Mushure mekutumira kwangu, " POTS - Who's the Real Grinch ," Ndakasangana naDkt. Benjamin Levine, uyo wandakadzidza purogiramu iyoyo. Dr. Levine akaita dzimwe pfungwa dzakanakisisa, saka ndakazvipira kuparidzira mhinduro kubva kwaari kana aifarira kuisa mumwe. Heino izvozvi. (Ndakagadzirisa mhinduro yake nokuda kwehupfupi uye ndakawedzera mazwi angu pakupedzisira.)
Anodiwa Dr. Fogoros,
Ndinokutendai nokuda kwebhuku rako rebhubhu pamusoro pekutsvakurudza kwedu kune varwere vane POTS - Ndinokoshesa mukana wekupa mazano mashomanana ekujekesa pamusoro pekudzidza iwe wakanyatsokurukura uye mamwe ekududzirwa kwezvinoreva kubva mukutsvakurudza.
1) Kukurudzira kwekutsvakurudza kutsvakurudza . Chokutanga pane zvose, regai ndikuratidzei kuti handina kumbo "kusimbisa" basa redu mune chero zvinyorwa zvemashizha, uye hapana mumwe munhu ari munharaunda yangu. Kutaura chokwadi, ini handiri mukuru mukuru wekubudisa nhau yezvesayenzi data, uye kunyange ini ndichataura nevanyori venhau kana vachidana kana ndikagona kupa chero humwe unyanzvi hwakasiyana, ini handitsvaki. Sezvandinoziva iwe unoziva, hatina simba pamusoro pevanyori venhau vanotaura nezvebasa redu. [Hezvino Dr. Levine akabatanidza vignette inotsanangura kuti mashizha ehurumende anokanganisa sei zvidzidzo zvezesayenzi, dambudziko rakafanana randakave narinosangana naro. RF] Vateereri vedu pamapepa edu ndevamwe vanachiremba uye masayendisiti, avo vanofanirwa kushandura dhepheni maererano nekuziva kwavo uye kuverenga kwemabhuku.
Ndinokutaurira iwe, nevarwere vose vanofanira kuwana ruzivo rwavo kubva kune vhidhiyo kuti varege kupfuura-kududzira zvavanenge vaverenga mumutsamba kana kuona paTV ...
2) POTS haisi kukonzerwa ne "usimbe." Nhau inotaurwa nevakawanda vevakapindura nyaya yako inonyanya kufanana nevatachiona vedu vePOTS zvakare. Vazhinji vevarwere vandinoona vaishanda zvikuru (semashambadziro edu, avo vatakagadzirira POTS chirongwa chekudzidzisa) zvisati zvaitika kune chimwe chinhu - kune vamwe utachiona hwehutachiona; vamwe kukuvara kana zvimwe zvirwere; vamwe ndiko kutora mimba kana zvinetso zvekupa mwana.
Ichi "chiitiko chetinel" chinokonzera chinhu chimwe chete chinoitika - chinoisa vanhu kurara.
Zvakakosha kusimbisa kuti kunyange maawa makumi maviri ekuzorora pamubhedha anogona kukonzera kurasikirwa kweplasma yepamusoro, kusina simba baroreflex basa, uye hutsika hunoita mutema mukati mevanhu vakawanda. Zviratidzo izvi zvinokurumidza kununurwa nekurara pasi uye kunokonzera kukurumidza kuderera kunokonzera kusagadzikana kwemashoko, hypovolemia (kurasikirwa kweplasma kubva muropa), mwoyo wepatiro (anenge 1% kurasikirwa kwemwoyo musumbu kwevhiki mubhedha) kufambira mberi kwekuvata kwekuvata kwepamusoro uye pakupedzisira kusagadzikana. Pashure pevhiki mbiri bedzi yemubhedha kana nzvimbo yepakati, inenge 2/3 yevanhu haigoni kumirira kwemaminitsi gumi!
Izvi zvakakoshawo kuziva kuti zvidzidzo zvepakutanga kubva panzvimbo yedu yakaratidza kuti ndiyo yaiva mitambo yakanakisisa yevamwe vanga vainge vasina kukwanisika kunyange kunyange nguva shoma (masvondo matatu) zororo zororo, uye kwenguva refu yekudzikinura nguva. Zvechokwadi, vazvipiri vakanga vasati vakodzera vasati vaenda kunorara, vakachimbidzika zvakakurumidza mukupindura kudzidziswa kwakapedzeredzwa, kazhinji mukati memavhiki maviri. Kune rumwe rutivi, ivo vanozvipira zvikuru kumitambo, mushure memavhiki matatu ekuzorora pamubhedha uye mwedzi miviri yekudzidziswa kwakasimba, vakanga vasati vadzokera kuhutano hwavo hwepakutanga. Zvinoshamisa, takadzidza zvidzidzo zvakafanana makore makumi matatu mushure mekudzidza kwepakutanga uye takaona kuti, zvinoshamisa, hakuna munhu mumwe chete akanga ari mumamiriro akaipisisa makore makumi matatu gare gare, kupfuura ivo mushure memavhiki matatu ekurara mumakore avo makumi maviri.
Mune mamwe mazwi, masvondo matatu ekurara aiva akaipa kune simba remuviri wekunyama muviri kune makore makumi matatu ekukwegura! (ona McGuire et al Circulation 2001).
Pasinei nokuti chii chakakonzera chiitiko chekutanga, panguva iyo chirwere (kana chero chii chakaitika) chakamhanya, varwere vakasara vane hurema hwakakomba (mumwe murwere mukudzidza kwedu akanga asingakwanisi kugara wakarurama kwemakore anopfuura 2 ) iyo inoratidzika kuva nani zviri nani nepurogiramu yedu yakatsaurirwa, yakananga, zvishoma nezvishoma kutanga muchikamu chechimiro chekugadzirisa. Izvozvo zvinoshandiswa zvinogona kunge zvakakosha mutsva kubwinya kwatakaunza patafura pakuchengeta varwere vePOTS.
Vazhinji POTS havagoni kushivirira kumira kwakanaka kuti kutanga kugara pasi kana kunyange kurara kumashure kunokosha pakubudirira kwavo. Uye zvakaoma! Varwere vakawanda vanotambudzika kuti vapedzise mavhiki mashomanana epurogiramu yekudzidzisa, iyo inotanga nenzira inotanga nemaminitsi makumi matatu pazuva, mazuva matatu pavhiki. Asi kana vakadzvinyirira kuburikidza nekunetseka kwekutanga, vanowanzozviwana ivo zvishoma nezvishoma vachinzwa zviri nani uye vakasimba.
Izvi zvinosimbisa pfungwa inokosha - Hatina kumbofunga kuti imwe POTS mumwe murwere akanga ane usimbe kana asina hanya - kana zvaive nyore kuratidzira POTS nekurovedza muviri, munhu wose aizoita !! Zvisinei kana tikashandisa purogiramu chaiyo yekudzidzisa yakatarira pakuita kuti mwoyo uwedzere, huwandu hwevarwere huri kunzwa huri nani uye vazhinji "vanoporesa", zvinoreva chete kuti havasati vasangana nemirairo yePOTS. Ndinofanira kusimbisa kunyange zvazvo kuchengetedza utano ndicho chinangwa cheupenyu hurefu chevarwere vedu vePOTS uye tinovakurudzira kuti vaone kurovedza muviri sechikamu chehutsanana hwavo. Kune avo vanorinzwa ini ndichitaura, voga kune avo vari varwere, kana kuti pachena pamisangano, vanoziva kuti Ndinonyatsotsanangura kuti "mwoyo yemavhuturo" ndiyo nzira chaiye uye yakatsanangurwa isina chinhu chero chipi zvacho chinoita neuchenjeri.
Ndapota cherechedza kuti varwere vane POTS HAVASINA kushaya simba kwezvigaro. Izvi hazvirevi kuti urongwa hwehutongi hwehutongi husati hwashatiswa pane imwe nguva mukugadzirisa kwePOTS. Kunyange zvakadaro muchikamu chisingaperi, hemodynamics inotungamirirwa nehutano hwehutano hwemwoyo - uye humwe uchapupu ndechokuti patinodzokorora iyi pathophysiology, nokuwedzera muwandu weropa mwoyo unowanikwa uye unogona kuputira nehondo imwe neimwe, iyo HR inoderera, kunzwira tsitsi kunotambudza kunoenda pasi, uye varwere vanonzwa vari nani.
Rega ndidzokerezve pfungwa iyi: CARDIOVASCULAR DECONDITIONING HAIYE YAKATAURWA "KUZIVA KUNYARA" !!!!! Chero ani anotsanangura deta yedu nenzira iyo kusanzwisisa zvitsva zvedu uye kurapa kwedu. Ndine tsitsi huru kuvarwere vedu vazhinji avo vanowanzovhiringidzika, uye ndakashungurudzika nokuda kwehuwandu hwebasa rangu ndichiedza kuwana mishonga inobata nguva dzose.
3) Pakusarudza varwere kune zvidzidzo zvekuongorora paPOTS. Nokuda kwekudzidza kwedu, takashandisa zvirevo zvakananga maererano nemitemo yakagadzirirwa nemasangano enyika uye enyika dzakabatanidzwa mumatambudziko ekuzvimirira. [Hezvino Dr. Levine inopa hurukuro yakajeka yehutano hwakasiyana-siyana hunobatanidza nePOTS, uye yehutambudziro hwenyika vese vatsva vanosangana pavanosarudza kutsanangurwa kwezvidzidzo zvekuchirapa paPOTS. Nezvinetso izvi mupfungwa, ndinove nechokwadi kuti vakatevera kugamuchirwa "zvakanakisisa maitiro" pakutsvaga varwere kwekuongorora kwavo kliniki. RF]
Ndinoziva izvi zvingave zvisina kugutsikana zvikuru nevarwere vane mamiriro aya, asi zvinoratidza chokwadi chekuongorora kwechiremba. Sezvaunogona kufungidzira, kunyanya kunyoresa zvinyorwa zvekunyoresa, zviri nani vatsvakurudzi vangave vari kuseka zvinyorwa zvehana yavo, kunyange zvisingakwanisi kugadziriswa zvingaguma. Sezvo iwe nevakawanda vevaverengi vako vangaziva, isu ikozvino tiri kuita hurukuro yakawanda yekudzidzira kuwanikwa munharaunda, apo> varwere mazana 200 vachadzidzwa nemitemo yakawanda shoma pakunyoresa. Tinotarisira kuti chidzidzo ichi chinopindura mibvunzo yatinayo isu nevamwe uye nezvekutsvaga kunyoresa.
Muzvidzidzo zvedu zvakabudiswa, takanyoresa mitezo yakatevera yevarwere inotaridzirwa kune yangu yepamusoro yezvidzidzo zvemakiriniki uye kuongororwa kwePOTS. Mukuita, takabvisa vashoma vashoma vane zvirwere zvepfungwa, muchikamu chekuti sezvo iwe wakataura muchirongwa chako, vazhinji vevarwere ava vakaona vamwe vanachiremba vakawanda vasati vatumirwa kwandiri, zvakafanana nevarwere veMayo Clinic kana Vanderbilt. Kubva kukurukurirana nezvevarwere vedu nevaya vedzimwe nyanzvi (uye isu tinowanzoona varwere vevamwe) ... mumunda, ndine chivimbo chokuti vanhu vedu vanofananidzira kupararira kwevanhu vakawanda vePOTS varwere.
4) Nezve "Grinch Syndrome." Pakupedzisira, rega ndipedze nemashoko mashomanana pamusoro peGrish. Iro huwandu hwevarwere vedu vanonzwa izwi rokuti "The Grinch Syndrome" kuseka uye kunyaradzwa mumweya umo inoratidzwa. Kune rumwe rutivi, ndinonzwisisa kuti vamwe varwere vasingandizivi, uye vane hanya nekunyorwa nezita iro rinosanganiswa nekuve rine simba, rinoshandiswa kushandiswa kwezwi rokuti Grinch Syndrome, uye ndinoremekedza izvo zvinonetsa. Kutaura chokwadi, dai ndaifanira kuzviita zvakare, zvimwe ndingadai ndakanga ndisingachadi kushandisa izwi racho, uye ndinoda kuti varwere vose vePOTS vazive kuti isu tinovaudza kuti hapana chakaipa. Hapana "mukurumbira uye hupfumi" hunosanganiswa nezita iri uye ini handiwani rubatsiro rwomunhu kubva pakushandisa izwi iri. Zvisinei, ndakaona kuti inoshanda zvakadini pakushevedza kune izvo zvatakaona sepakutanga pathophysiology inobatanidza nekunyanyisa kwakanyanya kwevarwere. Sezvo ini ndinowanzoudza varwere vangu, izwi rokuti "POTS" rinongoratidzira mutsara pokuti mwoyo wemurwere unorova nokukurumidza pavanomira. I "Grinch Syndrome" inotarisa kumucheto, pane CHIMWE chimiro chemwoyo chakamira zvakanyanya-kureva kuti moyo "mashoma maviri akawandisa."
Kubva pahuwandu hwehuwandu huwandu hwevanhu, 2.5% yevakadzi vose vari munyika vachave nemwoyo unopfuura maitiro maviri ezvisikwa pasi pezvinoreva - tsanangudzo ye "yakasununguka" mukurapa. Tinotenda kuti vakadzi ava vari pangozi yekuwana zviratidzo zvePOTS zvinogona kukonzerwa zvinoshamisa nokukurumidza kunyange nguva pfupi yekuvata.
Pakupedzisira, zvakadaro, ndinoda kusimbisa kuti kuseka chinhu chine simba chekuporesa, kwete chete kune varwere vane POTS, asi chinenge chinenge chirwere chipi zvacho. Tinobata varwere vedu vose neruremekedzo rwakadzama uye vanoziva zvakajeka zvavari, izvo zvatinotora zvakanyanya. Mark Twain akamboti "Kuzvininipisa ndiko chikomborero chikuru chevanhu"; tinotenda kuti chikamu chinokosha chekuporesa uye tariro yokuti varwere vedu vose vanoyemwerera pavanofunga nezveThe Grinch, uye voenda kunoshanda!
- Benjamin D. Levine, MD
Closing Thoughts
Dr. Levine mutsvakurudzi akazvitsaurira uye akangwarira, uye muviri wake webasa paPOTS yakasimudzira ruzivo rwedu pamusoro pechiitiko ichi zvikuru, uye somugumisiro, zviuru zvevanhu vane chirwere ichi vari kubatsirwa. Mukuwedzera, kutonga kubva pane dzimwe zvinyorwa zvakaonekwa zvichitevera zvandaimboita, varwere vane POTS vave vari pasi pake vanofunga zvikuru kwazvo pamusoro pake, uye vanomurumbidza nokuda kwekuremekedzwa, kunetseka, nekuzvitsaurira kwaakavaratidza ivo pachavo.
Ini ndichiri kufunga kuti zviri nyore kwazvo kune vasiri nyanzvi yePOTS (kufanana neni) kududzira chidzidzo ichi mubvunzo sechiratidza kuti POTS nenzira imwe neimwe zvirwere zvinokonzerwa nemunhu, uye kutonga kubva pane zvataurwa mutsva wangu wakagamuchira, izvo zvisiri izvo zvinyorwa zvese zvechokwadi inowanzopararira pakati pechiremba. Dhiabhorosi Levine pamusoro pechinhu ichocho (pamusoro) inoratidza zvakajeka kuti yakanga isati yambova nechinangwa chokuratidza kuti POTS inofungidzirwa. Pane kudaro, zvaakawana zvinoratidza kuti nguva shomanana yekuzorora pamubhedha, zvichida kunyanya mune vamwe vanhu vane simba (kazhinji vakadzi), zvingave zvakakwana kuti vauye pachiitiko ichi.
Chero zvazvingava, vanhu vane POTS vanoda kugutsikana navanachiremba nemhuri yavo kuti mamiriro avo haasi chimwe chinhu chavakaunza pamusoro pavo, iye zvino haafaniri kuvimba nedhidhiro yakanyorwa neni kuti ndiite saizvozvo (sevakawanda vavo vakaratidza kuti vaizoita zvavanotaura). Iye zvino vane zvinyorwa zvezviitiko izvo zvakanyorwa naDkt. Levine pachake.
Ndinoda kuonga Dr. Levine nekuda kwekudzidzira kwake pamusoro pekutsinhanisa uku, uye nekuda kwekuedza kwake kwaakaita mukuchenesa mhepo.
Verenga pamusoro pehutachiona hwetasycardia syndrome (POTS) .