Umyasthenia Gravis yini? Izimpawu, Izimbangela, Nokwelapha

Umyasthenia gravis iyisimo esingapheli somzimba esiholela ekuqedeni kwamandla emisipha futhi ikhathale kalula ngesikhathi somsebenzi. Isistimu yakho yokukhusela umzimba ihlasela ngephutha amaphuzu oxhumano phakathi kwemizwa yakho nemisipha, okwenza kube nzima ngemisipha yakho ukwamukela izimpawu ezidingekayo ukuze ihlangane kahle.

Lesi simo sithinta abantu abangaba ngu-20 ku-100,000, okwenza kube yinto engavamile kodwa ngokuqinisekile ayisiyona into engajwayelekile. Igama ngokwalo lisho ukuthi "ubuqina obukhulu bomsipha," kodwa ungakhathazeki. Ngokwelashwa okuqondile, abantu abaningi abane-myasthenia gravis bangaphila impilo egcwele, esebenzayo.

Ziyini izimpawu zomyasthenia gravis?

Isimpawu esiyinhloko yibuqina bomsipha obukhula kakhulu ngesikhathi somsebenzi futhi buthuthuka ngokuphumula. Ungase uqaphele ukuthi imisipha yakho inamandla ekuseni kodwa ibe buthakathaka ngokuqhubekayo usuku lonke.

Ake sihambe ngezimpawu ezivamile ongazihlangabezana nazo, sikhumbula ukuthi uhambo lwabo bonke ngalesi simo lubukekahlukile.

• Amaphethilo athambekele phansi (ptosis): Elinye noma womabili amehlo angase athambekele phansi, ikakhulukazi uma ukhathele noma ubelokhu ufunda isikhathi eside.
• Ukubona okubili: Ungase ubona izithombe ezimbili zethuluzi elifanayo, ikakhulukazi uma ubheka ezinye izindawo.
• Ubunzima bokuhlafuna noma ukugwinya: Imisipha yakho yomhlathi ingase ikhathale ngokushesha ngesikhathi sokudla, noma ukudla kungase kuzwakale sengathi kunamathele entanyeni yakho.
• Inkulumo ephazamisekile noma enenhlamba: Izwi lakho lingase lizwakale lihlukile, ikakhulukazi ngemuva kokukhuluma isikhathi eside.
• Ubuthakathaka ezingalweni nasemiileni: Ungase ube nobunzima bokuthwala izinto, ukukhuphuka izitebhisi, noma ukuhamba ibanga elide.
• Ubuthakathaka bomsipha wobuso: Ukuhleka, ukunama, noma ukwenza ezinye izimpawu zobuso kungase kube nzima.

Kwezinye izimo, ungase uhlangabezane nobunzima bokuqeda umoya uma imisipha elawula ukuqeda umoya ithinteka. Lokhu akukuvamile kodwa kudinga ukunakekelwa ngokushesha kwezokwelapha uma kwenzeka.

Ziyini izinhlobo zomyasthenia gravis?

Odokotela ngokuvamile bahlukanisa umyasthenia gravis zibe izinhlobo eziningana ngokusekelwe ekutheni imisipha ithinteka nini futhi izimpawu ziqala nini. Ukuqonda uhlobo lwakho oluthile kusiza ukuqondisa izinqumo zokwelapha.

Umyasthenia gravis wamehlo: uthinta imisipha kuphela eduze kwamehlo akho. Cishe u-15% lwabantu abanesimo salolu hlobo bayobona izimpawu zihlala zilinganiselwe emehlweni abo, kanti abanye bangase bathuthukise uhlobo olujwayelekile kamuva.

Umyasthenia gravis ojwayelekile: uthinta amaqembu amaningi emisipha kulo lonke umzimba wakho. Lolu uhlobo oluvamile kakhulu, olumelela cishe u-85% yezimo. Izimpawu zivame ukuqala eduze kwamehlo kodwa zisakazeke kwamanye amazwekazi.

Umyasthenia gravis ozalwa nawo: uhlobo olulodwa oluzuzwe olukhona kusukela ekuzalweni. Ngokungafani nezinhlobo zokuziphatha komzimba, lokhu kuvela ekuhlanganiseni i-genetic okuthinta uxhumano lwemizwa nemisipha.

Yini ebangela umyasthenia gravis?

Umyasthenia gravis uthuthuka lapho isimiso sakho sokuvikela umzimba sihlasele ngephutha ama-acetylcholine receptors endaweni ehlanganisa imizwa nemisipha. Cabanga ngala ma-receptors njengemabhokisi amancane okuthumela izincwadi azamukela imiyalezo yezinto ezikhiqizwayo ezikhuluma nemisipha ukuthi ihlangane nini.

Nanku lokho okuvamile kwenzeka emzimbeni wakho uma unesimo salolu hlobo:

• Ukukhiqizwa kwama-antibody: Isistimu yakho yokukhusela umzimba yenza ama-antibody abamba noma abhubhise ama-acetylcholine receptors.
• Ukuphulwa kwesiginali: Ngama-receptors amancane asebenza, iziginali zemizwa azikwazi ukufinyelela imisipha yakho ngokuphumelelayo.
• Ubuthakathaka bomsipha: Imisipha yakho yamukela iziginali ezibuthakathaka futhi ikhathale ngokushesha.
• Ukuhileleka kwe-thymus gland: Cishe u-75% lwabantu banezinkinga ze-thymus gland ezingase ziqalise impendulo yokuziphatha komzimba.

Isizathu esiqondile salempendulo yokuziphatha komzimba asiqondakali ngaso sonke isikhathi, kodwa abacwaningi bakholelwa ukuthi kuhilela ukuxuba kokuthambekela kwe-genetic nezici zezindawo eziqophi.

Nini okumele ubona udokotela ngomyasthenia gravis?

Kufanele uxhumane nodokotela uma uqaphela ubuthakathaka bomsipha obukhula kakhulu ngesikhathi somsebenzi futhi buthuthuka ngokuphumula. Lesi sibonakaliso sihlukile kakhulu futhi sidinga ukuhlolwa kwezokwelapha.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uhlangabezana nobunzima bokuqeda umoya, ubunzima obukhulu bokuginya, noma ukwanda ngokushesha kobuthakathaka bomsipha. Lezi zimpawu zingase zibonise ingozi yomyasthenia, edinga ukwelashwa okusheshayo.

Ungalindi uma une-double vision ehlala njalo, amehlo athambekele phansi ahlupha ukubona kwakho, noma ukuguquka kokukhuluma okwenza kube nzima kwabanye ukukuqonda. Ukuxilongwa kwangaphambi kwesikhathi nokwelashwa kungasiza ukuvimbela ukuqhubeka nokwenza impilo yakho ibe ngcono.

Ziyini izici ezingaholela ekuthuthukiseni umyasthenia gravis?

Izici eziningi zingandisa amathuba akho okuthuthukisa umyasthenia gravis, nakuba ukuba nalezi zici ezingaholela ekuthuthukiseni akusho ukuthi uzokuthuthukisa ngokuqinisekile lesi simo.

Ukuqonda lezi zici kungakusiza wena nodokotela wakho ukuthi niqaphele izimpawu zokuqala:

• Ubudala nobulili: Abafazi bayathinteka kakhulu ngaphambi kweminyaka engu-40, kanti amadoda avame ukuxilongwa ngemuva kweminyaka engu-60.
• Ezinye izimo zokuziphatha komzimba: Ukuba ne-rheumatoid arthritis, i-lupus, noma isifo se-thyroid kungase kukhulise ingozi yakho.
• Umlando womndeni: Nakuba kungadluliselwa ngokukhulu, ukuba nezihlobo ezinezimo zokuziphatha komzimba kungase kukhulise kancane ingozi.
• I-tumors ye-thymus gland: Cishe u-10-15% lwabantu abane-myasthenia gravis bane-thymomas (i-tumors ye-thymus gland).
• Imithi ethile: Amanye ama-antibiotic, imithi yenhliziyo, nemisipha yokupumula ingase ibe nzima izimpawu kubantu abathintekayo.

Kufanele kuqaphele ukuthi abantu abaningi abane-myasthenia gravis abanazo izici ezingaholela ekuthuthukiseni ezicacile. Lesi simo singathuthuka kunoma ubani, kungakhathaliseki isizinda sabo noma umlando wezempilo.

Ziyini izinhlanganisela ezingaba khona zomyasthenia gravis?

Nakuba abantu abaningi abane-myasthenia gravis baphila kahle ngokwelashwa, kubalulekile ukuqonda izinhlanganisela ezingaba khona ukuze ukwazi ukuqaphela izimpawu zokuqala.

Inhlanganisela eyingozi kakhulu yingozi yomyasthenia, eyenzeka lapho imisipha yokuqeda umoya ibe buthakathaka kakhulu. Lokhu kuthinta cishe u-15-20% lwabantu abane-myasthenia gravis ngesinye isikhathi futhi kudinga ukungena esibhedlela ngokushesha.

Ezinye izinhlanganisela okufanele uzazi zihlanganisa:

• I-aspiration pneumonia: Imisipha ebuthakathaka yokugwinya ingavumela ukudla noma amanzi ukuba angene emaphashini akho.
• Ingozi ye-cholinergic: Le nhlanganisela engajwayelekile ingase ivela ekusebenziseni imithi eminingi futhi iholele ekuqedeni kwamandla emisipha efana nesifo ngokwalo.
• I-tumors ye-thymus gland: Cishe u-10-15% lwabantu bathuthukisa i-thymomas, okungase kudinge ukususa ngokusebenza.
• Ezinye izimo zokuziphatha komzimba: Ungase ube nengozi enkulu yokuthuthukisa ezinye izifo zokuziphatha komzimba.

Ngokuqapha okuqondile nokwenza izinguquko ekwelapheni, izinhlanganisela eziningi zingavikeleka noma ziphathwe kahle. Iqembu lakho lezempilo lizohlala lisebenza nawe ukuze linciphise lezi ngozi.

Umyasthenia gravis utholakala kanjani?

Ukuxilongwa komyasthenia gravis kuhilela ukuhlolwa okuhlukene ngoba izimpawu zingafana nezinye izimo. Udokotela wakho uzoqala ngomlando wezokwelapha onemininingwane kanye nokuhlolwa komzimba, aqaphele ngokukhethekile izibonakaliso zokuqina komsipha.

Inqubo yokuxilongwa ngokuvamile ihlanganisa le mihlola ebalulekile:

• Ukuhlolwa kwegazi: Lokhu kuhlola ama-antibody athile ahlasela ama-acetylcholine receptors noma ezinye izinto ezihlobene.
• I-electromyography (EMG): Lolu hlolo luqapha umsebenzi wamagetsi emisipha yakho futhi lungabonisa izibonakaliso ezifanele.
• Ukuhlolwa kokusakaza kwemizwa: Lokhu kuhlola ukuthi iziginali zihamba kanjani kusuka emizwini yemisipha.
• Ukuhlolwa kwe-Edrophonium: Imithi esebenza isikhathi esifushane inikezwa ukubona ukuthi amandla emisipha athuthuka yini okwesikhashana.
• I-CT noma i-MRI yesifuba: Lezi zithombe ziqapha izinkinga ze-thymus gland noma i-tumors.

Udokotela wakho angase futhi enze ukuhlolwa kwe-ice pack, lapho i-ice ifakwa emehlweni athambekele phansi ukubona ukuthi ukubanda kuthuthukisa yini ubuthakathaka okwesikhashana. Lolu hlolo olucacile lunganikeza izinkomba ezibalulekile zokuxilongwa.

Yini ukwelashwa komyasthenia gravis?

Ukwelashwa komyasthenia gravis kugxile ekuthuthukiseni amandla emisipha, ukunciphisa izimpawu, nokukusiza ugcine ikhwalithi yempilo yakho. Izindaba ezinhle ukuthi kunezindlela eziningi zokwelapha ezisebenza kahle ezitholakalayo.

Uhlelo lwakho lokwelapha luzohlanganisa enye noma ngaphezulu yalezi zindlela:

• Ama-cholinesterase inhibitors: Imithi efana ne-pyridostigmine iyasiza ekuthuthukiseni ukuxhumana phakathi kwemizwa nemisipha.
• Imithi yokucindezela isimiso sokuvikela umzimba: Ama-corticosteroids nezinye izidakamizwa zisiza ekuthuthukiseni impendulo yokuziphatha komzimba.
• I-plasmapheresis: Le nqubo isusa ama-antibody abangela ubuhlungu egazini lakho, inikeza ukuthuthuka okwesikhashana.
• I-Intravenous immunoglobulin (IVIG): Lezi zinto ezinikwayo zingasiza ekulawuleni isimiso sakho sokuvikela umzimba.
• I-Thymectomy: Ukususa i-thymus gland ngokusebenza kungase kunikeze izinzuzo zesikhathi eside, ikakhulukazi kubantu abasebancane.

Ukwelashwa kuyahlukahluka kakhulu, futhi udokotela wakho uzohlala esebenza nawe ukuze uthole ukuxuba okulungele isimo sakho esithile. Abantu abaningi babona ukuthuthuka okukhulu ngokwelashwa okuqondile.

Ungalawula kanjani umyasthenia gravis ekhaya?

Ukulawula umyasthenia gravis ekhaya kuhilela ukwenza izinqumo zokuphila ezihlakaniphile ezisiza ekuqondeni amandla akho nokunciphisa ukwanda kwezimpawu. Ukuhlanganiswa okuncane kungenza umehluko omkhulu endleleni ozizwa ngayo usuku nosuku.

Nanku amasu asebenzayo angakusiza uzizwe ukhulu:

• Hlela imisebenzi yesikhathi sakho esinamandla: Hlela imisebenzi ebalulekile lapho imisipha yakho izizwa inamandla kakhulu, ngokuvamile ekuseni.
• Thatha ama-breaks njalo: Phumula ngaphambi kokuba ukhathale ukuvimbela ubuthakathaka bomsipha ukuba bube nzima.
• Dla ukudla okuncane, okuvamile: Le ndlela ilula emisipha ekhathele yokuhlafuna nokugwinya.
• Hlala ubandayo: Ukushisa kungase kube nzima izimpawu, ngakho-ke sebenzisa i-air conditioning futhi gwema izindawo ezishisayo uma kungenzeka.
• Lawula ukucindezeleka: Ukucindezeleka kwengqondo kungase kuqalise ukwanda kwezimpawu, ngakho-ke sebenzisa amasu okuphumula.

Cabanga ngokwenza indawo yakho yasekhaya ibe lula ngokufaka ama-grab bars, ukusebenzisa izinto zokudla ezilula, nokugcina izinto ezisetshenziswa njalo zifinyeleleka kalula. Lezi zinguquko zingakusiza uhlale uzimele ngenkathi ulawula isimo sakho.

Kufanele ulungiselele kanjani i-appointment yakho nodokotela?

Ukulungiselela i-appointment yakho nodokotela kungasiza ukuqinisekisa ukuthi uthola okuningi ngesikhathi sakho sokuhlangana. Ukulungiselela okuhle kuholela ekuxhumaneni kangcono nasekulungisweni kokwelapha okuphumelelayo.

Ngaphambi kwe-appointment yakho, gcina idayari yesimpawu uqaphele ukuthi ubuthakathaka buvela nini, yini ebuqalisa, nokuthi yini esiyasiza ukuthuthukisa. Lolu lwazi lusisiza udokotela wakho ukuthi aqonde isibonakaliso sakho esithile sezinto.

Letha uhlu oluphelele lwazo zonke izidakamizwa, izithasiselo, namavithamini owathatha, kuhlanganise nezinani kanye nesikhathi. Futhi, lungiselela imibuzo mayelana nehlolo lakho lokwelapha, imiphumela emibi engaba khona, nanoma yikuphi ukukhathazeka mayelana nesimo sakho.

Cabanga ngokuletha ilungu lomndeni noma umngani ongakusiza ukuba ukhulume ngokwakho futhi ukhumbule ulwazi olubalulekile oluxoxwe ngesikhathi sokuvakasha. Ukuba nokusekelwa kungase kube yigugu ikakhulukazi lapho uxoxa ngezinqumo eziyinkimbinkimbi zokwelapha.

Yini okufanele uyikhumbule mayelana nomyasthenia gravis?

Umyasthenia gravis iyisimo esingapheli esilawuleka esithinta amandla emisipha, kodwa akufanele sichaze impilo yakho. Ngokwelashwa okuqondile nokwenza izinguquko zokuphila, abantu abaningi abanesimo salolu hlobo bangqhubeka benza izinto abazithandayo.

Ukuze uphile kahle ngomyasthenia gravis, yilokho ukusebenzisana eduze neqembu lakho lezempilo, uhlale uqine ngokwelashwa, futhi wenze izinqumo ezihlakaniphile mayelana nendlela osebenzisa ngayo amandla akho. Khumbula ukuthi ukulawula izimpawu kuvame ukuthuthuka ngokuhamba kwesikhathi njengoba wena nodokotela wakho nilungisa uhlelo lwakho lokwelapha.

Hlala unethemba futhi ubekezelele inqubo. Abantu abaningi abane-myasthenia gravis baqhubeka benemisebenzi, imindeni, kanye nempilo esebenzayo. Ukuxilongwa kwakho kuyisiqalo nje sokuthola indlela yokulawula lesi simo ngokuphumelelayo.

Imibuzo evamile ebuzwayo mayelana nomyasthenia gravis

Q1. Ingabe umyasthenia gravis uyadluliselwa?

Umyasthenia gravis ngokuvamile awudluliselwa, nakuba kungase kube nokufana okuncane kwe-genetic ezimweni zokuziphatha komzimba ngokujwayelekile. Uhlobo oluzalwa nalo luyadluliselwa, kodwa lokhu limelela ngaphansi kuka-5% lazo zonke izimo. Abantu abaningi abane-myasthenia gravis abanazo izihlobo ezinesimo salolu hlobo.

Q2. Ingabe umyasthenia gravis ungaphiliswa?

Okwamanje, ayikho impilo yomyasthenia gravis, kodwa ilapheka kakhulu. Abantu abaningi bafinyelela ekuphumuleni isikhathi eside ngokwelashwa okuqondile. Abanye abantu, ikakhulukazi labo abenza i-thymectomy surgery, bangase babone ukuthuthuka okukhulu noma ukuxazululwa okuphelele kwezimpawu isikhathi eside.

Q3. Ingabe umyasthenia gravis uzoba mubi ngokuhamba kwesikhathi?

Ukuqhubeka kuyahlukahluka kakhulu kusuka komunye umuntu kuya komunye. Abanye abantu bahlangabezana nezimpawu ezihlala njalo iminyaka eminingi, kanti abanye bangase babe nezinyathelo zokwanda okulandela ukuthuthuka. Ngokwelashwa lamanje, abantu abaningi bangalindela isimo sabo ukuba silawulwe kahle kunokuba sibe sibi ngokuqhubekayo.

Q4. Ngingasebenza yini ngomyasthenia gravis?

Yebo, ungasebenza ngomyasthenia gravis, kodwa kuzodingeka uguqule indlela yakho. Ukuzivocavoca okulula kuye kube lula kungaba usizo, kodwa gwema ukusebenza kakhulu. Sebenza neqembu lakho lezempilo ukuze wenze uhlelo lokuzivocavoca oluhambisana namanqanaba akho amandla kanye nezibonakaliso zokuqina komsipha.

Q5. Ingabe kukhona ukudla okufanele ngikugweme ngomyasthenia gravis?

Ayikho ukudla okuthile okufanele ukugweme, kodwa abanye abantu bathola ukuthi ukudla okuthile kubenza kube nzima izimpawu. I-Quinine (etholakala emanzini e-tonic) ingase ibe nzima ubuthakathaka bomsipha kwabanye abantu. Gxila ekudleni ukudla okulinganiselayo nokugcina umzimba wakho uthambile, futhi uxoxe nanoma yikuphi ukukhathazeka kokudla nodokotela wakho.