Loaʻa pinepine iā ʻoe ka ʻeha hope? Malia paha ke manaʻo nei ʻoe i kahi ʻano ʻūlū ma kou mau wāwae. Akā e noʻonoʻo, me kēia ʻeha hope, ua paʻakikī koke ʻoe i ka mimi a i ʻole ka ʻōpala, a i ʻole ʻaʻole hiki iā ʻoe ke kāohi iā lākou? ʻAʻole kēia he mea hiki iā ʻoe ke hoʻowahāwahā wale. Hiki i kēia ke lilo i maʻi olakino koʻikoʻi loa e pono ai ke ʻoki kino koke. ʻO kēia ka mea a mākou e kamaʻilio nei i kēia lā.
He aha ka Cauda Equina Syndrome?
I ka ʻōlelo maʻalahi, he maʻi kakaikahi loa kēia akā he koʻikoʻi loa. Ma ka lalo o ko kākou iwi kuamoʻo, a i ʻole ke kaula kuamoʻo, aia kahi puʻupuʻu o nā aʻalolo. Ua like ke ʻano o kēia puʻupuʻu o nā aʻalolo me ka huelo o ka lio, no laila ua kapa ʻia ʻo "Cauda Equina" ma ka ʻōlelo Latina. Hoʻouna a loaʻa kēia mau aʻalolo i nā leka i a mai nā ʻōpū o ko kākou mau wāwae, nā wāwae, a me nā ʻōpū pelvic.
ʻO ka Cauda Equina Syndrome (CES) ke hoʻopaʻa ʻia kēia puʻupuʻu aʻalolo no kekahi kumu. Ua manaʻo ʻia kēia he pilikia ʻoki kino . Inā lohi ka mālama ʻana, ʻaʻole paha e hoʻihoʻi ʻia ka pōʻino i nā aʻalolo. ʻO ke ʻano kēia e lilo nā wāwae ʻelua i maʻi lolo mau loa , a aia kahi hiki ke nalowale mau loa ka mana o ka ʻōpū mimi a me ka ʻōpū.
Hiki ke hiki koke mai kēia ʻano (acute) a i ʻole e ulu aʻe i ka hala ʻana o ka manawa (chronic). Eia nō naʻe, he mea nui e ʻike i ke kauka i ka wā e ʻike ʻia ai nā hōʻailona.
He aha nā kumu o ka Cauda Equina Syndrome?
ʻOiai ʻo kēia ʻano maʻi ka mea maʻamau i nā pākeke, hiki nō hoʻi ke loaʻa i nā keiki me nā kīnā hānau a i ʻole ka poʻe i ʻeha nui i ko lākou iwi kuamoʻo. ʻO nā kumu nui:
- ʻO ke kumu maʻamau ka herniated disc ma ke kua i lalo, e kaomi ana ma luna o kahi aʻalolo .
- ʻO ka stenosis o ka iwi kuamoʻo .
- He puʻupuʻu a maʻi ʻaʻai paha ma ka iwi kuamoʻo.
- Nā maʻi, ka pehu ʻana, ke kahe ʻana o ke koko, a i ʻole nā haki ma ke kuamoʻo.
- ʻEha o ka iwi kuamoʻo mai kahi ulia koʻikoʻi (e.g., ulia kaʻa, hāʻule ʻana mai kahi kiʻekiʻe, ʻeha pū).
- Nā kīnā hānau, no ka laʻana, ka malformation arteriovenous (AVM).
- He pilikia ma hope o ke ʻoki kua.
- He pilikia o ka anesthesia spinal.
Nā hōʻailona hae ʻulaʻula o kēia maʻi
Hiki ke paʻakikī ke ʻike i kēia mau hōʻailona, no ka mea, ua like lākou me nā maʻi ʻē aʻe. Akā inā loaʻa iā ʻoe kekahi a ʻoi aku paha o nā "Red Flag Symptoms" ma lalo nei, e hele i ka Emergency Department (ETU) o ka haukapila a i ʻole e ʻike koke i ke kauka.
Mai noho wale ma ka home me ka manaʻo he ʻeha kua maʻamau kēia. He mea nui ka manawa ma ʻaneʻi.
| Hōʻailona | Ka wehewehe a me ka wehewehe ʻana |
|---|---|
| Anesthesia noho lio | ʻO kēia ka hōʻailona nui a weliweli loa . E noʻonoʻo i kou holo lio ʻana, ʻo nā ʻāpana o kou kino i paʻi ʻia i ka noho lio. ʻO ia hoʻi, e emi ana a ʻānai loa paha kou mau puʻupuʻu, nā ʻūhā o loko, a me ka ʻāpana a puni kou mau ʻōpū. Me he mea lā ua hoʻopau ʻia kēlā mau wahi. |
| Nā pilikia me ka kaohi ʻana o ka urinary a me ka bowel | Hiki paha iā ʻoe ke manaʻo koke i ka pono e mimi a i ʻole e kahe a ʻaʻole hiki ke hoʻōki (incontinence). A i ʻole hiki paha iā ʻoe ke manaʻo ʻaʻole hiki iā ʻoe ke mimi a i ʻole e kahe ʻoiai ʻoe e hoʻāʻo e mimi a i ʻole e kahe (paʻa). Hiki paha iā ʻoe ke nalowale i ka manaʻo o ka pono e mimi. |
| ʻEha nui ke kua a me ka ʻeha wāwae | ʻO Sciatica kahi ʻano ʻeha e like me ka haʻalulu uila ma lalo o ka wāwae, ʻoi aku ka ʻino ma mua o ka ʻeha kua maʻamau. Hiki i kēia ʻeha ke loaʻa ma nā wāwae ʻelua. |
| Ka nāwaliwali a i ʻole ka ʻeha o nā wāwae | E manaʻo paha ʻoe e like me kou mau wāwae a i ʻole kekahi o lākou e mae ana. E paʻakikī paha ʻoe e ala aʻe mai kahi noho, a i ʻole e kuʻia paha ʻoe i ka wā e hele ana. E manaʻo paha ʻoe i kahi ʻā ʻana i kou mau wāwae a me kou mau wāwae, a i ʻole kahi ʻano ʻūlū (paresthesia) e like me ka hele ʻana o nā ʻanuʻu. |
| Nā pilikia hana moekolohe | Ka hana moekolohe koke ʻana a i ʻole ka nalowale ʻana o ka ʻike moekolohe. |
Pehea e ʻike ai ke kauka i kēia?
Ke hele ʻoe i ka haukapila, e hoʻolohe pono ke kauka i kāu mau hōʻailona. A laila e nānā ʻo ia i kou kino, ʻoiai ka ikaika, nā reflexes, a me nā manaʻo i kou mau wāwae.
Akā no ka hōʻoia pono ʻana i kēia maʻi, pono maoli kahi scan MRI . Hiki i ka MRI ke loaʻa nā kiʻi ʻekolu-dimensional (3D) o ka iwi kuamoʻo a me nā aʻalolo. A laila hiki i kēia ke kuhikuhi i kahi kikoʻī o ke kaomi ʻana o ke aʻalolo. I nā hihia i loaʻa ʻole ai ka MRI, hiki ke hana ʻia kahi scan X-ray a i ʻole CT i kapa ʻia he myelogram .
Pehea e mālama ai? Pono ʻoe e wikiwiki?
Inā ʻike ʻia kēia maʻi, ʻo ka lāʻau lapaʻau ka hana koke ʻana i ke ʻoki e hoʻokuʻu i ke aʻalolo i ʻoki ʻia. Ua kapa ʻia kēia ʻoki he lumbar laminectomy .
E hoʻomanaʻo, ʻo ke ʻoki ʻana i loko o 48 mau hola o ka hoʻomaka ʻana o nā hōʻailona e hāʻawi i ka manawa kūpono loa e pale aku ai i ka hōʻino mau loa a me ka hoʻōla hou ʻana.
Ma waho aʻe o ke ʻoki ʻana, hiki ke hāʻawi ʻia nā lāʻau ʻē aʻe ma muli o ke kumu:
- Nā lāʻau lapaʻau steroid kiʻekiʻe (corticosteroids) e hōʻemi i ka pehu.
- ʻO nā lāʻau antibiotic inā he maʻi ka mea i hoʻokumu ʻia.
- Inā he puʻupuʻu maʻi kanesa ke kumu, hiki ke hāʻawi ʻia ka radiation therapy a i ʻole chemotherapy ma hope o ke ʻoki ʻana.
ʻOiai ma hope o ke ʻoki ʻana, ma muli o ka nui o ka hōʻino ʻia o ke aʻalolo, ʻaʻole paha e ho'ōla loa ʻia. Eia nō naʻe, hiki ke hala nā makahiki no nā mea e like me ka ʻōpū mimi a me ka kaohi ʻana i ka naʻau e hoʻi i ka maʻamau.
Ke noho nei me CES - He aha kāu e pono ai e ʻike?
Inā he pōʻino mau loa ma hope o ke ʻoki ʻana, pono ʻoe e aʻo e noho me nā loli. He mea nui loa ke kākoʻo kino a me ka naʻau nou i kēia huakaʻi.
E hoʻomaopopo i kou ʻohana e pili ana i kēia a loaʻa iā ʻoe ke kōkua mai iā lākou. Hiki iā ʻoe ke loaʻa ke kōkua mai nā poʻe loea like ʻole, e like me:
- Kauka Lapaʻau Kino
- Luna Hoʻōla Hana
- Kauka Hoʻōla Moe
- Kākā'ōlelo a i ʻole Kauka Noʻonoʻo
Inā pilikia ʻoe i ka kaohi ʻana i kāu mimi a i ʻole ka ʻōpala, hiki i kēia mau mea ke kōkua:
- E hoʻokahe loa i kou ʻōpū mimi me ka hoʻohana ʻana i kahi catheter ʻekolu a ʻehā manawa i ka lā.
- E inu i ka wai he nui a noho maʻemaʻe e pale aku i nā maʻi ʻōpū mimi.
- Inā pono, e hoʻohana i nā suppositories glycerin a i ʻole nā enemas e kōkua i ka hoʻohemo ʻana i ka ʻōpū.
- E komo i nā pale pale.
E kamaʻilio ākea me kāu kauka e pili ana i kēia mau mea a pau. E hāʻawi ʻo ia iā ʻoe i ke alakaʻi āu e pono ai.
Leka Lawe-Home
- ʻAʻole wale ka Cauda Equina Syndrome (CES) he ʻeha kua maʻamau, he pilikia olakino ia.
- Inā ʻike ʻoe i nā hōʻailona e like me ka mae ʻana a puni nā puʻupuʻu a me nā ʻōpū (saddle anesthesia), ka nalowale o ka mana o ka mimi/fecal, a i ʻole ka nalowale o ka ikaika o nā wāwae, e hele koke i ka haukapila .
- ʻO ke ʻano lapaʻau nui, ʻo ia ke ʻoki kino ulia pōpilikia i loko o 48 mau hola. ʻO ka lōʻihi o ka hoʻopaneʻe ʻia ʻana, ʻo ka nui aʻe o ka hiki ke hōʻeha mau loa ʻia.
- ʻOiai ma hope o ke ʻoki ʻana, hiki ke lōʻihi ka manawa e hoʻōla ai. He mea nui ka ʻōlelo aʻoaʻo lapaʻau a me ke kākoʻo ʻohana.
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