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In honor of International Women’s Day, we’re working to spread the word about taking care of your breast health and encouraging the women in your life to do the same.  Heather Reimer is on a mission — a mission to educate women everywhere about breast tissue type. For women with dense breasts, knowing your breast tissue type is absolutely critical, as cancers embedded in dense breast tissue are not always detectable with a mammogram alone. Dense breast tissue requires a breast ultrasound screening to get a complete breast health picture. Whole Breast Ultrasound for Dense Breast Tissue Heather knows this firsthand. She has dense breasts, and in this video she shares her story about finding breast cancer during a breast ultrasound screening — cancer that went undetected with her mammogram screening alone. As a result of that experience, Heather founded Each One. Tell One. — a movement to encourage women to pass along this information to others and to prompt those with dense breast and implants to consult with their doctor to schedule a whole breast ultrasound screening. To schedule a mammogram or a whole breast ultrasound, call 775-982-8100.

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Menopause is something that every woman experiences at some point in her lifetime. Learn what to expect and how you can help manage the symptoms and health risks. Most women don’t experience menopause until their 50s, but certain factors such as chromosomal abnormalities, glandular problems and chemotherapy can cause early menopause before the age of 40. No matter what your age, it’s a good idea be aware of the risks and treatments available to maintain a comfortable and healthy lifestyle. Health Risks of Menopause Two of the biggest health risks posed to women who have gone through menopause are bone density loss and risk of cardiovascular disease. Bone loss can be treated with bisphosphonate and estrogens. “Calcium with vitamin D and weight bearing exercise will also limit bone loss,” says Vickie Tippett, MD and OB/GYN at Renown Health. For cardiovascular risk, a healthy lifestyle is key. Discontinuing tobacco use, getting regular exercise and maintaining a healthy weight and diet all help reduce a woman’s risk of cardiovascular disease. Managing Discomforts of Menopause One of the most common complaints about menopause is the discomfort of hot flashes. “Hot flashes can be treated with systemic estrogen alone or in combination with progesterone or another agent similar to estrogen,” Dr. Tippett says. “Non-hormonal medications such as SSRIs and antidepressants also work.” Vaginal dryness, another common symptom of menopause, can also be treated with estrogen, estrogen-like compounds and personal lubricants. Pills, patches, creams and many other formulations are available to help alleviate discomfort. Knowing when, why and what to expect when it comes to menopause can help make the transition easier. Learn the facts about menopause in the infographic below.

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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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Thanks in part to the care provided by Renown’s award-winning team of ICU nurses, Tony Mowatt is alive, thriving and engaged. Read his story — and learn about the exclusive Beacon Award of Excellence — below.  The open road. The growl of the engine. The feeling of freedom. That’s what Oakland resident Tony Mowatt was enjoying as he drove up Highway 88 toward Reno for the semi-annual Street Vibrations event. But he wasn’t expecting to hit the diesel truck — or to fly off of his bike over 100 yards, skidding onto the side of the road. He was severely injured and in the midst of rural Nevada. He had crashed just outside Centerville, Nev., and was miles away from any critical care hospital. Having the only trauma center equipped to treat his serious injuries, Tony was flown to Renown Regional Medical Center and admitted to the intensive care unit (ICU).   ICU Nurses Treat Patient, Support Family  Tony’s girlfriend, Tasha Klubock, was notified by his friend that he had been taken to the hospital. She immediately drove from Oakland to Reno to see Tony at Renown. Her first night there was overwhelming and scary — nobody knew if Tony was going to survive. But the nurses helped Tasha cope with the initial shock. Caring for the patient isn’t their only job — they also care for the family. “They [the nurses] just kept coming in and checking on me,” she said. “Angela was so amazing that first night. I really just bonded to her, and I remember when the shift switched, I panicked thinking about who was coming on and wanting to meet the next nurse … But they all came to talk to me — I had updates from everybody. It was just amazing.” ICU Nurses Became Family Tony spent 32 days in Renown’s Sierra ICU, surviving a serious head injury, all with Tasha by his side. He and Tasha still stay in touch with Renown nurses. “Even though this was literally one of the most hideous, craziest things to go through,” Tasha said. “There was so much hope and they became such a family to me and I still think of that time fondly because of the nurses.” “I’m alive because they wanted me to be,” Tony said. And Tony and Tasha are now happily engaged and planning their wedding. Exceptional Care: Renown ICU Nurses Win Awards Renown’s ICU nurses provide care like this every day to countless patients — it’s so second nature to them that they forget how exceptional it truly is. But it’s certainly care like Tony’s that has earned them national recognition. The American Association of Critical Care Nurses awarded the Beacon Award of Excellence to the Sierra, Cardiac and Roseview ICUs. These are the only ICUs in Nevada to obtain this honor. The Beacon Award recognizes critical care nursing teams who exemplify excellence in areas like leadership, process systems, quality care, knowledge, learning and development, excellence in patient care and superior patient health outcomes. “I couldn’t have been more proud of what we’ve done to accomplish this,” said Nick Dovedot, Cardiac ICU nurse. “It represents who we are. Just a great group of individuals who all work together as a team to make our patients get better.”

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Health insurance is complicated, but you don't have to figure it out alone. Understanding terms and definitions is important when comparing health insurance plans. When you know more about health insurance, it can be much easier to make the right choice for you and your family. A common question when it comes to health insurance is, "Who pays for what?" Health insurance plans are very diverse and depending on your plan, you can have different types of cost-sharing: the cost of a medical visit or procedure an insured person shares with their insurance company. Two common examples of cost-sharing are copayments and coinsurance. You've likely heard both terms, but what are they and how are they different? Copayments Copayments (or copays) are typically a fixed dollar amount the insured person pays for their visit or procedure. They are a standard part of many health insurance plans and are usually collected for services like doctor visits or prescription drugs. For example: You go to the doctor because you are feeling sick. Your insurance policy states that you have a $20 copay for doctor office visits. You pay your $20 copay at the time of service and see the doctor. Coinsurance This is typically a percentage of the total cost of a visit or procedure. Like copays, coinsurance is a standard form of cost-sharing found in many insurance plans. For example: After a fall, you require crutches while you heal. Your coinsurance for durable medical equipment, like crutches, is 20% of the total cost. The crutches cost $50, so your insurance company will pay $40, or 80%, of the total cost. You will be billed $10 for your 20% coinsurance.

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Health insurance might be one of the most complicated purchases you will make throughout your life, so it is important to understand the terms and definitions insurance companies use. Keep these in mind as you are comparing health insurance plan options to choose the right plan for you and make the most of your health insurance benefits. One area of health insurance that can cause confusion is the difference between a plan's deductible and out-of-pocket maximum. They both represent points at which the insurance company starts paying for covered services, but what are they and how do they work? What is a deductible? A deductible is the dollar amount you pay to healthcare providers for covered services each year before insurance pays for services, other than preventive care. After you pay your deductible, you usually pay only a copayment (copay) or coinsurance for covered services. Your insurance company pays the rest. Generally, plans with lower monthly premiums have higher deductibles. Plans with higher monthly premiums usually have lower deductibles. What is the out-of-pocket maximum? An out-of-pocket maximum is the most you or your family will pay for covered services in a calendar year. It combines deductibles and cost-sharing costs (coinsurance and copays). The out-of-pocket maximum does not include costs you paid for insurance premiums, costs for not-covered services or services received out-of-network.  Here's an example: You get into an accident and go to the emergency room. Your insurance policy has a $1,000 deductible and an out-of-pocket maximum of $4,500. You pay the $1,000 deductible to the hospital before your insurance company will pay for any of the covered services you need. If you received services at the hospital that exceed $1,000, the insurance company will pay the covered charges because you have met your deductible for the year. The $1,000 you paid goes toward your out-of-pocket maximum, leaving you with $3,500 left to pay on copays and coinsurance for the rest of the calendar year. If you need services at the emergency room or any other covered services in the future, you will still have to pay the copay or coinsurance amount included in your policy, which goes toward your out-of-pocket maximum. If you reach your out-of-pocket maximum, you will no longer pay copays or coinsurance and your insurance will pay for all of the covered services you require for the rest of the calendar year.

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Award given to Truckee Meadows Health Communities, Renown Health & Washoe County Health District. Truckee Meadows Healthy Communities (TMHC), Renown Health and the Washoe County Health District received the BUILD Health Challenge® award, a $250,000 grant to support Caring For Reno’s Elders (C.A.R.E.) program. The award comes as a collaborative result of more than 30 local organizations submitting a proposal for the funding. Renown Health announced that the organization is matching the grant alongside other pledged funding from the community, bringing the current C.A.R.E. support to $580,000. Together the entities will focus on senior loneliness and the health issues it creates. The partners are honored that Truckee Meadows was selected as one of 18 communities to receive funding from BUILD in the 2019-2021 term. “C.A.R.E will be a community approach to enhance life quality for elders by reducing social isolation and loneliness, issues that seriously impact senior health,” said co-team leader Kindle Craig, Sr. Director Renown Institutes. “Loneliness is the root cause of many issues including suicide1 , chronic disease2 and a reduction in lifespan3 . Washoe County senior suicide rates are two and four times the national rate for those aged 65 and 85 years, respectively4 . That is unacceptable.” Sharon Zadra, TMHC executive director and co-team leader, said this project will tackle barriers to socialization such as access to affordable housing, transportation and healthcare.  “We’ll bring the entire community on-board, long-term, to increase social connectedness and reduce health and mortality issues associated with loneliness by starting a cross generational ‘Kindness Epidemic,’” Zadra said. The BUILD Health Challenge is a national program focused on bold, upstream, integrated, local and data driven projects that can improve community health. The award provides funding, capacity building support and access to a national peer-learning network to enhance collaborative partnerships locally to address our community’s most pressing health challenges. The C.A.R.E team expresses special thanks to the BUILD Health Challenge for its support of this initiative. “Loneliness and isolation in our senior population leads to declines in both mental and physical health, and increased mortality,” said Kevin Dick, Washoe County District Health Officer. “We are incredibly honored to join the BUILD cohort, teaming with TMHC and Renown Health to bring long-term solutions by building a cohesive social network to improve the health of our elders.”  The BUILD Health Challenge® is made possible with the support of: BlueCross BlueShield of South Carolina Foundation, the Blue Cross and Blue Shield of North Carolina Foundation, Blue Shield of California Foundation, Communities Foundation of Texas, de Beaumont Foundation, Episcopal Health Foundation, The Kresge Foundation, Methodist Healthcare Ministries of South Texas, Inc., New Jersey Health Initiatives, Robert Wood Johnson Foundation, and W.K. Kellogg Foundation. TMHC, Renown Health and WCHD have worked united for the last five years, rallying diverse partners and community leaders to influence and advocate for the region’s capacity to ensure a healthy community.

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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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When finding a provider to receive your health services, you've probably heard the terms "in-network" and "out-of-network" when it comes to your health plan. But what do these terms mean for a patient? And why should you be aware if a provider is out-of-network? What does it mean when a provider is "in-network" with a health plan? A provider is a person or facility that provides healthcare. When a provider is in-network it means there is a contractual agreement with that health plan regarding the rates for services. The provider will accept negotiated rates for services from the insurance. This means a patient will typically pay less for medical services received and is less likely to receive surprise bills. What does it mean when a provider is "out-of-network" with a health plan? Providers that are out-of-network are those that do not participate in that health plan's network. The provider is not contracted with the health insurance plan to accepted negotiated rates. This mean that patients will typically pay more or the full amount for the service they receive. Why should patients see in-network providers? Seeing an in-network provider for medical services can significantly reduce your medical expenses. Remember that in-network providers have a contractual agreement for negotiated rates with the health plan, so they cannot charge you more than that negotiated rate for a service. Seeing an in-network provider will always ensure any costs you do incur (copays or co-insurance) are applied to your health plan's deductible and out-of-pocket maximum (out-of-network costs don't apply to these amounts). To find the amounts you will pay for specific services, you can check your health insurance plan's Summary of Benefits. What is the best way to find which providers are in-network with a patient's health plan? Most health insurance companies offer multiple ways to find if a provider is in-network. To find the most accurate benefit information from your health plan, you can: Call their Customer Service department Check their website for their online provider directories If offered, check your online member portal.

Read More About Understanding "In-Network" and "Out-of-Network" Providers