ULWAZI NGOKUKHULELWA

UKUYA KU DOKOTELA / MHLENGIKAZI UMA UKHULELWE

Owesifazane okhulelwe ubonana no dokotela noma aye emtholampilo ukuze abe nolwazi lwalokhu okulandelayo:

• isiqiniseko sokuthi ukhulelwe
• ingabe kukhona izimo ezibucayi
• isimo nokukhula komntwana

KUMELE AQALE NINI OKHULELWE UKUYA KU DOKOTELA

Kufanele abonane no Dokotela uma sekuphele amaviki amabili engayi esikhathini.

OKUMELE UKULINDELE UMA UQALA UKUBONA U DOKOTELA

Inhloso enkulu yokubonana no Dokotela noma eyokuya emtholampilo:

• Ukuqiniseka ukuthi ukhulelwe
• Ukuqiniseka ukuthi umntwana usesibelethweni
• Ukwazi ukuthi umntwana usekhule kangakanani
• Ukwazi izinkinga noma ukukhubazeka okuthile
• Ukwazi ngesimo sempilo kaMama

Umlando wakho ngokwempilo uyathathwa. Lokhu kumayelana nemithi noma amaphilisi owathathayo, ukuhlinzwa ngaphambilini, abantwana onabo noma ukukhulelwa kwangaphambi kwalokhu.

Uxilongwa umzimba wonke bese kulandela nalokukuhlolwa:

• umchamo
• igazi
• isibeletho
• nokunye okuhlolwa okubalulekile

Uyobe sewaziswa ngezinkinga ezibucayi onazo ngalesosikhathi, bese uyalwa ukuthi uzosizakala kanjani.

UKUQHUBEKA NOKUYA EMTHOLAMPILO / DOKOTELA

Uma kungekho zinkinga uzobonana noDokotela kanye njalo emasontweni amane uze ube namasonto angama-28 kuya kwangama-30. Emva kwalokho uyobe usubuyela kuDokotela njalo emasontweni amabili uze ube namasonto angama-36, bese uya njalo ngesonto uze uyobeletha.

KULINDEKELENI KUWE UMA UYA EMTHOLAMPILO NOMA KU DOKOTELA

Kumele wazise uDokotela / Mhlengikazi ngezinkinga onazo (izinhlungu, ukushisa komchamo, ukukhathala, ukucinana, inkinga ngokunyakaza komntwana) nokunye obona kubalulekile ukuthi kwaziwe nguDokotela.

ISAZISO SOKWAMUKELEKA

Lencwajana iyona ekwazisa ngokubaluleka kokuhamba uMtholampilo / uDokotela uma ukhulelwe.

UKUKHULELWA OKUHLELIWE

Kubalulekile ukuhlelela noma ukulungiselela ukukhulelwa ungakakhulelwa.

Abathandanayo kumele babonisane ngesikhathi esizobavumela bobabili ukuthi babe nomntwana. Kumele babhekisise isimo sabo semali, isimo sempilo, nezinye izimo okumele zihlelwe ukuze umntwana akhule ngendlela.

Owesifazane kumele abonane noDokotela azohlola isimo sakhe sempilo, somzimba, ukuze ukuze kubonakale noma kugwemeke izifo ezithile engakakhulelwa.

Owesifazane onesifo soshukela, sokuwa, senhliziyo, sezinso, sesibindi, impilo yakhe ingaba sengozini kakhulu uma esekhulelwe. Ngakho-ke kubalulekile kakhulu ukuqaphela nokugwema lezizifo ungakakhulelwa.

Owesifazane obenezinkiga kokunye ukukhulelwa kwakhe (ukuchithekelwa isisu, ukukhulelwa okungaphandle kwesibeletho, ukubeletha ngaphambi kwesikhathi, ukushona komntwana esibelethweni, umntwana okhubazekile), usizakala kakhulu ngokubonana noDokotela engakakhulelwa.

Umama okhulelwe kanye nomntwana ongakazalwa bangaba nezinkinga ezithile kodwa ezingabuye zishabalale.

Abesifazane abanenkinga yesifo senhliziyo bayalwa ukuba bangakhulelwa ngoba baba sengozini yokushona lapho besakhulelwe.

Kunemithi noma amaphilisi angabeka impilo yomntwana engozini uma ephuzwa nguMama okhulelwe ngakho kumele okhulelwe angabe esawaphuza.

Umama kumele ahlolelwe izifo ezinjenge-Sandulela Ngculaza ukuze kutholakale usizo nokuvikeleka komntwana kanye nazwana naye.

Uma uDokotela engetholi inkinga ezovimbela ukuthi abazwanayo bakhulelwe, ube esebavumela ukuthi bakhulelwe.

Kuhlolwa umzimba kanzulu, kuhlolwe ukukhula komntwana, isisindo sikamama kanye nomfutho wegazi kanye nomchamo.

UMA UHLANGABEZANA NEZINKINGA KAPHAMBI KOSUKU OKUMELE UBUYELE NGALO EMTHOLAMPILO / KU DOKOTELA

Kumele ube nezindlela zokuxhumana noDokotela / Mhlengikazi. Uma uba nenkinga ufanele ukwazi ukuxhumana noDokotela usesekhaya ngokushesha noma ingasiphi isikhathi!

Lokhu kubaluleke kakhulu ukuzwe kugwenywe izinqinamba ezingavelela umama noma umntwana.

IZIPHI IZINKINGA OKUMELE UZIBIKE NGOKUSHESHA

Kumele ubikele uDokotela / Mhlengikazi uma:

• Uhlushwa ubuhlungu bekhanda nokuphalaza
• Ukungaboni kahle emehlweni
• Ukopha
• Iqolo elibuhlungu
• Ukuphuma kwamanzi ngaphansi ungalindele
• Umhelo noma Umsiko

Abesifazane abanenkinga ye gazi elinomfutho ophezulu (BP) uma bekhulelwe kumele baziqaphele kakhulu lezinkinga ezingenhla.

USIZO LWEMOTO OLUPHUTHUMAYO

Kufanele okhulelwe azilungiselele nothile amethembayo ongakwazi ukumuphuthumisa esibhedlela esiseduze noma ingasiphi isikhathi uma esesimweni esiphuthumayo.

QINISEKA NGALOKHU

• Iba nomlilo owanele ku-makhala ekhukhwini (selula) wakho.
• Iba nemali eyanele ukuxhumana nabantu ngocingo.
• Iba nezinombolo zabantu ababili obathembayo abangaba wusizo noma ingasiphi isikhathi.

IZINKINGA EZIBUCAYI UMA UKHULELWE

KUMAMA

Abesifazane abanesifo senhliziyo, izinso, isibindi, baba sengozini enkulu yokushona besakhulelwe ngoba izinga lokugula kwabo liyaphakama kakhulu kunokuba lehle. Kuyaye kuye nezinga lesifo noma ukugulula kwakhe kodwa akufanele akhulelwe nhlobo.

Uma ukukhulelwe lezizimo ziyahlaziywa bese uyalwa futhi ucaciselwe ngendlela.

Ngaphambilini abesifazane abasha noma abkhulile ngokweminyaka bayaye baqalwe isifo sokukhuphuka kwegazi ngamandla (BP) uma besakhulelwe.

Uma lenkinga ingatholakalanga noma inganakekelwanga kusenesikhathi, ingabanga ubuhlungu bekhanda okuhambisana nokuquleka, ukopha ebuchosheni nase maphashini okungalandelwa ukushona kwesinye isikhathi.

KUMNTWANA

Bonke abesifazane abakhulelwe baba sencupheni yokuchithekelwa isisu uma izinyanga zisephansi.

Laba besifazane baba sencupheni enkulu ngabantwana babo:

• Onesifo soshukela esinganakekelwa ngendlela.
• Obhema ugwayi
• Ophuza utshwala
• Osebenzisa izidakamizwa
• Osebenzisa imithi noma amaphilisi esifo esithile esingelapheki

Kanti njalo ukuhlola ungakakhulelwa kuyazivikela lezizimo futhi kwehlise nobucayi besifo.

Uma usohlwini lwabasencupheni, ungayalwa ukuba ungasebenzi izinyanga ezithile, lokhu kungadala inkinga emsebenzini. Kwabanye kungenzeka ukuthi baze balahlekelwe umsebenzi okungaphazamisa ukungena kwemali emndenini.

Kanti nokulala esibhedlela isikhathi eside kuphatha kabi abomndeni.

Emva kokuba usuhlolisisiwe uDokotela/Mhlengikazi angakuxwayisa ngezinye zezimo ezibucayi ongabhekana nazo nendlela okumele uzinakekele ngayo, kungenzeka uthunyelwe komunye uDokotela noma isibhedlela esingaba wusizo oluncono.

IZINGUBO, IZICATHULO NOMA-KHALA EKHUKHWINI

Uma uya eMtholampilo noma uyobonana noDokotela gwema ukugqoka izimpahla ezikuqinayo okukanye izicathulo. Gwema ukukhuluma noma ukuphendula ucingo lwakho uma usunoDokotela.

UKUKHOKHA KWE-MEDICAL AID

• Umele ulinde izinyanga eziyi-9 ukuze i-Medical Aid izokwazi ukukhokhela izindleko zokukhulelwa kwakho.
• Ungashintshi i-Medical Aid yakho uma usakhulelwe.
• Khumbula ukuthi i-Medical Aid ikhokhela ukuxilongwa kwakho ngomshini kabili kuphela
• Ungavakasheli oDokotela abahlukene ngoba ufuna ukuthola ukuqiniseka okungenasidingo.
• Hlela futhi usebenzise i-Medical Aid yakho ngobuhlakani, ukuze ungaphelelwa imali unyaka ungakapheli.

OKUMELE UKWENZE UKUZE I-MEDICAL AID YAKHO IKUKHOKHELE

Yazisa i-Medical Aid yakho ngesikhathi usunesiqiniseko sokuthi ukhulelwe.

IMVUME YOKUBELETHISWA

Uma usunamasonto angama-36 ukhulelwe, uDokotela uzoxhumana ne-Medical Aid yakho ukuze athole imvume yokukubelethisa.

YAZISA ISIBHEDLELA NGAPHAMBI KOKUBELETHA

Kuwumthetho wezibhedlela noma umtholampilo ozimele ukuthi umele ubazise uma uzobelethela khona ukuze bakulungiselele ungakabelethi.

UMA USUSIKWA

• Yazisa osondelene naye (umyeni, udadewenu noma umam)
• Xhumana noDokotela
• Pakisha isikhwama sakho uye esibhedlela noma emtholampilo oseduze nawe.

OKUMELE UKUPHATHE UMA UYA ESIBHEDLELA

OKOMNTWANA

• Izingubo zomntwana zokugqoka
• Izingubo zokusonga umntwana
• Izinto zokugeza umntwana nezokugcoba
• Amanabukeni
• Uvolo

OKUKA MAMA

• Okokulala okunezinkinobho ngaphambili
• Izicathulo zokuvuka
• Okwangaphansi okuthambile
• Okokugeza nezindwangu zokugeza
• Okuvimbela ukuvuza emabeleni
• Imibhukuzo
• Ucingo olune washi elivusanayo
• Ibhuku noma incwadi yokufunda
• Okokubhala
• Ipasi
• Ikhadi le-Medical Aid noma imali

UKUBHALISA UMNTWANA

Kumele ubhalise umntwana wakho ku-Medical Aid kungakapheli amahora angu-24 ezelwe, kungakapheli izinsuku ezingama-30 kumele abhaliswe kwa-Home Affairs, kufanele uphathe amapasi abazali bobabili.

UKUGOMA UMNTWANA

Ngemva kwesikhashana umntwana ezelwe uzogonywa, uyobe usunikwa ikhadi elinezinsuku / izinyanga zokugonywa komntwana. Umele ukulandele okubhalwe ekhadini.

IZIMPAWU EZIYINGOZI OKUMELE UZIBHEKE EMVA KOKUBELETHA

• Ifiva
• Uketshezi olunephunga oluvela esithweni sangasese
• Ukopha okukhulu
• Ubuhlungu noma ukushisa uma uchama
• Ukopha, ukuvuleka, ukuvuvuka noma amanzi aphuma esilondeni somthungo.
• Ubuhlungu nokuvuvuka kwamabele
• Ingcindezi engqondweni
• Ukuhlukumezeka ekhaya

XHUMANA NODOKOTELA UMA UBONA LEZIMPAWU KUMNTWANA

• Imfiva
• Ukulala okungajwayelekile emahoreni angu-24
• Ijondisi (umbala ophuzi emehlweni)
• Amanzana aphuma emehlweni
• Ukuphefumula kanzima
• Ukungondleki kahle, ukubuyisa kanye nesisu esikhulu
• Ukwehla emzimbeni

UKULANDELA EMVA KOKUBELETHA

Vakashela uDokotela ukuze ahlole ukululama kwakho, isimo somntwana kanye nokukhipha izitishi uma wawubelethe ngomthungo.

EMVA KWAMASONTO AMABILI

Kumele uye emtholampilo ukuze bakale umntwana futhi athole nomgomo ofanele.

EMVA KWAMASONTO AYISITHUPHA

Ngalesosikhathi umzimba wakho kumele ube usululame ngokuphelele. Udokotela kumele akucebise ngalokhu okulandelayo.

• Izinkinga ongabe unazo (zomzimba noma ingqondo)
• Izinkinga zomntwana
• Ukuvikela ukukhulelwa
• Ukhuhlolelwa umdlavuza wesibeletho
• Isikhathi esifanele sokukhulelwa okulandelayo
• Izingqinamba ezingavela ekukhulelwni okulandelayo.

UKUHLOLWA KOMDLAVUZA WESIBELETHO

Udaba lokubanjwa nokwelashwa kwesifo somdlavuza womlomo wesibeletho selube yimpumelelo kakhulu izinga lokufa ngenxa yalesisifo selehle ngo70% kuleminyaka angamashumi amane edlule.

Kuyemukeleka ukuthi lokwehla kangaka kwezinga lokufa ngenxa yalomdlavuza kuyimiphumela yokusetshenziswa kakhulu kocwaningo lwe Pap Smear. Odokotela abaningi bezifo zabesifazane bagqugquzela ukuthi owesifazane oseqale ukuya ocansini kufanele enziwe uhlolo lwe Pap Smear njalo ngonyaka, impilo yakhe yonke.

YINI UHLOLO LWE PAP

Uhlolo lwe Pap noma iPapanicolaou Test yaqanjwa ngegama lika George Papanicolaou owayengumcwaningi kwezokwelapha.

Lokhu kungukuhlolwa okulula futhi okungebuhlungu. Uma kuhlolwa kwengulwa ungwengwezi lwesikhumba esingaphezulu (amaseli) somlomo wesibeletho. Lamaseli angulelwa engilazini bese ithunyelwe ezindlini zokucwaninga zodokotela, ukuze ayohlola ngochwepheshe ababizwa ngama cyto technologists noma cytophathologists.

YENZIWELANI I PAP TEST?

Ukuhlola lokhu kungaveza ukubakhona kwegciwane elingabanga ukufa emlonyeni wesibeletho noma ezithweni zangasese zowesifazane. Nokho isizathu esimqoka sokwenza iPap test, ukubamba amaseli anokungajwayelekile angenziwa ukubamba kwesifo somdlavuza.

Ukubakhona koguquko emlonyeni wesibeletho ngenxa yomdlavuza kungabanjwa kalula ngokusebenzisa iPap smear, lokho okwenza umahluko nomdlavuza wezinye izitho zomzimba.

Ezigulini eziningi imiphumela yePap iba ngeyejwayelekile noma ekhombisa ukungabikhona kwesifo. Kwesinye isikhathi ukuhlola kuye kuveze ukubakhona kwe Candida, amaqhuqhuva (herpes). I – Human Papilloma Virus (HPV) kanye nezinye izifo. HPV ne Herpes, kuhambisana nokuqala nokuqhubeka komdlavuza womlomo wesibeletho.

Ukutholakala kwamaseli angejwayelekile uma kuhlolwa kukhombisa udokotela ukuthi kungase kubekhona ukuqala komdlavuza. Lamaseli angejwayelekile aqhamuka iminyaka ngaphambi kokuthi isifo somdlavusa esibulalayo siqale, kulesisigaba sokuqala lapho umdlavuza womlomo wesibeletho ungelapheka kalula khona.

Ukuze kufinyelelwe esiphethweni sobukhona balesisifo kakugcinwa ngokwenza iPap Test nje kuphela, kepha kujwayelekile ukuthi kusetshenziswe umshini wokuhlola isitho sangasese sowesifazane (colposcopy, kulandelwe ukuthathwa kwesicucwana samaseli angejwayelekile (biopsy) uma kuba nesidingo kwesinye isikhathi lendawo ethintekile isuke incane kangangokuthi isuswa yonke, lokho kususwa kwayo kube sekuwukhapheka kwesifo njalo.

Imiphumela engejwayelekile ingabangwa yilokhu:

• Amaseli asenqenqemeni lomlomo wesibeletho aguquke isimo kwesejwayelekile.
• Ukuhlatshwa yigciwane i-Human Papilloma Virus (HPV)
• Izinguquko ezisaqala zomdlavuza, okuthiwa yiCervical Intra-epithelial Lesion (CIN) ezibonakala ngezilonjana.
• Ukuhlasela kwegciwane lomdlavuza (Cancer)

Ukubonakala kwalezinguquko ezingejwayelekile kuxoxwa kabanzi ngakho lapha ngezansi.

ONQENQEMENI – ISIMO ESIGUQUKILE SAMASELI

Ukubakhona kwamaseli aseguquke isimo kuchaza ukuthi amaseli akasesona isimo esifanele, kodwa izinguquko zincane futhi azenele sekungathiwa zingumdlavuza.

Lezinguqukwana zingavela kanye nokunye ukugula okungabonakali, ukutshabuka noma umdlavuza. Kusemqoka-ke ukuthi uma kutholakala amaseli aseguquke isimo ekuhlolweni nge Pap ezikhathini ezimbili noma ezintathu zilandelana, bese kulandela ukuhlolwa nguDokotela ngomshini wokuhlola isitho sangasese sowesifazane.

I-HUMAN PAPILLOMA VIRUS (HPV)

I-HPV igciwane elejwayelekile elingadala izinsumpana esikhumbeni, kodwa futhi elingahlasela namaseli emlonyeni wesibeletho. Uma lokhu kwenzeka, ukuthelelana ngalegciwane kujwayele ukuthi kwenzeke ngokuya ocansini.

Leligciwane lingase lingenzi zinguquko ezigulini eziningi futhi lingahlala nje lingenzi lutho isikhathi eside. Nokho, iziguli eziningi ezihlaselwa umdlavuza womlomo wesibeletho zisuke zike zahlatshwa yi HPV. Okunye ukwanda kwaleligciwane kungahlanganiswa nokuqhubeka kwe CIN kanye nokuhlasela komdlauza. Kusemqoka-ke njalo ngonyaka kwenziwe uhlobo lwe Pap ukuze kuqedwe ukuqhubeka komdlavuza osaqala.

Akukenzeki ukuthi kubanjwe ukuthi isiphi isiguli esine HPV esingase siqhubeke sibe nomdlavuza womlomo wesibeletho. Uma kubonakala ukushabasheka kwegciwane le HPV emva kokuhlolwa nge Pap ezikhathini ezimbili noma ezintathu, kulapho-ke kudingeka kusetshenziswe umshini wokuhlola isitho sangasese sowesifazane ukuze kubonakale indawana encane okungenzeka ukuthi isihlaseleke kabana esiqhubeke ekubeni nomdlavuza.

Ucwaningo luthi cishe u-40% wabobonke abesifazane base United States banesifo i-Human Papilloma Virus, njengoba nabalingani babo boncansi abangu 50-70% benalo.

I-CIN (CERVICAL INTRA-EPITHELIAL NEOPLASIA)

(I-syn Dysplasia, Squamous Intra-epithelial Lesion-SIL)

Ukuhlolwa nge Pap okukhombisa izinguquko kumaseli okubizwa ngokuthi yi CIN kukhombisa ukuthi amaseli okuqala omdlavuza asebanjiwe. Lamaseli abekwa ngamazinga e-CIN 1, CIN 2, CIN 3.

I-CIN 3 iyizinga elibucayi kunawowonke amazinga oguquko. Ukutholakala kwamaseli eCIN kukhombisa ukuthi sekutholakale umdlavuza womlomo wesibeletho ezingeni elingaphambi kokuthi yande yeqe ingaphezulu lomlomo wesibeletho, ngakho-ke ilapheka kalula. Impumelelo yohlolo lwe Pap incike ekubanjweni ngokushesha kwamaseli e CIN. Yize lamaseli ebanjwa nge Pap kufanele kuqinisekwe ngokuhlola ngomshini wesitho sangasese sowesifazane kanye nokuthathwa kwesicucwana saleyo ndawo esihlabekile siyohlolwa.

Wonke amazinga eCIN (CIN 1,2,3) elapheka aphele nya ngokulashwa komlomo wesibeletho. Akujwayelekile ukuthi umuntu aze ahlinzwe kakhulu ukuze isifo selapheke ngempumelelo.

AMASELI E-SQUAMOUS CARCINOMA, I-INVASIVE SQUAMOUS CARCINOMA

Ukuhlola kwe Pap okukhombisa amaseli angejwayelekile kakhulu (frank cancerous squamous cells) kukhombisa ukuthi umonakalo sewande washona ngaphansi kwesikhumba eingaphezulu somlomo wesibeletho kwaze kwangena esikhumbeni esingaphansi. Kuhlale kudingekile uma kunjalo ukuthi kuthathwe isicucwana saleyondawo ethintekile naso siyohlolwa. Okunye okudingekile kungokubona kukadokotela ngokwezinga lokwanda kwesifo. Amazinga asethe thuthu omdlavuza abonakala kakhulu ezigulini ezingahlolwa njalo nge Pap smear.

UKUVUKA KABUSHA

Uhlelo lokuvikela ezifweni, komzimba lujwayele ukubuyisela izinguquko kumaseli asonqenqemeni lomlomo wesibeletho kwisimo esejwayelekile, kuthi izilonjana zomdlavuza ziphele okwezinyangana.

Nokho uma ukuhlola nge Pap kuphinda kuveza izinguquko ezingejwayelekile, kulapho-ke kudingeka khona ukuhlolwa ngomshini wokuhlola isitho sangasese sowesifazane.

ISIDINGO SOKUHLOLWA NGOMSHINI

Ukuhlolwa nge Pap kwenzeka kumaseli angephezulu kuphela, wona engulwa ngaphezulu emlonyeni wesibeletho. Njengoba lokhu kuhlola kungakhombisa kuphela ingxenye yamaseli angaphezulu, kungase kudingeke ukuthi kuhlolisiswe ngokunzulu umlomo wesibeletho. Ngokwejwayelekile ukuhlola ngomshini ongena esithweni sangasese sowesifazane kuyancomeka.

Lokhu kusho ukuthi ingaphezulu lihlolwa ngomshini oyisibonakhulu okuthiwa yi colpsoscope, okuthi uma kotholakala indawana eyonakele kuthathwe isicucwana esingango 1 kuya ku 2mm esibelethweni sihanjiswe endlini yokucwaninga ukuze kuhlolisiswe. Lokhu kuthiwas yi Biopsy. Lenqubo ayibuhlungu, ilula kakhulu futhi iyashesha kanti yenza ukuthi kusheshe kubanakale imiphumela icacile.

Kufanele kukhumbuleke ukuthi iziguli ezinamaseli aguqukile ngesikhathi ehlolwa nge Pap, akhombisa ukuguquka kokutshabuka noma ukuhlabeka (kujwayele ukuthi kube yi HPV) ekuhlolweni nge colposcopy. Kuba yidlanzana nje elikhombisa izinguquko zomdlavuza osaqalayo.

Kungakho kugqugquzelwa ukuba lokhu kuhlola nge colposcopy kwenziwe, ukuze kutholakale lelodlanzana leziguli. I-CIN izinga lokuqala lomdlavuza elingatholakala kanti lelapheka kalula.

ISIPHETHO

1. Ukubakhona kwamaseli aguquke isimo sawo noma ukuhlatshwa yi HPV akusho ukubakhona kwe CIN noma i-Cancer engasenakulapheka.

Kepha kuxwayisa isiguli ukuba siphinde size futhi ukuzohlolwa nge Pap noma nge colposcopy ukuze kutholakale indlela okwenzeke ngayo uguquko kumaseli.

2. Izinguquko zesimo samaseli onqenqemeni, izinguquko ze HPV kanye nezinguquko ze CIN 1 zingabuye zivuke kabusha kwezinye iziguli. Ngenxa yokuthi kungabuye kuvele futhi ukufa lokhu kufanele ukuthi kuhalle kwenziwa lokhu kuhlola.
3. Ukuba khona kwamaseli e-CIN nge Pap smear kukhombisa uguquko olwelapheka luphele nya.