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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.
She is 63 years old suffering from diabetes-on Insulin+other allopathy medicines but the sugar level running from 70 to 200 and more. Today fasting 90 but PP is going high between 200 to 300. She is on Insulin from last 15 years. Can she be treated with you? And I am also suffering from Slip Disc. L4 L5 S1 and taken 15 days Ayurvedic treatment such as Katibastyi, Malish, Steam bath etc but there is nothing complete and permanent. Please advise us to permanent treatment.
Hi doctor. I have a severe backache as per Dr. Advice I have done mri. My mri report is as under kindly advise in matter degenerative lumber spondylitis are seen in the form of marginal osteophytes and multilevel disc dessication. 1. D12-l1 & l1-l2 discs show mild bulge, indenting anterior thecal sac without significant never root compression 2. L2-l3 disc reveals right paracentral disc extrusion, indenting anterior thecal sac and causing right lateral recess narrowing, impinging on right traversing l3 nerve root. 3. L3-l4 disc shows mild diffuse disc protrusion, indenting anterior thecal sac and causing bilateral mild neural foraminal narrowing, minimally abutting bilateraltraversing l4 nerve roots. 4. L4-l5 disc reveals mild diffuse disc protrusion, indenting anterior thecal sac and causing bilateral mild neural foraminal narrowing, minimally abutting right existing l4 nerve root-bilateral traversing l5 nerve roots. Nerve roots. Cord is seen ending at d11 vertebral level. Distal cord and conus appear normal. Both hip and si joints are normal. No pre / paravertebral, epidural soft tissue or haematoma is seen. Bilateral psoas and posterior paraspinous muscles are normal. Please advise for home exercise / medicine.?
I am 33 years old my weight 69 kgs .l will take medicine to my disc problem before take medicine my weight 60 how to weight loss give me suggestion?
I am 51 yrs. I am suffering from neck pain and headache last two years. My mri report says that c5-6 disc shows diffuse asymmetric bulge[more towards left side], causing effacement of anterior subarachnoid space and indentation of bilateral c6 nerve roots[left>>right]. Along with posterior osteophytes, it constitutes hard disc. What should I do? please help me.
I am 39 years my weight is 95 kg, my height is 5.4, I have ligament tear in my right knee, I have slip disc in l4, l5, high bp. Etc, please suggest how to loose weight. Rapidly fast if any medicine that can help to reduce the weight.
Does Knuckle breaking at neck at regular intervals when I'm feel stressed, will that leads to an disk injury or any problems in future. Usually I keep doing that when I work out in gym.
I am a 25 years old male, I have been suffering from bulging disk at l5-s1. I have been resting for 2 months, now my neck has started paining too and left pelvic joint is making popping sound everytime it is bend. So I got my blood acid checked. And its been 8 for last two months, I have been drinking like 6 lts water everyday. Is uric acid main reason of pain? And how can I get it down as I don't want to start the medicine so early in life and drinking water is not working. Please suggest, my career is suffering a lot.
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
I want to know about exercises being done in case of diffuse disc bulge at l1-l2 level indenting anterior the cal sac mildly with bilateral mild neural foraminal narrowing.
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.
I have been suffering from disk problem since 7 months. I have consulted a doctor. I took x-Ray as per his advice. He said disk has been narrowed. He prescribed some painkillers and vitamin tablets. Could anyone please prescribe some medicine for me. I am really unable to sit without any support.
I have a back disc doctor has advised to take complete bed rest for 3 months but I am preparing for competitive exam which is not possible. is there any way so that I will be ok?
Breast cancer begins when the cells that are present in the breast start to go out of control. These cells generally form a tumor which can be seen on mammogram or one can feel it as a lump. The tumor is threatening if the cells can grow into the tissues that surround it or spread to other areas of the body. Breast cancer happens mostly in ladies. Here are a few methods with which you can prevent breast cancer-
- Keep your weight in check: Maintaining a healthy weight is important for everyone although, it is easy to tune it out since it is said so often. Being overweight can expand the danger of a wide range of cancers, including breast cancer, particularly after menopause.
- Be physically active: Women who are physically active for almost or at least 30 minutes a day have a lower danger of breast cancer. Normal activity is additionally one of the ideal approaches to keep weight under control.
- Eat Your Fruits and Vegetables and Avoid Too Much Alcohol: A balanced and healthy diet can bring down the danger of breast cancer. Attempt to eat a considerable measure of fruits and vegetables and keep liquor at moderate levels or lower. While moderate drinking can be useful for the heart in most grown-ups, even low levels of intake can build the danger of breast cancer. If you do not drink, don't feel you have to begin. In case you drink modestly, there is less risk.
- Try not to Smoke: Smokers and non-smokers alike know how undesirable smoking is. It brings down a person’s quality of life and expands the danger of heart and lung diseases, stroke, and no less than 15 types of cancer, including breast cancer. It additionally causes bad breath, awful teeth, and wrinkles.
- Breastfeed, If Possible: Breastfeeding for almost one year or more brings down the danger of breast cancer. It additionally has extraordinary medical advantages for the baby as well, especially in terms of immunity.
- Keep away from Birth Control Pills: Contraceptive pills have both dangers and advantages. In many cases, the more young a lady is, the lower the danger is. While ladies are taking birth control pills, they have more chances of falling prey to breast cancer as per various medical studies. This danger leaves rapidly in the wake of stopping the pill. The danger of stroke and heart attack is increased while on the pill, especially if the woman smokes. Long term use can likewise have essential advantages, such as bringing down the danger of ovarian cancer, colon tumor and uterine cancer and undesirable pregnancy. In case you are exceptionally worried about breast cancer, staying away from birth control pills is also an alternative to lower the risk. If you wish to discuss about any specific problem, you can consult an oncologist and ask a free question.
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.