He aha te whakawhitinga whatukuhu mai i te tangata kua mate? Te Whāinga, te Hātepe me ngā Hua

Ko te whakawhitinga whatukuhu mai i te tangata kua mate he pokanga whakaora oranga e whiwhi ai koe i tētahi whatukuhu hauora mai i tētahi tangata kua mate, i whakaae i mua ki te takoha i ō rātou okana. E whai wāhi ana tēnei hātepe ki te tūmanako ina kore e taea e ō whatukuhu ake te tātari i te para me te wai nui mai i tō toto.

E whai wāhi ana te haerenga ki te whakataurite i waenga i a koe me te whatukuhu takoha kia pai ai te hua. Ahakoa te tatari mō tētahi okana e tika ana ka pōuri, mā te māramatanga ki te hātepe ka āwhina koe ki te rongo i te rite me te māia mō tēnei whiringa maimoatanga nui.

He aha te whakawhitinga whatukuhu mai i te tangata kua mate?

Ko te whakawhitinga whatukuhu mai i te tangata kua mate e whakakapi ana i tō whatukuhu ngoikore ki tētahi hauora mai i tētahi tangata kua mate. Ko te whatukuhu takoha i ahu mai i ngā tāngata i whakatau i te whakatau atawhai ki te takoha i ō rātou okana i muri i te matenga, e hoatu ana ki ētahi atu tētahi tuarua o te oranga.

Ka whakatakotoria tō whatukuhu hou ki tō puku o raro, te nuinga ki te taha matau. He mea miharo, ko ō whatukuhu ake te nuinga ka noho tonu ki te wāhi mena kāore e raru ana. Ka hono te whatukuhu whakawhiti ki ngā oko toto tata me tō pūpū, kei reira ka tīmata te tātari i tō toto me te whakaputa i te mimi.

He rerekē tēnei momo whakawhitinga mai i ngā whakawhitinga mai i te tangata ora nā te mea ko te whatukuhu i ahu mai i tētahi tangata kua mate. Me tiaki pai te okana me te kawe tere kia mau tonu ai tōna mahi mō te kaiwhiwhi.

He aha te take e mahia ai te whakawhitinga whatukuhu mai i te tangata kua mate?

Ka tūtohu tō tākuta i tēnei whakawhitinga ina kore e taea e ō whatukuhu te pupuri i a koe kia hauora anō. Ko te mate whatukuhu i te wā whakamutunga te tikanga ko te mahi a ō whatukuhu i raro iho i te 10% o tō rātou kaha noa, e tika ana te tātai toto, te whakawhitinga rānei mō te oranga.

He maha ngā āhuatanga ka puta ki tēnei wāhi, ā, mā te māramatanga ki a rātou ka whakamārama he aha te take ka noho ko te whakawhiti te kōwhiringa pai. Ko ngā take tino nui ko:

• Te kino o te pūkahukahu e pā ana ki te mate huka (diabetic nephropathy)
• Te pēhanga toto tiketike e pā ana ki te kiko pūkahukahu
• Te mate pūkahukahu polycystic me ngā pūkahukahu nui, e ki ana i te pūtau
• Glomerulonephritis, e kino ana i ngā wae tātari o te pūkahukahu
• Ngā mate autoimmune pēnei i te lupus e pā ana ki te mahi pūkahukahu
• Ngā mate pūkahukahu tuku iho i te whānautanga
• Te kino o te pūkahukahu mai i ngā rongoā, i ngā paitini rānei

He maha ngā wā ka nui ake te kounga o te oranga i te whakawhitinga angitu i te dialysis wā-roa. He maha ngā tāngata e kaha ake ana te kaha, ā, ka taea te hoki ki ngā mahi i pai ai rātou i mua i te pūmautanga o te mate pūkahukahu.

He aha te tikanga mō te whakawhitinga pūkahukahu mai i te kaiwhakawhiwhi kua mate?

Ko te pokanga whakawhiti te tikanga e 3 ki te 4 haora, ā, ka puta mai he tikanga ohorere i te wā e wātea ana he pūkahukahu e hāngai ana. Ka whiwhi koe i te rongoā whānui, nō reira ka moe katoa koe i te wā o te mahi.

Ka hanga e tō tākuta he tapahi i tō puku o raro kia uru atu ki te wāhi ka whakatakotoria tō pūkahukahu hou. E whai ana te tukanga i ngā mahi atawhai kia pai ai te hua:

1. Ka whakatakotoria e te tākuta te pūkahukahu kaiwhakawhiwhi ki tō puku o raro matau
2. Ka hono ngā oko toto mai i te pūkahukahu hou ki ō oko toto o nāianei
3. Ka piri te ureter (te ngongo e kawe ana i te mimi) o te pūkahukahu ki tō pūpū
4. Ka whakamātau tō tākuta i ngā hononga kia pai ai te rere o te toto
5. Ka katia te tapahi ki ngā tuitui, ki ngā tūtohi rānei

He maha ngā wā ka tīmata tonu te pūkahukahu hou ki te whakaputa mimi, ahakoa i ētahi wā ka roa ngā rā, ngā wiki rānei kia tīmata ai te mahi katoa. Ka mātakitaki tata tō rōpū hauora i a koe i tēnei wā tino nui kia pai ai te mahi o ngā mea katoa.

Me pēhea te whakarite mō tō whakawhitinga pūkahukahu mai i te kaiwhakawhiwhi kua mate?

Ko te whakarite mō te whakawhitinga okana ko te uru ki te rārangi tatari me te noho rite mō te karanga ina wātea mai tētahi whatumanawa. Mā te tukanga arotake e mōhio ana kei te hauora koe mō te pokanga, ā, ka whai hua mai i te whakawhitinga okana.

Mā tō rōpū whakawhitinga okana koe e ārahi mā roto i ngā whakamātautau whānui e tirotiro ana i tō hauora whānui. Ko te wā whakarite i te nuinga o te wā e whai ana i ēnei:

• Ngā whakamātautau toto hei tirotiro i te mahi okana me te tūnga o te mate
• Ngā whakamātautau ngākau pēnei i te EKG me te echocardiogram
• Ngā whakamātautau mahi pūkahukahu me ngā hihi-X o te uma
• Te tātari mate pukupuku e tika ana mō tō tau
• Te tirotiro niho hei tautuhi i ngā mate
• Te arotake hinengaro hei aromatawai i te rite
• Te tohutohu pūtea mō ngā utu whakawhitinga okana

Ina whakaaetia, ka uru koe ki te rārangi tatari ā-motu mā te United Network for Organ Sharing (UNOS). Kia taea te whakapā atu ki a koe i ngā wā katoa nā te mea me haere koe ki te hōhipera i roto i ngā hāora i muri i te whiwhinga i te karanga.

Kia mau tonu tō hauora kia pūmau i te wā e tatari ana. Haere tonu i ngā rongoā tātai, tangohia ngā rongoā kua whakaritea, me te pupuri i te kai pai kia mōhio kei te pai koe mō te pokanga ina tae mai te whai wāhitanga.

Me pēhea te pānui i ō hua whakawhitinga whatumanawa?

I muri i te whakawhitinga okana, ka aroturukihia e tō rōpū hauora ngā whakamātautau toto motuhake hei tirotiro i te pai o te mahi a tō whatumanawa hou. Ko te tohu matua ko tō taumata creatinine, me heke nui iho i te wā i mua i te whakawhitinga okana i te wā e pai ake ana te mahi whatumanawa.

Ka aroturukihia e ō tākuta ētahi inenga nui hei mōhio kei te hauora tonu tō whakawhitinga okana. Mā ēnei whakamātautau e āwhina ana ki te kite wawe i ngā raruraru i te wā e taea ana te rongoā:

• Ngā taumata waihanga (me 0.6-1.2 mg/dL i roto i ngā whatukuhu hauora)
• Te hauota urea toto (BUN) e tohu ana i te tango para
• Te reiti tātari glomerular (GFR) e ine ana i te ōrau o te mahi whatukuhu
• Ngā taumata pūmua i roto i ngā whakamātautau mimi
• Ngā taumata rongoā aukati ārai i tō toto

He rerekē ngā hua noa i te tangata, ā, tē pea tō whatukuhu hou e mahi rite ana ki te whatukuhu tūturu hauora. Mā tō rōpū whakawhiti e whakamārama ngā tau e tika ana mō tō āhuatanga motuhake, ā, ka whakatika i ngā rongoā i runga i tērā.

Me pēhea te tiaki i tō whatukuhu whakawhiti?

Ko te tiaki i tō whatukuhu hou e hiahia ana i te whakapau kaha ki ngā rongoā me ngā whiringa oranga hauora i te roanga o te oranga. E hiahia ana tō pūnaha ārai mate ki te whakakore i te okana whakawhiti, nō reira he mea nui ngā rongoā aukati ārai hei aukati i tēnei whakakorenga.

Ko te tango rongoā i te tika i te mea i whakaritea te mea nui rawa atu ka taea e koe mō tō whakawhitinga. E hiahia ana ēnei rongoā kaha ki te aroturuki tupato nā te mea e pā ana ki tō pūnaha ārai mate katoa:

• Ngā rongoā aukati whakakorenga e tangohia ana i ngā wā kotahi i ia rā
• Ngā rongoā toto tiketike hei tiaki i te mahi whatukuhu
• Ngā rongoā hei aukati i ngā mate me ngā mate wheua
• Ngā whakamātautau toto i ngā wā katoa hei aroturuki i ngā taumata rongoā

E tautoko ana ngā whiringa oranga hauora i te angitu o tō whakawhitinga i te wā roa. Kei roto i tēnei ko te kai i te kai taurite, te whakakori tinana i ngā wā katoa i te mea kua whakaaetia e tō tākuta, te karo i te pā ki ngā mate, me te tiaki i tō kiri i te kino o te rā i te mea e whakanui ana ngā rongoā aukati ārai i te tūponotanga o te mate pukupuku.

He aha te hua pai i muri i te whakawhitinga whatukuhu?

Ko te hua pai ko te mahi pai o tō whatukuhu hou mō ngā tau maha, e āhei ana koe ki te noho i te oranga kaha, whai kiko. He nui te pai o te nuinga o te tangata i tō rātou i runga i te tātai, me te nui ake o te kaha me te herekore i roto i ā rātou mahi o ia rā.

He whakahihiri ngā reiti angitu mō ngā whakawhitinga tākihi mai i ngā tāngata kua mate, ahakoa rerekē ngā hua o ia tangata. Tata ki te 95% o ngā tākihi i whakawhitia e pai ana te mahi i te tau tuatahi, ā, tata ki te 85% e haere tonu ana te mahi i muri i ngā tau e rima.

Ko te angitu i te wā roa e whakawhirinaki ana ki ētahi mea, tae atu ki tō tau, te hauora whānui, te pai o tō whai i ngā tohutohu rongoā, me te pēhea te tata o te tākihi mai i te tāngata nāna i homai ki tō momo kiko. He ramai tāngata e hoki ana ki te mahi, te haereere, te whakakori tinana, me te pārekareka ki ngā mahi i uaua i te wā o te mate tākihi kua piki ake.

Ko te tiaki whai-muri i ngā wā katoa me tō rōpū whakawhiti e āwhina ana ki te pupuri i ēnei hua pai. Ko te kitenga wawe me te rongoā i ngā raruraru ka ārai i ngā raruraru nui me te āwhina ki te pupuri i tō mahi tākihi mō ngā tekau tau.

He aha ngā āhuatanga tūpono mō ngā raruraru whakawhiti tākihi?

He maha ngā āhuatanga ka whakanui i tō tūponotanga ki ngā raruraru i muri i te whakawhitinga, ahakoa he maha e taea ana te whakahaere mā te tiaki tika. Ko te māramatanga ki ēnei tūponotanga e āwhina ana i a koe me tō rōpū rongoā ki te mahi tahi ki te whakaiti i ngā raruraru.

Ko ētahi āhuatanga tūpono e kore e taea e koe te huri, engari ko ētahi e whakahoki ana ki ngā whakarerekētanga o te oranga me te whakahaere rongoā tupato. Ko ngā āhuatanga matua e pā ana ki ngā hua whakawhiti ko:

• Te tau (he nui ake ngā reiti raruraru e pā ana ki ngā kaiwhiwhi pakeke)
• Te mate huka, te mate ngākau rānei i mua i te whakawhitinga
• Ngā whakawhitinga o mua, ngā whakawhitinga toto rānei
• Ngā taumata tiketike o ngā paturopi i roto i tō toto
• Te kore whai i ngā rongoā i muri i te whakawhitinga
• Te pōhēhē, te inu waipiro nui rānei
• Te momomo e pā ana ki te whakaora i te pokanga

E arotake ana tō rōpū whakawhiti i ēnei āhuatanga i te wā o te arotake, ā, e mahi tahi ana me koe ki te whakapai ake i tō hauora i mua i te pokanga. He maha ngā āhuatanga tūpono ka taea te whakapai ake mā ngā huringa o te oranga, ngā whakatikatika rongoā, ngā rongoā rongoā atu rānei.

He pai ake te whakawhiti tākihi i te noho i runga i te tātai?

Mō te nuinga o te hunga e mate ana i te pūkahukahu mutunga, he nui ngā painga o te whakawhitinga okana i te rongoā dialysis mo te wā roa. E whakaatu ana ngā rangahau i te roa ake o te oranga o te hunga i whakawhitia, me te pai ake o te kounga o te oranga i te hunga e noho ana i runga i te dialysis.

Ka toro atu ngā painga i tua atu i ngā tatauranga oranga. He maha ngā tāngata e kite ana ka taea e te whakawhitinga okana te whakahoki i a rātou ki te ahua o rātou anō, me te nui ake o te kaha me te iti ake o ngā here kai i te mea e hiahiatia ana e te dialysis.

Heoi, kāore te whakawhitinga okana i te tika mō te katoa. Ko ētahi tāngata e mate ana i te mate ngākau nui, te mate pukupuku kaha, ētahi atu raruraru hauora nui rānei, he pai ake pea te haere tonu i te dialysis. Ka āta aromatawaihia e tō rōpū whakawhitinga okana mēnā he tūpono ka whai hua koe i te pokanga whakawhitinga okana.

Kei roto i te whakatau te whakataurite i ngā tūponotanga pokanga ki ngā painga pea. Ahakoa e hiahiatia ana e te whakawhitinga okana ngā rongoā aukati i te pūnaha ārai mate mō te wā roa, me ō rātou ake tūponotanga, he maha ngā tāngata e kite ana he pai tēnei whakawhitiwhiti mō te pai ake o te kounga o te oranga.

He aha ngā raruraru ka puta i te whakawhitinga pūkahukahu?

Pērā i ngā pokanga nui katoa, he tūponotanga tonu te whakawhitinga pūkahukahu i te wā tonu me te wā roa. Mā te māramatanga ki ēnei tūponotanga ka āwhina i a koe ki te tautohu i ngā tohu whakatūpato me te rapu āwhina hauora i te wā e tika ana.

Ka puta ngā raruraru wawe i ngā wiki tuatahi i muri i te pokanga, i te mea ka puta ētahi raruraru i ngā marama, i ngā tau rānei i muri mai. Koinei ngā āwangawanga nui e aroturukihia ana e tō rōpū hauora:

• Te whakakorenga koi i te wā e whakaeke ana tō pūnaha ārai mate i te pūkahukahu hou
• Ngā mate na te rongoā aukati i te pūnaha ārai mate
• Ngā kōpuku toto i roto i ngā oko toto o te pūkahukahu
• Ngā mate i te ara tūtae, te aukati rānei
• Ngā raruraru whakaora i te patunga i te wāhi pokanga
• Ngā pānga taha mai i ngā rongoā aukati i te whakakorenga
• Te piki ake o te tūponotanga o te mate pukupuku mai i te aukati i te pūnaha ārai mate
• Te haere whakamua o te mate ngākau

He maha ngā raruraru ka taea te rongoā inā kitea wawe, koinei te take he mea nui ngā whakaritenga whai-whai tonu. Ka whakaako te rōpū whakawhiti i a koe i ngā tohu whakatūpato hei mātakitaki, ā, ka whakarato i ngā kōrero whakapā mō ngā āwangawanga ohorere, e wātea ana i ngā hāora katoa.

Ngā raruraru wā-roa pea ko te whakakorenga tūturu, e ngaro haere ana te mahi o te tākihi i roto i ngā tau, me ngā pānga taha mai i ngā rongoā pērā i te mate wheua, te piki rānei o te tūponotanga o te mate. Mā te aroturuki i ngā wā katoa e āwhina ana ki te kite me te whakahaere i ēnei take i mua i te pūroto.

Āhea ahau tūpono ai ki te kite i te tākuta i muri i te whakawhitinga tākihi?

Me whakapā atu koe ki tō rōpū whakawhiti tonu mēnā ka pā ki a koe ētahi tohu āwangawanga i muri i tō whakawhitinga. Mā te aro rongoā tere e ārai i ngā raruraru iti kia kaua e pūroto.

Ko ētahi tohu e hiahia ana ki te arotake rongoā ohorere nā te mea pea e tohu ana i te whakakorenga, i te mate nui rānei. Kaua e ruarua ki te waea atu ki tō kaiwhakarite whakawhiti, ki te haere rānei ki te ruma ohorere mēnā ka kite koe i:

• Te kirika i runga ake i te 100.4°F (38°C) rānei, te wiri
• Te hekenga o te whakaputa mimi, te huringa rānei o te tae o te mimi
• Te pūhi i ngā waewae, ngā rekereke, i te taha rānei o ngā kanohi
• Te pikinga taumaha kāore i whakamāramahia (nui atu i te 3 pauna i roto i ngā rā e 2)
• Te mamae, te ngawari rānei i runga i te wāhi whakawhiti
• Te whakapairuaki nui, te ruaki, te korere rānei
• Te uaua ki te hā, te mamae rānei o te uma
• Te mamae nui o te upoko, te huringa rānei o te tirohanga

He mea nui anō ngā whakaritenga kua whakaritea i ngā wā katoa mō te aroturuki i te hauora o tō whakawhitinga. Ko ēnei haerenga ka puta i te tuatahi, ā, ka horapa haere i te wā e haere ana tō whakaora, ā, ka noho pūmau tonu tō tākihi hou.

Ka noho tō rōpū whakawhiti hei hoa rongoā wā-roa mōu, nā reira me pupuri te kōrero tuwhera mō ētahi āwangawanga hauora, ngā pānga taha o te rongoā, ngā huringa rānei i te āhua o tō tū. Mā te wawaotanga wawe e ārai ana i ngā take iti kia kaua e pūroto.

Ngā pātai e pātai pinepine ana mō te whakawhitinga tākihi mai i te kaiwhakawhiwhi kua mate

Q.1 He pai ake te whakawhitinga whatukuhu mai i te tangata kua mate i te whakawhitinga mai i te tangata ora?

Ko nga whatukuhu mai i te tangata ora te nuinga ka roa ake te mahi, ka pai ake hoki te mahi i nga whatukuhu mai i te tangata kua mate, engari e rua nga whiringa ka ora ai te tangata. Ko nga whatukuhu mai i te tangata ora te nuinga ka timata tonu te mahi, a tera pea ka mahi mo te 20-25 tau, i te wa e mahi ana nga whatukuhu mai i te tangata kua mate mo te 15-20 tau.

Heoi, ko te whakawhitinga mai i te tangata kua mate he whiringa pai tonu ina karekau he tangata ora. Ko te mea nui ko te whiwhi i te whakawhitinga i te momo kaiwhakarato, na te mea e rua e tino pai ake ana te oranga me te kounga o te oranga i te wa e roa ana te dialysis.

Q.2 Ka pa te roa o te tatari mo te whakawhitinga whatukuhu ki nga hua?

Ka pa te roa o te tatari ki te angitu o te whakawhitinga, ina koa ka tino kino to hauora i te wa e tatari ana. Ko nga tangata e whiwhi ana i nga whakawhitinga i mua i te tiimata i te dialysis, i muri tata ranei i te tiimata i te dialysis, he pai ake nga hua i te hunga e tatari ana mo nga tau maha.

Heoi, he mea nui ano te whiwhi i te whatukuhu e pai ana te taurite mo te angitu mo te wa roa. Ka taurite to roopu whakawhitinga i enei mea i te wa e whakaaro ana ki nga tuku whatukuhu, i etahi wa ka tūtohu kia tatari mo te pai ake o te taurite mena ka pumau to hauora.

Q.3 Ka taea e au te whanau tamariki i muri i te whakawhitinga whatukuhu?

He maha nga wahine e whanau ana i nga haputanga hauora i muri i te whakawhitinga whatukuhu, ahakoa me ata whakarite me te aro turuki. Me tatari koe kia kotahi tau i muri i te whakawhitinga i mua i te haputanga kia mohio ai he pumau to mahi whatukuhu.

Ko te haputanga i muri i te whakawhitinga ka kiia he morearea nui, me te manaaki motuhake mai i to roopu whakawhitinga me nga tohunga haputanga morearea nui. Me whakatika etahi rongoa aukati i te mate, a me nui ake te aro turuki i te wa e hapu ana.

Q.4 Kia pehea te roa ka taea e au te noho me te whatukuhu kua whakawhitia?

He maha ngā tāngata e noho ana 20-30 tau, neke atu rānei, me te pūkahukahu i whakawhitia, ā, he pai te mahi a ētahi pūkahukahu neke atu i te 40 tau. Ko tō hua ake e whakawhirinaki ana ki ngā āhuatanga pēnei i tō tau, te hauora whānui, te whai i ngā rongoā, me te pai o te whakaae a tō tinana ki te pūkahukahu hou.

E haere tonu ana te mahi a te haurua o ngā pūkahukahu mai i ngā tāngata kua mate i muri i te 15-20 tau, ā, he maha ngā kaiwhiwhi e noho ana i ngā oranga noa me ā rātou okana i whakawhitia. Ko ngā whakawhanaketanga i roto i ngā rongoā aukati i te pūnaha ārai mate me te manaaki whakawhiti e haere tonu ana ki te whakapai ake i ngā hua wā roa.

Q.5 He aha te mea ka pā mai ki te kore e pai taku pūkahukahu i whakawhitia?

Mēnā ka kore e pai tō pūkahukahu i whakawhitia, ka taea e koe te hoki ki te tātai toto, ā, ka whiwhi pea koe i tētahi atu whakawhitinga. He maha ngā tāngata e angitu ana ki te whiwhi i te tuarua, i te tuatoru rānei o ngā whakawhitinga pūkahukahu, ahakoa te uaua ake o ia whakawhitinga i muri mai nā te pikinga o ngā taumata paturopi.

E mātakitaki ana tō rōpū whakawhiti i te mahi o tō pūkahukahu kia kite wawe i ngā raruraru i te wā e pai ai ngā rongoā ki te pupuri i te mahi mō te wā roa. Mēnā ka kore e taea te karo i te korenga o te whakawhitinga, ka āwhina rātou i a koe ki te hoki ki te tātai toto, ā, ka arotake i a koe mō tētahi atu whakawhitinga mēnā e tika ana.