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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.
I have diagnosed with infiltrating ductal carcinoma, NOS, in right breast (in biopsy report, triple negative (ER-negative, PR-NEGATIVE, HER 2-NEGATIVE). The tumor measures 4 cm* 3 cm mammographically. After giving 3 no. Of chemo My doctor suggest me for modified radical mastectomy. Please tell me if I go for complete breast removal & subsequent chemotherapy Radiotherapy is must or optional?
The human brain is the most complex and least understood part of the human anatomy. There may be a lot we don’t know, but here are a few interesting facts that we’ve got covered.
Nerve impulses to and from the brain travel as fast as 170 miles per hour. Ever wonder how you can react so fast to things around you or why that stubbed toe hurts right away? it’s due to the super-speedy movement of nerve impulses from your brain to the rest of your body and vice versa, bringing reactions at the speed of a high powered luxury sports car.
The brain operates on the same amount of power as 10-watt light bulb. The cartoon image of a light bulb over your head when a great thought occurs isn’t too far off the mark. Your brain generates as much energy as a small light bulb even when you’re sleeping.
The human brain cell can hold 5 times as much information as the encyclopedia britannica. Or any other encyclopedia for that matter. Scientists have yet to settle on a definitive amount, but the storage capacity of the brain in electronic terms is thought to be between 3 or even 1, 000 terabytes. The national archives of britain, containing over 900 years of history, only takes up 70 terabytes, making your brain’s memory power pretty darn impressive.
Your brain uses 20% of the oxygen that enters your bloodstream. The brain only makes up about 2% of our body mass, yet consumes more oxygen than any other organ in the body, making it extremely susceptible to damage related to oxygen deprivation. So breathe deep to keep your brain happy and swimming in oxygenated cells.
The brain is much more active at night than during the day. Logically, you would think that all the moving around, complicated calculations and tasks and general interaction we do on a daily basis during our working hours would take a lot more brain power than, say, lying in bed. Turns out, the opposite is true. When you turn off your brain turns on. Scientists don’t yet know why this is but you can thank the hard work of your brain while you sleep for all those pleasant dreams.
Scientists say the higher your i. q. The more you dream. While this may be true, don’t take it as a sign you’re mentally lacking if you can’t recall your dreams. Most of us don’t remember many of our dreams and the average length of most dreams is only 2-3 seconds–barely long enough to register.
Neurons continue to grow throughout human life. For years scientists and doctors thought that brain and neural tissue couldn’t grow or regenerate. While it doesn’t act in the same manner as tissues in many other parts of the body, neurons can and do grow throughout your life, adding a whole new dimension to the study of the brain and the illnesses that affect it.
Information travels at different speeds within different types of neurons. Not all neurons are the same. There are a few different types within the body and transmission along these different kinds can be as slow as 0.5 meters/sec or as fast as 120 meters/sec.
The brain itself cannot feel pain. While the brain might be the pain center when you cut your finger or burn yourself, the brain itself does not have pain receptors and cannot feel pain. That doesn’t mean your head can’t hurt. The brain is surrounded by loads of tissues, nerves and blood vessels that are plenty receptive to pain and can give you a pounding headache.
80% of the brain is water. Your brain isn’t the firm, gray mass you’ve seen on tv. Living brain tissue is a squishy, pink and jelly-like organ thanks to the loads of blood and high water content of the tissue. So the next time you’re feeling dehydrated get a drink to keep your brain hydrated.
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.
Uterine fibroids, also referred to as uterine myomas) are non-cancerous tumors that grow within the muscle tissue of the uterus. As many as 20% to 50% women between the age group of 18 to 40 suffer from the condition, but not all cases warrant treatment.
It may be as tiny as a coin or it may grow to the size of a watermelon, making people think the lady is 6/7 months pregnant! There may be one big fibroid or several small ones.
Though the exact causes are not known, family history and hormonal imbalances are said to be the main causes for the same.
Types of Uterine Fibroids
The four types are:
- Subserosal uterine fibroids: Develops outside the uterus and continues to grow.
- Intramural uterine fibroids: The most common type that lead to pregnancy like tummy. They develop within the uterus wall and continue to expand.
- Submucosal uterine fibroids: Because these develop within the uterus lining, they are most likely to be the cause of heavy flow during periods.
- Pedunculated uterine fibroids: These grow on the inner or outer side of a small stalk connecting to the uterus.
- An enlarged uterus is the most common symptom. It is often mistaken for general weight gain or pregnancy.
- Prolonged and painful menstrual cycle, that is many times irregular.
- Urinary incontinence and constant urge to urinate.
- Pelvic pressure.
- Pressure on the bowels leading to constipation.
- Pain during intercourse.
If you find out that you have fibroids during an examination or if you consult a doctor with any of these symptoms, they will most likely ask for an ultrasound or Magnetic Resonance Imaging (MRI) which will confirm the type of fibroid and the extent of your problem. Treatment includes non-invasive-focused ultrasound surgery.
Treatment with Homeopathy:
One of the best advantages of choosing Homeopathy is that it works without side effects. It addresses the issue rather than the symptom. A surgical procedure mentioned in general treatment does remove the fibroids but there is no guarantee that they won't grow back as the underlying issue of hormonal imbalance remains.
During a clinical study of the effects of Homeopathy on fibroids, 85% patients showed improvement and 48% people had complete fibroid removal.
Treatment: There are medicines in Homeopathy that can treat uterine fibroids, cervical fibroids and help maintain normal hormonal balance in females.
Patra panda sweda(ela kizhi) is a specialized therapy which is performed for the diseases related to Bones, muscles and nerves. Patra means leaves of medicinal plants. Pinda means a bolus. Sweda means Fomentation or sudation. The swedana karma or sudation therapy which is given by using a bolus which is prepared by the different combination of medicinal leaves which is processed with medicinal oil along with the medicinal herbs is called as patra panda sweda or ela kizhi. This procedure is unique, which comprises both snehana (oleation) and swedana (sudation) (snehayukta swedana)
Benefits of Patra Pinda Sweda:
It strengthens and rejuvenates the bones, muscles and nerves
Strengthens the tissues
Increases the circulation
Provides color and complexion of the skin
Helps to Reduce pain, inflammation and stiffness of the muscles
Induces good sleep and reduces the stress.
Sprains and cramps
Breast cancer is a form of cancer which develops from the breast tissue. Breast cancer is indicated by signs such as a lump in the breast, changes in breast shape, fluid flowing from the nipple, dimpling of skin, or the development of red scaly patches. Breast cancer is a fatal form of cancer in women and immediate diagnosis is required on observing the symptoms.
Diagnosis of breast cancer
Other than the regular breast screening, the diagnosis of breast cancer involves the following steps and methods:
- Seeing your general practitioner (GP): It is very important to visit your GP soon after noticing the symptoms of breast cancer. Your GP will examine you properly and in case your symptoms need more assessment, he/she will refer you to a breast cancer clinic.
- Mammogram and breast ultrasound: You will be required to have a mammogram, as recommended by a specialist breast unit. This is an X-ray of the breasts. An ultrasound scan may also be required. Breast ultrasound should be undertaken only if you are less than 35 years of age. This is because, young women have denser breasts and a mammogram is not as effective as ultrasound in the diagnosis of breast cancer. In ultrasound, high frequency sound waves are used for obtaining an image of your breasts. It is observed to notice any abnormality or lumps. A breast ultrasound is also important for determining whether a lump is solid or contains liquid.
- Biopsy: In this diagnosis process, a sample of the tissue cells is taken from the breasts and tested under a microscope to find out if it is cancerous. A scan and needle test for the lymph nodes present in your armpit is also done to check whether they have also been affected. A biopsy is undertaken in several ways, depending upon the condition and severity. A needle aspiration biopsy is used for testing a sample of your breast cells without the removal of the tissues. This is the most common form of biopsy and it is also used for draining a small fluid-filled lump or benign cyst. During the process, you will be given a local anesthetic. Usually, a needle biopsy is carried out guided by an X-ray, ultrasound and an MRI scan as well. This helps in distinguishing it from non-invasive changes such as ductal carcinoma in situ.
Another form of biopsy used for the diagnosis of breast cancer is called vacuum assisted biopsy or mammotome biopsy. In this process, a needle gets attached to a suction tube, which helps in obtaining the sample and for clearing the bleeding. If you wish to discuss about any specific problem, you can consult a general-surgeon.
I have diagnosed with infiltrating ductal carcinoma, NOS, in right breast (in biopsy report. Please suggest me what is my treatment option.
Uterine cysts are a type of cysts or tumours, which grow in the uterus. This is prevalent in women when they are near their childbearing years. Uterine cysts have some typical symptoms, which would let you know when to consult a medical practitioner for further help. It would cause excessive bleeding for a long duration of time. There is bleeding from the uterus in between your menstrual cycles. At times, it becomes very difficult to empty your bladder and irritation and discomfort are caused. It also leads to constipation. These are frequent symptoms, which accompany uterine cysts. These types of cysts are almost always non-cancerous, but it is beneficial to take an expert advice on that matter. Homeopathy is a great option to treat such cysts.
Homeopathy is becoming increasingly popular throughout the entire world. Now it is time to prove to the world what homeopathy can offer in surgical diseases. Homeopathic medicines cannot take the place of surgery but can be of great help to the patients who do not want to go for surgery or cannot be operated upon due to various medical reasons. There are specific medications to treat cysts through homeopathy.
Some of them are:
Calcarea Carbonica: This medicine is suitable for those who bleed profusely during their menstrual cycle. Such excessive bleeding causes shivers and shrills in them, making them more prone to anaemia. In fact, excessive bleeding also influences their fertility cycles. This medicine is administered on overweight women who suffer from uterine cysts.
Thlaspi Bursa Pastoris: This is prescribed to women who experience frequent menstrual cycles within short intervals. In fact, one does not even recover from the shock of the previous cycle and the new one starts. It is usually accompanied by excessive pain in the uterus. This medicine not only treats the cysts, but also the frequent period cycles and pain in the uterus.
Trillium Pendulum: At times, due to excessive bleeding from the uterus, the patient suffers from fainting spells. Such cysts are also characterised by bright red blood flow during the menstrual cycle. These are the two main symptoms to administer this medicine on the individual.
Fraxinus Americana: Apart from irregular periods with pain in the uterus, it is also followed by breaking down spells. One experiences cramps in the feet during this type of cyst. In such conditions, the best natural homeopathic therapy that can be administered is Fraxinus Americana.
Calcarea Fluorica: This is a common medicine which is given to those patients who have extremely large tumours. These tumours are also characterised by their unique hardness.
Uterine cysts are a common problem in women and can be treated effectively. One needs to be alert about the symptoms and must immediately report to a specialized homeopathic practitioner for an effective administration of medicines, which may lead to a successful cure.
I am 54 year old male having MRI [LS-SPINE]. Finding Reveal Annular Tear, circumferential Disc Bulge With Small Posterocentral Protrusion at L4-L5 level, Causing No Significant Neural Compression Or Canal Stenosis" I have no pain anywhere since 5 months only difficulty in standing or on walking without pain. Become tired for few seconds, then start again walking. Ortho. Says no need to worry it will heal naturally. Spine Surgeon says need of "DISC FIX" treatment required. Getting confuse. WHAT TO DO.'
If you are suffering from breast cancer, it is recommended that you undertake Ayurvedic measures for an effective and natural treatment. Breast cancer is a form of cancer that occurs in the cells of your breasts. The breast cells undergo abnormal growth and go out of control. This form of cancer is likely to occur in both women and men, although it is most common in women. A lot of breast cancer cases start from the ducts or lobes, while others start from the cellular lining of your milk ducts.
According to the principles of Ayurveda, your body is based on the tridoshas, which include vata, pitta, and kapha.
- An imbalance in these doshas can lead to diseases and disruption in your health. Cancer occurs when an imbalance of all the three doshas is experienced.
- An improper diet and lifestyle account for being the primary reason for this imbalance in doshas, leading to breast cancer.
- Your digestive fire is also affected, which leads to the accumulation of toxins, thereby blocking all the channels of your body.
- All these factors are collectively responsible for the development of breast cancer.
- Ayurvedic treatment for breast cancer is very effective because of its natural approach.
- Without the use of any chemicals and radiation, you get efficient management by using Ayurvedic remedies for breast cancer.
- Your body functioning is enhanced without the concern of any negative effect on your health.
- Several Ayurvedic herbs are used for breast cancer treatment. These herbs help in controlling the abnormal growth of breast cells, and in the later stages of breast cancer, these also help in reducing pain.
The herbs play an important role in preventing the condition from spreading to other organs.
- This powerful Ayurvedic herb contains natural rejuvenating properties for your body.
- It also helps in eliminating stress, weakness and fatigue, which are associated with breast cancer.
- This effective Ayurvedic herb contains several medicinal properties.
- It is an antioxidant and helps in reducing free radicals from your body. This is beneficial for an improved health and immunity.
- The herb is capable of dealing with toxins and infections, and is super effective in treating malignant cancers.
- This is an Ayurvedic product, which is obtained by mixing several herbs such as amalaki, haritaki, ginger, kachnar bark and a lot more.
- This is effective in maintaining healthy tissues and cells. It also stops the abnormal growth of cancerous cells.
It is important for you to visit a licensed and experienced Ayurvedic practitioner for getting the best Ayurvedic remedies for breast cancer treatment. This will ensure that you get the most effective remedies, based on your condition.
Breast Augmentation is the most popular plastic surgery procedure performed worldwide.
Breast augmentation can enhance your appearance and your self-confidence, enlarging your breasts and making them more proportional with the rest of your body. Breast augmentation can also be used to correct differences in the size of your breasts or sagging breasts, which can occur after pregnancy and breastfeeding.
There are many choices and options in breast augmentation, which require careful planning to individualize what are the best options for you. All of these choices have advantages and disadvantages, which you should understand before you make a decision with your surgeon.
Breast augmentation does not correct severely drooping breasts. If you want your breasts to look fuller and to be lifted due to sagging, a breast lift may be required in conjunction with breast augmentation. Breast lifting can often be done at the same time as your augmentation or may require a separate operation. Your plastic surgeon will assist you in making this decision.
Most patients choose silicone implants rather than saline implants because they have a more natural look and feel. Modern silicone implants are substantially different from the old type of silicone implants used in the 1970s and 80s. Another advantage of the cohesive gel silicone implants is that they are made in a variety of round and tear-drop shapes, which means it is easier to choose an implant to achieve the breast shape that you desire.
Misinformation emerged about silicone in the late 80's and early 90's. The effects of silicone implants have since been studied extensively these claims were made, looking at 100,000s of women with breast implants. In June 1999, The Institute of Medicine at the National Academy of Sciences in the U.S.A. released a report, which confirmed that there is no increased risk of the development of cancer, immunologic or neurological problems associated with the use of silicone breast implants, which had been claimed in the late 80's. Patients with implants can breastfeed normally as there is no effect on breast milk.
Breast augmentation surgery requires a general anaesthetic, with the operation taking 1-2 hours, and is usually performed as a day-stay or overnight-stay procedure.
Implants are placed either behind the breast tissue or under the pectoralis muscle on the chest wall. Breast implants placed underneath the muscle have a more natural shape, a lower chance of capsular contracture (hardening) of the implant, and it is easier for mammography. There is also a choice of incision - in the crease under the breast, under the areola or in the armpit, all of which have advantages and disadvantages, which you should discuss with your surgeon.
Following the surgery, it is important to have restricted light activities, with no lifting or heavy duties for 7-10 days. Most patients may drive again and return to work within 7 days after the surgery. Heavy activities and sport should not be undertaken for 3-4 weeks following the surgery. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
My MRI INDICATE 1. Lumbosacral transitional Vertebra with complete socialization of L5 2. Disc desiccation with diffuse disc bulge and broad based posterior central disc protrusion at L4-L5 level causing ventral thecal sac indentation and significant compromise of bilateral neural forminal (right>left). Mild ligamentum flavum thickening is also seen at this level with maintained spinal canal dimensions. 3. Cervical spondylitis changes with disc osteophyte complexes at C4-C5 and C5-C6 levels. Broad based left paracentral disc protrusion at C4-C5 level causing ventral thecal sac indentation and moderate compromise of left sided neural forminal. 4. Mild disc bulge at d5-d6 (screening of rest of spine revealed) I am confused. Dr. Said physio will fix it. I read too many damages. Please guide and suggest sustainable solutions. I am willing to take prolonged treatment. What does this report mean?
A mastectomy is surgical removal of a breast. The surgery depends on various factors and choosing a type of mastectomy best suited for an individual suffering from breast cancer requires experience and expertise. With advancing technology, there are more options available for women to opt for surgeries, which are minimally invasive and conserving in nature. Following are the various types of mastectomies and the factors, which influence them:
Types of Mastectomy
1. Total or simple mastectomy
This is a surgical procedure which involves complete removal of the breast including the nipple. The lymph nodes, which are small glands, are an important part of your immune system and are kept intact during the surgery. This form of surgery is most suitable if the cancer has not spread to the lymph nodes.
2. Preventive mastectomy
Preventive mastectomy, also known as prophylactic mastectomy, is an option for women who have a high risk of developing breast cancer. Preventive mastectomy reduces the risk of breast cancer by a huge margin. In certain cases, removal of the entire breast along with the nipple is advisable. Women who develop cancer on one breast often opt for preventive mastectomy and remove the other unaffected breast as well.
3. Partial mastectomy
Women who are in stage I or stage ii of breast cancer can choose this procedure. It is a breast conserving technique where the tumor is removed along with the tissue that surrounds it. It is followed up by radiation therapy on the remaining breast tissue, which terminates the cancer cells and stops them from spreading. There are two types of partial mastectomy, namely, lumpectomy and quadrantectomy.
4. Radical mastectomy
Although this procedure is almost out of use, it is still considered in case the cancer has spread to certain areas like the chest muscle. In this form of surgery, the breast is removed entirety along with muscles beneath it and the lymph nodes.
5. Modified mastectomy
It is a more commonly used procedure characterized by complete removal of the breast including underarm lymph nodes. The chest muscles are untouched in the procedure, therefore allowing a breast reconstruction to follow.
Factors influencing the type of mastectomy:
• Age of the individual
• Health in general
• Size of the tumor
• The spread of the tumor
• The rate of progression of the tumor
• Whether lymph nodes are affected or not
If you wish to discuss about any specific problem, you can consult a doctor.
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.
Breast Cancer Prevention:
Anything that increases your chance of developing cancer is called a cancer risk factor; anything that decreases your chance of developing cancer is called a cancer protective factor.
Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer. Different ways to prevent cancer are being studied, including:
Changing lifestyle or eating habits. Avoiding things known to cause cancer. Taking medicine to treat a precancerous condition or to keep cancer from starting.
General information about breast cancer:
Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. Breast cancer is the second most common type of cancer in india
Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.
The breast is made up of lobes and ducts. Each breast has 15 to 20 sections called lobes, which have many smaller sections called lobules. Lobules end in dozens of tiny bulbs that can make milk. The lobes, lobules, and bulbs are linked by thin tubes called ducts.
Enlarge Drawing of female breast anatomy showing the lymph nodes, nipple, areola, chest wall, ribs, muscle, fatty tissue, lobe, ducts, and lobules.
Anatomy of the female breast. The nipple and areola are shown on the outside of the breast. The lymph nodes, lobes, lobules, ducts, and other parts of the inside of the breast are also shown.
Each breast also has blood vessels and lymph vessels. The lymph vessels carry an almost colorless fluid called lymph. Lymph vessels lead to organs called lymph nodes. Lymph nodes are small bean-shaped structures that are found throughout the body. They filter lymph and store white blood cells that help fight infection and disease. Clusters of lymph nodes are found near the breast in the axilla (under the arm), above the collarbone, and in the chest.
Avoiding risk factors and increasing protective factors may help prevent cancer. The following are risk factors for breast cancer:
Older agea personal history of breast cancer or benign (noncancer) breast diseasea family history of breast cancerinherited gene changesdense breasts
Exposure of breast tissue to estrogen made in the bodytaking hormone therapy for symptoms of menopause radiation therapy
The following are protective factors for breast cancer:
Less exposure of breast tissue to estrogen made by the bodytaking estrogen-only hormone therapy after hysterectomy,
Estrogen-only hormone therapy after hysterectomyselective estrogen receptor modulatorsaromatase inhibitors and inactivators
Risk-reducing mastectomy ovarian ablationgetting enough exercise
It is not clear whether the following affect the risk of breast cancer:
Factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk
Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.
A personal history of breast cancer or benign (noncancer) breast disease
Women with any of the following have an increased risk of breast cancer:
A personal history of invasive breast cancer, ductal carcinoma in situ (dcis), or lobular carcinoma in situ (lcis). A personal history of benign (noncancer) breast disease.
A family history of breast cancer
Women with a family history of breast cancer in a first-degree relative (mother, sister, or daughter) have an increased risk of breast cancer.
Inherited gene changes:
Women who have inherited changes in the brca1 and brca2 genes or in certain other genes have a higher risk of breast cancer, ovarian cancer, and maybe colon cancer. The risk of breast cancer caused by inherited gene changes depends on the type of gene mutation, family history of cancer, and other factors.
Men who have inherited certain changes in the brca2 gene have a higher risk of breast, prostate, and pancreatic cancers, and lymphoma.
Having breast tissue that is dense on a mammogram is a factor in breast cancer risk. The level of risk depends on how dense the breast tissue is. Women with very dense breasts have a higher risk of breast cancer than women with low breast density.
Increased breast density is often an inherited trait, but it may also occur in women who have not had children, have a first pregnancy late in life, take postmenopausal hormones, or drink alcohol.
Exposure of breast tissue to estrogen made in the body
Estrogen is a hormone made by the body. It helps the body develop and maintain female sex characteristics. Being exposed to estrogen over a long time may increase the risk of breast cancer. Estrogen levels are highest during the years a woman is menstruating.
A woman's exposure to estrogen is increased in the following ways:
Early menstruation: beginning to have menstrual periods at age 11 or younger increases the number of years the breast tissue is exposed to estrogen. Starting menopause at a later age: the more years a woman menstruates, the longer her breast tissue is exposed to estrogen. Older age at first birth or never having given birth: because estrogen levels are lower during pregnancy, breast tissue is exposed to more estrogen in women who become pregnant for the first time after age 35 or who never become pregnant.
Taking hormone therapy for symptoms of menopause:
Hormones, such as estrogen and progesterone, can be made into a pill form in a laboratory. Estrogen, progestin, or both may be given to replace the estrogen no longer made by the ovaries in postmenopausal women or women who have had their ovaries removed. This is called hormone replacement therapy (hrt) or hormone therapy (ht). Combination hrt/ht is estrogen combined with progestin. This type of hrt/ht increases the risk of breast cancer. Studies show that when women stop taking estrogen combined with progestin, the risk of breast cancer decreases.
Radiation therapy to the breast or chest:
Radiation therapy to the chest for the treatment of cancer increases the risk of breast cancer, starting 10 years after treatment. The risk of breast cancer depends on the dose of radiation and the age at which it is given. The risk is highest if radiation treatment was used during puberty, when breasts are forming.
Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast.
For women who have inherited changes in the brca1 and brca2 genes, exposure to radiation, such as that from chest x-rays, may further increase the risk of breast cancer, especially in women who were x-rayed before 20 years of age.
Obesity increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy.
Drinking alcohol increases the risk of breast cancer. The level of risk rises as the amount of alcohol consumed rises.
The following are protective factors for breast cancer:
Less exposure of breast tissue to estrogen made by the body
Decreasing the length of time a woman's breast tissue is exposed to estrogen may help prevent breast cancer. Exposure to estrogen is reduced in the following ways:
Early pregnancy: estrogen levels are lower during pregnancy. Women who have a full-term pregnancy before age 20 have a lower risk of breast cancer than women who have not had children or who give birth to their first child after age 35. Breast-feeding: estrogen levels may remain lower while a woman is breast-feeding. Women who breastfed have a lower risk of breast cancer than women who have had children but did not breastfeed.
Taking estrogen-only hormone therapy after hysterectomy, selective estrogen receptor modulators, or aromatase inhibitors and inactivators
Estrogen-only hormone therapy after hysterectomy
Hormone therapy with estrogen only may be given to women who have had a hysterectomy. In these women, estrogen-only therapy after menopause may decrease the risk of breast cancer. There is an increased risk of stroke and heart and blood vessel disease in postmenopausal women who take estrogen after a hysterectomy.
Selective estrogen receptor modulators:
Tamoxifen and raloxifene belong to the family of drugs called selective estrogen receptor modulators (serms). Serms act like estrogen on some tissues in the body, but block the effect of estrogen on other tissues.
Treatment with tamoxifen lowers the risk of estrogen receptor-positive (er-positive) breast cancer and ductal carcinoma in situ in premenopausal and postmenopausal women at high risk. Treatment with raloxifene also lowers the risk of breast cancer in postmenopausal women. With either drug, the reduced risk lasts for several years or longer after treatment is stopped. Lower rates of broken bones have been noted in patients taking raloxifene.
Taking tamoxifen increases the risk of hot flashes, endometrial cancer, stroke, cataracts, and blood clots (especially in the lungs and legs). The risk of having these problems increases with age. Women younger than 50 years who have a high risk of breast cancer may benefit the most from taking tamoxifen. The risk of having these problems decreases after tamoxifen is stopped.
Taking raloxifene increases the risk of blood clots in the lungs and legs, but does not appear to increase the risk of endometrial cancer. In postmenopausal women with osteoporosis (decreased bone density), raloxifene lowers the risk of breast cancer for women who have a high or low risk of breast cancer. It is not known if raloxifene would have the same effect in women who do not have osteoporosis. Talk with your doctor about the risks and benefits of taking this drug.
Aromatase inhibitors and inactivators:
Aromatase inhibitors (anastrozole, letrozole) and inactivators (exemestane) lower the risk of a new breast cancer in women who have a history of breast cancer. Aromatase inhibitors also decrease the risk of breast cancer in women with the following conditions:
Postmenopausal women with a personal history of breast cancer. Women with no personal history of breast cancer who are 60 years and older, have a history of ductal carcinoma in situ with mastectomy, or have a high risk of breast cancer based on the gail model tool (a tool used to estimate the risk of breast cancer).
In women with an increased risk of breast cancer, taking aromatase inhibitors decreases the amount of estrogen made by the body. Before menopause, estrogen is made by the ovaries and other tissues in a woman's body, including the brain, fat tissue, and skin. After menopause, the ovaries stop making estrogen, but the other tissues do not. Aromatase inhibitors block the action of an enzyme called aromatase, which is used to make all of the body's estrogen. Aromatase inactivators stop the enzyme from working.
Possible harms from taking aromatase inhibitors include muscle and joint pain, osteoporosis, hot flashes, and feeling very tired.
Some women who have a high risk of breast cancer may choose to have a risk-reducing mastectomy (the removal of both breasts when there are no signs of cancer). The risk of breast cancer is much lower in these women and most feel less anxious about their risk of breast cancer. However, it is very important to have a cancer risk assessment and counseling about the different ways to prevent breast cancer before making this decision.
The ovaries make most of the estrogen that is made by the body. Treatments that stop or lower the amount of estrogen made by the ovaries include surgery to remove the ovaries, radiation therapy, or taking certain drugs. This is called ovarian ablation.
Premenopausal women who have a high risk of breast cancer due to certain changes in the brca1 and brca2 genes may choose to have a risk-reducing oophorectomy (the removal of both ovaries when there are no signs of cancer). This decreases the amount of estrogen made by the body and lowers the risk of breast cancer. Risk-reducing oophorectomy also lowers the risk of breast cancer in normal premenopausal women and in women with an increased risk of breast cancer due to radiation to the chest. However, it is very important to have a cancer risk assessment and counseling before making this decision. The sudden drop in estrogen levels may cause the symptoms of menopause to begin. These include hot flashes, trouble sleeping, anxiety, and depression. Long-term effects include decreased sex drive, vaginal dryness, and decreased bone density.
Getting enough exercise:
Women who exercise four or more hours a week have a lower risk of breast cancer. The effect of exercise on breast cancer risk may be greatest in premenopausal women who have normal or low body weight.
It is not clear whether the following affect the risk of breast cancer:
Certain oral contraceptives contain estrogen. Some studies have shown that taking oral contraceptives (" the pill") may slightly increase the risk of breast cancer in current users. This risk decreases over time. Other studies have not shown an increased risk of breast cancer in women who take oral contraceptives.
Progestin -only contraceptives that are injected or implanted do not appear to increase the risk of breast cancer. More studies are needed to know whether progestin-only oral contraceptives increase the risk of breast cancer.
Studies have not proven that being exposed to certain substances in the environment, such as chemicals, increases the risk of breast cancer.
Studies have shown that some factors do not affect the risk of breast cancer.
The following do not affect the risk of breast cancer:
Having an abortion. Making diet changes such as eating less fat or more fruits and vegetables. Taking vitamins, including fenretinide (a type of vitamin a). Cigarette smoking, both active and passive (inhaling secondhand smoke). Using underarm deodorant or antiperspirant. Taking statins (cholesterol -lowering drugs). Taking bisphosphonates (drugs used to treat osteoporosis and hypercalcemia) by mouth or by intravenous infusion.
Cancer prevention clinical trials are used to study ways to prevent cancer.
Test to screen for breast cancer:
Mammography is the most common screening test for breast cancer. A mammogram is an x-ray of the breast. This test may find tumors that are too small to feel. A mammogram may also find ductal carcinoma in situ (dcis). In dcis, there are abnormal cells in the lining of a breast duct, which may become invasive cancer in some women.
Mammograms are less likely to find breast tumors in women younger than 50 years than in older women. This may be because younger women have denser breast tissue that appears white on a mammogram. Because tumors also appear white on a mammogram, they can be harder to find when there is dense breast tissue.
The left breast is pressed between two plates. An x-ray machine is used to take pictures of the breast. An inset shows the x-ray film image with an arrow pointed at abnormal tissue.
The breast is pressed between two plates. X-rays are used to take pictures of breast tissue.
The following may affect whether a mammogram is able to detect (find) breast cancer:
The size of the tumor. How dense the breast tissue is. The skill of the radiologist.
Women aged 40 to 74 years who have screening mammograms have a lower chance of dying from breast cancer than women who do not have screening mammograms.
Clinical Breast Exam (CBE):
A clinical breast exam is an exam of the breast by a doctor or other health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual. It is not known if having clinical breast exams decreases the chance of dying from breast cancer.
Breast self-exams may be done by women or men to check their breasts for lumps or other changes. It is important to know how your breasts usually look and feel. If you feel any lumps or notice any other changes, talk to your doctor. Doing breast self-exams has not been shown to decrease the chance of dying from breast cancer.
Mri (magnetic resonance imaging) in women with a high risk of breast cancer
Mri is a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (nmri). Mri does not use any x-rays.
MRI is used as a screening test for women who have one or more of the following:
Certain gene changes, such as in the brca1 or brca2 genes. A family history (first degree relative, such as a mother, daughter or sister) with breast cancer. Certain genetic syndromes, such as li-fraumeni or cowden syndrome.
Mris find breast cancer more often than mammograms do, but it is common for mri results to appear abnormal even when there isn't any cancer.
Other screening tests are being studied in clinical trials.
Thermography is a procedure in which a special camera that senses heat is used to record the temperature of the skin that covers the breasts. A computer makes a map of the breast showing the changes in temperature. Tumors can cause temperature changes that may show up on the thermogram.
There have been no clinical trials of thermography to find out how well it detects breast cancer or if having the procedure decreases the risk of dying from breast cancer.
Breast tissue sampling is taking cells from breast tissue to check under a microscope. Abnormal cells in breast fluid have been linked to an increased risk of breast cancer in some studies. Scientists are studying whether breast tissue sampling can be used to find breast cancer at an early stage or predict the risk of developing breast cancer. Three ways of taking tissue samples are being studied:
Fine-needle aspiration: a thin needle is inserted into the breast tissue around the areola (darkened area around the nipple) to take out a sample of cells and fluid.
Nipple aspiration: the use of gentle suction to collect fluid through the nipple. This is done with a device similar to the breast pumps used by women who are breast-feeding.
Ductal lavage: a hair-size catheter (tube) is inserted into the nipple and a small amount of salt water is released into the duct. The water picks up breast cells and is removed.
Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.
Here's what you should look for:
Breasts that are their usual size, shape, and color
Breasts that are evenly shaped without visible distortion or swelling
If you see any of the following changes, bring them to your doctor's attention:
Dimpling, puckering, or bulging of the skin
A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)
Redness, soreness, rash, or swelling
Step 2: now, raise your arms and look for the same changes.
Step 3: while you're at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).
Step 4: next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.
Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.
Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage.
Step 5: finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 4.
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
The sciatic pain caused due to a lumbar herniated disc can radiate down your legs and may make you immobile. It is quite common for a herniated disc to press against a nearby nerve and inflame, leading to pain radiating along the length of the affected sciatic nerve. For getting relief from lumbar herniated disc pain, you need to become active. Daily hamstring stretches are considered to be an effective way to tackle such pain if you do them regularly.
Here are three important hamstring stretches which will help you in strengthening your hamstring muscles:
- Seated chair stretches: This stretch is perfect for people whose mobility is limited or for those who have unusually tight hamstrings. It is carried out in a sitting position. While performing this stretch, you have to sit on a chair with another chair placed across. By resting one foot on the ground and the other on the second chair, you need to straighten your back and lean forward over the leg which is extended. Once you feel a stretch in the upper and rear thigh, you should be in that position for at least 30 seconds. You should switch legs and repeat the stretching exercise thrice for each leg.
- Towel hamstring stretch: If you like stretching while lying down, this stretch is an ideal option for you. For performing a towel hamstring stretch, you have to lie down on the floor and keep one leg flat. Tighten your abdominal muscles while you lift the other leg and keep it straight. You should wrap a belt around the elevated leg’s instep and use it for pulling back the leg towards you. Hold the position for around 30 seconds when you feel a stretch.
- Wall hamstring stretch: This stretch is for people who find the towel hamstring stretch hard to execute. For such people, extra stability can be attained by taking help of a solid surface such as a door jamb or a wall. You can rest the raised leg against the wall for support. You need to lie on the floor near a wall corner and leave one leg straight while placing the other against the wall. Your hips should be on the floor.
While you do stretches of any kind, you should only stretch as far as you are comfortable. You must not stretch to a point which causes pain. These hamstring stretches are quite safe, but you should avoid them in case of any sudden, acute pain.