Is there a relation between weight loss surgery and type 2 diabetes? Yes, there is and a very promising one. Many diabetics may not know this but a key hole procedure called metabolic/ bariatric surgery can help resolve type 2 diabetes.

It s scientifically proven that these surgeries can normalize blood sugar levels and control diabetes in most patients. This means that you may not need any medicines post such a surgery. One long-term study which tracked 400 people with type 2 diabetes showed that six years after bariatric surgery, 62% diabetics showed normal blood sugar levels. Apart from this, they also showed better blood pressure, cholesterol and blood triglyceride levels that can cause heart disease.

Should you get a metabolic/bariatric surgery done? You are a fit candidate for bariatric surgery if your:

BMI is 27.5 or higher
And if are finding it difficult to maintain blood sugar with medicines & lifestyle changes.
Your doctor will give you a physical exam to check whether you are fit for a major surgery and if you are emotionally ready to commit to necessary lifestyle changes like eating healthy and exercising regularly.

Types of weight loss/diabetes surgery:

The most popular type of weight loss surgery is one in which the size of your stomach is reduced so that you feel full even after small meals. Other types of bariatric surgeries change the way your body absorbs calories and nutrients and vitamins. A few other types of bariatric surgeries do both.

Gastric Bypass: In this surgery, your surgeon makes a small stomach pouch by dividing the top of the stomach from the rest. This small pouch is connected to intestine so other part of stomach is bypassed. So, when you eat, food goes into this small pouch, which makes you feel full faster and also makes it possible for your body to absorb fewer calories. This is a very promising type of bariatric surgery for diabetics as up to 80% of people have normal blood sugar after it. And they also lose 60% to 80% of their extra weight on an average.
Gastric Sleeve: In this surgery, your surgeon will remove a major part of your stomach. When your stomach is small, you will feel full faster. It also reduces hunger pangs. This type of surgery is also very effective in reducing diabetes and losing weight.
Adjustable Gastric Band: In this surgery, your surgeon puts an inflatable band around the top of your stomach. This forms a small pouch which makes you feel full faster. The good point is that your stomach is not cut and your intestines are not shifted. There are thus lesser complications. It also helps in controlling diabetes. The con is that you lose less weight in this type of surgery.
Biliopancreatic Diversion: This is an uncommon surgery but most effective for diabetics. In this the doctor removes a large part of your stomach and also changes the way the food goes to your intestines. This helps in losing weight but also affects digestion long term.
As with any major operation, all bariatric surgeries come with potential risks of bleeding, infection, and leaks in the digestive system. It is necessary to change lifestyle to avoid weight regain.

Is There A Relation Between Weight Loss Surgery & Type 2 Diabetes?

Causes and symptoms of enlarged prostate

The problem of an enlarged prostate or benign prostate hyperplasia is a very common occurrence as you grow older. It's known to strike men above the age of 50, with more than 50% of men after the age of 60, having this complaint.

Causes of enlarged prostate

A non-cancerous condition, enlarged prostate makes the passing of urine from the bladder through the urethra difficult. The multiplication of the prostate cells causes an enlargement of the gland, leading to a buildup of pressure on the urethra, affecting the discharge of urine from the body. The narrowing of the urethra, due to this benign condition, forces the bladder to contract more vigorously so as to push urine out of the body.

As time passes, the muscles of the bladder get significantly affected, causing them to become extremely sensitive, thicker and stronger. As a consequence, the bladder begins to contract, even if the amount of urine in the organ is negligible, causing episodes of frequent urination. Gradually, the bladder fails to completely empty itself of urine due to the constriction of the urethra. This can give rise to a number of health problems including the formation of bladder stones, urinary tract infections, blood in the urine and so on.

How can you identify the signs of the condition?

Signs of enlarged prostate are very easy to identify and include:

- A slow or weak urine flow
- Difficulty in initiating urination
- Instances of frequent urination
- A feeling of not completely emptying one's bladder
- Frequent urination during the night
- Exerting a lot to urinate
- Instances of dribbling
- Urgency to pass urine
- A feeling of urinating again minutes after doing so
- Urination that starts and stops



What Leads to an Enlarged Prostate?

A hysterectomy is a surgical procedure that is done to remove your uterus. Robotic hysterectomy is a more preferred procedure than open surgeries because:

They cause minimal discomfort.
They have better recovery options.
Loss of blood is minimized
The pain associated with the usual surgical procedures are less compared to other options.
This is one of the best procedures that have been designed after years of research in the field of robotics. It is true that they are safe, but it does not mean that there are immediate recovery options. The bottom line is that it is a procedure to remove the uterus and you have to give due importance to the recovery procedures that come along with such robotic surgeries. Let us have look at them.

Recovery
The recovery period depends on the type of surgery you had and also depends on a case to case basis. However, you might be asked to stay overnight in the hospital for observation. You would be constantly monitored during this period and any complications that might arise are given utmost care.

Pain medications and medicines to prevent infections that might arise due to the surgery are given during this period.
You may experience a light vaginal bleeding for a few days. However, this is normal and will gradually ease out. In case the ovaries are removed, the recovery period is extremely crucial. You will no longer have menstrual periods and your body would immediately start adapting to the menopause cycle.
During this transition, the hormonal changes start to occur and you might be experiencing mood swings and hot flashes. You may also experience periods of night sweats. However, all these factors are common occurrences and your body would gradually adapt to these changes. The exact recovery period can range from a week to about six weeks. During these times, you would be given the following advice:

Take plenty of rest and limit your activities.
Do not lift any weights or do any rigorous tasks during these periods.
Any sorts of sexual intercourse must be avoided till you heal completely. Talk to your doctor about this and get to know more about the recovery options.
Never miss a periodic check-up during these times.
Always take the prescribed medications on time.
There can be some sense of loss of your uterus during this period. For some women, this can mean that they would not be able to bear a child. These are some of the common stress factors that come into play during the recovery period. Watch out for them and get emotional support guidance from the counsellor, if the need arises.

Underwent A Robotic Hysterectomy? Here Are Some Recovery Tips!

Menorrhagia is a condition that is marked by heavy menstrual bleeding during the monthly menstrual cycles. Most women have a unique bleeding pattern during that time of the month with the flow going up and down over the first few days. Yet, for many women, the bleeding becomes consistently heavy during all the days of the period, during which the period itself may get extended by a few days. If this pattern continues to occurs, one must get it checked out by a doctor at the earliest. Here are a few ways in which this condition may be treated.

Factors considered during treatment

Before the treatment starts, and during the diagnosis stage, the doctor will take a look at a number of factors so that the correct form of treatment may be prescribed to the patient. To begin with, the doctor will take a complete medical history of the patient, including the family history to ascertain whether or not there may be a genetic problem at play. Further, the future childbearing plans of the patient will also be taken into consideration in such cases so that the treatment method does not hinder such plans. Also, the doctor will also try and understand the effect of the symptoms of this condition before prescribing any particular medication and surgery.

Medication

Iron supplements and non-steroidal anti-inflammatory medicines will be prescribed for the patient to bring down the level of inflammation and restore the production of blood, which will make up for the rapidly flowing blood from the body. This will also prevent the risk of anemia. Oral contraceptives, tranexamic acid, oral progesterone and hormonal therapy can also help in such cases.

Dilation and curettage

This procedure is also known as D&C, and it basically helps in dilation or opening up of the cervix so that the doctor may suction the tissue from the uterine lining. This tissue is usually known to bring about excessive bleeding.

Uterine artery embolisation

This is a procedure which shrinks any existing fibroids that may be the cause behind excessive bleeding. In this procedure, the uterine arteries are blocked and the blood supply to the same is cut off so that the fibroids do not get a chance to grow and cause unnecessary pressure that may lead to excessive bleeding.

Hysterectomy

This is a surgical procedure that removes the cervix as well as the uterus, and is usually the last resort followed by most doctors. In such cases, the doctor will first ascertain whether or not you plan to have any children in the future. Additionally, the ovaries may also be removed if the condition has spread too much to be contained sufficiently.

Ways to Treat Menorrhagia

If the blood flow between left ventricle and aorta is obstructed, it is known as Aortic Stenosis.
Aortic stenosis can occur in newborn, infants, children and adolescents. It is more common among boys than in girls.
Mild cases of this disorder do not need treatment. However, if a child has a severe case of aortic stenosis, then it requires treatment.

Aortic stenosis: Causes-

Blockage in the valve, mainly in the form of bicuspid valve stenosis (Aortic valve stenosis)
Muscular/fibrinous obstruction beneath the aortic valve (Subaortic stenosis)
Narrowing above the aortic valve in aorta itself (Supravalvular aortic stenosis)
Aortic valves regulate blood flow to the body parts. When aortic valve opens, it allows blood to go forward then it closed down so that blood will not come back to left ventricle.
However, if there is a problem with the aortic valve, it cannot open entirely and that restricts the passage of blood. The heart has to work extra hard to ensure that the entire volume of blood flow through the faulty valve.

Sometimes babies are born with deformed aortic valve in the form of bicuspid aortic valve that is prone for obstruction as compared to normal trileaflet aortic valve.

Aortic Stenosis: Symptoms-

Symptoms due to aortic stenos is depends on age of the child and its severity.
If occurs in newborn babies, it is generally severe in intensity and babies are generally in shock like state due to low cardiac output.
Infants are generally tired easily during feeding.
Children show signs of easy fatigue, chest pain, loss of consciousness and in late stages with shortness of breath.
Diagnosis of Aortic Stenosis-

Pre-natal testing like a fetal echocardiogram can reveal aortic stenosis if moderate to severe in intensity. That is why as soon as the baby is born, treatment is initiated.
Even if the child was not born with a problematic valve, this condition can arise a few years later.
For diagnosing this disease pediatric echocardiogram by pediatric cardiologist needs to be done from the chest of the child
Treatment of Aortic Stenosis-

If aortic stenosis is mild to moderate in intensity then we need to do follow-up of the child at regular intervals.
However, in severe aortic stenosis, treatment needs to be done
In valvular aortic stenosis, treatment of choice is by doing ballooning of aortic valve (Balloon aortic valvuloplasty, BAV) in any age group.

Balloon Aortic Valvuloplasty - This is not open-heart surgery. It is done in cardiac cath lab under fluoroscopic guidance by using vessels in thigh. We cross the valve with wire and catheters and we inflate a balloon across the stenosed aortic valve.

Open heart surgery: In subvalvular and supravalvular aortic stenosis, treatment is by open heart surgery.

Valve Replacement - An artificial valve or a donor valve is surgically attached at aortic valve location when valve is not amenable for ballooning. It is generally done in adolescent or adult patients.
Parents need to be alert and attentive to any physical discomfort that their child is suffering because that could be a symptom of aortic stenosis. The right treatment at the right time is necessary whenever required.

Aortic Stenosis - All You Must Know About It!

GERD or gastroesophageal reflux disease is a chronic digestive disease which occurs when the stomach acid and at times the contents in your stomach flows backwards into the food pipe. The backwash or reflux irritates the esophagus's lining and hence causes GERD. Individuals may manage GERD's discomfort by changing their lifestyle and by taking over-the-counter or OTC medications. But, certain people might also require stronger medications or surgery for reducing the symptoms.

Some of the basic signs include chest pain, burning sensation in the chest, dry cough, difficulty in swallowing, sore throat, etc. If you experience such symptoms at least twice a week or if your physician notices damage in your food pipe, then you might undergo diagnosis. Though drugs are the primary GERD treatment yet, an individual can manage it by following certain tips which may give relief.

Few ways to manage GERD- self-care tips:

One of the effective ways to help yourself is by consuming smaller meals. Instead of taking three big meals regularly, you may try having smaller meals frequently and avoid stuffing.
Almost all individuals tend to have dinner just half an hour before sleep, but this might affect GERD patients. It is best to eat 2 hours before going to bed as by doing so your stomach will get enough time to digest the food.
Due to a hectic schedule and fast paced lifestyle, people tend to eat as quickly as possible. To manage GERD, one must eat slowly and put down the spoon or fork in between each bite.
Changing the daily diet by striking off the trigger foods is beneficial in managing GERD symptoms. Though the food triggers vary from one person to another yet, it includes coffee, chocolate, peppermint, alcohol, tomato, citrus juices, onions, spicy and high- fat foods, etc.
Sleeping with the head end of the bed elevated by 6 inches is a very effective way of reducing night time reflux. It is also advisable to sleep on your left side . Never sleep on the right side as this position promotes reflux. Medications to reduce acid production are the mainstay of the medical treatment. 
One always has to ensure that they are following the various lifestyle changes along with the medication. Other medications include pro kinetic medicines which help the stomach empty. Surgery always remains the last resort in the treatment of GERD. Endoscopy is required for the diagnosis or GERD Prior to any surgery a Manometry and 24 hr ph merry test is compulsory.
If you are suffering from GERD symptoms frequently, then you may maintain a diary for figuring out which foods are giving you trouble.

When is a surgery required?
If lifestyle changing tips and other medications fail to provide any relief, then physicians recommend undergoing surgery.

Surgery is done for strengthening lower esophageal sphincter and also for reinforcing it. The surgery for reinforcing lower esophageal sphincter is performed by surgeons laparoscopically. The surgeon inserts instruments like a tiny camera and flexible tube by making 3-4 incisions in the abdomen. This surgery for managing GERD may be quite effective.
Experts state that candidates who undergo GERD surgery are those who are unwilling to take GERD drugs or are not getting relief from them. While choosing a surgeon, it is better to consider one who possesses huge experience of the particular operation which you need and also with a good track record.
So, you must visit a doctor if you experience frequent gastroesophageal reflux disease symptoms. It won't be a good decision to take OTC medications without your doctor's recommendation if you notice arm or jaw pain along with difficulty in breathing as these are signs of heart attack.

Gastroesophageal Reflux Disease - How Best Can You Manage It?

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