Nicole Hollander
Appearances
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
They always ask me, why was I put on Tamsulos and what does it do? I think that concept is sometimes hard to grasp. A lot of times they ask me, you know, to kind of explain like the pressure flow relationship.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
So Dr. Shaw uses this analogy, you know, when blood is pumping through the heart and the arteries and there's blockage, your heart pumps and pumps and pumps really hard for a long time or eventually your heart can give out. So we kind of say that in relation to the bladder, you know, Your bladder pressure is really high.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
It's pumping really hard and working overtime to get that urine out through the urethra where eventually your bladder can fail because they're like, I don't really understand, you know, why we have to do this if I'm not having symptoms. And a lot of times, you know, their uro cuff will look terrible, but they say they have no symptoms.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
And you look at the uro cuff and you're like, OK, well, maybe we should just take a look and see. So it's really just explaining, you know, why we're seeing what we're seeing and making it more easily, you know, interpreted.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
Also, UroCuff is a really good way to make sure that they follow up. So a lot of times if, you know, a patient is like, you know, I just want to stay on medication for now. I'm not really interested in a procedure. I'll be like, OK, well, maybe we should repeat the test in three to six months to see if anything's changed.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
And usually like, yeah, yeah, that's a good idea because, you know, they want to help themselves. But sometimes at the time it takes a little push to get them to do a sister or something. So I feel like it's really helped make sure that my patients follow up and don't just get lost.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
I kind of explained it a little bit after their UroCuff. Like, you know, if we do the cystoscopy, you know, eventually it might lead to you having some sort of minimally invasive procedure that can kind of open up the prostate so you don't have these symptoms and you don't further damage your bladder. So I'll kind of give them like a brief rundown just so they know what they're going into.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
And I do always tell them, you know, Even if you get a systo, it doesn't mean you have to do something, but it's a good way to at least see what's going on. But usually I kind of preface them after their UroCuff when they do decide to do a systo or a truss or whatever it is. And then I think Dr. Shaw ultimately decides what's best for them.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
Yeah, so the nurse practitioners normally see the post-ops. So like with resume, they'll come in. We do avoid trial as long as they pass, you know, we take out the catheter. Then typically we'll have them follow up in six weeks or six to eight weeks and then three months. That's like the typical kind of pathway we follow afterwards.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
You know, I don't always treat that just because a lot of those symptoms they're feeling is because they just had the resume. So I think it's like Dr. Shaw said, really important to drive that point home to them. Like you're going to have symptoms afterwards. You're going to feel like I made you worse, but you're going to get better. It just takes time.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
So, you know, depending on the patient, let's say it's. You know, it's been a long time and they're having, you know, overactive bladder symptoms. Maybe I'll give them some samples, but I try to hold off until they're, you know, a good few months outside of the procedure because I think it does take a little bit.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
And sometimes you can confuse overactive bladder for, you know, post-procedure symptoms.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
Sometimes it takes some convincing.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
Dr. Shah does a really good job of telling patients beforehand what's going to happen afterwards. He'll even say, after this procedure, you're going to say... I don't like Dr. Shaw. He messed me up. He says that beforehand. And it's really honestly, it lasts in their head.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
And when I see them, they're like, when I kind of explain to them, like, OK, over the next few weeks, you'll be feeling these things. They're like, yeah, Dr. Shaw told me. So they're like, you know, they're prepared. So it's really important you tell them beforehand and set, you know, realistic expectations.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
Thank you.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
I think that, you know, the APP program and Dr. Shaw and there's a couple other doctors that are involved a little bit. They've done a really good job of allowing us to like, you know, if we have an idea, there's something that we want to bring to light. They always are like, okay, you know, let's make a game plan. Let's get it moving. They're always willing to listen.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
You know, like recently I've been kind of interested in women's health and we don't really have a women's health program. So, you know, we've been talking about that and You know, I have to make a presentation and present it to them, but they're more than happy to support, you know, whatever goals I have and whatever, you know, I'm interested in. So I feel really lucky for them.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
They've been really great.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
I dabble in a little bit of both.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
She sounds awesome.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
Thanks for having us.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
Yes, this was my first job right out of nursing school or right out of getting my master's.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
So my dad's actually a urologist. So I had a little bit of a brief background in urology. But to be honest, I kind of fell into it. I had been looking for a job in Chicago and I couldn't really find a job. And I found this and Dr. Shaw and then our other doctor, Dr. Patel. We really vibed with one another. I think we really hit it off and I followed them.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
And, you know, I realized, oh, this could be something I like. And now, you know, I really like urology, something that I'm definitely passionate about.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
So you can ask Dr. Shah. I was the most nervous person. I was like, I don't know, I'm not doing anything right. So basically what we did is I followed Dr. Shah for, how long was it? Do you think a couple months?
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
A few months. And so I kind of watched him document. We worked on documentation first. I think that was one of the most important things we needed to work on. And, you know, obviously, as I followed him, I learned along the way different things. You know, I take notes. He would have actually like once a week say like, oh, OK, this week we're going to talk about this topic.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
And, you know, I take notes. I actually have like a whole binder. in my office. And then like slowly we started to give me patients. So I started to do some telehealth on my own to kind of like warm me up. And Dr. Shaw had to push me a little bit and see patients in the office. But eventually we got there. And, you know, I think really a lot of the learning happens when you are pushed.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
You know, sometimes people need that little push. I think that a lot of the learning I did was actually when I started practicing, but I definitely needed those months with Dr. Shah to, you know, get a base and understand what I was doing, especially because I'd never done it before.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
At first, I don't think I was sure I kind of needed to dip my fingers into different things, but I ended up really liking BPH and there's so much you can do with BPH. So that's kind of the direction I went. And now I interpret all the Eurocuffs. So we do a Eurocuff day every Tuesday. One of the nurses does the Eurocuffs.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
And then the next day, I have a day where I go over all the results with the patients and kind of talk about next steps. Yeah, so I ended up really liking BPH and That's kind of like the bread and butter of urology, I think, too. So it's been really interesting and I really enjoy interpreting the urocobs and I think I've gotten pretty good at it.
BackTable Urology
Ep. 190 Optimizing BPH Care: Insights from Physician-APP Collaboration with Dr. Arpeet Shah and Nicole Hollander
We usually do a telehealth visit. So I have a telehealth day on Wednesdays and most of my day is just interpreting UroCovs, you know, seeing what they need next. So a majority of those patients on that day are UroCov patients.