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I was having Slip Disc problem in year 2005 and was confined on bed for 35 days. MRI reports revealed problem in L5 S 1 area. Doctors advised me not to sit on ground and sleep sideways by bending both the knees and keeping pillow in between them. Although I do not have that pain again but Now my body has become very stiff, I can not bend my knees and having very poor flexibility what should I do.
Hello Dr. Sir, I am Harvinder singh from yamunanagar, Haryana. I have lower back pain since last 2 years. Its slip disc and sciatica pain in left leg. I am very unhappy with this problem. Please advice me best of best treatment for the same and where I can get the same.
Herniated disks or bone spurs in the vertebrae of the neck may become the reason behind severe neck pain. They sometimes take too much space and compress the nerves branching out from the spinal cord.
I am 24yr old male and have backache for 7 month. My mri report is mild annular disc bulge is seen at l4-5 level with subtle anterior thecal sac impression. What should I do?
I am 39 years my weight is 95 kg, my height is 5.4, I have ligament tear in my right knee, I have slip disc in l4, l5, high bp. Etc, please suggest how to loose weight. Rapidly fast if any medicine that can help to reduce the weight.
STROKE- Popularly known as "Brain Attack". It occurs due to sudden impairment of blood supply to a part of brain leading to acute neurological insult.
Stroke is an emergency. Know the signs of a stroke and Remember FAST.
F- Face Drooping - Ask the person to smile. See for any deviation/asymmetry of mouth. If YES..
A - Arm Weakness Ask the person to raise both arms. Does one arm drift downward? If YES..
S- Speech Difficulty Ask the person to speak, look for any slurring of speech. If YES..
T- Time is money , Call Ambulance/Rush to the hospital.
Other signs/ symptoms -
Sudden onset of numbness or weakness of the leg / arm.
Sudden confusion/ trouble seeing in one or both eyes, trouble walking, Chakker, loss of balance, severe headache / Loss of speech.
Be Aware, This can be STROKE.
Act FAST, Save LIFE and disability. Up to 80% of strokes are preventable
Breast cancer begins when cells in the breast(s) start to grow out of control. It is understood as being the most common cancer, seen predominantly in females, globally. It is reasonably treatable and often curable.
1. Type: Adenocarcinomas constitute more than 95% of breast cancers with infiltrating ductal carcinoma (IDC) being the most common form of invasive breast cancer.
Frequently occurring breast cancers present as one of the following types mainly
1. Ductal Carcinoma In Situ (DCIS): Is the most common type of non-invasive breast cancer and is confined to the milk ducts of the breast. There is no invasion in the basement membrane. Pure DCIS metastasizes rarely. Non comedo cribrioform carcinoma is the most common DCIS found which, when compared to the comedo type, is mostly non-aggressive.
2. Infiltrating Ductal Carcinoma (IDC): Represents majority (about 3/4th) of the breast cancers, and is known to metastasize commonly to bones, lungs and liver.
3. Lobular Carcinoma In Situ (LCIS): Develops in multiple lobules of the breast (bilaterally). LCIS is less commonly seen, compared to DCIS.
4. Infiltrating Lobular Carcinoma (ILC): Represent about a tenth of all breast cancers and tends to metastasize to other regions of the body.
Less commonly occurring breast cancers such as
5. Inflammatory Breast Cancer: Is relatively uncommon and are caused probably owing to viral infections. The breast is warm, red and swollen.
6. Paget’s disease of the nipple: Is a rare form of breast cancer. It begins in the milk ducts and spreads to the nipple and areola.
7. Medullary Carcinoma
8. Mutinous Carcinoma
9. Tubular Carcinoma
10. Phylloides tumor etc all.
2. Gender: Affects the female populace predominantly. However, a small percentage of breast cancer is attributable to the male populace as well.
3. Etiology: No definite cause is known. However, diet, lifestyle, environment, hormonal/ reproductive factors, personal or family history of breast cancer especially in first degree relatives and also any benign breast disease history etc all are known to increase the risk of breast cancers. Specifically, excessive fatty diet, obesity, type 2 diabetes mellitus, benign breast disease, heredity/ inheritance of mutated breast cancer genes 1 (BRCA1) and 2 (BRCA2), smoking, alcohol intake, infertility, estrogen therapy/ hormone replacement therapy (long term) in post menopausal women, delayed age at first pregnancy, nulliparity (not having child), early menstruation, delayed onset of menopause, lactating mothers not breast feeding, exposure to ionizing radiation, sedentary lifestyle, depression, exposure to MMTV virus etc all can potentially increase the risk for breast cancer.
4. Features: Signs & symptoms, of breast cancer, manifest majorly in the following ways
Lump/ nodule in the breast that gets attached to the skin of the breast over time. The lump / nodule could be hard and painless with irregular edges or it could also be soft, rounded, tender and painful.
Enlarged lymph nodes in the axilla which are palpable.
Swelling of whole or a part of a breast. This is even if there is no distinct lump felt.
Retraction or thickening of the nipple(s).
Pain in the breast or nipple.
Discharge from nipple other than breast milk.
Irritation/ scaliness of skin over the breast.
Redness of nipples
Rarely, red, swollen and tender breast.
5. Screening: Is generally recommended for asymptomatic populations goal of which, as usual, is to be able to detect & diagnose breast cancer at an early stage which is potentially curable. It is mostly radiologic with mammography/ USG being instrumental in raising suspicions for further diagnostics (i.e. biopsy) that help detect breast cancer, if any, early.
6. Diagnosis: A self-examination/ clinical exam of the breast(s)/ axilla that reveals a palpable mass prompts the following diagnostics. Abnormal blood test results may be indicative of malignancy, but a follow up imaging/ biopsy is always the gold standard for accurate diagnosis.
- Blood: ER/ PR/ HER2/neu, uPA, PAI-1, CA15-3, CA27.29 etc all tumor markers are helpful.
- Imaging: Mammography/ USG Scan usually, as relevant. Again, CT Scan of abdomen & pelvis and chest, PET CT scan, bone scan etc all help detect metastasis, if any, for cancers in stage III & above.
- Biopsy: either excisional, incisional, fine needle aspiration (FNA) or core biopsy technique, as contextually appropriate, is frequently employed and a histopathological examination (HPE) thereof clinches the diagnosis and the nature of the disease.
7. Treatment: Conventional treatment includes surgery, radiotherapy, hormone therapy/ chemotherapy as deems appropriate. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as would be feasible contextually.
8. Prognosis: Preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage breast cancer are more. The cure/ recovery chances are influenced by the type, grade, stage of cancer, recurrence and the patient’s general health & vitality etc all. Above-mentioned apart, age, menopause status, lymph node status, ER/ PR/ HER-2/ neu status, size & extent of breast cancer etc all also influence the treatment outlook in breast cancer. The five year survival rate is strongly correlated with the stage of breast cancer.
9. Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an increased focus on protective factors and avoidance of the risk factors can be of help. An adherence to a Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising (for at least 30 minutes daily), de-stressing and relaxation is highly recommended for reducing the risks of breast cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. It is advisable to limit milk/ dairy, preferably of low fat content, to 1 to 2 servings max daily. Although alcohol is optional and is not for everyone, the consumption of the same, if any, has to be strictly in moderation, and is best avoided. Smoking is to be avoided as well. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly or are best avoided too. Limiting dosage/ duration of hormone therapy, if any, especially to counteract post menopausal symptoms and also avoiding exposure to radiation and environmental pollution can help reduce the risks of breast cancer. Apart from the above-mentioned, for high risk cases, a prophylactic oophorectomy, prophylactic radical mastectomy, long term hormone therapy etc all can help reduce the chances/ risks of developing breast cancer significantly. Breastfeeding is known to confer protection against breast cancer risk too.
She has a desk job and feeling pain in right leg the mri shows reduced space in intervertebral disc.
Breast cancer is an abnormal growth of cells in the tissues of the breast. Mainly it occurs in females but less than 1% of all the breast cancer cases develop in males. The majority of breast cancers start in the milk ducts. A small number start in the milk sacs or lobules. It can spread to the lymph nodes and to the other parts of the body such as bones, liver, lungs and to the brain.
With more reliable early detection methods as well as the trend towards less invasive surgery, there is hope that even more women with breast cancer will be treated successfully and will go on to resume their normal lives.
Signs & Symptoms
It is painless, especially, during the early stage. Watch out for the following changes in the breast:
- A persistent lump or thickening in the breast or in the axilla.
- A change in the size or shape of the breast.
- A change in the colour or appearance of the skin of the breast such as redness, puckering or dimpling.
- Bloody discharge from the nipple.
- A change in the nipple or areola such as scaliness, persistent rash or nipple retraction (nipple pulled into the breast).
Consult a doctor immediately if you notice any of these changes.
Being a woman puts you at risk of getting breast cancer. There are certain factors that increase the risk of breast cancer. Some of them have been listed below:
- The risk increases with age; most cases of breast cancer develop after the age of 50
- Genetic alterations in certain genes such as BRCA1 and BRCA2
- Family history of breast cancer
- Being overweight
- Early menarche (onset of menstruation before the age of 12)
- Late menopause (after the age of 55)
- Never had children
- Late childbearing
- No breast feeding
- Excessive consumption of alcohol
- Use of hormonal replacement therapy (HRT) for a long period of time
However, most women who have breast cancer have none of the above risk factors. Likewise, not having any of these risk factors does not mean that you will not get breast cancer.
Early Detection and Screening
More treatment options are available when breast cancer is diagnosed at an early stage and hence the chances of recovery is also higher. So regular breast screening is important for early detection even if there are no symptoms. Following are the ways of screening:
- Breast Self-Examination (BSE): Perform BSE once a month about a week after your menses are over. If you no longer menstruate, choose a date each month which is easy to remember e.g. your date of birth or anniversary.
- Clinical Breast Examination: Get a breast specialist to examine your breast once a year if you are 40 years and above.
- Mammogram: Go for a screening mammogram once a year if you are 40 to 49 years old and once every two years if you are 50 years and above even if you do not have any symptom. It is not recommended for younger women (less than 40 years of age) as they have dense breasts, making it difficult for small changes to be detected on a mammogram. So ultrasonography of the breasts is advisable to them.
Types of Breast cancer
- Non-Invasive Breast cancer: These are confined to the ducts within the breasts. They are known as Ductal carcinoma in-situ (DCIS).
- Invasive Breast cancer: It occurs when cancer cells spread beyond the ducts or lobules. Cancer cells first spread to the surrounding breast tissue and subsequently to the lymph nodes in the armpit (Axillary lymph nodes). These cells can also travel to the other parts of the body such as bones, liver, lungs or brain and hence known as metastatic breast cancer.
Making A Diagnosis
If you notice any unusual changes in your breasts, you should see a doctor immediately. He will examine you clinically and may ask you to undergo some tests so that a definitive diagnosis can be made. Further, the staging work up is done to find out the stage of the disease and management accordingly.
Treatment of breast cancer may include various methods such as surgery with or without breast reconstruction, chemotherapy, radiation therapy, hormonal therapy and targeted therapy. Treatment options offered, depend upon the number of factors such as the stage of cancer and likelihood of cure, your general health and your preference. If you wish to discuss about any specific problem, you can consult an oncologist.
My husband hs cirrhosis of liver stomach very distended+an ugly umbilical hernia+very dry skin+rash on legs +occasionally loose motions+disinterested in everything+lathargy+very weak+no energy+ frequent urination at nite with the result doesnt sleep well at nite. Medications urimax, lasilactone, lasix, heptapro. Are all these symptoms related to the cirrhosis. Latest sonography report shows right lobe of liver is contracted n left lobe is enlarged with coarse bright echogencity with nodular surface. Intraheatic biliary radicles normal. Cbd normal. Portal vein is patent. Gallbladder is distended with no calculi or polyps spleen is borderline enlarged. Free fluid is noted approximately 200cc impression cirrhosis of liver borderline splenomeagly. Cortical calcific speck in both kidney s free fluid 200cc can you tell how serious is this condition his sodium is low 126.
I am 29 years old. I am from bangladesh. I have a problem with my backbone. I have slipped disc. I have been suffering from this since 2011. I consulted with some local doctors. They prescribed me with some exercise but no improvement till now. I feel that a bone or two is/are displaced somewhere my waist. I need expert suggestion.
My age is 28 and I am suffering from back pain due to L3, L4, L5 Disc bulging. Kindly suggest me a solution to over come from back pain without surgery.
The thought of going under the knife to treat your spine problem may give rise to a range of emotions; make you ponder over a number of things such as the recovery period, procedure and techniques involved and so on. Nonetheless, before opting for the surgery, there are certain points that you should go over and these are:
- Be well aware of the cause of your pain - Identifying the cause that is behind your pain is vital in order to decide whether the surgery is going to prove beneficial in the long run or not. If the cause is not identified as the right one, the surgery may prove futile and you may not get the pain relief that you're looking for.
- Gather detailed information about your spine surgeon - Before visiting the spine surgeon, you should collect detailed information about the specialist so as to be able to come up with appropriate questions concerning the surgery. From questions concerning about the surgeon's success and complication rates, numbers of surgeries performed to qualifications of the surgeon, these and much more should be part of your evaluation process.
- Prepare yourself before a consultation - It's good to prepare yourself before a medical consultation. Whether it's researching about the surgery and your condition or being well aware of your family's medical history, or details about the pain that you experience, or your expectations from the surgery, every aspect should be covered so that you derive the maximum benefit from your meeting.
- Carry out your own research - Carrying out your own research on the alternatives before opting for the surgery can put you on a better footing. It's imperative to compare the opinion put forward by the surgeon from genuine sources so that you're better able to understand the merits and demerits of the treatment. If you wish to discuss about any specific problem, you can consult an Orthopedist.
Cancer is the abnormal, uncontrolled growth of cells in a particular body part. With continued growth, pieces of this tissue travel through the blood to different body parts and continue to grow in the new area. This is known as metastases. Breast cancer is one of the most common forms of cancer and affects about 1 in 8 women in the USA. Read on to know more details of breast cancer – breast anatomy, causes, symptoms, risk factors, detection, prevention, and of course treatment.
Anatomy: The main function of the breast is lactation through its milk-producing tissue that are connected to the nipple by narrow ducts. In addition, there is surrounding connective tissue, fibrous material, fat, nerves, blood vessels and lymphatic channels which complete the structure. This is essential to know as most breast cancers develop as small calcifications (hardened particles) in the ducts or as small lumps in the breast tissue which then continues to grow into cancer. The spread can happen through lymphatic or blood flow to other organs.
Warning signs/symptoms: The following are some symptoms that need to be watched out for if you have a predisposition to breast cancer.
- A lump in either of the breasts or armpits
- Change in size, shape, or contour of either breast
- Redness of your breast or nipple
- Discharge of clear or bloody fluid
- Thickening of breast tissue or skin that lasts through a period
- Altered look or feel of the skin on the breast or the nipple (dimpled, inflamed, scaly, or puckered)
- One area on the breast that looks very different from the other areas
- Hardened area under the breast skin
Either one or a combination of these should be an indication to get a detailed checkup done. Early diagnosis results in controlling the disease with minimal treatment and reduced complications.
Causes and risk factors: The exact cause for breast cancer is yet to be pinned down. However, risk factors are clearly identified, and women with risk factors need to watch out for warning signs.
- Family history: Of all the risk factors, the family history is the most important. Breast cancer runs in families, and if there is a first-degree relative with the breast cancer, the chances of developing it are almost double. Two genes BRCA1 and BRCA2 are the carriers of the disease, and this testing can be done in women to identify if they are at risk.
- Family history of other cancers: Even if there is no breast cancer, if there are other cancers that run in the family, watch out.
- Age: Women over 50 are at higher risk of developing breast cancer.
- Race: Caucasian and Jewish women are at higher risk of breast cancer than African-American women.
- Hormones: Greater exposure to the female hormone estrogen increases the chances of developing breast cancer. Women who use birth control pills for contraception and hormone replacement after menopause are at a higher risk of developing breast cancer.
- Gynecologic milestones: Women who have abnormal menstrual milestones need to watch out. These include those who attain menarche before 12 years of age, get pregnant after 30, attain menopause after 55, and have menstrual cycles shorter than 26 days or longer than 29 days.
- Obesity and alcohol abuse are also likely to increase a woman’s chances of developing breast cancer.
Stages: Starting from stage 0, higher stages indicate advanced disease.
- Stage 0: The growth which has begun in the milk-producing tissue or the ducts has remained there (in situ) and not spread to any other area, including the rest of the breast.
- Stage I: The tissue slowly becomes invasive and has begun to affect the surrounding healthy tissue. It could have spread to the fatty breast tissue and some breast tissue may be found in the nearby lymph nodes.
- Stage II: The cancer at this stage grows considerably or spreads to other parts. There are chances that cancer may grow and also spread.
- Stage III: It may have spread to the bones or other organs but small amounts are present in up to 9 to 10 of the lymph nodes in the armpits and collar bones which makes it is difficult to fight.
- Stage IV: The cancer is widespread to far-flung areas like the liver, lungs, bones, and even the brain.
Screening: This is one of the most effective ways to identify the disease in its early stages. This will help in controlling cancer from spreading with minimal treatment.
- Self-examination: A thorough self-examination to look for changes in terms of shape, size, colour, contour, and firmness should be learned by all women. Watch for any discharge, sores, rashes, or swelling in the breasts, surrounding skin, and nipple. Examine them while standing and when lying down.
- In most women, annual screening mammograms are advised after the age of 40. However, in women who have a strong family history or genetic makeup, it is advisable to have screening mammograms starting at age 20 every 3 years and then annually from the age of 40.
- Women in high-risk categories should have screening mammograms every year and typically start at an earlier age.
- Ultrasound screening can also be given in addition to mammograms.
- Breast MRI is another way to screen for breast cancer if the risk is greater.
Breast Cancer Prevention: Now that there is so much awareness about causes and risk factors, there are definitely ways to prevent or delay the onset of the disease.
- Exercise and a healthy diet with reduced amount of alcohol are definitely effective in minimising the chances of developing cancer.
- Tamoxifen is used in women who are at high risk for breast cancer.
- Evista (raloxifene) which is used to treat osteoporosis after menopause. It is also widely used in preventing breast cancer.
- In high-risk women, breasts are surgically removed to prevent the development of cancer (preventive mastectomy).
Treatment: As with all cancers, treatment would depend on the stage at which it is identified and include a combination of chemotherapy, radiation, and surgery. As noted earlier, if you are at risk, look out for warning signs as early diagnosis is the key to maximum recovery.
What should I be doing to releave the pain for two herniated disc's one above and one below a fusion surgery of the cervical spine.
Lung cancer occurs at slightly younger age in women than in men. Adenocarcinoma is the commonest type of lung cancer in women. It warrants testing for some molecular markers which form the basis of targeted therapies. Thus lung cancer in women behaves biologically and clinically different from that in men
Women should take care of their health, stay away from tobacco and think positive