Mu 2010, ofufuza a yunivesite ya Texas Southwestern Medical Center adafalitsa nkhani yokhudza chifukwa cha matenda a post-orthostatic tachycardia syndrome (POTS) . Nkhaniyi inachititsa anthu ambiri odwala POTS kukangana ndi kukwiya, chifukwa cha kufotokoza kwa zotsatira zake, komanso chifukwa cha dzina latsopano omwe olembawo analongosola kuti ali ndi vutoli - Grinch Syndrome.
Kufuula, makamaka, kunali kwakukulu kwambiri moti mlembi wamkulu wa phunziro lino, adafufuza kafukufuku wa POTS Dr. Benjamin Levine, adavomereza pempho la wolembayi kuti afotokoze pa nkhaniyi pagulu. Yankho Lake likuwoneka pansipa.
POTS
POTS ndi chikhalidwe chomwe mtima wa munthu ukuwonjezeka kufika pamwamba pamene akuimirira. Kawirikawiri imaphatikizidwa ndi mitu yowala , kupopera , ndipo nthawi zina ndi syncope . POTS, zomwe zingakhale zolepheretsa kwambiri, zili ndi zinthu zambiri zofanana ndi ma dysautonomias osiyanasiyana. Nthawi zambiri amawoneka achinyamata, osakhala ndi thanzi labwino, komanso amayi nthawi zambiri kuposa amuna.
Kafukufuku
Gulu la a Levine linaphunzira anthu 27 akutchulidwa kumadzulo chakumadzulo ndi POTS. Zomwe anapezapo zinali: 1) Palibe nkhani zomwe zinali zosawerengeka m'thupi lawo lokhazikika. 2) Ambiri (pafupifupi 70%) anali ndi mitima yaying'ono ndi voliyumu ya magazi, zofukulidwa zomwe zimagwirizana ndi kufotokoza.
Ndipo 3) Kawirikawiri, maphunziro amavomereza bwino kwambiri pulogalamu yowonjezereka, yogwiritsa ntchito mankhwala.
Olembawo anatsimikizira kuti POTS ndi "pa se" mkhalidwe umene umayambitsidwa ndi malamulo. Chifukwa cha mitima yaing'ono yomwe adaiwona ambiri mwa anthu awo, olembawo akufuna (mwina ali ndi malilime pamasaya) kutchula POTS ku Grinch Syndrome (chifukwa kugwedeza, molingana ndi zenizeni, zimakhala ndi mitima yaying'ono).
Mmene Anthu Odwala POTS Amamvera
Manyuzipepala kuzungulira dzikoli adalumphira pa nkhaniyi pamene adatulutsidwa, akuwongolera mfundo ziwiri: dzina lozizira kwambiri la Grinch Syndrome, ndi lingaliro lakuti POTS imadzipangitsa kudzipangitsa kukhala ndi moyo wamoyo. Kuwonetsa kwapadera kumeneku kwa phunziroli kunayambitsa zochititsa chidwi kuchokera kwa odwala POTS padziko lonse lapansi.
Anthu omwe akugwira ntchito ndi POTS adasankha anthu ambiri kuti azidandaula za phunziroli. Kuphatikiza pa chikhumbo chodziwika chosafuna kutchulidwa ngati zokopa, iwo adanena kuti kuganiza kuti zochitika zonse za POTS kuti zisamangidwe sizolondola koma zikhoza kuvulaza odwala POTS.
N'zosakayikitsa kuti ambiri ngati si anthu onse omwe ali ndi POTS zofunikira kwambiri. Mudzakhalanso wovomerezeka ngati simungathe kuimirira popanda kukhala ndi mutu wopepuka kapena wotuluka. Ndipo phunziroli ndithudi linatsimikizira kuti izi ndizochitika.
Koma mfundo yakuti odwala omwe ali ndi POTS angasonyezedwe kuti kukhala ndi mfundo zovomerezeka sizitsimikiziranso (ndipo kwenikweni, sizitanthauzanso mwamphamvu) kuti kuvomereza ndiko chifukwa cha POTS, osati zotsatira zake.
Anthu amene amapezeka kuti ali ndi POTS amakhala ndi nthawi yovuta kwambiri kuti madokotala ndi mabanja awo atenge zizindikiro zawo mozama.
Nthawi zambiri amatha kuuzidwa ndi madokotala angapo kuti ali ndi nkhawa kapena kuvutika maganizo kapena kutembenuka kwa mtundu wina m'malo moona kuti ndi thupi lenileni. Nthawi zambiri amatha masabata kapena miyezi, ndipo nthawi zina, dokotala asanadziwe kuti ali ndi matenda otani.
Ndipo tsopano, ngakhale atapatsidwa mankhwala oyenera, amayembekezera kuti akuwoneka ngati akubweretsa mkhalidwe wawo, chifukwa cha "deconditioning," omwe nthawi zambiri amalankhula zachipatala chifukwa chokhala osasamala, osasamala, komanso aulesi. Ndipo pamene banja lawo likuuzidwa kuti vutoli ndilolokha, mwa njira ya sloth, ndipo akuuzidwa izi ndi dokotala mochepa, kuchuluka kwa chithandizo cha Odwala POTS amatha kulandira kuchokera kwa okondedwa, panthawi yomwe iwo ali kumenyana kuti apeze bwino ndipo akusowa kwambiri, adzaneneratu.
Kotero misozi ndi kulira kuchokera kwa Odwala POTS pamene nkhaniyi idafalitsidwa ndipafupi kufotokoza.
Dr. Levine Akuyankha
Dr. Levine analimbikitsidwa kuti athane ndi mavuto omwe odwala POTS amavutika nawo ataphunzira. Pochita izi anapanga mfundo zazikulu zitatu.
" 1) Kupititsa patsogolo Zotsatira zafukufuku. Choyamba, ndikuloleni ndikulimbikitseni kuti sindinayambe "kulimbikitsa" ntchito yathu muzinthu zilizonse zofalitsa, ndipo palibe wina aliyense amene ndikuyang'anira. Kunena zoona, sindiri wotchuka kwambiri wolemba nkhani za sayansi, ndipo ngakhale nditayankhula ndi olemba nkhani akamandiitana ngati ndingapereke luso lapadera, sindikufufuza. Monga ndikudziwira kuti mukudziwa, sitili ndi mphamvu pa zomwe olemba nkhani amanena zokhudza ntchito yathu. Omvera athu pa mapepala athu ndi madokotala ena ndi asayansi, omwe ayenera kutanthauzira deta malinga ndi zochitika zawo ndi kuwerenga za mabuku. Ndikuchenjeza odwala onse omwe ayenera kudziwa zambiri kuchokera kwa ailesi kuti asamawerenge zomwe amawerenga m'magazini kapena kuonera pa TV.
2) POTS siyimayendedwe ndi "ulesi." Ambiri mwa odwala omwe ndimawawona anali opambana kwambiri (monga akatswiri athu, omwe tinkawongolera maphunzilo athu a POTS) chisanachitike chinachake - kwa ena ndi kachilombo ka HIV; ena kuvulaza kapena matenda ena; ena ndi mimba kapena mavuto a kubereka mwana. Izi "zochitika" zimapangitsa chinthu chimodzi kuti chichitike - chimapangitsa anthu kugona.
Ndikofunika kutsimikizira kuti ngakhale mphindi zogona za maola makumi asanu ndi awiri (20) zogona zingapangitse kuti pulogalamu ya plasma ikhale yotayika, ntchito yovuta ya baroreflex, komanso umutu wa anthu ambiri. Pambuyo pa milungu iwiri yokha ya bedrest kapena spaceflight, pafupifupi 2/3 anthu sangathe kuyima kwa mphindi 10!
Ndiyeneranso kuzindikira kuti maphunziro oyambirira ochokera pa webusaiti yathu adawonetsa kuti anali masewera othamanga kwambiri omwe anali osowa kwambiri ngakhale nthawi yayitali (masabata atatu) kupuma kwa kama, ndi nthawi yayitali yochira. Ndipotu, odzipereka omwe anali osakwanira asanakagone, anafulumira kuchita maphunziro, makamaka mkati mwa masabata awiri. Komano, odzipereka othamanga kwambiri, atatha milungu itatu ya mpumulo wopuma ndi miyezi iwiri yophunzitsidwa mwamphamvu, sanapulumutsebe ku thupi lawo loyamba. Chodabwitsa, tinaphunzira maphunziro omwewo patatha zaka 30 chiyambireni phunzirolo ndikupeza kuti, zodabwitsa, palibe munthu mmodzi yemwe anali woipitsitsa patapita zaka 30, kuposa momwe analili patatha masabata atatu ogona atagona zaka makumi awiri.
Mwa kuyankhula kwina, masabata atatu ogona anali oipitsitsa kuti thupi likhoza kugwira ntchito zakuthupi kuposa zaka 30 za kukalamba. (onani McGuire et al Circulation 2001).
Mosasamala kanthu zomwe zinayambitsa zochitikazo, komabe nthawi yomwe matenda (kapena chinachitika) atatha, odwala ali ndi chilema chachikulu (wodwala wina mu phunziro lathu sanathe kukhala wokhazikika kwa zaka zoposa 2 ) zomwe zikuwoneka kuti zikukhala bwino ndi dongosolo lathu lodzipatulira, lolunjika, komanso lopititsa patsogolo panthawi yoyamba poyambira mu gawo lachimake. Zomwe zimapangidwirazo ndizofunikira makwinya atsopano omwe tabweretsa patebulo ndikusamalira odwala POTS.
Ambiri a POTS sangathe kulekerera chikhalidwe chowongoka kuti kuyamba kukhala pansi kapena kubwerera kumbuyo ndikofunikira kuti apambane. Ndipo ndizovuta! Odwala ambiri amavutika kuti athe kumaliza masabata angapo oyambirira a pulogalamu ya maphunziro, yomwe njirayo imayambira ndi mphindi 30 patsiku, masiku atatu pa sabata. Koma ngati akukakamiza kuti ayambe kusokonezeka, nthawi zambiri amadziona kuti ndi abwino komanso amphamvu.
Izi zikuwunikira mfundo yovuta - Sitinayambe tamvapo kuti wodwala mmodzi wa POTS anali waulesi kapena wosasamala - ngati zinali zosavuta kuchiza POTS ndi kuchita masewera olimbitsa thupi, aliyense angachite !! Komabe pamene tigwiritsa ntchito pulojekiti yeniyeni yowunikira kwambiri yowunikira mtima, odwala ambiri amamva bwino kwambiri ndipo ambiri "amachiritsidwa", kutanthauza kuti sagwirizana ndi zofunikira za POTS. Ndiyenera kugogomezera ngakhale kuti kukhala ndi thanzi labwino ndilo cholinga cha moyo wathu kwa odwala POTS ndipo timawalimbikitsa kuti azichita masewera olimbitsa thupi ngati mbali ya ukhondo wawo. Kwa odwala omwe adandimva ndikuyankhula, mwina kwa iwo monga odwala, kapena poyera pagulu, amadziwa kuti NDIMAKHULUPIRITSA kuti "mtima wolimba mtima" ndi ndondomeko yeniyeni yofotokozedwa bwino yomwe ilibe kanthu ndi ulesi.
Ndiroleni ine ndikugogomeze mfundo iyi: KUDZIWA KUDAVASCULAR DECONDITIONING SIYENSE YOYAMBA "KUKHALA KUKHALA KWAMBIRI" !!!!! Aliyense amene amatanthauzira deta yathu mwa njirayi akusinthanso zomwe tasanthula ndi mankhwala athu. Ndikumva chisoni kwambiri kwa odwala athu ambiri omwe amavutika kwambiri, ndipo ndakhala ndikukhumudwa chifukwa cha ntchito yanga yambiri ndikuyesetsa kupeza mankhwala omwe amagwira ntchito nthawi zonse.
3) Ponena za "Grinch Syndrome." Potsiriza, ndiroleni ine ndizimaliza ndi mawu pang'ono ponena za Grinch. Odwala ambiri omwe amamva mawu akuti "The Grinch Syndrome" amaseka ndipo amatonthozedwa ndi mzimu umene umaperekedwa. Komabe, ndimamvetsa kuti odwala ena omwe samandidziwa, ndipo akuda nkhawa ndi kutchulidwa ndi dzina lomwe limagwirizanitsidwa ndi kukhala wolimba mtima, sagwiritsa ntchito dzina lakuti Grinch Syndrome, ndipo ndimawalemekeza. Kunena zoona, ngati ndiyenera kuchitanso kachiwiri, mwina ndikanakhala ndikukayikira kugwiritsa ntchito mawuwa, ndipo ndikufuna kuti odwala onse a POTS adziwe kuti sitikutanthauza iwo ayi. Palibe "kutchuka ndi chuma" chokhudzana ndi dzina ili ndipo sindinapeze phindu lenileni pogwiritsa ntchito mawu awa. Komabe, ndawona momwe kulili kolimbikitsira pakusamala zomwe tawona monga chifuwa chachikulu cha matenda okhudzana ndi matenda okhudzidwa ndi odwalawa. Monga momwe ndimawauza odwala anga, mawu akuti "POTS" amangolembapo kuti mtima wa wodwalayo umamenya mwamsanga pamene akuimirira. "Grinch Syndrome" imayang'ana pamtunda, chifukwa CHIYANI chiwerengero cha mtima chili chokwanira - ndiko kuti mtima ndi "makulidwe awiri ochepa kwambiri."
Malinga ndi chiŵerengero chosavuta cha anthu, 2.5% mwa amayi onse padziko lapansi adzakhala ndi mtima umene uli oposa awiri osiyana siyana pansi pa tanthawuzo - tanthawuzo la "zachizolowezi" zamankhwala. Timakhulupirira kuti amayiwa ndi omwe ali pachiopsezo chotenga zizindikiro za POTS zomwe zingapangidwe mofulumira ngakhale ngakhale nthawi yochepa ya kugona.
Potsirizira pake, ndikufuna ndikutsindika kuti kuseka ndi chida champhamvu kuchiza, osati kwa odwala omwe ali ndi POTS, koma pafupifupi matenda alionse. Timapereka ulemu kwa odwala athu onse ndipo timadziwa bwino momwe iwo aliri, zomwe timachita zofunikira kwambiri. Mark Twain kamodzi adanena kuti "Humatu ndi dalitso lalikulu kwambiri la anthu"; Timakhulupilira kuti ndi gawo lofunikira la machiritso ndi chiyembekezo kuti odwala athu akumwetulira pamene akuganiza za The Grinch, ndikupita kukachita masewera olimbitsa thupi!
- Dr. Benjamin D. Levine "
Mawu Ochokera
Dr. Levine ndi wofufuzira wodzipereka ndi wochenjera, ndipo ntchito yake pa POTS yapititsa patsogolo chidziwitso chathu cha matendawa, ndipo chifukwa chake, zikwi za anthu omwe ali ndi vutoli akuthandizidwa.
N'zomvetsa chisoni kuti anthu ambiri - osati m'mabungwe a zamalonda koma m'mabungwe a zachipatala - adatsogoleredwa kutanthauzira momveka bwino phunziro lake ngati kuti POTS ndiyo matenda omwe amadzipangira okha. Kulongosola kwa Dr. Levine pazomweku zikuwonetsa kuti sizinali cholinga chake kuti atsimikize kuti POTS imadzipangira yekha. M'malo mwake, zomwe adapeza zimasonyeza kuti nthawi yochepa yopuma yopuma, mwinamwake mwa anthu otanganidwa kwambiri (makamaka akazi), akhoza kukhala okwanira kuti abweretse vutoli.
Mulimonsemo, anthu omwe ali ndi POTS omwe amafunika kuwalimbikitsa madokotala ndi mabanja awo kuti chikhalidwe chawo sichimene iwo adzibweretsera okha tsopano ali ndi mawu ochokera pakamwa pa kavalo kusonyeza kuti POTS ndi chinthu chomwe chimangochitika kwa anthu.
> Zotsatira:
> Freeman R, Wieling W, Axelrod FB, et al. Chigwirizano Chogwirizana pa Tanthauzo la Orthostatic Hypotension, Systope Yachilengedwe Yachilengedwe ndi Postural Tachycardia Syndrome. Auton Neurosci 2011; 161: 46.
> Fu Q, VanGundy TB, Galbreath M, et al. Chiyambi cha Cardiac Of The Postural Orthostatic Tachycardia Syndrome. JACC 2010; 55: 2858-68.
> Kimpinski K, Figueroa JJ, Singer W, et al. Cholinga Chotsatira Chotsatira cha Postural Tachycardia Syndrome. Mayo Clin Pro 2012; 87: 746.