Zvinodiwa nevanhu vane chirwere cheParkinson pakupera kwehupenyu hwavo

Tinotenda zvikuru nekutora nguva yekusangana nesu nhasi. Ndinokutendai zvikuru.

Dr. Marjan Meinders: Ndatenda nekukukokai. Chikomborero chikuru kukuudzai zvakaitika kwandiri mupodcast iyi

Ms. Nicole Duff: Saka nhasi tichakurukura nezvenyaya inonakidza zvikuru yamaishanda pamwe chete nayo, ine musoro unoti Zvinyorwa zveKupera Kwehupenyu hwevanhu vane Parkinson's Disease kana Parkinsonism muEurope. [00:01:00] Uye ndinofunga kuti zvakatibata pfungwa nekuti hazvina kunyanya kukosha munguva yakapfuura, asi ikozvino mumakore mashoma apfuura zvave nepfungwa yekutarisa kuguma kwehupenyu uye kutarisirwa kwevarwere, kunyanya mumunda weParkinson's.

Saka ndinofunga kuti chinyorwa chacho chainakidza pakuti ndiwo mavambo, sezvamakataura, ekudzidza uko kuchava nezvikamu zvakawanda zvinogona kuvhurwa mushure mazvo. Saka chinhu chandinofunga kuti chinogona kuita kuti tsvakurudzo yacho irambe ichiitwa kwenguva refu iri kuuya.

Saka ndinofunga kuti chinhu chekutanga chandaida kubvunza ndechekuti nyika dzaibatanidzwa dzaive Austria, Estonia, Germany, Greece, Italy, neSweden. Uye ndakafarira chaizvo kuti nyika idzodzo dzakasarudzwa sei kuti dzive chikamu chechidzidzo ichi.

Dr. Marjan Meinders: Kutaura zvazviri, iyi iongororo yekuEurope yakatsigirwa nemari nechirongwa cheHorizon 2020, [00:02:00] uye nyika dzakasarudzwa nemaPI chete. Idzi inhengo dzeMDS dzinosangana pamisangano uye dzichironga tsvakiridzo yakakodzera. Saka izvi ndizvo zvinoitika. Uye pamusoro penyika dzawataura, UK yakatorawo chikamu, kunyangwe chikamu chavo muchinyorwa chino chaive chidiki.

Asi zvakanaka kutaura kuti vakabatanidzwawo muchirongwa ichi chikuru chekuEurope.

Ms. Nicole Duff: Ndatenda. Ndinofunga kuti kunyangwe izvi zvakaitika netsaona, zvinonakidza nekuti nzira dzakawanda dzekuunganidza data kana kutarisa kwekuunganidza data dzakaitika kuti dzaive dzisina kurongeka, uye zvakapa ruzivo rwakadzama kuongororo, kana wakaunganidza neimwe nzira kana kuti yaive marekodhi ehutano emagetsi, zvakabva zvawedzera zvakawanda kudata rako rekudzidza, uye izvozvo-- zvaifadza zvikuru kukwanisawo kutarisa izvozvo.

Saka nekuti wakashandisa manyuko akawanda [00:03:00] wakaona here kuti rimwe chete raive nyore kuunganidza kubva mariri?

Dr. Marjan Meinders: Kutaura chokwadi ndiro raiva dambudziko guru muchirongwa ichi. Kunyora magwaro ekurapwa kwekupedzisira kwehupenyu muchinyorwa chekurapa kwakafanana zvikuru nekutarisirwa kwekiriniki, saka zvine musoro kutsvaga zvimwe zvinhu ipapo. Zvisinei, muongororo yedu, taisawana magwaro ekurapwa nguva dzese, saka iro raive dambudziko.

Uye kana taiva neruzivo rwekuti zvinyorwa zvekurapa zvakarongwa nenzira yakaoma zvikuru, saka kana pasina nzvimbo chaiyo muzvinyorwa zvekurapa apo zvishuwo izvi zvakanyorwa, zvakaomawo kuwana nzvimbo apo zvishuwo nezvido zvakakodzera zvakanyorwa. Saka izvozvo zvaive parutivi rwezvinyorwa zvekurapa.

Imwe nzira, tinoshandisa mareports edu uye zvakazoitika kuti kunyanya muGermany nemuAustria, vanhu vakanyora mirairo yepamusoro yakachengetwa kumba [00:04:00]. Vaichengeta mirairo iyi kumba, saka iyi yaivewo sosi huru yeruzivo rwezvakanyorwa zvekutarisirwa kwevarwere pakupera kwehupenyu.

Kunyange zvakadaro, takaonawo kuti vanhu vairatidza kuti havana ruzivo rwakanyorwa rwekuti munhu anofanira kurapwa sei pakupera kwehupenyu hwake, asi patakaongorora ruzivo rwezvekurapa, paiva nechimwe chinhu chaivapo. Saka kuti tinyatsoona kuti ruzivo rwedu rwakanaka zvechokwadi, tave tichinetseka, uye takaita nzira yakarongeka.

Uye pakupedzisira, ndinofunga kuti mumwe chete kana vaviri chete ndivo vaifanira kuita sarudzo pamwe chete nePI kuti tingaidudzira sei data racho. Saka handigoni kutaura kuti mumwe ari nani pane mumwe. Zvinoenderanawo nenyika, kuti hurongwa hwacho hwakarongwa sei. Semuenzaniso, kuchengetedza mirairo yepamusoro kumba kwakajairika muGermany.

Izvozvo zvaindishamisawo ini semuongorori wekuNetherlands. Asi zvakabatana zvakanyanya munharaunda zvichienzaniswa nedzimwe nyika.

Ms. Nicole Duff: Uye tiri kutaura nezveGermany nekuti munyaya yauri kutaura iyi inozivikanwa zvakanyanya kubva pakuona kwehutano hwevanhu, saka nekudaro kuva nemagwaro kumba, ungafunga kuti nhengo dzemhuri nevanotarisira varwere vanoziva kuti magwaro acho ari kumba. Nepo kune dzimwe nyika kwaasinganyanyi kuzivikanwa mubazi rehutano hwevanhu, haungatarisiri kuti magwaro acho ave kumba nekuti hapana angaziva kuchengetedza ruzivo urwu.

Saka zvinonyatsochengeterwa kupi, kana usiri kuiwana mumagwaro ehutano, mumagwaro ehutano emagetsi, saka zvakare, uchaiwana kupi ruzivo urwu? Saka zvakare, nekutarisa kwawakawana ruzivo urwu, wakaona here kuti rumwe rwakarurama kupfuura rumwe?

Dr. Marjan Meinders: Kwete. Ichi chaisava chinangwa chaicho chechidzidzo ichi. Taitsvaga magwaro nezvimwe zviri mukati, asi hatina kunyatsoongorora [00:06:00] chokwadi cheruzivo rwese. Kutaura zvazviri, zvakanga zvisiri pachena pachidzidzo ichi. Rangarirai kuti ichi chaive chikamu chebvunzo huru yakarongwa isina kurongeka, saka pane zvakawanda zvichabva muchidzidzo chePD PAL.

Uye magwaro ezvakanakira kutarisirwa kwevarwere pakupera kwehupenyu aive nzvimbo yakanaka yekutanga kudzidza nezvemaitiro munyika dzakasiyana siyana nekuti kune kusiyana kukuru muEurope mune izvozvo.

Ms. Nicole Duff: Ehe, ndinogona kufungidzira. Wakawana izvozvo here muzvinyorwa zvehutano zvemagetsi, kana wakawana mirairo yepamusoro yemurwere kuti maonero evashandi vehutano kana maonero avo pamusoro pemirairo yacho akambonyorwa?

Dr. Marjan Meinders: Kwete, handizivi. Handina kutora data ini pachangu. Uye, unoziva, izvi zvine chekuita nehukama huripo pakati pemurwere, nhengo dzemhuri nachiremba ari kurapa. Pakudzidza kwedu, hazvina kukodzera [00:07:00], uye hatina kuongorora izvozvo.

Ms. Nicole Duff: Saka zvamakawana ndezvekuti vanhu vanosvika 20% vaive nepfungwa dzekuti vanhu vanofanira kurapwa panguva yekufa kwavo, izvo zvinoita sezvishoma. Saka munyika imwe neimwe, makataura nezvezvikonzero zvamaifunga kuti ndizvo zvakakonzera izvi. Mungatiratidzawo here zvimwe zvezvikonzero izvi zvamakawana?

Dr. Marjan Meinders: Ehe, ndinofunga kuti tinogona kuona nhanho nhatu. Saka chekutanga inyaya yemagariro evanhu. Saka munharaunda dzekuMadokero, nyaya dzekuchengetedza hupenyu dzinoenderana nerufu, uye rufu rune chirevo chisina kunaka.

Hazvina kutenderwa kutaura nezvazvo, kunyangwe zviri chikamu chehupenyu. Tinopemberera kuzvarwa, asi rufu chikamuwo chehupenyu. Saka ichi chinhu chemagariro evanhu, uye uh, vanhu vainzwa kusagadzikana kutaura nezvezvinodiwa pakuchengetwa kwehupenyu, tisingatauri [00:08:00] chete kuzvinyora. Saka ndiyo nhanho yechipiri, vanhu pachavo.

Muchirwere cheParkinson, unofanira kunge uchitosangana nezvinhu zvakawanda muhupenyu hwako. Vanhu vazhinji vanodzivisa zvinhu zvisina kunaka muhupenyu. Vanosarudza kutarisa pane zvakanaka zvehupenyu. Saka kufunga nezvekuguma kwehupenyu kunobatanidzwa nechikamu chisina kunaka cheParkinson. Kunyangwe ndichizivawo vanhu vakatanga kupa mirairo nguva pfupi mushure mekuonekwa kuti vane chirwere ichi nekuti vaisada kuisa mutoro pamhuri kuti vaite sarudzo dzakaoma.

Asi kazhinji nyaya dzekutarisira varwere kusvika pakuguma kwehupenyu nehurukuro pamusoro peizvi hazvidiwi. Saka izvozvo zviri padanho revarwere. Mune dzimwe nyika, kunyanya mu-- muItaly nemuAustria vanhu vaifunga kuti kukurukura nyaya dzekutarisira varwere kusvika pakuguma kwehupenyu [00:09:00] chinhu chinofanira kuitwa mumhuri kwete nenyanzvi yehutano.

Saka ndicho chikonzero nei zvisina kunyorwa muzvinyorwa zvekurapa. Uye padanho rechitatu, ndiyo nzira yehutano pachayo. Saka, kutarisirwa kwevarwere vane marwadzo emusana hakunyatsobatanidzwa muhurongwa hwedu hwekurapa. Kukurukurirana kwakanaka nezvekuchengetedzwa kwemusana kusvika pakufa kunoda nzira dzakasiyana-siyana. Inzira inoda hurukuro dzakawanda.

Hapana kumhanya-mhanya. Nguva dzose pane mukana wekufungisisa, uye kazhinji iyi ndiyo - iyi imba, iyi nzvimbo haiwanikwe muongororo dzekiriniki. Saka zvakare hurongwa hwehutano hahutsigire magwaro ezvinodiwa pakuchengetwa kwehupenyu. Saka zvese zvinotsanangura 20%. Handina kushamiswa nenhamba iyi [00:10:00].

Ms. Nicole Duff: Ehe mushure mekunzwa tsananguro iyoyo ine zvikamu zvakawanda, ndinonzwisisa chaizvo kuti zvikamu zvakasiyana zviri kupi uye zvakanyatsojeka, saka ndatenda nazvo. Uye ndichifunga nezvekuti zvingada kunangwa sei pamatanho akawanda kuti ndiedze kufunga nezvekuvandudza izvi. Chinhu chimwe chete chandakawana chinonakidza ndechekuti pawakatsanangura nzvimbo nhatu dzakasiyana dzawakatarisa zvingafukidzwa mukati memurairo wekupedzisira wehupenyu.

Chandakawana chinonakidza ndechekuti mibvunzo mizhinji yaipindurwa kana kuti yaive neruzivo rwayo rwaive rwekuti vaive nemumiriri wepamutemo here. Saka kwandiri zvaifadza kuti vaisafanira kupindura mibvunzo yese ine chekuita nekwavaida kurapwa kana kuti vangade kupindira mune zvehutano zvakadii, asi vaive nechokwadi chekuti vaive nemumiriri wepamutemo pagwaro ravo.

Unofunga kuti izvozvo zvakare [00:11:00] kungova kushaya ruzivo rwevanhu here?

Dr. Marjan Meinders: Zvakanaka, ndinofunga kuti iyi inzvimbo yakanaka yekutanga. Kupa mumiriri wepamutemo chinhu chekuti pane mumwe munhu anogona kuita sarudzo achimiririra murwere, nekuti zvikasadaro sarudzo dziri kuitwa nenyanzvi dzezvehutano uye vanoshandisa mitemo yavo yehunyanzvi panzvimbo petsika dzemunhu.

Ndinofunga kuti iyi inzvimbo yakanaka yekutanga uye kusaziva munharaunda kuti dzimwe sarudzo dzinogona kunyorwawo. Ndinofunga kuti une pfungwa yakanaka ipapo. Zvishoma nezvishoma, kusaziva, asiwo kuoma kwesarudzo yakadaro, haugone kuienzanisa nekungopa mumiriri wepamutemo.

Kufunga nezvekurapa, kurega kurapwa kwakaoma zvikuru

Ms. Nicole Duff: Ehe, sezvandambotaura kare, ndinofunga kuti chidzidzo ichi chawana ruzivo rwakawanda rwe [00:12:00] rwatinofanira kuunganidza tozokwanisa kuedza kushandisa izvo zvichabatsira varwere munzira dzakawanda. Saka pawakanga uchitaura nezvechikwata chose chevanhu vane hunyanzvi hwakasiyana-siyana, muchidzidzo ichi chePD Pal chichiri kuenderera mberi, ndakaona kuti waitarisa kushanda zvakanaka kunotungamirwa nevakoti, saka ndiri kuda kuziva kuti sei wakatanga nekushandisa vanamukoti kwete, semuenzaniso, vashandi vemagariro evanhu kana vabatsiri vekurapa.

Saka ndinoziva kuti chidzidzo chakasiyana uye hachisi chikamu chechinyorwa, asi chikamu ichocho chakandibata pfungwa kana muchida kutsanangura zvakawanda nezvazvo.

Dr. Marjan Meinders: Ehe, mubvunzo wakanaka kwazvo. Vanamukoti, kunyanya muNetherlands uye mune dzimwe nyika muEurope vane chinzvimbo chakakosha mukutarisira vanhu vane chirwere cheParkinson's. Kazhinji, ndivo vanhu vekutanga kusangana navo panguva yese yechirwere, saka pane hukama hwekuvimbana, uye ndiyo nzvimbo yakanaka yekutanga [00:13:00] yekukurukura nekukurukura nguva nenguva.

Saka, mukoti munhu akanaka kutora chinzvimbo chekutungamira mune izvi. Asi ndinobvumiranawo kuti vamwe vashandi vezvehutano vanogona kuva nebasa uye pamwe kutotungamira. Kana munhu aine hukama hwakanaka nenyanzvi yekurapa, sei asingadaro? Asi zvakakosha kuti vamwe vari muchikwata chevanhu vane hunyanzvi hwakasiyana-siyana vazive kuti hurukuro idzi dzinoitika uye kuti ndedzipi sarudzo dziri kuitwa.

Saka dambudziko riripo nderekuti tingagovana sei ruzivo rwakadai sezvo pasina rubatsiro rwezvekurapa runogovaniswa nenyanzvi dziri kushanda munharaunda kwete muchipatara. Asi ndinobvumirana nazvo zvachose. Hazvisi mukoti anofanira kuita izvi. Ndinofunga kuti zvinoenderana zvikuru nehukama huri pakati pemunhu nenyanzvi.

Ms. Nicole Duff: Sezvamunotaura, vanhu vazhinji vanofunga kuti zvinofanira kuramba zviri mumhuri, asi sezvo vangangounganidza hukama ihwohwo, [00:14:00] ndiye munhu wekubatana naye. Ini ndinofunga kuti chimwe chezvamataura, chandinofunga kuti chichabatsira zvikuru mune ramangwana, ipfungwa yekuva netemplate yemirairo yekutarisira varwere yakajairika, uye kuti, sezvamunotaura, mukati mechikwata chevanoshanda muzvikoro zvakasiyana-siyana, munhu wese anogona kunzwisisa kuti pfungwa dzevarwere dzingaendepi kana kuti tinofanira kuedza sei kuti varwere vatange kufunga.

Saka mukati mechikwata chine mabasa akasiyana-siyana, munofunga here kuti muenzaniso uyu unobva kunyika imwe kuenda kune imwe, kana kuti munofunga kuti tinogona kuva neumwe wakarongeka muEurope yese, kana kuti munofunga kuti chimwe chinhu chinofanira kunge chakasiyana pachikwata chimwe nechimwe?

Dr. Marjan Meinders: Ini ndinofunga kuti panogona kuva nechiyero senzvimbo yekutanga uye MDS inogona kuva nebasa guru mukugadzira zviyero zvakadaro, nekuti kuita kuti zvive zvakanangana naParkinson kwakakoshawo, ndinofunga, kufukidza zvese zvine chekuita nekutarisira. Saka hongu template yakajairika inogona [00:15:00] kugamuchirwa uye kubatanidzwa mumasisitimu emagetsi anoshandiswa kutsigira kutarisirwa kwevakawanda.

Ehe, uye izvozvo zvakarongwa zvakasiyana munyika dzakasiyana. Asi zvatinoona muGermany avo vane magwaro ekuronga kutarisirwa kwepamusoro uye mafomati akajairika kuti zvinobatsira chaizvo kunyora. Uye magwaro aya magwaro aripo, handiti?

Zvinogona kuchinja pese pamunosangana moita hurukuro dzakawanda. Saka izvozvo zvakakoshawo kuvarwere kuti zvamunonyora nhasi zvigone kuchinjwa uye igwaro rinorarama.

Uye, uye vanhu vanotyawo kuti mhando dzemirairo iyi dzinodudzirwa, um-- zvisizvo nenyanzvi dzezvehutano.

Saka ichochowo chimwe chinhu chandinoda kusimbisa kuti kune varwere zvinofanira kujeka kuti basa remirairo yepamusoro chii uye chinzvimbo chemirairo yepamusoro chii.

Ms. Nicole Duff: Hazvifanirwe kunge zvichibva kunzvimbo yekutya, asi pane kunaka kwehupenyu uye [00:16:00] zvichivapa nzvimbo yekutonga.

Dr. Marjan Meinders: Ndizvo chaizvo. Ndinoda mashoko ako. Ehe.

Ms. Nicole Duff: Saka mubvunzo wekupedzisira, wandakawana wakanaka kwazvo muchikamu chimwe chete chamakakurukura chekuti maive nevatori vechikamu vanomwe apo MoCA yavo yaive pasi pegumi, uye paive nemibvunzo pamusoro pekuti vaifanira kunge vakapinda muchidzidzo here kana kuti kwete. Asi makataura kuti vaongorori vemunharaunda vakati vanofanira kunge vari muchidzidzo, uye kuti chaive chakakosha chaizvo nekuti zvakatibvumira kuchitaura kuvanhu vangave vakanyanya kukura, uye tichiziva kuti kunyangwe nevarwere veParkinson's, tinogona kunyora murairo wepamusoro, wandinofunga kuti zvinonyaradza kuziva.

Unofunga here kuti pane imwe nzira inogona uye inofanira kuramba ichiita advanced directive nevanhu vane Hoehn neYahr vari pasi pevatatu?

Dr. Marjan Meinders: Ehe. Kutanga hurukuro dzemirairo yepamusoro kunofanirwa kugadziriswa zvichienderana nezvinodiwa [00:17:00] uye nhanho iyo munhu ari. Saka izvozvo zvinoda nzira yekutaurirana ine hungwaru, uye kwandiri hazvitsamiri padanho raHoehn neYahr. Asi chatinofanira kudzivisa ndechekuti unopedzisira wava nemunhu asingachakwanisi kuita chero sarudzo, uye nhengo dzemhuri dzinofanira kuita.

Saka muchidzidzo chedu, takanga tine vamwe vanhu vaive neMoCA score yakaderera, asi muzviitiko izvi, nhengo dzemhuri dzaive dzakakosha zvikuru. Ndiyo imwe yenzira dzekubatanidzwa. Panofanira kunge paine nhengo yemhuri iripo. Saka kutaura chokwadi, muzviitiko izvi, ndinofunga kuti wanonoka, asi takavabvumira kutora chikamu, uye zvechokwadi takaratidza nezviitiko zvishoma kuti zvichiri kugoneka, asi kutaura chokwadi unofanira kudzivisa mamiriro ezvinhu aya. Asi zvakare, izvi zvinoenderana nekuti chii chiri kuitika uye kuti munhu agadzirira riini hurukuro dzakadai. [00:18:00] Uye kutanga nekukurumidza kune vanhu vazhinji kuchiri kunonoka, kunyangwe mukutongwa kwaBenzi Kluger, vanhu vane Hoehn naYahr danho rechipiri vakaverengerwawo.

Saka rubatsiro rwavo rwekurapa vanhu vakaremara rwakagamuchirwa zvakanaka nevanhu vaiva muchikamu chepasi cheHoehn neYahr.

Ms. Nicole Duff: Ndiko kuenzana kwakanaka uko varwere vanongogamuchira kunzwa nhau. Uye sezvamunotaura, izvozvo zvinogona kugadziriswa mumwe nemumwe. Ndine mimwe mibvunzo yakawanda yandinoda kukubvunzai, asi kuti ndigumise kubva pano here? Pane chimwe chinhu chakarongwa here? Zviri pachena kuti mune chidzidzo chePD Pal, asi pane chimwe chinhu chiri kurongwa here?

Dr. Marjan Meinders: Zvakanaka, tiri kupedzisa ongororo yedu yese uye zvinyorwa pamusoro pekuyedzwa kwekiriniki. Saka mhedzisiro huru, kuyedzwa kukuru kwave kuda kugamuchirwa kwechirwere cheNPJ Parkinson. Uye tine mamwe mabasa akawanda emhando yepamusoro akaitwa nekuti taida chaizvo kunzwisisa [00:19:00] mhedzisiro yekupindira nehurukuro dzinotungamirwa nevakoti, zvaireva kuti vanhu vane Parkinson vaite hurukuro dzakadaro.

Kune mamwe mabasa akawanda emhando yepamusoro ari kuuya. Uye ndinofunga kuti anobatsira zvikuru pakutsvaga rubatsiro rwevanhu vanorwara nepfungwa.

Ms. Nicole Duff: Izvi zvinonzwika zvinonakidza chaizvo, uye ndinotarisira mberi. Uye hongu, ndinokutendai zvakare nekuva nesu nekutaura nesu uye tinozvitenda zvikuru.