Why Nursing Is Still a Great Career Choice for Women – Donna Irving ARNP

Donna Irving, APRN of Naples, FLHi, My name is Donna Irving and I’m a Nurse Practitioner with Advanced Urology Institute.

I would say nursing, in general, [is] for women that get bored easily or they want some opportunity that will expand through a lifetime. You could still work into your sixties (60s) and still be able to do something in nursing and if you become a Nurse Practitioner you can have several specialties. You don’t have to rely on one specialty, you can go to another if you so choose so it gives you a wide variety of jobs within a job.

Kidney Stones: Risk Factors and Preventions

The prevalence of kidney stones in the United States has increased over the last decade. As many as 1 in 10 Americans have a kidney stone at some point in their lives, and every year more than half a million Americans go to emergency rooms for kidney stone related complications.

What are kidney stones?

A kidney stone is a small, hard deposit that forms in the kidneys. Stones occur when the urine concentration of crystal-forming substances—such as calcium, oxalate and uric acid—is more than the fluid in the urine can dilute.

They begin as small crystals and grow into larger masses (stones), which then make their way through the urinary tract. Unfortunately, a stone can get stuck on its way out of the urinary system, resulting in an unbearable pain that comes in waves until the stone eventually passes.

What causes kidney stones?

Genetics is one of the risk factors. If you have family members who had kidney stones, you are at a higher risk of having them yourself. Your risk is also higher if you have had kidney stones in the past.

Dehydration is another major cause of kidney stones, which is why more kidney stones occur in the summer. In fact, kidney stone frequency is known to vary by geographic location, with warmer climates having the highest rates of stone formation.

What you eat and drink makes a huge difference. Drinking enough fluids to make over two liters of urine a day reduces the risk of stone formation. Actually, as a rule, you should always check your urine for signs of dehydration. If your urine is dark or yellow, then you are not drinking enough fluid and run the risk of having stones.

Factors that increase dehydration will contribute to kidney stone formation. For instance, excess salt or sodium in food, such as in processed or fast foods, increase dehydration as the excess salt requires a lot of fluid to excrete. So reducing the sodium in your diet will minimize your risk of stone formation.

Matthew Truesdale, MD of Largo Bardmoor, FL

How do you know that you have kidney stones?

Kidney stones cause pain by getting stuck in the urinary system. Since the kidneys continue to make urine, which in turn can’t get out due to the blockage, the urine builds up, stretches the kidneys and leads to severe pain.

You will know you have kidney stones when you have severe, excruciating pain that comes in waves. The pain typically occurs in the back and does not get better with a change in position. Patients who have had kidney stones and also delivered children report that the stones are more painful than giving birth. In addition to pain, you may have fever, nausea, and even vomiting.

Kidney stones may require a trip to the emergency room if you have severe pain, nausea, vomiting, and a fever greater than 100.3 degrees. These symptoms constitute a urological emergency because they signal both a blockage and an infection. With the blockage preventing antibiotics from getting out via urine, you can get very sick, very quickly; hence the need for emergency care.

Emergency treatment with IV fluids at a hospital may be necessary if you are having nausea and vomiting to the point of dehydration. Emergency care is also appropriate when you have pain that cannot be alleviated by over-the-counter pain medicine.

What is the treatment for kidney stones?

The treatment for kidney stones depends on the size and location of the stone, and on the clinical stability of the patient. The most common approach is medical expulsion therapy—a conservative approach for healthy patients with stones that are small enough to pass on their own and with no fever or other signs of infection.
With medical expulsion, you are encouraged to drink a lot of fluid to help the stone pass on its own. You are also given medications to control the pain and to accelerate passage. If the stone is 5 millimeters or smaller (about half of your thumbnail), there is a 50% chance it will pass on its own and you will avoid surgery.

If you have severe pain, fever, chills and an inability to drink fluids, you may not qualify for medical expulsion therapy. In that case, a surgical procedure may be needed. There are two common surgical options: (1) ureteroscopy or laser lithotripsy, and (2) extracorporeal shockwave lithotripsy.

Ureteroscopy and laser lithotripsy are fancy ways of saying you go to sleep, a camera is inserted through your urethra to the stone, and a laser is used to break the stone into smaller fragments for removal. Extracorporeal shockwave lithotripsy means you go to sleep and sound waves are sent through your skin to fracture the stone into small pieces that can pass on their own in urine.

The advantage of shockwave lithotripsy is that nothing goes into your body, making it less invasive. However, the disadvantage is that the stone fragments still have to pass on their own, a process which can be painful and uncomfortable.

How do you prevent kidney stones?

1. Increase calcium intake

There is a misconception that increasing dietary calcium increases the risk of calcium oxalate stones. This is not true. In fact, eating more calcium rich foods, such as milk or cheese, ensures the oxalate in the diet binds to calcium. When oxalate binds to calcium in the intestines, it is not absorbed in the bloodstream and ends up in stool.

2. Reduce oxalate rich foods

Foods high in oxalate, such as beets, chocolate, tea, coffee, spinach, kale, rhubarb, nuts and beer contribute to stone formation. You may have to eat smaller portions of these foods alongside calcium-rich foods or avoid them altogether.

3. Stay hydrated

Drinking plenty of water will ensure that substances in your urine are diluted and cannot form crystals. As a rule, strive to drink enough water to pass two liters of urine every day—which is drinking roughly eight standard 8-ounce cups per day. It also helps to include some citrus beverages, such as orange juice and lemonade, as the citrate in these beverages helps to block stone formation.

4. Reduce sodium intake

A high salt or sodium diet increases the amount of calcium in your urine and triggers stone formation. Excess salt also wastes the fluid you take as a lot more fluid is necessary for salt-water balance. Make sure to limit your daily sodium intake to 2300mg or less to reduce your risk of kidney stones.

5. Minimize intake of animal protein

Animal protein, such as red meat, eggs, poultry, or seafood, increases the level of uric acid in the body and may cause kidney stones. A high protein diet will also reduce your urinary citrate—the chemical in urine that prevents stones from forming. You can limit animal proteins or replace them with plant-based proteins.

At Advanced Urology Institute, we offer a range of treatments for kidney stones depending on the severity of symptoms and the type, size and location of the stones. We also run tests to find out why they form and give you advice on how to prevent them.

If you or a relative has had kidney stones, consider meeting with one of our urologists for specific ways to reduce your risk. For more information on kidney stone causes, risk factors, diagnosis, treatment and prevention, visit the Advanced Urology Institute website.

Listen to the Podcast to learn more about Kidney Stones, Click here

Penile Implants for Erection Problems – Dr. Rishi Modh

My name is Rishi Modh, I am a board-certified urologist with Advanced Urology Institute.

So I think when you go see a urologist about erectile dysfunction, you need to see a urologist who specializes in implants as well. Not all urologists perform penile implants so they may not even offer it as an option for you. A penile implant is an outpatient procedure with a small incision and a fast recovery. It’s a mechanical device that’s placed inside your body that allows you to pump fluid into the penis in order to give you a great erection. Ninety-five percent (95%) of men are extremely happy with their penile implant and ninety-five percent (95) of partners would recommend it to someone else to have a surgery done.

Kidney Stones Pain, Symptoms and Treatment – Dr. Amar Raval

Dr. Amar Raval of Palm Harbor, FLMy name is Amar J. Raval and I’m with Advanced Urology Institute.

So kidney stone disease is very prevalent in Florida because of the heat, lack of hydration being a huge factor. Patients generally present with acute onset flank pain that doesn’t resolve with oral medication [and they experience] nausea, vomiting, fever, chills, even blood in their urine then they ultimately get some sort of imaging that shows that they have a stone that may be obstructing and causing them this discomfort. Approaches are very simple and they’re very endoscopic: they don’t require any incisions whether its leaving a stent to bypass a stone or if you’re going to treat the stone, you can use shockwaves from the outside to blast it or a laser to fine-tune the stone and take a piece of it and send it as a specimen to know what kind of stone it is. So technology certainly advanced in the realm of kidney stone disease, and there’s a lot of minimally invasive approaches to be able to treat that.

The Enjoyment of Being a Urologist

Urology is a wonderful specialty, being at the same time a surgical and medical practice. It offers an interesting mix of work in both the office and the operating room.

“For many of us, we enjoy spending time in the operating room—after all, we are surgeons by trade,” says Dr. Scott B. Sellinger, FACS, a board-certified urologist at Advanced Urology Institute. “But for many of us, we also enjoy interactions with our patients in the office. I love to see my folks, especially the ones I’ve been seeing for the past 25 years. They come back every year and we can chat about all kinds of things.”

Interesting surgical techniques

While most urology patients are followed long-term with medical interventions, at least half of them are surgical patients. The subspecialty of urology offers great opportunities to practice the surgical side of the profession, which includes the hands-on application of the latest technology, such as robots and lasers. “I enjoy the surgical side of our profession, and urology offers innovative techniques and technology that makes surgical procedures even more interesting,” says Dr. Sellinger.

Long-term relationships

The opportunity to build lasting doctor-patient relationships makes urology gratifying.

“As a urologist, you get to care for the entire spectrum of age groups of patients, such as children with congenital problems and patients in their declining years, when a lot of urologic problems tend to set in.” says Dr. Sellinger. “I like the fact that I see different patients every day, delve into their emotional problems, and with empathy, provide the support and solutions they need. I also enjoy speaking with the patients I see every year for several years since every time they come in they have something great to share,” he adds.

Tackling embarrassing problems

Urology brings relief to patients with personal and sometimes embarrassing medical problems. Through surgery, medications or both, urologists resolve these issues and improve the quality of life of their patients, which is quite appealing.

“As a urologist, not only do I treat life-threatening conditions like cancer, I also improve the quality of life of patients by freeing them from sexual dysfunction or incontinence,” says Dr. Sellinger.

Great outcomes

Unlike some other specialties, the treatments offered by urologists often provide quick relief and good outcomes. In fact, most patients treated by urologists do well and get better.

“Nowadays, urology is quite advanced, and we have at our disposal medicines, surgery, and the combination of both treatments that render our patients improved soon after they interact with us,” says Dr. Sellinger. “So we feel satisfied and secure in the knowledge that we can solve most, if not all, of the urologic problems,” he adds.

Because of consistently great results, urologists are held in high regard by their patients, who are usually grateful for the care. In turn, this gives a kind of satisfaction to urologists.

“I am happy that I chose urology. I’m always filled with joy every time patients come back to thank me for what I’ve achieved for them,” says Dr. Sellinger. “If I were to start all over again, I would still choose to become a urologist.”

Personalized, compassionate care

Want to have your urological problem treated by an effective urologist? AUI is a medical group with a long history of providing comprehensive, high-quality care. The urologists at AUI find it a joy to work in an environment that brings out the best of their knowledge and experience for the benefit of their patients.

Whether you have kidney, urinary tract, prostate, pelvic or other urological needs, at AUI you will find a urologist who can deliver the right treatment for you. For more information on the diagnosis and treatment of urological conditions, visit the Advanced Urology Institute website.

How Often Should Women See A Urologist

Female Urinary Incontinence: Lauren Masters, ARNPMy name is Lauren Masters with Advanced Urology Institute.

When we’re looking at urinary incontinence, for example, most women are having some degree of incontinence; whether it be soaking through one (1) pad a day or wearing depends all day long. Usually we can get someone at a minimum to a 50% improvement. It varies based on your history, your basic demographic and whatever else is going on in your body, but a lot of times we can get you to a good 50% and there are many women we can get to 80-90 [percent] and even a complete resolution of their issues.