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Hello Doctor I have degenerative disc disease after a fall down a flight of stairs in 2013. I sometimes have difficulty in breathing while asleep at night and develop colds frequently, is this due to the lumbar fracture? Also is inability to fill bladder a symptom of disc injury? Thank you for your time Doctor.
Age 51 years male. Slip disc happened jan'2010 and get to normal after 4 years doing only exercise till now and used lumbo scrarol belt when out of home. Due to filling uneasy during walking, a tmt brace protocol suggested. Is it ok to do the test.
Doctor my 13 year old daughter has developed slip disc in her L4 and L5 vertebrae. What should be her treatment?
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.
Blockage in heart is a common term used for narrowing of coronary arteries. Coronary arteries are vessels, which supply blood and thus oxygen and food to continuously working heart muscles. Heart muscles, which are not tired working from the birth till death, however, cannot sustain long without blood supply.
A reduction in blood supply gives rise to ischemia of heart muscles commonly manifested as chest discomfort or angina. A sudden complete shutdown of blood supply leads to heart attack leading to permanent damage to heart (if blood flow not reestablished promptly).
But what causes these arteries to block? Sedentry lifestyle is the most primary reason of these blockages. Cigarette smoke increases the rate of atherosclerosis in the arteries of the heart, legs, and the aorta -- the largest artery in the body. Also, there is an increase in the risk of heart attack if a first-degree relative (parent or sibling) has had a heart attack or stroke. That is mainly seen when the relative has had a heart attack before the age of 45 if they are male, 55 if they are female.
High levels of ''bad'' cholesterol, or low-density lipoprotein (LDL), are also the major contributors to arterial plaque formation. Having high blood pressure also increases the rate at which arterial plaque builds up. It also hastens the hardening of clogged arteries. LDL a normal component of blood (upto certain limit) starts depositing in arteries as early as 10 years of age!
Deposition of billions of LDL molecules over several years on inner surface of arteries gives rise to visible narrowings in these arteries. Flow ahead of these narrowings is reduced in proportion to the narrowing. At a level of 70 % narrowing the flow is reduced to give ischemia (and angina) during exercise. Gradually increasing degree of narrowing reduces the exercise needed for ischemia and angina; a narrowing of more than 90 % can give symptoms at rest. A sudden clot formation at any of these stages can block the flow suddenly giving a heart attack.
If LDL is a normal component of blood, why it is deposited in the arteries at first place?
LDL above a certain limit in blood starts depositing in the arteries. Diabetes, Hypertension, smoking, less exercise and genetics makes it more sticky thus making narrowing faster. This is why these risk elements need to be properly attended for prevention from heart disease. For treatment medicines are important for stopping the progression of narrowings; angioplasty is a method of fast resolution of blockage; and bypass surgery is the method of creating a whole new blood supply for the affected part of the heart. If you wish to discuss about any specific problem, you can consult a Cardiologist.
Flattening of thoracic curvature ,to some extent .diminution of disc spaces with small osteophytes formation at the adjacent vertebral margins at T4>T8. No other obvious abnormality IMPRESSION - (Early/min) spondylitis changes -Mid-thoracic spine This is my x ray report please tell me is that a major problem or it can be heal with medicine and exercise and what r the reason for this. Please tell.
My mother is suffering from DVT since one week. And is in the hospital by taking medicine. Doctor suggested to do surgery tomorrow. Please suggest what is correct to do?
Breast cancer is a type of a cancerous infection that develops in the skin cells of the breast. This condition is more commonly diagnosed after you have skin cancer and is more common in women than men. There are certain signs to identify this disease, which are as follows.
1. Breast lumps - Lumps are patches of skin that occur due to the thickening and swelling of the skin. Breast lumps is a very common phenomenon for women but that does not always lead to a breast cancer; however, frequent and reoccurring instances of the same increases the risk of breast cancer. A breast lump is easily identifiable through the naked eye as it looks different from the surrounding tissues.
2. Blood discharge - The nipple is one of the most sensitive areas in the human body. In case of women, it is meant to emit milk during pregnancy, in order to feed the infant externally. A probable symptom of breast cancer can also be a frequent discharge of blood from the nipple without any visible damage or injury.
3. Breast changes - If you are experiencing any visible changes in the size, appearance or shape of the breast, then it is an indicative sign that you may have breast cancer. Thus, it is of paramount importance that you observe, touch and physically examine your breast regularly for changes. If there is any major change detected then it is advisable to consult a doctor.
4. Inverted nipple - The tip of the nipple is generally bulging and pointing outwards both in cases of men and women. But sometimes the tip of the nipple is pushed inside due to excessive suction caused by the skin tissues present inside the breast around the nipple area. This suction forces the nipple to grow inwards which is abnormal and might harm the breast and skin in various ways.
However, apart from these main symptoms, some other signs are also there that increase your chances of being diagnosed with breast cancer. They are redness or pitting of the skin over your breast like an orange, peeling or scaling of the pigmented area around the nipple, dimpling of the skin on the breasts, and such others. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
Hello doctor plzz say me is surgery essential for Diffuse annular disc bulge seen at l4 and l5 level causing indentation over thecal sac with bilateral recess narrowing and significant nerve decompression.
Breast cancer, is a type of cancer, which is common to women, where cancer cells grow on the breasts or the female mammary gland. It starts out with the formation of a small lump in your breast and can spread out to your other organs very rapidly. It generally affects women above forty years of age. Breast cancer can be classified into two types. They can either start forming on the inner linings of your milk ducts ( known as Ductal carcinoma) or in the lobules which supply milk (known as Lobular carcinoma).
There are many causes responsible for breast cancer they are mentioned below:
- Obesity or post-menopausal obesity (Learn more about Heart Diseases Post Menopause)
- Exposure to frequent radiation (X-ray)
- Consumption of alcohol
- Being taller than average
- Start of periods at an early age
- Late menopause
- Hormone replacement therapy
- Consumption of birth control pills
The most common symptoms of breast cancer are as follows:
- Formation of a lump in your breast
- Swelling or shrinking of your breast
- Change of size, shape and color of your nipple
- Blood or milk discharge from the nipple
- Breast pain
- Itching sensation
- Appearance of rashes (Learn more about to maintain the skin health)
Breast cancer if not diagnosed and treated at an early stage may turn out to be fatal. Ayurveda offers promising cures for breast cancer.
A few of the Ayurvedic remedies are mentioned below:
- Include foods, which are well supplied with vitamin D in your diet. Researches show that women with less amount of vitamin D in their bodies are more likely to develop breast cancer. Consider including foods like eggs, orange juice, dairy products and fish like salmon in your diet.
- Drink more of green tea as it has anti cancer properties.
- Exercises like walking, yoga, meditation and certain breast exercises can help you to relax the pain sensation, reduce stress and also get cured.
- Incorporate bitter gourd in your diet. Researches show that bitter gourd can kill those cancer cells, which cause breast cancer.
- Ayurvedic herbs like Ashwagandha, tulsi, curcumin have certain properties that can destroy cancer cells.
If you wish to discuss about any specific problem, you can consult an Ayurveda.
I have cervical small disc bulge and disc protrusion inserting thecal sac. Is there any permanent cure in ayurveda?
Level 2 scan at 18 weeks 5 days showed decreased blood flow in right artery. Other artery was normal. Everything else was normal. Is it a concern.
My dad has a disc problem and in morning time he suffers from stiffness in lower back area. What should he do?
I am 36 year old having problem of of disc slip in lumbar spine Dr. Asked for the surgery is only surgery is the option please suggest me other treatment.
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.
A spinal cord injury is damage to the spinal cord. It’s an extremely serious type of physical trauma that’s likely to have a lasting and significant impact on most aspects of daily life.
The spinal cord is responsible for sending messages from the brain to all parts of the body. It also sends messages from the body to the brain. We are able to perceive pain and move our limbs because of messages sent through the spinal cord.
If the spinal cord sustains an injury, some or all of these impulses may not be able to ‘get through’. The result is a complete or total loss of sensation and mobility below the injury. A spinal cord injury closer to the neck will typically cause paralysis throughout a larger part of the body than one in the lower back area.
A spinal cord injury is often the result of an unpredictable accident or violent event. The following can all result in damage to the spinal cord:
- a violent attack such as a stabbing or a gunshot
- diving into water that’s too shallow and hitting the bottom
- trauma during a car accident (specifically trauma to the face, head and neck region, back, or chest area)
- falling from a significant height
- head or spinal injuries during sporting events
- electrical accidents
- severe twisting of the middle portion of the torso
Some symptoms of a spinal cord injury include:
- problems walking
- loss of control of the bladder or bowels
- inability to move the arms or legs
- feelings of spreading numbness or tingling in the extremities
- pain, pressure, stiffness in the back or neck area
- signs of shock
- unnatural positioning of the head
If you suspect that someone has a back or neck injury:
- Don’t move the injured person – permanent paralysis and other serious complications may result
- Call 911 or your local emergency medical assistance number
- Keep the person still
- Place heavy towels on both sides of the neck or hold the head and neck to prevent them from moving until emergency care arrives
- Provide basic first aid, such as stopping any bleeding and making the person comfortable, without moving the head or neck
Treatment should be focused upon that individual and tailored specifically to their condition. A treatment programme is formulated following a thorough physical assessment which might include:
- Stretching activities to maintain muscle and tendon length and reduce or keep muscle spasms/spasticity to a minimum.
- Flexibility and strengthening exercises for the whole body.
- Breathing exercises to maximise lung function and prevent chest infection.
- Balance and posture exercises which can help to reduce pain associated with poor posture and balance impairment and ensure correct transfer techniques (in/out of wheelchair, bed, toilet/bath, car etc.)
- Functional activities to improve fundamental movement patterns such as rolling over and sitting up, and standing where appropriate.
- Walking re-education, if there is sufficient muscle activity and power in the legs.
Your physiotherapist might also be able to advise an individual on use of appropriate equipment such as wheel-chairs and pressure releasing cushions, exercise equipment and electrical muscle stimulators.
Because spinal cord injuries are often due to unpredictable events, the best you can do is reduce your risk.
Some risk-reducing measures include:
- Always wearing a seatbelt while in a car
- Wearing proper protective gear while playing sports
- Never diving into water unless you’ve examined it first to make sure it’s deep enough and free of rocks
Extracorporeal Shock Wave Therapy (ESWT) is a highly effective and innovative treatment option in a variety of fields, from urology to cosmetology including orthopedics. This is a non-invasive method that employs high-energy shockwaves to bring about the healing of the affected tissues. It has been found to provide good results for recalcitrant orthopaedic problems like frozen shoulder to certain chronic degenerative or tendon conditions such as Achilles tendinitis (injury of the Achilles' tendon due to overuse) and plantar fasciitis in heel pain.
How does it work?
The procedure is basically an outpatient/ daycare job. It involves the application of a non-invasive probe to the affected tissue. This is followed by the external generation of shockwaves focused on the target area. The shockwaves cause a force to be created that brings about healing. Although it's still not clear as to why this kind of therapy works, the dominant understanding is that shockwaves render an improvement in the flow of blood so as to promote the body to fix and heal itself.
Depending on individual cases, high or low energy waves may be employed. While pain may occur during the transmission of high energy waves and would require short general anaesthesia, low-energy ESWT is carried out without anesthesia.
What problems can this form of therapy effectively tackle?
ESWT can be used to treat a number of musculoskeletal disorders. From plantar fasciitis (heel pain), tennis elbow, shoulder rotator cuff, degenerated tendons (Achilles' tendon) to hip and knee pain, the therapy has been found to reduce pain as well as accelerate healing in individuals.
Complications are very few and far between with this therapy. Individuals who suffer from hypersensitivity or poor sensation in the affected area are usually not recommended this procedure. Even individuals with heart conditions, seizures and open sores need to consult a doctor before going forward with the therapy.
The therapy has also been found to be very effective in bone healing as well as treatment of bone necrosis (a disease that occurs due to permanent or temporary loss of blood flow to the bones). Additionally in place of surgery, ESWT may also be a valuable option for non-healing fractures.