Ake sifunde ngokwelashwa kwakamuva okungekona ukuhlinzwa kokuthuthumela kwezandla (i-MR-Guided Focused Ultrasound).

Ingabe ngezinye izikhathi uzizwa ungakhululekile neze ngezandla zakho ziqhaqhazela, ungakwazi ngisho nokubamba inkomishi yetiye kahle? Noma ingabe othile omaziyo ubhekene nalesi simo? Awekho amagama okuchaza ubuhlungu nokungakhululeki ozizwayo lapho ungakwazi ukwenza ngisho nezinto ezilula njengokusayina idokhumenti noma ukufaka ukudla emlonyeni wakho. Esikhathini esiningi, abanye abantu bathola impumuzo emithini enikezwa lokhu, kodwa kwabanye, leyo mithi ayisebenzi. Ngakho okulandelayo izinto ezifana nokuhlinzwa kobuchopho. Kodwa ubani ongesabi uma kukhulunywa ngokuhlinzwa? Kodwa ungesabi, namuhla sizokhuluma ngendlela yakamuva nemangalisa kakhulu yokwelapha lokhu kuthuthumela engenziwa ngaphandle kokuhlinzwa, ngaphandle kokusikwa.

Iyini i-ultrasound eqondiswe yi-MR?

Leli gama lingase lizwakale liyinkimbinkimbi kancane, kodwa empeleni lilula kakhulu. Kalula nje, kuyindlela yokwelapha ehlanganisa ubuchwepheshe obubili.

1. Ukuthwebula nge-MR (Magnetic Resonance): Lesi yi-MRI scan okungenzeka ukuthi uyasazi. Kufana nemephu ecacile ekhombisa imigwaqo nezakhiwo ngaphakathi kobuchopho bethu. Odokotela bangabuka lezi zithombe ze-MRI bese bethola indawo eqondile ngaphakathi kobuchopho okufanele bayelaphe, kuze kufike ku-millimeter . Kuphinde kubasize ukuqinisekisa ukuthi konke kuhamba kahle ngesikhathi sokwelashwa.

2. I-Ultrasound Egxilile: I-Ultrasound iwumsindo ovame kakhulu esingawuzwa. Njengasebuntwaneni, wawugxila ilanga ephepheni bese ulishisa. Lobu buchwepheshe bugxila amaza omsindo angaphezu kwe-1,000 ngesikhathi esisodwa esihlokweni esincane ngaphakathi kobuchopho. Yilapho kuphela lapho le misebe yomsindo igxilile khona eshisa khona, ibhubhise amangqamuzana anenkinga lapho. Ngokumangalisayo, amangqamuzana obuchopho aphilile azungezile awalimali.

Lokho kusho ukuthi, ngaphandle kokuvula ikhanda, amaza omsindo athunyelwa evela ngaphandle futhi elashwa kuphela lapho kunenkinga ngaphakathi kobuchopho.

Lolu hlobo lokwelashwa lulungele bani? Yiziphi izinhlobo zezifo?

I-US Food and Drug Administration (FDA) okwamanje ivumile lokhu kwelashwa kwezimo ezimbili.

• Ukuthuthumela okubalulekile: Lesi yisimo abantu abaningi abanaso esibangela ukuba izandla zabo, ikhanda, noma izwi labo lithuthumele. Ukuthuthumela kuba nzima kakhulu uma bezama ukwenza okuthile. Lokhu kwelashwa kuyatholakala kubantu abangakwazi ukulawula ukuthuthumela kwabo ngemithi .
• Isifo sikaParkinson esivame ukuthuthumela: Nakuba isifo sikaParkinson sinezimpawu eziningi, kwabanye abantu, ukuthuthumela kuyisibonakaliso esiyinhloko. Lokhu kwelashwa kufanelekile nakubantu abanjalo.

Le ndlela ikunciphisa kanjani ukuthuthumela?

Lena indaba ethokozisayo kakhulu. Kukhona ingxenye yobuchopho bethu ebizwa ngokuthi i-thalamus . Lokhu kufana nesikhungo esikhulu sokushintshana ngocingo ezweni lakithi. Izimpawu zokunyakaza kanye nezinzwa ezivela ezingxenyeni ezahlukene zomzimba zithunyelwa kwezinye izingxenye zobuchopho zisuka lapha.

Abantu abanesifo sokuthuthumela okubalulekile kanye nesifo sikaParkinson banesici esincane emijikelezweni ebuchosheni. Yingakho kuthunyelwa izimpawu ezingalungile bese izandla ziqala ukuthuthumela.

Lokhu kwelashwa kuhilela ukuqondisa umsebe we-ultrasound ngqo endaweni lapho izimpawu ezinephutha khona nokudala isilonda esincane lapho. Kufana nokuvala iswishi enephutha. Izimpawu ezinephutha ziyayeka ukugeleza, futhi ukuthuthumela cishe ngokushesha kuncipha noma kume ngokuphelele.

Inqubo yokwelapha isinyathelo ngesinyathelo

Kulungile, manje ake sibone ukuthi kuzokwenzekani uma lokhu kwelashwa sekuqediwe. Akukho okufanele ukhathazeke ngakho, akukho ukusikeka noma imihuzuko.

1. Ukulungiselela: Ekuseni ngosuku lokwelashwa, izinwele zakho zizophucwa ngokuphelele. Lokhu kungenxa yokuthi amagagasi e-ultrasound kudingeka athintane nesikhumba sekhanda lakho. Ngemuva kwalokho, izinga lokushaya kwenhliziyo yakho kanye nomfutho wegazi kuzoqashwa.

2. Uhlaka Lwekhanda: Kuzobekwa uhlaka olukhethekile ekhanda lakho ukuvimbela ikhanda lakho ukuthi linganyakazi ngisho nakancane. Phakathi nalesi sikhathi, uzonikezwa inani elincane lomuthi ngemithambo ukuze uzizwe ungakhululekile.

3. Emshinini we-MRI: Uzobe usuthunyelwa emshinini we-MRI. Ngeke ukwazi ukuhambisa ikhanda lakho ngenxa yohlaka olunamathele ekhanda lakho. Odokotela bazothatha amaskeni obuchopho bakho bese bekhetha indawo efanele yokwelapha.

4. Ukuhlolwa: Ngaphambi kokuqala ukwelashwa, ithimba lezokwelapha lizokucela ukuthi udwebe iziyingi, ubhale igama lakho, noma wenze izinto ezithile ngeminwe yakho. Lokhu kuzolinganisa ubukhulu bokuthuthumela kwakho.

5. Ukuqala ukwelashwa: Manje yilapho umsebenzi wangempela uqala khona. Okokuqala, amaza e-ultrasound anamandla aphansi athunyelwa kuhlosiwe ukuqinisekisa ukuthi isendaweni efanele. Ngemva kokuqinisekisa nge-MRI, amandla ayanda kancane kancane.

6. Impendulo yakho: Uvukile ngenkathi wenza konke lokhu. Ungakhuluma nethimba lezokwelapha. Bazohlala bekubuza ukuthi uzizwa kanjani. Bazokucela nokuthi wenze izinto ezifanayo owazenza ngaphambili, njengokudweba nokubhala. Uzoqaphela ukuthi ukuthuthumela kuncipha khona lapho.

7. Inkinobho yokumisa eziphuthumayo: Kukhona inkinobho yokumisa eziphuthumayo esandleni sakho ongayicindezela phakathi nayo yonke imithi. Uma uzizwa ungakhululekile, imithi izoma ngokushesha nje lapho uyicindezela.

8. Isiphetho:Uma ukuzamazama sekulawulwe kahle, amagagasi e-ultrasound athunyelwa ngamandla afanele ukuze aphawule ngokuphelele inhloso. Yonke inqubo ithatha cishe amahora angu-3-4. Ngemva kwalokho, wonke amagajethi ayasuswa ekhanda lakho bese udluliselwa ewadini lokubuka.

Imiphumela kanye nezinzuzo kanye nokungalungi

Into engcono kakhulu ngalokhu kwelashwa ukuthi ungabona imiphumela ngokushesha. Ucwaningo lukhombisile ukuthi ukuthuthumela kwabantu abaningi kunciphisa ngo-50% - 60% cishe ngokushesha.

Ingabe konke kulungile? Ayikho yini imiphumela emibi?

Njenganoma yikuphi ukwelashwa kwezokwelapha, kunemiphumela emibi kanye nezingozi ezithile, kodwa iningi lazo lingokwesikhashana .

• Isicanucanu kanye nekhanda elibuhlungu (ngesikhathi sokwelashwa)
• Ukuba ndikindiki kwesikhashana ezinzwaneni noma ezindebeni
• Ukungakhululeki kancane lapho uhamba, izinkinga zokulinganisela (okwesikhashana)
• Ubunzima bokukhuluma noma ukugwinya (okwesikhashana)

Kukhona futhi izingozi eziningana zesikhathi eside .

• Ukuthuthumela kungase kuphinde kuvele ezinyangeni noma eminyakeni ngemva kokwelashwa.
• Ngezinye izikhathi ukuzamazama kungase kunganciphi nhlobo .
• Ezimweni ezingavamile kakhulu (cishe abantu abayi-10-15%), ubuthakathaka bemisipha kanye nokuba ndikindiki kungase kuhlale unomphela .

Ubani lokwelashwa okungafaneleki?

Lokhu kwelashwa akufanele wonke umuntu. Akufanele abantu abanezimo ezilandelayo:

• Abantu abanezinsimbi emizimbeni yabo (isib. i-pacemaker, i-spinal rod, i-joint implants) ngoba lokhu kwenziwa ngaphakathi komshini we-MRI.
• Abantu abanezibazi ezinkulu ekhanda labo.
• Abantu abanezimila zobuchopho.
• Abantu abanenkinga yezinso abahlinzwa nge-dialysis .
• Abantu abanezimo zezempilo ezinzima noma izifo ezingenakulawuleka.
• Abantu abangakwazi ukuhlala bemi endaweni efanayo amahora angu-3-4.
• Abantu abangakwazi ukuyeka ukuthatha i-antiplatelet noma i-anticoagulation therapy .

Ngakho-ke, wazi kanjani ukuthi lokhu kwelashwa kulungile kuwe?

Lena yinto ebaluleke kakhulu. Awukwazi ukwenza izinqumo ngalokhu wedwa. Kufanele ukhulume nodokotela wakho wezinzwa ngalokhu.

Ngokuvamile, ungase ube umuntu ofanele lokhu,

• Uma utholakale kahle ukuthi unesifo i-Essential Tremor noma i-Tremor-dominant Parkinson's disease .
• Uma ukuthuthumela kwakho kungalawulwa yimithi oyinikezwe.
• Uma lokhu kuthuthumela kuphazamisa imisebenzi yakho yansuku zonke (njengokudla, ukubhala, ukuphuza amanzi) kuze kube yilapho ungakwazi ukukwenza .

Udokotela wakho uzokuhlola kahle, enze ezinye izivivinyo uma kudingeka, futhi akuchazele ukuthi lokhu kwelashwa, noma okunye ukwelashwa okufana nokukhuthazwa kobuchopho obujulile (i-DBS), kungcono yini kuwe.