He ʻoi aku ma mua o hoʻokahi maʻi kāu? E kamaʻilio kākou e pili ana i kēia mau maʻi like ʻole!

I kekahi manawa ke hele mākou i ke kauka, hiki i kekahi o nā huaʻōlelo a lākou e ʻōlelo ai ke hopohopo iki, ʻeā? ʻO kekahi huaʻōlelo like ʻo 'Comorbidities'. Akā, ʻo ka hoʻomaopopo ʻana i ke ʻano o kēia mau mea a pehea lākou e pili ai i kou olakino hiki ke kōkua nui iā ʻoe e hoʻoponopono i kou mau maʻi. No laila, e kamaʻilio kākou e pili ana i kēia i kēia lā.

No laila he aha kēia mau maʻi like ʻole?

I ka ʻōlelo maʻalahi, ʻo nā maʻi hui pū ʻana ka loaʻa ʻana o kekahi a ʻoi aku paha mau maʻi ʻē aʻe ma waho aʻe o kāu maʻi nui. ʻO ka huaʻōlelo lapaʻau "morbidity" ʻo ia hoʻi ke loaʻa ʻana o kahi maʻi a i ʻole ke ʻano. No laila, ke hoʻokomo mua ʻia me "co" ʻo ia hoʻi ʻelua a ʻoi aku paha nā maʻi e loaʻa pū ana.

Hiki ke hopohopo iki ka lohe ʻana i ka huaʻōlelo "Comorbidity". Akā i ka manawa e maopopo ai iā ʻoe kona manaʻo a pehea e pili ai i kou olakino, hiki iā ʻoe ke hana ikaika i ka mālama ʻana i kou olakino. No ka mea hiki i kēia mau comorbidities ke hoʻopili kekahi i kekahi, hiki ke loli kāu hoʻolālā olakino.

E noʻonoʻo i kēia. Ke ʻōlelo aku nei kāu kauka iā ʻoe e hele i kēlā me kēia lā e kāohi i kou momona . Akā i kekahi mau lā ma hope mai, ʻike ʻoe he osteoarthritis kou. No laila, ma kahi o ka hele wāwae ʻana i kēlā me kēia lā, hiki iā ʻoe ke hoʻololi i ka aerobics wai e pale ai i ka ʻeha o kou hui. I kēia hihia, he hui pū ʻia ka osteoarthritis me ka momona. No laila, loli ke ʻano o kāu mālama ʻana i kou momona.

ʻO kekahi laʻana, ʻo ke koko kiʻekiʻe (Hypertension) . Hiki i nā poʻe me nā maʻi ʻē aʻe, e like me ka maʻi puʻuwai a i ʻole ka maʻi māmā, ke loaʻa i ke koko kiʻekiʻe. Inā loaʻa iā ʻoe ke koko kiʻekiʻe me nā maʻi ʻē aʻe, e noʻonoʻo pū kāu kauka i kēlā mau maʻi. Pono paha ʻo ia e kuhikuhi i kahi lāʻau hoʻohaʻahaʻa koko ʻaʻole e hoʻopilikia i nā lāʻau lapaʻau ʻē aʻe āu e lawe nei.

He mea nui loa ke kumumanaʻo o nā maʻi like ʻole i ke kahua lapaʻau. No laila, ʻo ka ʻike ʻana i kona manaʻo hiki ke kōkua iā ʻoe e kamaʻilio me kāu kauka a hoʻomaopopo maikaʻi i kāu hoʻolālā lapaʻau. Hiki nō hoʻi ke lilo i mea pono i ke kākoʻo ʻana i kāu poʻe aloha i ko lākou mau maʻi.

Eia kekahi mau huaʻōlelo ʻē aʻe i hoʻohana ʻia e wehewehe i nā maʻi like ʻole:

• Nā kūlana e noho pū ana
• Nā kūlana pili
• Nā maʻi mau loa he nui
• Nā maʻi like ʻole

He aha ka ʻokoʻa ma waena o ka hōʻailona mua a me nā maʻi comorbid?

ʻO ka maʻi hui pū ʻana he ʻano maʻi i ʻike maopopo ʻia iā ʻoe ma waho aʻe o kāu hōʻailona mua (i kekahi manawa i kapa ʻia ʻo ka hōʻailona kumu a i ʻole ka maʻi kuhikuhi). I kēia manawa ke noʻonoʻo nei paha ʻoe, "He aha kēia hōʻailona mua?" He paʻakikī iki nā wehewehe ʻana o kēia mau huaʻōlelo.

Ma ke ao lapaʻau,ʻO ka maʻi nui ka maʻi olakino āu e mālama ʻia nei i kahi manawa kikoʻī a i ʻole i loko o kahi manawa kikoʻī. ʻO ia paha ka maʻi koʻikoʻi loa āu i loaʻa ai, a i ʻole ka mea e pono ai ka mālama kūikawā loa. ʻO ia paha ka mea i hoʻokomo ʻia ai ʻoe i ka haukapila.

Ua kapa ʻia kahi maʻi he maʻi "nui" e ke kauka i nīnau ʻia. Hiki ke loli pū kāu maʻi nui ma muli o ke kauka āu e ʻike ai a pehea e loli ai kou olakino.

Eia kekahi laʻana, e noʻonoʻo he maʻi puʻupaʻa mau kou, ke koko kiʻekiʻe, a me ka maʻi diabetes Type 2. ʻIke ʻoe i kahi nephrologist a mālama mau ʻia no kou maʻi puʻupaʻa. A laila, manaʻo kēlā kauka i kou maʻi puʻupaʻa ʻo ia kou maʻi nui. No ka mea, ʻo ia ka mea āna e mālama ai. Manaʻo ʻo ia i ke koko kiʻekiʻe a me ka maʻi diabetes he mau maʻi like ʻole o ka maʻi puʻupaʻa. Mālama pū ʻo ia i kēia mau maʻi like ʻole i ka wā e mālama ai i kou maʻi puʻupaʻa.

Ma ka lawe ʻana i kēia laʻana hou aku, e noʻonoʻo e ʻike mau ana ʻoe i kahi endocrinologist e mālama i kāu maʻi diabetes. A laila manaʻo kēlā kauka ʻo kāu maʻi mua ʻo ia ka maʻi diabetes. Manaʻo ʻo ia ʻo kou maʻi puʻupaʻa a me ke koko kiʻekiʻe he mau mea like ʻole o ka maʻi diabetes.

No laila hiki iā ʻoe ke ʻike, he aha ka maʻi nui a he aha ka comorbidity e loli paha ma muli o ke kūlana. ʻIke pinepine nā kauka loea i kou kūlana olakino ma ke ʻano he maʻi nui a me nā comorbidities pili.

Akā, ʻo ka poʻe e like me kāu kauka ʻohana (Primary Care Provider) e nānā iki i kēia i kahi ʻano ʻokoʻa. Hiki iā lākou ke hoʻohana i ka manaʻo o "Multimorbidity" e loaʻa ai kahi ʻike ākea o kou olakino.

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He mea like anei kēia me ka multimorbidity?

Ua wehewehe ke Keʻena Ola Kino a me nā Hana Kanaka o ʻAmelika Hui Pū ʻIa i ka "multimorbidity" ʻo ia ke alo ʻana o ʻelua mau maʻi lapaʻau a i ʻole nā ​​kūlana e mau ana no ka ʻoi aku o hoʻokahi makahiki . ʻAʻole i ʻōlelo ʻia kēia wehewehe ʻana i kahi maʻi mua. He ʻokoʻa kēia mai ka wehewehe ʻana o ka comorbidity.

Hoʻohana ka nui o nā kānaka noiʻi i ke kumumanaʻo o ka "multimorbidity" e aʻo ai pehea e pili ai nā maʻi kekahi i kekahi. Eia nō naʻe, hoʻohana ka nui o ka poʻe i nā huaʻōlelo comorbidity a me multimorbidity me ke ʻano like ʻole, ʻo ia hoʻi ke wehewehe ʻana i ke alo o ʻelua a ʻoi aku paha nā maʻi olakino i hui pū ʻia.

Pehea ka hopena o kēia mau maʻi like ʻole i kou olakino?

ʻO ka loaʻa ʻana o nā maʻi like ʻole a i ʻole multimorbidity hiki ke hoʻopilikia i kou olakino ma nā ʻano he nui. Ke loaʻa iā ʻoe ʻelua a ʻoi aku paha nā maʻi maʻi:

• Hiki i kēia mau kūlana ke hoʻopilikia nui aku i kou olakino noʻonoʻo a/a i ʻole ke kino ma mua o kēlā me kēia kanaka, a hiki ke loaʻa ka hopena nui aʻe i kou "ʻano ola e pili ana i ke olakino".
• Ma muli o kahi comorbidity, hiki ke loli ka nānā ʻana i ka wā lōʻihi no kāu maʻi mua.
• Hiki ke paʻakikī ka lāʻau lapaʻau. No ka laʻana, hiki i ka lāʻau lapaʻau no kekahi maʻi ke hoʻonui i kekahi maʻi. A i ʻole, ʻo ka lawe pū ʻana i nā lāʻau lapaʻau no nā maʻi like ʻole hiki ke lilo i mea weliweli.
• Pono paha ʻoe e ʻike i kekahi mau loea like ʻole . E hana pū lākou ma ke ʻano he hui, e kaʻana like ana i ko lākou ʻike, a e hoʻomohala ana i ka hoʻolālā lapaʻau maikaʻi loa nāu.

E nānā kākou i nā maʻi like ʻole e pili pinepine ʻia.

Hiki ke ʻike ʻia nā ʻano maʻi like ʻole i waena o nā poʻe maʻi e loaʻa ana i ka mālama ʻia ma loko o nā haukapila a me waena o ka poʻe e ʻeha nei i nā ʻano maʻi like ʻole.

Ma waena o ka poʻe i hoʻokipa ʻia ma ka haukapila

Ua ʻike ʻia ma kekahi noiʻi he ʻoi aku ma mua o 84% o nā pākeke i hoʻokomo ʻia i ka haukapila ma ʻAmelika Hui Pū ʻIa i ka makahiki 2019 he hoʻokahi a ʻoi aku paha mau maʻi like ʻole, me ke kūlana kumu i alakaʻi ai i ko lākou hoʻokomo ʻia ʻana i ka haukapila. Ma kahi o 50% o kēia hui he ʻekolu mau maʻi like ʻole.

ʻO nā maʻi like ʻole i loaʻa pinepine i loko o kēlā noiʻi:

• Ke koko kiʻekiʻe (53.2% o nā maʻi maʻi)
• Maʻi diabetes (26.4% o nā maʻi maʻi)
• Maʻi māmā mau loa (20.5% o nā maʻi i loko)
• Nā anemia hemahema (18.0% o nā maʻi ma loko)
• Ka momona (17.0% o nā maʻi ma loko)
• Maʻi puʻupaʻa a me ka hāʻule ʻana (16.3% o nā maʻi ma loko)

Ua ʻike pū kēia haʻawina i kekahi mau mea ʻē aʻe:

• Hoʻonui ʻia nā maʻi like ʻole me ka makahiki. ʻO 8% wale nō o nā pākeke i piha i ka makahiki 18-24 he ʻekolu mau maʻi like ʻole. Eia nō naʻe, kokoke i 73% o ka poʻe 85 makahiki a ʻoi aku paha he ʻekolu mau maʻi like ʻole.
• Hoʻopilikia nā maʻi like ʻole i nā hopena. ʻO ka poʻe me ʻekolu a ʻoi aku paha mau maʻi like ʻole, ʻoi aku ka lōʻihi o ko lākou noho ʻana ma ka haukapila a ʻoi aku ka nui o ko lākou make ʻana ma ka haukapila ma mua o ka poʻe me ka liʻiliʻi a ʻaʻohe mau maʻi like ʻole. He ikaika loa ka hopena o nā maʻi like ʻole i ka wā e pili ana i ke ʻoki kino. ʻO ka poʻe me ʻekolu a ʻoi aku paha mau maʻi like ʻole, ʻewalu manawa ka nui o ko lākou make ʻana ma ka haukapila ma hope o ke ʻoki kino ma mua o ka poʻe me ka ʻole o nā maʻi like ʻole.

Nā maʻi like ʻole i ʻike pinepine ʻia me kekahi mau maʻi nui

Hoʻopaʻa pinepine nā kānaka noiʻi i nā poʻe me kahi maʻi kikoʻī - no ka laʻana, ka ʻāʻī a i ʻole ka hāʻule ʻana o ka puʻuwai - e ʻike i nā kūlana ʻē aʻe (comorbidities) i loaʻa iā lākou. ʻOiaʻiʻo, he ʻokoʻa nā kānaka a pau, a ʻaʻole pono kēia mau haʻawina e loaʻa i nā kānaka a pau me kahi maʻi kikoʻī kekahi mau comorbidities. Akā hāʻawi lākou iā mākou i kahi manaʻo o nā ʻano maʻamau.

E nānā kākou i kekahi mau laʻana:

• Ka maʻi hoʻolohe-nele/hyperactivity (ADHD)
• Nā maʻi maʻamau: Kaumaha, nā maʻi hopohopo, ka maʻi bipolar.

• ʻAno 2 Diabetes
• Nā maʻi maʻamau: Ke koko kiʻekiʻe, nā pae momona koko kiʻekiʻe (e.g. cholesterol kiʻekiʻe a me/a i ʻole triglycerides kiʻekiʻe - Dyslipidemia), Metabolic dysfunction-associated steatotic ate ​​maʻi - MASLD, Polycystic Ovary Syndrome - PCOS, Obesity, Obstructive Sleep Apnea.

• Ka hāʻule ʻana o ka puʻuwai
• Nā maʻi maʻamau: Diabetes Type 2, Sleep Apnea, Momona, Koko Kiʻekiʻe.

I kekahi manawa, loaʻa pū nā maʻi no ka mea he mau kumu like a i ʻole nā ​​​​kumu pilikia. No ka laʻana, hiki i ke koko kiʻekiʻe a me ka maʻi diabetes ke hoʻonui i kou pilikia o ka maʻi puʻuwai a me ka maʻi puʻupaʻa. Akā i kekahi manawa ʻaʻohe kumu like o nā maʻi comorbid. Hiki i kāu kauka ke haʻi iā ʻoe i nā mea hou aʻe e pili ana i nā kumu o kou mau kūlana a pehea e hiki ai i ka lāʻau ke kōkua.

No laila he aha ke koʻikoʻi o kou ʻike ʻana i kēia?

ʻO ke aʻo ʻana i ke ʻano o nā huaʻōlelo comorbidities a me multimorbidities e hiki ke kōkua iā ʻoe e kamaʻilio me kāu kauka e pili ana i kou olakino. Akā inā manaʻo ʻoe ua kaumaha ʻia e kēia mau huaʻōlelo, e kū a noʻonoʻo no kekahi manawa.

ʻO ka mea nui, ʻaʻole ia e hoʻopaʻanaʻau i nā huaʻōlelo lapaʻau a pau. ʻO ka mea nui, ʻo ia ka hoʻokaʻawale ʻana i ka manawa e aʻo ai e pili ana i kou mau kūlana olakino a pehea lākou e pili ai i kou olakino. E hoʻomaopopo i nā lāʻau lapaʻau āu e pono ai, no ke aha ʻoe e pono ai iā lākou, a pehea e mālama ai i kāu mau lāʻau lapaʻau ma ka home. He mea nui hoʻi e hoʻomaopopo ʻaʻole ʻelua mau kānaka e ʻike i ke kūlana like a i ʻole ka hui pū ʻana o nā kūlana i ʻokoʻa.

E haʻi i kāu kauka i kāu mau nīnau a me kou mau hopohopo a pau i hiki iā ia ke hāʻawi iā ʻoe i ke alakaʻi i kūpono i kou kūlana.

ʻO ka leka lawe home mai kēia ʻatikala penei:

ʻAe, eia nā mea nui e pono ai ʻoe e hoʻomanaʻo mai kā mākou i kamaʻilio ai i kēia lā:

• He mea maʻamau nā maʻi like ʻole: ke alo ʻana o hoʻokahi a ʻoi aku paha mau maʻi ʻē aʻe ma waho aʻe o kahi maʻi mua, kahi mea a nā poʻe he nui e ʻike ai.
• He mea nui e hoʻomaopopo: ʻO ka ʻike ʻana i kēia mau maʻi like ʻole, a me ka hoʻomaopopo ʻana i ke ʻano o ko lākou hopena i kou olakino, he mea kōkua nui ia i ka mālama ʻana i kou olakino holoʻokoʻa.
• Hiki ke paʻakikī ka lāʻau lapaʻau:Hiki ke paʻakikī iki ka hoʻolālā ʻana i ka mālama ʻana ke loaʻa iā ʻoe ma mua o hoʻokahi maʻi, no laila he mea nui e hahai pololei i nā ʻōlelo a kāu kauka.
• E kamaʻilio me kāu kauka: E haʻi i kāu kauka e pili ana i nā kūlana olakino āu e loaʻa ai a me nā lāʻau lapaʻau āu e lawe ai. Mai kānalua e nīnau i nā nīnau a hopohopo paha āu. Aia kāu hui mālama ola ma laila e kōkua iā ʻoe.

E hoʻomanaʻo, ʻaʻole ʻoe hoʻokahi. Nui ka poʻe e noho nei me kēia mau maʻi. Me ka ʻike kūpono, ke kākoʻo, a me nā ʻōlelo aʻoaʻo lapaʻau, hiki iā ʻoe ke hoʻoponopono pono i kēia mau maʻi!

Nā maʻi like ʻole, nā kūlana he nui, ka ʻike mua, ka maʻi like ʻole, nā maʻi mau, ka hoʻokele olakino, ka ʻōlelo aʻoaʻo lapaʻau