Imibuzo eyi-10 i-Rheumatologist yakho Ifuna Uyibuze

-Delile

• Ukuxilongwa kokuqala
• 1. Uyini umbono wami?
• 2. Kungokofuzo?
• 3. Ngingavivinya nini umzimba futhi?
• 4. Kuyoze kube nini kusebenza ama-meds ami?
• Ukuxilongwa okukhona
• 5. Ngingakhulelwa?
• 6. Kuthiwani uma izindondo zami ziyeka ukusebenza?
• 7. Yikuphi ukwelashwa okusha okutholakalayo?
• 8. Yini ebangela ukuvutha kwami?
• 9. Kuthiwani ngokuhlangana kwezidakamizwa?
• 10. Ngabe kufanele ngiphuze imishanguzo yami unomphela uma ngizizwa ngiphilile?
• Ukuthatha

Uma une-rheumatoid arthritis (RA), ubona i-rheumatologist yakho kuma-aphoyintimenti ahleliwe njalo. Lo mfundi osebenza ngamakhono aphansi uyilungu elibaluleke kakhulu lethimba lakho lokunakekela, ekuhlinzeka ngokuhlaziywa kwesimo sakho kanye nenqubekela phambili yaso kanye nokuqonda kokwelashwa kwakamuva.

Kepha ukulandela ukungasebenzi kahle komzimba kungaba ngumsebenzi onselele. Izimpawu ezinjengokuvuvukala namajoyini abuhlungu ziyafika zidlule, bese kuba nezinkinga ezintsha. Ukwelashwa nakho kungayeka ukusebenza. Kuningi okufanele ukukhumbule, futhi ungahle ukuthole ukhohlwa ukubuza imibuzo ebalulekile ngesikhathi sokuqokwa kwakho. Nazi ezinye izinto okufanele uzigcine engqondweni ukuthi i-rheumatologist yakho ifisa ukuthi ubuze.

Ukuxilongwa kokuqala

Isikhathi sokuxilongwa singadala ukukhathazeka kwabaningi, yize abanye bezizwa benomuzwa wokukhululeka ngokuthi isimo sesibonisiwe nokuthi singelashwa. Ngenkathi uthatha lonke lolu lwazi olusha, kuzoba wusizo ukuqala ukugcina iphephabhuku lokunakekela noma i-log oze nayo kuzo zonke izivumelwano ozisebenzisayo ukulandelela isimo sakho ekhaya. Ngesikhathi sokuqokwa kokuqala kokuxilongwa, buza i-rheumatologist yakho le mibuzo ebalulekile:

1. Uyini umbono wami?

Yize i-RA iziphatha ngokuhlukile kuzo zonke iziguli, kubalulekile ukuqonda okunye okwejwayelekile. Lesi sifo asihlali isikhathi eside, okusho ukuthi ngokuqinisekile sizohlala isikhathi sakho sokuphila. Kodwa-ke, okungamahlalakhona akusho ukungapheli. I-RA inemijikelezo futhi ingangena ekuxolelweni.

Imishanguzo emisha, njengemithi yokuguqula isifo elwa nezifo (i-DMARD) kanye ne-biologics, isindisa iziguli ekulimaleni okuhlala njalo futhi ivumela ukuthi zijabulele izimpilo ezigcwele. Buza udokotela wakho ngombono wakho, bese uzama ukuqaphela izindaba ezinhle kanye nolwazi olukhathazayo.

2. Kungokofuzo?

U-Elyse Rubenstein, MD, i-rheumatologist e-Providence Saint John's Health Centre eSanta Monica, eCalifornia, uveza ukuthi kubalulekile ukubheka umthelela we-RA emndenini wakho. Uma unezingane, ungahle uthande ukubuza ukuthi bangayakha yini i-RA.

Ngenkathi amafa we-RA eyinkimbinkimbi, kubonakala ngathi kunamathuba amakhulu okuba ne-RA uma othile emndenini wakho enayo.

3. Ngingavivinya nini umzimba futhi?

Ukukhathala, ubuhlungu, ukulala, nokudangala kungaphazamisa ukuvivinya umzimba njalo. Ngisho noma usutholakele, ungesaba ukuzivocavoca umzimba ngenxa yomthelela emajoyintini akho athintekile.

Kepha ukunyakaza kubalulekile ekuphatheni nasekubhekaneni neRA. Ngo-2011 kwatholakala ukuthi ukuvivinya umzimba kunezinzuzo ezithile zezempilo kubantu abane-RA. Buza udokotela wakho ukuthi ungahamba nini futhi nokuthi iziphi izivivinyo ezizokuzuzisa kakhulu. Ukubhukuda noma i-aerobics yamanzi kuhle kakhulu kulabo abane-RA.

4. Kuyoze kube nini kusebenza ama-meds ami?

Kwaphela amashumi eminyaka ngaphambi kweminyaka yama-1990, izidakamizwa ezingezona ukuvuvukala (ama-NSAID) kanye nama-corticosteroids kwakuyizisombululo eziyinhloko ezibekiwe kubantu abane-RA. Banikeza ukukhululeka okuqhamile kokuvuvukala nobuhlungu futhi kusasetshenziswa. (Imishanguzo yokudambisa izinhlungu i-opiate iya ngokuya yehla ngenxa yezinga eliphezulu lokulutha. I-Drug Enforcement Administration iyalele ukwehliswa kwezinga labo lokukhiqiza ngo-2017.)

Kodwa-ke, izindlela ezimbili zokwelapha -i-DMARD, okuyi-methotrexate evame kakhulu, ne-biologics - inendlela ehlukile. Zithinta izindlela zeselula eziholela ekuvukeleni. Lezi izindlela zokwelapha ezinhle kakhulu kubantu abaningi abane-RA, ngoba ukumisa ukuvuvukala kungavimbela ukulimala unomphela kwamalunga. Kepha kuthatha isikhathi eside ukusebenza. Buza udokotela wakho ngolwazi lwabo ngokusebenzisa le mithi.

Ukuxilongwa okukhona

Uma ngabe uphathe i-RA yakho isikhathi esithile, mhlawumbe unendlela ejwayelekile yokuqokwa kwabadokotela bakho. Ufika, uthathwe ubungqabavu bakho bese udonswa igazi, bese uhlangana nodokotela wakho nixoxe ngesimo sakho nanoma yikuphi okusha okwenzekayo. Nayi eminye imibuzo ongayicabanga ukukhuphula:

5. Ngingakhulelwa?

Cishe amaphesenti angama-90 abantu abane-RA bazothatha i-DMARD methotrexate ngasikhathi. Ngokuvamile kubhekwa njengokuvikelekile ukusetshenziswa njalo futhi kunemiphumela engemihle ephathekayo.

Kodwa-ke, lesi sidakamizwa sokuya eRA sibuye sikhiphe isisu, okusho ukuthi sizokwenza ukuthi ukukhulelwa kuqedwe. Kufanele usebenzise izilawuli zokubeletha njalo lapho uthatha i-methotrexate. Futhi kufanele njalo ubuze udokotela wakho uma ucabanga ukukhulelwa. "Ngempela, kufanele sitshele iziguli ngokukhulelwa ngaphandle kokubuza kwazo," kusho uStuart D. Kaplan, MD, oyinhloko ye-rheumatology eSouth Nassau Communities Hospital e-Oceanside, eNew York.

Uma ungowesifazane one-RA, ungakhulelwa okunempilo (ungahle uthokozele nokuphumula okuvela kwizimpawu ze-RA) nezinsana ezinempilo. Vele uqiniseke ukuthi uthintana ne-rheumatologist yakho njalo.

6. Kuthiwani uma izindondo zami ziyeka ukusebenza?

Ama-NSAID nama-corticosteroids asiza abantu abanezinhlungu zokulawula i-RA nokuvuvukala, kuyilapho ama-DMARD eqhubeka kancane nezifo futhi engagcina amalunga. Kungenzeka ukuthi wanikezwa le mithi ngokushesha ngemuva kokutholakala kwakho. Kepha kungahle kungasebenzi njalo.

Isidingo semithi eyengeziwe noma eyehlukile singaba sesikhashana. Isibonelo, ngesikhathi se-flare, ungadinga ukukhululeka okwengeziwe okwesikhashana kobuhlungu. Ungadinga futhi ukushintsha noma ukwengeza ukwelashwa ngokuhamba kwesikhathi.

Khuluma ne-rheumatologist yakho kulo lonke ukwelashwa kwakho ukuze uqonde ukuthi ungatshela kanjani uma ukwelashwa kungasasebenzi nokuthi ungahlelela kanjani ushintsho ekwelashweni lapho kudingeka.

7. Yikuphi ukwelashwa okusha okutholakalayo?

Ucwaningo nokwelashwa kweRA kuthuthuka ngokushesha. Ngaphezu kwama-DMARD amadala njenge-methotrexate, imishanguzo emisha ebizwa nge-biologics manje isiyatholakala. Lokhu kusebenza ngokufana nama-DMARD, kuvimbela ukuvuvukala kwamangqamuzana, kepha kuhloswe kakhulu ekusebenzisaneni kwawo namasosha omzimba wakho.

Ama-stem cell angabamba isithembiso njengokwelashwa kwe-RA. "Iziguli ezingasabeli ekwelashweni kwendabuko futhi ezibheke ukunciphisa ukuncika kwazo emithini kufanele zibuze udokotela wazo nge-stem cell therapy," kusho u-Andre Lallande, DO, umqondisi wezokwelapha we-StemGenex Medical Group.

8. Yini ebangela ukuvutha kwami?

Iphethini lokuxolelwa kwe-RA lingazizwa lingenabulungisa ikakhulukazi. Ngolunye usuku uzizwa uphilile, ngokulandelayo awukwazi ukuphuma embhedeni. Ungasusa okunye ukuhlukumezeka kulokhu kungabi nabulungisa uma uthola ukuthi kungani uthola ama-flare - okungenani lapho-ke unombono wokuthi yini okufanele uyigweme noma ungaqwashisa ngokuqubuka okuzayo.

Ukugcina idayari yokunakekelwa kungakusiza ukulandelela izimbangela ze-flare, futhi kanjalo nokubonisana ne-rheumatologist yakho. Buza ngokuhlangenwe nakho kwabo nezinye iziguli. Ngokubambisana, bhekisa kwirekhodi labo lokuqokwa kwakho ukukhomba okungenzeka kusebenze izimpawu zesifo.

9. Kuthiwani ngokuhlangana kwezidakamizwa?

Uhlu lwemithi ye-RA lungakhungathekisa. Noma ungathuthukisi ama-comorbidities we-RA njengezinkinga zenhliziyo nemithambo yegazi noma ukucindezeleka, uzothatha incwadi kadokotela yokulwa nokuvuvukala, i-corticosteroid, okungenani i-DMARD eyodwa, futhi mhlawumbe ne-biologic. Le mithi ithathwa njengephephile ukuyihlanganisa, kepha uma uzibuza ukuthi imithi yakho ingaxhumana kanjani nezinye izinto, buza udokotela wakho.

10. Ngabe kufanele ngiphuze imishanguzo yami unomphela uma ngizizwa ngiphilile?

Mhlawumbe unenhlanhla futhi i-RA yakho ifake ukuxolelwa okubanzi. Uthola ukuthi uyakwazi ukunyakaza njengoba wake wenza, nobuhlungu nokukhathala kwakho sehlile. Kungenzeka yini ukuthi iRA yakho yelaphekile? Futhi ungayeka ukuthatha izindondo zakho? Impendulo kuyo yomibili le mibuzo ingucha.

I-RA namanje ayinalo ikhambi, yize izindlela zokwelapha zesimanje zingaletha ukukhululeka futhi zivimbele omunye umonakalo. Kumele uqhubeke uphuza imishanguzo yakho ukuze uphile. “Uma nje ukuxolelwa sekutholakele emithini yokwelashwa, iziguli zizogcina ukusebenza kwezifo eziphansi noma kwezinye izimo kungabi bikho sifo esikhomba nhlobo ngokuqhubeka nemithi. Uma imiswa imishanguzo, maningi amathuba okuba kuqale ukusebenza kwezifo bese kuqubuka imililo futhi, ”kusho uRubenstein.

Kodwa-ke, udokotela wakho angacabanga ukwehlisa umthamo wemithi yakho kanye / noma ukwenza lula ukuhlanganiswa komuthi wakho ngokuqapha ngokucophelela.

Ukuthatha

I-rheumatologist yakho ingumngane wakho kulokho onethemba lokuthi kuzoba uhambo olunempilo lokwelapha i-RA yakho. Lolo hambo lude futhi lungaba nzima kakhulu njengoba ungeza futhi ususa imishanguzo futhi njengoba ukuqaqamba kwesifo sakho, kulungisa, noma kuthuthukisa izici ezintsha. Gcina iphephabhuku lokunakekela ukuze ubhale phansi okuhlangenwe nakho kwakho, uhlu lwemithi yakho, nezimpawu zethrekhi. Futhi sebenzisa le notebook njengendawo yokubhala imibuzo yokuqokwa kwakho kwe-rheumatology okulandelayo. Bese unganqikazi ukubabuza.