Ingabe ukhiqiza amangqamuzana egazi amaningi kakhulu emzimbeni wakho? Ake sifunde ngala ma-Myeloproliferative Neoplasms (MPN)!

Wake wazibuza ukuthi kuzokwenzekani uma umongo wakho wethambo ukhiqiza amangqamuzana egazi amaningi emzimbeni wakho? Yilokho okushiwo ama-myeloproliferative neoplasms, noma i-MPN ngamafuphi. Lona umdlavuza wegazi ongavamile, kodwa osongela ukuphila ongabulala uma ungaphathwa kahle. Ake sixoxe ngakho ngendlela elula ongayiqonda.

Iyini le myeloproliferative neoplasm (MPN)?

Kalula nje, ama-myeloproliferative neoplasms (ama-MPN) yizimo lapho umongo wakho wethambo (isicubu esithambile esitholakala ngaphakathi kwamathambo akho) wenza amangqamuzana egazi abomvu engeziwe , amangqamuzana egazi amhlophe, noma ama-platelet (amangqamuzana asiza ukujiya kwegazi lakho). Cabanga ngakho njengemboni ekhiqiza imikhiqizo eminingi kakhulu. Lokhu kwenzeka lapho kukhona okungahambi kahle enkambisweni yokwenza amangqamuzana egazi.

Lezi zimo ze-MPN zivame ukukhula kancane kakhulu . Ngakho-ke abanye abantu bangase bangabi nazo izimpawu iminyaka eminingi. Yingakho zibizwa nangokuthi "ama-neoplasms angama-myeloproliferative angamahlalakhona" noma ama-neoplasms esikhathi eside. Kodwa-ke, ezimweni ezingavamile, lezi zimo ze-MPN zingakhula zibe yinto engathi sína kakhulu.

Kodwa ungakhathazeki, kunezindlela zokwelapha ezinhle zokulawula izimpawu zalesi simo nokuvimbela ukuthi singabi yingozi kakhulu.

Yiziphi izinhlobo ze-MPN ezikhona?

Kunezinhlobo eziningana ze-MPN. Uhlobo ngalunye luthinta uhlobo lwamaseli egazi akhiqizwa umnkantsha wakho ngokweqile. Ngezinye izikhathi kungakhiqizwa amaseli abomvu egazi kuphela, kanti ngezinye izikhathi kungakhiqizwa amaseli amhlophe egazi noma ama-platelet kuphela. Kwezinye izinhlobo ze-MPN, inhlanganisela yalezi zinhlobo zamaseli ingakhiqizwa ngokweqile. Esinye isizathu ukuthi la maseli amaningi ngokweqile angase aziphathe ngendlela ehlukile kumaseli egazi anempilo.

Ubani othinteka kakhulu yilesi simo?

Izici ezimbili eziyinhloko ezithinta ukuvela kwe-MPN iminyaka yakho kanye nobulili .

• Ubudala: Nakuba i-MPN ingenzeka kubantu babo bonke ubudala, ivame ukubonakala kubantu abaneminyaka engu-50, 60, noma ngaphezulu .
• Ubulili: Isibonelo, i-polycythemia vera, uhlobo lwe-MPN, ivame kakhulu kwabesilisa. I-Essential thrombocythemia ivame kakhulu kwabesifazane. Ezinye izinhlobo ze-MPN zingathinta ubulili bobabili ngokulinganayo.

I-MPN ithinta kanjani umzimba wakho?

Lezi zifo ezihlobene negazi zenzeka lapho umongo wakho wethambo ukhiqiza uhlobo oluthile lweseli legazi oludingakalayo emzimbeni wakho. Ngakho-ke, umphumela walokhu emzimbeni wakho uncike ekutheni hlobo luni lweseli legazi elikhiqizwa ngokweqile . Isibonelo, uhlobo olulodwa lwe-MPN lungandisa ingozi yakho yokuba nesifo senhliziyo noma isifo sohlangothi. Olunye uhlobo lungabangela i-anemia.

Ukuze uqonde kangcono lezi zimo ezingavamile, kuyasiza ukuqonda okuncane ukuthi umnkantsha wakho wamathambo namaseli egazi akhiwa kanjani. Wonke amaseli ethu egazi aqala njengamaseli okuqala emnkantsha wakho wamathambo. Lo mnkantsha uyizicubu ezithambile, ezithambile ngaphakathi kwamathambo akho. Amaseli okuqala avela kuwo angaba amaseli okuqala e-myeloid noma amaseli okuqala e-lymphoid.

• Amaseli okuqala e-lymphoid ayizinhlobo zamaseli amhlophe egazi alwa nokutheleleka.
• Amaseli e-Myeloid stem angadala amaseli egazi abomvu (athwala umoya-mpilo kuwo wonke umzimba), ezinye izinhlobo zamaseli amhlophe egazi, kanye nama-platelet (okusiza ekumiseni ukopha uma kwenzeka).

Njengawo wonke amanye amangqamuzana, lawa maseli okuqala asebenza ngokwemiyalelo anikezwe yona yizakhi zofuzo. Ngokuvamile, lawa maseli okuqala ayahlukana futhi aphindaphindeke njengoba kudingeka emnkantsheni wakho wamathambo ukuze enze amangqamuzana amasha. Kodwa-ke, uma kukhona ukuguquka kwalawa maseli, okungukuthi, uma izakhi zofuzo zishintsha, lawo maseli athumela imiyalelo engalungile kumaseli okuqala ukuze aqhubeke nokuhlukana nokuphindaphinda. Ekugcineni, lawa maseli egazi angaphezulu aqoqana emnkantsheni wamathambo noma emithanjeni yegazi, okuvimbela ukugeleza kwegazi. Lapho lokhu kugeleza kwegazi kuvinjiwe, kungavela izinkinga ezinkulu zempilo.

Yiziphi izinhlobo ezivame kakhulu ze-MPN?

Kunezinhlobo ezintathu ezivame kakhulu ze-MPN: i-polycythemia vera, i-essential thrombocythemia, kanye ne-primary myelofibrosis.

I-Polycythemia Vera

Lolu uhlobo oluvame kakhulu lwe-MPN . Kwenzeka lapho umongo wakho wamathambo wenza amangqamuzana egazi abomvu amaningi kakhulu . Lokhu kubangela ukuthi igazi lakho lijiye futhi lehle. Abantu abane-polycythemia vera basengozini enkulu yokuqhekeka kwegazi. Lawa maqhekeka angabangela ukuhlaselwa yinhliziyo kanye nohlangothi. Akuvamile kakhulu, lesi simo singaba umdlavuza wegazi ongathi sína obizwa ngokuthi i-acute leukemia.

I-Myelofibrosis

Lolu hlobo lwe-MPN olunolaka kakhulu . Ku-myelofibrosis, umongo wakho wethambo ukhiqiza amaseli okuqala angajwayelekile. Lawa maseli ayavuvukala bese enza izicubu zesibazi ngaphakathi komongo wethambo. Ngokuhamba kwesikhathi, umongo wethambo ugcwala ngalezi zicubu zesibazi. Umongo wethambo awusakwazi ukwenza amangqamuzana abomvu egazi anele ukuthwala umoya-mpilo emzimbeni wonke. Lokhu kungabangela ukuthi ube ne-anemia. Uphinde ube nokukhiqizwa okuphansi kwama-platelet. Abanye abantu abane-myelofibrosis nabo bangaba ne-acute myeloid leukemia (AML).

I-Thrombocythemia Ebalulekile

I-Essential thrombocythemia yisimo lapho umongo wakho wamathambo ukhiqiza ama-platelet amaningi kakhulu.Ukwenza. Ngokuvamile, lapho umthambo wegazi uqhuma, ama-platelet ayahlangana ukuze akhe i-clot futhi amise ukuphuma kwegazi. Kodwa kulesi simo, ama-platelet enziwa emnkantsheni wamathambo ngaphandle kwesizathu. Lawa ma-platelet engeziwe angabangela ama-blood clot futhi andise ingozi yokuhlaselwa yinhliziyo kanye nohlangothi. Njengamanye ama-MPN, izimpawu zikhula kancane. Iningi labantu litholakala linalesi simo lapho ukuhlolwa kwegazi okuvamile kubonisa amazinga aphezulu ama-platelet. Kwabanye abantu, lesi simo singaqhubekela phambili sibe yi-leukemia.

Ingabe zikhona ezinye izinhlobo ze-MPN?

Yebo, kunezinhlobo eziningana ze-MPN. Ezinye zazo yilezi:

• I-Chronic eosinophilic leukemia (CEL): Lesi yisimo lapho kukhona ukukhiqizwa ngokweqile kohlobo lweseli elimhlophe legazi elibizwa ngokuthi i-eosinophil. Ngokuvamile lukhula espleen. Akuvamile, lungaqhubekela phambili lube yi-acute myeloid leukemia (AML). Lokhu kubizwa nangokuthi i-hypereosinophilic syndrome.
• I-Chronic myelogenous leukemia (CML): Lolu uhlobo lwamaseli amhlophe egazi abizwa ngokuthi ama-granulocyte akhiqiza ngokweqile. Lawa maseli ayaqoqana futhi enze kube nzima ngomnkantsha wamathambo ukwenza amanye amaseli egazi adingekayo.
• I-Chronic neutrophilic leukemia (CNL): Kulokhu, uhlobo lweseli elimhlophe legazi elibizwa ngokuthi ama-neutrophils lukhiqizwa ngokweqile.
• I-Myeloproliferative neoplasm, engahlukaniswa (i-MPN-U): Lolu uhlobo lwe-MPN olungangeni kunoma yiziphi ezinye izigaba. Lungabangela ukukhiqizwa ngokweqile kwezinhlobo ezahlukene zamaseli egazi, njengamaseli amhlophe egazi, amaseli abomvu egazi, noma ama-platelet.

Ziyini izimpawu ze-MPN?

Ezigabeni zokuqala, ungase ungabi nazimpawu . Njengoba isimo siqhubeka, ungase uqaphele izimpawu zokuvuvukala kolwelwesi (i-splenomegaly). Ulwelwesi lutholakala ohlangothini lwakho lwesobunxele ngaphansi kwezimbambo zakho. Lungase luzizwe lugcwele, luqinile, futhi lungakhululekile. Nakuba lokhu kuvuvukala kolwelwesi kuvamile ezinhlotsheni eziningi ze-MPN, akuvamile kangako kwi-essential thrombocythemia.

Ezinye izimpawu ziyahlukahluka kuye ngohlobo lwe-MPN .

I-leukemia ye-eosinophilic engapheli (CEL)

• Uphawu oluvame kakhulu ukuqubuka kwesikhumba .
• Ungase uzizwe ukhathele futhi unomkhuhlane.
• Ezinye izimpawu zincike ezingxenyeni zomzimba wakho ezithintekile amazinga akho aphezulu e-eosinophil.

I-leukemia ye-myelogenous engapheli (i-CML) kanye ne-leukemia ye-neutrophilic engapheli (i-CNL)

• Ubuhlungu bethambo
• Ukujuluka ebusuku
• Umkhuhlane nokukhathala
• Ukuphuka kalula
• Ukulahlekelwa yisifiso sokudla kanye nokwehla kwesisindo

I-thrombocythemia ebalulekile

• Ukuphuka kalula
• Ukopha ekhaleni, emlonyeni, noma ezinsinini ngaphandle kwesizathu
• Ukopha okuvela esiswini noma emathunjini
• Igazi emchameni

I-Polycythemia vera

• Ikhanda elibuhlungu
• Isiyezi
• Ukukhathala
• Umbono ofiphele noma umbono ophindwe kabili

I-myelofibrosis eyinhloko

• Izimpawu ze-anemia (ukukhathala, ubuthakathaka, ukuphelelwa umoya) zingase zivele.
• Ezinye izici:
• Isikhumba esikhanyayo
• Ukujuluka ebusuku
• Imfiva
• Isikhumba esilumayo
• Ukudla ngokweqile noma ukuzizwa usuthi ngokushesha ngemva kokudla (ukusutha kwasekuqaleni)
• Ukwehlisa isisindo
• Ubuhlungu bethambo

Yini ebangela i-MPN?

Zonke izimo ze-MPN ziyizifo zofuzo ezitholakalayo . Lokhu kusho ukuthi azizuzwa njengefa kubazali bakho. Zenzeka lapho kwenzeka izinguquko noma izinguquko ezakhiweni zofuzo ezilawula ukukhula kwamaseli, okubangela ukuba amaseli egazi akhule ngendlela engafanele.

Abacwaningi bezokwelapha bathole okulandelayo mayelana nokuguqulwa kwezakhi zofuzo okubangela i-MPN:

• Ukuguquka kwe-Janus kinase (JAK): Izimo ezifana ne-polycythemia vera, i-primary myelofibrosis, kanye ne-essential thrombocythemia zivame ukubangelwa ukuguquka kwezakhi zofuzo ezibizwa ngokuthi i-Janus kinase 2 (JAK2) . Lokhu kuguquka kungabangela amaseli ukuba ahlukane ngokungalawuleki.
• Ukuguquka kwezakhi zofuzo ze-MPL noma i-CALR gene: Abantu abane-thrombocythemia ebalulekile kanye ne-primary myelofibrosis bavame ukuba nokuguquka kwezakhi zofuzo zabo ze-MPL noma i-CALR gene.
• Amaphutha e-Chromosome: Abantu abane-chronic myelogenous leukemia (CML) banephutha elithile kuma-chromosome abo (isakhiwo esiqukethe izakhi zofuzo). Ku-CML, ingxenye ye-chromosome eyodwa ishintshana nenye i-chromosome, yakha "i-Philadelphia chromosome."

Nakuba lokhu okutholakele kungachazi kahle ukuthi yini ebangela izinguquko zofuzo, kusiza odokotela ukuthi baxilonge izifo futhi bathuthukise izindlela zokwelapha eziqondisa lezi zinguquko zofuzo.

Yiziphi izici eziyingozi ze-MPN?

Umlando womndeni walesi sifo (nakuba lezi ziyizifo ezitholwayo, eminye imindeni ingase ibonise ukuthambekela), ubudala, kanye nobulili kungandisa ingozi yokuthola i-MPN.

Abacwaningi bathole nokuxhumana phakathi kwe-MPN nokuchayeka ezintweni ezithile zobuthi kanye nemisebe . Ezinye izifundo zibonisa ukuthi abantu abachayeka emazingeni aphezulu emisebe kanye nobuthi obuthile, njenge-benzene, basengozini enkulu yokuthola ama-MPN, njenge-polycythemia vera, i-primary myelofibrosis, kanye ne-chronic myelogenous leukemia.

Itholakala kanjani i-MPN?

Udokotela wakho uzobuza ngezimpawu zakho kanye nomlando wempilo yakho. Ngemuva kwalokho, bazokwenza ukuhlolwa ngokomzimba ukuhlola izimpawu ze-MPN. Bazohlola igazi lakho kanye nomnkantsha ukuze bathole lesi sifo.

• Inani eliphelele legazi (i-CBC):Lokhu kulinganisa amazinga azo zonke izinhlobo zamaseli akho egazi. Ku-essential thrombocythemia, amazinga e-platelet ayahlolwa. Ku-polycythemia vera, i-hemoglobin (iphrotheni etholakala kumaseli abomvu egazi), kanye namazinga amaseli amhlophe egazi kanye nama-platelet, ayahlolwa.
• I-Peripheral blood smear (PBS): Lokhu kuhlolwa kungabheka izimo ezingavamile emangqamuzaneni egazi, okunganikeza izinkomba ngesimo sempilo.
• Ukuhlolwa kwamakhemikhali egazini: Lokhu kungalinganisa amazinga amakhemikhali ahlukahlukene (njengamaprotheni, ama-enzyme, kanye ne-glucose) egazini lakho. Lezi zinombolo zingakunikeza izinkomba mayelana nokuthi izitho zakho zisebenza kanjani, okungavusa ukusola nge-MPN.
• Ukuhlolwa komnkantsha wethambo: Udokotela wakho angase enze ukuhlolwa komnkantsha wethambo noma ukuhlolwa komnkantsha wethambo. Lokhu kuhilela ukuthatha isampula yomnkantsha wakho wethambo bese ewuhlola ukuze athole amaseli egazi. Odokotela bezifo zezokwelapha bahlola amaseli egazi nezicubu ngaphansi kwesibonakhulu ukuze babheke umehluko phakathi kwamaseli ajwayelekile nalawo angajwayelekile. Bazobheka nanoma yimaphi amaseli okuqala angajwayelekile. Bazobheka nezinguquko ze-chromosome kanye nokunye ukukhubazeka kwezakhi zofuzo okungase kubonise uhlobo lwe-MPN.
• Ukuhlolwa kwezakhi zofuzo: Odokotela bangahlaziya amangqamuzana akho egazi ukuze babone ukuthi kukhona yini izinguquko ezakhiweni zofuzo ezithinta ukukhiqizwa kwamangqamuzana egazi.

Ingabe i-MPN ingelapheka ngokuphelele? Yiziphi izindlela zokwelapha?

Ukwelashwa okuwukuphela kwendlela yokwelapha etholakalayo njengamanje yalezi zifo ukufakelwa kwamaseli e-stem allogeneic . Ngeshwa, abantu abaningi abakwazi ukwenza lokhu kufakelwa kwamaseli e-stem ngoba kuyinqubo enzima futhi edinga amandla omzimba.

Udokotela wakho uzokunikeza imithi yokwelapha ukuze uphathe isimo sakho, unciphise inani lamaseli egazi lakho, unciphise izimpawu, futhi uvimbele izinkinga. Ezinye izindlela zokwelapha zingenza ngisho nesifo siphumule. Ukwelashwa kwe-MPN kuyahlukahluka kuye ngohlobo:

• I-leukemia ye-eosinophilic engapheli (CEL): Udokotela wakho angasebenzisa i-chemotherapy, i-corticosteroids, noma i-immunotherapy ukuze anciphise amazinga akho e-eosinophil.
• I-Chronic myelogenous leukemia (CML): Ukwelashwa okusetshenziswa kakhulu ukwelashwa okuqondiwe, okuvimba amangqamuzana ukuthi angaphindaphindeki ngokungalawuleki. Ezinye izindlela zokwelapha zifaka phakathi i-chemotherapy, i-immunotherapy, i-radiation therapy, kanye nokufakelwa amaseli e-stem.
• I-Chronic neutrophilic leukemia (CNL): Ukwelashwa kungafaka phakathi i-chemotherapy, i-immunotherapy, kanye nokufakelwa amaseli e-stem.
• I-thrombocythemia ebalulekile:Uma ungenazo izimpawu, udokotela wakho angase anqume ukuqapha isimo sakho eduze esikhundleni sokukunikeza ukwelashwa. Uma unezimpawu, kungadingeka ukuthi uthathe ukwelashwa okuvimba amangqamuzana ukuthi angaphindaphindeki ngendlela engalawuleki. Kungadingeka futhi ukuthi uthathe imithi yokunciphisa ingozi yokuqhekeka kwegazi noma ukuvimba umnkantsha wakho ukuthi ungenzi ama-platelet amaningi kakhulu.
• I-Polycythemia vera: I-Phlebotomy iyindlela yokwelapha evame kakhulu ye-polycythemia vera. Kule nqubo, udokotela wakho uzosusa njalo inani elincane legazi (njengokumpontshelwa igazi) ukuze anciphise umthamo wegazi lakho futhi asuse amaseli abomvu egazi amaningi. Uma unezimpawu, ungase unikezwe ukwelashwa okuqondisiwe ukuze uvimbele amaseli ukuthi aphindaphindeke ngokungalawuleki. Ungase futhi unikezwe imithi enciphisa ingozi yokuqhekeka kwegazi (njenge-aspirin) noma imithi enciphisa inani lamaseli abomvu egazi.
• I-myelofibrosis eyinhloko: Uma ungenazo izimpawu, udokotela wakho angase anqume ukuqapha isimo sakho eduze. Kunezindlela noma imithi ehlukahlukene engasetshenziswa ukwelapha i-anemia. Isibonelo, uma umongo wakho wethambo ungakhiqizi amangqamuzana abomvu egazi anele, ungase udinge ukumpontshelwa igazi. Ungase udinge futhi ukuthatha imithi ekhuthaza umongo wethambo ukuthi wenze amangqamuzana egazi engeziwe. Ezinye izindlela zokwelapha zifaka phakathi ukwelashwa okuqondisiwe, i-chemotherapy, i-immunotherapy, ukwelashwa ngemisebe, kanye nokufakelwa kwamaseli e-stem.

Umuntu one-MPN angaphila isikhathi esingakanani?

Lokhu kuyahlukahluka kakhulu kumuntu nomuntu . Izinto eziningi zithinta lokhu, okuhlanganisa uhlobo lwe-MPN, ukuthi lesi sifo sitholakala ngokushesha kangakanani, nokuthi usabela kahle kangakanani ekwelashweni. Ngokuqapha nokwelashwa okuhle, abantu abaningi baphila iminyaka eminingi . Akukho ukubikezela okukodwa noma umphumela olindelekile walezi zimo. Ngokuvamile, abantu abaningi abatholakale bene-MPN basaphila ngemva kweminyaka emihlanu.

Amanani okusinda kwezinhlobo ezithile ze-MPN ami kanje:

• I-Chronic myelogenous leukemia (CML): Izinga lokusinda elihlotshaniswa ne-CML likhuphuke kakhulu ngenxa yempumelelo yezindlela zokwelapha ezintsha eziqondiwe. Izinga lokusinda kweminyaka emihlanu le-CML lingu-90%.
• I-Chronic neutrophilic leukemia (CNL) kanye ne-polycythemia vera: Ngokuphathwa kahle, abantu abaningi baphila isilinganiso seminyaka engaba ngu-20 ngemva kokuxilongwa.
• I-Essential thrombocythemia: Abantu abaningi baphila iminyaka eminingi uma bephuza imithi evimbela izinkinga ezisongela ukuphila njengokuqhekeka kwegazi.
• I-myelofibrosis eyinhloko: Iningi labantu abane-myelofibrosis eyinhloko baphila iminyaka emihlanu kuya kweyishumi ngemva kokuxilongwa.

Uma unalesi simo, buza udokotela wakho ngesibikezelo sakho. Yibo abazi zonke izici ezithinta isibikezelo. Futhi okubaluleke kakhulu, bayakwazi wena, iminyaka yakho, kanye nempilo yakho iyonke, kanye nezici eziyingozi ezithinta isibikezelo.

Ingabe lezi zifo ziyabulala?

Lezi akuzona izifo ezibulalayo zodwa , kodwa ezinye izinhlobo ze-MPN zingabangela izinkinga ezisongela ukuphila njengokuhlaselwa yinhliziyo kanye nohlangothi.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

I-MPN iyisifo esiyinkimbinkimbi. Kunezindlela eziningi zokwelapha, futhi ngezinye izikhathi imiphumela emibi. Futhi, kunezinkinga eziningi ezingavela kuye ngesimo sakho. Kubalulekile ukwazi ukuthi yiziphi izimpawu okufanele uziqaphele. Khuluma nodokotela wakho ukuze uqonde ukuthi uxilongwa kanjani futhi wenze izinqumo mayelana nokwelashwa.

Eminye imibuzo ongayibuza:

• Iyini inhloso yokwelashwa (ukuqeda lesi sifo, ukunciphisa izimpawu, ukuvimbela izinkinga, njll.)?
• Yiziphi izindlela zami zokwelapha?
• Yimiphi imiphumela emibi engaba khona yokwelashwa?
• Kuyoze kube nini ngidinga ukwelashwa ngesimo sami?
• Kukangaki ngidinga ukuhlolwa (ukuthatha izithombe noma ukuhlolwa kwegazi) ukuze ngiqaphe isimo sami?
• Yiziphi izimpawu ezizongisiza ukuthi ngazi ukuthi isimo sami siya siba ngcono noma siba sibi?
• Yiziphi izimpawu ezingixwayisa ngenkinga?
• Yiziphi izinkinga ezidinga ukwelashwa okuphuthumayo?
• Iyini iphrojekthi elindelekile yesimo sami?
• Yiziphi izinguquko zendlela yokuphila ozincomayo ukuze uphathe isimo sami kanye nemiphumela emibi yokwelashwa?

Ngizinakekela kanjani? (Ezinye izinto ezibalulekile kuwe)

Ukuphila ne-MPN kungaba yinto edidayo ngezinye izikhathi. Ungase uphile kahle futhi ungazizwa unezinkinga, kodwa ungase uzibuze ukuthi kukhona yini engingakwenza ukuvimbela izimpawu. Uma uthola ukwelashwa, ungase udinge usizo lokulawula imiphumela emibi yokwelashwa kanye nezimpawu. Kodwa-ke, kuzodingeka uphile nalesi sifo iminyaka eminingi ezayo. Nazi ezinye iziphakamiso ezingakusiza:

• Qonda isimo sakho sempilo: Izimpawu eziningi ze-MPN zifana nezezinye izimo ezingatheni kangako. Ezinye izimpawu zingaba yizimpawu zezinkinga ezinkulu zezokwelapha. Kungaba nzima ukubona umehluko, futhi ungase uzizwe sengathi uphuthelwa izinkomba ezibalulekile. Cela udokotela wakho ukuthi achaze ukuthi lesi simo singakuthinta kanjani. Ukwazi ukuthi yini ongayilindela kungakusiza uzizwe uqiniseka kakhulu ngesimo sakho.
• Lawula ukucindezeleka kwakho: Ukuphila nesifo sesikhathi eside kungaba yinto ekucindezelayo. Uma uzizwa ukhathazekile ngesimo sakho, khuluma nodokotela wakho ngaso. Bangachaza ukuthi yini abangayenza ukuze bakusize manje nokuthi yini abangayenza ukuze bakusize esikhathini esizayo.
• Yidla ukudla okunempilo okunempilo:Ukudla kahle kungakusiza ukuthi uphathe isimo sakho. Khuluma nochwepheshe wezokudla uma udinga usizo lokuthuthukisa imikhuba yokudla enempilo.
• Thola ukuzivocavoca: Ukuzivocavoca kuyindlela enhle yokulawula ukucindezeleka.
• Thola ukwesekwa: I-MPN iyisifo esingavamile. Amaqembu okusekelana angaba yindlela enhle yokuxhumana nokukhuluma nabantu abaziyo ukuthi ubhekene nani.

Khumbula, ngisho noma usesimweni esinjengalesi, ungaphila impilo enhle ngokuqaphela nangokulandela iseluleko sezokwelapha.

Kufanele ngimbone nini udokotela?

Uma une-MPN kodwa ungenazo izimpawu, noma ubona izinguquko emzimbeni wakho ezibonisa izimpawu, bona udokotela wakho ngokushesha.

Empeleni i-MPN iyimfihlakalo kancane. Abacwaningi bayazi ukuthi i-MPN ihlotshaniswa nokukhula okungavamile kwamangqamuzana egazi. Bayazi nokuthi kuyizifo zofuzo, kodwa imbangela eqondile yokuguquka kwezakhi zofuzo okubangela i-MPN ayaziwa . Ngenxa yokuthi lezi yizifo ezingavamile, abantu abaningi abazi ukuthi kunjani ukuhlala ne-MPN. Kodwa odokotela nabacwaningi bafunda kabanzi nge-MPN, ikakhulukazi ngezindlela eziphumelela kakhulu zokuphatha izimpawu nokunciphisa ingozi yezinkinga ezinkulu zezokwelapha. Ngakho-ke, ungalokothi ulahle ithemba .

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