Yini i-Pacemaker? Inhloso, Inqubo & Imiphumela

I-pacemaker iyithuluzi elincane, elisebenza ngamabhethri elisiza ukulawula ukushaya kwenhliziyo yakho uma uhlelo lukagesi lwenhliziyo yakho olwemvelo lungasebenzi kahle. Cabanga ngayo njengohlelo oluyisipele olungena ukuze lugcine inhliziyo yakho ishaya ngesigqi esiqinile, esinempilo. Leli thuluzi elimangalisayo lisize izigidi zabantu ukuthi ziphile impilo egcwele, esebenzayo ngokuqinisekisa ukuthi izinhliziyo zabo zigcina isigqi esifanele.

Yini i-pacemaker?

I-pacemaker iyithuluzi lezokwelapha elingangosayizi wefoni encane ephathekayo efakwa ngaphansi kwesikhumba eduze kwe-collarbone yakho. Liqukethe i-pulse generator (umzimba omkhulu) kanye nentambo eyodwa noma ngaphezulu encane ebizwa ngokuthi ama-lead axhunywe enhliziyweni yakho. Ithuluzi liqhubeka liqapha isigqi senhliziyo yakho futhi lithumele izimpulse zikagesi uma kudingeka ukuze kugcinwe ukushaya kwenhliziyo okuvamile.

Ama-pacemaker anamuhla athuthuke kakhulu futhi angakwazi ukuzivumelanisa nezidingo zomzimba wakho usuku lonke. Angazizwa uma usebenza futhi udinga izinga lenhliziyo elisheshayo, bese ehamba kancane uma uphumule. Ithuluzi lisebenza buthule ngemuva, likuvumela ukuthi uqhubeke nemisebenzi yakho yansuku zonke ngaphandle kokuyicabanga.

Kungani kwenziwa i-pacemaker?

Udokotela wakho angase ancome i-pacemaker uma inhliziyo yakho ishaya kancane kakhulu, ngokushesha kakhulu, noma ngokungajwayelekile ngenxa yezinkinga ngohlelo lukagesi lwenhliziyo yakho. Isizathu esivame kakhulu yi-bradycardia, okusho ukuthi inhliziyo yakho ishaya kancane kunokushaya okungama-60 ngomzuzu. Lokhu kungakushiya uzizwa ukhathele, unesiyezi, noma uphelelwa umoya ngoba umzimba wakho awutholi igazi elinothile nge-oxygen elanele.

Izimo eziningana zenhliziyo zingazuza ekwelashweni nge-pacemaker, futhi ukuqonda lezi kungakusiza ukuthi uzizwe uqiniseka kakhulu ngale ncomo. Nawa amazwi amakhulu lapho i-pacemaker iba yimfuneko:

• I-Sick sinus syndrome - uma i-pacemaker yakho yemvelo yenhliziyo (i-sinus node) ingasebenzi kahle
• I-Heart block - uma amasignali kagesi engakwazi ukuhamba ngendlela ejwayelekile enhliziyweni yakho
• I-Atrial fibrillation enesivinini senhliziyo esihamba kancane - ukushaya kwenhliziyo okungajwayelekile ngezinye izikhathi okuba kancane kakhulu
• Ukwehluleka kwenhliziyo - kwezinye izimo, ama-pacemaker akhethekile angasiza ukuxhumanisa ukumpompa kwenhliziyo yakho
• Iziqephu zokuquleka (i-syncope) ezibangelwa ukushaya kwenhliziyo okuhamba kancane

Ngokuvamile, ama-pacemaker asetshenziselwa izimo ezithile zofuzo ezithinta ukushaya kwenhliziyo noma ngemva kokuhlinzwa kwenhliziyo okungenzeka ukuthi kuthinte uhlelo lukagesi lwenhliziyo. Udokotela wakho wenhliziyo uzohlola ngokucophelela isimo sakho esithile ukuze anqume ukuthi i-pacemaker iyisixazululo esifanele yini kuwe.

Yini inqubo yokufakelwa kwe-pacemaker?

Ukufakelwa kwe-Pacemaker kuvame ukwenziwa njengenqubo yeziguli eziphuthumayo, okusho ukuthi ngokuvamile ungaqhubeka uye ekhaya ngosuku olufanayo. Ukuhlinzwa kuthatha cishe ihora elingu-1-2 futhi kwenziwa ngaphansi kwe-anesthesia yendawo, ngakho-ke uzobe uvukile kodwa uzizwa ukhululekile. Udokotela wakho uzokunikeza nokuthulisa okuncane ukukusiza ukuthi uphumule ngesikhathi senqubo.

Inqubo ilandela inqubo eqaphelayo, yesinyathelo ngesinyathelo eyenziwe ithimba lakho lezokwelapha izikhathi eziningi ngaphambili. Nakhu okwenzekayo ngesikhathi sokuhlinzwa:

1. Indawo yakho yesifuba ihlanzwa futhi ithuliswe nge-anesthetic yendawo
2. Ukuqhekeka okuncane (cishe ama-intshi angu-2-3) kwenziwa ngaphansi kwe-collarbone yakho
3. Ama-lead athungwa ngokucophelela ngomthambo wegazi ukuya enhliziyweni yakho kusetshenziswa isiqondiso se-X-ray
4. Idivayisi ye-pacemaker ibekwa ephaketheni elincane elenziwe ngaphansi kwesikhumba sakho
5. Ama-lead axhunywe ku-pacemaker futhi ahlolwe ukuze kuqinisekiswe ukusebenza kahle
6. Ukuqhekeka kuvalwa ngemithungo noma i-glue yokuhlinza

Ngemuva kwenqubo, uzoqeda amahora ambalwa ngenkathi ithimba lezokwelapha liqapha isigqi senhliziyo yakho futhi lihlole ukuthi konke kusebenza kahle yini. Abantu abaningi bazizwa bengakhululekile kancane, yize ungase uzwe ubuhlungu endaweni yokusika izinsuku ezimbalwa.

Ungalungiselela kanjani inqubo yakho ye-pacemaker?

Udokotela wakho uzokunikeza imiyalelo ethile okufanele uyilandele ngaphambi kokufakelwa kwe-pacemaker yakho, kodwa ukulungiselela kuvamile ukuthi kuqonde ngqo. Ngokuvamile uzodinga ukugwema ukudla noma ukuphuza amahora angu-8-12 ngaphambi kwenqubo, yize ngokuvamile ungathatha imithi yakho ejwayelekile ngamanzi amancane ngaphandle uma uqondiswe ngenye indlela.

Ukuthatha izinyathelo ezimbalwa ezilula ngaphambi kwesikhathi kungasiza ekuqinisekiseni ukuthi inqubo yakho ihamba kahle futhi kunciphise noma yikuphi ukukhathazeka ongase ukuzwe:

• Lungiselela othile ukuthi akuqhubele ekhaya ngemuva kwenqubo
• Gqoka izingubo ezikhululekile, ezikhululekile ezinamabhathini noma ama-zip ngaphambili
• Susa yonke ubucwebe, ikakhulukazi endaweni yakho yentamo nesifuba
• Tshela udokotela wakho ngayo yonke imithi, izithasiselo, kanye nemithi yezitshalo oyithathayo
• Tshela ithimba lakho ngazo zonke izinto ezingezwani noma izindlela zokuphendula emithini
• Letha uhlu lwemithi yakho yamanje kanye noxhumana nabo abaphuthumayo

Udokotela wakho angase akucele ukuthi uyeke imithi ethile efana ne-blood thinners izinsuku ezimbalwa ngaphambi kwenqubo, kodwa ungalokothi uyeke noma iyiphi imithi ngaphandle kwemiyalelo ethile. Uma uzizwa unovalo, lokho kuvamile ngokuphelele, futhi ithimba lakho lezokwelapha lilapho ukukusekela nokuphendula noma yimiphi imibuzo.

Ungayifunda kanjani ukusebenza kwe-pacemaker yakho?

I-pacemaker yakho izohlolwa njalo ngenqubo ebizwa ngokuthi ukuhlolwa noma ukuqapha, okungenabuhlungu futhi okungahlaseli. Ngesikhathi sokuhlolwa, udokotela wakho usebenzisa idivayisi ekhethekile ebizwa ngokuthi i-programmer ukuxhumana ne-pacemaker yakho futhi abuyekeze ukuthi ibisebenza kanjani. Lokhu kuvamile ukuthi kwenzeke njalo ezinyangeni ezi-3-6, kuye ngesimo sakho esithile.

Inqubo yokubheka inikeza ulwazi olubalulekile mayelana nomsebenzi wenhliziyo yakho nokusebenza kwe-pacemaker yakho. Udokotela wakho uzobuyekeza izici eziningana ezibalulekile ngesikhathi salezi zivakashi:

• Ukuphila kwebhethri nobude obusele (amabhethri e-pacemaker ngokuvamile ahlala iminyaka engu-7-15)
• Ukuthi i-pacemaker ibilokhu ilinganisa kaningi kangakanani inhliziyo yakho
• Isigqi senhliziyo yakho esingokwemvelo nanoma yimaphi amaphethini angajwayelekile
• Umsebenzi womthofu nezilinganiso zikagesi
• Noma yiluphi ulwazi olugciniwe mayelana ne-arrhythmias noma izigqi zenhliziyo ezingavamile

Ama-pacemaker amaningi anamuhla anikeza nokubhekwa okukude, okusho ukuthi angadlulisela ulwazi ehhovisi likadokotela wakho lisuka ekhaya lakho. Lobu buchwepheshe buvumela ukuqapha okuvamile ngaphandle kokudinga ukuvakashelwa komtholampilo okwengeziwe, okunikeza wena nodokotela wakho ukuthula kwengqondo.

Ungaphila kanjani ne-pacemaker yakho?

Ukuphila ne-pacemaker akusho ukuyeka imisebenzi oyithandayo, nakuba kunezinto ezithile okufanele uzicabangele. Abantu abaningi bathola ukuthi lapho beseluleme enqubweni yokufakelwa, bangakwazi ukubuyela cishe kuyo yonke imisebenzi yabo evamile. Eqinisweni, abantu abaningi bazizwa benamandla kakhulu kunalokho ababezizwa ngaphambi kokuthola i-pacemaker yabo ngoba inhliziyo yabo manje isishaya ngempumelelo.

Kuneziqondiso ezithile eziwusizo okufanele uzilandele ezizokusiza ukuthi uphile ngokuphepha nangokuzethemba nge-pacemaker yakho:

• Gwema ukuthintana isikhathi eside nezindawo ezinamandla kazibuthe (njengemishini ye-MRI, nakuba ama-pacemaker amasha athile ahambisana ne-MRI)
• Gcina omakhalekhukhwini okungenani amayintshi angu-6 kude ne-pacemaker yakho
• Tshela abahlinzeki bezempilo nge-pacemaker yakho ngaphambi kwanoma yiziphi izinqubo
• Thwala ikhadi lakho lokuhlonza i-pacemaker nawe ngaso sonke isikhathi
• Gwema ezemidlalo ezinokuthintana okuphezulu ezingalimaza idivayisi
• Qaphela eduze kwezinhlelo zokuphepha ezithile nezitholi zensimbi

Izinto eziningi zasendlini, okuhlanganisa ama-microwave, ziphephile ngokuphelele ukuzisebenzisa nge-pacemaker. Ngokuvamile ungaqhuba imoto, uhambe, uzivocavoce, futhi usebenze ngokujwayelekile, nakuba udokotela wakho engase ancome ukulinda amasonto ambalwa ngemva kokufakwa ngaphambi kokuphakamisa izinto ezisindayo noma ukuphakamisa ingalo yakho ngaphezu kwekhanda ngohlangothi lapho i-pacemaker ifakwe khona.

Yiziphi izici eziyingozi zokudinga i-pacemaker?

Izici eziningana zingakhuphula amathuba akho okuthuthukisa izinkinga zesigqi senhliziyo ezingase zidinge i-pacemaker, nakuba ukuba nalezi zici eziyingozi kungasho ukuthi uzoyidinga ngempela. Ubudala buyisici esibaluleke kakhulu, njengoba uhlelo lukagesi lwenhliziyo lushintsha ngokwemvelo ngokuhamba kwesikhathi, futhi iningi labantu abathola ama-pacemaker lineminyaka engaphezu kwengama-65.

Ukuqonda lezi zici eziyingozi kungakusiza wena nodokotela wakho ukuthi niqaphele impilo yenhliziyo yakho ngokucophelela:

• Ubudala obuthuthukile (ingozi iyanda kakhulu ngemva kweminyaka engama-65)
• Ukuhlaselwa yinhliziyo kwangaphambilini noma isifo senhliziyo
• Umfutho wegazi ophezulu ongaphathwanga kahle
• Isifo sikashukela, ikakhulukazi uma ushukela wegazi kube nzima ukuwulawula
• Umlando womndeni wezinkinga zesigqi senhliziyo
• Imithi ethile engathinta isigqi senhliziyo
• I-sleep apnea noma ezinye izifo zokuphefumula
• Izifo ze-thyroid

Abanye abantu bazalwa nezimo ezithinta uhlelo lukagesi lwenhliziyo yabo, kanti abanye bathuthukisa izinkinga kamuva empilweni ngenxa yokuguga, izifo, noma ezinye izimo zezokwelapha. Izindaba ezinhle ukuthi eziningi zalezi zici eziyingozi zingalawulwa ngokukhetha indlela yokuphila enempilo nokunakekelwa kwezokwelapha okufanele.

Yiziphi izinkinga ezingase zibe khona zokufakwa kwe-pacemaker?

Ngenkathi ukufakelwa kwe-pacemaker ngokuvamile kuphephile kakhulu, njenganoma iyiphi inqubo yezokwelapha, inezingozi ezithile. Izinkinga ezinzima azivamile, zenzeka ngaphansi kuka-1% wezinqubo, kodwa kubalulekile ukuqonda ukuthi yini okufanele uyibheke. Abantu abaningi bathola imiphumela emincane, yesikhashana kuphela esombuluka ngokushesha ngokunakekelwa okufanele.

Izinkinga ezivame kakhulu zivame ukuba zincane futhi zithathelwa kalula, kanti izinkinga ezinzima azivamile:

• Ukunyuka kwamagciwane endaweni yokusika (kwenzeka cishe kuma-1-2% wamacala)
• Ukuphuma kwegazi noma ukulimala eduze kwephakethe le-pacemaker
• Ukuthuthwa kwethambo (intambo isuka endaweni eyayihloselwe ukuba ibe kuyo)
• Ukuphendula komzimba emithini noma ezintweni ezisetshenzisiwe
• Iphaphu eliwile (i-pneumothorax) - akuvamile kakhulu kodwa lidinga ukunakekelwa ngokushesha
• Amaqhubu egazi noma ukulimala kwemithambo yegazi
• Ukungasebenzi kahle kwe-Pacemaker noma izinkinga zikagesi

Ithimba lakho lezokwelapha lizokuqapha ngokucophelela ngesikhathi nangemva kwenqubo ukuze libambe noma yiziphi izinkinga ezingase zibe khona ekuqaleni. Izinkinga eziningi, uma zenzeka, zingelashwa ngempumelelo ngaphandle kwemiphumela yesikhathi eside empilweni yakho noma ekusebenzeni kwe-pacemaker yakho.

Kufanele ngibone nini udokotela ngezinkinga ze-pacemaker?

Ngenkathi abantu abaningi abane-pacemakers bephila ngaphandle kwanoma yiziphi izinkinga, kunezimpawu ezithile okufanele zikushiyele ukuthi uthintane nodokotela wakho ngokushesha. Lezi zimpawu zokuxwayisa zingase zibonise inkinga nge-pacemaker yakho, isigqi senhliziyo yakho, noma inqubo yokuphulukisa ngemva kokufakelwa.

Kubalulekile ukufuna ukunakekelwa kwezokwelapha uma uhlangabezana nanoma yiziphi zalezi zimpawu, njengoba ukungenelela kwasekuqaleni kungavimbela izinkinga ezingathi sína:

• Ukuquleka, ukuphuma isithunzi, noma izigameko zokuquleka
• Ubuhlungu besifuba noma ukuphefumula okungavamile
• Ukuvuvukala, ububomvu, noma ukuphuma emgodini lapho kwenziwe khona ukuhlinzwa
• Umkhuhlane noma izimpawu zokutheleleka
• Ukuthimula okungami (kungase kubonise ukuthi umthofu ushintshile indawo)
• Ukuzwa sengathi inhliziyo yakho iyagijima noma ishaya ngokungajwayelekile
• Ukuqina kwemisipha esifubeni sakho, engalweni, noma e-diaphragm
• Ukukhathala okukhulu noma ubuthakathaka

Unganqikazi ukushayela udokotela wakho uma kukhona okungazwakali kahle, ngisho noma ungaqiniseki ukuthi kuhlobene yini ne-pacemaker yakho. Ithimba lakho lezempilo lingathanda ukukuhlola ngokungadingekile kunokuthi liphuthelwe okuthile okubalulekile. Khumbula, balapho ukukusekela ohambweni lwakho lwe-pacemaker.

Imibuzo evame ukubuzwa mayelana nama-pacemakers

Q1: Ingabe i-pacemaker ilungele ukuhluleka kwenhliziyo?

Yebo, izinhlobo ezithile zama-pacemakers zingaba usizo olukhulu kubantu abanenhliziyo ehlulekayo. Uhlobo olukhethekile olubizwa ngokuthi i-cardiac resynchronization therapy (CRT) pacemaker, noma i-biventricular pacemaker, ingasiza ukuxhumanisa ukushaya kwamagumbi enhliziyo yakho. Lokhu kungathuthukisa ukusebenza kahle kwenhliziyo yakho futhi kunciphise izimpawu ezinjengokuphefumula kanzima nokukhathala.

Kodwa-ke, akuwona wonke umuntu onenhliziyo ehlulekayo odinga i-pacemaker. Udokotela wakho uzohlola uhlobo oluthile lokuhluleka kwenhliziyo yakho, izimpawu zakho, nokuthi inhliziyo yakho isebenza kahle kangakanani ukuze anqume ukuthi le mithi ingakuzuzisa yini.

Q2: Ingabe izinga lenhliziyo elihamba kancane lidinga njalo i-pacemaker?

Akudingeki. Izinga lenhliziyo elihamba kancane (i-bradycardia) lidinga i-pacemaker kuphela uma libangela izimpawu noma izinkinga zempilo. Abanye abantu ngokwemvelo banamazinga enhliziyo ahamba kancane, ikakhulukazi abasubathi, futhi bazizwa bephile kahle. Okubalulekile ukuthi ngabe izinga lenhliziyo yakho elihamba kancane livimbela umzimba wakho ukuthi ungatholi umoya-mpilo kanye nezakhamzimba ezidingekayo.

Udktela wakho uzocabangela izimpawu zakho, impilo yakho yonke, nokuthi izinga lokushaya kwenhliziyo elihamba kancane lilithinta kanjani impilo yakho yansuku zonke ngaphambi kokuncoma i-pacemaker. Kwesinye isikhathi, ukulungisa imithi noma ukwelapha izimo ezingaphansi kungaxazulula inkinga ngaphandle kokudinga idivayisi.

Q3: Ngingakwazi yini ukuzivivinya nge-pacemaker?

Impela! Eqinisweni, ukuzivivinya njalo kuyakhuthazwa futhi kunenzuzo kubantu abane-pacemakers. I-pacemaker yakho yenzelwe ukuzivumelanisa nezinga lakho lomsebenzi, ikhuphula izinga lokushaya kwenhliziyo yakho uma usebenza futhi ilinciphisa uma uphumula. Abantu abaningi bathola ukuthi bangakwazi ukuzivivinya ngokunethezeka ngemva kokuthola i-pacemaker ngoba inhliziyo yabo igcina isigqi esiqhubekayo.

Udktela wakho uzohlinzeka ngemihlahlandlela ethile mayelana nokuthi ungaqala nini ukuzivivinya ngemva kokufakwa nokuthi yiziphi izinhlobo zemisebenzi ezingcono kakhulu kuwe. Abantu abaningi bangakwazi ukubuyela emsebenzini wabo ojwayelekile wokuzivivinya emasontweni ambalwa, nakuba imidlalo yokuxhumana okuphezulu ingase idinge ukugwenywa.

Q4: Ibhethri le-pacemaker lihlala isikhathi esingakanani?

Amabhethri e-pacemaker yesimanje ngokuvamile ahlala phakathi kweminyaka engu-7 nengu-15, kuye ngokuthi i-pacemaker yakho idinga kangaki ukuhambisa inhliziyo yakho kanye nohlobo oluthile lwedivayisi onayo. Uma isigqi senhliziyo yakho sihamba kancane kakhulu futhi i-pacemaker yakho isebenza njalo, ibhethri lingase lingahlali isikhathi eside njengomuntu i-pacemaker yakhe esebenza ngezikhathi ezithile kuphela.

Udktela wakho uzoqapha impilo yebhethri lakho ngesikhathi sokuhlolwa okuvamile futhi uzohlela ukushintshwa kahle ngaphambi kokuba ibhethri liphele. Inqubo yokushintshwa ngokuvamile ilula kune-implantation yasekuqaleni njengoba izintambo ngokuvamile zingadingi ukushintshwa.

Q5: Ngizokwazi yini ukuzwa i-pacemaker yami isebenza?

Abantu abaningi abazizwa neze ukuthi i-pacemaker yabo iyasebenza ngemva kokuba bejwayele. Ungase uqaphele ukuvuvukala okuncane ngaphansi kwesikhumba sakho lapho idivayisi ihlezi khona, ikakhulu uma ukhuthele, kodwa ama-impulse kagesi mancane kakhulu ukuthi angazizwa. Abanye abantu babika ukuzizwa benamandla kakhulu futhi bengakhathali kangako ngoba izinhliziyo zabo zishaya ngempumelelo enkulu.

Emasontweni ambalwa okuqala ngemva kokufakwa, ungase uqaphele kakhulu idivayisi njengoba umzimba wakho uzivumelanisa futhi ukusikwa kululama. Uma uke uzizwe izinzwa ezingavamile njengokuthuthumela kwemisipha noma ukubhixa okungami, xhumana nodokotela wakho, ngoba lokhu kungase kubonise ukuthi idivayisi idinga ukulungiswa.