Helen Dandurand (Host): Welcome back to the Well Within Reach podcast. I'm your host, Helen Dandurand. And today, I'm going to be joined by Laura Redenius, nurse practitioner at Riverside's Primary Care Associates Bourbonnais, to shed some light on screenings.

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Host: And we are back. Thanks for joining us today, Laura.

Laura Redenius: Yes. Thank you so much for having me, Helen. I appreciate it.

Host: Of course. So, this is your first podcast with us. Could you start by telling us a little bit about yourself?

Laura Redenius: Yeah. My name is obviously Laura Redenius. I actually grew up in this area and moved down south in the Gilman area about when I was 10. So, it's been a while. I don't want to give out my age here. But primarily, I've worked in Women's Health. And Labor and Delivery, Postpartum, and Nursery is where I found most of my years working as a nurse. I've worked for 15 years, and I just finished my advanced nurse practitioner degree this, and just recently started working at the Bourbonnais Primary Care Group. And I have nothing but great things to say about everybody there, they're so nice and welcoming. And I could not be happier in regards to where I've chose to work.

Host: Great. Well, great to hear all that. So, that'll be good to kind of segue in here. Our topic of the day is regular health screenings and primary care screenings. So, could you tell us a little bit about why regular health screenings are like essential even for people who feel pretty healthy?

Laura Redenius: So, regular health screenings are important, because it helps us catch potential problems before they happen or hopefully before they've caused other issues in your body. So, regular screenings that we do, we screen for thyroid disorders, vitamin B, vitamin D deficiencies, cholesterol screenings, and then electrolyte screening.

So, let's just go down to the basics of vitamins. So, you wouldn't think that vitamin D is that important other than people think of vitamin D, "Oh, I get enough sunlight. I have to have enough," right? Well, that's actually not true. We're not close enough to the equator to have enough vitamin D in our bodies. And vitamin D can actually mimic symptoms of anxiety and depression, as simple as that. So, most people around this area are actually vitamin D deficient. And so, it just brings very good information to people. Some very basic stuff, just an over-the-counter pill you can take every day to basically feel better.

Also, hypertension is known as the silent killer. So, people can go years without having symptoms of hypertension. Unfortunately, if health screenings are prolonged and they don't see their provider until later in life, now hypertension has caused potential damage to multiple organs. And now, we're having to deal with not just hypertension, but neuropathy, the feet, the eyes, kidney failure. So, it's really important to try to catch all these early.

Host: Got it. Yeah, that makes total sense. So, it can be something very serious in that capacity where it can really, you know, in the long run hurt you if you don't know in advance, but it could be something like that vitamin D where it would just make your quality of life better to know that and get that taken care of.

So yeah, that's really great. Is there like a schedule of how often patients should undergo specific common screenings like cholesterol checks, mammograms, colonoscopies, that kind of thing?

Laura Redenius: Yeah. So, the way I practice is that I would like to get a baseline lab on everyone. So, if you start seeing me at the age of 12, the age of 18, I like to get a baseline and see how everything is because everyone's baseline is different. So, if I have something to compare to, if I do it when you're 18 and not again until you're 25, at least I know that was your norm to start with or that's what we were working with to try to change maybe lifestyle habits to a better goal, okay? So, cholesterol screenings, like I said, baseline. And then, depending on the results, maybe not for another four years.

Again, with diabetes screening, maybe not again for a while depending on if you have a family history. Mammograms though, we start at age 40. Breast cancer I feel is becoming more prevalent. It's more of a common word unfortunately. Insurances typically pay every year so we recommend yearly mammogram screenings.

Colorectal cancer, that starts at age 45 unless you have a strong family history and again even with breast cancer. You can do breast cancer screening, colorectal screening potentially sooner if there is a very strong familial history. But colorectal screening starts at age 45. And with colonoscopies, as long as they don't find anything, colon cancer is very slow-growing. That's why they recommend every 10 years for a colonoscopy. Now, if they do find something, then they'll tell you when you need to follow up.

There's also Pap smears. So, we do recommend Pap smears. Pap smears start at the age of 21. The guidelines have changed a little bit over the years. So, at the age of 21 to 30, it's every 3 years. And then, after 30, it's every three years with just cytology only or every five with HPV screening. And HPV screening is important because HPV is the precursor to cervical cancer. So, those are also very important to get those done.

Host: Definitely. Is there a place that you can go to see what screenings you should get by age? Is there a good resource that you know of or just your primary care provider is your best resource?

Laura Redenius: So, your primary care provider is your best resource in regards to what's best for you. Sure. There are multiple guidelines out there right now. So if I saw somebody who has a history of breast cancer and their mom has had breast cancer, their sister, their aunt, my plan of care may change for that patient. So, while Google is a great resource for some things, sometimes, in regards to healthcare, it might prevent or hinder a patient from going to see them when they need to should see them sooner.

Host: Definitely. That's why you need that personalized touch of a provider that knows you. And like you said, having your baseline, that was really interesting. I had never really thought of it that way, but knowing what your baseline is so then you know what differentiates from that. And when you might need to look into things more is great. And then, you were just kind of chatting a little bit about, yeah, the family history portion of that and how you know what people should maybe screen for based on that. That was kind of my next question about explaining the role of age, gender, family history in determining the right screenings for a patient.

Laura Redenius: Yeah. So, age, gender, and family history all play a big part when it comes to determining the right screening for someone. So, like I said, someone who's young, healthy, has no other comorbidities, meaning any other diseases that they were previously diagnosed with, has a healthy weight, does not smoke, does not drink alcohol, I'll probably just do a baseline on him and have him come in yearly to be checked.

The two screenings that most people don't really think about is when you're, you walk into your healthcare provider's office, your blood pressure is typically taken every time. So, we do a hypertension screening right there. We also ask questions in regards to depression. Depression is considered the fourth leading cause of death in people ages 15 to 29, according to the World Health Organization.

So, just asking two questions can open up a door and a conversation between a patient and a provider that could be life-changing for them or at least give them resources in the community because we have a lot that aren't used and help them in every way possible.

And then, the reason we ask people to come in yearly is just to guide them, guide them into a healthier lifestyle or promote the lifestyle that they're having. While doing that, we are able to pick on potential changes in their life or add screenings that we see fit to what's going on in their life, all with the goal in mind of disease prevention.

Host: We are going to take a quick break to talk about primary care at Riverside.

Riverside knows that health is your greatest asset and that your primary care provider is your partner in health. Find a primary care provider that fits your needs at riversidehealthcare.org/primarycare.

And we are back. So, I guess my next question here is what advancements in screening technology are making it easier and more effective to detect health issues early?

Laura Redenius: Yeah. So, mammograms come to mind for me. So while the recommendations are different for mammograms, you can do them yearly. And actually, the American Breast Cancer Society states to do them yearly, but they're becoming more specific every year. And if your insurance covers it, if there are any abnormalities, there's something called an ABUS, which is an ultrasound, or an MRI as well, which is more specific in finding any abnormalities. For patients who may not be able to physically complete a colonoscopy for colorectal screening, the Cologuard is also another option, and this is sent to your house, and then you send it back. It's not necessarily prevention, but it's specific for testing that, if it came back positive, would require further testing. At least you know that we need to have further testing versus doing nothing at all. The Gardasil vaccination is not necessarily a screening tool, but it is an advancement that has come in helping prevent cancer from HPV, which like I said earlier, HPV is one of the leading causes of cervical cancer, but it is also recommended to men and women.

Host: How would you say that patients could best prepare for their screenings in order to, like, ensure accurate results, that kind of thing? I'm sure it varies, but any tips for that?

Laura Redenius: Yeah. So, patients can prepare themselves for screenings by asking questions. We're there to help guide your healthcare. I don't want to be the person that tells you what to do. I want to say, "These are your options. What would you like to do?" Or say, "These are your best options to do." I love having patients who ask questions because I feel like it helps them gain more control of their healthcare and their knowledge base.

So, lipid panels are often ordered for cholesterol screenings. This is important to test to be fasting for to get the most accurate results. So, we also want you to be honest. So if you went and got your labs done and you didn't fast, it's not a big deal. We'll just repeat them. So, at least I know that that abnormality is because you ate and that's okay. Along with testing for fasting blood sugar, you always want to be fasting at least 8 hours with nothing to eat or drink prior so we get an accurate fasting blood sugar.

Host: Got it. So, you should definitely ask questions and be honest.

Laura Redenius: Yes.

Host: Definitely. What role would you say that lifestyle changes play in conjunction with these regular screenings to maintain your overall health?

Laura Redenius: So, lifestyle changes can be the first thing your provider requests you to do prior to prescribing any medications, and it can also be one of the most effective things. I've seen pre-diabetics, diabetic patients, specifically type 2, hypertensive patients change diet and lifestyle and no longer have these comorbidities. This decreases potential other issues that they could have in life.

With today's world being so busy, I think in general we do the best we can to keep up with our lives, right? No one intentionally chooses to live unhealthy life. Sometimes we get caught up in the day to day and the hustle and we forget to take care of ourselves. We're always taking care of other people. So, a yearly check can help motivate people into getting their health under control with or without medications. Now, however, there are patients who are genetically predisposed to certain comorbidities. And for these patients, our goal is just to prevent further complications.

Host: Got it. That definitely makes sense and good to think about, you know, like, it could just be motivational to go and to find out like, "Hey, you could do better at this a little bit." It might be something you already kind of know. But then, just like putting it out there and having that conversation is a good way to start down that path. So, that's really great. So, how would you say you handle situations where a screening reveals a potential health issue, and what are the next steps as a patient? What would I expect if something like that were to happen?

Laura Redenius: When a patient's screening reveals a potential health issue, I, one, want to reassure them. For certain, if you have any diagnoses or lab results, it's nice to have your provider be the one that calls you because one, I just feel like it shows that I do care and I truly do. That's why I'm here. I care for other people. I want to see them live a healthy lifestyle. Two, I'm hoping that because we're performing these screenings that we caught something early on and that, "Hey, we caught it early, now we can do the right thing or reassure them that they did the right thing by doing the screening. We caught it. Now, we can deal with it."

I then provide them with information regarding what the diagnosis is and what was found and then refer them to a specialist if needed. If it is something that I can treat in primary care, I give all potential options possible for treatment and do my best to guide the patient in the best direction for the best outcome.

Host: Great. That's good to know. I feel like that can be maybe almost something that limits people from even getting them, even though that's kind of counterintuitive. But just saying like, "I don't know what's going to happen if there is something. You know, I'd rather just put that off for a while." so, it's good to know kind of reassuring that like your provider will be there every step of the way and have the right answers that you need.

Finally, I just want to ask what advice would you give to someone who's overdue for their health screenings and isn't sure where to start with that?

Laura Redenius: Yeah. So, the advice I would give to someone who's overdue for healthcare screenings would be to put yourself first. Pick up the phone and make the appointment. As I said before, if you're not making an appointment because you're too busy, none of it will matter if you're not here. So, start your prevention early and we can prevent complications that would occur later on in life.

Host: Great. Well, thank you so much. Is there anything else you wanted to add today?

Laura Redenius: No, I appreciate you having me on.

Host: Of course. Yeah. Thank you for being here. And thank you listeners for tuning into the Well Within Reach podcast brought to you by Riverside HealthCare. For more information, visit riversidehealthcare.org/primarycare.