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6 Healthcare Action Items for the LGBTQIA+ Community
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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Nationally Recognized Vascular Surgeons Join Renown Health
Two vascular surgeons bring a quarter of a century of experience to patients and community. As part of a continuing focus to bring comprehensive care to patients experiencing cardiac and vascular disease across northern Nevada, Renown Health Department of Surgery and Renown Institute for Heart & Vascular announce that vascular surgeons, John C. Hansen, MD, FACS and Benjamin P. Jaquish, MD, FACS have joined Renown Health. "Recognizing the significance of preventing, diagnosing and caring for people with heart and vascular disease, which continues to be on the rise and taking far too many lives, is of critical important to us at Renown," says Christos A. Galanopoulos, MD, MBA, MSc, FACS, VP, Chairman Department of Surgery at Renown Health. "Both Drs. Hansen and Jaquish are superb clinicians, skilled investigators, and effective educators. We are fortunate to have them helping to lead the growth of both the department and the Division of Vascular and Endovascular Surgery." Together, the vascular surgeons have more than 26 years of combined experience caring for northern Nevadans. Dr. Hansen has 20 years of experience in northern Nevada. He is a clinical associate professor of surgery at the University of Nevada, Reno School of Medicine (UNR Med) and currently serves as medical director of vascular and endovascular surgery for Renown Regional Medical Center. "Since 2002, Dr. Hansen has led our region with his expertise and knowledge of aortic stents, grafting for abdominal aortic aneurysms and thoracic aneurysms, as well as treating patients with carotid disease," says Jayson Morgan, MD, FACC, Director, Cardiovascular Services. "Dr. Hansen specializes in the comprehensive management of vascular disorders, including open and endovascular surgeries. He is meticulous, thorough, and compassionate in the extraordinary care he provides to patients. We are thrilled that he has joined the Institute for Heart & Vascular Health team at Renown." Dr. Hansen completed his fellowship in Vascular Surgery at the Mayo Clinic in Rochester, MN, and completed his residency in General Surgery at the University of South Carolina, Greenville. He graduated with his Doctor of Medicine from the University of North Carolina School of Medicine, Chapel Hill, and is board certified in both Surgery and Vascular Surgery from the American Board of Surgery and a Fellow of the American College of Surgeons. Dr. Hansen has an interest in complex and acute vascular surgery and is committed to expanding access to qualified vascular care in the region. His mission is to further develop and establish Renown as a premier vascular center in northern Nevada. "Dr. Jaquish has extensive experience in carotid artery disease, carotid endarterectomy, aortic aneurysm and dissection, and peripheral vascular disease," says Sam Obilie-Mante, MBA, MIS, RDCS, RVT, LBBP, VP Administrator, Cardiovascular Services. "Dr. Jaquish is intelligent, professional, conscientious, and always perseveres on behalf of his patients. How proud we are to have him bringing his time and talent to patients across Renown Health." Dr. Jaquish received both his B.S. in Biochemistry (2005), graduating Magna Cum Laude with his Doctor of Medicine (2009) from the University of Nevada, Reno School of Medicine. Dr. Jaquish completed his fellowship in General Surgery at Ascension St. John Hospital and Medical Center in Detroit and a fellowship in Vascular Surgery at Texas A&M at Baylor, Scott & White Hospitals in Temple, TX. He is board certified in both General Surgery and Vascular Surgery. Dr. Jaquish currently serves as Assistant Professor of Clinical Surgery for UNR Med. Dr. Jaquish is bilingual in Spanish, proficient in American Sign Language and serves as an instructor for Advanced Trauma Life Support. Why Vascular and Endovascular Care Matters to You People with complex and serious conditions of the blood vessels and lymph system (vascular diseases) often find the help they need from Renown Health's vascular and endovascular surgical team. Renown's experts provide coordinated and comprehensive treatment to people of all ages. Renown's surgeons use advanced technology to perform vascular and endovascular surgery, including complex stenting procedures, blood clot removal and bypass surgery. Conditions treated include peripheral artery disease, aortic disease, mesenteric disease, nutcracker syndrome and carotid artery disease. "Our expert vascular and endovascular surgeons and staff treat problems that extend from mild to the most critical of emergencies," says Adnan Akbar, MD, Chief Medical Officer for Renown Acute Care. "Specialized physicians including cardiologists, interventional radiologists, heart and vascular surgeons, emergency medicine and trauma surgeons, neurologists, radiologists, physical medicine and rehabilitation specialists, primary care providers, nurses and other clinicians work as a team to determine the best treatment plan for each patient. We encourage all patients to discuss with their primary care providers whether they should undergo formal screening for early vascular disease." "Renown's reputation as the region's vascular and endovascular care leader has been built over many years. We performed the area's first open-heart surgery, angioplasty, stent and valve replacements decades ago. Renown Regional offers incredible advancements like trans-catheter aortic valve replacement (TAVR) and trans-catheter mitral valve repair (TMVr) with MitraClip therapy, lifesaving alternatives to open-heart surgery for patients considered high-risk or inoperable," says Chris Nicholas, FACHE, Chief Executive Officer of Renown Regional Medical Center. "Offering the highest level of comprehensive care for patients experiencing cardiac and vascular disease, Renown developed its first division of cardiothoracic surgery dedicated to heart surgery patients in 2019." The Renown Institute for Heart & Vascular Health program now offers a Diagnostic Electrophysiology Lab; a Chest Pain Center using the D-SPECT® heart camera; multiple Interventional Labs; Heart Failure Program; several Cardiac Catheterization Labs; Interventional Cardiology and Cardiac Surgery when necessary; and the only Pritikin-certified Healthy Heart Program in the West, creating individualized rehabilitation plans tailored to each patient's needs, so they can exercise safely, eat healthy, manage stress and cook nourishing, balanced meals, all while gaining a healthy mindset. In the most recent US News & World Report Best Hospital rankings, Renown Regional Medical Center was named as the number one hospital in Nevada. No other hospitals in the state met their stringent standards for the 2021 rankings. Renown Health is High Performing, its highest rating possible, in eight procedures and conditions including Heart Failure, Colon Cancer Surgery and Chronic Obstructive Pulmonary Disease, Hip Replacement and Knee Replacement. A hospital's score is based on multiple data categories, including patient outcomes, safety and volumes. Hospitals earning a High Performing rating were significantly better than the national average. The 2021-22 Best Hospitals rankings are drawn from a universe of 4,523 facilities, representing nearly all U.S. hospitals providing inpatient care. Hospitals are evaluated across a wide range of conditions and procedures, including 16 medical specialty areas of care. US News & World Report evaluated 58 hospitals in Nevada. Renown Health is Nevada's largest, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 6,500 employees, Renown has fostered a longstanding culture of excellence, determination, and innovation. The organization comprises a trauma center, two acute care hospitals, a children's hospital, a rehabilitation hospital, a medical group and urgent care network, and the locally owned not-for-profit insurance company, Hometown Health. Renown is currently enrolling participants in a community-based genetic population health study, the Healthy Nevada Project®. For more information, visit renown.org. The University of Nevada, Reno School of Medicine (UNR Med), Nevada's first public medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Since 1969, UNR Med has trained more than 3,900 students, residents and fellows. UNR Med continues to improve the health and well-being of all Nevadans and their communities through excellence in student education, postgraduate training and clinical care, research with local, national and global impact and a culture of diversity and inclusion. For more information, visit med.unr.edu.
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