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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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Renown Thanks Community as COVID-19 Drive-Thru Ends
After administering more than 73,000 dose one and dose two vaccinations to our community, Renown's vaccine team will conclude its efforts at Renown's drive-thru site later this month. Renown Health has been pleased to work with the Washoe County Health District, the state, and the CDC to distribute the limited supplies of COVID-19 vaccines. Leaders of the COVID-19 vaccine taskforce at Renown announced today that Wednesday, May 12, 2021 will be the last day the organization will administer dose one of the COVID-19 vaccine to community members at Renown’s drive-thru clinic. Renown's vaccine clinic will remain open until all individuals who receive their first dose of the vaccine through Renown have the opportunity to receive their second dose. To date, Renown’s vaccine team has administered more than 73,000 dose 1 and dose 2 vaccinations to medical staff members, Renown employees, students, volunteers and eligible community members. “It has been an honor assisting our local and statewide health partners in the herculean feat of vaccinating the hundreds of thousands of area residents excited to receive the vaccine,” said Tony Slonim, MD, DrPH, President and CEO of Renown Health. “As we conclude our efforts at our drive-thru vaccine clinic, we are glad to continue working closely with our community health leaders and be ready to assist once again should there be a need for our support in the future. We are proud to be part of the solution for our community and pleased to have made a genuine difference in the health and well-being of others throughout this unprecedented time in our history.” “As we look forward to a brighter future beyond the pandemic, we can’t help but reflect on the more than 73,000 vaccine doses our teams administered to our community,” said Melodie Osborn, RN, Chief Nursing and Quality Officer for Health Services at Renown. “From our nurses, pharmacists, security teams, public safety experts and countless volunteer staff, each dose of the vaccine was made possible—rain, snow or shine—by dedicated healthcare champions committed to the health and safety of northern Nevadans.” “We want to offer our sincere gratitude and appreciation to the public for placing their trust in Renown to receive their vaccines, and for their patience and support of this important work,” said Wendy Meyers, Manager of Health and Wellness at Hometown Health. “The masked smiles, emotional tears of gratitude and relief, heartfelt thanks, food deliveries and many other acts of kindness will forever hold a special place in our hearts.” Community members 16+ still interested in receiving the Pfizer vaccine at Renown on May 12 are invited to make an appointment through MyChart; and walk-ins will be accepted from noon to 2 p.m. Minors ages 16 and 17 must be with a parent or guardian to receive the vaccine. For assistance, please call 775-982-2781. To schedule your COVID-19 appointment in Washoe County outside of Renown, please visit covid19washoe.com. Renown will continue providing ongoing updates to help keep our community safe on our website at covid.renown.org. About Renown Health Renown Health is the region’s largest, locally governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 7,000 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 region’s largest, locally owned not-for-profit insurance company, Hometown Health. Clinical institutes include; Cancer, Heart and Vascular Heath and Neurosciences. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project®. For more information, visit renown.org
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First COVID-19 Vaccines Administered to Physicians Today
This week, many of the nation’s health care systems in communities across the U.S. began vaccinating physicians and health care workers caring for patients with COVID-19. Many of these health care heroes have been on the front-line of this pandemic and working around-the clock over the last ten months. Vaccinations signal hope for the future Here in Washoe County, today is the highly anticipated start date of what public health and medical experts hope is a nationwide wave of vaccinations that signal the beginning of the end of the COVID-19 pandemic. Today’s good news from Renown coincided with a dark new milestone for Washoe County—384 confirmed COVID-19 deaths, and over 13,579 active cases in our population of nearly 500,000. COVID-19 positivity test results and hospitalizations continue to be high across the country, our state and here in northern Nevada; straining hospital capacity, physicians and healthcare workers. Today we saw a bright light at the end of this dark tunnel. Renown began vaccinating health care workers caring for patients with COVID-19, and invited media to view the first vaccinations of those on the front-line of COVID-19. One vaccine, a Herculean effort of thousands “Although the vaccination process as you see it here looks relatively simple, it took a herculean logistical effort to implement the COVID-19 vaccination process that has begun today,” said Tony Slonim, MD, DrPH, President & CEO of Renown Health. “Today, thanks to the synchronized efforts of thousands of people and organizations across the country, we give thanks for this vaccination provided to Luis Martinez, an excellent ambassador for the thousands of healthcare heroes caring for patients with COVID-19. The health and safety of our staff is our top priority, and we remain steadfast in our determination to fight the good fight for our community.” Luis, on the front-line of the COVID-19 pandemic, receives 1st vaccine from Renown Luis Martinez received the 1st of his Pfizer-BioNTech vaccine which received emergency use authorization from the Food and Drug Administration last week. He will receive the second and final vaccination in the series in 21 days. The first dose of vaccine was given to Luis outside of his vehicle so cameras could capture the experience. Renown’s COVID-19 Vaccination process includes pre-scheduling physicians and employees through the Epic MyChart electronic medical record used by Renown. Employees are masked, and in their personal vehicles, as they drive through the vaccination site. Each physician and healthcare worker provides their verification, identification, documentation and consent. They then extend their upper arm to receive the Pfizer vaccination. Following the receipt of the vaccination they have a 15-minute observation period to assure they do not experience any immediate side effects. These Tier 1A healthcare employees were encouraged to schedule their vaccination after their completed work schedule to have time to rest. As with all vaccinations, there is a potential for injection site reactions (redness, swelling and pain) as well as fever, fatigue, headache, chills, vomiting, diarrhea, muscle pain and/or joint pain. Fever is not an infrequent side effect, especially on the 2nd dose, so these vaccinated employees will self-monitor their temperatures, as they cannot work at Renown with a fever. In addition to Luis, you’ll see, first in his truck- Dr. Bret Frey, representing the Medical Staff and Emergency Medicine physicians at Renown; Nurse Matt Polak, Supervisor of Clinical Nursing of Renown’s Respiratory Intensive Care Unit representing Renown nurses; Holly Irwin, a Clinical Respiratory Therapist in her vehicle; Alexis Bertauche, Respiratory Specialist in his vehicle; Eric Whitney, the supervisor representing the 168 members of Renown’s Environmental Services team who have performed extensive disinfecting measures throughout the pandemic, physician representatives from partners at UNR School of Medicine, Reno Orthopedic Clinic, the Surgery Center of Reno and across the community. Brighter days ahead for Luis Luis has been working in Renown’s Alternate Care Site in the Mill Street parking structure since it opened to patients in mid-November. He’s been at Renown since 2016, where he started as a phlebotomist and was encouraged to explore career advancement in the medical field. He applied to work as a technician on Renown’s Clinical Decision Unit- a short stay unit within the hospital for people who need clinical care, but do not need to be admitted to the hospital. Luis worked with patients and clinicians in the Clinical Decision Unit for a year before requesting to work in Renown’s innovative Alternate Care Site, built for patients recovering from COVID-19, for additional care before they returned home. Luis was scheduled to take the Medical College Admission Test® in April of this year to fulfill his dreams of becoming a doctor, but the COVID-19 pandemic forced him to change his plans. He plans to reschedule his medical school admission exam in February. He is excited to begin his training, possibly at UNR School of Medicine, and hopes one day to be a physician caring competently and compassionately for those in need. Luis has so much to look forward to, after such a difficult year. Luis turned 33 in October, and on his birthday, contracted COVID-19 after attending a family party. He experienced fever and noticed how dramatically the COVID-19 virus affected his breathing, his lungs, and his energy level. After spending time at home recovering, Luis recovered, tested negative, and returned to work. As a result of his experience and his interest in medicine, Luis has done a lot of research on the vaccine. Luis is bilingual and volunteers with CARE Chest of Sierra Nevada, a non-profit organization that provides free medical equipment, supplies, and prescription assistance to underserved populations when he is not working at Renown. Vaccine one more tool to help fight pandemic “The best protection from COVID-19 will be a combination of getting a COVID-19 vaccine, wearing a mask, staying at least 6 feet away from others, avoiding crowds, and washing your hands often,” says Amy McCombs, MSN, RN, CCRN, CNML, vice president of Quality for Acute Services for Renown, and the champion of the vaccination effort for Renown. “No one tool alone will stop this pandemic, it will take a combination of all of us using all of these efforts to fight the spread of this virus. Though there has been positive news about vaccine development, no one knows when those vaccines will be ready for widespread use. In the meantime, everyone must remain vigilant, take precautions and follow public health orders.” “This vaccination is a game-changer in terms of improving the health of our community,” said Paul Sierzenski, MD, MSHQS, Chief Medical Officer, Acute Services, Renown Health. "Given the demands of this COVID-19 pandemic, we are pleased to be able to provide this vaccination to help in the fight. We will follow CDC recommendations for a tiered approach to vaccine distribution. Our goal is that by spring, all Renown physicians; employees and their family members; and all Hometown Health members and Renown patients interested in receiving the vaccine will have an opportunity to be vaccinated.” The COVID-19 vaccine is not mandatory for all Renown employees, but is strongly advised. Renown is covering all costs of the vaccine, and it is being offered free of charge to employees. Register for Renown Epic MyChart now. To streamline the notification, consent, scheduling and reminder process for vaccine distribution, as well as to post to Web IZ Nevada’s Statewide Immunization Information System, all who are interested in receiving the vaccine through Renown will need to enroll and obtain an Epic MyChart account. Stay Up-to-date on COVID-19 Renown Health is prepared to safely screen, diagnose and care for patients with respiratory illness, including COVID-19. To stay up-to-date on communications regarding Renown’s distribution of the COVID19 vaccine, FAQs and the scientific evidence behind the vaccine, visit https://covid.renown.org/ Join the Renown team Renown Health remains committed to hiring key roles in our organization to support the health and well-being of our community. To join the Renown family to Fight the Good Fight, apply on line at https://careers.renown.org/ Support the Renown team Renown Health, a charitable, not-for-profit organization, is so grateful for our community’s support during these unprecedented times. To donate to Renown patients or providers, visit https://www.renown.org/donations-covid-19/. About Renown Health Renown Health is a locally governed and locally owned, not-for-profit integrated healthcare network serving northern Nevada, Lake Tahoe and northeast California. Renown is one of the region’s largest private employers with a workforce of more than 7,000. It comprises three acute care hospitals, a rehabilitation hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown has a long tradition and commitment to continually improve the care and the health of our community. For more information, visit renown.org. About the Washoe County Health District The Washoe County Health District has jurisdiction over all public health matters in Reno, Sparks, and Washoe County through the policy-making Washoe County District Board of Health. The District consists of five divisions: Administrative Health Services, Air Quality Management, Community and Clinical Health Services, Environmental Health Services and Epidemiology & Public Health Preparedness. More info can be found here.
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