Ua manaʻo paha ʻoe i ka mae a i ʻole ka ʻeha ʻē ma kou lima, a i ʻole ke anu ma kou lima? A i ʻole ua ʻike ʻoe ua loli ke kala o kou lima a lōʻihi paha ka manawa e ho'ōla ai ma hope o kahi ʻoki? Mai manaʻo wale he mau mea maʻamau kēia. He hōʻailona paha kēia o kahi maʻi i kapa ʻia ʻo `(Arterial Thoracic Outlet Syndrome)`. E kamaʻilio kākou e pili ana i kēia me nā kikoʻī a me ka maʻalahi i kēia lā.
He aha kēia `(Arterial Thoracic Outlet Syndrome)`? E hoʻomaopopo maʻalahi kākou, ʻeā?
I ka ʻōlelo maʻalahi, ʻo ka `(Arterial Thoracic Outlet Syndrome)` ʻo ia ka wā e ʻomi ʻia ai kekahi o ko mākou mau kīʻaha koko nui (arteries) i loko o ka hakahaka ma waena o ko mākou ʻāʻī a me ka iwi ʻāʻī (kapa mākou i kēia `(Clavicle)`), ʻo ia hoʻi, ma kahi i kapa ʻia ʻo `(Thoracic Outlet)`. ʻIke ʻoe, ʻo nā aʻa nā kahawai e lawe i ke koko mai ko mākou puʻuwai a i ke kino holoʻokoʻa. No laila, i loko o ke kanaka me kēia kūlana `(ATOS)`, e ʻomi ʻia kahi aʻa ma kēia wahi i kapa ʻia ʻo `(Thoracic Outlet).`
E noʻonoʻo e like me ka paipu wai e paʻa ana, kahi e hōʻemi ai i ke kahe o ka wai. Ke paʻa kahi aʻa e like me kēia, hiki iā ia ke ālai i ke kahe koko. Inā ʻaʻole mālama pono ʻia, hiki iā ia ke alakaʻi i nā pilikia olakino koʻikoʻi. I kekahi poʻe, hiki i kēia paʻa ke hoʻonāwaliwali i ka paia o ke aʻa a puʻupuʻu e like me ka pōpō. Kāhea mākou iā ia he "Aneurysm". No laila, inā loaʻa iā ʻoe kēia mau hōʻailona, he mea nui loa ia e ʻike i ke kauka a nānā ʻia.
ʻO wai ka mea i ʻoi aku ka paʻakikī e loaʻa i ka "Arterial Thoracic Outlet Syndrome"?
E like me nā ʻano āpau o ka Thoracic Outlet Syndrome, ʻoi aku ka maʻamau i nā wahine ma waena o 20 a me 50 mau makahiki. ʻO ka hapa pinepine, hiki mai kēia ʻano o ke kaomi ʻana o ke aʻa ma muli o kahi iwi ʻē aʻe (i kapa ʻia he iwi ʻē aʻe cervical) ma ka ʻāʻī, a i ʻole no ka mea aia kahi iwi ʻē ma kahi kūpono ʻole. Aia pinepine kēia iwi ʻē aʻe ma luna o ko mākou iwi ʻē mua.
He aha nā pilikia e hiki ai i kēia ke hana? No ke aha he mea weliweli kēia?
ʻO ka ʻoiaʻiʻo, ʻo ka `(Arterial Thoracic Outlet Syndrome)` ke ʻano weliweli loa o `(Thoracic Outlet Syndrome)`. Inā ʻaʻole mālama pono ʻia, hiki i kēia `(ATOS)` ke hana i nā ʻūpā koko weliweli i loko o kou mau aʻa. Hiki i kēia mau ʻūpā koko ke ālai i ke kahe o ke koko i kou mau lima a me kou mau lima. ʻOiai he mea kakaikahi loa, hiki i kēia mau ʻūpā koko ke hele i ka lolo a hoʻoulu i nā maʻi e like me `(Stroke)`.
No laila, inā manaʻo ʻoe he mau hōʻailona kou o ka Thoracic Outlet Syndrome, he mea nui e ʻimi koke i ka lāʻau lapaʻau.
Pehea ka maʻamau o ka `(Arterial Thoracic Outlet Syndrome)`?
ʻO kaʻoiaʻiʻo, he mea kākaʻikahi nā ʻano āpau o ka Thoracic Outlet Syndrome. ʻAʻohe ʻikepili e pili ana i ka nui o ka poʻe i loaʻa iā ia. Eia naʻe, ʻo ke ʻano i kapa ʻia ʻo Arterial TOS ka mea i emi loa ka maʻamau. ʻIke ʻia kēia ʻano ma lalo o hoʻokahi i loko o 100 mau maʻi me Thoracic Outlet Syndrome.
He aha nā kumu o ka "Arterial Thoracic Outlet Syndrome"?
He nui ka poʻe me ATOS, e like me ka mea i ʻōlelo ʻia ma mua, ua hānau ʻia me kahi iwi ʻaoʻao keu (Cervical Rib) ma luna o ka iwi ʻāʻī (Clavicle). ʻO ke aʻa ma waena o ko mākou lima a me ka iwi ʻāʻī, i kapa ʻia ʻo Subclavian Artery, e lawe i ke koko i ko mākou mau lima, nā lima, ka ʻāʻī, a me ke poʻo. Ma muli o kēlā iwi ʻāʻī Cervical keu, hiki i kēia Subclavian Artery ke paʻa, e ālai ana i ke kahe ʻana o ke koko, a hiki ke hana ʻia nā ʻūpā koko. Hiki i kēia mau ʻūpā koko ke haki a hele i lalo o ka lima, e ālai ana i ke kahe ʻana o ke koko.
Hiki i nā kumu ʻē aʻe ke hoʻopilikia i kēia:
- Momona: I ka piʻi ʻana o ke kaumaha o ke kino, kau ʻia ke kaomi hou ma luna o nā hono.
- ʻEha kino: Nā ʻeha e like me nā mea i hana ʻia e kahi ulia kaʻa.
- Kūlana maikaʻi ʻole: Nā mea e like me ka noho ʻana ma ke kūlana hoʻokahi no ka manawa lōʻihi, kūlou i mua i ka wā e hana ana, a pēlā aku.
- Hāpai (`(Pregnancy)`).
- Nā Neʻe Hana Hou: No ka laʻana, ke oli ʻana i kahi raketa tennis, ke kiola ʻana i kahi softball a baseball paha, a i ʻole ka hāpai ʻana i nā pahu kaumaha ma luna o kou poʻo.
He aha nā hōʻailona o ka `(Arterial Thoracic Outlet Syndrome)`? Pehea e ʻike ʻia ai?
Hiki i nā hōʻailona o kēia ʻano ke hoʻopilikia pinepine i kou mau manamana lima, ka pāma, a i ʻole ka lima holoʻokoʻa. ʻO ka hōʻailona maʻamau ka ʻūlū a i ʻole ka mae ʻana ma kekahi lima. Hiki ke ʻoi aku ka ʻino o kēia mau hōʻailona ke hana ʻoe i kahi mea me kou lima a hiki ke hoʻomaikaʻi ke hoʻomaha ʻoe i kou lima. ʻO ka poʻe me ATOS ʻaʻole lākou e ʻike i ka ʻeha ma ka ʻāʻī a i ʻole nā poʻohiwi.
Ma muli o ka hiki iā ATOS ke hōʻemi i kou kahe koko, e ʻike paha ʻoe i nā mea e like me kēia ma kou mau manamana lima, lima, a i ʻole nā lima:
- Anuanu.
- Manaʻo mae a ʻūlū paha.
- ʻEha (`(ʻEha)`).
- Ka hoʻololi ʻana o ke kala keʻokeʻo.
- Nā ʻeha e ho'ōla lohi ana.
E noʻonoʻo, hana ʻo Nilanthi Akka ma ke kamepiula mai ke kakahiaka a hiki i ka pō. Ua hoʻomaka ʻo ia e ʻike i kahi ʻeha ʻē ma kona lima ʻākau me kahi ʻano ʻūlū iki. I kekahi manawa ua anuanu kona lima. Ua manaʻo ʻo ia no ka luhi. Akā inā e hoʻonui iki ana kēia mau hōʻailona, hiki paha iā ia ke `(ATOS)`.
Pehea e ʻike ai nā kauka i kēia maʻi (Arterial Thoracic Outlet Syndrome)?
Inā loaʻa iā ʻoe nā hōʻailona o ka "Arterial Thoracic Outlet Syndrome", e nānā mua kāu kauka i kou ʻāʻī a me kou poʻohiwi. E noi lākou iā ʻoe e hana i kekahi mau neʻe ʻana e nānā i ka "Range of Motion" o kou mau hono.
E ana pū ke kauka i kou koko a nīnau iā ʻoe e pili ana i kāu mau hōʻailona. Inā kānalua lākou iā ATOS, hana paha lākou i kekahi mau hoʻokolohua hou aʻe e nānā i kou Thoracic Outlet.
He aha nā hoʻokolohua e hana ʻia nei no kēia?
ʻO kēia ke kūlana me ka "Arterial Thoracic Outlet"E hoʻoholo i nā `(Nā Hoʻāʻo Kiʻi)`, ʻo ia hoʻi nā hoʻāʻo e nānā i loko o kou kino. Hiki ke hana ʻia kēia mau hoʻāʻo e nānā i kou mau aʻa, ke kahe koko, a me nā ʻano o loko:
- ʻO ke scan ultrasound: Hoʻohana kēia i nā nalu kani e nānā i loko o ke kino, ʻoi aku hoʻi e ʻike i ke kahe ʻana o ke koko. ʻO kēia ka hoʻāʻo mua i hoʻohana ʻia e ʻike i kēia maʻi.
- Arteriogram: Hoʻokomo ʻia kahi ʻōmole liʻiliʻi a lahilahi (catheter) a me kahi wai kūikawā (dye contrast) i loko o kou mau aʻa, a lawe ʻia kahi X-ray.
- CT scan: Ua hui pū ʻia kekahi mau kukuna X e hana i nā kiʻi kikoʻī.
- MRI scan (`(MRI)`): Hoʻohana i nā nalu lekiō a me nā kahua magnetic e kiʻi i nā kiʻi kikoʻī.
- X-ray (`(X-ray)`): Lawe ʻia nā kiʻi me ka hoʻohana ʻana i nā ana o ka radiation.
He aha nā lāʻau lapaʻau no ka `(Arterial Thoracic Outlet Syndrome)`?
ʻO kēia kūlana, i kapa ʻia ʻo Arterial Thoracic Outlet Syndrome, ʻo ia ka mea e mālama ʻia me ke ʻoki kino. Eia nō naʻe, ma mua o ke ʻoki kino, hiki i kāu kauka ke kuhikuhi i nā lāʻau hoʻokahe koko, e like me Warfarin (Coumadin®) a i ʻole Heparin (Hep-Lock™). Hiki iā lākou ke hoʻāʻo e wehe i nā clots e kū nei ma o ka injection a i ʻole nā ʻano ʻē aʻe.
I ka wā o ke ʻoki kino, hiki i ke kauka ke hana i nā mea e like me:
- Ua wehe ʻia kahi ʻāpana o kou iwi ʻaoʻao keu ("(Cervical Rib)`), e hoʻēmi ana i ke kaomi.
- Hoʻohana ʻia kahi ʻāpana aʻa olakino i lawe ʻia mai kahi ʻāpana ʻē aʻe o kou kino (Arterial Graft) e pani i ke aʻa i hōʻino ʻia.
- Hoʻokomo ʻia kahi ʻōmole hana e pani ai i ke aʻa i hōʻino ʻia, e hoʻihoʻi ana i ke kahe o ke koko.
He aha kā mākou e hana ai e hōʻemi i kēia pilikia `(ATOS)`?
ʻAʻohe ala e pale loa ai i kēia mai ka hana ʻana, akā hiki iā ʻoe ke hana i kekahi mau hoʻololi i ke ʻano o ka nohona e hōʻemi i kou pilikia o nā ulia i hoʻokumu ʻia e nā pilikia kaʻa:
- E mālama i kahi kaumaha olakino e kūpono i ke ʻano o kou kino, ka makahiki, a me ke kāne.
- E pale i ka lawe ʻana i nā ʻeke kaumaha ma kekahi poʻohiwi.
- E kaupalena i nā neʻe pinepine ʻana ma luna.
- E hoʻoikaika i kou mau poʻohiwi ma ka hana ʻana i ka hāpai kaumaha a i ʻole nā hoʻomaʻamaʻa kūʻē.
- E hoʻolōʻihi i kou ʻāʻī, poʻohiwi, a me ka umauma i kēlā me kēia lā.
He aha ka manaʻo no ke kūlana `(ATOS)`? Pono anei kākou e makaʻu?
ʻO kaʻoiaʻiʻo, inā ʻaʻole mālama ʻia, hiki i ka Arterial Thoracic Outlet Syndrome (ATOS) ke alakaʻi i nā pilikia koʻikoʻi e like me ke koko ʻana, nā ʻeha o nā lālā, a (i nā hihia koʻikoʻi) ka nalowale o nā manamana lima. Eia nō naʻe, ʻo ka nūhou maikaʻi, ʻo ka wikiwiki o kou ʻimi ʻana i ka lāʻau lapaʻau, ʻoi aku ka maikaʻi o kou kūleʻa. No laila, inā loaʻa iā ʻoe kekahi mau hōʻailona e hōʻike ana he ATOS paha kāu, e ʻike koke i ke kauka.
He aha hou kāu e makemake ai e ʻike mai ke kauka?
Ke hālāwai ʻoe me ke kauka, hiki iā ʻoe ke nīnau i nā nīnau e like me:
- He aha ke kumu kūpono loa o koʻu mau hōʻailona?
- He aha nā hoʻokolohua e pono iaʻu e hana e ʻike pono ai i ke ʻano o kēia?
- He aha nā koho lapaʻau e loaʻa ana?
- E ho'ōla anei nā lāʻau lapaʻau ʻoki ʻole i koʻu mau hōʻailona?
- He aha nā hoʻololi e hiki iaʻu ke hana i koʻu nohona e hōʻemi ai i nā hōʻailona?
ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)
ʻO ka Arterial Thoracic Outlet Syndrome (ATOS) kahi maʻi e hoʻopilikia ai i ke aʻa subclavian i loko o ka thoracic outlet. ʻO kēia ka manawa e paʻa ai ke aʻa a hoʻomaka ke koko e hana. Hiki i kēia mau clots ke haki a hele i lalo i ka lima, e hōʻeha ai i ka ʻeha a me ka mae ʻana. Hiki i ka mālama mua ke hōʻemi i ka pilikia o nā pilikia. Inā loaʻa iā ʻoe nā hōʻailona o ATOS, e ʻoluʻolu e ʻike koke i ke kauka. Mai hopohopo, hiki ke mālama ʻia kēia maʻi me ka ʻōlelo aʻoaʻo lapaʻau kūpono a me ka mālama ʻana.
ʻO ka maʻi thoracic outlet syndrome, arterial thoracic outlet syndrome, ATOS, ʻeha lima, mae lima, ʻūpā koko, iwi ʻaoʻao cervical, aʻa subclavian
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