Nyaya iyi yakatumirwa kuAspergillosis Patients support group muna 2001.

Mary Jo anga ari nhengo inoshingaira yeAspergillus Support Group uye anga achirwara neAllergic BronchoPulmonary Aspergillosis (ABPA) kwehupenyu hwake hwose. Chirwere ichi chinokonzerwa nehutachiona hweAspergillus husina hutachiona hwemapapu. Iyo fungus inogara munzvimbo dzemhepo dzemapapu, inogara pamusoro peiyo inonzwika yemapapu tishu inokonzera kuzvimba asi haipindi munyama yemapapu.

Izvi zvinoreva kuti kunyange zvazvo ABPA isiri chirwere chinouraya nokukurumidza (kureva kuti kusiyana neaspergillosis inoparadza, inoda kurapwa nokukurumidza), panguva ino inowanzogara zvachose.

Kuzvimba kwetishu yemapapu kunogona kuita kuti kufema kunetse, saka masteroid (eg prednisone) anoshandiswa kudzora izvi. Iyo antifungal drug itraconazole (Sporanox) ichangobva kuratidzwa kuti inobatsirawo kudzora chirwere.

Chikamu 1, makore ekutanga, kuvhiyiwa kwemapapu uye kuongororwa

Ndichiri mucheche ndakaita chigwere chairwadza zvekuti amai vakatya kana kundisimudza vakandibata. Chiremba wevana akamuudza kuti aigona kutarisira mamwe matambudziko neni gare gare. Mashoko ake akabvumikisa kuva ouporofita zvikuru.

Pandakanga ndava nemakore matatu ndakanga ndava neasthma. Pandakanga ndiine makore gumi ekuberekwa vakatorwa x-ray yepachipfuva chiremba wangu wevana akaudza amai vangu kuti ndaiva ne“bayo yekufamba.” Sezvineiwo ndiko kwaive kutanga kweABPA. Chero ani zvake kunze uko achiverenga izvi akamboudzwa kuti ane "pneumonia yekufamba" anogona kuzorora aine chokwadi chekuti ndipo pavanogona kufambidzana nekutanga kweABPA. Panenge panguva iyi chiremba wangu wevana akabva kukiriniki yedu kuti adzokere kuchikoro kunova chiremba weallergist. Akaudza vabereki vangu kuti vandiendese kuna general internist nekuda kwematambudziko andaisangana nawo. Ndainzi ndichiri mudiki kuti ndiende kunodzidzira basa, uye ndine chokwadi chekuti ndaiva murwere mudiki pane vose waakambova naye, asi kwaiva kudyidzana kwakagara kusvika paakazorega basa makore mashoma apfuura.

Panenge panguva ino chisarudzo chakaitwa chokundiendesa kuMayo Clinic. Vaifunga kuti zvaishamisa chaizvo kuti mwana mudiki akadaro ane asima uye bronchiectasis sezvo vaiona bronchiectasis sehosha yemunhu akura. Mazuva iwayo kuongororwa kwebronchiectasis kwaiitwa nechirongwa chinonzi bronchogram sezvo vaisashandisa katsi scan sezvavari kuita iye zvino. Izvi zvakaitika mukupera kwema60. Bapu rangu rekuruboshwe rakavharirwa uye harina kujeka uye vakasarudza kuita oparesheni pandaiva nemakore 12. Lobe repamusoro uye lingula zvakabviswa. Vanachiremba vakatevera vave vachitsoropodza zvikuru kurapwa kwandakawana panguva ino. Vakataura kuti panguva iyoyo chirwere chingadai chakaitwa uye chaifanira kuitwa uye kuti kuvhiyiwa kwacho kwaisafanira kumboitwa. Kuvhiya kunenge kusingambokurudzirwe ABPA. Kunyanya nekuti iyo plugging inogona uye inovandudza chero kupi. Pandakanga ndichangopedza chikoro chesekondari ndakatanga kugadzira plugging mumapapu angu ekurudyi. Panguva iyoyo vabereki vangu vakatanga kunetseka kana ndaizorarama kuti ndione makore 20. Havana kumbotaura zvakawanda kwandiri pamusoro paikoku asi ndaiziva zvirokwazvo kuti vainetseka zvikuru. Panguva ino ndinoyeuka ndichibvunza mumwe wavanachiremba vangu kuti vaizoitei apo mapapu ose andaiva nawo akanga avharwa uye vakanga vaagura ose. Hapana airatidza kuva nemhinduro pane izvozvo. Pandinotarira shure panguva iyoyo pandakanga ndava nemakore anenge 15 kana kuti 16 hanzvadzi yangu inoti kwaiva nefunganyo huru nevabereki vangu. Anoti pakanga paine kushushikana kwakanyanya nezveramangwana rangu kana kushaikwa kwaro uye kushushikana kukuru nekushaikwa kwekuongororwa uye kuti zvairevei maererano nekugona kwangu kushanda panguva iyoyo uye zvazvaizoreva kune ramangwana.

Ndinoita sendisina kuzviona sezvaakaita. Mukoma wangu anoti haana kuzvionawo. Pandakanga ndichiri mudiki uye vaindiisa muchipatara sisi vangu vaikanda mhindo huru kwazvo. Ndine chokwadi chekuti aifunga kuti handichadzoki. Taiedza kufunga zvinhu zvaizomuvhiringidza. Dai ndanga ndiri kumadoctors ivo vachiri kuchikoro dai ndaifanira kuenda kuchipatara namai vangu ndaikasira kumhanyira kumba kunotora suitcase ndozobuda mumba vasati vadzoka kubva kuchikoro nekuti vairasa. zvakadai zvingava zvakaoma kubva kwaari. Rimwe gore vakatombomupa birthday present but she ran after us as we drove ndokudzingirira mota mumugwagwa ndokukandira chidhori chake mumugwagwa ndokubva baba vangu vamudzingire vodzokera naye mumba. Pakuzosvika gore rangu rechipiri muchikoro chesekondari kushushikana kwakadzikama nekuti pazera re16 ndakazoongororwa. Takanga tava kuziva kuti chii chakanga chaitika kwandiri. Taizivawo kuti prednisone ndiwo mabatirwo ayaiitwa. Sezvineiwo zvakakwana mukati maaya makore mukuru wangu wechikoro akanga ave achindibata neprednisone. Akazviita nekuda kwekupererwa asingazivi kuti ichi chaive chinhu chakanaka chekuita. Pamwe ndiye akandiraramisa. Asi haanawo kubvisa mapapu angu. Nekuti aindiisa pa quick tapers. Aiva nehanya nazvo nekuti panguva iyi ndakanga ndava kuita mukadzi uye aisada kundikanganisa kukura kwangu kana chimwe chinhu. Akazviita nemaziviro aaiita asi akanzwa kurerukirwa kuti avhenekwewo. Kubva ipapo takanga tava kunyanya kuita zvehasha tichishandisa prednisone. Izvi ndezve 1972 kusvika 1973.

Chikamu 2 yekutanga koreji, inhaled antifungal zvinodhaka, systemic zviratidzo

Panguva yandakanga ndava kukoreji, ma<em>prednisone akanga asiri kundiitira. Ndakanga ndiine maplugs akawandisa uye takasarudza kundiisa pane mamwe madhizi ezuva. Izvi zvaiita sezviri nani kwandiri. Asi sevanhu vazhinji vane ABPA ndakanga ndisingazorori uye kusagutsikana nazvo uye ndaida imwe nzira yeprednisone.

Panguva iyoyo pane zvimwe zvidzidzo zvaiitwa pachishandiswa antifungal mishonga. Aya zvino ave pakati pe70's. Chiremba wangu neni takasarudza kuedza kufema Nystatin. Hatina kuziva panguva iyoyo kuti yaisashanda paAspergillus asi takazviita zvakadaro. Zvakabatsira zvishoma asi kwete zvakanyanya. Yaidhura zvikuru uye yainetsa zvikuru, saka takazoisiya. Ini ndinofunga pamwe yakabatsira vamwe asi ini ndakanga ndisingazivi panguva iyoyo kuti mumakore aitevera, bvunzo dzaizoratidza kuita kwakanaka kuCandida chinova chipenyu chaanonyanya kushanda nacho. Takazofunga kuedza amphotericin B. Uyu mushonga wakasimba zvikuru uye wakatambanuka. Zvakare kwaive kubudirira zvishoma. Takava nedambudziko neni kuzvishivirira sezvo zvine hukasha uye zvine pH isina hushamwari. Takatora matanho ekuyedza kudzikamisa pH asi hazvina kubatsira. Ndaiita kubatwa nemaoko ekukosora pakuedza kuifemesa. Ndaisakwanisa kuishandisa zuva nezuva nekuti mapapu angu aifanira kudzika kubva pairi. Kwakanga kwakafanana nekuedza kukweva doro rekukwesha kana zvimwewo zvakafanana. Zvakaoma uye zvinogumbura. Takazosiyawo izvozvo.

Ndinofanira kutaura kuti pandaiishandisa ndainzwa kuti kubuda kwemapapu angu kwairatidza kuti “kwakachena” uye kwakanga kusina kushata, asi panguva iyi ndakanga ndisati ndambonyatsokwanisa kuderedza dhodhi rangu reprednisone uye ndicho chaiva chinangwa changu pandakatanga kuenda. kuita izvi. Saka raive bhegi rakasanganiswa. Waivawo mushonga unodhura zvikuru. Yakanyanya kuparara uye yakaoma kushanda nayo. Ndakazongorega kuishandisa.

Iye zvino tava kupinda mukutanga kwema80. Kwemakore ndave ndichirwisana nezviratidzo zvakawanda kureva:

Kuneta

Tsandanyama nemajoini kurwadza uye

kurwadziwa

Nausea

Diarrhea

Chest pain

Pleurisy

Pneumonia

Low grade fevers

Ndakanzwa kuti ndakanga ndapedza zvose zvaidiwa nemishonga yechivanhu uye yakanga yave nguva yekutarisa dzimwe nzira.

Ndakasarudza "alternative allergist" uye kwaive kufamba kwakanaka. Chekutanga haana kumbobvira aita zvekunyanyisa. Akatya kuti ndakanga ndiine mapfuti alergy kwemakore gumi ndichiri mwana. Hongu vakatondiomesera, asi dai ndaiva ndabatwa nechirwere makore iwayo isu tingadai tisina kumbozviitawo. Allergy shots ihombe kwete kwete yeABPA uye usamborega chero munhu achikuudza zvakasiyana. Muchinda uyu akaita ongororo yakawandisa yeallergy uye ini ndanga ndaenda kune vamwe vanorwara. Ndakaona kuti ini ndinoyambuka ndichibata kune yega mold, mbiriso uye fungi pamusoro penyika. Aiita seane nzwisiso yakanaka ye mold allergies in general uye ndakadzidza zvakawanda. Akadzidzawo zvakawanda kwandiri. Haana kukwanisa kundibatsira asi chaive chiitiko chakanaka. Gare gare mumwe chiremba wangu wepulmonologist uyo akamuramba akaita kuyedzwa kwese kwaakaita pandiri kwakadzokororwa uye akawana mhedzisiro yakafanana. Saka munhu wese akadzidza panguva iyoyo. Iye zvino tava muna 10.

Chikamu 3 ovarian cyst, uye deflazacort

Muna 1985 ndakavhiyiwa nechimbichimbi nokuda kwecyst ovarian. Handizivi kuti ndakaitora nguva yakareba sei asi handina kana zviratidzo zvachose kusvikira ndakotama nekurwadziwa rimwe zuva uye handina kutwasanuka kusvikira mushure mekuvhiyiwa. Cyst yaive saizi yegrapefruit uye ndakarasa ovary yangu yekurudyi nechubhu. Ndaigara ndichizvidemba kuti handina kuisirwa fungus nekuti haumboziva. Ndinonzwa kuti maererano nehutano hwangu hwese ndakadzika mukuderera panguva ino nenguva. Ndakanga ndagara ndiine hutano husina kunaka asi nekuda kwechimwe chikonzero ndakave ndisisashande zvakanyanya mushure mechiitiko ichi.

Kuma 90s zvakava pachena kwandiri kuti ndakanga ndisingachakwanisi kushanda kwenguva yakareba uye kuti ndaifanira kutanga kufunga nezvehurema. Ndakanga ndagara ndisingapindi zvakanaka uye ndaigona kungoshanda uye kusaita zvakawanda zvechimwe chinhu. Mhuri yangu yaindiitira mabasa ese epamba nekunditengesera ndaiti kana ndabva kubasa ndainogeza ndopfeka nighttie yangu ndodya kasupper kekusvebera mumagumbeze. Maweekend ndaingorima.

Rimwe zuva mutsamba ndakawana tsamba kubva kumunun'una wangu pamwe chete nechidimbu kubva pabepa reRochester. Yakataura kuti Mayo Clinic yakanga yava kuda kutanga miedzo yekiriniki pamushonga waifanirwa kunge uri "prednisone usina mhedzisiro." Ndakafunga kuti ndichafambisa denga nenyika kuti zvive nemushonga iwoyo uye saka ndakatanga imwe yezviitiko zvisinganzwisisike zvehupenyu hwangu.

Zita remushonga wacho raiva "deflazacort" uye vakanga vatoishandisa muEurope. Ndakanga ndatova nachiremba mudhipatimendi remapapu paMayo Clinic. Akaita zvese zvaaigona kuti andipinze muchidzidzo asi maive mudhipatimendi reallergies uye vaisada ABPA. Nhanho yedu yaitevera yaive yekutora iyo FDA nekambani yezvinodhaka kuti isunungure kwatiri kuti tingoshandisa isu pachedu uye kufuratira chidzidzo. Zvakare takarova mudhuri wezvidhinha. Kuti uburitse mushonga nenzira yetsitsi mushonga unofanirwa kuve wakasiyana zvakanyanya pane chero chinhu chiripo chiripo chakatobvumidzwa neFDA. Hatina kukwanisa kuziva izvi, sezvo deflazacort yakanga yatova yekirasi imwe chete yemishonga seprednisone. Sezvo mushonga wacho wakanga wava kutoshandiswa kuEurope zvaiita sokuti yaizova pfungwa yakanaka kuedza kuutora wouyisa kuno. Waona ndapererwa. Dai zviri zvese zvandaida kuti zviite ndaizokwanisa kutora madosi akakura kwazvo ndiine njodzi shoma yemhedzisiro uye pamwe ndoramba ndichishanda uye pamwe kushanda zvirinani kupfuura zvandaimbofunga. Handiti zviroto zvemunhu wese zvinozadzika here? Ndakanga ndakagadzirira kuvhiringidza chero munhu wandaifanira kuita, uye ndakanga ndakagadzirira kuzviparadza mune zvemari kana zvichidiwa. Mushure mezvose, kana yakashanda yaizozvibhadhara zvayo. Ndakatsvaga gweta rainyanya kuita zvemitemo yenyika. Akatsvaga vanachiremba vekune dzimwe nyika vakaenda kuzvikoro zvekurapa zvekuAmerica uye vakanga vava kudzidzira kunyika dzavo. Akavanyorera vose. Takawana mhinduro imwe kubva kune ane mutsa kwazvo wekuItaly pulmonologist. Akandinyorera deflazacort. Kambani yeAmerican Express yakanga yazadza uye yakatumirwa kwandiri nemutumwa akazvimiririra. Yaifambiswa nemaoko mucustoms. Uye hongu. Izvi zvaidhura chaizvo.

Pandakawana mushonga ndaiva nemirairo yekuunwa. Ndakaenda kunoona chiremba wangu uye takaita shanduko kubva kuprednisone kuenda ku deflazcort. Apo allergy dept. vakanzwa kuda kuziva kuti ndaitora zvakawanda sei uye kuti ndainzwa sei etc. Chiremba wangu akakurukura navo. Unofunga kuti chaive chinhu chakanaka here kuti ndiite ok'd izvozvo? Kana kuti ndaifanira kuvaudza kuti vaende kunosvetukira mudhamu here?

Ndakagara pa deflazacort kwerinenge gore. Handina kukwanisa kuona mutsauko zvachose pakati payo neprednisone uye kana chiremba wangu aisagona. Ini handizive chaizvo zvakaitika nechidzidzo cheMayo Clinic asi ndinokahadzika kuti zvakamboitika. Sekuziva kwangu haina kumbobvira yawana mvumo yeFDA. Dai yakashanda isu tose taizove pa 100 mg ye deflazacort zuva uye kubuda kunze tichitamba manheru ega ega uye mune hutano hwakasimba. Izvi zvino 1991.

Chikamu 4 Kuremara

Muna May 1991 ndakanyorera Social Security Disability. Ndakanga ndisisakwanise kuzvibata uye ndakanga ndava kuda kuzviuraya ndichiedza kushanda. Kupinda kwangu kwakange kwakashata uye ndakanga ndave pedyo nekudonha zvachose. Shamwari yangu ine lupus uye kusanzwa kwemakemikari akawanda yakandipa zita regweta rakanaka. Akanga atopinda mugwara. Aiva gweta rakanaka zvikuru asi zvakatora kubva muna May 1991 pandakatanga kukumbira kusvika muna July 1992 pandakanyatsowana mari yekugadzirisa nyaya yangu. Iwe zvechokwadi unoda gweta kuti upfuure nehurongwa. Zvikumbiro zvangu, kukumbirazve uye zvikumbiro zvese zvakarambwa uye zvakasvika kure zvekuti ndakatozonzwa. Dambudziko raiva rei? Zvechokwadi ndakanga ndichirwara zvakakwana uye zvechokwadi ndakanga ndine nyaya yakanyorwa zvakanaka ichidzoka makore mazhinji.

Chikamu chedambudziko chaive chekuti mabasa angu emapapu akange achiri mushe kunyangwe makore ekupfeka uye kubvaruka. Saka handina kukwanisa kuita izvozvo ndega. Dambudziko rakanyanya kuve rekuti hapana hurumende rondedzero yeABPA saka ini ndaifanira kukodzera pasi pezvakaenzana. Zuva rekutongwa kwehurema hwangu raiva rimwe remazuva akaipisisa muupenyu hwangu. Ndaienda kudare kuti ndiratidze kuti ndakanga ndichirwara zvokutadza kushanda. Izvi zvakabva zvandiwedzera kurwara. Chakanyanya kushamisa ndechekuti zvakabuda zvakanaka. Pamberi pedare mumwe murume wechikuru akauya kwandiri ndokuzvisuma. Akanga ari chiremba uyo SS akapinza basa kuti ave mudare. Mutongi paakangotanga kutonga akasimuka ndokuzivisa kuti mutongi anofanira kundiwana ndaremara. Sezvinei akanga atoita pfungwa dzake kubva pakuverenga zvinyorwa. Akabva audza mutongi zvinhu zvakaenzana nekushandisa. Asthma, Bronchiectasis, uye Myasthenia Gravis (kuvhara kuneta nezvimwewo). Chinhu chimwe icho gweta rangu neni takanyatsozvitarisira pasi ndechokuti uremu hupi hwaizopiwa kumigumisiro yeprednisone. Isu takanga tasimbisa chirwere zvakanyanya asi chiremba akapa huremu hukuru kumhedzisiro, uye izvo zvakatishamisa zvishoma. Sezvo akakurangarira kuva kuri madikanwa mukurapa kuti ndive pairi akabatanidza Myasthenia Gravis yakaenzana kuvhara migumisiro yangu kubva kuprednisone.

Nyaya yacho haina kutora nguva yakareba kudaro. Handizivi kuti nei vakazvinetserei zvachose sezvo sarudzo yacho yainyanya kuitwa kubva pamapepa avakanga vatova nawo uye zvinotoda mari kuti vanzwe saizvozvo. Mushure mekunzwa chiremba akakumbira kutaura neni. Lawyer rangu rakaita kakuvhunduka asi ndakati ok. Akabva ataura nezvekumwe kurapwa uye marapiro andakanga ndawana (sezvaaigara achitsoropodza kuvhiyiwa kwandakanga ndaita) uye akabva aenderera mberi nekundiudza kuti vanhu vazhinji vane dambudziko rakawanda rekuongororwa. Ainyatsoziva zvakawanda nezveABPA. Akandiudza nezvemudzidzi wezvekurapa pachikoro chekurapa kwaakadzidzisa akagadzira ABPA. Vakaona kuti aiva nechirwere cherurindi vachibva vatoda kumuuraya. Saka ndiyo muenzaniso wezvinogona kuitika munzvimbo yakanaka. Mushure mezvose, mudzidzi uyu aive nemachiremba ekutanga ekutanga kumuchengeta. Zvakakwana kuti nditaure kuti ndakanga ndarerukirwa chaizvo nekugadzikana uku.

Chikamu 5 zvisinganzwisisiki rashes, sporanox uye dzimwe pfungwa dzekupedzisira

Mukupera kwa1993 ndakaona kuti ganda rangu rakanga rava kupenga. Ndagara ndiine matambudziko eganda senge eczema uye mburwa asi izvi zvaive zvakasiyana chaizvo. Zvakatanga kuita semikoko. Zvadaro mushure mokurwiswa kwemikoko, yaibva yaserera. Zvakadaro mashoma emawelt aizosara. Haasi ese emawelts aizoramba ari kunze kwechikamu chimwe nechimwe, asi mashoma. Izvi zvakaitika muviri wese kusara kwechiso nemusoro nemaoko. Manyumburu akasara aibva aoma nekusimudza uye ndiwo aive machuru anosekesa. Dzakada kuita kunge marwati. Asi haasi ese akasara akasara akashanduka kuita madundundu zvakare. Mamwe acho akashanduka kuita maronda akazaruka mune tutuvara tutsvuku. Ndakaita sendine gwirikwiti kana chidembo. Aka kakanga kasiri kekutanga kuita dambudziko reganda risinganzwisisike. Ndichiri mudiki ndakatanga kuita mapundu eropa anosetsa pamaoko angu. Hatina kumboziva kuti chii chakonzeresa uye ndichiri kuvabata nanhasi. Ndichifunga izvozvo handina kunyanya kutarisira kuwana mhinduro panyaya iyi asi ndakaenda kunoona chiremba wedermatologist zvakadaro. Akaongorora maviri emanodule ndokuatumira mukati. Akadzoka asina kunaka patsika dzese dzaakaraira - panguva ino kusanganisira ongororo dzefungi. Akashaya kuti oita sei. Kugara ndichikwenya kwaindipengesa. Mushure mekushanya kwaishungurudza akazondiudza kuti aive nechokwadi kuti zvaive zvakabatana nechirwere changu asi kuti aisakwanisa kuzvitsanangura uye aisaziva zvekundiitira. Akatora chisaga chihombe chegirosari ndokuzadza chizere nemasamples emafuta nesipo nezvimwewo, ndokundipa ndokundishuvira rombo rakanaka. Chimwe chinhu chandinofanira kugara nacho.

Nekukurumidza kusvika kuchando cha1997. Kwemwedzi yakawanda ndakanga ndichitarira kushambadza mumagazini eSporanox. Iyo kambani yemishonga yaive ichizvitaura semushonga we toenail fungus. Ndaiziva kuti yakauraya aspergillus uye vanofanira kunge vakafunga kuti yakachengeteka kana vaishambadzira zvakananga kune vatengi. Ini nachiremba wangu takasarudza kuti yakanga yava nguva yokuti tiedze. Akabva andipa prescription akati nditange zvishoma nezvishoma kuti ndione kuti ndazvishivirira here. Takasarudza kuedza 1 100 mg capsule pazuva. Ndinodemba kutaura kuti ndakatora mazuva matatu chaiwo pamutengo iwoyo. Ndakatemwa nomusoro zvakanyanya, saka zvaiita sekuti ndaizokundikana. Mamwe mangwanani vhiki kana kuti gare gare ndakamuka ndokutarisa pasi makumbo angu. Ganda rangu rakanga ratanga kuchena kekutanga mukati memakore mana. Ndakafunga kuti ndaizvifungidzira saka ndakaona vabereki vangu uye vose vakashamisika. Mapiritsi matatu chete uye akanyatsovandudzwa. Ndakatanga kupatsanura macapsules uye ndikakamura mabeads kuita gelatin capsules kuti nditore madosi madiki uye ganda rangu rakapotsa rachena. Chiremba wangu akashamisika uye anoenderera mberi nanhasi kuti andipe zvishoma zveSporanox kuchengetedza ganda rangu rakajeka. Nehurombo handina kumbobvira ndaona shanduko yakawanda mumapapu angu asi ndinokahadzika kuti ndinombotora zvakakwana kuita zvakawanda nenzira iyoyo.

Izvi zvekuzviputira asi ini ndichataura zvimwe zvinhu zvishoma.

Chinonyanya kukosha ndechekuti uve navanachiremba vane hanya zvechokwadi nekugara zvakanaka kwako. Kana vasina ruzivo rwese, hapana chinovamisa kutarisa zvinhu kumusoro, asi haugone kutsiva chero chinhu kune chiremba ane hanya.

Mai vangu vaive shamwari yangu yepamoyo uye shasha huru. Aiva nekutenda kukuru muna Mwari uye chirevo chake chaive chekuvimba naye uye kungorarama zuva rimwe panguva. Imwe nguva pandakanga ndiine nguva yakashata akandiudza kuti ndisararame zuva rimwe panguva, asi kuti ndingorarama miniti imwe panguva. Uye ndinokusiira iwe nepfungwa iyoyo.

Appendix A prednisone

Vazhinji vedu tine rudo/kuvenga hukama neprednisone. Ndinofunga izvi zvakajairika. Tinohuda kuti tirambe tiri vapenyu. Iyo inoderedza kuzvimba mumapapu edu, inobatsira yakajeka mapulagi uye nekudaro kuderedza kukuvadzwa kumapapu edu, uye inobatsira kudzikisa IgE yedu uye kuderedza allergic reaction. Nehurombo zvakare ine akawanda maside effects. Inogona kukanganisa chero chikamu chemuviri. Muchiitiko changu zvakakonzera uremu, cataracts uye nyore kuputika. Inogona kukonzera osteoporosis nemamwe matambudziko emapfupa, high blood pressure, maronda, ganda ritete, tsinga dzeropa, chirwere cheshuga, cataracts, glaucoma, kuvhiringidzika kwepfungwa uye mamwe matambudziko akawanda. Iwe unofanirwa kunge uri pedyo nachiremba wako paunenge uchishandisa mushonga uyu. Izvo zvaisazokuvadza kutarisa kumusoro kwese mhedzisiro mubhuku rekushandisa zvinodhaka nekuti unogona kugadzira chimwe chinhu chisina kujairika icho chingabatsira kuziva. Kazhinji prednisone inofanira kushandiswa zvishoma sezvinobvira. Iyo yakanyanya kuchengetedzeka nzira yekuishandisa inokurumidza taper, kana iwe uri pairi kweinenge vhiki kana zvakadaro uye mazuva mashoma ekutanga madosi akakwira ayo anodonha nekukurumidza kusvika waenda. Kana izvo zvisingakwanisi kukubata nemazvo saka chinhu chinotevera chekufunga chingave mamwe madhizi ezuva. Izvi zvinofungidzirwa kuderedza adrenal kudzvanywa. Mushure maizvozvi, zvirongwa zvine hukasha zvaizova madhisi ezuva nezuva uye akapatsanurwa madosi, ayo angave anodarika dosi rimwe chete pazuva. Iyo padhuze iyo madosi ari pamwe chete ndipo iwe unowedzera mhinduro yekurapa asi mhedzisiro inowedzera kutaurwa zvakare. Ndichiri mudiki ndaingoiswa ma quick taper nekuti ndainge ndichiri kukura asi pandaiva ndiri kucollege takazondichinja kuti ndiite imwe steady alternate day dose nekuti ma quick taper aisandiitira uye ndainge ndakura. zvimwe zvishoma. Iye zvino ndinotora doses zuva nezuva.

Kana uye kana iwe uchibata tepi iwe unofanirwa kushanda padhuze nachiremba wako. Iwe unofanirwa kupihwa purogiramu yekutepa yekutevera. Izvi zvinofanira kuitwa zvishoma nezvishoma. Kurega prednisone kamwe kamwe kunogona kukonzera kuvhunduka uye kana kufa. Handisi kutamba. Kana iwe ukasangana nekushaya simba kwakanyanya paunenge uchibata iwe unofanirwa kuonana nachiremba wako, asi tanga waputira yako prednisone dose kubhadhara izvo zvingave adrenal suppression. Chero nguva yaunenge uri paprednisone unofanirwa kupfeka chitupa chekurapa kwenguva inosvika makore maviri mushure mekunge wabva pairi. Kune vazhinji vedu zvinoreva kuramba wakapfeka ID yekurapa. Izvi zvakakosha kana iwe uri mutsaona kana kurwara nekukurumidza. Vashandi vekurapa vanofanirwa kuziva kana vachifanira kufunga kuti wakadzvinyirirwa. Vanogona kubhadhara izvi nekukupa IV steroids. Kusave neruzivo urwu kunogona kukonzera kufa kwako. Aya ndiwo mashoko ose andakapiwa kwemakore akawanda navanachiremba vakasiyana-siyana.

Appendix B Bronchiectasis

Ndinofunga kuti vanhu vazhinji vanoshamisika kuti sei vasvika pakuva nezvirwere zviviri zvemapapu nemutengo weimwe. Ko bronchiectasis inoitika sei?

Kana tikagadzira mapulagi mumapapu edu kubva kuABPA anogara mumachubhu edu ebronchi. Iyo mucus inozara imomo zvakasimba uye izvi zvinoita kuti iyo yakakanganisika bronchial chubhu kuti itambanuke kubva pachimiro. Rinogona kuita sechibharumu chidiki. Iwe unogona kukwanisa kujekesa plugging kunze kwekupedzisira asi iyo bronchial chubhu haimbonyatso tangazve chimiro chayo chepakutanga. Yakakuvadzwa zvachose. Izvi zvinogona kuitika munzvimbo dzakawanda dzakasiyana dzemapapu uye ndakave nemapulagi akawanda akasiyana muzvikamu zvakawanda uye ndine bronchiectasis yakakura. Vanhu vazhinji vane ABPA vanogadzira bronchiectasis kubva pakudzokorora plugging episode. Chinhu chakanakisa chekuita kuderedza izvi kushandisa prednisone nepaunogona napo kuti plugging iite shoma. Iyo yakawanda bronchiectasis iwe yaunowedzera matambudziko akawanda aunenge uine. Matambudziko aya anosanganisira kuderera kwekushanda kwemapapu uye kuwedzera kubatwa nehutachiona. Kurasikirwa kwekunaka kubva pakutambanudza kunoita kuti zviome kufema zvakanaka. Vazhinji vedu vane asthma futi saka iko kaviri kaviri. Isu zvakare tinotapukirwa nehutachiona nekuda kweizvi nekuti kugona kwemapapu kuzvichenesa pachawo kunokanganiswa nekusagadzikana. Izvi zvinodaro nekuti zvakawoma kukosora zvinhu kubva munzvimbo dzakakanganisika uye nzvimbo idzi dzinowanzo kuunganidza mucus.

Pane imwe nguva vamwe vanhu vanogona kushanduka kubva kune iyi kuita pulmonary fibrosis uye kupera nhanho yechirwere chemapapu asi izvi handizvo hazvo zvechokwadi mune chero chiitiko. Iye zvino ndava nemakore 45 uye ndave ndine bronchiectasis kubva pazera remakore gumi uye hapana akambondiudza kuti ndiri kuenda nenzira iyoyo. Basa remapapu angu harina kumira zvakanaka asi ndichiri panzvimbo yakatwasuka mazuva mazhinji.

Ndakave nebronchiectasis yakaoma kudzokera kuhudiki uye ndine hutachiona nekuda kweizvi. Ndinotora mishonga inorwisa mabhakitiriya kanenge kamwe chete pamwedzi kuti ndigadzirise izvi. Unogonawo kuwana rimwe ropa mukati mako sputum apo neapo nekuda kweizvi. Zvisinei chero nguva yaunokosora chero huwandu hwakakosha hweropa nyowani unofanirwa kuonekwa nekukurumidza nekuti ichi chinogona kunge chiri chinhu chakakomba kupfuura huwandu diki hweropa rinonyanya kuoma rinogona kuenda nekuve nebronchiectasis. Ini ndinotenda kuti mune yangu imwe nyaya episodhi yepleurisy uye kurwadziwa kwemadziro echipfuva zvakabatanidzwawo nekuva nebronchiectasis pamwe nekuve zvichikonzerwa nekuzvimba uye kuwedzera kweABPA. Chero ani zvake kunze uko akagamuchira kuongororwa kwebronchiectasis anogona kunge ane chokwadi chokuti izvi zvinoratidza basa rechirwere cheABPA kwenguva iyo inogona kunge iri nguva yemakore uye kwete mavhiki kana mwedzi. Izvi ndizvo zvinhu zvandakaudzwa navanachiremba vakasiyana-siyana kwemakore akati kuti.

14th July 2002
Zvine kusuwa kukuru kuti isu tinofanirwa kutaura kuti Mary Jo akafa nguva pfupi yadarika kubva kumatambudziko ehurwere aakanyora nezvawo muzvinyorwa izvi. Akanyora zvinyorwa izvi uye aive nhengo inoshingaira yeboka revatariri veboka revarwere mukuedza kwake kuedza kubatsira vanhu vari mumamiriro ezvinhu akafanana uye mune izvo akawana kubudirira kukuru - tichamusuwa.

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