Ngo-2010, abaphenyi baseNyuvesi yaseTexas Southwestern Medical Centre bashicilela isihloko esibangelwa imbangela ye- postural orthostatic tachycardia syndrome (i-POTS) . Lesi sihloko sabangela ukuphikisana nokuhlukumeza phakathi kwabaningi abagulayo be-POTS, ngenxa yokuchazwa kabanzi kwemiphumela yayo, futhi ngenxa yegama elisha abalobi abahlongozwa kule nkinga - Grinch Syndrome.
Ukukhala, empeleni, kwakunzima kangangokuba umlobi oyinhloko walolu cwaningo, waphawula umcwaningi we-POTS uDkt. Benjamin Levine, wavuma isicelo salomlobi ukuba aphendule ngalolu daba esidlangalaleni. Impendulo yakhe ivela ngezansi.
Mayelana ne-POTS
I-POTS yinkinga lapho izinga lomuntu landa khona kumazinga aphakeme uma evuka. Ngokuvame ukuhambisana nobunzima obunzima, izimpande , futhi ngezinye izikhathi nge- syncope . I-POTS, engakwazi ukukhubaza kakhulu, inezici eziningi ezifana nama- dysautonomia ahlukahlukene. Kuvame ukubonwa kubantu abancane, ngaphandle kwalokho abantu abanempilo enhle, nabesifazane ngokuphindaphindiwe kunamadoda.
Isifundo
Ithimba likaDkt. Levine lacwaninga abantu abangu-27 babhekisela eNingizimu-ntshonalanga ngePOTS. Okutholwe yizinhloko kwakuyizi: 1) Akukho okunye kwezihloko okwakungalingani okungaqondakali ohlelweni lwabo lwezinzwa ezizimele. 2) Abaningi (abangaba ngu-70%) babe nezinhliziyo ezincane kanye nomthamo wegazi ophansi, okutholakala ukuthi yizici zobunzima.
Futhi 3) Ngokwesilinganiso, izifundo zamukele kahle kakhulu ohlelweni olude, olulinganiselwe lwezokwelapha.
Abalobi baphetha ngokuthi i-POTS "yiyona ngayinye" isimo esibangelwa ukuchithwa kwemithetho. Ngenxa yezinhliziyo ezincane abazitholile kuzo zonke izihloko zabo, abalobi bahlongozwa (mhlawumbe ngezilimi esihlathini) bamba kabusha i-POTS ku-Grinch Syndrome (ngoba ukugoqa, ngokusho kwemithombo ecacile, kunezinhliziyo ezincane).
Ukuphendula kwama-POTS Sufferers
Amaphephandaba azungeze leli zwe aphikisana nalesi sihloko ngenkathi eshicilelwe, efaka amaphuzu amabili: igama elisha elihle iG Grinch Syndrome, nomqondo wokuthi i-POTS iyenziwa ngokwayo ngokuhola impilo yokuphila. Lokhu okungaqondakali okuqhutshisiwe kwalolu cwaningo kubangele ukusabela okumangalisayo okuvela kubagulayo be-POTS emhlabeni jikelele.
Abantu abasebenzisana ne-POTS bathatha imithombo yezokuxhumana ngobuningi ukuze bakhononde ngalolu cwaningo. Ngaphandle kwesifiso esicacile sokungafuni ukubizwa ngokuthi ukugubha, basho ukuthi ukubeka wonke amacala we-POTS ekunqumeni akuyona into engalungile kodwa kungase kube yingozi kubo abagulayo be-POTS.
Akungabazeki ukuthi yiqiniso ukuthi iningi uma kungenjalo bonke abantu abanePOTS ephawulekayo bahlehlisiwe. Uzobe unqunywe futhi uma ungenakuma ngaphandle kokuba umkhonto obala kakhulu noma uphume. Futhi isifundo ngempela saqinisekisa ukuthi yilokho okwenzekayo.
Kodwa iqiniso lokuthi iziguli ezine-POTS zingase ziboniswe ukuthi ukuchithwa kwezimpawu akuqinisekisi (futhi empeleni, akusho ngisho nokusikisela ngokuqinile) ukuthi ukumiswa kwembangela yimbangela ye-POTS, kunokuba umphumela.
Abantu abatholakala bephethe i-POTS kakade banenkinga engavamile kakhulu ukuthola odokotela nemindeni yabo ukuthi bathathe izimpawu zabo ngokungathí sina.
Bavame ukubhekana nobunzima obuningi bokutshelwa odokotela abaningana ukuthi banenkathazo noma ukucindezeleka noma uhlobo oluthile lokuguqulwa kokuguquguquka kunokuba isimo seqiniso, physiologic. Ngokuvamile amaviki noma izinyanga, futhi ngezikhathi ezithile, ngaphambi kokuba udokotela othile abone ukuthi ukuxilongwa kwangempela kuyini.
Futhi manje, ngisho nangemva kokuba kutholakala ukuxilongwa okulungile, babhekene nethemba lokubhekwa njengaletha lesi simo ngokwabo, ngenxa yokuthi "ukuhlambalaza," okuyinto evame ukukhuluma ngezokwelapha ngenxa yokulala, ukungahambi kahle nokuvilapha. Futhi uma umndeni wabo utshele ukuthi inkinga iyenziwa ngokwayo, ngendlela yokwehla, futhi utshele udokotela ngalutho, inani lezinkinga ze-POTS ezigulayo cishe zizotholakala kubathandekayo, ngesikhathi esifanayo ukulwa ukuze kutholakale futhi banesidingo esikhulu, kuzokwenqabela ngokubikezela.
Ngakho-ke i-hue bese ikhala kusukela kubagulayo be-POTS lapho lesi sihloko sishicilelwa kulula ukuchaza.
UDkt. Levine Uphendula
UDkt. Levine washukumiseleka ukuba asabele ekucindezelekeni okwakhulunywa ngabagulayo abaningi be-POTS ngemva kokutadisha kwakhe. Ngokwenza kanjalo wenza amaphuzu amathathu amakhulu.
" 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. Izilaleli zethu zamaphepha ethu zenye odokotela kanye nososayensi, okumele bahumushe idatha ngenxa yokuhlangenwe nakho kwabo futhi bafunde ngezincwadi. Ngiyaxwayisa zonke iziguli okufanele zithole ulwazi lwazo kumaphephandaba ukuze zingapheli lokho ezikufunayo kumagazini noma zibone ku-TV.
2) Ama-POTS awabangelwa "ubuvila." 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. 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 engama-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 ngasesidlangalaleni ezifundweni, bayazi ukuthi ngigcizelela kakhulu ukuthi "ukuhlukunyezwa kwenhliziyo" kuyindlela enhle futhi echazwe kahle engenalutho oluphathelene nobuvila.
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) Ngokuphathelene "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!
- UDkt. Benjamin D. Levine "
Izwi elivela
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.
Kuyadabukisa ukuthi abantu abaningi - ngaphakathi kungakapheli nje kuphela abezindaba kodwa ngaphakathi kochwepheshe bezokwelapha - baholwa ekuchazeni ngokucacile isifundo sakhe njengoba kubonisa ukuthi i-POTS ngandlela-thile isifo esithatha umuntu siqu. Ukuchazwa kukaDkt. Levine kulelo phuzu 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 abanesitatimende esivela emlonyeni wehhashi esibonisa ukuthi i-POTS yinto eyenzeka ngabantu nje.
> Imithombo:
> Freeman R, Wieling W, Axelrod FB, et al. Isitatimende sokubambisana mayelana nencazelo ye-Orthostatic Hypotension, i-Syncope engokwemvelo ne-Postural Tachycardia Syndrome. I-Auton Neurosci 2011; 161: 46.
> Fu Q, i-VanGundy TB, i-Galbreath M, et al. Iziqalo Zezinhliziyo Ze-Postural Orthostatic Tachycardia Syndrome. I-JACC 2010; 55: 2858-68.
> Kimpinski K, Figueroa JJ, Singer W, et al. I-Prospective, 1-year Study-Up of Postural Tachycardia Syndrome. I-Mayo Clin Proc 2012; 87: 746.