Gallstone removal surgery is mainly of two types i.e. keyhole surgery and open surgery. In the case of the former, the patient is not required to stay in the hospital after the surgery, but in the case of the latter, the patient cannot be immediately discharged. Even though after the surgery the amount of bile that is necessary is made by the liver, still patients sometimes feel difficulty in digesting foods with fatty acids. But there are some steps which you can undertake that will give you relief from the complications that arise after the surgery.

A proper diet: A proper diet is very necessary for the fast recovery of your gall bladder. So, introduce different food groups gradually. To start with you can have liquid foods like broth or gelatin and then progress to solid foods. You should avoid fatty foods and fried foods as much as you can. Maintain a low-fat diet. Hence, the food items which you must discard from your list includes pizzas, creamy soups, burgers, chocolate, spicy foods, meat gravies and oily foods. And probably after a month, you can start eating the high fiber foods like nuts, legumes, whole-grain bread, broccoli, cabbage and others which would help prevent constipation.
Do some mild exercise: Exercise is essential in improving body condition in any circumstance, and gallstone removal surgery is no exception. Heavy exercise that will place stress on your wounds is not recommended. You can go for a walk or indulge in such mild workouts. Any physical activity that causes discomfort should be stopped immediately.
Increase your fluid intake: Don t let your body be dehydrated. Drink water from time to time. Dehydration will slow down the recovery process and also result in fatigue. Drink fruit juices too as they will not help in restoring the nutrients in your body but also prevent dehydration.
Take care of your incision area: Taking care of the cuts is very important otherwise they might get infected. So take care of your incisions and change the bandage regularly. Wash the area carefully, and you can apply any antiseptic too but only with the advice of the doctor. You must avoid swimming pool or warm water or bathtub till the incision is completely healed.
Take pain medications if it becomes unbearable: If you experience too much after the surgery, then you can ask your doctor to prescribe some pain medications that will help you with the pain. However, don t panic as the pain is completely normal in the initial days and you may even feel pain in other portions of the body like your shoulders as well.
With these points in mind, you will be able to recover very fast and resume your normal day-to day activities in no time.

Gallstone Removal Surgery - Get Relief In A Fast And Easy Way!

Are you experiencing a sudden pain in the right upper part and at the center of your abdomen? This might be an indication of the presence of gallbladder stones. These stones are deposits of digestive fluid which may form in your gallbladder.

Risk Factors Associated With Gall Stones:

Family history of gallstones

Women are twice as likely as men to develop gallstones

Overweight

High cholesterol

High-fat diet

Rapid weight loss

Over age 60

In the case of gallbladder stones, you need to dissolve and remove them. Among the different modes of treatment of gallbladder stones, homeopathy is considered to be an ideal method.

Homeopathy successfully dissolves small and medium-sized gallstones and help you avoid the gallbladder removal. Homeopathy also provides fast pain relief in gallbladder attacks and can be used for prevention and treatment of biliary colic. The medicines are natural, effective and have no side effects. In patients with gallbladder removal homeopathy can alleviate the digestive disorders after surgery. Here is a list of the top homeopathic medicines, which help in dissolving and removing gallbladder stones:

Chelidonium: This is an effective homeopathic medicine used in the treatment of gallbladder stones. It treats the pain caused because of the stones and jaundice when the bile ducts are obstructed. The medicine is used when the skin turns yellowish, stool turns clay colored and the urine becomes dark. The patient may have an urge for having hot drinks. This medicine is also ideal for gall bladder problems in women during pregnancy.

Lycopodium: This medicine is the best natural cure for gall bladder stones when accompanied by gastric symptoms such as acidity, a bloated abdomen, or gas in the abdomen. Distension in the abdomen may occur even after taking a small meal. Gas rolls in the abdomen and it is difficult for it to pass out. Acidity is likely, which worsens after taking flatulent food containing starch. The patient s appetite may decrease and the craving for sweet and hot drinks increases.

Calcerea Carb: This is another effective homeopathic medicine for gallbladder stones. It is mostly used in case of obese patients who have a flabby and fatty constitution. The abdomen is full of excess fat with hardness and distension. Profuse sweating on the head and an increased sensitivity to cold air are other symptoms. The patient might crave for boiled eggs or unusual things such as lime, chalk and pencils. He may avoid hot food and crave for sweet drinks. The medicine is also used in relieving sour belching and sour vomiting.

Carduus Marianus: This is a very effective medicine in case of an inflamed gallbladder. Pain is experienced in the right upper abdomen and it is also accompanied by nausea and vomiting of burning fluid. It treats jaundice in gall stones as well.

Phosphorus: This homeopathic medicine is used in case of gall bladder stone patients who experience sour belching and vomiting after any meal. The patient will love cold drinks, chicken, ice cream and fish in his diet.

Homeopathic medicines treat gallbladder stones effectively without any side effects. In case you notice the symptoms of gallbladder stones, you should consult a homeopathic practitioner.

Can Homeopathy Help In Dissolving And Removing Gallbladder Stones?

Eczema is a common skin problem that appears as red, raised rashes on the skin, commonly the face, neck, elbows, hands, and feet. Considered as an allergic response, it is often seen in people who have a predisposition to other allergies like asthma, hay fever, hives, etc.

The good news is that these have identified patterns, and there are things that can be easily done which can prevent flare-ups.

Reduce soap: Soaps are known to dry the skin up and irritate the skin, so eczema flare-up is common in those who love to lather themselves up. If possible, switch to soap or body wash that contains moisturizer as reduce the bacterial load on the skin. People who live in hot and humid locations, such as Mumbai it is important that they cleanse their face completely, else it can lead eczema eruption. 
Moisturize: Keep a moisturizer handy at all times. Eczema is common when the skin is dry, so keep applying moisturizer at regular intervals and keep eczema at bay. Make it a habit to apply moisturizer soon after the bath. The moist skin soaks it in nicely and provides maximum benefit when applied this way.
Avoid artificial fragrances: While deodorants and skin care creams which contain fragrances smell appealing, they also cause irritation and are harsh on the skin. This exacerbates eczema, and so avoiding these products is advised.
Know your trigger: This could be anything from a dishwasher liquid to a bath soap or a deodorant to some plant in your garden. Over a period of time, you will be able to identify the trigger, and avoid it so that eczema does not flare up. Remember, it is a type of allergy after all.
Detergents for washing clothes: Using milder detergents, especially for undergarments, greatly helps. Also, wash these twice to get rid of all the soap. Avoid fabric softeners as they are fragrant and can cause irritation.
Avoid hot baths: While a hot bath at the end of a long day sounds very relaxing, it also leaves your skin dry. This can worsen the condition of eczema. Add to this the irritation from your bedspread and pillow covers. Unless you have the habit of applying copious amounts of moisturizer before going to sleep.
Cover up your hands and face: When possible, use gloves and a mask especially when washing dishes and using laundry detergents. This way, you can prevent dryness and irritation of the skin on the hands and prevent eczema.
Soak it in the tub: When you stay for about 20 minutes in a tub (no hot water though, but lukewarm), the skin absorbs moisture which prevents it from drying. This greatly helps prevent eczema.
Cut down stress: Like any allergy, eczema acts up when stressed, so manage it. There is no point stressing anyways!

Eczema - How To Prevent Its Flare-ups?

Hypothyroidism is a condition in which the thyroid gland is not producing the thyroid hormones adequately. This is a fairly common condition.

What is thyroid gland?

The thyroid gland is a small butterfly-shaped gland located just below Adam s apple. It encircles the windpipe or the trachea. It is about 4 cms in height and weighs about 18 gms. This gland is responsible for the secretion of thyroid hormones. Hormones are chemicals produced by special glands like thyroid, adrenals, ovaries etc. They act as messengers and are carried by the blood to the various target organs.

What are the hormones produced by thyroid gland and what do they do?

The thyroid hormones are of two types   T3 (Tri iodo thyronine) and T4 (Thyroxine). These hormones are mainly responsible for the body s metabolism - a process in which food is converted into energy in the cells. They influence growth and development and regulate various bodily functions which are mentioned below:

Heartbeat
Body temperature
Breathing
Body weight
Metabolism of fat
Menstrual cycles in females
Functioning of Nervous system
Digestion
Burning calories etc.
What is Hypothyroidism?

Inadequate production of hormones by the thyroid gland is termed as hypothyroidism. This is also called Underactive thyroid state. Hypothyroidism can make the body s development to slow down and reduces metabolism rates.

What are the causes of Hypothyroidism?

Hypothyroidism can be caused by a number of factors:

Hashimoto's thyroiditis: This is the commonest cause. This is an autoimmune disorder (normally body s defence system fight against external infections. In autoimmune disorder the defence system attacks the healthy cells of the body by mistake). In Hashimoto s thyroiditis the immune system/defence system produces antibodies that attack the thyroid gland and destroy it.
Iodine deficiency in diet. For the production of thyroid hormones iodine is very important. The body does not produce iodine normally, so it needs to be supplemented from outside. Iodine is mainly present in the food we eat. It is mainly present in shellfish, salt-water fish, eggs, dairy products. If a person does not eat iodine rich foods, he may end up with iodine deficiency leading to hypothyroidism. Currently, this causative factor is on the decline due to government initiative of table salt with iodine.
Surgery: Surgery to remove thyroid gland (for e.g. thyroid cancer treatment, overactive thyroid etc.)
Radiation to the neck (to treat cancer in the neck area): The thyroid gland cells are damaged due to the radiation.
Treatment with radioactive iodine: This treatment is used for managing hyperthyroidism/overactive thyroid, where the thyroid gland produces excessive thyroid hormones. One of the treatment modalities is by radioactive iodine. Sometimes this radiotherapy destroys normal functioning cells which lead to hypothyroidism.
Certain medicines: Certain medicines used to treat heart conditions, cancer, psychiatric conditions etc.   for e.g. amiodarone, lithium, interleukin-2, interferon-alpha.
Pregnancy: Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery   this is called Postpartum thyroiditis.
Damage to the pituitary gland: Pituitary gland is a gland which is present in the brain. It produces a hormone called TSH (Thyroxine-Stimulating hormone).The TSH tells the thyroid gland how much thyroid hormone it should make. If the levels of thyroid hormone in the blood are low, then the TSH will stimulate the thyroid gland to produce more Thyroid hormone.
Hypothalamus disorders: This is an organ in the brain. This produces a hormone called TRH (Thyrotropin Releasing Hormone) which acts on the Pituitary gland to secrete TSH. So any disorder of Pituitary gland will indirectly effect the production and secretion of Thyroid hormones. These are very rare disorders.
Congenital thyroid defects: Some babies are born with thyroid problems. This is due to the thyroid not being developed normally during pregnancy. Sometimes the thyroid gland does not function normal. This can be identified by screening for thyroid disorders in the first week after delivery. This is usually by a blood test using a small drop of blood from the baby s heel.
What are the different types of hypothyroidism?

One classification is based on whether the defect is with the thyroid gland or not:

Primary hypothyroidism: The problem is in the thyroid gland itself and thus there is reduced production /secretion of thyroid hormones.
Secondary hypothyroidism: Here the problem is with the Pituitary gland or the Hypothalamus. This results in abnormal production of TSH or TRH, which indirectly leads to less production and secretion of thyroid hormones.
Another classification is based on the symptoms and levels of the thyroid hormones and TSH:

Overt hypothyroidism: Here the patient is having the symptoms. Further the T3/T4 are low and TSH is high
Subclinical hypothyroidism: Here patient may or may not have symptoms. The T3/T4 levels are normal but TSH is high. In this situation the patient is at an increased risk of developing overt hypothyroidism in the future especially if he has Thyroid peroxidase antibodies on testing.
Who are at risk of developing Hypothyroidism?

Women have a higher risk of suffering from hypothyroidism than men.
Older people are at increased risk.
People suffering from other autoimmune diseases like Coeliac disease, Type-1 Diabetes Mellitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis, Addison s disease etc.
People with psychiatric conditions such as bipolar disorder
People with Chromosomal abnormalities like Down syndrome, Turners syndrome also have a high risk of suffering from hypothyroidism.
What are the symptoms of hypothyroidism?

Symptoms vary from person to person. They may also mimic other conditions and hence be difficult to diagnose. Symptoms may also develop very slowly over a span of moths-years. Some of the characteristic symptoms of this disease are:

Depression
Constipation
Hair loss
Dry hair
Dryness of the skin
Tiredness
Body pains
Fluid retention in the body
Irregular menstrual cycle
Increased sensitivity to cold
Reduced heart rate
Increase in size of the thyroid gland   called Goitre. This is due to constant stimulation of the thyroid gland by TSH.
Weight gain
Carpal tunnel syndrome
Hoarse voice
Infertility
Loss of libido/sex drive
Confusion or memory problems especially in the elderly
What are the symptoms to look for in a baby if you suspect hypothyroidism?

Infants suffering from congenital hypothyroidism may show no symptoms or exhibit signs of excessive drowsiness, cold hands, cold feet, constipation, hoarse cry, poor growth or absent growth, poor appetite, bloating of abdomen, puffiness of face, swollen tongue, persistent jaundice.

How to diagnose hypothyroidism?

Blood tests:

TSH: This hormone is made in the pituitary gland and it stimulates the thyroid gland to produce thyroxine. If the thyroxine levels are low in the blood, the pituitary gland produces and secretes more TSH into the blood to act on the thyroid gland to produce more thyroxine. A raised TSH level indicates hypothyroidism. Other tests are not usually necessary unless a rare cause of hypothyroidism.
T4: A low level of thyroxine indicates hypothyroidism.
T3: these levels are generally not needed to diagnose hypothyroidism
Anti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.
Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.
Ultrasound of the neck is done if the patient presents with a thyroid swelling.
What is the treatment of hypothyroidism?

Overt hypothyroidism is treated by synthetic Thyroxin hormone which should be taken every day on an empty stomach at least 30   45 minutes before breakfast. The treatment is continued for the rest of the patient s life. Regular thyroid function tests are done once every 8 weeks-12 weeks to adjust the dose of the thyroxine in the initial period of diagnosis. Once the thyroxine dose is stabilised, the tests can be done even once a year. This treatment is quite effective.

Sub-clinical hypothyroidism is only treated if the patient is a woman and is contemplating pregnancy, in patients with symptoms or if the TSH is quite high.

What are the side-effects of thyroxine medication?

There are few side effects if any. Most people tolerate these medications quite well. An important consideration before starting medication is to check if the patient has chest pain/angina. These people are started on the least available dose. If these patients are started on a higher dose they notice a worsening of their angina pains.

Side effects mainly occur if the thyroxine dose is high which leads to hyperthyroidism. The symptoms of this could be palpitations 9increased heart beat), weight loss, profuse sweating, anxiety, irritability etc.

There are some tablets which increase with thyroxine tablets. These include carbamazepine, iron supplements, calcium supplements, rifampicin, phenytoin, warfarin etc.

What are the complications of hypothyroidism?

If untreated hypothyroidism can lead to:

heart problems like heart attack due to increased levels of bad cholesterol like LDL, or heart failure due to fluid retention
obesity
infertility
joint pains
depression
A pregnant woman with hypothyroidism is at increased risk of giving birth to a baby with congenital hypothyroidism, also known as cretinism. Further, the woman may have pregnancy related complications like pre-eclampsia, premature delivery, low birth weight baby, anemia, post-partum haemorrhage (bleeding after delivery) etc.
Myxoedema is another complication where the patient has extremely low levels of thyroid hormone. The body temperature drops drastically making the person lose consciousness or go into a coma.
References:

2013 ETA Guideline: Management of Subclinical Hypothyroidism; European Thyroid Association (Nov 2013)
Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee; British Thyroid Association (2015)
The diagnosis and management of primary hypothyroidism; Royal College of Physicians and others (June 2011)
Suh S, Kim DK; Subclinical Hypothyroidism and Cardiovascular Disease. Endocrinology Metabolism (Seoul). 2015 Aug 4.
UK Guidelines for the Use of Thyroid Function Tests; British Thyroid Association (2006)
Gaitonde DY, Rowley KD, Sweeney LB; Hypothyroidism: an update. American Family Physician. 2012 Aug 1 86(3):244-51.
Bindra A, Braunstein GD; Thyroiditis. American Family Physician. 2006 May 15 73(10):1769-76.
Wilson GR, Curry RW Jr; Subclinical thyroid disease. American Family Physician. 2005 Oct 15 72(8):1517-24.
British National Formulary; NICE Evidence Services (UK access only)
Baumgartner C, Blum MR, Rodondi N; Subclinical hypothyroidism: summary of evidence in 2014. Swiss Medical Weekly. 2014 Dec 23 144:w14058. doi: 10.4414/smw.2014.14058. eCollection 2014.

Know Everything About Hypothyroidism

Tennis toe is also known as runner s toe since athletes are mostly runners; skiers and tennis players also get this injury often. Due to its ugly appearance, tennis toe is also known as a black toenail. This injury causes bleeding under the toe along with moderate to heavy pain. Although it is not considered to be type 1 serious injury, it can still force an athlete to abstain from participating in any events. The blood from the toenail might take its own sweet time to get out of the way. As a result, the recovery time for this injury can last for weeks together. This, unfortunately, is also an ideal condition for infection to set in.

How does it happen?
This condition may arise because of the friction between the toenail and the running shoes or constant downward pressure on the toe. In case if the shoe is tighter than normal, it can damage the toenail. If on the other hand, the shoe is very loose, it can result in similar condition due to heavy pressure on the nail. Tennis toe can also arise in a situation, if the toe constantly bangs the shoe from inside. Extreme hot weather may also result in toe swelling. Finally, one may encounter tennis toe if a blow is faced on the toe. Irrespective of the cause, the blood clots inside the nail resulting in swelling and pain. Too much damage might result in falling off of the toenail altogether.

Treatment plan:
1. If the tennis toe is minor, the injury resolves all by itself
2. The toenail should be clipped together to ensure that it does not result in any friction with the shoe.
3. During the injury, it is advised that a person wears bigger size shoes with wider toe space so that it does not result in any further irritation.
4. If the toenail is torn, make sure to tap it up so that adequate protection is there from outside forces.
5. In case the injury is serious a doctor might have to intervene and drain the blood with a surgical instrument.
6. Another medical solution is to remove the toenail surgically, drain the blood and tape it up for a good one week until new nail formation takes place.

Precautionary measure:
1. Running shoes should be at least half a size bigger than the normal size.
2. Toenails should be regularly trimmed in order to avoid any injury.
3. If a person has a tendency of sweating too much, it makes sense to wear a pair of socks at all times.
4. While running, shoe laces should be tightened to avoid sudden friction between the toe and the shoe resulting into tennis toe.

Tennis Toe - How it Should be Treated?

Gallstone Pancreatitis is the result of a blockage in the pancreatic duct by a gallstone. Due to the blockage in the pancreatic duct, inflammation occurs and causes the problem to begin.

This can be a life-threatening situation and should be immediately checked. If the stones from the gallbladder travel down the common bile duct and get stuck at the sphincter, it can stop the outflow of all materials from the pancreas as well as the liver and become quite severe. There are a lot of risks involved when a person suffers from this issue. Rapid weight loss, high cholesterol levels, diabetes are a few of the risks of the disease.

Symptoms of Gallstone Pancreatitis
There are a number of symptoms like pangs of pain in the upper left abdomen and the back, swollen and tender abdomen, vomiting and nausea, increase in the heart rate, fever and more can be seen in a patient suffering from gallstone pancreatitis. Any individual who notices any of the following symptoms should get themselves checked immediately. Any pain in the upper abdominal area can be aggravated by eating foods which are high in fat as well.

Diagnosis of Gallstone Pancreatitis
In order to be completely sure about having gallstone pancreatitis, a number of tests are performed. Blood tests are followed by abdominal CAT scan to check for the inflammation of the pancreas. This also shows how severe the inflammation of the pancreas is. Sometimes abdominal ultrasound is also suggested as CAT scans are sometimes not as sensitive in identifying the problem. Once the problem has been detected, immediate treatment is recommended by doctors.

The Treatment of Gallstone Pancreatitis
The best treatment for pancreatitis is done in the initial stage of the problem. By avoiding taking in liquids and solid food up until the inflammation subsides is one of the best treatments. If the inflammation is relatively modest, the swelling can reduce in a few days by intravenous delivery of fluids for a couple of days.

1. If a CAT scan or MRI of abdomen suggest that a stone in present in the Common bile Duct (CBD), the an Endoscopic treatment referred as ERCP (endoscopic retrograde cholangio-pancreatography) is done. 

2. After the acute pancreatitis episode settles down, patient must undergo a Gall Bladder removal surgery. This is done as gall bladder is the factory of gall stones and patient is at-risk to another episode of Acute Pancreatitis.

In case of severe inflammation, fever and persisting pain, intravenous delivery of food should continue if oral intake of food does not start within 5 to 7 days. Anti-nausea medications are used to treat severe nausea and vomiting along with nasogastric tube. In certain cases, it is important to remove the gallstones from the bladder immediately while in some cases doctors suggest waiting for a period of 24-48 hours before starting the removal procedure. Sometimes a surgical removal of the gallstones is also required but only if the stones do not pass out of the system on their own.

All You Need to Know About Gallstone Pancreatitis

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