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ʻO ka Bacillus o Calmette a me Guerin (BCG) vaccine live intravesical route he lapaʻau maʻi ʻaʻai ʻōpū kūikawā e hoʻohana ana i kahi ʻano nāwaliwali o ka bacteria e kōkua i kāu ʻōnaehana pale e hakakā i nā sela maʻi ʻaʻai. ʻAʻole like kēia me ka BCG vaccine i hoʻohana ʻia no ka pale ʻana i ka maʻi tuberculosis - ua hoʻolālā kūikawā ʻia e waiho pololei i loko o kou ʻōpū ma o ka catheter. Ke kōkua nei kēia lapaʻau i ka poʻe me kekahi mau ʻano maʻi ʻaʻai ʻōpū no nā makahiki he nui, a ke hana nei ia ma ka hoʻomaʻamaʻa ʻana i nā pale kūlohelohe o kou kino e ʻike a hoʻouka i nā sela maʻi ʻaʻai me ka maikaʻi.
ʻO ka BCG vaccine live intravesical route he lāʻau lapaʻau bacteria ola, nāwaliwali e waiho pololei nā kauka i loko o kou ʻōpū e mālama i ka maʻi ʻaʻai ʻōpū. ʻO ka huaʻōlelo
Hoʻohana nui ʻia ka lāʻau lapaʻau BCG ola intravesical e mālama i ka maʻi ʻaʻai ʻōpū ʻaʻole e komo i ka ʻiʻo, ʻoiai ma hope o ka hana ʻana e wehe i nā ʻōpū i ʻike ʻia. Kōkua kēia lapaʻau i ka pale ʻana i ka maʻi ʻaʻai mai ka hoʻi ʻana mai a hiki i kekahi manawa ke mālama i ka maʻi ʻaʻai i hiki ʻole ke wehe ʻia i ka wā o ka hana.
Hiki i kāu kauka ke ʻōlelo i kēia lapaʻau inā loaʻa iā ʻoe ka maʻi ʻaʻai ʻōpū kiʻekiʻe a i ʻole carcinoma in situ (CIS), he ʻano maʻi ʻaʻai ʻōpū mua e noho ana ma ka ʻili akā hiki ke ʻino. He mea kōkua nui ka lāʻau lapaʻau BCG no ka poʻe i loaʻa i ka maʻi ʻaʻai i ka manawa kiʻekiʻe e hoʻi mai a i ʻole e laha hohonu i loko o ka paia ʻōpū.
I kekahi manawa, hoʻohana nā kauka i ka lāʻau lapaʻau BCG no ka poʻe i loaʻa i nā ʻōpū ʻōpū he nui a i ʻole i hoʻi mai ka maʻi ʻaʻai ma hope o ka lapaʻau mua. Hiki i kēia lapaʻau ke hōʻemi nui i kou pilikia o ka hoʻi hou ʻana o ka maʻi ʻaʻai ke hoʻohana ʻia ma ke ʻano he ʻāpana o kahi hoʻolālā lapaʻau piha.
Hana ka lāʻau lapaʻau BCG ma ka hana ʻana i kahi pane immune i mālama ʻia ma kou ʻōpū, e aʻo ana i kou kino e ʻike a luku i nā pūnaewele maʻi ʻaʻai. Ke pili nā bacteria nāwaliwali me kou ʻili ʻōpū, hoʻomaka lākou i kāu ʻōnaehana immune e hoʻouna i nā pūnaewele e hakakā ana i ka maʻi i ka wahi.
He ikaika loa a kuhikuhi ʻia kēia pane immune. ʻAʻole hakakā maoli nā bacteria i ka maʻi ʻaʻai iā lākou iho - akā, hana lākou e like me kahi papahana hoʻomaʻamaʻa no kāu ʻōnaehana immune. Aʻo nā pale kūlohe o kou kino e ʻike i nā pūnaewele maʻi ʻaʻai ma ke ʻano he poʻe komo malihini a hana e hoʻopau iā lākou.
Hoʻokumu ka lapaʻau i ka mumū i loko o kou ʻōpū, kahi mea e hopohopo ai, akā ʻo kēia mumū ka hopena i makemake ʻia. Lawe mai ia i nā pūnaewele immune i ka ʻili ʻōpū kahi e hiki ai iā lākou ke ʻimi a luku i nā pūnaewele maʻi ʻaʻai i koe i liʻiliʻi loa e ʻike a wehe ʻia i ka wā o ka hana.
Ua manaʻo ʻia ka lāʻau BCG he lāʻau lapaʻau ikaika waena e hiki ke maikaʻi loa, akā pono nō hoʻi e hana maikaʻi kāu ʻōnaehana pale. Aia ka ikaika o kēia lāʻau lapaʻau i kona hiki ke hana i kahi hoʻomanaʻo pale mau loa e kūʻē i nā sela maʻi maʻi ʻōpū.
Hāʻawi pololei ʻia ka BCG vaccine live intravesical route i loko o kou ʻōpū ma o kahi paipu lahilahi a maʻalahi i kapa ʻia he catheter. ʻAʻole ʻoe e lawe i kēia lāʻau lapaʻau ma ka waha a i ʻole ka injection - ua waiho ʻia ma kahi e pono ai e hana. Hana mau ʻia ka lāʻau lapaʻau i loko o kahi hoʻonohonoho mālama ola e nā poʻe loea i hoʻomaʻamaʻa ʻia.
Ma mua o kāu lāʻau lapaʻau, pono ʻoe e kaupalena i kāu inu wai no kahi o 4 mau hola i ʻole e piha loa kou ʻōpū. E hoʻokomo kāu hui mālama ola i kahi catheter ma kou urethra (ka paipu āu e mimi ai ma o) a i loko o kou ʻōpū. A laila, hoʻokomo mālie ʻia ka hopena BCG i loko o kou ʻōpū ma o kēia catheter.
Ma hope o ka loaʻa ʻana o ka lāʻau lapaʻau, pono ʻoe e paʻa i ka lāʻau lapaʻau i loko o kou ʻōpū no kahi o 2 mau hola inā hiki. I kēia manawa, e noi ʻia paha ʻoe e hoʻololi i nā kūlana i kēlā me kēia 15-30 mau minuke e kōkua i ka lāʻau lapaʻau e uhi i nā wahi a pau o kou ʻōpū. Nui ka poʻe i ʻike he mea kōkua ke hoʻonohonoho i nā mea hoʻomanaʻo mālie a i ʻole e lawe mai i kekahi mea e noho ai i ko lākou manawa i kēia manawa kali.
I ka manawa e mimi ai, pono ʻoe e noho i lalo (me ka nānā ʻole i kāu mau hana maʻamau) a mimi pololei i loko o ka lua. No nā hola 6 mua ma hope o ka lāʻau lapaʻau, e hoʻohui ʻoe i kahi 2 kīʻaha o ka bleach hale i ka lua ma mua o ka holoi ʻana e hoʻopau i nā bacteria i koe.
ʻO ka maʻamau, hahai ka lāʻau BCG i kahi papa manawa kikoʻī e hoʻopilikino ai kāu kauka ma muli o kou kūlana. Hoʻomaka ka hapa nui o ka poʻe me kahi papa mua o 6 mau lāʻau lapaʻau i kēlā me kēia pule, e kōkua ana i ka hoʻokumu ʻana i ka pane pale i loko o kou ʻōpū.
Ma hope o ka pau ʻana o ka papa mua he 6 pule, nui ka poʻe e hoʻomau me ka mālama mālama. ʻO ka mea maʻamau e pili ana i ka loaʻa ʻana o nā lapaʻau BCG i nā manawa 3 mahina no ka lōʻihi o 3 mau makahiki, akā pili ka papa hana pololei i ka maikaʻi o kāu pane ʻana i ka lapaʻau a me kou olakino holoʻokoʻa.
E nānā kāu kauka i kou holomua me nā hoʻokolohua cystoscopy maʻamau (kahi e nānā ai lākou i loko o kou ʻōpū me kahi kamera liʻiliʻi) a hiki ke hoʻoponopono i kāu papa hana lapaʻau e pili ana i kā lākou mea e ʻike ai. Pono kekahi poʻe i nā papa pōkole, aʻo nā mea ʻē aʻe e pōmaikaʻi mai nā manawa lapaʻau lōʻihi.
Hoʻohui ka lōʻihi o ka lapaʻau i ka pono me ka hiki ke ʻae ʻia. Hiki i nā papa lapaʻau lōʻihi ke hāʻawi i ka pale maikaʻi ʻana i ka hoʻi hou ʻana o ka maʻi kanesa, akā hoʻonui pū lākou i ka manawa o nā hopena ʻaoʻao. E hana pū kāu hui mālama ola me ʻoe e ʻimi i ke kaulike kūpono no kou kūlana.
Hiki i ka BCG vaccine live intravesical route ke hana i nā hopena ʻaoʻao no ka mea ua hoʻolālā ʻia e hana i kahi pane immune i loko o kou ʻōpū. ʻO ka hapa nui o nā hopena ʻaoʻao e pili ana i ka huhū o ka ʻōpū a hiki ke mālama ʻia, akā hiki i kekahi poʻe ke ʻike i nā hopena nui.
Hiki i ka hoʻomaopopo ʻana i ka mea e manaʻo ai ke kōkua iā ʻoe e mākaukau a ʻike i ka manawa e hoʻokaʻaʻike aku ai i kāu hui mālama ola. Eia nā hopena ʻaoʻao maʻamau e ʻike ai ʻoe:
Hoʻomaka pinepine kēia mau hopena ʻaoʻao i loko o kekahi mau hola o ka mālama ʻana a hiki ke mau no 2-3 mau lā. ʻIke ka hapa nui o nā kānaka e lilo nā hōʻailona i mea hiki ke mālama ʻia i ka wā e hoʻoponopono ai ko lākou kino i ka lāʻau lapaʻau i nā pule he nui.
ʻO nā hopena ʻaoʻao liʻiliʻi akā ʻoi aku ka koʻikoʻi e koi i ka lāʻau lapaʻau koke. ʻOiai ʻaʻole kēia e hana i ka hapa nui o nā kānaka, he mea nui e ʻike iā lākou:
Hiki i nā pilikia kakaʻikahi akā koʻikoʻi ke komo i ka maʻi BCG e laha ana ma waho o ka ʻōpū, e koi ana i ka lāʻau lapaʻau koke me nā lāʻau anti-tuberculosis. ʻAʻole maʻamau kēia akā hiki ke koʻikoʻi inā ʻaʻole ʻike ʻia a mālama koke ʻia.
E nānā pono kāu hui mālama ola iā ʻoe no nā hōʻailona o nā pilikia a e hāʻawi iā ʻoe i nā ʻōlelo maopopo e pili ana i ka manawa e kāhea ai i ke kōkua. Hoʻomanawanui ka hapa nui o nā kānaka i ka lāʻau lapaʻau BCG, a ʻoi aku ka liʻiliʻi o nā hopena ʻaoʻao i ka wā e hoʻomau ai ka mālama ʻana.
ʻAʻole kūpono ka BCG vaccine live intravesical route no nā mea a pau, ʻo nā kānaka me nā ʻōnaehana pale nāwaliwali a i ʻole kekahi mau maʻi. No ka mea, pili kēia lāʻau lapaʻau i kāu ʻōnaehana pale e hana pono ai, he mea nui e hiki i kou kino ke mālama i ka pilikia bacterial me ka palekana.
ʻAʻole pono ʻoe e loaʻa i ka lāʻau lapaʻau BCG inā loaʻa iā ʻoe kekahi maʻi maʻi a i ʻole nā hōʻailona o ka maʻi. Makemake kāu hui mālama ola e hōʻoia e maikaʻi ana ʻoe ma mua o kēlā me kēia lāʻau lapaʻau e hōʻemi i ka pilikia o nā pilikia.
He nui nā maʻi e hoʻolilo ai i ka lāʻau BCG i mea palekana ʻole a i ʻole ʻaʻole pono. Aia kēia mau mea i nā kūlana kahi e pane ʻole ai kou ʻōnaehana pale:
Hiki i kekahi mau lāʻau lapaʻau ke hoʻolilo i ka lāʻau BCG i mea kūpono ʻole. E nānā kāu kauka i kāu mau lāʻau lapaʻau a pau, me nā lāʻau lapaʻau i kau ʻia, nā lāʻau lapaʻau i kūʻai ʻia, a me nā mea hoʻohui, e hōʻoia ʻaʻole lākou e keakea i ka lāʻau lapaʻau.
ʻAʻole pono ka poʻe e lawe ana i nā lāʻau antibiotic e hakakā ana i ka bacteria tuberculosis e loaʻa i ka lāʻau BCG, no ka mea, hiki i kēia mau lāʻau lapaʻau ke pepehi i ka bacteria vaccine ma mua o ka hiki iā lākou ke hana. Pēlā nō, hiki i kekahi mau lāʻau lapaʻau e hoʻopau ana i ka pale ke pale i ka BCG mai ka hana pono ʻana.
E loiloi pono kāu hui mālama ola i kāu mōʻaukala olakino a me ke kūlana olakino i kēia manawa ma mua o ka ʻōlelo ʻana i ka lāʻau BCG. E kūkākūkā pū lākou i nā lāʻau lapaʻau ʻē aʻe inā ʻaʻole kūpono ka BCG iā ʻoe.
Loaʻa ka lāʻau BCG live intravesical route ma lalo o nā inoa inoa like ʻole, ʻo ka mea maʻamau ʻo TICE BCG a me PACIS. Loaʻa i kēia mau hōʻailona like ʻole ke ʻano like o ka bacteria nāwaliwali akā he ʻokoʻa iki paha i ke ʻano o ka hoʻomākaukau ʻana a i ʻole ka mālama ʻana.
ʻO TICE BCG kekahi o nā ʻano i hoʻohana nui ʻia ma ʻAmelika Hui Pū ʻIa a ua kōkua i ka poʻe me ka maʻi ʻaʻai ʻōpū no nā makahiki he nui. ʻO PACIS kekahi hōʻailona i hoʻokumu ʻia e hana like me TICE BCG.
Na kāu hui mālama ola e koho i ka brand kikoʻī ma muli o ka loaʻa, ko lākou ʻike me ka huahana, a me kou pono pilikino. Hoʻokō nā lāʻau lapaʻau BCG i ʻae ʻia no ka hoʻohana intravesical i nā kūlana palekana a me ka pono, no laila hiki iā ʻoe ke manaʻoʻiʻo i ka brand a kāu kauka e ʻōlelo ai.
Inā ʻaʻole kūpono ka lāʻau BCG iā ʻoe a i ʻole ʻaʻole hana pono, hiki i nā lāʻau lapaʻau ʻē aʻe ke kōkua i ka mālama ʻana i ka maʻi ʻaʻai ʻōpū. E noʻonoʻo kāu kauka i kou kūlana kikoʻī, me ke ʻano a me ke kahua o kāu maʻi ʻaʻai, kou olakino holoʻokoʻa, a me kāu mau pahuhopu lapaʻau.
Hiki ke waiho pololei ʻia nā lāʻau lapaʻau intravesical ʻē aʻe i loko o ka ʻōpū e like me BCG. Aia kēia mau mea i nā lāʻau chemotherapy e like me mitomycin C a i ʻole gemcitabine, e hana ʻokoʻa ana ma mua o BCG ma ka hoʻouka pololei ʻana i nā sela maʻi ʻaʻai ma mua o ka hoʻoulu ʻana i kou ʻōnaehana pale.
No ka poʻe i hiki ʻole ke ʻae i nā lāʻau lapaʻau intravesical, he koho paha nā lāʻau lapaʻau systemic. Aia kēia mau mea i nā lāʻau immunotherapy hou e hana ana ma kou kino a pau, ʻoiai ua mālama ʻia lākou no nā hihia holomua.
I kekahi manawa, pono nā koho ʻoki, ʻoiai inā ʻaʻole i kūpono nā lāʻau lapaʻau ʻē aʻe. Hiki ke loli kēia mau mea mai nā ʻoki ʻōpū nui aʻe i ka wehe ʻana i ka ʻōpū piha me ke kūkulu hou ʻana, ma muli o kou kūlana kikoʻī.
E kūkākūkā kāu hui mālama ola i nā koho i loaʻa iā ʻoe, me ka noʻonoʻo ʻana i ka pono o nā lāʻau lapaʻau like ʻole a me ko lākou hopena i kou maikaʻi o ke ola. ʻO ka pahuhopu ka loaʻa ʻana o ke ala e hāʻawi iā ʻoe i ka manawa maikaʻi loa o ka mālama ʻana i kāu maʻi ʻaʻai me ka mālama ʻana i kou hōʻoluʻolu a me kou olakino.
He maikaʻi nā lāʻau lapaʻau BCG vaccine live intravesical route a me mitomycin C no ka mālama ʻana i ka maʻi ʻaʻai o ka ʻōpū, akā hana lākou ma nā ʻano like ʻole a ʻoi aku paha ka maikaʻi no nā kānaka like ʻole. ʻOi aku ka maikaʻi o ka BCG no ka pale ʻana i ka hoʻi ʻana mai o ka maʻi ʻaʻai i nā hihia pilikia nui, a ʻoi aku paha ka maikaʻi o ka mitomycin C no ka poʻe i hiki ʻole ke ʻae i ka BCG a i ʻole nā maʻi olakino.
Hōʻike ka noiʻi ʻoi aku ka maikaʻi o ka BCG ma mua o ka mitomycin C no ka pale ʻana i ka maʻi ʻaʻai o ka ʻōpū mai ka hoʻi ʻana mai, ʻoiai no ka poʻe me nā maʻi ʻaʻai kiʻekiʻe a i ʻole carcinoma in situ. Hiki i ka lāʻau lapaʻau BCG ke hōʻemi i ka pilikia o ka hoʻi ʻana mai o ka maʻi ʻaʻai ma kahi o 30-40% i hoʻohālikelike ʻia me ka mitomycin C i kēia mau kūlana pilikia kiʻekiʻe.
Eia naʻe, ʻoi aku ka nui o nā hopena ʻaoʻao o ka lāʻau lapaʻau BCG ma mua o ka mitomycin C no ka mea e hana ana i kahi pane immune ikaika. ʻO ka poʻe i loaʻa nā hopena ʻaoʻao nui me ka BCG e ʻike paha i ka mitomycin C i ʻoi aku ka maikaʻi, ʻoiai ʻaʻole paha ia e like me ka maikaʻi i ka pale ʻana i ka hoʻi ʻana mai.
Aia ke koho ma waena o kēia mau lāʻau lapaʻau i nā mea he nui me nā ʻano o kāu maʻi ʻaʻai, kou olakino holoʻokoʻa, kou hiki ke ʻae i nā hopena ʻaoʻao, a me kāu mau makemake pilikino. E kōkua kāu oncologist iā ʻoe e hoʻomaopopo i ke koho e hana maikaʻi loa no kāu kūlana.
Hiki ke hoʻohana palekana ʻia ka BCG vaccine live intravesical route i ka poʻe me ka maʻi diabetes, akā pono e mālama pono ʻia kāu kaohi kō koko ma mua o ka mālama ʻana. Hiki i ka maʻi diabetes ke hoʻopilikia i ka hiki o kāu ʻōnaehana immune ke pane i nā maʻi, no laila e makemake kāu hui mālama ola e hōʻoia i ka paʻa o kāu maʻi diabetes.
Inā mālama maikaʻi ʻia kāu maʻi diabetes, ʻaʻole pono ka lāʻau lapaʻau BCG e hoʻopilikia nui i kāu pae kō koko. Eia naʻe, hiki i ke koʻikoʻi o ka mālama ʻana a me nā hopena ʻaoʻao e like me ke kuni a i ʻole ka emi ʻana o ka ʻai ke hoʻopilikia i kāu mālama ʻana i ka maʻi diabetes.
E hana pū paha kāu kauka me kāu hui mālama maʻi diabetes e nānā pono i kou kōpaʻa koko i ka wā o ka mālama BCG. Hiki nō hoʻi iā lākou ke ʻōlelo aku e hoʻoponopono i kāu mau lāʻau lapaʻau diabetes inā pono e noʻonoʻo i nā loli e pili ana i ka mālama ʻana i kāu ʻai a i ʻole nā hana.
Inā loaʻa iā ʻoe ka nui o ka lāʻau BCG, e hoʻokaʻaʻike koke i kāu mea mālama ola, ʻoiai inā maikaʻi ʻoe. ʻOiai ʻaʻole maʻamau ka overdose me ka intravesical BCG no ka mea e hāʻawi ʻia ka mālama ʻana i kahi hoʻonohonoho lapaʻau i mālama ʻia, hiki i ka loaʻa ʻana o ka nui ke hoʻonui i kou pilikia o nā hopena ʻaoʻao koʻikoʻi.
ʻO nā hōʻailona e loaʻa paha iā ʻoe ka nui o ka BCG e pili ana i nā hōʻailona e like me ka maʻi flu, ke kuni kiʻekiʻe loa, a i ʻole nā hōʻailona ʻōpū e ʻoi aku ka maikaʻi ma mua o ka mea i manaʻo ʻia. Mai kali e ʻike inā e ulu nā hōʻailona - ʻoi aku ka maikaʻi o ka hoʻokaʻaʻike koke ʻana i kāu hui mālama ola.
Hiki i kāu kauka ke ʻōlelo aku i ka nānā ʻana hou aku, nā lāʻau lapaʻau e hōʻemi i nā hopena ʻaoʻao, a i ʻole, i nā hihia kakaʻikahi, nā lāʻau antibiotic e hana ana i ka maʻi bacteria tuberculosis. ʻO ke kī ka loaʻa ʻana o ka lāʻau lapaʻau wikiwiki i hiki ke pale ʻia a mālama ʻia paha nā pilikia hiki ke hiki.
Inā hala ʻoe i kahi mālama BCG i hoʻonohonoho ʻia, e hoʻokaʻaʻike i kāu mea mālama ola i ka hiki wawe e hoʻonohonoho hou. Mai ho'āʻo e hoʻoponopono i ka mahele i hala ma ka pāpālua ʻana i kāu mālama ʻana e hiki mai ana - hiki i kēia ke pilikia a ʻaʻole e hoʻomaikaʻi i ka pono o kāu therapy.
E hoʻoholo kāu kauka i ke ala maikaʻi loa e hoʻihoʻi ai i kāu mālama ʻana. I kekahi manawa, ʻo ia hoʻi ka hoʻonohonoho hou ʻana i kāu mahele i hala no ka manawa i loaʻa. I nā manawa ʻē aʻe, pono paha i kāu kauka e hoʻoponopono i kāu papa hana lapaʻau holoʻokoʻa.
ʻAʻole pinepine ka nalo ʻana o hoʻokahi mahele i ka hopena nui i ka pono o kāu lapaʻau, akā he mea nui e hoʻopau i ka papa piha e like me ka mea i kauoha ʻia. Hoʻomaopopo kāu hui mālama ola i ka mea e hana nei ke ola, a e hana pū me ʻoe e ʻimi i kahi papa hana e kūpono i kou kūlana.
Pono ʻoe e hooki i ka lapaʻau BCG ke haʻi aku kāu kauka iā ʻoe he palekana ke hana pēlā. Aia ka hoʻoholo e hooki i ka lapaʻau i ka maikaʻi o kāu pane ʻana, ka mea e hōʻike ai kāu mau hoʻokolohua ma hope, a inā paha e ʻike nei ʻoe i nā hopena ʻaoʻao koʻikoʻi.
Hoʻopau ka hapa nui o nā kānaka i kā lākou papa i kauoha ʻia o ka lāʻau BCG, kahi e pili ana i ka moʻo 6-wiki mua a pinepine i nā lapaʻau mālama no 1-3 mau makahiki. E hoʻohana kāu kauka i nā hoʻokolohua cystoscopy maʻamau a me nā hoʻokolohua ʻē aʻe e nānā i kāu holomua a e hoʻoholo i ka manawa kūpono e hooki i ka lapaʻau.
Inā ʻoe e ʻike nei i nā hopena ʻaoʻao koʻikoʻi e paʻakikī ai ka lapaʻau e ʻae ʻia, hiki i kāu kauka ke ʻōlelo e hooki i ka BCG i ka wā mua a hoʻololi i kahi lapaʻau ʻē aʻe. Eia naʻe, pono e hana mau kēia hoʻoholo me kāu hui mālama ola, e noʻonoʻo ana i nā pilikia a me nā pōmaikaʻi o ka hoʻomau ʻana i ka lapaʻau.
Hiki iā ʻoe ke hoʻomau i ka hana moe kolohe ma hope o ka lapaʻau BCG, akā aia kekahi mau mea palekana nui e pono e hoʻomanaʻo. No nā hola 48 mua ma hope o kēlā me kēia lapaʻau, pono ʻoe e pale i ka hana moe kolohe e pale ai i ka hoʻouna ʻana i ka bacteria vaccine i kāu hoa.
Ma hope o ka manawa 48-hola mua, palekana ka hana moe kolohe, ʻoiai paha e ʻike ʻoe e hana ana nā hōʻailona hoʻonāukiuki ʻana i ka ʻōpū i mea hōʻoluʻolu ʻole. Hiki i ka hoʻohana ʻana i ka lubrication ke kōkua inā ʻoe e ʻike i ka maloʻo a i ʻole ka huhū, a he mea nui ka kamaʻilio ʻana me kāu hoa e pili ana i kekahi hōʻoluʻolu ʻole.
Inā e ʻike ana ʻoe i nā hōʻailona koʻikoʻi o ka ʻōpū mimi e like me ka ʻeha, ke kuni, a i ʻole ka mimi pinepine, e ʻoluʻolu paha ʻoe e kali a hiki i ka wā e hoʻomaikaʻi ai kēia mau hōʻailona ma mua o ka hoʻomau ʻana i ka hana moe kolohe. Hiki i kāu hui mālama ola ke hāʻawi i ke alakaʻi kikoʻī e pili ana i kou kūlana a me nā hōʻailona.