Kodi CFS Ndinthenda Yeniyeni?

“NDINAPITA kwa madokotala osiyanasiyana,” anatero Priscilla, wodwala CFS (chronic fatigue syndrome) wa mu Mzinda wa Washington, U.S.A. “Ndinapimidwa mwazi kangapo ndipo ndinafunsidwa ponena za umoyo wanga. Anandiuza kuti ndinalibe vuto lirilonse ndi kundilangiza kuti ndikafune uphungu wa akatswiri a zamaganizo. Palibe aliyense wa madokotala amene anali wofunitsitsa kundisamalira kwenikweni kapena kuwona zizindikiro zanga mwamphamvu.”

Chokumana nacho chimenechi sichachilendo. Dokotala wolemba mu JAMA (Journal of the American Medical Association) chaka chatha anati: “Pa avareji, wodwala CFS aliyense anawonana ndi madokotala 16 osiyanasiyana. Ochuluka anauzidwa kuti anali ndi thanzi labwino, kuti anachita tondovi, kapena kuti anali opsinjika maganizo kwambiri. Ambiri anatumizidwa kwa akatswiri amaganizo. Mkhalidwewo uli bwinopo tsopano, koma sikwambiri.”

CFS imapereka zitokoso zapadera, monga momwe The American Journal of Medicine ikunenera kuti: “Kumakhala kosautsa kwambiri kusamalira nthenda imene munthuyo akuwoneka wathanzi labwino, amene kupimidwa kwa thupi lake kusonyeza kuti ali bwino, ndipo zotulukapo za kupima kwa m’labolatole zikhala zabwino. Nthendayo kaŵirikaŵiri imaphatikizapo kusamvana bwino kwa munthuyo ndi mwamuna kapena mkazi wake, achibale ena, akulu apantchito, aphunzitsi, akatswiri azaumoyo, ndi makampani a inshuwalansi.”

Chitokoso kwa madokotala nchakuti kutopako ndichizindikiro chofala kwambiri. “Ngati dokotala angamapeze $1 pa wodwala aliyense wodandaula ndi kutopa, akhoza kukhupuka ndi kuleka ntchitoyo,” analemba motero mkonzi wa nkhani zamankhwala. Koma mwachiwonekere, ndiochepa okha odandaula ndi kutopa amene ali ndi CFS. Popeza kuti palibe kupima kwa nthendayo, kodi ndimotani mmene dokotala angaidziŵire?

Kalongosoledwe ka Cfs

M’March 1988 CDC (U.S. Centers for Disease Control) inafalitsa mu Annals of Internal Medicine ndandanda ya zizindikiro zakunja ndi zamkati zimene zonse pamodzi zimadziŵitsa CFS. (Onani bokosi.)

Njira zazikulu zodziŵira CFS ndizo (1) kuyambika kwatsopano kwa kutopa kumene kupitiriza kwa miyezi isanu ndi umodzi ndi kuchepetsa zochita za munthu ndi 50 peresenti ndipo (2) kupatulidwa kwa mikhalidwe ina yamaganizo imene ingachititse zizindikirozo. Komabe, kuti CFS idziŵidwe, wodwalayo ayeneranso kukhala ndi zizindikiro 8 mwa 11 zapandandanda ya njira yaing’ono yodziŵira kapena zizindikiro 6 mwa 11 zimenezi limodzinso ndi 2 mwa 3 zapandandanda ya njira ya thupi yodziŵira.

Mwachiwonekere, awo amene amakhala ndi zizindikiro zenizeni za CFS amadwala kwambiri kwanthaŵi yaitali. CDC inapanga kalongosoledwe ka CFS kukhala kosamalitsa kwambiri kotero kuti anthu ameneŵa azindikiridwe mosalakwika. Awo amene amakhala ndi mitundu yaing’ono chabe ya nthendayo, pakali pano samaphatikizidwa pakalongosoledweka.

Kodi Cfs Ingakhale Kuchita Tondovi?

Bwanji ponena za madokotala amene amati anthu odwala CFS amachita tondovi ndi mavuto ena amaganizo? Kodi odwala ameneŵa ali ndi zizindikiro zenizeni za kuchita tondovi?

Odwala CFS ambiri amachita tondovi, koma monga momwe Dr. Kurt Kroenke, profesala wa pasukulu yamakhwala m’Bethesda Maryland, U.S.A., anafunsira kuti: “Kodi aliyense sangachite tondovi ngati akhala wotopa kwa chaka chonse kapena kuposerapo?” Chotero tikhoza kufunsa kuti: Kodi kuchita tondovi ndiko kumachititsa CFS, kapena kodi ndiko chotulukapo chake?

Funsolo kaŵirikaŵiri limakhala lovuta kuyankha. Dokotala angatenge mfundo yachiŵiri ya njira yaikulu yodziŵira, imene imati ‘mikhalidwe yamaganizo imene ingachititse zizindikirozo siiyenera kuphatikizidwapo,’ ndi kugamula kuti munthuyo akudwala tondovi ndipo osati nthenda yachiwalo kapena thupi. Komabe, m’zochitika zambiri imeneyi simakhala njira yokhutiritsa yodziŵira nthendayo.

Magazini a zamankhwala a The Cortlandt Consultant anati: “Umboni wokhutiritsa kwambiri wakuti CFS iri nthenda ya ‘m’thupi’ ndiwo kubuka kwake kwadzidzidzi mwa 85 peresenti ya oidwala. Ochuluka a odwalawo amanena kuti matenda awo anayamba patsiku lakutilakuti monga ngati chimfine cha flu chotsagana ndi malungo, [zironda zapammero, kutupa anabere, kuphwanya m’thupi], ndi zizindikiro zina.” Madokotala amene anasamalira odwala CFS ngokhutiritsidwa kuti kuchita tondovi kaŵirikaŵiri sindiko kumachititsa zizindikirozo.

“Pamene tinayerekezera zimene tinapeza,” anatero Dr. Anthony Komaroff, mkulu wa ku General Medicine pachipatala cha Brigham and Women’s Hospital mu Boston, U.S.A., “tinachita chidwi kuwona kuti odwala ochuluka anati anali ndi thanzi labwino, anyonga ndi achipambano m’moyo kufikira tsiku lina pamene anadwala chimfine, flu, malungo kapena chifuŵa ndipo sizinathe konse. Zizindikiro zimene zikanalingaliridwa kukhala zamaganizo—tondovi, kupsinjika, kusoŵa tulo ndi zina zotero—panalibepo nthendayo isanayambe.”

Umboni wina waukulu wa tondovi ndiwo kusakondweranso ndi chirichonse. Koma Dr. Paul Cheney anafotokoza kuti: “Odwalaŵa ali osiyana kwambiri ndi zimenezo. Amada nkhaŵa kwambiri ponena za zimene zizindikirozo zimatanthauza. Satha kuchita kanthu. Satha kugwira ntchito. Ambiri amachita mantha kwambiri. Koma samakhala osakondweretsedwa ndi zinthu zowazinga.”

Kutupa anabere, malungo, kuchepekera kodabwitsa kwa maselo akupha tizirombo m’thupi, chifuŵa chobwerezabwereza, kupweteka kwa minofu ndi mfundo, ndipo makamaka kutopa kwachilendo ndi kulumaluma kwa m’thupi ngakhale pambuyo pa kuyenda pang’ono—zizindikirozi sizimayenerera konse nthenda ya kuchita tondovi.

Kufunika kwa Umboni Waposachedwapa

M’kope lake la November 6, 1991, JAMA inapereka lipoti lakuti: “Zotulukapo zoyambirira za kufufuza kumene kukuchitidwa pa odwala amene amayenerera kalongosoledwe ka bungwe la CDC ka CFS (chronic fatigue syndrome) zimasonyeza kuti odwala ochuluka amatendawo samachita tondovi kapena kukhala ndi mavuto ena amaganizo.”

Dr. Walter Gunn, amene anapenda mosamalitsa kufufuzidwa kwa CFS pa CDC, analongosola m’kope la JAMA limeneli kuti: “Mosasamala kanthu ndi chenicheni chakuti madokotala ambiri akanalingalira odwala onseŵa [ofufuzidwa] kukhala ochita tondovi, tinapeza kuti 30% okha a odwala CFS ndiwo anali ndi zizindikiro za kuchita tondovi pachiyambi cha kutopa kwawoko.”

Pangakhale kusiyana kwa m’thupi pakati pa odwala CFS ndi ochita tondovi ambiri. “Odwala tondovi lalikulu lotchedwa (MDD) kaŵirikaŵiri amakhala ndi mavuto patulo totchedwa rapid-eye movement (REM), pamene kuli kwakuti odwala CFS amakhala ndi mavuto patulo totchedwa non rapid-eye movement (non-REM),” anatero magazini azamankhwala The Female Patient.

Magazini a Science a December 20, 1991, anapereka chopezedwa china chofunika. Ananena kuti kufufuza kumasonyeza kuti “odwala CFS ali ndi unyinji wosiyanasiyana wa mahomoni ena a muubongo” ndipo amati: “Ngakhale kuti kusiyanako mwa anthu osadwala sikunali kwakukulu, odwala CFS nthaŵi zonse anasonyeza mlingo wochepekera wa homoni yazakugonana yotchedwa cortisol, ndi mlingo wokwera wa homoni yochokera m’mwanabere wotchedwa pituitary yotchedwa ACTH (adrenocorticotropin hormone), zosiyana kotheratu ndi kusintha kopezeka mwa munthu wochita tondovi.”—Kanyenye ngwathu.

Bwanji Ngati Cfs Ndithenda Yeniyeni?

Madokotala amakhala okaikira ponena za matenda amene samamvetsetsa, monga ngati CFS. “Kukaikira nkwakukulu m’ntchito yathu,” analemba motero Dr. Thomas L. English. “Kukaikira kwabwino ndiko kaimidwe kamaganizo kofala tsopano ka madokotala aluntha.” Komabe, Dr. English akukaikira kuti kukaikirako nkwabwino motani kwa wodwalayo “ngati CFS iri nthenda yeniyeni.” Iye akufunsa madokotala anzake okaikira kuti: “Bwanji ngati muli olakwa? Kodi zotulukapo zidzakhala zotani kwa odwala anu?”

Dr. English iye mwiniyo akudwala CFS, ndipo chaka chatha JAMA inafalitsa nkhani yake yolembedwera madokotala anzake. Anawapempha kuti adziyerekezere kukhala munthu wodwala, akumalongosola nthendayo kuti:

“Mugwidwa ndi ‘chimfine’ ndipo pambuyo pake moyo wanu usintha kotheratu. Simutha kulingalira bwino . . . Nthaŵi zina mutofunikira kuyesayesa mwamphamvu kuti muŵerenge nyuzipepala kapena kuti mutsatire nkhani ya kanema yosonyezedwa pa TV. Mumamva ngati chizwezwe koma chosatha. Mumayenda pang’onopang’ono mumkhalidwe wokaikiritsa wakudwala, mmene kalero munayendamo ndi chidaliro. Myalgias [kulumaluma m’minofu] kumayendayenda m’mbali zonse za thupi lanu popanda dongosolo. Zizindikiro zimabwera ndi kupita, kuwonjezereka ndi kuchepa. . . . Inunso mukanayamba kukaikira zina za zizindikiro zanu mukadapanda kukambitsirana ndi odwala ena okumana ndi zofananazo . . . kapena kukambirana ndi madokotala amene awona mazana ambiri okhala ndi mavuto ofananawo. . . .

“Ndakambitsirana ndi odwala anzanga ambirimbiri amene anapita kwa madokotala athu kukafuna chithandizo, koma amene anabwerako ochititsidwa manyazi, okwiya, ndi amantha. Matupi awo anawauza kuti anali odwala, koma lingaliro la madokotala awo lakuti nthenda yawo inali yamaganizo linali longochititsa mantha ndi lokwiitsa—osati lolimbikitsa. Linawapangitsa kuwona madokotala awo kukhala osamvetsetsa kwenikweni chimene chinali vuto lawo lenilenilo. . . . Kodi tiyenera kukhulupirira kuti chabe chifukwa chakuti zizindikirozo nzachilendo ndi zosadziŵika sizingakhale zenizeni? Kodi tiyenera kulingalira kuti kupima kwathu kwa m’labolatole kukhoza kupeza matenda atsopano limodzi ndi akale? Kusakhulupirira malingaliro atsopano nkwakale kuchokera pachiyambi cha mtundu wa anthu; momwemonso zotulukapo zaupandu za kusakhulupirira koteroko.”—JAMA, February 27, 1991, tsamba 964.

Ubwino Wakuzindikira Nthendayo

“Madokotala amene amathera nthaŵi yambiri akukambitsirana ndi odwala CFS amauzidwa nkhani imodzimodzi yosasintha; ndiyo nkhani yawo odwalawo,” anatero Dr. Allan Kind, katswiri wa matenda oyambukira. “Ndikukuuzani kuti Chronic Fatigue Syndrome ndinthenda yeniyeni.”

Madokotala owonjezereka akuvomera tsopano. Chotero The Female Patient inalimbikitsa madokotala kuti: “Kufikira pamene kupima nthendayo kotsimikizirika ndi kuchiritsa koyenera kwadziŵidwa, dokotala ali ndi thayo lapadera lakuuza odwalaŵa kuti iwo alidi ndi nthenda yeniyeni, ndi kuti ‘sivuto lamaganizo.’”

Ubwino wakutsimikizira kukhalapo kwa nthenda ya wodwala ungakhale waukulu. Pamene dokotala anauza mkazi wina kuti anali ndi CFS, mkaziyo anati: “Pamenepo misozi inayamba kugwa.” Kumva dokotala akunena kuti nthenda yake inali yeniyeni, ndi kuti inali ndi dzina, kunali chitonthozo chachikulu kwa iye.

Komabe, kodi nchiyani chimayambitsa CFS? Kodi kufufuza kwavumbulanji?

[Bokosi patsamba 7]

Njira Zodziŵira Chronic Fatigue Syndrome

Njira Yaikulu

1. Kubuka kwatsopano kwa kutopa kopitirizabe kuposa pa miyezi isanu ndi umodzi ndi kuchepetsedwa kwa zochita za munthu ndi 50 peresenti

2. Palibe mikhalidwe ina yamalingaliro imene ingachititse zizindikirozo

Njira Yaing’ono

Zizindikirozo ziyenera kuyamba pakuyambika kwa kutopako kapena pambuyo pake

1. Malungo ang’ono

2. Zironda zapammero

3. Kupweteka kwa anabere otupa

4. Kufooka kwa thupi lonse

5. Kulumaluma kwa m’minofu

6. Kutopa kwanthaŵi yaitali pambuyo pamaseŵera olimbitsa thupi

7. Kudwala mutu

8. Kupweteka m’mfundo zathupi

9. Kusoŵa tulo

10. Madandaulo okhudza maganizo, monga ngati kuiŵalaiŵala, kusokonezeka maganizo, kulephera kusumika maganizo, kuchita tondovi

11. Kukanthidwa kwakukulu (kwa maola angapo kufikira masiku angapo)

Njira ya Thupi

1. Malungo ang’ono

2. Kupweteka pammero

3. Kupweteka pang’ono kwa anabere

[Chithunzi patsamba 8]

Madokotala ayenera mosamalitsa kusiyanitsa tondovi ndi “chronic fatigue syndrome”