Ingabe izinkophe zakho ziyawa nazo? Ingabe uzizwa ungenampilo? Ingabe lokho kuyi-myasthenia gravis?

Ingabe ngezinye izikhathi uzizwa sengathi uphilile uma uvuka ekuseni, kodwa njengoba usuku luqhubeka, umzimba wakho uqala ukulahlekelwa amandla? Ikakhulukazi uma amehlo akho ezizwa esinda futhi egobile, amazwi akho eba mafinyela lapho ukhuluma, noma ukuthola kunzima ngisho nokuphakamisa ingalo noma umlenze? Uma lokhu ukujwayele, kubalulekile ukuthi uqaphele isimo esikhuluma ngaso namuhla, esibizwa ngokuthi i-Myasthenia Gravis , noma i-MG ngamafuphi.

Kalula nje, iyini iMyasthenia Gravis?

Lesi yisifo sokuzivikela komzimba esingahlala impilo yonke. Kalula nje, uhlelo lokuzivikela lomzimba wethu, uhlelo lokuzivikela komzimba, luqala ngephutha ukuhlasela izingxenye zomzimba wethu ezinempilo. Ku-MG, lokhu kuhlasela kuhlose ukuxhumana phakathi kwezinzwa zethu nemisipha.

Cabanga nje, ubuchopho bethu butshela imisipha ukuthi, "Kulungile, manje uzoncipha." Lo myalezo kufanele uhambe ngemizwa bese ufinyelela imisipha. Kodwa kumuntu one-MG, "ama-receptor" lapho lo myalezo uhanjiswa khona aphazanyiswe amasosha omzimba awo. Kufana nokulahlekelwa isignali uma uzama ukushaya ucingo.

Ngenxa yalokho, izimpawu ezithunyelwa emisipheni ziba buthakathaka njengoba zisetshenziswa, futhi imisipha ilahlekelwa amandla kancane kancane. Kodwa ngemva kwesikhathi esifushane sokuphumula, ibuyela esimweni sayo esijwayelekile. Lesi yisici esivelele kakhulu se-MG. Nakuba lesi simo singase senzeke kunoma yimuphi ubudala, sivame kakhulu kwabesifazane abangaphansi kweminyaka engama-40 kanye nabesilisa abangaphezu kweminyaka engama-60.

Kungani umzimba wethu uzenzela lokhu? Yiziphi izizathu?

Akwaziwa kahle ukuthi kungani amasosha omzimba ehlasela i-neuromuscular junction yethu ngale ndlela. Kodwa isizathu esiyinhloko ukuthi umzimba ukhiqiza ama-antibodies ngokumelene nama-receptor athola i-neurotransmitter acetylcholine. Le acetylcholine "iyisithunywa" esithwala umyalezo otshela imisipha ukuthi inciphe. Ngakho-ke lapho indawo yesenzo salesi sithunywa ivinjiwe, imisipha ayisebenzi kahle.

Abanye abantu bakha nama-antibodies ngokumelene namanye amaprotheni. Nakuba kucatshangwa ukuthi lokhu kungaba nethonya lezakhi zofuzo, abantu abaningi abane-MG abanabo abanye emndenini wabo abanalesi sifo.

Futhi, kutholakale ukuthi i-thymus gland , isitho esisesifubeni esingaphezulu, ihilelekile. Le gland iyanda kwabanye abantu abane-MG. Abacwaningi bakholelwa ukuthi ngezinye izikhathi le gland idlulisela ulwazi olungalungile emzimbeni futhi ibangele ukuthi ikhiqize la ma-antibodies angafuneki.

Yiziphi izimpawu eziyinhloko ezingabonakala?

Izimpawu ze-MG ziyahlukahluka kumuntu nomuntu. Abanye abantu bangase babe nezimpawu ngokuzumayo. Abanye bangase bazibonakalise kancane kancane. Ake sibheke izindawo eziyinhloko ezithintekile nokuthi yiziphi izimpawu.

Wazi kanjani ukuthi lesi yisifo?

Uma unalezi zimpawu, kufanele uqale ubonane nodokotela womndeni wakho. Uma ekusola lokhu, uzokudlulisela kudokotela wezinzwa. Uzokubuza ngezimpawu zakho futhi enze ukuhlolwa ngokomzimba. Ngaphezu kwalokho, kunezivivinyo eziningana ezingenziwa ukuqinisekisa ukuxilongwa:

• Ukuhlolwa kwegazi: Hlola igazi lakho ukuthi alinawo yini lawo ma-antibodies ayingozi (ama-antibodies e-acetylcholine receptor) esikhulume ngawo ngaphambili.
• Ukuhlolwa kwe-Edrophonium: Lokhu kuhlolwa kuhlola ukuthi umuthi uyawandisa yini amandla emisipha yakho okwesikhashana. Uma kukhona ukwanda kwamandla ngokuzumayo, kungaba uphawu lwe-MG.
• Ukuhlolwa kokuvuselela imizwa: Inaliti encane ifakwa emisipheni bese kulinganiswa ijubane lezimpawu zemizwa. Lokhu kungasetshenziswa ukubona ukuthi imisipha iba buthaka ngokushesha kangakanani uma isetshenziswa ngokuphindaphindiwe (i-electromyography).
• Ukuhlolwa kwephakethe leqhwa: Iphakethe leqhwa libekwa esweni eligobile imizuzu embalwa ukuze kubonakale ukuthi ijwabu liyaphakama yini. Lokhu kunganikeza umbono wesimo ngoba umkhuhlane uthuthukisa okwesikhashana ukuxhumana kwezinzwa nemisipha.
• Izithombe: Uma ukuxilongwa sekuqinisekisiwe, kungenziwa i-CT scan noma i-MRI scan ukuze kuhlolwe noma yiziphi izinkinga nge-thymus gland yakho, njengesimila (thymoma).

Yiziphi izindlela zokwelapha ezitholakalayo?

I-MG yisifo esingelapheki ngokuphelele, kodwa singalawulwa ngempumelelo enkulu. Udokotela wakho uzokhetha ukwelashwa okufanele kakhulu ngokusekelwe ebunzimeni bezimpawu zakho, iminyaka yakho, kanye nempilo yakho iyonke.

1. Imithi yokuqinisa imisipha: Umugqa wokuqala wokwelashwa yimithi efana ne-pyridostigmine. Le mithi isebenza ngokwandisa inani le-acetylcholine lapho kuhlangana khona imisipha. Lo muthi unikeza amandla zingakapheli imizuzu eyi-15-30 ngemva kokuwuthatha, futhi uhlala cishe amahora ama-3-4.

2. Ama-immune system suppressors: Abantu abaningi bayayidinga le mithi ngoba lesi sifo sibangelwa amasosha omzimba ethu. Okokuqala, kunikezwa ama-steroid afana ne-prednisone, bese kushintsha eminye imithi efana ne-azathioprine. Lokhu kungathatha izinyanga eziningana ukukhombisa imiphumela.

3. Ukususwa kwe-Thymectomy: Kungakhathaliseki ukuthi kukhona isimila ku-thymus gland noma cha, ukususwa kwaso ngokuhlinzwa kunciphisa kakhulu izimpawu kwezinye iziguli.

4. Ukwelashwa Nge-IV:Lokhu kwelashwa kunikezwa uma izimpawu zinzima kakhulu, noma ezimweni ezifana nenkinga ye-myasthenia.

• I-Plasmapheresis: Umshini okhethekile ususa ama-antibodies ayingozi egazini lakho bese ubuyisela i-plasma enempilo emzimbeni wakho.
• Ukwelashwa nge-IVIG: Ngokunikeza ama-antibodies (i-immunoglobulin) athathwe kubanikeli abanempilo aya emzimbeni, kushintsha okwesikhashana ukusebenza kwesimiso somzimba sokuzivikela.
• Ama-antibodies e-Monoclonal: Lawa angama-antibodies akhethekile enziwa elabhorethri ahlasela izingxenye ezithile zesimiso somzimba sokuzivikela ezingasebenzi kahle.

Kufanele uzinakekele kanjani?

Kanye nokwelashwa, ungathola impumuzo enkulu ezinguqukweni ezincane endleleni yakho yokuphila.

• Thola ukudla okunempilo: Yidla ukudla okuncane okuningana phakathi nosuku kunokudla okukodwa okukhulu. Yidla ukudla kwakho okuyinhloko uma unamandla amaningi. Khuluma nodokotela wakho mayelana nokuphuza imithi yokuqinisa imisipha ngaphambi kokudla.
• Ukuzivocavoca, kodwa yazi imingcele yakho: Nakuba ukuzivocavoca kungakunika amandla esikhathi eside, gwema ukuzikhandla ngokweqile. Buza udokotela wakho noma uchwepheshe wezokwelapha ukuthi yikuphi ukuzivocavoca okufanele wena.
• Phumula uma uzizwa ukhathele: Qhubeka nomsebenzi wakho wansuku zonke. Kodwa ngokushesha nje lapho uqala ukuzizwa ukhathele, thatha ikhefu. Lalela umzimba wakho.
• Yazi ukuthi yini ebangela lesi sifo: Abanye abantu bangase babe nokwanda kwezimpawu ze-MG uma begula, lapho becindezelekile, ngesikhathi sokuya esikhathini kwabesifazane, kanye nangenxa yemithi ethile. Khuluma nodokotela wakho ngalokhu.