Pregnancy is accompanied by a lengthy list of do's and don'ts—take prenatal vitamins, no alcohol, exercise carefully, and eat well. But what about when an unplanned health issue presents itself, such as the necessity for a mammogram? For most women, this might not even be something they think about until they are in a position where breast cancer screening is an option.

Perhaps you're over 40 and in need of your yearly mammogram, or perhaps you have a history of breast cancer in your family and you want to keep your screenings current. More emergently, you've found a lump in your breast. So, can you have a mammogram when pregnant? The answer is yes, but there are several things to consider.

Pregnancy creates substantial hormonal changes that affect the body, as well as breast tissue. Estrogen and progesterone's rise causes the breasts to expand and condition to produce milk, which results in denser tissue. This increased density is more challenging to detect any abnormalities with using mammograms. Even post-delivery, should the woman be breastfeeding, milk-filled glands can also make the breasts denser and, as a result, make mammogram readings less clear.

While 3D mammograms have improved imaging technology to help navigate dense breast tissue, doctors often suggest postponing routine screening mammograms until after pregnancy if there are no symptoms or high-risk factors. However, if a lump or abnormality is found, your doctor may recommend immediate diagnostic imaging.

When Is a Mammogram Necessary During Pregnancy?

Mammograms are not done routinely if a woman becomes pregnant, yet there are specific situations where one might be unavoidable. Breast cancer in pregnancy does occur—1 in 3,000 times—but it's not common. If a lump is detected by a woman, she has constant breast pain and no explanation, or she is at high risk (e.g., strong history of breast cancer in her family or genetic defect such as BRCA1 or BRCA2), a physician will order a mammogram.

The process itself takes very little radiation exposure. The radiation employed by a mammogram is concentrated on the breast, and there is little to no radiation that reaches other areas of the body. A lead apron is also placed over the belly to shield the unborn child.

Alternative Breast Imaging Options During Pregnancy

For pregnant women requiring breast imaging, physicians may initially suggest an ultrasound. In contrast to a mammogram, an ultrasound is not done with the use of radiation and is deemed safe for pregnant women.

An ultrasound of the breast can establish whether a lump is a fluid-filled cyst or a solid tumor that needs further investigation. Yet ultrasounds are not always diagnostic, and in certain instances, a mammogram or biopsy is needed to determine or rule out cancer.

Magnetic Resonance Imaging (MRI) is also an imaging choice but has some drawbacks. The majority of breast MRIs employ a contrast material called gadolinium, which is able to pass through the placenta and to the fetus. Although risks are not entirely clear, physicians usually do not use MRI with contrast unless necessary. Some practitioners may offer an MRI without contrast as an option.

What If You Find a Lump In Your Breast During Pregnancy?

Breast changes throughout pregnancy are normal, but finding a lump should never be taken lightly. If you notice a lump, alert your medical provider right away. They will conduct a clinical breast exam and potentially have you get an imaging study such as an ultrasound or mammogram to see whether anything needs to be done.

If imaging indicates a suspicious mass, a biopsy can be suggested. Core needle biopsy is the most frequently used and is safe during pregnancy. It consists of numbing the skin with local anesthetic and inserting a hollow needle into the area to obtain a small sample of tissue to be tested.

Breast Cancer Treatment During Pregnancy

In the extremely uncommon event of a diagnosis of breast cancer while pregnant, therapy will be determined by the nature and extent of cancer and by how far along in pregnancy one is. The most frequent form of treatment is surgery—either mastectomy (surgical removal of the entire breast) or lumpectomy (surgical removal of the lump)—which is usually safe while pregnant.

Chemotherapy is also possible but usually only attempted after the first trimester, when it can damage developing fetal tissue. Radiation therapy is not used during pregnancy and is typically deferred until after giving birth. Hormonal therapy and targeted therapies are also omitted until after giving birth.

Can I Get a Mammogram While Breastfeeding?

Yes, you can have a mammogram while you are breastfeeding. The radiation in a mammogram does not impact breast milk or hurt the baby. But breast density is still high during lactation, and this might complicate detection of abnormalities. To enhance image quality, physicians usually advise breastfeeding or pumping 30 minutes prior to the mammogram.

Routine screening mammograms are usually delayed in pregnancy unless there is a high-level concern.

If a lump is detected, an ultrasound is typically the initial imaging study done, with a mammogram being a consideration if additional assessment is necessary.

• Pregnancy mammograms utilize minimal radiation and are safe when required.
• Breast MRI with contrast is usually avoided in pregnancy.
• Breast biopsy, when necessary, is safe during pregnancy.

If breast cancer does develop during pregnancy, there are available treatment options that can be adjusted to keep the mother and infant safe.

Pregnancy is a period of significant change, and health issues particularly those involving breast health, are anxiety-provoking. Routine mammograms are typically postponed until after giving birth, but diagnostic testing can be done if necessary. The best you can do is discuss changes you notice in your breasts with your healthcare provider in an open manner. Early detection and prompt treatment can make a very big difference in the health of both mother and fetus.

Although monsoon rains provide relief from the unbearable summer heat, they also increase the risk of infections, dehydration, and diseases that are transmitted through water and that can affect the functioning of your kidneys. Since kidneys play a crucial role in eliminating toxins from your body and maintaining fluid balance, kidney care during the monsoon season becomes necessary.

Stay Hydrated

Though it is cooler during monsoon rains, your body needs enough water to help the kidneys filter the toxins efficiently. Try drinking 2-3 liters of clean water daily, or according to the requirement advised by your doctor. Avoid drinking contaminated water, as it increases the risk of infections in the kidneys.

Eat Healthy and Fresh Food

Eat fresh and cooked food at home instead of junk food that might get contaminated during the monsoon rains. Include seasonal fruits, vegetables, whole grains, and healthy protein sources in your diet. Restrict the intake of excess salt, canned products, and sugar drinks.

Prevent Infections

The monsoon season is prone to UTIs that may eventually reach the kidneys if not treated on time. Keep your body clean, wear dry clothes, and never keep urine in your bladder for a prolonged period. In case you have burning sensations while passing urine, fever, or pain in your lower abdomen, do see a doctor.

Control Health Problems

Individuals suffering from diabetes, hypertension, or pre-existing kidney problems should take special care of themselves throughout the monsoon. They should be taking their medications, measuring their sugar and blood pressure levels, and undergoing regular medical examinations to avoid kidney diseases.

No Self-medication

Analgesics and other OTC medications can cause damage to the kidneys when consumed frequently and without consulting a doctor.

Conclusion

It does not take much effort to maintain the health of your kidneys during the monsoon season. Simple things such as staying well-hydrated, consuming hygienic food, preventing any infection, keeping control of existing illnesses, and taking no medicines unnecessarily will ensure that your kidneys continue to perform at their best. In case of any swelling, change in urine output, fever, or back pain, you must see a doctor right away. The importance of the kidneys is undeniable for your well-being.

(By Dr. Bhanu Mishra, a Consultant- Nephrologist at Fortis Hospital, Shalimar Bagh)

When one hears about plastic surgery, he or she usually associates it with beauty operations designed to improve one's appearance.

Reconstructive plastic surgery is a very particular field of medicine that addresses problems with the restoration of patients' form and functions who suffer from trauma, cancer, birth defects, burns, and complicated wounds. For many people, reconstructive surgery is far from beautification. It is all about getting back to an independent life.

Reconstructive Surgery After Trauma and Cancer

Injuries that can occur following accidents on the road, incidents at industries, electric burns, and animal bites often lead to severe destruction to the skin, muscles, tendons, nerves, blood vessels, and bones. In addition, cancers of the breast, head and neck, mouth, skin, and limb regions are often treated with extensive surgical excisions to provide complete clearance from the disease.

Though these operations are necessary to save lives, they might lead to considerable impairment and deformities in the patients. Reconstructive plastic surgery helps solve these problems.

Advanced Techniques in Modern Reconstruction

Today's reconstruction surgery uses sophisticated methods, including microsurgical free tissue transfer, perforator flaps, local and regional flap reconstruction, split-thickness and full-thickness skin grafting, nerve grafting, tendon reconstruction, and vascular anastomosis.

The application of microsurgery, in particular, has greatly improved the possibilities for performing reconstruction surgeries through transferring viable tissue from one region of the body to another with the re-establishment of blood supply from blood vessels of just one to three millimeters in diameter using a surgical microscope.

Restoring Function After Cancer Surgery

One of the biggest breakthroughs in the field of reconstructive surgery has been in the area of post-cancer treatment. Women who have undergone surgery due to breast cancer have the option to undergo either immediate or delayed breast reconstruction surgery through implants or through autologous tissues to help restore their self-image and mental well-being.

Similarly, patients who have undergone surgery due to oral, jaw, or facial cancer can improve their functionality and social standing through microvascular surgery.

Burn Reconstruction and Functional Recovery

The other significant factor to consider is the importance of reconstructive surgery in the treatment of burns. Severe burns typically lead to contracture scars and limited movement of joints.

Excision, skin grafting, flaps, and scar revision surgeries are key in improving function, aesthetics, and reducing disability. Reconstruction of hands following injuries or burns allows people to carry out their daily tasks and work.

Restoring Hope Beyond Surgery

Reconstruction is not limited to the surgical theater but is best done using a multi-disciplinary team comprising plastic surgeons, oncologists, trauma surgeons, physiotherapists, occupational therapists, psychologists, dietitians, and rehabilitators. Rehabilitation, scar management, physiotherapy, and follow-up are just as important after surgery as the surgery itself.

Reconstructive plastic surgery is thus much more than a field of surgery; it is a specialty whose goal is to restore hope. Through a blend of surgical skills and compassion, it gives people an opportunity to transcend the physical and psychological effects of injuries or cancers. For many people, it changes the experience of survival into that of recovery.

With the onset of the monsoon, the risk of several water-borne, mosquito-borne, and bacterial infections increases significantly due to stagnant water, flooding, poor sanitation, and contaminated food and water.

Many of these diseases can start with mild symptoms similar to the flu, but if they're diagnosed early, you can get the appropriate medical care in time, avoiding serious complications.

Early Symptoms Of Various Monsoon Diseases

One of the important ways to prevent monsoon infections and diseases is to identify warning signs early, Dr. Amit Saraf, Director, Department of Internal Medicine, Jupiter Hospital, told HealthandMe.

Leptospirosis

Leptospirosis gained attention after its cases surged in Kerala recently. The infection has also been reported in Maharashtra, Gujarat, Tamil Nadu, and Karnataka. The bacterial infection typically spreads via contact with water or soil that has been contaminated by the urine of animals infected with leptospirosis, especially during floods.

Initial signs and symptoms include:

• High fever

• Chills

• Intense muscle pain (especially in calves)

• Headache

• Red eyes

• Nausea

• Vomiting

“Wearing protective footwear, avoiding wading in floodwaters, and covering any open wounds will help minimize the risk of infection,” Dr Saraf recommended.

Typhoid

• High fever

• Headache

• Weakness

• Loss of appetite,

• Abdominal pain

• Constipation or diarrhea

• Body aches

Dr. Saraf said: “It can cause serious gastrointestinal issues if not treated. Safe drinking water, good hand hygiene, and freshly cooked food are important preventive measures.”

Cholera

Cholera is a water-borne bacterial disease that commonly occurs during monsoons. It often begins with excessive watery stools, vomiting, leg cramps, and rapid dehydration. Dehydration can quickly become an immediate danger of cholera.

The doctor said: “Prevention includes drinking clean water, eating hygienically prepared food, and practicing proper sanitation and handwashing.”

Dengue

Dengue is one of the most common viral diseases spread by Aedes mosquitoes. Often reported in various Indian states during the monsoon, dengue presents with flu-like symptoms. Dengue usually begins with high fever, severe headache, pain behind the eyes, extreme muscle and joint pain, nausea, skin rash, and fatigue.

Malaria

Malaria, a common monsoon disease, is spread by infected mosquitoes and characterized by the following symptoms:

• Recurrent fever

• Shivering or sweats

• Headache

• Muscle pain

• Weakness

• Nausea

• Vomiting

Dr Saraf said, “Early diagnosis is important to prevent severe diseases. The best ways of preventing mosquito bites are by using mosquito repellents, mosquito nets, and the elimination of breeding sites.”

Chikungunya

Mosquito-borne viral diseases are reported to be the highest during the rainy season. One of them is Chikungunya. The infection is usually marked by sudden high fever and severe joint pain in the limbs. Other early symptoms may include headache, muscle pain, fatigue, and skin rash.

“The infection is usually not deadly but can cause joint pain for weeks or months. Preventive measures include mosquito control and avoidance of mosquito bites,” the expert advises.

Gastrointestinal Infections

During the monsoon period, gastrointestinal infections are also more common as food and water sources are more likely to get contaminated. Early signs of gut infections may include diarrhea, vomiting, cramps, nausea, bloating, fever, and dehydration.

The majority are due to bacteria, viruses, or parasites. The expert said that the risks can be minimized by maintaining food hygiene, drinking boiled or purified water, washing fruit and vegetables before cooking and consuming, and refraining from eating street foods and drinks.