Ngaba nawe uziva unesiyezi xa uphakama ngequbuliso? Kusenokuba yi-(Orthostatic Hypotension)! Masithethe.

Ngaba uziva unesizungu okanye unesizungu xa uphakama ngequbuliso, nokuba uhleli okanye ulele phantsi? Ngamanye amaxesha ude uzive ngathi uza kuquleka okwethutyana, akunjalo? Le yimeko esiza kuthetha ngayo namhlanje, ebizwa ngokuba yi-"Orthostatic Hypotension". Abanye abantu bayibiza ngokuba yi-"Postural Hypotension." Ungakhathazeki, le yinto enokwenzeka kubantu abaninzi, ingakumbi njengoko bekhula. Makhe sithethe ngale nto ngokweenkcukacha nangokulula.

Yintoni `(Orthostatic Hypotension)`? Ngamafutshane...

Ngamafutshane, `(Orthostatic Hypotension)` kuxa uxinzelelo lwakho lwegazi luhla ngequbuliso xa usukuma uhleli okanye ulele. Khawuthelekelele, uhleli esitulweni ufunda iphephandaba uze uphakame ngequbuliso kuba kukho umntu othethayo. Kulapho uziva unesizungu. `(Orthostatic)` ibhekisa kwindawo ethe nkqo. `(Hypotension)` ibhekisa kuxinzelelo lwegazi oluphantsi. Ngoko ke, kulapho uxinzelelo lwakho lwegazi luhla khona xa utshintsha indawo.

Ngoko ke, luthini olu xinzelelo lwegazi?

Sihlala sisiva ngoxinzelelo lwegazi, okanye "uxinzelelo lwegazi". Oku kulinganisa uxinzelelo olukhutshwa ligazi eludongeni lwemithambo yegazi njengoko intliziyo yethu ibetha. Kufana noxinzelelo olukhutshwa ngamanzi kwimibhobho xa ehamba ngepompo yamanzi. Oku kulinganiswa ngeemilimitha ze-mercury ``(mmHg)``.

Xa usiya kugqirha, bakuxelela amanani amabini xa bejonga uxinzelelo lwakho lwegazi, akunjalo?

• Inombolo ephezulu `(Systolic)`: Oku kubhekisa kuxinzelelo xa intliziyo yakho ibetha kwaye ipompa igazi emithanjeni yakho.
• Inombolo esezantsi `(Diastolic)`: Oku kubhekisa kuxinzelelo olukwimithambo yegazi phakathi kwentliziyo ezimbini, oko kukuthi, xa intliziyo iphumla kancinci.

Ugqirha uyibhala njengenombolo ephezulu/esezantsi (umz. 120/80 mmHg). Uxinzelelo lwegazi olusempilweni lwabantu abaninzi lungaphantsi kwe-120/80 mmHg. Umlinganiselo ongaphantsi kwe-90/60 mmHg uthathwa njengoxinzelelo lwegazi oluphantsi.

Uxinzelelo lwegazi lwehla kangakanani kwi-"Orthostatic Hypotension"?

Akukho xabiso lichanekileyo loku. Nangona kunjalo, oogqirha bafumanisa oku ngokujonga uxinzelelo lwakho lwegazi oluqhelekileyo kunye nokuba luyehla kangakanani xa usukuma. Ngokuqhelekileyo, ukuba inani eliphezulu elithi ``Systolic`` lehla nge-20 mmHg okanye inani elisezantsi elithi ``Diastolic`` lehla nge-10 mmHg kwimizuzu emithathu emva kokuma , kuthathwa njenge ``Orthostatic Hypotension``.

Ngubani onokuba nethuba elikhulu lokufumana i-Orthostatic Hypotension?

Le meko inokuthi ivele nakubani na, kodwa iba yinto eqhelekileyo njengoko ukhula. Ezi zinto zilandelayo zinokunyusa umngcipheko wokuba nayo:

• Ukungabikho kwegazi okanye ukungabikho kweVithamin B12: Le meko inokwenzeka xa kukho ukwehla komthamo wegazi okanye ukwehla kweVithamin B12.
• Ukuphelelwa ngamanzi emzimbeni ngenxa yeziyobisi zokuhambisa isisu, ukuhlanza, okanye amayeza okukhupha isisu: Xa umlinganiselo wamanzi emzimbeni uncipha, uxinzelelo lwegazi lunokwehla.
• Iingxaki ze-endocrine:Iimeko ezifana nesifo seswekile, isifo se-thyroid, kunye nesifo sika-Addison.
• Iimeko zentliziyo: Izinto ezifana nokuphazamiseka kwesantya sentliziyo (iiArrhythmias), isifo sevalvu yentliziyo.
• Amayeza athile: Ingabangelwa nangamayeza athile athathwayo xa umntu enesifo soxinzelelo lwegazi oluphezulu, isifo sentliziyo, okanye ukudakumba.
• Iingxaki ze-neurological: Izifo ezifana nesifo sikaParkinson kunye ne-dementia.
• Ukukhulelwa: Ingakumbi kwiiveki ezingama-24 zokuqala.
• Ukuhlala ebhedini ixesha elide ngenxa yokugula: Njengokuphumla ebhedini ngexesha lokukhulelwa.

Khawucinge nje, uMalume uSomapala ohlala kwilali yethu. Unesifo seswekile kwaye usela amayeza oxinzelelo lwegazi oluphezulu. Uthi uziva enesiyezi xa evuka ebhedini kusasa. Abantu abanjalo banamathuba amaninzi okufumana esi sifo.

Ixhaphake kangakanani le meko?

Uxinzelelo lwegazi olubangelwa yi-orthostatic luchaphazela malunga nama-20% abantu abadala , ingakumbi abo bahlala kumakhaya abantu abadala. Kuqhelekile nakubantu abaye bahlala ebhedini ixesha elide, nakubamama abatsha abaye baba nomntwana. Kunokwenzeka nakubantu abaselula abakhula ngokukhawuleza.

Zithini iimpawu zoku?

I-Orthostatic hypotension idla ngokubonakala kakhulu kwaye iimpawu ziba mandundu kusasa. Oku kungenxa yokuba uxinzelelo lwethu lwegazi luhlala luphantsi kancinci xa sivuka kusasa.

Abanye abantu basenokungabi nazo iimpawu konke konke. Kwabanye, ezi mpawu ziya zisiba mandundu xa kushushu, kumkhuhlane, okanye kuhlamba ngamanzi ashushu.

Uphawu oluphambili kukuba nesiyezi okanye ukuba nentloko ebuhlungu xa umile . Oku kufanele kuphele xa uhleli okanye ulala phantsi kwakhona. Abanye abantu banokude balahlekelwe zingqondo (syncope).

Ezinye iimpawu zezi:

• Umbono ofipheleyo
• Intlungu yesifuba, intlungu yamagxa okanye intlungu yentamo
• Ubunzima bokugxila
• Ukudinwa okanye ubuthathaka
• Intloko ebuhlungu (Uxolo, igama elivela kolunye ulwimi lifakwe apha ngempazamo. Igama elichanekileyo: Intloko ebuhlungu )
• Ukubetha kwentliziyo
• Isicaphucaphu okanye ukuziva ushushu kwaye ubila
• Ukuphefumla nzima/Ukuphelelwa ngamandla

Kutheni le nto `(Orthostatic Hypotension)` isenzeka? Zithini izizathu?

Xa sihleli okanye silele, igazi elikwimithambo yemilenze yethu libuyela lula entliziyweni yethu. Kodwa xa sima, amandla adonsela phantsi enza kube nzima ukuba igazi elikwimilenze neenyawo zethu lifikelele entliziyweni yethu. Oku kunciphisa inani legazi elinokupompelwa entliziyweni yethu, kwamanye amalungu omzimba, nakwimisipha. Ngenxa yoko, uxinzelelo lwethu lwegazi luyehla okwethutyana.

Kunokubakho izizathu ezahlukeneyo zoku:

• Intliziyo yakho ayinakukwazi ukupompa igazi elaneleyo.
• Inkqubo yakho yemithambo-luvo elawula uxinzelelo lwegazi (inkqubo eqhele ukulawula uxinzelelo lwegazi) ayisebenzi kakuhle.
• Ukuba unezifo ezifana nesifo sikaParkinson, i-Lewy body dementia, okanye i-multiple system atrophy .
• Ukuba ubukwimeko efanayo (umz. ulele phantsi) ixesha elide (njengokuphumla ebhedini ngexesha lokukhulelwa).
• Ukuba umthamo wegazi lakho unciphile ngenxa yokulahlekelwa ligazi okanye lulwelo (ukuphelelwa ngamanzi emzimbeni).
• Ukuba unengxaki nge-adrenal gland yakho .
• Ngenxa yendlela umzimba wakho osabela ngayo kumayeza athile owaselayo .

Ungayixilonga njani ngokuchanekileyo i-orthostatic hypotension?

Xa usiya kugqirha, baza kuqala balinganise uxinzelelo lwakho lwegazi ngelixa uhleli, baze balale phantsi, baze bame ngeenyawo. Akupheleli apho, baza kukubuza nangeemeko zakho zempilo kunye namayeza owasebenzisayo.

Ukongeza, olunye okanye ngaphezulu kwezi vavanyo zilandelayo lunokwenziwa:

• Uvavanyo lwegazi: Jonga iimeko ezifana nesifo seswekile kunye ne-anemia.
• I-Echocardiogram (I-Echocardiogram / i-echo): Jonga indlela intliziyo epompa ngayo igazi.
• I-Electrocardiogram (EKG): Khangela utshintsho kwisingqisho sentliziyo.
• Uvavanyo loxinzelelo lokuzivocavoca: Linganisa izinga lokubetha kwentliziyo yakho ngelixa usenza umthambo.
• Izixhobo ze-EKG eziphathekayo / isixhobo sokubona i-Holter: Linganisa isingqisho sentliziyo imini yonke.
• Uvavanyo lwetafile yokuthambeka: Uvavanyo olulinganisa ngokukhuselekileyo uxinzelelo lwegazi, izinga lokubetha kwentliziyo, kunye nesingqisho sentliziyo ngokukulalisa etafileni uze uthambekise itafile ime nkqo.

Ziziphi iindlela zonyango lwe-Orthostatic Hypotension?

Unyango luxhomekeke kwisizathu sale meko.

Oku kulandelayo kungenziwa njengonyango:

• Ukuba kukho isifo okanye imeko ebangela i-orthostatic hypotension, yinyange.
• Ukutshintsha umthamo weyeza elibangela le meko okanye ukutshintshela kwelinye iyeza (oku kufuneka kwenziwe emva kokuthetha nogqirha wakho).
• Ukuba ulele ebhedini, qhela ukuhlala ebhedini.
• Ukunxiba iikawusi ezithambileyo. Ezi zinciphisa ukuhlangana kwegazi emilenzeni.
• Ukuba uphelelwe ngamanzi emzimbeni, sela amanzi amaninzi kunye neziselo ezinetyuwa.

Ngawaphi amayeza anikwa oku?

Oku kunokulawulwa rhoqo ngokutshintsha indlela yokuphila. Nangona kunjalo, abanye abantu banokufuna ukuthatha amayeza okunyusa umthamo wegazi kunye noxinzelelo lwegazi. Nangona kunjalo, ezi azixhaphakanga kakhulu.

Ezinye zezi ntlobo zamayeza zezi:

• `I-Droxidopa`
• Ii-Erythropoiesis-stimulating agents (ii-ESA) (umz. iProcrit® okanye iEpogen®)
• `Desmopressin (Nocdurna® okanye `DDAVP®)`
• `Octreotide (Bynfezia Pen™` okanye `Mycapssa®)`
• `I-Fludrocortisone`
• `I-Midodrine hydrochloride`
• `I-Pyridostigmine (iMestinon®` okanye `iRegonol®)`

Kubalulekile: La mayeza afanele athathwe kuphela phantsi kwengcebiso kagqirha. Ukusela amayeza ngokwakho kunokuba nemiphumo eyingozi.

Ngaba kukho naziphi na iziphumo ebezingalindelekanga zonyango?

Amanye amayeza asetyenziselwa i-Orthostatic Hypotension anokubangela iziphumo ebezingalindelekanga ezifana nezi:

• Ukuba ndindisholo
• Ukurhawuzelela
• Intloko ebuhlungu
• Ukudumba
• Amanqanaba aphantsi e-potassium
• Ukusilela kwentliziyo (oku kunqabile kakhulu)

Kungoko ke kubalulekile ukufumana unyango phantsi kweliso likagqirha.

Ziziphi iingxaki ezinokubakho ngenxa ye-Orthostatic Hypotension?

Abantu abanale meko banokuba semngciphekweni omkhulu woku:

• Ukuqhekeka kwamathambo okanye ukwenzakala entloko (ukuxhuzula) kunokubangelwa kukuwa xa unesizungu okanye ungazi nto .
• Uxinzelelo lwegazi oluphantsi emva kokutya: Oku kukwehla koxinzelelo lwegazi kwimizuzu engama-30 ukuya kwiiyure ezimbini emva kokutya isidlo (ingakumbi isidlo esineecarbohydrate ezininzi).
• Ukuba uxinzelelo lwegazi luqhubeka luphantsi kakhulu, ukungaphumeleli okanye ukungasebenzi kakuhle kwamalungu omzimba kunokwenzeka (oku kunqabile kakhulu).
• Ingozi yestroke okanye isifo sentliziyo ngenxa yokuguquguquka koxinzelelo lwegazi .
• Uxinzelelo lwegazi oluphantsi: Oku kuthetha ukuba uxinzelelo lwegazi luyehla xa ulele phantsi (oku kunokubangelwa ngamanye amayeza).

Kuza kwenzeka ntoni ukuba ndine-`(Orthostatic Hypotension)`?

Abantu abaninzi banokuzilawula iimpawu zale meko (Orthostatic Hypotension) ngokulandela amanyathelo okuthintela. Umzekelo, kufuneka uzinike ixesha xa uvuka. Oku akunakwenzeka ukuba kubangele iingxaki ezinkulu zexesha elide.

Ngaba akunakwenzeka ukuba uphile ngokupheleleyo kule meko?

Akukho "nyango" lwe-orthostatic hypotension. Nangona kunjalo, iimpawu zinokulawulwa kakhulu ngokulandela icebiso elinikwa ngugqirha wakho. Eli cebiso lingabandakanya:

• Ukuthatha amayeza amiselweyo ngokuchanekileyo.
• Yitya ukutya okuncinci endaweni yokutya ukutya okukhulu ngaxeshanye.
• Sela amanzi amaninzi kunye nolwelo.
• Ukunxiba iintlobo ezikhethekileyo zeekawusi (iisokisi zokucinezela).

Ndingayinciphisa njani ingozi ye-Orthostatic Hypotension?

Ukuba unesiyezi esinje, ukulandela la manyathelo kunokunceda ukunciphisa iimpawu:

• Lawula ubushushu bomzimba wakho: Musa ukuhlamba ngamanzi ashushu kakhulu.
• Hlala unamanzi emzimbeni: Sela amanzi amaninzi. Nciphisa utywala. Musa ukutya isidlo esinzima esineekhabhohayidreyithi ezininzi ngaxeshanye.
• Gcina intloko yakho iphakanyisiwe kancinci xa ulele ebhedini: sebenzisa umqamelo omnye okanye emibini eyongezelelweyo, okanye uphakamise intloko yomatrasi kancinci.
• Lungisa ngaphambi kokuba uvuke: Zinike ixesha lokuma uhleli okanye ulele. Yiba nento eqinileyo onokuyibamba xa uvuka.
• Zilolonge izihlunu zakho: Ukuba kufuneka ume ixesha elide, endaweni yokuma ungashukumi, hambahamba kancinci ngokuphakamisa imilenze yakho ngokutshintshana. Ngaphambi kokuba uvuke, yenza umthambo we-isometric (umz., ukucinezela ibhola encinci yerabha). Oku kunokunyusa uxinzelelo lwegazi kancinci.
• Phucula ukujikeleza kwegazi noxinzelelo: Nxiba iikawusi ezikhethekileyo zokucinezela okanye i-abdominal binder.

Ndifanele ndimbone nini ugqirha?

Ukuba uhlala uziva unesiyezi xa usukuma, ngokuqinisekileyo kuya kufuneka ubone ugqirha . Nokuba oku kwenzeka ngamanye amaxesha, kulungile ukuxelela ugqirha wakho ngako.

Ndingaya nini kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

Ukuba unezi mpawu, funa unyango ngokukhawuleza :

• Iintlungu zesifuba.
• Ukuwa okanye ukuquleka.
• Iingxaki ngokulinganisela okanye ukulungelelaniswa.
• Ukuba kukho ukurhanelwa kokuba kukho ukwaphuka okanye ukwenzakala entloko ngenxa yokuwa.
• Ukuba indle yakho inegazi okanye imnyama.
• Iimpawu zokothuka (umzimba obandayo, ukubila, ukuphefumla ngokukhawuleza, ulusu oluluhlaza okwesibhakabhaka, ukubetha kwentliziyo okubuthathaka).

Ndingayibuza yiphi imibuzo ugqirha?

Xa usiya kugqirha, ungabuza imibuzo efana nale:

• Kutheni ndinesi simo esibizwa ngokuba yi-"Orthostatic Hypotension"?
• Yeyiphi eyona ndlela ilungileyo yokunyanga oku?
• Ingaba ezi mpawu zibangelwa ngamayeza endiwasebenzisayo? Ngaba kufuneka nditshintshe amayeza am?
• Zeziphi iinguqu ekufuneka ndizenze ukuze ndilawule ezi mpawu?
• Zeziphi iimpawu zeengxaki ekufuneka ndiziqaphele?

Ngaba `(Orthostatic Hypotension)` kunye `(Postural Tachycardia Syndrome - POTS)` ziyafana?

Iimpawu zesifo esibizwa ngokuba yi-`(Postural Tachycardia Syndrome)` okanye `(POTS)` zifana ne-`(Orthostatic Hypotension).` Kuzo zombini iimeko, isiyezi kunye nokuquleka kunokwenzeka xa umile. Nangona kunjalo, kwi-`(POTS)`, ukongeza ekuncipheni koxinzelelo lwegazi, izinga lentliziyo liyanda malunga ne-30-40 beats ngomzuzu kwimizuzu eli-10 yokuma. Kwi-`(Orthostatic Hypotension)`, izinga lentliziyo lidla ngokunganyuki kangako.

Imeko ethi ``POTS'' ayibonakali rhoqo kune ``Orthostatic Hypotension''.

I-Orthostatic hypotension (Hypotension) inokuba yimeko enzulu kakhulu. Inokuba yingozi ukuba ulahlekelwa yibhalansi yakho uze uwe okanye ukuba ulahlekelwa zingqondo. Nangona kunjalo, iimpawu zihlala ziphucuka xa utshintsha indlela oma ngayo. Thetha nogqirha wakho malunga neempawu zakho. Kusenokufuneka utshintshe amayeza akho. Kwiimeko ezinzima ngakumbi, ugqirha wakho unokukunika amayeza okuphucula ukuhamba kwegazi kunye noxinzelelo lwegazi.

Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ngoku uyaqonda ngcono into ebesithetha ngayo, i-Orthostatic Hypotension. Asinto yokuxhalaba ngayo, yimeko eyenzeka kubantu abaninzi. Eyona nto ibalulekileyo yile:

• Ukuba ngequbuliso uziva unesizungu okanye amehlo akho afiphele, musa ukuwatyeshela. Funa ingcebiso kagqirha.
• Vuka kwangethuba, ingakumbi xa uvuka ebhedini kusasa, okanye xa uvuka emva kokuhlala ixesha elide, thatha umzuzwana ubambe into yokuma.
• Sela amanzi amaninzi. Oku kunokwenzeka naxa uphelelwe ngamanzi emzimbeni.
• Thetha nogqirha wakho malunga namayeza owasebenzisayo. Amanye amayeza nawo anokubangela le meko.
• Ziphephe iindawo ezishushu kwaye uhlambe ngamanzi ashushu.
• Lumka kuba ungawa. Ukuba uziva unesiyezi, zama ukuhlala phantsi okanye ulale phantsi ngokukhawuleza.

Siyathemba ukuba olu lwazi luza kukunceda. Kungcono ukufuna ingcebiso kugqirha wakho ngayo nayiphi na ingxaki yempilo onokuba unayo.

Uxinzelelo lwegazi oluphantsi , uxinzelelo lwegazi oluphantsi, isiyezi, ukuphelelwa ngamandla, ukwehla koxinzelelo lwegazi, uxinzelelo lwegazi, impilo yentliziyo, impilo yabantu abadala, ukuphelelwa ngamanzi emzimbeni, iziphumo ebezingalindelekanga ngamayeza, ulwazi lwezempilo lwesiSinhala