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What is ECMO?
Like dialysis for unfunctional kidney, Ecmo for unfunctional lung.
Ecmo stands for extracorporeal membrane oxygenation. It is a method of giving oxygen for the body when icu pateint lungs and/or heart are not able to supply oxygen on their own.
Why ICU pateint put on ECMO?
Doctors place ICU patients on ECMO when patients are not able to supply oxygen to the body.
ICU patients’ lungs fail for a number of reasons including pneumonia, lung cancer, pulmonary edema, pulmonary embolism and COPD.
When a patient’s lungs fail, he/she first is intubated (breathing tube) and hooked up to a ventilator (breathing machine).
However, sometimes lungs are so damaged that providing oxygen through intubation is not enough.
This is when doctors turn to v-v ecmo.
A heart can fail for many reasons including heart attack, pulmonary embolism, bad valve disease, or worsening heart failure. When a heart fails, doctors try to fix the underlying problem. They may also start medications (called ionotropes) to help improve the pump function of the heart. If medications are not enough, doctors will turn to v-a ecmo.
How long can someone stay on ecmo?
That is a complicated question. Due to the risks of ecmo discussed above, doctors try to keep patients on ecmo for as short a time as possible. Often patient will be on ecmo for several days up to 1-2 weeks. Every day, several blood and imaging tests are done to determine if a patient is ready to come off ecmo. As the technology of ecmo improves, hopefully side effects will decrease and patients can remain on ecmo for longer periods of time.
What is the difference between ecmo and a ventilator (breathing machine)?
Both ecmo and a ventilator aim to provide oxygen to the body when the patient’s own lungs and breathing are failing. The ventilator assists the patient’s own lungs by pushing oxygen with pressure into the lungs. Ecmo instead provides oxygen directly via a catheter placed in a patient’s vein or artery. We almost always try oxygenating a patient with a ventilator first. However, when a patient’s lungs are too sick for this, we turn to ecmo to assist in providing oxygen to the body. V-v ecmo provides oxygen through a vein. This blood then has to travel to the heart and be pumped around the rest of the body through arteries. Therefore, with v-v ecmo or with a ventilator, a patient must have a well-functioning heart to get the oxygen pumped throughout the body. V-a ecmo has the additional advantage of pumping blood directly to arteries. This “by-passes” the heart and is therefore the method of ecmo we use when a patient’s heart is failing.
Becoming a mum can lay down a whole lot of stress on you. But now you know that your brain is going to help you with all the adjustment s! ah ah a relief you get when your baby gives you a hug by kissing your cheecks the joy you get is amazing and gratitude to the almighty creater
It is perfectly normal for women to experience the periodic monthly bleeding cycle. However, if a woman experiences uterine bleeding which is abnormal and dysfunctional, it could be a symptom of infection. Other causes of abnormal uterine bleeding include hormonal imbalance, infection in cervix and cancer of the uterus. Many women can also experience abnormal uterine bleeding during first trimester of pregnancy.
The following are considered to be abnormal or dysfunctional uterine bleeding:
- A menstrual cycles occurs between 21 to 35 days, anything shorter or longer than this is abnormal
- No period for 3–6 months (amenorrhea) is abnormal
- Spotting or bleeding between periods
- Spotting or bleeding after intercourse
- Bleeding that is heavier or lasts longer than usual
- Spotting or bleeding after menopause
What can cause such a situation?
Some of the common causes leading to abnormal bleeding are as follows:
- Ectopic pregnancy
- Cervical or uterine infections
- Hormonal imbalances
- Problems with blood clotting
- Polycystic ovaries
- Endometrial hyperplasia
- Cancer of the reproductive tract
How to Diagnose it?
Most women tend to ignore abnormal bleeding, taking it as something to do with age or hormones. A detailed physical examination and history is done to understand menstrual cycle patterns and family history. In addition, the following would be used.
- Ultrasound: The pelvic organs are examined through sound waves to locate the problem area
- Hysteroscopy: Through a thin device that is inserted into the vagina, the doctor takes a look at the inside of the organs and identify the cause for the bleeding
- Endometrial biopsy: The uterine lining tissue is removed and examined under microscope to look for tissue changes that could be causing the bleeding
How Best to Treat It?
This would depend on the reason for the abnormal bleeding. However, in most cases, combinations of the following are useful in treatment.
- Hormone replacement can be done depending on the age and gynecological history, the type and the dose of the hormone would be decided upon. These could be in the form of tablets, vaginal creams, injections, or through an intrauterine device
- Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are useful in reducing bleeding and controlling cramps during excessive menstrual bleeding.
- Antibiotics may be useful if there is infection of the pelvic organs.
- Polyps, cysts, cancers, and other growths can be removed via hysteroscopy and sent for biopsy to confirm they are not cancerous.
- Endometrial ablation where the endometrial tissue is treated with heat can be used to control bleeding permanently.
- Hysterectomy would be done if other forms of treatment have failed. This could depend on their gynecologic history and other considerations as she cannot get pregnant after this.
Do not ignore if you see a change in the pattern of your uterine bleeding. It definitely calls for medical attention and if identified early, can be managed in much simpler ways.
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.
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?
Hello, I have very much pain in L5 S1 spine from last 2 months. MRI report says: "Annular tear of l5-s1 disc with diffuse posterior bulge, central & right para central prolapse & mild inferior migration of the prolapsed fragment causing compression of right exiting nerve root. Please suggest me what I do? Pain is very much. Should I go for surgery or any other option available. If surgery then how much time time required to recover & what is accuracy of surgery treatment. Thank you.
Age 51 years male. Slip disc happened jan'2010 and get to normal after 4 years doing only exercise till now and used lumbo scrarol belt when out of home. Due to filling uneasy during walking, a tmt brace protocol suggested. Is it ok to do the test.
I am having problem in my spinal cord disc L4 -L5. With some loss of fluid. Now my knee joint also getting pain. What you wil suggest.
Sir I am FROM CHENNAI having back pain when mri scanned impression as follows Early lumbar spondylosis. Mild disc bulge with focal posterocentral and bilateral postrtolateraldisc at l3_ 4 disc level causing thecal sac ibdentation and bilatrral mild beural foranimal narrowings (L>R) MILD ligamentum flavum hypertrophy at L3_4 & L4_5 disc level causing mild posterior thecal sac indention Disc desiccation in L4_5 & L5_ S1 DISC LEVEL AS LOSS OF HYPERINTENSE SIGNAL ON T2W1 PLEASE HELP I REPLY ME POSITIVELY
As per my MRI report for lumber spine, disc protrusion seen at L5-S1 indenting anterior thecal sac and narrowing left neural recess. Disc hydration is Los at L5-S1. I have severe lower back pain for last one month. What is the ideal plan for treatment?
I have back pain before 3 years. I have checked MRI test in hospital that result show the mild disc dics bulge noted at L4 and L5 level intending the thecal sac without neurological compression. Doctor has given pain relief tablets but no get relaxation. Please give me solution.
Umbilical hernia diet
An umbilical or belly button hernia occurs when a part of the intestines or the abdominal lining protrudes through an opening in the abdominal muscles. The protruding intestines may get squeezed or strangulated resulting in the blood supply getting cut off. Surgery may be required in serious cases of umbilical hernia. Doctors often suggest a special diet for umbilical hernia patients as this helps to prevent further complications.
Foods to avoid
Certain foods are not recommended for people with an umbilical hernia and should be avoided.
White refined flour foods made from white refined flour have a low fiber content. Eating these foods may cause constipation and should therefore be avoided. This is because constipation causes straining of the abdominal muscles during bowel movements and may cause further protrusion of the intestines through the abdominal muscles in the region of the belly button.
Low fiber fruits and vegetables the low fiber content in these foods can also lead to constipation. Examples of fruits and vegetables with low fiber content include skinless raw fruits, cooked fruits, and canned or cooked vegetables without seeds, hulls or skin.
Fatty foods foods with a high fat content should be avoided. This is because obesity results in greater pressure on the abdominal muscles and can increase the risk of umbilical hernia. Examples of foods with a high fat content include fatty meat such as pork, whole milk, butter, cream, margarine and fried foods.
Sugar limit your calorie intake by cutting down on foods such as pastries, cakes, chocolates and soda pop. Limiting your sugar intake will also help you to lose some weight, taking pressure off your abdominal region.
Foods to include
A special diet is required after umbilical hernia surgery. This will help you to minimize your convalescence time. The special dietary requirements include:
Fruits fresh fruits that have high fiber content and are rich in antioxidants should form a part of every meal. The high fiber content will ensure that you do not get constipated and the antioxidants will help protect your body and boost your immune system. Try to eat different types of fruits so as to get adequate amounts of different vitamins. Citrus fruits, berries, and apples are some examples of fruits with a high fiber and vitamin content.
Vegetables these too have a high fiber content that will guard against the dangers of constipation after an umbilical hernia surgery. They also have high levels of vitamins and minerals and should also be included with every meal.
Lean meat meat is a source of protein, which is essential to the repair of damaged tissue. Lean meat like poultry and fish is an excellent source of low fat protein. Have one good source of low fat protein with every meal.
Low fat dairy products these are a good source of protein and can be alternated with lean meats to provide your body with sufficient protein.
High fiber breakfast foods will aid digestion and so your breakfast should consist of foods made from whole wheat flour, wheat germ, oatmeal, or bran.
I am 33 years old, I have backache from last 1 year, x ray indicate there is borderline slip disk, what kind of precaution can I take for future?
I am 26 years old boy, I am suffering fron hip disorder problem, Avn. How to get rid out of this, I do not have money for operation,
Are you experiencing excessive uterine bleeding? Excessive uterine bleeding may occur between a woman’s periods or before the periods, after having sex, or due to the development of spotting or bleeding after attaining menopause. Any menstrual cycle, which lasts longer than 21–35 days is called excessive, and this is an abnormal form of uterine bleeding.
Causes of Excessive Uterine Bleeding:
The various causes of excessive uterine bleeding are as follows:
One of the main causes is hormonal imbalance, as the balance between estrogen and progesterone gets disrupted. This balance is required for the regulation and development of the lining of endometrium or uterus lining. Because of the hormonal imbalance, the endometrium develops excessively causing heavy bleeding.
Uterine fibroids, which are non cancerous tumours, may lead to prolonged and excessive uterine bleeding.
Polyps are small benign developments on the uterus lining which cause heavy bleeding. They occur because of high levels of hormones.
Adenomyosis is a condition which develops when the endometrium glands get embedded in the uterine muscle, leading to excessive uterine bleeding.
Using intrauterine devices or IUDs may cause side effects as well.
Several uterine cancers, ovarian cancers and cervical conditions may be responsible as well. Inherited bleeding disorders such as von Willebrand’s disease is another likely cause.
Several medicines and drugs, including NSAIDs and anticoagulants are a common cause.
There are different ways of treating excessive uterine bleeding, depending upon the cause of bleeding and the patient’s age.
Medications: Several medicines are used for the treatment of abnormal uterine bleeding. Hormonal medicines and birth control pills are used to improve the regularity of periods. Non steroidal anti-inflammatory drugs are also used to manage excessive uterine bleeding. Several antibiotics are also used.
Surgery: In many cases, a woman has to undergo a surgery for the removal of polyps and fibroids, which cause excessive bleeding. Certain fibroids are removed via hysteroscopy and other techniques for treatment are used as well. Endometrial ablation can be carried out to manage the bleeding. This treatment aims at permanent reduction of the excess bleeding. Hysterectomy has to be carried out when other treatments are unsuccessful. This is a serious surgery and after it, a woman will no longer have periods, and she will not be able to conceive a child.
In case of excessive uterine bleeding, you must consult a doctor as soon as possible. This will enable early treatment and prevent the development of further complications.