Cromwell Hospital

Ten expert tips to keep your heart healthy

Andrew Martin — Thu, 11 Apr 2024 06:55:00 +0000

Heart disease stands as the leading global cause of mortality, as affirmed by the World Health Organisation (WHO). Fortunately, it is also among the most preventable conditions. Irrespective of age, adopting a healthy lifestyle—embracing physical activity, nutritious eating, and mental well-being—can significantly diminish the risk of heart attack and stroke.

Dr. Rakesh Sharma, Consultant Cardiologist at Cromwell Hospital, underscores the importance of nurturing this vital organ: “Your heart is a crucial organ, and it’s imperative that you take care of it. While following these tips for heart health serves as a commendable start, if you harbor any concerns, consulting with your doctor is essential.”

In this blog, we compile ten expert tips to guide you in safeguarding your heart. These recommendations need not be overwhelming; the gradual incorporation of small steps can pave the way for substantial enhancements in your overall health.

Discover the path to a healthier heart with insights from our experts at Cromwell Hospital, a renowned Heart Hospital in London, where your cardiovascular well-being is our top priority. Your journey to heart health begins here.

How to Keep Your Heart Healthy

Move your body

Sitting for long hours working at a computer or desk, and then collapsing onto a sofa at the end of the day, is damaging our health. In fact, the British Heart Foundation estimates that one in six deaths in the UK is caused by physical inactivity. It’s clear: to keep our hearts healthy, we need to move our bodies more. The government recommends at least 150 minutes of moderate-intensity physical activity a week. That’s about 30 minutes a day, five days a week. It could be walking, running, cycling, sport, housework or gardening – anything that gets you moderately out of breath.

It’s worth it. Keeping physically active lowers your blood pressure, stops fatty material building up in your arteries, helps you manage your weight, and reduces your risk of heart disease by up to 35%.

Focus on daily movement

The best way to increase your physical activity – and crucially, to sustain it over time – is to make it part of your daily routine. Walk or cycle to work if you can. Or take public transport. You’ll be amazed how many steps you notch up walking to and from the station. At lunch, make sure you take a break from your desk, especially if you’re working from home. Get outside, walk around the block or your favourite nearby park. Even 15 minutes walking each lunchtime will make a difference.

Get your heart racing

Once you’ve banked your daily activity, it’s time to add interest with more intensive exercise (if you have a history of heart problems, then it’s best to check with your doctor first). That means doing something that gets your heart racing and makes it hard to talk without pausing for breath. Aim to do this at least once or twice a week. Join your local parkrun or take the plunge at your local lido, flex it in Zumba, play tennis, box or hit the gym. If you haven’t exercised for a while, your local gym will offer classes tailored for you. Find an activity you enjoy, so that you stick at it.

Eat a Mediterranean-style diet

Food fads come and go. But for years now, experts have agreed that the Mediterranean diet – plenty of fish, fresh fruit and vegetables, olive oils, grains, pulses and small amounts of meat – is one of the healthiest ways to eat. It’s why people in parts of Greece and Italy live such long and healthy lives. No doubt the sunshine and azure seas help too. Other healthy food cultures are found in Japan, the Nordic countries and West Africa. The ingredients and flavours vary, but these diets are all rich in whole foods, plants and fibre, and low in added sugar, trans fats and processed meats.

Prepare food healthily

Of course, it’s not just what you eat, it’s how you prepare it. Our brains are evolutionarily hardwired to reward us for energy-rich foods, giving us a welcome dopamine hit after eating them. That’s fine if you spend your day hunting for food or labouring in fields to grow it; you’ll need the energy. It’s not so good if you sit at a desk and only forage in Waitrose. So, when you’re cooking, add less oil and butter, avoid deep frying, and opt for grilling, healthy roasts, boiling, steaming or stewing instead.

Hold the salt

Sodium in salt is linked to high blood pressure, which increases your chances of heart disease and stroke. While we need a certain amount of salt in our diets – the NHS recommends 6g a day, or about a teaspoon, most of us are eating quite a bit more. That’s because a lot of the foods we buy – cereals, bread, readymade sauces, stock cubes, processed meat and snacks – contain high amounts of salt, as it’s an easy way to add flavour. So, check the nutritional labels on pre-packaged food and look for foods low in salt (coded green). And hold the salt at the table. Your food might taste a little bland at first, but your taste buds will soon adjust. Your heart will thank you for it.

Drink alcohol in moderation

Like salt, drinking too much alcohol also raises your blood pressure. Many alcoholic drinks, including wine and beer, are high in calories too. This can lead to you putting on weight and developing obesity, another risk factor for cardiovascular disease. So, enjoy drinking within the recommended guidelines – no more than 14 units a week for men and women. That’s about six pints of beer or 10 small glasses of wine. And be sceptical about any stories your read on the health benefits of some alcoholic drinks. You won’t find any doctors or dieticians recommending you take up drinking.

Get some good-quality sleep

Recently there has been a growing interest in the science of sleep. No wonder. Our busy lives, and the endless glow of our smartphones and tablets, means that many of us aren’t getting enough. The NHS says most of us need between seven and nine hours a night. If you’re getting less, or your sleep is disturbed through the night, you’re more likely to develop high blood pressure. You’re also more likely to use sugary foods and caffeine boosts to get you through the day. This raises your risk for high blood pressure and also developing obesity. So, practice good sleep hygiene and try to get your head down between 10-11pm, as research has shown this is an optimal bedtime for heart health.

And relax….

Stress in itself doesn’t cause heart problems, any raising of blood pressure is temporary. And it can be very useful, motivating us to overcome problems or hit targets. But chronic stress – that is with you all the time – can lead to unhealthy decisions, like turning to unhealthy comfort food, drinking more, exercising less or smoking. It can also damage your mental health, which will impact on your physical health. So it’s important to find ways to relax. Try meditation or mindfulness, both of which can lower blood pressure. Or listen to music, spend time with friends, exercise or get into nature.

Make the changes last

The importance of mindset cannot be overstated. While it may seem challenging to find time for exercise or view it as a hassle, recognising it as a fundamental aspect of life crucial for both physical and mental health makes prioritisation easier. Psychiatrists at Maudsley Learning emphasize the power of habit in sustaining changes. Integrating activities into your routine increases the likelihood of consistent commitment. Over time, these practices become part of your identity, serving as a motivating force. For instance, identifying as “a healthy eater” enhances the likelihood of choosing nutritious foods during your weekly shopping.

At Cromwell Hospital, a leading Heart Hospital in London, we understand the significance of mindset in heart health. Whether it’s incorporating regular exercise, monitoring your heart with a Hospital Heart Monitor, or consulting with a specialised Heart Surgeon for procedures like Heart Bypass Surgery or Open-Heart Surgery, we encourage a positive mindset. Be kind to yourself, use setbacks as opportunities for self-understanding, and persist in your journey toward a healthier heart.

Visit our heart and lung centre today.

Why Choose Us?

At Cromwell Hospital, we redefine cardiovascular care with a commitment to your heart health. Here’s why you should choose us for your cardiac well-being:

Expertise in Heart Health: Benefit from the insights of our skilled medical professionals, including experienced Heart Surgeons, ensuring the highest standard of care.
Comprehensive Heart Services: From routine check-ups to complex procedures like Heart Bypass Surgery and Open-Heart Surgery, we offer a full spectrum of cardiac services under one roof.
Cutting-Edge Facilities: Our state-of-the-art facilities feature advanced technology for precise diagnostics, monitoring, and innovative treatments, ensuring the best possible outcomes.
Patient-Centric Approach: Your unique needs and concerns are our top priority. Experience personalised care tailored to your individual heart health requirements.

Choose Cromwell Hospital for excellence in heart care. Trust us to be your partner in maintaining a healthy heart, providing expertise, advanced technology, and a patient-focused approach for your cardiovascular well-being.

Find out more about the cardiology services at Cromwell Hospital and how they can support you

The post Ten expert tips to keep your heart healthy appeared first on Cromwell Hospital.

Her healthy heart

Andrew Martin — Wed, 10 Apr 2024 02:18:00 +0000

Cardiologist Dr Rakesh Sharma talks about the differences in men’s and women’s hearts and how you make sure you stay heart healthy.

Heart disease affects women

World Heart Day, observed every September, serves as a crucial reminder for everyone to prioritise cardiovascular health. Despite prevailing misconceptions associating heart disease primarily with overweight men, it is imperative to acknowledge its impact on women. Shockingly, heart disease claims the lives of approximately one in eight women, surpassing the the mortality rate of breast cancer by more than threefold.

In the realm of heart health, awareness plays a pivotal role. It’s not just a concern for men; it affects women as well. While breast cancer may dominate the fears of many women, understanding and recognising the symptoms of heart disease is equally vital. As we navigate the complexities of heart health, seeking expert guidance and considering options like heart surgery or heart monitoring at a reputable Heart Hospital in London becomes increasingly significant. Expertise from a skilled Heart Surgeon, as well as procedures like Heart Bypass Surgery or Open Heart Surgery, can contribute to effective management and treatment.

Remember, your heart’s well-being is not gender-specific, and being proactive about heart health is a universal imperative. Whether you are concerned about general heart health or considering specific interventions like Heart Surgery in London, empowering yourself with knowledge and seeking the right medical expertise can make a significant difference.

Women’s hearts are different than men’s

Women’s hearts are different to men’s. They are smaller and they beat faster – so women can experience different symptoms. The public tend to think of heart disease manifesting itself as someone falling to the ground, clutching their chest. But it doesn’t always work like that. In addition to classic symptoms such as crushing chest pains, shortness of breath and sweating, women can often present with less typical symptoms, such as:

neck and jaw pain
upper back pain
abdominal pain, like indigestion
nausea and fatigue

Worryingly, because women are often unaware that these symptoms may be cardiac in origin, they are less likely to seek medical help and advice when they need to, meaning that often they present at a later and more serious stage of the disease.

Keep your heart healthy

The positive news is that there is a multitude of actions women can take to diminish their risk of developing heart disease. Various risk factors, including smoking, high cholesterol, diabetes, and high blood pressure, can be effectively addressed. Women who have undergone menopause face an elevated risk of heart disease, emphasising the need to proactively address these factors early on to minimise their risk. Here are some valuable tips for maintaining heart health:

1. Seek Expert Guidance at a Heart Hospital in London:

Regular consultations with a specialised Heart Surgeon or at a reputable Heart Hospital can provide personalised insights and recommendations tailored to your heart health.

2. Utilise Hospital Heart Monitor Services:

Incorporate regular monitoring with Hospital Heart Monitor services to track your heart’s performance and detect potential irregularities at an early stage.

3. Consider Heart Bypass Surgery or Open-Heart Surgery if
Necessary:

In cases where intervention is required, explore options like Heart Bypass Surgery or Open-Heart Surgery, performed by skilled professionals.

4. Adopt a Heart-Healthy Diet:

Modify your eating habits to lower cholesterol and blood pressure. Consume three to five servings of fruits and vegetables daily, reduce salt and sugar intake, and consider incorporating omega-rich foods like oily fish.

5. Embrace Regular Exercise:

Make exercise a regular part of your routine – aim for 150 minutes of moderate exercise per week. Simple changes, like taking the stairs or walking, can significantly contribute to heart health.

6. Quit Smoking:

Cease smoking to experience immediate health improvements. Within a year of quitting, your heart attack risk is halved, and after fifteen years, it reaches the level of someone who has never smoked.

If you suspect any symptoms of heart disease, consult your GP. In the case of new-onset chest pain, call for an ambulance. Timely diagnosis is crucial for effective management and treatment of heart disease.

Dr Rakesh Sharma is a cardiologist at Cromwell Hospital.

Explore more expert tips for keeping your heart healthy.

Why Choose Us?

At Cromwell Hospital, we stand out as a beacon of excellence in heart care. Our commitment to your cardiovascular health is unwavering, making us the preferred choice for comprehensive and compassionate cardiac services. Here’s why you should choose us:

1. Expert Heart Surgeons:
Our team comprises skilled Heart Surgeons with a wealth of experience, ensuring
top-tier care and successful outcomes.

2. Cutting-Edge Facilities:
Equipped with state-of-the-art technology, our hospital provides advanced
diagnostics, precise monitoring, and innovative treatments.

3. Personalised Care: We
prioritise your unique needs, offering personalised treatment plans tailored to
your specific heart health requirements.

4. Heart Hospital of Choice:
As a leading Heart Hospital in London, we have earned trust through a proven
track record of delivering exceptional cardiac care.

5. Comprehensive Services:
From routine check-ups to complex procedures like Heart Bypass Surgery and Open-Heart Surgery, we cover a spectrum of cardiac services under one roof.

Come to our heart and lung centre for unparalleled expertise, advanced technology, and a patient-centric approach to ensure your heart health is in the best hands.

The post Her healthy heart appeared first on Cromwell Hospital.

Menopause: Symptoms and treatment options

P White — Mon, 25 Mar 2024 16:27:30 +0000

Although its symptoms are often unwanted, a range of modern, effective treatment options mean that menopause need not be disruptive to a woman’s daily life. We spoke to Professor Jay Chatterjee, Consultant Gynaecological Surgeon, to find out more.

What is menopause?

Menopause occurs when hormone levels lower and your periods stop as a result. Although menopause is often used as a catch-all term, it specifically refers to the day on which it’s been 12 months since your last period.

Perimenopause is the transition period leading up to menopause, where your periods become irregular and begin to stop. You may also experience symptoms like hot flashes and vaginal dryness.

Postmenopause is the period after the menopause has officially occurred.

Menopause is a natural event that occurs as part of biological aging. However, in some cases, menopause may occur prematurely or be induced through cancer treatments, such as chemotherapy, or through surgery.

What age does menopause start?

Perimenopause usually begins between the ages of 45 and 55. In the UK, the average age for reaching menopause is 51.

What is early menopause?

If menopause occurs before the age of 40, it is known as early menopause or premature ovarian insufficiency (POI).

Early menopause can occur as a result of surgery (involving removal of the ovaries), cancer treatments like chemotherapy, or an underlying health condition.

If you have surgery which involves the removal of the ovaries, such as a hysterectomy, you will reach menopause immediately. This is known specifically as surgical menopause.

What is perimenopause?

Perimenopause is the transition period before menopause, where your ovaries gradually begin to slow down and stop producing eggs regularly.

Perimenopause can last from months to years – although, on average, perimenopause lasts around four years. During this time, you may experience an irregular menstrual cycle and menopause-like symptoms such hot flashes, insomnia, and vaginal dryness.

You can still become pregnant during perimenopause, so it is important to continue using contraception if you wish to avoid pregnancy.

Perimenopause ends when your period has stopped for twelve months.

What is postmenopause?

Postmenopause refers to the time period after you haven’t had your period in twelve months and lasts for the rest of your life.

The symptoms of menopause may or may not stop once you officially reach postmenopause. However, symptoms can last for up to seven years in around 50% of women and for up to 12 years in 10% of women.

Postmenopausal women are at increased risk of osteoporosis and heart disease due to lowered oestrogen levels. However, these risks can be reduced through lifestyle changes and/or hormone replacement therapy (HRT).

How long does menopause last?

Menopause refers specifically to the day on which you haven’t had a period in 12 months – therefore, it technically only lasts for one day.

Perimenopause lasts for four years on average. Postmenopause lasts for the rest of a woman’s life, although symptoms can last for up to 12 years on an average.

Menopause symptoms

Menopause can cause a wide range of symptoms. Some women may experience severe symptoms that impact their day-to-day life, while others will have mild symptoms.

The physical symptoms of menopause include:

heart palpitations
insomnia or poor sleep
fatigue
hot flushes and night sweats
dizziness and fainting
headaches
muscle and joint pain
vaginal dryness
increased thrush and UTIs
thinning hair
dry, itchy skin
tinnitus
dry mouth and eyes

As well as physical symptoms, many women also experience psychological symptoms, too. These include:

low mood and depression
anxiety
memory problems
panic attacks
difficulty concentrating
irritability
crying spells
mood swings
brain fog
loss of interest in sex

Blood tests for menopause

Menopause can usually be diagnosed based on symptoms alone. However, there are some diagnostic tests that can be carried out to confirm levels of FSH.

Follicle-stimulating hormone (FSH) stimulates the ovaries to release eggs (ovulation). During perimenopause, when fewer eggs are released, your body produces more FSH to try and encourage ovulation. Therefore, blood tests that show elevated levels of FSH can be a positive indicator of menopause and is inversely related to the level of oestradiol.

Blood tests for thyroid-stimulating hormone (TSH) may be used to rule out hypothyroidism, as the symptoms closely resemble those of menopause.

What are the signs of coming to the end of menopause?

You can estimate when you’ll officially reach menopause by keeping track of the monthly periods that you have missed.

You might also see your menopausal symptoms stabilise or improve with time – for example, your sleep may improve, or you find you have fewer hot flashes.

Treatments for menopause

Hormone replacement therapy (HRT)

The main treatment for symptoms of menopause is hormone replacement therapy (HRT), which is used to replenish the declining levels of hormones (oestrogen and progesterone). Taking HRT should improve almost all symptoms of menopause.

Low levels of oestrogen can increase your risk of developing osteoporosis, heart disease, type 2 diabetes, dementia, depression, and bowel cancer. HRT can also help reduce the risk of these conditions developing in the future.

There are different ways in which you can take HRT, including tablets, skin patches, creams and gels, and implants. Women who have a low sex drive as a result of the menopause may also be offered testosterone gel or cream.

HRT may not be suitable for all menopausal women. If you have had breast cancer or blood clots in the past, you may be advised not to take HRT as it can increase the risk of these conditions reoccurring.

Find out more about our gynaecology service >

Treatment for hot flashes

Women who cannot take HRT may be prescribed clonidine (a blood pressure medication), gabapentin (a seizure medication), or a new drug called Veoza (Fezolinetant) to improve their hot flashes.

MonaLisa Touch® for vaginal dryness

The hormone oestrogen is important in keeping the vagina healthy and lubricated. It also encourages the presence of ‘good’ bacteria that protect against infections.

During menopause, when oestrogen levels begin to lower, many women experience vaginal dryness. Vaginal dryness, also known as vaginal atrophy, occurs when the tissue lining of the vagina becomes thinner and drier.

MonaLisa Touch® is a non-hormonal, chemical-free treatment to address vaginal dryness. It may be a good option for women who can’t (or would prefer not to) use oestrogen-based therapies.

MonaLisa Touch® works by delivering fractional CO2 laser energy to the tissue of the vaginal wall, which stimulates the production of collagen and new blood vessels and restores proper balance to the mucous membrane. The procedure requires no anaesthesia, takes just a few minutes to complete, and allows patients to go home the same day.

More about MonaLisa Touch® >

About the consultant

Professor Jay Chatterjee is a senior Consultant Gynae-oncologist at the Royal Surrey County Hospital NHS Foundation Trust (Guildford) – associated with the renowned St Luke's Cancer Centre – and sees patients at the Cromwell Hospital.

Professor Chatterjee provides all aspect of surgical gynaecological and gynaecological-oncological care. He is internationally known for his surgical expertise in advanced open abdominal and laparoscopic/robotic operative skills. He is presently working to develop genomic, proteomic and immunomic characterisation of tumours, so that novel therapies can be applied as part of personalised cancer care to improve survival from gynaecological cancers.

Known for his patient-centred focus, Professor Chatterjee employs the most up-to-date clinical techniques in order to ensure that he can provide the utmost in patient care.

Book an appointment with Professor Chatterjee >

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Patient testimonial: Prostate cancer diagnostic pathway

P White — Wed, 20 Mar 2024 08:41:45 +0000

Mr Finlan accessed our prostate cancer diagnostic pathway through his Bupa insurance, and shares his experience of the pathway here:

“After experiencing periodic urinary tract infections, my doctor recommended a CT scan to see what was going on. The scan showed that I was suffering from a urinary retention issue, so my doctor provided a referral for follow-up investigation.

I choose to contact Bupa after experiencing a waiting list on the NHS. After discussion with Bupa, they recommended that I use their prostate pathway, and I was able to select Mr Taimur Shah as my consultant at Cromwell Hospital. My initial appointment was confirmed very quickly, and I visited the hospital within a week of making contact.

I attended the hospital initially for blood and urine tests, and these suggested an issue with my prostate in addition to urinary retention. I very quickly had an MRI scan and received the results on the same day in conversation with Mr Shah.

He recommended attending the hospital to have a catheter fitted to begin dealing with the bladder issue. He also highlighted that I had an enlarged prostate, with an indication of something that may be prostate cancer, but this needed to be followed up.

I then attended the hospital for two days, have been wearing a catheter for nearly three months, and have follow-up care starting soon, including further scans and a biopsy. While I’m still under treatment, for now I am well and living a fully normal life.

I have appreciated and enjoyed being under the care of Mr Shah. He is very straightforward and very supportive. My hospital stay was just before Christmas, and he popped in to see me which was unexpected and appreciated. He was available to contact directly over Christmas and has been quick and decisive about next steps.

I was very impressed that he chose to take my scans to a peer review as the results were a little unclear. I took great confidence from this flexibility.

Everyone at the hospital has been excellent, professional, and human. While I would like to recognise everyone, I want to thank Carmen at Cromwell Hospital for her tireless efforts.

I would recommend the prostate pathway. It has been reassuring to go through a structured process that is both quick and supportive. I have felt in control of my treatment and involved fully in discussion and decision making. In cases like mine there are many potential pathways, and this full involvement has been excellent.”

More about the prostate pathway >

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Enlarged prostate: Diagnostics and treatment options

P White — Wed, 21 Feb 2024 08:51:21 +0000

Around one in three men aged over 50 will experience urinary symptoms – and most of these will be caused by an enlarged prostate. We spoke to Mr Neil Barber, Consultant Urological Surgeon, to find out more about this condition and its treatment options.

What is an enlarged prostate?

Enlarged prostate is a common condition in men aged 50 and over, which often causes difficulty urinating. It is also formally known as benign prostate enlargement (BPE) or benign prostatic hyperplasia (BPH).

The prostate is a small gland, located between the penis and bladder. When it becomes enlarged, it presses on the bladder and the urethra (the tube urine passes through) which can cause problems with urination.

An enlarged prostate is not a symptom of prostate cancer, and men who have an enlarged prostate are not at an increased risk of developing prostate cancer.

What causes an enlarged prostate?

We don’t know for certain what causes an enlarged prostate, although it has been suggested that hormonal changes through aging contribute to the condition.

Is enlarged prostate dangerous?

An enlarged prostate is not cancer and is not considered a serious threat to overall health. However, it is important to have an enlarged prostate assessed and treated as soon as possible. Left untreated, an enlarged prostate could lead to complications with urination.

Symptoms of enlarged prostate

Symptoms of an enlarged prostate mainly relate to urination and may include:

finding it difficult to start weeing
straining to wee
having a weak flow of urine
weeing that stops and starts
an urgent need to wee
needing to get up frequently to wee at night
leaking wee (urinary incontinence)

Small amounts of urine may leak when you cough, sneeze, or lift something heavy (stress incontinence).

You may also experience leakage when you have an urge to wee but can’t make it to the toilet in time (urge incontinence).

Not all men experience symptoms of an enlarged prostate; some may have no symptoms at all.

Untreated enlarged prostate may lead to urinary tract infections (UTIs). In this instance, you may experience pain when urinating or have small amounts of blood in your urine.

How is enlarged prostate diagnosed?

If you think you have an enlarged prostate, you should make an appointment with a GP. Your GP will be able to assess your symptoms and medical history and make a referral to a urologist if required.

You will usually have a rectal examination, which involves feeling your prostate gland through the wall of your back passage (rectum).

You may also have a prostate-specific antigen (PSA) blood test, to check for prostate cancer, and a urine test, to check for diabetes.

A urologist can provide specialist advice, diagnostics, and treatment if you are experiencing complications from your enlarged prostate. You may be referred if:

you are not responding to normal treatments
you have frequent and/or difficult-to-treat UTIs
you cannot fully empty your bladder
you have kidney problems
you have stress and/or urge incontinence
you have a raised prostate-specific antigen (PSA) level
your prostate feels abnormal during a rectal examination

Can an enlarged prostate be cured?

An enlarged prostate cannot be cured, but the symptoms can be controlled. In most cases, men with an enlarged prostate respond well to treatment.

If your symptoms are very mild, you may opt to ‘watch and wait’ to see if your condition worsens. Sometimes, symptoms can be effectively relieved with lifestyle changes.

Lifestyle changes for enlarged prostate

If your symptoms are mild, you may be advised to make the following lifestyle changes:

Reduce your consumption of fizzy drinks and drinks that contain caffeine, artificial sweeteners, and alcohol. All these types of drinks can irritate the bladder and worsen symptoms.
Drink less fluid in the evening. Stopping drinking two hours before bed may decrease the number of times you need to get up to wee during the night. However, it is important to ensure you are getting enough fluid throughout the day.
Empty your bladder regularly. This is especially important if you know you will have reduced access to a toilet – for example, on long car journeys.
Practice double voiding. Double voiding is when you pause after emptying your bladder before trying to empty it again. This ensures your bladder is fully emptied. However, you shouldn’t strain or put too much pressure on your bladder.
Review your medications with a GP. Some common medications, like antidepressants or decongestants, can worsen enlarged prostate symptoms.
Eat more fibre. This helps avoid constipation, which puts pressure on the bladder and can worsen symptoms. Fibre-rich foods include fruit, vegetables, and wholegrain cereals.
Use absorbent pads or sheaths for leakage. These types of products can catch small amounts of urinary leakage and help you feel more confident.
Try bladder training. Bladder training is a set of exercises that aim to increase the amount of urine you can hold and reduce the number of times you need to urinate. You should ask your clinician for more information if this is something you would like to try.

Medication for enlarged prostate

For mild to moderate symptoms that cannot be controlled through lifestyle changes alone, you may wish to try medication. You may need to take more than one type.

Commonly recommended medications include:

alpha-blockers – which relax the muscles to make it easier to wee
anticholinergics – which relax the bladder muscle if it’s overactive
5-alpha reductase inhibitors – which shrink the enlarged prostate gland
diuretics – which are taken during the day, to speed up urine production (therefore decreasing the number of times you need to wee at night)
desmopressins – to slow down urine production at night
mirabegron – to relax your bladder muscle, allowing you to hold more urine and reducing your urge to wee

Surgery for enlarged prostate

If lifestyle changes and medication do not resolve your symptoms, you may be recommended surgery. There are several surgical procedures to treat an enlarged prostate and your consultant can help you decide on the best option for your case.

Aquablation

Aquablation, also known as water ablation, is a minimally invasive procedure that uses a robotically controlled, heat-free waterjet to remove enlarged prostate tissue. Compared to other procedures, Aquablation benefits from longer-lasting results and reduced complications.

The procedure uses a camera (called a cystoscope) and ultrasound imaging, which allows the surgeon to see and treat the prostate in real time. This increased precision helps reduce the chance of unwanted side effects and provides excellent clinical outcomes for patients.

UroLift

The UroLift system uses tiny implants which lift and hold two sections of the prostate apart, relieving pressure on the urethra and restoring urine flow. The procedure is minimally invasive, requiring no tissue removal, and most patients can go home on the same day. The procedure benefits from a very low rate of side effects, and most men retain full sexual function.

Rezum steam therapy

Rezum therapy uses steam to help eliminate unwanted tissue within the prostate. Steam is delivered to the prostate using an instrument inserted through the urethra, so that the steam energy can destroy the excess tissue.

Unlike other procedures, patients can often go home (with a catheter fitted) on the same day.

Transurethral resection of the prostate (TURP)

Transurethral resection of the prostate (TURP) is the most common type of surgical treatment for enlarged prostate in the UK, which uses electrocautery (an electrically heated instrument) to eliminate tissues that are causing urine flow blockages.

TURP is often recommended when medication does not work, or patients do not want to be on medication long-term. Most patients will spend two nights in hospital before being discharged.

Find out more about TURP >

Greenlight laser prostatectomy

Greenlight laser prostatectomy, also known as photovaporisation of the prostate, is a minimally invasive procedure, which uses a laser to remove excess prostate tissue. The excess tissue is immediately vapourised (destroyed) without affecting the healthy tissue around it.

Find out more about Greenlight laser prostatectomy >

Holmium laser (HoLEP)

The Holmium laser (HoLEP) laser is a similar type of procedure to Greenlight, which uses laser technology to remove excess prostate tissue. However, in this procedure, the laser cuts the excess tissue into very small pieces before it is removed from the body via means of another instrument.

What if I can't have surgery for enlarged prostate?

If you are not suitable for surgery, you may have a catheter placed to help your bladder drain.

A catheter is a soft, thin, and flexible tube which can be passed through the penis or through a small hole in your stomach. Its purpose is to carry urine away from the body.

Does enlarged prostate come back?

Unfortunately, for some men, an enlarged prostate will re-occur following treatment. These patients will often require repeat treatment.

What are the side effects of enlarged prostate treatment?

Occasionally, you may experience unwanted side effects depending on what type of treatment you have. This may include:

retrograde ejaculation – where semen doesn't come out of your penis during sex or masturbation, but flows into your bladder instead
urinary incontinence – when you have problems controlling your bladder
erectile dysfunction – difficultly getting and maintaining an erection
urethral strictures – narrowing of the urethra, causing urinary problems

Side effects are uncommon and can often be effectively treated.

Commonly asked questions around enlarged prostate

Can an enlarged prostate cause erectile dysfunction?

Erectile dysfunction is not typically caused by an enlarged prostate. Rarely, it can be a side effect following a TURP procedure.

Can an enlarged prostate cause constipation?

An enlarged prostate does not usually cause constipation. However, being constipated can make your enlarged prostate symptoms worse – this is because of the pressure placed on your bladder.

What is the best treatment for enlarged prostate?

Every patient is different and there is no universal treatment to suit every case. Our team of experienced urologists at Cromwell Hospital will work with you to find the most suitable treatment option for your case.

The post Enlarged prostate: Diagnostics and treatment options appeared first on Cromwell Hospital.

An interview with Mr Inderpaul Birdi, Consultant Cardiac Surgeon

Alice Leach — Thu, 15 Feb 2024 13:30:07 +0000

Mr Inderpaul Birdi is a consultant cardiac surgeon and a member of the Heart Partners specialist cardiac group at Cromwell Hospital. In this article, Mr Birdi tells us more about what his role as a heart surgeon entails.

What does your role as a consultant cardiac surgeon involve?

Surgery is a significant part of my role. Whether performing complex procedures or pioneering minimally invasive techniques, I strive to provide optimal care and outcomes for my patients.

I oversee the evaluation and diagnosis of complex cardiac conditions, collaborating closely with a multidisciplinary team to craft tailored treatment plans for patients and ensuring each approach aligns with their unique needs. Online patient education and post-operative care are also vital components, and I always strive to offer individualised support to patients throughout their journey to recovery.

I often engage in teaching and research, sharing knowledge with other aspiring surgeons wishing to learn about keyhole heart surgery, and contributing to advancements in cardiac surgery through ongoing studies and innovation.

What attracted you to specialising in cardiac surgery?

The allure of cardiac surgery lies in its ability to make an immediate and profound impact on someone's life. The heart is the engine of the body, and being able to intervene and restore its function is incredibly rewarding. The complexity of the procedures, the precision required, and the opportunity to innovate and improve techniques all drew me in.

Moreover, the profound gratitude from patients and their families, seeing them regain health and vitality after surgery, is unparalleled. It's a field where every day brings new challenges and opportunities to make a tangible difference in people's lives, and that's what continues to captivate and inspire me.

What does a typical day in your life look like?

My days tend to be quite dynamic and diverse. Mornings often begin early, when I have a quiet moment to review new medical developments to understand and communicate their meaning to my patients.

I often lead rounds with the medical team, discussing cases and adjusting treatment plans as needed. Collaboration with colleagues, attending meetings, and engaging in research or teaching activities also fill my schedule.

Surgical days are meticulously structured, starting in the operating room, where I perform intricate procedures, sometimes for several hours. Precision and focus are paramount during these times.

Between surgeries or non-surgical days, I dedicate time to meeting patients from all over the world, either in outpatient clinics or online, discussing their conditions, explaining procedures, and offering guidance.

What do you enjoy most about your job?

The most fulfilling aspect of my job is witnessing the transformation in my patients' lives. Being part of their journey towards better health and witnessing their gratitude and relief after successful surgeries or treatments is incredibly rewarding. There is nothing quite like seeing someone regain their vitality and quality of life.

Additionally, I thrive on the constant learning and innovation in the field of cardiac surgery. The opportunity to push boundaries, refine techniques, and contribute to advancements keeps me motivated and engaged. Finally, the collaborative nature of my work, the camaraderie with my team, and the shared goal of improving patients' lives create a fulfilling and enriching environment every day.

What do you like to do outside of work?

Music has always been a significant part of my life—I'm a tenor (certainly not one worth hearing though) and revel in the artistry of those who have mastered the craft. I occasionally perform as a soloist and in a choir to unwind and express myself differently from being a heart surgeon.

Engaging with the vastness of space and the intricacies of the cosmos has always been fascinating to me, and I continue to immerse myself in this captivating field whenever I can. Additionally, my fascination with the cosmos and the vastness of space is a constant source of wonder. My second career choice, had I not ventured into heart surgery, would have likely been astrophysics.

Maintaining a balance between work and personal life is crucial, so I make it a point to carve out moments for relaxation, exercise, and spending time with family and friends. Each day is a blend of challenges, patient care, continuous learning, and personal fulfilment.

Why do you love working at Cromwell Hospital?

Working at Cromwell Hospital is an absolute pleasure. The location itself is delightful, providing a serene and conducive environment for delivering exceptional care. The infrastructure is well-designed, fostering an atmosphere that enables our team to operate at the highest standards.

What truly sets Cromwell Hospital apart is not just its impressive facilities but also its outstanding management team. Their leadership ensures seamless operations and a supportive environment for all clinical and allied professionals, empowering us to provide world-class care for our patients.

The dedication and expertise of the team of professionals are truly commendable. Their commitment to delivering unparalleled care ensures that our patients receive nothing short of the best. It's a privilege to be part of such a remarkable institution where excellence is not just a goal but a daily practice.

Make an appointment with Mr Inderpaul Birdi >

The post An interview with Mr Inderpaul Birdi, Consultant Cardiac Surgeon appeared first on Cromwell Hospital.

Patient testimonial: Minimally invasive mitral valve repair

P White — Thu, 15 Feb 2024 13:10:53 +0000

Last year, Cromwell Hospital carried out their first minimally invasive mitral valve repair. The operation was carried out by Mr Inderpaul Birdi, Consultant Cardiac Surgeon, and Mr Roberto Casula, Consultant Cardiac Surgeon.

Here, the patient explains their diagnosis and experience at Cromwell Hospital:

“My diagnosis was discovered 15 years ago, by a very good doctor. You could just hear a murmur. Around four or five years ago it was checked once a year by ultrasound. About eighteen months ago it got worse, and my blood pressure went up.

I had some tests, and it was discovered I needed a valve replacement, because there’s two flaps going independently opposite each other. They told me about my options, which included open heart surgery.

I immediately wanted to have a minimally invasive repair, as that has the faster recovery time, and I’m really active.

I started to look for surgeons – you want to someone who does this regularly, who is an expert. I learnt about Mr Birdi, and knew he was an expert.

Mr Birdi and Mr Casula operated on me, they’re the best in the world. It was the first minimally invasive mitral valve repair that took place at the hospital and everything was perfect. I didn’t have any pain or discomfort.

Everyone was first class, including the anaesthetist and ICU staff. They’re just a team that flows together. The food was also excellent. I really couldn’t be more happy.

After my operation, I was shown my heart on a scanner, and you could see there was no regurgitation, no minor leak, nothing. I’ve got a heart that I've always had, that's working as perfectly as it was when I was a teenager. Thank you from me, thank you so much.”

After the operation, the patient was able to return home seven days after surgery. His recovery has gone well, and he has been able to return to the activities he enjoys.

“Minimally invasive cardiac operations have been shown through studies to provide a quicker recovery time with less discomfort for the patient. Although it is not suitable for every patient, being able to offer minimally invasive cardiac operations at Cromwell Hospital allows patients more options and a better experience. Supporting our first patient to retain his independence with a minimally invasive repair was important, and his recovery has gone well,” said Mr Birdi, Consultant Cardiac Surgeon.

“Supporting Mr Birdi and Mr Casula on the first minimally invasive mitral valve repair at Cromwell Hospital was a privilege. I’ve learnt a lot under their expertise, and I’m excited to support more patients access minimally invasive cardiac care,” said Georgia Henson, Cardiac and Respiratory Clinical Nurse Specialist.

Find out more about cardiac care at Cromwell Hospital >

The post Patient testimonial: Minimally invasive mitral valve repair appeared first on Cromwell Hospital.

Atrial fibrillation: What to know

P White — Tue, 30 Jan 2024 10:58:16 +0000

Atrial fibrillation is the most common heart rhythm condition in the UK, affecting around 1.4 million people. We spoke to Mr Aziz Momin, Consultant Cardiac Surgeon and Dr Riyaz Kaba, Consultant Cardiologist to find out more about atrial fibrillation and treatment options.

What is atrial fibrillation?

Atrial fibrillation, often shortened to AFib, is a heart condition that causes the heart to beat irregularly and often abnormally fast.

A healthy heart will beat with a steady, regular rhythm. If you have atrial fibrillation, the upper chambers of the heart (atria) beat irregularly – this leads to a decrease in heart function.

As well as making your heart beat irregularly, atrial fibrillation may also make your heart beat too fast. At rest, a normal heart rate is between 60 and 100 beats a minute; people with atrial fibrillation have a heart rate over 100 beats a minute.

How does atrial fibrillation occur?

The heart is made up of four chambers: two upper (atria) and two lower (ventricles). An electrical system helps keep the heart beating at a regular, steady rhythm.

The heart’s natural pacemaker (the sino-atrial node) is located in the right atrium. This node sends the signals that allow your heart to contract; the signals travel to the left atrium, then to the left and right ventricles. The atria contract to move blood into the ventricles, while the ventricles contract to move blood out to the body.

When you have atrial fibrillation, the heart receives signals from outside the sino-atrial node, causing the atria to quiver (fibrillate) in an irregular fashion. The ventricles receive these erratic signals and are unable to efficiently pump blood out to the body. These irregular contractions can also cause blood to pool in the heart.

If blood pools within the heart, it may start to clot. Most clots form inside the left atrium, because it has a pouch within the muscle wall (the left atrial appendage) where blood can become trapped. Clots have the potential to leave the heart and travel to the brain, causing a stroke – in fact, around 20% of all strokes in the UK are caused by atrial fibrillation.

Is atrial fibrillation heart failure?

Heart failure is when the heart becomes unable to pump blood properly around the body, meaning that your cells can’t receive the oxygen and nutrients they need. It can develop suddenly (acute) or gradually worsen over time (chronic).

Atrial fibrillation is not the same as heart failure. However, having atrial fibrillation can raise your risk of developing heart failure, alongside other heart-related complications.

How long can a person live with atrial fibrillation?

Untreated atrial fibrillation may lead to reduced life expectancy – this is because atrial fibrillation can raise your risk of heart failure, strokes, and more. However, most people who receive ongoing treatment for atrial fibrillation will lead long and healthy lives.

Atrial flutter vs atrial fibrillation

Atrial flutter is a type of abnormal heart rhythm (arrythmia) that causes the upper chambers of the heart (atria) to beat too quickly.

Atrial flutter is like atrial fibrillation. However, in atrial flutter, the heart rate is fast but regular; in atrial fibrillation, the heart rate is more erratic. It is possible to have episodes of both atrial flutter and atrial fibrillation.

Atrial fibrillation symptoms

If you have atrial fibrillation, you may feel that your heart beats irregularly and too fast, even if you’re at rest.

You may also experience other symptoms, including:

heart palpitations (the sensation of your heart skipping a beat)
chest pain
tiredness
shortness of breath
dizziness
feeling faint
difficulty exercising

Some people do not experience any symptoms and their atrial fibrillation is only detected at a routine appointment.

Atrial fibrillation symptoms at night

Atrial fibrillation symptoms at night may differ from those experienced in the daytime – largely because you’re usually lying down and resting.

If you have atrial fibrillation symptoms at night, you may experience:

frequent waking from sleep
waking with an odd feeling in your chest
feelings of anxiety

Atrial fibrillation causes

The causes of atrial fibrillation aren’t completely understood. It most often occurs in older people and those who have chronic conditions, such as heart disease, high blood pressure, or obesity.

However, some people who have atrial fibrillation don’t have any risk factors or pre-existing conditions. In these cases, their condition is known as lone atrial fibrillation.

Is atrial fibrillation hereditary?

There is a type of atrial fibrillation called familial atrial fibrillation, which is hereditary. However, not all cases of atrial fibrillation are hereditary.

Can stress cause atrial fibrillation?

Both stress and anxiety can contribute to atrial fibrillation, although they are not a direct cause of it.

Heightened emotional states can cause cardiac responses, such as heart palpitations when scared. It has been suggested that stress and anxiety can worsen episodes of atrial fibrillation in those who already have the condition.

Non-cardiac causes of atrial fibrillation

Atrial fibrillation can occur in some non-cardiac conditions, including:

asthma
overactive thyroid gland
chronic obstructive pulmonary disorder (COPD)
lung cancer
type 2 diabetes

It may also be triggered by things like:

consuming large amounts of alcohol or caffeine
being overweight
taking illegal drugs
smoking

How is atrial fibrillation diagnosed?

If you think you have atrial fibrillation, you should make an appointment with your GP, who will be able to review your symptoms and medical history and refer you for tests.

Tests for atrial fibrillation

There are various tests you may be recommended if you have suspected atrial fibrillation:

electrocardiogram (ECG) – a test that measures the electrical signals of the heart (a snapshot at that time)
24-hour or 3-day Holter monitor – a test that measures electric signals of the heart of a longer period
echocardiogram – a scan used to examine the heart and surrounding blood vessels
chest X-ray – this may be carried out if you have a suspected lung problem that might be causing your atrial fibrillation
blood tests – to check for other underlying causes of atrial fibrillation, such anaemia or an overactive thyroid gland

Atrial fibrillation treatment

If you are diagnosed with atrial fibrillation, a cardiologist will work with you to determine the best course of treatment. There are different treatment options available, depending on the severity of your case.

Atrial fibrillation medication

Some cases of atrial fibrillation can be controlled by medication called anti-arrhythmics, which help restore a normal heart rhythm and control the rate of your heartbeat.

You may also be given a type of medication, called anti-coagulants, to help prevent a stroke – this is because atrial fibrillation can raise your stroke risk. Anti-coagulants help stop the blood from clotting.

Catheter ablation for atrial fibrillation

Catheter ablation is a treatment used to correct certain types of abnormal heart rhythms. It works by either heating (radiofrequency ablation) or freezing (cryoablation) the area of the heart that’s causing the abnormal rhythm, creating scar tissue that blocks the electrical pathways. It can also destroy areas of the heart muscle that are responsible for triggering the abnormal rhythm.

During the procedure, thin, flexible tubes called catheters are passed through the blood vessels into the heart. Once the area to be treated is identified, any patches of abnormal tissue are destroyed. Patients are usually able to go home the same day, or after one night in hospital.

Find out more about catheter ablation >

Hybrid ablation for atrial fibrillation

Hybrid ablation is an innovative new type of treatment for patients with persistent atrial fibrillation, which involves a combination of two procedures: keyhole surgery and catheter ablation. Ablation is used to destroy tissue inside the heart, while surgery destroys tissue on the outside of the heart.

The surgical portion of the treatment involves using a long, thin device called a pericardioscope, which has a tiny camera and light attached to one end. This allows the surgeon to effectively see the outside of the heart and enables them to destroy any fibrillation-causing tissues with greater precision.

In some cases, during the hybrid ablation procedure, your surgeon may choose to place a special clip or suture on a part of the heart called the left atrial appendage. This may help reduce your chances of having a stroke in the future.

At Cromwell Hospital, hybrid ablation is carried out jointly by Mr Aziz Momin, Consultant Cardiac Surgeon, and Dr Riyaz Kaba, Consultant Cardiologist – collectively they carried out the highest number of hybrid AF ablations in Europe in 2019, 2022, and 2023.

Find out more about hybrid ablation >

Cardioversion for atrial fibrillation

Cardioversion is a treatment that aims to return your abnormal heart rhythm to a regular state through the use of electrical signals. It may be suitable for certain types of atrial fibrillation.

During the procedure, you will be fitted with electrodes that are attached to your chest. Controlled electric shocks are then delivered to the heart via a defibrillator, which continuously monitors the heart rhythm throughout treatment.

Find out more about cardioversion >

Pacemaker for atrial fibrillation

A pacemaker is a small electronic device inserted into the chest to help control your heart rhythm. In some instances, it may be used as a treatment for atrial fibrillation – often for those who are older or do not respond to medication.

Inserting a pacemaker is a short and simple procedure that takes around 30 minutes to complete. Your surgeon will make a small incision just below the collarbone and insert the pacemaker into your chest, before feeding the pacemaker’s leads through a vein to your heart. Most patients stay in hospital overnight.

Find out more about pacemakers >

Atrial fibrillation treatment at Cromwell Hospital

If you require treatment for atrial fibrillation, the Heart and Lung Centre at Cromwell Hospital provides a comprehensive range of treatment options carried out by world-leading cardiac specialists. We are also one of the only private hospitals in the UK to provide minimally invasive (keyhole) cardiac surgery.

Patients at the Centre can benefit from our multidisciplinary approach to care, with input from cardiologists, cardiac surgeons, physiologists, and more. Every aspect of care is tailored to your unique needs, ensuring you feel supported throughout treatment.

Find out more about cardiology at Cromwell Hospital >

About the consultants

Mr Aziz Momin graduated in medicine from King's College London and undertook surgical training at the Royal College of Surgeons of England. In 2013, he was appointed Consultant Cardiac Surgeon and Senior Lecturer at St. George's Hospital and Medical School, London. Mr Momin currently runs a new patient clinic and has a special interest in total arterial grafting, AF surgery, aortic surgery, and minimally invasive surgery.

View Mr Aziz Momin’s profile >

Dr Riyaz Kaba is a clinical academic Consultant Cardiologist and Cardiac Electrophysiologist at St George's, University of London, and Ashford and St Peter's Hospitals, Surrey, with an additional academic appointment at Royal Holloway, University of London. He has a special interest in arrhythmias and hosts the Surrey Atrial Fibrillation (AF) Meeting to enhance the clinical treatment and care of patients with atrial fibrillation and related conditions. Dr Kaba is the chief investigator of the HALT-AF (Hybrid AbLaTion of Atrial Fibrillation) trial.

View Dr Riyaz Kaba's profile >

Both consultants are members of the London Heart Partnership, a specialist cardiac group based at Cromwell Hospital.

The post Atrial fibrillation: What to know appeared first on Cromwell Hospital.

Winter dry skin: How to protect skin during the cold weather

P White — Fri, 26 Jan 2024 10:05:58 +0000

Dry, itchy skin is a common complaint when the temperature drops. We spoke to Dr Christina George, Consultant Dermatologist, to find out more about treatment options for dry skin.

What is the skin barrier?

The skin is made up of several layers. The outermost layer is called the epidermis, which itself is made up of further layers. The outermost epidermis layer is called the stratum corneum – or, more informally, the skin barrier. This is the layer that is affected the most by cold weather.

The skin barrier is made up of cells called corneocytes, which are bound together by lipids including fatty acids, cholesterol, and ceramides.

The skin barrier runs slightly acidic, at a pH of around 4.7; the very thin slightly acidic film which forms on the surface of the skin is called the acid mantle. The acid mantle helps protect against the growth of bacteria, viruses, and fungi that could lead to infections and other skin conditions.

The skin barrier’s purpose is to prevent harmful toxins from entering the body, so it plays an important role in your overall health.

Why is my skin dry in winter?

Moisture is essential to keeping the skin barrier healthy. There are many reasons why the skin may lose excess moisture during the winter, including:

indoor heating, which reduces humidity and leads to less moisture in the air
hot baths and showers, which can dry out the skin
harsh weather, which strips the skin of its natural, protective oils

Symptoms of dry skin

Dry skin is formally known as xerosis, the symptoms of which include:

dry, scaly, or rough-feeling skin
itchy or flaky skin
red, sensitive, or inflamed skin
acne or skin infections

How to care for dry skin in winter

Choose the right moisturiser for dry skin

To remedy dry skin, you must replenish your moisture levels. The easiest way to do this is through the use of moisturisers.

Moisturisers help to rehydrate the epidermis and prevent further moisture loss in the skin. If you’re looking to replenish dry skin, find a moisturiser with the following ingredients.

Humectants, including ceramides, hyaluronic acid, glycerin, and aloe vera. These help attract moisture back into the skin.
Emollients, including shea or cocoa butter, colloidal oatmeal, squalene, and triglycerides (lipids). These help to fill gaps in the skin where moisture has been lost.
Occlusives, including silicones, oils, petrolatum, lanolin, and beeswax. These help to form a protective barrier on the skin, preventing moisture loss.

For best results, you should apply your moisturiser directly after a shower or bath; gently pat your skin dry and apply immediately, to help seal in moisture.

Stay hydrated

Staying hydrated internally will reflect outwardly on your skin. Ensure you are drinking the recommended amount of water per day – most adults need around six to eight glasses, approximately 2 to 2.5 litres – to help your skin function at its best.

Avoid excessive heat

As enjoyable as a steaming hot bath or shower can be, they can have a detrimental effect on your skin’s moisture levels – try turning down the temperature to a lukewarm option instead. Similarly, avoid sitting too close to fires or heaters, as these draw moisture away from the skin.

Protect your skin

To prevent further moisture loss, protect your skin wherever it’s required – this includes putting on gloves when washing up, to wearing scarves and hats in cold weather.

Visit a dermatologist

If your dry skin isn’t improving with at-home treatment, it’s time to schedule an appointment with a dermatologist. Cromwell Hospital has a comprehensive dermatology service, which provides tailored treatment to meet your skin’s unique needs.

About the consultant

Dr Christina George is a consultant dermatologist at Cromwell Hospital, who is experienced in all aspects of general dermatology including eczema, psoriasis, acne, rosacea, hair loss, excessive sweating, melasma, skin rashes, and skin cancer.

View Dr Christina George’s profile >

The post Winter dry skin: How to protect skin during the cold weather appeared first on Cromwell Hospital.

Gastric bypass: What to know

P White — Thu, 04 Jan 2024 09:09:36 +0000

For many people experiencing obesity – particularly those who have struggled to lose weight through diet and exercise – bariatric surgery is an excellent option to kickstart weight loss and embrace long-term healthier habits.

Gastric bypass is a well-studied and highly effective type of weight loss surgery, which can help patients to lose up to 35% of their total body weight. Mr Ahmed Ahmed, Consultant GI and Bariatric Surgeon at Cromwell Hospital, explains more about this popular surgical weight loss option.

What is a gastric bypass?

Gastric bypass is a type of weight loss (bariatric) surgery that reduces the size of the stomach, making you feel full quicker. It is an option for people who have a BMI over 35 and would like to lose weight but have not seen results through diet changes or increased exercise.

During full gastric bypass surgery, staples are used to separate the upper portion of your stomach from the lower part, creating a small egg-sized pouch. The lower portion of the stomach remains attached to the upper part of the small intestine.

The small intestine is then divided, and the lower part is brought up to be reattached to the newly created pouch. Finally, the upper part of the small intestine (attached to the remaining stomach) is reattached to the part which has been brought up to the pouch – creating a ‘Y’ shape.

A full gastric bypass may also be called Roux-en-Y gastric bypass (RYGBP) – this is the name of the surgical technique used within the procedure.

What is a mini gastric bypass?

A mini gastric bypass (MGBP) is similar to a full gastric bypass but differs slightly in technique.

In a mini gastric bypass, a small pouch is created and connected further down the small intestine, bypassing around 2-3 metres of intestine in total. This type of bypass can be carried out more quickly, as there is only one new join (anastomosis) created whereas a full bypass creates two.

How does gastric bypass work?

Gastric bypass reduces the stomach to around the size of an egg, so that when you eat you quickly feel full. This is because the stomach can contain less food than it previously could, and because changes in gut hormone secretion give an earlier sensation of fullness.

What are the BMI requirements for gastric bypass surgery?

BMI requirements for gastric bypass surgery may vary between different providers.

At Cromwell Hospital, gastric bypass may be carried out for patients with:

a BMI over 35
a BMI of 30 or above and type 2 diabetes
for Asian patients – a BMI of 27 or above and type 2 diabetes

However, being physically fit for surgery is not the only consideration – you must also be able and willing to commit to the long-term dietary and lifestyle changes required.

Gastric bypass side effects

Long-term side effects for gastric bypass surgery include dumping syndrome, malnutrition, bowel obstruction, gallstones, hernias, stomach perforations, ulcers, and vomiting. Many of these can be remedied through revision surgery.

Immediately following surgery, the side effects of gastric bypass may include infection, blood clots, bowel leakage, or narrowing of the new join. These risks increase for patients with pre-existing health conditions, such as heart disease or high blood pressure.

Gastric sleeve vs gastric bypass

A gastric sleeve, also known as sleeve gastrectomy, is another type of weight loss surgery that involves reducing stomach size. Like gastric bypass, patients can expect to lose up to 35% of their total body weight and see an improvement in type 2 diabetes and high blood pressure.

There are several benefits to a gastric sleeve. This type of surgery is carried out laparoscopically (keyhole surgery), meaning it is less invasive and patients often recover faster. A gastric sleeve also comes with a reduced risk of developing side effects like dumping syndrome. However, weight loss is usually slower with a gastric sleeve than with gastric bypass.

Because gastric sleeve surgery can be carried out in a shorter length of time, it may be recommended for patients with a very high BMI who are at risk during longer operations. If required, the gastric sleeve can then be converted into a gastric bypass once the patient has lost weight.

What happens during gastric bypass surgery?

Preparing for gastric bypass surgery

Preparation for gastric bypass surgery begins at least several weeks in advance of your operation date.

You will receive a pre-operative diet plan, which you will be required to follow prior to your surgery – this is to help you lose a small amount of weight prior to your bypass. It is also recommended that you walk for 30 minutes per day, as this may help reduce the risk of post-operative complications.

People who smoke will be advised to quit at least six weeks prior to surgery, as smoking can raise your risk of post-operative complications.

On the day of your surgery, you will not be able to eat for at least six hours, and not drink for at least two hours, prior to going into theatres.

During gastric bypass surgery

Gastric bypass surgery is carried out under general anaesthetic, which means you’ll be asleep. It usually takes around one hour to complete.

Gastric bypass is usually carried out laparoscopically, using small surgical instruments, guided by a telescope with a video camera. The instruments are inserted through a series of small cuts in your abdomen.

Your surgeon will use surgical staples to separate the top section of your stomach from the lower part, creating a pouch. They will then cut an opening in the pouch and connect it to a section of the small intestine.

Your surgeon will close the cuts in your abdomen using dissolvable stitches or small metal clips and place a dressing over the area.

After gastric bypass surgery

Following surgery, you will awaken in the recovery room before being taken back to your own private room on the ward. It is normal to feel sore or in pain, and our nurses can give you medication to help you feel more comfortable.

Four hours after surgery, you will be encouraged to get out of bed and move around – this helps prevent blood clots from forming. You will need to walk around for 10 minutes roughly every two hours.

On the day of surgery, you will be allowed to sip on liquids such as water, tea, coffee, and soups.

You will be discharged home one to two days after surgery. On your return home, you will be given a diet plan which you will need to follow closely. If you have any questions or need advice, a member of the team will always be available via phone call.

How long does it take to recover from gastric bypass surgery?

You should be able to return to work one week after surgery, provided your job is desk-based and not strenuous. It is important to keep active and you will be encouraged to do 30 minutes of moderate daily exercise, such as walking.

For up to two weeks post-surgery, you will be on a liquid diet. Gradually, you will be able to transition to a pureed diet after two to four weeks, soft foods after four to eight weeks, and regular food after eight weeks.

You will continue to have follow-up appointments with the bariatric team, where blood will be taken to ensure you are not malnourished.

Commonly asked questions around gastric bypass surgery

What can you never eat again after gastric bypass?

Once you have fully recovered from surgery, you should not be limited in terms of what food you can consume. However, some patients find that they can no longer tolerate foods that are high in fat, sugar, and starch.

An important part of the gastric bypass journey is adopting new, healthier dietary and lifestyle choices. Immediately after surgery, you will be limited to a liquid diet and will slowly transition back to solid food over the course of eight weeks.

You will be required to take a nutritional supplement for the rest of your life, to prevent malnutrition. This is because bariatric surgery can affect the way your body absorbs nutrients from food.

What is the average weight loss after gastric bypass surgery?

Most patients can expect to lose between 30% to 35% of their total body weight during treatment.

Weight loss from gastric bypass surgery also comes with other health benefits, such as reversal of type 2 diabetes and an improvement in high blood pressure. Patients with gastro-oesophageal reflux disease (GORD) may also see a decrease in symptoms.

What is dumping after gastric bypass?

Dumping syndrome, or rapid gastric emptying, is when food moves too quickly from the stomach to the first part of the small intestine (duodenum) and cannot be properly digested. In rare cases, it occurs as a side effect of bariatric surgery.

There are two types of dumping syndrome: early and late. Early dumping occurs during or right after eating and is likely to be triggered by the consumption of sugary, fatty, or liquid foods. This type of dumping can cause stomach pain, bloating, nausea, and diarrhea.

Late dumping occurs two to three hours after eating. It is usually caused by the consumption of either sugary foods or large amounts of simple carbohydrates, which trigger a hypoglycemic response in the body. This can cause physical symptoms such as dizziness, heart palpitations, and excessive sweating, as well as emotional responses such as confusion and irritability.

Dumping syndrome can often be resolved by reducing foods that trigger the condition, such as those high in sugar and fat, and eating appropriate portion sizes.

Is gastric bypass reversible?

It is possible to reverse gastric bypass surgery. However, reversals are usually only considered for patients who have experienced severe side effects from their original procedure, such as chronic nausea and vomiting, chronic abdominal pain, or dumping syndrome. This is because the reversal procedure is complicated and carries some risks.

If your gastric bypass is reversed, you may regain weight. Your consultant can recommend an alternative weight loss procedure, such as a gastric sleeve, if you feel you need continued support to lose weight.

There is also the option of revision surgery. Because this is a very complex procedure, it is important to choose a highly experienced bariatric surgeon. Mr Ahmed Ahmed, who leads the bariatric surgery service at Cromwell Hospital, has carried out hundreds of revisional operations both privately and within the NHS.

How much is gastric bypass surgery?

Cromwell Hospital provides a variety of ways to pay, including all-inclusive, fixed price packages. For more information about pricing, please fill out an enquiry form or get in touch with our dedicated self-pay team at +44 (0)20 7244 4886.

Occasionally, bariatric surgery is covered by private health insurance – you may wish to confirm with your provider whether this is covered under your policy.

Find out more about gastric bypass surgery >

Why is it better to have surgery in the UK rather than abroad?

Many people are tempted to go for surgery abroad, often due to reduced procedure prices.

It is important to remember that bariatric procedures are considered major surgery; they can be complex and occasionally incur post-operative complications. It is much safer to have surgery at home in the UK, where your bariatric team are nearby and ready to support with any issues that arise.

Because the British healthcare system is strictly regulated, you can also be assured that any providers of bariatric surgery in the UK are reputable and experienced – something which cannot be guaranteed when having surgery abroad.

About the consultant

Mr Ahmed Ahmed is one of the UK’s leading bariatric surgeons and co-founder of The London Weight Clinic. He is an expert in minimally invasive (laparoscopic) surgery, and, in addition to bariatric procedures, provides a range of gastrointestinal surgeries including gallbladder surgery, anti-reflux surgery, and hernia repair. Mr Ahmed also offers a range of non-surgical weight loss options, including gastric balloons and weight loss injections.

View Mr Ahmed Ahmed’s profile >

The post Gastric bypass: What to know appeared first on Cromwell Hospital.

Cromwell Hospital

Ten expert tips to keep your heart healthy

How to Keep Your Heart Healthy

Move your body

Focus on daily movement

Get your heart racing

Eat a Mediterranean-style diet

Prepare food healthily

Hold the salt

Drink alcohol in moderation

Get some good-quality sleep

And relax….

Make the changes last

Why Choose Us?

Her healthy heart

Heart disease affects women

Women’s hearts are different than men’s

Keep your heart healthy

1. Seek Expert Guidance at a Heart Hospital in London:

2. Utilise Hospital Heart Monitor Services:

3. Consider Heart Bypass Surgery or Open-Heart Surgery ifNecessary:

4. Adopt a Heart-Healthy Diet:

5. Embrace Regular Exercise:

6. Quit Smoking:

Why Choose Us?

Menopause: Symptoms and treatment options

What is menopause?

What age does menopause start?

What is early menopause?

What is perimenopause?

What is postmenopause?

How long does menopause last?

Menopause symptoms

Blood tests for menopause

What are the signs of coming to the end of menopause?

Treatments for menopause

Hormone replacement therapy (HRT)

Treatment for hot flashes

MonaLisa Touch® for vaginal dryness

About the consultant

Patient testimonial: Prostate cancer diagnostic pathway

Enlarged prostate: Diagnostics and treatment options

What is an enlarged prostate?

What causes an enlarged prostate?

Is enlarged prostate dangerous?

Symptoms of enlarged prostate

How is enlarged prostate diagnosed?

Can an enlarged prostate be cured?

Lifestyle changes for enlarged prostate

Medication for enlarged prostate

Surgery for enlarged prostate

Aquablation

UroLift

Rezum steam therapy

Transurethral resection of the prostate (TURP)

Greenlight laser prostatectomy

Holmium laser (HoLEP)

What if I can't have surgery for enlarged prostate?

Does enlarged prostate come back?

What are the side effects of enlarged prostate treatment?

Commonly asked questions around enlarged prostate

Can an enlarged prostate cause erectile dysfunction?

Can an enlarged prostate cause constipation?

What is the best treatment for enlarged prostate?

An interview with Mr Inderpaul Birdi, Consultant Cardiac Surgeon

Patient testimonial: Minimally invasive mitral valve repair

Atrial fibrillation: What to know

What is atrial fibrillation?

How does atrial fibrillation occur?

Is atrial fibrillation heart failure?

How long can a person live with atrial fibrillation?

Atrial flutter vs atrial fibrillation

Atrial fibrillation symptoms

Atrial fibrillation symptoms at night

Atrial fibrillation causes

Is atrial fibrillation hereditary?

Can stress cause atrial fibrillation?

Non-cardiac causes of atrial fibrillation

How is atrial fibrillation diagnosed?

Tests for atrial fibrillation

3. Consider Heart Bypass Surgery or Open-Heart Surgery if
Necessary: