Imibuzo eli-10 iRheumatologist yakho ifuna ukuba ubuze

Umxholo

• Ukuxilongwa kwasekuqaleni
• 1. Ndijonga ntoni?
• 2. Ngaba lilifa?
• 3. Ndingaphinda ndizilolonge kwakhona nini?
• 4. Kude kube nini isebenza?
• Uxilongo olukhoyo
• 5. Ndingakhulelwa?
• 6. Kuthekani ukuba amayeza am ayayeka ukusebenza?
• 7. Loluphi unyango olutsha olufumanekayo?
• 8. Yintoni ebangela ukutsha kwam?
• 9. Kuthekani ngokudibana kweziyobisi?
• 10. Ingaba kunyanzelekile ndiwasele amayeza am ngonaphakade ukuba ndiziva ndiphilile?
• Ukuthatha

Ukuba une-rheumatoid arthritis (RA), ubona i-rheumatologist yakho kwiindawo zokucwangciswa rhoqo. Eli ziko elikhethekileyo lelona lungu libalulekileyo kwiqela lakho lokhathalelo, ekubonelela ngohlalutyo lwemeko yakho kunye nenkqubela yayo kunye nokuqonda kunyango lwamva nje.

Kodwa ukulandelela ukungasebenzi kakuhle kunokuba ngumsebenzi onzima. Iimpawu ezinjengokudumba kunye namalungu aqaqambayo eza kwaye ahambe, kwaye kuvela iingxaki ezintsha. Unyango lunokuyeka nokusebenza. Kuninzi ekufuneka uyikhumbule, kwaye unokufumana ulibale ukubuza imibuzo ebalulekileyo ngexesha lokuqeshwa kwakho. Nazi izinto onokuzigcina engqondweni ukuba i-rheumatologist yakho inqwenela ukuba ubuze.

Ukuxilongwa kwasekuqaleni

Ixesha lokuchongwa linokubangela uxinzelelo kubaninzi, nangona abanye beziva ngathi bakhululekile ukuba imeko ichongiwe kwaye inokunyangwa. Ngelixa uthatha lonke olu lwazi lutsha, kuya kuba luncedo ukuqala ukugcina iphepha lokukhathalela okanye ilog oza nayo kuzo zonke iindibano kwaye uzisebenzise ukulandelela imeko yakho ekhaya. Ngexesha lokuqala kokuchongwa kwesifo, cela i-rheumatologist yakho le mibuzo ibalulekileyo:

1. Ndijonga ntoni?

Nangona i-RA iziphatha ngendlela eyahlukileyo kuzo zonke izigulana, kubalulekile ukuqonda ezinye zezinto eziqhelekileyo. Esi sifo asinyangeki, oko kuthetha ukuba kuya kuhlala ixesha lokuphila kwakho. Nangona kunjalo, okungapheliyo akuthethi ukungapheli. I-RA inemijikelezo kwaye ingena kuxolelo.

Unyango olutsha, njengokuguqula iziyobisi kwi-antirheumatic drug (DMARDs) kunye ne-biologics, kugcina izigulana kumonakalo odibeneyo wokuhlala kunye nokuvumela ukuba bonwabele ubomi obupheleleyo. Buza ugqirha wakho malunga nembono yakho, kwaye uzame ukuqaphela iindaba ezilungileyo kunye nolwazi oluyinkxalabo.

2. Ngaba lilifa?

U-Elyse Rubenstein, MD, ugqirha wamathambo e-Providence Saint John's Health Centre eSanta Monica, eCalifornia, uthi kubalulekile ukuqaphela ifuthe leRA kusapho lwakho. Ukuba unabantwana, unokufuna ukubuza ukuba bangayiphuhlisa na iRA.

Ngelixa ubunzima be-RA bunzima, kubonakala ngathi kukho amathuba amakhulu okuphuhlisa i-RA ukuba umntu othile kusapho lwakho unayo.

3. Ndingaphinda ndizilolonge kwakhona nini?

Ukukhathala, iintlungu, ukulala, kunye nokudakumba kunokuphazamisa ukuzilolonga rhoqo. Nokuba sele ufumanekile, unokoyika ukwenza umthambo ngenxa yefuthe kumalungu akho achaphazelekayo.

Kodwa intshukumo ibalulekile ekulawuleni nasekujonganeni neRA. Ngo-2011 kwafunyaniswa ukuba umthambo unezibonelelo ezithile zempilo kubantu abaneRA. Buza ugqirha wakho xa unokuhamba kwakhona kwaye yeyiphi imithambo eya kukunceda kakhulu. Ukuqubha okanye i-aerobics yamanzi zilunge ngakumbi kwabo bane-RA.

4. Kude kube nini isebenza?

Kumashumi eminyaka ngaphambi kwee-1990s, iziyobisi ezichasayo (ii-NSAIDs) kunye ne-corticosteroids yayizezona zisombululo ziphambili zichazwe kubantu abane-RA. Banikezela ngesiqabu esikhawulezayo sokudumba kunye neentlungu kwaye zisasetyenziswa. (Unyango lwe-opiate pain relievers luyehla ngenxa yenqanaba eliphezulu lokulutha. Ulawulo lokuNyanzeliswa kweziyobisi luyelele ukuba kuncitshiswe izinga labo lokuvelisa ngo-2017.)

Nangona kunjalo, unyango ezimbini -i-DMARD, apho i-methotrexate yeyona ixhaphakileyo, kunye ne-biologics- inendlela eyahlukileyo. Ziye zachaphazela iindlela zeselfowuni ezikhokelela kukudumba. Olu lolona nyango lubalaseleyo kubantu abaninzi abane-RA, kuba ukuyeka ukudumba kunokuthintela ukonakala okusisigxina kumalungu. Kodwa bathatha ixesha elide ukusebenza. Buza ugqirha wakho ngamava abo ekusebenziseni la machiza.

Uxilongo olukhoyo

Ukuba ubulawula iRA yakho kangangexesha elithile, mhlawumbi unesiqhelo esimiselweyo sodokotela bakho. Uyafika, uthathe iivali zakho zithathiwe kwaye utsale igazi, emva koko udibane nogqirha wakho ukuxoxa ngesimo sakho kunye nolunye uphuhliso olutsha. Nantsi eminye imibuzo ekufuneka uyiqwalasele ngokuzisa:

5. Ndingakhulelwa?

Phantse iipesenti ezingama-90 zabantu abane-RA baya kuthatha i-DMARD methotrexate ngamanye amaxesha. Ngokuqhelekileyo ithathwa njengekhuselekileyo ekusebenziseni rhoqo kwaye ineziphumo ebezingalindelekanga ezilawulekayo.

Nangona kunjalo, eli chiza lokuya kwi-RA likwayi-abortifacient, oko kuthetha ukuba kuya kubangela ukuba ukukhulelwa kupheliswe. Kuya kufuneka usoloko usebenzisa ulawulo lokuzalwa xa uthatha i-methotrexate. Kwaye kufuneka uhlale ubuza ugqirha wakho ukuba ucinga ukukhulelwa. "Ngokwenyani, kufanele ukuba sixelela izigulana malunga nokukhulelwa ngaphandle kokubuza," utshilo uStuart D. Kaplan, MD, oyintloko ye-rheumatology kwiSibhedlele soLuntu lwaseSouth Nassau e-Oceanside, eNew York.

Ukuba ungumfazi one-RA, unokukhulelwa okunempilo (usenokonwabela nekhefu kwiimpawu zeRA) kunye neentsana ezisempilweni. Qinisekisa ukuba uqhagamshelana ne-rheumatologist rhoqo.

6. Kuthekani ukuba amayeza am ayayeka ukusebenza?

Ii-NSAID kunye nee-corticosteroids zinceda abantu abane-RA yokulawula iintlungu kunye nokudumba, ngelixa ii-DMARDs zihamba kancinci isifo kwaye zinokugcina amalungu. Ubunokuthi uyalelwe la mayeza kwakamsinya emva kokuba ufunyanisiwe. Kodwa zisenokungasebenzi rhoqo.

Isidingo samachiza ongezelelweyo okanye ahlukeneyo sinokuba sesethutyana. Umzekelo, ngexesha lokuvutha, unokufuna ukongezwa kweentlungu okwethutyana. Kuya kufuneka ukuba utshintshe okanye ungeze unyango ngokuhamba kwexesha.

Thetha kwi-rheumatologist yakho kunyango lwakho ukuze uqonde indlela yokuxelela xa unyango lungasasebenzi kunye nendlela yokucwangcisa utshintsho kunyango xa kufuneka njalo.

7. Loluphi unyango olutsha olufumanekayo?

Uphando lonyango lweRA kunye nophuhliso luqhubela phambili ngokukhawuleza. Ukongeza kwii-DMARD ezindala ezifana ne-methotrexate, amachiza amatsha abizwa ngokuba yi-biologics ngoku ayafumaneka. Ezi zisebenza ngokufanayo nee-DMARD, zithintela ukuvuvukala kwamaselula, kodwa zijolise ngakumbi kunxibelelwano lwayo nenkqubo yomzimba yokuzikhusela.

Iiseli zesinti zinokubamba isithembiso njengonyango lweRA. "Izigulana ezingaluphenduliyo unyango lwamayeza emveli kwaye zijonge ukunciphisa ukuthembela kwabo kunyango kufuneka zibuze ugqirha wabo malunga nonyango lwe-stem cell," utshilo u-Andre Lallande, DO, umlawuli wezonyango weStemGenex Medical Group.

8. Yintoni ebangela ukutsha kwam?

Umzekelo wokuxolelwa kwe-RA unokuziva ungalunganga. Ngenye imini uziva uphilile, ngokulandelayo akunakufane uphume ebhedini. Ungasithatha isithuba sokungabikho kokusesikweni ukuba ufumanisa ukuba kutheni ufumana i-flares-ubuncinci ke unoluvo lokuba uza kukuphepha okanye ungalumka kulangazelelo oluzayo.

Ukugcina idayari yokhathalelo kunokukunceda ulandele umkhondo weflare, kwaye ke kuya kuboniswana ne-rheumatologist yakho. Buza ngamava abo nezinye izigulana. Ngokudibeneyo, jonga kwiirekhodi zabo zokuchongwa kwakho ukuze uchonge ukuba zeziphi na ezinokuthi zibangele iimpawu zesifo.

9. Kuthekani ngokudibana kweziyobisi?

Uluhlu lwamayeza eRA lunokuba nzima. Nokuba awuphuhlisi i-RA comorbidities ezinje ngengxaki ye-cardiovascular or depression, uyakuthi uthabathe iyeza lokuchasana nokudumba, i-corticosteroid, ubuncinci i-DMARD, kwaye mhlawumbi ne-biologic. La machiza athathwa ngokuba akhuselekile ukuba angawathatha kunye, kodwa ukuba uyazibuza ukuba ingaba amayeza akho anokusebenzisana njani nezinye izinto, buza ugqirha wakho.

10. Ingaba kunyanzelekile ndiwasele amayeza am ngonaphakade ukuba ndiziva ndiphilile?

Mhlawumbi unethamsanqa kwaye iRA yakho ingene kuxolelo olubanzi. Ufumanisa ukuba uyakwazi ukuhamba njengokuba ubuhamba, kwaye iintlungu nokudinwa kwakho kuye kwathomalala. Ngaba iRA yakho iyanyangeka? Ngaba ungayeka ukuthatha amayeza akho? Impendulo kuyo yomibini le mibuzo nguhayi.

IRA asikabinalo unyango, nangona unyango lwanamhlanje lunokuzisa isiqabu luthintele omnye umonakalo. Kuya kufuneka uqhubeke ukuthatha amayeza akho ukuba uphile. “Nje ukuba uxolelo lufezekiswe kumayeza, abaguli baya kugcina imisebenzi ephantsi yezifo okanye kwezinye iimeko akukho sifo sichongiweyo konke konke ngokuqhubeka namayeza. Xa amayeza enqunyanyisiwe, maninzi amathuba okuba kusebenze isifo kwaye iirabha ziphinde zenzeke, utshilo uRubenstein.

Nangona kunjalo, ugqirha wakho unokucinga ngokunciphisa idosi yeyeza lakho kunye / okanye ukwenza lula ukudibana kwesiyobisi kunye nokujonga ngononophelo.

Ukuthatha

I-rheumatologist yakho liqabane lakho kwinto onethemba lokuba iya kuba luhambo olusempilweni lokunyanga i-RA yakho. Olo hambo lude kwaye lunokuba nzima kakhulu njengoko usongeza kwaye ushenxisa unyango kwaye njengoko isifo sakho sivele, siphume okanye siphuhlise imikhwa emitsha. Gcina iphepha lokunyamekela ukubhala phantsi amava akho, uluhlu lwamayeza akho, kunye neempawu zokulandelela. Sebenzisa le ncwadana njengendawo yokubhala uluhlu lwemibuzo kwi-rheumatology yakho elandelayo. Emva koko musa ukuthandabuza ukubabuza.