Surgery: Archives

Knee Replacement December 11, 2021

How To Take Care Of Your Knee Pain During Winters

A drop in the temperature can mean an increase in the intensity of knee pain for people suffering from injuries or arthritis. People experience stiffness in joints more than usual during winters. This happens for several reasons, the cold makes muscles feel tight and lead to less flexibility in the joints. This often affects one’s daily routine adding to the physical discomfort. Fortunately, there are ways to prepare for these circumstances and also avoid knee pain altogether. However, it is important to first understand how and why the changes in the weather cause knee pain.

How changes in the weather affect knee pain

Atmospheric pressure changes

Changes in the atmospheric pressure affect the natural gases and fluids in the body, causing the spaces between knee joints to expand with air pressure changes in the environment. That results in pressure on the nerves which then causes inflammation and pain in the joints.

Levels of humidity

A significant drop in temperatures causes complex cellular network damage that is a fundamental component of cartilage and bone. This leads to aggravated pain.

Risk of injury

During winters, the risk of aggravated inflammation and pain due to potential injuries is increased. Cold temperatures are also likely to pose stress on the muscles, especially around the knees, which can prolong your healing process.

Increased nerve sensitivity

Nerves around the knees become hypersensitive due to a drop in temperature causing mild to moderate pain and inflammation in the joints. This aggravates the formation of scars, abrasions, etc if knee injury occurs.

Joint fluid viscosity

A drop in temperature causes enhanced viscosity of a joint fluid. A drop in the temperature increases the thickness of joint fluid which behaves like a shock absorber and prevents friction. This leads to stiffness and pain in the knee joints.

Decreased physical activity

Colder seasons bring changes in lifestyle habits and prevent physical activity. A prolonged inactive lifestyle can result in chronic damage in the knee joints.

Traumatic Knee

Colder weather also tends to decrease the muscle’s reaction time, around the joints involved in knee movements during running. This causes runner’s knee, a condition involving dull pain that occurs mostly during exercise like running, jogging, etc. This weather change increases the risk of damage in the cartilage around the knee cap, causing sore joints.

Jumper’s Knee

This is the condition in which there is an injury to the patellar tendon, which connects the knee cap to the shin bone. Jumper’s knee is characterized by inflammation and pain radiating from the back portion of the knee cap. This pain can be aggravated by jumping, using stairs, or kneeling, as cold temperatures reduce blood flow may render increased stiffness of tendons.

Fortunately, you can prepare for the winter season and manage the knee pain effectively, thus even preventing the pain.

Things you can do to manage knee pain during winters

Keep physical activity consistent

It’s essential to keep your body active, even in the winter months. While you shouldn’t work through significant joint pain without the assistance of a medical professional, stiff or achy joints shouldn’t mean canceling your gym membership.

It is very important to keep your body moving and active in the winter. While it is cozy and warm during the winter, and you feel less motivated to work out or go out altogether, it is essential to maintain your physical activity for your body to remain healthy. Try simple activities like brisk walking, yoga, or indoor swimming so that your joints keep moving.

Avoid cold baths, and prepare for knee swelling

A drop in the temperature means swelling of joints and muscles. Using special knee compresses or bands can help with knee swelling. Avoid bathing in cold water as low temperatures lead to higher chances of experiencing joint pain. Using warm water for baths minimizes joint pain and helps relieve stiffness in the joints. Warm baths are also commonly soothing for everyone, and can specifically soothe knee pain for people suffering from arthritis.

Make sure your posture is good

A major reason for increased joint pain is bad posture. Slouching, constant sitting for long hours, heavy lifting, etc lead to joint pain. Practice maintaining an upright posture during daily chores, and other physical activities to prevent aggravated joint pain during winter.

Stay warm

This may seem like basic advice, but more often than not it is the basics that help you prepare for uncomfortable circumstances as such. Taking care of your joints, especially your knees during winter is essential. Wear sufficient warm clothing while going outside, so that your body is warm against the harsh winter. Adjust your indoor temperatures wherever possible, for example in your home or your car. The body is prone to cold while you are sleeping, hence the use of blankets, heated pillows, or even electric blankets if needed can prove to be quite beneficial in the long run.

While these are preventive measures, they are not going to eliminate your knee pain. If your knee pain is persistent even after these measures you must consult a physical therapist or your doctor to find out the underlying problem and an appropriate solution.

Hip Replacement November 30, 2021

New Techniques For Total Hip Replacement | Advances And Innovations In THA

Many people suffering from arthritis of the hip find relief in medicines, exercises, and weight management programs. However, several patients experience intense pain and discomfort. Doctors may recommend hip replacement surgery for patients who do not get relief from other treatments.

Total Hip Arthroplasty (THA) is one of the most successful surgeries performed in orthopedics. THA provides reliable outcomes such as pain relief, restoration of the joint up to functionality, and overall improved quality of life.

The traditional surgical approach to total hip replacement uses a single, long incision to view and access the hip joint. Another variation is a minimally invasive procedure in which one or two shorter incisions are used to reduce pain and promote a speedy recovery. But, it is not suitable for all patients. You need to discuss different surgical options with your orthopedic surgeon based on your condition.

Traditional hip replacement surgery involves making an incision of 12-18 inches along the patient’s thigh. The doctor then removes the diseased hip joint and replaces it with an implant. THA is a major surgery that requires ample time for the tissue in the body to adapt and adjust to the new implant. The point of the incision also needs time to heal as the muscles and tissue in the leg are disrupted.

Only an orthopedic surgeon can determine whether the patient can opt for a minimally invasive hip replacement procedure. Like every other surgery, a hip replacement procedure comes with its risks. Some of the most adverse events that occur post-surgery are loosening, deformation or infection, fracture of the bone or components, etc.

Advances and Innovations in Total Hip Replacement

Virtual Reality

Thanks to virtual reality, it is possible to replicate the exact feeling of being inside an operating room. The virtual simulation allows for unlimited practice, paving way for the surgical technique to be mastered with great precision, thus reducing potential errors in the procedure. Moreover, multiple operators can simultaneously work on the same surgery, remotely.

Virtual reality opens up new avenues in total joint arthroplasty as it can be used to try new surgical techniques and get familiarised with new instruments and devices.

3D printing technology

In recent years, 3D printing technology is a major advancement in the field that has increasingly been used in total joint arthroplasty. The technology is used to create patient-specific guides, allowing the surgeon to position the implants with precision according to the pre-operative plan. This is called PSI or Patient-specific Instrumentation.

This technology uses CT scans to personalize a preoperative plan for each patient’s anatomy. It aids the operative surgeon to plan and execute with great precision the positioning of the acetabular implant while preserving hip stability.

The development of computer navigation and robotics has led to the minimization of human error and improved the accuracy of implant positioning and restoration of the native hip biomechanics.

Robotic Total Hip Replacement

Robots have different functions. While some operate autonomously, others are active-constrained, i.e the surgeon is in control. In the latter system, a 3D plan based on CT scans is handed over to the operating surgeon based on which they can optimize the surgery. The goal is to complete the procedure with precision to deliver patient-specific operative plans.

Although the role of the surgeon is critical, the robotic arm delivers surgeon-led procedural plans that are based on a complete understanding of the patient’s anatomy to give an accurate outcome to the patient.

Benefits of new technology and advancements in Total hip replacement surgery

Precision

The new advancements in Total Hip Replacement Surgery have led to aiding the medical procedure to be completed with greater precision and hence, results derived for patients are better. The new technology is patient-centric and helps the surgeon understand the particular patient’s anatomy better, thereby delivering what the patient needs. Moreover, as compared to total knee replacement, total hip replacement surgery reduces stress on the bones and increases the life of the implants.

Long term results

Total hip replacement is a long-term solution that enjoys a higher success rate. Evidence shows that 80-85% of hip replacements still function after 20 years of insertion.

Less recovery time & minimally invasive technique

New advancements have resulted in minimally invasive surgeries that require less recovery time. It is likely that the patient may lose less blood and may experience less muscle damage or soreness.

Data from CT scans

Robotic technology presents the potential to capture data from CT scans for processing of the pre-op plan, and final execution of the hip replacement and implant positioning. Using this data and artificial intelligence allows us to tailor our approach to deliver personalized solutions.

Improved Quality of Life

With minimally-invasive and precise procedures becoming possible, thanks to these advancements, the patient can recover sooner and return to their normal lives faster as compared to traditional surgery. Lesser side effects and lower chances of complications also contribute to a fuller, speedy recovery and better quality of life.

Total hip arthroplasty is a safe procedure, resulting in substantial improvements for patients. However, there is a significant increase in the number of THAs in the world, with an even more evident increase in younger patients undergoing the surgery. It is important to note that it is imperative to achieve the best functional outcomes as the population demands utmost functionality post-surgery. To achieve this, the advancements and innovations in the field showcase substantial potential, where improvements are still in process.

Heart Attack November 19, 2021

Life Expectancy After Stenting

Coronary Artery Disease (CAD) is the number one cause of death, disability, and human suffering globally. Once you are diagnosed with CAD you have to learn to live with it by adopting a lifestyle that fits you and your heart health. By lowering the risk factors, you can live your life despite having CAD.

There is a possibility that you may be living with CAD long before you realize it. It creates fear and anxiety due to the close association with heart attacks.

Coronary artery disease occurs when your heart’s primary blood arteries become damaged or diseased. Coronary artery disease is caused by cholesterol-containing deposits (plaques) in your coronary arteries and inflammation. The coronary arteries supply your heart with blood, oxygen, and nourishment. Plaque development can restrict these arteries, reducing blood flow to the heart. Reduced blood flow may eventually result in chest pain (angina), shortness of breath, or other signs and symptoms of coronary artery disease. A heart attack might be caused by a total blockage. Although Coronary Artery Disease (CAD) is not completely curable, the doctor would suggest an option of a procedure known as Percutaneous Coronary Intervention (PCI), which allows one to live a normal life. Coronary angioplasty, also known as percutaneous coronary intervention, is a non-surgical procedure for treating obstructive coronary artery disease that involves inserting a stent through a catheter (a thin flexible tube) into the blocked arteries.

Why is it done?

Coronary Angioplasty restores blood flow to the heart muscle and can improve symptoms of blocked arteries, such as chest pain and shortness of breath.

Does stenting improve long-term survival?

Not guaranteed. It saves your coronary, but stents do not increase a cardiac patient’s long-term survival rate. However, they do give a considerable early and sustained reduction in the requirement for subsequent treatments to reopen the treated artery. While studies have indicated that placing stents in newly re-opened coronary arteries reduces the need for repeat angioplasty procedures, it has also shown that stents do not affect death overtime. The findings have significant economic and clinical consequences for doctors considering whether to perform coronary artery bypass surgery or less-invasive angioplasty with stent implantation on their heart patients.⁵ According to medical opinion, your stents can help you live longer if you manage your other risk factors as per your cardiologist’s recommendations. Diet and exercise, however, are the most important factors to consider. Your risk factors for a heart attack, such as hypertension, diabetes, and obesity, can be controlled by the type and amount of food you eat. Along with these two critical components, follow your cardiologist’s advice and take your prescribed medicines on time to manage your blood pressure, diabetes, and cholesterol. As a result, even after implanting stents in three major coronary arteries, if correctly controlled, you can live a long life.

If you have a heart attack in your late thirties and have stents, is it likely you will not have an average life expectancy?

Over the last few decades, aging has been identified as one of the leading causes of heart attacks, affecting men and women aged 50 and up. People in their 20s, 30s and 40s are now more likely to suffer from cardiovascular attacks.

The guidelines emphasize lifestyle changes and the proper use of medicines as first-line treatment in adults with stable CAD. However, for people suffering from Non-ST Segment Elevation Myocardial Infarction aka NSTEMI (substernal pain while resting or with minimal exertion) and unstable angina; clinical insight is required to assess if other procedures such as CABG (Coronary artery bypass graft) or OMT (Optimal medical therapy) are more appropriate.

Whatsoever the application, PCI should not be viewed as a ‘fast cure’ but rather as a procedure that should be discussed with your doctor to balance the benefits, risks, and limitations.

Source:

https://www.narayanahealth.org/blog/coronary-artery-disease-life-expectancy-and-prognosis/
https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613
https://www.heartandstroke.ca/heart-disease/treatments/surgery-and-other-procedures/percutaneous-coronary-intervention
https://www.onhealth.com/content/1/stents_save_coronaries_not_lives
https://www.verywellhealth.com/do-angioplasty-and-stents-prolong-life-4021221

Cancer November 9, 2021

Prostate Cancer: A Comprehensive Guide

The prostate gland is a small gland found only in males. It produces the seminal fluid that helps transport the sperms. The prostate gland is located below the bladder and in front of the rectum. As the name itself suggests, prostate cancer begins at the prostate gland, when the cells grow and multiply uncontrollably.

Prostate cancer is one of the most common types of cancer, and it may show no signs or symptoms in the early stages. However, patients with prostate cancer have higher chances of complete recovery if the cancer is detected early.

Symptoms of Prostate Cancer

As mentioned above, prostate cancer does not show any signs or symptoms during the earlier stages. Some common symptoms visible during the advanced stage of prostate cancer are:

Trouble urinating, or the need to urinate more often than usual
Blood present in the urine
Blood in the semen
Erectile dysfunction
Pain in the bones – especially the hips, spine, and ribs
A feeling of weakness/numbness in the feet
Loss of weight

While most of these signs and symptoms may point to several other underlying conditions or diseases, it is necessary to talk to your healthcare provider if these symptoms are persistent or continue to worsen.

What causes prostate cancer?

Though the causes of prostate cancer remain unclear, it is known prostate cancer occurs when the cells in the prostate mutate. The mutation causes cells to grow and multiply rapidly, forming abnormal cells. The abnormal cells continue living, while the healthy cells die. These growing abnormal cells form a tumor and invade the nearby tissues or organs. Gradually, these abnormal cells also spread to the other parts of the body, causing cancer to grow.

Risk Factors of Prostate Cancer

Several factors can increase the risk of prostate cancer, such as:

Age: The risk of prostate cancer increases with age. Prostate cancer is more prevalent among men over the age of 50.

Ethnicity: For reasons unknown and undetermined, prostate cancer is more common among men of African-American descent. As per to urology.org, African-American men tend to get diagnosed with prostate cancer at an earlier age, and the cancer is likely to be aggressive in growth.

Family History: Men with a family history of prostate cancer have higher chances of being diagnosed with the same. A strong family history of breast cancer can also increase the chances of one developing prostate cancer.

Obesity: People who are obese have higher chances of developing prostate cancer, compared to those who maintain a healthy weight.

Prostate Cancer Diagnosis

If your doctor suspects that you might have prostate cancer, he might enquire about your symptoms such as urinary and sexual problems. He might also ask you about possible risk factors such as your family history to analyze the chances of you developing prostate cancer. after this, the doctor will run several diagnostic tests to diagnose the disease:

Digital Rectal Exam (DRE): During this, the doctor might insert a gloved finger into your rectum to examine the prostate, and feel for any bumps or hardened areas. If the doctor finds any abnormalities in the shape or size of the gland, he may advise further tests.

PSA Blood Test: A blood sample is taken and tested for PSA. PSA stands for Prostate-specific Antigen, which is a protein produced by the prostate gland. It is normal for a small amount of PSA to be found in your bloodstream. However, if it is higher than usual, it may be an indication of prostate cancer.

Ultrasound: During this test, a small probe is inserted into the rectum, and uses soundwaves to create images of the prostate gland.

MRI: Magnetic Resonance Imaging (MRI) scan may be suggested by your doctor to create a more detailed picture of your prostate gland.

Biopsy: The doctor may also collect a sample of cells in your prostate gland to check for signs of cancerous cells. This procedure is known as a prostate biopsy. A thin needle is inserted into the prostate to collect a sample of the tissue.

If you are diagnosed with prostate cancer, the doctor may use tests such as ultrasound, CT scan, or MRI to determine the stage of cancer.

Treating Prostate Cancer

The treatment for prostate cancer depends on how aggressive the cancer is and the extent it has spread. The right treatment option will also be chosen depending on the side effects and their impact on overall health.

Surgery: This involves removing the prostate gland, along with some nearby tissues and lymph nodes. Surgery is usually performed when the cancer is confined to the prostate. It may also be used to treat advanced prostate cancer combined with other treatment methods.

Radiation Therapy: This involves using high-powered radiation to kill the cancerous cells. This can be performed externally (external beam radiation) or internally (brachytherapy), by placing radiation sources in the prostate tissue.

Cryotherapy: This treatment involves using extremely cold gases to freeze the prostate tissue. After this, the tissue is allowed to thaw, and the procedure is repeated.

Hormone Therapy: This treatment stops the body from producing testosterone, the male hormone. Since prostate cancer cells rely on testosterone to grow, cutting the hormone supply may cause the cancerous cells to die.

Chemotherapy: This therapy uses drugs to kill the rapidly growing cancerous cells. Chemotherapy is usually used when cancer has spread to the other organs and areas of the body.

Immunotherapy: As the name itself suggests, this therapy involves using the immune system to fight cancer cells. The immune system usually does not attack cancer cells as they produce proteins that help protect the cancer cells. Immunotherapy interferes with this process.

Targeted Therapy: This treatment emphasizes the abnormalities present in the cancerous cells. Targeted therapy blocks and combats these abnormalities, causing the cancer cells to die.

Though several factors increase the risk of developing prostate cancer, early detection and following a healthy lifestyle can help nip prostate cancer in the bud. Though certain risks such as age, family history, and ethnicity cannot be avoided, other factors such as obesity can be avoided by maintaining a healthy diet and exercising regularly. Talk to your healthcare provider immediately if you notice certain symptoms and take the necessary precautions!

Cancer November 9, 2021

Lung Cancer Awareness Month

Lung cancer is the most common cancer in the world. According to the World Health Organization, there were 2.21 million cases in the year 2020. It is the most common cause of death around the world. Patients have a 13 times better chance of living for five years if they are diagnosed early. Lung Cancer Awareness Month (LCAM) is celebrated every year in November to raise awareness about the disease and continue to challenge the stigma associated with lung cancer.

The goal of the month is to urge individuals to seek medical assistance sooner rather than later, to encourage early diagnosis so that patients have the best chance of a successful treatment, and to emphasise other key aspects that affect patient outcomes. Educating people on the complexity of lung cancer, the vast spectrum of people who are affected, and the harmful effects of lung cancer stigma can aid in earlier diagnosis and better patient treatment. Furthermore, LCAM is also an occasion to highlight therapeutic developments, advocate for global access to care, and, most importantly, demonstrate our support for patients and their loved ones.

Facing the stigma

Lung cancer is often misunderstood to be solely a smoker’s disease. However, more than half of individuals diagnosed are former smokers or non-smokers. This misunderstanding has been associated with poor outcomes due to factors like waiting too long to seek treatment, disease-related distress, a lack of social support, and poor care quality.

What you need to know about Lung cancer

Cancer is a condition in which the cells of the body grow out of control. Lung cancer is cancer that starts in the lungs and spreads throughout the body. Lung cancer begins in the lungs and can spread to the lymph nodes or other organs in the body, including the brain. Cancer that has spread to other organs may extend to the lungs as well. Metastases are the spread of cancer cells from one organ to another.

There are two types of lung cancer:

Small cell lung cancers (SCLC) and non-small cell lung cancers (NSCLC) are the two forms of lung cancer. This classification is based on the appearance of tumour cells under a microscope. Making the distinction between these two types of tumours is critical since they develop, spread, and are treated differently.

SCLC accounts for roughly 10% to 15% of all lung malignancies. This form of lung cancer is the most aggressive and fastest-growing of all. Cigarette smoking is highly linked to SCLC. SCLCs spread quickly throughout the body, and they are usually detected after they have spread widely.

The most common type of lung cancer is non-small cell lung cancer (NSCLC), which accounts for roughly 85% of all occurrences. NSCLC is divided into three categories based on the cells detected in the tumour. They are as follows:

Adenocarcinomas, like other lung cancers, are linked to smoking, this form is also seen in nonsmokers, particularly women, who get lung cancer. The majority of adenocarcinomas develop in the lungs’ periphery. They have a proclivity for spreading to lymph nodes and beyond.
Squamous cell carcinomas used to be more common than adenocarcinomas, but now they make up around 25% to 30% of all lung cancer cases. Squamous cell tumours are most common in the bronchi of the central chest. This type of lung cancer tends to stay in the lung, spread to lymph nodes, and grow large enough to produce a cavity.
Large cell carcinomas, also known as undifferentiated carcinomas, are the least prevalent kind of NSCLC, accounting for 10% to 15% of all lung cancer cases. This malignancy has a significant proclivity for spreading to lymph nodes and distant locations.

Adenocarcinomas, like other lung cancers, are linked to smoking, this form is also seen in nonsmokers, particularly women, who get lung cancer. The majority of adenocarcinomas develop in the lungs’ periphery. They have a proclivity for spreading to lymph nodes and beyond.
Squamous cell carcinomas used to be more common than adenocarcinomas, but now they make up around 25% to 30% of all lung cancer cases. Squamous cell tumours are most common in the bronchi of the central chest. This type of lung cancer tends to stay in the lung, spread to lymph nodes, and grow large enough to produce a cavity.
Large cell carcinomas, also known as undifferentiated carcinomas, are the least prevalent kind of NSCLC, accounting for 10% to 15% of all lung cancer cases. This malignancy has a significant proclivity for spreading to lymph nodes and distant locations.

Types of Treatment

Depending on the type of lung cancer and how far it has gone, there are numerous treatment options. Surgery, chemotherapy, radiation therapy, targeted therapy, or a combination of these treatments can be used to treat non-small cell lung cancer. Small cell lung cancer is usually treated with a combination of radiation and chemotherapy.

Surgery: A procedure in which surgeons remove cancerous tissue from the body.
Chemotherapy: Special medications are used to shrink or kill cancer cells. The drugs can be pills that you consume or medicines that are injected into your veins, or both.
Radiation therapy: Treatment that involves the use of to kill cancer, high-energy rays (similar to X-rays) are used.
Target therapy: Drugs are used to stop cancer cells from growing and spreading. The drugs can be taken orally or administered intravenously. Before targeted therapy is employed, tests will be performed to determine if it is appropriate for your cancer type.

In the treatment of lung cancer, doctors from various specialties frequently collaborate. Pulmonologists are doctors who specialise in lung illnesses. Surgeons are medical professionals who carry out procedures. Thoracic surgeons specialise in surgery of the chest, heart, and lungs. Medical oncologists are doctors who specialise in using medications to treat cancer. Radiation oncologists are doctors who use radiation to treat cancer.

It is important to educate yourself and your loved ones about the most common type of cancer so that lives can be saved. If you notice anything unusual contact your doctor immediately.