Dr. Dhananjaya

Breast cancer is a type of cancer which occurs due to the development of cancerous cells in a person's breasts. Women are usually affected by breast cancer and breast cancer is one of the most common forms of cancer after skin cancer. Usually fatal if not diagnosed in its early stage, breast cancer is a very serious medical ailment. Read on more to find all about the different symptoms, causes, preventive measures and treatment of breast cancer.

Symptoms-

Breast cancer has a few distinct characteristics and if you have a few or all the following symptoms you could be more likely to suffer from breast cancer. 

1. The formation of a lump in your breast which is different from the surrounding tissue and usually more thickened.
2. The discharge of bloody fluid  material from the nipples.
3. Sudden change of the size, shape and appearance of the breast.
4. Certain distinct changes to the skin over the breast for example an indentation in the skin similar to that of a dimple.
5. Appearance of an extra nipple which is inverted.
6. If the darkened area around the nipples known as the areola is flaking or peeling off.

Causes-

Studies and researches remain inconclusive on what causes breast cancer. Breast cancer occurs due to abnormal division of the cells located in the breast which over time accumulate and form lumps. They
might spread to other parts of the body. Breast cancer is caused mainly due to a complex interaction of personal genetics, environment and lifestyle choices. Breast cancer can also be caused due to genetics as about 5% to 10% of cases are due to gene mutations which pass onto generations.

Risk factors-

There are certain factors which increase the probability of contracting breast cancer. Increasing age, personal and family history of breast cancer, obesity, radiation exposure, pregnancy at an older age, post-menopausal hormone therapy are some of the factors that increase the chances of breast cancer.

Treatment-

Several forms of surgical methods exist to treat breast cancer. Depending on the condition and spread of the disease a suitable surgery is performed. These include mastectomy, lumpectomy, axillary lymph node dissection and removal of both breasts. Other forms of treatment include chemotherapy or the use of high doses of drugs to destroy cancerous cells. Radiation therapy where X-rays are used to destroy the cancer cells is also effective. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

Breast cancer begins when the cells that are present in the breast start to go out of control. These cells generally form a tumor which can be seen on mammogram or one can feel it as a lump. The tumor is threatening if the cells can grow into the tissues that surround it or spread to other areas of the body. Breast cancer happens mostly in ladies. Here are a few methods with which you can prevent breast cancer-

1. Keep your weight in check: Maintaining a healthy weight is important for everyone although, it is easy to tune it out since it is said so often. Being overweight can expand the danger of a wide range of cancers, including breast cancer, particularly after menopause.
2. Be physically active: Women who are physically active for almost or at least 30 minutes a day have a lower danger of breast cancer. Normal activity is additionally one of the ideal approaches to keep weight under control.
3. Eat Your Fruits and Vegetables and Avoid Too Much Alcohol: A balanced and healthy diet can bring down the danger of breast cancer. Attempt to eat a considerable measure of fruits and vegetables and keep liquor at moderate levels or lower. While moderate drinking can be useful for the heart in most grown-ups, even low levels of intake can build the danger of breast cancer. If you do not drink, don't feel you have to begin. In case you drink modestly, there is less risk.
4. Try not to Smoke: Smokers and non-smokers alike know how undesirable smoking is. It brings down a person’s quality of life and expands the danger of heart and lung diseases, stroke, and no less than 15 types of cancer, including breast cancer. It additionally causes bad breath, awful teeth, and wrinkles.
5. Breastfeed, If Possible: Breastfeeding for almost one year or more brings down the danger of breast cancer. It additionally has extraordinary medical advantages for the baby as well, especially in terms of immunity.
6. Keep away from Birth Control Pills: Contraceptive pills have both dangers and advantages. In many cases, the more young a lady is, the lower the danger is. While ladies are taking birth control pills, they have more chances of falling prey to breast cancer as per various medical studies. This danger leaves rapidly in the wake of stopping the pill. The danger of stroke and heart attack is increased while on the pill, especially if the woman smokes. Long term use can likewise have essential advantages, such as bringing down the danger of ovarian cancer, colon tumor and uterine cancer and undesirable pregnancy. In case you are exceptionally worried about breast cancer, staying away from birth control pills is also an alternative to lower the risk. If you wish to discuss about any specific problem, you can consult an oncologist and ask a free question.

A fracture requires quick and careful medical attention to ensure proper healing and alignment of the bone. Most fractures usually recover within six weeks but that is only half the problem. A lot of other tissues get damaged in the process when there is enough stress placed in the body to fracture a bone. Additionally, when you are unable to move that bone, you will have joint stiffness and significant muscle weakness.

After a fracture, physiotherapy might be recommended to guarantee that you come back to your ideal capacity. You might have to go for regular appointments to your physiotherapist in order to achieve full recovery. Usually, your physiotherapist will try to prevent your post-fracture stiffness in the nearby joints and muscles after the initial six weeks while you are recovering from your fracture. After six weeks or later, if x-rays show that the bone has not been fully healed, your physiotherapist can take a shot at recovering full movement of the joints and muscles near the affected area.

Here are five ways in which physiotherapy helps heal post-fracture:

1. Physiotherapy after a fracture can help you enhance your muscle movement. In case you have fractured your leg, your physiotherapist can help you improve your walk and help you decide whether you need to take the support of a walking stick, crutches or a cane. In case you have broken an arm or shoulder, exercises focused on reaching and grasping are included.
2. Modalities might be used to help with the pain and swelling. Your physiotherapist may choose to use ice, heat or whirlpool baths.
3. Electrical stimulation can also be used to improve your muscle movement. You need to keep in mind that while inactive treatments like electrical stimulation or ultrasound might be used, you also need to keep your muscles physically active to better your movement and strengthen your bones.
4. If you have had surgery to join the fractured bone, you may have surgical scar tissue. Scar massage can decrease scar attachments and increase movement around the scar.
5. Exercise to improve the scope of movement and strength can also be started. Particular focus points need to be treated in the joints around the fractured area. If you have fractured a bone close to your elbow, exercises need to be included for your elbow, wrist, and shoulder. Moreover, a fracture in the shin needs to include exercises for the knee, lower leg, and hip. Exercise can guarantee that your bone can endure the load during daily routine work. Make sure to consult with your physiotherapist to learn the correct exercises for your condition.

A fracture can be very painful and might lead to a disability or problem in movement. Depending on the seriousness of the damage, the loss may be temporary or permanent. Physiotherapy can help you come back to your optimum function as quickly as possible. In case you have a concern or query you can always consult an expert & get answers to your questions!

What is ECMO?
Like dialysis for unfunctional kidney, Ecmo for unfunctional lung.

Ecmo stands for extracorporeal membrane oxygenation. It is a method of giving oxygen for the body when icu pateint lungs and/or heart are not able to supply oxygen on their own. 

Why ICU pateint put on ECMO?

Doctors place ICU patients on ECMO when patients are not able to supply oxygen to the body.

ICU patients’ lungs fail for a number of reasons including pneumonia, lung cancer, pulmonary edema, pulmonary embolism and COPD.

 When a patient’s lungs fail, he/she first is intubated (breathing tube) and hooked up to a ventilator (breathing machine).
 However, sometimes lungs are so damaged that providing oxygen through intubation is not enough.

This is when doctors turn to v-v ecmo.
A heart can fail for many reasons including heart attack, pulmonary embolism, bad valve disease, or worsening heart failure. When a heart fails, doctors try to fix the underlying problem. They may also start medications (called ionotropes) to help improve the pump function of the heart. If medications are not enough, doctors will turn to v-a ecmo.

How long can someone stay on ecmo?

That is a complicated question. Due to the risks of ecmo discussed above, doctors try to keep patients on ecmo for as short a time as possible. Often patient will be on ecmo for several days up to 1-2 weeks. Every day, several blood and imaging tests are done to determine if a patient is ready to come off ecmo. As the technology of ecmo improves, hopefully side effects will decrease and patients can remain on ecmo for longer periods of time.

What is the difference between ecmo and a ventilator (breathing machine)?

Both ecmo and a ventilator aim to provide oxygen to the body when the patient’s own lungs and breathing are failing. The ventilator assists the patient’s own lungs by pushing oxygen with pressure into the lungs. Ecmo instead provides oxygen directly via a catheter placed in a patient’s vein or artery. We almost always try oxygenating a patient with a ventilator first. However, when a patient’s lungs are too sick for this, we turn to ecmo to assist in providing oxygen to the body. V-v ecmo provides oxygen through a vein. This blood then has to travel to the heart and be pumped around the rest of the body through arteries. Therefore, with v-v ecmo or with a ventilator, a patient must have a well-functioning heart to get the oxygen pumped throughout the body. V-a ecmo has the additional advantage of pumping blood directly to arteries. This “by-passes” the heart and is therefore the method of ecmo we use when a patient’s heart is failing.

STROKE- Popularly known as "Brain Attack". It occurs due to sudden  impairment of blood supply to a part of brain leading to acute neurological insult. 

Stroke is an emergency. Know the signs of a stroke and  Remember  FAST.

F- Face Drooping - Ask the person to smile. See for any deviation/asymmetry of mouth. If YES..

A - Arm Weakness  Ask the person to raise both arms. Does one arm drift downward? If   YES..

S- Speech Difficulty  Ask the person to speak, look for any slurring of speech. If YES..

T- Time is money , Call Ambulance/Rush to the hospital. 

Other signs/ symptoms - 

• Sudden onset of  numbness or weakness of the leg / arm. 

• Sudden confusion/ trouble seeing in one or both eyes, trouble walking, Chakker, loss of balance, severe headache / Loss of speech.

Be Aware, This can be STROKE.

Act FAST, Save LIFE and disability. Up to 80% of strokes are preventable

The womb or the uterus is a muscular structure that is fixed in its place by the ligaments and the pelvic muscles. If these ligaments or muscles become weak or stretch, they no longer will be capable of holding the uterus, resulting in a prolapse. Uterine prolapse happens when the uterine slips or sags from its usual position into the birth canal or vagina. The main indications of uterine prolapse are recurrent bladder infections, constipation, a tug at the pelvic area, the cervix or uterus protruding out of the vagina, problems during sexual intercourse, increased discharge and vaginal bleeding.

What causes it?
1. Age is the most important reason for this condition to manifest itself.
2. A dip in the estrogen level as this hormone keeps the pelvic muscles strong.
3. Damage to the pelvic tissues and muscles due to pregnancy or during childbirth can also contribute to this condition.
4. A woman who has undergone multiple vaginal births is at an increased risk of this condition.
5. Any physical activity that exerts pressure on the pelvic muscles can also result in this disorder.
6. Chronic constipation and obesity, over time, can lead to this disorder.

How it can be treated?
1. Nonsurgical methods:

• Shedding the extra kilos helps reduce stress from the pelvic structures. This helps to avert this disorder.
• Avoid lifting heavy objects throughout the course of the treatment.
• Pelvic floor exercises or Kegel exercises help build up the vaginal muscles.
• Estrogen replacement therapy or Hormone Replacement Therapy can help relieve the symptoms of this disease.
• Wearing a pessary (an instrument that is placed into the vagina and fits under the cervix) helps to push up and stabilize the cervix and the uterus.

2. Surgical treatments:

• Uterine suspension- In this case, the surgeon inserts the uterus back into its former position by reattaching the pelvic ligaments by the use of surgical techniques.
• Hysterectomy- Here, the surgeon removes either the whole or just a part of the womb.

However, such procedures should not be opted by women who plan on getting pregnant. If you wish to discuss about any specific problem, you can consult a Gynaecologist.