Watya singa omusuwa mu bwongo bwo guzibikira? Tubeere bamanyi ku 'Thrombotic Stroke'!

Wali owuliddeko ku bulwadde bwa stroke obubaawo ng’omusaayi guzibiddwa mu bwongo? Oluusi obulwa obusobozi bw’okwogera mu bwangu, oba owulira ng’olina obuyinza ku ludda olumu olw’omubiri gwo. Kino kye tuyita ‘thrombotic stroke.’ Eno mbeera ya mangu eyinza okutta obulamu, n’olwekyo kikulu ggwe n’abaagalwa bo okumanya kye musuubira.

‘Obulwadde bwa Thrombotic Stroke’ kye ki? Ka tukizuule mu ngeri ennyangu!

Mu ngeri ennyangu, strombotic stroke ye stroke ebaawo ng’omusaayi (thrombus) gukoleddwa munda mu musuwa mu bwongo bwo ne guguziba. Kilowoozeeko ng’ekitundu kya kasasiro ekisibira mu payipu y’amazzi ne kiyimiriza amazzi okukulukuta. Okuzimba omusaayi kuno kulemesa ebitundu by’obwongo okufuna omusaayi gwe byetaaga ekitegeeza oxygen n’ebiriisa. Obutoffaali bw’obwongo tebusobola kuwangaala nga tebulina mukka gwa oxygen okumala ebbanga ddene, era ekyo bwe kibaawo, obutoffaali obwo butandika okufa.

Stroke yonna evudde ku kuzibikira kw’omusuwa nga guno eyitibwa ‘ischemic stroke’. ‘Thrombotic stroke’ kika kya njawulo ekya ‘ischemic stroke’.

Eno mbeera ya mangu ey’obujjanjabi eyinza okutta omuntu. Kale bw’oba ​​ggwe oba omuntu gw’omanyi alina obubonero buno, kuba ku ssimu 911 mu bwangu oyite ambyulensi, oba mutuuke mu ddwaaliro erikuli okumpi amangu ddala nga bwe kisoboka. Jjukira nti buli sikonda ebalwa. Gy’okoma okufuna obujjanjabi amangu, gy’okoma okukendeeza ku kwonooneka kw’obwongo n’okutaasa obulamu.

Bubonero ki obulaga nti omuntu alina ‘thrombotic stroke’?

Obubonero bw’okusannyalala kw’omusaayi (thrombotic stroke) bufaanagana nnyo n’obw’ebika ebirala eby’okusannyalala kw’omusaayi (ischemic stroke). Ekimu oba ebisingawo ku bino biyinza okubaawo mu bwangu, awatali kulabula :

• Okulaba emirundi ebiri (diplopia) kwe kulaba mu liiso erimu bwe kufuuka okuzibuwalirwa mu bwangu.
• Obulumi bw’omutwe obw’amangu, obutagumiikiriza.
• Okubulwa okufuga ebinywa ku ludda olumu olwa ffeesi, gamba ng’akamwa akagwa oba obutasobola kuziba liiso limu bulungi.
• Okuziyira n’okusiiyibwa ebipya ebitandise.
• Okuzirika / Okuzirika.
• Okuwuuma ebigambo nga oyogera, ng’olinga ayogera, n’okusiwuuka ebigambo (Dysarthria).
• Okufiirwa okuwulira okw’amangu mu sensa zo emu oba eziwera. Kino kitegeeza nti ebintu ng’okulaba, okuwulira, okuwunyiriza, okuwooma, n’okukwata bibula mangu.
• Okukaluubirirwa okwogera, oba obutasobola kufuna bigambo by’oyogera, oba n’okufiirwa ddala okwogera (aphasia).
• Okukaluubirirwa okutambula, okuwulira ng’omubiri gufiiriddwa bbalansi, ng’olinga ogutalinnya bulungi ku ttaka (okutambula okutali kwa nkalakkalira).
• Obutaddamu kintu kyonna. Kiyinza obutabaawo kwanukula ku kwogera oba okukwata ku muntu.
• Okusannyalala oba okunafuwa kw’oludda olumu olwa ffeesi n’omubiri (oludda olwa ddyo oba olwa kkono).

Olw’okuba obubonero buno bubaawo mu bwangu, kikulu nnyo okufaayo ku kino.

Obubonero obulabula ku stroke: Jjukira ‘BE FAST’!

Okumanya oba ggwe oba omwagalwa wo alina stroke, jjukira ennukuta zino ez’Olungereza ezitegeeza ‘BE FAST’. Ka tulabe kye zitegeeza:

• B - Bbalansi: Kebera oba bbalansi efiiriddwa mu bwangu oba obutanywevu ng’otambula.
• E - Amaaso: Noonya okubulwa okulaba okw’amangu, okulaba okuzibu, oba okulaba emirundi ebiri mu liiso erimu oba gombi.
• F - Feesi: Saba omulabi amwenya. Laba oba oludda olumu olwa ffeesi lulabika nga lugwa oba nga lugwa.
• A - Emikono: Basabe okusitula emikono gyombi butereevu mu maaso gaabwe. Laba oba omukono ogumu gugwa wansi oba gulabika nga munafu, nga tegusobola kusitula waggulu nga omulala.
• S - Okwogera: Laba oba ebigambo byo bitabula, oba olina obuzibu okulonda ebigambo ebituufu, oba tosobola kwogera n’akatono. Laba oba osobola okwogera sentensi ennyangu mu butuufu ng’obuuziddwa.
• T - Ebiseera: Ebiseera bya muwendo nnyo nnyo! Gezaako okujjukira ddi ddala obubonero buno lwe bwatandika. Bwe kiba kisoboka, tunuulira essaawa oba essimu era owandiike essaawa. Kino kijja kuyamba abasawo okulonda obujjanjabi. Bw’oba ​​olina obubonero buno, kuba 1990 mu bwangu awatali kulwa!

Biki ebivaako ‘thrombotic stroke’?

Kati tukimanyi nti ‘thrombotic stroke’ eva ku kuzibikira mu musuwa oguli munda mu bwongo bwo. ‘Thrombus’ kye kigambo ky’obusawo ekitegeeza okuzimba omusaayi. ‘Thrombosis’ y’enkola omusaayi mwe gukola. Kale, ‘thrombotic stroke’ ye ‘thrombus’, ekitegeeza okusannyalala okuva ku kuzimba omusaayi.

Waliwo embeera z’obulamu eziwerako eziyinza okuvaako okuzimba omusaayi okutondebwa mu ngeri eno:

• Obulwadde bw’emisuwa (okukaluba/okuzibikira ebisenge by’emisuwa): Kino kye kiseera kolesterol n’amasavu lwe bikuŋŋaana munda mu misuwa gyaffe, ne kireetera ebisenge by’emisuwa okugonza mpolampola n’okukaluba, ne bifunda omukutu oguyingira omusaayi. Kiringa obusagwa obuzimba munda mu payipu y’amazzi enkadde. Ebitundu bino ebifunda bitera okukola ebizimba by’omusaayi.
• Atrial Fibrillation: Eno mbeera omutima gye gukuba mu ngeri etategeerekeka. Olw’okuba omutima tegukuba bulungi, omusaayi guyinza okutondebwa munda mu mutima, oguyinza okugenda mu bwongo ne guziba emisuwa.
• Obuzibu mu kuzimba omusaayi:Abantu abamu bayinza okuba n’omuze gw’omusaayi gwabwe ogw’okuzimba amangu, oba okuva lwe bazaalibwa oba olw’endwadde ezibeerawo oluvannyuma.
• Covid-19: Obulwadde bwa Covid-19 nabwo buzuuliddwa nti byongera obulabe bw’okuziyira omusaayi mu mbeera ezimu.
• Puleesa (Hypertension): Puleesa eyonoona emisuwa n’eyongera obulabe bw’omusaayi okutondebwamu.
• Cholesterol omungi / Hyperlipidemia: Kolesterol bwe yeeyongera, obulabe bw’okulwala obulwadde bw’emisuwa bweyongera.
• Yinfekisoni: Okuzimba omusaayi nakyo kisobola okutondebwawo olw’ebintu nga yinfekisoni ezimu eza bakitiriya oba ffene, sepsis, ne yinfekisoni za valve z’omutima.

Ka tuyige ne ku ‘Transient Ischemic Attack’ (TIA).

‘Olumba oluyitibwa transient ischemic attack’ era abamu bakiyita ‘mini-stroke’. Kiba ng’okusannyalala, naye obubonero buno buba bwa kaseera buseera. Obubonero buno butera okuggwaawo mu ssaawa ezitakka wansi wa 24, emirundi mingi mu ddakiika ntono. Obubonero bwa TIA bufaananako n’obw’okusannyalala.

TIA si kintu kitono kyokka. Kulabula kwa maanyi nnyo! Omuntu abadde n’obulwadde bwa TIA ali mu bulabe bwa maanyi nnyo obw’okufuna obulwadde bwa stroke obw’amazima mu bbanga eritali ly’ewala. N’olwekyo, singa obubonero bwa TIA bubaawo, ne bwe buba buweddewo, kyetaagisa okugenda mu basawo amagezi amangu ddala.

Ani ali mu bulabe bwa ‘thrombotic stroke’?

Wadde ng’omuntu yenna asobola okufuna obulwadde bwa strombotic stroke, abantu abamu bali mu bulabe bwa maanyi:

• Abantu abasukka mu myaka 65. Obulabe bweyongera n’emyaka olw’enkyukakyuka mu misuwa.
• Ebika ebimu okwetoloola ensi yonna nabyo bizuuliddwa nti biri mu bulabe obw’amaanyi. (Ekiwandiiko ekyasooka kyogera ku bantu "Abaddugavu"; kirungi kino okugatta ku balabi ba Sri Lanka okuggyako nga data specific local ejuliziddwa.)
• Ku abo abanywa sigala oba abakozesa ebintu ebirala ebikolebwa mu taaba/nicotine (nga vaping). Okunywa sigala kya bulabe nnyo eri emisuwa.
• Ku abo abakozesa ebiragalalagala ebimenya amateeka.

Ate era, abantu abalina embeera z‟obulamu ezimu bali mu bulabe bwa maanyi:

• Ku abo abanywa ennyo omwenge (Obuzibu bw’okukozesa omwenge).
• Ku abo abalina puleesa (Hypertension).
• Ku bantu abalina obulwadde bwa sukaali. Ssukaali era asobola okwonoona emisuwa.

Abasawo bazuula batya obulwadde bwa ‘thrombotic stroke’?

Bw’oba ​​oteebereza nti olina obulwadde bwa ssukaali, abasawo bajja kusooka kukeberebwa busimu. Kino kitegeeza nti bajja kukebera okujjukira kwo, okwogera kwo, amaanyi go ne bbalansi yo. Bajja kukola n’okukebera omubiri n’okukeberebwa okulala okutonotono. Singa oleetebwa mu kisenge ky’abalwadde ab’amangu, abasawo abaliyo bajja kutandika okukebera kuno amangu ago.

Ebigezo nga bino bisobola okukozesebwa okukakasa nti omuntu alina stroke:

• Okukebera omusaayi: Kebera ebintu ng’obuzibu mu kuzimba omusaayi, ssukaali, ne kolesterol.
• Carotid ultrasound: Kino kiyamba okulaba oba waliwo ebizibikira mu misuwa emikulu mu bulago (carotid arteries).
• CT scan ne/oba CT angiogram: Kino kikuba ebifaananyi by’obwongo era kisobola okuzuula amangu oba waliwo okuvaamu omusaayi, omusaayi oguzimba oba obwongo okwonooneka. Ekifaananyi ky’omusaayi ekiyitibwa CT angiogram kisobola okulaba obulungi embeera y’emisuwa.
• Echocardiogram: Okukebera kuno kukolebwa okukebera enkola y’omutima n’okumanya oba waliwo ebizimba omusaayi mu mutima.
• MRI ne/oba MRI angiogram: Kino era kiyinza okukuba ebifaananyi ebikwata ku bwongo n’emisuwa mu bujjuvu. Kiyinza okulaga obulungi obwongo okwonooneka okusinga CT scan.

Bujjanjabi ki obuweebwa ‘thrombotic stroke’?

Ekisinga obukulu ng’ojjanjaba obulwadde bwa strombotic stroke kwe kuzzaawo omusaayi mu bwongo mu bwangu nga bwe kisoboka. Abasawo bagezaako okukikola okukendeeza ku bulabe bw’okwonooneka kw’obwongo obw’olubeerera, obulemu obupya, n’okufa.

Waliwo enkola bbiri enkulu ez’obujjanjabi ezikozesebwa:

1. Mechanical thrombectomy: Kino kizingiramu okuggyamu omusaayi oguzimba nga bakozesa akatundu akatono akagonvu (catheter). Omusawo ayingiza ttanka eno mu musuwa oguli mu ngalo oba mu kisambi n’agiyingiza mu kizimba ky’omusaayi mu bwongo bwo. Olwo omusawo aggyawo ekizimba amangu oba n’akimenyamu ebitundutundu n’aggyamu ebitundutundu. Obujjanjabi buno busobola okukolebwa mu ssaawa 24 okuva obubonero bwe butandise.

2. Obujjanjabi obuyitibwa Thrombolytic therapy: Lino ddagala erisaanuusa ebizimba omusaayi. Wabula eddagala lino lisobola okuweebwa mu ssaawa nnya n’ekitundu (4.5) zokka okuva obubonero bwe butandise. Eno y’ensonga lwaki bagamba nti obudde bwe bukulu.

Ng’oggyeeko obujjanjabi buno obukulu, oyinza okwetaaga obujjanjabi obulala:

• Enzirukanya ya ssukaali mu musaayi: Okukuuma omutindo gwa glucose mu musaayi mu musaayi kiyamba obwongo okuwona.
• Ebirongoosa omusaayi:Emirundi egisinga, ojja kwetaaga okumira eddagala eriweweeza ku buwuka obuleeta obulwadde bwa ‘platelet’, gamba nga aspirin. Bw’oba ​​olina obulwadde bw’okuzimba emisuwa oba obuzibu bw’okuzimba omusaayi, oyinza okuweebwa eddagala ery’amaanyi eriziyiza okuzimba omusaayi. Bino bikendeeza ku bulabe bw’okuddamu okutondebwa kw’omusaayi.
• Endarterectomy: Kuno kulongoosa okuggyamu obuwuka obuyitibwa ‘plaque’, ekika ky’amasavu, ku misuwa egy’omusaayi egyfunda oba egyazibiddwa. Kino kiyinza okukendeeza ku bulabe bw’okuzimba omusaayi omulala.
• Mild intentional hypothermia: Mu mbeera ezimu, abasawo bakendeeza ku bbugumu ly’omubiri gwo katono awatali bulabe. Kino kiyinza okukendeeza ku kwonooneka kw’obwongo mu kiseera ky’okusannyalala n’oluvannyuma lw’okusannyalala.
• Obujjanjabi bwa oxygen: Oluvannyuma lw’okusannyalala, obwongo tebufuna oxygen emala. Kale abasawo bayinza okukuwa omukka gwa oxygen ogw’enjawulo nga bayita mu ttanka eteekebwa mu nnyindo. Kino kyanguyiza okussa era kiyamba omubiri gwo okufuna omukka omungi mu bwongo.
• Stenting: Stent ye ttanka entono ennyo eringa akatimba eteekebwa munda mu musuwa n’eyamba okugukuuma nga guggule, omusaayi okutambula amangu.

Okuddaabiriza kikulu kitya oluvannyuma lw’okusannyalala kw’omusaayi (thrombotic stroke)?

Okuddaabiriza kikulu nnyo oluvannyuma lw’okusannyalala. Stroke ereeta enkyukakyuka mu bwongo n’omubiri gwo. Obujjanjabi bw‟okuddaabiriza busobola okukuyamba okumanyiira enkyukakyuka ezo, okuddamu okufuna obusobozi bwo obw‟edda, oba okuyiga okubeera n‟obulemu obupya. Oyinza okwetaaga obujjanjabi bumu oba okugatta ku bujjanjabi buno wammanga:

• Cognitive rehab: Kino kiyamba okulongoosa obukugu mu birowoozo nga okujjukira kwo, okufaayo kwo, n’obukugu mu kugonjoola ebizibu.
• Obujjanjabi bw’emirimu: Obujjanjabi buno bukuyamba okukola emirimu gyo egya bulijjo mu ngeri ey’obukuumi naddala emirimu egyetaagisa okutambula obulungi (e.g., okulya, okwambala, okuwandiika).
• Obujjanjabi bw’omubiri: Kino kiyamba okunyweza ebinywa by’omubiri, okulongoosa bbalansi, n’okuddamu okukozesa emikono n’amagulu.
• Obujjanjabi bw’okwogera: Obujjanjabi buno bukuyamba okuddamu okufuna olulimi n’obukugu mu kwogera, wamu n’okufuga ebinywa ebikuyamba okwogera, okussa, okulya n’okumira.

Enkola y’okuddaabiriza eyinza okuba enzibu katono, naye ebivaamu biba bya mugaso.

Emikisa ki egy’okuwona ‘thrombotic stroke’?

Ekirungi, obujjanjabi obupya obw’amangu obw’okusannyalala bwe bugenda bukolebwa, omuwendo gw’abantu abawona okusannyalala gweyongera. Naye kizibu okwogera ekiseera oba endowooza entuufu ey’okudda engulu eri buli muntu.

Okutwalira awamu strombotic strokes (n’ebika ebirala ebya ischemic strokes) zitera okuwona okusinga hemorrhagic strokes, eziva ku kubwatuka kw’omusuwa mu bwongo. Naye ekyo tekitegeeza nti olina emikisa mingi okuwona okusinga abalala. Omubiri gwa buli muntu guddamu mu ngeri ya njawulo ku stroke, n’olwekyo kizibu abasawo okuwa prognosis entuufu ekola ku buli muntu.

Prognosis eri etya?

Embeera ya ngeri ki gy’oyinza okusuubira kisinziira ku bintu ebiwerako:

• Engeri gye wafuna obujjanjabi mu bwangu.
• Bitundu ki eby’obwongo ebyonooneddwa?
• Obulamu bwo okutwalira awamu buli butya?

Ebiseera ebisinga kitwala emyezi egiwerako okuwona mu bujjuvu. Abamu kiyinza okutwala ekiseera ekiwanvu. Omusawo ajja kukubuulira ky’osuubira. Tofaayo, zijja kukuyamba okuteekawo n’okutuukiriza ebiruubirirwa by’okudda engulu ebikusaanira.

Obulwadde bwa strombotic stroke busobola okuziyizibwa?

Yee, osobola! Okukuuma obulamu obulungi okutwalira awamu y’engeri esinga okuziyiza okusannyalala kw’omusaayi (thrombotic strokes) n’okuzimba omusaayi okubireeta. Gezaako ebintu bino:

• Lya emmere ennungi. Lya nnyo ebibala, enva endiirwa, emmere ey’empeke, n’ebiwuziwuzi. Kendeeza ku mafuta, omunnyo ne ssukaali. Kuuma obuzito obulungi obukukwatako.
• Weenyigire mu dduyiro w’omubiri buli kiseera. Kola dduyiro ow’engeri emu ekuleetera okutuuyana, waakiri eddakiika 30 olunaku, ennaku 5 mu wiiki.
• Kuuma kolesterol, puleesa, n’embeera endala ez’obulamu (nga ssukaali) nga zifugibwa. Eddagala lyo limira ng’omusawo bw’akulagidde.
• Bw’oba ​​onywa sigala, lekera ddala. Bw’oba ​​weetaaga obuyambi okulekayo, noonya obuyambi okuva eri omusawo oba okuva mu pulogulaamu ezikuyamba okulekayo.

Laba omusawo waakiri omulundi gumu mu mwaka (oba ng’omusawo bw’akugamba) okwekebejjebwa mu bujjuvu. Ebizibu bingi eby’obulamu ebivaako ‘thrombotic strokes’ bikula mpolampola. Oyinza obutalaba bubonero bwabwe. N’olwekyo, okukeberebwa kw’abasawo kusobola okuzuula obubonero obwo obw’okulabula nga bukyali ne bubufuga.

Nkola ntya okwerabirira oluvannyuma lwa ‘thrombotic stroke’?

Okudda engulu n'okuddaabiriza oluvannyuma lw'okusannyalala si kyangu, kaweefube munene. Goberera enteekateeka y’obujjanjabi ggwe n’omusawo wo gye mukola awamu nga bwe kisoboka. Okutwaliza awamu, faayo ku bintu bino:

• Kakasa nti ogenda mu rehab yo n’obujjanjabi obulala. Bwe wabaawo ekintu kyonna ekikuleetera okuwulira nga tolina mirembe oba nga tolina bukuumi, tegeeza omusawo wo. Rehab nzibu, naye tolina kubeera mu bulumi buli kiseera.
• Naawe tewerabira ku bulamu bwo obw’omutwe.Okwennyamira n’okweraliikirira bitera nnyo oluvannyuma lw’okusannyalala. Obulamu bwo obw’omutwe bukulu nnyo ng’obulamu bwo obw’omubiri. Tolowooza nti okuwulira ennaku oba okweraliikirira kikufuula omunafu. Bw’oba ​​owulira nga weetaaga obuyambi mu kudda engulu, yogerako n’omusawo oba omubuulirizi ku by’obulamu bw’obwongo .
• Eddagala lyo limira ddala nga bwe likulagiddwa, mu biseera ebituufu ne mu ddoozi entuufu. Naddala bw’oba ​​omira eddagala eriweweeza ku musaayi, kakasa nti okikola bulungi. Okumira eddagala lyo mu ngeri entuufu kikulu okukendeeza ku bulabe bw’okulwala omusaayi mu biseera eby’omu maaso.

Ddi lwe nneetaaga okuddamu okugenda mu kitongole ky’abalwadde ab’amangu (ETU) ?

Bw’oba ​​olowooza nti olina stroke endala (nga obubonero bwa BE FAST bwe twayogeddeko emabegako), kuba 1990 awatali kulwa, oba genda mu ddwaaliro mu bwangu. Bw’oba ​​olina obulwadde bwa stroke obw’okubiri, akabi k’okufuna ebizibu eby’amaanyi n’okufiirwa obulamu buba bungi nnyo.

Omuntu abadde n’obulwadde bwa strombotic stroke ali mu bulabe bw’okufuna ebizibu ebirala eby’amaanyi, gamba nga:

• Okuzimba omusaayi mu misuwa emiwanvu egy’amagulu (Deep vein thrombosis - DVT) .
• Omutima okulwala
• Obulwadde bw’okuzimba amawuggwe
• Obulwadde bw’ekifuba
• Embeera z’okusannyalala/ okukonziba

Bw’ofuna obubonero bw’ekizibu eky’ekika kino, kuba essimu ey’amangu oba genda mu ddwaaliro mu bwangu.

Bibuuzo ki bye nnina okubuuza omusawo wange?

• Nkyukakyuka ki ze nneetaaga okukola mu bulamu bwange obwa bulijjo?
• Lwaki nnafuna stroke eno?
• Wa mu bwongo bwange ekizimba ky’omusaayi we kyakolebwa?
• Eddagala lya ngeri ki lye nnina okumira era limira ntya?
• Obulabe ki obw’okufuna obulwadde bwa ssukaali obulala? Kiki kye nnyinza okukola okukikendeeza?

N’ekisembayo, kiki ky’olina okujjukira! (Obubaka Obutwala Awaka)

Wadde ng’okusannyalala kw’omusaayi (thrombotic stroke) kuba kwa mangu, ebizibu ebikireeta bitera okukula mpola okumala ekiseera. Eno y’ensonga lwaki kikulu okulaba omusawo waakiri omulundi gumu mu mwaka okukebera obulamu bwo. Mu ngeri eyo, osobola okutegeera obubonero obulabula n’obuddukanya ng’omusaayi tegunnabaawo ne gukuleetera okusannyalala. Yogerako n’omusawo wo ku bulabe bw’okulwala obulwadde bwa ssukaali. Asobola okukuyamba okulabirira obulamu bwo okutwalira awamu n’okuddukanya ensonga z’obulabe bwo.

Bw’oba ​​ofunye obulwadde bwa ssukaali era mu kiseera kino ng’otereera, beera musanyufu buli katono k’olongoosa mu lugendo lwo olw’okudda engulu.Ennaku ezimu zijja kuba nzibu okusinga endala naye olina okwenyumirizaamu. Okudda engulu kaweefube munene, era olina okwewa ekitiibwa olw’ekyo. Tofaayo, toli wekka. Waliwo abasawo, abajjanjabi, ab’omu maka n’emikwano abasobola okukuyamba.

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