He uaua hoki tō manawa, ā, he maremare mau tonu? Tērā pea he mate pūkahukahu aukati mau tonu (COPD)!

He maha ngā wā ka pōturi te manawa, ka pēhia te uma? He maremare rānei tōu e haere tahi mai ana me te huware mō te wā roa? Tērā pea ka whakaaro koe he makariri noa iho tēnei, he mate pēnei i te mate huango rānei. Engari ki te mau tonu ēnei tohu, tera pea ko te COPD (Chronic Obstructive Pulmonary Disease) tēnei, he mate pūkahukahu me mōhio tātou katoa. Kaua e manukanuka, ka kōrerohia e tātou tēnei i tēnei rā, me te mea kei te kōrero tātou ki tētahi hoa.

He aha te COPD (Te Mate Pūkahukahu Ārai Mau)?

I te whakarapopototanga, he mate kore e taea te whakaora te COPD e kino ai ō tātou pukahukahu me ngā ara manawa (ngā ara manawa), ka whakaiti haere i tā rātou mahi, ā, ka uaua ai te manawa. Pērā i te ngongo rapa tawhito, ka ngaro te ngāwari o ngā pēke hau iti (ngā alveoli) i roto i ō tātou pukahukahu me ngā ara manawa. Ka pupuhi hoki, ka kī tonu i te hūpē, ka ārai i ō tātou ara manawa. Whakaarohia he rite ki te paipa wai e purua ana e te paru, ka uaua ai te rere o te wai.

I roto i te COPD, ka pāngia pea ō pūkahukahu me ō ara manawa e ēnei huringa:

• Te ngaronga o te ngāwari o ngā pēke hau (alveoli) me ngā ara manawa o ngā pukahukahu.
• Te mumura, te whara (fibrosis), me te whaiti o ngā ara manawa.
• Te pupū ake o te hūpē matotoru i roto i te ara manawa.
• Ka pakaru ngā pakitara i waenganui i ngā pēke hau (alveoli), ka nui haere, ā, ka mau te hau e manawahia ana ki roto.

He maha ngā wā ka kino haere ngā tohumate o te hunga whai COPD. Ka kiia ēnei he "whakanuitanga". I ēnei wā, ka uaua ake te manawa, ka nui haere te hūpē, ka puta te whewhe, ā, ka piki haere te maremare. I ētahi wā, ki te kino haere tēnei mate, me kawe pea koe ki te hōhipera .

He mate haere tonu te COPD, ā, ka kino haere i te roanga o te wā. Engari he rerekē tēnei i ia tangata, i ia tangata. Tērā pea ētahi tāngata kāore e kite i ngā huringa nui mō ngā tau, ko ētahi ia ka tere haere te whanaketanga o te mate.

He aha ngā momo matua o te COPD?

E rua ngā mate matua e taka ana ki raro i te kupu matua o te COPD. He maha ngā wā, ka pāngia te tangata e te COPD e ngā tohu o ngā tohu e rua.

Te mate pūkahukahu

Koinei te wā ka pakaru, ka nui haere hoki ngā pēke hau ririki (alveoli) i roto i ō pukahukahu. Ka uaua te manawa. Ko te tohu matua ko te poto o te manawa (dyspnea) , he rite ki te poto o te manawa ahakoa he iti noa te kaha.

Te mate pūkahukahu mau tonu

Koinei te wā e mumura ai ngā ara manawa nui (ngā ngongo pūkahukahu) i roto i ō pukahukahu. Ka whaiti ngā ara manawa, ka nui hoki te hūpē e puta. Ko te tohu matua ko te maremare tonu, inā koa he maremare me te hūpē .

He aha ngā tohu o te COPD?

Nā, kia tirohia ngā tohu e pā ana ki te tangata whai COPD. Whakaarohia mēnā kei a koe ētahi o ēnei tohu:

• He maremare roa me te hūpē (he maremare e toru marama te roa i te iti rawa, mō te rua tau te roa).
• Te uaua ki te manawa hōhonu.
• Te poto o te manawa , inā koa i te wā e mahi ana i ngā mahi o ia rā, i te wā rānei e ngenge ana koe.
• Te whewhe, te tangi rānei o ētahi atu oro o te pukahukahu.
• He uma āhua-peera (inā he kino te mate).
• I ētahi wā ka puta he kikorangi te kiri (cyanosis) , inā koa ko ngā ngutu me ngā maikuku (ina kore e nui te hāora i roto i te toto).

Mena kei a koe tētahi, neke atu rānei o ēnei tohu, he mea tino nui kia rapu tohutohu hauora koe.

He aha ngā take o te COPD?

Ko te tino take o te COPD ko te kai hikareti . Ka uru tika te paoa o ngā hikareti, ngā hikā, me ngā pī ki roto i ō tātou pukahukahu, ā, ka pakaru i a rātou. Ki te mea he kai hikareti koe, me whakaaro koe ki tēnei.

Engari ka taea hoki e te hunga kāore e kaipaipa te pāngia e te COPD. Ko ētahi atu take ko:

• Te ngoikore o te Alpha-1 antitrypsin: He mate ira tēnei. Ina iti te pūmua, ka kino pea ngā pukahukahu.
• Auahi tuarua: Ahakoa kāore koe e momi hikareti, ki te noho pinepine koe ki ngā wāhi e momi hikareti ana te tangata, ka pāngia hoki koe.
• Te parahanga o te hau: Ngā mea pēnei i te paoa mai i ngā wheketere me ngā waka.
• Te pāngia e te puehu me ngā kohu mai i te mahi, i ngā mahi whakangahau rānei: He kino anō hoki te puehu me ngā kohu mai i ētahi ahumahi (te keri kohatu, te keri maina, ngā ahumahi kakahu) me ētahi mahi whakangahau (te mahi rakau, te whakarewa).

Ko wai kei te nui ake te mōrearea ki te whakawhanake i tēnei mate?

Ahakoa ko te kai paipa te take nui rawa atu o te mōrearea, ehara i te mea ko te hunga kai paipa katoa ka pāngia e te COPD. Heoi, tera pea ka nui ake tō mōrearea ki te pāngia e te COPD mēnā:

• Mena he wahine koe (e whakaatu ana ngā rangahau hou he nui hoki te mōrearea o ngā wāhine).
• Mena kua neke atu i te 65 tau tō pakeke .
• Mena he maha ngā wā ka pāngia koe e te parahanga o te hau .
• Mena ka pāngia koe e ngā matū, te puehu, ngā paoa rānei i roto i tō mahi.
• Mena he ngoikore tōu alpha-1 antitrypsin .
• Mena he maha ngā mate manawa kua pāngia koe i a koe e tamariki ana .

He aha ngā raruraru ka puta mai i te COPD?

Ka taea e te COPD te whakatupu i ngā huakita ki roto i ngā pukahukahu, ka puta ai ngā mate. Ka ārai hoki i te tinana ki te whiwhi i te nui o te hāora me te tango i te hauhā waro mai i te tinana. Ka arahi pea tēnei ki ngā raruraru nui. Ko ētahi o ēnei ko:

• Pneumonia: He mate pāwera ki ngā pukahukahu.
• I roto i te totoTe pikinga o ngā taumata o te hauhā waro (hypercapnia).
• Te iti o te hāora i roto i te toto (hypoxemia).
• Te ngoikore o te manawa: He āhuatanga e kore ai e taea e ngā pukahukahu te mahi ko rātou anake.
• Te toto toto tiketike o te pūkahukahu: Te pikinga o te pēhanga i roto i ngā oko toto o ngā pūkahukahu.
• Te ngoikore o te ngākau taha matau (`cor pulmonale`): Ka pāngia te taha matau o te ngākau e ngā raruraru o roto i ngā pukahukahu.
• Pneumothorax: Ka turuturu te hau mai i ngā pukahukahu ka kohia ki roto i te uma.
• Polycythemia: He nui rawa ngā toto whero e whakaputaina ana e te tinana (ina kore he hāora).

Koia te mea nui kia rapu maimoatanga tika me te whai i ngā tohutohu hauora mēnā kei a koe te COPD.

Me pēhea te tātaritanga o te COPD (Mate Pūkahukahu Ārai Mau)?

Ki te whakaaro koe kei a koe ngā tohu o te COPD, he pai ake te toro atu ki te tākuta mō tētahi tirotiro hauora. Ka tirotirohia koe e te tākuta, ka pātai atu ki a koe mō tō hītori hauora, ā, ka whakahaerehia pea ētahi whakamātautau hei tirotiro i te pai o te mahi a ōu pukahukahu.

Tērā pea ka pātai atu te tākuta ki a koe i ētahi pātai pēnei:

• He kaipaipa koe? Kua kaipaipa koe i mua?
• Kua roa koe e pāngia ana e te puehu me te parahanga o te hau?
• Kei te pāngia tetahi o tō whānau e te COPD, ētahi atu mate pūkahukahu, mate ate rānei?
• Ka pōturi te manawa i a koe e whakakorikori tinana ana? Ka pā mai rānei tēnei ahakoa ka tū noa koe?
• He roa te wā e maremare ana koe, ā, he haruru wheezing anō hoki e puta mai ana i tō uma?
• Ka puta mai te huware ina maremare koe?

He aha ngā whakamātautau e whakamahia ana hei tautuhi i te COPD?

Ka whakamahia pea e tō tākuta ngā whakamātautau e whai ake nei hei whakaū i te COPD:

• Ngā whakamātautau mahi a te pūkahukahu: Ko te whakamātautau matua i konei ko te spirometry . Mā tēnei ka whakamātautau i te kaha me te nui o te hau ka taea e koe te whakaputa i roto i te manawa kotahi. Ka taea e tēnei te whakaatu ki a koe te nui o te aukati i ō ara manawa.
• Te oximetry o te manawa: He whakamātautau māmā e ine ana i te taumata hāora i roto i te toto mā te whakatakoto i tētahi mea pērā i te topenga ki tō maihao.
• Ko te hihi-X o te uma, ko te matawai CT rānei: Ka taea e ēnei whakaahua te whakaatu i ngā huringa o ngā pukahukahu i puta mai i te COPD.
• Whakamātautau hau toto uaua: He whakamātautau tēnei e tango ana i tētahi tauira toto, ā, ka taea te whakatau tika i ngā taumata o te hāora me te hauhā waro i roto i te toto.
• Whakamātautau whakakori tinana: Ka mahia tēnei hei tirotiro mēnā ka heke te taumata hāora o roto i tō toto i a koe e whakakori tinana ana.
• Te hiko-mātao (ECG, EKG rānei): Mā tēnei ka āwhina ki te whakatau mēnā ko te poto o te manawa nā te mate manawa, me te tirotiro hoki i te mahi a te manawa.
• Ngā whakamātautau toto:Ka taea e koe te whakamātautau i ō taumata pūmua AAT kia kite ai mēnā kei a koe te 'Alpha-1 antitrypsin deficiency'.
• Whakamātautau ira: Ka taea te whakahaere i tēnei whakamātautau mēnā e whakapae ana te tākuta kei te pāngia ngā pukahukahu e tētahi mate ira.

He aha ngā wāhanga o te COPD?

Ka taea e tō tākuta te whakatau i te taumata o te COPD i runga i ngā hua o tō whakamātautau spirometry, inā koa ko tō uara FEV1 (Forced Expiratory Volume in one second) . Mā tēnei ka mōhio koe ki te nui o te aukati i ō ara manawa.

Ko ngā wāhanga o te COPD, i runga i te kaha o te mate, koia ēnei:

• Wāhanga 1: Te uara FEV1 80%, neke atu rānei. (He iti noa te mate)
• Wāhanga 2: Ko te uara FEV1 i waenga i te 50% me te 79% (wāhanga waenga)
• Wāhanga 3: Ko te uara FEV1 i waenga i te 30% me te 49% (tino kino)
• Wāhanga 4: Ko te uara FEV1 kei raro iho i te 30%. (He tino kino rawa atu)

Hei tāpiri, ka whakarōpū pea tō tākuta i a koe ki ngā kāwai A, B, E rānei i runga i ō tohu me te mōrearea o te whakararuraru:

• A: He iti ake ngā tohu, he iti ake te mōrearea o te whakahōhā.
• B: He nui ake ngā tohu, he iti ake te mōrearea o te whakahōhā.
• E: He nui te mōrearea o te pikinga ake.

Kāore e haere tahi tonu te taumata o tō mate me ō tohumate. Hei tauira, tera pea he iti ake ō tohumate ahakoa kei te taumata 3, 4 rānei koe. Ka whakaarohia e tō tākuta ēnei mea katoa hei whakatau i te maimoatanga pai rawa atu māu.

Me pēhea te rongoā mō te COPD?

Engari, ehara te COPD i te mate e kore e taea te rongoā katoa . Kāore e taea te whakakore i te kino o ngā pukahukahu. Heoi, he maha ngā maimoatanga hei āwhina i te whakahaere i ngā tohu, te whakapai ake i te kounga o te oranga, me te whakaiti i ngā whakaekenga kino .

Ka tūtohu pea tō tākuta i ngā maimoatanga penei:

• Ngā kaupapa whakamutu kai paipa: Mena he kai paipa koe, koinei te mea nui rawa atu, me te mea tuatahi hoki me mahi e koe . Mā te whakamutu kai paipa ka tino whakaiti i te mōrearea o te COPD e kino haere.
• Ngā rongoā manawa: Ka taea te tango i ngā rongoā pēnei i ngā bronchodilator me ngā steroids mā te inhaler, mā te nebulizer rānei. Ka whakaitihia e ēnei te pupuhi i roto i ngā ara manawa, ka whakatuwherahia, ā, ka māmā ake te manawa.
• Te whakaora hāora: Mena he iti te taumata hāora o tō toto, me whiwhi pea koe i te hāora tāpiri.
• Te whakaora i ngā pūkahukahu: He kaupapa whakakori tinana me te ako tēnei e āwhina ana ki te whakapakari i ngā pūkahukahu, me te āwhina i a koe ki te urutau ki te noho me te COPD.
• Ngā corticosteroids:I te wā e kaha haere ana te mumura, ka hoatu pea he pire steroid, he werohanga rānei mō te wā poto hei whakaiti i te pupuhi.
• Te rongoā mō te pēhanga ara manawa pai: Ka tūtohu pea tō tākuta kia whakamahia he mīhini 'BiPAP' hei āwhina i a koe ki te manawa, inā koa i ngā wā e kaha haere ana te manawa.
• Ngā rongoā paturopi: Mena he maha ngā mate kitakita kei roto i ō pukahukahu, ka hoatu pea he rongoā paturopi hei ārai i aua mate me te whakaiti i te kaha o te mate.
• Pokanga, tikanga rānei mō te whakaiti i te rōrahi o te pukahukahu (LVR): Mō te hunga e tika ana, ā, he nui te mate, ka taea te mahi pokanga, te tikanga rānei mō te whakanoho takirere hei whakaiti i te nui o te hau e mau ana i roto i ngā pukahukahu.
• Ngā whakamātautau haumanu: Ngā rangahau e whakamātautau ana i te haumaru me te whai huatanga o ngā maimoatanga hou. Mena he maimoatanga hou e tika ana māu, ka tukuna pea koe e tō tākuta ki te rongoā.

Ka taea e te tangata e pāngia ana e te COPD te ora ake?

He pumau te kino o te COPD ki ō pūkahukahu, ā, kāore e taea te whakakore. Heoi anō, he huarahi hei whakahaere i ō tohumate, ā, i ētahi wā ka pai ake, kia roa ake ai te ora. Mā te whai i ngā tohutohu a tō tākuta me te whai wāhi atu ki tētahi kaupapa whakaora pūkahukahu, ka taea e koe te whakaiti i ō tohumate me te whakapai ake i te kounga o tō oranga.

Ka taea te ora roa me te COPD?

Ko te roa o te oranga me te COPD e whakawhirinaki ana ki te kaha o te mate me te tere o te kino haere. He maha ngā tāngata e ora ana mō ngā tekau tau i muri i te tautuhi i a rātou , inā koa mēnā ka tīmata wawe te maimoatanga. E kiia ana ko te hunga whai wāhanga 3, 4 rānei o te mate ka taea te ora mo te ono ki te iwa tau te iti iho i te tangata toharite. Engari he rerekē tēnei i ia tangata, i ia tangata.

He mate whakamate te COPD?

Ahakoa he mate kino haere te COPD i te roanga o te wā, ehara i te mea ka mate i ngā wā katoa . He rerekē te tere o tōna kino haere i ia tangata, i ia tangata. I roto i te wā (he maha ngā tau, i ētahi wā he tekau tau), he maha ngā tāngata whai COPD kāore e kaha ki te manawa ko rātou anake. Engari ko ētahi tāngata ka roa te ora me te kore he tohu kino.

Ka taea te ārai i te COPD?

Ko te huarahi pai ki te ārai i te COPD ko te karo i te kai paipa me te tiaki i a koe anō mai i te auahi tuarua me ētahi atu poke ka kino ki ō pukahukahu.

He nui ake te tūponotanga ka pāngia te hunga whai COPD e ngā mate manawa. Ka taea e ēnei mate te arahi ki te niumōnia, te whakanui ake rānei i ngā tohu. Ka taea e koe te mahi i ēnei mea hei āwhina i a koe ki te tiaki i a koe mai i ngā mate:

• Tikina ngā kano ārai mate katoa e taunakitia ana e tō tākuta. Hei tauira, ko te kano ārai mate rewharewha (rewha), te kano ārai mate niumōnia (pneumococcal pneumonia), me te kano ārai mate COVID-19 (COVID-19).
• Horoia ō ringaringa i ngā wā katoa.
• Whakakorea ngā mata o ngā wāhi e haereerea ana e koe.
• Ki te taunaki tō tākuta, mauria he kopare ina tata koe ki ētahi atu tāngata.
• Āta karohia ngā wāhi e kī ana te tangata , inā koa i te wā e pā mai ana te makariri me te rewharewha, me te wā hoki e pā mai ana te mate urutā COVID.

Mena he COPD tōku, me pēhea taku tiaki i ahau anō?

Mena kei a koe te COPD, whai i ēnei tohutohu hei tiaki i a koe anō:

• Me matara atu i ngā mea e kino ana ki ngā pukahukahu, e whakanui ana hoki i ngā tohu. Kei roto i ēnei ko te momi hikareti, te auahi tuarua, te puehu, te parahanga o te hau, me ngā hinu kakara kaha.
• Whai wāhi atu ki ngā wā whakaora pūkahukahu. Kei roto i tēnei ko ngā mahi whakakori tinana, te whakaora mahi, me ngā kaupapa mātauranga. Me haere tonu te mahere ahakoa kua mutu ngā wā.
• Kōrero ki tētahi tohunga kai kua rēhitatia. Ka taea e ia te āwhina i a koe ki te mārama he aha ngā kai e pai ana mō tō hauora, he aha ngā mea me kai e koe, me ngā mea me karo e koe.
• Tangohia ō rongoā katoa kia rite ki te whakahaunga, i ngā wā kua whakaritea. Kawea mai ō rongoā o ia rā i mua i te paunga.
• Hangaia he mahere mō ngā putanga mai o te mate. Kōrero ki tō tākuta, ā, hangaia he mahere mō ngā mea hei mahi mēnā ka puta mai ō tohumate, ngā rongoā hei tango, me te wā tika hei haere ki te hōhipera.
• Akohia te whakamahi tika i ō taputapu hauora. Kei roto i tēnei ko ngā mea pēnei i ngā inhaler, nebulizer, me ngā mīhini CPAP. Pātai atu ki tō tākuta kia whakaaturia mai e ia te whakamahi tika i ēnei.
• Kia tiakina tō hauora hinengaro. Ka taea e te noho me te mate pūmau te whakararuraru. Tirohia he tohunga hinengaro, he tohunga hinengaro, he kaiwhakatakoto whakaaro rānei hei kōrero mō tēnei.

Āhea ahau me toro atu ki te tākuta?

Ki te whakaaro koe kei a koe te COPD, kaua e whakaroa ki te toro atu ki te tākuta . Mā te tautuhi me te maimoatanga wawe ka āwhina i te whakaiti i te mōrearea o te kino haere o ō tohu.

Mena kei a koe te COPD, me toro atu ki tō tākuta tonu mēnā ka kite koe i tētahi o ēnei tohu o te mate, i ngā huringa rānei o ō tohumate:

• Te uaua haere o te manawa: Ki te mea kāore e taea e koe te hikoi i te tawhiti i taea e koe i mua, ki te mea he uaua ake tō manawa i te pō, ki te mea rānei me whakamahi koe i ō maimoatanga manawa (rongoā, inhaler) i ngā wā maha atu i te tikanga.
• Ngā Huringa o te Huhu: Te Huringa o te Tae o te Huhu, te Huhu he Toto, te Haunga Kino, te Nui Atu o te Huhu i te Noa, te Keke Ake rānei o te Huhu.
• Te nui haere o te maremare, te kikī rānei o te uma.
• He pupuhi hou, he pupuhi kino rānei i roto i ō pona waewae, i ō waewae rānei. Mēnā kāore te pupuhi e memeha ahakoa kua moe koe me ō waewae e hiki ake ana i te pō, me kōrero ki tō tākuta.
• Te hekenga, te piki rānei o te taumaha, kāore he take.
• Te maha o ngā mamae o te upoko, te whanoke rānei i te ata.
• Kāore he takeE tino ngenge ana koe, e ngoikore ana rānei. Mēnā ka roa atu i te rā kotahi tēnei.
• Te kirika, te makariri rānei.
• Ētahi atu tohu o te mate urutā: ngā āhuatanga pēnei i te korokoro mamae, te ihu pupuhi rerekē, te ihu pupū, te ānini, te mamae rānei i te paparinga o runga.

Āhea ahau me haere ki te rūma whawhati tata?

Mena kei a koe ētahi o ēnei tohu, haere tonu ki te rūma whawhati tata:

• Te kirika nui (neke atu i te 40 Celsius).
• Te uaua ohorere, te uaua rānei ki te manawa.
• Te kore okiokinga, te pōhēhē, te wareware, te pukuriri rānei.
• Kōrero pōturi.

He aha ngā pātai me pātai atu e au ki taku tākuta?

He pai pea te pātai i ēnei pātai ina kite koe i tō tākuta:

• He aha ngā huarahi pai hei tiaki i ahau anō?
• Ka taea e au te whakapai ake i aku tohu?
• Me pēhea taku whakamahi i ēnei rongoā?
• Me pēhea taku whakamahi i taku inhaler, nebulizer, tetahi atu taputapu hauora rānei?
• Āhea ahau me kite anō i a koe?
• Āhea ahau me haere ki te rūma whawhati tata?

Ko te noho me te mate pūkahukahu mau tonu pēnei i te COPD ka taea te ahua taumaha, whakamataku, whakarihariha, me te mokemoke i ētahi wā. Engari he huarahi hei pupuri i te kaha o ngā uaua o ō pūkahukahu mō te roa e taea ana, tae atu ki te whakahaere i ō tohumate. Ko te mahi tahi me tō rōpū hauora ki te waihanga i tētahi mahere hei pupuri i a koe kia ora, hei whakaiti hoki i ngā putanga o te mate ka āwhina i a koe ki te whakahaere i tō āhua. Kōrero ki ō whanaunga mō te huarahi e taea ai e koe te tautoko i a rātou me te aha me mahi mēnā ka kino haere tō āhua.

Kia maumahara, ki te mea kei te raru tonu koe i te manawa, kei te maremare tonu koe, kei te ngenge wawe rānei, kaua e whakaroa ki te toro atu ki te tākuta. Mā te kitenga wawe i te mate ka pai ake te kounga o tō oranga, ā, ka āwhina i a koe kia noho hauora mō ngā tau e haere ake nei.

Hei whakamutunga, ngā mea hei maumahara

Nō reira, ehara te COPD i te mea hei wehi, engari ehara hoki i te mea hei whakahawea . Ko te mea nui ko te rapu tohutohu hauora tonu mēnā ka pāngia koe e ngā tohu, ā, mēnā he kaipaipa koe, me whakapau kaha koe ki te mutu i tēnei rā tonu.

• Kati te kai paipa - Koinei te taahiraa nui rawa atu me te taahiraa pai rawa atu ka taea e koe te mahi hei ārai i te COPD.
• Whakamahia tika te rongoā e tohua ana e tō tākuta . Akohia me pēhea te whakamahi tika i tō inhaler.
• He mea tino whai hua mēnā ka taea e koe te whai wāhi atu ki ngā kaupapa whakaora pūkahukahu .
• Kia mau ki tētahi kai hauora me ngā tikanga whakakori tinana (kia rite ki ngā tohutohu a tō tākuta).
• Me werohanga koe, me te mahi i ngā tikanga hauora pai hei tiaki i a koe mai i ngā mate urutā .

Kāore koe i te mokemoke. Kei reira ngā tākuta, ngā nēhi, me ngā mema o te whānau hei āwhina i a koe. Nō reira kia kaha, kia whai i ēnei tohutohu, kia ngana hoki ki te noho i te oranga pai me te COPD.

` COPD, mate pūkahukahu, uauatanga manawa, mate pūkahukahu mau tonu, mate pūkahukahu, kai paipa, mate manawa