Mubvunzo kune chiremba mukuru Maarten: Chirwere chePaget uye kurwadziwa mugumbo rekuruboshwe
Maarten Vasbinder anogara kuIsaan. Basa rake ndere general practitioner, basa raainyanya kudzidzira kuSpain. PaThailandblog anopindura mibvunzo kubva kuvaverengi vanogara muThailand.
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,
Ndine makore 74, kureba 182 cm, 95/96 kilos, handisvuti uye handina doro. Kumanikidzwa kweropa 130/80. Usashandise chero mishonga, kunze kwekurwadziwa kuruboshwe / gumbo rekuruboshwe, kuva 200mg Celebrex cap uye Voltaren emulgel.
Nhoroondo. Kupera kwe2019 MRI scan, prostate biops, bone scan, orchiectomy uye bone biops. Mushure memapfupa emapfupa zvakazoitika kuti kenza yeprostate yakanga isati yapararira asi kuti ndine chirwere chePaget. Izvi zvisati zvaitika, mushure mekubvunzurudzwa neLMC Nederland, kuiswa neZoledronate kwakaiswa. Chekupedzisira cheki PSA mukutanga Mbudzi 2020 yakaratidza kukosha kwe0,79.
Masvondo mashoma apfuura ndaiva nepfungwa yokuti gumbo rangu rekuruboshwe rakanga rakati kuoma. Pakutanga ndakapomera mhosva yekutyaira murima uye kuchinaya. Kufunga kungwara saka zuva rinotevera pabhasikoro rekurovedza muviri uye pachinzvimbo che 1 nguva maminetsi gumi nemashanu akaitwa 15 x 3 maminetsi zuva rese. Sarudzo yakaipa nekuti ndakarwadziwa zvakanyanya mugumbo rangu rekuruboshwe. Ndakatadza kurara nedivi. Mushure mechinguva ndakaenda kuBangkok Hospital muKorat nekuti pakanga paine data rangu rese maererano nenhoroondo yangu yataurwa pamusoro.
First orthopedist: unogara zvakanyanya, wati kurei, kurwadziwa mhasuru uye heino mimwe mishonga. Hapana kuvandudzwa. Wechipiri orthopedist: pamwe une tendonitis, wakagamuchira mishonga yakafanana. Ini zvakare ndinokuendesa kuna Physio. Mushonga wekupedzisira ijekiseni recortisone. Nekuti chirwere chePaget hachizivikanwe pano, handizive kana jekiseni recortisone richava mushonga chaiwo.
Physio (Bangkok Hospital): kupihwa nhoroondo yako, zvinosuruvarisa kuti handibvumidzwe kushandisa laser. Saka ultrasonic, paddles, massage uye hot packs. Akaita mana kurapwa uye hapana kuvandudzwa chaiko.
Mushure mekushanyira chiremba wePSA, pakarepo kune imwechete (yechipiri) orthopedist. Akataura nyaya yekutadza kushandisa laser. Akadaidza chiremba wepa physio ndikabvumirwa kuuya.
Chiremba wepa physio akandiongorora ndokuti: dambudziko rinobva ku gluteal tsandanyama. Yakadzika zvekuti laser haikwanise kusvika pairi, saka akakurudzira Shockwave neredhiyo frequency kurapwa pamwe chete nemaekisesaizi. Zvakare 4 marapirwo ayo ini zvino ndapedza 3, mangwana nguva yekupedzisira. Masikati ndainzwa zvakanaka asi kuti ndirare ndaida mushonga wekukotsirisa. Sezvineiwo, gomarara reprostate rinowanzoita kuti ndimuke ndiende kuchimbuzi.
Manheru hudyu yangu yekuruboshwe negumbo rekuruboshwe zvakarwadza zvekuti ndakamuka kuma 00.05 am. Dzimwe nhambo pfupi dzokurara (1,5 kusvika kumaawa 2 panguva) dzaitora kusvika 04.30 am.
Pane zano kupi kwandinofanira kutarisa iko zvino? Imhaka yechirwere chePaget, icho chakonzera kukanganisa kwemapfupa uye kudzvinyirira kwetsinga? Inogona kunge iri sciatica here?
Ndinovimba unogona kunzwisisa nyaya yangu. Ndinokutendai mberi kwemhinduro yenyu.
Kwazisai,
R.
******
Wadiwa R,
Mamiriro akaita sei. Nyaya yako yakanyatsojeka.
Zvingangodaro, chirwere chePaget chiri kukonzera marwadzo. Chirwere ichi chinonziwo Osteitis deformans. Pamwe vachaziva kuti chii.
Heino chinyorwa nezvechirwere chePaget: emedicine.medscape.com/article/334607-treatment.
Zvakakosha kurapwa nebiphosphonates. Iyo iri nyore uye yakachipa ndeye alendronate, iyo inotorwa padumbu risina chinhu mangwanani negirazi remvura (40mg pazuva). Zvadaro usadya, kunwa kana kurara pasi kwehafu yeawa, zvikasadaro kutsamwa kwehuro uye esophagus kunogona kuitika. Ikokoaast Calcium (1500 mg pazuva) uye Vit. D 500 mg pazuva).
Zviratidzo zvemapfupa muropa zvinofanira kuongororwa nguva dzose, kutanga nealkaline phosphatase. A skeletal scintigraphy inokurudzirwawo kuona kuti pfupa rinokanganiswa kupi.
Nyanzvi yechiitiko ichi ndiye internist kana rheumatologist uye kwete orthopaedist. Kuongororwa nguva dzose kwakakosha nekuda kwengozi yekenza yemapfupa, iyo inowanzoonekwa munyaya yePaget.
Iwe zvino wava nemarwadzo, ayo anogona zvechokwadi kubuda kubva muchiuno chechiuno. Zvingave kuti Paget iri kubatikanawo ikoko. Sezvineiwo, chirwere chacho chinowanzogara munharaunda uye naizvozvo hachipo mumapfupa ose.
Pakupedzisira, pane mukana wekusagadzikana kweropa, asi ini handisarudze izvozvo kutanga.
Zvinoita sekunge wakamborapwa zvine hasha zveprostate yako, asi pamwe zvaive zvakakodzera. Nemhaka yokuti iwe unenge uchirega kubudisa testosterone, iyo Paget inogona kuva yehasha.
Zano rangu mune izvi nderekushanyira internist nekukurumidza sezvinobvira.
Shingai,
Pachokwadi,
Dr. Maarten