Yu tink se pat pan yu bren de kɔmɔt dɔŋ insay yu skel? Mek wi lan bɔt Chiari Malformation!

Sɔntɛnde yu kin gɛt ed we de at ɛn yu nɛk kin at? Ɔ yu kin fil lɛk se yu nɔ de balans ɔ yu de waka rawnd de fil lɛk se yu go trip? Sɔntɛm dɛn tin ya nɔto jɔs random tin. Tide wi go tɔk bɔt wan kɔndishɔn we kɔmplikt smɔl, bɔt nɔto bɔku pipul dɛn no bɔt. Dat na Chiari Malfɔmeshɔn. Nɔ wɔri, lɛ wi tɔk bɔt am simpul wan.

Wetin na Chiari Malfɔmeshɔn?

Fɔ tɔk am simpul wan, Chiari malfɔmeshɔn na wan kɔndishɔn we di bren tisu we de na di bak pat pan yu skel, we de dɔŋ, de push dɔŋ ɛn gro along yu spɛnal kɔd. Tink bɔt yu skel lɛk os. Sɔntɛnde, rum nɔ kin de fɔ mek yu bren fit insay da os de. we dat apin, pat pan yu bren, spεshal wan yu sεribra, de push tru wan nεchכral opin we de na di bכs pat pan yu sכkul - wi kכl am di foramen magnum - εn de push dכn εn dכn tכwεd yu spεnal kכd.

Yu sɛribɛl na wan impɔtant pat pan yu bren. I de kɔntrol bɔku tin dɛn, lɛk aw yu mɔsul dɛn de muv, aw yu de tinap, aw yu de balans, aw yu de tɔk, ɛn aw yu de wok togɛda . So, we dis sik de afɛkt di sεribra, di sayn dεm we gɛt fɔ du wit am kin bigin fɔ sho. Fɔ ɛgzampul, tin dɛn lɛk fɔ lɛf fɔ balans.

we dεn push pat pan di bren dכn lεk dis, i de prεs di bכs pat pan di sכkul. dis de blכk di fכ fכlכ di sεribrospεnal fכluid (CSF). Dis wata de protɛkt yu bren ɛn yu spɛnal kɔd, i de mek di tin dɛn we de mek yu it ɛn kemikal dɛn go ɔlsay, ɛn i de pul di dɔti tin dɛn. So we dis wata nɔ de flɔ, difrɛn prɔblɛm dɛn kin apin.

Wetin na di kayn Chiari Malformation?

Bɔku men kayn tin dɛn de fɔ dis sik. Lɛ wi si wetin dɛn bi:

• Chiari malformation type 0: Dis kin rili rare. insay dis tכp, pat dεm na yu sεribεl de kכmכt sכmtεm כ nכ de kכmכt atכl insay di opin we de na di bכs pat pan yu sכkul (foramen magnum). Bɔt sɔm kayn we de we pipul dɛn kin ful-ɔp wit pipul dɛn. di simptom dεm kin kכz fכ di abnכmal fכ fכlכ fכ di sεribrospεnal fכluid (CSF) nia di bεs fכ yu sכkul.

• Chiari malformation type I: Dis na di kayn we we dɛn kin yuz mɔ. dis na di say we di lכw pat pan di sεribra de push insay di opin we de na di bכs pat pan di sכkul (foramen magnum). yu spεnal kכd nכmal fכ pas tru dis opin. Sɔm pipul dɛm wae gɛt tayp I nɔr kin gɛt ɛni sayn. Di sayn dɛm kin sho wae pɔrsin yɔŋ ɔr leta na layf.

• Chiari malfɔmeshɔn tayp II: .dis kin apin insay di εmbrayo stej, we di pikin de divεlכp insay di bכdi. na ya, di sεribεl εn di bren stεm de divεlכp abnכmal, we de mek prεshכn insay di sכkul. dis kayn kin apin togeda wit myelomeningocele, we na wan bad bad fכm fכ spina bifida. Maylomeningocele na wan kכndyushכn we di spεnal kכd εn di spεnal kanal nכ de kכloz fayn bifo dεn bכn di pikin. dεn kin kכloz di spayna afta dεn bכn am, bכt kכndishכn lεk paralayz kin apin.

• Chiari malformation tayp III: Dis tu kin rili rare, εn na di mכst siriכs tכp fכ Chiari malformation. insay dis kes, pat dεm na di sεribεl εn di bren stεm de kכmכt tru wan abnכmal opin na di bak pat pan di sכkul (nכto di foramen magnum). pan tap dat, sכm pan di mεmbran dεm we de rawnd di bren כ di spεnal kכd de kכmכt bak tru dis opin. Dis kin mek di bak pat na di skel swel, we dɛn kɔl ɛnsɛfalosɛl . Tayp III kin mek yu gɛt siriɔs sik dɛn we kin mek yu layf de pan denja we kin bigin we yu smɔl. Dɛn pikin ya kin gɛt prɔblɛm wit dɛn nyurolɔjik, dɛn nɔ kin ebul fɔ lan, ɛn dɛn kin gɛt sik we dɛn kɔl . Bɔku tɛm, dis kin nid fɔ du ɔpreshɔn.

• Chiari malformation tayp IV: Dis kin rili rare bak. dis na di say we di sεribεl insεf nכ de divεlכp ful wan, כ pat dεm pan am nכ de. Dis kayn tin kin tranga bak, bɔrku tɛm i kin de pan denja fɔ day we i smɔl.

Aw dis sik kin kɔmɔn?

Stɔdi dɔn sho se lɛk 1 pan ɛvri 1,000 pipul dɛn na Amɛrika nɔmɔ kin gɛt Chiari Malformation. Bɔt dis sik kin kam mɔr bikɔs sɔm pipul dɛn nɔr kin gɛt ɛni sayn ɔr simptom wae kin apun wae dɛn yɔŋ ɔr ol.

Aw e kin fil fɔ gɛt Chiari Malformation?

If yu gɛt Chiari Malformation, yu kin gɛt sɔm kayn sik lɛk:

• Di ed we de at kin gɛt shap shap pen we pɔsin kin chuk, mɔ na di bak pat na di ed, nɛk, ɔ di sholda dɛn. Dis pen kin wɔs we yu de kɔf ɔ sniz .
• Prɔblɛm dɛn wit balans ɛn kɔdineshɔn. Yu kin fil lɛk se yu de shek shek we yu de waka, lɛk se yu nɔ ebul fɔ kɔntrol yusɛf.
• Diziz ɛn vertigo (fɔ fil lɛk se di tin dɛn we de arawnd yu de spin).
• Di mɔsul dɛn we wik.
• Di an ɔ fut kin swɛla, ɔ di finga dɛn, di fut, ɔ di lip kin bɔn.
• Fɔ fil lɛk se yu at de skip wan bit (palpitations).
• Nɔ slip ɛn taya fɔ lɔng tɛm.

Wetin na ɔda sayn dɛm fɔ Chiari Malformation?

Na sɔm ɔda kɔmɔn sayn dɛn ya:

• Di chenj we yu de si: yu de si tu tɛm, yu nɔ de si fayn, yu de muv yu yay we nɔ kɔmɔn, ɛn yu de fil lɛk layt.
• Prɔblɛm fɔ yɛri: Ring na yu yes (tinnitus) ɔ yu nɔ de yɛri fayn.
• I nɔ izi fɔ swɛla: yu de drɔl, yu de vɔmit, yu de fil lɛk se yu trot dɔn blok, we de mek i nɔ izi fɔ it, drink, ɛn tɔk.
• Skɔliosis we de mek pɔsin gɛt sik.
• Nɔ ebul fɔ kɔntrol di urine ɔ stɔl.
• Fɔ mek pɔsin nɔ ebul fɔ du natin.
• I nɔ izi fɔ blo we yu de slip (slip apnea).

Impɔtant: Dɛn sayn ya kin difrɛn frɔm wan pɔrsin to ɔda pɔrsin. Sɔm pipul dɛn nɔr kin gɛt ɛni sayn, sɔm kin gɛt sɔm kayn sik wae nɔr kin fayn, ɛn ɔda wan dɛn kin gɛt sayn wae rili bad. Sɔm pipul dɛn kin gɛt sɔm sayn dɛn frɔm we dɛn bɔn dɛn. Ɔda pipul dɛn kin gɛt dis sik leta, we dɛn smɔl ɔ we dɛn big. Di sayn dɛm kin waks bak ɛn kin stɔp as tɛm de go.

Wetin na di tin dɛn we kin mek pɔsin gɛt Chiari Malformation?

dis kכndyushכn kin apin we dεn push di lכw pat pan yu bren insay di spεnal kanal כ foramen magnum (we di bren εn di spεnal kכd de mit). di men tin we kin mek dis apin na di abnכmaliti na di strכkchכral divεlכpmεnt fכ yu bren εn spεnal kכd. dis min se di sayz fכ di sכkul na di εria we di sεribכl de sכm sכm pas aw dεn bin de tink. dis kin put prεshכn pan da pat de na di bren, we kin mek di sεribכl gro dכn na ples we yu nכ bin de εkspεkt. dis kin apin bכku tεm we di pikin de divεlכp.

Chiari malfomesh כn dεm na mכst kכnεkshכn. Bɔt, di sayn dɛm kin sho leta na layf. Dis kin bi bikɔs ɔf wan jenɛtik mutation we kin gɛt frɔm yu famili, ɔ i kin bi sɔntin we kin apin randomly afta yu gɛt bɛlɛ.

Bɔt, nɔr kin bɔrku, pɔrsin wae nɔr bɔn wit dis sik kin gɛt Chiari malfɔmeshɔn leta in layf. insay dεn kayn kes dεm ya, di shep fכ di sכkul כ spεnal kכd kin chenj biכs fכ dεn rizin dεm ya:

• Wan tumbu we de na di bren.
• Wan sist we dɛn kɔl sist.
• Wan blɔd we de klɔt (Hematoma).
• Hydrocephalus we gɛt di sik.
• Intrakranial haypatɛnshɔn ɔ pseudotumor sɛribri.

Sɔntɛnde, Chiari malfɔmeshɔn kin apin wit ɔda ɔndalayn wɛlbɔdi kɔndishɔn dɛn, lɛk:

• Goldenhar sindrom we gɛt di sik.
• Akɔndroplasia we dɛn kɔl akondroplasia.
• di kכnεktiv tisu kכndishכn dεm lεk Ehlers-Danlos sεndrכm.
• Spina bifida we de na di bɔdi.

Wetin na di risk factor dɛm fɔ Chiari Malformation?

Dis sik kin afɛkt ɛnibɔdi, bɔt if pɔrsin na yu famili gɛt am, yu kin gɛt Chiari malfɔmeshɔn.

Wetin na di kɔmplikɛshɔn dɛm fɔ Chiari Malformation?

Chiari malformation kin mek siriɔs wɛl bɔdi prɔblɛm ɛn divɛlɔpmɛnt delay. Sɔm pan di prɔblɛm dɛn we kin apin na:

• Hydrocephalus: Dis na sik we de mek pɔsin in layf de pan denja. dis na we di sεribrospεnal fכluid (CSF) de bכku insay yu bren. Dis kin apin we di CSF nɔ ebul fɔ dreyn fayn fayn wan. we di CSF de bכku, di prεshכn insay di sכkul de inkrεs. Dis kin mek yu gɛt prɔblɛm wit di we aw yu de tink ɛn di ed shep we nɔ fayn . If dɛn nɔ trit am, i kin mek pɔsin in layf de pan denja. dis komplikashכn dεn kin si am mכst pan Chiari malfכmeshכn tayp II.

• Syringomyelia εn Hydromyelia: we di sεribrospεnal fכluid (CSF) bitwin yu bren εn spεnal kכd nכ de fכlכ fayn, i kin bכku insay di spεnal kכd. Dis wata we de bɔku kin pwɛl di spɛnal kɔd ɛn mek yu gɛt sɔm sayn dɛn lɛk we yu nɔ de muv ɛn balans, pen, yu mɔsul dɛn wik, yu mɔsul dɛn kin swɛt, yu nɔ kin fil fayn, yu nɔ kin fil fayn fɔ wam ɛn kol, ɛn yu nɔ kin ebul fɔ kɔntrol yu blad ɛn yu bɔdi .

• Tethered cord syndrome: Pikin dεm we dεn bכn wit myelomeningocele (we na wan siriכs fכm fכ spina bifida) kin gεt bכku risk fכ gεt tethered cord syndrome as dεn de ol. dis kin apin we dεn spεnal kכd de atak di spεnal kכd bikoz fכ ska afta dεn spεnal כpεrayshכn. Dis kכndyush כn kin mek di nεv dεm sכmtεm dεm we de afekt di mכsul dεm na di lכw bכdi εn di leg dεm. I kin afɛkt bak aw di bɔdi ɛn di urinary wok.

Apat frɔm dat, di sayn dɛm fɔ Chiari malformation kin afɛkt yu mud, mɔ if yu nɔr de slip ɔ yu gɛt siriɔs ed pen. Sɔm pipul dɛn kin gɛt tin dɛn bak lɛk pwɛl hat . If dis sik de afɛkt yu maynd, tɔk to yu dɔktɔ ɔr pɔsin we de gi advays bɔt yu maynd .

Aw dɛn kin no se Chiari Malformation gɛt am?

Dɔktɔ go no dis sik afta dɛn dɔn chɛk in bɔdi kɔmplit wan. Yu dɔktɔ go chɛk aw yu de muv, yu balans, ɛn aw yu de fil na yu an ɛn yu fut . Apat frɔm dat, dɛn go luk fɔ sayn dɛn we de sho se pikin dɛn nɔ ebul fɔ mɛmba tin, dɛn nɔ kin ebul fɔ lan, ɛn dɛn nɔ kin ebul fɔ gro fayn fayn wan.

Fɔ mek dɛn no se yu gɛt di sik, dɔktɔ go ɔda fɔ mek dɛn du imej tɛst fɔ tek ditayli pikchɔ dɛn bɔt yu bren ɛn yu spɛnal kɔd. Dɛn tin ya kin bi:

• MRI (Magnetic Resonance Imaging) skan: Dis kin si klia wan di sɔft tisu ɛn bon dɛn. I de ɛp di dɔktɔ fɔ si yu bren, yu spɛnal kɔd, ɛn yu sɛribrospaynal fluid (CSF). i kin si bak aw fa di sεribכl dכn go insay di spεnal kanal.
• Cine MRI: Dis tan lɛk MRI we dɛn kin du ɔltɛm, bɔt i kin mek di dɔktɔ si di we aw di sɛribrospinal fluid (CSF) de flɔ rawnd di bays pan di skel.
• CT (Computed Tomography) Scan: CT skan de ɛp fɔ no di prɔblɛm dɛn we de wit di bon dɛn na di skel bays ɛn di spayna.
• X-ray: Dɛn kin tek ɛkstrem rayt fɔ chɛk if tin nɔ de na di bon dɛn na di skel ɛn nɛk.

sכmtεm, yu kin si Chiari malfכmeshכn dεm bak we dεn de du di כltra saund bifo di bכn , we na tεst dεm we de yuz sawnd wev fכ mek imej fכ sכft tisu dεm.

If yu nɔ gɛt di sayn dɛm fɔ Chiari malfɔmeshɔn, dɛn kin no se yu gɛt dis sik we yu gɛt imej tɛst fɔ rizin we nɔ gɛt natin fɔ du wit am.

Aw dɛn kin trit Chiari Malformation?

Yu dɔktɔ go mek wan tritmɛnt plan bay aw yu sik bad bad wan. If yu nɔ gɛt ɛni sayn, yu nɔ nid fɔ gɛt ɛni tritmɛnt. Yu dɔktɔ go wach yu wɛlbɔdi wit MRI skan ɔltɛm.

Fɔ sɔm kayn sayn dɛm lɛk ed pen ɔr nɛk pen, yu kin tray dɛn tin ya:

• Fɔ tek mɛrɛsin wae de mek yu fil pen ɔr mɛrɛsin fɔ ɛp fɔ kɔntrol di sayn dɛm.
• Fɔ tek pat pan masaj tɛrapi ɔ fizik tɛrapi.
• Fɔ stɔp fɔ du tin dɛn lɛk fɔ es wet.
• Yuz tin dɛn lɛk tin fɔ ɛp pɔsin fɔ yɛri ɔ glas fɔ mek pɔsin nɔ yɛri ɔ fɔ si fayn.

Chiari malfɔmeshɔn ɔpreshɔn

If Chiari malfɔmeshɔn bad bad wan, i kin nid fɔ du ɔpreshɔn. Bɔku we dɛn de fɔ du ɔpreshɔn:

• Kraniɛktɔmi: Di ​​dɔktɔ we de du ɔpreshɔn kin pul wan smɔl bon na yu skel fɔ mek i nɔ gɛt prɛshɔn pan di bren ɛn ɛp fɔ mek di wata we de na di bɔdi (CSF) flɔ.
• di posita fכs dεkכmpreshכn: Dis na di mכst kכmכn prosidכs we dεn kin yuz fכ trit Chiari malfכmeshכn. di sajin de pul wan pat pan di bak pat pan di skel (we dεn kכl di posita fכs) fכ mek di prεshכn pan di bren εn mek mכr spεs fכ di bren.
• Laminektomi we dɛn kin du: .dipכnt pan aw di Chiari malfכmeshכn siriכs, di sכjaman go pul sכm pat pan di bon dεm we de kכba yu spayna fכ mek di sεribrospεnal fכluid (CSF) fכ fכlכ bak εn mek mכr spεs fכ di spεnal kכd.
• Duraplasty: Insay dis dikɔmpreshɔn ɔpreshɔn, di dɔktɔ de opin di dura (di ɔda pat na yu bren). Dɔn, di dɔktɔ we de du di ɔpreshɔn kin siŋ wan pat fɔ mek di mɛmbran big, ɛn dis kin mek mɔ ples fɔ di bren. Dis prosidur de mek di eria big ɛn i de ridyus di prɛshɔn pan di bren.
• Ilɛktrokɔtiri: Fɔ mek yu gɛt mɔ ples ɛn fɔ mek di wata we de na yu bɔdi (CSF) flɔ, di dɔktɔ dɛn we de du ɔpreshɔn kin yuz smɔl ilɛktrishɔn fɔ mek wan smɔl pat na yu bren we dɛn kɔl di sɛribɛl tɔnsil dɛn smɔl. Dɛn tɔnsil ya kin shrink we nɔ de pwɛl di bren ɔ di nerv dɛn.
• Shunt ples: If yu gɛt haydrosɛfalɔs, yu dɔktɔ go put shunt, ɔ tiub, na yu skel fɔ gɛda di ɛkstra sɛribrospaynal fluid (CSF). Dis wata go kɔmɔt na yu skel ɛn yu bren ɛn gɛda na ɔda pat na yu bɔdi.

Ɛni bad tin de we di tritmɛnt kin du?

Bifo yu bigin fɔ trit yu, yu dɔktɔ go tɔk to yu bɔt di sayd ɛfɛkt dɛm we di tritmɛnt go gɛt so dat yu go disayd fɔ du gud tin bɔt yu wɛlbɔdi biznɛs. Ɔl di ɔpreshɔn dɛn gɛt prɔblɛm dɛn. Di ɔpreshɔn pan yu bren ɛn yu skel kin gɛt mɔ risk bikɔs di say dɛn we dɛn kɔt ɛn di we aw dɛn kin du am kin nia di bren. Yu kin nid bak fɔ du mɔ ɔpreshɔn as yu de ol.

Aw kwik a go fil fayn afta dɛn dɔn trit mi?

Dipen pan di tritmɛnt plan we yu ɛn yu dɔktɔ pik, yu kin gɛt fridɔm frɔm di smɔl smɔl sik dɛn kwik kwik wan afta yu dɔn tek mɛrɛsin fɔ mek yu fil pen ɔ afta yu dɔn go na di tritmɛnt. Fɔ wɛl afta dɛn du ɔpreshɔn kin tek ɛnisay frɔm sɔm wiks to sɔm mɔnt. Yu kin notis se yu sik kin go ɔr kin ridyus bad bad wan afta dɛn dɔn du yu ɔpreshɔn.

Chiari Malformation na siriɔs sik?

Sɔntɛnde, Chiari malfɔmeshɔn kin rili siriɔs, bɔt nɔto ɔltɛm. Bɔku tɛm, dɛn kin bɔn pikin dɛn wit Chiari malfɔmeshɔn. Bɔt nɔr kin si di sayn dɛm ɔltɛm, ɛn dɛn kin no di sik let, ilɛksɛf i smɔl ɔ we i dɔn big, we dɔktɔ tɛl fɔ mek dɛn du imej tɛst fɔ rizin we nɔ gɛt natin fɔ du wit am.

Pan ɔl we no kɔmplit mɛrɛsin nɔ de fɔ Chiari malfɔmeshɔn, tritmɛnt dɛn lɛk ɔpreshɔn kin ɛp fɔ kɔntrol yu sik dɛn, mek yu wɛl, ɛn mek yu nɔ gɛt prɔblɛm dɛn we go mek yu layf de pan denja.

Wetin na di lukin-grɔn fɔ tumara bambay wit dis sityueshɔn?

Di we aw yu de si tin dipen pan aw i siriɔs ɛn di kayn Chiari malfɔmeshɔn. I impɔtant fɔ woke klos wit yu dɔktɔ ɛn di tim we de kia fɔ yu. Dɛn kin wach yu sayn dɛm ɛn no di bɛst tritmɛnt plan fɔ yu.

Wetin na di layf we pɔsin we gɛt Chiari Malformation de liv?

If yu nɔ gɛt ɛni sayn ɔ na smɔl smɔl sayn dɛn nɔmɔ afta dɛn dɔn no se yu gɛt Chiari malfɔmeshɔn, i go mɔs bi se yu go gɛt nɔmal layf . Sivεr simptom dεm εn sכm kayn Chiari malfכmeshכn kin kil. Tɔk to yu dɔktɔ bɔt wetin fɔ ɛkspɛkt afta dɛn dɔn no se yu gɛt di sik.

Yu tink se dɛn kin ebul fɔ stɔp Chiari Malformation?

Naw, no we nɔ de we dɛn no fɔ mek dis tin nɔ apin.

If yu de plan fɔ gɛt bɛlɛ, tɔk to yu dɔktɔ bɔt aw fɔ gɛt wɛlbɔdi. Yu dɔktɔ kin tɛl yu fɔ tek vaytamɛn dɛn lɛk fɔlik asid ɔltɛm . Dis kin ridyus di risk fɔ bɔn pikin we gɛt spina bifida. Yu dɔktɔ kin tɛl yu bak fɔ tɛst yu jɛnɛtiks , so dat yu go ɔndastand di prɔblɛm we yu gɛt fɔ bɔn pikin we gɛt wan sik we yu gɛt.

Ustɛm a fɔ go to dɔktɔ?

Si dɔktɔ if yu gɛt sayn dɛm fɔ Chiari malfɔmeshɔn, ɔ if yu simptom dɛn de wɔs. If yu gɛt pikin we gɛt Chiari malfɔmeshɔn ɛn dɛn de mis di maylston dɛm fɔ gro we fit dɛn ej, tɔk to dɛn dɔktɔ. Afta dɛn dɔn du di ɔpreshɔn, if dɛn sho sayn dɛn fɔ se dɛn gɛt di sik, lɛk fɔ fil pen bad bad wan, fɔ swel, ɔ fɔ gɛt wund we dɛn du ɔpreshɔn pan we nɔ de wɛl , kɔl yu dɔktɔ.

Sɔntin yu nɔ plan! If yu ɔ pɔsin we yu lɛk gɛt di sik fɔ di fɔstɛm, kɔl di lokal imejensi savis ɔ 1990 wantɛm wantɛm.

Us kwɛstyɔn dɛn a fɔ aks mi dɔktɔ?

• Us kayn Chiari malfɔmeshɔn a gɛt?
• Us kayn tritmɛnt yu kin advays?
• Aw ɔltɛm yu nid fɔ gɛt MRI skan fɔ wach dis sik?
• Yu kin se yu fɔ du ɔpreshɔn?
• Ɛni bad tin de we di tritmɛnt kin du?
• Yu tink se dis go apin to di pikin dɛn we a go gɛt tumara bambay?

Fɔ dɔn, tin dɛn fɔ mɛmba (Take-Home Message) .

Chiari malformation de afekt ɔlman difrɛn we. Yu nɔr kin gɛt ɛni sayn atɔl, ɔr kin so smɔl dat dɛn nɔr kin afɛkt di tin dɛm wae yu kin du ɛvride. Ɔda pipul dɛn kin gɛt siriɔs sik, bɔku tɛm dɛn kin mek dɛn nɔ ebul fɔ du dɛn wok ɛn dɛn kin nid fɔ du ɔpreshɔn. De gud nyus na dat, tritmɛnt de fɔ sɔm kayn dis sik wae kin ɛp fɔ ridyus de sik ɛn fɔ mek yu nɔr gɛt prɔblɛm wae kin mek yu layf de pan denja.If yu sik nɔr de bɛtɛ, yu de wɔs, ɔr yu gɛt prɔblɛm lɛk infɛkshɔn afta dɛn dɔn du yu ɔpreshɔn, mek shɔ se yu kɔl yu dɔktɔ. Nɔr wɔri, wit de rayt mɛrɛsin advays ɛn sɔpɔt, yu kin liv fayn fayn wan wit dis sik.

` Chiari Malfomeshכn, Bren Disiz, Sεribεl, Hεd at, Nyurכlכji, Sεribrospεnal Fluid