Dr. Shefqet Deliallisi<\/p>\n
N\u00eb vitin 1978, Susan Sontag n\u00eb essen\u00eb e saj \u201cS\u00ebmundja si metafor\u00eb\u201d nd\u00ebr t\u00eb tjera shkruan : \u201c kushdo q\u00eb lind n\u00eb k\u00ebt\u00eb bot\u00eb ka \u2018shtet\u00ebsi\u2019 t\u00eb dyfisht\u00eb : nj\u00eb p\u00ebr \u201cmbret\u00ebrin\u00eb e sh\u00ebndetit\u201d dhe nj\u00eb tjet\u00ebr p\u00ebr \u201cmbret\u00ebrin\u00eb e s\u00ebmundjes.\u201d
\nHer\u00ebt a von\u00eb, t\u00eb gjith\u00eb ne do t\u00eb jemi t\u00eb detyruar ta shohin veten si qytetar\u00eb t\u00eb \u201cmbret\u00ebris\u00eb t\u00eb s\u00ebmundjes\u201d. Por nj\u00eb prirje v\u00ebrehet. \u201cMbret\u00ebria e sh\u00ebndetit\u201d po rrudhet, po gllab\u00ebrohet me shpejt\u00ebsi nga \u201cmbret\u00ebria e s\u00ebmundjes.\u201d Mjek\u00ebt po kalojn\u00eb nj\u00eb num\u00ebr gjithnj\u00eb e m\u00eb t\u00eb madh njer\u00ebzish nga sh\u00ebndeti tek s\u00ebmundja, madje m\u00eb her\u00ebt se kurr\u00eb, madje p\u00ebr nj\u00eb q\u00ebndrim gjithnj\u00eb e m\u00eb t\u00eb gjat\u00eb. Mjetet p\u00ebr ta arritur k\u00ebt\u00eb q\u00ebllim nxirren nga zgjerimi i p\u00ebrkufizimit t\u00eb s\u00ebmundjes. Duke kthyer n\u00eb s\u00ebmundje edhe ato q\u00eb n\u00eb fakt jan\u00eb faktor\u00eb risku p\u00ebr s\u00ebmundje. E gjitha kjo ligj\u00ebrohet me t\u00eb ashtuquajtur\u00ebn epidemi t\u00eb s\u00ebmundjeve kronike. Sipas Santag motivi \u00ebsht\u00eb \u201ckombinimi toksik i q\u00ebllimeve t\u00eb mira, d\u00ebshirave, q\u00eb n\u00eb fakt jan\u00eb t\u00eb
\nparealizueshme, dhe interesave t\u00eb caktuar ekonomike.\u201d <\/p>\n
S\u00ebmundje t\u00eb reja….<\/p>\n
Ajo q\u00eb po ndodh \u00ebsht\u00eb se \u00e7do dit\u00eb n\u00eb shifra t\u00eb konsiderushme diagnostikohen njer\u00ebz me gjendje t\u00eb reja ( nuk po i quaj s\u00ebmundje) si : pre-hypertensioni, pre-diabeti, pre-osteoporoza, pre…..D\u00ebgjon t\u00eb p\u00ebrdoren terma si : presion \u201cnormal i lart\u00eb\u201d i gjakut, tek njer\u00ebzit me pre-hypertonsion, nivel \u201cnormal i lart\u00eb\u201d i sheqerit n\u00eb gjak, te njer\u00ebzit me pre- diabet, nivel \u201cnormal i lart\u00eb\u201d t\u00eb yndurave n\u00eb gjak. N\u00ebse vazhdohet k\u00ebshtu, shumica e adult\u00ebve mund t\u00eb transformohet n\u00eb pacient\u00eb, apo th\u00ebn\u00eb ndryshe n\u00eb popullsi me risk- shkruan Larm n\u00eb revist\u00ebn British Medical Journal. Dhe kur nj\u00eb popullsi \u00ebsht\u00eb e gjitha me risk, e logjikshme \u00ebsht\u00eb q\u00eb e gjitha t\u00eb trajtohet !? T\u00eb trajtohet por si ?
\nNd\u00ebrsa ndryshimi i stilit t\u00eb jet\u00ebs (shkaktari kryesor i k\u00ebtyre gjendjeve t\u00eb reja) mund t\u00eb ishte trajtimi origjinal, gjthnj\u00eb e m\u00eb shpesh po rekomandohet edhe p\u00ebrdorimi i medikamenteve. Disa vite m\u00eb par\u00eb t\u00ebrhoqi v\u00ebndejn publikimi i nj\u00eb mendim eksperimental i epidemiolog\u00ebve britanik\u00eb, sipas t\u00eb cilit parashikohej trajtimi i t\u00eb gjith\u00eb adult\u00ebve mbi 55 vje\u00e7 me nj\u00eb kombinim q\u00eb p\u00ebrmban tre medikamenteve anti-hypertensiv\u00eb (p\u00ebr uljen e tensionin e gjakut), nj\u00eb statin\u00eb (medikament kund\u00ebr yndyrnave), aspirin\u00eb (p\u00ebr hollim t\u00eb gjakut). Sot rekomandohet edhe nj\u00eb antidiabetik, p\u00ebr t\u00eb parandaluar nj\u00eb diabet t\u00eb mundsh\u00ebm !
\nT\u00eb gjitha k\u00ebto medikamente rekomandohen n\u00eb fakt pa qen\u00eb ende i s\u00ebmur\u00eb, madje shpesh pa pasur edhe simptoma !
\nE gjitha kjo duket jo logjike. P\u00ebr m\u00eb tep\u00ebr s\u2019\u00ebsht\u00eb dhe pa pasoja. Duke kaluar gjithnj\u00eb e m\u00eb shum\u00eb njer\u00ebz nga \u201cmbret\u00ebria e sh\u00ebndetit\u201d te \u201cmbret\u00ebria e s\u00ebmundjes\u201d, devijohen vazhdimisht resurset q\u00eb do t\u00eb p\u00ebrdoreshin p\u00ebr t\u00eb s\u00ebmur\u00ebt, p\u00ebr tek t\u00eb sh\u00ebndetshimit. P\u00ebr pasoj\u00eb mbi-diagnoza dhe mbi-trajtimi i njer\u00ebzve me sh\u00ebndet t\u00eb mir\u00eb, pashmangshm\u00ebrisht do t\u00eb shkaktoj\u00eb n\u00ebn-trajtimin e atyre q\u00eb jan\u00eb v\u00ebrtet\u00eb t\u00eb s\u00ebmur\u00eb. Nga ana tjet\u00ebr, s\u2019duhet t\u00eb n\u00ebnvler\u00ebsuar fakti se \u00e7dokush i imponuar t\u00eb hyj\u00eb n\u00eb \u201cmbret\u00ebrin\u00eb e s\u00ebmundjes\u201d detyrohet t\u00eb heq\u00eb dor\u00eb nga shum\u00eb k\u00ebnaq\u00ebsi t\u00eb jet\u00ebs, ve\u00e7 kostos individuale, sociale, dhe ekonomike t\u00eb konsiderueshme.<\/p>\n
Parametrat normal\u00eb …<\/p>\n
P\u00ebr t\u00eb p\u00ebrcaktuar kufirin mes sh\u00ebndetit dhe s\u00ebmundjes ne vazhdojm\u00eb t\u00eb bazohemi n\u00eb disa prametra t\u00eb p\u00ebrcaktuara koh\u00eb m\u00eb par\u00eb si \u201cnormale\u201d p\u00ebr organizmin. K\u00ebshtu ne kemi nivelin \u201cnormal\u201d t\u00eb sheqerit n\u00eb gjak, dhe kur ky nivel kalohet themi q\u00eb personi ka diabet. Kemi nivel \u201cnormal\u201d t\u00eb presionit t\u00eb gjakut, dhe kur ky nivel kalohet kemi hipertension, e k\u00ebshtu me rradh\u00eb, kemi \u201cnorma\u201d t\u00eb yndyrnave n\u00eb gjak, etj, etj… K\u00ebto nivele t\u00eb p\u00ebrcaktura si \u201cnormale\u201d jan\u00eb kthyer n\u00eb tabu. Madje t\u00eb prera me thik\u00eb. Mjafton t\u00eb p\u00ebrmend nj\u00eb fakt : n\u00ebse niveli i sheqerit n\u00eb gjak es\u00ebll 100-125mg\/dl konsidrohet normal, 126mg\/dl, konsiderohet diabet !
\nNga ana tjet\u00ebr, k\u00ebto nivele \u201cnormale\u201d, n\u00eb nj\u00eb far\u00eb m\u00ebnyr\u00eb jan\u00eb p\u00ebrcaktuar p\u00ebr t\u00eb \u201ctjer\u00eb njer\u00ebz\u201d q\u00eb jetonin n\u00eb nj\u00eb koh\u00eb t\u00eb caktuar, n\u00eb nj\u00eb mjedis t\u00eb caktuar dhe q\u00eb kishin t\u00eb tjera p\u00ebrmasa fizike.
\nNe jetojm\u00eb sot n\u00eb nj\u00eb ambient t\u00eb ndryshuarshuar n\u00eb t\u00eb gjitha drejtimet krahasuar 100 vjet, madje dhe 50 vjet m\u00eb par\u00eb. Jetojm\u00eb n\u00eb nj\u00eb modernizimi q\u00eb b\u00ebn t\u00eb mundur t\u00eb kalojm\u00eb kontinente dhe oqeane n\u00eb pak or\u00eb. Ushqimi sigurohet m\u00eb me leht\u00ebsi \u00ebsht\u00eb i bollsh\u00ebm dhe m\u00eb i lir\u00eb. Automobilat, paisjet sht\u00ebpiake, robotizmi n\u00eb industri, automatizimi n\u00eb bujq\u00ebsi, kursejn\u00eb pun\u00ebn fizike.
\nK\u00ebto ndryshime, nd\u00ebr t\u00eb tjera, kan\u00eb b\u00ebr\u00eb q\u00eb rraca njerzore t\u00eb ndryshoj\u00eb duksh\u00ebm. F\u00ebmij\u00ebt t\u00eb rriten m\u00eb shpejt, t\u00eb arrijm\u00eb pjekurin\u00eb seksuale 3\u20134 vjet m\u00eb shpejt se gjysh\u00ebrit e tyre. Njer\u00ebzit kan\u00eb p\u00ebrmasa m\u00eb t\u00eb m\u00ebdha. Mashkulli 70 kg, i cili ne vet\u00ebm disa gjenerata m\u00eb par\u00eb e konsideronim si etalon nga student\u00ebt e mjeksis\u00eb, tashm\u00eb \u00ebsht\u00eb z\u00ebv\u00ebnd\u00ebsuar me nj\u00eb mashkull 80 kg, madje me tendeca inflamatore….
\nMe t\u00eb drejt\u00eb lind pyetja : n\u00eb kushtet e ndryshimit t\u00eb shpejt\u00eb t\u00eb mjedisit, stilit t\u00eb jetes\u00ebs (ushqyerjes dhe aktivitetit fizik), ndryshimit q\u00eb po p\u00ebson (tashm\u00eb ka p\u00ebsuar) raca njer\u00ebzore, a duhen t\u00eb vazhdohet me \u201cnorma\u201d t\u00eb vjetra, apo k\u00ebto \u201cnormat\u201d duhen rishikuar ? Mos ka ardhur koha q\u00eb ajo \u00e7far\u00eb ne prerceptojm\u00eb si s\u00ebmundje, nisur nga \u201cnormat\u201d e vjetra q\u00eb vazhdojm\u00eb t\u00eb p\u00ebrdorim, t\u00eb mos konsiderohet m\u00eb si e till\u00eb ? N\u00eb fund t\u00eb fundit ne sot jetojm\u00eb shum\u00eb m\u00eb gjat\u00eb se parardh\u00ebsit tan\u00eb, madje dekada m\u00eb shum\u00eb se para-ardh\u00ebsit tan\u00eb t\u00eb af\u00ebrt n\u00eb koh\u00eb.
\nKa dhe nj\u00eb tjet\u00ebr paradoks. Nd\u00ebrsa e llogjikshme p\u00ebrsa tham\u00eb m\u00eb sip\u00ebr, do t\u00eb ishte q\u00eb pragu q\u00eb ndan kufirin mes sh\u00ebndetit dhe s\u00ebmundjes (normat q\u00eb p\u00ebrcaktojn\u00eb k\u00ebt\u00eb prag), t\u00eb rritej, e kund\u00ebrta po ndodh. Ai po ulet m\u00eb tej duke b\u00ebr\u00eb q\u00eb t\u00eb shtohet artificialisht numri i njer\u00ebzve q\u00eb kan\u00eb nevoj\u00eb p\u00ebr trajtim mjeksor. Madje k\u00ebto norma po ulen deri n\u00eb at\u00eb nivel sa shpesh po b\u00ebhen nj\u00eb objektiv i pa arritsh\u00ebm, stresues dhe demotivues.
\nPse nuk rishikohen normat, ose dhe kur medohet t\u00eb rishikohen, mendohet t\u00eb ulen m\u00eb tej, kur e kund\u00ebrta n\u00eb fakt duhet t\u00eb ndodhte ?
\nE gjitha kjo \u00ebsht\u00eb e lidhur me faktin se kush vendos p\u00ebr nj\u00eb gj\u00ebndje n\u00ebse \u00ebsht\u00eb normale apo s\u00ebmundje. N\u00eb shekuj ky vendim i \u00ebsht\u00eb rezervuar profesionit t\u00eb mjekut, i ndihmuar 150 vite m\u00eb par\u00eb nga shkeca moderne mjeksore q\u00eb b\u00ebri q\u00eb profesioni mjeksor t\u00eb zhvillohet shum\u00eb pran\u00eb atyre q\u00eb p\u00ebrfitojn\u00eb nga p\u00ebrdorimi i medikamenteve p\u00ebr s\u00ebmundje t\u00eb reja. Dhe tashm\u00eb s\u2019jan\u00eb m\u00eb vet\u00ebm mjek\u00ebt ata q\u00eb marrin k\u00ebt\u00eb vendimin t\u00eb r\u00ebnd\u00ebsish\u00ebm. <\/p>\n
Fundi i sh\u00ebndetit dhe fillimi i s\u00ebmundjes…<\/p>\n
Kufiri mes sh\u00ebndetit dhe s\u00ebmundjes duhet par\u00eb edhe n\u00eb tjet\u00ebr aspekt : at\u00eb t\u00eb mosh\u00ebs. Jam s\u00ebmur\u00eb apo shqetsimet q\u00eb kam jan\u00eb normale p\u00ebr mosh\u00ebn?
\nJa si e p\u00ebrjeton k\u00ebt\u00eb shqet\u00ebsim nj\u00eb mjek : \u201cMendoj se jam me sh\u00ebndet t\u00eb mir\u00eb. Por a jam v\u00ebrtet\u00eb ? Flok\u00ebt m\u00eb jan\u00eb zbardhur. M\u00eb kan\u00eb r\u00ebn\u00eb krejt\u00ebsisht n\u00eb disa pjes\u00eb. Shikimi m\u00eb \u00ebsht\u00eb v\u00ebshtir\u00ebsuar. Kur sapo ngrihem nga shtratin\u00eb n\u00eb m\u00ebngjes, l\u00ebviz me v\u00ebshtir\u00ebsi, kam dhimbije t\u00eb tendineve t\u00eb Akilit. Jam i s\u00ebmur\u00eb, apo shqetsimet jan\u00eb normale p\u00ebr mosh\u00ebn ? Para k\u00ebsaj dileme ndodhen sot shum\u00eb njer\u00ebz, n\u00eb kushtet e rritjes s\u00eb shpejt\u00eb t\u00eb jetgjat\u00ebsis\u00eb.
\nLe t\u00eb analizojm\u00eb.
\nAjo \u00e7far\u00eb ne konceptojm\u00eb si gjendje \u201cnormale\u201d t\u00eb organizmin, e merr origjin\u00ebn nga gjendja q\u00eb kemi pasur kur kemi qen\u00eb t\u00eb rinj n\u00eb mosh\u00eb. Gjendje q\u00eb ne pretendojm\u00eb ta kemi gjat\u00eb gjith\u00eb koh\u00ebs, edhe kur mosha ka ecur. Por a kemi t\u00eb drejt\u00eb p\u00ebr nj\u00eb pretendim t\u00eb till\u00eb ? A duhet t\u00eb pretendoj\u00eb dikush ne prag t\u00eb 60-tave t\u00eb ket\u00eb organizmin e nj\u00eb 20 vje\u00e7ari ? Sigurisht ndryshimet dhe shqetsimet normale me rritjen e mosh\u00ebs s\u2019jan\u00eb s\u00ebmundje, pranaj dhe s\u2019duhen trajtuar dhe si t\u00eb tilla.
\nMjeku q\u00eb m\u00eb lart p\u00ebrmenda, vazhdon m\u00eb tej : \u201cNuk pi duhan. Pi pak alkool. L\u00ebviz shum\u00eb n\u00eb k\u00ebmb\u00eb, por ushtrime fizike b\u00ebj pak. Kam koh\u00eb q\u00eb s\u2019e kam matur presionin e gjakut. As yndyrnat. Dyshoj se m\u00eb \u00ebsht\u00eb zmadhuar prostata. S\u2019e kam egzaminuar. Duhet ta v\u00eb ujin n\u00eb zjarr p\u00ebr t\u00eb zbuluar ndonj\u00eb tension t\u00eb lart\u00eb t\u00eb gjakut, apo ndonj\u00eb kancer t\u00eb heshtur diku brenda meje, apo t\u00eb vazhdoj pa u shqet\u00ebsuar…?
\nMendimet jan\u00eb t\u00eb ndryshme.
\nJa \u00e7\u2019shkruan Koehlo te \u201cAlkimisti\u201c :
\n\u201cPse duhet t\u00eb interesohemi kaq shum\u00eb p\u00ebr t\u00eb ditur t\u00eb ardhmen ? P\u00ebrgjigia : p\u00ebr t\u00eb b\u00ebr\u00eb disa gj\u00ebra q\u00eb t\u2019i paraprin\u00eb t\u00eb keqes, p\u00ebr tu p\u00ebrgatitur p\u00ebr at\u00eb q\u00eb do t\u00eb ndodh\u00eb. Mir\u00eb n\u00ebse parashikimet do t\u00eb ishin t\u00eb mira, por n\u00ebse do t\u00eb ishin t\u00eb k\u00ebqia, \u00e7far\u00eb do t\u00eb ndodhte ? S\u2019do b\u00ebnim gj\u00eb tjet\u00ebr ve\u00e7se do fillonim t\u00eb vuanim shum\u00eb koh\u00eb para se vuajtja t\u00eb ndodhte. Dhe frika nga vuajtja \u00ebsht\u00eb m\u00eb e keqe se vet\u00eb vuajtja.\u201d
\nPra a ja vlen ta k\u00ebrkojm\u00eb ta dim\u00eb t\u00eb ardhmen e sh\u00ebndetit ton\u00eb nd\u00ebrkoh\u00eb q\u00eb pa-parashikueshm\u00ebria e s\u00eb ardhmes p\u00ebrb\u00ebn nj\u00eb ngush\u00ebllim t\u00eb madh ? Askush me sakt\u00ebsi nuk di se \u00e7far\u00eb do t\u00eb ndodh\u00eb nes\u00ebr. Ne dim\u00eb shum\u00eb rreth probabilitetit, por probabiliteti \u00ebsht\u00eb larg t\u00eb sigurt\u00ebs. N\u00ebse do t\u00eb q\u00ebndrojm\u00eb gjithmon\u00eb n\u00eb t\u00eb sotmen do t\u00eb jemi njer\u00ebz t\u00eb lumtur….
\nFrika nga vdekja, lind bashk\u00eb me njeriun, dhe na b\u00ebn t\u00eb jemi m\u00eb t\u00eb kujdessh\u00ebm, na b\u00ebn t\u00eb p\u00ebrpiqemi ta shtyjm\u00eb sa m\u00eb larg vdekjen, t\u00eb kurohemi. Por pavar\u00ebsisht perfeksionit, pavar\u00ebsisht se sa larg shkenca mjek\u00ebsore ka shkuar, dhe vazhdon t\u00eb shkoj\u00eb, ajo kurr\u00eb s\u2019mund t\u00eb zhduk\u00eb vuajtjen njer\u00ebzore, apo vet\u00eb vdekjen. Kurimi nuk n\u00ebnkupton pavdek\u00ebsin\u00eb.<\/p>\n
“Q\u00ebllimi nuk duhet t\u00eb jet\u00eb se si t\u00eb zgjasim vitet e jet\u00ebs – thot\u00eb Thomas Perls – por si t\u00eb zgjasim vitet e jet\u00ebs me sh\u00ebndet t\u00eb mir\u00eb.”<\/p>\n","protected":false},"excerpt":{"rendered":"
Dr. Shefqet Deliallisi N\u00eb vitin 1978, Susan Sontag n\u00eb essen\u00eb e saj \u201cS\u00ebmundja si metafor\u00eb\u201d nd\u00ebr t\u00eb tjera shkruan : \u201c kushdo q\u00eb lind n\u00eb k\u00ebt\u00eb bot\u00eb ka \u2018shtet\u00ebsi\u2019 t\u00eb dyfisht\u00eb : nj\u00eb p\u00ebr \u201cmbret\u00ebrin\u00eb e sh\u00ebndetit\u201d dhe nj\u00eb tjet\u00ebr p\u00ebr \u201cmbret\u00ebrin\u00eb e s\u00ebmundjes.\u201d Her\u00ebt a von\u00eb, t\u00eb gjith\u00eb ne do t\u00eb jemi t\u00eb detyruar […]<\/p>\n","protected":false},"author":2,"featured_media":93022,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":{"0":"post-93021","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-te-tjera"},"_links":{"self":[{"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/posts\/93021","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/comments?post=93021"}],"version-history":[{"count":1,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/posts\/93021\/revisions"}],"predecessor-version":[{"id":93023,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/posts\/93021\/revisions\/93023"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/media\/93022"}],"wp:attachment":[{"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/media?parent=93021"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/categories?post=93021"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/tags?post=93021"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}