I ding chhuak nghal hian i lu a buai bawk em? (Orthostatic Hypotension) pawh a ni thei! I sawi dawn nia.

I ṭhut emaw, i mu emaw pawh nise, i ding chhuak nghal a, i lu a hah emaw, i lu a na emaw i ti em? A chang chuan rei lo te chhung chu i muhil mai ang tih pawh i inhria a ni lawm ni? Hei hi vawiin a kan sawi tur condition chu a ni a, ``Orthostatic Hypotension'' tih a ni. Mi thenkhat chuan ``Postural Hypotension'' an ti bawk.Lungngai suh, hei hi mi tam tak chungah a thleng thei a, a bik takin an upat deuh deuh chuan. Hemi chungchang hi chipchiar tak leh awlsam takin sawi ila.

`(Orthostatic Hypotension)` tih hi eng nge ni? A awlsam zawngin...

A awlsam zawngin sawi ila, `(Orthostatic Hypotension)` chu thut emaw, mut emaw atanga i ding atanga i thisen sang a tlahniam thut hi a ni. Ngaihtuah teh, chair-ah thuin chanchinbu i chhiar a, mi pakhatin thu a sawi avangin i ding nghal a. Chutah chuan i lu a na hle. `(Orthostatic)` tih hian dinglam dinhmun a kawk a ni. `(Hypotension)` tih hian thisen sang hniam tihna a ni. Chuvangin, hei hi position i thlak huna i thisen sang a tlahniam hun a ni.

Chuti a nih chuan, he thisen sang hi eng nge ni?

Thisen sang, a nih loh leh ``Blood Pressure'' tih hi kan hre fo thin. Hei hian kan thinlung a nat lai hian thisenin thisen kalna kawng (arteries) bang a pressure a pek dan a teh a ni. Tui pump hmanga tui a luang chhuah hian pipe-a pressure a pek ang chiah a ni. Hei hi mercury millimeter ``(mmHg)`` hmanga teh a ni.

Doctor i pan chuan i thisen sang an check hunah number pahnih an hrilh che a ni lawm ni?

• The top number `(Systolic)`: Hei hian i thinlung a thawk a, i thisen kalna thisen a pump chhuah huna pressure a kawk a ni.
• A hnuai lam number `(Diastolic)`: Hei hian heartbeat pahnih inkar, arteries-a pressure awm chu a kawk a, chu chu heart relax deuh a nih chuan a ni.

Doctor-te chuan top number/bottom number (e.g. 120/80 mmHg) angin an ziak a. Mi tam zawk thisen sang hrisel hi 120/80 mmHg aia hniam a ni. 90/60 mmHg hnuai lam reading chu thisen sang hniam anga ngaih a ni.

``Orthostatic Hypotension'' ah hian thisen sang engzat nge a tlahniam?

Hei hi a hlutna dik tak a awm lo. Mahse, hei hi doctor-te chuan i thisen sang pangngai leh i ding chhuah huna a tlahniam zat enin an hre chiang thin. A tlangpuiin, a ding atanga minute thum chhunga a chung lam number ``Systolic`` chu 20 mmHg emaw, a hnuai lam number ``Diastolic`` chu 10 mmHg in a tlahniam emaw chuan ``Orthostatic Hypotension`` anga ngaih a ni.

Tute nge Orthostatic Hypotension vei tam zawk?

Hetiang dinhmun hi tu pawhah a awm thei tak tak a, mahse i tar chhoh zel chuan a hluar zual zel a ni. A hnuaia thilte hian i vei theihna a tipung thei a ni:

• Anemia emaw Vitamin B12 tlakchhamna: Hetiang dinhmun hi thisen volume tlahniam emaw, vitamin B12 tlahniam emaw a awm thei.
• Laxatives, vomiting, diuretics avanga tui tlakchhamna: Taksa chhunga tui awm zat a tlahniam chuan thisen sang a tlahniam thei.
• Endocrine lama harsatna nei: 1.1.Diabetes, thyroid natna, leh Addison natna ang chi dinhmun.
• Lung lam natna: Lungphung lama harsatna (Arrhythmias), thinlung valve natna ang chi thil.
• Damdawi thenkhat: Thisen sang, thinlung natna emaw, lungngaihna emaw damdawi thenkhat ei avanga lo awm thei a ni bawk.
• Neurological problems: Parkinson natna leh dementia ang chi natna.
• Naupai: A bik takin kar 24 hmasa berah.
• Natna avanga khumah rei tak awm: Naupai laiin khumah mut mutna ang chi.

Ngaihtuah teh, kan khua atanga lo kal Uncle Somapala. Zunthlum a vei a, thisen sang damdawi a ei thin. Zing lama khum atanga a thawh chuan a lu a hah tih a sawi. Chutiang mite chuan he natna hi an nei tam zawk.

Hetiang dinhmun hi engtiang chiahin nge a awm?

Orthostatic hypotension hian tar 20% vel a nghawng a , a bik takin nursing home-a chengte chu a nghawng nasa hle. Hun rei tak khum mut tawhah te, nu thar nau nei tawhah te pawh a awm fo bawk. Tleirawl, thanlenna lama harsatna tawk mekte pawh a awm thei bawk.

Hei hi eng symptoms nge ni?

Orthostatic hypotension hi a langsar ber fo a, zing lamah a symptoms a na zual thin. Hei hi a chhan chu zing kan thawh hian kan thisen sang hi a hniam deuh tlangpui a ni.

Mi thenkhat chuan symptoms an nei lo thei. Mi dangte tan chuan khaw lum lai te, khawsik lai te, tui lum a inbual lai te hian heng symptoms te hi a zual sauh sauh thin.

A lan chhuah dan ber chu ding chhuakin luak chhuak emaw lu hah emaw a ni . Hei hi i thut emaw, i mut leh hunah emaw a bo tur a ni. Mi thenkhat phei chuan hriatna an hloh thei (syncope).

A lan chhuah dan dangte chu:

• Mit hmuh a fiah lo
• Chhung na, kekawr na emaw, kawng na emaw
• Thil ngaihtuah harsa tak a ni
• Chauhna emaw, chak lohna emaw
• Lu na (Sorry, hetah hian tawng dang atanga thumal pakhat a rawn lut palh a. Thumal dik: Lu na )
• Lung na tak tak
• Nausea emaw, lum leh thawk hah emaw
• Thâwk hah / Dyspnea

Engvangin nge hetiang `(Orthostatic Hypotension)` hi a lo awm? A chhante chu engte nge ni?

Kan ṭhut emaw, kan mut emaw hian kan ke ruh chhunga thisen chu awlsam takin kan thinlungah a luang let leh thin. Mahse kan ding chhuak hian gravity hian kan ke leh kea thisen awmte chu kan thinlung thleng a harsat phah thin. Hei hian kan thinlung, taksa peng dang leh taksa peng hrang hranga thisen pump theih zat a tihtlem phah a ni. Chumi avang chuan kan thisen sang chu rei lo te chhungin a tlahniam a.

Hei hi chhan hrang hrang a awm thei:

• I thinlung hian thisen a pump tling thei lo.
• I autonomic nervous system (a tlangpuiin thisen sang tidanglamtu) chu a thawk tha lo hle.
• Parkinson natna, Lewy body dementia, emaw multiple system atrophy ang chi natna i neih chuan .
• Hun rei tak chhung (e.g. muhil) dinhmun inang (e.g. mut) i awm tawh chuan (naupai laiin khum mutna ang chi).
• Thisen emaw tui hloh (dehydration) avanga i thisen volume a tlahniam chuan .
• I adrenal gland ah harsatna i neih chuan .
• I taksain damdawi engemaw i ei avanga a chhan dan avang hian .

Engtin nge orthostatic hypotension dik taka i hriat theih ang?

Doctor i pan chuan i ṭhut laiin i thisen sang an teh hmasa ang a, chumi hnuah mut chungin an teh ang a, ding chungin an teh ang. Chu mai ni lovin, i damdawi lam dinhmun leh i damdawi ei tur te pawh an zawt ang che.

Chu bakah, a hnuaia test pakhat emaw a aia tam emaw pawh tih theih a ni bawk:

• Thisen test: Zunthlum leh thisen tlakchhamna ang chi dinhmun enfiah thin ang che.
• Echocardiogram (Echocardiogram / echo): Thinlung in thisen a pump dan en rawh.
• Electrocardiogram (EKG): Lungphun inthlak danglamna zawng rawh.
• Exercise stress test: Exercise i tih laiin i heart rate teh thin ang che.
• Portable EKG devices / Holter monitor: Nitin thinlung rhythm teh thin.
• Tilt table test: Table-a muttir a, table chu vertical position-a tilt-a dahin thisen sang, heart rate leh heart rhythm him taka tehna test a ni.

Orthostatic Hypotension enkawlna tur engte nge ni?

Enkawlna chu he natna thlentuah hian a innghat a ni.

Enkawlna atan a hnuaia mite hi tih theih a ni:

• Natna emaw, dinhmun emaw, orthostatic hypotension thlentu a awm chuan enkawl rawh.
• Hetiang natna thlentu damdawi hman dan tur thlak emaw, damdawi dang hmanga thlak emaw (hei hi doctor nena inbiakna hnuah tih tur a ni).
• Bed rest-a i awm chuan khumah thut dan thiam rawh.
• Elastic stockings a ha a. Chungte chuan kea thisen awm zat a ti tlem a ni.
• I dehydrated a nih chuan tui leh salty fluid tam tak in thin ang che.

Hemi atan hian eng damdawi nge pek thin?

Hei hi nunphung inthlak danglamna hmangin thunun theih a ni fo. Amaherawhchu, mi thenkhat chuan thisen volume leh thisen sang tihpun nan damdawi an ei a ngai mai thei. Mahse, hengte hi a tlem hle.

Heng damdawi chi hrang hrang thenkhat chu:

• `Droxidopa` tih a ni
• Erythropoiesis tichaktu (ESAs) (e.g. Procrit® emaw Epogen® emaw) te hi a tha hle.
• `Desmopressin (Nocdurna® emaw `DDAVP®) emaw hman a ni
• `Octreotide (Bynfezia PenTM` emaw `Mycapssa®) emaw hmanga siam a ni
• `Fludrocortisone` tih a ni
• `Midodrine hydrochloride hmanga siam`
• `Pyridostigmine (Mestinon®` emaw `Regonol®) emaw hman a ni

Pawimawh: Heng damdawi te hi Doctor thurawn ang chauha ei tur a ni. Mahni damdawi ei hian a rah chhuah hlauhawm tak a nei thei a ni.

Enkawlna hian side effect a nei em?

Orthostatic Hypotension damdawi hman thenkhat hian side effect a thlen thei a, chungte chu:

• Numbness a awm
• Itching a ni
• Lu na
• Vung
• Potassium level a tlahniam
• Heart failure (hei hi a tlem hle) .

Chuvang chuan doctor enkawlna hnuaia inenkawl hi a pawimawh hle.

Orthostatic Hypotension avanga harsatna awm thei te chu engte nge ni?

Hetiang natna vei te hi a hnuaia mite hi an hlauhawm zual thei a ni:

• Ruh tliak emaw lu hliam (concussions) hi luak chhuak emaw, hriat lohna emaw avanga tlu emaw a awm thei .
• Postprandial hypotension: Hei hi chaw ei atanga minute 30 atanga darkar hnih chhunga thisen sang (a bik takin chaw ei kha carbohydrates tamna) a tlahniam tihna a ni .
• Thisen sang a hniam lutuk chuan shock emaw organ failure emaw a awm thei (hei hi a tlem hle).
• Thisen sang inthlak danglam avanga stroke emaw thinlung natna emaw vei theihna .
• Supine hypotension: Chumi awmzia chu mut laiin thisen sang a tlahniam tihna a ni (hei hi damdawi thenkhat avanga lo awm thei a ni).

`(Orthostatic Hypotension)` ka neih chuan eng nge thleng ang?

Mi tam tak chuan he natna lan chhuah dan (Orthostatic Hypotension) hi invenna kawng thenkhat zawmin an thunun thei a ni. Entirnan, i thawh hunah i hun i hmang tur a ni. Hei hian hun rei tak chhung harsatna lian tak a thlen a rinawm loh hle.

Hetiang dinhmun atang hian dam kim theih a ni lo em ni?

Orthostatic hypotension hi "damdawi" a awm lo. Mahse, i doctor-in thurawn a pek che zawm hian symptoms chu a tam zawkah chuan control theih a ni. He thurawn hian a huam thei ang:

• Damdawi pek dik tak ei.
• Vawi khata chaw lian ei ai chuan chaw te te ei thin ang che.
• Tui leh tui tam tak in thin ang che.
• Socks chi hrang hrang (Compression stockings) ha.

Engtin nge Orthostatic Hypotension vei theihna hi ka tihziaawm theih ang?

Hetiang hian luak chhuak i neih chuan heng step te hi zawm hian symptoms te chu a tihziaawm thei ang:

• I taksa lumna thunun rawh: Tui lum takah inbual suh.
• Tay hydrated: Tui tam tak in thin ang che. Zu hi tihtlem rawh. Chaw rit tak tak, carbohydrates tam tak awmna chu vawi khatah ei suh.
• Khumah i mut dawnin i lu chu sang deuhin dah la: pillow pakhat emaw pahnih emaw hmang la, a nih loh leh mattress lu chu tlem han chawi sang rawh.
• Tho hmain inbuatsaih rawh: Thut emaw, mu emaw atanga ding turin hun rei vak lo hmang rawh. I thawh huna vawn tlat tur thil nghet tak nei rawh.
• I taksa ruhte exercise la: Hun rei tak i ding a ngai a nih chuan, ding reng lovin, i ke chu a inthlak danglamin chawi sangin, kea kal rei vak lo la. I thawh hmain isometric exercise (e.g., rubber ball te tak te squeezing) tih tur a ni. Hei hian i thisen sang tlem a tisang thei a ni.
• Thisen kal leh pressure tihchangtlun: Special compression stockings emaw abdominal binder emaw ha la.

Engtikah nge Doctor ka hmuh ang?

I ding chhuah laiin i lu a hah fo chuan doctor i pan ngei ngei tur a ni . Hetiang thil hi a chang chuan thleng chauh pawh ni se, doctor hnenah hrilh mai a tha.

Engtikah nge Emergency Treatment Unit (ETU) ah ka kal ang ?

Heng symptoms te hi i neih chuan enkawlna zawng nghal rawh :

• A rilru a na.
• Tlu emaw, muhil emaw.
• Balance emaw coordination emaw lama harsatna awm.
• Tlu avanga lu hliam emaw, lu hliam emaw rinhlelhna a awm chuan.
• I bawlhhlawh thisen chhuak emaw, dum emaw a nih chuan.
• Shock chhinchhiahna (taksa lum, thawk hah, thawk rang, vun sen, pulse chak lo).

Doctor hnenah eng zawhna nge ka zawh ang?

Doctor hmu tura i kal hian hetiang zawhna hi i zawt thei ang:

• Engvangin nge he natna hi ``Orthostatic Hypotension'' tih hi ka neih?
• Hemi atan hian eng enkawlna tha ber nge ni ang?
• Heng symptoms te hi ka damdawi ei vang a ni em? Damdawi ka thlak tur em ni?
• Heng symptoms te hi enkawl turin eng inthlak danglamna nge ka tih ang?
• Eng harsatna chhinchhiahna nge ka fimkhur tur?

`(Orthostatic Hypotension)` leh `(Postural Tachycardia Syndrome - POTS)` te hi thil inang an ni em?

`(Postural Tachycardia Syndrome)` emaw `(POTS)` emaw an tih natna lan chhuah dan hi `(Orthostatic Hypotension) nen a inang a ni.` Heng pahnihah hian ding chhuak hian luak chhuak leh muhil thei a ni. Mahse, `(POTS)`-ah chuan thisen sang tlahniam bakah hian ding atanga minute 10 chhungin minute khatah beat 30-40 velin heart rate a sang chho thin. `(Orthostatic Hypotension)` ah chuan heart rate hi chutiang chuan a sang lo tlangpui.

``POTS'' natna hi ``Orthostatic Hypotension'' aiin a tlem deuh hlek a ni.

Orthostatic hypotension (Hypotension) hi natna khirh tak a ni thei. I balance hloh a, i tlu emaw, i hriatna i hloh emaw chuan a hlauhawm thei hle. Mahse, i dinhmun i thlak danglam chuan a natna lan chhuah dan chu a ṭha chho fo ṭhin. I natna lan chhuah dan tur chu i doctor nen sawiho rawh. Damdawi i thlak a ngai mai thei. A nasat zawkah chuan i doctor chuan thisen kal dan leh thisen sang tihchangtlunna tur damdawi a pe thei a ni.

Hriat reng tur pawimawh ber berte (Take-Home Message) .

Okay, chuti a nih chuan tunah chuan kan sawi tawh, Orthostatic Hypotension kha i hrethiam tawh zawk a ni. Thil ngaihtuah tur a ni lo, mi tam tak chunga thleng thin condition a ni. A pawimawh ber chu:

• I lu a hah thut emaw, i mit a hrual emaw a nih chuan ngaihthah suh. Damdawi lam thurawn zawng rawh.
• Thawh hma, a bik takin zing khum atanga tho chhuah hunah emaw, rei tak ṭhut hnua i thawh hunah emaw, rei vak lo la la, ding turin thil pakhat man rawh.
• Tui tam tak in thin ang che. Hei hi tui tlakchhamna i neih chuan a thleng thei bawk.
• I damdawi ei tur chungchang hi i doctor nen sawiho rawh. Damdawi thenkhat pawhin he natna hi a thlen thei bawk.
• Environment lum leh tui lum a inbual loh tur.
• I tlu thei ang berin fimkhur rawh. I luak chhuak a nih chuan thut emaw, mut emaw vat tum ang che.

He thu hi i tan a \angkai ngei kan beisei. Hriselna lama harsatna i neih chuan doctor thurawn lak a tha ber.

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