post cardiac surgery rehabilitation

immediately after discharge patient will notice dry cough which irritates them while going to sleep . it is a common occurance after open heart surgery . taking nebulization of normal saline will help the patient . if the cough doesnot stop medical advise should be taken .
very rarely cough can extend to more than 15 days and ent surgeon consultation is required 

heart matters: city health

heart matters: city health

heart matters: rheumatic heart disease

heart matters: rheumatic heart disease

heart matters: rheumatic heart disease

heart matters: rheumatic heart disease

Sleeping with enemy

Sleep is integral part of ourliving . Sleep in appropiate way and time stimulates body to achieve a balance .
I saw a man sleeping in his shop and snoring . His brother consented he doesnot sleep at a stretch and all day also he will doze off every hour or so . Sleep apnoea syndrome . Poor man he was on psychiatric treatment for behaving in a vague way .
I could make a diagnosis of him . Because of constant loud snooring his soft palate used to collapse and cause obstruction to free flow of air .he would wake up to gasp for air and again sleep . The cycle repeats and the patient doesnot sleep at night and so also day . Day time somnolence. 

Such patients are prone for hypertension and heart diseases . If not diagnosed in time can manifest s in a amalgamation of diseases.

There is treatment available for this and doctor might recommend a cpap machine or surgery
.
Came across other dimension of sleep during my practice . Insomnia . The rich wealthy man came for cabg . On history he told he has not slept for 30 years and we should help him with sleep medications after surgery . He owned 36 mines around the area but no sleep . Could it be responsible for his heart disease  ?

Sleep praceful under the starry skies is a sign of royalty . So even if one doesnot own a car bike or say mobile of he is able to sleep peacefully them he is blessed . Modern man in his zest to achieve more wealth has lost his sleep and has to resort to drugs and pills .

A man who has sound sleep will seldom have hypertension.  Other diseases are a ping ball effect of the same and a time reaches exponential magnitude. 

So how much sleep is required ? On an average sleeping for 8 hours is good and this stimulate s body time for wear tear . This repair process is lost in insomnia . And many diseases come forth .

Constant worry of wealth ,

residency blues:surgeon dreams

incidences that have left a lasting impression on me .
railway accident young girl had lost both legs above knee . i was the houseman incharge and had to do her dressings everyday . it was painful ordeal for her and i had to struggle with her wound .
each day the trauma of dressing her wound was too much to bear .

3 years passed and i was returning from my seminar . a young lady welcoming me with smiles and walking towards me . i could not recognise varsha . she had got new prosthesis and a new life . all thanks . 

a dream come true for becoming a surgeon.

buzzing the maze

few heart patients experience changes in heart rhythm also known as palpitations .in medical terms it is called arrhythmia.  

to eliminate arrhythmia electric current is passed through the heart muscle , which sets the abnormal beats to normal . the procedure is maze . maze is but a drawing of few lines on the heart and blocking abnormal firing of extra nodal points . and synchronised beating of heart ensues .

more than 80 % success rate is achieved . those patients are put on simultaneous antiarrythmogic drugs such as amiodarone . 

patient selection is mandatory for planning MAZE procedure during a surgery . chronic atrial fibrillation more than 6 months duration , and left atrium large than 60 mm will not benefit from the procedure . in patients who have undergone MAZE extraprecaution need  to be employed in form of pacing wires are put in situ to be able to attach to pacemaker if need be .