Ukufuna Imbangela

KWATHATHA iminyaka eminingi ukuba kutholakale ukuthi yini eyayiphazamisa isimiso sokuzivikela komzimba seziguli ezinengculaza, kodwa kuthatha isikhathi eside ngisho nangokwengeziwe ukuthola ukuthi yini ebangela umonakalo emizimbeni nasebuchosheni balabo abaneCFS (isifo sokukhathala esingamahlalakhona). Nakuba imbangela ingakatholakali, izikhulu zezokwelapha ziyakwazi ukunikeza ubufakazi obuqinisekisayo bokungaphili komzimba kuleziguli. Empeleni, lobobufakazi buye basetshenziswa enkantolo.

IMedical Post yaseCanada yabika ukuthi ecaleni elingokomthetho, ochwepheshe bezokwelapha banikeza ubufakazi bokusekela lokho ummangalelwa ayekushilo kokuthi ikhono lesiguli lokwahlulela lalikhubazwe isifo saso. Kanjalo uJustice William G. N. Egbert washukumiseleka ukuba aphethe ngokuthi: “Lesifo sithinta yonke indawo yokwahlulela. . . . Izindawo ezincane zobuchopho ziyalimala.”

Ingabe lokhu kuyiqiniso?

Ukuphazamiseka Kobuchopho

Ukucwaninga kwezokwelapha kusekela ukuphikisa kokuthi ubuchopho beziguli ezineCFS buyathinteka. INew York Times yangoJanuary 16, 1992, yayinalesihloko esikhulu: “Ukuhlola Kuthola Ukuphazamiseka Kobuchopho Ezigulini Ezinesifo Sokukhathala Esingamahlalakhona.” Lesihloko, esasisekelwe embikweni owashicilelwa ngosuku olungaphambili kuAnnals of Internal Medicine, saphawula:

“Ukuhlola okukhulu kunakho konke osekwenziwe kwesifo sokukhathala esingamahlalakhona kuye kwathola ubufakazi bokulimala kwamangqamuzana ebuchosheni beziguli, ubufakazi bokuqala obubhaliwe bokuphazamiseka kwezinzwa okuhlangene nesifo esiyisimangaliso.” Lesihloko sanezela: “Lokhu kuhlola okwamuva ochungechungeni lwamuva olubonisa ukungafani kwesimiso sokuzivikela komzimba kanye namahormone phakathi kwalabo abanalesifo kanye nabanempilo enhle.”

Okunye ukuhlola okwadonsa ukunaka okukhulu kwabikwa kumagazini wangoDecember 1991 weJournal of Clinical Endocrinology and Metabolism. Kwathola izinkomba zokuntuleka kwamahormone esimisweni sezindlala kanye nasebuchosheni babantu abaneCFS. Kanjalo ukuhlola kwenezela ubufakazi bokuthi izici zokusebenza kwamakhemikhali nezokuzivikela komzimba ziveza izimpawu zeCFS.

UDkt. Walter Gunn, lapho esasebenza eCDC (Izikhungo Zokunqanda Izifo ZaseU.S.), waqondisa ukuhlolwa okuningi kweziguli ezineCFS. Waphawula ukuthi “abanye ososayensi abaphambili sebeqala ukuhileleka ekucwaningeni ngeCFS.” Nakuba lokho labacwaningi ababekuthola ngokuvamile kwakukhomba izimbangela ezingenzeka ezingefani, uDkt. Gunn wagcizelela: “Into eyodwa okuvunyelwana ngayo ukuthi akekho obika ukuthi akukho ukuphazamiseka.”

Iyiphi imbangela noma izimbangela okungenzeka zibangela iCFS? Ingabe kunegciwane elihilelekile, noma amagciwane? Uma kunjalo, ngayiphi indlela? Isimiso sokuzivikela komzimba sithinteka kanjani kabi? Kungani ukungasebenzi kahle kwaso kubangela ukuba khona kwezimpawu ezigulini ezineCFS?

Izimbangela Ezingenzeka

Ukucwaninga kubonisa ukuthi kunamagciwane ahilelekile. Kodwa maphi amagciwane? Maningi aye asikiselwa abacwaningi. “Iretrovirus, ispuma amagciwane ‘awugwebu’, ienterovirus, igciwane iEpstein-Barr, kanye nohlobo lwesithupha lwegciwane lesikhumba sabantu wonke aphakathi kwezimbangela ezingenzeka zalesifo,” kuphawula iJournal of the American Medical Association ngoNovember odlule.

Amagciwane angayibangela kanjani iCFS? Lokho akwaziwa. Nokho, uDkt. Anthony L. Komaroff, umcwaningi ophambili weCFS, waphawula: “Okuqala ukutholakala ezigulini isimiso sokuzivikela komzimba esisebenza kakhulu, isimiso sokuzivikela komzimba esisohlotsheni oluthile lwempi engapheli esilwa nento ethile ebonakala ivela ngaphandle komzimba.”

Isimiso sokuzivikela komzimba esinempilo lapho kunegciwane eliyisitha, noma amagciwane, sisabela ngokudedela amakhemikhali, abizwa ngokuthi amacytokine, ukuze alwe nabahlaseli. Nokho, lapho isimo esiphuthumayo sesinakekelwe, ngokuvamile ukukhiqizwa kamacytokine kuyanqamuka. Kodwa ezigulini ezineCFS isimiso sokuzivikela komzimba ngokusobala siyahluleka ukuyeka ukukhiqiza. Ngokuphawulekayo, okutholakala njalo kubantu abaneCFS ukukhiqizwa okwandayo kwamacytokine.

Lokhu kubalulekile, ngoba akulona igciwane elenza umuntu azizwe egula lapho lihlasela umzimba wakhe. Uzizwa egula ngenxa yokuthi amangqamuzana omzimba wakhe akhiqiza amacytokine, abangela imfiva, ukuqaqamba, kanye nokukhathala. UDkt. William Carter, uprofesa wezokwelapha waseU.S., waphawula: “Amacytokine ayasala futhi aqale ukulimaza umuntu kuze kube yilapho ekugcineni sibona isiguli esingasavuki embhedeni esingakwazi nokunyakaza.”

Nokho, yini ebangela ukuba isimiso sokuzivikela komzimba siqhubeke sikhiqiza amacytokine kuyilapho kufanele ngabe sesikunqamulile ukuwakhiqiza? “Igciwane elingenzi lutho lishukunyiswa into ethile,” ngokukaDkt. Jay A. Goldstein, “okwenza amangqamuzana esimiso sokuzivikela komzimba akhiqize [amacytokine] ngezilinganiso ezinkulu kakhulu.”

Ngaphezu kwalokho, kubonakala sengathi amangqamuzana angokwemvelo angababulali kanye namamacrophage, angamasosha okuvikela aphambili kubahlaseli, isibalo sawo noma ukusebenza kwawo kuyancipha ezigulini ezineCFS, okuqhubeka kwenza isimiso sokuzivikela komzimba sibe buthakathaka. Into ebalulekile iwukuthi isimiso sokuzivikela komzimba seziguli ezineCFS sibonakala singasebenzi kahle, nakuba imibono yehluka ngokuphathelene nokuthi kungani senza kanjalo.

Njengoba kuphawuliwe esihlokweni esandulelayo, ngokuvamile odokotela baphawula ukuthi ezigulini eziningi ukucindezeleka akuyona imbangela yeCFS. Nokho, kwezinye iziguli abanye odokotela banomuzwa wokuthi izinkinga eziphathelene nokusebenza kwengqondo, ezinjengokucindezeleka, kungenzeka zibe isici esiyimbangela. Ngokuthakazelisayo, ukucwaninga kuye kwembula ukuthi ukucindezeleka kungasilimaza isimiso sokuzivikela komzimba. “Ukucindezeleka kwengqondo ngokwakho kungabangela ukuphazamiseka kokusebenza kwezinzwa namahormone kanye nokwesimiso sokuzivikela komzimba,” kubhala uDkt. Kurt Kroenke, weWalter Reed Army Medical Center eWashington, D.C.

Kanjalo, kwezinye izimo ukucindezeleka kungabangela izinguquko esimisweni sokuzivikela komzimba okungaba nengxenye kuCFS. Nokho, cishe kuhileleke nezinye izici eziningi ezingenza isimiso sokuzivikela komzimba sibe buthakathaka.

Izici Eziningi

Abacwaningi abaningi bayavuma ukuthi cishe akunakwenzeka ukuba kube into eyodwa ebangela iCFS. “Kunalokho, iCFS cishe iyisifo esiba khona kumuntu ongavikelekile lowo ukucindezeleka, [ukuzwela komzimba ezintweni ezithile], ukungenwa igciwane, noma ezinye izici ngesilinganiso esithile okuye kwabangela ukukhubazeka esimisweni sokuzivikela komzimba,” kuchaza umagazini wezokwelapha iCortlandt Forum.

Udokotela othile, ebhala kuMedical Post yaseCanada, waphawula: “Kungenzeka ukuthi isimo esisibangelayo ukungakwazi ukuzilwela komzimba okuzuzwe ngofuzo noma kungenzeka ukuthi umzimba okhandleke kakhulu wenza uthambekele kulesifo. Khona-ke isenzakalo esibucayi, ngokuvame kakhulu ukungenwa igciwane elibucayi, ligadla kumuntu okhandlekile. Inhlanganisela yazo zonke lezici cishe ibangela ukulimala esimisweni sokuzivikela komzimba.”

“Ukucindezeleka kungenye yezimbangela ezinkulu esizibonayo,” kusho uDkt. Charles Lapp. “Ngezinye izikhathi siye sabona amakhemikhali athile efeza indima. . . . Futhi ngokuthakazelisayo iningi leziguli zami (nakuba singakaze senze ukuhlola) ziye zaphawula ukuthi lapho isifo sazo siqala kwakuhileleke izibulala-zinambuzane, opende, kanye novanishi.”

Akukaze emlandweni kwenzeke ukuba abantu babesengozini yokuhlaselwa kwemizimba yabo ukungcola kwendawo njengamanje. Izinongo zokudla kanye nemilaliso nakho kungawulimaza umzimba futhi kusithinte kabi isimiso sokuzivikela komzimba. Odokotela abathile baze ngisho bathi ukusetshenziswa isikhathi eside kwamasosha omzimba kuyasicindezela isimiso sokuzivikela komzimba.

Kungenzeka ukuthi futhi kuhileleke nezinye izici ekuguleni okubonakala ezigulini eziyizinkulungwane ezineCFS. Kodwa nakuba kunemikhondo engaqinisekile kanye nezimbangela ezithakazelisayo ezingenzeka, imbangela yeCFS ayikaziwa.

Isibonakaliso Sezinsuku Zokugcina

Esiprofethweni sakhe esikhulu esiphathelene nezinsuku zokugcina zalesimiso sezwe, uJesu Kristu wabikezela: “Kuyakuba-khona . . . nobici . . . izindawo ngezindawo.” (Luka 21:11) Yeka ukuthi lokhu kuyiqiniso kanjani ngokuphathelene nesikhathi sethu! Eziningi zezifo zanamuhla azinayo imbangela eyaziwayo, nokho lokhu akuzenzi zibe ezingekho ngokoqobo noma zidambe.

ICFS ngokusobala imane nje ingesinye isifo esakha ingxenye yesibonakaliso uJesu athi sasiyophawula izinsuku zokugcina. Kodwa ukuqaphela lokhu akwenzi ukuphila kube lula ngalabo abagulayo. Iziguli ezineCFS zingabhekana kanjani nokugula kwazo?