Mina míasrɔ̃ nusianu tso Stem Cell Transplant ŋu le mɔ bɔbɔe aɖe nu.

Ðewohĩ èse lãmenugbagbeviwo dodo na ame ŋu nya kpɔ. Le nyateƒe me la, wonye atike si ŋu viɖe le ŋutɔ, si xɔa ame ɖe agbe, na dɔléle aɖewo. Gake exɔa ɣeyiɣi aɖe hafi wohayana keŋkeŋ. Ðe míaƒo nu tso esia ŋu tsitotsito vie, abe alesi míele nu ƒom na mía xɔlɔ̃ aɖe enea?

Nukae Nye Lãmenugbagbeviwo?

Kpuie ko la, lãmenugbagbeviwo nye lãmenugbagbevi tɔxɛ aɖe ŋutɔ le míaƒe ŋutilã me. Ŋutete wɔnuku aɖe le lãmenugbagbevi siawo si be woatsi azu lãmenugbagbevi vovovo geɖe. Lãmenugbagbevi siwo ŋu míele nu ƒom tsoe le lãmenugbagbeviwo dodo na ame sia me lae naa lãmenugbagbevi vevi siwo le míaƒe ʋu me la dona. Ema nye:

• Ʋumenugbagbevi dzĩwo: Esiawoe tsɔa ɔksidzin yia ŋutilã bliboa me.
• Ʋumenugbagbevi ɣiwo: Lãmenugbagbevi siawo kpɔa mía ta to avuwɔwɔ kple dɔlékuiwo kple dɔléle siwo gena ɖe míaƒe ŋutilã me me.
• Ʋumenugbagbevi dzĩwo: Esiawoe kpena ɖe ʋu ŋu ne abi aɖe le ame ŋu.

Bu eŋu abe lãmenugbagbevi siawo le abe anyikpe si woate ŋu awɔ nusianu ene. Le alesi wòhiãe nu la, woate ŋu azãe atsɔ awɔ ʋumenugbagbevi dzĩwo, ʋumenugbagbevi ɣiwo, alo ʋumenugbagbevi dzĩwo.

Nukatae wowɔa lãmenugbagbeviwo ƒe lãmenugbagbeviwo dodo na ame siawo?

Azɔ, mina míakpɔ nɔnɔme siwo me lãmenugbagbeviwo dodo na ame siawo ate ŋu akpe ɖe ame ŋu le. Esia menye nusi wowɔna na dɔléle ɖesiaɖe o, gake le dɔléle sesẽ aɖewo me la, esiae nye egbɔkpɔnu nyuitɔ kekeake.

• Le amesiwo ŋu ʋudɔléle sesẽwo le gome: Le kpɔɖeŋu me, ʋumenugbagbeviɣidɔ ƒomevi aɖewo, siwo dzɔna ne ƒumeŋuɖui mewɔa dɔ nyuie o.
• Le amesiwo ŋu kansa ƒomevi aɖewo le gome la: Kansa abe Lymphoma alo Multiple Myeloma ene.
• Le amesiwo ƒe dɔlélenutsiŋutete gbɔdzɔ vevie gome: Woƒe dɔlélenutsiŋutete gbɔdzɔ ale gbegbe be woƒe ŋutilã mete ŋu wɔa avu kple dɔlélewo o.
• Le amesiwo ŋu dɔléle aɖewo siwo dɔlékuiwutikewo tsona gome: Le kpɔɖeŋu me, le dɔlélewo abe lupus ene me la, ne ŋutilãa ŋutɔ ƒe lãmenugbagbeviwo dze ŋutilãa dzi.
• Dɔdamɔnu sia wɔa dɔ ŋutɔ na ʋumenugbagbeviɣidɔ bubuwo hã: Thalassemia alo Sickle Cell Disease.

Afikae míekpɔa lãmenugbagbevi siawo tsonɛ?

Enyo, fifia ɖewohĩ èle eŋu bum be afikae míekpɔa lãmenugbagbevi xɔasi siawo tsoe hã. Teƒe vevi etɔ̃e ɖɔktawo ate ŋu akpɔ lãmenugbagbevi siawo le:

1. Ƒumeŋuɖui: Esiae nye mɔnu si ame geɖe zãna wu. Woyɔa esia zi geɖe be ‘ƒumeŋuɖui ƒe dodo’. Ƒumeŋuɖui nye akpa si fa miamiamia si le abe ƒumeŋuɖui ene le míaƒe ƒu gãwo me. Afi mae wowɔa ʋumenugbagbeviwo le.

2. To Ʋukawo Me: To atike tɔxɛwo nana me la, woate ŋu aɖe lãmenugbagbevi siwo tso ƒumeŋuɖui me ayi ʋukawo me, eye emegbe woate ŋu aƒo lãmenugbagbevi siawo nu ƒu to mɔ̃ si sɔ kple ʋudodo edziedzi dzi. Woyɔa esia be Peripheral Blood Stem Cell (PBSC) ƒe nuƒoƒoƒu.

3. 3. .Vidzidɔ ƒe Ʋu: Ne wodzi vidzĩ vɔ la, ne woɖe vidzidɔa ɖa la, lãmenugbagbevi xɔasi siawo nɔa ʋu si wogblẽ ɖi la me. Ame aɖe si hiã tu ate ŋu aƒo esiawo nu ƒu ahazã wo.

To mɔ sia dzi la, míeyɔa amesi naa lãmenugbagbeviawo be ‘nunala’ . Nusi le vevie ŋutɔ enye be le dɔléle aɖewo me la, amesi ŋu dɔlélea le ate ŋu anye eya ŋutɔ ƒe nunala hã. Eyae nye be woxɔa eya ŋutɔ ƒe lãmenugbagbeviwo hafi wodzea dɔlélea dada gɔme, wotsɔa wo dea tsikpe me, eye emegbe wogbugbɔa wo dea eme ne ehiã. Woyɔa esia be ‘Autologous Transplant’ .

Gake zi geɖe la, ame bubue tsɔa lãmenugbagbevi siawo naa amewo. Woyɔa esia be ‘Allogeneic Transplant’ . Ne woxɔ lãmenugbagbeviwo tso ame bubu gbɔ la, ele be lãmenugbagbevi mawo ƒe domenyiŋusẽfianu, vevietɔ HLA (Human Leukocyte Antigen) ƒe dzesiwo, nasɔ ŋutɔ. Ne míagblɔe kpuie la, ID-gbalẽvi sue aɖe le lãmenugbagbevi ɖesiaɖe si le míaƒe ŋutilã me. Ele be ID-gbalẽvi eve siawo naɖi wo nɔewo ŋutɔ, ne menye nenema o la, ŋutilãa maxɔ lãmenugbagbevi yeyeawo o. Zi geɖe la, ɖevi nɔviŋutsue nyea amesi sɔ nyuie wu. Ɣeaɖewoɣi la, woate ŋu akpɔ amesi sɔ kplii tso dzila alo nunala si medo ƒome kplii o gbɔ. Nyatakakadzraɖoƒe gãwo (registries) li na esia be woake ɖe nunala siwo sɔ ŋu.

Nukae dzɔna ne womekpɔ nunala si sɔ kplii o?

Bu eŋu kpɔ, ne lãmenugbagbevi siwo tso nunala gbɔ mesɔ pɛpɛpɛ o (ɣeaɖewoɣi ne wosɔ pɛpɛpɛ gɔ̃ hã la, nya siawo ate ŋu ado mo ɖa le agbɔsɔsɔ gã alo sue aɖe me), kuxi vevi eve ate ŋu ado mo ɖa:

1. Gbegbe: Esiae nye ne dɔnɔa ƒe dɔlélenutsiŋutete dze lãmenugbagbevi yeye siwo wodo na amea dzi. Esusu be, "Esiawo menye mía ŋutɔwo ƒe lãmenugbagbeviwo o, wole abe dutatɔwo ƒe amedzidzelawo ene," eye wòdzea agbagba be yeatsrɔ̃ wo. Atike siwo tsia dɔlélenutsiŋutete nu xea mɔ na esia.

2. Graft-versus-Host Disease (GVHD): Esia to vovo na ema. Dɔla ƒe dɔlélenutsiŋutete ƒe lãmenugbagbevi siwo wodo yeyee (vevietɔ T-lymphocytes) dzea lãmenugbagbevi siwo le lãmesẽ me dzi dzedze gɔme le dɔnɔa ƒe ŋutilã me, henɔa susum be, "Menye mía tɔe ŋutilã sia nye o." Esia ate ŋu agblẽ nu le teƒewo abe ŋutigbalẽ, aklã, kple dɔgbo ene ŋu. Atikewo li siwo woatsɔ aɖu esia hã dzi.

Aleke lãmenugbagbeviwo dodo na ame ƒe ɖoɖo sia dzɔnae?

Enyo, eyata mina míakpɔ alesi amedodo ƒe ɖoɖo sia wɔa dɔe ɖa. Enye afɔɖeɖe geɖe ƒe ɖoɖo.

1. Dzadzraɖo:

Hafi woado lãmenugbagbeviwo na ame bubuwo la, ɖɔktawo ade nane si woyɔna be ‘central line’, alo ‘central venous catheter’ . Esia le abe IV (si wodona ɖe ʋuka me) ƒe ka gã tɔxɛ aɖe ene. Wodenɛ ʋuka gã aɖe si te ɖe dzia ŋu, le ŋutigbalẽ te le kɔ, akɔta, alo akɔta. Woate ŋu agblẽ titinafli sia ɖe teƒea ɣeyiɣi didi wu IV si wozãna edziedzi. Esia wɔnɛ be wònɔa bɔbɔe na ɖɔktawo kple dɔnɔdzikpɔlawo be woana atike wò, axɔ ʋu, eye woana lãmenugbagbevi siwo wodo na wò. Mehiã be nàdo aŋe enuenu o.

2. Atikewɔwɔ na ame ƒe nɔnɔme:

Wowɔa lãmenugbagbeviwo dodo na ame le dɔwɔƒe tɔxɛ aɖe le kɔdzi. Gbã la, wonaa atike kple/alo keklẽŋusẽ ƒe agbɔsɔsɔ gbogbo aɖe amesi le lãmenugbagbevi siwo wona la xɔ ge (amesi xɔe) la ŋkeke geɖe. Woyɔa esia be atikewɔwɔ si naa ame ƒe nɔnɔme trɔna. Susu vevi eve tae wowɔa esia ɖo:

• Tsɔtsrɔ̃ lãmenugbagbevi gbegblẽ siwo gblẽa nu le ame ŋu (e.g. kansa lãmenugbagbeviwo, ƒumeŋuɖui ƒe lãmenugbagbevi siwo mewɔa dɔ nyuie o) siwo hea dɔléle vɛ.
• Gbɔdzɔ eƒe dɔlélenutsiŋutete ale be woate ŋu ade lãmenugbagbevi yeye siwo wòna la nyuie evɔ womagbe wo o.

3. Lãmenugbagbeviwo dodo na ame:

Ne wowu dɔdamɔnua nu vɔ la, le ɖiɖiɖeme ŋkeke ɖeka alo eve megbe la, wotsɔa lãmenugbagbevi siwo tso amesi na ʋua me la dea dɔnɔa me to titina fli aɖe dzi (abe alesi ko wòle le ʋu nana gome ene). Esia nye dɔ si xɔa gaƒoƒo geɖe. Lãmenugbagbevi siawo toa ʋua me henɔa ƒumeŋuɖui me, afisi wodzea ʋumenugbagbevi yeye siwo le lãmesẽ me wɔwɔ gɔme le.

Nukae dzɔna le ame ƒe ŋutilã dodo vɔ megbe?

Ne wodo lãmenugbagbeviwo na ame vɔ la, exɔa ɣeyiɣi aɖe hafi eƒe ŋutilã te ŋu wɔa ʋumenugbagbevi dzĩwo, ʋumenugbagbevi ɣiwo, kple ʋumenugbagbevi dzĩ yeyewo. Zi geɖe la, exɔa abe kwasiɖa 2-4 ene hafi lãmenugbagbevi yeye siawo dzea dɔwɔwɔ gɔme. Le ɣeyiɣi sia me la, dɔlékuiwo xɔxɔ, ʋudodo, kple kuxi bubuwo ƒe afɔkua lolo ŋutɔ. Esia le alea elabena ʋumenugbagbeviwo ƒe xexlẽme le sue ŋutɔ esime wole ʋumenugbagbevi xoxoawo tsrɔ̃m hele yeyewo wɔm.

Ame akpa gãtɔ nɔa xɔ tɔxɛ aɖe me le kɔdzi kwasiɖa 3 va ɖo 5 (alo ɣeyiɣi didi wu gɔ̃ hã) le woƒe ŋutilã dodo vɔ megbe. Le ɣeyiɣi sia me la, atikewɔlawo ƒe ƒuƒoƒoa kpɔa nyuie ŋutɔ le nusiwo gbɔna ŋu:

• Wodoa ʋu kpɔna gbesiagbe be woakpɔe ɖa be wole ʋumenugbagbevi yeyewo wɔm tso lãmenugbagbevi siwo wodo ɖe lãme na ame me hã.
• Wona atikewo be woatsɔ axe mɔ ɖe gbegbe kple Graft-versus-Host Disease (GVHD) nu.
• Wona atikewo abe dɔlékuiwutikewo, dɔlékuiwutikewo, kple dɔlékuiwutikewo ene be woatsɔ axe mɔ ɖe dɔlékuiwo xɔxɔ nu.
• Ne ehiã la, wonaa ʋumenugbagbevi dzĩwo kple ʋumenugbagbevi dzĩwo le gota (wodoa ʋu na ame).
• Eléa ŋku ɖe eŋu be ŋutinuwo abe aklã kple ayiku ene le dɔ wɔm nyuie hã.
• Wodaa kuxi ɖesiaɖe abe nu me abi, ʋuʋudedi, aɖuɖɔtoe, dɔlékuiwo, ʋu ƒe dodo, gbegbe, alo GVHD ene enumake.
• Kpɔ egbɔ be dɔnɔa le nunyiame si sɔ xɔm. Esia ate ŋu anye nuɖuɖu nana to mɔ̃ me alo nuɖuɖu si wotsɔna naa nuɖuɖu bliboe (TPN).
• Woléa ŋku ɖe amesiame si va kɔdzia ŋu be woakpɔe ɖa be wole dɔlékuiwo xɔxɔ ƒe sewo dzi wɔm hã. Ema fia be:
• Ame aɖeke si ŋu dɔléle aɖeke le (asrã gɔ̃ hã) mate ŋu ava kpɔ dɔnɔa o.
• Ele be amesiame naklɔ asi nyuie hafi age ɖe xɔa me.
• Ele be amesiame nado ametakpɔnu, asigɛ, kple awudziwui.

Aleke dzilawo (ne vi aɖee wonye) ate ŋu akpe ɖe ŋuwòe?

Ne wodo lãmenugbagbeviwo na ɖevi vɔ la, etɔExɔa ɣleti 6 va ɖo 12, alo esi wu nenema gɔ̃ hã hafi dɔlélenutsiŋutetea haya keŋkeŋ. Hafi ɣemaɣi naɖo la, dɔlékui suesuesuewo gɔ̃ hã ate ŋu asesẽ na ɖeviwo ŋutɔ. Afɔku ate ŋu anɔ dzamezã si bɔ gɔ̃ hã me. Nu aɖewo siwo nàte ŋu awɔ atsɔ akpe asi ɖe viwòa takpɔkpɔ tso dɔlékuiwo me lae nye esi:

• Ele be viwòa, ƒomea me tɔwo, kple amedzrowo (siwo woɖe mɔ na be woava srã wo kpɔ) natsɔ adzalẽ si wua dɔlékuiwo kple/alo asiklɔtike aklɔ asi nyuie eye woaklɔ asi enuenu. Esiae nye nu vevitɔ kekeake.
• Mègakplɔ ame aɖeke si le dɔ lém la va ɖe ɖevia gbɔ o.
• Tsɔ atike fafɛ kple adzalẽ klɔ viwòa gbesiagbe. Na ŋutigbalẽa nanɔ dzadzɛ.
• Wɔ ɖe ɖɔkta ƒe mɔfiamewo dzi pɛpɛpɛ:
• Ɣekaɣie ɖevia ate ŋu ayi suku alo dutoƒo teƒe bubuwo (teƒe siwo amewo sɔ gbɔ ɖo, sinimaxɔwo, asitsaƒewo).
• Ɣekaɣie wòle be ɖevi nado ametakpɔnu ne ele gota?
• Nuɖuɖu siwo nyo na ɖevia be wòaɖu kple nuɖuɖu siwo gblẽ na ɖevia be wòaɖu (e.g. salad ƒuƒu, lã kple tɔmelã si womeɖa nyuie o).
• Ðe ɖevia ate ŋu anɔ aƒemelãwo gbɔ ahaka asi wo ŋua?

Nu bubu kawoe wòle be míanya?

Ðevi geɖe (kple ame tsitsiwo) hayana ne wodo lãmenugbagbeviwo na wo vɔ. Gake ɣeyiɣi si woatsɔ anɔ kɔdzi kple ɣeyiɣi si woatsɔ ahaya le aƒeme ate ŋu anye kuxi na dɔnɔa kple woƒe ƒomea siaa, le susu kple ŋutilã siaa gome.

"Mègadze agbagba be ye ɖeka yeayi mɔzɔzɔ sia dzi o. Bia kpekpeɖeŋu."

Xɔ kpekpeɖeŋu tso ƒomea me tɔ bubuwo, xɔlɔ̃wo, wò atikewɔha, aɖaŋuɖola, alo hadomekpekpeɖeŋudɔwɔla aɖe gbɔ. Ne èlé be na ɖokuiwò nyuie ko hafi nàte ŋu alé be na wò dɔnɔ (alo vi, ne ɖevie wònye) nyuie.

Be nàkpe ɖe wò dɔnɔa ŋu wòahaya eye wòanɔ lãmesẽ me la, wɔ nusiawo:

• Na ɖɔkta ƒe sasrãkpɔ siwo katã woatsɔ akplɔe ɖo la nanɔ anyi eye nàna wò atikewo ɖe game dzi.
• Do alɔ dɔnɔa eye nàde dzi ƒo nɛ le ŋutilã me tɔtrɔwo (e.g., ɖa ƒe vuvu, ɖeɖiteameŋu, ŋutigbalẽ ƒe tɔtrɔ) siwo ate ŋu adzɔ le atikewɔmɔnu kple/alo keklẽŋusẽ ta.
• Kpe ɖe wo ŋu woakpɔ akogotsitsi kple ame ɖokui ɖeɖe ɖe aga si dona tso xɔlɔ̃wo kple ƒometɔwo gbɔ nɔnɔ le woƒe hayahayaɣi la gbɔ. Na mɔnukpɔkpɔwo nàɖo dze, to videokaƒoƒo gɔ̃ hã dzi.
• Bia dɔnɔa nenye be adi be yeaƒo nu kple aɖaŋuɖola alo hadomekpekpeɖeŋudɔwɔla aɖe be wòakpe ɖe ye ŋu yeakpɔ seselelãmewo abe blanuiléle, vɔvɔ̃, kple dziku si ate ŋu ado mo ɖa le hayahaya me gbɔ.
• Kpe ɖe dɔnɔa (vevietɔ ɖevi) ŋu wòaɖo gbesiagbenuwɔna bɔbɔe aɖe si me kamedede si mesẽ o (ne ɖɔkta da asi ɖe edzi), nuɖuɖu le ɣeyiɣi siwo sɔ me, kple nuwɔna siwo doa dzidzɔ nɛ, abe fefe, nuxexlẽ, kple nutata ene.

Ɣekaɣie wòhiã be míayi ɖɔkta gbɔ kaba?

Afɔku aɖewo li ne ètrɔ gbɔ va aƒeme le wò ŋutilã dodo vɔ megbe. Ne dzesi siwo gbɔna dometɔ aɖe le ŋuwò:Ele be nàƒo ka na ɖɔktaa enumake, eye màhe ɖe megbe aɖabaƒoƒo ɖeka pɛ hã o, alo ahiã be woakplɔ wò ayi kɔdzi:

• Ne yame ƒe dzoxɔxɔ nye 38.0°C (100.4°F) alo esi wu nenema ne wokpɔe tso nu me (esiae nye dzesi si me afɔku le wu).
• Ne ŋɔti me tsi le dodom, kɔdzi, akɔta le tetem, alo gbɔgbɔ sesẽ na wò.
• Ne ʋuʋudedi alo aɖuɖɔtoedɔ gakpɔtɔ li.
• Ne èle aɖuɖɔ yibɔ, si me aŋɔ le (poops) tom (esia ate ŋu anye ʋu si le dodom le dɔgboa me ƒe dzesi).
• Ne èxɔ abi bɔbɔe alo ʋu si womate ŋu atɔ te o le dodom le ŋuwò (e.g. tso ŋɔti alo aɖuwo me).
• Ne ʋu le aɖuɖɔ me, alo ne aɖuɖɔa ƒe amadede trɔ.
• Ne taɖuame sesẽ aɖe le ŋuwò, taɖuame, alo ŋku megakpɔa nu nyuie o.
• Menyo be nàkɔ ʋu o, gake ne màte ŋu aɖu ʋu si dona le ŋɔti me le aɖabaƒoƒo ʋɛ aɖewo me o la, .
• Ne nu yeye aɖe do ɖe ŋutilãa dzi, abe ʋuʋudedi ene.

Mlɔeba la, nu vevi aɖewo siwo dzi wòle be míaɖo ŋkui

Eyata, lãmenugbagbeviwo dodo na ame ate ŋu anye dɔléle sesẽ aɖewo dada si akpɔ dzidzedze ŋutɔ, si atrɔ ame ƒe agbenɔnɔ. Gake enye dɔdamɔnu vevi aɖe, eye hayahaya bia ɣeyiɣi, dzigbɔɖi, kple ɖokuitsɔtsɔna. Nu vevitɔe nye be nàwɔ ɖe ɖɔkta ƒe mɔfiamewo dzi pɛpɛpɛ, ana lɔlɔ̃, lɔlɔ̃, kple kpekpeɖeŋu madzudzɔmadzudzɔe dɔnɔa (ne ɖevi, ɖevia), eye vevietɔ akpɔ wo ta tso dɔlékuiwo me.

Ðo ŋku edzi be menye wò kple wò dɔnɔa ɖeɖe koe le mɔzɔzɔ sesẽ sia me o! Atikewɔlawo ƒe ƒuƒoƒoa, ƒometɔwo, kple xɔlɔ̃wo katã le gbɔwò. Ne nyabiase alo ɖikeke aɖe le ŋuwò, aleke kee wòɖale sue o, mègavɔ̃ be yeabia atikewɔlawo ƒe ƒuƒoƒoa o. Wole afima be yewoakpe ɖe ŋuwò.

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