Pambuyo polemba, " POTS - Who's The Real Grinch ," Ndinafikiridwa ndi Dr. Benjamin Levine, yemwe ndinamuyesa maphunziro ake pamsonkhanowu. Dr. Levine anapanga mfundo zabwino kwambiri, choncho ndinapempha kuti ndifalitse yankho lake kuchokera kwa iye ngati anali ndi chidwi chogonjera. Nachi. (Ndasintha yankho lake chifukwa chafupipafupi ndikuwonjezera ndemanga zanga pamapeto.)
Wokondedwa Dr. Fogoros,
Tikukuthokozani chifukwa cha zolemba zanu za kafukufuku wokhudza odwala omwe ali ndi POTS - Ndikuyamikira mwayi wopereka ndondomeko zochepa zokhudza phunziro lomwe mwaligwiritsa ntchito komanso zomwe zinafotokozera zotsatira zafukufukuyu.
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. [Pano Dr. Levine anaphatikizapo vignette kufotokoza momwe ma TV amalepheretsa kafukufuku maphunziro a sayansi, vuto lalikulu limene ndakhala ndikukumana nazo. RF] Omvera athu pa mapepala athu ndi madokotala ena ndi asayansi, omwe ayenera kutanthauzira deta chifukwa cha zochitika zawo ndi kuwerenga za mabuku.
Ndikuchenjezani inu, ndi odwala onse omwe ayenera kupeza zambiri zawo kuchokera kwa wailesi kuti asapitirize-kutanthauzira zomwe amawerenga muzofalitsa kapena kuziwona pa TV ...
2) POTS siyimayendedwe ndi "ulesi." Nkhani yomwe inanenedwa ndi anthu ambiri omwe anafunsidwa m'nkhani yanu ndi yofanana ndi odwala athu a POTS. 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. Zizindikirozi zimamasulidwa mwamsanga ndi kugona pansi ndipo zimapangitsa kuti munthu asamangokhalira kusamvana, hypovolemia (imfa ya plasma kuchokera m'magazi), mtima wa atrophy (pafupifupi 1% kupweteka kwa mtima pamlungu pa bedi) kupititsa patsogolo kugona kwa bedi pamapeto pake kulephera. 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.
M'mawu ena, masabata atatu ogona anali ovuta kwambiri kuti thupi likhoza kugwira ntchito yapamwamba kuposa zaka 30 za ukalamba! (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 pamakambirano, amadziwa kuti NDIMAKHULUPIRIRA kwambiri kuti "mtima wolimba mtima" ndi ndondomeko yeniyeni komanso yofotokozedwa bwino yomwe ilibe ulesi.
Chonde dziwani kuti odwala omwe ali ndi POTS sakhala ndi zolephera. Izi sizikutanthauza kuti dongosolo lodzidzimitsa lachitsale silinayambe lagonjetsedwa panthawi ina pokhapokha pakuchitika patsogolo kwa POTS. Komabe, pazigawo zosalephereka, mankhwalawa amachitidwa ndi thupi la maganizo a mtima - ndipo umboni ndi wakuti tikamatsutsana ndi matendawa, poonjezera kuchuluka kwa magazi omwe mtima uli nawo ndipo akhoza kupopera ndi kumenya mtima, kuti HR apite, Ntchito yachifundo imakhala pansi, ndipo odwala amamva bwino.
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) Posankha odwala pa maphunziro a kafukufuku pa POTS. Pa maphunziro athu, tinagwiritsa ntchito matanthauzo a zikhalidwe malinga ndi ndondomeko zotsogoleredwa ndi mabungwe a dziko lonse ndi mayiko omwe akukhudzidwa ndi zovuta zawo. [Pano Dr. Levine akufotokozera mwatsatanetsatane zochitika zosiyanasiyana zachipatala zogwirizana ndi POTS, komanso zovuta zapadera omwe ofufuza onse amakumana nawo pakudziwa zofunikira za maphunziro a zachipatala pa POTS. Ndili ndi mavuto mu malingaliro, ndikukhulupirira kuti adatsatira "zabwino" polemba odwala pa mayesero awo. RF]
Ndikudziwa kuti izi sizikhoza kukhutiritsa odwala omwe ali ndi zifukwa izi, koma zikuwonetsa zenizeni za kafukufuku wamakono. Monga momwe mungaganizire, zovuta zowonjezereka zowonjezereka, ndizowonjezereka kuti ofufuzirawo azidzasokoneza malingaliro awo, ngakhale kuti zochepa zowonjezera zingatheke. Monga momwe inu ndi owerenga anu mukudziwira, panopa tikuchita zolembera zazikulu kwambiri m'deralo, kumene> odwala 200 adzaphunziridwa ndi zochepetsedwa zambiri zolembera. Tikukhulupirira kuti phunziroli lidzayankha mafunso omwe ife ndi anthu ena tiri nawo pankhani yotsutsa.
Muzofukufuku wathu, tinalembetsa mndandanda wotsatira wa odwala omwe amatchulidwa ku chipatala changa chapamwamba ndikudziwika ndi POTS. Mwachizoloŵezi, tinapatula odwala ochepa kwambiri omwe ali ndi vuto lalikulu, makamaka chifukwa chakuti munapereka ndemanga yanu, ambiri mwa odwalawa adamuwona madokotala ambiri asanandiyitane, mofanana ndi anthu odwala pa chipatala cha Mayo kapena Vanderbilt. Kuyambira kukambirana za odwala athu ndi a akatswiri ena (ndipo nthawi zambiri timawawona odwala ena), ndikukhulupirira kuti chiwerengero chathu chikuimira odwala ambiri a POTS odwala.
4) 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!
- Benjamin D. Levine, MD
Maganizo Otseka
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. Kuonjezera apo, ndikuwongolera pazinthu zina zomwe zakhala zikuwonekera pambuyo kwanga, anthu odwala POTS omwe ali m'manja mwake amalingalira kwambiri za iye, ndipo amamutamanda chifukwa cha ulemu, nkhawa, ndi kudzipatulira kwawawonetsera iwo.
Ndikuganizabe kuti ndi zophweka kwa munthu wosadziŵa pa POTS (monga ine) kutanthauzira phunzirolo motere ndikuwonetsa kuti POTS ndiyo matenda omwe amadzipangira okha, ndikuweruza kuchokera pa ndemanga zomwe positi zandilandila, zofala kwambiri pakati pa madokotala. Kulongosola kwa a Levine pazomwezi (pamwambapa) zikuwonekera momveka bwino kuti sichinali cholinga chake kuti atsimikizire kuti POTS imadzipangira yekha. M'malo mwake, zomwe anapeza zikusonyeza kuti nthawi yayitali yokhala pabedi, makamaka mwa anthu omwe ali otanganidwa (makamaka akazi), akhoza kukhala okwanira kuti abweretse vutoli.
Mulimonsemo, anthu omwe ali ndi POTS omwe amafunika kutsimikizira madokotala awo ndi achibale awo kuti chikhalidwe chawo sichimene iwo adzibweretsera okha, tsopano sichiyenera kudalira chikalata cholembedwa ndi ine kuti ndichite chomwecho (ambiri mwa iwo adasonyeza kuti ndemanga zawo). Iwo tsopano ali ndi zolembera za zotsatirazo zolembedwa ndi Dr. Levine mwiniwake.
Ndikufuna kuthokoza Dr. Levine chifukwa cha zomwe amakhulupirira pa nkhaniyi, komanso chifukwa cha khama lomwe adachita poyeretsa.
Werengani za matenda a tachycardia (post-orthostatic tachycardia syndrome) (POTS) .