Wetin yu nid fɔ no bɔt Epatopulmonary Syndrome!

If yu ɔr pɔrsin wae yu sabi gɛt liva sik, ɔr if yusɛf gɛt dis sik, e fayn fɔ no bɔt dis sik wae kin mek yu nɔr ebul fɔ blo fayn sɔmtɛm. Wi kin kɔl am Ɛpatopulmonary Syndrome. Di nem kin tan lɛk se i kɔmplikt smɔl, bɔt lɛ wi kip am simpul, nɔto so? Bikɔs na prɔblɛm we de kɔmɔt na di liva to di lɔng.

Wetin na di Epatopulmonary Syndrome rili?

Fɔ tɔk am simpul wan, di ɛpatopulmonary syndrome na wan prɔblɛm we nɔ kin apin so ɔltɛm bɔt we kin gɛt siriɔs liva sik we kin afɛkt di lɔng dɛn. di wɔd "hepato" min "we gɛt fɔ du wit di liva." "pulmonary" min "we gɛt fɔ du wit di lɔng dɛm." Yu no se na blɔd vesel dɛn de kɔnɛkt wi liva ɛn lɔng?

Naw imajin, we pɔsin gɛt liva sik, mɔ wan sik lɛk sirosis, usay di liva kin stif ɛn smɔl, sɔm pan di blɔd vesel dɛn we gɛt kɔnekshɔn to di lɔng dɛn kin big we nɔ nid fɔ de. Lɛk balyɔn we de blo. Insay mɛrɛsin, wi kin kɔl dis ``Vasodilation`` . We di blɔd vesel dɛn big dis we, di nɔmal we aw di blɔd de flɔ na di lɔng dɛn kin chenj. Sɔntɛnde, di blɔd nɔ kin miks wit ɔksijɛn na di lɔng dɛn fayn fayn wan, bɔt bifo dat, i kin pas dairekt tru dɛn. dis kayn bכdi fכ fכlכ we nכ de rεgulεr dεn kכl dεm ``Shunts`` . di wayd we di bכdi vεsul dεm na di lכng dεm de wayd na bikoz fכ ``Vasodilation``, εn di כksijεn lεvεl na di bכdi de dכn bikoz fכ dεn ``Shunts`` dεm. Wi kin kɔl dis ``Hypoxemia`` . Yu ɔndastand?

Aw dis sik kin afɛkt yu? I nɔ izi fɔ yu fɔ blo?

Naw yu go mɔs de tink se, "Okay, aw dis de afɛkt mi?" Di men tin wae kin afɛkt dis na wae yu nɔr kin ebul fɔ blo fayn (dyspnea) . Dis nɔ kin kam wantɛm wantɛm, i kin wɔs smɔl smɔl. Sɔm pipul dɛn nɔ kin notis am fɔs. Bɔt as tɛm de go, dis sik kin so bad dat i kin at fɔ blo ivin we yu tinap wansay.

Sɔm pipul dɛn kin gɛt prɔblɛm fɔ blo we dɛn sidɔm ɔ tinap, bɔt dɛn kin fil fayn we dɛn de ledɔm. Fɔ ɔda pipul dɛn, na di ɔda we; dɛn kin gɛt prɔblɛm fɔ blo we dɛn de ledɔm, ɛn dɛn kin fil fayn we dɛn sidɔm. Bɔt bikɔs dis shɔt briz kin wɔs as tɛm de go, wi kin kɔl am Chronic Respiratory Failure. Dis min se ɔltin nɔ kin stɔp wantɛm wantɛm, bɔt smɔl smɔl yu bɔdi in ɔgan ɛn tisu dɛn nɔ kin gɛt bɛtɛ ɔksijɛn. Wi kin kɔl dis haypoksia .

Dis na tin we rili denja. Yu no wetin? Ɔksijɛn impɔtant fɔ wi bɔdi. We i lɔs kpatakpata, i kin mek di impɔtant pat dɛn lɛk di bren ɛn di at pwɛl fɔ ɔltɛm. If dɛn nɔ trit dis sik fayn, i kin mek pɔsin in layf de pan denja.

Udat dɛn kin gɛt di sik we dɛn kɔl ɛpatopulmonary syndrome?

Risach dɔn sho se lɛk wan kwata, ɔ 25%, pan pipul dɛm wae gɛt krɛse sik na dɛn liva kin gɛt ɛpatopulmonary syndrome. I kin apin bak we di liva nɔ wok wantɛm wantɛm, we dɛn kɔl akyu liva we nɔ de wok fayn, bɔt i nɔ kin bɔku.

Bɔku tɛm, na dis kin apin: Sirosis na di liva kin mek di prɛshɔn na di blɔd vesel dɛn we gɛt kɔnekshɔn to di liva go ɔp. Insay mɛrɛsin, wi kin kɔl am ``Pɔtal Haypatɛyshɔn'' . dat ``Portal Hypertension'' kכndyushכn na in de mek di bכdi vεsul dεm na di lכng dεm de wayd pan sכm pipul dεm, we de mek dis hεpatopulmonary syndrome. כltu, na sכm tεm, ``Pכtal Haypatεnshכn'' kin apin bikoz fכ כda kכz dεm, lεk bכdi kכlכt, εn dis sεndrכm kin apin bak tru dat.

Wetin na di rial rizin fɔ dis?

Infakt, sayɛnsman dɛn stil nɔ no bɛtɛ bɛtɛ wan wetin mek dis sik we dɛn kɔl pɔtal haypatɛnshɔn kin mek di blɔd vesel dɛn na di lɔng dɛn big (vasodilation) pan sɔm pipul dɛn. Bɔku tiori ɛn opinion dɛn de bɔt am. E nɔr kin klia bak wae mek e nɔr kin apin to ɔlman, bɔt na sɔm pipul dɛm nɔmɔ. I tan lɛk se i nɔ gɛt ɛnitin fɔ du wit di kayn we aw di liva sik de tranga.

Bɔt wan tin klia. di vasodilayshכn na di lכng dεm de mek di כksijεn lεvεl dεm na di bכdi dכn (Hypoxemia). Fɔ tɔk am simpul wan, nɔ balans de bitwin di kayn briz we de go insay di lɔng ɛn di blɔd we de pas na di lɔng. Dis na di rizin we mek di bɔdi nɔ de gɛt di ɔksijɛn we i nid.

Wetin na di sayn dɛm we de sho se yu gɛt dis sik? Aw wi no dis?

If di kɔndishɔn fɔ Epatopulmonary Syndrome nɔr tu siriɔs, yu nɔr kin notis ɛni sayn. Di fɔs sayn we bɔku pipul dɛn kin fil na, lɛk aw wi bin dɔn tɔk, i nɔ kin izi fɔ blo (Dyspnea) . Bɔt bɔku rizin dɛn de we mek i nɔ kin izi fɔ blo. Pɔsin we gɛt liva sik kin gɛt prɔblɛm fɔ blo difrɛn we dɛn. So, sɔmtɛm, di sik pipul ɛn dɔktɔ dɛn nɔ kin no wantɛm wantɛm se dis na sayn fɔ di sik we dɛn kɔl Hepatopulmonary Syndrome.

As de sik de wɔs, yu kin gɛt ɔda sayn dɛm bak lɛk:

• Platypnoea: Dis na we yu gɛt prɔblɛm fɔ blo we yu sidɔm ɔ tinap, bɔt yu kin fil sɔm kayn fridɔm we yu de ledɔm.
• Ɔtopnia: Dis na di ɔda we. I nɔ kin izi fɔ blo we yu ledɔm, bɔt i bɛtɛ we yu sidɔm.
• Saynosis: Na di lip, finga nel, ɛn sɔm tɛm dɛn na di skin kin chenj di kɔlɔ we blu bikɔs ɔksijɛn nɔ de na di bɔdi. Dis na sayn we pɔsin kin si.
• Finga dɛn we gɛt klɔb:Di tip dɛn na di finga ɔ fut finga dɛn kin tan lɛk se dɛn dɔn swel ɛn dɛn kin bɔl, lɛk di tip dɛn na drɔmstik. Dis na ɔda sayn fɔ hypoxemia.

Apat frɔm dɛn sayn ya, yu kin gɛt sɔm sayn dɛm bak we kɔmɔn fɔ liva sik ɛn/ɔ pɔtal haypatɛnshɔn. Fɔ ɛgzampul:

• Spayda angiomas: Smɔl, rɛd, blɔd vesel dɛn we tan lɛk spayda we de sho ɔnda di skin.
• Varicose veins: Dɛn kin si di blɔd vesel dɛn we dɔn big na di bɛlɛ ɔ di εsophagus.
• Wan histri bɔt blɔd we bin dɔn kɔmɔt na di bɛlɛ bifo tɛm .
• Ascites (we de swel na di bɛlɛ) .

Aw dɔktɔ dɛn kin no bɔt dis?

Dɔktɔ dɛn kin no dis ɛpatopulmonary syndrome we tri men sayn dɛn kin apin togɛda:

1. Pɔtal Haypatɛyshɔn: Dis kin apin bɔku tɛm wit liva sik.

2. Intrapulmonary vascular dilateations: dis min se di bכdi vεsul dεm we de insay di lכng dεm de dilayt.

3. Di ɔksijɛn lɛvɛl na di blɔd we de go dɔŋ (Hypoxemia) .

Bɔku tɛm, we yu gɛt dis `(Hepatopulmonary Syndrome)`, yu dɔktɔ dɛn dɔn ɔlrɛdi si se yu gɛt liva sik `(Liver Disease)` ɔ `(Portal Hypertension).` If nɔto dat, yu mɛdikal tim go fɔs du difrɛn skan ɛn blɔd tɛst fɔ si if di liva dɔn pwɛl. Dɔn dɛn go luk di vein dɛn na yu lɔng ɛn mɛzhɔ ɔmɔs ɔksijɛn de na yu blɔd. dis tεst dεm kin sho klia wan se di bכdi vεsul dεm na yu lכng dεm de wayd `(Vasodilation)`, we de mek כksijεn lכw na yu bכdi `(Hypoxemia).`

Us spɛshal tɛst dɛn kin du fɔ dis?

Dɔktɔ dɛn kin du bɔku tɛst fɔ no if pɔsin gɛt dis sik. Sɔm pan dɛn na:

• Pulse oximetry: Yu go mɔs dɔn mek dɛn du dis bifo. Na wan rili simpul tɛst we nɔ de mek pɔsin fil pen. Dɛn kin tay wan smɔl tin we tan lɛk klip na di tip na yu finga. I de shayn layt tru yu finga ɛn mɛzhɔ di layt we de kɔmɔt na di ɔda say, we dɛn kin yuz fɔ mɛzhɔ ɔmɔs ɔksijɛn de na yu blɔd (Oxygen Saturation). Dis na wan bɛsik tɛst.
• Arterial Blood Gas (ABG): If di pulse oximetry sho se yu blɔd ɔksijɛn nɔ bɔku, di nɛks tɛst we yu go du na di ABG. Dis na tin we dɛn tɔk mɔ bɔt smɔl. Dɛn kin tek smɔl blɔd frɔm wan at we de na yu an . dεn de tεst di bכdi sεmpl fכ no di כksijεn we dεn sכlv na yu bכdi (PaO2). Dis na fɔ no aw yu lɔng dɛn de tek ɔksijɛn insay yu blɔd fayn fayn wan.
• Kɔntrast Ɛkokadyografi: .dis na di bεst raydiolojikal mεtכd fכ fכn dilated pulmonary veins. Echocardiogram na ɔltra saund. I de yuz ay frikyuɛnsi sawnd wev fɔ tek pikchɔ fɔ yu at ɛn di vein dɛn na yu lɔng. Insay wan ɔltra saund we dɛn kin yuz fɔ mek difrɛns, dɛn kin put wan kɔntrast ɛjɛn, we na spɛshal wata, insay wan vein fɔ mek dɛn si di vein dɛn mɔ. We yu gɛt kɔntrast ɛkokadiogram, wan tɛknishian kin injɛkt wan agitated saline solution insay yu vein. Dis na sɔlv we dɛn mek bay we dɛn ad smɔl smɔl bɔbul dɛn we gɛt briz to sɔl wata. Dɔn dɛn kin wach fɔ si if dɛn smɔl smɔl bɔbul ya de muf frɔm di rayt say na yu at to di lɛft say as tɛm de go (rayt to lɛft kadyak shunt). Dis kin tɛl dɛn if yu gɛt `(Hepatopulmonary Syndrome)` ɔ yu nɔ gɛt am.

Aw dɛn kin trit dis?

di onli tritmεnt we de naw fכ hεpatopulmonary syndrome na supliment כksijεn . Ɔksijɛn tɛrapi involv fɔ blo 100% ɔksijɛn fɔ ɛp yu bɔdi. Yu kin nid fɔ gɛt ɔksijɛn frɔm wan prɛshɔn chamba na ɔspitul, we dɛn kɔl haypabarik ɔksijɛn tɛrapi. Ɔ, dɛn kin gi yu wan tin we yu kin kɛr go na os, lɛk ɔksijɛn mask. Ɔksijɛn kin ɛp fɔ ridyus di sik dɛn, mɔ we yu nɔ de blo fayn, ɛn mek yu bɔdi in tisu dɛn wok fayn bay we i de gi dɛn di ɔksijɛn we dɛn nid.

Yu tink se di ɛpatopulmonary syndrome kin kam bak? Yu tink se dɛn go ebul fɔ mɛn am kpatakpata?

di onli tritmεnt fכ dis hεpatopulmonary syndrome na fכ transplant liva . Yɛs, yu yɛri mi rayt. Afta we dɛn dɔn transplant di liva fayn fayn wan, di blɔd vesel dɛn we de na di lɔng dɛn we de big (vasodilation) ɛn di ɔksijɛn we nɔ de na di blɔd (hypoxemia) kin chenj smɔl smɔl. Dat min se i kin bɛtɛ. I kin tek lɛk siks to twɛlv mɔnt fɔ mek yu lɔng wok kam bak to nɔmal.

Bɔt nɔto ɔlman fit fɔ gɛt liva transplant. Difrɛn rizin dɛn de fɔ dis. Ivin if dɛn kwalifay, tɛm kin de we dɛn kin wet fɔ lɔng tɛm fɔ mek dɛn gɛt liva. So dis we aw pɔsin de wɛl tan lɛk we pɔsin de rɔn wit tɛm.

Yu tink se dis kin kil pɔsin? Wetin wi go se bɔt di tɛm we dɛn go sev?

If yu gɛt Epatopulmonary Syndrome, yu go dɔn gɛt Kronik Liva Disease. Ɛnd-stej liva sik na wan sik we kin kil pɔsin if dɛn nɔ transplant di liva. Epatopulmonary Syndrome na jɔs wan pan di sayd ɛfɛkt ɛn kɔmplikeshɔn dɛm wae kin kam wit am. Bɔrku pipul nɔr kin day wit Hepatopulmonary Syndrome, wae na wae dɛn nɔr gɛt ɔksijɛn (hypoxemia), bɔt i kin ɛp bak fɔ gɛt ɔl dɛn wɛl bɔdi ɛn i kin mek dɛn layf shɔt.

Aw lɔng yu kin liv wit Epatopulmonary Syndrome de dipen pan bɔrku tin. Dis kin inklud aw yu liva sik tranga, yu ɔl wɛl bɔdi, ɛn if yu gɛt ɔda mɛrɛsin. Na avrej, pɔsin we gɛt sirosis na in liva bɔt we nɔ gɛt Epatopulmonary Syndrome kin liv fɔ lɛk sɛvin ia so we dɛn nɔ transplant in liva. Bɔt fɔ pɔsin we gɛt sirosis ɛn Epatopulmonary Syndrome, di avɛrej layf we pɔsin kin liv we i nɔ transplant in liva kin ridyus to lɛk tu ia so.

Sɔm pipul kin gɛt mild hepatopulmonary syndrome, wae nɔr kin tranga lɛk liva sik. Dɛn kin ebul fɔ liv lɔng wit sɔpɔt tritmɛnt. Dɔn bak, sɔm pipul dɛn nɔ kin liv we dɛn transplant dɛn liva if dɛn sik rili bad. di avrej fayv ia rεt fכ pipul dεm we gεt hεpatopulmonary syndrome we gεt saksesful liva transplant na bכt 70%. dis sכmtεm lכs pas di כvala sכvayv rεt afta dεn transplant di liva (75%).

Liva sik kin afɛkt ɔlman difrɛn we. Epatopulmonary Syndrome na wan sik wae nɔr kin bɔrku ɛn kin kil pɔrsin wae kin apun. Sɔntɛm yu nɔ go dɔn yɛri bɔt am te i apin to yu ɔ pɔsin we de nia yu.

Bɔrku pipul dɛn nɔr kin gɛt sɔm kayn sik ɔr nɔr kin gɛt ɛni sayn. Bɔt fɔ sɔm, mɔ di wan dɛn we dɔn ɔlrɛdi gɛt bad wɛlbɔdi, dis kin fil lɛk di “las straw.” Lɛk di liva sik, di ɛpatopulmonary syndrome (HPS) kin wɔs as tɛm de go. If yu dɔn ɔlrɛdi de na di liva transplant wet list, dɛn go muf yu ɔp na di list we dɛn no se yu gɛt HPS. Dis na bikɔs dɔktɔ dɛn no se dis sik kin mek yu layf shɔt ɛn ridyus yu kwaliti fɔ liv – ɛn dɛn no se if yu transplant yu liva kin mɛn am. Insay da tɛm de, if yu kɔntinyu fɔ gɛt ɔksijɛn tritmɛnt, dat kin ɛp yu fɔ gɛt sɔm rilif ɛn ɛp yu fɔ liv lɔng.

Fɔ dɔn, sɔm impɔtant tin dɛn we yu fɔ mɛmba

So, a op se yu dɔn gɛt sɔm klia tin frɔm wetin wi dɔn tɔk bɔt bɔt Epatopulmonary Syndrome. Yu fɔ mɛmba dɛn pɔynt dɛn ya:

• Dis na wan prɔblɛm we nɔ kin apin so ɔltɛm bɔt we kin gɛt siriɔs prɔblɛm wit di liva sik .
• De men sayn na wae yu nɔr kin ebul fɔ blo fayn (dyspnea) , mɔr lɛk pɔrsin wae gɛt liva sik.
• If pɔsin we gɛt liva sik gɛt prɔblɛm fɔ blo, dɛn fɔ saspek dis sik bak (Hepatopulmonary Syndrome) ɛn dɛn fɔ tɛl di dɔktɔ bɔt am.
• Liva transplant na di onli tritmɛnt we de mɛn am naw.
• Te da tritmɛnt de gɛt, ɔksijɛn tritmɛnt kin ɛp fɔ kɔntrol di sik dɛn ɛn kɔntinyu fɔ liv.
• If yu ɔ pɔsin we yu sabi gɛt dɛn sik ya, i rili impɔtant fɔ go to dɔktɔ wantɛm wantɛm fɔ advays. Bikɔs, if dɛn no am kwik, i kin izi fɔ manej ɛn plan fɔ ɔda tritmɛnt. Nɔ fred, bɔt i bɛtɛ fɔ mek yu no.

` Epatopulmonary syndrome, liva sik, lכng sik, i at fכ brith, nכ gεt כksijεn, sirosis, liva transplant