Istroke—Unobangela Waso
“UBUCHOPHO bulelona lungu liethe-ethe lomzimba,” satsho isazi ngezifo zemithambo-luvo uGqr. Vladimir Hachinski, weYunivesithi yaseWestern Ontario eLondon, eKhanada. Nangona ubunzima babo busisi-2 ekhulwini kubunzima bomzimba uwonke, ubuchopho buqulethe ngaphezu kweshumi lamawaka ezigidi zeeseli zomthambo-luvo, ezithi ziqhubeke zinxibelelana ukuze zivelise ingcinga, intshukumo, kwanoluvo ngalunye. Buxhomekeke kwioksijini nakwiswekile ukuze bufumane amandla, ubuchopho bufumana ezi zinto ngokuthe ngqo ngendlela edlula kwinkqubo entsokothileyo yoonothumela.
Noko ke, xa nayiphi na inxalenye encinane yobuchopho ingayifumani ioksijini kwanokuba yimizuzwana nje embalwa, imithambo-luvo e-ethe-ethe iyayeka ukusebenza. Ukuba oku kuyaqhubeka ngaphezu kwemizuzu embalwa, kuphumela ekonakaleni kobuchopho, njengokuba iiseli zobuchopho ziqalisa ukungasebenzi kwanemisebenzi eziwenzayo uyaphela. Le meko ibizwa ngokuthi yi-ischemia, ukungabikho kweoksijini ngokuyintloko okubangelwa kukuvaleka koonothumela. Kubakho umonakalo obhekele phaya ebuchotsheni njengoko ukungafumaneki kweoksijini eyaneleyo kubangela udederhu oluyingozi lokuguquka kwemichiza. Umphumo uba sistroke. Kwakhona istroke sibakho xa kugqabhuke imithambo yegazi, izalise ubuchopho ngegazi, nto leyo evala ukuqhagamshelana kwemithambo-luvo. Oku kuphazamisa ukuthunyelwa kwemiyalezo engokwemichiza neyokunika amandla kwizihlunu kuze kubangele umonakalo ebuchotsheni.
Imiphumo Yaso
Istroke ngasinye siyahluka, yaye iintlaselo zestroke zisenokuchaphazela ubani ngamnye ngeendlela ezininzi gqitha. Nangona imiphumo yestroke ingafani kubantu bonke, sisenokukuqala kancinane side sikubhuqe ngendlela ebuhlungu ngokungathethekiyo. Ukuba ngawaphi amalungu omzimba angasebenziyo kuxhomekeke kwicala lobuchopho elinestroke.
Iingxaki ezidla ngokubangelwa siso bubuthathaka okanye ukungasebenzi kwamalungu omzimba angasentla nangasezantsi. Ngokuqhelekileyo, oku kwenzeka kuphela kwicala elinye lomzimba, kwicala elimeleneyo nelo ubuchopho buye bafumana istroke kulo. Ngoko, ukonakala kobuchopho ngasekunene kuphumela ekubeni amalungu omzimba angasekhohlo angasebenzi, yaye ukonakala kobuchopho ngasekhohlo, kubangela amalungu angasekunene angasebenzi. Kwabanye zisenokuqhubeka zisebenza iingalo kwaneenyawo zabo, bafumanise ukuba izihlunu zabo ziyangcangcazela kangangokuba amalungu abo aya lilelo kwicala lalo. Elo xhoba lifana nomntu osafunda ukutyibilika emkhenkceni ozama ukulungelelana. UGqr. David Levine, weNew York University Medical Center, uthi: “Abakwazi ukuva enoba ilungu labo liyashukuma kusini na kwanalapho likhoyo.”
Ngaphezu kwe-15 ekhulwini labasinde emva kokuhlaselwa sesi sifo bayaxhuzula, nto leyo ephumela ekubeni amalungu omzimba ashukume ngokungalawulekiyo yaye, ngokuqhelekileyo, bade bamkelwe ziingqondo. Kwakhona, ukuqaqanjelwa kwanokuguquka kweemvakalelo kuqhelekile. Omnye umntu osindileyo emva kokuhlaselwa sistroke nosoloko enezandla neenyawo ezindindisholo uthi: “Ngeentsuku ezithile ebusuku kubakho into ethi xhokro ezinyaweni zam endivusa ngoko ekubeni kuba ngathi ndibethwa ngumbane.”
Istroke sisenokwenza ubone nto nganye ngokungathi zimbini uze ube neengxaki zokuginya. Ukuba izivamvo zokungcamla zomlomo kwanezomqala zonakele, abo bangamaxhoba estroke banokuba neengxaki ezingathandekiyo, ezinjengokuvuza izinkcwe. Nasiphi na kwizivamvo ezintlanu sisenokuchaphazeleka, sibangele ukungaboni kakuhle, ukungeva, ukungakwazi ukujoja, ukungcamla, kwanokuchukumisa.
Iingxaki Zonxibelelwano
Khawube nomfanekiso-ngqondweni ulandelwa zizigantsontso ezimbini ongazaziyo kwisitrato esikhanyise luzizi. Xa ukrwaqula ngemva, uzibona zikuleqa. Uyazama ukukhwaza ucela uncedo, kodwa ilizwi aliphumi! Ngaba unokuyithelekelela indlela obuya kucaphuka ngayo xa ukwimeko enjalo? Oko koko kuviwa ngamaxhoba estroke xa ngequbuliso esiba zizimumu.
Ukungakwazi ukudlulisela iingcinga, iimvakalelo, amathemba, okanye uloyiko—ngokungathi kunjalo usahlukaniswa nabahlobo kwanentsapho—yenye yeyona miphumo inxunguphalisayo yestroke. Omnye osindileyo emva kokuhlaselwa sistroke ukuchaza ngale ndlela: “Ngalo lonke ixesha ndizama ukuvakalisa izimvo zam ilizwi lalingaphumi. Kwakunyanzeleka ukuba ndithule yaye ndandingakwazi ukulandela umyalelo othethwayo okanye obhaliweyo. Amazwi ayevakala . . . ngokungathi abantu endikunye nabo babethetha olunye ulwimi endingalwaziyo. Ndandingakwazi ukuluqonda okanye ukulusebenzisa ulwimi.”
Noko ke, uCharles wayekuqonda konke okwakuthethwa kuye. Kodwa xa kufuneka ephendule, ubhala esithi: “Ndandiwayila amagama endandifuna ukuwathetha, kodwa ndandishwantshwatha nje yaye ndiwaginya amazwi. Ngelo xesha ndandiziva ndikhinkxekile.” Kwincwadi yakhe ethi Stroke: An Owner’s Manual, uArthur Josephs uthi: “Ebudeni bokuthetha izihlunu ezahlukahlukeneyo ezingaphezu kwezilikhulu ziyasebenza zize zilungelelaniswe yaye ngasinye kwezi zihlunu silawulwa yimithambo-luvo ebangela intshukumo engaphezu kwekhulu. . . . Kufuneka imithambo-luvo ishukume kangange-140 000 ngasihlandlo sinye xa kuthethwa. Ngaba kuyamangalisa ke ngoko ukuba ukonakala kwecala elithile lobuchopho obulawula ezi zihlunu kuphumele ekushwantshwatheni?”
Istroke sibangela amagingxigingxi amaninzi ekuthetheni. Ngokomzekelo, umntu ongakwaziyo ukuthetha usenokukwazi ukucula. Omnye usenokuthetha amazwi athile engaziva kodwa kungekho nto afuna ukuyithetha okanye mhlawumbi, kwelinye icala, athethe angayeki. Abanye baphinda-phinda amagama okanye amabinzana athile okanye amagama angafanelekanga, besithi ewe xa befuna ukuthi hayi baze bathi hayi xa befuna ukuthi ewe. Abanye bayakwazi oko bafuna ukukuthetha, kodwa ubuchopho abukwazi ukukhokelela umlomo, imilebe, kwanolwimi ekuthetheni oko. Okanye basenokuthetha into engavakaliyo ngenxa yobuthathaka bezihlunu. Abanye basenokugqibezela intetho yabo ngokudubuleka.
Omnye umonakalo obangelwa sistroke usenokuba kukungasebenzi kakuhle kwecala lobuchopho elilawula iimvakalelo. Umphumo usenokuba kukuthethela phantsi. Okanye kusenokuba nzima ukuqonda oko kuthethwa ngabanye. Ubunzima bonxibelelwano obunjengobu kwanobo buchazwe ngasentla busenokubangela umsantsa phakathi kwamalungu entsapho, njengendoda nomfazi wayo. UGeorg ucacisa esithi: “Kuba i-stroke sichaphazela inkangeleko yobuso kwanezimbo zomzimba, ewe ubuntu bukabani bubonke, ngequbuliso sasingavani njengangaphambili. Kwakubonakala ingathi ndandinomfazi omtsha, umntu ekwakufuneka ndimazi kakuhle kwakhona.”
Ukuguquka Kweemvakalelo Kwanobuntu
Ngokutshintshatshintsha kwendlela ubani avakalelwa ngayo, ukutsho ngesikrakra isikhalo kwanokuhleka kube buhlungu amathumbu, ukuba nomsindo ongalawulekiyo, ukuba neemvakalelo ezingaqhelekanga zokukrokra, kwanokudana kakhulu ezo zezinye zezinto ezididayo neziphazamisa iimvakalelo kwanobuntu babo basinde emva kokuhlaselwa sistroke kwaneentsapho zabo.
Elinye ixhoba lestroke elinguGilbert lithi: “Maxa wambi, ndiyachukumiseka, ndihleke okanye ndikhale ngenxa yento nje encinane. Ngamanye amaxesha, xa ndihleka, mntu uthile uyabuza, ‘Yintoni ehlekisayo?’ yaye ngokwenene andinakuyixela.” Oku, kunye neengxaki zokungakwazi kuxhathisa kwanokuqhwalela kancinane, kwabangela uGilbert athi: “Ndivakalelwa ngokungathi ndinomnye umzimba, ngokungathi ndingomnye umntu, ndingenguye laa mntu bendinguye ngaphambi kokuba ndifumane i-stroke.”
Bambalwa ukuba bakho kwaukubakho abantu abaneziphene engqondweni abangaphazamisekiyo ngokweemvakalelo. UHiroyuki, esamshiya istroke engakwazi ukuthetha yaye eneziphene ezingephi, ugqabaza esithi: “Kwanasekuhambeni kwexesha andizange ndibe bhetele. Ekubeni ndandiqonda ukuba andinakuphinda ndikwazi ukuqhubeka nomsebenzi wam njengangaphambili, ndaphelelwa lithemba. Ndaqalisa ukubeka ityala kwizinto ezithile kwanakubantu abathile yaye intliziyo yam yayilihlwili. Ndasuka ndalityutyusi.”
Uloyiko kwanokuxhalaba kuqhelekile kumaxhoba estroke. UEllen uthi: “Ndiziva ndingakhuselekanga xa ndisiva uxinezeleko entloko olubonisa ukuba ndiza kuhlaselwa si-stroke kwakhona. Ndiba noloyiko kakhulu ukuba ndiyazivumela ukuba ndikhathazeke.” URon ucacisa ngenkxalabo asoloko enayo: “Ukufikelela kwizigqibo ezifanelekileyo kubonakala kungenakwenzeka ngamanye amaxesha. Ukucombulula iingxaki ezimbini okanye ezintathu ezincinane ngexesha elinye kuyandicaphukisa. Ndizilibala msinya izinto kangangokuba andikwazi ukukhumbula isigqibo endisenze kwimizuzu embalwa edlulileyo. Umphumo woku kukuba ndenza iimpazamo ezinkulu, yaye oku kundibangela iintloni kwanabanye abantu. Ndiza kuba njani kwiminyaka embalwa ezayo? Ngaba ndiza kukwazi ukuncokola into esezingqondweni okanye ukuqhuba inqwelo-mafutha? Ngaba ndiza kuba ngumthwalo kumfazi wam?”
Amalungu Entsapho Nawo Angamaxhoba
Ngoko, kuyabonakala ukuba asingomaxhoba estroke athwaxwa yimiphumo enxunguphalisayo. Kunjalo kwanakwiintsapho zawo. Kwezinye iimeko zimele zihlangabezane nokothuka okubi kokubona lowo owayesakuba ngumntu ophilileyo, okwaziyo ukwenza izinto ngephanyazo esiya ephelelwa bejongile, esiba kwimeko enjengeyosana olungakwaziyo ukuzenzela nto. Ulwalamano lusenokuphazamiseka njengoko amalungu entsapho kusenokwenzeka adlale iindima angaqhelananga nazo.
UHaruko uchaza loo miphumo ilusizi ngolu hlobo: “Umyeni wam wayelibala phantse yonke into ebalulekileyo. Ngokukhawuleza kwafuneka siyivale inkampani awayeyiqhuba saza salahlekelwa yindlu yethu kwanezinto zethu. Okwandidakumbisa kakhulu kukuba ndandingakwazi ukuthetha nomyeni wam ngokukhululekileyo okanye ndiye kuye xa ndifuna icebiso. Edidekile enoba kuyahlwa okanye kuyasa, ngokufuthi wayesusa izinto zokusikhusela ezifunekayo ebusuku. Nangona sasisazi ukuba liyeza ixesha laxa le meko akuyo iza kuba bhetele, kusenzima ukuba siyamkele le meko akuyo. Imeko yethu iguquke ngokupheleleyo, kangangokuba sithetha nje mna nentombi yam singabagcini bendoda yam.”
“Ukunyamekela umntu one-stroke—enoba umthanda kangakanani na—kusenokuba luxanduva ngamanye amaxesha,” utsho uElaine Fantle Shimberg kwincwadi ethi Strokes: What Families Should Know. “Ingcinezelo neembopheleleko azipheli.” Kwezinye iimeko umgangatho wokunyamekela onikelwa ngamanye amalungu entsapho unokubangela umonakalo kwimpilo, kwiimvakalelo, nakubumoya balowo unyamekela umguli. UMaria uthi ukugula kukanina sistroke kwamchaphazela ngamandla: “Ndiyamtyelela imihla ngemihla yaye ndizama ukumkhuthaza ngokomoya, ndifunda ndize ndithandaze naye, ndize ndibonakalise uthando, ndimange, yaye ndimncamise. Xa ndibuyela ekhaya, ndifika ndidiniwe ngokweemvakalelo—ngezinye iintsuku ndide ndikhuphe.”
Eyona nto inzima kwabanye abantu abanyamekela abaguli kukuhlangabezana nokuguquguquka kwesimilo. Ingcali ngokusebenza kwemithambo-luvo uGqr. Ronald Calvanio uxelela uVukani! oku: “Xa ubani enesifo esichaphazela ukusebenza kommandla ongasentla wobuchopho—oko kukuthi indlela ubani acinga ngayo, abuphila ngayo ubomi bakhe, ukusabela kwakhe ngokweemvakalelo—siqhubana nobuntu bakhe, ngoko ngezinye iindlela ukonzakala ngokwengqondo okwenzekayo ngokwenene kubuguqula ngokupheleleyo ubomi bentsapho.” UYoshiko uchaza oku: “Umyeni wam ukhangeleka etshintshe ngokupheleleyo emva kokugula kwakhe, ucatshukiswa nayinto le encinane. Eneneni andonwabi kwaphela ngaloo maxesha.”
Ngokufuthi, ukuguquka kobuntu akunakubonwa ngabo bangaphandle entsatsheni. Ngenxa yoko, abanye abanyamekela abaguli baziva bengamalolo yaye besingathe imithwalo yabo bebodwa. UMidori uthi: “Iintlaselo ze-stroke zimshiye umyeni wam onzakele ngokwengqondo nangokweemvakalelo. Nangona elufuna ngamandla ukhuthazo, akasokuze athethe ngaso nakubani na yaye oku kumgqiba ngaphakathi. Ngoko kuxhomekeke kum ukuba ndiqhubane neemvakalelo zakhe. Ukubukela ukutshintshatshintsha kweemvakalelo zomyeni wam suku ngalunye kundenza ndibe nexhala yaye ngamanye amaxesha kuyandoyikisa.”
Abo baye basinda emva kokuhlaselwa sistroke neentsapho zabo baye bahlangabezana njani neenguquko eziziswe sistroke kubomi babo? Kungaziphi iindlela thina ngabanye esinokubaxhasa ngazo abo babandazeleke yimiphumo eyonzakalisayo yestroke? Inqaku lethu elilandelayo liyacacisa.
[Ibhokisi/Umfanekiso okwiphepha 7]
Imiqondiso Esisilumkiso
• Ubuthathaka bequbuliso, ukuba ndindisholo, okanye ukujijeka kobuso, ukugogeka kwengalo, okanye umlenze, ingakumbi kwicala elinye lomzimba
• Ukungaboni kakuhle ngequbuliso, ingakumbi kwiliso elinye; ube namathuba okubona into ngokungathi zimbini
• Ukuba nobunzima ekuthetheni okanye ekuqondeni kwanezivakalisi ezilula
• Ukuba nesiyezi okanye ukungakwazi ukuxhathisa, ingakumbi xa kukho nolunye uphawu lwesi sifo
Iimpawu Ezingaxhaphakanga Kakhulu
• Ukuphathwa yintloko ebuhlungu kakhulu ngequbuliso ngaphandle kwesizathu—ngokufuthi ichazwa “njengeyona ntloko yakhe yabuhlungu”
• Ngequbuliso ubucaphucaphu kwanefiva—okwahlukileyo kukugula okubangelwa yintsholongwane ngenxa yokukhawuleza kwabo (imizuzu okanye iiyure kuneentsuku eziliqela)
• Ukulahlekelwa ngokufutshane ziingqondo okanye ukukhe uthi siba (ukuwiswa sisiyezi, ukudideka, ukuxhuzula, ukufa isiqaqa)
Musa Ukuzityeshela Iimpawu Zesi Sifo
UGqr. David Levine uyabongoza ukuba xa iimpawu zesi sifo zibonakala, umguli “makaye ngokukhawuleza kangangoko kunokwenzeka kwicandelo lezongxamiseko esibhedlele. Kukho ubungqina bokuba xa i-stroke sinyangwe kwiiyure ezimbalwa zokuqala, umonakalo unokuncipha.”
Maxa wambi iimpawu zesi sifo zisenokuvela kwixesha elifutshane kakhulu zize ziphele. Ezi zihlandlo zaziwa njengeeTIA, okanye iitransient ischemic attacks (ukungahambi kakuhle kwegazi ebuchotsheni). Musa ukuzityeshela, ekubeni zisenokubonakalisa ubungozi bestroke esinzulu, yaye istroke esipheleleyo sisenokulandela. Ugqirha usenokunyanga unobangela aze athothise ubungozi bestroke sexesha elizayo.
Adapted from guidelines provided by the National Stroke Association, Englewood, Colorado, U.S.A.