A broken bone or a fracture can be painful and it requires medical attention for the fracture to heal properly. Proper healing is necessary for the right alignment of the bone. A doctor chooses to either reduce or set the bone in terms of new alignment. The bone reduction can happen manually or surgically depending on the severity of the injury. A Surgical procedure known as the open reduction internal fixation is performed for serious fractures. It ensures that the all the broken pieces are fixed together and the injury can heal properly.
Post the fracture, the bone need to be immobilised for proper healing. This is generally achieved by imposing a cast. For fractures that are not severe in nature, a doctor might choose to impose a temporary cast so that simple motion can happen around the site of the injury. For serious fractures, a permanent cast is placed around the injury site. In the case of a shoulder injury, a patient is required to wear a sling so that the bones are immobilised.


Time Duration of a Therapy Session:
While the exact duration of physiotherapy can vary from individual to individual, it takes a minimum of 2-8 weeks for the fracture to completely heal. Certain fractures take more time to heal. The rate of healing also depends on the severity of the injury, pain threshold level of the patient, extent of work with the physiotherapist, the robustness of the physiotherapy program, extent of the injury of the soft tissue and certain other factors. Typically shoulder and neck injuries heal quicker than a fracture of the legs. The time duration of fracture healing also depends on the type of bone that has been affected.


Physiotherapy in a Hospital:
If the fracture happens in the ankle or leg, a physiotherapist might have to intervene in the hospital in order to teach patient about using assistive devices such as crutches and cane. Things that are taught during this time include using the device in order to climb stairs, right walking posture, getting into a car, taking the device off while sitting and such other techniques.


Physiotherapy at Home:
Physiotherapy can also happen from home if the doctor specifically instructs to do the same. This is typically done for people where the condition is too serious to go outside and get the physiotherapy done. Certain weight bearing restrictions are imposed around this time. The training remains the same as in the case with a hospital.


In the Clinic:
Once the patient becomes mobile enough, a doctor might suggest a patient go to a clinic to get the physiotherapy done. A physiotherapist evaluates certain things such as pain, range of motion, gait, flexibility etc. of the patient before suggesting a certain exercise plan. 




How Long Do You Need Physiotherapy Post-Fractures?

A mammogram is an imaging test where an X-ray is taken to recreate the internal imagery of your breasts. This is a screening test that is widely used to find the earliest signs of cancer. There have been instances where the early signs of cancer have been found up to three years before the actual development of the same. There are a number of benefits and risks in this screening method. So let us find out more about getting a mammogram, and whether or not you should get one.

    Procedure: A special X-ray machine is used for conducting a mammogram. There is a clear plastic plate on which the specialist will place the breast while another plate will press on the breast from above. While both the plates serve to flatten the breast and hold it still, the X-ray will be taken. Some pressure will be felt and the same steps will be repeated so as to get the side view of the breasts. The same procedure will be repeated for the other breast. Meanwhile, once it is done, you will need to wait so that the technician can check for clarity, and whether or not the procedure needs to be done again. The results of this procedure cannot be relayed by the technician, and all the images will be different because all breasts are slightly different from each other.
    Preparation: You will need to remember that the process can be a slightly painful one, especially once the pressure gets applied. Many women complain of discomfort and pain. Yet, this discomfort gets over before you know it. The pressure and pain will depend on the size of your breasts and how much they will have to be pressed in order to get a picture. The skill of the technician will also come into play here. One must remember not to get this procedure done a week or so before or after the menstrual cycle, as the breasts tend to be tender around this time, and the pain will be much more.
    Radiologist: Within a few weeks after the procedure, the radiologist will usually deliver the result. This is the professional who does an accurate reading of the X-ray.
    Normal and Abnormal Readings: If your mammogram result has a normal reading, then you can resort to getting one done every once in a while. But an abnormal reading will require further X-ray and tests so as to be able to tell for sure.
    Why should I get one: If you are over 40 and have a family history of such ailments, then you will have to get a mammogram done regularly.

Should You Get a Mammogram?

Breast cancer begins when cells in the breast(s) start to grow out of control. It is understood as being the most common cancer, seen predominantly in females, globally. It is reasonably treatable and often curable.

1. Type: Adenocarcinomas constitute more than 95% of breast cancers with infiltrating ductal carcinoma (IDC) being the most common form of invasive breast cancer.

Frequently occurring breast cancers present as one of the following types mainly

1. Ductal Carcinoma In Situ (DCIS): Is the most common type of non-invasive breast cancer and is confined to the milk ducts of the breast. There is no invasion in the basement membrane. Pure DCIS metastasizes rarely. Non comedo cribrioform carcinoma is the most common DCIS found which, when compared to the comedo type, is mostly non-aggressive.

2. Infiltrating Ductal Carcinoma (IDC): Represents majority (about 3/4th) of the breast cancers, and is known to metastasize commonly to bones, lungs and liver.

3. Lobular Carcinoma In Situ (LCIS): Develops in multiple lobules of the breast (bilaterally). LCIS is less commonly seen, compared to DCIS.

4. Infiltrating Lobular Carcinoma (ILC): Represent about a tenth of all breast cancers and tends to metastasize to other regions of the body.

Less commonly occurring breast cancers such as

5. Inflammatory Breast Cancer: Is relatively uncommon and are caused probably owing to viral infections. The breast is warm, red and swollen.

6. Paget s disease of the nipple: Is a rare form of breast cancer. It begins in the milk ducts and spreads to the nipple and areola.

7. Medullary Carcinoma

8. Mutinous Carcinoma

9. Tubular Carcinoma

10. Phylloides tumor etc all.

2. Gender: Affects the female populace predominantly. However, a small percentage of breast cancer is attributable to the male populace as well.

3. Etiology: No definite cause is known. However, diet, lifestyle, environment, hormonal/ reproductive factors, personal or family history of breast cancer especially in first degree relatives and also any benign breast disease history etc all are known to increase the risk of breast cancers. Specifically, excessive fatty diet, obesity, type 2 diabetes mellitus, benign breast disease, heredity/ inheritance of mutated breast cancer genes 1 (BRCA1) and 2 (BRCA2), smoking, alcohol intake, infertility, estrogen therapy/ hormone replacement therapy (long term) in post menopausal women, delayed age at first pregnancy, nulliparity (not having child), early menstruation, delayed onset of menopause, lactating mothers not breast feeding, exposure to ionizing radiation, sedentary lifestyle, depression, exposure to MMTV virus etc all can potentially increase the risk for breast cancer.

4. Features: Signs & symptoms, of breast cancer, manifest majorly in the following ways

Lump/ nodule in the breast that gets attached to the skin of the breast over time. The lump / nodule could be hard and painless with irregular edges or it could also be soft, rounded, tender and painful.

Enlarged lymph nodes in the axilla which are palpable.

Swelling of whole or a part of a breast. This is even if there is no distinct lump felt.

Retraction or thickening of the nipple(s).

Pain in the breast or nipple.

Discharge from nipple other than breast milk.

Irritation/ scaliness of skin over the breast.

Redness of nipples

Rarely, red, swollen and tender breast.

5. Screening: Is generally recommended for asymptomatic populations goal of which, as usual, is to be able to detect & diagnose breast cancer at an early stage which is potentially curable. It is mostly radiologic with mammography/ USG being instrumental in raising suspicions for further diagnostics (i.e. biopsy) that help detect breast cancer, if any, early.

6. Diagnosis: A self-examination/ clinical exam of the breast(s)/ axilla that reveals a palpable mass prompts the following diagnostics. Abnormal blood test results may be indicative of malignancy, but a follow up imaging/ biopsy is always the gold standard for accurate diagnosis.

Blood: ER/ PR/ HER2/neu, uPA, PAI-1, CA15-3, CA27.29 etc all tumor markers are helpful.
Imaging: Mammography/ USG Scan usually, as relevant. Again, CT Scan of abdomen & pelvis and chest, PET CT scan, bone scan etc all help detect metastasis, if any, for cancers in stage III & above.
Biopsy: either excisional, incisional, fine needle aspiration (FNA) or core biopsy technique, as contextually appropriate, is frequently employed and a histopathological examination (HPE) thereof clinches the diagnosis and the nature of the disease.
7. Treatment: Conventional treatment includes surgery, radiotherapy, hormone therapy/ chemotherapy as deems appropriate. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as would be feasible contextually.

8. Prognosis: Preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage breast cancer are more. The cure/ recovery chances are influenced by the type, grade, stage of cancer, recurrence and the patient s general health & vitality etc all. Above-mentioned apart, age, menopause status, lymph node status, ER/ PR/ HER-2/ neu status, size & extent of breast cancer etc all also influence the treatment outlook in breast cancer. The five year survival rate is strongly correlated with the stage of breast cancer.

9. Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an increased focus on protective factors and avoidance of the risk factors can be of help. An adherence to a Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising (for at least 30 minutes daily), de-stressing and relaxation is highly recommended for reducing the risks of breast cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. It is advisable to limit milk/ dairy, preferably of low fat content, to 1 to 2 servings max daily. Although alcohol is optional and is not for everyone, the consumption of the same, if any, has to be strictly in moderation, and is best avoided. Smoking is to be avoided as well. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly or are best avoided too. Limiting dosage/ duration of hormone therapy, if any, especially to counteract post menopausal symptoms and also avoiding exposure to radiation and environmental pollution can help reduce the risks of breast cancer. Apart from the above-mentioned, for high risk cases, a prophylactic oophorectomy, prophylactic radical mastectomy, long term hormone therapy etc all can help reduce the chances/ risks of developing breast cancer significantly. Breastfeeding is known to confer protection against breast cancer risk too.

Breast Cancer - In A Nutshell

Cancer that originates in the bones of a human body is referred to as bone cancer. Any bone could come under the threat of this disease, but generally the longer bones of your body, so to say the bones of your limbs, are at a greater risk. 

A few factors that might push you an inch closer to bone cancer are:

 Genes could jinx your health: a few typical genetic syndromes could increase a person's chances of contracting bone cancer. These syndromes could have been active in any person belonging to your lineage. One such syndrome is li-fraumeni.
 Treatment for one kind of cancer can make you prone to some other kind: radiation affects your bones adversely. A patient of breast cancer might be undergoing radiation therapy that further increases his or her risk of contracting bone cancer in future. 
 Paget's disease can have unfavorable implications: paget's disease is a disease that affects elderly people. This condition, if left untreated, can turn into bone cancer at a later stage. 

Several symptoms of bone cancer can be found below:

 Sudden loss of weight: if you lose a considerable amount of weight in a few weeks time without having made any effort at all, you should probably be worried about the health of your bones. Bone cancer can result in sudden and unintentional weight loss. 
 Unexpected bone fracture or breakage: cancer of the bones is known to gnaw at the strength of your bones. Weakened and diseased bones can break or get fractured very easily. An unexpected fracture should not be overlooked so as to prevent chances of anything more harmful.
 Long spans of unyielding exhaustion: constant fatigue and sleepiness might be hinting at a more serious underlying problem. The bones in your body hold you together; cancerous bone cells can make you feel exhausted without much exertion as your bones lose their inherent potency.
 Persistent pain in the bones: excruciating cramps or pangs of stinging pain in a person's bones either continuously or at odd hours, could be indicative of bone cancer. Such instances require the advice and guidance of an experienced oncologist.
 Bone swelling: the area affected by bone cancer can grow big and tender or the bone itself can swell up.

All About Bone Cancer

Brain injury can happen as a result of trauma, infection or degeneration with old age. Whatever be the reason, injury on the head can result into brain dysfunction and should be given required medical diagnosis. In these cases, occupational therapy can be a major help.

It helps in improving health, providing rehabilitation and educational service to enable people to participate in things they are interested in and manage their daily activities. Occupational therapy can be used to manage issues relating to memory, organization and attention span, behavior and emotion control, safety issues and issues which contribute to society. Depending on expectations, different therapies can be sought. Read on to know a little more about how occupational therapy can help adults with brain injury. 

The person's skills and what they want to do are to be assessed and accordingly a daily plan that can be easily followed is made. Where possible, use technology like smart phone or voice recorder to manage this plan. The therapist can train the person to use these tools, review progress and make changes as necessary.
The therapist will also teach ways to do things on their own like cooking and small shopping, so they become independent and are therefore less frustrated.
Patients in need of anger management, the therapist will help them to identify what induces anger or frustration and support in managing those before it turns into actual anger. This will help the person relax and be more positive.
This could also be done using small roleplays, wherein they are taught ways to respond and be more relaxed and calm.
If you are keen on participating in social events or volunteering opportunities, then the therapist can recommend options for you based on your areas of interest. The therapist can also work with the identified organization (school, NGO, or workplace) to inform them of the kind of support required by you. Work behavior and social behavior can be taught to help the affected person succeed.
If the affected person happens to be alone, then they need to be assessed for ability to judge (e.g., self-awareness, impulsivity, and reliability), even while doing daily activities like bathing and dressing. Driving is permissible only if cleared for it by the therapist.
The home needs to be assessed for safety. You may have to make some safety modifications, for instance replace power tools with hand tools. Else, shared housing options, where independence and having someone close by is possible, should be evaluated.
So, with a brain injury, not all is lost. Occupational Therapy can definitely help restore function to a large extent, so use it to reap maximum benefits.

Adults With Brain Injury - Know How Occupational Therapy Can Help You!

Of all cancer types that affect the female population, breast cancer is the most common one. Statistics show that above 1 in 8 women in the USA are likely to develop breast cancer (invasive type, which is often severe). Changing lifestyles including prolonged use of birth control, smoking, alcohol abuse, lack of physical activity, dietary changes, etc., have led to an increased incidence. As these are here to stay, the only way is to prevent.

The likelihood of developing breast cancer is determined by risk factors. Some of these risk factors cannot be changed. For instance, age, ethnicity, and history of familial breast cancer. However, there are others, which can be acted upon or modified to reduce the chances of developing breast cancer. 

Some of the preventable risk factors are as follows:

Nicotine abuse: Quitting smoking has multiple benefits for a woman, and one major benefit is the reduced risk of developing breast cancer. Other benefits include reduced incidence of diabetes, heart disease, and other cancers.
Hormone replacement therapy: To the extent possible, avoid prolonged use of birth control pills or hormones for other treatment purposes. In addition to using non-hormonal methods, if not avoidable, constantly monitoring hormone levels is very important. Birth control pills should especially be avoided by women over 35 years of age who smoke. The risk associated with developing cancer reduces as soon as the hormone supplement is stopped.
Weight Management: One of the major risk factors is obesity, and in people with other non-alterable risk factors, it is best to work on weight management from an early age. Talk to your doctor about your ideal BMI and ensure this is maintained.
Physical Activity: Regular physical activity, at least 30 minutes per day, in addition to strength training will help in keeping the body agile and managing weight. It also reduces the risk of breast cancer.
Breastfeeding: Studies have shown that breastfeeding has protective effect against breast cancer; longer a baby is breast fed, greater is the protective benefit.
Screening: Even if not completely preventable, early detection of breast cancer is very important. This will help in less severe treatment and better prognosis. Recommended ages for mammography are as follows: 
In the age of 40 to 44, an annual mammogram is advised along with a discussion with the doctor on the risks.
An annual mammogram for all women in the age of 45   54 is important as most women enter menopause by this time. This needs to be continued annually, as self-breast exams alone cannot detect cancer, thus it is a good practice and anything abnormal will not go undetected.
These will help reduce the risk of developing breast cancer, help in early detection, and improve prognosis.

Breast Cancer - 6 Ways You Can Reduce The Risk!

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