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A quick guide to routine antenatal scans done during Pregnancy [2020]
May 14, 2020|Dr. Astha Dayal

A quick guide to routine antenatal scans done during Pregnancy [2020]

Pregnancy is notoriously associated with dramatic physiological changes!  As your hormones steadily shift during this phase, you may realize that your weight, mood, eating habits, and even sleeping patterns seem to be going haywire. Understandably, many of these changes can be somewhat uncomfortable. Some of these changes are, however, both normal and essential for the development and health of your unborn child.

Given that every woman’s pregnancy experience is unique, the changes you experience during pregnancy can range from mild to severe and even life-threatening illnesses. Therefore, getting early and regular prenatal care becomes essential to determine if the symptoms you are experiencing are normal or not.

The World Health Organization (WHO) recommends that all pregnant women should get at least four antenatal care (ANC) assessments done by a qualified doctor or skilled attendant. But the proportion of women receiving the minimum of four antenatal assessments in India has only modestly increased from 37% to 51.2% between 2006-2016.

John Hopkins Medicine underlines that most pregnancies may progress without any complications. However, approximately 8 per cent of all pregnancies can involve some complications which, if left untreated, can harm the mother or the baby. You must, therefore, prioritise your routine antenatal scans.

Prenatal care may involve blood tests, imaging tests, and ultrasound exams, among others. These methods can help monitor your baby’s development in the womb as well as identify any ongoing health problems or existing health risks that you may have.

This article discusses some of the routine antenatal scans done during pregnancy.

Routine Antenatal scans in pregnancy:

You can schedule your first antenatal visit with your doctor as soon as your pregnancy has been confirmed. Your first appointment is likely to take place between eight and twelve weeks of your pregnancy. Throughout your pregnancy, your doctor may suggest several tests to check if both you and your baby are in good health.

Some of these tests will be a part of your routine prenatal checkups. Other tests may be voluntary and only done if your doctor thinks it may be appropriate for you to get tested. The following are the routine antenatal scans that you may experience during pregnancy:

1. Height, weight and blood pressure

During your first booking appointment, your doctor will note down your height and weight measurements to calculate your Body Mass Index (BMI). Obesity can put you at risk for complications such as preeclampsia, blood pressure, and blood clotting. Thus, if you are overweight, your doctor may advise you to lose some weight.

Additionally, your doctor will check your blood pressure on every visit. Your blood pressure can be comparatively lower in the middle of your pregnancy. But, if your blood pressure is high later in pregnancy, it could be a sign of pregnancy-induced hypertension.

2. Blood tests

On your first prenatal visit, you may have to give a blood sample. This blood sample helps determine your blood group, your rhesus status, and your HCG levels. Blood tests also check your immunity to certain diseases like HIV, Hepatitis B, and syphilis (unless you have specifically requested not to be tested for these diseases).

Apart from this, your blood sample may also be evaluated for conditions such as:

  • Thalassemia
  • Sickle cell anaemia
  • Cystic fibrosis
  • Tay-Sachs
  • Other genetic conditions

3. Urine tests and pap smear

A urinalysis helps your doctor check for potentially dangerous complications associated with pregnancy. These include urinary tract infection, preeclampsia or high blood pressure and gestational diabetes. If your doctor suspects a serious problem, he or she may send your urine sample to a lab for more in-depth testing.

A pap smear is a routine part of your first-trimester antenatal screening and will check for abnormal cervical cells. If any abnormality is suspected, your doctor may perform a second test called colposcopy.

4. Ultrasound exams

Your doctor may perform ultrasound exams at any point during your pregnancy. If you have a healthy pregnancy, however, you may only need to get two antenatal ultrasound scans done.

Your first ultrasound exam is likely to be scheduled when you around 11 to 14 weeks into your pregnancy. During this first antenatal scan, your doctor will give you the estimated date of delivery and will also identify and rule out any significant abnormalities.

A detailed ultrasound will be done again in the second trimester to look at the anatomy of the whole fetus. This antenatal growth scan is usually done around 18 to 20 weeks of pregnancy.

5. Nuchal translucency ultrasound

The Nuchal Translucency (NT) Ultrasound is an optional antenatal scan in pregnancy. This specialised ultrasound serves the purpose of screening for chromosomal abnormalities such as open neural tube defect, Down Syndrome and Trisomy 18.

The scan may be done sometime between 11 and 14 weeks of your pregnancy and is often combined with two other tests:

  • Noninvasive prenatal Test (NIPT)
  • Quad screen (also called Maternal Serum Screen, multiple marker screen, AFP, triple test or triple screen).

If any of these antenatal anomaly scans indicate that your baby is at a higher risk for certain congenital conditions, your doctor may recommend more invasive diagnostic tests such as chorionic villus sampling (CVS) or amniocentesis.

6. Glucose screening 

A glucose screening is done at approximately 26 to 28 weeks of pregnancy. This test determines your risk of gestational diabetes. Based on the results, your doctor may also recommend a glucose tolerance test.

7. Group B streptococcus

This test, done around 36 to 37 weeks of pregnancy, checks for bacteria that can cause pneumonia or other serious infections in your newborn. A swab will be used to take cells from your vagina and rectum for testing purposes.

Conclusion

Routine antenatal scanning can ensure that you have a healthy pregnancy as well as a healthy baby. All mothers-to-be are encouraged to have these scans done as recommended by your doctor from time to time.

You can make an appointment with your doctors for your care during pregnancy. Ensure that you are fully informed about all the necessary tests and treatments. Discuss all your concerns with your medical professional openly to receive the best care possible.

All you need to know about inguinal hernia | Symptoms and treatment

All you need to know about inguinal hernia | Symptoms and treatment

Do you feel pain in your lower abdomen or groin area when you bend, cough, or lift something heavy? Or, do you feel a noticeable bump around the pubic or groin area, especially when you stand up or cough?

If you answered in an affirmative to either of the above, you might have developed an inguinal hernia, and you must visit a doctor to prevent any further complications. 

To help you out, we have compiled all the information you need to recognize the symptoms of inguinal hernia and when to seek help.

What is an Inguinal Hernia?

A hernia is a common condition, which occurs when a part of an internal organ or tissue bulges through a muscle. An inguinal hernia involves a part of the small intestine or fat bulging through the lower abdominal wall into the inguinal canal or the groin area. 

Both men and women have inguinal canals – which is a passage in the lower abdominal wall that contains nerves and blood vessels. In males, it also holds the spermatic cord and the testes descend through the canal before birth. For women, the inguinal canal is the passage for the ligament that supports the uterus.

As mentioned before, a hernia in this passage can lead to a noticeable bump and may be painful during movement.

Types of Inguinal Hernia

Two types of inguinal hernia are identified, that is:

  • Indirect inguinal hernia caused by a birth defect in the abdominal wall
  • Direct inguinal hernia, which occurs due to weak abdominal wall muscles, caused by heavy lifting or straining over time

Direct inguinal hernias are most common in older adults. According to an article published by Cleveland Clinic, male adults over the age of 40 are more likely to develop an inguinal hernia. Another study conducted in India reveals that groin hernias are 20 times more common in men than women.

Health experts also agree that smoking, abdominal surgery and a family history of inguinal hernias may put individuals at a higher risk. 

When to seek help?

If you feel a noticeable bump in the groin area or experience pain during movement, it is best to get checked for an inguinal hernia. On the whole, an inguinal hernia is not a serious or fatal condition. Still, medical intervention is necessary to prevent complications such as incarcerated hernia or strangulation.

Incarceration occurs when a part of the fat or small intestine from the abdomen gets stuck in the groin area, and cannot go back into the stomach. If this condition remains untreated, the blood supply to the small intestine can be cut off (strangulation), which can have serious consequences. 

Symptoms of Inguinal Hernia

Symptoms of an inguinal hernia include:

  • A bulge in the groin area, which will be more noticeable if you stand or sit erect, cough, or strain the abdominal muscles.
  • You may feel pain or itching in the bulge at times, or mild discomfort when lifting heavy things, coughing, exercising or bending over.
  • A feeling of weakness, pressure, heaviness or burning in the groin area
  • Some men may also experience swelling in the scrotum
  • In infants, a hernia may only be visible while crying, coughing or straining during a bowel movement. The infant may be irritable and suffer from a low appetite.

Causes of Inguinal Hernia

There isn’t any single cause for hernia, but weak abdominal and groin muscles can be major contributors. Other risk factors for a hernia include family history, premature birth, chronic cough, constipation, obesity, etc.

As you can see, you cannot control many factors on this list. However, it is in your hands to eat a healthy, high-fibre diet and maintain a healthy weight. It is also advisable to not lift heavy weights and quit smoking to reduce your chances of developing an inguinal hernia.

Inguinal Hernia diagnosis 

If you or your child experience swelling, bumps or pain or pressure in the groin, it is advisable to seek immediate medical attention. 

Your doctor will ask you a few questions about your family history and lifestyle, before conducting a physical examination to feel the bulge. The doctor may ask you to sit erect, cough or strain to see if the bulge comes out.

In some instances, an X-Ray may be recommended to determine the state of the hernia, according to which your healthcare provider will prescribe the treatment.

Inguinal Hernia treatment

All hernias in the inguinal canal do not require surgery. Sometimes, a healthcare provider may ‘push’ a small inguinal hernia back into the abdomen – which can resolve the issue for good. 

However, if this approach does not work, surgery may be required for inguinal hernia repair.

Inguinal hernia repair, also known as herniorrhaphy, is of the following types:

  • Open hernia repair: In this case, an incision is made in the groin to push back the hernia into the abdomen. The abdominal wall is strengthened using mesh or stitches, to prevent the problem in the future.
  • Laparoscopic hernia repair: This is a less invasive surgical procedure using a laparoscope to repair the hernia through small incisions. It results in faster healing and recovery post-surgery. Robotic hernia repair using a laparoscope is also being undertaken at many hospitals currently.

Conclusion

Do not feel shy or afraid to discuss bumps in your groin area or pelvic region with your doctor. An inguinal hernia is a common problem, and more prevalent in male adults. Fortunately, it isn’t a serious problem and, in most cases, can be quickly taken care of by a medical professional. 

However, it is strongly recommended to contact a healthcare practitioner if you:

  • Feel any sudden pain or pressure in your groin
  • Notice a bulge in your pelvic area
  • Experience discomfort in the groin while moving or working out

Call up your doctor to discuss your symptoms openly or book an appointment at CK Birla Hospital for instant expert care.

Coronavirus Precautions and Cancer Patients

Coronavirus Precautions and Cancer Patients

Coronaviruses are a family of viruses that can cause common cold as well as more severe respiratory diseases such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). COVID-19 is the name of the disease caused by a new strain of coronavirus called SARS-CoV-2, reported in China for the first time in December 2019. 

The new coronavirus spreads in the same way as common cold or influenza. Experts believe that most individuals who contract the novel coronavirus will experience only mild to moderate symptoms, such as fever, tiredness, body ache, sore throat, and diarrhoea, and can be cured at home. However, according to the WHO and other health experts, people with weakened immune systems, such as diabetics, cancer patients, or those undergoing chemotherapy, are at a higher risk of experiencing a more severe form of the illness. 

Are cancer patients at a higher risk for COVID-19?

Unfortunately, the answer to this question is probably yes. Several reasons put cancer patients at a higher risk for COVID-19. First and foremost, some forms of cancer treatment suppress the immune system, which makes them more susceptible to catching infections, including the novel coronavirus. Advanced types of cancer are also known to impact critical organs, such as the lungs and kidneys, making it harder for cancer patients to withstand a severe illness. 

According to a study in China, COVID-19 patients with cancer and survivors of cancer showed a higher incidence of severe complications, including intensive care, mechanical ventilation, and death, as compared with other patients who did not have cancer. 

While this study was conducted using a small group of patients, it is best for cancer patients to should follow the utmost precautions and limit social interactions to prevent any exposure to the virus. 

Best practices for cancer patients and survivors to prevent Coronavirus infection

At present, there is no vaccination to prevent COVID-19 or any specific treatment or cure. Therefore, the best way to prevent any complications is by avoiding exposure to the virus.

If you are a cancer patient or at a higher risk for COVID-19 due to other medical conditions, such as diabetes, heart disease, lung disease, chronic liver or kidney diseases, etc., it is important to be extra cautious to minimise your chances of contracting the disease or worsening your existing conditions. Especially for cancer patients, it is vital to:

  • Remain in touch with your treating cancer oncologist. They will outline the treatment protocol during this period
  • If you have early-stage cancer which is curable, you should not defer your treatment during this period, as it can lead to the progression of cancer.
  • If you are suffering from cancer which has spread to the body, then discuss with your doctor if the chemotherapy frequency can be reduced or if you can be shifted to hormonal therapy/oral treatment for the time being.

Coronavirus infection is usually severe in patients who are suffering from pre-existing conditions like cancer, diabetes, hypertension. So, please take all precautions to prevent infections and follow these tips to stay healthy during the coronavirus pandemic

  • Stay at home as much as possible, and avoid touching your eyes, nose, and mouth.
  • Remember to wash your hands with soap and water frequently for at least 20 seconds, especially after using the bathroom, coming in contact with others, before eating, and after coughing or sneezing. 
  • Clean and disinfect the frequently touched surfaces in your home, such as doorknobs, light switches, keyboards, faucets, sinks, toilets, and even your smartphone.
  • Keep several weeks of your medication handy in case you have to stay at home for a prolonged period.
  • If you do need to step out of the house, wear a cloth mask, and stay at least six feet away from other people. Once you return home, remove your mask and be careful not to touch your mouth, nose, or eyes while doing so. Immediately wash your hands after removal.

In addition to these precautions, try to clock in at least eight hours of sleep, eat nutritious food, and do some form of exercise (if possible) to boost your immunity.

How does the COVID-19 outbreak impact your cancer treatment?

Hospital visits are linked to a higher risk of infection, which is why patients have been asked to minimise hospital visits. However, if you are already undergoing treatment for your cancer, you need to discuss the situation with your healthcare provider in detail. Talk about planning your next visit and the risk of missing a medical appointment vis-à-vis the possibility of increased exposure to the virus.

Medically speaking, while some cancer treatments can be safely delayed, others cannot. However, due to the excessive burden on healthcare infrastructure, many hospitals are not providing chemotherapy to cancer patients presently.

At the CK Birla Hospital, Gurgaon, patients can seek a consultation via telemedicine and video conferencing to minimise their hospital visits while continuing their regular treatment to the best extent possible.

In addition, cancer patients who need chemotherapy urgently can visit the hospital, even during the pandemic. Our dedicated healthcare staff maintains the highest standards of hygiene and other precautions to limit patients’ exposure to coronavirus.

 

If you are a cancer patient, have a frank discussion with your oncologist about continuing or delaying your treatment during the coronavirus outbreak.

What to do if you think you may have COVID-19

Many patients around the globe have recovered from the novel coronavirus, thanks to early detection and proper treatment.

If you are experiencing a high fever, sore throat or shortness of breath, or think you may have come in contact with someone who tested positive for COVID-19, call up the government helpline number shared below and inform them of your concern and medical history.

The Gurgaon Nodal Centre, SGT Medical College Hospital & Research Institute, Budhera, Gurgaon – 122505, Near Sultanpur Bird Sanctuary or call the COVID-19 Helpline for Gurugram (M: – +91 9911519296; L: +91 124 2322412)

The Delhi Nodal Centre, RML Hospital, Baba Kharak Singh Road, Near Gurudwara Bangla Sahib, Type III, Connaught Place, Delhi, 110001:  011 22307145 / 011 22300036 CATS Ambulance (9717655774)

We also suggest that you stay indoors and avoid unnecessary physical contact until you are tested negative for COVID-19 to prevent the spread of the virus.

How to Prepare Your Body for Pregnancy: A Complete How-to Guide
Apr 29, 2020|Dr. Aruna Kalra

How to Prepare Your Body for Pregnancy: A Complete How-to Guide

Parenthood is one of the most blessed gifts for a couple to experience in their lifetime.  But before you step ahead, you need to prepare your body for pregnancy. This would ensure health and fitness for you and your baby throughout the pregnancy period and even after delivery.

 

Check out the following 30-day guide to prepare your body for pregnancy:

Phase 1

Once you start thinking on the lines of getting pregnant, you need to go back to basics with these tips to prepare your body for pregnancy.

Learn how Conception works

Get complete learning and knowledge about how to conceive. By knowing the rules and guidelines about the most fertile days, you would be at a better chance to get pregnant.

Stop using Contraceptives

The first step towards preparing for pregnancy is to quit any kind of birth control that you have been using. Stopping to take birth control pills may get your periods within two weeks of quitting the medicine. This opens up your cycle of trying to conceive.

Track your cycle

Start tracking your menstrual cycle and try to understand the dates on which you are most fertile. Various apps can help you keep track of your periodical cycle month after month.

Phase 2

As far as preparing your body for a baby is concerned, you need to bring about many lifestyle changes in your everyday schedule.

Have sex during ovulation

Having frequent unprotected sex throughout your menstrual cycle will get you pregnant. Sex should be timed according to your ovulation dates to increase the chances of fertilisation.

Quit tobacco, alcohol, and drugs

Using addictive like tobacco, alcohol, and drugs can impose high risks of miscarriage, abnormality, and stillbirth of a newborn. Hence, if you wish to prepare your body for pregnancy shortly, you need to quit all these today.

Switch to a multivitamin

Getting your body ready for pregnancy calls for prenatal multivitamins. These would help you gear up against any nutritional deficiencies during the early stages of your pregnancy.

Take folic acid

An extra folate supplement is compulsory, right from the planning stages of your pregnancy. This would keep any neural tube defects, during pregnancy, at bay. For a pre-pregnancy dose, take a least of 400-800 micrograms of folic acid per day.

Eat well to stay well

Eating a healthy balanced diet can suffice for your daily intake of vitamins and minerals to a great extent. Go for whole foods over processed ones and incorporate dietary folates, iron, and calcium in your daily menu.

Add ‘fertility foods’ to your diet

Foods like asparagus, almonds, yam, eggs, and leafy green vegetables add to the fertility rate in a woman. Including these in your diet can help you in your endeavour to get pregnant.

Exercise regularly to remain fit

Target to achieve an exercise plan of 150 to 300 minutes per week, depending upon how active you are. Start off with something as simple as walking or take up a little more challenging action like jogging or cycling.

Reach your healthy weight

Your BMI (Body Mass Index) should fall into the required category. You should not be over-weight or under-weight when preparing your body for pregnancy. Both these conditions are undesirable and risky.

Limit caffeine

The recommended intake of coffee for a pregnant woman is 12 ounces per day. If you have more than this, curb your caffeinated drinks intake as you prepare your body for a healthy and trouble-free pregnancy.

Limit toxin intake or exposure

Taking high amounts of toxins can be dangerous for a developing baby. Hence, it is important to restrict the use of these to the bare least. Go for chemical-free home and personal products and avoid pre-packaged foods.

Phase 3

The next phase focuses on medically preparing your body for conception. Follow these steps soon after you have rescheduled your diet and health plan.  

Get a physical health check-up done

A yearly physical health check-up lets you detect health problems before they become severe. Considering all the conditions that can affect your pregnancy, a physical check-up can let you know any health concerns before conceiving.

Check vaccinations

Check for any overdue vaccinations like measles, tetanus, rubella, chicken-pox, etc. The right vaccines at the right time can protect you and your baby at all times.

Schedule a preconception visit

Plan a preconception visit with your obstetrician. You may discuss any concerns relating to planning your pregnancy. Prepare a list of salient questions before your appointment.

Visit the dentist

Hormonal changes in the body can affect your gums and teeth. As you set ahead to prepare your body for pregnancy, you need to ensure your teeth are free of any gingivitis or cavities.

Gather your family medical history

Genetic factors in your family tree will affect your baby’s health. It is important to rule out any genetic conditions that run in your bloodline. You can seek help from a genetic counsellor who gets you sailing in this comfortably.

Discuss prescriptions

Before planning a pregnancy, discuss your previous prescriptions or supplements that you might be on, with your doctor. Some of your regular OTC medicines may not be safe for pregnancy.

Phase 4 

Remember, many hormonal changes would occur in your body while preparing for pregnancy. To handle the physical, mental and emotional pressures that would follow, try sticking to these simple rules.

Practice stress relief

Find out ways to release stress. This could be through a relaxing walk or some breathing exercises or anything else that brings pleasure to you.

Practice Yoga

A regular yoga session would help you strengthen your body for pregnancy. It would even help you to handle your anxieties and emotions relating to pregnancy.

Get good sleep

Sleep plays a pivotal role in your well-being when preparing for a pregnancy. So catch up on it as and when you can.

Boost your immune system

Pregnancy requires more immunity as your body becomes more susceptible to common illnesses like colds and the flu. Switch to healthy foods like the ones rich in antioxidants, vitamin C, etc. to boost your immunity levels.

Have enough water

It is important to keep yourself hydrated for optimal health at all times. Pregnant women should have about nine glasses of water every day for a smooth pregnancy.

Take it easy

Your work may be strenuous physically. Yet, when preparing your body for pregnancy, you need to avoid lifting heavy things, bending or stooping over too often.

Get regular acupuncture

A very good way to get your body ready for pregnancy is with acupuncture. It helps improve ovarian function and even increases blood flow to the uterus. Research proves that acupuncture has improved the rate of pregnancy and live birth in women.

Phase 5  

Once your body is ready to handle the anxieties and physical changes in it during pregnancy, you can now plan the logistics for a safe and comfortable pregnancy. For this, you need to follow the following steps.

Do your homework

At this point, expect a lot of advice from everyone about what you should and should not be doing during pregnancy. You may be overwhelmed or even misguided by the constant flow of information. Do the homework yourself and make a list of things that need to be avoided. 

Follow a healthy regime

Your routine should include everything from a proper exercise regime to a healthy diet and even positive thinking. Incorporate all the Do’s and Don’t for achieving a high fertility rate to get pregnant. This would let you achieve success faster than you had thought. 

Stay determined

Not all women achieve their target of getting pregnant very easily. It may take months, and even years, sometimes. You need to remain strong and determined with your goal in mind at all times and not give up or lose hope if you do not get the desired results soon. 

Check your insurance coverage

Regular prenatal visits are very important during the entire course of your pregnancy. Plan in advance and make sure you have an insurance cover to deal with all your maternity expenses, including hospital charges and other post-natal expenses.

You Can Also Read: A Guide to Increasing Baby Weight When 9 Months Pregnant

Conclusion

Preparing your body for pregnancy naturally should be done under your obstetrician’s guidance to achieve the best results.

Consult your doctor immediately if you:

  • Happen to miss your periods
  • Need to discuss fertility dates for the best pregnancy results
  • Face any complications like spotting, bleeding, etc.

What to expect when you are diagnosed with Breast cancer

What to expect when you are diagnosed with Breast cancer

Breast cancer is, by far, one of the most common cancers in Indian women. Breast cancer ranks number one in cities and comes at the second position in rural areas. According to one study, breast cancer accounts for 25% of all female cancer cases that occur in rural India and 32% of total cancer cases in cities.

In India, one woman in every 4 minutes is diagnosed with breast cancer. On the other hand, every 13 minutes that passes, a woman dies due to breast cancer in India. We can consider the notoriously high mortality rate as a consequence of a lack of awareness in our medical system and delays in screening.

To this day, there are no known preventive measures that women can take for breast cancer. However, while you cannot prevent it from happening, with proper medical attention, breast cancer can surely be treated.

Our primary focus for this article is to tell women that it’s okay if they are diagnosed with breast cancer. It may look like it’s the end of the world for you. But ultimately, proper treatment and medication will set you on the road to recovery.

An important aspect of your treatment journey is a good support system, so hold on tight to your loved ones. You need someone close to you to send you positive vibes during your breast cancer treatment.

Triple assessment of Breast Cancer 

The triple test assessment is the best way to find out about any issues and diseases related to the breast in women. The evaluation includes consultation with the doctor for a patient’s examination, along with imaging testing and biopsy.

  • Clinical Breast Examination: This involves looking thoroughly at the whole breast area of the patient for any physical lumps present. This process includes an examination of both the breasts, nipples, armpits, all the way up to the collarbone.
  • Image Testing: This entails two types of testing: a mammogram and an ultrasound. The age of the patient determines the tests required. 
    • Mammogram: Using low-dose-X-rays to examine breasts
    • Ultrasound: Using high-frequency sound waves to find abnormalities in the breast and armpit area
  • Biopsy: This procedure involves extracting sample tissues. This allows the doctor to examine cells and tissues in the area for any sign of breast cancer.

Questions You Need to Ask After Getting Diagnosed 

After conducting the triple assessment of breast cancer, your doctor will understand more about your condition. If you find you are diagnosed with breast cancer, don’t panic. Feel free to ask as many questions about your diagnosis as you want. They, too, want to answer all your questions. In this way, you will be able to make better-informed decisions for your treatment.

Not every question mentioned here may apply to you. But they will help you get started on your knowledge of the procedure. For one thing, you know your symptoms and body much better than anyone else does. Try to write down some questions all by yourself. 

  • What kind of breast cancer do I have? And what test procedures will be needed to do my treatment? 
  • At what stage is my breast cancer in? And should I be worried?
  • What are the major side effects of breast cancer treatment?
  • What’s the probability of my survival from this cancer, based on my breast tumour size and cancer stage?
  • How should I be preparing my body for the treatment?
  • When will you start my treatment?

It’s a good thing to have two sets of ears when the doctor is explaining the overall medical management of breast cancer. Be sure to bring someone with you when you are visiting your doctor for your breast cancer prognosis.

Coming to terms with breast cancer is no small feat and may lead to emotional trauma. If you face any mental health issues during this difficult time, do not hesitate to reach out to your doctor for professional support.

Also Read: Treatment of fibroadenoma without surgery | Is it possible?

What Do You Need to Do if One of Your Family Members Gets Diagnosed? 

It’s hard when someone in your family gets diagnosed with breast cancer. But with the right steps, you can be the pillar of support to your loved one. You need to stick close to her during and after her treatment. Let’s talk about some tips on how you can help someone who’s diagnosed with breast cancer and make them feel comfortable. 

  1. First, you need to prepare yourself for a change in behaviour and mood in your loved one. It happens quite a lot with breast cancer treatment medications. Moreover, patients often go through emotional and physical stress after their breast cancer prognosis
  2. Secondly, you need to make her feel happy and encourage her to be active in her life. Tell her to do as much for herself as possible. It will give her a sense of control, along with freedom and responsibility. 
  3. Don’t forget to involve your other family members and friends. There is no denying the fact that more love and affection is always better. During tough times, the people who are closest to you would likely appreciate a chance to help. 
  4. Find some activity which you two can do on your own. Play some music or watch her favourite movies. Think of things that can help her forget about the breast tumour treatment for a while and make her enjoy the moment. 

In Conclusion  

Once you and your doctor decide on the best breast cancer treatment plan, make sure that you follow every word of advice from your healthcare provider.

Breast cancer tends to go undetected, and a delayed diagnosis can take a turn for the worse. You need to seek immediate breast tumour treatment if you develop these symptoms in your body:

  • You need to seek immediate care if you develop these symptoms in your body
  • Lumps or nodes felt on or inside of the breast
  • Nipple discharge other than breast milk
  • Change in breast colour along with changes in touch, the appearance of nipples

Staying fit with Ketosis – a beginners’ guide to the Keto diet plan
Apr 14, 2020|Ms. Deepali Sharma

Staying fit with Ketosis – a beginners’ guide to the Keto diet plan

The keto diet has gained massive popularity in recent times. While there is little research on the ideal duration, studies suggest that the keto diet can work in weight loss. Hence, the keto diet can essentially point towards your first steps to eating clean.

Before we learn how to do the keto diet, let us understand the mechanism behind it.

Keto diet explained

Carbohydrates burn down in the body to produce glucose, the primary source of energy. The general idea behind the keto diet is to reduce glucose levels in the body and substitute them with fat.

The fat would be converted to ketones, a clean source of energy for your body. This, in turn, would stabilise your blood sugar levels and effectively bring down your overall weight.

When your body is fuelled by ketones, instead of glucose, you tend to feel more energised, have fewer hunger pangs, and also reduced mood swings. However, keto is not just about lowering your carbohydrate intake and substituting it with fat.

Here are some things you must know before you start this regime.

10 steps to a Keto diet for beginners

1. Knowing the right fat

An ideal keto diet plan for beginners must include a healthy dose of fat. You must look for heart-healthy variants of unsaturated fats like olives, cottage cheese, nuts, avocado, eggs, and seafood like salmon. Substitute your rice, bread, and pasta with healthier substitutes like non-starchy greens and lean meat.

Keto diet should not become an excuse to eat loads of processed fat. Processed food comes loaded with complex sugar and a high level of carbs. Focusing on cleaner fats that are whole and unprocessed is pivotal to get the desired results.

2. Do your research

The best way to begin your keto diet is to know everything about it. Read reliable sources online on how to start a keto diet and learn about all the associated benefits and risks. Talk to friends and family members who practice the diet to understand how it will impact your current lifestyle.

Analyse and read if you would be able to manage the regime without any glitch.

3. Talk to your medical practitioner

Understand from your medical practitioner if this diet plan would be ideal for you. Sometimes a specific medical condition, dietary restriction, or medication can render you unsuitable for this diet plan.

Some conditions are:

  • High risk of cardiac ailments
  • Pregnancy and breastfeeding
  • Pre-existing liver, kidney, and thyroid conditions

4. Make a healthy Keto meal plan

You can design a simple keto diet menu for beginners with the staples you have in your home. Make a diet chart with the required calorie count and stick to it to ensure desired results.

Ensure that you don’t have many cheat days as even one cheat day can pull you very far from your goal.

5. Keep hydrating yourself

The biggest challenge in this diet regime is to keep replenishing the electrolytes in your body. When you start a keto diet, you tend to urinate more often and can easily fall prey to dehydration.

Ensure that you have lots of fluids at regular intervals and also consume enough electrolytes like sea salt to maintain a healthy level.

6. Eat the right amount

The key to a successful keto diet for beginners is to eat right. Often the main reason to start a keto diet is weight loss. To avoid any health risks, ensure that weight loss is a slow and steady process.

Sudden and drastic weight loss can be detrimental to your overall health and can even prove fatal. You need the right amount of macronutrients along with the regular intake of fats.

Protein is an essential part of your meal. However, too much of it can hinder your ketone production. Generally, a keto diet menu for beginners should have around 20-25% Proteins, 70-75% of fats, and less than 5% of carbs.

You can try a protein supplement like Gradual protein powder that has a Gradual Release Energy System (GRES).

7. Be prepared for change

When your body starts keto, it will take time to adapt to it and initially may resist the diet. In this case, you might show flu-like symptoms.

There would be episodes of fatigue, nausea, joint pain, and mental fogginess during the initial few days.

Be patient and persistent as these would go away after a while. You can manage these symptoms effectively by doing the following:

  • Drinking loads of fluids
  • Consuming adequate electrolytes
  • Increasing non-saturated fat content in your diet

8. Inform your family

From the day you start the keto diet, your meal chart would look utterly different from that of your other family members. You must keep them updated about your diet plan and ensure that they understand everything about it.

While you might get back to your regular diet eventually, they must be on the same page as you and know your restrictions.

9. Track your results

Keto is a successful way to lose weight, but it might not work for everyone. You must track your progress and look out for any red flags. See if you feel better physically and mentally after following this regimen for a week.

Measure your weight daily and get your blood work analysed by your medical practitioner. You might want to download a reliable ketone tracking app for yourself to get started.

10. Know when to stop

Keto is not a forever plan, and you must get back to your usual routine after a while. However, some people make changes to their lifestyle and adopt a healthier diet plan after trying keto. Your change must be a gradual and steady process.

Avoid suddenly switching to your regular dietary pattern. This will only promote unhealthy weight gain and negate any positive effect the keto diet had on you.

In conclusion

It is incredible to see how a keto lifestyle can do wonders for your overall health. However, if done recklessly, a keto diet plan can also pose significant health risks. Get your diet plan approved by a practising dietician before you start the keto diet.

Seek medical assistance if you experience:

  • Extreme exhaustion
  • Persistent digestive issues
  • No weight loss
  • Vitamin deficiency
  • Sleep disorders

How to Help Your Family Member Diagnosed with Breast Cancer?

How to Help Your Family Member Diagnosed with Breast Cancer?

Social conditioning has led to the term “breast cancer” being associated with women. According to a survey, the number of women undergoing breast cancer tests is almost triple the number of men.

But the fact of the matter is that breast cancer affects men, too. Either way, getting diagnosed with cancer is heartbreaking. Thus, the support of loved ones holds immeasurable value to a cancer patient.

As a family member, you may wonder how to cope when a loved one has cancer. You may be caught in a dilemma as to how you ought to behave and what you should do to help them.

Remember that every person is different. It is not for you to decide how they should get on with this life-altering condition. Instead, you need to be their pillar of strength.

Tips on how to help someone diagnosed with Breast cancer:

1) Understand Your Role

Trying times like these call for being open with your loved one. Ask them how involved they want you to be.

Some people would rather deal with this diagnosis by themselves or with select family members. It doesn’t help anyone if you are butting in where you are not needed.

It is much better to openly talk about their state of mind and avoid misunderstandings from the very beginning.

2) Discuss Options

Anything involving medical tests and frequent visits to the hospital can be nerve-wracking. Depending on the stage of cancer, the treatments may vary. Maybe your family member just needs someone with whom to discuss the options available.

So be their sounding board. Help them choose the path they feel most certain about, without imposing your thoughts on them.

People have a habit of taking to the internet every time they have a health-related query. Dissuade your loved one from doing the same. The internet is not the most credible space for medical advice.

Reading incorrect information can cause more harm than you’d realise. Help them understand that making an appointment with an oncologist is a far better decision.

3) Accompany Them to the Hospital

Sometimes, to console a breast cancer patient, you just need to be by their side. Offer to accompany them to the hospital for the consultation and the subsequent treatment days.

The environment in hospitals is already grim. Your family member shouldn’t have to feel like they are alone in this.

As a person who is caring for them, you can also speak to the oncologist yourself. This shows that you are attentive to your family member’s needs and willing to support them in your limited capacity.

4) Take Care of Their Dietary Changes

Chances are, your family member is already being subjected to a lot of breast cancer advice. What you can do differently is help them with their dietary routine.

Cancer treatments can lead to side effects that might disrupt their eating habits.

Moreover, it may also require the patient to eat foods with certain revitalising nutrients. Ask them what they feel like eating and if they’d want you to step in with grocery shopping or cooking.

A protein-rich spread on the table can go a long way in energising your family member.

5) Do Not Mollycoddle

Lending help is one thing. But becoming overprotective can be detrimental to the mental health of a cancer patient. Coping when a loved one has cancer is challenging, and may make you go overboard with suggestions and care.

This may cause your family member to feel like they are incapable of doing anything by themselves.

Don’t suffocate them with your constant breast cancer advice and assurances. Draw a line between being reliable and hovering around them all the time.

6) Restore a Sense of Normalcy

Knowing how to console a patient is not an exact science. Some things work, and others don’t. But almost always, patients crave a sense of normalcy.

They might prefer some aspects of their life to be untouched or unchanged by their medical condition.

Students might want to work on their assignments, and fathers might want to pitch in with household chores. Don’t admonish them for doing so.

Carry on with your life as you would and also encourage them to go about with theirs as much as possible. Do not let your conversations with them be weighed down by the diagnosis.

7) Help Other Family Members Understand

Even if you’ve wrapped your mind around how to help someone diagnosed with cancer, it doesn’t mean that all your other family members have gotten the memo.

They may not know how to cope when a loved one has cancer and might make the patient feel like an invalid with their behaviour.

Of course, they mean well. But it can come across as overbearing to the person battling cancer and may even result in needless animosity among family members. So intervene if you can and shed some light on the situation.

Help everyone understand cancer from the perspective of your loved one going through this difficulty.

8) Encourage Them to Join a Support Group

No matter what’s said and done, there’s only so much you can do as a family member to console the patient. Your loved one may better be able to relate to someone who is suffering from cancer just like they are.

Joining a support group can be a positive move for their mental health. It may even make the journey of recovery more bearable.

Family members still learning to cope when a loved one has cancer also benefit from support groups.

Final Words

Your role in the life of a person going through cancer depends greatly on their outlook towards life. Along with breast cancer advice, have a heartfelt talk with your oncologists and counseling team.

They may guide you in alleviating some of the stress and pain that your family member is going through.

To help someone diagnosed with cancer, you need to be supportive, open-minded and understanding. That is what matters the most.

Normal delivery – tips & preparation
Apr 13, 2020|Dr. Aruna Kalra

Normal delivery – tips & preparation

For new mothers-to-be, the last trimester of their pregnancy can be a period wrought with mixed feelings. On the one hand, there is the increased exhaustion, and then there’s also the eager anticipation of getting to hold their baby.

It is only natural that they would have plenty of questions about the upcoming childbirth. While it is up to the mother to choose between a natural delivery and cesarean delivery, correct information regarding the risks and benefits associated with the procedures will help her make the right decision.

Here’s some information about the natural way of giving birth:

What Is normal delivery?

A normal delivery occurs when the mother goes into labor either spontaneously or with the help of drugs and/or other techniques. Most types of normal delivery do not involve a surgical procedure as the infant is passed through the birth canal.

Also known as a vaginal delivery, this process may include the use of instruments and has far fewer complications than a c-section.

It is the safer option for an infant and also increases the chances of your subsequent pregnancies being free of risks.

Which factors improve your chances of normal delivery?

1) Weight:

Weight control is a crucial factor that can increase the probability of you having a normal delivery. Women who are overweight or obese are likely to have infants who weigh more than the average. In such a case, the obstetrician might recommend a c-section.

2) Stamina:

Going through labor and enduring natural childbirth requires substantially more resilience on the part of the mother. Increased stamina and endurance can aid normal delivery.

3) Fetal position:

Doctors giving advice for normal delivery often state that the position of the baby is what determines whether a normal delivery is suitable or not. When the infant has an anterior position, i.e., his/her head is facing downward, and towards the spine, it is highly preferred.

There are a few ways to encourage such positioning. Read the next section for some normal delivery tips.

Tips for normal delivery

One of the things to do for normal delivery is to ensure that you adopt some new lifestyle practices. This includes dietary changes, regular exercise, changes in sleeping and resting positions, etc.

  • To urge the infant into an anterior position for a natural delivery, you must avoid lying on your back. Try and condition yourself to sleep on your side, even if you are just resting.
  • Apart from that, there are some specific foods for normal delivery that you could incorporate into your pregnancy diet. Raspberries, mangoes, and pineapples are known to be good for the cervix. The latter two also stimulate labor.
  • Eating healthy is extremely important. Do not skip meals, but also avoid eating high-fat foods. That is because gaining excessive weight during the term of your pregnancy could minimize your chances of having a natural childbirth. Adding whole grains and lean protein to your diet is going to provide your body with the necessary nutrients.
  • You must keep in mind to exercise for normal delivery. Walking regularly, doing breathing and relaxation exercises, and yoga are some of the ways to ensure a healthy pregnancy. Speak to your doctor before you begin exercising because, depending on your trimester, they may suggest a different routine.

Signs and symptoms of normal delivery

These are some of the signs of normal delivery:

1) Pressure in the uterus:

One of the normal delivery symptoms is a feeling of increased pressure in the uterus.  This marks the beginning of the labor period, and once your contractions become more regular, you are well into the first stage of natural delivery.

2) Pressure on your bladder:

As the fetus is about to be pushed out of the birth canal, you may feel the urge to urinate since the pressure has shifted onto your bladder. The same holds true for your bowels. Hence, women are asked to have an empty stomach before the process begins.

3) Increased energy:

You may experience sudden changes in energy levels. This is due to the release of adrenaline into the blood. It is your body’s way of aiding the childbirth by giving you the boost you need to push through.

4) Water breaking:

As you may well know, the amniotic sac is what holds the fetus. When you are ready for the delivery, this sac breaks and the liquid spills out. This is more commonly known as water breaking.

Why should you prefer normal delivery?

The possibilities of normal delivery vary from person to person. But so far as there are no pre-existing medical conditions that necessitate a cesarean, it is better to opt for a natural delivery.

There are several reasons for this.

  • First and foremost, normal delivery is much safer for the mother and the child. You will recover faster from a normal delivery than a cesarean. Also, the several health complications associated with c-sections easily outweigh the minute benefits of the procedure.
  • If you are planning to have more children biologically, a normal delivery ensures that you don’t have to undergo cesarean for the next pregnancy.
  • The process of natural delivery not only secretes the essential hormones that a mother needs after delivery but also allows for lactation, which is very important for the newborn.
  • Moreover, vaginal delivery ensures that your baby’s immune system is heightened because of the bacteria present in the birth canal.

What is the process of normal delivery?

The process of normal delivery has three stages:

  • Going into labor
  • Childbirth
  • Delivering the placenta

In the labor phase, the cervix should soften and stretch. Once the cervix is completely dilated, the uterine contractions enable the infant to pass through the birth canal.

On the whole, it lasts around 36-48 hours if there is no surgical incision involved. In contrast, a c-section can go on for 72-108 hours as both the child and mother get hospitalized for a longer duration.

Conclusion

In the year 2018-19, as many as 33.80% of childbirths at private facilities were a result of caesareans, according to a report by the Ministry of Health and Family Welfare in India. That is an alarmingly higher rate in comparison to the normal standard of 10-15% set by the World Health Organization.

No expecting mother should go through such a beautiful phase of life without expert guidance. Visit CK Birla Hospital and consult our obstetrician to decide a path that is best for you and your child.

Tumour Size and Breast Cancer Staging

Tumour Size and Breast Cancer Staging

Breast cancer is one of the most prevalent cancers among Indian women. As per a 2019 report published in NCBI, breast cancer constitutes more than 30 per cent of all cancers in females.

The survival rate largely depends on early diagnoses and the right treatment.

Breast tumour size is an important factor in determining breast cancer stage but not the only one. Other factors like the location of the tumour, how much it has spread, hormone receptor status also play a significant role in deciding the stage of breast cancer.

Doctors use various tests and examinations to evaluate the specific characteristics of a person’s breast cancer while determining breast cancer stages.

The TNM Staging System

The diagnostics tests and scans of the person help the doctors in tumour staging.  The TNM staging system is a commonly used tool to describe the stage.

  • T (Tumour) – How large is the size of the primary tumour?
  • N (Node) – Has the cancer spread to the nearby lymph nodes?
  • M (Metastasis) – Is the cancer metastatic, i.e., has it spread to distant parts of the body like liver, lungs, bones, or brain?

Combined results are used to determine the stage of cancer for each person.

1) T – Measuring Breast Tumour Size and Staging

Tumour size is generally measured in millimetres (mm) or centimetres (cm). A number suffixed with T tells you the main tumour’s size. Higher the number, larger is the tumour and its spread.

The American Cancer Society uses this particular system for tumour staging:

TX – The primary tumour cannot be evaluated

T0 – No evidence of cancer in the breast

T1 – The tumour detected is less than 20 mm in size. It further has four sub-stages categorized as per the size of tumour:

  • T1mi – less than 1 mm
  • T1a – between 1 mm to 5 mm
  • T1b – between 5 mm to 10 mm
  • T1c – between 10 mm to 20 mm

T2 – When the tumour is larger than 20 mm but smaller than 50 mm

T3 – When the tumour is larger than 50 mm

T4 – The tumour has grown into the chest wall and/or skin. It also includes inflammatory breast cancer.

2) N – Lymph Node Status and Staging

The N value of the TNM staging system assesses whether cancer has spread to the nearby lymph nodes. The doctor generally takes the sample from the armpit area called the axillary lymph nodes and graded through the following:

  • NX – Unable to evaluate lymph node status
  • N0 – No cancer detected in the nearby lymph nodes
  • N1 – The cancer has spread to 1 to 3 lymph nodes
  • N2 – It has spread to 4 to 9 lymph nodes
  • N3 – It has spread to 10 or more lymph nodes

3) M – Metastasis and Staging

When cancer cells have spread to distant organs or tissues of the body, it is metastatic breast cancer. The most common metastatic areas are the liver, bones, and lungs. The assessment is as follows:

MX – Unable to evaluate the distant spread

M0 – No evidence found for cancer spreading to distant parts

M1 – Cancer has spread to distant parts

Other Factors Affecting Breast Cancer Stages

Breast tumour size is one crucial determinant of the cancer stage along with lymph node and metastatic status.

However, some other deciding factors that doctors use to evaluate breast cancer staging are:

1) Hormone Receptor Status

Knowing the hormone receptor status is essential in tumour staging and also deciding an effective breast cancer treatment plan. For this, the doctors evaluate the breast cancer cells for specific proteins that are estrogen and progesterone receptors.

The cancer cells often attach themselves to these hormones and feed on them to grow.

  • Estrogen receptors are identified as ER-positive (ER+) cancers.
  • Progesterone receptors are identified as PR positive (PR+) cancers.
  • If both the receptors are positive, then it is called hormone-positive (HR+) breast cancer.
  • If both the receptors are negative, then it is called hormone negative (HR-) breast cancer.

Hormone therapy is generally the most effective treatment in such cases. It prevents estrogen and progesterone from attaching themselves to the receptors, thereby keeping cancer from growing and spreading.

2) HER2 Status

One of the newest determinants to be incorporated into breast cancer staging is HER2 status. HER2, i.e., human epidermal growth factor receptor 2, is a gene that can play a role in the development of breast cancer.

HER2 receptors are proteins that control how a healthy breast cell grows, divides, and repairs itself. Doctors test HER2 status to see if there are higher than normal levels of this receptor and then term it as HER2 positive cancer.

Targeted therapies generally work best in such cases.

3) Cancer Cell Appearance

This is known as breast cancer grading. In this, the breast cancer cells are carefully observed under a microscope for their appearance.

The ones that look quite similar to normal cells are considered to be slower growing. Contrarily, the ones that look very different will probably grow and spread faster.

  • Grade I – Well-differentiated; these resemble normal cells and aren’t growing rapidly
  • Grade II – Moderately differentiated; these look somewhat different from normal cells and are growing faster than normal cells
  • Grade III – Poorly differentiated; these look like abnormal cells and are multiplying aggressively

Breast Cancer Stages

  • Stage 0 – A non-invasive breast cancer such as DCIS (ductal carcinoma in situ). There is no sign of cancer cells invading any nearby tissue.
  • Stage 1 – Presence of small tumours usually up to 2 cm but hasn’t spread to lymph nodes yet.
  • Stage 2 – Presence of large tumours usually 2 cm to 5 cm which have spread to some surrounding lymph nodes
  • Stage 3 – In this larger tumours are present and also probably grow into surrounding tissues like chest wall and skin.
  • Stage 4 – Breast cancer that has spread beyond the breasts and has metastasized to other organs of the body is said to be in stage 4.

Breast Cancer Staging Chart

How does tumor size relate to breast cancer stages
Source

Treatment

Depending on the stage of breast cancer, age and general health of the patient, your doctor will prepare a treatment plan.

Options include:

  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Hormone therapy
  • Targeted therapy
  • Immunotherapy

Every person’s breast cancer is different. The tumour staging helps in evaluating the extent of cancer present and deciding the best suitable treatment option for it.

In Closing

Breast tumour size is undoubtedly the most important deciding factor for breast cancer staging. Early diagnosis holds the key to the efficient and effective treatment of breast cancer. It is important to consult your doctor right away whenever you feel you show any signs or symptoms of breast cancer.