Ingabe nawe uzizwa unesizungu lapho usukuma ngokuzumayo? Kungaba (Orthostatic Hypotension)! Ake sixoxe.

Ingabe uzizwa unesizungu noma unesizungu uma usukuma ngokuzumayo, kungakhathaliseki ukuthi uhleli noma ulele phansi? Ngezinye izikhathi uzizwa sengathi uzoquleka isikhashana, akunjalo? Lesi yisimo esizokhuluma ngaso namuhla, esibizwa ngokuthi "i-Orthostatic Hypotension". Abanye abantu basibiza nangokuthi "i-Postural Hypotension." Ungakhathazeki, lokhu kuyinto engenzeka kubantu abaningi, ikakhulukazi njengoba bekhula. Ake sixoxe ngalokhu ngokuningiliziwe nangokulula.

Kuyini `(Orthostatic Hypotension)`? Kalula nje...

Kalula nje, `(Orthostatic Hypotension)` yilapho umfutho wegazi wakho wehla ngokuzumayo lapho usukuma uhleli noma ulele. Cabanga nje, uhleli esihlalweni ufunda iphephandaba bese usukuma ngokuzumayo ngoba othile ukhuluma. Yilapho uzizwa unesizungu. `(Orthostatic)` ibhekisela endaweni eqondile. `(Hypotension)` ibhekisela ekucindezelekeni kwegazi okuphansi. Ngakho-ke, yilapho umfutho wegazi wakho wehla khona lapho ushintsha indawo.

Ngakho-ke, uyini lo mfutho wegazi?

Sivame ukuzwa ngomfutho wegazi, noma "Umfutho Wegazi". Lokhu kulinganisa umfutho wegazi osebenza ezindongeni zemithambo yegazi njengoba inhliziyo yethu ishaya. Kufana nomfutho amanzi awenzayo emapayipini lapho egeleza ngepompo yamanzi. Lokhu kulinganiswa ngamamilimitha e-mercury ``(mmHg)``.

Uma uya kudokotela, bakutshela izinombolo ezimbili uma behlola umfutho wegazi lakho, akunjalo?

• Inombolo ephezulu `(Systolic)`: Lokhu kubhekisela ekucindezelekeni lapho inhliziyo yakho ishaya futhi ipompa igazi emithanjeni yakho.
• Inombolo engezansi `(Diastolic)`: Lokhu kubhekisela ekucindezelekeni kwemithambo yegazi phakathi kokushaya kwenhliziyo okubili, okungukuthi, lapho inhliziyo iphumula kancane.

Odokotela bayibhala njengenombolo ephezulu/engezansi (isb. 120/80 mmHg). Umfutho wegazi onempilo wabantu abaningi ungaphansi kuka-120/80 mmHg. Ukufundwa okungaphansi kuka-90/60 mmHg kubhekwa njengomfutho wegazi ophansi.

Umfutho wegazi wehla kangakanani ku-"Orthostatic Hypotension"?

Akukho inani eliqondile lalokhu. Kodwa-ke, odokotela banquma lokhu ngokubheka umfutho wegazi wakho ojwayelekile nokuthi wehla kangakanani uma usukuma. Ngokuvamile, uma inombolo ephezulu ethi ``Systolic`` yehla ngo-20 mmHg noma inombolo engezansi ethi ``Diastolic`` yehla ngo-10 mmHg zingakapheli imizuzu emithathu yokuma , kubhekwa ``Orthostatic Hypotension``.

Ubani onamathuba amaningi okuthuthukisa i-Orthostatic Hypotension?

Lesi simo singakhula kunoma ubani, kodwa siba sivame kakhulu njengoba ukhula. Izici ezilandelayo zingandisa ingozi yakho yokuba naso:

• Ukuntuleka kwegazi noma i-Vitamin B12: Lesi simo singase senzeke uma kunokwehla komthamo wegazi noma ukwehla kwe-vitamin B12.
• Ukuphelelwa amanzi emzimbeni ngenxa yemithi yokuhlanza, ukuhlanza, noma imithi yokukhipha isisu: Uma inani lamanzi emzimbeni lehla, umfutho wegazi ungehla.
• Izinkinga ze-endocrine:Izimo ezifana nesifo sikashukela, isifo se-thyroid, kanye nesifo sika-Addison.
• Izimo zenhliziyo: Izinto ezifana nokuphazamiseka kwesigqi senhliziyo (i-Arrhythmias), isifo se-valve yenhliziyo.
• Imithi ethile: Kungabangelwa futhi yimithi ethile ethathwa ngenxa yomfutho wegazi ophakeme, isifo senhliziyo, noma ukucindezeleka.
• Izinkinga ze-neurological: Izifo ezifana nesifo sikaParkinson kanye ne-dementia.
• Ukukhulelwa: Ikakhulukazi phakathi namaviki angu-24 okuqala.
• Ukuhlala embhedeni isikhathi eside ngenxa yokugula: Njengokuphumula embhedeni ngesikhathi sokukhulelwa.

Cabanga nje, uMalume Somapala wasesigodini sakithi. Unesifo sikashukela futhi uphuza imithi yokucindezeleka kwegazi okuphezulu. Uthi uzizwa enesizungu lapho evuka embhedeni ekuseni. Abantu abanjalo banamathuba amaningi okuthola lesi simo.

Sivame kangakanani lesi simo?

Ukwehla kwamandla omzimba okubangelwa yi-orthostatic kuthinta cishe ama-20% abantu asebekhulile , ikakhulukazi labo abahlala emakhaya asebekhulile. Kuvamile nakubantu asebelele embhedeni isikhathi eside, nakubamama abasha abathole umntwana. Kungavela nasebasha ababhekene nokukhula okusheshayo.

Ziyini izimpawu zalokhu?

Ukwehla kwengcindezi yegazi okubangelwa yi-orthostatic kuvame ukubonakala kakhulu futhi izimpawu ziba zimbi kakhulu ekuseni. Lokhu kungenxa yokuthi umfutho wegazi wethu uvame ukuba phansi kancane uma sivuka ekuseni.

Abanye abantu bangase bangabi nazimpawu nhlobo. Kwabanye, lezi zimpawu ziya ziba zimbi kakhulu uma kushisa, umkhuhlane, noma ukugeza ngamanzi ashisayo.

Uphawu oluyinhloko isiyezi noma ukuba nekhanda elibuthakathaka lapho usukuma . Lokhu kufanele kuphele uma uhleli noma ulala phansi futhi. Abanye abantu bangase balahlekelwe ngisho nokuqwasha (i-syncope).

Ezinye izimpawu yilezi:

• Umbono ofiphele
• Ubuhlungu besifuba, ubuhlungu behlombe noma ubuhlungu bentamo
• Ubunzima bokugxila
• Ukukhathala noma ubuthakathaka
• Ubuhlungu bekhanda (Uxolo, igama elivela kolunye ulimi lifakwe ngephutha lapha. Igama elifanele: Ubuhlungu bekhanda )
• Ukushaya kwenhliziyo
• Ukucanuzela noma ukuzizwa ushisa futhi ujulukile
• Ukuphelelwa umoya / Ukuphelelwa umoya

Kungani lokhu `(Orthostatic Hypotension)` kwenzeka? Ziyini izimbangela?

Uma sihlala noma silele phansi, igazi elisemithanjeni yemilenze yethu ligeleza kalula libuyele enhliziyweni yethu. Kodwa uma sisukuma, amandla adonsela phansi enza kube nzima ukuthi igazi elisemilenzeni nasezinyaweni zethu lifinyelele enhliziyweni yethu. Lokhu kunciphisa inani legazi elingapontshwa liye enhliziyweni yethu, kwezinye izitho zomzimba kanye nasemisipheni. Ngenxa yalokho, umfutho wegazi wethu wehla okwesikhashana.

Kungase kube nezizathu eziningana zalokhu:

• Inhliziyo yakho ayikwazi ukupompa igazi elanele.
• Uhlelo lwakho lwezinzwa oluzimele (oluvame ukulawula umfutho wegazi) alusebenzi kahle.
• Uma unezifo ezifana nesifo sikaParkinson, i-Lewy body dementia, noma i-multiple system atrophy .
• Uma ubulokhu usesimweni esifanayo (isib. ulele phansi) isikhathi eside (njengokuphumula embhedeni ngesikhathi sokukhulelwa).
• Uma umthamo wegazi lakho wehla ngenxa yokulahlekelwa yigazi noma uketshezi (ukuphelelwa amanzi emzimbeni).
• Uma unenkinga ngendlala yakho ye-adrenal .
• Ngenxa yendlela umzimba wakho osabela ngayo emithini ethile oyiphuzayo .

Ungayixilonga kanjani ngokunembile i-orthostatic hypotension?

Uma uya kudokotela, bazoqala balinganise umfutho wegazi lakho ngenkathi uhleli, bese belala phansi, bese besukuma. Hhayi lokho kuphela, bazophinde bakubuze ngezimo zakho zezempilo kanye nemithi oyiphuzayo.

Ngaphezu kwalokho, ukuhlolwa okulandelayo kungenziwa okukodwa noma ngaphezulu:

• Ukuhlolwa kwegazi: Hlola izimo ezifana nesifo sikashukela kanye ne-anemia.
• I-Echocardiogram (I-Echocardiogram / i-echo): Bona ukuthi inhliziyo ipompa kanjani igazi.
• I-Electrocardiogram (EKG): Bheka izinguquko esigqini senhliziyo.
• Ukuhlolwa kokucindezeleka kokuzivocavoca: Kala izinga lokushaya kwenhliziyo yakho ngenkathi uzivocavoca.
• Amadivayisi e-EKG aphathekayo / i-Holter monitor: Kala isigqi senhliziyo usuku lonke.
• Ukuhlolwa kwetafula lokutsheka: Ukuhlolwa okulinganisa ngokuphephile umfutho wegazi, izinga lokushaya kwenhliziyo, kanye nesigqi senhliziyo ngokukulalisa etafuleni bese utshekisa itafula liye endaweni eqondile.

Yiziphi izindlela zokwelapha i-Orthostatic Hypotension?

Ukwelashwa kuncike embangela yalesi simo.

Lokhu okulandelayo kungenziwa njengokwelashwa:

• Uma kukhona isifo noma isimo esibangela ukwehla kwengcindezi yegazi okubangelwa yi-orthostatic hypotension, selaphe.
• Ukushintsha umthamo womuthi obangela lesi simo noma ukushintshela komunye umuthi (lokhu kufanele kwenziwe ngemva kokukhuluma nodokotela wakho).
• Uma ulele embhedeni, jwayela ukuhlala embhedeni.
• Ukugqoka amasokisi anwebekayo. Lokhu kunciphisa ukuhlangana kwegazi emilenzeni.
• Uma uphelelwe amanzi emzimbeni, phuza amanzi amaningi kanye noketshezi olunosawoti.

Yimiphi imithi enikezwayo ngalokhu?

Lokhu kungalawulwa kaningi ngokushintsha indlela yokuphila. Kodwa-ke, abanye abantu kungadingeka bathathe imithi yokwandisa umthamo wegazi kanye nomfutho wegazi. Kodwa-ke, lokhu akuvamile kakhulu.

Eminye imithi enjalo yile:

• `I-Droxidopa`
• Ama-Erythropoiesis-stimulating agents (ama-ESA) (isib. i-Procrit® noma i-Epogen®)
• `I-Desmopressin (i-Nocdurna® noma i-`DDAVP®)`
• `I-Octreotide (i-Bynfezia Pen™` noma `i-Mycapssa®)`
• `I-Fludrocortisone`
• `I-Midodrine hydrochloride`
• `I-Pyridostigmine (i-Mestinon®` noma `i-Regonol®)`

Okubalulekile: Le mithi kufanele ithathwe kuphela ngaphansi kweseluleko sikadokotela. Ukuthatha imithi ngokwakho kungaba nemiphumela eyingozi.

Ingabe ikhona imiphumela emibi yokwelashwa?

Eminye imithi esetshenziselwa i-Orthostatic Hypotension ingabangela imiphumela emibi efana nalokhu:

• Ukuba ndikindiki
• Ukuluma
• Ubuhlungu bekhanda
• Ukuvuvukala
• Amazinga aphansi e-potassium
• Ukwehluleka kwenhliziyo (lokhu akuvamile kakhulu)

Yingakho kubalulekile ukuthola ukwelashwa ngaphansi kokuqondisa kukadokotela.

Yiziphi izinkinga ezingaba khona ngenxa ye-Orthostatic Hypotension?

Abantu abanalesi simo bangase babe sengozini enkulu yalokhu okulandelayo:

• Ukuphuka kwamathambo noma ukulimala ekhanda (ukubhajwa kwemisipha) kungabangelwa ukuwa ngenkathi uzizwa udidekile noma ungazi lutho .
• Ukwehla komfutho wegazi ngemva kokudla: Lokhu ukwehla komfutho wegazi kungakapheli imizuzu engama-30 kuya emahoreni amabili ngemva kokudla ukudla (ikakhulukazi ukudla okunama-carbohydrate amaningi).
• Uma umfutho wegazi uqhubeka uphansi kakhulu, kungase kwenzeke ukushaqeka noma ukwehluleka kwezitho zomzimba (lokhu akuvamile kakhulu).
• Ingozi yokushaywa yisifo sohlangothi noma isifo senhliziyo ngenxa yokushintshashintsha komfutho wegazi .
• Ukwehla kwengcindezi yegazi ngesikhathi sokulala: Lokhu kusho ukuthi umfutho wegazi uyehla uma ulele phansi (lokhu kungabangelwa eminye imithi).

Kwenzekani uma ngine-`(Orthostatic Hypotension)`?

Abantu abaningi bangakwazi ukulawula izimpawu zalesi simo (i-Orthostatic Hypotension) ngokulandela izinyathelo ezithile zokuvimbela. Isibonelo, kufanele uthathe isikhathi sakho lapho uvuka. Lokhu akunakwenzeka ukuthi kubangele izinkinga ezinkulu zesikhathi eside.

Ingabe akunakwenzeka ukululama ngokuphelele kulesi simo?

Akukho "khambi" lokunciphisa umfutho wegazi ophakeme. Kodwa-ke, izimpawu zingalawulwa kakhulu ngokulandela iseluleko udokotela wakho akunikeza sona. Lesi seluleko singafaka:

• Ukuthatha imithi ebhalwe ngudokotela ngendlela efanele.
• Yidla ukudla okuncane esikhundleni sokudla ukudla okukhulu ngesikhathi esisodwa.
• Phuza amanzi amaningi kanye noketshezi.
• Ukugqoka izinhlobo ezikhethekile zamasokisi (amasokisi okucindezela).

Ngingayinciphisa kanjani ingozi ye-Orthostatic Hypotension?

Uma uzwa isiyezi esinjengalesi, ukulandela lezi zinyathelo kungasiza ekunciphiseni izimpawu zakho:

• Lawula izinga lokushisa lomzimba wakho: Ungagezi ngamanzi ashisayo kakhulu.
• Hlala unamanzi: Phuza amanzi amaningi. Nciphisa utshwala. Ungadli ukudla okunzima okunama-carbohydrate amaningi ngesikhathi esisodwa.
• Gcina ikhanda lakho liphakeme kancane uma ulele embhedeni: sebenzisa umcamelo owodwa noma emibili eyengeziwe, noma uphakamise ikhanda lomatilasi kancane.
• Lungiselela ngaphambi kokuvuka: Zinike isikhashana sokuma uhleli noma ulele. Yiba nento eqinile ozoyibamba uma uvuka.
• Zivocavoce imisipha yakho: Uma kufanele ume isikhathi eside, esikhundleni sokuma unganyakazi, hamba kancane ngokuphakamisa imilenze yakho ngokushintshana. Ngaphambi kokuvuka, yenza izivivinyo ze-isometric (isb., ukucindezela ibhola elincane lerabha). Lokhu kungakhuphula kancane umfutho wegazi lakho.
• Thuthukisa ukujikeleza kwegazi kanye nomfutho wegazi: Gqoka amasokisi akhethekile okucindezela noma i-belly binder.

Kufanele ngimbone nini udokotela?

Uma uvame ukuzizwa unesizungu lapho usukuma, kufanele nakanjani ubone udokotela . Ngisho noma lokhu kwenzeka ngezinye izikhathi, kuwumqondo omuhle ukutshela udokotela wakho ngakho.

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

Uma unalezi zimpawu, funa ukwelashwa ngokushesha :

• Ubuhlungu besifuba.
• Ukuwa noma ukuquleka.
• Izinkinga ngokulinganisela noma ukuhlanganisa izinto.
• Uma kukhona ukusolakala kokuphuka noma ukulimala kwekhanda ngenxa yokuwa.
• Uma indle yakho inegazi noma imnyama.
• Izimpawu zokushaqeka (umzimba obandayo, ukujuluka, ukuphefumula okusheshayo, isikhumba esiluhlaza okwesibhakabhaka, ukushaya kwenhliziyo okubuthakathaka).

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Uma uya kudokotela, ungabuza imibuzo efana nale:

• Kungani nginalesi simo esibizwa ngokuthi "i-Orthostatic Hypotension"?
• Yikuphi ukwelashwa okungcono kakhulu kwalokhu?
• Ingabe lezi zimpawu zibangelwa imithi engiyithathayo? Ingabe kufanele ngishintshe imithi yami?
• Yiziphi izinguquko okufanele ngizenze ukuze ngiphathe lezi zimpawu?
• Yiziphi izimpawu zezinkinga okufanele ngiziqaphele?

Ingabe `(Orthostatic Hypotension)` kanye `(Postural Tachycardia Syndrome - POTS)` ziyinto efanayo?

Izimpawu zesimo esibizwa ngokuthi `(Postural Tachycardia Syndrome)` noma `(POTS)` zifana ne `(Orthostatic Hypotension).` Kuzo zombili izimo, isiyezi kanye nokuquleka kungenzeka lapho usukuma. Kodwa-ke, ku `(POTS)`, ngaphezu kokwehla komfutho wegazi, izinga lokushaya kwenhliziyo likhuphuka cishe ngokushaya okungu-30-40 ngomzuzu phakathi nemizuzu eyi-10 yokusukuma. Ku `(Orthostatic Hypotension)`, izinga lokushaya kwenhliziyo ngokuvamile alikhuphuki kangako.

Isimo esithi ``POTS'' sibonakala kancane kancane kunesithi ``Orthostatic Hypotension''.

Ukwehla kwe-Orthostatic hypotension (Hypotension) kungaba yisimo esibi kakhulu. Kungaba yingozi uma ulahlekelwa yibhalansi yakho bese uwe noma uma ulahlekelwa ingqondo. Kodwa-ke, izimpawu zivame ukuthuthuka uma ushintsha indlela oma ngayo. Khuluma nodokotela wakho ngezimpawu zakho. Kungadingeka ushintshe imithi yakho. Ezimweni ezimbi kakhulu, udokotela wakho angakunikeza imithi yokuthuthukisa ukugeleza kwegazi kanye nomfutho wegazi.

Izinto ezibaluleke kakhulu okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, manje usuqonda kangcono lokho ebesikhuluma ngakho, i-Orthostatic Hypotension. Akuyona into okufanele ukhathazeke ngayo, yisimo esenzeka kubantu abaningi. Into ebaluleke kakhulu yile:

• Uma uzizwa unesizungu ngokuzumayo noma amehlo akho efiphele, ungakushayi indiva lokho. Funa iseluleko sezokwelapha.
• Vuka ekuseni kakhulu, ikakhulukazi uma uvuka embhedeni ekuseni, noma uma uvuka ngemva kokuhlala isikhathi eside, thatha isikhashana uthathe okuthile ukuze ume.
• Phuza amanzi amaningi. Lokhu kungenzeka futhi uma uphelelwe amanzi emzimbeni.
• Khuluma nodokotela wakho ngemithi oyiphuzayo. Eminye imithi nayo ingabangela lesi simo.
• Gwema izindawo ezishisayo nokugeza ngamanzi ashisayo.
• Qaphela ngoba ungawa. Uma uzizwa unesiyezi, zama ukuhlala phansi noma ukulala phansi ngokushesha.

Sithemba ukuthi lolu lwazi luzokusiza. Kungcono ukufuna iseluleko kudokotela nganoma yiziphi izinkinga zempilo ongase ube nazo.

Ukwehla komfutho wegazi okubangelwa yi - Orthostatic, ukwehla komfutho wegazi okubangelwa yisimo sendawo, umfutho wegazi ophansi, isiyezi, ukuquleka, ukwehla komfutho wegazi, umfutho wegazi, impilo yenhliziyo, impilo yabantu asebekhulile, ukuphelelwa amanzi emzimbeni, imiphumela emibi yemithi, ulwazi lwezempilo lwesiSinhala