Surgery: Archives

Peripheral Vascular February 1, 2022

What is Peripheral vascular system, and Peripheral vascular disease: Signs, Symptoms, and Treatment

The Peripheral Vascular System is part of the body’s circulatory system which supplies to & receives blood from all parts of the body except Heart and Brain. The Peripheral Vascular system consists Peripheral Arteries which are responsible for oxygenated blood to get supplied from heart to all body parts, and Peripheral Veins carry deoxygenated blood from the extremities back to the heart.

What is peripheral vascular disease?

Peripheral Vascular Disease or PVD is a blood circulation disorder.

In this condition, your blood vessels narrow or get blocked or spasmed outside the heart and brain.

Peripheral vascular disease can happen in both arteries and veins throughout the body, but often affects the leg’s arteries the most causing fatigue particularly during exercise. This is called intermittent claudication.

One of the major causes of it is arteriosclerosis which is Plaque building up in a vessel and limiting blood flow and oxygen. As plaque build up progresses, it can reduce or completely block the blood flow in that artery leading to organ damage, loss of fingers, toes, etc.

This condition is different from Coronary Artery Disease and Cerebrovascular disease; these are when the narrowing happens in the heart or the brain respectively.

The Types of PVD

There are two types of Peripheral vascular disease: Functional and Organic

Functional PVD

Vessels widen and narrow in response to brain signals, temperatures changes, etc causing a decrease in the blood flow when vessels are narrowing.

There is no physical damage to your blood vessels’ structure in functional PVD

The common causes of Functional PVD are emotional distress, colder temperatures, operating vibrating machinery or tools, drugs.

Organic PVD

This is caused due to Physical damage like plaque Built up, inflammation and more. There is damage to the physical blood vessels’ structure. The primary causes of Organic PVD are diabetes, high cholesterol levels, smoking and high blood pressure.

Risk factors

Some lifestyle factors majorly affect your body, hence putting you at a higher risk for PVD. For instance,

Overweight,
Age above 50,
History of stroke or cerebrovascular disease,
Abnormal cholesterol levels,
Family history of
- High cholesterol
- Heart disease,
- Blood pressure
- PVD
- Kidney disease on hemodialysis.

Symptoms of Peripheral vascular disease

For majority, the first sign of PVD is fatigue and discomfort in your legs and feet, which gradually gets worse due to physical activity and lack of blood flow. This sign is rather slow and irregular but persistent.

The major symptom is Claudication. Claudication is lower limb muscle pain experienced while walking. You may notice the pain increasing when you walk long distances or faster and the pain subsides after some rest, but when the pain returns it takes some time to recede.

Other than the pain, some other symptoms also include

Reduced hair growth in the legs,
Cramps while lying in bed,
Arms or legs turning reddish-blue or even page,
Legs feeling thin,
Paler skin,
Weak pulses,
Wounds or ulcers that don’t heal,
Thick opaque toenails, and
Numbness and heaviness in the muscles.

If you’re experiencing these symptoms, do visit a doctor for a further look. More often than not these symptoms are disregarded as a sign of old age, but delayed diagnosis can lead to complications.

In extreme cases of blood loss, dead tissue can occur. If you suddenly develop a pale, cold limb with weak to no pulse, this is a medical emergency and you require treatment as soon as possible. Untreated limbs as such can lead to amputation.

Treatments for PVD

The treatments for PVD are directed to lower your risk of serious complications and manage your pain and symptoms helping you remain active.

Major lifestyle modifications – Initially treatment.

Regular balanced diet,
Exercise daily
Losing some weight.
Discontinuing Smoking as it directly causes the reduced blood flow in the vessels, and increases your risk of heart attack or stroke.

Medication

Prescribed by your doctor in order to treat the symptoms.

For instance, medications could be suggested to

Increase blood flow and relieve symptoms of leg pain
Reduced blood clotting,
Lowering high levels of cholesterol and for diabetes may be prescribed

Angioplasty or Vascular surgery

Intervention recommended in cases major artery blockages are diagnosed.

Angioplasty is when your doctor inserts a catheter into the artery and a balloon is inflated and open into the artery. In some other cases, a stent is used to keep the artery open.
Vascular surgery, on the other hand, allows the blood to pass the narrow arteries through vein grafting.

If PVD is diagnosed in time, many cases will respond to lifestyle treatments. The best way to examine whether improvement has taken place is to see how far you can walk without pain.

Conclusion

It is imperative to contact your doctor for a clear diagnosis if your legs look pale or blue to you if your legs become cold or you experience chest pain along with leg pain if you find new sores or ulcers have developed but they don’t heal, fever or any other sign of infections.

Bariatric December 15, 2021

Obesity And Its Treatment

Most people enjoy their leisure time binge-watching movies and shows, this sedentary behavior has contributed to the development of obesity. Obesity is viewed by many individuals as a moral failing rather than a disease.

According to the World Health Organisation (2016), there are around 2 billion adults overweight, of those 650 million are considered to be affected by obesity.

What is obesity?

Obesity is a complicated condition characterized by an excess of body fat. Obesity isn’t just a cosmetic problem. It’s a medical condition that puts you at risk for various diseases and health problems like heart disease, diabetes, high blood pressure, and some cancers.

It is typically caused by a mix of genetic, physiological, and environmental factors, as well as nutritional, physical activity, and exercise choices.
The good news is that even minor weight loss can assist or prevent obesity-related health issues. A healthier diet, more physical exercise, and behavioral adjustments can all help you lose weight. Prescription medications and weight-loss treatments can also be used to treat obesity.

So, how can you treat obesity?

Overweight and obesity are commonly treated with a combination of a healthier diet, increased physical activity, and other lifestyle changes. Some people may benefit from weight-management programs to lose weight or avoid regaining it. Some obese people are unable to either lose enough weight to improve their health or maintain their weight loss. In such cases, further treatments such as weight-loss medicines, weight-loss gadgets, or bariatric surgery may be considered.

Regular physical activity and a healthy eating plan

Following a healthy eating plan with fewer calories is typically the first step in reducing overweight and obesity. People who are overweight or obese should begin regular physical activity as soon as they start a healthy eating plan. Physical activity can assist you in burning calories more quickly. Physical activity can help you stay in shape and maintain a healthy weight.

Making a habit change

Start with small changes and include positive habits in your lifestyle. Your weight loss starter kit must have – a concrete healthy eating plan, dedication to follow, regular workout, and proper sleep.

The following suggestions may assist you in considering ways to lose weight, increase your exercise, and enhance your long-term health.

– Expect setbacks since they are unavoidable: If you experience a setback, such as overeating during a family or company gathering, try to refocus and get back on track as soon as possible. Only eat in your dining room or kitchen when seated at a table. Avoid trigger areas where sweets may be offered. Track your progress with online food or physical activity trackers which help you manually track your progress.

– Make a plan: Having precise objectives can assist you in staying on track. Rather than “be more active” set a goal to walk 15 to 30 minutes before work or at lunch on Monday and Friday. If you skip a stroll on Monday, make up for it the next day.

– Seek help: Seek help from family, friends, or medical experts if you need it. You can seek assistance in person, via email or text, or over the phone. You can also become a member of a support group. Health specialists with specialized training can assist you in making lifestyle changes.

Programs to help you lose weight

Some people benefit from a structured weight-loss program. In a weight-loss program, professional weight-loss specialists will create a customized strategy for you and assist you in sticking to it. The plan includes a lower-calorie diet, increased physical activity, and tools to help you adjust and sustain your behaviors. You can work with the specialists in individual or group sessions on-site (that is, face-to-face). To support your plan, the specialists may contact you frequently by phone or via the internet. Smartphones, pedometers, and accelerometers can all help you keep track of how well you’re sticking to your diet and exercise plan.

Medicines for weight loss

Your doctor may prescribe drugs to manage overweight and obesity if healthy eating and physical exercise habits aren’t enough. While taking weight-loss medications, you should endeavor to keep to your healthy eating plan and maintain regular physical activity.

Bariatric surgery

Bariatric surgery refers to a variety of procedures that alter your digestive system to help you lose weight. If you’re severely obese and haven’t been able to shed enough pounds to improve your health or avoid regaining the weight you’ve lost with conventional therapies, bariatric surgery may be a possibility. If you have major health problems associated with obesity, such as type 2 diabetes or sleep apnea, bariatric surgery may be an option at a lower degree of obesity. Many medical disorders connected to obesity, particularly type 2 diabetes, can be improved by bariatric surgery.

Obesity has the potential to reduce one’s overall quality of life. It’s possible that you won’t be able to participate in physical activities that you used to like. Long-term weight reduction success requires being motivated to decrease weight. Various variables motivate different people, therefore it’s crucial to figure out what motivates you particularly. Remember to be flexible with yourself and to enjoy your small victories as you lose weight. Also, don’t be scared to seek assistance when necessary.

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