Tattaunawa da Elizabeth "Lily" Conrad, MD
Elizabeth Conrad, MD - wanda aka sani ga marasa lafiya a matsayin "Dr. Lily" - likita ne a cikin aikin McLean, Virginia. Dr. Lily yana da kyawawan biyan marasa lafiya wadanda suke ganinta don maganin maganin kawanci da kuma hormonal. Ta amince ta raba tunaninta game da tsarinta don magancewa da magance marasa lafiya a wannan Q & A hira.
Maryamu: Shin ka fara ne tare da niyyar kasancewa a cikin magani na al'ada / na gargajiya da kuma canzawa zuwa haɗin kai / cikakke, ko ko yaushe kake so ya kasance mai zaman kanta MD?
Menene ya motsa ko ya yi wahayi zuwa gare ku?
Dr. Lily: Na san cewa zan kasance likita mai haɗin gwiwa. Muna da yawa fiye da abin da zamu iya gani, tabawa ko auna a jarrabawar jarraba. Abubuwan da za mu iya inganta mu farin ciki da kiwon lafiya yana fadada ƙaruwa sosai yayin da muke kula da hankali, jiki, da ruhu. Na yi matukar farin ciki cewa dan likita na likita wanda ya gudanar da ganawar da nake yi a Cibiyar Kwalejin Jami'ar Columbia na likitoci da likitoci ya kasance mai hankali sosai kuma yana sha'awar sauraron aikin da kuma amfani da tunani. Mun shafe yawancin tattaunawar game da numfashi da kuma kamance tsakanin tunani da motsa jiki.
Hormonal Issues
Maryamu Gabon: Ayyukanka, Kwarewa-Da kyau, yana aiki tare da marasa lafiya da yawa waɗanda ke da halayen hormonal. Mene ne abubuwan da suka fi dacewa na al'amuran al'ada da kuke gani a cikin marasa lafiyar ku?
Dr. Lily: Muna ganin mata da yawa da ke da damuwa game da cutar shan jini na Pandemal (PMS), Polycystic Ovarian Syndrome (PCOS), hypothyroidism , perimenopause, da menopause .
Har ila yau muna ganin marasa lafiya da suke tunanin ciki, mata da gwajin insulin, ciwo na rayuwa, da kuma ciwon sukari .
Maryamu: Me ya sa kake ganin yana da wuya ga marasa lafiya da yawa da suka ga likitoci na al'ada don su samu maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin rashin daidaito, adrenal, ko wasu matsalolin rashin daidaito na hormonal?
Dr. Lily: Yana daukan lokaci, wanda zai iya zama iyakance a cikin ayyukan da ke gani 20 ko fiye da marasa lafiya a rana. Har ila yau, da yawa daga cikin waɗannan zalunci sun yi ta da hankali kuma ba a iya gano su ta hanyar yin amfani da gwaje-gwaje masu kyau. Mutane na iya samun matakan kiwon lafiya na ainihi da kuma ƙididdigar ƙididdiga na iya zama a cikin iyakokin al'ada. Alal misali, al'ada na al'ada don cortisol yana da faɗi sosai, banda haka, abin da yake a al'ada a kan lab shine ba abin da yake mafi kyau ba. Yana da muhimmanci a magance kowa da kowa, a cikin haɗin gwiwa, da kuma duba abubuwa da yawa: abinci mai gina jiki, gudanarwa, halayen muhalli da dai sauransu don taimakawa wajen inganta lafiya.
Yaranmu a magani na musamman shi ne mafi yawan asibiti da kuma kyakkyawan kyawawan abubuwa har zuwa bincikar cutar da kuma magance matsaloli masu tsanani. Zuciyar zuciya, bugun jini, da kuma appendicitis sun fi dacewa tare da tsari na musamman. Masanan likitocin da aka horar da su sun gane cewa kowane tsarin ya shafi wasu. Alal misali, nauyin nauyi da rashin daidaituwa lokaci sukan inganta lokacin da aka gyara thyroid. Duk da haka, a kan kansa, wani tsari na musamman zai iya zama marar taimako ga cututtukan cututtuka da rashin daidaituwa.
Magungunan yana canzawa kullum da ingantawa. A matsayin likitoci, muna so mafi kyau ga marasa lafiya. Dole likitan likitoci suna da matsayi na musamman tare da wasu kayan aiki don magance matsalolin yaudara; irin su ganye, abinci mai gina jiki, da acupuncture don samar da kulawa na musamman ga kowane mai haƙuri.
Magungunan gabas ya ƙunshi ma'aunin ma'auni, kuma wannan yana ƙara yawan ra'ayi. Jiki yana kama da lambun da za a kula da ita, inganta jituwa da mahimmanci. Halin na al'ada shi ne ya dubi cutar kamar wani abu da muke fadawa ko magance kwayoyi.
A matsayin daliban likita, ba sau da yawa muna da tasiri sosai ga kayan lambu, abinci mai gina jiki da kari, acupuncture da fasaha na jiki. Abin farin cikin, wannan yana canzawa kuma makarantun sun fara haɗawa da Karin Mahimmanci / Magungunan Magunguna (CAM). Yana da ƙarfafa ganin majalisun kamar Dr. Jim Gordon, na Cibiyar Kula da Lafiran Jiki da Jami'ar Georgetown a Washington, DC, na inganta wannan canji na kiwon lafiya, yayin da muka tashi daga cibiyar mayar da hankali akan kwayoyi da tiyata a zuciyar tare da kula da kansu da kuma hanyoyin CAM a gefe don mayar da hankali kan kula da kai, tare da rigakafi da farfadowa a matsayin abin da ake mayar da hankali kuma don haka ya kamata a yi amfani da kwayoyi da tiyata.
Yana da hankali sosai.
Yourroid Matsaloli
Maryamu: Wanne gwaje-gwaje da matsalolin da kake yi la'akari yayin da kake nazarin mace don matsalar matsalar thyroid ?
Dr. Lily: Ina sha'awar tarihinta da abin da ta ke fuskanta, idan akwai tarihin maganin maganin thyroid a cikin iyalinta. Zan sake gwada wasu cututtuka kuma in yi jarrabawar jiki. Gwajiji ya ƙunshi TSH, Free T3, Free T4, Gyara T3, Thyroid Antibodies, anti-thyroglobulin da thyroid peroxidase antibody. Sau da yawa ana gwajin gwaji da kuma wasu gwaje-gwaje da ake bukata.
Marigayi Maryam: Amfanin Thyroid Association's 2014 Hypothyroidism Guidelines da'awar cewa hypothyroid marasa lafiya ne kawai za a wajabta levothyroxine, da kuma cewa ya rubuta T3 da / ko na halitta desiccated thyroid kwayoyi ne unethical ga likitoci. Mene ne tunaninku game da matsayin ATA?
Dr. Lily: Akwai rikici game da amfani da shirye-shiryen T3 .
Wasu marasa lafiya suna karɓa da kyau zuwa T4 kuma zasu iya canza T4 zuwa T3 ba tare da wata matsala ba. Duk da haka, ba dukkan marasa lafiya ba zasu iya yin hakan sosai. Na sami ƙarin T3 da kuma T3 na zama masu amfani da hankali don fahimtar rashin amfani da T4 a wasu marasa lafiya. Yawancin bincike sun nuna cewa samun jinƙai mai girma ya fi girma tare da tsarin T4 / T3 . Abin farin ciki, ATA ta fahimci bukatar ci gaba da bincike a wannan yanki. Ina farin ciki cewa an gudanar da binciken yau a kan S3 Slow Release T3. Saurin shirye-shiryen saurin sau da yawa ya fi dacewa da haƙuri fiye da sauke T3.
Maryamu: Yankin Kawancen Thyroid Association na Amurka 2014 Hypothyroidism Guidelines sun ce hypothyroid marasa lafiya da basu jin dadi yayin da aka ba su levothyroxine da mayar da su zuwa "euthyroid" ya kamata a kira su don dubawa. Mene ne tunaninku game da matsayin ATA?
Dr. Lily: Akwai bayanai da ke nuna cewa matakan T4 masu haƙuri zai iya zama isasshen amma matakan T3 sun fadi a lokacin da aka ba T4 kadai. Hanyoyin T3-serotonin zasu iya shafar yanayi da kuma jin daɗin jin daɗi.
Ina tsammanin ya fi kyau in ga su likita ko likita su tabbata cewa duk an duba. Marasa lafiya da suka ci gaba da bayyanar cututtuka sun cancanci a gwadawa sosai, watakila wani abu yana faruwa ... kamar Lyme cuta ko Lupus . Yawancin cututtuka na iya ba da gajiya. Idan akwai damuwa za su iya amfana daga ganin wani likitan kwakwalwa.
Maryamu: Mene ne kwarewarku tare da likitocin hypothyroid ? Mene ne kuka fi son rubutawa ga marasa lafiyarku: levothyroxine, roba T4 / T3, T3 kawai, halitta desiccated thyroid, ƙaddara meds?
Dr. Lily: Na rubuta wannan a kan wani akwati ta hanyar bita. Marasa lafiya suna da farin ciki tare da hade farfajiya da na halitta desiccated thyroid aiki da kyau. Haka kuma yana samuwa ta hanyar mafi yawan ƙwayoyi.
Adbanal Imbalances
Maryamu Shomon: Akwai matsala mai yawa game da wanzuwar "gajiya mai tsanani" ko rashin lafiya . Ƙwararrun likita a duniya sun ce muna da Cushing ta cuta ko Addison ta cuta , kuma in ba haka ba, babu wani inuwa da launin toka a cikin aiki adrenal. Mene ne kake tunani game da dalilin da yasa maganganun gargajiya ke kallon ta a cikin hanyar da baƙi da fari?
Dr. Lily: Cushing ta cututtuka da kuma cututtuka na Addison su ne cututtuka masu tsanani na cortisol wuce haddi da rashin aiki. Na yi imanin cewa ganewar rashin lafiyar dangi (RAI) yana tashi. Alal misali, yana da mahimmanci a cikin cutar hanta na kullum. An wallafa wani binciken sosai akan RAI a cikin marasa lafiya tare da cutar hanta, (Ailment Pharmacol, Ther, 2014 Oktoba; 40 (7) 819-26.)
Ɗaya daga cikin dalilai da ke haifar da rashin jin dadin rayuwa mai wuya don ganewa shine dabi'u na al'ada suna da irin wannan iyakar, alal misali, wata rana cortisol na da nau'i na 2-20. Wannan "hoto" da safe ba zai isa ba. Na fi so in samu jimloli masu yawa a ko'ina cikin yini kamar yadda aka yanke mini, jarrabawar gwajin gwajin Genova Adrenal.
Maryamu: Mene ne tsarinka na ganowa da kuma magance matsalar rashin lafiya a cikin marasa lafiya ?.
Dr. Lily: Muna yin tarihin cikakke da kuma nazarin jiki wanda aka dace idan an buƙata. Mutane da yawa marasa lafiya na iya samun hawan jini, kuma za mu duba bugun jini da karfin jini a wurare daban-daban. Sau da yawa zan umarci gwajin gwaji don cortisol wanda ya ba mu karatun da yawa a ko'ina cikin yini, DHEA-S an haɗa shi a wannan gwajin. Anyi aikin haɗin jini tare da haɓakaccen halayen halayen sunadarai. Muna duban kayan abinci mai mahimmanci irin su Vitamin D da ma'adanai kamar magnesium. Dangane da masu haƙuri, zan iya bincika wasu dalilai na bayyanar cututtuka. Sai muka fara tsara tsari don magance matsalolin magungunan bayyanar cututtuka idan ya yiwu. Ayyuka masu sauƙi don magance waɗannan batutuwa suna samuwa, irin su fasaha ta jiki da kuma amfani da tsire-tsire masu kama da Ashwagandha.
Rashin Lura
Maryamu Shomon: Yawancin mata a cikin shekaru masu tsufa, da shekarun perimenopausal da menopausal suna gwagwarmaya tare da kwarewar nauyi, ko wahalar rasa nauyi. Wadanne shawarwari kake da ita ga matan da suke ci da kyau da kuma yin amfani da su, amma da rashin ciwo mai nauyi?
Dr. Lily: Na farko, ina son in ce, mai kyau a gare ku. Yin aikin motsa jiki da cin abinci mai lafiya zai taimaka maka ka ji kwarewa kuma ka kula da lafiyarka fiye da kasancewar zama ba tare da cin abinci da 'ya'yan itatuwa ba. Na gaba, Ina so in tabbatar cewa tana cin abinci sosai, shan ruwan sha mai kyau kuma samun hutawa sosai. Sau da yawa asarar asarar nauyi saboda rashin amfani da gina jiki da adadin kuzari ko rashin hutawa. Idan har yanzu kuna da matsala ga mutumin da zai iya tarayya tare da ku don taimakawa wajen gano inda kake, kuma ku shirya shirin tallafa ku inda za ku so ku je. Wasu mata suna tayar da cortisol ta hanyar yin amfani da su, yayin da wasu na iya hawan insulin. Dole ne a tsara ka da shirinka.
Mind-Body Medicine
Maryamu: Mun fara fara fahimtar muhimmancin rage damuwa, hada da shakatawa, da kuma karfafa ikon haɗin jiki don aiki a matsayin wani ɓangare na jin dadi. Kuna da wasu tunani game da wasu hanyoyi mafi kyau da mata za su iya yi, ya ba da rayuwarmu?
Dr. Lily: Ɗaya daga cikin hanyoyin da na fi so shi ne aiki a cikin lokutan tunani a kowace rana. Lokacin da ka fita daga waje, ka ji ƙafafunka a kasa, dauki numfashi kuma duba sama. Yi la'akari da sama, kuna jin rana akan fuskarku? Akwai girgije, akwai iska? Akwai tsuntsaye ko wasu dabbobi? Lokacin da kuka isa gida ku ɗauki numfashi kuma ku lura yadda kuke ji a wannan lokacin. Lokacin da kuke cin abinci, sai ku yi tunani a kan wani abu da kuke gode da godiya. Bayan haka sai ku lura da bayyanar abincin, launi kuma sai ya ƙanshi rubutun da dandano. A matsayin mata, muna kasancewa a tsakiyar iyalinmu kuma za mu iya ciyar da kanmu a cikin wannan hanya kuma mu koya wa 'ya'yanmu su yi wasa a wannan lokacin. 'Ya'yana za su tunatar da ni idan na manta da alherinmu, wanda ya fi sau da yawa kamar haka: kowane mutum ya faɗi taƙaice abu guda da suke godewa yayin da muke tafiya a teburin. Samun lokacin da za a dakata da kuma godiya zai iya canza tunanin mu kuma ya taimake mu mu kasance a shirye mu karbi.
Wani kayan aiki mai sauƙi shine ƙirƙira abubuwa uku da kuke godewa a kowace rana, watakila a kan ɗan ƙarami a kan tebur ɗin ku. Yana da hanya mai kyau don fara ko ƙare ranar.
Nemo wani aikin da kake so, wanda ke jin dadi. Yoga, pilates, Tai Chi, Qi Gong, massage, tafiya a waje, tunani na tunani da kuma zane-zane da aka tsara zasu iya taimaka mana karfafa haɗin gwiwa.
Nemi wani abu da kuke so kuma kuyi kokarin yin shi akai-akai. Akwai wasu samfurori masu kyau waɗanda suke da taƙaitacciyar tasiri mai tasiri wanda za ku iya yi a cikin minti 10.
Idan kuna son yoga ɗin ku, mai girma! Zaɓi wuri a cikin gidanka inda za a iya fitar da gadonka kuma ku ciyar da minti 5-10 a kowace rana yana yin tasiri da numfashi. Idan zaka iya shimfiɗa wannan zuwa minti 20, koda mafi kyau!
Abin da Kowane Mai Tsai Ya Kamata Ya Yi
Maryamu: Idan akwai abu ɗaya zaka iya tabbatar da cewa duk marasa lafiya za suyi don inganta lafiyar jiki, menene zai kasance?
Dr. Lily: Ka kasance da kirki a kanka, dauki lokaci don kula da kanka, ka kula da kanka kamar yadda za ka kasance abokin aboki!
Elizabeth (Lily) Conrad, MD, ya kammala karatun digiri daga kwalejin likitoci da likitoci na Jami'ar Columbia a shekarar 1991. Ta kammala zama a cikin tsarin iyali a tsarin Montenegro Family Practice Program in Norristown, PA. Dokta Lily, kamar yadda sanannunta ke santa, an yarda da shi a cikin Gidajen Iyali na iyali tun 1994. Anyi aikinsa don warkar da dukan mai haƙuri a cikin hadin kai, aiki tare da ke tallafawa lafiyar da zamantakewa. Baya ga al'adar gargajiya ta al'adun gargajiya, Dokta Lily tana nazarin tunani tun lokacin da ya gabatar da ita zuwa ayyukan kwarewa a 1985. Ya yi nazarin hanyoyi da yawa na al'ada / warkaswa don warkar da su tare da ragewar damuwa tare da Jon Kabat-Zinn da Saki Santorelli a Jami'ar Massachusetts. Har ila yau, karatunsa sun hada da Yoga, Ayurvedic magani, da kuma homeopathy. Dr. Lily ya yi nazarin ilimin acupuncture a UCLA, wanda aka gane shi ne babban makarantar acupuncture na kasar don likitoci. Ta fara zama takarda a asibitin Acupuncture a shekara ta 2004. Ta ci gaba da nazarin acupuncture da magani na kasar Sin da magungunan maganin daji da abinci. Tana yin maganin magance juna a cikin McLean, Virginia, a da kyau, inda ta kuma mayar da hankali akan maganin yanayi da na al'ada, tsarin tsare-tsaren da aka tsara don tallafawa daidaituwa na hormonal da ƙarfafa marasa lafiya tare da ilimin ilimi da kuma hanyoyin da za su jagoranci lafiyayyu, mafi yawan daidaito.
Elizabeth Conrad, MD
Kyakkyawan Kwarewa, 6862 Elm Street # 720, McLean, Virginia 22101, Ph: 703-635-2158