Ukukhathala Nokungaqondi

Sengibe sesikhundleni sokunakekelwa okuyisisekelo amashumi eminyaka ambalwa.

Kakhulu noma ubani oke waba ngumnikezeli wokunakekela oyinhloko (i-PCP) uyazi ukuthi kuneqembu leziguli esike sazibona ezihlushwa ukukhathala, ukukhathala, futhi ngokuyisisekelo ezizizwa kabi esingakwazi ukuthola imbangela yazo. Besingalalela, senze ukuhlola okucophelelayo, si-ode ukusebenza kwegazi okufanelekile, futhi sibhekise kochwepheshe ukuze bathole ukuqonda okwengeziwe futhi sibe singakabi nawo umbono ocacile mayelana nokuthi kwenzekani.

Ngeshwa, abanye abahlinzeki bangaxosha lezi ziguli. Uma bengakwazi ukudalula okuthile okungavamile ekuhlolweni, ekusebenzeni kwegazi, noma okunye, bangalingeka ukuba banciphise izimpawu zabo noma bazibize njengezihlambalazayo noma “ezinezinkinga” ezingokwengqondo.

Izimo eziningi ziye zathinteka njengezimbangela okungenzeka eminyakeni edlule. Sengimdala ngokwanele ukukhumbula “umkhuhlane we-yuppie.” Amanye amalebula asetshenzisiwe afaka umkhuhlane ongapheli, i-fibromyalgia, i-Epstein-Barr engapheli, ukungezwani kokudla okuhlukahlukene, nokunye.

Manje, esinye isimo siveza ukugqagqana kwalezi zimo; “isipho” sobhubhane lwethu lwakamuva. Ngibhekise ku-COVID-19 ende, izihambisi ezinde, i-post-COVID-19, i-COVID-19 engapheli, noma i-post-acute sequelae ye-SARS-CoV-2 (PASC). Konke kusetshenzisiwe.

Izimpawu eziqhubekayo kuhlanganise nokukhathala zilandela izinhlobo ezihlukahlukene zezifo ezithathelwanayo. Lezi zimpawu zokukhathala “okungemva kwamagciwane” zibonakala zifana nalokho okubizwa ngokuthi i-myalgic encephalitis/chronic fatigue syndrome (ME/CFS). Ezikhathini eziningi, lesi simo ngokwaso ngokuvamile silandela ukugula okufana nokuthathelwanayo.

Ukulandela i-COVID-19 eyingozi, kungakhathaliseki ukuthi ilaliswe esibhedlela noma cha, iziguli eziningi ziyaqhubeka nokuba nokukhubazeka nezimpawu izinyanga eziningi. Abanye balaba “abadonsa isikhathi eside” bangase babe nezimpawu ezibonisa ukulimala kwesitho. Lokhu kungase kuhlanganise inhliziyo, amaphaphu, noma ubuchopho. Abanye abadonsa isikhathi eside bazizwa bengaphilile nakuba bengenabo ubufakazi obucacile bokulimala kwesitho esinjalo. Eqinisweni, iziguli ezizizwa zigula namanje ngemva kwezinyanga eziyisithupha kulandela ukuqubuka kwe-COVID-19 zibika eziningi zezimpawu ezifanayo njenge-ME/CFS. Singabona ukuphindeka kabili kwabantu abanalezi zimpawu kulandela ubhubhane. Ngeshwa, njengabanye, abaningi babika ukuthi baxoshwa ochwepheshe bezempilo.

I-Myalgic encephalomyelitis/chronic fatigue syndrome ithinta phakathi kwezigidi ezingu-836,000 nezingu-2.5 zabantu baseMelika bayo yonke iminyaka, izinhlanga, ubulili, kanye nezizinda zenhlalo-mnotho. Iningi alitholakali noma alixilongwanga kahle. Amanye amaqembu athinteke ngokungafanele:

• Abesifazane bathinteka ngenani eliphindwe kathathu kunabesilisa.
• Ukuqala kuvame ukwenzeka phakathi kweminyaka eyi-10 kuye kweyi-19 kanye nengu-30 kuye kwengama-39. Isilinganiso seminyaka ekuqaleni singu-33.
• Abamnyama namaLatinx bangase bathinteke ngenani eliphezulu nangobunzima obukhulu kunamanye amaqembu. Asazi njengoba idatha yokuvama ishoda kubantu bemibala.

Nakuba iminyaka yesiguli ekuxilongweni kwayo i-bimodal, nenani eliphakeme eminyakeni yobusha kanye nelinye inani eliphakeme eminyakeni yama-30s, kodwa lesi simo siye sachazwa kubantu abaneminyaka emi-2 kuya kwengama-77.

Odokotela abaningi abanalo ulwazi lokuxilonga noma ukuphatha i-ME/CFS ngendlela efanele. Ngeshwa, isiqondiso somtholampilo besilokhu siyindlala, siphelelwe yisikhathi, noma singaba yingozi. Ngenxa yalokhu, iziguli eziyisishiyagalolunye kweziyishumi e-United States azikatholakali, futhi lezo ezitholakele ngokuvamile zithola ukwelashwa okungafanele. Futhi manje, ngenxa yobhubhane lwe-COVID-10, lezi zinkinga ziya ngokuya zibanda kakhulu.

Ukuphumelela?

Lezi ziguli ngokuvamile ziba nokutheleleka okuqinisekisiwe noma okungaqondile kodwa ziyehluleka ukululama njengoba bekulindelekile futhi ziqhubeke nokugula emasontweni ambalwa kuya ezinyangeni kamuva.

Ukusetshenziswa kokwelashwa kokuzivocavoca kanye nokungenelela kwengqondo (ikakhulukazi ukwelashwa kokuziphatha kwengqondo) ukwelapha ukukhathala okuhlobene nomdlavuza, izimo ezivuthayo, izimo ze-neurologic, kanye ne-fibromyalgia sekusetshenziswe iminyaka ngomphumela omuhle ngokuvamile. Kodwa-ke, lapho inani labantu elisolwa ukuthi line-ME/CFS linikezwa ukwelashwa okufanayo, lalilokhu lenza okubi kakhulu, hhayi okungcono, ngokuzivocavoca nokusebenza.

“Ikomidi Lemibandela Yokuxilonga Ye-Myalgic Encephalomyelitis/Chronic Fatigue Syndrome; Ibhodi Lezempilo Lokukhethiwe Kwabantu; I-Institute of Medicine” ibheke imininingwane yase iqhamuka nemibandela. Empeleni, bafuna ukuchazwa kabusha kwalesi sifo. Lokhu kwashicilelwa kuNational Academies Press ngo-2015. Inselelo iwukuthi abahlinzeki bezempilo abaningi abakazazi lezi zindlela zokunquma. Manje ngokwanda kweziguli okulethwa yi-post-COVID-19, inzalo ikhule kakhulu. Imibandela:

• Ukwehliswa okukhulu noma ukonakala ukuze uhileleke emazingeni angaphambi kokugula okusebenza, esikoleni, noma ezenzweni zomphakathi eziqhubeka isikhathi esingaphezu kwezinyanga eziyisithupha ezihambisana nokukhathala, ngokuvamile okujulile, okungabangelwa ukuvivinya umzimba futhi okungathuthukiswa ukuphumula.
• I-post-exertional malaise - okusho ukulandela umsebenzi, kukhona ukukhathala okuphawulekayo noma ukulahlekelwa amandla.
• Ukulala okungaqabuli.
• Futhi okungenani noma:
  • Ukungabekezelelani kwe-Orthostatic - ukuma isikhathi eside kwenza lezi ziguli zizizwe zimbi kakhulu.
  • Ukukhubazeka kwengqondo - ukungakwazi nje ukucabanga ngokucacile.

(Iziguli kufanele zibe nalezi zimpawu okungenani isigamu sesikhathi sokuqina okuthambile, okumaphakathi, noma okunzima.)

• Abantu abaningi abane-ME/CFS nabo banezinye izimpawu. Izimpawu ezengeziwe ezivamile zihlanganisa:
  • Ubuhlungu besisu
  • Ubuhlungu emalungeni ngaphandle kokuvuvukala noma ububomvu
  • Ubuhlungu bekhanda bohlobo olusha, iphethini, noma ukuqina
  • Ama-lymph nodes avuvukele noma athambile entanyeni noma ekhwapheni
  • Umphimbo obuhlungu njalo noma ophindaphindayo
  • Ukugodola nokujuluka ebusuku
  • Ukuphazamiseka okubonakalayo
  • Ukuzwela ekukhanyeni nomsindo
  • I-nausea
  • Ukungezwani komzimba noma ukungezwani kokudla, iphunga, amakhemikhali, noma imithi

Ngisho nangemva kokuxilongwa, iziguli ziyabazabalaza ukuthola ukunakekelwa okufanele futhi ngokuvamile ziye zanikezwa imithi yokwelapha, efana nokwelashwa kwengqondo-yokuziphatha (CBT) kanye nokwelashwa kokuzivocavoca okulinganiselwe (GET), okungase kwenze isimo sazo sibe sibi.

Umbhali othengisa kakhulu we-New York Times uMeghan O'Rourke usanda kubhala incwadi ebizwa ngokuthi “Umbuso Ongabonakali: Ukuhlaziya Kabusha Ukugula Okungalapheki.” Inothi elivela kumshicileli lethula isihloko ngokuthi:

“Umqedazwe othule wezifo ezingamahlalakhona uhlupha amashumi ezigidi zabantu baseMelika: lezi yizifo ezingaqondwa kahle, ezivame ukubukelwa phansi, futhi ezingase zingabonakali futhi zingabonakali ngokuphelele. Umbhali wethula uphenyo olwembulayo kulesi sigaba sokugula “okungabonakali” esihlanganisa izifo ezizimele, i-post-treatment Lyme disease syndrome, kanye ne-COVID ende manje, ehlanganisa okomuntu siqu kanye nendawo yonke ukuze isize sonke ngalo mngcele omusha. ”

Ekugcineni, kuye kwaba nocwaningo oluningana olusikisela ukuthi igama elithi “chronic fatigue syndrome” lithinta imibono yeziguli ngokugula kwazo kanye nendlela abanye abasabela ngayo, okuhlanganisa izisebenzi zezokwelapha, amalungu omkhaya, nabasebenza nabo. Le lebula inganciphisa ukuthi lesi simo sibucayi kangakanani kulabo abahlukumezekile. Ikomidi le-IOM lincoma igama elisha elizongena esikhundleni se-ME/CFS: isifo se-systemic exertion kutolerance (SEID).

Ukuqamba lesi simo ngokuthi i-SEID empeleni kungagqamisa isici esiyinhloko salesi sifo. Okungukuthi, ukuzikhandla kwanoma yiluphi uhlobo (ngokomzimba, ngokomqondo, noma ngokomzwelo) - kungathinta kabi iziguli ngezindlela eziningi.

Resources

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

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

"Umbuso Ongabonakali: Ukucabanga Kabusha Ukugula Okungapheli" Meghan O'Rourke