Leukemia Lymphocytic Oiwi

ʻO ka leukemia lymphocytic ʻoi aku ka nui (ALL) kahi ʻano kanesa o ke koko a me ka iwi ʻiwi—ka ʻiʻo spongy i loko o nā iwi kahi i hana ʻia ai nā cell koko.

Mai ka huaʻōlelo "ʻoi aku ka nui" ma ka leukemia lymphocytic ʻoi aku ka nui mai ka mea e holomua koke ai ka maʻi a hana i nā cell koko makua ʻole, ma mua o nā mea makua. ʻO ka huaʻōlelo "lymphocytic" ma ka leukemia lymphocytic ʻoi aku ka nui e pili ana i nā cell koko keʻokeʻo i kapa ʻia ʻo lymphocytes, ka mea i hoʻopilikia ʻia e ka ALL. Ua ʻike ʻia hoʻi ka leukemia lymphocytic ʻoi aku ka nui ma ke ʻano he leukemia lymphoblastic ʻoi aku ka nui.

ʻO ka leukemia lymphocytic ʻoi aku ka nui ka ʻano kanesa maʻamau loa i nā keiki, a ʻo nā lāʻau lapaʻau e hopena ai i ka manawa maikaʻi no ka hoʻōla. Hiki ke loaʻa ka leukemia lymphocytic ʻoi aku ka nui i nā mākua, ʻoiai ua emi nui ka manawa o ka hoʻōla.

Hōʻailona a me nā hōʻailona o ka leukemia lymphocytic ʻoi loa paha e komo pū me: Ke kahe koko mai nā gums ʻEha iwi Fever Infections pinepine Kahe ihu pinepine a i ʻole nui Nā ʻāpana i hana ʻia e nā lymph nodes pehu ma a puni ka ʻāʻī, nā armpits, ka ʻōpū a i ʻole ka groin ʻIli palupalu Pōkole o ka hanu Nawaliwali, luhi a i ʻole ka emi ʻana o ka ikehu E hana i kahi kūkā me kāu kauka a i ʻole ke kauka o kāu keiki inā ʻike ʻoe i kekahi mau hōʻailona a me nā hōʻailona mau loa e hopohopo nei iā ʻoe. Nui nā hōʻailona a me nā hōʻailona o ka leukemia lymphocytic ʻoi loa e hoʻohālikelike i nā mea o ka maʻi flu. Eia naʻe, e hoʻomaikaʻi nā hōʻailona a me nā hōʻailona o ka maʻi flu. Inā ʻaʻole hoʻomaikaʻi nā hōʻailona a me nā hōʻailona e like me ka mea i manaʻo ʻia, e hana i kahi kūkā me kāu kauka.

E hoʻomaka i kahi kūkā me kāu kauka a i ʻole ke kauka o kāu keiki inā ʻike ʻoe i kekahi mau hōʻailona a me nā hōʻailona mau loa e hopohopo nei iā ʻoe.

He nui nā hōʻailona a me nā hōʻailona o ka leukemia lymphocytic ʻoi aku ka nui e like me nā mea o ka maʻi flu. Eia naʻe, e hoʻomaikaʻi nā hōʻailona a me nā hōʻailona o ka maʻi flu. Inā ʻaʻole i hoʻomaikaʻi nā hōʻailona a me nā hōʻailona e like me ka mea i manaʻo ʻia, e hoʻomaka i kahi kūkā me kāu kauka.

Hoʻomaka ka leukemia lymphocytic ʻoi aku ka nui i ka wā e loaʻa ai i kahi cell iwi kuamoʻo nā loli (mutations) i kāna mea genetic a i ʻole DNA. Aia i loko o ka DNA o kahi cell nā ʻōlelo aʻo e haʻi aku i kahi cell i ka mea e hana ai. Ma ke ʻano maʻamau, e haʻi aku ka DNA i ka cell e ulu i kahi wikiwiki i hoʻonohonoho ʻia a make i kahi manawa i hoʻonohonoho ʻia. I ka leukemia lymphocytic ʻoi aku ka nui, e haʻi aku nā mutations i ka cell iwi kuamoʻo e hoʻomau i ka ulu ʻana a me ka mahele ʻana.

Ke hana ʻia kēia, e lilo ka hana ʻana o nā cell koko i mea ʻole. E hana ka iwi kuamoʻo i nā cell ʻōpiopio e ulu i nā cell keʻokeʻo leukemia i kapa ʻia ʻo lymphoblasts. ʻAʻole hiki i kēia mau cell maʻamau ke hana pono, a hiki iā lākou ke kūkulu a hoʻopiʻi i nā cell olakino.

ʻAʻole maopopo ka mea e hoʻokumu ai i nā mutations DNA e alakaʻi ai i ka leukemia lymphocytic ʻoi aku ka nui.

Nā kumu e hoʻonui ai paha i ka pilikia o ka leukemia lymphocytic ʻoi aku:

• Lapaʻau kanesa ma mua. Loaʻa paha i nā keiki a me nā mākua i loaʻa i kekahi mau ʻano chemotherapy a me ka radiation therapy no nā ʻano kanesa ʻē aʻe kahi pilikia nui e loaʻa ai ka leukemia lymphocytic ʻoi aku.
• Hōʻike ʻia i ka radiation. Loaʻa paha i nā kānaka i hōʻike ʻia i nā kiʻekiʻe kiʻekiʻe loa o ka radiation, e like me nā mea ola mai ka ulia o ka mea hana nuklea, kahi pilikia nui e loaʻa ai ka leukemia lymphocytic ʻoi aku.
• Nā maʻi genetic. Hoʻopili ʻia kekahi mau maʻi genetic, e like me ka Down syndrome, me kahi pilikia nui e loaʻa ai ka leukemia lymphocytic ʻoi aku.

Ho'ike o ka iwi kuamo'o Ho'onui i ke ki'i pani Ho'ike o ka iwi kuamo'o Ho'ike o ka iwi kuamo'o Ma ka huki'ana i ka iwi kuamo'o, ho'ohana ka limahana ola i ka nila lahilahi e lawe mai i kahi wai li'ili'i o ka iwi kuamo'o wai. Ho'okomo pinepine 'ia mai kahi ma hope o ka iwi 'ūhā, i kapa 'ia ho'i he pelvis. Hana pinepine 'ia ka biopsy iwi kuamo'o i ka manawa like. Ho'one'e kēia hana lua i kahi'āpana li'ili'i o ka'i'o iwi a me ka iwi kuamo'o i loko. Puncture lumbar, i'ike 'ia ho'i he spinal tap Ho'onui i ke ki'i pani Puncture lumbar, i'ike 'ia ho'i he spinal tap Puncture lumbar, i'ike 'ia ho'i he spinal tap I ka wā o ka puncture lumbar, i'ike 'ia ho'i he spinal tap, moe pinepine 'oe ma kou'ao'ao me kou mau kuli i huki 'ia i kou umauma. A laila ho'okomo 'ia ka nila i loko o ke kahawai spinal ma kou kua lalo e hō'ili'ili i ka wai cerebrospinal no ka ho'okolohua. Ho'okomo 'ia nā ho'okolohua a me nā ka'ina hana i ho'ohana 'ia e hō'ike i ka leukemia lymphocytic'ākau: Nā ho'okolohua koko. Hō'ike paha nā ho'okolohua koko i ka nui loa a i 'ole ka li'ili'i o nā ke'oke'o koko, 'a'ole lawa nā'ula'ula koko, a 'a'ole lawa nā platelets. Hō'ike paha ka ho'okolohua koko i ke alo o nā'ō'ō'ō blast - nā'ō'ō'ō'ō'ō'ō makua 'ole i loa'a ma'amau i loko o ka iwi kuamo'o. Ho'okolohua iwi kuamo'o. I ka wā o ka aspiration a me ka biopsy iwi kuamo'o, ho'ohana 'ia ka nila e lawe mai i kahi'āpana o ka iwi kuamo'o mai ka iwi 'ūhā a i 'ole ka iwi umauma. Ho'ouna 'ia ka'āpana i kahi lumi ho'okolohua no ka ho'okolohua e nānā i nā'ō'ō'ō leukemia. E ho'oka'ina nā kauka i loko o ka lumi ho'okolohua i nā ke'oke'o koko i nā'ano kūikawā ma muli o ko lākou nui,'ano, a me nā hi'ohi'ona genetic a molecular'ē a'e. Nānā pū lākou i nā loli i nā'ō'ō'ō ma'i'a'e a ho'oholo i ka ho'omaka 'ana o nā'ō'ō'ō leukemia mai nā lymphocytes B a i 'ole nā lymphocytes T. Kōkua kēia 'ike i kāu kauka e ho'omohala i kahi papa hana lapa'au. Nā ho'okolohua ki'i. Hiki i nā ho'okolohua ki'i e like me ka X-ray, ka computerized tomography (CT) scan a i 'ole ka ultrasound scan ke kōkua i ka ho'oholo 'ana i ka ho'olaha 'ana o ka ma'i'a'e i ka lolo a me ke kaula'ō'ō a i 'ole nā'āpana'ē a'e o ke kino. Ho'okolohua wai spinal. Hiki ke ho'ohana 'ia ka ho'okolohua puncture lumbar, i kapa 'ia ho'i he spinal tap, e hō'ili'ili i kahi'āpana o ka wai spinal - ka wai e ho'opuni ana i ka lolo a me ke kaula'ō'ō. Ho'okolohua 'ia ka'āpana e nānā inā ua ho'olaha 'ia nā'ō'ō'ō ma'i'a'e i ka wai spinal. Ke ho'oholo 'ana i kāu prognosis Ho'ohana kāu kauka i ka 'ike i hō'ili'ili 'ia mai kēia mau ho'okolohua a me nā ka'ina hana e ho'oholo ai i kāu prognosis a e ho'oholo ai i kāu mau koho lapa'au. Ho'ohana nā'ano ma'i'a'e'ē a'e i nā kahua helu e hō'ike i kahi i ho'olaha 'ia ai ka ma'i'a'e, akā 'a'ohe mau kahua o ka leukemia lymphocytic'ākau. Ma kahi o kēlā, ho'oholo 'ia ka ko'iko'i o kou kūlana e: Ke'ano o nā lymphocytes i komo - nā sela B a i 'ole nā sela T Nā loli genetic kūikawā i loa'a i loko o kāu mau'ō'ō'ō leukemia Kou mau makahiki Nā hopena mai nā ho'okolohua lumi ho'okolohua, e like me ka nui o nā ke'oke'o koko i'ike 'ia i loko o kahi'āpana koko Mālama ma Mayo Clinic Hiki i kā mākou hui mālama o nā po'e akamai Mayo Clinic ke kōkua iā 'oe me kāu mau pilikia olakino e pili ana i ka leukemia lymphocytic'ākau Ho'omaka maanei 'Ike hou aku Mālama leukemia lymphocytic'ākau ma Mayo Clinic Biopsy iwi kuamo'o CT scan Puncture lumbar (spinal tap) Ultrasound X-ray Hō'ike hou aku i nā'ike pili

Ma keʻano laulā, ʻo ka mālama ʻana no ka leukemia lymphocytic ʻoi aku ka nui o nā papa hana like ʻole:

• Ka mālama hoʻoikaika. I kapa ʻia hoʻi ʻo ka mālama ma hope o ka hoʻōla ʻana, ua manaʻo ʻia kēia papa hana e luku i kekahi leukemia i koe i loko o ke kino.
• Ka mālama mālama. ʻO ke kolu o ka papa hana e pale aku i ka ulu hou ʻana o nā sela leukemia. Hoʻohana pinepine ʻia nā mālama i kēia kahua ma nā nui haʻahaʻa loa ma kahi manawa lōʻihi, pinepine i nā makahiki.
• Ka mālama palekana i ke kīhāpai kua. I kēlā me kēia papa hana, hiki i nā poʻe me ka leukemia lymphocytic ʻoi aku ka nui ke loaʻa ka mālama hou aku e pepehi i nā sela leukemia i loaʻa i loko o ka ʻōnaehana nerve waena. I kēia ʻano mālama, hoʻokomo pinepine ʻia nā lāʻau chemotherapy pololei i loko o ka wai e uhi ana i ke kīhāpai kua.

Ma muli o kou kūlana, hiki i nā papa hana o ka mālama ʻana no ka leukemia lymphocytic ʻoi aku ka nui ke lōʻihi mai ʻelua a ʻekolu mau makahiki.

Hiki i nā mālama ke komo:

• Chemotherapy. Hoʻohana pinepine ʻia ka chemotherapy, kahi e hoʻohana ai i nā lāʻau e pepehi i nā sela kanesa, ma ke ʻano he mālama hoʻomaka no nā keiki a me nā mākua me ka leukemia lymphocytic ʻoi aku ka nui. Hiki ke hoʻohana ʻia nā lāʻau chemotherapy i nā papa hana hoʻoikaika a me ka mālama.
• Ka mālama i hoʻonohonoho ʻia. Ua nānā nā mālama lāʻau i hoʻonohonoho ʻia i nā hemahema kūikawā i loaʻa i loko o nā sela kanesa. Ma ka pale ʻana i kēia mau hemahema, hiki i nā mālama lāʻau i hoʻonohonoho ʻia ke hoʻopōʻino i nā sela kanesa. E ho'āʻo ʻia kāu mau sela leukemia e ʻike inā hiki ke kōkua ka mālama i hoʻonohonoho ʻia iā ʻoe. Hiki ke hoʻohana ʻia ka mālama i hoʻonohonoho ʻia me ka chemotherapy no ka mālama hoʻomaka, ka mālama hoʻoikaika, a i ʻole ka mālama mālama.
• Ka mālama radiation. Hoʻohana ka mālama radiation i nā kukuna mana kiʻekiʻe, e like me nā X-rays a i ʻole nā proton, e pepehi i nā sela kanesa. Inā ua pālahalaha nā sela kanesa i ka ʻōnaehana nerve waena, hiki i kāu kauka ke ʻōlelo aku i ka mālama radiation.
• Ka hoʻololi ʻana o ka iwi ʻiwi. Hiki ke hoʻohana ʻia ka hoʻololi ʻana o ka iwi ʻiwi, i ʻike ʻia hoʻi ʻo ka hoʻololi ʻana o nā sela kumu, ma ke ʻano he mālama hoʻoikaika a i ʻole no ka mālama ʻana i ka hoʻi hou ʻana inā loaʻa. Hāʻawi kēia kaʻina hana i kahi kanaka me ka leukemia e hoʻokumu hou i ka iwi ʻiwi olakino ma ka pani ʻana i ka iwi ʻiwi leukemia me ka iwi ʻiwi leukemia-ʻole mai kahi kanaka olakino.

Hoʻomaka ka hoʻololi ʻana o ka iwi ʻiwi me nā nui kiʻekiʻe o ka chemotherapy a i ʻole ka radiation e luku i kekahi iwi ʻiwi e hana ana i ka leukemia. A laila pani ʻia ka iwi ʻiwi e ka iwi ʻiwi mai kahi mea hāʻawi kūpono (hoʻololi allogeneic).

• Ke hoʻolālā ʻana i nā sela pale e hakakā i ka leukemia. ʻO ka mālama kūikawā i kapa ʻia ʻo ka chimeric antigen receptor (CAR)-T cell therapy e lawe i nā sela T pale kino o kou kino, hoʻolālā iā lākou e hakakā i ka kanesa a hoʻokomo hou iā lākou i loko o kou kino.

Hiki i ka CAR-T cell therapy ke lilo i koho no nā keiki a me nā ʻōpio. Hiki ke hoʻohana ʻia no ka mālama hoʻoikaika a i ʻole no ka mālama ʻana i ka hoʻi hou ʻana.

• Nā hoʻokolohua klinika. ʻO nā hoʻokolohua klinika nā hoʻokolohua e hoʻāʻo i nā mālama kanesa hou a me nā ala hou e hoʻohana ai i nā mālama i loaʻa. ʻOiai nā hoʻokolohua klinika e hāʻawi iā ʻoe a i kāu keiki i ka manawa e hoʻāʻo ai i ka mālama kanesa hou loa, hiki ke maopopo ʻole nā pono a me nā pilikia o ka mālama. E kūkākūkā i nā pono a me nā pilikia o nā hoʻokolohua klinika me kāu kauka.

Ka hoʻololi ʻana o ka iwi ʻiwi. Hiki ke hoʻohana ʻia ka hoʻololi ʻana o ka iwi ʻiwi, i ʻike ʻia hoʻi ʻo ka hoʻololi ʻana o nā sela kumu, ma ke ʻano he mālama hoʻoikaika a i ʻole no ka mālama ʻana i ka hoʻi hou ʻana inā loaʻa. Hāʻawi kēia kaʻina hana i kahi kanaka me ka leukemia e hoʻokumu hou i ka iwi ʻiwi olakino ma ka pani ʻana i ka iwi ʻiwi leukemia me ka iwi ʻiwi leukemia-ʻole mai kahi kanaka olakino.

Hoʻomaka ka hoʻololi ʻana o ka iwi ʻiwi me nā nui kiʻekiʻe o ka chemotherapy a i ʻole ka radiation e luku i kekahi iwi ʻiwi e hana ana i ka leukemia. A laila pani ʻia ka iwi ʻiwi e ka iwi ʻiwi mai kahi mea hāʻawi kūpono (hoʻololi allogeneic).

Ke hoʻolālā ʻana i nā sela pale e hakakā i ka leukemia. ʻO ka mālama kūikawā i kapa ʻia ʻo ka chimeric antigen receptor (CAR)-T cell therapy e lawe i nā sela T pale kino o kou kino, hoʻolālā iā lākou e hakakā i ka kanesa a hoʻokomo hou iā lākou i loko o kou kino.

Hiki i ka CAR-T cell therapy ke lilo i koho no nā keiki a me nā ʻōpio. Hiki ke hoʻohana ʻia no ka mālama hoʻoikaika a i ʻole no ka mālama ʻana i ka hoʻi hou ʻana.

ʻOi aku ka nui o nā pilikia mai nā mālama i nā mākua kahiko, e like me nā poʻe ma mua o 65 mau makahiki. A ʻoi aku ka maikaʻi ʻole o nā mākua kahiko ma mua o nā keiki i mālama ʻia no ka leukemia lymphocytic ʻoi aku ka nui.

E kūkākūkā i kāu mau koho me kāu kauka. Ma muli o kou olakino holoʻokoʻa a me kāu mau pahuhopu a me nā makemake, hiki iā ʻoe ke hoʻoholo e mālama i kāu leukemia.

Hiki i kekahi poʻe ke koho e haʻalele i ka mālama ʻana no ka kanesa, ma kahi o ka nānā ʻana i nā mālama e hoʻomaikaʻi i kā lākou mau hōʻailona a kōkua iā lākou e hana i ka manawa i koe iā lākou.

ʻAʻohe mālama ʻē aʻe i hōʻoia ʻia e hoʻōla i ka leukemia lymphocytic ʻoi aku ka nui. Akā hiki i kekahi mau lāʻau lapaʻau ʻē aʻe ke kōkua i ka hoʻomaha ʻana i nā hopena o ka mālama kanesa a hoʻoluʻolu iā ʻoe a i kāu keiki. E kūkākūkā i kāu mau koho me kāu kauka, ʻoiai hiki i kekahi mau mālama ʻē aʻe ke hoʻopilikia i nā mālama kanesa, e like me ka chemotherapy.

ʻO nā mālama ʻē aʻe e hiki ke hoʻomaha i nā hōʻailona:

• Acupuncture
• Hoʻoikaika kino
• Massage
• Meditation
• Nā hana hoʻomaha, me ka yoga a me ka tai chi

Hiki i ka mālama ʻana no ka leukemia lymphocytic ʻoi aku ka nui ke lilo i alanui lōʻihi. Pinepine ka mālama ʻana i ʻelua a ʻekolu mau makahiki, ʻoiai ʻo nā mahina mua ka ikaika loa.

I nā papa hana mālama, hiki i nā keiki ke ola i kahi ola maʻamau a hoʻi i ke kula. A hiki i nā mākua ke hoʻomau i ka hana. No ke kōkua ʻana iā ʻoe e hoʻomanawanui, e ho'āʻo e:

• E aʻo i ka lawa e pili ana i ka leukemia e ʻoluʻolu i ka hana ʻana i nā hoʻoholo mālama. E noi i kāu kauka e kākau i ka nui o ka ʻike e pili ana i kāu maʻi kūikawā. A laila hoʻonui i kāu huli ʻana no ka ʻike e like me ia.

E kākau i nā nīnau āu e makemake ai e nīnau i kāu kauka ma mua o kēlā me kēia hālāwai, a e ʻimi i ka ʻike ma kāu waihona puke kūloko a ma ka pūnaewele. ʻO nā kumu maikaʻi ke National Cancer Institute, ka American Cancer Society, a me ka Leukemia & Lymphoma Society.

• E ʻimi i nā papahana no nā keiki me ka kanesa. Hāʻawi nā kikowaena lapaʻau nui a me nā hui waiwai ʻole i nā hana a me nā lawelawe he nui no nā keiki me ka kanesa a me ko lākou mau ʻohana. ʻO nā laʻana nā kahua hoʻomoana kauwela, nā hui kākoʻo no nā kaikuaʻana a me nā papahana hāʻawi makemake. E noi i kāu hui mālama ola e pili ana i nā papahana ma kou wahi.
• E kōkua i nā ʻohana a me nā hoaaloha e hoʻomaopopo i kou kūlana. E hoʻonohonoho i kahi pūnaewele pilikino manuahi ma ka pūnaewele waiwai ʻole ʻo CaringBridge. Hāʻawi kēia iā ʻoe e haʻi i ka ʻohana holoʻokoʻa e pili ana i nā hālāwai, nā mālama, nā pilikia a me nā kumu e hoʻolauleʻa ai - me ka ʻole o ke kaumaha o ke kāhea ʻana i nā mea a pau i kēlā me kēia manawa he mea hou e hōʻike.

E aʻo i ka lawa e pili ana i ka leukemia e ʻoluʻolu i ka hana ʻana i nā hoʻoholo mālama. E noi i kāu kauka e kākau i ka nui o ka ʻike e pili ana i kāu maʻi kūikawā. A laila hoʻonui i kāu huli ʻana no ka ʻike e like me ia.

E kākau i nā nīnau āu e makemake ai e nīnau i kāu kauka ma mua o kēlā me kēia hālāwai, a e ʻimi i ka ʻike ma kāu waihona puke kūloko a ma ka pūnaewele. ʻO nā kumu maikaʻi ke National Cancer Institute, ka American Cancer Society, a me ka Leukemia & Lymphoma Society.

Hiki ke lōʻihi ke ala o ka mālama ʻana i ka leukemia lymphocytic ʻoi aku ka nui. Hoʻomau pinepine ka mālama ʻana i ʻelua a ʻekolu paha makahiki, ʻoiai ʻo nā mahina mua ka ikaika loa. I nā wā mālama, hiki i nā keiki ke ola maʻamau a hoʻi i ke kula. A hiki paha i nā mākua ke hoʻomau i ka hana. No ke kōkua ʻana iā ʻoe e kūpaʻa, e ho'āʻo e: E aʻo lawa e pili ana i ka leukemia e ʻoluʻolu ai ʻoe i ka hoʻoholo ʻana i ka mālama. E noi i kāu kauka e kākau i ka nui o ka ʻike e pili ana i kou maʻi kūikawā. A laila e ho'emi i kāu huli ʻana i ka ʻike. E kākau i nā nīnau āu e makemake ai e nīnau i kāu kauka ma mua o kēlā me kēia hālāwai, a e ʻimi i ka ʻike ma kāu waihona puke kūloko a ma ka pūnaewele. ʻO nā kumu maikaʻi e komo pū ai ka National Cancer Institute, ka American Cancer Society, a me ka Leukemia & Lymphoma Society. E hilinaʻi i kāu hui mālama ola holoʻokoʻa. Ma nā kikowaena lapaʻau nui a me nā kikowaena kanesa pediatric, hiki i kāu hui mālama ola ke komo pū me nā psychologists, psychiatrists, recreation therapists, nā limahana ola keiki, nā kumu, nā dietitians, nā kahuna pule a me nā limahana pilikanaka. Hiki i kēia mau loea ke kōkua i kahi hui o nā pilikia, me ka wehewehe ʻana i nā kaʻina hana i nā keiki, ka loaʻa ʻana o ke kākoʻo kālā a me ka hoʻonohonoho ʻana no ka hale noho i ka wā mālama. Mai kānalua e hilinaʻi i ko lākou akamai. E ʻimi i nā papahana no nā keiki me ka kanesa. Hāʻawi nā kikowaena lapaʻau nui a me nā hui waiwai ʻole i nā hana a me nā lawelawe he nui no nā keiki me ka kanesa a me ko lākou mau ʻohana. ʻO nā laʻana e komo pū ai nā kahua hoʻomoana kauwela, nā hui kākoʻo no nā kaikuaʻana a me nā papahana hāʻawi makemake. E nīnau i kāu hui mālama ola e pili ana i nā papahana ma kou wahi. E kōkua i nā ʻohana a me nā hoaaloha e hoʻomaopopo i kou kūlana. E hoʻonohonoho i kahi ʻaoʻao pūnaewele pilikino manuahi ma ka pūnaewele waiwai ʻole ʻo CaringBridge. Hāʻawi kēia iā ʻoe e haʻi i ka ʻohana holoʻokoʻa e pili ana i nā hālāwai, nā mālama, nā pilikia a me nā kumu e hoʻolauleʻa ai - me ka ʻole o ke kaumaha o ke kāhea ʻana i nā mea a pau i kēlā me kēia manawa he mea hou e hōʻike ai.