Ke pilikia nei hoʻi ʻoe i ka hanu ʻana? E aʻo kākou e pili ana i ka emphysema, ka mea e hoʻopilikia ai i nā māmā!

Ke manaʻo nei ʻoe i kekahi manawa he pōkole iki ka hanu? Ke hanu nei ʻoe i ka wā e piʻi ai i nā alapiʻi a i ʻole e hele wāwae ana i kahi mamao pōkole? A i ʻole ke ʻeha nei ʻoe i ka ʻū mau? He mau hōʻailona paha kēia o kahi maʻi māmā i kapa ʻia ʻo emphysema, a mākou e kamaʻilio nei i kēia lā. Mai hopohopo, e kamaʻilio kākou e pili ana i kēia.

He aha ka Emphysema? E hoʻomaopopo maʻalahi kākou

I ka ʻōlelo maʻalahi, ʻo ka emphysema kahi maʻi e kū mai ana i ka wā e hōʻino ʻia ai nā ʻeke ea liʻiliʻi i loko o kou mau māmā, i kapa ʻia ʻo alveoli. ʻO kēia mau alveoli ka mea a mākou e hanu ai, e hoʻohui ana i ka oxygen mai ka lewa i ke koko a hoʻokuʻu i ke kalapona dioxide mai ke koko. E noʻonoʻo i kou mau māmā e like me ka ʻōwili pehu. ʻO kēia mau pehu liʻiliʻi ka mea a mākou e kapa aku ai he alveoli. Aia ma kahi o 300 miliona alveoli i loko o kahi māmā olakino maʻamau. I ka emphysema, ua hōʻino ʻia nā paia o kēia mau alveoli a pohā. Ma kahi o kēlā mau pehu liʻiliʻi, hana ʻia nā ʻeke ea nui. Ua like ia me ka puhi ʻana i kahi puʻu o nā pehu liʻiliʻi i loko o ka ʻōwili pehu e hana i hoʻokahi pehu nui. Hoʻemi kēia i ka ʻili o nā māmā no ka hoʻololi ʻana o ka oxygen. Eia kekahi, hiki i ka ea ke paʻa i loko o nā māmā. Hiki i kēia ke paʻakikī i ka hanu ʻana, e hoʻoulu ai i ka wheezing. Hiki i kekahi poʻe ke loaʻa i ka umauma pehu, e hāʻawi ana iā lākou i kahi ʻano barrel-chested.

He aha nā kumu nui o ka emphysema?

Hoʻomaka pinepine ka emphysema i nā poʻe i puhipaka no nā makahiki he nui. Eia naʻe, ʻaʻole ʻo ka puhipaka wale nō ke kumu. Aia kekahi mau kumu ʻē aʻe:

• Nā mea haumia o ka ea ma ka home a i ʻole ma kahi hana: Ka hanu ʻana i nā mea e like me ka lepo a me nā uahi kemika no ka manawa lōʻihi.
• Nā kumu hoʻoilina : Hiki i kekahi poʻe ke loaʻa iā ia ma muli o nā kūlana e like me ka hemahema o Alpha-1 antitrypsin, he kūlana hoʻoilina ia. He mea kākaʻikahi kēia.
• Nā maʻi hanu : Hiki i nā maʻi pinepine o ka māmā ke hoʻopilikia pū kekahi.

Ua ʻōlelo ʻia he ʻoi aku ma mua o 3 miliona mau kānaka ma ʻAmelika Hui Pū ʻIa wale nō e ʻeha nei i ka emphysema. No laila, ʻaʻole kēia he mea e lawe māmā ʻia.

He aha ka ʻokoʻa ma waena o ka Emphysema a me ka COPD?

Ua lohe paha ʻoe i ka huaʻōlelo COPD. ʻO COPD (Chronic Obstructive Pulmonary Disease) ke kū nei no ka maʻi pulmonary obstructive chronic. ʻAʻole ia he maʻi hoʻokahi, akā he huaʻōlelo maʻamau no kahi hui o nā maʻi e hōʻino mālie i nā māmā. ʻO ka Emphysema kekahi maʻi e pili ana i kēia hui COPD. ʻO ka bronchitis mau kekahi ʻano o COPD. Hiki i kekahi mau maʻi COPD ke loaʻa i ka hānō.

He aha ka ʻokoʻa ma waena o ka Emphysema a me ka Bronchitis Mau?

ʻO kēia nā ʻano COPD ʻelua. Hiki i nā poʻe he nui ke loaʻa i nā mea ʻelua i ka manawa like.

• Emphysema: Hoʻopilikia nui kēia i nā alveoli o nā māmā. ʻO ka hōʻailona nui ka paʻakikī o ka hanu ʻana .
• ʻO ka Bronchitis Mau Loa: Hana ʻia kēia e ka luku ʻia ʻana o nā ʻano lahilahi, e like me ka lauoho i loko o nā alaloa (i kapa ʻia he cilia). ʻO kēia mau cilia ke kuleana no ka wehe ʻana i nā germs a me nā ʻōpala e komo i loko o nā alaloa. ʻO ka hōʻailona nui o ka bronchitis mau loa ka hoʻonui ʻia ʻana o ka hana mucus. ʻO ia hoʻi, he ʻūhū huahua e hana ana i ka mucus mānoanoa, melemele, ʻōmaʻomaʻo, a hina paha. I ka emphysema, hiki ke loaʻa nā hōʻailona e like me ke ʻūhū ma waho aʻe o ka pōkole o ka hanu.

He aha nā pae o ka emphysema?

Hoʻokaʻawale nā ​​kauka i ka emphysema i nā pae o ka COPD. Ua kapa ʻia kēia ʻo ka hoʻokaʻawale ʻana o GOLD (Global Initiative for Chronic Obstructive Lung Disease) . Kōkua kēia i ka hoʻomaopopo ʻana i ke koʻikoʻi o ka maʻi.

• Pae 1 (ʻAʻohe ona ʻeha): ʻO kēia ke pae ʻaʻohe ona ʻeha. Ke hana nei kou mau māmā ma ka liʻiliʻi he 80% o ka hana māmā o ke kanaka olakino, ma muli o kou makahiki, ke kiʻekiʻe, a me ke kāne.
• Pae 2 (Waena): Emphysema waena. Aia ka hana o ka māmā ma waena o 50% a me 79%.
• Pae 3 (Pae 3 - Koʻikoʻi): Emphysema koʻikoʻi. Hoʻemi ʻia ka hana o ka māmā ma waena o 30% a me 49%.
• Pae 4 (Koʻikoʻi Loa): Emphysema koʻikoʻi loa. Ua emi ka hana o ka māmā ma mua o 30%.

Ma muli o kēia mau pae e hoʻoholo ai nā kauka e pili ana i nā ʻano lapaʻau a me ke ʻano o ke ola.

He aha ke kūlana o ke ola o kahi mea maʻi me ka emphysema?

He nīnau paʻakikī kēia e pane ʻia. Aia ia i kou mau makahiki, ke kahua o ka maʻi, a inā paha ua puhipaka ʻoe, ua haʻalele, a ʻaʻole paha i puhipaka. Ua ʻōlelo ʻia e hōʻemi ka puhipaka i kou manaʻolana ola ma kahi o 3.5 mau makahiki. He kuleana ko nā kumu hoʻoilina. ʻO ka emphysema ka mea maʻamau i nā kāne ma waena o 50 a me 70 mau makahiki. No laila, he mea nui e hopohopo ʻole a ʻimi koke i ke kōkua lapaʻau inā loaʻa iā ʻoe nā hōʻailona.

He aha nā hōʻailona mua o ka emphysema?

ʻAʻole hoʻomaka ka hapa nui o ka poʻe e ʻike i nā hōʻailona o ka emphysema a hiki i ka luku ʻia ʻana o 50% a ʻoi aku paha o ko lākou ʻiʻo māmā. I kēlā manawa, ʻo nā hōʻailona mua e hoʻonui mālie ana i ka pōkole o ka hanu a me ka luhi. ʻO nā hōʻailona ʻē aʻe:

• ʻŪhū lōʻihi (ʻūhū a ka mea puhipaka).
• Hanu ʻū.
• Paʻakikī ka hanu ʻana, ʻoiai ke hana ʻana i nā hoʻoikaika kino māmā e like me ke piʻi ʻana i nā alapiʻi.
• Ke manaʻo mau nei ʻoe ua nele ʻoe i ka hanu.
• Paʻa ka umauma.
• Hoʻonui ʻia ka hana mucus.
• Ka loli ʻana o ke kala o ka mucus (melemele a ʻōmaʻomaʻo paha).
• Luhi mau .
• Nā pilikia o ka puʻuwai .
• ʻAʻole hiki ke hiamoe.
• Hopohopo .
• Kaumaha.
• Ka emi ʻana o ke kaumaha.

Inā loaʻa iā ʻoe ka emphysema, ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i nā maʻi māmā e like me ka pneumonia a me ka bronchitis.

He aha ke kumu nui o ka emphysema?

ʻO ka puhipaka ke kumu nui o ka emphysema. Hoʻopōʻino ka uahi o ka cigarette i kou ʻiʻo māmā a hoʻonāukiuki i kou mau ala ea. Hoʻoulu kēia i kou mau ala ea e pehu ai, hana i ka mucus, a hoʻolilo iā ia i mea paʻakikī ke hoʻomaʻemaʻe i kou mau ala ea. Hoʻolilo kēia mau mea a pau i mea paʻakikī ke hanu. Aia kekahi mau kumu ʻē aʻe ma waho aʻe o ka puhipaka:

• Uahi cannabis.
• ʻO ka Vaping a me nā e-cigarette.
• Uahi cigar.
• Ka haumia o ka ea.
• Lepo.
• Nā uahi kemika.

He maʻi lele anei ka Emphysema?

ʻAʻole, ʻaʻole he maʻi lele ka emphysema. Inā loaʻa iā ʻoe ka emphysema, ʻaʻole hiki iā ʻoe ke hāʻawi aku i kekahi.

Pehea e ʻike ʻia ai ka Emphysema?

Hiki i kāu kauka ke ʻike i ka emphysema. Eia naʻe, ʻaʻole hiki i nā hōʻailona wale nō ke hōʻike maopopo. E nānā ke kauka iā ʻoe. E hoʻolohe ʻo ia i kou mau māmā me ka stethoscope. Inā lohe ʻoe i kahi leo hakahaka ke pā ʻoe i kou umauma, ʻo ia hoʻi he ea i paʻa i loko o kou mau māmā. A laila, e kauoha lākou i nā hoʻokolohua hou aʻe e hōʻoia i ka emphysema.

He aha nā hoʻokolohua i hoʻohana ʻia e hōʻoia i ka emphysema?

Hiki i ke kauka ke kauoha i kēia mau hoʻokolohua:

• X-ray umauma: No ka nānā ʻana i ke kūlana o nā māmā. Eia nō naʻe, he paʻakikī ke ʻike ʻana i nā X-ray i nā pae mua o ka maʻi. He mea pono wale nō ia i nā hihia waena a koʻikoʻi paha.
• CT scan: Hiki i kēia ke kiʻi i kahi kiʻi ʻekolu-dimensional (3D) o nā māmā. Hāʻawi ia i nā kikoʻī maopopo aʻe ma mua o kahi X-ray.
• Hoʻāʻo hana pulmonary (PFT): Ana i ka maikaʻi o ka hanu ʻana o kou mau māmā i loko a i waho. ʻO kēia hoʻāʻo, i ʻike ʻia hoʻi he spirometry , ana i ke kahe o ka ea ma o kou mau māmā a me ka nui o ka ea i loko o kou mau māmā.
• ʻO ke Kinoea Koko Arterial (ABG): Ke ana nei kēia hoʻāʻo i ka nui o ka oxygen a me ke kalapona dioxide i loko o kahi hāpana koko i lawe ʻia mai kahi aʻa. Hana ʻia kēia hoʻāʻo e ʻike inā pono ʻoe i ka oxygen hoʻohui inā e ʻoi aku ka ʻino o kou emphysema.
• Electrocardiogram (EKG): Hoʻāʻo kēia i ka hana o ka puʻuwai. Hana ʻia kēia e ʻike inā ʻo ka maʻi puʻuwai ke kumu o kou hanu pōkole.
• Nā hoʻāʻo koko a me nā hoʻokolohua genetic: Hana ʻia kēia mau mea e hōʻoia inā he kumu genetic, e like me ka hemahema o Alpha-1 antitrypsin .

Hiki ke ho'ōla ʻia ka pōʻino i nā māmā i hoʻokumu ʻia e ka emphysema?

ʻO ka mea pōʻino, ʻaʻole hiki ke hoʻohuli piha ʻia ka pōʻino i nā māmā i hoʻokumu ʻia e ka emphysema. Eia nō naʻe, hiki i ka lāʻau lapaʻau ke hōʻemi i nā hōʻailona, ​​hoʻomaikaʻi i ke ʻano o ke ola, a pale i nā pōʻino hou aʻe.

Pehea e mālama ʻia ai ka Emphysema?

He maʻi ka emphysema e hiki ke ʻoi aku ka ʻino i ka hala ʻana o ka manawa. No laila, ʻo ka pahuhopu nui o ka mālama ʻana, ʻo ia ke hoʻolohi i ka holomua o ka maʻi a hoʻonui i ka hana o ke koena o ka māmā olakino. ʻOkoʻa nā koho lapaʻau ma muli o ke koʻikoʻi o ka maʻi. Hiki i nā koho lapaʻau ke komo pū me:

• Ke haʻalele ʻana i ka puhipaka: Inā he mea puhipaka ʻoe, ʻo ka hana maikaʻi loa a koʻikoʻi loa no ka kaohi ʻana i ka emphysema, ʻo ia ke haʻalele. Hiki iā ʻoe a me kāu kauka ke hana pū e ʻimi i ke ala maikaʻi loa e hana ai i kēia.
• Nā Bronchodilators: Hoʻomaha kēia mau lāʻau lapaʻau i nā ʻiʻo a puni nā alaloa, e ʻae ana i ka ea hou aku e komo a haʻalele i nā māmā. Hāʻawi pinepine ʻia kēia mau mea ma ke ʻano he mau lāʻau lapaʻau hanu ʻia.
• Nā corticosteroids hanu ʻia: Hoʻemi kēia i ka pehu a me ka hana mucus i loko o nā alaloa. Pono paha ʻoe e lawe i kēia mau mea i kēlā me kēia lā e pale aku i nā hōʻailona.
• Nā corticosteroids waha: Ua kauoha ʻia kēia mau mea no kahi manawa pōkole i ka wā o ka flare-ups.
• Nā lāʻau lapaʻau: Hāʻawi ʻia kēia mau mea e mālama i nā maʻi bacteria e like me ka pneumonia a me ka bronchitis.
• Nā lāʻau lapaʻau anti-inflammatory: E hōʻemi i ka mumū ma nā alaloa hanu.
• ʻO ka lāʻau lapaʻau oxygen: Inā ʻaʻole lawa ka oxygen i kou koko mai kou mau māmā (ua kapa ʻia kēia he hypoxemia) , hiki i ka lāʻau lapaʻau oxygen ke kōkua. Hoʻouna ʻia ka oxygen e kahi mīkini ma o kahi cannula nasal a i ʻole ka pale maka.
• ʻO ke ʻoki ʻana i ka nui o ka māmā (LUM): ʻO kēia ʻoki ʻana e pili ana i ka wehe ʻana i kahi ʻāpana o ka ʻiʻo māmā maʻi a me ka hoʻopili hou ʻana i ke koena o nā ʻiʻo. ʻO ka wehe ʻana i nā ʻiʻo i hōʻino ʻia hiki ke hōʻemi i ke kaomi ma luna o nā ʻiʻo hanu a hoʻonui i ka hiki o ka māmā ke hoʻonui. ʻAʻole hiki i nā kānaka a pau ke hana i kēia ʻoki.
• Hoʻemi ʻana i ka nui o ka māmā Bronchoscopic: Ma kēia kaʻina hana, hoʻokomo ʻia kahi kiwikā hoʻokahi ala i loko o nā ala ea me ka hoʻohana ʻana i ka bronchoscope. ʻAe kēia mau kiwikā i ka ea e puka mai nā māmā, akā ʻaʻole e ʻae i ka ea hou e komo. Hoʻomaʻalahi kēia i ka hanu ʻana. ʻAʻole kēia no nā mea āpau.
• Hoʻoili māmā: Inā loaʻa iā ʻoe ka emphysema koʻikoʻi a ʻaʻole holo pono nā lāʻau ʻē aʻe, hiki paha iā ʻoe ke loaʻa kahi hoʻoili māmā olakino e pani ai i ka māmā i hōʻino ʻia.

He aha kāu e manaʻo ai inā loaʻa iā ʻoe ka emphysema?

Aia kou ʻano i ke koʻikoʻi o kou emphysema. Inā he emphysema iki kou, maikaʻi ka ʻano. Eia nō naʻe, hiki i ka emphysema iki ke hoʻopilikia i kekahi mau hana o kēlā me kēia lā, ʻoiai inā ʻoe ma luna o 65. Hiki ke ʻike ʻia nā hōʻailona i ka wā e hana ai i nā mea e like me ka hele wāwae, piʻi i nā alapiʻi, a i ʻole ke komo ʻana i ke kapa. Inā he emphysema koʻikoʻi kou, hiki ke paʻakikī loa ka hanu ʻana, a pono paha ʻoe i ke kōkua lapaʻau pinepine.

ʻAʻohe lāʻau lapaʻau o ka emphysema. Inā paha e hoʻōki ʻoe i ka puhipaka, ʻaʻole e hoʻihoʻi ʻia ka pōʻino i kou mau māmā. Eia nō naʻe, hiki ke mālama ʻia ka maʻi me ka lāʻau lapaʻau. ʻO ka wikiwiki o kou hoʻomaka ʻana i ka lāʻau lapaʻau, ʻoi aku ka maikaʻi o kou ola.

Pehea e hōʻemi ai i ka pilikia o ka hoʻomohala ʻana i ka emphysema?

ʻO ke ala maikaʻi loa e hōʻemi ai i kou pilikia o ka loaʻa ʻana o ka emphysema, ʻo ia ka pale ʻana i ka puhipaka. ʻAʻole maʻalahi ka haʻalele ʻana i ka puhipaka. Pono paha he mau hoʻāʻo e haʻalele pono ai. Inā ʻoe e noʻonoʻo nei e haʻalele i ka puhipaka, e kamaʻilio me kāu kauka. Hiki iā ia ke kōkua iā ʻoe. He manaʻo maikaʻi nō hoʻi e hui pū me kahi hui kākoʻo. Nā ala ʻē aʻe e hōʻemi ai i kou pilikia o ka emphysema:

• E pale i ka uahi lua, ka haumia o ka ea, nā uahi kemika, ka lepo, ka pollen, a me ka dandruff holoholona.
• E nānā i kou home no ke kinoea radon.
• E ʻaʻahu i ka pale maka i ka wā e hana ana me nā kemika a i ʻole ma nā wahi lepo.

Pehea wau e mālama ai iaʻu iho?

Inā loaʻa iā ʻoe ka emphysema, ʻo ke ala maikaʻi loa e pale aku ai i nā pilikia hou aʻe, ʻo ia ka haʻalele ʻana i ka puhipaka a pale iā ʻoe iho mai nā maʻi hanu. Hiki i kēia mau ʻōlelo aʻoaʻo ke kōkua i ka pale ʻana i nā maʻi hanu:

• E holoi pinepine i kou mau lima.
• E palaki a hoʻohana i ka floss i kou mau niho i kēlā me kēia lā. E hoʻohana i ka wai holoi waha antiseptic ma hope o ka ʻai ʻana.
• E mālama i kāu mau lako hanu maʻemaʻe.
• E hoʻomaʻemaʻe i kou home a e hoʻokuʻu pinepine i ka lepo.
• E kiʻi i kāu mau lāʻau pale i ka manawa kūpono, e komo pū ana me ka pana paʻi flū, ka lāʻau pale pneumococcal, a me ka lāʻau pale COVID-19.
• E kiʻi i kahi papahana hoʻoikaika kino mai kāu kauka a e hahai iā ia.
• E pale i nā mea hoʻonāukiuki e like me ka uahi, ka ʻōpala o ke kaʻa, nā mea ʻala ikaika, nā huahana hoʻomaʻemaʻe, nā pena/varnish, ka lepo, ka pollen, a me ka dander holoholona.

Āhea wau e ʻike ai i ke kauka?

Inā he pilikia nui kou hanu ʻana, e kāhea koke aku i ka 1990.

E kamaʻilio me kāu kauka inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona:

• Inā ʻoi aku ka paʻakikī o ka hanu ʻana ma mua o ka maʻamau a i ʻole ʻoe e pōkole maʻalahi i ka hanu.
• Inā ʻoe e hana ana i ka mucus ma mua o ka maʻamau.
• Inā he melemele a ʻōmaʻomaʻo paha ka huʻa.
• Inā pono ʻoe e hoʻohana pinepine i kāu bronchodilator a i ʻole ka lāʻau corticosteroid inhaled.
• Inā ʻaʻole kōkua kāu lāʻau lapaʻau iā ʻoe e ʻoluʻolu.
• Inā piʻi aʻe ka ʻū.
• Inā ʻaʻole hiki iā ʻoe ke hiamoe i ka pō a ala aʻe paha i waenakonu o ka pō ma muli o ka paʻakikī o ka hanu ʻana.
• Inā manaʻo ʻoe ua haʻahaʻa kou ikehu.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

Ke hele ʻoe e ʻike i ke kauka, e mākaukau e nīnau i nā nīnau e like me kēia:

• Pehea ʻoe e ʻike ai inā loaʻa iaʻu ka emphysema?
• Inā ʻaʻohe oʻu emphysema, he aha ke ʻano olakino ʻē aʻe i loaʻa iaʻu?
• He aha nā mea e hiki ai ke hoʻonui i ka ʻino o koʻu emphysema?
• Pehea e ʻike ai au inā e ʻino ana koʻu hanu ʻana?
• He aha nā koho lapaʻau āu e paipai nei?
• He aha nā hoʻomaʻamaʻa kino āu e paipai nei?
• He aha kaʻu e hana ai e pale aku i ka maʻi hanu?
• He aha kaʻu e hana ai e hoʻōki i ka puhipaka?
• Aia kekahi mau hui kākoʻo e hiki ke kōkua iaʻu e hoʻōki i ka puhipaka?
• Pono anei au i kahi loiloi no nā kaʻina hana hoʻemi i ka nui o ka māmā a i ʻole kahi hoʻoili māmā?

Ke kumu nei ʻo COVID-19 i ka emphysema?

Inā ʻaʻohe ou maʻi māmā a i ʻole ka pōʻino, hiki i ka COVID-19 ke hoʻoulu i ka emphysema nui. Eia naʻe, he mea kākaʻikahi loa kēia. He kakaikahi loa nā hōʻike e pili ana i ka pilina ma waena o COVID-19 a me ka emphysema nui. He maʻi bullous ka emphysema nui. Inā loaʻa iā ʻoe ka emphysema, lilo nā ʻeke ea i nui, e uhi ana i kahi hapakolu o hoʻokahi a i ʻole nā ​​​​māmā ʻelua. Kāhea nā kauka i kēia mau ʻeke ea nui he bullae (plural: bulla).

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

He maʻi mau ka emphysema e hōʻino ana i nā ʻeke ea i loko o kou mau māmā, e paʻakikī ai ka hanu ʻana. ʻAʻole hiki ke hoʻihoʻi ʻia ka pōʻino mai ka emphysema, a hiki ke lilo i mea ʻino i ka hala ʻana o ka manawa. Eia nō naʻe, hiki i ka lāʻau lapaʻau ke kōkua i ka kaohi ʻana i nā hōʻailona a hōʻemi i ka hopena o ka emphysema.Ma waho aʻe o ka mālama ʻana, ʻo ka hahai ʻana i nā ʻōlelo aʻoaʻo e pale aku i nā maʻi hanu e kōkua iā ʻoe e hanu maʻalahi. ʻO ka ʻike mua ʻana i ka maʻi hiki ke kōkua iā ʻoe e mālama i kahi ola maikaʻi no ka manawa lōʻihi. Inā pilikia ʻoe i ka hanu ʻana, ʻoiai inā he puhipaka ʻoe, e ʻike pono i ke kauka. Hiki iā ia ke ʻike i ka emphysema a hana i kahi hoʻolālā olakino e kūpono iā ʻoe. A laila hiki iā ʻoe ke hoʻomau i ka hana ʻana i nā mea āu e makemake ai. Emphysema, maʻi māmā, pōkole o ka hanu, puhi paka, COPD, bronchitis mau, maʻi hanu