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Dilation and curettage procedure which is commonly referred to as D&C is a minor surgical procedure where the cervix is dilated while a special instrument is used for scraping out the lining of the uterus. It is important to know what you can expect before, after and during the process so that you can stay ahead of unnecessary worries and help the process to be smooth and fruitful.
When do doctors recommend dilation and curettage process?
You may be required to undergo the dilation and curettage procedure for one of many reasons. It can be used for removal of tissues in the uterus during or after an abortion or miscarriage or to remove little pieces of placenta after delivery. This process aids in preventing infection as well as heavy bleeding. On the other hand, it can help in diagnosing and treating abnormal uterine bleeding including polyps, fibroids, hormonal imbalances and even uterine cancer. A sample of the tissues in the uterus is tested under a microscope to check if there is any abnormal cell present.
What can you expect during the dilation and curettage process?
The D&C procedure is a minor one and takes about 15 minutes even though you will have to spend about 4 to 5 hours in the healthcare facility. Before the procedure, your doctor would check complete history, and at this point, you should tell your doctor if you suspect that you are pregnant, you are sensitive to latex or any medicines or if you have a history of bleeding disorders. You will then be given anesthesia so that you don’t feel any pain or discomfort during the procedure. Before this procedure, you will have to empty your bladder.
The D&C procedure comprises two main steps, dilation, and curettage.
Dilation involves opening of the lower part of the uterus or the cervix for allowing insertion of a slender rod. This is done to soften the cervix so that it opens and allows curettage to be performed. Curettage involves scraping of the lining and removal of the uterine contents with the help of a spoon-like instrument known as a curette. This may cause some amount of cramping, and a tissue sample would be taken out for examination in the laboratory.
After the completion of the procedure, you may experience slight bleeding and cramping. In some rare cases, adhesions or scar tissues may start forming inside the uterus, and this condition is termed as Asherman’s syndrome which can cause changes in the menstrual cycle along with infertility. This problem, if arises, can be solved with the help of surgery and therefore, you should report any abnormality in your menstrual cycle to your doctor. Consult an expert & get answers to your questions!
My wife had breast cancer and she went into remission this February 2017. She was diagnosed around mid November 2014. My wife just turned 39 and had ER PR positive tumor which was destroyed using radiotherapy in New York. As such she has been on Tamoxifen since she was diagnosed but then stopped it as she went into remission. We want to have children and were wondering which will be the best kind of doctor and some recommendations too since this is not a very usual case. Thank you in advance,
1. You felt a lump in your breast and it always means you have breast cancer.
It's a small percentage of breast lumps only that will turn out to be cancer. If you discover a persistent lump in your breast or notice any changes in breast tissue, never ignore it. You must see a physician for a clinical breast examination. He or she may possibly order breast imaging studies to determine if this lump is of concern or not.
Take charge of your health by performing routine breast self-exams, establishing ongoing communication and counseling with your doctor, getting an annual clinical breast exam, and scheduling your routine screening mammograms.
2. Only women get breast cancer, men do not.
Quite the contrary, each year it is estimated that approximately 2,190 men will be diagnosed with breast cancer and 410 will die. While this percentage is still small, men should also check themselves periodically by doing a breast self-exam while in the shower and reporting any changes to their physicians.
Breast cancer in men is usually detected as a hard lump underneath the nipple and areola. Men carry a higher mortality than women do, primarily because awareness among men is less and they are less likely to assume a lump is breast cancer, which can cause a delay in seeking treatment.
Extracorporeal Shock Wave Therapy (ESWT) is a highly effective and innovative treatment option in a variety of fields, from urology to cosmetology including orthopedics. This is a non-invasive method that employs high-energy shockwaves to bring about the healing of the affected tissues. It has been found to provide good results for recalcitrant orthopaedic problems like frozen shoulder to certain chronic degenerative or tendon conditions such as Achilles tendinitis (injury of the Achilles' tendon due to overuse) and plantar fasciitis in heel pain.
How does it work?
The procedure is basically an outpatient/ daycare job. It involves the application of a non-invasive probe to the affected tissue. This is followed by the external generation of shockwaves focused on the target area. The shockwaves cause a force to be created that brings about healing. Although it's still not clear as to why this kind of therapy works, the dominant understanding is that shockwaves render an improvement in the flow of blood so as to promote the body to fix and heal itself.
Depending on individual cases, high or low energy waves may be employed. While pain may occur during the transmission of high energy waves and would require short general anaesthesia, low-energy ESWT is carried out without anesthesia.
What problems can this form of therapy effectively tackle?
ESWT can be used to treat a number of musculoskeletal disorders. From plantar fasciitis (heel pain), tennis elbow, shoulder rotator cuff, degenerated tendons (Achilles' tendon) to hip and knee pain, the therapy has been found to reduce pain as well as accelerate healing in individuals.
Complications are very few and far between with this therapy. Individuals who suffer from hypersensitivity or poor sensation in the affected area are usually not recommended this procedure. Even individuals with heart conditions, seizures and open sores need to consult a doctor before going forward with the therapy.
The therapy has also been found to be very effective in bone healing as well as treatment of bone necrosis (a disease that occurs due to permanent or temporary loss of blood flow to the bones). Additionally in place of surgery, ESWT may also be a valuable option for non-healing fractures. In case you have a concern or query you can always consult an expert & get answers to your questions!
Broken bone is commonly known as bone fracture a d it occurs when an exorbitant amount of force is applied causing the bone to split or shatter. While some minor fractures lead to cracks and crannies, others may lead to complete breakage of the bones. Despite being hard, bones are formed in such a way that they can absorb pressure to only a certain extent, beyond which they break. Statistically, the incidence of broken bones are most common in children and in old age people.
Causes of Bone Fracture
Bone fracture can be caused due to a number of reasons; both intentional and accidental. Some of them include:
1. Accidents and injuries: Sports injuries, being hit by a car and tripping and falling are some of the typical episodes.
2. Old age: Diseases such as osteoporosis and brittle bone disease are common in aged people. As bones tend to become more fragile among the aged, they are at a greater chance of bone fractures.
Type of bone fractures
- Complete fracture: This type of fracture refers to a complete breakage of the bone wherein the fracture may occur at various parts of the bone.
- Incomplete fracture: In this type of fracture, the bone partially breaks instead of splitting entirely.
- Compound fractures: This is a type of a fracture wherein the bone breaks past the skin. It is also known as an open fracture.
- Simple fracture: In this type of a fracture, the bone breaks without causing an open wound on the skin.
Treatment of bone fractures
In case of a broken bone, the immediate course of action would be to reach for the first aid box. This can be done to stabilize the bone prior to hospitalization. Icing the injury, elevating the injured area to prevent further swelling and covering the wound with bandages are common measures. In many cases, people also make household splints (made of newspapers) to keep the bone stabilized. Hospitalization and especially surgery, can be also opted for in case of severe fractures. Consult a doctor for more details.
Sir I am 30 years old male and I have a problem of slip disk in l5 s1 from last one year. I have tried so many medicine for this but it pains regularly. What should I do now for proper relief from pain?
Breast Cancer can be detected at various stages. Some women might feel a difference in their breast area, with a lump or kind of a skin rash around the nipple or they could see that their nipple has become inverted, so then the treatment procedures would be different. The different stages of cancer and their respective treatment procedures are discussed below:
Stage I Breast Cancer - Treatment
In this case, breast cancers are at their nascent stage, either they have not spread to the lymph nodes or might have spread to only a small area. Treatment options are as follows:
- Surgery: The main treatment for breast cancer in stage I is surgery. These types of cancers get treatment with either breast-conserving surgery or mastectomy. There are some cases when breast reconstruction can also be done along with the surgery to get rid of cancer.
- Radiation therapy: When doctors feel the need to do a breast construction surgery, then radiation therapy is normally given after surgery. This helps in lowering the chance of cancer getting relapsed. Older women, aged close to 70 years, should go for breast reconstruction surgery without radiation therapy, provided the following conditions are true:
- The lump was 2cm or less across and it has been completely removed.
- None of the lymph nodes removed contained cancer.
- The cancer is either ER or PR-positive and hormone therapy is conducted.
- Chemotherapy and other drugs: Women who have either ER or PR-positive hormone receptor, doctors would recommend them to go for hormone therapy. The therapy is given for 5 years. In case the tumor is larger than 1cm across, adjuvant chemotherapy is recommended.
Stage II Breast Cancer-Treatment
This is the stage when cancer has spread to some nearby lymph nodes. The treatment methods followed are:
- Surgery and radiation therapy: This second stage of cancer gets treated with breast-conserving surgery or mastectomy. The lymph nodes nearby get checked either with a sentinel lymph node biopsy or an axillary lymph node dissection. Women, on whom BCS have been conducted, get treated with radiation therapy after surgery.
- Neoadjuvant and adjuvant systemic therapy: This is another method followed for treating stage II cancer. It is a good option for women with large tumors as they shrink the tumor before conducting surgery. Chemotherapy, HER2 targeted drugs and Hormone therapy all form part of treatment in this stage II.
Stage III Breast Cancer – Treatment
In stage III breast cancer, the size of a tumor is more than 5 cm, with cancer spreading on to the nearby lymph nodes. The treatment procedures followed are:
- Neoadjuvant therapy: Generally the stage III cancers are treated with neoadjuvant chemotherapy. Radiation therapy is also given after surgery, followed by breast reconstruction surgery.
- Starting off with surgery: Another treatment option for this stage is to get started off with surgery. The tumors are quite large and they even grow on to nearby tissues, which means women need to get a mastectomy. Women having large breasts can even go for Breast Reconstruction Surgery, in case cancer has not spread on to the nearby tissues.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Kidney cancer or renal cancer is when kidney cells grow uncontrollably and form a tumour. Kidney cancer often begins in the tubules (tiny tubes in the kidneys). The prognosis may depend on the stage of the kidney cancer.
Different Stages of Kidney Cancer
The TNM system helps to categorize each stage of the kidney cancer.
Tumour (T) – Describes the size and location of the tumour.
Node (N) – Describes the spread of cancer to lymph nodes.
Metastatis (M) – Describes the spread of cancer to other body parts.
These results combined with the five stages (0 and 1 to 4) can help to identify the right treatment option for every patient. Zero stage describes no cancer presence. For instance –
Stage 1 – Here the tumour is confined to kidneys and its size is smaller than 7 centimetres. (T1 or T1, N0, M0)
Stage 2 – Here the tumour is confined to kidneys and its size is more than 7 centimetres. (T2)
Stage 3 – Here the tumour is in kidneys or blood vessels or fatty tissues but also a lymph node; cancer spreads to major veins but doesn’t extend beyond renal or Gerota’s fascia (connective tissues surrounding adrenal glands and kidneys). (T3)
Stage 4 – Here the cancer is in the fatty tissues surrounding kidneys and adjacent lymph nodes; has spread to other nearby organs and beyond renal fascia. (T4)
Treatment and management of kidney cancer
Once your doctor has determined the staging of your kidney cancer, a treatment plan can be formulated for you.
- Simple nephrectomy removes the affected kidney.
- Radical nephrectomy is a common surgery for kidney cancer. It removes all affected parts such as the kidneys, adrenal gland, lymph nodes and surrounding tissues.
- Partial nephrectomy is for small tumours and removes the kidneys and the surrounding tissues.
- Interventional radiology: This is a surgery aided by real-time images. An advanced surgery using a nano knife is minimally-invasive and is effective for inoperable kidney tumours.
- Targeted therapy: Drugs target specific tumour cells and destroy them.
- Immunotherapy: Used for kidney cancer that has spread to other organs, this therapy may use different types of drugs to either help immune cells find cancer growth or regulate the immune system activity to stop or slow cancer growth.
- Arterial embolization: It is a procedure to stop blood supply to the kidney tumour, in order to shrink it in size prior to surgery.
- Cryotherapy: This procedure involves using extreme cold to kill cancer cells.
Chemotherapy is not very effective for treating kidney cancer. Talk to your doctor about all possible treatment options for your cancer. You can lower your risk of kidney cancer by eating healthy, maintaining your ideal body weight and managing your blood pressure. In case you have a concern or query you can always consult an expert & get answers to your questions!
I am 27 years old. I have L5-S1 bread based right paracentral posterolateral forminal disc herniation with compression on S1 nerve root, bilateral neural foramina narrowing (R>L), thecal sac compression, spinal canal measures 5 mm. I have been doing physio exercises since 9 months. But still can not sit/stand for long and also can not freely bend forward and move upward after bending. What to do further? I am able to squat slowly without any pain. Should I continue to squat or stop it?
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.
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.
- The formation of a lump in your breast which is different from the surrounding tissue and usually more thickened.
- The discharge of bloody fluid material from the nipples.
- Sudden change of the size, shape and appearance of the breast.
- Certain distinct changes to the skin over the breast for example an indentation in the skin similar to that of a dimple.
- Appearance of an extra nipple which is inverted.
- If the darkened area around the nipples known as the areola is flaking or peeling off.
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
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.
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.