In most cases, pain anywhere in the body can be explained as a symptom of some other problem, but sometimes, there is no reason for abdominal pain. This type of pain is known as chronic functional abdominal pain. This is a gastrointestinal disorder that cannot be explained through X-ray or laboratory findings. It can be triggered by altered sensitivity to nerve impulses in the brain and gut. People suffering from this condition are often so debilitated by the pain that it becomes the central focus of their life.

This condition cannot be cured, but with proper treatment, it can be managed so that it does not affect the quality of your life. The aim of treatment for this condition is to control the symptoms and improve functioning. When it comes to treating this condition, the patient s relationship with his or her doctor plays an important role as the condition cannot be proven through any form of testing and it has a great psychological effect on the person. Regular checkups are also a key to managing this condition effectively.

The first step towards achieving this is to identify possible emotional and situational triggers. Maintaining a journal that records these experiences can help with this. Further treatment is usually either through psychological treatment or antidepressants.

Psychological treatment is based on the understanding that the brain can block pain by diverting attention elsewhere. Nerve impulses that travel from the abdomen to the brain must pass through a type of  gate  that is controlled by nerve impulses generated by the brain. When these impulses close the gates, pain is blocked while when these gates are open, the pain can be magnified. Psychological treatment for chronic functional abdominal pain can be in the form of relaxation techniques, imagery, hypnosis and cognitive behavioral therapy. While relaxation techniques such as meditation and hypnosis help a person shift focus from the pain, cognitive behavioral therapy teaches a person how to change thoughts and perceptions in order to control the pain.

Antidepressants can also act as pain relievers. This form of medication stimulates the production of brain signals that close the  gates  of nerve transmissions. This blocks the pain but can take several weeks to be effective. Some people may experience side effects such as drowsiness and nausea and hence should never be taken without a doctor s supervision. In some cases, antidepressants may also be combined with cognitive behavioral therapy or medication to regulate bowels.

Ways to Treat Chronic Functional Abdominal Pain!

Pericardial effusion is the excess fluid between the heart and sac surrounding the heart. The fluid keeps the heart moving in the sac. The excess fluid can cause a problem in the workings of the heart and may lead to death. The space between two layers of sac usually contain 2-3 tablespoons of clear liquid. But pericardial effusion can affect the heart beats and make it weaker.

Causes 

The leading cause of the pericardial effusion is pericarditis. In this condition, the layered sac of the heart is inflamed due to some viral infection. This inflamed sac produces more fluid.

Some of the most common infections that cause pericarditis are: 

  Viral infection 

  Cytomegalovirus 

  Coxsackieviruses 

  Echoviruses 

  HIV 

The other causes of pericarditis and pericardial effusion are: 

  Injury in the heart or the sac 

  Cancer 

  Kidney failure 

  Tuberculosis 

  Lupus 

Symptoms 

Generally, when there is minimal or no inflammation in the sac, there are no symptoms. However, chest pain and short-breathing are the most common symptoms for pericardial effusion. 

The large pericardial effusion in the heart sac can show symptoms like: 

  Shortness of breath 

  Passing out occasionally 

  Fast heart pounding 

  Fatigue 

  Clammy skin 

In some cases, where the condition is not worse, patients may experience: 

  Fever 

  Fatigue 

  Vomiting 

  Muscle aches 

  Viral illness

Diagnosis 

The person experiencing the above-mentioned symptoms should visit a cardiologist for a checkup. The doctor may ask for following tests and checkups for determining the condition: 

  Physical Checkup: In the physical checkup, the doctor listens to the heartbeat of the patient and assess the heart beat rate. He will also ask about the family history and medication records. 

  EKG: With EKG, doctors determine the heart rate with the help of electronic devices. Electrodes are placed on the chest, and heart activity is tested. However, the presence of pericardial effusion is difficult with EKG. 

  Chest X-Ray: X-Ray is an excellent way to detect the presence of pericardial effusion in the patient. The enlarged portion is detected in the image. Once an enlarged sac is detected, doctors order the echocardiogram test. It is an Ultrasound for the heart and gives a clear picture of the patient&#39;s heart condition. Once it is determined that the patient has pericardial effusion, the doctor determines the size of the enlarged sac and quantity of liquid in it. Most of the time, pericardial effusion is small and not severe. But if the size and quantity of the liquid are high, the doctor determines the condition of the heart and the ability to pump the blood. The doctor may also take a sample of the fluid from the sac to determine the exact cause for inflammation. 

Take Away 

Pericardial Effusion is a condition in which fluid is accumulated between the heart and sac surrounding the heart. Though the problem is not severe, it is advisable to consult a doctor.

Pericarditis / Pericardial Effusion - Know More About It!

Everyone dreams of having a flawless and smooth looking skin but it is not just the looks that are impacted if the skin rough and cracked, it is also your skin health. There are many skin issues which people suffer from, dry skin being the commonest of all. Read on to know more about the condition.

Ques 1 - What is dry skin?
Rough, dry, red patches on the skin which are usually itchy can be termed as dry skin. Dry skin is medically known as xeroderma.

Ques 2 - What are the causes of dry skin?
Though long hot showers and seasonal changes are the main causes of dry skin. There are other factors which may lead to dry skin such as indoor heating, frequent hand washing, lack of moisturizing, dehydration, licking your lips and unhealthy eating habits.

A hot shower with some harsh soap washes out the amino acids, salts and oils from your body that are responsible for your skin s natural moisture protection barrier. This makes the skin lose its ability to hang on to water and stay hydrated.

Ques 3 - What are the main symptoms of dry skin?
Itching is the most annoying and noticeable symptom of dry skin. As your skin gets drier, the itching becomes worse. This leads to the  itch-scratch  cycle where you constantly scratch to get rid of the itch and it just causes more itching. Scaling and cracking of the skin are the other common symptoms. The cracking may be severe in some cases leading to bleeding.

Ques 4 - How do you treat dry skin?
The best way to handle dry skin is to be nice to your skin. Here are some tips that can help manage dry skin effectually.

Moisturise - Moisturizing is one of the best treatments for managing dry skin. No matter what the season is, you need to ensure that you use a proper moisturizer after a shower or after even washing your hands. Coconut oil is also a great substitute for a moisturizer.

Use mild soaps - Most shower gels and soap now days are loaded with harsh chemicals. You should opt for milder soaps or go for the organic and natural shower gels to avoid the problem of dry skin. Excessive use of soaps and cleansers can also lead to dry skin.

Avoid extreme weather conditions - Extreme hot or cold can both have an adverse effect on the skin resulting in acne breakouts, itchy skin, rashes, bumps and dry patches.

Ques 4 - What are the most common areas of dry skin?
Your legs are the first to get affected. Dry skin is commonly seen on the hands and forearms as well. Although all parts of the body can present with dry skin.

Dry skin is just a skin condition reminding you to care for your skin and pamper it. Cleanse and moisturize daily to have a smooth and healthy skin. 

Healthy Skin! Happy You!

5 FAQs About Dry Skin!

Spine surgeries are complicated and have serious repercussions if the procedure doesn t go as planned. Probing your doctor is therefore very critical to ensure a safe operation and early post-op recovery. Questions can range from the type of treatment chosen for speedy recovery to side effects. Here is a list of questions that you need to ask your spine surgeon:

1. Why is the surgery recommended?
Typically, there could be more than one treatment option for a particular problem. Your doctor should be able to tell you very precisely as to why the surgery is recommended and how it is going to address the problem.

2. Is there any non-surgical option?
Many spine related issues can be treated with medicines and physiotherapy. Ask your doctor if such options exist.

3. Explain the surgical procedure in detail
Your doctor should explain the whole surgical procedure, explaining the minute details and help will help you to understand the implications.

4. What is the duration of the surgery?
Spine surgeries do not take more than 2 hours. It, however, depends on the procedure that is being performed.

5. How will the surgery address the pain?
It is important to know the source of the pain. Exploratory surgeries are not performed on the spine. Ask your doctor how he intends to address the pain through the surgery.

6. What are the risks involved?
Risks and side effects vary from patient to patient. For instance, a person with obesity, spondylitis and smoking has greater chances of complications associated with the operation.

7. Will the doctor perform the whole procedure or he will use practicing surgeons and intern for the job?
Many senior surgeons use interns and junior surgeons to perform a minor procedure. Get a clear understanding of the role of the doctor and his assistants. It is a good idea to know the background if the surgical team who is going to perform the procedure.

8. What is the success rate of the doctor for the procedure he is going to perform?
A successful spine surgeon should be able to give you valid data on his/her success rate and the overall success rate of surgeons all across the country.

9. How many days do you need to spend in hospital?
Your hospital stay is directly related to your insurance. It is essential to get a clear picture on the same.

10. Whether a back brace is necessary after surgery?
Limiting the spine movement speed the process of healing. Most Doctors suggest braces after a spine surgery.

11. What is the time required for recovery?
The recovery greatly varies from patient to patient. What you should ask your Doctor is the expected time required for you to join your job/school.

12. Will there be any physical limitation after the operations?
Many spine surgeries require you to refrain from strenuous jobs for a while. For instance, certain surgeries require you to stay away from driving for a while. Address all these apprehensions from your doctor.

12 Questions You Must Ask Your Spine Surgeon

You might have a wonderful morning routine to keep you healthy. However, do you know what really determines health is also your bed time routine? Each night you end one day and stand at the brink of starting a new one. It is therefore crucial how you organize your bed time.

Here are 7 things to adopt for your bed time- 

1) Plan for next day: Preparing in advance always gives you more time and leaves you stress free. Things like looking for keys, deciding what to wear etc make you late and add to your morning stress. Prepare also for breakfast or what to cook the next day. Planning at night doesnt take much time and makes your next day start on a good note.

2) Shut out the buzz: Most of us say goodnight to family and head to bed only to spend the next hour checking Facebook and social media. Or you end up watching a funny video or movie late into the night. If you keep yourself distracted, you can't go off to sleep early or get quality sleep. The light from your gadget's screen can be harmful and stress inducing. It is best to give yourself an hour away from your mobile phone or other gadgets before you sleep.

3) Write a 'Thank-You' Diary: There are many ways to become a more positive person and the best is to have appreciation. Try finding out that 1 thing (more is better) that you are thankful for. Do it everyday. This practice right ahead of your sleep time calms you down, makes you feel happy, satisfied and goes on a long way in contributing to a heathy lifestyle.

4) Stretch it out: Like most people do you also have a job where you keep sitting for long hours? Stretching really works, it helps lengthen tendons and muscles and can reduce the frequency and severity of cramps ensuring you get a better night's sleep.

5) Try meditating: Our work life has become ever so demanding, we are constantly bombarded with information via the television, social media, the internet, friends and work which results in stress and anxiety! Few minutes of meditation before bed, slows down your brain activity which results in a deeper and more peaceful sleep. You will wake up feeling well-rested, energized and ready to take on the day!

6) Book by your side: Reading before bed is has amazing benefits. Firstly, it calms the nerves by eliminating excess sound and vision stimulus (exactly the opposite of what you get from watching television!). It helps you to wind down and sleep better, it also improves brain function, your memory and the thinking process overall.

7) Sleep is crucial: Foremost is to simply make sleep a priority. It is not as simple as it sounds. Sleep deficiency directly relates to increased stress, weight gain and productivity loss. Going to bed late and managing with 5 or 6 hours sleep sets a bad tone for your day.

Your happiness and general wellbeing is controlled by how relaxing you make your bed time.

Click on Consult Privately to ask me a private question on this topic or a related one.

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Dr. Sapna Zarwal Tells You How To Improve Your Bed-time Routine

It is very challenging to find operative treatments for chronic pain that offer improved daily functioning. Spinal Cord Stimulation is an excellent pain management method that can be used for patients when their neck or back pain cannot be treated by surgery or other options.

Each year more than 14,000 patients undergo the spinal cord stimulator transplant. The procedure comprises of mild electrical stimulations to the spinal cord. This modifies the nerve activity reducing the pain sensation or sensitivity that reaches the brain.

Neurostimulation therapy recommended by doctors is very effective, especially for chronic pain sufferers. The benefit of this proven therapy is that the pain experienced by the brain is minimized to a great extent. The therapy was designed only after observing how pain is managed by the brain. The therapy approved by the FDA is used to treat the pain caused due to nerve damage in the legs, arms and in the trunk. Spinal cord stimulation for chronic back and neck pain is provided to patients in pain management centers. The staff taking care of patients in these centers are specialized and trained in pain relief -how it occurs and best ways to treat it. Injections are also used to ease the pain.

How to treat back Pain?
Probably the worst pain an individual can experience is back pain, in some cases so severe that it hampers daily life. The treatment options that are used for treating back pain include electrical stimulation to the back and medication to the spine. The most common reason for spinal cord stimulation is failed back surgery. The pain related to the following conditions can also be alleviated through this therapy, scarring of the protective layers of the spinal nerves, painful inflammation and arachnoiditis.

Devices Used for Spinal Cord Stimulation
The devices used for spinal cord stimulation are available in several types but they comprise mainly of three parts. The pulse generator with a battery, a lead wire with 8-32 electrodes and a hand-held remote control that is useful in adjusting the settings of the device, and to switch it on and off. Electrical pulses are delivered to the spinal cord through the electrodes. It is very important that the procedure is carried out by doctors who specialize in pain management or by neurosurgeons.


Spinal Cord Stimulation For Chronic Back And Neck Pain!

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