Becoming a Physician Assistant – Chelsie Ferrell, PA-C

A successful medical team has several positions. One of these positions is the physician assistant. Also referred to as a PA, a physician assistant is a trained medical professional whose education takes less time to complete than a doctor’s. Chelsie Ferrell, PA remembers the first time she shadowed another physician assistant and decided it was the career for her. According to Chelsie, “I met a really great PA and loved her job, and I fell in love with the profession.” After becoming a PA, her career path led her to urology.

Urology is a specialized medical field that focuses primarily on the male and female urinary systems and the male reproductive system. Because of how many different organs are involved in the urinary system, urology covers a wide range of medical issues for both men and women.

Chelsie Ferrell, PA of DeLand, FLOne reason men see a urologist is to check for prostate cancer. Prostate cancer is the most common form of cancer that affects men. As they age and their likelihood of developing the disease increases, regular prostate cancer screenings by a urologist become increasingly important. If cancer is found, the urologist will discuss treatment options with the patient. Some non-aggressive cases can be treated simply by monitoring the cancer. Others cases may need to be treated with surgery or radiation therapy.

For women, urinary tract infections (UTIs) are a common reason to see a urologist. UTIs are infections that flare up in any part of the urinary system, including the kidneys, bladder or urethra. Symptoms can vary between patients, with the most common symptoms being intense pain, frequent need for urination, nausea and vomiting. Although easily treated with antibiotics, UTIs are known to be a recurring problem for some women.

Physician Assistants are important urology team members who help doctors and patients as they work together to achieve the best possible outcome in medical care. They have the satisfaction of knowing that the work they do can make a positive change in a patient’s life. Their work can even be life-saving when it results in the early detection of prostate cancer. The Advance Urology Institute relies on committed staff members like Chelsie Ferrell, PA to provide quality patient care.

Prostate Cancer Types of Treatment

Prostate cancer is one of the most prevalent types of cancer men face. According to board certified urologist Dr. Arash Rafiei, “One in nine men will have prostate cancer in their lifetime.” Although somewhat common, not all cancers in the walnut-shaped prostate gland are the same. Every case of prostate cancer is different and affects men differently. Urologists work with their patients to find the most effective treatment option based on each patient’s individual needs.

Dr. Arash Rafiei: Urologist in Orange City, FLUrologists will consider their patient’s health, age, and the type cancer when deciding how to proceed. For some cases, the best treatment is none at all. When a patient has slow growing prostate cancer that is not spreading, a urologist may suggest holding off on treatment while monitoring the growth through routine appointments. The cancer needs to be taken seriously and watched closely, but invasive treatment is not always necessary for the patient’s health.

When treatment for the prostate cancer is needed, there are two main options: radiation and surgery. Both options offer the same level of prostate control and urologists will discuss the pros and cons of each with their patients. For surgical options the urologist may suggest a radical prostatectomy or robotic surgery. Both are well-tested invasive options that produce very good patient outcomes.

Radiation therapy is another common cancer treatment option. The radiation is centered on the prostate to kill cancer cells. The radiation will also kill some healthy cells as well, causing side effects. This is a non-invasive option that, like surgery, has its pros and con that a patient and doctor will want to discuss. Follow-up appointments to determine if the cancer responded to the treatment will also be necessary.

In addition to radiation and surgery, there are also some newer options that can be utilized in prostate cancer treatment. For instance, cryotherapy uses very cold temperatures to kill cancerous tissues and cells in the prostate by freezing them. There are also treatments using intense ultrasound waves centered on the prostate to destroy the cancer cells. These procedures are newer and there is less data on when they are the most effective, but they are options to consider.

All cancer is serious and can be a stressful and frightening prospect. Having a dedicated urologist who will listen and suggest the best treatment for each patient is key to success. Whether the best option is observation, radiation, surgery or a newer procedure, the Advance Urology Institute is a team of dedicated urologists with an array of treatment options for their patients.

What is the best treatment for enlarged prostate?

All men can experience difficulties caused by an enlarging prostate. As Board Certified Urologist Dr. Arash Rafiei says, “All men have prostates, and as we age our prostates enlarge, some more than others.” Yet each man’s situation and health is different. The symptoms of an enlarged prostate will differ greatly between individuals and the best treatment option for one may not be the best option for another.

Urologist in DeLand, FL: Dr. Arash RafieiFor most men, the symptoms of an enlarging prostate include the slowing of their urine stream, pushing to urinate, and having to go to the bathroom frequently. Many men also have the feeling of not fully emptying their bladder after urination. In many cases, men will find that they need to wake up multiple times in the night to go to the bathroom.

Because the symptoms of an enlarging prostate differ for everyone, the first thing a urologist will ask is if the symptoms are bothering the patient. For some men, the symptoms, especially in their early stages, are not a problem. Men may notice that they urinate a little more often. It may also take a bit longer for them to urinate when they do. They may have to get up once or twice at night when they did not have to before. A lot of men see these symptoms as inconveniences that they can adapt to and live easily with. In these cases, the urologist and their patient will just want to continue to watch the situation and may not need to take any action.

For men with more severe prostate enlargement the symptoms may be causing issues that are negatively affecting their lives. In these cases, their urologist may recommend medical therapy. Urologists will recommend medication that will help slow the growth of the prostate and relax the muscles around the bladder. This treatment will help make urination easier for men you have been experiencing difficulties. Slowing prostate growth will also give the patient more time before more invasive treatment options become necessary.

For cases where medication does not produce successful outcomes there are plenty of procedures that can help. One common procedure is a transurethral resection of the prostate. For this procedure a resectoscope in inserted through the tip of the penis and into the urethra. The urologist uses this device to trim away excess tissue on the prostate, relieving pressure on the urethra. This is an outpatient procedure and often helps relieve the patient’s urinary problems.

Another procedure that is new and becoming more common for treating enlarged prostates is Urolift. For this cutting-edge treatment, a urologist separates and lifts the prostate from the urethra using a suture, relieving pressure on the urethra and allowing better urine flow. A plus side to Urolift is that, unlike in a transurethral resection, no prostate tissue is removed allowing for quicker recovery. Most patients return home the same day as the procedure.

Having plenty of treatment options is the key to successfully managing prostate enlargement. The urologists at Advance Urology Institute get to know and understand their patients in order to find the best option for each individual. For more information, visit the Advanced Urology Institute website.

Talk With Your Doctor About Erectile Dysfunction

The first step in treating erectile dysfunction is talking to your doctor about it. Unfortunately, for many men this can be difficult as erectile dysfunction is often a sensitive subject for those experiencing it. However, the issue is far more common than most men realize. As Chelsea Ferrell , physician assistant, states, “Fifty percent of men over 50 have some degree of erectile dysfunction, so you do not have to be embarrassed to speak to your doctor about it.” Urologists and PAs discuss erectile dysfunction with patients on a daily basis.

Chelsie Ferrell, Physician Assistant at DeLand, FLUrologists can usually diagnose erectile dysfunction during the appointment by asking a few questions about medical history and having a conversation with the patient. Once diagnosed, urologists try to discuss erectile dysfunction with the patient by reassuring him that even in the most severe cases there are still plenty of treatment options available. Because there are so many options available, the decision really is up to the patient working with his urologist to decide the best treatment for a successful outcome in his case.

There are plenty of different treatments available for erectile dysfunction and, in many cases, if one does not work another will. The most common options are pills like Viagra and Cialis, or generic versions of these pills that offer the same effects at a lower price. Others prefer the vacuum erection device. This is a cylindrical pump that the penis goes into and works like a vacuum to draw blood to the area, with a band that goes around the base of the penis to keep the erection.

Many men respond to at least one of these treatments. However, for those who do not there are still plenty of options. The urologist may want to try injection therapy. Men can give themselves small, relatively pain-free injections of a treatment into the base of the penis that will stimulate an erection. If injection treatment does not help, then the urologist may suggest a penile prosthesis. An implant is surgically inserted into the penis attached to a pump in the scrotum that can be used to give the patient an erection. This treatment will correct the patient’s erectile dysfunction for life.

Talking to your doctor about an issue as common as erectile dysfunction does not have to be an uncomfortable experience. And with the many options available now to treat erectile dysfunction, the right option is just a conversation away. Chelsea Ferrell PA at the Advanced Urology Institute is one of the many friendly and intelligent professionals helping patients find their best treatment option. For more information, visit the Advanced Urology Institute website.

The Two Most Common Female Urology Problems

Although it can feel embarrassing to discuss them with your doctor, problems with your kidneys, bladder and other parts of the urinary system are very common and are usually highly treatable. For women, two of the most common problems are urinary tract infections (UTIs) and urinary incontinence.

Urinary Tract Infection

Chelsie Ferrell, PA of DeLand, FLA urinary tract infection is an infection of a part of the urinary system which includes the bladder, kidneys, ureters and urethra. A UTI can occur when bacteria enters the urinary system, usually via the urethra. Symptoms of a UTI include a strong, constant need to urinate, a burning sensation during urination, and urine that is cloudy or pink or red-tinged and has a strong smell. There also may be pain around the pelvis. Although UTIs are usually not serious, if the infection spreads from the bladder into the kidneys, complications can occur. If you are diagnosed with a UTI, your doctor most likely will prescribe antibiotics to help clear up the infection.

UTIS are more common in women than men because women have shorter urethras. There are easy steps you can take to prevent getting a UTI. Drinking plenty of liquids, wiping from front to back after using the restroom, and urinating soon after sexual intercourse are all important preventative measures you can take to reduce your risk of developing a UTI.

Incontinence

Urinary incontinence, or the involuntary release of urine, is also a common problem for women, especially those who have given birth or have gone through menopause. These life events weaken the pelvic floor, making muscle control around the bladder more difficult. Incontinence also can be caused by weak or overactive bladder muscles or nerve damage.

Incontinence can vary in severity. For some women, this means only a few drops of urine being released when they cough or laugh. Others may experience a sudden urge to urinate and lose control of their bladders before they have time to get to a restroom. This can cause feelings of embarrassment and keep women from participating in activities they enjoy. Thankfully, urinary incontinence is very treatable. If it is becoming a major nuisance in your life, talk to your doctor about specific treatment steps to permanently help deal with the issue rather than addressing the symptoms.

Although problems with the urinary system can feel embarrassing, it is important to remember that you are not alone and that these issues are treatable. The physicians at Advanced Urology Institute are here to help with any urological issues you may be facing. For more information, visit the Advanced Urology Institute website.

Patient Communication: COVID-19

Coronavirus

Reschedule Appointment if you have Flu Symptoms

For patients who are experiencing flu symptoms: please reschedule your appointment for another time.

Please stay home if you are experiencing flu symptoms including fever, cough, sore throat, runny nose, aching, headache, fatigue, or have recently traveled out of the country or been on a cruise ship. The flu virus can spread very easily from person to person.

For the safety of patients, employees, and physicians, we will be implemented visitor restrictions to our facilities effective Wednesday, March 17th.

Patients who are minors, have disabilities, or need a translator will be allowed 1 companion. All other parties will be asked to wait outside of the facility. Please call to reschedule your appointment today if you are having any of the above stated symptoms. We are happy to reschedule you for a later date without penalty.

Symptoms & Treatment of Kidney Stones

Kidney stones are a serious and painful medical issue. They cause a wide range of symptoms and can be treated in different ways depending on their size and the patient. Understanding the symptoms of kidney stones and the treatment options available are essential to passing them.

No two people are the same and the symptoms of kidney stones can vary from patient to patient. Some of the most common symptoms are pain in the back or belly, pain or burning during urination, a frequent and urgent need to urinate, urinating in small amounts, and cloudy or bloody urine. Someone experiencing these symptoms most likely has kidney stones and may need to consult a urologist for help.

One of the most troubling symptoms is the pain caused by kidney stones. Some female patients say the pain caused by the stones is worse than being in labor. In many cases, the person with kidney stones may suffer from nausea and vomiting. Although stones can often be passed by the patient on their own, in some cases medical assistance is required.

Treatment for kidney stones is done on a case-by-case basis, with the doctor examining the patient to determine the best treatment method for the individual. For patients experiencing pain, but who may be able to pass the kidney stone, the doctor may prescribe medication to ease the pain and make them comfortable as they wait for the stone to pass. In more serious cases, the doctor may need to surgically remove the stones or bypass them to drain urine and relieve pain.

A new way to remove large painful stones without surgery is Shock Wave Lithotripsy (SWL). With this non-invasive method the stones are broken up by a shock wave of energy focused on the point where the kidney stone is located. This shock wave breaks the kidney stone into a fine powder that is easier for the patient to pass. In severe cases, the doctor will enter with a scope through the urinary tract or kidney and destroy the stones with a laser.

Relief from the pain of kidney stones can be found at the Advanced Urology Institute, where experienced physicians determine the best treatment method available for each patient. For more information, visit the Advanced Urology Institute website.

How Do I Know If I Have a Kidney Stone

Kidney stones is the common term for the medical condition of renal lithiasis or nephrolithiasis. The stones are made up of salts and minerals that form into hard deposits inside your kidneys.

Kidney stones can be caused by many different factors and can show up in different sections of your urinary tract. They may travel from the kidneys to your bladder, and from the bladder to the ureter. Sometimes kidney stones occur when the urine is too concentrated, which allows minerals to coalesce and crystallize. Heeding early signs like painful urination and an irregular urge to pee can help you seek medical help earlier and get treatment.

Pain from Kidney Stones

How can you be sure that kidney stones are causing your pain?
Because there are other maladies that have similar symptoms to kidney stones, a visit to your urologist may save you from uneccesary grief. Some symptoms of kidney stones include:

  • Acute pain below the ribs on the side of your body or in your back. The pain may intensify or shift to various locations as the stones travel along the urinary tract.
  • Pain located in the lower abdomen or groin
  • Pain that fluctuates in severity
  • Painful urination
  • Cloudy or discolored urine (pink, red or brown)
  • Foul-smelling urine
  • Persistent need to urinate or urinating more than usual
  • Urinating in small amounts
  • Nausea and consequent vomiting
  • Chills and fever due to associated infection

You could have just one of these symptoms or several. If you are experiencing severe discomfort along with nausea or blood in your urine, you should seek medical help.

Kidney stones do not usually cause any permanent damage if treated early and correctly. You may be able to drink plentiful amounts of water, take a pain medication, and be able to pass the stone on your own. However, if the stones get lodged in the urinary tract or cause a urinary infection, more aggressive treatment may be in order.

Tests for Kidney Stones

There are several ways your doctor can test for kidney stones that will also reveal their size and precise location. These tests include:

  • Imaging tests: The imaging technology to determine if you have kidney stones includes X-rays, CT scans and ultrasounds.
    CT scans are more thorough than X-rays and result in lucid composite images of kidney stones. Ultrasound is also used to create images of the affected area.
  • Blood tests: Your doctor can determine if your have too much uric acid or calcium in the blood, which can cause kidney stones to form.
  • Urine tests: These lab tests can detect minerals that cause kidney stones in your urine. They can also reveal if you lack elements that prevent stones from forming.

Treatment for Kidney Stones

Your doctor can determine if sound-wave therapy can resolve the problem or if surgery is indicated due to stones being too large to pass, causing infection or other damage. If you are able to pass the stone on your own, saving it for your urologist to examine can help your doctor determine what causes your stones and what can be done to prevent additional ones from forming.

If you would like more information about kidney stones and their treatment, schedule a consultation at the Advanced Urology Institute location nearest you or visit the website.

What is Advanced Prostate Cancer

A person hears the prognosis, the urological doctor’s conclusion after many exams and tests, that he has advanced prostate cancer. What does that mean? Can it be treated? What kind of life may one expect from that point onward? There are many questions that can be asked of the doctors, but a patient must remember that many questions depend on current medical techniques, the combined experience of all the doctors involved, and how well their clinics are equipped. Advanced prostate cancer is any cancer that has spread, or metastasized, to other tissues or bones around the prostate gland, so no single cure can exist for it. The cancer can no longer be treated by focusing on the prostate gland alone, so it is no longer “curable” in the simple sense. The most important questions are how well the cancer can be controlled or how long it can be kept in remission.

Dr. Michael Grable of Deland, FLThere are many factors that determine how much longer an advanced prostate cancer patient can survive. Age, along with other associated health issues, is more often of greater significance than the prostate cancer. Most men with prostate cancer will die from old age or other illnesses rather than from the cancer itself.

Advanced prostate cancer may be treated by androgen deprivation therapy (ADT), which lowers testosterone levels, slowing cancer growth. Hormonal therapies may be recommended. Chemotherapy might be used if hormonal therapy does not work. Surgery in some situations may help to remove larger clumps of cancer. Other therapies could utilize vaccines, immunotherapy, radiopharmaceuticals, bisphosphonates and radiation therapy. Sometimes a patient may be recommended to take part in a clinical trial of a new and promising treatment. The drawbacks of all such treatments are their side effects, which a patient may or may not be willing to accept.

Essentially, the factors that determine a patient’s longevity after diagnosis are:

  • the age of the patient
  • the condition of a person’s overall health
  • what stage the cancer is in
  • what the physical symptoms are
  • where the cancer may have spread
  • if the cancer has infected any bones
  • a patient’s outlook on life
  • a patient’s social life

Each person is different, which makes the determination of how much longer a person may live more like an educated guess rather than a precise mathematical equation. In other words, no doctor can ever state with complete certainty how long a person with any advanced cancer could live. Each person also responds differently to the same types of treatments. Other issues that cannot be overlooked, but also differ from person to person, are their mental outlook on life and social support; doctors cannot prescribe friendships or worldviews, though they can suggest support groups that help people with similar problems learn to cope with their situations.

When a patient is diagnosed with advanced prostate cancer, what medical care is available becomes very important. In a large specialist clinical network, its many doctors regularly share new knowledge and interesting experiences with each other, so a patient is always assured of receiving the best care possible. Thanks to modern advanced medical treatments, such as available through the Advanced Urology Institute, a patient’s hope for longevity after a diagnosis is now considerably better. For more information, visit the Advanced Urology Institute website.

Monitoring and Treating Prostate Cancer

Prostate cancer is one of the more serious conditions men face as they age. It occurs in approximately one out of six men, making it all too common and well worth monitoring with your doctor. With contributing factors like age, race, genetic make-up and diet all playing a role in disease development, it is important that men consult with their doctors if they have symptoms that might indicate a prostate problem.

Dr. Michael GrableRecent medical developments have changed how doctors treat prostate cancer and are revolutionizing patient care. For years, doctors treated all cases of prostate cancer the same way. They attacked the cancer with aggressive treatments that could be difficult for the patient. Treatment would often leave patients weak, sick, and sometimes unable to care for themselves. Even worse, this blanket use of aggressive treatment was not always necessary for the patients.

Just as all people are different, the way each person reacts to a disease is different as well. What works for one patient does not necessarily work for all patients across the board. Recently doctors have found that there are a number of cases of prostate cancer that do not need to be treated.
For these patients, costly and aggressive treatments are probably not their best option. Instead, doctors can utilize “active surveillance.” Although a significant amount of prostate cancers may not develop into more serious issues, thanks to in-depth surveillance and treating patients on an individual level, they can monitor different cancers and act quickly if an issue occurs. And they can avoid unnecessary treatments if issues do not occur.

Doctors are making this kind of treatment possible by developing personalized medicine. Taking an individualized approach gives patients the best chance of receiving the optimal treatment for their disease and giving patients the chance to reach the best possible outcome. At Advanced Urology Institute, doctors and patients are taking part in cutting-edge treatments for prostate cancer. For more information, visit the Advanced Urology Institute website.