Ukuphila ne-Parkinson's, kwabaningi, kufana nokugibela izimpawu eziningi . Kunezinsuku lapho umzimba usabela kahle khona kanti ezinye, ngaphandle kwesixwayiso, kubonakala sengathi sesivale ngokuphelele. Lokhu kuguquguquka akulona iphutha lesiguli noma ukuntuleka kwamandla okuzimisela, kodwa kuyingxenye evamile yendlela lesi sifo esiqhubeka ngayo eminyakeni edlule.
Uma sikhuluma ngokushintshashintshashintsha, empeleni sibhekisela kulezo zinguquko ekuhambeni nasekuphileni kahle ezenzeka usuku lonke. Yilowo muzwa wokuthi ngezinye izikhathi umuthi usebenza izimanga kanti ngezinye izikhathi kubonakala sengathi awuzange wenze lutho, uthinta hhayi ukunyakaza kuphela kodwa futhi nesimo sengqondo kanye nekhono lokuxhumana nabanye.
Isenzakalo se-ON ne-OFF: Siquketheni ngempela?
Ukuze ukuqonde kalula, cabanga ngokushintsha. Isikhathi se-ON yilapho ukushintsha kuvuliwe: i-levodopa yenza umsebenzi wayo, amazinga e-dopamine ebuchosheni anele, futhi isiguli sinokulawula okwanele ukunyakaza kwaso, sizizwa sishesha futhi sisebenza kakhudlwana.
Ngakolunye uhlangothi, isikhathi se-OFF senzeka lapho umphumela womuthi uphela noma unganele. Kulesi simo, izimpawu zokunyakaza komzimba zibuya ngamandla; ukuqina komzimba kuvela, ukuthuthumela kuyaqina, futhi kungase kukhule ukubambezeleka okukhulu. Ngaphezu kwalokho, kunesigaba esiphakathi esibizwa ngokuthi i-ON ene-dyskinesia , lapho umuntu ehamba khona ngendlela evamile kodwa ebonisa ukunyakaza okungazikhetheli, okuguquguqukayo, noma okunjengokudansa okubangelwa umuthi ngokwawo.
Izinhlobo zokuguquguquka: Lapho umzimba ungahambisani nesigqi
Akuzona zonke izikhathi ze-OFF ezifanayo. Kuye ngokuthi zenzeka nini futhi kanjani, odokotela bezinzwa bazihlukanisa ngendlela engcono yokwelapha:
- Ukuphelelwa yisikhathi: Lokhu kuvame kakhulu. Izimpawu ziphinde zivele ngaphambi nje kokuba kufike umthamo olandelayo wemithi, njengokungathi umuthi "usetshenziswa" ngaphambi kwesikhathi.
- AKUKHO ekuseni: Kungumzwa wokuqina okuphelele lapho uvuka, owaziwa ngokuthi i-akinesia yasekuseniokungahlala isikhathi esingafika ehoreni ngaphambi kokuba umthamo wokuqala wosuku uqale ukusebenza.
- Ukushintshashintsha okungalindelekile: Lezi yizona ezikhungathekisa kakhulu ngoba azilandeli uhlelo oluthile. Kungaba nokwehluleka okuphelele komthamo, ukuqala komphumela we-ON okubambezelekile kakhulu, noma ukulahlekelwa ukunyakaza ngokuzumayo ngaphandle kwesizathu esibonakalayo.
- I-Onething EVALIWE: Kwenzeka uma umuthi usiza, kodwa Akakwazi ukulawula izimpawu. ngokuphelele.
Kubalulekile ukungakhohlwa ukuthi kukhona nokushintshashintsha okungenazo izinzwa zomzimba . Ngezinye izikhathi, isiguli asizizwa siqinile, kodwa sibhekana nokuhlaselwa ukukhathazeka, ukunganaki, ukukhathala okukhulu, noma izinkinga zomchamo ezihambisana nokwehla kwe-dopamine.
Kungani lokhu kwenzeka? Izimbangela ezibangela ukwehla nokwehla
Ekuqaleni kwalesi sifo, ubuchopho busenamandla okugcina nokulawula i-dopamine. Kodwa-ke, ngokuhamba kwesikhathi, ama-neuron e-dopaminergic ayafa, futhi ubuchopho buxhomeke ekukhuphukeni kwemithi , bulahlekelwe yilokho kuzinza kwemvelo.
Ngaphezu kwalokho, kunezici zangaphandle ezingenza izinto zibe nzima. Isibonelo, isifo sikaParkinson sinciphisa ukuphuma kwesisu, okusho ukuthi i-levodopa ithatha isikhathi eside ukufinyelela emathunjini amancane ukuze imuncwe. Ngokufanayo, ukudla okunamaprotheni amaningi kungancintisana nomuthi osemathunjini, kuvimbele inani elidingekayo ukuthi lifinyelele ebuchosheni.
Amasu kanye nezindlela zokwelapha zokubuyisela ibhalansi
Umgomo wezokwelapha ukuqinisekisa ukuthi i-dopamine ifinyelela ebuchosheni kancane kancane, hhayi ngokuqhuma okukhulu. Ukuze kufezwe lokhu, udokotela wezinzwa angahlukanisa imithamo ibe yimithi emincane, evame ukusetshenziswa noma angenise imithi eyengeziwe njenge-COMT inhibitors noma i-dopamine agonists.
Ezimweni ezithuthukile kakhulu, kunezinketho ezinamandla kakhulu:
- Amadivayisi okufaka i-Dopamine: Njengejeli levodopa, lilethwa ngqo emathunjini noma emaphampini angaphansi kwesikhumba ukuze lidlule isisu.
- Ukukhuthazwa Kobuchopho Okujulile (i-DBS): Ukuhlinzwa lapho kufakwa khona ama-electrode ukusiza ukulawula izifunda zobuchopho.
- Imithi yokuhlenga: Njenge-apomorphine engaphansi kwezilimi ezimbili noma i-levodopa ephefumulayo ukuze inqobe ngokushesha isikhathi se-OFF esingalindelekile.
Kodwa umuthi awukona konke. Ukuvivinya umzimba njalo kuyithuluzi elinamandla lokunciphisa inqubekela phambili nokuthuthukisa ibhalansi. Ukwelapha ngokuzivocavoca umzimba kusiza ekuphatheni ukuphazamiseka kokuhamba, ukwelashwa ngenkulumo kuqeqesha izwi ngezikhathi zokuthula, futhi ukwesekwa kwengqondo kuyisihluthulelo sokunqoba ukukhathazeka okubangelwa yilezi zinguquko.
Indlela yokuthola nokudlulisela izimpawu kudokotela
Ukuze udokotela wezinzwa enze izinguquko eziqondile, akwanele ukumane athi, "Ngizizwa kabi." Okufanelekile, kufanele ugcine idayari yezimpawu , ubhale isikhathi esiqondile othatha ngaso imithi yakho kanye nesikhathi esiqondile lapho kuvela khona noma yikuphi ukuvinjelwa noma ukuqina. Lokhu kumvumela ukuthi ahlukanise phakathi kwesibonakaliso esishintshashintshayo (esithuthuka ngomthamo) kanye nesibonakaliso esiqhubekayo sokuqhubeka kwesifo.
Ukusekelwa ngumndeni kubalulekile, njengoba abanakekeli bevame ukubona izinguquko ezincane ekubonakaleni kobuso noma ekuhambeni kwesiguli ngezinye izikhathi ezinganakwa yisiguli. Ukukhulumisana okuvulekile nokwethembeka nochwepheshe kuyindlela kuphela yokwenza ukwelashwa kube ngokwakho nokunciphisa umthelela ongokomzwelo wokuphila ngokungazinzi njalo.
Ukuphatha lokhu kuguquguquka kudinga isineke kanye nethimba elihlanganisa imithi nokwelashwa ngokomzimba kanye nokusekelwa kwengqondo. Ukuhlonza kahle ukuthi ngabe kuyinto yokuphela komthamo noma ukwehluleka okungalindelekile kuvumela ukulungiswa kwemithamo yemithi kanye nokudla, ukubuyisela ukuzimela okukhulu kanye nokuzinza endleleni yansuku zonke yesiguli kanye nokuvimbela lesi sifo ukuthi singabeki ijubane lempilo yaso.