Interstitial Cystitis

Interstitial Cystitis is also known as BPS or Bladder Pain Syndrome. It causes pain in the pelvis or urinary bladder, producing an urgent need and frequent need to void. This disorder commonly occurs in women.
Method of Diagnosis

In order to diagnose whether there is Interstitial Cystitis, your health care giver will use a Cystoscopy, which is a thin tube, which has a light at the end of the tube. This cystoscopy will be inserted into the bladder to enable the doctor to study the bladder for signs of interstitial cystitis. An additional test, a urine analysis may be performed to rule out urinary tract infections. 

Causes

No clear cause has been, as yet, identified. However, it is thought that the abnormal change in the lining of the bladder causes BPS. Consequently treatment is focused more on treating the symptoms, rather than the cause. 

Symptoms of BPS

The origin of the pain, which can be mild and could progress to be severe, is either in the pelvis or bladder region and often goes away after voiding. BPS also produces other symptoms such as:

• Need to frequently urinate during the day as well as in the night
• A discomfort and constant feeling of pressure on the bladder, consequently causing a feeling of a need to urinate
• Pain in the lower abdomen or pelvic region

In some cases it is possible for those affected by BPS to experience no pain for several days / weeks. 

Treatment

• Bladder Control – Note the frequency of when you urinate. Say if it is every 20 to 30 minutes. Then try holding on for another ten or fifteen minutes and then urinate. Continue this pattern for a week and slowly keep increasing the time limit to an hour, then an hour and half and finally try and bring it to 2 ½ hours. 
• Physical Therapy – A physical therapist who is trained in pelvic floor exercises, can help you with exercises that will help relax the muscles in your buttocks, groin and lower abdomen. 
• Medications – Medications both oral and insertions in the bladder may be prescribed to kill the pain and improve bladder control
• Electrical Simulations = Mild electrical pulses are used to block nerve pain
• Other forms of treatment – these other forms of treatment have helped some people – Acupuncture, biofeedback and transcutaneous electrical nerve stimulations. 
• Surgery – if none of the other treatment methods can resolve BPS, then surgery may be performed to repair the bladder or alleviate the nerve pain 

Managing Chronic BPS

• Maintain an active lifestyle which does not generate pain. Walk, perform yoga or Pilates
• If sitting for long periods causes pain then using a standing posture to do work or any other activity, may help
• Eat those foods which help avoid the pain from occurring. Spicy foods may be avoided, together with alcohol and coffee
• Lower stress levels by listening to calming music, meditate, or take warm water baths

Don’t forget to consult your doctor and follow his / her advice. 

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Types of spinal problems and treatments

The spine is made up of small bones which are placed one on top of the other. Any misalignment in these bones or the discs between them can cause spinal problems.

Common spinal problems

Lordosis - This is also referred to as swayback. This occurs when the spine curves inwards on the lower back.
Kyphosis - This occurs when the curve of the spine on the upper back is more than 50 degrees.
Scoliosis - The spine is curved sideways and can be S or C shaped.

Causes of spinal problems?

Lordosis - Causes

• Spondylolisthesis occurs when a vertebrae slips forward
• Osteoporosis happens when the vertebrae become fragile and can shatter
• Obesity
• Achondroplasia is when bones grown abnormally
• Discitis occurs when the discs between vertebrae get infected and inflamed.
•  Juvenile lordosis (occurs in children)

Kyphosis – Causes

• Poor posture
• Scheuermann's disease
• Arthritis
• Osteoporosis
• Spina bifida
• Spine infections
• Spine tumors

Scoliosis – Causes

• Hereditary
• Injury
• Infection

Symptoms of spinal problems

• Severe pain to upper or lower back
• Pain radiating down the back of the leg
• Pain in the neck or radiating to shoulders
• Sudden incontinence
• Sudden, uncontrollable bowel movement
• Unbearable abdominal pain
• Severe pain when bending or lifting things
• Pain when sitting or getting up

Different kinds of spinal surgeries
Doctors usually suggest spinal surgery if there is no other treatment. But many spinal problems can only be treated with surgery. These are usually elective. Examples of common spinal surgeries include:

Minimally Invasive / Endoscopic Spine Surgery like:

• Lumbar Microdiscectomy
• Anterior Cervical Discectomy and Fusion
• Spinal Decompression
• Posterior Cervical Foraminotomy

Congenital Paediatric anomalies like:

• Split Cord Syndrome (Diastemetomyelia)
• Lipomyelomeningocele
• Open myelomeningocele

Spinal Cord Tumours like: 

• All Intradural Spinal Cord Tumours
• Brain Stem and Foramen Magnum Tumours

Complex Spinal procedures like:

• Minimal invasive trans-thoracic discectomy
• Trans-oral and Trans-mandibular approach to anterior CVJ
• Occipito Cervical fusion and C1-2 procedures
• Degenerative scoliosis and Anterior Lumbar procedures

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Getting ready for Summer ’17 – Let’s beat the heat

On December 12th 2016, Chennai was hit by Cyclone Vardah. Trees were uprooted, and most of the city’s green cover was destroyed. It is safe to say that the city will experience one of the worst summers in known history. There is a call to arms to plant more greenery in place of what we lost to help the ecosystem of Chennai bounce back in time. But for now, we have all got to do what we can to get through the summer. Here are a few tips on how to beat the heat and save power and water, this summer.

Image Courtesy - hindustantimes.com

Keep cool

These ten tips will help you keep cool even if it feels like the sun is out to get you.

1. Keep hydrated – Constant sweating in the heat can dehydrate you. Make sure that you drink plenty of water.
2. Wear cotton clothes – Cotton absorbs sweat and is comfortable in the summer heat.
3. Eat plenty of water based fruits like watermelon, musk melon etc.
4. Eat more cooling vegetables like cucumber, pumpkin etc.
5. Drink plenty of liquids – fruit and vegetable juices, and buttermilk and tender coconut water.
6. Use a spritzer – A spritzer bottle with cold water to spray your face with is a great way to feel refreshed.
7. Cook early in the morning before it gets too warm or late in the evenings after the sun goes down.
8. Eat more fresh salads and simpler foods that need minimum cooking.
9. Avoid spicy food and baked and roasted food (Using an oven heats up the house)
10. Rubbing ice cubes on the wrist and neck (cooling points in your body) will cool you down.

Save power

Though it will be extremely warm, it is our duty to avoid using too much power for coolers and air conditioners. Instead of running the units the entire day, once you cool down the room with air conditioner, try these tips:

1. Put wet curtains on the window.
2. Keep bowls of water in the room. This keeps the room cool.
3. Put thattis outside your windows and wet them.
4. Splash a little water on the terrace over the room.

Save water

Yes, we do use more water in the summer, but we can help conserve water in small ways.
1. Make sure that you don’t have leaky taps or faucets.
2. Use a mug to dispense water when you brush your teeth or wash your face rather than keep the tap running.
3. Don’t shower. Fill water in a bucket and bathe using a mug.
4. Don’t use sprinklers in the garden. Water the garden using a pipe.
5. Make sure that your building has rain water harvesting.
6. Wait for clothes to pile up and do one large load rather than many small loads of laundry.
7. Make sure to keep an eye on the water pump when pumping to the overhead tank and ensure that it doesn’t overflow.
8. Have a water butt on the overhead tank drainpipe to catch any overflow which can be used for the garden.

Hopefully, with a little care, we can get through the summer in an environmentally friendly way!

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Doctor, I have heard about the harmful impact of Meningitis. Could you give me a clear picture of this illness?

Meninges are the three membranes that cover and protect the brain and the spinal cord. Meningitis is the inflammation of the meninges caused by injury or infection. There two types of meningitis: the first is caused by a virus and the second by bacteria, the latter being the more virulent. Infections caused by viruses most often get better on their own, but if infected by bacteria, it is very important to seek treatment immediately. Bacterial meningitis can cause death or brain damage unlike viral meningitis.

In addition to the viral and bacterial types, meningitis can also be caused by the following triggers:

• Parasites
• Fungi
• Chemical irritations
• Tumours

There are many types of viruses which can cause meningitis, some of which include:

• Enteroviruses (which cause intestinal illnesses as well)
• West Nile Virus – spread by a species of mosquitoes causing viral meningitis
• Mumps and HIV viruses – cause a type of meningitis called aseptic meningitis
• Herpes virus – causes Herpes meningitis. This is the same type of virus that causes genital herpes and cold sores, though people with cold sores or genital herpes do not necessarily develop meningitis.

Late summer, into the East Monsoons is generally the time when viral meningitis may occur. Children and adults under the age of 30 are the most vulnerable to an attack of viral meningitis.

Symptoms to watch out for:

• Severe headache
• Fever and shivers (particularly in children and newborns)
• Agitation
• Changes in mental status
• Photophobia
• Meningismus (stiff neck)
• Vomiting and Nausea
• Decreased alertness
• Rapid breathing
• Head and neck arched backwards
• Bulge in the fontanelles in babies (soft spot on the skull)

If you observe one or more of these symptoms, or suspect that it could be an attack of meningitis, then consulting a doctor immediately and seeking urgent medical treatment is very important.

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Dealing with Sports Injuries

With people getting into fitness in a big way, sports injuries have gotten more common. Some injuries that occur often are:

• Shin splints
• Knee injuries
• Groin pulls
• Hamstring injury
• Shoulder and neck strains
• Ankle sprains

What causes sports injuries?

Apart from fractures which are injuries to the bone, injuries occur to ligaments and tendons.

Ligaments injuries - Ligaments are the elastic bundle of tissues connecting bones and they stretch and retract when the joints bend. Too much strain on them can tear or snap them, leading to many knee and ankle injuries.

Tendon injuries - Muscle fibres, also called tendons are bundles of tissues which attach muscle to bone. When they are stretched too much they can twist and tear.

Treating common sports injuries

If the injury is mild, the most useful treatment is the RICE treatment.

R - Rest

I - Ice

C - Compression

E - Elevation

When you feel pain or there is swelling after a particularly strenuous work out or game, using the RICE treatment and resting the area can alleviate pain.

When to see a doctor

• If the pain has not subsided in a day or two

• If the pain increases

• If the swelling doesn’t come down

• If unable to move the limb

Preventing sports injuries

• Make sure that you warm up well before starting the activity (Warming up increases blood flow)
• Increase the activity at a gradual pace (Don’t do a 100 squats on Day 1-your body isn’t ready for it)
• Stop when you know you are straining your body
• Use protective gear like helmets, knee and ankle guards etc.
• Cool down after a game (Your stretched muscles need it)
• Don’t play when you are injured

By being careful, you can ensure that you can do sports activities longer and with less chance of injury.

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World Health Day 2017 – “Depression, Let’s Talk”

“A healthy outside starts from the inside” – Robert Urich

April 7th, 2017 is World Health Day and this year the theme is a topic that many are still unwilling to talk about and others are sceptical of, depression. People associate the term with mental disorder and insanity and do not like to admit that they are suffering from depression. This year, the World Health Organization has decided to help raise awareness about depression and how talking about it can help people get through it.

In other countries, help for people who are suffering from depression is available more easily as the topic has been in the forefront for a while now. Indians still hesitate to come out in the open and talk about their problem. It has taken the courage of certain celebrities to bring this illness out in the open and the fact that they are talking about it openly and admitting that they are suffering has helped raise awareness. Earlier, people dismissed those suffering from depression as seeking attention or making up problems. 

“Get over it”, was the attitude. Instead of helping them by listening, they have had to suffer alone and in silence. The now famous open letter by Deepika Padukone has changed people’s opinion. 

James Chau, an internationally renowned news presenter and ambassador for WHO has released this touching video about his personal fight against depression, as a lead up to World Health Day - https://www.youtube.com/watch?v=Jo0NHx2MIk8&feature=youtu.be

It’s time to talk about depression

On World Health Day, hospitals, NGOs and support groups in India will join in the effort to raise awareness and have events where current health concerns and topics will be discussed. This year, among other concerns, panels will be discussing depression and how organizations can help. So, in keeping with this year’s theme if you are suffering from depression or know someone who is, let’s talk!

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Kidney Stones – Causes, Symptoms and Treatment

A kidney stone is a hard, crystalline substance formed in the kidney or urinary tract

What causes kidney stones?

• Not drinking adequate amounts of water
• Accumulation of dissolved minerals in the kidney
• Calcification in kidneys or urethra
• Decreased urine output
• Diet and hereditary factors
• Medication or supplements

Symptoms of presence of kidney stones

• Unbearable pain in the groin or on the side above the thigh
• Traces of blood when passing urine
• Vomiting and nausea
• Pus when passing urine
• Decreased urine output
• Burning sensation when urinating
• Persistent urge to urinate
• Fever
• Chills
• Infection
• Incontinence

Treatment for kidney stones

• In mild cases, when the stones are small, they could be flushed out with constant hydration (Pain management may be needed)
• Lithotripsy – In this treatment, a shockwave is sent into the kidney stone to break it up into smaller pieces (Pain management and anti inflammatory treatment may be needed)
• Large stones which do not respond to above treatment may need surgical procedures like percutaneous nephrolithotomy (removing stone through an incision in the back) or ureteroscopic stone removal (removing stone by inserting a thin tube into the urethra)

Preventing occurrence of kidney stones

• Drink adequate amounts of water (at least 8 to 10 glasses a day)
• Sip water throughout the day
• Consume less oxalate-rich foods
• Maintain a low sodium diet
• Decrease protein rich foods
• Consult with doctor on calcium supplements

Risks associated with kidney stones

1. Kidney stones have the chance of re-occurring.
2. People who are prone to kidney stones have a higher risk of other kidney problems.

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