BHUKU 29, CHIKAMU 4 • ZVITA 2025.
Pfungwa yekuti "hutano hwakanaka" yakachinja hutano muzvirwere zvemwoyo, oncology, uye chirwere cheshuga. Neurology, uye chirwere cheParkinson, zviri kutanga kusvika pari zvino. Mune pepa rakakosha rakaburitswa munguva pfupi yapfuura mu Movement Disorders Clinical Practice rine musoro unoti “Mushonga Wehutano Hwakazara weChirwere cheParkinson: Maonero Akavakirwa Pauchapupu uye Zvinodiwa Zvisina Kuzadzikiswa,” International Parkinson and Movement Disorder Society Task Force on Wellness inoronga hurongwa hwepasi rose hwehutano hwakanaka muPD.
Takagara pasi naSachigaro weTask Force uye munyori wekutanga papepa iri, Dr. Indu Subramanian, kuti tikurukure nezverwendo rwake, zvinoreva hutano, uye kuti vanachiremba vangatanga sei kushandisa muenzaniso uyu mumabasa ezuva nezuva.
Mubvunzo: Tisati tapinda mupepa, mungatiudze zvishoma nezverwendo rwenyu rwebasa uye chii chakakukwezvai kupfungwa yehutano hwakanaka muchirwere cheParkinson?
Ndakakurira mumhuri yemaIndia muCanada. Amai vangu chiremba wemhuri, uye kubva pakutanga vaitiratidza maitiro "asina kujairika" akadai seAyurvedic nzira dzekudya zvinovaka muviri uye kuporesa patairwara. Saka, ndaigara ndichifunga nezvekurapa kupfuura tsika dzekumadokero. Ndakaenda kuchikoro chekurapa muToronto ndikatamira kuLos Angeles kuti ndigare, kwandakakwezvwa nepfungwa dzeuropi nekuti, sevakawanda vedu, ndaifunga kuti uropi hwaifadza. Ndakakwezvwa zvikuru nechirwere cheParkinson nekuti ndine chido chechokwadi kune vanhu vanorarama nacho nevanhu vanovatarisira. Chirwere chakaoma uye chinonakidza, uye ndakachiona senzvimbo yatinogona kuunza mamwe emazano aya asina kujairika mukurapa kwekiriniki. Ndakadzidziswa semudzidzi kuUCLA, ndakaramba ndiripo, uye ndakashanda nguva shoma kuUCLA uye nguva shoma kuVA. KuVA, tine Parkinson's Center of Excellence, yandakatungamira kwemakore gumi apfuura. Chiitiko ichocho, pamwe nekudzidziswa kwangu uye kufarira kwangu mushonga unobatanidza zvinhu - zvinhu zvakaita seyoga, kufunga zvakanaka, mushonga wechivanhu wechiChinese, Ayurveda, uye kufarira kwangu hutano hwepfungwa uye zvinhu zvepfungwa zvechirwere ichi, zvese zvakandiunza pano.
Ndava kufarirawo zvikuru kuti ndiani asiri kubatsirwa: Vanhu vasina zvinhu zvakawanda. Tingavabatsira sei kurarama zviri nani nechirwere ichi? Kune ini, hutano chinhu chatinogona kupa kune chero munhu ane chirwere cheParkinson, zvisinei nekuti vanogara kupi kana kuti vane chii.
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— Indu Subramanian, Sachigaro weMDS Task Force on Healthness |
Mubvunzo: Kune vaverengi vatsva mupfungwa iyi, munotsanangura sei "hutano" muchirwere cheParkinson, uye hwakasiyana sei nemaitiro echinyakare ekutarisira?
Imwe tsananguro yehutano yandinonyanya kufarira ipfungwa yesarudzo dzemararamiro ekugadzirisa dambudziko iro munhu anorarama nechirwere anogona kuita zuva nezuva kuti ararame zviri nani. Pane pfungwa yakasimba yekuti munhu wacho haasi kungogamuchira mishonga chete asi kuti atore chikamu muhutano hwake.
Patinotaura nezveutano hwakanaka muParkinson's, tiri kufunga nezvesarudzo dzezuva nezuva dzine chekuita nekurovedza muviri, kudya, kurara, kushamwaridzana nevamwe, chimwe chinhu chakasimbiswa nedenda iri, uye maitiro epfungwa nemuviri ayo akakosha mumishonga yakawanda yechinyakare.
Chinonyanya kukosha ndechekuti, tinosimbisa kuzvitarisira. Izvi hazvisiri izvo zvaiitwa kuWestern Western medication, uko varwere vanouya kuzotiona, vonyunyuta nezvechiratidzo, topindura nepiritsi kana nzira yekuvhiya, uye toonanazve mumwedzi mitanhatu kana chimwe chinhu chisina kumira zvakanaka. Medication iyoyo inoshanda zvikuru. Pakati pekushanya, varwere vanowanzovhiringidzika uye havanyanyi kuita chimwe chinhu, vasingazive zvavanogona kuita vega.
Saka, vanotanga kutsvaga rubatsiro kubva pa internet, kubva kuChatGPT, kubva kune marudzi akasiyana-siyana ezvinyorwa. Zvatiri kutaura muna Parkinson's, sevanachiremba vepfungwa, ndezvekuti sarudzo idzi dzemararamiro hadzisi "zvinhu zvidiki-diki"; asi dzinogona kuchinja zvirwere. Pakupedzisira tiri kuvaka humbowo hwekuti zvinhu zvakaita sekurovedza muviri zvinogona kuita mutsauko mukuru pakurarama kwevanhu vane PD.
Mubvunzo: Musumo yenyu, munoti hurongwa hwehutano hwakatove hwakabatikana muzvirwere zvemwoyo, oncology, uye chirwere cheshuga asi kwete muzvirwere zvetsinga. Sei neurology yasara kumashure, uye chii chakakonzera MDS kuumba Wellness Task Force yakatsaurirwa izvozvi?
Neurology yagara iri hunyanzvi hwe "kuongorora neadios". Pandaiva kuchikoro chekurapa, chinhu chaindisetsa ndechekuti vanachiremba vetsinga vaiongorora zvinhu nemazvo asi vakanga vasina zvakawanda zvavaigona kuita panyaya yekurapa. Varwere vaienda kumba vongorarama nezvirwere izvi zvisina kunaka. MuParkinson's, tafambira mberi zvikuru. Iye zvino tine nzira dzakawanda dzekurapa dzakanaka dzekufambisa nhengo dzemuviri dzinovandudza zvikuru kuremara. Asi kana zvasvika kumatambudziko asiri etsinga dzemuviri nepfungwa, tichiri nedambudziko shoma rekupa, asi izvi ndizvo zvinowanzo kanganisa hupenyu.
Zvichakadaro, mamwe mabasa apinda zvakanyanya mukudzivirira uye mararamiro. Funga nezvemishandirapamwe yakapoteredza kudzivirira kurwara kwemoyo, kenza yemapapu, kusvuta, cholesterol, uye kudya. Neurology yava kungosvika papfungwa yekuti tinogona kudzivirira kana kugadzirisa zvirwere zveuropi. Tinoona izvi zvichiitika mu dementia nestroke, uye tiri kuziva kuti tine basa rekutaura nezvekudzivirira uye hutano hwekuzvidzivirira muPD zvakare.
Tiri kuongorora chirwere cheParkinson nekukasika. Tine vanhu vane zviratidzo zveprodromal zvakaita seREM sleep behavior disorder, majini anowanzo shandiswa, mifananidzo isina kujairika, kana kunyange mhedzisiro ye biopsy yeganda. Patinoudza mumwe munhu kuti, "Uri panjodzi huru yechirwere cheParkinson," tinofanirawo kukwanisa kutaura kuti, "Uye hezvino zvinhu zvaunogona kuita kuti urarame zviri nani uye zvingangokanganisa kufambira mberi kwechirwere." Varwere vane nzara yeizvi. Ndiyo nzvimbo chaiyo iri kuedza kuzadza Wellness Task Force.
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— Indu Subramanian, Sachigaro weMDS Task Force on Healthness |
Mubvunzo: Pepa renyu rine musoro unoti “Mushonga weHutano Hwakazara weChirwere cheParkinson: Maonero Akavakirwa paUchapupu uye Zvido Zvisina Kuzadzikiswa.” Ndezvipi zvinangwa zvikuru zvepepa iri, uye “mushonga wehutano” unofanira kutaridzika sei mumabasa ezuva nezuva?
Patakaunganidza Task Force, takakumbirwa kuti tiite kuti ive yepasi rose uye ine hunyanzvi hwakawanda kwete kungova vanachiremba kana nyanzvi dzezvirwere zvekufamba. Saka, takaunganidza boka rakasiyana-siyana: Nyanzvi yezvepabonde kubva kuIsrael, nyanzvi yezvemabasa kubva kuAustralia, nyanzvi yezvemuviri kubva kuPortugal, nyanzvi yepfungwa, nyanzvi yepfungwa, nevamwe. Zvaive zvakakura nemaune.
Chinangwa chedu chakabatana necheMovement Disorder Society: Kupa rubatsiro kune munhu wese anorarama neParkinson's pasi rose. Izvi zvaireva kuti hutano hwakanaka hahuna kugona kuva chinhu chaunotenga - chinhu chakakosha chekuwedzera kune vanhu vane zviwanikwa. Takanyanya kutarisa pane izvo vanhu vanogona kuzviitira ivo pachavo, kwete zvavanogona kutenga chete.
Taidawo kusimudzira hutano hwepfungwa sechinokosha. Saka mushonga unosimbisa kuti:
- Pfungwa dzekuongororwa uku uye hutano hwepfungwa huri kuramba huripo,
- Sarudzo huru dzemararamiro: Kudya, kurovedza muviri, kurara, maitiro ekufunga nemuviri, kushamwaridzana nevamwe,
- Uye kuremekedza zvikuru tsika, izvo zvandinofunga kuti zvitsva chose.
Kugara zvakanaka kwemurume ari mumakore ake ekuma30 ane chirwere chePD anogara munharaunda ine vanhu vanomushora muKenya kuchasiyana zvikuru nemunhu ari munzvimbo dzakapfuma dzeSydney kana Los Angeles dzine mukana wekuwana rubatsiro zviri nyore. Taida kuti hurongwa uhwu huve hwakakodzera uye hunowanikwa nevanhu vari munzvimbo dzisina zviwanikwa zvakakwana zvakare.
Muchidimbu, tinoronga mapoka ane pokutangira. Tinosimbisa kwete kuremedza varwere. Asi, tinotsigira nzira yekubatsirana: Kunzwisisa kuti munhu wacho ndiani, zvaanokwanisa kuwana, uye kuvabatsira kusarudza nzvimbo imwe chete yekutanga nayo. Zvinoreva kugadzira pamwe chete mushonga wehutano wechokwadi uye une chinangwa kumunhu iyeye.
Mubvunzo: Mungatiratidza here zvinhu zvakakosha zvekurapa hutano uye humwe humbowo huripo? Pane chakakushamisai here pamakaongorora mabhuku aya?
Inguva inonakidza zvikuru. Semuenzaniso, boka raBas Bloem rakaburitsa mapepa akakosha pamusoro pemararamiro nePD anotsanangura mashandiro uye mashandiro emuviri. Maitiro edu mupepa iri aive ekutarisa humbowo hwakakura hwezvikamu, pane kupindira kwakamanikana, kwakanyatsorongwa.
Kutanga nekurovedza muviri, pane humbowo huri kukura hunoratidza kuti zvinobatsira zviratidzo zvemuviri nemuviri zvisiri zvemuviri. Kurovedza muviri kunokanganisawo kurara uye hutano hwepfungwa. Bas Bloem akanyora nezvepfungwa yekuti kupindira uku kunobatsira: Chiitiko chimwe chete, ngatitii, kirasi yeyoga muboka, panze muchiedza chezuva, chinogona kubata nzvimbo dzakawanda panguva imwe chete: Kufamba, manzwiro, kurara, kubatana nevamwe, pamwe kunyange kuzvimba uye kutonga kwemuviri.
Zvakaoma kusarudza nzira imwe chete, asi tichiri kukwanisa kupa nhungamiro dzakakura, dzakavakirwa pauchapupu: Semuenzaniso, kuwedzera kurova kwemoyo wako kwemaminitsi angangoita makumi matatu pazuva, mazuva mashanu pasvondo, chero nenzira inogoneka.
Panyaya yekudya, tinoratidza maitiro anobva mumiti akadai seMediterranean kana MIND diet. Kunyungudutsa mvura mumuviri kwakakoshawo, uye tinokurudzira kufunga nezvemvura mumuviri sechikamu che "mushonga," wakagadzirirwa zvirwere zvakasiyana-siyana uchibvunza chiremba.
Kushamwaridzana nevamwe ndeimwe nyaya huru. Humbowo hunoratidza kuti kusashamwaridzana nevamwe kunowedzera njodzi yekubatwa nechirwere cheParkinson, uye kana wava nePD, kusurukirwa kunobatanidzwa nezviratidzo zvemuviri nemuviri zvisiri zvemuviri, kukurumidza kukura, uye mwero wepamusoro wekuora mwoyo nekuzvidya mwoyo. Mamwe mashoko angu anotsigira izvi.
Munzira dzepfungwa nemuviri, kune zvidzidzo zvakananga:
- Tai Chi yemhedzisiro yemotokari,
- Yoga uye kufunga zvakanaka kwekuzvidya mwoyo nekuora mwoyo.
Tinoenderera mberi nekuwedzera nzvimbo iyi, tichifunga nezvekusvikika kwevanhu uye mamiriro etsika. Izvi zvinosanganisira kurapa kutamba, kurapa kwakavakirwa paunyanzvi, madhiramu - zvinhu zvinogona kuwanikwa munharaunda uye zvine zvazvinoreva mutsika. Kune mumwe munhu muKenya, izvozvo zvinogona kunge zviri kutamba munharaunda kana kuridza ngoma pane kirasi ye yoga yemu studio.
Tinosimbisawo zvinhu "zvinokosha" zvatinombokanganwa zvakaita sekubuda kunze muzvisikwa, chiedza chezuva mangwanani kuti titsigire kurara, kufamba-famba kwezuva nezuva kuri nyore. Zvinganzwika sezviri nyore, asi hatina kumbobvira tava negwaro rinoita kuti izvi zvive zvechokwadi, zvingakurukurwa mu neurology. Ndizvo zvatinotarisira kuti bepa iri richapa.
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— Indu Subramanian, Sachigaro weMDS Task Force on Healthness |
Mubvunzo: Vanachiremba vazhinji havadi nguva yakakwana. Tinogona kuva nehafu yeawa nemurwere mwedzi mishoma yega yega. Munoti tingatangira papi pakushandisa nzira yehutano muPD?
Ini ndinofunga kuti hurongwa uhwu hunogona kutisunungura zvishoma. Hunotiyeuchidza kuti isu, vanachiremba, hatisi isu chete. Kushanya kukiriniki kwakakosha, asi hatigone, uye hatifanirwe, kupa zvese zveutano isu pachedu.
Mupepa iri tinoshandisa mufananidzo we "maruva", une maruva anomiririra vanhu vakasiyana-siyana vanogona kunge vari "chikamu chemushonga," vakaita sevanorapa muviri, nyanzvi dzezvekudya kana vezvekudya, vatungamiriri vemapoka anotsigira, vashandi vezvemagariro evanhu, vatungamiriri vezvemweya, nyanzvi dzehutano hwepfungwa, mapoka ekurovedza muviri munharaunda kana ezvehunyanzvi.
Izvi zvinopa vanachiremba mvumo yekufunga nezvekutarisira varwere vari muchikwata uye zviwanikwa zvemunharaunda. Basa redu ringave rekuzivisa pfungwa yehutano, kusimbisa kukosha kwayo, uye tobva taudza varwere kuti vawane "mapetals" akakodzera paruva iroro.
Ndanga ndichipa hurukuro pamusoro peizvi kubvira pakaburitswa bepa iri, uye chimwe chinhu chinonakidza ndechekuti "PD Avengers," boka repasi rose rinotsigira, rakatora mushonga wedu ndokugadzira shanduro yepeji rimwe chete yevarwere, yevarwere. Pamusangano weboka rekutsigira, mutungamiri akaidhinda kune wese munhu, uye takagara pamwe chete ndokuti: "Sarudza chinhu chimwe chete papeji rino chekutanga nacho vhiki rinouya. Chiise mukarenda yako."
Kazhinji tinopa mapurogiramu akaomarara anoda treadmill kana nzvimbo yekurovedza muviri katatu pasvondo kwemwedzi yakati wandei. Uye kana chirongwa ichi chapera, varwere havachina nzira yekurarama nayo. Pane kudaro, tinofanira kuvavarira kukunda kudiki, kunogara kwenguva refu, murwere achisarudza zvinoonekwa sezvine musoro uye zvinogoneka, uye zvakawanda zvezviitiko zviri kuitika munharaunda yavo. Ndipo pandingatanga.
Mubvunzo: Chinyorwa chako chinotaurawo zvakananga nezvekusarongeka kwepasi rose - vanhu vazhinji pasi rose havawani kunyange levodopa, tisingatauri nezvemabasa ehutano akasiyana-siyana. Ndeapi matambudziko makuru ekushandisa modhi yakavakirwa pahutano muhurongwa hwehutano hwakasiyana, uye tingaakunda sei?
Matambudziko acho akakura, uye anogona kuita seanorema. Asi ndinovimba kuti bepa iri pamwe nemufananidzo wepeji rimwe chete zvinoita kuti zvive nyore, kwete zvakaoma, kutanga.
Vanachiremba vanogona kushandisa ruva kana kuti one-pager senzira yekutarisa nekukurumidza: Sarudza nzvimbo imwe chete, munhu mumwe chete kana ruzivo kubva pamaruva, uye ipa murwere chimwe chinhu chaicho chekuedza: “Taura naRabhi wako nezvenyaya iyi,” kana kuti “Ngatione kana tingawana kirasi yeunyanzvi,” kana kuti “Joinha boka iri rekufamba-famba remunharaunda.” Ndiyo nzvimbo yekutanga.
Tariro yangu ndeyekuti, sezvo chinyorwa ichi chiripo pachena, vandinoshanda navo pasi rese vachachigadzirisa kuti chienderane nemamiriro avo emunharaunda, vozotipa mhinduro: Chii chakashanda? Chii chisina kushanda? Chii chatakarasikirwa nacho? Iri raive chirongwa chepasi rose chandakatungamira pamwe chete nacho, asi chakagadzirirwa kuva chinodzokorora uye chinopindura mamiriro ezvinhu emunzvimbo.
Tava padanho repamusoro. Mabhuku edu makuru ari kuburitsa nezveutano hwakanaka. MDS iri kuratidza kuti izvi zvakakosha. Iye zvino tinofanira kutora izvi mumagaraji edu — Sydney, LA, Nairobi, São Paulo — tobvunza kuti, "Tingazviita sei pano?"
Chimwe chezvinangwa zvedu ndechekuchinja kubva kuTask Force kuenda kuStudy Group iri kuramba ichienderera mberi, yakavhurirwa chero ani zvake anofarira. Tinoda kugadzira zvinhu zvakagadzirwa zvemhando yega yega yemararamiro, kuzvichengeta panzvimbo dzinosvikika, uye kutoshandura mufananidzo wekuona kuita mifananidzo inoenderana netsika, ruva rakasiyana, (pamwe koala kana kangaroo yeAustralia) kuitira kuti nharaunda dzemunharaunda dzinzwe dzichionekwa muzvinyorwa.
Mubvunzo: Basa rehutano muPD rinofanira kuenda kupi kubva pano? Ndezvipi zvinhu zvinotevera zvinokosheswa pakutsvagisa?
Iyi inyaya yakaoma kudzidza kana tikaomerera pakushandisa nzira dzechinyakare, dzakaoma zvikuru: Miedzo mikuru yakarongwa isina kurongeka inotora makore gumi pamararamiro ese. Kana tikaramba tiri "mubhokisi," tinova panjodzi yekuoma mitezo.
Pane kudaro, ndinofunga kuti tinoda nzira dzakasiyana-siyana dzinosanganisira
- Mapurojekiti madiki, ekuvandudza mhando mumamiriro ezvinhu chaiwo,
- Miedzo inoshanda, uye
- Zvidzidzo zvekutarisa zvinotevera mhedzisiro patinenge tichitanga zvirongwa zvehutano hwakanaka.
Pane mikaha mikuru muuchapupu. Kurara muenzaniso wakanaka. Tose tinoona kuti kana varwere vakarara zviri nani, vanoita zviri nani. Asi zvinoshamisa kuti hapana humbowo hwakasimba hunoratidza izvozvo kana kutungamira kupindira.
Saka tinofanira kushanda pamwe chete senharaunda yepasi rose, kuona zvibereko zvisingatarisirwi, uye kugadzira tsvakurudzo inoongorora uye inoshandisa tsika dzehutano panguva imwe chete. Chinangwa ndechekufambisa tsono nesainzi uye, panguva imwe chete, kubatsira vanhu kurarama zviri nani nhasi.
Mubvunzo: Pane meseji yekupedzisira kune vaverengi vedu here?
Kutenda kukuru. Tinotenda uye nekufamba pamwe chete, nekutsanangura nyaya iyi. Tinotenda mumwe wako wekuAustralia uye Mutungamiriri weMDS weInstantly uye Purofesa Victor Fung, avo vanga vari mutungamiriri mukuru wenzvimbo iyi, uye kuMDS nekuona hutano senzvimbo yakakosha uye yakakosha. Ndinotenda vanyori vangu pamwe neTask Force yese. Yave iri purojekiti yakanaka kwazvo yekubatsira cheerlead.
Ndinovimba kuti vandinoshanda navo vachaverenga pepa racho, vorigadzirisa, voripikisa, uye vobva varishandisa. Hutano hwakanaka hachisi chinhu cheumbozha - ndicho chinhu chikuru pakurarama kwevanhu vane chirwere cheParkinson.
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