Yu tink se di at we de gi blɔd to yu at dɔn blok? Lɛ wi lan bɔt Korona Ata Disease!

Tide wi go tɔk bɔt wan kɔmɔn bɔt kin siriɔs at sik. Sɔntɛm yu dɔn yɛri bɔt am, ɔ sɔmbɔdi na yu famili kin gɛt am. Lɛ wi tek wan luk pan wetin na korona at sik (CAD) , wetin mek i kin apin, ɛn aw wi go protɛkt wisɛf. I tan lɛk pɔsin we de kil pɔsin we nɔ de tɔk natin, so i impɔtant fɔ no bɔt am.

Wetin na Koronari At Diziz?

Fɔ tɔk am simpul wan, na sik we di korona at we de gi yu at we gɛt bɔku ɔksijɛn, kin smɔl ɔ blok. As tɛm de go , plek , mɔ di kɔlɔstrel, kin bɔku na dɛn at dɛn ya, ɛn dis kin mek di blɔd nɔ go rich di at mɔsul.

Imajin, tu len dɛn de we trafik de na wan rod, ɛn wantɛm wantɛm dɛn de bil di rod, so dɛn ridyus am to wan len. Dɔn di trafik go flɔ fayn fayn wan, nɔto so? Na so i bi. Yu nɔ go notis ɛnitin te dis plek mek blɔd klot ɛn blok di at kpatakpata. Blɔd we de klɔt tan lɛk kɔnkrit barɛri we de na di midul pat na di rod. Dɔn di trafik kin stɔp kpatakpata. Semweso, at atak kin apin we blɔd nɔ ebul fɔ flɔd to di at.

Bɔrku tɛm dis sik kin go fɔ lɔng tɛm ɛn nɔr kin si ɛni sayn, te hat atak kin kam wantɛm wantɛm. Na dat mek dɛn kɔl am di "silent killer."

Dɛn kin kɔl am bak Korona At Disiz (CHD) ɛn Ischemic Hat Disease . Dis na wetin bɔrku pipul kin kɔl "at prɔblɛm."

Ɛni men kayn tin dɛn de we kin apin to dis?

Yɛs, tu men kayn sik dɛn de we de mek pɔsin gɛt korona at:

1. Stebul Ischemic Hat Disease: Dis na di kayn we we nɔ de mɛn, ɔ we de te fɔ lɔng tɛm. Yu korona at dɛn kin smɔl smɔl fɔ lɔng tɛm. As tɛm de go, di blɔd we yu at de gɛt we gɛt bɔku ɔksijɛn kin go dɔŋ. Yu kin gɛt sɔm sayn dɛm, bɔt yu kin ebul fɔ du yu ɛvride layf nɔrmal wan.

2. Akyu Korona Sindrom: Dis na denja sik we kin apin wantɛm wantɛm ɛn i nid fɔ go to dɔktɔ wantɛm wantɛm. Di plek we de na wan korona at kin brok wantɛm wantɛm, ɛn i kin mek wan blɔd we kin mek di blɔd nɔ go na di at. Dis we aw pɔsin kin blok wantɛm wantɛm kin mek pɔsin gɛt at atak.

Aw kɔmɔn tin dis kin apin?

Koronari at sik kin rili kɔmɔn . Na Amɛrika nɔmɔ, i pas 18 milyɔn big pipul dɛn we gɛt dis sik. I tan lɛk se dis tin de bɔku de go bifo na wi kɔntri bak. Korona at sik na di big tin we de mek pipul dɛn day ɔlsay na di wɔl.

Wetin na di sayn dɛm we de sho se yu gɛt dis sik?

Yu nɔr kin gɛt ɛni sayn fɔ korona at sik fɔ lɔng tɛm. Dis na bikɔs i kin tek sɔm ia, ivin bɔku bɔku ia, fɔ mek dis plet bɔku. Bɔt as yu at dɛn bigin fɔ smɔl, yu kin bigin fɔ notis sɔm kayn sayn dɛn we nɔ klia. Dis na sayn dɛm we de sho se yu at de wok tranga wan pas aw i kin wok fɔ pɔmp blɔd we gɛt ɔksijɛn rawnd yu bɔdi.

Di sayn dɛm fɔ CAD we nɔr de dɔn kin bi:

• Stebul Angina: Dis na de sik wae kin kam pan pɔrsin. Stebul angina na chɛst pen ɔ diskɔmfɔt. I kin kam ɛn go insay wan we we nɔ de chenj. Bɔku tɛm yu kin fil am we yu de du ɛksasaiz, we yu de wok tranga wan, ɔ we yu strɛs. I kin go we yu rɛst ɔ we yu tek naytroglycerin (wan mɛrɛsin we dɛn kin yuz fɔ angina).
• Shortness of breath / Dyspnea: Sɔm pipul dɛn kin gɛt prɔblɛm fɔ blo ivin we dɛn de du simpul wok.

Sɔntɛnde, di fɔs sayn fɔ korona at sik na at atak , so yu nid fɔ tek tɛm bad bad wan bɔt dis.

Wetin kin mek i apin?

Di men tin we kin mek pɔsin gɛt korona at na wan sik we dɛn kɔl atherosclerosis . Atεrosklεrosis na we di plek de kכmכt sכmtεm insay yu bכdi in at dεm. We dɛn plek ya de blok di blɔd we de pas na yu korona at, yu kin gɛt korona at sik.

Dis plek na tin dɛm lɛk kɔlɔstrel, dɔti tin dɛm, kalsiɔm, ɛn fibrin (wan tin we de ɛp fɔ mek blɔd klɔt). we dεn tin ya kin bכku along di wכl dεm na di at, dεn kin sכmtεm εn stif.

Dɛn dipɔsit ya kin mek di at dɛn smɔl ɔ pwɛl. Dis kin mek di blɔd nɔ go na wan pat na di bɔdi ɔ i kin stɔp am kpatakpata. we dεn diposit dεm ya de bכku na di korona at, di at mכsul nכ de gεt inof bכdi. Dis min se di at nɔ de gɛt di ɔksijɛn ɛn di tin dɛn we i nid fɔ mek i wok fayn fayn wan. Dɛn kɔl dis mayokardial ischemia . Dis kin mek yu chɛst pen (angina) ɛn i kin mek yu gɛt at atak.

Pipul dεm we gεt korona atεri sik kin gεt plek we de bכku na כda pat dεm na di bכdi, we kin mek dεn gεt kכndyushכn lεk di atεri dεm we de na di nεk) εn pεrifεral atεri sik (PAD) (we de involv di at dεm na di an εn leg).

Dis na sɔntin we kɔmɔt frɔm jɛnɛreshɔn?

To sɔm mak, yɛs. Famili histri kin afɛkt yu risk fɔ gɛt korona at sik. Bɔt bɔku ɔda tin dɛn de we kin mek yu gɛt prɔblɛm we nɔ gɛt natin fɔ du wit yu jin. Di disizhɔn dɛm wae yu kin mek ɛvride kin gɛt di big impak pan yu risk fɔ gɛt CAD.

Wetin na di tin dɛn we kin mek pɔsin gɛt dis sik?

Bɔku tin dɛn de we kin mek pɔsin gɛt korona at. Yu nɔr kin chenj ɔl dɛn, bɔt sɔm kin kɔntrol sɔm pan dɛn wit chenj na yu layf ɔr mɛrɛsin. Tɔk to yu dɔktɔ bɔt wetin yu kin du bɔt dɛn tin ya we kin mek yu gɛt dis sik:

• If yu na man, yu dɔn pas 45 ia, ɛn if yu na uman, yu pas 55 ia.
• Fɔ gɛt pɔsin na yu famili we gɛt at sik (especially papa ɔ brɔda bifo i ol 55 ia, ɔ mama ɔ sista bifo i ol 65 ia).
• Fɔ it tumɔs sɛtyuret fat ɔ rifin kabɔhaydrɛt (lɛk bred, rays, pasta).
• Nɔ de du ɛksɛsayz inof.
• Nɔ gɛt bɛtɛ slip.
• Fɔ smok, fɔ vap, ɔ fɔ yuz ɔda tin fɔ smok.
• Fɔ gɛt wan sik we dɛn kɔl atherosclerosis .
• Di ay blɔd prɛshɔn .
• Di bad bad kɔlɔstrel (LDL kɔlɔstrel) we de go ɔp .
• Di lɛvɛl we di gud kɔlɔstrel (HDL kɔlɔstrel) de go dɔŋ .
• di triglisεrayd lεvεl dεm we de εlevεt ( haypa triglisεridemia ).
• Anemia we nɔ gɛt bɛtɛ blɔd .
• Ɔtoimyun sik dɛm lɛk lupus ɛn rεumatoid at at .
• Kidni sik we nɔ de mɛn .
• Dayabitis (Dayabitis Mɛlitɔs) .
• HIV/AIDS .
• Mɛtabolik sindrom .
• Bɔdi Mas Indeks (BMI) we pas 25.
• Slip dizayd lɛk slip apnea .
• Menopause kwik (bifo i ol 40 ia).
• Ɛndomɛtriɔsis we dɛn kɔl .
• Fɔ gɛt histri bɔt kɔndishɔn dɛn lɛk gestational diabetes , eclampsia , ɔ preeclampsia .
• Yuz di we dɛn we dɛn kin yuz ɔmon fɔ kɔntrol bɔn pikin.

Yu tink se prɔblɛm dɛn kin apin?

Di men kɔmplikeshɔn fɔ korona at sik na at atak . Dis na mɛdikal imejensi we kin mek pɔsin in layf de pan denja. Di at mɔsul kin bigin fɔ day bikɔs i nɔ kin gɛt inof blɔd. Fɔ sev yu layf, yu nid mɛrɛsin kwik kwik wan fɔ mek blɔd go bak na yu at.

As tɛm de go, CAD kin mek di at wik ɛn mek prɔblɛm dɛn lɛk:

• Aritmi (at nɔrmal at bit, fכ egzampl atrial fibrilashכn ).
• Day wantɛm wantɛm bikɔs in at nɔ de wok .
• Shok we kin mek pɔsin gɛt at .
• At we nɔ de wok fayn .

Aw dɛn kin no dis sik?

Dɔktɔ dɛn kin no se pɔsin gɛt korona at sik bay we dɛn de chɛk dɛn bɔdi ɛn difrɛn tɛst dɛn.

We dɛn de du di bɔdi ɛgzam, yu dɔktɔ:

• Dɛn de mɛzhɔ yu blɔd prɛshɔn .
• Fɔ lisin to di at wit stetɔskɔp.
• Dɛn kin aks us sik yu gɛt ɛn aw lɔng yu dɔn gɛt dɛn.
• Fɔ aks bɔt yu mɛdikal istri.
• A de aks bɔt yu layf stayl.
• Aks bɔt yu famili in mɛdikal histri (especially if yu mama ɛn papa ɔr yu brɔda ɛn sista dɛn gɛt at sik).

Ɔl dis infɔmeshɔn de ɛp yu dɔktɔ fɔ no if yu gɛt at sik.

Us kayn tɛst dɛn kin du?

Fɔ no aw yu at de wok ɛn fɔ no se yu gɛt CAD, yu dɔktɔ kin tɛl yu fɔ du wan ɔ mɔ pan dɛn tɛst ya:

• Blɔd tɛst dɛn .
• Kateshɔn fɔ di kadyak .
• CT korona angiogram (Kɔmpyut tomografi (CT) korona angiogram) .
• At MRI (magnɛtik rɛsɔnans imej) .
• Koronari kalsiɔm skan .
• Ekokardiogram (Ekokardiogram - ɛko) .
• Ilɛktrokardiogram (EKG/ECG) .
• Ɛksesaiz strɛs tɛst .
• Chɛst X-ray .

Aw dɛn kin trit am?

Bɔrku tɛm, di tritmɛnt fɔ korona at sik kin gɛt fɔ du wit fɔ chenj in layf, fɔ mɛn di risk factor, ɛn fɔ tek mɛrɛsin. Sɔm pipul dɛn kin nid ɔpreshɔn bak ɔ ɔda tin dɛn we dɛn kin du fɔ mɛn pipul dɛn.

Yu dɔktɔ go tɔk to yu bɔt di bɛst tritmɛnt plan fɔ yu. I rili impɔtant fɔ fala yu tritmɛnt plan ɛksaktɔli fɔ ridyus yu risk fɔ gɛt siriɔs kɔmplikeshɔn frɔm CAD.

Di we aw pipul dɛn de liv dɛn layf kin chenj

Di chenj na di layf we pɔsin de liv kin rili ɛp fɔ mɛn di sik we dɛn kɔl korona at. Dɛn tin ya na:

• Nɔ smok, vap, ɔ yuz ɛnitin we dɛn mek wit tabak .
• It it we go ɛp yu at we nɔ gɛt bɔku sodium (sɔl), sɛtyuret fat, trans fat, ɛn shuga . Di it we dɛn kin it na di Mɛditarenian na wan we we dɛn dɔn pruv fɔ ridyus di risk fɔ gɛt at atak ɔ strok.
• Ɛksesaiz : Aim fɔ waka (ɔ du ɔda tin) fɔ 30 minit, fayv dez insay di wik.
• Limit fɔ drink rɔm .

Mek shɔ se yu tɔk to yu dɔktɔ bifo yu bigin fɔ du nyu ɛksɛsayz. Yu dɔktɔ kin gayd yu fɔ ɛni chenj na yu layf we yu nid. Dɛn kin tɛl yu bak aw fɔ ɛp yu fɔ lɛf fɔ smok ɔ tɔk to pɔsin we sabi bɔt it bɔt aw fɔ it fayn.

Risk factor manejmɛnt

If yu de kɔntrol di tin dɛn we de mek yu gɛt CAD, dat kin ɛp fɔ mek yu nɔ wɔs. Wok wit yu dɔktɔ fɔ mɛn dɛn sik ya:

• Shuga .
• Di ay blɔd prɛshɔn .
• Ay kɔlɔstrel .
• di ay triglisεrayd (haypa triglisεridεmia) .
• BMI valyu we pas 25 .

Mɛrɛsin dɛn we dɛn kin yuz

Mεdikeshכn kin εp fכ kכntrכl yu risk factor dεm εn trit de simptom dεm fכ korona atεri sik. Yu dɔktɔ kin gi yu wan ɔ mɔ pan dɛn mɛrɛsin ya:

• Di wan dɛn we de mek blɔd prɛshɔn go dɔŋ.
• Di wan dɛn we de mek di kɔlɔstrel smɔl.
• Di wan dɛn we de kɔntrol stebul angina, lɛk naytroglycerin ɛn ranolazine .
• Di wan dɛn we de ridyus di risk fɔ mek blɔd klɔt.

Ɔpreshɔn ɛn ɔda tin dɛn we dɛn kin du

Sɔm pipul dɛn kin nid fɔ du ɔ ɔpreshɔn lɛk dis fɔ kɔntrol korona at sik:

• Pɛrkyutanɛs Korona Intɛrvɛnshɔn (PCI): Dis na wan we we nɔ kin ambɔg bɔku, we dɛn kin kɔl bak korona angioplasty . Yu at we dɔn blok de opin bak ɛn blɔd de flɔ fayn fayn wan. Dɛn kin put stent bak fɔ ɛp fɔ mek di at opin.
• Coronary Artery Bypass Grafting (CABG): Dis ɔpreshɔn de mek nyu rod fɔ mek blɔd flɔ rawnd di blɔk. dis "baypas" de mek di bכdi fכ fכlכ bak na di at. CABG ɔpreshɔn kin ɛp pipul dɛn we gɛt siriɔs blɔk na sɔm korona at.

Ɛni bad tin de we di tritmɛnt kin du?

Koronari at sik tritmɛnt kin mek yu gɛt prɔblɛm ɔr sayd ɛfɛkt lɛk:

• Blɔd we de kɔmɔt.
• Rɔnbɛlɛ.
• Diziz we pɔsin kin gɛt.
• Kɔf.
• Fɔmeshɔn fɔ wan blɔd we de klɔt.
• Di korona at we dɔn pwɛl.
• Infεkshכn dεm.
• Di at we nɔ de bit.
• Cardiac tamponade ( we wata kin gɛda rawnd di at).

Aw lɔng i kin tek fɔ mek i wɛl?

Afta PCI (angioplasty) , yu kin ɔltɛm bigin fɔ du tin dɛn we yu nɔ bin de du insay wan wik. Afta CABG (bypass surgery) , yu go nid fɔ de na ɔspitul fɔ pas wan wik. Afta dat, i go tek lɛk 6 to 12 wiks fɔ mek i wɛl.

Yu nɔ tink se dɛn go ebul fɔ stɔp dis?

Nɔr kin ebul fɔ avɔyd korona at ɔltɛm bikɔs sɔm tin dɛm wae kin mek yu gɛt dis sik nɔr kin ebul fɔ kɔntrol. Bɔt yu kin ridyus yu risk fɔ gɛt korona at sik ɛn ɛp fɔ mek i nɔ wɔs bay we yu:

• Mek yu maynd fɔ stɔp fɔ smok ɛn ɔl kayn tabak kpatakpata .
• It tin dɛn we go ɛp yu at.
• Gɛt inof slip.
• Mek yu gɛt wɛlbɔdi wet we go fayn fɔ yu.
• Yu fɔ no bɔt di prɔblɛm dɛn we kin apin we pɔsin gɛt at sik.
• Limit fɔ drink rɔm.
• Muv mɔ, bi aktif.
• Tek yu mɛrɛsin lɛk aw dɛn tɛl yu fɔ tek am.

Wetin kin apin if a gɛt dis sik?

Yu dɔktɔ na di bɛst pɔsin fɔ tɛl yu bɔt yu sik. Di tin dɛn we kin apin kin difrɛn frɔm wan pɔsin to ɔda pɔsin. Yu dɔktɔ go tink bɔt ɔltin frɔm yu ej, ɔda mɛrɛsin, tin dɛn we kin mek yu gɛt prɔblɛm, ɛn di sayn dɛn we yu kin gɛt fɔ disayd fɔ du sɔntin. We yu chenj yu layf ɛn ɔda tritmɛnt dɛn kin ɛp yu fɔ mek yu gɛt bɛtɛ chans fɔ wɛl.

Yu tink se dɛn go ebul fɔ mɛn dis sik kpatakpata?

Yu nɔ go ebul fɔ "kyu" korona at sik kɔmplit wan. Bɔt yu kin ebul fɔ kɔntrol yu sik ɛn mek i nɔ wɔs . If yu woke wit yu dɔktɔ ɛn fala yu tritmɛnt plan gud gud wan, yu kin gɛt mɔ chans fɔ liv strɔng ɛn wɛl as yu ebul.

Aw a kin kia fɔ misɛf?

De tin wae impɔtant pas ɔl wae yu kin du na fɔ fala yu tritmɛnt plan ɛksaktɔli. Dis kin inklud fɔ chenj yu layf ɛn fɔ tek mɛrɛsin. I kin inklud bak ɔpreshɔn ɔ ɔda tin dɛn we dɛn kin du ɛn di tɛm we i nid fɔ wɛl afta dat.

Apat frɔm di tritmɛnt, yu dɔktɔ kin tɛl yu bak fɔ mek yu du program fɔ mek yu at pwɛl . Dis kayn program kin rili ɛp fɔ pipul dɛm wae de wɛl frɔm hat atak ɔr de liv wit at pwɛl hat. I kin ɛp yu fɔ du ɛksɛsayz, chenj di it dɛn we yu de it, ɛn fɔ kɔntrol yu strɛs.

Korona Atri Disease ɛn Mental Ɛlth

We dɛn tɛl yu se yu gɛt CAD, yu kin bigin fɔ tink mɔ bɔt yu at ɛn yu at pas aw yu go tink. Dis kin mek yu taya ɛn i kin mek yu at pwɛl. Yu kin fil bad fɔ wɔri bɔt yu sik ɔr wetin go apin to yu. Bɔrku pipul dɛm wae gɛt korona at sik kin gɛt pwɛl hat ɛn wɔri . Na nɔmal tin fɔ fil wɔri we yu de liv wit wan sik we go mek yu layf de pan denja.

Bɔt nɔ mek da wɔri de tek yu layf ɛvride. Yu kin liv aktif, fulfil layf ivin wit hat sik. If di sik we yu gɛt de afɛkt yu maynd, tɔk to pɔsin we de gi yu advays. Fɛn sɔpɔt grup usay yu go mit pipul dɛn we de go tru di sem tin lɛk yu. Yu nɔ nid fɔ kip ɔl dis to yusɛf, ɛn yu nɔ nid fɔ fil lɛk se yu fɔ strɔng fɔ ɔda pipul dɛn. CAD na wan sik we de chenj in layf. E fayn fɔ ɔndastand ɔl dis ɛn tek yu tɛm fɔ fɛn we fɔ gɛt wɛl bɔdi, pan bɔdi ɛn maynd.

Ustɛm yu fɔ go to dɔktɔ?

Yu dɔktɔ go tɛl yu aw ɔltɛm yu nid fɔ kam insay fɔ tɛst ɛn fɔ fala yu. Apat frɔm we yu kin go to yu dɔktɔ ɔltɛm, yu kin go to spɛshal dɔktɔ dɛn bak (fɔ ɛgzampul , dɔktɔ we de mɛn yu at ).

Tɔk to yu dɔktɔ pan dis kayn tin:

• If yu notis nyu sayn ɔr chenj na di sayn dɛm.
• If sayd ɛfɛkt dɛn de frɔm di mɛrɛsin.
• If yu gɛt ɛni kwɛstyɔn ɔr wɔri bɔt yu kɔndishɔn ɔr tritmɛnt plan.

Ustɛm yu fɔ go to tritmɛnt kwik kwik wan?

If yu gɛt sayn fɔ hat atak ɔ strok, kɔl 1990 ɔ yu lokal imejensi nɔmba. Dɛn tin ya na mɛdikal imejensi dɛn we kin mek pɔsin in layf de pan denja ɛn we nid fɔ gɛt tritmɛnt wantɛm wantɛm. I kin fayn fɔ print wan list fɔ di sayn dɛm ɛn kip am usay yu go si dɛn. Dɔn bak, tɛl yu fambul ɛn padi dɛm bɔt dɛn sik ya so dat dɛn go kɔl 1990 fɔ yu if dɛn nid fɔ du dat.

Wetin a fɔ aks di dɔktɔ/dɔkta?

If dɛn nɔr dɔn no se yu gɛt korona at sik yet, tink bɔt fɔ aks yusɛf dɛn kwɛstyɔn ya:

• Wetin na di tin dɛm wae kin mek a gɛt korona at sik?
• Wetin a go du fɔ ridyus di prɔblɛm we a gɛt?
• Us chenj dɛn na mi layf we impɔtant pas ɔl to mi?
• Us mɛrɛsin dɛn we go mek a nɔ gɛt bɔku prɔblɛm, ɛn wetin na dɛn bad tin dɛn we dɛn kin du?
• Aw lɔng a fɔ tek dis mɛrɛsin?

If yu gɛt korona at sik, dɛn kwɛstyɔn ya kin ɛp yu:

• Wetin a go du fɔ kɔntrol di sik fɔ mek i nɔ wɔs?
• Wetin na di bɛst tritmɛnt plan fɔ mi?
• Us chenj dɛn we a nid fɔ chenj mi layf?
• Us mɛrɛsin a nid ɛn wetin na dɛn sayd ɛfɛkt?
• A go nid ɔpreshɔn ɔ ɔda tin dɛn fɔ du? Aw a go wɛl?
• Ɛni sɔpɔt grup ɔ risɔs de we yu kin rɛkɔmɛnd?

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

Fɔ no se yu gɛt korona at sik kin bi miks bag fɔ filin. Yu go kɔnfyus bɔt aw dis bin apin. Yu kin fil bad, ɔr yu kin wish se yu bin dɔn du tin difrɛn we fɔ avɔyd dis sik. Bɔt dis nɔto tɛm fɔ tink bɔt di tin dɛn we dɔn pas, bɔt na fɔ tink bɔt di tumara bambay. Lɛf ɛni gilti ɔ blem we yu go fil. Bifo dat, bigin fɔ mek plan fɔ ɛp yu at tide.

Wok wit yu dɔktɔ fɔ mek chenj dɛn na yu layf we yu go ebul fɔ manej. Lan bɔt di tritmɛnt dɛn we yu kin gɛt, lɛk di mɛrɛsin dɛn, ɛn aw dɛn kin ɛp yu at fɔ gɛt wɛlbɔdi. Tɛl yu fambul ɛn padi dɛn bɔt yu gol dɛn ɛn aw dɛn go ɛp yu. Dis na yu joyn, bɔt yu nɔ nid fɔ go am yu wan. Mɛmba se if yu no di rayt tin, sɔpɔt yu, ɛn gɛt gud abit, yu go ebul fɔ liv fayn wit dis sik.

` Korona at sik, hat sik, hat atak, angina, kכlestכl, blכk at, at hεlth