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    • Wednesday, Jan 05, 2022

    As Community Covid-19 Cases Rise, Renown Has Capacity; Prepared And Ready To Serve

    Renown team is prepared and ready to serve the community with staff, technology, supplies, equipment and remote patient monitoring services to meet needs and assure the highest quality care and safety. Many parts of the country and Nevada are seeing increases in COVID-19 cases and patients hospitalized with both the Delta and the new Omicron variant. As Nevadans experience the impact of the pandemic, the Renown Health team continues to be prepared to serve the community with staff, technology, supplies, equipment and services in place to meet the needs of patients and assure the safety of Renown's care teams. The Renown Health team ensures constant readiness and continues to safely screen, diagnose and care for patients with respiratory illnesses, including those at risk for COVID-19. Renown Health continues to have capacity to accept patients at all 11 Urgent Care locations, Renown's three Emergency Departments, including the Children's ER at Renown Regional Medical Center and the Emergency Department at Renown South Meadows Medical Centers. There is capacity if needed for additional patients on Renown's three Intensive Care Units or ICUs, and Renown hospitals continue to operate a full surgery schedule. "Every community member can feel confident that Renown has a 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 Susan Lee, MD, MBA, Chief Medical Officer, Acute Services. "News about the COVID-19 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." He reminds us, "Emergency departments are experiencing large numbers of patients presenting with COVID-like symptoms. Please do not visit the emergency department if you are experiencing non-life threatening symptoms including a sore throat or cough. Consider these options to get the care you need; use Renown's MyChart "Talk to a Doctor" for a virtual visit, obtain free COVID-19 screening and testing through the Washoe County Health District, or contact Renown at 775-982-5000 to make an appointment with a primary care provider." Renown Uses Analytics and Predictive Modeling in Service to the Community Renown continues to use current local and national data, analytics and public data sets for predictive modeling in service to our community. When there is heightened concern around an illness, enhanced infection prevention strategies are in place to ensure Renown is ready with the appropriate supplies and alternate plans should the need arise. Renown medical experts report the following information this week: 1. Cases in Washoe County have started climbing. It appears the Omicron wave has started in northern Nevada. The good news is that studies continue to show that vaccines and previous infection still provide people with protection from severe disease. Predictive analytics at Renown show that the Omicron wave is expected to peak in northern Nevada sometime between January 10 and February 10. 2. Data continues to mount that Omicron infections are much less severe than previous variants. The Renown team is preparing to see an increase in hospitalized patients, but at a far lower rate than during previous surges. 3. Today, new patient hospital admissions to Renown Regional Medical Center and Renown South Meadows Medical Center for patients with COVID-19 are low. Today, of the 501 patients hospitalized at Renown, less than 9% or 43 patients are hospitalized with COVID-19. This may change at any time and medical experts and scientists at Renown will continue to monitor data on a daily basis. Renown Offers State-of-the-Art Remote Patient Monitoring to Enhance Patient-Centered Model of Care Renown continues to enact the emergency preparedness plans that have been in place since the beginning of the pandemic, creating additional capacity for inpatients while allowing Renown to continue to deliver high-quality care. Renown now has state-of-the-art clinical remote monitoring services to serve additional patients diagnosed with COVID-19 who are clinically stable or improving. Remote patient monitoring is now being visualized and monitored by clinical staff within the new Renown Transfer and Operations Center (RTOC). The Transfer and Operations Center is powered by Renown doctors, nurses, technicians and national technology partners help ensure seamless care for patients and providers. Through this highly coordinated care logistics system, Renown is able to customize health care to the needs of every patient; delivering the right care, at the right time and place across the integrated delivery system. Renown clinicians are able to access near real-time information on patients' vital signs and symptoms, enabling them to identify adverse changes in health sooner and intervene earlier. "We are excited to continue to enhance our relationships with patients by integrating technology that supplements our care teams to provide patients with a virtual care solution that continuously tracks vital signs, making healthcare more accessible, affordable and convenient," said Tony Slonim, MD, DrPH, president and CEO, Renown Health. Patients and their loved ones have said they have greater confidence and security knowing that our clinical team is closely monitoring their health data and communicating regularly to deliver high quality, personalized care." Renown Continues to Welcome Patient Supporters at the Hospital Bedside Renown Health continues welcome two patient supporters to visit their loved ones during their medical visit, surgery, birthing or hospital stay. Renown continues to have extra safety measures in place to protect the health of patients, visitors and healthcare employees. All people entering Renown sites must continue bringing and wearing a face mask for their entire visit, including inside patient rooms. "Visiting the hospital can be an anxious experience," says c. "It's incredible how the company of loved ones can reduce anxiety and promote healing. What we can do together with families to support patient care and excellent outcomes is greater than what any of us can do alone. We are glad to welcome patient supporters to our hospitals to help our patients feel more at ease, so they can focus on their recovery, health and healing." In addition to in-person visits, there are many ways to brighten the day of a patient at Renown hospitals. You can send a personalized message that will be hand-delivered to your loved one, call 775-982-4100 to speak with a patient, or Renown's care team can facilitate virtual visits via computer or tablet from the bedside. Please note that Renown Health reserves the right to limit visitors in the best interests of patients, families, visitors or staff. The Best Protection Remains Vaccination At this time, the medical experts at Renown remind us that vaccination is still the best protection against Omicron and COVID-19, and Renown providers and hospitals have full capacity to care for those who are sick or injured. "The most important action you can take to protect yourself from the Delta and Omicron strains and the COVID-19 virus is to get fully vaccinated," says Brion Hill, MD who practices at Renown Urgent Care - Los Altos location. "The COVID-19 virus and its related strains are preventable and controllable through safe and effective COVID-19 vaccines, which are free and now widely available in our area. The CDC recommends all people 5 years and older be vaccinated against COVID-19. Data shows that nearly all COVID-19 deaths are now occurring among unvaccinated individuals." A list of providers in our area offering vaccines is available at vaccines.gov." Renown Hospitals #1 in State of Nevada In the most recent U.S. News and World Report Best Hospital rankings, Renown Regional Medical Center was listed the #1 hospital in the State of Nevada. Last year, Renown South Meadows Medical Center was named the #1 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.   Stay Up-to-date on COVID-19 To stay up-to-date on communications regarding Renown's preparation for COVID-19, FAQs and the scientific evidence behind the vaccine, visit https://covid.renown.org/   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 on line at https://careers.renown.org/   Support the Renown team Renown Health, a charitable, not-for-profit organization, is so grateful for our community's support during these unprecedented times. If you are interested in supporting Renown Health, a charitable, non-profit health organization, please consider giving to Renown Health Foundation. Donations are accepted through the following ways: Make a gift at www.renown.org/give Call Renown Health Foundation at 775-982-5545 Mail a check to Renown Health Foundation, 1155 Mill St., O2, Reno, NV 89502 Venmo: @RenownFoundation About Renown Health Renown Health is the region's largest, locally 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 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.

    Read More About As Community Covid-19 Cases Rise, Renown Has Capacity; Prepared And Ready To Serve

    • Friday, May 01, 2020

    Renown Resumes Medically Necessary Surgeries in Phased Approach

    Health System Follows Governor’s Announcement to Resume Necessary Surgeries on May 11, Remains Ready for Possible COVID-19 Surge. Renown Health announced today that they will align with the Governor’s Office and the state Medical Advisory Team in adopting a phased-in approach to resume limited medical and surgical procedures under strict guidelines and lift temporary restrictions due to the COVID-19 virus. The decision follows yesterday’s release of Governor Sisolak’s “Nevada United: A Roadmap to Recovery,” a plan designed to move forward to safely restart Nevada under a “new normal.” The health system will begin a phased approach to scheduling non-high risk patients as soon as Monday, May 4 for necessary surgeries beginning on Monday, May 11, 2020. “We’re able to resume some surgical services due to the flattening of the COVID-19 surge curve and the low COVID-19 transmission rate within our community due to the implementation of strong social distancing practices,” said Tony Slonim, MD, D.Ph., President and CEO, Renown Health. He added, “Our primary concern will always be the health and safety of our patients, physicians, healthcare employees and community members. We continue to monitor the surge curve and our current situation. Until a vaccine or cure is found, Renown Health remains prepared at all times to handle a surge and continues to care for those across northern Nevada.” “Elective-optional” procedural cases were temporarily postponed at Renown hospitals on March 17, to slow the spread of COVID-19 and to preserve critical resources.  Christopher P. Demers, MD, FAANS, Managing Partner at Sierra Neurosurgery Group and Medical Director of Neurosurgery at Renown, said, “I know how important surgery is to enhancing a patient’s quality of life. I am privileged to have the opportunity to perform surgeries that help people get back to doing the activities they love. We are guided by a simple and important principle: the patient always comes first.” “This is excellent news for so many patients who may have placed their surgeries and care plans on hold due to COVID-19,” said Christos Galanopoulos, MD, chair, department of surgery for Renown Medical Group, and a specialist in oncologic surgery. “Renown’s expert team is ready to deliver safe and effective care to all patients and has earned recognition as the region’s leader in patient safety, technology and specialized care,” said Galanopoulos. “We are proud of the incredibly detailed health and safety measures in place at Renown.” Health and safety protocols in place at Renown facilities include: All individuals entering Renown sites, including team members, are screened for COVID-19 symptoms; Patients scheduled for elective procedures will be tested for COVID-19 up to 5 days prior to scheduled procedure date. Patients will remain in isolation following the test, up to the time of surgery. Positive COVID-19 patients and symptomatic patients will not be scheduled for elective surgery. All individuals entering Renown sites are asked to don a cloth mask. Patients may bring their own mask or may opt to wear one supplied by Renown. All care team members wear surgical masks and protective eye wear, as well as other necessary personal protective equipment (PPE), at all times when caring for patients. Visitor restrictions are still in place. A support person is still encouraged for surgical patients, delivering OB mothers; children under the age of 18; patients with confusion, altered mental status or developmental delays; and end-of-life patients. Six-foot social distances have been established in public areas such as waiting rooms, elevators, cafeterias. Extra cleaning and disinfection is in place for all high-touch, public surface areas. Erik Olson, MHA, Chief Executive Officer of Renown Regional Medical Center adds, “Renown’s mission is to make a genuine difference in the health and well-being of the people and communities we serve. We deliver on this promise by collaborating with expert surgeons to offer general and specialized surgical interventions to alleviate disabilities and reduce the risk of death from traumatic injuries, cancers, cardiovascular disease and other conditions. Together we are dedicated to delivering safe, high-quality, compassionate, personalized health care.” Patients who wish to schedule their elective surgery or outpatient procedure should first contact their appropriate ordering provider. -END- Those interested in supporting Renown’s healthcare heroes are invited to visit www.renown.org/give for more ways on how to help. For up-to-date information on Renown’s approach to keeping our community safe, visit our website at www.renown.org/covid-19/.     About Renown Health Renown Health is a locally governed and locally owned, not-for-profit integrated healthcare network serving northern Nevada, Lake Tahoe and northeast California. Renown is one of the region’s largest private employers with a workforce of more than 7,000. It comprises three acute care hospitals, a rehabilitation hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown has a long tradition and commitment to continually improve the care and the health of our community. For more information, visit renown.org.

    Read More About Renown Resumes Medically Necessary Surgeries in Phased Approach

  • Histotripsy

    Renown’s Surgical Oncology team are amongst the first to use HistoSonic Edison® Liver Ablation system, a revolutionary advancement that leverages focused ultrasound to provide non-invasive, precise and efficient treatment solutions, thanks to a private donation.   This state-of-the-art solution for liver tumor ablation requires no incisions or introducers into the body by using focused ultrasound waves to noninvasively destroy a designated tissue or tumor in the liver, providing leading-edge surgical care to patients. Renown joins the Cleveland Clinic, Mayo Clinic and Johns Hopkins in being amongst the first in the country to offer this revolutionary non-invasive clinical procedure.

    Read More About Histotripsy

    • Renown Health
    • HealthyNV Project

    Healthy Nevada Project Returning Clinical Results to Participants

    The Healthy Nevada Project – a first-of-its-kind population health study combining genetic, clinical, social and environmental data – has reached another landmark milestone. The study is notifying study participants at risk for familial hypercholesterolemia, BRCA and Lynch syndrome. “I took part in the Healthy Nevada Project to find out my ancestry. I didn’t even realize the test could give me so much information,” says 29-year-old Jordan Stiteler, who was recently diagnosed with familial hypercholesterolemia (also known as FH) through the Healthy Nevada Project. “After my dad passed away suddenly at age 45, I learned I had high cholesterol but I didn’t know it was genetic and I didn’t get an FH diagnosis until last week,” Jordan explains. “I immediately changed my diet, started walking more and doing more cardio. I also set up an appointment with my primary care physician for the first time in a while. I’ve talked with my family and even strangers about testing since my diagnosis. I hope my story will inspire others to test and can save someone’s family from going through the same loss I did.” Healthy Nevada Project Notifying Patients of Familial Hypercholesterolemia Risks Jordan is among the first Healthy Nevada Project participants to receive clinical results from the genetic study led by Renown Institute for Health Innovation (Renown IHI) – a collaboration between Renown and the Desert Research Institute Foundation. This groundbreaking population health study is now reaching out to study participants like Jordan, who asked to be notified of health risks. If study volunteers choose, the project will also provide guidance on treatment and additional testing for family members who may also be at risk. The project is starting with the return of FH risks which is a genetic tie to high cholesterol. Just a few months ago, a paper in the Journal of the American College of Cardiology recommended genetic testing become the standard of care for patients with a definite or probable FH diagnosis. Jordan says she plans to have her young son tested as well. “This is the future of health; not just reacting to sick people, but a coordinated effort between innovative technologies, data-driven researchers, and responsive practitioners to deliver personalized interventions to identify, prevent and treat disease,” says Anthony Slonim, M.D., Dr.PH., FACHE, president and CEO of Renown Health and president of Renown IHI. “As care providers, we often don’t see patients until they’re already sick and that’s a difficult problem. By embracing personal genomics, we can accelerate the ability of researchers to access data and apply those learnings back to our health system sooner.” In the Months Ahead: Notification of BRCA1/2 & Lynch Syndrome Risks The Healthy Nevada Project will start notifying study volunteers at risk for other CDC Tier 1 conditions including hereditary breast and ovarian cancer syndrome (BRCA 1/2 genes) and Lynch syndrome in the months ahead. These conditions are the key focus for the Healthy Nevada Project. The reason: Because early detection and treatment will save lives, and these conditions are some of the most common. “This research allows us to look into cancer, cardiac, respiratory illness and beyond to identify underlying causes, assess real risks and eventually initiate appropriate preventive actions much earlier. Human subject research is often intangible to participants – we are treated as subjects. The Healthy Nevada Project is creating actionable information for our participants while engaging in leading-edge research on health determinants,” said Joseph Grzymski, Ph.D., associate research professor at DRI, principal investigator of the Healthy Nevada Project and chief scientific officer for Renown Health. Landmark Population Health Study Continues to Expand Since launching two years ago, the Healthy Nevada Project has quickly evolved and expanded. The pilot project enrolled 10,000 participants in just 48 hours in September 2016. In March 2018, phase two of project expanded to an additional 40,000 participants with genetic testing partner, Helix. Helix’s genomic sequencing provides participants and researchers greater depth and quality of DNA data. With this, they can gain further insights to improve health. During a recent media roundtable announcing the return of clinical results, the Healthy Nevada Project also announced plans to complete testing of 40,000 people by the end of 2018. This will bring the project’s total enrollment to 50,000 people – approximately 10 percent of northern Nevada’s population. The Healthy Nevada Project hopes to reach more than 250,000 people in its next phase. The ultimate goal is to offer genetic testing to every Nevadan interested in learning more about their genetics and health. Join the Healthy Nevada Project Recruitment for phase two is still open. In addition to opting in to receive clinical results, participants receive National Geographic’s Geno 2.0 ancestry app at no cost. They also have the chance to pick an additional app for health and wellness after completing a follow-up survey. Learn More or Sign Up

    Read More About Healthy Nevada Project Returning Clinical Results to Participants

    • Thursday, Nov 17, 2022

    Renown Health Honored with 2022 Digital Health Most Wired Award

    Most Wired Hospitals Use Technology to Deliver Better Patient Care & Experience. The College of Healthcare Information Management Executives (CHIME) has released their coveted Digital Health Most Wired Survey results for 2022, recognizing Renown Health with Most Wired status. Among the more than 38,000 organizations surveyed by CHIME, Renown Health ranked above peers in categories like analytics and data management, population health, infrastructure and patient engagement. The survey assessed the adoption, integration and impact of technologies in healthcare organizations at all stages of development, from early development to industry leading. Renown Health earned a Most Wired level 7 (of 10) achievement for use of technology for better patient care and patient experience in both CHIME’s acute and ambulatory surveys. This is Renown’s sixth consecutive year on CHIME’s Most Wired list, and Renown is the only healthcare organization in Nevada recognized with this prestigious award. “New and emerging technologies have transformed healthcare in recent years,” says Brian Erling, MD, MBA, President & CEO of Renown Health. “We are proud that our physicians, nurses, clinicians, and employees continue to be nationally recognized for their efforts to implement clinical systems and digital health tools to improve care for patients. Improving care through advances in technology and IT systems allows us to realize meaningful outcomes including increasing patient access to healthcare services, improving patient experience, and reducing costs across the entire system.” “To care for all those we serve, Renown’s IT team has open discussions and collaboration with care providers to think creatively and strategically about how to deploy advanced technologies that enable the best clinical outcomes for our patients,” says Chuck Podesta, Chief Information Officer, Renown Health. “Renown’s proactive approach to technology supports our mission– and is one of the many elements that set our organization apart. We are honored by CHIME’s recognition of our teams and processes to better care for patients.” “When clinicians have instant access to the information that they need to make care decisions; patients benefit,” says Sarah Kramer, MD, Chief Medical Information Officer, Renown Health. “Our technology investments include a single, unified electronic medical record system that spans all major hospital areas including inpatient, outpatient, emergency, intensive care, and surgical units. Having a single digital electronic medical record for our patients makes it possible for an entire team of clinicians across the continuum of care able to review a patient’s chart without needing to request that a physical chart be transported to them, which can take time and resources and sometimes delay care decisions. Our automated medical record system allows the right information to flow to our clinicians when and where they need it, ensuring safe and effective care. Patients also have ready access to all their medical information through the MyChart ® smartphone app, and are able to self-schedule for mammograms and lab appointments, message their primary care providers and refill medications as needed.” “The medical record is not the only area that benefits from an infusion of health IT,” says Melanie Morris, MSN, RN, Director of the Renown Transfer and Operations Center (RTOC). “Renown is pleased to serve as a model of coordinated patient care for the nation. Similar to how air traffic controllers manage traffic in and out of airports, the Renown Transfer and Operations Center (RTOC) team sees a birds-eye view of what’s happening with patients across our entire integrated delivery system. Having access to real-time information is critical because every action we take is tied to improving the health and well-being of our patients. Time and accuracy are always of the essence, and this Center drastically improves the efficiency of the entire Renown Health system.” Success in digital health increasingly determines the quality of patient care, and the scope of the CHIME Digital Health Most Wired survey reflects the progress of leading healthcare providers as they reinvent healthcare for a new century. The survey and recognition program serves as a comprehensive digital health checkup for healthcare organizations worldwide. “We are proud to honor your team’s exceptional dedication to excellence in digital health,” said Russell P. Branzell President and CEO, CHIME. “Your pioneering performance in the industry inspires other organizations by example. Patients in communities around the world receive better care when you drive change through digital transformation, as you have proven through your success in this rigorous program.” 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 CHIME The College of Healthcare Information Management Executives (CHIME) is an executive organization dedicated to serving chief information officers (CIOs), chief medical information officers (CMIOs), chief nursing information officers (CNIOs), chief innovation officers (CIOs), chief digital officers (CDOs) and other senior healthcare IT leaders. With more than 5,000 members in 58 countries plus two U.S. territories and over 190 healthcare IT business partners and professional services firms, CHIME and its three associations provide a highly interactive, trusted environment enabling senior professional and industry leaders to collaborate, exchange best practices, address professional development needs, and advocate the effective use of information management to improve the health and care in the communities they serve. For more information, please visit chimecentral.org.

    Read More About Renown Health Honored with 2022 Digital Health Most Wired Award

    • Employee Story

    3,000 Miles Away But Close to Home

    Overcoming poverty is not a task of charity, it is an act of justice. Like slavery and apartheid, poverty is not natural. It is man-made and can overcome by the actions of human beings. Sometimes it falls on a generation to be great. You can be that great generation. Let your greatness bloom. – Nelson Mandela, February 2005, Make Poverty History Campaign in London Lifting away the curtain that symbolized the front door, I entered a dark, cinderblock room and instantly became overwhelmed by an unpleasant odor. Working with oncology patients as a Child Life Specialist and an Occupational Therapist for over ten years, I recognized that smell. I had arrived in Guatemala – more than 3,000 miles from Reno – and it was my first day of a week-long trip where I would be serving alongside physicians in low-income communities providing free medical care for residents. My name is Brittany Jemmoua, I am an occupational therapist at Renown, and I recently volunteered with Kalan Kuxtal, a non-profit Guatemalan organization. I served alongside physicians by providing free primary care mobile clinics and home visits. The care we provided focused on prevention, intervention, education and lifestyle/medication management as we partnered with local entities, such as fire stations, community centers and schools to transform hundreds of lives. Speaking in both English and Spanish, I collected patient intake information, performed exams, tested for diabetes, and collaborated on a diabetes research project focused on daily risk assessment. Beyond these tasks, I immersed myself in the culture and learned more from the Guatemalan people than I could have ever imagined. Similar to Renown, Kalan Kuxtal Operates with Community at its Core Kalan Kuxtal, a Mayan expression meaning “life guardian,” is different from other volunteer medical trip organizations, and I took home valuable insights and lessons from their way of life that I now consider daily in my practice at Renown. I expanded my knowledge about diabetes, hypertension, pharmacology, infectious diseases, pregnancy complication, vector-borne illness and tuberculosis. We conducted home visits for socially neglected populations rather than expecting everyone to come to our clinics. I found that being welcomed into people’s homes gives you a different lens in which to view how their medical diagnoses interact with living conditions, occupations, and quality of life. This is when I met Mercedes and her mom. Her mom, Ms. Valencia, had jaundice skin and a substantial Basal Cell Carcinoma aggressively protruding from her face that impacted eating, hearing, seeing, sleep and social interactions. This opportunity to serve within their home led to an important palliative care conversation that would have been missed had we stayed in the clinic. We combed the rural neighborhoods assessing people’s risk for diabetes, taking glucose tests and educating families about their next steps. Many individuals had uncontrolled diabetes and misunderstandings regarding basic health management strategies. At the end of the day, many people demonstrated feelings of empowerment by actively offering solutions regarding how they will manage their day-to-day glucose with diet and exercise. Small actions can lead to big changes, and in the long-term, these health actions can help them avoid medication costs and focus on affording basic life necessities, such as water and electricity. Kalan Kuxtal organized a cultural day that included going to local businesses and community leaders to learn more about how they support the people of Guatemala. For example, Valhalla Macadamia Farm’s main goal is to help communities gain access to income, employment, and improved wellbeing by donating macadamia trees to families to grow and then sell macadamia products. A Weeklong Trip with Lifelong Impacts Each patient made a lasting impact on me, both personally and professionally. One specific family I saw in the clinic had a unique situation in that their two-year-old daughter, Margareth Elizabeth Cifuentes Bautista, was laboriously diagnosed with irregular corneal syndrome associated with glaucoma of congenital origin. Due to Guatemala’s limited prenatal screens and interventions, Elizabeth is nearly blind. While highly spirited and happy, she trips, bumps and feels her way through life. One barrier to her healthcare access is that her hard-working parents remain well below the poverty line, making less than $900/month. I am working to connect them with generous US Ophthalmologists and pediatric eye specialists to explore how we might save her sight and help her family. Their biggest dream is that she could recover her eyesight. “I know that this is not a life-threatening situation, but it is still something that never stops hurting me,” Jorge Cifuentes, Elizabeth’s father, said. “Unfortunately, our situation here is very hard. This country [Guatemala], although beautiful, it is very difficult to get ahead. We are people living in underprivileged conditions which complicates our situation even more. However, we are still trying to thrive by being kind and hardworking people. Thank you for helping us.” I have had the privilege of an opportunity for education, access to healthcare, employment and am aware that inequity and injustice prevail. This experience reinforced my understanding that medicine is a physically and mentally demanding profession that requires a commitment to service, continuous learning and adaptation both on local and global scales. I encourage everyone to please join me in serving the underserved by volunteering. Brittany is an experienced Occupational Therapist at Renown and volunteers with Kalan Kuxtal and other entities, such as The Robert Unsworth Foundation and Rock Steady Boxing to elevate communities. She loves being an Occupational Therapist; however, her life experiences confirm that her true calling is to become a physician. She is currently applying to medical school. Brittany is eager to earn the responsibility to improve lives and communities as their engaged physician. Brittany is tentatively scheduled to return to Guatemala at the end of this year to continue partnering with the people for a better future. You are welcome to join!

    Read More About 3,000 Miles Away But Close to Home

    • Employees
    • Renown Health

    Department Spotlight: Transformation Management

    Process improvement, program oversight and performance growth are the three “P’s” that mark the crucial aspects of ensuring everyone within our health system rows in the same direction. The duty of ensuring we transform together under the guidance of strong leadership and clear goals is no easy task – consistently finding performance gaps to close and focusing attention on our many strategic initiatives requires the care and collaboration of team members devoted to continually finding new ways to make Fighting the Good Fight better, brighter and broader. The forefront of innovation and organizational excellence can be found within Renown Health’s Transformation Management Office (TMO). As the heart of program management and strategic business analysis at Renown, the TMO steps up to the plate to ensure our organizational goals resonate through every layer of our health system, from teams on the frontlines to senior leadership. The mastery of these team members lies not only in their abilities to direct resources where they matter most but also in their roles as stewards of our health system’s future.  The Eagle Eyes of Improvement  When it comes to understanding and supporting Renown’s strategic direction, the TMO acts as our eagle eyes in the sky, overseeing the programs and processes that keep our health system running every day, which in turn helps improve the health and well-being of all our patients. The TMO manages three main functions that are vital to our health system’s bottom line:  Leadership Alignment: Aligning organizational goals with management’s plans and the work of the frontline team members, ensuring that everyone is working to achieve the same purpose and partnering with leaders for performance improvement along the way. Program Management: Emphasizing our resources on high-impact strategic initiatives while developing and overseeing 1-3 year roadmaps for all programs at Renown. Strategic Business Analysis: Assisting with closing performance gaps by identifying process improvement opportunities and new capability requirements.  “The TMO is here to ensure alignment between organizational goals (strategy) and the plans of our leaders (projects, improvement initiatives and roadmaps) so that our frontline teams are focused on the right things and receiving the maximum amount of support,” said Jamie Baldemor, Director of Transformation Management. “We are all here to fulfill our purpose for our community; we can do this faster and more effectively when we are rowing in the same direction all together.”  “In this role, no two days are the same,” added Alan Smith, Transformation Manager. “The team is enthusiastic about the work and vigilant about tackling new challenges. There are days when we engage with frontline teams, listening and observing to gain an understanding of a problem to solve. Other days are spent collaborating with department leaders, identifying new projects and working to shepherd ideas through complicated processes and remove barriers. It is easy for us to see the impact of our work where the change happens daily. As a relatively new department, we have been able to quickly understand the strengths of the team and get to work.”  Knowing that ensuring the longevity of our health system heavily involves successful leadership, the TMO’s approach to achieving our organization’s short-term and long-term goals involves closely collaborating with leadership to align growth strategies with support services.  “We engage with operational leadership teams at all levels across the organization,” said Robert Forrest, Manager of Enterprise Portfolio Planning. “Most days, we work alongside leadership teams to understand how they aim to grow their business and then work to identify impacted support services teams. This usually involves understanding how project needs match up with resource availability and how we can execute when resources are not available.”  The TMO is staunchly dedicated to improving patient outcomes. Our health system can always count on this team to find new ways to expand and enhance our clinical impact to meet the healthcare needs of Renown’s service areas – and they do it by being expert collaborators.  “On a daily basis I collaborate with administrative leaders, physician leaders and executives to intake, prioritize and scope projects and ideas,” said Rob Blamire, Enterprise Program Manager. “These projects enhance patient care in neurosciences, cardiology, oncology, children’s health and women’s health. My team is currently working on numerous projects that will expand clinical space and services to support our growing community.”  Amidst their culture of enthusiasm and dedication, each member of this team finds their work deeply satisfying, eagerly anticipating each day full of new challenges to solve. Fueled by a shared passion for Renown’s trajectory that drives their collective efforts, they look forward to the promising horizon of our health system’s future.   “Being a part of the TMO is fulfilling, and I enjoy coming in to work every day,” said Samy Arellano, Enterprise Program Manager. “The people on this team are passionate about where the organization is heading. I am excited for Renown’s future!”  Unique Backgrounds, Exceptional Results  Many teams at Renown draw attraction from a diverse array of professional experiences, and the TMO is no different. No two team members have the same background – a fact that the TMO uses to their advantage to pull from a wide range of expertise in order to optimize our organizational goals.  "I have experience in healthcare settings as an aide, analyst and manager,” said Rob Blamire. “My diverse professional background includes physical therapy, primary care, pediatrics, healthcare consulting and multispecialty settings. I ended up in the Transformation Management Office while seeking work with overlap among Renown divisions. A team member in the TMO is an exciting position to understand and support the strategic direction of Renown.”  For some of these team members, process and program improvement has always been a calling. Being at the forefront of furthering the strategic initiatives for the largest integrated not-for-profit health system in Nevada continues to be an opportunity they embrace daily.  "I am grateful to have started my career in process improvement, then called the Transformational Health Care department, where the team was responsible for the execution of 40+ improvement initiatives each year,” said Alan Smith. “After leadership roles in Emergency Services and Renown Medical Group, I returned to my true passion of process improvement to make an impact on a large scale to improve patient outcomes and experiences, as well as contribute to our future goals as a health system.”  “I began my time here in process improvement and was exposed to the wildly complex nature of our healthcare system,” added Robert Forrest. “I spent four years on the team running Kaizen and rapid process improvement workshop (RPIW) events, piloting and deploying our daily management system, and supporting organization-wide initiatives as needed. From there, I transferred to the Enterprise Project Management Office as a Strategic Business Analyst. In this role, I supported new projects and initiatives by collaborating with Operational Leadership teams and Project Team members to develop the scope of new requests.”  While their backgrounds may differ, one collective goal remains the same among the TMO: help Renown achieve new heights and further its goals, which in turn helps us expand on our mission to make a genuine difference in the health and well-being of our community. The best part? This team gets to do precisely that day in, day out.  "Prior to working at Renown, I worked at the Reno Housing Authority as the Director of IT,” said Samy Arellano. “I led IT initiatives and strategic goals for the agency. The goal was to provide better client experiences through technological innovation. I joined the TMO at Renown because I felt that this team was excited about helping Renown leadership reach organizational strategic goals, and I really loved that part of my role as the Director of IT. Now I get to do that every day!”  As the team weaves their enthusiasm for our health system into their daily work, the TMO’s commitment to realizing Renown’s vision will never waver. Through their dedicated efforts, this team exemplifies how strategic transformation can pave the way to a healthier future for all our patients.  The Renown Reason  The TMO is a stellar example of Renown’s determination in action – and to them, working for Renown is a no-brainer. With their devoted efforts and community-minded spirit, they embody our health system’s pursuit of excellence in healthcare delivery.  “I am proud to work at Renown Health and drive strategic programs focused on improving membership and patient access,” said Joseph Brooke, Enterprise Program Manager. “This is so important to the community we serve. Our TMO team, Renown leaders and so many colleagues that I work with day to day are committed to making a difference.”  "My passion for working to make a difference locally is why I chose to work at Renown,” added Samy Arellano. “I stay because I see the good this organization does in the community.”  Like every department at Renown, these team members feel a special attachment to Renown’s mission. They feel a sense of fulfillment not only within their career goals but also within their personal lives.  “I love Renown’s mission,” said Robert Forrest. “Coming in every day knowing that we are making a genuine difference in the health and well-being of the people and communities that we serve makes this job incredibly rewarding.”  “Renown aligns with my career aspiration to work in a large, clinically integrated healthcare system focused on improving population health,” added Rob Blamire.  As a driving force behind improvement and progress, the TMO continues to shape a future of transformative healthcare processes and programs. Here at Renown, we can proudly call them the pioneers of fostering lasting change for our health system for years to come.  “Renown has been the best hospital and health system I’ve been a part of. For as long as I’ve been here, there has been an obvious commitment to providing exceptional care to the community which includes many of my family members and friends. I am proud every day to be a part of making it even better,” closes Alan Smith.

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    • Wednesday, Oct 09, 2024

    Nationally Recognized Bariatric and Gastroesophagel Surgeon Joins Department of Surgery at Renown

    Renown Health, the region’s largest, locally governed, not-for-profit integrated academic health care system serving Nevada, Lake Tahoe, and northeast California is proud to announce the appointment of Alexander L. Ayzengart, MD, MPH, FACS, FASMBS, as the first robotic bariatric and gastroesophageal surgeon to be employed by the Department of Surgery.  “Dr. Ayzengart brings a wealth of expertise and experience, specializing in minimally invasive management of obesity, reflux, esophageal and stomach disorders, and select abdominal general surgical conditions,” says Rahul Mediwala, MD, MBA, CEO of Renown Medical Group. “We are committed to addressing the growing need for effective, long-term solutions for obesity, stomach disorders and related conditions. Dr. Ayzengart specializes in gastric bypass, sleeve gastrectomy, and revisional bariatric surgeries, and provides personalized care for people struggling with obesity and its associated risks, such as diabetes, heart disease, and hypertension.”  Dr. Ayzengart is affiliated with the University of Nevada, Reno School of Medicine as a clinical assistant professor of surgery and is involved with educational and research efforts through UNR. Dr. Ayzengart earned his medical degree from the University of Michigan Medical School in Ann Arbor, MI. Dr. Ayzengart completed his general surgery residency at the University of California San Francisco Medical Center. He completed subspecialty training in advanced laparoscopic, robotic, and bariatric surgery at the Cedars-Sinai Medical Center in Los Angeles, CA. He also served as a lieutenant commander in the U.S. Navy Medical Corps. As an active-duty general surgeon, Dr. Ayzengart was a staff surgeon at the U.S. Naval Hospital in Camp Pendleton and a department head at the U.S. Naval Hospital in Yokosuka, Japan.  “Dr. Ayzengart has earned a national reputation for excellence in patient care, with a holistic approach that emphasizes not only surgical outcomes but also post-surgery support, nutrition, and lifestyle changes for long-term success,” says Christos A. Galanopoulos, MD, MBA, MSc, FACS, VP, Chairman Department of Surgery at Renown Health. “We are fortunate to have him on our team. The addition of bariatric surgery aligns with our mission to provide comprehensive and essential healthcare services to our growing community. Dr. Ayzengart is a superb clinician, skilled investigator and effective educator. His expertise is a critical resource for people looking to achieve a healthier, more fulfilling and active lives.”  Dr. Ayzengart is excited to join the Renown team and to serve the community. “I’m honored to be part of such a progressive and innovative healthcare organization that puts people first and prioritizes excellent care. Together, we will help individuals regain control of their health and overall well-being,” said Dr. Ayzengart.  Dr. Ayzengart’s clinical interests include bariatric, anti-reflux, gastroesophageal, and abdominal surgery. He is board-certified through the American Board of Surgery and is a Fellow of the American College of Surgeons and American Society for Metabolic and Bariatric Surgery. He is currently a vice president of the California / Nevada state chapter of the American Society for Metabolic and Bariatric Surgery (ASMBS), and previously served as a president-elect of the Florida, Puerto Rico, and the Caribbean state chapter. Dr. Ayzengart is a long-term committee member of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), the Society for Surgery of the Alimentary Tract (SSAT), the American Foregut Society (AFS) and ASMBS.  He is widely recognized as an expert in the fields of bariatric and gastroesophageal surgery, having published numerous peer-reviewed publications and book chapters, and presented at a variety of regional, national, and international conferences. Dr. Ayzengart is bilingual in Spanish and Russian and is a trainer and mentor for other surgeons who are interested in adopting robotic surgery into their practice. Dr. Ayzengart’s Clinical Expertise Includes:  Metabolic bariatric surgery – adult, adolescent, and pediatric; revisional and primary;  Anti-reflux surgery, benign gastric and esophageal disorders, peptic ulcer disease;  Gastroesophageal cancer surgery and palliative surgery for obstruction of stomach and esophagus; Abdominal solid organ and small bowel surgery for variety of benign and malignant conditions;  Advanced therapeutic endoscopy for management of bariatric and foregut complications;  Robotic management of inguinal and certain abdominal incisional hernias. If you are a physician and would like to refer patients, or a person who wishes to be screened for surgery by Dr. Ayzengart, please contact Renown Surgery Care at 775-982-6270. Dr. Ayzengart sees patients at Renown Surgery at 1500 E 2nd St, Ste 300 in Reno, NV.  As the region’s only Level 2 Trauma Center for adults and children, Renown serves over 1 million people and 100,000 square miles. In U.S. News and World Report Best Hospital Rankings, Renown Regional Medical Center is named #1 Hospital for the State of Nevada for 2024, 2023 and 2022.    About the University of Nevada, Reno School of Medicine 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.     About Renown Health Renown Health is the region’s largest, locally governed, not-for-profit integrated health care network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 7,500 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. For more information, visit renown.org.

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    • Thursday, Jul 01, 2021

    First Student Welcomed to Medical Assistant Program at Renown

    As the need for Medical Assistants grows, graduating Hug High Health Science Academy senior, Ana Hernandez Rodriguez, starts NHSE sponsored Renown Medical Assistant apprenticeship at TMCC According to the U.S. Bureau of Labor Statistics, employment of Medical Assistants is projected to grow 19 percent from 2019 to 2029, much faster than the average for all occupations. The growth of the aging baby-boom population continues to increase demand for preventive medical services here in Nevada and across the country. An increasing number of group medical practices, clinics, and other healthcare facilities also need medical assistants to perform administrative and clinical duties. Medical assistants work mostly in primary care, a steadily growing sector of healthcare. With an eye towards this future, Renown Health proudly accepted its first student, Ana Hernandez Rodriguez, a graduating senior from Procter R. Hug High School’s Health Science Academy CTE program in Washoe County, into its newly created Medical Assistant apprenticeship program. Ana will begin the program as a full-time employee with benefits and start her apprenticeship coursework at Truckee Meadows Community College (TMCC). Sponsored by the Nevada System for Higher Education (NSHE), Renown’s Medical Assistant Apprenticeship Program was approved by the Nevada State Apprenticeship Council, which was overseen by the Governor’s Office of Workforce Innovation (OWINN), in February. The Renown Medical Assistant Apprenticeship is a one-year competency-based program that includes up to 2,000 hours of On-the-Job training and 193 hours of Related Technical Instruction offered through TMCC. All classroom, clinic and work time is paid. Apprentices work under the supervision of a Medical Assistant, Registered Nurse, or medical provider to assist in responsibilities including escorting the patient from the waiting room to the examination room, taking vital signs, stocking supplies, placing and receiving phone calls including appropriate documentation in the Electronic Medical Record, preparing lab specimens for processing, completing the necessary referral forms, obtaining authorizations and keeping records for referrals. Upon completion of the program, apprentices complete the final exam to become a National Certified Medical Assistant. “NSHE is proud to serve as the apprenticeship program sponsor and create more apprenticeship opportunities like this program throughout Nevada,” said Cheryl Olson, NSHE Apprenticeship Navigator and Director of the Nevada Alliance for Youth Apprenticeship. “We welcome Ana as she joins our extraordinary team of healthcare professionals at Renown,” said Tony Slonim, MD, DrPH, President & CEO of Renown. “We are always looking to support and invest in the next generation of health professionals to address the health needs of our community. Medical Assistants serve an essential role in physician offices, hospitals and other healthcare facilities performing important administrative and clinical responsibilities and assisting in medical care including greeting patients, recording medical histories and vital signs and helping to coordinate care.” According to the US Department of Labor “Projections Central” the demand for Medical Assistants in Nevada will increase by over 25% by 2028, with over 260 job openings available per year. On the importance of apprenticeship programs like Renown’s Medical Assistant program, NSHE Chancellor Melody Rose said, “The Nevada System of Higher Education is committed to promoting more attainable, affordable, and innovative pathways toward successful careers in fields like healthcare, advanced manufacturing, and information technology through apprenticeships. Programs such as the Renown Medical Assistant apprenticeship are changing how we think about accessing higher education and offering true ‘Learn and Earn’ pathways.” Ana’s acceptance into the Medical Assistant apprenticeship program is a proud moment for her soon-to-be alma mater. “Ana has earned this opportunity through hard work and dedication to her studies,” said Melissa Osterhage, who teaches health sciences at Procter Hug High School. “She is a compassionate, caring, and intelligent young woman, and I look forward to seeing everything she will accomplish as she moves forward in a career in the medical field. I couldn’t be more proud of her, and I am grateful she has been awarded this apprenticeship.” Ana graduates from Hug High on June 22 and starts her Medical Assistant apprenticeship program just a few days later on June 29, and is excited for her future. "Being accepted to this opportunity at Renown has been amazing and wonderful. When they told me I was accepted, I was so excited that I cried because I felt so blessed. This is going to help my future in so many ways. It is going to give me the opportunity to work in the medical field. I will start as a Medical Assistant and my goal is to work toward becoming a registered nurse. I took a leap of hope and made it. So, I tell others- believe in yourself and you can accomplish anything in life," she said. Ana is also welcomed to Renown by Michelle Sanchez-Bickley, Chief Human Resources Officer at Renown, who helped coordinate this workforce program. “Healthcare jobs in Nevada represent excellent employment for thousands of Nevadans poised to enter the state’s workforce over the next decade. Opportunities are increasing as we encounter growing demand for health care services at Renown, coupled with population growth, an improving economy, and retirees relocating to the Silver State. Ana and our Medical Assistants are so vital to helping our medical providers care for patients and are critical to the excellent care we provide.” For more information on the next Medical Assistant Apprenticeship program, please email kayla.mcmain@renown.org. To apply for a career opportunity at Renown visit our website.     About Renown Health Renown Health is the region’s largest, local not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 7,200 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. Clinical institutes include: Cancer, Heart and Vascular Heath and Neurosciences. 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 OWINN OWINN helps drive a skilled, diverse, and aligned workforce in the state of Nevada by promoting cooperation and collaboration among all entities focused on workforce development. Its chief objectives are to prepare all K-12 students for college and career success, increase the number of Nevadans with postsecondary degrees and credentials, and boost employment outcomes in training and credentialing programs. About NSHE The Nevada System of Higher Education, comprised of two doctoral-granting research universities, a state college, four comprehensive community colleges, and one environmental research institute, serves the educational and job training needs of Nevada. NSHE provides educational opportunities to more than 100,000 students and is governed by the Nevada Board of Regents. The System includes the University of Nevada, Las Vegas, the University of Nevada, Reno, Nevada State College, Desert Research Institute, the College of Southern Nevada, Great Basin College, Truckee Meadows Community College, and Western Nevada College. About Washoe County School District The Washoe County School District includes the Reno/Sparks metropolitan area, Incline Village, Gerlach, and Wadsworth, Nevada. The District provides each of its 62,000 students with a superior education in a safe and challenging environment and is committed to graduating every child career- and college ready.

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    • Men's Health
    • Active Living

    Testosterone, Men and Health: What You Need to Know

    You probably know testosterone (T) plays an important role in how boys physically develop into men. But is that all you know? What happens when a man's T levels are off? Are there symptoms men should look for? And what are the treatment options? Dr. Bobby Kahlon, MD, Renown Medical Group provides answers in a Testosterone Q&A.   What does testosterone do for men?  "Testosterone is known as the 'manly hormone' for a reason," says Dr. Kahlon. "Though women also naturally produce small amounts of it, men produce testosterone at much higher concentration levels. And it affects men in more physical and obvious ways. How much hair a man has on his chest, how deep his voice is, or how muscular he is are all attributable in some way to testosterone. It's also responsible in large part for sex drive and bone strength and affects how men think, learn and experience their surroundings."  Testosterone in men:   Powers virilization (male physical characteristics) and sexual function Builds muscle mass and strength  Supports bone density  Improves cognition  T Trivia: Discover Magazine reveals that “manly” testosterone and other sex hormones evolved long before we did — 500 million years ago — from the ultimate “female” hormone, estrogen. Can you have too much or too little testosterone?  Though high testosterone isn't a concern for most men, low testosterone or low T occurs more frequently and develops for two primary reasons.  Dr. Kuhadiya explains, "Subnormal testosterone concentrations occur either due to pituitary or testicular failure and the causes for each need to be discussed with your physician."  Pituitary failure: Approximately one-third of men with obesity, type 2 diabetes, or metabolic syndrome (which includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels) have low free — or "bioavailable" — testosterone. These health conditions can cause the pituitary gland to "fail" to release follicle stimulating hormone (FSH) and luteinizing hormone (LH) which are essential for triggering testosterone and sperm production. And that can cause low testosterone (hypogonadism). Testicular failure: Though less common than pituitary failure, testicular failure may also be responsible for low T. It's caused by diseases or illnesses affecting the testicles, injury or trauma to the testicles, or certain medicines and treatments such as chemotherapy or opioid pain medication. Providing your complete medical history to your doctor is always the first step toward a proper diagnosis.  What are the symptoms of low T?  The following indicators could be a sign that you have low T, say the doctors.  Lack of motivation and determination, including mild depression  Loss of physical endurance and muscle strength  Loss of or diminished early morning erections  Reduced libido (sex drive)   Erectile dysfunction (ED — difficulty achieving or maintaining an erection)   Gynecomastia (male breasts)  Small testes  T and Time: T levels in men naturally begin to decline by about 1% a year starting at age 30.  How do you test for low T?  "There are different methods for testing testosterone levels," says Dr. Kuhadiya. "Each approach uses a blood sample to evaluate total testosterone, which includes free and attached testosterone that combines with proteins albumin and sex hormone-binding globulin (SHBG). For the most accurate results, testing is based on samples collected in the morning after fasting, and from tests on two different days."  What treatment options are available?  "Well, your best natural option may be YOU," says Dr. Kahlon. "Men with pituitary failure are often able to treat their low T by losing weight to increase levels of the hormone. And even if you don't lose weight, exercise can help boost your testosterone. Unfortunately, if you have testicular failure, weight loss and exercise may not have the same effect."  So, are there other options? "You may want to consider Testosterone Replacement Therapy (TRT)," says Dr. Kuhadiya. "TRT is only available to men who are hypogonadal — with a clinical diagnosis of low T. Injection, gel, skin patch and nasal spray are available TRT options. The best option is the one that works best for the patient. Convenience, insurance coverage and cost are all factors to consider." Dr. Kahlon's TRT preference? Daily gel treatments, which are applied directly to the skin. On the other hand, Dr. Kuhadiya recommends intramuscular injections, which take place once a week or every two weeks.  But both doctors agree on this: physicians and their patients need to weigh the benefits and risks of TRT before proceeding with treatment — especially if your low T condition may require lifelong treatment. "In my clinical practice, I have seen some very good long-term results with an improved quality of life," says Dr. Kuhadiya. "However, in certain situations, TRT may increase the risk of heart disease and is not recommended for men with a history of prostate cancer." Dr. Kahlon adds, "Patients receiving any type of hormone therapy need to be closely monitored throughout the treatment process for any changes in their health."   How do you feel about steroids and T boosters?  "I don't recommend them, certainly not for hypogonadism," advises Dr. Kahlon. "There is no evidence to support anabolic-androgenic steroids or testosterone boosters as a safe or effective treatment for low T in men."  "In fact, there continues to be emerging evidence they may lead to side effects that could potentially harm the liver and the pituitary and endocrine functions of the body," warns Dr. Kuhadiya. "And that damage may be irreversible."

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