Xa i-sensory ichaphazelekayo ngenxa yokulimala okanye isifo, iimbilini ngaphakathi kweso simiso azikwazi ukusebenza ngokufanelekileyo ukuhambisa iimvakalelo kunye neemvakalelo kwingqondo. Oku kusoloko kubangela ukuvakalelwa, okanye ukungahambi kakuhle. Nangona kunjalo, kwiimeko ezithile, xa le nkqubo inobungozi, abantu banokuva ubunzima kwiindawo ezichaphazelekayo.
Intlungu ye-neuropathic ayiqali ngokukhawuleza okanye isombulula ngokukhawuleza; yi Ubuhlungu obungapheliyo imeko ekhokelela kwiimpawu eziqhubekayo zentlungu. Kwabaninzi abantu, ubunzima beempawu zabo banokuxhoma kwaye baxhamle yonke imini. Nangona ubuhlungu be-neuropathic bufanele ukuba buhlobene nemibandela yempilo yesifo se-nerve, njenge-neuropathy ebangelwa isifo sikashukela okanye isisu somgudu, ukulimala kwengqondo okanye umthambo womgudu kunokukhokelela kwintlungu engapheliyo ye-neuropathic. Intlungu ye-neuropathic ikwabizwa ngokuba yintlungu.
Intlungu ye-neuropathic inokungafani neentlungu zesifo. Intlungu ye-neuropathic ayihlakuli nayiphi na imeko okanye i-external stimulus, kodwa kunoko, iimpawu zivela nje ngenxa yokuba inkqubo ye-nervous mayingasebenzi ngokufanelekileyo. Njengokuba kunjalo, abantu ngabanye banokuva iintlungu zentswelo nangona xa inxalenye yomzimba ekhusekileyo okanye eyonakele ingekho apho. Le meko ibizwa ubuhlungu bentlungu ye-phantom, enokuthi ivele kubantu emva kokuba bexoshe.
Ubuhlungu be-nociceptive bubunzima kwaye bukhula ekuphenduleni imeko ethile, njengokuba umntu efumana ukulimala ngokukhawuleza, njengokungena ngomunwe ngesinyundo okanye ukunyathela inzwane xa uhamba ngeengubo zokuhamba. Ngaphezu koko, intlungu ye-nociceptive ihamba ngokukhawuleza xa isayithi elichaphazelekayo liphilisa. Umzimba uqulethe iisensi ze-nerve ezikhethekileyo, ezaziwa ngokuba yi-nociceptors, ezifumanisa umonakalo onobungozi obonakalisa umzimba, njengobushushu obushushu okanye ubanda, uxinzelelo, ukuququzelela kunye nokuchithwa kweekhemikhali. Ezi zibonakaliso ezilumkiso zigqitywa kunye nenkqubo yeentlanzi ukuya kwingqondo, okubangelwa intlungu ye-nociceptive.
Contents
Ziziphi iingozi zobungozi be-Neuropathic Pain?
Nantoni na egalela ukungabikho komsebenzi ngaphakathi kwenkqubo ye-nervous sensory ingakhokelela kubuhlungu be-neuropathic. Ngaloo ndlela, imiba yempilo yengqondo evela kwi-carpal tunnel syndrome, okanye iimeko ezifanayo, ekugqibeleni zingabangela intlungu e-neuropathic. I-trauma, eyabangela ukulimala kwentsholongwane, kunokukhokelela ekubuhlungu kwentlungu. Ezinye iimeko ezinokubangela ukuba abantu bavelise ubuhlungu be-neuropathic zibandakanya: isifo sikashukela, ukusilela kwe-vitamin, umhlaza, i-HIV, isifo, isifo se-sclerosis, i-shingles, kunye neyonyango lomhlaza.
Ziziphi iimeko ezibangelwa ubuhlungu be-neuropathic?
Kukho izimbangela ezininzi apho abantu bahlakulela khona ubuhlungu be-neuropathic. Kodwa kwinqanaba leselula, enye inkcazo yenyusa ukukhululwa kweemvume ezithile ezibonisa intlungu, kunye nekhono elinciphileyo leemisipha ukuze ilandelelanise le miqondiso, iholele ekuveleleni kwentlungu evela kummandla ochaphazelekayo. Ukongezelela, kwintambo yomthambo, ummandla onempawu ezibuhlungu uphinde ulungelelaniswe neenguqu ezihambelana nama-hormone kunye nokulahlekelwa kwamalungu omzimba asebenza ngokuqhelekileyo. Ezi zinguqu ziphumela ekubonweni kwentlungu ngenxa yokungabikho kwangaphandle. Kwingqondo, ukukwazi ukukhusela intlungu kunokuchaphazeleka emva kokulimala, njengokubetha okanye ukuphazamiseka ngenxa yokulimala. Njengoko kudlula ixesha, umonakalo olongezelelweyo lweseli luya kwenzeka kwaye intlungu yesifo iyaqhubeka. Intlungu ye-neuropathic idibene nesifo sikashukela, isifo esingasigxina sotywala, izifo ezithile zomshukela, ubunqongophe be-vitamin B, izifo, ezinye izifo ezinxulumene nesifo, iibisi, kunye neziyobisi ezithile.
Ziziphi iimpawu zoPhando lwe-Neuropathic?
Ngokuchasene nezinye iimeko ze-neurological, ukubonakaliswa kweentlungu zesifo se-neuropathic kunokuba nzima. Nangona kunjalo, ezininzi, ukuba zikhona, iimpawu zephambili zikhona. Abaqeqeshi bempilo kufuneka baqaphele kwaye baguqule ukuxhaswa kwamazwi asebenzisa izigulane ukuchaza intlungu. Izigulane zingachaza iimpawu zabo njengezibukhali, ezinotshani, ezitshisa, ezibandayo, ezinobunzima, ezinobunzima, ezinzulu, ezitshitshisayo, ezitshisayo, phakathi kwezinye iindidi ezichazayo. Ukongezelela, ezinye izigulane zinokuva iintlungu ngenxa yokuchukumisa ukukhanya okanye uxinzelelo.
Ngomgudu wokunceda ukufumanisa ukuba ziphi izigulana ezibuhlungu ezibangelwayo, izikali ezahlukeneyo zisetyenziswa rhoqo. Izigulane zicelwa ukuba zilinganise intlungu yazo ngokwezinga elibonakalayo okanye igrafu yamanani. Imimandla emininzi yeentlungu ezikhoyo, njengaleyo iboniswe ngezantsi. Ngokuqhelekileyo, imifanekiso yobuso ebonisa iintlobo ezahlukeneyo zentlungu inokuba luncedo xa abantu bexesha elinzima bachaza ubuninzi beentlungu abahlangabezana nazo.
Ubuhlungu obungapheliyo kunye neMpilo yengqondo
Kwabaninzi, impembelelo yobuhlungu obungapheliyo ayinakuphelelwa kwintlungu; kusenokuchaphazela kakubi isimo sabo sengqondo. Ucwaningo olutsha olwenziwa ngabaososayensi kwiYunivesithi yaseNorweswestern e Chicago lungachaza ukuba kutheni abantu abaneentlungu ezingapheliyo banenkxalabo enempilo, njengokudandatheka, ukuxinezeleka, ukungabikho kokulala kunye nobunzima bokugxila.
Uvavanyo lwabonisa ukuba abantu abaneentlungu ezingapheliyo babonisa imimandla eyahlukeneyo yengqondo ehlala ikhuthele, ngokukodwa, indawo ehambelana nomoya kunye nokuqwalaselwa. Le ntshukumo eqhubekayo ibuyisela kwakhona uxhumano lweentambo ezisuka kwingqondo kwaye ishiya iintlungu ezingapheliyo ezinobungozi obukhulu kwimingcipheko yengqondo. Abaphandi bacetyisa ukuba ukubonakaliswa kweentlungu rhoqo kunokubangela ukuguqulwa kwengqondo okuphazamisa ingqondo. Ukukhwabanisa kuphoqa ubulumko babo ukuba banikezele izixhobo zengqondo ngokwahlukileyo ukujongana nemisebenzi yansuku zonke, ukusuka kwimathematika, ukukhumbula uluhlu lokuthengwa, ukuvuyisa.
Ukuxhamla kwengqondo-ubuchopho sele kubhalwe kakuhle, ubuncinci, kunye nabaninzi beengcali zokunakekelwa kwezempilo bathi babone isandla sokuqala ngendlela yengqondo yengqondo yesigulane ingahlahla ngayo xa ixinzezelekile intlungu. Iingcamango ezinzulu malunga nokuxhamla kwengqondo-intlungu zingabonakala ngenxa yokungabikho kobubungqina bokuba intlungu inomlinganiselo onokulinganisa, ohlala njalo kwingqondo. Abaphengululi balindele ukuba uphando olongezelelweyo malunga nendlela yokwenza ubuhlungu obungapheliyo bangela ukuba abantu baninzi banenkinga yokukhathazeka kwemizwelo, abantu baya kuba nokukwazi ukulawula kakuhle impilo yabo yonke.
Inkcubeko kunye nobuhlungu obungapheliyo
Zininzi izinto ezenza ukuba sibone indlela ethetha ngayo kwaye siveze intlungu, nangona kunjalo, kwakhona kuphakanyiswe ngabaphandi ukuba inkcubeko ibhekise ngqo kwiintlungu. Imilinganiselo yethu yokukhulisa kunye neentlalo zichaphazela indlela esibonisa ngayo intlungu kunye nobume bayo, ubunzulu nobude. Nangona kunjalo, ezi zintlukwano azibonakali njengemilinganiselo yentlalo-yengqondo, njengeminyaka yobudala kunye nesondo.
Uphando lubonisa ukuba intlungu engapheliyo yinkqubo eninzi kunye nokusebenzisana okufanayo phakathi kwe-pathophysiology, ingqiqo, ukuziphatha, kunye neenkcubeko kunye nezimo zenkcubeko kunye neziganeko zentlalo. Kuye kwavela ukuba intlungu engapheliyo yahluke ngokuhlukileyo phakathi kwezigulane zenkcubeko kunye noluntu.
Ezinye iinkcubeko zikhuthaza ukubonakalisa intlungu, ngakumbi kwi-Méditerali naseMpumalanga Mpuma. Abanye abantu bayayicima, njengokuba kukho ezininzi izifundo kwizingane zethu ngokuziphatha ngokuzibindi kwaye singakhange sikhale. Ubuhlungu buyabonwa njengenxalenye yamava abantu. Siyakwazi ukucinga ukuba ukunxibelelana malunga nentlungu kuya kuhamba imida yenkcubeko. Kodwa abantu beentlungu baxhomekeke kwimimiselo yabo impucuko baye baqeqesha ukuba baveze kwaye baveze intlungu.
Bobabini abantu beentlungu kunye nabaqeqeshi bezempilo bafumana ubunzima bokuthetha intlungu kwimida yonxulumene neentlanga. Kwimiba enjengeentlungu, apho unxibelelwano olufanelekileyo lunokuba nefuthe elide ekunakekeleni unyango, umgangatho wobomi kunye nokuba usaphila, indima yenkcubeko kwiintlungu zokunxibelelana ihlala ingaphononongwa. Intlungu eqhubekayo yimiba emininzi, ukudibanisa okudibeneyo eyenziwe ngokubambisana kunye nokuchaphazela ngokubambisana izinto eziphilayo kunye nengqondo. Ukukwazi ukuphela kwezi zinto kubalulekile ukuqonda ukungafani kokubonakaliswa nokuphathwa kwayo.
Ngaba i-Neuropathic Pain Diagnosed?
Ukuxilongwa kweentlungu ze-neuropathic kuxhomekeke ekuhloleni okongeziweyo kwimbali yomntu. Ukuba isalathiso se-nervous is suspected, ngoko uhlalutyo lweentlungu kunye nokuvavanywa lunokugwetyelwa. Iindlela eziqhelekileyo zokuvavanya ukuba ingekho inzwa yenzalo eyalimalayo usebenzisa i-electrodiagnostic medicine. I-subspecialty yonyango isebenzisa ubuchule bokuqhutyelwa kwezifundo zesondlo nge-electromyelography (NCS / EMG). Ukuvavanywa kwezonyango kunokubonisa ubungqina bokulahlekelwa komsebenzi, kwaye kunokubandakanya uvavanyo lokuthintela ukukhanya, amandla okuhlukanisa ubuhlungu obubuhlungu kunye nokukwazi ukuqonda ukushisa, kwakunye nokuvavanya kokutshintsha.
Emva kokuba uvavanyo olupheleleyo lweklinikhi lugqityiwe, uhlalutyo lwe-electrodiagnostic lungacwangciswa. Ezi zifundo ziqhutywa yi-neurologist ne-physiatrists. Ukuba i-neuropathy ikhunjulwa, ukuzingela izizathu ezibuyiselwayo kufuneka kufezekiswe. Oku kunokubandakanya umsebenzi wegazi ngenxa yokusilela kwevithamini okanye iingxaki ze-thyroid, kunye nezifundo zokucinga ukuba ungabandakanyi i-lesion yesakhiwo echaphazela intambo yomgogodla. Ngokuxhomekeke kwiziphumo zolu vavanyo, kunokuba neendlela zokunciphisa ubunzima be-neuropathy kwaye mhlawumbi unciphise intlungu eyenziwa isigulane.
Ngokudabukisayo, kwiimeko ezininzi, ukulawulwa kakuhle kweyona nto ebangela ukuba i-neuropathy ingakwazi ukuguqula ubuhlungu be-neuropathic. Oku kubonakala ngokuqhelekileyo kwizigulane ezinentsholongwane yesifo sikashukela. Kwiimeko ezinqabileyo, kunokukho iimpawu zenguqu kwimizekelo yokukhula kwesikhumba kunye neenwele kwindawo echaphazelekayo. Ezi zinguqu zinokudityaniswa neenguqu zokufuma. Ukuba kukho, olu tshintsho lunokukunceda ukufumanisa ukuba kukho ubuhlungu beentlungu ezihlobene neemeko ezibizwa ngokuba yintlungu yesifo seengingqi.
Insight of Dr. Alex Jimenez
Intlungu ye-neuropathic yimeko yokubuhlungu engapheliyo ngokuqhelekileyo inxulumene nomonakalo othe ngqo okanye ukulimala kwinkqubo yesantya okanye kwiisondlo. Olu hlobo lentlungu luhluke kwiintlungu zesifo se-nociceptive, okanye uvakalelo oluqhelekileyo lweentlungu. Intlungu ye-nociceptive yintlungu okanye ivakalelwa ngokukhawuleza intlungu eyenza inkqubo ye-nervous ithumele iimpawu zentlungu kamva emva kokuxhwaleka. Noko ke, ngenxa yentlungu, iigulane zinokubuhlungu, ukuvutha kwentlungu ngaphandle kokulimala okanye ukulimala ngqo. Ukuqonda izizathu ezibangelwa yintlungu yesifo sengqondo kunye naluphi na uhlobo lwentlungu, lunokunceda abaqeqeshi bezempilo ukuba bafumane iindlela ezingcono zokuphatha iimeko ezibuhlungu ezingapheliyo.
Iyintoni iNyango yePauropathic Pain?
Amayeza ahlukeneyo asetyenziselwa ukuzama ukunyanga iintlungu. Uninzi lwala machiza lusetyenziswa kwi-ileyile, oko kuthetha ukuba iyeza lavunywa yi-FDA ukuphatha izimo ezahlukileyo kwaye kwaye kwabonakala njengenzuzo yokuphatha intlungu e-neuropathic. I-tricyclic antidepressants, efana ne-amitriptyline, i-nortriptyline kunye ne-desipramine, imiselwe ukuba ilawulwe intlungu ye-neuropathic iminyaka emininzi.
Abanye abantu bafumanisa ukuba oku kunokuba luncedo kakhulu ekubancedeni. Ezinye iintlobo ze-antidepressants ziye zaboniswa ukuba zinike inkxaso. I-serotonin i-reuptake inhibitors, okanye ii-SSRI, ezifana ne-paroxetine kunye ne-citalopram, kunye nezinye izidakamizwa, ezifana ne-venlafaxine kunye ne-bupropion, ziye zasebenziswa kwizigulane ezithile. Olunye unyango oluqhelekileyo lweentlungu zesifo se-neuropathic luquka imishanguzo yokuxhatshazwa, kuquka ne-carbamazepine, i-phenytoin, i-gabapentin, i-lamotrigine kunye nabanye.
Kwiimeko ezinzima ze-neuropathy ezibuhlungu ezingaphenduliyo kubathengi bokuqala, amachiza asetyenziswa ngokusesikweni ukulawula i-arrhythmias yenhliziyo ingaba yinzuzo ethile; nangona kunjalo, oku kungakhokelela kwimiphumo ebalulekileyo kwaye kufuneka ukuba ihlolwe ngokukhawuleza. Imichiza esetyenziswa ngokuthe ngqo kwesikhumba inokunikela ngokuthobeka ukufumana inzuzo kwizigulane ezithile. Iifom ezisetyenziswa ngokubanzi ziquka i-lidocaine (kwipaki okanye uhlobo lwe-gel) okanye i-capsaicin.
Ukunyanga ubuhlungu be-neuropathic kuxhomekeke kwisizathu esiyintloko. Ukuba isisombululo sibuyiselwa, ngoko iimbilini ze-peripheral ziyakwazi ukuhlaziywa kwaye intlungu iya kuphelisa; Nangona kunjalo, ukunciphisa intlungu kunokuthatha inyanga eziliqela ukuya kwiminyaka. Ezinye iindlela zokwenza unyango, ezinokuquka ukunakekelwa kwe-chiropractic kunye nonyango, zingasetyenziselwa ukunceda ukuxhatshazwa nokuxinezeleka kunye neentlungu, ekugqibeleni kunceda ukuphucula iimpawu ezibuhlungu.
Yintoni i-Prognosis ye-Pauro ne-Neuropathic Pain?
Abantu abaninzi abaneentlungu zesifo se-neuropathic bayakwazi ukufumana uncedo olunjalo, nangona intlungu yabo iqhubeka. Nangona ubuhlungu be-neuropathic abuyingozi kwisigulane, ubukho bentlungu engapheliyo lunokuchaphazela kakubi ubomi bomgangatho. Izigulane ezinentlungu engapheliyo zingabandezeleka ngenxa yobunzima bokulala okanye ukukhathazeka kwemizwelo, kuquka ukuxinezeleka, uxhalaba kunye nokuxinezeleka, njengoko kuchazwe ngasentla. Ngenxa ye-alopecia ebonakalayo kunye nokuntula kwengxelo engqondweni, izigulane zisengozini yokuhlaselwa okanye ukusuleleka okanye ukungazi ngokukrakra ukulimala okwangoku. Ngoko ke, kubalulekile ukufumana unyango olusisiseko kwaye ulandele izikhokelo ezithile ezilawulwa ngunyango lwezempilo ukuze ukhusele kwaye uqaphele.
Ngaba ubuhlungu be-Neuropathic buya kuthinteka?
Indlela efanelekileyo yokuthintela intlungu ye-neuropathic kukuphepha ukuphuhliswa okanye ukuqhubela phambili kwe-neuropathy. Ukubeka iliso kunye nokutshintsha iindlela zokuphila, kubandakanywa nokunciphisa ukusetyenziswa kotywala kunye necuba; ukugcina ubunzima obunempilo ukunciphisa amathuba okuba nesifo seswekile, isifo se-joint degenerative, okanye i-stroke; kunye nokuba nefomu enkulu ye-ergonomic emsebenzini okanye xa uqhuba izinto zokuzilibazisa ukunciphisa umngcipheko wokulimala okuphindaphindiweyo koxinzelelo zizicwangciso zokunciphisa amathuba okuphuhlisa i-neuropathy kunye neentlungu ezinokuthi zibe ne-neuropathic. Qinisekisa ukuba ufune unyango olukhawulezileyo kwimeko yazo naziphi na iimpawu ezinxulumene neentlungu ze-neuropathic ukwenzela ukuba uqhubeke neyona ndlela yonyango efanelekileyo. Ukuxoxa ngalo mbandela, nceda uzive ukhululekile ukubuza uGqr. Jimenez okanye uqhagamshelane nathi apha915-850-0900 .
Ikhutshwe nguDkt. Alex Jimenez
Imixholo eyongezelelweyo: Ubunzima bokubuyisela
Umqolo obuhlungu enye yezona zizathu ezibangeleko zokukhubazeka kunye neentsuku eziphosakeleyo emhlabeni wonke. Njengokuba kunjalo, iintlungu zenziwa emva kweyona sibini isizathu esivakalayo sokutyelela iofisi yee-dkt. Ngokumalunga neepesenti ze-80 zabemi ziya kuba nolunye uhlobo lweentlungu zentlungu ubuncinane kanye kanye ebomini babo. Umgudu uyisakhiwo esiyinkimbinkimbi esakhiwa ngamathambo, amajoyina, iigaments kunye nezihlunu, phakathi kwezinye iifomthi ezithambileyo. Ngenxa yoko, ukulimala kunye / okanye iimeko ezihlaziyiweyo, ezifana disni, ekugqibeleni unokukhokelela kwiimpawu zentlungu. Ukulimala kwezemidlalo okanye ukulimala kwengozi yeemoto ngokuqhelekileyo kubangelwa yintlungu yokubuhlungu, kodwa ngamanye amaxesha ukuhamba kwezinto ezilula kunokuba neziphumo ezibuhlungu. Ngethamsanqa, ezinye iindlela zokhathalela unyango, ezifana nokunyamekelwa kwe-chiropractic, kunokunceda ukubuyisela intlungu emva kokusetyenziswa kwemilenze kunye nokunyanzeliswa kwemigaqo, ekugqibeleni ukuphucula intlungu.
ISIHLOKO ESIBALULEKILEYO: Ulawulo oluPhantsi lwePain Pain
IINKCUKACHA NGOKUGQITHISILEYO: UKONGEZA KWEZINTLOKO: PainUbuhlungu obungapheliyo kunye nonyango
Umgangatho wobuchule wokuSebenza *
Ulwazi olulapha ku "Iyintoni Intlungu ye-Neuropathic?"Akujoliswanga ukuthatha indawo yobudlelwane obubodwa kunye nomntu oqeqeshiweyo wezempilo okanye ugqirha onelayisensi kwaye akusiyo isiluleko sonyango. Sikhuthaza ukuba wenze izigqibo zezempilo ngokusekelwe kuphando lwakho kunye nentsebenziswano kunye nochwepheshe bezempilo abaqeqeshiweyo.
Ulwazi lweBlog kunye neengxoxo zoMda
Umda wethu wolwazi ilinganiselwe kwiChiropractic, i-musculoskeletal, amayeza omzimba, impilo, igalelo le-etiological ukuphazamiseka kwe-viscerosomatic ngaphakathi kweentetho zeklinikhi, ezinxulumene ne-somatovisceral reflex clinical dynamics, i-subluxation complexes, imiba yezempilo ebuthathaka, kunye / okanye amanqaku amayeza asebenzayo, izihloko kunye neengxoxo.
Sibonelela kwaye sibonise intsebenziswano yeklinikhi neengcaphephe kumacandelo ahlukeneyo. Ingcali nganye ilawulwa ngumsebenzi wabo wobugcisa kunye negunya labo lokufumana iphepha-mvume. Sisebenzisa iiprothokholi ezisebenzayo zempilo kunye nempilo entle ukunyanga nokuxhasa ukhathalelo lokwenzakala okanye ukuphazamiseka kwenkqubo ye-musculoskeletal.
Iividiyo zethu, izithuba, izihloko, imixholo, kunye nokuqonda zibandakanya imiba yezonyango, imiba, kunye nezihloko eziyelelene kwaye zixhase ngokuthe ngqo okanye ngokungathanga ngqo umda wokuziqhelanisa wethu.
I-ofisi yethu izamile ngokufanelekileyo ukubonelela ngeengcaphulo ezixhasayo kwaye ichonge uphando olufanelekileyo lophando okanye izifundo ezixhasa izithuba zethu. Sinikezela ngeekopi zophando ezixhasayo ezifumanekayo kwiibhodi ezilawulayo nakuluntu ngesicelo.
Siyaqonda ukuba sigubungela imicimbi efuna inkcazo eyongezelelweyo yokuba inganceda njani kwisicwangciso esithile sokhathalelo okanye inkqubo yonyango; ke, ukuqhubeka nokuxoxa ngombandela ongentla, nceda ukhululeke ukubuza UDkt Alex Jimenez, DC, okanye qha ga mshelana nathi 915-850-0900.
Silapha ukunceda wena kunye nosapho lwakho.
Iintsikelelo
UDkt Alex Jimenez D.C., I-MSACP, RN*, I-CCST, IFMCP*, I-CIFM*, I-ATN*
email: qeqeshi@elpasofunctionalmedicine.com
Ilayisenisi njengoGqirha weChiropractic (DC) kwi Texas & New Mexico*
Texas DC Ilayisensi # TX5807, New Mexico DC Ilayisensi # I-NM-DC2182
Unikwe Ilayisensi njengoMongikazi oBhalisiweyo (RN*) in Florida
Florida License RN Ilayisensi # I-RN9617241 (Nombolo yolawulo. 3558029)
Ubume obubambeneyo: ILayisensi yeeNkcazo ezininzi: Ugunyaziswe Ukuziqhelanisa I-40 States*
UGqr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
Ikhadi lam loShishino lweDijithali
