Kua paku ngenge tō ngākau? Kia ako tātou mō te Congestive Heart failure i roto i tētahi huarahi māmā!

Ahakoa he poto noa te hikoi, he piki arawhata rānei, ka pēhia koe e te uaua o te manawa? Kei te pupuhi rānei ō waewae, ō pona rānei? Tērā pea ko tō ngākau ēnei e kōrero ana i tētahi mea. I tēnei rā ka kōrero tātou mō te Congestive Heart failure , e ai ki ētahi, ko te congestive heart failure . Kaua e manukanuka, ki te mārama koe ki tēnei, ā, ki te whakahaere tika koe, ka ora koe.

He aha tonu te ngoikore o te ngākau?

Ki te kī māmā noa, ko te Congestive Heart Failure ko te wā kāore e taea e tō ngākau te pupuhi toto kia rite ki tana e hiahia ana. Whakaarohia tō ngākau he pokapū tohatoha nui. Ko ia kete e tae mai ana (arā, te toto) me tuku ki te wāhi tika (arā, ngā whekau) i te wā tika. Engari he aha te mea ka tupu ina ngoikore te pokapū nei, ā, kāore e taea te tuku i ngā kete katoa i te wā tika? Ka puranga ngā kete, tika? Koinā hoki te mea ka tupu i konei. Ina kore e taea e te ngākau te pupuhi toto tika, ka hoki te toto ka kohia ki ngā wāhanga rerekē o te tinana, inā koa ki ngā pukahukahu, ngā waewae, ngā pona waewae, me te puku . Koinei te mea e kiia nei e tātou ko te Congestive, ko te tikanga he "kohinga."

He aha ngā momo matua o te ngoikore o te ngākau?

Ae, he maha ngā momo matua:

• Te ngoikore o te ngākau taha maui: Koinei te momo tino noa. Koinei te wā kāore e taea e te taha maui o te ngākau (te ventricle maui) te pupuhi toto puta noa i te tinana. Ka taea e tēnei te whakaemi toto i roto i ngā pukahukahu, ka uaua ai te manawa.
• Te ngoikore o te ngākau taha matau: Ko te nuinga o te wā ka puta mai i te ngoikore o te ngākau taha maui. Ina kore e taea e te taha matau o te ngākau te pupuhi tika i te toto mai i ngā pukahukahu, ka pupū te toto ki roto i te pūnaha uaua ka pupuhi i ngā wāhi pēnei i ngā waewae, ngā pona waewae, me te puku.
• Te ngoikore o te ngākau putanga nui: He momo onge tēnei. I roto i tēnei āhuatanga, ka pai te pupuhi o te ngākau i te toto, engari nā te nui o te hiahia o te tinana (hei tauira, te anemia nui, te hyperthyroidism), kāore e taea e te ngākau te whakatutuki i taua hiahia.

He pēhea te noa o tēnei āhuatanga?

E miriona ngā tāngata huri noa i te ao e pāngia ana e tēnei mate. He mea tino kitea tēnei i waenga i te hunga neke atu i te 65 tau te pakeke , ā, koinei te tino take o te noho hōhipera i taua rōpū tau. Nō reira, he mea tino nui kia mōhio ki tēnei mate.

He aha ngā tohu o te ngoikore o te ngākau?

Ka rerekē pea ēnei tohu i ia tangata, i ia tangata, ā, ka rerekē anō hoki i runga i te kaha o te mate. Heoi anō, kei reira ētahi tohu noa ka kitea:

• Te poto o te manawa: Te āhua nei ka hemo koe i te mahi māmā, te hikoi pakupaku, te piki rānei i ētahi arawhata. I ngā wā tino kino, ka uaua pea te manawa ahakoa te tū tonu.
• Te ara ake i te pō me te uaua ki te manawa:Ki te oho whakarere koe i a koe e moe ana, ā, ka pōrearea te manawa, he tohu anō tēnā nō tēnei.
• Te mamae, te kore whakamarie rānei o te uma: Ka rongo pea ētahi tāngata i te kikī, i te taumaha rānei i roto i ō rātou uma.
• Te tere o te manawa: Tērā pea ka rite te manawa ki te mea e pā nui ana, e tere ana, e kore rānei e tika te pā.
• Te tino ngenge i te wā e mahi ana: Te tino ngenge ki te mahi i ngā mea ngāwari i mua.
• Te pupuhi o ngā waewae, ngā pona waewae, me te puku: Ka pupuhi pea ngā pona waewae me ngā māikuku tae noa ki te wāhi e uaua ai te mau hu, te tango rānei i ngā mowhiti.
• Te pikinga ohorere o te taumaha: Ki te piki ake tō taumaha i roto i ētahi rā, tērā pea nā te pupuri wai i roto i te tinana.
• Te hiahia kia mimi pinepine i te pō.
• He maremare maroke, he maremare tere e puta mai ana, kāore he take: Ka kino ake pea tēnei maremare, inā koa kei te maremare koe.
• Te ahua o te kī, te kikī rānei o te puku.
• Te ngaronga o te hiahia kai, te whakapairuaki rānei.

Kia maumahara, i ētahi wā ka tino ngawari ēnei tohu, ka ngaro rānei. Engari ehara i te mea kāore he ngoikore o te ngākau i a koe. Ka haere mai, ka haere atu ngā tohu. He mea noa te kino haere o te mate i roto i te wā. Nō reira, ki te kitea e koe tētahi, e rua rānei o ēnei tohu, he mea whakaaro nui kia toro atu ki te tākuta.

He aha ngā take o te ngoikore o te ngākau?

He maha ngā take e ngoikore ai te ngākau. Ko ētahi o ngā take matua ko:

• Te mate uaua o te ngakau me/ranei te mate manawa: Te kino ki te uaua o te ngakau nā te aukati i ngā uaua e tuku toto ana ki te ngakau.
• Cardiomyopathy: Tērā pea nā ngā take ira, ngā mate huaketo, ētahi atu take rānei, e ngoikore ai, e matotoru ai rānei te uaua o te ngākau.
• Mate ngākau whānau: Te whānautanga mai me te mate ngākau.
• Mate huka: Ka pāngia te ngākau e te mate huka mō te wā roa.
• Te toto toto tiketike: Ka kaha ake te mahi a te ngākau i te toto toto tiketike kāore e taea te whakahaere.
• Te koretake o te pā o te ngakau (Arrhythmia): Ka whakaitihia te pai o te mahi a te ngakau e te koretake o te pā o te ngakau.
• Mate whatukuhu: Ina kore e mahi tika ngā whatukuhu, ka piki ake te nui o te wai me te tote i roto i te tinana, ka pēhi i te ngākau.
• Te taupū papatipu tinana (BMI) neke atu i te 30 (momona).
• Te tupeka me te whakamahi ture kore i ngā raau taero.
• Te nui rawa o te whakamahi waipiro.
• Ētahi rongoā: Hei tauira, ko ētahi rongoā chemotherapy e whakamahia ana hei rongoā i te mate pukupuku ka kino pea ki te ngākau.

Ko tētahi atu mea hei mōhio ko te ngoikore o te ngākau o te taha maui te tino take o te ngoikore o te ngākau o te taha matau. Ina kore te taha maui e mahi tika, ka rere whakamuri te toto mā roto i ngā pukahukahu, ā, ka pā ki te taha matau.

Ko wai te mea tino mōrearea mō tēnei?

He nui ake te tūponotanga o ētahi tāngata ki te pāngia e tēnei mate. Ko ēnei āhuatanga mōrearea ko:

• Neke atu i te 65 tau te pakeke.
• Te whakamahi i ngā hua tupeka, i ngā raau taero pēnei i te kōkāne, i te waipiro rānei.
• He momo noho noho kore, kāore e kaha ki te korikori tinana.
• Te kai pinepine i ngā kai he nui te tote me te ngako.
• He toto toto tiketike.
• He mate uaua coronary kei a koe.
• Kua pāngia koe e te mate ngakau i mua.
• He hītori whānau tō te ngoikore o te ngākau.

He aha ngā raruraru ka pā mai i te ngoikore o te ngākau?

Ki te kore tēnei āhuatanga e rongoatia tika, e whakahaeretia rānei, ka puta ake pea ētahi atu raruraru.

• Te pāorooro o te ngakau kāore i te ōrite.
• Ka taea e te hopukanga ohorere o te manawa te arahi ki te mate.
• Ngā raruraru o te takirere ngākau.
• Te kohikohinga wai i roto i ngā pukahukahu (Te pupuhi pūkahukahu).
• Te toto toto tiketike o te pūkahukahu.
• Te pakaru o te whatukuhu, te ngoikore rānei o te whatukuhu.
• Te kino o te ate.
• Te kore kai pai.

Me pēhea koe e mōhio ai mēnā kei a koe te Congestive Heart Failure?

Mena kei a koe ēnei tohu, ina kite koe i te tākuta, ka pātai tuatahi ia ki a koe.

• Ngā mea pēnei i ngā tohumate kei a koe me te roa o te wā kua pāngia koe e aua tohumate.
• Ētahi atu mate hauora kei a koe (pēnei i te mate huka, te toto toto tiketike).
• Kua pāngia tetahi o tō whānau e te mate manawa, e te mate ohorere rānei?
• Kei te whakamahi koe i ngā hua tupeka, i te waipiro, i ngā raau taero rānei?
• Ahakoa kua whiwhi koe i te chemotherapy, i te radiation rānei mō te mate pukupuku i mua.
• He aha ngā rongoā e whakamahia ana e koe?

Kātahi ka tirohia koe e te tākuta. Ka whakarongo rātou ki tō ngākau, ka tirohia ō pukahukahu, ā, ka tirohia hoki ō waewae mō te pupuhi.

He aha ngā wāhanga e whā o te ngoikore o te ngākau?

Nā te mea he mate tēnei e kino haere ana i roto i te wā, e whā ngā wāhanga. Ko ēnei wāhanga ko A, B, C, me D. Arā, he haerenga mai i te taumata iti-mōrearea ki te taumata teitei-mōrearea.

Wāhanga A (Wāhanga A - I mua i te ngoikore o te ngākau)

Ko te tikanga o tēnei he nui te mōrearea o te ngoikore o te ngākau. Tērā pea nā te mea kua pāngia tētahi o tō whānau e te mate. Tērā pea nā te mea kei a koe tētahi, ētahi rānei o ēnei āhuatanga:

• Te toto toto tiketike (hypertension).
• Mate huka.
• Te mate uaua koronari.
• Te mate pāwera.
• He hītori o te mate whakamahi waipiro.
• Kei te pāngia koe e te kirika rūmātika.
• He hītori whānau tō te mate cardiomyopathy.
• Te whakamahi i ngā rongoā ka kino ki te ngākau (hei tauira, ētahi rongoā ārai matepukupuku).

Wāhanga B (Wāhanga B - I mua i te ngoikore o te ngākau)

I tēnei wā, kāore tō pūkahukahu maui (te ruma matua e pupuhi ana i te toto puta noa i te tinana) e mahi tika ana, kei te rerekē rānei tōna hanganga (hei tauira, te matotoru). Engari kāore anō kia kitea he tohu o te ngoikore o te ngakau.

Wāhanga C

Kua tautuhia te hunga kei tēnei wāhanga kei te pāngia rātou e te Congestive Heart Failure. Tērā pea kei a rātou ngā tohu i nāianei, i mua rānei kua pāngia rātou e ngā tohu engari kāore anō kia pāngia e te mate.

Wāhanga D me te Wāhanga Whakaitihia o te Pehanga (EF)

He tino matatau (Advanced) (Heart Failure) te āhua o ēnei tāngata. Ahakoa kua rongoatia, he uaua ki te whakahaere i ngā tohu. He tino iti te nui o te toto e tukuna ana mai i te ngākau i te wā kotahi, arā, `(Ejection fraction - EF)`, ā, tera pea he `(HFrEF - heart failure with reduced ejection fraction)`. Koinei te wāhanga whakamutunga o (Heart Failure).

He aha ngā whakamātautau tātaritanga?

He maha ngā whakamātautau ka mahia e ngā tākuta hei whakatau mēnā kei te pāngia koe e te ngoikore o te ngākau, kei hea te wāhanga, me te aha tonu te take:

• Ngā whakamātautau toto: Ka taea e ēnei te kite i ētahi atu āhuatanga e pā ana ki te ngākau (hei tauira, te anemia, te mate tākihi, ngā raruraru tairoi) me te kite mēnā kua pakaru te ngākau (mā te tirotiro i ētahi taumata whākōkī).
• Te whakaurunga o te catheterization o te ngākau: Ka mahia tēnei hei tirotiro mō ngā aukati i roto i ngā uaua coronary o te ngākau.
• X-ray o te uma: Ka taea te whakamahi i tēnei hei tirotiro i te nui haere o te ngākau me te nui haere o te wai i roto i ngā pukahukahu.
• Echocardiogram (Echo): He rite tēnei ki te matawai ultrasound o te ngākau. Ka kitea māramatia ngā mea maha pērā i ngā rūma o te ngākau, ngā takirere, te mahi a te uaua o te ngākau, me te pai o tana pupuhi toto (te "Ejection fraction - EF").
• MRI (Whakaahua Āhua Aukume) o te ngākau.
• Matawai CT (Tomography Rorohiko) o te ngākau.
• Te hiko-cardiogram (EKG, ECG rānei): Mā tēnei ka āwhina i te kite i ngā mea pēnei i te ngohe hiko o te ngākau me te manawataki o te pao o te ngakau.
• Matawai MUGA (Matawai Whakaemi Maha): Ka taea hoki te whakamahi i tēnei hei tirotiro i te pai o te pupuhi toto o ngā rūma o te ngākau.
• Whakamātautau ahotea: Ka mahia he ECG i a koe e hikoi ana i runga i te mīhini oma, e eke pahikara ana rānei, hei tirotiro i te urupare a tō ngākau ki te whakakori tinana.
• Whakamātautau ira: I ētahi wā, inā koa he hītori whānau, ka mahia ēnei whakamātautau hei rapu i ngā take ira.

Me pēhea te rongoā mō te ngoikore o te ngākau?

Ko te maimoatanga e whakawhirinaki ana ki te momo ngoikore o te ngākau kei a koe, tōna pūtake, me te taumata kei roto koe. He wāhanga nui o ia mahere maimoatanga ngā rongoā me ngā huringa āhua noho. Ma tō tākuta koe e kōrero mō te mahere maimoatanga pai rawa atu māu.

Ko te mea nui, ehara te (Rangoā o te Manawa) i te mate e kore e taea te rongoā katoa. I a ia e kino haere ana, ka heke te nui o te toto e pupuhihia ana e te manawa ki ngā whekau, ā, ka neke atu koe ki te wāhanga e whai ake nei. Kāore e taea e koe te hoki whakamuri i ēnei wāhanga. Nō reira, ko te whāinga matua o te maimoatanga he aukati i a koe kei haere ki te wāhanga e whai ake nei, he whakaroa i a ia, he whakahaere i ngā tohu me te whakapai ake i te kounga o tō oranga.

Kia tirohia me pēhea te hurihanga o te maimoatanga i ia wāhanga ki ia wāhanga:

Te maimoatanga mō te wāhanga A:

Kāore anō ēnei tāngata kia pāngia e te ngoikore o te ngākau, engari he nui te mōrearea. Koia rātou e mahi ana i ngā mea hei whakaiti i te mōrearea.

• Te whakakori tinana i ia rā, pērā i te hikoi.
• Te kore rawa e kai i ngā hua tupeka.
• Te rongoā i te toto toto tiketike (rongoā, kai iti te tote, noho ora).
• Te maimoatanga o ngā taumata cholesterol tiketike.
• Te karo i te waipiro me ngā raau taero ture kore.
• Mena kei a koe ētahi atu mate hauora pēnei i te mate uaua o te ngakau, te mate huka, te toto toto tiketike rānei, ka tohua pea he rongoā aukati whākōkī Angiotensin-converting (ACE-I) he rongoā aukati Angiotensin II receptor (ARB) rānei.

Te maimoatanga mō te wāhanga B:

He mate manawa tō ēnei tāngata, engari kāore he tohu.

• Ngā maimoatanga katoa kua whakahuatia i te Wāhanga A.
• Mena he 40%, he iti iho rānei tō `(Ejection fraction - EF)`, ko `(ACE-I)` ko `(ARB)` rānei te rongoā tika.
• Mena kua pāngia koe e te mate ngakau i mua, ā, ko tō EF he 40%, he iti iho rānei (mēnā kāore anō kia tangohia e koe), me tango e koe he rongoā e kiia nei ko te beta-blocker.
• Mena kua pāngia koe e te mate ngakau i mua, ki te mea rānei he 35%, iti iho rānei tō EF, me whiwhi pea koe i te rongoā e kiia nei ko te Aldosterone antagonist.
• I ētahi wā, ka hiahiatia he pokanga, he wawaotanga rānei mō ngā āhuatanga pēnei i te mate uaua coronary, te ngoikore o te ngakau, te mate takirere (te whakatikatika, te whakakapi rānei i te takirere), te mate ngakau whānau rānei.

Te maimoatanga mō te wāhanga C (HFrEF - mō te hunga he iti te kaha pupuhi toto):

He ngoikore te ngākau o ēnei tāngata, ā, he tohumate kei a rātou/kua pāngia hoki e rātou.

• Ngā maimoatanga kua whakahuatia i ngā wāhanga A me B.
• Ngā rongoā '(Beta-blocker)' me '(Aldosterone antagonist)'.
• He momo rongoā e kiia nei ko `(Ngā aukati kawe konutai-kurukose 2 - SGLT2i)`.
• Ka whakamahia he rongoā whakakotahi e kiia nei ko te ``(Hydralazine/nitrate)`` mēnā kāore e taea e ētahi atu maimoatanga te whakahaere i ngā tohumate, inā koa mō te hunga uri Āwherika-Amerika.
• Mena he nui ake i te 70 ngā pao o te ngakau i te meneti, ā, ka mau tonu ngā tohu, me whiriwhiri he rongoā whakaiti i te tere o te ngakau.
• Ki te mau tonu ngā tohu (ina koa ko te pupuhi me te uaua ki te manawa), ka hoatu he rongoā whakaheke toto (e kīia nei ko ngā pire wai).
• Te whakawhāiti i te nui o te tote (konutai) i roto i te kai.
• Paunatia tō taumaha i ia rā. Mēnā ka nui ake, ka ngaro rānei tō taumaha i te 2 kirokaramu (4 pauna) i roto i te rā kotahi, e rua rānei, me whakamōhio tonu atu ki tō tākuta .
• Me whakawhāiti anō hoki te nui o te wai e inuhia ana e koe i ia rā.
• Me tāuta he taputapu whakateretere motuhake mō ētahi tāngata e kiia nei ko te "Cardiac Resynchronization therapy - CRT", te "biventricular pacemaker" rānei.
• Ka whakauruhia he taputapu e kiia nei ko te implantable cardiac defibrillator (ICD) ki roto i te hunga e mōrearea ana ki te whakawhanake i ngā rerekētanga o te manawa o te ngakau e morearea ai te ora.
• Ahakoa ka pai ake ngā tohu i te wā e rongoatia ana, he mea tino nui kia haere tonu te maimoatanga hei whakaroa i te haere whakamua o te mate ki te wāhanga D.

Te maimoatanga mō te wāhanga D:

He mate kino tō ēnei tāngata (te ngoikore o te ngākau).

• Ko ngā maimoatanga katoa kua whakahuatia i ngā wāhanga A, B, me C. Hei tāpiri, kei te whakaarohia ngā maimoatanga matatau ake:
• Te whakawhitinga ngākau.
• Ngā taputapu ā-ringa hei tautoko i te ngākau (ngā taputapu āwhina ventricular - VAD)
• Ngā pokanga ngākau motuhake `(Pokanga ngākau)`.
• Ngā rongoā inotropic e werohia ana ki roto i te uaua (ngā rongoā e whakanui ake ana i te kaha o te whakakorikori o te ngakau).
• Manaaki mamae, manaaki hōhipera rānei.

Ngā Wāhanga C me D (HFpEF - mō te hunga kāore he raruraru ki te pupuhi toto mai i te ngākau):

I tēnei āhuatanga, ahakoa he noa te kaha o te ngākau ki te whakawhāiti (ejection fraction), he raruraru kei te kī tonu o te ngākau i te toto (diastolic function) ka hua ake te ngoikore o te ngākau.

• Ngā maimoatanga kua whakahuatia i ngā wāhanga A me B.
• Te rongoā i ētahi atu āhuatanga hauora ka pā mai, ka kino atu rānei te ngoikore o te ngākau (hei tauira, te fibrillation atrial, te toto toto tiketike, te mate huka, te momona, te mate uaua coronary, te mate pūkahukahu mau tonu, te cholesterol tiketike, te mate tākihi).
• Ngā rongoā diuretic (pire wai) hei whakaiti, hei whakamamae rānei i ngā tohu.

Kaua e wareware he mea tino nui te whakahaere i ō mate hauora kē atu (te mate huka, te mate tākihi, te toto toto tiketike, te mate tairoi, te mate huango, te mate pūkahukahu mau tonu) hei whakahaere i tēnei mate (te ngoikore o te ngākau) .

He pānga taha, he raruraru rānei kei te rongoā?

Tērā pea he iti noa ngā pānga taha o ētahi maimoatanga.

• Te toto toto iti (hypotension).
• Ngā pānga ki te mahi a te whatukuhu (Te ngoikore o te whatukuhu).
• Ka nui ake te mōrearea o te mate nā te maha o ngā whakaurunga hōhipera ki te hōhipera, inā koa me ngā rongoā ā-uaua (ngā IV pokapū).

Kōrero ki tō tākuta mō tēnei, kia mōhio ai koe ki ngā mea e pā ana ki a koe.

Me pēhea te whakaiti i te mōrearea o te (Congestive Heart Failure)?

Ahakoa kāore e taea e tātou te whakarerekē i ngā mea pēnei i te pakeketanga me te hītori whānau, ka taea e tātou te whakaiti i te mōrearea o te whakawhanake i tēnei mate (Te ngoikore o te ngākau) mā te whakarerekē i tō tātou momo noho.

• Te pupuri i te taumaha hauora e tika ana mōu.
• Te kai i ngā kai hauora mō te ngākau (whakaitihia te tote, te huka, te hinu, engari me nui ake ngā huawhenua me ngā hua).
• Te whakakorikori tinana i ia wā, i ia wā.
• Te whakahaere pai i te ahotea.
• Te whakamutu katoa i te whakamahinga o ngā hua tupeka.
• Te kore e inu waipiro, te kore rānei e inu iti rawa.
• Te kore e whakamahi i ngā raau taero turekore.
• Mena kei a koe ētahi atu mate hauora e whakanui ake ana i tō mōrearea (pēnei i te toto toto tiketike, te mate huka, te cholesterol tiketike), me whiwhi koe i te rongoā tika me te whakahaere i aua mate.

He aha te momo āmua ka taea e te tangata e pāngia ana e te ngoikore o te ngākau?

Mā te maimoatanga tika, ngā huringa momo noho, me te piri ki ngā tohutohu a tō tākuta, ka taea e te tini o te tangata te noho harikoa ahakoa te mate manawa pāwera. Ko tō heke mai kei runga i ēnei mea:

• Kei te pai o te mahi a te uaua o tō ngākau.
• Kei runga i te āhua me te kaha o ō tohumate.
• Kei te pai o tō urupare ki te mahere maimoatanga te mea e whakawhirinaki ana.
• Kei te pai o tō whai i tō mahere maimoatanga (rongoā, kai, whakakori tinana) te āhua.

E ai ki ētahi rangahau, ko te hunga e pāngia ana e te ngoikore o te ngākau, ka ora pea rātou ki te 10 tau te iti iho i te hunga kāore i te pāngia e te ngoikore o te ngākau. Engari he rerekē rawa tēnei i ia tangata, i ia tangata. Nō reira, he pai ake te kōrero tuwhera me te pono mō tō āhua ki tō tākuta. He mate mau tonu te ngoikore o te ngākau, ā, he mate mō te wā katoa. Me rongoā me te whakahaere mō te wā katoa.

Me pēhea taku tiaki i ahau anō? (Te tiaki i ahau anō)

I te wā e noho tahi ana koe me te ngoikore o te ngākau, he mea tino nui kia tiakina koe e koe anō.

• Tangohia tō rongoā kia rite ki tā te tākuta i tohutohu ai, i te wā tika. Kaua e mahue tetahi rā.
• Kia kaha tonu te mahi. Pātai atu ki tō tākuta he aha ngā mahi whakakori tinana e tika ana māu.
• Me whai i tētahi kai iti te tote. He nui te tote i roto i ngā kai kua tākaihia, ngā kai kēne, me ngā kai tere.
• Tirohia tō taumaha i ia rā. Ki te kite koe i tētahi pikinga taumaha ohorere (hei tauira, 1-2 kirokaramu i roto i te rā kotahi, e rua rānei), me kōrero ki tō tākuta .
• Ki te puta mai ngā tohu hou, ki te kino ake rānei ngā tohu o nāianei, me whakamōhio tonu atu ki tō tākuta .
• Kia mahara ki te haere ki te tākuta i ngā wā tirotiro whai muri kua whakaritea.
• Nā te mea he mate tēnei ka mate pea, he mea pai kia whakamōhio atu koe ki tō tākuta me tō whānau i ō hiahia mō tō tiaki hauora (hei tauira, mēnā kei te hiahia koe ki te maimoatanga roa/noho hōhipera). Ka taea tēnei mā te whakakī i tētahi "tohutohu mua" me tētahi "whakatau ora". He mea whakaaro nui kia whakaritea tēnei i a koe e ora ana, mehemea kāore e taea e koe te whakatau i ēnei i tētahi wā i muri mai.

He aha ngā mea kāore e taea te kai me te inu tahi me koe (Te ngoikore o te ngākau)?

Me whakawhāiti te nui o te tote e kainga ana e te hunga e pāngia ana e te ngoikore o te ngākau i ia rā. Me whakawhāiti anō hoki te nui o te wai e kainga ana e ētahi tāngata (pēnei i te wai, te tī, te hupa). Mā tō tākuta, mā tō tohunga kai rānei koe e tohutohu mō tēnei.

Āhea ahau me kite i te tākuta?

He mea tino nui kia kōrero koe ki tō tākuta mēnā he tohu hou kei a koe, mēnā rānei ka kino haere ō tohu o te ngoikore o te ngākau. Ina koa mēnā kei a koe tētahi o ēnei e whai ake nei:

• Mena he uaua ki te manawa ahakoa kei te okioki koe.
• Mena ka piki ake te pupuhi i ngā waewae, i ngā pona waewae, i te puku rānei.
• Ki te piki haere tō taumaha (neke atu i te 1-2 kg i roto i te rā kotahi, e rua rānei).
• Mena kei te ngenge tonu koe, kei te hiamoe hoki.

Āhea ahau me haere ki te Tari Whawhati Tata (ETU) ?

Ki te kino haere tō ngoikore o te ngākau (hei tauira, te poto o te manawa, te mamae nui o te uma), me whiwhi koe i te maimoatanga ohorere. Ka kiia tēnei e ngā tākuta ko te ngoikore o te ngākau kāore i te tino pai . I tēnei wā, ka hoatu pea he rongoā me te hāora ki a koe hei āwhina i te whakapai ake i tō āhua. Mā te tere o te haere ki te hōhipera me te kore e moumou taima ka taea te whakaora i te ora.

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

Ina haere koe ki te tākuta, kaua e wehi ki te pātai i ngā pātai e pā ana ki tō hinengaro.

• "He aha te wāhanga o (te ngoikore o te ngākau) kei a au?"
• "He aha te rongoā pai mōku i tēnei wā?"
• "He aha ētahi mahi whakakori tinana haumaru ka taea e au te mahi? Kia pēhea te roa me mahi au i aua mahi?"
• "He aha ngā huringa me mahi e au ki taku kai?"
• "He rōpū tautoko kei reira mō te hunga e pāngia ana e te (Paheketanga o te Manawa)?"
• "Me aha ahau mēnā ka kino haere aku tohumate?"

Ngā mea tino nui hei maumahara (Karere hei kawe ki te kāinga)

Ehara i te mea hei wehi i te ngoikore o te ngākau, engari ehara hoki i te mea hei whakahawea. Mena kei a koe tēnei mate, he maha ngā mea ka taea e koe te mahi hei whakapai ake i te hauora o tō ngākau.

• Tangohia tō rongoā i te wā tika, ā, i te wā tika hoki.
• Kai i ngā kai iti te tote, he kai hauora mō te ngākau.
• Kia kaha tonu te mahi.
• Tirohia tō taumaha i ia rā, kia tūpato hoki ki ngā huringa ohorere.
• Kia mahara ki te haere ki te tākuta i ngā rā kua whakaritea.
• Puritia he pūkete o ō tohumate, ā, mēnā ka kino haere, me kōrero ki tō tākuta .

Mena he pātai, he āwangawanga rānei āu mō ō rongoā, mō ngā huringa āhua noho, mō tētahi atu mea rānei i roto i tō mahere maimoatanga, kōrero noa ki tō tākuta. Kei reira rātou hei āwhina i a koe ki te whakahaere i tēnei mate, me te noho i te oranga pai rawa atu. Kia maumahara, ehara i te mea ko koe anake!

`Te whakaeke ngakau, te whakaeke ngakau, te mate ngakau, te mamae o te uma, te uaua ki te manawa, te ngoikore o te ngakau, te pupuhi o ngā waewae