Emva kwesithuba sam, "I- POTS - Ngubani oyi-Real Grinch ," Ndatshatswa nguDkt. UDkt. Levine wenza amaphupha amahle kakhulu, ngoko ndamcela ukuba ndipapashe impendulo kuye ukuba unomdla wokuhambisa enye. Nantsi. (Ndiyilungisile impendulo yakhe ngokukhawuleza kwaye ndongezele amazwana wam ekupheleni.)
Othandekayo uDkt. Fogoros,
Ndiyabonga ngeposi yakho yeblog malunga nophando lwethu kwizigulane nge-POTS - Ndiyayixabisa ithuba lokubonelela ngamaphuzu ambalwa okucacisa malunga nokufundisisa oye wathetha ngokuthe ngqo kunye nokutshintshwa kweempembelelo ezivela kuloluphando.
1) Ukukhuthazwa koPhando . Okokuqala, makhe ndiqiniseke ukuba andizange "ndikhuthaze" umsebenzi wethu kuyo nayiphi na imithombo yeendaba, kwaye akukho namnye umntu kwiziko lam. Enyanisweni, andiyena mfana omkhulu weengxelo zeendaba zenzululwazi, kwaye nangona ndiza kuthetha nabathengisi xa bebiza ukuba ndiyakwazi ukubonelela naluphi na ubuchule obukhethekileyo, andiyikhangela. Njengoko ndiqinisekile ukuba uyazi, asinakho ukulawula malunga nantoni na intatheli ngomsebenzi wethu. [Kulapha uDkt. Levine waquka i-vignette echaza indlela amajelo eendaba atshisa ngayo rhoqo izifundo zenzululwazi, ingxaki eqhelekileyo endiyifumene nayo. RF] Abaphulaphuli bethu ngamaphepha ethu ngabanye oogqirha kunye nososayensi, ngubani omele aguqule idatha ngokubhekiselele kumava abo kwaye afunde leencwadi.
Ndiyaqaphela wena, kunye nabo bonke abagulane kufuneka bafumane ulwazi lwabo kwiimidiya ukuba bangaphindi ukutolika oko bakufunda kumaphephandaba okanye babone kwi-TV ...
2) I-POTS ayibangelwa "ubuvila." Ibali elithethwa ngabaninzi abaphenduliweyo kwinqaku lakho lifana nezigulane zethu ze-POTS. Uninzi lwezigulane endazibonayo ziphezulu kakhulu (njengabalingisi bethu, esizibonakalisa kuyo inkqubo yethu yoqeqesho lwe-POTS) ngaphambi kokuba kwenzeke into eyenzekayo - ngenxa yentsholongwane ye-virus; abanye ukulimala okanye esinye isifo; ezinye zikhulelwe okanye iingxaki zokuhambisa umntwana.
Lo "mcimbi we-sentinel" wenza ukuba into efanayo ifumaneke - ibeka abantu ukuba balele.
Kubalulekile ukugxininisa ukuba kunye neeyure ezingama-20 zokuphumla kombhede zingabangela ukulahlekelwa komthamo we-plasma, umsebenzi we-baroreflex ongenakukhubazeka, kunye nobunzima be-orthostatic-headedness kubantu abaninzi. Ezi zimpawu zikhawuleza zikhululekile ngokulala phantsi kwaye zenza ukuba kubekho ukunyamezela komzimba, i-hypovolemia (ukulahleka kweplasma egazini), i-carroac atrophy (malunga ne-1% ukulahlekelwa kwentliziyo yesonto nganye kwibhedi) ukulala kwembhedlele yokulala kunye nokugqibela ukungaphumeleli. Emva kweeveki ezimbini kuphela zokulala okanye i-spaceflight, phantse 2/3 yabantu abakwazi ukuma imizuzu eyi-10!
Kuyafaneleka ukuba uqaphele ukuba izifundo zangaphambili ezivela kwisayithi yethu zibonise ukuba zezifundo eziphambili kakhulu ezithintekayo kwithuba elifutshane (iiveki ezi-3) ukuphumla kombhede, kunye nexesha elide lokuphucula. Enyanisweni, amavolontiya abancinci phambi kokulala, abuyele ngokukhawuleza ekuphenduleni uqeqesho olulawulwayo olulandelayo, ngokubanzi kwiiveki ezimbini. Ngakolunye uhlangothi, amavolontiya athile kakhulu, emva kweeveki ezi-3 zokuphumla kokulala kunye neenyanga ezi-2 zokuqeqesha ngokukhawuleza, akazange aphinde abuyele kwimpilo yazo yokuqala. Ngokuthakazelisayo, safunda izifundo ezifanayo emva kweminyaka engama-30 emva kokufundwa kwangaphambili kwaye safumanisa ukuba, ngokumangalisayo, akukho mntu omnye owayesesimweni esingalunganga kwiminyaka engama-30 kamva, kunokuba bebakho emva kweveki ezi-3 zokulala e-20s.
Ngamanye amagama, iiveki ezi-3 zokulala zibi kakhulu ukuba umzimba unamandla okusebenza ngokomzimba kuneminyaka engama-30 yokuguga! (bona iMcGuire et al Circulation 2001).
Kungakhathaliseki ukuba yintoni eyenza isiganeko sokuqala, ngelixa ixesha lokugula (okanye nayiphi na into eyenzekayo) liye laqhuba ikhosi, izigulane zishiywe ukukhubazeka okukhulu (esinye isigulane kwisifundo sethu asizange sikwazi ukuhlala sigqibelele ngaphezu kweminyaka emi-2 ) ebonakala ngathi ngcono ngeenkqubo zethu zokuzilolonga, ezigxilwe kuzo, eziqhelana nokuqala ngokuqala kwisigxina esisigxina. Ukugqithiswa kokugqibela mhlawumbi kungumngcipheko omtsha we-wrinkle esiwazise etafileni ekunyamekeleni izigulane ze-POTS.
Uninzi lwe-POTS alukwazi ukunyamezela ukunyaniseka okuthe tye ukuqala ukuhlala phantsi okanye ukuhlala uhlala emuva kubaluleke kakhulu kwimpumelelo yabo. Kwaye kunzima! Izigulane ezininzi zizabalazela ukugqiba iiveki ezimbalwa zokuqala zenkqubo yoqeqesho, ehamba ngendlela eqala ngemizuzu engama-30 ngosuku, iintsuku ezi-3 ngeveki. Kodwa xa beyichukumisa ngokuqala ukungathandeki, ngokuqhelekileyo bazifumana beziva bengcono kwaye banamandla.
Oku kugxininisa iphuzu elibalulekileyo - Asizange sikuve ukuba esinye isiguli se-POTS sinobuqili okanye singenakuxanduva - ukuba kwakungelula ukuphatha i-POTS ngokuzivocavoca, wonke umntu uya kwenza !! Nangona kunjalo xa sisebenzisa inkqubo ekhethekileyo yoqeqesho ejolise ekwenzeni intliziyo ikhudlwana, ininzi yezigulane zivakale ngokugqithiseleyo kwaye zininzi "zonyango", ezibhekisela kuphela ukuba ababahlangabezane neendlela zokufumana i-POTS. Ndimele ndigxininise nangona ukuba ukugcina impilo yinjongo yobomi bethu kwizigulane ze-POTS kwaye siyabakhuthaza ukuba baqwalasele umsebenzi njengenxalenye yobunono babo. Kuba abo baguli baye bandivayo ndithetha, mhlawumbi ngabagulane, okanye ngabafundi kwiintetho, bayazi ukuba ndigxininisa ngokucacileyo ukuba "i-cardiovascular deconditioning" yinkqubo yokwenene kwaye ichazwe kakuhle into engenanto yokwenza nobudenge.
Nceda uqaphele ukuba izigulane ezinePOTS azikwazi ukuhluleka ukuzimela. Oku akuthethi ukuba inkqubo ye-neon autonomic ye-nervous is never compromised at some point in the process of progression of POTS. Nangona kunjalo kwisigaba esingasigxina, i-hemodynamics ilawulwa yi-physiology ye-cardiovascular deconditioning - kwaye ubungqina kukuba xa siphendulela le pathophysiology, ngokunyusa inani legazi intliziyo iqulethe kwaye ikwazi ukupompa ngentliziyo nganye, ukuba i-HR ihla, Imisebenzi yokukhathazeka iyancipha, kwaye izigulane ziziva zingcono.
Makhe ndigxininise le ngongoma: IKHONDO LOKWENZA UKUBHALWA KWEKHADI KUNYE KUNYE KUNYE KUNYE "UKUPHATHWA KWE-SHAPE" !!!!! Nabani na otolika idatha yethu ngendlela engacacisekanga iziphumo zethu kunye neyeza lethu. Ndiba novelwano olukhulu kwizigulane zethu ezininzi ezithintekayo ngokugqithiseleyo, kwaye ndididekile ngenxa yemisebenzi yam eninzi ndizama ukufumana unyango olusebenza rhoqo.
3) Xa ukhetha izigulane zophando zophando kwi-POTS. Ngezifundo zethu, sasebenzisa iinkcazo eziqhelekileyo ngokwemiqathango esekwe yimibutho kazwelonke nakwamanye amazwe abandakanyekayo kwizifo ezizimeleyo. [Lapha uDkt. Levine unikeza inkcazo enzulu malunga neemeko ezahlukeneyo zonyango ezinxulumene ne-POTS, kunye nobunzima obuyiyo bonke abaphandi abajongene nayo xa bekhetha iikhrayitheriya zokhetho kwizifundo zeklinikhi kwi-POTS. Ngale ngxaki engqondweni, ndiqinisekile ukuba bakulandela "iindlela ezilungileyo" zokufumana izigulane kwiilingo zabo zonyango. RF]
Ndiyazi ukuba oku kunokuba kunelisekile kakhulu kwizigulane ezinemiqathango, kodwa ibonisa ukuba yintoni uphando lweklinikhi. Njengoko unokucinga, ukunyanzeliswa komgaqo-nkqubo wokubhalisa, kubhetele abaphenyayi baya kuhlaziya i-hypothesis yabo, nangona kungenakwenzeka ukufikelela kwizigqibo. Njengoko wena kunye nabafundi bakho banokwazi, njengamanje sisenza isifundo esikhulu serejistra phakathi koluntu, apho> izigulane ezingama-200 ziya kufundiswa kunye nemimiselo embalwa ebhalisiweyo. Siyathemba ukuba esi sifundo siya kuphendula imibuzo thina kunye nabanye esinayo malunga nokukhwabanisa.
Kwiingxelo zethu ezipapashiweyo, sabhalisa uluhlu olulandelelanayo lwezigulane ezibhekiselele kwikliniki yam yokuzimela ephakamileyo yemfundo kunye nokuxilongwa kwe-POTS. Ngokwenza oko, asifaki izigulane ezimbalwa kakhulu ezineengxaki eziphambili, ngenxa yokuba zicetyiswa ukuphononongwa kwakho, ezininzi zezi gulane ziye zabona abanye oogqirha ngaphambi kokuba bathunyelwe kum, okufana nesigulane esinezigulane eMayo Clinic okanye kwiVanderbilt. Ukususela ekuxoxeni ngesigulane sethu sengqondo kunye nezinye iingcali (kwaye sisoloko sibona izigulane zabanye) ... endle, ndiqinisekile ukuba uluntu lwethu lubonakalisa uluntu olubanzi oludluliselwayo lwezilwanyana ze-POTS.
4) Ngokuphathelele "i-Grinch Syndrome." Ekugqibeleni, makhe ndigqibe ngamagama ambalwa malunga neGrach. Ininzi yezigulane zethu eziva igama elithi "I-Grinch Syndrome" zihleka kwaye zithuthuzele emoyeni apho zinikezelwa khona. Ngakolunye uhlangothi, ndiyaqonda ukuba ezinye izigulane ezingandiziyo, kwaye zixhalabile ngokuba zibhalwe igama elidibaniswa nokuba luthethwa ngumoya, into enokusetyenziswa kwegama elithi Grinch Syndrome, kwaye ndiyazihlonela ezo nkxalabo. Ngenene, ukuba bekufuneka ndiyenze kwakhona, mhlawumbi ndiza kukhangeka ukusetyenziswa kwekota, kwaye ndifuna zonke izigulane ze-POTS zikwazi ukuba asithandi ukuba bafune ukuthanda. Akukho "udumo kunye nenhlanhla" enxulumene nalo gama kwaye andifumana inzuzo yangasese ekusebenziseni eli gama. Nangona kunjalo, ndiyibonile indlela enempumelelo ngayo ekubhekiseleleni kwinto esiye yabona njengento ephambili ye-pathophysiology ehambelana nokunyanzeliswa okukhulu kwezi zi gulane. Njengoko ndidla ngokuxelela izigulane zam, igama elithi "POTS" libeka nje ileyibhile kwinto yokuba intliziyo yesigulane ibetha ngokukhawuleza xa iphakame. "I-Grinch Syndrome" igxininisa ingqwalasela, malunga NOKUBA ukuma kwenhliziyo ephakamileyo kuphezulu-oko kukuthi intliziyo "ubukhulu bomibini ubuncinane."
Ngokusekelwe kumanani amanani alula, i-2.5% yabo bonke abafazi kwihlabathi baya kuba neentliziyo ezingaphezu kwezimbini eziphambukileyo ezingezantsi kwintsimi-ntetho "yesiqhelo" kwiyeza. Sikholelwa ukuba ngaba ngaba besetyhini abasemngciphekweni wokufumana iimpawu ze-POTS ezinokunyanzeliswa ngokukhawuleza kwithuba elifutshane lokulala.
Ekugqibeleni ke, ndingathanda ukugxininisa ukuba ukuhlaziya kuyisisombululo esinamandla sokuphilisa, kungekhona kuphela kwizigulane ezine-POTS, kodwa phantse nasiphi na isifo. Siphatha zonke izigulane zethu ngentlonelo ejulile kwaye siyazi kakuhle indlela abaxhatshazwa ngayo, esiyithatha kakhulu. UMark Twain wambi wathi "Uthotho luyintsikelelo enkulu yabantu"; sikholwa ukuba yinxalenye ebalulekileyo yenkqubo yokuphilisa kunye nethemba lokuba zonke izigulane zethu zincuma xa becinga nge-Grinch, kwaye ke uya kusebenzisa!
- UBenjamin D. Levine, MD
Iingcamango Zokuvala
UDkt Levine ungumphandi ozinikeleyo kwaye unononophelo, kunye nomzimba wakhe womsebenzi kwi-POTS uye waqhubela phambili ulwazi lwethu ngale meko ngokugqithiseleyo, kwaye ngenxa yoko, uninzi lwabantu abanalo meko bancediswa. Ukongezelela, ukugweba kwezinye iimbono ezibonakala emva kwesithuba sam esingaphambili, izigulane ezinePOTS eziphantsi kokunyamekela zicinga kakhulu ngaye, kwaye zimdumise ngentlonipho, ukukhathazeka nokuzinikezela.
Ndicinga ukuba kulula kakhulu ukuba ongeyena ingcali kwi-POTS (njengami) ukutolika isifundo ngokubhekiselele ekuboniseni ukuba i-POTS ngandlela-thile isifo esizenzayo, kunye nokugweba ukusuka kwimbono yam isithuba esifumeneyo, loo nto ingenakuthetha eziqhelekileyo phakathi koogqirha. Uluvo lukaDkt. Levine kule ngongoma (ngasentla) lubonisa ngokucacileyo ukuba akuzange kubekho injongo yakhe yokubonisa ukuba i-POTS iyakwenza. Kunoko, iziphumo zakhe zibonisa ukuba ixesha elincinane lokuphumla kwebhedi, mhlawumbi ngokukodwa kubantu abathile abakhutheleyo (ngokuqhelekileyo abafazi), kunokunokwanela ukuzisa kule meko.
Kwimeko nayiphi na into, abantu abanePOTS abafuna ukukholisa oogqirha kunye nosapho ukuba imeko yabo ayiyiyo into abayifake yona, ngoku akudingeki ukuba bathembele kumqulu obhalwe nguwe ukwenza njalo (njengabaninzi babo babonisa ukuba baya zabo izimvo). Ngoku banamaxwebhu aloo nto ebhaliweyo nguDkt. Levine ngokwakhe.
Ndingathanda ukubulela uDkt Levine ngenxa yesimo sakhe sengqondo ngokumalunga nokutshintshisana, kunye nomzamo awawenziwe ekucoceni umoya.
Funda malunga ne- post-orthostatic syndrome ye-tachycardia (POTS) .