Peripheral Artery Disease (PAD) is caused by atherosclerosis or plaque build-up in the leg arteries. Mostly, individuals with PAD have mild or no symptoms. But with the extension of the blockages, individuals may experience disability and pain that restricts free walking. In more severe cases, individuals may develop a risk of losing their limb if the circulation is not improved. 

There are various ways to improve the flow of blood in the leg, especially for individuals with severe PAD. The objectives of improving the blood flow in the limb include improving functional ability, reducing pain, preventing amputation, and providing a better quality of life. 

Symptoms 

Symptoms of Peripheral Artery Disease may include gangrene, claudication or pain in leg muscle while walking, pain at night mainly in the feet and leg, and feet sores.

Bypass Surgery

There are a number of treating methods for PAD. Both invasive and traditional methods are used to treat Peripheral Artery Disease. 

Stenting and Angioplasty are invasive treatment methods. The traditional method includes bypass surgery. The best available treatment method for an individual depends upon various factors such as severity, location of the artery blockage in the leg, general health of the patient, history of any vascular problems, and previous treatments.

Surgical bypass in the leg or Lower Extremity Bypass Surgery is usually the last option for the patients with PAD. This method is used when all the other alternative treatment methods fail or are not suitable for the individual. During the Leg Bypass Surgery, the surgeon forms an alternative channel for blood flow to bypass or avoid the blocked area and restore the direct flow of blood to the lower leg and foot. 

The risks and benefits of the surgery are calculated prior to the surgery. For the best result of the surgery, surgeons try to use the patient s own saphenous vein, from inside the leg, to execute these grafts. Surgeons may also use veins from other leg or arms or use prosthetic or artificial graft, in case the required length of the saphenous vein cannot be achieved. 

The results of artificial and saphenous vein from other limbs are not as effective as the saphenous vein from the same leg. Thus, the availability of an appropriate vein to execute this method is an important consideration that is taken into account before the surgery. 

Takeaway

Leg Bypass Surgery is one of the medical procedures for the treatment of Peripheral Artery Disease. In PAD, the artery of the leg is blocked which can hinder the daily life of the individual. 

The symptoms can be mild or absent but, in the case, where symptoms are severe, and affecting the quality of life of the patient, treatment becomes a necessity. Bypass surgery is the last option used when other alternative methods fail to help the patient. 

Leg Bypass - Know More About It!

Terms like ileostomy and colostomy really sound a bit too scientific, don t they? Well, it is true that may seem to be pretty scary to almost anybody who is not professionally familiar with them! That being said, it is quite important to know what these things are, as it is always good to be informed of things like these. After all, one never knows when he or she may need to consider the possibility of having one.

The similarity which exists between these two procedures is due to the fact that both of them require the surgeon to cut an opening into the intestine from the skin of the abdominal wall. To be more specific about each of the procedures, the ileostomy involves the removal of the entire colon as well as the rectum of the person who is undergoing it. When this operation is performed, the small intestine s end is adapted so as to expel the faeces which are produced as a result of the digestive process.

Now, this does seem like quite a daunting prospect, does it not? Well, it does and with good reason as it is really not a small matter, at all. That is why the surgery is performed on people who suffer from diseases such as Crohn's disease, who have a condition in which entire sections of their gut cannot be linked in a proper manner!

On the other hand, a colostomy refers to a follow-up surgery to a colectomy, in which the surgeon creates an opening which is known as a stoma. A colectomy is when there is a removal of a part of the large intestine. In many cases of colostomies being performed, they are intended to be temporary in nature.

Now, taking into account just how serious these operations are, a person may wonder just what unfortunate thing needs to happen to warrant a surgery of this sort to be performed! Well, essentially, if there is an occurrence of bowel cancer which is significantly bad, then there may be a need which arises as a result of the same.

Advanced medicines do have some interesting facts; contrary to what most people think, a stoma does not hurt. This is because there are no nerves in the area! While a person may hopefully never need either surgery performed on oneself, that surely does not mean that awareness about them should not be widespread.

Colostomy And Ileostomy - What's The Difference Between Them?

The  Roux en Y Gastric Bypass  surgery was first performed by Professor Mason in 1966. Being done in the conventional way (i.e by open surgery) earlier and later laparoscopically, the Gastric Bypass has stood the test of time over the last 52 years.

Over 50 years the Gastric bypass surgery is being performed across the globe. It has given excellent results in terms of significant and long-standing weight loss in the morbidly obese, as well as remission of Type 2 diabetes in properly selected patients. Selection of the patient to undergo this procedure is paramount. 50 years of successful results are enough to term this procedure as the GOLD Standard.

Obesity and Diabetes have been a menace over the last 2 decades world over. In India obesity is growing in such a rampant way that we can equate it to an epidemic.

As we all know, India is considered to be the Diabetic Capital of the world. Type 2 diabetes contributes to the major chunk of diabetes affected population. We Indians get affected by diabetes at very early ages and hence complications are seen at very early ages among us. Strikingly important to notice is that Diabetes is seen not only in the obese category of people but also in the normal weight people.

Diabetes is feared of only because of the complications it is capable of causing affecting the vital organs like the brain, heart, eyes, kidneys.

Intermittent or elevated surges in the blood sugars levels during the course of the day are responsible for causing microangiopathies ( damage to the small vessels supplying blood to the vital organs).

We have seen that diabetes is accompanied by high blood pressure and dyslipidemia in most of the cases. So, when a person has diabetes, high blood pressure and dyslipidemia, we label them as having the metabolic syndrome.

Oral hypoglycemic agents (OHA) and insulin form the mainstay of treatment in getting sugars under control. But these are not able to avoid these surges in high sugar levels. This does not mean that OHA s and Insulin are not the right way to treat diabetes- they indeed are.

We are going a step higher, in an attempt to get control of diabetes without OHA and insulin. Not only this, we are trying to tackle not just diabetes, but the metabolic syndrome on the whole i.e one procedure that will take care of diabetes, dyslipidemia and hypertension. This procedure is popularly known and referred to as the  Gastric Bypass  or the  Roux en Y Gastric Bypass . Thus, In short, the gastric bypass surgery offers ICE BURG treatment.

Now, the first question is that  Is this possible . The answer is YES. The second question is that is this procedure applicable for all diabetics. The answer is NO. Only Type 2 diabetics are the beneficiaries of this procedure where insulin resistance has a major role to play. (This procedure does not benefit Type 1 diabetics) Reasons for this will be explained later. The third and important question is that,  Is the Gastric bypass going to give remission of diabetes in all type 2 diabetics?  The answer is NO.

There is strict selection criterion or eligibility criteria to select a patient for The Roux en Y Gastric Bypass surgery. Best results of the Gastric Bypass surgery are seen when it is confirmed that the person is suffering from Type 2 diabetes, duration of diabetes is less than 5 years, the pancreatic reserve is good and showing good levels of C -peptide in the blood, the person has a family history of diabetes, Insulin was not required to control sugar levels within the first 5 years of onset of diabetes and person should not be underweight( BMI > 27.5 preferred).

Losing weight is not easy and even if we lose weight, weight regain is very common. Most of us would have already experienced it. When we are tackling just the weight issue, we are talking into consideration only the morbidly obese people who have a BMI > 37.5. In the morbidly obese, at first, it is very difficult to lose significant weight by the normal method of diet and exercise. Even if weight loss does occur, weight regains or bouncing back is sure.

Here we bring in the trump card   The  Roux en Y Gastric Bypass  that helps the :

 Morbidly Obese  (BMI >37.5) to lose significant weight and reach their ideal weight.
 Obese  (BMI >32.5) who also have comorbidities (like diabetes, hypertension, dyslipidemia, sleep apnea, obesity-induced infertility) not only to lose significant weight and reach their ideal weight but also to get control of the associated comorbidities.
 Type 2 Diabetics  (BMI > 27.5) to get Remission from type 2 Diabetes.
 Metabolic Syndrome  (BMI > 27.5) to get remission from type 2 diabetes, dyslipidemia and Most cases hypertension.
Type 2 diabetics can be offered this procedure even if they are not morbidly obese, is what I would like to bring it to notice.

Exposure to Type 2 diabetes for long years can lead to potential complications like coronary heart disease, chronic kidney failure, brain stroke, gangrene of the lower limbs.

In some, in spite of talking OHA s, Insulin, sugars are not under control. In these cases, the gastric bypass can be offered to those who fulfil the eligibility criteria.

Remission of diabetes after the gastric bypass procedure is very quick, ranging from a week to a month in most of the cases. However, in some, The sugar levels come to normal the very next day after the surgery in some without the OHA and /or insulin.

Gastric bypass is done through laparoscopy i.e through tiny holes over the tummy, requiring 3 days hospital stay. Supplements need to be taken following the procedure on a daily basis. Following the procedure, intake is reduced to a great extent which increases over few months as the gastric pouch stretches.

Gastric Bypass - Be It Bariatric Or Metabolic Surgery, Get Amazing Results!

Egg yolk and cholesterol - is there a link?

Although egg is considered one of the most nutritious foods, people with high cholesterol avoid its consumption as they believe that eggs may increase cholesterol and risk heart diseases.

Is there a link between egg yolk and cholesterol?

Egg yolk is rich in dietary cholesterol. One large egg contains 185 milligrams of cholesterol. People with normal cholesterol levels require about 300 milligrams of dietary cholesterol and people with high cholesterol need 200 milligrams of dietary cholesterol from food.

Dietary cholesterol has the minimum impact on blood cholesterol as compared to saturated and trans fats which contain bad cholesterol. Hence dietary cholesterol present in egg yolk has minimal or no effects on increasing your cholesterol levels.

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

Egg Yolk and Cholesterol - Is There Really a Link?

If you are experiencing pain in the muscles and joints, an enhanced craving for salt, symptoms of low glucose in the blood or low blood pressure, you could be suffering from adrenal insufficiency (AI). The outer layer or cortex of our adrenal gland produces three forms of steroid hormones. In adrenal insufficiency, the cortex fails to produce enough steroid hormones. Some people do not know that they have been affected with adrenal insufficiency until they experience a sudden worsening of symptoms. This is called an adrenal crisis.

Causes
The different types of adrenal insufficiencies occur because of different reasons. Primary AI is commonly caused by autoimmune diseases in which our body s defence system destroys the body s tissues. Bleeding in glands, genetic diseases and infections are other likely causes.

Secondary AI occurs because of problems with the pituitary gland. The pituitary gland produces a hormone named adrenocorticotrophic hormone (ACTH) because of which the adrenal glands produce cortisol. In the case of secondary AI, the pituitary glands stop sending ACTH to the adrenal glands, and cortisol is hence not produced. This may occur by taking certain prescribed medicines.

Diagnosis
A patients s medical symptoms and medical history are observed. The blood levels of cortisol, sodium, potassium and glucose are checked for the detection of AI. The adrenal glands and the pituitary gland are observed by imaging tests. X-rays, ultrasound, and CT and MRI scans may be required.

Treatment
The treatment of adrenal insufficiency aims at ensuring proper levels of hormones in the body. You may require regular replacement of hormones for life. You have to take glucocorticoids for replacing the cortisol which your body does not provide anymore. Mineralocorticoids should be taken when the body does not produce aldosterone. Extra glucocorticoids may be required during times of intense stress such as a surgery or serious health conditions.

Glucocorticoid helps the body in coping with stress, injury and illness. It helps in the regulation of blood glucose levels and blood pressure levels. It performs the function of cortisol.
Mineralocorticoid helps in maintaining a proper balance of water and salt in our body. This is actually carried out by aldosterone.
Adrenal androgens, which are weak male sex hormones, present in both men and women, help in the regulation of pubic and armpit hair growth in women.
If you experience any symptoms of adrenal insufficiency, it is recommended that you visit a doctor immediately. Early diagnosis will enable early treatment, which is beneficial for you.

Adrenal Insufficiency (AI) - Ways It Can Be Treated!

There is no fixed definition for the best diet. It solely depends on the health condition, requirement, and restrictions of a patient that a diet can be planned that can help deal with or prevent a particular health threat while ensuring overall good health.

Cholesterol is becoming a widely known threat responsible for inflammation and forming blood clots which may lead to strokes and heart attacks. Since it is a growing concern, it is recommended the patient follows a proper diet that can help in keeping the cholesterol level in the blood under control. To make such a best diet, below are few necessary and practical tips.

Opt For Healthier Fats
One must remember that the saturated fat found in the dairy products and red meat raise the level of the bad cholesterol or LDL, instead of reducing it. Receiving around 7 percent of the regular calorie need of the body is necessary from saturated fats. Therefore, one needs to opt for healthier saturated fats, such as canola or olive oils, monounsaturated fat products, low-fat dairy products, etc.

Increase the Intake of Fiber
The more the sources of fiber will be there in one s diet, especially the soluble ones, the more health benefits one can have from that diet regarding the cholesterol reduction. Fresh fruits, oat bran, oats, beans, vegetables, and lentil are excellent sources of fiber and must be there in one's diet to make it the best.

Avoid having Trans Fats
Trans fats are known to increase the bad cholesterol(LDL) and reduce the good cholesterol (HDL). Therefore, eliminating sources of trans fats from one's diet will automatically contribute to keeping the cholesterol levels under control. Usually, it is the fried foods, various commercial products such as snack cakes, crackers or cakes, junk foods that are filled with trans fats and must be avoided.

Include Whey Protein
Whey protein has found to be a good source of reducing LDL or low-density lipoprotein and maintaining a balance in the overall cholesterol production inside the body. Therefore, including foods like ricotta cheese, yogurt, cereals, oatmeal, etc., each of them being rich in whey, can be a smart way of making one's diet more heart-friendly.

Add Omega 3 Fatty Acid Rich Foods
To make your diet a cholesterol reducer, try eating foods that are rich in omega 3 fatty acid. Though this particular fat is not associated with affecting the LDL cholesterol, it helps in the good cholesterol or HDL level in the blood, reducing both the triglycerides in the blood and blood pressure. Walnuts, ground flaxseeds, almonds, fishes like salmon, herring and mackerel are a few good sources of omega 3 fatty acid.

Apart from making the diet healthier and heart friendly, one should consider making some lifestyle changes such as to exercise regularly, to quit smoking, etc., to make the diet more effective and its results long-lasting.

Diet That Can Keep Cholesterol Under Control!

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