ʻOiai he mea pono, hiki i kekahi mau lāʻau lapaʻau no ka lymphoma ke hoʻopilikia i kou puʻuwai. ʻO ka maʻi puʻuwai kahi huaʻōlelo ākea e wehewehe i nā ʻano maʻi like ʻole e pili ana i ka puʻuwai. I kekahi mau hihia, he manawa pōkole paha ka maʻi puʻuwai akā mau kekahi i ke koena o kou ola. Pono paha ʻoe e ʻike i kekahi kauka ʻē aʻe (Cardiologist) nāna i loea i ka mālama ʻana i ka maʻi puʻuwai.
ʻO ka loaʻa ʻana o ka lāʻau lapaʻau i kahi kokoke i kou puʻuwai, kekahi chemotherapy, kekahi mau antibodies monoclonal a me kekahi mau lāʻau lapaʻau i manaʻo ʻia e hiki ke hoʻomohala i ka maʻi puʻuwai.
He aha nā lāʻau lapaʻau hiki ke hoʻoulu i ka maʻi puʻuwai?
ʻO nā ʻano hoʻololi āu e ʻike ai ma muli o ke ʻano o ka lapaʻau i loaʻa iā ʻoe. Kaomi ma nā poʻomanaʻo ma lalo e aʻo e pili ana i nā ʻano hoʻololi e hiki mai ana.
Hiki ke hoʻopilikia i kou puʻuwai ka lapaʻau ʻana i ka radiation ma kahi ʻāpana waena, a i ʻole ma ka ʻaoʻao hema o kou umauma. Hiki i nā ʻenehana hou me ka radiation therapy ke hoʻemi i ka nui o ka radiation i hiki i kou puʻuwai, akā ʻaʻole hiki ke hoʻopau loa i ka pilikia.
Hiki ke loaʻa nā hopena i kou puʻuwai i loko o nā pule a i ʻole mau mahina ma hope o ka mālama ʻana, akā naʻe, piʻi ka pilikia o ka puʻuwai me ka manawa. ʻAʻole paha ʻoe i loaʻa kekahi hōʻailona o ka maʻi puʻuwai no nā makahiki he nui ma hope o ka pau ʻana o ka radiation therapy.
ʻO ka pōʻino i kou puʻuwai ke kumu o ka mumū a me ka ʻeha i ka:
- ʻO ka membrane lahilahi e laina ana i waho o kou puʻuwai e pale i ka hakakā ʻana i ka wā e paʻi ai kou puʻuwai (pericarditis).
- kou puʻuwai puʻuwai (myocarditis).
- ʻO nā hale o loko o kou puʻuwai e like me ka ʻiʻo hohonu a me nā kiwi e hoʻomau i ke kahe ʻana o ke koko ma ke ala pololei (endocarditis).
- ka uhi o kou puʻuwai (endocarditis).
ʻAʻole pili ka chemotherapy a pau i kou puʻuwai. Eia nō naʻe, aia kekahi mau chemotherapies maʻamau i nā kuʻuna lapaʻau i hiki ke hoʻoulu i ka maʻi puʻuwai. Loaʻa paha ʻoe i ka maʻi puʻuwai ma ke ʻano he hopena ʻaoʻao inā loaʻa iā ʻoe nā mea pilikia e like me ka maʻi diabetes, ke koko kiʻekiʻe, a i ʻole e loaʻa ana ʻoe i ka radiotherapy i kou umauma.
- daunorubicin
- doxorubicin
- epirubicin
- idarubicin
- mitoxantrone
- cisplatin
- cyclophosphamide
- ifosphamide.
He ʻano ʻano antibody monoclonal nā mea hoʻopaʻa hoʻopaʻa kino e hana ana ma ke kāohi ʻana i nā protein i kāu mau sela lymphoma. Hoʻohālikelike kēia mau protein i ka lymphoma i mea maʻamau i kāu ʻōnaehana pale no laila hiki i kāu ʻōnaehana pale ke hoʻomau iā lākou e ulu. Ma ka pale ʻana i nā protein, hiki i kāu ʻōnaehana pale ke ʻike i ka lymphoma ma ke ʻano he maʻi kanesa a hakakā a hoʻopau iā ia.
ʻO ka mea pōʻino, loaʻa kēia mau pūmua like ma kāu mau keena maʻamau - me nā pūnaʻi o kou puʻuwai. No laila ke paʻa ʻia kēia mau protein i kou puʻuwai, hiki i kāu ʻōnaehana pale ponoʻī ke hoʻomaka e hoʻouka i kou puʻuwai e hoʻoulu ai i ka mumū a me ka ʻili.
ʻO nā wahi hoʻopaʻa kino e hiki ke hoʻopilikia i kou puʻuwai:
- nivolumab
- pembrolizumab
- durvalumab
- avelumab
- atezolizumab
- ipilimumab.
Hiki i kekahi mau lāʻau lapaʻau ke hoʻoulu i ka arrythmia. ʻO ka Arrythmia nā hoʻololi i ka puʻuwai o kou puʻuwai. Hiki i kēia ke komo i ka pu'uwai wikiwiki a lohi paha ma mua o ka manawa ma'amau, a i kekahi manawa he pu'uwai ma'amau.
ʻO ka hapa nui o kēia mau arrythmias hiki ke ʻike ʻole ʻia a ʻaʻohe hopena pōʻino. Eia nō naʻe, i kekahi manawa ʻoi aku ka koʻikoʻi a me ka kakaikahi hiki ke lilo i mea weliweli i ke ola. ʻOi aku ka maʻamau o nā pilikia serous me ka poʻe i loaʻa i ka maʻi puʻuwai (me ke koko kiʻekiʻe, a i ʻole arrhythmias), a i ʻole nā maʻi e like me ka maʻi diabetes.
E hōʻike i nā loli a pau o kou puʻuwai i kāu kauka. Pono paha lākou e hoʻololi i kāu ʻano o ka lāʻau lapaʻau, a i ʻole e hoʻomaka iā ʻoe ma kahi lāʻau lapaʻau ʻē aʻe e kōkua i ka paʻa pinepine ʻana o kou puʻuwai.
Nā hōʻailona o ka maʻi puʻuwai
I ka hoʻomaka mua ʻana o ka maʻi puʻuwai ʻaʻohe āu hōʻailona. Eia naʻe, hiki ke komo i nā hōʻailona maʻamau:
- pilikia i ka hanu ʻana a i ʻole ka liʻiliʻi o ka hanu
- pākī
- hoʻololi i kou puʻuwai puʻuwai a i ʻole ka manaʻo o kou puʻuwai ma mua o ka maʻamau (palpitations)
- hoʻololi i kou koko koko
- ʻo ka ʻūhā a i ʻole ka manaʻo māmā a maule paha
- ka pehu ʻana ma kou mau lima a wāwae paha
- luhi loa (fatigue).
I ka wā e launa aku ai i kāu kauka
E hōʻoia ʻoe e hōʻike koke i kekahi o kēia mau hōʻailona i kāu kauka haematologist a kahu hānai paha. Inā ʻaʻole ʻoe i hālāwai me kāu kauka haematologist a i ʻole oncologist i nā lā 2 a i ʻole 3 e hiki mai ana ma hope o ka hoʻomaka ʻana o kēia mau hōʻailona, e kipa koke i kāu kauka kūloko (GP).
E hōʻike i nā loli hou i kāu kauka, ʻoiai inā hoʻopau ʻoe i ka mālama ʻana i nā mahina, a i ʻole mau makahiki i hala. E hoʻomaopopo iā lākou ua mālama ʻoe i ka lymphoma i ka wā ma mua, hiki ke hoʻonui i kou pilikia i ka maʻi puʻuwai.
* Pokole hanu
* Ka ʻeha o ka umauma a i ʻole ke kaomi ʻana i kou umauma
Management
ʻO ka mālama ʻana i ka maʻi puʻuwai e pili ana i ke ʻano o ka mālama ʻana i kāu lymphoma, a me ke ʻano o ka maʻi puʻuwai āu i loaʻa ai.
Nui nā ʻano maʻi puʻuwai. I kekahi mau hihia, pono paha ʻoe i kahi liʻiliʻi liʻiliʻi o ka lāʻau e pilikia ai. Hiki i kāu kauka ke koho e wehe a hoʻololi paha i kahi lāʻau no ka mea hiki ke hōʻeha i kou puʻuwai.
I kekahi mau kūlana, pono paha ʻoe e hoʻouna ʻia i ka Cardiologist, he kauka nona ka ʻike i nā maʻi naʻau. A laila hiki iā lākou ke loiloi a mālama i kou maʻi puʻuwai.
ʻO kekahi mau lāʻau lapaʻau no ka maʻi maʻi puʻuwai paha:
- nā lāʻau naʻau e hoʻomaikaʻi a hoʻopaʻa i ke kahe koko a i ʻole ka puʻuwai puʻuwai.
- kaohi wai no laila ʻaʻole pono kou puʻuwai e hana nui.
- nā lāʻau diuretics, ʻo ia nā lāʻau lapaʻau e kōkua iā ʻoe e wī (mimi) hou aku e hoʻopau i ka wai keu.
hōʻuluʻulu manaʻo
- ʻO ka maʻi puʻuwai kahi inoa e wehewehe ai i kahi hui o nā kūlana like ʻole e hiki ke hoʻopilikia i kou puʻuwai.
- Hiki i nā ʻano lāʻau lapaʻau like ʻole no ka lymphoma ke hopena i ka maʻi puʻuwai, ʻo ka hapa nui paha he manawa pōkole, akā pono nā mea ʻē aʻe e mālama i ke ola holoʻokoʻa.
- Loaʻa iā ʻoe ka maʻi puʻuwai ma ke ʻano he hopena ʻaoʻao o ka mālama ʻana inā loaʻa ʻoe i kahi maʻi puʻuwai a i ʻole nā maʻi ʻē aʻe e like me ke koko kiʻekiʻe a i ʻole ka maʻi diabetes.
- Hoʻomaka koke ka maʻi puʻuwai ma hope o kāu mālama ʻana, a i ʻole he mau makahiki ma hope o ka pau ʻana o ka mālama ʻana.
- Ma muli o ke ʻano o ka maʻi puʻuwai i loaʻa iā ʻoe a me kou olakino holoʻokoʻa.
- E hōʻike i nā hōʻailona a pau o ka maʻi puʻuwai i kāu kauka i ka hikiwawe loa, ʻoiai inā ua pau kāu mālama ʻana i nā makahiki i hala.
- E kāhea aku i kahi kaʻa kaʻa ma 000 (Australia) inā loaʻa iā ʻoe ka ʻeha o ka umauma a i ʻole ka pōkole o ka hanu.
