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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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As the temperatures skyrocket and we return to more outdoor activity, one thing is certain: you must hydrate to stay cool, healthy, and functional. But how much water do you need, and what are some easy ways to ensure you are getting enough? Aurosis Reddy, DO a family medicine provider with Renown Medical Group, shares what you need to know.  How Much Water Is Enough?  Experts agree that recommended daily water intake can vary depending on different factors such as your weight, metabolism, location, diet, physical activity, and health. As a rule of thumb, women should aim for a daily fluid intake of 91 ounces, and men should aim for 125 ounces. It is important to listen to your body and recognize when you might need to increase your water intake. For example, if you’re partaking in strenuous exercise, or spending time outside in the heat, you’ll want to give your body more water and electrolytes to function properly.  How Can I Tell If I Am Dehydrated? Decreased coordination Fatigue Less urination Dizziness Dry, sticky lips and mouth Increased thirst Headache

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Dry weather – as northern Nevadans we know it well. Of course this doesn’t mean we’re not affected by its health impact whether you’re new to the area or are a native. Stephanie Stutz, DO, a Renown Medical Group doctor specializing in family medicine, explains how to live comfortably in the high desert. Have you noticed dry skin, itchy eyes or more bloody noses? If you call northern Nevada home, you’re probably no stranger to these problems. “We get a lot of questions from people wanting to know, ‘what can I do to prevent things from happening from the dry weather?’” says Dr. Stutz. “We do have a dry climate, and obviously in the summertime you notice it more than in the winter, so we look at things like dry skin, dry eyes and dry nose.” It generally takes about two weeks to become used to the change in climate. Dry Weather Health Tips Fortunately, there are some easy things you can do to reduce your discomfort in dry weather. Dry skin. “If you have dry skin, use a lotion without perfumes so it won’t increase the potential for drying your skin out,” recommends Dr. Stutz. For example, one home remedy for extremely dry skin (or for those with thinner skin) is cocoa butter. “It’s thicker so it goes under the skin and takes more time to absorb. As a result, you get a much more long-lasting effect.” Dr. Stutz adds. “You can also add lavender essential oil to your cocoa butter to help you sleep at night.” Dry and itchy eyes. “Use eye drops on a regular basis and keep them with you. I recommend people have a couple of bottles – one at home and one in their bag,” Dr. Stutz suggests. Dry nose. “Overall one of the best things to use is a simple nasal wash,” she says. “You can get it over the counter; it’s a saline nasal wash. Use it a couple of times each day and it can be extremely helpful. In particular, gets up into the sinuses and clears them of any pollen or residue in there.” Dry Weather Nosebleed Advice In our dry climate, you may also notice more allergies and nosebleeds. Dr. Stutz cautions, “Surely the dry air can make your allergies much worse. It can create much more irritation, pain and pressure, particularly in the nose and sinuses.” Again, Dr. Stutz recommends using a nasal wash to remove discomfort. Using a nasal wash two to three times a day can also help prevent nosebleeds. “And if you’re someone who has severe or chronic nosebleeds, you can put a little bit of Vaseline along the inside of your nose to create a moisture barrier”. Dry Weather Medication Advice In addition to allergy and nosebleed sufferers, people on certain medications may be at greater risk for symptoms in our dry climate. “The medications you are on can make you much more susceptible to drying out and becoming slightly dehydrated,” Dr. Stutz warns. For this reason discuss all of your medications with your doctor. Specifically, see if you can time them throughout the day or look at changing the dosage. Should I Get a Humidifier? Given our year-round dry weather, you may want to purchase a humidifier to help ease your symptoms. But there are some things you should know first. “You have to be careful with humidifiers as there are pros and cons,” states Dr. Stutz. “The small tabletop humidifiers are not beneficial. You need to get one covering a huge amount of square footage and holding approximately 10 to 30 gallons of water to help your home. On the negative side, if you’re not maintaining it on a regular basis, it will hold on to mold and other allergens. So the next time you turn it on, you’re actually putting that back into the air.” Do I Need to Go to the Doctor? To be sure, it’s important to know yourself and your family. If this is something you experience each year, you can try over-the-counter medications. “But remember, there’s always the caution if you’re on prescription medications,” Dr. Stutz explains. “If you are on chronic prescriptions, come in to get evaluated just to make sure you’re not using anything which interferes with your medications.” Not Just a Summer Problem As the temperatures drop, remember this isn’t just a seasonal issue here in the Reno-Tahoe area. During the winter months, our dry climate combined with cold temperatures and heaters can still cause dry skin, aggravated sinuses and even itchy eyes. So use these helpful dry weather tips all year. Comprehensive Primary Care Renown Medical Group primary care physicians provide comprehensive primary care by appointment. Doctors coordinate each patient’s medical care including checkups, immunizations, referrals to specialists, lab work, X-ray & imaging and hospital admissions. Find a Doctor

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Head, neck and oral cancers account for just 3 percent of all cancer in the U.S. and can be hard to diagnose. Dr. Abhinand Peddada, radiation oncologist with the Renown Institute for Cancer, explains. While you likely don’t frequently hear about head, neck and oral cancers — they are significantly less common than many kinds of cancer — they can be extremely dangerous. One of the primary reasons: some symptoms mimic the common cold, making them difficult to detect without a medical professional. We asked Abhinand Peddada, M.D., radiation oncologist with the Renown Institute for Cancer, to break down the symptoms and lifestyle risks of these rare cancers. First off, what are some of the signs and symptoms of head, neck and oral cancers? Symptoms can vary based on where the cancer is. For example, throat cancer may show up as a persistent sore throat, while sinus cancer may present as soreness or pressure in the sinuses that doesn’t get better. Some other symptoms to watch may include: Swelling in the throat Painless swelling in the neck Red or white patches in the throat Hoarseness Bloody noses or blood in the mucus or saliva A new and unexplained lump or bump anywhere on the face, neck, mouth or throat Difficulty breathing Difficulty swallowing, chewing or moving the muscles in your face, neck, mouth or throat Bad breath, even with good oral hygiene Loose teeth Dentures or retainers that no longer fit Double vision Who is most at risk for head, neck and oral cancers? Both men and women can develop head, neck and oral cancers, but men are at almost twice the risk of women. People over the age of 40 are also at a higher risk, and these cancers tend to be more common in African Americans. Tobacco use — including cigarettes, cigars, pipes and chewing tobacco — is another risk factor. Tobacco is linked to 85 percent of head and neck cancers. Exposure to fumes and chemicals can increase your risk as well. We’re also seeing more HPV-related head and neck cancers in the U.S., so patients with HPV may want to watch more closely for symptoms. What about screening and prevention? Your dentist already looks for signs and symptoms at your regular dental checkups. Additionally, if you have one of these risk factors and are experiencing signs and symptoms, it’s a good idea to check with your doctor about possible screenings. To help prevent these types of cancers, try to minimize your controllable risk factors. This means quitting tobacco, watching your alcohol consumption and taking care of your oral hygiene by brushing and flossing regularly. We also recommend the HPV vaccination for both boys and girls starting at age 11. By vaccinating at an earlier age, one is less likely to develop oral HPV. What do diagnosis and treatment look like for these cancers? At Renown Institute for Cancer we offer the most advanced diagnostic testing available including fiberoptic photos, CT and PET scans, as well as MRIs. Together, you and your care team will decide which treatment best fits your needs. For these types of cancers, treatment options include radiation, chemotherapy and surgery. Renown Institute for Cancer | 775-982-4000 At the Renown Health Institute for Cancer, our experienced team provides the support and care to maintain the highest quality of life and then achieve the best possible outcome, all in one location that’s close to home. Our dedicated team, clinical expertise and advanced treatment options allow us to tailor care to each patient. Learn about: Our Team Cancers We Treat Screening and Prevention Treatment Options Find a Cancer Doctor

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