Ukudinwa nokungaqondwa kakuhle

Bendikukhathalelo lokuqala amashumi eminyaka.

Kakhulu nabani na oye waba ngumboneleli wokhathalelo oluphambili (PCP) uyazi ukuba kukho iqela lezigulane esizibonileyo sonke ezibandezelekayo ngenxa yokudinwa, ukudinwa, kwaye ngokusisiseko siziva singalunganga esingakwaziyo ukufumana unobangela othile. Besiya kumamela, senze uviwo olunenyameko, siyalele ukusebenza kwegazi okufanelekileyo, kwaye sibhekisa kwiingcali ukuze sifumane ulwazi olongezelelweyo kwaye sibe singenalo nofifi malunga nokuba kuqhubeka ntoni.

Ngelishwa, abanye ababoneleli baya kuzigxotha ezi zigulana. Ukuba abanakukwazi ukufumanisa ukufunyaniswa okungaqhelekanga kuvavanyo, umsebenzi wegazi, okanye enye into, banokuhendeka ukuba bangazithobi iimpawu zabo okanye bazibhale njengezinyeliso okanye “ezinemiba” yengqondo.

Iimeko ezininzi ziye zachaphazeleka njengezizathu ezinokwenzeka kwiminyaka. Ndimdala ngokwaneleyo ukuba ndikhumbule "umkhuhlane we-yuppie." Ezinye iilebhile ezisetyenzisiweyo ziquka umkhuhlane ongapheliyo, i-fibromyalgia, i-Epstein-Barr engapheliyo, ukungakhathali kokutya okuhlukeneyo, kunye nabanye.

Ngoku, enye imeko ityhila ukugqithelana kwezi meko; "isipho" sobhubhane wethu wamva nje. Ndibhekisa kwi-COVID-19 ende, iinqwelo ezinde, i-post-COVID-19, i-COVID-19 engapheliyo, okanye i-post-acute sequelae ye-SARS-CoV-2 (PASC). Zonke zisetyenzisiwe.

Iimpawu ezingapheliyo ezibandakanya ukudinwa zilandela iintlobo ezahlukeneyo zezifo ezosulelayo. Ezi “postinfectious” fatigue syndromes zibonakala zifana noko kubizwa ngokuba yi-myalgic encephalitis/chronic fatigue syndrome (ME/CFS). Amaxesha amaninzi, le meko ngokwayo idla ngokulandela isifo esosulelayo.

Ukulandela i-COVID-19 ebukhali, nokuba isibhedlele okanye akunjalo, izigulana ezininzi ziyaqhubeka nokuba nobuthathaka kunye neempawu iinyanga ezininzi. Abanye baba “bakhweli bexesha elide” basenokuba neempawu ezibonisa ukonakala kwamalungu. Oku kunokubandakanya intliziyo, imiphunga okanye ingqondo. Abanye abahambi ixesha elide baziva bengaphilanga nangona bengenabo ubungqina obucacileyo bomonakalo onjalo wamalungu. Ngapha koko, abaguli abaziva begula nangoku emva kweenyanga ezintandathu ezilandela i-COVID-19 baxela uninzi lweempawu ezifanayo njenge-ME/CFS. Sinokubona ukuphinda-phindana kwabantu abanezi mpawu kulandela ubhubhane. Ngelishwa, njengabanye, abaninzi baxela ukugxothwa ngabasebenzi bezempilo.

I-Myalgic encephalomyelitis / i-chronic fatigue syndrome ichaphazela phakathi kwe-836,000 kunye ne-2.5 yezigidi zabantu baseMerika beminyaka yonke, ubuhlanga, ubulili, kunye nemvelaphi yentlalontle yezoqoqosho. Uninzi lwabo alufunyaniswanga okanye alufunyaniswanga kakuhle. Amanye amaqela achatshazelwa ngokungafanelekanga:

• Abasetyhini bachaphazeleka ngomlinganiselo ophindwe kathathu kunamadoda.
• Ukuqala kwenzeka rhoqo phakathi kweminyaka eyi-10 ukuya kwi-19 kunye ne-30 ukuya kuma-39. Umyinge weminyaka ekuqaleni ngama-33.
• Abamnyama kunye neLatinx banokuchaphazeleka kwizinga eliphezulu kunye nobukhulu obukhulu kunamanye amaqela. Asazi ngokuthe ngqo kuba idatha yokuxhaphaka ilahlekile kubantu bemibala.

Nangona iminyaka yesigulana ekuxilongeni i-bimodal, kunye nencopho kwiminyaka yeshumi elivisayo kunye nenye incopho kwi-30s, kodwa imeko ichazwe kubantu abaneminyaka emi-2 ukuya kwe-77.

Oogqirha abaninzi abanalo ulwazi lokuxilonga ngokufanelekileyo okanye ukulawula i-ME/CFS. Ngelishwa, isikhokelo sonyango sinqabile, siphelelwe lixesha, okanye sinokuba yingozi. Ngenxa yoku, abaguli abali-10 kwabali-19 eUnited States bahlala bengafunyaniswanga, yaye abo bafunyaniswayo ngokufuthi bafumana unyango olungafanelekanga. Kwaye ngoku, ngenxa yobhubhani we-COVID-XNUMX, ezi ngxaki ziya zixhaphaka ngakumbi.

Ukuphumelela?

Ezi zigulana zihlala zifumana usulelo oluqinisekisiweyo okanye olungachanekanga kodwa luyasilela ukululama njengoko bekulindelekile kwaye luqhubeke nokugula kwiiveki ukuya kwiinyanga kamva.

Ukusetyenziswa konyango lokuzivocavoca kunye nokungenelela kwengqondo (ngokukodwa unyango lokuziphatha kwengqondo) ukunyanga ukukhathala okunxulumene nomhlaza, iimeko ezivuthayo, iimeko ze-neurologic, kunye ne-fibromyalgia zisetyenziswe iminyaka kunye nesiphumo esihle ngokubanzi. Nangona kunjalo, xa abantu abarhanelwa ukuba bane-ME / CFS banikwa unyango olufanayo, bahlala besenza okubi kakhulu, kungekhona ngcono, ngokuzilolonga kunye nomsebenzi.

"IKomiti yeMithetho yokuHlola ye-Myalgic Encephalomyelitis / Chronic Fatigue Syndrome; Ibhodi kwiMpilo yabaNtu abakhethiweyo; Institute of Medicine” yajonga idatha kwaye yeza nemigaqo. Bona, eneneni, bafuna ukuchazwa ngokutsha kwesi sigulo. Oku kwapapashwa kwiNational Academies Press ngo-2015. Umceli mngeni ngoononophelo lwezempilo abaninzi abakazazi ezi nqobo zokugweba. Ngoku ngokunyuka kwezigulana okuziswe yi-post-COVID-19, umdla unyuke kakhulu. Iikhrayitheriya:

• Ukuncitshiswa okukhulu okanye ukonakala kokubandakanyeka kumanqanaba okugula kwangaphambili komsebenzi, isikolo, okanye imisebenzi yentlalo eqhubeka ngaphezu kweenyanga ezintandathu ehamba nokudinwa, okuhlala kunzulu, okungabangelwa ngumthambo kwaye akuphuculwanga kukuphumla.
• I-post-exertional malaise - oku kuthetha ukulandela umsebenzi, kukho ukukhathala okukhulu okanye ukulahlekelwa kwamandla.
• Ubuthongo obungaqabuliyo.
• Kwaye nokuba:
  • Ukunganyamezelani kwe-Orthostatic - ukuma ixesha elide kwenza ezi zigulana zizive zibi kakhulu.
  • Ukuphazamiseka kwengqondo - awukwazi nje ukucinga ngokucacileyo.

(Izigulana kufuneka zibe nezi mpawu ubuncinci isiqingatha sexesha elithambileyo, eliphakathi, okanye elibukhali.)

• Abantu abaninzi abane-ME/CFS nabo banezinye iimpawu. Iimpawu ezongezelelweyo eziqhelekileyo ziquka:
  • Ubuhlungu besisu
  • Ubuhlungu kumalungu ngaphandle kokuvuvukala okanye ubomvu
  • Intloko yohlobo olutsha, ipateni, okanye ubunzima
  • I-lymph nodes ezidumbileyo okanye ezithambileyo entanyeni okanye ekhwapheni
  • Umqala obuhlungu oqhelekileyo okanye ophindaphindayo
  • Ukugodola nokubila ebusuku
  • Ukuphazamiseka okubonakalayo
  • Uvakalelo kukukhanya kunye nesandi
  • I sizathu
  • Ukwaliwa okanye uvakalelo kukutya, ivumba, iikhemikhali, okanye amayeza

Nasemva kokuxilongwa, izigulana ziyasokola ukufumana ukhathalelo olufanelekileyo kwaye kaninzi ziye zimiselwe unyango, olufana nonyango lwe-cognitive-behavioral (CBT) kunye nonyango lwe-graded exercise (GET), olunokuthi lube mbi ngakumbi imeko yabo.

Umbhali othengisa kakhulu kwiNew York Times uMeghan O'Rourke kutshanje ubhale incwadi ebizwa ngokuba "UBukumkani obungabonakaliyo: Ukucinga kwakhona ukugula okungapheliyo." Inqaku elisuka kumpapashi lazisa isihloko ngolu hlobo:

“Ubhubhani wezifo ezinganyangekiyo uthwaxa amashumi ezigidi zabantu baseMerika: ezi zizifo ezingaqondwa kakuhle, ezisoloko zijongelwa phantsi, nezinokungafunyaniswanga kwaye zingaqondwa ngokupheleleyo. Umbhali unikezela ngophando olusityhilelo kolu didi lunzima lwesigulo "esingabonakaliyo" esibandakanya izifo ezizimelayo, isifo se-Lyme emva konyango, kwaye ngoku i-COVID ende, idibanisa ubuntu kunye nendalo iphela ukuze sincede sonke kulo mda mtsha.

Okokugqibela, kuye kwakho izifundo ezininzi ezibonisa ukuba igama elithi “chronic fatigue syndrome” lichaphazela indlela abajonga ngayo izigulana ngesigulo sabo kwakunye nendlela abasabela ngayo abanye, kuquka abasebenzi bezonyango, amalungu entsapho kunye nabo basebenza nabo. Le leyibhile inokunciphisa ukuba le meko imbi kangakanani kwabo baxhwalekileyo. Ikomiti ye-IOM icebisa igama elitsha endaweni ye-ME/CFS: isifo se-systemic exertion intolerance (SEID).

Ukuthiya le meko i-SEID ngenene iya kuqaqambisa eyona nto iphambili yesi sifo. Oko kukuthi, umgudu walo naluphi na uhlobo (emzimbeni, engqondweni, okanye ngokweemvakalelo) - kunokuchaphazela kakubi izigulana ngeendlela ezininzi.

Resources

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

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

"UBukumkani obungabonakaliyo: Ukucinga kwakhona ukugula okungapheliyo" uMeghan O'Rourke