Leg bypass surgery is needed when the patient suffers from peripheral artery disease. PAD is a very common condition in elderly people, where the rate of flow of blood to the limbs (in this case, the legs) is reduced due to narrowing of the blood vessels.

Causes and risk factors-

The narrowing of the blood vessels occurs due to excess calcium accumulation and fat deposits in the walls of the arteries. The following are the risk factors of PAD-

  Age (60 years and above)
  Smoking
  Diabetes

The condition may be life-long or can last for years.

Symptoms that indicate you might need a leg bypass surgery-

The following are the signs and symptoms of PAD, which suggest you should consider having a leg bypass surgery-

  Pain in the legs, especially when walking
  Pain in the buttocks
  A sore on a foot/leg that does not seem to heal
  Thinning of the skin on the legs
  Loss of hair on the legs
  Tingling, weakness, or numbness in the legs
  One or both the feet/legs may feel cold
  The feet or legs may appear bluish, pale, or dark reddish in colour

You should get yourself checked by a specialist in the initial stage, or else the condition may get worse and affect your day-to-day activities.

Vascular surgery for PAD in the legs:

Vascular surgery is a surgical sub-specialty, which manages vascular system disorders- disorders of the veins, arteries, and lymphatic circulation- by surgical reconstructions, minimally invasive procedures, and medical therapies.

The most commonly used surgical procedure is the leg bypass surgery. The surgery aims to reroute the supply of blood around an obstructed artery in one of the legs.

How is leg bypass surgery performed?

The surgeon performs leg bypass surgery using a graft (usually made of plastic tube) to bypass or replace the blocked portion of the artery. On some occasions, the graft may be a vein or blood vessel taken from the patient s body (usually, the other leg).

During the surgery, the surgeon will first administer anaesthesia so that you are not able to feel pain or discomfort. He/she will make an incision over the portion of the blocked artery. After carefully removing the skin tissues, the surgeon will place clamps on each side of the narrowed artery and sew the grafts in place. The surgeon will ensure that the flow of blood in your lower extremity (legs) is good. An arteriogram (an X-ray of the arteries/blood vessels) is recommended to make sure that the graft is working fine after the leg bypass surgery.

For most people, leg bypass surgery helps improve the flow of blood in the arteries. The prognosis is better if underlying medical conditions like diabetes are controlled.

Leg Bypass - Treating It Through Vascular Surgery!

Why Does Your Back Hurt?

Most of us, experience back pain due to incorrect posture or longer duration of sitting.

Sometimes you may experience back pain because of exertion - you spent the entire day doing the same kind of job or maybe you bent in a wrong manner while picking up your child. However, the actual cause of your spinal agony may not be very clear, but it pays to be aware of the possible reasons that can cause backache. It is good to consult a doctor if your back pain is consistent and recurrent.

Here are few of the causes:

1. The position of your pelvis

The pelvis consists of three bones that can shift depending on which muscles become weak or stiff. This brings about a pull in the muscle of the lower back, resulting in severe strain to this area. You should consult a physiotherapist for suggestions regarding the best exercises for strengthening your pelvic area.

2. Weak abdominal muscles

A cause of your back pain can be weak stomach muscles. Abdominal muscles play an important role in balancing out the constant bending that your back muscles perform. When you've weak abdominal muscles, your spine is not able to maintain proper balance, resulting in severe stress on the spinal column.

3. Disc injuries

Located between the bones of your spine, discs perform the function of a shock absorber. Physical injury to these padded cushions can cause them to break open, leading to a condition known as herniated disc. This can then bring about pain in the back area.

Few precautions that can be taken for a hurting back. Despite the causes, there are certain precautions that you can take, which are:

- Avoid sitting in a bad posture, that is, keep your back straight as much as you can. Pull and stretch your body in continual intervals to keep it relaxed.

- Consult the right physician instead of doing exercise that can aggravate your pain.

- Take a break from work and go for short walks, every couple of hours.

If you would like to consult with me privately, please click on 'consult'.

Why Does Your Back Hurt? + What To Do About It

Wounds and bruises are both injuries. However, they differ widely in terms of the causing factors, the nature of the injury, the pain they cause and the kind of treatment they require. The following are a few of the myriad ways in which the two injuries differ from each other:

1. A wound causes quick damage - the skin tissue is cut or punctured while a bruise (also called a closed wound) is where the skin is not torn. 

2. A wound is usually caused by a sharp object but bruises are the results of blunt force or trauma.

3. A wound almost certainly bleeds due to ruptured tissue and blood vessels. Blunt injury also damages the blood capillaries of the skin and causes blood to accumulate under the skin tissue, creating a dark patch of skin. Blood vessels can also break due to lifting of heavy objects or overexertion of muscles.

4. A wound carries the risk of infection because the skin is open but a bruise does not get infected.

5. A wound has a burning or stinging sensation but a bruise is characterized by swelling and a blunt throbbing pain.

6. A wound can be healed by antiseptic and antibiotic medication. Large wounds need to be closed by stitching them up to avoid severe infection. On the other hand, a bruise usually heals by itself. A cold compress and pain killers may be used to ease discomfort. Heat can be applied to the injured spot to normalize the blood flow and dissolve the blood clot.

7. A wound can lead to complications like bacterial infections or the healing might be delayed by chronic diseases like diabetes. In case of a bruise, it usually does not cause complications but if there's a blunt injury to sensitive areas like the head, the tailbone or the eyes, medical attention is advised.

8. Wounds and bruises can also be differentiated on the basis of their subtypes. The different types of wounds are:

a. Incision (sharp objects cutting the dermis layer of skin)
b. Abrasion (the epithelial tissue is scraped off)
c. Avulsion (a body structure is torn off)
d. Penetration (a sharp object causes an entry and an exit wound)
e. Puncture (only an entry wound caused by a sharp object)

The different types of bruises are:
a. Hematoma (blood pools under the skin)
b. Purpura (tiny spots of blood on the inside of the mouth)
c. Contusion (similar to hematoma and caused by external trauma)
d. Crush injury (caused due to a large amount of force on the body part for a long time)

Wounds VS Bruises

Hemorrhoids or piles are diagnosed by swelling of veins in the lower part of anus and rectum. Due to swelling, the walls of rectum and anus are stretched and thus become irritated. Hemorrhoids are of two types: Internal and External hemorrhoids.

Internal Haemorrhoids: As the name suggests, the piles are not visible from outside. These are present deep inside the rectum, located above the pectinate line and these are covered with the cells that are present through the rest of intestines. Internal hemorrhoids are normally painless. The first sign of internal hemorrhoids is rectal bleeding. However, straining can push internalhemorrhoid and it protrudes through the anus and this can be painful.

Causes of Haemorrhoids
The swelling of hemorrhoid occurs only when the pressure in the small vessels of rectum and anus is increased and is engorged with blood. The size of the hemorrhoids is also increased. The increased pressure may be due to various factors:

Consuming low fiber diet and pushing or straining while passing stools, thus blood vessel pressure is increased.
Pregnancy also is a cause of swelling as there is the increased pressure of the uterus on rectum and anus.
Sitting for long on toilet also increases pressure.
Obesity is also a cause of hemorrhoids.
People suffering from diarrhea, both acute and chronic.
A person having colon cancer might have hemorrhoids.
Signs and Symptoms of Haemorrhoids:

The most common symptoms of hemorrhoids are painless bleeding, itching in anal, swelling and feeling of the presence of lump at the anus.
All these symptoms are associated with inflamed hemorrhoid.
Inflamed internal hemorrhoid can cause swelling, but is painless as there are no fibers attached to veins above the pectinate line that cause pain. However, passing hard stools can scrape off the thin lining of hemorrhoid, which can cause the painless bleeding.
Spasms of the rectum and anal muscles caused by these swollen hemorrhoidscause pain, especially when they are protruded through the anus.
Internal hemorrhoids can form a clot or thrombose resulting in severe pain.
The presence of has inflammation, stool,and constant moisture and these can lead to itching and burning sensation in the anus among patient of internal hemorrhoid.
Treatment of Haemorrhoids

Diet: Haemorrhoids can be treated when individuals consume a fiber-rich diet in order to soften the stools and ease their bowel movements. Fiber-rich foods include fresh fruits, dry fruits, grains, vegetables, and cereals. About 20 to 30 grams per day of fibrous foods is recommended. Dietary fiber will help create bulk in the intestines which will help in softening of stools and ease bowel movement. Supplemental fiber available in the marketincludes psyllium husk, methylcellulose, and calcium polycarbophil. Other recommendations include increased intake of liquids and having stool softeners. Drinking enough water and liquids will prevent stool from hardening.
Over-the-counter topical treatment: There are various products available to treat hemorrhoids, such as gels, hydrocortisone creams, ointments, foams, pads, and suppositories.
Home remedies: Soaking anus in a warm sitz bath might also help in hemorrhoids for about 10 to 15 minutes per day. One should practice good hygiene and clean anus with warm water while showering. Avoid using soap and dry toilet paper. One can also use a cold compress on the anus.
Minimally Invasive Procedure for Hemorrhoids (MIPH)

Out of the various types of medical and surgical interventions available to treat Piles, Minimally Invasive Procedure for Hemorrhoids (MIPH) 0r painless stapler surgery is known to be very popular since it acts an alternative approach to surgical interventions made for piles.

MIPH is defined as a minimally invasive surgical technique in which a band of loose or prolapsed mucosa and sub mucosa in the rectum is excised, proximal to the piles and disrupted mucosa is fixed by  stapled end to end mucosal anastomosis.

This will ultimately occlude the blood supply to the superior hemorrhoidal artery above the hemorrhoidal tissue, resulting in the retraction of prolapsed mucosa back to its original anatomical position. A special circular stapler known as PPHO3 is used in the anastomosis and the whole maneuver will take around 30 45 minutes.

Internal Haemorrhoids - Best Ways They Can Be Treated!

One of the most common complaints of men and women is that of a back ache with lower back aches being the most common. Apart from an improper posture, this may be caused by old age, lifting heavy weights or an injury to the back. A consistent back ache can affect your daily life and make performing regular tasks uncomfortable. Luckily, it can be managed quite well with simple ayurvedic remedies.
According to Ayurveda, backaches are triggered by an excess of Vata dosha. Thus, the Ayurvedic remedies for a back ache aim at reducing the Vata dosha. Ayurvedic remedies are natural and have negligible side effects. 

For this reason, they can be prescribed to both children and adults. Some such remedies are:

Cut down on spices: One of the main characteristics of the Vata dosha is dryness. This can be caused by pungent spices such as wasabi and green or red chillies. The internal dryness caused by these spices can lead to constipation which in turn can be one of the causes of low back aches. Hence, if you suffer from a chronic backache that may or may not be accompanied by constipation, cut back on the spices and try eating food that is slightly blander.
Eat food before it gets cold: Eating cold food or cold drinks can also increase the Vata dosha levels in our body. Coldness creates congestion and constricts the internal organs while warm food allows the digestive and stool carrying channels to stay open. This allows for the easy expulsion of waste and reduces toxins in the body. Hence, opt for warm drinks like tea or coffee instead of soft drinks and juices and try to eat your food while it is hot.
Padahastasana or the standing forward fold pose: This yoga asana is very effective when it comes to treating back pain as it allows the Vata dosha to flow easily through the body. In doing this it opens up the digestive channels that may have been causing constipation and back pain. It also relieves problems associated with sciatica. To practise this asana begin by standing upright with your feet beside each other. While inhaling, lift your arms over your head till they touch your ears. Bend forward from your hips while exhaling and try to keep the back and your legs straight. Touch the floor or wrap your hands around your calves. Bring your head as close to the knees as possible and hold for 5   10 seconds. Inhale and the slowly roll your body upright again.

Back Pain - Ayurvedic Remedies for Managing it!

Repairing shoulder tendons through a telescope! When doctors talk about shoulder tendon repair, often they may be refering to rotator cuff surgery. The rotator cuff is a set of tendons and muscles that together form the cuff above the shoulder joint. The rotator cuff is responsible for stabilizing & keeping the arm within the joint, at the same time enabling the joint to move freely without any hindrance.

Thus it is responsible for maintaining strength of the shoulder. The tendons can become damaged due to injury or even overuse. When this occurs, the rotator cuff can be repaired with the help of surgery. Generally, a rotator cuff surgery makes use of an incision.

A shoulder arthroscopy, on the other hand, makes use of smaller incisions and repair is done with the help of a telescope.

Here are some of the commonly used techniques to repair a rotator cuff tear:

  When going for an open repair, the surgical incision is made and the deltoid gently moves out of the way making room to perform the surgery. Rarely an open repair method may prescribed for complex and larger tears or if any associated procedures are to be performed.

  In the case of the arthroscopy procedure, the small camera referred to as an arthroscope is put inside the small key hole incision that has already been made. The arthroscope, which connects to a video monitor, enables the surgeon to view the complete interior region of the shoulder. Further, few more incisions are made in order to allow insertion of various other instruments. During this surgical procedure, the damaged tissues are removed, or they are repaired depending on the damage levels. All of this is done with the help of an arthroscope.

Repairing the rotator cuff:

  In order to do so, the tendons need to be re-affixed to the bone.

  Small rivets referred to as suture anchors help to refasten the tendon and the bone. The suture is usually made of a special strong material that holds the repair for a long duration.

  The sutures are responsible for tying the tendon to the bone.

Why is this surgery recommended?

The physician recommends a rotator cuff tear or tendon surgery when the patient experiences pain while sleeping at night or faces difficulty carrying out daily physical activities, or when it has shown little improvement over the months in spite of exercising. This procedure is also recommended for people who lift heavy weights or are involved in sports activities. Moreover, the risks associated with this procedure are few and common to all surgical procedures.

A rotator cuff surgery performed arthroscopically has a very high success rate as it is performed under magnification. The procedure is far more precise than an open surgical procedure. Any associated injuries within the shoulder can be tackled simutaneously thus leaving very little room for errors. The recovery is therefore complete and faster due its minimally invasive nature.

Repairing Shoulder Tendons Through Surgery!

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