He mau kīʻaha koko haiki ko kou i loko o kou mau māmā? E kamaʻilio kākou e pili ana i ka Pulmonary Arterial Hypertension (PAH)!

Ke manaʻo nei ʻoe i kekahi manawa he pōkole iki ka hanu? A i ʻole ke manaʻo nei ʻoe i ka luhi ʻē aʻe i ka wā e hele ana i kahi mamao pōkole? Ua ʻike anei ʻoe ua polū kou mau manamana lima a me kou mau lehelehe me ka ʻeha a paʻa paha i kou umauma? Mai hoʻokuke i kēia mau mea he mau mea maʻamau wale nō. No ka mea, i kekahi manawa, ma hope o kēia mau hōʻailona, ​​aia paha kahi maʻi e pono ai ka nānā ʻana. ʻO kekahi o ia ʻano maʻi ʻo ia ka Pulmonary Arterial Hypertension (PAH) . ʻOiai paha he mea weliweli iki ka inoa, e kamaʻilio kākou e pili ana i ia mea ma ke ʻano maʻalahi a ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

He aha ka Pulmonary Arterial Hypertension (PAH)? I ka ʻōlelo maʻalahi...

I ka ʻōlelo maʻalahi, ʻo ka Pulmonary Arterial Hypertension (PAH) kahi kūlana e hoʻohaiki ʻia ai nā kīʻaha koko liʻiliʻi i loko o kou mau māmā (nā aʻa pulmonary) . E noʻonoʻo e like me ka paipu wai i ālai ʻia, a paʻakikī i ka wai ke kahe ma o ia mea. Ke hoʻohaiki ʻia kēia mau kīʻaha koko, ʻaʻole hiki i ke koko ke kahe pono ma o kou mau māmā. ʻO kēia ke kumu o ke kaomi i loko o kēia mau kīʻaha koko, a i ʻole ke koko, e lilo i kiʻekiʻe loa . ʻO kēia mau kīʻaha koko nā mea e lawe i ke koko nele i ka oxygen mai kou puʻuwai a i kou mau māmā, kahi e hoʻomaʻemaʻe ʻia ai.

No laila he aha ka mea e hana ai ke hana ʻia kēia? Pono ka ʻaoʻao ʻākau o kou puʻuwai e hana ikaika ma mua o ka maʻamau e pamu i ke koko i nā māmā. Ua like ia me ka hāpai ʻana i kahi mea kaumaha a me ka piʻi ʻana i kahi mauna. Ke pono ka puʻuwai e hāpai i kēia ukana keu i ka hala ʻana o ka manawa, hoʻomaka mālie ia e nāwaliwali. Inā ʻaʻole mālama pono ʻia, hiki i kēia kūlana, ʻo PAH, ke hana i kekahi mau pilikia ʻaʻole wale no kou puʻuwai a me kou māmā, akā no kou kino holoʻokoʻa.

E hoʻomanaʻo, ʻo PAH kekahi ʻano kikoʻī o kahi mahele nui i kapa ʻia ʻo Pulmonary Hypertension . ʻO ka Pulmonary Hypertension ka hoʻonui ʻia o ke kaomi i loko o nā kīʻaha koko o nā māmā ma muli o kekahi kumu.

Pehea ka hopena o PAH i kou kino?

Hoʻokomo nui ka Pulmonary Arterial Hypertension (PAH) i ke kaomi ma ka ʻaoʻao ʻākau o kou puʻuwai. ʻO kēia no ka mea ʻo kēia ʻāpana o ka puʻuwai e pamu i ke koko nele i ka oxygen i nā māmā. I ka hala ʻana o ka manawa, hiki i kēia kaomi kiʻekiʻe ke alakaʻi i ka hāʻule ʻana o ka puʻuwai ʻākau .

ʻAʻole wale kēlā, hoʻolohi pū ka PAH i ke kahe o ke koko ma waena o ka puʻuwai a me nā māmā. ʻO ke ʻano kēia, emi ke koko e hele ana i nā māmā e loaʻa ai ka oxygen hou. ʻO ka hopena, emi ka oxygen e hele ana i nā ʻōpū a me nā ʻiʻo ʻē aʻe i loko o kou kino. ʻO ka ʻoiaʻiʻo, pono kēlā me kēia ʻāpana o ko mākou kino i ka oxygen e ola ai. Inā ʻaʻole lawa, hiki ke kū mai nā pilikia.

Pehea ke koʻikoʻi o kēia kūlana i kapa ʻia ʻo PAH?

He maʻi koʻikoʻi loa ka Pulmonary Arterial Hypertension (PAH), a i kekahi manawa he mea hoʻoweliweli i ke ola . Eia nō naʻe, inā ʻike mua ʻia a mālama koke ʻia, hiki iā ʻoe ke ola i kahi ola lōʻihi a maikaʻi hoʻi. No laila he mea nui e makaʻala i nā hōʻailona.

ʻO wai ka mea i hoʻopilikia nui ʻia e PAH?

Hiki i ka PAH ke hoʻopilikia i nā pākeke o kēlā me kēia makahiki. Eia nō naʻe, ʻoi aku ka maʻamau i nā wahine , ka poʻe i ʻike pinepine ʻia ma waena o 30 a me 60 mau makahiki. Ua ʻike ʻia hoʻi he ʻoi aku ka nui o ka pilikia o nā kāne ma luna o 65 mau makahiki e loaʻa ana iā PAH i ka loaʻa ʻana o ka maʻi.

Hiki i kēia kūlana ke hoʻopilikia i nā pēpē ʻōpio. Ke hana ʻia i nā pēpē hānau hou, kapa mākou iā ia he Persistent Pulmonary Hypertension in the Neonate (PPHN) .

Pehea ka maʻamau o ka PAH?

Ke hoʻohālikelike ʻia me nā ʻano ʻē aʻe o ke koko kiʻekiʻe pulmonary, e like me ke koko kiʻekiʻe pulmonary i hoʻokumu ʻia e ka maʻi puʻuwai a i ʻole ka maʻi māmā, ʻaʻole maʻamau ka PAH. ʻOiai ma kahi ʻāina e like me ʻAmelika Hui Pū ʻIa, he 500 a 1,000 wale nō hihia hou o PAH i ʻike ʻia i kēlā me kēia makahiki. Ma nā ʻāina Komohana, ʻo ka nui o ka maʻi ma kahi o 25 no ka miliona.

He aha nā hōʻailona o ke koko kiʻekiʻe o ke koko (PAH)?

ʻAʻole paha ʻoe e ʻike i kekahi mau hōʻailona i nā pae mua o PAH. Hoʻomaka ka hapa nui o ka poʻe e ʻike i nā hōʻailona i ka wā e holomua ai ka maʻi. ʻO kekahi o kēia mau hōʻailona:

• Ka ʻuliuli ʻana o ke kala o nā manamana lima a i ʻole nā ​​​​lehelehe: Me he mea lā ua nele ke koko i ka oxygen.
• ʻEha a ʻeha paha ka umauma: Me he mea lā e ʻomi ana kekahi i kou umauma.
• Pōniuniu a nāwaliwali paha: Hiki ke hana kēia i ka wā e emi ai ke kahe o ke koko i ka lolo.
• Luhi: Manaʻo nui i ka luhi , ʻaʻole wale ka luhi.
• Ka holo wikiwiki a i ʻole ke kuʻi ʻana o ka puʻuwai.
• Pōkole o ka hanu: Hoʻonui kēia i ka hala ʻana o ka manawa. ʻOiai ka hana ʻana i nā hana liʻiliʻi hiki ke hana i ka pōkole o ka hanu.
• Ka pehu ʻana (Edema): Hiki ke hoʻomaka mua ka pehu ʻana ma nā wāwae a me nā kuʻekuʻe wāwae, a laila e pālahalaha i ka ʻōpū a me ka ʻāʻī.

Inā ʻaʻole mālama ʻia, e ʻoi aku ka ʻino o kēia mau hōʻailona PAH i ka hala ʻana o ka manawa. Hiki paha iā ʻoe ke ʻike iā ʻoe iho ʻaʻole hiki ke hana i nā hana maʻamau o kēlā me kēia lā me ka ʻole o ka loaʻa ʻana o kou hanu a hoʻomaha paha.

He aha nā kumu o ke koko kiʻekiʻe o ke koko o ka puʻuwai (PAH)?

ʻO ke kumu nui o PAH ka hōʻino ʻana i ka uhi o nā kīʻaha koko i loko o kou mau māmā. Eia naʻe, ʻaʻole maopopo mau ke kumu o kēia hōʻino.

Nā hihia kahi i loaʻa ʻole ai ke kumu (Idiopathic PAH)

I kekahi manawa, ʻaʻole hiki ke loaʻa ke kumu kikoʻī . Kāhea mākou nā kauka iā ia he "idiopathic" pulmonary arterial hypertension . Ua like ia me kahi mea pohihihi.

Nā kumu i ʻike ʻia

Eia nō naʻe, i nā manawa ʻē aʻe, aia nā kumu maopopo. ʻO kekahi o nā kumu i ʻike ʻia o PAH:

• Kekahi mau kūlana olakino:
• Maʻi puʻuwai hānau
• Nā maʻi mālama glycogen
• ka maʻi HIV
• Maʻi akepaʻa
• Nā maʻi autoimmune e like me ka lupus
• ʻO ke koko kiʻekiʻe o ka puka (ka piʻi ʻana o ke kaomi i loko o nā kīʻaha koko e hiki aku ana i ke akepaʻa)
• ʻO ka hemangiomatosis capillary pulmonary (ka ulu ʻana o nā capillaries i loko o nā māmā)
• ʻO ka maʻi veno-occlusive pulmonary (pale ʻana o nā veins i loko o nā māmā)
• ʻO Schistosomiasis (kahi maʻi i hoʻokumu ʻia e kahi parasite)
• Scleroderma (mānoanoa o ka ʻili a me nā ʻiʻo pili)

• Nā hoʻololi hoʻoilina:
• ʻO ka hapa pinepine, ʻo kēia ma muli o kahi mutation i loko o kāu gene BMPR2 . Hoʻomalu kēia gene i ka helu o nā cell i loko o kekahi mau ʻiʻo i loko o ko mākou kino. No laila, ke hoʻololi ʻia kēia gene, hiki i nā cell i loko o nā kīʻaha koko liʻiliʻi i loko o kou mau māmā ke ulu nui. Ke piha kēia mau cell, lilo nā puka i loko o nā kīʻaha koko i haiki.
• Hiki i ka PAH ke holo i loko o nā ʻohana. Kapa mākou iā ia he PAH hoʻoilina . Ma kahi o 80% o ka poʻe me kēia maʻi he mau mutations i loko o ka gene BMPR2.
• Loaʻa i kekahi poʻe kēia gene i hoʻololi ʻia, akā ʻaʻole lākou e loaʻa i ka PAH.
• Hiki i kekahi poʻe ke loaʻa iā PAH ʻoiai ʻaʻohe o ko lākou ʻohana i loaʻa iā ia, ma muli o kahi hoʻololi genetic. Ua kapa ʻia kēia he PAH sporadic .

• ʻO kekahi mau lāʻau lapaʻau a me nā lāʻau lapaʻau:
• Ua pāpā ʻia kekahi mau pila ʻai , e like me ka lāʻau kahiko "fen-phen," akā hiki nō ke hana i ka PAH i nā makahiki ma hope o ka hoʻohana ʻana.
• Nā lāʻau lapaʻau leʻaleʻa , e like me ka cocaine a me ka methamphetamine.

Pehea e ʻike ʻia ai ka Pulmonary Arterial Hypertension (PAH)?

Hiki ke paʻakikī ke ʻike i ka PAH no ka mea ua like nā hōʻailona o PAH me nā maʻi ʻē aʻe he nui. E hana kāu kauka i kahi hoʻokolokolo kino a kamaʻilio pū me ʻoe e pili ana i kāu mau hōʻailona a me ka mōʻaukala olakino. E hana lākou i kekahi mau hoʻokolohua (me nā hoʻokolohua kiʻi a me nā hoʻokolohua koko) e ʻike ai inā he hypertension pulmonary kou, a inā pēlā, he aha ke ʻano.

Hiki i kāu kauka ke kuhikuhi iā ʻoe i kahi pulmonologist a i ʻole cardiologist . E hana kēia mau loea i nā hoʻokolohua kūikawā e nānā i ka hana o kou puʻuwai a me kou mau māmā. E hoʻoholo lākou inā he PAH kou a i ʻole kekahi ʻano hypertension pulmonary ʻē aʻe. E loiloi pū lākou i ke koʻikoʻi o kou kūlana.

Aia kekahi mau lāʻau lapaʻau kūikawā no PAH i loaʻa ʻole no nā ʻano ʻē aʻe o ke koko kiʻekiʻe pulmonary. No laila, pono i kāu hui lapaʻau ke ʻike i ka mea hiki e pili ana i nā mea e hana nei i loko o kou mau māmā a me kou puʻuwai. E kōkua kēia ʻike iā lākou e hoʻomohala i ka hoʻolālā lapaʻau maikaʻi loa nāu.

He aha nā hoʻokolohua i hoʻohana ʻia e ʻike ai i ka PAH?

E hoʻohana kāu hui lapaʻau i kahi hui pū ʻana o nā hoʻokolohua e hoʻoholo i nā maʻi ʻē aʻe a hoʻopaʻa i ka PAH.

Inā kānalua kāu kauka he PAH paha kāu ma hope o kāu hoʻokolohua kino, ʻo ka hoʻāʻo mua a lākou e kauoha ai he transthoracic echocardiogram . Loiloi kēia hoʻāʻo i ke ʻano holoʻokoʻa a me ka hana o kou puʻuwai.

Hiki i nā hoʻokolohua ʻē aʻe ke komo pū me:

• Nā hoʻāʻo koko: E nānā i ka hana o nā ʻōkana, nā pae hormone, a ʻike i nā maʻi kumu. ʻOi loa aku nā hoʻāʻo e like me ka panel metabolic piha a me ka helu koko piha .
• ʻO ke scan CT umauma: No ka nānā ʻana a me ka hoʻopau ʻana i nā kūlana ʻē aʻe e like me ka maʻi puʻupaʻa. (Malia paha ʻo ka maʻi puʻupaʻa ma ka ʻatikala kumu he maʻi māmā. Nānā ka scan umauma CT i nā māmā a me nā ʻōpū umauma. E ʻōlelo kākou e nānā ana mākou i ke kūlana o nā māmā.
• X-ray o ka umauma: No ka ʻike ʻana inā ʻoi aku ka nui o kou puʻuwai a i ʻole nā ​​aʻa pulmonary ma mua o ka maʻamau.
• MRI o ka puʻuwai: E loiloi i ke kūlana o ka ventricle ʻākau o kou puʻuwai (ʻo kēia ke keʻena o ka puʻuwai e pamu i ke koko i nā māmā).
• Polysomnogram (PSG): Nānā no ka apnea hiamoe, hiki ke hoʻonui i ka PAH. ʻO ka PSG kahi ʻano hoʻāʻo hiamoe i hana ʻia i ka pō.
• Nā hoʻāʻo hana pulmonary: E ʻike i ka hana maikaʻi o kou mau māmā.
• ʻO ke nānā ʻana i ka ea/perfusion pulmonary (VQ): Nānā i nā ʻōpū koko i loko o nā māmā. Hiki i kēia hoʻāʻo ke kāpae i kahi kūlana i kapa ʻia ʻo ka hypertension pulmonary thromboembolic mau loa .
• ʻO ke catheterization puʻuwai ʻākau: Ke ana ʻana i ke kaomi i loko o nā kīʻaha koko i loko o kou mau māmā (nā kaomi artery pulmonary). He mea nui kēia hoʻāʻo no ka ʻike maopopo ʻana i ka PAH.
• Hoʻāʻo hele wāwae ʻeono minuke: E ʻike i ka nui o ka hoʻoikaika kino hiki iā ʻoe ke ʻae a me ka nui o ka oxygen e kaʻapuni ana i loko o kou koko ke neʻe ʻoe.

E kamaʻilio me kāu kauka e pili ana i nā hoʻokolohua āu e pono ai a pehea e hoʻomākaukau ai no lākou.

He aha nā pae hoʻohālikelike no ka ʻike ʻana i ka Pulmonary Arterial Hypertension?

Hoʻoholo nā kauka i ke koko kiʻekiʻe o ka pulmonary ma ke ana ʻana i ke kaomi i loko o nā kīʻaha koko i loko o kou mau māmā. ʻO nā kumu hoʻohālikelike , ʻoi aku ke kaomi o ke kīʻaha pulmonary i loko o kou mau māmā ma mua o 20 milimita o ka mercury (20 mmHg) ke hoʻomaha ʻoe . Ana ʻia kēia waiwai e ka catheterization puʻuwai ʻākau .

He aha nā lāʻau lapaʻau no ka Pulmonary Arterial Hypertension (PAH)?

ʻO nā pahuhopu nui o ka mālama ʻana no PAH, ʻo ia ke kāohi i ka holomua o ka maʻi a hāʻawi iā ʻoe i kahi ola maikaʻi aʻe. ʻAʻohe lāʻau lapaʻau hoʻokahi e kūpono i nā mea āpau no PAH. E hana pū kāu kauka me ʻoe e hoʻoholo i ka lāʻau lapaʻau maikaʻi loa no kāu mau pono kikoʻī.

Hiki i kāu hoʻolālā mālama PAH ke komo pū me:

• ʻO ka Balloon atrial septostomy (BAS): Hana pinepine ʻia kēia kaʻina hana no nā pēpē me nā kīnā puʻuwai hānau, akā i kekahi manawa hoʻohana ʻia no nā pākeke me PAH. Kōkua ka septostomy i ka hōʻemi ʻana i ke kaomi ma ka ʻaoʻao ʻākau o ka puʻuwai, e ʻae ana i ka oxygen hou aʻe e kaʻapuni i loko o ke koko. Hiki ke hana ʻia ma ke ʻano he alahaka i kahi hoʻoili māmā.
• Nā mea pale o ke kahawai calcium: Kōkua kēia mau lāʻau lapaʻau i ka hoʻohaʻahaʻa ʻana i ke koko i loko o nā kīʻaha koko o kou mau māmā a ma kou kino holoʻokoʻa.
• Diuretics: ʻIke ʻia hoʻi he "nā pila wai," kōkua kēia mau lāʻau lapaʻau i ka wehe ʻana i ka wai keu mai ke kino a hoʻemi i ka pehu.
• ʻO ka lāʻau lapaʻau oxygen: Pono paha kēia lāʻau lapaʻau inā ʻaʻole lawa ka oxygen i loko o kou koko. Hiki i ka oxygen keu ke kōkua i ka wā e hoʻomaha ai, hiamoe ai, a hoʻoikaika kino paha.
• Nā vasodilators pulmonary: Kōkua kēia mau lāʻau i nā kīʻaha koko i loko o kou mau māmā (nā aʻa pulmonary) e hoʻomaha a wehe ākea. Hoʻemi kēia i ke kaumaha ma kou puʻuwai a kōkua i ka hōʻoluʻolu i kāu mau hōʻailona.

No kekahi poʻe me ka PAH koʻikoʻi , ʻo ka hoʻoili ʻana o ka māmā paha ke koho hope loa. Hiki i kēia ʻoki kino ke hāʻawi iā ʻoe i hoʻokahi a ʻelua paha mau māmā hou. Hiki i ka hoʻoili ʻana o ka puʻuwai-māmā ke hāʻawi iā ʻoe i kahi puʻuwai hou.

He aha nā lāʻau lapaʻau i hāʻawi ʻia no PAH?

Loaʻa nā lāʻau lapaʻau e mālama ai iā PAH i nā ʻano like ʻole:

• Nā lāʻau lapaʻau waha: Kōkua kēia mau lāʻau lapaʻau i ka hoʻomaha ʻana i nā kīʻaha koko i loko o nā māmā a pale iā lākou mai ka ʻūlū ʻana. Hiki i kēia mau lāʻau lapaʻau ke kōkua iā ʻoe e hana kino.
• Nā lāʻau lapaʻau i hanu ʻia: E mālama i nā pilikia hanu.
• ʻO ka pamu hoʻokomo lawe lima: Hiki i kēia ke kōkua i ka wehe ʻana i nā kīʻaha koko a hoʻonui i ke kahe koko. Hiki paha i kēia ke kōkua i ka hoʻomaikaʻi ʻana i kāu mau hōʻailona.
• Nā lāʻau lapaʻau intravenous (IV): E wehe i nā kīʻaha koko a hōʻoluʻolu i nā hōʻailona e like me ka ʻeha o ka umauma a me ka paʻakikī o ka hanu ʻana.

Eia kekahi mau lāʻau lapaʻau i ʻāpono ʻia e ka US Food and Drug Administration (FDA) no nā poʻe maʻi PAH:

• ʻAmbrisentan (waha)
• Bosentan (waha)
• ʻEpoprostenol (IV)
• ʻIloprost (hanu ʻana)
• Macitentan (waha)
• ʻO Riociguat (waha)
• Selexipag (waha)
• Sildenafil (waha)
• Tadalafil (waha)
• Treprostinil (waha, inhalation, pump, IV)

Nā hopena ʻaoʻao o nā lāʻau PAH

ʻO kekahi mau hopena ʻaoʻao maʻamau o nā lāʻau lapaʻau i hoʻohana ʻia e mālama iā PAH:

• Manaʻo puni a nāwaliwali paha.
• Manaʻo o ka mehana ma ka maka, ka ʻāʻī, a i ʻole nā ​​​​lima (flushing).
• Nā hōʻailona gastrointestinal e like me ka nausea, ka luaʻi ʻana, ka ʻōpū, a me ka maʻi pā.
• ʻEha poʻo (ʻeha poʻo).
• Ke koko haʻahaʻa (Hypotension) .
• Ka pehu ʻana o nā wāwae a me nā kuʻekuʻe wāwae (Pedal edema) .
• ʻŌhūhū ʻili.
• Ke manaʻo nei i ka ʻūpā ʻana o ke ala hanu luna.

Hiki i kekahi mau lāʻau lapaʻau ke loaʻa nā hopena ʻaoʻao hou aʻe. E kamaʻilio me kāu kauka e pili ana i ke ʻano o ka mālama ʻana i nā hopena ʻaoʻao. I kekahi mau hihia, pono paha kāu kauka e hoʻololi i ka nui o kāu lāʻau lapaʻau.

Hiki ke ho'ōla loa ʻia ka Pulmonary Arterial Hypertension (PAH)?

ʻOiai hiki i nā lāʻau lapaʻau o kēia manawa ke kāohi i ka holomua o ka PAH, ʻaʻole hiki iā lākou ke hoʻohuli i ka pōʻino i hana mua ʻia . Eia nō naʻe, ke noiʻi nei nā kānaka noiʻi i nā lāʻau lapaʻau hou a lākou e manaʻo nei e hoʻohuli i ka PAH. Hiki i kēlā mau lāʻau lapaʻau ke hoʻoponopono i ka pōʻino i nā cell endothelial e hoʻopili ana i nā kīʻaha koko i loko o kou mau māmā.

E kamaʻilio me kāu kauka e aʻo hou e pili ana i nā noiʻi hou loa a me nā hoʻokolohua lapaʻau no nā lāʻau PAH.

He aha nā kumu e hoʻonui ai i ka pilikia o ke kanaka i ka loaʻa ʻana o ka Pulmonary Arterial Hypertension (PAH)?

ʻO kekahi mau kumu e hoʻonui ai i ka pilikia o ka hoʻomohala ʻana i ka PAH:

• Ka maʻi pili o nā ʻiʻo .
• ʻO ka maʻi Down syndrome .
• Ka moʻolelo ʻohana o ke koko kiʻekiʻe pulmonary.
• Ka maʻi HIV .
• Ke hoʻohana nei i nā lāʻau hoʻemi kaumaha e like me "fen-phen" (dexfenfluramine a me phentermine).
• Ka hoʻohana ʻana i nā lāʻau lapaʻau kū ʻole i ke kānāwai (nā lāʻau lapaʻau alanui).

Inā loaʻa i kekahi o kou ʻohana ka PAH, e nīnau i kāu kauka e pili ana i ka hoʻāʻo genetic. Inā ua ʻike ʻia ʻoe me PAH, he manaʻo maikaʻi e noi i kou ʻohana e noʻonoʻo pū i ka hoʻāʻo genetic.

Pehea e pale aku ai i ke koko kiʻekiʻe o ke koko o ka puʻuwai (PAH)?

ʻAʻole hiki iā mākou ke kāohi i kekahi mau mea pilikia no ka PAH (e like me nā hoʻololi genetic). Eia nō naʻe, ʻo ka noho ʻana mai nā lāʻau lapaʻau kū ʻole i ke kānāwai hiki ke hōʻemi i kou pilikia o ka PAH ʻaʻole wale nō, akā, i nā pilikia olakino ʻē aʻe he nui. Eia kekahi, e kamaʻilio me kāu kauka ma mua o ka lawe ʻana i kekahi lāʻau hoʻemi kaumaha.

Ma muli o kāu mau kumu pilikia, hiki i kāu kauka ke ʻōlelo i nā nānā pale no PAH.

He aha ka manaʻolana no ka wā e hiki mai ana no ka poʻe me ka Pulmonary Arterial Hypertension (PAH)?

Me nā holomua o ka mālama ʻana, ʻoi aku ka lōʻihi o ke ola o ka poʻe me PAH ma mua o ka wā ma mua. Aia kou manaʻolana ola ma nā kumu he nui, me ke koʻikoʻi o kou kūlana a me ka wā mua o kou ʻike ʻia ʻana. E kamaʻilio me kāu kauka e pili ana i kou kūlana kikoʻī.

ʻO ka mea nui loa, ʻo ia ka hoʻomau ʻana i kāu lāʻau lapaʻau a hahai pono i nā ʻōlelo a kāu kauka. Aia kekahi mau mea hiki iā ʻoe ke hana e hoʻomaikaʻi i kou kūlana o ke ola:

• E hana i kahi pahu pilikia. Aia kekahi mau lako a me nā ʻike e pono ai ʻoe e lawe mau me ʻoe. E nīnau i kāu kauka i nā mea e hoʻokomo i loko o kāu pahu, a mai haʻalele i ka home me ka ʻole o ia mea.
• E kiʻi i nā lāʻau pale kau e like me ka ʻōlelo a kāu kauka. He mea nui loa ia e pale iā ʻoe iho mai ka maʻi palū a me ka niumonia.
• E mālama i nā manawa hoʻopaʻa a pau. He mea nui nā nānā mau ʻana e nānā i kou māmā a me ka hana o ka puʻuwai a ana i ka holomua o kāu lāʻau lapaʻau.
• E lawe i kāu mau lāʻau lapaʻau e like me ke kuhikuhi a kāu kauka, i ka manawa like i kēlā me kēia lā. Mai hoʻololi i ke ʻano o kāu lawe ʻana i kāu mau lāʻau lapaʻau me ka ʻole o ke aʻo ʻana a kāu kauka.

He aha nā hoʻololi o ke ʻano o ka nohona e pono iaʻu e hana?

E hahai i nā ʻōlelo aʻoaʻo a kāu kauka e pili ana i nā hoʻololi nohona āu e makemake ai e hana. Ma keʻano laulā, eia kekahi mau ʻōlelo aʻoaʻo koʻikoʻi:

• E hōʻalo i nā ʻauʻau wela, nā sauna, a me ka hele ʻana i nā wahi kiʻekiʻe.
• E noʻonoʻo i ka kaohi hānau. Hiki i ka hāpai ʻana ke lilo i mea weliweli no ka poʻe me PAH. E kamaʻilio me kāu kauka inā ʻoe e hoʻolālā ana e hāpai a inā paha ʻoe e hāpai.
• E hoʻoikaika kino a e noho ikaika i ka hiki. E kamaʻilio me kāu kauka e pili ana i nā hoʻoikaika kino palekana nou a me ka nui o ka hana āu e hana ai i kēlā me kēia lā. E nīnau i kāu kauka ma mua o ka hoʻomaka ʻana i kahi papahana hoʻoikaika kino hou.
• E hahai i kahi papaʻai olakino no ka puʻuwai. ʻO kēia hoʻi nā meaʻai haʻahaʻa i ka momona saturated, ka momona trans, a me ka sodium.
• E ho'ōki i ka puhipaka a me ka hoʻohana ʻana i nā huahana paka. Eia kekahi, e pale i ka uahi lua.
• E ʻimi i ke kākoʻo, mai hoʻāʻo e hele wale i kāu huakaʻi PAH. E nīnau i kāu kauka e pili ana i nā hui kākoʻo a me nā kumuwaiwai.

Āhea wau e kāhea aku ai i kaʻu kauka?

E kāhea i kāu kauka inā loaʻa iā ʻoe kekahi o kēia mau nīnau:

• Inā ʻoi aku ka nui o ka puʻuwai ma mua o 120 mau kuʻi i kēlā me kēia minuke (wikiwiki ka puʻuwai).
• Inā e ʻoi aku ka ʻino o ka maʻi hanu a i ʻole ke kuni.
• Inā pinepine ʻoe e manaʻo poniuniu a nāwaliwali paha.
• Inā loaʻa iā ʻoe ka ʻeha o ka umauma a i ʻole ka ʻoluʻolu ʻole me ka hana kino.
• Inā ʻike ʻoe i ka luhi nui a i ʻole ka emi ʻana o kou hiki ke hana i nā hana maʻamau.
• Ka luaʻi a i ʻole ka nalowale o ka makemake.
• Ka hoʻomaha ʻole a i ʻole ka huikau.
• Inā e ʻoi aku ka ʻino o kou hanu pōkole, ʻoiai inā manaʻo ʻoe ua pōkole kou hanu i kou ala ʻana.
• Inā e ʻoi aku ka ʻino o ka pehu ʻana ma kou mau kuʻekuʻe wāwae, nā wāwae, a i ʻole ka ʻōpū.
• Ka paʻakikī o ka hanu ʻana i ka wā o nā hana maʻamau a i ka wā hoʻomaha paha.
• Piʻi kaumaha (2 paona i ka lā a i ʻole 5 paona i ka pule).

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

Inā loaʻa iā ʻoe kekahi o kēia mau mea, e hele i ka lumi pilikia a i ʻole e kelepona i kāu helu pilikia kūloko:

• Inā ʻaʻole e emi ka helu o ka puʻuwai (120-150 mau kuʻi i kēlā me kēia minuke).
• Ka mae ʻana, e nalowale ana ka ʻike.
• Nā pilikia mai kāu pamu IV a i ʻole ka pamu infusion (e like me ka maʻi, ka wehe ʻana o ka catheter, ka liki ʻana o ka hopena, ke kahe ʻana o ke koko, ka hana hewa ʻana o ka pamu IV).
• Inā ʻaʻole e nalowale ka hanu pōkole ma hope o ka hoʻomaha ʻana.
• ʻEha koke a koʻikoʻi ka umauma.
• He ʻeha poʻo koke a koʻikoʻi.
• Ka nāwaliwali koke a i ʻole ka lolo ʻana o nā lima a i ʻole nā ​​wāwae.

ʻO ka mea hope loa, he leka e hoʻomanaʻo ai

He hōʻailona hoʻololi ola ka Pulmonary Arterial Hypertension (PAH). Inā ua ʻike hou ʻia ʻoe a i ʻole kahi mea aloha me kēia maʻi, e hoʻokaʻawale i ka manawa e aʻo ai e pili ana i ke kūlana a me nā mea āu e manaʻo ai. E nīnau i kāu kauka e pili ana i nā kumuwaiwai e wehewehe ana i ka hana a PAH a pehea e hiki ai i nā lāʻau lapaʻau ke kōkua.

ʻO kekahi o nā kumuwaiwai waiwai nui loa hiki iā ʻoe ke loaʻa, ʻo ia ke kākoʻo o nā poʻe ʻē aʻe i kou ola. Mai hoʻāʻo e hoʻokele wale i kēia kūlana. Inā ʻaʻole kou ʻohana a me kou mau hoaaloha a puni, e nīnau i kāu kauka e pili ana i nā hui kākoʻo a me nā kumuwaiwai kaiāulu.

Inā ua ʻike ʻia kāu mea aloha me kēia maʻi, e hana i nā mea āpau e hiki ai iā ʻoe ke hōʻike iā lākou i ke kākoʻo ʻia a kōkua iā lākou e pili me nā poʻe ʻē aʻe. Hiki i ka maʻi ke hoʻolilo iā mākou i ka noho kaʻawale ma kekahi mau ʻano, akā hiki nō hoʻi iā ia ke hoʻokokoke aku iā mākou. E hoʻohana i kēia manawa e kūkulu i kahi kaiāulu e hiki ke kōkua iā ʻoe a i ʻole kāu mea aloha e neʻe i mua.

ʻO ke koko kiʻekiʻe o ke akepaʻa, PAH, ke koko kiʻekiʻe o ka pulmonary, ka pōkole o ka hanu, ka maʻi puʻuwai, ka maʻi māmā, nā hōʻailona