Fibroid, risiko tetap ada

Assalamualaikum,
Artikel ibu bersalin hari ini akan membincangkan tentang Fibroid. Amat sesuai dibaca untuk menambahkan ilmu pengetahuan.Selamat membaca.

AINA membaca buku sambil meniarap, tetapi cepat-cepat bingkas bangun semula. Eisy… sakitnya perut, kenapa ya, bisik hatinya. Lantas dia melihat dirinya di cermin. Tiada banyak bezanya, cuma perutnya agak buncit sedikit.Malah, ramai kawannya menyangka dia mengandung. Tetapi dia tersenyum sendiri. Mana mungkin. Haidnya datang begitu banyak sekali sampai berbungkus-bungkus tuala digunakan. Pasti tidak hamil!

Kawan-kawan mengesyorkannya berjumpa doktor, malu juga sebab sudah berusia, haid macam orang muda malah lebih daripada itu lagi. Bila berjumpa doktor, Aina disahkan mempunyai fibroid yang perlu dikeluarkan secepat mungkin.

Fibroid bagaikan sudah menjadi lumrah bagi wanita, biarpun tidak berbahaya namun risikonya tetap ada. Bunyi lucu tetapi serius. Kata-kata yang dihamburkan doktor pakar membuat sesiapa sahaja yang mendengarnya tersenyum.

Apa tidaknya, menurut beliau, andai bedah siasat dilakukan ke atas wanita-wanita yang sudah meninggal dunia, lebih 20 peratus daripada mayat-mayat itu didapati mempunyai ketumbuhan fibroid.
Maknanya, fibroid adalah sesuatu yang biasa bagi wanita dan ia tidak berbahaya biarpun mendatangkan ketidakselesaan kepada wanita yang mengalaminya.

Pakar Perbidanan dan Sakit Puan Hospital Pusrawi, Kuala Lumpur, Dr. Salleh Mohd. Yatim memberitahu, justeru wanita tidak perlu bimbang kecuali jika ia mendatangkan masalah kepada mereka.
“Bagaimanapun apabila ia memberi masalah, mereka perlu berjumpa doktor dengan segera untuk pemeriksaan dan rawatan selanjutnya,” ujarnya.

Menurutnya, ramai wanita tidak menyedari bahawa mereka mempunyai fibroid di dalam rahim atau ovari kerana tumor itu lazimnya tidak membesar sebaliknya mengecut apabila wanita itu mencapai usia menopaus.
Beliau bagaimanapun mengingatkan, terdapat kes-kes ketumbuhan fibroid yang memudaratkan apabila tumbesarannya berlaku dengan begitu pantas. Dari sekelumit kutil ia boleh membesar sehingga 50 paun dan rekod fibroid terbesar dikeluarkan di dunia adalah 140 paun!

Dr. Salleh berkata, ini menyebabkan ramai pesakit tidak menyedari mereka mempunyai ketumbuhan dalam rahim, kerana kebanyakan fibroid hampir sifar simptom.
Tambahnya, jika fibroid begitu cepat membesar dan boleh menghinggap atau melekat pada organ-organ lain, ketika itulah ia mengundang kemudaratan. Ia turut membawa kesengsaraan lain bagi pesakit.

* Apa itu fibroid?
Fibroid adalah ketumbuhan biasa atau benign (bukan kanser) yang terdapat di dalam uterus/rahim wanita yang berusia sekitar 30 hingga 40-an.
Ia merupakan salah satu ketumbuhan yang biasa terjadi kepada wanita semasa tahun-tahun kesuburan mereka.
Biarpun begitu ia boleh tumbuh di lain-lain organ yang mengandungi sel-sel otot licin. Fibroid adalah tumor pejal yang terjadi daripada tisu-tisu fiber di mana dari situlah ia mendapat namanya.
Lazimnya, fibroid tercetus sebagai ketumbuhan dan membesar secara perlahan-lahan, selalunya tanpa simptom.
Malah kedudukan fibroid yang boleh menyebabkan kemandulan ini, telah mencetuskan kontroversi.
Kenapa? Ketumbuhan ini merupakan penyebab utama bagi pembedahan histerektomi iaitu pembedahan mengeluarkan fibroid dan rahim.

* Tidak pernah mengandung
Dr. Salleh berkata, lazimnya mereka yang tidak pernah mengandung, gemuk, berkulit hitam, mempunyai risiko untuk mendapat fibroid.
“Bagaimanapun tiada sebab-sebab tertentu seseorang itu boleh mendapat fibroid. Hanya sekitar 25 peratus sahaja pesakit fibroid yang mengalami simptom-simptom.
“Ini termasuklah mereka yang mengalami pendarahan haid yang banyak, sakit sewaktu hubungan kelamin, kemandulan mahupun masalah dubur yang disebabkan oleh tekanan akibat daripada ketumbuhan fibroid ini,” jelas beliau.
Bagi wanita mengandung pula, fibroid boleh menyebabkan komplikasi termasuk keguguran, sakit bersalin sebelum waktunya dan kesakitan akibat daripada infarksi yang berpunca daripada kekurangan bekalan darah atau menyebabkan kedudukan bayi tidak normal dan terpaksa menjalani pembedahan Caesarean semasa bersalin.
Biarpun amat jarang berlaku, fibroid boleh berubah keadaannya dengan menjadi malignan, apabila ia cukup besar mahupun membesar dengan cepatnya.

* Diagnosis
Lazimnya, diagnosis dilakukan dengan mengambil kira sejarah simptom-simptom seperti yang dijelaskan di atas, atau secara kebetulan apabila pesakit menjalani pemeriksaan faraj yang berkala seperti ujian pap smear.
“Bagi sesetengah wanita yang menjalani pemeriksaan kemandulan, fibroid boleh dilihat sewaktu menjalani imbasan ultrasound.
“Imbasan ultrasound adalah sangat penting memandangkan ia juga boleh membezakan di antara sis dan lain-lain tumor pelvik,” kata Dr. Salleh.
Imbasan Pengimejan Resonans Magnetik (MRI) di mana magnet-magnet berkuasa tinggi digunakan untuk melihat struktur tisu-tisu juga berguna walaupun ia adalah mahal.
Ia bermanfaat bagi membezakan di antara fibroid dengan adenomiosis iaitu satu keadaan yang berkaitan dengan endometriosis dan agak sukar untuk dirawat.
Katanya: “Malah, ada yang datang berjumpa doktor setelah mendapati abdomen mereka semakin lama semakin membesar seperti mengandung. Selepas pemeriksaan dilakukan barulah diketahui wanita ini mengalami fibroid.”

* Jenis-jenis fibroid
Lokasi fibroid sering mempengaruhi tanda-tanda yang dialami dan pada sesetengah kes, rawatannya.
- Fibroid submukus terdapat di bawah lapisan uterus dan boleh menyebabkan masalah haid termasuk kesakitan apabila ia membesar.
- Fibroid intramural adalah fibroid bulat yang terdapat di dalam dinding uterus yang boleh menyebabkan pembesaran uterus.
- Fibroid subserous tumbuh di luar dinding uterus dan selalunya tidak menyebabkan sebarang tanda-tanda sehinggalah ia membesar dan mengganggu organ-organ lain.
- Fibroid pedunkel berbentuk gagang tercetus apabila fibroid subserous mengeluarkan tangkai atau pedunkel, membesar serta membengkok dan menyebabkan kesakitan yang amat sangat.
- Fibroid submukus dan intramural lebih banyak mengundang kesakitan semasa haid dan mendatangkan masalah seperti keguguran. Sementara itu, subserous dan pedunkel pula boleh menyebabkan masalah kemampatan dan kesakitan terutamanya semasa kehamilan.
- Fibroid interliganmentous tumbuh di sisi di antara ligamen yang menyokong uterus di dalam abdomen dan adalah sukar untuk mengeluarkannya yang berkemungkinan menjejaskan bekalan darah.
- Fibroid parasitik, paling jarang berlaku di mana fibroid melekat pada organ lain.

* Waktu sesuai merawat fibroid
“Fibroid perlu dirawat sekiranya ia mula menunjukkan tanda-tanda seperti yang dijelaskan tadi.
“Ia juga difikirkan sesuai, bagi sesetengah kes apabila seseorang wanita ingin hamil dan pandangan perubatan berbelah bahagi sama ada fibroid perlu dirawat atau mencari peluang mengandung,” kata Dr. Salleh.
Kadangkala, haid yang terlalu banyak boleh menyebabkan seseorang wanita itu mendapat anemia.
Pun begitu, katanya, kebanyakan doktor bersetuju biarpun tiada simptom-simptom, fibroid pedunkel agak jarang mencetuskan masalah besar bagi wanita hamil.
Bagaimanapun bagi fibroid submukus, ia berkemungkinan menyebabkan wanita lambat hamil serta mengakibatkan wanita hamil mengalami keguguran.
Keputusan untuk merawat atau tidak sebenarnya bergantung kepada usia wanita itu sendiri, saiz fibroid, pernah keguguran dan sama ada rahim menjadi herot kerana kewujudan fibroid itu.
Dr. Salleh menambah, usia adalah faktor penting kerana fibroid akan membesar di bawah pengaruh estrogen dan fibroid juga mudah dikeluarkan di kalangan wanita muda dan ketika fibroid masih kecil lagi.
Bagi wanita yang berusia, mereka perlu berjaga-jaga apabila membuat keputusan untuk melengahkan pembedahan.
“Bagaimanapun, wanita yang telah menjalani pembedahan mengeluarkan fibroid perlu mengambil masa sebelum mengandung. Pakar akan menasihati masa yang sesuai mengikut keadaan pesakit,” ujarnya lagi.

* Rawatan fibroid
Rawatan fibroid bergantung kepada saiz dan kedudukan fibroid itu.
- Rawatan hormon; terapi hormon sangat berguna kepada wanita yang hampir menopaus dan bercadang untuk mengelak pembedahan. Bagaimanapun terapi ini tidak banyak memberi manfaat kepada wanita yang bercadang untuk hamil.
- Reseksi histeroskopi; lazimnya dilakukan ke atas fibroid submukus asalkan fibroid itu berukuran kurang daripada l0 sentimeter garis pusat. Beberapa proses dilakukan sebelum pembedahan dapat dilakukan.
Pembedahan membuang fibroid ini menggunakan sejenis alat berupa wayar khas bersama histeroskop yang dimasukkan ke dalam uterus melalui serviks/pangkal rahim.
- Pembedahan laparoskopi atau miomektomi laparoskopi pula adalah pembedahan bagi mengeluarkan fibroid.
Intramural dan subserous boleh dikeluarkan melalui pembedahan ini melalui dua insisi/pemotongan 10 milimeter panjang, satu di bahagian pusat dan satu lagi di garisan abdomen.
Hanya segelintir sahaja pakar yang mengambil pilihan ini kerana ia mengambil masa yang lama dan cukup mencabar.
- Miomektomi terbuka, pembedahan konvensional yang dilakukan melalui insisi di bahagian bawah, memanjang atau menegak di bahagian garisan bikini (antara ari-ari dan abdomen). Otot-otot uterus dibedah dan fibroid dikeluarkan.
Doktor biasanya akan mengesyorkan wanita yang hamil selepas pembedahan ini untuk menjalani pembedahan Caesarean apabila sampai masanya untuk bersalin.
- Histerektomi bergantung kepada usia, bilangan anak, masalah kesihatan wanita serta lain-lain faktor.
Wanita yang menjalani histerektomi tidak akan mempunyai haid lagi kerana rahimnya sudah dikeluarkan sekali bersama fibroid.

* Nasihat pakar
Dr. Salleh menegaskan, bagi wanita yang menopaus, mereka perlu mendapat rawatan sekiranya mengalami tanda-tanda menopaus yang teruk.
Dalam hal ini, suami perlu memberi sokongan yang sewajarnya untuk isteri dalam meneruskan kehidupan seharian termasuk dalam hubungan suami isteri.
Beliau juga menekankan, wanita perlu menjalani ujian pap smear secara berkala untuk mengesan kanser servik dan fibroid. Fibroid yang aktif dan cepat membesar juga berbahaya bagi wanita.
Wanita yang melalui pembedahan perlu mengamalkan gaya hidup sihat, pemakanan yang ideal serta melakukan senaman yang bersesuaian apabila mereka sudah pulih sepenuhnya. Jumpalah doktor untuk nasihat selanjutnya.

Sumber: http://duniaherbahpa.com/2006/11/artikel-kesihatan/

Sunday January 23, 2011

After Caesar

WOMEN'S WORLD By Dr NOR ASHIKIN MOKHTAR

Tips for women who have to undergo Caesarean sections – how to have a positive delivery and care for yourself after surgery.

IN my years of practice, I have had many pregnant women walk through my doors, with different opinions on the method of their delivery.

Some women are adamant about having vaginal deliveries, while others may prefer to go straight for a Caesarean section.

In reality, the choice of method ultimately depends on the woman’s body and the baby. As doctors, we know that nature has given babies a way out through vaginal delivery, but some circumstances may call for a surgical method instead.

In one of my earlier articles for this column, I had written about the pros and cons of a C-section, and when it may be medically necessary.

Pain is to be expected after a Caesarean section. Ask your doctor for advice about painkillers, but if you are breastfeeding, discuss the possible side effects and safety issues for your baby. – AFP

In this article, I will provide some tips for women who have to undergo C-sections – how to have a positive delivery and care for yourself after surgery.

When a C-section is needed

A C-section is when the baby is delivered through an incision in the mother’s abdomen and uterus. Sometimes your obstetrician will advise you to have a C-section in advance, due to certain pre-existing conditions that you may have or that you developed during pregnancy, including genital herpes, gestational diabetes, or multiple births.

At other times, you may go into labour wanting a natural delivery, but certain complications, like breech positions or foetal distress, require you to have a C-section instead.

Some of my patients are totally against C-sections because they have heard horror stories about the dangers of, and recovery from, the surgery.

You are right to feel cautious about undergoing a C-section, as it is a major surgical procedure and carries risks.

However, your obstetrician would not recommend a C-section unless he or she felt that it was absolutely necessary. Under these circumstances, the benefits of a C-section would outweigh the risks, potentially saving your life and that of your baby’s.

Post-op care

If you do need to undergo a C-section, you should take great care of yourself after the operation, so that you heal and recover quickly, and are able to enjoy being a mother!

Here are some tips for what to expect, and how to care for yourself, after the surgery:

·Start getting up and going to the bathroom within the first 24 hours after surgery. This will help you heal faster and get you used to moving around with your wound. When you first try to get up, move slowly and have someone with you because you may feel dizzy or short of breath.

·Take slow strolls around the hospital, or sit in a rocking chair. This will help to speed up healing and help with gas after abdominal surgery.

·If you find it painful to urinate after the catheter is removed, ask the doctor or nurse to suggest solutions that will ease the pain.

·Pain is to be expected after the surgery. Ask your doctor for advice about painkillers, but if you are breastfeeding, discuss the possible side effects and safety issues for your baby. If you want to avoid medications, ask your doctor about any drug-free alternatives.

·Don’t be alarmed when you experience heavy bleeding. This is due to your uterus shrinking down to its pre-pregnancy size, so you will have a heavy flow of bright red blood for up to six weeks post-surgery. Use extra-absorbent menstrual pads or special post-delivery pads, not tampons. The colour of the bleeding will change over time to pale pink or dark red, and then eventually to a yellowish or light colour.

·When you are back at home, avoid housework, strenuous activities and heavy lifting. Do not lift anything heavier than your baby. If you start bleeding more, that will give you an idea that you are doing too much.

·Make sure that the baby changing station and feeding supplies are near you, so that you don’t have to move around too much.

·Drink plenty of fluids to prevent constipation, and eat nutritious meals to restore your energy and promote healing. Keep an eye out for fever or pain that doesn’t go away, as that could be a sign that your wound is infected.

·Talk to your doctor about family planning, and when is an appropriate time to try and conceive again. Your body needs time to heal after this pregnancy and delivery.

There are a lot of old wives’ tales about what you should or should not do after a Caesarean. Some of these are based on sound medical advice. For instance, do not have sexual intercourse or do exercise until your doctor says it’s safe.

Do not take baths, only showers, until your wound is healed and you are no longer experiencing vaginal bleeding.

Avoid going to public pools, hot tubs, spas and saunas until your doctor advises otherwise.

Going up and down the stairs repeatedly may not be good for your wound, so avoid movement like that for several months.

What to watch out for

Your healing is of paramount importance after surgery. Look out for signs that you may be suffering from post-op infection or are not healing well.

If you experience any of the following, call your doctor immediately:

● Fever of more than 38 degrees Celsius

● Severe headache that begins after birth and does not let up in intensity

● Sudden onset of pain, tenderness and burning in the abdominal area

● Foul-smelling vaginal discharge

● Sudden pain in the wound area, including discharge of pus

● Pain in one area of the leg, which is swollen and red

● Burning sensation when you urinate, or blood in the urine

● Rash or hives on the skin

● Extremely heavy bleeding that soaks a maxi pad in one hour, or bleeding large clots

● Sore, red and painful area on the breasts, may be accompanied by flu-like symptoms

● Feeling anxious, panicky or depressed

Emotional care

Some women may feel quite upset after a Caesarean section, either because they had really wanted to have a normal delivery or because it was an emergency operation to overcome a critical situation. Such distress is normal, and women need support and understanding to get through this.

Do not be afraid to talk about your feelings to someone, either to family or a trusted friend. Describe how you felt throughout the birth process, so that you can deal with any negative feelings you may have.

If you have problems breastfeeding, talk to a lactation consultant through your hospital or the support groups – there are many groups in Malaysia who are available to give advice online.

Do not be ashamed to ask for help from family, relatives or friends to take care of you or the household. You may feel overwhelmed that simple tasks leave you feeling drained, so don’t try pushing yourself.

Most importantly, spend time every day to hold your baby and bond with him or her. All the pain will be worth it when you look into your baby’s eyes.

■ Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK). For further information, visitwww.primanora.com. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

source: http://thestar.com.my/health/story.asp?file=/2011/1/23/health/7839619&sec=health

Health Tips During Pregnancy

Health Tips During Pregnancy
By Lacey Cormier

Pregnancy is the stage where a woman bears a child in her womb and has to take care of not only herself but also the baby within her. A woman's body can be very delicate during this stage and thus the people around her needs to know what she needs and have to avoid. Some, because of their lifestyle, those who are down because of poverty, sometimes forgets the things they need to do during those nine months. Here's a list of easy activities that doesn't need too much money but definitely important for pregnant woman.

- Medical Check Ups
It is the most important for a pregnant woman to have her monthly check ups with an OB gynecologist. If not, "barangay" or city health centers offer free consultations. The gynecologist or the midwife/doctor will check you and your baby if you are in good conditions.

- Daily Vitamins
After a check up, the midwife will give the mother free vitamins for the baby's development and also for herself as her body undergoes changes for the child's growth. During pregnancy, women should always take in mind that she needs to be healthy in order for her child to be healthy as well. The right vitamins and supplements will always do the trick.

- Vaccines
While pregnant, women shouldn't take any sort of medicine unless prescribed by a doctor. Some of the drugs can affect the child's development mentally and physically. But there are vaccines such as Tetanus Toxoid as a preparation for giving birth. Infection might affect the mother or the child (like the Tetanus infection) during birth so just before that due date, the mother must have her complete shots of T. T. to protect herself and the baby. In case of wounds or any other complication, anti-tetanus serum e.g. elisa kits, etc. should also be given for faster protection. It also measures the mother's protective status and thus, determines the proper treatment.

- Exercise
It is always good for the body; exercise helps your immune system to get stronger and a lot fitter, adjusting to the change due to pregnancy. It also prevents a lot of swelling at some parts of the body.

- Diet
Food is one of the most important factors when a woman's pregnant. This is where she gets most of the nutrients and vitamins for her and her baby. Also, a balanced diet affects the nutrients that help the baby's formation and development.

- Stress/Depression
These are the factors that a pregnant woman must avoid. Depression and stress affects the child's mental development and might result into a complication after birth. It can also cause low blood pressure and might turn the mother unhealthy. As far as possible, a mother should be healthy not only physically but also mentally and emotionally.

Pregnancy can be risky but easy to handle with proper intelligence and information. Women should take care of themselves while pregnant for their child's development, it is important that a child should be born healthy and perfectly well. Though always at home, there should always be enough caution and preparation even inside the house. Parents should always be prepared for anything and keep things in handy. Just like first aid kits (also like Elisa Test Kit ), emergency hotlines, and anything that could be used in times of unexpected events. "Prevention is better than cure" is always a sensible quote to keep in mind.

Silent but highly focused, Lacey Cormier is a 20 year-old working student who studies nursing at night and works part-time on a pharmacy during the day. She likes helping customers and referring items like elisa test kits and elisa kits, new and effective generic drugs and food supplements. She lives with her family in Ohio.

Senggugut Boleh Menghalang Ibu Bersalin

Artikel sulung ini akan membincangkan berkenaan Senggugut kerana ianya boleh mengakibatkan kesukaran untuk mengandung bagi kaum wanita sekaligus menafikan anda untuk menjadi Ibu Bersalin.

Panduan/Petua/Artikel Berkaitan Senggugut Tulisan Tn Haji Ismail, Pengarah Urusan HPA

Senggugut

Sakit ketika kedatangan haid boleh disembuhkan dengan mengambil sinergi seperti dibawah:

1. Paramaria – 2 X 3
2. Tuju angin – 2X 3
3. Senggugut – 2 x 3

InsyaAllah senggugut tidak akan berulang dan banyak testimoni yang diberikan oleh pengguna sehinggakan kita boleh kategorikan sinergi ini sebagai sinergi yang mempunyai keberkesanan melebihi 90%. Disamping itu juga terdapat kes ketumbuhan seperti fibriod yang menjadi semakin kecil. Biiznillah.

Senggugut

Kesakitan apabila kedatangan darah haid (senggugut) merupakan satu keluhan yang sering ditanya dalam KPJ. Dalam pemerhatian saya ada pasangan yang tidak mendapat cahaya mata mungkin ada hubunganya secara langsung atau tidak dengan masalah senggugut.Ini dapat dilihat apabila senggugutnya hilang ,si isteri didapati mengandung.

Kalau hanya untuk menghilangkan kesakitan senggugut, anda boleh menggunakan sedikit(hujung jari) kapur makan yang dimasukan dalam air teh biasa dan minum,InsyaAllah akan beransur-ansur sembuh dengan izin Allah.Namun begitu bagi pasangan yang tidak mendapat cahaya mata hendaklah mengambil ubat periuk senggugut dahulu dan kemudian mengambil set kesuburan lelaki dan set kesuburan perempuan.

Set kesuburan lelaki ialah:
1.Radix kapsul;
2.Omega 3;
3.EQ minda;
4.Roselle; dan
5.Tuju Angin.

Manakala set kesuburan wanita pula ialah:
1.Paramaria Plus;
2.Omega 3;
3.Roselle; dan
4.Spirulina .

Jika “infertiliti” itu disebabkan oleh logam berat (rambut gugur,gatal-gatal kulit dan kuku rosak) sebaiknya menggunakan “deep cleansing” sebagai tambahan.
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Tuan Hj Ismail adalah pakar dalam bidang perubatan herba. Jika anda benar-benar mengikuti apa yang disarankan, InsyaAllah anda akan mengandung dan bakal menjadi Ibu Bersalin.

Untuk membeli Herba Senggugut secara online silakan melawat web berniaga online

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