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Diagnostic X- Ray
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Uterine Artery Embolization
Interventional Diagnostic Procedures
Angiography Radial Approach
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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.
Q1. What exactly is Laparoscopy?
Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.
Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?
Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.
Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?
Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.
Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?
Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.
Q5. Will there be much pain or discomfort after Laparoscopic Surgery?
There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.
Q6. When can I be discharged from hospital?
Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.
Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?
Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.
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.
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.
Please suggest me Reasons of breast of cancer and ways to avoid it. Does pressing breasts have wrong effect on it.
My MRI report says, Mild posterior broad base protrusion of L4-L5 intervertebral disc resultant mild central and lateral canal narrowing causing mild compression over thecal sac and right traversing L5 nerve root. I am doing bed rest from 10 days, what's the report says.
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.
Breast cancer is a medical condition that refers to the uncontrolled growth of cells in the breast. These cells can be like small tumours or lumps. The tumour can be malignant if it is found that the cells are growing into surrounding tissues or are spreading. It occurs mostly in women.
Breast cancers can originate from any part of the breast. Most of these cancerous growths start in the milk-carrying ducts. There are also cancerous growths in the glands that produce milk. These are known as lobular cancers. In rare cases, cancer may also start from the breast tissues. These are known as sarcomas and lymphomas.
Here are some of the ways to get prevented from the possibility of developing breast cancer:
- Check your weight: It is important that you maintain a healthy weight. You don’t need do follow the hard and fast dieting charts or starve. But eat a balanced diet and exercise a bit to maintain a stable and healthy weight throughout. Being obese or overweight increases the chance of developing breast cancer.
- Be Active: A sedentary lifestyle devoid of activities is something that invites diseases. It has been found that women who are physically active and exercise for at least 30 minutes a day are at a low risk of developing breast cancer.
- Don’t avoid fruits and vegetables: It is important for you to have a balanced diet. Include lots of leafy vegetables and fruits in your diet to avoid the possibility of developing any form of cancer. Don’t drink excessive alcohol on regular basis. Remember a healthy diet is a key to a healthy life.
- Don’t Smoke: Smoking increases the chance of developing heart diseases, stroke and 15 types of cancers. It also increases the risk for breast cancer.
- Breastfeed your baby: It is mandatory for good health that you breastfeed your baby. Exclusive breastfeeding is best for the health of your baby as well as yours. It lowers the chances of developing breast cancer.
- Avoid Birth Control Pills: These pills have side-effects. They increase the risk of developing breast cancer. It also increases the chances of developing heart diseases and ovarian cancer.
- Avoid Post-Menopausal Hormones: Post-menopausal hormones have an adverse effect on the health. They increase the risk of some diseases while lowering the effects of other ones. It should be taken for a shorter period and its prolonged use must be avoided. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
Beet juice: apart from being a nutritional powerhouse, beet juice is a great source of nitric acid. The latter helps with blood flow in the body. A smooth blood flow, on the other hand, helps the brain in functioning properly. A study has found that people who consume beet juice have an increased circulation in the white matter resulting from an increased brain activity. This juice is sweet in taste and can be consumed every alternate day.
Berry smoothies: acai is a fruit which has a south african origin and hits the top of the list when it comes to brain assisting food. It increases the flow of the blood and dilates the blood vessels. However, this is extremely expensive. Berries also have a similar effect on the brain, but they are less powerful in nature. What can be done is to mix a little ingredient of acai in frozen berries juice and drink the same every day. Frozen berries retain the freshness and the nutritional benefits. This drink will improvise your brain and increase blood flow in the body.
Pomegranate juice: pomegranate is a great antioxidant and it very aptly limits the free radicals from damaging the brain cells. Antioxidants are also credited with increased blood flow and protection of the heart. A healthy cardiovascular system is synonymous to an increased brain function. What is surprising is the fact that pomegranate has more antioxidant content compared to red wine and green tea. Pomegranate juice can be consumed daily during the morning or afternoon.
Carrot juice: carrot is known for its healthy components that are beneficial for the eyes. Recent studies have revealed that they are great for the brain too. Like other colored vegetables, they are a great source of antioxidant and have a high content of beta-carotene. Carrot juice can reduce the inflammation of the brain cells and improve memory. Carrot juice is not at all bitter and the same can be consumed every alternate day after your meal.
Cocoa: a harvard study revealed that two cups of cocoa on a daily basis greatly helps a person in improving memory. Cocoa contains flavanols that keep the blood pressure normal and relaxes the blood vessel linings. Cocoa is also known to be a great antioxidant agent that limits the free radical to affect the brain cells. Cocoa should not be overloaded with sugar and should be consumed hot before starting your day.
Noncancerous growths of the muscle tissue surrounding the uterus are known as uterine fibroids. This is a common disease which about 70 to 80% of women contract by the time they are 50 years of age. The uterine fibroids can sometimes be very big and cause heavy periods as well as severe abdominal pain while at other times, uterine fibroids give no signs or symptoms whatsoever and go away on their own. This is why it is crucial to know what type of uterine fibroids you have and how to diagnose them. Here are the types of uterine fibroids and how to diagnose them;
There are three main types of uterine fibroids. They are;
- Intramural fibroids: The most common type of uterine fibroids are intramural fibroids. They typically appear in the endometrium and may grow larger which results in your womb getting stretched.
- Subserosal fibroids: Subserosal fibroids are called so because they form on the serosa. The serosa is the outside of your uterus. Sometimes, Subserosal fibroids may grow so large that your uterus appears bigger on one side.
- Pedunculated fibroids: Pedunculated fibroids tumors are basically Subserosal fibroids with a stem. A base which supports the tumor is called the stem.
There are a number of tests done to diagnose uterine fibroids. They are;
- Pelvic exam: A pelvic exam is a thorough inspection of a woman’s pelvic area. The organs which are in the pelvic area include the cervix, ovaries, uterus and vagina. Normally, this and the next test in this article are enough to diagnose uterine fibroids.
- Medical history: The history of your periods as well as the other symptoms you have will often be enough to diagnose the uterine fibroids. If your medical history is not enough, then you might need to undergo a pelvic exam.
- Pelvic ultrasound: An ultrasound is when high-intensity sound waves are used to produce images of the pelvic area. This is only done when a pelvic exam and your medical history are not enough to diagnose uterine fibroids. If you wish to discuss any specific problem, you can consult a general surgeon.
Of all cancer types that affect the female population, breast cancer is the most common one. Statistics show that above 1 in 8 women in the USA are likely to develop breast cancer (invasive type, which is often severe). Changing lifestyles including prolonged use of birth control, smoking, alcohol abuse, lack of physical activity, dietary changes, etc., have led to an increased incidence. As these are here to stay, the only way is to prevent.
The likelihood of developing breast cancer is determined by risk factors. Some of these risk factors cannot be changed. For instance, age, ethnicity, and history of familial breast cancer. However, there are others, which can be acted upon or modified to reduce the chances of developing breast cancer.
Some of the preventable risk factors are as follows:
- Nicotine abuse: Quitting smoking has multiple benefits for a woman, and one major benefit is the reduced risk of developing breast cancer. Other benefits include reduced incidence of diabetes, heart disease, and other cancers.
- Hormone replacement therapy: To the extent possible, avoid prolonged use of birth control pills or hormones for other treatment purposes. In addition to using non-hormonal methods, if not avoidable, constantly monitoring hormone levels is very important. Birth control pills should especially be avoided by women over 35 years of age who smoke. The risk associated with developing cancer reduces as soon as the hormone supplement is stopped.
- Weight Management: One of the major risk factors is obesity, and in people with other non-alterable risk factors, it is best to work on weight management from an early age. Talk to your doctor about your ideal BMI and ensure this is maintained.
- Physical Activity: Regular physical activity, at least 30 minutes per day, in addition to strength training will help in keeping the body agile and managing weight. It also reduces the risk of breast cancer.
- Breastfeeding: Studies have shown that breastfeeding has protective effect against breast cancer; longer a baby is breast fed, greater is the protective benefit.
- Screening: Even if not completely preventable, early detection of breast cancer is very important. This will help in less severe treatment and better prognosis. Recommended ages for mammography are as follows:
- In the age of 40 to 44, an annual mammogram is advised along with a discussion with the doctor on the risks.
- An annual mammogram for all women in the age of 45 – 54 is important as most women enter menopause by this time. This needs to be continued annually, as self-breast exams alone cannot detect cancer, thus it is a good practice and anything abnormal will not go undetected.
- These will help reduce the risk of developing breast cancer, help in early detection, and improve prognosis.
In case you have a concern or query you can always consult an expert & get answers to your questions!