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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.

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When you meet Poeth Kilonzo, Director of Oncology Nursing at Renown Health, you are immediately greeted with a warm smile that puts your mind at ease. Within the William N. Pennington Cancer Institute, Poeth enjoys a strong reputation among her employees and patients as someone they can always rely on, no matter how rough the tides may flow.   As an incredibly humble oncology professional, you may not realize that behind that smile is the power of a best-in-class nurse and leader holding a 20+ year career of diverse nursing experience and leadership excellence – dedicating the majority of her service to Renown Health.  Join us as we dive into Poeth’s unique journey through Renown.  Finding Her Passion  Ever since she could remember, Poeth has been a “people person.” Above all else, she cared for people – and she cared a lot. What better place for her to be than healthcare?  After moving to northern Nevada from Kenya, she began working in private patient care working with home health and dementia patients while taking classes at Truckee Meadows Community College (TMCC) in 2000. One day, a patient asked her a question that would change the course of her career journey: Did you ever think about becoming a nurse?  Driven by not only the words of encouragement of her patients and supervisors in home health but also the rallying support from her family and friends, including her husband and high school friend, who both have decades of experience interacting with nurses in healthcare (with her husband spending many of those years at Renown), Poeth knew this was the path she was meant to take.  “That was it; it was like a light switch had flipped,” said Poeth. “I switched to nursing overnight.”  According to Poeth, TMCC’s nursing program offered her an incredibly supportive environment, which was especially important as she was a young mom at the time. Working in healthcare, going to nursing school and raising a family all at the same time is no easy task, but to Poeth, this was her calling.  “Regardless of my path, I knew I wanted to be a nurse that was close to patients, sitting with them and holding their hand throughout their treatment,” said Poeth.  During nursing school, Poeth completed clinicals at several hospitals in Reno – three of them were at Renown Health (known as Washoe Medical Center at the time). What immediately stood out to her was the passion of the pediatrics unit, especially in the neonatal intensive care unit (NICU).  “While I knew that pediatrics wasn’t going to be my arena, some of the best times in my life were during my pediatrics clinical,” said Poeth. “It opened me up to how welcoming Renown is.”  While doing her rotations, nursing leaders helped Poeth and her fellow classmates discover Renown’s Nurse Apprentice program, an apprenticeship designed exclusively for local northern Nevada nursing students. One of those leaders asked her, “have you considered doing a rotation in oncology?”  And another light switch flipped.  “Bingo. I am becoming an oncology nurse apprentice,” Poeth recalls. And that’s exactly what she did.   After her four-month apprenticeship ended in February 2002, she walked into her interview with Joanna Gold, who would end up being her supervisor and one of her greatest mentors until she passed away in recent years. With her experience and enthusiastic spirit on her side, Poeth fervently expressed her passion and interest in working in oncology. And Joanna saw all of that and more.  In June 2002, Poeth was presented with a two-year oncology RN contract, which she easily signed – however, she knew right then and there but she was not going anywhere. Renown was her home, and oncology ignited the fire within her.  “The nurses in this unit are part of what kept me here,” Poeth remembers. “These nurses would really do anything for their patients. The commitment and love they all had for one another truly was like family. It inspired me to learn more and give even better care to my patients."  To Poeth, it didn’t feel like she was coming to work just to do a job – she was following her dreams.  “You don’t think about the work you do; you think about the service,” said Poeth.  From there, Poeth spent three years on the floor as an oncology RN and became a night shift supervisor in 2005. She was thriving.  But this part of her journey was only the beginning.  When Opportunity Arises, Take It  In March 2007, Poeth and her husband welcomed their third child – and for her, working a day shift position would serve her the best at her current stage of life. This revelation led her down to Renown South Meadows Medical Center, where she became a staff nurse in Medical Telemetry.  It was in the telemetry unit where Poeth contributed to one of the largest digital transformations Renown would ever go through: transitioning from paper records to electronic records on EPIC.  From there, Poeth was inspired to get back into leadership in 2012 as the Supervisor of Clinical Nursing overseeing nurses, clinical outcomes and payroll in the medical/telemetry unit and intensive care unit (ICU). The timing of her leadership role lined up perfectly with her decision to take her skills to the next level, achieving a bachelor’s degree from Nevada State College in 2016. The timing of her degree lined up perfectly with what was about to come; she embarked on her first leadership role at Renown  This is where she would happily stay for 11 years, eventually becoming the Manager of Nursing in telemetry and the ICU, noting that Renown South Meadows felt like a second home to her.  “I wore many hats at South Meadows,” Poeth recalls. “From piloting back coding and handling compliance work to being on the patient floor and heading up South Meadows’ first high school hospital volunteer program, I got very involved. We had seven years without having a single nurse traveler in our unit."  It wasn’t long before Poeth was inspired to expand her education even further, and she graduated in January 2018 with a master’s degree in nursing clinical leadership from Western Governors University. Thanks to Renown’s educational assistance programs, our health system invested directly in Poeth’s education with tuition reimbursement and a $1,000 nursing scholarship.  Soon after celebrating her achievement, Jennifer Allen Fleiner – who was the Director of Nursing at Renown South Meadows at the time – asked Poeth yet another question that would bring her to the precipice of another career detour: “Have you ever considered transferring from South Meadows to Renown Regional?”   Moments later, Alicia Glassco, Director of Nursing for Renown Regional, asked her the same question, noting that the hospital’s neurosurgery unit needed the leadership of someone just like Poeth.  “It took me a whole week to make a decision, because this was one of the toughest decisions I’ve ever made in my life,” said Poeth. “I truly loved South Meadows. After that week, my leader told me, ‘you know what, Poeth? You’ve reached your pinnacle. You need and deserve a new challenge. Learn from this new team and teach them something. I think you have a huge opportunity for growth.”  So, Poeth decided to apply for the position and shadow the neurosurgery team, where unlike her unit, the majority of the team at the time were travelers. But this was a challenge Poeth was up to – so she was accepted into the role.  “At the end of the day, these patients deserved consistent care,” Poeth emphasized. “I knew I had to take this position for the patients – they were the ones who sold me on this job. They are the reason why we are all here. It was important for me to be an advocate for them.”  The big hills to climb didn’t slow down Poeth; in fact, the exact opposite happened. Within her first year in the neurosurgery unit, her team onboarded 18 new graduates and replaced travelers.  “We were hiring like crazy,” said Poeth. “My standing agenda at all section meetings focused on hiring and our quality metrics. I started having a relationship with our doctors. Once we created a strong doctor/nurse collaboration, our nurses started staying with us longer.”  Everything on the unit was going great.  Then, COVID-19 hit.   “Since we had private patient rooms, our unit became the first COVID unit at Renown Regional,” Poeth recalls. “My whole staff that I had built up had to be distributed elsewhere. I started caring for COVID patients. We relied on our Infection Prevention team a lot. And at the same time, I was worried about my family in Africa.”  Despite the stressful nature that the pandemic brought upon health systems everywhere, according to Poeth, she knew she had to continue on.  “The neurosurgery team ended up merging with orthopedic trauma, which was very difficult,” said Poeth. “We went from 28 beds to 58 beds. The key to success here was training. Nurses are very resilient, and through training, we were able to stabilize the unit.”  Noticing the opportunity for virtual demonstrations that were previously offered only in-person, Poeth spearheaded online trainings for nursing, physical therapy, mobility, head injuries and more, allowing teams across Renown to upskill in safe spaces.  These programs continued throughout the pandemic, and Poeth was proud to be a figurehead through it all, helping to stabilize the unit while creating strong relationships with the entire team, many of whom followed her from Renown South Meadows to Renown Regional.  Then, she gets another visitor – her Chief Nursing Executive – in her office with yet another opportunity.  Have You Considered...  In September 2022, Chief Nursing Executive Melodie Osborn walked into Poeth’s office with those three words that Poeth has heard for decades: “Have you considered...”  “Before Melodie could even finish, I thought, ‘I have considered A LOT in my career!’” said Poeth.  Melodie told Poeth that the William N. Pennington Cancer Institute was looking for a Director of Oncology Nursing, noting that this could be yet another growth opportunity for her and a chance for her to go back to her roots.  “I had just celebrated my twentieth year at Renown; I knew this was going to be a decision I really had to think about,” said Poeth. “Everyone believed in me. Alicia Glassco told me, ‘Poeth, you are ready for this. Go for it.’ Once I applied for the position and started getting my updated chemotherapy certifications, I thought, ‘they are right; I got this.’”  At this point in her career, Poeth had been hyper-focused on inpatient care, and this role would be her first time caring for patients in the outpatient setting. After going through the interview process, however, Poeth knew that this was where she was meant to be yet again – and colleagues she hadn’t seen in years reaffirmed that commitment.  “I felt the most excited about the job when I toured the facility,” Poeth recalls. “I’ll never forget what one of the infusion nurses told me on my tour. She told me, ‘I don’t know if you remember me, but I remember you; I came from Renown South Meadows, and you were so nice to me as I was precepting as a new nurse. Your kindness was unforgettable to me.’ The fact that people like her wanted me in the unit so badly inspired me to come back.”  Soon enough, Poeth became the Director of Oncology Nursing, a position she still proudly holds to this day. Once she was hired, she immediately went into deep learning mode, mastering skills such as revenue integrity, credentialing and the insurance process. She attributes Supervisor of Infusion Kaitlin Hildebrand and Director of Radiation Oncology Services Susan Cox for helping her succeed.  Shortly after assuming the position, Poeth noticed yet another opportunity for cross-training within the organization to combat short staffing – training nurses from the Float Pool to care for patients in Infusion Services.  “Between May and July of this year, we trained six nurses from Float Pool to do infusion therapy services, which offered so much relief to my team; I am so thankful to Rendee Perry, the Manager of Nursing in our Float Pool unit, and her team for their support,” said Poeth. “My mission in outpatient oncology is to serve the staff and patient population and create those strong relationships."  Poeth's efforts to circumvent nurse burnout go beyond cross-training – as a director, she is always there for her team members no matter what, leading with kindness every step of the way.  “I never miss a 7:45 a.m. huddle unless I am in a ‘cannot miss’ commitment; I want my employees to always know that I am there for them and that they are cared for both on and off the job,” Poeth emphasizes. “I want them to feel like they are valued, their families are valued and their mental health is valued; after all, without my team, we cannot care for patients. It’s important for them to know that I am here to be a security blanket and that there is always something we can do to solve a problem."  Today, Poeth enjoys a full team of core Renown staff members whom patients look forward to seeing – and the high patient satisfaction scores to prove it.  “Our team is so established that patients feel comfort in knowing they are always going to know exactly who they are being treated by,” said Poeth. “We will always work to maintain that consistency.”  Staying True to the Mission  Renown’s mission of making a genuine difference in the health and well-being of our community resonates closely with Poeth. Before she arrives at the infusion unit every day, she asks herself: What can I do to make it easier for my team to deliver care?  “It takes a village to deliver the care we do,” said Poeth. “Our nurses are priceless. You can’t place a monetary value on dealing with life and death every day. This is what inspires me. It’s all about helping each other out and keeping those relationships strong.”  Maintaining those relationships on the floor, according to Poeth, requires one main ingredient: work-life balance.  “I want my nurses to be able to balance sending their kids to kindergarten and giving their patients their first chemotherapy treatments,” Poeth emphasizes. “I genuinely care about their lives. It’s nice when you get to know your team’s children, grandkids, spouse and hobbies. I’m grateful that Renown has given us the autonomy to foster that flexible environment within our teams. It is so rewarding to have such a strong impact on these employees.”  To Poeth, it’s all about doing and then duplicating. Luckily for her team and infusion patients in northern Nevada, a new infusion center at Renown South Meadows is planned to open in the coming years as part of our commitment to expanding care. Her team is excited to grow their expertise down to south Reno – Poeth's original home hospital.  “I strongly believe that as nurses, we are meant to be where we are meant to be at the time,” said Poeth. “Be kind to yourself and remember your ‘why.’ Take advantage of the opportunity you have.”  To all nurses (and future nurses) out there, Poeth wants you to know that you are welcomed and valued. You are saving lives every day, and to her, that is worth everything.  “Always remain focused, even throughout all the challenges. Never forget why you got into nursing. And lastly, always stay true to your own mission,” closes Poeth.

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Becoming a caregiver or playing a more active role in another’s healthcare is a big responsibility. At some point, almost all adults will support an aging parent or a loved one in need. Keeping track of their needs and wellbeing, while also prioritizing your own can become overwhelming. It’s important to know: you are not alone, and help is available. Read on for 11 tips to help you manage your time, your own wellbeing and your loved one’s care. Self-care comes first. When your main priority is the person in your life who needs care, it’s easy for your own needs to take the backseat. Give yourself time each day to focus on your personal wellbeing. It’s hard to give a loved one the care they need if your own needs are not met. Prioritize the Activities of Daily Living (ADL). Make a note of what ADLs your loved one can do alone, what they need help with and what activities require the most help. This will help you work through the day with them, as well as plan out how the day’s activities will go. Do a home safety audit. Do showers, bathtubs and steps have safety grab bars? Look around the house for additional tripping hazards, like rugs or electrical cords. If your loved one struggles with day-to-day navigation of the home, consider scheduling an occupational therapy appointment. This type of therapy helps a person develop or maintain the motions required to accomplish daily tasks. You might also qualify for a referral to in-home healthcare, such as Home Care. Have the hard conversation. The best time to discuss views about end of life care and to learn what choices are available is before a life-limiting illness or crisis occurs. With advance care planning, you can help reduce the doubt and anxiety related to decision making at the end of life. Completing an Advance Directive is a great tool to sort out all these decisions before they’re needed. Attend a free workshop to learn more and complete this important document. Identify when you need respite. Respite care involves receiving a short-term break from caregiving. Organizing in-home care for your loved one will allow you to step away and tend to your needs. By identifying what kind of respite care you are seeking, you can find the right person to provide you with that much-needed break. Don’t wait until you feel overwhelmed, plan ahead. Write down insurance contact information. Have a direct connection to the right insurance professional for support and advice. If your loved one is eligible Medicare, this is a good opportunity to review their current selections and if they would benefit from a Medicare Advantage Plan or Medicare Supplement Insurance. Seeking out expert advice or information on Medicare options is a great way to navigate this. Consider calling a broker, or attend a free educational seminar with Senior Care Plus. Gather legal and financial information. Make a list of all existing legal documents and financial accounts that your loved one has. These might include a will, advance directive, power of attorney, bank accounts or investment accounts. If you have questions about how to manage them, or need assistance in setting up additional framework, reach out to a lawyer, legal service, financial adviser or bank representative. Create an inventory of medical information. Identify where all of your loved one’s medical records are, as well as a list of providers or healthcare practices where they have received care. Consider if you should have your loved one give you Proxy Access in MyChart, which allows you to access all the features in MyChart on their behalf, including viewing upcoming appointments, viewing test results and emailing a doctor on their behalf. Make a list of what others can do. Think about all the little (and big) things that need to happen, and write down tasks that others could take care of you. When someone says “let me know what I can do” you’ll be ready with a pre-written list of items they may be able to assist with. Tasks could include tackling around-the-house repairs, scheduling lawn work, helping to walk the dog, taking a car for an oil change and cleaning. Find programs and events for social enjoyment. If and when possible, seek an activity outside of the home. Look for community centers that have programs for seniors, recreational activities or meals that you can patriciate in together. If leaving the home is not an option, arrange for visits or in-home activities, such as movie nights, card games or time to visit with family. Research long-term options. If you will be considering a nursing home or assisted living, make a list of amenities that you and the person you are caring for would like. Take this list with you when visiting potential locations to make sure you don’t forget to ask about each item.

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February is American Heart Month. While cardiac care is crucial every time of year – especially as heart disease stays the number one killer in the United States – American Heart Month serves as a great reminder to stay on top of your heart health. We spoke with Malina Ruiz, a cardiology nurse practitioner at Renown Health, on three key ways to embrace heart-healthy living and how genetic screening can help inform you of certain genetic risks that can play a role on the cardiac life stage.  1.  Invest in a heart-healthy diet. Eating a diet that is rich in fruits, vegetables, whole grains and healthy fats (including monounsaturated fats such as avocados and polyunsaturated fats such as sunflower oil) is a key defense in protecting your cardiac health, according to Malina. While you are filling your plate with these nutritious foods, remember to keep an eye on your saturated and trans-fat intake, and try limiting foods that are high in those fats.   “No matter what age we are, maintaining a heart-healthy diet will always be important,” said Malina.    Need help finding cardiac-friendly meals? The National Heart, Lung and Blood Institute makes it easy with heart-healthy recipes and tips from experts.  2.  Do an exercise audit. “Keeping an active lifestyle during our younger years is one of the most important factors that affect heart health in future years,” said Malina. Maintaining a regular exercise regimen that allows you to raise your heart rate and break a sweat can help prevent future cardiac events.     A good rule of thumb is to aim for 150 minutes a week of moderate-intensity exercise, which averages out to 30 minutes a day on 5 days out of the week.    It’s never too late to start a regular exercise routine! Exercise doesn’t have to be something you dread – leverage American Heart Month to find activities that you enjoy. The American Heart Association can help you discover new ways to move your body. At the end of the day, as Malina emphasizes, “any movement is better than nothing!”  3. Don't skip those check-ups. Regular preventative visits with your primary care provider can help you identify possible risk factors for heart conditions before they start actively affecting your life. “Check-ups become even more important as we age, along with being aware of the signs and symptoms of heart disease, heart attack and stroke,” added Malina.     There’s no time better than the present – call our expert scheduling team today at 775-982-5000 to request a preventative check-up with your primary care provider.

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November is National Alzheimer’s Disease Awareness Month. At Renown Health, we know that Alzheimer's safety for your loved one is a priority, as the symptoms can sometimes lead to unsafe situations. We asked Dr. Jonathan Artz – a neurology physician with Renown Health and an assistant professor of clinical neurology at the University of Nevada, Reno School of Medicine – for tips on keeping loved ones safe and secure.  According to the Alzheimer’s Association, Alzheimer’s disease affects safety in various ways, specifically due to body and brain adjustments. These changes can include: Judgment, including forgetfulness  Sense of place – getting lost on the way home  Behavior – being suspicious or fearful  Body difficulty – losing balance Sensing ability – noticeable sensitivity in hearing, seeing or temperature  Dr. Artz gives us four major tips to ensure your loved one’s safety as you both navigate this disease together.  Watch for Wandering  Those experiencing Alzheimer’s disease tend to wander and get lost. Try the following tips to reduce the risk of wandering:  Get your loved one an ID bracelet and have them wear it at all times. You can also enroll your loved one in “Wandering Support.”  Install door chimes so you know when exterior doors are open.  Ask neighbors to call you if they see your loved one out alone. Go with your loved one when they insist on leaving the house. Don’t argue or yell. Instead, use distraction or gentle hints to get them to return home.  Discourage Driving  Driving can be unsafe for someone with this disease. With this in mind, ask a doctor whether it’s safe for your loved one to drive. For example, on a case-by-case basis, there are certain situations where doctors are required to report individuals with particular cognitive impairments, wherein a form of a driving assessment will be recommended.  Limit access to the car. Keep the keys with you or lock them away.  Ask an authority figure, such as an insurance agent or a doctor, to tell them not to drive.  Adult-Proof Your Abode  A simple living space is a safe living space. This means reducing clutter and removing any issues that may pose a safety concern. You may also want to get advice from an occupational therapist (home safety expert). Keep in mind that some changes may not be needed right away. Focus on major safety concerns first.  Try the following tips:  Add lighting (or glow-in-the-dark tape) to brighten dark areas, including stairways and halls.  Use color contrast or texture indicators for dials, knobs and appliance controls.  Remind your loved one not to carry items while walking to avoid a fall.  Remove sharp objects from drawers and countertops.  Avoid using small throw rugs or doormats, as they are easy to trip on.  Move frequently used items so that they are easy to reach.  Lock away alcohol and tobacco products, as they are not recommended for dementia patients.  Install handrails in the shower, tub and near the toilet. Bathroom falls are especially common.  Adjust the setting on your hot water heater so water does not scald. Those with Alzheimer’s can lose their sensitivity to temperature.  Move and lock up hazardous chemicals and cleaning supplies, such as bleach and insecticides.  Disable and remove guns or any weapons. Supervise any medication taken by your loved one.  Promote a Positive & Healthy Lifestyle  Continually emphasize the strengths of your loved one by promoting participation in meaningful activities, wellness visits and healthy habits to help them improve their well-being. Here are some ways to keep them physically and mentally active:   Maintain regular vision and hearing screenings and make necessary adaptations.  Establish a routine for daily activities.  Encourage participation in self-care and leisure activities.  Work with your loved one’s doctor to establish a healthy diet.  Ensure proper hydration. It may help to set reminders for your loved one to drink fluids.  Encourage regular exercise. Exercise delivers oxygen to the brain, improving brain health. Promote good sleep habits. Good quality sleep can increase overall brain health and has been associated with improving memory, attention and concentration.  Resources and support are available with the Renown Memory Disorders Program. Providers within this program are specifically dedicated to treating several different memory-related disorders. Memory Disorders Resources & Support.

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What exactly is the relationship between genetics and disease? Powered by Renown Health, the Healthy Nevada Project is one of the most visible genomic studies in the United States. They are recruiting participants here in northern Nevada to understand the relationship between genetics and nonalcoholic liver disease. Joseph Grzymski, Principal Investigator at the Healthy Nevada Project and Chief Scientific Officer at Renown Health, shares why this study is so important and who should take part. Many people are aware that heavy drinking can lead to liver disease. Yet they are unaware that other types of liver disease are not caused by alcohol consumption. These types of liver disease are more difficult to diagnose but are equally dangerous. What is NASH? A build-up of fat causes nonalcoholic Fatty Liver Disease (NAFLD) in the liver. The most dangerous form is called Nonalcoholic Steatohepatitis (NASH). It causes inflammation and damages liver cells, leading to fibrosis, scarring of the liver, and decreased liver function. If NASH goes untreated, irreversible liver damage can occur, leading to cirrhosis, cancer, or liver failure. These conditions can be fatal. What’s most concerning about NASH is that the symptoms don’t typically cause pain and aren’t noticeable. The good news is that a new local study is raising awareness about this disease by recruiting at-risk people for NASH. Am I at risk for developing NASH? The following factors put you at risk: Obesity Type 2 diabetes Metabolic syndrome High blood lipids, such as cholesterol and triglycerides Does having a family member with nonalcoholic liver disease increase my risk? We do not know a lot about inheriting NASH, although a lot risk factors run in families. One goal of this study is to better understand the genetic component of NASH. There are certainly other risks too, such as environmental and behavioral risk factors. However, we don’t yet have a good grasp on how these impact NASH risk. How is NASH diagnosed? Diagnosis is traditionally done with either a liver ultrasound or biopsy. However, both procedures are expensive and the invasive biopsy has risks. Therefore doctors often use risk factors or less invasive blood tests for diagnosis. This NASH study will include a new blood test called the enhanced liver function (ELF) test. Doctors and researchers have data suggesting that the ELF test is a better diagnostic test for NASH risk. Conducting this cutting-edge test with study participants allows them to share results with their doctors to ensure the best care. What can I do to reduce my NASH risk? Limiting exposure to the risk factors of NASH often lowers risk. Eating a healthy diet, maintaining a recommended weight and exercising regularly can proactively lower your risk.

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The Healthy Nevada Project (HNP) is one of the most visible genomic studies in the United States, and guess what? Renown Health powers it! The Healthy Nevada Project (HNP) aligns with Renown's goal to do the best for our patients. The genomic study is at no-cost for Nevadans and gives participants insight into different genetic traits, including results on three prevalent and serious health conditions known as CDC Tier 1 conditions. CDC Tier 1 Conditions Include: Hereditary Breast and Ovarian Cancer Syndrome (HBOC) Lynch Syndrome Familial Hypercholesterolemia (FH) Not only does HNP give participants insights into their genetic background, but it also facilitates Renown's ability to study population health. Research lays the foundation for the future of medicine, and Renown's HNP is on the cutting edge of genetic research. We do this by providing skilled researchers access to studies for the diseases that currently have limited treatment, including nonalcoholic steatohepatitis liver disease or NASH. For example, the observational NASH study helps researchers understand genetic links to the disease. Make an Appointment to Get Screened If you haven't already, join the over 55,000 HNP participants and make an appointment to have yourself screened. You can schedule a screening appointment through MyChart. Click “Schedule an Appointment" and select Research Appointment - Genetic Screening. Prior to your appointment, please complete e-Check-in and complete your consent form.

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Did you know an estimated 1.9 million neurons and 14 billion synapses are lost per minute during a stroke? That’s why every second counts. Anyone can have a stroke, but your chances increase if you have certain risk factors. That’s why the best way to protect yourself or your loved ones from a stroke is to know the risks and how to manage them. You can make changes to your lifestyle to lower your risk of stroke by asking yourself the following questions: 1. Is my blood pressure normal? High blood pressure is the leading cause of stroke and the most important controllable risk factor. If you’ve had a stroke, lowering your blood pressure can help prevent future strokes. 2. Can I quit smoking? Smoking damages blood vessels, clogs arteries and raises blood pressure — doubling your risk of stroke. If you want to reduce your risk of stroke and heart attack, quitting smoking is the first step — and Renown can help you with this. Learn more: Renown Health Quit Tobacco Program. 3. Do I make time to exercise 30 minutes a day? Many studies link consistent exercise habits with lower stroke risk. Also, being overweight contributes to high cholesterol, high blood pressure, heart disease and diabetes, all increasing your stroke risk. You don’t need to run a marathon — just commit to making time to move each day. 4. Do I regularly eat processed food and sugar? Eating less cholesterol and fat, especially saturated and trans fats, may reduce the fatty deposits (plaque) in your arteries. Also, eating five or more servings of fruits and vegetables per day may reduce your stroke risk. If you are diabetic, follow recommendations to get your diabetes under control.

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Colorectal cancer is the number two cancer killer in Nevada, only second to lung cancer, yet it is also one of the most preventable. Still, in 2020, 20.7% of Nevadans said they had never been screened for this deadly disease, according to the Nevada Cancer Coalition. At the start of the COVID-19 pandemic, unfortunately many healthcare services were halted, including colorectal cancer screenings. Those delays in screenings can lead to delays in diagnoses of colorectal cancer, resulting in poorer outcomes. Per the American Cancer Society, if colorectal cancer can be found early the relative 5-year survival rate is approximately 90%. Screening is key, and it is important to engage in preventative care. Even if you have no personal or family history of colorectal cancer, ask your doctor about colorectal risk factors and when to start screening, and if you’re up to date on your screenings, talk to loved ones and make sure they are too. According to the American Cancer Society, most colorectal cancer cases are found in those without a family history. This month let us help raise awareness for colorectal cancer and the importance of routine, life-saving screenings. To learn more, we spoke to Renown Health oncology nurse Christina Alsop, APRN. What is Colorectal Cancer Colorectal cancer is a disease in which the cells in the colon or rectum grow out of control. It usually forms from precancerous polyps, or abnormal growths, in the colon or rectum, which can become malignant without presenting any symptoms. How do Screenings Work Screening tests like stool tests, colonoscopies and others can detect these precancerous polyps, so they can be removed by a physician before turning into cancer. Screening tests can also find colorectal cancer early, resulting in better treatment outcomes. As of 2021, the U.S. Preventative Services Task Force recommends adults begin colorectal cancer screenings beginning at age 45, through 75. Screening methods include a blood stool test, which needs to take place every year or a colonoscopy, which takes place every 5-10 years. Healthy Habits Can Help Stave Off Risk Routine screenings are the only way to determine colorectal health, yet some healthy habits may reduce your risk for colorectal cancer. These factors include maintaining a healthy weight, being physically active, eating a diet rich in fresh fruits, vegetables and whole grains, limiting alcohol intake and not smoking.

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Stroke is unfortunately common, with 1 in 5 American women experiencing it each year. When it comes to a stroke the phrase “time is brain” speaks to the urgency of getting rapid care. In fact, a woman may lose nearly 2 million neurons per minute of oxygen loss to the brain. The Renown Health Comprehensive Stroke Center experts share the importance of timely treatment and how stroke symptoms can differ in women. Women and Stroke – Surprising Symptoms  Each year stroke affects more women than men. Even more concerning, women are less likely to recover from a stroke. The following non-traditional, less common, warning signs can be common in women: Hiccups with chest pain Sudden disorientation, drowsiness, confusion or a general altered mental status Nausea or vomiting A sudden headache that feels like the ‘worst headache of your life’ Unusual chest pain (especially with hiccups) Body numbness or weakness, such as an arm or leg suddenly ‘falling asleep’ Fainting or loss of consciousness Stroke Diagnosis The first step is neuroimaging by CT scan. This allows for rapid identification of any bleed, and also assists in determining candidacy for the early clot busting medication. MRI brain imaging is much higher resolution, and can better determine the core stroke size, assisting in prognosis and recovery. Since strokes have several different origins, an inpatient workup is essential to determine the underlying cause. Whether the stroke is secondary to plaque in the large vessels, clots being thrown in the setting of atrial fibrillation (an abnormal heart rhythm), or small vessel disease from years of uncontrolled vascular risk factors (high blood pressure, smoking, high cholesterol, diabetes), determining the cause is essential to implementing a management plan to reduce risk for further strokes. Quick Treatment for Stroke is Key Early recognition of stroke symptoms and seeking prompt attention is paramount. There are interventions that can be instituted to minimize the stroke and increase likelihood of recovery, but only if a patient presents to the hospital early. A clot busting medication, called tPA, can be given to patients with stroke if given within 4-5 hours from time of onset. Renown Regional Health Center is designated as a Comprehensive Stroke Center, the highest level of stroke certification available. To earn the designation of comprehensive stroke center, a hospital has to meet stringent requirements, including biannual on-site evaluations. This includes care for ischemic stroke patients (lack of blood flow), hemorrhagic stroke patients (bleeds), and determining the underlying cause to guide secondary stroke management prevention. Stroke Symptoms Remember “B.E.F.A.S.T.” to recognize the symptoms of a stroke below: B – Balance Being off balance or dizzy, is common. E – Eyes An eyesight change such as blurring or double vision may occur. F – Face droop One side of the face, or lip, droops A – Arm weakness Does one arm drift down? S – Speech Talking may slur or sound strange. T – Time Time to call 911. Call an ambulance immediately if you or anyone else, experiences any of these symptoms.

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In 2018, Jordan Stiteler became a Healthy Nevada Project advocate. Her DNA results revealed that she had Familial Hypercholesterolemia (FH). FH is a genetic condition that can cause high cholesterol. Since then, Jordan’s taken action to lower her cholesterol and make her family aware of this potentially dangerous condition. Read Part I of Jordan’s story Taking Control of High Cholesterol Looking at Jordan, an active young mother, you would never suspect she has high cholesterol. However, because of FH, Jordan’s cholesterol levels are unusually high. She chose to take action when learning of her FH gene, in order to maintain her long-term health. Jordan started by exercising more and eating healthier. “I’ve definitely been checking all the labels to see if the food has a lot of cholesterol, trans fats, or saturated fats,” she explains. She now eats a 100% plant-based diet which helps to lower her cholesterol naturally. Additionally, Jordan partnered with Dr. Michael Bloch, a lipid specialist, to monitor and manage her cholesterol. She told Dr. Bloch that she and her husband were planning on having a second baby. With this in mind, he helped Jordan create a plan to accommodate her pregnancy. Several months after giving birth to her beautiful daughter Logan, it was time to revisit her cholesterol treatment plan. Dr. Bloch prescribed Jordan a statin called Lipitor. It successfully cut her total cholesterol by half in just three months. “I had blood work done in November 2019 and my total cholesterol was 293 (normal is less than 199). I started taking cholesterol medication in February 2020. I had blood work done in June 2020 and my total cholesterol was 149, ” Jordan shares. “My LDLs went from 219 to 78! I am so grateful that the medication worked so well and so quickly! It’s a weight lifted off of my shoulders.” Although Jordan no longer limits herself to a strictly vegan diet, she is mindful of what she eats and how it affects her cholesterol. She’s thrilled that her cholesterol is now at a healthy level!

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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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