Dr. Coppes came to Reno in 2014 from the British Columbia Cancer Agency in Vancouver, where he served as president with responsibility for six regional cancer centers and two cancer research centers. He was an attending physician at BC Children's Hospital, an adjunct professor of Health Sciences at Simon Fraser University, and a professor of Medicine and Pediatrics at the University of British Columbia. During his career, Coppes served as senior vice president at Children's National Medical Center in Washington, D.C. and held positions at several prestigious facilities in the U.S. and Canada including The Hospital for Sick Children (SickKids) in Toronto, Georgetown University, The National Cancer Institute, and the Cleveland Clinic. Since 2016, Dr. Coppes has served in the joint leadership role as the Nell J. Redfield Chair of Pediatrics at the University of Nevada School of Medicine and pediatrician-in-chief at Renown Children's Hospital, a position made possible through generous philanthropic support from the Nell J. Redfield Foundation along with investments by Renown Health and the UNR School of Medicine. Over the last five years, Duncan has served as Vice President of Pediatrics and Surgery & Administrator of Renown Children's and Women's Hospital, with oversight for Renown’s Pediatric Emergency Room and general and specialty pediatric physician practices. He has also served as Chief Operating Officer for Renown Regional Medical Center with oversight of pharmacy, imaging, nutrition, laboratory services and operating rooms. Prior to coming to Renown, Duncan served as CEO for El Paso Children’s Hospital and served in executive capacities for Children's Hospital of Wisconsin, The Children's Hospital of Philadelphia and Rush University Medical Center. “The Renown Institute for Cancer has Full Accreditation with Commendation from the Commission on Cancer of the American College of Surgeons in all 7 areas. Only 25% of cancer programs attain this distinction, which recognizes the quality of comprehensive, multidisciplinary patient care. Renown is the only accredited Community Hospital Comprehensive Cancer program in northern Nevada to be selected, and one of only three programs statewide,” says Max J. Coppes, MD, PhD, MBA. “That is certainly an excellent foundation on which to build on, and such a gift for our community.” “Renown’s cancer nurses, patient navigators, social workers, palliative care specialists, geneticists, nutritionists, clinical trial researchers, physical rehab specialists and the entire team provides prevention and screening to help reduce the incidence of cancer and reduce the late stage presentation of cancers,” says Larry Duncan, MS. “Helping patients and families navigate their journey begins at the time of diagnosis, with the help of our nurse navigators, and extends throughout the patient’s treatment. We are making great strides in long-term survivorship and are pleased to be recognized for the comprehensive nature of our research, care, education and community outreach programs.” According to the National Cancer Institute, the Age-Adjusted Death Rate of 153.5 per 100,000 population due to Cancer for Washoe County has seen significant improvement in the last several years, and now meets the Healthy People 2020 national health target of reducing the overall cancer death rate below 161.4 per 100,000 population. The Healthy People 2030 national health target is to reduce the overall cancer death rate to 122.7 deaths per 100,000 population. The National Cancer Institute (NCI) defines cancer as a term used to describe diseases in which abnormal cells divide without control and are able to invade other tissues. According to the NCI there are over 100 different types of cancer, but breast, colon, lung, pancreatic, prostate, and rectal cancer lead to the greatest number of annual deaths. Risk factors of cancer include but are not limited to; age, alcohol use, tobacco use, a poor diet, certain hormones, and sun exposure. Although some of these risk factors cannot be avoided -- such as age -- limiting exposure to avoidable risk factors may lower risk of developing certain cancers. 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 Health, 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, www.renown.
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Tummy Trouble? Renown Children’s Hospital Adds Another New Specialty, Pediatric Gastroenterology
Two pediatric gastroenterologists bring life-saving care to kids and make Renown their new home The Renown Children’s Hospital team and our community is celebrating the addition of a new life-saving pediatric specialty to its practice serving children and families in northern Nevada. Parents and guardians will now be able to seek professional pediatric gastroenterologist care with the addition of Drs. Juan Gregory and Kathleen Holland to Renown Medical Group. “Recognizing the importance of diagnosing and caring for children who have conditions that affect the organs in the digestive system, including the stomach, liver and bowel, while also helping children who have issues feeding and eating, is critically important to us at Renown,” said Kristina Deeter, MD, MBA, FAAP, Chair of Pediatrics, University of Nevada Reno School of Medicine (UNR Med) and Physician-in-Chief, Renown Children’s Hospital. “Both Drs. Gregory and Holland are superb clinicians, we are excited to have them join Renown Children’s Hospital to offer pediatric gastroenterology services, including a wide range of complex and vital procedures and screenings, endoscopies and colonoscopies.” Juan Carlos Gregory, MD, has 18 years of experience caring for children in northern Nevada. He is a clinical associate professor of pediatrics at UNR Med with a special interest in celiac disease, abdominal pain, and gastroesophageal reflux in children. Gregory earned his undergraduate degree at Texas Christian University in Fort Worth, TX before completing his medical training, including a residency in pediatrics at the University of San Diego in Pediatrics and fellowships in Pediatric Gastroenterology and Nutrition at both Children’s National Medical Center in Washington, DC, and at the National Institutes of Health, Digestive Disease Section in Bethesda, MD. He is board-certified in Pediatric Gastroenterology and speaks Spanish. Kathleen Holland, MD, MPH brings a global health perspective to her work caring for children. A graduate of the University of Nevada Reno School of Medicine (UNR Med) with her medical doctorate and her master’s in public health with a social and behavioral health emphasis, she has donated her skills to providing international medical relief for children in Uganda and Nicaragua. Holland earned her undergraduate degree at University of Nevada Reno in Biology, Health Ecology and Healthcare Ethics before completing her medical training and residency in Pediatrics and a fellowship in Pediatric Gastroenterology at Indiana University School of Medicine in Indianapolis, IN. Her research and scientific interests include vaccination rates and family barriers among children with inflammatory bowel disease, Crohn’s and colitis, pediatric autoimmune pancreatitis, and cystic fibrosis. How Pediatric Gastroenterologists Help Children and Families The Pediatric Gastroenterology Program at Renown Children’s cares for children experiencing common GI-related problems of childhood; nausea, vomiting, abdominal pain, diarrhea, constipation, reflux, colic, milk protein allergy, poor growth and feeding difficulties, and sees patients from infancy to 18 years old. “As specialists in the care of children with gastrointestinal and liver problems, we focus on the diagnosis and treatment of these issues,” said Larry Duncan, MD, Vice President of Pediatrics and Surgery & Administrator of Renown Children’s & Women’s Services. “Our physicians play an active role in teaching and research. We have several areas of expertise including prevention, diagnosis and treating disease of the digestive tract including the esophagus, gallbladder, stomach, pancreas, colon, small intestine and liver disease.” Special expertise includes: Pediatric feeding and growing disorders Aerodigestive disorders Food and hypersensitivity disorders Inflammatory bowel disease Celiac disease Liver diseases Children requiring parenteral and enteral nutrition Renown Children’s Hospital is the only dedicated children’s hospital in northern Nevada, offering programs and services for families from a 100,000 square mile area, from Sacramento, CA to Salt Lake City, Utah. Renown Children’s provides the area’s only Children’s Emergency Room, Pediatric ICU (PICU), children’s imaging center and the largest neonatal ICU (NICU), a level III intensive care unit. Specialty Children’s Care at Renown Today, over 90% of families in northern Nevada seek care from the experts at Renown Children’s Hospital. “We are so grateful to the William N. Pennington Foundation for its support in establishing the William N. Pennington Fund for Advance Pediatric Care in 2016, which allowed us to hire our first 15 pediatric specialists,” said Dr. Deeter. “Today we have over 40 pediatric physician specialists at Renown Children’s Hospital who provide care in adolescent medicine, pediatric endocrinology, pediatric hematology/oncology, pediatric pulmonology, pediatric neurology, pediatric nephrology, pediatric infectious diseases, pediatric ophthalmology, pediatric orthopedic surgery, pediatric cleft and craniofacial surgery, pediatric urology, pediatric dentistry, pediatric emergency medicine, and now, pediatric gastroenterology. Our clinicians provide 30,000 patient visits annually, offering an exceptional level of care. The Pennington gift is truly a gift that keeps giving to the families in our area.” Now Being Constructed: Expanded Inpatient Care at Renown Children’s Hospital New construction of an expanded Neonatal Intensive Care Unit (NICU) with increased capacity to 49 bassinets, an expanded Pediatric Intensive Care Unit (PICU) with increased capacity to 16 private patient and family rooms, and a new Renown Children's Hospital inpatient floor with increased capacity for 38 private patient and family rooms for a total capacity of 58 pediatric beds are currently being constructed on Tahoe Tower, Level 5 of Renown Regional Medical Center. It is expected that the new units will open to patients and families in April 2023. In the most recent US News & World Report Best Hospital rankings, Renown Regional Medical Center was named as the number one hospital in Nevada. No other hospitals in the state met their stringent standards for the 2021 rankings. Renown Health is High Performing, its highest rating possible, in eight procedures and conditions including Heart Failure, Colon Cancer Surgery and Chronic Obstructive Pulmonary Disease, Hip Replacement and Knee Replacement. A hospital's score is based on multiple data categories, including patient outcomes, safety, and volumes. Hospitals earning a High Performing rating were significantly better than the national average. Renown Medical Group is an in-network provider for Hometown Health and other health plans. Drs. Gregory and Holland are pleased to see new patients at their location at the Renown Children’s Subspecialty Clinic inside Renown Regional Medical Center at 75 Pringle Way, Suite 505, Reno, Nev. Ask your pediatrician for a referral to a medical specialist when further evaluation of a particular issue is necessary. About Renown Health Renown Health is Nevada’s largest, 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 locally owned not-for-profit insurance company, Hometown Health. Renown is currently enrolling participants in a community-based genetic population health study, the Healthy Nevada Project®. About UNR Med The University of Nevada, Reno School of Medicine (UNR Med), Nevada’s first public medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Since 1969, UNR Med has trained more than 3,900 students, residents, and fellows. UNR Med continues to improve the health and well-being of all Nevadans and their communities through excellence in student education, postgraduate training and clinical care, research with local, national and global impact and a culture of diversity and inclusion. For more information, visit med.unr.edu.
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Kristina Deeter, MD, MBA, FAAP Appointed Chair of Pediatrics (UNR Med) and Physician-in-Chief, Renown Children’s Hospital
Kristina Deeter, MD, MBA, FAAP has been promoted from Vice Chair of Pediatrics to Chair of Pediatrics, University of Nevada Reno School of Medicine (UNR Med) and Physician-in-Chief, Renown Children’s Hospital, effective July 15, 2022. Dr. Deeter follows Dr. Max Coppes who recently stepped down to lead Renown’s Pennington Cancer Institute on a full-time basis. Dr. Coppes will continue to serve as Professor of Pediatrics and Internal Medicine at UNR Med. In her new role, Dr. Deeter will be responsible for leading a growing team of over 40 pediatric physician specialists and 15 general pediatric providers at Renown Children’s Hospital who provide over 30,000 patient and family visits annually for families across northern Nevada, Lake Tahoe and northern California. Larry Duncan, MS, Vice President of Pediatrics and Surgery & Administrator of Renown Children's & Women’s Services will serve as dyad partner with Dr. Deeter. “Together, Dr. Deeter and Larry Duncan will be responsible for the strategic direction, operations, fiscal management and recruitment of professionals to Renown Children’s,” said Sy Johnson, MBA, president and chief of staff for Renown Health. “As one of Renown’s ‘Destination Health’ service lines, Dr. Deeter and Larry will continue to support an integrated leadership model that puts the youngest patients- and their families- at the center of all that we do.” As Physician-in-Chief for Renown Children’s Hospital, Dr. Deeter will serve as a senior clinical leader with oversight for the healthcare system’s pediatric medical and surgical services, academic advancement, research and teaching programs. “Dr. Deeter is an energetic, collaborative physician, researcher and mentor who cares deeply about improving the health and well-being of children everywhere,” said Thomas Graf, MD, CEO of Renown Health. “This is an exceptionally exciting time to shape the future of pediatrics in this community, and we are so excited that she is embarking on this new role. I know her talent, energy and inspiring leadership will further elevate our mission of outstanding care, exceptional training, innovative research and impactful advocacy in children’s health.” Dr. Kris Deeter is a highly accomplished physician leader with over twenty years of experience in children’s hospitals and outpatient settings, including federal, academic and private practices. Locally, Dr. Deeter has served as Vice Chair of Pediatrics for Renown Children’s while also leading the ICU teams of Pediatrix National Medical Group as their Specialty Medical Officer since August 2021. For the past six years, she has been the Medical Director of the Pediatric Intensive Care Unit (PICU) and Pediatric Hospitalist teams for Renown and Pediatrix. Since 2017, Dr. Deeter has served as an Educator for REMSA and other Northern Nevada counties, providing pediatric education for Care Flight teams, paramedics and fire departments. Dr. Deeter also recently completed her MBA from the University of Nevada, Reno. “The School of Medicine is delighted to appoint Dr. Deeter as the new Chair of Pediatrics at UNR Med and Physician-in-Chief, Renown Children’s Hospital, says, Melissa Piasecki, MD, UNR Med Acting Dean. “She brings extensive experience in medical education, a positive leadership style and unwavering commitment to the community. We look forward to the ongoing development of medical education and research opportunities in pediatrics.” Dr. Deeter has a passion for service. Coming from an underserved background, her education started in a Head Start preschool. Years later, she received a full-ride scholarship to the University of California, Berkeley where she double-majored in biology and psychology. Dr. Deeter found her true calling in pediatrics while at medical school at New York Medical College. There, she developed an interest in pediatric HIV and infectious diseases while volunteering to help during the HIV/AIDS crisis. Her medical training was primarily funded through a government scholarship that allowed her to start her career as a pediatrician caring for underserved children with the National Health Service Corps. After residency, she and her military husband followed orders and educational opportunities and moved around the country. She worked in a Federally Qualified Health Center (FQHC) in San Antonio with predominantly Spanish-speaking patients and led one of the first academic pediatric hospitalist programs at the University of Texas. Early on, Dr. Deeter developed a passion for medical education developing a new curriculum for students and transitioning residents to new work hour rules. After a move with the military to Ft Benning, Georgia and a busy private practice, she was recruited to Seattle Children’s/University of Washington School of Medicine for ICU fellowship training. There, she joined a large DKA study group and launched her own research into sedation andcomfort practices for critically ill children, publishing in top journals in pediatrics. She later transitioned to clinical practice in a large CICU/PICU in South Florida where she continued her academic collaborations with Florida Atlantic University. Dr. Deeter volunteers her time locally and internationally, including many visits to help improve the only PICU in Haiti after the earthquake there in 2012. She was a board member for a women and children’s hospital in Bangladesh while also supporting local children’s organizations like Head Start. She has served in leadership positions throughout her career, both in academic and private settings, including terms as vice president of the Broward County (FL) medical society, legislative positions with the TMA and FMA, and chairing the hospital’s peer review committee. The Deeter family moved to Reno in 2016 for an opportunity to move closer to family and for what she calls her “dream job” as a leader at Renown Children’s Hospital. “Dr. Deeter is a highly competent and passionate care giver, dedicated teacher, and fierce advocate for the health and well-being of children and their families,” said Max J. Coppes MD, former Chair of Pediatrics (UNR Med) and Physician-in-Chief, Renown Children’s Hospital. “We are fortunate to have her step up to this new role. Her extensive experience will springboard our Children’s Hospital, our membership in Children’s Oncology Group, and if approved in September 2022, a new 3-year accredited pediatric residency program in Reno. She is an inspiration to all, and will help encourage UNR Med students who choose pediatric specialties to excel as pediatricians and eventually practice in northern Nevada, our rural communities and our state.” Dr. Deeter is a member of the Society of Critical Care Medicine: Pediatric section; American Academy of Pediatrics, Nevada Chapter; AAP Section Membership: Critical Care; Pediatric Trauma Society; Pediatric Sedation Society and the American Medical Association. She is a frequent contributor to national and local media on topics regarding pediatrics and child health. The University of Nevada, Reno School of Medicine (UNR Med), Nevada’s first public medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Since 1969, UNR Med has trained more than 3,900 students, residents and fellows. UNR Med continues to improve the health and well-being of all Nevadans and their communities through excellence in student education, postgraduate training and clinical care, research with local, national and global impact and a culture of diversity and inclusion. For more information, visit med.unr.edu. Renown Health is the region’s largest, locally governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoeand 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 locally owned not-for-profit insurance company, Hometown Health. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project®.