Kwenzekani emzimbeni wakho uma udla konke ngesikhathi esisodwa ngemva kokungadli? Ake sifunde kahle nge-Refeeding Syndrome!

Wake wazibuza ukuthi kwenzekani emzimbeni wakho uma udla izinsuku eziningi ungadli bese uqala ukudla futhi? Ngezinye izikhathi, uma uqala ukondla umzimba wakho ngokuzumayo, ungaba nezinkinga ezingalindelekile. Yilokho odokotela abakubiza ngokuthi "i-refeeding syndrome." Lokhu kungase kuzwakale kuyinkimbinkimbi, kodwa masikwenze kube lula.

Iyini le "Refeeding Syndrome"?

Kalula nje, `(Refeeding Syndrome)` yisimo esibi kakhulu esingase senzeke lapho umuntu ongondlekile eqala ukudla futhi . Ukungondleki kahle kwenzeka lapho umzimba wakho ungatholi izakhamzimba ozidingayo. Ngakho-ke, ngemva kokungadli isikhathi eside kangaka, lapho uthola ukudla ngokuzumayo, kwenzeka izinguquko ezinkulu ezinqubweni zamakhemikhali emzimbeni wethu. Ikakhulukazi, kungaba nokungalingani okukhulu enanini losawoti obalulekile (`(Electrolytes)`) emzimbeni. Lokhu kungalimaza izitho ezibalulekile njengemisipha yakho , amaphaphu, inhliziyo, kanye nobuchopho .

Ubani okungenzeka kakhulu ukuthi athole "i-Refeeding Syndrome"?

Lokhu kungenzeka kunoma ubani ongondlekile kahle futhi oqala ukudla futhi. Uma ungatholi ukudla okwanele nokuphuza, ungase ungondlekile kahle. Futhi, ukungondlekile kahle kungenzeka ngenxa yezifo ezithile. Ngoba, ngenxa yezifo ezinjalo, ungase ungakwazi ukudla noma umzimba wakho ungase ungakwazi ukumunca ukudla okudlayo ngendlela efanele.

Abantu abanezici ezilandelayo eziyingozi banamathuba amaningi okuthuthukisa i-"Refeeding Syndrome":

• Uma usanda kulahlekelwa ngaphezu kwe-10% yesisindo somzimba wakho. Isibonelo, uma unesisindo esingamakhilogremu angu-60, ukulahlekelwa ngaphezu kwamakhilogremu angu-6 ngesikhathi esisodwa kuyingozi.
• Uma ubungadli ukudla izinsuku ezingaphezu kweziyisikhombisa, ucindezelekile engqondweni, futhi umzimba wakho uzizwa ubuthakathaka.
• Kubantu abanezinkinga zokudla, njenge-Anorexia Nervosa (inkinga yokudla) noma i-Bulimia Nervosa (inkinga yokudla).
• Abantu abanezifo ezivimbela umzimba ukuthi umunce ukudla ngendlela efanele , njenge-pancreatitis engapheli noma isifo samathumbu esivuvukalayo.
• Kulabo asebethole ukudla okunomsoco kwabazali isikhathi eside.
• Kwabagulayo abanomdlavuza kanye nalabo abelashwa ngamakhemikhali.
• Kulabo abanesifo sikashukela esingalawuleki (i-Diabetes Mellitus).
• Kulabo abaphuza utshwala ngokweqile isikhathi eside.
• Kulabo asebethathe imithi yokunciphisa i-asidi noma imithi yokukhipha isisu isikhathi eside.

Kwenzeka kanjani lokhu "Ukubuyela Kokudla"?

Uma umzimba wakho ungatholi izakhamzimba ozidingayo, wenza izinguquko ezithile ukuze uzivumelanise nezimo. Inqubo umzimba oguqula ngayo ukudla kube amandla ibizwa ngokuthi i-metabolism.Esikhundleni sama-carbohydrate asuka ekudleni, umzimba uqala ukushisa amafutha nemisipha yawo ukuze uthole amandla. Lokhu futhi kunciphisa izinga lokuguqulwa kwe-metabolism. Inani lamandla owasebenzisayo ngenkathi uphumule (`Izinga Lokuphumula Lokuguqulwa Kwe-Metabolic`) lingehla cishe ngo-20%.

Lolu hlobo lokuguqulwa kwezakhi zomzimba lusebenzisa izinsiza ezimbalwa. Amavithamini, amaminerali, kanye "nama-electrolyte" ashiwo ngenhla awasetshenziswa kule nqubo, njengasekuguqulweni kwezakhi zomzimba okuvamile.

Kodwa, uma uqala ukudla futhi, ama-carbohydrate aqala ukwenziwa ngendlela evamile. Ngemuva kwalokho umzimba ngokuzumayo udinga lawo '(ama-Micronutrients)' ukuze enze lo msebenzi. Kunjengokungathi isitolo asisekho futhi kungazelelwe kungena i-oda elikhulu. Uma umzimba wakho unezakhamzimba ezimbalwa kakhulu ezigciniwe, yilapho inkinga iqala khona.

Iyini imbangela yangempela ye-`(Refeeding Syndrome)`?

Isizathu esiyinhloko salokhu ukuntuleka kwezakhamzimba ezithile emzimbeni wakho. Lezi ziyaphela uma ungondlekile kahle. Izakhamzimba eziyinhloko ezihilelekile kulokhu yiPhosphorus , iPotassium, neMagnesium . Uma uqala ukudla futhi, amangqamuzana akho adinga lawa ma-electrolyte ngokuzumayo ukuze asebenzise ukudla. Lokhu kubangela ushintsho olukhulu ekulinganisweni kwamakhemikhali emzimbeni wakho, njengokushaqeka.

Lawa `(ama-Electrolyte)` egazini lakho athuthwa ayiswe emangqamuzaneni ngokushesha okukhulu. Kodwa-ke, ngenxa yokuthi awunawo anele emzimbeni wakho, amazinga alawa egazini lakho ancipha kakhulu ngenxa yalolu shintsho. Lokhu ukwehla kwamazinga `(ama-Electrolyte)` egazini lakho okubizwa ngokuthi ``ukuntuleka``. Kungenxa yalawa maphutha ukuthi ibhalansi yamakhemikhali yomzimba iyaphazamiseka, futhi kuvela izinkinga ezahlukahlukene ezibonakala ku-`(i-Refeeding Syndrome)`.

Yiziphi izimpawu ze-`(Refeeding Syndrome)`?

Lesi simo singabonakala ngezindlela ezahlukene. Okuvame kakhulu ukuntuleka kwe-phosphate. Kodwa-ke, okunye ukuntuleka kanye nokungalingani nakho kungaba nomthelela kulokhu.

Ukuntuleka kwe-phosphate (`(Hypophosphatemia)`)

Ukuntuleka kwe-phosphorus kuyisibonakaliso esivame kakhulu se-"Refeeding Syndrome." Uma amazinga e-phosphate ephansi, kuthinta ukusebenza kwamaseli kuwo wonke umzimba. Lokhu kungabangela izimpawu ezifana nalezi:

• Ubuthakathaka bemisipha (njengokungathi isitho siyaba ndikindiki)
• Ubunzima bokuphefumula.
• Ukuqala ukubona izinto kabili (`Double Vision`).
• Ubunzima bokugwinya.
• Ukuquleka.
• I-Coma.
• Ubuthakathaka bemisipha yenhliziyo (`(Cardiomyopathy)`).

Uma lezi zimpawu ziba zimbi kakhulu , ezinye izitho zomzimba zingase ziyeke ukusebenza futhi impilo ingase ibe sengozini . Ngakho-ke, lokhu akufanele kuthathwe kalula.

Ukuntuleka kwe-magnesium (`(Hypomagnesemia)`)

I-magnesium nayo ibalulekile ekusebenzeni komzimba wethu. Uma i-magnesium iphansi, ingathinta zonke izitho zomzimba. Izimpawu ezifana nalezi:

• Isicanucanu nokuhlanza.
• I-Anorexia (ukulahlekelwa yisifiso sokudla).
• Ukuthuthumela.
• Ukuqaqamba kwemisipha.
• Ukuquleka.
• I-Coma.
• Ukuphazamiseka kokugeleza kwegazi enhliziyweni (i-Cardiac Ischemia).
• Ukungalingani kwesigqi senhliziyo (`(Arrhythmia)`).

Ukuntuleka kwe-potassium (`(Hypokalemia)`)

Uma unesifo sokuntuleka kwe-potassium esincane, ungase ungabi nazo izimpawu ezinkulu. Kodwa-ke, uma ukuntuleka kwayo kukhulu, ungase ube nalokhu okulandelayo:

• Ubuthakathaka bemisipha.
• Ukuqaqamba kwemisipha, ubuhlungu.
• Ukukhathala ngokweqile.
• Ukunyakaza kwamathumbu kuyayeka, okubangela ukuqunjelwa okukhulu.
• Ukungalingani kwesigqi senhliziyo (`(Arrhythmia)`).
• Ukwehluleka Kokuphefumula.

Ukuntuleka kwe-Thiamine (Vitamin B1) (`Ukuntuleka kwe-Thiamine`)

Lokhu kuntuleka kwe-thiamine kubonakala kakhulu lapho ukudla okucebile ngama-carbohydrate kubuyiselwa. Lokhu kungaholela ezimpawini ezinkulu zezinzwa:

• Ukuphambana kwengqondo, ukudideka.
• Izinkinga zokubona.
• Ukwehla kwezinga lokushisa lomzimba (`(Hypothermia)`).
• Izinkinga ngokulinganisela kanye nokuxhumana (`(Ataxia)`). "Ubunzima bokuhamba, njengomuntu odakiwe."
• Ukulahlekelwa yinkumbulo (`(i-Amnesia)`).
• Ukuhlangana (izinkumbulo zezinto ezingazange zenzeke).

Izinkinga ngokulinganisela koketshezi emzimbeni

Izinguquko kumetabolism zingathinta ibhalansi ye-sodium namanzi emzimbeni. Uma ukudla okunomsoco kuqalwa kabusha, lokhu kungaholela "ekugcwaleni ngokweqile kwe-Fluid" noma "ekuphelelweni kwamanzi emzimbeni". Lokhu kungaholela ezimweni ezifana nalezi:

• Umfutho wegazi ophansi (hypotension).
• Ukuqaqamba kwemisipha.
• I-Pulmonary Edema (ukuqongelela koketshezi emaphashini).
• Ukungasebenzi kahle kwezinso.
• Ukwehluleka kwenhliziyo (`(Ukwehluleka kwenhliziyo okubangelwa ukuqina kwemithambo yegazi)`).
• Ukuquleka.

Izinkinga zezinga likashukela egazini

Uma uphinda ukondla, ukubuyiselwa kwe-glucose kungabangela amazinga aphezulu kashukela egazini (i-hyperglycemia). Lokhu kungenxa yokuthi:

• Ikhanda elibuhlungu .
• Umbono ofiphele.
• Ukuchama njalo.
• Ngikhathele.

Ungayibona kanjani i-`(Refeeding Syndrome)`?

Uma usuqalile ukudla futhi, ithimba lakho lezokwelapha lizohlola njalo izimpawu zakho ezibalulekile . Uma kuvela noma yikuphi ukukhubazeka noma izimpawu, bazokwenza "Ukuhlolwa Kwegazi" ukuze bahlole. Lokhu kuzobasiza ukuthi babone ukuthi yikuphi ukungalingani okuthile onakho emzimbeni wakho nokuthi kukhulu kangakanani.

Iphathwa kanjani i-"Refeeding Syndrome"?

Ngaphambi kokuthi uqale ukudla futhi, odokotela bakho bazokwenza ukuhlolwa kwegazi ukuze bahlole amazinga akho e-electrolyte futhi bathole noma yikuphi ukuntuleka. Bese, bazofaka lawa ma-micronutrients anciphile kufomula yakho yokudla okunempilo. Umqondo uwukuqala ngokugcwalisa lawa ma-micronutrients anciphile. Ngemuva kwalokho, umzimba wakho uzobe ulungele kangcono ukugaya ama-carbohydrate.

Kodwa khumbula, ngezinye izikhathi, ukuhlolwa kwegazi kokuqala akubonisi konke lokhu kuntuleka kwe-`(Electrolyte)`. Ngenxa yokuthi umzimba awukaqali ukondla okwamanje, awazi ukuthi uzodinga lawa ma-`(Electrolyte)` esikhathini esizayo. Ushintsho olukhulu ekudluliselweni kwama-`(Electrolyte)` kusuka egazini kuya emangqamuzaneni alukakenzeki okwamanje. Ngenxa yalokhu, ngezinye izikhathi ukuntuleka kuvela kuphela ngemva kokuqala kokuphakela.

Ithimba lakho lezokwelapha lizoqhubeka nokukuqapha izimpawu. Lizohlola amazinga akho e-electrolyte nsuku zonke. I-Refeeding syndrome ivame ukwenzeka ezinsukwini ezinhlanu zokuqala zokupha ukudla. Uma kuvela izimpawu, ithimba lakho lezokwelapha lizonciphisa izinga ophakela ngalo. Bazonciphisa inani lama-carbohydrate kufomula yakho. Ungase futhi unikezwe ezinye zezakhamzimba ozintulayo nge-IV.

Ngizolulama ngokushesha kangakanani ngemva kokwelashwa?

Uma udokotela esethole ukuthi "i-Refeeding Syndrome", bangayilungisa ngokushesha. Kodwa-ke, kungathatha amasonto ambalwa ukuthi ukuntuleka kwezakhamzimba ezincane kuphole. Lokhu kusho ukuthi inqubo ephelele yokondla kabusha ithatha isikhathi esithile.

Unganciphisa kanjani ingozi ye-`(Refeeding Syndrome)`?

Ngezinye izikhathi isidingo sokuphinda uncelise ingane asinakugwenywa. Kodwa-ke, singathatha izinyathelo zokuphepha:

• Uma unesifo sesikhathi eside esibangela ukungondleki kahle, kubalulekile ukuthi selashwe ngendlela efanele . Udokotela wakho angase akuncomele izithako zokudla, ezifana namavithamini namaminerali, ukuze kukusize uthole izakhamzimba ozidingayo.
• Uma uzila ukudla izinsuku eziningana, kungcono ukwenza kanjalo ngaphansi kokuqondisa kukadokotela.
• Ungasebenzisi kabi utshwala, izidakamizwa, noma imithi kadokotela. Uma usebenzisa noma yikuphi kwalokhu njalo, kuwumqondo omuhle ukubona udokotela ukuze ahlolwe futhi ahlolwe igazi.

Ungasinda yini `(Refeeding Syndrome)`?

Nakuba izinkinga ezivela ku-"Refeeding Syndrome" ngezinye izikhathi zingaba yingozi, isikhathi esiningi azibi zimbi kangako . Uma ithimba lezokwelapha selilungisile ukungalingani, izimpawu eziningi zingase ziphenduke, okusho ukuthi zingelapheka.

"(Isifo Sokondla Kabusha)" kuyinkinga eyenzeka ngesikhathi sokwelashwa kokungondleki kahle. Ukungondleki kahle nakho kuyisimo esibeka ukucindezeleka okukhulu emzimbeni. Kungase kubonakale kungavamile kuwe ukuthi ukunikeza ukwelashwa okuningi ngokushesha kungaba yingozi. Kodwa,Ukuphakela kabusha ingane kuyindlela ebucayi kakhulu futhi eyinkimbinkimbi. Kungcono ukwenza lokhu ngaphansi kokuqashwa ngudokotela. Uma uphakela kabusha ingane ngaphansi kokuqashwa ngudokotela, bazokuqapha eduze. Bazozama ukuvimbela ukuthi ingane ingenzeki (i-Refeeding Syndrome)`, futhi bazokulungela ukubhekana nayo uma kwenzeka.

Izinto ezibaluleke kakhulu okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

• Kudingeka uqaphele kakhulu uma uqala ukudla futhi ngemva kokungondleki kahle isikhathi esithile.
• Njengoba isisho sithi, "Uhambo oluhamba kancane luyindlela engcono kakhulu," ukuphakela kufanele kwenziwe kancane kancane.
• Kuphephile kakhulu ukupha ukudla kabusha ngaphansi kokuqashwa kwezokwelapha, ikakhulukazi kulabo abasemaqenjini asengozini enkulu.
• Lalela umzimba wakho. Uma uzizwa ungavamile, ungangabazi ukufuna iseluleko sezokwelapha.
• "(Isifo Sokondla Kabusha)" akuyona into okufanele uyesabe, kodwa kubaluleke kakhulu ukuyiqaphela.

Ngakho-ke, ngithemba ukuthi lolu lwazi luwusizo kuwe. Hlala uphilile!

Isifo Sokondla Kabusha, ukungondleki kahle, ama-electrolyte, ukudla okunempilo, ukuzila ukudla, izimpawu, ukwelashwa