Kuneta uye Kusanzwisiswa

Ndave ndiri muprimary care kwemakumi emakore anoverengeka.

Zvakawanda chero munhu anga ari mutarisiri wekutanga (PCP) anoziva kuti kune boka revarwere isu tese takaona vanotambura nekuneta, kuneta, uye nekunyanya kunzwa zvisina kunaka izvo isu tisingakwanisi kuwana chaicho chikonzero. Taiteerera, tainyatsoongorora, toronga ropa rakakodzera, uye taitumira kune nyanzvi kuti tiwedzere nzwisiso uye tichiri tisina pfungwa yakajeka pamusoro pezviri kuitika.

Sezvineiwo, vamwe vapepi vaizodzinga varwere ava. Kana vakatadza kuburitsa pachena zvakawanikwa pabvunzo, basa reropa, kana zvimwewo, vangayedzerwa kuti vadzikise zviratidzo zvavo kana kuzvidaidza sevanonyomba kana kuti vane “nyaya” dzepfungwa.

Mamiriro mazhinji akaverengerwa sezvikonzero zvinobvira mumakore. Ndakura zvekukwanisa kurangarira "yuppie flu." Mamwe mavara akashandiswa anosanganisira chisingaperi furuwenza, fibromyalgia, chisingaperi Epstein-Barr, kusanzwa kwakasiyana kwechikafu, nezvimwe.

Zvino, chimwe chimiro chiri kuratidza kumwe kupindirana nemamiriro aya; “chipo” chedenda redu razvino. Ndiri kureva kureba COVID-19, vatakuri vakareba, post-COVID-19, vasingaperi COVID-19, kana post-acute sequelae yeSARS-CoV-2 (PASC). Zvose zvakashandiswa.

Zviratidzo zvenguva refu zvinosanganisira kuneta zvinotevera marudzi akasiyana ezvirwere zvinotapukira. Aya “postinfectious” fatigue syndromes anoita seakafanana neari kunzi myalgic encephalitis/chronic fatigue syndrome (ME/CFS). Kazhinji yenguva, chirwere ichi pachacho chinowanzotevera chirwere chinotapukira.

Kutevera acute COVID-19, vangave vari muchipatara kana kwete, varwere vazhinji vanoramba vachiona kuremara uye zviratidzo kwemwedzi yakawanda. Vamwe veava "vanotora-refu" vanogona kunge vaine zviratidzo zvinoratidza kukuvara kwenhengo. Izvi zvinogona kusanganisira mwoyo, mapapu, kana uropi. Vamwe vafambisi venguva refu vanonzwa kusanzwa zvakanaka kunyangwe vasina humbowo hwakajeka hwekukuvara kwenhengo yakadaro. Asi izvo, varwere vanonzwa kurwara vachiri mushure memwedzi mitanhatu vachitevera bout neCCIDID-19 vanotaura zvakawanda zvezviratidzo zvakafanana neME/CFS. Tinogona kuona kuwanda kwevanhu vane zviratidzo izvi zvichitevera denda. Nehurombo, sevamwe, vazhinji vari kutaura kuti vadzingwa nevashandi vehutano.

Myalgic encephalomyelitis/chronic fatigue syndrome inokanganisa pakati pe836,000 ne2.5 miriyoni vekuAmerica veese mazera, madzinza, varume, uye magariro nehupfumi. Zvizhinji hazvizivikanwi kana kuti zvisizvo. Mamwe mapoka ari kukanganiswa zvisingaite:

• Vakadzi vanobatwa pamwero wakapetwa katatu kupfuura wevarume.
• Kutanga kunowanzoitika pakati pemakore 10 kusvika 19 uye 30 kusvika 39. Avhareji yezera pakutanga i33.
• Vatema neLatinx vanogona kukanganiswa pamwero wepamusoro uye nekuomarara kwakakura kupfuura mamwe mapoka. Isu hatizive chaizvo sezvo data rehuwandu richishaikwa muvanhu veruvara.

Nepo zera remurwere pakuongororwa riri bimodal, nenhamba yepamusoro mumakore ekuyaruka uye imwe yepamusoro mu30s, asi mamiriro acho akatsanangurwa muvanhu kubva pamakore maviri kusvika makumi manomwe nemanomwe.

Vanachiremba vakawanda havana ruzivo rwekuongorora zvakakodzera kana kutarisira ME / CFS. Nehurombo, kutungamira kwekiriniki kwave kushoma, kusashanda, kana kukuvadza. Nemhaka yaikoku, varwere vapfumbamwe mugumi muUnited States vanoramba vasina kuongororwa, uye avo vanowanwa vanowanzogamuchira kurapwa kusina kufanira. Uye ikozvino, nekuda kweCOVID-10 denda, matambudziko aya ari kuwedzera kuwanda.

Breakthrough?

Varwere ava vanowanzosangana nechirwere chetachiona kana chisiri chaicho asi vanotadza kupora sezvanga zvichitarisirwa uye vanoramba vachirwara mavhiki kana mwedzi gare gare.

Kushandiswa kwekurovedza muviri uye kupindira kwepfungwa (kunyanya cognitive behavior therapy) kurapa kuneta kune chokuita nekenza, mamiriro ekuputika, neurologic mamiriro, uye fibromyalgia zvakashandiswa kwemakore akawanda ane maitiro akanaka. Zvisinei, apo vanhu vaifungidzirwa kuva ne ME / CFS vakapiwa mishonga yakafanana, ivo vakaramba vachiita zvakanyanya, kwete zviri nani, nekurovedza muviri uye basa.

Dare re“Dare Rinoona Nezvekuongororwa kweMyalgic Encephalomyelitis/Chronic Fatigue Syndrome; Bhodhi pamusoro peHutano hweVasarudzo Voruzhinji; Institute of Medicine ”akatarisa data uye akauya nemaitiro. Ivo, kutaura zvazviri, vakadaidzira kutsanangurwa patsva kwechirwere ichi. Izvi zvakatsikiswa muNational Academies Press muna 2015. Dambudziko nderekuti varapi vehutano vazhinji havasati vaziva nezvemaitiro aya. Zvino nekuwedzera kwevarwere kwakaunzwa nepost-COVID-19, kufarira kwawedzera zvakanyanya. The criteria:

• Kudzikisira kwakanyanya kana kukanganisa kuita basa risati rarwara, chikoro, kana zviitiko zvekugarisana zvinoenderera kwemwedzi inopfuura mitanhatu zvichiperekedzwa nekuneta, kazhinji kwakadzika, izvo zvisingakonzerwi nekurovedza muviri uye hazvivandudzwe nekuzorora.
• Post-exertional malaise - zvinoreva kutevera basa, kuneta kukuru kana kurasikirwa kwesimba.
• Kusazorodza hope.
• Uye zvirinani kana:
  • Orthostatic kusashivirira - kumira kwenguva refu kunoita kuti varwere ava vanzwe zvakanyanya.
  • Kukanganisa kwekuziva - kungotadza kufunga zvakajeka.

(Varwere vanofanira kuva nezviratidzo izvi zvishoma nehafu yenguva yehunyoro, huri pakati nepakati, kana kusimba kwakanyanya.)

• Vanhu vazhinji vane ME/CFS vanewo zvimwe zviratidzo. Zvimwe zviratidzo zvinowanzoitika zvinosanganisira:
  • Uturu hunorwadza
  • Marwadzo mumajoini pasina kuzvimba kana kutsvuka
  • Musoro wemhando itsva, pateni, kana kuomarara
  • Kuzvimba kana kunyorova lymph nodes mumutsipa kana muhapwa
  • Chirwere chehuro chinowanzoitika kana kudzokorora
  • Kutonhorwa nokudikitira usiku
  • Kuvhiringidzika kunoonekwa
  • Sensitivity kune chiedza uye inzwi
  • Nausea
  • Allergies kana kusanzwa kwechikafu, hwema, makemikari, kana mishonga

Kunyangwe mushure mekuongororwa, varwere vanonetsekana kuwana rubatsiro rwakakodzera uye kazhinji vakanyorerwa marapiro, akadai secognitive-behavioral therapy (CBT) uye graded exercise therapy (GET), iyo inogona kuwedzera mamiriro avo.

New York Times munyori akatengesa zvakanyanya Meghan O'Rourke nguva pfupi yadarika akanyora bhuku rainzi "Humambo Husingaoneki: Reimagining Chronic Illness." Chinyorwa chinobva kumuparidzi chinosuma musoro wenyaya se:

“Denda rakanyarara rezvirwere zvisingaperi rinotambudza makumi emamiriyoni evaAmerica: izvi zvirwere zvisinganzwisiswi, zvinowanzoshorwa, uye zvinogona kuenda zvisingazivikanwe uye zvisingazivikanwe zvachose. Munyori anopa ongororo yakaratidza muchikamu ichi chisingaonekwe chechirwere "chisingaoneki" chinosanganisira zvirwere zve autoimmune, mushure mekurapwa chirwere cheLyme, uye ikozvino refu COVID, kubatanidza iyo yega uye yepasirese kutibatsira isu tese kuburikidza nemuganho mutsva uyu."

Pakupedzisira, pave neongororo dzinoverengeka dzinoratidza kuti izwi rekuti “chronic fatigue syndrome” rinokanganisa maonero anoita varwere nezvehurwere hwavo pamwe nemabatirwo anoitwa vamwe vanhu, kusanganisira vezvokurapa, vomumhuri, uye vavanoshanda navo. Ichi chinyorwa chinogona kuderedza kuti chirwere ichi chakakomba sei kune avo vanotambura. Dare reIOM rinokurudzira zita idzva kutsiva ME/CFS: systemic exertion kutolerance disease (SEID).

Kutumidza chimiro ichi SEID chaizonyatso ratidza chinhu chepakati chechirwere ichi. Sezvineiwo, kuita chero chero rudzi (kwemuviri, kuziva, kana manzwiro) - kunogona kukanganisa varwere munzira dzakawanda.

Resources

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

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

"Humambo Husingaonekwi: Kufungazve Kurwara Kusingaperi" Meghan O'Rourke