Buscar

© 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

Dr. Derek Beenfeldt first joined the Renown family in 2014 as a family medicine physician after graduating from University of Nevada, Reno, School of Medicine (UNR Med) in 2011. His son Davis was only 10 years old when Dr. Beenfeldt decided to change careers and attend medical school. Ten years later, Davis is following in his dad’s footsteps as a third year student at UNR Med. “I am proud of Davis for taking on the challenges and the commitment that I know goes along with attending medical school,” Dr. Beenfeldt said. “I also feel lucky that we have a medical school with such a great reputation and resources close to home.” The affiliation is a great source of pride for Dr. Beenfeldt. Not just because two important organizations in his life are joining forces, but he also sees it as both entities taking on an immense responsibility – the challenge to be better for incoming students, and subsequently to improve healthcare in Nevada. Davis is currently going through his rotations and spending countless hours a week at Renown Regional. His dad is right there by his side supporting him along the way. “It has been really interesting to have discussions about the UNR medical school with Davis, I recognize the names of many of the professors and courses from when I was a student,” Dr. Beenfeldt said. “I tried to be empathetic, as I can relate to how difficult and stressful this time is for him. Dr. Beenfeldt currently works as chief medical officer for Renown’s insurance arm Hometown Health, and Davis is still browsing specialties. “I don’t know what kind of medicine I want to focus on yet, but I feel lucky that I can attend medical school so close to home and have the option to continue helping my fellow Nevadans after I graduate.” UNR Med at a Glance UNR’s Medical School was established in 1969 Over the last 50 years, UNR Med has educated 3,900+ physicians More than 30% of UNR Med physician graduates continue to practice in Nevada UNR Med is the state’s oldest medical school

Read More About A Family's Legacy

Something wasn’t right. Even though it was the holiday season, on December 23, 2018, Mondo Corona didn’t feel good…not to mention his sudden earache. Although Christmas was a happy celebration with his family. He still felt tired. Was it the flu? And that darn earache wouldn’t go away. On that cool winter day, Mondo could not imagine he was near death. Or that he would become a heart attack survivor. Know Your Heart A few days later, on December 27, he wasn’t feeling any better. He decided to go to the emergency room at Renown Regional Medical Center. That’s when a simple blood test revealed shocking results. “I thought about death a lot. I was calling people to ask them to help take care of my family if I wasn’t going to be here anymore,” he emotionally confesses. Although Mondo loves his job as a railroad engineer, it involves on-call shifts and an erratic sleep schedule. At that time his exercise and eating habits weren’t the best either. Yet he never imagined he would have a massive, often lethal, type of heart attack called ‘the widowmaker.’ In fact, his family had been concerned about his health for awhile. “He worked so much and he didn’t take care of himself and he didn’t exercise – he was burning the candle at both ends,” shares his wife, Alison. His daughter Justice, an avid exerciser, was always encouraging him to join her at the gym, but could never quite convince him. Mondo remembers the time before he became a heart attack survivor. “I didn’t have any exercise whatsoever in my life. At that point my eating habits were just terrible,” he shares. He went to the emergency room due to his earache, but nothing was found until one of the doctors ordered some tests. Specifically blood work showed high troponin levels. Troponin is a blood protein often released in large amounts when the heart muscle has damage, sometimes by a heart attack. Heart Attack Survivor “My surgeon came in and told us that it was going to be a triple bypass – that three of the four…major arteries were clogged 100 percent,” Mondo explains. Amazingly his heart was pumping on only 10 percent blood flow. Heart surgeon, Joseph Brandl, MD, told him he survived a widowmaker heart attack. This type of heart attack happens when there is a 100 percent blockage in the critical left anterior descending artery (LAD) of the heart. Frequently the symptoms can often be mistaken for the flu. According to the Centers for Disease Control and Prevention (CDC), every 40 seconds a person in the U.S. has a heart attack. And 1 in 5 heart attacks are “silent” – meaning you can be a heart attack survivor, but not know it. For Mondo’s children, seeing their strong father struggle after heart surgery was difficult. Justice tearfully shares, “It was really hard seeing him so vulnerable. He really needed anybody’s and everybody’s help at that point.” A Heart Attack Survivor Program After leaving the hospital on January 5, 2019, he was extremely weak. On February 12, Mondo began Renown Health’s Intensive Cardiac Rehabilitation (ICR) Program called the Healthy Heart Program. This program, requiring a doctor referral, includes 12 weeks of supervised exercise along with nutrition education and stress management skills. In spite of heart disease being the leading cause of death in the U.S. – more than all cancers combined, the risk can be lessened with daily lifestyle habits. Mondo credits the ICR program with motivating him and getting his focus back on his health. He saw the team members setting an example and also caring about his health. He describes one of his favorite recipes, “In ICR Sara showed us how to make this incredible fruit salad, with jicama, watermelon, grapes, oranges, red onion, and ginger!” Of course, the recovery process was not overnight. “It did take a long time to really realize that he was going to be back to normal, that he was going to be okay and that he was going to be that strong provider for me and my children,” Alison reflects. “Mondo’s had an amazing outcome and he’s not limited in his activities at all and should hopefully have a life that’s not limited at all from heart disease as we’re monitoring everything and everything’s looking good,” reports his heart doctor Jayson Morgan, MD. Mondo describes his care experience being a heart attack survivor as life-changing. “The care teams at both Renown and ICR were incredible. There wasn’t a single person we came across who didn’t immediately become a part of the family. They truly cared for us, all of us, including the extended family that came to visit. They were informative and supportive. I felt like I created lasting bonds with so many of them, especially the gang in ICR. What amazing people.” Lynice Anderson, Director of Intensive Cardiac Rehab, Healthy Heart Program, shares,” Mondo is one of the most genuine, thoughtful and humble people I have ever met. His love for his family is palpable. His impact on me personally and our team is forever.” She acknowledges family support is key to his success, “Mondo’s family is his rock and they are his. I have never met a family that was so ‘all in’ in the support of their loved one. His new heart healthy lifestyle is modeled through his family every day.” Fighting The Good Fight Of course, Mondo may look familiar to you. That’s because he is featured in Renown Health’s “Fight The Good Fight” brand campaign. For this reason, you may have seen him in advertising working out on a treadmill, shirtless, with his open heart surgery scar in full view. When asked how he feels about showing his scar he confidently says, “I don’t mind showing it to people. I don’t. I earned that scar.” He is a proud heart attack survivor. Today, he’s grateful to be alive and takes his health commitment seriously. “Things have a different feel now. The skies and lakes are bluer and the trees greener. My family is so much more a part of my day. We go on so many more outdoor adventures, trying to incorporate a little exercise into our fun. We watch what we eat more and are trying to teach our children and loved ones about healthy choices. And I think with a few we’ve even been successful!” he observes. “Don’t take life for granted.” “Unconditional love. I get nothing but support from my family without them I wouldn’t be where I’m at. What happened to me definitely makes me a fighter for sure. I’m fighting for my life – the good fight – I think life is good,” he adds.

Read More About Heart Attack Survivor Fights the Good Fight

With more than 29 million adult Americans having high cholesterol, it’s important to know the facts. We asked Jayson Morgan, MD, a cardiologist with Renown Institute for Heart and Vascular Health, explains the numbers, the risk factors and how to maintain healthy levels. What is cholesterol? There are two types: Low-density lipoprotein (LDL) cholesterol, also known as the “bad” variety, because it can eventually build up within the walls of your blood vessels and narrow the passageways. High-density lipoprotein (HDL), also known as the “good” variety, because it helps remove other forms of cholesterol from the bloodstream. In adults, total cholesterol is considered high if it is more than 200 mg/dL. If the total is more than 200 or if high-density lipoprotein (HDL) levels are less than 40, your heart and brain may not be getting as much oxygen-rich blood as they need. This puts you at greater risk of heart attack and stroke. HDL levels greater than 60 mg/dL can actually lower your risk. What are the risk factors for high levels? Diet high in saturated fat Excess body weight Lack of exercise Smoking Family history Age (as people age, they are more prone to high levels) How often should someone get their numbers checked, and what kind of test is done? The American Heart Association recommends all adults age 20 or older have their cholesterol checked every four to six years. Those with cardiovascular disease or who are at higher risk of it may need their levels and other risk factors assessed more often. Your primary care provider can perform the test, along with assessing your other risk factors to help determine a treatment plan if necessary. The test will likely be one you will need to fast for, meaning no food, beverages or medications for around nine to 12 hours. Your healthcare provider will let you know if, and for how long, to fast. A simple blood test is all that’s needed to get your levels. What are some ways to lower “bad” cholesterol and raise “good” cholesterol? To achieve healthier levels, people should: Eat a heart-healthy diet: Choose healthier fats, eliminate trans fats, eat foods rich in omega-3 fatty acids and increase soluble fiber. Increase physical activity: Exercise on most days of the week. Quit smoking: If you smoke, it’s time to stop. Quitting smoking will improve HDL “good” cholesterol levels. Lose weight: Losing as little as five to 10 percent of your weight can improve cholesterol levels. Drink alcohol only in moderation. And finally, if lifestyle changes aren’t enough, your care provider might recommend medication to help lower your numbers. Renown Institute for Heart & Vascular Health For optimal heart health, the American Heart Association encourages you to “Know Your Numbers” which include: blood pressure, body mass index (BMI), cholesterol and fasting blood sugar, by scheduling a visit with your doctor. These numbers are critical in assessing your current risk for heart disease and stroke. Find a Cardiologist

Read More About Top 3 Cholesterol Questions Answered

Maintaining a healthy weight has many benefits: among those is improved heart health. If you’re trying to eat right as well as become healthier, nutrition experts say you might want to consider a plant-based diet. Plants provide air to breathe, beauty in our surroundings — and just may be a viable solution to your weight-loss goals. According to the Centers for Disease Control and Prevention, more Americans than ever are overweight: Today, 7 in 10 Americans are classified as “obese” or “overweight,” and childhood obesity rates are growing rapidly. So experts encourage would-be dieters to look to plants as a source of daily inspiration. “When you slowly and consistently expand your daily food choices to include more plant-based options, you will feel fuller, have more energy and lose weight,” says Lynice Anderson, director of Renown’s Healthy Heart Program. But according to a recent study from the U.S. Centers for Disease Control and Prevention, just 1 in 10 adults eats enough vegetables and only 12 percent get the recommended amount of fruit daily. The same study notes that eating a diet rich in fruits and vegetables daily can help reduce the risk of many leading causes of illness and death, including heart disease, type 2 diabetes, some cancers and obesity. Plant Foods = Foods with Fiber One of the overwhelming health benefits of plant-based foods: fiber. A study published in a recent issue of the Annals of Internal Medicine suggests that something as simple as aiming to eat 30 grams of fiber each day can help you lose weight, lower your blood pressure and improve your body’s response to insulin just as effectively as a more complicated diet. Fiber contains no calories and comes in two forms: soluble, which dissolves in water, and insoluble, which doesn’t dissolve. Both are important for different reasons. The soluble fiber found in oats, fruits and beans forms a gel-like substance and helps to lower blood cholesterol and blood sugar levels. Insoluble fiber found in fruit skins, green beans and cauliflower goes through your intestines relatively intact providing “bulk” and improving bowel-related health problems. “My fiber champion is chickpeas, also known as garbanzo beans,” says Renown Chef Chris Wyatt. “They are high in fiber, low in fat, low sodium and have zero cholesterol. Not only do they not contain any cholesterol, chickpeas work to remove cholesterol from your body. It’s a win-win.” Snacks That Are Part of a Plant-Based Diet Looking for the best sources of fiber from the plants and trees in your life? Here are the best options, according to this CDC fact sheet: Fruits Raspberries, 1 cup: 8.0 grams of fiber Pear, with skin, 1 medium: 5.5 grams of fiber Apple, with skin, 1 medium: 4.4 grams of fiber Strawberries (halved), 1 1⁄4 cup: 3.8 grams of fiber Banana, 1 medium: 3.1 grams of fiber Orange, 1 medium: 3.1 grams of fiber Veggies Artichoke, cooked, 1 medium: 10.3 grams of fiber Peas, cooked, 1 cup: 8.8 grams of fiber Broccoli, boiled, 1 cup: 5.1 grams of fiber Turnip greens, boiled, 1 cup: 5.0 grams of fiber Sweet corn, cooked, 1 cup: 4.2 grams of fiber Brussels sprouts, cooked, 1 cup: 4.1 grams of fiber Potato; with skin, baked, 1 medium: 2.9 grams of fiber Carrot, raw, 1 medium: 1.7 grams of fiber Renown Health Improvement Programs | Appointments: 775-982-5073  Renown Health offers a number of educational and support programs to help people overcome the challenges presented through various health conditions and to aid in creating and adopting a healthy lifestyle. To get an assessment of your dietary needs, schedule a consultation with one of Renown’s registered dietitians, who can help with: Diabetes Programs Medical Weight Management Nutrition Programs Make an Appointment

Read More About Want to Eat for Heart Health? Consider a Plant-Based Diet