Ubunzima bokuphefumula ngenxa yokukhuluphala? Ake sixoxe nge-(Obesity Hypoventilation Syndrome)!

Ingabe ngezinye izikhathi uzizwa uphelelwa umoya? Ingabe ukhathele futhi ulele nje emini? Kubalulekile ukuqaphela lezi zinto, ikakhulukazi uma ukhuluphele ngokweqile. Namuhla sizokhuluma ngenkinga yokuphefumula engaziwa kakhulu, kodwa engaba yingozi, engahlotshaniswa nokukhuluphala. Lokhu kubizwa ngokuthi `(Obesity Hypoventilation Syndrome)` noma i-OHS. Ungakhathazeki, ake sikuchaze kalula.

Kuyini i-OHS (Obesity Hypoventilation Syndrome)?

Kalula nje, `(Obesity Hypoventilation Syndrome)` isifo sokuphefumula esenzeka kwabanye abantu abakhuluphele ngokweqile. Lokhu kwenzeka lapho inani le-carbon dioxide egazini lethu landa futhi inani le-oxygen lehla. Ngokuvamile, lapho siphefumula, sithatha i-oxygen bese sikhipha i-carbon dioxide. Kodwa lapho izinga lokuphefumula lehla futhi umoya ungangeni kahle emaphashini, leli bhalansi liyalahleka. Lokhu kubizwa ngokuthi `(Hypoventilation)` (ukuphefumula okuncishisiwe).

Ngaphezu kokuphefumula kancane, ukuphefumula okuphazamisekile ebuthongweni nakho kungenzeka ku-OHS. Eqinisweni, ama-90% ezinkinga zokuphefumula okuphazamisekile ebuthongweni ezihlobene ne-OHS zibangelwa yi-obstructive sleep apnea.

Ngakho-ke, i-OHS ifana nenhlanganisela yezinto ezintathu eziyinhloko:

• Ukukhuluphala ngokweqile.
• Ukuphefumula okunciphile (i-Hypoventilation).
• Ukuphefumula okuphazamisekile ekulaleni.

Kukhona elinye igama lale OHS, eliyi-`(Pickwickian Syndrome)`. Leli gama laqanjwa ngenxa yomlingiswa enoveli kaCharles Dickens owayenezimpawu ze-OHS.

I-OHS iyinkinga enkulu yokuphefumula ebangelwa ukukhuluphala. Nakuba ingabangela izinkinga zempilo ezisongela ukuphila, inezindlela zokwelapha ezinhle.

Ubani onamathuba amaningi okuthuthukisa i-OHS?

I-OHS ivame kakhulu kwabesilisa kunabesifazane. Kukhona futhi umehluko othile obikiwe phakathi kwamaqembu athile ezinhlanga. Kodwa-ke, isici esiyinhloko sengozi ukukhuluphala ngokweqile.

Kunzima ukusho ukuthi lokhu kuvame kangakanani, kodwa ezinye izifundo ziphakamisa ukuthi kungathinta iphesenti elincane labantu abadala. Lokho kusho ukuthi akuvamile kakhulu, kodwa kuyinto ethinta inani elikhulu labantu.

Ziyini izimpawu ze-OHS?

Izimpawu ze-OHS zivame ukubangelwa ukungalali kahle kanye namazinga aphansi omoya-mpilo egazini (i-Hypoxemia). Ezinye zalezi zimpawu zifaka:

• Ukuphelelwa umoya.
• Ukuzizwa ukhathele ngaso sonke isikhathi (Ukukhathala).
• Ukuntuleka kwamandla.
• Ukulala ngokweqile emini (ukuvilapha emini).
• Ubuhlungu bekhanda obuhlala bukhona.
• Isiyezi.
• Ukucindezeleka.

Ngesikhathi ulele, umlingani wakho angase abone izinto ezifana nalezi:

• Ukuhona okukhulu.
• Ukuzizwa sengathi uyaminza noma uyaphefumula ngenkathi ulele.
• Ukuphefumula kuyama. Cabanga uma othile ekutshela ukuthi, "Uma ulele ebusuku, ngezinye izikhathi kuba sengathi uyeka ukuphefumula imizuzwana embalwa." Lokho kuyinto efana naleyo.

Yiziphi izimbangela ze-OHS?

Abacwaningi abakakazi kahle ukuthi yini ebangela i-OHS, kodwa bakholelwa ukuthi kungenzeka ukuthi ibangelwa yinhlanganisela yezici:

• Kungase kube khona okungahambi kahle ngendlela ubuchopho bakho obulawula ngayo ukuphefumula . Kunjengokungathi kukhona iphutha elincane "eswishini" yethu yokuphefumula.
• Isisindo esengeziwe esifubeni singenza kube nzima ngamaphaphu ukufutha kahle nokuphefumula ngokujulile. Kufana nokuzama ukuphefumula unesisindo esifubeni sakho.
• Amafutha amaningi ezindaweni ezifana nentamo, isifuba kanye nesisu angandisa ukukhiqizwa kwama-hormone athile , okungathinta izindlela zokuphefumula.

Uthola kanjani ukuthi une-OHS?

Uma uya kudokotela, bazobuza ngezimpawu zakho futhi bakuhlole. Bazokala ubude nesisindo sakho bese bebala i-Body Mass Index (BMI) yakho. Abantu abakhuluphele kakhulu bane-BMI engama-30 noma ngaphezulu.

Ngemva kwalokho, udokotela angase acele ukuhlolwa okwengeziwe ukuze anqume ukuthi une-OHS yini. Ezinye zalezi zifo zifaka:

• Ukuhlolwa kwegesi yegazi lemithambo: Lokhu kuhilela ukuthatha inani elincane legazi emthanjeni wakho bese ulinganisa inani le-carbon dioxide nomoya-mpilo okuwo. Lena yindlela ongazi ngayo ukuthi igazi lakho liphezulu ku-CO2 noma liphansi ku-O2.
• I-pulse oximeter: Kungenzeka ukuthi ukubonile lokhu, ithuluzi elincane elifana ne-clip olifaka emunweni wakho. Lingalinganisa inani lomoya-mpilo egazini lakho. Kodwa-ke, alikwazi ukukala i-carbon dioxide, futhi alinembile njengesampula yegazi.
• Ukuhlolwa kokusebenza kwamaphaphu: Lokhu kuhlolwa kuhlola ukuthi amaphaphu akho asebenza kahle kangakanani futhi kubheka ezinye izimbangela zokuphelelwa umoya.
• I-X-ray yesifuba: Lokhu kungasiza futhi ekuqedeni ezinye izimbangela zokuphelelwa umoya.
• Ucwaningo lokulala `(Polysomnography):` Lolu ukuhlolwa okukhethekile. Ngemva kokuchitha ubusuku obubodwa esibhedlela, ukuphefumula kwakho, ukushaya kwenhliziyo, kanye namaza obuchopho kuyaqashelwa ngenkathi ulele. Lokhu kungasiza ekunqumeni ukuthi une-`(Sleep Apnea)` nokuthi, uma kunjalo, ukuthi imbi kangakanani.

Yiziphi izindlela zokwelapha i-OHS?

Ukwelashwa kwe-OHS kuhilela kakhulu ukwehlisa isisindo kanye nokusekelwa kokuphefumula.

Ukwehlisa isisindo

Ukufinyelela esisindweni esinempilo esifanelana nomzimba wakho nokusigcina kuyisinyathelo sokuqala nesibaluleke kakhulu ekwelapheni i-OHS.Ngezinye izikhathi, ukwehlisa isisindo nje kungasiza ekulawuleni izimpawu futhi kuthuthukise isimo. Ukwamukela indlela yokuphila enempilo kungasiza kakhulu. Isibonelo:

• Ukudla ukudla okunempilo. Isibonelo, ukudla okulinganiselayo njengokudla kwaseMedithera.
• Ukuzivocavoca okungenani imizuzu engama-30 ngosuku.
• Yakha imikhuba emihle yokulala.

Kuye ngesimo sakho, udokotela wakho angase futhi ancome ukuhlinzwa kokunciphisa isisindo, njengokuhlinzwa kwesisu.

Ukusiza ukuphefumula

Udokotela wakho angase akuncome umshini wokungenisa umoya osebenza ngomshini ukuze akusize uphefumule. Lawa amadivayisi angahlaseli, okusho ukuthi angasetshenziswa ngaphandle kokuhlinzwa okukhulu. Le mishini igcina imigudu yakho yokuphefumula ivulekile ebusuku ngenkathi ulele, okwandisa inani lomoya-mpilo egazini lakho. Ugqoka imaski ekhethekile ngenkathi ulele, futhi umshini ukhipha umoya ngepayipi. Kunezinhlobo eziningana zemishini:

• Umshini we-CPAP (Continuous Positive Airway Pressure): Umshini we-CPAP uletha umoya ngengcindezi efanayo uma uphefumula futhi ukhipha umoya.
• Umshini we-BiPAP (Bilevel Positive Airway Pressure): Umshini we-BiPAP uletha umoya ngomfutho ophezulu uma uphefumula kanye nomfutho ophansi uma uphefumula. Lokhu ngezinye izikhathi kubizwa ngokuthi igama lomkhiqizo elithi ``(BiPAP®)``.

Akuvamile kakhulu, uma le mishini ethi "Positive Airway Pressure" ingakwazi ukulawula lesi simo, kungase kudingeke i-"Tracheostomy". Lokhu kusho ukuthi udokotela ohlinzayo wenza imbobo entanyeni yakho bese eyixhuma ku-windpipe yakho ukuze akusize uphefumule. Lokhu kuvame ukuba yindlela yokugcina.

Ungayinciphisa kanjani ingozi yokuthola i-OHS?

Indlela engcono kakhulu yokunciphisa ingozi yakho yokuthola i-OHS ukugcina isisindo esinempilo. Uma udokotela wakho ekunike i-CPAP noma i-BiPAP, kubalulekile ukuyisebenzisa njengoba nje kuqondiswe.

Ngaphezu kwalokho, uma uzondiza noma uzohlinzwa, tshela udokotela wakho kusenesikhathi, njengoba ingozi yezinkinga ezinkulu iphezulu ezimweni ezinjalo.

Sinjani isimo sempilo somuntu one-OHS?

Ngokwelashwa, izimpawu ze-OHS zingancishiswa noma ziqedwe ngokuphelele. Kwabanye abantu, ngisho nokwehlisa isisindo nje kungasiza. Ukwelashwa kubalulekile ngoba kungathuthukisa ikhwalithi yempilo yakho futhi kunciphise ingozi yezinkinga ezengeziwe. Ukwelashwa kusenesikhathi ngomshini wokuphefumula kuye kwabonakala kunciphisa izinga lokufa okuvela ku-OHS ngo-10%.

Kodwa-ke, uma ingelashwa, i-OHS ingaholela ezinkingeni ezisongela ukuphila, ikakhulukazi izinkinga zenhliziyo nemithambo yegazi. Ukuntuleka komoya-mpilo kubeka inhliziyo enkingeni enkulu. Uphinde ube sengozini enkulu yezinkinga ezibangelwa ukungalali kahle. Ngaphandle kokwelashwa, izinga lakho lempilo lizokwehla futhi cishe kuzodingeka ulaliswe esibhedlela.

Isibikezelo salabo abangatholi ukwelashwa asisihle neze. I-OHS engelashwanga inganciphisa isikhathi sokuphila. Phakathi kwabantu abanezinye izifo, izinga lokufa kwezinyanga ezingu-18 ngenxa ye-OHS liphezulu ngamaphesenti angu-23.

Yiziphi izinkinga ezingaba khona ngenxa ye-OHS?

Uma ingelashwa, i-obesity hypoventilation syndrome ingaholela ezinkingeni ezihlobene nokulala. Lezi zifaka:

• Ukucindezeleka.
• Ukucasuka nokucasuka.
• Ingozi ephezulu yezingozi.
• Izinkinga empilweni yocansi kanye nobudlelwano obuseduze.

I-OHS ingadala nesifo senhliziyo, isibonelo:

• Umfutho wegazi ophezulu (i-Hypertension).
• Ukwehluleka kwenhliziyo ohlangothini lwesokudla.
• Umfutho wegazi ophezulu wamaphaphu.

Kufanele ubonane nini nodokotela?

Kufanele nakanjani ubone udokotela ezimweni ezilandelayo:

• Uma ukhuluphele kakhulu futhi unezinye izimpawu ezihlobene ne-OHS.
• Ingabe umlingani wakho uthi uhogela kakhulu ebusuku bese ubona izinto ezinjengokuthi uyeka ukuphefumula ngezikhathi ezithile?
• Uma uzizwa ukhathele kakhulu futhi ulele emini.

I-Obesity Hypoventilation Syndrome (OHS) iyinkinga enkulu yokuphefumula ebangelwa ukukhuluphala. Uma ukhuluphele, unenkinga yokuphefumula, noma unezinkinga ezihlobene nokulala, bona udokotela ngokushesha. Bakhona ukukusiza. Uma udokotela ekuxilonga ukuthi une-OHS, bazokunikeza uhlelo lokwelashwa olufanele kakhulu.

Okokugcina, izinto okufanele uzikhumbule

Kulungile, ngakho-ke, ake ngikucele ukuthi ukhumbule ezinye zezinto ezibaluleke kakhulu kulokho esikhulume ngakho.

• I-Obesity Hypoventilation Syndrome iyinkinga yokuphefumula engaba yingozi kakhulu futhi ehambisana nokukhuluphala ngokweqile.
• Okwenzekayo kulokhu ukuthi i-carbon dioxide iyanda futhi umoya-mpilo uyancipha egazini.
• Into engcono kakhulu ukuthi, kukhona ukwelashwa kwalokhu! Ukwehlisa isisindo nokusebenzisa imishini yokuphefumula efana ne-CPAP/BiPAP kubalulekile.
• Ukuxilongwa kusenesikhathi kanye nokwelashwa kungavimbela umonakalo omkhulu empilweni futhi kuthuthukise kakhulu ikhwalithi yokuphila.
• Uma ukhuluphele kakhulu futhi unezimpawu ezifana nokuphelelwa umoya, ukozela emini, kanye nokuhona ebusuku, sicela ufune iseluleko sezokwelapha. Akukho okufanele ukwesabe noma ube namahloni ngakho. Impilo yakho iyona nto ebaluleke kakhulu.

Ngiyethemba ukuthi lolu lwazi luwusizo kuwe. Hlala uphilile!

I- Obesity Hypoventilation Syndrome, i-OHS, i-Pickwickian Syndrome, ukukhuluphala, ubunzima bokuphefumula, i-sleep apnea, i-CPAP, i-BiPAP