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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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Renown Home Care dedicated to improving your health in the comfort of your home. With over 35 years of service, we help you live independently when you have an illness or injury. We are recognized as Medicare-certified and accredited by The Joint Commission. Available for referrals and questions 24 hours a day, seven days a week. Call us at 775-982-5860.  Your home health care team includes:  Medical Director Registered Nurse Licensed Practical Nurses Certified Nursing Assistant Physical Therapist Occupational Therapist Speech Therapist Medical Social Worker Registered Dietitian – The only Home Health agency in the area that offers Dietitian services We provide the following care:   Balance & Mobility Training   Bladder Control   Blood Draws   Heart Care  Congestive Heart Failure (CHF) Care   COPD Management   Diabetes Management   Fall Prevention   Feeding Tubes   Home Infusion   Home Safety Evaluations   Medication Management   Neurological Therapy   Ostomy & Catheter Care   Pain Management   Surgical Aftercare   Total Joint Recovery   Wound Care

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What is an institute for cancer — and why does it matter that we have one right here in Reno? Here, a radiation oncologist answers those questions and more.  Sadly, our community health needs assessment shows cancer is the second leading cause of death in Washoe County. But many residents may not know there is an institute for cancer right here in Reno that can care for you or your loved one after diagnosis. Dr. Michael Hardacre, a radiation oncologist with Renown Institute for Cancer is here with more. What is an institute for cancer? The way I like to think of it: An Institute has healthcare providers highly trained in patient-centered care. For example, when you have cancer, many times you’ll see a lot of doctors. A program brings those doctors together — so you really have one team working together. An Institute takes that one step further. Say there are other needs beyond the doctor’s office such as nurse navigators, dietitians, physical therapists to help you get on track, etc. An Institute really proactively thinks of the need of the cancer patient. It then makes sure all those things are available to them throughout their treatment. The term “institute for cancer” identifies a cancer program that is comprehensive and multidisciplinary in nature. For Renown, that means that we have the specialists in medical oncology, surgical oncology and radiation oncology working together with other specialists to assure that a patient has coordinated care throughout the entire treatment course of cancer care. Together with cancer prevention and diagnostics, genetic assessment, supportive care, clinical trials, and cancer survivorship, the institute for cancer provides care for the community, families and patients along the entire spectrum of cancer care. What types of cancer do you treat? We’re fortunate to be able to provide cancer treatments for all types of cancers, and we’re one of the major referral centers for northern Nevada. Most commonly, just like much of the country, lung cancer, prostate cancer and breast cancer are the most frequent we see. Our care spans brain, to neck cancer and everything in between. As an accredited comprehensive community cancer program, Renown Health provides services for all cancer types. The highest volume cancers treated at Renown are breast, colorectal, lung, genitourinary, blood and gynecologic cancers. Most treatments can be done right here in Reno, but when there are specialty needs such as stem cell or bone marrow transplantation, we partner with quaternary centers, like Stanford, to assure a smooth transition of care both to and from the quaternary center. What kinds of care and treatments are offered? We offer a wide range of comprehensive care. We treat the cancer itself — surgical, radiation oncology, medical oncology in the form of chemotherapy or pills. Also addressed: dietary needs, physical therapy and navigation through this whole process. People may be surprised by the scope and scale of the Renown Institute for Cancer. For instance, our Radiation Center has the latest technologies to treat cancers. This includes the Linear Accelerators, which are machines with treatment planning software tools. In addition to the traditional external radiation treatments provided in most centers, Renown performs specialty treatments using High-Dose Brachytherapy, a treatment with an active radiation “source” and in Brain Stereotactic Radiosurgery, assuring that patients can stay right here in northern Nevada — close to home. What does that mean for the quality of care? I think it’s always great in any environment to have external people come into your program and not only share what’s happening nationally and what we could do better, but also to validate “are you doing things at the highest level you can?” That accreditation process is just one way to give us that seal of approval. We’re lucky enough this year to get the gold award by the American College of Surgeons — its highest honor. We were honored to receive it. Why is important that you’re an accredited institute? Accreditation assures our community that quality is a top priority for us. Each of the accrediting bodies has a set of standards that identify service and quality standards. Renown Institute for Cancer has the following accreditations: American College of Surgeons’ Commission on Cancer: Full Cancer Program accreditation, standards address issues from cancer prevention/diagnosis to treatment to survivorship and/or end-of-life. Renown received the Gold Level Accreditation in 2018, the highest level of accreditation possible; American College of Surgeons’ National Accreditation Program for Breast Centers: Full Breast Center/Program accreditation, standards address issues from breast cancer prevention/diagnosis to treatment to survivorship and/or end-of-life; American College of Radiology – Radiation Therapy: Full Radiation Oncology accreditation for radiation equipment, treatment planning, treatment and treatment follow-up; and American College of Radiology – Mammography Services.

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There are some important numbers to know when it comes to good health. Learn more and receive a free blood pressure check at a primary care open house Feb. 27 at Renown Medical Group – Double R. Know Your Numbers Adults are pretty good at knowing and memorizing numbers — from passwords and PINs to addresses and phone numbers. But what about the numbers that could help save your life? Heart disease remains the leading cause of death in the U.S., with 633,842 deaths attributed to the disease in 2016, according to the National Center for Health Statistics. The American Heart Association lists the vital numbers you need to monitor to help prevent heart disease as blood pressure, total cholesterol, blood sugar and body mass index (BMI). With these numbers, your doctor can assess your risk of developing heart issues such as atherosclerosis, which can lead to other serious heart conditions. Atherosclerosis is a condition wherein plaque builds up in the arteries — the blood vessels that transport oxygen-rich blood to cells, the heart and other organs. These fatty deposits clog the arteries, inhibiting blood flow and reducing the amount of much-needed oxygen the body receives. These blockages can lead to angina, coronary heart disease, peripheral artery disease and even heart attack or stroke. But knowing your numbers and keeping them in healthy ranges can mitigate your risk of atherosclerosis and other heart conditions. First things first: Make an appointment with your healthcare provider to see how you’re doing. Learn your numbers and discuss how they may increase your personal risk of heart disease: Total Cholesterol Because cholesterol contributes to the buildup of plaque, keeping your numbers in check means keeping your arteries free of blockages. Check LDL (bad) cholesterol and HDL (good) cholesterol. Your body needs low levels of LDL, but not enough good cholesterol in your system can also increase risk. You can maintain healthy numbers by staying physically active and consuming a heart-healthy diet low in cholesterol and sodium. Statins, the class of drugs used to reduce LDL cholesterol, have proven so effective that the U.S. Preventive Service Task Force recommended in November that all adults older than 40 with one or more risk factors consider taking them. Blood Pressure High blood pressure places undue strain on your heart and arteries to move blood and oxygen throughout the body. And a heart that’s working too hard can lead to stroke, heart attack and heart failure. High blood pressure cannot be cured, but it can be managed by eating a heart-healthy diet low in alcohol, staying active and maintaining a healthy weight. Blood sugar Given that the body converts most of the food we eat into glucose, or blood sugar, for energy, adding sugar to the diet can raise blood sugar to unhealthy levels and damage the heart, increasing risk of cardiovascular disease and obesity. Opt for foods that are low in fat and added sugars and, instead, get your sweets in naturally occurring foods. Let added sugars be a treat and not the norm. Body Mass Index (BMI) Your BMI is used to determine whether you’re at a healthy weight. If you’re carrying extra pounds, the heart has to work harder, which increases risk of heart disease. Losing those pounds and maintaining a healthy weight reduces the burden on your heart and blood vessels and improves your blood pressure and cholesterol levels. So eat a heart-healthy diet and get active — even if you simply walk for 30 minutes a day. Because no symptoms indicate that you have poor cholesterol numbers, high blood pressure or high blood sugar levels, getting screened and learning your numbers is vital. Your doctor can determine what healthy levels look like for you individually and work with you to develop a plan for staying in optimum ranges. That plan will include heart-healthy eating, exercise, abstaining from smoking and, in some cases, medication. It’s up to you to stick with that plan between doctor visits. Do it for yourself, but consider making a pact for a more heart-healthy, active life with a buddy. Research shows people stick with exercise plans longer when they have a partner. This article also appeared in the Reno Gazette-Journal’s Health Source Aug. 27.

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Although going to the bathroom is not a typical conversation among women and their doctors, it’s an important one. It is a topic you may want to discuss with a urogynecologist, a physician who diagnoses, manages and treats pelvic health conditions in women. Kerac Falk, MD, a urogynecologist and assistant professor at the University of Nevada, Reno and Renown Health discusses overactive bladder in women and how to treat it. According to the National Institutes of Health, about 1 in 4 women struggle with pelvic health conditions, with over 40 percent of women over age 60 experiencing problems. While these conditions may be common, they shouldn’t just be accepted as a normal part of getting older. In fact, many women don’t think of urine leakage as a medical problem, and only 1 in 3 women with incontinence seek care. So, while these conditions may be common, they shouldn’t just be accepted as a normal part of getting older. There are excellent treatment options that can significantly improve the quality of life. Overactive Bladder Symptoms in Women: As your body changes and ages, so does your pelvic health. Whether you just had a baby, are experiencing urgency issues or find you cannot go about your daily routine, sneeze or laugh without leaking urine – you’re not alone. An overactive bladder, also known as OAB, is more than feeling an urgent need to go to the bathroom. It can also include the following: Incontinence or lack of control over urination Waking up in the middle of the night to empty your bladder Going to the bathroom often, even every 30 to 60 minutes Symptoms of OAB can lead to a decreased quality of life, feeling as if you cannot go about your normal daily routine, or even become hazardous, increasing the risk of trips, falls, and bone fractures. Various Treatments are Available: Behavioral management (eliminating coffee, soda and alcohol which irritate your bladder) Pelvic floor physical therapy to optimize nerve and muscular function and coordination to prevent leakage Medications including tablets and local estrogen replacement Pelvic nerve stimulation and reprogramming treatments Botox to relax the bladder muscle Solutions for an Overactive Bladder: Simply put, OAB is a nerve and muscle problem, so the bladder needs to calm down. Although there is no underlying reason for OAB, some underlying conditions may exist, such as: High blood pressure Recent trauma Neurological conditions (such as stroke and multiple sclerosis) Lifestyle and non-invasive measures can usually reduce symptoms by as much as 50%, significantly improving quality of life. However, if these measures do not help your OAB, further bladder testing may be needed. Dr. Falk notes that “every patient has a unique situation and set of symptoms. My job as a urogynecologist and pelvic floor subspecialist is to work as a team with each individual to figure out what’s going on and design the best treatment approach that fits your needs and goals, whether that is conservative or with more advanced procedures. The outcome we are working towards is improved quality of life.” If you are bothered by your bladder, the best thing you can do is bring this up with your primary care doctor or gynecologist to begin to discuss solutions

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Being diagnosed with a chronic heart condition like atrial fibrillation (A-fib) can shift the course of your entire life. Embracing heart medications and lifestyle changes become your norm, and thanks to advancements in medicine and medical technology, managing the condition can bring you to a new sense of normalcy.  But what if a different option was possible – one that would make medications and activity limits a thing of the past?  This became the reality for Renown Health patient Richard Preyer after receiving a hybrid catheter ablation. Thanks to the vigilant surgical care of Shining Sun, MD, a cardiologist at the Renown Institute for Heart & Vascular Health, and his compassionate team, Richard has a new lease on life.  Minimally Invasive with Maximal Results  An A-fib patient since 2010 who had been living with an unfinished ablation, the 59-year-old Carson City resident turned to the internet to look for alternate solutions. He had heard that the Renown Institute for Heart & Vascular Health was a top-tier location for cardiovascular care. “I changed health insurance plans through Nevada Health Link to ensure I could see a Renown cardiologist,” said Richard.   Choosing a cardiologist was an even easier decision for Richard. Dr. Sun’s introductory Find a Doctor video on Renown’s YouTube channel, where he displayed his expertise and determination, was more than enough for Richard to choose him as his cardiac care leader.  At his first visit, Dr. Sun reviewed Richard’s records, and noted his prior unfinished ablation. The nine-hour procedure had been performed several years ago. With the enhanced technologies at Dr. Sun's disposal, Richard was excited at the thought of his life potentially being changed for good – with a minimally-invasive solution.  Dr. Sun collaborated closely with Richard’s previous and current care teams – including a surgeon who performed a maze operation on him right before his surgery at Renown, to ensure his hybrid ablation was tailored uniquely to him. “Dr. Sun is clearly a very powerful cardiologist with many connections, and the coordination between his team and my other doctors was great,” said Richard.   After working on the exterior of the heart in the first phase of the surgery and the interior of the heart during the second phase, Richard’s hybrid ablation was successful, completing the unfinished portion of his previous ablation.   “Fixing A-fib can take one to three ablations, and sometimes it never holds,” said Richard. “That is one of the largest reasons why I am so thankful for this procedure and how it ended up.”  Life After A-fib  Now comes the long, arduous healing process, right? Not for Richard. With only eight incisions (four on each side of his chest), he was able to remove his bandages after two days, and he healed completely in one week.  “I was even back to taking three-mile walks within a week of my operation,” said Richard.  No more blood thinners.  No more activity limits. And most importantly for Richard, no more heart-stabilizing medications that came with side effects he didn’t enjoy. He attributes his enhanced life to Dr. Sun and his team.   “I highly recommend Dr. Sun and everyone that works with him,” he said. “Everyone in the group, from the nurses and anesthesiologists going above-and-beyond to the schedulers who helped me navigate the appointment process, made me have a lot of confidence. Their calm demeanors made so much difference.”  Today, Richard now enjoys elongated walks in the northern Nevada outdoors, exotic vacations with his wife and, as he describes, “feeling like I’m in my 40’s again.” Learn more about the region's leader in cardiac health, heart and vascular care here.

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Breast cancer is the leading cause of cancer deaths in women in the U.S. That’s why early detection is so important. Dr. George Krakora, a radiologist with Renown Institute for Cancer, explains what to watch for and how new technology can lead to early detection. Most women know the importance of breast health and staying current with annual breast exams, but may not know that both screening guidelines and technology is evolving. So we asked George Krakora, MD, a radiologist for the Renown Institute for Cancer, what every woman should know about breast cancer detection and which screening method is right for them. First off, when should women start getting breast exams? Generally, women should start getting breast exams using mammography or ultrasound after they turn 40 years old. But we also want women ages 18 to 39 to talk to their primary care provider and ask for what’s called a formal risk assessment to see if screening is needed sooner. And you want to make sure your care provider is giving you a breast exam starting at age 25. It’s also a good idea to be familiar with how your breasts look and feel so you can report any changes to your care provider. What are the risk factors for breast cancer? Are there any preventive steps women can take? There a few risk factors you can’t control, like your age, family history of breast or other cancers, and if you have dense breast tissue. Your risk for breast cancer increases as you get older, and most breast cancers are diagnosed after age 50. Knowing your family history is important because a history of cancer and shared lifestyle can raise your risk. Your breast density can also increase your risk: Women with high breast density are four-to-five times more likely to get breast cancer than women with low breast density. But the good news is there are quite a few things you can do to prevent breast cancer, like not smoking, watching your alcohol intake, and maintaining a healthy weight with good diet and exercise. There are a lot of newer screenings out today. What is the difference between 2-D and 3-D mammography? In a 2-D mammogram, the tech takes X-rays of the breast. These pictures can show the radiologist if there are any lumps or tumors you might not be able to feel. In 3-D mammography, the process is largely the same but more X-rays are taken and it takes a few seconds longer for each image. This kind of exam detects 41 percent more cancers and reduces the number of false-positive results given to patients. This improvement in technology is great for both patients and their care providers. 3-D mammography provides better images of the breast, which allow doctors to more clearly diagnose and avoid false positives, especially in women with dense breast tissue. And what about a whole breast ultrasound. What is that? A whole breast ultrasound uses sound waves to detect cancerous tumors in the breast without using any radiation — it’s an ultrasound just like pregnant women get to check up on their baby. And the exam only takes about 20 minutes. We recommend these exams for patients whose mammograms have shown that they have dense breast tissue. Dense breast tissue can make it harder for doctors to see any abnormalities, lumps or tumors in a mammogram, so this technology ensures better early detection.

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