Tips | Causes | Symptoms

Tips for Healthy Lifestyle With time becoming an important commodity and the need to succeed at any cost the prime motive, health and healthy lifestyle has indeed gone for a toss. The demands of our profession includes late nights, it is not just the watchman who is keeping awake in the night….a student studying for his exams, a computer geek trying to crack a code, the BPO kids trying to prove their mettle, the surgeon operating on an emergency with his team of paramedics, everybody is at it. Add to this the stress of completing assignments on time, travel, improper time and unhealthy food. This lifestyle finally does take a toll on our mental and physical health. No wonder we are seeing young patients visiting hospitals with cardiac problems, hypertension, strokes, diabetes, depression all these are in some way or the other linked to our lifestyles. I have started encountering the effects of this in my clinical practice also, every third patient of brain stroke I have seen in the last few years have been young people in their 30’s, this is an alarming trend. There are few thing which are absolute essentials for our body and mind and we need to give that to it for it to function optimally. Sleep. If you don’t get enough sleep in the night try to make up for it the next day, long periods of bad or inadequate sleep is harmful. If you have to travel long distances to reach your workplace use the time to get some sleep than playing games on the phone or listening to music. Get regular exercise, 30 minutes atleast 4 times a week is recommended. Plus a run in the open under the sky with fresh air beating on your face is rejuvenating and a definite stress buster. Avoid junk food, fruits are cheaper and way healthier. Smoking looks good only on screen and pan gutka not even on screen. If you think about the next weekend on Monday mornings I feel you should think hard about getting yourself a new job. Try involving yourself in a profession that you like, then you not only are more efficient but also enjoy work more. While at work especially for people sitting on the computer for long hours it is worthwhile getting up every 1-2 hour for a quick stroll in the open, this not only reduces stress but also helps relax the neck and eye muscles. Dr Sunil Kutty Minimal Access Brain and Spine surgeon.

Pain in the neck! Is not just a common idiom but in reality a very common and painful condition. The other fact is it is being increasingly seen in otherwise healthy looking young individuals. The common causes are Muscle Spasm, Spondylosis and prolapsed Inter-vertebral discs.  Why is it commoner now? The probable reason would lie in the lifestyle and work profile of the people. People spend most of their time indoors without any exercise and sunlight exposure. lack of exercise makes the neck muscles weaker and lack of exposure to sunlight makes you deficient in vitamin D which makes the bones weaker, the end result, a weak neck. This weak neck is then abused day in and day out, sitting perched in front of a computer. This is the perfect recipe for neck pain. Constant neglect of the neck or sudden trauma or other conditions affecting the bones and muscles can alter the delicate balance of the structures constituting and contained in the cervical spine. When the space between two adjacent vertebrae narrows, there is outgrowth of bony spurs this can cause compression of a nerve root emerging from the spinal cord may result in radiculopathy (sensory and motor disturbances, such as severe pain in the neck, shoulder, arm, back, and/or leg, accompanied by muscle weakness). Less commonly, direct pressure on the spinal cord may result in myelopathy, characterized by  weakness, loss of balance, and loss of bowel and/or bladder control. The patient may experience a  shock like sensation (paresthesia) in hands and legs because of nerve compression and lack of blood flow. The main facets of neck pain prevention are  regular exercises, spending some time outdoors especially in the morning sun , eating healthy food with a generous dose of calcium. Also, if your job involves sitting in one position for long, a  short break of a couple of minutes to exercise your neck muscles can do wonders to keep  neck pain at bay. People with severe pain and /or associated neurological deficit (limb weakness, abnormal or loss of sensation, loss of urinary and bowel control) has to consult a doctor. Surgery of the spine has now become much safer because of use of microscope and endoscopes , which allow better visualization of the vital structures. In simple terms the surgery for degenerative diseases of spine involves decompression of the involved neural structures and fusion of the bone to prevent movement at the involved level. The newer disc implants available also allow normal mobility of the neck. It is important to note that it is the delay in obtaining treatment for neck pain, than the treatment procedure that is responsible for the morbidity of this condition. Dr. Sunil Kutty – Minimal Access Brain & Spine Surgeon

An Interview With Dr. Kutty – Minimal Access Brain & Spine Surgeon  “Minimally invasive neurosurgery brings a new facet of treatment to the fore”   Is minimally invasive brain surgery more risky than traditional surgery? Minimally invasive brain surgery is not more or less riskier than traditional surgery when performed with the purpose of making the patient’s life easier and secure. As long as the goal of the procedure is not compromised, it will always offer something extra than an open surgery, such as a better quality of life through faster recovery and less scarring. In some cases, minimally invasive neurosurgery brings an entirely new facet of treatment to the fore, for example, in the treatment of hydrocephalus. Hydrocephalus is a condition frequently encountered in clinical practise, in which there is an abnormal amount of cerebrospinal fluid (CSF) accumulation in the cranium. Traditionally, the treatment of hydrocephalus has been through correcting the overproduction of CSF or diverting the build-up away from the head by surgically placing tubes called shunts inside the brain ventricles and draining it into body cavities. Though effective, shunts are occasionally associated with serious complications, including infection, over-drainage or malfunction. Now using video guidance and no hardware, a surgeon can insert an endoscope through a small hole in the skull into the third ventricle of the brain. There a perforation is made in a membrane to restore normal flow of CSF. Though not all hydrocephalus patients are eligible for this approach, approximately 70-80 percent of properly selected patients are successfully treated this way. What challenges do you face as a surgeon in using the minimally invasive approach? Although the technology and techniques vary between microscopic neurosurgery and endoscopic neurosurgery, the primary difference is to move away from 3-D (in microscopic) visuals to 2-D (endoscopic) visuals. This requires some time to adjust to. The surgeon requires a re-orientation from the endoscopic point of view. The instruments are also different and that takes a while to master. I believe a good approach would be to look at the endoscope as simply a visualisation tool. Then things quickly start falling into place; the surgeon sees it differently but the neurosurgical principle stays the same. The other challenge is to create an infrastructure for it in terms of the instruments and equipment required, especially in the Indian context. So far, these techniques have been restricted to only a few centres. Finally, it takes some convincing by the surgeon to the patient who would rather go with the tried-and-tested approach. That can sometimes be a deterrent. Is minimally invasive neurosurgery accepted and performed in India? Minimally invasive neurosurgery is a young field of 20-odd years old the world over. In India, its advent started perhaps 10 years ago and neurosurgeons here have wholeheartedly embraced this new technology and are exploring the numerous possibilities it throws up. We perform endoscopic third ventriculostomy (like in the case of hydrocephalus), endoscopic removal of pituitary tumours, endoscopic treatment of intra-ventricular bleeds, intra-ventricular tumours etc. Infact, almost all the techniques that are being practised elsewhere are being replicated or reinvented here. Our hospital was amongst the first in India to remove a tumour endoscopically from the skull base through the nasal route.  Only pituitary tumours have previously been removed through this approach. Endoscopic neurosurgery continues to evolve with technical contributions from neurosurgeons around the world. Dr. Sunil Kutty – Minimal Access Brain & Spine Surgeon.