Bariatric surgery is unlike other surgeries, the success is defined after 6-18months later. It is not without its complications. But complications managed well by Bariatric surgeons and the introduction of Laproscopy, it gives advantages of reduced post-op pain to less incisional hernias and less post-operative hospital stay. 

Sometime problems may happen like- 

Post-operative bleeding: Managed well by the surgeon. 
Dehydration: Chances of dehydration, therefore, one of the main post-op instructions, would be to increase water intake significantly, after the first week of course, when water is included in the diet. For someone who is not used to drinking lots of water, this can be difficult. 
Indigestion: Difficulty digesting food after the surgery is very common. There could be a burning sensation in the stomach. This is often managed by dietary changes like avoiding fatty foods, eating small frequent meals, avoiding too much sugary food items, etc. Too much fruits and vegetables should not be introduced early on, as fibre can be difficult to digest. Avoid fruits like nuts, seeds, fried foods, processed foods, etc. Gradually moving from water to pureed diet to semi-solids to solids can help in getting the stomach used to it. 
Vitamin and mineral deficiency: With the drastic cut in the amount of food consumption, there could be multiple problems including skin rashes, weak bones, dental issues, hair loss, gallstones, kidney stones, etc. All these are due to deficiency of various essential minerals like calcium, potassium, etc. This can be managed through minor diet modifications to ensure the body gets the required minerals and vitamins, even if they are in the form of supplements. 
Dumping syndrome: With a reduced size of the stomach, the food moves from the stomach into the smaller intestine much faster. Therefore, the sugar levels increase rapidly, producing various symptoms like bloating, diarrhoea, nausea, weakness, and anxiety. This is managed by eating less amount of sugars and fats and spacing out the meals through the day. Five to six small meals are preferred over 2 to 3 large meals. Some people also get relief from lying down after eating. 
Hernias: Less after laproscopic surgery but sometime it may happen. 
Diet changes: Whether it is medications or foods, some substances have to be knocked off your list. A detailed diet plan should be made with the doctor, as some can affect the stomach in an adverse manner. 
Altered bowel habits: Some people may have diarrhoea, others have constipation. Looking into one s diet and making suitable changes will help. Therefore, it is very important that you must keep regular follow-up and consultation with your surgeon, in order to avoid complications.

Bariatric Surgery - 8 Complications It Can Cause!

Washing your skin with water is something that you probably do daily, but you may not know at what temperature the water should be. Using water at the correct temperature is advantageous for the skin. Water at extreme temperatures is harmful for the skin as your skin is not designed that way.

The temperature of the water should also depend on the purpose for which it is being used. Here are some tips on how to set the temperature of the water depending on the purpose: 

1. Showering: while showering, if you are using hot water, then it may strip your skin of its essential oils and make it vulnerable to dryness. This may cause various skin complications, such as cracked and rough skin. Hence, use lukewarm water while you shower.

2. Washing your hair: using hot water to wash your hair may lead to hair damage as it rids your hair of all the essential oils and makes it limp and dull. Lukewarm to normal water is recommended while washing your hair as it will allow the hair to retain its natural oils.

3. Brushing: the right temperature of water while brushing your teeth should optimally be lukewarm. Too cold or hot water can lead to teeth sensitivity and cause oral problems.

4. Washing your face: before you apply a cleansing agent on your face, use warm water to wet the face as it helps to open up your pores. After the cleansing agent is applied, then use cold water to wash your face. Cold water helps in closing the pores after the impurities are removed from the skin.

5. Shaving: if you are going to shave, then opt for warm water as it opens the pores up and thus makes it easier for the blade to glide through the skin. This also reduces the risk of razor burns on your skin.

6. Washing your feet: wash your feet with lukewarm water as it facilitates dead cell removal and also helps in getting rid of warts.

Hot vs Cold: Which Water Temperature is Best for Your Skin

The heart is a muscular organ that pumps blood to the entire body through a network of arteries and veins. This network contains big vessels which branch out further to supply blood to the distant organs. There is, therefore, some pressure that the heart and thereby the vessels need to exert to push the blood through these vessels. This is known as blood pressure, and normal pressure levels range from 90-140(systolic)/60-90(diastolic) mm of Hg. However, due to various reasons, this pressure could be more, which is one of the first signs of heart disease. 

Causes of increased blood pressure: 

Thickening of the blood vessels. With age, the elastic blood vessels naturally turn rigid and less elastic, so there is more pressure required to push blood. It is natural for people over 55 years of age to have higher readings of blood pressure. This is known as primary hypertension (HTN) 
Narrowed blood vessels. This happens due to cholesterol accumulation along the walls of the blood vessels. Faulty dietary habits along with sedentary lifestyle have increased the incidence of hypertension due to this condition, known as atherosclerosis. Critical atherosclerotic narrowing of renal arteries lead to renovascular HTN that is one of the commonest of secondary HTN. 
Other Causes of secondary hypertension are: 

Kidney problems 
Thyroid hormone disorders 
Congenital heart defects 
Chronic alcohol abuse 
Adrenal gland tumours 
Chronic use of medications like birth control pills, pain killers, etc. 
Unidentified and uncontrolled hypertension can be silent and can lead to more severe conditions like heart attack and stroke. India is fast becoming the new hypertension capital of the world. Some of the common risk factors are: 

Age 
Family history 
Being obese or overweight 
Sedentary lifestyle 
Smoking 
Alcohol consumption 
Excessive salt intake 
Stress levels 
Ethnic background 
Symptoms: 

Hypertension can go undetected for years together, but if there are risk factors like diabetes and high cholesterol, it is advisable to periodically monitor blood pressure. 
Headaches, nosebleeds, and shortness of breath should not be ignored. These can be the first warning signs of hypertension, and if detected early, preventive measures can be taken. 
If there are co-morbid risk factors, it is advisable to constantly keep a check on BP readings. 
Management: 

This includes a combination of diet and lifestyle modifications. 

Quit smoking and alcohol: Of the many wonders quitting smoking can do, reducing BP readings is just one. The improvement would be almost instantaneous. Quit or else reduce alcohol and see dramatic improvements. 
Weight management: Through a combination of diet and exercise, ensure that weight is brought under control. Set a target BMI (Below 26 kg/m2) and work towards it religiously. 
Diet: Reduce salt, increase potassium, increase vitamin D, eat a heart-healthy diet, and see the hypertension readings improve. Please find attached and reviewed copy for health tip for posting

High Blood Pressure - All You Need To Know About It!

Coronary artery disease or CAD is the name given to the heart condition in which the major blood vessels that supply your heart with blood, oxygen and nutrients, also called coronary arteries, get blocked, damaged or diseased.

Blockages usually happen when cholesterol-containing deposits called plaque deposit in your arteries. Plaque narrows the lumen of your coronary artery which means your heart gets lesser and lesser oxygen and nutrients to function properly.
Inflammation is also to blame for coronary artery disease.
Common symptoms of CAD include

Angina or pain in the chest
Shortness of breath
If the blockage is complete, you can get a heart attack.
Common Diagnostic tests
When you go to a heart specialist, she will ask questions about your medical history and follow it up with a physical exam and order routine blood and diagnostic tests to confirm CAD like:

Electrocardiogram (ECG): An ECG records electrical signals as they travel through your heart revealing evidence of a previous heart attack or one that s happening. Holter monitoring is a type of ECG where you wear a portable monitor for 24 hours as you go about your normal daily activities. Abnormalities in the results suggest reduced blood flow to the heart signaling CAD.
Echocardiogram: This test uses sound waves to produce images of your heart. It helps your doctor determine whether all parts of your heart wall are contributing to your heart's pumping activity. If certain parts are moving weakly it can mean damage to muscle due to a heart attack or because of receiving too little oxygen- again signaling CAD.
Exercise Stress test: This test is done by making you do exercises like walking on a treadmill or riding a stationary bike during an ECG. Sometimes, medication to stimulate your heart may be used instead of exercise.
This again detects areas in your heart that receive less blood flow.

Cardiac catheterization or angiogram. A special dye is injected into your coronary arteries to observe blood flow through your heart in a test known as an angiogram.
The dye is sometimes also injected into the arteries through a long, thin, flexible tube called catheter that is threaded through an artery in your leg to the arteries in your heart. This procedure is called cardiac catheterization. This test is very good in diagnosing CAD as the dye outlines narrow spots and blockages on the X-ray images of your heart.
Heart scans. Computerized tomography or CT can help your doctor actually see calcium deposits in your arteries that can be narrowing your arteries. If a substantial amount of calcium deposits are found, coronary artery disease could be the reason.
MRI scans are also done to diagnose CAD.

Common Tests For Coronary Artery Disease!

When dieting and exercising fail to help an obese person in managing his/her weight, bariatric surgery may be suggested. One of the most popular types of bariatric surgery is a gastric sleeve surgery or sleeve gastrectomy. The main aim of this surgery is to reduce the amount of food that can be consumed in one sitting. It does not affect the amount of nutrients and fats absorbed from the food that has been eaten. A majority of the weight loss resulting from this surgery happens within the first 6 months following which there is a slower weight loss over the next 6 months.

A gastric sleeve surgery is a relatively safe and short duration surgery. Prior to the surgery, you would have been given a special diet to be followed, the duration varies between one week to two weeks. It is essential to follow this diet strictly. This surgery may be performed laparoscopically, through tiny keyholes. More than half the outer side of the stomach is removed. The remaining part of the stomach takes the form of a tube. This surgery is not reversible. 

Recovery from a gastric sleeve surgery is quite smooth and varies from person to person. A certain amount of pain and discomfort is normal for the first and second day following the surgery. The patient is put on clear liquids for the first 2 weeks following surgery. Soft foods are introduced in week 3 and 4. You can get back to small amounts of your normal food in week 5. You will notice that you feel fuller much faster and are able to consume a very limited portion of your normal food intake. In some rare cases, your food may also be emptied into the small intestines at a very fast rate. This is known as dumping syndrome. This may cause diarrhea and nausea and leave you feeling weak. It is essential to drink plenty of water to allow for smooth bowel movements and to prevent constipation.

On an average, this surgery can help people lose between 60 to 90% of their excess body weight. However, this requires control over your diet and the amount of exercise you do. At some point in time, your weight loss may plateau. This is normal to overcome this, you must make a change to your diet or exercise schedule. A dietician can also help you address the right number of meals needed by your body. It is very important not to fall back to your earlier unhealthy lifestyle and to maintain a positive attitude.

Gastric Sleeve - Understanding The Course Of It!

In our bodies, the vascular system is composed of vessels. This system is comprised of a complex network of veins and arteries. The arteries transport oxygenated blood away from the heart and spread it throughout our bodies and veins brings the deoxygenated blood (oxygen-poor) back to the heart for purification. Whenever this complicated process gets disturbed, pain, dysfunction of the system, and other complications may occur.

Most common complications among all are:
1. Abdominal Aortic Aneurysm: This condition is when there is a  bulge  formed in the weak area of the largest artery in the abdomen and keeps on increasing with each pressure flow of blood from that artery. This condition weakens the artery further and massive internal bleeding may occur.

2. Carotid Artery Disease - Stroke: This condition arises when the main blood vessels flowing blood to the brain develops a plague caused due to hardening of the arteries (atherosclerosis). The continuous increase of plague can cause a stroke.

3. Peripheral Arterial Disease: This condition occurs when the flow of oxygen-rich blood is insufficient to the lower limbs of the body due to hardening of the arteries in that area. This can cause difficulty in walking, foot ulcers, infections and can even lead to amputation.

The complication of these types are corrected by the vascular surgeon with the process is commonly known as vascular surgery. However, this condition is sometimes medically managed by an innovative, less invasive procedure called Endovascular surgery. 

Vascular Surgery-
Vascular surgery is generally the traditional surgery that corrects the diseases outside of the heart and the brain. This procedure is more invasive as it involves incisions that are surgical in nature. Vascular surgery comprises of the surgery of the aorta, carotid arteries, and other small diametric arteries. This surgery also involves surgery of veins for treating various conditions such as varicose veins and May-Thurner syndrome.

Endovascular Surgery:
However, this type of surgery is an innovative way to treat medical conditions related to the vascular system. For instance, during the procedure of treating the Abdominal Aortic Aneurysm, it involves making a small cut near the hip area and inserting the endovascular graft through the arteries and is positioned inside the aorta, in a catheter, which is a flexible, long, and narrow tube. The endovascular graft is a tube device made up of special fiber and is framed within stainless steel self-expanding stents. The grafts expand and seal off the aneurysm. This stops the internal bleeding the system and the graft remain in the aorta permanently.

This method has a short recovery time, smaller incisions, less discomfort, less stress on the heart and has fewer risks. This surgery is appropriate for the patient who is at high
risk of complications. 

Take Away-
Diseases related to artery and veins are now being treated with various methods such as angiography, stenting, sclerotherapy in various countries. These days vascular surgeons have become proficient with the endovascular surgical methods. Endovascular surgery is durable and less painful and stressful when viewed with the context of vascular surgery. However, the cost of staying longer at the hospitals is somewhat got balanced by the high cost of imaging equipment and other high financial expenses in the endovascular surgery.

Endovascular VS Vascular Surgery - Know The Difference!

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