Obesity is a major problem across the world. In India, fast foods and an unhealthy lifestyle have led to widespread obesity as well. While following a proper diet and leading a healthy life can help manage obesity and weight gain in most cases, severely obese people require surgeries to lose weight.

Weight loss surgery, known as bariatric surgery, aims to reduce hunger and appetite in extremely obese people. However, simply undergoing surgery does not guarantee positive results. In fact, the lifestyle changes post-surgery is the most important factor to keep the extra weight off your body.

Recovery post bariatric surgery:

If you undergo a bariatric surgery, your lifestyle changes will depend on the procedure of the surgery. For instance, in laparoscopic bariatric surgery, the recovery period is short. In this surgery, the doctor will make 5-6 very small incisions on your stomach. He will then insert a tube-like equipment with a camera in your stomach and carry out the surgery.

Since very small incisions are made instead of a large cut, you will be discharged within a week. Furthermore, you can return to your normal routine within a month.

Lifestyle changes to follow:

1. Eating healthy: Post the surgery, you will need to follow a low sugar and low-fat diet. If this is a break from your usual diet then you need to get used to this diet, since you will need to stick to it for a long time. Immediately after the surgery, you will need to stick to a liquid diet, so that your stomach can adjust to the food.

Once your stomach starts adjusting to the sudden change, consume soft proteins. You will be able to return to solid foods around six months after your surgery. In the initial six months, it is essential to avoid foods such as white bread, pasta, and potatoes. Furthermore, you need to consult your doctor before consuming certain medicines such as painkillers.

2. Exercise daily:

Exercise becomes vital in your long-term goal of losing excess weight after the surgery. Your doctor will first need to clear you to take part in light activities, which will help enhance your body s metabolism. Joining a gym is helpful in this regard   you will have access to trainers and training equipment to help you exercise correctly. However, make sure to inform your instructor of your surgery before beginning an exercise regimen.

Most people fail to understand that you do not magically lose weight after bariatric surgery. You will need to maintain a healthy lifestyle if you want to achieve an ideal body mass and stay in shape. Therefore, you need to be committed to the procedure for the rest of your life.

Lifestyle After Bariatric Surgery!

Breast examination is a way of detecting early changes that help in detecting lumps or other growth in the breast. This is a manual form of examination that may be carried out by the doctor or even by the patient. This kind of examination helps in detecting the onset of breast cancer and helps in successful treatment of the same. It is an essential screening strategy that all women must go through. Let us cast a glance on the various details regarding this examination, and also how frequently it must be conducted.

Age: Women who have reached the age of 18 are said to have matured physically and sexually. They should perform this examination once they have reached the said age in order to detect any anomalies in the way the physical changes occur in the breast tissue.
Procedure: One should begin by looking at one's reflection in the mirror to find any rashes or dimpling in the breasts. The shape, size and colour of the breasts and nipples must also be studied so as to check for any anomalies. Inverted nipples, redness and soreness must also be reported to the doctor. Once you are done checking the visuals, you can raise your arms and look for any changes. Then, you will need to lie down and feel your breasts by using a circular motion. The finger pads must be used in order to check for any lumps. One must start from the centre and move the breasts sideways. Any wet and slippery feeling must be reported to the doctor immediately.
Pressure: During the breast examination, you must use light pressure for the skin and tissue that lie beneath the breasts, while medium to moderate pressure should be used for the middle portion of the breasts. One must use a firm hand to check the tissue that lies at the back of the breasts, near the rib cage.
Frequency: One must get into the habit of conducting a breast examination at least once a fortnight or once a month, without fail. You can also go to the gynaecologist for an examination in case you are not confident of conducting it on your own with proper movements and accuracy. You may also journalise your breast examination findings.
Menstrual Cycles: When you are going through your menstrual cycle or period, it is important to remember that your breasts can become tender just before or after the start of the cycle. So, do not panic if you think you have found a lump or any other growth at this time. It is best to check again after a week and then visit the doctor about checking the same.

How Frequently Should a Breast Examination Be Done?

What are Different Types of Bariatric Surgeries? 

Bariatric Surgery is one of the most popular options for obese people looking for a way to control their weight. To get bariatric surgery, one has to qualify for certain criteria like BMI (Body Mass Index), associated comorbidities like Diabetes, Hypertension, sleep apnea, infertility, hypercholesterolemia etc. There are many kinds of bariatric surgeries or weight loss surgeries, different surgeries work differently in order to give the desired effect, which is why it is important to understand these surgeries thoroughly. 

Weight loss surgeries are divided into different categories like - 

  Restrictive surgeries: Some bariatric surgeries are focused on limiting the amount of food that can be stored in the stomach. This allows a person to eat less than they used to, because of the limited capacity of the stomach. Sleeve gastrectomy, Adjustable gastric banding, Gastric imbrication, Gastric balloon surgery are examples of restrictive procedures. In sleeve gastrectomy, the stomach is divided into two halves first, then one half of the stomach is completely removed. The remaining part of the stomach is formed into a tube-like structure. This tube-like structure cannot hold enough food and restricts excessive food intake. It also limits the secretion of an appetite hormone called Ghrelin which limits the desire of a person to eat. 

  Malabsorptive procedures: In this procedure, a large segment of the small intestine is bypassed i.e the food is not allowed to enter a large segment of the small intestine and hence malabsorption will be there. Duodenal switch is a malabsorbtive surgery. 

To Summarize: The weight loss procedures that suit our Indian population are the Roux en Y gastric bypass and the sleeve gastrectomy. We do not come across any sign of malnutrition in patients who have undergone these procedures. For successful outcomes, vitamin, calcium and protein supplements are required. 

There are certain myths about bariatric surgery --- life will never be normal after the surgery, pregnancy is a problem after this surgery, one will never be able to eat after this surgery, marriage is a problem after this surgery etc. All these are incorrect as one live a better life after the surgery as one has shed the extra kilos, one is cured of existing problems like diabetes, high cholesterol, hypertension, obesity induced infertility and sleep apnea extra. IN FACT, the quality of life is phenomenal after this surgery. CHOICE of surgery depends on the existing BMI, existing associated problems and results of the investigations that are done prior to the surgery. Your surgeon is the best to decide the right procedure for you. As the procedure which your friend has undergone might not be good for you. Choice of procedure and proper follow up are the key points for a successful surgical outcome. 

  Combination of restrictive and Malabsorptive surgeries: In these procedures, the surgery is done on the stomach as well as the small intestine. It involves creating a small stomach pouch which is attached to the small intestine, thus bypassing a small segment of the small intestine to get the desired effect if the person has diabetes associated. The rest of the stomach produces important digestive juices and is also connected to the intestine so that it can transfer these digestive juices in it. As a part of the stomach and few centimetres of the small intestine are bypassed i.e food does not enter this part, the surgery is called the gastric bypass. The Roux en Y gastric bypass and the Mini Gastric bypass surgeries are examples of these combination procedures.

Bariatric Surgeries - Know Forms Of Them!

If the blood flow between left ventricle and aorta is obstructed, it is known as Aortic Stenosis.
Aortic stenosis can occur in newborn, infants, children and adolescents. It is more common among boys than in girls.
Mild cases of this disorder do not need treatment. However, if a child has a severe case of aortic stenosis, then it requires treatment.

Aortic stenosis: Causes-

Blockage in the valve, mainly in the form of bicuspid valve stenosis (Aortic valve stenosis)
Muscular/fibrinous obstruction beneath the aortic valve (Subaortic stenosis)
Narrowing above the aortic valve in aorta itself (Supravalvular aortic stenosis)
Aortic valves regulate blood flow to the body parts. When aortic valve opens, it allows blood to go forward then it closed down so that blood will not come back to left ventricle.
However, if there is a problem with the aortic valve, it cannot open entirely and that restricts the passage of blood. The heart has to work extra hard to ensure that the entire volume of blood flow through the faulty valve.

Sometimes babies are born with deformed aortic valve in the form of bicuspid aortic valve that is prone for obstruction as compared to normal trileaflet aortic valve.

Aortic Stenosis: Symptoms-

Symptoms due to aortic stenos is depends on age of the child and its severity.
If occurs in newborn babies, it is generally severe in intensity and babies are generally in shock like state due to low cardiac output.
Infants are generally tired easily during feeding.
Children show signs of easy fatigue, chest pain, loss of consciousness and in late stages with shortness of breath.
Diagnosis of Aortic Stenosis-

Pre-natal testing like a fetal echocardiogram can reveal aortic stenosis if moderate to severe in intensity. That is why as soon as the baby is born, treatment is initiated.
Even if the child was not born with a problematic valve, this condition can arise a few years later.
For diagnosing this disease pediatric echocardiogram by pediatric cardiologist needs to be done from the chest of the child
Treatment of Aortic Stenosis-

If aortic stenosis is mild to moderate in intensity then we need to do follow-up of the child at regular intervals.
However, in severe aortic stenosis, treatment needs to be done
In valvular aortic stenosis, treatment of choice is by doing ballooning of aortic valve (Balloon aortic valvuloplasty, BAV) in any age group.

Balloon Aortic Valvuloplasty - This is not open-heart surgery. It is done in cardiac cath lab under fluoroscopic guidance by using vessels in thigh. We cross the valve with wire and catheters and we inflate a balloon across the stenosed aortic valve.

Open heart surgery: In subvalvular and supravalvular aortic stenosis, treatment is by open heart surgery.

Valve Replacement - An artificial valve or a donor valve is surgically attached at aortic valve location when valve is not amenable for ballooning. It is generally done in adolescent or adult patients.
Parents need to be alert and attentive to any physical discomfort that their child is suffering because that could be a symptom of aortic stenosis. The right treatment at the right time is necessary whenever required.

Aortic Stenosis - All You Must Know About It!

Hernia surgery is performed for the correction of a hernia which refers to the bulging of internal organs or tissues through an abnormal opening. It is easy to detect hernia through any pain or discomfort while lifting heavy objects, cough and strain during urination or bowel movements or during prolonged standing or sitting. It can be found in both men and women. The Hernia can be congenital or can be developed over a period of time. If it doesn t get better over time and also does not go away by itself, then surgery becomes the only option.

Types of Surgery
There are two types of surgery for hernia treatment. One is the conventional open method, which requires an incision in the skin directly over the hernia. The other one is the Laparoscopic hernia repair in which surgery is performed using a small telescope known as a laparoscope. In this type of surgery minimal invasions are made and the hernia is repaired with only small incisions adjacent to the hernia. Most hernia operations are performed on an outpatient basis, which means that you can go home the very same day.

Tips for early recovery

    Wear comfortable clothing with expandable waistbands.
    Keep yourself active by moving around as much as you can as it increases circulation, which further speeds up healing.
    Eat a diet rich in fibre, fresh fruits and vegetables.
    Drink lots of water and other fluids to avoid constipation.
    Do not lift any objects even if it is very light as it can bring back pain.
    Do not to pick up things from the floor as it will be difficult to bend.
    Hold a pillow against your stomach while sneezing or coughing to lessen the pain.
    Use stool softener for a few days before and after surgery to help you with your bowel movements.
    Avoid driving till the time you feel any pain and as long as you are taking narcotic pain medicines.
    Band-Aids which cover the incisions should be changed as and when needed.
    Refrain yourself from intercourse as it can be painful.
    Check with your doctor when to take a shower so as not to hurt your incisions, and make sure to gently dry your incisions and replace the Band-Aids after taking a shower.
    Do not consume any alcoholic drinks for at least 24 hours.

The tips mentioned above will definitely provide help to cope up with post surgery blues. However, in case of fever, excessive sweating, difficulty in urinating, bleeding or any prolonged pain consult your doctor immediately.

Hernia Surgery - 13 Tips to Help You Recover from it

Menorrhagia is a condition that is marked by heavy menstrual bleeding during the monthly menstrual cycles. Most women have a unique bleeding pattern during that time of the month with the flow going up and down over the first few days. Yet, for many women, the bleeding becomes consistently heavy during all the days of the period, during which the period itself may get extended by a few days. If this pattern continues to occurs, one must get it checked out by a doctor at the earliest. Here are a few ways in which this condition may be treated.

Factors considered during treatment

Before the treatment starts, and during the diagnosis stage, the doctor will take a look at a number of factors so that the correct form of treatment may be prescribed to the patient. To begin with, the doctor will take a complete medical history of the patient, including the family history to ascertain whether or not there may be a genetic problem at play. Further, the future childbearing plans of the patient will also be taken into consideration in such cases so that the treatment method does not hinder such plans. Also, the doctor will also try and understand the effect of the symptoms of this condition before prescribing any particular medication and surgery.

Medication

Iron supplements and non-steroidal anti-inflammatory medicines will be prescribed for the patient to bring down the level of inflammation and restore the production of blood, which will make up for the rapidly flowing blood from the body. This will also prevent the risk of anemia. Oral contraceptives, tranexamic acid, oral progesterone and hormonal therapy can also help in such cases.

Dilation and curettage

This procedure is also known as D&C, and it basically helps in dilation or opening up of the cervix so that the doctor may suction the tissue from the uterine lining. This tissue is usually known to bring about excessive bleeding.

Uterine artery embolisation

This is a procedure which shrinks any existing fibroids that may be the cause behind excessive bleeding. In this procedure, the uterine arteries are blocked and the blood supply to the same is cut off so that the fibroids do not get a chance to grow and cause unnecessary pressure that may lead to excessive bleeding.

Hysterectomy

This is a surgical procedure that removes the cervix as well as the uterus, and is usually the last resort followed by most doctors. In such cases, the doctor will first ascertain whether or not you plan to have any children in the future. Additionally, the ovaries may also be removed if the condition has spread too much to be contained sufficiently.

Ways to Treat Menorrhagia

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