Dialysis is a very important and life-saving procedure. It is performed to replace kidney function in case of renal failure. Wastes and extra fluids in the blood are filtered out during this process. To be able to perform Dialysis, the connection between the patient s bloodstream and the equipment for performing Dialysis (dialyzer) outside the body is established. This connection is created through Dialysis Access Surgery. It is a type of Vascular Surgery which forms the vascular opening for access during Dialysis. Thus, Dialysis Access Surgery is the lifeline for the survival of the patient.

Types of Vascular Access for Dialysis- 
There are three types of Vascular Access for Dialysis: Arteriovenous (AV) Fistula, Arteriovenous (AV) Graft, and Venous Catheter.

  Arteriovenous (AV) fistula is a surgical connection of an artery to a vein. An AV fistula is usually placed in the upper arm or in the forearm. It causes extra blood to flow into vein making it grow large. A larger vein hence provides easy access to blood vessels. An AV fistula is preferred over other methods as it lasts longer than other methods of access and provides a good flow of blood. Moreover, it is less prone to infection and blood clots than other methods. Before an AV Surgery, a Vessel Mapping Test is sometimes performed for assessing the blood vessels most suitable for Dialysis. An AV fistula is performed under local anaesthesia and requires two to three months for maturation before hemodialysis. If it fails to mature, the procedure is repeated.

  Arteriovenous (AV) graft is performed when AV fistula fails to mature. It is hence the second most preferred choice for long-lasting access to vascular tissues for Dialysis. An AV graft is a looped plastic tube which establishes a connection between an artery and a vein. Like AV fistula, AV graft is also performed under local anaesthesia. It is slightly more difficult to maintain than an AV fistula.

  A venous catheter is used for short- term hemodialysis. It is a tube which is inserted into chest, neck, leg, or near groin for vascular access. After exiting the body, the tube splits into two halves. In the case where a renal disease has made quick progression leaving little or no time for the AV fistula or AV graft to mature, a venous catheter is used to establish the required vascular connection. This procedure is also performed under local anaesthesia. It is a tool for emergencies but is not suited for long- term use. It can cause narrow vein due to an infection,
scarring, or blood clot. If long- term venous catheter is used, it is tunnelled under the skin which has fewer problems associated with it and is more comfortable. 

How to Care for a Vascular Access?
  Get checked for infections and other problems before each hemodialysis session;
  Use the operated site for access only for the intended use;
  Always keep the access clean;
  Prevent cutting or bumping the access;
  Check for thrill/ vibration in the access and inform the doctor if any;
  Do not put pressure on the access site;
  Do not put blood pressure cuff around the access arm;
  Do not wear jewellery or tight-fitting garments over the site;
  Do not lift a weight.

Take Away-
Vascular Surgery for Dialysis is performed to provide vascular access for the procedure. AV fistula is the most preferred type followed by an AV graft. A venous catheter is recommended to be used only in case of an emergency when there is not much time left for the other two options to mature.

Vascular Surgery - Can It Help For Dialysis?

Is your child getting exhausted after a bout of cough? Does he or she suffer from constant wheezing and tightness of the chest? Does your child feel drained out after climbing a flight of stairs? Do you know a child who always seems to run out of breath and cannot participate in school sports tournaments or play outside for a long time? The child could be suffering from asthma, which is a serious breathing problem. Most children are affected by asthma. Staying in a polluted city just makes the condition worse.

Asthma - Know the disease

Asthma is a condition that causes inflammation of the airways, known as trachea and bronchioles.
The muscles around the airways constrict and prevent the smooth flow of air.
The lining of the bronchioles swell and block the airways.
Asthma is mostly triggered by an allergic reaction.
There is a difficulty in breathing out. Exhalation of air is often accompanied by a wheezing, that is, a whistling sound.
There is a constant shortness of breath, feeling out of breath and gasping for air.
There is an uncomfortable tightness in the chest, the feeling of not breathing in enough air.
Coughing bouts in the middle of the night, that leave the child feeling exhausted and completely out of breath.
Causes of Asthma 

Asthma is mostly triggered by asthma allergens. These allergens are mostly pollens and animal fur.

Exposure to pollution, such as dust and smoke
Heredity
Obesity
History of heartburn, GERD and acid reflux
Inflammation of sinus and airways
History of bronchial disorders and pneumonia
Viral infections
Chronic rhinitis
Low immunity causing constant cold and blockage of nose
Treatments of asthma

A nebulizer that turns asthma medicine into a mist can then be inhaled easily
An inhaler can be used to take in inhaled steroids into the lungs or a bronchodilutor
Try and avoid asthma triggers and allergens as much as possible
Avoid physical stress and heat
Get sufficient rest of about 7-8 hours every day

Troubled Breathing - Can It Be a Sign of Asthma?

5 Symptoms that Indicate Your Heart is in Trouble!

Your heart gives you warning signs before the onset of a major problem. You may not even know that you are at risk of one or more heart diseases if you fail to notice these small signs that your heart sends out. Even a minor symptom, like chest pain, can indicate that your heart may be in trouble. While there could be many causal factors for a heart condition, here some symptoms, which are possible indications of a heart disease and should not be ignored in any case.

1. Chest pain or discomfort

This symptom is the most common one, which indicates that your heart is not healthy. It usually comes in the form of a pain, pressure or tightness in the chest and may happen due to a blocked artery. This may be an early warning sign of a heart attack and you should seek professional advice before it turns into a major problem.

2. Excessive sweating

If you often sweat without any valid reason, it might be a sign to be concerned for. The sweating experienced will feel more like the one that arises due to stress rather than common perspiration experienced due to any vigorous physical activity.

3. Difficulty in breathing

Shortness of breath is an indication that you are at high risk of getting a heart attack. The symptom includes having difficulty in breathing and feels similar to the panting experienced after a long run.

4. Nausea and frequent stomach problems

If you experience nausea, heartburn, indigestion or abdominal pain frequently, it may be the result of an unhealthy heart. Of course, these signs may be due to other diseases as well, but if you experience any of the other symptoms of heart problems too, it's highly probable that your heart is in trouble.

5. Exhaustion

If you fall into the high-risk zone of being a potential heart patient, you may feel exhausted after doing some simple chores, which didn't tire you earlier. Common examples may be climbing the stairs or carrying something from your doorstep inside the house to name a few.



5 Symptoms That Indicate Your Heart Is in Trouble!

Chest pain may be caused by multiple problems within the body and while being a problem in itself, may also be a symptom of a bigger underlying problem. Chest pain may be caused by anything from simple chest congestion due to a cold to something far more serious such as the onset of a heart attack. While it is important that life style changes be made to prevent major issues, homeopathy can provide relief for many symptoms till extensive medical steps are taken to correct the problem.

Some causes of chest pain
1. Angina
2. Onset of a heart attack
3. Atherosclerosis
4. Weakness of the arteries
5. Weakness of the heart muscle
6. Palpitations
7. Bradycardia
8. Chest congestion or cold

Symptoms associated with chest pain

Stable angina   Vice like constriction or choking, pain may be spread to right or left arm or both, dyspnoea before pain.
Unstable angina   Chest pain occurs at rest.
Pericarditis   Pain radiates to the left side of the shoulder which gets worse by lying in a flat position.
Pneumothorax   Severe chest pain along with shortness of breath, cyanosis, restlessness and collapse.
Pneumonia   Sharp pain which, gets worse by taking deep breath and coughing.
Pulmonary embolism   Short rapid breathing, sharp pain in middle of the chest that is worse by deep breathing.
Gastroesophagial reflux disease   Difficult painful swallowing, pain in the middle of chest which, extends to neck, back and shoulders.
Myocardial  Vomiting, dyspnoea features of shock, profuse sweating, fever, low blood pressure, pulse small rapid and irregular
Homeopathic remedies for various kinds of chest pain

Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which a patient is suffering.

The aim of homeopathy is not only to treat chest pain, but to address its underlying cause and individual susceptibility of the patient. For this patient s current symptoms, past medical history and family history are taken into account. There are many homeopathic remedies which cover the symptoms of chest pain and can be selected on the basis of cause, location, sensation, modalities and extension of the pain. For individualized remedy selection and treatment of chest pain, the patient should consult a qualified homeopathic doctor in person. In medical emergencies like myocardial infarction and pulmonary embolism, immediate hospitalization is usually required. Some important remedies are given below for the treatment of chest pain:

Arnica mont.   Chest pain with sore and bruised feeling.
Ranunculus b.   Good remedy for intercostal rheumatism, sharp stitching pain in the chest along with dyspnoea.
Kali carb.   Stitching pain in the chest,  which gets worse between 2-3 A.M
Actea racemosa.   Pain worse on the right side.
Bryonia   Chest pain is of stitching, burning and stabbing in nature, is worse by motion and better by rest and pressure. Thirst for large quantities of water and dryness of mucous membranes often accompanies.
Rumex c.   Sharp stitching pain through the left lung, often with cough.
Stannum   Knife like stitches, worse on bending forward and left side.
Phosphorus   Violent tickling cough, chest pain due to tuberculosis of lungs or pneumonia along with oppression of the chest.
Aconite   Chest pain due to pneumonia of first stage along with anxiety and restlessness.
Robinia   Burning pain behind sternum due to hyperacidity.
Strophanthus   Chest pain is of stitching and twitching in nature and often of cardiac origin.

Chest Pain - Can Homeopathic Remedies Treat it?

If you are facing difficulties in breathing, especially in the process of exhaling, you are suffering from emphysema. Emphysema is a condition in which the air sacs of the lungs are damaged and enlarged, causing breathlessness. It occurs as a result of several triggers, smoking being the most common one. Emphysema is a type of chronic obstructive pulmonary disease. People with this condition struggle to exhale, which implies that there is some obstruction in the air flow. This disease has no permanent cure but by quitting smoking, you can stop it from getting worse.

Stages
The progression and severity of emphysema occurs with the staging systems. The staging of the condition can help in developing a prognosis.

The Gold emphysema staging system
Gold is a major emphysema staging system created by a group known as the Global Initiative for Chronic Obstructive Lung Disease. The amount of air a patient can exhale forcefully in one second is determined during this stage. It is also referred to as the forced expiratory volume or FEV1.

The staging is as follows:

Stage 1: Mild emphysema (FEV1 greater than 80% of normal)
Stage 2: Moderate emphysema (FEV less than 80%, but more than 50% normal)
Stage 3: Severe emphysema (FEV lesser than 50%, but more than 30% normal)
Stage 4: Extremely severe emphysema. (FEV lesser than 30% of normal or lesser than 50% normal, with low levels of oxygen in the blood.
The BODE emphysema staging system
The condition affects several abilities. The BODE index, an acronym for BMI (body mass index), obstruction, dyspnea (breathlessness), exercise capacity (health index) is another staging system for emphysema in which the emphysema s impact on several areas of life are measured. They include the following:

Body mass index (B)
Airflow limitation or obstruction (O), which is measured by pulmonary function tests
Breathless or dyspnea (D), which is assessed thoroughly via a questionnaire
Exercise capacity (E), which is measured to check how long a person with emphysema can walk in a span of six minutes
Life expectancy
The prognosis of emphysema is impossible to be determined in any person individually. The staging system helps to identify the severity of the condition, but the future cannot be predicted. Not many studies have been undertaken for the determination of the effects of emphysema on life expectancy. The best research that has been carried out included around 100 people, which is very less. The condition varies largely among people, even if they are in the same stage.

The statistics available on emphysema are not reliable enough for individuals who wish to know their life expectancy. It is considered that if a patient falls in a higher stage, his/her long-term life expectancy is less.

Emphysema - Know The Life Expectancy and Stages!

The term 'chest pain  is a very common term and is usually used in day to day life. Basically, chest pain refers to the pain that may generate in your chest, shoulder and can travel to your ribs, jaws and towards your arms. The feeling of the pain can be sharp or dull, depending on the severity of your condition and cause.

There can be several reasons behind chest pain. You need to conduct a few tests to examine the real cause of the chest pain. It is always advised by health experts to take the symptoms of chest pain very seriously in order to avoid any serious problem in the future. Most of the severe and life-threatening diseases behind chest pain involve lung and heart problems. People having serious heart problems often feel discomfort, followed by pain in their chest area.

Symptoms
Chest pain which is related to any heart disease such as heart attack usually has symptoms like:

Feeling of fullness and tightness in the chest region
Vomiting
Nausea
Burning or crushing pain, which travels from the chest to jaw, hands and back region.
Weakness
Breathing problem
Usually, it is very tough to distinguish whether the pain is associated with a heart problem or not. But generally chest pains which are not related to heart problems involves symptoms like

Sensation in your mouth
Problem in swallowing food
Pain that worsens when you cough
Burning sensation in your chest
Common causes of chest pain

Angina: Angina is a medical condition described as a feeling of discomfort or pain in the chest region. This situation occurs when your heart muscles don't receive blood, which contains rich oxygen. Angina is a symptom of Coronary Heart Disease (CHD). The pain can take place in your shoulder, jaw, neck and arms also.
Lung problems: People with lung disorders can encounter various types of chest pains. But some common causes are:
Pleurisy: It is a type of medical condition, which occurs due to inflammation of the lining of chest and lungs. Due to this, you feel a sharp pain at the time of breathing, coughing or sneezing.
Pneumonia: It is a type of lung infection, which causes chest pain.
Pneumothorax: It is a type of lung disorder, which occurs when a portion of your chest gets collapsed.
Asthma: It is a type of condition, which occurs due to shortness of breath and causes chest pain while coughing, sneezing and breathing.
Gastrointestinal problem: Gastroesophageal reflux disease (GERD) is also a common reason for chest pain such as burning sensation in your heart.
Other causes of chest pain: There are several other reasons of chest pain such as muscle strain, ribs injury, shingles, anxiety and panic attacks. It is always important to visit a physician whenever you encounter any of such chest pain symptoms.

How Chest Pain Related to Heart Problems?

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