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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.

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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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Getting the COVID-19 booster is the best way to protect yourself from severe illness or death due to COVID-19, and both the CDC and the FDA have approved booster shots for people ages 18 and older. So, with the holidays right around the corner and infection rates on the rise both in Nevada and nationally, the best thing you can do to prevent the continued spread of this deadly virus is to get boosted today. The Basics: Who: It is recommended that everyone 18 years or older get a COVID-19 booster shot. When: At least 6 months after completing your primary COVID-19 vaccination series. What: Any of the COVID-19 vaccines authorized in the United States. The CDC allows for mix and match dosing for booster shots. How: To make an appointment for your COVID-19 vaccine booster, please visit vaccines.gov today. Appointment Reminders: Don’t forget to bring your CDC vaccination record card to your appointment. Refresh yourself on the potential side effects and remember that these are normal signs your body is building up protection. Commonly Asked Questions: Q: Does anything change if I received the Johnson & Johnson as my first COVID-19 vaccine? A: If you received the Johnson & Johnson COVID-19 vaccine, you are elidable for a booster two months after completing your primary vaccine. Q: Is the formula the same for the boosters as it was for the primary vaccine? A: COVID-19 booster shots are the same formulation as the current COVID-19 vaccines. However, in the case of the Moderna COVID-19 vaccine booster shot, it is half the dose of the vaccine people get for their primary series. Q: Am I still considered “fully vaccinated” if I don’t receive a COVID-19 booster shot. A: Yes, everyone is still considered fully vaccinated two weeks after their second dose in a two-shot series, such as the Pfizer-BioNTech or Moderna vaccines, or two weeks after a single-dose vaccine, such as the J&J/Janssen vaccine. All information courtesy of the Center for Disease Control and Prevention. All information courtesy of the Center for Disease Control and Prevention

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Getting a shot can be scary for kids and anxiety-inducing for parents and caregivers. With flu shot season well underway and children's COVID-19 vaccine clinics in full swing, we wanted to share ways to reduce the stress for you and your child. Plan Ahead and Be Honest A few days before the scheduled appointment, casually mention to your child that you’re both going to the doctor’s office (or vaccine clinic, or pharmacy) soon for their vaccine. Explain to them that this will help protect them and will only take a second. Being honest is important, telling your child that it will hurt for a moment. If possible, try and schedule the vaccine at a kid-specific vaccine clinic, your pediatrician's office or a school-based site. Remember that words are powerful. Take notice if you are using a word that might make them more upset, such as prick, jab, needle or shot. You can interchange words such as vaccine, immunization or injection. Bring Toys Don’t be afraid to let your child bring one of their favorite toys or stuffed animals to the appointment. This can make them feel more comfortable and provide distraction. Ask for Pain Reliever/Numbing Agent If you know from past experience (or suspect) that your child has a needle phobia, talk to the vaccination location ahead of time and ask if they can use a pain reliever or numbing agent before administering the vaccine. Distract. Distract. Distract. Sing a song, tell them a joke, make a funny face. If you can pull your child’s attention away from the needle and make them laugh, they won’t focus all their energy on worrying about the shot. Lead By Example If you haven't gotten your flu shot, COVID shot or COVID-19 booster yet, ask the facility ahead of time if you can also get a shot before your child. Show them that the shot is no big deal and that they will have no problem getting it themselves. Celebrate Don’t be afraid to celebrate this victory with your child once it is over – bring them to the park, go out for an ice cream cone, let them pick what’s for dinner. This reward will show that you’re proud of them for being brave and may also make the next time your child is due for a shot easier.

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We get it – the entire world has been overwhelmed with COVID-19 vaccine information, questions and celebrations around vaccines developed to combat COVID-19 induring the past several months. It’s hard to know where to start in digesting all this news and information. But one thing is clear: healthcare experts agree that the authorized COVID-19 vaccines are safe, effective and recommended to help end this pandemic. If you are passionate about stepping up in your community to encourage the vaccination efforts, we’re offering a few ideas on how you can be an ambassador. Find the Facts Content on the vaccine is abundant, but and there’s a few resources that we can all rely on to help digest the information: The Centers for Disease Control (CDC) updates its website content around the vaccine regularly, and also offerings information in Spanish. Health departments across the U.S. are leading the way in distribution logistics planning, and partnering with other providers, like such as hospitals and pharmacies, to distribute give people doses. Their websites are great resources to understand options where you live. Locally, check out washoecounty.gov/health/programs-and-services/environmental-health/covid-19-guidance for vaccine updates in Washoe County. Many providers like Renown Health and other providers are sharing content around their recommendations for the vaccine. Get answers about the vaccine types from one of our pharmacists, read common concerns addressed by experts and view videos from many doctors and other specialists on our YouTube Channel.

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Vaccines that provide protection against the COVID-19 virus are bringing us closer to the end of this deadly pandemic. Two different COVID-19 vaccines are currently available in the U.S. today: one from Pfizer and the other from Moderna. Kate Ward, PharmD, BCPS, Director of Clinical Pharmacy at Renown Health and Adam Porath, PharmD, Vice President of Pharmacy at Renown, share what you need to know about these vaccines. When two COVID-19 vaccines were approved by the U.S. Food & Drug Administration (FDA) in December 2020, it was cause for celebration. Why? Because according to the CDC, the vaccines are 94 percent or more effective in providing protection against the COVID-19 virus! Many people are seeking information about the new Moderna and Pfizer vaccines. Below, our pharmacy leaders provide answers to some commonly asked questions. How do the COVID-19 Vaccines Work? The Pfizer and Moderna vaccines are both mRNA vaccines that help your immune system develop antibodies against the COVID-19 virus. The vaccines use messenger RNA, or mRNA, to show our bodies’ protein-making cells how to make the spike proteins of the COVID-19 virus. Our immune system reacts to these spike proteins by creating antibodies that can recognize and destroy them. So when a person is exposed to the virus in the future, they will be less likely to get sick. What are the Differences between the Pfizer and Moderna Vaccines? The Pfizer and Moderna COVID-19 vaccines are very similar, with just a few small differences worth noting. The main difference between the two vaccines is when you should receive your follow-up dose. Patients who receive a first dose of Pfizer should receive their second dose about three weeks later. Those who receive a first dose of Moderna should receive their follow-up vaccination roughly four weeks after their first dose. People 18 years and older can receive the Moderna vaccine while people 16 years and older can receive the Pfizer vaccine. Dosage for the Moderna vaccine is 0.5 ml (100 mcg). Dosage for the Pfizer vaccine is 0.3 ml (30 mcg).

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With front-line workers receiving the first COVID-19 vaccinations, many of us are feeling hope, but also worry. As a result, we are joining with the Ad Council, the COVID Collaborative, HHS, CDC and NIAID (along with top health and medical organizations) to address your vaccine concerns and questions. Will the vaccine be available to everyone in Nevada? The Nevada Department of Health and Human Services (DHHS) is collaborating with health systems about the use of initially available, limited supplies of COVID-19 vaccines. They will provide guidance on the prioritization order of who will receive the vaccine. This will be based on available quantities, high-risk locations of work and certain other risk factors, and recommendations and guidance for public health agencies. The CDC has provided guidance to initially focus on the following groups: Healthcare personnel likely to be exposed to or treat people with COVID-19, nursing home residents and others in institutional settings; People at risk for severe illness from COVID-19 due to underlying medical conditions; People 65 years of age and older; Other essential workers. I worry the vaccine has been rushed The U.S. national vaccine safety system ensures that all vaccines are as safe as possible, and because vaccines are given to millions of healthy people to prevent serious diseases, they’re held to very high safety standards. COVID-19 vaccines are undergoing a rigorous development process that includes vaccinating tens of thousands of people who participate in a study to generate the needed clinical data. These clinical trials generate scientific data for the FDA to determine the safety and efficacy of each vaccine. It’s worth noting that the clinical studies to establish the safety and efficacy of the Covid-19 vaccines were as big and thorough as recent studies for other licensed vaccines (for example, the shingles vaccine). I'm concerned about the vaccine's side effects The most common side effects are very similar to those seen with most vaccines, such as: sore arms, fevers, and tiredness within 72 hours after the vaccine. These side effects usually mean that the vaccine is generating an immune response, indicating it is working. Short-term side effects observed in the leading COVID-19 vaccine trials include: Injection site pain and redness Fatigue Muscle aches and pains Joint pain Headache I’m afraid I’ll get COVID-19 from the vaccine None of the authorized and recommended COVID-19 vaccines, or COVID-19 vaccines currently in development in the United States, contain the live virus that causes COVID-19. This means that a COVID-19 vaccine cannot make you sick with COVID-19. Can children receive the COVID-19 vaccine? Not at the moment. In early clinical trials for various COVID-19 vaccines, only non-pregnant adults at least 18 years of age participated. However, clinical trials continue to expand those recruited to participate. The groups recommended to receive the vaccines could change in the future. As of now, it is recommended that children do not receive the vaccine. More information will be available from the vaccine manufacturers. I do not believe vaccines are effective Both this disease and the vaccine are new. We don’t know how long protection lasts for those who get infected or those who are vaccinated. What we do know is that COVID-19 has caused very serious illness and death for a lot of people. If you get COVID-19, you also risk giving it to loved ones who may get very sick. Getting a COVID-19 vaccine is a safer choice. The FDA is responsible for making sure that, just like any other medications, any FDA-authorized or approved COVID-19 vaccines are safe and they work. The EUA (Emergency Use Authorization) will not be provided if the FDA feels that the vaccine is unsafe. I can't get vaccines to due to a medical condition Adults of any age with certain underlying medical conditions are at increased risk for severe illness from the virus that causes COVID-19. mRNA COVID-19 vaccines may be administered to people with underlying medical conditions provided they have not had a severe allergic reaction to any of the ingredients in the vaccine. The following information aims to help people in the groups listed below make an informed decision about receiving the mRNA COVID-19 vaccine. It is extremely important to speak with your doctor regarding your specific medical condition, and always follow their strict advice regarding the COVID-19 vaccine, or any other vaccines. Sources: Renown COVID-19 Ad Council COVID Collaborative U.S. Department of Health & Human Services Centers for Disease Control and Prevention National Institute of Allergy and Infectious Disease

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Dry weather – as northern Nevadans we know it well. Of course this doesn’t mean we’re not affected by its health impact whether you’re new to the area or are a native. Stephanie Stutz, DO, a Renown Medical Group doctor specializing in family medicine, explains how to live comfortably in the high desert. Have you noticed dry skin, itchy eyes or more bloody noses? If you call northern Nevada home, you’re probably no stranger to these problems. “We get a lot of questions from people wanting to know, ‘what can I do to prevent things from happening from the dry weather?’” says Dr. Stutz. “We do have a dry climate, and obviously in the summertime you notice it more than in the winter, so we look at things like dry skin, dry eyes and dry nose.” It generally takes about two weeks to become used to the change in climate. Dry Weather Health Tips Fortunately, there are some easy things you can do to reduce your discomfort in dry weather. Dry skin. “If you have dry skin, use a lotion without perfumes so it won’t increase the potential for drying your skin out,” recommends Dr. Stutz. For example, one home remedy for extremely dry skin (or for those with thinner skin) is cocoa butter. “It’s thicker so it goes under the skin and takes more time to absorb. As a result, you get a much more long-lasting effect.” Dr. Stutz adds. “You can also add lavender essential oil to your cocoa butter to help you sleep at night.” Dry and itchy eyes. “Use eye drops on a regular basis and keep them with you. I recommend people have a couple of bottles – one at home and one in their bag,” Dr. Stutz suggests. Dry nose. “Overall one of the best things to use is a simple nasal wash,” she says. “You can get it over the counter; it’s a saline nasal wash. Use it a couple of times each day and it can be extremely helpful. In particular, gets up into the sinuses and clears them of any pollen or residue in there.” Dry Weather Nosebleed Advice In our dry climate, you may also notice more allergies and nosebleeds. Dr. Stutz cautions, “Surely the dry air can make your allergies much worse. It can create much more irritation, pain and pressure, particularly in the nose and sinuses.” Again, Dr. Stutz recommends using a nasal wash to remove discomfort. Using a nasal wash two to three times a day can also help prevent nosebleeds. “And if you’re someone who has severe or chronic nosebleeds, you can put a little bit of Vaseline along the inside of your nose to create a moisture barrier”. Dry Weather Medication Advice In addition to allergy and nosebleed sufferers, people on certain medications may be at greater risk for symptoms in our dry climate. “The medications you are on can make you much more susceptible to drying out and becoming slightly dehydrated,” Dr. Stutz warns. For this reason discuss all of your medications with your doctor. Specifically, see if you can time them throughout the day or look at changing the dosage. Should I Get a Humidifier? Given our year-round dry weather, you may want to purchase a humidifier to help ease your symptoms. But there are some things you should know first. “You have to be careful with humidifiers as there are pros and cons,” states Dr. Stutz. “The small tabletop humidifiers are not beneficial. You need to get one covering a huge amount of square footage and holding approximately 10 to 30 gallons of water to help your home. On the negative side, if you’re not maintaining it on a regular basis, it will hold on to mold and other allergens. So the next time you turn it on, you’re actually putting that back into the air.” Do I Need to Go to the Doctor? To be sure, it’s important to know yourself and your family. If this is something you experience each year, you can try over-the-counter medications. “But remember, there’s always the caution if you’re on prescription medications,” Dr. Stutz explains. “If you are on chronic prescriptions, come in to get evaluated just to make sure you’re not using anything which interferes with your medications.” Not Just a Summer Problem As the temperatures drop, remember this isn’t just a seasonal issue here in the Reno-Tahoe area. During the winter months, our dry climate combined with cold temperatures and heaters can still cause dry skin, aggravated sinuses and even itchy eyes. So use these helpful dry weather tips all year. Comprehensive Primary Care Renown Medical Group primary care physicians provide comprehensive primary care by appointment. Doctors coordinate each patient’s medical care including checkups, immunizations, referrals to specialists, lab work, X-ray & imaging and hospital admissions. Find a Doctor

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Due to the stubborn nature of this year’s flu season, Hometown Health and Renown Health are adding additional flu shot events. Learn more about being protected and how to weather this year’s cold and flu season. Typical for this time of year, Renown is currently seeing a rise in patients with flu-like symptoms and other winter illnesses. To help protect the community, flu shots will be offered at the dates and times listed below: Friday, Feb. 23, 10 a.m. to noon Wednesday, Feb. 28, 5-7 p.m. Both flu shot events will be held at in the Hometown Health building located at 10315 Professional Circle, Reno NV 89521. These are walk-in flu shot events — no appointment required. No out-of-pocket costs for Medicare beneficiaries (Part B), Senior Care Plus members and Hometown Health fully insured HMO and PPO plans. Please bring your insurance card and current ID. Without a qualifying plan, the individual cost is $35. If you have questions regarding these flu shot events, please contact Hometown Health Wellness Services at 775-982-5433. And to help you weather the intense cold and flu season this year, we asked Kathleen Burns, an advance practice registered nurse at Renown Health, about flu prevention and how to know the difference between the flu virus and the common cold. How do you prevent the seasonal flu? The annual flu vaccine is truly the best form of protection to help prevent the spread of the flu. Even if you do get the flu after being vaccinated, your symptoms will be lessened. Flu vaccines are still available in the community, including health providers at Renown Medical Group. Call 775-982-5000 to make an appointment. Although they are not substitutes for the flu vaccine, simple preventative actions can do a lot to help slow the spread of the virus, including: Covering your mouth when coughing and staying away from people who are coughing. Washing your hands often. If you have the flu, stay home. If you have the flu and need to go out, including a visit to the doctor’s office, wear a protective mask. Other precautionary measures include cleaning shared spaces and avoiding shared utensils and drinks. Who should get the flu shot? Almost everyone. The Centers for Disease Control and Prevention recommends a yearly flu vaccine for everyone 6 months of age and older as the first and most important step in protecting against influenza. Different flu shots are approved for people of different ages, but there are flu shots that are approved for use in people as young as 6 months of age and up. Flu shots are approved for use in pregnant women and people with chronic health conditions. Bottom line: Your best chance of avoiding the flu this season is to get your flu vaccine. How do you know if it’s the flu or a cold? The flu and the common cold have similar symptoms and it can be difficult to tell the difference between the two. Your healthcare provider can give you a test within the first few days of your illness to determine whether or not you have the flu. In general, the flu is worse than the common cold. Symptoms such as fever, body aches, fatigue and cough are more common and intense with the flu. People with colds are more likely to have a runny or stuffy nose. Flu symptoms include: A 100 degree or higher fever or feeling feverish (not everyone with the flu has a fever) A cough and/or sore throat A runny or stuffy nose Headaches and/or body aches Chills Fatigue Nausea, vomiting, and/or diarrhea (most common in children) Does washing your hands really help prevent sickness like cold and flu? Yes. Again, the single best way to prevent seasonal flu is to get vaccinated each year, but good health habits like washing your hands often can help stop the spread of germs and prevent illnesses like the cold and flu. The proper way to wash your hands is to wet them with clean, running water (warm or cold) and apply soap. Lather your hands by rubbing them together. Be sure to lather the backs of your hands, between your fingers and under your nails. Scrub your hands for at least 20 seconds. If you need a timer, hum the “Happy Birthday” song from beginning to end twice. Rinse your hands well and dry them using a clean towel or air dry them. If soap and water are unavailable, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol to clean hands. Other good health habits include covering your cough; avoiding close contact with people who are sick; staying home when you are sick; and practicing a healthy lifestyle by getting plenty of sleep, being physically active, drinking plenty of fluids and eating nutritious food.

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