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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.

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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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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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An alcohol problem can affect anyone at any age. Many factors, including job stress, genetics or depression, may contribute to the start of disordered drinking.  Drinking alcohol exists on a continuum. For example, if someone feels down in the dumps for some time, it doesn’t mean they are clinically depressed. So if someone goes through a period with above-normal alcohol consumption, it doesn’t necessarily mean they abuse alcohol. Although “alcoholic” and “alcoholism” are common, they are not clinical descriptions. Alcohol use disorder is the preferred term. Symptoms are often mild but can be the start of a more significant problem. According to the National Institutes of Health (NIH), over 16 million adults live with alcohol use disorder. Symptoms of Alcohol Use Disorder Do you recognize any of the following symptoms in yourself or someone you know? Drinking more or longer than intended Trying to cut down or stop drinking but not able to Having to drink more than you once did to get the same feeling Being annoyed when family members discuss your drinking Regretting your behavior while you were drinking

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Approximately 476,000 Americans are diagnosed and treated for Lyme disease every year. Lyme disease is an infection that is transmitted to humans through the bite of infected black-legged or “deer” tick. It’s the most common and fastest-growing vector-borne disease in the United States. This bacterial infection, if left untreated, can cause serious pain, fatigue and other crippling symptoms. Keeping an eye out for early signs of Lyme disease, implementing prevention techniques and understanding testing and treatment options can go a long way in maintaining your health. We consulted with Peter O’Reilly, PA-C at Renown Medical Group – South Carson to learn more. 1. Recognizing the Signs of Lyme Disease Lyme disease is extremely easy to misdiagnose, given that most of its early signs and symptoms mimic those of other conditions, such as COVID-19. Common Lyme Disease symptoms include: Fever Chills Joint or muscle pain Swollen glands Extreme fatigue Headache  The primary initial symptom that occurs in about 80 percent of Lyme disease cases is a “bulls-eye” rash that spreads around the site of the tick bite – called “erythema migrans.” Tick bites can be hard to find and not everyone gets the classic bullseye rash, making Lyme disease difficult to self-diagnose. O’Reilly suggests talking to either your primary care doctor or infection doctor as soon as possible if you’re concerned about Lyme disease.

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If you and your partner are looking for a more permanent birth control method, you might consider a vasectomy. Although vasectomies are common, knowledge about them isn’t quite as common or talked about. If you are considering a vasectomy, talking with your primary care doctor is a great way to learn more and start the process. We consulted with Dr. Aurosis Reddy a primary care doctor with Renown Health – South Carson, about key topics to discuss with your doctor when considering a vasectomy. What is a vasectomy? A vasectomy – also called male sterilization – is a form of male birth control that blocks sperm from reaching semen, according to the American Urological Association (AUA). How effective and safe are vasectomies? Vasectomies are one of the most effective methods of birth control with a long-term success rate of over 99%. A vasectomy has been a safe and successful birth control method for many years. More than 500,000 men elect to have vasectomies every year in the U.S., and the number is rising. A vasectomy is also generally a low-risk procedure with a low complication rate ranging between 1-2%. What does the recovery period look like? A vasectomy is typically a quick procedure that takes under thirty minutes and can be performed in an outpatient setting under local anesthesia. Recovery from a vasectomy is also considered relatively easy. After a vasectomy, most can: Resume everyday activities within two to three days Resume normal exercise in one week Start engaging in sexual activity again in one week Your doctor can provide more details on what your individualized recovery process will look like.

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Renown Health is closely following the national outbreak of the monkeypox virus and urging healthcare providers to be alert for patients with illnesses associated with a rash. In working with the Washoe County Health District (WCHD), Renown is closely monitoring the spread of monkeypox in the community and looking to prevent and reduce the spread of monkeypox. To help to ease worries, we consulted with Paul De Leon, Infection Preventionist at Renown Health. What Exactly is Monkeypox? Monkeypox is a rare viral illness caused by the monkeypox virus — the same family of viruses that causes Smallpox. Although symptoms are similar to Smallpox, monkeypox symptoms are milder and rarely fatal. However, it's important to mention that this virus can be more severe for these susceptible groups: Immunocompromised Pregnant women A fetus or newborn baby Women who are breastfeeding Young children Those with severe skin diseases such as eczema How is Monkeypox Transmitted? The monkeypox virus is not easily transmitted but occurs through sustained person to person close contact with an infected individual. Monkeypox can also be transmitted through direct contact with infectious rash, scabs, or body fluids. Monkeypox can also be spread through prolonged intimate physical contact, such as kissing, cuddling or sex. Lastly, monkeypox can be spread through contaminated linens or bedding. Transmission through respiratory secretions is uncommon but has been reported after prolonged face-to-face contact with symptomatic individuals. In addition, pregnant women can spread the virus to their fetuses through the placenta. Monkeypox Testing If you think you have monkeypox, contact your primary care physician or other medical providers to obtain testing. Notify the provider ahead of time before entering the physical office. Signs & Symptoms This current outbreak of West African monkeypox does not have the typical presentation of classic monkeypox. Symptoms usually appear one to three weeks after infection and include: Pimple-like rash or blisters on the face, inside the mouth, and on other areas of the body, like the hands, feet, chest, genitals, or anus. The rash will go through serval stages, including scabs, before healing and may be painful or itchy. Other symptoms of monkeypox can include: Fever Headache Muscle aches and backache Swollen lymph nodes Chills Exhaustion Respiratory symptoms such as sore throat, nasal congestion, or cough Symptoms of monkeypox may occur before or after a rash with some individuals only report experience a rash. Individuals with monkeypox are infectious once symptoms begin and remain infectious until lesions form scabs, scabs fall off, and a fresh layer of skin forms. The illness typically lasts 2-4 weeks.

Read More About Monkeypox: A Renown Expert Weighs In

Renown Health recently announced that it has contracted with the Centers for Medicare and Medicaid Services (CMS) on a new program that offers enhanced Medicare benefits for Medicare beneficiaries. This new direct contracting Medicare program is designed specifically for patients with Original Medicare. Here are three things to know about Renown’s new program: The goal of the program is to help care providers work together to improve patients’ health by better coordinating patient care and reducing costs. Medicare beneficiaries who choose to sign up will have peace of mind knowing that they are in a program that ensures coordinated care along with potential cost-sharing assistance for chronic care management. Signing up for this program is easy – and it does not affect your existing Medicare benefits in any way. Simply click the button below, select either your current Renown Health or Geriatric Specialty Care provider from the drop down menu, complete the form and click “Submit Form.” It only takes a minute or two to fill out the form. You will be asked to provide the name of your primary care provider and be sure have your red, white, and blue Medicare card handy. Sign Up for Renown’s Enhanced Medicare Benefit Program Voluntary Alignment Sign Up Note: Participation in this program is voluntary. If you choose to sign up, your benefits will NOT change, and you can visit any doctor, other health care professional, or hospital. Learn more about Renown’s Direct Contracting Entity for Medicare Beneficiaries here. The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.

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Many millennials are fortunate to have good health, but it’s important to be prepared for your next doctor’s visit. Here are three things that millennials should stay on top of for tracking and maintaining their health. For many millennials, doctor visits and preventive healthcare fall by the wayside. Alison Lynch, MD, a family medicine provider with Renown Medical Group says there are a few key things you can do now to set yourself up for a healthy future. 1. Establish with a Primary Care Provider Millennials are more likely to go to urgent care or consult the internet when a healthcare issue arises. While these are helpful tools, here’s a better one: a primary care provider. The benefit of establishing with a primary care provider is that your medical records, history and a baseline for your health will be documented. That means that when a problem or question comes up, your doctor will already have helpful information on file and can help you navigate your needs. Having a primary care provider is often required for prescription refills and referrals to a specialist. By establishing now, you’ll be able to get what you need in the future much faster. Make an Appointment Today 2. Protect Yourself and Your Community There are a few vaccinations and screenings that Dr. Lynch recommends for millennials. Flu Shots: These are available every year and are recommended for protecting not only yourself against the flu but also others you may come into contact with. Flu shots are usually available from August through December through your healthcare provider, pharmacies and pop-up events. Tetanus or Tdap: Most people receive a tetanus shot as a child, but it’s recommended that everyone get a booster every 10 years. If you are overdue, talk to your primary care provider or pharmacist about getting updated. Pap smear: If you’re a woman, a pap smear is recommended every three years in your 20s and every five years in your 30s. HPV vaccine: This vaccine helps prevent the virus that causes cervical cancer as well as the majority of head and neck cancers and warts. The HPV vaccine is recommended for all genders up until age 45. STD screening: Consider an STI/STD screening if you’re sexually active.

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Heart disease is the number one killer of women – claiming one life every minute – yet many women don’t know that the signs of heart attack may not be the same symptoms they’ve learned about all their lives. In women, nearly 71% experienced unusual exhaustion in the weeks before, 50% had trouble sleeping and 42% suffered shortness of breath. Most importantly, about 43% had no chest pain. Women and Heart Attacks: The Subtle Symptoms In both men and women, the most common symptom is pressure or pain in the mid chest, but there are also more subtle signs. “Women can experience a heart attack without chest pain,” explains Letitia Anderson, M.D., cardiologist with Renown Institute for Heart & Vascular Health. “It is not uncommon for women to experience extreme fatigue, shortness of breath, dizziness, lightheadedness, nausea, vomiting and pain in the abdomen or back as their primary symptom.” Other symptoms can include: Neck or jaw pain Fullness or pressure that goes away and comes back The feeling of a rope being tied around your body and squeezed Some doctors have reported seeing patients who just didn’t "feel right." One woman simply felt more tired than usual while cleaning, while another woman reported feeling winded carrying boxes to the basement. Admittedly these are symptoms many of us would shrug or sleep off versus going to the hospital for immediate care, which is why it’s important to pay close attention to the warning signs. “Women are good at being the caregiver for the rest of the family and writing off their own symptoms as something minor, like indigestion or a muscle pull,” says Dr. Anderson. “Remember that heart attacks have early warning signs, and if they are recognized and treated in time, a heart attack can be prevented and heart damage avoided.” When You Need to Call 911 Paying attention to your body is key. If you’ve experienced any unusual or flu-like symptoms, struggled to breathe or just don’t feel right – give yourself a gut check and ask if you’ve honestly felt this way before. If you’re worried at all, you need to seek emergency care. Do not wait – call 911 immediately Take an ambulance to the hospital if at all possible Try to stay calm and take deep, slow breaths until medical help arrives.

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Although going to the bathroom is not a typical conversation among women and their doctors, it’s an important one. It is a topic you may want to discuss with a urogynecologist, a physician who diagnoses, manages and treats pelvic health conditions in women. Kerac Falk, MD, a urogynecologist and assistant professor at the University of Nevada, Reno and Renown Health discusses overactive bladder in women and how to treat it. According to the National Institutes of Health, about 1 in 4 women struggle with pelvic health conditions, with over 40 percent of women over age 60 experiencing problems. While these conditions may be common, they shouldn’t just be accepted as a normal part of getting older. In fact, many women don’t think of urine leakage as a medical problem, and only 1 in 3 women with incontinence seek care. So, while these conditions may be common, they shouldn’t just be accepted as a normal part of getting older. There are excellent treatment options that can significantly improve the quality of life. Overactive Bladder Symptoms in Women: As your body changes and ages, so does your pelvic health. Whether you just had a baby, are experiencing urgency issues or find you cannot go about your daily routine, sneeze or laugh without leaking urine – you’re not alone. An overactive bladder, also known as OAB, is more than feeling an urgent need to go to the bathroom. It can also include the following: Incontinence or lack of control over urination Waking up in the middle of the night to empty your bladder Going to the bathroom often, even every 30 to 60 minutes Symptoms of OAB can lead to a decreased quality of life, feeling as if you cannot go about your normal daily routine, or even become hazardous, increasing the risk of trips, falls, and bone fractures. Various Treatments are Available: Behavioral management (eliminating coffee, soda and alcohol which irritate your bladder) Pelvic floor physical therapy to optimize nerve and muscular function and coordination to prevent leakage Medications including tablets and local estrogen replacement Pelvic nerve stimulation and reprogramming treatments Botox to relax the bladder muscle Solutions for an Overactive Bladder: Simply put, OAB is a nerve and muscle problem, so the bladder needs to calm down. Although there is no underlying reason for OAB, some underlying conditions may exist, such as: High blood pressure Recent trauma Neurological conditions (such as stroke and multiple sclerosis) Lifestyle and non-invasive measures can usually reduce symptoms by as much as 50%, significantly improving quality of life. However, if these measures do not help your OAB, further bladder testing may be needed. Dr. Falk notes that “every patient has a unique situation and set of symptoms. My job as a urogynecologist and pelvic floor subspecialist is to work as a team with each individual to figure out what’s going on and design the best treatment approach that fits your needs and goals, whether that is conservative or with more advanced procedures. The outcome we are working towards is improved quality of life.” If you are bothered by your bladder, the best thing you can do is bring this up with your primary care doctor or gynecologist to begin to discuss solutions

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Much like general physical and mental health, sexual health is an essential aspect of your overall well-being. Therefore, educating yourself on your sexual health is an important piece regarding your overall wellness. Secure & Private Virtual Visits Did you know that many sexually transmitted disease appointments can happen virtually, in the privacy of your own home? Our providers can perform a screening examination for sexually transmitted illness (without symptoms) when it’s convenient for you. This is a great option if the topic makes you uncomfortable during an in-person visit, or if you can’t find time to visit your primary care provider or local urgent care. After the telehealth appointment, your provider will determine the  next steps for you. Remember, in-person visits are always an option as well.   Here’s how you can take charge of your sexual health:  Get Comfortable with Getting Tested  Surprisingly, some people with STDs don't show symptoms, meaning they may not even know they have an STD unless they get tested. Even if an STD shows no symptoms, the result of non-treatment can be serious. Bret Michael Bellard, MD, with Renown Medical Group, shares that it’s important for people to get tested for STDs because if left untreated, they can cause the following health problems: Loss of fertility Pregnancy complications Other health issues  When to Visit Your Primary Care Provider  Who should get tested and how often? “The recommendations are that everyone from ages 13 to 64 should get tested at least once for HIV. All sexually active adults should also be tested for other STDs once a year, and all pregnant women should be tested at the start of their pregnancy,” says Dr. Bellard. Some STDs, like syphilis, can be passed from mother to baby, so it's important for women to get tested as soon as they know they’re pregnant.  Dr. Bellard recommends going to your primary care provider for testing. “They can also give advice on prevention and other health topics.” If you don’t have a primary care provider, this is a great reason to get established with one. Women with an established OB/GYN can have STD testing done simultaneously with their annual pelvic exam. The providers in Renown's network care for patients of all ages and specialize in family medicine, internal medicine, pediatrics and OB/GYN.   Practice Safe Sex  STDs are preventable. Practicing safe sex and getting tested routinely are your best defenses against all types of STDs.  For many, the conversation about sexually transmitted diseases is awkward and many avoid it. To lower your risk of contracting an STD, don’t wait until you’re “in the moment” to have the conversation with your partner about the last time you were both last tested. If you haven’t gotten tested in-between new partners, use latex condoms every time you have sex until you are both confirmed negative of STDs. Condoms are not 100% effective at preventing disease or pregnancy. However, they are extremely effective if used properly.   To establish Primary Care, visit renown.org/virtualvisits or call 775-982-5000

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