Yini i-Implantable Cardioverter Defibrillator (ICD)? Injongo, Inqubo & Imiphumela

I-implantable cardioverter defibrillator (ICD) iyithuluzi elincane likagesi elibekwa ngaphansi kwesikhumba sakho ukuqapha ukushaya kwenhliziyo yakho futhi linikeze ukushaqeka okusindisa impilo uma kudingeka. Cabanga ngayo njengomqaphi wakho siqu oqapha inhliziyo yakho 24/7, olungele ukungenelela uma kwenzeka ukushaya okuyingozi. Leli thuluzi elihlaba umxhwele lisize izigidi zabantu ukuthi ziphile impilo egcwele, enokuzethemba ngaphandle kokuba nezifo zenhliziyo ezibabeka engozini yokufa kungazelelwe ngenxa yenhliziyo.

Yini i-implantable cardioverter defibrillator?

I-ICD iyithuluzi elisebenza ngebhethri elingangosayizi wefoni encane ephathekayo elibekwa ngokuhlinzwa ngaphansi kwesikhumba eduze kwethambo lakho lekhola. Lixhumeka enhliziyweni yakho ngocingo oluncane, oluguquguqukayo olubizwa ngokuthi ama-lead aqapha ngokuqhubekayo umsebenzi kagesi wenhliziyo yakho. Uma leli thuluzi lithola ukushaya kwenhliziyo okuyingozi, linganikeza izinhlobo ezahlukene zokwelashwa kusukela ekushayeni okumnene kuya ekushaqekeni kukagesi okusindisa impilo.

Leli thuluzi lisebenza ngokuhlaziya njalo amaphethini okushaya kwenhliziyo yakho. Uma lizwa i-ventricular tachycardia (ukushaya kwenhliziyo okusheshayo kakhulu) noma i-ventricular fibrillation (ukushaya kwenhliziyo okungahlelekile, okungasebenzi kahle), lisabela ngokushesha. Lezi zimo zingabangela ukuthi inhliziyo yakho iyeke ukumpompa igazi ngempumelelo, yingakho ukusabela okusheshayo kwe-ICD kubaluleke kakhulu ekusindeni kwakho.

Ama-ICD anamuhla athuthuke kakhulu futhi angahlelwa ngokuqondile ngezidingo zenhliziyo yakho. Udokotela wakho angashintsha izilungiselelo ukude futhi athole ngisho nedatha mayelana nomsebenzi wenhliziyo yakho phakathi nokuhlolwa emtholampilo. Lobu buchwepheshe buvumela ukunakekelwa komuntu siqu okuguquguqukayo ngendlela isimo sakho esishintsha ngayo ngokuhamba kwesikhathi.

Kungani kwenziwa i-implantable cardioverter defibrillator?

Odokotela batusa ama-ICD kubantu abasinde ekumeni kwenhliziyo kungazelelwe noma abasengozini enkulu yezigqi zenhliziyo ezisongela impilo. Umgomo oyinhloko ukuvimbela ukufa kwenhliziyo kungazelelwe, okungenzeka lapho uhlelo lukagesi lwenhliziyo yakho lungasebenzi kahle futhi luyeka ukumpompa igazi ngempumelelo. Ungase ube ngumuntu okufanele uma usuvele uhlangabezane ne-ventricular tachycardia noma i-ventricular fibrillation, noma uma ukusebenza kwenhliziyo yakho kuncishiswe kakhulu.

Izimo eziningana zenhliziyo zikwenza ukuthi udinge i-ICD. I-Cardiomyopathy, lapho imisipha yenhliziyo yakho iba buthakathaka noma ikhule, ingenye yezizathu ezivame kakhulu. Iziguli ezinenhliziyo ehlulekayo ezinomphumela wokukhipha ngaphansi kuka-35% naphezu kokwelashwa okungcono kakhulu kwemithi zivame ukuzuza ekuvikelweni kwe-ICD. Ukuhlaselwa kwenhliziyo kwangaphambilini kungashiya izicubu ezinamanxeba ezenza ukungazinzi kukagesi, okwenza amathuba okuthi izigqi eziyingozi zenzeke.

Abanye abantu bazuza izimo zofuzo ezibabeka engozini yokufa kwenhliziyo kungazelelwe. I-Hypertrophic cardiomyopathy, i-arrhythmogenic right ventricular cardiomyopathy, kanye nezifo ezithile zesiteshi se-ion konke kungakhuphula ingozi yakho kakhulu. I-Long QT syndrome ne-Brugada syndrome yizibonelo zezimo ezizuzwe ngofuzo lapho ama-ICD enikeza ukuvikelwa okubalulekile, ngisho nasezigulini ezincane.

Izizathu ezingavamile kodwa ezibalulekile zihlanganisa i-cardiac sarcoidosis, lapho amaseli okuvuvukala ethinta uhlelo lukagesi lwenhliziyo yakho. Isifo sikaChagas, imithi ethile, kanye nokungalingani okukhulu kwe-electrolyte nakho kungadala izimo lapho i-ICD iba yimfuneko. Udokotela wakho uzocabangela impilo yakho yonke, isikhathi sokuphila, kanye nekhwalithi yempilo lapho enza le ncomo.

Yini inqubo ye-implantable cardioverter defibrillator?

Ukufakwa kwe-ICD kuvame ukwenziwa njengenqubo yosuku olulodwa e-electrophysiology lab noma ku-cardiac catheterization suite yesibhedlela. Uzothola i-conscious sedation, okusho ukuthi uzobe ukhululekile futhi uzizwa kahle kodwa awuzukuba ngaphandle kwengqondo ngokuphelele. Le nqubo ivame ukuthatha amahora angu-1-3, kuye ngobunzima becala lakho nokuthi ngabe udinga ezinye izintambo noma izinqubo.

Udokotela wakho uzokwenza ukusikeka okuncane, ngokuvamile ngakwesobunxele ngaphansi kwe-collarbone yakho, futhi enze iphakethe ngaphansi kwesikhumba sakho ukuze libambe i-ICD. Izintambo zibe sezifakwa ngokucophelela ngemithambo yegazi zize zifike enhliziyweni yakho kusetshenziswa isiqondiso se-X-ray. Le nqubo idinga ukunemba ngoba izintambo kumele zibekwe ngendlela efanele ukuze zizwe umsebenzi kagesi wenhliziyo yakho futhi zilethe ukwelashwa ngempumelelo.

Uma izintambo sezikhona, udokotela wakho uzohlola uhlelo ukuze aqiniseke ukuthi konke kusebenza kahle. Lokhu kufaka phakathi ukuhlola ukuthi idivayisi ingakwazi yini ukuzwa ukushaya kwenhliziyo yakho ngendlela efanele futhi ilethe ukwelashwa okufanele. I-ICD ibe isibekwa ephaketheni ngaphansi kwesikhumba sakho, futhi ukusikeka kuvalwa ngama-sutures noma i-glue yokuhlinza.

Ngemuva kwenqubo, uzoqashwa amahora amaningana ukuze kuqinisekiswe ukuthi azikho izinkinga ngokushesha. Abantu abaningi bangahamba ngosuku olufanayo, yize abanye kungadingeka ukuthi bahlale ubusuku bonke ukuze babukwe. Udokotela wakho uzohlela i-aphoyintimenti yokulandela ngemva kwamasonto ambalwa ukuze ahlole ukuthi ululama kanjani futhi enze noma yiziphi izinguquko ezidingekayo kuzilungiselelo zedivayisi yakho.

Ungalungela kanjani inqubo yakho ye-implantable cardioverter defibrillator?

Ukulungiselela ukufakwa kwe-ICD yakho kuqala ngengxoxo ephelele nethimba lakho lezokwelapha mayelana nokuthi yini ongayilindela. Kuzodingeka uyeke ukudla nokuphuza okungenani amahora angu-8 ngaphambi kwenqubo, okufana nokulungiselela ezinye izinqubo zokuhlinza. Udokotela wakho uzobuyekeza yonke imithi yakho futhi angakucela ukuthi uyeke ama-blood thinners athile noma ulungise eminye imithi ngaphambi kokuhlinzwa.

Yazisa ithimba lakho lezempilo nganoma yikuphi ukungezwani komzimba onakho, ikakhulukazi emithini, imibala ehlukile, noma ilatex. Uma unesifo sikashukela, uzothola imiyalelo ethile mayelana nokuphatha ushukela wakho wegazi ngaphambi nangemva kwenqubo. Udokotela wakho uzofuna ukwazi mayelana nanoma yiziphi izifo zakamuva, njengoba izifo zingase zibe nzima inqubo yokuphola.

Hlela isikhathi sakho sokululama ngokuhlela ukuthi othile akuqhubele ekhaya ngemva kwenqubo. Uzodinga usizo ngemisebenzi yansuku zonke ezinsukwini ezimbalwa zokuqala, ikakhulukazi noma yini edinga ukuphakamisa ingalo yakho ohlangothini lapho i-ICD ibekwe khona. Gcina izingubo ezikhululekile, ezikhululekile ezingabeki ingcindezi endaweni yokusika.

Qiniseka ukuthi uqonda imikhawulo ngemva kwenqubo, evame ukuhlanganisa ukugwema ukuphakamisa okunzima nokunyakaza kwengalo okunamandla amasonto angu-4-6. Udokotela wakho uzohlinzeka ngemihlahlandlela ethile mayelana nokuthi ungalibuyela nini emsebenzini, ukuqhuba, futhi uqale kabusha imisebenzi ejwayelekile. Ukuba nethemba eliqotho mayelana nenqubo yokululama kuzokusiza ukuthi uphole ngokunethezeka.

Ungazifunda kanjani imiphumela yakho ye-implantable cardioverter defibrillator?

Ukuqonda umsebenzi we-ICD yakho kuhilela ukufunda ngezinhlobo ezahlukene zokungenelela engakuhlinzeka nokuthi idatha isho ukuthini ngempilo yakho. Idivayisi yakho igcina imininingwane enemininingwane mayelana nokushaya kwenhliziyo yakho, noma yiziphi izindlela zokwelapha ezinikeziwe, nokuthi inhliziyo yakho yaphendula kanjani. Le datha ibuyekezwa ngesikhathi sokuqokwa okulandelayo njalo, ngokuvamile njalo emavikini angu-3-6.

Into ebaluleke kakhulu okufanele uyiqonde ukuthi i-ICD yakho iletha amazinga ahlukene okwelapha ngokusekelwe kulokho okudingwa yinhliziyo yakho. Ukuhamba nge-anti-tachycardia (ATP) kuhilela ukushaya okusheshayo, okungabuhlungu okungavame ukumisa ukushaya kwenhliziyo okusheshayo ngaphandle kokuthi uzwe lutho. I-Cardioversion iletha ukushaqeka okulinganiselwe ozokuzwa kodwa akunamandla njengokukhishwa kwe-defibrillation. I-Defibrillation iyindlela yokwelapha enamandla kakhulu, eyenzelwe ukumisa ukushaya okuyingozi kakhulu.

Umbiko wakho wedivayisi uzokhombisa ukuthi lezi zindlela zokwelapha bezidingeka kangakanani nokuthi beziphumelele yini. Ama-shocks afanele asho ukuthi i-ICD yakho iqaphele futhi yelapha kahle isigqi esiyingozi. Ama-shocks angafanele enzeka lapho idivayisi ihumusha kabi isigqi esivamile noma esingesiyingozi esisheshayo njengesisongelo, okungenzeka kodwa akuvamile ngamadivayisi anamuhla.

Ukuqapha okukude kuvumela udokotela wakho ukuthi ahlolisise ukusebenza kwedivayisi yakho nomsebenzi wenhliziyo yakho phakathi nokuhlolwa emtholampilo. Lobu buchwepheshe bungathola izinkinga kusenesikhathi futhi busize ithimba lakho lezokwelapha ukuthi lenze izinguquko ukuze lithuthukise ukunakekelwa kwakho. Uzoqeqeshwa ukuthi uqaphele nini lapho idivayisi yakho ilethe ukwelashwa nokuthi ungaxhumana nini nomhlinzeki wakho wezempilo.

Ungaphila kanjani nesiqapha senhliziyo esifakelwayo?

Ukuphila ne-ICD kudinga ezinye izilungiso, kodwa abantu abaningi babuyela ezimpilweni ezisebenzayo, ezigcwalisayo ezinyangeni ezimbalwa ngemva kokufakelwa. Okubalulekile ukuqonda ukuthi yimiphi imisebenzi ephephile nokuthi yiziphi izinyathelo zokuphepha okudingeka uzithathe. Udokotela wakho uzohlinzeka ngemihlahlandlela ethile esekelwe esimweni sakho ngasinye, kodwa imithetho ejwayelekile isebenza ezigulini eziningi ze-ICD.

Umsebenzi womzimba ngokuvamile uyakhuthazwa ngoba ukuzivocavoca kunenzuzo empilweni yenhliziyo yakho iyonke. Kuzodingeka ukuthi ugweme imidlalo yokuxhumana engalimaza idivayisi yakho, kodwa ukuhamba, ukubhukuda, ukuhamba ngebhayisikili, neminye imisebenzi eminingi kuphephile ngokuphelele. Qala kancane kancane futhi wandise kancane kancane izinga lomsebenzi wakho njengoba ululama futhi uthola ukuzethemba ngedivayisi yakho.

Amadivayisi athile kagesi angaphazamisa i-ICD yakho, nakuba lokhu kungavamile ngamamodeli amasha. Kufanele ugweme ukuchayeka isikhathi eside ezindaweni ezinamandla kazibuthe, njengalezo ezitholakala emshinini we-MRI (ngaphandle uma unedivayisi ehambisana ne-MRI), imishini yokushisela, neminye imishini yezimboni. Izinto eziningi zasendlini, okuhlanganisa ama-microwave namafoni, ziphephile ukuthi zisetshenziswe ngokujwayelekile.

Ukuhamba ngezindiza kuvamile ukuphepha nge-ICD, nakuba kuzodingeka ukwazisa abasebenzi bezokuphepha ngedivayisi yakho ngaphambi kokudlula kumathuluzi okuthola insimbi. Uzothwala ikhadi elikhomba i-ICD yakho elichaza noma yiziphi izinto ezikhethekile okufanele zicatshangelwe. Abantu abaningi bathola ukuthi idivayisi yabo ayinayo imithelela emikhulu emisebenzini yabo yansuku zonke uma sebeqhelelene nokuphila nayo.

Yiziphi izici eziyingozi zokudinga i-implantable cardioverter defibrillator?

Izici eziningana zikhuphula amathuba akho okudinga i-ICD, ngobuthakathaka bemisipha yenhliziyo obuyisizathu esivame kakhulu. Uma umsebenzi wokumpompa wenhliziyo yakho wehla ngaphansi kuka-35% wokujwayelekile (okulinganiswa njenge-ejection fraction), usengozini enkulu yezigqi eziyingozi kungakhathaliseki ukuthi yini ebangela. Lokhu kungenzeka ngenxa yokuhlaselwa yinhliziyo, izifo ezibangelwa amagciwane, izimo zofuzo, noma izimbangela ezingaziwa.

Ukuhlaselwa yinhliziyo kwangaphambilini kudala izicubu ezinamanxeba ezingabangela umsebenzi ongajwayelekile kagesi enhliziyweni yakho. Uma inxeba likhulu, ingozi yakho iyanda. Noma ngabe ukuhlaselwa yinhliziyo kwenzeka eminyakeni edlule, izicubu ezinamanxeba zihlala zikhona futhi zingaba yinkinga ngokuhamba kwesikhathi. Umlando womndeni wokufa okungazelelwe kwenhliziyo, ikakhulukazi ezihlotsheni ezingaphansi kweminyaka engama-50, kusikisela ukuthi ungase ube nezifo eziyingozi ezikhuphula ingozi yakho.

Ezinye izimo zezokwelapha zikhuphula kakhulu iphrofayili yakho yengozi. Ukuhluleka kwenhliziyo kunoma iyiphi imbangela, ikakhulukazi uma kuhlangene nezimpawu ngaphandle kwemithi, kuvame ukuholela ekucatshangelweni kwe-ICD. I-Cardiomyopathy, kungakhathaliseki ukuthi i-dilated, hypertrophic, noma i-restrictive, ingadala ukungazinzi kagesi. Izimo zofuzo ezinjenge-arrhythmogenic right ventricular cardiomyopathy noma izifo ezithile zomgudu we-ion zingadinga ukuvikelwa kwe-ICD ngisho nakweziguli ezincane.

Izinto ezingavamile kodwa ezibalulekile eziyingozi zihlanganisa i-cardiac sarcoidosis, ebangela ukuvuvukala emisipheni yenhliziyo yakho. Isifo sikaChagas, esivame kakhulu ezindaweni ezithile, singalimaza uhlelo lukagesi lwenhliziyo yakho. Eminye imithi, ikakhulukazi imithi ethile ye-chemotherapy, inganciphisa imisipha yenhliziyo yakho futhi ikhuphule ingozi yakho. Isifo esibi sezinso kanye nezimo ezithile ze-autoimmune nazo zingaba nomthelela ezinkingeni zesigqi senhliziyo.

Ziyini izinkinga ezingenzeka zokufakelwa kwe-implantable cardioverter defibrillator?

Ngenkathi ukufakelwa kwe-ICD kuvamile ukuthi kuphephile, ukuqonda izinkinga ezingaba khona kukusiza ukuthi wenze izinqumo ezinolwazi futhi uqaphele izinkinga kusenesikhathi. Izinkinga ezivame kakhulu zincane futhi zihlobene nenqubo yokuhlinzwa uqobo. Lokhu kufaka phakathi ukopha, ukulimala, nokungakhululeki okwesikhashana endaweni yokusika, okuvame ukuxazululwa emasontweni ambalwa.

Ukutheleleka kuyinkinga enkulu kodwa engavamile engenzeka endaweni yokusika noma ngaphesheya kwedivayisi uqobo. Izimpawu zihlanganisa ukubomvu okwandayo, ukufudumala, ukuvuvukala, noma ukuphuma endaweni yokusika, kanye nomkhuhlane noma ukuzizwa ungaphilile. Ukutheleleka kwedivayisi kuvame ukudinga ukwelashwa ngama-antibiotic futhi ngezinye izikhathi kususwe lonke uhlelo, yingakho ukulandela imiyalelo yokunakekelwa ngemuva kwenqubo kubaluleke kangaka.

Izinkinga ezihlobene nomthofu zingenzeka ngesikhathi noma ngemuva kokufakelwa. I-Pneumothorax, lapho umoya ungena endaweni ezungeze iphaphu lakho, kwenzeka cishe kuma-1-2% ezinqubo futhi kungadinga ukwelashwa. Ukususwa komthofu, lapho izintambo zihamba zisuka endaweni ezihloswe ukuba zibe kuyo, kungathinta ukusebenza kwedivayisi futhi kungadinga ukubekwa kabusha. Ukuqhekeka komthofu akuvamile kodwa kungenzeka eminyakeni eminingi ngemuva kokufakelwa, ikakhulukazi ezigulini ezisebenzayo.

Ukungasebenzi kahle kwedivayisi akuvamile ngama-ICD anamuhla kodwa kungabandakanya ukushaqeka okungafanele, ukwehluleka ukuthola amarhythms ayingozi, noma izinkinga zebhethri. Ukuphazamiseka kwe-electromagnetic okuvela kumadivayisi athile kungathinta okwesikhashana umsebenzi, nakuba lokhu kungavamile. Abanye abantu bahlangabezana nezinselelo zengqondo, okuhlanganisa ukukhathazeka ngokuthola ukushaqeka noma ukucindezeleka okuhlobene nesimo senhliziyo yabo esingaphansi. Lezi zimpendulo ezingokomzwelo zivamile futhi ziyelapheka ngosizo olufanele.

Kufanele ngibone nini udokotela ngomshini wami wokufaka i-cardioverter defibrillator?

Kufanele uxhumane nomhlinzeki wakho wezempilo ngokushesha uma uthola ukushaqeka ku-ICD yakho, ngisho noma uzizwa ulungile ngemva kwalokho. Nakuba ukushaqeka ngokuvamile kubonisa ukuthi idivayisi yakho isebenza kahle, udokotela wakho udinga ukubukeza okwenzekile futhi anqume ukuthi ngabe kudingeka yini ukulungiswa. Ukushaqeka okuningi ngesikhathi esifushane, okubizwa ngokuthi isiphepho sikagesi, kudinga ukunakekelwa kwezempilo okuphuthumayo.

Izimpawu zokutheleleka ngase divayisini yakho zidinga ukuhlolwa kwezokwelapha okusheshayo. Qaphela ukubomvu okwandayo, ukufudumala, ukuvuvukala, noma ubumnene endaweni yokusika, ikakhulukazi uma kuhambisana nomkhuhlane, ama-chills, noma ukuzizwa ungaphilile. Noma yikuphi ukukhipha emgodini, ikakhulukazi uma kunamafu noma kunuka, kudinga ukunakwa ngokushesha. Lezi zimpawu zingabonisa ukutheleleka kwedivayisi, okudinga ukwelashwa okunonya.

Izimpawu zokungasebenzi kahle kwedivayisi zihlanganisa ukuzwa inhliziyo yakho igijima ngaphandle kokuthola ukwelashwa okufanele, noma ukuthola ukushaqeka lapho ungezwa inhliziyo yakho ishaya ngokungavamile. Uma uhlangabezana nesiyezi, ukuquleka, noma ubuhlungu besifuba obufana nalobo owazizwa ngaphambi kokuthola i-ICD yakho, lokhu kungabonisa ukuthi idivayisi yakho ayisebenzi kahle noma isimo sakho sishintshile.

Landela isimiso sakho esivamile sokuqapha, esivame ukuhlanganisa ukuhlolwa kwemishini njalo emavikini angu-3-6. Phakathi kwama-aphoyintimenti, xhumana nodokotela wakho uma unokukhathazeka ngemishini yakho, uqaphela izinguquko ezimpawini zakho, noma uhlangabezana nezinkinga ezintsha ezihlobene nenhliziyo. Unganqikazi ukuxhumana ngemibuzo - ithimba lakho lokunakekelwa kwezempilo lifuna ukuqinisekisa ukuthi uzizwa uqinisekile futhi uphephile nge-ICD yakho.

Imibuzo evame ukubuzwa mayelana nama-defibrillators afakelwayo e-cardioverter

Q.1 Ingabe i-cardioverter defibrillator efakelwayo ilungele ukuhluleka kwenhliziyo?

Yebo, ama-ICD angaba usizo olukhulu kubantu abahluleka inhliziyo, ikakhulukazi labo abane-ejection fraction encishisiwe engaphansi kuka-35%. Ukuhluleka kwenhliziyo kwandisa ingozi yakho yokufa okungazelelwe ngenxa yezigqi zenhliziyo eziyingozi, futhi i-ICD inikeza ukuvikelwa okubalulekile kulezi zenzakalo ezisongela impilo. Iziguli eziningi zokuhluleka kwenhliziyo zithola amadivaysi ahlanganisiwe abizwa nge-CRT-D (i-cardiac resynchronization therapy ene-defibrillator) ethuthukisa umsebenzi wenhliziyo futhi inikeze ukuvikelwa kwesigqi.

Q.2 Ingabe ukuba ne-ICD kubangela izinkinga zenhliziyo?

Cha, ama-ICD awabangeli izinkinga zenhliziyo - afakelwa ukwelapha izimo zenhliziyo ezikhona nokuvimbela izinkinga eziyingozi. Idivayisi ngokwayo ayilimalisi inhliziyo yakho noma idale izinkinga ezintsha. Kodwa-ke, ama-leads ngezinye izikhathi angabangela izinkingana ezincane njengama-clots egazi noma ukutheleleka, kodwa lokhu akuvamile futhi izinzuzo zokuvikelwa ekufeni okungazelelwe kwenhliziyo zidlula lezi zingozi kubantu abafanelekayo.

Q.3 Ungaphila impilo ejwayelekile nge-ICD?

Abantu abaningi abane-ICDs baphila impilo esebenzayo, egcwele ngezinguquko ezincane nje emisebenzini yabo yansuku zonke. Ungasebenza, uhambe, uzivocavo, futhi uhlanganyele emisebenzini eminingi obuyijabulela ngaphambili. Imikhawulo emikhulu ihlanganisa ukugwema imidlalo yokuxhumana nokuba nokuqapha eduze kwemikhakha enamandla kagesi. Abantu abaningi babika ukuzizwa benethemba elikhulu futhi bephephile bazi ukuthi idivayisi yabo iyabavikela emazingeni enhliziyo asongela impilo.

Q.4 Ubuhlungu obungakanani ukushaqeka kwe-ICD?

Ukushaqeka kwe-ICD kuzizwa njengokushaya okungazelelwe, okuqinile noma ukukhahlela esifubeni sakho, okuvame ukuchazwa njengokufana nokushaywa yibhola le-baseball. Ukuzwa kuthatha isikhashana nje, nakuba ungase uzwe ubuhlungu ngemva kwalokho. Nakuba kungathandeki, abantu abaningi bayakubekezelela ukushaqeka kahle futhi bazizwe bebonga ngokusivikela abakuhlinzekayo. Udokotela wakho angashintsha izilungiselelo ukuze anciphise ukushaqeka okungadingekile ngenkathi egcina ukuphepha kwakho.

Q.5 Ibhethri le-ICD lihlala isikhathi esingakanani?

Amabhethri e-ICD yesimanje ngokuvamile ahlala iminyaka engu-7-10, nakuba lokhu kuhluka ngokuya ngokuthi idivayisi yakho inikeza kaningi kangakanani ukwelashwa kanye nezilungiselelo zakho zedivayisi ngayinye. Udokotela wakho uqapha impilo yebhethri ngesikhathi sokuhlolwa okuvamile futhi uzohlela ukuhlinzwa kokushintshwa uma kudingeka. Ukushintshwa kwebhethri kuvame ukuba lula kunokufakwa kokuqala njengoba izintambo zivame ukungadingi ukushintshwa, iyunithi yejeneretha kuphela.