Kuchengetedza Kwevanhu Vakagadzikana Nechirwere Chete: Chii Chaunofanira Kuziva?
Kunyangwe achitaura shoko izwi rinoparidzira rinotyisa kune ani zvake anorarama nekenza. Zvinosuruvarisa, shoko rokuti hospice dzimwe nguva rinoenzaniswa nekusiya, kunyange iri kure neizvozvo.
Nekenza yemapapu, vanhu vazhinji vanokundikana kugamuchira zvigaro zvekuchengetedza kusvikira mazuva ekupedzisira ekurwara kwavo. Panguva imwecheteyo, vamwe vanhu vanosarudza kutarisira varwere kuti kune nzira itsva uye inobudirira yekurapa mukwere wavo wakamera wemapapu .
Chii chaunoda kuziva kuti uve nesimba mukuita chisarudzo pamusoro pekuchengetedza varwere; zvose kuve nechokwadi chokuti hausi "kutumbuka pfuti" kana mushonga unoshanda huripo unogona kuwedzera hupenyu nehuwandu hwemigumisiro, nekusarudza iyo nzira yekuchengetedza nokukurumidza kuitira kuti ugone kuwana mhindu?
Sei Zvakakosha Kutaura Nezvipatara Paunenge Uchinzwa Zvakanaka?
Pakati pevanhu vane mutsa wemapapu , tinoziva kuti hospice inoshandiswa. Isuwo tinoziva kuti vanhu vazhinji vanosarudza hospice chete pamagumo ehupenyu hwavo-mazuva ekupedzisira uye pamwe mavhiki-asingabatsiri zvakawanda zvezvikomborero zvepurogiramu iyi.
Panguva imwecheteyo, kurapwa kwemukenza wemapapu kwakashanduka zvakajeka mumakore achangobva kupfuura, uye pane kuchinja kweparadimu mukutungamirirwa kwezvikamu zvakatangira zvechirwere. Mishonga isinganzwisisiki yemakore gumi apfuura ikozvino inoita kuti vamwe vanhu vararame kwenguva yakareba kupfuura kare; kunyange nechitsauko 4 yemukenza wemapapu.
Pakati pekuchinja uku, ungaziva sei kuti inguva yekusarudza hospice? Ngatitange nekutaura pamusoro pechirwere chaicho uye kuti zvinorevei kwauri. Ipapo ngatitaurei nezvekuita sarudzo iyi inorwadza.
Zvinosuruvarisa, zvidzidzo zvinotitaurira kuti vanachiremba vakawanda vanokundikana kuuya nevanotarisira kutarisira. Zvinorevei ndezvikuti iwe nemhuri yako munogona kudii kutanga nhaurirano nachiremba wenyu, uye zvichida zvisati zvaitika.
Mukuwedzera pakuve nemukana wekubatsirwa nehutano hwekufambisa, chidzidzo che 2017 chakawana kuti kukurukurirana kwepakutanga kwekuchengetedza vanhu vane chirwere chemapapu kwakaguma nekurwisa kusina maturo pakuguma kwehupenyu. (Kwakanga kusina musiyano mukupona kwevaya vaiva nechisimba pakupedza pamagumo ehupenyu neavo vasina.) Mukumwe kuongorora, nhengo dzemhuri dzevanhu vane kenza yemapapu dzakanga dzave nekunyoreswa kwepachipatara munguva yekare dzaive nemaonero akanaka ekuguma kwe kutarisira hupenyu kune vadiwa vavo kupfuura avo vasina.
Chii Chinonzi Chipatara Chirwere Chemhino?
Panzvimbo ye "nzvimbo," kunyange kune zvivako zvinopa kutarisira varwere, hospice inowedzera huzivi. Inotsanangurwa semuitiro unopa vanhu vane tsitsi uye vane hanya nehanya nevanhu muzvikamu zvekupedzisira zvezvirwere zvisingaregi kuitira kuti vararame zvakakwana uye zvakanyatsogona sezvinobvira.
Chinangwa chekuchengetedza chirwere ndechekubata munhu wacho panzvimbo pechirwere nenzira isingakurumidze kana kuchinja rufu.
Vanhu vazhinji vanovhiringidzika pakati pekuchengetwa kwekuchengetedza nekuchengetwa kwepamusoro sezvo zvose zvinotarisa pamusoro pokuzorodzwa kwezviratidzo uye kupa mutsigiro, mumuviri, uye mumweya. Chinhu chakasiyana-siyana ndechokuti kuchengetedza kwepfungwa kunogona kushandiswa chero nguva, kunyange nekenza inoporesa, asi kuchengetwa kwekuchengetedzwa kwevanhu kunogadzirirwa vanhu mumwedzi 6 yekupedzisira yehupenyu.
Kune ngano dzakawanda pamusoro pekuchengetedza varwere , kusanganisira nhema yokuti pakusarudza kutarisira kutarisira uri "kurasa." Icho chiri kure nechokwadi, uye pakusarudza vanhu vanochengetedza vanogara vachiita chisarudzo chekugara kunze kwemazuva avo ekupedzisira mukuremekedzwa nekunyaradza.
Haasi yese yekuchengetedza varwere yakangofanana, uye kune zvikamu zvina zvakasiyana-siyana zvekuchengetwa kwekuchengetwa kwevanhu vanochengetedzeka maererano nemhinduro yeMedare. Izvi zvinosanganisira:
- Nharaunda 1: Routin health care. Izvi zvinopa hutano huripo kubva pakuchengetwa kwekuchengetedza kunotsigirwa mupfungwa.
- Nhamba 2: Kuenderera mberi kwekuchengetwa kwemusha. Kuenderera mberi kwekuchengetedza kumba kunowanzosarudzwa kwenguva pfupi inoshandiswa apo kurwadziwa kwakanyanya kana kupererwa kwemhepo iripo. Kuchengetedza kunoongororwa zuva rega rega uye mukoti kana musha wehutano rubatsiro runobva maawa 8 kusvika ku24 pazuva.
- Nhamba 3: Gara rekuchengetedzwa kwepfungwa. Iyi nheyo yakafanana nekuchengetwa kwekugara kweimba asi pane vanhu vanofarira kuchengetwa mune chirwere chechipatara.
- Nhamba yechina: Kuchengetedza. Rutsigiro rwekuchengetedza nderwenguva isingakoshi muhutano kune avo vanogamuchira nheyo 1 yekuchengetedzwa kwekuchengetedza, asi mutarisiri wekutambudzika ari kukonzera matambudziko uye mhuri inoda kupfupika kwenguva pfupi. Iko kunowanzosvika 5 muganhu wezuva pane izvi.
Ndezvipi Zvipi Zvinopiwa Nehwere?
Zviri nyore kunzwisisa zvirongwa zvinopiwa newa hospice kana iwe unonzwisisa kuti hospice yakagadzirirwa kutarisira munhu mumuviri, mupfungwa, uye mumweya, uye kwete chete munhu ari kufa, asi mhuri yose. Mimwe yemasangano anopiwa nevechipatisheni anosanganisira:
- Chiratidzo chekuchengetedza: Girasi rako rekuchengetedza varwere rinoshanda kuti ripe mishonga uye rubatsiro kubatsira nezviratidzo zvakadai sekurwadziwa , kupera kwekufemerwa , kusuruvara kana kurutsa, uye zvimwe zviratidzo zvekenza yako kana zvimwe zvinokonzerwa nemishonga yawakave nayo.
- Kuchengetedzwa kwevarwere : Vanhu vazhinji vanogona kusarudza musha kana kuti chirwere chekuchengetedzwa kwepachipatara. Kune avo vanosarudza pamba, kuchengetedza chirwere chepfungwa (kwemazuva anosvika kumashanu) kunopiwa apo nhengo dzemhuri dzinodedera kana dzinoda kuputsa chero chikonzero chipi nechipi.
- Kuchengetwa kwemweya: Seboka rako rekuchengetedza varwere rinosanganisira vafundisi vanogona kukubatsira nemibvunzo yakaoma yakasangana pamagumo ehupenyu. Izvi zvinogadzirirwa izvo zvaunoda uye hazvikurudziri kana kusabvisa imwe tsika yechitendero pane imwe.
- 24/7 kuwana: Uchakwanisa kuonana neboka rako rekuchengetedza varwere panguva ipi zvayo yemasikati kana usiku nemibvunzo chero ipi zvayo kana zvinetso zvaunazvo.
- Kutsigirwa kwemhuri: Tora yekuchengetedza mhuri inowanikwa, uye kunze kwekubatsira mhuri yako kunzwisisa zvauri kutarisana nemishonga, rubatsiro runopiwa nezvemibvunzo yavo uye kutambura kwemanzwiro. Misangano yemhuri inogonawo kuitirwa kuitira kuti nhengo dzemhuri dzigone kugovana zvavari kunzwa, uye kutaura pamusoro pekutya kwavo nezvinetso.
- Kuchengetedzwa kwekuchera : Kwemwaka wegore rose mushure mekufa, hospice inopa rubatsiro kune nhengo dzemhuri dzinopona. Izvi zvinogona kusanganisira kupa mazano kana kuti vafundisi pachavo kana nefoni.
Unogona Kuramba Uchingorapwa Here Paunenge Uchishanda?
Vanhu vazhinji vanotya nekusarudza kuporesa sezvo vachifunga kuti kurapwa kunomira zvakakwana. Izvi hazvisi chokwadi. Mukusarudza hospice iwe unosarudza kupikisa kutsvaga kushandiswa kwakasimba kwekenza yemapapu ako, asi izvi hazvirevi kuti mishonga yose ichaguma. Misiyano ndeyokuti kurapwa kunotarisa kununurwa kwezviratidzo nekuvandudza mararamiro ako ehupenyu panzvimbo yekurapa kenza pachayo.
Vapateri vakasiyana-siyana vanopa mazano akasiyana-siyana pamusoro pezvinoitwa kushanda nesimba. Semuenzaniso, kushandiswa kwehutano hwekudya kunogona kuonekwa kana kusingafungidzirwi kutarisirwa kwehutano zvichienderana nesangano rekuchengetedza. Nemukenza wemapapu zvakanyatsonaka, zvirongwa zvekuchengetedza varwere zvinogona kusiyana mune izvo zvinogamuchirwa zvakadai sekutungamirirwa kwechirwere chinosuruvarisa chisingaiti (kuwedzera kwemvura kumativi emapapu ane kenza masero).
Mamwe mapurogiramu angangotarisa kudonha mvura inoshandiswa kana kuisa zviyero zvinotapira zvinokonzera kukurumidza kufema. Mumwe muenzaniso ungadai uri kurwadziwa kana kuputika nemhaka yemasitasase emapfupa. Radiation therapy (kana bone bone modifying agents) dzimwe nguva inoshandiswa kuderedza marwadzo, asi inogona kana kuti isingafungi sechimiro che "kushanda zvakasimba" zvichienderana nesangano rekuchengetedza. Imwe fungiro inogona kuva kushandiswa kwemvura inopisa kana munhu ane chiratidzo nokuda kwekudzikisa mvura.
Zvechokwadi, kurapwa kunonyanya kuratidza marwadzo, kufema kunetseka, uye kushungurudzika kwakavharwa, sezvo chinangwa chiri kukurisa hupenyu hwako.
Unofanira Kusarudza Kupi Mukana Wekuchengetedza Mukana Wekenza?
Hospice inowanzokurudzirwa apo njodzi nemigumisiro yezvimwe zvirwere zvichange zvichinyanya kukosha. Zvechokwadi ichi chiyero icho munhu mumwe nomumwe anoda kuzviyera, uye mhinduro yacho inogona kusiyanisa pakati pevanhu vakasiyana. Hapana chakakosha uye chakashata pane izvi zvinonzi; chete chisarudzo chakanaka iwe nemhuri yako.
Zvakakosha kuziva kuti nekufambira mberi mukurapa kenza yemapapu mumakore achangopfuura, kunyange kuchinja kwakaitika pakati pegore ra2015 na2017, mhinduro yacho inogona kunge yakasiyana zvikuru kupfuura ingadai yakanga iri makore mashomanana akapfuura.
Newer Treatment Options yekufunga nezvazvo Usati wasarudza Hospice
Munguva yakapfuura, nekenza yemapapu isingagoneki pane zvishoma chete zvingasarudzwa. Chirwere chemajekiseni mumagariro emukenza wemapapu yakakurumbira inonyanya kufara-yakagadzirirwa kuderedza marwadzo uye kutambura. Iyo inowanzosiya chemotherapy chete sechinhu chisarudzo chingawedzera upenyu; uye kuenzanisa njodzi nemigumisiro ye chemotherapy regimens yaiva mubvunzo mukuru.
Izvi zvakashandura zvakanyanya nemaitiro matsva ekurapwa zvakadai sekurapa kurapa uye immunotherapy. Zvakakosha kuti munhu wose ane kero kaduku kadiki yemapapu yemapapu ane kufungidzirwa kwema molecular (kuongorora kwejeni) yakaitwa pamaronda avo, kwete vose vanofanirwa nemishonga iyi vanoziva kuti varipo. Kana kuchinja kunogadziriswa kwakadai sekuchinja kwe EGFR , rearrangement ye ALK , kana reROS1 rearrangement gene .
Immunotherapy imwe imwe nzira iyo dzimwe nguva inobudirira (uye zvinoshamisa kune vamwe vanhu) vane cancer yemapapu yakakura. Iyi mishonga inowanzoita kuti ibudirire kana iwe uine PD-L1 kuongorora kunoratidza mazinga akareba. Kunyange zvazvo immunotherapy mishonga isingashandi kune munhu wese, inogona, kune vamwe vanhu, inoguma nekupindura kwenguva refu (kwenguva yakareba kudzora kenza).
Zvirongwa zvekurapa pamwe nekuzivikanwa kwemishonga inogadzirisa zvirwere hazvisi kunze kwemigumisiro, asi inowanzomirirwa zviri nani kupfuura tsika dzekemotherapy.
Zvakakosha kucherechedza kuti, kunyange kana kurapwa nevanenge vakatarisa, immunotherapy, kana chemotherapy zvingawedzera hupenyu, vamwe vanhu vachasarudza kusafambisa kurapwa. Kuenda kuburikidza nekenza mishonga yemhando ipi zvayo haisi nyore kune ani zvake, uye vamwe vanhu vari kungonzwa vachineta kuti vatevere dzimwe nzira dzokurapa Mukuita sarudzo yako unoda kukudza zvaunoda uye kuita sarudzo yakakunakira iwe pachako, kwenguva refu sezvo iwe uchiziva zvizere zvaunosarudza. Mukuwedzera, kunyange zvazvo kurapwa uku kunogona kubudirira dzimwe nguva, pakupedzisira marapirwo akawanda anoramba kushanda, uye chisarudzo pamusoro pekuchengetedza chirwere chichasangana.
Kubva pakusarudza kurapwa ndiko kunyanya kuita sarudzo yekurega kurapwa, tora nguva yekutaura nemhuri yako pamusoro pezviitiko izvi zvokufunga nezvazvo usati warega kurapwa kwemukenza .
Mibvunzo Yokubvunza Usati Wasarudza Hospice
Chisarudzo chokusarudza hospice chinogona kukurira, asi chinogona kubatsira kubvunza mibvunzo yakawanda:
- Pane imwe nzira yakasara yekurapa here? Pakubvunza mubvunzo uyu iwe ungada kubvunza zvakananga nezvemakemikirwo emakemikirwo, mazano ekurapa maitiro, zvirongwa zve immunotherapy, pamwe nekukwanisa kwepi zvese makiriniki maedzo angave akakodzera iwe.
- Unhu hupi hwehupenyu hwakafanana nanhasi? Iwe unoda kuti hupenyu hwako huve hupi? Pane zvimwe zvirwere zvinoderedza hupenyu hwako huri mberi here?
- Wakave wakanyatsotarisa kutarisirwa here? Kunyatsotarisirwa kunetseka kunotaura nezvehukama hwako, hwepfungwa, uye hwemweya kunyange kana chinangwa chenyu chiri chirwere.
- Mhuri yako inonzwa sei pamusoro pechisarudzo chako?
- Iscare care hospice yakavharwa nehutano uhu inshuwarisi kana hospice Medicare inobatsira here?
Tora kanguva kurondedzera zvose zvakanakira uye kukanganisa kwekuchengetwa kwekuchengetedza . Dzimwe nguva kuzviona izvi pamapepa ari madema uye machena zvinogona kuita kuti sarudzo yako ionekwe zvakajeka.
Nzira Yokuwana Nayo Yakanakisisa Inotarisira Kuchengetedza
Kuwanikwa kwekuchengetwa kwekuchengetwa kwevarwere kunopesana zvichienderana nekugara kwaunogara, uye kunowanzova nyore kana iwe uchigara mune rimwe remaguta panzvimbo yekumaruwa. Chigadziro chekutanga ndechekusarudza kana iwe uchida kuva neimba-yekuchengetedza mumba kana kana uchida kuva mune imwe nzvimbo yekuchengetedza. Hapana chakanaka chakanaka, uye chisarudzo chakanakisisa iwe iwe nemhuri yako unonzwa kuti chakakunakira iwe.
Nharaunda dzakawanda dzine vanopfuura vanoripira varwere, saka iwe uchada kusarudza kuti ndiani anonyatsosangana neunoda. Wako oncologist uye mukoti oncology anogona kubatsira. Kana iwe uchibatanidzwa mumapoka ekutsigira kenza yemapapu kana munharaunda, unogona kukumbira mazano kubva kuvanhu ava zvakare. Panewo masangano ehurumende uye enyika, akadai sangano rako rekuchengetedza, iyo iwe unogona kutaurirana nemibvunzo.
Zvakadini Kana Uchishandura Pfungwa Dzako?
Zvakakosha kune ani zvake anosarudza kutarisira varwere kuziva kuti zvakakodzera kuchinja pfungwa dzako. Kana ukasarudza kuti unoda kudzokerazve chekushanda kenza yakasimba, kana kana mushonga mutsva kurapa kenza yemapapu inogamuchirwa uye chisarudzo kwauri, unogona kubva nguva dzose muchipatara.
Shoko Rinobva
Kutaura pamusoro pekuchengetedza chirwere ndiko kukurukurirana kwakaoma kune vanhu vane kenza uye avo oncologist zvakafanana. Zvinosuruvarisa, tinoziva kuti vashomananawo vanhu vanosarudza kuvepa hospice kusvikira vaswedera pedyo nekufa, uye vanorasikirwa nemhando dzakawanda dzehutano hunochengetedza hospice inogona kupa. Chisarudzo pamusoro pekurapwa nemukenza wemapapu chinonyanya kusanganisira mibvunzo nemafungiro akawanda kupfuura kare, nekuda kwekufambira mberi pakuchengetwa kwekenza yemapapu yakapfurikidza seyakarongwa nemishonga uye immunotherapy.
Hapana vanhu vaviri kana maviri kanzira dzakasiyana, uye hakuna munhu anogona kukugadzirisa ichi chinokosha. Zvakakosha kunzwisisa zvose zvaunogona kuita, uye wozoita sarudzo inokudza iwe pachako iwe neyemhuri yako. Izvozvo zvakati, tsvakurudzo dzakawanda dzakawana kuti mhuri dzevanhu vane kenza yemapapu dzinotenda hunodiwa hwehudiwa hwehupenyu hwaive huri nani apo kutarisira chirwere kwakasarudzwa kare pane kupfuura gare gare muzvikamu zvekupedzisira zvechirwere.
> Sources:
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