Coronary Revascularization
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What is Coronary Revascularization?

Coronary Revascularization restores the flow of oxygen and nutrients back to the heart. To restore blood flow to the heart, open heart surgery is required to bypass the existing blockages or obstructions in the coronary arteries of the heart. Once the blockages or obstructions are removed, blood circulates to the heart again. The most common type of revascularization procedure is called Coronary Artery Bypass or Coronary Artery Bypass Grafting, sometimes called CABG (“cabbage”).

What is Coronary Artery Bypass (surgery)?

Coronary Artery Bypass surgery is also known as Coronary Artery Bypass Graft as well as "heart bypass."  Coronary Artery Bypass  is performed to relieve angina and reduce the risk of death from coronary artery disease. Arteries or veins from the patient's body (usually arteries or veins in the patient's legs) are grafted to the coronary arteries to bypass atherosclerotic narrowings and improve the blood supply to the coronary circulation supplying the myocardium (heart muscle). Coronary Artery Bypass  is usually performed with the heart stopped, necessitating the usage of a cardiopulmonary bypass machine.

What are Neurological Disorders?

Neurological Disorders are disorders that affect the central nervous system (brain and spinal cord), the peripheral nervous system (peripheral nerves - cranial nerves included), or the autonomic nervous system (parts of which are located in both central and peripheral nervous system).

What are 3 diseases that are neurological disorders or neurodegeneretive disorders?

1.  Alzheimer's disease

2.  Parkinson's disease

3.  Amyotrophic Lateral Sclerosis also known as Lou Gehrig's disease.

Endometrial Ablation is the removal of the lining of the uterus, or "endometrium."  After the doctor removes the uterine lining, this significantly decreases a woman's menstrual flow or stops it completely.

A "tilted uterus," which is also referred to as either a " tipped uterus" or a " retroverted uterus" is diagnosed when a physician notices that the woman's uterus is in a slightly backwards or "tilted" position. 

Normally, a woman's uterus is located in a straight and vertical position in reference to her pelvis - and sometimes the uterus is tilted slightly forward. 

A tilted uterus can make conception and pregnancy more difficult.

Having a tilted uterus is not that uncommon. The American College of Obstetrics and Gynecology states that about 20% of all women have a tilted uterus. 

And, not all women that have a tilted uterus will have difficulty when trying to conceive. Many women will get pregnant with no trouble and may not have any idea that they even had a tilted uterus until their obstetrician informs them. 

Uterine Suspension is a surgical procedure that is used to relieve pelvic pain or dyspareunia (painful intercourse) when the pain is thought to be the result of uterine retroversion (also known as a "tilted uterus," "tipped uterus" or retroverted uterus). 

Generally, there are two methods that are used to accomplish Uterine Suspension surgery; 1. laparotomy or 2. laparoscopy. 

Uterine Suspension is sometimes used to increase fertility although this is very controversial and has never really been shown to increase one’s chances of becoming pregnant. 

What conditions will Uterine Suspension treat? 

Uterine Suspension is used to treat pelvic pain and dyspareunia (painful intercourse). It is used to correct the position of a uterus that has tilted away from the midline and toward the back. 

Sometimes, before Uterine Suspension surgery, the doctor may ask his patient to try a vaginal pessary in an attempt to correct uterine position. 

If the vaginal pessary does not relieve the pain, then Uterine Suspension surgery may be the next best course of action.

Menorrhagia is the medical term for women (and young girls first starting their menstrual cycles) that excessive menstrual bleeding. Excessive menstrual bleeding is defined as having a period that lasts 7 or more days each menstrual cycle (period) or is so heavy that you saturate your menstrual pad and/or tampon and need to change your feminine hygiene product(s) every one to two hours.  It is very important to inform your doctor if you have excessive menstrual bleeding! 

Women that are suffering from Menorrhagia may experience; anemia, fatigue,  embarrassing menstrual accidents, and feel that you have to restrict your life and social activities to such an extent that you "miss out on life."  Many women prefer to stay close to home so as to avoid embarrassment due to their need to go to the restroom so often so that they can change their feminine hygiene products before they become too saturated and cause even more embarrassment.


How many women have Menorrhagia?

Approximately 1 in 5 women have Menorrhagia.

Are there any treatments or therapies for Menorrhagia?

Yes, there's hope and help for women with Menorrhagia!

Here are a few of the options and therapies you will want to discuss with your doctor.

Hormone therapy - also known as "both control pills," and/or other medications may be prescribed to treat hormone imbalance. Hormone therapy is effective about 50% of the time, and may be required for a long period of time. 

Uterine Balloon Therapy - Also known as Thermal Balloon Ablation) (see below for more information)

Dilation and curettage - also referred to as a "D & C" - is a surgical procedure whereby the doctor scrape the inside of the woman's uterus to remove the lining. For most women with Menorrhagia, a D&C is temporary and reduces excessive bleeding for only a few periods.

Endometrial Ablation is another possible therapy but only if you and your husband don't plan to have children in the future. Typical Endometrial Ablation removes the lining of the uterus with an electrosurgical tool or laser. Like any surgical procedure, there are risks, which include perforation of the uterus, bleeding, infection, or even heart failure due to fluids used to open up or distend the uterus.

Hysterectomy is the surgical removal of the uterus.  As a hysterectomy involves the removal of the woman's uterus, Menorrhagia will no longer be a problem. Hysterectomy is also a surgical procedure and also involves risks. The recovery period after hysterectomy is 3 to 6 weeks. 

Perineoplasty, also known as "Perineorrhaphy,"is one of the fastest growing elective medical procedures and is the reparative or plastic surgery of the perineum which helps women with problems with vaginal opening laxity or looseness - medically referred to as "Vaginal Relaxation."  Many also incorrectly call this procedure "vaginoplasty" or "vaginaplasty."

Perineorrhaphy is the reconstruction of the muscles and tissues at the opening of the vagina and has successfully decreased the "introitus" or size of the vaginal opening. Perineorrhaphy does NOT reduce sexual sensation, in fact, properly performed, Perineorrhaphy INCREASES sensation for the woman as well as her husband/partner.

What is Colporrhaphy? 

Colporrhaphy is the surgical repair of the vaginal wall. This includes repairing many types of vaginal surgery, including the repairs of the vagina in a "Pelvic Organ Prolapse," "vaginal prolapse," "Vaginal Vault Prolapse," or the repair of a "cystocele" in the vaginal wall(s) or vaginal vault or a rectocele. A cystocele occurs when the bladder protrudes into the vagina, and a rectocele when the rectum protrudes into the vagina.

In the Colporrhaphy procudeure, a uro-gynecologist, or gynecological surgeon, places a vaginal speculum inside the vagina, which spreads/keeps the vagina open, for the doctor to inspect and repair the vagina. The vaginal wall is cut opened to reveal an opening in the supporting structures, or fascia and the defect is closed and then the vagina is repaired by suture and closed, and the speculum removed. 

Who performs the Colporrhaphy and where is it performed?

Colporrhaphy is usually performed in a nearby hospital operating room by a uro-gynecologist, urologist or gynecological surgeon.

What is a Pelvic Prolapse? Colporrhaphy is the surgical repair of the vaginal wall. This includes repairing many types of vaginal surgery, including the repairs of the vagina in a "Pelvic Organ Prolapse," "vaginal prolapse," "Vaginal Vault Prolapse," or the repair of a "cystocele" in the vaginal wall(s) or vaginal vault or a rectocele. A cystocele occurs when the bladder protrudes into the vagina, and a rectocele when the rectum protrudes into the vagina.

In the Colporrhaphy procudeure, a uro-gynecologist, or gynecological surgeon, places a vaginal speculum inside the vagina, which spreads/keeps the vagina open, for the doctor to inspect and repair the vagina. The vaginal wall is cut opened to reveal an opening in the supporting structures, or fascia and the defect is closed and then the vagina is repaired by suture and closed, and the speculum removed. 

Who performs the Colporrhaphy and where is it performed?

Colporrhaphy is usually performed in a nearby hospital operating room by a uro-gynecologist, urologist or gynecological surgeon.

What is a Pelvic Prolapse?

Pelvic Prolapse is another term used for "Pelvic Organ Prolapse."  Pelvic Prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapse in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown. 

Pelvic Organ Prolapse may also be called; genital prolapse, pelvic relaxation, prolapsed uterus, uterovaginal prolapse, pelvic floor dysfunction, urogenital prolapse, vaginal relaxation, or vaginal vault prolapse.

Pelvic Organ Prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapse in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown. 

Pelvic Organ Prolapse may also be called; genital prolapse, pelvic relaxation, prolapsed uterus, uterovaginal prolapse, pelvic floor dysfunction, urogenital prolapse, vaginal relaxation, or vaginal vault prolapse.

A Prolapsed Uterus refers to a collapsed uterus, or descended uterus, or other change in the position of the uterus in relation to the surrounding structures within the pelvis. The pelvis contains many soft tissue structures vital to normal body functions, supported primarily by the diaphragms, layers of muscles, fibrous coverings called fasciae, and various ligaments and tendons. These soft tissues of the pelvis derive their ultimate support from the bony pelvis. 

A Prolapsed Uterus may be one of three types, depending on the severity:

• First-degree prolapse occurs when the uterus sags downward into the upper
vagina.

• Second-degree prolapse occurs when the cervix is at or near the outside of the
vagina.

• Third-degree prolapse (sometimes referred to as total prolapse) occurs when the entire uterus extends outside the vagina.

What is a Vaginal Vault Prolapse?

The vaginal vault is the area at the top of the vagina, next to and adjacent to the cervix. It can only “fall” or descend downwards toward the introitus, or the entrance of the vagina, after a woman's womb has been removed (hysterectomy). Vaginal Vault Prolapse occurs in about 15% of women who have had a hysterectomy for uterine prolapse, and in about 1% of women who have had a hysterectomy for other reasons.

Vaginal Vault Suspension is a surgical procedure that provides support for the apex/vault of the vagina to various pelvic structures.

What is Vaginal Dryness?

Vaginal dryness is one of the most distressing, and painful problems a woman faces.  Vaginal dryness occurs when the natural vagina secretions decreases within the vagina. The amount of vaginal moisture varies throughout a woman's monthly menstrual cycle. Vaginal dryness is particularly problematical as a woman enters and becomes menopausal.

Vaginal moisturizers, provided by numerous companies, and a variety of brand names, are products designed to relieve the pain and discomfort of vaginal dryness. These products are applied or inserted, into the vagina, one or more times per day, depending on the amount of vaginal dryness she may be experiencing.

A vaginal moisturizer may or may not be a vaginal lubricant.  Vaginal lubricants are normally used as an aid for intercourse and used on a short-term basis to help a woman that is not able to produce enough vaginal moisture to permit her to comfortably (and painlessly) engage in intercourse.  

A menstruating woman's vaginal moisture changes from day to day, and varies depending upon her hormones that control the production of vaginal moisture.  A woman can experience vaginal dryness even during times of menstrual bleeding.  

Menopause is a normal change in a woman's life when her period stops. That's why some people call menopause "the change of life" or "the change." During menopause a woman's body slowly produces less of the hormones estrogen and progesterone. This often happens between the ages of 45 and 55 years old. A woman has reached menopause when she has not had a period for 12 months in a row.

Hormone therapy for menopause has also been called hormone replacement therapy (HRT). Lower hormone levels in menopause may lead to hot flashes, vaginal dryness and thin bones. To help with these problems, women are often given estrogen or estrogen with progestin (another hormone). Like all medicines, hormone therapy has risks and benefits. Talk to your doctor, nurse, or pharmacist about hormones. If you decide to use hormones, use them at the lowest dose that helps. Also use them for the shortest time that you need them.

Every woman's period will stop at menopause. Some women may not have any other symptoms at all. 

As women begin reaching the age of 40, their bodies are preparing for menopause, or the stopping of their monthly menstrual periods.  Menopause never happens all at once.  As young ladies approach their first period and monthly menstruation, her body's hormones are "transitioning" to producing hormones levels that will support monthly menstruation for about the the next 35 years. Similarly, as women reach their 40's, their bodies' hormone levels begin to change, and in preparation of menopause. 

Women will know they are approaching menopause, as they will notice the following symptoms:

• Changes in your period - time between periods or flow may be different.

• Hot flashes ("hot flushes") - getting warm in the face, neck and chest.

• Night sweats and sleeping problems that lead to feeling tired, stressed or tense.

• Vaginal changes - the vagina may become dry and thin, and sex may be painful.

• Thinning of your bones, which may lead to loss of height and bone breaks (osteoporosis).

• For some women, many of these changes will go away over time without treatment.

• Some women will choose treatment for their symptoms and to prevent bone loss. If you choose treatment, estrogen alone or estrogen with progestin (for a woman who still has her uterus or womb) can be used.

Hormone therapy is the most effective FDA approved medicine for relief of hot flashes, night sweats or vaginal dryness.

Hormones may reduce your chances of getting thin, weak bones (osteoporosis) which break easily.

For some women, hormone therapy may increase their chances of getting blood clots, heart attacks, strokes, breast cancer, and gall bladder disease. For a woman with a uterus, estrogen increases her chance of getting endometrial cancer (cancer of the uterine lining). Adding progestin lowers this risk.

You can, but there are also other medicines and things you can do to help your bones.

No, do not use hormone therapy to prevent heart attacks or strokes.

No, do not use hormone therapy to prevent memory loss or Alzheimer's disease.

Studies have not shown that hormone therapy prevents aging and wrinkles or increases sex drive.

You should talk to your doctor, nurse or pharmacist. Again, hormones should be used at the lowest dose that helps and for the shortest time. (For example, check if you still need them every 3-6 months.)

The risks and benefits may be the same for all hormone products for menopause, such as pills, patches, vaginal creams, gels and rings.

At this time, we do not know if herbs or other "natural" products are helpful or safe. Studies are being done to learn about the benefits and risks.

 

 

 

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Coronary Revascularization
www.CoronaryRevascularization.com

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