Buscar

Located on the 5th floor of the Tahoe Tower, Renown’s newly updated Level III Neonatal Intensive Care Unit (NICU) is decorated with colorful artwork on the walls, the lights dim for the newborns resting, and parents conversing next to the bassinet with nurses on their baby’s journey to health. In the quiet, shuffling hallways stands Mariah DaSilva, a Renown NICU Nurse, whose own birth story showed her true compassion and professional dedication to what it means to care for the tiniest and most vulnerable patients. From the Medical Floor to the NICU Mariah started her nursing career on the medical floor at Renown; however, after a year, she was excited to see her dream job open in the NICU and helping to provide compassionate care for the most fragile patients. “I’ve always known that I wanted to work with babies so being a NICU nurse was a dream of mine,” said Mariah. “I truly love what I do, and I can’t imagine being anywhere else than the NICU.” A high-stakes environment, the NICU is where babies are transferred to after birth when they require medical intervention. They care for babies as young as 23 weeks gestation, up to full-term babies. Any babies born less than 35 weeks are automatically admitted into the NICU for treatment. Other than prematurity, babies can be admitted to the NICU for respiratory distress, low blood sugar (hypoglycemia), cardiac anomalies, birth defects, seizures and other medical conditions that need treatment or assessment. A Day in the NICU: The Heart of Care A typical day for Mariah starts with reviewing her assignments and receiving a detailed report from the night shift. Preparing for the day involves scrubbing in and wiping down patient care areas to maintain a clean environment. Once everything is set, she begins a series of scheduled care tasks, which include performing assessments, feeding, changing diapers and facilitating parent involvement in their baby’s care “There are so many exciting ‘firsts’ that happen in the NICU; parents holding their baby for the first time, parents' first time changing their baby’s diaper, bathing their baby for the first time, first time breast-feeding or bottle-feeding, the baby’s first time taking a full bottle, watching a baby breathe on their own without any respiratory support, etc.,” said Mariah. “There are so many big milestones that happen in the NICU that I am so incredibly lucky to be a part of.” The NICU nurses work closely with neonatologists, nurse practitioners, respiratory therapists, speech therapists, physical therapists, occupational therapists and other specialists to deliver comprehensive care. This teamwork and collaboration ensure that each baby receives the best care possible for their health journey. Mariah shared a reflection on her team: “Our NICU team is amazing. Being a part of a team that is so compassionate and collaborative is amazing. We all work closely together to ensure we’re providing the best care possible for every single baby that comes to the NICU. We are all very protective of the babies that we care for in the NICU and truly want the best outcomes for them and their families. Taking care of such a vulnerable population comes with a lot of responsibility and we take pride in what we do each day.” As with all healthcare professionals, NICU nurses require immense strength and compassion to care for the youngest patients in a highly sensitive environment. “More often than not, we have really good days in the NICU, but we also have really hard days that affect every single person in the NICU,” said Mariah. “The loss of a baby, delivering bad news to a parent, an extended NICU stay and a baby withdrawing from drugs are all situations that we unfortunately deal with in the NICU. These situations are all very challenging, but we have to stay strong for the babies and their families.”

Read More About From Renown NICU Nurse to NICU Mom: Mariah DaSilva’s Inspiring Journey

Early detection is a significant piece of the breast cancer puzzle. Susan Cox, Renown Health Senior Director of Cancer Operations, discusses what you need to watch for and how the latest technology can help detect potential cancer sooner. When should women start getting breast exams? It depends on risk factors: Average-risk women: Most medical organizations recommend the first mammogram between 40 and 44. Higher-risk women: Dependent on their high risk, which will dictate when they start screening, but generally around the age of 30 and not before 25 years old.

Read More About Ladies! Get Screened for Breast Cancer

Mammograms are an effective means for early detection of breast cancer. Still, many women shy away from them for fear of pain or discomfort. Let us debunk a few mammogram myths that will remove your worries and encourage proactive breast health. Reviewed by Dr. Colleen O'Kelly-Priddy, MD, FACS, breast surgical oncologist at Renown Women's Health. Myth 1: Mammograms Are Painful Reality: Although some women experience discomfort during a mammogram, most say it is not painful. Breast compression, which is important to get a clear image, can cause a sensation of pressure, but this lasts for a few seconds. Let your technician know how much pressure you can handle so you're not uncomfortable. Myth 2: Discomfort Persists Long After the Procedure Reality: The sensation of pressure developed through the compression process diminishes quickly after the procedure. Most women go about their day afterward without experiencing any residual pain.

Read More About Do Mammograms Hurt? 4 Myths Debunked

Cancer can develop at any age, and that’s why the experts at Renown are ready to help you stay ahead of breast cancer, especially if you're in your 20s or 30s. We're talking about early detection, signs to be aware of, and why being proactive is a big deal. Studies show there has been an increase in breast cancer in younger women. Although breast cancer is rare in women under 40, when it occurs, it tends to be aggressive. The tricky part? Many young women don't think it can happen to them, so they don't check for the signs as often as they should. Reviewed by Dr. Colleen O'Kelly-Priddy, MD, FACS, breast surgical oncologist at Renown Women's Health. Early Signs and Symptoms New or Different Lump in the Breast: A lump is probably the most well-known symptom. Breast cancer is usually painless and firm, but it can also be soft. If you find a new lump, don't panic, but don't ignore it either. Changes in Breast Size or Shape: Have you noticed that one breast looks a little different? Whether it's swelling, shrinking, bulging, dimpling, or seems off, it's worth mentioning to your doctor. Skin Changes: If the skin on your breast starts to thicken or turn red, it's time to pay attention. If your skin starts looking like an orange peel (thickened, with prominent pores), that warrants evaluation. Nipple Discharge: Spontaneous drainage coming from your nipple that isn't breast milk—especially if it's clear or bloody—should be checked out. Nipple Changes: If your nipple starts to invert, flatten, or look different, call your doctor. Breast Pain: Continuous pain in your breast or nipple that isn't linked to your menstrual cycle is another symptom to note. However, breast pain is very common and is only rarely a sign of cancer, so don’t panic. Swelling or Lumps in the Armpit: When it spreads, breast cancer usually first goes to the lymph nodes in the armpit, so swelling or lumps under your arm should be on your radar.

Read More About 7 Symptoms of Breast Cancer in Young Women

One of the most crucial aspects of maintaining health and wellness is staying proactive about regular cancer screenings. Early cancer detection significantly increases the chances of successful treatment and survival. The multidisciplinary care team at the William N. Pennington Cancer Institute at Renown Health provides compassionate care and support to the community for early detection and diagnoses. This comprehensive guide outlines the various cancer screenings available for breast, colorectal, lung, cervical, prostate and skin cancer. Breast Cancer Screening Who Should Get Screened? Mammograms are recommended starting age 40 for those considered at average risk for breast cancer. Women with a family history or other risk factors should discuss appropriate screening options with their healthcare provider. Women under 40 with a family history should discuss risk factors with a healthcare provider. Screening Methods Mammogram: This provides an X-ray of the breast and can detect tumors that are not yet palpable. Breast MRI: This type of scan is recommended for women at high risk for breast cancer due to genetic factors or family history. Screening Breast Ultrasound: This scan can help in identifying masses in denser breast tissue that might not be visible on mammogram. It is recommended in addition to a mammogram for patients at a higher risk for breast cancer. What to Expect During a mammogram, the breast is compressed between two plates to capture X-ray images. Some pressure or discomfort may be felt, but the procedure is brief and critical for early detection. Colorectal Cancer Screening Who Should Get Screened? Adults aged 45 to 75 should undergo regular colorectal screenings. Some adults under 45 may need to be screened earlier depending on family history or other genetic risks. Those over 75 should consult with their healthcare provider to determine if continued screening is necessary. Screening Methods Colonoscopy: This procedure uses a flexible tube with a camera to examine the entire colon. Fecal Immunochemical Test (FIT): A non-invasive test that detects hidden blood in the stool. CT Colonography (Virtual Colonoscopy): Uses Computed tomography (CT) imaging to provide detailed views of the colon. What to Expect A colonoscopy can detect changes or abnormalities in the large intestine (colon) and rectum. Screening is usually advised every ten years, but if you are at risk, screening may be recommended every 3 to 5 years after your initial colonoscopy. Colonoscopy preparation includes bowel cleansing the day before and sedation during the procedure. FIT is a simple at-home test requiring no special preparation. Lung Cancer Screening Who Should Get Screened? Adults aged 50 to 80 with a significant smoking history (20 pack years or more) and who currently smoke or have quit within the past 15 years. Screening Methods Low-dose Computed Tomography (LDCT): A CT scan with low radiation doses to create detailed images of the lungs. What to Expect LDCT is a non-invasive scan that requires you to hold your breath for a few seconds. Cervical Cancer Screening Who Should Get Screened? Women aged 21 to 65 should undergo regular screenings. Women aged 21 to 29 should have a Pap test every three years. Women aged 30 to 65 should have a Pap test and HPV test every five years, or a Pap test alone every three years. Screening Methods Pap Test (sometimes called a Pap Smear): Collects cells from the cervix to detect precancers. HPV Test: Identifies high-risk human papillomavirus (HPV) types that can cause cervical cancer. What to Expect The Pap test involves collecting cells from the cervix using a small brush. Some discomfort may be felt, but the procedure is brief and crucial for early detection. Prostate Cancer Screening Who Should Get Screened? Men aged 50 and older should discuss screening options with their healthcare provider. Men at higher risk (African American men and those with a family history of prostate cancer or are a BRCA2 gene carrier) should begin discussing screenings  at age 40. Screening Methods Prostate-Specific Antigen (PSA) Test: Measures PSA levels in the blood. Digital Rectal Exam (DRE): A physical examination where the provider feels the prostate through the rectum to detect abnormalities. What to Expect The PSA test is a simple blood test. The DRE may cause slight discomfort but is quick and essential for early detection. Skin Cancer Screening Who Should Get Screened? Anyone with a suspicious lesion or abnormal area on their skin. Individuals with more than 50 moles or dysplastic moles. Those with a personal history of melanoma or history of other skin cancers. Those who have more than one member of immediate family with a history of cancers (melanoma, breast cancer, pancreatic cancer) or a family member who was diagnosed with melanoma before they were 50 years old. Positive gene testing for BRACA2, Lynch syndrome genes (MLH1, MSH2, MSH6, PMS2 or EPCAM). Screening Methods Skin Exam: A visual examination by your provider to check for unusual moles, birthmarks, or other skin changes. Biopsy: Removal of a small sample of skin for testing if an abnormal area is identified. What to Expect A skin exam is non-invasive and visual. A biopsy involves minor discomfort and local anesthesia if needed. Expert Advice Although the cadence of these skin screenings may or may not be annual, as one's age increases, the risk of many cancers rises. Everyone benefits from attentive sun protection, including avoiding direct sun between 10 a.m. and 4 p.m. by seeking shade and wearing hats, clothing and sunscreen. When purchasing sunscreen, look for SPF 50, UVA/UVB broad spectrum. Questions to Discuss with Your Healthcare Provider What is my risk level for different types of cancer? Which screening tests do you recommend for me and why? What are the potential risks and benefits of each test? How often should I get screened? What steps to follow if a test result is abnormal? Importance of Cancer Screenings Regular cancer screenings are vital for maintaining your health and catching cancer early, when it is most treatable. Renown Health is dedicated to guiding you through the process and providing the highest quality of care. Consult with your healthcare provider to determine the appropriate screenings for your specific needs and to take proactive steps toward a healthier future.

Read More About Guide to Cancer Screenings

Immunizations save thousands of lives each year by preventing serious illnesses, hospitalizations, and deaths. They also protect those who can't be vaccinated, like young children and the elderly, through herd immunity. Renown Pediatrician Dr. Kristin Wilson highlights the crucial role of vaccines. Immunizations Your Child Needs (and when) Birth to 6 Months Hepatitis B: Shortly after birth, first vaccine dose Diphtheria, Tetanus, and Pertussis (DTaP), Polio, Haemophilus Influenza (HiB), Pneumonia, Hepatitis B and Rotavirus: Ages 2, 4 and 6 months, boosters and vaccines One Year to 18 Months MMR and Varicella (chickenpox) vaccine: Age 1, first vaccine dose Hepatitis A, HiB and Pneumonia: Age 1, booster DTaP: 15 months, fourth vaccine dose Hepatitis, second dose: 18 months Flu Vaccine: 6 months and older, annually* *In the year after receiving their first dose, an infant will need a booster one month later. Four Years Old MMRV, DTaP and Polio, final dose: Four years of age Pre-Teen and Beyond Tdap and Meningitis: Before starting middle school, children receive these vaccines. They are also old enough to start the HPV vaccine, an essential vaccine for all young adults to protect against cancer, genital warts and cervical dysplasia.

Read More About Why Childhood Immunizations Are So Important

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

Dr. Carilyn Hoffman with Renown's Women's Health explains the symptoms, causes and treatments of Polycystic Ovary Syndrome (PCOS) (also referred to as Polycystic Ovarian Disease (PCOD)), a prevalent condition among women of reproductive age that influences hormonal balance, metabolism and fertility. Make an appointment with Renown Women's Health Click here to schedule Call to schedule: 775-982-5000 PCOS Defined PCOS is a constellation of symptoms characterized by two of the three criteria: multiple small cysts on the ovaries visible via ultrasound, irregular periods and signs of hyperandrogenism. Other symptoms include infertility, insulin resistance, and increased risk of cardiovascular disease. Symptoms of PCOS The symptoms of PCOS can vary from woman to woman, but some of the most common include: Irregular menstrual cycles: This is often one of the first signs of PCOS. Women may experience fewer than nine periods a year, more than 35 days between periods, frequent spotting, and/or abnormally heavy periods. Excess androgen levels: High levels of male hormones may result in physical signs such as excess facial and body hair (hirsutism), severe acne and male-pattern baldness. Polycystic ovaries: Enlarged ovaries containing numerous small cysts can be detected via ultrasound.     Causes and Risk Factors The exact cause of PCOS is unknown, but several factors may play a role: Genetic predisposition: A family history of PCOS increases the risk. Insulin resistance: High insulin levels might increase androgen production, causing difficulty with ovulation. Obesity: Women with elevated BMI’s are more likely to have PCOS, although 20% of women with PCOS are not obese. Diagnosis and Treatment Dr. Hoffman outlines that diagnosing PCOS requires a medical history review, a physical exam, blood work and an ultrasound to evaluate the ovaries. Treatment options can range from lifestyle modifications, like diet and exercise and weight loss, to medications for menstrual regulation, fertility assistance, and rarely surgery. Lifestyle Changes A healthy lifestyle is a cornerstone of managing PCOS. Regular exercise, a nutritious diet, and weight management can help reduce symptoms and the risk of long-term health issues. In overweight patients, weight loss as little as 5% has been shown to improve symptoms of PCOS. Medication Medications may include hormonal contraceptives to regulate menstrual cycles, anti-androgens to reduce hair growth and acne, and Metformin to address insulin resistance. Fertility Treatment For women with PCOS who are trying to conceive, ovulation induction with clomiphene or letrozole is sometimes necessary. Sometimes a referral to a reproductive endocrinologist and infertility specialist is needed for more advanced technologies like IVF. Health Implications PCOS is not just about cystic ovaries or irregular periods; it can have profound implications on a woman's overall health. Women with PCOS are at an increased risk for several conditions, including type 2 diabetes, high blood pressure, heart disease, and endometrial cancer.

Read More About What is Polycystic Ovary Syndrome (PCOS)?

© 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.

Read More About Optimizing Mammogram Screenings: A Genetic Approach to a Personalized Screening Schedule

Respiratory syncytial virus, also known as RSV, is a common respiratory virus that impacts the lungs and breathing pathways. The virus can be dangerous for infants and young children and is also concerning for older adults. While most older kids and adults only experience cold-like systems and recover in a week or two, an estimated 58,000-80,000 children younger than 5 years old are hospitalized due to RSV each year, and in 2022 healthcare organizations across the country are experiencing higher infection rates than in years past.  "We are experiencing a strong RSV season and do not expect it to go away anytime soon," said Dr. Kris Wilson, Division Chief of Renown Children's Primary Care. "Infants who are infected with RSV almost always show symptoms of runny noses and cough. Call your healthcare provider immediately if your child is having difficulty breathing, is not drinking enough fluids, or is experiencing any worsening of these symptoms.” Symptoms of RSV: Runny nose  Decrease in appetite/inability to drink Dry diapers, an indication of dehydration  Cough, which may progress to wheezing or difficulty breathing Irritability (most common in very young infants) Decreased activity (most common in very young infants) Decreased appetite (most common in very young infants) Apnea, pauses in breathing for more than 10 seconds (most common in very young infants) What to do if you think your child has RSV: Call your pediatrician! If you suspect your child might have RSV, consulting their healthcare provider is the best first line of defense. From here they will help you build an appropriate treatment plan for child. Keep in mind that many pediatrician offices offer 24/7 call lines.  If your child is experiencing retracted breathing (when the area between the ribs and in the neck sinks in when a person attempts to inhale), dehydration (not drinking and decrease in wet diapers) or apnea (pauses in breathing for more than 10 seconds) please call 911 or go to the closest emergency room.

Read More About What You Need to Know About RSV

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

Read More About Strategies for Lasting Weight Loss

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!

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