Ukuthi yini i-Polymyalgia Rheumatica? Izimpawu, Izimbangela, Nokwelashwa

I-Polymyalgia rheumatica yisimo sokuvuvukala esibangela ubuhlungu bemisipha nokuqina, ikakhulukazi eduze kwamahlombe akho, intamo, namathanga. Uma uneminyaka engaphezu kuka-50 futhi uvuka uzizwa sengathi ubethwe yiloli, ngokuqina okukhulu okwenza imisebenzi elula njengokwehluka embhedeni noma ukuphakamisa izandla kube nzima kakhulu, lesi simo singaba yilokho okubhekene nakho.

Igama ngokwalo lisho ukuthi "ubuhlungu bemisipha eminingi," futhi nakuba lizwakala liyesabekisa, empeleni yisimo esiqondakali kahle esiphendula ngokumangalisayo ekwelapheni. Abantu abaningi bazizwa bephilile kakhulu ezinsukwini ezimbalwa nje ngemuva kokuqala ukwelashwa okulungile, yize uhambo lokuphulukiswa ngokuphelele luthatha isineke nokuphathwa ngokucophelela.

Ukuthi yini i-Polymyalgia Rheumatica?

I-Polymyalgia rheumatica yisifo sokuvuvukala esithinta ikakhulu abantu abangaphezu kweminyaka engama-50, sibangela ubuhlungu bemisipha obunwabu nokuqina. Isistimu yakho yokuzikhusela iyihlasela ngephutha ithishu enempilo, okubangela ukuvuvukala ekuqaleni komthambo eduze kwamaqakala akho, ikakhulukazi emahlombe akho, intamo, namathanga.

Lokhu akuyona impela isifo semisipha, naphezu kwegama layo. Ubuhlungu nokuqina okukuzwayo kuvela ekuvuvukaleni eduze kwamaqakala akho nethishu ezizungezile. Cabanga ngakho njengesistimu yakho yokuzikhusela edideka futhi idala ukuvuvukala lapho kungafanele kube khona.

Lesi simo sithinta abesifazane kabili kunabesilisa, futhi sivame kakhulu kubantu baseYurophu yaseNyakatho. Nakuba kungazizwa kukhulu lapho izimpawu ziqala ukuvela, izindaba ezinhle ukuthi i-polymyalgia rheumatica iyakwelashwa kakhulu, futhi abantu abaningi bangabuyela emisebenzini yabo evamile ngokunakekelwa okulungile.

Ziyini Izimpawu ze-Polymyalgia Rheumatica?

Isimpawu esiyinhloko yukuqina okukhulu ekuseni okungagcina amahora amaningi, okwenza uzizwe sengathi umzimba wakho uvalwe ebusuku. Lokhu kuqina kuvame ukuthinta kokubili izinhlangothi zomzimba wakho ngokulinganayo, ikakhulukazi eduze kwamahlombe akho, intamo, namathanga.

Nawa izimpawu ezivamile ongazihlangabezana nazo:

• Ukuqina okukhulu ekuseni okugcina imizuzu engama-45 noma ngaphezulu
• Ubuhlungu obuhlungu emahlombe, entanyeni, nasesifundeni sethambo
• Ubunzima bokuphonsa izandla zakho ngaphezu kwekhanda lakho
• Ubunzima bokuphuma embhedeni noma ezihlalweni
• Ubuhlungu obuthinta kokubili izinhlangothi zomzimba wakho ngokulinganayo
• Ukukhathala okunzima kunokukhathala okuvamile
• Ukuvuvukala okuncane (ngokuvamile ngaphansi kuka-101°F)
• Ukulahlekelwa isisindo okungachazeki
• Ukuzizwa okuvamile kokungaphili kahle

Ukuqina kuvame ukuba yingxenye ecasulayo kakhulu ngoba kwenza imisebenzi elula njengokuhloba izinwele zakho, ukufinyelela into eshelfuni, noma ngisho nokugqoka ihembe kuzwakale kungenakwenzeka. Abantu abaningi bachaza ukuzizwa sengathi badala iminyaka engama-20 ebusuku.

Ezimweni ezithile, ungase uhlangabezane nezimpawu ezingavamile njengokuvuvukala ezandleni nasezinzweni zakho, noma ubuhlungu ezinhlungwini nasemaqakaleni akho. Lezi zimpawu ngezinye izikhathi zingenza ukuxilongwa kube nzima, kodwa zisengxenye yendlela efanayo yokuvuvukala.

Yini ebangela i-Polymyalgia Rheumatica?

Imbangela eqondile ye-polymyalgia rheumatica ayaziwa, kodwa abacwaningi bakholelwa ukuthi ivela ekuhlanganiseni kokuthambekela kwezakhiwo nezici zemvelo. Isistimu yakho yokuzikhusela ngokuyisisekelo iyadida futhi iqala ukuhlasela ithishu enempilo, idala ukuvuvukala okubangela izimpawu zakho.

Izici eziningi zingase zinikeze ukukhula kwalesi simo:

• Izici zezakhiwo - amajini athile akwenza ube sengozini enkulu
• Ukutheleleka okuvela kuma-virus noma amabhaktheriya okungase kuqalise impendulo yokuzivikela
• Izici zemvelo ezingaqondakali ngokuphelele okwamanje
• Ukuguquka okuhlobene nobudala ohlelweni lwakho lokuzivikela

Abacwaningi abathile bacabanga ukuthi ukutheleleka kungase kusebenze njengokuqalisa kubantu abasenesikhathi sokuthambekela kwesakhiwo lesi simo. Isistimu yakho yokuzikhusela iphendula ukulwa nokutheleleka, kodwa bese iyaqhubeka nokusebenza ngokweqile ngisho nangemva kokuba ukutheleleka sekudlulile.

Kubalulekile ukuqonda ukuthi lokhu akuyona into oyibangele noma obungayivimbela. Ukuhlanganiswa kwezici eholela ku-polymyalgia rheumatica kunciphile ngaphandle kokulawula kwakho, futhi asikho ubufakazi bokuthi ukukhetha indlela yokuphila kuhlanganyela ekukhuleni kwayo.

Nini Okufanele Ubheke Udokotela nge-Polymyalgia Rheumatica?

Kufanele ubheke udokotela wakho ngokushesha uma uhlangabezana nokuqina okukhulu ekuseni okugcina ngaphezu kwemizuzu engama-45, ikakhulukazi uma kuhambisana nobuhlungu bemisipha emahlombe akho, entanyeni, noma emathangeni. Ungalindi ukubona uma kuphulukana ngokwalo, njengoba ukwelashwa okusheshayo kungavimbela izinkinga futhi kukusize uzizwe ukhulu ngokushesha.

Funani ukunakekelwa kwezokwelapha uma unezimpawu zezesiluleko:

• Ukuqala ngokushesha kokuqina nobuhlungu obukhulu
• Ubunzima bokufeza imisebenzi yansuku zonke ngenxa yokuqina
• Izimpawu ezingaphuli ngezihlangu zokulwa nobuhlungu
• Ukukhathala okuhlupha umkhuba wakho ovamile
• Ukulahlekelwa isisindo okungachazeki noma ukuvuvukala okuncane

Kufanele ufunani ukunakekelwa kwezokwelapha ngokushesha uma uthuthukisa izinhlungu ezibuhlungu ngokushesha, izinkinga zobuso, noma ubuhlungu be-jaw ngenkathi uqamula. Lokhu kungaba izimpawu zesimo esihlobene esibizwa nge-giant cell arteritis, esidinga ukwelashwa okusheshayo ukuvimbela izinkinga ezinzima njengokulimala kobuso.

Khumbula, i-polymyalgia rheumatica ngokuvamile ithuthuka ngokushesha, ngokuvamile ezinsukwini ezimbalwa noma ezemva. Uma uhlangabezana nalezi zimpawu, thembela ezingqondweni zakho futhi ungangabazi ukufinyelela kunikezeli wakho wezokunakekelwa kwezempilo.

Ziyini Izici Zengozi ze-Polymyalgia Rheumatica?

Ubudala yiyona nto ebaluleke kakhulu yengozi, njengoba lesi simo sithinta abantu abangaphezu kweminyaka engama-50, ngeminyaka evamile yokuxilongwa ecishe ibe yiminyaka engama-70. Uma usesiqwini salo budala futhi uhlangabezana nezimpawu, kufanele uxoxe nodokotela wakho.

Izici eziningi zingandisa amathuba akho okukhula kwe-polymyalgia rheumatica:

• Ukuba neminyaka engaphezu kwengu-50 (into ebalulekile)
• Ukuba owesifazane (kabili kunabesilisa)
• Ukuba nozalo lwaseYurophu yaseNyakatho
• Ukuba namamaki athile ezakhiwo (HLA-DRB1 ne-HLA-DQB1)
• Ukuba nomlando womndeni waleli simo
• Ukutheleleka kwamuva kwama-virus noma amabhaktheriya

Nakuba ungakwazi ukushintsha lezi zici zengozi, ukuziqonda kungakusiza wena nodokotela wakho ukuba niqonde lesi simo ngokushesha uma izimpawu zivele. Ingxenye yezakhiwo isikisela ukuthi uma unezilwane zomndeni ezinale polymyalgia rheumatica, ungase ube nengozi encane.

Kufanele kuphawulwe ukuthi ukuba nalezi zici zengozi akusho ukuthi uzokuthuthukisa ngokuqinisekile lesi simo. Abantu abaningi abanazo izici eziningi zengozi abazange bahlangabezane ne-polymyalgia rheumatica, kanti abanye abanazo izici ezimbalwa zengozi bayithuthukisa.

Ziyini Izinkinga Ezingase Zivele ze-Polymyalgia Rheumatica?

Abantu abaningi abane-polymyalgia rheumatica bayaphulukiswa ngokuphelele ngokwelashwa okulungile, kodwa kunezinkinga ezingase zivele okufanele uzazi. Ukukhathazeka okukhulu yilokhu ukuthuthukiswa kwe-giant cell arteritis, isimo esihlobene esingabangela ukulahlekelwa kobuso uma singelashwa ngokushesha.

Nawa izinkinga eziyinhloko ezingase zenzeke:

• I-Giant cell arteritis (ithinta i-15-20% yabantu abane-polymyalgia rheumatica)
• Imiphumela emibi yokusetshenziswa kwama-steroid isikhathi eside
• Ukuqina kwamathanga (osteoporosis) kusuka ku-prednisone
• Ukungena engozini enkulu yokutheleleka
• Ukuzuza isisindo nokushintsha kwemizwelo
• Ukuphindaphindiwe kwegazi nokushintsha kwegazi
• Ubuthakathaka bemisipha ovela ekungasebenzi isikhathi eside

I-Giant cell arteritis yiyona nkinga ephambili ngoba ingathinta imithambo yegazi enikeza amehlo akho nobuchopho bakho. Uma uthuthukisa izinhlungu ezibuhlungu, ukushintsha kobuso, noma ubuhlungu be-jaw ngenkathi uqamula, xhumana nodokotela wakho ngokushesha.

Izindaba ezinhle ukuthi izinkinga eziningi ezivela ekwelapheni ziyaphathwa ngokubeka iliso ngokucophelela nokwenza izinguquko ekwelapheni kwakho. Udokotela wakho uzohlangana nawe ukuthola inani eliphansi le-medication futhi angase anikeze ukwelashwa okwengeziwe ukuvikela amathambo akho nempilo yakho jikelele.

I-Polymyalgia Rheumatica Ixilongwa Kanjani?

Alukho uvivinyo olulodwa olungaxilonga ngokuqinisekile i-polymyalgia rheumatica, ngakho udokotela wakho uzohlanganisa izimpawu zakho, ukuhlolwa komzimba, nezivivinyo zegazi ukwenza ukuxilongwa. Inqubo ngokuvamile ihilela ukukhipha ezinye izimo ezingabangela izimpawu ezifanayo.

Udokotela wakho ngokuvamile uzoqala ngokubuza imibuzo eningiliziwe mayelana nezimpawu zakho, ikakhulukazi egxile esimweni sokuqina nobuhlungu. Uzothanda ukwazi ukuthi izimpawu zaqala nini, ukuthi ukuqina ekuseni kugcina isikhathi esingakanani, nezindawo zomzimba wakho ezithintekayo.

Inqubo yokuxilongwa ngokuvamile ihlanganisa lezi zinyathelo:

• Ukuhlolwa komzimba ukuhlola ukunyakaza nobuhlungu
• Izivivinyo zegazi ukuhlola ukuvuvukala (mazinga e-ESR ne-CRP)
• Izivivinyo zegazi ukuqeda ezinye izimo (isici se-rheumatoid, ama-anti-CCP antibodies)
• Ngezinye izikhathi izifundo zokwenza izithombe njenge-ultrasound noma i-MRI
• Impendulo ekwelapheni kwe-steroid (ngokuvamile kusiza ukuqinisekisa ukuxilongwa)

Izivivinyo zegazi kubaluleke kakhulu ngoba ngokuvamile zibonisa amamaki okuvuvukala aphezulu. Izinga lokuncibilika kwama-erythrocyte (ESR) nama-C-reactive protein (CRP) ngokuvamile aphezulu kakhulu kunokujwayelekile, okubonisa ukuvuvukala emzimbeni wakho.

Ngezinye izikhathi, udokotela wakho angase aphakamise ukuzama i-prednisone enani eliphansi (i-steroid medication). Uma une-polymyalgia rheumatica, ngokuvamile uzizwa ukhulu kakhulu ezinsukwini ezimbalwa ngemuva kokuqala ukwelashwa, okusisiza ukuqinisekisa ukuxilongwa.

Ukwelashwa kwe-Polymyalgia Rheumatica yini?

Ukwelashwa okuyinhloko kwe-polymyalgia rheumatica yi-corticosteroids, ngokuvamile i-prednisone, engase inikeze usizo olukhulu ekuphulukiseni izimpawu. Abantu abaningi bazizwa bephilile kakhulu phakathi kwamahora angu-24 kuya kwangu-72 ngemuva kokuqala ukwelashwa, abaningi bachaza lokhu njengokubuyela ekuphileni kwabo.

Uhlelo lwakho lokwelashwa ngokuvamile luzolandela le ndlela:

• Inani lokuqala le-prednisone (ngokuvamile i-15-20 mg nsuku zonke)
• Ukuncipha kancane kwamanani eminyaka engu-12-24
• Ukubeka iliso njalo ezimpawu nasezivivinyweni zegazi
• Imithi yokuvikela amathambo (ikhalsiyam, i-vitamin D, mhlawumbe ama-bisphosphonates)
• Ukuvakashela njalo ukuze kulungiswe ukwelashwa

Ukuphumelela ekwelapheni yilokhu ukuthola ibhalansi efanele phakathi kokulawula izimpawu zakho nokunciphisa imiphumela emibi yemithi. Udokotela wakho uzohlangana nawe ukunciphisa kancane inani le-prednisone ngenkathi ubeka iliso ezimpawu zakho namamaki okuvuvukala.

Abanye abantu bangase badinge imithi eyengeziwe njenge-methotrexate noma i-tocilizumab uma benenkinga yokunciphisa i-prednisone noma behlangabezana ne-flares njalo. Le mithi ingasiza ukunciphisa inani le-prednisone edingekayo futhi ingase isize ukuvimbela ukubuyela kwesimpo.

Isikhathi esiphelele sokwelashwa sihlukahlukene, kodwa abantu abaningi badinga ukuthatha uhlobo oluthile lwemithi iminyaka engu-1-2. Cishe ingxenye yabantu ingayekisa ukwelashwa ngokuphelele ngemuva kwalesi sikhathi, kanti abanye bangase badinge ukwelashwa okuncane kokugcina isikhathi eside.

Ungazinakekela Kanjani Ngesikhathi Sokwelashwa?

Nakuba imithi iyisisekelo sokwelashwa, kunezinto eziningi ongazenza ekhaya ukuze usekele ukuphulukiswa kwakho futhi unciphise imiphumela emibi. Ukusebenza ngaphakathi kwemingcele yakho nokugcina imikhuba emihle yempilo jikelele kungenza umehluko omkhulu endleleni ozizwa ngayo.

Nawa amasu abalulekile okuzinakekela okufanele uwacabangele:

• Ukuzivocavoca okulula njengokuhamba noma ukubhukuda ukuze ugcine amandla
• Ukuzivocavoca ukuze uthuthukise ukuqina nokunciphisa ukuqina
• Ukudla ukudla okunama-calcium amaningi ukuvikela amathambo akho
• Ukuthola ukulala okwanele nokuphatha ukucindezeleka
• Ukuthatha imithi ngokuqondile njengoba kulotshwe
• Ukubeka iliso ezimpawu zakho nokubika izinguquko kudoctor wakho
• Ukuzivikela ekuthelelekeni ngenkathi usebenzisa ama-steroid

Ukuzivocavoca kubaluleke kakhulu ngoba kusiza ukugcina amandla akho emisipha nokuqina kwamathanga ngenkathi uthatha i-prednisone. Qala kancane futhi wandise kancane amazinga akho okuzivocavoca njengoba izimpawu zakho ziphulukana futhi udokotela wakho avume.

Phatha izimpawu zomzimba wakho futhi ungaphuli ubuhlungu obukhulu, kodwa ungavumeli ukwesaba ubuhlungu kukugcine ungasebenzi nhlobo. Abantu abaningi bathola ukuthi ukuhamba okulula empeleni kusiza ukunciphisa ukuqina nobuhlungu ngokuhamba kwesikhathi.

Kufanele Uzilungiselele Kanjani Ukuvakashela Udokotela Wakho?

Ukulungiselela ukuvakashela udokotela wakho kungasiza ukuqinisekisa ukuthi uthola ukuxilongwa okuchane kakhulu nehlelo lokwelashwa eliphumelelayo. Ukuletha ulwazi oluqondile mayelana nezimpawu zakho nomlando wezokwelapha kuzosiza udokotela wakho ukuqonda isimo sakho kangcono.

Ngaphambi kokuqokwa kwakho, butha lolu lwazi oluqondile:

• Incazelo eningiliziwe yezimpawu zakho, kufaka phakathi ukuthi zaqala nini
• Uhlu lwemithi yonke nezinhlanganisela ozithathayo
• Ulwazi mayelana nezifo zakamuva noma ukutheleleka
• Umlando womndeni wezimo zokuvuvukala noma zokuvuvukala
• Imibuzo mayelana nezinketho zokwelashwa nokuthi yini okulindelekile
• Nazo zonke iziphumo zezivivinyo zegazi noma amarekhodi ezempilo

Kungaba usizo ukugcina idayari yesimpawu izinsuku ezimbalwa ngaphambi kokuqokwa kwakho, uqaphele ukuthi ukuqina kubi nini, yimiphi imisebenzi enzima, nokuthi izimpawu zishintsha kanjani usuku lonke. Lolu lwazi lungase lunikeze izinkomba eziyigugu kudoctor wakho.

Ungangabazi ukuletha ilungu lomndeni noma umngani ekuqokweni, ikakhulukazi uma uzizwa ukhulu ngezimpawu. Bangakusiza ukukhumbula ulwazi oluqondile futhi banikeze ukwesekwa ngesikhathi esingase sibe yisikhathi esicindezelayo.

Iyini into ebaluleke kakhulu mayelana ne-Polymyalgia Rheumatica?

I-Polymyalgia rheumatica yisimo esiphatheka kakhulu esingase sibe sesabekayo futhi sibuthakathaka ekuqaleni, kodwa siphendula ngokumangalisayo ekwelapheni okulungile. Into ebaluleke kakhulu okumele uyikhumbule ukuthi ukuxilongwa okusheshayo nokwelashwa kungakusiza ukubuyela emisebenzini yakho evamile ngokushesha.

Ngokunakekelwa kwezokwelapha okulungile, abantu abaningi bazizwa bephilile kakhulu ezinsukwini ezimbalwa ngemuva kokuqala ukwelashwa. Nakuba inkambo ephelele yokwelashwa ingathatha iminyaka engu-1-2, abantu abaningi bakwazi ukugcina impilo esebenzayo, ezele ngesikhathi sonke.

Ukuphumelela kuyilokhu ukusebenzisana eduze neqembu lakho lokunakekelwa kwezempilo, ukuthatha imithi njengoba kulotshwe, nokuba nesineke ngenqubo yokunciphisa kancane. Khumbula ukuthi lesi simo sinomphumela omuhle, futhi abantu abaningi bayaphulukiswa ngokuphelele ngaphandle kwemiphumela ehlala njalo.

Imibuzo Evamile Ebuzwayo Mayelana ne-Polymyalgia Rheumatica

Ingabe i-polymyalgia rheumatica ingabuya ngemuva kokwelashwa?

Yebo, i-polymyalgia rheumatica ingabuya kwabanye abantu, ikakhulukazi uma imithi iyeka ngokushesha kakhulu. Cishe i-25% yabantu ihlangabezana nokubuyela kwesimpo ngesikhathi esithile, kodwa lokhu akusho ukuthi isimo siyaphuka. Uma izimpawu zibuyela, udokotela wakho angalungisa uhlelo lwakho lokwelashwa, futhi ngokuvamile uzizwa ukhulu futhi ngokushesha ngemithi ephindwe noma engezwe.

Ingabe ngizoba kuma-steroid kuze kube phakade?

Abantu abaningi abadingi ama-steroid kuze kube phakade, yize inqubo yokunciphisa kancane ithola isikhathi nesineke. Isikhathi sokwelashwa esivamile yiminyaka engu-1-2, ngokunciphisa kancane. Cishe ingxenye yabantu ingayekisa ukwelashwa ngokuphelele, kanti abanye bangase badinge amanani amancane kakhulu okugcina isikhathi eside. Udokotela wakho uzohlangana nawe ukuthola inani eliphansi eliphumelelayo futhi ekugcineni akuyeke ngokuphelele uma kungenzeka.

Ingabe i-polymyalgia rheumatica ihlobene ne-rheumatoid arthritis?

Nakuba kokubili kuyizimo zokuvuvukala, i-polymyalgia rheumatica ne-rheumatoid arthritis ziyizifo ezahlukene ezinimbangela nokwelashwa okuhlukile. I-Polymyalgia rheumatica ngokuvamile ithonya abantu abangaphezu kweminyaka engama-50 futhi iphendula kahle kuma-steroid, kanti i-rheumatoid arthritis ingase ivela kunoma yimiphi iminyaka futhi ngokuvamile idinga imithi ehlukile. Noma kunjalo, ukuhlukanisa phakathi kwabo ngezinye izikhathi kudinga ukuhlolwa ngokucophelela ngudokotela wakho.

Ingabe ukuzivocavoca kungenza i-polymyalgia rheumatica ibe mbi?

Ukuzivocavoca okulula ngokuvamile kusiza kunokulimaza, kodwa kubalulekile ukuqala kancane futhi ulalele umzimba wakho. Uma izimpawu zakho zilawulwa ngemithi, imisebenzi evamile ephansi njengokuhamba, ukubhukuda, noma ukuzivocavoca okulula kungasiza ukugcina amandla akho nokuqina. Gwema imisebenzi ephakeme noma enzima kuze kube yilapho udokotela wakho ekunikeza imvume, futhi uhlale uyeka uma uhlangabezana nobuhlungu noma ukukhathala okwandayo.

Kufanele ngenze ini uma ngicabanga ukuthi nginawo imiphumela emibi evela ku-prednisone?

Xhumana nodokotela wakho uma uhlangabezana nemiphumela emibi ecasulayo evela ku-prednisone, kodwa ungayeki ukuthatha imithi ngokuzumayo ngaphandle kwesiqondiso sezokwelapha. Imiphumela emibi evamile ihlanganisa ukwanda kokudla, ukushintsha kwemizwelo, ubunzima bokuphumula, nokukhuphuka kokutheleleka. Udokotela wakho angakusiza ukuphatha le miphumela futhi angase alungise inani lakho noma engeze imithi yokuvikela njenge-calcium ne-vitamin D yempilo yamathambo.