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A Blood Test: What Valuable Clues It Tells Your Doctor
Blood. It can make you squeamish to think about it, yet every drop is vital to your health. In fact, a tiny vial of it can tell your doctor a wealth of information. We asked Benjamin Hansen, M.D., to explain what providers can learn from a blood test and why it’s important to get one as part of your annual checkup. CBC, the initials, sound innocent enough, right? In fact, when your favorite TV doctor orders a CBC, or complete blood count, it’s often the first step in getting an overall picture of your health. "It primarily measures white blood cells, red blood cells and platelets," explains Hansen. Although a blood test is one test you don’t have to study for, the measurements it takes can point to a host of information. What a Blood Test Says About Your Health White Blood Cell Count "The white blood cell count in your CBC helps us to determine the strength of your immune system," says Hansen. "It also helps us to determine the likelihood of infection because white blood cells fight off infection. Knowing the white blood cell count can also be helpful in patients with compromised immune systems, such as those on certain medicines or with conditions that impair immunity," he adds. White blood cells are made in your bone marrow and are alive only one to three days. Therefore, your body is constantly making them. Red Blood Cell Count "The red blood cells carry oxygen from your lungs throughout your body, while also carrying away waste. The hemoglobin (red blood cell protein) count is important because it helps us determine how well you're able to deliver oxygen from your lungs to the rest of your body," states Hansen. If these counts are low, you may have trouble breathing or experience fatigue. Red blood cells also grow in bone marrow, but they have a long lifespan – generally 100 to 120 days. Why Get a Blood Test? Although the CBC is just one type of blood test, according to the National Institutes of Health (NIH) there are a number of blood tests available that can help check for diseases and conditions such as: Heart disease Cancer Anemia (low iron) Diabetes High cholesterol Alcohol or Drug use disorder HIV/AIDS Additionally some tests show how well your kidneys, liver, heart and other organs are working. If you are taking a medication, a blood test can also let your provider know if it is helping you. What to Expect From a CBC Blood Test When you are not feeling well, it may take some detective work to figure out what is wrong and sometimes a CBC can be helpful. With this in mind, a lab order from your provider is needed to order a CBC blood test. Some blood tests require you to not eat food (fast) eight to 12 hours before the blood draw. Your provider will let you know the type of blood test(s) they are ordering for you. Usually it's important to drink plenty of water before your blood test, to make it easier to locate your veins. Generally a small sample of blood is taken from your arm vein and then sent to a lab for analysis. Discussing Your Results "A CBC can help your provider determine if there is an infection, your level of immunity, if you are anemic or if you are prone to bleeding," says Hansen. When to Get a Blood Test "A CBC is usually ordered for a specified purpose. If you think you might need a CBC, please call your provider. It's also important to see your provider regularly to keep an eye on your health. Many patients should see their provider at lease yearly," Hansen clarifies.
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Department Spotlight: Pathology
Celebrate Leap Day by leaping into the world of Pathology at Renown Health! Think of discovering a diagnosis like solving a mystery: the condition is the suspect, the nurses are the frontline police force and the doctors are the lieutenants or captains finalizing the results of the case. You may notice that one crucial role is missing on this list – the detectives. In the diverse network of healthcare, the detectives are a significant part of each patient’s mystery-solving care team and represent many roles across our health system. When it comes to figuring out the elaborate details of a growth, disease, organ abnormality or cause of death, one team of detectives, quite literally, goes as deep as possible. Those detectives are the team members within Renown Pathology. For each specialized field within medicine or surgery, the Pathology department is here to play a crucial role in accurate diagnoses. With each slide examined and each test meticulously conducted in their bright laboratories, these dedicated professionals shape a path towards wellness and recovery. Meet Your Anatomy Experts Whether you have a chronic disease that needs consistent testing, a high-risk birth that requires placenta testing, a suspected cancerous tumor that needs a biopsy or a gall stone that must be removed (or anything in between), Renown’s Pathology team steps in to provide biological answers to your body’s questions. This department offers the most comprehensive in-house diagnostic testing in the region, from routine histology to full pathology. As the busiest pathology department in northern Nevada, this team boasts the fastest turnaround times from respected experts, including: Pathologists Pathology Assistants Histotechnicians Histotechnologists Clinical Lab Assistants Let’s break down the complex nature of these team members' jobs by walking through their everyday responsibilities at work! Pathologists Pathologists are medical doctors who specialize in the study and diagnosis of disease. With every slide they scrutinize and every sample they analyze, pathologists unravel the mysteries of disease with precision and compassion. Their responsibilities include interpreting laboratory tests, analyzing tissue and fluid samples (obtained from a variety of different sources, including biopsies and surgeries), staging cancer diagnoses and providing diagnostic insights that guide treatment decisions. “Our job is to help the patients and their doctors figure out what’s wrong,” said Dr. Christie Elliott, Pathologist and Medical Director of the Clinical Laboratory at Renown Regional Medical Center. “As the bulk of our cases deal with cancer, almost every day we start with a tumor board alongside fellow surgeons, oncologists, radiologists and geneticists. From there, we order extra studies, run through our cases to make diagnoses, review slides and ensure all information goes into the charts, which is especially important as 70% of data in medical charts is from the lab. A patient’s history is everything.” Pathology Assistants With the steadiest of hands, pathology assistants, also known as PAs (not to be confused with physician assistants), guide the diagnostic journey from patient specimen to diagnosis. They can typically be found processing surgical and biopsy specimens (includes accessioning, gross examination, description, and sampling for microscopic analysis), preparing tissue samples for microscopic evaluation, helping the pathologist determine a cause of death for autopsies by conducting organ dissections and maintaining detailed records of all diagnostic findings. “As a PA, I still impact patient care without being directly patient-facing,” said Andrew Whitner, Pathology Assistant. “I handle 300-350 small tissue blocks a day. During dissections, I identify landmarks, document what I see and turn those landmarks into slides, looking for things that don’t look normal.” “Our job is 90% all about gross specimens, and we also do eviscerations for autopsies,” added Leslieann Haffner, Pathology Assistant. “We are trained on what normal looks like; our goal is to find the abnormal.” Histotechnicians Histotechnicians work behind the scenes to help transform ordinary tissue into extraordinary windows of insight, revealing the inner workings of the human body. As vital members of the Pathology team, histotechnicians embed tissue specimens in paraffin wax blocks (a process that preserves the tissue's structure for examination), cut thin sections of tissue from the paraffin blocks using a microtome, mount tissue onto glass slides and stain the tissue slides using histological stains to highlight structures or cells. “With all the patient specimens we work with, we get to see a lot of organs and learn what is causing the abnormalities,” said Reiny Hitchcock, Histotechnician. “I enjoy the opportunities to expand my knowledge, especially while working alongside the doctors.” “Our job can change by the week,” added Jessica Fahrion, Histotechnician. “One week I’ll be in the grossing room, and the next week I might be training in cytology." Histotechnologists In a world where every slide holds the key to a patient's future, histotechnologists are the champions of progress. One career ladder step above histotechnicians, these team members often have a broader scope of responsibilities, including more complex laboratory procedures, developing and validating new techniques, managing laboratory operations, interpreting results and troubleshooting technical issues. You can count on histotechnologists for validating antibodies and handling orders from pathologists, oncologists, emergency physicians and more. “My day always involves looking into cases, reading reports, getting orders together and working with pathologists to help them with their diagnoses; I also work a lot with immunohistochemistry, helping out with routine slides,” said Charles Koeritz, Histotechnologist. “I especially enjoy doing validations, which help maintain the integrity of lab testing and our diagnostic processes.” Clinical Lab Assistants Our pathology clinical lab assistants are the masters at “filling in the blanks,” assisting in whatever area needs it most, especially in cytology and the grossing room. They are essential aspects of the Pathology team, collecting and storing specimens for further testing, assisting in managing test results, gathering data, managing supply inventory and more. “As a Clinical Lab Assistant, I can be scheduled anywhere, from tissue cassetting to grossing,” said Ellie Somers, Clinical Lab Assistant. “Working in cytology is one of my favorite parts of my job. It’s very rewarding to work with the doctors to uncover what treatments will help each patient. We do cytology very well here.” The Bottom Line Even though the Pathology department doesn’t always experience a lot of patient face-to-face time, they interact with patients in a different way – by uncovering the story that is the inner workings of the human body, one slide and one sample at a time. “It’s important to remember that the slide IS a patient,” said Dr. Elliott. “We are constantly learning from every case so we can continue to provide the best patient care possible.” Take a Photo Tour of the Pathology Lab!
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Understanding Your Risks for Fatty Liver Disease
Did you know that about one in four adults and one out of every ten kids in the U.S. might have a liver problem called non-alcoholic fatty liver disease (NAFLD)? This happens when too much fat builds up in the liver, and it's not because of drinking alcohol. The most serious type of this liver problem is called metabolic and non-alcoholic steatohepatitis (M/NASH). It means there's damage and can be scarring in the liver. About 20% of people with fatty liver disease have M/NASH. What's worrying is that many people don't even know they have it. Dr. Catherine McCarthy, a family medicine doctor at the University of Nevada, Reno School of Medicine, talks about the main risks of M/NASH and how you can check your risk for liver disease during Liver Health Matters Month, or anytime. Who Might Get M/NASH? Doctors aren't sure exactly why some people get fatty liver or M/NASH. While anyone can get M/NASH, people who might be more at risk include those with: Type 2 diabetes Insulin resistance or prediabetes High body mass index (BMI) or obesity High cholesterol or other fats in the blood High blood pressure Signs of liver problems from tests or biopsies A family member living with M/NASH How Do Doctors Find Out If You Have M/NASH? Doctors can do different checks and tests to see if someone has fatty liver or M/NASH. They might look at your liver health through non-invasive tests such as blood work, ultrasounds or MRIs. They might also suggest a special blood test called an Enhanced Liver Fibrosis (ELF) test– offered at no-cost through the Healthy Nevada Project – to check your risks of advancing liver disease. How Can You Treat Fatty Liver Disease or M/NASH? Patients with moderate to advanced liver scarring may also be prescribed a recently approved therapy called Rezdiffra. However, prevention of advancing disease is still the best option. Actions you can take to improve your liver health and reduce your risk include: Eating healthy, especially low-carb foods Exercising regularly Losing weight if needed Not drinking alcohol Keeping an eye on blood sugar if you have diabetes No-Cost Liver Screening Through the Healthy Nevada Project If you live in Nevada and are 18 or older, you can qualify for a no-cost liver health screening by enrolling in the Healthy Nevada Project, one of the largest community-based population health studies in the entire country. This study helps doctors understand your liver health better and plan early treatments to stop liver disease from getting worse. By joining the Healthy Nevada Project, you can: Get the FDA-approved ELF test to check your risks for liver disease See your test results in your medical record to help your doctor plan your care better Help doctors and researchers learn more about M/NASH and work on future treatments Participate in genetic sequencing for high-risk conditions linked to heart disease and certain cancers, including breast and ovarian cancer Gain high-level health insights, including food sensitivities, and ancestry information. Enrolling in the study is easy: Schedule a Virtual Consent Appointment through MyChart where a study representative will answer any questions, confirm your eligibility and sign you up. Once you’re signed up, your representative will schedule your blood test. Go to your blood draw appointment. By taking part in this study, you're helping to make a difference in liver health research!
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Department Spotlight: Core Laboratory at Renown Regional Medical Center
When it comes to your health, tests are not only common but often also required to receive the most ideal treatment plan. From your routine urinalysis to more complex hematology cases, these tests help open the doors to proper diagnosis. Thousands of patients are seen at Renown Regional Medical Center every year, which results in thousands of lab samples needing to be processed every day. So, who rises to the occasion? Answer: The Core Laboratory team at Renown Regional. With the largest lab workload in our health system, the Renown Regional Core Lab is where compassionate care meets scientific excellence. While under the care of the Core Lab Team, patients can rest assured that they are in the greatest of hands - literally and figuratively - with every scientist, technical specialist and lab assistant that serves in this department. A Core Mission of Accuracy and Precision At Renown Regional, the only Level II Trauma Center in the region, the Core Laboratory works on a wide variety of lab tests to help providers diagnose, treat and monitor each patient’s condition. Those testing processes, known as “benches,” include: Blood Gas Chemistry & Immunoassay Coagulation Hematology & Differentials Urinalysis Working together in harmony, each member of the Core Lab team has an equally vital role in our health system, and all share a common goal. “Our number one priority is to provide accurate results for our patients, ensuring that the providers have all the correct information they need to treat them,” said Lauren Anderson, Manager of Core Laboratory. As one can imagine, there are several factors involved when it comes to ensuring those accurate patient lab results that Lauren mentioned above. “Throughout the day in the core laboratory, there are many tasks to be performed for the accuracy and validity of our patient results,” said Jackie Blazquez, Sr. Medical Lab Scientist. “The medical lab scientists perform maintenance on the instruments daily while accommodating patient samples and releasing results. Our clinical lab assistants help the scientists with receiving samples, reviewing patient labels for any discrepancies, answering phone calls and assisting with the automated lab sample line.” “The roles and responsibilities will vary depending on the bench assignment, but every bench will have one responsibility in common: performing preventative maintenance on our analyzers and running quality controls afterwards,” added Brittany Oliver-Stergiou, Medical Lab Scientist. From start to finish, there is rarely a dull moment in Renown Regional’s Core Lab. In fact, this capable team can process up to 7,000 samples per day at this hospital alone. "As a Medical Lab Scientist, for each instrument we use, we have to perform maintenance, calibration and quality control to ensure that the analyzer is ready for patient testing,” said Lauren Anderson. “Once the analyzers are ready for patient testing, we perform analysis on the samples, ensuring that the patient's results are consistent with their condition and no errors are found. Between our inpatient and outpatient centers, we run thousands of samples every day, prioritizing and juggling many tasks at once while producing accurate results.” “Right when we get in, we are putting samples on the analyzers, reading results and calling critical alerts or recollects,” added Rosalina Lunsford, Medical Lab Scientist. “Our chemistry analyzers have all the analytes one can think of. Each individual chemistry test that the hospital uses is calibrated, quality checked and reviewed by our chemistry maintenance experts.” Although there are many moving pieces when it comes to the work of our Core Lab experts, these team members work like a well-oiled machine in order to keep patient care at Renown Regional running efficiently. “I start my shift by reviewing my pending worklist and verifying any outstanding STAT tests; then, I track all my untracked samples for easy retrieval, and I'll go through my pending worklist again to make sure that everything is on track for proper turn-around time,” said Lindsey Randle, Medical Lab Scientist. "I'll retrieve anything that may need further special testing, and before releasing results, I will check the sample for any interferences or contamination. This process is on a constant loop throughout my shift in addition to performing analyzer maintenance and quality control testing at timed intervals. This is all done to ensure that we are releasing precise and accurate test results so that patients can receive proper treatment.” “We play a major role in keeping the hospital functioning,” added Rosalina Lunsford. “While the hospital doesn’t see us, we keep patient care moving. Core Lab is not stagnant; it is evolving each day. Tests are being added, machines are being updated and policies are changing. We see hundreds of patient results from different departments throughout the hospital. We analyze, question and conclude many times throughout the day and night.” Think of discovering a diagnosis and monitoring a condition as an ongoing investigation. Our Core Lab professionals are key detectives in the investigation, playing an essential – and often life-saving – role in the diagnosis, treatment and maintenance of each patient’s condition. “Oftentimes, we are the first to detect a patient's problem and escalate it to their provider,” said Lauren Anderson. “For example, looking under the microscope at a patient's white blood cells, Medical Lab Scientists may be the first to see a patient's leukemia and, with the collaboration of our pathologists, ensure that the next steps are taken towards diagnosis and treatment.
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Department Spotlight: Point-of-Care
When you visit your provider for your annual exam or to address a health concern, or if you’re admitted to the hospital for any reason, lab draws – including blood tests, urine samples and saliva swabs – are common. When it comes to lab draws when you’re sick with a virus, such as strep, flu, RSV or COVID, or routine tests for chronic conditions, such as blood glucose or hemoglobin A1C, the last thing you’d want to do as a patient is wait a long time to get your results back. You’re focused on getting your results, receiving the proper medication and feeling better as soon as possible. Luckily for patients at Renown Health, we have a talented team to meet that need. Meet the Point-of-Care team at Renown, an important subset of the larger Core Laboratory department. With decades of collective experience in the field and some of the finest point-of-care technology at their fingertips, this team works with our healthcare teams to ensure you have access to fast, accurate test results to help you on a quicker road to recovery. Pointed Towards Efficient Solutions Point-of-care testing can be defined as exactly how it sounds – lab testing at or near the patient or their care area, otherwise known as “at the point-of-care.” While our clinicians utilize this specialized equipment every day for point-of-care testing on patients, they rely on the Point-of-Care department for training, everyday guidance, quality checks, audits and leadership. At Renown, Point-of-Care testing is used in nearly every nursing unit across our hospitals and 53 outpatient care locations, including primary care, urgent care, pediatrics and women’s health – alleviating some of the workload of our central lab. Because so many teams rely on this crucial technology and test processes, this team accomplishes a great deal each day, from checking equipment to ensuring test accuracy. “Our day starts early, with our first team member opening the department at 5 a.m. and circulating on the nursing units to address broken point-of-care equipment issues or supply shortages that could impact patient testing,” said Joni Boury, Lab Program Coordinator. “Once the point-of-care scientists arrive, they will address any charting issues that arose overnight and ensure all test results are correctly charted in Epic. After critical issues are addressed, we visit the testing locations and performing audits to ensure all testing equipment is functioning, clean and being appropriately maintained.” In order to provide these efficient tests – in minutes! – to patients anxiously awaiting their results, our first step is to make sure our equipment and processes are up-to-code. Point-of-care testing is regulated at both the state and federal levels, and this team never leaves a checkbox unmarked when it comes to testing regulations. “As a part of the ambulatory side of the Point-of-Care team, I make sure that state and federal licensing is maintained so the practices that perform these tests can continue to perform in-office testing for patients,” said Wende Lane, Clinical Lab Assistant Lead. “I also round in these practices to make sure they are adhering to state and federal guidelines, as well as Renown policies.” And it’s not just existing equipment that needs oversight – the Point-of-Care department also implements new equipment and processes across Renown. These team members are expert jugglers when it comes to this effort, handling training, collaborating with leaders, recommending the proper placement of equipment and much more. "Each day, we work on our many deployments scheduled throughout the hospital and outpatient locations,” said Joni Boury. “That work includes meeting with leaders to ensure new spaces are correctly built to accommodate the point-of-care devices, configuring new equipment, training new leaders and device operators and ensuring appropriate ordering and charting of the test results.” “In being able to perform these tests in the outpatient setting instead of having to send them somewhere else for a test, providers can begin treating their patients within a matter of a few minutes, rather than hours,” added Wende Lane. For a small-but-mighty team of six employees, the heights this team reaches knows no bounds. They’ve celebrated many achievements and expansions this year, including offering new-and-improved PCR testing across various outpatient practices. “Our team has had several notable accomplishments over the past year,” said Breanna Van Dyck, Medical Lab Scientist and Lab Program Coordinator. “We successfully rolled out a massive Cepheid PCR testing initiative to over 30 Renown outpatient locations within the community. This expansion significantly improved our testing capacity and accessibility and will help ensure timely and accurate diagnostic tests for respiratory viruses and strep to a broader patient population, including our rural practices.” By combining cutting-edge technology with compassionate patient care, our Point-of-Care team members are essential to contributing to Renown’s goal of providing efficient, high-quality care tailored to each patient’s individual needs. Take a Point-of-Care Tour! The Point-of-Care department covers a lot of ground around Renown, reaching Reno, Sparks, Carson City, Fernley and Fallon. Take a glance at the photo carousel below to put yourself in the shoes of our Point-of-Care team members on a regular day!