Mubvunzo kunaChiremba Maarten: Ropa muweti yangu
Maarten Vasbinder anogara kuIsaan. Basa rake ndere general practitioner, basa raainyanya kudzidzira kuSpain. PaThailandblog anopindura mibvunzo kubva kuvaverengi vanogara muThailand uye anonyora nezvechokwadi chezvekurapa.
Iwe une mubvunzo kuna Maarten uye unogara muThailand here? Tumira izvi kumupepeti: www.thailandblog.nl/contact/ Zvakakosha kuti upe ruzivo rwakakwana se:
- Zera
- Zvichemo)
- Nhoroondo
- Kushandiswa kwemishonga, kusanganisira kuwedzera, nezvimwewo.
- Kusvuta, doro
- kufuta
- Optional: mhedzisiro yerabhoritari uye kumwe bvunzo
- Zvinogoneka BP
Unogona kutumira mafoto ku [email inodzivirirwa] zvese zvinogona kuitwa zvisingazivikanwe, zvakavanzika zvako zvinovimbiswa.
Wadiwa Martin,
Ndiri murume, ane makore 57, 1m72, 65 kg, asingasvuti, doro rinorema 1 kana 2 units/zuva. Zvakapfuura zvekurapa:
- high cholesterol (> 10 makore), ikozvino tora 40mg yeBestatin zuva nezuva.
- pakuongororwa (3 years ago) maronda eprotein neropa muweti.
- Makore matatu apfuura, chirwere cheshuga chakatanga, asi ikozvino chiri pasi pekutonga (?) nekudya kunorema (low carb). HBA3C gore rapfuura 1 (yaimbova 5,3).
- ropa rangu rinowanzoitika (vhiki yapfuura 112/75), asi rinogona kukwidziridzwa mi nekuda kwekunetseka (zvigumisiro) kana kofi mangwanani (kusvika ku145). Kazhinji pasi pe130.
Ndine urombo nenyaya yese, asi handikwanise kuipfupisa…
Inenge mwedzi 4 yapfuura ndakangoerekana ndatambura kubva (rakawanda) ropa muweti yangu, pasina kurwadziwa (painless hematuria).
Zuva rekutanga ndiro ropa rebrown (yekare), gare gare ropa nyoro. Mushure memazuva maviri kuenda kuchipatara cheko. Chiremba akaseka pakutanga ndokuti matombo eitsvo, asi hapana marwadzo uye hapana chiratidzo chematombo eitsvo paX-ray. Ipapo ndakagadzira Ultrasound uye chiremba akaona bundu “white” (2 cm) muitsvo yangu yokurudyi. Yakagamuchira ropa coagulant uye nzira yemishonga inorwisa mabhakitiriya (mazuva mana). Kubuda ropa kwakabva kwamira.
Zano raive rekuenda kuchipatara chikuru, ndoda zuva raitevera… Ndakabva ndaenda kuchipatara cheyunivhesiti muKhon Kaen mazuva maviri gare gare. Chiremba ikoko akaonawo chinhu chichena muitsvo yangu, asi maererano naye hazvina ngozi, nokuti mapundu matema paultrasound. Hapana chimwe chekuona ne echo.
Zvadaro aifanira kudzoka nokuda cytoscopy uye CT scan (2,5 mwedzi kumirira nguva pashure zororo, kana pakarepo mukiriniki yakazvimirira, 3x mutengo). Pacycstoscopy hapana chaionekwa muurinary tract yangu, hapana kuwedzera kweprostate (zvakare PSA yakajairika), makwapa mashoma matsvuku (seabrasion) mudundira rangu. Biopsy yakatorwa. Handina kuwana mhedzisiro kusvika gare gare, nekuda kwedambudziko reIT. Yakaburitsa chimwe chinhu senge "urotelial kuwanda kusingazivikanwe zvakaipa zvinogona". Maererano nachiremba kwete chaizvoizvo kuva nehanya, nokuti hapana chinoshamisa kuona pamusoro cystoscopy uye kana zvakanga zvakaipa chaizvo kwaizova ikoko.
Iyo CT scan yaisaratidza chinhu muitsvo dzangu, hapana mudundira kana kumwewo ... zvese zvaive zvakanaka uye zvichena.
Sekureva kwachiremba, ini zvino ndinofanira kuuya kuzoongororwa mwedzi mitanhatu yega yega yeurinalysis (creatinine nguva dzose 6) uye mumakore maviri cystoscopy uye CT scan.
Panguva ino ndinoramba ndichitambura nekurasikirwa neropa shoma, yero kana dzimwe nguva weti yeorenji (dzimwe nguva kusvika ku5RBC).
Chiremba wangu (urologist) anga achidzidziswa kwemwedzi mina ikozvino, asi ini ndichiri nemibvunzo mishoma:
- Vanachiremba vakaita nemazvo pakuongororwa here? Kana kuti zvimwe zvinogona kuitika? Kumirira ndiyo sarudzo yakanaka here? Ndinovimba navanachiremba muno, kunyanya muchipatara cheSrinagarind. Vanamazvikokota vanowanzo taura Chirungu chakanaka uye hachidhure, kunyanya zvichienzaniswa nezvipatara zvakazvimiririra. Unofanira kumirira kakawanda.
- Kubuda ropa kukuru muweti yangu kungava nekuda kwedambudziko risipo/rinotanga dundira here? Kana kuti kubva kuitsvo? Uye nei zvichiri kubuda ropa kana itsvo dzangu dzine hutano (anodaro chiremba)?
- Ko bundu "chena" muitsvo ringangonyangarika sei mushure memwedzi 2/3? Kana kuti izvo hazvionekwe paCT scan (nekuti inosanganisirawo tekinoroji yeX-ray).
- Pane chimwe chinhu chandingaita here kudzivirira kuipa kunze kwekunwa mvura yakawanda?
Pachokwadi,
E.
*******
Anodiwa E,
Ndatenda neruzivo rwakadzama. Ini ndinoitora iwe hautore chero mumwe mushonga kunze kweBestatin? Nenzira, iwe unogona kusiya kunze kweBestatin. Inogona kuva (chikamu) chikonzero chechirwere cheshuga.
Kana kuri kubuda kweropa kwawakaita uye uchiri kuita pamwero wakati, zvinowanzoitika nekuda kwedambudziko redundira. Coagulant inoshanda chete kana pasina mudziyo mukuru unobatanidzwa mukubuda ropa. Uyezve, hakusi kurapa kusingakuvadzi.
Mavara matsvuku ari mudundira anogona kuratidza CIS (carcinoma in situ) uye zvine hungwaru kuramba uchiiongorora. Ndokusaka ndaizoisa pamberi pe cytoscopy ne biopsy uye kwete kumirira makore maviri.
Bvunza kana iyo biopsy inogona kuongororwa nevatatu vakasiyana pathologist. Izvi zvinoderedza avhareji yekukanganisa kusvika pa3%.
Bundu rinongonyangarika rinowanzobva pane chigadzirwa, nemamwe mazwi, harina kumbovapo.
Saka zano rangu ndere kudzokorora cytoscopy uye kuve nechokwadi neimwe urologist. Zvadaro une maonero echipiri chaiwo. Iwe haugone kuita zvimwe zvakawanda.
Pachokwadi,
Dr. Maarten