Ingabe amandla omzimba wakho okulwa nezifo anciphile? (Ungavikelekile) Ake sixoxe ngalokhu!

Ingabe uvame ukubanjwa umkhuhlane kodwa awupheli ezinsukwini ezimbalwa? Noma uzizwa sengathi ubanjwa izifo kalula kunezinye? Mhlawumbe ikhono lomzimba wakho lokulwa nezifo, okungukuthi, amasosha omzimba wakho, liyancipha. Lesi simo sibizwa ngokuthi `(Immunocompromised)`. Ungakhathazeki, ake sixoxe ngalokhu ngokuningiliziwe.

Kalula nje, siyini lesi simo esibizwa ngokuthi `(Immunocompromised)`?

Ake sithi sinebutho lokuzivikela emzimbeni wethu, njengezwe. Leli butho lisigcina siphilile ngokulwa namagciwane abangela izifo ezivela ngaphandle. Lokhu sikubiza ngokuthi isimiso sokuzivikela . Ngakho-ke, ukuba ``nomzimba ongavikelekile'' kusho ukuthi isimiso sakho sokuzivikela asisebenzi kahle, okungukuthi, sibuthakathaka. Khona-ke asikwazi ukulwa nezifo njengoba kufanele.

Ungase uzalwe unalesi simo. Noma amasosha akho omzimba angase abe buthaka ngenxa yezifo ezithile, imithi, izimo ezifana nomdlavuza, noma ezinye izinkinga zempilo impilo yakho yonke. Ungase uzwe lokhu kubizwa ngokuthi "i-Immunosuppression." Akuyona into owazalwa nayo ngqo, kodwa ukwelashwa kamuva noma ukugula okwehlisa amasosha akho omzimba.

Wazi kanjani ukuthi unalesi simo?

Izimpawu eziyinhloko zalokhu ukugula njalo nokuthatha isikhathi eside kakhulu ukuze ululame uma ugula. Kodwa-ke, akuwona wonke umuntu ogula njalo onesimiso somzimba esibuthakathaka. Uhlobo lwesifo ositholayo nalo lubalulekile. Isibonelo, kuvamile ukuthi izingane ezincane zithole umkhuhlane njalo.

Kodwa-ke, uma uthola izifo ezibangelwa amagciwane njalo, izifo ezifana ne-pneumonia, noma ezinye izifo ezithile, kungaba uphawu lokuthi amasosha omzimba wakho awasebenzi kahle. Esimweni sokukhubazeka kwamasosha omzimba, izinto ezinjengalezi zingenzeka:

• Uguliswa amagciwane avame ukugcina abanye bengaguli.
• Isifo esilula futhi esingelapheki kubantu abaningi singaba yingozi kakhulu kuwe.
• Kuthatha isikhathi eside ukululama ekuguleni.
• Unamathuba amaningi kunabanye okuba nezinkinga ngenxa yokugula (isib., ukuba ne-pneumonia ngemva kwegciwane lokuphefumula).
• Ezinye izifo ezibangelwa amagciwane eseziphelile ngaphambilini, isibonelo igciwane le-Epstein-Barr noma igciwane le-varicella-zoster (igciwane elibangela i-chickenpox), zingaphinde zivele.
• Ngisho noma uthola imijovo, umzimba wakho ungase ungakhiqizi ama-antibodies.

Ungase ungabi nazo izimpawu ezithile ngoba amasosha omzimba akho abuthakathaka. Kodwa-ke, uma unesifo esibangela lesi simo (njengezinhlobo ezithile zomdlavuza), ungase ube nezimpawu ezifana nalezi:

• Ukuzizwa ukhathele kakhulu (Ukukhathala)
• Ukujuluka ebusuku
• Umkhuhlane ophindaphindayo
• Ukwehlisa isisindo okungahlosiwe
• Ama-lymph node avuvukele

Ukutheleleka okukhethekile okwenzeka kubantu abanezivikeli mzimba ezibuthakathaka

Kunezinye izifo umuntu ophilile angazilwa kalula futhi azinqobe. Kodwa uma uthola izifo ezinjalo, udokotela angase asole ukuthi amasosha omzimba wakho abuthakathaka. Izifo ezinjalo zifaka:

• I-Pneumocystis pneumonia (PCP) uhlobo lwe-pneumonia.
• Ukutheleleka kwe-cytomegalovirus (CMV) okunezimpawu
• Ukutheleleka kwesikhunta okusabalala kusuka emaphashini kuya kwezinye izingxenye zomzimba (isib. i-coccidioidomycosis, i-cryptococcosis, i-histoplasmosis)
• Ukutheleleka njalo kwamagciwane
• Izifo ezivame noma ezihlala isikhathi eside njenge-pneumonia, i-herpes simplex, i-campylobacter, noma i-cyclosporiasis.

Yiziphi izimbangela zalokhu kuncipha kwamasosha omzimba?

Izikhathi eziningi, izimbangela eziyinhloko zobuthakathaka besimiso somzimba sokuzivikela komzimba yizimo ezithile zezokwelapha, imiphumela emibi yemithi ethile, nezinto ezifana nokufakelwa isitho noma iseli le-stem. Konke lokhu kungenza buthaka isimiso sakho somzimba sokuzivikela komzimba ngezindlela ezahlukene.

Izifo nezimo ezenza buthaka isimiso somzimba sokuzivikela

Ezinye izifo zibhubhisa amangqamuzana ethu omzimba noma zithinta ikhono lawo lokuzilungisa kahle. Izifo ezinjalo zifaka:

• Ukuntuleka kwamasosha omzimba okuyinhloko: Lesi yinoma yisiphi isimo esenza amasosha omzimba akho abe buthaka, kungakhathaliseki ukuthi uzalwe unaso noma uma amasosha omzimba wakho eba buthaka ngokwemvelo kamuva ekuphileni.
• Ukutheleleka nge-HIV (igciwane le-human immunodeficiency virus): Lokhu kuhlasela ngqo amasosha omzimba.
• Umdlavuza: Umdlavuza ohlobene negazi, ikakhulukazi i-leukemia, i-lymphoma, kanye ne-multiple myeloma, yiwona umdlavuza ovame kakhulu othinta amasosha omzimba. Kodwa-ke, ezinye izinhlobo zomdlavuza nazo zingathinta amasosha omzimba.
• Isifo Sikashukela (i-Diabetes Mellitus)`
• Izifo ezizenzakalelayo: Yilapho amasosha omzimba ehlasela khona amangqamuzana omzimba.
• Isifo se-sickle cell
• Isifo sesibindi
• I-hepatitis ebangelwa yigciwane (ukuvuvukala kwesibindi)

Ngokufanayo, labo abangenayo i-thymus (lapho amaseli ethu e-T, uhlobo lweseli lokuzivikela komzimba, evuthwa khona) noma i-spleen (isitho esiqukethe futhi silawula amaseli amhlophe egazi) nabo banamandla okuzivikela omzimba aphansi.

Imithi yokuvimbela amasosha omzimba kanye nokwelashwa

Ezinye izindlela zokwelapha, njengokwelashwa ngemisebe kanye nokwelashwa ngamakhemikhali omdlavuza, zinganciphisa isimiso somzimba sokuzivikela njengomphumela ongemuhle. Kunezinye izindlela zokwelapha ezicindezela isimiso somzimba sokuzivikela njengengxenye yomsebenzi wazo. Isibonelo, ukufakelwa umnkantsha wethambo kuvame ukubhubhisa wonke amasosha omzimba wakho bese kuwushintsha ngongcono.

Imithi eminingi yezifo ezihlasela amasosha omzimba isebenza ngokwenza buthaka isimiso somzimba sokuzivikela, siyivimbe ekuhlaseleni amaseli anempilo. Siyibiza ngokuthi le mithi yokucindezela amasosha omzimba (enciphisa ukusebenza kwesimiso somzimba sokuzivikela) noma imithi yokulawula amasosha omzimba (eshintsha indlela isimiso somzimba sokuzivikela esisebenza ngayo).

Eminye imithi kanye nokwelashwa okucindezela amasosha omzimba kufaka phakathi:

• Ukufakelwa kwethambo noma ukufakelwa kwezitho eziqinile
• Ukwelashwa ngamakhemikhali
• Ukwelashwa ngemisebe
• Ama-corticosteroids (isib. i-prednisone, i-prednisolone, i-dexamethasone)
• `I-Azathioprine (Imuran®)`
• "I-Cyclosporine (Gengraf®, Neoral®)"
• `I-Hydroxychloroquine (i-Plaquenil®)`
• `I-Leflunomide (i-Arava®)`
• `I-Methotrexate (i-Rheumatrex®, i-Trexall®)`
• "I-Sulfasalazine (Azulfidine®)"

Yimiphi imiphumela engemihle engaba khona ngenxa yalokhu?

Uma amasosha omzimba wakho ebuthakathaka, usengozini enkulu yokuthola izinkinga ezisongela ukuphila ngenxa yokutheleleka. Ngenxa yokuthi umzimba wakho awukwazi ukulwa nokugula, ukutheleleka kungasakazeka emzimbeni wakho wonke. Lokhu kungaholela ekulimaleni kwezitho zomzimba, i-sepsis (isimo esifana nobuthi egazini), kanye nokushaqeka kwe-septic (ukwehla okukhulu komfutho wegazi). Konke lokhu kungaba yingozi. Uma usenkingeni enkulu, iya ekamelweni lezimo eziphuthumayo eliseduze.

Udokotela ukubona kanjani lokhu?

Odokotela baxilonga ukuntuleka kwamasosha omzimba kanye nezifo ezibangela lokhu ngokuhlola igazi lakho kanye nezicubu zomzimba. Kusetshenziswa ezinye izivivinyo ezithile ukwenza lokhu:

• Inani legazi eliphelele (i-CBC)
• Ukuhlolwa kwama-antibody
• I-Flow cytometry (ukubala amangqamuzana omzimba)
• Ukuhlolwa kwezakhi zofuzo ukuze kubhekwe izinguquko zezakhi zofuzo ezithinta amasosha omzimba
• Ukuhlolwa komchamo
• Ukuhlolwa kwe-HIV
• I-biopsy ye-lymph node
• I-biopsy yomnkantsha wethambo
• Ukuhlolwa kwesibindi
• I-CT scan noma ezinye izivivinyo ze-X-ray

Umphatha kanjani umuntu onesimiso somzimba esiphansi sokuzivikela?

Ukwelashwa kwesimiso somzimba sokuzivikela esibuthakathaka kuncike embangela. Odokotela bangelapha ezinye izimo eziyisisekelo futhi basize ekuqiniseni isimiso somzimba wakho sokuzivikela. Ukwelashwa okunjalo kufaka phakathi:

• Ukwelashwa ngemithi yokulwa negciwane: Lokhu kwelashwa kunganciphisa kakhulu inani legciwane lesandulela ngculaza emzimbeni wakho. Uma linciphile ngokwanele, alithinti amasosha omzimba wakho.
• Ukwelashwa komdlavuza:Umdlavuza othinta amasosha omzimba welashwa nge-chemotherapy, i-radiation therapy, kanye ne-immunotherapy.
• Umjovo we-Pegfilgrastim (Fulphila®, Neulasta®): Uma inani lamaseli akho amhlophe egazi liphansi kakhulu (i-neutropenia), lo mjovo usiza umzimba wakho ukuthi wakhe amaseli amhlophe egazi amaningi futhi uqinise amasosha omzimba wakho.
• Ukumpontshelwa kwe-granulocyte: Lokhu ukumpontshelwa igazi okungavamile kwe-neutropenia enzima.
• Ukufakelwa kwe-stem cell: Ukufakelwa kwe-stem cell kungenziwa ukuze kwelashwe noma kulawulwe ezinye izifo ezenza buthaka isimiso somzimba sokuzivikela.

Kunezinye izindlela zokwelapha ezingasiza ekuvimbeleni noma ekulweni nezifo.

Ukwelapha izifo lapho amasosha omzimba ephansi

Uma amasosha omzimba wakho ebuthaka, ungase ungakwazi ukuba ngcono ngemithi etholakala ngaphandle kwemithi kadokotela uma ugula. Udokotela wakho uvame ukuqala ukwelashwa ngama-antibiotic, ama-antifungal, ama-antiviral, noma ama-antiparasitic ngokushesha, kuye ngohlobo lokutheleleka.

Ungangeniswa esibhedlela ukuze usize ekulweni nokutheleleka. Lapho, unganikezwa ukwelashwa okufana nalokhu:

• Ama-antibodies e-monoclonal
• I-plasma yokuguquka
• Imijovo ye-Interferon gamma
• I-Intravenous immune globulin (IVIG)

Yini okufanele uyilindele uma uphila nalesi simo?

Akuwona wonke umuntu onesimiso somzimba esibuthakathaka esifanayo. Kwabanye, kungaba ushintsho oluncane, kodwa kwabanye kungashintsha yonke indlela yabo yokuphila.

Futhi, amasosha omzimba abanye abantu ancipha okwesikhashana nje. Abanye bangadinga imithi noma izifo ezilawula amasosha omzimba impilo yonke. Khuluma nethimba lakho lezempilo ngalokho ongakulindela ngokusekelwe esimweni sakho.

Ngokuvamile, isimo sengqondo somuntu onesimiso sokuzivikela esibuthakathaka sincike embangela eyinhloko. Izifo eziningi ezenza isimiso sokuzivikela sibe buthaka zingalawulwa. Kodwa-ke, ngokuvamile kuyadingeka ukuba uqaphele kakhulu kukho konke ukuphila ukuze uvimbele izifo noma ufune ukwelashwa lapho zenzeka.

Ingabe lokhu kungavinjelwa?

Izifo eziningi ezicindezela amasosha omzimba azinakuvinjelwa. Kodwa-ke, ukugwema ukutheleleka kwabanye abantu kuyindlela engcono kakhulu yokugwema izinkinga ezinkulu. Kungasiza futhi ekuvikeleni kwezinye izifo ezicindezela amasosha omzimba.

Ungenza lezi zinto ukuze unciphise ingozi yokutheleleka:

• Izindlela eziphephile: Geza izandla zakho njalo, yenza ucansi oluphephile, futhi ulandele imikhuba yokuphepha kokudla.
• Ukugoma: Thola yonke imijovo enconyelwe wena. Eminye imijovo ingenza abantu abanezivikeli mzimba ezibuthakathaka bagule. Ngakho buza udokotela wakho ukuthi yimiphi imijovo ekufanele.
• Ukuvimbela i-HIV ngaphambi nangemva kokuvezwa: Uma usengozini enkulu yokuchayeka ku-HIV, ungathatha i-Preexposure prophylaxis (PrEP). Uma uke wachayeka ku-HIV, ungathatha i-Post-exposure prophylaxis (PEP). Kukhona nezinketho zokuvimbela i-Hepatitis B ngemuva kokuvezwa.
• Nciphisa ukuchayeka: Gwema abantu abagulayo noma abaye bachayeka kumuntu ogulayo. Yiya esitolo uyothenga ukudla lapho kunabantu abambalwa. Lokhu kubaluleke kakhulu ngesikhathi somkhuhlane kanye nenkathi yomkhuhlane kanye nalapho ukutheleleka kwe-COVID-19 kuphezulu.
• Qala ukwelashwa kusenesikhathi: Udokotela wakho angase akunike ama-antibiotic noma ama-antifungal ukuze avimbele ukutheleleka.
• Ukuhlolwa kwezifo: Ngaphambi kokuqala ukwelashwa kokucindezela amasosha omzimba, udokotela wakho angase akuhlolele izinto ezifana ne-HIV, i-hepatitis, isifo sofuba, izifo zesikhunta, kanye nezifo ezibangelwa amagciwane.

Uzinakekela kanjani?

Uma amasosha akho omzimba ebuthaka, kudingeka uqaphele kakhulu ngempilo yakho. Ngisho nomkhuhlane ovamile ungakwenza ugule kakhulu. Ngaphezu kokuthatha izinyathelo zokuphepha ezikhethekile zokuzivikela ekuguleni, kunezinye izindlela ezimbalwa ongazinakekela ngazo:

• Qaphela impilo yakho: Buza udokotela wakho ukuthi yiziphi izimpawu zokutheleleka okufanele uziqaphele nokuthi yini okufanele uyenze uma unazo. Isibonelo, umkhuhlane ongaphezu kwezinga lokushisa elithile, izimpawu eziqhubekayo, njll.
• Hlela kusenesikhathi: Gcina imaski nesihlanzi sezandla ziseduze. Uma uhamba, yazi ukuthi ungalutholaphi usizo lwezokwelapha noma ngabe uya kuphi. Abanye abantu baphatha ikhadi elibonisa ukuthi banesimiso somzimba esiphansi sokuzivikela.
• Yazisa abathandekayo bakho: Khuluma nomndeni wakho nabangani mayelana nokuthatha izinyathelo zokuphepha. Kudingeka baqonde ukuthi bangakusiza ukuthi uhlale uphilile. Uma bezizwa begula, kudingeka bakutshele ngaphambi kokuba bakubone.
• Yenza uhlelo nesikole sakho/indawo yakho yokusebenza: Khuluma nomnyango wezisebenzi noma isikole senkampani yakho (uma kuyisikole sengane yakho) nganoma yiziphi izinguquko okudingeka uzenze ukuze uhlale uphilile futhi uphephile. Kungadingeka usebenzisane nodokotela wakho ukuze uqhamuke nohlelo oluchaza ezinye izindlela zokulungisa lapho wena noma ingane yakho ningakwazi ukuya emsebenzini/esikoleni.
• Khuluma ngokukhululekile nodokotela wakho: Abanye abantu bayakugwema ukubonana nodokotela ngoba besaba ukuba phakathi kwabanye abantu. Khuluma nodokotela wakho ngendlela engcono kakhulu yokuthola ukunakekelwa kwezokwelapha ngaphandle kwengozi. Bona ukuthi ungakwazi yini ukuhlela ukuvakasha okubonakalayo (njengezingcingo zevidiyo) noma ama-aphoyintimenti ngezikhathi ezingezona ezesikhathi esimatasa.
• Bona ukuthi izinguquko zendlela yokuphila zingasiza yini: Buza udokotela wakho ukuthi ukuzivocavoca noma ukudla okunempilo kungenza umehluko empilweni yakho yomzimba.
• Beka impilo yengqondo phambili: Ukunakekela impilo yakho engokwenyama njalo kungathinta nempilo yakho yengqondo.Ukukhuluma nomeluleki wezempilo yengqondo, ukuhamba nsuku zonke, kanye nezinye izindlela zokuzinakekela kungasiza ekunciphiseni amazinga akho okucindezeleka. Lokho kusiza futhi amasosha omzimba wakho.

Ngidinga ukubona udokotela/ukuya esibhedlela ngasiphi isikhathi?

Khuluma nodokotela wakho ngokuthi kufanele uphinde ubabone nini uma unesimiso somzimba esibuthakathaka, nokuthi wenzeni uma ucabanga ukuthi unesifo. Bangase bakutshele ukuthi uye ngqo egumbini lezimo eziphuthumayo uma unezimpawu ezithile. Okuningi kuncike esimweni sakho esithile, kodwa kungcono ukuthi uyohlolwa uma ukhathazekile ngokuthile.

Kufanele uye nini e-Emergency Treatment Unit (ETU) ?

Buza udokotela wakho ukuthi yiziphi izimpawu okufanele uziqaphele nokuthi kufanele uye nini egumbini lezimo eziphuthumayo. Njalo yiya ku-ER uma unezimpawu zokutheleleka okukhulu:

• Umkhuhlane (ngokuvamile noma yiliphi izinga lokushisa elingaphezu kuka-100.4 Fahrenheit/38 Celsius)
• Ukudideka noma ukushintsha kwengqondo
• Ikhanda elibuhlungu kakhulu
• Ukuqina kwentamo
• Ukuhlanza njalo noma uhudo
• Uma inxeba libomvu, livuvukile, libuhlungu, likhipha ubomvu, noma lifudumele uma ulithinta

Yimiphi imibuzo okufanele uyibuze udokotela?

Kungaba usizo ukubuza udokotela wakho imibuzo efana nale:

• Ngizohlala isikhathi esingakanani "ngingenawo amasosha omzimba aqinile"? Ingabe lokhu kungokwesikhashana noma kungokwaphakade?
• Yiziphi izinyathelo engingazithatha ukuze ngizivikele ezifweni?
• Yiziphi izimpawu zokutheleleka okufanele ngiziqaphele?
• Kufanele ngiye nini egumbini lezimo eziphuthumayo?
• Kufanele ngiphinde ngikubone nini futhi?

Abantu bangaba "abangavikelekile emzimbeni" ngezizathu ezahlukahlukene. Okuhlangenwe nakho kwakho kungase kuhluke kokwabanye abantu. Mhlawumbe ufunda lokhu ngaphambi kokuqala imithi yokucindezela amasosha omzimba, unethemba lokuthi ngeke ikuvimbele ekwenzeni izinto ozithandayo. Mhlawumbe usesibhedlela, unesinye isifo, uzibuza ukuthi ikusasa liphetheni. Noma mhlawumbe ingane yakho "ingavikelekile emzimbeni", futhi uzama ukukholisa umhlaba ukuthi umndeni wakho awukaze "uvele" uhlaselwe umkhuhlane.

Into eyodwa efanayo kubo bonke abanesimiso somzimba esibuthakathaka ukuthi kufanele benze izinguquko futhi bathathe izinyathelo zokuphepha abanye abangase bangafuni ukuzenza. Kungaba nzima ukuchaza ukuphathwa kwezempilo yakho kwabanye. Thembela eqenjini lakho lezokwelapha. Bangase babe neziphakamiso zamaqembu okusekela kanye nezinye izindlela zokukugcina uphephile futhi uphilile.

Uma othile omaziyo enesifo sokuzivikela komzimba esibuthakathaka, lalela izidingo zakhe. Yenza lokho akucelayo ukuthi ukwenze ukuze uvikele impilo yakhe yengqondo neyomzimba.

Izinto okudingeka uzazi (Umyalezo Wokuya Nawe Ekhaya)

Ukuba nesimiso somzimba esiphansi sokuzivikela akuyona into okufanele uyesabe, kodwa kubaluleke kakhulu ukuqaphela lokho futhi uthathe izinyathelo ezidingekayo.

• Uma ugula njalo noma uma ukugula kwakho kuthatha isikhathi eside ukuphulukiswa, funa iseluleko sezokwelapha.
• Kunezizathu ezahlukahlukene zokuthi kungani amasosha omzimba engase ehle; qonda lokho.
• Landela ukwelashwa kukadokotela kanye nemiyalelo yakhe ngqo.
• Yenza konke ongakwenza ukuze uzivikele ezifweni. Zijwayeze ukugeza izandla zakho futhi ugweme izindawo ezinabantu abaningi.
• Impilo yakho yengqondo nayo ibaluleke kakhulu. Unganqikazi ukuthola usizo uma uludinga.
• Awuwedwa. Kukhona odokotela, umndeni, nabangani abazokusiza.

Khumbula, lolu lwazi lungolwezinjongo zokunikeza ulwazi kuphela. Uma unezinkinga zempilo, sicela uxhumane nodokotela.

Ukukhubazeka kwamasosha omzimba, ukucindezeleka kwamasosha omzimba, ukugula njalo, isimiso somzimba sokuzivikela, izifo, ukwelashwa