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A wedding is a big day for the wedding couple, but it’s also special for loved ones. A patient at Renown, Ken, got to take part in his daughter’s special day as her wedding plans changed to accommodate his medical condition. Grab some tissues and read how Renown’s team of compassionate caregivers and chaplains planned a wedding in Fianna’s Healing Garden. Ken was hospitalized at Renown Regional Medical Center where he was battling a lung problem – which was unrelated to COVID-19 – and his condition worsened rapidly on Wednesday, Aug. 12. His family made the decision to transition him to palliative care, which helps patients near the end of their lives remain comfortable, while supporting their dignity and quality of life.  Ken’s medical condition altered wedding plans for his daughter, Chandra, and her fiancé, Tyler, who were planning to tie the knot later in 2020. Chandra wanted her father there, but knew he could not leave the hospital. That’s why Chandra’s sister, Heather, approached Ken’s care team with a request to have a small wedding ceremony at the hospital.  Planning the Wedding A member of Ken’s care team, Amy Heston, registered nurse (RN), began planning how the wedding could be held outdoors in Fianna's Healing Garden in the E. L. Wiegand Pavilion, which was donated by the E. L. Wiegand Foundation.   In 24 hours, Amy planned a wedding ceremony with the help of her colleague, Breyanna Aufiero, RN; the Renown Spiritual Care team; and nursing leaders on the coronary intensive care unit (ICU). Together, they decorated the aisle in the garden with flowers and battery-operated candles. They also made a sign for Ken’s hospital bed, which read, “Father of the Bride,” and crafted a bow tie for him to wear for the special occasion.  With visitor restrictions in place at the hospital due to coronavirus (COVID-19), having the wedding outside in the Healing Garden allowed for more members of Ken’s family to attend including his wife, Charlotte, and his dog, Bella.   Every step in planning the wedding required thoughtful and thorough care coordination so Ken could participate. His breathing was supported by oxygen and special arrangements were made to transport the oxygen tanks he needed to take part in his daughter’s wedding. Amy worked with respiratory technician, Kasey Benfield, and critical care technician, Ruben Duckworth, to ensure Ken’s oxygen needs were met using portable machines.  Celebrating Love and Life Together Ken’s team of caregivers bathed him and shaved his face so he could look and feel his best for the ceremony. They put on his bow tie, covered his bed in decorations and his favorite blue, flannel blanket, and wheeled his bed outside for the ceremony.  Renown associate chaplains Terri Domitrovich and Susan Palwick coordinated music and performed the ceremony for Chandra and Tyler on Thursday, Aug. 13, 2020. The bride and groom shared their first dance in the garden and Ken’s care team provided water and treats to give the family a full wedding experience.   Shortly after the ceremony, Ken passed away. This wedding provided Ken and his family meaningful memories for their big life-changing moments as they celebrated and said goodbye.  “Seeing Ken surrounded by family he never would have gotten to see again while in the hospital, watching him get to share a father-daughter dance with Chandra on her wedding day, and having him tell me that this day meant more to them than we would ever know were some of the most moving moments I’ve witnessed as a nurse,” Amy said. “I am so thankful for the team we have here. I know that this beautiful day wouldn’t have happened without the help of every single person who gave their time, money, creativity and passion to make it a day to remember.”

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As many people search for diets to try to achieve weight loss resolutions, Kim Colegrove, Renown Dietary Educator, has all you need to know about one of the trendiest diets – intermittent fasting. What is intermittent fasting? Intermittent fasting is an eating pattern that switches between periods of fasting with no food or very restricted caloric intake, and periods of unrestricted eating. The diet has come into popularity as a way to help people lose weight without restricting what they eat, just when they eat. How does it work? The rationale behind intermittent fasting is that the pattern of eating promotes weight loss due to hormonal changes – namely, the decrease in insulin levels – as well as effects on your gut and overall decreased energy consumption. There are various schedules, including alternate-day fasting and time-restricted feeding. For example, one popular method involves restricting your eating period to eight hours per day and then fasting for the remaining 16 hours. Another requires fasting for 24 hours once or twice per week. What should people consider before they try intermittent fasting? Some people have found success in losing weight with intermittent fasting. However, it’s important to note that it’s not a diet that necessarily promotes sustainable habits and lifestyle changes. There’s also not enough research conducted that shows its lasting impact on health, weight, or metabolic improvement. For most, an intermittent fasting diet is just that – a diet. A person will likely lose weight because they consume fewer calories, but keeping the pounds off is an aspect of healthy weight loss that requires a permanent lifestyle change. Who should NOT try intermittent fasting? Intermittent fasting is not for everyone and it can pose a health risk to women who are pregnant or breastfeeding, people with diabetes, and children and adolescents in an active growth stage. Also, it would not be appropriate for those with a history of eating disorders, as well as people with certain health conditions that require them to eat every few hours. You should always talk to your doctor before beginning a restrictive diet such as this, especially if you have a chronic health condition or are taking certain medications.

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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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