He aha ka Brachytherapy? Ke Kumu, ke Kaʻina Hana & nā Hopena

ʻO ka Brachytherapy kekahi ʻano o ka lāʻau lapaʻau radiation e waiho pololei ana i nā kumu radioactive i loko a i ʻole kokoke loa i ka wahi e mālama ʻia nei. ʻAʻole like me ka radiation waho e hele ana ma kou ʻili mai nā mīkini o waho, hāʻawi kēia lapaʻau i ka radiation i hoʻopaʻa ʻia mai loko mai o kou kino. Hoʻohana pinepine ʻia ia no nā maʻi ʻaʻai o ka prostate, cervix, umauma, a me nā wahi ʻē aʻe kahi e hiki ai i ka pahuhopu pololei ke hana i kahi ʻokoʻa maoli i ka hopena o kāu lapaʻau.

He aha ka brachytherapy?

Hana ʻo Brachytherapy ma ka hoʻonoho ʻana i nā hua radioactive liʻiliʻi, nā uea, a i ʻole nā mea noi pololei ma ke kahua tumora. Hāʻawi kēia ala i nā kauka e hāʻawi i kahi kiʻekiʻe o ka radiation ma kahi e pono ai me ka pale ʻana i nā ʻiʻo olakino kokoke. No ka ʻōlelo Helene mai ka huaʻōlelo "brachy", ʻo ia hoʻi "ka mamao pōkole," e wehewehe pono ana i ka hana ʻana o kēia lapaʻau.

Aia nā ʻano nui ʻelua e hiki iā ʻoe ke hālāwai. Hāʻawi ka brachytherapy kiʻekiʻe (HDR) i ka radiation me ka wikiwiki ma o nā mea kanu manawa e wehe ʻia ma hope o kēlā me kēia kau. Hoʻohana ka brachytherapy haʻahaʻa (LDR) i nā mea kanu mau e hoʻokuʻu mālie i ka radiation ma luna o nā pule a i ʻole nā mahina a hiki i ka wā e lilo ai lākou i mea ʻole.

Na kāu kauka oncologist radiation e hoʻoholo i ke ʻano e hana maikaʻi loa ai no kāu ʻano maʻi maʻi, kahi, a me ke olakino holoʻokoʻa. Aia ke koho i nā mea e like me ka nui o ka tumora, kou anatomy, a me ke ʻano o kou kino e pane ai i nā papa hana radiation like ʻole.

No ke aha e hana ʻia ai ka brachytherapy?

Hāʻawi ʻo Brachytherapy i nā mea maikaʻi he nui e lilo ai i koho maikaʻi loa no nā maʻi maʻi maʻi he nui. ʻO ka pololei o ka hāʻawi ʻana i ka radiation kūloko, ʻo ia hoʻi, hiki i nā mea kiʻekiʻe ke hiki palekana i nā cell maʻi ʻaʻai me ka hōʻemi ʻana i ka pōʻino i nā ʻōkana olakino a puni. ʻO kēia ala i hoʻopaʻa ʻia e alakaʻi pinepine i nā hopena lapaʻau maikaʻi me ka liʻiliʻi o nā hopena ʻaoʻao i hoʻohālikelike ʻia me ka radiation waho wale nō.

Hiki i kāu kauka ke ʻōlelo aku i ka brachytherapy inā loaʻa iā ʻoe kekahi mau ʻano maʻi maʻi e pane maikaʻi ana i kēia ʻano lapaʻau. Eia nā kūlana maʻamau kahi e hōʻoia ai kēia ʻano lapaʻau:

• Ka maʻi maʻi prostate, ʻoiai ka maʻi maʻi mua kahi e hiki ai ke waiho mau ʻia nā hua
• Ka maʻi maʻi cervical, kahi e hiki ai i nā mea noi ke hāʻawi i ka radiation pololei i ka cervix a me nā ʻiʻo a puni
• Ka maʻi maʻi umauma, ʻoiai ma hope o ka lumpectomy e mālama i ka pūnaewele ʻoki
• Ka maʻi maʻi endometrial, kahi e hiki ai i nā mea noi i loko ke kuhikuhi i ka uhi uterine
• Nā maʻi maʻi ʻili ma nā wahi kahi e paʻakikī ai ka radiation waho
• Nā maʻi maʻi maka, kahi e hiki ai i nā plaques liʻiliʻi ke mālama i nā maʻi maʻi me ka mālama ʻana i ka ʻike

I kekahi manawa hoʻohana ʻia ka brachytherapy me ka radiation beam waho a i ʻole ke ʻoki ʻana ma ke ʻano he ʻāpana o kahi hoʻolālā lapaʻau piha. E kūkākūkā kāu hui oncology inā paha e pōmaikaʻi kēia hui pū ʻana i kāu kūlana.

He aha ke kaʻina hana no ka brachytherapy?

He ʻokoʻa ke kaʻina hana brachytherapy ma muli o ke ʻano o ka implant a me ka wahi e mālama ʻia nei. E hele kāu hui lapaʻau iā ʻoe ma kēlā me kēia ʻanuʻu ma mua i ʻike maoli ʻoe i ka mea e manaʻo ai. Hana ʻia ka hapa nui o nā kaʻina hana i loko o kahi haukapila a i ʻole ke kikowaena lapaʻau kūikawā me ke alakaʻi kiʻi e hōʻoia i ka waiho pololei ʻana.

Ma mua o kāu kaʻina hana, e loaʻa iā ʻoe nā ʻōlelo kikoʻī e pili ana i ka ʻai ʻana, ka inu ʻana, a me nā lāʻau lapaʻau. Pono paha ʻoe e hooki i kekahi mau lāʻau lapaʻau e lahilahi ai ke koko a i ʻole e hahai i nā alakaʻi meaʻai kūikawā. E kūkākūkā pū kāu kauka i nā koho anesthesia, hiki ke hele mai ka numbing kūloko i ka anesthesia maʻamau e pili ana i ka paʻakikī o kāu lapaʻau.

Eia ka mea e hana maʻamau i ka wā o ke kaʻina hana:

1. E hoʻonoho ʻia ʻoe ma luna o kahi papa hana, a e hoʻomaʻemaʻe ʻia a hoʻomākaukau ʻia ka wahi lapaʻau
2. E hāʻawi ʻia ka anesthesia e like me kāu hoʻolālā lapaʻau
3. Me ka hoʻohana ʻana i ke alakaʻi kiʻi e like me nā ultrasound a i ʻole nā ​​CT scans, e kau pono kāu kauka i nā kumu radioactive
4. No nā implants manawa, e hoʻopili ʻia nā kumu i kahi mīkini i hoʻomalu ʻia e ka lolouila e hāʻawi ana i ka mahele i hoʻolālā ʻia
5. No nā implants mau, e waiho ʻia nā hua liʻiliʻi a e noho mau i loko o kou kino
6. E nānā ʻia ka wahi lapaʻau, a e hoʻoneʻe ʻia ʻoe i kahi wahi hoʻōla

Hiki ke lōʻihi ka manawa hāʻawi radiation mai kekahi mau minuke a i kekahi mau hola, ma muli o kāu ʻano lapaʻau. ʻO ka maʻamau, e lawe ana nā implants hua mau i 1-2 hola e waiho ai, ʻoiai e koi ana nā lapaʻau manawa i nā kau he nui i nā lā he nui.

Pehea e hoʻomākaukau ai no kāu brachytherapy?

ʻO ka hoʻomākaukau ʻana no ka brachytherapy e pili ana i ka mākaukau kino a me ka naʻau. E hāʻawi kāu hui mālama ola i nā ʻōlelo kikoʻī i hoʻopili ʻia i kāu ʻano lapaʻau a me ka mōʻaukala olakino. ʻO ka hahai ʻana i kēia mau alakaʻi me ka mālama pono e kōkua i ka hōʻoia ʻana i ka hopena lapaʻau maikaʻi loa a e hōʻemi i ka pilikia o nā pilikia.

Hiki i kāu hoʻomākaukau ke komo i kekahi mau manawa lapaʻau ma mua o ke kaʻina hana maoli. E loaʻa paha iā ʻoe nā scans kiʻi e kōkua i kāu kauka e hoʻolālā i ke kau ʻana o nā kumu radioactive. Pono paha nā hoʻokolohua koko e nānā i kou olakino holoʻokoʻa a e hōʻoia ua mākaukau ʻoe no ke kaʻina hana.

Eia nā ʻanuʻu hoʻomākaukau nui e pono ai ʻoe e hahai:

• E hooki i ka lawe ʻana i nā lāʻau e lahilahi ai ke koko e like me ke kuhikuhi ʻana a kāu kauka, maʻamau 7-10 mau lā ma mua o ka lapaʻau
• E hahai i nā ʻōlelo kuhikuhi meaʻai kūikawā, e komo paha i ka pale ʻana i kekahi mau meaʻai a i ʻole ka hoʻokē ʻai ʻana ma mua o ke kaʻina hana
• E hoʻonohonoho i kekahi e hoʻokele iā ʻoe i ka home ma hope o ke kaʻina hana, no ka mea, e hiamoe paha ʻoe mai ka anesthesia
• E hoʻopau i nā hoʻomākaukau ʻōpū inā pili kāu lapaʻau i ka wahi pelvic
• E ʻauʻau me ke kopa antibacterial i ke kakahiaka o kāu kaʻina hana
• E ʻaʻahu i nā lole ʻoluʻolu a me nā lole ʻaʻahu i kāu manawa
• Wehe i nā mea nani, nā niho, a i ʻole nā mea metala ʻē aʻe e hiki ke hoʻopilikia i ke kiʻi

Mai kānalua e nīnau i nā nīnau e pili ana i kekahi ʻāpana o ke kaʻina hana hoʻomākaukau. Makemake kāu hui lapaʻau e manaʻo ʻoe he hilinaʻi a mākaukau no kāu lā lapaʻau.

Pehea e heluhelu ai i kāu hopena brachytherapy?

Hoʻohālikelike ʻia nā hopena Brachytherapy ma mua o nā hoʻokolohua lapaʻau ʻē aʻe no ka mea e hōʻike ʻia ka hopena o ka lapaʻau i ka manawa. E nānā kāu kauka i kāu holomua ma o nā manawa e hahai ai, nā haʻawina kiʻi, a me nā hoʻokolohua kikoʻī e pili ana i kāu ʻano maʻi ʻaʻai. ʻO ka pahuhopu e ʻike i nā hōʻike e pane ana ka maʻi ʻaʻai i ka lapaʻau ʻoiai e hōʻoia ana e pale ʻia kāu mau ʻiʻo olakino.

E nānā kāu hui mālama ola i kekahi mau hōʻailona koʻikoʻi i ka wā o kāu hoʻōla a me ka mālama ʻana. Kōkua kēia mau māka e hoʻoholo i ka maikaʻi o ka hana ʻana o ka lapaʻau a inā pono e hoʻoponopono i kāu hoʻolālā mālama. ʻO ka hoʻomaopopo ʻana i kēia mau ana hiki ke kōkua iā ʻoe e komo hou i kāu huakaʻi lapaʻau.

E nānā kāu kauka i kēia mau wahi nui:

• Ka pane ʻana o ka maʻi ma o nā kiʻi e like me CT, MRI, a i ʻole PET scans i nā manawa maʻamau
• Nā pae hōʻailona maʻi maʻi i loko o kou koko, e loli ana ma muli o ke ʻano o kou maʻi maʻi
• Nā hopena o ka hoʻokolokolo kino ma kahi o ka lapaʻau
• Ka loiloi ʻana i nā hopena ʻaoʻao e hōʻoia ana e ʻae maikaʻi ana ʻoe i ka lapaʻau
• Nā ana o ka maikaʻi o ke ola e pane aku i nā hopohopo e pili ana i nā hana o kēlā me kēia lā
• Ka nānā ʻana i ka wā lōʻihi no ka hoʻi hou ʻana o ka maʻi maʻi a i ʻole nā maʻi maʻi hou

He ʻokoʻa nui ka manawa no ka ʻike ʻana i nā hopena ma muli o ke ʻano o kou maʻi maʻi a me ke ʻano o ka lapaʻau. ʻIke kekahi poʻe maʻi i nā hoʻomaikaʻi ʻana i loko o nā pule, aʻo nā mea ʻē aʻe e pono paha i kekahi mau mahina e ʻike i nā hopena lapaʻau piha. E wehewehe kāu kauka i ka mea e manaʻo ai no kāu kūlana kikoʻī.

He aha nā mea pilikia no nā pilikia o ka brachytherapy?

ʻOiai ua palekana a maikaʻi ka brachytherapy, hiki i kekahi mau mea ke hoʻonui i kou pilikia o ka ʻike ʻana i nā hopena ʻaoʻao a i ʻole nā pilikia. ʻO ka hoʻomaopopo ʻana i kēia mau mea pilikia e kōkua iā ʻoe a me kāu hui mālama ola e mālama i nā hana kūpono a nānā pono i kāu holomua. Hiki ke mālama ʻia ka hapa nui o nā pilikia ke hopu ʻia i ka wā mua a mālama koke ʻia.

Aia kou pilikia pilikino ma luna o kekahi mau mea pilikino a me nā mea e pili ana i ka lapaʻau. E loiloi pono kāu hui lapaʻau i kēia mau mea ma mua o ka ʻōlelo ʻana i ka brachytherapy a e kūkākūkā i nā hopohopo kikoʻī e pili ana i kāu kūlana. ʻO ka ʻike ʻana i kēia mau mea e kōkua iā ʻoe e hana i nā hoʻoholo i ʻike ʻia e pili ana i kāu lapaʻau.

Eia nā mea pilikia nui e hiki ke hoʻonui i kou manawa o nā pilikia:

• Ka mālama ʻana i ka radiation ma mua i ka wahi like, hiki ke hoʻonui i ka ʻike i ka radiation hou
• Nā maʻi olakino kekahi e like me ka maʻi diabetes a i ʻole nā maʻi autoimmune e pili ana i ka hoʻōla
• ʻO ka makahiki kiʻekiʻe, ʻoiai ʻaʻole kēia wale nō e kāpae iā ʻoe mai ka mālama ʻana
• ʻO ke kūlana olakino maikaʻi ʻole a i ʻole nā maʻi olakino he nui
• Ka puhi ʻana i ka paka, hiki ke hoʻopilikia i ka hoʻōla a hoʻonui i ka pilikia o ka maʻi
• Ka momona, hiki ke paʻakikī i ka waiho ʻana i ka implant
• Nā maʻi koko e pili ana i kou hiki ke hoʻōla pono
• Nā lāʻau lapaʻau e kāohi ana i kou ʻōnaehana pale

E hana pū kāu kauka me ʻoe e hōʻemi i kēia mau pilikia i ka hiki. Hiki i kēia ke komo i ka hoʻomaikaʻi ʻana i kou olakino ma mua o ka mālama ʻana, ka hoʻoponopono ʻana i nā lāʻau lapaʻau, a i ʻole ke koho ʻana i nā ʻenehana kikoʻī e hana maikaʻi loa no kou kūlana.

He aha nā pilikia hiki ke loaʻa i ka brachytherapy?

Hiki ke loli nā pilikia o ka brachytherapy mai nā hopena ʻaoʻao maʻalahi a hiki i nā pilikia lōʻihi loa. ʻO ka hapa nui o nā maʻi e ʻike i nā hopena ʻaoʻao hiki ke mālama ʻia e hoʻomaikaʻi i ka manawa e hoʻōla ai nā ʻiʻo olakino. E nānā pono kāu hui mālama olakino iā ʻoe a hāʻawi i nā lāʻau lapaʻau e kōkua i ka mālama ʻana i nā pilikia e kū mai.

ʻO nā pilikia kikoʻī āu e ʻike ai e hilinaʻi nui ʻia i ka wahi mālama a me kou mau mea olakino pilikino. ʻO ka hoʻomaopopo ʻana i ka mea e nānā ai e kōkua iā ʻoe e ʻimi i ka mālama kūpono inā e kū mai nā pilikia. E hoʻomanaʻo ʻaʻole ʻo ka ʻike ʻana i nā hopena ʻaoʻao ʻaʻole ia he manaʻo ʻaʻole e hana ana kāu mālama ʻana.

Eia nā pilikia maʻamau āu e ʻike ai:

• Ka luhi e mau ana no kekahi mau pule i ka wā e ola ana kou kino mai ka radiation
• Hoʻonāukiuki ʻili a i ʻole nā loli i ka wahi i mālama ʻia, me ka ʻulaʻula a i ʻole ka ʻike
• Pehu a puni ka wahi i hoʻokomo ʻia ai, e pau ana i loko o nā lā a i ʻole nā pule
• ʻEha a i ʻole ka hōʻoluʻolu ʻole e hiki ke mālama ʻia me nā lāʻau lapaʻau kūpono
• Nā hōʻailona mimi e like me ke alapine a i ʻole ke kuni inā kokoke ka wahi lapaʻau i ka ʻōpū
• Nā loli ʻōpū me ka maʻi palahē a i ʻole ka huhū rectal no nā lapaʻau pelvic
• Nā loli hana moe kolohe, ʻoiai me nā lapaʻau prostate a i ʻole gynecologic

Pono nā pilikia koʻikoʻi akā kakaʻikahi i ka lāʻau lapaʻau koke. Hiki i kēia mau mea ke komo i ke kahe nui ʻana, nā hōʻailona o ka maʻi e like me ke kuni a i ʻole ka hoʻokuʻu ʻana i ka maʻamau ʻole, a i ʻole ka ʻeha nui ʻaʻole e hoʻomaikaʻi me nā lāʻau i kuhikuhi ʻia. E hāʻawi kāu hui lapaʻau iā ʻoe i nā alakaʻi kikoʻī e pili ana i ka manawa e kāhea ai i ke kōkua.

I ka manawa hea wau e ʻike ai i ke kauka no nā hopohopo brachytherapy?

ʻO ka ʻike ʻana i ka manawa e hoʻopili ai i kāu hui mālama ola ma hope o ka brachytherapy he mea nui ia no kou palekana a me ka holomua o ka mālama ʻana. ʻOiai ua manaʻo ʻia a hiki ke mālama ʻia kekahi mau hopena ʻaoʻao ma ka home, pono nā mea ʻē aʻe i ka lāʻau lapaʻau wikiwiki. E hāʻawi kāu kauka i nā alakaʻi kikoʻī e pili ana i nā hōʻailona hōʻailona e nānā ai e pili ana i kāu ʻano lapaʻau.

Mai kānalua e hoʻopili i kāu hui lapaʻau me nā nīnau a i ʻole nā hopohopo, ʻoiai inā ʻaʻole ʻoe maopopo inā he mea koʻikoʻi kekahi mea. ʻOi aku ka maikaʻi o lākou e lohe mai iā ʻoe e pili ana i kahi pilikia liʻiliʻi ma mua o ka kali ʻana i ka lōʻihi e hoʻoponopono i kahi pilikia nui. Loaʻa i ka hapa nui o nā kikowaena lapaʻau nā helu pili 24-hola no nā kūlana pilikia.

E hoʻopili koke i kāu kauka inā ʻike ʻoe i kekahi o kēia mau hōʻailona hōʻailona:

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• Ka wela ma luna o 101°F (38.3°C) a i ʻole nā haʻalulu, hiki ke hōʻike i ka maʻi
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• Ke kahe nui ʻana o ke koko mai kahi i mālama ʻia ai, ʻaʻole e pau me ke kaomi mālie
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• ʻEha nui ʻaʻole e hoʻomaikaʻi me nā lāʻau ʻeha i kuhikuhi ʻia
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• Nā hōʻailona o ka maʻi e like me ka hoʻokuʻu ʻana i ka maʻamau ʻole, ka ʻulaʻula e piʻi ana, a i ʻole ka mehana
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• He paʻakikī ke mimi a i ʻole ka hiki ʻole ke mimi
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• Nāwaliwali nui a i ʻole ka luaʻi ʻana e pale ai iā ʻoe mai ka mālama ʻana i nā wai
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• Ka pōkole o ka hanu a i ʻole ka ʻeha o ka umauma
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• ʻO kēlā me kēia mea kanu a i ʻole hua i ʻike ʻia ua neʻe a i ʻole i hāʻule i waho
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Pono nō hoʻi ʻoe e hoʻonohonoho i nā manawa e hahai ai i nā manawa maʻamau inā maikaʻi ʻoe. Hāʻawi kēia mau kipa i kāu kauka e nānā i kāu holomua, e nānā i nā pilikia e ulu ana, a e hoʻoponopono i kāu hoʻolālā mālama e like me ka mea e pono ai.

Nā nīnau i nīnau pinepine ʻia e pili ana i ka brachytherapy

Q.1 ʻOi aku ka maikaʻi o ka brachytherapy ma mua o ka radiation waho?

Hāʻawi ka brachytherapy i nā pono kūikawā no kekahi mau maʻi maʻi, akā ʻaʻole pono ia he

Aia ke kiʻekiʻe o kou radioacticity ma hope o ka brachytherapy ma ke ʻano o ka lapaʻau āu e loaʻa ai. Me nā mea kanu manawa, e radioactīve wale nō ʻoe i ka wā e waiho ʻia ai nā kumu, a ʻaʻohe radioacticity i koe ma hope o ka wehe ʻia ʻana. Me nā mea kanu hua mau, e hoʻopuka ʻoe i nā pae haʻahaʻa o ka radiation no kekahi mau pule a i mau mahina, akā e emi ana kēia i ka manawa.

E hāʻawi kāu hui lapaʻau i nā alakaʻi kikoʻī e pili ana i nā hana palekana radiation inā pono. Hiki i kēia ke komo i ka palena manawa o ka pilina pili me nā wahine hāpai a me nā keiki ʻōpio, a i ʻole ka pale ʻana i ka halihali lehulehu no kahi manawa pōkole. Hiki i ka hapa nui o nā maʻi ke hoʻomau i nā hana maʻamau i loko o kekahi mau lā a i mau pule, ma muli o ke ʻano o kā lākou lapaʻau.

Q.3 Pehea ka lōʻihi o ka lapaʻau brachytherapy?

He ʻokoʻa nui ka lōʻihi o ka brachytherapy ma muli o ke ʻano o ka lapaʻau a me ka wahi e mālama ʻia nei. Lawe pinepine nā mea kanu hua mau i 1-2 mau hola e waiho ai i kahi kaʻina hana outpatient. Pono paha nā lapaʻau kiʻekiʻe-dose i nā kau he nui i nā lā he nui, me kēlā me kēia kau e mau ana i 10-30 mau minuke no ka hāʻawi ʻana i ka radiation.

Pono paha nā lapaʻau haʻahaʻa-dose me nā mea kanu manawa e noho ʻoe i ka haukapila no 1-7 mau lā i ka wā e waiho ʻia ai nā kumu. E wehewehe kāu kauka i ka manawa kikoʻī no kāu lapaʻau a kōkua iā ʻoe e hoʻolālā e like me ia no ka manawa mai ka hana a i ʻole ka hoʻonohonoho ʻana i ke kōkua ma ka home.

Q.4 Hiki iaʻu ke hele ma hope o ka brachytherapy?

Aia nā palena huakaʻi ma hope o ka brachytherapy ma ke ʻano o kāu lapaʻau a me ka manawa. Inā he mau hua radioactive mau kāu, pono paha ʻoe e pale i ka huakaʻi ea no kekahi mau pule no ka mea hiki i nā scanners palekana kahua mokulele ke ʻike i ka mea radioactive. E hāʻawi kāu kauka iā ʻoe i kahi kāleka ʻeke e wehewehe ana i kāu lapaʻau inā pono.

No nā lapaʻau hoʻokomo manawa pōkole, hiki iā ʻoe ke hele ma hope o kou ola ʻana mai ke kaʻina hana, maʻamau i loko o kekahi mau lā a i hoʻokahi pule. E kūkākūkā mau i nā hoʻolālā huakaʻi me kāu hui mālama ola, ʻoiai inā ʻoe e hoʻolālā ana e hele i waho i ka wā o kāu manawa koho e hele ai no ka nānā ʻana.

Q.5 Ua ʻeha anei ka brachytherapy?

ʻO ka hapa nui o nā mea maʻi e ʻike i kekahi ʻoluʻolu i ka wā a ma hope o ka brachytherapy, akā ʻaʻole maʻamau ka ʻeha nui. Hana ʻia ke kaʻina hana hoʻokomo ma lalo o ka anesthesia, no laila ʻaʻole pono ʻoe e ʻeha i ka wā o ka lapaʻau. Ma hope, hiki iā ʻoe ke ʻike i ka ʻeha, ka pehu, a i ʻole ka ʻeha ma kahi o ka lapaʻau.

E hāʻawi kāu hui mālama ola i nā hoʻolālā hoʻokele ʻeha me nā lāʻau lapaʻau, nā ʻenehana hoʻonohonoho, a me nā hana hōʻoluʻolu ʻē aʻe. ʻO ka hapa nui o ka ʻoluʻolu he māmā a i ka waena a hoʻomaikaʻi i loko o kekahi mau lā a i nā pule i ka wā e holomua ai ka hoʻōla. Mai kānalua e noi i ke kōkua i ka mālama ʻana i kekahi ʻeha āu e ʻike ai.