Ke ʻeha nei ʻoe a i ʻole ka mae ʻana o kou mau wāwae, ʻoiai ke hele wāwae ʻoe i kahi mamao pōkole a piʻi paha i nā alapiʻi? ʻAʻole anei e nalowale ma hope o ka noho ʻana no kekahi manawa? Manaʻo ka poʻe he ʻāpana maʻamau kēia o ka ʻelemakule a i ʻole ka ʻeha o nā hono, akā he hōʻailona paha ia o kahi mea ʻoi aku ka koʻikoʻi. I kēia lā ke kamaʻilio nei mākou e pili ana i kahi maʻi i kapa ʻia ʻo Peripheral Artery Disease, a i ʻole PAD, ka mea e hoʻoulu ai i kēia mau hōʻailona. He ʻano maʻalahi kēia e mālama ʻia inā ʻike mua ʻia.
I ka ʻōlelo maʻalahi, he aha ka Peripheral Artery Disease (PAD)?
ʻAe, e ʻōlelo kākou penei. Loaʻa iā kākou kahi pūnaewele o nā kīʻaha koko ( nā aʻa ) e lawe ana i ke koko i nā wahi āpau o ko kākou kino, ʻeā? Ua like ia me ka ʻōnaehana paipu e lawe ana i ka wai ma loko o ka hale. ʻO ka maʻi Peripheral Artery (PAD) ka wā e emi mālie ai kēlā mau kīʻaha koko, ʻoiai nā mea e lawe ana i ke koko i nā wāwae, nā pūhaka, a i kekahi manawa nā lima.
E noʻonoʻo i ka hala ʻana o ka manawa, lilo nā paipu wai i loko o kou hale i ʻōpala a paʻa i ka lepo, e hōʻemi ana i ke kahe ʻana o ka wai mai ka piula wai. Pēlā nō, hōʻiliʻili nā mea e like me ka momona a me ka cholesterol i loko o ko kākou mau kīʻaha koko a hana i kahi 'plaque'. I ka lāʻau lapaʻau, kapa mākou i kēia (atherosclerosis) . Hoʻemi kēia plaque i ka hakahaka i loko o nā kīʻaha koko. A laila keakea kēia i ke kahe ʻana o ke koko ma o lākou. Hoʻomaka kēlā ʻeha ke loaʻa ʻole i nā ʻiʻo o nā wāwae ka oxygen a me nā meaʻai e pono ai lākou mai ke koko.
Hoʻopilikia kēia maʻi ma mua o 200 miliona mau kānaka ma ka honua holoʻokoʻa. Piʻi ka pilikia o ka loaʻa ʻana me ka ʻelemakule. No laila, he mea nui loa ka makaʻala i kēia.
He aha nā hōʻailona o ka PAD?
ʻAʻole hōʻike ka nui o ka poʻe i kekahi mau hōʻailona i ka wā mua. Eia nō naʻe, i ka holomua ʻana o ka maʻi, hiki ke ʻike ʻia kēia mau hōʻailona. E nānā kākou i nā hōʻailona nui.
| Hōʻailona | Wehewehena |
|---|---|
| ʻEha wāwae i ka wā e hoʻoikaika kino ai | ʻO kēia ka hōʻailona maʻamau. Hiki iā ʻoe ke ʻike i ka ʻeha, ka ʻoʻoleʻa, ka luhi, a i ʻole ka mae ʻana o kou bipi, ʻūhā, a i ʻole ka ʻūhā i kou wā e hele ai a piʻi paha i ke alapiʻi. ʻO ka mea kupanaha, nalo pinepine kēia ʻeha i loko o 10 mau minuke o ka hoʻomaha ʻana. |
| ʻEha e kū mai ana ʻoiai ke hoʻomaha nei | I ka holomua ʻana o ka maʻi, hiki iā ʻoe ke ʻike i ka ʻeha wela ma kou mau wāwae, nā wāwae, a i ʻole nā manamana wāwae i kou wā e moe wale ana, ʻoiai i ka pō. Hiki ke emi ka ʻeha ke kau ʻoe i kou wāwae i lalo. He hōʻailona koʻikoʻi kēia. |
| Nā ʻeha ʻaʻole e ho'ōla ma nā wāwae a me nā manamana wāwae | Ma muli o ka maikaʻi ʻole o ke kahe koko o nā wāwae, ʻoiai nā ʻōpala liʻiliʻi e lōʻihi ka manawa e ho'ōla ai. I kekahi manawa hiki i kēia ke lilo i mau ʻeha nui a lilo i maʻi. |
| Nā loli i ke kala a me ka mahana o ka ʻili | Inā paʻa koke kahi kīʻaha koko, e lilo paha ka ʻili ma ka wāwae i poni, ʻōmaʻomaʻo, ʻeleʻele, a i ʻole e mae koke . Hiki nō hoʻi ke anuanu o ka wāwae ma mua o ka wāwae ʻē aʻe. Hiki paha iā ʻoe ke manaʻo i kahi manaʻo "pine a me nā nila" . He kūlana kēia e pono ai ke kōkua lapaʻau koke. |
ʻO ka mea nui, ʻo ka wahi o ka ʻeha e hiki ke hāʻawi iā ʻoe i kahi manaʻo maʻamau o kahi i paʻa ai ke kīʻaha koko. No ka laʻana, inā ʻoe e ʻeha ana ma kou puʻupuʻu, nā pūhaka, a i ʻole nā ʻūhā, ʻo ka paʻa ʻana paha ma nā kīʻaha koko nui ma kou ʻōpū haʻahaʻa a i ʻole pelvis. Inā ʻo ka ʻeha ma kou ʻūhā wale nō, ʻo ka paʻa ʻana paha ma nā kīʻaha koko kokoke i kou mau kuli .
No nā kāne, hiki i kēia maʻi ke hoʻoulu i ka erectile dysfunction ma muli o ka nele o ke koko i ka penis.
ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i ka PAD?
ʻOiai hiki i kekahi ke loaʻa i kēia maʻi, ʻoi aku ka nui o ka pilikia o kekahi poʻe. E nānā inā loaʻa iā ʻoe kēia mau mea pilikia .
- No ka poʻe puhi paka : ʻO kēia ke kumu nui a koʻikoʻi loa o ka pilikiaHoʻopōʻino ka puhipaka i nā paia laumania o loko o nā kīʻaha koko a hoʻolalelale i ke kūkulu ʻia ʻana o nā clots koko.
- No ka poʻe me ka maʻi diabetes : Hiki i nā pae kō koko kiʻekiʻe ke hōʻino i nā kīʻaha koko. ʻO ke kanaka me ka maʻi diabetes a me ka puhipaka he ʻelua a ʻehā manawa ka nui o ka loaʻa ʻana o ka PAD ma mua o ka mea me ka ʻole o kekahi o nā maʻi.
- No ka poʻe me ke koko kiʻekiʻe: I ka piʻi ʻana o ke kaomi, ua hōʻino ʻia nā paia o nā kīʻaha koko a ua maʻalahi ka hana ʻana o nā ʻōpū koko.
- No ka poʻe me ke kiʻekiʻe o ka cholesterol a i ʻole ka triglyceride: ʻO ka nui o ka momona i loko o ke koko, ʻo ka nui o ka manawa e waiho ai i loko o nā kīʻaha koko ma ke ʻano he plaque.
- No ka poʻe me ka maʻi puʻupaʻa mau loa.
- Inā ua loaʻa i kekahi o kou ʻohana ka PAD, ka maʻi puʻuwai, a i ʻole ka hahau ʻana.
He aha nā hopena koʻikoʻi e hiki mai ana inā ʻaʻole mālama ʻia?
Inā ʻoe e hoʻowahāwahā i kēia, me ka manaʻo he pilikia wāwae wale nō ia, hiki ke loaʻa nā hopena koʻikoʻi.
ʻO kekahi, ʻo ia ka wā e pau loa ai ke kahe koko i ka wāwae a hoʻomaka ka make ʻana o nā ʻiʻo. Ua kapa ʻia kēia he gangrene . Inā hana ʻia kēia, pono paha ke ʻoki ʻia ʻana o kahi manamana lima, manamana wāwae, a i ʻole kekahi ʻāpana o ka wāwae e pale aku i ka laha ʻana o ka maʻi ma ke kino holoʻokoʻa. Akā, mai hopohopo, ke hana nei nā kauka i kā lākou mea maikaʻi loa e pale aku i kēia.
Aia kekahi mea ʻoi aku ka nui. E noʻonoʻo, inā ua ālai ʻia nā kīʻaha koko i kou mau wāwae, aia kahi manawa kūpono e ālai ʻia nā aʻa koko e lawe ana i ke koko i kou puʻuwai a me kou lolo ma ke ʻano like. ʻO ke ʻano kēia, ʻoi aku ka nui o ka pilikia o ka loaʻa ʻana o ka hōʻeha puʻuwai a i ʻole ka hahau ʻana i kahi kanaka me PAD. No laila, ʻo ka mālama ʻana i ka PAD ʻaʻole wale ia e hoʻopakele i kou mau wāwae, akā e hoʻopakele pū i kou ola.
Pehea e ʻike pono ai ke kauka i kēia maʻi?
Ke hele ʻoe e ʻike i kāu kauka, e nīnau mua ʻo ia iā ʻoe e pili ana i kāu mau hōʻailona. A laila e nānā ʻo ia i kou mau wāwae. Ma ke ʻano kūikawā, e hoʻopā ʻo ia i nā pulse ma nā ʻāpana like ʻole o kou mau wāwae e nānā i nā loli o ke kahe koko.
A laila, hiki ke hana i kekahi mau hoʻokolohua e hōʻoia i ka maʻi:
- ʻO ka helu kuʻekuʻe wāwae-brachial (ABI): He hoʻāʻo maʻalahi loa kēia, ʻaʻohe ʻeha. Ana ia i ke kaomi ma kou lima a me ke kaomi ma kou kuʻekuʻe wāwae a hoʻohālikelike i nā mea ʻelua. ʻO ka maʻamau, pono ke kaomi ma kou kuʻekuʻe wāwae e ʻoi aku ka kiʻekiʻe ma mua o ke kaomi ma kou lima. Inā haʻahaʻa, ʻo ia hoʻi he pilikia me ke kahe koko i kou wāwae.
- ʻO ke kani ultrasound o nā kīʻaha koko:Ua like kēia me ke kiʻi ʻana i kahi pēpē. Hiki iā ia ke ʻike i ka wikiwiki o ke kahe ʻana o ke koko i loko o nā kīʻaha koko a me nā mea i ālai ʻia.
- Hoʻopaʻa leo pulse (PVR): Ke ana kēia i ka nui o ke koko e kahe ana i nā wāwae.
- ʻO ka CT angiogram / MRA (Magnetic resonance angiogram - MRA): Hiki i kēia ke kiʻi i nā kiʻi kikoʻī o nā kīʻaha koko a kuhikuhi i ka wahi a me ka nui o ka paʻa ʻana.
He aha nā lāʻau lapaʻau no PAD?
Aia ka lāʻau lapaʻau i ke koʻikoʻi o kāu mau hōʻailona. I nā pae mua, hiki ke hoʻomalu maikaʻi ʻia me nā loli o ke ʻano o ka nohona a me nā lāʻau lapaʻau.
1. Nā loli o ke ʻano o ka nohona
ʻO kēia ke kumu o ka lāʻau lapaʻau.
- Hoʻoikaika Kino: He mea kūpono loa ka hoʻoikaika kino, ʻoiai ka hoʻoikaika kino i kiaʻi ʻia (Structured Exercise Therapy) . Maanei, ua hana ʻia ʻoe e hele ma luna o ka treadmill. Ke hoʻomaka ka ʻeha o kou mau wāwae, kū ʻoe no kekahi manawa, a i ka wā e pau ai ka ʻeha, hele hou ʻoe. Hoʻoulu kēia i ka ulu ʻana o nā kīʻaha koko hou i kou mau wāwae.
- Nā meaʻai olakino no ka puʻuwai: He mea nui loa ka ʻai ʻana i ka ʻai e nui ana i nā mea kanu, nā huaʻai, nā nati, a me nā palaoa holoʻokoʻa, a haʻahaʻa hoʻi i ka ʻaila a me ka paʻakai.
- Ke Haʻalele ʻana i ka Puhipaka: Ke haʻi hou nei au, ʻo ka mea maikaʻi loa hiki iā ʻoe ke hana nou iho, ʻo ia ke haʻalele i ka puhipaka i kēia lā inā hana ʻoe. E kamaʻilio me kāu kauka no ke kōkua me kēia.
2. Nā lāʻau lapaʻau (nā ʻano lāʻau lapaʻau)
Hiki i kāu kauka ke kuhikuhi i kēia ʻano lāʻau lapaʻau.
- Nā lāʻau hoʻokahe koko: Hoʻemi lākou i ke kāpili ʻana o ke koko a hoʻomaʻamaʻa i ke kahe ʻana o ke koko. (Ex: Clopidogrel, Aspirin)
- Nā lāʻau hoʻohaʻahaʻa kolesterol (Statins): Hoʻemi lākou i ka hōʻiliʻili ʻana o ka plaque i loko o nā kīʻaha koko.
- Nā lāʻau lapaʻau koko: E hōʻemi i ka hōʻino ʻana i nā kīʻaha koko.
- Nā Vasodilators: Kōkua kēia mau lāʻau lapaʻau i ka hoʻonui iki ʻana i nā kīʻaha koko, e hoʻonui ana i ka mamao hiki iā ʻoe ke hele me ka ʻeha ʻole. (Ex: Cilostazol)
3. Mālama kūikawā no nā wāwae
He mea nui loa i kekahi me PAD ke mālama i ko lākou mau wāwae.
- E nānā i kou mau wāwae i kēlā me kēia lā no nā ʻeha, nā māwae, a me ke kala ʻole o ke kala.
- E holoi i kou mau lima me ke kopa i kēlā me kēia lā a hoʻomaloʻo pono iā lākou, a ma waena o kou mau manamana wāwae.
- Mai hele wāwae ʻole.
- E hoʻohana i nā kāmaʻa a me nā soka palupalu, kūpono a palahalaha hoʻi.
4. Nā Kaʻina Hana a me nā ʻoki kino
Inā ʻaʻole hiki ke kāohi ʻia ka maʻi me nā lāʻau lapaʻau a me nā loli o ke ʻano o ka nohona, a inā he koʻikoʻi ka maʻi, pono paha ʻoe e hoʻohana i kēia ʻano lāʻau.
- Angioplasty: Hoʻokomo ʻia kahi ʻōmole lahilahi (catheter) i loko o ke kīʻaha koko i paʻa a hoʻopiha ʻia kahi mea e like me ka pōpō ma ka hopena e hoʻonui i ka mea i paʻa. I kekahi manawa hoʻokomo ʻia kahi mea liʻiliʻi e like me ka ʻupena i kapa ʻia he stent e pale aku iā ia mai ka pani hou ʻana.
- Atherectomy: Hoʻohana ʻia kahi catheter e kahakaha i ka plaque i loko o ke kīʻaha koko.
- ʻO ke ʻoki ʻana i ke aʻa peripheral: E like me ke ʻoki ʻana i ke aʻa puʻuwai, hana ʻia kahi aʻa hou ma ka hoʻohana ʻana i kahi kīʻaha koko i lawe ʻia mai kahi ʻāpana ʻē aʻe o ke kino a i ʻole kahi aʻa hana e kāpae i ke aʻa i ālai ʻia.
Āhea wau e ʻike ai i ke kauka? Āhea wau e hele ai i ka ETU?
Inā ʻike ʻoe i kēia mau mea, e ʻike pono i kāu kauka.
- Inā ua hoʻomaka wale nā hōʻailona a inā paha e ʻoi aku ka ʻino o nā hōʻailona i kēia manawa.
- Inā paʻakikī loa ka hele wāwae ʻana a hiki ʻole iā ʻoe ke hana i nā hana maʻamau.
- Inā ʻeha kou mau wāwae ʻoiai ke kū wale ʻana.
- Inā he ʻeha kou ma kou wāwae e ola ʻole ana.
Nā kūlana i ka wā e pono ai ʻoe e hele koke i ka haukapila:
Inā make koke kou wāwae, ʻaʻole hiki ke neʻe, a ʻokoʻa paha ke kala (ʻeleʻele a poni paha) a ʻoi aku ke anuanu ma mua o kekahi wāwae, ʻo ia hoʻi ua pau koke ke kahe ʻana o ke koko. He pilikia kēia. Pono ʻoe e hele koke i ka ETU (Emergency Treatment Unit).
He maʻi ola ka PAD. Akā inā mālama pono ʻia, hiki iā ʻoe ke ola i kahi ola maʻamau. He mea nui e mālama mau i ka launa pū ʻana me kāu kauka.
Leka Lawe-Home
- Mai hoʻowahāwahā i ka ʻeha o nā wāwae i ka wā e hele ana no ka mea he mea maʻamau ia. He hōʻailona paha ia o ka maʻi Peripheral Artery (PAD).
- ʻAʻole wale ka PAD he maʻi wāwae. He hōʻailona koʻikoʻi ia e pili ana i ka pilikia o ka hōʻeha puʻuwai a me ka hahau.
- ʻO ka puhipaka a me ka maʻi diabetes nā kumu nui ʻelua no ka hoʻomohala ʻana i kēia maʻi. Inā ʻoe e puhipaka, e hoʻōki i kēia lā.
- Hiki ke hoʻomalu maikaʻi ʻia ka maʻi ma o ka hoʻololi ʻana i ke ʻano o ka nohona (hoʻoikaika kino, ʻai maikaʻi) a me ka hoʻohana ʻana i ka lāʻau lapaʻau i kauoha ʻia e kāu kauka.
- E mālama pono i kou mau wāwae. E nānā iā lākou i kēlā me kēia lā, e hoʻomaʻemaʻe iā lākou, a e ʻaʻahu i nā kāmaʻa kūpono.
- Mai hoʻowahāwahā i nā hōʻailona. E ʻike koke i ke kauka no ka ʻōlelo aʻo. Hiki iā ia ke hoʻopakele i kou wāwae a me kou ola.
ʻO ka maʻi ʻaʻai Peripheral, PAD, ʻeha wāwae, nalowale o ka lauoho, ke ālai ʻana o ke kīʻaha koko, atherosclerosis, puhi paka, maʻi diabetes
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