{"id":14955,"date":"2014-02-26T00:08:53","date_gmt":"2014-02-25T23:08:53","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=14955"},"modified":"2014-10-20T20:16:06","modified_gmt":"2014-10-20T18:16:06","slug":"kdyz-se-ochrnuty-po-mrtvici-zotavi-je-to-radost","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=14955","title":{"rendered":"Kdy\u017e se ochrnut\u00fd po mrtvici zotav\u00ed, je to radost"},"content":{"rendered":"

Neurologov\u00e9 l\u00e9\u010d\u00edc\u00ed c\u00e9vn\u00ed mozkov\u00e9 p\u0159\u00edhody maj\u00ed rozhodn\u011b co d\u011blat. Prim\u00e1\u0159 Richard Pln\u00fd z nemocnice v Trutnov\u011b pova\u017euje mrtvice za nejv\u011bt\u0161\u00ed t\u00e9ma sv\u00e9ho oboru i za v\u00fdzvu. Rozhovor den\u00edku MfD.\u00a0<\/strong><\/p>\n

Mozkov\u00e1 mrtvice vy\u0159ad\u00ed \u010dlov\u011bka z b\u011b\u017en\u00e9ho \u017eivota na cel\u00e9 m\u011bs\u00edce anebo tak\u00e9 nadobro. Kdy\u017e se v\u0161ak dostane do nemocnice v\u010das, m\u00e1 \u0161anci na uzdraven\u00ed. I kv\u016fli tomu vznikla s\u00ed\u0165 iktov\u00fdch center, v kraji jsou t\u0159i. „Rozhodn\u011b m\u00e1 smysl je budovat. Za patn\u00e1ct let, kdy jsem v oboru, vid\u00edm posun k lep\u0161\u00edmu. Zlep\u0161ily se diagnostick\u00e9 mo\u017enosti, rehabilitace s pacienty po mrtvici je intenzivn\u011bj\u0161\u00ed. P\u0159esto v\u0161ak je\u0161t\u011b po\u0159\u00e1d z\u016fst\u00e1vaj\u00ed mrtvice n\u011bkdy neovlivniteln\u00e9,“ m\u00edn\u00ed prim\u00e1\u0159 neurologick\u00e9ho odd\u011blen\u00ed v Oblastn\u00ed nemocnici v Trutnov\u011b Richard Pln\u00fd.<\/p>\n

– Jak \u00fasp\u011b\u0161n\u00ed jste v l\u00e9\u010db\u011b c\u00e9vn\u00edch mozkov\u00fdch p\u0159\u00edhod pr\u00e1v\u011b u v\u00e1s?<\/strong><\/p>\n

T\u0159etina lid\u00ed se obecn\u011b vrac\u00ed k norm\u00e1ln\u00edmu stavu. T\u0159etina projde v\u00edce \u010di m\u00e9n\u011b n\u00e1ro\u010dnou rehabilitac\u00ed a vr\u00e1t\u00ed se s n\u011bjak\u00fdm posti\u017een\u00edm, nap\u0159\u00edklad s poruchou \u0159e\u010di, ale jejich stav je lep\u0161\u00ed ne\u017e t\u011bsn\u011b po mrtvici, co\u017e jim dovoluje n\u00e1vrat do zam\u011bstn\u00e1n\u00ed. Posledn\u00ed t\u0159etinu tvo\u0159\u00ed t\u011b\u017ece nemocn\u00ed, hodn\u011b ochrnut\u00ed lid\u00e9, kte\u0159\u00ed dlouho pob\u00fdvaj\u00ed na rehabilita\u010dn\u00edch nebo n\u00e1sledn\u00fdch l\u016f\u017ek\u00e1ch. Nikde na sv\u011bt\u011b nejde mrtvici vyl\u00e9\u010dit \u00fapln\u011b, jako kdy\u017e se d\u00e1 na anginu penicilin.<\/p>\n

– Kter\u00e9 lidi mrtvice ohro\u017euje v\u00edc?<\/strong><\/p>\n

Postihuje o tro\u0161ku v\u00edc \u017eeny. \u010c\u00edm je pacient star\u0161\u00ed, t\u00edm v\u00edc p\u0159ib\u00fdv\u00e1 mrtvic v d\u016fsledku komplikac\u00ed ateroskler\u00f3zy neboli kornat\u011bn\u00ed tepen. Je zn\u00e1m\u00e9, \u017ee celosv\u011btov\u011b roste po\u010det c\u00e9vn\u00edch mozkov\u00fdch p\u0159\u00edhod ve skupin\u011b lid\u00ed od \u010dty\u0159iceti do pades\u00e1ti let. Nikdo nev\u00ed pro\u010d, ale mo\u017en\u00e1 to p\u016fsob\u00ed stres \u010di strava bohat\u00e1 na cholesterol.<\/p>\n

– Kdo byl v\u00e1\u0161 nejmlad\u0161\u00ed pacient?<\/strong><\/p>\n

M\u011bli jsme tu jednadvacetiletou \u017eenu a jej\u00ed stav se upravil v\u00fdborn\u011b. Takto mlad\u00e9 lidi postihuje mrtvice \u010dasto kv\u016fli nerozpoznan\u00e9mu onemocn\u011bn\u00ed krevn\u00ed sr\u00e1\u017elivosti. U \u017een nen\u00ed vz\u00e1cnost\u00ed, \u017ee se na vzniku mrtvice m\u016f\u017ee pod\u00edlet hormon\u00e1ln\u00ed antikoncepce. Rizikov\u00fdm faktorem je i kou\u0159en\u00ed, migr\u00e9ny \u010di \u00farazy. T\u0159eba p\u0159i sportu se m\u016f\u017ee st\u00e1t, \u017ee se natrhne c\u00e9va a pak se uzav\u0159e.<\/p>\n

– Vybral jste si mrtvice schv\u00e1ln\u011b, nebo tak \u0161el \u017eivot?<\/strong><\/p>\n

Cht\u011bl jsem p\u016fvodn\u011b d\u011blat internu. Po ukon\u010den\u00ed studia na 3. l\u00e9ka\u0159sk\u00e9 fakult\u011b v Praze jsem nastoupil do Broumova pr\u00e1v\u011b na intern\u00ed odd\u011blen\u00ed. D\u0159\u00edv se b\u011b\u017en\u011b l\u00e9\u010dily mrtvice na intern\u011b. Problematika m\u011b zaujala, nav\u00edc se mi tato oblast medic\u00edny zd\u00e1la perspektivn\u00ed. Po necel\u00fdch dvou letech jsem p\u0159ijal nab\u00eddku na neurologii, tak\u00e9 jsme se st\u011bhoval. T\u00e9ma c\u00e9vn\u00edch mozkov\u00fdch p\u0159\u00edhod je dnes v neurologii dominantn\u00ed a je to i v\u00fdzva, z\u00e1rove\u0148 v sob\u011b obsahuje intern\u00ed problematiku. L\u00edb\u00ed se mi, co d\u011bl\u00e1m. N\u011bjak\u00e9 v\u00fdsledky m\u00e1me. Ur\u010dit\u011b m\u00e1m radost, kdy\u017e se \u010dlov\u011bk ochrnut\u00fd po mrtvici zotav\u00ed. N\u011bkte\u0159\u00ed posti\u017een\u00ed se nemohli posadit ani chodit, m\u011bli pravou ruku i nohu nefunk\u010dn\u00ed, ale za p\u00e1r m\u011bs\u00edc\u016f u\u017e chod\u00ed. Oproti tomu, kdy\u017e jsem za\u010d\u00ednal, je patrn\u00fd posun k lep\u0161\u00edmu.<\/p>\n

– Kdy\u017e se pacienta nepovede vr\u00e1tit do b\u011b\u017en\u00e9ho \u017eivota, b\u00fdv\u00e1 to jist\u011b hodn\u011b smutn\u00e9.<\/strong><\/p>\n

Jde o to, aby lid\u00ed, u kter\u00fdch to nedopadne, bylo co nejm\u00e9n\u011b. Mimo jin\u00e9 to \u0161et\u0159\u00ed n\u00e1klady poji\u0161\u0165oven a soci\u00e1ln\u00ed p\u00e9\u010de. Kdy\u017e se \u010dlov\u011bk zlep\u0161\u00ed a vr\u00e1t\u00ed se do p\u016fvodn\u00edho \u017eivota, je to levn\u011bj\u0161\u00ed varianta, ne\u017e kdy\u017e se dlouhodob\u011b ocitne na l\u016f\u017eku n\u00e1sledn\u00e9 p\u00e9\u010de. Relativn\u011b drah\u00e1 l\u00e9\u010dba se z dlouhodob\u00e9ho pohledu vyplat\u00ed.<\/p>\n

– Kdy\u017e jsou lidi po mrtvici \u010d\u00e1ste\u010dn\u011b ochrnut\u00ed, je to nejsp\u00ed\u0161 dost n\u00e1ro\u010dn\u00e9 pro sestry.<\/strong><\/p>\n

Sna\u017e\u00edm se, aby person\u00e1l ned\u011blal svou pr\u00e1ci jen form\u00e1ln\u011b. L\u00e9ka\u0159i maj\u00ed z\u00e1jem o obor, sestry se vzd\u011bl\u00e1vaj\u00ed. V\u011bt\u0161inu lid\u00ed, mysl\u00edm, problematika c\u00e9vn\u00edch mozkov\u00fdch p\u0159\u00edhod bav\u00ed. Chci, aby o pacienta projevovali osobn\u00ed z\u00e1jem, p\u0159istupovali k n\u011bmu individu\u00e1ln\u011b a nebrali ho jako kus. V tom je pr\u00e1ce sester nezastupiteln\u00e1, ony mus\u00ed nav\u00e1zat s pacientem emo\u010dn\u00ed kontakt. Lid\u00e9 po mrtvici upadaj\u00ed \u010dasto do deprese, ale i kdy\u017e dostanou antidepresiva, lidsk\u00fd kontakt a povzbuzen\u00ed jsou pro n\u011b v jejich stavu velmi d\u016fle\u017eit\u00e9. Podobn\u00e9 to je s rehabilita\u010dn\u00edmi pracovn\u00edky, ale nerad bych podce\u0148oval i takov\u00e9 posty, jako jsou t\u0159eba sanit\u00e1\u0159i. Nep\u0159\u00e1l bych si tu n\u011bkoho trvale otr\u00e1ven\u00e9ho. Lidi c\u00edt\u00ed pozitivn\u00ed atmosf\u00e9ru a pro uzdravov\u00e1n\u00ed to d\u011bl\u00e1 hodn\u011b. Ale nechci, aby to zn\u011blo jako n\u011bjak\u00e1 poh\u00e1dka, probl\u00e9my jsou v\u0161ude. Kdy\u017e to shrnu, u\u010d\u00edme se l\u00e9ty a sna\u017e\u00edme se o dobrou \u00farove\u0148.<\/p>\n

– Je p\u00e9\u010de o pacienty s mrtvic\u00ed pro prim\u00e1\u0159e velk\u00fd stres?<\/strong><\/p>\n

Tuhle pr\u00e1ci jsem si vybral. Nejsem p\u0159\u00edznivcem ho\u0159ekov\u00e1n\u00ed, \u017ee m\u00e1m p\u0159\u00edli\u0161 pr\u00e1ce. Sna\u017e\u00edm se b\u00fdt profesion\u00e1ln\u00ed a v\u017edycky tak\u00e9 existuje mo\u017enost zm\u011bny. Probl\u00e9my ve zdravotnictv\u00ed v\u0161eobecn\u011b jsou, ale co d\u011bl\u00e1m tady na odd\u011blen\u00ed a za co odpov\u00edd\u00e1m, je solidn\u00ed a nen\u00ed d\u016fvod k malomyslnosti. Pob\u00fdval jsem v zahrani\u010d\u00ed, m\u00e1m reference odjinud, tak\u017ee v\u00edm, \u017ee \u00farove\u0148 na\u0161eho zdravotnictv\u00ed je dobr\u00e1, i t\u0159eba v porovn\u00e1n\u00ed s Franci\u00ed. Pacienti by m\u011bli v\u011bd\u011bt, \u017ee p\u0159es v\u0161echny probl\u00e9my je p\u00e9\u010de na solidn\u00ed \u00farovni, l\u00e9\u010dba je dostupn\u00e1, na vy\u0161et\u0159ovac\u00ed metody nen\u00ed dlouh\u00e1 \u010dekac\u00ed doba. Kdy\u017e si n\u011bkdo st\u011b\u017euje, \u017ee \u010dek\u00e1 na magnetickou rezonanci m\u011bs\u00edc nebo dva, m\u011bl by v\u011bd\u011bt, \u017ee jinde je to p\u016fl nebo t\u0159i \u010dtvrt\u011b roku, jako t\u0159eba v Anglii. Nen\u00ed to u n\u00e1s tak \u0161patn\u00e9, jak se to prezentuje.<\/p>\n

– Nos\u00edte si pr\u00e1ci dom\u016f?<\/strong><\/p>\n

Nar\u016fst\u00e1 administrativa, vykazov\u00e1n\u00ed, statistiky, tak\u017ee dom\u016f opravdu ob\u010das n\u011bco nos\u00edm. \u010clov\u011bk si doma taky p\u0159em\u00fd\u0161l\u00ed nad pacienty, ale m\u00e1 to sv\u00e9 meze. Jeden extr\u00e9m jsou l\u00e9ka\u0159i, kte\u0159\u00ed v p\u016fl \u010dtvrt\u00e9 skon\u010d\u00ed pr\u00e1ci a v\u00edc je nezaj\u00edm\u00e1. Druh\u00fd extr\u00e9m jsou \u0159e\u010di o tom, \u017ee doktor m\u00e1 b\u00fdt po\u0159\u00e1d p\u0159ipraven a Hippokratovu p\u0159\u00edsahu dodr\u017eovat nonstop. Jen\u017ee l\u00e9ka\u0159 pot\u0159ebuje \u010das na relaxaci. Vyspal\u00fd a odpo\u010dat\u00fd l\u00e9ka\u0159 je m\u00e9n\u011b chybuj\u00edc\u00ed, to je zn\u00e1m\u00e1 pravda. V t\u00e9hle pr\u00e1ci je person\u00e1l pln\u011b vyt\u00ed\u017een\u00fd. M\u00e1me iktov\u00e9 centrum, l\u016f\u017ekov\u00e9 odd\u011blen\u00ed neurologie, ambulanci pro objednan\u00e9 pacienty, ambulanci pro akutn\u00ed p\u0159\u00edpady, sp\u00e1nkovou laborato\u0159, vy\u0161et\u0159en\u00ed. Trvale je co d\u011blat, voln\u00fd \u010das na k\u00e1vu tady zrovna neb\u00fdv\u00e1.<\/p>\n

redak\u010dn\u011b kr\u00e1ceno, cel\u00fd \u010dl\u00e1nek je v den\u00edku Mlad\u00e1 fronta DNES<\/em><\/p>\n

\u00a0ilustra\u010dn\u00ed foto: stockimages-FreeDigitalPhotos<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Neurologov\u00e9 l\u00e9\u010d\u00edc\u00ed c\u00e9vn\u00ed mozkov\u00e9 p\u0159\u00edhody maj\u00ed rozhodn\u011b co d\u011blat. Prim\u00e1\u0159 Richard Pln\u00fd z nemocnice v Trutnov\u011b pova\u017euje mrtvice za nejv\u011bt\u0161\u00ed t\u00e9ma sv\u00e9ho oboru i za […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14888,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12],"tags":[],"class_list":["post-14955","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-rozhovory"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/14955","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=14955"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/14955\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14888"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=14955"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=14955"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=14955"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}