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Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs.  Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health.  PrEP and PEP  Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months.  Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days.  PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location.   HPV Immunization  All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime.  The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never!

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Giving birth expends as much energy as running a marathon. And just like you would only run a marathon with training beforehand, there are exercises you can do to prepare for birth. But instead of a coach, you'll have your birth team. Your birth team exists to help you navigate pregnancy and labor and support your choices. Let's say you've never put together a birth team before and are wondering where to start. Today we'll go over the three main positions to fill for your birth team's starting lineup. Birthing Person The birthing person is the leader of the team. After all, you can't have a birth team without someone giving birth. This person could be the baby's mother, gestational surrogate, birth parent before adoption, a transgender father or a non-binary parent. If you are not the birthing person, don't presume to know what the ideal labor and birth circumstances should be. And if you are the birthing person, don't allow anyone else to tell you what you want. This is your body and your birth; you are the boss in the birth room. Doula No birth team is complete without a doula, and although doulas have increased in popularity lately, many people still don't know what a doula is. Simply put, a doula is a birth professional – not a medical provider – who offers emotional, physical and informational support during pregnancy, labor and beyond. Most doulas' services include at least one prenatal visit and one postpartum visit, as well as continuous care throughout active labor. Some doulas provide more than one prenatal/postpartum visit, so be sure to ask what is included in their fee. Even if you have a partner who will support you during labor, studies have shown that a doula can significantly increase your likelihood of a positive birth outcome. Even the most supportive partner needs to rest, and a doula can ensure that you still get the care you need while your partner gets a break. Midwife or Obstetrician Finally, you'll want to choose the medical professional who will attend your birth. Many folks choose to give birth with the OB/GYN who does their annual check-ups, but there are many reasons someone might choose a different provider for their birth. The first step to finding the best attending provider for your birth is to decide which model of care aligns closest to your values and goals: the Midwifery Model of Care or the Medical Model of Care. .tg {border-collapse:collapse;border-spacing:0;} .tg td{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; overflow:hidden;padding:10px 5px;word-break:normal;} .tg th{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; font-weight:normal;overflow:hidden;padding:10px 5px;word-break:normal;} .tg .tg-gqvw{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-weight:bold; text-align:left;vertical-align:top} .tg .tg-8vim{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-size:18px; font-weight:bold;text-align:left;vertical-align:top} .tg .tg-qm8j{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;text-align:left; vertical-align:top} .tg {border-collapse:collapse;border-spacing:0;} .tg td{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; overflow:hidden;padding:10px 5px;word-break:normal;} .tg th{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; font-weight:normal;overflow:hidden;padding:10px 5px;word-break:normal;} .tg .tg-gqvw{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-weight:bold; text-align:left;vertical-align:top} .tg .tg-8vim{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-size:18px; font-weight:bold;text-align:left;vertical-align:top} .tg .tg-2rvk{background-color:#ffffff;color:#000000;font-family:Arial, Helvetica, sans-serif !important;text-align:left; vertical-align:top} Midwifery Model of Care Medical Model of Care Philosophy Birth is physiological. Birth is potentially pathological. Interventions Medical interventions can cause more complications, and therefore are only used as needed. Medical interventions should be used, even in non-emergency situations and sometimes as preventative measures. Decisions Birthing person is the key decision maker. Medical professional is the key decision maker. Provider’s Role Providers monitor labor and will intervene or transfer to hospital if needed. Providers assess and control the birthing process.

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If you’re expecting a new baby, you may have been given the advice to hire a doula. You may have seen statistics of improved outcomes among those who’ve had a doula attend their birth. Perhaps you’ve heard that the etymology is from the Greek word meaning “to serve.” But how does a doula serve their clients? A doula is a non-medical birth professional who will guide you through labor, birth, postpartum and beyond. Your doula can discuss your options with you so you can make informed decisions, as well as provide emotional and physical support to ease your experience. While each doula offers their own style, there are certain services that most doulas will provide for their clients. Typically, a birth doula will provide at least one prenatal visit, one postpartum visit and continuous support during active labor. A postpartum doula usually provides support during the 12 weeks immediately following birth, sometimes referred to as the “fourth trimester,” but some will continue care after that as well. Simply put, a doula provides informational, physical and emotional support during the childbearing year(s). Let’s take a closer look at these three ways a doula can support you. The Basics If you don’t know your options, you don’t have any. This is a common phrase in the world of birth work. When you’re in labor, you’re exhausted, in pain and there’s often urgency inherent or implied in any choices you make. So, when an intervention is offered, many birthing people accept it without question. One method that can help the decision-making process is to check your BRAIN: Benefits: What are the benefits of the proposed intervention? Risks: What are the risks of the proposed intervention? Alternatives: What are the alternative options? Intuition: What does your intuition tell you? Nothing: What if we do nothing? What if we wait? When you’re in active labor, you might have difficulty remembering this acronym; that’s where your doula comes in. At your prenatal visits, you can ask your doula for guidance in preparing your birth plan, which can include contingencies for certain potential interventions. And as choices arise during labor, your doula can guide you through the benefits and risks and can provide you with alternative options you might not otherwise be aware of that are available to you. Your doula can remind you to check in with your intuition and can help you quiet your mind so you can listen to your instincts. The Body Although we tend to see depictions of people giving birth on their backs with their feet in stirrups, this is only one of many ways to give birth. Walking and dancing can speed up early labor. Side-lying or hands-and-knees can prevent tearing during the pushing stage. Sometimes labor stalls, and a change of position is often helpful to get things moving again. Your doula can suggest positions depending on your stage of labor. Some labor positions might require the support of another person – your doula could fill this role or assist your partner in doing so. Some doulas also provide massage or even acupressure, and most will do the “hip squeeze” that so many laboring people swear by. If your baby is presenting posterior, or “sunny side up,” your doula can apply counter pressure to alleviate back pain during labor. Some postpartum doulas will do light housework while you rest and bond with your newborn. Others might care for your baby through the night so you can catch up on sleep. Many doulas have also gone through additional training to offer breastfeeding support and may be able to assist you with latch issues and nursing positions. The Mind Pregnancy, birth and postpartum periods can be some of the most emotional times in a person’s life. A doula will hold space for you and help you process your emotions before and after birth. It’s normal to feel apprehensive, or even fearful, about labor and birth, and discussing these feelings is the first step. A doula can help you navigate your concerns in a safe space so you can be prepared emotionally for your upcoming labor. Many doulas will also guide you through writing your birth plan, which can lessen anxiety about the unknown. If you have a history of trauma, your doula can assist in communicating this, so you don’t have to relive the experience every time you meet a new medical provider. Most people will experience some form of what’s often called the Baby Blues in the immediate postpartum period. The third day after birth tends to hit hard, as hormones attempt to regulate, but the Baby Blues can continue for weeks for some new parents. A postpartum doula’s support can be incredibly valuable during this time. When the baby blues last longer than a few weeks, it could considered a mood disorder. Most doulas will recognize signs of postpartum mood disorders and will have resources available for additional support. Choosing the Best Doula for You With so many wonderful doulas in northern Nevada, you might wonder how you could ever choose just one to attend your birth. Some expectant parents are unfortunately restricted by cost. With so many expenses related to a new baby, it can be difficult to budget doula services as well. Thankfully, Nevada Medicaid now covers doula care, and some commercial insurances are following suit. Check with your insurance company to find out if they might cover part of the cost for hiring a doula. If your insurance doesn’t cover doula services, some doulas offer a sliding scale based on income. You may want to interview multiple doulas to find the right one for you. If you’re the kind of person who wants all the information you can get, a more detail-oriented doula might be the best choice. But if you tend to feel overwhelmed by too many options, you might prefer a doula who only offers additional information as the situation calls for it. If you want massage or acupressure during labor, you might want to hire a doula with those certifications. Or maybe informational and physical support are not as important to you as emotional support, in which case your best choice could be a doula who has experience with postpartum mood disorders or trauma support. Regardless of who you hire, be sure to clearly communicate your desires and expectations – not just for your birth, but also for your doula. The most important thing when choosing your doula is trusting your gut. You need to feel comfortable with your doula, as they’ll be tending to you at one of the most vulnerable times in your life. When you find a doula that you click with, who listens to you and supports your choices, you have found the best doula for you.

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March is Colorectal Cancer Awareness Month, and we want you to receive the best preventative care possible. Early detection can help prevent serious illness, yet many people still choose to skip their annual exams and routine screenings. Bonnie Ferrara, MD, MPH, Section Chief for Primary Care at Renown Medical Group, further explains the importance of this simple, easy way to stay healthy. Why are annual exams so important? The benefits of early detection and prevention to save lives and reduce the impacts of disease have been proven. These exams are the perfect opportunity to get your health questions answered. “This is your chance to sit down with your provider and talk about your overall health and your family’s health history as well as your concerns for the future,” says Bonnie Ferrara, M.D., family medicine. “It’s the opportunity for your provider to talk with you about your lifestyle, tobacco use, exercise and alcohol use, all of which make a difference in your future longevity.” The annual wellness exam is also an ideal time for most adult patients to discuss health screenings. In addition, these visits are the perfect time to address issues that may not directly relate to a particular medical problem or immediate illness. A good rule of thumb is to schedule these appointments around your birthday each year to make sure you and your provider are both updated on your care. Why would you need an annual exam if you aren’t feeling sick? According to Dr. Ferrara, seeing your care provider when you aren’t sick is one of the best times. “It is better if you try to arrange this visit when you are not feeling ill,” she says. “It is an opportunity to talk about wellness. Not only how to contribute to your wellness but also the changes that you can make that will make huge dividends in the future for your wellness. In addition, it allows us to do some education about what to expect in the coming years as far as your health and lifestyle changes.” What can you expect at an annual exam? Annual exams usually check your: History – lifestyle behaviors, health concerns, vaccination status, family medical history Vitals – blood pressure, heart rate, respiration rate and temperature General appearance – your care provider can find out a lot about you just by watching and talking to you Dr. Ferrara adds, “If this is a Medicare annual wellness exam, it is an opportunity to talk to your provider about depression and dementia as well as be tested for those.” You can also leverage your annual exam to speak to your provider about managing your chronic health problems. "As a provider, these visits give us the opportunity to hear how the medications and lifestyle changes we have recommended are working and if you are having problems with these, we have the opportunity to make suggestions of how to do things better for the future," Dr. Ferrara.

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There are a lot of impressive titles you can use to describe Stephanie Kruse: entrepreneur, marketer, philanthropist, leader, adventurer, nurse. And now with her planned gift to the Renown Health Nursing Excellence Endowment, she can add one more to the list: a member of the Renown Legacy Society – a group of visionary supporters who have chosen to make a lasting commitment to the future health and wellbeing of northern Nevadans. This generous planned gift comes on the heels of a significant cash gift made to the Nursing Education Fund last summer. Stephanie is an inspiring example of someone who has dedicated her life to helping others. The daughter of a nurse and a retired nurse herself, Stephanie knows the hard work, selflessness and dedication it takes to create a successful business and community. As Chair of the Renown Health Foundation Board of Directors, she also understands the importance of attracting and retaining nurses within a healthcare system. As a way to contribute to a cause near and dear to her heart, she decided to include the Renown Nursing Excellence Endowment as a beneficiary of her retirement plans. “I wanted to honor the memory of my mother, who was a registered nurse in a small-town hospital in Iowa.,” said Stephanie. “I was always very conscious of her passion for providing great care to her patients, and I wanted to provide funding for others interested in nursing.” Across the nation, health systems are facing a shortage of nurses and nursing-related professionals. Renown is proactively implementing programs to build our pipeline of potential future nurses and keep those already in the field. Stephanie’s generous gift will help the endowment provide programs such as training, scholarships, loan repayment and professional development to increase retention and recruitment of prospective nurses. “As nurses, we are entrusted with our patients’ lives,” said Melodie Osborn, Chief Nurse Executive at Renown Health. “We have the privilege of caring for people in their most vulnerable time and helping those who cannot help themselves. Stephanie’s generous gift to the Nursing Excellence Endowment Fund will help us develop new nurses for the future so we can continue to provide care to those in need for generations to come.” No Stranger to Healthcare Long before she found herself leading the Renown Health Foundation Board, Stephanie learned the ins and outs of healthcare. She graduated from nursing school and became a part-time nurse in a Sioux Falls, South Dakota nursing home while attending Augustana College to obtain a degree in journalism and a minor in theater. As part of her journalism program, Stephanie completed an internship in the public relations department of a Sioux Falls hospital, and that led to her accepting a position as director of public relations at a sister hospital. She later was recruited by Saint Mary's Hospital and moved to Reno to be the director of marketing in 1981. She stayed at Saint Mary's for almost 10 years before starting her own company in pursuit of her passion for marketing strategy. Since launching her brand, Stephanie has grown KPS3 to a multi-million-dollar firm with more than 60 staff members. Somehow, she is still able to find time to serve on six (!) volunteer boards, most of which are dedicated to improving access to better health and human services. “I have a soft spot in my heart for organizations who strive against all odds to help those with the greatest needs,” said Stephanie.

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Reviewed by Dr. Takesha Cooper, MD, MS, FAPA, Chair, Department of Psychiatry and Behavioral Sciences, Professor of Psychiatry at University of Nevada Reno School of Medicine, Chief of Behavioral Health at Renown Health Sometimes it feels like every time you turn on the news, there is a new report about violence in our schools. Instead of being able to focus on the typical youth growing pains of learning test-taking skills, dealing with physical body changes, navigating friendships and dating and figuring out grades and routines, our children instead must prepare to deal with active shooter incidents, bullying, gang presence and hate crimes. These are heavy weights for children to bear and simply preparing for the possibility of such events can affect their mental health.  As adults, it’s important to recognize when our children are struggling with anxiety, and to equip them with healthy tools and resources to help manage it.  How to recognize signs of anxiety in children Anxiety in children can present itself in several different ways, depending on the child. Oftentimes, younger children will suffer from actual physical symptoms. They may wake up with a stomachache or headache, or they may often feel tired or irritable. In pre-teens and teens, anxiety can take the form of behavioral changes. They may withdraw from social connections and activities or have trouble sleeping or eating.  As a parent, it may be difficult to know what to do when you see your child struggling with anxiety over school violence. How can you help your child when you are trying to figure out the same answers for yourself? You should know, however, that one of the best things you can do for your child is to simply be there for them. Anxiety tries to convince us that we are alone in our feelings, creating a sense of isolation, guilt and shame. A hug, reassurance and open conversation can provide the comfort your child needs during times of anxiety. How to talk to children about school violence Some important things to remember when talking to your children about school violence are: 1. Present the facts: Many times, children receive information about school violence from unreputable sources. Social media, peers and even family members are not always the most accurate sources of data and facts. Take the time to confirm the main details to stop wild theories and accusations in their tracks. 2. Provide Reassurance: It’s okay to let your children know when you are sad or scared about school violence, but you should do so in an age-appropriate manner and follow up with honest parental reassurance. Keep your explanations of the violent incident short and tailored to the age of the child. Acknowledge their feelings and the current situation but be sure to remind them that there are rules, laws and people in place to protect them, should that protection ever be needed. You can empathize with their anxious thoughts and feelings but also remind them that you are there to take care of them and that it is not their responsibility as a child to worry about school violence. 3. Promote Open Communication: Don’t be afraid to have complicated conversations with your children. They are usually able to process more than adults give them credit for. Find opportunities to have one on one time with your child and guide the discussion towards their anxious thoughts and feelings. Actively listen and validate their feelings without escalating fear and remind them that you are a safe and trusted resource who will not dismiss or judge their feelings but promises to be there as a support system. 4. Prepare with the Necessary Tools: Help teach your children coping mechanisms such as deep breathing, yoga, mindfulness or journaling. They can also learn to process their thoughts through physical outlets such as exercise, sports or hobbies to help foster a sense of control and normalcy. 5. Practice Safety Routines: While it can be sad to acknowledge that bad things happen in the world, it can be empowering for children to learn that there are sometimes things they can do to help in a challenging situation. You can discuss safety measures at school and remind them of teachers, staff and first responders who are available to help. Additionally, some children find that role-playing emergency protocols can help them feel prepared and powerful. 6. Protect Their Media Intake: In today’s world, news and information are available 24/7, coming to us from numerous media platforms. For adults, this constant stream of content can feel overwhelming, and for children, it can be even more distressing—especially during times of crisis. Children may struggle to process the information they have been exposed to, and they may lack the ability to distinguish between factual reporting and sensationalism. This constant influx of bad news can take a toll on their mental health, and they may not even recognize that they’re feeling stressed. Limiting their media exposure is an important step in caring for their emotional well-being.  Take Care of Yourself Each time you fly on an airplane, the flight attendants tell you to “put your oxygen mask on first before helping others.” This is important because, in order to think clearly and be helpful to others in need, you have to be able to breathe and function on your own. This adage also rings true when it comes to helping your children manage their anxiety. You must take care of yourself and manage your own fears and stress so that you can effectively provide guidance and support to your children. Remembering to eat properly, exercise, get enough sleep and find strategies to manage your own mental health are crucial to you being the best you can be, so that you can provide comfort to your child and advocate for their health and wellbeing. When to Seek Professional Help Remember that it’s okay to ask for help. If you find that you or your child are struggling with depression, anxious thoughts, persistent fears, loss of appetite, irritability, lack of desire to engage in life activities or with loved ones or other signs of distress, please reach out for professional help. Counseling, support groups and therapy with a licensed mental health professional are all effective ways to cope with these emotions and serve as a helpful reminder that no one has to face them alone. Click here for additional information about Renown Behavioral Health.

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Cancer changes everything; it takes, it challenges, and it reshapes lives forever. For Yvonne Murphy, a cancer survivor and development officer at Renown Health, the experience has been profoundly transformative. Recently, Yvonne and her husband, Murray Mackenzie, made a heartfelt donation of $10,000 to support the Conrad Breast Center at the William N. Pennington Cancer Institute—a gift inspired by her own battle and in honor of those who have faced this disease. A Family’s Battle with Cancer Yvonne’s journey with cancer began with the death of her grandmother when she was a teenager, a shock that left a permanent mark on her family. "She was my friend, confidant, and angel," Yvonne recalls. "Losing her changed everything." In the years that followed, nine more of her family members passed away from cancer. These experiences highlighted the harsh reality that cancer invades every aspect of life, bringing grief and uncertainty to so many. For Yvonne, that reality grew even more personal when she was diagnosed with cervical cancer, marking a pivotal moment in her life. A Fight for Her Life During the height of COVID-19, Yvonne noticed blood in her urine, a discovery that sent her rushing to the ER at Renown South Meadows. She received the devastating news: stage one cervical cancer. "When I received my diagnosis, it felt like the world stopped," Yvonne said. "But I knew I couldn't let this define me. I had to fight, not just for myself, but for all the people I've lost." Yvonne faced a grueling course of treatment, undergoing two major surgeries within just 60 days. The first was a hysterectomy, followed by the removal of 32 lymph nodes. Her treatment also included radiation therapy and a challenging recovery, all within a single year. Throughout this intense period, Yvonne drew strength from her faith. "I prayed every day," she said. "And I promised that if I survived, I would dedicate my life to serving others." This promise became her guiding force. It inspired her to make a profound impact through her work at Renown. A Gift of Hope True to her word, Yvonne reached out to the former CEO of Renown in 2021, exactly one year after celebrating her cancer-free milestone. She was determined to contribute in any way possible. This marked the beginning of her career at Renown Health Foundation.  Today, she works as a development officer, partnering with philanthropists, corporations, and fellow employees to raise funds for vital programs and services at Renown, a not-for-profit health system. Yvonne recently had her 18th scan and remains cancer-free, a testament to her strength and perseverance.

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You may recognize Debe Fennell from the Senior Care Plus advertising campaign that premiered last October. Debe is a Reno resident who enjoys staying busy with her career, gardening, music and more. We’re excited to introduce her as our featured Sterling Silver Club member for this fall. From Coast to Coast Debe was born in 1949 in the historical city of Elmira, New York. Mark Twain (Samuel Clemens) also lived in Elmira, which is where he got married, had children and wrote a few of his famous novels, including The Adventures of Huckleberry Finn. In fact, Mark Twain was a friend of Debe’s great-grandfather, who migrated from Europe to build what used to be called The Elmira Hotel. Debe and her family moved from Elmira to Kentucky in 1950, where they lived until Debe was 14. Debe grew up with three sisters and two brothers. Her family moved to Arkansas in 1964 and lived there until 1970. Debe graduated from Southside High School in 1964 and was part of the school’s first graduating class. After high school, Debe traveled to London with a group of missionaries to sing at the Lambeth Conference. When she returned, she went to the University of Arkansas - Little Rock for a couple of years before moving to Reno, Nevada in 1970.  Debe spent the next 15 years in Reno, enjoying life as a self-proclaimed ski bum and working at various jobs. Her first job in Reno was at the YMCA of the Sierra on Foster Drive, before Debe completed dealer school through Harrah’s Casino and became a high-limit blackjack dealer. In 1985, Debe moved from Reno to Nashville, where she began an exciting career in the music industry.   Making History in Music City Debe’s first job in Nashville was working as a journalist for a music publication. Her other business ventures included being a talent coordinator for two nationally syndicated radio shows, and a national records promotion executive for Sony/BMG, Curb Records, Magnatone Records and Giant Records. She was one of very few female Vice Presidents in the music industry in Nashville at the time, and worked for many big names in country music, including Tim McGraw and Randy Travis.

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It’s important to establish children with a pediatrician so that their health baselines can be monitored regularly throughout each stage of their life, from infancy to young adulthood. Well-child visits are comprehensive, preventative check-ups that are vital to each child and teen’s overall health and wellbeing.  At Renown Children’s Hospital, our Pediatric Primary Care team is dedicated to treating children with personalized medical care – we are focused on each child’s individualized healthcare needs, offering services ranging from well-child visits and immunizations to sports physicals, care for illnesses and minor injuries, mental health support and specialist referrals when needed. Here is an overview of the timeline and importance of well-child visits for you to reference as you care for your children. Well-Child Visit Schedule Renown Children’s Primary Care provides the following well-child visit schedule: Three to five days after birth 2 weeks Two months Four months Six months Nine months One year 15 months 18 months Two years, and yearly after

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Every 8 minutes, someone is added to the national kidney transplant list – in Nevada, 575 people are waiting for their new lease on life. On average, transplant hopefuls are waiting for three to five years before they are matched with a new kidney.  One of those 575 Nevadans on the list is Kirill Zelenin, the son of an employee who has been with Renown for over 10 years, Masha Zelenin, Application Analyst.    As the recipient of Masha’s living kidney donation at 8 years old, Kirill’s life changed for the better at a young age. His new kidney reignited his energy, and according to Masha, it was as though “a light had turned back on” for Kirill.   Now, Kirill is 22 years old. Since transplanted kidneys last anywhere between 8 to 20 years on average, the need for a new kidney has returned. This year, Kirill was placed back on the kidney transplant list, awaiting another life-saving organ to, as Masha says, “bring the light back.” The mother-son duo is hoping for a match any day now. And thanks to the soon-to-be-opened Renown Transplant Institute, their hope gets a little closer to reality. A Mother’s Love, A Son’s Courage When Kirill was first diagnosed with kidney failure after his providers discovered a concerning level of hemoglobin in his blood, he was put on the transplant list and started on dialysis at home. While the dialysis was successful in absorbing and pulling out toxins, the side effects were grueling on Kirill. His appetite suffered, he had little energy, missed a lot of school days and didn’t feel “normal.” Masha, a single mom of two kids, was his primary caretaker.  The Zelenins knew that dialysis was never going to be a permanent solution for Kirill. The best possible solution for his failing kidneys was to give him a new one. So, Masha decided to get tested to see if she was a match. “Most donors can live a normal life with just one kidney without any restrictions,” she said.  The good news arrived in 2010: Masha was a match for her son.  Masha and Kirill headed to a transplant center, where the procedure went off without a hitch. Masha was proud to have had the opportunity to give her son the most precious gift of all – life. After the surgery, Kirill lived as a happy, healthy child and teenager. His appetite increased, he played sports and excelled in school. Masha felt the same – she went back to work as normal and continued to be the loving, involved mother of her two children. Even though Kirill has to be on immunosuppressants and be especially wary of infections, which can strongly affect transplant patients, both Kirill and Masha were able to live an otherwise normal life.  When the COVID-19 pandemic hit, Masha was working in the ICU at Carson Tahoe Health and in the Neurosurgery unit at Renown, and she knew she could be a contact risk for her immuno-compromised son. She made the difficult decision to separate from Kirill for six months, a loving action to protect his health while continuing to care for others.  And in the spring of 2020, at 18 years of age, Kirill received his high school diploma, excited to start college at the University of British Columbia that fall. New Kid(ney)s on the Block Masha’s generous organ donation proved to work wonders for Kirill for over a decade. At the 10-year mark, as the Zelenins expected, the kidney was ready to retire from its job as life saver and pass the baton onto a new kidney. This also meant Kirill had to go back on dialysis and begin the process of being placed back onto the national transplant list all over again. Due to the pandemic, the dialysis and the side effects he experienced, he began his college career online. This year, he successfully graduated with a double-major in History and Psychology.  “It broke my heart that he didn’t have a regular college experience,” Masha reflected. “The 10 medications he has to take daily for his kidney disease make him sleepy, have high blood pressure and feel unwell overall. But he is very determined and has a lot of dreams for the future.”  Currently, Kirill is taking computer science courses at Truckee Meadows Community College while he’s at home. Masha continues to care for him while the family waits for another life-saving organ. They remain optimistic about the future.  “Kirill has dreams of going to Europe for his master’s degree in history or architecture,” said Masha. “He wants to travel and experience as many places as possible.”  Kirill is now about four years away from receiving a match from a donor on the national kidney transplant waiting list.Filling the Need in Northern Nevada The establishment of the Renown Transplant Institute means a lot to many members of our community. Masha and Kirill are no different. To have access to advanced kidney treatment and transplantation right in their own backyard without having to travel out-of-the-area, according to Masha, “is a huge deal financially and emotionally.”  As Masha and Kirill have both experienced, kidney donors and recipients can live a full, healthy life with only one kidney. And once the Renown Transplant Institute officially opens, world-class transplant care for both the donor and the recipient will be closer to home. All donors are kept confidential; no donor is required to reveal their identity to the recipient unless they decide otherwise. If you or someone you know is interested in becoming an organ donor like Masha, join the 1.6 million Nevadans who have already done so. We strongly encourage you to learn more about the possibilities of organ donation from our partners at the Nevada Donor Network. Any questions about our transplant program or inquiries about kidney donation at Renown can be directed to the Renown Transplant Institute at 833-746-4684.  “Renown is a huge organization, and I have always felt a culture of support and understanding here. Everyone is compassionate and supportive. From the bottom of my heart, I believe we can find our hero within the Renown community,” Masha closes.

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August is National Make-a-Will Month. We talked to Abbey Stephenson, Planned Giving Officer at Renown Health Foundation, to learn more about wills, trusts and estate plans and why you should feel motivated this month to get started. Why Make a Will There are so many reasons why it is difficult to make a will or put an estate plan in place. These include: Lack of time or money to prepare a plan The misperception that “only rich people need an ‘estate plan’” How intimidating legal documents can be General discomfort with planning for the future Given the barriers to making a plan, it’s not surprising that only 32% of Americans have a will or trust in place. But having a will or trust matters because these are the documents where you can say who will inherit your assets, who will manage your assets and estate, and who should be guardian of a minor or a child with a disability. Where to Begin If you have been thinking about putting together a will and don’t know where to begin, here are some next steps you can take. 1.  Learn the terms. If you have never created a will, trust, or an estate plan, the language can be hard to get used to. A few important terms to know include: Last will and testament (also known as a will): a legal document that describes how you would like your property and other assets to be distributed after your death. This is also the document where you can nominate a guardian for a minor or disabled child. Personal representative (also known as an executor): a person named in a will responsible for collecting your assets, paying your debts and final taxes, and distributing the remaining assets to those stated in your will. Personal representatives must be formally appointed by a judge and report certain information to the judge for review and approval. Living trust (also known as a revocable or family trust): a legal arrangement set up through a document called a trust instrument or a declaration of trust that gives someone called the trustee power to make decisions about the trust creator’s money or property held in the trust. Estate plan: a collection of documents that help organize what happens to you and your assets upon your disability and death. Your estate plan is comprised of documents such as a will, trust, and advance health care directive. If you want to learn more about these terms and estate planning in general, you are invited to attend a free one-hour estate planning education session on Aug. 22, 2024, at 10 a.m. or Oct. 21, 2024, at 11 a.m., hosted by Renown Health Foundation. Click here for more information and to register. 2.  Create a list of assets. Start by creating a list of your assets including real estate, investments, bank accounts, retirement accounts, business ownership interests, vehicles, life insurance, valuable personal property like jewelry or artwork, and any other significant assets. Click here and read our free estate planning guide. 3.  Put together a list of 2-3 people you trust. When you create your will, you need to name a personal representative who will collect all your assets, pay your debts, and work with the probate court to distribute the balance to the people and charities you name in your will. If you create a trust, you need to name a trustee to manage the trust assets under the terms of the trust document. It is a good idea to include at least two people who can take on these roles in case the first person becomes unavailable. If you do not have anyone you would trust as a personal representative or trustee, there are trust companies, banks, and other professionals and institutions who may be able to assist you. If you are the parent of a child who is under 18 or has a disability, you will also nominate a guardian in your will to care for that child if you and the other parent are gone.  4.  Start a list of who you would like to inherit your assets. Which people and organizations would you like to inherit the assets you own at the time of your passing? And which assets or how much would you like them to receive? You might want to consider who relies on you for support such as family members or charities, individuals and organizations that have made a difference in your life, or those you have a special fondness for. It is important to use the legal names of individuals you include as beneficiaries and the Tax ID number for any charity you include.  If you decide to make a gift to Renown as part of your will or estate plan and notify us, you will be included in the Renown Legacy Society. Legacy Society members enjoy invitations to exclusive events, special acknowledgments, and other unique benefits. Click here to learn more about the Renown Legacy Society. 5.  Put together a list of your professional advisors and enlist their help. Write down the names and contact details for any professional advisors you work with such as your accountant, financial advisor, investment manager, attorney, insurance agent, and planned giving officer.  You may want to seek their advice on how best to proceed and which assets are best gifted to which individuals and organizations from a tax standpoint. Collaboration among the professionals with whom you work can help your plan to run more smoothly when it is needed. Depending on your circumstances, it may make sense for you to introduce your trusted individuals to these professionals. 6.  Start drafting. Once you have these items in place, you will be in a good position to begin the drafting process. There are many capable estate planning attorneys in our community who can help you with drafting. There are other drafting resources available as well, but only a licensed attorney can provide you with legal advice. Click here to attend the free Family Estate Planning Series sponsored by Renown and presented by PBS Reno and the Community Foundation of Northern Nevada.

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When a sudden illness or injury occurs, the emergency room (ER) provides immediate medical attention to those in need. Understanding the top reasons for visiting the ER can help people make informed decisions about seeking emergency care. Here are the five most common reasons people in Nevada visited an ER in 2023. 1. Abdominal pain  One of the top reasons people visit the ER is abdominal pain. The abdomen has many organs, including the stomach, liver, small and large intestines, gallbladder and pancreas. Significant pain in this area can be a cause of concern.  Warning signs of a serious problem include abdominal pain with fever, vomiting, and not being able to move or perform everyday tasks due to pain. Seeking medical attention when experiencing these symptoms is essential. Emergency physicians can perform abdominal exams, assess the condition and rule out significant threats.    2. Fever  High fevers that do not get better with medicine and are accompanied by other symptoms can cause concern. This can indicate that the body is fighting off an infection or illness.  Fever with symptoms like vomiting, pain, altered mental status, shortness of breath or inability to perform daily functions are warning signs to watch out for. Adults and children should visit an ER, where the team can assess the causes of the fever.   3. Chest pain and shortness of breath  Chest pain and discomfort, or pain in the upper body can suggest warning signs of a heart attack. If a person is experiencing signs of a heart attack, call 911 immediately to ensure timely treatment or assessment by a medical professional. Heart attack symptoms include:  Chest pain, including pain that can be described as chest pressure, heaviness or squeezing   Discomfort in the chest, arms, back, neck, shoulders and jaw  Difficulty breathing   Sweating with any of the above symptoms   When visiting a Renown ER for chest pain, a trained medical professional will promptly perform an Electrocardiogram (EKG) in an area where preliminary assessments, also known as triage, take place. Individuals experiencing shortness of breath or trouble breathing, whether from a respiratory infection, asthma complications or other pre-existing conditions should not ignore symptoms as these can signify more serious issues.  Warning signs of respiratory distress may include:  A significant change in breathing rate A significant change in the amount of energy used to inhale or exhale when breathing Changing of the skin color to blue, gray or paleness, which can indicate a lack of oxygen Nasal flaring  Chest retractions, which can suggest difficulty bringing air into the lungs What this looks like: the chest sinking in just below the neck, breastbone or rib cage while breathing 4. Neurological symptoms  Sudden and severe headaches or seizures may prompt individuals to visit the ER if symptoms are extremely disorientating or debilitating. These symptoms could be indicative of various conditions, including strokes or neurological disorders that require prompt evaluation.  If a person is experiencing signs of stroke, call 911 immediately to ensure timely treatment.  Stroke symptoms include:  Numbness, weakness or loss of movement in the face, leg or arm, especially on one side Confusion, including trouble speaking or understanding Trouble with vision or loss of balance  When choosing emergency care for signs and symptoms of stroke, a Comprehensive Stroke Center can provide patients with immediate intervention, including evaluation, treatment and education. 5. Cough/flu-like symptoms  Emergency departments are staffed by medical professionals trained to prioritize and treat emergency and trauma situations. Receiving care at an ER should be reserved for severe symptoms and life-threatening conditions. It’s best to schedule a visit with a primary care physician for mild cold and flu symptoms. Most urgent care locations are equipped with rapid testing options, including RSV, COVID-19, influenza, mononucleosis, urinary issues and strep throat. It is critical to distinguish between common respiratory infections and more severe cases, such as pneumonia or complications from the flu.   Symptoms that may warrant a visit to the ER include:  Rapid decline in the ability to perform regular daily activities  Coughing or throwing up blood  Severe dehydration and inability to drink fluids High fever not responsive to medication  Understanding top ER visits in Nevada  While these ER complaints are common reasons for emergency room visits in Nevada, it's important to remember that emergency care is available for all immediate medical needs. Do not hesitate to seek help at an emergency room if someone experiences a sudden or severe health concern. Quick and appropriate action can make a significant difference in keeping you and your loved ones healthy.  Renown Health is the largest locally governed, not-for-profit healthcare network in northern Nevada, providing leading emergency and trauma care by board-certified emergency physicians 24/7 at three locations, including the region’s only pediatric emergency department. Renown Health emergency rooms prioritize swift assessments, advanced diagnostic tools and compassionate care, providing leading emergency and trauma care. Trust Renown ER for not just emergency care but exceptional care. Learn more at renown.org/ER.

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