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To be on the move is a scary concept when you’re recovering from surgery. But did you know getting up and at ’em could be the key to a quicker recovery, post-surgery? Here’s some expert insight from Renown Surgical Services. The team at  has some news for you: Rest and movement are important to prevent serious complications. Here are some tips about how to get mobile after your procedure — and why it’s fundamentally important. Tip 1: Start Simple While you’re in bed, move your legs and feet up and down. Be sure to ask the nurses to help you get out of bed and into the chair for all your meals, or walk to the bathroom when needed. If you feel up to it, take a walk in the hallways with the nursing staff. Tip 2: The Sooner, the Better This may be surprising, but too much rest is not necessarily a good thing. The old saying “You use it, or you lose it” rings very true to maintaining the strength needed to get yourself out of bed. Beginning the mobility process early in your hospital stay will not only help you maintain strength and function, it may also help you get home sooner. Though it may seem counter intuitive, lying in bed all day can delay your healing time and cause serious complications to arise, including pneumonia, deep vein thrombosis or blood clots, pressure ulcers and sometimes constipation. Tip 3: Mobilize Your Support System Getting out of bed, sitting in a chair for meals and walking around your room or hospital unit can help reduce your risk of complications. The nursing staff will help you out of bed the same day of your surgery if it’s cleared by your doctor. Tip 4: Safety First The nursing staff is here to keep you safe, so make sure you call them for assistance getting out of bed. Even if you think you can do it yourself, use your call light to notify the nursing staff you are ready to get up and move. In addition, new medications can sometimes impair our judgment, balance and safety, so it’s always better to have help even though you may not need it. This is also why you may have a “bed alarm” on, to remind you to call for help and keep you safe while you are recovering. Tip 5: Move, But Manage Your Pain Many people find that getting up and moving actually helps their pain, rather than making it much worse. Taking the right amount of medication at the right times will minimize your pain and help you to get moving. Your care team will work with you on how much pain medication is right to manage any postoperative pain, with the goal for you to be comfortable enough to be able to move and gradually increase your activity each day. Tip 6: Maintain that Momentum at Home Mobility doesn’t end once you’re discharged from the hospital. It’s key to keep moving to maintain health and function. When you first arrive home, it’s crucial to take frequent movement breaks throughout the day. Increase activity as it becomes more comfortable, and be sure to ease back into an active daily routine. If you have concerns about your mobility once home, be sure to discuss this with your doctor at your follow-up appointment. Renown Surgical Services | 775-982-3993 Ask your doctor if you have any questions about your medical condition or the specific surgical procedure planned, or contact the team at Renown Surgical Services. Learn More

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Many factors are contributing to the rise of early onset puberty in girls. Learn what they are below and how you can support your daughter. The number of girls experiencing early puberty has increased dramatically over the last few years and continues to grow. More and more girls in the U.S. are starting to show signs of development before the age of 8. Recent studies show that up to 10 percent of Caucasian girls and 23 percent of African American girls are showing signs of puberty by age 7. What’s Contributing to Early Puberty in Girls? Determining the exact cause is difficult. But experts agree that several factors may be contributing to these growing numbers. Increasing rates of childhood overweight and obesity. Excess body fat alters the levels of hormones responsible for the acceleration of pubertal timing. Physical inactivity may decrease melatonin levels, which can also trigger pubertal development. Increased animal protein intake. Higher total protein, animal protein and meat intake in children ages 3 to 7 have been associated with earlier onset of menstruation. High protein intake elevates IGF-1 levels and promotes growth, which could accelerate the onset of puberty. Poor diet. Children with lower-nutrient diets tend to enter puberty earlier. A diet rich in processed foods and meats, dairy, and fast food is disruptive to normal physical development. Exposure to EDCs (endocrine-disrupting chemicals). EDCs are synthetic chemicals found in plastics, pesticides, fuels and other industrial chemicals that inhibit or alter the action of natural hormones. Because EDCs accumulate in the fatty tissues of animals, animal foods contain higher levels of these chemicals than plant foods. Exposure to BPA (bisphenol A). BPA is an industrial petrochemical found in a variety of products including plastics, tin-can linings and even cash register receipts. Because it acts as a synthetic estrogen it may speed up pubertal development. Soy products. Soy contain isoflavones which are converted to phytoestregens in the body, and are similar to the hormone estrogen, Dr. Chelsea Wicks says. “Soy consumed from natural food sources is likely safe and will not cause abnormal hormones levels. However, when consumed in large amounts, such as with soy supplements or in more processed foods, there have been links to chronic medical problems due to elevated estrogen levels. I feel a good answer to this is to continue working on eating fresh foods and trying to avoid the processed, packaged foods as this will be best for overall general nutrition as well,” she adds. What You Can Do While some genetic factors play a role in the early onset of puberty, parents can help lessen environmental causes of the condition. Encourage and help your child to maintain a healthy weight with proper nutrition and exercise. Avoid exposure to hormones such as estrogen and testosterone that may be found in hair products, medications and nutritional supplements. Avoid exposure to EDCs and BPA. Offer your child a diet centered around whole plant foods rather than animal foods, which will help keep protein intake within a safe range and reduce consumption of EDCs. Create a supportive environment for your daughter. Avoid commenting on her appearance and instead focus on her achievements, academic successes or artistic talents. Speak to her openly and honestly about the physical changes she’s experiencing — that although these changes are normal, she’s simply developing early — and that ultimately her peers will undergo the same changes. Encourage your daughter to continue participating in social activities and pursuing her interests, and reassure her you are always open to discuss any questions or worries. If you are concerned that your child may be going through these changes before expected, speak with your pediatrician. Sources: Early Puberty: Causes and Consequences When Is Puberty Too Early? Precocious Puberty (Early Puberty) Precocious Puberty

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Humidifiers are a great way to moisturize the air in your home as outside temperatures plummet, helping with chapped skin, allergies and cold and flu symptoms in children and adults. But without regular upkeep, humidifiers can breed dangerous mold and bacteria and do more harm than good. We’ve gathered some tips for keeping your humidifier — and your home — clean and bacteria-free. Dirty humidifier tanks can quickly breed bacteria and mold. This can be a problem for healthy people, but especially problematic for people with asthma and allergies when the contaminated mist or steam is released into the air. Here are some top ways to keep your humidifier humming and prevent unintended bacterial growth. Use distilled or demineralized water. Tap water contains mineral-creating deposits inside your humidifier that promote bacterial growth. These minerals often appear as white dust on your furniture. You may also breathe in some of these minerals. Distilled or demineralized water has a much lower mineral content compared with tap water. Instead of distilled water, you can also use demineralization cartridges or filters in your humidifier if they’re recommended by the manufacturer. Change the water often. Avoid letting water sit in the tank for long periods of time. This causes mineral deposits to collect on the bottom and sides of the tank. The longer the water sits, the more deposits will collect and the harder they’ll be to remove. Keep the area around the humidifier dry. If the area around your humidifier becomes too damp, turn it down. Surrounding the humidifier with dampness can lead to mold and bacterial growth. Change the filter in your central air conditioning and heating system regularly. Your humidifier is circulating more water in the existing air in your home. Optimize the cleanliness of your humidifier by ensuring your general air quality is clean. Clean the humidifier regularly. When the humidifier is in heavy use during the winter or when a family member has a cold, clean it weekly with a simple vinegar or hydrogen peroxide rinse. Do a deep monthly clean of the tank, base and filter (or per your manufacturer’s instructions). Replace the humidifier when necessary. Old humidifiers may start to break down over time. The worn-out parts will be more prone to hosting bacterial growth. If you’ve had your humidifier for five years, you might want to consider replacing it. Humidifiers can build up difficult mineral deposits, which are impossible to remove and encourage bacterial growth. Store the humidifier properly. Before putting your humidifier in storage, clean it thoroughly. Throw away any temporary parts (such as used filters or water cartridges) and make sure it is completely dry. Rinse or clean it again before using it the next time. Order any new filters or cartridges you’ll need when you use it again and store them with the humidifier. With proper maintenance, a humidifier can be an affordable at-home method for fighting colds and flu, and for making indoor winter air more hospitable. If you have a humidifier built into your central heating and cooling system, consult the instruction manual or ask your heating and cooling specialist about proper upkeep. Learn more healthy living tips and sign up for wellness classes through Renown’s Health Improvement Programs.

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The longer days of spring bring us more daylight and more hours to enjoy the sun. At dinnertime, we’re craving something lighter than the heavy stews and dishes of winter. Lighten up your palate for spring and usher in the new season — without sacrificing taste — with these do-it-yourself spring rolls. And with no cooking required, kids can roll up their sleeves and easily join the fun.

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Craving Mexican food, but staying away from sodium and trans-fats? These heart-healthy bean tostadas will satisfy without ingredients that are bad for your heart. These tostadas are rich in protein, vegetables and best of all — flavor.   We asked Renown Chef Chris Wyatt to lighten up one of our favorite dishes, and he delivered! Check out his recipe for black bean tostadas that are rich in protein, vegetables, and best of all, flavor.

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Every 40 seconds someone in the U.S. has a stroke, but 80 percent of all strokes are preventable. That’s why knowing the signs and symptoms and what to do is so important. With May being National Stroke Month, we asked Sadie Wangler, program manager with Renown Institute for Neurosciences, to explain more. We can prevent strokes by changing our lifestyle behaviors that increase our risk. Knowing the symptoms and being prepared to B.E. F.A.S.T. are key as well. We asked Sadie Wangler, program manager for the Renown Institute for Neurosciences, what everyone person should know about stroke. What is a stroke? A stroke can be caused by a blood clot within an artery in the brain or a blood vessel. The clot can burst due to blockage and this causes blood flow to the brain to be cut off. Without the proper bloodflow and oxygen getting to the brain, the brain’s tissue begins to die. How to spot symptoms of a stroke? The easiest thing is to remember the word “B.E.F.A.S.T.” B – Loss of balance: Ask the person to walk 5-10 feet, with light assistance, and ask if they felt dizzy or off balance. E – Double Vision or blurred vision: Ask the person if their vision has changed in any way. F – Look for face drooping: Ask the person to smile and see if one side of their face droops. A – Arm weakness: Ask the person to raise both arms. Does one arm drift downward? S – Speech difficulty: Ask the person to repeat something. Is their speech slurred or strange? T – Time to call 911: Time matters – so don’t wait to call an ambulance if you or a loved one is experiencing these symptoms. You can also watch for sudden numbness or weakness in the face, arm or leg, especially on just one side of the body. Look for any confusion — if they’re having trouble speaking or difficulty understanding others talk — and if they have trouble seeing in one or both eyes, trouble walking, dizziness, loss of balance, or sudden and unexplained severe headache. The signs of stroke happen suddenly and a lot of people may deny their symptoms, thinking they’re overreacting. But it’s critical to act quickly and get medical attention right away — when it comes to stroke and saving your brain, minutes matter. What should you do if you think you or someone you love is having a stroke? In addition to seeking help right away, it’s best to call 911 and get an ambulance. A lot of people make the mistake of driving themselves to the hospital or have someone else drive them, and this can be dangerous for a number of reasons. First of all, it can put you, your loved ones and others on the road in danger. Second, going to the hospital on your own can take more time than calling an ambulance, and when it comes to stroke, every minute of medical care counts. So it’s important to call 911 and get treatment immediately. What can you do to prevent stroke? A stroke can happen to anyone, but certain risk factors can increase your risk. There are some risk factors you can’t control: your age, family history, race and gender. Stroke risk is higher for women and people over the age of 55. Fortunately, there are some risk factors you can control, such as high blood pressure, smoking, artery or heart disease, high cholesterol, as well as obesity, poor diet and lack of exercise. A lifestyle focused on healthy diet and regular exercise can greatly reduce your risk for stroke. Quitting smoking and watching your alcohol intake can help too. The Renown Regional Medical Center has been certified as a Comprehensive Stroke Center by the Joint Commission and received the Gold Plus Achievement award by the American Stroke Association. Our Stroke Program provides evidence-based primary stroke care including evaluation, treatment and education to patients who arrive at a Renown facility with the signs and symptoms of stroke. Learn more online. Renown Institute for Neurosciences: 775-982-2970 The Renown Regional Medical Center Comprehensive Stroke Program provides evidence-based comprehensive stroke care including evaluation, treatment and education to patients who arrive at a Renown facility with the signs and symptoms of stroke. Learn more about treatment options for stroke and additional ways to reduce risk factors online. Learn More

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How do you take the waiting game out of your Urgent Care visit? Book ahead! Here’s how this convenient service can help you schedule your appointment and see updated wait times at area urgent care facilities. We’ve all been there, done that: It’s after hours, you need to see a doc, and urgent care is slammed. Renown now offers a convenient option that will enhance your experience. Here’s How Book Ahead Works: From your phone or computer, you can check urgent care wait times around our region. This lets you see if the urgent care by your office is busier than the one closest to home — which may help your planning. Through Book Ahead, you can join the line at a specific urgent care just as you would in person. This allows you to stay home or at work as long as possible so you are more comfortable. Book Ahead When and Where to Receive Care We have many choices when it comes to our medical care. Should you visit a doctor’s office, urgent care, emergency care or make a Virtual Visit? It’s important to know which choice is right for your situation or condition. We asked Luis Palacio, M.D., with Renown Urgent Care to explain the differences and how to make your visit as smooth as possible. If you have been experiencing flu-like symptoms for less than 48 hours, call your doctor’s office. They can then determine if you can be treated with a prescription antiviral medicine. Visit urgent care or the emergency room only if you are unable to eat or drink anything and may be dehydrated, have a fever over 102.5 degrees F, or are experiencing shortness of breath. You can use Renown’s Virtual Visits videoconference service for flu-like symptoms so that you don’t need to leave the comfort of your home and you reduce the risk of spreading the virus to others. Virtual Visits allow you to see an urgent care provider from your home or office using a cellphone, computer or tablet with video capabilities. It is open from 8 a.m. to 6 p.m. Monday through Friday, and 9 a.m. to 4 p.m. Saturday and Sunday. How Do You Book Virtual Visits? Go to Virtual Visits to get started. Here, you’ll learn what virtual check-in is all about: It allows you to stay where you are and receive text notifications once a care provider is almost ready to see you. Click, join a line, and we will ask you some questions about your symptoms. This allows us to make sure you don’t need to call 911 or go to the ER. Reasons to visit the ER include stroke, chest pain, severe shortness of breath, uncontrolled bleeding, seizures and severe allergic reaction. If you answer “no,” you will see the wait times for each urgent care location. If you need to get in right away, you can select the location with the shortest wait time. Or, if time is not an issue and you’d prefer to stay closer to your home or office, you can select that location. Once you’ve selected a location, you input your cell number, name and number of patients. As your appointment gets closer, urgent care will text you with updates on timing. When you get the text message, you can choose to get “more time” and have your appointment pushed back, or tell them you’re ready to be seen and on your way. Learn more about how to Book Ahead at Renown urgent care below.

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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

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With a family history of breast and other cancer, Aime′ Landaburu isn’t missing a single health screening. She recently had her first mammogram as well as a whole breast ultrasound, which detects 41 percent more cancers and reduces the number of false-positive results. Like many people, Aime′ Landaburu is busy juggling parenthood and a career. It would be easy to put health screenings on the back burner, but with a grandmother who has survived breast cancer three times and a grandmother who had ovarian cancer, Landaburu is addressing her family health history head-on. “I decided at 35 that I needed to get my screenings done because I have my family history of both grandmothers having had cancer,” Landaburu says. “In addition to the mammogram, I was really interested in doing the whole breast ultrasound. It is the same price as getting my hair done and it’s potentially something that could save my life.” Landaburu says the procedures were painless. “It was really comfortable, and the techs were all so nice and kind and gentle and explained things along the way.” Breast Screening Technology Provides Greater Insight George Krakora, MD, lead radiologist for Renown’s Breast Health Center, says the new 3D imaging for mammograms is picking up subtle cancers that would not have been seen with the previous 2D imaging. “It’s an additional tool that helps find those subtle cancers that may be missed in dense breasts,” Dr. Krakora says. With the whole breast ultrasound, the tech screens for masses — which are often obscured on the mammogram X-ray. Studies show it detects an additional 2 to 3 cancers per 1,000 women that would not have been detected with routine mammography. “Aime′ was noted to have heterogeneous dense breast tissue. That puts her at a little higher risk for cancer and also limits the sensitivity of mammography,” Dr. Krakora says. Multiple Ways to Screen for Breast Cancer However, Dr. Krakora notes, breast ultrasound is not a substitute for mammography, which can detect calcifications that can represent the earliest forms of cancer.” Surprisingly to Landaburu, her results came in just three days. “It’s so important to know what’s going on in your body. I was really nervous when I first got the paperwork, but ultimately it was negative, “ Landaburu says. “I’m thankful it was good and I have a baseline for the future.” Landaburu also advises other young women with a history of breast cancer to proactively communicate. She says it’s important to reach out to women they know who have survived breast cancer. “You have to take the first step and you want to be around for your kids and your family and yourself,” she says. “So utilize your resources, educate yourself and go get screened.” Breast Cancer Screening and Prevention Breast cancer begins when abnormal cells in the breast grow out of control. These cells form tumors that can grow into the surrounding tissue and spread to other parts of the body. Breast cancer occurs mostly in women, but men can also develop breast cancer. To schedule a mammogram or whole breast ultrasound, call 775-982-8100, or schedule an appointment online. Make an Appointment

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Every cancer journey is different — and so are the ways individuals deal with a cancer diagnosis. So if you’re a close friend or family member, how can you help? Bobbi Gillis, manager of cancer support services with Renown Institute for Cancer, explains more. Just as we are all unique, we all also have our own ways of dealing with difficult news. For some, receiving a cancer diagnosis is devastating, and they want family members rallying around them in support; for others, they want to be left completely alone. So how do you know what is helpful and what is hurtful? For advice, we reached out to Bobbi Gillis, manager of cancer support services with Renown Institute for Cancer. Support, Defined What are some ways to support a loved one when they find out they have cancer? First and foremost, let them know you are there for them. As we can all imagine, a cancer diagnosis is scary, and it’s helpful just to know you have support if and when you need it. Second, try to listen and give advice only when you are asked. In trying to help as much as possible, many family and friends take on the role of “researcher” to find out more treatment options, but it’s best to avoid saying “you should try this” or “you ought to do that.” Patients are already dealing with a lot of information at once from care providers and their own research. You don’t want to make them feel overwhelmed or question the treatment they’re planning. What are some words of encouragement or support people can use? Just as you would in any difficult situation, speak from the heart and be genuine. But also be careful not to show false optimism or to tell them to just stay positive; saying these things may discount their fears and concerns. Here are some ideas to get you started: “We’re going to get through this together.” “Count me in to help out.” “I’m not sure what to say, but I want you to know I care and I’m here.” What resources are available to patients? What about their families? For patients with cancer, we offer support groups in-person or online. There are also support groups specific to the type of cancer you or your loved one have. You can check these out on our website, renown.org, or ask your care provider. There are also support groups and emotional support services available for family and friends. How can family and friends help throughout cancer treatment? It’s great to offer help, but it’s important to be specific when you offer. Saying “call me if you need something” is very general, and people may feel like they’re putting you out when they do ask for something specific. Instead, offer help with certain tasks — like driving them to treatment, babysitting, making them dinner or buying groceries. As much as possible, keep things normal. For some patients, being able to do everyday things like walking the dog helps them feel better. Loved ones can try to do too much for a patient, and while well-intentioned, this can make them feel less useful after being diagnosed. Renown Institute for Cancer | 775-982-4000 At the Renown Health Institute for Cancer, our experienced team provides the support and care to maintain the highest quality of life and then achieve the best possible outcome, all in one location that’s close to home. Our dedicated team, clinical expertise and advanced treatment options allow us to tailor care to each patient. Learn about: Our Team Cancers We Treat Screening and Prevention Treatment Options Find a Doctor

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