Imajin se yu fambul, yu padi, ɔ yusɛf gɛt ɛpilepshi, ɔ yu dɔn de sɔfa wit siriɔs pwɛl hat fɔ lɔng tɛm. I nɔ mata ɔmɔs mɛrɛsin yu tek ɛn ɔmɔs tritmɛnt yu tray, i tan lɛk se yu nɔ go ebul fɔ kɔntrol di sik. Dɔktɔ dɛn dɔn tray ɔl wetin dɛn ebul. We dis kayn tin apin, yu kin yɛri bɔt wan tritmɛnt we difrɛn smɔl ɛn we dɔn go bifo. Na dat wi kin kɔl VNS, ɔ Vagus Nerve Stimulation.
Wetin na vagus nerve stimulation (VNS)?
Fɔ tɔk am simpul wan, dis na tritmɛnt we de chenj di we aw di nerv dɛn de wok. Fɔ tɔk di kɔrɛkt tin, i tan lɛk we dɛn put pesmɛka na di at. Na dat mek sɔm pipul dɛn kin kɔl am di "pacemaker of the brain."
Dis tritmɛnt na fɔ ɔpreshɔn fɔ put wan smɔl tin ɔnda di skin na yu chɛst we de ɔp. Dis divays gɛt wan waya we rili tan we dɛn tay pan wan spɛshal nɛv we dɛn kɔl di vagus nɛv na yu nɛk. Dɔn di divays kin sɛn ilɛktrik puls dɛn we rili saful wan ɔltɛm . dis signal dεm de travul along di vagus nerve to di bren stεm. frכm de, dεn signal dεm ya de sheb to difrεn pat dεm na di bren εn bigin fכ chenj di we aw di bren sεl dεm de wok.
Tipikli, dɔktɔ go tink bɔt VNS tritmɛnt we ɔl di ɔda tritmɛnt dɛn dɔn fel. Naw, dɛn dɔn gri fɔ am ɔlsay na di wɔl fɔ smɔl nɔmba pan pipul dɛn we gɛt ɛpilepsi we nɔ kin gɛt tritmɛnt ɛn pwɛl at we nɔ kin gɛt tritmɛnt. Dɛn dɔn gri fɔ am bak as ɛp fɔ rihabiliteshɔn fɔ sɔm pasɛnt dɛn we jɔs gɛt strok.
Usay di Vagus Nɛv de? Wetin i de du?
12 men pe nεv dεm de we de kכri ilektrikal signal frכm wi bren to difrεn pat dεm na di bכdi. Wi kin kɔl dɛn kraynia nɛv ya. di vagus nεv na di tεn (X) pan dεn nεv dεm ya. Dis na di kranial nerve we lɔng pas ɔl na wi bɔdi.
Wi gɛt tu vagus nerves, wan na ɛni say na wi bɔdi. Dɛn tu kin bigin na di bren stem. Dɔn dɛn kin rɔn tru di nɛk, go insay di chɛst, ɛn go insay di bɛlɛ. Fɔ tɔk am simpul wan, di vagus nerve na pat pan wan big sɛktri we de kɔnɛkt di ɔgan dɛn na wi nɛk, at, lɔng, ɛn bɛlɛ to di bren.
Us kɔndishɔn dɛn kin yuz VNS tɛrapi fɔ?
Big big ɛjɛnshi dɛm, lɛk di US Food and Drug Administration (FDA), dɔn gri naw fɔ gi VNS tritmɛnt fɔ tri mɛrɛsin. Lɛ wi luk dis infɔmeshɔn na wan tebul.
| Mɛdikal kɔndishɔn | Aw fɔ yuz ɛn udat fit fɔ am |
|---|---|
| Epilepsy we pɔsin kin gɛt | As adjɔnt tritmɛnt fɔ pikin dɛn we dɔn pas 4 ia ɛn big pipul dɛn we gɛt fɔs sik we kin bigin na wan pat na di bren ɛn we dɛn nɔ kin kɔntrol wit mɛrɛsin. |
| Pwɛl at | Big pipul dɛm wae dɔn pas 18 ia wae gɛt lɔng tɛm ɔr wae de kam bak wit big big pwɛl hat sik wae nɔr dɔn ansa at le 4 ɔr mɔr difrɛn mɛrɛsin dɛm wae de mek pɔrsin fil bad. |
| Strɔk Rihabiliteshɔn | As ɔda ɛp fɔ rihabiliteshɔn ɛgzampul fɔ pasɛnt dɛn we gɛt mɔdaret to siriɔs impεryans pan an ɛn an fכnshכn afta wan ischemic strok we kכz bay we wan blɔd vesel blok. |
Aw dis VNS divays kin rili wok?
Di trut na dat, sayɛnsman dɛn stil nɔ shɔ 100% aw ɛksaktɔli dis VNS divays de wok, bɔt dɛn gɛt sɔm gud aidia dɛn.
- Epilepsy control: We epilepsy seizure apin, di bren in ilɛktrik aktiviti kin ambɔg. dεn biliv se VNS stimulashכn de inkrεs di bכdi fכ fכlכ to imכtant pat dεm na di bren, altεr dis disrupt ilektrikal patεn, εn inkrεs di lεvεl dεm fכ di nyurotransmit dεm ``norepinephrine'' εn ``serotonin'' na di bren, we de εp fכ kכntrכl εpilepsi.
- Fɔ diprɛshɔn mɛnejɛmɛnt: Dɛn kin tink se VNS kin ridyus di simptom dɛm fɔ pwɛl hat bay wae i kin chenj di lɛvɛl dɛm fɔ sɔm nyurotransmit dɛm wae kin kɔntrol wi muud.
- fכ strok rihabiliteshכn: Dis stimulashכn de mek di mכtalman kכtεks, di pat pan di bren we de kכntro di muvmεnt fכ wi an εn an dεm. Dis kin mek am izi fɔ di bren fɔ lan dɛn muvmɛnt dɛn de bak we dɛn de du ɛksɛsayz fɔ rihabiliteshɔn.
Aw e kin fil fɔ gɛt di VNS divays na yu bɔdi?
Bɔku tɛm, yu nɔ go ivin notis se dis divays de ɔp. Bɔt sɔm pipul dɛn kin fil smɔl difrɛns we dɛn de pan di stimulashɔn.
- Wan tin we kin mek pɔsin fil tik na yu trot ɔ yu nɛk
- Wan smɔl smɔl vɔys we de ala lawd wan
- Wan kɔf we rili smɔl
Ivin if yu fil dis kayn we, bɔku tɛm yu kin yus to am as tɛm de go. Bɔt if dis stimulashɔn de mɔna yu, tɔk to yu dɔktɔ wantɛm wantɛm. I kin chenj di sɛtin dɛn na di divays ɛn ridyus di tin dɛn we de mek i want fɔ du sɔntin.
Udat nɔ fɔ gɛt VNS tritmɛnt?
VNS tritmɛnt nɔr fayn fɔ pipul dɛm wae gɛt sɔm kayn wɛl bɔdi prɔblɛm. If yu gɛt ɛni wan pan dɛn kɔndishɔn ya, yu nɔ go bi gud kandidet fɔ VNS.
- If yu gɛt bɛlɛ .
- If yu gɛt prɔblɛm wit yu brith lɛk asma ɔ slip apnea .
- If yu gɛt aktif bɛlɛ ɔlsa (pɛptik ɔlsa sik) .
- If yu gɛt dayabitis we de dipen pan insulin .
- If yu gɛt wan vagus nerve nɔmɔ (dɛn kin bɔn sɔm pipul dɛn wit am).
- If yu gɛt wan sik we dɛn kɔl dysautonomias, we na abnɔmal wok we di ɔtonomik nɛvɔ sistɛm de du.
- If yu dɔn ɔlrɛdi de gɛt ɔda tritmɛnt dɛn we de mek yu bren .
- If yu gɛt at ritm abnɔmaliti (at aritmia) ɔr ɔda at sik. If yu gɛt histri bɔt maynd sik lɛk skizofrenia ɔr schizoaffective disorder.
- If dɛn dɔn pul wan pat pan yu lɛft vagus nerve insay wan ɔpreshɔn we dɛn bin dɔn du bifo.
Wetin kin apin bifo ɛn we dɛn de du VNS ɔpreshɔn?
Dis nɔto big ɔpreshɔn we de mek pɔsin fred. Bɔku tɛm, i kin tek lɛk wan ɛn af awa so.
Fɔ rɛdi fɔ ɔpreshɔn
Bifo di ɔpreshɔn, yu dɔktɔ go du wan kɔmplit ɛgzam fɔ yu bɔdi. I kin du bɔku blɔd tɛst dɛn bak fɔ mek shɔ se no ɔda wɛlbɔdi prɔblɛm nɔ de we go ambɔg di ɔpreshɔn.
Aw dɛn kin du di ɔpreshɔn
Di de we dɛn go du yu ɔpreshɔn, dɛn go gi yu antibayɔtik fɔ mek yu nɔ gɛt di sik. Dɔn dɛn go gi yu anestezi. Yu kin jɔs de na di nɛk ɛn chɛst eria usay dɛn go du di ɔpreshɔn, ɔ dɛn kin gi yu jenɛral anestezi ɛn put yu na slip.
di dɔktɔ we de du di ɔpreshɔn kin kɔt tu smɔl smɔl say dɛn: wan na di lɛft say na di nɛk (fɔ rich di vagus nerve) ɛn di ɔda wan na di ɔp lɛft say na di chɛst.
1. Dɛn kin put wan tint waya wit ilɛktrɔd tru wan say we dɛn kɔt na di nɛk ɛn tek tɛm rap am rawnd di vagus nɛv.
2. Dɔn dɛn kin briŋ di waya ɔnda di skin to di say we dɛn kɔt di chɛst.
3. Frɔm di kɔt we dɛn kɔt na di chɛst, we big smɔl pas fayv rup kɔyn, .wan stimulator we lεk batri (pulse generator) dεn de put am insay wan sכmכl spεs we dεn mek oba di chεst mכsul.
4. fכ finish, di waya we de kכmכt na di nεk de kכnekt to dis stimulator.
We ɔltin dɔn kɔnɛkt, di dɔktɔ we de du di ɔpreshɔn go tɛst di divays. Set am to wan rili lכw setin εn rכn am fכ lεk 30-90 sekכnd fכ si if di stimulashכn de wok fayn fayn wan. If ɔltin fayn, dɛn go lɔk di say dɛn we dɛn kɔt ɛn put stich dɛn.
Wetin kin apin afta di ɔpreshɔn?
Fɔ ɔpreshɔn ɛn ajɔst di divays
Yu go nid fɔ si yu dɔktɔ bak 2-4 wik afta dɛn dɔn du di ɔpreshɔn. Na da tɛm de di divays go aktiv fayn fayn wan. Di dɔktɔ go yuz kɔmpyuta ɛn spɛshal tin (programming wand) fɔ mek di sɛtin fɔ yu sik. (Fכ egzampl, aw lכng i go de on, aw lכng i go כf, aw strכng di stimulashכn go bi, εn כda tin dεm).
Yu nɔ go ebul fɔ chenj dɛn sɛtin dɛn ya, bɔt dɛn go gi yu magnet we yu go ebul fɔ ol na yu an .
- Fɔ pɔsin we gɛt ɛpilepshi: We pɔsin want fɔ gɛt sik, dɛn kin swip dis magnet oba di divays we de na in chɛst. Dis go gi ɔda stimuleshɔn ɛn i kin stɔp di sik ɔ ridyus in siriɔs.
- Fɔ pɔsin we de du strok rihabiliteshɔn: We yu swip dis magnet bifo yu bigin fɔ du ɛksɛsayz, di stimulashɔn go aktiv fɔ 30 minit.
- Stɔp di divays fɔ sɔm tɛm: If yu ol di magnet oba di divays, di stimulashɔn go stɔp. We yu pul di magnet, i go bigin fɔ wok bak lɛk aw di dɔktɔ dɔn program am.
Batri layf
Di divays in bateri kin las fɔ lɛk 6 ia (sɔm kin las frɔm wan ia to 15 ia). We di batri dɔn lɔs, dɛn fɔ chenj di wan ol stimulator. Dis kin nid bak fɔ du smɔl ɔpreshɔn we dɛn kin du tru wan smɔl say we dɛn kɔt di chɛst.
I rili impɔtant: If yu gɛt VNS divays, yu fɔ rili tɛl yu dɔktɔ bifo yu du skan, lɛk MRI, bikɔs di strɔng magnɛtik fil na di MRI mashin kin pwɛl di VNS divays.
Wetin na di risk ɛn sayd ɛfɛkt dɛm fɔ VNS tritmɛnt?
Lɛk ɛni mɛrɛsin, VNS kin gɛt sɔm risk ɛn sayd ɛfɛkt. Bɔrku pan dɛn tin ya nɔr kin siriɔs ɛn dɛn go stɔp as tɛm de go.
| Risk/sayd ɛfɛkt tayp | Tɔk bɔt |
|---|---|
| Kɔmɔn sayd ɛfɛkt dɛn | |
| Voys chenj | Fɔ mek yu vɔys ala ɔ chenj yu vɔys |
| Trot de at | Kɔf, trot we de at, ɔ we yu de ala lawd lawd wan |
| I nɔ izi fɔ blo | I nɔ izi fɔ blo (Dyspnea) . |
| Ɔda | I nɔ izi fɔ swɛla (Dysphagia), ed we de at |
| Siriɔs bɔt Rare Sayd Ɛfɛkt dɛn | |
| Nɛv dɛn we dɔn pwɛl | Vokal kɔd paralayz, we di mɔsul dɛn we de dɔŋ di fes wik |
| Infεkshכn dεm | Infεkshכn we dεn kin pwεl wit insishכn |
| Prɔblɛm dɛn we gɛt fɔ du wit mɛkanikal | Waya brok ɔ divays nɔ de wok fayn |
Aw lɔng i kin tek fɔ mek i wɛl? Wetin na di tin dɛn we kin apin?
Yu kin bigin fɔ du tin dɛn we yu kin du bak tu dez (48 awa) afta yu dɔn du di ɔpreshɔn. Di stich dɛn kin sɔlv, so nid nɔ de fɔ mek dɛn kɔt dɛn.
Bɔt i kin tek sɔm tɛm fɔ si di tin dɛn we kin apin. I kin tek wan ia ɔ mɔ fɔ no ustɛm yu go bɛnifit frɔm VNS.
- Epilepsy we pɔsin kin gɛt:VNS nɔ de mɛn ɛpilepsi ɔltogɛda. I nɔ de stɔp di sik dɛn we de mek pɔsin sik kpatakpata. Yu go nid fɔ kɔntinyu fɔ tek yu epilepsy mɛrɛsin. Di gol fɔ VNS na fɔ ridyus di frɛkuɛns, di siriɔs, ɛn di tɛm we di sik kin tek. Insay wan stכdi, bכt 43% pan di sik pipul dεm bin εkspiriεns 50% כ pas dat rεdukshכn pan di frεkuεns we dεn kin sik insay tri ia.
- Pwɛl hat: Dɛn stil de du risach bɔt aw VNS kin woke fɔ pwɛl hat. As a so, dɛn kin jɔs tink bɔt am afta di mɛrɛsin ɛn saykotɛrapi dɔn fel. Insay sɔm stɔdi dɛm, na 20%-30% pan di sik pipul dɛm nɔmɔ dɔn gɛt bɔku impɔtant improvement.
- Strok rihabiliteshɔn: Insay wan stɔdi, di pasɛnt dɛn we bin du rihabiliteshɔn ɛgzampul wit VNS stimulashɔn bin rili impɔtant fɔ mek dɛn muv dɛn an ɛn an we dɛn kɔmpia dɛn wit di wan dɛn we bin de du ɛksɛsayz we nɔ gɛt VNS.
Ustɛm a fɔ go to dɔktɔ?
If yu gɛt ɛni wan pan dɛn sayn ya, kɔl yu dɔktɔ wantɛm wantɛm.
- Di sayn dɛn we de sho se pɔsin gɛt infekshɔn:
- If di say we dɛn kɔt am rɛd, i swel, ɔ i de fil pen we yu tɔch am.
- If di kɔt de smɛl bad ɔ wata we tan lɛk pus de kɔmɔt pan am.
- If yu fil fiva ɔ yu gɛt kol.
- Ɔda siriɔs sayn dɛn:
- If di vɔys kɔntinyu fɔ de ala.
- If di stimulashɔn de pen, we de mek i nɔ izi fɔ blo ɔ swɛla.
- If yu fil se yu de slip bad bad wan.
- If i tan lɛk se di divays nɔ de wok fayn ɔ signal de fɔ se di bateri dɔn lɔs.
- If yu mɛrɛsin (epilepsy, pwɛl hat) de wɔs.
Mɛsej we dɛn kin kɛr go na os
- VNS na wan advans tritmɛnt we dɛn kin yuz fɔ ɛpilepshi, pwɛl hat, ɛn strok rihabiliteshɔn we ɔda tritmɛnt nɔ kin ebul fɔ kɔntrol.
- Dis kin wok lɛk "pacemaker for the brain," bɔt i nɔ kin mɛn di sik ɔltogɛda. Di gol na fɔ kɔntrol di sayn dɛm.
- Dis kin mek dɛn put wan divays na di bɔdi tru smɔl ɔpreshɔn.
- Sɔm bad tin dɛn lɛk we pɔsin de ala lawd lawd wan kin apin, bɔt dɛn kin ebul fɔ kɔntrol bɔku pan dɛn.
- If yu gɛt VNS divays we dɛn put insay yu bɔdi, i impɔtant fɔ mek yu tɛl ɔl yu dɔktɔ dɛn bifo yu du ɛni mɛdikal tɛst ɔ tritmɛnt (espɛshali MRI skan).
- Na spɛshal dɔktɔ nɔmɔ go ebul fɔ no if dis tritmɛnt fayn fɔ yu, so tɔk to yu dɔktɔ fɔ no mɔ.
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