Iyini i-Aneurysm? Izimpawu, Izimbangela, Nokwelapha

I-aneurysm iyindawo ebuthakathaka odongeni lwezinsimbi zegazi eliqhuma ngaphandle, njengobhaluni. Lokhu kuqhuma kwenzeka lapho udonga lwesibindi liba lukhulu noma lilimale, kubangele ukuba likhule ngaphansi kokucindezela kwegazi elikhulayo.

Nakuba igama elithi "aneurysm" lingase lizwakale liyesabekayo, abantu abaningi bahlala ne-aneurysms encane ngaphandle kokwazi. I-aneurysms eningi ikhula kancane eminyakeni eminingi futhi ayibangeli izinkinga. Noma kunjalo, ukuqonda ukuthi yini kanye nokuthi nini kufanele ufunesekare kungakusiza wenze izinqumo ezicacile mayelana nempilo yakho.

Ziyini izimpawu ze-aneurysm?

I-aneurysms eningi ayibangeli zimpawu nhlobo, ikakhulukazi lapho incinyane. Ungaba nayo njengamanje uzizwe uphilile ngokuphelele. Lokhu kuyinto evamile futhi ngokuvamile akubiyingozi.

Lapho izimpawu zivele, ziyahluka kuye ngokuthi i-aneurysm ilapho, nokuthi ikhule kangakanani. Ake sibheke izimpawu ezivamile umzimba wakho ongazikunikeza:

• Ubuhlungu obukhulu, obukhulu kakhulu (ngokuvamile kubizwa ngokuthi "ubuhlungu obukhulu kakhulu ekuphileni kwakho")
• Ukuqina noma ubuhlungu emadolweni
• Ukuphefumula nokugabha
• Ukukhanya okukhulu
• Ukubona okungacaci noma okubili
• I-eyelidi eyihluphekayo
• Ukuphazamiseka noma ukukhuluma okunzima
• Ubuthakathaka ohlangothini olulodwa lomzimba

Nge-aneurysms esiswini sakho, ungase ubone ukuzwa okuqhuma eduze nombhobho wakho wesisu, ubuhlungu emuva, noma ubuhlungu obukhulu esiswini sakho noma eceleni. Lezi zimpawu yindlela yomzimba wakho yokukutshela ukuthi kukhona okudinga ukunakekelwa.

Kubalulekile ukukhumbula ukuthi ukuba nalezi zimpawu akusho ukuthi uqinisile une-aneurysm. Izimo eziningi zingabangela izimpawu ezifanayo, kungakho ukuhlolwa kwemithi kubaluleke kakhulu.

Ziyini izinhlobo ze-aneurysms?

I-aneurysms ikakhulukazi ihlukaniswe ngokuthi ilapho emzimbeni wakho. Izinhlobo ezimbili ezivamile zithinta izindawo ezahlukene futhi zinamakhono ahlukene.

I-aneurysms yobuchopho, ebizwa nangokuthi i-aneurysms ye-cerebral, ikhula ezinsimbini zegazi ezinikeza ubuchopho bakho. Lezi zivame ukuba zincinyane futhi zifana ne-berries, kungakho odokotela ngezinye izikhathi bazibiza ngokuthi "i-aneurysms ye-berry." I-aneurysms eningi yobuchopho ayihlupheki futhi abantu abaningi bahlala impilo yabo yonke ngaphandle kokwazi ukuthi banayo.

I-aneurysms ye-abdominal aortic (AAA) ivela esibindini esikhulu esithwala igazi enhliziyweni yakho kuye kwenye ingxenye yomzimba wakho. Lezi zivame ukukhula kancane ngokuhamba kwesikhathi futhi zivame kakhulu kubantu abadala, ikakhulukazi amadoda angaphezu kweminyaka engama-65.

Izinhlobo ezingavamile zihlanganisa i-aneurysms ye-thoracic aortic esifubeni sakho, i-aneurysms ye-peripheral ezingalweni noma ezinyaweni, kanye ne-aneurysms ye-splenic artery. Nakuba lezi zingavamile, zilandela izindlela ezifanayo zokukhula futhi zingaphathwa kahle lapho zitholakala.

Yini ebangela i-aneurysms?

I-aneurysms ikhula lapho izindonga zezinsimbi zegazi zibuthakathaka ngokuhamba kwesikhathi. Cabanga ngayo njengompompo wegadi oqala ukuba nobuthakathaka ngeminyaka yokucindezela kwamanzi okuhamba kuwo.

Izimbangela ezivamile zihlanganisa izinto ezibeka ukucindezela okukhulu ezinsimbini zakho zegazi noma ezizibuthakathaka kancane kancane:

• Ukucindezela kwegazi okuphezulu (imbangela ehamba phambili)
• Ukubhema (kubuthakathaka kakhulu izindonga zezinsimbi zegazi)
• Umlando womndeni we-aneurysms
• Iminyaka (izinsimbi zegazi zibuthakathaka ngokwemvelo ngokuhamba kwesikhathi)
• I-Atherosclerosis (ukuqina kwe-arteries)
• Ukulimala kwekhanda noma ukulimala
• Ukutheleleka okuthile okuthinta izinsimbi zegazi
• Ukusetshenziswa kwezidakamizwa, ikakhulukazi i-cocaine

Abanye abantu bazalwa nezimo ezenza i-aneurysms kube lula ukukhula. Lezi zinto zofuzo zingathinta ukuqina kwezindonga zezinsimbi zakho zegazi kusukela ekuzalweni. Izimo ezifana ne-polycystic kidney disease, i-Ehlers-Danlos syndrome, noma i-Marfan syndrome zingakwandisa ingozi yakho.

Kwezinye izimo ezingavamile, i-aneurysms ingakhula ngezimbangela ezingavamile njengokuvuvukala kwezinsimbi zegazi, umdlavuza othile oya ezinsimbini zegazi, noma ukutheleleka okukhulu. Nakuba lezi zimo zingavamile, zisikhumbuza ukuthi imizimba yethu yizinhlelo eziyinkimbinkimbi lapho izinto eziningi zingathinta impilo yethu.

Nini kufanele ubone udokotela nge-aneurysm?

Kufanele ufunesekare esiphuthumayo uma uhlangabezana nobuhlungu obukhulu, obukhulu kakhulu obuhlukile kunabo bonke obuke waba nabo ngaphambili. Lokhu kungabonisa i-aneurysm yobuchopho ehluphekile, edinga ukunakekelwa kwesikhathi esisheshayo.

Shaya u-911 ngokushesha uma unezimpawu zezeshwa zokuxwayisa kanye nobuhlungu obukhulu: ukuqina kwamadolo, ukugabha, ukuphazamiseka, noma ukulahlekelwa yikwazi. Lezi zimpawu ndawonye zibonisa ukuthi kukhona okuthile okubi kwenzeka okudinga ukunakekelwa ngokushesha.

Ngezimo ezingaphuthumayo, hlela i-aphoyintimenti nodokotela wakho uma uqaphela ubuhlungu obuqhubekayo besisu noma emuva, ikakhulukazi uma ungazwa ukuzwa okuqhuma esiswini sakho. Nakuba lokhu kungase kungabi yi-aneurysm, kufanele kuhlolwe ukuqinisekisa.

Uma unezingozi ezifana nokucindezela kwegazi okuphezulu, umlando womndeni we-aneurysms, noma ungumuntu ongaphezu kweminyaka engama-65 obheme, khuluma nodokotela wakho ngokuhlola. Ukutholakala kwesikhathi esisheshayo kungaba usizo kakhulu ekuphatheni i-aneurysms ngaphambi kokuba kube yinkinga.

Ziyini izingozi ze-aneurysms?

Ukuqonda izingozi zakho kungakusiza wena nodokotela wakho wenze izinqumo ezinhle kakhulu mayelana nokukhetha nokuvimbela. Ezinye izinto ongaziqondisa, kanti ezinye ziyisithombe sempilo yakho siqu.

Izingozi ongazithinta ngokukhetha indlela yokuphila zihlanganisa:

• Ukucindezela kwegazi okuphezulu (ingozi ebaluleke kakhulu engashintshwa)
• Ukubhema (kwandisa kakhulu ingozi futhi kusheshisa ukukhula kwe-aneurysm)
• Ukusetshenziswa okukhulu kotshwala
• Ukusetshenziswa kwezidakamizwa, ikakhulukazi izithuthukisi ezifana ne-cocaine
• Ukudla okubi okunamafutha amaningi e-cholesterol namafutha agcwele
• Ukwehluleka kokuzivocavoca njalo

Izinto ongenakuzishintsha kodwa kufanele uzazi zihlanganisa iminyaka yakho, ubulili, nomlando womndeni. Amadoda avame ukukhula i-aneurysms yesisu, kanti abesifazane banegozi encane ye-aneurysms yobuchopho. Ukuba nomzali noma umfowethu one-aneurysm kukwandisa ingozi yakho kakhulu.

Izimo ezithile zezokwelapha nazo zikwandisa amathuba akho okukhula i-aneurysms. Lezi zihlanganisa izifo ze-connective tissue, i-polycystic kidney disease, kanye nezimo ezenza ukuvuvukala ezinsimbini zakho zegazi. Uma unezinye zalezi zimo, udokotela wakho cishe uzothanda ukukulamula eduze.

Ziyini izinhlanganisela ezingaba khona ze-aneurysms?

Inhlanganisela eyingozi kakhulu iwukuthi i-aneurysm ihlupheka noma iphule. Nakuba lokhu kungenzeki e-aneurysms eningi, kuyisimo esiphuthumayo sezempilo esidinga ukwelashwa ngokushesha.

Lapho i-aneurysm yobuchopho ihlupheka, ibangela ukopha endaweni eseduze nobuchopho bakho, okuthiwa yi-subarachnoid hemorrhage. Lokhu kungabangela isifo sobuchopho, ukulimala okungapheliyo kobuchopho, noma ezimweni ezinkulu, ukufa. Noma kunjalo, ngokunakekelwa kwesikhathi esisheshayo kwemithi, abantu abaningi bayaphila kahle ngemuva kwe-aneurysms yobuchopho ehluphekile.

I-aneurysms yesisu ehluphekile ibangela ukopha okungaphakathi esiswini sakho, okungaba yingozi uma kungenakwenzeka ukwelashwa ngokushesha. I-aneurysm yesisu enkulu ikhula, ingozi yokuhlephuka iyanda, kungakho odokotela beyilandela ngokucophelela.

Ngisho ne-aneurysms engakahlupheki ngezinye izikhathi ingabangela izinhlanganisela. I-aneurysms enkulu yobuchopho ingacindezela izinzwa eziseduze, ibangela izinkinga zokubona, ubuhlungu, noma ubuthakathaka. I-aneurysms yesisu ingakha ama-blood clots ahlukana futhi avikele izinsimbi zegazi ezincane kwenye ingxenye yomzimba wakho.

Kwezinye izimo ezingavamile, i-aneurysms ingatheleleka, ibangela isimo esibizwa ngokuthi yi-mycotic aneurysm. Lokhu kwenza udonga lwesibindi libe buthakathaka futhi likhulise ingozi yokuhlephuka. Ngenhlanhla, le nhlanganisela ayivamile futhi ingaphathwa ngama-antibiotics kanye ngezinye izikhathi ukwelashwa.

I-aneurysms ingavimbeka kanjani?

Nakuba ungakwazi ukuvimbela yonke i-aneurysms, ikakhulukazi lezo ezihlobene nobuhle, unganciphisa kakhulu ingozi yakho ngokunakekela izinsimbi zakho zegazi. Ikhona ukuphatha izinto ezibeka ukucindezela okukhulu ezindongeni zezinsimbi zakho.

Ukuphatha ukucindezela kwegazi kwakho kuyisinyathelo esibaluleke kakhulu ongasithatha. Ukucindezela kwegazi okuphezulu kufana nokuthi unecindzeze kakhulu empompeni yamanzi - ekugcineni, kukhona okumele kunike.

Ukuyeka ukubhema kubaluleke kakhulu uma ubhema njengamanje. Ukubhema kubuthakathaka izindonga zezinsimbi zegazi futhi kwenza i-aneurysms kube lula ukukhula nokwehluka. Ngisho noma ube ubhema iminyaka eminingi, ukuyeka manje kungasiza impilo yezinsimbi zakho zegazi.

Ukuzivocavoca njalo, ukudla ukudla okunempilo yentliziyo, nokulinganisela utshwala konke kungasiza ekuqinisweni kwezinsimbi zakho zegazi. Ukuphatha ukucindezeleka, ukuthola ukulala okwanele, nokulondoloza isisindo esinempilo nazo zinikeza impilo engcono yezinsimbi zegazi.

Uma unemlando womndeni we-aneurysms, xoxa nodokotela wakho ngezinketho zokuhlola. Ukutholakala kwesikhathi esisheshayo kuvumela ukuqapha nokuphathwa ngaphambi kokuba kube khona izinkinga, kukunikeze imiphumela emihle kakhulu.

I-aneurysms ihlonishwa kanjani?

I-aneurysms eminingi itholakala ngengozi ngesikhathi sokuhlola izimo ezithile. Udokotela wakho angase abone enye kwi-CT scan yekhanda lakho ngemuva kengozi yemoto noma ngesikhathi se-ultrasound yesisu sakho ngenxa yobuhlungu besisu.

Uma udokotela wakho ekholelwa ukuthi ungaba ne-aneurysm ngenxa yezimpawu zakho noma izingozi, cishe uzoqala ngokuhlola izithombe. Nge-aneurysms yobuchopho, i-CT scan noma i-MRI ingabonisa isibindi segazi esiqhuma kahle. Ngezinye izikhathi i-dye ekhethekile ifakwa ukuze izinsimbi zegazi zivele kahle.

I-aneurysms yesisu ngokuvamile itholakala nge-ultrasound, esebenzisa amaza omsindo ukwenza izithombe zezinsimbi zakho zegazi. Lolu viwo alubuthi futhi lungalinganisa ngokuqondile usayizi we-aneurysm. I-CT scans inganikeza ulwazi oluqondile uma kudingeka.

Ukuze ubone ngokuningiliziwe izinsimbi zegazi, udokotela wakho angase akukhuthaze i-angiogram. Lokhu kuhilela ukufaka i-contrast dye ngokuqondile ezinsimbini zakho zegazi nokudubula ama-X-rays ukubona ukuthi igazi lihamba kanjani kuzo. Nakuba kuhileleke kakhulu kunokuhlola okunye, kunikeza isithombe esicacile se-aneurysms.

Udokotela wakho uzothatha nomlando ophelele wezokwelapha futhi enze ukuhlolwa komzimba. Uzobuza ngezimpawu zakho, umlando womndeni, kanye nezingozi. Ngezinye izikhathi bangazizwa i-aneurysms enkulu yesisu ngesikhathi sokuhlolwa komzimba, ikakhulukazi kubantu abancane.

Iyini ukwelashwa kwe-aneurysms?

Ukwelashwa kuyahluka kuye ngosayizi, indawo, kanye nezici ze-aneurysm yakho, kanye nempilo yakho yonke. I-aneurysms eminingi encane iyalandelelwa nje ngokuhlola okujwayelekile nokukhetha izithombe ukuqinisekisa ukuthi ayikhulumi.

Nge-aneurysms yobuchopho edinga ukwelashwa, odokotela banezinketho ezimbili eziyinhloko zokwelapha. Ukucindezela kuhilela ukufaka i-clip encane yensimbi ebusweni be-aneurysm ukuvimbela igazi elikhulayo. Ukufaka ama-coils kusebenzisa izinsimbi ze-platinum ezincinyane ezifakwe nge-catheter ukugcwalisa i-aneurysm nokuvimbela ukukhuphuka kwegazi.

I-aneurysms yesisu enkulu kunamamitha angaba ngu-5.5 ngokuvamile idinga ukulungiswa ukuvimbela ukwehluka. Ukwelashwa okuvulekile okujwayelekile kuhilela ukushintsha ingxenye ebuthakathaka nge-synthetic tube graft. Lokhu kuyilona opharetha olukhulu kodwa oluphumelelayo kakhulu ekuvimbeleni ukwehluka.

Inketho entsha, engathinti kakhulu, ukulungiswa kwe-endovascular, lapho odokotela befaka khona i-stent graft ngezinsiza ezincane emathangeni akho. I-graft iqondiswa phezulu kuya kwi-aneurysm futhi ikhule ukuqinisa udonga lwesibindi. Ukubuyela esimweni esijwayelekile ngokuvamile kushesha kunokwelashwa okuvulekile.

Nge-aneurysms engadingi ukwelashwa ngokushesha, ukuphatha izingozi zakho kuba yikho okugxile kukho. Lokhu kusho ukuphatha ukucindezela kwegazi, ukuyeka ukubhema, nokuthatha imithi ukuze ugcine izinsimbi zakho zegazi zisempilweni ngangokunokwenzeka.

Indlela yokuphatha i-aneurysms ekhaya?

Uma une-aneurysm encane elandelelwa, ukunakekela wena ekhaya kubalulekile ekuvimbeleni ukukhula kanye nezinhlanganisela. Izinqumo zakho zansuku zonke zingenza umehluko wangempela empilweni yakho yesikhathi eside.

Ukuphatha ukucindezela kwegazi kwakho kuyilona lo msebenzi wakho obaluleke kakhulu. Thatha imithi ngokuqondile njengoba kulotshwe, ngisho noma uzizwa uphilile. Hlola ukucindezela kwegazi kwakho njalo ekhaya uma udokotela wakho ekukhuthaza, futhi gcina i-log ukuze uhlanganyele ngayo emihlanganweni.

Gxila ekudleni okunempilo yentliziyo ngokukhetha izithelo eziningi, imifino, ama-grains aphelele, nama-proteins ahlanzekile. Linganisela usawoti, ongakhuphula ukucindezela kwegazi, futhi gwema ukudla okuthuthukisiwe uma kungenzeka. Uma ungaqiniseki ukuthi uqale kuphi, buza udokotela wakho ngokuhlangana nodokotela wezondlo.

Hlala usebenza ngaphakathi kwemingcele udokotela wakho akubekela yona. Abantu abaningi abane-aneurysms bangazivocavoca ngokuphepha, kodwa ungase udinge ukugwema imisebenzi eqinile kakhulu noma ukuphakamisa okukhulu. Ukuhamba, ukubhukuda, kanye ne-yoga ebushelelezi ngokuvamile kuyizinqumo ezinhle.

Gwema imisebenzi ekhuphula ngokushesha ukucindezela ezinsimbini zakho zegazi. Lokhu kuhlanganisa ukucindezela ngesikhathi sokuhamba kwesisu, ukuphakamisa okukhulu ngokushesha, noma imisebenzi ekwenza ubambe umoya wakho futhi ubeke phansi. Uma une-constipation, khuluma nodokotela wakho ngezindlela eziphephile zokuyiphatha.

Funda ukuqaphela izimpawu zokuxwayisa futhi ube nenhlelo yokuthola ukunakekelwa kwesikhathi esiphuthumayo ngokushesha. Gcina izinombolo ezibalulekile zocingo ziseduze futhi uqinisekise ukuthi amalungu omndeni wakho azi ukuthi yini okufanele bayiqaphele nokuthi yini okufanele bayenze.

Kufanele ulungiselele kanjani i-aphoyintimenti yakho yodokotela?

Ukuza ulungile e-aphoyintimenti yakho kusiza uqinisekise ukuthi uthola ulwazi oluwusizo kakhulu nokunakekelwa. Qala ngokubhala zonke izimpawu zakho, ngisho nalabo ababonakala bengenahlangene ne-aneurysms.

Yenza uhlu lwemithi yonke oyithathayo, kuhlanganise nemithi yokuthengwa ngaphandle komthetho, amavithamini, kanye nezinhlanganisela. Letha amabhodlela angeziwe uma kungenzeka, njengoba lokhu kusiza udokotela wakho ukubona amagama nezinga eliqondile. Faka noma yiziphi izidakamizwa zezimila noma ukwelashwa okunye okuyisebenzisa.

Bula ulwazi mayelana nomlando wezempilo womndeni wakho, ikakhulukazi noma yimiphi izihlobo ezibe ne-aneurysms, izifo sobuchopho, noma izinkinga zenhliziyo. Lolu lwazi lusiza udokotela wakho ukulinganisa ingozi yakho futhi enze izincomo ezinhle zokwelapha.

Bhala imibuzo ofuna ukuyibuza ngaphambi kokuba ufike e-aphoyintimenti. Imibuzo ebalulekile ingaba: Iyinkulu kangakanani i-aneurysm yami? Ingalandelelwa kangaki? Yiziphi izimpawu engizibheka? Yiziphi imisebenzi engizigwemayo?

Uma unezivivinyo zokukhetha izithombe zokulandelela, cela amakhophi ezithombe zangaphambili ukuze uzilethe nawe. Lokhu kuvumela udokotela wakho ukuba aqhube iziphetho zamanje nalezo zangaphambili ukubona ukuthi kukhona yini okushintshile.

Cabanga ngokuletha ilungu lomndeni noma umngani e-aphoyintimenti. Bangakusiza ukukhumbula ulwazi nokubuza imibuzo ongayikhohlwa. Ukuba nokusekelwa ngesikhathi semihlangano yezokwelapha kungakusiza uzizwe uqinile futhi unolwazi.

Iyini into ebaluleke kakhulu mayelana ne-aneurysms?

Into ebaluleke kakhulu okumele uyiqonde mayelana ne-aneurysms iwukuthi ukuba nayo akusho ukuthi usengozini ngokushesha. I-aneurysms eningi ayibangeli izinkinga, futhi lapho idinga ukwelashwa, imithi yanamuhla inikeza izinketho ezinhle.

Ukutholakala kwesikhathi esisheshayo nokuphathwa okuqondile kuyizixhobo zakho ezinhle kakhulu zokuhlala unempilo nge-aneurysm. Ukuhlola okujwayelekile, ukulandela uhlelo lwakho lokwelashwa, nokuphatha izingozi ezifana nokucindezela kwegazi nokubhema kungasiza ekuvimbeleni izinhlanganisela.

Khumbula ukuthi awunamandla kule simo. Ukunakekela impilo yakho yonke, ukuhlala unolwazi mayelana nesimo sakho, nokusebenzisana eduze neqembu lakho lezempilo kukubeka ekulawuleni uhambo lwakho lwempilo.

Uma ukhathazekile nge-aneurysms ngenxa yomlando womndeni noma izingozi, xoxa nodokotela wakho ngokuhlola. Ulwazi yilona mandla uma kuziwa empilweni yakho, futhi ukwazi isimo sakho kukuvumela ukuba wenze izinqumo ezinhle ngekusasa lakho.

Imibuzo evamile ebuzwayo mayelana ne-aneurysms

Ingaphela yodwa i-aneurysms?

I-aneurysms ngokuvamile ayipheli yodwa uma isakhiwe. Noma kunjalo, i-aneurysms encane kakhulu ingase ihlale iqinile iminyaka eminingi noma amashumi eminyaka ngaphandle kokukhula noma ukubangela izinkinga. Ikhona ukuqapha okujwayelekile ukuqapha noma yiziphi izinguquko ngokuhamba kwesikhathi.

I-aneurysms ikhula ngokushesha kangakanani?

I-aneurysms eningi ikhula kancane kakhulu, ngokuvamile kuthatha iminyaka ukwanda ngokuphawulekayo ngobukhulu. I-aneurysms yesisu ngokuvamile ikhula cishe ngamamilimitha angu-1-4 ngonyaka, kanti i-aneurysms yobuchopho ingase ihlale inguquki iminyaka eminingi. Izilinganiso zokukhula ziyahluka kakhulu phakathi kwabantu futhi ziyahluka kuye ngezinto ezifana nokulawulwa kokucindezela kwegazi kanye nesimo sokubhema.

Ungaphila impilo evamile nge-aneurysm?

Yebo, abantu abaningi abane-aneurysms baphila impilo evamile ngokuphelele. Ikhona ukulandela izincomo zedokotela wakho zokuqapha nokuphatha izingozi. Abantu abaningi basebenza, bazivocavoca, bahamba, futhi bajabulela yonke imisebenzi yabo evamile ngokunakekelwa kwemithi okuqondile nokuphathwa kwendlela yokuphila.

Ingabe i-aneurysms iyofuzo?

Nakuba i-aneurysms ingase ihambe emindenini, ukuba nomlando womndeni akusho ukuthi uzokhula enye. Uma unelungu lomndeni oluqonde (umzali, umfowethu, noma ingane) ene-aneurysm, ingozi yakho iphakeme, futhi udokotela wakho angase akukhuthaze ukukhetha okusheshayo noma okuvamile. Izinto zofuzo ziyachaza ezinye izimo, kodwa izinto zendlela yokuphila nazo zidlalela indima enkulu.

Yini engingayigwema uma ngine-aneurysm?

Izinto ezibaluleke kakhulu okufanele uzigweme ukubhema nokucindezela kwegazi okuphezulu okungalawuleki. Kufanele futhi ugweme ukusebenza ngamandla okungazelelwe, ukuphakamisa okukhulu (ngokuvamile ngaphezu kwamakhilogremu angu-23), kanye neminye imisebenzi ehilela ukucindezela noma ukubamba umoya wakho. Odokotela abaningi bakhuthaza ukugwema izidakamizwa ezithuthukisayo ngokuphelele. Imisebenzi evamile njengokuhamba, ukuzivocavoca okulula, kanye neminye imisebenzi yansuku zonke ngokuvamile ilungile futhi ikhuthazwa.