So womene aduan ne anonne nso wɔ kokoam? Momma yɛnka Silent Aspiration ho asɛm!

Ɛyɛ ade a ɛfata sɛ yɛbɛmene yɛn ho kakra bere a yɛredi anaa yɛrenom no. Nanso so wunim sɛ ɛtɔ mmere bi a nneɛma te sɛ aduan ne anonne tumi wia yɛn ho kɔ yɛn mframa kwan mu a yenhu ɔfe anaa ɔhaw biara mpo? Ɛno ne nea yɛfrɛ no "silent aspiration." Eyi yɛ biribi a ɛsɛ sɛ wɔhwɛ yiye wɔ ho, titiriw ma awofo a wɔwɔ mmofra nkumaa.

Dɛn ne Kommyɛ Apɛde?

Sɛ yɛbɛka no tiawa a, ``Silent Aspiration`` yɛ bere a wunhyɛ da home aduan, anonne, nnompe, anaa yafunu mu acid kɔ wo mframa kwan (trachea) mu. Mpɛn pii no, sɛ yɛmene a, ntini ne ntini a ɛwɔ yɛn ano ne yɛn menewa mu no bom pia aduan no kɔ yafunu no mu tẽẽ, sen sɛ ɛbɛkɔ mframa afiri no mu. Akwan ketewa bi wɔ yɛn menewa atifi a wɔfrɛ no ``Epiglottis``. Sɛ yɛmene a, saa anim yi to mu, na ɛkata mframa afiri no so. Enti sɛ saa ntini, ntini, ne ``Epiglottis`` reyɛ adwuma yiye a, aduan no kɔ yafunu no mu na mframa kɔ ahurututu no mu.

Nanso obi a ɔwɔ ``Silent Aspiration'' no nkɔfe anaasɛ ɔnte nka sɛ saa nneɛma yi akɔ mframa mu. Ɛno nti na wɔde asɛmfua "komm" aka ho no. Saa kwan yi so no, ɛnyɛ aduan, anonne, ne nnompe nko, na mmom nnipa binom nso, yafunu mu acid (acid a ɛba menewam wɔ tebea horow te sɛ gastritis - ``Acid Reflux'') betumi akɔ mframa mu wɔ kokoam.

Dɛn na eyi yɛ nipadua no?

Ebia ade ketewaa a ɛtɔ mmere bi a ɛkyere mframa kwan no mu no renyɛ ɔhaw kɛse. Mpɛn pii no, yɛn nipadua no ɔfe.

Nanso sɛ wowɔ ``Silent Aspiration'' a, ebia worenhu sɛ ɛrekɔ so anaasɛ mpɛn dodow a ɛkɔ so. Sɛ wokɔ so nya nsuo kɔ wo mframa kwan mu saa a, wobɛtumi anya tebea bi a wɔfrɛ no ``Aspiration Pneumonia'', a ɛyɛ ɔyareɛ a ɛwɔ w'ahurututu mu. Sɛ wɔansa no yiye a, ``Aspiration Pneumonia'' betumi ayɛ asiane kɛse.

Dɛn ne sɛnkyerɛnne ahorow a ɛkyerɛ sɛ obi pɛ komm?

Ebia nnipa a wɔwɔ ``Silent Aspiration'' no renkyerɛ sɛnkyerɛnne biara. Nanso, sɛ sɛnkyerɛnne ahorow bi wɔ hɔ a, ebetumi ayɛ soronko a egyina wo – anaa wo ba no – mfe so. Nkokoaa nkumaa a wɔwɔ ``Silent Aspiration'' betumi ada sɛnkyerɛnne te sɛ:

• Wo home kɔ soro anaasɛ wo home bere a worema nufu no.
• Mpɛn pii no, wunya atiridii kakra a ntease biara nnim, anaasɛ wunya nyarewa wɔ ɔhome nhyehyɛe no mu, titiriw ahurututu mu.
• Wɔmpɛ sɛ wɔbɛnom nufusu, na wɔdan wɔn anim fi toa anaa nufusu no ho.
• Sɛ wɔnom nufusu wie a, nnyigyei "nsu" bi ba nne no mu, te sɛ nea nsuo wɔ mu, anaa nnyigyei a ɛte saa bere a wɔresu.

Mmofra a wɔn mfe akɔ anim ne mpanyimfo betumi anya sɛnkyerɛnne ahorow a edidi so yi sɛ wɔwɔ ``Silent Aspiration'' a:

• Ahome a wɔhome kɔ soro bere a wɔredidi no.
• Mete nka sɛ biribi akɔhyɛ me menewam.
• Mmofra a wɔretu mmirika ka sɛ wontumi nnidi na wɔpow.
• Me hwene tow bere a madi awie no, nanso ɛkɔ bere tiaa bi akyi.
• Nnyigyei a ɛyɛ dede bi ba a ntease biara nnim, na dede bi ba bere a wɔrehome no.
• Sɛ wodidi wie a, ɛnne no sesa te sɛ nea nsõ wɔ menewam.
• Ɔhome mu nyarewa te sɛ ahurututu mu yare taa ba.

Dɛn na ɛde eyi ba?

Nneɛma pii nti na ``Silent Aspiration'' betumi aba. Ɛtɔ da bi a, ebetumi asi a ntease biara nnim na ebetumi asi ara kwa. Nanso mpɛn pii no wohu wɔ nnipa a wɔwɔ aduruyɛ mu tebea bi a ɛmma wontumi mene ade no mu. Nhwɛsoɔ:

• Anofafa a apaapae anaasɛ anom a apaapae.
• Ɛyɛ den sɛ ɔbɛmene (Dysphagia) anaasɛ ɛnne nhama a ɛyɛ mmerɛw.
• Yare a Ɛma Yafunu Mu Nsu a Ɛsan Fa Yafunu Mu (GERD). Nnipa a wɔwɔ saa tebea yi betumi ama yafunu mu acid akɔ soro akɔ mframa afiri no mu a wonnim.
• Tebea bi a wɔfrɛ no ``Laryngomalacia.`` Eyi ka akokoaa no ahurututu (nne adaka), na ebetumi ama ayɛ den sɛ ɔbɛmene na ama asiane a ɛwɔ hɔ sɛ obenya ``GERD.`` no ayɛ kɛse
• Ɔhaw ahorow a ɛfa amemene ne ntini ahorow ho. Sɛ nhwɛso no, tebea horow te sɛ Cerebral Palsy, Multiple Sclerosis (MS), akisikuru, anaa amemene mu opira anaa akisikuru a atwam.
• Tubes a wɔde guu menewa no ase esiane aduruyɛ mu tebea afoforo nti. Sɛ nhwɛso no, nasogastric tube anaasɛ tracheostomy tube.

Hena na ɔwɔ asiane kɛse mu sɛ obenya eyi?

Saa tebea yi a wɔfrɛ no ``Silent Aspiration'' betumi aka obiara fi nkokoaa nkumaa so kosi wɔn a wɔn mfe akɔ anim so. Nanso momma yɛnhwɛ nea ɔwɔ asiane kɛse mu:

• Nkokoaa nkumaa: Nkokoaa ntumi nka nkyerɛ wo sɛ wɔn menewa mu yɛ wɔn yaw anaasɛ ɛyɛ den ma wɔn sɛ wobedi. Enti ɛyɛ den sɛ wobɛhunu sɛ wɔwɔ ``Silent Aspiration'' anaa. Afei nso, esiane sɛ wɔtaa di nnuan a ɛyɛ nsu nti, ɛnyɛ den sɛ nsu bɛkɔ mframa kwan no mu sen nnuan a ɛyɛ den.
• Nnipa a wɔwɔ nyarewa a enni sabea anaa wɔadi dɛm: Nyarewa pii te sɛ multiple sclerosis (MS) anaa akisikuru betumi aka sɛnea wutumi mene ade. Saa akwahosan tebea horow a ɛka menewa yi ma asiane a ɛwɔ hɔ sɛ obi bɛtwetwe obi a ɔyɛ komm no yɛ kɛse.
• Nkwakoraa ne mmerewa: Tebea horow te sɛ adwenemhaw ne akisikuru abu so wɔ onyin mu. Eyinom betumi ama nsakrae aba sɛnea womene ade mu na ebetumi ama wunhu sɛ biribi akɔhyɛ wo menewam.

Wobɛyɛ dɛn ahu eyi?

Sɛ worehu sɛ wowɔ kommyɛ mu aspiration a, ade a edi kan a wo duruyɛfo bɛtaa ayɛ ne sɛ ɔbɛhwehwɛ wo hwene, w’ano, ne w’ahurututu mu na wasusuw w’aduruyɛ ho abakɔsɛm ho. Sɛ wo ba no wɔ saa sɛnkyerɛnne ahorow yi a, ɛda adi sɛ wo duruyɛfo no de nhwehwɛmu koro no ara befi ase.

Sɛ ɛho hia a, oduruyɛfo no betumi ahyɛ sɛ wɔnyɛ nhwehwɛmu bi mfa nhwɛ wo menewa mu na wɔhwɛ sɛnea womene. Ebia ɛho behia sɛ wo anaa wo ba no yɛ nhwehwɛmu te sɛ eyinom:

• Koko so X-ray: .Eyi yɛ sɔhwɛ a ɛnyɛ yaw. Ɛtwa w’ahurututu ne wo moma so mfonini. Ebetumi ahwɛ sɛ ahurututu mu yare wɔ w’ahurututu mu na ahwɛ nneɛma a ɛwɔ wo menewa ne wo home nhyehyɛe mu.
• Fiber-optic Endoscopic Evaluation of Swallowing (FEES): Wɔ sɔhwɛ yi mu no, oduruyɛfo no de afiri a ɛyɛ tratraa bi a mfoninitwa afiri bi fa wo hwene mu abata ho hyɛ mu. Eyi tumi hu wo menewa mu bere a womene no. Ɛtɔ da bi a, wobetumi ama wo nsu titiriw bi anom na aboa ma woahu nea woremene no yiye.
• Laryngoscopy: Wɔ saa adeyɛ yi mu no, oduruyɛfo no de afiri teateaa bi a wɔde mfoninitwa afiri ahyɛ mu hwɛ wo menewa.
• Upper GI series: Ansa na wɔbɛyɛ X-ray yi no, wɔbɛma wo nsu (barium) bi anom, na ɛbɛda adi wɔ X-ray no so. Eyi betumi aboa ma wɔahu ɔhaw ahorow wɔ aduan mu a ebetumi de tebea horow te sɛ GERD aba.

Ɔkwan bɛn so na wɔsa eyi?

Sɛ woresa ``Silent Aspiration'' a, adeɛ a ɛdi kan a ɛsɛ sɛ woyɛ ne sɛ wobɛsa tebea a ɛwɔ aseɛ a ɛde baeɛ no. Nhwɛsoɔ:

• Sɛ wowɔ GERD a, ebia wo duruyɛfo bɛkyerɛw wo nnuru a ɛbɛma yafunu mu acid a ɛbɛsen akɔ wo menewam no ano.
• Sɛ wo ba no nya aspiration a ɛnyɛ den bere a ɔrema nufu a, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ fa wo ba no gyina hɔ tẽẽ bere a worema no aduan no. Saa gyinabea a ɛteɛ yi betumi aboa wo ba ma wamene nufusu anaa nufusu a wɔde ma no ntɛm.
• Ebia nkokoaa a wɔtaa memene wɔn nufusu anaa nufusu a wɔde ma no behia aduan a wɔayɛ mu nsakrae a aduan a ɛyɛ den wom. Sɛ tebea no mu yɛ den a, ebia ebehia sɛ wɔde bere tiaa mu afiri a wɔde ma wɔn aduan fa hwene anaa yafunu mu hyɛ mu. Mpɛn pii no, nnuruyɛfo yi afiri no fi hɔ bere a akokoaa no tumi mene ade yiye no.
• Obi a n’ano anaa n’anom apaapae no betumi amene sɛnea ɛsɛ bere a wɔayɛ no oprehyɛn asiesie no.

Bere a wo duruyɛfo no asa nea ɛde ba no akyi no, ebia ɔbɛyɛ nhwehwɛmu foforo ahwɛ sɛ ebia wo mene tumi no atu mpɔn anaa.

So wobetumi asiw Silent Aspiration ano?

Ɔkwan biara nni hɔ a ɛda adi pefee a wɔbɛfa so asiw ``Silent Aspiration'' ano. Nanso wubetumi ama wo ne wo ba no anya apɔwmuden denam wo duruyɛfo a wobɛkɔ akɔhwɛ wo daa na woakɔhwɛ wo ho no so. Sɛ w’adwene mu yɛ wo naa wɔ w’akwahosan anaa wo ba no akwahosan ho a, wo ne wo duruyɛfo nkasa. Wo duruyɛfo wɔ hɔ sɛ obesiw akwahosan ho haw ano na wama no ayaresa bere a ɛho hia.

Nea ɛho hia sen biara ne sɛ wo ne oduruyɛfo bɛkasa sɛ w’adwene mu yɛ wo naa, ketewaa bi mpo a.

Sɛ mewɔ (Silent Aspiration) a, dɛn na ɛba?

Wɔ nkokoaa mu no, ``Silent Aspiration'' betumi akɔ n'ankasa bere a wɔrenyin no. Nanso, sɛ aduruyɛ mu tebea pɔtee bi na ɛde wo anaa wo ba no ho sɛnkyerɛnne no ba a, ade a edi kan a ɛsɛ sɛ woyɛ ne sɛ wubehu nea ɛde ba.

Sɛ wɔsa nea ɛde ba no yiye a, mpɛn pii no wobetumi asa ``Silent Aspiration'', na wubetumi atra ase a ahoɔden wom. Bisa wo duruyɛfo sɛ ɛsɛ sɛ wokɔ no nkyɛn daa na woahwɛ wo tebea no anaa.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wo ba no wɔ sɛnkyerɛnne ahorow a ɛkyerɛ sɛ ne menewa, anaasɛ wususuw sɛ ebia wo ba no wɔ ``Silent Aspiration,'' a, kɔ wo ba no oduruyɛfo nkyɛn ntɛm ara. Afei nso, hwɛ wo ba no mu duru na kɔyɛ akwahosan ho nhwehwɛmu sɛnea wo duruyɛfo kamfo kyerɛ no. Eyi nso betumi aboa ma wo ba no anya aduannuru a ohia.

Sɛ wowɔ GERD ho sɛnkyerɛnne anaasɛ ɛyɛ den sɛ wobɛmene a, yɛ nhyehyɛe kɔ oduruyɛfo nkyɛn. Ɛdenam nhwehwɛmu a ɛfata a wobɛyɛ na woasa w’akwahosan tebea horow so no, wubetumi asiw aspiration a ɛyɛ komm ne nsɛnnennen afoforo ano.

Bere bɛn na ɛsɛ sɛ mekɔ Emergency Department (ETU) ?

Hwehwɛ ayaresa a egye ntɛmpɛ ntɛm ara sɛ wo ba no wɔ nea edidi so yi mu biara a:

• Sɛ honam ani yɛ bruu a.
• Sɛ ɛyɛ den ma wo sɛ wobɛhome a.
• Atiridiinini a ɛboro digrii F 100.4 (digrii C 38) sɛ akokoaa no nni asram 3 a, anaasɛ atiridii a ɛboro digrii F 102.2 (digrii C 39) sɛ akokoaa no adi fi asram 3 kosi mfe 3 a.
• Sɛ ɛyɛ den sɛ wobɛsɔre afi nna mu a.

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi bi a, hwehwɛ ayaresa ntɛm ara:

• Sɛ wuntumi nmene sɛnea ɛsɛ a.
• Sɛ wote nka sɛ worehyia ɔhaw wɔ ahome anaasɛ wo menewa mu a.
• Sɛ wowɔ koko mu yaw a.
• Sɛ wote nka sɛ aduan anaa biribi akɔhyɛ wo menewam anaa mframa afiri mu a.

Aspiration a ɛyɛ komm betumi ayɛ ade a ɛyɛ hu, titiriw sɛ ɛka wo ba no a. Nanso asɛmpa no ne sɛ wobetumi adi ahomegye a ɛyɛ komm no so anaasɛ wɔasa denam nea ɛde ba no a wɔbɛsa so. Bere a wo ba no ntini ne ne ntini nyin na osua sɛnea wɔbom yɛ adwuma no, ɛtɔ mmere bi a n’ankasa ho tɔ no. Ɛmfa ho nea ɛde ba biara no, wo duruyɛfo no wɔ hɔ sɛ ɔbɛboa wo ma woanya nhwehwɛmu ne ayaresa a wuhia. Wo ne no nkasa fa nneɛma a ɛhaw wo ho. Afei, mubetumi ayɛ nhyehyɛe a ɛbɛboa wo ne wo ba no ma moanya apɔwmuden.

Nneɛma a ɛho hia sen biara a ɛsɛ sɛ wokae (Take-Home Message) .

Okay, enti seesei woanya nteaseɛ pa wɔ deɛ yɛaka ho asɛm no ho, ``Silent Aspiration''. Nea ɛho hia sen biara ne sɛ wobɛkɔ oduruyɛfo nkyɛn ntɛm ara sɛ wususuw sɛ wo anaa wo ba no wɔ saa sɛnkyerɛnne ahorow yi a. Ɛtɔ mmere bi a ebia ɛnyɛ aniberesɛm biara, nanso nyansa wom sɛ wobɛkɔ oduruyɛfo nkyɛn akɔhwɛ sen sɛ wubesusuw sɛ ɛte saa.

• Sɛ worema wo ba no nufu a, hwɛ sɛnea ɔhome ne ne nne yiye.
• Sɛ wotaa nya atiridiinini anaa ɔhome mu yare a, hwɛ yiye wɔ ɛno nso ho.
• Sɛ woyɛ ɔpanyin a, hwɛ yiye sɛ ɛyɛ den sɛ wobɛmene na nsakrae a ɛba bere a woadi awie no.
• Ɛmfa ho nea ɛde ba biara no, ayaresa ahorow wɔ hɔ. Enti mma wo ho nnyɛ wo hu.

W’akwahosan ne w’abusua deɛ na ɛho hia, enti ɛho hia paa sɛ wohwɛ nneɛma te sɛ yei.

` Silent Aspiration, Ɛyɛ den sɛ wɔbɛmene, Aspiration Pneumonia, Mmofra Akwahosan, Ɔhome mu Ɔhaw, Aduan Aspiration