Ubuhlungu obuhlala isikhathi eside ngisho nangemva kwe-shingles? Ingabe yi-postherpetic neuralgia (PHN)? Ake sixoxe ngakho!

Wake waba ne-shingles? Noma wake wambona umuntu omaziyo eyithola? Ukulunywa yinyoka kuyinto ebuhlungu kakhulu. Kodwa ngezinye izikhathi, ngisho nangemva kokuba ukulunywa yinyoka sekupholile, ubuhlungu bungaqhubeka bubuya. Yilokho esikhuluma ngakho namuhla, i-Postherpetic Neuralgia (PHN). Ungakhathazeki, sizokhuluma ngalokhu kalula, ngendlela ongayiqonda.

Kuyini i-postherpetic neuralgia (PHN)? Kuzwakala kanjani?

Kalula nje, i-postherpetic neuralgia (PHN) iyinkinga ye-shingles. Ungase ukhumbule ukuthi i-shingles ibangelwa ukuvuselelwa kwegciwane elifanayo elibangela i-chickenpox, igciwane le-Varicella-zoster. Libizwa nangokuthi i-Herpes Zoster.

Uma kulunywa yinyoka, kuvela ubomvu obubuhlungu, obufana namaqhubu ohlangothini olulodwa lomzimba, ikakhulukazi esifubeni noma esiswini. Njengoba ubomvu buphela ngokuhamba kwesikhathi, ubuhlungu buzophela. Kodwa-ke, kwabanye abantu, ubuhlungu endaweni yokulunywa bungase buqhubeke. Lokhu yilokho esikubiza ngokuthi 'i-PHN', ubuhlungu obuhlala ngisho nangemva kokuba ukulunywa yinyoka sekuluphele.

Ngakho-ke ubuhlungu be-'PHN' bunjani?

Uzozwa ubuhlungu endaweni efanayo lapho ukulunywa yinyoka kwenzeke khona. Lobuhlungu bungase buhlale njalo, noma bungase bufike budlule. Abanye abantu bathi buzwakala njengomuzwa wokushisa, umuzwa wokugwazwa, noma ubuhlungu obubukhali obuvela ngaphakathi . Abanye (abangavamile) bangase bezwe umuzwa wokuthuthumela noma wokulunywa endaweni.

I-PHN ingahlala isikhathi esingakanani? Ubani onamathuba amaningi okuyithola?

Ubuhlungu be-PHN bungahlala amasonto, izinyanga, ngisho neminyaka ngemva kokuba ukulunywa yinyoka sekuluphele. Kwabaningi abantu, ubuhlungu buyaphela phakathi nenyanga eyodwa kuya kwezintathu. Kodwa-ke, kulinganiselwa ukuthi cishe umuntu oyedwa kwabahlanu uzoba nobuhlungu isikhathi esingaphezu konyaka.

Kwabanye abantu, ubuhlungu obuvela ku-PHN bukhulu kangangokuthi kwenza kube nzima ukusebenza empilweni yabo yansuku zonke. Abacwaningi abakazi kahle ukuthi kungani abanye abantu benobuhlungu obukhulu kangaka obuhlala isikhathi eside kanti abanye abanabo.

Kuvame kangakanani lokhu 'i-PHN'?

Igciwane le-Varicella-zoster liyimbangela ye-chickenpox kanye ne-shingles. Cishe ama-99% abantu baseMelika abangaphezu kweminyaka engama-40 bake baba ne-chickenpox. Ngaphezu kwalokho, oyedwa kwabathathu baseMelika uzoba nokulunywa yinyoka empilweni yakhe. Phakathi kuka-10% no-18% wabantu abalunywa yinyoka bazoba ne-PHN. I-PHN iyinkinga evame kakhulu yokulunywa yinyoka.

Ubani osengozini enkulu yokuthola i-PHN?

Izici ezilandelayo zandisa ingozi yokuthola i-PHN:

• Ukukhula kweminyaka:Ingozi yokuthola i-PHN iyanda njengoba ukhula. Uma usukhulile futhi ulunywe yinyoka, kungenzeka kakhulu ukuthi uthole i-PHN, futhi ubuhlungu buzohlala isikhathi eside futhi bube bukhulu kakhulu kunokuba ubusemncane. Phakathi kuka-10% no-13% wabantu abangaphezu kweminyaka engu-50 abalunywe yinyoka bathola i-PHN. I-PHN ayivamile kubantu abangaphansi kweminyaka engu-40.
• Isimiso somzimba esibuthakathaka: Njengoba sikhula, ikhono lomzimba wethu lokulwa nezifo, noma isimiso sethu somzimba, liyaba buthaka. Khona-ke igciwane le-varicella-zoster elingasebenzi lingaphinde livuseleleke futhi libangele ama-shingles. Isimiso somzimba singaba buthaka futhi yizinto ezifana nomdlavuza, izifo ezingamahlalakhona (njenge-HIV/AIDS), ukufakelwa kwezitho zomzimba, noma ukusetshenziswa kwemithi ecindezela isimiso somzimba (njenge-chemotherapy, imithi yokucindezela amasosha omzimba, ama-steroids, kanye nemithi evimbela ukwenqatshwa kwezitho zomzimba).
• Ubunzima bokulunywa yinyoka: Uma ulunywe kakhulu, kungenzeka kakhulu ukuthi ube ne-PHN.
• Uma ubunobuhlungu, ukulunywa, noma ukuba ndikindiki ngaphambi kokulunywa yinyoka: Uma ubunalezi zimpawu esikhumbeni sakho ezinsukwini ezimbalwa ngaphambi kokulunywa yinyoka, usengozini enkulu yokuthola i-PHN.
• Uma wephuza ukubona udokotela ngemva kokulunywa yinyoka: Uma wephuza izinsuku ezingaphezu kwezintathu ngemva kokulunywa, okusho ukuthi uphuthelwa isikhathi sokuthatha imithi yokulwa namagciwane, kungenzeka kakhulu ukuthi ube ne-PHN.

Kungani i-PHN yenzeka? Iyini imbangela?

I-PHN ibangelwa ukulimala kwemicu yezinzwa ngesikhathi sokulunywa yinyoka. Cabanga ngakho, imicu yezinzwa ithwala imizwa efana nobuhlungu obuvela esikhumbeni sethu iye ebuchosheni. Ngakho-ke lapho imicu yezinzwa endaweni lapho inyoka ilunywe khona yonakele, iqala ukuthumela izimpawu zobuhlungu obukhulu ebuchosheni. I-postherpetic neuralgia isho "ubuhlungu bezinzwa obuvela ngemva kwe-herpes". Ukulunywa yinyoka kubizwa nangokuthi i-Herpes Zoster.

Njengoba sishilo ngaphambili, ukulunywa yizinyoka kubangelwa yigciwane elifanayo elibangela i-chickenpox (i-Varicella-zoster virus). Uma usune-chickenpox, igciwane lihlala emzimbeni wakho impilo yonke, kodwa lingalala lithule noma "lithule" iminyaka eminingi. Ukulunywa yizinyoka kwenzeka kuphela uma igciwane liphinde lisebenze. Iphesenti elincane (ngaphansi kuka-20%) labantu abalunywa yizinyoka bathola i-PHN.

Ziyini ngempela izimpawu ze-PHN?

Izimpawu ezivame kakhulu ze-PHN yilezi:

• Ukusha, ubuhlungu obukhulu, ubuhlungu obuhlabayo, noma umuzwa wobuhlungu bangaphakathi endaweni yokulunywa yinyoka.
• Ukuluma noma ukuba ndikindiki endaweni yokulimala kwangaphambilini noma eduze kwayo.
• Ubuhlungu buhlala njalo noma buyafika buphele. Ubuhlungu buvame ukuhlala cishe izinyanga ezintathu ngemva kokuba inxeba selipholile, kodwa bungahlala isikhathi esingaphezu konyaka.
• Ngisho noma ingubo ithinta indawo ebuhlungu yesikhumba, ngisho nokuthinta kancane kungandisa ubuhlungu.
• Ubuhlungu bungase bube bubi kakhulu ebusuku noma ekushiseni okukhulu noma emakhazeni.

Udokotela uyixilonga kanjani i-PHN?

Udokotela uvame ukuxilonga i-PHN ngokusekelwe ezimpawu zakho, kungakhathaliseki ukuthi uke walunywa yinyoka muva nje, kanye nokuhlolwa ngokomzimba. Uma uke walunywa yinyoka muva nje futhi usazwa ubuhlungu endaweni yokulunywa, cishe une-PHN. Udokotela wakho angase afune nokususa ezinye izimbangela zobuhlungu, kodwa esikhathini esiningi, azikho ezinye izivivinyo ezidingekayo.

Ingabe i-PHN ingabangela ezinye izinkinga?

Yebo, i-PHN ingabangela izimo ezifana nalezi:

• Ukuzizwa ukhathele futhi ukhathele.
• Ukungalali.
• Ukudla akunambitheki.
• Ubunzima bokugxilisa ingqondo.

Uma unezinhlungu ze-PHN zesikhathi eside, zingaholela ezimweni ezifana nokucindezeleka. Ngakho-ke, kubaluleke kakhulu ukunakekela lokhu.

Yiziphi izindlela zokwelapha i-PHN?

Manje ake sibone ukuthi lokhu kungenzani.

Uma ubona udokotela zingakapheli izinsuku ezintathu zokuqala zokulunywa yinyoka, cishe uzokunikeza imithi yokulwa namagciwane. Isibonelo, i-Acyclovir (Zovirax®), i-Valacyclovir (Valtrex®), noma i-Famciclovir (Famvir®). Le mithi ingasiza ukulunywa ukuthi kuphole ngokushesha, kumise ukulunywa okusha, kunciphise ubuhlungu nokulunywa, futhi kufinyeze isikhathi sobuhlungu ngemva kokuba ukulunywa kuphole.

Kodwa uma ukulunywa yinyoka kungabonwa kusenesikhathi, noma uma ithuba liphuthelwa, odokotela banezinye izindlela eziningana zokuphatha izimpawu zakho ze-PHN.

Uma ubuhlungu bakho buncane, udokotela angase ancome izinto ezifana nalezi:

• `I-Acetaminophen (Tylenol®)` noma `ama-NSAID` (imithi engeyona eye-steroidal yokulwa nokuvuvukala) njenge-`Ibuprofen (Advil®, Motrin®)`.
• Okhilimu nama-patches aduduzayo esikhumbeni, isibonelo, lawo aqukethe i-`Lidocaine (Lidoderm®)` kanye ne-`Capsaicin (Zostrix®)`.

Uma ubuhlungu bakho bukhulu, udokotela angase akunike imithi efana nale:

• Eminye imithi esetshenziselwa ukwelapha izimo ezifana nesifo sokuwa (esibizwa ngokuthi `imithi yokuvimbela ukuqunjelwa`), njenge `Gabapentin (Neurontin®, Gralise®)` kanye ne `Pregabalin (Lyrica®)`, ivame ukusetshenziswa ukwelapha ubuhlungu bemizwa.
• Imithi yokucindezeleka, njenge-Escitalopram (Lexapro®), i-Quetiapine (Seroquel®), noma i-Amitriptyline, ingasiza futhi ngobuhlungu bemizwa.
• Ukujova i-'Botulinum toxin (Botox®)` endaweni yobuhlungu.

Into ebalulekile ukuthi, akukho "lokhu kuyindlela engcono kakhulu yokwelapha" ye-PHN. Udokotela wakhoUngase ufune ukuzama imithi engaphezu kweyodwa, noma ungase unikezwe inhlanganisela yemithi. Wena nodokotela wakho nizoxoxa ngezinketho zenu futhi ninqume ukuthi yikuphi okufanele nina. Uma ubuhlungu bakho bungathuthuki ngemva kokuthatha imithi yakho, qiniseka ukuthi uyamtshela udokotela wakho . Kubaluleke kakhulu ukuphuza yonke imithi njengoba nje uyalelwe.

Ingabe i-PHN ingalapheka ngokuphelele?

Akukho ukwelashwa kwe-PHN, kodwa kungalawulwa. Kwabaningi, ubuhlungu obuvela ku-PHN buyancipha kancane kancane ngokuhamba kwesikhathi futhi ekugcineni buphele. Njengoba sishilo ekuqaleni, abantu abaningi bazothola impumuzo ebuhlungwini phakathi nenyanga eyodwa kuya kwezintathu.

Ingabe zikhona izindlela zokuvimbela i-PHN ukuthi ingakhuli?

Yebo, lena yingxenye ebaluleke kakhulu! Indlela engcono kakhulu yokuvimbela i-PHN ukugwema ama-shingles.

• Umuthi wokugomela i-Shingrix®: I-Food and Drug Administration igunyaze umuthi wokugomela ukuvimbela ukulunywa yizinyoka. Lokhu kungasiza ekunciphiseni ingozi yokuthola ukulunywa yizinyoka kanye nokuthola i-PHN. Lo muthi wokugomela, obizwa ngokuthi i-Shingrix®, unconywa kubantu abaneminyaka engu-50 nangaphezulu ukuvimbela ukulunywa yizinyoka. Umuthi wokugomela wemithamo emibili, kanti umthamo wesibili unikezwa izinyanga ezimbili kuya kweziyisithupha zihlukene. Lo muthi wokugomela wemithamo emibili usebenza kahle ngo-90% ekuvimbeleni ukulunywa yizinyoka kanye ne-PHN. Uzovikeleka okungenani iminyaka emine ngemuva kokuthola umuthi wokugomela.
• Umuthi wokugomela i-chickenpox: Uma ungakaze ube ne-chickenpox, noma uma izingane zakho sezike zaba ne-chickenpox, ukuthola umuthi wokugomela i-chickenpox (i-Varivax) kungavimbela lokhu kutheleleka kwasekuqaleni. Uma ungakaze ube ne-chickenpox, awunayo igciwane le-varicella-zoster emzimbeni wakho, ngakho ngeke uthole i-shingles noma i-PHN.

Ubani okufanele athole umuthi wokugomela i-Shingrix®?

Umuthi wokugomela i-Shingrix® unconywa kuwo wonke umuntu onempilo futhi oneminyaka engu-50 noma ngaphezulu. Akukho mkhawulo weminyaka ephezulu. Kufanele futhi uthole umuthi wokugomela uma:

• Ngisho noma uke walunywa yinyoka ngaphambili.
• Ngisho noma ungakhumbuli kahle ukuthi wawune-chickenpox nini (cishe ama-99% abantu baseMelika abangaphezu kweminyaka engama-40 bake baba ne-chickenpox, noma ngabe abakhumbuli besaseyingane).
• Ngisho noma uke wathola umuthi wokugomela i-Zostavax ngaphambilini (lo muthi wokugomela awusasetshenziswa e-United States), khuluma nodokotela wakho ngesikhathi esingcono kakhulu sokuthola umuthi wokugomela i-Shingrix®.

Uma usuvele ulunywe yinyoka, kufanele ulinde kuze kube yilapho inxeba selipholile. Khuluma nodokotela wakho ngesikhathi esingcono kakhulu sokuqala umuthi wokugomela i-Shingrix®.

Hlobo luni lomphumela umuntu one-PHN angalulindela?

Akukho ukwelashwa okujwayelekile kwezimpawu ze-PHN. Kuye ngobukhulu bobuhlungu bakho, ungaqala ngemithi etholakala ngaphandle kwemithi kadokotela. Uma ubuhlungu bukhulu, ungase ufune ukuzama umuthi owodwa noma ngaphezulu kadokotela. I-PHN yisimo esinzima ukwelapha. Kokunye ukuhlola, ngaphansi kwengxenye yeziguli ezine-PHN zithole ukukhululeka okuphelele kwezimpawu.

I-PHN ivame ukwenzeka kubantu asebekhulile abangase babe nezinye izinkinga zempilo. Lokhu kungenza ukwelashwa nemiphumela kube nzima kakhulu. Ubuhlungu bungahlala amasonto, izinyanga, noma ngisho nangaphezulu konyaka. Kwabanye abantu, ubuhlungu bungaba nzima ukububekezelela. Kodwa kubantu abaningi, ubuhlungu be-PHN buyancipha kancane kancane ngokuhamba kwesikhathi.

Uma usune-chickenpox, igciwane le-varicella-zoster lihlala emzimbeni wakho impilo yakho yonke. Uma igciwane liphinde livuke futhi ulunywe yinyoka, ukubona udokotela ezinsukwini ezimbalwa ngemuva kokuqubuka kanye nokuthatha imithi yokulwa namagciwane kunganciphisa kakhulu izimpawu zakho. Uma uba ne-PHN, odokotela banemithi eyahlukahlukene yokusiza ukulawula izimpawu zakho. Ngakho-ke ungesabi, khuluma nodokotela bese uthola ukwelashwa okufanele.

Umyalezo Wokuya Ekhaya:

Kulungile, ake sifingqe izinto okudingeka sizikhumbule kule ndaba ende:

• I-PHN ubuhlungu bemizwa obuqhubeka ngisho nangemva kokuba ama-shingles esepholile.
• Isizathu esiyinhloko salokhu ukulimala kwemicu yezinzwa okubangelwa ukulunywa yizinyoka.
• Abantu asebekhulile, labo abanezivikeli mzimba ezibuthakathaka, kanye nalabo abaye balunywa yizinyoka kakhulu banamathuba amaningi okuthola i-PHN.
• Ubuhlungu be-PHN bungazwakala njengomuzwa wokushisa, ukugwaza, ukuqaqamba, noma ukulunywa .
• Nakuba kungekho ukwelashwa kwe-PHN, kunezindlela zokwelapha ezingasiza ekulawuleni ubuhlungu. Ezimweni eziningi, ubuhlungu buzophela ngokuhamba kwesikhathi.
• Ukufuna ukwelashwa ngokushesha ngangokunokwenzeka ngemva kokulunywa yinyoka (ezinsukwini ezintathu zokuqala) kunganciphisa ingozi ye-PHN.
• Umuthi wokugomela i-Shingrix® unganciphisa kakhulu ingozi yokulunywa yinyoka kanye ne-PHN. Kunconywa kuwo wonke umuntu oneminyaka engaphezu kwengu-50.
• Uma ucabanga ukuthi une-PHN, ungangabazi ukubona udokotela ukuze akunike iseluleko.

Ngiyethemba ukuthi lolu lwazi luwusizo kuwe. Hlala uphilile!

I- postherpetic neuralgia, i-PHN, ukulunywa yinyoka, ama-shingles, i-herpes zoster, i-chickenpox, ubuhlungu bemizwa, umuthi wokugomela i-Shingrix