Dialysis is a very important and life-saving procedure. It is performed to replace kidney function in case of renal failure. Wastes and extra fluids in the blood are filtered out during this process. To be able to perform Dialysis, the connection between the patient s bloodstream and the equipment for performing Dialysis (dialyzer) outside the body is established. This connection is created through Dialysis Access Surgery. It is a type of Vascular Surgery which forms the vascular opening for access during Dialysis. Thus, Dialysis Access Surgery is the lifeline for the survival of the patient.

Types of Vascular Access for Dialysis- 
There are three types of Vascular Access for Dialysis: Arteriovenous (AV) Fistula, Arteriovenous (AV) Graft, and Venous Catheter.

  Arteriovenous (AV) fistula is a surgical connection of an artery to a vein. An AV fistula is usually placed in the upper arm or in the forearm. It causes extra blood to flow into vein making it grow large. A larger vein hence provides easy access to blood vessels. An AV fistula is preferred over other methods as it lasts longer than other methods of access and provides a good flow of blood. Moreover, it is less prone to infection and blood clots than other methods. Before an AV Surgery, a Vessel Mapping Test is sometimes performed for assessing the blood vessels most suitable for Dialysis. An AV fistula is performed under local anaesthesia and requires two to three months for maturation before hemodialysis. If it fails to mature, the procedure is repeated.

  Arteriovenous (AV) graft is performed when AV fistula fails to mature. It is hence the second most preferred choice for long-lasting access to vascular tissues for Dialysis. An AV graft is a looped plastic tube which establishes a connection between an artery and a vein. Like AV fistula, AV graft is also performed under local anaesthesia. It is slightly more difficult to maintain than an AV fistula.

  A venous catheter is used for short- term hemodialysis. It is a tube which is inserted into chest, neck, leg, or near groin for vascular access. After exiting the body, the tube splits into two halves. In the case where a renal disease has made quick progression leaving little or no time for the AV fistula or AV graft to mature, a venous catheter is used to establish the required vascular connection. This procedure is also performed under local anaesthesia. It is a tool for emergencies but is not suited for long- term use. It can cause narrow vein due to an infection,
scarring, or blood clot. If long- term venous catheter is used, it is tunnelled under the skin which has fewer problems associated with it and is more comfortable. 

How to Care for a Vascular Access?
  Get checked for infections and other problems before each hemodialysis session;
  Use the operated site for access only for the intended use;
  Always keep the access clean;
  Prevent cutting or bumping the access;
  Check for thrill/ vibration in the access and inform the doctor if any;
  Do not put pressure on the access site;
  Do not put blood pressure cuff around the access arm;
  Do not wear jewellery or tight-fitting garments over the site;
  Do not lift a weight.

Take Away-
Vascular Surgery for Dialysis is performed to provide vascular access for the procedure. AV fistula is the most preferred type followed by an AV graft. A venous catheter is recommended to be used only in case of an emergency when there is not much time left for the other two options to mature.

Vascular Surgery - Can It Help For Dialysis?

Hypertension is a condition where the blood has to exert extra pressure to flow through the blood vessels. While there is a genetic component to it, the more strong contributing factors are modified lifestyle and dietary changes. There are also a lot of environmental changes that have contributed to this new epidemic. While earlier people in their 50s and 60s would be diagnosed with hypertension, now there are people in 30s and 40s taking hypertension pills. Excess fat accumulation is the major cause of hypertension in younger patients.

There begins the complexity of the issue. Hypertension which requires medications to control it, they lead to side effects and bring in a host of other diseases like diabetes, and obesity which in turn bring in a whole lot of complications. A more easy way to manage would be to prevent and of course, after onset, look at how naturally it can be managed.

Ayurveda has numerous substances that have been proven to have beneficial effects in controlling blood pressure over the past 1000s of years.

1. Celery or ajwain helps blood vessels to dilate and reduces concentration of stress hormones in the blood.

2. Ashwagandha has a wide range of actions and improves the body's ability to handle physical and mental stress. This in turn improves blood pressure, obesity, and depression.

3. Citrus fruits contain vitamin c which prevents fragility of the capillaries (thinner blood vessels).

4. Cow's urine prevents hardening of blood vessels and is of curative value in those who have blood pressure due to hardening of blood vessels. 

5. Triphala which is a combination of amla, haritaki, and bibhitaki helps reduce inflammation that leads to blood pressure, thereby helping to control it.

6. Jatamansi - by helping the free radical damage on the arteries, it protects the arteries and prevents cholesterol accumulation. It also is a very well-proven stress reliever and has additional benefits on hypertension.

7. Arjuna - by helping the metabolism of the bad cholesterol in the liver, this protects the inner lining of the heart and thereby helps control hypertension.

8. Calcium and potassium containing substances help remove sodium and thereby improve blood pressure.

9. Natural herbs like brahmi, sarpagandha, shankhpushpi, and chandana are effective ayurvedic cure and treatment for hypertension.

10. Rasayana treatment from ayurveda is having excellent results, however everyone requires unique rasayan as per their body types.

11. Watermelon helps in dilation of the blood vessels.

12. Aloe gel, barberry, calamus, valerian, skullcap, gotu kola cayenne, myrrh, motherwort, hawthorn and jatamansi have all been shown to help manage hypertension over thousands of years.

13. A glass of warm milk mixed with saraswat powder is also helpful for patients with high blood pressure.

These are natural remedies which were a part of diet since times immemorial. Including them in the diet, reducing processed foods, regular exercise, avoiding alcohol and smoking can be some natural ways to prevent and if required control hypertension. Stress is here to stay, but can definitely be managed with a little conscious effort.

Control Blood Pressure With Ayurveda

Asthma is a respiratory disorder, which is characterized by the narrowing down and inflammation of the inner lining of the airways of the lung, resulting in excessive secretion of mucous. The airways are responsible for the passage of air from and to the lungs. Asthma can affect any person of any age group; however, the symptoms of the condition can vary. The symptoms of asthma include severe pain in the chest, coughing and problems in breathing, interruption in sleep due to breathing problems and a croaking sound during exhalation. Asthma, in most cases, tends to be chronic and can exist throughout your life with eventual changes in the nature of attack.

The most common causes of asthma are:

    Common cold and allergies from dust particles, smoke and minute insects might be catalysts for asthma.
    Suffering from severe anxiety might also cause asthma.
    Asthma might occur as a result of physical exercise and as a side effect of some medications such as ibuprofen and aspirin.

As of now, asthma is incurable. But medications can control the symptoms. Homeopathic preparations can also be useful for the treatment of asthma. Some common homeopathic remedies are as follows:
1. Arsenic album: If the symptoms include severe episodes of stress and nervousness, immense thirst but the inability to drink much water, severe attacks at night and intense pain in the upper right portion of the chest, Arsenic Album might be very useful to cure the problem.
2. Nux Vomica: If the attack is primarily caused because of gastric disorders or sudden outbursts of anger along with symptoms of dry cough, headaches and stomach aches, Nux Vomica might be used as a remedial medicine.
3. Carbo Veg: Carbo veg can be recommended if the symptoms include a pale face at the time of attack along with cold feet and hands and an itchy sensation in the larynx.
4. Kali bichromicum and Moschus: If the attacks become worse in the morning accompanied by yellow mucus discharge, the above mentioned homeopathic preparations are recommended.

Asthma: Breathing Made Easy with Homeopathy

In addition to pumping blood to various organs, the heart also has its own blood supply, through which it receives its oxygen and nutrient supply. In patients with coronary artery disease and atherosclerosis, there is a narrowing of the blood vessels which reduces the amount of blood flow to the target organs, including the heart. 

When this happens in the heart, there is chest pain due to overexertion of the heart muscles. There could be two patterns to this chest pain. With regular exertion like exercise, there would be chest pain, and most patients are familiar with this pattern.

This is known as angina pectoris or stable angina. In some people or in some instances, chest pain occurs which is sudden and not of a predictable pattern. It could be related to extreme exertion or stress. This is known as unstable angina and can lead to heart attack and be life-threatening.

Stable angina or angina pectoris has a stable, predictable pattern which most patients get familiar with over a period of time and learn to manage. Read on to know more about the signs and symptoms and management techniques.

Signs and symptoms: Stable angina usually occurs after a round of physical exertion. The patient feels a feeling of tightness in the chest which feels like the chest being squeezed. The pain can gradually spread to the shoulder, arms and even the neck. The pain can also be induced by eating, exposure to cold, emotional stress. It lasts for about 15 minutes and is relieved by rest and sublingual nitroglycerin. The pain intensity does not change with position or coughing. In addition, the patient may also experience shortness of breath, fatigue, profuse sweating, nausea, and dizziness.
The patient may be able to detect signs on further testing including ECG, echocardiography and stress testing. Features like cardiomegaly, altered ejection fraction would be detected based on the severity of the disease.

Treatment: Immediate treatment to relieve the pain includes resting and sublingual nitroglycerin. On an ongoing basis, the treatment would include 3 approaches   lifestyle changes, medications, and surgery.

Lifestyle changes: Regular exercise, smoking cessation, reduced fat intake, reduced alcohol consumption, weight loss, and stress management are some lifestyle changes to be made to improve symptoms.
Medications: A number of medications would be used depending on patient s symptoms. Aspirin to prevent clotting, medications to control blood pressure and cholesterol and diabetes.
Surgery: In patients with advanced coronary artery disease, revascularization methods may be required, which includes angioplasty and coronary bypass.
In a person with known risk factors, it is advisable to have regular checkups so that the disease progression can be controlled and symptoms managed with minimal intervention.

Predictable Chest Pain Pattern - What Does It Indicate?

Peripheral Artery Disease (PAD) is a disease of blood vessels that are located outside the heart and brain. The condition develops due to fatty deposits in the arteries and veins that stops the blood flow to the heart and mind as the case may be. It narrows the artery and restricts the blood flow, which causes problems to other organs of the body such as kidney, liver, and stomach.


Symptoms of Peripheral Artery Disease-
Peripheral Artery Disease is the most common type of condition in people. Some people may not even notice the symptoms. The symptoms include:

Pain in the hips and lower leg area.
Brittle toenails.
Short breath while taking stairs.
Pain in the calf.
Numbness and coldness in the leg around a calf
Hair loss on legs and feet
Erectile dysfunction in men
Repeated sores and ulcers in legs
Causes of Peripheral Artery Disease-
The most common cause of Peripheral Artery Disease is the deposit of fatty substances inside the arteries. The fatty deposits build in the arteries gradually with a process called Atherosclerosis. Most of the time people do not know that they are facing the problem of Atherosclerosis. With time deposits increase and the arteries become narrow. It restricts the blood flow and causes problems for other organs.
Another cause for Peripheral Artery Disease is clot created in the arteries due to diabetes. Also, this problem is common in diabetic patients and increases with old age.

The risk factors that contribute to the development of Peripheral Artery Disease are high blood pressure, bad cholesterol, obesity, and diabetes.

Diagnosis of Peripheral Artery Disease-
The primary way to test and diagnose Peripheral Artery Disease is to check the blood pressure in the arm and ankles. If the pressure is low as compared to arm in the ankles, one might be facing Peripheral Artery Disease. It is commonly known as the ankle-brachial index. Other ways to determine Peripheral Artery Disease are CT scans, angiography, and blood tests. Since the disease is prevalent and gradually progress, most of the time it remains undetected.

It is essential that Peripheral Artery Disease gets detected and treated well in time. If the condition persists for a more extended period of time, it may result in loss of leg, increased chances of coronary artery disease and carotid atherosclerosis.

Treatment for Peripheral Artery Disease-
The only way to treat Peripheral Artery Disease is to indulge in physical activity. A regular regime of exercise and physical work will help a person to burn fat and makes the arteries fat free. Doctors suggest that daily 30 minutes of walking or gyming will help treat Peripheral Artery Disease with significant effects. One may notice the signs in just a couple of months.

Along with exercise, one also needs to monitor the weight and eating habits. Foods that are rich in fats and bad cholesterol should be avoided. Make changes in the lifestyle and eat a healthy balanced diet. Include fruits and fresh vegetables in the diet and follow a low carb diet for regular food intake. If a person is addicted to smoking and alcohol, then he/she should consider leaving the bad habits for their own good health.

Take Away-
Above are some of the common and tried treatments. However, it is advisable to consult a doctor before opting for any of these options as these treatments are depended upon the condition of the patients.


Learning In depth About Peripheral Artery Disease!

Coronary Artery Disease - Symptoms and Causes

Coronary artery disease is the disease in which the major blood vessels (coronary arteries) that supply blood, nutrients and oxygen to your heart get damaged or disease stricken. It is mostly caused due to the coronary artery getting plagued or inflamed. The consequent reduction in blood flow to the heart causes the various symptoms of coronary artery disease like angina (chest pain), short breath etc.

Symptoms:

Here is a list of a few symptoms that help in identification of the coronary artery disease.

1. Angina

Pressure or tightness may be felt in or near the area of the chest that results in pain. It is mostly felt in the middle or left side of the chest.

2. Shortness of breath

Another symptom of coronary artery disease is short breath, fatigue and a feeling of exertion.

3. Heart attack

Complete blockage of the coronary artery results in a heart attack that is a prominent symptom of coronary artery disease. A person may feel heavy pressure in the chest, pain in the shoulder or arm, sweating etc. prior to getting a heart attack.

Causes:

Coronary artery disease occurs when damage or injury is done to the inner layer of the coronary artery. This damage causes plaque, which are deposits made of fat, cholesterol and other cellular waste materials to accumulate near the damaged area of the artery. This process is known as atherosclerosis.

The various causes that result in coronary artery damage are listed below.

- Smoking
- High blood pressure
- Diabetes
- High cholesterol
- Obesity
- High stress
- Physical inactivity

Knowing Coronary Artery Disease - Symptoms and Causes

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