Kuyini Ukuhlolwa Kokucindezeleka Kokuzivocavoca Umzimba? Ake sixoxe ngakho!

Wake wezwa 'ngeMetabolic Exercise Stress Test'? Mhlawumbe wesaba kancane noma wazibuza lapho udokotela wakho ekutshela ukuthi wenze lokhu. Noma mhlawumbe ubufuna ukwazi ngakho. Ngakho-ke, namuhla sizokhuluma ngalolu vivinyo kalula, ngendlela ongayiqonda.

Uyini umehluko phakathi kwalokhu okubizwa ngokuthi ukuhlolwa kokucindezeleka kokuzivocavoca umzimba kanye nokuhlolwa kokucindezeleka okuvamile?

Kalula nje, lokhu ukuhlolwa okuhlola impilo yakho ngenkathi uzivocavoca. Kwenziwa ngenkathi ugibela ibhayisikili noma uhamba nge-treadmill. Udokotela noma uchwepheshe oqeqeshiwe ukukuqapha ngokucophelela. Okukhethekile kwalokhu ukuthi kubheka ukuthi inhliziyo namaphaphu akho asebenza kahle kangakanani, nokuthi imisipha yakho ithola umoya-mpilo kahle kangakanani uma uzivocavoca (`Cardiorespiratory Fitness` - CRF). Ngezinye izikhathi odokotela bakubiza nangokuthi ``Cardiopulmonary Exercise Test`` (`CPET`). Ngoba ``cardio'' isho inhliziyo, kanye ``pulmonary'' isho amaphaphu. Ngakho-ke umsebenzi wazo zombili lezi zinto uhlolwa ngesikhathi esisodwa.

Manje ungase ucabange, 'Ngakho-ke uyini umehluko phakathi kokuhlolwa kokucindezeleka okuvamile nalokhu?' Lowo ngumbuzo omuhle! Ukuhlolwa kokucindezeleka okuvamile kubheka nje inhliziyo yakho. Uzivocavoca futhi uthola idatha ezintweni ezifana ne-EKG. Kodwa kulokhu kuhlolwa kokucindezeleka kwe-metabolic, uphefumula nge-facemask ekhethekile noma i-mouthpiece. Le divayisi ilinganisa inani le-oxygen ne-carbon dioxide emphefumulweni wakho ophumayo. Iphinde ilinganise ukuthi amaphaphu akho angawuthatha umoya ongakanani. Eqinisweni, inguqulo ethuthukisiwe yokuhlolwa kokucindezeleka okuvamile enazo zonke izinsimbi namakhwela. Ngakho-ke, inani ledatha elitholwe kulokhu nalo likhulu, futhi kungenzeka ukuqonda kahle ukuthi inhliziyo namaphaphu asabela kanjani ekuzivocavoceni.

Yini esingayifunda kulolu vivinyo?

Ngakho-ke, yini ngempela le test engayithola? Cabanga ukuthi uzizwa ukhathele ngisho nangemva komzamo omncane, noma uzizwa ukhathele ngaso sonke isikhathi. Le test ingakusiza ukuthola ukuthi yini ebangela lokhu. Ingakutshela kahle ukuthi ukungabekezeleli kwakho ukuzivocavoca kubangelwa yisifo senhliziyo, isifo samaphaphu, noma inhlanganisela yakho kokubili.

Izinto eziyinhloko ezilindelekile kulolu vivinyo yilezi:

• Thola ukuthi kungani uzizwa uphelelwa umoya futhi ukhathele kakhulu uma uzivocavoca.
• Nquma ukuthi inhliziyo namaphaphu akho angawusebenzisa kangakanani umsebenzi .
• Thola izifo zenhliziyo namaphaphu.
• Hlola ubucayi besimo sakho bese uthola umbono wokuthi ikusasa liphetheni (isibikezelo).
• Hlola ingozi yezinkinga ngaphambi kokuhlinzwa okukhulu.
• Lungisa uhlelo lwakho lokwelashwa .
• Bona ukuthi umzimba wakho usabela kanjani ekwelashweni kwamanje .
• Hlola intuthuko ezinhlelweni zokuqeqesha ngokomzimba njengokuvuselelwa kwenhliziyo.
• Siza ukudala uhlelo olukuvumela ukuthi uvivinye umzimba ngokuphepha nangokusebenza kahle .

Uyabona, kubaluleke kangakanani lokhu kuhlolwa? Ikakhulukazi uma unesifo esifana nokuthi "Heart Failure", lokhu kuhlolwa kwe-"CPET" kunganquma ukuthi isimo sakho sibi kangakanani nokuthi hlobo luni lokwelashwa oludingayo.

Kubaluleke kakhulu: Uma une-pacemaker noma i-defibrillator, kufanele nakanjani uyihlole ngudokotela ngaphambi kwalokhu kuhlolwa . Ngakho-ke, khuluma nodokotela wakho ngalokhu ngaphambi kokuhlela ukuhlolwa.

Ubani odinga lokhu kuhlolwa kokucindezeleka kwe-metabolic?

Ngakho-ke, ubani odinga ukuhlolwa kokucindezeleka komzimba? Empeleni, udokotela wakho uzonquma ukuthi uyakudinga noma cha. Ngokuvamile, izingane ezingaphezu kweminyaka eyi-10 kanye nabantu abadala banoma yimuphi ubudala bangaba nalokhu kuhlolwa. Odokotela batusa lokhu kuhlolwa, ikakhulukazi ukuxilonga nokuphatha lezi zimo ezilandelayo:

• `Isifuba`
• Isifo Sokuvinjelwa Kwamaphaphu Esingamahlalakhona (i-COPD)
• I-Cystic Fibrosis
• `Ukwehluleka Kwenhliziyo`
• Isifo Samaphaphu Esingaphakathi Kwezitho Zomzimba
• Umdlavuza Wamaphaphu
• `I-Primary Ciliary Dyskinesia`
• Umfutho Wegazi Ophakeme Wemithambo Yephaphu (i-PAH)
• I-Sarcoidosis

Futhi, lokhu kuhlolwa kwenziwa ngaphambi kokuhlinzwa okukhulu. Isibonelo:

• Ukuhlinzwa Kokususwa Kwamaphaphu
• Ukufakelwa Kwamaphaphu Nokuhlinzwa Kokufakelwa Kwamaphaphu Nenhliziyo
• Ukuhlinzwa Kokunciphisa Umthamo Wamaphaphu (i-LVRS)
• Okunye ukuhlinzwa okukhulu kwesifuba

Ingabe bakhona abantu okungafanele babhale lolu vivinyo?

Kodwa-ke, akuwona wonke umuntu ongenza lokhu kuhlolwa. Kunezizathu ezithile zokuthi kungani kungase kungaphephile ukuthi ukukwenze. Odokotela bakubiza ngokuthi 'izithiyo'. Lokhu kuhlolwa kungase kungakufaneleki uma unezinye zezimo ezilandelayo:

• Ukutheleleka okukhulu (njengomkhuhlane noma umkhuhlane)
• I-Acute Myocarditis noma i-Pericarditis (ukuvuvukala kwemisipha yenhliziyo noma ulwelwesi oluzungeze inhliziyo)
• "Ukuhlaselwa yinhliziyo" okwenzeka phakathi nenyanga
• I-Deep Vein Thrombosis (DVT) emilenzeni
• I-Endocarditis (ukutheleleka kolwelwesi lwangaphakathi lwenhliziyo)
• I-Hypertrophic Cardiomyopathy (ukuqina okungajwayelekile kwemisipha yenhliziyo)
• `Ukwehluleka Kwezinso`
• I-'Heart Valve Stenosis' ephakathi noma eqinile
• Ukukhulelwa okunezinkinga noma okuseduze nokubeletha
• Umfutho wegazi ophakeme kakhulu
• Umfutho Wegazi Ophakeme Wemithambo Yephaphu Onamandla (i-PAH)
• I-Arrhythmias Engalawulwa
• Ukwehluleka Kwenhliziyo Okungalawulwa
• Ubuhlungu benhliziyo obungazinzile (i-angina)

Ungalungiselela kanjani ukuhlolwa?

Kulungile, manje ake sibone ukuthi ungalungiselela kanjani lolu vivinyo. Kufanele ulandele ngqo imiyalelo enikezwe udokotela wakho. Nazi ezinye zemiyalelo ejwayelekile:

• Ungaphuzi lutho oluqukethe i-caffeine amahora angama-24 ngaphambi kokuhlolwa. I-caffeine ingathinta imiphumela yokuhlolwa. Ikhofi, itiye, iziphuzo ezibandayo, kanye noshokoledi kuqukethe i-caffeine. Ama-strawberry kanye nemikhiqizo ebhalwe ukuthi ``decaffeinated`` noma ``engenayo i-caffeine`` nayo ingase ibe nenani elincane, ngakho-ke kungcono ukuyigwema.
• Ungadli noma uphuze lutho ngaphandle kwamanzi amahora amane ngaphambi kokuhlolwa.
• Yeka ukubhema noma ukuvuba i-vape amahora ayisishiyagalombili ngaphambi kokuhlolwa (kungcono ukuyeka amahora angama-24 uma kungenzeka). I-Nicotine nayo ingathinta imiphumela.

Ngenzenjani ngemithi engivame ukuyithatha?

Kufanele ubuze udokotela wakho ngalokhu. Eminye imithi kungadingeka ithathwe ngendlela ehlukile ngosuku lokuhlolwa. Ngokuvamile, amaphilisi okudambisa ubuhlungu aqukethe i-caffeine (njengamaphilisi athile okunciphisa umzimba, njenge-NoDoz®, i-Excedrin®, ne-Anacin®) awanconywa amahora angama-24 ngaphambi kokuhlolwa.

Iseluleko esikhethekile kubantu abanesifo sikashukela:

Uma uthatha i-insulin ukulawula ushukela egazini lakho, buza udokotela wakho ukuthi kufanele uthathe malini ngosuku lokuhlolwa. Iningi labantu lizokutshela ukuthi uthathe ingxenye yomthamo wakho ojwayelekile ekuseni bese udla ukudla okulula emahoreni amane ngaphambi kokuhlolwa.

Uma uthatha iphilisi lokulawula ushukela egazini lakho, ungase ucelwe ukuthi ungalithathi kuze kube ngemva kokuhlolwa.

Yini okufanele uyigqoke ngosuku lokuhlolwa?

Gqoka izingubo ongazihambahamba ngazo bese uzivocavoca . Njengoba ungase ujuluke kancane, kungcono ukhethe izingubo ezenziwe ngokotini eziphefumulayo (njenge-T-shirt engenamikhono). Ungazigqoka lezi zingubo ekhaya, noma ungazishintsha lapho. Futhi, letha izicathulo ezikhululekile (njengezicathulo ze-canvas noma ama-sneakers). Kuzoba khona ilokha lapho ukugcina izimpahla zakho. Kodwa-ke, kungcono ukushiya izinto eziyigugu ekhaya.

Lokhu kuhlolwa kokuvivinya umzimba kwenziwa kanjani?

Kulungile, manje sekuza ingxenye ebalulekile. Lokhu kuhlolwa kwenziwa kanjani? Kwenziwa 'elabhorethri yokucindezeleka', igumbi elikhethekile lapho kwenziwa khona ukuhlolwa kokucindezeleka. Uchwepheshe oqeqeshiwe wenza ukuhlolwa, ngaphansi kokuqondisa kukadokotela. Ungagibela ibhayisikili elinganyakazi noma 'uhambe nge-treadmill'. Ukugibela ibhayisikili kuyinto evame kakhulu. Udokotela wakho uzonquma ukuthi iyiphi indlela engcono kakhulu kuwe ngokusekelwe eminyakeni yakho, impilo yakho, kanye nezinga lokufaneleka komzimba.

Ngesikhathi uzivocavoca, uzoxhunywa kudivayisi elinganisa ukuphefumula kwakho. Lokhu kungenziwa kusetshenziswa ``imaski yobuso`` noma ``i-mouthpiece``. Ungase ukwazi ukukhetha noma yikuphi okukhululekile kakhulu kuwe.

Nansi indlela izinyathelo zokuhlola ezisebenza ngayo:

• Ukuxhuma i-`EKG`: Uchwepheshe uzobeka ama-`electrode` amancane, ayisicaba afana nesitikha ezingxenyeni ezahlukene zesifuba sakho. Lawa axhunywe kusikrini esizoqapha ukusebenza kukagesi kwenhliziyo yakho kulo lonke ukuhlolwa.
• Isigaba sokuphumula: Lokhu kuvame ukuthatha imizuzu emithathu. Uchwepheshe uzokusiza ukuthi ujwayele imaski yobuso noma i-mouthpiece bese ekucela ukuthi uqale ukuphefumula ngayo. Umfutho wegazi lakho kanye namazinga e-oxygen egazini (izimpawu ezibalulekile eziyisisekelo) kuzolinganiswa. I-monitor ye-ECG izosetshenziswa futhi ukuhlola izinga lokushaya kwenhliziyo yakho. Ukuhlola amazinga e-oxygen ne-carbon dioxide egazini lakho (izilinganiso zegesi yegazi le-arterial), uchwepheshe uzofaka ithubhu elincane (i-catheter ye-arterial) emthanjeni osengalweni yakho (umthambo we-radial). Lokhu kuzothatha amasampula egazi ngezikhathi ezithile ngesikhathi sokuhlolwa.
• Isigaba sokukhulula umthwalo (ukufudumeza): Lokhu kuthatha imizuzu emibili kuya kwemithathu. 'Ukukhulula umthwalo' kusho ukuthi uhamba ngebhayisikili noma uhamba ngaphandle kwesisindo esengeziwe. Phakathi nalesi sikhathi, uchwepheshe uqoqa 'ulwazi oluyisisekelo olusebenzayo'. Lena yindlela inhliziyo namaphaphu akho asabela ngayo ezingeni eliphansi kakhulu lokuzivocavoca.
• Isigaba sokuzivocavoca esikhulayo: Lena yingxenye ebaluleke kakhulu yokuhlolwa. Ihlala phakathi kwemizuzu engu-8 nengu-12. Ugibela ibhayisikili noma uhamba njalo. Uchwepheshe kancane kancane ukhulisa ukumelana komshini. Uzoqala ukuzizwa ukhathele kancane kancane. Phakathi nalesi sikhathi, uchwepheshe uzokubuza ukuthi uzizwa kanjani. Into ebaluleke kakhulu ukuzivocavoca isikhathi eside ngangokunokwenzeka.
• Isigaba sokululama (ukupholisa): Lokhu kuthatha imizuzu emithathu kuya kwemihlanu. Uzoqhubeka nokugibela noma ukuhamba njengokujwayelekile, ngaphandle kwesisindo. Uchwepheshe uzohlola izimpawu zakho ezibalulekile futhi alinganise ukululama kwenhliziyo yakho. Uma izinga lokushaya kwenhliziyo yakho kanye nomfutho wegazi sekubuyele esimweni esijwayelekile, usukulungele ukuhamba.

Iyini isikali se-`RPE`?

Kukhona indlela esetshenziswa ukuchaza ukuthi uzizwa ukhathele kangakanani ngesikhathi sokuhlolwa. Ibizwa ngokuthi isikali esithi `Rating of Perceived Exertion` (RPE). Kunezikali eziningana ze-`RPE`. Esivame kakhulu ukusetshenziswa ku-`CPET` ukusebenzisa iminwe yakho ukukhombisa ukuthi kunzima kangakanani ukuphefumula nokuthi imilenze yakho ikhathele kangakanani esikalini esisuka ku-0 kuya ku-10. Uma inombolo iphakeme, uzizwa ukhathele kakhulu.

Ngisho noma wonke lawo madivayisi eqoqa idatha eningi mayelana nokuthi kwenzekani emzimbeni wakho, nguwe kuphela ongasho ukuthi uzizwa kanjani. Ngakho-ke, uma unemibuzo mayelana nalesi sikali ngaphambi kokuqala ukuhlolwa, buza uchwepheshe.

Ngizozizwa kanjani uma ngibhala isivivinyo?

Ukuhlolwa kuzwakala kanjani? Ukuze uthole imiphumela enembile newusizo ngempela, udinga ukuzivocavoca uze ukhathale ngempela. Kuvamile ukuthi izinga lokushaya kwenhliziyo yakho, umfutho wegazi, kanye nezinga lokuphefumula kukhuphuke. Uzojuluka, futhi imilenze yakho izozizwa ikhathele kancane. Ungase uzizwe nomlomo owomile ngenxa yokuphefumula ngomlomo.

Lokhu ukuhlolwa, ngakho kuzwakala njengokuhlolwa. Kodwa-ke, uma uhlangabezana nanoma yiziphi izimpawu ezingavamile ngesikhathi sokuhlolwa, kufanele uyeke ukuzivocavoca ngokushesha bese utshela uchwepheshe. Izimpawu ezinjalo zifaka:

• Ubuhlungu, ukungakhululeki, ukuqina esifubeni, engalweni, emhlathini
• Ukuphefumula kanzima
• Isiyezi, umuzwa wokuphelelwa yithemba

Lezi zimpawu zingaba uphawu lwesimo esiphuthumayo sezokwelapha, njengokuthi "ukuhlaselwa yinhliziyo." Njengoba ochwepheshe bebheke i-monitor ye-E.C.G., bazoyeka ukuhlolwa ngokushesha uma bebona noma yiziphi izinguquko eziyingozi.

Kuthatha isikhathi esingakanani lokhu kuhlolwa?

I-aphoyintimenti yakho yonke izothatha cishe imizuzu engama-75, kodwa empeleni uzobe uzivocavoca cishe imizuzu engama-20, okuhlanganisa nokuzifudumeza kanye nokuphola.

Ngiyithola kanjani imiphumela yokuhlolwa?

Udokotela wakho uzokutshela ukuthi imiphumela uzoyibona nini futhi kanjani. Cishe uzokwazi ukubona imiphumela kurekhodi lakho lezokwelapha elekthronikhi. Uzothola nethuba lokuhlangana nodokotela wakho ukuze nixoxe ngalokhu.

Lokhu kuhlolwa kuqopha izinkulungwane zezilinganiso, eziboniswa ngefomethi yegrafu eyinkimbinkimbi ebizwa ngokuthi ``i-nine-panel plot``. Lawa amagrafu ayinkimbinkimbi, obuchwepheshe anikeza isithombe esiphelele sendlela inhliziyo namaphaphu akho asebenza ngayo. Udokotela wakho uzohlaziya le miphumela futhi akuchazele yona ngendlela ongayiqonda.

Kuvamile ukuzizwa ukhathazekile futhi wesaba kancane uma utshelwa ukuthi uzohlolwa ukucindezeleka kokuvivinya umzimba. Lokho kuyaqondakala. Kodwa ungacabangi kakhulu ngakho.Lolu uhlobo lokuhlolwa oluvamile olungakunika wena nodokotela wakho ukuqonda okuhle ngalokho okwenzekayo enhliziyweni nasemaphashini akho.

Yebo, kungaba yinto exakile ukuzivocavoca ngenkathi ugqoke ama-electrode namanye amadivayisi. Kodwa khumbula, idivayisi ngayinye iqoqa ulwazi olubalulekile oluzosiza ukuhlanganisa ukwelashwa kwakho. Uma unemibuzo mayelana nokuthi ungalungiselela kanjani ukuhlolwa noma ukuthi yini ongayilindela uma ufika elabhorethri, ungesabi ukubuza udokotela wakho.

Ngakho-ke, yiziphi izinto ezibaluleke kakhulu esifuna ukuzithatha ekhaya kulesi sihloko?

Kalula nje, i-`Metabolic Exercise Stress Test` (`CPET`) iyisivivinyo esikhethekile esilinganisa ukuthi inhliziyo namaphaphu akho asabela kanjani ekuzivocavoceni. Ingakusiza ukuthola imbangela yokuphelelwa umoya nokukhathala kwakho, ukuhlonza izimo zezokwelapha, ukuhlela ukwelashwa, nokuhlola ingozi ngaphambi kokuhlinzwa.

Kubaluleke kakhulu ukulandela imiyalelo kadokotela (mayelana ne-caffeine, ukubhema, ukudla, kanye nemithi) ngaphambi nje kwalolu vivinyo.

Kuvamile ukuzizwa ukhathele kancane ngesikhathi sokuhlolwa. Kodwa-ke, uma uhlangabezana nanoma yiziphi izimpawu ezingavamile, tshela uchwepheshe ngokushesha. Khumbula, lokhu ukuhlolwa okuzokunikeza ulwazi olubalulekile mayelana nempilo yakho futhi kukusize uthole ukwelashwa okungcono kakhulu. Ngakho-ke, ungesabi ukukhuluma nodokotela wakho futhi ufunde kabanzi ngalokhu.

Ukuhlolwa Kokucindezeleka Kokuzivocavoca Kwe - Metabolic, i-CPET, Ukuhlolwa Kwenhliziyo, Ukuhlolwa Kwamaphaphu, Ukuhlolwa Kokuzivocavoca, Izimbangela Zokukhathala, Impilo Yenhliziyo, Impilo Yokuphefumula