Bariatric surgery is unlike other surgeries, as its effects are not instant but gradual and are seen over the months. Like any other surgery, it is not without complication. But again unlike all other surgeries, the complication rate can be negligible if a strict protocol is followed. Moreover, the factors like technology advancements, development in the field of advanced laparoscopy, enhanced skillset of the bariatric surgeon, dedicated management of bariatric and metabolic surgeries by bariatric surgeons, play a vital role in the reduction of complication rate which eventually results in safe surgery.

As the procedure is done laparoscopically, the pain is just for a day and is minimally managed by analgesics.

The fear of increasing incidence of incisional hernias while operating an obese patient is so negligible or nil, as the procedure is performed through tiny key holes and all precautions are taken to suture the sheath through which the ports are put to perform the surgery.

Reduced hospital stay and early resuming to work is one of the biggest benefits of this laparoscopic bariatric procedure.

Sometimes, problems that may be faced are:- 

Post-operative bleeding: Normally, this a nearly bloodless surgery involving 5 to 10ml loss of blood. However bleeding from the staple edges is known, but this can be managed well by the surgeon, by choosing the right size of the cartridge as well the right technique of application of the cartridge.

Dehydration: We are normally accustomed to drinking water at long intervals (a few hours) as we can consume nearly 200 to 400ml at one go. Following bariatric surgery, gulping or drinking water in one go is not possible in the first 2 to 4 weeks, due to reduced capacity of the gastric pouch. Hence, care needs to be taken to drink small quantities of water at frequent intervals to avoid dehydration. This is possible only if the patient is counselled about this prior to surgery and is fully aware of this. Also, the patient needs to be given good and clear post operative instructions regarding the quantity and frequency of liquid consumption, not forgetting the type of liquids. Coffee taken frequently could be another cause for dehydration. Family members and colleagues and friends at work play a major role in reminding tthe patient about consuming water frequently. Special care needs to be taken in people who are not accustomed to consuming adequate quantities of water prior to surgery as a general habit.

Vomiting/Fullness/ Discomfort/Indigestion: Following bariatric surgery, soft food is introduced in the diet in the third week, after the first 2 weeks of taking liquids. Due to the reduced capacity of the gastric pouch, the morsel size is significantly reduced and one has to chew the morsel well and eat slowly, giving a gap of 40 to 50 seconds between the morsels. This prevents distension or overdistension of the gastric pouch and thus avoids vomiting. This again requires good counselling prior to the surgery and on the follow up visit too before stating soft food. There is a subjective difference when we say small morsels and we cannot reach a standardization as the morsels size of each individual varies prior to the surgery itself. The best way to avoid this confusion is to make the person have the first soft food meal before you where in you can physically show the way food is expected to be eaten. However, by mistake, there is a chance that one can have a regular sized morsel as over years one is used to eating in that manner. If this happens, the person will vomit , and this will be a reminder to gauge the morsel size the next time the person eats. Following the vomiting, there could be a burning sensation in the stomach which will subside afer taking an antacid. If one follows the instructions of small morsel size, chewing properly and eating slowly, there is no chance that there will be vomiting. Another reason for vomiting could be keeping the stomach empty for a longer duration or having sicy food on an empty stomach. Avoid nuts, seeds, fried foods and processed foods. Very rarely vomiting could be due to reduced size of the joint between the gastric pouch and the small intestine. This could require an Endoscopy and necessary treatment.

Vitamin and mineral deficiency: It is seen that many of the obese patients are seen to have vitamin B12, vitamin D, iron and protein deficiencies in their blood tests that are done prior to surgery. With the significant reduction in the amount of food consumed after bariatric surgery, the existing deficiencies are bound to increase. Hence, it is necessary to do these tests, before surgery and rectify the deficit prior to the surgery.  

Gall bladder stones: Significant weight loss which is consistant over a short duration could lead to the formation of gall bladder stones, be it with or with out surgery in a small percentage of patients. To avoid this there are two schools of thought, one is have a prophylactic removal of the gall bladder along with the bariatric surgery and another is to put the patient on ursodeoxycholic acid (a tablet) for the first few months after surgery during which there is significant weight loss.

Skin sagging: In the morbidly obese, when the skin is overstretched beyond a certain point, it tends to sag once significant weight is lost. This sagging is influenced by a number of factors like age of the patient, the BMI, pre existing sagging, pre-existing muscle tone and protein supplements taken during weight loss and exercises done during the weight loss period. Skin sagging is less if the age is less than 45, BMI less than 45, good protein intake during weight loss and good toning exercises done during the weight loss period.

Hairfall: Significant weight loss either by diet and exercise, aerobics, bariatric surgery, will entail hair loss. But this can be minimised to a greater extent by ensuring good protein intake during the weight loss period and adequate supplements in terms of vitamins and minerals.

Dumping syndrome: With a reduced size of the stomach, the food moves from the stomach into the smaller intestine much faster. This causes the pancreas to release excessive amount of insulin, leading to very low blood sugar levels , producing various symptoms like abdominal cramps, bloating, diarrhoea, sweating, dizziness, nausea, weakness, and anxiety. This is managed by eating less amount of sugars and fats and spacing out the meals through the day, having four to five small meals compared to  2 to 3 large meals. Having a high protein diet and avoiding liquids during meals is also an option.

Bariatric Surgery - Know Problems Of It!

When dieting and exercising fail to help an obese person manage their 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 12-18 months.

A gastric sleeve surgery is a relatively safe, straightforward and short surgery. Prior to surgery, few patients would have been given a special diet.  This surgery is always  performed laparoscopically popularly known as keyhole route. More than half the outer side of the stomach is removed. The remaining part of the stomach takes the form of a tube. 

Though recovery from any surgery varies from person to person, most patients are able to walk and allowed sips of water by evening. Though certain amount of pain and discomfort is expected, this remains in bearable range with pain killers. Usually liquid diet is advised for 2 weeks followed by soft foods for 4 weeks.

You will notice that you feel fuller much faster and are able to consume a very limited portion of your normal food intake. It is essential to drink plenty of water to remain adequately hydrated and to prevent constipation.

On an average, this surgery can help people lose up to 70% - 100%% of their excess body weight. However, this depends largely on your understanding and compliance of post operative dietary changes. A dietician can also help you make right food choices, decide meal portions and address the right number of meals needed by your body. For long term weight maintenance it is important not to fall back to your earlier lifestyle and to maintain a positive attitude.

Gastric Sleeve Surgery - What Is The Process Of It?

A gland that produces a liquid which mixes with sperm and is ejaculated as semen during sexual activity, is the prostate gland and is located under the bladder of a man. Cancer in the prostate is one of the most common cancers that occur among men.

The risk of developing prostate cancer increases progressively with age. Although there is no absolute prevention of prostate cancer, evidence and doctors suggest that a healthy diet can play a key role. Here are a few tips that can go a long way in prevention of prostate cancer:

Red Foods: Tomatoes, carrot, watermelon, and other red foods get their bright color from a powerful antioxidant called lycopene. Studies have proved that by having fruits that contain lycopene, you can reduce your risk of prostate cancer. Some findings suggest that cooking tomatoes make it easier for your body to absorb this antioxidant.
Fruits and Vegetables: Green vegetables contain compounds called carcinogens, which help your body in breaking down cancer-causing substances. Spreading of cancer can be slowed down through a nutrient-rich diet. Avoiding processed junk food and eating fruits and vegetables containing nutrients and vitamins may lower the risk of getting prostate cancer.
Feast on Fish: Fatty acid, also known as omega-3, is found in certain fish including sardines, tuna, mackerel, trout, and salmon. This may help in reducing the risk of developing prostate cancer.
Soy and Tea: Some studies suggest that men who drink green tea or take green tea extract supplements have a lower risk of developing prostate cancer. Many soy products and other foods contain a nutrient called isoflavones, which has been linked to a reduced risk of prostate cancer.
Coffee: Studies show that drinking three cups of coffee a day can reduce the chances of prostate cancer by 11 percent. There is a dose-response relationship between coffee and prostate cancer. The effects of prostate cancer go up or down with the amount of coffee you take. Someone who grabs an occasional cup only, may not have these effects. However, high doses of caffeine can result in major health issues.
Fat: Studies indicate that animal fats and an increased risk of prostate cancer are linked. It is advised to replace animal-based fats with any kind of plant-based fat. In addition to this, overcooking the meat produces carcinogens, therefore it is suggested to be strictly avoided.
Quit Smoking: Smokers are more likely to have an aggressive form of prostate cancer. The chances of a recurrence of the disease are more for people who smoke. It is never too late to quit smoking.
Exercise: Regular exercise and maintaining a healthy body can help you to increase your muscle mass and metabolism. Too much fat in the middle of your body is linked to an increased risk of prostate cancer. You can try walking, running, bicycling or swimming to reduce the weight to lead a healthy life.
It is important to look after yourself and start taking essential steps to prevent prostate cancer rather than trying to manage it once you get it.

8 Easy Ways By Which You Can Prevent Prostate Cancer!


Feeling a lump on your breasts can be a terrifying moment. 'Cancer' is the first thing that comes to mind but in reality, most lumps in the breast are not caused by cancer. Apart from cancer, breast lumps can be caused by non-cancerous growths, injuries and infections. The only way to correctly diagnose the cause of a lump in the beasts is through a biopsy. Hence, this is the first step towards treating a breast lump. From here on, treatment will depend on the cause identified.

Mastitis or Breast Infection

Mastitis is a painful infection of the breast tissue often faced by women who are breastfeeding. It can be treated with heat treatment and antibiotics. Massaging the breast while taking a warm shower or applying a warm compress. This will open up the milk ducts and should be followed by nursing the baby or using a breast pump to relieve the swelling and pain.

Abscess

Antibiotics are the first line of treatment against an abscess but this is effective only if given in the initial stage of the infection. In later stages, an abscess will need to be surgically drained.

Fibroadenomas

This is a non-cancerous tumour often found in young women. It is often difficult to distinguish between a Fibroadenoma and a cancerous tumour and hence these are usually surgically removed.

Fibrocystic Changes

In some cases, the breast itself is composed of knotted, rope like tissue. This is known as having fibrocystic breasts. If a new lump presents itself on fibrocystic breasts, a mammogram and an ultrasound are performed to evaluate the lump. In most cases fibrocystic changes do not require any medication or surgery.

Breasts Cysts

Cysts can be defined as fluid filled lumps. In some cases, these cysts become apparent at the time of ovulation and disappear after the period. In other cases, it may need to be drained with a thin needle. Cysts often recur and need to be re-drained.

Fat Necrosis and Lipoma

Fat necrosis is a lump caused by an injury to the fatty tissue in the breast. Lipoma is a fatty growth within the fatty tissue. In both these cases, no treatment is required but if it causes any problems, it can be removed.

Breast Cancer

If the biopsy reveals the presence of a cancerous tumour, you must immediately consult an oncologist. Treatment options for breast cancer include chemotherapy, radiation, surgery and hormone treatment.

Treating Lumps and Pain in Breasts of Women

Formation of blood clots in the arteries of the lungs, heart or legs can actually kill a person. In such a case, the immediate medical action is necessary and the only way to deal with blood clots is thrombolysis.
Thrombolysis or thrombolytic therapy is a medical process that dissolves blood clots and facilitates blood flow to all parts of the body. Thus, it protects tissues and muscles from damage.

What are the causes of blood clots in the body?

  Poor blood circulation
  Conditions such as Deep Venous Thrombosis and atrial fibrillation
  Blood clots can also be formed because of dialysis catheters and by-pass grafts

How can you tell if you have blood clots?

  Swelling in one or more legs
  Cramp and tenderness in the legs
  Breathing trouble might indicate that blood clots have travelled to the lungs
  Sweating and frequent chest pain may suggest that blood clots have travelled to the heart

How is Thrombolysis performed?

Thrombolytic drugs are injected into the body intravenously. They make their way to where the blood clots exist and dissolve them. If there is a medical emergency, the drugs are delivered to the exact location of the blood clots and immediately start dissolving them. Another method is inserting a device into the blood clot infested region to break the clots up. The drugs which on entering the body dissolve blood clots are called thrombolytics. There are many varieties of thrombolytics such as the following-

  Streptokinase - It is a kind of enzyme. It is used when a person has just suffered a heart attack or pulmonary embolism. Doctors do not usually prescribe the second usage of this drug. It is injected into a vein and can be administered to pregnant women.

  Tenecteplase - Also an enzyme, it is a plasminogen activator. When it binds to the surface of the blood clot, it makes the clot degenerate.

  Reteplase - It is actually extracted from E-Coli. It is a sterile intravenous bolus injection

The leading cause of heart attacks and ischemic heart disorder is the formation of blood clots in the arteries that connect the heart and the brain. Thrombolysis is often employed as an emergency treatment for this purpose. Thrombolysis is also effective against blood clots formed in the lungs (which lead to acute pulmonary embolism). Sometimes blood clots are formed in the legs, upper extremities of the body, the pelvic region (deep vein thrombosis). These clots may travel to the lungs and heart.

Consult your doctor before undergoing the treatment.

Thrombolysis - Causes, Symptoms & Treatment Of It!

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!

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