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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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Weight loss and healthier living tend to top most people’s lists of New Year’s Resolutions. So if you’re like the vast majority, here’s help — a comprehensive look at all of Renown Health’s programs that will help you lose weight and tackle metabolic challenges. Quick quiz: How many of the following apply to you? You have a need to lose weight, but you haven’t been guided on how to make sustainable change; You’re experienced a recent rapid weight gain, but lab tests didn’t reflect a change in your health; You’ve experienced a life-changing event that caused weight gain; You have problems with where you are carrying your weight, such as your mid-section; You’ve tried other weight loss programs, but they didn’t work. If you found yourself nodding in agreement to any one of the above statements, Renown’s programs can help. They cover the spectrum of helping with weight or metabolism challenges. But the million dollar question is: Where do you start? How to Lose Weight and Live Healthier Ideally, it’s best to start by talking with your primary care provider. Your provider knows your medical history and concerns related to your health. Talk to your provider about your past history with weight loss and gain. Your primary care provider will assist with the referral process and provide you with options you might not considered on your own. Most importantly, by starting with your primary care provider, you can take full advantage of all your health benefits. Renown offers four weight loss/management programs: Medical Nutrition Therapy Meet one-on-one with a Registered Dietitian at Renown’s Health Improvement Program to discuss your health goals. You may qualify for this program if you have: Heart or kidney disease Gastrointestinal issues Weight gain or weight loss Food allergies or sensitivities High blood pressure or high cholesterol A thyroid condition Diabetes – classes available, including: Type 2 Diabetes, insulin and gestational diabetes management during pregnancy (Offered in English & also in Spanish). For more information, call 775-982-5073. Medical Weight Management This program includes a one-on-one appointment with a board-certified bariatric doctor. You will receive a comprehensive evaluation and customized treatment plan to meet your needs and medically manage your overweight or metabolic challenges. Treatment options in this program may include nutrition changes, meal replacements, medication, exercises and also behavioral therapy. Here are a few qualifications for the program: A BMI of 25 or higher and health risk such as Type 2 diabetes, obstructive sleep apnea, cardiovascular disease, stroke, gout, osteoarthritis, infertility or polycystic ovarian syndrome A BMI of 30 and higher A metabolic problem such as diabetes, fatty liver and is not responding to regular medical care. Those with a metabolic problem may be considered normal weight, however may need to lose fat mass or reduce their waist size to get healthier. An increased risk of heart disease, stroke or Type 2 diabetes, regardless of weight that is not responding to regular medical care. For more information, call 775-982-5073. Bariatric Weight Loss Surgery We understand that the desire to have bariatric surgery is a choice you are making for your long-term health. Our team provides education on the necessary steps before, during and after surgery to ensure you are successful in controlling your obesity. You may qualify for this program if you have: A BMI of 40 or more, or: A BMI of 35 to 39.9 with significant health problems such as hypertension, high cholesterol, sleep apnea, diabetes or diagnosed arthritis To learn more, visit our Bariatric Surgery. You may also attend one of our monthly Weight Loss Surgery Seminars to learn if you are a candidate. Dietary Consultation at Renown Medical Group Many people aren’t aware that you can schedule short, frequent visits with a registered dietitian at Renown Medical Group locations in Reno or Sparks. Telehealth is also available at the Renown Medical Group – Fernley. Qualifications include: A BMI of 30 or greater You have a primary care provider with Renown Medical Group Medicare or Senior Care Plus member Since this program is only offered through Renown Medical Group, you must be an established patient. To establish with a primary care provider, call 775-982-5000. Talk to your primary care provider to see if you qualify for one of Renown’s weight management programs. Going through the referral process is the best way to ensure you are taking full advantage of your health benefits.

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