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It is said that anything that causes an increase in pressure in the abdomen can cause a hernia. It is usually innocuous and painless, however, time and again it can bring utmost pain and discomfort especially on doing certain activities which we will discuss further in the blog. Though, anyone can develop a hernia at any age, adults are more likely to have an inguinal hernia. Among adults, the chances of having an inguinal hernia increase with age. Hence, it becomes important to follow certain precautionary measures in order to avoid getting one. Adults who frequently find themselves doing strenuous sports and physical activity, particularly weight-lifting, can develop an inguinal hernia. However, hernias are not just caused by lifting heavy weights, but could be congenital or may also be caused by a bad adult lifestyle i.e. smoker’s cough, and other conditions like COPD that cause heavy coughing, which exerts pressure on the abdominal wall. It is always recommended for both males and females to not ignore any type of hernia and seek immediate medical attention if any discomfort stays for a long period.

Now let’s go deeper in understanding exact reasons that contribute to the causes of hernia in adults.

In simple terms, hernia is a protrusion of the inner organ or part of the organ through a weak muscle area. Although there are multiple reasons for a hernia, below are some common contributing factors of muscular weakness or tension that can cause hernia in adults.

  • A congenital condition – a defect that may be present during infant development but is detected during adulthood.
  • Muscular weakness due to advanced age or as a result of an injury or surgery. Reasons such as obesity, smoking, and an unbalanced diet can lead to the weakening of muscles in the abdominal region which can cause a hernia.
  • Constantly recurring respiratory disease or coughing can put strain on the weak muscles.
  • Performing heavy exercises or frequent lifting of heavy objects.
  • Multiple pregnancies (twins, triplets and more) can cause a hernia. Pregnant women have a higher risk of getting one due to an increased pressure on the abdomen during pregnancy.
  • Longstanding chronic constipation and pushing hard for a bowel movement can be a big cause of hernia in adults.
  • Accumulation of more fluid (>25 ml) in the abdomen area could be a cause of hernia in adults due to the increased pressure of fluids.
  • Obesity/ overweight is another factor because it increases the strain and pressure on the abdominal muscles, therefore making them weaker and more prone.

Each kind of hernia has various causes in adults, which implies that the measures you take to intercept them will also be moderately different. However, consuming a high fiber diet, maintaining a healthy weight, and quitting smoking can help curb a hernia. Please note that not all of them are preventable and it’s always advisable to seek proper medical care to avoid severe consequences as they cannot heal on their own. And, just in case you’re experiencing any discomfort while sitting, walking or performing any routine physical activities then contact your primary care provider as soon as possible and request an appointment.

Although Mr. Shivdas Swami is 74 years old, after going through the TAVR procedure, he feels that he has turned 47 years and is delighted to get back to his daily routine, farming. He also plans to visit Kashi Vishwanath temple and fulfill all his incomplete dreams. He gives equal credit to the doctors who counseled him well and boosted his confidence to go through the procedure.

Hernia? Isn’t that something that happens only to athletes or only bodybuilders and weightlifters?
You may also have such similar questions in mind but the truth isn’t the same. Hernias happen more often than you think. A hernia can happen to men, women, and children. However, overall hernias do tend to be more common in men than women. You may not be born with a Hernia but you may end up getting one. Not many know but Hernias can cause complications that can be life-threatening. It’s important to seek emergency care if you experience symptoms. Though Hernias often show no troublesome symptoms, frequent abdominal complaints may signal a serious problem. Let us now learn more about Hernia and its various types.

What is a Hernia?

A hernia occurs when an internal organ or fatty tissue compresses through the wall of tissue or muscle that contains it which is referred to as the fascia. Most hernias are found within the abdominal cavity which lies between the chest and hips. Usually, an abnormal bulge under the skin of the abdomen near the groin or the navel is observed. Anything that increases the pressure in the abdomen can result in a hernia, this can be by lifting heavy objects, diarrhea or constipation, obesity, persistent coughing or sneezing or even after giving birth.

There are mainly six types of Hernias: Inguinal Hernia, Femoral Hernia, Umbilical Hernia, An incisional hernia, Epigastric Hernia, and Hiatal hernia.

  • Inguinal Hernia: This is one of the most common forms of Hernia which usually affects men more often as compared to women. In an Inguinal Hernia, a part of the intestine penetrates a little into the groin at the top of the inner thigh through the inguinal canal post-birth after which the canal is supposed to close almost completely behind them. This type of Hernia may be painful or touch-sensitive. Some symptoms may include swelling in the groin, burning sensation or pain while coughing and while bending over.
  • Femoral Hernia: A femoral hernia is common in women as compared to men. A part of the intestine or the fatty tissue enters the canal that carries the femoral artery into the upper thigh. Women who are obese or pregnant have a higher chance of having a femoral Hernia. Most femoral hernias cause no symptoms but one may have some groin discomfort. It may get worse while standing, lifting heavy objects, or strain.
  • Umbilical Hernia: Common in infants and sometimes also affects obese women or the ones who have had many children. This is caused when a part of the small intestine protrudes through the abdomen near the navel. Umbilical hernias in children are usually not that painful but if they appeared at an older age then it may cause abdominal discomfort, vomiting, etc.
  • Hiatal Hernia: A hiatal hernia is when your stomach bulges up into your chest through an opening in your diaphragm, the muscle that separates the lungs from the abdominal organs. The opening is called the hiatus, so this condition is also called a hiatus hernia. A lot of people might not notice any symptoms but few might have heartburn, bloating, burping, upset stomach and vomiting.
  • Incisional Hernia: This is more prominent if you’ve had any previous abdominal surgery. The intestine pushes through the abdominal wall where the surgery had occurred. Apart from a prominent bulge, incisional hernias might also cause nausea, vomiting, diarrhea, thin stool, burning sensation and fever.
  • Epigastric Hernia: In Epigastric hernia, a fatty portion of the intestine pushes through the abdominal wall between the belly button and the chest. The bump or bulge caused due to this phenomenon is visible all the time or sometimes only when one coughs, sneezes or laughs. This type of Hernia is often seen more in men than in women. It is said the epigastric hernia may occur due to increasing tension on the abdominal wall near the diaphragm.

Ultimately, the fact is that one can get Hernia either by birth or can develop as they age. The treatment for hernia can be either surgical or non-surgical. However, most of the Hernias need surgical repair. It is always recommended to get yourself checked by an expert as soon as any of the above-mentioned symptoms continue to cause severe pain and discomfort.

With so much debate going around the risk of Hernia and chances of returning to normal life post a Hernia surgery, it becomes very important for people to have a deep understanding of the problem first and some of the most common types of Hernia that are often seen in individuals. For the people who don’t know, a Hernia occurs when an internal organ or fatty tissue compresses through the wall of tissue or muscle that contains it which is referred to as the fascia. There are various types of Hernias e.g  Inguinal Hernia, Femoral Hernia, Umbilical Hernia, an Incisional Hernia, Epigastric Hernia, and Hiatal Hernia but the most commonly found ones are Hiatal and Inguinal. Though many Hernias occur in the abdominal region between your chest and hips, they can also appear in the upper thigh and your groin area.

Although anyone of any age can get a Hernia, a child, the elderly, smokers, and the obese stand a much higher chance of developing one. People who have already had Hernia surgery are also vulnerable to getting Hernias again. But, nothing to stress about, it is crucial to treat Hernia just like any other health problem in life which tends to worsen if not addressed on time. Mild symptoms can later be turned into serious ones and hence, early detection and treatment become very important in the case of Hernia too. Let us now learn more about the most common types of Hernia and its symptoms.

1) Hiatal Hernia

A Hiatal Hernia occurs when the upper stomach squeezes through the Hiatus through which the esophagus passes. A lot of people might not notice any symptoms of Hiatal Hernia but in some cases, patients have raised issues like heartburn, a feeling of burning in the lower chest area. It mainly happens when the patient is lying down or is in a bending position, preferably after meals. This heartburn may get worse after consuming citrus fruits, spicy food, raw onions, carbonated drinks and even alcohol. Below are a few other symptoms of Hiatal Hernia:

  • Feeling bloated
  • Bad taste in the throat region, or belching
  • Acid Reflux
  • Difficulty in swallowing
  • Abdominal pain
  • Breathing problems
  • Vomiting
  • Black stools which reflect Gastrointestinal bleeding

2) Inguinal Hernia

In an Inguinal Hernia, the intestine or the bladder get extended beyond the abdominal wall or into the inguinal canal in the abdomen. 96% of all groin Hernias are Inguinal by nature, and the majority of them occur in men because of a natural weakness in this area. Here are some of the common symptoms of an Inguinal Hernia:

  • Swelling/lump in the pubic region
  • Burn or pain in the swollen area
  • Groin pain, especially during bending or coughing
  • Heaviness in the groin or Pain
  • Swelling in the testicular region

Though there’s not a lot that one can do to avoid getting Hernia from developing, there are a few steps you can follow to reduce the pressure on your abdominal muscles like avoiding heavy lifting or doing it in a right manner, maintaining a balanced diet, maintain healthy body weight,  etc.

Remember, it is very important to not take any stress as it can be effectively treated with surgery. You can get back to living a normal life a few months after the surgery. 

Life after a hernia surgery could be a little tricky. Though with the help of a hernia repair surgery you manage to get the problem fixed and are hoping to get back to your normal life, it is important to ensure that all the necessary instructions suggested by the doctor are followed. Most people do not face any long term problems after a hernia repair but a brief recovery period is necessary for all hernia cases. Children might face a lot of pain and would require extra attention in the initial days after a hernia surgery but this is considered normal and is expected to pass with time. Most children and adults are discharged within a few hours after a hernia surgery depending upon the severity but usually, an overnight stay is recommended for people with a medical history.

One of the major risks associated with hernia repair surgery is that the hernia can return. And, If there is a hernia repair failure and the hernia somehow reappears, then it is called as a recurrent hernia. Hence, it becomes even more important for you to take all the precautionary steps to avoid the recurrence of a hernia. The recovery period post a hernia surgery completely depends on the type of hernia and surgery performed. A laparoscopic surgery that uses minimally invasive procedures has been proved to be highly safe and effective. Also, the overall recovery time has reduced and lesser post-operative trouble is seen.

Let us now look deeper into some of the most common precautionary measures to follow irrespective of the patients or the surgeries performed. Below are a few points to keep in mind post a hernia surgery:

  • Regular walking: As per your doctor’s instructions, try to stay active as much as you can. Take a walk indoors to boost your blood flow and to prevent constipation. Take sufficient rest as you are more prone to unrelenting tiredness. Although your doctor’s advice will depend on your surgery type, most patients post a hernia surgery are recommended to stay away from lifting heavy objects for the initial two weeks.
  • Adequate rest: Though the laparoscopic hernia surgery patients can return to their routine much earlier, it is still favored to follow a complete bed rest for the entire first-week post-surgery, preferably in complex patient subsets.
  • Avoid lifting heavy objects: Tasks that put strain to the groin must be avoided at all costs and if your job involves manual labor, you may need a prolonged resting period before resuming your work but you can return to your desk jobs by the second week after surgery.
  • Healthy Diet: You should focus more on your diet especially after a hernia repair surgery by consuming plenty of fluids and fiber-rich foods like fruits, vegetables, whole grains, oatmeal, bran, etc.  to prevent constipation and strenuous bowel movement. Additionally, avoid consumption of citrus fruits such as lemon, orange, smoking, and alcohol as it can prolong your recovery process or even lead to complications.
  • Avoid sex after any hernia surgery: Usually, it is advised to avoid having sex immediately after the hernia surgery that may add extra pressure near the groin area. You can get back to a precaution-free and active lifestyle, 4-6 weeks post-surgery and may resume your regular gym sessions as per your doctor’s instructions.

Keep these tips in mind and follow them religiously for a better recovery post-surgery. In case, you start bleeding or show any symptoms of an infection, immediately consult your doctor. Also, don’t forget to miss out on your regular appointment for a safe recovery.

There are ailments, which most of us just see as a small hurdle to our lives, and then there are ailments that need to be ‘operated’ upon; which, for most of us, becomes a life-changing decision.

People tend to look at non-surgical options for ailments whenever they can. This is largely due to the fear of going under the knife, even for routine surgery.

The same applies to Hernias as well. Due to the commonality of the ailment, there are a variety of treatment options available for people which include both surgical as well as non-surgical options. To begin with, the non-surgical options include:

  • Dietary Changes: For people suffering from Hiatal Hernia, small changes to their diet can help relieve the pain caused due to the ailment. As it occurs in the stomach, people can soothe the pain by avoiding heavy meals or doing any immediate physical activity like lying down on bending over after a meal. Bear in mind, doing so can only help manage the pain to an extent. While this gives temporary respite, it doesn’t make the hernia go away, and for that, you need medical intervention.
  • Medication: When you do feel the symptoms of hernia like acute pain or unnatural bulges in any part of the body, consult a doctor immediately. Depending on the size and seriousness of the hernia, they will recommend a course of medicine. These may include basic antacids, H-2 receptor blockers, and proton pump inhibitors. In the case of Hiatal Hernia, the purpose of these medicines is to reduce discomfort by decreasing stomach acids.

Medications will help manage your hernia better. But if the pain is extremely difficult to manage, you will need to look at surgical intervention to remove it. Fortunately, both these options are non-complicated and carry very limited surgery-associated risks. So, if you do need to get a hernia removed, here’s what you can look at.

Open Hernia Repair

In an Open Hernia repair, referred to as Herniorrhaphy, the surgeon will make an incision after giving the patient local anesthesia. This incision is done in the groin region and the doctor then moves the hernia back in place or removes it altogether. Then, the weaker muscle wall will be strengthened via stitches to avoid it from forming again. More often than not, the muscle areas facing weakness will be reinforced with a synthetic mesh placed by the doctor. This procedure is called a Hernioplasty.

Laparoscopic Surgery

As a second option, your doctor may ask you to opt for a Laparoscopic Surgery. In this, a doctor uses a Laparoscope, which is a slender tube that has a camera attached to it. With its help, the doctor can see the exact location of the hernia and it’s surrounding tissue. Then, using a synthetic mesh, the surgeon carefully repairs the Hernia. Patients who undergo laparoscopic surgery generally see quicker recovery times, but getting one depends completely on the recommendation of the doctor. This procedure is only done after considering the size of the hernia and the patient’s medical history.

When it comes to treating a hernia, there are a lot of options that your doctor can recommend for you. But at the end of the day, they know best when it comes to treating you. So, while there are non-surgical methods to manage your hernia, if the doctor recommends surgery, do opt for it!

Whether you have just commenced exploring treatment options for your hip pain or already have decided to go for a hip replacement surgery, we’ve got some information that might help you in your decision making. It has been proven that hip replacement surgery is one of the most successful procedures performed by orthopaedic surgeons for relieving chronic hip pain. With more than 90% success rate, hip replacement implants have managed to drastically reduce pain and improve function for people with damaged joints. The most conventional reason for having a hip replacement is osteoarthritis while other possible reasons include rheumatoid arthritis, a hip fracture or hip dysplasia; a condition where the hip joint hasn’t developed properly. It is essential to understand that a hip replacement implant is usually done when all other options including medication have failed to provide sufficient pain relief. The main objective behind the procedure is to relieve a sore hip joint, thus making walking and other activities easier.

The surgery involves taking off parts of the hip joint that are problem causing (usually the ball and socket) and then replacing them with new parts made from metal, plastic, and ceramic. Many people undergo this surgery every year and it usually brings great effects in terms of enhanced strength and well-being. However, it’s always vital to discuss with your doctor about the probable risks involved in it.

The material for the hip implant is normally selected by your surgeon depending on your medical condition and unique requirements. Full metal implants are now not readily preferred by surgeons due to the high risk of metal poisoning. Thus came titanium metal and ceramic implants at your rescue. Let’s find out how both of these are different from each other and which one can be the right fit for you.

Ceramic Implants

Ceramic hip implants are among the latest type of prosthesis being used for hip replacement, giving greater resistance to damage and smooth movement of the joint. For those who are not aware of Ceramic material, it’s a tough substance and does not get worn out easily as compared to metals and plastic. However, ceramic is also not completely devoid of problems. They tend to develop cracks and breaking down easily. However, newer ceramic materials have demonstrated lesser problems but, long-term clinical outcomes with ceramic implants are less published contrary to the metallic implants. This fact somewhat restricts the preference for ceramic implants.

Titanium Implants

Most hip implants these days consist of Titanium. Both the ball and the socket of the hip joint are replaced with a titanium implant, and a plastic spacer is placed in between. Titanium metal has a long history of established effectiveness in hip replacement and continues to be preferred by many surgeons. Based on current practice, metal (Titanium) implants are preferred in aged patients, while ceramic implants are being increasingly recommended in younger candidates due to their reliable durability.

Despite rising concerns over metal and other material implants used in the surgery, the majority of the hip replacement implants have been successful and have improved the quality of life and function.

To round off, when it comes to choosing the best material, both have their pros and cons. While ceramic does not get as worn out as metal or plastic, they can develop cracks or break suddenly.  It will eventually depend on the surgeons to pick the best one for you after analyzing the risks and benefits of various implants.

Condition of COVID 19 pandemic in the USA

When the dreadful novel coronavirus reached the USA, it granted the USA an exclusive luxury of “perception after the fact”. The virus’s biological character and course were already revealed in China, and its genome had also been charted. It was already established that it was a novel virus corona without known treatment or prophylactic means. It was known that only non-drug-based interventions like quarantine, isolation, and social distancing could aid in containing its spread.

Still, the USA turned out to be the epicenter of the COVID-19 pandemic and as of now, suffers the highest death toll. As of April 10th, it possessed 30% of confirmed cases and 18% of COVID-19 deaths in the world.

As the USA is a superpower, there was even no lack of commitment, skill or financial means to counter the pandemic. The first confirmed case of COVID-19 in the USA was detected on January 21st.

Reasons of non-containment of coronavirus in USA

The reasons are as much cultural as these are political:

  1. Higher Air Traffic with China
  2. Preference for Personal Freedom: Politicians in the USA are seriously afraid to do anything that can be demonstrated to violate citizen’s rights. Their individual freedom is given foremost importance which makes, essential limitations on public activities, hard. However, unexpected times need unexpected solutions. Before the above realization, thousands of citizens were already infected and dead in the community.
  3. Private Healthcare System: The healthcare system in the USA is largely private which makes organizations among different hospitals and public health officials more challenging as compared to a centralized healthcare system. Any well-meant reform in the healthcare sector by the government is perceived as communist and is violently opposed. Also, profit drive in the healthcare industry gave slight respite for dealing with crises of such nature. Consequently, poor American minorities, forced out of the medical insurance net, and forced to work through the crisis are being increasingly affected by the disease and related fatalities.
  4. Disjointed Central and State Response: US bodies such as CDC had substantial problems initially in developing and introducing COVID-19 testing, which made it increasingly tough to ascertain the range of the disease outbreak. Also, state authorities did not co-operate with the federal government in policy implementation.

Condition of India as compared to  the USA amid global COVID 19 crisis

India is still a lower-middle-income country. It witnessed her first case on January 30th, 2020. India with almost 430% of the US population and just 14% of US GDP has seen far fewer infections and deaths due to COVID 19. There are several learning here related to India’s success story.

  1. Strong Leadership: Prime minister of India understood the magnitude of the situation early and was swift to seek faith of the countrymen on the need for compulsory strict measures needed to preserve lives. Early lockdown implementation at the national level prevented the pandemic to spread without control. Currently, India stands unified regardless of political affiliations at state levels.
  2. Effective Policy Implementation at Grass-root Levels: Reflecting the urgency at the capital level, district and rural bodies, also understood the seriousness of the problem at hand and contributed to an already motivated bureaucracy in curbing the pandemic. Its outcomes can be witnessed in the significantly lesser numbers of COVID 19 cases seen in the rural and semi-urban areas of India.
  3. Disaster preparedness: India’s frequent encounter with natural disasters has facilitated the countrymen to develop a seamless response system where hundreds of workers are organized rapidly. These acts and rules of disaster management are traditionally verified, effective, and devoid of political interference. Such freedom to take spot assessments and act peculiarly to unique ground situations is the strength of the Indian system of governance.
  4. Full Supply of Empirical HCQ: Due to the inherent Indian policy of helping its partners, India was generous in supplying Hydroxychloroquine tablets to countries including the USA and the entire world, which bore good outcomes in terms of exchanging ideas, apart from saving lives at home.

However, there is a caution to this analysis. The USA consists of significantly higher air traffic than India and containment would have always been comparatively tough in the USA.

The COVID-19 pandemic continues challenging healthcare systems globally. As per an estimate, we are yet to experience the complete impact of the outbreak, despite practicing social distancing. Surgeons also require to aid in policy implementation for helping to tackle the potential rise in COVID-19 patients at their respective hospitals. Regarding this fact, it is recommended that surgeons and hospitals cut down the number of “elective” surgical procedures to reduce patient traffic. However, owing to the uncertainties in defining the surgeries, elective surgeries can realistically be classified into essential or non-essential procedures, which means that there is an elevated risk of adverse results by delaying the “essential” elective surgery compared to a non-essential elective procedure, which is purely not time-sensitive as far as medical emergencies are concerned.

Why are elective surgeries on hold?

Surgical patient’s stratification will help in accurate decision-making and reduce patient-burden in each hospital and also aid in proper resource allocation. As per this stratification, essential elective procedures bear an urgency of carrying out the surgery in 1 to 3 months and include cancer surgeries, cardiac valve surgeries, hernia repair, hysterectomy, reconstructive surgeries, etc. Contrary to the above procedures, discretionary elective procedures can be delayed by 3 months or more, such as cosmetic, bariatric, joint replacement surgeries, or others. Elective surgeries should preferably be postponed before it seems necessary. Postponing surgeries will cut needless patient movement in the hospital and lessen the likelihood and the spread of disease between symptomatic and asymptomatic patients and hospital staff. Also, the reduction in surgeries saves healthcare assets including hospital beds, personal protective equipment, along with maintaining the health of surgical staff.

The need for postponing “elective” surgeries is vital because:

1. Elective surgeries need “personal protective equipment” which is in short supply presently and is badly needed by health care providers in the areas worst affected by the pandemic for caring for COVID-19 patients.

2. Surgical patients or their caretakers may be an undiagnosed case of COVID-19, which may be spread to the health care staff and others in the hospital.

3. Operating rooms require ventilators that may be needed to support COVID-19 patients rather than being utilized for elective surgeries.

If your “elective” surgery is delayed, you need to follow certain precautions until your surgery is rescheduled:

  1. Change your activities to avoid positions that may cause pain and discomfort
  2. In some extreme cases, injection of a heavy dose painkiller may be given by your doctor
  3. Use NSAID to control your pain or swelling
  4. Apply ice or heat pads to the affected area, depending on your comfort levels
  5. Try restricting your movement levels and avoid lifting heavy loads
  6. Try conservative treatments such as physical therapy if you have been a patient of arthritis
  7. Immediately consult your doctor if your condition becomes unbearable and you need an emergency operation

When an infectious disease outbreak begins, the ultimate response is for public health officials to begin testing for it early. Without any doubt, one can say that testing is one of the principal factors responsible for countering COVID-19’s spread around the world. More testing leads to more identification of positive cases and helps in responding faster to those who are suffering. It does not only help in understanding who needs complete isolation and needs immediate attention but also helps in stopping the transmission of the virus from one region to another. 

Testing also helps in identifying the precise rates of infection and survival. Let us now understand the working of these tests in particular and who all are required to get one done. 

How does the test work? Currently, two kinds of tests are available to detect COVID-19 infection in suspected patients. The most widely used test type to detect the SARS-CoV2 (COVID-19 virus) is the RT-PCR (Reverse Transcription-Polymerase Chain Reaction) test which targets the RNA of the virus (organ of the virus responsible for its replication). This type of test can identify even a single virus particle present in swabs taken from a suspected patient’s mouth or nostrils. Another test quantifies the immune (antibody) response against the virus in the blood serum of the patient. In this test, a test tube is coated with the virus components and then a minor quantity of diluted blood sample from the patient is added in the test tube. If any antibodies are present in the blood, they will bind to the coated virus components.

Who should take the test? Because of the limited amount of test kits, the medical authorities and the doctors are taking a final call on who needs one and who doesn’t need a test at all. The main objective behind this approach is only to identify as many cases as they can with whatever resources they have available. Hence, we’ve have highlighted a few points that can help you understand if you need to get yourself tested or no.

  • All patients having symptoms of the disease and have traveled internationally in the last 14 days
  • All persons who have been in contact with patients having symptoms of the disease
  • All healthcare workers who show the disease symptoms
  • All patients having symptoms of severe acute respiratory disease/Flu
  • Persons who don’t show symptoms but have been in direct and high-risk contacts of a confirmed case should be tested once between day 5 and day 14 of coming in his/her contact