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Munhau dzanhasi ama, aimbova vadzidzi veGerald Harld Harld Harld Harld Harmon, MD, anobatana nezvokupokana kwekuremekedza kushomeka uye kukosha kwevarapi vakuru. Dr. Harmon vanogovana mifungo yake pane yake itsva basa seyakawana Dean yeSouth Carolina Chikoro chehutano muPawleys Island, South Carolina, uye Zvazvinotora Kuti Utore Medical munda. shamba sachiremba. Mazano ekuti ungare sei kushanda. Vanachiremba vanopfuura makore makumi matanhatu nemashanu ekuzvarwa. Host: AMA Chief Chiisiko Officer Todd Unger.
Mushure mekurwa kune vanachiremba panguva yechidhori, vekurapa kweAmerica vari kutora dambudziko raro rinotevera: Kuchengetedzwa kuzvipira kwerudzi kune vanachiremba.
Unger: Mhoro uye wobva wagamuchirwa kune yakagadziridzwa ama vhidhiyo uye podcast. Nhasi tiri kutaura nezve kushomeka kwebasa uye kukosha kwevanachiremba vakura mukugadzirisa dambudziko iri. Nyaya iyi inokurukurwa pano naDr. Grad Hardon, Interim Dean yeSouth Carolina Chikoro cheMushonga muColumbia, South Aya Mutungamiriri, kana mumashoko ake ama. Ini ndiri todd unger, Chief chiitiko chevakuru veAsa Chicago. Dr. Harmon, zvakanaka kusangana newe. Uri kuzviita sei?
Dr. Harmon: Todd, iwo mubvunzo unonakidza. Pamusoro pebasa rangu seAma Kuporesa Chigaro, ndawana basa idzva. Just mwedzi uno, ndakatanga basa idzva mubasa rangu sebasa rehutano hwehutano hweSystemist uye Interim Dean yechikoro chekurapa kuYunivhesiti yeSouth Carolina muSouth Carolina.
Dr. Harmon: Zvakanaka, ndiyo nhau huru. Yakanga iri shanduro isingatarisirwi yekuchinja kwandiri. Mumwe munhu akandibata nezvezvakakodzera uye zvinotarisirwa. Ndinonzwa senge uyu mutambo wakagadzirwa kudenga, kana zvisiri mutambo wakagadzirwa kudenga pakadaro pakati penyeredzi.
Unger: Zvakanaka, ndine chokwadi chekuti pavakatarisa kutangazve kwako, vakafadzwa nezvimwe zvezvakakwanisa kuita. Iwe wave uri wemhuri wekudzivirira kwemakore kwemakore makumi matatu nemashanu, mubatsiri anovhiya kuwanda kweUnited States Air Force, chiremba anovhiya weNational Guard, uye, zvechokwadi, Mutungamiri wenguva pfupi yapfuura, purezidhendi weAma. Izvo hazvisi kunyange hafu yehondo. Iwe unofanirwa kuwana kodzero yekuenda pamudyandigere, asi iwe uri kutanga chitsauko chitsva. Chii chinokonzera izvi?
Dr. Harmon: Ini ndinofunga kuti ndaive ndichiziva kuti ndichine mukana wekugovera hupenyu hwangu zviitiko nevamwe. Izwi rekuti "chiremba" rinobva kuLatin uye rinoreva "kutakura kana kudzidzisa." Ini ndinonzwa kuti ndichiri kugona kudzidzisa, kugovera hupenyu hwangu zviitiko, uye tinopa dzidzo uye nhungamiro (kana zvisiri kutungamira) kuchizvarwa chevanachiremba mukudzidziswa uye kunyange vanachiremba. Saka zvaive zvakanaka kwazvo kuti zvive chokwadi kutora pabasa rekutsvagira paunenge uchichengeta kugona kwangu kwekudzidzisa kwekudzidzisa. Saka ini ndakanga ndisingakwanise kuramba mukana uyu.
Dr. Harmon: Zvakanaka, basa rekuratidzira ndechimwe chinhu chandisati ndamboita. Ini ndaive purofesa koreji uye ndakadzidziswa makirasi (chaicho kudzidziswa) mumunhu pane zvekupa mamakisi uye vakanyorwa, uye dzimwe nyanzvi dzehutano (vanamukoti, vabatsiri, vabatsiri vepaiririri). Kune mazhinji emakore angu makumi matatu nemashanu ekudzidzira, ndakanga ndiri mudzidzisi, mudzidzisi anoshanda. Saka chikamu ichi hachisi mutorwa.
Kukwikwidza kweAcademia hakugone kurerutswa. Ndiri kudzidza - ndiri kushandisa iyi fananidzo kwete nemoto hose, asi ine bhaketi brigades. Ini ndinokumbira vanhu kuti vandidzidzise chidimbu chimwe cheruzivo panguva. Saka dhipatimendi rimwe chete rinounza ndoo yavo, rimwe dhipatimendi rinounza ndoo yavo, maneja anounza ndoo yavo. Ipapo ini ndakatora bhakiti panzvimbo pekuvharwa nemoto hose uye kunyura. Saka ini ndinogona kudzora iyo data inonongedza zvishoma zvishoma. Tichaedza imwe bhaketi vhiki rinouya.
Unger: Dr. Harmon, zvirevo zvauri kuvhura chitsauko chitsva pano zvinonakidza. Panguva imwecheteyo, isu tinoziva kuti vanachiremba vazhinji vari kusarudza kuti vatore mari yekuzorora kana kukurumidza nekuda kweiyo dengic. Wakaona here kana kuti wakanzwa izvi zvichiitika pakati pevanoshanda navo?
Dr. Harmon: Ndakaiona svondo rapfuura, Todd, hongu. Isu tine pakati pe data Ivo vanozorora mumwedzi inotevera makumi maviri nemana. Isu tinoona izvi pakati pevamwe vashandi vehutano, kunyanya vanamukoti. 40% yevanamukoti (maviri muzvishanu) akati ndingadai ndichisiya giniki yangu yekurera vanhu mukati memakore maviri anotevera.
Naizvozvo hongu, sezvandataura, ndakaona vhiki ino yavhiki. Ini ndaive nepakati-danho rechiremba akaparidza pamudyandigere. Iye chiremba anovhiya, ane makore makumi matanhatu. Iye akati: Ndiri kusiya tsika inoshanda. Iyi denda yakandidzidzisa kutora zvinhu zvakanyanya kupfuura tsika yangu. Ini ndiri mune yakanaka yemari chinzvimbo. Pamberi pekumberi, anofanira kushandisa nguva yakawanda nemhuri yake. Saka akafunga zvekuzorora zvizere.
Ndine mumwe wandinoshanda naye akanaka mumushonga wemhuri. Kutaura zvazviri, mudzimai wake akauya kwandiri mwedzi mishoma yadarika ndokuti, "Iwe unoziva, denda iri rakaisa kunetseka kwakawanda pamhuri yedu." Ndakabvunza Dr. X, murume wake, uye aishanda naye mumuitiro wangu kudzikisa dosage. Nekuti anoshandisa imwe nguva muhofisi. Paakadzokera kumba, akagara pakombuta uye akaita basa rose rekomputa raasina nguva. Aive akabatikana kuona nhamba huru yevarwere. Saka anocheka kumashure. Aive achimanikidzwa kubva kumhuri yake. Ane vana vashanu.
Zvese izvi zvinokonzeresa kushushikana kwakawanda kwevarapi vazhinji vakura, asi avo vari pakati pebasa, ane makore makumi mashanu uye mukuru, vari panjodzi huru yekushushikana, senge zvizvarwa zvedu zvizvarwa zvedu.
Unger: Izvo zvinowanzo kanganisika chiremba wechiyeuchidzo mamiriro ezvinhu atatoona. Kutaura zvazviri, chidzidzo nekushamwaridzana kwekurapa kweAmerica mapurojekiti kushomeka kweChiremba kunosvika zviuru zana nemakumi mairi 2034, izvo zvinosanganisira musanganiswa wezvinhu isu takangokurukura, huwandu hwevanhu vanokwegura uye chiremba anokwegura uye chiremba anokwegura uye chiremba anokweguru.
Semunhu aimbova chiremba wemhuri yemhuri achishumira vanhu vazhinji vekumaruwa, ndedzipi pfungwa dzako pane izvi?
Dr. Harmon: Todd, iwe uri kutaura chokwadi. Kupfumiswa kwechiremba kuri kuita zvakawandisa, kana kuti zvisingaite Logarithmically, kwete nekuwedzera nekubvisa. Vanachiremba vari kuchembera. Tiri kutaura nezve chokwadi chekuti mumakore gumi anotevera, varwere vari muUS vachave ane makore makumi matanhatu nemashanu kana kupfuura, uye 34% yavo zvino vachazoda kurapwa. Kwemakore gumi anotevera, 42% kusvika ku45% yevanhu vanozoda kurapwa. Ivo vanoda kutarisirwa kwakawanda. Iwe wakataura kushomeka kwevanachiremba. Varwere vekare ava vanoda huwandu hwepamusoro hwekutarisira, uye vazhinji vanogara munzvimbo dzine vanhu vekumaruwa.
Saka sachiremba zera, pamudyandigere haasiye mafashama evanachiremba nevashandi vehutano vehutano vanoda kuenda kumaruwa, vanoda kuenda kunzvimbo dzakatove dzakange dzatetepa. Saka, mamiriro ezvinhu enzvimbo dzekumaruwa achawedzera kuwedzera. Zvinoita sekunge varwere vari munzvimbo iyi vachembera uye huwandu hwemaruwa hadzi kukura. Hatisiwo tisingaone kuwedzera kwehuwandu hwevashandi vehutano vanoenda kunzvimbo idzi dzekumaruwa.
Saka isu tinofanirwa kuuya nedzvinyiriro dzinosimudzira, mazano ekutsvaga, teremidicine, timu-timu yekubatsira kusangana nezvinodiwa zvevararidzi vekumaruwa.
Unger: huwandu hwevanhu huri kukura kana kukwegura, uye vanachiremba vari kuchembera. Izvi zvinoumba gakava yakakosha. Iwe unogona kungo tarisa pane iyo raw data chii chinotaridzika sedhiti?
Dr. Harmon: Ngatitii chiremba wechiremba wepachiremba anorwa vanoshumira 280,000 varwere. Sezvo iyo US huwandu hwevanhu, iri 34% ikozvino uye 42% kusvika pa45% mumakore gumi, saka sezvawaona, ini ndinofunga idzo nhamba dzakatenderedza vanhu zviuru zvina makumi mana. Saka ichi iganda rakakura. Pamusoro pekuda kudiwa kwevamwe vanachiremba, iwe uchadawo vanachiremba vazhinji kuti vashumire vanhu vanokwegura.
Rega ndikuudze. Kwete chete vanachiremba. Iyi inhepferi radiologist, uyu imwi, kuti usataure kuti vanamukoti vanozorora sei. Masisitimu echipatara edu kumaruwa America anoremerwa: Iko hakuna kukwana midziyo, radiologists, uye nyanzvi dzebarabhoratari. Yese yehutano hwehutano muUnited States yakatotambanudzwa yakatetepa nekushomeka kwevashandi vehutano vemhando dzose.
Unger: Kugadzirisa kana kugadzirisa chiremba wechiyeuchidzo kushomeka izvozvi zvinoda mhinduro dzakawanda. Asi ngatitaurei zvakanyatsojeka. Iwe unofunga sei varapi vakuru vanokodzera kuita izvi? Nei vakakodzera kwazvo kutarisira kutarisira kwevakuru?
Dr. Harmon: Zvinonakidza. Ini ndinofunga hapana mubvunzo kuti ivo vachanyatsonzwisa tsitsi, kana vasinganyaradze, nevarwere vanouya. Sezvatinotaura pamusoro pevaAmerican 65 uye mukurukure kumusoro kwehuwandu hwehuwandu hwehuwandu, iyi denderedzwa inoratidzwawo muChiremba Basa reChiremba: 42-45% yevarapi vevarapi makumi matanhatu nemashanu. Saka vachazova nezviitiko zvehupenyu zvakafanana. Ivo vachakwanisa kunzwisisa kana iri masaloskeletal Joint kusimuka, yekuziva kana yekuziva kudzikira, kana kunzwa uye kuona uye pamwe nechiratidzo chatinosvika pakuzvarwa, chirwere chemoyo. chirwere cheshuga. .
Takataura nezve kuti iyo podcast yandairatidza sei kuti mapodces of 90 maAmerican ane hongaBetes, uye 85 kusvika 90 muzana yevakadaro vasingatomboziva kuti vane chirwere cheshuga. Nekuda kweizvozvo, huwandu hwevanhu veAmerica hunounganidza zvakare mutoro wechirwere chisingaperi. Kana tikapinda mumisangano yavanachiremba, muchawana kuti vanonzwira tsitsi, asiwo vane ruzivo rweupenyu. Vane hunyanzvi hwakaiswa. Ivo vanoziva nzira yekuita kuongororwa.
Dzimwe nguva ini ndinoda kufunga kuti vanachiremba vezera rangu uye ndinogona kufunga uye kunyange kuita dzinza pasina mamwe matekinoroji. Hatifanirwe kufunga nezve chokwadi chekuti kana munhu uyu aine dambudziko diki neiyi kana kuti organ system, ini handidi kuita mri kana peturu yekutarisa kana chero bvunzo yerabhoritari. Ini ndinogona kuudza iyi rash is shingles. Izvi hazvisi zvekubata Dermatitis. Asi zvinongoda kuona varwere kwemakore makumi matatu nemashanu kana makumi mana kuti ini ndine psychological index inondibatsira kushandisa izvo zvandiri kudaidza huchenjeri hwevanhu, kwete nehungwaru hwekunyepedzera, kuongororwa.
Saka ini handifanire kuita zvese izvi bvunzo. Ini ndinogona kutangisa zvinobudirira-kuongorora, kurapa uye kusimbisa huwandu hwevanhu.
Unger: Uku kutevera kukuru. Ini ndinoda kutaura newe zvakanyanya nezve nyaya iyi maererano neTekinoroji. Iwe uri nhengo inoshanda yechiremba wepfungwa, ichiratidza maonero uye kuita mazano pazvinhu zvine chekuita nevanorapwa vakuru. Chimwe chezvinhu chinouya zvakanyanya nguva pfupi yadarika (chokwadi, ndanga ndichitaura zvakanyanya nezvehungwaru hwekungwarira mumavhiki mashoma apfuura) ndiwo mubvunzo wekuti vanachiremba vakura sei vanoenderana nedzitsva dzehunyanzvi. Ndeapi mazano aunawo nezve izvi? Ko Ama Inogona Sei Kubatsira?
Dr. Harmon: Zvakanaka, iwe wakandiona kare - ndataura pachena pane hurukuro uye mapaneru - tinoda kugamuchira iyi tekinoroji nyowani. Hazviendi. Zvatinoona muhunyanzvi hwekungwarira (iyo ama inoshandisa izwi iri uye ini ndinobvuma zvakanyanya nazvo) inowedzerwa nehungwaru. Nekuti hazvizombofi zvakanyatso kutsiva komputa iyi pano. Tine zvimwe zvekutonga uye kugona kwekuita sarudzo kuti kunyangwe michina yakanaka kwazvo haigoni kudzidza.
Asi isu tinofanirwa kugona tekinoroji iyi. Hatifanirwe kunonoka kufambira mberi kwake. Hatidi kunonoka kuishandisa. Hatifanirwe kubvisa zvimwe zvinyorwa zvemagetsi zvatinotaura nezve kusarongeka. Iri tekinoroji nyowani. Hazviendi. Izvi zvichavandudza gadziriro yemasevhisi ekuchengeta. Izvi zvinovandudza kuchengeteka, kuderedza zvikanganiso uye, ini ndinofunga, kugadzirisa kurongeka kwekuongorora.
Saka vanachiremba vanonyatsoda kugamuchira izvi uye kuitisa. Icho chishandiso, kungofanana nechimwe chinhu. Zvakafanana nekushandisa stethoscope, uchishandisa maziso ako, kubata uye kutarisa vanhu. Iko kusimudzira kune hwako hunyanzvi, kwete chinotadzisa.
Unger: Dr. Harmon, Mubvunzo wekupedzisira. Ndedzipi dzimwe nzira dzingadzoserwa nevanachiremba vanosarudza kuti havachagona kutarisira varwere vanoramba vachishanda mumabasa avo? Nei zvichibatsira kune vanachiremba uye basa rekuchengeta kubatana kwakadaro?
Dr. Harmon: Todd, munhu wese anozviita zvisarudzo zvake mune zvakasikwa pachavo achishandisa yavo data. Saka, nepo chiremba vangave nemibvunzo nezvekwavo, kana kuchengeteka kwake, kungave kuri mukamuri rekushanda kana mumamiriro ekunze paunenge uchingoita kuongororwa, hausi kungoita chishandiso kana kuvhiyiwa. Pane kumwe kujairika kuchinjika. Tese tinoda kunetseka nezveizvi.
Kutanga, kana uine hanya zvechokwadi, kana ukasukwa kugona kwako, kuziva kana muviri, taura nemumwe waunoshanda naye. Usanyara. Tine dambudziko rakafanana nehutano hwakanaka. Pandinotaura nemapoka ezvechiremba, ndinoziva kuti tinotaura nezvechiremba kupera simba. Isu tinotaura nezve matambudziko evashandi uye isu takavhiringidzika sei. Yedu data inoratidza kuti vanopfuura makumi mana muzana evanachiremba vaitarisa sarudzo yavo yebasa-ndinoreva, ndiyo nhamba inotyisa.
Kutumira Nguva: Oct-13-2023