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When Should You Consider Hospice? 5 Important Signs
Deciding on hospice care for a loved one is a deeply personal and challenging decision, balancing their wishes and medical realities. Rebecca Edwards, DNP, from Renown Hospice Care, explains the signs indicating when it might be time for hospice and offers guidance on navigating this decision with compassion and clarity. Understanding Hospice Care Before exploring the decision-making process, it’s crucial to have a clear understanding of what hospice means. Hospice care represents a shift in how we approach living with a terminal condition, emphasizing comfort, dignity, and quality of life above all else. When there is no longer a pathway to a cure, side effects of treatment outweigh the benefits, or someone is simply tired of frequent hospital visits, then it may be time for hospice. Hospice care is mainly done in the home, where most people wish to be. It's a compassionate, team approach to care that focuses on meeting the physical, emotional, and spiritual needs, supporting their families, and honoring individual preferences. 5 Critical Signs to Be Aware Of Decline in Overall Health: When a loved one's health continues to decline despite ongoing medical interventions, this may be a sign that these treatments are no longer effective. Increasing Pain and Symptoms: When managing symptoms such as pain, nausea, fatigue or shortness of breath becomes increasingly challenging, hospice can offer specialized support and expertise in symptom management. Frequent Hospitalizations: Repeated hospitalizations or emergency room visits can signify that the disease has progressed to a point where managing symptoms and providing comfort at home or in a hospice setting is a more appropriate approach. Difficulty with Daily Activities: If your loved one is experiencing difficult with activity of daily living such as dressing, bathing, or mobility, it may be a sign that they require additional support and assistance. Prognosis of Six to 12 Months: Hospice Care is typically recommended for patients with a prognosis of about one year or less if the disease follows its normal course. However, it’s important to remember that every individual is unique and prognosis can vary.
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When Care Can’t Wait: True Stories of Renown ER
Renown Health is home to three 24/7 Emergency Rooms (ERs) providing comprehensive emergency and trauma care, access to specialists and inpatient services backed by the area's most extensive health system. In 2023, Renown Health cared for 132,340 patients across three ER locations. Renown is also home to the region’s only level II trauma centers for both adult and pediatric patients. We spoke to three patients who sought immediate medical attention for various ailments and conditions to learn more about their emergency care experience and why they chose Renown ERs. Kamrin’s Story: From Worrisome to Critical In the spring of 2021, Danielle and her 13-year-old son Kamrin visited his primary care doctor for unexplained vomiting and were promptly referred to Renown Children's ER via ambulance for further evaluation and seen by board-certified emergency physician, Dr. Lisa Nelson. What initially began as an unassuming doctor's visit quickly turned into something much more severe after several tests confirmed a devastating abdominal tumor and a stage-four cancer diagnosis, unbeknownst to the family. Kamrin was immediately admitted to the Pediatric Intensive Care Unit (PICU) and referred to a Pediatric Oncologist at Renown Children’s Hospital to begin his plan of care with expert pediatric hematology and oncology specialists. Regarding the board-certified physician, who delivered the results to the family, Danielle said, “She was so calming to us, even as the diagnosis haunted us. She led us by guiding our family through the unknowns. She felt like a family member to us in that moment, letting all the unknowns be well known.” “The love, empathy, support and guidance these employees gave us carried us. The care team quickly and easily became a source of relief, knowing we were their priority and in the best hands. We are forever grateful for the team at Renown Children's Hospital and Renown Children’s ER; they truly saved our son's life and continue to be our guiding light whenever it's needed in our son’s health journey,” Danielle said. Today, Kamrin is in remission and navigating the aftereffects of chemotherapy, including an immune system deficiency. However, his family chooses to navigate each day by embracing the positive side of things, such as the life-saving impact of his treatment. Did you know? Renown Children's Pediatric Hematology and Oncology is located within Renown Regional Medical Center and offers expert pediatric specialists dedicated to providing comprehensive treatment for pediatric hematology and oncology, including chemotherapy, radiation therapy and infusion services. Taylor’s Story: From Crisis to Recovery Promptly after cosmetic surgery performed by a medical professional not associated with Renown, Taylor Salas (Chacon) began to lose consciousness and notice her post-surgery drainage systems, also known as Jackson-Pratt drains, fill with blood. She was transported to Renown Regional ER via ambulance and immediately seen by ER staff and board-certified emergency physician Thea Berning, MD, for medical assessment. Taylor drifted in and out of consciousness as the ER team began blood transfusions and a CT scan to determine her plan of care. Dr. Berning began facilitating communication with a community plastic surgeon with privileges at Renown Health and emergency surgery was performed to stop Taylor’s internal bleeding. Taylor was placed on a ventilator due to respiratory distress and trauma from the event, then transferred to Renown’s Intensive Care Unit (ICU) to continue her care. Thankfully, Taylor listened to her gut when something didn’t feel right after her surgery and sought immediate medical attention. The ER team's quick response, communication and collaboration with a plastic surgeon saved Taylor from severe internal bleeding. “I was informed every step of the way about what was happening and why. I felt comfort in this,” she said. Did you know? Because of Renown Regional Medical Center’s Level II Trauma Center distinction, you have immediate access to an extensive list of specialists and physicians trained in a wide array of specialties, in the event of a traumatic injury or accident. This is one of the many benefits of Renown Regional’s Level II Trauma status. Ted’s Story: The Unsuspected Threat Bothered by symptoms of heartburn, fatigue, neck pressure and arm discomfort, Ted was in the middle of a busy workweek in June 2023 when he began to suspect something was wrong. Knowing the importance of addressing early heart attack symptoms immediately, Ted and his wife headed to Renown Regional ER because of proximity and some familiarity with Renown’s leading cardiology care and technological expertise. After prompt assessment by the Renown ER team, including blood work, imaging tests and the administration of medication, Ted was admitted to the hospital to treat the blockage and narrowing of his coronary artery. On June 8, Ted was admitted for treatment, where he successfully underwent a single bypass surgery and recovered in the Cardiac Intensive Care Unit (CICU), before being discharged and following up with the Intensive Cardiac Rehab (ICR) program at Renown. The ICR program at Renown played a pivotal role in Ted's 55-pound weight loss and overall health improvement, empowering him to embrace a healthier lifestyle and find ways to use his newfound energy and strength today. “Overall, I believe I had the best care possible because of the collective group of people at Renown caring for this community, who we could see in the grocery store, at the ball game and in the shopping malls. This community feeling is something you might not get in a big city hospital,” Ted said. Did you know? Intensive Cardiac Rehab at Renown Health is a medically supervised program designed to improve cardiovascular health after a significant heart condition or procedure. Since its inception in 2016, this program has been a pioneer in the region for cardiac rehabilitation focusing on three key pillars including exercise, nutrition and stress management.
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El Papel de los Ginecólogos Obstetras en la Atención de la Salud de la Mujer
Obstetrician-gynecologists (OBGYNs) see patients from menses (the monthly menstrual cycle that occurs as a part of the female reproductive system), pregnancy and childbirth through menopause and play a pivotal role in managing reproductive health and overall wellness. Dr. James Alexander with Renown Women's Health explains. "As experts in women's health, we are uniquely positioned to recognize subtle changes or symptoms that might indicate broader health issues. This comprehensive approach allows us to serve as a valuable first touchpoint for various health concerns." Preventive Screenings: A Proactive Approach One key aspect is an OBGYN's ability to recommend preventive screenings based on your symptoms, age, lifestyle and medical history. For instance, lipid screenings are critical for monitoring cholesterol levels, which can be a significant factor in women’s heart disease. An OBGYN keeps up with the current guidelines for routine screening as well as in women with risk factors such as high blood pressure, diabetes, or a family history of heart disease during your visit. By identifying risks and abnormal screening early, they can collaborate with you to implement lifestyle changes or treatments to reduce your risk of heart conditions. Schedule Your Screening Appointment Make an Appointment by Phone: 775-982-5000
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Celebrating Resilience: Raquel's Remarkable Journey Through Breast Cancer Treatment
Raquel was 33 when she was diagnosed with breast cancer. It was April 2023, when she found a lump in her breast and was referred to the William N. Pennington Cancer Institute. After comprehensive imaging, she was diagnosed with invasive lobular carcinoma, which is a type of breast cancer that begins in the milk-producing glands of the breast. Between June 2023 and January 2024, she received a total mastectomy, chemotherapy and radiation at Renown Health. “Breast cancer is uncommon in women under 40, but any woman with a mass or lump in her breast should have an exam by a physician and imaging at any age,” said Dr. Lee Schwartzberg. In fact, according to the Centers for Disease Control and Prevention (CDC), only 9% of all new cases of breast cancer in the U.S. are found in women younger than 45. “It was a pretty scary diagnosis, but I’ve been led by great people through the process,” she said. “They were so helpful and there for me throughout the chemo and radiation.” Raquel's journey through breast cancer treatment at the William N. Pennington Cancer Institute was marked by the exceptional care provided by the Renown Health team, including nurses, nurse navigators, therapists, support teams and providers. Among the dedicated professionals, Dr. Michelle Chu and Dr. Lee Schwartzberg played pivotal roles in Raquel's diagnosis and subsequent treatment plan. Their expertise, compassion and commitment to patient care left an indelible impact on Raquel's experience. Their thorough examination and comprehensive approach ensured that Racquel received the best possible care for her invasive lobular carcinoma. In addition to the care provided at Renown, Raquel greatly benefitted from being connected with a mentor by Dr. Chu. This mentor, Kayla, had undergone a similar diagnosis and treatment plan, and at the same age Raquel. They texted and called each other throughout Raquel’s treatment, providing additional support through a challenging time. As of January 2024, Raquel is done with her treatment and continues to see her care team for follow-up appointments. “I’m through the worst and ready to rebuild my life,” Raquel said. To help celebrate this milestone, Nevada Athletics invited Raquel to receive the game ball at a Nevada Men’s Basketball game. She was joined on the basketball court for this special recognition by her husband, Raul; mother, Arlene; and two daughters, Ryleigh and Rhiannon. Racquel's journey is not only a testament to her resilience but also a tribute to the invaluable contributions of Dr. Chu and Dr. Schwartzberg in guiding her towards triumph over breast cancer.
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A Transformative Journey: Mary's Bariatric Surgery Story at Renown Health
Embarking on the path to bariatric surgery is a unique and deeply personal journey. Individuals like Mary Escobar choose this life-changing route for reasons ranging from improved cardiovascular health to managing diabetes or finding relief from various health complications. In Mary's case, her two-decade-long healthcare journey not only underscores the challenges she faced but also highlights the support and expertise that ultimately led to her successful transformation through bariatric surgery. Mary's Resilience: December 2002 through February 2003 More than two decades ago, Mary experienced unforeseen health complications just days after giving birth via c-section. Septic shock, hemolytic uremic syndrome, thrombocytopenia, renal failure and a blood clot in her lung plunged her into a critical state. Intensive care, plasma exchange and a long recovery followed. After being discharged with compromised kidney function, Mary faced complete renal failure two years later, leading to dialysis and a spot on the donor list. Mary's brother, a perfect match, selflessly donated his kidney on Dec. 14, 2007, marking a turning point in Mary's health. However, the post-transplant period brought new challenges, including diabetes, high blood pressure and a significant weight gain, reaching 230 pounds. Determined to regain control, Mary explored various diets without success until she consulted with a bariatric doctor. Journey to Bariatric Surgery: November 2009 - April 2021 In November 2009, Mary opted for a gastric band, shedding 40 pounds within a year. Despite initial success, issues with the gastric band arose, prompting a consultation with Dr. John Ganser at Renown Health in April 2021. Together, they decided to transition to a gastric sleeve, with comprehensive education provided to ensure long-term success.
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How Regular Cervical Cancer Screenings Can Save Lives
According to the American Cancer Society, approximately 13,820 new cases of invasive cervical cancer will be diagnosed, and 4,360 women will die from cervical cancer. However, cervical cancer is preventable with regular screening tests and the HPV vaccine. It’s important to note that medical advances have allowed progress in diagnosing and treating cervical cancer. While it used to be one of the most common causes of cancer death for American women, the incidence of death has significantly declined. What to Know About the HPV Vaccine HPV vaccination is the best way to prevent cervical cancer and is recommended for all youth starting as early as age 9, or for teens and adults up to age 45 who didn’t start or finish the series. In Nevada, only 50.1% of teens ages 13-17 have been vaccinated for HPV. There are 13 types of HPV, and the vaccine Gardasil 9 protects against 9 of those HPV strains, greatly reducing the incidence of cervical cancer among vaccinated individuals. What to Know About Cervical Cancer Screenings The CDC says the most important thing you can do to help prevent cervical cancer is to have regular screening tests starting at age 21. And there are two common tests that can detect early stages of cervical cancer (or precancer) and improve health outcomes. The pap test (or pap smear). This screening looks for precancers. Women should begin getting pap smears when they’re 21. The human papillomavirus (HPV) test looks for the virus that can cause these cell changes. Cervical Cancer Screening Schedule The American Cancer Society offers the following guidelines for screenings: All women should begin cervical cancer screening at 21. Women between 21 and 29 should have a pap test every three years. Beginning at 30, the preferred way to screen is with a pap test combined with an HPV test every five years. This is called co-testing and should continue until age 65. A pap test (or pap smear) is performed during a regular screening appointment to look for precancers, cell changes on the cervix that might become cervical cancer if they are not evaluated or appropriately treated. Typically outpatient procedures can reduce the risk of long-term health impacts that prevent pre-cancerous cells from becoming cancer cells. Women over 65 who have had regular screenings in the previous ten years should stop cervical cancer screening as long as they haven’t had any severe precancers found in the last 20 years. How to Get Screened Request an appointment with your primary care physician or OBGYN to schedule a screening.
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Optimizing Mammogram Screenings: A Genetic Approach to a Personalized Screening Schedule
© Arthon Meekodong via Canva.com Breast cancer screening has long been a cornerstone of women's healthcare. With 1 in 8 women diagnosed with breast cancer in their lifetime1, the United States Preventive Services Task Force (USPSTF) has developed screening recommendations to help detect early-stage cancer. Notably in 2023, the USPSTF revised the recommended age for biennial mammogram screenings for women with average risk to start at age 40 instead of 502, estimated to result in 19% more lives being saved3 by starting screening earlier. While initiating screening at an earlier age offers advantages to a wide demographic, concerns about the potential of over-screening prompted research into the feasibility of identifying women with lower breast cancer risk who could safely delay mammograms. While guidelines address high-risk individuals, a notable gap exists in providing recommendations tailored to those at lower risk. To gain insight into a patient's risk level, physicians are able to utilize genetic testing to understand an individual's genetic makeup, providing precise insights into their predisposition to various health conditions, including breast cancer. Armed with this genetic information, healthcare providers could craft tailored screening strategies that align with an individual’s specific risk profile. This genetic risk-based approach underscores the value of genetics in individualizing the onset of screening to help avoid over-screening and its associated costs. Surprisingly, genetic information is not currently being widely utilized to identify women at risk of breast cancer or other diseases in clinical practice, despite its potential to make a significant positive impact for patients. A recent retrospective analysis of 25,591 women from the Healthy Nevada Project4 sheds light on the potential benefits of this genetic risk-based approach. The study classified 2,338 (9.1%) of these women as having a low genetic risk for breast cancer. What's remarkable is that these women exhibited a significantly lower and later onset of breast cancer compared to their average or high-risk counterparts. This finding suggests that it might be safe for low-risk women to delay mammogram screening by 5 to 10 years without compromising their health.
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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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Why I Give: The Meinzer Family’s Story
Losing a loved one is a devastating experience that can leave a permanent mark on one's heart. It is a journey that's difficult to navigate, but with the help of family and friends the process can be eased. For the Meinzer family, the healing process was made a little easier because of the exceptional care their loved one, Susie, received at Renown. In the fall of 2022, Susie Meinzer, a breast cancer survivor, suffered a fatal stroke. The care provided by Renown’s team was a reminder of the important role healthcare workers play in the lives of their patients and families. “We just knew, the doctors, the nurses, everyone… we knew that we didn’t have much time left with Susie,” said Ken Meinzer, Susie’s widower. Humanizing Healthcare The compassion provided by the care team at Renown made a significant impact on the Meinzer family. They ensured that Susie's last moments were as comfortable as possible, and their kindness and empathy have stuck with the family since. Dr. William Graham, pulmonologist with Renown Health, was among the many healthcare workers who provided care to Susie. "It was hard enough to lose her, and we ask ourselves, ‘Why?’ a lot, but the compassion we received from Dr. Graham made it a little bit easier,” said Ken. “One night he sat with us for over an hour, just grieving with us." This act of kindness made a profound impact on the family. “As an ICU doctor, I try not only to care for my patients, but also for their families,” said Dr. Graham. “Ken and his family displayed such sincerity, compassion and love for Susie and one another. They are just wonderful people; the kind of people that inspire me to be the best doctor possible.” A Family Legacy In gratitude for the exceptional care Susie received, the Meinzer family, including Ken and his three daughters, Melissa, Nicole and Kyra, decided to donate to Renown Health Foundation. Their gift is a beautiful reflection of their love and devotion to Susie. “The donation was a way to say thank you, and a way to support the healthcare workers who continue to make a difference in the lives of patients and families every day,” said Ken. "The nurses in Renown’s ICU went above and beyond. They were a constant source of comfort and support for our entire family," said Melissa Meinzer-Benson, Ken and Susie’s eldest daughter. This was not the first time the family had experienced exceptional care at Renown. Ken and Susie had both undergone cancer treatment the previous year. Susie was diagnosed with breast cancer and had recently completed her treatment before her stroke, while Ken was treated for neck cancer. Dr. Abhinand Peddada, oncologist with Renown Health, led both their care teams, demonstrating a deep dedication to their well-being throughout their treatments. “I am grateful and humbled by the trust that Mr. and Mrs. Meinzer placed in Renown and me for their care in difficult times,” said Dr. Peddada.” Both Ken and Susie deeply appreciated Dr. Peddada’s care for them throughout their respective battles with cancer. The Meinzer family, who own Pinnacle Heating and Air Conditioning in Reno, are known for their commitment to giving back to the community. Melissa is a Veteran and has spoken about the importance of supporting others in any way possible. Susie instilled in Melissa and her sisters a spirit of compassion from an early age, and they have continued to donate to charitable causes throughout their lives. “She was such a force of inspiration, compassion and love. She was aways caring for others,” said Kyra, Ken and Susie’s youngest daughter. Susie was a beloved member of the Oak Community Church. It was there that she spent many Thanksgivings alongside her daughters, volunteering to serve meals to those in need. Charity work was a passion for Susie, and she always found ways to help those around her. She was a shining example of the importance of supporting your community and making a positive impact on the world.
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A Fighting Chance at 24 Weeks Sloans Story
Most babies weigh just one pound and are roughly the size of an eggplant when they reach 24 weeks of development inside the womb. It is a crucial stage when internal organs begin functioning, and the babies' respiratory and central nervous systems are still developing. So, in November 2021 when Kallie Johnson experienced a premature rupture of amniotic fluid around this point in her pregnancy, her care team in Winnemucca decided to transport her via Care Flight to Renown Regional Medical Center. The team at Renown Children’s Hospital immediately began discussing the risks of delivering at 24 weeks with the Johnson family. Moving Forward with Hope Knowing the stakes, Kallie remembers never feeling rushed to decide about delivering her baby preterm. “I felt educated and supported by my care team at Renown throughout our entire stay, starting with the education they provided about what it meant to deliver my baby early,” Kallie said. “The team really helped me make the best decision for myself and my family.” Together, Renown employees and the Johnson family moved forward with a healthy set of nerves and a powerful feeling of hope. Weighing in at one pound 11 ounces, Sloan entered the world on Nov. 19, 2021, via emergency Cesarean section. Her birth was classified as a micro preemie because she was born before week 26 of pregnancy and so small that she fit inside the palm of her father Sterling’s hand. A full-term pregnancy is classified as reaching 39 weeks. A Fighting Chance Called a fighter by many Renown Children’s Hospital care team members, Sloan spent over five months in the neonatal intensive care unit (NICU). She was placed on a ventilator, fed through a feeding tube and monitored 24/7, overcoming daily challenges with the Renown team and her family. As a result of being born prematurely, Sloan developed a grade one brain bleed and a congenital heart defect called patent ductus arteriosus, a persistent opening between two major blood vessels, causing too much blood to flow to the lungs and heart. To meet the oxygen needs of her tiny lungs, Sloan was intubated and developed a severe oral aversion and high-arched palate as a result. The effects would lead to difficult developmental and physical challenges that she still conquers today. Yet, with the help of her care team – including physical, occupational and speech therapists, dieticians and doctors – Sloan continues to make progress every day.
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¿Por qué son importantes los exámenes anuales y las pruebas de rutina?
March is Colorectal Cancer Awareness Month, and we want you to receive the best preventative care possible. Early detection can help prevent serious illness, yet many people still choose to skip their annual exams and routine screenings. Bonnie Ferrara, MD, MPH, Section Chief for Primary Care at Renown Medical Group, further explains the importance of this simple, easy way to stay healthy. Why are annual exams so important? The benefits of early detection and prevention to save lives and reduce the impacts of disease have been proven. These exams are the perfect opportunity to get your health questions answered. “This is your chance to sit down with your provider and talk about your overall health and your family’s health history as well as your concerns for the future,” says Bonnie Ferrara, M.D., family medicine. “It’s the opportunity for your provider to talk with you about your lifestyle, tobacco use, exercise and alcohol use, all of which make a difference in your future longevity.” The annual wellness exam is also an ideal time for most adult patients to discuss health screenings. In addition, these visits are the perfect time to address issues that may not directly relate to a particular medical problem or immediate illness. A good rule of thumb is to schedule these appointments around your birthday each year to make sure you and your provider are both updated on your care. Why would you need an annual exam if you aren’t feeling sick? According to Dr. Ferrara, seeing your care provider when you aren’t sick is one of the best times. “It is better if you try to arrange this visit when you are not feeling ill,” she says. “It is an opportunity to talk about wellness. Not only how to contribute to your wellness but also the changes that you can make that will make huge dividends in the future for your wellness. In addition, it allows us to do some education about what to expect in the coming years as far as your health and lifestyle changes.” What can you expect at an annual exam? Annual exams usually check your: History – lifestyle behaviors, health concerns, vaccination status, family medical history Vitals – blood pressure, heart rate, respiration rate and temperature General appearance – your care provider can find out a lot about you just by watching and talking to you Dr. Ferrara adds, “If this is a Medicare annual wellness exam, it is an opportunity to talk to your provider about depression and dementia as well as be tested for those.” You can also leverage your annual exam to speak to your provider about managing your chronic health problems. "As a provider, these visits give us the opportunity to hear how the medications and lifestyle changes we have recommended are working and if you are having problems with these, we have the opportunity to make suggestions of how to do things better for the future," Dr. Ferrara.
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11 Tips Caregivers Need to Know
Becoming a caregiver or playing a more active role in another’s healthcare is a big responsibility. At some point, almost all adults will support an aging parent or a loved one in need. Keeping track of their needs and wellbeing, while also prioritizing your own can become overwhelming. It’s important to know: you are not alone, and help is available. Read on for 11 tips to help you manage your time, your own wellbeing and your loved one’s care. Self-care comes first. When your main priority is the person in your life who needs care, it’s easy for your own needs to take the backseat. Give yourself time each day to focus on your personal wellbeing. It’s hard to give a loved one the care they need if your own needs are not met. Prioritize the Activities of Daily Living (ADL). Make a note of what ADLs your loved one can do alone, what they need help with and what activities require the most help. This will help you work through the day with them, as well as plan out how the day’s activities will go. Do a home safety audit. Do showers, bathtubs and steps have safety grab bars? Look around the house for additional tripping hazards, like rugs or electrical cords. If your loved one struggles with day-to-day navigation of the home, consider scheduling an occupational therapy appointment. This type of therapy helps a person develop or maintain the motions required to accomplish daily tasks. You might also qualify for a referral to in-home healthcare, such as Home Care. Have the hard conversation. The best time to discuss views about end of life care and to learn what choices are available is before a life-limiting illness or crisis occurs. With advance care planning, you can help reduce the doubt and anxiety related to decision making at the end of life. Completing an Advance Directive is a great tool to sort out all these decisions before they’re needed. Attend a free workshop to learn more and complete this important document. Identify when you need respite. Respite care involves receiving a short-term break from caregiving. Organizing in-home care for your loved one will allow you to step away and tend to your needs. By identifying what kind of respite care you are seeking, you can find the right person to provide you with that much-needed break. Don’t wait until you feel overwhelmed, plan ahead. Write down insurance contact information. Have a direct connection to the right insurance professional for support and advice. If your loved one is eligible Medicare, this is a good opportunity to review their current selections and if they would benefit from a Medicare Advantage Plan or Medicare Supplement Insurance. Seeking out expert advice or information on Medicare options is a great way to navigate this. Consider calling a broker, or attend a free educational seminar with Senior Care Plus. Gather legal and financial information. Make a list of all existing legal documents and financial accounts that your loved one has. These might include a will, advance directive, power of attorney, bank accounts or investment accounts. If you have questions about how to manage them, or need assistance in setting up additional framework, reach out to a lawyer, legal service, financial adviser or bank representative. Create an inventory of medical information. Identify where all of your loved one’s medical records are, as well as a list of providers or healthcare practices where they have received care. Consider if you should have your loved one give you Proxy Access in MyChart, which allows you to access all the features in MyChart on their behalf, including viewing upcoming appointments, viewing test results and emailing a doctor on their behalf. Make a list of what others can do. Think about all the little (and big) things that need to happen, and write down tasks that others could take care of you. When someone says “let me know what I can do” you’ll be ready with a pre-written list of items they may be able to assist with. Tasks could include tackling around-the-house repairs, scheduling lawn work, helping to walk the dog, taking a car for an oil change and cleaning. Find programs and events for social enjoyment. If and when possible, seek an activity outside of the home. Look for community centers that have programs for seniors, recreational activities or meals that you can patriciate in together. If leaving the home is not an option, arrange for visits or in-home activities, such as movie nights, card games or time to visit with family. Research long-term options. If you will be considering a nursing home or assisted living, make a list of amenities that you and the person you are caring for would like. Take this list with you when visiting potential locations to make sure you don’t forget to ask about each item.