Akatswiri a Chithokomiro Amagawana Maganizo Awo
Pofunsa mafunso, akatswiri a chithokomiro a Richard Shames, MD, ndi Karilee Halo Shames, RN, PhD, adafufuza chifukwa chake n'kofunikira kupeza lingaliro lachiwiri pa chithandizo cha chithokomiro.
Q: Tikudziwa kuti inu nonse mwakhala mukugwira ntchito ya chithokomiro kwa zaka zoposa 25-panokha komanso mwakhama. Kodi mukuganiza bwanji pa odwala kupeza lingaliro lachiwiri?
Monga akatswiri azaumoyo, tikuthandizira kwambiri kuti tipeze mphamvu ndi kudzikonda.
Kuwonjezera pa mabuku, abwenzi, ndi intaneti, timamva kuti ndikofunikira kuti tikhalebe paubwenzi wabwino ndi dokotala. Dokotala wabwino akhoza kukuthandizani kupeza matenda oyenera komanso kuthandizira kwambiri vuto lanu la chithokomiro, kukupulumutsani zaka za mavuto, zovuta, ndi mavuto.
Koma, kumbukirani kuti madokotala onse ali ndi malire awo. Nthaŵi yawo, chidziwitso, ndi zochitika zachipatala sizatha. Ndizochizoloŵezi chachipatala chodziwika kuti muitanenso mu lingaliro lina pamene pakufunikira. Kawirikawiri ndi dokotala amene amasankha pamene lingaliro lina likufunika payekha. Mu chithokomiro cha chithokomiro, zikuwonjezeka kwambiri kuti wodwala akupanga chisankho ichi. Monga timu ya asing'anga, tikugwirizana kwathunthu ndi chitukuko chatsopano ndi chofunika kwambiri.
Q: Kodi mumamva bwanji kuti wodwala ayambe kuganiza mozama?
Kwa odwala chithokomiro, nthawi zambiri amayamba kumayambiriro kwa matendawa, kapena pakapita kukambirana za mankhwala.
Mwachitsanzo, poyambitsa vuto la chithokomiro, dokotala wodziwa bwino amatenga mbiri yakale, kumvetsera mwatcheru maonekedwe, ndi kuzindikira machitidwe. Kenaka, iye amafufuza bwinobwino ndi kulamula zoyenera kuyesa ma laboratory, kuti adziwe chomwe chikuchititsa zizindikirozo.
Mwa njira iyi, mukhoza kudziwa molondola mankhwala omwe angakuthandizeni kwambiri. Musadzitengere nokha mwachidule. Onetsetsani kuyambira pachiyambi kuti mkhalidwe wanu uli bwino. Ngati dokotala wanu nthawi zonse samayang'ana chithokomiro mofulumira kapena mosamala monga momwe mungafunire, mwa njira iliyonse muyankhule. Izi ndizowona ngati muli ndi matenda a chithokomiro nokha kapena mbiri yanu yachipatala .
Ngati mwapeza zambiri kuchokera kwa anzanu kapena mawebusaiti okhudzana ndi chikhalidwe chanu, zingakhale bwino kulinganirana ndi dokotala wanu kuti mupeze zina. Muzochitika izi, samalirani kuyankha kwa dokotala wanu. Ngati dokotala wanu akungokhala ngati mafunso anu akuvutitsa, kapena simunayankhe mwachindunji, ganizirani ngati mukulandira chithandizo chabwino. Muyenera kuwonjezera chisamaliro cha dokotala uyu ndi lingaliro lina. Ngati dokotala wanu sakudziwa mayankho a mafunso anu, funsani ngati angakupezeni, kapena akutsogolereni kuzinthu zoyenera. Mungafunikire kugula zinthu izi, monga momwe mungagulitsire makaniki abwino, makontrakitala, kapena ntchito ina yomwe mumayamikira.
Q: Ndichifukwa chiyani mukuganiza kuti wodwala chithandizo cha chithokomiro akuyenera kugula pafupi?
Madokotala ambiri oyambirira samawoneka kuti akudziwa kuti chithokomiro chochepa chimafala kwambiri kapena chiwerengero chazochitika pa thanzi la mtunduwo. Monga momwe taonera mu bukhu lathu, kufufuzidwa ndi zipatala za yunivesite, komanso chipatala cha Mayo, zatsimikiza kuti chiwerengero cha chithokomiro chikufalikira kwambiri-chimachititsa kuti anthu ambiri azikhala ndi thanzi la khumi, ndipo zikuwoneka kuti khalani owonjezeka kwambiri. Zatenga nthaŵi yaitali kwa madokotala, omwe makamaka akuyang'aniridwa ndi chisamaliro chachikulu, kuti adziŵe vutoli.
Popeza kuti vutoli silili loopsa kapena likuwopsyeza moyo, sangangoganizira za madokotala otanganidwa.
Komanso, popeza chithokomiro chimayendetsa mbali zambiri za thupi ndi m'maganizo ntchito , mndandanda wautali wa madandaulowo ukhoza kuwoneka wosagwirizana komanso wochuluka kwa wodwala. Wodwala angakhale ndi vuto la khungu, vuto la m'mimba, kutopa, phindu , tsitsi kapena misomali, kukhumudwa, kumverera bwino, nthawi zina komanso kutentha kwa ena.
Pamene akukumana ndi zizindikiro zooneka ngati zapadziko lonse, dokotala nthawi zambiri amakayikira, ndipo, m'malo moganizira kuti chithokomiro chachepa, amakhulupirira kuti wodwalayu angakhale ndi vuto la maganizo monga kupsinjika maganizo. Tsopano siteji imayikidwa kuti apeze matenda ovutika maganizo, kapena chinachake chofanana, ndi mankhwala a Prozac kapena Zoloft. Izi zikusowa chitsimikizo chenicheni cha chithokomiro chochepa, chomwe chikuchititsa zizindikiro zomwe zimaphatikizapo kuvutika maganizo. Ngati mumamva kuti ndinu mmodzi mwa anthu mamiliyoni ambiri omwe ali ndi vuto la chithokomiro osadziwika bwino mwanjira imeneyi, ndiye kuti mungafunikire kugula mozungulira ndikupeza ndemanga yachiwiri yowonjezera.
Q: Bwanji ponena za wodwala yemwe mwinamwake wakhala ndi lingaliro lachiwiri ndi dokotala wotseguka kwambiri, wakhala ndi mayeso ochuluka kwambiri a mayendedwe a chithokomiro, amapezeka (mwina kwa zaka kale), ndipo chithandizo sichingakhalenso bwino iye kapena iye angafune. Nanga bwanji?
Zimadziwika bwino kuti vuto losauka kwambiri kuposa mankhwala okhutira ndilofala kwambiri. Tiyerekeze kuti vuto lanu silili ndi matenda a chithokomiro, komabe ndikutanthauzira kwachidziwitso zizindikiro ndi mayesero omwe angapangitse kuti muyambe bwino kwambiri. Pamene kuyesedwa kwa magazi kumawerengedwa, kusiyana komwe kumatchulidwa ngati kachilombo ka chithokomiro kawirikawiri ndi kwakukulu kwambiri moti zomwe zimaonedwa ngati zogwira mtima zingathe kunyalanyaza zosowa zapadera za munthu mmodzi. Anthu oterewa amatha kumva chisoni kwa zaka zambiri ndi zodandaula zosiyanasiyana, ngakhale ntchito yawo ya labwere itabwerera ku "zachilendo." Mosasamala kanthu za zionetsero za odwala, madokotala ena amaumirira kuti ngati TSH yanu ili bwino, ndiye kuti chithokomiro chanu ndi chabwino. Komabe, matenda a chithokomiro angakhale akuipiraipira pang'ono pang'onopang'ono, ndipo mwina potsiriza amakhala okhumudwa. Ngati muli mu ngalawayi, mungafunike maganizo achiwiri kuchokera kwa dokotala amene amawona ntchito ya labu ngati gawo limodzi la nkhani yonse ya chithokomiro.
Q: Tsoka, owerenga anga ndipo ndapeza kuti madokotala ngati amenewa ndi ochepa komanso ochepa kwambiri.
Izi zikhoza kukhala zoona, koma pali zambiri za ife. Muzochita zathu, timasamalira mwachidwi komanso ndemanga yachiwiri. Mayesero a ma labata ndi chimodzi mwa zinthu zomwe zimapita ku zisankho zathu ndi malingaliro athu. Pali madokotala ena ambiri onga ife. Odwala amafunika kuwatsata.
Mwachitsanzo, taganizirani za "Baibulo," Dokotala wa Desk Reference (PDR). M'magulu onse a mankhwala a chithokomiro, pali kachigawo kakang'ono kotchedwa "mayeso a ma laboratory." Apa madokotala akulangizidwa kuti asadalire payekha kuyesa magazi kwina kuti athetse chithokomiro chochepa. M'malo mwake, akukumbutsidwa kuti agwirizane ndi chidziwitso chochokera ku ma laboratory ndi chidziwitso chabwino cha zachipatala. Komabe, ndi chisamaliro chosamaliridwa cholamula malamulo, madokotala ambiri amanyalanyaza malangizo awa. Madokotala ochepa, komabe, akutsatira ndondomeko yoyenerayi; odwala amangofuna kupeza madokotala awa. Ndiye odwala angapeze lingaliro lachiwiri kuti mwachiyembekezo adzalimbikitsa dokotala wawo wamkulu kuti azikhala omasuka kwambiri pa zokambirana za mankhwala. Zingakhale kuti kuwonjezeka kosavuta kwa mlingo wa mankhwala kapena kusintha kosavuta pa mankhwala a mankhwala kudzakhala kusintha kwakukulu. Mwinamwake lingaliro lachiwiri lidzanena kuti kuphatikiza mankhwala awiri a chithokomiro, omwe nthawizina amaposa mankhwala amodzi okha. Dokotala wamkulu wotseguka ndiye angagwiritse ntchito malingaliro achiwiri pazoyesa ndikuwona momwe zimagwirira ntchito.
Q: Odwala ambiri sakuwona mtundu wa madokotala omwe mukuwafotokoza. Nchifukwa chiyani mukuganiza kuti palibe madokotala ena omwe amachitanso chimodzimodzi kwa inu?
Titha kumvetsa mosavuta chifukwa chomwe ambiri operekera sakufuna kuchita motere. Ndi nthawi yochuluka kwambiri, yomwe imafuna kuwonjezerapo mlingo wa kuleza mtima kuti muyang'ane kupita patsogolo kwa wodwalayo.
Cholingacho chimafuna kuti wothandizira aziyenda mozungulira ndi wodwala, kuphunzitsa ndi kumuthandiza munthu amene ali pakati pa nthawi (nthawizina) yowonjezereka. Chilengedwe chosamalidwa sichilola antchito kuti asamalire mosamala, kuti apeze mlingo woyenera, mankhwala abwino, kwa munthu aliyense.
Komanso, odwala nthawi zambiri samadwala kwambiri. Mkhalidwe wawo ndi wautali, wodwala umene ukuyenda pang'onopang'ono. Anthu ena ogwira ntchito zaumoyo alibe chidwi chachikulu pa vutoli.
Ndizowopsa kuti dokotala atuluke mumtundu woyenerera, kuti ayese mosiyana. Kumbukirani kuti madokotala amayang'aniridwa ndipo akuyenera kuchita mogwirizana ndi chikhalidwe china. Izi zikutanthauza kuti ngati akuluakulu asanu ndi awiri mumzinda uliwonse sapereka chithokomiro chokha, ndipo GP nthawi yachisanu ndi chitatu imagwiritsa ntchito zowonongeka ndipo nthawi zina imagwiritsa ntchito chithokomiro chachilengedwe, kuti dotolo wachisanu ndi chitatu saganiziridwa kuti amachita mogwirizana ndi miyezo ya anthu ammudzi.
Mavuto enieni alamulo ndi osawerengeka, komabe amakhumudwitsa madokotala ambiri kuzinthu zatsopano.
Q: Ndikhoza kumvetsa zonsezi. Zimene ine ndi owerenga anga ambiri timakumana nazo ndi pamene dokotala akuwoneka wodzikuza kapena wovuta.
O, ndilo nkhani yaikulu kwambiri. Chithandizo chamankhwala nthawi zambiri chimakhala chokwanira kwa nthawi yowunikira-kusintha kwa maubwenzi odwala.
Icho chiyenera kukhala ndi mgwirizano wofanana komanso wogwirizana pokhapokha pophunzira ndi kuchiritsa. Madokotala ambiri amaphunzitsidwa kuganiza kuti khalidwe lodziwika bwino limalimbikitsa kwambiri wodwalayo. Nthawi zina izi ndi zoona, mwinamwake makamaka ndi odwala achikulire, amene aphunzitsidwa kuti adziwe kuti dokotala ndi wosalephera. Ife timakhulupirira, mmalo mwake, kuti ntchito yathu ndi yophunzitsa ndi kulimbikitsa, osati kulamula. Dokotala ayenera kukhala omasuka, okonzeka kuyesa mankhwala osiyanasiyana, komanso kuthandiza odwala kusankha chomwe chikuwathandiza kwambiri.
Timaona kuti gawo lathu la udindo monga wothandizira ndikupatsa mphamvu ndi kulemekeza anthu omwe amafuna nzeru, nzeru, ndi chithandizo chathu poteteza thanzi lawo. Zili bwino kuti zikhulupiriro za odwala zimathandiza kwambiri kuchiritsa. Zimatchulidwanso bwino kuti wodwala ali ndi mphamvu kwambiri kuposa amene amangofuna kutsatira malamulo.
Ngati wodwala atakhala ndi vuto linalake ndi mankhwala ena, timalemekeza nkhawa zawo. Timalimbikitsa ogwira ntchito zaumoyo kuti atsimikizire kufotokoza maganizo ndi zikhulupiliro za mankhwala. Ngati wothandizira zaumoyo wanu sakufuna kumva zomwe mumamva kapena zikhulupiliro zanu, ndiye kuti mungafune kuti mutenge maganizo ena.
Q: Kodi mungathe kuwerenga zonsezi kuti mukhale mndandanda wa ovomerezeka kwa odwala?
Mwamtheradi. Apa ndi pamene wodwala wa chithokomiro ayenera kuyamba kuganiza za kupeza lingaliro lachiwiri:
- ngati dokotala wanu sakufotokozera zotsatira za lab yanu kapena kupereka nambala enieni (izi ndizoona ngati mupempha zotsatira ndipo simungazipeze)
- ngati dokotala wanu kapena woimira ofesi sakubwezerani foni yanu
- ngati dokotala wanu akunena kuti zonsezi ziyenera kukhala pamutu mwanu, kapena zokhudzana ndi nkhawa kapena PMS- kapena zokhudzana ndi kusamba kwa mimba (Zoonadi zonsezi zokhudzana, koma nthawi zambiri chithokomiro chiyenera kuonedwa ngati choyambitsa)
- pamene adokotala akunena chizindikiro china chimene mwawona pa webusaitiyi "sichikhoza kukhala chifukwa cha chithokomiro chochepa" (mbendera yofiira)
- pamene mwakhala mukuchiritsidwa kwa zaka zambiri ndipo simukumva nokha, koma dokotala sakufuna kusintha chilichonse
- Ngati muli ndi mwayi wokhala ndi dokotala wothandizira, koma wakhala akuyesera zinthu zomwe zikuwoneka kuti sizikugwira ntchito, kapena zikukuipitsani (Dokotala wanu angafunikire chithandizo kuti muthe kupeza zomwe mukupezazo zikukuchitikirani)
Q: Pambuyo pake, chidziwitso chachiwiri chingakwaniritse bwanji zotsatira kwa odwala?
Nazi zomwe tazipeza zothandiza kwambiri.
- Ndi bwino kuti dokotala wanu wamkulu adziwe kuti mungaganize kuti mukutsatira malingaliro achiwiri monga kuyesera kwachinthu china chatsopano. Ngati sikugwira ntchito, mudzakhala okhutira kuti mupitirize kugwira ntchito ndi dokotala mwinamwake kumalo ena, kapena osachepera, kubwereranso ku zomwe munkachita poyamba.
- Awuzeni dokotala wanu wamkulu kuti muli wokonzeka kutenga udindo wonse pazomwe mukukumana nazo poyesera lingaliro lachiwiri. Ndipotu, ndinu wokonzeka kulemba mawu otere pa chithunzi (Izi zimatsitsimutsa kwambiri chithandizo kwa dokotala, ndipo zimakuika mu mpando wa oyendetsa).
- Dokotala wanu wamkulu adziwe kuti mukumvetsa kuti chithokomiro chabwino kwambiri cha chithokomiro ndi chodziwika bwino komanso nthawi zina "chogwera ndi chosowa", kuti muli okonzeka kuchitapo kanthu, ndikuti, mukuwona kuti ndibwino kuti chithandizo chamankhwala chikhale chonchi chifukwa mukuvutika ndi "zosasokonezeka" ndipo mwinamwake zosafunikira m'moyo wanu (kuti chithandizo chachipatala chidzamvetsetsa dokotala wanu koposa kungonena kuti "Sindimakonda kutopa.")