Cabanga ngengane yakho ingezwani nokudla okunama-peanut. Ngakho-ke njalo uma uyiyisa ephathini noma uyiyisa esikoleni, uba nokwesaba okukhulu engqondweni yakho. "O, kuthiwani uma othile ekunika ucezu lwekhekhe olunama-peanut? Kuzokwenzekani uma ucezu oluncane lungena emlonyeni wengane yakho ngengozi?" Lokhu kwesaba, lokhu kucindezeleka, cishe kujwayelene kakhulu nawe. Yilabo kuphela abake babhekana nakho abazi ukuthi kunzima kangakanani ukuphila nokungezwani nokudla okunjalo. Kodwa, uke wezwa ngokwelashwa okusha okungakusiza ukuthi uvalelise kulokhu kwesaba? Yilokho esizokhuluma ngakho namuhla.
Kalula nje, kuyini i-Oral Immunotherapy (OIT)?
Nakuba igama lingase lizwakale liyinkimbinkimbi, lo mqondo ulula. I-Oral Immunotherapy (OIT) iyindlela yokwelapha ukungezwani nokudla. Ihilela ukukunikeza inani elincane kakhulu lokudla okubangelwa ukungezwani nokudla (okubizwa ngokuthi i-allergen) ngaphansi kokubhekwa eduze kukadokotela we-allergen.
Cabanga ngale ndlela. Unikwa ukudla okubangela ukungezwani komzimba, njengomuthi, ngaphansi kweso likadokotela. Okokuqala, uqala ngenani elincane kakhulu ongakwazi nokulibona. Bese, ngokuhamba kwesikhathi, ukhulisa inani ngokucophelela.
Umgomo oyinhloko walokhu ukugulisa kancane kancane amasosha omzimba wakho ekudleni okukubangela i-allergy. Ngokuvamile, umzimba wakho uphambanisa iphrotheni ekudleni ibe "yisitha esiyingozi" bese uqala ukulwa nayo. Yilokho okubangela i-allergy. Kodwa ekwelashweni kwe-OIT, kancane kancane sethula "isitha" emzimbeni wakho, ngakho ngokuhamba kwesikhathi amasosha omzimba wakho ayaqaphela ukuthi, "O... akayona ingozi kangako." Lokhu sikubiza ngokuthi "ukungazweli." Okusho ukuthi, umzimba awube usazwela kangako kulokho kudla.
Into ebaluleke kakhulu ukuthi ngemva kwalokhu kwelashwa, uma ngengozi udla inani elincane lokudla okubangela ukungezwani komzimba, uzokwazi ukuvimbela ukusabela okubi kakhulu.
Yimaphi amalungiselelo okufanele enziwe ngaphambi kokuqala ukwelashwa nge-OIT?
Lokhu akuyona into ongayiqala nje. Kudingeka kwenziwe ngendlela ehleliwe kahle, ngemva kokukhuluma nodokotela wakho. Ngokuvamile, kuzodingeka uqedele lezi zinto ngaphambi kwalokhu.
| Okufanele ngikwenze | Kungani kunjalo? |
|---|---|
| Ukuhlolwa kokungezwani komzimba Ukuhlolwa kwesikhumba nokuhlolwa kwegazi. | Ukuqinisekisa ukuthi unesifo sokungezwani komzimba ngempela kulokho kudla, nokubona ukuthi ukwelashwa kuyasebenza yini, ukuthola isisekelo ngaphambi nangemva kokwelashwa. Ikakhulukazi, izinga le-antibody ebizwa ngokuthi i-IgE liyalinganiswa. |
| Ukuphatha kahle i-asthma kanye ne-eczema | Uma ezinye izimo zokungezwani komzimba ezifana nalezi zingalawulwa kahle, ingozi yokusabela okuyingozi ngesikhathi sokwelashwa nge-OIT iphezulu . |
| Ukuthenga izinto ezidingekayo Amadivayisi okulinganisa kanye nokudla okukhulunywa ngakho (njengesipuni, i-paste). | Kubalulekile ukuzithatha nsuku zonke ngomthamo oqondile obekwe udokotela wakho. Kunezimpushana ezikhethekile zokungezwani nokudla kwamantongomane, njengePalforzia®. |
| Ukuthola i-Epinephrine Auto-Injector Isibonelo: i-EpiPen®, i-Auvi-Q® | Lena yinto ebaluleke kakhulu futhi ephoqelekile . Lona umuthi wokugoma ongasindisa impilo yakho uma unesifo sokungezwani komzimba esibi kakhulu (i-anaphylaxis). Awukwazi ukuqala ukwelashwa nge-OIT ngaphandle kwalokhu . Udokotela wakho uzokunikeza umuthi walokhu. |
Le nqubo yokwelashwa yenzeka kanjani?
Lonke lolu hlelo lungahlukaniswa ngezigaba ezimbili eziyinhloko: "isigaba sokukhuphuka" kanye "nesigaba sokulungisa."
1. Isigaba Sokubuyekeza
Lesi yisikhathi sokwelashwa esisebenza kakhulu.
- Usuku 1: Kuzodingeka uqale uye ehhovisi likadokotela noma emtholampilo. Lapho, ngaphansi kokuqondisa kukadokotela, uzonikezwa inani elincane kakhulu lokudla okubangela ukungezwani komzimba. Udokotela uzochaza konke mayelana nokuthi kufanele udle malini nokuthi ungakulinganisa kanjani. Bazobe sebekulungele ukukwelapha uma unezinkinga.
- Ekhaya: Bese kuthi, lowo mthamo wokuqala udokotela awunike wona, kufanele uyithathe ekhaya nsuku zonke. Kungcono ukuyithatha ngesikhathi esifanayo ngangokunokwenzeka.
- Njalo emavikini amabili: Uzocelwa ukuthi ubuye uzobona udokotela wakho njalo emavikini amabili. Lapho, futhi ngaphansi kokuqashwa ngudokotela, umthamo wakho uzokhushulwa kancane. Ngemuva kwalokho uzoya ekhaya uthathe umthamo omusha nsuku zonke.
Ngale ndlela, umthamo ukhushulwa kancane kancane njalo emavikini amabili kuze kube yilapho udokotela efinyelela umthamo oqondiwe.
2. Isigaba Sokulungisa
Uma usufinyelele kulowo mthamo oqondiwe, "isigaba sokunakekela" siyaqala.
- Okwenzekayo lapha ukuthi uyaqhubeka nokuthatha umthamo ophezulu kakhulu owawugcine ukuwuthatha ngempumelelo nsuku zonke .
- Lo mthamo wokunakekela kufanele uthathwe okungenani izinyanga eziyisithupha.
- Ngemva kwezinyanga eziyisithupha, udokotela wakho uzokwenza olunye ukuhlolwa kwegazi ukuze abone ukuthi izinga lama-antibodies emzimbeni wakho ngokumelene nalokho kudla lehlile yini.
- Ngezinye izikhathi, ungenza futhi "Ukuhlolwa Kwenselele Yokudla." Lokhu kusho ukuthi esibhedlela, ngaphansi kokuqashwa kwezokwelapha, unikezwa inani elincane lokudla okubangela ukungezwani komzimba ukuze kubonakale ukuthi kukhona yini ukusabela.
- Ngokusekelwe emiphumeleni yalezi zivivinyo, udokotela wakho uzonquma ukuthi kufanele uqhubeke nokuthatha umthamo wokunakekela nsuku zonke, noma ukuthi ukuwuthatha izinsuku ezimbalwa ngesonto kwanele.
Khumbula, ngisho nangesikhathi sokulungiswa, kubalulekile ukuthi uhlale uphethe i-epinephrine auto-injector yakho , njengoba amathuba okusabela ngokuzumayo engaqedwa ngokuphelele.
Yimiphi imithetho okufanele ilandelwe ngesikhathi sokwelashwa?
Ukuze lokhu kwelashwa kuphumelele, futhi kuphephe wena, kunezinto ezimbalwa okufanele uzilandele. Ukulandela lokhu ngqo kunganciphisa izingozi eziningi ezingadingekile.
| Umthetho okufanele uwulandele | Kungani kunjalo? |
|---|---|
| Gcina imithi eduze. Hlala ugcina imithi yakho yokungezwani komzimba kanye ne-EpiPen engaphelelwa yisikhathi nawe. | Ngoba uma kuvela isimo esiphuthumayo, kudingeka isinyathelo esisheshayo. |
| Ungathathi isisu esingenalutho. Yidla ukudla ngaphambi kokuthatha umthamo. | Ukuthatha umthamo esiswini esingenalutho kwandisa ingozi yemiphumela emibi noma ukusabela. |
| Yithathe ngesikhathi. Thatha umthamo wanamuhla zingakapheli amahora amabili kusukela kumthamo wangayizolo (amahora amabili ngaphambi noma kamuva). | Gcina amazinga emithi azinzile emzimbeni futhi unciphise ingozi yokusabela. |
| Gwema ukuzivocavoca umzimba nokugeza ngamanzi ashisayo. Gwema umsebenzi onzima womzimba kanye nokugeza ngamanzi ashisayo amahora amabili ngaphambi nangemva kokuthatha umthamo. | Lezi zinto zingandisa ukujikeleza kwegazi emzimbeni futhi zandise ingozi yokusabela kokungezwani komzimba. |
| Ungathathi i-ibuprofen. Ungathathi imithi yokunciphisa izinhlungu i-ibuprofen (njenge-Advil®, i-Motrin®) emahoreni angu-3-4 ngaphambi nangemva kokuthatha umthamo wakho. | Le mithi ingandisa ingozi yokusabela kokungezwani komzimba. |
| Ungawuthathi umthamo uma ugula. Gwema ukuthatha umthamo uma unesifo esifana nomkhuhlane, ukukhwehlela, noma ukuhlanza. | Uma ugula, umzimba wakho usengozini enkulu yokusabela. Futhi, ungadidanisa izimpawu zesifo nezimpawu zokusabela kokungezwani komzimba. Qiniseka ukuthi ukhuluma nodokotela wakho ngaphambi kokweqa umthamo. |
Wenzani uma kwenzeka ukusabela okungazelelwe?
Lena yingxenye ebaluleke kakhulu okufanele wonke umuntu ayazi. Udokotela wakho uzokunikeza imiyalelo ecacile yokuthi yiziphi izimpawu okufanele uziqaphele, ukuthi ungazisebenzisa nini i-EpiPen, nokuthi kufanele uye nini eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela.
Uma uhlangabezana nesinye noma ngaphezulu kwalezi zimpawu ezilandelayo eziyingozi , ungalibali .
- Ukuvuvukala kobuso, izindebe, ulimi, noma umphimbo
- Ubunzima bokuphefumula
- Ukuzwa ukuqina esifubeni
- Ukuvela kwama-blister amaningi amakhulu (ama-hives) emzimbeni wonke
- Ukuhlanza
- Ukuba ndikindiki ezandleni, ezinyaweni, noma ezindebeni
- Ubuthakathaka bomzimba, isiyezi, ukuquleka
- Ukuzwa inhlekelele ezayo (umuzwa wokwesaba okukhulu, njengokuthi "kukhona okuzokwenzeka kimi").
Uma uhlangabezana nanoma yiziphi zalezi zimpawu, sebenzisa i-EpiPen yakho ngokushesha bese uya eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze ngokushesha okukhulu.
Azikho yini izingozi kulokhu kwelashwa?
Njenganoma yiluphi uhlobo lokwelashwa, i-OIT inezingozi ezithile.
- Ingozi enkulu ukusabela okukhulu kokungezwani komzimba okubizwa ngokuthi "i-anaphylaxis" esikhulume ngakho ngaphambilini. Yingakho lokhu kwelashwa kufanele kwenziwe ngaphansi kokuqashwa ngudokotela futhi akufanele neze kuzanywe ekhaya wedwa .
- Ngaphezu kwalokho, kungase kube nokusabela okuncane okufana nama-blister amancane esikhumbeni kanye nokuphazamiseka okuncane kwesisu.
- Enye ingozi engavamile kodwa engathi sína yisimo esibizwa ngokuthi i-Eosinophilic Esophagitis . Lokhu ukuvuvukala komhubhe. Uma uzwa izimpawu ezifana nokuhlanza noma umuzwa wokudla ubhajwa emphinjeni wakho, kufanele utshele udokotela wakho ngokushesha. Izingane ezincane zingase zenqabe ukudla. Lesi simo sivame ukuxazululeka uma ukwelashwa kwe-OIT sekumisiwe.
Yiziphi izinzuzo kanye namazinga empumelelo okwelashwa kwe-OIT?
Inzuzo eyinhloko yalokhu kwelashwa ukuthi kususa ingcindezi enkulu empilweni yakho. Okuwukuphela kwento enhle ngokuphila ngaphandle kokwesaba ingozi enkulu uma udla ngengozi ukudla okungezwani nomzimba. Abanye abantu, ikakhulukazi izingane eziqala ukwelashwa zisencane , baze bajwayele ukudla lokho kudla ngokujwayelekile ngaphandle kokwesaba ngemva kokuqeda i-OIT.
Ngokuphathelene nempumelelo, izifundo zibonisa ukuthi lokhu kwelashwa kusebenza kahle kakhulu ezinganeni ezingaphansi kweminyaka engu-4. Isibonelo, ocwaningweni lwe-OIT lokungezwani nokudla kwamantongomane, izingane ezingaphezu kuka-70% eziphakathi kweminyaka engu-1 no-4 ubudala zazikwazi ukudla okulingana ne-peanut kernel yeprotheni ngaphandle kwezinkinga.
Udokotela wakho ungumuntu ongcono kakhulu ukunquma ukuthi lokhu kulungile yini kuwe noma enganeni yakho. Lokhu ukwelashwa okudinga ukuzibophezela okukhulu futhi kuthatha isikhathi. Ngakho-ke, kubalulekile ukuxoxa ngayo yonke imibuzo yakho kanye nokwesaba kwakho nodokotela wakho bese wenza isinqumo esinolwazi.
Umlayezo Wokuya Nawe Ekhaya
- Ukwelashwa Nge-Oral Immunotherapy (OIT) akuyona into yokuzenzela wena. Kuyindlela yokwelapha okufanele yenziwe kuphela ngaphansi kokuqondisa okugcwele kochwepheshe .
- Inhloso eyinhloko yalokhu ukuvikela ekusabeleni okuyingozi okungase kwenzeke uma ukudla okungezwani nomzimba kudliwa ngephutha.
- Lokhu kudinga ukuzibophezela okukhulu kanye nesikhathi esivela emndenini. Luhambo olude .
- Kuyo yonke inqubo yokwelapha,Kubalulekile ukuhlala uphethe i-EpiPen futhi wazi ukuthi uyisebenzisa kanjani.
- Uma wena noma ingane yakho ninokungezwani nokudla, khuluma nodokotela wakho ukuze ufunde kabanzi ngokwelashwa kwe-OIT.
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