Kwenzeka ntoni emzimbeni wakho xa usitya yonke into ngaxeshanye emva kokungatyi? Masifunde ngqo nge-Refeeding Syndrome!

Ngaba wakha wazibuza ukuba kwenzeka ntoni emzimbeni wakho xa ungatyi kangangeentsuku uze ngequbuliso uqale ukutya kwakhona? Ngamanye amaxesha, xa ngequbuliso uqala ukondla umzimba wakho, unokuba neengxaki ezingalindelekanga. Yiloo nto oogqirha bayibiza ngokuba yi-"refeeding syndrome." Oku kunokuvakala kuyinkimbinkimbi, kodwa masikwenze kube lula.

Yintoni le "Refeeding Syndrome"?

Ngamafutshane, `(Refeeding Syndrome)` yimeko enzima enokwenzeka xa umntu onesifo sokungondleki eqala ukutya kwakhona . Ukungondleki kuxa umzimba wakho ungafumani izondlo ozifunayo. Ngoko ke, emva kokungatyi ixesha elide kangaka, xa ufumana ukutya ngequbuliso, kukho utshintsho olukhulu oluvela kwiinkqubo zeekhemikhali emzimbeni wethu. Ngokukodwa, kunokubakho ukungalingani okukhulu kubungakanani betyuwa ebalulekileyo (`(Electrolytes)`) emzimbeni. Oku kunokubangela umonakalo kwizitho ezibalulekileyo ezifana nezihlunu zakho, imiphunga, intliziyo, kunye nengqondo .

Ngubani onokuthi abe nesifo "sokuphinde atye"?

Oku kunokwenzeka nakubani na ongondlekanga kakuhle aze aqale ukutya kwakhona. Ukuba awufumani ukutya okwaneleyo nokusela, ungondlekanga. Kwakhona, ukungondleki kakuhle kunokubakho ngenxa yezifo ezithile. Kuba, ngenxa yezifo ezinjalo, usenokungakwazi ukutya okanye umzimba wakho usenokungakwazi ukufunxa ukutya okutyayo ngokufanelekileyo.

Abantu abanezi zinto zilandelayo ezinobungozi banokuba sengozini enkulu yokuba ne-"Refeeding Syndrome":

• Ukuba kutshanje ulahlekelwe ngaphezu kwe-10% yobunzima bomzimba wakho. Umzekelo, ukuba unobunzima obuyi-60 kg, ukulahlekelwa ngaphezu kwe-6 kg ngaxeshanye kuyingozi.
• Ukuba ubungatyi kangangeentsuku ezingaphezu kwesixhenxe, uxinezelekile engqondweni, kwaye umzimba wakho uzive ubuthathaka.
• Kubantu abaneengxaki zokutya, ezifana ne-Anorexia Nervosa (ingxaki yokutya) okanye i-Bulimia Nervosa (ingxaki yokutya).
• Abantu abanezifo ezithintela umzimba ekufunxeni ukutya ngendlela efanelekileyo , njenge-pancreatitis engapheliyo okanye isifo samathumbu esidumbileyo.
• Kwabo bebefumana isondlo se-parenteral ixesha elide.
• Kwabo banesifo somhlaza kunye nabo bafumana unyango lwe-chemotherapy.
• Kwabo banesifo seswekile esingalawulekiyo (iDiabetes Mellitus).
• Kwabo bebesele utywala kakhulu ixesha elide.
• Kwabo bebesebenzisa amayeza okunciphisa i-asidi okanye amayeza okukhupha umchamo ixesha elide.

Ingaba le "Refeeding Syndrome" yenzeka njani?

Xa umzimba wakho ungafumani izondlo ozifunayo, wenza utshintsho oluthile ukuze uzivumelanise nazo. Inkqubo umzimba oguqula ngayo ukutya kube ngamandla ibizwa ngokuba yimetabolism.Endaweni yeecarbohydrates ekutyeni, umzimba uqala ukutshisa amafutha kunye nezihlunu zawo ukuze ufumane amandla. Oku kukwanciphisa isantya semetabolism. Ubungakanani bamandla owasebenzisayo ngelixa uphumle (`Ukuphumla kweMetabolic Rate`) bunokwehla malunga ne-20%.

Olu hlobo lwe-metabolism lusebenzisa izixhobo ezimbalwa. Iivithamini, iiminerali, kunye ne-"electrolytes" ezikhankanyiweyo apha ngasentla azisetyenziswa kule nkqubo, njengakwi-metabolism eqhelekileyo.

Kodwa, xa uqala ukutya kwakhona, iicarbohydrates ziqala ukucolwa ngendlela eqhelekileyo. Emva koko umzimba ngequbuliso uzifuna ezo `(Micronutrients)` ukuze zenze lo msebenzi. Kufana nokuba indawo yokugcina impahla ayisekho kwaye ngequbuliso kungena uluhlu olukhulu. Ukuba umzimba wakho unezondlo ezimbalwa kakhulu ezigciniweyo, kulapho ke ingxaki iqala khona.

Yintoni unobangela wokwenene we-`(Refeeding Syndrome)`?

Isizathu esiphambili soku kukungabikho kwezakhamzimba ezithile emzimbeni wakho. Ezi ziyaphela xa ungondlekanga. Izakhamzimba eziphambili ezibandakanyeka koku yiPhosphorus, iPotassium, kunye neMagnesium . Xa uqala ukutya kwakhona, iiseli zakho ngequbuliso zifuna ezi electrolytes ukuze zikwazi ukucola ukutya. Oku kubangela utshintsho olukhulu kwibhalansi yeekhemikhali emzimbeni wakho, njengomothuko.

Ezi `(Electrolytes)` egazini lakho zithuthwa ziye kwiiseli ngokukhawuleza kakhulu. Nangona kunjalo, ngenxa yokuba awunazo ezaneleyo emzimbeni wakho, amanqanaba ezi zinto egazini lakho ancipha kakhulu ngenxa yolu tshintsho. Oku kukuncipha kwamanqanaba e`(Electrolyte)` egazini lakho okubizwa ngokuba yi`Deficiencies`. Kungenxa yezi ngxaki apho ibhalansi yeekhemikhali yomzimba iphazamiseka, kwaye iingxaki ezahlukeneyo ezibonakala kwi`(Refeeding Syndrome)` zenzeka.

Zithini iimpawu ze-`(Refeeding Syndrome)`?

Le meko ingabonakala ngeendlela ezahlukeneyo. Eyona ixhaphakileyo kukunqongophala kwe-phosphate. Nangona kunjalo, ezinye iziphene kunye nokungalingani nazo zinokuba negalelo koku.

Ukunqongophala kwe-phosphate (`(Hypophosphatemia)`)

Ukunqongophala kwe-phosphorus lolona phawu luqhelekileyo lwe-"Refeeding Syndrome." Xa amanqanaba e-phosphate ephantsi, ichaphazela ukusebenza kweeseli emzimbeni wonke. Oku kunokubangela iimpawu ezifana nezi:

• Ubuthathaka bemisipha (njengokuba ilungu liphelelwa ngamandla)
• Ubunzima bokuphefumla.
• Ukuqala ukubona izinto ngambini (`Double Vision`).
• Ubunzima bokuginya.
• Ukuxhuzula.
• I-Coma.
• Ukubuthathaka kwemisipha yentliziyo (`(Cardiomyopathy)`).

Ukuba ezi mpawu ziba nzima , amanye amalungu omzimba anokuyeka ukusebenza kwaye ubomi bunokonakala . Ke ngoko, oku akufanele kuthathwe lula.

Ukunqongophala kweMagnesium (`(Hypomagnesemia)`)

I-magnesium ikwabalulekile kwimetabolism yomzimba wethu. Xa i-magnesium iphantsi, inokuchaphazela onke amalungu omzimba. Iimpawu ezifana nezi:

• Isicaphucaphu nokuhlanza.
• I-Anorexia (ukulahlekelwa yimdla wokutya).
• Iinyikima.
• Ukuqaqamba kwemisipha.
• Ukuxhuzula.
• I-Coma.
• Ukuphazamiseka kokuhamba kwegazi ukuya entliziyweni (iCardiac Ischemia).
• Ukungahambi kakuhle kwesingqisho sentliziyo (`(Arrhythmia)`).

Ukunqongophala kwePotassium (`(Hypokalemia)`)

Ukuba unesiphene esincinci se-potassium, usenokungabi nazo naziphi na iimpawu ezinkulu. Nangona kunjalo, ukuba isiphene sinzima kakhulu, unokufumana oku kulandelayo:

• Ubuthathaka bemisipha.
• Ukuqaqamba kwemisipha, iintlungu.
• Ukudinwa kakhulu.
• Ukushukuma kwamathumbu kuyayeka, nto leyo ebangela ukuqhinwa okukhulu.
• Ukungahambi kakuhle kwesingqisho sentliziyo (`(Arrhythmia)`).
• Ukungasebenzi kakuhle kokuphefumla.

Ukunqongophala kweThiamine (iVitamin B1) (`Ukunqongophala kweThiamine`)

Oku kunqongophala kwe-thiamine kubonakala ngakumbi xa ukutya okutyebileyo kwiicarbohydrate kuphinda kusetyenziswe. Oku kunokukhokelela kwiimpawu ezinzulu zemithambo-luvo:

• Ukuphambana, ukudideka.
• Iingxaki zokubona.
• Ukwehla kobushushu bomzimba (`(Hypothermia)`).
• Iingxaki zokulinganisela kunye nokulungelelanisa (`(Ataxia)`). "Ukuba nobunzima bokuhamba, njengomntu onxilileyo."
• Ukulahlekelwa yinkumbulo (`(i-Amnesia)`).
• Ukudibana (iinkumbulo zezinto ezingazange zenzeke).

Iingxaki ngokulinganisela kolwelo emzimbeni

Utshintsho kwindlela umzimba osebenza ngayo izinto lunokuchaphazela ibhalansi yesodium namanzi emzimbeni. Xa isondlo siphinda siqaliswe, oku kunokukhokelela kwi-"Fluid Overload" okanye kwi-"Dehydration". Oku kunokukhokelela kwiimeko ezifana nezi:

• Uxinzelelo lwegazi oluphantsi (uxinzelelo lwegazi oluphantsi).
• Ukuqaqamba kwemisipha.
• Ukudumba kweMiphunga (ukuqokelelana kolwelo emiphungeni).
• Ukungasebenzi kakuhle kwezintso.
• Ukusilela kwentliziyo (`(Ukusilela kwentliziyo okubangelwa kukuqina kwentliziyo)`).
• Ukuxhuzula.

Iingxaki zenqanaba leswekile egazini

Xa umntwana ephinda encelisa, ukuphinda afumane iswekile kunokubangela amanqanaba aphezulu eswekile egazini (i-hyperglycemia). Oku kungenxa yokuba:

• Intloko ebuhlungu .
• Umbono ofipheleyo.
• Ukuchama rhoqo.
• Ndidiniwe.

Ungayiqaphela njani `(Refeeding Syndrome)`?

Wakuba uqalile ukutya kwakhona, iqela lakho lezonyango liza kujonga rhoqo iimpawu zakho ezibalulekileyo . Ukuba kukho naziphi na iimpawu ezingaqhelekanga okanye ezibonakala, baya kwenza uvavanyo lwegazi ukuze baphande. Oku kuya kubanceda babone ukuba zeziphi iingxaki ezithile onazo emzimbeni wakho kwaye zinzima kangakanani.

Inyangwa njani i-"Refeeding Syndrome"?

Ngaphambi kokuba uqale ukutya kwakhona, oogqirha bakho baza kwenza uvavanyo lwegazi ukujonga amanqanaba akho e-electrolyte baze babone naziphi na iziphene. Emva koko, baza kongeza ezi micronutrients ziphelileyo kwifomyula yakho yesondlo. Ingcinga kukuba uqale uzalise ezi micronutrients ziphelileyo. Emva koko, umzimba wakho uya kuba ulungele ngcono ukucola iicarbohydrates.

Kodwa khumbula, ngamanye amaxesha, uvavanyo lokuqala lwegazi aluziboni zonke ezi `(Electrolyte)` zisilela. Ngenxa yokuba umzimba awukaqali ukondla, awazi ukuba uza kuzifuna ezi `(Electrolyte)` kwixesha elizayo. Utshintsho olukhulu ekudluliseleni kwe `(Electrolyte)` ukusuka egazini ukuya kwiiseli alwenzeki okwangoku. Ngenxa yoku, ngamanye amaxesha izisilela zivela kuphela emva kokuba kuqalile ukondla.

Iqela lakho lezonyango liza kuqhubeka nokukujonga iimpawu. Liza kujonga amanqanaba akho e-electrolyte yonke imihla. I-Refeeding syndrome idla ngokuvela kwiintsuku ezintlanu zokuqala emva kokuphinda wondle. Ukuba kuvela iimpawu, iqela lakho lezonyango liza kunciphisa isantya osondla ngaso. Baza kunciphisa inani lee-carbohydrates kwifomyula yakho. Usenokunikwa nezinye zezondlo oziphosayo nge-IV.

Ndingaphila ngokukhawuleza kangakanani emva konyango?

Xa ugqirha efumanise ukuba "i-Refeeding Syndrome", angayilungisa ngokukhawuleza. Nangona kunjalo, kungathatha iiveki ezininzi ukuba ukunqongophala kwezakhamzimba zokuqala kuphole. Oku kuthetha ukuba inkqubo epheleleyo yokondla kwakhona ithatha ixesha elithile.

Ungayinciphisa njani ingozi ye-`(Refeeding Syndrome)`?

Ngamanye amaxesha imfuneko yokuphinda wondle ayinakuphepheka. Nangona kunjalo, singathatha amanyathelo okhuseleko:

• Ukuba unesifo esihlala ixesha elide esibangela ukungondleki kakuhle, kubalulekile ukuba unyangwe ngendlela efanelekileyo . Ugqirha wakho unokucebisa izongezo, ezifana neevithamini kunye neeminerali, ukuze zikuncede ufumane izondlo ozifunayo.
• Ukuba uzila ukutya kangangeentsuku ezininzi, kungcono ukwenze oko phantsi kweliso likagqirha.
• Musa ukusebenzisa kakubi utywala, iziyobisi, okanye amayeza kagqirha. Ukuba usebenzisa nayiphi na kwezi rhoqo, kungcono ukubona ugqirha ukuze ahlolwe ngokubanzi kwaye ahlolwe igazi.

Ngaba ungasinda `(Refeeding Syndrome)`?

Nangona iingxaki ezivela kwi-"Refeeding Syndrome" ngamanye amaxesha zinokubulala, uninzi lwexesha azibi zinkulu kangako . Nje ukuba iqela lezonyango lilungise ukungalingani, iimpawu ezininzi zinokubuyiselwa kwimeko yazo, oko kuthetha ukuba zinokunyangeka.

"(Isifo Sokondla Kwakhona)" yingxaki eyenzeka ngexesha lonyango lokungondleki kakuhle. Ukungondleki kakuhle kukwayimeko ebangela uxinezeleko olukhulu emzimbeni. Kusenokubonakala kungaqhelekanga kuwe ukuba ukunika unyango oluninzi ngokukhawuleza kunokuba yingozi. Kodwa,Ukondla kwakhona yinkqubo ebuthathaka kakhulu neyinkimbinkimbi. Kungcono ukwenza oku phantsi kweliso likagqirha. Xa ukondla kwakhona phantsi kweliso loogqirha, baya kukubeka esweni ngokusondeleyo. Baza kuzama ukuthintela ukuba `(Refeeding Syndrome)` ingenzeki, kwaye baza kukulungela ukujongana nayo ukuba iyenzeka.

Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

• Kufuneka ulumke kakhulu xa uqala ukutya kwakhona emva kokuba ungondlekanga okwethutyana.
• Njengoko intetho ithi, "Uhambo olucothayo lolona hambo lubalaseleyo," ukondla kufuneka kwenziwe kancinci kancinci.
• Kukhuselekile ngakumbi ukuzondla kwakhona phantsi kweliso likagqirha, ingakumbi kwabo bakwiqela elisengozini enkulu.
• Mamela umzimba wakho. Ukuba uziva into engaqhelekanga, ungathandabuzi ukufuna ingcebiso kugqirha.
• ``(Refeeding Syndrome)`` asinto yokoyika, kodwa kubaluleke kakhulu ukuba uyiqaphele.

Ngoko ke, ndiyathemba ukuba olu lwazi luluncedo kuwe. Hlala usempilweni!

Isifo Sokondla Kwakhona , ukungondleki kakuhle, ii-electrolytes, isondlo, ukuzila ukutya, iimpawu, unyango