Nui nā mea e pono ai ke mālama ʻia e ke kanaka me ka maʻi diabetes, ʻeā? ʻO ke kō koko, ke koko kiʻekiʻe, ka cholesterol... I waenakonu o kēia mau mea a pau, i kekahi manawa hiki iā kākou ke poina e nānā i ko kākou mau maka. Akā, he mea nui loa ia e ʻike kākou i nā hopena o ka maʻi diabetes i nā maka. No ka mea, inā ʻike mua kākou iā ia, hiki iā kākou ke pale i ko kākou ʻike maka.
I ka ʻōlelo maʻalahi, he aha ka Diabetic Macular Edema (DME)?
ʻOiai he inoa paʻakikī kēia, e hoʻomaopopo wale kākou i ka mea e hana nei.
Ke loaʻa iā ʻoe ka maʻi diabetes, hiki i ke kiʻekiʻe o ke kō koko ke hōʻino i nā kīʻaha koko palupalu (nā kīʻaha koko) i loko o kou mau maka i ka hala ʻana o ka manawa. Ua kapa ʻia kēia ʻano maʻi diabetic retinopathy .
Hoʻomaka ka wai e kahe mai kēia mau kīʻaha koko i hōʻino ʻia. Hōʻiliʻili kēia wai ma ka retina, ka ʻāpana mālamalama o ke kua o ka maka. Loaʻa i ka retina kahi ʻāpana kikowaena koʻikoʻi loa e hāʻawi iā mākou i ka ʻike maopopo a ʻoi, i kapa ʻia ʻo ka macula . Hōʻiliʻili ka wai e kahe ana ma kahi i loaʻa ai ka macula a hoʻoulu iā ia e pehu. Ua kapa ʻia kēia pehu ʻo Diabetic Macular Edema (DME) .
E noʻonoʻo, i ka wā e pehu ai ka lens, ke kiko nui o ka retina, e like me ke kiʻiʻoniʻoni i loko o ke kāmela, lilo ke kiʻi a mākou e loaʻa ai i mea palalulu. Ua like ia me ka nānā ʻana i kahi mea ma o ke aniani wai.
Loaʻa iā ʻoe kēia mau ʻano?
ʻO ka mea weliweli loa e pili ana i ka DME, ʻaʻole ia e hōʻike i kekahi mau hōʻailona i nā pae mua. ʻO ia ke kumu he mea nui i nā mea a pau me ka maʻi diabetes e nānā ʻia ko lākou mau maka ma ka liʻiliʻi hoʻokahi i ka makahiki. Eia nō naʻe, e makaʻala i kēia mau hōʻailona:
- ʻIke maka pōwehiwehi: ʻO nā mea āu e nānā pololei ai, e like me ka helehelena o kekahi, nā kikokikona i loko o ka puke, a i ʻole nā kiʻi ma ke TV, ʻike ʻia he pōwehiwehi.
- ʻAno ʻāwiliwili: ʻO nā mea me nā laina pololei (e like me nā mōlina puka makani a me nā mōlina puka) e ʻike ʻia paha he ʻāwiliwili a kīkoʻo paha.
- Nā waihoʻoluʻu mae: ʻO nā waihoʻoluʻu i ʻike ʻia he ʻōlinolino ma mua, i kēia manawa ua "male," mae.
Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, e ʻike koke i kāu kauka. ʻO ka wikiwiki o kou hoʻomaka ʻana i ka lāʻau lapaʻau, ʻoi aku ka maikaʻi o kou kūlana e pale aku ai i ka hōʻino mau ʻana o ka maka.
Pehea e ʻike ai ke kauka i kēia maʻi?
Ke hele ʻoe i ke kauka, e nīnau ʻo ia iā ʻoe i kekahi mau nīnau. Eia kekahi laʻana, ke ʻike nei ʻoe i kekahi mau loli i kou ʻike, loaʻa iā ʻoe ka maʻi diabetes, he aha kou kō koko a me nā pae A1c, ke koko, a me nā pae cholesterol?
Ma hope o kēlā, hana ʻia kahi hoʻokolokolo maka piha, ʻo ia hoʻi kekahi mau hoʻokolohua.
| Inoa o ka hoʻāʻo | He aha kēia e hana nei? |
|---|---|
| Hoʻāʻo ʻIke Maka | ʻO ka hoʻāʻo heluhelu a mākou a pau i hana ai, kahi āu e nānā ai i kahi papa a heluhelu. Ana ia i ka maopopo o kou ʻike ʻana ma nā mamao like ʻole. |
| Hoʻokolohua Maka Dilated | Hoʻokomo ʻia kahi wai kūikawā (nā kulu maka) i loko o ka maka e hoʻonui i ka haumāna . A laila, hoʻohana ʻia kahi mea hana kūikawā e nānā i loko o ka maka a nānā i ke kūlana o ka retina, inā he wai e kahe ana mai nā kīʻaha koko, a inā he pehu. |
| ʻO ka Fluorescein Angiogram (FA) | Hoʻokomo ʻia kahi waihoʻoluʻu kūikawā i loko o kahi aʻa koko ma ka lima. I ka hele ʻana o kēia waihoʻoluʻu ma nā kīʻaha koko i loko o ka maka, lawe ʻia nā kiʻi me kahi kāmela kūikawā. Hiki i kēia ke kuhikuhi pololei i kahi o nā kahe koko. |
| ʻO ka Tomography Hoʻohui Optical (OCT) | Ua like kēia me ke kiʻi ʻokiʻoki o loko o ka maka. Hoʻohana ia i nā kukuna kukui kūikawā e ana pololei i ka mānoanoa, ka pehu ʻana, a me ka nui o ka wai i hōʻiliʻili ʻia i loko o ka retina a me ka sclera. |
Ma hope o kēia mau hoʻokolohua, e hoʻoholo ke kauka inā he DME kou a pehea kona koʻikoʻi.
He aha nā lāʻau lapaʻau no kēia?
ʻO ka mea pōmaikaʻi, aia i kēia manawa nā lāʻau lapaʻau kūpono loa no DME. ʻO ka pahuhopu nui o ka lāʻau lapaʻau, ʻo ia ke kāohi i ke kahe ʻana o ke wai mai nā kīʻaha koko a hōʻemi i ka pehu ʻana.1. Nā inikini Anti-VEGF
ʻO kēia ka lāʻau lapaʻau maʻamau a kūpono hoʻi i loaʻa. Hiki ke hopohopo iki ke noʻonoʻo e pili ana i ka loaʻa ʻana o kahi inikini i loko o ka maka, akā hana ʻia me kahi nila lahilahi loa a me kahi lāʻau hoʻomāʻū. No laila, ʻaʻole ia e ʻeha nui.
Hana kēia mau inikini ma ka pale ʻana i ka ulu ʻana o nā kīʻaha koko hou a nāwaliwali e kahe maʻalahi ana. Hoʻopaʻa kēia mau lāʻau lapaʻau (nā laʻana: Aflibercept, Bevacizumab, Ranibizumab, Faricimab) i nā kīʻaha koko a hoʻōki i ka kahe ʻana o ke wai. Pono ʻoe e loaʻa i kekahi mau lāʻau lapaʻau, ma kahi o hoʻokahi manawa i ka mahina.
2. Ka mālama ʻana i ka laser (Laser Photocoagulation)
I kekahi mau hihia koʻikoʻi, hoʻohana ʻia nā kukuna laser e "sila" a puhi paha i nā kīʻaha koko e liki ana. Pale kēia i ka hōʻino hou aʻe.
3. Nā inikini Steroid
Hāʻawi ʻia kekahi mau maʻi i nā inikini steroid e kāohi i ka pehu ʻana.
4. ʻO ke ʻoki kino (Vitrectomy)
ʻAʻole hana pinepine ʻia kēia, ʻoiai inā he nui ke kahe ʻana o ke koko i loko o ka maka a nalowale loa ka ʻike. Pili kēia i ka wehe ʻana i ke wai pohihihi i loko o ka maka a hoʻololi iā ia me kahi wai moakaka.
Na kāu kauka maka e hoʻoholo i ke ʻano o ka lāʻau lapaʻau kūpono loa iā ʻoe.
Pehea ʻoe e mālama ai iā ʻoe iho?
Ma waho aʻe o ka lāʻau lapaʻau a kāu kauka e hāʻawi ai, he mea nui loa ka mālama ʻana iā ʻoe iho i ka kaohi ʻana i kēia maʻi.
- Kaohi i ka maʻi diabetes: ʻO kēia ka mea nui loa . E mālama i kou kō koko, ke koko, a me nā pae cholesterol e like me nā kuhikuhi a kāu kauka. He mea nui ka ʻai kūpono, ka hoʻoikaika kino, a me ka lawe ʻana i nā lāʻau lapaʻau i kuhikuhi ʻia.
- Mai hōʻalo i nā hoʻokolohua maka: ʻOiai inā ʻaʻohe ou hōʻailona, e nānā i kou mau maka e like me ka papa hana a kāu kauka e ʻōlelo ai. He mea nui hoʻi kēia e nānā i ka holomua o kāu mau lāʻau lapaʻau.
- Inā haʻahaʻa kou ʻike maka, e noʻonoʻo i nā mea kōkua: Inā ʻaʻole lawa nā aniani wale nō, e kamaʻilio me kāu kauka e pili ana i nā mea e like me nā aniani hoʻonui.
He mea nui loa nō hoʻi ke olakino noʻonoʻo.
He mea maʻamau ke kaumaha, ka hopohopo, a me ka makaʻu ke loaʻa iā ʻoe kahi pilikia ʻike. ʻAʻole pono ʻoe e hakakā wale i kēia mau manaʻo.
- E kamaʻilio e pili ana i kou mau manaʻo: E kamaʻilio e pili ana i kēia me kou ʻohana a me nā hoaaloha. E haʻi i kāu kauka i kou manaʻo.
- E ʻimi i ke aʻo ʻana: Inā pono, e noi i kāu kauka no ke kōkua mai kahi loea olakino noʻonoʻo e hana pū ana me nā poʻe me ka maʻi diabetes a i ʻole ka poʻe maka ʻole.
- E hui pū me nā hui kākoʻo: E ʻike ʻoe i ka ikaika nui ke kamaʻilio ʻoe me nā poʻe ʻē aʻe e hele nei i ke kūlana like me ʻoe.
Leka Lawe-Home
- He hopena koʻikoʻi ka Diabetic Macular Edema (DME) o ka maʻi diabetes, akā inā ʻike ʻia a mālama ʻia i ka wā mua, hiki ke mālama ʻia ka ʻike.
- Inā ʻike ʻoe i nā hōʻailona e like me ka ʻike maka pōwehiwehi, ka hoʻopilikia ʻana o ke kiʻi, a i ʻole ka mae ʻana o ke kala , e ʻike koke i ke kauka.
- ʻO ka mea nui loa hiki iā ʻoe ke hana, ʻo ia ke kāohi pono i kāu maʻi diabetes. E kāohi i kou kō koko, ke koko kiʻekiʻe, a me ka cholesterol.
- Mai poina i nā hoʻokolohua maka a me nā lāʻau lapaʻau i kauoha ʻia e kāu kauka.
- ʻAʻole ʻoe hoʻokahi ma kēia huakaʻi. Aia nā kauka, ka ʻohana, a me nā hui kākoʻo e kōkua iā ʻoe. ʻO ka noho maikaʻi ʻana kekahi ʻāpana o ka lāʻau lapaʻau.
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