Surgery: Archives

Cancer April 7, 2021

Cervical Cancer – Signs, Symptoms, and Treatments

Cancer – just the word is enough to scare the best of us. But in reality, Cancer isn’t a singular, blanket term. There are many different types of cancers that can be formed in the body. Usually, once cancer forms, they spread to other parts of the body, which makes it fatal. Generally speaking, these are the clinical terms used for cancer –

Cancer that starts in the skin or the tissues which line other organs is Carcinoma.
The cancer of connective tissues such as muscles, bones, and blood vessels is Sarcoma.
The cancer of bone marrow is Leukemia.
The cancer of the immune system is Lymphoma and Myeloma.

Cancer cells grow out of control and become invasive, unlike normal cells. Cancer cells are less specialized than normal cells. Normal cells mature into distant cells, unlike cancer cells. They can influence normal cells, molecules, and blood vessels that feed and surround the tumor.

So, what is Cervical Cancer?

Unlike most other cancers, Cervical cancer spreads slowly, giving enough time for specialists to diagnose and treat it before it gets complicated. But Cervical cancer shouldn’t be taken lightly as it can metastasize, which is, spread to other parts of the body. These often include cancer spreading to the Liver, Bladder, Lungs, Vagina, and Rectum.

In the majority of cases, cervical cancer is caused by various strains of human papillomavirus (HPV), a sexually transmitted infection that is preventable through vaccines. When exposed to HPV, the body itself fights against the virus. But in some cases, the virus survives for years contributing to the development of cancer. Hence it is important to go for regular screen testing or to get an HPV vaccine.

The HPV vaccine protects women against these infections. The purpose of the vaccine is to produce antibodies that help fight against the HPV, thus preventing it from infecting cells.

The vaccine does not treat the existing HPV infection or prevent other sexually transmitted diseases.

In the year 2018, an estimated 570, 000 women were diagnosed with cervical cancer and about 311 000 women died from cancer. It is the fourth most common type of cancer. But that being said, if Cervical cancer is detected early and managed effectively, it is one of the most successful and treatable types of cancer.

What are the symptoms you need to look out for?

A woman might experience no signs or symptoms at all in the early stage of cancer . Depending on the tissue and organ in which the disease has spread, the symptoms might differ. As a result of which women should have regular cervical smear tests or pap tests.

The most common signs or symptoms of cervical cancer are:

Increased watery or bloody vaginal discharge will have a foul odor.
Bleeding after menopause.
Bleeding in between periods.
Pelvic or back pain is unexplainable.
Bleeding after intercourse.
Pain while having intercourse.
Longer and heavier menstrual bleeding.

The cause of these symptoms may also occur due to some other medical condition or infection but it is important to visit the doctor if you spot any of the symptoms.

How is Cervical Cancer Treated?

While the final call for treatment lies in the hands of your doctor, there are some factors that they will consider which include the stage of cancer, age as well as overall health.

Cervical cancer treatments include Surgery, Chemotherapy, Radiotherapy, or the combination of these according to cancer.

The early-stage treatment:

When cancer has not spread from the cervix, surgery is the common treatment method. If the doctor feels the cancer cells are still inside the body then they might suggest radiation therapy.

Radiation therapy also decreases the chances of reoccurrence.

Advanced cancer treatment:

Advanced cancer is also referred to as invasive cancer because it has invaded other parts of the body. Surgery is usually not an option after cancer has spread beyond the cervix.

In the advanced stages, doctors often suggest palliative therapy to relieve symptoms and improve quality of life.

Chemotherapy

Chemotherapy is an aggressive drug treatment that targets the cancer cells that divide and grow rapidly. In simpler terms, chemotherapy is the use of medication to treat the disease.

What are the side effects after treatment?

Post-treatment, women may experience certain symptoms. These vary from treatment to treatment. While your doctor will tell you about these in detail, on a general note, these are some of the side effects you may face.

The side effects after Chemotherapy –

Diarrhea
Nausea
Mood swings
Early menopause
Hair loss
Fatigue
Infertility

The side effects from Radiation Therapy

Radiation therapy involves the high energy of beam that is used to destroy the cancer cells. Radiation therapy is targeted to the pelvic area. It also has certain side effects which may occur after the course of treatment is over such as:

Upset stomach
Bladder Irritation
Interrupted menstrual cycle
Narrowing of the vagina

It is important to remember that the success rate of the treatment in the early stage is more compared to the ones detected after it has injected the other tissues or organs. So, you must take steps to prevent it as much as possible.

Here are ways to prevent Cervical Cancer:

Have regular Pap tests with screenings: A pap test can help you find any precancerous cells to treat and monitor them to prevent cervical cancer.
Safe Sex: Take measures to prevent sexually transmitted infections like using condoms every time you have sex and limiting sexual partners one has.
HPV vaccine: Talk to your doctor about the HPV vaccine and whether it is appropriate for you.
Say no to smoking: If you are a regular smoker then talk to your doctor about the methods to quit smoking. Smoking is linked to various cancers.

Regular tests and visiting the doctor when you observe any change are important. Practicing all the preventive measures can reduce the risk of getting cervical cancer. Cervical cancer found in the early stages is highly treatable and is associated with long survival and good quality of life.

Knee Replacement March 12, 2021

Five Reasons Why You Should Not Undergo Knee Replacement Surgery During The Winter Season

You might be thinking: “Why do my joints ache when it’s cold?”

Usually, joint pains are symptoms of some injury or an extension of an underlying health condition. But, the winter season does create more muscle stiffness and joint aches if one is spending more time outdoors. It is also true that many people who suffer from chronic joint issues like arthritis and osteoarthritis find that their condition worsens during the winter season. And, as we all know that warmth improves your blood circulation, keeps all tissues well-nourished, cold weather can lead to a drop in blood circulation levels. Though there’s no scientific evidence behind this relationship, taking a few extra measures to ease joint pain may help you tackle problems related to fluctuating temperatures. Let’s now take a brief look and understand the possible reasons for this kind of pain, tips on tackling joint stiffness during cold, and the reason why you should not have a Total Knee Replacement surgery during the winter season.

POSSIBLE REASONS FOR JOINT PAIN IN THE WINTER SEASON

1. During winters, the protective fluid inside our joints gets thicker leading to stiffening of the joints.

2. Drop in the barometric pressure can cause your muscles, tendons, and surrounding tissues to expand beyond the confined body space which causes pain.

3. Even the nerves become sensitive during the winter season leading to increased anxiety and tension on the muscles and joints.

4. People who are less active in the winter season face issues while maintaining the good health of the joints.

5. During winters, our body circulates less blood to the entire body and even to the central areas of the body causing more pain and stiffness.

TIPS ON TACKLING JOINT PAIN AND STIFFNESS DURING THE WINTER SEASON

During the winter season people who experience chronic joint stiffness and pain, their symptoms get worse due to the cold weather. Taking few measures and extra efforts during winter would help you fight the pain. These tips would not cure your joint pain but help you in causing relief during the winters.

Stay warm

This tip would depend on the area an individual stays in. Depending on the area, if it is too cold they should wear warm clothes and make sure that their hands, legs, and joints that are affected by arthritis are covered at all times. Try to stay indoors whenever possible.

Hydrating is a must

Dehydration makes people sensitive to pain. Drinking lots of water during winter is very important as the dry air makes people feel dehydrated, tired, and achy. Apart from drinking water at regular intervals, drinking warm soups and tea can also help you stay warm.

Take your Vitamin D

Lack of Vitamin D can also be a reason for joint pain. It also raises the risk for osteoporosis. Consult your doctor regarding the best supplement for you.

Exercise and be active

People often gain weight during winters. As the weather makes you lazy and you tend to eat more. The excess weight would make your joints pain more as it puts a lot of pressure on it. Hence it is important to stay active and maintain your weight.

REASONS WHY YOU SHOULD NOT HAVE TKR DURING THE WINTER SEASON

Many patients have this question regarding when is the best time to have a Total Knee Replacement surgery. People should always do their TKR surgery during warm weather as it makes the recovery process better for a majority of people.

1. Changing of clothes

Changing clothes during the summer season is less hectic as you put on fewer layers for obvious reasons on your body making it easier for the wound to be untouched for a longer period. It is always advisable to wear clothes that are easy to wear and remove.

2. Sleeping

Sleeping for few weeks just after the surgery can be a big task and hence it is always good to wear light cotton clothes and light bedding for a sound sleep.

3. Air conditioner and heater

The normal temperature will make less unnecessary usage of the heater and air conditioner while you are recovering from the surgery. Warm weather always allows you to get out for small walks and trips without any hassle.

4. Travelling

Post your in-home therapy, you would be often visiting your therapist for offsite therapy and that’s when avoiding unnecessary (traveling in winter season) and load on your surgery site is crucial. Driving by yourself is a strict NO during this period.

5. Work-life balance
Taking days off and resting for an adequate amount of time is paramount and hence deciding on the right surgery time during your long holidays will help you go through it faster and better. It’s always advisable for seasonal workers to have surgery, especially during their off-season.

Several additional factors contribute to one’s recovery, especially total knee replacement. And, despite a successful TKR, rehabilitation will play a key role in a successful recovery. Also, it is important to acknowledge the fact if you are a person that gets affected negatively, then paying closer attention to your diet and supplements becomes of the highest importance. Preparing yourself from the inside out can help you minimize the impact of cold weather in general and also in case of surgery. Consuming vitamin-rich foods and consulting your primary care doctor in case of any difficulty will only in faster recovery.

Heart Attack March 3, 2021

Suffering From Diabetes Type 2? Here’s How You Can Prevent Silent Heart Attack

A heart attack can come with numerous apparent symptoms like chest pain and pressure or pain in the jaw, arm, or neck. However, in nearly 50% of all heart attack cases, those signs & symptoms are relatively missing. The signs and symptoms that do show up might be so mild and average that a patient may barely think about them by any stretch of the imagination.

More than 1.1 million individuals experience a heart attack (myocardial infarction) annually. Several of them when they get a heart attack it is the first indication of coronary artery disease. A heart attack could also be severe enough to cause death or it’s going to be a silent one.

A silent heart attack or a silent myocardial infarction (SMI), is a heart attack with minimum to no related signs and symptoms. Due to the lack of signs and symptoms, the affected person is unaware that they have suffered a significant cardiovascular event. Instead, the affected person will characterize reputedly minor symptoms like fatigue or mild chest soreness to ailments like the flu or indigestion.

Regardless of the lack of signs and symptoms, silent heart attacks are still heart attacks and may have a few extreme consequences, leaving behind scar tissue, weakening the heart, and growing the threat for a next, more serious heart attack. Thus, it is vital to mention all potential signs and symptoms, even seemingly insignificant ones, to a doctor. Specifically, in case you also have contributing factors which include type 2 diabetes.

SYMPTOMS

Even though silent heart attacks strike men more frequently than women, the latter are equally at risk. For example, men could feel exhaustion or physical discomfort and chalk it up to overwork, poor sleep, or some general age-related ache or pain. Other typical symptoms like mild pain within the throat or chest are often confused with gastric reflux, indigestion, and heartburn. Also, in many cases, the situation of pain is usually misunderstood. Amidst, a silent myocardial infarction (SMI), a person will feel discomfort within the center of the chest and not a sharp pain on the left side of the chest, which many of them accompany a heart attack.

If you’ve got no symptoms or don’t notice the signs, a silent heart attack could also be discovered accidentally once you undergo tests for an additional reason. For instance, blood tests can show you’ve got tissue damage in your heart, and an EKG measures electrical activity in your heart. Heart damage can interrupt or delay several electrical activities. Finally, an echocardiogram, which is an ultrasound of your heart, also can show if there’s damage. A silent heart attack is as dangerous as the usual one. Simply because you can’t feel it, doesn’t mean it’s not serious.

Heart and vascular disease frequently go hand-in-hand with diabetes. People with diabetes are at a way greater threat for stroke, heart attack, and hypertension. Other vascular problems due to diabetes include inadequate circulation to the legs and feet. Sadly, many cardiovascular issues can go undetected and begin early in life.

Serious cardiovascular disease can start before age of 30 in individuals with diabetes. Type 2 diabetes (also called non-insulin-dependent diabetes mellitus) is the after-effect of the body’s inability to form or use enough insulin. One study found that individuals with type 2 diabetes, without apparent heart problems, ran an equivalent risk for a heart condition as people without diabetes who had already suffered one heart attack.

How Does Type 2 Diabetes Increase the Risk of Silent Heart Attack?

Having diabetes increases the danger of developing a wide range of ailments, a few of which directly impact the heart. When it involves a silent heart attack, diabetics are particularly susceptible for a few reasons:

Higher Risk of Heart Disease – Diabetic patients are at an increased risk of a silent heart attack in large part because the condition has already put their heart in a more precarious position overall. Additionally, to damaging levels of blood sugar, patients also are more likely to experience high cholesterol and obesity, all of which strain the cardiovascular system.
Autonomic Neuropathy – A significant side effect of diabetes is damage to the autonomic nervous system. The nerves of this technique are liable for controlling several bodily functions including breathing, digestion, and pulse. Furthermore, nerve damage can reduce a patient’s ability to feel pain, including the painful symptoms related to heart attack, making the signs easier to miss.

Studies have shown that up to 16% of participants with Type 2 diabetes also are likely to have suffered a silent heart attack. It’s a connection that can’t be ignored. If you’ve been diagnosed with Type 2 diabetes, it’s important to know the risks related to the condition and to be cautious in maintaining and monitoring your health.

How can patients with type two diabetes prevent a silent heart attack?

The best way to one can prevent a silent heart attack is to take excellent care of themselves and also, keep proper control of type two diabetes.

Maintain your blood sugar as normal as possible.
Manage your blood pressure, with medication if necessary. The target for people with diabetes is under 130/80.
Get your cholesterol numbers in check from time-to-timeby taking proper medications.
Try to lose weight if you’re obese.
Keep exercising regularly.
Make sure you consume or eat a healthy diet daily.
Quit smoking.
Try calming exercises regularly to reduce your daily stress.

Lastly, it is important to check with your doctor when it comes to matters of the heart. In the end, it’s only the timely precautions and treatment that save your time and life. The more you are equipped with the knowledge, the safer you are.

Aortic Stenosis/TAVR/TAVI March 3, 2021

Tavr – Procedure To Replace The Damaged Aortic Valve With A Biological Valve

As we all know that our heart is the center of the circulatory system. It is a network of vessels that delivers blood to every part of the body. To tell you more about how our heart functions, let us know more about the four valves that make the whole functioning possible. The heart has four valves – mitral valve, tricuspid valve, pulmonic valve, and aortic valve.

The mitral valve and tricuspid valve are located between the upper heart chambers and lower heart chambers and amidst the ventricles and the major blood vessels, located are the aortic valve and pulmonic valve.

FUNCTIONS OF THE VALVES

These valves have different roles that keep the heart functioning properly. Hence, it should be healthy and functioning. It must be open all the so that blood can pass and valves must close tightly so no blood flows into another chamber.

When we talk about the aortic valve, it separates the left ventricle from the aorta, allows blood to leave the heart from the left ventricle through the aorta and the body, and prevents the backflow of blood from the aorta to the left ventricle.

When the aortic valve isn’t working properly, it becomes difficult for the heart to send blood to the rest of the body which leads to various aortic valve diseases.

AORTIC VALVE DISEASE

There are two major types of aortic valve diseases:

Aortic Stenosis

Aortic Stenosis is the narrowing of the Aortic valve opening. The narrowing of the valve could lead to reduction or blockage of the blood flow from the heart into the main artery to the body and towards the rest of the body. This forces the heart to work harder.

Aortic Regurgitation

Aortic regurgitation or insufficiency causes when the valve doesn’t close properly causing the blood to leak into the heart which over time makes the heart stretch and enlarge which later can lead to heart failure.

AORTIC VALVE TREATMENT

Treating the dysfunction of the aortic valve depends upon the severity of the aortic disease. Traditionally, Aortic Valve Replacement Surgery was done through traditional open-heart surgery. This procedure involves a cut in the chest which is risky and requires a longer recovery time. Another way is replacing a valve via a minimally invasive method where an incision is made in the chest or a catheter inserted in the leg or chest. It is by far the safest option and this procedure is called TAVR or Transcatheter Aortic Valve Replacement.

This can be done using a mechanical valve or a biological valve.

WHAT IS A BIOLOGICAL VALVE?

While performing the TAVR procedure, the doctor removes the damaged valve and replaces it with a mechanical valve or biological valve. Biological valves are also known as bioprosthetic valves. That is a valve that is made an animal tissue or human heart tissue. Animal tissue is known as Xenograft and human heart tissue is known as Homograft. Animal tissues are made from a cow or pig. But, to perform this procedure, depends on the severity of the condition and the situation of the patient. Accordingly, if needed, the doctor might suggest replacing the damaged aortic valve with a biological valve.

The reason why the biological valve is used is that they degenerate over some time and they comparatively require no blood-thinning medicines, post-surgical care, and hospital stay.

Biological valves are not as strong as mechanical valves and they need to be replaced every 10 years or so. These valves breakdown much faster in children and young adults, so these valves are used mostly in elders.

WHAT IS A MECHANICAL VALVE?

Titanium and carbon are the materials used to make Mechanical valves. These valves are sewn in the place of original valves, they consist of two leaflets and a metal ring surrounded by a ring of knitted fabric. The advantage of these valves is that they are durable and last longer. But the valves provide a surface on which it is easy to form a blood clot.

These valves should be avoided for women of child-bearing age and those with a high risk of falls or bleeding.

HOW IS TAVR PROCEDURE PERFORMED USING A BIOLOGICAL VALVE?

TAVR procedure is a minimally invasive procedure that is used to repair or replace the damaged aortic valve. On the day of surgery, the doctor will decide which type of anesthesia is best for you but your heart will continue to beat during the procedure. Once you are asleep, a short hollow tube called a sheath is inserted into your femoral artery. The new valve is placed in the delivery system using a balloon at the end of the catheter. It contains the replacement valve folded around it. This delivery system is pushed up to your aortic valve.

Once it reaches the diseased valve, it is inflated which pushes aside the leaflets of your diseased valve. This valve replacement surgery usually does not require cardiopulmonary bypass. Once the biological valve is placed, the balloon is deflated and the catheter is removed.

The doctor will check if the new valve is opening and closing like the normal aortic valve should and close the incision once the new biological valve starts functioning properly.

PROS OF USING A BIOLOGICAL VALVE DURING TAVR

The benefits of replacing the damaged Aortic Valve with A Biological Valve is that they don’t come with a higher risk of a blood clot. They are the best for people over the age of 65, pregnant women, and people who have kidney stones.

Valves used from Bovine (cow) is not an actual valve but it is a tissue surrounding the cow’s heart. It is strong and flexible.

Using a biological valve during TAVR operation for pregnant women is more beneficial because it doesn’t require using blood thinners as consuming those medicines can harm the fetus.

CONS OF USING A BIOLOGICAL VALVE DURING TAVR

TAVR, of course, includes some risks. Generally, risks are minimal which includes complications in blood vessels, infection – if not taken care of it properly, etc. Only in extreme cases, does one suffer from stroke if post-surgical care is not taken properly. It all depends on one’s health and medical history. So, if you or somebody you know is suffering from post-surgical complications, it is better to consult a doctor immediately.

To conclude, it is important to understand the risk and advantages of valve replacement surgeries. It is better to listen to the advice of your doctor and research about TAVR in depth before undergoing the procedure. TAVR is a procedure of the heart, all the precautions must be taken into consideration. And after the TAVR procedure, you should constantly be in touch with your doctor for regular health check-ups.

Cancer March 3, 2021

Breast Cancer- Symptoms, Prevention and Treatment. Things you need to know about breast cancer and how to prevent them

Cancer can start anywhere in the body. They are a group of large cells that invades the organ or tissue and start growing aggressively if not controlled in time can lead to spreading to other parts of the body. Cancer is the second leading cause of death globally, accounting for an estimated 9.6 million deaths, or one in six deaths, in 2018.

Breast cancer is cancer that develops in the cells of the breast. Lobules are the glands that produce milk and ducts are the pathways that bring the milk from the glands of the nipples. The cancer cells are generally formed in these glands but they can also form in the fatty tissue or the connective tissue within your breast.

The lymph nodes are the general pathway that helps the cancer cells spread to the rest of the body parts. The unchecked cancer cells invade their way to healthy cells then can travel through lymph nodes under the arms.

Breast cancer cells can develop in both males and females, but it is most commonly diagnosed in females. It is the most common type of cancer. As per the American Society of clinical oncology 1 in 29 females develop breast cancer in India.

Breast Cancer Symptoms

In the early stages, it is difficult to detect breast cancer as it may not have any clear symptoms, sometimes the lump could be small making it hard to know. However, a mammogram could detect any abnormality.

The first symptom would a lump under your arms or on your breast that was not there before.

Other symptoms of Breast cancer are:

Pain in the breast
Rash around the nipples
Inverted nipples
Bloody discharge from the nipples
Redness and pit around the breasts
Change in the size and shape of the breast
Any change of appearance of the skin on the breast or nipples

All lumps are not cancerous it could also be a benign cyst but if there is any lump or other symptoms it is ideal to visit a doctor to exam further.

Key steps to prevent developing Breast Cancer in the future.

There is no way one could prevent breast cancer. But certain lifestyle decisions in one’s life can decrease the risk of breast cancer.

Be active and maintain a healthy weight

It is necessary to have a healthy weight to prevent cancer. Hormone receptors can cause breast cancer cells to grow and develop. An increase in Hormone receptors can be caused due to excess fat in the body.

If you have a healthy weight maintaining it is very important as it decreases the chances of developing breast cancer. If you have an unhealthy try to get it under control through your diet. Adults should aim for at least 150 minutes a week of moderate activity.

Avoid alcohol and smoking

There are pieces of evidence that show a strong link between smoking and breast cancer. Smoking is unhealthy and is linked to several cancers including lung cancer. Based on research it is advised to take not more than one glass of alcohol per day as having alcohol at a small amount still puts one at risk.

The more you drink or smoke the higher the chance of developing breast cancer.

Regular visits to gynecologists and mammograms

It is ideal for women above the age of 40 to visit a gynecologist for an annual mammogram. Mammograms are effective to detect any abnormality and catching signs of cancer. Additional to regular visits and annual mammograms women should also self-examine their breasts as it will help to notice any changes in size and shape. Regular mammograms would not prevent cancer but help it detect at an early stage. If you detect any breast cancer symptoms it is important to communicate them to a doctor.

Hereditary Factor.

Few women are at a higher risk of developing breast cancer due to hereditary factors. If a close relative in one’s family has or had breast cancer then the person’s chance increase. Women who carry certain mutations in the BRCA1 and BRCA2 genes are genes that produce a protein that repairs damaged DNA. Everyone has two copies of this gene that we inherit from our parents. They are also called tumor suppressor genes as they have certain changes that are harmful (pathogenic) variants (mutation) that can also have a higher chance of developing it. You may need to do a DNA test and to diagnose this mutation.

Limitation in hormonal therapy

Discuss with your doctor the risks and benefits of hormonal therapy if you are taking it for menopause and chronic diseases. Combination hormonal therapy may put people at higher risk. That is why it is important to study and talk to your doctor regarding alternative medication and treatment. If at all there is no substitute then consult your doctor and limit the dosage of medication.

Breast Cancer Treatment

Breast cancer treatment includes:

Surgery

There are two types of surgery depending on the size of the tumor.

Lumpectomy- The tumor and small amount of healthy tissue around the tumor along with tissues under your arms are removed.
Mastectomy- The surgical removal of the entire breast.

Chemotherapy

Chemotherapy is drugs used to destroy the cancer cells keeping the cancer cells from growing and multiplying.

It can be suggested to be given before surgery if the tumor is larger. As it will help it to shrink a bit making surgery go easier.

May also be given after surgery to reduce the risk of recurrence.

Radiation

The use of high x-ray particles to destroy cancer cells.

After lumpectomy radiation therapy is advised 3-4 times per week that is if the cancer cells have not spread to lymph nodes.

After a mastectomy, it is usually given 5 days a week.

The length of your radiation therapy depends upon the tumor and spread of cancer cells.

Following few steps and adding them to your lifestyle could be lifesaving. Be vigilant regarding any changes that are unusual and consult your doctor.