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LIVING WELL from
northern nevada
SUMMER 2015
MEDICAL CENTER
“Rehab’s
our hero”
A small center that
gets BIG results
INSIDE:
Get a leg up on
varicose veins
Less painful, minimally
invasive therapy
Summer heart
health guide
Heart-smart strategies
including a better way
to grill
Quality counts. NNMC is the first hospital in the nation to receive
a certification from The Joint Commission for Low Back Pain! We are
also the only hospital in Nevada to receive certifications from The
Joint Commission in all of the following: Stroke (Primary Stroke Center),
Spine Surgery, Joint Replacement – Hip and Joint Replacement –
Knee. NNMC’s Chest Pain Center is accredited by the Society of
Cardiovascular Patient Care (SCPC).
Compliments of
FROM THE
CEO
IN TH
IS ISS
UE
IN THIS ISSUE
4
GET A LEG UP ON
VARICOSE VEINS
Introducing Venefit™
and ClosureFAST™
6
“REHAB’S
OUR HERO”
A program that helps most
patients go straight home
10
NO MORE
CHRONIC
ACID REFLUX
An incision-less procedure
can bring relief
At Northern Nevada Medical Center, we know
that health starts at home. That’s why we offer
a team of professionals who work with you and
your family, hand in hand, to achieve optimal
health and wellness. We recognize this requires
a breadth of services to ensure patients receive
the highest quality of care and best service at a
reasonable cost. This includes affordable health
insurance for families and access to skilled physicians conveniently
located throughout the community.
Our affiliation with Prominence Health Plan is an example of the
expansiveness of our care. Northern Nevada residents can protect
themselves and their families with health insurance that includes
HMO and PPO plan options. Also, Prominence Health Plan now
offers Medicare Advantage HMO plans for people age 65 and older.
Visit www.prominencehealthplan.com or refer to the back cover of
this publication for more information.
This Living Well covers some of the other ways we are meeting the
evolving needs of Washoe County. We feature Deven Khosla, MD,
and his surgical and non-surgical treatments for adult scoliosis; and
Northern Nevada Medical Group physician Wynter Phoenix, MD,
and his innovative treatment for venous insufficiency.
Finally, we spotlight two patients who, with help from Northern
Nevada Medical Center’s skilled rehabilitation staff, were able to get
on with their lives after devastating health events. Their inspirational
stories of courage help illustrate that healthcare is a lot more than
just caring for someone who is sick. It includes prevention, follow-up
and, of course, compassion.
Northern Nevada Medical Center is here to serve you.
Alan Olive
Chief Executive Officer
Sunscreen: Don’t leave home without it
Each year, nearly 5 million people are treated for skin cancer.
According to the Skin Cancer Foundation, applying sunscreen with an SPF of 16 daily can reduce risk
of melanoma by 50 percent. Select a broad-spectrum sunscreen that filters out both UVA and UVB rays
and carries the Skin Cancer Foundation’s Seal of Recommendation. An SPF of 16 is fine for everyday
activities; however, if you work outside or are at the beach, choose a higher number and reapply often.
2 www.nnmc.com
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for adult scolios
A
dult scoliosis, an abnormal curvature of the
spine with no known cause, usually begins
in the teenage years and can progress as a
person grows. Symptoms include shoulder
unevenness or a lump in the lower back on the
side of the curvature. Sometimes, a brace is worn
when the abnormality appears, but if there are no
disabling symptoms, scoliosis is often managed
simply with observation and over-the-counter pain
relievers. With aging, the curvature can get worse
as the discs in the back settle, causing the person
to lean progressively forward. If arthritis sets in and
bone spurs form, the condition can be aggravated
by weakness and pain.
“There’s a spectrum of physical effects, ranging
from hardly any curvature to curvature in two
directions, which comes with disabling back
and/or leg pain and spinal imbalance,” says
neurosurgeon Deven Khosla, MD, with Northern
Nevada Medical Center. He explains that a
decision about treatment for adult scoliosis is
based on factors such as age, bone density, other
medical conditions and family support. “We first
try all reasonable nonsurgical measures,” he says,
possibly including exercise, physical therapy,
injections, acupuncture, chiropractic treatments
and massage therapy.
When surgery
is necessary,
Deven Khosla, MD
Neurosurgeon
Dr. Khosla
Northern Nevada
customizes
Medical Center
it for each
individual
patient. The
operation can encompass procedures from fusion
and stabilization of the spinal segments to removal
of parts of the spine followed by realignment.
Recent advances in surgical techniques have
enabled smaller incisions for faster healing,
and computer assisted surgical navigation that
contributes to improved precision. For fusion and
stabilization, Dr. Khosla is one of the few surgeons
in the region to use the CD Horizon® Legacy™
PEEK Rod, a device that can replicate the natural
load distribution of the lumbar spine.
“Natural load-bearing behavior of the spine helps
the muscles recover and reduces long-term stress
on the points where the rod is screwed to the
bone,” says Dr. Khosla. “Early experience indicates
that, because of its distribution ability, the PEEK
Rod also lessens degeneration of adjacent areas
of the spine.” Dr. Khosla says, regardless of the
technology or the approach taken to treat adult
scoliosis, “The baseline goal of what we do is to
improve quality of life.” ■
Northern Nevada Medical Center is the only local hospital to receive
The Joint Commission Gold Seal of Approval for Spine Surgery.
To learn more, go to www.nnmc.com/ortho.
www.nnmc.com 3
Venefit™ helps patients get
a leg up on varicose veins
Less painful, minimally invasive radiofrequency ablation
therapy for symptomatic venous disease is available
now at Northern Nevada Medical Center.
C
hronic venous insufficiency
is when valves in the veins
in the legs that normally keep
blood moving toward the heart have
become damaged, and the vein walls
have weakened. When the leg veins
stay filled with blood, the resulting
condition is called varicose veins.
While not everyone with varicose
veins has venous insufficiency, an
incorrect diagnosis can lead to
ineffective therapy.
Wynter Phoenix, MD
General Surgeon
Northern Nevada
Medical Group
“Treatment such as compression
stockings may help alleviate symptoms
but fail to address the underlying
disease,” says Wynter Phoenix, MD,
a general surgeon with Northern
Nevada Medical Group. He now
uses Venefit™, featuring ultrasound
guidance, radiofrequency energy and
the ClosureFAST™ catheter, to close
abnormally enlarged veins in the legs.
4 www.nnmc.com
Venefit – performed as an outpatient
procedure at NNMC – involves a
catheter inserted into the vein and
heats a full 7 centimeters of vein length
in one, 20-second interval. “The heat
provided by the catheter shrinks and
collapses the target vein, creating a
fibrotic seal that blocks the vessel,”
says Dr. Phoenix. “Blood flow is
naturally redirected to healthy veins as
the recovery process begins.”
Dr. Phoenix points out that previous
treatment for varicose veins was not as
effective or as comfortable for patients.
“When compared with laser surgery,
for example, this showed significantly
less patient pain and bruising with
fewer adverse events later,” he says. In
clinical trials, Venefit has demonstrated
procedural efficacy of over 93 percent
at a three-year follow-up. “The
ClosureFast catheter represents the
latest advancement in radiofrequency
technology,” says Dr. Phoenix. ■
To schedule an appointment with
Dr. Phoenix, call 775-356-4888.
COMMON
SYMPTOMS
OF VENOUS
INSUFFICIENCY
• Varicose veins
• Burning or itching
of the skin
• Color and texture
changes to the skin
• Aching, tired or weak
legs, especially after
sitting or standing
• Swollen ankles
and/or legs
• Poorly healing
wounds
Specialty Care for those special to you
Convenient locations
throughout Reno, Sparks
and Northern Nevada
Northern Nevada Medical Group is dedicated
to the health of your family, from infants to
seniors. Our group features family and internal
medicine physicians, plus a wide range of
specialists just around the corner.
Designed for your busy schedule
• Same-day appointments
• A
ccepting most area health plans,
including Medicare
• Sports physicals and annual exams
CARDIOLOGY: 775-356-4514
Sparks Medical Building
2385 East Prater Way, Suite 302
Reno - 5575 Kietzke Lane, Suite B
Yerington - 306 Surprise Street
Winnemucca - 395 West Minor Street
Fallon - 1020 New River Parkway, Suite 301
Chad Bidart, MD, FACC
Colin Fuller, MD, FACC, FACP, FSCAI
Michael Newmark, MD, FACC, FSCAI
Tom Nylk, MD, FACC
Thomas Truong, DO
GENERAL SURGERY: 775-356-4888
Sparks Medical Building
2385 East Prater Way, Suite 205
Fallon - 1020 New River Parkway, Suite 200
Announcing our newest provider:
BOARD-CERTIFIED
NEUROLOGIST
Kiran Nuthi, MD
Now accepting new patients!
Sparks Medical Building
2385 East Prater Way, Suite 205
775-356-4888
Thomas McCormick, MD, FACS
Michael Murray, MD, FACS
Wynter Phoenix, MD
PODIATRY: 775-356-4888
Sparks Medical Building
2385 East Prater Way, Suite 205
Fallon - 1020 New River
Parkway, Suite 200
Timothy Mooney, DPM,
FACFAS, DABPS
www.NNMG.com
SPORTS MEDICINE: 775-352-5335
Spanish Springs
5070 Ion Drive, Suite 200
Luis Palacio, MD
I N PAT I E N T
rehab
For these patients,
our hospital is a hero!
Michael Mendiville:
A “walking miracle”
In February 2013, Michael Mendiville, 40, started
to have numbness in his right hand. He thought
he’d strained it at work, but the numbness moved
to his left hand then to his arms. That night he
couldn’t grip the bed covers, and the next morning,
his legs were so numb he couldn’t stand. His wife
took him to the hospital, where he was diagnosed
with a rare form of Guillain-Barre Syndrome (GBS),
a disorder in which the body’s immune system
attacks the nervous system.
Michael was in a 17-day coma paralyzed from the
neck down. Once he woke up and his GBS was
treated, he began rehabilitation at Northern Nevada
Medical Center. “I could talk just fine, but I had no
strength in my arms or legs,” he says. “I could move
my fingers, that was about all.”
Lots of leg exercises, work with a standing frame,
hand exercises and “positive thinking” taught to
him by his parents were part of the long road back
to function. By the twelfth day, Michael was able
to go a short distance with a walker, and ride the
stationary bike with his hands Velcroed® to the
handlebars because he couldn’t grip them. “If the
therapists asked me to ride for five minutes, I’d do
10, then I’d add a minute and a half to make up for
the time it took to re-Velcro my hands,”
he says.
6 www.nnmc.com
Physical Therapy Assistant Carlos Burns, left, leads Michael Mendiville
in rehabilitative arm exercises.
After several weeks of occupational and physical
therapy, he returned home to his wife and two
beloved beagles on April 6, 2013. Michael had
much better use of his hands and arms and was
walking with a cane. He says the rehab staff made
it easier for him by creating a “fun” environment.
“Everyone was great, from the nurses and therapists
to the CNAs,” says Michael. “There’s a reason why
Northern Nevada is in the top 10 percent of rehabs
in the country.” ■
“The small size of the RehabCenter is an advantage.
There’s a homier atmosphere, we can take a holistic
approach to rehabilitation and interact more with
our patients.” – George Mars, MD
Rick Griego: “No wheelchair for me”
Hemorrhagic stroke, which accounts for about 13 percent of all strokes,* occurs when a weakened blood
vessel ruptures and bleeds into the surrounding brain. Rick Griego, 55, a truck driver who travels throughout
the state of Nevada, didn’t know that’s what had happened when he began dropping things from his right
hand while getting ready for work one morning in October last year. Before long, Rick couldn’t walk; his
whole right side “felt dead,” he says. He wife recognized the signs of stroke and took him to the hospital.
After he was stabilized, Rick spent three more days in the hospital and was then transferred into the
rehabilitation program at Northern Nevada Medical Center. When Rick arrived, he couldn’t walk, couldn’t
move his right side and had trouble speaking, so he began working with physical, occupational and speech
therapists. “The first day, they helped me walk,” says Rick. “When you start moving, it feels really good. If
you walk five feet, it’s a big deal.”
After two weeks in rehab, Rick was able to walk more and to stop relying on a wheelchair. He worked hard
through the depression that had set in. “I became determined to be there for my wife, sons and family,”
says Rick. He took special interest in the educational part of rehab,
where therapists and the program’s medical director, physiatrist
George Mars, MD, teach patients about diet, exercise and stress
relief. Rick says that rehab helped him learn how to better care
for himself, adding that he lost 25 pounds during his stay and
has been able to keep off the weight.
Rick went home – after spending almost a month in rehabilitation.
He can’t drive yet and his leg still hurts sometimes, but he
continues to make progress each and every day. He goes back
to visit the therapists at NNMC once a month and they’re amazed
at how well he’s doing. “God was a big part of this. It happened
so I’d put a stop to my unhealthy life,” he says. “I have a lot to
live for. I’m thankful that I found the right people to help me.
I can’t say enough good about them.” ■
*American Stroke Association
Stroke reco
very for Rick
Griego, right
Winkle, a sp
, included w
eech therap
orking with
ist at NNMC
Ellie Van
.
www.nnmc.com 7
A small center, BIG results
“Over 85 percent of our rehab patients go straight home.” – Lita McCaw, OTR-L
Our multi-disciplinary team of rehab specialists focuses on achieving
the highest possible level of independence for each patient.
What makes Northern Nevada’s
Inpatient Rehab program different
starts with what you can see. “You
can see for miles; all the way to the
Sierras,” says Lita McCaw, OTR-L,
Director for Inpatient Rehabilitation
and Case Management. She explains
that the windows in the rehab unit are
full-length, offering patients lots of
light and a cheery space along with
the panoramic view. McCaw is proud
to describe the unit as “small,” which
enables a homier feel and more
opportunity to interact with patients.
There are many more advantages
patients have at Northern Nevada.
“Our Medical Director, Dr. Mars, is trained in both Eastern and Western medicine to look at
patients holistically – considering mind, body and spirit,” says McCaw. As an example, she explains
that successfully managing pain might not always involve taking medication, but could include
non-medicinal techniques such as acupuncture. She adds: “All therapists in the rehab center are
licensed and work with patients one-on-one, not in groups. Plus, we involve the patient’s family so
he or she will be best prepared to go home.”
McCaw says that the longevity and dedication of the staff, and Dr. Mars’ commitment to spend time
at each patient’s bedside, helps them continue to see patients make amazing gains. “It’s extremely
rewarding working with people whose main passion is helping others get better,” she says.
The RehabCenter at Northern Nevada Medical Center ranked in the top 10 percent of
more than 700 inpatient rehabilitation facilities qualified to be ranked in the Uniform
Data System for Medical Rehabilitation from 2011 to 2013. For more information on the
center’s personalized care and to take a virtual tour, visit www.nnmc.com/rehabcenter.
8 www.nnmc.com
Be heart smart this summer
Summer is the perfect time to take the leap toward improved cardiac health,
and offers lots of new opportunities to stay fit. Tom Nylk, MD, FACC, a
cardiologist with Northern Nevada Medical Group, says that what we eat,
whether we exercise and how much water we drink are cornerstones for
heart health. Here are some facts and ideas to consider:
PHYSICAL ACTIVITY GIVES YOU MORE ENERGY
Inactivity can contribute to many diseases including heart attack and stroke. Exercise gives
you more energy for the things you like to do, helps manage stress and helps contribute to
a longer life. Dr. Nylk recommends 150 minutes of moderate exercise per week (walking at a
brisk pace, pushing a lawnmower or weeding and mulching), or 75 minutes of vigorous activity
(jogging, tennis or biking up a hill).
PROPER HYDRATION PROTECTS YOUR HEART
Dr. Nylk explains that adequate hydration makes it easier for the heart to pump blood through
the vessels to the muscles. He says water is the best thing to drink to stay hydrated and the
amount needed varies according to a person’s build and climatic conditions. “An indication
of whether you’re getting enough is the color of your urine. Pale and clear means you’re well
hydrated,” he says. “If it’s dark, drink more fluids.”
GRILLING SENSIBLY REDUCES FAT INTAKE
“Try to grill more fish – it’s lower in fat,” says Dr. Nylk. He says the healthiest kinds of fish are
high in omega-3 fatty acids such as salmon, trout and herring. You should also remove skin
from chicken breasts after grilling, buy “choice” rather than “prime” grades of beef and make
sure to trim off excess fat when you get home. “Also, when grilling, use a rack so the fat drips
away from the food,” says Dr. Nylk.
To schedule an appointment with a Northern Nevada
Medical Group cardiologist, call 775-356-4514.
www.nnmc.com 9
ASK THE
doctor
An incision-less solution to chronic acid reflux
While an
occasional
backup of
stomach
acid is
nothing to
be concerned about, chronic
gastroesophageal reflux
disease (GERD) can be a
precursor to esophageal
cancer if not treated. Here,
Michael Murray, MD, a
general surgeon at Northern
Nevada Medical Center,
discusses the basics of GERD
and an incision-less surgery
available at NNMC that has
brought many patients relief.
Q: What is GERD?
Q: What is TIF?
Gastroesophageal reflux disease
(GERD) is also known as acid
reflux disease and affects about
60 million Americans.* GERD
occurs when the one-way valve
between the esophagus and
stomach stops functioning
properly and allows stomach
contents to “reflux” back into
the esophagus. Symptoms
include heartburn, regurgitation,
hoarseness, sore throat, asthmalike-symptoms, chest pain or
discomfort. If left untreated,
GERD can cause permanent
structural changes to the
esophagus lining that can lead
to cancer.
Unlike laparoscopic surgery,
TIF does not require cutting
the abdomen, allowing for a
less invasive restoration of the
antireflux barrier. With the patient
under general anesthesia, the
surgeon inserts a device with a
small camera into the patient’s
stomach through the mouth.
Manipulating the device, the
surgeon makes and fastens
several tissue folds to create an
antireflux valve at the juncture of
the stomach and the esophagus.
Q: What are the
treatment options?
Gastrointestinal physicians
can often treat GERD with
pharmaceuticals. These, along
with diet and lifestyle changes,
may alleviate symptoms. If
you experience nighttime
reflux, you might find sleeping
upright helps. In cases of
moderate to severe GERD,
surgery called transoral
incisionless fundoplication
(TIF) may be an option.
Q: What makes the TIF
procedure an attractive
option for GERD?
The TIF procedure is usually
performed in under an hour and
typically requires only one night
in the hospital. The day after a
TIF procedure, most patients
feel fine. After four weeks, most
patients stop experiencing
heartburn at all. After only two
weeks, the majority of TIF patients
can return to eating foods they
could not previously tolerate and
can stop taking their formerly
required medications. ■
*National Institute of Diabetes and
Digestive and Kidney Disorders
For more information about gastroenterology at NNMC, go to
www.nnmc.com and click Hospital Services.
10 www.nnmc.com
CALENDAR OF
events
Summer 2015
JUNE
JULY
Stroke Support Group
Wednesday, June 10
12:30 – 1:30 p.m.
Varicose Veins and
Venous Insufficiency
Wednesday, June 17
6 – 7 p.m.
Presenter:
Wynter Phoenix, MD
General Surgeon
AUGUST
Spinal Cord Stimulation
for Back Pain
Wednesday, July 1
6 – 7 p.m.
Presenter: Jeffrey
Zollinger, DO, Pain
Management Specialist
Cardiac Device Clinic:
Drugs That Treat Arrhythmias
Friday, July 10
Noon – 1 p.m.
Presenter: Laurie Newmark, RN,
Certified Cardiac Device Specialist
Less Invasive Solutions
for Obesity and Diabetes
Wednesday, July 15
6 – 7 p.m.
Presenter: Kent Sasse, MD
General and Bariatric
Surgeon
Cardiac Device Clinic:
Electromagnetic Interference
and Your Cardiac Device
Friday, August 21
Noon – 1 p.m.
Presenter: Laurie Newmark, RN,
Certified Cardiac Device Specialist
cept for
All events, ex
e held in Suite
health fairs, ar
Building
arks Medical
201 of the Sp
Sparks.
in
Prater Way
at 2385 East
vided.
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will be
Healthy snacks
for
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ir
is requ
Registration
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-NNMC
Call 775-356
for
E
E
R
F
nts are
to register. Eve
st
ju
d
an
embers
Advantage m
s!
ember
$5 for non-m
HEALTH FAIRS AT NNMC
First Thursday of the month
July 2, August 6
7:30 – 11 a.m., NNMC Lobby
For a full list of screenings and pricing, visit
www.nnmc.com and click on Community Events.
www.nnmc.com 11
PRSRT STD
U.S. POSTAGE
PAID
2375 East Prater Way
Sparks, NV 89434
PERMIT NO. 322
PONTIAC, IL
Prominence Health Plan
A NAME YOU WANT TO KNOW
Prominence Health Plan has a variety of health
insurance options available to fit your needs.
• Individual and family plans available on
the Health Care Exchange marketplace
• Medicare Advantage options
These health insurance options are available
to eligible residents in Douglas, Lyon, Storey,
and Washoe counties and Carson City.
Learn more about Prominence Health Plan
and all we have to offer you and your family.
Call 775-770-9300, talk to your broker
or visit prominencehealthplan.com
Prominence Health Plan is affiliated with Northern Nevada Medical Center and Northern Nevada Medical Group.
LIVING WELL FROM
NORTHERN NEVADA MEDICAL CENTER
Randall Pierce, MD
Chair, Board of Governors
Robert Dalrymple, MD
Chief of Staff
Alan Olive
Chief Executive Officer
Don Butterfield
Director of Marketing and
Business Development
www.nnmc.com | 775-331-7000 |
|
Follow us on Twitter
@NNMCHealth
Information in Living Well comes from a wide range of medical experts. If you have any concerns or questions about specific
content that may affect your health, please contact your healthcare provider. Models may be used in photos or illustrations.
Any opinions expressed by an author whose article appears in this publication are solely the opinions of the author and do not
necessarily reflect the views of Northern Nevada Medical Center or Universal Health Services, Inc. Physicians mentioned in this
publication are independent practitioners who are not employees or agents of Northern Nevada Medical Center. The hospital
shall not be liable for actions or treatments provided by physicians. ©2015. All rights reserved. Printed in the U.S.A.
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