Ingabe ngezinye izikhathi uzizwa ukhathele kakhulu ngisho nangemva kokwenza into encane, noma uzizwa sengathi kunzima ukuphefumula? Ingabe uthola ukuthi awukwazi ukugijima noma ukugxuma njengoba wawuvame ukwenza, futhi uphelelwe umoya ngisho nalapho ukhuphuka izitebhisi? Mhlawumbe inhliziyo yakho ayishayi ngesivinini esifanele izinga lakho lokuzikhandla. Namuhla, sizokhuluma ngesimo esinjalo. Ngokwezokwelapha, lokhu kubizwa ngokuthi (Chronotropic Incompetence) . Nakuba igama lizwakala liyinkimbinkimbi kancane, masiliqonde kalula.
Kuyini (Ukungakwazi Ukusebenza Kwe-Chronotropic)? Kalula nje...
Kalula nje, (Ukungakwazi Ukuqonda Okuqhubekayo) yisimo lapho izinga lokushaya kwenhliziyo yakho lingakwazi ukwanda ngokwanele uma wenza umsebenzi womzimba, njengokuzivocavoca umzimba noma umsebenzi onzima. Cabanga ngakho: uma simatasa noma sihamba, imizimba yethu idinga umoya-mpilo omningi kunalapho siphumule. Lo moya-mpilo uthwalwa yigazi emzimbeni wonke, futhi inhliziyo inesibopho sokupompa leli gazi.
Kumuntu one- (Chronotropic Incompetence) , inhliziyo ayikwazi ukuphatha kahle lokhu kukhula kwesidingo se-oxygen. Lokhu kusho ukuthi inhliziyo yehluleka ukushaya ngokushesha ngokwanele ukupompa inani legazi elidingekayo (eliqukethe i-oxygen) emzimbeni. Cabanga ngakho njengenjini yemoto; njengoba nje sandisa ijubane lenjini lapho sidinga ukuhamba ngokushesha, inhliziyo yethu kufanele ishaye ngokushesha lapho sizikhandla. Izinkinga ziyavela uma lokhu kungenzeki.
Ngenxa yalokhu, kungenzeka ukuthi unciphise ukubekezelela ukuzivocavoca . Lokhu kusho ukuthi ungase ungakwazi ukwenza imisebenzi yomzimba abanye abangontanga yakho abangayenza. Ungase uzizwe sengathi awusakwazi ukuhamba amabanga obuwahamba kalula ngaphandle kokuphefumula noma ukukhathala.
Ziyini izimpawu (zokungasebenzi kahle kwe-Chronotropic)?
Kunezimpawu eziningana eziyinhloko ongase uzizwe ngalesi simo:
- Ukukhathala ngokweqile ngesikhathi sokuzilolonga: Ukuzizwa ukhathele kakhulu ngisho nangemva kokwenza into encane. Isibonelo, ungase uzizwe ukhathele kakhulu ngenkathi wenza imisebenzi yasekhaya, uphethe isikhwama sokuthenga, noma uhamba ibanga elifushane.
- Ukuphelelwa umoya (ukuphelelwa umoya) ngesikhathi sokusebenza ngokomzimba: Ubunzima bokuphefumula noma ukuzizwa uphelelwa umoya lapho uzikhandla. Ungase uzizwe uphelelwa umoya kangangokuthi awukwazi ukubamba ingxoxo.
Lezi zimpawu zihlukile ekukhathaleni okuvamile. Uma uzizwa ukhathele noma uphefumula kanzima kangangokuthi awukwazi ukwenza imisebenzi yakho yansuku zonke, kufanele uyinake.
Yiziphi izimbangela (Ukungakwazi Ukusebenza Kwe-Chronotropic)?
Lesi simo singabangelwa yizinto eziningana, hhayi esisodwa nje kuphela. Ake sibheke ukuthi ziyini:
- Imithi ethile: Ikakhulukazi eminye imithi efana (nama-beta-blockers) enikezwa umfutho wegazi ophakeme noma isifo senhliziyo inganciphisa izinga lokushaya kwenhliziyo .
- Ukungasebenzi kahle kwe-Sinus node: I- (Sinus node) yilapho ukushaya kwenhliziyo yethu kuvela khona; isebenza njenge-pacemaker yemvelo yenhliziyo. Uma kukhona inkinga ngalokhu, ukushaya kwenhliziyo kungase kungalawulwa kahle.
- Izinkinga zokulawula ukushaya kwenhliziyo: Ukuze inhliziyo ishaye, izimpawu zikagesi kumele zihambe kahle kuyo yonke inhliziyo. Uma kukhona ukuvaleka noma inkinga ezindleleni lezi zimpawu ezihamba ngazo, ukushaya kwenhliziyo kungaba okungajwayelekile noma izinga lokushaya kwenhliziyo lingase lehle.
- Ukungasebenzi kahle kwe-ventricle yesobunxele: Inhliziyo yethu inezindawo ezine eziyinhloko. I-ventricle yesobunxele ingenye yazo, futhi inesibopho sokupompa igazi liye emzimbeni wonke. Uma umsebenzi wale ventricle yesobunxele ubuthakathaka, ayikwazi ukupompa igazi elanele emzimbeni.
- Ukuncipha kokunikezwa kwegazi emisipheni yenhliziyo (Ischemic heart disease): Ukuvaleka kwemithambo yegazi enikeza inhliziyo kuvimbela imisipha yenhliziyo ekutholeni umoya-mpilo odingekayo kanye nezakhamzimba. Lokhu kungaba yimbangela.
- Ukwehluleka kwenhliziyo : Ngenxa yokuthi inhliziyo ayikwazi ukupompa igazi ngokwezidingo zomzimba, izimo ezifana nokugcinwa koketshezi zingaba khona.
- Isifo senhliziyo esizalwa naso: Abanye abantu bazalwa benezinkinga ezithile zenhliziyo. Izimo ezinjalo zingaba nomthelela ekuthuthukisweni (kwe-Chronotropic Incompetence) kamuva ekuphileni.
Yiziphi izinto ezibangela lesi simo?
Abanye abantu basengozini enkulu yokuthola lesi simo. Nazi ezinye zezinto ezibangela lokhu:
- Abantu abanesifo senhliziyo .
- Abantu abanokukhuluphala okukhulu .
- Abantu abanesifo sikashukela (i-Diabetes Mellitus) .
- Abantu abanezifo zamaphaphu ezingamahlalakhona ezifana ne- (COPD - Chronic obstructive pulmonary disease) .
- Abantu abanomfutho wegazi ophakeme .
- Abantu abanesifo (i-HIV) .
- Abantu abake batheleleka ngegciwane (i-Epstein-Barr virus) (igciwane elivame ukubangela umkhuhlane kanye nomphimbo obuhlungu).
- Abantu abahlushwa yi- (Long COVID) , okusho labo abaqhubeka nokuba nezimpawu isikhathi eside ngemva kokuba ne-COVID-19.
Uma unalezi zinto eziyingozi, kuhle ukuhlala uqaphile.
Odokotela bakuthola kanjani ukuthi une-Chronotropic Incompetence?
Udokotela uxilonga lesi simo uma izinga lokushaya kwenhliziyo yakho lihluleka ukufinyelela ezingeni elithile. Ngokuvamile, odokotela basola lesi simo uma izinga lokushaya kwenhliziyo yakho lingakhuphuki libe okungenani u-70% kuya ku-85% (i-APMHR - izinga lokushaya kwenhliziyo elibikezelwe ubudala) ngesikhathi somsebenzi womzimba ophezulu.
Ifomula evamile esetshenziswa ukuthola izinga lokushaya kwenhliziyo lakho elibikezelwe ngeminyaka (i-APMHR) yile: ukususa iminyaka yakho ku-220 . Kodwa-ke, lena akuyona yodwa indlela; odokotela basebenzisa ezinye izindlela namafomula. Isibonelo, uma izinga lokushaya kwenhliziyo yakho lingakwazi ukufinyelela okungenani u-80% (wesilinganiso sokushaya kwenhliziyo esigciniwe) , lokho kusetshenziselwa nokuhlonza (Ukungakwazi Ukushaya Inhliziyo Okungapheli) .
Akukho simiso esisodwa esamukeleka emhlabeni wonke salokhu okwamanje, ngakho udokotela uzofinyelela esiphethweni ngokusekelwe esimweni sakho esithile.
Yiziphi izivivinyo zalokhu?
Uma udokotela wakho esola lesi simo, angase acele ukuhlolwa okuningana:
- Isiqaphi senhliziyo esiqhubekayo: Lena idivayisi encane ongayigqoka. Ivumela udokotela ukubona ukuthi izinga lokushaya kwenhliziyo yakho lishintsha kanjani ngenkathi wenza imisebenzi yakho yansuku zonke usuku lonke.
- Ukuhlolwa kokuzivocavoca (EKG - Electrocardiogram):
Kulesi sivivinyo, izinga lokushaya kwenhliziyo yakho liqashwa nge-EKG ngenkathi uhamba nge-treadmill noma ugibela ibhayisikili elingashukumi. Udokotela uhlola ukuthi izinga lokushaya kwenhliziyo yakho liyakhuphuka yini liye ezingeni elilindelekile ngesikhathi sokuzikhandla ngokomzimba.
Yiziphi izindlela zokwelapha ukungasebenzi kahle kwe-Chronotropic?
Odokotela balandela izindlela eziningana lapho belapha lesi simo. Eziyinhloko zifaka:
- Umsebenzi womzimba: Ungamangali! Ngisho noma ukuzivocavoca kungase kuzwakale kunzima, enye indlela yokwelapha ukuzibandakanya ekuzivocavoceni okuhlelekile ngaphansi kwesiqondiso sezokwelapha. Lokhu kungakusiza ukuthi uthuthukise kancane kancane amandla akho okusebenza ngokomzimba.
- I-Pacemaker: Abanye abantu bangase badinge idivayisi encane kagesi ebizwa ngokuthi i -pacemaker efakwe ngaphansi kwesikhumba eduze kwenhliziyo. Le divayisi isiza inhliziyo ukuthi inyuse izinga layo liye ezingeni elidingekayo uma uzikhandla.
- I-Biventricular pacemaker (Ukwelashwa Kokuvumelanisa Inhliziyo - CRT): Lolu uhlobo olukhethekile lwe-pacemaker. Luqinisekisa ukuthi amakamelo amabili aphansi enhliziyo (ama-ventricles) ayashayana ndawonye ngesigqi esivumelanayo. Lokhu kuwusizo kubantu abanezimo ezithile zenhliziyo.
Udokotela wakho uzonquma ukuthi yikuphi ukwelashwa okukufanelekelayo ngokusekelwe esimweni sakho, izimpawu, kanye nezinye izinkinga zempilo eziyisisekelo.
Yini ongayilindela ngenkathi uphila nalesi simo?
Abantu abadala abanenkinga yokungakwazi ukusebenza kahle kwe-Chronotropic bangase bakhathale kakhulu futhi baphelelwe umoya kunokulindelekile ngesikhathi semisebenzi evamile yansuku zonke noma ukuzivocavoca. Isibonelo, ungase uzizwe uphelelwa umoya ngemva kokuphumula ewashini noma ukukhwela izitebhisi.
Ezimweni ezingavamile, uma ukushaya kwenhliziyo kunganele ukunikeza igazi elanele ebuchosheni, kungaholela ekuqulekeni .
Izifundo zikhombisile ukuthi abantu abadala abanokukhuluphala ngokweqile kanye nokungakwazi ukusebenza kahle kwe-Chronotropic basengozini enkulu yokuhlaselwa yinhliziyo noma ukwehluleka ukusebenza kahle kwenhliziyo. Olunye ucwaningo lusikisela ukuthi labo abanalesi simo basengozini enkulu yokuthola isigqi senhliziyo esingajwayelekile esaziwa ngokuthi i-Atrial fibrillation (Afib) . Uma umuntu onesifo senhliziyo engakwazi ukusebenza kahle enesifo se-Chronotropic , lokhu kuhlotshaniswa nokubikezela okubi kakhulu. Ezinye izifundo zikhombisile nokuxhumana phakathi kwalesi simo nokuncipha kwesikhathi sokuphila.
Sabelana ngalolu lwazi hhayi ukuze sikuthuse, kodwa ukuqinisekisa ukuthi uyazi ngalesi simo futhi ukhuthazwa ukuba uthathe izinyathelo ezidingekayo.
Ingabe ukungakwazi ukusebenza kahle kwe-Chronotropic kungavinjelwa?
Ezinye izimbangela zalesi simo, njengokukhubazeka kwenhliziyo okuzalwa nakho, azikwazi ukulawulwa. Kodwa-ke, kunezinto eziningana ongazenza ukuze unciphise ingozi yakho:
- Uma unesifo senhliziyo noma samaphaphu, kubalulekile ukuthola ukwelashwa okufanele kwaso .
- Ukugcina isisindo somzimba esinempilo kubaluleke kakhulu. Ukukhuluphala ngokweqile kungaholela ezinkingeni eziningi zempilo.
- Uma unezifo ezifana ne-Diabetes Mellitus noma umfutho wegazi ophakeme, kubalulekile ukuzigcina zilawulwa kahle .
Ngokunaka lezi zici, ungasiza ekuzivikeleni hhayi kuphela ekungakwazini ukusebenza kwe-Chronotropic kodwa nakwezinye izinkinga eziningi zezempilo.
Ngingazinakekela kanjani?
Ukuphila Nokungakwazi Ukusebenza Kwe-Chronotropic kusho ukuthi umzimba wakho ungase ubeke imingcele ethile kulokho ongakwenza. Ukubekezela kubaluleke kakhulu phakathi nalesi sikhathi. Zama ukuzivumelanisa nalesi simo kancane kancane ngaphandle kokushesha.
- Khuluma nodokotela wakho mayelana nokuthi udinga ukushintsha noma yimiphi imithi yakho noma udinga i -pacemaker .
- Uma udokotela wakho efake idivayisi (isib. i-pacemaker) esifubeni sakho, kufanele ube nokuqonda okuhle kokuthi isebenza kanjani .
- Hlala uya kuma-aphoyintimenti akho okulandelela ukuqinisekisa ukuthi idivayisi yakho isebenza kahle.
- Uma udokotela wakho ekunikeze uhlelo lokwandisa kancane kancane umsebenzi wakho womzimba, landela leyo miyalelo ngokunembile . Ungazami ukuzikhandla ngokweqile ngokuzumayo.
Kuvamile ukuzizwa udangele noma ukhungathekile uma ungasakwazi ukwenza izinto obuzenza. Ukuzizwa ukhathele ngisho nalapho uphethe izingubo eziningi kungaba yinto ekhathazayo ngempela. Kodwa-ke, akudingeki ubhekane nalesi simo wedwa. Ithimba lakho lezokwelapha lihlala likulungele ukukusekela.
Yimiphi imibuzo okufanele ngiyibuze udokotela wami?
Uma uvakashela udokotela wakho, ungabuza imibuzo efana nale:
- Ungakwazi yini ukuchaza imbangela yokungakwazi kwami ukusebenza kahle kwe-Chronotropic ?
- Yini engingayenza ukuze ngiphile kahle ngangokunokwenzeka ngalesi simo?
- Yini engingayilindela kumshini wokushaya indlwabu owufakelwe? (Uma kusebenza)
- Ingabe zikhona izinhlelo noma izindlela ezingangisiza ngandise umsebenzi wami womzimba ngokuphephile?
Ngaphezu kwalokhu, zizwe ukhululekile ukubuza udokotela wakho nganoma yini enye engqondweni yakho noma noma yikuphi ukungabaza ongase ube nakho.
Ekuphetheni, khumbula!
Ukungakwazi ukusebenza kahle kwe-Chronotropic kuyisimo esidinga ukunakekelwa okuthile. Kodwa-ke, ngeseluleko esifanele sezokwelapha, ukwelashwa, kanye nokuzibophezela kwakho , usengakwazi ukuphila impilo enhle. Ungesabi. Lalela iseluleko sikadokotela wakho bese usilandela ngokufanele. Ngikufisela ukululama okusheshayo eNirogi Lanka!
