Month: January 2018

Obesity and Cancer

For us the word cancer evokes panic and fear of imminent death, whenever some one close is diagnosed with cancer we are shocked. All cancers though are not same; a great majority can be cured when caught early. And then there are types associated with predisposing medical conditions. We normally picture cancer patients as thin, worn out, barely able to eat, in pain, and in a state of constant dread. This may be true to a large extent. But many recently diagnosed cancer patients are in fact overweight and even obese. You will be surprised to know that obesity is a major risk factor for many cancers, so much so that it is considered to be second only to smoking, the most common one. Here are a few well known facts, for example obesity in women increases risk of Breast cancer fourfold, the uterine and ovarian cancer 5 fold, obese men and women are much more prone to cancers of esophagus, colon, gall bladder and thyroid, and many more.

Not only Cancer occurs more in obese, it is also more difficult to diagnose early. A lump may remain hidden in fat for a long time. The imaging and tests are less reliable in bulky and are less sensitive making it difficult to pick even a moderate size tumor. Severely obese even cannot be accommodated in a standard size CT scanner. Secondly it is diagnosed a t a more advanced stage, so is difficult to treat, the surgery becomes riskier and limited in scope in serious obesity. Radiation and chemotherapy likewise are needed in larger doses resulting in more side effects and morbidity.

So it is all the more important to keep weight in-check and treat serious obesity early. Bariatric surgery with its long long-lasting and superior results is the best way to lose weight in suitably selected patients. Bariatric surgery`s benefits compound with time and are consistent with lifelong health and happiness.

Needle Stick Injuries

On a December weekend, I, was eagerly waiting in ER to do my first Nursing procedure, when a boy came in pain and I was asked to draw his blood samples. Excited, I held the syringe with needle, positioned his arm, cleaned it with spirit, in went the needle, and out came the blood, in first shot. However, as I was thrilled, I noticed blood inside my latex glove and felt sore. I had inadvertently sustained a needle stick injury in right hand finger.

Needle stick injuries are wounds caused by needles that accidentally puncture the skin. These injuries are a hazard for people who work with hypodermic syringes and other needle equipment. These injuries can occur at any time when people use, disassemble, or dispose of needles.

Needle stick injuries are increasingly being encountered in site of many safeguards in place. This has resulted in emergence of iatrogenic hepatitis and HIV cases. According to WHO, 2% of the HIV infections are because of unsafe injections with 96,000 people being infected with HIV every year.

  • According to Centre for disease control and prevention(CDC), 3,85,000 or more sharps related injuries occur in US hospitals annually, i.e. a 1000 per day It is estimated that more than 20 types of bugs are transmitted from needle injuries. Some of these injuries lead to severe and fatal infections such as hepatitis B, hepatitis C, or HIV.

National institute for health and care excellence (NICE) recommends :

  • Safe use and disposal of sharps. Handling should be minimum of sharps and should not be passed directly from hand to hand.
  • Used needles must not be bent or broken before disposal and must not be recapped.
  • Sharp containers must be located in safe position that avoids spillage.
  • Sharp containers must be disposed of when the fill line is reached.
  • Sharp containers must be temporarily closed when not in use.
  • Report all needle stick and other sharps related injuries.

Steps to be taken following Needle stick injuries

  • Wash wound with soap and water Flush out mouth, nose or skin with water
  • Do not suck or squeeze the wound
  • Report the incident to supervisor
  • Immediately seek medical treatment at the ER

IT is important not only for healthcare professionals but for all of us who are involved with caring our loved ones. Do take care while you are tending to small wounds, dressings or giving injections at home, please wear gloves and take precautions.

Diet after Intra Gastric Ballooning

Intra gastric Ballooning helps us lose anything between 10 to 15 Kgs over six months to 1 year. This procedure enables us to feel full early, thus better control cravings & appetite. We eat smaller meals, follow healthy diet, feel lighter, healthier and better.

After this procedure, you need to re-learn how to drink and eat. Your diet will gradually progress, from liquids to pureed, then to soft, and finally you resume normal diet any time after four weeks, but each one advances at their own pace.

During the first post- operative week, the patient begins with clear fluids and gradually goes on to full liquids. For the first two days, be sure to take luke- warm fluids, not more than half a cup at a time. Sip small, sip slowly, do not use straw, and avoid carbonated beverages. Please ensure that you drink at least 10 cups of liquids throughout the day. To get enough calories and protein, drink more dairy products. Do add to your drinks one tablespoon of good fats like olive oil, canola, or avocado oil to provide essential fatty acids and prevent complications.

When on liquids, you can have beverages like coconut water, lemon water, green tea, iced tea, veg broth and soups, chicken broth & soup, skimmed milk, butter milk, dal soups, regular tea & coffee etc. Do not add sugar to your drinks.

Second week onwards you can introduce pureed food to your diet. This will include items which are well cooked and blended or mashed in a puree. Khichdi, porridge, fruit yoghurt are some good examples. You need to eat slowly in small bites, chew well & stop once you feel full.

From third week on you may start with soft foods, once you are comfortable with pureed diet.

Three to four weeks after the procedure you gradually return to normal eating. Chew well, eat slow, eat small at a time. At this time, start light exercise –like walking. Maintaining regular physical activity is a must to promote good circulation and to help achieve healthy weight. However, strenuous exercise are better avoided for a minimum of 6 weeks, till you are on your normal solid diet.