He aha te Whakakapinga Takirere Aorta Transcatheter (TAVR)? Te Whāinga, te Hātepe & ngā Hua

Ko te whakakapinga takirere aorta transcatheter (TAVR) he hātepe ngākau iti-whakauru e whakakapi ana i tētahi takirere aorta kua pakaru me te kore he pokanga tuwhera-ngākau. Engari i te hanga i tētahi tapahi nui ki te uma, ka whakauru tō tākuta i tētahi takirere hou mā tētahi katita iti, te nuinga mā tētahi uaua i tō waewae. Mā tēnei huarahi auaha e āwhina ana i ngā tāngata e tino mate ana i te takirere aorta, ā, tērā pea he nui rawa te tūponotanga mō te pokanga tuku iho.

He aha te TAVR?

Ko te TAVR he hātepe whakahirahira e hoatu ana ki tō ngākau tētahi takirere aorta hou mā tētahi huarahi ngawari atu i te pokanga tuku iho. Ko tō takirere aorta e whakahaere ana i te rere o te toto mai i tō ngākau ki te toenga o tō tinana, ā, ka whāiti rawa, ka pakaru rānei, me kaha rawa tō ngākau ki te mahi.

I te wā o te TAVR, ka ārahi tētahi tīma tohunga i tētahi takirere whakakapinga kua hinga mā roto i ō uaua toto kia tae ki tō ngākau. Kia tū ana ki te tūnga, ka whānui te takirere hou, ka mau i te mahi o tō takirere kua pakaru. Ko te tikanga ka roa te hātepe i te 1-3 hāora, ā, ka mahia i roto i tētahi taiwhanga katita ngākau motuhake.

Ko te ataahua o te TAVR kei roto i tōna iti-whakauru. Ko te nuinga o te tāngata ka ora wawe atu i te pokanga tuwhera-ngākau, ka hoki ki te kāinga i roto i te 1-3 rā. Ka noho tonu tō takirere taketake ki tōna wāhi, ā, ka tū te takirere hou ki roto.

He aha te take e mahia ana te TAVR?

Ko te TAVR te mea nui e mahia ana hei rongoā i te stenosis aortic nui, tētahi āhuatanga ka whāiti rawa tō takirere aorta kia kore ai e rere tika te toto. Ka pēnei tēnei i te wā e matotoru, e mārō, e calcified ana ngā rau takirere i te wā, e uaua ai tō ngākau ki te pūhi i te toto.

Tērā pea ka tūtohu tō tākuta i te TAVR mēnā he tohumate tō, pēnei i te poto o te manawa, te mamae o te uma, te whanoke, te ngaro rānei o te mōhiotanga e whakararu ana i āu mahi o ia rā. Ka puta ēnei tohumate nā te mea e mahi ana tō ngākau i te wā nui ki te tūhau i te toto mā roto i te takirere whāiti.

He tino whai hua te TAVR mō te hunga e kiia ana he nui te tūponotanga, he tūponotanga takawaenga rānei mō te pokanga ngākau tuwhera tuku iho. Kei roto i tēnei ko ngā pakeke kaumātua, te hunga he maha ngā āhuatanga hauora, te hunga rānei i pokangia ngākau i mua. Heoi, kei te piki haere te tuku TAVR ki ngā tūroro he iti te tūponotanga.

Ko ētahi tāngata he nui te aortic regurgitation (kei te turuturu te takirere ki muri) tērā pea ka tika mō te TAVR, ahakoa he iti noa iho tēnei. Ka āta arotakehia e tō rōpū ngākau tō āhuatanga motuhake hei whakatau mēnā ko te TAVR te kōwhiringa tika mōu.

He aha te tikanga mō te TAVR?

Ka tīmata te tikanga TAVR mā te whiwhi koe i te whakamātau i te rongoā, i te rongoā whānui rānei, i runga i tō keehi motuhake me te hiahia o tō tākuta. Ka aroturukihia koe i te wā katoa o te tikanga mā te whakamahi i ngā taputapu whakaahua matatau.

Anei te mea e pā ana ki te tikanga TAVR:

1. Ka hanga e tō tākuta he wero iti i roto i te uaua, te nuinga i tō waewae, engari i ētahi wā ka whakamahi rātou i te uaua i tō uma, tō ringa, tō kaki rānei
2. Ka āta ārahina tētahi katetā angiangi, ngawari mā roto i ō uaua toto kia tae ki tō ngākau
3. Ko te takirere whakakapi kua hinga, kua whakairihia ki runga i te pōro, i te anga whānui-whaiaro rānei, ka haere mā roto i te katetā
4. Mā te whakamahi i te ārahitanga whakaahua tika, ka whakatakotoria te takirere hou ki te wāhi tika e noho ana tō takirere kua pakaru
5. Ka whānuitia te takirere, mā te pupuhi i te pōro, mā te tuku rānei kia whānui-whaiaro
6. Ka tirohia e tō tākuta te tūnga me te mahi o te takirere mā te whakamahi i te whakaahua, ā, ka whakatika pea mehemea e tika ana
7. Ka tangohia te katetā, ā, ka katia te wāhi uru iti

Ko te tikanga katoa te nuinga o te wā ka roa te 1-3 haora, ahakoa ka roa pea te wā whakarite me te whakaora i te rūma tikanga. Ko te nuinga o te hunga e oho ana i te wā o te tikanga, ā, ka taea e rātou te mātakitaki i ētahi wāhanga i runga i te aroturuki mehemea e hiahia ana rātou.

Ko te rōpū ngākau e mahi tahi ana ko te tohunga ngākau, te tākuta pokanga ngākau, te tohunga tairongo, me ngā nēhi whai mātauranga. Mā tēnei mahi tahi e whakarite kia whiwhi koe i te manaakitanga haumaru me te whai hua.

Me pēhea te whakarite mō tō TAVR?

Ko te whakarite mō te TAVR e whai ana i ētahi mahi nui hei āwhina i te putanga pai rawa atu. Mā te rōpū hauora koe e ārahi i ia mahi, engari mā te māramatanga ki ngā mea e tūmanakohia ana ka āwhina koe kia māia me te rite.

I ngā wiki i mua i tō tukanga, ka whai koe i ngā whakamātautau whānui hei whakaatu i te hanganga o tō ngākau me te whakapūmau he tika te TAVR mōu. Ko te tikanga, kei roto i tēnei he karapa CT o tō pouaka, te whakauru katetā ki te ngākau, te echocardiogram, me ngā whakamātautau toto.

Ko tō rārangi whakarite ka uru pea ki ēnei mahi nui:

• Te whakamutu i ētahi rongoā i runga i te tohutohu a tō tākuta, ina koa ngā rongoā whakaheke toto
• Te whakarite i tētahi tangata hei taraiwa i a koe ki te kāinga me te noho tahi me koe i te rā tuatahi
• Te whai i ngā tohutohu nohopuku, te tikanga kāore he kai, he inu i muri i te pō waenga i mua i tō tukanga
• Te kaukau ki te hopi patu huakita i te pō i mua me te ata o tō tukanga
• Te mau i ngā kākahu hāneanea, whānui, me te waiho i ngā whakapaipai ki te kāinga
• Te mau mai i te rārangi o ō rongoā katoa me ngā tohutohu i mua

Kaua e whakaroa ki te pātai ki tō rōpū manaaki mō ō āwangawanga, pātai rānei. E hiahia ana rātou kia māia koe me te hāneanea. Mēnā ka puta ētahi tohu o te mate pēnei i te kirika, te maremare, te tohu makariri rānei i mua i tō tukanga, whakapā atu ki tō tākuta tonu.

Me pēhea te pānui i ō hua TAVR?

Ko te māramatanga ki ō hua TAVR e arotahi ana ki te pai o te mahi a tō tātā hou me te pēhea te urupare a tō ngākau ki te rere toto pai ake. Ka whakamahi tō tākuta i ētahi inenga me ngā whakamātautau rerekē hei arotake i te mahi o tō tātā.

I muri tonu i te TAVR, ka tirohia e tō rōpū hauora te mahi o tō pūwāhi mā te whakamahi i te echocardiography me ētahi atu whakaahua. Kei te rapu rātou i te whakatuwheratanga me te kati tika o te pūwāhi, te iti o te rerenga, me ngā tauira rere toto pai. Ko te nuinga o ngā tāngata ka kite i te whakapai tonu i te kaha o tō rātou ngākau ki te pōpō toto.

Ko ngā inenga matua ka aroturukihia e tō tākuta ko:

• Te pākēneke pūwāhi (rerekētanga pēhanga puta noa i te pūwāhi) - me iti rawa i mua
• Te rohe pūwāhi - me nui ake, kia pai ake te rere o te toto
• Te hautanga pana - e ine ana i te pai o te pōpō toto o tō ngākau
• Te noho me te kaha o te rerenga pūwāhi
• Te mahi ngākau me te manawataki whānui

He tohu nui hoki ō tohu mō te angitu. He maha ngā tāngata e kite ana i te whakapai ake i te manawa, te taumata pūngao, me te kaha ki te mahi i roto i ngā rā ki ngā wiki i muri i te tikanga. Heoi, ka roa pea te marama e hiahiatia ana kia ora katoa tō ngākau, ā, kia whiwhi koe i ngā painga nui.

Ko ngā whakaritenga whai muri ka puta i te 1 marama, 6 marama, ā, ia tau. I ēnei haerenga, ka whakamahi tō tākuta i ngā echocardiograms me ētahi atu whakamātautau kia mōhio ai kei te pai tonu te mahi o tō pūwāhi, ā, kei te pūmau te hauora o tō ngākau.

Me pēhea te whakapai ake i tō whakaora i muri i te TAVR?

Ko te whakaora i muri i te TAVR he tere ake, he iti ake te kaha i te pokanga ngākau tuwhera tuku iho, engari he mea nui tonu te tiaki tika i a koe anō mō te hua pai. Ka taea e te nuinga o ngā tāngata te hoki ki ngā mahi noa i roto i ngā wiki ruarua, ahakoa he rerekē te wā o te katoa.

I ngā rā tuatahi i muri i tō tikanga, ka arotahi koe ki te okioki me te whakanui haere i te mahi. Mā tō rōpū tiaki koe e ārahi mō te wā e pai ana ki te kaukau, te taraiwa, me te hoki ki te mahi. He maha ngā tāngata e pai ake ana i roto i te wiki tuatahi i te wa e whakatika ana tō rātou ngākau ki te rere toto pai ake.

Ko ngā āhuatanga nui o tō whakaora ko:

• Te tango rongoā kua whakaritea kia rite tonu ki ngā tohutohu, tae atu ki ngā mea whakaheke toto
• Te whakanui haere i te mahi tinana i runga i ngā tohutohu a tō tākuta
• Te haere ki ngā hui whai muri katoa mō te aroturuki
• Te tūpato ki ngā tohu o ngā raruraru pēnei i te kirika, te toto rere ke, te pōrohe rānei o ngā tohu
• Te pupuri i ngā tikanga hauora-ngākau pēnei i te kai pai me te noho kaha
• Te karo i te hiki i ngā mea taumaha (te nuinga neke atu i te 10 pauna) mō ngā wiki tuatahi

He maha ngā wā ka tūtohutia te whakahou i te ngākau i muri i te TAVR hei āwhina i a koe ki te whakahoki i tō kaha me tō manawanui. Mā tēnei hōtaka whakakori tinana e ārahi ana ka tino pai ake tō whakaora me te hauora ngākau mō te wā roa.

He maha ngā tāngata e kite ana ka tino pai ake te kounga o te oranga i muri i te TAVR. Ka kite pea koe ka ngāwari ake te piki i ngā arawhata, ka roa ake te haere, ā, ka iti ake te hā i ngā mahi o ia rā.

He aha te momo tātā TAVR pai rawa atu?

Ko te tātā TAVR pai rawa atu mōu e whakawhirinaki ana ki ō āhua tinana, ō āhuatanga hauora, me ō āhuatanga noho. He maha ngā kōwhiringa tātā pai e wātea ana, ā, mā tō rōpū ngākau e whiriwhiri mārire te mea e tika ana mō tō āhuatanga.

I tēnei wā, e rua ngā momo tātā TAVR matua: te mea ka whānui mā te pōro me te mea ka whānui anō. Ko ngā tātā ka whānui mā te pōro ka whakatakotoria kia tika, ā, ka whānui mā te pōro, i te mea ka tuwhera aunoa ngā tātā ka whānui anō ina tukuna mai i tā rātou pūnaha tuku.

Ngā āhuatanga e pānga ana ki te kōwhiri tātā ko:

• Tō āhua me te rahi o te tātā aortic
• Te āhua me te tauira whakakāpō o tō tātā
• Tō hauora whānui me ētahi atu āhuatanga hauora
• Ngā tikanga ngākau o mua, ngā pokanga rānei
• Tō tau me te roa e tūmanakohia ana
• Ngā āhuatanga mō ngā raruraru

I hangaia ngā tūāpapa TAVR hou katoa kia roa ngā tau, ahakoa kei te ako tonu mātou mō te roa o te roa o te roa. Ko ngā tūāpapa i hangaia mai i te kiko o te kau (kau) rānei, te kiko poaka (poaka), he rite ki ngā tūāpapa pokanga, ā, he pai te whakawhitiwhiti e te nuinga o te tangata.

Ka kōrero tō tākuta i te tūāpapa motuhake e tūtohu ana rātou, ā, ka whakamārama he aha te mea pai mō tō āhuatanga. Ko te mea nui ko te tika te rahi me te tūnga o te tūāpapa mō tō tinana.

He aha ngā āhuatanga mō ngā raruraru TAVR?

Ahakoa he tino haumaru te TAVR, mā te māramatanga ki ngā āhuatanga mō te mōrearea ka āwhina i a koe me tō tākuta ki te whakatau i ngā whakatau pai mō tō manaakitanga. He pai te nuinga o te tangata ki te TAVR, engari ko ētahi āhuatanga ka piki ake te tūponotanga o ngā raruraru.

Ko te pakeke anake ehara i te āhuatanga mō te mōrearea, engari ko ētahi atu āhuatanga hauora e haere tahi ana me te koroheketanga ka pā ki te putanga o tō TAVR. Ka āta arotake tō rōpū ngākau i ēnei āhuatanga katoa i mua i te tūtohu i te tikanga.

Ngā āhuatanga mō te mōrearea e piki ake ai ngā raruraru ko:

• Te mate tākihi nui, te ngoikore rānei o te tākihi
• Te whiu o mua, te mate rānei o te pūngao nui
• Te mate pūkahukahu nui, ngā raruraru rānei o te manawa
• Ngā raruraru toto, te hiahia rānei mō ngā whakaheke toto
• Te mate huka me ngā raruraru
• Te uaua ngākau ngoikore rawa
• Te pokanga ngākau o mua, ngā tikanga rānei
• Te tino calcified, te āhua rānei o te tūāpapa

Ngā āhuatanga mō te mōrearea e kore e kitea, engari he nui ake te kino ko te mate ate nui, te mate kaha, me ētahi momo raruraru o te manawa. Ka whakaaro hoki tō tākuta ki tō ngoikoretanga whānui me te kaha ki te whakawhiti i te tikanga.

Ahakoa he āhuatanga mō te mōrearea, kei te TAVR tonu pea tō kōwhiringa pai. Ka mahi tō rōpū ngākau ki a koe ki te whakaiti i ngā mōrearea me te whakapai ake i tō putanga. Ka tūtohu pea rātou i ngā rongoā atu, i ngā whakatūpato rānei hei whakapai ake i tō haumaru.

He pai ake te TAVR, te whakakapinga tūāpapa pokanga rānei?

Ko te whakatau i waenga i te TAVR me te whakakapinga o te uaua aortic pokanga e whakawhirinaki ana ki nga ahuatanga takitahi, a he pai nga tikanga e rua mo te rongoa i te mate uaua aortic nui. Ka awhina to roopu ngakau ki a koe ki te mohio ko tehea huarahi te mea pai mo to ahuatanga motuhake.

He maha nga painga o te TAVR, tae atu ki te whakaora tere, kaore he hiahia mo te tapahi i te uma, nga nohoanga hōhipera poto, me te iti o nga tupono i te wa tonu mo te maha o nga turoro. Ka taea e te nuinga o nga tangata te hoki ki nga mahi noa i roto i nga wiki, kaua ki nga marama.

Heoi, he pai ake pea te whakakapinga o te uaua pokanga i etahi ahuatanga:

• Mena he rangatahi koe, a tera pea ka hiahia koe ki te uaua kia roa mo nga tau tekau
• Mena he raruraru ngakau ke atu kei te hiahia pokanga i te wa ano
• Mena karekau to anatomy uaua e tika ana mo te TAVR
• Mena he momo mate uaua to i tua atu i te aortic stenosis
• Mena he mate kaha to i roto i to ngakau

E whakaatu ana nga rangahau tata nei he pai nga hua o te TAVR ahakoa i roto i nga turoro rangatahi, iti-morearea. He maha nga tangata i whakaarohia i mua ko te pokanga anake he pai inaianei mo te TAVR.

Ka whakaatu to roopu ngakau i o whiringa katoa me te whakamarama i nga painga me nga tupono o ia huarahi. Ka whakaarohia e ratou to tau, te hauora katoa, te anatomy uaua, te oranga, me nga hiahia whaiaro hei awhina i a koe ki te whakatau i te whakatau pai.

He aha nga raruraru ka puta mai i te TAVR?

Ahakoa he tino haumaru te TAVR, he mea nui kia mohio ki nga raruraru ka puta mai kia taea ai e koe te whakatau i tetahi whakatau mohio me te mohio ki nga mea hei matakitaki i muri i to tikanga. Ko te nuinga o nga tangata karekau he raruraru, engari ko te mohio ka awhina i a koe ki te mohio ki te wa ki te rapu rongoa.

He onge nga raruraru nui engari ka puta. He maha nga whakatupatotanga a to roopu rongoa hei aukati i enei take, a kua rite ki te whakahaere i a raatau mena ka puta.

Ko nga raruraru ka puta i te wa, i muri tata ranei i te TAVR ko:

• Te toto i te wāhi uru, i roto rānei
• Te whiu, ngā tohumate rānei o te roro mō te wā poto
• Ngā raruraru o te manawa e hiahia ana ki te tākaro manawa
• Te turuturu o te takirere huri noa i te takirere hou
• Ngā raruraru o te pūkahukahu mai i te waikano rerekē
• Te whara, ngā raruraru rānei o te uaua toto
• Te whakaeke manawa, te whara rānei o te uaua manawa
• Te mate i te wāhi uru

Ko ngā raruraru kāore i te pōturi engari he nui te kino, ko te neke o te takirere, te aukati i te uaua toto o te ngākau, te hiahia rānei ki te pokanga ohorere. Ko tō tūponotanga mō ēnei raruraru e whakawhirinaki ana ki tō hauora me tō āhua tinana.

He onge ngā raruraru mō te wā roa engari kei roto pea te kino o te takirere i te roanga o te wā, ngā pūhui toto, te mate rānei. Mā te whai i te tiaki i ngā wā katoa e āwhina ana ki te kite me te whakatika i ngā take i te wā wawe.

Ka kōrero tō rōpū ngākau mō tō āhua tūpono motuhake, ā, ka whai i ngā mahi hei whakaiti i ngā raruraru. Ka hoatu hoki e rātou ngā tohutohu mārama mō ngā tohu whakatūpato hei mātakitaki, me te wā hei whakapā atu ki a rātou.

Āhea au e kite ai i te tākuta i muri i te TAVR?

Ko te mōhio ki te wā hei whakapā atu ki tō tākuta i muri i te TAVR he mea nui mō tō haumaru me te rangimārie o te hinengaro. Ahakoa te nuinga o te tangata e ora ana i te pai, ko ētahi tohumate e hiahia ana ki te āwhina hauora tonu hei ārai i ngā raruraru nui.

Me whakapā atu koe ki tō tākuta tonu mēnā ka pā ki a koe te mamae o te uma, te poto o te manawa, te whanoke, te ngaro rānei o te mōhiotanga, ngā tohu rānei o te toto. Ko ēnei tohumate e tohu ana i ngā raruraru e hiahia ana ki te rongoā wawe.

Rapua te āwhina hauora ohorere tonu mēnā ka whakawhanake koe:

• Te mamae nui o te uma, te pēhanga rānei
• Te poto o te manawa ohorere, nui
• Te ngaro o te mōhiotanga, te ngaro rānei o te mōhiotanga
• Ngā tohu o te whiu (te tō o te kanohi, te ngoikore o te ringa, ngā raruraru o te kōrero)
• Te toto nui mai i tō wāhi uru
• Te kirika i runga ake i te 101°F (38.3°C)
• Te mamae ohorere o te waewae, te pūhi, ngā rerekētanga rānei o te tae

Whakapā atu ki te tari o tō tākuta i ngā hāora pakihi mō ngā tohumate pērā i te pōkaikaha ngawari e pōkaikaha ana, te pūhi i ō waewae, i ō waewae rānei, te ngenge tonu, i ngā pātai rānei mō ō rongoā.

Ahakoa te pai o tō tū, kia mau ki ngā whakaritenga whai-whai katoa kua whakaritea. Mā ēnei haerenga e āhei ai tō tākuta ki te aroturuki i te mahi o tō pūwāhi me te hauora o te ngākau, me te whakatika i tō mahere maimoatanga ki te hiahiatia.

Kaua e whakaroa ki te waea atu mō ngā āwangawanga, ngā pātai rānei. E hiahia ana tō rōpū ngākau kia mōhio kei a koe te whakaora pai rawa atu me te putanga wā-roa.

Ngā pātai e pātai pinepine ana mō te TAVR

Q1: He pai te TAVR mō te aortic regurgitation?

Ka taea te whakamahi i te TAVR mō te aortic regurgitation (te turuturu o te pūwāhi) nui, engari kāore i te nuinga o te wā e mahia ana pērā i te aortic stenosis. He uaua ake te tikanga i ngā keehi regurgitation nā te mea he iti ake te hanganga pūwāhi hei punga i te pūwāhi hou.

Ka āta arotake e tō tākuta tō āhua pūwāhi me te kaha o te regurgitation hei whakatau mēnā he tika te TAVR. Ko ētahi tāngata e pā ana ki te regurgitation he pai ake te tūnga mō te whakakapinga pūwāhi pokanga, i te wā e pai ana ētahi atu ki te TAVR.

Q2: E hiahia ana te TAVR ki ngā whakaiti toto mō te wā katoa o te ora?

Ko te nuinga o te tāngata e hiahia ana ki ngā whakaiti toto mō te 3-6 marama i muri i te TAVR hei ārai i ngā pūhui toto i te wā e ora ana te pūwāhi, ka hipokina e te kiko tūturu o tō tinana. I muri i tēnei wā, ka taea e te nuinga o te tāngata te whakamutu i ngā whakaiti toto ki te kore ō rātou āhuatanga e hiahia ana ki a rātou.

Ka whakatau tō tākuta i te tikanga whakaiti toto pai rawa atu i runga i ō āhuatanga tūpono takitahi, ētahi atu rongoā, me te hauora whānui. Ko ētahi tāngata e hiahia ana ki ngā whakaiti toto wā-roa mō ngā take kāore i te pā ana ki tā rātou TAVR.

Q3: Kia pehea te roa o te pūwāhi TAVR e mau ana?

I hanga ngā tātā TAVR kia roa te ora, ā, e whakaatu ana ngā raraunga o nāianei i te tino roa o te ora i te 5-8 tau i muri i te whakaurunga. I te mea he tikanga hou te TAVR, kei te ako tonu mātou mō te roa rawa atu o te ora i tua atu i te 10 tau.

E whakawhirinaki ana te roa o te ora o te tātā ki ngā āhuatanga pēnei i tō tau, te hauora whānui, me te pai o tō tiaki i a koe anō i muri i te tikanga. Mā te tiaki whai muri i ngā wā katoa e āwhina ana ki te aroturuki i te mahi o te tātā me te kite i ngā huringa i te wā wawe.

Q4: Ka taea e au te whai TAVR anō mēnā ka kore e pai taku tātā?

Āe, ka taea te whai i te tikanga TAVR tuarua (e kīia ana ko te tātā-i-tātā TAVR) mēnā ka kore e pai tō tātā tuatahi. Koinei tētahi o ngā painga o te TAVR - kāore e aukati i ngā whiringa maimoatanga ā muri ake nei.

Heoi, he uaua ake pea ngā tikanga tukurua, ā, he rerekē ngā tūponotanga. Ka arotakehia e tō rōpū ngākau ō whiringa katoa mēnā ka puta ngā raruraru tātā, tae atu ki te TAVR tukurua, te whakakapinga rānei mā te pokanga.

Q5: He aha ngā mahi ka taea e au i muri i te TAVR?

Ka taea e te nuinga o te tangata te hoki ki ngā mahi katoa e mahia ana e rātou i muri i te TAVR, he maha tonu te pai o te manawanui ki te whakakori tinana i mua i te tikanga. Ka tīmata koe ki ngā mahi māmā, ā, ka piki haere tō taumata mahi i raro i te aratohu a tō tākuta.

He maha ngā tāngata ka taea te taraiwa i roto i te wiki, te hoki ki te mahi i roto i te 2-4 wiki, me te hoki ki te whakakori tinana me ngā hākinakina i roto i te 4-6 wiki. Ka tūtohu pea tō tākuta i te whakahōunga ngākau hei āwhina i a koe ki te hanga anō i tō kaha me tō manawanui.