Ngo-2010, abaphandi baseNyuvesi yaseTexas Southwestern Medical Centre banyathelisa i-athimba malunga ne- postural orthostatic tachycardia syndrome (i-POTS) . Le nqaku yaba negalelo elininzi lokuphikisana kunye nentlungu phakathi kwabaninzi abanesifo sePOTS, ngenxa yokuchazwa ngokubanzi kweziphumo zayo, kwaye ngenxa yegama elitsha ngababhali abacebisa le meko-iGrach Syndrome.
Isibhalo, eqinisweni, sasinkulu kangangokuba umbhali oyintloko wolu cwaningo, waphawula umphandi we-POTS uDkt. Benjamin Levine, wavuma ukuba isicelo somlobi senze ingxelo malunga nomcimbi. Impendulo yakhe ibonakala ngezantsi.
Malunga nePOTS
I-POTS yimeko apho izinga lentliziyo yomntu linyuka kumazinga aphezulu xa ephakama. Ngokuqhelekileyo ihamba kunye nobunzima obunzima, iipilitations , ngamanye amaxesha nge syncope . I-POTS, ekwazi ukukhubaza kakhulu, inemiba emininzi efana ne- dysautonomi . Ngokuqhelekileyo kubonakala kubantu abancinci, abanye abantu bephilileyo, kunye nabasetyhini ngokuphindaphindiweyo kunamadoda.
Isifundo
Iqela likaDkt. Levine lafunda abantu abangama-27 abhekiselwe kuMzantsi-ntshona ngePOTS. Iziphumo eziphambili zifunyenwe: 1) Akukho nanye kwezi zifundo ezazingalinganiswanga kwinkqubo yazo ye-nervous system. 2) Abaninzi (malunga nama-70%) baneentliziyo ezincinci kunye nomthamo wegazi ophantsi, iziphumo ezibonakalayo zokumisa.
Kwaye-3) Ngokomyinge, izifundo ziphendule kakhulu kwiprogram eqhubekayo, ecwangcisiweyo yokusebenzisa unyango.
Ababhali baphetha ngelithi i-POTS "yiyodwa" imeko ebangelwa yi-deconditioning. Ngenxa yeentliziyo ezincinci ezichazwe ezininzi kwizifundo zabo, abalobi bacebisa (mhlawumbi ngeelwimi esetekeni) ukubiza kwakhona i-POTS kwi-Grinch Syndrome (kuba i-grinches, ngokwemithombo ecacileyo, inentliziyo ezincinci).
Ukuphendula kwee-POTS Sufferers
Amaphephancwadi ajikeleze ilizwe akhankanya kweli nqaku xa lipapashwe, lihamba ngeengongoma ezimbini: igama elitsha elipholileyo iGrach Syndrome, kunye nembono yokuba i-POTS iyakhokelela ekukholeni ubomi bokuhlala. Ukuchazwa okungaqhelekanga kweso sifundo kwabangela ukuphendula okuphawulekayo kubagulayo be-POTS emhlabeni jikelele.
Abantu abasebenzisana ne-POTS bathatha amajelo asekuhlaleni amaninzi amaninzi ukukhalaza ngalolu cwaningo. Ukongeza kwisifiso esicacileyo sokungafuneki ukubizwa ngokuba yi-grinches, baxela ukuba ukubeka zonke iimeko ze-POTS ukuhlaziya akusibi nje kuphela kodwa kungabangela ingozi kubantu abane-POTS.
Akungathandabuzeki ukuba ininzi ukuba ayinabo bonke abantu abanePOTS ezibalulekileyo. Uya kuba yinto enqabileyo xa ungeke ukwazi ukuma ungakhange ube ngumkhonto ogqithiseleyo okanye uphume. Kwaye ngokuqinisekileyo isifundo sifunde ukuba le yimeko.
Kodwa ukuba izigulane ezine-POTS zingabonakaliswa ukuba zineziqinisekiso ezingenakubonakalisa (kwaye eqinisweni, ayicacisanga ngokucacileyo) ukuba ukuchithwa kwembambiso yimbangela ye-POTS, kunokubangela umphumo.
Abantu abafunyaniswa ukuba babe ne-POTS sele benalo ixesha elingaqhelekanga ukufumana oogqirha kunye neentsapho zabo ukuba bathathe impawu zabo.
Bavame ukuhamba nobunzima bexesha elide lokuxelelwa ngamagqirha amaninzi ukuba banenkxalabo okanye ukuxinezeleka okanye uhlobo oluthile lokuguquka kwenguquko kunokoqobo, imeko ye-physiologic. Ngokuqhelekileyo iiveki okanye iinyanga, kwaye ngamanye amaxesha, ngaphambi kokuba ugqirha othile ekugqibeleni akwazi ukuxilonga.
Kwaye ngoku, nangona emva kokuxilongwa ngokuchanekileyo kwenziwa, bajamelana nethemba lokuthathwa njengokuba bazisile le mqobo ngokwabo, ngenxa ye-"deconditioning," edla ngokuba yintetho yezobugqirha yokuba ingasondeli, ingabonakali, kwaye ivila. Yaye xa intsapho yabo ixelelwa ukuba le ngxaki iyenziwa ngokwabo, nge-mechanism ye-sloth, kwaye uxelelwa ngugqirha akukho ngaphantsi, isixa senkxaso abaxhamli be-POTS banokufumana kwabo bathandekayo, ngeli xesha ukulwa ukuze abuye kwaye baninzi abayidingayo, kuya kuqikelela ukuba kuncipha.
Ngako-ke i-hue kwaye ukhale kumalungu e-POTS xa eli nqaku lishicilelwe kulula ukuchaza.
UDkt. Levine Uphendula
UDkt. Levine washukunyiswa ukuba aphendule ekubandezelekeni kwabalandeli abaninzi bePOTS emva kokufundiswa kwakhe. Ngokwenza njalo wenza ezintathu iingongoma eziphambili.
" 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. Abaphulaphuli bethu kumaphepha ethu ngabanye oogqirha kunye nososayensi, ngubani omele aguqule idatha ngokubhekiselele kumava abo kwaye afunde ngeencwadi. Ndiyaqaphela zonke izigulane ezimele zifumane ulwazi lwazo kwiimidiya ukuba zingabonakali ngaphezu kwezinto ezizifunde kumaphephandaba okanye zibone kwiTV.
2) I-POTS ayibangelwa "ubuvila." 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. 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 amazwi, iiveki ezi-3 zokulala zibi kakhulu kumzimba womzimba wokusebenza 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 kubo njengezigulane, okanye esidlangalaleni kwiintetho, bayazi ukuba NDIKHUBEKA ngokugqithiseleyo ukuba "i-cardiovascular deconditioning" yinkqubo yokwenene kwaye ichazwe kakuhle into engenayo nayiphi inzululwazi.
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) 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!
- UDkt. Benjamin D. Levine "
ILizwi
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.
Kuyadabukisa ukuba abantu abaninzi - kungekhona nje kuphela kumaphephandaba kodwa ngaphakathi kwicandelo logqirha-bekhokelwa ekuchazeni ngokucacileyo isifundo sakhe njengoko kubonisa ukuba i-POTS ngandlela-thile isifo esizenzayo. Ukuchazwa kukaDkt. Levine kweso sizathu kubonisa ngokucacileyo ukuba akuzange kubekho injongo yakhe ukuphakamisa ukuba i-POTS iyakhokelela. Kunoko, ukufunyaniswa kwakhe kubonisa ukuba ixesha elifutshane elincinci lokuphumla kombhede, mhlawumbi ngokukodwa kubantu abathile abakhutheleyo (ngokuqhelekileyo abasetyhini), kunokunokwanela ukuzisa le meko.
Kwimeko nayiphi na into, abantu abanePOTS abafuna ukukholisa oogqirha kunye nosapho ukuba imeko yabo ayiyiyo into abayifumene ngayo ngoku inomxholo ovela kumlomo wehashe obonisa ukuba i-POTS yinto eyenzekayo kubantu.
> Imithombo:
> Freeman R, Wieling W, Axelrod FB, et al. Ingxelo yesigqibo malunga neNkcazo ye-Orthostatic Hypotension, i-Syncope engokwemvelo kunye ne-Postural Tachycardia Syndrome. Auton Neurosci 2011; 161: 46.
> Fu Q, VanGundy TB, Galbreath M, et al. Iziqalo zeCardiac ze-Postural Orthostatic Tachycardia Syndrome. I-JACC 2010; 55: 2858-68.
> Kimpinski K, Figueroa JJ, Umculi W, et al. I-Outlook, I-1-year Study-up of Postural Tachycardia Syndrome. IMayo Clin Proc 2012; 87: 746.