Ubunzima bokuphefumla ngenxa yokutyeba kakhulu? Masithethe nge-(Obesity Hypoventilation Syndrome)!

Ngaba ngamanye amaxesha uziva uphelelwa ngumphefumlo? Ngaba udiniwe kwaye ulele emini? Kubalulekile ukuzazi ezi zinto, ingakumbi ukuba utyebile kakhulu. Namhlanje siza kuthetha ngengxaki yokuphefumla engaziwa kangako, kodwa enokuba yingozi, enokunxulunyaniswa nokutyeba kakhulu. Oku kubizwa ngokuba yi-`(Obesity Hypoventilation Syndrome)` okanye i-OHS. Ungakhathazeki, masiyichaze ngokulula.

Yintoni i-OHS (Obesity Hypoventilation Syndrome)?

Ngamafutshane, `(Obesity Hypoventilation Syndrome)` sisifo sokuphefumla esenzeka kwabanye abantu abatyebe kakhulu. Oku kwenzeka xa ubungakanani bekhabhoni diokside egazini lethu busanda kwaye ubungakanani beoksijini buyehla. Ngokwesiqhelo, xa siphefumla, sithatha ioksijini size sikhuphe i-carbon diokside. Kodwa xa izinga lokuphefumla lehla kwaye umoya ungangeni kakuhle emiphungeni, olu lungelelwaniso luyalahleka. Oku kubizwa ngokuba yi`(Hypoventilation)` (ukuphefumla okunciphileyo).

Ukongeza kwi-hypoventilation, ukuphefumla okuphazamisekayo ebuthongweni nako kunokwenzeka kwi-OHS. Enyanisweni, i-90% yeengxaki zokuphefumla okuphazamisekayo ebuthongweni ezinxulumene ne-OHS zibangelwa yi-obstructive sleep apnea.

Ngoko ke, i-OHS ifana nomxube wezinto ezintathu eziphambili:

• Ukutyeba kakhulu.
• Ukuncipha kokuphefumla (Hypoventilation).
• Ukuphefumla okuphazamiseka ebuthongweni.

Kukho elinye igama lale OHS, eliyi `(Pickwickian Syndrome)`. Eli gama laqanjwa ngenxa yomlinganiswa kwinoveli kaCharles Dickens owayeneempawu ze-OHS.

I-OHS yingxaki enkulu yokuphefumla ebangelwa kukutyeba kakhulu. Nangona inokubangela iingxaki zempilo ezisongela ubomi, ineendlela ezilungileyo zonyango.

Ngubani onokuthi abe nethuba elingcono lokuphuhlisa i-OHS?

I-OHS ixhaphake kakhulu kumadoda kunakwabasetyhini. Kukwakho nomahluko othile oxeliweyo phakathi kwamaqela athile eentlanga. Nangona kunjalo, eyona nto iphambili ebangela umngcipheko kukutyeba kakhulu.

Kunzima ukutsho ukuba oku kuqheleke kangakanani na, kodwa ezinye izifundo zibonisa ukuba kunokuchaphazela ipesenti encinci yabantu abadala. Oko kuthetha ukuba akuqhelekanga kangako, kodwa yinto echaphazela inani elikhulu labantu.

Zithini iimpawu ze-OHS?

Iimpawu ze-OHS zihlala zibangelwa kukungakwazi ukulala kakuhle kunye namanqanaba aphantsi eoksijini egazini (i-Hypoxemia). Ezinye zezi mpawu ziquka:

• Ukuqhawukelwa ngumphefumlo.
• Ukuziva udiniwe ngalo lonke ixesha (Ukudinwa).
• Ukungabikho kwamandla.
• Ukulala kakhulu emini (ukungalali kakuhle emini).
• Intloko ebuhlungu rhoqo.
• Isiyezi.
• Uxinzelelo.

Ngelixa ulele, iqabane lakho lisenokubona izinto ezifana nezi:

• Ukurhona okukhulu.
• Uziva ngathi uyakrwitshwa okanye uyaphefumla xa ulele.
• Ukuyeka ukuphefumla. Khawucinge ukuba umntu ebenokuthi kuwe, "Xa ulele ebusuku, ngamanye amaxesha uziva ngathi uyeka ukuphefumla imizuzwana embalwa." Yinto efana naleyo.

Zithini izizathu ze-OHS?

Abaphandi abakayazi kakuhle into ebangela i-OHS, kodwa bakholelwa ukuba isenokubangelwa yindibaniselwano yezinto:

• Kusenokuba kukho into engalunganga ngendlela ingqondo yakho elawula ngayo ukuphefumla . Kungathi kukho ingxaki encinci "kwiswitshi" yethu yokuphefumla.
• Ubunzima obongezelelekileyo kwindawo yesifuba bunokwenza kube nzima ukuba imiphunga ivuvuke kakuhle kwaye iphefumle nzulu. Kufana nokuzama ukuphefumla unesisindo esifubeni sakho.
• Amafutha amaninzi kwiindawo ezifana nentamo, isifuba, kunye nesisu anokunyusa ukuveliswa kweehomoni ezithile , ezinokuchaphazela iindlela zokuphefumla.

Ufumanisa njani ukuba unayo i-OHS?

Xa usiya kugqirha, baza kukubuza ngeempawu zakho baze bakuhlole. Baza kulinganisa ubude nobunzima bakho baze babale i-Body Mass Index (BMI) yakho. Abantu abatyebe kakhulu bane-BMI engama-30 nangaphezulu.

Emva koko, ugqirha angayalela ezinye iimvavanyo ukuze abone ukuba unayo na i-OHS. Ezinye zezi ziquka:

• Uvavanyo lwegesi yegazi lemithambo: Oku kuquka ukuthatha igazi elincinci kwimithambo yakho yegazi kunye nokulinganisa ubungakanani bekhabhoni diokside kunye neoksijini ekuyo. Le yindlela onokubona ngayo ukuba igazi lakho liphezulu kwi-CO2 okanye liphantsi kwi-O2.
• I-pulse oximeter: Usenokuba uyibonile le nto, isixhobo esincinci esifana ne-clip osibeka emnweni wakho. Sinokulinganisa ubungakanani beoksijini egazini lakho. Nangona kunjalo, asinakulinganisa i-carbon dioxide, kwaye asichanekanga njengesampuli yegazi.
• Uvavanyo lokusebenza kwephaphu: Olu vavanyo lujonga ukuba imiphunga yakho isebenza kakuhle kangakanani kwaye lukhangela ezinye izizathu zokuphefumla kancinci.
• I-X-ray yesifuba: Oku kunokunceda ekususeni ezinye izizathu ezibangela ukuphefumla okunzima.
• Isifundo sokulala `(Polysomnography):` Olu luvavanyo olukhethekileyo. Emva kokuchitha ubusuku obunye esibhedlele, ukuphefumla kwakho, izinga lokubetha kwentliziyo, kunye namaza obuchopho kuyajongwa ngelixa ulele. Oku kunokunceda ekuqinisekiseni ukuba unayo `(Sleep Apnea)` kwaye, ukuba kunjalo, ukuba imbi kangakanani.

Zithini iindlela zonyango lwe-OHS?

Unyango lwe-OHS lubandakanya ikakhulu ukunciphisa umzimba kunye nenkxaso yokuphefumla.

Ukunciphisa umzimba

Ukufikelela kubunzima obusempilweni obufanele umzimba wakho kunye nokugcina ubunzima bunjalo linyathelo lokuqala nelibaluleke kakhulu ekunyangeni i-OHS.Ngamanye amaxesha, ukunciphisa umzimba nje kunokunceda ukulawula iimpawu kunye nokuphucula imeko. Ukwamkela indlela yokuphila enempilo kunokunceda kakhulu. Umzekelo:

• Ukutya ukutya okunempilo. Umzekelo, ukutya okunesondlo okufana nokutya kwaseMedithera.
• Ukuzilolonga ubuncinane imizuzu engama-30 ngosuku.
• Misela imikhwa emihle yokulala.

Ngokuxhomekeke kwimeko yakho, ugqirha wakho unokucebisa utyando lokunciphisa umzimba, njengotyando lwesisu olubizwa ngokuba yi-gastric bypass.

Ukunceda ukuphefumla

Ugqirha wakho unokucebisa umatshini wokungenisa umoya oomatshini ukukunceda uphefumle. Ezi zizixhobo ezingangenisi gazi, oko kuthetha ukuba zingasetyenziswa ngaphandle kotyando olukhulu. Ezi matshini zigcina iindlela zakho zomoya zivulekile ebusuku ngelixa ulele, nto leyo enyusa ubungakanani beoksijini egazini lakho. Unxiba imaski ekhethekileyo ngelixa ulele, kwaye umatshini uhambisa umoya ngetyhubhu. Kukho iintlobo ezahlukeneyo zoomatshini:

• Umatshini we-CPAP (Continuous Positive Airway Pressure): Umatshini we-CPAP ukhupha umoya ngengcinezelo efanayo xa uphefumla kwaye ukhupha umoya.
• Umatshini weBiPAP (Bilevel Positive Airway Pressure): Umatshini weBiPAP uhambisa umoya ngoxinzelelo oluphezulu xa uphefumla kwaye uphantsi xa uphefumla. Oku ngamanye amaxesha kubizwa ngokuba ligama lophawu ``(BiPAP®)``.

Amaxesha amaninzi, ukuba ezi matshini "zoxinzelelo lomoya oluhle" azikwazi ukulawula imeko, i-"Tracheostomy" inokuba yimfuneko. Oku kuthetha ukuba ugqirha wenza umngxuma entanyeni yakho aze awuqhagamshele kumbhobho wakho womoya ukuze akuncede uphefumle. Oku kudla ngokuba yindlela yokugqibela.

Ungayinciphisa njani ingozi yokuba ne-OHS?

Eyona ndlela ilungileyo yokunciphisa umngcipheko wakho wokuba ne-OHS kukugcina ubunzima bakho busempilweni. Ukuba ugqirha wakho ubhale i-CPAP okanye i-BiPAP, kubalulekile ukuyisebenzisa kanye njengoko kuyalelwe.

Ukongeza, ukuba uza kubhabha okanye uza kwenziwa naluphi na utyando, xelela ugqirha wakho kwangaphambili, njengoko umngcipheko weengxaki ezinkulu uphezulu kwiimeko ezinjalo.

Injani imeko yempilo yomntu one-OHS?

Ngonyango, iimpawu ze-OHS zinokuncitshiswa okanye zipheliswe ngokupheleleyo. Kwabanye abantu, nokunciphisa umzimba nje kunokunceda. Unyango lubalulekile kuba lunokuphucula umgangatho wobomi bakho kwaye lunciphise umngcipheko weengxaki ezingaphezulu. Unyango lwasekuqaleni ngomatshini wokuphefumla lubonakalisile ukuba lunciphisa izinga lokufa ngenxa ye-OHS nge-10%.

Nangona kunjalo, ukuba ayinyangwa, i-OHS inokukhokelela kwiingxaki ezisongela ubomi, ingakumbi iingxaki zentliziyo kunye nemithambo yegazi. Ukunqongophala kweoksijini kubeka uxinzelelo olukhulu entliziyweni. Ukwaba sesichengeni ngakumbi seengxaki zokungalali ngokwaneleyo. Ngaphandle konyango, umgangatho wobomi bakho uya kuhla kwaye kuya kufuneka ulaliswe esibhedlele.

Ingqikelelo yabo bangafumani nyango ayilunganga kangako. I-OHS enganyangwanga inokunciphisa ixesha lokuphila. Phakathi kwabantu abanezinye izifo, izinga lokufa kweenyanga ezili-18 ngenxa ye-OHS liphezulu njenge-23%.

Ziziphi iingxaki ezinokubakho ze-OHS?

Ukuba ayinyangwa, i-obesity hypoventilation syndrome inokukhokelela kwiingxaki ezinxulumene nokulala. Ezi ziquka:

• Uxinzelelo.
• Ukucaphuka nokucaphuka.
• Umngcipheko ophezulu weengozi.
• Iingxaki kubomi besondo kunye nobudlelwane obusondeleyo.

I-OHS inokubangela isifo sentliziyo, umzekelo:

• Uxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu).
• Ukusilela kwentliziyo kwicala lasekunene.
• Uxinzelelo lwegazi oluphezulu lwemiphunga.

Ufanele uye nini kugqirha?

Ngokuqinisekileyo kufuneka ubone ugqirha kwezi meko zilandelayo:

• Ukuba utyebile kakhulu kwaye unezinye iimpawu ezinxulumene ne-OHS.
• Ngaba iqabane lakho lithi urhona kakhulu ebusuku kwaye uqaphela izinto ezifana nokuphefumla kwakho kuyeka amaxesha ngamaxesha?
• Ukuba uziva udiniwe kakhulu kwaye ulele emini.

I-Obesity Hypoventilation Syndrome (OHS) yingxaki enkulu yokuphefumla ebangelwa kukutyeba kakhulu. Ukuba utyebile kakhulu, unengxaki yokuphefumla, okanye uneengxaki ezinxulumene nokulala, bona ugqirha ngokukhawuleza. Bakhona ukukunceda. Ukuba ugqirha ukuxilonga ukuba une-OHS, baya kukunika isicwangciso sonyango esifanelekileyo.

Okokugqibela, izinto ekufuneka uzikhumbule

Kulungile, mandikucele ukuba ukhumbule ezinye zezona zinto zibalulekileyo kwizinto esithethe ngazo.

• I-Obesity Hypoventilation Syndrome yingxaki yokuphefumla enokuba yingozi kakhulu kwaye iza nokutyeba kakhulu.
• Okwenzekayo koku kukuba ikhabhoni diokside iyanda kwaye ioksijini iyancipha egazini.
• Eyona nto ingcono kukuba, kukho unyango loku! Ukunciphisa umzimba nokusebenzisa oomatshini bokuphefumla abafana neCPAP/BiPAP kubalulekile.
• Ukuxilongwa kwangoko kunye nonyango kunokuthintela umonakalo omkhulu ebomini kwaye kuphucule kakhulu umgangatho wobomi.
• Ukuba utyebile kakhulu kwaye uneempawu ezifana nokuphefumla kancinci, ukozela emini, kunye nokurhona ebusuku, nceda ufune ingcebiso kagqirha. Akukho nto yokoyika okanye yokuba neentloni ngayo. Impilo yakho yeyona nto ibalulekileyo.

Ndiyathemba ukuba olu lwazi luluncedo kuwe. Hlala usempilweni!

Isifo sokutyeba kakhulu, i-OHS, i-Pickwickian Syndrome, ukutyeba kakhulu, ubunzima bokuphefumla, i-sleep apnea, i-CPAP, i-BiPAP