Ke manaʻo nei hoʻi ʻoe i ka poniuniu ke kū koke ʻoe i luna? Hiki paha ke lilo i (Orthostatic Hypotension)! E kamaʻilio kākou.

Ke manaʻo nei ʻoe ua poniuniu a poʻo paha ke kū koke ʻoe, inā ʻoe e noho ana a moe paha? I kekahi manawa manaʻo ʻoe e like me ʻoe e hiolo ana no kekahi manawa, ʻeā? ʻO kēia ke kūlana a mākou e kamaʻilio ai i kēia lā, i kapa ʻia ʻo "Orthostatic Hypotension". Ua kapa pū kekahi poʻe iā ia he "Postural Hypotension." Mai hopohopo, he mea kēia e hiki ke hana i nā poʻe he nui, ʻoiai ke ʻelemakule lākou. E kamaʻilio kākou e pili ana i kēia me nā kikoʻī a me ka maʻalahi.

He aha ka `(Orthostatic Hypotension)`? I ka ʻōlelo maʻalahi...

I ka ʻōlelo maʻalahi, ʻo `(Orthostatic Hypotension)` ka wā e hāʻule koke ai kou koko ke kū ʻoe mai kahi noho a moe paha. E noʻonoʻo, e noho ana ʻoe ma kahi noho e heluhelu ana i kahi nūpepa a kū koke i luna no ka mea ke kamaʻilio nei kekahi. ʻO ia ka manawa e manaʻo ai ʻoe i ka poniuniu. ʻO `(Orthostatic)` ke ʻano o ke kūlana kū pololei. ʻO `(Hypotension)` ke ʻano o ke koko haʻahaʻa. No laila, ʻo kēia ka wā e hāʻule ai kou koko ke hoʻololi ʻoe i ke kūlana.

No laila, he aha kēia kaomi koko?

Lohe pinepine mākou e pili ana i ke kaomi koko, a i ʻole "Kaomi Koko". Ana kēia i ke kaomi a ke koko e kau ai ma luna o nā paia o nā aʻa i ka wā e paʻi ai ko mākou puʻuwai. Ua like ia me ke kaomi a ka wai e kau ai ma luna o nā paipu i ka wā e kahe ana ma o kahi pamu wai. Ua ana ʻia kēia ma nā millimeters o ka mercury "(mmHg)".

Ke hele ʻoe i ke kauka, haʻi lākou iā ʻoe i ʻelua mau helu ke nānā lākou i kou koko, ʻeā?

• ʻO ka helu kiʻekiʻe `(Systolic)`: Pili kēia i ke kaomi i ka wā e paʻi ai kou puʻuwai a pamu i ke koko i loko o kou mau aa koko.
• ʻO ka helu lalo `(Diastolic)`: Pili kēia i ke kaomi i loko o nā aʻa ma waena o nā puʻuwai ʻelua, ʻo ia hoʻi, ke hoʻomaha iki ka puʻuwai.

Kākau nā kauka iā ia ma ke ʻano he helu kiʻekiʻe/helu lalo (e.g. 120/80 mmHg). ʻOi aku ka liʻiliʻi o ke koko olakino o ka hapa nui o nā kānaka ma mua o 120/80 mmHg. ʻO ka heluhelu ma lalo o 90/60 mmHg ua manaʻo ʻia he haʻahaʻa ke koko.

ʻEhia ka nui o ka hāʻule ʻana o ke koko i ka "Orthostatic Hypotension"?

ʻAʻohe waiwai pololei no kēia. Eia nō naʻe, hoʻoholo nā kauka i kēia ma ka nānā ʻana i kou koko koko maʻamau a me ka nui o kona emi ʻana ke kū ʻoe i luna. Ma ke ʻano laulā, inā hāʻule ka helu kiʻekiʻe "Systolic" ma 20 mmHg a i ʻole ka helu lalo "Diastolic" e hāʻule ma 10 mmHg i loko o ʻekolu mau minuke o ke kū ʻana , ua manaʻo ʻia he "Orthostatic Hypotension".

ʻO wai ka mea i ʻoi aku ka paʻakikī o ka hoʻomohala ʻana i ka Orthostatic Hypotension?

Hiki i kēia maʻi ke ulu i loko o kekahi kanaka, akā lilo ia i mea maʻamau i kou wā ʻelemakule. Hiki i nā mea aʻe ke hoʻonui i kou pilikia o ka loaʻa ʻana:

• Anemia a i ʻole ka nele o ka Vitamin B12: Hiki ke kū mai kēia ʻano ke emi ka nui o ke koko a i ʻole ka emi ʻana o ka vitamin B12.
• Ka maloʻo ʻana ma muli o nā laxatives, ka luaʻi ʻana, a i ʻole nā ​​diuretics: Ke emi ka nui o ka wai i loko o ke kino, hiki ke hāʻule ke koko.
• Nā pilikia endocrine:ʻO nā kūlana e like me ka maʻi diabetes, ka maʻi thyroid, a me ka maʻi ʻo Addison.
• Nā pilikia o ka puʻuwai: Nā mea e like me nā maʻi o ka puʻuwai (Arrhythmias), ka maʻi valve o ka puʻuwai.
• Kekahi mau lāʻau lapaʻau: Hiki ke hana ʻia e kekahi mau lāʻau lapaʻau i lawe ʻia no ke koko kiʻekiʻe, ka maʻi puʻuwai, a i ʻole ke kaumaha.
• Nā pilikia neurological: Nā maʻi e like me ka maʻi Parkinson a me ka dementia.
• Hāpai keiki: ʻOi loa aku i loko o nā pule he 24 mua.
• Ke noho ʻana ma kahi moe no ka manawa lōʻihi ma muli o kahi maʻi: E like me ka hoʻomaha ʻana ma kahi moe i ka wā hāpai.

E noʻonoʻo, ʻo ʻAnakala Somapala mai ko mākou kauhale mai. Loaʻa iā ia ka maʻi diabetes a lawe ʻo ia i ka lāʻau lapaʻau no ke koko kiʻekiʻe. Ua ʻōlelo ʻo ia ua manaʻo ʻo ia ua poniuniu ʻo ia ke ala aʻe ʻo ia mai kahi moe i ke kakahiaka. ʻOi aku ka nui o ka poʻe e like me ia e loaʻa i kēia maʻi.

Pehea ka maʻamau o kēia ʻano?

Hoʻopilikia ka hypotension Orthostatic ma kahi o 20% o ka poʻe ʻelemakule , ʻoiai ka poʻe e noho ana ma nā hale mālama. He mea maʻamau nō hoʻi ia i ka poʻe i moe ma kahi moe no ka manawa lōʻihi, a i nā makuahine hou i hānau keiki. Hiki nō hoʻi ke hana i nā ʻōpio e ʻike nei i ka ulu wikiwiki.

He aha nā hōʻailona o kēia?

ʻIke pinepine ʻia ka hypotension Orthostatic a ʻoi aku ka ʻino o nā hōʻailona i ke kakahiaka. ʻO kēia no ka mea he haʻahaʻa iki ko mākou koko ke ala mākou i ke kakahiaka.

ʻAʻohe paha he mau hōʻailona o kekahi poʻe. No kekahi poʻe, ʻoi aku ka ʻino o kēia mau hōʻailona i ka wā wela, ke kuni, a i ʻole ka ʻauʻau ʻana i ka wai wela.

ʻO ka hōʻailona nui ka poniuniu a i ʻole ka māmā o ke poʻo i ke kū ʻana . Pono e nalo kēia ke noho hou ʻoe a moe hou paha. Hiki i kekahi poʻe ke nalowale ka ʻike (syncope).

ʻO nā hōʻailona ʻē aʻe:

• ʻIke pōwehiwehi
• ʻEha umauma, ʻeha poʻohiwi a ʻeha ʻāʻī paha
• Paʻakikī i ka noʻonoʻo ʻana
• Luhi a nāwaliwali paha
• ʻEha poʻo (E kala mai, ua hoʻokomo hewa ʻia kahi huaʻōlelo mai kahi ʻōlelo ʻē aʻe ma ʻaneʻi. Huaʻōlelo pololei: ʻEha poʻo )
• Nā palpitations o ka puʻuwai
• Ka luaʻi a i ʻole ka manaʻo wela a me ka hou
• Pōkole o ka hanu / Dyspnea

No ke aha e kū mai ai kēia `(Orthostatic Hypotension)`? He aha nā kumu?

Ke noho a moe paha kākou, kahe maʻalahi ke koko i loko o nā aʻa o ko kākou mau wāwae i ko kākou puʻuwai. Akā ke kū kākou i luna, hoʻolilo ka umekaumaha i mea paʻakikī no ke koko i loko o ko kākou mau wāwae a me nā wāwae e hiki i ko kākou puʻuwai. Hoʻemi kēia i ka nui o ke koko e hiki ke pamu ʻia i ko kākou puʻuwai, nā ʻōpū ʻē aʻe, a me nā ʻiʻo. ʻO ka hopena, hāʻule ko kākou koko no kekahi manawa.

Aia paha kekahi mau kumu no kēia:

• ʻAʻole hiki i kou puʻuwai ke pamu i ke koko lawa.
• ʻAʻole e hana pono ana kāu ʻōnaehana nerve autonomic (ka mea maʻamau e hoʻoponopono i ke kaomi koko).
• Inā loaʻa iā ʻoe nā maʻi e like me ka maʻi Parkinson, ka Lewy body dementia, a i ʻole ka atrophy ʻōnaehana lehulehu .
• Inā ua noho ʻoe ma ke kūlana like (e.g. moe i lalo) no ka manawa lōʻihi (e like me ka hoʻomaha ʻana ma kahi moe i ka wā hāpai).
• Inā ua emi ka nui o kou koko ma muli o ka nalowale o ke koko a i ʻole nā ​​​​wai (dehydration).
• Inā he pilikia kou me kou kelepa adrenal .
• Ma muli o ke ʻano o ka pane ʻana o kou kino i kahi lāʻau lapaʻau āu e lawe ai .

Pehea e hoʻoholo ai i ka orthostatic hypotension me ka pololei?

Ke hele ʻoe i ke kauka, e ana mua lākou i kou koko i kou wā e noho ana, a laila e moe ana, a laila e kū ana. ʻAʻole wale kēlā, e nīnau pū lākou iā ʻoe e pili ana i kou mau kūlana olakino a me nā lāʻau lapaʻau āu e lawe nei.

Eia kekahi, hiki ke hana ʻia hoʻokahi a ʻoi aku paha o nā hoʻokolohua aʻe:

• Nā hoʻāʻo koko: E nānā i nā maʻi e like me ka maʻi diabetes a me ka anemia.
• Echocardiogram (Echocardiogram / echo): E nānā pehea e pamu ai ka puʻuwai i ke koko.
• Electrocardiogram (EKG): E nānā i nā loli i ka mele o ka puʻuwai.
• Hoʻāʻo koʻikoʻi hoʻoikaika kino: E ana i ka helu o kou puʻuwai i kou wā e hoʻoikaika kino ana.
• Nā polokalamu EKG lawe lima / Nānā Holter: E ana i ke kuʻina o ka puʻuwai i ka lā a pau.
• Hoʻāʻo papa ʻālohilohi: He hoʻāʻo e ana palekana i ke kaomi koko, ka helu o ka puʻuwai, a me ke kuʻina o ka puʻuwai ma ka hoʻomoe ʻana iā ʻoe ma luna o kahi papa ʻaina a hoʻāʻo i ka papa ʻaina i kahi kūlana kū pololei.

He aha nā lāʻau lapaʻau no ka Orthostatic Hypotension?

Pili nā lāʻau lapaʻau i ke kumu o kēia ʻano.

Hiki ke hana i kēia mau mea ma ke ʻano he lāʻau lapaʻau:

• Inā he maʻi a kūlana paha e hoʻoulu ai i ka orthostatic hypotension, e mālama iā ia.
• Ke hoʻololi nei i ka nui o ka lāʻau lapaʻau e hoʻoulu ai i kēia kūlana a i ʻole ke hoʻololi ʻana i kahi lāʻau lapaʻau ʻē aʻe (pono e hana ʻia kēia ma hope o ke kamaʻilio ʻana me kāu kauka).
• Inā ʻoe e hoʻomaha ana ma kahi moe, e hoʻomaʻamaʻa i ka noho ʻana i luna ma kahi moe.
• Ke komo ʻana i nā kāmaʻa elastic. Hoʻēmi kēia i ka hōʻiliʻili ʻana o ke koko ma nā wāwae.
• Inā ua maloʻo ʻoe, e inu i ka wai nui a me nā wai paʻakai.

He aha nā lāʻau lapaʻau i hāʻawi ʻia no kēia?

Hiki ke hoʻomalu pinepine ʻia kēia me nā hoʻololi ʻana i ke ʻano o ka nohona. Eia nō naʻe, pono paha kekahi poʻe e lawe i nā lāʻau lapaʻau e hoʻonui i ka nui o ke koko a me ke koko. Eia naʻe, he mea kakaikahi loa kēia.

ʻO kekahi o kēia mau ʻano lāʻau lapaʻau:

• ʻO Droxidopa
• Nā mea hoʻouluulu Erythropoiesis (ESA) (e.g. Procrit® a i ʻole Epogen®)
• ʻO ka Desmopressin (Nocdurna® a i ʻole ʻo DDAVP®)
• ʻO ka Octreotide (Bynfezia Pen™ a i ʻole Mycapssa®)
• ʻO ka Fludrocortisone
• ʻO ka Midodrine hydrochloride
• ʻO Pyridostigmine (Mestinon® a i ʻole Regonol®)

He mea nui: Pono e lawe ʻia kēia mau lāʻau lapaʻau ma lalo o ke aʻo a ke kauka. ʻO ka lawe ʻana i nā lāʻau lapaʻau ma kāu iho hiki ke loaʻa nā hopena weliweli.

Aia kekahi mau hopena ʻaoʻao o ka lāʻau lapaʻau?

ʻO kekahi mau lāʻau i hoʻohana ʻia no ka Orthostatic Hypotension hiki ke hana i nā hopena ʻaoʻao e like me:

• Māʻule
• ʻĀnai
• Nā ʻeha poʻo
• Pehu ʻana
• Nā pae potassium haʻahaʻa
• Ka hāʻule ʻana o ka puʻuwai (he mea kākaʻikahi loa kēia)

ʻO ia ke kumu he mea nui e loaʻa ka lāʻau lapaʻau ma lalo o ka nānā ʻana a ke kauka.

He aha nā pilikia e hiki ke kū mai ma muli o ka Orthostatic Hypotension?

Hiki i ka poʻe me kēia kūlana ke piʻi aʻe ka pilikia no kēia mau mea:

• Hiki i nā haki iwi a i ʻole nā ​​ʻeha poʻo (concussions) ke hana mai ka hāʻule ʻana i ka wā poniuniu a ʻike ʻole paha .
• ʻO ka hypotension postprandial: ʻO kēia ka emi ʻana o ke koko i loko o 30 mau minuke a ʻelua mau hola ma hope o ka ʻai ʻana i ka ʻai (ʻoi aku ka ʻai i kiʻekiʻe i nā carbohydrates).
• Inā hoʻomau ke koko haʻahaʻa loa, hiki ke loaʻa ka haʻalulu a i ʻole ka hāʻule ʻana o nā ʻōkana (he mea kākaʻikahi loa kēia).
• Ka pilikia o ka hahau ʻana a i ʻole ka maʻi puʻuwai ma muli o nā loli o ke koko .
• ʻO ka hypotension supine: ʻO ke ʻano kēia e hāʻule ke koko i ka wā e moe ana (hiki ke hana ʻia e kekahi mau lāʻau lapaʻau).

He aha ka mea e hana inā loaʻa iaʻu ka `(Orthostatic Hypotension)`?

Hiki i nā poʻe he nui ke kāohi i nā hōʻailona o kēia maʻi (Orthostatic Hypotension) ma ka hahai ʻana i kekahi mau hana pale. No ka laʻana, pono ʻoe e hoʻolōʻihi i kou manawa ke ala ʻoe. He mea paʻakikī loa kēia e hoʻoulu i nā pilikia koʻikoʻi lōʻihi.

He mea hiki ʻole anei ke hoʻōla piha ʻia mai kēia maʻi?

ʻAʻohe "lāʻau lapaʻau" no ka hypotension orthostatic. Eia nō naʻe, hiki ke hoʻomalu nui ʻia nā hōʻailona ma ka hahai ʻana i nā ʻōlelo aʻoaʻo a kāu kauka e hāʻawi ai iā ʻoe. Hiki i kēia ʻōlelo aʻoaʻo ke komo pū me:

• Ke lawe pono ʻana i ka lāʻau lapaʻau i kuhikuhi ʻia.
• E ʻai i nā meaʻai liʻiliʻi ma kahi o ka ʻai ʻana i nā meaʻai nui i ka manawa hoʻokahi.
• E inu i ka nui o ka wai a me nā wai.
• Ke komo ʻana i nā ʻano socks kūikawā (compression stockings).

Pehea e hōʻemi ai i ka pilikia o ka Orthostatic Hypotension?

Inā ʻike ʻoe i ka dizziness e like me kēia, hiki i ka hahai ʻana i kēia mau ʻanuʻu ke kōkua i ka hōʻemi ʻana i nā hōʻailona:

• E kāohi i ka mahana o kou kino: Mai ʻauʻau i ka wai wela loa.
• E noho wai: E inu i ka wai he nui. E hōʻemi i ka waiʻona. Mai ʻai i ka ʻai kaumaha me ka nui o nā kalapona i ka manawa hoʻokahi.
• E hoʻokiʻekiʻe iki i kou poʻo i ka wā e hiamoe ana ma kahi moe: e hoʻohana i hoʻokahi a ʻelua paha uluna keu, a i ʻole e hoʻokiʻekiʻe iki i ke poʻo o ka moena.
• E hoʻomākaukau ma mua o ke ala ʻana: E hoʻokaʻawale i kahi manawa e kū ai mai kahi noho a moe paha. E loaʻa i kahi mea paʻa e paʻa ai ke ala ʻoe.
• E hoʻomaʻamaʻa i kou mau ʻiʻo: Inā pono ʻoe e kū no ka manawa lōʻihi, ma kahi o ke kū mālie ʻana, e hele wāwae pōkole ma ka hāpai ʻana i kou mau wāwae ma ke ʻano ʻē. Ma mua o ke ala ʻana, e hana i nā hoʻomaʻamaʻa isometric (e laʻa, e ʻomi ana i kahi pōpō laholio liʻiliʻi). Hiki i kēia ke hoʻonui iki i kou koko.
• Hoʻomaikaʻi i ke kahe koko a me ke kaomi: E ʻaʻahu i nā kāʻei hoʻopaʻa kūikawā a i ʻole kahi mea hoʻopaʻa ʻōpū.

Āhea wau e ʻike ai i ke kauka?

Inā pinepine ʻoe e poniuniu i kou kū ʻana i luna, pono ʻoe e ʻike i ke kauka . ʻOiai inā hana wale kēia i kekahi manawa, he manaʻo maikaʻi e haʻi aku i kāu kauka e pili ana i ia mea.

Āhea wau e hele ai i kahi Emergency Treatment Unit (ETU) ?

Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​e ʻimi koke i ka lāʻau lapaʻau :

• ʻEha ka umauma.
• Hāʻule a hiolo paha.
• Nā pilikia me ke kaulike a i ʻole ka hoʻonohonoho ʻana.
• Inā he kānalua no ka haki ʻana o ke poʻo a i ʻole ka ʻeha o ke poʻo mai ka hāʻule ʻana.
• Inā he koko a ʻeleʻele paha kou noho.
• Nā hōʻailona o ka haʻalulu (kino anu, hou, hanu wikiwiki, ʻili polū, naʻau palupalu).

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

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

• No ke aha i loaʻa ai iaʻu kēia kūlana i kapa ʻia ʻo "Orthostatic Hypotension"?
• He aha ka lāʻau lapaʻau maikaʻi loa no kēia?
• Ke kumu ʻia nei kēia mau hōʻailona e ka lāʻau lapaʻau aʻu e lawe nei? Pono anei au e hoʻololi i kaʻu lāʻau lapaʻau?
• He aha nā hoʻololi e pono iaʻu e hana e mālama ai i kēia mau hōʻailona?
• He aha nā hōʻailona o nā pilikia e pono iaʻu e makaʻala?

He like anei ka (Orthostatic Hypotension) a me ka (Postural Tachycardia Syndrome - POTS)?

ʻO nā hōʻailona o kahi maʻi i kapa ʻia ʻo `(Postural Tachycardia Syndrome)` a i ʻole `(POTS)` ua like ia me `(Orthostatic Hypotension).` I nā hihia ʻelua, hiki ke ʻike ʻia ka poniuniu a me ka māʻule ʻana i ke kū ʻana. Eia nō naʻe, i loko o `(POTS)`, me ka emi ʻana o ke koko, piʻi ka helu o ka puʻuwai ma kahi o 30-40 mau kuʻi i kēlā me kēia minuke i loko o 10 mau minuke o ke kū ʻana. I loko o `(Orthostatic Hypotension)`, ʻaʻole pinepine ka piʻi ʻana o ka helu o ka puʻuwai.

ʻIke pinepine ʻole ʻia ke kūlana "POTS" ma mua o ka "Orthostatic Hypotension".

Hiki i ka hypotension Orthostatic (Hypotension) ke lilo i maʻi koʻikoʻi loa. Hiki ke lilo i mea weliweli inā nalowale kou kaulike a hāʻule a i ʻole inā nalowale kou ʻike. Eia nō naʻe, hoʻomaikaʻi pinepine nā hōʻailona ke hoʻololi ʻoe i ke ʻano o kou kū ʻana. E kamaʻilio me kāu kauka e pili ana i kāu mau hōʻailona. Pono paha ʻoe e hoʻololi i kāu mau lāʻau lapaʻau. I nā hihia koʻikoʻi, hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau e hoʻomaikaʻi i ke kahe koko a me ke koko.

Nā mea nui e hoʻomanaʻo (Leka Lawe-Home)

ʻAe, i kēia manawa ua ʻoi aku kou maopopo i ka mea a mākou i kamaʻilio ai, ʻo Orthostatic Hypotension. ʻAʻohe mea e hopohopo ai, he kūlana ia e kū nei i nā poʻe he nui. ʻO ka mea nui loa:

• Inā manaʻo koke ʻoe ua poniuniu a ua pōwehiwehi paha kou mau maka, mai hoʻowahāwahā. E ʻimi i ke kōkua lapaʻau.
• E ala koke, ʻoiai ke ala aʻe mai kahi moe i ke kakahiaka, a i ʻole ke ala ʻana ma hope o ka noho lōʻihi ʻana, e hoʻokaʻawale i kahi manawa a hopu i kahi mea e kū ai.
• E inu i ka nui o ka wai. Hiki nō hoʻi kēia ke hana inā ua maloʻo ʻoe.
• E kamaʻilio me kāu kauka e pili ana i nā lāʻau lapaʻau āu e lawe nei. Hiki i kekahi mau lāʻau lapaʻau ke hana i kēia maʻi.
• E pale i nā wahi wela a me ka ʻauʻau ʻana i ka wai wela.
• E makaʻala no ka mea hiki iā ʻoe ke hāʻule. Inā manaʻo ʻoe ua poniuniu, e hoʻāʻo e noho i lalo a moe koke paha.

Lana ko mākou manaʻo he kōkua kēia ʻike iā ʻoe. ʻOi aku ka maikaʻi o ka ʻimi ʻana i ka ʻōlelo aʻo a ke kauka no kekahi mau hopohopo olakino āu e loaʻa ai.

ʻO ka hypotension orthostatic, postural hypotension, ke koko haʻahaʻa, ka poniuniu, ka maule, ka hāʻule ʻana o ke koko, ke koko, ke olakino o ka puʻuwai, ke olakino o ka poʻe ʻelemakule, ka maloʻo ʻana o ka wai, nā hopena ʻaoʻao o ka lāʻau lapaʻau, ʻike olakino Sinhala