Unhlangothi—Imbangela Yawo
“UBUCHOPHO buyisitho somzimba esintekenteke kakhulu,” kusho isazi sezinzwa uDkt. Vladimir Hachinski, wase-University of Western Ontario eLondon, eCanada. Nakuba bungamaphesenti amabili kuphela esisindo somzimba, ubuchopho bunamangqamuzana ezinzwa angaphezu kwezigidi eziyizinkulungwane eziyishumi, asebenzelana njalo ukuze kwakheke yonke imicabango yethu, ukunyakaza nemizwa. Njengoba buthembele kumoya-mpilo nakuyi-glucose ukuze bube namandla, ubuchopho buthola lezi zinto njalo ngesimiso esiyinkimbinkimbi semithambo yegazi.
Nokho, uma ingxenye ethile yobuchopho ingawutholi umoya-mpilo ngisho imizuzwana nje embalwa, ukusebenza kwamangqamuzana ezinzwa abucayi kuyaphazamiseka. Uma lokhu kuqhubeka imizuzu embalwa, ubuchopho buyalimala, njengoba amangqamuzana abo eqala ukufa futhi kunqamuke nemisebenzi ayenzayo. Lesi simo kuthiwa yi-ischemia, ukuntuleka komoya-mpilo okubangelwa ngokuyinhloko ukuvaleka kwemithambo yegazi. Ubuchopho bulimala nakakhulu lapho ukuntuleka komoya-mpilo kubangela ukuxubana kwamakhemikhali okunhlobonhlobo okubulalayo. Umphumela uba unhlangothi. Umuntu ushaywa unhlangothi nalapho imithambo yegazi iqhuma, kugcwale igazi ebuchosheni, livimbe imizila yabo yokuxhumana. Lokhu kuphazamisa imiyalezo yamakhemikhali nekagesi futhi kubangele ukulimala kwezicubu zobuchopho.
Imiphumela Yawo
Ukuhlasela ngakunye kukanhlangothi kuhlukile, futhi imiphumela yawo kubantu ayinakubalwa. Nakuba kungekho muntu obhekana nayo yonke imiphumela kanhlangothi, imiphumela ingasuka kwengenamandla nengabonakali iye kwenamandla kakhulu nesobala ngendlela edabukisayo. Ingxenye yobuchopho eshaywa yilesi sifo inquma ukuthi imiphi imisebenzi yomzimba ephazamisekayo.
Inkinga evamile ubuthakathaka noma ukukhubazeka kwezingalo nemilenze. Ngokuvamile, lokhu kwenzeka ohlangothini olulodwa lomzimba, uhlangothi olungaqondene nengxenye yobuchopho eshaywe unhlangothi. Ngakho, ukufa kobuchopho ngakwesokudla kubangela ukukhubazeka kohlangothi lwesobunxele lomzimba, kanti ukufa kobuchopho ngakwesobunxele kubangela ukukhubazeka kohlangothi lwesokudla lomzimba. Abanye abantu bangase bakwazi ukuqhubeka besebenzisa izingalo nemilenze yabo, kodwa imisipha yabo igqagqazele kakhulu kangangokuba kuze kubonakale sengathi izitho zabo ziyazixegela nje. Isisulu sibukeka njengemfundamakhwela yokushwibeka eqhweni ezama ukuma ingawi. UDkt. David Levine, waseNew York University Medical Center, uthi: “Awube usasebenza umuzwa obatshelayo ukuthi isitho siyanyakaza yini noma cha nokuthi sikuphi.”
Abashaywa unhlangothi abangamaphesenti angu-15 baba nemiqhabanyeko, ebangela ukudlikizeka komzimba okungalawuleki kanye nokuquleka ngezinye izikhathi. Futhi, ukuzwa ubuhlungu nokushintsha kwemizwa kuvamile. Owashaywa unhlangothi ovame ukuba nezandla nezinyawo ezindikindiki uthi: “Ngezinye izikhathi ebusuku imilenze yami iyaye ithintwe okuthile bese ngiyaphaphama ngoba kuba sengathi ngibanjwa ugesi.”
Umphumela kanhlangothi ungase uhlanganise ukubona njengengxemu nobunzima bokugwinya. Uma izinzwa ezilawula umlomo nomphimbo zilimele, abafe uhlangothi bangabhekana nezimo eziphoxa nakakhulu, njengokugxaza amathe. Noma yiziphi izinzwa kwezinhlanu zingathinteka, kubangele ukuphazamiseka kwamehlo, ukuzwa, ukuhogela, ukunambitha nokuthinta.
Izinkinga Zokukhulumisana
Ake uzicabange ulandelwa abantu ababili ongabazi abayizidlakela emgwaqweni onezibani ezilufifi. Uma ujeqeza, ubabona beza begijima. Uzama ukuhlaba umkhosi, kodwa izwi aliphumi! Ungacabanga ukukhungatheka obungaba nakho esimweni esinjalo? Yilokho abaningi abashaywa unhlangothi ababhekana nakho lapho ngokungazelele bengasakwazi ukukhuluma.
Ukungakwazi ukuveza imicabango, imizwa, amathemba, nokwesaba onakho—ukuhlukaniswa nabangane nomkhaya ngomqondo ongokomfanekiso—kungomunye wemiphumela ekhungathekisa kakhulu kanhlangothi. Omunye owashaywa unhlangothi wakuchaza ngale ndlela: “Njalo lapho ngizama ukusho okuthile ngangingakwazi ukukusho. Ngaphoqeleka ukuba ngihlale ngithulile futhi ngangingayiqondi imiyalo ekhulunywayo noma ebhalwe phansi. Amagama ayezwakala . . . njengokungathi abantu abangizungezile bakhuluma ulimi engingalwazi. Ngangingaluqondi ulimi futhi ngingakwazi ukulukhuluma.”
Nokho, uCharles wayekuzwa konke ayetshelwa kona. Kodwa ngokuqondene nempendulo, uyabhala: “Ngangiwacabanga kahle amagama engifuna ukuwasho, kodwa uma ngikhuluma ulimi lwaluvele lubophane. Ngaleso sikhathi ngangizizwa sengathi ngivalelwe ngaphakathi kimi.” Encwadini yakhe ethi Stroke: An Owner’s Manual, u-Arthur Josephs uyachaza: “Lapho umuntu ekhuluma kusuke kusebenzelana imisipha engaphezu kweyikhulu futhi ngamunye waleyo misipha ulawulwa isilinganiso sama-motor unit angaphezu kwayikhulu. . . . Kudingeka izinqubo eziyinkimbinkimbi ezingu-140 000 zezinzwa nemisipha ukuze umuntu akhulume umzuzwana ngamunye. Ingabe kuyamangalisa yini ukuthi ukulimala kwengxenye yobuchopho elawula le misipha kungase kubangele ukubophana kolimi lapho umuntu ekhuluma?”
Ukushaywa unhlangothi kubangela izinto eziningi ezixakile ekhonweni lokukhuluma. Ngokwesibonelo, umuntu ongakwazi ukukhuluma angase akwazi ukucula. Omunye angase aphahluke kodwa angakwazi ukukhuluma lapho efuna, noma ngakolunye uhlangothi, angase akhulumele futhi. Abanye baphindaphinda amagama noma bawasebenzise ngendlela engafanele, bathi yebo lapho befuna ukuthi cha. Abanye bayawazi amagama abafuna ukuwasho, kodwa ubuchopho abuwushukumisi umlomo, izindebe nolimi ukuba kukhulume. Noma bangase bangakhulumi kahle ngenxa yemisipha ebuthakathaka. Abanye bangase babhoke ngolaka lapho begcizelela abakushoyo.
Omunye umonakalo obangelwa ukushaywa unhlangothi kungase kube ukukhubazeka kwengxenye yobuchopho elawula imizwelo. Umphumela ungaba ukukhuluma ngendlela engaguquguquki. Noma kungase kube nzima ukuqonda imizwa yabanye. Izithiyo zokukhulumisana ezinjengalezi kanye nalezo ezichazwe ngenhla zingahlukanisa amalungu omkhaya, njengendoda nomkayo. UGeorg uyachaza: “Ngenxa yokuthi ukushaywa unhlangothi kushintsha ukubukeka kobuso nokushukuma komzimba, empeleni kushintsha bonke ubuntu, ngokungazelele mina nomkami sase singasezwani njengakuqala. Ngabona sengathi nginenkosikazi ehluke ngokuphelele, okwakufanele ngiqale phansi ngiyazi kabusha.”
Ushintsho Olungokomzwelo Nolobuntu
Ukushintshashintsha kwemizwelo okungafanele, ukukhihla isililo noma ukuhleka, ukuthukuthela ngokweqile, ukuzindlekela abanye, nokudumala kakhulu kumane kungezinye zeziphazamiso ezixakile ezingokomzwelo nezobuntu lezo abashaywe unhlangothi nemikhaya yabo okungase kudingeke babhekane nazo.
Owashaywa unhlangothi okuthiwa uGilbert uyalandisa: “Ngezinye izikhathi, ngiyathinteka ngokomzwelo, ngihlekiswe noma ngikhaliswe izinto eziwubala. Ngezinye izikhathi, lapho ngihleka, othile uyaye abuze, ‘Uhlekani?’ bese ngiswela impendulo.” Lokhu, kanye nezinkinga zokuma angantengi nokuxhuga, kwashukumisela uGilbert ukuba athi: “Ngizizwa sengathi ngikomunye umzimba, njengokungathi ngingomunye umuntu, hhayi lowaya muntu enganginguye ngaphambi kokushaywa unhlangothi.”
Njengoba bephila nokukhubazeka okushintsha ingqondo nomzimba, bambalwa abantu, uma bekhona, abakwazi ukugwema umuzwa wokuphazamiseka ngokomzwelo. UHiroyuki, owashaywa unhlangothi wamshiya enenkinga yokukhuluma futhi engakhubazekile ngokuphelele, uyaphawula: “Ngisho nangemva kwesikhathi esithile angizange ngibe ngcono. Lapho ngiqaphela ukuthi ngangingeke ngisaqhubeka nomsebenzi wami njengakuqala, ngaphelelwa yithemba. Ngaqala ukusola izinto ezithile nabantu futhi ngaba nomuzwa wokuthi ngizosangana. Angizange ngiziphathe njengendoda.”
Abantu abashaywe unhlangothi ngokuvamile bayesaba futhi bakhathazeke. U-Ellen uthi: “Ngifikelwa ukwesaba lapho ngizwa ubuhlungu bekhanda obungase bube ibika likanhlangothi. Ngiba novalo kakhulu uma ngizivumela ukuba ngigxile emiqondweni ephambene.” URon uchaza indlela akhathazeka ngayo: “Ngezinye izikhathi ngiyehluleka ukufinyelela iziphetho ezifanele. Ukuxazulula izinkinga ezincane ezimbili noma ezintathu ngasikhathi sinye kuyangikhungathekisa. Ngikhohlwa kalula kangangokuthi ngezinye izikhathi angisikhumbuli isinqumo engisenze emizuzwini nje embalwa ngaphambi kwalokho. Ngenxa yalokho, ngenza amaphutha amabi kakhulu, futhi lokhu kungibangela amahloni mina nabanye abantu. Ngiyobe nginjani eminyakeni embalwa ezayo? Ingabe ngiyohluleka ukukhuluma kahle noma ukushayela imoto? Ingabe ngiyoba umthwalo kumkami?”
Amalungu Omkhaya Nawo Ayizisulu
Khona-ke, kuyacaca ukuthi abashaywe unhlangothi akubona kuphela okumelwe babhekane nemiphumela ethena amandla. Nemikhaya yabo ibhekana nayo. Kwezinye izimo kumelwe ibhekane nokushaqeka kokubona umuntu owayeyiciko futhi enamakhono ewohloka ngokungalindelekile, eba njengosana oluthembele kwabanye abantu. Ubuhlobo bungaphazamiseka njengoba kungase kudingeke amalungu omkhaya afeze izindima angazijwayele.
UHaruko ulandisa imiphumela eyinhlekelele ngale ndlela: “Umyeni wami wakhohlwa cishe yizo zonke izinto ezibalulekile. Ngokungazelele kwadingeka ukuba siyeke inkampani ayeyiphethe futhi silahlekelwe indlu nezimpahla zethu. Okwakubuhlungu nakakhulu ukuthi ngangingasakwazi ukukhuluma ngokukhululekile nomyeni wami noma ngicele iseluleko kuye. Ngenxa yokudideka engazi ukuthi kusebusuku yini noma kusemini, uyaye akhumule ibhulukwana okudingeka aligqoke ebusuku. Nakuba sasazi ukuthi sizofika isikhathi lapho ayezoba kulesi simo, kusenzima ukuba samukele isimo abhekene naso. Isimo sethu sishintshe ngokuphelele, ngoba manje mina nendodakazi yami singabanakekeli bomyeni wami.”
“Ukunakekela othile oshaywe unhlangothi—kungakhathaliseki ukuthi umthanda kangakanani—kungaba ngaphezu kwamandla ngezinye izikhathi,” kusho u-Elaine Fantle Shimberg kwethi Strokes: What Families Should Know. “Ukucindezeleka nomthwalo akupheli.” Kwezinye izimo ukunakekela okusezingeni eliphakeme amanye amalungu omkhaya akunikezayo kungalimaza impilo yomnakekeli, imizwelo nengokomoya lakhe. UMaria uthi ukushaywa kukanina unhlangothi kwamcindezela kakhulu ekuphileni: “Ngimvakashela nsuku zonke futhi ngizame ukumakha ngokomoya, ngimfundele futhi ngithandaze naye, bese ngimbonisa uthando ngokumsingatha nangokumanga. Lapho ngifika ekhaya, ngisuke ngikhandlekile ngokomzwelo—ngezinye izinsuku ngize ngihlanze.”
Into enzima kakhulu kubanakekeli abaningi ukubhekana nayo ukushintsha kokuziphatha. Isazi sezinzwa zengqondo uDkt. Ronald Calvanio sitshela i-Phaphama! ukuthi: “Uma kuyisifo esithinta ukusebenza kwengqondo—okuwukuthi, indlela umuntu acabanga ngayo, aziphatha ngayo, asabela ngayo ngokomzwelo—thina sisuke sisebenzelana nomuntu ngokwakhe, ngakho ngandlela-thile ukukhubazeka ngokwengqondo okuvelayo empeleni kushintsha ukuphila komkhaya ngendlela ephawulekayo.” UYoshiko uyalandisa: “Kubonakala sengathi umyeni wami washintsha ngokuphelele ngemva kokugula kwakhe, uthukutheliswa ubala. Ngalezo zikhathi ngiba lusizi ngempela.”
Ngokuvamile, labo abangewona amalungu omkhaya bangase bangaluqapheli ushintsho ebuntwini. Ngenxa yalokho, abanye abanakekeli bazizwa benganakiwe futhi bethwele umthwalo bodwa. UMidori uyachaza: “Ukushaywa unhlangothi kwashiya umyeni wami ekhubazekile ngokwengqondo nangokomzwelo. Nakuba esidinga kakhulu isikhuthazo, akatsheli muntu futhi uhlupheka yedwa. Ngakho yimina engibhekana nemizwelo yakhe. Ukubheka ukushintsha kwemizwelo yomyeni wami usuku nosuku kuye kwangenza ngangakhululeka futhi ngezinye izikhathi ngesaba ngisho nokwesaba.”
Abaningi abashaywe unhlangothi nemikhaya yabo baye babhekana kanjani noshintsho olulethwa yilesi sifo ekuphileni kwabo? Thina ngabanye singabasekela kanjani labo ababhekene nemiphumela elimazayo yokushaywa unhlangothi? Isihloko sethu esilandelayo siyachaza.
[Ibhokisi/Isithombe ekhasini 7]
Izimpawu Eziyisixwayiso
• Ubuthaka, ukuba ndikindiki, noma ukungasebenzi okungalindelekile kwemisipha yobuso, yengalo noma yomlenze, ikakhulukazi ohlangothini olulodwa lomzimba
• Ukufiphala noma ukungaboni kahle kwamehlo, ikakhulukazi esweni elilodwa; ukuba ingxemu ngezikhathi ezithile
• Ubunzima bokukhuluma noma ukuqonda ngisho namagama alula
• Isiyezi noma ukungakwazi ukuzimela noma ukuzinza, ikakhulukazi uma kunezinye izimpawu
Izimpawu Ezingavamile
• Ubuhlungu bekhanda obungalindelekile futhi obuqaqambayo—ngokuvamile okuthiwa ngabo “alikho ikhanda elibuhlungu ngaleyo ndlela”
• Isicanucanu nemfiva eqhamuka isigubhukane—ehlukile emkhuhlaneni ovamile ngokugadla ngokushesha (ithatha imizuzu noma amahora kunokuba ithathe izinsuku ezimbalwa)
• Ukuquleka okwesikhashana noma ukudungeka kwengqondo (ukuquleka, ukudideka, imiqhabanyeko)
Ungazishalazeli Izimpawu
UDkt. David Levine unxusa ukuba lapho kuvela izimpawu, ogulayo “aphuthume esibhedlela ngokushesha ngangokunokwenzeka. Kunobufakazi bokuthi uma unhlangothi welashwa phakathi namahora ambalwa okuqala, umonakalo ungancishiswa.”
Ngezinye izikhathi izimpawu zingase zivele okwesikhashana zibuye zinyamalale. Lokho kwaziwa ngokuthi i-TIA, noma i-transient ischemic attack (ukucinana kobuchopho okudlulayo). Ungazishalazeli, ngoba zingase zibonise ingozi engathi sína yokushaywa unhlangothi, ongase ugadle ngamandla ngemva kwalokho. Udokotela angelapha izimbangela futhi asize ekunciphiseni ingozi yokufa uhlangothi esikhathini esizayo.
Adapted from guidelines provided by the National Stroke Association, Englewood, Colorado, U.S.A.