{"id":31701,"date":"2019-05-22T21:27:53","date_gmt":"2019-05-22T19:27:53","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=31701"},"modified":"2019-05-22T21:47:45","modified_gmt":"2019-05-22T19:47:45","slug":"z-chemoterapie-mi-je-zle-tuto-vetu-uz-u-pacienta-neuslysime","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=31701","title":{"rendered":"„Z chemoterapie mi je zle.“ Tuto v\u011btu u\u017e u pacienta neusly\u0161\u00edme"},"content":{"rendered":"

Chemoterapie je v pov\u011bdom\u00ed dosud spojena s ob\u00e1van\u00fdmi ne\u017e\u00e1douc\u00edmi \u00fa\u010dinky – zejm\u00e9na nevolnost\u00ed a\u00a0\u00faporn\u00fdm zvracen\u00edm. L\u00e9ka\u0159i v\u0161ak ji\u017e dnes maj\u00ed modern\u00ed l\u00e9ky, kter\u00e9 tyto ne\u017e\u00e1douc\u00ed \u00fa\u010dinky nejen m\u00edrn\u00ed, ale mohou je i zcela potla\u010dit. O tom sv\u011bd\u010d\u00ed i p\u0159\u00edb\u011bh pacientky Ji\u0159iny.<\/strong><\/p>\n

na sn\u00edmku\u00a0MUDr. Tesa\u0159ov\u00e1<\/strong><\/em><\/p>\n

Nemocn\u00ed rakovinou p\u0159i chemoterapii mnohdy trp\u00ed nevolnost\u00ed a\u017e zvracen\u00edm. Zejm\u00e9na zvracen\u00ed nejen\u017ee pacienta zat\u011b\u017euje a\u017e na samou m\u00edru \u00fanosnosti, ale \u010dasto vede ke zhor\u0161en\u00ed jeho celkov\u00e9ho stavu kv\u016fli ztr\u00e1t\u011b tekutin a\u00a0miner\u00e1l\u016f, a\u00a0t\u00edm i\u00a0k\u00a0ni\u017e\u0161\u00ed \u00fa\u010dinnosti protin\u00e1dorov\u00e9 l\u00e9\u010dby.<\/p>\n

\u201ePr\u00e1v\u011b nevolnost a\u00a0zvracen\u00ed, p\u0159edev\u0161\u00edm v\u00a0souvislosti s\u00a0chemoterapi\u00ed, jsou velmi nep\u0159\u00edjemnou komplikac\u00ed, kterou v\u0161ak d\u00edky v\u010dasn\u00e9mu preventivn\u00edmu pod\u00e1n\u00ed modern\u00edch antiemetick\u00fdch l\u00e9k\u016f m\u016f\u017eeme v\u00fdrazn\u011b minimalizovat u\u00a0naprost\u00e9 v\u011bt\u0161iny na\u0161ich pacient\u016f,\u201c \u0159\u00edk\u00e1 prof. MUDr. Samuel Vokurka, Ph.D., z\u00a0Onkologick\u00e9 a\u00a0radioterapeutick\u00e9 kliniky LF UK a\u00a0FN Plze\u0148.<\/p>\n

I\u00a0kdy\u017e jsou nevolnost a\u00a0zvracen\u00ed \u010dast\u00fdmi ne\u017e\u00e1douc\u00edmi \u00fa\u010dinky chemoterapie, nepostihuj\u00ed ka\u017ed\u00e9ho pacienta p\u0159i ka\u017ed\u00e9 l\u00e9\u010db\u011b a ani je nepostihuj\u00ed ve stejn\u00e9 m\u00ed\u0159e. Vy\u0161\u0161\u00ed riziko vzniku nevolnosti a\u00a0zvracen\u00ed maj\u00ed obecn\u011b \u017eeny, lid\u00e9 do 50 let, d\u00e1le ti, kte\u0159\u00ed maj\u00ed sklony ke zvracen\u00ed (p\u0159i cestov\u00e1n\u00ed, v\u00a0t\u011bhotenstv\u00ed apod.), \u00fazkostn\u00ed pacienti a\u00a0tak\u00e9 abstinenti. Pravd\u011bpodobnost zvracen\u00ed stoup\u00e1 i\u00a0tehdy, pokud se pacient myln\u011b domn\u00edv\u00e1, \u017ee zvracen\u00ed vyvol\u00e1v\u00e1 ka\u017ed\u00e1 chemoterapie, a\u00a0tud\u00ed\u017e nevolnost o\u010dek\u00e1v\u00e1.<\/p>\n

Ne\u017e\u00e1douc\u00ed p\u0159\u00edznaky p\u0159i chemoterapii mohou prob\u00edhat akutn\u011b<\/strong> (rozv\u00edj\u00ed se b\u011bhem 24 hodin po pod\u00e1n\u00ed chemoterapie) nebo v opo\u017ed\u011bn\u00e9<\/strong> f\u00e1zi, kdy p\u0159etrv\u00e1vaj\u00ed i\u00a02.\u20135. den po pod\u00e1n\u00ed chemoterapie. \u201eTeprve objev mechanismu vzniku nevolnosti po chemoterapii, kter\u00e1 je zp\u016fsoben\u00e1 p\u0159\u00edm\u00fdm podr\u00e1\u017ed\u011bn\u00edm centra zvracen\u00ed, umo\u017enilo\u00a0 objevit\u00a0 \u00fa\u010dinnou l\u00e9\u010dbu a\u00a0dokonce prevenci\u00a0 nevolnosti zp\u016fsoben\u00e9 protin\u00e1dorovou l\u00e9\u010dbou. T\u00edm se z\u00e1sadn\u011b zm\u011bnila kvalita \u017eivota\u00a0 onkologick\u00fdch pacient\u016f, kte\u0159\u00ed u\u017e nemus\u00ed za svoje uzdravov\u00e1n\u00ed platit da\u0148 v\u00a0podob\u011b nep\u0159\u00edjemn\u00fdch za\u017e\u00edvac\u00edch pot\u00ed\u017e\u00ed,\u201c zd\u016fraz\u0148uje doc. MUDr. Petra Tesa\u0159ov\u00e1, CSc., z\u00a0Onkologick\u00e9 kliniky 1. LF UK a\u00a0VFN v\u00a0Praze.<\/p>\n

\u00da\u010dinn\u00e9 l\u00e1tky jsou dnes obsa\u017eeny v\u00a0jedn\u00e9 tobolce a\u00a0sta\u010d\u00ed jej\u00ed jednor\u00e1zov\u00e9 pod\u00e1n\u00ed p\u0159ed ka\u017edou chemoterapi\u00ed, aby pacienta ochr\u00e1nila p\u0159ed akutn\u00edmi i\u00a0opo\u017ed\u011bn\u00fdmi ne\u017e\u00e1douc\u00edmi \u00fa\u010dinky po celou dobu l\u00e9\u010debn\u00e9ho cyklu.<\/p>\n

P\u0159esto v\u00a0re\u00e1ln\u00e9 praxi dost\u00e1v\u00e1 antiemetika pouze asi polovina nemocn\u00fdch. Na tyto ne\u017e\u00e1douc\u00ed \u00fa\u010dinky by se proto pacienti m\u011bli sv\u00fdch l\u00e9ka\u0159\u016f pt\u00e1t a\u00a0m\u011bli by se zaj\u00edmat o\u00a0mo\u017enosti prevence, kter\u00e1 vede ke sn\u00ed\u017een\u00ed ne\u00fanosn\u00fdch p\u0159\u00edznak\u016f nebo dokonce k\u00a0jejich potla\u010den\u00ed.<\/p>\n

P\u0158\u00cdB\u011aH PACIENTKY JI\u0158INY<\/strong><\/p>\n

\"pacientkaV\u00a0kv\u011btnu lo\u0148sk\u00e9ho roku se tehdy 48let\u00e1 pan\u00ed Ji\u0159ina po vy\u0161et\u0159en\u00ed na mamografu dozv\u011bd\u011bla diagn\u00f3zu: rakovina prsu. \u201ePrvn\u00ed, co mi prol\u00e9tlo hlavou, bylo, \u017ee to je n\u011bjak\u00e1 chyba. \u017de u\u017e jsem si toho pro\u017eila tolik, \u017ee tohle mne p\u0159ece potkat nem\u016f\u017ee…\u201c vzpom\u00edn\u00e1 dnes s\u00a0odstupem \u010dasu. Bohu\u017eel, nebyl to omyl, ale realita. \u201eKdy\u017e mi to do\u0161lo, myslela jsem, \u017ee je to konec v\u0161eho. Sedla jsem si v\u00a0parku a\u00a0jenom jsem bre\u010dela,\u201c p\u0159izn\u00e1v\u00e1 pan\u00ed Ji\u0159ina.<\/p>\n

Po prvn\u00ed chemoterapii mi bylo stra\u0161n\u011b zle\u00a0<\/strong><\/p>\n

Po operaci prsu na ni \u010dekalo osm cykl\u016f chemoterapie. \u201eT\u00e9 jsem se vlastn\u011b moc neb\u00e1la. Prost\u011b jsem si \u0159\u00edkala, \u017ee je to nutn\u00e9 a\u00a0\u017ee to zvl\u00e1dnu. Proto\u017ee nikdo v\u00a0m\u00e9m okol\u00ed se chemoterapi\u00ed nikdy nel\u00e9\u010dil, nem\u011bla jsem o\u00a0tom, co obn\u00e1\u0161\u00ed, \u017e\u00e1dn\u00e9 bezprost\u0159edn\u00ed informace, jen to, co jsem p\u0159e\u010detla r\u016fzn\u011b na internetu, zku\u0161enosti pacient\u016f a\u00a0podobn\u011b. Ty mne pon\u011bkud vyd\u011bsily. Do t\u00e9 doby jsem po\u010d\u00edtala maxim\u00e1ln\u011b s\u00a0t\u00edm, \u017ee mi bude asi trochu \u0161patn\u011b. Ov\u0161em realita, ta mne nakonec hodn\u011b zasko\u010dila,\u201c vzpom\u00edn\u00e1 pan\u00ed Ji\u0159ina.<\/p>\n

P\u0159ed prvn\u00ed chemoterapi\u00ed ji jej\u00ed l\u00e9ka\u0159ka vybavila jak pot\u0159ebn\u00fdmi informacemi, tak i\u00a0standardn\u00ed preventivn\u00ed l\u00e9\u010dbou proti nevolnosti. Ta ov\u0161em u\u00a0pan\u00ed Ji\u0159iny ne\u00fa\u010dinkovala, jak by si v\u0161ichni p\u0159\u00e1li. \u201ePrvn\u00ed hodina \u010di dv\u011b po pod\u00e1n\u00ed chemoterapie byly relativn\u011b dobr\u00e9. Pak se mi ale ud\u011blalo opravdu stra\u0161n\u011b zle. Do ve\u010dera jsem zvracela snad osmkr\u00e1t, u\u017e jsem ani nem\u011bla co zvracet, ale \u00faleva nep\u0159ich\u00e1zela. Tou\u017eila jsem po tm\u011b a\u00a0po tichu, jako kdy\u017e m\u00e1 \u010dlov\u011bk migr\u00e9nu. Vzpom\u00edn\u00e1m si, \u017ee utrpen\u00edm pro mne bylo i\u00a0sly\u0161et, jak man\u017eel, kter\u00fd mne vezl dom\u016f, za volantem \u017ev\u00fdk\u00e1 \u017ev\u00fdka\u010dku…\u201c<\/p>\n

Doma se nezmohla na v\u00edc ne\u017e si lehnout, sto\u010dit se do klub\u00ed\u010dka a\u00a0pokusit se myslet na n\u011bco hezk\u00e9ho \u2013 nejv\u00edce j\u00ed pom\u00e1hala vzpom\u00ednka z\u00a0d\u011btstv\u00ed na okam\u017eiky, kter\u00e9 tr\u00e1vila na louce se sv\u00fdm pejskem. \u00daporn\u00e1 nevolnost a\u00a0zvracen\u00ed pan\u00ed Ji\u0159inu t\u00fdraly po prvn\u00edch chemoterapi\u00edch \u0159adu dn\u016f. Na j\u00eddlo nem\u011bla ani pomy\u0161len\u00ed, zle j\u00ed d\u011blaly i\u00a0jen pachy z\u00a0kuchyn\u011b. Kdy\u017e po t\u00fddnu dostala poprv\u00e9 chu\u0165 na k\u00e1vu, bylo to pro ni znamen\u00ed, \u017ee se situace kone\u010dn\u011b m\u011bn\u00ed k\u00a0lep\u0161\u00edmu.<\/p>\n

\u00dalevu od zvracen\u00ed p\u0159inesla jedin\u00e1 tobolka<\/strong><\/p>\n

P\u0159ed dal\u0161\u00edmi chemoterapiemi bylo jasn\u00e9, \u017ee bude t\u0159eba preventivn\u00ed l\u00e9\u010dbu nevolnosti a\u00a0zvracen\u00ed zm\u011bnit. Pan\u00ed Ji\u0159ina se tak do\u010dkala modern\u00ed kombinace pod\u00e1van\u00e9 v\u00a0jedn\u00e9 tobolce, a\u00a0to jen jednou p\u0159ed ka\u017edou chemoterapi\u00ed. \u201eRozd\u00edl byl oproti prvn\u00ed zku\u0161enosti opravdu zn\u00e1t. Po pod\u00e1n\u00ed chemoterapie jsem se te\u010f vyzvracela t\u0159eba jen jednou, nevolnost trvala do ve\u010dera \u2013 a\u00a0u\u017e druh\u00fd den to bylo nesrovnateln\u011b lep\u0161\u00ed.\u201c Obrovsk\u00fdm \u0161t\u011bst\u00edm pro pan\u00ed Ji\u0159inu byla po celou dobu p\u00e9\u010de jej\u00ed rodiny.<\/p>\n

\u201eHodn\u011b mi pomohly ob\u011b maminky \u2013 moje i\u00a0m\u00e9ho mu\u017ee. Ob\u011b jsou vynikaj\u00edc\u00ed kucha\u0159ky a\u00a0jejich pol\u00e9vky a\u00a0dom\u00e1c\u00ed kompoty byly pro mne v\u00a0t\u00e9 dob\u011b neoceniteln\u00e9! Jsem vd\u011b\u010dn\u00e1 i\u00a0dce\u0159i, kter\u00e1 db\u00e1 na zdravou stravu \u2013 a\u00a0mn\u011b ve chv\u00edl\u00edch, kdy jsem na nic nem\u011bla chu\u0165, nakonec\u00a0 ty jej\u00ed ovesn\u00e9 ka\u0161e s\u00a0ovocem a\u00a0\u0161paldov\u00e9 l\u00edvance s\u00a0jogurtem jako jedin\u00e9 von\u011bly. A\u00a0j\u00edm je st\u00e1le. Zat\u00edmco n\u011bkter\u00e1 j\u00eddla, kter\u00e9 jsem m\u011bla d\u0159\u00edve r\u00e1da, m\u00e1m tak spojen\u00e9 s\u00a0chemoterapi\u00ed, \u017ee mi u\u017e nechutnaj\u00ed.\u201c<\/p>\n

Nakonec tedy pro pan\u00ed Ji\u0159inu t\u00edm nejh\u016f\u0159e pro\u017e\u00edvan\u00fdm ne\u017e\u00e1douc\u00edm \u00fa\u010dinkem chemoterapie byla ztr\u00e1ta vlas\u016f. \u201eM\u00edvala jsem je 30\u00a0cm dlouh\u00e9 \u2013 a\u00a0najednou si do nich s\u00e1hnete a\u00a0z\u016fstane v\u00e1m jich cel\u00e1 hrst v\u00a0ruce… Nav\u00edc jsem m\u011bla pocit, jako by to, co mne \u0161imr\u00e1 vzadu na krku, nebyly moje vlasy, ale n\u011bco ciz\u00edho…\u201c Jej\u00ed vypadan\u00e9 vlasy byly doma \u00fapln\u011b v\u0161ude. Nakonec nezbylo, ne\u017e po vzoru zku\u0161enost\u00ed jin\u00fdch onkologick\u00fdch pacientek s\u00e1hnout po strojku a\u00a0hlavu si vyholit. \u201eNejd\u0159\u00edv jsem se b\u00e1la, \u017ee se na mne budou n\u011bkte\u0159\u00ed lid\u00e9 d\u00edvat divn\u011b, ale pak jsem si \u0159ekla, tak a\u0165! Po\u0159\u00eddila jsem si paruku, r\u016fzn\u00e9 \u0161\u00e1tky a\u00a0turbany \u2013 a\u00a0d\u00e1l se na to sna\u017eila nemyslet.\u201c<\/p>\n

V\u00a0\u017eivot\u011b nejde v\u017edy v\u0161echno podle pl\u00e1nu, tak pro\u010d se tr\u00e1pit?! S\u00a0odstupem \u010dasu pan\u00ed Ji\u0159ina oce\u0148uje, \u017ee m\u00e1 po celou svou nemoc \u0161t\u011bst\u00ed na v\u00fdborn\u00e9 zdravotn\u00edky. \u201eZejm\u00e9na pan\u00ed docentka Tesa\u0159ov\u00e1 je \u00fa\u017easn\u00e1 osoba. kdy\u017e se b\u011bhem l\u00e9\u010dby objev\u00ed n\u011bjak\u00fd probl\u00e9m, tak j\u00ed nap\u00ed\u0161u e-mail a\u00a0mohu se stoprocentn\u011b spolehnout, \u017ee mi odpov\u00ed, porad\u00ed, \u017ee j\u00ed to prost\u011b nen\u00ed jedno.\u201c<\/p>\n

Zm\u011bnil se i\u00a0jej\u00ed pohled na \u017eivot. \u201eTrochu l\u00edp u\u017e rozezn\u00e1v\u00e1m, co m\u00e1 smysl a\u00a0co ne. J\u00e1 jsem v\u017edycky o\u00a0v\u0161em moc p\u0159em\u00fd\u0161lela, musela jsem m\u00edt pro ka\u017edou situaci nachystan\u00fd nejen pl\u00e1n B, ale nejm\u00ed\u0148 i\u00a0pl\u00e1n C a\u00a0cht\u011bla jsem vid\u011bt a\u017e za t\u0159et\u00ed roh… Pak p\u0159ijde nemoc a\u00a0\u010dlov\u011bk pozn\u00e1, \u017ee to vlastn\u011b nem\u00e1 smysl, proto\u017ee v\u00a0\u017eivot\u011b to podle pl\u00e1nu v\u017edycky nechod\u00ed.\u201c<\/p>\n

Aktu\u00e1ln\u011b se pan\u00ed Ji\u0159ina chyst\u00e1 do l\u00e1zn\u00ed a\u00a0v\u011b\u0159\u00ed, \u017ee to bude nov\u00fd za\u010d\u00e1tek, po kter\u00e9m se bude moci op\u011bt vr\u00e1tit do norm\u00e1ln\u00edho \u017eivota i\u00a0do pr\u00e1ce. \u201eKdy\u017e si vzpomenu na v\u0161echny ty zku\u0161enosti pacient\u016f, kter\u00e9 jsem si p\u0159ed chemoterapi\u00ed \u010detla na internetu nebo je vyslechla v\u00a0\u010dek\u00e1rn\u011b \u2013 a\u00a0v\u011b\u0159te, \u017ee n\u011bco by \u010dlov\u011bk opravdu rad\u011bji nesly\u0161el\u00a0\u2013, mus\u00edm \u0159\u00edci, \u017ee v\u00a0mnoh\u00e9m se sice shodovaly s\u00a0m\u00fdmi, ale na\u0161t\u011bst\u00ed ne ve v\u0161em. Co bych ale ur\u010dit\u011b uv\u00edtala, to by byla mo\u017enost do\u010d\u00edst se tak\u00e9 v\u00edce o\u00a0tom, \u017ee existuje l\u00e9\u010dba, kter\u00e1 umo\u017en\u00ed pro\u017e\u00edt chemoterapii aspo\u0148 bez t\u011bch nejhor\u0161\u00edch ne\u017e\u00e1douc\u00edch p\u0159\u00edznak\u016f,\u201c \u0159\u00edk\u00e1 pan\u00ed Ji\u0159ina. A\u00a0na z\u00e1klad\u011b toho, co si pro\u017eila, vzkazuje ostatn\u00edm onkologick\u00fdm pacient\u016fm, \u017ee chemoterapie nen\u00ed t\u0159eba se vylo\u017een\u011b d\u011bsit, proto\u017ee: \u201ePrakticky v\u0161echno se d\u00e1 nakonec vy\u0159e\u0161it, i\u00a0to zvracen\u00ed.\u201c<\/p>\n","protected":false},"excerpt":{"rendered":"

Chemoterapie je v pov\u011bdom\u00ed dosud spojena s ob\u00e1van\u00fdmi ne\u017e\u00e1douc\u00edmi \u00fa\u010dinky – zejm\u00e9na nevolnost\u00ed a\u00a0\u00faporn\u00fdm zvracen\u00edm. L\u00e9ka\u0159i v\u0161ak ji\u017e dnes maj\u00ed modern\u00ed l\u00e9ky, kter\u00e9 tyto ne\u017e\u00e1douc\u00ed […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":31703,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-31701","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/31701","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=31701"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/31701\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/31703"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=31701"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=31701"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=31701"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}