Ukuzivocavoca, ukuzwelana, nokuguquka okungokomoya Ekupheleni kokuPhila
Kunzima ukubuza ukuthi yini ongayilindela ekupheleni kokuphila nomdlavuza wamaphaphu. Kodwa abantu abaningi bafisa ngomqondo othile walokho okumele balindelwe kulesi sigaba sokugcina sothandekayo wethu noma thina.
Yeka indlela umuntu ahlangabezana ngayo nokuphela kokuphila kuyohluka, njengoba nje abantu behluke ngokuphelele. Abanye abantu bazoba nobuhlungu kodwa abanye ngeke babe nanoma iyiphi. Abanye abantu bayodinga oksijeni ukulawula ukuphefumula; abanye bangaphefumula kahle emoyeni wendawo.
Abanye abantu behla ngokushesha kakhulu ekupheleni kohambo lwabo nomdlavuza, kanti abanye babonakala bephila ngaphandle kwazo zonke izinkinga.
Njengoba nje izimpawu zomzimba ezigabeni zokugcina zomdlavuza wamaphaphu ziyahlukahluka kubantu abahlukene, ukusabela komzwelo wethu kunzima ukubikezela. Abanye abantu baqhubeka, befuna "ukulwa" nomdlavuza wabo ekupheleni. Abanye babonakala bamukela ukufa kalula. Kodwa naphezu kokungafani kwethu, kukhona izinguquko ezivamile ezenzeka kubantu abaningi. Yini engenzeka ekupheleni kokuphila?
Ukuphela Kwezinguquko Zokuphila
Futhi, kubalulekile ukuqaphela ukuthi wonke umuntu uhlukile. Lokho kusho ukuthi ukubuka emva kwemindeni eminingi kungatshela ukuthi izinto "zaqala ukushintsha." Kukhona kokubili izinguquko ezingokomzwelo nezinguquko zomzimba ezikhona yonke indawo, kungakhathaliseki ukuthi umuntu ufa ngamuphi isimo.
Ngomdlavuza wamaphaphu, kuvame ukuvela okwenzekayo okwezinye izindlela okwethula ukuphela. Eminye yalezi zimo ezikhomba ukuthi ukuphela kusondela kufaka hlangana ukukhwabanisa kwesibindi okudinga ukwedluliswa ngokuphindaphindiwe noma ukufakwa kwe-shunt, ubuhlungu obukhulayo kuze kube lapho ukuphaphazeka kuphazamisa, ubuthakathaka obukhulu, nokulahlekelwa okuphelele kokudla.
Ake sibheke ezinye izinguquko ezithile ongayibona.
Izinguquko Zomzwelo
Kusukela ezinyangeni ezimbalwa zokugcina ngaphambi kokufa, othandekayo wakho angase aqale ukuhoxisa futhi abonakale enesithakazelo esincane ekuvakasheni nomndeni nabangane. Imisebenzi eyake yamujabulisa ingase ingasithandi.
Angase abonakale elahlekile ekucatshangweni, futhi njengowesifazane oyedwa owakhuluma ngomyeni wakhe eziteshini ezisheshayo zomdlavuza wamaphaphu, kubonakala sengathi "unyawo olulodwa ezweni elizayo." Angase aqale ukulala okuningi futhi athukuthele lapho ukukhathala nokuncipha kungaphazamisa ngekhono lakhe lokuzinakekela yena njengoba enza esikhathini esidlule.
Ukuba nesimiso sokusekela nokuzinakekela kwakho kubaluleke kakhulu kulesi sigaba sohambo, kokubili ngenhlalakahle yakho futhi ukuze ukwazi ukusekela othandekayo wakho ngomdlavuza kanye nokusemandleni akho.
Izinguquko ezingokomoya
Kuvame kakhulu ukuphela kokuphila kwabantu ukuthi bakhulume ngokubona labo abafile ngaphambili noma babone izulu. Lokhu kwenzeka kaningi, kungakhathaliseki ukuthi umuntu uyenkolo noma cha. Ngezinye izikhathi amalunga omndeni angahle enze iphutha lezi "zenzakalo" njengokungabikho kokuphumula nokungapheli , okungabacasula kakhulu labo abafa. Okufanayo kungenzeka uma umuntu obhubha ebonakala ekwazi ukuthi ukufa kuseduze . Kubalulekile ukukhuluma ngomusa othandekayo wakho oshonile, esikhundleni sokuthi "ukulungisa" imibono yakhe, unikeze induduzo yokuthi akayena yedwa ekuphileni okwamanje ohlala lapha. Ngempela, asazi ngempela ukuthi umuntu oshona angahle noma angaboni noma angaqondi. Uma abathandekayo bezama ukulungisa umuntu ofayo, noma ubatshele ukuthi "bahlolisisa," bavame ukuphazamiseka kakhulu. Kungcono ukumane ulalele futhi uvumele othandekayo wakho abelane ngemibono efana nalezi, noma ngabe ayaphazamisa wena.
Izinguquko zomzimba
Izinguquko zomzimba phakathi kwezigaba zokugcina zomdlavuza wamaphaphu zingahlobene nesisu emaphashini, ukusakazwa komdlavuza kwezinye izingxenye zomzimba, noma ngenxa yezigaba zokugcina zomdlavuza ngokujwayelekile.
Ngencazelo, isigaba sokugcina somdlavuza wamaphaphu sisho ukuthi ukhetho lwezokwelapha luphelile; ukwelashwa akunakwenzeka. Kodwa izindlela zokwelashwa , izindlela zokwelapha ezisetshenziselwa ukunciphisa izimpawu noma ukuthuthukisa induduzo, zisengasetshenziswa. Uma ubhaliswe esibhedlela, unganikwa isikhungo sokududuza esibhedlela esinezinto ezingasiza ngempawu eziningi ekupheleni kokuphila. Ezinye izinguquko zomzimba ezivamile zihlanganisa:
- Ukwakhiwa kwamagciwane okuzungeze amaphaphu: I- flux equkethe amangqamuzana omdlavuza (i- effusion ye-pleural malicious ) ingakhiwa esikhaleni esungeze amaphaphu, okubangelwa ukuphefumula. Ukuze uthuthukise ukuphefumula futhi wenze umuntu akhululeke, odokotela bavame ukukhipha lokhu okuketshezi. Uma uketshezi luqhubeka nokwakha, inqubo okuthiwa i- pleurodesis ingase iphakanyiswe ukuze kuvimbele uketshezi ukuthi ungagcini futhi, noma ukufakwa kwe-shunt kungenziwa ukuze wena noma othandekayo ukwazi ukukhipha umthamo ekhaya. Ukuba ne-shunt okudingeka ukhiphe kungase kuzwakale kusabisa, kodwa le nqubo isetshenziselwa kaningi kulabo abanomdlavuza wamaphaphu futhi bangenza okuningi ukunciphisa ukuphefumula kokuphefumula ngenxa yokuphindaphindiwe koketshezi oluseduze kwamaphaphu eduze nokuphela kokuphila. Khumbula ukuthi umthamo akudingeki ukhiphe ngaphandle uma ubangela ukuphefumula.
- Ukuvimbela noma ukuphuma e-airways emikhulu: Ngomdlavuza wamaphaphu okhula eduze nemimoya yomoya, ukusabalala kwesisu ku-airway kungabangela ukuvinjelwa nokuphuma kwegazi. Odokotela bangase batusa inqubo noma imisebe ukuze kuncishiswe ukuvimbela noma ukulawula ukuphuma kwegazi.
- Izimpawu ngenxa ye-metastases yobuchopho: Uma umdlavuza wamaphaphu usakazeka ebuchosheni , abantu bangase babhekane nezinsizwa, ukugunjwa, nezinye izimpawu zezinzwa ezinjengobunzima bokukhuluma nobuthakathaka noma izinkulumo. Ukwelashwa kwezidakamizwa kungase kunconywe ukunciphisa ukukhula kwalezi zicubu futhi kunciphise izimpawu. Ngezinye izikhathi izifo eziphuthumayo ekupheleni kokuphila zingadinga imithi ukunciphisa inani lokutholwa.
- Ukukhwehlela okungeke kuvuleke: Ngezinye izikhathi ukukhwehlela kungakwazi ukuyeka, ngenxa yokukhula kwesimila emoyeni noma ngenxa yemfihlo engakwazi ukukhukhulwa. Kunezinto eziningi ezingenziwa ukuze ulawule ukukhwehlela futhi wenze umthandi wakho abe mnandi kakhulu.
- Ukuphefumula : Abantu abaningi besazi ukuthi ukuphefumula okukhulayo okwenyukayo futhi besaba ukuthi bazozizwa benjengezinkinga. Ngokujabulisayo, okwamanje lokhu akuvamile. I-oksijeni ingaba usizo kakhulu, kepha imithi ngokuvamile iyisisekelo esincane. Imithi efana ne-morphine ingasusa isignali ebuchosheni ekutshela ukuthi awuphefumuli, ngakho-ke ngisho noma amazinga akho e-oksijeni awela, ngeke ukwazi ukuphefumula.
- Izimpawu zomdlavuza wokuphela: Ukukhathala okujulile kuvame kakhulu ezinkathini ezisheshayo zomdlavuza wamaphaphu. Ukulahleka kwesisindo kufinyeleleke nasemhlabeni wonke, futhi kwenzeka ngisho nalapho abantu bedla ukudla nokudla okwanele. I-cachexia ye-Cancer , i-syndrome kuhlanganise nokulahlekelwa kwesisindo esingenasisekelo nokubhujiswa kwemisipha, kuvame kakhulu ezinyathelweni zamuva zomdlavuza.
- Ubuhlungu: Abantu abaningi bakhathazekile mayelana nezinguquko zomzimba ekupheleni kokuphila, bebuza umbuzo othi, " Ingabe ukufa kuyabuhlungu ?" Akukhona neze ubuhlungu ekupheleni kokuphila, futhi lokhu kuhluka kakhulu phakathi kwabantu abahlukene. Lapho umdlavuza wamaphaphu usakazeka emathanjeni esifubeni nomgogodla, kunezinketho eziningi zokulawula ubuhlungu , kuhlanganise nokwelashwa kwama-radiation kanye nemithi yokwelashwa. Qiniseka ukuthi othandekayo wakho uyaqonda ukuthi ukusebenzisa imithi yobuhlungu manje ngeke kusho ukuthi akukho lutho olutholakala uma ubuhlungu bakhe buba bubi kakhulu, ukukhathazeka okuvamile. Kunezindlela eziningi ezihlukene zokulawula ubuhlungu, futhi othandekayo wakho ngeke aphelelwe izinketho uma efuna ukuba ubuhlungu bakhe buphathwe namuhla.
Izinsuku Zokugcina
Phakathi nezinsuku zokugcina, othandekayo wakho angase aqale isigaba esaziwa ngokuthi "ukufa okusebenzayo." Kunokuba umcimbi lapho umzimba uphela khona, abacwaningi manje bakholelwa ukuthi ukufa kuyinkqubo esebenzayo umzimba eklanyelwe ukuba uqhubeke.
Ngokwemvelo, njengoba ukufa kusondela, isikhumba somthandi wakho singase siphumelele njengoba izinga lokushisa lomzimba liyehla, futhi ungase uqaphele ukushisa esikhumbeni sakhe (ama-bluish, ama-blotchy patches). Ukuphefumula kungakhuphuka, futhi nakuba kupholile, isikhumba sakhe singase sibe nomuzwa omanzi kanye ne-clammy. Ngokuvamile uzoyeka ukudla nokuphuza, kodwa lokhu kuyindlela evamile ekupheleni kokuphila. Ngeke azizwe elomile noma elambile.
Njengoba ukufa kusondela, ukuphefumula kwakhe kungase kungene ngokungavamile. Ngokushesha, ukuphefumula okujulile kungase kuhambisane nezikhathi zokuphefumula kakhulu (ukuphefumula kwe- Cheyne-stokes ). Umsindo wokugcoba ( ukubulawa kwesifo ) kungase kwenzeke ngenxa yokwakha imfihlo emhlane. Lokhu kungabangela ukucindezeleka kakhulu kumalungu omndeni, kodwa ngokusobala akungakhathazeki ngomuntu oshona.
Ngomzwelo, othandekayo wakho angathuthumela, ekhetha amashidi noma izingubo. Ukudideka nokucabangela kuvamile, futhi labo ababulawa ngokuvame ukuvame ukukhuluma ngabathandekayo abaye bahamba ngaphambili. Ezinsukwini ezimbalwa zokugcina, angase abe nokuqina kwamandla, ehlezi phezulu uma elele embhedeni, noma edla ukudla okuphelele ngemva kokudla izinsuku ezimbalwa.
Lokhu kungaba ukunambitheka inhliziyo uma amalungu omndeni angachazi kahle lokhu njengesibonakaliso sokuthi othandekayo wabo uphumelela. Kungenzeka ukuthi yindlela yomzimba yokuvumela umuntu oshonile ithuba lokugcina lokusho. Njengoba inqubo yokufa iqhubeka, uzoyeka ukuxhumana nokufaka ubuthongo obunzima. Ngisho noma engabonakali ukukuzwa noma wazi ukuthi ukhona, qhubeka uveza uthando lwakho. Kuzwakala ukuthi ukuzwa kungenye yezinzwa zokugcina ukuhamba enkambeni yokufa.
Ukufa
Abanye abantu bafisa ukwazi okwengeziwe mayelana nendlela eyenza ukufa kuvele kubantu abanomdlavuza wamaphaphu. Abanye abafisi ukwazi lemininingwane. Uma ungathanda ukwazi ukuthi lokhu kungenzeka kanjani futhi ukhululekile ukufunda ngezinqubo zomzimba ezingase zihileleke, ungabheka ulwazi olulandelayo ukuthi abantu bafa kanjani ngomdlavuza wamaphaphu ? Kodwa ukwazi le mininingwane akudingekile ukunikeza othandekayo wakho ukunakekelwa okungcono kunokwenzeka.
Njengoba ukufa kuqhubeka, othandekayo wakho uzoyeka ukuphefumula futhi inhliziyo yakhe izoyeka ukushaya. Abanye abantu bathi bayazi ukuthi umthandi wabo washiya nini; baye babe nombono noma ukuzwa kwenyama yomthandekayo wabo oshiya. Abanye bathola induduzo ngokuhlala emzimbeni womuntu othandekayo njengoba kuba sepholile, okuthola kulula ukuyeka emuva kwalokho.
Uma othandekayo wakho efa ekhaya, hlola umhlengikazi wakho noma udokotela ngaphambi kwesikhathi ukuze wazi ukuthi iyiphi inqubo okufanele ulandele ngemva kokufa. Ezimweni eziningi, amalungu omndeni avunyelwe ukuchitha isikhathi sokulila nokusho ukuthi umngane wabo othandekayo uhlezi ngaphambi kokuba umngcwabo ubizwe.
Kwabathandekayo
Ukunakekela okuthandayo okufayo, ngesikhathi esifanayo, kube yinto enzima kunazo zonke futhi enenzuzo kakhulu owake wakwenza. Kungenzeka uzizwe ugovu ngezinye izikhathi, kodwa qinisekisa ukuthi uzotlhogomela ngalesi sikhathi. Khumbula ukuthi ukudabuka kuvame ukuqala ngaphambi kokufa komuntu othandekayo- into ethiwa ukukhathazeka- futhi kungenzeka ube nesizungu njengoba abanye abazungezile bengase bangaboni le nsizi yokuqala.
Uma othandekayo wakho edlulayo, ungase uzithole usesimweni sokuthuthumela. Yini ezayo ngokulandelayo? Uma uxhumekile ku-hospice ithimba lakho lokubeletha lingakusiza ngezinyathelo ezilandelayo, noma ulandele lolu hlu lokuhlola ukuze uthole imithwalo yemfanelo yabasindile ngemuva kokufa .
Ngisho noma uke wabhekana nosizi olulindelekile, uzobe usizi lapho udlula othandekayo wakho. Wonke umuntu uyabuhlungu ngokuhlukile, futhi lokhu kubalulekile ukukhumbula. Awukwazi ukuphuthuma usizi. Thatha isikhathi odinga ukusho ukuthi uzuze kule ngxenye yokuphila kwakho ngaphambi kokuthuthela kokulandelayo. Uma uqhubeka nobunzima ngemva kokulahlekelwa othandekayo wakho, funa umeluleki omuhle wezinsizi. Njengoba nje wawukhona ngenxa yomthandi wakho ngesikhathi sokufa, labo abahlala njalo badinga ukwesekwa nokududuzeka njengoba bebhekana nokuphila ngaphandle komthande wabo.
> Imithombo:
> Society of American of Clinical Oncology. Ukunakekela Ekupheleni Kokuphila. http://www.cancer.net/navigating-cancer-care/advanced-cancer/care-through-final-days.
> Lim, R., End-of-Life Care Iziguli ezine-Cancer Advanced Lung Cancer. Ukuthuthukiswa Kwezokwelapha Emzimbeni Wokuphefumula. 2016.