He aha ke Kanesa ʻŌpū Liʻiliʻi?
I ka ʻōlelo maʻalahi, ʻo ke Kanesa ʻōpū liʻiliʻi ka ulu ʻana o nā hunaola kanesa i loko o kou ʻōpū liʻiliʻi, a i ʻole ka mea a mākou e kapa nei ʻo " ʻōpū liʻiliʻi ". Ua ʻike anei ʻoe he ʻāpana koʻikoʻi loa ka ʻōpū liʻiliʻi o kā mākou ʻōnaehana hoʻoheheʻe ? Loaʻa pū i kēia ʻōnaehana nā ʻāpana ʻē aʻe he nui, e like me ke akepaʻa a me ka pancreas . Aia ka ʻōpū liʻiliʻi i loko o kā mākou ala gastrointestinal (GI) . ʻO ia hoʻi, aia ia ma ke ala mai ka waha, ma o ka esophagus, a i ka ʻōpū, a laila i ka ʻōpū liʻiliʻi, a mai laila aku a i ka ʻōpū nui (colon). I mea e pololei ai, ua pili ka ʻōpū a me ka ʻōpū nui e kēia ʻōpū liʻiliʻi. ʻEkolu mau ʻāpana nui o ka ʻōpū liʻiliʻi:- Duodenum : ʻO kēia ka ʻāpana mua kokoke loa i ka ʻōpū.
- ʻO Jejunum: ʻO kēia ka ʻāpana waena o ka ʻōpū liʻiliʻi.
- ʻIleum: ʻO kēia ka ʻāpana hope loa a lōʻihi loa o ka ʻōpū liʻiliʻi.
Pehea ka maʻamau o kēia maʻi kanesa?
ʻO ka ʻoiaʻiʻo, he maʻi laha ʻole ka maʻi ʻōpū liʻiliʻi . Wahi a ka ʻikepili ʻAmelika, ʻo kēia ʻano maʻi ʻaʻai he 3% o nā maʻi ʻaʻai āpau i loko o ke ala ʻai. ʻOi aku ka maʻamau o ka maʻi ʻaʻai colon , rectal, esophageal, a me ka maʻi ʻaʻai ʻōpū. No laila, hiki iā ʻoe ke noʻonoʻo he haʻahaʻa iki kēia.He aha nā ʻano o ke kanesa ʻōpū liʻiliʻi ?
Aia kekahi mau ʻano maʻi kanesa e kū mai ana i loko o ka ʻōpū liʻiliʻi. Ua hoʻokaʻawale ʻia kēia mau mea ma muli o ke ʻano o ke keena e hoʻomaka ai ke kanesa.- Nā puʻupuʻu Carcinoid: Hoʻomaka kēia i loko o kāu mau pūnaewele neuroendocrine . Kōkua kēia mau pūnaewele i kou kino e hana i nā hormones a kāohi i ka hoʻokuʻu ʻana o nā wai ʻai i loko o ka ʻōpū liʻiliʻi. ʻO nā puʻupuʻu Carcinoid ka hapalua o nā maʻi kanesa ʻōpū liʻiliʻi āpau.
- ʻO Adenocarcinomas: Hoʻomaka kēia i loko o nā pūnaewele glandular e hoʻopili ana i ka uhi o ka ʻōpū liʻiliʻi. He hapakolu lākou o nā maʻi ʻaʻai ʻōpū liʻiliʻi āpau.
- Sarcomas: Hoʻomaka kēia i loko o ke cartilage.a i ʻole nā ʻiʻo hoʻohui e like me ka ʻiʻo. ʻO ke ʻano sarcoma maʻamau e hoʻopilikia ana i ka ʻōpū liʻiliʻi he gastrointestinal stromal tumor (GIST) . Ua kapa ʻia ʻo ia ma mua he leiomyosarcoma.
- Lymphoma: Hoʻomaka kēia mau mea i loko o nā pūnaewele i kapa ʻia ʻo lymphocytes . ʻO nā Lymphocytes kahi ʻano o nā cell koko keʻokeʻo i loaʻa i loko o kāu ʻōnaehana lymphatic . He ʻāpana koʻikoʻi loa ka ʻōnaehana lymphatic o kā mākou ʻōnaehana pale. Kōkua ia i ke kino e hakakā i nā cell ʻino a me nā germs e hoʻoulu ai i ka maʻi.
He aha nā hōʻailona o kēia maʻi kanesa?
Hiki ke ʻokoʻa nā hōʻailona o ke kanesa ʻōpū liʻiliʻi. Aia lākou i ke ʻano o ka puʻupuʻu a me kona wahi. I kekahi manawa, hiki ke loaʻa nā puʻupuʻu akā ʻaʻole ia e hōʻike i kekahi mau hōʻailona (asymptomatic) . No ka laʻana, ʻaʻole pinepine nā puʻupuʻu carcinoid i hōʻike i nā hōʻailona. Loaʻa pinepine lākou i ka wā o nā hoʻokolohua kiʻi no kekahi maʻi ʻē aʻe. ʻO nā hōʻailona maʻamau:- ʻEha a ʻūlū paha ka ʻōpū.
- He puʻu i loko o ka ʻōpū e like me he mea lā e paʻa ʻia ana i ka lima.
- Ka luaʻi, ka luaʻi ʻana, a me ka maʻi pākī.
- Ka pohō kaumaha me ke kumu ʻole.
- Anemia ( ka nele o ke koko).
- Jaundice ( melemele o nā maka a i ʻole ka ʻili).
- Nā ʻōpala koko (hiki ke ʻike ʻia he ʻulaʻula a ʻeleʻele paha i loko o ka lua).
- ʻUlaʻula o ka ʻili, ʻoiai hoʻi nā lima a me ke kino o luna, e lilo ana i poni.
He aha nā kumu o ke kanesa ʻōpū liʻiliʻi?
Hoʻomohala ʻia nā puʻupuʻu ʻino o ka ʻōpū liʻiliʻi i ka wā e māhele wikiwiki ai nā hunaola kanesa a ulu pū i loko o kahi puʻupuʻu. I ka hala ʻana o ka manawa, hiki i kēia mau hunaola kanesa ke hemo mai ka puʻupuʻu mua a hele ma waena o nā lymph nodes a i ʻole ke koko i nā ʻāpana ʻē aʻe o ke kino, kahi e hiki ai iā lākou ke hana i kahi puʻupuʻu hou (tumor lua). Ua kapa ʻia kēia kaʻina hana he metastasis . Hoʻomohala nā hunaola kanesa ma muli o nā mutations genetic . ʻO ia hoʻi, hana ʻia nā loli i loko o ka DNA o kahi hunaola, e hoʻokaʻawale ana i ke hunaola me ka ʻole o ke kāohi. ʻAʻole maopopo i nā mea noiʻi ke kumu o kēia mau loli.He aha nā kumu pilikia no kēia maʻi kanesa?
ʻO kahi mea pilikia kekahi mea e hoʻonui ai i ka manawa kūpono o ka loaʻa ʻana o kahi maʻi. Eia nō naʻe, ʻo ka loaʻa ʻana o kahi mea pilikia ʻaʻole ia he manaʻo e loaʻa iā ʻoe ka maʻi kanesa. Pēlā nō, ʻo ka loaʻa ʻole o nā mea pilikia ʻaʻole ia he manaʻo ʻaʻole ʻoe e loaʻa i ka maʻi kanesa. Aia kekahi mau mea pilikia e hiki ke hoʻopilikia i ka maʻi kanesa o ka ʻōpū liʻiliʻi:- Makahiki: Piʻi ka pilikia o ka hapa nui o nā ʻano maʻi ʻōpū liʻiliʻi me ka makahiki. ʻO ka awelika o ka makahiki o ka ʻike ʻia ʻana ma kahi o 65 mau makahiki.
- Kāne: ʻOi aku ka nui o ka loaʻa ʻana o kēia maʻi kanesa i nā kāne.
- Lāhui: Wahi a ka ʻikepili mai ʻAmelika Hui Pū ʻIa, ʻoi aku ka maʻamau o kēia maʻi i waena o ka poʻe ʻeleʻele, ʻoiai ʻoi aku ka maʻamau o ka lymphoma i waena o ka poʻe keʻokeʻo.
- Nā kūlana hoʻoilina: Inā loaʻa i kou mau mākua, nā kaikaina, a i ʻole nā keiki kekahi mau kūlana, hiki paha iā ʻoe ke piʻi aʻe ka pilikia. ʻO nā laʻana e komo pū me (Familial Adenomatous Polyposis - FAP) , (Peutz-Jeghers syndrome) , (Hereditary Nonpolyposis Colorectal Cancer - HNPCC) , a me (Lynch syndrome) .
- Nā kūlana mumū: ʻO nā maʻi e hoʻoulu ai i ka mumū lōʻihi o nā ʻōpū, e like me ka maʻi a Crohn a me ka maʻi Celiac , hiki ke hoʻonui i ka pilikia.
- Nā maʻi Autoimmune a i ʻole ka ʻōnaehana pale i nāwaliwali: ʻO nā maʻi e hoʻonāwaliwali i ka ʻōnaehana pale, e like me ka HIV/AIDS , ka maʻi Crohn , a me ka maʻi Celiac, hiki ke hoʻonui i kou pilikia. Eia kekahi, hiki i nā lāʻau lapaʻau e like me ka radiation therapy ke hoʻonāwaliwali i ka ʻōnaehana pale, e hoʻonui ana i kou pilikia o ka maʻi ʻōpū liʻiliʻi. Hiki i nā lāʻau lapaʻau e kāohi ana i ka ʻōnaehana pale ma hope o ka hoʻoili ʻana i kahi kino ke hoʻonui i kou pilikia.
Inā manaʻo ʻoe he mau kumu pilikia kou, ʻoi aku ka maikaʻi o ke kamaʻilio ʻana me ke kauka .
Pehea e ʻike ʻia ai ke kanesa ʻōpū liʻiliʻi?
Hiki ke paʻakikī ke ʻike i ka maʻi ʻaʻai ʻōpū liʻiliʻi no ka mea he mea kakaikahi loa ia. Eia kekahi, ʻokoʻa nā hōʻailona ma muli o ke ʻano o ka puʻupuʻu. Pono paha ʻoe e hana i nā hoʻokolohua a me nā kaʻina hana nui ma mua o kou loaʻa ʻana o kahi hōʻailona.Ka hoʻokolokolo kino a me ka mōʻaukala lapaʻau
E nānā ke kauka iā ʻoe, e nānā i kou olakino holoʻokoʻa, e nānā i nā hōʻailona o ka maʻi, a e nīnau e pili ana i kāu mau maʻi i hala, nā lāʻau lapaʻau, a me nā ʻano olakino.Nā hoʻāʻo koko
- Nā haʻawina kemika koko: Ke ana nei kēia i ka nui o kekahi mau mea i hoʻokuʻu ʻia i loko o ke koko mai nā ʻōpū a me nā ʻiʻo. Inā he nui ʻē aʻe (kiʻekiʻe a haʻahaʻa paha) o kahi mea, hiki ke hōʻike i kahi maʻi i loko o ke ʻōpū a i ʻole ka ʻiʻo e hana ana i kēlā mea. No ka laʻana, hiki ke hana ʻia kahi hoʻāʻo hana ate e ʻike inā ua laha ka maʻi ʻaʻai i ke akepaʻa.
- Helu koko piha (CBC): Hāʻawi kēia hoʻokolohua i kāu kauka i ka ʻike e pili ana i nā hunaola i loko o kou koko. Hiki i nā ʻōpū liʻiliʻi ke hoʻoulu i ke kahe koko, hiki ke hoʻemi i ka helu o nā hunaola koko ʻulaʻula, e hoʻoulu ai i ka anemia.
Nā Kiʻi
- Endoscopy: Pili kēia i ka nānā ʻana i loko o ke ala gastrointestinal (GI) me ka hoʻohana ʻana i kahi mea lahilahi e like me ka paipu (endoscope). Aia i loko o kēia paipu kahi kukui a me kahi kāmela ma luna.I ka wā o ka endoscopy luna, hoʻokomo ke kauka i kahi endoscope ma o ka waha a nānā i ka esophagus, ka ʻōpū, a me ka hapa mua o ka ʻōpū liʻiliʻi (duodenum). Hiki i kahi endoscope kūikawā i kapa ʻia he double-balloon enteroscopy ke nānā hohonu i loko o ka ʻōpū liʻiliʻi. I ka wā o ka endoscopy, hiki i ke kauka ke lawe i nā laʻana ʻiʻo ( biopsies ) a hoʻouna iā lākou no ka hoʻāʻo ʻana. A laila e nānā ʻia lākou ma lalo o kahi microscope e ʻike inā he mau hōʻailona o ka maʻi.
- ʻO ka endoscopy capsule (kāmela pila): Pili kēia i ka moni ʻana i kahi capsule me kahi kāmela liʻiliʻi. Ke hele nei ka capsule ma ke kino, lawe ia i nā kiʻi o ke ala GI. Hiki ke hoʻoiho ʻia kēia mau kiʻi i kahi kamepiula a nānā ʻia e ke kauka. ʻOiai he huikau iki paha ka inoa, ʻaʻole hoʻohana kēia kaʻina hana i kahi endoscope.
- CT scan (CT scan - CAT scan): He hana kēia e lawe ana i kahi moʻo o nā kiʻi kikoʻī o loko o ke kino mai nā kihi like ʻole. Hōʻike ʻia kēia mau kiʻi ma kahi kamepiula i pili i kahi mīkini X-ray. I kekahi manawa hiki ke hoʻokomo ʻia kahi kala i loko o kahi aa a i ʻole e hāʻawi ʻia e inu. ʻAe kēia i nā ʻōpū a i ʻole nā ʻiʻo e ʻike maopopo ʻia.
- MRI (kiʻi resonance magnetic): Hoʻohana kēia i kahi magnet, nā nalu lekiō, a me ke kamepiula e hana i kahi moʻo o nā kiʻi kikoʻī o loko o ke kino. ʻOiai ʻo ka MRI a me ka CT scan e hāʻawi i ka ʻike like e pili ana i ke ʻano o ka hoʻopilikia ʻana o kahi puʻupuʻu i nā ʻiʻo palupalu, hoʻohana pinepine ʻia ka CT scan e ʻike i ka maʻi ʻōpū liʻiliʻi.
- ʻŌpū X-ray: He ʻōpuʻu X o nā ʻōpū i loko o ka ʻōpū. He kukuna ikehu ka ʻōpuʻu X e hele ana ma ke kino a hōʻike ʻia ma luna o ke kiʻiʻoniʻoni, e hana ana i kiʻi o loko o ke kino.
- ʻO Barium X-ray: Pili kēia i ka uhi ʻana i kou ala GI me kahi mea ʻōnika i kapa ʻia ʻo barium. Hōʻike ka barium i ke ala GI ma kahi X-ray. Ma kahi moʻo GI kiʻekiʻe , lawe ʻia kahi moʻo o nā kiʻi X-ray i ka wā e hele ai ka barium ma ke ala GI (esophagus, ʻōpū, ʻōpū liʻiliʻi). Ma kahi moʻo GI haʻahaʻa (barium enema) , hoʻokomo ʻia kahi barium wai i loko o ka rectum. Lawe ʻia nā kiʻi X-ray i ka wā e uhi ai ka barium i ke ala GI haʻahaʻa.
ʻoki kino
Inā ʻaʻole hāʻawi nā hoʻokolohua ʻē aʻe i ka ʻike lawa e hana ai i kahi hōʻailona, hiki i kāu kauka ke hoʻoholo e hana i ke ʻoki kino. ʻAe kēia mau kaʻina hana i kāu kauka e nānā pololei i kou mau kino. Inā he ʻiʻo kānalua, lawe ʻia kahi biopsy e nānā i nā hōʻailona o ka maʻi kanesa. Hiki ke hana ʻia ke ʻoki kino i:- Laparoscopy: Ma kēia kaʻina hana, hoʻokomo ʻia kahi ʻōmole lahilahi e like me ke kelepona (laparoscope) ma o hoʻokahi a ʻoi aku paha mau ʻoki liʻiliʻi ma ka ʻōpū. ʻAe ka laparoscope i ke kauka e ʻike i nā ʻōpū o ka ʻōpū no nā hōʻailona o ka maʻi ʻaʻai.
- Laparotomy:Ma kēia, hana ke kauka i kahi ʻoki ma ka paia o ka ʻōpū a nānā i nā ʻōpū o ka ʻōpū no nā hōʻailona o ka maʻi kanesa.
He aha nā pae o ka maʻi ʻaʻai ʻōpū liʻiliʻi?
ʻO ke kahua o kahi maʻi ʻaʻai e haʻi iā ʻoe i ka nui o ka puʻupuʻu, kahi o ia, a inā ua pālahalaha (metastasized). Hana pinepine ʻia nā hoʻokolohua a me nā kaʻina hana e hoʻoholo ai i ke kahua o ka maʻi ʻaʻai ʻōpū liʻiliʻi i ka manawa o ka hōʻoia ʻana. ʻO ke ʻano o ka maʻi ʻaʻai ʻōpū liʻiliʻi āu e loaʻa ai (carcinoid tumor, adenocarcinoma, sarcoma, a lymphoma paha) e hoʻoholo ai i ka ʻōnaehana hoʻonohonoho a kāu kauka e hoʻohana ai.He aha nā lāʻau lapaʻau no kēia?
ʻO ke ʻano o ka lāʻau lapaʻau āu e loaʻa ai, pili ia i ke ʻano o ka maʻi kanesa āu e loaʻa ai, kona pae, kahi o ka puʻupuʻu, a me nā ʻano o nā ʻāpana i loko o ka puʻupuʻu. Hoʻopili pū kāu mau makemake i nā hoʻoholo lapaʻau.ʻoki kino
ʻO ke ʻoki kino ke ʻano lapaʻau maʻamau no ka maʻi ʻōpū liʻiliʻi. Hiki ke komo pū ke ʻoki kino me:- ʻOki ʻoki: ʻO ke ʻoki ʻana e wehe i nā ʻāpana a pau o ke kino kahi i loaʻa ai ke kanesa. Inā ua pālahalaha ke kanesa, hiki i ke kauka ke wehe i nā ʻāpana o ka ʻōpū liʻiliʻi a me nā kino kokoke. A laila, hiki ke hana ʻia kahi anastomosis (e hoʻopili hou i nā wēlau ʻoki o ka ʻōpū). Hiki ke wehe ʻia nā lymph node kokoke i ka ʻōpū liʻiliʻi a nānā ʻia e ʻike inā ua pālahalaha ke kanesa.
- Bypass: Inā he puʻupuʻu e ālai ana i ka ʻōpū akā ʻaʻole hiki ke wehe ʻia, he ʻoki kino e ʻae ai i ka meaʻai i loko o ka ʻōpū liʻiliʻi e kāpae i ka puʻupuʻu.
Kemoterapia
ʻO ka Chemotherapy ka hoʻohana ʻana i nā lāʻau lapaʻau e hoʻōki i ka ulu ʻana o nā hunaola kanesa. Pepehi lākou i nā hunaola a hoʻōki paha iā lākou mai ka māhele ʻana. Ma muli o ka mālama ʻana i ka chemotherapy, hiki i nā lāʻau lapaʻau ke kuhikuhi i nā hunaola kanesa ma kahi ʻāpana kikoʻī o ke kino (chemotherapy kūloko) a pepehi paha i nā hunaola kanesa ma ke kino holoʻokoʻa (chemotherapy ʻōnaehana). Hiki i kāu kauka ke kuhikuhi i ka chemotherapy e pepehi i nā hunaola kanesa e koe ma hope o ke ʻoki ʻana (adjuvant therapy) . Inā ua laha kou kanesa (metastasized), hiki ke hāʻawi ʻia iā ʻoe ka chemotherapy ʻōnaehana.Hoʻōla radiation
ʻO ka radiation therapy ka hoʻohana ʻana i nā kukuna X-energy kiʻekiʻe a i ʻole nā ʻano radiation ʻē aʻe e pepehi i nā hunaola kanesa a i ʻole e hoʻōki iā lākou mai ka ulu ʻana. Hiki i kāu kauka ke paipai i ka radiation therapy inā ʻaʻole hiki ke wehe ʻia kou kanesa me ke ʻoki ʻana. Hiki ke hāʻawi ʻia ka radiation therapy ma ke ʻano he ʻāpana o ka mālama palliative e kōkua i ka hōʻoluʻolu ʻana i nā hōʻailona. I kekahi manawa, hāʻawi pū ʻia ka radiation therapy me ka chemotherapy (chemoradiation therapy) e pepehi i nā hunaola kanesa i koe ma hope o ke ʻoki ʻana.Nā analog Somatostatin
Hoʻoponopono ke kauka i nā ʻōpū carcinoid o ka ʻōpū liʻiliʻi me nā analog somatostatin.Hoʻōki kēia mau lāʻau i kou kino mai ka hana ʻana i nā hormones he nui. Hiki i kēia ke kōkua i ka hōʻemi ʻana i nā hōʻailona a me ka kaohi ʻana i ka maʻi. ʻO nā hiʻohiʻona o kēia mau lāʻau lapaʻau e komo pū me ka lanreotide a me ka octreotide.Pono nā noiʻi hou aku e pili ana i nā pono o ka hoʻohui ʻana i ka radiation therapy a me ka chemotherapy ma hope o ke ʻoki ʻana no ka maʻi ʻaʻai ʻōpū liʻiliʻi.
Hoʻōla i kuhikuhi ʻia
Hana nā lāʻau lapaʻau i kuhikuhi ʻia ma ka ʻike ʻana i nā nāwaliwali o nā hunaola kanesa a me ka hoʻohana ʻana i kēlā mau nāwaliwali e luku iā lākou. Ke aʻo nei nā kānaka noiʻi i nā lāʻau lapaʻau i kuhikuhi ʻia e hiki ke kōkua i ka mālama ʻana i nā adenocarcinomas, GISTs, a me nā lymphomas.Hoʻōla lāʻau pale
Hana ka Immunotherapy ma ka hoʻoikaika ʻana i kāu ʻōnaehana pale a me ka hoʻonui ʻana i kona hiki ke hakakā i nā hunaola kanesa. Kūʻē maoli kāu ʻōnaehana pale i nā hunaola ʻē a me nā mea komo hewa e like me nā germs. Eia nō naʻe, i kekahi manawa hiki i nā hunaola kanesa ke hala i nā pale o ka ʻōnaehana pale. Hoʻomaʻalahi ka Immunotherapy i ka ʻōnaehana pale e ʻike a luku i nā hunaola kanesa. Ma muli o ke ʻano o nā hoʻololi gene i loko o kāu puʻupuʻu, hiki i kāu kauka ke ʻōlelo aku i ka immunotherapy.Nā hoʻokolohua lapaʻau
ʻO nā hoʻokolohua lapaʻau he mau haʻawina e hoʻoholo ai inā palekana, pono, a ʻoi aku paha ka maikaʻi o nā lāʻau lapaʻau hou ma mua o nā lāʻau lapaʻau maʻamau. I kēia manawa, ke aʻo ʻia nei ka chemotherapy adjuvant, nā therapies i hoʻopaʻa ʻia, a me ka immunotherapy i nā hoʻokolohua lapaʻau. E nīnau i kāu kauka inā he moho maikaʻi ʻoe no kahi hoʻokolohua lapaʻau.He aha ka nui o ka ho'ōla ʻana no ka maʻi ʻaʻai ʻōpū liʻiliʻi?
ʻOkoʻa nā helu ola ma muli o ke ʻano o ka maʻi ʻaʻai ʻōpū liʻiliʻi, kona pae, a me kahi i hoʻomaka ai ke kanesa i loko o ka ʻōpū liʻiliʻi. No ka laʻana, 65% o ka poʻe i ʻike ʻia me nā adenocarcinomas mua e ola ana ma hope o ʻelima mau makahiki. ʻOi aku ka haʻahaʻa o kēia helu, ma 4%, no nā maʻi ʻaʻai hope. ʻO ka helu ola ʻelima makahiki no nā ʻōpū carcinoid mua he 95%, ʻoiai no nā maʻi ʻaʻai hope he 42%.E nīnau i kāu kauka pehea e pili ai nā hōʻailona o kou maʻi ʻaʻai i kāu prognosis.
He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?
I ka manawa e like me kēia, nui paha nā nīnau ma kou manaʻo. Mai makaʻu. E kamaʻilio ākea me kāu kauka. Eia kekahi mau nīnau koʻikoʻi hiki iā ʻoe ke nīnau:- He aha ke ʻano o ka puʻupuʻu i loaʻa iaʻu?
- I ke kahua hea koʻu maʻi ʻaʻai?
- He aha nā mea e hoʻopilikia ai i koʻu kūlana e ho'ōla ai?
- He aha ka lāʻau lapaʻau āu e paipai nei?
- He aha nā pilikia a me nā pono o kēia mau lāʻau lapaʻau?
- Pehea ka lōʻihi e ho'ōla ai mai kaʻu hoʻolālā lapaʻau?
- He aha nā hopena e pono iaʻu e manaʻo e pili ana i koʻu maʻi kanesa, ke olakino laulā, a me ka pane ʻana i ka lāʻau lapaʻau?
ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)
ʻO ke Kanesa ʻŌpū Liʻiliʻi kahi maʻi i lohe pinepine ʻole ʻia, akā pono ia e nānā ʻia.- He mea kākaʻikahi loa kēia, akā he mea nui e ʻimi koke i ke kōkua lapaʻau inā loaʻa nā hōʻailona.
- E makaʻala i nā hōʻailona e like me ka ʻeha o ka ʻōpū, ka pohō kaumaha i wehewehe ʻole ʻia, a me nā ʻōpala koko.
- Inā he mau kumu pilikia kou, e kamaʻilio me ke kauka a e hana i nā hoʻokolohua e pono ai.
- Aia nā hoʻokolohua like ʻole no ka hōʻoia ʻana . Mai hopohopo, e kōkua nā kauka iā ʻoe.
- Aia kekahi mau koho lapaʻau , ma muli o kou kūlana.
- Inā ʻike ʻia i ka wā mua, kiʻekiʻe ka manawa e hoʻōla ai.
ʻO ka mea nui loa, inā he kānalua a makaʻu paha kāu e pili ana i kēia, mai ʻeha hoʻokahi, akā e kamaʻilio me ke kauka hilinaʻi . E hāʻawi lākou iā ʻoe i ke alakaʻi a me ke kākoʻo āu e pono ai. E noho olakino!
Ka maʻi ʻōpū liʻiliʻi, Ka maʻi ʻōpū, ʻŌnaehana hoʻoheheʻe, Nā hōʻailona, Lapaʻau Ka maʻi ʻōpū, ʻōpū, Ka maʻi ʻōpū liʻiliʻi











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