Ubuhlungu Bezihlunu Ezininzi

I-polymyalgia rheumatica yisifo esibangela ukuvuvukala okubangela ubuhlungu neqhubu ezihlangwini, ikakhulukazi emagxeni nasezinqeni. Izimpawu ze-polymyalgia rheumatica (pol-e-my-AL-juh rue-MAT-ih-kuh) ngokuvamile ziqala ngokushesha futhi zibi kakhulu ekuseni.

Abantu abaningi abathuthukisa i-polymyalgia rheumatica baneminyaka engaphezu kuka-65. Ayivame ukubathinta abantu abaneminyaka engaphansi kuka-50.

Lesi simo sihambisana nesimo esibangela ukuvuvukala esibizwa ngokuthi yi-giant cell arteritis. I-giant cell arteritis ingabangela izikhathi zokukhathazeka, ubunzima bobukhazikhazi, ubuhlungu emathanjeni nobuhlungu ezingutsheni. Kungenzeka ukuba nalezi zimo zombili ndawonye.

Izimpawu nezimpawu ze-polymyalgia rheumatica ngokuvamile zivela ngakwababili eceleni lomzimba futhi zingafaka:

• Ubuhlungu noma ubuhlungu emagxalabeni akho
• Ubuhlungu noma ubuhlungu entanyeni yakho, ezingalweni eziphezulu, emikhondweni, ezinqeni noma emilenzeni
• Ukuqina ezindaweni ezibuhlungu, ikakhulukazi ekuseni noma ngemuva kokungasebenzi isikhathi esithile
• Ukulinganiselwa kokunyakaza ezindaweni ezibuhlungu
• Ubuhlungu noma ukuqina ezinqenqemeni zakho, ezingalweni noma emadoyeni

Ungase futhi ube nezimpawu nezimpawu eziningi, kufaka phakathi:

• Ukuthuthumela okukhulu
• Ukukhathala
• Ukuzizwa okungekuhle (ukulahlekelwa amandla)
• Ukwehluleka ukudla
• Ukwehluleka kokukhulu kwesisindo okungahloseki
• Ukucindezeleka

Bona udokotela wakho uma unezinhlungu, ubuhlungu noma ukuqina okungaka:

• Okuyintsha
• Okuthinta ubuthongo bakho
• Okulinganiselwe ikhono lakho lokwenza imisebenzi yakho evamile, njengokugqoka

Imbangela eqondile ye-polymyalgia rheumatica ayaziwa. Kukhona izici ezimbili ezihlobene nokuthuthukiswa kwalesi simo:

• I-Genetics. Amanye ama-jini kanye nezinguquko zama-jini kungenzeka ukuba andise ukuthi ube sengozini.
• Ukudalulwa komkhathi. Izimo ezintsha ze-polymyalgia rheumatica zivame ukuza ngezikhathi, mhlawumbe zithuthuke ngezikhathi. Lokhu kusikisela ukuthi i-trigger yemvelo, njengoba yi-virus, ingase ibe nendima. Kodwa-ke akukho virus ethile eboniswe ukuthi ibangela i-polymyalgia rheumatica.

Izimbangela ezingozi ze-polymyalgia rheumatica zifaka phakathi:

• Ubudala. I-Polymyalgia rheumatica ihlukanisa abantu abadala kuphela. Ngokuvamile kwenzeka phakathi kweminyaka engama-70 nama-80.
• Ubulili. Abesifazane banethuba elingaphezulu kakhulu lokuthola leli gciwane, cishe kabili noma kathathu.
• Uhlanga. I-Polymyalgia rheumatica ivame kakhulu kubantu abamhlophe abantu bakubo bevela eScandinavia noma enyakatho yeYurophu.

Amasimptomu e-polymyalgia rheumatica angathinta kakhulu ikhono lakho lokwenza imisebenzi yansuku zonke, efana nalezi:

• Ukuphuma embhedeni, ukuvuka esihlalweni noma ukuphuma emotweni
• Ukulungisa izinwele zakho noma ukugeza
• Ukugqoka

Lezi zinkinga zingathinta impilo yakho, ukuxhumana nabantu, umsebenzi womzimba, ukulala nokuphila kahle ngokujwayelekile.

Ukuhlolwa komzimba, okuhlanganisa ukuhlolwa kwamaqakala nawemithambo yezinzwa, kanye nemiphumela yokuhlolwa kungasiza udokotela wakho ukuthi aqonde imbangela yobuhlungu bakho nokuqina. Phakathi kokuhlolwa, angase ahambise ikhanda lakho namagxa ngobumnene ukuhlola ukunyakaza kwakho.

Udokotela wakho angase ahlole kabusha ukuxilongwa kwakho njengoba ukwelashwa kwakho kuqhubeka. Abanye abantu abaqale banikezwe ukuxilongwa kwe-polymyalgia rheumatica kamuva bahlelwa kabusha njengabane-rheumatoid arthritis.

Izivivinyo udokotela wakho angase azincoma zihlanganisa:

Udokotela wakho uzakugcina elandela izimpawu nezimpawu ezingabonisa ukuqala kwe-giant cell arteritis. Xhumana nodokotela wakho ngokushesha uma unezinye zalezi zinto ezilandelayo:

Uma udokotela wakho enomuzwa wokuthi ungase ube ne-giant cell arteritis, cishe uzoyala ukwenziwa kwe-biopsy ye-artery kwenye yezitempile zakho. Le nqubo, eyenziwa ngaphansi kokwelashwa kwendawo, ihilela ukususa isampula encane ye-artery, bese ihlolwa ukuze kubonwe ukuvuvukala.

• Izivivinyo zegazi. Ngaphandle kokuhlola ukubalwa kwamagazi akho okuphelele, udokotela wakho uzobheka izibonakaliso ezimbili zokuvuvukala — i-erythrocyte sedimentation rate (sed rate) ne-C-reactive protein. Noma kunjalo, kwabanye abantu abane-polymyalgia rheumatica, lezi zivivinyo ziyajwayelekile noma ziphakeme kancane nje.

• Izivivinyo zokwenza izithombe. Ngokwanda, i-ultrasound isetshenziswa ukuhlukanisa i-polymyalgia rheumatica kwezinye izimo ezibangela izimpawu ezifanayo. I-MRI ingabuye ibonise ezinye izimbangela zobuhlungu ehlombe, njengokuguquka kwamaqakala.

• Izinhlungu zikhanda ezintsha, ezingavamile noma ezihlala njalo

• Ubuhlungu noma ubuhlungu emaxatheni

• Ukubona okuphazamisekile noma okubili noma ukulahleka kokubona

• Ubuhlungu besikhumba sekhanda

Ukwelapha kuvame ukubandakanya imithi ekusiza ukunciphisa izimpawu zakho. Ukubuyela kwesifo kuyinto evamile.

I-Corticosteroids. I-Polymyalgia rheumatica ivame ukwelashwa ngenani elincane le-corticosteroid yomlomo, njenge-prednisone (Rayos). Cishe uzoba nomuzwa wokukhululeka ebuhlungwini nasekuqinisweni phakathi kwezinsuku ezimbili noma ezintathu zokuqala.

Ngemva kwamasonto amabili kuya kwane okuqala kokwelashwa, udokotela wakho angaqala ukunciphisa kancane inani lemithi oyithathayo, kuye ngezimpawu zakho kanye nemiphumela yokuhlolwa kwegazi. Ngenxa yemiphumela emibi engenzeka, umgomo ukukugcina unenani elincane kangangokunokwenzeka ngaphandle kokubuyela kwesifo.

Abantu abaningi abane-polymyalgia rheumatica kudingeka baqhubeke nokwelashwa kwe-corticosteroid unyaka noma ngaphezulu. Uzodinga ukuvakashela udokotela wakho njalo ukuze uqaphele ukuthi ukwelashwa kusebenza kanjani nokuthi unemiphumela emibi yini.

Ukusetshenziswa kwe-corticosteroids isikhathi eside kungabangela imiphumela emibi emibi, kubandakanya ukwanda kobunzima, ukulahleka kwamathambo, ukucindezeleka kwegazi, isifo sikashukela kanye ne-cataracts. Udokotela wakho uzokulandela eduze ngenxa yezinkinga. Angase alungise inani lemithi oyithathayo futhi anikeze ukwelashwa kokuphatha ukusabela ekwelapheni kwe-corticosteroid.

Abantu abaningi abathatha i-corticosteroids ye-polymyalgia rheumatica babuyela emazingeni abo wangaphambili wemisebenzi. Kodwa-ke, uma uke waba nesikhathi eside sengqondo elinganiselwe, ungase uzuze ekuqeqeshweni komzimba. Xoxa nodokotela wakho mayelana nokuthi ukuqeqeshwa komzimba kuyindlela efanele yini kuwe.

• I-Corticosteroids. I-Polymyalgia rheumatica ivame ukwelashwa ngenani elincane le-corticosteroid yomlomo, njenge-prednisone (Rayos). Cishe uzoba nomuzwa wokukhululeka ebuhlungwini nasekuqinisweni phakathi kwezinsuku ezimbili noma ezintathu zokuqala.

  Ngemva kwamasonto amabili kuya kwane okuqala kokwelashwa, udokotela wakho angaqala ukunciphisa kancane inani lemithi oyithathayo, kuye ngezimpawu zakho kanye nemiphumela yokuhlolwa kwegazi. Ngenxa yemiphumela emibi engenzeka, umgomo ukukugcina unenani elincane kangangokunokwenzeka ngaphandle kokubuyela kwesifo.

  Abantu abaningi abane-polymyalgia rheumatica kudingeka baqhubeke nokwelashwa kwe-corticosteroid unyaka noma ngaphezulu. Uzodinga ukuvakashela udokotela wakho njalo ukuze uqaphele ukuthi ukwelashwa kusebenza kanjani nokuthi unemiphumela emibi yini.

  Ukusetshenziswa kwe-corticosteroids isikhathi eside kungabangela imiphumela emibi emibi, kubandakanya ukwanda kobunzima, ukulahleka kwamathambo, ukucindezeleka kwegazi, isifo sikashukela kanye ne-cataracts. Udokotela wakho uzokulandela eduze ngenxa yezinkinga. Angase alungise inani lemithi oyithathayo futhi anikeze ukwelashwa kokuphatha ukusabela ekwelapheni kwe-corticosteroid.

• I-Calcium ne-vitamin D. Udokotela wakho cishe uzokunikeza inani lemithi yansuku zonke ye-calcium ne-vitamin D ukuze usize ukuvimbela ukulahleka kwamathambo ngenxa yokwelashwa kwe-corticosteroid. I-American College of Rheumatology iphakamisa ama-milligrams angu-1,000 kuya ku-1,200 we-calcium supplements kanye nama-600 kuya ku-800 ama-international units we-vitamin D supplements kunoma ubani othatha i-corticosteroids izinyanga ezintathu noma ngaphezulu.

• I-Methotrexate. Iziqondiso ezihlangene ze-American College of Rheumatology ne-European League Against Rheumatism ziqondisa ukusetshenziswa kwe-methotrexate (Trexall) ne-corticosteroids kubanye abantu. Lena imithi ecindezela isimiso somzimba esithathwa ngomlomo. Kungase kube usizo ekuqaleni kokwelashwa noma kamuva, uma ubuyela esifweni noma ungaphenduli kwi-corticosteroids.

Imithi engaphezu kwekhauntara engasebenzi njenge-anti-inflammatory, njenge-ibuprofen (Advil, Motrin IB, nabanye) noma i-naproxen sodium (Aleve), ayivame ukunconywa ekuqedeni izimpawu ze-polymyalgia rheumatica.

Ukuphila impilo enempilo kungakusiza ukuphatha imiphumela emibi yokwelashwa kwe-corticosteroid:

• Dla ukudla okunempilo. Dla ukudla okunezithelo, imifino, ukudla okugcwele, namaprotheni amancane nama-dairy. Khawulela usawoti (i-sodium) ekudleni kwakho ukuvimbela ukwakheka kwamanzi kanye nokuphakama kwegazi.
• Zivocavoca njalo. Xoxa nodokotela wakho ngokuvocavoca okulungele wena ukuze ugcine isisindo esinempilo nokuqina amathambo nemisipha.
• Tholani ukuphumula okwanele. Ukuphumula kuyadingeka emzimbeni wakho ukuze uthole amandla ngemuva kokuzivocavoca nemisebenzi yansuku zonke.
• Sebenzisa amadivayisi asisiza. Cabanga ngokusebenzisa izikhwama nezinkwama zokuthengisa, izinto zokufinyelela, amabhaa okupaka eshawa, namanye amadivayisi asisiza ukuze kwenziwe kube lula imisebenzi yansuku zonke.