Lasers in the treatment of women's diseases :
Greatest laser advancements in the field of surgery:
One of the greatest laser advancements in the field of surgery in the second half of this century has been the advent of the use of lasers. Lasers have made a most remarkable improvement over other means of surgery, making things so much easier for treating women's diseases with advanced laser surgery
Laser therapy is generally getting widely accepted as an alternative to conventional surgery. This also includes its increasing usage in the treatment of women's diseases such as warts in the perineal area, early cancerous lesions of the vulva, vagina and cervix, pathologies of the uterine lining, the uterus and so much more.
Successfully treating women's diseases with advanced laser surgery of the lower abdomen and genital tract:
Lasers such as the CO2 , thulium and others are being used to successfully treat diseases of the lower abdomen and genital tract. The CO2 laser has a great capacity for precision, cleaner incisions and faster healing. This confers a host of benefits over traditional surgery by reducing invasiveness, reducing blood loss, lessening the chances of infection and reducing damages to healthy surrounding tissue. Morbidity and recovery time are reduced and there are lesser complications.
In fact, along with a colposcope (an instrument used to examine the vagina and cervix) the CO2 laser is treatment of choice in treating dysplasia or early cancerous changes of the vulva, vagina and cervix with least damage to surrounding healthy tissues. It is ideal for treating cervical intraepithelial neoplasia or CIN by ablation of the diseased cells instead of excision with a surgical knife. What makes this an ideal treatment is that it is an outpatient procedure not requiring admission into hospital. It is very accurate having very good clinical effectiveness along with no loss of blood and minimal side effects. In similar fashion, it is also the ideal choice of treatment for dysplasia of the vulva and vagina.
Along with the colposcope vaginal, vulvar and anal warts, cysts and abscesses can be treated successfully with lasers. Vaginal endometriosis, condylomas, polyps, fistulas and precancerous endoanal or lower genital tract lesions can also be treated.
Lasers can also be used for surgeries in the lower abdomen along with a laparoscope (a slender, lighted telescope that is passed into the abdomen through a tiny incision). The laser can be passed through the laparoscope for the intended surgery. The advantage is that the depth of penetration into tissues can be controlled and damage to surrounding important structures such as the bladder, ureter or intestines is totally avoided.
Lasers in treating endometriosis:
Lasers are used this way to ablate areas affected by endometriosis with minimal damages to other tissues. They are also used to dissolve pelvic adhesions from previous infections or surgeries or endometriosis. Operations on the fallopian tubes are also much easier. Hysterectomy, removal of the ovaries and fallopian tubes can also be carried out. In the excision of uterine and ovarian fibroids lasers outdo all other forms of surgery with much less bleeding and other complications.
Treating intra-uterine women's diseases with advanced laser surgery:
Along with a hysteroscope (a thin lighted tube passed inside through the vagina) lasers are recommended for many intra-uterine surgeries such as the removal of polyps, myxomas, endometrial ablation, lysis of adhesions and corrections of uterine malformations, such as septate uterus.
Advantages of laser surgeries:
The advantages of laser surgeries are many, such as no loss of blood, high degree of effectiveness, early recovery, and lesser complications. The only disadvantages may be the high costs.
10 things to do before taking most advanced laser treatment:
Going in for an advanced laser treatment? Here are some things you must do:
Advanced Laser treatment is the latest and most advanced treatment we have in the present times, be it for the skin, eyes, female diseases or cancers. If you have been recommended most advanced laser treatment for any of these or other reasons there are certain things which you must do.
1. Know advantages of advanced laser treatment compared to conventional procedures:
Talk with your doctor as to why laser treatment would be better for you than ; what are the advantages that there might be over other treatments and what other options there are.
2. Know about the possible risks of advanced laser treatment:
Do not hesitate to ask the doctor or operating surgeon what side effects there could be. You can be direct and ask him what could go wrong during the operation and what the worst case scenario might be so that you can make an informed decision as to whether you want to go ahead with the laser treatment or not.
You must ascertain that the doctor has appropriate training, certification, licensing and good experience in the particular procedure that he is going to perform for you. For example, a doctor who has been trained to perform LASIK or eye surgery is not qualified to operate on the skin, and vice versa. The laser machines that are used could also be different. The proficiency of the operating surgeon for that particular procedure may be the single most important factor in the success of the procedure.
4. Ask beforehand, the number of sittings that might be required to cure your condition:
You must also find out what the potential cost of the treatment as well as the number of sittings that might be required for cure of your condition. For example, in skin conditions one may require only one session for destruction of skin growths, 3-5 sessions for acne scars, 4-8 sessions for hair removal but upto 8-10 sessions for vascular birthmarks. The more the number of sessions that would be required the more your costs are going to be.
5. Inform the doctor about all the serious medical problems you have:
If you are pregnant or have some serious medical problems like cardiac or pulmonary disease, diabetes, compromised immune system, or advanced cancer you must inform the doctor as some procedures cannot be carried out in your case.
6. Get a physical exam done to check your fitness for the procedure:
The doctor will take a detailed medical history and do a physical exam to check for fitness for the procedure. You may need to take some medicines or apply some ointments for a few weeks before the procedure.
7. Get more awareness about the side effects of laser treatments:
You should also be aware that laser treatments have their own set of side effects which are quite different from those of conventional surgery. While bleeding, chances of infection and recovery time are reduced and effectiveness and healing is enhanced with lasers as compared with conventional surgery, you must not forget that essentially tissues can get burnt especially in the hands of a not-so-experienced practitioner of laser machines. Organs and skin have been known to get burnt. In operations on the eye, corneal burns are not so common but there still could be some redness and pain.
8. Take care about the eye protection, if treatment is related to face:
For any operation on the face, eye protection is a must both for the patient as well as the doctor. Eye patches are usually used to cover the eyes for treatments on the face. Clothes and hair could catch fire so these must be firmly tucked away from the operating area. There is also the danger of electric shock if the wires have not been properly insulated.
9. Take proper rest:
After the treatment you will need to rest for a couple of days as in conventional surgery. There could be some redness and swelling over the area.
10. Follow the doctor's suggestions strictly:
You must strictly follow the doctor's orders regarding medicines, dressings and avoiding the sun. Recovery time would depend upon the reason for the treatment, age, and other factors.
Major advances in laser technology has made laser surgery much more effective and safe :
Lasers have been used to treat skin conditions for around 40 years. Initially, argon and carbon dioxide (CO2) lasers were used but there were many side effects such as scarring. However, since the last 20 years major advances in laser technology has made laser surgery much more effective and safe.
Different types of skin lesions :
It is now possible for many different types of skin lesions to be treated successfully with laser surgery. These include birthmarks, tattoos, scars, warts, facial wrinkles and even acne.
Birthmarks are skin abnormalities present at birth. Birthmarks could be port-wine stains, a pink, red or purple discolouration of the skin which can grow darker with age. These can be treated by pulse dyed lasers. Haemangiomas are another common type of birthmark, caused by an abnormal buildup of blood vessels. Haemangiomas may occur as red raised patches to deeper purple areas. Tan coloured lesions or cafe au lait spots and red, purple or blue coloured birthmarks called telangiectasis can also be removed for cosmetic reasons by lasers.
Scars may occur on any part of the body after infections, surgery, injuries, or inflammation of tissue. Acne scars especially are very distressing to teenagers. Scars may be flat, lumpy, sunken, colored, painful, or itchy. These scars can be treated with a variety of different lasers along with steroid injections, and specific dressings. The scars can be flattened, filled or smoothened out resurfacing the skin.
There is also a wide spectrum of laser technologies available for skin rejuvenation. Laser treatment can reduce or completely remove facial wrinkles and restore youthful looking skin.
If the procedure, called a laser peel, is carried out by an efficient and experienced surgeon it is safer than other cosmetic plastic surgery procedures.
Procedure of before surgery :
Before the surgery, medicines are applied to the facial skin for 4 to 6 weeks to prepare the skin. After the procedure proper care must be taken to prevent infections and crust formation, sunburn and infection.
There may be side effects of treatment such as post-treatment pain, redness and swelling which may last for weeks. There could also be scarring as well as resurgence of herpes. In dark skinned women there may be variable pigmentation on the face. However, despite these side effects the results are usually excellent. The latest in skin rejuvenation techniques is skin smoothening.
Warts are benign growths of skin or membrane caused by the human papilloma virus (HPV). They are are often hard to get rid of by conventional methods such as surgical removal, putting medicines on the wart, or freezing the wart. Laser removal is thus a good option.
Laser surgery can help remove unwanted tattoos . However, the success of the surgery depends upon the patient's age, skin type, type of tattoo, such as cosmetic, traumatic, or medical, and the tattoos colour, age, size and type of ink used.
Lasers can be used to remove excessive and psychologically distressing hair growth due to hypertrichosis or hirsutism as in PCOD. Several treatment cycles may be required to completely remove the hair. There may be side effects like superficial burns, pigmentation and scarring.
Keloids and hypertrophic scars are difficult to remove by conventional methods. However, certain lasers have been used to improve them and shown promising results. Lasers can also be used to treat seborrhoeic keratoses and skin cancers. However, conventional surgery might be as effective and cheaper.
Violet blue metal halide light (407-420 nm) has been used to treat acne. The laser has a toxic effect on the acne bacteria, Proprionibacterium acnes.
One of the latest treatments in the field of medicine is laser therapy. LASER is actually a short form for "light amplification by stimulated emission of radiation". In understandable terms it means simply that light radiation is focussed so precisely that it becomes powerful enough to even cut stone.
How can this power be useful in the medical field?
How can this power be useful in the medical field? In experienced hands laser becomes a most efficient tool which can cut through body tissues with such exactitude that any damage to the surrounding tissues is completely avoided. Thus there is less pain, less swelling, less blood loss and lesser scarring. This translates into easier, quicker and better healing for the patient.
Uses of laser in treatment are manifold :
The uses of laser in treatment are manifold. Lasers are used for surgeries to zap away precancerous growths, tumours, polyps, warts on the skin. They are used to cut away unreachable portions of tissues as in the brain, prostrate or other organs. With lasers, blood vessels and lymph vessels can be sealed to prevent blood loss and stop the spread of cancers.
In the hands of a trained and skilled surgeon lasers can be used to perform almost any surgical procedure. Surgeons use them to cut, coagulate, ablate, and remove tissue. They can perform complex surgeries all the while reducing blood loss, post operative pain, chances of infections, spread of cancer and better wound healing.
Laser surgery is often standard for surgeries or procedures of the heart, teeth, skin, eyes, ears, nose, throat, stomach, intestines, on the brain and nervous system, in women's diseases, on the urinary system and in treatment of cancers.
Lasers can be used to correct refractive errors in the eyes, for cataract surgery and to repair a detached retina. Laser therapy can also be used to treat chronic pain as in sciatica or in cancers. Laser treatment of the skin includes permanent hair removal, removal of acne scars, birthmarks, tattoos, sunspots, wrinkles and other blemishes.
Lasers are also used to treat many cancers including those of the cervix, vagina, vulva, penis, certain cancers of the skin and lungs. Some other conditions in which laser therapy can be used are ablation of tumours, angina, cold and canker sores, gum disease, tooth decay, ectopic pregnancy, endometriosis, fibroid tumors, kidney stones, gallstones, astigmatism, migraines, benign enlargement of prostate, nosebleeds, ovarian cysts, ulcers and varicose veins.
What are the different types of lasers treatments?
There are several different types of lasers, using solid, liquid or gas. The three types of lasers most often used in medical treatment are the carbon dioxide or CO 2 laser used mainly for surgeries, the Nd: YAG laser used to penetrate deeper into tissues and the Argon laser used for eye surgery and superficial skin disorders. With light-sensitive dyes the Argon laser can also shrink or dissolve tumors, called photodynamic therapy or PDT.
In modern medicine, lasers with better precision and safety, are being increasingly deployed for a vast array of pathologies. From life-threatening diseases to distressing cosmetic defects, laser therapy has led to great advancements in treatment of diseases benefitting both patients and doctors.
How to decide, which abortion method is safe for you?
If you are going in for an abortion you should know what to expect. Before any medicine is given or procedure performed you will get a physical examination. The doctor must be informed about any medicines which you may be on. You will have an ultrasound scan to confirm the pregnancy, it’s length and to make sure that it is located in the uterus itself. If you are less than 8 weeks pregnant you will be advised a medical abortion. If the pregnancy is more than 8 weeks you will have to go in for a surgical abortion. You will need to sign a consent form for either.
For a medical abortion you will be given a tablet or an injection initially followed by tablets orally or to be inserted in the vagina after a few days. You will begin to get menstrual like cramps and start to bleed soon after as the uterus expels it’s contents. You will continue to bleed for 2 weeks after which the bleeding will stop.
For a surgical abortion you will have the procedure in the out-patient clinic of the hospital. You will be required not to smoke, eat or drink anything for at least 6 hours before the procedure. When you report to the clinic you will be made to change into a hospital gown. You will lie flat on the operating table and your feet put up in stirrups. You could be given a local anaesthetic to numb your cervix, as well as a sedative to relax you. Or you might be put under general anaesthesia
through an I/V injection. The actual procedure will take from 10 minutes to 30 minutes at the most.
After the procedure you will be given a sanitary pad to use and asked to relax for some time before being sent home. You should have someone with you to drive you home. You will bleed for about 2 weeks. Initially, the bleeding might be heavy but will gradually decrease.
Is medicine require after abortion?
You will be given pain killers for any pain and advised to avoid tampon usage and sex for at least a month. You will also be advised to take showers and avoid baths and swimming for a month. You will also be importantly advised birth control methods to avoid unwanted pregnancy again.
Visit your doctor :
You will need to see your doctor again two weeks after the procedure to ensure that the abortion is complete. However, if you get high fever, a foul discharge from the vagina, excessive bleeding, chills, or severe pain you must immediately contact your doctor.
When surgical termination of pregnancy is the only option ...
A surgical abortion involves the removal of the pregnancy, that is the foetus and it’s tissues, through the vagina by surgical means. Doctors commonly advise termination of pregnancy with surgical termination of pregnancy if the pregnancy is more than 8 weeks.
At which stage do doctors advise termination of pregnancy with surgery?
If the pregnancy is less than 12 weeks a vacuum is used to suck out the contents of the uterus. This is called suction aspiration. However, to reach the uterus with surgical instruments the cervix must be first dilated or widened. An injection is given into the cervix to numb it for the procedure. Then rods of increasing sizes are inserted into the cervix till the cervix is sufficiently widened. This process is called dilation.
Next, a cannula, which is a long plastic tube connected to a suction device, is inserted into the uterus. The uterus is then emptied of its contents by gentle suction.
What is the process of curettage?
Lastly, another scoop like or spoon shaped instrument called the curette is inserted to scrape out any remaining tissues of the pregnancy from the uterine lining. This is called curettage. The whole procedure takes about 10 to 15 minutes.
If the pregnancy is more than 12 weeks the procedure may be carried out under general anaesthesia. Also, the cervix is dilated differently. Medicines such as misoprostol may be given orally or inserted into the vagina about 2 hours before the operation to soften the cervix.
Are there any alternate methods?
Another method that may be used is to first dilate the cervix a bit and then insert an osmotic device called laminaria into the cervix. This absorbs moisture and swells over several hours until the cervix is sufficiently dilated.
The curette, and sometimes a forceps is used to remove the foetus and tissues. The last step is usually a final suctioning to make sure the contents are completely removed. The procedure normally takes between 15 to 30 minutes.
How is medical termination of pregnancy with pill or injections done?
Women mostly find out they are pregnant as soon as they miss a period, that is at a very early stage in the pregnancy. There is no need for panic as medical termination of pregnancy with pill or injections can be carried out up to 49 days of pregnancy. You can take your time to decide whether you want to keep the baby or not. Once the decision is made you can go in for an abortion within 24 weeks of pregnancy by various means.
At which stage is medical abortion helpful?
Medical abortion is done only when the pregnancy is not more than 49 days. A pill or injection is given to terminate the pregnancy and there is no surgery involved. Firstly, either an injection of methotrexate or a pill of mifepristone is given. Both work to stop the embryo from growing. The foetus and it’s tissues separate from the uterine lining.
About 3 to 7 days later a pill of misoprostol or a vaginal suppository of it is inserted into the vagina. These tablets cause the uterus to contract and expel the separated foetus and placenta.
When an injection is given initially the patient needs to take 2 pills orally or insert 4 pills in her vagina after 3 to 7 days. When a tablet is given on the first visit the patient needs to take 2 pills orally or 4 in the vagina 1 to 3 days later.
Injection of methotrexate :
The complete process may take a few hours or as long as a few days. When an injection (of methotrexate) has been given, women can either have an abortion the same day they take the misoprostol or within a week or two.
Pill of mifepristone :
When a tablet (of mifepristone) has been given most women abort the same day or within a week of being given the second tablet, that is of misoprostol.
Both methods are completely effective and safe. However, if they do not work surgical abortion must be carried out especially as there is a risk of birth defects caused by these medicines.
The patient is expected to experience bleeding and cramps as the uterus tries to expel the foetus and its linings. The bleeding may continue for up to 2 weeks. There may be cramping, nausea, vomiting, diarrhoea and heavy bleeding as a side effect of the medicines.
A physical exam is given a week or two later to ensure that the abortion procedure is complete and to check for complications.
Is medical abortion advised for women?
Medical abortion is not advised for women who have anemia, bleeding disorders, liver or kidney disease, seizure disorder, acute inflammatory bowel disease or for those who use an intrauterine device (IUD).
Spontaneous abortion occurs when the foetus stops growing inside the womb for some reason and is expelled from the uterus naturally. Sometimes you may need to deliberately terminate pregnancy. Medical Termination of Pregnancy or MTP on the other hand is an abortion which is carried out or induced by deliberate medical means. Its purpose is to do away with unwanted pregnancy.
The pregnancy may be an unwanted one if
there has been a failure of contraception,
the mother is very young and not ready to be a parent,
she cannot afford to look after the baby either physically or financially,
she does not want to be a single parent,
the pregnancy has been caused by rape or incest,
she does not wish to disclose that she has had sex and is pregnant or
the family is complete.
Are medical reasons involved to terminate pregnancy?
Termination of the pregnancy may also be advised for medical reasons such as the possibility of physical or mental harm to either mother or child if the pregnancy continues. For example, hereditary or genetic defects may be detected in the foetus or there may be a structural defect in the uterus of the mother or other health problem that could make a full term pregnancy unsafe for her.
Till what stage there is a chance to terminate pregnancy by taking medicines ?
MTP can be legally carried out only if the pregnancy is up to 20 weeks of gestation. The earlier the abortion is carried out the safer it is for the mother. When the pregnancy is up to 9 weeks of gestation the pregnancy can be terminated by taking medicines.
At which stage, we have to go with surgical termination :
If the pregnancy is more than 10 weeks the pregnancy has to be terminated by surgical means. It is then called a surgical termination of pregnancy.
Both medical and surgical termination of pregnancy must be carried out by a qualified doctor and one who has been trained in performing MTPs. This is to reduce the risks, such as a perforated uterus, that can occur in the hands of untrained professionals. It is also to ensure that the termination is complete as an incomplete termination can have serious consequences such as excessive bleeding, infections and even death.
Who has the right to take a decision to terminate pregnancy?
It is totally a woman’s prerogative as to whether or not she wants to continue the pregnancy. If a woman does not wish to have a baby it is her right to terminate the pregnancy. Women may consult their husbands or their parents on the issue but the last decision stands with her.
Living with lupus: What are your treatment options?
Even though lupus is a potentially serious condition, most people with the disease go on to live normal lives. Lupus treatments have become much more effective and the disease can be managed well. Most patients can live their full life spans with good treatment and management.
Medicines help us to control lupus
Although medicines are important in lupus treatments, there are certain things that you can do to help manage your symptoms and prevent your disease from getting worse. Here are some of the things that you can do to help yourself get better and live a long healthy life.
Lupus treatments process :
1. Active part in your treatment process
Take an active part in your lupus treatments process. Learn as much as you can about your disease and medication options. Be pro-active. Keep a watch out for any new symptoms and do not ignore them. Bring them to the attention of your doctor as soon as possible.
2. Get physically examined regularly
Form a good relationship with your primary health caretaker and visit him often. Get physically examined regularly to spot early onset of any problem. Take lab tests as required to keep a check on any progress of the disease.
3. Support of family and friends
Take the support of family and friends as the disease is going to be there for a long time and could change at any time.
4. Exposure to the sun
Avoid exposure to the sun. Sunlight can bring on a flare of the disease apart from exacerbating your skin lesions. If you need to go out in the sun use a shade and lots of strong sunscreen (50+). Limit your time in rooms that have a lot of fluorescent lighting.
5. Regular exercise
Exercise regularly to keep your joints supple, and to make the active muscles
6. Plan your pregnancy with the advice of a doctor
Plan your pregnancy with the advice of your doctor. You should ideally plan to get pregnant during a period of remission. Avoid getting pregnant if you are on immuno-suppressive therapy as the intake of the drugs (cyclophosphamide, cyclosporine and mycophenolate mofetil) could harm your baby.
7. Test results
If your test results show a raised antiphospholipid antibodies then you must avoid taking oestrogen as it increases the risk of blood clots and of worsening the disease.
Take care of your heart. Eat a healthy balanced diet, avoid stress, try relaxation techniques such as yoga and meditation and keep active.
9. Inflammatory foods
Natural strategies such as reducing inflammatory foods like those high in sugar and saturated fat, reducing stress, detoxification methods and healing your gut also seem to help.
10. Suffer from a dry mouth
If you suffer from a dry mouth it can be remedied by sugar-free chewing gum or hard candy staying hydrated and using lip balm. Keep your mouth clean as you may be more prone to tooth decay if you have a dry mouth.
11. Healthy habits
Lifestyle changes like exercise, weight management, and overall healthy habits are also very important.
12. Chronic illness
It can be quite challenging to maintain a positive outlook while managing the daily effects of a chronic illness. Watch out for signs of depression such as a lack of interest in everyday activities, sleeping too little or too much, loss of appetite, deep sadness, irritability or anxiety, and suicidal thoughts. Talk to your doctor if you think you are depressed. Counselling and certain anti-depressant medications will certainly help.
There is no known cure for lupus at present. The disease can also often be life threatening in so many ways. However, in spite of these two facts, the course of the disease can be effectively managed and most patients go on to live, long, normal and healthy lives.
How complex to manage lupus?
Managing lupus can be complex though. As the symptoms and actual disease patterns in lupus are very different in individuals so also the treatment regimens prescribed by the doctor are custom made for each patient.
What kind of specialist a lupus patient need to consult?
Once diagnosed, a lupus patient needs to consult various specialists according to the systems that are involved in her particular case. For instance, if the patient presents with joint pains she would need to consult a rheumatologist and if there are skin lesions she would have to be treated by a skin specialist and so on. There will not be just one single doctor attending to the symptoms of a patient unless her symptoms are very system specific.
The main aims of a treatment regimen are:
To manage the symptoms such as fatigue, joint pains, so that the patient is comfortable.
To prevent flares.
Treat flares when they occur.
Reduce organ damage and other problems.
Medications may include anti-inflammatory medication, immune-suppression medication, corticosteroids, and anticoagulants to
Reduce swelling and pain
Prevent or reduce flares
Help the immune system
Reduce or prevent damage to joints
Manage skin lesions
Common treatment options include
1.Non-steroidal anti-inflammatory drugs (NSAIDs):
These help to decrease joint swelling and pain, fever, skin rashes, fatigue and inflammation of the heart and lung linings. NSAID drugs include ibuprofen and naproxen. Some of these drugs can cause serious side effects like stomach bleeding or kidney damage.
Hydroxychloroquine is one drug that is prescribed for every patient with lupus. It is effective for lupus related arthritis, fatigue, rashes, and mouth sores. It has been seen to prevent flares.
3.Corticosteroids and immune suppressants:
Patients with serious or life-threatening problems such as kidney inflammation, lung or heart involvement, and central nervous system symptoms may need high-dose corticosteroids such as prednisone. They also need drugs that suppress the immune system such as azathioprine, cyclophosphamide, cyclosporine and the new mycophenolate mofetil. Most immune-suppressing medications require close monitoring. They may cause side effects such as a raised risk of infections, nausea, vomiting, hair loss, diarrhea, high blood pressure, and osteoporosis (weak bones).
New drugs specific for active SLE treatment which are rituximab and belimumab or Benlysta. These decrease the number of antibodies in the blood thus reducing the autoimmune effect of the disease and the ensuing organ damage.
5.Medications for lupus problems :
Medications for problems related to lupus such as high cholesterol, high blood pressure, or infection.
6.Bone marrow transplants :
Bone marrow transplants and genetically altered T cells that could retrain the body to no longer attack itself might soon become part of the regimen.
Each treatment carries its own risks. Thus the dose of a drug may be reduced or a medication stopped because of its side effects or when the disease goes into remission.
Over time treatments have to be adapted according to how the disease progresses. Treatment plans often need to be changed when symptoms flare up or new symptoms appear. Thus, new medications are put into use while previous medications that once worked so well may need to be trashed.
Is treatment help us?
In most cases, treatments are very effective. Also presently much research is ongoing to find new means of treating and perhaps one day being able to cure the disease.