带b 单词 形容信念的:揭秘女性健忘和抑郁的原因

揭秘女性健忘和抑郁的原因

By Caroline Day

作者： Caroline Day  发表时间：2011年11月8日

'Tiredness and "brain drain" were a regular feature of my life,' said Caroline Day

On a baking June day last year, while my husband Ben and I — Pimm’s in hand — watched Roger Federer on Centre Court at Wimbledon, I became aware of a dull ache in my upper right thigh and groin. 

去年6月烘烤节那一天，我和我的丈夫Ben在现场观看费德勒的温网比赛，手上还拿着Pimm's饮料，突然我感觉到一阵隐约的疼痛，位置就在大腿和腹股沟上面偏右的地方。

I assumed it was due to spending an entire afternoon, albeit a glorious one, perched on a rather hard spectator’s seat.

我以为这是因为整个下午都坐在一个硬邦邦的观众席位上的缘故，幸好比赛还算精彩。

I’d also just turned 40, and was expecting to feel more aches and strains as my body aged. 

而且我也已经进入40岁了，随着身体的日渐衰老，更多地感觉到疼痛和劳累也是情理之中的事。

Indeed, tiredness and ‘brain drain’ were a regular feature of my life now; but I had simply put this down to balancing working from home with bringing up two children, Alex, then ten, and Ava, then six.

I’d often walk into a room and forget why I’d gone in. I complained my brain had melted in pregnancy and never quite recovered.

我经常会走进一个房间然后忘记进去要做什么事情。我抱怨自己的脑子在怀孕的时候化掉了，而且还恢复的不怎么样。

But two days after my Wimbledon trip, during a pub lunch with family, I also began to experience waves of pain around the bottom of my ribs on the right side of my back. 

This was a far more intense pain than the one I’d first felt in my leg, which had continued intermittently since Wimbledon.

这次的疼痛比上次腿上的更加严重，而腿上的疼痛从温网那时起就会不定期地发作。

And when I nipped to the loo, my urine was blood-coloured. Though concerned, I decided to wait to see the doctor the following day.

That night was the first of many I was kept awake by excruciating spasms in my back.

当天晚上，我让背部的一阵阵痉挛折腾地睡不着觉，事实上，在随后的许多个夜晚都是这样。

My GP, when I visited the next morning, immediately suspected a renal calculus, more commonly called a kidney stone. 

第二天一早我去看医生，他立即就怀疑是肾结石。

He referred me for an ultrasound scan, which was performed ten days later and which, along with the emergency CT scan carried out afterwards, revealed not one kidney stone, but a collection of roughly eight. 

医生让我做一次超声波扫描。当我十天之后做完超声波扫描以及紧急CT扫描之后，出来的结果是：肾结石不止一个，而是八个左右。

A kidney stone is a solid mass formed when minerals in our urine crystallise. On my right side, one of these stones had been released into the ureter, the tube that connects the kidney to the bladder. The pain, termed renal colic, was my body straining to expel it.

'Effectively blocked on both sides, my left and right kidneys had become abnormally swollen,' said Caroline

However, while most kidney stones have a diameter of 5mm or less and can be passed out naturally, this one was 8mm — and had lodged at the entrance to my bladder. 

大多数肾结石的直径都在5毫米之内，并且能够自然排除。然而，我的这一个直径达到了8毫米，而且刚好卡在我膀胱的出口处。

Strangely, I’d had no trouble going to the loo, despite the fact that the scan showed another stone, 18mm in diameter, sitting across the left kidney’s opening to the ureter.

奇怪的是，我小便时没有任何困难，尽管扫描结果显示还有一个直径18毫米的结石卡在左肾到输尿管的出口上。

Effectively blocked on both sides, my left and right kidneys had become abnormally swollen. 

由于我两侧的肾脏都被堵塞，它们已经变得异常的肿胀。

Kidney stones are most often formed from calcium — indeed, tests showed the levels of calcium in my blood were far higher than normal. Normal levels are between 2.2 and 2.6 millimoles per litre. Mine at this point, were 3.1 and later reached 3.4.

肾结石通常由钙质形成，测试表明我血液中的钙含量严重超标。正常水平是每升2.2到2.6毫摩尔。而我测试时达到了3.1，随后又升到了3.4。

Kidney stones are known to be caused by a sedentary lifestyle and a low-fibre diet. But my calcium surplus was caused by a common condition called primary hyperparathyroidism.

In some people this causes no symptoms. Others will feel tired and a little unwell, though it will be nothing they can put their finger on.

有的人并不会有任何症状。而有的人却会感觉疲劳和不适，但却说不出为什么。

Often symptoms can be more pronounced. Doctors describe hyperparathyroidism in terms of ‘Stones, bones, moans and groans’. ‘Stones’ and bones are self-explanatory. 

通常情况下，这些症状可以被更好地表述出来。医生用“石头、骨头、呻吟和哼哼”等词汇来形容甲状旁腺功能亢进。这里“石头”和“骨头”的含义简直是不言自明。

‘Moans’ means nausea, constipation or stomach problems, while ‘groans’ refers to psychological symptoms, from depression to confusion.

“呻吟”代表恶心、便秘和胃部不适，而“哼哼”则代表心理症状，包括抑郁和困惑等。

The culprits in all this are the parathyroid glands. There are four of these, each just the size of a grain of rice, which are located in the neck.

这一切的罪魁祸首就是甲状旁腺。人体的甲状旁腺总共有4个，每个的大小和米粒差不多，它们分布在颈部。

Like most people, I’d never even heard of hyperparathyroidism — even though more than half a million of us will be diagnosed with it in our lifetime. 

和其他人一样，我也是从未听说过甲状旁腺功能亢进这回事，尽管存在该问题的人数可能会超过50万。

It is most common in women after the menopause, with the average age of onset 65, though, as in my case, it can strike younger women.

女性多在更年期后患上甲状旁腺功能亢进，平均年龄为65岁，不过我自己的病例说明，不到65岁也有可能患上这种病。

It occurs when one of the parathyroid glands becomes overactive. The role of these glands is to regulate calcium and phosphate in our bloodstream.

甲状旁腺的亢进是引发症状的原因。这些腺体的作用是稳定血液中钙质和磷酸盐的含量。

Levels of calcium in our body fluctuate and a healthy parathyroid monitors these levels to produce parathyroid hormone (PTH) each time they dip. This causes the bones to release calcium and thus to bring blood levels back up. 

人体中钙质的水平是不断波动的，健康的甲状旁腺会监视人体钙质的含量，并在钙质减少时产生甲状旁腺素（PTH）。甲状旁腺素使骨头释放出钙质，并籍此将血液中的钙质提升至正常水平。

Occasionally, though — often due to a non-cancerous growth (or adenoma) on one or more of the parathyroids — these glands continue releasing PTH even when calcium levels are back to normal. 

Because calcium is crucial for transporting messages between nerve cells, too much can affect your mental state, triggering forgetfulness and even depression.

由于钙质是神经细胞之间传递信息的重要物质，过多的钙将影响人的精神状态，引发健忘甚至抑郁。

In the past, elderly sufferers have been initially misdiagnosed with Alzheimer’s when their confused state of mind was caused by hypercalcaemia, high calcium levels.

在过去，老年患者会被误诊为老年痴呆，但他们困惑的精神状态事实上是由超标的钙质引起的。

Too much calcium can affect your mental state, triggering forgetfulness and even depression

       过多的钙将影响人的精神状态，引发健忘甚至抑郁。

But many sufferers won’t even realise they’re ill — even though kidney stones can be forming and bones can be weakening as they release more of their calcium store. 

Michela Rossi, an endocrinologist at Whittington Hospital, London — where my hyperparathyroidism was identified says: ‘We are probably diagnosing more cases of primary hyperparathyroidism than 30 years ago because of routine calcium testing.’ 

伦敦惠廷顿医院的内分泌专家Michela Rossi说：“由于钙质检查的推广，如今我们比30年前更容易诊断出原发性甲状旁腺功能亢进。”（我的病情也是在这家医院确诊的）

This is because if your GP orders investigative blood tests, calcium levels are often included. 

这是因为如果你的医生要求给你做一个血液检查，钙质检查通常是包含在其中的。

Indeed, when it comes to older patients, it is normal to test calcium levels in anyone suffering from mood change or possible Alzheimer’s.

当然，对于精神状态不稳定或可能患有老年痴呆的老年患者而言，检查钙质水平是常规项目。

It was two months after my kidney stones were discovered that doctors finally diagnosed the growth on my parathyroid gland. And in those months, my state deteriorated further.

在我肾结石被发现两个月后，医生最终将病情诊断为甲状旁腺亢进。而我的身体状况也在这两个月里变得更加糟糕。

By autumn last year I couldn’t concentrate. At times I found myself incapable of stringing a coherent sentence together. It was a scary, isolating experience. 

Meanwhile, I had blood tests, scans and X-rays, and infusions of pamidronate, a drug which temporarily brought down my calcium levels. 

患病期间，我会去做血液检查、扫描和X 光，还注射用于暂时降低钙含量的磷酸盐。

It was then discovered  I did, in fact, have a 20mm adenoma on my lower left parathyroid gland. Doctors are still unsure about what causes them, although in some cases (but not mine) there is a family history.

后来，在我左下的甲状旁腺上发现了一个20毫米的腺瘤。医生无法确认引起腺瘤的原因，虽然有时这与遗传有关，但我不是这种情况。

I underwent various removal procedures, including Extra-Corporeal Shock Wave Lithotripsy (ESWL), which targets a stone with shock waves to break it down, and keyhole surgery through my back. 

我做了各种手术，其中包括体外冲击波粉碎结石术（ESWL），还有在背部进行的锁孔手术。

At the same time, it was decided I needed to have my faulty parathyroid removed, which left a 3cm scar on my neck. 

与此同时，医生摘除了我病变的甲状旁腺，于是我的颈部留下了一条3厘米的疤痕。

In milder cases, with older patients or where an operation is risky, doctors are likely to ‘watch and wait’. Medicines called bisphosphonates are an option to bring down calcium levels.

I had two doses of this — delivered directly into my vein, but after each treatment my calcium levels started to rise again within weeks. Dr Rossi was in no doubt that my high levels of calcium indicated surgery was necessary. 

我注射了两剂双磷酸盐，但是我血液中的钙含量在注射完几周后就开始反弹。Rossi医生坚定地认为，我如此之高的钙含量说明必须进行手术。

During the operation last November, my blood was tested to ensure the gland’s removal brought about an expected PTH drop.

在去年11月份进行的手术中，医生检测了我的血液，以确认甲状旁腺的摘除能使甲状旁腺素含量降低。

‘We measure the PTH during this operation,’ explains Mr Tom Kurzawinski, a consultant pancreatic and endocrine surgeon who performs around 100 of the procedures a year, in London, privately and for the NHS.  

“我们在手术过程中测量了甲状旁腺素的水平。” Tom Kurzawinski说。这名胰腺及内分泌的外科顾问在伦敦一年要做约100台这种手术，对私对公都有。

‘If you are removing one gland without looking at the others, you need confirmation you have the right one.We look for a 50 per cent reduction after five or ten minutes.’

“如果你在没有观察其它甲状旁腺之前就摘除了其中一个，你得确认摘除是正确的。我们在摘除后5至10分钟内观察到甲状旁腺素下降了50%。”

Before surgery, Mr Kurzawinski warned me there was a minimal risk — about a 1  per cent chance — of vocal cord damage. 

在手术前，Kurzawinski医生提醒我手术存在微小的风险──大约有1%的可能会给声带造成损伤。

Also, because one parathyroid was overactive, the other three had become dormant. 

而且，由于其中一个甲状旁腺亢进的缘故，其余三个都处于休眠状态。

It was possible they would not reactivate immediately. So I risked temporarily trading hyperparathyroidism for hypoparathyroidism — underactive parathyroid glands. 

这三个甲状旁腺无法立即激活的可能性是存在的。这意味着我冒了一个险，让甲状旁腺机能由亢进变成了减退──即摘除亢进的甲状旁腺而留下那些活性不足的腺体。

Symptoms for this include tingling hands or muscle spasms. Thankfully, after a slight dip, by this September my calcium levels were normal. 

甲状旁腺机能减退会引起手部刺痛或肌肉痉挛。幸好，在经历了一小段低潮后，我的钙含量于今年9月恢复到了正常水平。

A couple of weeks after the operation I felt my energy and concentration returning. It was a huge relief. 

在手术后的几周时间里，我感觉到自己的能量和注意力在逐渐恢复，心里的石头总算落了地。

Now I drink plenty of water to keep my kidneys healthy. I take vitamin D supplements on prescription to help the body absorb calcium and I will be monitored with annual blood tests.

现在我用足量的饮水保证肾脏的健康。我还按照医嘱服用维生素D以帮助身体吸收钙质，并接受一年一次的血液检查。

Touch wood, I’m back to normal. But I find it remarkable that a small change in calcium could have such a big effect on my body and my mind.

真是走运，我又恢复了正常。不过我确实觉得，钙含量的一点点改变就能给我的身体和精神造成如此巨大的影响，实在是不可思议。