E noʻonoʻo ua loaʻa iā ʻoe kahi ʻeha ʻōpū nui no kekahi mau lā. No laila, hele ʻoe e ʻike i ke kauka. Nīnau ke kauka iā ʻoe, nānā iā ʻoe, a ʻōlelo, "Hmm... he gastritis paha, he appendicitis paha. E hana kākou i kekahi mau hoʻokolohua." Ua noʻonoʻo paha ʻoe no ke aha ʻaʻole i ʻōlelo wale nā kauka i ka pilikia, ʻōlelo wale lākou i kekahi mau mea i hewa paha? ʻO ia ka mea a mākou e kapa nei he differential diagnosis i ka lāʻau lapaʻau. Mai hopohopo, he huaʻōlelo nui ia, akā he maʻalahi loa. E kamaʻilio kākou e pili ana i kēia lā.
I ka ʻōlelo maʻalahi, he aha ka diagnost differential?
ʻAʻole kēia kāu hōʻailona hope loa. E noʻonoʻo i kahi mākaʻi maikaʻi. Ke hele ʻo ia i kahi hana hewa, ʻaʻole ʻo ia e ʻōlelo koke, "ʻO kēia ka mea hana hewa," ʻeā? ʻO ka mea mua āna e hana ai, ʻo ia ka hana ʻana i kahi papa inoa o ka poʻe āna i manaʻo ai ua hana i ka hewa. A laila hōʻiliʻili ʻo ia i nā hōʻike, nānā kekahi i kekahi, hoʻopau i nā poʻe pili ʻole mai kēlā papa inoa, a laila hopu i ka mea hana hewa maoli.
Hana kekahi kauka i kahi mea like. Ke hele mai ʻoe me kekahi mau hōʻailona, e hōʻike mai ke kauka i kahi papa inoa o nā maʻi hiki ke kūpono i kēlā mau hōʻailona. ʻO kēlā "papa inoa o nā maʻi hiki" ka mea a mākou e kapa nei (Differential Diagnosis). He hana mua koʻikoʻi loa kēia i ke kaʻina hana diagnostic.
He aha nā ʻanuʻu e hoʻohana ai ke kauka e ʻike pololei ai i kahi maʻi?
Aia kahi huakaʻi hoʻonohonoho a ke kauka e hana ai e ʻike pono ai i ke ʻano o ka maʻi. Ua like ia me ka piʻi ʻana i luna o kahi alapiʻi. ʻAʻole hiki iā ʻoe ke lele i hoʻokahi kapuaʻi.
1. Nīnau nui lākou iā ʻoe e pili ana i kou mau hōʻailona: "Pehea kou manaʻo?", "Pehea ka lōʻihi o kēia pilikia iā ʻoe?", "Pehea ke ʻano o ka ʻeha? He ʻōʻō anei? A i ʻole he mea e kaomi ana?", "He aha nā pilikia ʻē aʻe āu e loaʻa nei?" Hoʻāʻo lākou e kiʻi i kahi kiʻi piha o kou kūlana ma ka nīnau ʻana i nā nīnau e like me: "Pehea kou manaʻo?", "Pehea ka lōʻihi o kēia pilikia iā ʻoe
2. E nīnau e pili ana i kou mōʻaukala olakino: "Ua loaʻa anei kēia iā ʻoe ma mua?", "He mau maʻi ʻē aʻe kou e like me ka maʻi diabetes a i ʻole ke koko kiʻekiʻe?", "Aia kekahi o kou ʻohana i loaʻa i kēia mau maʻi?", "Ke lawe nei ʻoe i kekahi mau lāʻau lapaʻau a i ʻole nā wikamina?" He mea nui kēia mau mea a pau.
3. Hoʻokolokolo Kino: Ma kēia, e hoʻopā lākou i kou kino, e pā i kou ʻōpū, e hoʻolohe i kou umauma a me kou māmā me ka stethoscope, e ana i kou koko, a e nānā i kou mahana. E hāʻawi kēia i ke kauka i nā hōʻailona he nui.
4. Hoʻokumu ʻia kahi papa inoa o nā maʻi hiki ke loaʻa (Differential Diagnosis) i loko o ka noʻonoʻo: I kēia manawa, ma hope o ka hoʻohui ʻana i nā kikoʻī āpau āu i haʻi mai ai iā mākou a me nā mea i manaʻo ʻia i ka wā o ka hoʻokolokolo ʻana, manaʻo ke kauka, "ʻAe, ma muli o kēia mau hōʻailona, hiki paha kēia maʻi."
5. Inā pono, e kākau ʻia nā hoʻokolohua hou aʻe:Pono nā hōʻike hou aku e ʻike ai i ka mea hewa maoli mai kēlā papa inoa o nā mea i kānalua ʻia. ʻO ia ke kumu e hana ʻia ai nā mea e like me nā hoʻāʻo koko, nā hoʻāʻo mimi, nā scan, a me nā X-ray.
6. Ke Nānā Hou ʻana i nā Hopena Hoʻāʻo a me nā Hōʻailona: Ke hiki mai nā hopena hoʻāʻo, e hoʻohālikelike ke kauka iā lākou me kāu mau hōʻailona. A laila, hiki iā ia ke hoʻopau i kekahi o nā maʻi ma ka papa inoa ma ka ʻōlelo ʻana, "ʻAʻole, ʻaʻole hiki kēia."
7. Ke Hōʻea ʻana i kahi Hōʻailona Hope Loa: Ma hope o ka pau ʻana o kēia mau mea a pau, hiki i ke kauka ke ʻōlelo me ka maopopo, "ʻAe, loaʻa iā ʻoe kēia maʻi." A laila wale nō e hoʻomaka ai ka lāʻau kūpono.
Hiki i kēia kaʻina hana ke lōʻihi i kekahi manawa. He paʻakikī ke ʻike koke i ka maʻi, ʻoiai i nā kūlana paʻakikī. No laila, he mea nui loa ke ahonui.
No ke aha he mea pono e hana i kahi papa inoa e like me kēia? No ka mea hiki ke hewa?
I mea e pololei ai, hoʻohana ʻia kēia ʻano hana e pale aku i nā hewa . E noʻonoʻo, inā hele mai kekahi me ka ʻeha umauma, manaʻo ke kauka, "ʻAuē, he gastritis kēia" a hāʻawi iā lākou i ka lāʻau lapaʻau no ia mea, akā pehea inā ʻo ia ka hoʻomaka ʻana o ka hōʻeha puʻuwai? He ulia nui paha kēlā, ʻeā?
Akā ke hoʻohana ke kauka i ke ʻano hana Differential Diagnosis, manaʻo ʻo ia, "Hiki ke loaʻa kēia ʻeha umauma ma muli o ka gastritis. I ka manawa like, hiki nō hoʻi ke loaʻa ma muli o ke kaumaha o nā ʻiʻo. Akā ʻo ka mea weliweli loa, he liʻiliʻi ka manawa e hiki ai ke lilo i ka hōʻeha puʻuwai." A laila hana ʻo ia i nā hoʻokolohua e pono ai (e laʻa, he ECG) e hōʻoia inā hiki ke hana ʻia ka mea weliweli loa. Ke hōʻoia ʻia ʻaʻole ia he hōʻeha puʻuwai, hiki iā ia ke nānā i nā kumu ʻē aʻe. ʻO kēia ke hōʻoia i kou palekana.
ʻO kekahi mau hiʻohiʻona o nā maʻi me nā hōʻailona like
I mea e maopopo ai ke koʻikoʻi o kēia kaʻina hana, e nānā kākou i kekahi mau hōʻailona maʻamau a me nā kūlana olakino like ʻole e hiki ai ke hoʻoulu iā lākou.
| ʻO kou mau hōʻailona | Papa inoa o nā maʻi hiki ke kū mai i ka manaʻo o ke kauka (Differential Diagnosis) |
|---|---|
| ʻeha ka ʻōpū |
|
| Kuke | |
| ʻEha umauma | |
| ʻEha poʻo | |
| Luhi | |
| ʻO ka maʻi ʻaʻai mimi (nā hōʻailona UTI) |
I kēia manawa hiki iā ʻoe ke ʻike i ka nui o nā kumu like ʻole no ka hōʻailona like, ʻeā? No laila hiki iā ʻoe ke ʻike i ke koʻikoʻi o kou palekana no ke kauka e noʻonoʻo i kēia ʻano.
He aha nā mea e pono e hana ʻia ma kāu ʻaoʻao ma kēia kaʻina hana?
Ma kēia huakaʻi mākaʻi, ʻo ʻoe ka mea hōʻike nui. No laila, he mea waiwai nui kāu kōkua i ke kauka .
- E ʻoiaʻiʻo i nā mea āpau: Mai hūnā i nā mea liʻiliʻi loa āu e manaʻo nei. I kekahi manawa, ʻo kahi mea āu e manaʻo ai "ʻaʻole koʻikoʻi kēia" hiki ke lilo i hōʻailona nui no ke kauka e ʻike ai i ka pilikia.
- E lawe mai i kahi papa inoa o kāu mau lāʻau lapaʻau: E haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei (ʻo ia mau mea no nā kūlana ʻē aʻe, nā huaora, nā pauka, a me nā lāʻau Sinhala). I kekahi manawa, ʻo ke kumu o kāu mau hōʻailona he lāʻau lapaʻau ʻē aʻe paha āu e lawe nei.
- Mai makaʻu e nīnau i nā nīnau: "E ke kauka, he aha ke ʻano o kēia maʻi?", "He aha ke ʻano o nā hoʻokolohua e pono ai iaʻu e hana?", "He aha kaʻu e manaʻo ai mai kēia mau hoʻokolohua?" E nīnau. ʻO ka ʻoi aku o kou ʻike, ʻo ka emi ʻana o kou makaʻu.
- E noho mālie: Mai hopohopo ke ʻōlelo mai ke kauka, "Hiki paha i kēia maʻi, hiki paha i kēlā maʻi." E hoʻomanaʻo, ʻaʻole ia he manaʻo ua loaʻa iā ʻoe kēlā mau maʻi āpau. ʻO ia hoʻi ke noʻonoʻo nei lākou i nā mea hiki ke hiki ma mua o ka hiki iā lākou ke kuhikuhi i ka maʻi pololei.
Āhea ʻoe e makemake ai e ʻike hou i ke kauka?
I ka wā o ke kaʻina hana hōʻoia, he mea nui e hoʻomaopopo i kāu kauka inā he mau loli i kou kūlana. E hōʻoia e kāhea hou a ʻike paha i kāu kauka ma nā kūlana aʻe:
- Inā e ʻoi aʻe ka ʻino a nalowale loa paha kou mau hōʻailona .
- Inā ʻoe e hoʻomohala i nā hōʻailona hou.
- Inā pono ʻoe e hoʻokomo ʻia i ka haukapila no kekahi kumu ʻē aʻe.
- Inā pono ʻoe e hana i kekahi hoʻololi i nā lāʻau lapaʻau āu e lawe nei (e.g. inā kuhikuhi kekahi kauka ʻē aʻe i kahi lāʻau lapaʻau hou)
E kōkua kēia ʻike i ke kauka e ʻike i kou maʻi.
Leka Lawe-Home
- ʻO ka hōʻailona ʻokoʻa he "papa inoa o nā maʻi hiki ke loaʻa" iā ʻoe, ʻaʻole kāu hōʻailona hope loa.
- He hana koʻikoʻi loa kēia a he hana maʻamau i hoʻohana ʻia e nā kauka e pale aku i nā hewa a hōʻoia i kou palekana.
- ʻO ka haʻi pololei ʻana i kāu kauka e pili ana i kāu mau hōʻailona, nā maʻi i hala, a me nā lāʻau lapaʻau āu e lawe nei e kōkua nui iā lākou e ʻike i ke ʻano o ka maʻi.
- Mai hopohopo ke haʻi aku ke kauka iā ʻoe e pili ana i kekahi mau maʻi hiki. ʻO ke ʻano kēia e kāpae lākou i nā kūlana ʻē aʻe ma o ka hoʻāʻo ʻana e ʻike i ke kumu maoli.
- Inā he loli i kāu mau hōʻailona, mai kānalua e hoʻomaopopo i kāu kauka.











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