Otopa ndi Osamvetsetseka

Ndakhala m'chipatala kwa zaka makumi angapo.

Wokongola kwambiri aliyense amene wakhala wothandizira wamkulu (PCP) amadziwa kuti pali gulu la odwala omwe tonse tiwawona omwe akuvutika chifukwa chotopa, otopa, komanso kumva kuti alibe chifukwa chomwe sitingathe kupeza chifukwa chake. Titha kumvetsera, kuyesa mosamala, kuyitanitsa magazi oyenera, ndikutumiza kwa akatswiri kuti adziwe zambiri koma osazindikira bwino zomwe zikuchitika.

Tsoka ilo, ena opereka chithandizo amachotsa odwalawa. Ngati sangathe kuwulula zopezeka zachilendo pakuyezetsa, magazi, kapena zina, angayesedwe kuti achepetse zizindikiro zawo kapena kuzitcha ngati akunyoza kapena kukhala ndi "nkhani" zamaganizidwe.

Zinthu zambiri zakhala zikukhudzidwa ngati zomwe zingatheke pazaka zambiri. Ndine wamkulu mokwanira kukumbukira "yuppie flu". Zolemba zina zomwe zakhala zikugwiritsidwa ntchito ndi chimfine chosatha, fibromyalgia, matenda a Epstein-Barr, kusamva zakudya zosiyanasiyana, ndi zina.

Tsopano, chikhalidwe china chikuwulula kuphatikizika kwina ndi mikhalidwe iyi; "mphatso" ya mliri wathu waposachedwa. Ndikunena za COVID-19 yayitali, zotengera zazitali, post-COVID-19, COVID-19, kapena zotsatira za SARS-CoV-2 (PASC). Zonse zagwiritsidwa ntchito.

Zizindikiro zokhalitsa kuphatikizapo kutopa zimatsatira mitundu yosiyanasiyana ya matenda opatsirana. Matenda otopa a “postinfectious” ameneŵa akuwoneka ngati akufanana ndi chimene chikutchedwa myalgic encephalitis/chronic fatigue syndrome (ME/CFS). Nthawi zambiri, matendawa amatengera matenda monga matenda.

Kutsatira pachimake COVID-19, kaya agonekedwa m'chipatala kapena ayi, odwala ambiri akupitiliza kufooka ndi zizindikiro kwa miyezi yambiri. Ena mwa “onyamula utali”wa angakhale ndi zizindikiro zosonyeza kuwonongeka kwa chiwalo. Izi zingaphatikizepo mtima, mapapo, kapena ubongo. Anthu ena oyenda maulendo ataliatali samva bwino ngakhale kuti alibe umboni woonekeratu wa kuwonongeka kwa chiwalo choterocho. M'malo mwake, odwala omwe amadwalabe pakadutsa miyezi isanu ndi umodzi atadwala COVID-19 amafotokoza zambiri za zizindikiro zofanana ndi ME/CFS. Titha kuwona kuwirikiza kawiri kwa anthu omwe ali ndi zizindikiro izi pambuyo pa mliri. Tsoka ilo, monganso ena, ambiri akuti akuchotsedwa ntchito ndi akatswiri azaumoyo.

Myalgic encephalomyelitis/chronic fatigue syndrome imakhudza pakati pa 836,000 ndi 2.5 miliyoni aku America azaka zonse, mafuko, jenda, komanso chikhalidwe cha anthu. Ambiri sadziwidwa kapena kuzindikiridwa molakwika. Magulu ena amakhudzidwa kwambiri:

• Akazi amakhudzidwa kwambiri kuwirikiza katatu kuposa amuna.
• Kuyambika nthawi zambiri kumachitika pakati pa zaka 10 mpaka 19 ndi 30 mpaka 39. Avereji ya zaka zoyambira ndi 33.
• Akuda ndi a Latinx angakhudzidwe pamlingo wapamwamba komanso mwamphamvu kwambiri kuposa magulu ena. Sitikudziwa ndendende chifukwa kuchuluka kwa anthu kulibe anthu amitundu.

Ngakhale kuti msinkhu wa wodwala pa matenda ndi bimodal, ndi pachimake mu zaka zachinyamata ndi pachimake china mu 30s, koma chikhalidwe chafotokozedwa anthu a zaka 2 mpaka 77.

Madokotala ambiri alibe chidziwitso chowunikira kapena kuyang'anira ME / CFS. Tsoka ilo, malangizo azachipatala akhala akusowa, okalamba, kapena owopsa. Chifukwa cha zimenezi, odwala asanu ndi anayi mwa 10 alionse ku United States amakhalabe osawazindikira, ndipo opezeka ndi matendawa kaŵirikaŵiri amalandira chithandizo chosayenera. Ndipo tsopano, chifukwa cha mliri wa COVID-19, mavutowa akuchulukirachulukira.

Kupambana?

Odwalawa nthawi zambiri amakhala ndi matenda otsimikizika kapena osadziwika koma amalephera kuchira monga amayembekezera ndipo amapitilira kudwala pakadutsa milungu ingapo.

Kugwiritsa ntchito masewera olimbitsa thupi komanso kuchitapo kanthu m'maganizo (makamaka chidziwitso cha khalidwe) pofuna kuchiza kutopa kokhudzana ndi khansa, kutupa, matenda a ubongo, ndi fibromyalgia akhala akugwiritsidwa ntchito kwa zaka zambiri ndi zotsatira zabwino. Komabe, pamene anthu akukayikira kuti ali ndi ME/CFS anapatsidwa mankhwala omwewo, iwo anapitiriza kuchita zoipa, osati bwino, ndi kuchita masewera olimbitsa thupi ndi kuchita.

Komiti ya "Komiti Yoyang'anira Matenda a Myalgic Encephalomyelitis / Chronic Fatigue Syndrome; Board on the Health of Select Populations; Institute of Medicine” idayang'ana zomwe zidachitika ndipo adapeza njira. Iwo, kwenikweni, adafuna kufotokozedwanso kwa matendawa. Izi zinasindikizidwa mu National Academies Press mu 2015. Chovuta ndi chakuti ambiri opereka chithandizo chamankhwala sakudziwa bwino izi. Tsopano pakuwonjezeka kwa odwala omwe abwera ndi post-COVID-19, chidwi chakula kwambiri. Zoyenera kuchita:

• Kuchepetsa kapena kufooka kwambiri pochita nawo ntchito, sukulu, kapena zochitika zapagulu zomwe zimapitilira miyezi isanu ndi umodzi ndi kutopa, komwe nthawi zambiri kumakhala kozama, komwe sikuli chifukwa chochita masewera olimbitsa thupi komanso sikukhazikika pakupuma.
• Post-exertional malaise - zomwe zikutanthauza kutsatira ntchito, pali kutopa kwakukulu kapena kutaya mphamvu.
• Kugona kosatsitsimula.
• Ndipo mwina:
  • Kusalolera kwa Orthostatic - kuyimitsidwa kwanthawi yayitali kumapangitsa odwalawa kumva kuti akuipiraipira.
  • Kusokonezeka kwa chidziwitso - kulephera kuganiza bwino.

(Odwala ayenera kukhala ndi zizindikiro izi osachepera theka la nthawi yofatsa, yochepetsetsa, kapena yamphamvu kwambiri.)

• Anthu ambiri omwe ali ndi ME / CFS amakhalanso ndi zizindikiro zina. Zizindikiro zina zodziwika bwino ndi izi:
  • Kupweteka kwa minofu
  • Ululu m`malo olumikizirana mafupa popanda kutupa kapena redness
  • Mutu wamtundu watsopano, chitsanzo, kapena kuuma
  • Ma lymph nodes otupa kapena ofewa m'khosi kapena m'khwapa
  • Kupweteka kwapakhosi komwe kumachitika kawirikawiri kapena mobwerezabwereza
  • Kuzizira ndi kutuluka thukuta usiku
  • Zosokoneza zowoneka
  • Kumverera kwa kuwala ndi phokoso
  • nseru
  • Kusagwirizana ndi zakudya, fungo, mankhwala, kapena mankhwala

Ngakhale atapezeka ndi matenda, odwala amavutika kuti apeze chithandizo choyenera ndipo nthawi zambiri amapatsidwa chithandizo chamankhwala, monga cognitive-behavioral therapy (CBT) ndi graded exercise therapy (GET), zomwe zingawononge matenda awo.

Wolemba wogulitsa kwambiri ku New York Times Meghan O'Rourke posachedwapa analemba buku lotchedwa "Ufumu Wosaoneka: Kukonzanso Matenda Osatha." Ndemanga yochokera kwa wofalitsayo ikufotokoza mutuwo motere:

“Mliri wachete wa matenda osachiritsika ukuvutitsa anthu mamiliyoni makumi ambiri a ku America: awa ndi matenda amene samvetsetseka bwino, amanyozedwa kaŵirikaŵiri, ndipo sangazindikiridwe ndi kuzindikiridwa nkomwe. Wolembayo akupereka kafukufuku wowunikira pagulu losawoneka bwino la matenda "osawoneka" omwe amaphatikiza matenda a autoimmune, matenda a Lyme pambuyo pa chithandizo, komanso COVID yayitali, kupanga zamunthu komanso zapadziko lonse lapansi kuti zitithandize tonsefe kudutsa malire atsopanowa. ”

Pomaliza, pachitika kafukufuku wambiri wosonyeza kuti mawu akuti “chronic fatigue syndrome” amakhudza mmene odwala amaonera matenda awo komanso mmene anthu ena amachitira, kuphatikizapo ogwira ntchito zachipatala, achibale awo komanso anzawo akuntchito. Chizindikirochi chikhoza kuchepetsa kuopsa kwa matendawa kwa omwe ali ndi vutoli. Komiti ya IOM ikuvomereza dzina latsopano loti lilowe m’malo mwa ME/CFS: systemic exertion intolerance disease (SEID).

Kutchula vutoli SEID kungasonyeze mbali yaikulu ya matendawa. Kunena zoona, kuyesetsa kwamtundu uliwonse (kwakuthupi, kozindikira, kapena kwamalingaliro) - kumatha kukhudza odwala m'njira zambiri.

Resources

aafp.org/pubs/afp/issues/2023/0700/fatigue-adults.html#afp20230700p58-b19

mayoclinicproceedings.org/article/S0025-6196(21)00513-9/fulltext

"Ufumu Wosaoneka: Kuganiziranso Matenda Osatha" Meghan O'Rourke