Paʻakikī ka hanu ʻana ma muli o ka momona? E kamaʻilio kākou e pili ana i ka (Obesity Hypoventilation Syndrome)!

Ke manaʻo nei ʻoe i kekahi manawa ua pōkole ka hanu? Ua luhi a hiamoe wale ʻoe i ke ao? He mea nui e makaʻala i kēia mau mea, ʻoiai inā he momona ʻoe. I kēia lā e kamaʻilio mākou e pili ana i kahi pilikia hanu i ʻike ʻole ʻia, akā he koʻikoʻi paha, hiki ke pili me ka momona. Ua kapa ʻia kēia ʻo `(Obesity Hypoventilation Syndrome)` a i ʻole OHS. Mai hopohopo, e wehewehe maʻalahi kākou.

He aha ka OHS (Obesity Hypoventilation Syndrome)?

I ka ʻōlelo maʻalahi, ʻo ka `(Obesity Hypoventilation Syndrome)` he maʻi hanu e kū mai ana i kekahi poʻe momona. ʻO kēia ka manawa e piʻi ai ka nui o ke kalapona ʻokikene i loko o ko kākou koko a emi iho ka nui o ka oxygen. ʻO ka maʻamau, ke hanu mākou, lawe mākou i ka oxygen a hoʻokuʻu i ke kalapona ʻokikene. Akā i ka wā e emi ai ka nui o ka hanu ʻana a ʻaʻole komo pono ka ea i loko o nā māmā, nalowale kēia kaulike. Ua kapa ʻia kēia ʻo `(Hypoventilation)` (ka hanu ʻana i emi iho).

Ma waho aʻe o ka hypoventilation, hiki ke loaʻa pū ka hanu ʻana me ka pilikia hiamoe i ka OHS. ʻO kaʻoiaʻiʻo, 90% o nā pilikia hanu ʻana me ka pilikia hiamoe e pili ana me OHS ma muli o ka obstructive sleep apnea.

No laila, ua like ka OHS me ka hui pū ʻana o ʻekolu mau mea nui:

• Ka momona.
• Ka emi ʻana o ka hanu ʻana (Hypoventilation).
• Ka hanu ʻana me ka pilikia o ka hiamoe.

Aia kekahi inoa ʻē aʻe no kēia OHS, ʻo ia hoʻi ʻo `(Pickwickian Syndrome)`. Ua kapa ʻia ka inoa ma muli o kekahi kanaka i loko o kahi moʻolelo a Charles Dickens i loaʻa nā hōʻailona o OHS.

He pilikia koʻikoʻi ka OHS i ka hanu ʻana o ka momona. ʻOiai hiki iā ia ke hoʻoulu i nā pilikia olakino e hoʻoweliweli ana i ke ola, he mau lāʻau maikaʻi kona.

ʻO wai ka mea i ʻoi aku ka paʻakikī o ka loaʻa ʻana o ka OHS?

ʻOi aku ka maʻamau o ka OHS i nā kāne ma mua o nā wahine. Aia kekahi mau ʻokoʻa i hōʻike ʻia ma waena o kekahi mau hui lāhui. Eia nō naʻe, ʻo ke kumu pilikia nui ka momona.

He mea paʻakikī ke ʻōlelo pololei i ke ʻano maʻamau o kēia, akā ua hōʻike kekahi mau noiʻi e hiki ke hoʻopilikia i kahi pakeneka liʻiliʻi o ka heluna kanaka makua. ʻO ia hoʻi , ʻaʻole ia he mea maʻamau loa, akā he mea ia e hoʻopilikia ai i kahi heluna nui o ka poʻe.

He aha nā hōʻailona o ka OHS?

ʻO ka maʻamau, ʻo nā hōʻailona o ka OHS ka nele o ka hiamoe a me ka haʻahaʻa o ka oxygen i loko o ke koko (Hypoxemia). ʻO kekahi o kēia mau hōʻailona:

• Pōkole o ka hanu.
• Luhi mau ka manaʻo (Fatigue).
• Ka nele o ka ikehu.
• Ka hiamoe nui ʻana i ke ao (Lohi ka hiamoe i ke ao).
• ʻEha pinepine ka ʻeha.
• Pōʻaiʻī.
• Kaumaha.

ʻOiai ʻoe e hiamoe ana, e ʻike paha kāu hoa i nā mea e like me:

• Hanu nui.
• Manaʻo e like me ʻoe e ʻū ana a hanu paha i ka wā e hiamoe ana.
• Hoʻomaha i ka hanu ʻana. E noʻonoʻo inā haʻi aku kekahi iā ʻoe, "Ke hiamoe ʻoe i ka pō, i kekahi manawa manaʻo ʻoe ua oki kou hanu ʻana no kekahi mau kekona." He mea like ia.

He aha nā kumu o ka OHS?

ʻAʻole maopopo i nā kānaka noiʻi ke kumu o ka OHS, akā manaʻoʻiʻo lākou he kumu ia o ka hui pū ʻana o nā kumu:

• Aia paha kekahi mea hewa i ke ʻano o kou lolo e kāohi ai i ka hanu ʻana . Me he mea lā he hemahema iki i kā mākou "switch" hanu.
• ʻO ke kaumaha keu ma ka ʻāpana umauma e hiki ai i nā māmā ke pehu pono a lawe i nā hanu hohonu. Ua like ia me ka hoʻāʻo ʻana e hanu me ke kaumaha ma kou umauma.
• Hiki i ka momona keu ma nā wahi e like me ka ʻāʻī, ka umauma, a me ka ʻōpū ke hoʻonui i ka hana ʻana o kekahi mau hormones , hiki ke hoʻopilikia i nā ʻano hanu.

Pehea ʻoe e ʻike ai inā loaʻa iā ʻoe ka OHS?

Ke hele ʻoe e ʻike i ke kauka, e nīnau lākou e pili ana i kāu mau hōʻailona a nānā iā ʻoe. E ana lākou i kou kiʻekiʻe a me kou kaumaha a e helu i kāu Body Mass Index (BMI). ʻO 30 a ʻoi aku paha ka BMI o ka poʻe momona.

Ma hope o kēlā, hiki i ke kauka ke kauoha i kekahi mau hoʻokolohua hou aʻe e hoʻoholo ai inā loaʻa iā ʻoe ka OHS. ʻO kekahi o kēia mau mea:

• Hoʻāʻo kinoea koko arterial: Pili kēia i ka lawe ʻana i kahi liʻiliʻi o ke koko mai kou aʻa a me ke ana ʻana i ka nui o ke kalapona ʻokikene a me ka oxygen i loko. Penei e hiki ai iā ʻoe ke ʻike inā kiʻekiʻe kou koko i ka CO2 a haʻahaʻa paha i ka O2.
• ʻO ka pulse oximeter: Ua ʻike paha ʻoe i kēia, he mea liʻiliʻi e like me ke clip āu e kau ai ma kou manamana lima. Hiki iā ia ke ana i ka nui o ka oxygen i loko o kou koko. Eia naʻe, ʻaʻole hiki iā ia ke ana i ke kalapona dioxide, a ʻaʻole pololei e like me kahi hāpana koko.
• Nā hoʻāʻo hana pulmonary: Nānā kēia mau hoʻokolohua i ka hana maikaʻi o kou mau māmā a nānā i nā kumu ʻē aʻe o ka pōkole o ka hanu.
• X-ray umauma: Hiki i kēia ke kōkua i ka hoʻopau ʻana i nā kumu ʻē aʻe o ka hanu pōkole.
• Haʻawina hiamoe `(Polisomnography):` He hoʻokolohua kūikawā kēia. Ma hope o ka noho ʻana i hoʻokahi pō ma ka haukapila, e nānā ʻia kou hanu ʻana, ka helu o ka puʻuwai, a me nā nalu lolo i kou hiamoe ʻana. Hiki i kēia ke kōkua i ka hoʻoholo ʻana inā loaʻa iā ʻoe `(Sleep Apnea)` a, inā pēlā, pehea kona koʻikoʻi.

He aha nā lāʻau lapaʻau no OHS?

ʻO ka mālama ʻana no OHS e pili ana i ka hoʻemi kaumaha a me ke kākoʻo hanu ʻana.

Ka emi ʻana o ke kaumaha

ʻO ka loaʻa ʻana o kahi kaumaha olakino e kūpono i kou kino a me ka mālama ʻana iā ia ke kaʻina mua a koʻikoʻi loa i ka mālama ʻana i ka OHS.I kekahi manawa, ʻo ka hōʻemi wale ʻana i ke kaumaha hiki ke kōkua i ka kaohi ʻana i nā hōʻailona a hoʻomaikaʻi i ke kūlana. ʻO ka lawe ʻana i kahi nohona olakino hiki ke kōkua nui. Eia kekahi laʻana:

• ʻAi ʻana i kahi meaʻai olakino. Eia kekahi laʻana, kahi meaʻai kaulike e like me ka meaʻai Mediterranean.
• E hoʻoikaika kino no 30 mau minuke ma ka liʻiliʻi i ka lā.
• E hoʻokumu i nā ʻano hiamoe maikaʻi.

Ma muli o kou kūlana, hiki i kāu kauka ke ʻōlelo aku i ke ʻoki ʻana i ke kaumaha, e like me ke ʻoki ʻana i ka gastric bypass.

Kōkua i ka hanu ʻana

Hiki i kāu kauka ke ʻōlelo aku i kahi mīkini hoʻoulu ea mechanical e kōkua iā ʻoe e hanu. He mau mea hana ʻaʻole invasive kēia, ʻo ia hoʻi hiki ke hoʻohana ʻia me ka ʻole o ke ʻoki kino nui. Mālama kēia mau mīkini i kou mau ala ea i ka pō i kou hiamoe ʻana, e hoʻonui ana i ka nui o ka oxygen i loko o kou koko. Hoʻokomo ʻoe i kahi pale maka kūikawā i kou hiamoe ʻana, a hāʻawi ka mīkini i ka ea ma o kahi ʻōmole. Aia kekahi mau ʻano mīkini:

• Mīkini CPAP (Continuous Positive Airway Pressure): Hāʻawi ka mīkini CPAP i ka ea ma ke kaomi like i kou hanu ʻana a me kou hoʻokuʻu ʻana i waho.
• Mīkini BiPAP (Bilevel Positive Airway Pressure): Hāʻawi ka mīkini BiPAP i ka ea ma ke kaomi kiʻekiʻe ke hanu ʻoe i loko a me ke kaomi haʻahaʻa ke hanu ʻoe i waho. I kekahi manawa ua kapa ʻia kēia ʻo ka inoa inoa ``(BiPAP®)``.

He mea kākaʻikahi loa, inā ʻaʻole hiki i kēia mau mīkini "Positive Airway Pressure" ke kāohi i ke kūlana, pono paha kahi "Tracheostomy". ʻO ke ʻano kēia, hana ke kauka lapaʻau i kahi lua ma kou ʻāʻī a hoʻopili iā ia i kou ʻōpū hanu e kōkua iā ʻoe e hanu. ʻO kēia ka hopena hope loa.

Pehea e hiki ai iā ʻoe ke hōʻemi i ka pilikia o ka hoʻomohala ʻana i ka OHS?

ʻO ke ala maikaʻi loa e hōʻemi ai i kou pilikia o ka loaʻa ʻana o OHS, ʻo ia ka mālama ʻana i kahi kaumaha olakino. Inā ua kuhikuhi kāu kauka iā CPAP a i ʻole BiPAP, he mea nui e hoʻohana pono ia e like me ke kuhikuhi ʻana.

Eia kekahi, inā ʻoe e lele ana a i ʻole e hana ʻia kekahi ʻoki kino, e haʻi mua i kāu kauka , no ka mea, ʻoi aku ka nui o ka pilikia o nā pilikia koʻikoʻi i ia mau hihia.

He aha ke kūlana olakino o kekahi me OHS?

Me ka mālama ʻana, hiki ke hoʻemi ʻia a hoʻopau loa ʻia paha nā hōʻailona o ka OHS. No kekahi poʻe, hiki i ka hōʻemi wale ʻana i ke kaumaha ke kōkua. He mea nui ka mālama ʻana no ka mea hiki iā ia ke hoʻomaikaʻi i kou ʻano ola a hōʻemi i ka pilikia o nā pilikia hou aʻe. Ua hōʻike ʻia ka mālama mua ʻana me ka mīkini hanu e hōʻemi i ka nui o ka make mai ka OHS ma 10%.

Eia nō naʻe, inā ʻaʻole mālama ʻia, hiki i ka OHS ke alakaʻi i nā pilikia e hoʻoweliweli i ke ola, ʻoiai nā pilikia me ka puʻuwai a me nā kīʻaha koko. ʻO ka nele o ka oxygen e kau i ka nui o ke kaumaha ma ka puʻuwai. Lilo pū ʻoe i mea maʻalahi i nā pilikia mai ka nele i ka hiamoe. Me ka ʻole o ka lāʻau lapaʻau, e emi ana kou ʻano o ke ola a e ʻoi aku ka nui o kou pono e hoʻokomo ʻia i ka haukapila.

ʻAʻole maikaʻi loa ka wānana no ka poʻe i loaʻa ʻole ka lāʻau lapaʻau. Hiki i ka OHS i mālama ʻole ʻia ke hoʻopōkole i ka manaʻolana ola. Ma waena o ka poʻe me nā maʻi ʻē aʻe, ʻo ka nui o ka make ʻana o 18 mahina mai OHS he 23%.

He aha nā pilikia e hiki ke loaʻa mai ka OHS?

Inā ʻaʻole mālama ʻia, hiki i ka maʻi momona hypoventilation ke alakaʻi i nā pilikia e pili ana i ka hiamoe. ʻO kēia mau mea:

• Kaumaha.
• Ka huhū a me ka huhū.
• ʻOi aku ka nui o ka pilikia o nā ulia.
• Nā pilikia i ke ola moekolohe a me nā pilina pili.

Hiki i ka OHS ke hana i nā maʻi puʻuwai, no ka laʻana:

• Ke koko kiʻekiʻe (Hypertension).
• Ka hāʻule ʻana o ka puʻuwai ʻākau.
• Ke koko kiʻekiʻe o ka puʻuwai.

Āhea ʻoe e ʻike ai i ke kauka?

Pono ʻoe e ʻike i ke kauka ma nā kūlana aʻe:

• Inā he momona ʻoe a he mau hōʻailona ʻē aʻe e pili ana i ka OHS.
• Ke ʻōlelo mai nei kāu hoa e kani nui ana ʻoe i ka pō a ʻike ʻoe i nā mea e like me kou hanu ʻana e kū pinepine ana?
• Inā ʻoe e manaʻo i ka luhi nui a me ka hiamoe i ke ao.

ʻO ka Obesity Hypoventilation Syndrome (OHS) kahi pilikia hanu koʻikoʻi o ka momona. Inā momona ʻoe, paʻakikī ka hanu ʻana, a i ʻole he mau pilikia e pili ana i ka hiamoe, e ʻike koke i ke kauka. Aia lākou ma laila e kōkua iā ʻoe. Inā ʻike ke kauka iā ʻoe me OHS, e hāʻawi lākou iā ʻoe i ka hoʻolālā lapaʻau kūpono loa.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai

ʻAe, no laila, ke noi aku nei au iā ʻoe e hoʻomanaʻo i kekahi o nā mea nui loa mai nā mea a kākou i kamaʻilio ai.

• ʻO ka Obesity Hypoventilation Syndrome kahi pilikia hanu hiki ke lilo i mea koʻikoʻi a hele pū me ka momona.
• ʻO ka mea e hana ʻia ana ma kēia, ʻo ia ka piʻi ʻana o ke kalapona ʻokikene a me ka emi ʻana o ka oxygen i loko o ke koko.
• ʻO ka mea maikaʻi loa, aia ka lāʻau no kēia! ʻO ka hoʻemi kaumaha a me ka hoʻohana ʻana i nā mīkini hanu e like me CPAP/BiPAP nā mea nui.
• Hiki i ka ʻike mua ʻana a me ka mālama ʻana ke pale i nā pōʻino nui i ke ola a hoʻomaikaʻi nui i ka maikaʻi o ke ola.
• Inā ʻoe he momona nui a loaʻa iā ʻoe nā hōʻailona e like me ka hanu pōkole, ka hiamoe i ke ao, a me ka ʻūhā ʻana i ka pō, e ʻoluʻolu e ʻimi i ke kōkua lapaʻau. ʻAʻohe mea e makaʻu ai a hilahila paha. ʻO kou olakino ka mea nui loa.

Manaʻolana wau he mea pono kēia ʻike iā ʻoe. E ola kino!

ʻO ka maʻi momona Hypoventilation, OHS, Pickwickian Syndrome, momona, pilikia hanu, apnea hiamoe, CPAP, BiPAP