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?

Cystic fibrosis is a genetic condition, which primarily affects the lungs and persistence of this condition might lead to severe breathing problems and loss of lung function. If you have inherited two copies of the defective gene from your parents, you are likely to suffer from this disease. Cystic Fibrosis causes a buildup of thick mucus in your lungs and affects other organs such as the kidneys, pancreas and the intestines in your body.

It isn't very uncommon as one out of fifty people in Asia is a carrier of this disease. The disease gets its name from the cysts formed in the pancreas of the sufferer. However, this disease can be detected by testing the quantity of salt present in your sweat. Prenatal testing for Fibrosis is another method to test if your newborn is likely to contract a lung infection.

Complications faced due to cystic fibrosis include:
1. Serious sinus infections
2. Serious damage in lungs due to inflammation and incessant infection
3. Malnutrition
4. Complication in breaking down protein
5. Respiratory tract contamination

If you observe one or more of the following symptoms, you might be suffering from Cystic Fibrosis:
1. Salty-tasting skin
2. Bowel obstruction caused due to meconium ileus (obstruction of the bowels)
3. Mucus amiss in your alveoli
4. Persistent coughing with phlegm discharge
5. Shortness of breath while engaging in a physical task
6. Stunted or measly growth despite healthy lifestyle habits
7. Infertility in males

If you're suffering from cystic fibrosis, there isn't any particular treatment which is recommended due to the varying degrees of it found in people. However, consultation with a medical practitioner and an individualised treatment plan can help you minimise the risks and lead a better life.

Some therapies you can opt for are:
a) Airway clearance: This therapy helps sift the thick layer of mucus around your organs. Some people have also chosen to use the inflatable vest which vibrates around your chest, thereby, thinning and loosening the layer of mucus.

b) Inhaled medicines: Another breakthrough in the field of respiratory medicine, this method requires the patient to sniff a liquid consisting of mist, which is inhaled with the aid of a nebuliser. This method is known to be beneficial for opening airways.

c) Pancreatic enzyme supplements: Along with multivitamins, these specially designed supplements are known to cater to your pancreas with the much-needed nutrients and they need to be consumed with every meal.

Cystic Fibrosis: All You Need to Know

The lungs take in oxygen and leave out carbon dioxide through breathing. It often does not get noticed but is the most vital function. When a person is not able to breathe properly, then the overall physical ability of a person is reduced. Even walking a few steps or doing simple chores can seem daunting tasks. Therefore, shortness of breath can be very limiting and may alter the quality of life of the patient.

The medical term being dyspnea, it can be short or long-term, acute or chronic. Any problem in the heart or lungs can cause shortness of breath.

Shortness of breath can be caused by various conditions including:

Asthma
Lung infections
Heart conditions including congestion and failure
Allergies
Fever
Any systemic illness or infection
Chronic obstructive pulmonary disease
Pneumonia
Bronchitis
Given that shortness of breath is caused by almost any ill health condition, especially in people with chronic conditions, it is best that the lungs are empowered to improve their function and do not cause shortness of breath. The idea is to delay the onset of shortness of breath and also to reduce the severity.

Some techniques to reduce shortness of breath are:

Breathe by reducing the rate of respiration. This reduces shallow breathing, which often happens, and so improves the amount of oxygen that reaches the system with each breath.
The patient should learn to relax, sit, and pace around without exertion.
Become aware of air movement during respiration   controlled breathing and active cycle of breathing techniques.
Postural drainage   Depending on the area of the lung that is causing shortness of breath, the person is made to lie prone and turn to a side that will allow the fluid in that region to drain out.
Overall relaxation techniques to improve airflow and control short of breath.
Avoid bending down, as it can induce shortness of breath.
Over-eating at one go in one meal should be avoided.
Weight needs to be maintained, especially if not under control. This can lead to shortness of breath without any associated medical condition either.
The patient should learn to push objects instead of pulling them.
Heavy objects should not be lifted but moved down at ground level.
Avoid extreme hot or cold showers.
Quit smoking as it causes various lung problems.
Help physiotherapy provides for people who are short of breath:

Improve exercise tolerance
Calms the person
Allows the person to control symptoms
Improve the quality of life
Provide manual treatment

Can Physiotherapy Cure Shortness Of Breath?

Breathing is life, without breathig, there is no life. Who knows this better than an asthmatic or someone with breathing problems like wheezing, coughing and shortness of breath 24/7? If you have breathing problems, read on about possible causes and treatments for them

Causes

There can be a number of causes of breathing problems. They can happen due to colds, acute sinusitis or inflammation of sinuses. This usually subsides in a week or two with the inflammation going down and the sinuses draining out.
But if you are still experiencing breathing problems, you could be in more dangerous territory.
Breathing difficulties can happen in a case of asthma, allergies, and infections of the lungs, bronchitis and even heart problems especially if you feel a shortness of breath during exertion. These can all be long-term problems that need proper management.
Symptoms
Chronic issues that cause breathing problems, especially asthma and allergies have a number of symptoms like

Nasal and chest congestion
Runny nose
Itchy or watery eyes
Cough
Wheezing
Laboured and/or shallow breathing.
A number of virus and allergens like pollen reach the lungs via the nasal passage. Any inflammation in the nasal passage due to an allergy is a major cause for concern because the number one trigger for asthma is allergies. If left undiagnosed and untreated, these can make life hell for you.

Chronic obstructive pulmonary disease or COPD, which includes emphysema and chronic bronchitis, also causes breathing problems. Breathing issues can also stem from other serious diseases like lung cancer, tuberculosis, and pneumonia. Most of these can be diagnosed by a specialist.


How are breathing problems treated?



Breathing problems caused due to asthma and allergies are usually treated by avoiding allergy triggers like air pollutants, pollen, dog hair, dust, mites or dander.
Wearing masks, avoiding peak traffic, staying indoors during low air quality days, all make a significant difference to allergy and asthma sufferers.
Medications are another way to treat breathing problems due to asthma and allergies. Allergy drugs such as antihistamines and decongestants can make it easy to breathe for some.
Inhaled steroids are also given to people with chronic allergies and sinusitis for reducing inflammation in the airways. Allergy shots to reduce sensitivity to allergens are another option.
Asthma is treated with inhaled or oral drugs that help open nasal airways and reduce inflammation. These cut down on breathing difficulties because the airways are cleared of excess mucus and inflammation.
If you have more serious issues like cancers, heart disease and lung diseases, the medication will vary according to your diagnosis. Your specialist will diagnose the problem first and set you on a proper course of medication.
The last piece of advice before we go, don t ignore breathing difficulties especially if they persist beyond 2-3 weeks, get yourself a doctor s appointment.

Breathing Problem - Common Causes Behind It!

Peripheral Artery Disease (PAD) is caused by atherosclerosis or plaque build-up in the leg arteries. Mostly, individuals with PAD have mild or no symptoms. But with the extension of the blockages, individuals may experience disability and pain that restricts free walking. In more severe cases, individuals may develop a risk of losing their limb if the circulation is not improved. 

There are various ways to improve the flow of blood in the leg, especially for individuals with severe PAD. The objectives of improving the blood flow in the limb include improving functional ability, reducing pain, preventing amputation, and providing a better quality of life. 

Symptoms 

Symptoms of Peripheral Artery Disease may include gangrene, claudication or pain in leg muscle while walking, pain at night mainly in the feet and leg, and feet sores.

Bypass Surgery

There are a number of treating methods for PAD. Both invasive and traditional methods are used to treat Peripheral Artery Disease. 

Stenting and Angioplasty are invasive treatment methods. The traditional method includes bypass surgery. The best available treatment method for an individual depends upon various factors such as severity, location of the artery blockage in the leg, general health of the patient, history of any vascular problems, and previous treatments.

Surgical bypass in the leg or Lower Extremity Bypass Surgery is usually the last option for the patients with PAD. This method is used when all the other alternative treatment methods fail or are not suitable for the individual. During the Leg Bypass Surgery, the surgeon forms an alternative channel for blood flow to bypass or avoid the blocked area and restore the direct flow of blood to the lower leg and foot. 

The risks and benefits of the surgery are calculated prior to the surgery. For the best result of the surgery, surgeons try to use the patient s own saphenous vein, from inside the leg, to execute these grafts. Surgeons may also use veins from other leg or arms or use prosthetic or artificial graft, in case the required length of the saphenous vein cannot be achieved. 

The results of artificial and saphenous vein from other limbs are not as effective as the saphenous vein from the same leg. Thus, the availability of an appropriate vein to execute this method is an important consideration that is taken into account before the surgery. 

Takeaway

Leg Bypass Surgery is one of the medical procedures for the treatment of Peripheral Artery Disease. In PAD, the artery of the leg is blocked which can hinder the daily life of the individual. 

The symptoms can be mild or absent but, in the case, where symptoms are severe, and affecting the quality of life of the patient, treatment becomes a necessity. Bypass surgery is the last option used when other alternative methods fail to help the patient. 

Leg Bypass - Know More About It!

Be it burgers, bagels, muffins, sandwiches or simple toasts, bread has made headway into the diets of a huge portion of the populace. Although a staple diet for many since time immemorial, the consumption of bread has increased extensively in the recent past. But, which type of bread should we intake to incur the best health impacts is a question that bothers many. The general assumption is that the wholegrain variety is the best alternative. However, the barrage of marketing tactics makes it impossible to distinguish the best variety from the others. 

There are a whole lot of myths surrounding the best variety of bread and you must choose wisely before settling for one particular type. It is expedient to look beyond the overt appearance or the name of the bread, one needs to be wary of the ingredient before taking a call.

Mostly, white bread is made out of refined flour which is often striped off essential nutrients and fibers. To worsen the situation, white bread is often bleached with certain chemicals to enhance its appearance.
Certain assumptions deem brown bread as the healthier option. Unfortunately, it isn't true always. More often than not, brown bread is simply white bread with artificial coloring added to it or is caramelized. They essentially add no surplus nutritional value.

Similarly, multigrain bread can often mislead the consumers about its health impacts. Unlike whole wheat bread, multigrain breads are usually chemically treated with softened grains. This does not effectively recover the lost nutrients of the bread.

Whole wheat bread has more pronounced health benefits. It contains more wheat germ and fibers in comparison to the more processed varieties of bread. Having evaded the toxic additives, it has relatively healthier effects on our blood sugar levels.

As you realize that the bread that you eat does not necessarily affect your health favorably, wisdom lies in seeking out the least harmful variety. In that context, rye bread or spelt bread contains greater amount of minerals. Besides, bread made from barley, oats and millets have greater mineral content than the commercially hybridized varieties and promote better health.

Brown Bread Vs White Bread Vs Whole Grain?

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