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Primary Care vs. Urgent Care vs. The ER
When seeking medical care, there are several different provider types and options from which to choose. For example, you may have asked yourself a common question: Should I go to my primary care provider, urgent care or the emergency room? Sarah Herbert, APRN with Renown Medical Group – South Carson, provides guidelines to help you easily make this decision. When should you go to the Emergency Room (ER)? Making a visit to the ER should be reserved for severe symptoms and/or life-threatening conditions, including: Chest pain Severe shortness of breath or difficulty breathing Weakness or numbness on one side Slurred speech Fainting/loss of consciousness Continuous bleeding or major open wounds Severe allergic reactions Coughing or throwing up blood Drug or alcohol overdose Sharp pain in lower abdomen Severe dehydration and not responding to nausea medication (needing IV fluids) High fever that does not get better with medicine Serious burns Broken bones/dislocated joints Head trauma Find an Emergency Department Near You If you’re still unsure of where to go for appropriate medical care, it’s best to check with your primary care physician. And remember, for a life-threatening emergency, call 9-1-1 immediately!
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When to Seek Care for Abdominal Pain
Abdominal pain is one of the most common complaints that brings individuals to the emergency room. We spoke with emergency physician Bret Frey, MD, to ask about when and where to seek care for abdominal pain. Dr. Frey advises that any time you feel something is developing inside your body that is substantially different from what is normal for you, understand that something is wrong. He further explains that warning signs of an acute medical situation include fever, vomiting or a rapid change in function and ability to move due to pain. These symptoms indicate that one needs to be evaluated by a medical professional. This evaluation will include the care team conducting an examination and asking a series of questions to determine if additional diagnostics, such as lab work or imaging, are needed. Be prepared to discuss where the pain is and what it feels like, in addition to how long it’s been bothering you and if it’s constant or intermittent. While appendicitis often comes to mind when thinking about abdominal pain, Dr. Frey says that this is not the bulk of cases that the Emergency Department sees. In fact, often the pain does not have a specific diagnosis, but our team of board-certified emergency physicians are experienced in assessing and caring for those experiencing the acute symptoms he described. “We often don’t come away with an answer about exactly what it is, but we substantially rule out life threats in a very methodical and systematic way,” said Frey. The abdomen includes many organs, including the stomach, liver, small and large intestines, gallbladder and pancreas. In addition, pain stemming from your chest, pelvis or back may be felt in the abdominal area. If you are experiencing abdominal issues that are persistent but not an emergency, talk to your primary care doctor about what you are experiencing, and be prepared to review the history of this pain, medications, allergies and diet. He or she will be a good partner to review conditions such as gas, heartburn, constipation, diarrhea, inflammation or menstrual and ovulation pain. Drinking plenty of water is always an important part of supporting your health.
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Renown Recognized for Quality Care for Heart Attack & Failure
American Heart Association awards shine national spotlight on care offered in northern Nevada. Renown Regional Medical Center has been honored once again by the American Heart Association (AHA) for high quality heart care. Renown’s focus on quality and applying the most up-to-date, evidenced-based treatment guidelines improves patient outcomes, getting people home sooner and back to doing what they love. “We are pleased to recognize Renown for their commitment to heart failure care,” said Lee H. Schwamm, M.D., national chairperson of the Quality Oversight Committee and Executive Vice Chair of Neurology, Director of Acute Stroke Services, Massachusetts General Hospital, Boston, Massachusetts. “Recognizing the significance of preventing, diagnosing and caring for people with heart and vascular disease, which continues to be on the rise and taking far too many lives, is of critical importance to us at Renown,” says Tony Slonim, M.D., DrPH, FACHE, president and CEO, Renown Health. “We are proud of our incredible team for providing the highest-quality clinical care, and thank the American Heart Association for this national recognition.” Renown Regional was awarded The Get with the Guidelines – Heart Failure Gold Plus Quality Achievement award for continually ensuring heart failure patients receive the most appropriate treatment according to nationally recognized, research-based guidelines, as well as AHA’s Mission: Lifeline Gold Receiving honor for the treatment of patients who suffer severe heart attacks. “Renown offers the most highly-skilled and experienced heart and vascular team and the most advanced heart center in the region. Having national recognition for being the region’s heart care leader is critical to a Destination Health strategy,” said Josiah "Sy" Johnson, MBA, chief of staff for Renown Health. “We at Renown are proud to bring a high level of world-class care providers, leading-edge care and new delivery approaches to meet the needs of people in northern Nevada through our Institute for Heart & Vascular Health.” Por qué este reconocimiento es importante para usted: atención del ataque cardíaco Cada año, más de 250,000 personas experimentan un infarto de miocardio con elevación del segmento ST (STEMI), el tipo más mortal de ataque cardíaco, causado por un bloqueo del flujo sanguíneo al corazón que requiere tratamiento oportuno. Renown earned the award by meeting specific criteria and standards of performance for quick treatment to re-establish blood flow to blocked arteries in heart attack patients. “Our expert staff treat problems that extend from mild to the most critical of emergencies,” said Christopher M. Kozlowski, MD, MHA, vice president and medical director of Renown Institute for Heart & Vascular Health. “Specialized physicians including cardiologists, interventional radiologists, heart and vascular surgeons, emergency medicine and trauma surgeons, primary care providers, nurses and other clinicians work as a team to determine the best treatment plan for each patient. We encourage all patients to discuss with their care team whether they should undergo formal screening for early heart disease.” Por qué este reconocimiento es importante para usted: atención de la insuficiencia cardíaca De acuerdo con la AHA, más de 6.5 millones de adultos en los Estados Unidos experimentan insuficiencia cardíaca. Heart failure patients can lead full, enjoyable lives when their condition is managed with proper medications or devices and with healthy lifestyle changes. “Renown’s reputation as the region’s heart care leader has been built over many years. We performed the area’s first open-heart surgery, angioplasty, stent and valve replacements decades ago. Renown Regional offers incredible advancements like trans-catheter aortic valve replacement (TAVR) and trans-catheter mitral valve repair (TMVr) with MitraClip therapy, lifesaving alternatives to open-heart surgery for patients considered high-risk or inoperable,” said Erik Olson, chief executive officer of Renown Regional Medical Center. “Al ofrecer el más alto nivel de cuidado completo a los pacientes que sufren enfermedades cardíacas y vasculares, Renown desarrolló su primera división de cirugía cardiotorácica dedicada a los pacientes elegibles para cirugía cardíaca en 2019”. The Renown Institute for Heart & Vascular Health program now offers a Diagnostic Electrophysiology Lab; a Chest Pain Center using the D-SPECT® heart camera; multiple Interventional Labs; Heart Failure Program; several Cardiac Catheterization Labs; Interventional Cardiology and Cardiac Surgery when necessary; and the only Pritikin-certified Healthy Heart Program in the West, creating individualized rehabilitation plans tailored to each patient’s needs, so they can exercise safely, eat healthy, manage stress and cook nourishing, balanced meals, all while gaining a healthy mindset. Renown se encuentra entre los hospitales de mejor desempeño del país para el tratamiento de ataques cardíacos y es uno de los únicos 105 hospitales de todo el país en recibir el premio ACTION Registry Silver Performance Achievement Award del Colegio Estadounidense de Cardiología, que reconoce el éxito en la implementación de un estándar de atención más alto para pacientes con ataques cardíacos. Renown’s Roseview, Sierra and Cardiac Intensive Care Units (ICUs) are the only ICUs in Nevada to receive the Beacon Award of Excellence from the American Association of Critical Care Nurses. U.S. News and World Report’s Best Hospital rankings recently named Renown hospitals as best in the state of Nevada. Los pacientes que necesitan atención cardíaca avanzada pueden hablar con su proveedor de atención médica sobre la atención de especialidad del Renown Medical Group, con el que puede comunicarse llamando al 775-982-6270 o si visita renown.org/HeartCare. About Renown Health Renown Health is the region’s largest, locally owned and governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. Con una fuerza laboral diversa de más de 7,000 empleados, Renown ha fomentado una cultura de excelencia, determinación e innovación de larga data. La organización se compone de un centro de urgencias, dos hospitales de cuidados agudos, un hospital infantil, un hospital de rehabilitación, un grupo médico y una red de atención de urgencias y Hometown Health, la compañía de seguros sin fines de lucro más grande de la región y de propiedad local, Hometown Health. Renown’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Heath, Neurosciences and Robotic Surgery. Actualmente, Renown está inscribiendo participantes en el estudio genético de salud poblacional basado en la comunidad más grande del mundo, el Healthy Nevada Project®. Visite renown.org para obtener más información. About Mission: Lifeline The American Heart Association’s Mission: Lifeline program helps hospitals and emergency medical services develop systems of care that follow proven standards and procedures for STEMI patients. The program works by mobilizing teams across the continuum of care to implement American Heart Association/American College of Cardiology Foundation clinical treatment guidelines. For more information, visit heart.org. About Get With The Guidelines Get With The Guidelines® is the American Heart Association/American Stroke Association’s hospital-based quality improvement program that provides hospitals with the latest research-based guidelines. Desarrollado con el objetivo de salvar vidas y acelerar la recuperación, Get With The Guidelines ha influido en la vida de más de 9 millones de pacientes desde 2001. For more information, visit heart.org.
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Make Hydration a Priority for Your Health
As the temperatures skyrocket and we return to more outdoor activity, one thing is certain: you must hydrate to stay cool, healthy, and functional. But how much water do you need, and what are some easy ways to ensure you are getting enough? Aurosis Reddy, DO a family medicine provider with Renown Medical Group, shares what you need to know. How Much Water Is Enough? Experts agree that recommended daily water intake can vary depending on different factors such as your weight, metabolism, location, diet, physical activity, and health. As a rule of thumb, women should aim for a daily fluid intake of 91 ounces, and men should aim for 125 ounces. It is important to listen to your body and recognize when you might need to increase your water intake. For example, if you’re partaking in strenuous exercise, or spending time outside in the heat, you’ll want to give your body more water and electrolytes to function properly. How Can I Tell If I Am Dehydrated? Decreased coordination Fatigue Less urination Dizziness Dry, sticky lips and mouth Increased thirst Headache
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Nationally Recognized Vascular Surgeons Join Renown Health
Two vascular surgeons bring a quarter of a century of experience to patients and community. As part of a continuing focus to bring comprehensive care to patients experiencing cardiac and vascular disease across northern Nevada, Renown Health Department of Surgery and Renown Institute for Heart & Vascular announce that vascular surgeons, John C. Hansen, MD, FACS and Benjamin P. Jaquish, MD, FACS have joined Renown Health. "Recognizing the significance of preventing, diagnosing and caring for people with heart and vascular disease, which continues to be on the rise and taking far too many lives, is of critical important to us at Renown," says Christos A. Galanopoulos, MD, MBA, MSc, FACS, VP, Chairman Department of Surgery at Renown Health. "Both Drs. Hansen and Jaquish are superb clinicians, skilled investigators, and effective educators. We are fortunate to have them helping to lead the growth of both the department and the Division of Vascular and Endovascular Surgery." Together, the vascular surgeons have more than 26 years of combined experience caring for northern Nevadans. Dr. Hansen has 20 years of experience in northern Nevada. He is a clinical associate professor of surgery at the University of Nevada, Reno School of Medicine (UNR Med) and currently serves as medical director of vascular and endovascular surgery for Renown Regional Medical Center. "Since 2002, Dr. Hansen has led our region with his expertise and knowledge of aortic stents, grafting for abdominal aortic aneurysms and thoracic aneurysms, as well as treating patients with carotid disease," says Jayson Morgan, MD, FACC, Director, Cardiovascular Services. "Dr. Hansen specializes in the comprehensive management of vascular disorders, including open and endovascular surgeries. He is meticulous, thorough, and compassionate in the extraordinary care he provides to patients. We are thrilled that he has joined the Institute for Heart & Vascular Health team at Renown." Dr. Hansen completed his fellowship in Vascular Surgery at the Mayo Clinic in Rochester, MN, and completed his residency in General Surgery at the University of South Carolina, Greenville. He graduated with his Doctor of Medicine from the University of North Carolina School of Medicine, Chapel Hill, and is board certified in both Surgery and Vascular Surgery from the American Board of Surgery and a Fellow of the American College of Surgeons. Dr. Hansen has an interest in complex and acute vascular surgery and is committed to expanding access to qualified vascular care in the region. His mission is to further develop and establish Renown as a premier vascular center in northern Nevada. "Dr. Jaquish has extensive experience in carotid artery disease, carotid endarterectomy, aortic aneurysm and dissection, and peripheral vascular disease," says Sam Obilie-Mante, MBA, MIS, RDCS, RVT, LBBP, VP Administrator, Cardiovascular Services. "Dr. Jaquish is intelligent, professional, conscientious, and always perseveres on behalf of his patients. How proud we are to have him bringing his time and talent to patients across Renown Health." Dr. Jaquish received both his B.S. in Biochemistry (2005), graduating Magna Cum Laude with his Doctor of Medicine (2009) from the University of Nevada, Reno School of Medicine. Dr. Jaquish completed his fellowship in General Surgery at Ascension St. John Hospital and Medical Center in Detroit and a fellowship in Vascular Surgery at Texas A&M at Baylor, Scott & White Hospitals in Temple, TX. He is board certified in both General Surgery and Vascular Surgery. Dr. Jaquish currently serves as Assistant Professor of Clinical Surgery for UNR Med. Dr. Jaquish is bilingual in Spanish, proficient in American Sign Language and serves as an instructor for Advanced Trauma Life Support. Why Vascular and Endovascular Care Matters to You People with complex and serious conditions of the blood vessels and lymph system (vascular diseases) often find the help they need from Renown Health's vascular and endovascular surgical team. Renown's experts provide coordinated and comprehensive treatment to people of all ages. Renown's surgeons use advanced technology to perform vascular and endovascular surgery, including complex stenting procedures, blood clot removal and bypass surgery. Conditions treated include peripheral artery disease, aortic disease, mesenteric disease, nutcracker syndrome and carotid artery disease. "Our expert vascular and endovascular surgeons and staff treat problems that extend from mild to the most critical of emergencies," says Adnan Akbar, MD, Chief Medical Officer for Renown Acute Care. "Specialized physicians including cardiologists, interventional radiologists, heart and vascular surgeons, emergency medicine and trauma surgeons, neurologists, radiologists, physical medicine and rehabilitation specialists, primary care providers, nurses and other clinicians work as a team to determine the best treatment plan for each patient. We encourage all patients to discuss with their primary care providers whether they should undergo formal screening for early vascular disease." "Renown's reputation as the region's vascular and endovascular care leader has been built over many years. We performed the area's first open-heart surgery, angioplasty, stent and valve replacements decades ago. Renown Regional offers incredible advancements like trans-catheter aortic valve replacement (TAVR) and trans-catheter mitral valve repair (TMVr) with MitraClip therapy, lifesaving alternatives to open-heart surgery for patients considered high-risk or inoperable," says Chris Nicholas, FACHE, Chief Executive Officer of Renown Regional Medical Center. "Offering the highest level of comprehensive care for patients experiencing cardiac and vascular disease, Renown developed its first division of cardiothoracic surgery dedicated to heart surgery patients in 2019." The Renown Institute for Heart & Vascular Health program now offers a Diagnostic Electrophysiology Lab; a Chest Pain Center using the D-SPECT® heart camera; multiple Interventional Labs; Heart Failure Program; several Cardiac Catheterization Labs; Interventional Cardiology and Cardiac Surgery when necessary; and the only Pritikin-certified Healthy Heart Program in the West, creating individualized rehabilitation plans tailored to each patient's needs, so they can exercise safely, eat healthy, manage stress and cook nourishing, balanced meals, all while gaining a healthy mindset. In the most recent US News & World Report Best Hospital rankings, Renown Regional Medical Center was named as the number one hospital in Nevada. Ningún otro hospital del estado cumplió con sus estrictos estándares para el ranking de 2021. Renown Health is High Performing, its highest rating possible, in eight procedures and conditions including Heart Failure, Colon Cancer Surgery and Chronic Obstructive Pulmonary Disease, Hip Replacement and Knee Replacement. La calificación de un hospital se basa en múltiples categorías de datos, que incluyen resultados de los pacientes, seguridad y volúmenes. Los hospitales calificados como sobresalientes eran significativamente mejores que el promedio nacional. Las instituciones que componen los rankings de Mejores Hospitales de 2021-22 se seleccionan de entre un conjunto de 4,523 instalaciones, que representan a casi todos los hospitales estadounidenses que brindan atención para pacientes hospitalizados. Los hospitales se evalúan en función de una amplia gama de afecciones y procedimientos, incluidas 16 áreas de especialidad médica. US News & World Report evaluó 58 hospitales en Nevada. 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 6,500 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. Renown is currently enrolling participants in a community-based genetic population health study, the Healthy Nevada Project®. Visite renown.org para obtener más información. 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. Desde 1969, UNR Med ha capacitado a más de 3,900 estudiantes, residentes y becarios. UNR Med continues to improve the health and well-being of all Nevadans and their communities through excellence in student education, postgraduate training and clinical care, research with local, national and global impact and a culture of diversity and inclusion. For more information, visit med.unr.edu.
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3 datos importantes de atención médica para la generación milenial
Many millennials are fortunate to have good health, but it’s important to be prepared for your next doctor’s visit. Here are three things that millennials should stay on top of for tracking and maintaining their health. For many millennials, doctor visits and preventive healthcare fall by the wayside. Alison Lynch, MD, a family medicine provider with Renown Medical Group says there are a few key things you can do now to set yourself up for a healthy future. 1. Establish with a Primary Care Provider Millennials are more likely to go to urgent care or consult the internet when a healthcare issue arises. While these are helpful tools, here’s a better one: a primary care provider. The benefit of establishing with a primary care provider is that your medical records, history and a baseline for your health will be documented. That means that when a problem or question comes up, your doctor will already have helpful information on file and can help you navigate your needs. Having a primary care provider is often required for prescription refills and referrals to a specialist. By establishing now, you’ll be able to get what you need in the future much faster. Make an Appointment Today 2. Protect Yourself and Your Community There are a few vaccinations and screenings that Dr. Lynch recommends for millennials. Flu Shots: These are available every year and are recommended for protecting not only yourself against the flu but also others you may come into contact with. Flu shots are usually available from August through December through your healthcare provider, pharmacies and pop-up events. Tetanus or Tdap: Most people receive a tetanus shot as a child, but it’s recommended that everyone get a booster every 10 years. If you are overdue, talk to your primary care provider or pharmacist about getting updated. Pap smear: If you’re a woman, a pap smear is recommended every three years in your 20s and every five years in your 30s. HPV vaccine: This vaccine helps prevent the virus that causes cervical cancer as well as the majority of head and neck cancers and warts. The HPV vaccine is recommended for all genders up until age 45. STD screening: Consider an STI/STD screening if you’re sexually active.
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6 Healthcare Action Items for the LGBTQIA+ Community
© Niyazz via Canva.com Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs. Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health. PrEP and PEP Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months. Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days. PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location. HPV Immunization All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime. The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never! STI Testing Sexually-transmitted infections form from bacteria, viruses or parasites that can be transmitted by person-to-person sexual contact through semen, vaginal, blood and other bodily fluids. According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new STI cases across the nation each year. Luckily, most STIs are preventable. Annual STI testing for HIV, gonorrhea, chlamydia and syphilis is important to stay on top of your sexual health. Because these STIs may sometimes have no symptoms, screening is recommended regularly and with any change in sexual partners. Depending on the specific condition, tests for these infections include urine, swab and blood tests. Speak with your primary care provider on a screening schedule that works best for you. Prostate Exams Prostate exams look for early signs of prostate cancer in patients who still have a prostate. The CDC recommends those who are at least 55 years old get regular prostate screenings; however, for patients with a family history of prostate cancer, screenings may be recommended as early as 45 years old. These exams are done via two common methods – a prostate specific antigen (PSA) blood test and a digital rectal examination (DRE). Your provider can help you determine your risk and when you should start getting screened. Pap Tests and Pelvic Exams Patients of all genders who have a cervix, uterus, vagina and/or ovaries will benefit from regular pelvic exams and Pap screenings. A pelvic exam consists of a provider looking inside the vagina and at the cervix for anything unusual. A Pap test, also known as a Pap smear, involves your provider using a small, soft swab to collect cervical cells to check for early signs of cancer. Generally speaking, people with these organs should have a Pap test every three years starting at age 21 through the age of 30. After age 30, patients should receive a Pap test with HPV co-testing every five years until age 65. These recommendations are changing based on new research, so it is important to have a conversation with your PCP about the current guidelines so you can make an informed choice about what schedule you should follow. A gynecologist or your primary care provider can counsel you and perform these screenings. Mammograms and Breast Exams People with breast tissue, especially dense breast tissue, are at risk for breast cancer, and regular breast screenings are your best line of defense. At-home breast self-exams are the first step – you will want to check your breasts for any lumps, changes, fluid leaks, irregular tissue thickening or anything else that feels unusual. The Breast Cancer Risk Assessment tool, provided by the National Cancer Institute, is a good place to start to identify your risk. Talk with your primary care provider about the risks and benefits of starting screening at age 40 so you can make an informed decision about when to start. If you have any family history of breast or ovarian cancer, your PCP will offer you genetic testing for BRCA 1 and 2 mutations. Nevadans over the age of 18 can also get BRCA genetic test for free by enrolling in the Healthy Nevada Project. Mammograms are important screening tools, but for a significant portion of people with breast tissue, density of the breast tissue may make mammograms less helpful in detecting cancer. Your primary care provider can help you decide what additional imaging (such as breast ultrasound) might be best for you.
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