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?

Causes and symptoms of knee pain

Knee pain is characterized by a feeling of pain in the knee joint caused by injury or overuse. The knee joint consists of small bone structures, the kneecap, supporting ligaments and cartilage of the knee. This joint bears the full weight of the body, which makes it very vulnerable to injury.

Causes of knee pain

Knee pain is usually caused by injuries to the knee such as exposure to a direct force on the knee, abnormal twisting of the knee or falling on your knees. Some causes of knee pain are -

Knee strains and sprains - Overworking the knee joints can damage the tissues of the knee joint resulting in knee sprains and strains

Osteoarthritis - it is condition where the protective cartilage around the kneecap is damaged, resulting in knee pain

Bursitis - Excessive movement of the knee or kneeling down for extended periods can irritate the bursa (a fluid sac below the skin above the knee joint) that causes swelling and pain, thereby giving rise to this condition

Gout - This condition is characterized by the accumulation of uric acid in crystal form around the knee joint, causing inflammation and pain

Tendon disorders - Tendons connect the muscles to the bones, and overworking the knee can cause the tendons around the knee to become sore and painful

Kneecap dislocation - Injuries may cause the kneecap to shift out of its position, this causes swelling and pain in the knee joint

Symptoms of knee pain

Severe knee pain can restrict movements such as walking or standing. The symptoms vary according to the extent of the damage suffered by the knee. Most common symptoms of knee pain are problems in climbing stairs, inability to extend the knees, limping and swelling of the knee joint. In some cases, knee pain may also cause fever.

Causes and Symptoms of Knee Pain

About a 45 percent of adults snore occasionally, and although most people tend to ignore it, snoring is a problem that must be dealt with consideration. There are many families where one spouse snores and keeps the other person from a good night s sleep. It has been reported that snoring can create severe disputes in marriage and one who snores must take steps to control snoring.

Snoring is not simply a nuisance, but a major proportion of individuals who snore are affected with obstructive sleep apnea by which breathing is disrupted while a person is fast asleep. This condition increases the risk of heart diseases. Fortunately, there are ways to control a person's snoring.

Weight loss: Having a large neck circumference and being overweight increases the risk of pushing the fat down at the throat resulting in snoring. With a suitable weight loss training, one can control the snoring to a considerable extent.
Altering sleep positions: Sleeping on the sides help in forbidding the tongue from resting backwards and blocking the throat while sleeping. Some specially created pillows can help the individuals from rolling back during sleep.
Limit alcohol intake: Drinking alcohol contributes to further relaxation of muscles in the airways and collapse the path which makes snoring even worse. Limiting consumption of alcohol and avoiding to drink it at least 4 to 5 hours before going to bed can reduce snoring to a significant extent.
Stop smoking: Smoking invariably leads to nasal congestion as well as inflammation which in turn worsen snoring. If one is running out of reasons to avoid smoking, then this is one of the most convincing reasons to quit smoking and enjoy overall good health.
Certain medications: There are some medicines, particularly sedatives and antihistamines are designed to have a relaxing effect and can, therefore, aggravate snoring. But it is advised to consult with the general physician before making any alterations in the medicine routine.
Avoid opening the mouth: Those who are aware of snoring with the mouth open must avoid opening the mouth during sleep by using a specifically designed tape or adhesive for closing shut the mouth while sleeping.
Using specialised device: The mandibular advancement device is specifically crafted for those who suffer from tongue-based snoring. This equipment helps in moving the jaw forward as well as prevent the tongue from blocking the backside of the throat while sleeping.
Avoid nasal collapse: Those who suffer from nasal collapse must use some form of adhesive nasal dilator strip which has to be placed over the nose. This would aid in keeping the airways open as well as reduce snoring.
Treat allergies: Inflammation, as well as nasal congestion triggered by allergies, is a common cause of snoring while sleeping. One must opt to do an allergy test to identify and reduce potential allergens in the area where the individual sleeps such as bedding type, pet hair, dust mites, wheat or dairy intolerance and lessen snoring.
Thus, snoring can be controlled before it becomes a problem.

Snoring - 9 Ways You Can Prevent It!

Our kidneys act as filters which constantly flushes out toxins and excess minerals with water in form of urine. Urine contains lots of minerals which may precipitate and form stones. Urine has lots of pro-precipitating agents and anti-precipitating agents. When their balance disturbs due to some disease, stones start forming. These stones may often lead to abdominal pain which is referred to as renal colic. 

What exactly is renal colic? 

Renal or ureteric colic is the term used for typical pain in one side of abdomen in flank region starting from back and radiating forward towards lower abdomen up to scrotum. This is usually associated with nausea, vomiting and urinary discomfort. There may be blood in urine. 

How kidney stones are related to renal colic? 

Kidney stones usually form inside kidney and lies there without causing any pain. But whenever they are dislodged and stuck at mouth of kidney (pelvis) or anywhere in ureter, they block the passage of urine of that kidney. This causes swelling in kidney termed as hydronephrosis. This swelling in kidney causes renal / ureteric colic. This colic is protective phenomenon and tries to push out the stones. Small stones do come out in urine by this natural process. This spontaneous expulsion of small stones is common and many local practitioners used to get credit of it feigning benefit of their medicine. However large stones need some form of intervention to come out. Otherwise, they do harm to kidneys in long term. 

Symptoms of kidney stones along with renal /ureteric colic - 

Most stones which are lying in calyces of kidney are asymptomatic 
Nausea & vomiting 
Frequent urinary tract infections 
Fever with chills 
Foul smelling urine 
Hesitency, frequency and burning in urination 
Blood in urine (urine with a reddish, pink or brownish hue) 
Passage of small stones in urine 
Treatment of renal colic 

Treatment of ureteric/renal stones involves control of symptoms and stone removal. 

Expectant Treatment or Medical Expulsion Therapy: Small stones of less than 4 mm size usually pass on its own and some medicines like alpha-blockers and steroid hasten up their expulsion. Medium size stone (4-6 mm), sometimes passes with aid of these medications. But stones larger than 6 mm usually require intervention. 
Lithotripsy: This method involves breaking of stones by shock waves into small dusty particles which pass through urine on its own. This is usually suitable for stones upto 1.5 cm and lying in kidneys. This is non-operative treatment which can be done on OPD or Daycare basis. 
Ureteroscopy (URS): This method involves entry of very thin semirigid scope through urethra into ureter. Stone is broken by LASER and removed. This involves single day admission and spinal anaesthesia. 
RIRS- Retrograde Intra Renal Surgery: In this method very thin flexible scope in maneuvered through urethra into the upper ureter and pelvi-calyceal system of kidney. Stones in kidney or upper ureter are broken by LASER and removed. This is also done under anaesthesia and requires a day admission. 
Mini- PCNL: This method is suitable for large renal stones. In this technique, a small hole is made into the kidney through back and tiny scope is entered into the kidney. Stones are broken by LASER and removed. This is done under anaesthesia and require two to three days admission.

Renal Colic - Ways it Can Be Treated?

What Causes Meniere s Disease?
Meniere's Disease is a disorder that basically affects the sense of balance and hearing of the patient. This condition takes place in the inner ear and it may cause problems like vertigo, where patients experience a spinning sensation and a ringing sound as well. This is a chronic disorder, which requires a number of lifestyle changes so that it can be managed and treated without becoming a debilitating problem.

Read on to know more about the symptoms and causes of the condition.

Symptoms: The various signs and symptoms of this disease include a feeling of fullness in the ear, which has been affected by the condition. Also, most patients have a spinning sensation and a ringing sound in the affected ear. Nausea and vomiting may also be caused by this condition, along with sweating and loss of balance. It is also normal to feel uncoordinated when you are suffering from this condition.

Secondary Symptoms: This condition may also cause many other complications, which are known as secondary symptoms. These include anxiety, depression and stress. This usually happens due to the problems in the ear and even the problem of vertigo. This may cause problems for people who climb heights or ladders for their work or even for other recreational causes. The constant sense of dizziness and spinning may cause a person to become anxious and undertake stress when it comes to carrying out various kinds of functions in day to day living.

Causes:  There are various causes of this condition, even though many medical reports suggest that the exact cause has not really been understood so far. As any doctor will tell you, the in the inner ear there is a labyrinth which contains fluids. When there is a problem with the composition and level of these fluids, the patient may develop Meniere s Disease. This condition specifically affects the inner part of the ear. This part is made up of passages and a cavity as well as soft membrane like structures with hair like sensors. These sensors respond to the fluid s movement within the ear. When this fluid does not have the appropriate levels, it can lead to many complications like Meniere s Disease, which affect the nerve impulse that these sensors catch and transmit to the brain.
Stages: This disease progresses over a set of three stages. In the very first stage, the patient will experience much dizziness and nausea, before that progresses to the second stage. In this stage, the patient will have moderate to severe vertigo. This is also known as the middle stage. Finally, this may culminate into the third or late stage, which leads to more frequent episodes of vertigo. The hearing of the patient and the ringing sound in the ears will also get worse in this stage.

Meniere s Disease -  What are the Reasons Behind It 

Paranoid personality disorder (ppd) is a mental disorder which makes you feel fearful, nervous and suspicious about people or situations around. This disease usually starts to show its signs from early adulthood and is more common in men than women. People suffering from this disorder are unable to maintain close and long lasting relationships with people as they have the habit of blaming and not trusting other people. The most common symptoms of this disorder are:


	Doubting the loyalty of others
	Fear of revealing their own personal information
	A tendency of holding long lasting grudges
	Inability to handle criticisms
	Abrupt instances of anger and instant reaction
	Showing traits of coldness in a relationship
	Having a feeling of always being right
	Having problems in relaxing
	Being stubborn, argumentative and hostile



	Causes: the exact cause behind pdd is still unknown, but according to some medical researchers it happens due to a combination of biological and psychological conditions. Additionally, bad emotional experiences during childhood and having gone through a physical or mental trauma also leads to the development of the disease.
	Diagnosis:&nbsp;this condition cannot be diagnosed at home and is usually diagnosed by a specialist. The first step taken by a doctor in order to diagnose the disorder is an examination of the medical and psychiatric history of the person. Additionally, if the health records of a person do not indicate anything, then the doctors usually go for some expert opinions by a psychiatrist.
	Treatment:&nbsp;most of the people suffering from this disease are not even aware about it, until someone brings it to their notice. Doctors usually believe that psychotherapy, which is a form of counseling, is the best way to treat pdd.



All About Paranoid Personality Disorder

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