Stitches or sutures act as a closure for either surface wounds or deep wounds. Procedure to close a deep wound comprises of sewing the two edges and applying stitches under the skin surface.

Catagories of sutures

    Non-absorbable stitches: Such stitches are applied in case of skin wounds or internal wounds. Such stitches get healed quickly and are easy to remove. Non-absorbable stitches are made of natural fibers or synthetic threads like nylon polypropylene. As the name suggests, these stitches are either permanent or persist for a long time.
    Absorbable stitches: Such stitches are applied on layers, which have the property of healing quickly. They are very firm during the initial days. Then they start getting dissolved in the body.

Precautions taken by medical team before applying stitches to prevent infection

    Careful checking of nose for occurrence of germs before the start of operation.
    Skin must be cleansed prior to surgery.
    Sanitizing hands prior conducting the surgery.
    Usage of germ free gloves and sterile clothes while applying sutures.
    Prescribing antibiotics to the patients who may fear high risk of infection.

Precautions to be taken by patient to prevent infection

    Take a bath prior to surgery.
    Avoid using razor at the surgical site. The same can be carried out by using clippers by the surgery team itself.
    Keep all your jewellery aside before the operation starts. Do not apply nail polish.
    It is advised to cover up the wound. Try to keep the adjacent areas germ free. This is a crucial step in avoiding infection.
    Visit your doctor at once on finding redness around the wound.

When to see the doctor
Pain up to a certain threshold is normal. In case pain gets unbearable, the scene can be alarming. It may be an indication of infection. Taking immediate remedial steps is necessary to avoid infection or any other side effects post the surgery. On meeting with any of the following signs, it is better to consult doctor at once.

    If the skin around the wound gets swollen.
    If you detect redness around the wound.
    If the pain becomes unbearable.
    If the wound starts developing pus.
    If your body temperature increases abnormally or if you have fever.
    If you observe red streaks around the wound.
    If in case a stitch gets opened up and the edges of the suture start widening. This is the most alarming sign. In case a suture gets opened, you must immediately seek a remedy.

Ask your doctor for the precautions you can take to avoid experiencing any of the above signs. If you come across such alarming symptoms, rush to the nearest hospital and get the appropriate treatment.

Pain in Stiches - When You Should See Your Doctor?

There are various neurodegenerative disorders and Huntington Disease is one of them. It is characterized by loss of thinking ability, chorea or uncontrolled writhing and jerking movements, and psychiatric difficulties. 

Nerve cells in the brain are impaired in this disease. This leads to loss of coordination and involuntary movements. As the disease progresses, patients slowly fail to control their throat and mouth muscles and simple tasks like eating, swallowing, and speaking becomes challenging.

Huntington's Disease may also affect the reasoning and thinking abilities of an individual and makes communication and conversations more challenging. The problem of swallowing food can lead to choking as food can go down the wrong way or a lung infection in more severe cases. 

Speech-Language Pathologist or Speech Therapist helps the patients with speaking and swallowing problems with the help of various therapies.

Visiting a Speech-Language Pathologist in the initial stage of Huntington's Disease is advised. This helps in planning in advance about the ways to handle changes as the disease progresses. The therapist can help the patients when they begin showing an inability to speak or understand and swallowing problems. The symptoms showing swallowing difficulties may include choking, coughing and altered eating habits of the patient and loss of weight.

Symptoms

Dysarthria, in which the ability to remember words, understanding and forming a sentence is not lost but clear speech becomes difficult.

Stammering.

Slow or imprecise speech.

Aphasia, inability to understand what is being said and inability to remember grammar and vocabulary, and the pattern of losing a word in between the sentences.

Weak voice or low volume because of respiration issues.

Scanned Speech or unusual lengthy pauses between words.

Problem with pitch control and resonance.

Treatment

The progression of Huntington s disease varies from patient to patient and the therapy also varies as per the needs and challenges of the patients. The therapy usually starts with the discussion of problems and symptoms faced by the patients. 

For swallowing difficulties, patients may be recommended to maintain a journal of swallowing problems and fixing a time for meal intake every day. He/she may be recommended to eat soft food items, and eat slowly and chew the food properly.

As for speech therapy, one may be recommended breathing exercises. The therapist may demonstrate the patients how to overemphasize certain mouth movements to make the words easier to understand. The family of the patient is advised to reduce distraction while communicating with the patient. 

Assistive devices can also help with communication such as computers, smartphones or tablets. Other low-tech objects from everyday life, such as calendars, picture boards with a depiction of daily life activities, and object images and notebooks can also be helpful.

Take Away
Huntington Disease is a brain disorder where it becomes difficult for a person to control mouth muscles. In this, speaking, swallowing, and eating becomes a task for them. There are speech therapies that can help the patients to gather control over their words and communication problems.

 Huntington's Disease - How Effective Is Speech Therapy In It?

6 Bodily Pains You Must Never Ignore

Any pain in the body is an indication and demands attention. Some pains go away by themselves or by home treatment, while few need medical attention. 

Here are 6 types of pains which should never be ignored.

Chest Pain - Chest pain that doesn't go away and is accompanied by shortness of breath can prove to be fatal if not treated at the earliest. Do not wait for it to subside, nor should you try self medication. Consult the doctor immediately.
Abdominal Pain - While abdominal pain could be because of various smaller reasons, if it is unbearable, consult a doctor at the earliest. This pain could be because of ruptured appendix, stomach ulcer, problems in your pancreas or gallbladder or even intestinal blockages.
Severe Headache - Normally we tend to take headaches lightly, believing that all we need to do is pop a medicine or rest it out. However, if the pain is excruciating, consult the doctor as soon as possible.
Prolonged Backache - If you are experiencing pain in the back with tingling in your toes, this could be associated with your discs. Give it medical attention at the earliest, as it could turn fatal.
Lower Abdomen  - Appendicitis' indicator is sharp pain on the side. If you feel a sharp pain in your lower abdomen on the right side along with symptoms like nausea, vomiting, fever, shaking, constipation and diarrhea, reach out for medical assistance as soon as possible.
Leg Pain - Yet another pain one should not ignore is deep vein thrombosis which is blood clots in the legs? deep veins.

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

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6 Bodily Pains You Must Never Ever Ignore

Shoulder pain can be a persistent dull and nagging sensation in the upper arm or shoulder area. It can be easily differentiated from neck pain as it is related to the movement of shoulders i.e. it will increase and decrease with shoulder movements, especially overhead activities. The other signs to identify shoulder pain is if your shoulder movements are reduced.

If you find it difficult to scratch / wash your back, comb your hair or reach your back pocket, it clearly shows you are suffering from shoulder pain. Shoulder pain can happen due to various reasons, it varies from person to person depending on the activities he/she is involved in, for e.g. sports, manual job etc. It can be a single major injury or multiple small injuries due to repetitive usage patterns. Also, degenerative changes in various parts of the shoulder can lead to shoulder pain.

In case of middle to old age, injuries that can cause shoulder pain are:

    Biceps Tendonitis
    Acromio-clavicular Joint arthritis
    Scapular Dyskinesia
    Trapezitis
    Suprascapular nerve entrapment In young age, injury due to sports or gym activity can cause shoulder pain
    Superior labral anterior/posterior (SLAP tear)lesion

Also, traumatic or repeated dislocations of shoulder can cause shoulder pain due to:

    Bankart lesion

Diagnose Shoulder Pain

Shoulder pain can be diagnosed only after thorough history taking and clinical examination. However, some imaging studies can be very helpful like:

    X-rays: Through an x-ray one can view the shoulder in many different views.
    Ultrasound: With an ultrasound, you can also check the damaged caused to the tendons and muscles of the shoulder but the quality of reporting depends upon the expertise of the doctor.
    MRI: MRI gives a clear picture of the shoulder as it shows everything related to a shoulder joint that is joints, vessels, tendons and muscles that too from different angles.
    Diagnostic Arthroscopy: A surgical procedure often used by orthopaedic surgeons to diagnose and treat issues inside a joint. Arthroscopy has the big advantage that one can use it to diagnose as well as treat at the same time.

Treatment for Various Types of Shoulder Pain

    For Shoulder Impingement or Rotator Cuff tear: Give rest to the shoulder for a few days only Dedicated Physiotherapy Protocol Bursal injections If these fail then, (Surgery)Arthroscopic sub-acromial decompression If Cuff tear is found, then one can go for Arthroscopic/Mini-open repair
    Labral Lesions: For anterior Labral lesions (Bankart's) following anterior shoulder dislocation then surgery in the form of Arthroscopic Bankart's repair is the only option to reduce risk of recurrence and degeneration.

SLAP Lesions

    Pain relief and physiotherapy as first step If this fails then following surgical options are available
    Arthroscopic debridement or repair of labrum
    Biceps tenotomy or tenodesis

Arthritis

In this case, the joint is already destroyed and has to be resurfaced for pain relief and to maintain ROM. If Rotator cuff muscles are working, then Shoulder resurfacing hemiarthroplasty (preferred in young people), that has a life of 10 to 15 years, Total shoulder replacement (preferred in middle aged to old people) has a life of 10 to 15 years. But, if rotator cuff muscle are not working then Reverse Geometry Shoulder replacement is recommended, that has a life of 10 years.

It is always advisable to get yourself diagnosed properly in case of shoulder pain as management changes depending on clinical situations. Neglecting shoulder conditions can lead to bigger problems later on.

Always remember 'a stitch in time saves nine'

Shoulder Pain: Causes, Diagnoses & Treatment

Our body is composed of many elements that carry out emotional and physical functions that are usually in sync with one another. It is important for these organs and other elements to be in sync for good health. All nerves are connected to the brain and are responsible for sending important signals throughout your body. Therefore, even one pressed nerve may send you warning signals such as pain to the body. It is advisable not to overlook these signals. Damage from a pressed nerve might be minor or extreme. It might bring about persistent and chronic issues. Therefore, the sooner you get a treatment for nerve compression, the more relieving experience you will have. In a few cases, you cannot reverse the damage caused by a pressed nerve. However, treatment does relieve you from the pain in most cases.

Nerves are the most vulnerable at spots in your body where they go through narrow spaces and have very less tissue to protect them. These are the places they are more likely to get pinched. A number of the causes may include:

If the nerve is pressed between tissues, for example, your tendon, ligament or bone.
Nerve compression in your neck or arm may likewise bring pain in zones, for example, your elbow, hand, wrist or fingers.
Aggravation or weight on a nerve root leaving the spine may bring about neck or low back pain.
In case a disc tears, it is known as a herniated circle that can put weight on a spinal nerve.
Some of the common symptoms of pinched nerves are:

Pain in the region of pressure, for example, the neck or low back
Transmitting pain, for example, sciatica or radicular pain
Numbness
Tingling
Blazing sensation
Weakness
To what extent you are affected depends from individual to individual. Treatment fluctuates, based upon the seriousness and reason for the pinched nerve. You may find that you benefit from just resting the affected area and by maintaining distance from any exercises that may cause you harm. If side effects endure or torment is serious, it is best to see your specialist. You may require one or more types of treatment to contract swollen tissue around the nerve.

Treatment may include:

NSAIDs - Non steroidal inflammation mitigating drugs (NSAIDs, for example, headache medicine, ibuprofen, or naproxen may diminish swelling).
Oral corticosteroids - These are utilized to lessen swelling and agony.
Opiates - These are utilized for brief periods to lessen extreme pain.
Steroid infusions - These infusions may diminish swelling and allow the affected nerves to recover.
Exercise based recuperation - This will extend and reinforce muscles.
Brace - A prop or delicate neckline limits movement and permits muscles to rest for brief periods.
Interventional Pain Procedures: They are the most cost effective and non invasive methods for pain relief as recommended by the WHO. Your pain will be taken care of by the interventional pain physician or the pain specialist.
Surgery - Surgery might be required for more serious issues that do not react to different sorts of treatment.

What to Do When You Have a Pinched Nerve?

Panchakarma is an ayurvedic technique which is used to detoxify the body, boost the immune system and restore the balance in the body. Due to lack of exercise and a poor diet, the waste material generated by the body is not effectively discharged. This causes accumulation of toxins in the body that can result in diseases.

Panchakarma can be used to treat and heal the pain in the joints and the spine. There are specific treatments in panchakarma that targets these regions, they are:

1. Abhyanga - Abhyanga is a technique where warm oil is used to cover the entire body. The oil is then gently massaged so that it can penetrate the underlying tissues. It is used to lubricate the joints, muscle toning and to increase blood supply around nerve endings.

 2. Pindasweda - In this technique hot cotton bags consisting of herbs, rice, and sand or medical powder are used to massage the body. This rejuvenating therapy induces perspiration in the body by which the herbs and the heat penetrates into the body. It is used to treat problems of the joints such as gout, arthritis, and sciatica.

 3. Upanaha - A combination of herbal medicine is applied to the affected part and then covered with medicinal leaves. The herbs help in easing the muscles and tendons of the affected part. It relieves pain, reduces swellings and improves mobility in the joint.

 4. Kati vista - In this treatment, medicated oil is pooled into a collar made from dough and then placed on the lower back for a specific amount of time. It strengthens the lower back, lubricates the spine and acts as a muscle pain reliever.

Soothe Your Joint and Spine Pain with Ayurvedic Panchakarma

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