Ngemuva kokuthunyelwe kwami, "I- POTS - Ubani I-Real Grinch ," Ngathintana noDkt. Benjamin Levine, ocwaningo lwami engangikusola ngalolo daba. UDkt. Levine wenza amaphuzu amahle kakhulu, ngakho ngacela ukushicilela impendulo evela kuye uma enesithakazelo ekuhambiseni eyodwa. Nakhu. (Ngilungise impendulo yakhe ngobukhulu futhi ngengeza amazwana ami ekugcineni.)
Othandekayo uDkt. Fogoros,
Siyabonga ngokuthunyelwe kwebhulogi yakho mayelana nokucwaninga kwethu ngeziguli ezine-POTS - Ngiyazisa ithuba lokunikeza amaphuzu ambalwa okucacisa mayelana nokucwaninga okukhulunywe ngakho ngokuqondile kanye nokuhumusha okushiwo kulolu cwaningo.
1) Ukukhuthazwa kokuthola okuseshweni . Okokuqala, ake ngikuqinisekisile ukuthi angikaze "ngiphakamise" umsebenzi wethu kunoma yiziphi izitolo zemidiya, futhi akekho omunye umuntu esikhungweni sami. Ngokweqiniso, angiyena omkhulu fan wokubika abezindaba kwedatha yesayensi, futhi nakuba ngizokhuluma nabathengi uma bebiza uma ngingahlinzeka noma yiluphi ubuchwepheshe obungavamile, angiyikusesha. Njengoba ngiyaqiniseka ukuthi uyazi, asinakho ukulawula lokho abashicileli abakushoyo ngomsebenzi wethu. [Lapha uDkt Levine wafaka i-vignette echaza ukuthi imithombo yezindaba isiphazamisa kanjani izifundo zesayensi, inkinga evamile engiye ngaba nakho kwami siqu. RF] Izilaleli zethu zamaphepha ethu ezinye odokotela kanye nososayensi, okumele bahumushe idatha ngenxa yokuhlangenwe nakho kwabo futhi bafunde ngezincwadi.
Ngiyaxwayisa wena, nazo zonke iziguli okufanele zithole ulwazi lwazo kumaphephandaba ukuze zingapheli-zihumushe lokho ezikufunayo kumagazini noma zibone ku-TV ...
2) Ama-POTS awabangelwa "ubuvila." Indaba ekhulunywe yilabo abaningi abaphendulile indaba yakho ifana neziguli zethu ze-POTS. Iningi leziguli engizibonayo zazisebenza kakhulu (njengezimboni zethu, esiziqondisa kuzo izinhlelo zethu zokuqeqesha ze-POTS) ngaphambi kokuba kwenzeke okuthile - kwabanye ukutheleleka ngegciwane; abanye ukulimala noma ukugula okunye; abanye ukukhulelwa noma izinkinga zokuletha umntwana.
Lokhu "umcimbi we-sentinel" kubangele into eyodwa evamile - ibeka abantu ukuba balale.
Kubalulekile ukugcizelela ukuthi ngisho nokuphumula kwamahora angama-20 kungabangela ukulahlekelwa komthamo we-plasma, umsebenzi we-baroreflex ongasebenzi kahle, kanye nokuphathwa kwe-orthostatic-headed kubantu abaningi. Lezi zimpawu zisheshe zikhululeke ngokulala phansi futhi zenze ukuhlukumezeka kwe-orthostatic ngokushesha kakhulu, i-hypovolemia (ukulahlekelwa kwe-plasma egazini), i-atrophy ye-cardiac (cishe i-1% ukulahlekelwa kwenhliziyo emasontweni ngesonto embhedeni) ukulala komzimba okuqhubekayo ekugcineni kokulala futhi ekugcineni ukukhubazeka. Ngemuva kwamasonto amabili kuphela okulala noma i-spaceflight, cishe abantu abangu-2/3 bangakwazi ukuma imizuzu engu-10!
Kumele futhi kuqaphele ukuthi izifundo zangaphambili ezivela kusayithi lethu zibonise ukuthi yizihloko ezithinta kakhulu ezithintekayo kakhulu ngisho nesikhathi esifushane (amaviki amathathu) ukuphumula kombhede, ngezikhathi zokubuyisa eside kakhulu. Eqinisweni, amavolontiya ayencane kangako ngaphambi kokulala, athola ngokushesha ngokuphendula ukuqeqeshwa okulawulwa okulandelayo, ngokuvamile kungakapheli amasonto amabili. Ngakolunye uhlangothi, izisebenzi zokuvolontiya ezithandwa kakhulu, emva kwezinsuku ezingu-3 zokuphumula kombhede nezinyanga ezimbili zokuqeqeshwa okujulile, kwakungakaze zibuyele emzimbeni wazo wokuqala. Ngokuthakazelisayo, safunda izifundo ezifanayo eminyakeni engu-30 ngemuva kokutadisha kwangempela futhi sathola ukuthi, ngokumangalisayo, akekho umuntu oyedwa owayesimweni esibi kakhulu eminyakeni engu-30 kamuva, kunokuba abe ngemva kwamasonto amathathu okulala emashumini angu-20.
Ngamanye amazwi, amaviki amathathu okulala embhedeni ayebi kakhulu ekuzikhandla komzimba kuneminyaka engu-30 yokuguga! (bheka uMcGuire et al Circulation 2001).
Kungakhathaliseki ukuthi yini eyabangela umcimbi wokuqala, kodwa ngesikhathi sokugula (noma noma ngabe kwenzekani) sekuqhubekile, iziguli zishiywe ukukhubazeka okukhulu (isiguli esisodwa esifundweni sethu asizange sikwazi ukuhlala siqotho iminyaka engaphezu kwengu-2 ) okubonakala sengathi ngcono ngehlelo lwethu lokuzivocavoca, olugxile, oluthile lokuzivocavoca kusukela ekuqaleni kwesikhundla esiphezulu. I-nuance yokugcina mhlawumbe yinkimbinkimbi ebalulekile esilethe etafuleni ekunakekeleni iziguli ze-POTS.
Iningi le-POTS alikwazi ukubekezelela ukuma okuqondile ukuze uqale ukuhlala phansi noma ukuhlala emuva emuva kubalulekile empumelelweni yabo. Futhi kunzima! Iziguli eziningi zihlukumeza ukuqedela amasonto ambalwa okuqala ohlelweni lokuqeqesha, okuyindlela eqala ngamaminithi angu-30 ngosuku, izinsuku ezintathu ngesonto. Kodwa uma behlupha ekuthomeni kokuqala, ngokuvamile bazithola bethola kancane kancane bezwa kangcono futhi banamandla.
Lokhu kugcizelela iphuzu elibucayi - Asikaze sibe nomuzwa wokuthi isiguli esisodwa se-POTS sinobuvila noma singenacala - uma kulula ukuphatha i-POTS ngokuzivocavoca, wonke umuntu uzokwenza !! Kodwa uma sisebenzisa uhlelo oluthile lokuqeqesha olugxile ekwenzeni inhliziyo ikhudlwana, iningi leziguli lizwa ngendlela engcono kakhulu futhi abaningi "baphulukiswa", okusho ukuthi abasahlangabezane nemigomo ye-POTS. Kumele ngigcizelele ukuthi ukugcina ukuqina kungumgomo wokuphila kwabaguli bethu be-POTS futhi sibakhuthaza ukuba bacabange ukuzivocavoca njengengxenye yokuhlanzeka kwabo. Kulezo ziguli ezangizwile ngikhuluma, noma ngasese njengeziguli, noma ngasese ezifundisweni, bayazi ukuthi Mina ngigcizelela ukuthi "ukuhlukunyezwa kwenhliziyo" kuyindlela enhle futhi echazwe kahle engenalutho oluphathelene nobuvila.
Sicela wazi ukuthi iziguli ezine-POTS azikwazi ukuhluleka kokuzimela. Lokhu akusho ukuthi isimiso sezinzwa esizimele asizange sithinteke ngesikhathi esithile kwinqubo yokuqhubekela phambili kwe-POTS. Kodwa-ke esigabeni esingapheli, i-hemodynamics ilawulwa yi-physiology ye-cardivascular deconditioning - kanti ubufakazi buwukuthi uma siphenduka le-pathophysiology, ngokukhulisa inani legazi inhliziyo equkethe futhi ingahloma ngenhliziyo ngayinye, ukuthi i-HR iya phansi, Umsebenzi wokuzwela ozwelayo wehla, futhi iziguli zizwa zingcono.
Ake ngiphinde ngigcizelele leli phuzu: UKUQALA KWEKARDIVASCULAR AYINYE OKUYE "NJENGOBA NGOKUBA NGOKUKHUBA" !!!!! Noma ubani ohumusha idatha yethu ngaleyo ndlela ahlukumezi ukutholakala kwethu kanye nokwelapha kwethu. Nginesihawu esikhulu ngeziguli zethu eziningi zazo ezikhubazekile ngokweqile, futhi ngikhungathekile ngenxa yemisebenzi yami eminingi ezama ukuthola izindlela zokwelapha ezisebenza njalo.
3) Ekukhetheni iziguli zocwaningo lwezocwaningo kwi-POTS. Mayelana nezifundo zethu, sasebenzisa izincazelo ezijwayelekile ngokulandela imihlahlandlela eyenziwe izinhlangano zikazwelonke nezamazwe ngamazwe ezihilelekile ekuhluphekeni kokuzimela. [Lapha uDkt Levine unikeza ingxoxo eningiliziwe yezimo ezihlukahlukene zezokwelapha ezihlobene ne-POTS, kanye nobunzima obuyinkimbinkimbi bonke abaphenyi abhekene nazo lapho benquma izinqubo zokukhetha ezifundweni zemitholampilo ku-POTS. Ngalokhu kunzima engqondweni, ngiyaqiniseka ukuthi balandela "imikhuba engcono kakhulu" ekutholeni iziguli ekuhlolweni kwabo emtholampilo. RF]
Ngiyazi ukuthi lokhu kungase kunganeliseki kakhulu iziguli ezinalezi zimo, kodwa kubonisa ukuthi kwenzekani ngokucwaninga emtholampilo. Njengoba ungase ucabange, ukucwaninga okubaluleke ngaphezu kokubhalisa, kungcono abaphenyi bahlehlise lokho okushiwo yi-hypothesis yabo, nakuba kungenakwenzeka ukuthi iziphetho zingaba khona. Njengobe wena nabafundi bakho abaningi bangase bazi, njengamanje sifaka isifundo esikhulu sokubhalisa emphakathini, lapho> iziguli ezingu-200 zizocwaningwa ngemingcele eminingi embalwa ekubhaleni. Sithemba ukuthi lolu cwaningo luzophendula imibuzo thina nabanye esinayo mayelana nokukhwabanisa kokudlulisela.
Esifundweni sethu esishicilelwe, sabhalisa uchungechunge olulandelayo lweziguli ezibhekiswe emtholampilo wami wezemfundo ephakeme kanye nokuxilongwa kwe-POTS. Ngokwenzayo, asifakanga iziguli ezimbalwa kakhulu ezinezinkinga ezingaphansi, ngenxa yokuthi njengoba uphakamisile ekubuyekezweni kwakho, iningi lalezi ziguli liye labona abanye odokotela abaningi ngaphambi kokudluliselwa kimi, okufana neziguli zesiguli eMayo Clinic noma iVanderbilt. Ukusuka ukuxoxa ngesiguli sethu sabantu abanolwazi (futhi sivame ukubona iziguli zomunye nomunye ...) ensimini, ngiyaqiniseka ukuthi inani lethu limelela isibalo esikhulu sokudluliselwa kwesiguli seziguli ze-POTS.
4) Mayelana "Grinch Syndrome." Ekugcineni, ake ngigcwalise ngamazwi ambalwa mayelana ne-Grinch. Iningi leziguli zethu ezizwa igama elithi "The Grinch Syndrome" lihleka futhi liduduza emoyeni lapho linikezwa khona. Ngakolunye uhlangothi, ngiyaqonda ukuthi ezinye iziguli ezingingazi, futhi ziyakhathazeka ngokuthi zibhalwe igama elihlotshaniswa nokusho okuvuthiwe, into ekusetshenzisweni kwegama elithi Grinch Syndrome, futhi ngiyazihlonipha lezo zinto ezikhathazayo. Ngenhlanhla, uma ngabe kufanele ngiphinde ngifinyelele futhi, mhlawumbe ngingaba nesibindi ukusebenzisa leli gama, futhi ngifuna bonke abagulane be-POTS bazi ukuthi asikhombisanga. Ayikho "udumo nenhlanhla" ehlotshaniswa negama futhi angitholi nzuzo yomuntu siqu ngokusebenzisa leli gama. Kodwa-ke, ngiye ngabona ukuthi kusebenza kahle kanjani ekubhekiseni lokho esikubonile njengendlela epathophysiology eyinhloko ehambisana nokukhubazeka ngokweqile kwalezi ziguli. Njengoba ngivame ukutshela iziguli zami, igama elithi "POTS" libeka nje ilebula lokuthi inhliziyo yesiguli ishaya ngokushesha uma ivuka. I-"Grinch Syndrome" igxile ukunakwa, ukuthi kungani ukuma kwenhliziyo kumile kakhulu - okungukuthi inhliziyo "ubukhulu obukhulu kakhulu."
Ngokusekelwe kwezibalo zabantu ezilula, u-2.5% wabo bonke abesifazane emhlabeni bazoba nenhliziyo engaphezu kokubili ukwehluka okujwayelekile ngaphansi kwencazelo - incazelo "evamile" kwezokwelapha. Sikholelwa ukuthi yiloba besifazane abasengozini yokuthola izimpawu ze-POTS ezingadluliselwa ngokushesha kakhulu ngisho nesikhathi esifushane sokulala.
Ekugcineni, ngingathanda ukugcizelela ukuthi amahlaya ayithuluzi elinamandla lokuphulukisa, hhayi kuphela iziguli ezine-POTS, kodwa cishe noma yisiphi isifo. Siphatha zonke iziguli zethu ngenhlonipho ejulile futhi siziqaphela kahle ukuthi ziyizinto ezinzima kangakanani, esizibheka kakhulu. UMark Twain wake wathi "Ukuzidla kuyisibusiso esikhulu kunazo zonke zesintu"; sikholwa ukuthi yingxenye ebalulekile yenqubo yokuphulukisa futhi nethemba lokuthi zonke iziguli zethu ziyamamatheka lapho zicabanga nge-Grinch, bese uyahamba ukuzivocavoca!
- Benjamin D. Levine, MD
Imicabango yokuvala
UDkt. Levine ungumcwaningi ozinikezele futhi oqaphele, nomzimba wakhe womsebenzi ku-POTS uye waqhubela phambili ulwazi lwethu ngalesi simo ngokuphawulekayo, futhi ngenxa yalokho, izinkulungwane zabantu abanezimo ziyasizwa. Ngaphezu kwalokho, ukwahlulela kwezinye iziphakamiso ezivela ngemuva kokuthunyelwe kwami kwangaphambilini, iziguli ezine-POTS eziye zazinakekelwa zicabanga kakhulu ngaye, futhi zimdumisa ngenhlonipho, ukukhathazeka, nokuzinikezela ozibonisile ngokwabo.
Ngicabanga ukuthi kulula kakhulu kumuntu ongeyena ochwepheshe ku-POTS (njengami) ukuhumusha isifundo esibucayi njengoba kubonisa ukuthi i-POTS ngandlela-thile isifo esenzelwe ukuzimela, futhi ngahlulela ngokuphawula okuthunyelwe kwami, lokho okungahunyushwa kahle nakanjani ejwayelekile kakhulu odokotela. Ukuchazwa kukaDkt. Levine ngalelo phuzu (ngenhla) kubonisa ngokucacile ukuthi kwakungakaze kube nenhloso yakhe ukuphakamisa ukuthi i-POTS iyenzayo. Kunalokho, okutholakala kwakhe kubonisa ukuthi isikhathi esifushane sokuphumula kombhede, mhlawumbe ikakhulukazi kubantu abasebenza kakhulu (ngokuvamile abesifazane), kungase kube ngokwanele ukuletha lesi simo.
Kunoma yikuphi, abantu abane-POTS abadinga ukuqinisekisa odokotela babo nomndeni ukuthi isimo sabo akuyona into abazenzele yona, manje akudingeki ukuba bathembele embhalweni olotshwe yimi ukwenza kanjalo (njengoba kubaningi babo babonisa ukuthi bazo imibono yabo). Manje banezincwadi kulokho okubhaliwe nguDkt. Levine ngokwakhe.
Ngingathanda ukubonga uDkt Levine ngesimo sakhe sengqondo sokufunda ngokuphathelene nalolu shicilelo, nangenxa yomzamo azenzile ekuhlanzeni umoya.
Funda mayelana ne- postural orthostatic tachycardia syndrome (POTS) .