I at fɔ tɔk bɔt di fred ɛn sɔri we yu kin fil we yu yɛri se yu pikin we yu jɔs bɔn gɛt at sik, nɔto so? Bɔt nɔ wɔri. Sɔntɛnde, pikin dɛn kin gɛt tu pan di men blɔd vesel dɛn na dɛn at we dɛn kin chenj we dɛn bɔn dɛn. Tide wi de tok bɔt wan kayn kɔndishɔn, we dɛn kɔl `(Transposition of the Great Arteries)`. Dis kin tan lɛk se i kɔmplikt smɔl, bɔt lɛ wi kip am simpul.
Wetin na Transpɔzishɔn fɔ di Gret At?
Fɔ tɔk am simpul wan, dis na ``kɔnjɛnital`` kɔndishɔn we kin apin we dɛn bɔn pikin. Dat min se dis prɔblɛm kin apin we di pikin stil de na di mama in bɛlɛ. Wi gɛt tu men blɔd vesel dɛn we de kɛr blɔd kɔmɔt na wi at to di ɔda pat dɛn na wi bɔdi. Wan na
di pulmonary artery, we de kɛr blɔd go na di lɔng , ɛn di ɔda wan na
di aorta, we de kɛr blɔd go na di ɔda pat na wi bɔdi . Wetin kin apin pan dis kɔndishɔn na dat dɛn tu big blɔd vesel ya kin kɔnɛkt to di at na di rɔng ples, nɔto di rayt ples. I tan lɛk se dɛn dɔn swich di paip dɛn we de go na tu wata tank dɛn.
Aw blɔd kin travul nɔmal wan? Wetin kin apin pan dis sityueshɔn?
nכmal wan, na dis kin apin: di bכdi in bכdi we nכ gεt כksijεn (blu bכdi) de go na di at, frכm de go na di lכng fכ pik כksijεn. Dɔn di nyu blɔd we gɛt bɔku ɔksijɛn (rɛd blɔd) kin go bak na di at, frɔm de go na di wan ol bɔdi tru di big at dɛn. bכt insay dis ``Transposition of the Great Arteries'' kכndishכn, biכs di tu bכdi vεsul dεm de swich, di bכdi we nכ gεt כksijεn de go bak na di bכdi insted fכ go na di lכng dεm. Semweso, di blɔd we gɛt bɔku ɔksijɛn we de kɔmɔt na di lɔng dɛn kin go bak na di lɔng dɛn instead fɔ go na di bɔdi. Imajin aw dis go gɛt smɔl ɔksijɛn to di pikin in ɔgan dɛn.
Yu tink se kayn tin dɛn de we kin apin to dis?
yes, tu men tכp dεm de fכ dis: 1.
lεvo-transposishכn (Levo-transposishכn כ l-TGA): insay dis kes, di pikin in aorta de na di lεft say na di pulmonari at. insay dis kes, nכto di tu blכd vesel dεm nכmכ, bכt di lכw chεmba dεm na di at de chenj. Bɔt pan dis kayn blɔd we nɔ gɛt ɔksijɛn kin go na di lɔng ɛn blɔd we gɛt ɔksijɛn kin go na di bɔdi, so i nɔ kin du bɔku bad tin. Dis nɔ kin apin smɔl. 2.
Dεkstro-transposishכn (Dεkstro-transposishכn כ d-TGA): insay dis kes, di pikin in aorta de na di rayt say na di pulmonari at. Dis na di kayn we we pipul dɛn kin gɛt mɔ, ɛn
na di kayn we bak we dɛn nid fɔ pe atɛnshɔn mɔ pan. Wi go tɔk mɔ bɔt dis `(d-TGA)` na dis atikul.
Wetin mek dɛn kɔl dis sik d-TGA denja fɔ pikin dɛn?
As a bin se bifo, insay di kes fɔ `(d-TGA)`, di pikin in bɔdi ful-ɔp wit blɔd we nɔ gɛt ɔksijɛn. Dis min se ɔl di impɔtant pat dɛn na di pikin lɛk di bren, di kidni, ɛn di liva, nɔ kin gɛt di ɔksijɛn we dɛn nid. Dis kin rili denja fɔ di pikin in layf. sכmtεm, we dεn bכn dεn pikin ya, i kin gεt wan ol bitwin di כp chεmba dεm na di at `(Atrial Septal Defect or ASD)` כ wan ol bitwin di lכw chεmba dεm na di at `(Ventricular Septal Defect or VSD)`. Pan ɔl we dɛn ol ya rili nɔ kɔmɔn, we dɛn kayn tin ya kin apin, dɛn ol ya nɔ kin ɛp bɛtɛ. Dat min se dɛn ol ya kin mek sɔm blɔd we gɛt bɔku ɔksijɛn miks wit di blɔd we nɔ gɛt ɔksijɛn. Bɔt di ɔksijɛn we dɛn kin gɛt nɔ kin du fɔ am atɔl. So, di pikin rili nid tritmɛnt.
Nɔ wɔri, ɔpreshɔn de fɔ dis sik. Fɔ lɔng tɛm naw, dɔktɔ dɛn dɔn de du dɛn ɔpreshɔn ya fayn fayn wan.
Wetin na di sayn ɛn simptom dɛm if yu pikin gɛt dis sik? (Sayn dɛn)
nyu bכn pikin dεm we gεt `(d-TGA)` kin gεt wan kכndyushכn we dεn kכl `(cyanosis),` we na blu/grεy kכla na di skin bikoz dεn nכ gεt כksijεn. Dɛn kin gɛt wik at bak. Di men sayn dɛm wae de sho se yu gɛt dis sik na:
- I nɔ kin izi fɔ yu fɔ blo .
- Di puls rili wik.
- Sho se i nɔ want fɔ drink ɛn i nɔ izi fɔ drink milk.
- Mi at de fil lɛk se i de bit tumɔs, lɛk se i de bit tumɔs.
- di skin εn di wayt dεm na di yay kin sho blu (insay pikin dεm we gεt fayn skin) כ grey (insay pikin dεm we gεt dak skin).
Ustɛm dɛn sayn ya kin bigin?
di pikin we gεt `(d-TGA)` go bigin fכ sho dεn simptom dεm ya we dεn bכn am. כltu, sכmtεm, bikoz fכ tin dεm lεk `(ASD)`, di sכm sכm ol dεm na di pikin in at kin mek sכm bכdi we gεt כksijεn go na di bכdi, so di sayn dεm kin nכ notis. כlso, di `(patent ductus arteriosus)`, we na bכdi we di pikin de yuz we i de insay di bכdi, kin opin fכ fכ de afta dεn bכn am, we de mek di bכdi miks. Bɔt wans dɛn tɛmporari ol ɛn tiub ya dɔn lɔk, di sayn dɛn kin bɔku wantɛm wantɛm. If na so i bi, di pikin nid fɔ go to dɔktɔ wantɛm wantɛm.
Wetin mek dis de apin? (Rizin dɛn)
Dɔktɔ dɛn stil nɔ no bɛtɛ bɛtɛ wan wetin kin mek pɔsin gɛt Transposition of the Great Arteries. Lɛk ɔda at sik dɛn we dɛn kin bɔn wit, dɛn kin tink se i kin kam bikɔs ɔf wan jenɛtik chenj ɔ we i gɛt pɔyzin we i gɛt bɛlɛ. Sɔm pan de tin wae kin mek pɔrsin gɛt dis sik na:
Nɔ mek yu fred fɔ dɛn tin ya. Nɔto ɔlman we dɔn gɛt wan pan dɛn tin ya go gɛt dis.
Aw dɔktɔ dɛn kin no bɔt dis? (Diagnosis) .
Sɔntɛnde, dɔktɔ dɛn kin no dis sik we yu stil gɛt bɛlɛ. Dɛn kin du dis tru tɛst we dɛn kin du bifo dɛn bɔn pikin. If
yu dɔktɔ sɔspɛkt se sɔntin nɔ rayt we dɛn de du ɔltra saund skan fɔ yu pikin, i kin aks yu fɔ mek dɛn du fetal ɛkokadiogram. Dis tan lεk כltra saund, bכt i de luk di pikin in at bכku bכku wan. Dis kin kɔnfɔm if yu gɛt d-TGA. if dεn nכ no am we uman bεlε, dεn kin no am insay di fכs wik afta dεn bכn am.
Us tɛst dɛn kin du fɔ dis?
Di tɛst dɛm wae dɔktɔ dɛm kin yuse fɔ kɔnfirm dis sik na:
- Echocardiogram (Echo): Dis na ɔltra saund skan bak fɔ di at.
- Ilɛktrokardiogram (EKG): Na tɛst we de luk aw di at de wok wit ilɛktrik.
- Nyu bכn puls כksimetri skrεnin: dεn kin du dis bכku tεm pan כl di nyu bכbi dεm.
- Chɛst X-ray tɛst.
- Kadiak kateshɔn: Dis na tɛst we kin mek i izi fɔ du. Dɛn kin put wan tin tiub ( kateta ) tru di leg ɔ an insay di at. Dɛn kin du dis if ɔda tɛst dɛn nɔ klia.
- CT skan na tɛst.
Aw fɔ trit dis? Yu pikin nid ɛp kwik kwik wan!
di pikin we dεn bכn wit `(d-TGA)`
fכ du כpεrayshכn fכ liv. Bɔku tɛm, dɛn kin du dis ɔpreshɔn
insay di fɔs wik we dɛn bɔn am. Dɛn kɔl dis ɔpreshɔn
wan arterial switch prosidur . Fɔ tɔk am simpul wan, dis involv fɔ kɔnɛkt bak di tu blɔd vesel dɛn we dɔn swich (di aorta ɛn di pulmonary artery) bak na dɛn kɔrɛkt pozishɔn. Dis kin mek blɔd flɔ fayn fayn wan. if yu pikin gεt ol na in at, lεk wan `(VSD)`, we dεn go ripεr bak we dεn de du dis כpεrayshכn.
Tin dɛn we pɔsin fɔ du fɔ sɔm tɛm bifo dɛn du di ɔpreshɔn
Dɔktɔ dɛn kin yuz sɔm tɛmporari tritmɛnt dɛn fɔ mek di pikin in kɔndishɔn stebul te dɛn ebul fɔ du big ɔpreshɔn. Dɛn tin ya na:
- Prostaglandin: Dɛn kin yuz dis mɛrɛsin fɔ opin di ductus arteriosus, we na wan blɔd vesel we di pikin bin de gɛt na di bɛlɛ bɔt i kin lɔk afta dɛn bɔn am. We dis dɔn opin, sɔm blɔd we gɛt ɔksijɛn kin bigin fɔ flɔ insay di bɔdi.
- Di we aw dɛn kin du am we dɛn kɔl Balloon atrial septostomy:insay dis, dεn de yuz wan tin tכb (kateta) fכ mek di nכmal opin bitwin di tu כp chεmba dεm na di at big. Dis kin mek di blɔd we gɛt ɔksijɛn ɛn we nɔ gɛt ɔksijɛn miks, ɛn dis kin mek di bɔdi gɛt sɔm ɔksijɛn.
Yu tink se dɛn go ebul fɔ mek dis tin nɔ apin?
No we nɔ de we dɛn no fɔ mek dɛn nɔ gɛt Transpɔzishɔn fɔ di Gret At. Bɔt i impɔtant fɔ fala gud wɛlbɔdi we yu gɛt bɛlɛ. Gɛt ɔl yu shot dɛn di rayt tɛm, tek yu multivitamin, ɛn kip yu dɔktɔ apɔntinmɛnt dɛn. If ɛnibɔdi na yu famili gɛt histri bɔt at sik we dɛn bɔn wit, tɔk to yu dɔktɔ bɔt am. I kin tɛl yu fɔ advays yu bɔt yu jɛnɛtiks.
Wetin kin apin afta dɛn dɔn du di ɔpreshɔn? Aw fɔ liv wit TGA
Pan ɔl we ɔpreshɔn nɔ de "kyu" di kɔndishɔn kɔmplit wan, bɔku pipul dɛn we gɛt `(d-TGA)` de liv ful, wɛlbɔdi layf. Bɔt di wan dɛn we gɛt dis `(congenital)` kɔndishɔn
nid fɔ gɛt mɛdikal sɔpɔtishɔn fɔ dɛn layf. Wan dɔktɔ we de mɛn yu pikin go de wach yu pikin ɔltɛm ɛn gi am ɛni advays we i nid. di rεt we de liv afta `(arterial switch)` כpεrayshכn pas 95%. Dɛn se dis rit kin stil de di sem ivin afta 25 ia.
Yu pikin kin liv fayn wit TGA?
Yɛs, na fɔ tru. Afta tritmεnt fכ di kכndyushכn `(Transposition of the Great Arteries)`, yu pikin kin liv nכmal layf. Bɔt, wi nid fɔ kia fɔ di at ɔlsay na in layf. Dat min se:
- Yu fɔ de kɔntakt ɔltɛm wit dɔktɔ we de mɛn yu at ɛn we spɛshal pan dɛn kayn tin ya.
- Yu nid fɔ tek di mɛrɛsin we dɛn gi yu di rayt we.
- tεst dεm we de chεk aw di at de wok, lεk `(EKG), `(Holter monitor), `(exercise stress tests), εn `(echocardiogram),' go nid fכ du am כltεm.
Bɔku dɔktɔ dɛn we de mɛn at nɔ kin se yu fɔ ple kɔmpitishɔn spɔt afta yu dɔn du `(d-TGA)` ɔpreshɔn. So, yu ɛn yu pikin, yu dɔktɔ we de mɛn pikin dɛn, ɛn yu dɔktɔ we de mɛn yu at fɔ wok togɛda fɔ disayd fɔ du di bɛst tin fɔ yu pikin in wɛlbɔdi. Bɔku uman dɛn we dɔn gɛt `(d-TGA)` ɔpreshɔn dɔn gɛt bɛlɛ we dɔn wok fayn. Bɔt i impɔtant fɔ tɔk to yu dɔktɔ ɛn dɔktɔ we de mɛn yu at bifo yu gɛt bɛlɛ.
Yu tink se dɛn go nid fɔ du mɔ ɔpreshɔn pan dɛn at tumara bambay?
Yɛs, dɛn go nid fɔ du mɔ ɔpreshɔn leta. Bɔku tɛm, dɛn fɔ kɔrɛkt wan prɔblɛm we gɛt fɔ du wit di at ritm ɔ fɔ mek di at valv dɛn fayn.
Risk de fɔ gɛt ɛndokarditis?
Endocarditis na wan sik we kin apin we baktri infεkshכn go insay di at. Pipul wae gɛt hat sik lɛk TGA kin gɛt dis kayn sik. So, pipul dɛm wae dɔn gɛt transpɔzishɔn ɔpreshɔn kin nid fɔ tek antibayɔtik bifo dɛn gɛt tritmɛnt fɔ dɛn tit.
Yu tink se i kin afɛkt di we aw di bren de gro?
Sɔm pikin dɛm wae dɔn gɛt arterial switch kin gɛt ADHD (attention deficit hyperactivity disorder). Ɔ dɛn kin nid spɛshal ɛp fɔ du skul wok. Yu fɔ no bɔt dis bak.
Ustɛm a fɔ go to dɔktɔ?
If yu pikin gɛt dɛn sik ya...
- If yu fil se yu de gɛt prɔblɛm fɔ blo.
- If di puls rili wik.
- If di skin we de rawnd di mɔt dɔn tɔn blu/wayt.
If yu si sɔntin lɛk dis, go to dɔktɔ wantɛm wantɛm.
If yu bin gɛt dis ɔpreshɔn as pikin...
Yu go nid fɔ de chɛk yu
ɔltɛm ɛn fɔ wach yu ɔlsay na yu layf. Si dɔktɔ we de mɛn di at we gɛt ɛkspiriɛns pan big pipul dɛn (we dɛn bɔn wit) at sik.
Us kwɛstyɔn dɛn yu fɔ aks di dɔktɔ?
If yu pikin gɛt Transposition of the Great Arteries, yu kin aks di dɔktɔ dɛn kwɛstyɔn ya:
- Yu tink se mi pikin nid ɔpreshɔn jisnɔ?
- Wetin na di bɛst tritmɛnt?
- Us kayn fɔlɔp kia mi pikin nid?
- Yu tink se i go gɛt fɔ du ɔda ɔpreshɔn?
- Ɛnitin de we de stɔp am fɔ du wetin i de du?
- Aw a fɔ kia fɔ mi pikin afta di ɔpreshɔn?
If dɛn bin gɛt ɔpreshɔn fɔ dis sik we yu bin smɔl, yu kin aks yu dɔktɔ:
- A go nid fɔ du ɔda ɔpreshɔn?
- Us kayn mɛdikal sɔpɔtishɔn a nid?
- Ɛnitin de we de stɔp mi fɔ du sɔntin?
- A kin bɔn pikin?
Fɔ dɔn, di tin we impɔtant pas ɔl (Take-Home Message) .
Fɔ no se yu nyu bɔbɔ gɛt at sik we dɛn bɔn wit nɔto sɔntin we ɛni mama ɔ papa kin ɛkspɛkt. I kin mek pɔsin in at pwɛl. Bɔt,
nɔto yu wan de. Yu pikin in dɔktɔ kin ɛp yu fɔ du dis waka ɛn gayd yu fɔ di tin dɛn we yu kin disayd fɔ du.
Mɛmba se, dɔktɔ dɛn dɔn de trit bebi dɛn wit TGA fɔ lɔng lɔng tɛm, ɛn di tin dɛn we kin apin kin rili fayn. Bi trɛnk fɔ yu pikin. Nɔr frayd fɔ aks yu dɔktɔ kwɛstyɔn bɔt ɛnitin wae yu nɔr ɔndastand ɔr nɔr shɔ bɔt. Yu no na di big tin we yu pikin gɛt fɔ gɛt wɛlbɔdi tumara bambay.
Kadyak shunting, congenital hat sik, arterial switch ɔpreshɔn, saynosis, infantil at sik, d-TGA, kadyak ɔpreshɔn
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