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© 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.

Read More About 6 Healthcare Action Items for the LGBTQIA+ Community

National Radiologic Technology Week is from Nov. 5-11, 2023. Join us in celebrating Renown's Interventional Radiology department!Try to put yourself in the shoes of someone who is told that they have a massive blood clot in their lung, someone who needs a biopsy to determine the next steps of their care, someone facing a stroke or brain aneurysm or someone who needs a catheter to receive treatment such as chemotherapy. You may immediately think that an intense and intimidating surgery is on the horizon. What if, instead of surgery, your care teams were able to use the necessary tools to treat your blockage or administer your medicine with an image-guided procedure?  That’s precisely what the Interventional Radiology (IR) team at Renown Health does. Behind the doors of this department is where you’ll find a team of highly skilled individuals who operate like a well-oiled machine, ensuring that each procedure is executed with precision and care. Their commitment to excellence knows no bounds as they provide essential interventions to patients of all ages, from the tiniest newborns to the elderly. Their mission extends beyond diagnostic and therapeutic procedures; they are experts in understanding and serving the ever-evolving needs of their patients.  Minimally Invasive, Maximally Impactful  With their advanced expertise, our IR teams at both Renown Regional Medical Center and Renown South Meadows Medical Center harness the power of X-ray, CT and ultrasound technologies to navigate their way through life-saving minimally invasive procedures, such as thrombectomies, angioplasties, stent placements, embolizations, catheter and drain insertions and needle biopsies. In the world of medicine, Interventional Radiology often offers an alternative to traditional surgical methods, reducing the risk of hospitalization and helping patients embrace recovery more quickly.  Our IR teams have a diverse and busy daily work life in order to make these complex and life-saving interventions happen – and they all have each other’s backs to ensure that every patient gets the care they deserve.  “Every day is different, and no two days are alike,” said Ryan Nunes, Specialty Procedure IR Technologist at Renown Regional. “The day can start off first thing in the morning with several emergent cases, such as ruptured brain aneurysms to brain blockages. We all work really well together; we help each other out and come together to do things as a team.”   Like every other team at Renown, patient well-being is always a number one priority. The IR department takes this commitment seriously, upholding the highest standards of ethics and safety.  “We start the day by preparing rooms and making sure they are well-stocked, checking that all devices are working, performing safety checks and making sure the entire team is well-prepared for whatever cases come through the door,” said Aubrey Goldsmith, Supervisor of Clinical Nursing in IR at Renown Regional. “We have routine cases like drain placements, biopsies, line placements and more, and we also have life-threatening cases that come at a moment’s notice. Our nurses are responsible for monitoring patients throughout the procedure to make sure they are doing well the entire time and are there to respond if the patient has a decline.”  "After completing the prior assessment of each patient, we look for any medical problems the patient may have before confirming it is safe for the patient to have procedure done,” said Brandon Hartwig, Interventional Radiology RN at Renown South Meadows. “We work closely with the physicians on all our cases while assessing each patient, going through labs and vitals and personalizing the procedure for each patient.”  Even though the procedures they oversee are minimally invasive, the IR team understands that any procedure, regardless of the severity, can be incredibly frightening for any patient. Their best tool for handling patient anxieties? Communication.  "The best thing we can do to reduce anxieties and fears in patients is to have communication with them to ensure they know what is going on and what to expect,” said Megan Rios, IR Technologist at Renown Regional. "We set clear expectations for the patients and give reassurance throughout the entire procedure.”  "All of our team members are very attentive to our patients when it comes to potential fears and anxieties that they may have,” added Jazmynn Kimsey, IR Technologist at Renown Regional. “We always take the extra time to listen to our patients and break things down, explaining every step before, during and after the procedure.”  Knowledge sharing is also a crucial part of the IR process. No patient will ever have to wonder, “what exactly is going on here?”  “We provide each patient with education and advocacy throughout the process,” said Blaire Henderson, Interventional Radiology RN at Renown Regional. “We ensure every patient is as comfortable as possible at all times.”  “When it comes to procedures, patients tend to be scared and nervous,” added Ryan Nunes. “The silver lining to what we do is that it is all done through very small openings of the skin, and we all explain this to patients. Most procedures we do are done under moderate sedation which helps put the patient more at ease.”  In a world where advanced medical care meets the human touch, the IR team exemplifies Renown’s commitment to making a genuine difference in the health and well-being of everyone they serve.

Read More About Department Spotlight: Interventional Radiology

The imaging department is where scientific precision and patient connection come together in harmony to help diagnose a multitude of conditions. When a mystery needs to be unraveled, experts in X-ray, CT, MRI, ultrasound, echocardiography, mammography and nuclear medicine step in to provide a deeper lens into each patient’s inner workings. At Renown Health, our imaging specialists exemplify this and more.  With the inpatient teams at Renown Regional Medical Center and Renown South Meadows Medical Center and many outpatient locations across Reno and Sparks, our dedicated and compassionate imaging and radiology technologists make this symphony of healing a melodious reality. Through the lens of their expertise and the state-of-the-art equipment at their fingertips, the invisible becomes visible, pain transforms into answers and the path to recovery.  A Picture Tells a Thousand Words  Every patient image tells a story, and Renown’s Imaging department is full of master storytellers. From X-rays that capture the intricate architecture of bones to MRIs that unveil the complex structure of organs, these team members use sophisticated techniques to make sure every patient receives the highest standard of care.  Within the imaging landscape, no day looks the same – and each team can expect a different set of challenges to overcome, all while helping providers gain better diagnostic clarity.  “Every day in imaging is a little bit different, and I love that,” said Savannah Terrana, Outpatient CT Scan Technologist at Renown X-Ray and Imaging – Vista. “We start like everyone else: getting our rooms stocked and ready for patients and protocoling the day's exams. We have a lot of different types of scans, like x-ray, CT and bone density, and a variety of conditions that we are evaluating for the ordering providers, like fractures, cancer, bleeds and more.  “When we get into work, we get a daily assignment that decides whether we are in one of our outpatient or inpatient rooms,” added Ireland Bennett, Echo Technologist at Renown Regional. “Then when we are on inpatients, we get our assignments for whether we are assigned to transesophageal echocardiograms, the cath lab or pediatrics. When we are on outpatients, we get a set schedule for the day with patients every hour from 7:15 a.m. until 4:15 p.m. We do our best to be efficient as possible to not delay any patient care or discharges.”  “X-rays aren’t just for bones; we do chest X-rays to look for pneumonia and intestinal issues, and we also do fluoroscopy, which is a live video X-rays while patients drink contrast or while surgeons fix fractures with screws and other hardware in the operating room,” said Amethyst Winters, Inpatient Diagnostics Imaging Lead at Renown South Meadows. “There is a lot of variety, and we provide imaging for patients in the entire hospital.”  Equipped with advanced technologies and the unique skills they acquired in a trade program, at the university-level or in the military, the Imaging department can deliver precise and comprehensive information to help providers make accurate diagnoses. And their role transcends beyond the image scanner.  “A typical day for an MRI Technologist depends greatly on outpatient or inpatient settings,” said Sean Fryer, Supervisor of Imaging for Renown X-Ray and Imaging – Pringle. “There is a lot of screen time and usually in dark areas, but this is where our technologist skill set comes into play – manipulating parameters to either increase quality by signal/resolution or decrease them a little to gain time."  “A day in the life as an ultrasound tech would of course be performing ultrasounds on our patient community, but there is much more to it,” added Mary Rushton, Ultrasound Specialist at the Renown Breast Center. “This includes keeping rooms clean and stocked with supplies, protocoling exams and studying patient history so you can give the best patient care possible, continuing education and training to keep up with new technologies and being an aide to your radiologist. Working with many different personalities, you recognize that you cannot complete every step of the patient care process all by yourself – it requires collaboration from your team to give the ultimate patient care experience."  Mary brings up an excellent point about the wide variety of people her team meets every day, on both the patient and employee side, with the common goal of solving diagnostic mysteries. This aspect of their work has become one of the highlights of their career.  “Working in imaging allows us to meet many members of our community,” Teresa Shutts, Breast Health Coordinator at Renown X-Ray and Imaging – Pringle. “We are responsible for providing imaging exams, managing patient needs and creating a comfortable and caring environment for people who are possibly going through the worst times of their lives.”  Along with every day being different, our Imaging team members thrive in their dynamic and fast-paced work environment, where efficiency and urgency are vital, especially among a constant stream of patients in need of timely diagnoses.  “Our days in CT are very fast paced,” said Shelly Lavin, Imaging Lead for Inpatient Diagnostics at Renown Regional. “Our modality is the first choice for assessing stroke and trauma patients. We are fortunate to have very competent tech aides who help work up CT orders by checking orders, IV status and labs. We generally have inpatients scheduled every half hour, and we work these around a very full ER list.  When we get extremely busy, we have to strategize how we schedule our patients in the various scanners to expedite exams and not delay patient care.”  “We provide patient care for those who come in for emergencies, trauma, inpatient care, surgery and fluoroscopy studies,” added Sean Elliott, Inpatient Radiology Technologist at Renown Regional. “I was always told in school that our main purpose was to help doctors better diagnose patients, and imaging provides many modalities to appropriately diagnose.”  Behind-the-scenes, our Imaging surgery schedulers are the keys to ensuring each appointment runs smoothly, communicating directly with patients to get their exams off to a good start.   “Every day it is my task to make sure we have everything we need to do the exam that is ordered for a patient,” said Isela Gonzalez, Surgery Scheduler for Renown X-Ray and Imaging – Double R. “This includes the order, authorization approval, completing the protocol, confirming the appointment, re-stating the address and directions, going over any prep for the exam and giving them their estimate cost for the exam. I always do my best to give the patient the best experience possible.”  Whether they are in the weeds of radiology or in the depths of patient coordination, Renown’s Imaging department is unmatched – and the direct beneficiaries are their patients.

Read More About Department Spotlight: Imaging

Read More About LGBTQ+ at Renown