Abafazi, Amadoda, kunye Owu! Inyaniso Ebuhlungu

izitshisiNgaphezulu kokubandezeleka okukhulu kwe-migraines, i-fibromyalgia, kunye neninzi yezinye izifo ezibangela iintlungu, abafazi baziva iintlungu kakhulu kunamadoda. Kodwa isayensi ephambili inokuphucula amathuba akho okufumana isiqabu. Ndiyazibuza, ngoku, kutheni ndingazange ndibuze umbuzo: Ngaba ibuhlungu? Umama wayebulawa ngumhlaza wamabele, kodwa akazange athethe ngeentlungu zakhe. Ubuncinci hayi kum. Noko ke, kungekudala emva komngcwabo wakhe, omnye wabo wayecingelwa ukuba ngabahlobo bakhe wathi (egculela kakhulu) ukuba uMama wayemphambanisile ngokusoloko ekhalaza.



O nyhani? Ngaba awukwazi ukukhalaza, nangona uvakalelwa kukuba intlungu iyakubulala?

Kwandithatha iminyaka (kulungile, amashumi eminyaka) ukuyeka ukucaphuka ngenxa yala mazwi amangalisayo angenaluvelwano. Ndazibuza, ‘Kuthekani ukuba umama wayeyindoda? Ngaba umhlobo wakhe wayenovelwano? Amadoda kudala ecinga (kwaye kulindeleke) ukuba abe stoic ngakumbi. Kodwa ngaba ngokwenene bangcono ekuphatheni iintlungu? Okanye ngaba amadoda nabafazi banentambo ukuba bayive ngokwahlukileyo?



Imvumelwano yesayensi kulo mbuzo wokugqibela ngu-ewe, sibonga kakhulu kuJeffrey Mogil, PhD, umlawuli welebhu yezofuzo zentlungu kwiYunivesithi yaseMcGill eMontreal. Umsebenzi wakhe kwiintlungu ukhokelela kunyango olutsha olujoliswe kwi-genetic makeup yesigulane, i-grail engcwele yentsimi entsha eshushu ebizwa ngokuba yi-pharmacogenetics.



U-Mogil waqala ukujika iintloko kuluntu lwezenzululwazi ngo-2003 xa wafumanisa i-gene echaphazela ukwamkelwa kwee-painkillers-kodwa kuphela kwabasetyhini. Iqela lakhe labaphandi lifumanise ukuba iintloko ezibomvu, abasetyhini abanolusu olusulungekileyo, ngakumbi, abanomahluko welo jini (i-melanocortin-1, eyenzeka nokuba sisimiselo sombala weenwele) bafumana isiqabu ngakumbi kudidi lweentlungu ezibandakanya Talwin kunye neStadol kunabanye abafazi, ngelixa amachiza ayenempembelelo nje eqhelekileyo kuwo onke amadoda. 'Ndicinga ukuba ekugqibeleni siza kufumanisa ukuba kukho imijikelezo ye-neural eyahlukileyo yamadoda nabasetyhini,' utshilo uMogil. 'Iimpembelelo zoko ziyamangalisa, akunjalo? Kuba icebisa ukuba ukuba uphuhlisa iyeza elisekelwe kwiprotheyini kwindlela yamadoda, elo chiza liza kubulala iintlungu kuphela kumadoda hayi abafazi. Kwaye ukuba uphuhlisa iyeza elisekelwe kwiprotheyini ekwindlela yabasetyhini, elo chiza lingabulala kuphela iintlungu kubasetyhini hayi amadoda. Ngoko ubuya kuba neepilisi ezipinki nezeblue zentlungu. Khawube nomfanekiso-ngqondweni wephulo lokuthengisa!'

UMogil ulayita njengoko endixelela le nto. Sihamba ngaphaya kwelebhu yakhe yobugcisa obuphantsi obuphantsi eMcGill-hayi kakhulu kwindlela yomgangatho ophakamileyo okanye izixhobo zokucinga-ephethwe kukubethwa kwamagcisa aselebhu kunye nabafundi abagqibeleleyo abaphumeleleyo. UMogil yindoda eyonwabileyo, into eyothusayo xa ucinga ukuba uchitha iintsuku zakhe ecinga ngeentlungu. Ukhomba ngebhongo umfanekiso wekhrayoni wakhe emsebenzini wenziwe ngunyana wakhe, emva koko oneminyaka emi-6, kunye nomenzi wekofu awufumene kwilebhu 'yenkomfa-slash-lunchroom.' Emva koko uvula olunye ucango, abeke umnwe emilebeni yakhe, aze andibonise izifundo zakhe zophando, iindlwana ezizele ziimpuku ezikhangeleka zanelisekile. Kuyandiqinisekisa ukufunda ukuba uninzi lovavanyo lubazisa kuphela emgubasini apho baqala khona ukuva intlungu, hayi ngaphaya. Uthatha intende yam aze ayiqhube ngobunono ngocingo olubhityileyo kwisixhobo esibizwa ngokuba yivon Frey filament, emva koko ngolunye, ucingo olubukhali, ndide nditsale isandla sam. Emva kokuba imouse ishukuma kwaye iqala ukukhotha i-paw yayo (ukukhotha okungxamisekileyo kufana nentlungu eninzi), uvavanyo luphelile. Igcisa laselebhu liqaphela impendulo kwigridi yekhompyuter kwaye libuyisela imawusi kwindawo yayo.

Oku, ndifunda, ilabhoratri enethuba elilinganayo leempuku zamadoda nabasetyhini: ubungqina bokukholelwa kukaMogil ukuba intlungu kufuneka ifundwe kubasetyhini kunye namadoda. Ngokusebenza kunye nesini sobabini kwibhubhoratri yakhe, uye wafaka isithethe kuphando lwezonyango olusekelwe kwingcinga yobuxoki yokuba abafazi babonisa ukuhluka okukhulu kwiimpendulo zabo ngenxa yebhayisikile yehomoni. Ugxininiso kumadoda lubonakala luhlekisa kuye, kuba uninzi lwezigulane zeentlungu zeklinikhi ngabasetyhini. 'Amabhinqa aziva eziva iintlungu kunamadoda,' utsho. 'Banamandla aphezulu okucalula phakathi kwamanqanaba ahlukeneyo entlungu.' Ezinye ii-syndromes, ezibandakanya i-migraine kunye ne-fibromyalgia, 'zinemilinganiselo ephosakeleyo kakhulu, ukuya kuthi ga kwisithoba ukuya kwelinye ngokuthanda abafazi.'


Liyinyani, utsho uMogil, ukuba abasetyhini basengozini enkulu yokufuna unyango lwentlungu kunamadoda, ukuxela ukuba kubi kakhulu, kwaye bangazicingeli kakhulu. Kodwa, uthi, ‘ufumana umahluko ofanayo kwizilwanyana’—iimpuku ezingamamazi zibonakala zineentlungu ezisezantsi ngandlel’ ithile kunezo zingamadoda. Ngaphezu koko, uyongezelela, uphando kwiintsana zabantu ezisanda kuzalwa lubonisa ukuba amantombazana ahlambalaza ngakumbi ekuphenduleni umkhonto wesithende (i-poke ngesixhobo esibukhali) kuneentsana zamadoda. 'Ngokuqinisekileyo anditsho ukuba akukho ngcaciso yenkcubeko yentlalo malunga nalo mahluko ngokwesondo. Into endiyithethayo kukuba amadoda namabhinqa abonakala emiswe ngokwahlukileyo kwasekuqaleni, kwibhayoloji ecocekileyo, engundoqo.'

Emva kokuchasa okokuqala, uluntu lwezenzululwazi luye lwajikeleza kwindlela yokucinga kaMogil. Kutshanje kuye kwaboniswa ukuba i-estrogen ichaphazela intlungu yentlungu; izilwanyana zovavanyo zamadoda ezitofelwe ngehomoni zibonakala zineentlungu ezisezantsi kunangaphambili, ngelixa inaliti ye testosterone ibonakala iphakamisa umda kwizilwanyana zabasetyhini. Enyanisweni, i-estrogen inokusebenza njengokutshintsha, ukuguqula amandla okuqonda intlungu.

Xa kujongwa izinto eziye zafunyaniswa ngolo hlobo, unokucinga ukuba oogqirha bangonwaba bayakumisela ezona zithomalalisi zinamandla kubasetyhini—kodwa abakwenzi oko. Abasetyhini babenethuba eliphindwe kabini kunamadoda ukuba anganyangelwa ziintlungu, kuphononongo lwezigulana ezingama-550 ze-AIDS kwiZiko loMhlaza we-Memorial Sloan Kettering kunye namanye amaziko amakhulu kwisiXeko saseNew York. Kuko konke ukulunga, oogqirha banexhala malunga neziphumo ebezingalindelekanga kunye nokuxhomekeka, ngenxa yoko bayathandabuza ukunika abasetyhini amayeza anamandla kodwa anokubakho njenge-opioids (i-morphine, i-OxyContin), ngakumbi kuba urhulumente ebebaxabela oogqirha ababamisela kakhulu. Kwaye nangona izikena zinokubonisa impendulo yobuchopho kwiintlungu-ngamanye amaxesha kumbala ophilayo-amava oluvo ahlala exhomekeke. Kweli nqanaba, ukuba nesigulana silinganise intlungu yakhe kwisikali esinye ukuya kweshumi sesona sixhobo sithembekileyo ugqirha anaso sokwazi ukuba uziva njani ngokwasemzimbeni: 'Ekuphela kwendlela yokwenyani yokufumana intlungu engakanani umntu akuyo,' uMogil. uthi, 'kukubuza, uze ubathembe.' Sekunjalo, ngokoluvo lwakhe, ‘ingozi yokungakholelwa kwabantu inkulu kakhulu kunengozi yokuchaza i-opioids. Umngeni omkhulu esinawo kukufundisa oogqirha bezonyango. Abezopolitiko banzima nangakumbi, kodwa oogqirha nabo bangqindilili okwezitena.'

Eyona ngxaki inameva kubaphandi abafana noMogil kukuthomalaliswa kweentlungu ezingapheliyo, eziye zagxothwa ngumsebenzi wezonyango njengowona monakalo wesifo. 'Intlungu engapheliyo ye-neuropathic [uhlobo oluvela kumonakalo wemithambo-luvo kukwenzakala, umzekelo] lunokuhlala iminyaka emihlanu, iminyaka elishumi, ubomi bakho bonke,' utshilo uMogil. 'Kuyoyikeka ngokwenene kubantu abaninzi.' Iindaba ezilungileyo kukuba intlungu engapheliyo ekugqibeleni ithathwa njengesifo ngokwaso. “Abantu babedla ngokucinga ukuba, ‘Sishenxisa esi sifo kwaye uya kuphelisa iintlungu,’ utshilo uMogil. Kodwa loo ndlela yayingachananga kwaphela. 'Iintlungu zikho ukuze sikwazi ukufunda ukusikelwa kwethu umda—ukusigcina singahambi ngomlenze owaphukileyo, okanye ukufundisa umntwana osakhasayo ukuba angatsibeki kwibhedi. Sisiphi isizathu sokuba ube neentlungu engalweni yakho kwiminyaka emihlanu emva kwelo nxeba lokudutyulwa? Akusekho kwenzakala, akunjalo? Iintlungu ezingapheliyo azinamsebenzi, kwaye izinto ezingasebenzisiyo nezibangela ubunzima zizifo.'


KuMogil, elona themba lilele kuphando lwemfuza. 'Siyazi ngeeamolekyu ezininzi, iijini ezininzi kunye neeprotheni ezibandakanyeka kwintlungu kunokuba senze iminyaka elishumi edlulileyo,' utsho. Oko kuthetha ukuba kukho iinjongo ezininzi ekujoliswe kuzo amachiza amatsha. 'Umzekeliso endithanda ukuwusebenzisa uthi, uphuhliso lweziyobisi luseyi-crapshoot. Uphosa iibhola eludongeni kwaye unethemba lokuba ziya kuncamathela. Kodwa okukhona kufuneka uphose iibhola, kokukhona ayanda amathuba okuba abambalwa bazo bancamathele. Ndinethemba lokuba le ngxaki yeentlungu iza kuconjululwa.'

UMogil akaze adinwe ukuphosa iibhola zakhe, ephonononga iimeko zentlalo kunye nokusingqongileyo kwiintlungu. Sele kucacile ukuba iimvakalelo zinokwenza umahluko; ukwesaba ukuba kukho into eya kubuhlungu, umzekelo, kwandisa intlungu, ngelixa ukulindela okulungileyo kuyayinciphisa. Kwaye izifundo zikholisa ukukala iintlungu zabo ngezantsi xa ziphazamisekile kunokuba zijolise ekubeni zibuhlungu kangakanani okanye zihlaba.

Ngehlobo lika-2006, uMogil wenza imvakalelo entsha ngokufumanisa kwakhe ukuba uvelwano lunyusa ubuntununtunu beentlungu kwiimpuku, ezinemfuzo efana neyabantu. 'Kuyaziwa kwiingcali ezifunda intlungu kubantu ukuba izinto zentlalo, ezifana nendlela iqabane elisabela ngayo kwizikhalazo zesigulane, zinkulu ekuchazeni ukuba ziqhuba njani izigulana ezibuhlungu ezingapheliyo,' utsho uMogil. 'Ukuba iqabane liyathandabuza lize lithi, 'Owu, Harry, mandiyokukhelela amanzi, wena mntwana ndini,' oku kwenza intlungu engapheliyo kaHarry ibe mbi ngakumbi. Yaye ukuba iqabane lithi, 'Owu, yiza, Harry, yifunxe,' iyenza ngcono intlungu kaHarry.' Into eyafunyanwa nguMogil ngokujonga iimpuku yayikukuba ukubona esinye isidalwa sisentlungwini kunokuba buhlungu ngokwenene: Impuku ekungaphatheki kakuhle (elilingana nesisu esibuhlungu, esinyanzelwa ngabaphandi elabhoratri) iya kuziva imbi ngakumbi xa ibona enye impuku ibandezeleka — nangona, umdla, kuphela ukuba baye babelana ngekheji (imbandezelo yomntu wasemzini ayinayo isiphumo esinjalo). UMogil ngoku uzama ukwahlula ijene kunye neeproteni ezichaza isekethe ye-neural enoxanduva lovelwano.

Ngeengqondo ezifana nekaMogil esebenza ekuthomalaliseni iintlungu, impumelelo inokwenzeka—ukuba nje abaphandi bafumana inkxaso abayifunayo. 'Sinalo lonke olu lwazi,' utsho, 'kodwa ukuza kuthi ga ngoku akukho nto ingako sele iguqulelwe ecaleni kwebhedi.' Unethemba lokuba ulwazi olwandisiweyo ngale ngxaki luya kutsala iidola zophando ngakumbi: idabi elinyukayo, kuba kwiminyaka yakutshanje inkxaso-mali yomdibaniso ibikwi-downslide, ngokutsho kwe-NIH, ishiya abaxhasi babucala ukuba bathathe ukudodobala. 'Ezinye izifo zinabantu abenza ibhayisekile-ethoni kunye nokuthengisa amabhaka,' utshilo. 'Iintlungu azinanto injalo.'

Undibalisela ngenenekazi elisele likhulile elineminyaka emithathu lingamki endlwini yalo kuba lingakwazi ukunyamezela ukunxiba impahla. 'Unento eyaziwa ngokuba yi-mechanical allodynia, apho eyona nto incinci ibonwa njengeentlungu ezinganyamezelekiyo. Ngoko uhamba ze endlwini yakhe kwaye akakwazi ukuhamba. Oku akufanelanga ibhayisekile-a-thon?'

Inokwenzeka. Inani lemibutho enamandla kakhulu idibanisa izigulane ukuba zilwele ukuqaphela intlungu njengeyona nto iphambili kwimpilo yesizwe, kunye nokukhuthaza abo, njengomama wam, bafuna inkxaso. Ngeli xesha, uMogil uqhubeka ephosa iibhola eludongeni, esebenzisa ubuchule bakhe kunye ne-intuition ukuze aqonde iindlela ezintsonkothileyo zobuchopho bomntu, kunye nendlela ezisebenza ngayo ukulungisa iintlungu. Uthi: 'Sineengxaki zokuzama ukufunda eyona nto intsonkothileyo kwindalo iphela. 'Kufana nokucela i-carburetor ukuba iziqonde ngokwayo. Sizama ukuqonda ingqondo, yaye ekuphela kwesixhobo esinaso bubuchopho.' Oko, kunye nentliziyo yokunamathela kolu phando lufuneka ngokungxamisekileyo, olunokuthi ngenye imini luvule umnyango wobomi obungenazintlungu.

Njengesikhumbuzo, soloko udibana nogqirha wakho ngeengcebiso zonyango kunye nonyango ngaphambi kokuba uqale nayiphi na inkqubo.

Amanqaku Umdla