Ochwepheshe be-Thyroid Bahlanganyela Imicabango Yabo
Enkulumweni, ochwepheshe bezelapha uRichard Shames, MD, noKarilee Halo Shames, uRN, PhD, bahlola ukuthi kungani kubalulekile ukufuna umbono wesibili ngokunakekelwa kwe-thyroid.
Q: Siyazi ukuthi bobabili baye bahileleka emsebenzini we-thyroid iminyaka engaphezu kwengu-25-ngokwabo nangomsebenzi. Uyini isimo sakho kuziguli ezithola umbono wesibili?
Njengezifundiswa zezempilo, sisekela ngokweqile ukunika amandla kanye nokuzinakekela.
Ngaphandle kwezincwadi, abangane, ne-intanethi, sizizwa kubalulekile ukugcina ubuhlobo obuzuzisayo nodokotela wakho. Udokotela omuhle angakusiza ekuxilongweni okufanelekile nokuphathwa kahle kwempikiswano yakho ye-thyroid, ekugcineni iminyaka yokucindezeleka, izindleko, nobunzima.
Kodwa, khumbula ukuthi bonke odokotela banemingcele yabo. Isikhathi sabo, ulwazi, kanye nokuhlangenwe nakho komtholampilo akupheli. Kuyinto yokwelashwa evamile ukubiza ngomunye umbono uma kudingeka. Ngokuvamile uyidokotela okhetha ukuthi kunesiphi isikhathi lapho kudingeka khona umbono. Esigungwini se-thyroid, kuyaqhubeka ngokwengeziwe ukuthi isiguli senza lesi sinqumo. Njengethimba labahlengikazi nodokotela, sisekela ngokugcwele lokhu kuthuthukiswa okwakamuva futhi okudinga kakhulu.
Q: Uzizwa kanjani ukuthi isiguli siqale ukucabanga ngalezi zindlela?
Ngeziguli ze-thyroid, ngokuvamile ziqala ekuqaleni kwesigaba sokuxilongwa, noma kamuva ezinkingeni zokwelashwa.
Isibonelo, lapho kuqala inkinga ye-thyroid, udokotela owaziyo uthatha umlando ophelele, ulalele ngokucophelela ama-nuances, nokukhomba amaphethini. Khona-ke, uhlola kahle umzimba futhi uyala izivivinyo ezifanele ze-laboratory, ukuze aqiniseke ukuthi yini ebangela izimpawu.
Ngale ndlela, ungakwazi ukunquma ngokunembile ukuthi yiziphi izindlela zokwelashwa ezizokusiza kakhulu kuwe. Ungazithengisi ufushane. Qinisekisa kusukela ekuqaleni ukuthi isimo sakho sitholakale kahle. Uma udokotela wakho ovamile engahlolisisi i-thyroid ngokuseduze noma ngokucophelela ngendlela ongathanda ngayo, ngandlela-thile ukhulume. Lokhu kuyiqiniso ikakhulukazi uma unesifo se-thyroid ngokwakho noma emlandweni wempilo yomndeni wakho.
Uma uthola ulwazi kubangani noma amawebhusayithi ahlobene nesimo sakho, kungaba umqondo omuhle ukwabelana ngalokhu nodokotela wakho ukuthola okunye okufakwayo. Kulezi zimo, qaphela ukuphendula komsebenzi wakho. Uma udokotela wakho enza njengokungathi imibuzo yakho iyayikhathaza, noma ayiphenduli ngokuqondile, cabanga ukuthi uthola ukwelashwa okufanele. Kungadingeka ukwandise ukunakekelwa kwalesi dokotela ngemibono eyengeziwe. Uma udokotela wakho engazi izimpendulo zemibuzo yakho, cela ukuthi angakuthola yini, noma akuqondise emithonjeni efanele. Kungase kudingeke ukuthi uthenge lokhu okungeziwe, njengoba nje ungathengisa umshini oqondile, umkhontilaki noma enye insizakalo oyithandayo.
Umbuzo: Kungani uzizwa ukuthi isiguli sengqondo se-thyroid kufanele sithenge?
Odokotela abaningi abayisisekelo abonakala bengaboni ukuthi isifo se-thyroid esincane esivela kunani labantu noma sesibalo saso esihlangene empilweni yesizwe. Njengoba sibonile encwadini yethu, uphenyo lwezikhungo zezokwelapha zaseyunivesithi, kanye ne-Mayo Clinic, zithole ukuthi ukusabalala kwemibandela ye -roid kuphakeme kakhulu-kunciphisa impilo yabantu abangamaphesenti angu-10, futhi kubonakala sengathi kube kakhulu ukwanda. Kuthathe isikhathi eside emphakathini wezokwelapha, okugxile kakhulu ekunakekelweni okubalulekile, ukuze uqaphele lesi simo esibucayi.
Ngenxa yokuthi lesi simo ngokuvamile asinamandla noma sisongela ukuphila, kungase kungaboni nje odokotela abamatasa.
Kanti futhi, njengoba uhlelo lwe-thyroid lulawula izici eziningi zokusebenza ngokomzimba nangokwengqondo, uhlu olude lweziguli lwezikhalazo lungabonakala lungavumelani futhi lunomthelela emtholampilo. Isiguli singase sibe nenkinga yesikhumba, inkinga yesisu, ukukhathala, inzuzo yesisindo , izinwele noma izinkinga ze-nail, ukucindezeleka ngokomzwelo, ukuzwela kwesinye isikhathi, nokushisa kwabanye.
Lapho ebhekene nalezi zimpawu eziningi ezibonakala sengathi zikhona emhlabeni wonke, udokotela ngokuvamile uvame ukungabaza, futhi, esikhundleni sokusola i-thyroid ephansi, angakholelwa ukuthi lesi siguli singase sibe nenkinga yengqondo njengokucindezeleka. Manje isiteji sisetshenziselwa ukuxilongwa kokucindezeleka, noma okufanayo, nomuthi we-Prozac noma u-Zoloft. Lokhu kulahlekelwa ukuhlolwa okuyiqiniso kwe-thyroid, okubangela izimpawu ezifaka ukucindezeleka. Uma uzizwa ngokuqinile ukuthi ungomunye wezigidi zabantu abanenkinga ye-thyroid abangenakulinganiswa ngalendlela ngaleyo ndlela, khona-ke kungenzeka ukuthi udinga ukuthenga nxazonke futhi uthole umbono wesibili ogcwele.
Q: Kuthiwani ngesiguli okungenzeka ukuthi sinombono wesibili nodokotela ovulekile ngokwengeziwe, sinephaneli ephelele yokuhlolwa kwe-thyroid, itholakale (mhlawumbe iminyaka kakade), futhi ukwelashwa okwamanje akuhambanga kahle yena angathanda. Yini-ke?
Kuyaziwa ukuthi lesi simo esibi esingaphansi kokwelashwa okwanelisayo sivame kakhulu. Ake sithi inkinga yakho ayikho ekutholeni inkinga ye-thyroid, kodwa ngokuchazwa okuqhubekayo kwezimpawu nezivivinyo ezingabangela ukuphathwa okungcono kwesimo. Uma ukuhlolwa kwegazi kufundwa, ibanga elichazwe njengelesijwayelekile le-thyroid livame kakhulu kangangokuthi lokho okubhekwa njengezinga eligculisayo kungakunaki izidingo eziyingqayizivele zomuntu ngamunye. Abantu abanjalo bangazizwa bebuhlungu iminyaka eminingi ngezikhalazo ezihlukahlukene, naphezu komsebenzi wabo webhulethi bebuyele "evamile." Kungakhathaliseki ukuthi izimbhikisho zeziguli, ezinye odokotela ziphikelela ukuthi uma i- TSH yakho ihle , i-thyroid yakho ihle kakhulu. Nokho, isiguli se-thyroid singase sibe sibi kakhulu kancane kancane, futhi mhlawumbe sigcine siphelelwe amandla. Uma ukhona kulo mkhumbi, ungase ufune umbono wesibili udokotela obheka umsebenzi webhule njengengxenye eyodwa yendaba yonke ye -roid.
Q: Ngeshwa, abafundi bami nami ngithole ukuthi odokotela abanjalo bancane kakhulu futhi baphakathi.
Lokhu kungase kube yiqiniso, kodwa kukhona abaningi kithi. Ngokwenza kwethu, senza ukunakekelwa okuyinhloko kanye nemibono yesibili. Ukuhlola kweLabhu kungenye yezinto ezibangela izinqumo neziphakamiso zethu. Kunabanye odokotela abaningi abanjengathi. Iziguli zidinga nje ukuzifuna.
Ngokwesibonelo, cabangela "udokotela" weDokotela, i-Physician's Desk Reference (PDR). Kuzo zonke izigaba zemithi ye-thyroid, kunesihloko esithi "ukuhlola kwe-laboratory." Lapha odokotela bayelulekwa ukuba bangathembeli kuphela kunoma yikuphi ukuhlolwa kwegazi okukhethekile ukulawula i-thyroid ephansi. Esikhundleni salokho, bakhunjuzwa ukuba bahlanganise ulwazi olutholakala ekuhloleni kwe-laboratory ngesinqumo esihle semitholampilo. Noma kunjalo, ngokunakekelwa okuphethwe ukuqondisa ukulandelwa kwemithetho, odokotela ngokuyinhloko bayayinaki lesi seluleko. Nokho, odokotela abambalwa balandela le nqubo efanele; iziguli zidinga nje ukuthola lezi odokotela. Khona-ke iziguli zingathola umbono wesibili othemba ukuthi uzogqugquzela udokotela wabo oyinhloko ukuba abe nengqondo evulekile mayelana nezingxoxo zokwelapha. Kungenzeka ukuthi ukunyuka okulula emithini yemithi noma ushintsho olulula emithini yemithi kuyoba ngcono okukhulu. Mhlawumbe umbono wesibili uzophakamisa ukuhlanganisa imithi emibili ye-thyroid, ngezinye izikhathi engcono kunazo zonke izidakamizwa zodwa. Udokotela oyinhloko evulekile futhi angasebenzisa ukusikisela kwesibili-mbono ngesikhathi sokuhlolwa futhi ubone ukuthi kusebenza kanjani kahle.
Q: Iziguli eziningi azibona uhlobo lwadokotela ochazayo. Kungani ucabanga ukuthi akekho odokotela abengeziwe abasebenzisa indlela efanayo?
Singaqonda kalula ukuthi kungani abahlinzeki abaningi bengenakufuna ukwenza ngale ndlela. Kuyisidlo esiningi kakhulu, kudinga isilinganiso esithile sokubekezela ukuqapha intuthuko yesiguli ngasinye.
Le nqubo idinga ukuba umnakekeli ahambe eceleni nesiguli, afundise futhi asekele umuntu ophakathi kwalokhu (ngezinye izikhathi) ukuhlala kwe-roller-coaster. Imvelo yokunakekelwa ephethwe ayivumeli abahlinzeki ukuba banakekele ngokucophelela okudingekayo, ukuze bathole umthamo ofanele kuphela, wemithi noma imithi efanele, kumuntu ngamunye.
Ngaphezu kwalokho, iziguli ngokuvamile azigula kahle. Isimo sabo singaphezu kwesimo eside eside, esingapheli esihamba kancane. Abanye abahlinzeki bezempilo abanesithakazelo esiqinile kule simo esibucayi.
Kubuye kube yingozi ukuba udokotela angene esikhunjini esijwayelekile, ukuze azame okuthile okuhlukile. Khumbula ukuthi odokotela baqashwe futhi kulindeleke ukuba benze ngokuvumelana nesilinganiso esithile somphakathi. Lokhu kusho ukuthi uma abasebenzi abayisikhombisa abahlala edolobheni elinikeziwe bengalokothi banikeze noma yini ngaphandle kwesifo se-thyroid, kanti i-GP yesishiyagalombili isebenzisa ama-synthetics futhi ngezinye izikhathi isebenzisa i-thyroid yemvelo, ukuthi udokotela wesishiyagalombili awubhekwa njengokwenza ngokuvumelana nemigomo yomphakathi.
Ingozi engokomthetho yangempela ayilutho, kodwa namanje idumaza odokotela abaningi kusuka emisha.
Q: Ngiyakwazi konke lokho. Lokho mina nabafundi bami abaningi abanenkinga ngakho lapho udokotela ebonakala ekhukhume noma enesibindi.
O, lokho kuyinkinga enkulu kakhulu. Ukunakekelwa kwezempilo ngokujwayelekile kuphelelwe yisikhathi isikhathi esidinga ukuguqulwa kwesigqila-mgama obudlelwane nodokotela.
Kudingeka ibe ngaphezulu kokubambisana okulinganayo nokuhlanganyela ngokuhlanganyela kokufunda nokuphulukisa. Odokotela abaningi baqeqeshwe ukuba bacabange ukuthi ukuziphatha okuvamile kuyakhuthaza kakhulu isiguli. Kwezinye izimo lokhu kuyiqiniso, mhlawumbe ikakhulukazi neziguli ezikhulile, eziye zafundiswa ukuthi zikholelwe ukuthi udokotela akakwazi ukwehluleka. Sikholwa ukuthi umsebenzi wethu ukufundisa nokugqugquzela, kunokuba iphoqe. Udokotela kufanele abe nomqondo ovulekile, ezimisele ukuzama imithi ehlukahlukene, nokusiza iziguli zithathe ukuthi ubani osebenza kahle kakhulu kubo.
Sibheka ukuthi ingxenye yendima yethu njengomnakekeli ukunika amandla nokuhlonipha abantu abafuna ulwazi lwethu, ukuhlakanipha nokusekela ekuvikeleni impilo yabo. Kubhalwe kahle ukuthi izinkolelo zeziguli zidlala indima enkulu ekuphulukiseni. Kubuye kubhalwe kahle ukuthi isiguli esinikwe amandla senza kangcono kakhulu kunomuntu olandela imiyalo nje.
Uma isiguli siye sabhekana nokuhlangenwe nakho okungalungile ngemithi ethile, sihlonipha ukukhathazeka nokuhlangenwe nakho kwabo. Sikhuthaza abathengi bezempilo ukuthi baqiniseke ukuveza imizwa nezinkolelo mayelana nokwelapha. Uma umhlinzeki wakho wezempilo engafisi ukuzwa imizwa yakho noma izinkolelo zakho, ungase ufune ukucabanga ngokuthola olunye umbono.
Q: Ungakwazi yini ukulinganisa lokhu konke ohlwini lwamanothi "amantongomane nezinketho" zeziguli?
Kulungile. Nakhu lapho isiguli segciwane kufanele siqale ukucabanga ngokuthola umbono wesibili:
- uma udokotela wakho engachazi imiphumela yakho yebhu noma unikeze izinombolo zangempela (lokhu kuyiqiniso ikakhulukazi uma ucela imiphumela futhi awukwazi ukuthola ngabo)
- uma udokotela wakho noma ummeleli wehhovisi engeke abuyisele izingcingo zakho zefoni
- uma udokotela wakho ethi konke lokhu kufanele kube ekhanda lakho, noma ukuhlobene nokucindezeleka noma i-PMS- noma ukuhlobene nokunqamuka kwamadoda (Kuyiqiniso konke kuhlobene, kodwa ngokuvamile i-thyroid kufanele ibhekwe njengesizathu esiyinhloko)
- lapho udokotela wakho ethi uphawu oluthile olubonile kuwebhusayithi "alukwazanga ukuba ngenxa ye-thyroid ephansi" (ifulegi elibomvu)
- uma usuphethe ukwelashwa okufanayo iminyaka futhi usazizwa uqobo lwakho, kepha udokotela wakho akazimisele ukushintsha noma yini
- uma unenhlanhla ngokwanele yokuba nodokotela obambisene naye, kodwa ubelokhu ezama izinto ezingabonakali ukuthi zisebenza, noma zikukulimaza kakhulu (udokotela wakho angadinga usizo olutholakala nje ukuthola okutholakele nje kokuthola)
Q: Okokugcina, isipiliyoni sombono wesibili singayithola kanjani imiphumela emihle yeziguli?
Nakhu esikutholile kuyasiza kakhulu.
- Kungcono ukuvumela udokotela wakho oyinhloko wazi ukuthi uzocabangela ukuhambela iziphakamiso zombono wesibili njengesivivinyo "sesikhashana" sento entsha. Uma kungasebenzi, uzokwaneliseka ukuqhubeka usebenza nodokotela wakho kwenye indawo, noma okungenani, ubuyele kulokho okwakwenze ngaphambilini.
- Tshela udokotela wakho oyinhloko ukuthi uzimisele ukuthatha umthwalo ogcwele nganoma yimuphi umphumela omubi ekuzameni isiphakamiso sombono wesibili. Eqinisweni, uzimisele ukusayina isitatimende esinjalo eshadini (Lokhu kukhulula ukucindezelwa okuningi kudokotela, futhi kukubeka esihlalweni sabashayeli).
- Vumela udokotela wakho oyinhloko wazi ukuthi uyaqonda ukuthi ukuphathwa kahle kwe-thyroid yiyona simo esizimele futhi ngesinye isikhathi "sokushaya nokuphuthelwa" isimo, ukuthi uzimisele ngokuzibandakanya ngokuphelele, nokuthi, empeleni, ubheka ukunakekelwa okuhle kwezokwelapha ukuze uhlanganyele ngale ndlela ngoba uhlushwa "ngokungahambi kahle" futhi mhlawumbe ukukhubazeka okungadingekile empilweni yakho (ukuthi ingosi yezokwelapha izothola ukunakwa kukadokotela okungaphezu nje kokuthi "Angithandi ukuzwa ngikhathele.")