Loretta Nevarez-Kells, RN, MS, OGNP

Hot flashes, itchy skin,  mood swings, and memory lapses – when the symptoms of menopause and  perimenopause appear, they create a barrage of questions in women's  minds struggling to prepare for this life milestone.  When will my  periods completely disappear?  Should I investigate hormone replacement  therapy?  Do I need to have my FSH (follicle stimulating hormone) level  tested?  Will my sex life change?    Patients can feel overwhelmed and  panicked by uncertainty while health care providers may feel challenged to address these concerns.

Taking the questions into a relaxed and less intimidating environment  by offering a happy hour discussion is a new, innovative success at  Scottsdale OB/GYN Women's Care, according to Loretta Nevarez-Kells RN  and nurse practitioner with a background in women's health.   Nevarez-Kells offers informative, yet casual and open happy hour  meetings held in a comfortable setting outside the clinic, where  patients can gather to discuss questions on life changes, options for  managing symptoms, products and more. 

The idea began with Nevarez-Kells getting together with her own  friends and seeing how easily questions and information flowed within  the group of women over a glass of wine and hors d'oeuvres.  She thought  that if her friends were asking questions about women's health, other  women could definitely benefit from the same kind of forum. 

Nevarez-Kells immediately saw the opportunity to help women learn  more about the symptoms and challenges of perimenopause and menopause,  knowing that this part of a woman's life is often clouded with  uncertainty, and panic.  Just as the day a woman begins her period is a  life altering moment, the days she realizes that she is no longer  menstruating is similarly significant.

Nevarez-Kells found that pharmaceutical and medical products  companies were more than happy to sponsor the meetings in order to have  the opportunity to have products and solutions presented.  It was a win  for her patients and a win for her practice at the same time. 

It became a very cost effective way for the practice to be able to  hold the meetings and defray some of the costs through the  pharmaceutical and other medical supply company sponsorships.  Women  responded, often asking friends or family members along for the  meetings.  The opportunity to educate current patients and reach out to  new ones was immediately opened.

Nevarez-Kells, a labor delivery nurse for 12 years before getting her  masters degree and teaching for three years at Arizona State  University, joined Scottsdale OB/GYN Women’s Care three years ago.  She  credits her teaching at ASU as the foundation for her in looking at  overall health and not just obstetrics and gynecology in terms of  pregnancy and birth only.

Women's healthcare  has evolved rapidly in the past several years and the changes mean  spending more time with patients, explaining the details behind test  results and working together to achieve overall health, according to  Nevarez-Kells.

"When I first came into the practice, we were doing bone density  tests as part of our exam routine," she says.  "Then, we began looking  at cholesterol levels and helping patients understand what it means to be heart healthy."

Nevarez-Kells found the more time she spent with her patients, the  better their health.  She could extrapolate information from medical  conferences and provide it to her patients.  Instead of just saying that  a patient's lab work was normal, she began helping her patients  understand what that exactly means to them now and later in terms of  health.  She found that meetings outside of the schedule of the office  allowed for time to discuss the importance of bone density  testing, taking calcium, exercising and helping patients understand  that it is possible to make a new, healthy plan for every year no matter  where they are in their lives.

Meeting together in groups empower the women to discuss topics that  might be uncomfortable in a clinical environment and also give them the  opportunity to learn the answers to other questions they might not have  even considered.  The approach to addressing and maintaining women's  health overall and not just looking at lab results or handing over  prescription refills has been very empowering for patients as well as  for the practice, according to Nevarez-Kells.

"There are changes for every decade," Nevarez-Kells says.  "Besides  addressing her reproductive system, we're looking at maintaining quality  of life from her psychosocial well being to taking care of her heart,  her bones, her weight - looking at the patient as a whole."

And meeting together in groups outside of the office gives this nurse  practitioner the opportunity to better address questions that can  impact a woman's overall health. 

Topics like being comfortable in your own body, learning about  masturbation and orgasm and having a fulfilling sex life even as your  body goes through the stages of menopause are all up for discussion in  the non-threatening forums.  Patients are often better able to talk  together and ask questions without being intimidated by the subject  matter according to Nevarez-Kells.  And Nevarez-Kells helps patients  understand products and what they do, while trying to match a patient's  specific needs and wants to a particular product.    "I always try to  talk a little about the sexuality part because sometimes, as women who  are married, we forget," Nevarez-Kells says.  "We get complacent with  our partners too. You have to go back to thinking about your partner on a  regular basis."

An offsite, relaxing environment is also more conducive to patients  interacting with each other about personal relationship challenges, the  difficulties of balancing romance and the daily stresses of bills,  childrearing, grocery shopping, household budgets and everything else  that can complicate a relationship.  Today’s women often find themselves  with many responsibilities and demands on their time.  Women with busy lives  can forget that multi-tasking takes a big chunk out of their time for  relationships, according to Nevarez-Kells.  Women worry about their  relationships, taking care of children, how their lives may change once  they are past the childbearing years, how their relationships may change  and more.  Getting together with other women to talk about these topics  help patients realize they are not alone and gives them a wonderful  sense of belonging.

Another bonus is that taking time away from the office to thoroughly  discuss patients' concerns also allows for more detailed information to  be shared about new diseases and information, such as the human  papillomavirus (HPV) vaccine, approved by the Centers for Disease  Control and Prevention (CDC) in June.  Although the vaccine is now only  available for the age group of 9 to 26, it has potential for older women  as well.  More women are curious about the disease and the vaccine, as  information becomes more widely disseminated in advertisements on  television and the Internet.

Nevarez-Kells is able to open each meeting up for many topics  important to patients and provide further details that help women  understand their health and options for improving it or maintaining it.   And, the informal gatherings are a good way not only to meet the needs  of her own patients but to introduce her practice to new patients as  well – a “win-win” situation for everyone.   In the happy hour meetings  and other social gatherings held by Scottsdale OB/GYN Women’s Care,  Nevarez-Kells has truly found a creative way to reach out to established  and prospective patients with minimal cost and maximum exposure.

Articles

Hot flashes, itchy skin, mood swings, and memory lapses – when the symptoms of menopause and perimenopause appear, they create a barrage of questions in women's minds struggling to prepare for this life milestone.  When will my periods completely disappear?

Loretta Nevarez-Kells, RN, MS, OGNP

Articles

Menopause and Cocktails: Good for Patient/Good for Practice