Ngaba ICFS Isisifo Ngokwenene?
UPRISCILLA ogula yiCFS (isifo sokudinwa ngokungapheliyo) weLizwana laseWashington, eUnited States, wachaza oku, “Ndandiquqa koogqirha ngoogqirha. Bandixilonga igazi yaye bendibuza ngendlela endiziphethe ngayo. Babesithi kwakungekho ndonakele ngam yaye bacebisa ukuba ndifune ukuncedwa ngokwasengqondweni. Akukho namnye kwabo gqirha owayekulungele ukukuthabatha nzulu oko ndandikuthetha okanye iimpawu zokugula endandinazo.”
La ngamava aqhelekileyo. Omnye ugqirha ebhala kwi JAMA (Journal of the American Medical Association) kunyaka ophelileyo wathi: “Ngaphambili umguli oqhelekileyo weCFS waya koogqirha abahlukeneyo abali-16. Inkoliso yaxelelwa ukuba yayiphile qete, ukuba yayidandathekile, okanye ukuba yayinoxinezeleko olukhulu. Abaninzi bathunyelwa koogqirha bengqondo. Namhlanje imeko ayisafani, nangona ingekaphucuki kangako.”
ICFS izisa ucelomngeni olwahlukileyo, njengokuba iThe American Journal of Medicine isithi: “Kuluxanduva olukhulu ukusebenza ngesigulo athi umntu onaso abonakale esempilweni, ekwimeko eqhelekileyo xa exilongwa nakwiziphumo zovavanyo oluqhelekileyo lwaselebhu. Ngokuqhelekileyo esi sigulo sinxulunyaniswa nokuphazamiseka kolwalamano lwamaqabane atshatileyo, nezinye izalamane, nabaqeshi, nabafundisi-ntsapho, neengcali kwezempilo kunye neenkampani zeinshorensi.”
Into elucelomngeni koogqirha kukuba ukudinwa kuluphawu oluxhaphakileyo. Umhleli kwezamayeza wabhala oku, “Ukuba ugqirha ebebiza [ii-R3] kumguli ngamnye oze kukhalazela ukudinwa, ebeya kuyeka ukuba ngugqirha.” Kodwa ke, ngokucacileyo, bambalwa abantu abakhala ngokudinwa kuba beneCFS. Ekubeni kungekho ndlela yezamayeza yokubona esi sigulo, oogqirha banokusiqonda njani?
Ukuchaza ICFS
NgoMatshi 1988 iCDC (U.S. Centers for Disease Control [Amaziko Okuthintela Izifo AseUnited States]) yapapasha kwiAnnals of Internal Medicine iqela lemiqondiso neempawu ezithi xa zidibene zibe ziimpawu zeCFS. (Bona ibhokisi elapha.)
Imigqaliselo ebalaseleyo yokuxilonga iCFS yile (1) ukuhlaselwa okutsha kukudinwa okuhlala ngaphezu kweenyanga ezintandathu nokuphelisa amandla kabani ngomlinganiselo wama-50 ekhulwini kunye (2) nokubekela ecaleni olunye unyango okanye iimeko zezigulo zengqondo ezinokubangela iimpawu zayo. Noko ke, ukuze kuqinisekwe ukuba uneCFS, kwakhona umguli umele abe neempawu ezisi-8 kwezili-11 kuludwe lwemigqaliselo emincinane okanye ezi-6 kwi-11 lezi mpawu ndawonye nezimbini kwezintathu kuludwe lwemigqaliselo yasemzimbeni.
Licacile elokuba, abo bafunyenwe beneempawu zeCFS bagula kakhulu ixesha elide. ICDC yayenza inkcazelo yeCFS yayelinganiselwe kakhulu ukuba ibachaze ngokucacileyo aba bantu. Okwangoku le nkcazelo ayingeni tu kwabo baneentlobo ezingaxhalabisi kangako zesi sifo.
Ngaba ICFS Inokuba Ludandatheko?
Kuthekani ngoogqirha abathi abaguli abeneCFS banodandatheko nezinye izigulo zengqondo? Ngaba aba baguli baneempawu eziqhelekileyo zodandatheko?
Ngokuqhelekileyo abaguli abaneCFS bayadandatheka, kodwa kunjengokuba uGqr. Kurt Kroenke, ongunjingalwazi kwisikolo samayeza esiseBethesda, eMaryland, eUnited States, wabuza oku: “Ngaba nabani na ebengayi kudandatheka ukuba unokuhlala ediniwe kangangonyaka okanye ngaphezulu?” Ngoko ukubuza ngolu hlobo kufanelekile: Ngaba udandatheko lungunobangela weCFS, okanye lungumphumo wayo?
Kudla ngokuba nzima ukuwuphendula loo mbuzo. Ugqirha usenokuqwalasela ingongoma yesibini kuludwe lwemigqaliselo ebalaseleyo, ngongoma leyo ethi ‘iimeko zengqondo ezinokubangela iimpawu zayo mazibekelwe ecaleni,’ aze agqibe kwelokuba umguli udandathekile yaye akaguli ngokwasemzimbeni. Kanti kumaxesha amaninzi le asiyondlela yanelisayo yokuqiniseka ngesigulo.
Ulindixesha wezamayeza iThe Cortlandt Consultant wathi: “Eyona nxalenye yobungqina obeyisayo bokuba iCFS isisigulo ‘esingokwasemzimbeni,’ buvela ekuhlaseleni kwayo ngesiquphe abaguli abangama-85 ekhulwini. Uninzi lwabaguli luthi ukugula kwabo kwaqala ngaminazan’ ithile ngesigulo esibumkhuhlane esiphawulwa ngokuba nefiva, [ukuqaqamba komqala, ukudumba kwamadlala enkovu, ukuqaqamba kwezihlunu] nezinye iimpawu ezifanayo.” Oogqirha abaye banyanga abaguli abaneCFS beyisekile kukuba ngokufuthi udandatheko alungonobangela weempawu zayo.
UGqr. Anthony Komaroff, oyintsumpa kwiGeneral Medicine eBrigham nakwiWomen’s Hospital eBoston, eUnited States, wanikela le ngxelo: “Xa sasihlolisisa abaguli bethu, sachukunyiswa sisibakala sokuba inkoliso yabaguli yathi yayiphile qete, inamandla yaye inempumelelo ebomini kwade kwayiloo mini yavelelwa yingqele, ngumkhuhlane okanye isifo semibhobho yemiphunga nezaba sisanama ndokunamathela. Iimpawu ezinokugqalwa njengezinokuthanani nengqondo—Udandatheko, ukungemi kakuhle engqondweni, ukungalali kakuhle nezinye—azizange zibekho ngaphambi kokuqalisa kwesi sigulo.”
Olunye uphawu oluqhelekileyo lokudandatheka kukuphelelwa ngumdla kwinto yonke. Kodwa uGqr. Paul Cheney wachaza oku: “Aba baguli bahluke mpela. Bakuxhalabele kakhulu oko kuthethwa ziimpawu zabo. Akukho nto banokuyenza. Abanakusebenza. Abaninzi bayoyika. Kodwa abaphelelwa ngumdla kwizinto ezibangqongileyo.”
Ukudumba kwamadlala, ifiva, umlinganiselo ongaqhelekanga weeseli ezimhlophe zegazi, ukuphazamiseka ngokuphindaphindiweyo kwenkqubo yokuphefumla, iingqaqambo zezihlunu namalungu, yaye ngokukodwa ukungemi kakuhle engqondweni okungaqhelekanga nokuqaqamba kwezihlunu okusenokubakho emva kokwenza umthambo ongephi—ezi mpawu ayizompawu zesifo esinokuthanani nodandatheko.
Ukubaluleka Kobungqina Bakutshanje
Kwinkupho yayo kaNovemba 6, 1991, i JAMA yanikela le ngxelo: “Inkcazelo yokuqala yophengululo oluqhubekayo olwenziwa kubaguli abaneempawu ezichazwe yiCDC njengeziphawula isifo sokudinwa ngokungapheliyo (CFS) ibonisa ukuba inkoliso yabaguli enesi sigulo ayingomaxhoba okudandatheka okanye ezinye izigulo zengqondo.”
UGqr. Walter Gunn, owayeluqwalasele ngokunzulu uphando olwenziwa yiCDC ngeCFS, wachaza oku kule nkupho yeJAMA: “Phezu kwaso nje isibakala sokuba oogqirha abaninzi bebeya kucinga ukuba aba baguli [kolu phengululo] babenodandatheko, sifumanise ukuba kuphela ngama-30 ekhulwini abaguli abaneCFS ekwafumaniseka ukuba babedandathekile ekuqaliseni kwabo ukuba nokudinwa.”
Kusenokubakho ukwahluka okungokwasemzimbeni phakathi kwabaguli abaninzi abaneCFS kunye nabo bagula kukudandatheka. Ulindixesha wezamayeza iThe Female Patient wathi: “Ngokufuthi abaguli abanesigulo esinzulu sokudandatheka (MDD [major depression disorder]) banengxaki xa befikelela kwinqanaba lokuba kubuthongo obunzulu olubizwa ngokuthi yirapid-eye-movement (REM) sleep ngoxa abaguli abaneCFS benengxaki kwamanye amanqanaba okulala angelilo eli, nto leyo ebizwa ngokuthi yinon-REM [sleep].”
Iphephancwadi iScience likaDisemba 20, 1991, lanikela ingxelo ngenye into ephawulekayo eyafunyanwayo. Lathi uphando lubonisa ukuba “umlinganiselo weencindi ezithile zamadlala engqondo kubaguli abaneCFS uguqukile” yaye lathi: “Nangona umahluko okhoyo phakathi kwabo nabo babengenayo iCFS wawumncinane, abaguli abaneCFS ngokufanayo baye babonakalisa ukuncipha komlinganiselo westeroid hormone cortisol baze babe nomlinganiselo owandileyo wencindi ekhutshwa lidlala elingaphantsi kobuchopho iACTH (adrenocorticotropin hormone), nto ezo ezahluke mpela kwiinguqulelo ezibakho ngenxa yokudandatheka.”—Akekeliswe sithi.
Kuthekani Ukuba ICFS Isisifo Ngokwenene?
Iingcaphephe kwezamayeza zimi nematha zixakene nezifo, ezinjengeCFS. UGqr. Thomas L. English wabhala oku: “Ukuthandabuza kwesamele kulo msebenzi wethu. Ukuthandabuza okusengqiqweni kuyindlela yokucinga ‘ethandwayo’ ngoogqirha abakrelekrele, nabaqondayo.” Kanti uGqr. English uthandabuza indlela ekuyingenelo ngayo kubaguli ukuthandabuza “ukuba iCFS isisifo ngokwenene.” Ubuza oku koogqirha asebenza nabo abathandabuzayo: “Kuthekani ukuba niyaphazama? Yiyiphi imiphumo okunayo oko kubaguli benu?”
UGqr. English naye ngokwakhe ugula yiCFS, yaye kunyaka ophelileyo iJAMA yapapasha inqaku lakhe awayelibhalela oogqirha asebenza kunye nabo. Wabacela ukuba bazibeke kwimeko yaba baguli babandezelekileyo, echaza esi sifo wathi:
“Ungenwa ‘ngumkhuhlane’ yaye emva koko imeko yobomi bakho iguquka ngokupheleleyo. Akunako nokucinga kakuhle . . . Maxa wambi ngumgudu omkhulu ukufunda iphephandaba okanye ukunikela ingqalelo kwisiqendu senkqubo kamabonwakude. Umzimba uyadinwa yaye uba nesicaphucaphu esingapheliyo. Awuqinisekanga kakuhle ngoko umele ukwenze ukunyamekela umguli, nto leyo owakhe waqiniseka ngayo ngaphambili. Imyalgias [ukuqaqamba kwezihlunu] iyazenzela emzimbeni wakho ingakhethi ndawo. Iimpawu zezifo ziyadakasa apha kuwe, zikupheka zikophula. . . . Nawe ezinye iimpawu zakho zisenokukumangalisa ukuba akuzange uthethe ngazo kwabanye abaguli abaneengxaki ezifanayo . . . okanye uthethe ngazo noogqirha abakhe bazibona iimeko ezininzi ezifanayo. . . .
“Ndaye ndathetha nenkitha yabaguli esigula ngendlela efanayo ababekhe baya koogqirha ukuze bancedwe, kodwa babuya bedane bemanzi, benomsindo yaye besoyika. Imizimba yabo yayibachazela ukuba babegula ngokwasemzimbeni, kodwa into yokuba oogqirha babo baqikelele ukuba babenesigulo sengqondo yayiboyikisa yaye ibacaphukisa—yayingabanik’ ithemba. Yababonisa ukuba abo gqirha babo babengayazi eyona nto banayo. . . . Ngaba sifanele sikholelwe kwelokuba ngenxa yokuba nje iimpawu zingaziwa yaye zingaqhelekanga azinakuba zikho ngokwenene? Ngaba sifanele sikuthabathe njengokuyinyaniso ukuba uhlolisiso olwenziwa kuthi elebhu lunako ukuvelisa izigulo ezitsha ndawonye nezidala? Ukuthandatyuzwa kweembono ezintsha kwazalwa nomntu; ibe kukwanjalo ke nangemiphumo eyingozi yoko kuthandabuza.”—IJAMA kaFebruwari 27, 1991, iphepha 964.
Ukubaluleka Kokubamkela Ubukho Besi Sigulo
UGqr. Allan Kind, oyingcali kwizifo ezasulelayo, wathi: “Oogqirha abaye bachitha ixesha bedlan’ indlebe nabaguli abaneCFS babaxelela ibali elinye; kuphela kwento abanokukuxelela yona. Ndingatsho ndithi iSifo Sokudinwa Ngokungapheliyo sikho ngokwenene.”
Oogqirha abangakumbi nangakumbi bayakuvuma oko ngoku. Ngaloo ndlela iThe Female Patient yakhuthaza oogqirha yathi: “Kude kube kuveliswe indlela yokuxilonga eqinisekileyo nonyango oluchanileyo, ugqirha unembopheleleko ekhethekileyo yokuxelela aba baguli ukuba bayagula ngokwenene, yaye ‘oku akukho kuphela nje ezingqondweni zabo.’”
Ukuqinisekisa umguli ukuba uyagula kunokuba yingenelo emangalisayo. Xa ugqirha waxelela elinye ibhinqa ukuba lalineCFS, lathi: “Zasuka zehla iinyembezi.” Ukuva ugqirha esithi uyagula ngokwenene, yaye isigulo anaso sasinegama, kwamnika isiqabu.
Kanti, yintoni ebangela iCFS? Yintoni eye yatyhilwa luphando?
[Ibhokisi ekwiphepha 7]
Imigqaliselo Yokuxilonga Isifo Sokudinwa Ngokungapheliyo
Imigqaliselo Ebalaseleyo
1. Ukuqalisa kokudinwa okuhlala ngaphezu kweenyanga ezintandathu nokucutheka kwamandla akho ngama-50 ekhulwini
2. Azikho ezinye iimeko zezamayeza okanye zezigulo zengqondo ezinokubangela ezi mpawu
Imigqaliselo Emincinane
Iimpawu zimele ziqalise ekuqaliseni kokudinwa okanye emva kwako
1. Umkhuhlane ongephi
2. Ukuqaqamba komqala
3. Ukuqaqamba kwamadlala enkovu
4. Ubuthathaka nje obungengako bezihlunu zomzimba
5. Ukuqaqamba kwezihlunu
6. Ukudinwa okuhlala kuhleli emva kokwenza umthambo
7. Intloko eqaqambayo
8. Imikhinkqi
9. Ukungalali kakuhle
10. Iingxaki ezinokuthanani nesigulo sengqondo, njengokulibala, ukudideka, ukungakwazi ukunikela ingqalelo, udandatheko
11. Ukuhlasela kwayo ngokuqatha (kwiiyure ezimbalwa ukuya kwiintsuku ezimbalwa)
Imigqaliselo Engokwasemzimbeni
1. Ifiva engephi
2. Ukukrala komqala
3. Ubuthathaka okanye ukuphawuleka kwamadlala enkovu
[Umfanekiso okwiphepha 8]
Oogqirha bamele babe neliso elibukhali ekwahlukaniseni udandatheko nesifo sokudinwa ngokungapheliyo