Kuyini Ukufakelwa izinso ezivela kumuntu oshonile? Inhloso, Inqubo & Nemiphumela

Ukufakelwa izinso ezivela kumuntu oshonile kuyindlela yokuhlinzwa esindisa impilo lapho wamukela khona izinso ezinempilo ezivela kumuntu oshonile owayevumile ukunikela ngezitho zakhe. Le nqubo inikeza ithemba uma izinso zakho zingasakwazi ukuhlunga imfucuza kanye noketshezi oluningi egazini lakho ngempumelelo.

Uhambo luhlanganisa ukufaniswa ngokucophelela phakathi kwakho kanye nesinso somnikeli ukuze kuqinisekiswe umphumela ongcono kakhulu. Ngenkathi ukulinda isitho esifanele kungase kuzizwe kukhulu, ukuqonda inqubo kungakusiza ukuthi uzizwe ulungile futhi uzethembile ngale ndlela ebalulekile yokwelapha.

Kuyini ukufakelwa izinso ezivela kumuntu oshonile?

Ukufakelwa izinso ezivela kumuntu oshonile kuthatha indawo yesinso sakho esihlulekayo ngesinso esinempilo esivela kumuntu oshonile. Isinso somnikeli sivela kubantu abenza isinqumo esihle sokunikela ngezitho zabo ngemva kokufa, benikeza abanye ithuba lesibili ekuphileni.

Isinso sakho esisha sizobekwa esiswini sakho esingezansi, ngokuvamile ngakwesokudla. Ngokumangalisayo, izinso zakho ngokuvamile zihlala endaweni ngaphandle uma zibangela izinkinga ezithile. Isinso esifakelwe sixhuma emithanjeni yegazi eseduze nomchamo wakho, lapho siqala khona ukuhlunga igazi lakho futhi sikhiqize umchamo.

Lolu hlobo lokufakelwa lwahlukile ekufakweni kwezinso ezivela kumuntu ophilayo ngoba isinso sivela kumuntu oshonile. Isitho kumele silondolozwe ngokucophelela futhi sithuthwe ngokushesha ukuze sigcine umsebenzi waso kumamukeli.

Kungani kwenziwa ukufakelwa izinso ezivela kumuntu oshonile?

Udokotela wakho uncoma lokhu kufakelwa uma izinso zakho zingasakwazi ukukugcina uphilile ngokwazo. Isifo sezinso esiphelile sisho ukuthi izinso zakho zisebenza ngaphansi kuka-10% womthamo wazo ovamile, okwenza i-dialysis noma ukufakelwa kube yimpoqo ukuze usinde.

Izimo eziningana zingaholela kuleli phuzu, futhi ukuziqonda kuyasiza ukuchaza ukuthi kungani ukufakelwa kuba yindlela engcono kakhulu. Izizathu ezivame kakhulu zihlanganisa:

• Umonakalo wezinso ohlobene nesifo sikashukela (i-diabetic nephropathy)
• Umfutho wegazi ophezulu obangela ukulimala kwezinso
• Isifo sezinso se-Polycystic esinezinsu ezikhulisiwe, ezigcwele ama-cyst
• I-Glomerulonephritis, elimala amayunithi okuhlunga ezinso
• Izifo ze-Autoimmune njenge-lupus ezithinta ukusebenza kwezinso
• Izifo zezinso ezizuzwe ngemvelo ezikhona kusukela ekuzalweni
• Umonakalo wezinso ovela emithini noma ubuthi

Ukufakelwa okuphumelelayo kuvame ukuhlinzeka ngekhwalithi yempilo engcono kune-dialysis yesikhathi eside. Abantu abaningi bazizwa benamandla futhi bangabuyela emisebenzini abayijabulelayo ngaphambi kokuba isifo sezinso siqhubeke.

Yini inqubo yokufakelwa izinso zomnikeli oshonile?

Ukuhlinzwa kokufakelwa ngokuvamile kuthatha amahora angu-3 kuya kwangu-4 futhi kwenzeka njengenqubo ephuthumayo lapho izinso ezihambisanayo zitholakala. Uzothola i-anesthesia ejwayelekile, ngakho-ke uzobe ulele ngokuphelele ngesikhathi sokuhlinzwa.

Udkt wakho ohlinzayo wenza ukusikeka esiswini sakho esingezansi ukuze afinyelele endaweni lapho izinso zakho ezintsha zizobekwa khona. Le nqubo ihlanganisa izinyathelo eziningana eziqaphile ukuze kuqinisekiswe umphumela ongcono kakhulu:

1. Udkt ohlinzayo ubeka izinso zomnikeli esiswini sakho esingezansi kwesokudla
2. Imithambo yegazi evela ezinso ezintsha ixhunywa emithanjeni yakho yegazi ekhona
3. I-ureter yezinso (ithumbu elithwala umchamo) linamathiselwe esinyeni sakho
4. Udkt wakho ohlinzayo uhlola ukuxhumana ukuze aqinisekise ukuthi ukugeleza kwegazi okulungile
5. Ukusikeka kuvalwa ngemithungo noma iziqeshana

Izinso ezintsha zivame ukuqala ukukhiqiza umchamo ngokushesha, nakuba ngezinye izikhathi kuthatha izinsuku noma amasonto ukuthi ziqale ukusebenza ngokugcwele. Ithimba lakho lezokwelapha likuqapha eduze ngalesi sikhathi esibucayi ukuze liqinisekise ukuthi konke kusebenza kahle.

Ungalungela kanjani ukufakelwa izinso zomnikeli oshonile?

Ukulungiselela ukufakelwa amalungu kuhilela kokubili ukungena ohlwini lokulinda nokuhlala ulungele ucingo uma ithambo litholakala. Inqubo yokuhlola iqinisekisa ukuthi unempilo eyanele yokuhlinzwa futhi cishe uzohlomula ekufakelweni amalungu.

Ithimba lakho lokufakelwa amalungu lizokuqondisa ekuhlolweni okubanzi okuhlola impilo yakho yonke. Lesi sigaba sokulungiselela ngokuvamile sihlanganisa:

• Ukuhlolwa kwegazi ukuhlola ukusebenza kwamalungu kanye nesimo sokutheleleka
• Ukuhlolwa kwenhliziyo njenge-EKG ne-echocardiogram
• Ukuhlolwa kokusebenza kwamaphaphu kanye nemisebe ye-X yesifuba
• Ukuhlolwa komdlavuza okufanele iminyaka yakho
• Ukuhlolwa kwamazinyo ukukhomba noma yiziphi izifo
• Ukuhlolwa kwengqondo ukuhlola ukulungela
• Ukubonisana ngezimali mayelana nezindleko zokufakelwa amalungu

Uma usuqinisekisiwe, uzojoyina uhlu lokulinda lukazwelonke nge-United Network for Organ Sharing (UNOS). Hlala utholakala ngaso sonke isikhathi ngoba uzodinga ukuya esibhedlela kungakapheli amahora ngemuva kokuthola ucingo.

Gcina impilo yakho izinzile ngangokunokwenzeka ngenkathi ulindile. Qhubeka nokwelashwa kwe-dialysis, thatha imithi enqunyiwe, futhi ugcine ukudla okunempilo ukuze uqinisekise ukuthi usesimweni esingcono kakhulu sokuhlinzwa lapho ithuba lifika.

Ungazifunda kanjani imiphumela yakho yokufakelwa izinso?

Ngemuva kokufakelwa amalungu, ithimba lakho lezokwelapha liqapha ukuhlolwa kwegazi okuthile ukuhlola ukuthi izinso zakho ezintsha zisebenza kahle kangakanani. Isikhombi esibalulekile izinga lakho le-creatinine, okufanele lehle kakhulu uma kuqhathaniswa nangaphambi kokufakelwa amalungu lapho ukusebenza kwezinso zakho kuthuthuka.

Odokotela bakho balandela izilinganiso eziningana ezibalulekile ukuqinisekisa ukuthi ukufakelwa kwakho amalungu kuhlala kunempilo. Lokhu kuhlolwa kusiza ukuthola noma yiziphi izinkinga ekuqaleni lapho ziselashwa kakhulu:

• Amazinga e-Creatinine (kufanele abe ngu-0.6-1.2 mg/dL ezinso ezinempilo)
• I-Blood urea nitrogen (BUN) ekhombisa ukususwa kwemfucuza
• I-Glomerular filtration rate (GFR) elinganisa iphesenti lomsebenzi wezinso
• Amazinga amaprotheni ezivivinyweni zomchamo
• Amazinga emithi yokucindezela amasosha omzimba egazini lakho

Imiphumela ejwayelekile iyahlukahluka kumuntu nomuntu, futhi izinso zakho ezintsha zingase zingasebenzi ngendlela efana nezinso ezinempilo. Ithimba lakho lokufakelwa izitho lizochaza ukuthi yiziphi izinombolo ezifanele isimo sakho esithile futhi lilungise imithi ngokufanele.

Ungayigcina kanjani izinso zakho ezifakelwe?

Ukuvikela izinso zakho ezintsha kudinga ukuzibophezela ekuphileni konke emithini kanye nokukhetha indlela yokuphila enempilo. Isistimu yakho yokuzivikela emzimbeni ngokwemvelo ifuna ukulahla isitho esifakelwe, ngakho-ke imithi yokucindezela amasosha omzimba ibalulekile ukuvimbela lokhu kulahlwa.

Ukunatha imithi ngendlela eqondile njengoba kunqunywe yinto ebaluleke kakhulu ongayenza ngokuqondene nokufakelwa kwakho. Le mithi enamandla idinga ukuqapha ngokucophelela ngoba ithinta lonke uhlelo lwakho lokuzivikela emzimbeni:

• Imithi yokulwa nokulahla ethathwa ngezikhathi ezifanayo nsuku zonke
• Imithi yokwehlisa umfutho wegazi ukuvikela ukusebenza kwezinso
• Imithi yokuvimbela izifo nezifo zamathambo
• Ukuhlolwa kwegazi njalo ukuqapha amazinga emithi

Ukukhetha indlela yokuphila enempilo kusekela impumelelo yesikhathi eside yokufakelwa kwakho. Lokhu kufaka phakathi ukudla ukudla okunomsoco, ukuzivocavoca njalo njengoba kuvunywe udokotela wakho, ukugwema ukuchayeka ezifweni, nokuvikela isikhumba sakho ekulimaleni yilanga ngoba imithi yokucindezela amasosha omzimba ikhuphula ingozi yomdlavuza.

Yini umphumela ongcono kakhulu ngemva kokufakelwa izinso?

Umphumela ongcono kakhulu usho ukuthi izinso zakho ezintsha zisebenza kahle iminyaka eminingi, okukuvumela ukuthi uphile impilo esebenzayo, egcwalisayo. Abantu abaningi bazizwa bengcono kakhulu kunalokho ababenza ngayo ku-dialysis, benamandla amaningi nenkululeko emisebenzini yabo yansuku zonke.

Amanani empumelelo yokufakelwa izinso ezivela kubanikeli abashonile ayakhuthaza, nakuba imiphumela yomuntu ngamunye ihluka. Cishe u-95% wezinso ezifakelwe zisebenza kahle ngonyaka wokuqala, futhi cishe u-85% uqhubeka nokusebenza ngemva kweminyaka emihlanu.

Impumelelo yesikhathi eside incike ezintweni eziningana ezihlanganisa iminyaka yakho, impilo yonke, ukuthi uyilandela kahle kangakanani imiyalelo yezokwelapha, nokuthi inso yomnikeli ifana kangakanani nohlobo lwakho lwezicubu. Abantu abaningi babuyela emsebenzini, bahambe, bazivocavoce, futhi bajabulele imisebenzi okwakunzima ukuyenza ngesikhathi sokugula kwezinso okuthuthukile.

Ukunakekelwa okuvamile okulandelayo neqembu lakho lokufakelwa kusiza ukugcina le miphumela emihle. Ukutholwa kwangaphambi kwesikhathi nokwelashwa kwanoma yiziphi izinkinga kungavimbela izinkinga ezingathi sína futhi kusize ukulondoloza ukusebenza kwezinso zakho amashumi eminyaka.

Ziyini izici eziyingozi zezinkinga zokufakelwa izinso?

Izici eziningana zingakhuphula ingozi yakho yezinkinga ngemva kokufakelwa, nakuba eziningi zilawuleka ngokunakekelwa okufanele. Ukuqonda lezi zingozi kukusiza wena nethimba lakho lezokwelapha ukuthi nisebenzisane ukuze zinciphise izinkinga.

Ezinye izici eziyingozi awukwazi ukuzishintsha, kanti ezinye ziphendula ekushintsheni kwendlela yokuphila nasekuphathweni kwezokwelapha okucophelelayo. Izici eziyinhloko ezithinta imiphumela yokufakelwa zihlanganisa:

• Ubudala (abamukeli abadala babhekana namanani aphezulu ezinzima)
• Isifo sikashukela noma isifo senhliziyo esikhona ngaphambi kokufakelwa
• Ukufakelwa kwangaphambilini noma ukumpontshelwa igazi
• Amazinga aphezulu ama-antibodies egazini lakho
• Ukungalandeli imithi ngemva kokufakelwa
• Ukubhema noma ukusetshenziswa ngokweqile kotshwala
• Ukukhuluphala okuthinta ukululama kokuhlinzwa

Iqembu lakho lokufakelwa lihlolela lezi zici ngesikhathi senqubo yokuhlola futhi lisebenza nawe ukuze uthuthukise impilo yakho ngaphambi kokuhlinzwa. Izici eziningi eziyingozi zingathuthukiswa ngokushintsha indlela yokuphila, ukulungiswa kwemithi, noma ukwelashwa okwengeziwe kwezokwelapha.

Ingabe kungcono ukuba nokufakelwa izinso kunokuhlala ku-dialysis?

Kubantu abaningi abanesifo sezinso esiphelile, ukufakelwa izitho zomzimba kunikeza izinzuzo ezinkulu kune-dialysis yesikhathi eside. Ucwaningo lukhombisa njalo ukuthi abamukeli bokufakelwa izitho zomzimba bavame ukuphila isikhathi eside futhi bajabulele izinga elingcono lempilo kunalabo abahlala ku-dialysis.

Izinzuzo zidlulela ngale kwamanani okuphila. Abantu abaningi bathola ukuthi ukufakelwa izitho zomzimba kubenza bazizwe sengathi bangabona futhi, benamandla engeziwe kanye nemikhawulo emincane yokudla kunalokho okudingwa yi-dialysis.

Nokho, ukufakelwa izitho zomzimba akulungile kuwo wonke umuntu. Abanye abantu abanezifo zenhliziyo ezinzima, umdlavuza osebenzayo, noma ezinye izinkinga ezinkulu zempilo bangenza kangcono ngokuqhubeka ne-dialysis. Ithimba lakho lokufakelwa izitho zomzimba lihlolisisisa ukuthi kungenzeka yini ukuthi uzuze ekuhlinzweni kokufakelwa izitho zomzimba.

Isinqumo sihlanganisa ukulinganisa izingozi zokuhlinzwa ngokumelene nezinzuzo ezingaba khona. Ngenkathi ukufakelwa izitho zomzimba kudinga imithi yokucindezela amasosha omzimba yokuphila konke enezingozi zayo, abantu abaningi bathola ukuthi lokhu kushintshana kufanelekile ngoba kuthuthukisa izinga lempilo.

Ziyini izinkinga ezingaba khona zokufakelwa izinso?

Njenganoma yikuphi ukuhlinzwa okukhulu, ukufakelwa izinso kuthwala izingozi zesikhashana nezesikhathi eside. Ukuqonda lezi zinto ezingenzeka kukusiza ukuthi uqaphele izimpawu zokuxwayisa futhi ufune ukunakekelwa kwezokwelapha ngokushesha uma kudingeka.

Izinkinga zakuqala zingenzeka emasontweni ambalwa ngemuva kokuhlinzwa, ngenkathi ezinye izinkinga zingase zivele ezinyangeni noma eminyakeni eminingi kamuva. Nazi izinto ezinkulu ezikhathaza ithimba lakho lezokwelapha:

• Ukwenqatshwa okukhulu lapho amasosha akho omzimba ehlasela izinso ezintsha
• Ukutheleleka ngenxa yemithi yokucindezela amasosha omzimba
• Amaqhubu egazi emithanjeni yegazi yezinso
• Ukutheleleka emgudwini womchamo noma ukuvinjelwa
• Izinkinga zokuphola kwamanxeba endaweni yokuhlinzwa
• Imiphumela emibi evela emithini yokulwa nokwenqatshwa
• Ukwanda kwengozi yomdlavuza ngenxa yokucindezelwa kwamasosha omzimba
• Ukuqhubeka kwesifo senhliziyo nemithambo yegazi

Izinkinga eziningi ziyelapheka uma zitholwa ngesikhathi, yingakho ukuqokwa okulandelayo okuvamile kubaluleke kakhulu. Ithimba lakho lokufakelwa lilufundisa izimpawu zokuxwayisa okufanele uzibheke futhi linikeza imininingwane yokuxhumana amahora angama-24 ngezinkinga eziphuthumayo.

Izinkinga zesikhathi eside zingabandakanya ukwenqatshwa okungamahlalakhona, lapho izinso zilahlekelwa umsebenzi kancane kancane eminyakeni eminingi, noma imiphumela emibi yemithi efana nesifo samathambo noma ukwanda kwengozi yokutheleleka. Ukuqapha njalo kusiza ukuthola nokuphatha lezi zinkinga ngaphambi kokuba zibe zimbi.

Kufanele ngibone nini udokotela ngemva kokufakelwa izinso?

Kufanele uthinte ithimba lakho lokufakelwa ngokushesha uma uhlangabezana nanoma yiziphi izimpawu ezikhathazayo ngemva kokufakelwa kwakho. Ukunakekelwa kwezokwelapha okusheshayo kungavimbela izinkinga ezincane ukuthi zingabi yizinkinga ezinkulu.

Ezinye izimpawu zidinga ukuhlolwa kwezokwelapha okuphuthumayo ngoba zingase zikhombe ukwenqatshwa noma ukutheleleka okukhulu. Unganqikazi ukushayela umxhumanisi wakho wokufakelwa noma uye egumbini eliphuthumayo uma uqaphela:

• Umkhuhlane ongaphezu kuka-100.4°F (38°C) noma ama-chills
• Ukwehla komchamo noma izinguquko emibaleni yomchamo
• Ukuvuvukala emilenzeni, emaqakaleni, noma emehlweni
• Ukwanda kwesisindo okungachazeki (ngaphezu kwamaphawundi amathathu ezinsukwini ezi-2)
• Ubuhlungu noma ukuzwela ngaphezu kwendawo yokufakelwa
• Isicanucanu esibi, ukuhlanza, noma isifo sohudo
• Ukuphefumula kanzima noma ubuhlungu besifuba
• Ikhanda elibuhlungu elibuhlungu noma izinguquko embonweni

Ukuqokwa okuvamile okuhleliwe kubaluleke ngokulinganayo ekuqapheni impilo yokufakelwa kwakho. Lokhu kuvakasha ngokuvamile kwenzeka kaningi ekuqaleni, bese kancane kancane kusabalala njengoba ukululama kwakho kuqhubeka futhi izinso zakho ezintsha zihlala zizinzile.

Ithimba lakho lokufakelwa liba ngumlingani wakho wezokwelapha wesikhathi eside, ngakho-ke gcina ukuxhumana okuvulekile mayelana nanoma yiziphi izinkinga zempilo, imiphumela emibi yemithi, noma izinguquko endleleni ozizwa ngayo. Ukungenelela kwasekuqaleni kuvame ukuvimbela izinkinga ezincane ukuthi zingabi yizinkinga ezinkulu.

Imibuzo evame ukubuzwa mayelana nokufakelwa izinso komnikeli oshonile

Umb.1 Ingabe ukufakelwa izinso ezivela kumuntu oshonile kungcono kunokufakelwa izinso ezivela kumuntu ophilayo?

Izinso ezivela kumuntu ophilayo ngokuvamile zihlala isikhathi eside futhi zisebenza kangcono kunezinsu ezivela kumuntu oshonile, kodwa zombili lezi zinketho zingasindisa impilo. Izinso ezivela kumuntu ophilayo zivame ukuqala ukusebenza ngokushesha futhi zingase zisebenze iminyaka engama-20-25, kanti izinso ezivela kumuntu oshonile zisebenza iminyaka eyi-15-20.

Nokho, ukufakelwa izinso ezivela kumuntu oshonile kuseyindlela enhle uma abanikeli abaphilayo bengatholakali. Into ebaluleke kakhulu ukuthola ukufakelwa izinso kunohlobo oluthile lomnikeli, njengoba zombili zithuthukisa kakhulu ukusinda kanye nekhwalithi yempilo uma kuqhathaniswa ne-dialysis yesikhathi eside.

Umb.2 Ingabe ukulinda isikhathi eside ukuthola ukufakelwa izinso kuthinta imiphumela?

Izikhathi zokulinda ezinde zingathinta impumelelo yokufakelwa izinso, ikakhulukazi uma impilo yakho iba ngcono kakhulu ngenkathi ulindile. Abantu abathola ukufakelwa izinso ngaphambi kokuqala i-dialysis noma ngemva nje kokuqala i-dialysis bavame ukuba nemiphumela engcono kunalabo abalinda iminyaka eminingi.

Nokho, ukuthola izinso ezihambisana kahle nakho kubalulekile empumelelweni yesikhathi eside. Ithimba lakho lokufakelwa izinso lilawula lezi zinto lapho licabangela ukunikezwa kwezinso, ngezinye izikhathi lincoma ukulinda ukuthola okuhambisana kangcono uma impilo yakho ihlala izinzile.

Umb.3 Ngingaba nezingane ngemva kokufakelwa izinso?

Abesifazane abaningi baphumelela ekutholeni ukukhulelwa okunempilo ngemva kokufakelwa izinso, nakuba kudinga ukuhlelwa nokuqapha ngokucophelela. Kufanele ulinde okungenani unyaka owodwa ngemva kokufakelwa izinso ngaphambi kokukhulelwa ukuze uqinisekise ukuthi umsebenzi wakho wezinso uzinzile.

Ukukhulelwa ngemva kokufakelwa izinso kuthathwa njengengozi enkulu futhi kudinga ukunakekelwa okukhethekile okuvela eqenjini lakho lokufakelwa izinso kanye nochwepheshe bokukhulelwa okuyingozi enkulu. Eminye imithi yokucindezela amasosha omzimba ingase idinge ukulungiswa, futhi uzodinga ukuqapha kaningi ngesikhathi sokukhulelwa.

Umb.4 Ngingaphila isikhathi esingakanani ngenso efakelwe?

Abantu abaningi baphila iminyaka engu-20-30 noma ngaphezulu ngesitho sezinso esitshaliwe, kanti ezinye izinso zisebenza kahle iminyaka engaphezu kwengu-40. Umphumela wakho ngamunye uncike ezintweni ezinjengobudala bakho, impilo yonke, ukuthobela imithi, nokuthi umzimba wakho usamukela kanjani isinso esisha.

Ingxenye yezinso ezinikelwe ngabantu abashonile zisaqhubeka nokusebenza ngemva kweminyaka engu-15-20, kuyilapho abaningi abamukeli bephila impilo ejwayelekile ngezitho zabo ezitshaliwe. Intuthuko emithini yokucindezela amasosha omzimba nokunakekelwa kokutshala izitho zomzimba iyaqhubeka nokuthuthukisa imiphumela yesikhathi eside.

Q.5 Kwenzekani uma isinso sami esitshaliwe sehluleka?

Uma isinso sakho esitshaliwe sehluleka, ungaqhubeka nokwelashwa nge-dialysis futhi ungase uthole okunye ukutshalwa. Abantu abaningi bathola ngempumelelo ukutshalwa kwezinso okwesibili noma okwesithathu, nakuba ukutshalwa ngakunye okulandelayo kungase kube yinselele enkulu ngenxa yokwanda kwamazinga e-antibody.

Ithimba lakho lokutshala izitho zomzimba liqapha ukusebenza kwesinso sakho ngokucophelela ukuze lithole izinkinga ekuqaleni lapho ukwelashwa kungase kulondoloze ukusebenza isikhathi eside. Uma ukwehluleka kokutshala izitho zomzimba kungagwemeki, bazokusiza ukuthi ubuyele ku-dialysis futhi bakuhlole ukuthi uthole okunye ukutshalwa uma kufanelekile.