Ingabe uhlala uzwa ubuhlungu entanyeni, emahlombe, noma ezingalweni zakho? Lesi simo singaba yi-Thoracic Outlet Syndrome (TOS)!

Ingabe ngezinye izikhathi uzizwa ubuhlungu obungavamile noma ukuba ndikindiki okusuka entanyeni nasemahlombe akho kuye ezansi ezingalweni zakho? Mhlawumbe lobu buhlungu buyanda uma uphakamisa isisindo noma uphakamisa ingalo yakho. Uma unezimpawu ezinjengalezi, imbangela ingaba yisimo esinegama eliyinkimbinkimbi. Namuhla sikhuluma ngesimo esinjalo, okungukuthi i-Thoracic Outlet Syndrome (TOS) . Nakuba igama lingase lizwakale liyesabeka kancane uma ulizwa, uma unolwazi olufanele ngalo, unganciphisa izinkinga eziningi.

Iyini i-Thoracic Outlet Syndrome?

Kalula nje, i-Thoracic Outlet Syndrome (TOS) iqoqo lezimpawu ezibangelwa ukucindezelwa kwemizwa noma imithambo yegazi entanyeni yakho engezansi nasesifubeni esingaphezulu. Elinye igama lalokhu "i-thoracic outlet."

Cabanga ukuthi kukhona isikhala esincane, njengomnyango, phakathi kwentamo yakho nesifuba sakho. Yilokhu odokotela abakubiza ngokuthi "i-Thoracic Outlet." Ngalesi sikhala kudlula imizwa ebalulekile eya engalweni yakho, kanye nemithambo ethwala igazi engalweni yakho kanye nemithambo ebuyisela igazi lisuka engalweni yakho liye enhliziyweni yakho. Okubaluleke kakhulu kwalokhu yi-brachial plexus, inethiwekhi yemizwa eya engalweni yakho, kanye nomthambo we-subclavian kanye nomthambo.

Ngokuvamile, lesi sikhala esibizwa ngokuthi "indawo yokukhipha ithoni" sikhulu ngokwanele ukuthi lezi zinzwa nemithambo yegazi kudlule ngaphandle kokuvinjelwa. Kodwa-ke, ngezinye izikhathi lesi sikhala singaba sincane ngenxa yokushintshashintsha okuthile komzimba emzimbeni wethu noma ngenxa yokulimala entanyeni noma esifubeni. Yilapho inkinga iqala khona. Lapho lesi sikhala siba sincane, izinzwa noma imithambo yegazi edlula kuso iqala ukucindezelwa amathambo noma imisipha engezansi. Lokhu kucindezela kubangela izimpawu ezifana nobuhlungu kanye nokungazweli engalweni yakho, ehlombe, nasentanyeni. Lezi zimpawu zingase zingahlobene futhi zihluke, ngakho-ke ngezinye izikhathi kungathatha isikhathi ukuqaphela lokhu njengesimo se -TOS .

Kodwa ungakhathazeki. Abantu abaningi bangathola impumuzo ngokwelashwa okulula njengokwelashwa ngokomzimba kanye nemithi yokubulala izinhlungu. Kodwa-ke, uma lokho kungasizi noma uma kukhona ukuvaleka okukhulu kwegazi, kungase kudingeke ukuhlinzwa.

Ingabe zikhona izinhlobo ze-TOS?

Yebo, odokotela bahlukanisa i-TOS ngezinhlobo ezintathu eziyinhloko, kuye ngokuthi yini ebangela lokhu kushaya:

I-TOS ye-Neurogenic (i-Tos ebangelwa ukucindezelwa kwemizwa)

Lolu uhlobo oluvame kakhulu lwe-TOS . Cishe ama-95% azo zonke iziguli ze-TOS analolu hlobo. Okwenzekayo lapha ukuthi i-"Brachial plexus", inethiwekhi yezinzwa ezigijima kusukela entanyeni yakho zidlule emakhwapheni ziye engalweni yakho, iyacindezelwa. Ngokuvamile kwenzeka kubantu abaseminyakeni yabo-30. Ukulimala okuphindaphindiwe kokucindezeleka - ikakhulukazi kwezemidlalo - kanye nokulimala okungazelelwe entanyeni, njenge-"Whiplash" ngenxa yengozi yemoto, yizona zimbangela eziyinhloko.

I-TOS ebangelwa ukuminyana kwemithambo yegazi (i-Venous TOS)

Yilapho "umthambo wakho we-Subclavian" ungena khona. Lona umthambo wegazi oyinhloko othwala igazi elingcolile lisuka engalweni uliyise enhliziyweni. Kwenzeka kaningi emadodeni , ngokuvamile aphakathi kweminyaka engama-20 nengama-30. Izimpawu zivame ukuvela engalweni esetshenziswa kakhulu ('ingalo evelele').

I-TOS ebangelwa ukucindezelwa kwemithambo yegazi (i-Arterial TOS)

Lolu uhlobo lwe-TOS olungavamile kakhulu . Luthinta cishe u-1% wabo bonke abaguli be-TOS. Kodwa-ke, luyimbangela evame kakhulu yokuqhekeka kwegazi okungazelelwe ezingalweni kubantu abangaphansi kweminyaka engu-40. Lolu hlobo lwe-TOS lwenzeka emthanjeni wakho we-subclavian, umthambo wegazi oyinhloko othwala igazi elinomoya-mpilo lisuka enhliziyweni yakho liye ezingalweni zakho. Luvame ukubangelwa ukukhubazeka kokuzalwa. Isibonelo ubambo olwengeziwe entanyeni (ubambo lomlomo wesibeletho). Cishe abantu abangu-70% abanebambo lomlomo wesibeletho ngabesifazane, ngakho lolu hlobo lwe-TOS luvame kakhulu kwabesifazane.

Odokotela ngezinye izikhathi bahlanganisa izinhlobo ezimbili ze-venous kanye ne-arterial TOS bese bezibiza ngokuthi "i-Vascular Thoracic Outlet Syndrome." Zombili izinhlobo zivame ukudinga ukuhlinzwa ukuze kuncishiswe izimpawu futhi kuvinjelwe izinkinga. Uhlobo lwe-TOS oluhlobene nemizwa (i-Neurogenic TOS) lusabela kahle ekwelashweni ngokomzimba nasekuzivocavoceni, kodwa abanye abantu bangadinga ukuhlinzwa.

Sivame kangakanani lesi simo?

Ngokusho kwabacwaningi, minyaka yonke:

• I-TOS ye-neurogenic yenzeka cishe koyedwa kubantu abangu-40,000.
• I-Venous TOS yenzeka cishe koyedwa kubantu abayizigidi ezingu-1.25.

Kodwa-ke, ngenxa yobunzima bokuhlonza lesi simo ngokunembile, inani langempela labantu abaphethwe yilesi sifo lingase libe phezulu kakhulu.

Ziyini izimpawu ze-TOS?

Izimpawu ze-TOS zivame ukwenzeka ohlangothini olulodwa lomzimba wakho ongaphezulu (intamo, isifuba esingaphezulu, ihlombe, ingalo, noma iminwe). Ungase ubhekane nezinto ezifana nalezi:

• Ubuhlungu: Lobuhlungu bungakhula uma uphakamisa ingalo yakho.
• Ukuba ndikindiki noma umuzwa "wokukhasa".
• Ukuba ndikindiki, ukungazizwa lutho esandleni .
• Ubuthakathaka besandla.
• Ukuvuvukala noma ukusinda esandleni.
• Umbala wesikhumba uyashintsha (isikhumba siyashintsha sibe mhlophe noma sibe luhlaza okwesibhakabhaka).
• Ukuzizwa ubanda uma uthinta isikhumba.
• Amanxeba eminwe athatha isikhathi eside ukuphola.

Lezi zimpawu zingase zihluke kuye ngohlobo lwe-TOS onayo. Ngoba izimpawu zincike kulokho okucindezelwayo (umthambo noma umthambo wegazi). Ukuze kube sobala, yilezi ezilandelayo:

• "I-brachial plexus" yakho yilapho ingalo yakho ithola khona ukunyakaza kwayo kanye nomuzwa wayo. Ngakho-ke, lapho le nethiwekhi yezinzwa icasulwa, kuvela izinto ezifana nobuhlungu kanye nokungazweli.
• Umthambo wakho we-subclavian yiwona othwala igazi lisuka engalweni yakho uliyise enhliziyweni yakho. Ngakho-ke, uma lo mthambo uvalekile, igazi elingalweni lakho alikwazi ukuphuma kahle, okwenza ingalo yakho ivuvuke futhi izwakale isinda.
• Umthambo wakho we-subclavian unikeza igazi elinomoya-mpilo engalweni yakho. Ngakho-ke, uma lo mthambo uvaliwe, ukugeleza kwegazi engalweni yakho naseminweni yakho kuyancipha. Lokhu kungabangela ukungakhululeki, ukuqaqamba, ubuhlungu, kanye nokubanda engalweni yakho.

Ubuhlungu be-TOS buzwakala kanjani? Ingabe budidaniswa ne-angina?

I-TOS ingadala ubuhlungu entanyeni yakho, esifubeni esingaphezulu, ehlombe, kanye nasengalweni. Lokhu kungaba ubuhlungu obungajabulisi, njengobuhlungu obuhlala buqhubeka, futhi kungase kube kubi kakhulu uma ushukumisa ingalo yakho.

Abanye abantu badidanisa ubuhlungu be-TOS ne -angina , isimo senhliziyo. I-Angina ubuhlungu besifuba obubangelwa ukuthi imisipha yenhliziyo ayitholi umoya-mpilo owanele. Kodwa kunemehluko obalulekile phakathi kwalokhu okubili:

• Ubuhlungu be-TOS abuveli noma bube bubi ngokuhamba. Kodwa-ke, ubuhlungu be-angina buvame ukuba khona. I-angina ingahambisana nezinye izimpawu ezifana nokuphelelwa umoya, ukushaya kwenhliziyo okusheshayo, kanye nesiyezi.
• Ubuhlungu be-TOS buvame ukwanda lapho ingalo ethintekile iphakanyiswa. Lokhu akwenzeki nge-angina.

Okubalulekile: Ungadidanisi i-TOS nokuhlaselwa yinhliziyo noma isifo sohlangothi!

Lokhu kuyinto okufanele uyikhumbule . Ezinye zezimpawu ze-TOS zingafana nezezimo ezibucayi njengokuhlaselwa yinhliziyo kanye nesifo sohlangothi, ezidinga ukwelashwa okuphuthumayo. Isibonelo:

• Ubuhlungu besifuba , ikakhulukazi uma bufika ngokuzumayo nangokungalindelekile, bungaba uphawu lokuhlaselwa yinhliziyo. Kodwa-ke, ekuhlaselweni yinhliziyo, kungase kube nezimpawu ezengeziwe, njengokuphelelwa umoya, ubuhlungu besisu, ukujuluka, kanye nomuzwa wokwesaba ukufa.
• Ubuthakathaka ohlangothini olulodwa lomzimba kungaba uphawu lokukhubazeka. Kodwa-ke, ukukhubazeka kungaba nezimpawu ezengeziwe, njengokukhuluma okungaqondakali, ukugoba kohlangothi olulodwa noma zombili zobuso, kanye nokulahlekelwa umbono ngokuzumayo.

Uma unezimpawu zokuhlaselwa yinhliziyo noma isifo sohlangothi, funa usizo lwezokwelapha ngokushesha. Lezi yizimo eziphuthumayo ezisongela impilo. Ukuhlehlisa ukwelashwa kungaba yingozi.

Yiziphi izimbangela ze-TOS?

Odokotela bahlukanisa izimbangela ze-TOS ngezigaba ezintathu eziyinhloko:

Izimbangela zokuzalwa

Lezi ezinye zezinguquko eziba khona emzimbeni wakho lapho uzalwa. Isibonelo, ungase uzalwe unombambo owengeziwe ('umbambo wesibeletho') entanyeni yakho. Lokhu kuseduze, futhi mhlawumbe kuxhunywe nombambo wokuqala. Noma ungase ube nokukhubazeka ezimbanjeni zakho, emisipheni yentamo, noma emithanjeni. Lezi zinguquko zingabangela ingcindezi emithanjeni noma emithanjeni yegazi 'esithobeni sokukhipha izicubu'.

Ngenxa yezingozi (Ezibuhlungu)

Lokhu ukulimala okungazelelwe entanyeni yakho nasesifubeni sakho esingaphezulu. Ukulimala okuvela ezingozini zezimoto, ikakhulukazi i-whiplash, kuyisibonelo esihle salokhu. Cabanga nje, uma ubugibele i-three-wheeler bese uba nengozi futhi intamo yakho yaphuka ngokuzumayo, lokhu kungenzeka.

Ngenxa yemisebenzi eqhubekayo (Esebenzayo)

Lokhu kusho ukuthi uma wenza into efanayo ngokuphindaphindiwe, izinto eziku-"thoracic outlet" ziyalimala. Lesi yimbangela evamile yalokhu phakathi kwabadlali (ikakhulukazi abadlali bekhilikithi - abadlali bebhowuda, abadlali bebhola, kanye nababhukudi) ngenxa yokunyakaza kwezingalo okusheshayo. Esinye isibonelo ukuphakamisa izinto njalo ngaphezu kwekhanda kweminye imisebenzi. Ngisho nomuntu osebenza phambi kwekhompyutha usuku lonke enesimo esibi sokuma angaba sengozini.

Nakuba abanye abantu bezalwa benezici eziyingozi zokuthuthukisa i-TOS, bangase bangabi nazo izimpawu kuze kube yilapho bethola ingozi engazelelwe entanyeni noma behlala benza uhlobo olufanayo lomsebenzi bese yonakala.

Ubani osengozini enkulu yokuthola i-TOS?

Ungase ube sengozini enkulu yokuthola i-TOS uma:

• Uma udlala imidlalo evame ukuhilela ukunyakaza kwezingalo noma kwamahlombe okuphindaphindiwe. Izibonelo: ikhilikithi, ukubhukuda, igalofu, i-volleyball.
• Uma wenza ukuphakamisa izinsimbi.
• Uma uvame ukuthwala izikhwama ezisindayo emahlombe akho noma uphakamisa izinto ngaphezu kwekhanda lakho. (isib., abantu abasebenza embonini yokwakha, abantu abalayisha izimpahla)
• Uma ulimele entanyeni noma emhlane, isibonelo `(Whiplash)`.
• Uma unezimila noma ama-lymph node amakhulu esifubeni esingaphezulu noma ekhwapheni.
• Uma ukuma kwakho kokuma noma ukuhlala kwakho kungalungile. (Isibonelo: abantu abasebenza kukhompyutha begobe umhlane usuku lonke)

Ingabe i-TOS iyisimo esibucayi? Yiziphi izinkinga ezingaba khona?

Uma ingelashwa, i-Thoracic Outlet Syndrome ingaholela ezinkingeni ezinkulu. Ezinye zazo zifaka:

• Ukuqhekeka kwegazi ekhwapheni kanye nasemithanjeni ehlobene nayo (`i-Axillo-subclavian vein thrombosis`).
• Ukuvuvukala okuqhubekayo kanye nobuhlungu esandleni, ikakhulukazi kulabo abane-venous TOS (`Venous TOS`).
• Ukufa kwezicubu (`Gangrene`).
• Izilonda ze-Ischemic zenzeka eminweni ngenxa yokuncipha kokugeleza kwegazi.
• Ukulimala kwemizwa okungapheli.
• I-pulmonary embolism - Lesi yisimo esiyingozi kakhulu.

Ngakho-ke, uyabona, akuwona umqondo omuhle ukucabanga ukuthi lokhu kuyinkinga encane nje. Kubaluleke kakhulu ukuyixilonga nokuyiphatha kusenesikhathi.

Wazi kanjani ukuthi unesiqiniseko sokuthi une-TOS? (Ukuxilongwa)

Udokotela uzokuxilonga futhi akubuze ngomlando wakho wezokwelapha ukuze anqume ukuthi une-TOS. Ngesikhathi sokuhlolwa ngokomzimba, udokotela wakho uzokucela ukuthi wenze ezinye izivivinyo zokunyakaza. Isibonelo:

• `Ukuhlolwa kokuqina kwemilenze engenhla` (ukuhlolwa kokubona ukuthi imilenze engenhla ithintekile yini)
• `Ukuhlolwa kokucindezeleka kwengalo okuphakanyisiwe`

Phakathi nalezi zivivinyo, udokotela wakho uzokucela ukuthi wenze izinto ezilula njengokuphakamisa ingalo yakho, ukujika ikhanda lakho, nokuxhawula isandla sakho. Uzobe esebheka ukuthi yikuphi ukunyakaza okubangela ubuhlungu noma ezinye izimpawu. Imiphumela ingasiza ekuxilongeni isimo.

Ngaphezu kwalokho, udokotela wakho angase acele ukuhlolwa kwelebhu kanye nokuhlolwa kwezithombe ukuqinisekisa ukutholakala kwe-TOS nokukhipha ezinye izimbangela zezimpawu zakho.

Yiziphi ezinye izivivinyo ozenzayo?

Kungadingeka ukuthi wenze olunye noma ngaphezulu lwalezi zivivinyo:

• Ukuhlolwa kwegazi .
• I-X-ray yesifuba .
• Ukuhlolwa kwesifuba kanye/noma umgogodla nge-CT scan .
• Ukuhlolwa kwe-EMG (`I-Electromyography (EMG)`) – Lokhu kuhlola ukusebenza kwemisipha kanye nezinzwa.
• I-magnetic resonance angiography (MRA) yemithambo yegazi yakho .
• I-magnetic resonance imaging (MRI) yesifuba kanye/noma umgogodla .
• Ucwaningo lokuqhutshwa kwemizwa - Lokhu kulinganisa isivinini imiyalezo ehamba ngaso ngemizwa.

Lezi zivivinyo zingasiza udokotela ukuthola ukuthi:

• Hlola ukukhubazeka kokuzalwa (isib. ubambo lomlomo wesibeletho).
• Hlola ukuthi igazi ligeleza kanjani emithanjeni yakho yemithambo yegazi kanye nemithambo yegazi.
• Susa ezinye izimo ezingase zibangele lezi zimpawu.
• Bheka ukusebenza kwemisipha yakho kanye nemizwa.
• Thola ukuthi ingcindezi ikuphi ngempela.

Yiziphi izindlela zokwelapha i-TOS?

Ukwelashwa kwe-TOS kuyahlukahluka kuye ngohlobo lwe-TOS onalo kanye nezimpawu zakho. Umgomo oyinhloko wokwelashwa ukunciphisa izimpawu nokuvimbela izinkinga ezingaba khona. Udokotela wakho uzonquma ukuthi yikuphi ukwelashwa okungcono kakhulu kuwe.

Nazi ezinye izindlela zokwelapha ezingaba khona:

• Ukwelashwa ngokomzimba: Lona umugqa wokuqala wokwelashwa kwe-TOS ebangela ukungezwani kwezinzwa. Udokotela wezokwelapha ngokomzimba angakusiza ukwandisa ububanzi bokunyakaza kwakho entanyeni nasemahlombe akho, aqinise imisipha yakho, futhi alondoloze ukuma okufanele. Lokhu kuyimpumuzo enkulu kubantu abaningi abane-TOS ebangela ukungezwani kwezinzwa.
• Imithi yokuqeda ubuhlungu: Udokotela wakho angase akunike imithi yokuqeda ubuhlungu, njenge-NSAID (imithi elwa nokuvuvukala engeyona i-steroidal), ongayithenga ekhemisi.
• Imithi evimbela noma encibilikisa amahlule egazi:Abantu abane-TOS yemithambo yegazi noma yemithambo yegazi bangasizwa ngokwelashwa nge-thrombolytic. Lokhu kuhilela ukunikeza imithi nge-IV line noma i-catheter ukuze kuncibilikiswe amahlule akhona futhi kuvinjelwe amasha ukuthi akheke. Udokotela wakho angase futhi akunike imithi yokuvimbela ukugabha kwegazi.
• Ukuhlinzwa: Abantu abaningi abane-TOS ecindezela imithambo noma imithambo badinga ukuhlinzwa. Abanye abantu abane-TOS ecindezela imizwa nabo bangadinga ukuhlinzwa uma ezinye izindlela zokwelapha zingasizi. Odokotela abahlinzayo basebenzisa amasu ahlukene okuhlinzwa kuye ngohlobo lwe-TOS kanye nohlobo lomzimba wakho. Isibonelo, ukuhlinzwa kokunciphisa ukucindezeleka kususa ithambo noma izicubu ezingavamile ezibangela ukucindezeleka. Okunye ukuhlinzwa kungathuthukisa ukugeleza kwegazi ngokulungisa izinkinga zesakhiwo emithanjeni yegazi. Udokotela wakho uzochaza ukuthi udinga ukuhlinzwa, ukuthi kwenziwa kanjani, nokuthi yiziphi izingozi.

Ingabe i-TOS izothuthuka yodwa ?

Cha, ungalindi ukuthi izimpawu zibe ngcono zodwa. Uma unezimpawu ze-TOS , funa usizo lwezokwelapha ngokushesha. Nakuba izinto ezilula njengokwelashwa ngokomzimba zivame ukusiza ekunciphiseni izimpawu, abanye abantu bangadinga ukuhlinzwa noma ezinye izindlela zokwelapha ukuvimbela izinkinga ezinkulu. Udokotela wakho uzokutshela ukuthi yiluphi uhlelo lokwelashwa olukulungele.

Ingabe i-TOS ingavinjelwa?

I-TOS ayinakuvinjelwa ngaso sonke isikhathi. Ngenxa yokuthi izici eziningi ezibangela lokhu zingaphezu kwamandla ethu (isib. izici zofuzo), kunezinto ezithile ongazenza ukuze unciphise ingozi yakho:

• Uma udlala umdlalo odinga ukunyakaza kwezingalo njalo, khuluma nomqeqeshi wakho noma umqeqeshi wakho mayelana nokuzivocavoca okungaqinisa imisipha ezungeze amahlombe akho.
• Uma umsebenzi wakho udinga ukuthi uphakamise izinsimbi noma usebenze kanzima, khuluma nodokotela mayelana nokuzivocavoca okunganciphisa ingozi yokulimala.
• Gcina ukuma okufanele. Gcina umhlane wakho uqondile ngenkathi uhleli, umile, futhi usebenza.
• Ungahlali endaweni efanayo ngaso sonke isikhathi. Sukuma uhambehamba okungenani kanye ngehora, welula umzimba wakho kancane.

Uma une-TOS, yini okufanele uyilindele? / Ungazinakekela kanjani?

Umbono womuntu one-TOS uyahlukahluka kuye ngohlobo lwe-TOS analo. Udokotela wakho angakutshela kangcono ngombono wakho.

Uma une-TOS, landela imiyalelo kadokotela wakho yokuthi ungazinakekela kanjani. Udokotela wakho angakutshela izinto ezifana nalezi:

• Yehlisa noma uyeke ukuthwala izikhwama ezisindayo phezu kwamahlombe akho futhi uphakamise izinto phezu kwekhanda lakho ngangokunokwenzeka.
• Sebenza nodokotela wezokwelapha ngokomzimba. Yenza izivivinyo akunikeza zona.
• Yenza izivivinyo ongazenza ekhaya ukuze uqinise imisipha yakho futhi uthuthukise ukuma kwakho.
• Nciphisa noma ugweme ukunyakaza okuthile okwandisa izimpawu.Shintsha indlela yakho yansuku zonke.

Kufanele ubonane nini nodokotela? / Imibuzo okufanele uyibuze udokotela

Uma uba nezimpawu ezintsha noma uma izimpawu zakho zishintsha, khuluma nodokotela wakho. Uzokutshela ukuthi kufanele ubonane kangaki nodokotela wakho nokuthi ngabe udinga ukuhlolwa yini.

Uma usanda kutholakala ukuthi une-Thoracic Outlet Syndrome, nansi eminye imibuzo ongayibuza udokotela wakho:

• Uhlobo luni lwe-Thoracic Outlet Syndrome enginalo?
• Iyini imbangela yalokhu?
• Yikuphi ukwelashwa okuncomayo? Kufanele kwenziwe nini?
• Sazi kanjani ukuthi ukwelashwa kuphumelele?
• Ziyini izingozi zokwelashwa?
• Yiziphi izinguquko okudingeka ngizenze emisebenzini yami yansuku zonke noma emikhubeni yami evamile?
• Yini engingayenza ekhaya ukuze nginciphise izimpawu?
• Uyini umbono wami?

Izinto okufanele uzikhumbule kulesi sihloko (Umyalezo Wokuya Ekhaya)

I-Thoracic Outlet Syndrome (TOS) ingaphazamisa impilo yakho evamile. Kungaba yinto ekhungathekisayo ukuthatha ikhefu kwezemidlalo noma emsebenzini wakho. Kodwa yiba nesineke. Ngokuzinakekela ngokwelashwa ngokomzimba noma ngezinye izindlela zokwelapha, ungaphinde uthole amandla akho futhi uhlale uphilile ngokuhamba kwesikhathi.

Into ebaluleke kakhulu ukufuna iseluleko sezokwelapha uma unezimpawu, kunokuzishaya indiva. Ukutholwa kusenesikhathi kwenza ukwelashwa kube lula futhi kunciphisa ingozi yezinkinga.

Uma unemibuzo mayelana nesimo sakho, uhlelo lokwelashwa, noma umbono wakho, khuluma nodokotela wakho.

Isifo Se-Thoracic Outlet, i-TOS, ubuhlungu bentamo, ubuhlungu bengalo, ubuhlungu behlombe, ukungazweli, ukucindezelwa kwemizwa