It is said that if all the veins of the human body were laid out in a single line, it would stretch over 60000 miles. We don t usually think of our veins or notice them unless an intravenous injection is to be administered or the person suffers from varicose veins. These veins are usually benign and can be described as enlarged veins that rise to the surface, and become prominently visible. The varicose veins can usually be seen on the feet and calves. For most people, it is simply a cosmetic problem but for others it can be the cause of pain and discomfort. The good news is that in either case, varicose veins can be treated.

EVLT refers to Endovenous Laser Therapy, which is also known as EVLA or Endovenous Laser Ablation. This is a type of laser therapy that can be used to destroy veins from within. The procedure is performed while the patient is under local anesthesia and hospitalization is not required. Know the steps in which it is carried out:

The first stage involves mapping the veins and identifying the problem veins. A Duplex Ultrasound is usually used to create this map. It is important to note that this procedure cannot treat bulging veins on the surface of the skin. The veins that can be treated include the Great Saphenous Vein (GSV), Small Saphenous Vein (SSV) and their major tributaries.
Once the veins have been identified a needle is inserted into the vein near the ankle or knee with the help of ultrasound controls. A wire is then passed into the vein and a long sheath is then passed to the top, and positioned with the help of the ultrasound.
Ultrasound is again used to then inject local anesthetic into the area around the vein. This numbs the vein and surrounding tissue. The adrenaline in it also makes the vein contract, so as to fit the sheath perfectly. This technique is called  Tumescent anesthesia .
This is followed by passing a laser fiber inside the sheath and switching the laser on. The laser and sheath are then pulled back simultaneously so as to destroy the vein without damaging any of the surrounding tissues.
Once done, you should be able to get back to work and your normal lifestyle, the day after the surgery. But it is advisable to take good rest for few days, before you get back to your regular routine. Your doctor may advise you to wear compression stockings for up to 2 weeks. You should also avoid letting your legs come in contact with water. To avoid getting varicose veins in future, exercise regularly and have a balanced diet to control your weight.

EVLT Endovenous Laser Treatment For Varicose Veins!

Speech therapy helps in improving the speech, understanding the language skills, and also help in communicating in non-verbal ways such as listening and taking turns. Speech therapy treats various kinds of communication and swallowing problems.

Children with Cleft Palate are diagnosed with an opening in the upper tissue palate in the mouth. This condition causes Velopharyngeal dysfunction (VPD) which results in excessive airflow from the nose while speaking. Although it can be corrected with surgery, the patient will still be affected by VPD.

Speech therapists help in this condition by assisting the patient with speech and language skills. The speech therapy for such a patient can be categorized as auditory feedback and articulation practice.

Auditory Feedback

Before involving the patient with any speech therapy, it is essential for the patient to understand the difference between normal voice and nasal voice output.

For this purpose, the child is instructed to use a tube to listen to the voice of the normal person. To understand the difference, one end of the tube is then held near the ear of the child and the other is held near his nasal and then he is instructed to make sounds so that he understands the nasal voice.

After this understanding, the different approaches to speech therapy starts.

Articulation Practice

This is usually where speech therapy begins. In this practice, the different type of condition is understood that relates to different speech organs. The understanding of different vowels, consonants and related sounds is taught to the child for making the speaking sound less nasal.

Some of the methods for achieving these sounds are:

Pharyngeal Plosives: This sound is produced when the tongue is moving backward. The practice of making  ng  sound, and dropping the tongue and producing  k  sound.

Pharyngeal fricatives: When the tongue retracts but is not able to make contact with the pharyngeal wall is when this sound is produced. The speech therapists make the child learn the techniques of making sounds of  t ,  ts ,  ch , or  sh , and provide feedback for learning the proper positioning of the tongue.

Nasal Plosives: This sound usually occurs when the tongue is positioned improperly and it obstructs the vocal tract. A speech therapist may make the child yawn so that the back of the tongue is pushed down, and feel as the mouth stretches.

Palatal-Dorsal Productions: It occurs due to the malocclusion of the teeth. Practicing sounds like  t ,  d ,  n ,  k ,  g , and  ng  often helps in such condition.

Take Away
Cleft Palate is generally developed due to improper growth while the child was in the womb. The difficulty of producing proper sounds when there is excessive airflow in the mouth can be overcome by training and practicing certain sounds, as instructed by a speech therapist.

 Cleft Palate - How Efficient Is Speech Therapy?

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?

Polycystic ovary syndrome (pcos) and infertility are considered synonymous by most. However, the truth is that they are not and there are a lot of treatment options that can lead to pregnancy, even in a lady who is suffering from pcos.

Reasons pcos leads to infertility
Women with pcos have different hormonal pathways than a normal woman without pcos. It changes the system of how your body produces the eggs and prepares your uterus for pregnancy. Three reasons why women with pcos do not get pregnant or why it is difficult for them to maintain pregnancy are:
1. Women who are suffering with pcos do not ovulate normally.
2. They have irregular periods and thus their monthly cycles are not predictable.
3. As they have irregular periods, their endometrium may not be prepared when the egg is released. Thus, it does not help in sustaining the pregnancy.

Symptoms of pcos
There are a lot of symptoms that show the hormonal imbalance due to pcos.
1. Ovarian cysts
2. Excessive amounts of male hormones
3. High levels of insulin
4. Fertility problems
5. Weight gain
6. Ovulation and menstrual problems
7. Excess body and facial hair
8. Acne
9. Anxiety and depression

As there is hormonal imbalance in a woman with pcos, the eggs may not develop properly and at the same time, they may not be ready to get fertilized, thus leading to infertility.

Pcos infertility treatment
The good news is that even if you are one of them with pcos, there are treatments that can help you to get pregnant.

Here are the drugs that help patients with pcos.

Metformin (glucophage)
It helps in reducing the insulin levels and stabilizes the hormones. Thus, doctors often prescribe metformin that will help in making the ovulation cycles regular.

Clomid (clomiphene citrate)
Another fertility drug that helps in conceiving is clomid. It may be prescribed with or without metformin. When women with pcos take these two drugs together, their chances of getting treated for pcos and getting fertile become more. Many women may need a high dose of clomid so that they can retain fertility.

Gonadotropins
This medication is necessary for helping you with ovulation as gonadotropins are hormones that stimulate your ovaries to release eggs. When someone is not responding to clomid then this medication may be tried.
If you too are trying to conceive and yet have not succeeded and can find the symptoms mentioned above, visit your doctor and start the treatment.

How to Get Pregnant Even if You Have Polycystic Ovary Syndrome (PCOS)?

People with spine problems face tough choices when considering treatment. Depending on the severity and scale of the disorder, you will have to decide which treatment works the best for you, and keep an eye out for its long-term impact. Owing to the numerous myths and misconceptions surrounding spine surgery, many patients are unreasonably reluctant to consider this as a treatment option.
Before you make your mind, learn the truth behind these myths about spine surgery. 

  Myth: Spine surgery invariably leads to paralysis

Fact: With the introduction of modern technology in the field of medical science, the efficacy and success rates of spine surgery has improved significantly. The chances of paralysis following surgery are less than 1%. Latest advancements in operating techniques have made the procedure safer and more effective than before.

  Myth: You might require multiple surgeries following spine surgery in the future

Fact: In over 90% of all cases, one successful spine surgery at the right time is all you need to treat the disorder. Majority of patients can do without a second surgery. However, it is essential that patients follow all the instructions and preventive measures to make the surgery successful. The post-treatment guidelines include simple things, such as   eating healthy, reducing and maintaining body weight, exercising regularly, quitting tobacco etc. In rare cases, failing to keep up with these instructions may lead to the need for a second surgery.

  Myth: Spine surgeries are painful

Fact: This was once true when open spine surgeries requiring long incisions were performed   but not anymore. Spine surgeries are now relatively painless as compared to earlier times   all thanks to technological advancements. The modern-day minimally invasive procedure has made spine surgery less painful with no or minimal complications, as you need not go under the knife, literally. In fact, patients do not require anaesthesia before opting for the procedure.

  Myth: You will be bed-ridden for life after the surgery

Fact: The common belief among people is that they will never be able to walk again after spine surgery. But that is not true. With minimally invasive techniques and keyhole surgery, the patient is able to walk the very same day of the surgery. In most cases, they are discharged in a few hours following the procedure. Moreover, pain management techniques and physiotherapy have made it easier for patients to move about without much difficulty.

  Myth: The complication rates are very high in the case of surgery

Fact: With advancements in technology, the overall rates of complications have reduced drastically   less than 3% precisely. The state-of-the-art neuro-monitoring system monitors every nerve during the surgery and allows no scope for error. Surgeons have reportedly been able to avoid all nerve-related complications and offer a 100% success rate using this technique.
The decision to undergo spine surgery can be difficult and the misconceptions floating around do not make it easier. Nevertheless, distinguishing the facts from myths is important. Be sure to discuss any concerns or questions you may have with your physician. They can clear your doubts and help you find out if surgery is the appropriate approach to treat your condition.

Myths About Spine Surgery - Debunked!

Sciatica refers to the pain one experiences due to the irritation or compression of nerve roots contributing to formation of Sciatic nerve. The sciatic nerve is the longest and widest nerve in the body, running from the lower back, down to the back of each leg. The pain can occur in the lower back and spread to the hips, buttocks and leg. Sciatica generally affects one side of the body. There are numerous causes of irritation of the sciatic nerve and sciatica.
 
Some of them are:
 
1. Spinal Stenosis
The narrowing of the spinal canal caused by natural wear and tear of the vertebrae (individual bones in the spine protecting underlying nerves) of the spine is known as spinal stenosis. The narrowing may put pressure on the roots of the sciatic nerve, causing pain.
 
2. Herniated Disc
A disc is made up of cartilage and acts as a cushion between vertebrae, allowing flexibility of the spine. A herniated or slipped disc occurs when a disc is temporarily pushed out of place, putting pressure on the sciatic nerve.
 
3. Spondylolisthesis
It is a condition where one of the lower vertebrae slips forward over another. This also causes a collapse of the disc space between both, causing the nerve to get pinched. This may cause sciatica.
 
4. Piriformis Syndrome
Piriformis is a muscle found deep inside the buttocks, which connects the lower spine to the upper thighbone, running directly over the sciatic nerve. Spasming of this muscle can pressurize the sciatic nerve, triggering symptoms of sciatica.

5. Sacroilitis
Sacroillac joints are the place where the lower spine meets the pelvis and inflammation of one or both of these joints causes sacroilitis. This can give rise to symptoms of sciatica as it causes pain in the lower back, buttocks and legs.
 
6. Spinal tumors
Very rarely, tumors growing inside or along the spine may put pressure on the sciatic nerve.
 
7. Infection or injury
Muscle inflammation, infections, fractures or any other spinal injury may lead to irritation or compression of the sciatic nerve.
 
8. Pregnancy
Pregnant women may suffer from sciatica due to weight gain, expansion of the uterus or increased fluid retention or other changes occurring in the body, which put pressure on the sciatic nerve.
 
9. Other causes
Osteoarthritis and fractures caused by osteoporosis may also affect the sciatic nerve, producing symptoms of sciatica.

Top 9 Causes Of Sciatica Nerve Pain - You Need To Know About

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