Maluhiluhi me ka hoomaopopo ole
Ua mālama au i ka mālama mua no kekahi mau makahiki.
Maikaʻi ka poʻe i lilo i kahu mālama mua (PCP) ʻike aia kekahi pūʻulu o nā maʻi a mākou i ʻike a pau e ʻeha nei i ka luhi, luhi, a me ka manaʻo maikaʻi ʻole i hiki ʻole iā mākou ke ʻimi i kahi kumu kikoʻī. E hoʻolohe mākou, e hana i kahi hoʻokolokolo pono, e kauoha i ka hana koko kūpono, a e ʻimi i nā loea no ka ʻike hou aʻe a ʻaʻole maopopo ka manaʻo e pili ana i ka mea e hana nei.
ʻO ka mea pōʻino, hoʻokuʻu kekahi mau mea lawelawe i kēia mau maʻi. Inā ʻaʻole hiki iā lākou ke wehe i kekahi ʻike ʻino ma ka hoʻokolokolo, ka hana koko, a i ʻole nā mea ʻē aʻe, e hoʻowalewale ʻia lākou e hōʻemi i kā lākou mau hōʻailona a i ʻole e hōʻailona iā lākou he malingering a i ʻole nā pilikia noʻonoʻo.
Ua hoʻopili ʻia nā kumu he nui i nā makahiki. Ua ʻelemakule wau e hoʻomanaʻo i ka "yuppie flu." ʻO nā lepili ʻē aʻe i hoʻohana ʻia e pili ana i ka maʻi maʻi maʻi, fibromyalgia, Epstein-Barr mau loa, nā ʻano meaʻai like ʻole, a me nā mea ʻē aʻe.
I kēia manawa, ke hōʻike mai nei kekahi ʻano ʻē aʻe i ke kau ʻana o kēia mau kūlana; he "makana" o kā mākou maʻi maʻi hou. Ke ʻōlelo nei au i ka COVID-19 lōʻihi, nā mea huki lōʻihi, post-COVID-19, COVID-19 maʻi, a i ʻole ka hopena post-acute o SARS-CoV-2 (PASC). Ua hoʻohana ʻia nā mea a pau.
ʻO nā hōʻailona lōʻihi e pili ana i ka luhi e pili ana i nā ʻano maʻi lele. Ua like kēia mau maʻi luhi "postinfectious" i ka mea i kapa ʻia ʻo myalgic encephalitis/chronic fatigue syndrome (ME/CFS). ʻO ka hapa nui o ka manawa, ʻo kēia maʻi ponoʻī e hahai pinepine i kahi maʻi infectious-like.
Ma hope o ka maʻi maʻi COVID-19, inā i mālama ʻia i ka haukapila a i ʻole, hoʻomau ka nui o nā mea maʻi i ka nāwaliwali a me nā hōʻailona no nā mahina he nui. Loaʻa paha i kekahi o kēia mau "lōʻihi lōʻihi" nā hōʻailona e hōʻike ana i ka pōʻino o ke kino. Hiki i kēia ke komo i ka puʻuwai, ka māmā, a i ʻole ka lolo. ʻAʻole maikaʻi nā poʻe holo lōʻihi ʻē aʻe me ka loaʻa ʻole o nā hōʻike maopopo o ia pōʻino kino. ʻO ka ʻoiaʻiʻo, ʻo nā mea maʻi e maʻi mau ana ma hope o ʻeono mahina ma hope o kahi hakakā me COVID-19 e hōʻike i nā hōʻailona like me ME/CFS. Hiki iā mākou ke ʻike i ka pālua o ka poʻe me kēia mau hōʻailona ma hope o ka maʻi maʻi. ʻO ka mea pōʻino, e like me nā mea ʻē aʻe, nui ka poʻe e hōʻike nei i ka hoʻokuʻu ʻia ʻana e nā limahana mālama olakino.
ʻO ka myalgic encephalomyelitis/chronic fatigue syndrome e pili ana ma waena o 836,000 a me 2.5 miliona ʻAmelika o nā makahiki āpau, nā lāhui, nā kāne, a me nā kūlana socioeconomic. ʻO ka hapa nui ʻaʻole i ʻike ʻia a kuhi hewa paha. Hoʻopilikia ʻia kekahi mau hui:
- Hoʻopilikia ʻia nā wahine i ʻekolu manawa ma mua o nā kāne.
- Hoʻomaka pinepine ʻia ma waena o nā makahiki 10 a hiki i 19 a me 30 a hiki i 39. ʻO ka awelika o nā makahiki i ka hoʻomaka ʻana he 33.
- Hiki ke hoʻopili ʻia nā ʻeleʻele a me nā Latinx ma kahi kiʻekiʻe a me ka ʻoi aku ka paʻakikī ma mua o nā hui ʻē aʻe. ʻAʻole maopopo iā mākou no ka mea, nele ka ʻikepili prevalence i ka poʻe kala.
ʻOiai he bimodal ka makahiki o ka mea maʻi i ka maʻi maʻi, me kahi kiʻekiʻe i nā makahiki ʻōpio a me kahi kiʻekiʻe ma nā makahiki 30, akā ua wehewehe ʻia ke kūlana i nā poʻe mai ka makahiki 2 a hiki i 77.
He nui nā kauka lapaʻau i nele i ka ʻike e hoʻopaʻa pono a hoʻokele paha i ka ME/CFS. ʻO ka mea pōʻino, ʻaʻole liʻiliʻi nā alakaʻi lapaʻau, kahiko ʻole, a i ʻole hiki ke pōʻino. Ma muli o kēia, ʻeiwa o 10 mau maʻi ma ʻAmelika Hui Pū ʻIa e noho mau me ka ʻike ʻole ʻia, a ʻo ka poʻe i ʻike ʻia e loaʻa pinepine ka lāʻau kūpono ʻole. A i kēia manawa, ma muli o ka maʻi maʻi COVID-19, ke ulu nui nei kēia mau pilikia.
ʻO ka holomua?
ʻIke pinepine kēia mau maʻi i kahi maʻi i hōʻoia ʻia a ʻaʻole kikoʻī akā ʻaʻole hiki ke hoʻōla e like me ka mea i manaʻo ʻia a hoʻomau i ka maʻi ʻana i nā pule he mau mahina ma hope.
ʻO ka hoʻohana ʻana i ka lāʻau hoʻoikaika kino a me nā hana noʻonoʻo (ʻoi aku ka cognitive behavior therapy) e mālama i ka luhi e pili ana i ka maʻi kanesa, nā maʻi ʻeha, nā kūlana neurologic, a me ka fibromyalgia i hoʻohana ʻia no nā makahiki me ka hopena maikaʻi loa. Eia naʻe, i ka wā i manaʻo ʻia ai ka heluna kanaka no ka loaʻa ʻana o ME/CFS i nā ʻano lapaʻau like, ʻoi aku ka maikaʻi o ka hana a me ka hana.
ʻO ke Kōmike o ka Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome; Papa ma ke ola o na kanaka wae; Ua nānā ka Institute of Medicine" i ka ʻikepili a loaʻa mai nā koina. ʻO ka mea nui, ua kāhea lākou i ka wehewehe hou ʻana i kēia maʻi. Ua paʻi ʻia kēia ma ka National Academies Press i ka makahiki 2015. ʻO ka paʻakikī ʻo ka nui o nā mea mālama olakino ʻaʻole i kamaʻāina i kēia mau pae. I kēia manawa me ka hoʻonui ʻana o nā mea maʻi i lawe ʻia e ka post-COVID-19, ua piʻi nui ka hoihoi. Nā pae hoʻohālike:
- ʻO ka hoʻemi nui a i ʻole ka hōʻemi ʻana i ka hana ma mua o ka maʻi, ke kula, a i ʻole nā hana pilikanaka e hoʻomau ʻia no ʻeono mahina me ka luhi, pinepine hohonu, ʻaʻole ia ma muli o ka hoʻoikaika kino a ʻaʻole i hoʻomaikaʻi ʻia e ka hoʻomaha.
- Ma hope o ka hoʻoikaika kino - ʻo ia hoʻi ma hope o ka hana, nui ka luhi a i ʻole ka nalowale o ka ikehu.
- ʻO ka hiamoe hoʻomaha ʻole.
- A ma ka liʻiliʻi paha:
- Orthostatic intolerance - ʻo ka lōʻihi o ke kū ʻana e ʻoi aku ka ʻino o kēia mau maʻi.
- ʻAʻole hiki ke noʻonoʻo pono.
(Pono e loaʻa i nā maʻi kēia mau hōʻailona ma ka hapa liʻiliʻi o ka manawa o ka maʻalahi, haʻahaʻa, a koʻikoʻi paha.)
- Nui nā poʻe me ME/CFS i loaʻa nā hōʻailona ʻē aʻe. Loaʻa nā hōʻailona maʻamau hou aʻe:
- ʻO kaʻehaʻeha
- ʻO ka ʻeha ma nā ami me ka ʻole o ka pehu a ʻulaʻula
- ʻO nā ʻeha poʻo o kahi ʻano hou, ʻano, a i ʻole ke koʻikoʻi
- ʻO nā ʻōpū lymph ma ka ʻāʻī a ʻāʻī paha
- ʻO ka ʻeha ʻāʻī i pinepine a i ʻole e hoʻi hou ana
- ʻO ke anuanu a me ka wela o ka pō
- Nā haunaele ʻike
- ʻO ka noʻonoʻo i ka māmā a me ke kani
- 'O Nausea
- Allergies a maʻi ʻole i nā meaʻai, nā mea ʻala, nā kemika, a i ʻole nā lāʻau lapaʻau
ʻOiai ma hope o ka hōʻoia ʻana, paʻakikī ka poʻe maʻi i ka loaʻa ʻana o ka mālama kūpono a ua kuhikuhi pinepine ʻia nā lāʻau lapaʻau, e like me ka cognitive-behavioral therapy (CBT) a me ka graded exercise therapy (GET), hiki ke hōʻeha i ko lākou kūlana.
Ua kākau ʻo Meghan O'Rourke i kahi puke i kapa ʻia ʻo "The Invisible Kingdom: Reimagining Chronic Illness." ʻO kahi leka mai ka mea hoʻopuka e hoʻolauna i ke kumuhana penei:
"ʻO kahi maʻi maʻi leo o nā maʻi maʻi e hoʻopilikia nei i nā ʻumi miliona o ʻAmelika: ʻo kēia nā maʻi i hoʻomaopopo maikaʻi ʻole ʻia, hoʻokaʻawale pinepine ʻia, a hiki ke ʻike ʻole ʻia a ʻike ʻole ʻia. Hāʻawi ka mea kākau i kahi hoʻokolokolo hōʻike i kēia māhele paʻakikī o ka maʻi "ʻike ʻole" e hoʻopuni ana i nā maʻi autoimmune, post-treatment Lyme disease syndrome, a i kēia manawa lōʻihi COVID, synthesizing i ka pilikino a me ke ao holoʻokoʻa e kōkua iā mākou āpau ma kēia palena hou.
ʻO ka hope, ua nui nā noiʻi e hōʻike ana i ka huaʻōlelo "chronic fatigue syndrome" e pili ana i ka ʻike o ka poʻe maʻi i ko lākou maʻi a me ka hopena o nā mea ʻē aʻe, me nā limahana lapaʻau, nā ʻohana, a me nā hoa hana. Hiki i kēia lepili ke hōʻemi i ke koʻikoʻi o kēia maʻi no ka poʻe i ʻeha. Manaʻo ke komite IOM i inoa hou e pani i ka ME/CFS: systemic exertion intolerance disease (SEID).
ʻO ka inoa ʻana i kēia maʻi SEID e hōʻike maoli i ka hiʻohiʻona o kēia maʻi. ʻO ia hoʻi, ka hoʻoikaika ʻana o kēlā me kēia ʻano (ke kino, ka noʻonoʻo, a i ʻole ka naʻau) - hiki ke hoʻopilikia i nā maʻi ma nā ʻano he nui.
Resources
aafp.org/pubs/afp/issues/2023/0700/fatigue-adults.html#afp20230700p58-b19
mayoclinicproceedings.org/article/S0025-6196(21)00513-9/fulltext
"ʻO ke aupuni ʻike ʻole ʻia: hoʻomaʻamaʻa hou i ka maʻi maʻi" ʻo Meghan O'Rourke