Spinal surgery becomes inevitable when back pain cannot be managed with medications and/or exercise. This is a major decision and requires planning for many things before, during, and after the surgery.

Before a spinal surgery- This preparation will help in smooth recovery, especially if you do not have a full-time caretaker.

Discontinue pain killers: Discontinue pain killers at least 10 to 14 days before surgery. These are blood thinners and can prolong bleeding during the surgery.

Prepare for blood loss: Most people experience some blood loss, but not excessive.

Use a toilet seat raiser: Sitting and getting up from the toilet seat may be difficult. The seat raiser is used to increase the height, making this movement easy.

Enable easy access to common items: Before heading for the surgery, keep things which are commonly used within easy reach. This will help reduce movement and avoid searching (especially if someone else is going to be doing it).

Stock it up: Cooking may not be feasible during the initial postop period, and so it is advisable to stock up food items (ready to eats, fruits, soups, etc.) which will come in handy.

Slip-ons: Bending down and tying shoes may not be easy, so slip-ons can be used.

Caregiving: It is always advisable to have someone stay over with you during the initial postop days. They could help with regular household chores, cooking, etc.

Lifestyle changes: Ensure you eat well in the days before surgery, quit smoking, quit/use moderate amounts of alcohol, and exercise as advised by your surgeon.

After Surgery- Post surgery, there will be some pain and limitation of movement. It is important to understand that adherence to post-op instructions will improve the success rate of the surgery. Also, recovery time for spine surgery is slightly longer and affects overall quality of life, so psychological preparation is required.

Postoperative medications: These will be given to control infection and pain in the immediate postop period, and should be taken without fail

Rehab: The surgeon will recommend physical therapy and rehab exercises which need to be followed. Complete recovery may take anywhere between 3 to 12 months. During this time, care should be taken to avoid repeat injury.

Support: Adequate back support should be provided using lumbar support and ergonomic chairs, and the right posture should be maintained. Ensure there is no undue strain on the back muscles.

Weight management: With excess weight, there is too much strain on the lower disks. Therefore, weight should be managed to reduce this strain.

Smoking and alcohol should be completely stopped, as healing can be hampered.

With some preparation, spinal surgery can be sailed through smoothly.

What To Expect Before and After Spine Surgery?

Fatty liver is a condition where excess fat is deposited on this organ. Also called as steatosis, this condition happens when more than 5- 10 percent of the weight of the liver is made up of fat.

Fatty liver is a common condition among people. A study from coastal regions of India found ~ 25% of healthy persons had patients had fatty liver on ultrasound.

It can occur at all ages including childhood, highest prevalence is in 40 50 year age group. Prevalence more in patient who are obese and in diabetic patients.

Types of Fatty Liver

1 Alcoholic fatty liver: This condition occurs when there is a heavy consumption of alcohol. Gastroenterologists recommend abstention from alcohol for this condition to subside. If the patient continues to consume alcohol, then liver cirrhosis may develop.

2 Non alcoholic fatty liver (NAFL): One may develop a fatty liver even if one is not an alcoholic. The liver in some cases is unable to process the fat in cells causing them to build-up on the organ.

When more than 10% of the liver is made of fat then this condition is called Non Alcoholic Fatty Liver (NAFL).

Non alcoholic steatohepatitis (NASH): When fatty liver is associated with inflammation in liver patient is said to be having Non alcoholic steatohepatitis. NASH is a more advanced stage of NAFLD, and has a higher risk of progressing to liver cirrhosis or hepatocellular carcinoma (HCC). These condition display symptoms like jaundice, vomiting, nausea, loss of appetite and abdominal pain. Blood test (LFT) shows raised enzymes level. Approx 5-8% of the Indian population has NASH. Consult a doctor if you are experiencing any of these symptoms.

3 Fatty liver during pregnancy: Occurring mainly in the third trimester, the symptoms of this condition are vomiting, nausea, pain the right part of the abdomen and jaundice.

Symptoms

During the early stages (fatty liver) of the disease, patients usually have no symptoms directly related to liver disease. However, people may experience a vague abdominal discomfort. If their liver is inflamed (NASH) then they may display symptoms of poor appetite, weight loss, pain in the abdomen and disorientation.

What causes fatty liver?

The most common cause of fatty liver is alcoholism. When the human liver is unable to metabolize fat fast enough or when there is an excess accumulation of fat on the liver cells then the liver becomes fatty. However, intake of high-fat foods may not result in a fatty liver.

Predisposing factor:

1 Diabetes mellitus

2 Obesity or being overweight

3 Hyperlipidemia or the condition where there are high levels of fat in the blood

4 Genetic reasons

5 Rapid loss of weight

6 Drugs: Aspirin, steroids, tamoxifen, tetracycline etc. cause side effects which also leads to fatty liver

7 Nutritional status (eg, overnutrition, severe malnutrition, total parenteral nutrition [TPN], or starvation diet)

8 Other health problems (eg, Hepatitis C infection, celiac sprue and Wilson disease)

Know More About Fatty Liver!

A breast lump is a restricted swelling, projection, lump or knot in the breast that doesn't feel like a breast tissue. There are diverse reasons why breast lumps occur.

Not all lumps are cancer. These can also be breast conditions that are not harmful and which can be easily curable.Knots that feel harder or are not the same as the rest of the breast need to be checked. This kind of irregularity might be an indication of breast cancer.

A self-examination should be your starting point. This is how you can detect a lump on your own:

Step 1: Begin by taking a look at your breast in the mirror. Keep your shoulders straight and your arms on your hips.

This is what you need to search for:

    Breasts that are their typical size, shape, and shading
    Breasts that are uniformly formed without distortion or swelling

In the event that you see any of the changes mentioned below, convey them to your doctor:

    Dimpling, puckering, or protruding of the skin
    A nipple that is not in its initial position
    Redness, rash or swelling

Step 2: Now, raise your arms and look for the changes mentioned above.

Step 3: While you're in front of the mirror, search for any indications of liquid or blood discharge from the nipples.

Step 4: Next, examine your breasts while resting.Use Your right hand to feel your left breast and use your left hand to feel your right breast. Cover the whole breast from your collarbone to the highest point of your mid-region, and from your armpit to your cleavage to search for any lumps.

Step 5:Examine your breasts while either standing or sitting. Many women find that the easiest approach to examine their breasts is when their skin is wet, so this step could be done while taking a bath as well.

Diagnosis:

    Mammogram: Mammography is a technique using X-rays to diagnose and locate tumours of the breasts.
    Breast ultrasound: Breast ultrasound utilises sound waves to create pictures of the breasts from the inside.
    Breast MRI:This involves using an effective and attractive field, and radio frequency pulses to create photos of the insides of the breasts.
    Ultrasound-guided biopsy: During this sort of biopsy, utilising ultrasound imaging to discover the bump, a radiologist will give you anesthesia and afterward insert a needle into the lump to evacuate some tissue for assessment under a magnifying lens. Stereotactic biopsy and an X-ray-guided biopsy may also be used.

Possible treatments:

    In case the knot turns out to be cancerous, surgery is typically performed.
    You may have a few discussions with different doctors for additional treatment, including radiation treatment and chemotherapy or hormone treatment.

What You Should Know About Breast Lump Detection

Are you a 'What-If' person? Kill anxiety in 4 easy ways

Thinking about dangers and risks is a normal phenomenon, it helps us to stay alert and to become a good problem solver. It’s only when worrying gets out of a person’s control, it turns into a problem. If a person is constantly preoccupied with “what-if " and keeps imagining worst-case scenarios, worry actually turns into the cause for high pulse rate, insomnia, poor mental and physical health. 

Here are 4 simple steps to cope with anxiety and worry.

1. Breathing technique: The first thing to do when you get anxious is to take deep breath. Deep breathing is a powerful anxiety-reducing technique because it activates the body’s relaxation response. Try slowly inhaling to a count of 5, filling your belly first and then your chest, gently holding your breath to a count of 5, and slowly exhaling to a count of 5 and repeat several times.

2. Accept that you’re anxious: Remember anxiety is just a feeling, like any other feeling, by reminding yourself that anxiety is simply an emotional reaction, you can start to accept it. Acceptance is critical because trying to eliminate anxiety often worsens it. But accepting your anxiety doesn’t mean liking it or resigning yourself to a miserable existence. It just means you would benefit by accepting reality as it is – and in that moment, reality means 'anxiety' you are feeling.

3. Question your worries. When people are anxious, most of the time their brains start coming up with all sorts of unrealistic ideas, which most likely will never occur. To avoid unnecessary worry, one should ask himself / herself a few questions like:
- Is there a reason to believe something is wrong?
- What evidence is there that something is wrong?
- If the worst possible outcome happens, what would be so bad about that?
- What are the options I can use to handle the situation at hand?


4. Focus on right now: When people are anxious, they are usually obsessing about something that might occur in the future. It is important that when a person becomes anxious, he/she takes a deep breath and pay attention to what’s happening right now, around them. Even if something serious is happening, focusing on the present moment will improve your ability to manage the situation.

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

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Are you a 'What-If' person? Kill anxiety in 4 easy ways

Do you know that all the facts you know and have heard regarding post traumatic stress disorder are not true? Post traumatic stress disorder or PTSD is a mental health condition, which occurs because of a certain traumatic past event, witnessed or experienced by an affected patient. As there are several myths about this condition, it is important for you to get your facts right regarding PTSD.

Myth: Post traumatic stress disorder only affects war veterans.
Fact: Even though PTSD is common among war veterans, the condition is capable of affecting any person. It is expected that almost 70% people of the world gets exposed to some kind of traumatic event during their lifetime, and almost 20% of them end up with this mental condition. The victims of physical abuse and sexual harassment are very likely to develop PTSD. Women are more likely to experience this condition on the basis of traumatic experiences such as rape, beatings, and interpersonal violence.

Myth: People should be able to move on in life after facing a traumatic event. Those who cannot get over and cope are weak people.
Fact: Many people who experience a traumatic event of extreme intensity go through periods of adjustment after the situation. Most people become capable of getting back to normal life after some time of therapy and treatment. However, the stress which is caused due to the trauma gravely affects a person s emotional, mental, and physical well-being. Prolonger trauma is capable of disrupting and altering a person s brain chemistry. The views, perceptions, and thinking patterns of many people change after a traumatic event. This results in PTSD.

Myth: People develop PTSD right after experiencing a traumatic life event.
Fact: The symptoms of PTSD start developing within three months of experiencing an extremely traumatic situation, but they also might not show or appear before several months, or even years in some cases. The symptoms are likely to be experienced for several years after the traumatic event. In some cases, the symptoms may subside or leave, only to reoccur again at a later stage in life. This is common in the case of victims who have experienced extreme situations of child abuse in the past.

Many people do not recognize that they are suffering from PTSD. This is because they may not relate the current symptoms they experience with the past traumatic event. In cases of domestic violence, a victim may fail to realize that his or her prolonged abuse exposure is harmful.

Post Traumatic Stress Disorder - Myths & Facts About It!

The heart is a muscular organ that pumps blood to the entire body through a network of arteries and veins. This network contains big vessels which branch out further to supply blood to the distant organs. There is, therefore, some pressure that the heart and thereby the vessels need to exert to push the blood through these vessels. This is known as blood pressure, and normal pressure levels range from 90-140(systolic)/60-90(diastolic) mm of Hg. However, due to various reasons, this pressure could be more, which is one of the first signs of heart disease. 

Causes of increased blood pressure: 

Thickening of the blood vessels. With age, the elastic blood vessels naturally turn rigid and less elastic, so there is more pressure required to push blood. It is natural for people over 55 years of age to have higher readings of blood pressure. This is known as primary hypertension (HTN) 
Narrowed blood vessels. This happens due to cholesterol accumulation along the walls of the blood vessels. Faulty dietary habits along with sedentary lifestyle have increased the incidence of hypertension due to this condition, known as atherosclerosis. Critical atherosclerotic narrowing of renal arteries lead to renovascular HTN that is one of the commonest of secondary HTN. 
Other Causes of secondary hypertension are: 

Kidney problems 
Thyroid hormone disorders 
Congenital heart defects 
Chronic alcohol abuse 
Adrenal gland tumours 
Chronic use of medications like birth control pills, pain killers, etc. 
Unidentified and uncontrolled hypertension can be silent and can lead to more severe conditions like heart attack and stroke. India is fast becoming the new hypertension capital of the world. Some of the common risk factors are: 

Age 
Family history 
Being obese or overweight 
Sedentary lifestyle 
Smoking 
Alcohol consumption 
Excessive salt intake 
Stress levels 
Ethnic background 
Symptoms: 

Hypertension can go undetected for years together, but if there are risk factors like diabetes and high cholesterol, it is advisable to periodically monitor blood pressure. 
Headaches, nosebleeds, and shortness of breath should not be ignored. These can be the first warning signs of hypertension, and if detected early, preventive measures can be taken. 
If there are co-morbid risk factors, it is advisable to constantly keep a check on BP readings. 
Management: 

This includes a combination of diet and lifestyle modifications. 

Quit smoking and alcohol: Of the many wonders quitting smoking can do, reducing BP readings is just one. The improvement would be almost instantaneous. Quit or else reduce alcohol and see dramatic improvements. 
Weight management: Through a combination of diet and exercise, ensure that weight is brought under control. Set a target BMI (Below 26 kg/m2) and work towards it religiously. 
Diet: Reduce salt, increase potassium, increase vitamin D, eat a heart-healthy diet, and see the hypertension readings improve. Please find attached and reviewed copy for health tip for posting

High Blood Pressure - All You Need To Know About It!

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