With recent lifestyle changes, more and more people, younger in age, are falling prey to heart attacks. While some silently suffer the attack during their sleep and never wake up, others have symptoms which they dismiss as acidity or muscular pain and ignore them. There are multiple media programs that are trying to create awareness about how to identify a heart attack. If done at the right time, there is a good chance that the person can be saved.

What is a Heart Attack?

The blood vessels gradually narrow, reducing the blood flow to the target organs. This reduces the efficiency of the target organ, and if this happens to be the heart, it is known as a heart attack. The area that should ideally receive blood does not, leading to its  death.  If the damage is not severe, it can be reversed. However, if this attack happens in one of the critical areas of the heart, it can even be fatal.

Symptoms To Watch For: Very few attacks happen suddenly. Most start slowly and progress, and if identified on time, a life can be saved. The episode takes about an hour, and if you are well-versed with the symptoms, it could help identify the condition correctly and save a life. Most people use antacids and muscle relaxants to ease the situation, which does provide immediate relief, but not a proper cure.

There is a central pain which is constant, nagging, and has a squeezing like sensation. This causes discomfort and most often, this pain is in the center of the chest area, which lasts for just a few minutes. Sometimes the pain can go and come back. This pain radiates down into the arm, up into the neck area, and also into the jaw and is almost always indicative of a heart attack.

With chest pain, there is always shortness of breath which the person will experience. This is due to reduced oxygen levels in the body.

Associated symptoms include fatigue, exhaustion, nausea, dizziness, light-headedness.

There is almost always profused sweating where the person breaks into a cold sweat.

If the attack happens during sleep, the person may be snoring and may feel, as if something is choking his airway.

Due to reduced return of blood from the peripheral organs, there could be swelling of the feet and ankles.

If there is irregular heart beat (palpitations) very often, talk to your doctor about it.

When you suspect a person of having a heart attack, check for these signs. Very often, a heart attack is detectable and can be managed with timely intervention.

Signs Of A Heart Attack

Being overweight is becoming a common sight. However, opting for bariatric surgery is not the first option for everyone who is obese. Also to remember is that morbid obesity is not an isolated condition. It affects a person s overall physical and mental health in various ways, and therefore bariatric surgery becomes an option only as a last resort. 

Some defining criteria for this surgery would be:

A male who is at least 100 pounds overweight for his height or a female who is at least 80 pounds overweight for her height. This puts them at a body mass index (BMI) of more than 40.
If the BMI is in the range of 35 to 39 and if there are significant health issues like metabolic syndrome, then bariatric surgery can be done. For BMI less than 35, other conservative measures are usually tried before resorting to a surgical approach.
Most people with BMI in the range of 35 and above will have health issues like sleep apnoea, heart disease, lipid disorders, and metabolic syndrome.
Conservative measures to lose weight including diet changes and exercise have failed to produce any desired results.
The person, in addition to physical health, should also be emotionally strong to undergo the demands of bariatric surgery. There are changes involving almost all body systems including digestive, respiratory, cardiac, and musculoskeletal, and so the person needs to be prepared for a lifestyle change.
Strict lifestyle changes including diet and exercise are required, so the person needs to be counseled and convinced about these. A person who can see the long-term benefits will be willing to take the effort.
It is also essential that the person has a strong social support system. For immediate post-op care when skin flaps need to be managed, and for long-term emotional support to manage emotional issues, it works wonders if there is a strong social network. The results are usually better in such people.
A person s overall health would be screened to make sure the lab tests are well within acceptable limits before surgery. It would be unreasonable to get these numbers within limits, if they are way too beyond acceptable limits.
Not the least consideration, but bariatric surgery is an expensive affair. It requires not just surgical costs, but also post-op costs. The good thing, however, is that overall healthcare costs would come down, once the results are visible.
Identifying the right candidate for a bariatric surgery is very essential, as doing this extensive surgical approach on an unsuitable candidate would be a failure.

Bariatric Surgery - Who Is Eligible For The Same?

Kidney transplantation is a major surgery. In this surgery, doctors will remove your damaged/malfunctioning kidney and replace it with a healthy kidney from a donor. A successful kidney transplantation surgery will greatly increase your life expectancy if doctors have diagnosed you with chronic kidney disease.

However, some kidney transplantation surgeries have a better outcome than others do. This is mainly due to some factors that can affect the chances of success before and after the surgery. Here is a look at what these factors are.

Pre-surgery:

You may not be able to control what happens before the transplantation surgery, but here are some things that can affect your chances of a healthy life:

1. Age of the donor and the recipient: Younger people have healthier bodies and easily recover from surgery. Therefore, to achieve the best results in kidney transplantation surgery, it is important for the kidney donor to be young. Kidneys from a younger donor are likely to be healthier and function better for a longer time. For instance, if donor A is 60 years old and donor B is 30 years old, the outcome of transplant will be better if you receive the kidney from donor B. Similarly, if you are too old, your body may reject the transplanted kidney. However, your body will easily adjust to the transplant if you are young.

2. Living donors are better: If you receive a kidney from a living donor, the surgery is much more likely to be successful. In most cases of living donors, a friend or family member donates the kidney to the patient. Therefore, if you have a friend or relative willing to donate a kidney to you, you should opt for that instead of waiting for a kidney from a dead donor.

Post-surgery:

When you undergo a kidney transplant, you can develop heart diseases. Here are some things that will help you prevent that-

1. Keep blood pressure low

Some medications for your kidney disease can lead to an increase in blood pressure. Therefore, you should consult the doctor and report the elevated blood pressure, so that he/she can change the medicine. Additional medication may be required to keep your blood pressure under check so that you do not develop cardiac conditions.

2. Keep cholesterol levels in check:

To prevent organ rejection after the transplant surgery, doctors prescribe immunosuppressants. These drugs can increase cholesterol levels in the blood, which leads to blood and heart disorders. Therefore, you need to reduce cholesterol intake through diet. Ask your doctor about exercises that you can do to reduce cholesterol build up in the body.

Lastly, maintaining proper body weight is also essential after kidney transplantation surgery. Taking these measures will keep your overall body healthy while keeping heart disease and other problems at bay.

How To Achieve Best Results In Kidney Transplantation?

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!

GERD is a digestive disorder that affects the lower esophageal sphincter, which is the ring of muscle between the esophagus and stomach. Gastroesophageal reflux is the backward flow of acids from the stomach into the esophagus. Doctors believe that some people usually suffer due to a condition called hiatal hernia. Pregnant women usually suffer from heartburn or acid indigestion caused by Gastroesophageal Reflux Disease.

The primary goals in the treatment of this disease are relief from symptoms, healing of erosive esophagitis and prevention of complications of esophagitis. The symptoms include heartburn and regurgitation. The setting includes a proton pump inhibitor (PPI). Patients suspected due to GERD with non-cardiac chest pain are recommended to have diagnostic evaluation before institution of therapy. For diagnosing GERD, barium radiographs should not be used.

The other points that must be remembered to diagnose GERD are
1. Endoscopy is recommended only in case of alarming symptoms. Even in typical symptoms, the upper endoscopy is not recommended.
2. For preoperative evaluation, esophageal manometry is recommended, but it has no role in diagnosing GERD.
3. Ambulatory reflux monitoring is a test that can assess association of reflux symptoms.

Management:
The suggested lifestyle modifications for the patients with GERD are

    Weight loss is recommended for patients who are overweight. So, avoid large meals and decrease dietary fat intake.
    Avoid alcohol, chocolate, onions, garlic, acidic foods and peppermint.
    Do not lie down within 3 to 4 hours after meal (recommended for nocturnal GERD patients).
    For symptom relief and to heal erosive esophagitis, a 8-week course of PPIs is the therapy of choice.
    Medications that help in potentiating GERD symptoms, including alpha-adrenergic agonists, nitrates, calcium channel blockers and theophylline should be avoided.
    For patients without diagnostic evaluation, therapy for GERD other than acid suppression, including prokinetic therapy should not be used.
    For patients with partial response to PPI therapy, additional symptom relief can be achieved by increasing the dose twice daily or switching to a different PPI.
    It is recommended to elevate the head of the bed 10 to 20 cm.
    Avoid wearing clothes which are tight around the waist.
    If patients experience heartburn relief, Histamine-receptor antagonists (H2RA) therapy can be used as a maintenance option in patients without erosive disease.

Some surgical options
1. For long-term therapy for patients suffering with GERD, surgical therapy is the best treatment option.
2. In patients who have no evidence of erosive esophagitis, preoperative ambulatory pH monitoring in mandatory.
3. Gastric bypass is the preferred operation for patients who are suffering with obesity and are contemplating surgical therapy for GERD.

Apart from these, there are potential risks that are associated with PPIs such as switching them can be considered in setting of side effects and the therapy can be a risk factor for Clostridium difficile infection.

Management of Gastroesphageal Reflux Disease (GERD)

Natural ways to remove your blackheads and whiteheads
 
Blackheads and whiteheads not only make you look unattractive, but also are hard to cure and keep recurring. Fortunately, there are quite a few substances and food items available in every kitchen that can effectively and naturally treat them and can also prevent them from recurring! 

Some of the best natural treatments for whiteheads and blackheads are-

1. Use milk- milk is a natural cleanser. Add a hint of lemon juice to half a cup of milk and mix it well with half a spoon of salt. Apply this mixture while scrubbing thoroughly on the entire surface of your face skin. This method decreases whiteheads and blackheads in a week and also stops them from recurring.

2. Cinnamon &amp; honey- a paste made up of one tablespoon of cinnamon powder and adequate honey is a very effective mixture. Apply it on the face, especially on the affected areas, and keep it on for the entire night. Wash it off in the morning. Continue this every night till whiteheads and blackheads disappear.

3. Baking soda- baking soda is exceptionally good to treat several skin problems. A mixture of baking soda and water must be applied on the face. Once it dries, wash it off. This mixture dries off the whiteheads and blackheads and also removes excessive oil from the skin.

4. Mint &amp; turmeric- extract 4 teaspoons of mint juice and add half a spoon of turmeric making a thick paste. Apply it on affected areas for a while. Once this paste dries off, wash your face with water. Milk can replace mint juice if desired.

5. Lemon juice- squeeze out lemon juice from 2 big sized lemons. Add some water to reduce the acidic effect. Dip a cotton ball in it and rub it across your face. You can do this several times a day. This is the simplest method to treat whiteheads and blackheads.

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Everybody Has Them! Remove Blackheads &amp; Whiteheads Naturally.

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