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When it comes to intimidating procedures such as surgery, cardiac catheterization (Cath) or interventional radiology (IR), there can be a lot of unknowns. What can I expect on the big day? What will happen after I’m all done? Will I have to worry about my orders not being in the system? Who can I call if I have any last-minute questions? It’s easy for your thoughts to race as you approach your procedure date, but luckily, there is a team who puts your mind at ease.  With Renown Health’s Surgery & Procedure Scheduling department, patients can breathe a sigh of relief knowing that all the nitty-gritty is taken care of before they step foot in the procedure room. This team operates in the mindset of a complex Tetris board – fitting in all the pieces to make sure every patient is set on the path for surgery success.  Consistent Contact Our Surgery & Procedure Scheduling team has a unique history. Initially operating as two separate teams, over the last year, our leaders skillfully combined the two teams together under one umbrella. That allows the now singular team to have line of sight across every surgery and Cath or IR procedure plan and be better stewards of the resources they have at their fingertips to provide streamlined, more-connected care for patients.  As one might imagine, with the merger of the two teams, the day-in-the-life of each team member is full of a variety of crucial checklist items to cross off – all supporting constant communication from patients to providers.  On the surgery scheduling front, these team members are resource rockstars. From working with referring providers to get patients scheduled appropriately to ensuring rooms and equipment are available for every patient, this team makes sure everything and everyone is in place when the time comes to help create a successful procedure and the best possible patient experience.   “In surgery scheduling, we handle inbound calls for the outside offices to get time scheduled for each patient in the operating room (OR),” said Lydia Sharkey, Senior Scheduler. “We make sure there are plenty of anesthesia resources and equipment for every surgery, including any important information that we need to schedule patients appropriately and adding all documents to the OR board. If we need to swap rooms or move patients around, we handle that process too.”  Over on the IR/Cath scheduling side of things, this team is on the frontlines of patient communication. They are experts in helping patients navigate their procedure from start (seeing their provider and obtaining the proper referrals) to finish (the day of the procedure and post-procedure process).  “My day is a little different than the hospital schedulers; our part of the team handles the outpatient aspect,” said Adrienne White, Senior Scheduler. “We are in constant contact with patients and the IR and Cath departments. We help them navigate their procedure, including what to expect during and after the procedure. We get them through the process as easily as possible and ease their minds, so they know what is going to happen every step of the way. It’s all about communication, communication, communication!”  This department has a significant overarching role: make sure all documents and ancillary information is set up for all our clinical teams that help with surgeries and procedures. This critical work means that every process is followed, and no important details are left out.  “No one wakes up and says, ‘I want to have surgery;” our team goes above and beyond to make sure every single detail is taken care of so that when patients arrive, everything is in place,” said Trisha White. “Our team works hard to ensure everything runs as efficiently as possible because we want to use our resources in the best way possible to serve our patients without delays. We make sure we receive all the orders, codes and insurance and that the teams that follow after us – including our pre-admit team and nurses – have all the information they need to do their job seamlessly."  With all the work they accomplish daily – not to mention how they wholeheartedly support each other through it all – it’s no question that the entire team has a lot to be proud of. Besides helping make patient care possible, the team puts their departmental merger and the move to fully remote work at the top of the list.  “We’re most proud of merging the surgery scheduling and procedure scheduling teams together and therefore more cohesive,” said Mary Gray, Senior Scheduler. “The merger has made our team blossom and be able to connect with and rely on one another even more. We aren’t afraid to speak up and say something. At the end of the day, we’re here to take care of the patient, but we also help each other out. Our morale has gone up, and everybody is happier. Even though we all work remotely, we are more connected and have a great work-life balance.”  “Along with transitioning the two teams into one big team, the move to being fully remote was huge," added Patricia Cruz-Hernandez, Surgical RN Scheduling Coordinator. “We worked through all the glitches, and it was a seamless transition to move into a remote setting. What’s great is that it did not affect patients at all; everything still gets done exactly as it should.”  No matter how busy the days may get, Renown’s surgery and procedure schedulers always remember one thing: they are incredibly grateful for their fellow team members.  “We have a very efficient and hard-working team of women,” said Pam Chapa Valencia, Senior Scheduler.  “I could not have handpicked better people for our team,” added Trisha White. “I feel so lucky to have the team that we have.”  A Renown “Why” Our Surgery and Procedure Scheduling team members all have diverse stories to tell about their road to Renown and why they’ve stayed in the department for as long as they have. Whether they’ve been with us for two years or two decades, they all share the same strong calling to care for their community.  “I always wanted to help people, and my grandma was a nurse,” said Pam Chapa Valencia, Senior Scheduler.  “I loved hearing her stories, and it made me want to be involved in patient care.”  “I have a caring nature, and a hospital nature seemed like the right fit – I've been here for 25 years,” added Mary Gray.  Several of our schedulers recognized the influence Renown has within our community and the ability to grow professionally and personally, both of which were a driving factor in their decision to make our health system their long-term career.  “I’m originally from southern California, and I moved here about eight years ago; my husband always talked so positively about Renown, especially with how big it is and how it has the only level II trauma center in northern Nevada, so my goal was always to get a job here,” said Lydia Sharkey. “It’s been a great environment to be a part of.”  “I’ve been with Renown for 17 years, and I chose to come here because of the reputation of the services Renown provided and care they gave,” added Trisha White. “I also knew what opportunities there were for me professionally, and in doing so, we are taking care of our community. I’ve had the chance to grow within my own professional skills and leadership skillset.”  A profound feeling of ‘home’ is a common theme among this department. These team members appreciate the sense of community Renown has, the strides we’ve made in expanding our reach and how our health system gives healthcare professionals who are new to the field a chance to succeed.  “At the time, Renown was the only hospital that would train nurses, and as a brand-new nurse, I had no experience – Renown took a chance on me,” said Patricia Cruz-Hernandez. “I feel like this is home. Our health system is so community-based and people-first minded, keeping ‘mission over margin.’ We’re growing, we’re expanding, we’re everywhere!”  “I was a part of a transition as the cardiology private practice I worked with became a Renown practice, and it was great,” added Adrienne White. “This transition enabled us to provide more services and better care to patients. I stay here because I see the leaps and bounds we’ve been able to make in terms of procedures, accessibility and patient experience.”  As true advocates for both patients and each other, the team is proud to have found their niche – and the ultimate beneficiaries? Everyone undergoing a surgery or procedure at Renown.  A Culture of Kindness and Gratitude When you meet the Surgery & Procedure Scheduling team, you are greeted with warm smiles and an enthusiastic “Nice to meet you!” You can’t help but smile back and feel the infectious kindness they exude.  Renown operates with a People-First mindset, a vision that this department especially takes to heart. They emulate the exact definition of our “Collaboration” cultural commitment.  “We’ve built very good relationships and rapport with the OR managers and board runners,” said Lydia Sharkey. “The communication that we have at all three locations is very solid.”  “The OR leadership is always so willing to help out whenever they can, and the resources they’ve provided have been huge for us,” added Adrienne White.  “All the teams that see the patients after us – especially the surgical pre-admit team and the case managers, are fantastic about collaborating with us and reaching out to solve any issues they may have,” added Trisha White. “We all work so well together, especially since we all impact patient care.”  In any organization, strong and compassionate leadership is key to a thriving team. Luckily for our surgery and procedure schedulers, they have Trisha White on their side. They attribute a lot of their success to having a supportive leader who “gets it.”  “Trisha has been a scheduler like us, so she completely understands when we’re having an issue, because she’s struggled with the same thing and knows where we are coming from,” said Mary Gray. “It makes us feel like we are not alone – I can always reach out to her, or any of my other coworkers, to ask questions and figure out a solution together.”  Despite being a remote-only team that meets in-person only one or two times a month, this group never misses an opportunity to reconnect both online and offline. They frequently shout out their Culture Ambassadors, schedulers Pam Chapa Valencia and Roxanne Abundis, for their team’s high morale.  “Even though we all primarily work remotely, our in-person days are some of my favorite days of the month,” said Trisha White. “We feel so uplifted, we laugh and we have fun. We love being with each other. Pam and Roxanne are our Culture Ambassadors, and they both have been amazing at planning fun things for our teams. They go above and beyond to make our team feel cohesive and included.”  “Pam and Roxanne have been leaders in creating a fun environment and supportive culture for us,” added Lydia Sharkey. “Whether it’s creating care packages or making sure we all have a good time when we see each other in person, they deserve a lot of credit.”  As this team excels in their roles and foster a culture rooted in kindness and gratitude, we can trust that Renown’s surgeries and procedures will continue to thrive, and patients will continue to benefit from their diligent efforts and commitment to efficiency.  “We make the magic happen!” closes Mary Gray.

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Want to know more about osteoporosis and osteopenia? We'll dive into these conditions and give you some handy tips on preventing future problems and taking care of your bones. What is Osteopenia? Osteopenia (low bone density) is the initial stage of bone mineral density loss, which can eventually progress to osteoporosis if steps are not taken to prevent it. What is Osteoporosis? Osteoporosis is a condition that weakens our bones. While it literally means “porous bone," it doesn’t mean that our bones are doomed to succumb to the changes that can happen to us silently over time. Our bones are living tissues that are constantly breaking down and remodeling themselves.  Osteoporosis and osteopenia are typically diagnosed by testing bone mineral density using scans that your primary care provider can easily order. This is important testing because it dictates your risk of breaking a bone in common areas like your hip, wrist or spine. It also helps set the stage for talking with your healthcare team to develop a treatment plan. Most people will reach their peak bone mass in their mid to late twenties. There are several factors that increase our risk of osteoporosis or osteopenia as we age, such as menopause, genetics and other lifestyle factors. However, there are several things you can do to mitigate this breakdown and assist your body in the constant remodeling it does to our bones. 3 Controllable Factors to Build Strong Bones 1. Talk to your primary care provider They can go over a plan and prescribe things such as vitamin D, calcium and medications that can help if you are at risk or have osteoporosis or osteopenia. 2. Maintain a healthy diet Talk to a dietician if you need further help as they can be an invaluable resource to develop a plan.  Eat foods rich in calcium, vitamin D and vitamin C. These assist with the rebuilding of bone. Examples include but aren’t limited to leafy greens, legumes, salmon and healthy dairy products.  Don’t smoke — it directly correlates with a decrease in bone mass. Smokers also take longer to heal from a fracture.  Limit alcohol to two to three beverages per week. Alcohol interferes with the production of vitamins needed to absorb calcium and the hormones that help protect bones. 3. Exercise Talk to your primary care provider to get a referral to physical therapy if you need help with exercise.  Our bones adapt to the stresses we put them through. Therefore, exercise should be tailored to putting the right stress on our bones. There is good quality research that most exercise is safe when dealing with less bone mineral density.  The exercises should be progressively challenging and increase the load for resistance and weight training at least two to three days a week. Examples include squats, step-ups, chest presses and rows.  Exercises higher in velocity will lead to more power and bone adaptation. Examples include quicker push-ups, marching and quicker walks.  Exercises that are weight-bearing will lead bones to adapt to the stress placed on them. Movements such as mini stomps, step-ups, jumping, jogging and so forth may be used depending on how your body tolerates these things to really stimulate bone adaptation. There are aspects of aging and bone health we can’t control, but we can take steps to minimize the chances of bone loss and osteoporosis. Talk to your healthcare team to determine your risk and don’t forget to show your bones a little TLC – you’re going to need them.

Read More About A Therapist's Tips to Prevent and Manage Osteoporosis

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.

Read More About When Care Can’t Wait: True Stories of Renown ER

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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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.

Read More About Celebrating Resilience: Raquel's Remarkable Journey Through Breast Cancer Treatment

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.

Read More About A Transformative Journey: Mary's Bariatric Surgery Story at Renown Health

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.

Read More About How Regular Cervical Cancer Screenings Can Save Lives

Managing weight is a complicated and often difficult journey for many individuals, and obesity stands as a common and serious chronic health condition. In fact, the Center for Disease Control and Prevention reports that the prevalence of obesity in the US is greater than 40% in adults and 20% in children, and those numbers are continuing to climb. In Nevada, according to the 2020 Behavioral Risk Factor Surveillance System, 28.7% of adults reported being obese. By 2030, almost 80% of American adults may be overweight and half of them will be obese. But obesity isn't just about the numbers on the scale; it's a multifaceted, lifelong, neurobehavioral disease triggered by a combination of factors. These include abnormal eating patterns, reduced physical activity levels, environmental stressors, genetics and various other contributors. Obesity extends far beyond appearance, often leading to the development of numerous medical conditions such as diabetes, heart disease, elevated blood pressure, stroke, sleep apnea, liver disease, various cancers and infertility. Join us as we delve into the complexities of obesity and explore strategies for effective weight management available right here in northern Nevada. Why Can Losing Weight be so Difficult? The challenge behind weight loss finds its roots in the Set-Point Theory of Obesity, a concept that says our bodies have a predetermined weight, or fat mass, within a defined set-point range. In other words, when an individual's weight deviates from this set point, the body initiates mechanisms to bring it back to the established range. So, if someone loses weight below their set point, the body may respond by increasing hunger and reducing metabolism, making it challenging to sustain weight loss. There Isn’t One Right Answer, But Renown is Here to Help Various weight management strategies can be utilized by patients struggling with obesity, which may lead to substantial weight loss, resolution of associated medical conditions and improved psychosocial health. In fact, the most successful strategy involves a multidisciplinary approach under the guidance of trained specialists that includes a combination of tactics, including: Behavioral adaptations Dietary modifications Physical exercise  Anti-obesity medications  Weight loss surgery

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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

According to the Global Sepsis Alliance, 1 in 5 deaths worldwide are associated with sepsis. If not recognized early and treated promptly, sepsis is the final common pathway to death from most infectious diseases worldwide, including viruses such as COVID-19. We spoke with Jeremy Gonda, MD, a critical care physician from Renown Health’s Sepsis Committee to increase public awareness of this preventable medical emergency. What is sepsis? Sepsis is a response to infection—bacterial, viral or fungal—and can start anywhere in the body and spread into the bloodstream. The body is trying so hard to fight an infection that it begins releasing chemicals into the bloodstream that cause inflammation and the shutdown of multiple organ systems. “It carries a very poor prognosis in general unless you catch and treat it very early,” said Dr. Gonda. “Any infection can lead to sepsis. Typically your immune system takes care of the infection. It doesn’t progress, but in cases where the infection becomes severe, or the immune system doesn’t function properly, people can certainly die. So there’s, unfortunately, a very high mortality rate associated with sepsis.” According to the Centers for Disease Control and Prevention, each year at least 1.7 million adults in America develop sepsis. While you can recover from sepsis if caught early, many sepsis survivors suffer from long-term physical and psychological effects. What are the signs of sepsis? One way to spot sepsis is to use the acronym SEPSIS: S – Slurred speech and confusion E – Extreme shivering or muscle pain/fever P – Passing no urine all day S – Severe breathlessness I – “I feel like I might die” S – Skin mottled or discolored Keep in mind that sepsis symptoms can vary depending on where the infection starts. “Patients may experience urinary burning if they have a urinary tract infection or a cough and shortness of breath if they have pneumonia first,” said Dr. Gonda. “However, often symptoms are more generalized or subtle such as fevers, confusion and malaise.” How do you develop sepsis? When germs enter your body, they can cause an infection. If you don’t stop that infection, it can cause sepsis. Areas of infection that more commonly result in sepsis include: Lungs, such as pneumonia Kidney, bladder and other parts of the urinary system Digestive system Bloodstream (bacteremia) Catheter sites Wounds or burns Who is most at risk? People with compromised immune systems are at greater risk for sepsis, such as “The very young, the elderly and any people who may have conditions that suppress your immune system,” said Dr. Gonda. “For instance, if you have diabetes or if you’re an organ transplant patient who is on immunosuppressant therapy, you’re at somewhat higher risk.” Sepsis is often considered a hospital-acquired infection, but a study in The Journal of American Medical Association found that 80% of sepsis cases occur outside of a hospital. That’s why it’s especially important to remember any infection can lead to sepsis, and anyone can develop sepsis from an infection. What do I do? Timing is critical in the case of sepsis and septic shock. According to a study on septic shock patients, there is a 7.6 percent decrease in survival for each hour treatment is delayed. On the other end, if treatment is given within an hour of the first drop in blood pressure, the survival rate is 80 percent. Because sepsis can be so deadly, it’s important to seek medical attention as soon as possible. “If you’re not getting any better, if you think symptoms are progressively worsening – you should definitely be evaluated by a doctor,” said Dr. Gonda. You can help #StopSepsis by getting involved at worldsepsisday.org.

Read More About Sepsis: Causes & Symptoms

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.

Read More About Why I Give: The Meinzer Family’s 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.

Read More About A Fighting Chance at 24 Weeks Sloans Story