Kuvamile ukuzizwa wesaba futhi ukhathazekile lapho udokotela wakho ekutshela ukuthi izinso zakho azisebenzi kahle. Kungenzeka ukuthi utshelwe ukuthi kuzodingeka wenze i-dialysis. Abantu abaningi bayakhathazeka lapho bezwa la mazwi, futhi abakwazi ukucabanga ukuthi kuzokwenzekani. Kodwa uma siyiqonda kahle le ndlela yokwelapha, uzoqonda ukuthi lena yindlela ebaluleke kakhulu engasindisa impilo yakho. Ngakho-ke, namuhla sizokhuluma nge-hemodialysis ngamagama alula.
Kalula nje, kuyini i-hemodialysis?
Cabanga ngezinso zakho njengezihlungi ezimbili ezinkulu emzimbeni wethu. Zihlunga imfucuza engafuneki, ubuthi, kanye noketshezi oluningi egazini lethu bese zikukhipha njengomchamo. Kodwa uma isifo sezinso sizivimbela ekwenzeni lo msebenzi ngendlela efanele, lobu buthi buqala ukuqongelela emzimbeni.
I-Hemodialysis inqubo yokuhlanza igazi kusetshenziswa umshini osusa imfucuza ye-nitrogen (urea), imikhiqizo yemfucuza emisipheni (creatinine), kanye nama-acid egazini, bese ubuyisela igazi elihlanziwe emzimbeni.
Lo mshini uhlanza kanjani igazi?
Lo mshini we-hemodialysis une-filter ekhethekile. Ubizwa ngokuthi 'i-dialyzer'. Abanye abantu bawubiza nangokuthi 'izinso zokwenziwa'. Igazi elithathwe emzimbeni wakho liya kule 'dialyzer'. Njengoba igazi ligeleza ngamapayipi amahle kakhulu afana ne-mesh ngaphakathi kuwo, kuhlungwa kuphela imfucuza namanzi angaphezulu egazini.
Le mikhiqizo yokungcola iqoqwa kuketshezi olukhethekile olubizwa ngokuthi 'i-dialysate'. Lokhu kwakhiwe ngamanzi, usawoti, kanye nama-electrolyte. Manje igazi elihlanzekile, elinodoti wonke osusiwe, lithunyelwa emzimbeni wakho ngomshini. Uketshezi 'lwe-dialysate', olunemikhiqizo yodoti, lususwa emshinini. Cabanga ngakho njengesihlungi setiye esihlunga amaqabunga etiye bese kuthi itiye kuphela liwele enkomishini.
Kunezindlela ezimbili eziyinhloko zokwenza i-hemodialysis:
Ungakhuluma nodokotela wakho bese unquma ukuthi iyiphi indlela engcono kakhulu kuwe.
| Indlela yokwelapha | Incazelo |
|---|---|
| Ukuhlanza igazi kwenziwa esibhedlela noma esikhungweni (i-In-center hemodialysis) | Lena yindlela evame kakhulu. Kuzodingeka uye esibhedlela esikhethekile noma esikhungweni se-dialysis ukuze uthole lokhu. Lapho, umhlengikazi oqeqeshiwe noma uchwepheshe uzokunikeza lokhu kwelashwa. Ngokuvamile kuzodingeka uye cishe izinsuku ezintathu ngesonto. Isikhathi ngasinye sizothatha cishe amahora amathathu kuya kwamane. |
| I-hemodialysis yasekhaya | Kulesi simo, ungakwenza lokhu kwelashwa ekhaya. Kodwa emasontweni ambalwa noma ezinyangeni ezimbalwa ngaphambi kwalokho, isibhedlela sizokufundisa ukuthi ungakwenza kanjani kahle nokuthi yini okufanele uyenze uma unezinkinga. Ngemva kwalokho, ungakwenza ngokwakho ngendlela othanda ngayo. |
Kukhona nezinhlobo ze-home hemodialysis.
- Ukuhlanza igazi ekhaya okuvamile: Kule ndlela, ukwelashwa kwenziwa izinsuku ezintathu ngesonto, amahora angu-3-4 ngesikhathi.
- Ukuhlanza i-hemodialysis yasekhaya okufushane nsuku zonke: Lokhu kungenziwa ngobuchwepheshe obusha. Lokhu kwenziwa cishe izinsuku ezi-5-7 ngesonto, kodwa kuthatha isikhathi esifushane, cishe amahora amabili ngesikhathi.
- Ukuhlanza igazi ekhaya ebusuku: Lokhu kwenziwa ebusuku ngenkathi ulele. Umshini usebenza amahora angu-6-8 ngesikhathi, cishe izinsuku ezingu-4-6 ngesonto. Lokhu kuvumela igazi ukuthi lihlanzwe isikhathi eside, ngakho-ke kususa imfucuza kangcono kunezinye izindlela.
Ubani ngempela odinga lokhu kwelashwa?
Uma unesifo sezinso esibi kakhulu, esibizwa ngokuthi i-End-Stage Kidney Disease (ESKD) , uzodinga i-hemodialysis. Futhi, kumuntu olinde ukufakelwa izinso, lokhu kwelashwa kubalulekile ukuze kuphile kuze kube yilapho ukufakelwa.
Kubalulekile ukuqonda lokhu: I-Hemodialysis akuyona ikhambi lesifo sezinso. Imane isiza izinso zakho ukuthi zenze umsebenzi ezidinga ukuwenza, ikusize uphile isikhathi eside.
Kwenzekani uma ukwelashwa kwenqatshwa?
Lesi yisihloko esibucayi kancane, kodwa sidinga ukukhuluma ngaso. Uma umuntu enquma ukungaqali i-hemodialysis, noma uma eqala bese eyeka, ubuthi buqala ukunqwabelana egazini. Lesi simo sisibiza ngokuthi '(uremia)'. Ngeshwa, lesi simo siyabulala. Ngaphandle kokwelashwa, ungaphila izinsuku noma amasonto ambalwa kuphela.
Lesi yisinqumo somuntu siqu ngokuphelele. Kodwa-ke, ngaphambi kokwenza isinqumo esinjalo, kufanele nakanjani ukhulume nodokotela wakho nomndeni wakho ngezinto ezikukhathazayo, ukwesaba kanye nemizwa yakho.
Ngingalungiselela kanjani ngaphambi kokwelashwa?
Ngaphambi kokuqala i-hemodialysis, amasonto ambalwa noma inyanga kusengaphambili, kudingeka kwenziwe amalungiselelo amancane. Okusho ukuthi, 'ukufinyelela' kudinga ukwenziwa ukuze igazi lisuswe kalula emzimbeni futhi libuyiselwe emzimbeni ngesikhathi sokwelashwa. Lokhu kudinga ukuhlinzwa okuncane.
Kunezindlela ezimbili eziyinhloko zokwenza lokhu:
- I-AV fistula (i-Arteriovenous fistula - i-AV fistula): Kulokhu, udokotela ohlinzayo uxhuma umthambo kanye nomthambo engalweni yakho.
- Ukufakelwa kwemithambo yegazi (i-AV graft): Uma umthambo kanye nomthambo osengalweni yakho kunganele ukuxhuma, udokotela ohlinzayo usebenzisa ipayipi elincane, elithambile (i-graft) ukuxhuma lokhu kokubili.
Zombili lezi zindlela zakha umthambo wegazi oqinile okulula ukufaka izinaliti kuwo ngesikhathi se-hemodialysis. Lokhu kusiza futhi ukuthi igazi ligeleze ngokushesha.
Uma kudingeka kuqalwe i-hemodialysis ngokuzumayo, udokotela wakho angase afake ithubhu elithambile elibizwa ngokuthi i-catheter okwesikhashana emthanjeni omkhulu entanyeni yakho, esifubeni, noma emlenzeni.
Kubaluleke kakhulu ukunakekela ukufinyelela kwakho!
Le divayisi yokufinyelela oyenzile kufanele iphathwe njengokungathi iyimpahla eyigugu. Uma itheleleka noma yonakala, ngeke ikwazi ukwelashwa. Izimpawu zokutheleleka zifaka:
- Ubuhlungu
- Ubuhlungu uma ucindezela
- Ukuvuvukala
- Ukushintsha kombala (obomvu, ompunga, opinki, onsundu, noma omnyama)
- Imfiva
Ukuze uvikele ukufinyelela, khumbula lezi zinto:
- Ungalali uhlangothi lokungena lubheke phansi.
- Ungagqoki izingubo noma ubucwebe obuzobanjwa yileso sandla.
- Ungavumeli ibhande lesikhwama liwele phezu kwendawo yokungena.
- Ungalokothi uvumele umuntu ukuthi ahlolwe umfutho wegazi lakhe noma akhishwe igazi engalweni ekwazi ukungena kuyo.
Ingabe udinga ukwenza izinguquko ekudleni kwakho?
Yebo, impela. Lokho okudlayo nokuphuzayo kuthinta ngqo impumelelo yokwelashwa nge-hemodialysis. Okunye ukudla kwandisa ukungcola egazini, ukugcinwa kwamanzi, umfutho wegazi, kanye nokushaya kwenhliziyo. Ngakho-ke, kufanele ukhulume nochwepheshe wezokudla kwezinso ukuze wakhe uhlelo lokudla olufanele wena.
Ngokuvamile, kufanele unciphise ukudla neziphuzo eziqukethe lezi zinto.
| Okufanele ukhawulele | Isizathu nezibonelo |
|---|---|
| I-Potassium | Uma amazinga e-potassium enyuka, ukushaya kwenhliziyo kungase kusheshe ngendlela engavamile. Izibonelo: Ubhanana, u-avokhado, i-orenji, i-pear, izithelo ezomisiwe (amadethi, omisiwe), amazambane. |
| I-Phosphorus | Uma i-phosphorus iyanda, amathambo angase abe buthakathaka futhi isikhumba singase silume. Izibonelo: ubisi nokudla kobisi (iyogathi, ushizi), inkukhu, amasoseji, ukudla okusemathinini, amalentili, ama-cashew. |
| I-Sodium - usawoti | Uma udla usawoti omningi, uba nokoma okukhulu futhi ugcine amanzi emzimbeni wakho. Izibonelo: usawoti, amasoso, i-ketchup, amasobho apakishiwe, ama-noodle asheshayo, ukudla okuthengwa esitolo. |
Kwenzekani ngesikhathi sokwelashwa?
Umhlengikazi noma uchwepheshe uzofaka izinaliti ezimbili endaweni yokungena eyenziwe engalweni yakho. Inaliti eyodwa izokhipha igazi emzimbeni wakho bese ilithumela emshinini. Ngemva kokuba igazi selihlanziwe nge-dialyzer emshinini, enye inaliti izobuyisela igazi elihlanzekile emzimbeni wakho.
Umshini uqapha umfutho wegazi lakho kulo lonke ukwelashwa. Umshini ungakhuphula noma wehlise izinga lokugeleza kwegazi uma kudingeka.
Ingabe lokhu kuyalimaza?
Uzozwa umuzwa omncane wokuhlaba lapho izinaliti ezimbili zifakwa endaweni yakho yokufinyelela. Kodwa-ke, ngeke uzizwe ubuhlungu amahora amaningana ngemva kokwelashwa. Abantu abaningi bafunda incwadi, babukele i-TV, noma balale phakathi nalesi sikhathi.
Kungani lokhu kuthatha isikhathi eside kangaka?
Izinso ezimbili eziphilile zihlanza igazi njalo amahora angama-24 ngosuku, ngisho noma ulele. Umshini wokuhlanza igazi awukwazi ukwenza lokho. Izinso eziphilile zihlanza cishe amalitha ayi-140 egazi ngosuku. Kodwa ukusebenza kahle kokwelashwa nge-hemodialysis kuphansi kakhulu. Yingakho kufanele kwenziwe okungenani amahora ama-3-4 ngesikhathi.
Ngemva kokwelashwa kanye nemiphumela engemihle engaba khona
Uma ukwelashwa sekuqediwe, izinaliti ziyasuswa, izindawo ziyahlanzwa, bese kufakwa iplasta. Ngemva kwalokho, ungaya ekhaya njengenjwayelo.
Abantu abaningi bazizwa bekhathele kancane noma bekhathele ngemva kokwelashwa. Lokhu kungase kuthathe amahora ambalwa. Lokhu kujwayelekile. Kodwa uma uzizwa ungakhululekile, tshela udokotela wakho ngakho.
Kuneminye imiphumela emibi eminingana engahlotshaniswa ne-hemodialysis. Akuwona wonke umuntu ozobhekana nalokhu, kodwa kuhle ukukwazi.
| Imiphumela emibi evamile | |
|---|---|
| Umfutho wegazi ophansi (i-Hypotension) | Kungase kube nesiyezi kanye nokuquleka. |
| Ukuqaqamba kwemisipha | Kungavela ikakhulukazi emilenzeni. |
| Isicanucanu nokuhlanza | Abanye abantu banalobu bunzima. |
| Ukuluma (Pruritus) | Lokhu kungancishiswa ngokulawula izinga le-phosphorus egazini. |
| Ubuhlungu bekhanda, isifuba noma umhlane | Lokhu kungenzeka futhi ngezinye izikhathi. |
Ngingambona nini udokotela?
Uma unezinye zezimpawu ezilandelayo, yazisa udokotela wakho ngokushesha.
- Izimpawu zomfutho wegazi ophansi (isiyezi, ukuquleka (i-syncope))
- Isicanucanu nokuhlanza
- Izimpawu zokutheleleka endaweni yokungena (ukuvuvukala, ukubomvu, ubuhlungu, umkhuhlane)
- Ubuhlungu obukhulu besisu
Umlayezo Wokuya Nawe Ekhaya
- I-Hemodialysis iyindlela yokwelapha esindisa impilo ekusiza ukuthi uhlale uphila lapho izinso zakho zingasebenzi kahle. Akuyona ikhambi.
- Kubaluleke kakhulu ukulawula ukudla kwakho ngalolu hlobo lokwelashwa.Landela imiyalelo enikezwe udokotela wakho kanye nochwepheshe wezokudla kahle.
- Ukufinyelela okwenzile kuyindlela yakho yokuphila. Kuvikele kahle ezifweni nasezingozini.
- Kuvamile ukuzizwa ukhathele ngemva kokwelashwa. Kodwa-ke, ungesabi ukukhuluma nodokotela wakho nganoma yikuphi ukungakhululeki okutholayo.
- Awuwedwa kulolu hambo. Umndeni wakho, abangani, kanye nabasebenzi bezokwelapha bakhona ukukusekela. Ungumuntu obaluleke kakhulu eqenjini lakho lezempilo. Ngakho-ke yenza zonke izinqumo zinolwazi.
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