Polycythemia Vera

I-Polycythemia vera (pol-e-sy-THEE-me-uh VEER-uh) uhlobo lwe-kansa legazi. Ibanga ukuba u-marrow wamathambo akhe i-red blood cells eziningi kakhulu. Lezi zicell eziningi kakhulu ziqinisile igazi lakho, ziphoqa ukusabela kwalo, okungabangela izinkinga ezinzima, njenge-blood clots.

I-Polycythemia vera iyabambeka. Ngokuvamile ithuthuka kancane, futhi ungaba nayo iminyaka ngaphandle kokwazi. Ngokuvamile isimo sifunyanwa ngesikhathi sokuhlolwa kwegazi okwenziwe ngesinye isizathu.

Ngaphandle kokwelashwa, i-polycythemia vera ingaba yingozi eyingozi. Kodwa ukunakekelwa okufanele kwezokwelapha kungasiza ukunciphisa izimpawu, izimpawu nezinhlungu zalesi sifo.

Abantu abaningi abane-polycythemia vera abanawo ubufakazi noma izimpawu ezibonakalayo. Abanye abantu bangase bathuthukise izimpawu ezingaqondakali njengokukhathazeka, ukukhungatheka, ukukhathala nokuqina kobumnyama.

Izimpawu ezithile ze-polycythemia vera zihlanganisa:

• Ukukhahlela, ikakhulukazi ngemva kokugeza okufudumele noma i-shawa
• Ukungazizwa, ukukhahlela, ukushisa, noma ubuthakathaka ezandleni, ezinyaweni, ezingalweni noma emilenzeni yakho
• Ukuzizwa ukugcwaliswa ngokushesha ngemva kokudla nokukhukhumela noma ubuhlungu ngakwesobunxele phezulu esiswini ngenxa yespleen enkulu
• Ukopha okungavamile, njengokuphuma igazi ekhaleni noma igazi emazinyweni
• Ukukhukhumela okuhlungu kwesinye ijoyinti, ngokuvamile ithumbu elikhulu
• Ukuphefumula okufushane nobunzima bokuphumula uma ulele

Bika kwidokotela wakho uma unezimpawu noma izimpawu ze-polycythemia vera.

I-polycythemia vera ivela lapho ukuhlukahluka kwesizinda kwenza inkinga ekukhiqizweni kwamaseli egazi. Ngokuvamile, umzimba wakho ulawula inani ngayinye yezinhlobo ezintathu zamaseli egazi anawo—amaseli egazi abomvu, amaseli egazi amhlophe namaplatelets. Kodwa ku-polycythemia vera, u-bone marrow wakho wenza amaningi amaseli egazi athile.

Imbangela yokuhlukahluka kwesizinda ku-polycythemia vera ayaziwa, kodwa ngokuvamile ayithathwa kubazali bakho.

I-polycythemia vera ingahle ibonakale kunoma iyiphi iminyaka, kodwa ivame kakhulu kubantu abadala abaphakathi kweminyaka engama-50 nama-75. Amadoda amaningi ahlushwa yi-polycythemia vera, kodwa abesifazane bathambekela ekubeni bahlushwe yileli gciwane besebancane.

Izingozi ezingase zenzeke ngenxa ye-polycythemia vera zihlanganisa:

• Ukuqina kwegazi. Ukuncipha kokugeleza kwegazi nokuncipha kokugeleza kwegazi, kanye nokungalingani kwamapuleti akho, kukwandisa ingozi yokuqina kwegazi. Ukuqina kwegazi kungabangela isifo sobuchopho, ukuhluleka kwenhliziyo, noma ukuvimba kwe-artery emaphashini akho noma i-vein ejulile ngaphakathi kwemisipha yomlenze noma esiswini.
• Ukuqina kwespleen. I-spleen yakho ikusiza ukulwa nokutheleleka nokucwecwa kwezinto ezingafuneki, njengezisele zegazi elidala noma elilimaziwe. Inani elikhulayo leziseli zegazi elibangelwa yi-polycythemia vera lenza i-spleen yakho isebenze nzima kunokujwayelekile, okubangela ukukhula kwayo.
• Izinkinga ezivela emazingeni aphezulu ezisele ezihlaza ebomvu. Izisele ezihlaza ebomvu eziningi kakhulu zingabangela ezinye izingozi, kufaka phakathi amaqhuzu avulekile ekuqaleni kwesisu sakho, isisu esincane esiphezulu noma i-esophagus (amaqhuzu e-peptic) nokuvuvukala ezinhlangothini zakho (igout).
• Ezinye izifo zegazi. Kwezinye izikhathi, i-polycythemia vera ingabangela ezinye izifo zegazi, kufaka phakathi isifo esithuthukayo lapho u-bone marrow uthathelwa indawo yi-scar tissue, isimo lapho izisele ze-stem zingakhula noma zisebenzi kahle, noma umdlavuza wegazi ne-bone marrow (i-acute leukemia).

Udokotela wakho uzothatha umlando wezokwelapha onemininingwane futhi enze ukuhlolwa komzimba.

Uma une-polycythemia vera, ukuhlolwa kwegazi kungase kuveze:

Uma udokotela wakho ekungabaza ukuthi une-polycythemia vera, angase acebise ukuqoqa isampula yomgogodla wakho ngokusebenzisa ukukhipha noma ukuhlola umgogodla.

Ukuhlolwa komgogodla kuhilela ukuthatha isampula yento enqabile yomgogodla. Ukukhipha umgogodla kuvame ukwenziwa ngesikhathi esifanayo. Phakathi nokukhipha, udokotela wakho uzothola isampula yengxenye eyi-liquid yomgogodla wakho.

Ekukhipheni komgogodla, umhlinzeki wezinsizakalo zezempilo usebenzisa inhlanzi encane ukuze asuse inani elincane lomgogodla oyi-liquid, ngokuvamile kusuka endaweni ngemuva kwethambo lakho le-hip (pelvis). Ukuhlolwa komgogodla kuvame ukwenziwa ngesikhathi esifanayo. Le nqubo yesibili isusa ingxenye encane yethambo kanye nomgogodla ofakiwe.

Uma une-polycythemia vera, ukuhlaziywa komgogodla wakho noma igazi kungase kubonise ukuguqulwa kwe-gene okuhambisana nesifo.

• Amakhemikhali egazi abomvu angaphezu kwanoma yini futhi, ngezinye izikhathi, ukwanda kwamapulethi noma amangqamuzana amhlophe egazi
• Izingxenye ezinkulu zamaseli egazi abomvu ezenza ivolumu yonke yegazi (ukulinganisa kwe-hematocrit)
• Amazinga aphezulu weprotheni ecebile ngensimbi emakhemikhali egazi abomvu ethwala i-oksijini (hemoglobin)

Asikho ukwelashwa kwe-polycythemia vera. Ukwelashwa kugxile ekunciphiseni ingozi yezinkinga. Lezi zindlela zokwelapha zingase futhi zikhulise izimpawu zakho.

Ukwelashwa okuvamile kakhulu kwe-polycythemia vera ukukhipha igazi njalo, usebenzisa unhlanzi e-vein (phlebotomy). Kuyindlela efanayo esetshenziswa ekuhlinzekeni igazi.

Lokhu kunciphisa umthamo wegazi lakho futhi kunciphisa inani lamaseli egazi engeziwe. Ukuthi uzodinga kangakanani ukukhipha igazi kuncike ebukhali besimo sakho.

Uma une-itching ephazamisayo, udokotela wakho angase anikeze imithi, njenge-antihistamines, noma ancoma ukwelashwa kokukhanya kwe-ultraviolet ukuze akhulule ukungakhululeki kwakho.

Imithi evamile ukusetshenziswa ekwelapheni ukucindezeleka, ebizwa ngokuthi yi-selective serotonin reuptake inhibitors (SSRIs), isize ekuqedeni ukukhahlela ekuhlolweni kwezokwelapha. Izibonelo ze-selective serotonin reuptake inhibitors (SSRIs) zihlanganisa i-paroxetine (Brisdelle, Paxil, Pexeva, ezinye) noma i-fluoxetine (Prozac, Sarafem, Selfemra, ezinye).

Uma i-phlebotomy yodwa ingasizi ngokwanele, udokotela wakho angase aphakamise imithi engunciphisa inani lamaseli ebomvu egazi egazini lakho. Izibonelo zihlanganisa:

Udokotela wakho uzophinde abeke imithi yokulawula izici zengozi zesifo senhliziyo nemisipha yegazi, kuhlanganise nokucindezeleka kwegazi, isifo sikashukela kanye ne-cholesterol engavamile.

Udokotela wakho angase akukhuthaze ukuba uthathe i-aspirin encinyane ukuze unciphise ingozi ye-blood clots. I-aspirin encinyane ingase futhi isize ekuqedeni ubuhlungu obukhulu ezinyaweni noma ezandleni zakho.

• Hydroxyruea (Droxia, Hydrea)
• Interferon alfa-2b (Intron A)
• Ruxolitinib (Jakafi)
• Busulfan (Busulfex, Myleran)

Ungenza izinyathelo zokuzisiza uzizwe kangcono uma ukwaziswe ukuthi une-polycythemia vera. Zama ukwenza okulandelayo:

Gcina ilusu lakho liphilile. Ukuze unciphise ukukhahlela, gcoba emanzini abandayo, sebenzisa i-cleanser ebushelelezi bese uthinta ilusu lakho liyome. Ukuhlanganisa i-starch, njenge-cornstarch, emanzini akho okugeza kungasiza. Gwema ii-hot tubs, ii-whirlpools ezishisayo, nama-showers ashisa noma imithi yokugeza.

Zama ukungagqabi, njengoba lokho kungalimaza ilusu lakho futhi kukhulise ingozi yokutheleleka. Sebenzisa i-lotion ukuze ulusu lakho luhlale lunamafutha.

• Ukwenza umsebenzi womzimba. Ukwenza umsebenzi womzimba ophakathi, njengokuhamba, kungathuthukisa ukugeleza kwegazi lakho. Lokhu kusiza ekuqedeni ingozi yama-blood clots. Ukululama kwamagxathu nezinyawo kanye nokuzivocavoca nakho kungathuthukisa ukugeleza kwegazi lakho.
• Gwema utshaba. Ukusebenzisa utshaba kungabangela imithambo yegazi yakho ibe mncinci, kukhulise ingozi yokuhlasela kwenhliziyo noma isikhubekiso ngenxa yama-blood clots.
• Gwema izindawo ezingenasikhalazo esanele. Ukuphila emazingeni aphezulu, ukuski noma ukukhuphuka ezintabeni konke kunciphisa amazinga oksijini egazini lakho nakakhulu.
• Gcina ilusu lakho liphilile. Ukuze unciphise ukukhahlela, gcoba emanzini abandayo, sebenzisa i-cleanser ebushelelezi bese uthinta ilusu lakho liyome. Ukuhlanganisa i-starch, njenge-cornstarch, emanzini akho okugeza kungasiza. Gwema ii-hot tubs, ii-whirlpools ezishisayo, nama-showers ashisa noma imithi yokugeza.

Zama ukungagqabi, njengoba lokho kungalimaza ilusu lakho futhi kukhulise ingozi yokutheleleka. Sebenzisa i-lotion ukuze ulusu lakho luhlale lunamafutha.

• Gwema ukushisa okukhulu. Ukugeleza okubi kwegazi kukhulise ingozi yokulimalala ngenxa yokushisa okukhulu nobusika. Ngesikhathi esibandayo, gqoka izingubo ezifudumele njalo, ikakhulukazi ezandleni nasezinzweni. Ngesikhathi esishisayo, zivikele elangeni bese uphuza amanzi amaningi.
• Qaphela amaqhubu. Ukugeleza okubi kwegazi kungenza kube nzima ukwelapha amaqhubu, ikakhulukazi ezandleni nasezinzweni. Hlola izinyawo zakho njalo bese utshela udokotela wakho nganoma yimaphi amaqhubu.