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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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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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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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