Te Whakahaere Mamae i roto i te Mate Pukupuku
Ko te mamae tētahi o ngā amuamu tino noa, tino whakararuraru hoki i roto i ngā tūroro matepukupuku. Ka puta te mamae i te tīmatanga o te mate, i te wā e kitea ai te mate, i te wā e rongoatia ana (pokanga, chemotherapy, radiotherapy), tae noa ki ngā wāhanga o muri mai. Ehara i te mea ko te tinana anake te pānga, engari ko te kare ā-roto, te pāpori, me te wairua hoki. Nō reira, ko te whakahaere mamae i roto i te matepukupuku he wāhanga nui o te tiaki whānui e aro ana ki te whakapai ake i te kounga o te oranga mō ngā tūroro me ō rātou whānau.
Te Mārama ki te Mamae i roto i te Mate Pukupuku
Kāore te mamae i roto i te mate pukupuku e tohu ana kei te kino haere te mate pukupuku, engari he maha ngā wā e pā ana ki ngā momo tikanga. Ka puta te mamae i te pēhitanga o te pukupuku ki ngā io, ngā wheua, ngā whekau rānei; te horapa o te mate pukupuku ki te wheua; te mumura; te aukati; ngā pānga taha rānei o te maimoatanga. Hei tāpiri, ka pāngia te mamae e te manukanuka, te pouri, te raruraru moe, me ngā wheako mamae o mua.
I te nuinga o te wā, ka taea te wehewehe i te mamae o te mate pukupuku ki ētahi momo:
1. Mamae kore e rongohia: ka puta mai i te kino o te kiko (hei tauira, te mamae o te wheua, te mamae rānei nā te pēhanga mai i te pukupuku). He rite tonu ki te pupuhi, te pēhanga, te mamae rānei.
2. Mamae neuropathic: ka puta mai i te kino o te io, i te riri rānei (hei tauira, nā te pēhanga o te io e te pukupuku, nā ngā pānga rānei o te chemotherapy). He maha ngā wā ka whakaahuahia te mamae he wera, he ngau, he wero, he rite ki te ru hiko.
3. Mamae whakauru: he huinga o ngā momo e rua i runga ake nei, e kitea pinepine ana i roto i ngā tūroro matepukupuku.
4. Mamae tino tere: te mamae e puta ohorere ana, e kaha ana ahakoa kua whakahaeretia te mamae taketake mā te rongoā noa.
He mea nui te mārama ki te momo mamae, nā te mea ka ārahi i ngā kōwhiringa rongoā tino whai hua.
Aromatawai Mamae: He Hipanga Tuatahi Hira
Ka tīmata te whakahaere mamae mā te aromatawai pai. Ko te tikanga, ka aromatawaihia e ngā tīma hauora te mamae mā te pātai mō tōna wāhi, tōna kaha, tōna roa, tōna āhua, ōna āhuatanga whakararuraru, whakamāmā rānei, me tōna pānga ki ngā mahi o ia rā. He maha ngā wā ka whakamahia he tauine mamae o te 0–10: ko te 0 te tikanga kāore he mamae, ā, ko te 10 te mamae tino kino ka taea te whakaaro.
Kei roto hoki i te aromatawai te hītori o te whakamahinga rongoā, te aroaro o ngā pānga taha, te mahi a te whatukuhu me te ate, me ngā āhuatanga hinengaro. E akiakihia ana ngā tūroro kia pono, kia tuwhera hoki te whakaahuatanga o te mamae, nā te mea he mamae takitahi te mamae, ā, ko te tūroro anake ka taea te aromatawai pono i tōna kaha.
Ngā Mātāpono Matua o te Whakahaere Mamae i te Mate Pukupuku
Ko ngā whāinga matua o te whakahaere mamae ko: te whakaiti i te kaha o te mamae, te whakapai ake i te mahi me te kounga o te oranga, me te whakaiti i ngā pānga taha o te rongoā. Ko ngā mātāpono e whakamahia whānuitia ana ko:
– Te whakawhaiaro i te rongoā: he rerekē ngā āhuatanga me ngā manawanui o ia tūroro.
– Te hoatu rongoā i ia wā: mō te mamae tonu, ka nui ake te whai huatanga o te rongoā mēnā ka hoatu i runga i tētahi wātaka, kaua i te wā e pā mai ana te mamae anake.
– Huarahi maha-ara: te whakakotahi i te rongoā, te wawaotanga whakaora, me te tautoko hinengaro-pāpori.
– Te aro turuki me te aromatawai i ia wā: ka taea te whakarerekē i te horopeta me te momo rongoā i runga i te urupare.
Te Whakaora Rongoā: Te Arawhata Whakamamae me te Whakarerekētanga Haumanu
Ko tētahi huarahi matarohia ko te "arawhata whakangāwari mamae" e tīmata ana i te rongoā i runga i te nui o te mamae, ā, ka whakanuia ake ina hiahiatia.
1. Rongoā Mamae Ngāwari: Kore-Opioid
Mō te mamae ngawari, ka taea te whakamahi i ngā rongoā pēnei i te paracetamol, i ngā rongoā anti-inflammatory kore-steroidal rānei (NSAID). He pai ngā NSAID mō te mamae o te wheua, te mamae rānei me te wāhanga mumura. Heoi, me tino tupato te whakamahi i ngā NSAID mō ngā tūroro he mate puku, he mate tākihi rānei, he mōrearea rānei ki te toto.
2. Ngā Opioid mō te Mamae Waenga ki te Mamae Nui
Mena he mamae ngawari ki te kino, he mamae rānei kāore e taea te whakahaere mā te whakamahi i ngā rongoā kore-opioid, he kōwhiringa pea ngā opioid. Hei tauira, ko te tramadol (mō te mamae ngawari), me te morphine, te oxycodone, te fentanyl rānei (mō te mamae kino rawa atu). Ka taea te hoatu i ngā opioid i roto i ngā momo āhua: papa, kāpūru tuku puhoi, pata, pāti, werohanga rānei.
He maha ngā wā ka ara ake ngā āwangawanga mō te whakawhirinaki ki te rongoā, engari i roto i te whakamahinga hauora e tirotirohia ana e te tākuta mō te mamae o te mate pukupuku, ko te arotahi matua ko te whakahaere i ngā tohu me te pupuri i te mahi. Ka taea te whakaiti i ngā mōrearea mā te whiriwhiri i te horopeta tika, te mātauranga, me te aroturuki tata.
3. Ngā Rongoā Āwhina mō te Mamae Neuropathic
He maha ngā wā ka kore e pai te urupare a te mamae neuropathic ki ngā opioid anake. Nō reira, ko ngā rongoā āwhina pēnei i:
– ētahi rongoā ārai pouri (hei tauira, duloxetine, amitriptyline rānei),
- ngā rongoā antiepileptic (hei tauira, gabapentin, pregabalin rānei),
– ngā corticosteroids hei whakaiti i te pupuhi/mumura i ētahi wā,
– he rongoā whakamoe ā-rohe i roto i ētahi āhuatanga.
4. Te wikitoria i te mamae nui
Hei tāpiri atu ki ngā rongoā noa, me whakamahi he rongoā tere te mamae nui, arā, he "horopeta whakaora". Mā tō tākuta e whakatau te momo, te horopeta, me te tikanga haumaru mō te tuku.
Te Whakahaere i ngā Pānga Taha o te Whakaora Mamae
Ka pā mai pea ngā pānga taha pēnei i te whakapairuaki, te hiamoe, te waha maroke, me te mea nui, te mate puku. Tata tonu ka puta te mate puku me ngā opioids me te kore he ārai, nō reira ka tohua ngā rongoā whakangote i te tīmatanga. Mēnā ka pā mai te whakapairuaki, te hiamoe rānei, ka taea e te tākuta te whakarerekē i te horopeta, te whakarerekē i te momo opioid, te tāpiri rānei i ngā rongoā tautoko.
He mea nui kia ripoatahia e ngā tūroro ngā pānga taha i te wā e taea ai. Mā tēnei, ka taea te whakapai ake i te maimoatanga me te kore e whakararu i te whakamarie.
Te Whakaora Kore-Rongoā: He Huarahi Tāpiri
Kāore te rongoā anake e whakawhirinaki ana ki te whakahaere mamae whai hua. He maha ngā huarahi kore-rongoā ka āwhina i te whakaiti i te māramatanga o te mamae me te whakapai ake i te manawanui hinengaro, tae atu ki:
– te tautoko hinengaro (te tohutohu, te whakaora hinengaro-whanonga),
– ngā tikanga whakangā me te manawa,
– te whakaaroaro, te aroātea, te inoi rānei e ai ki ō whakapono,
– te whakaora tinana hei pupuri i te nekenekehanga me te whakaiti i te pakari,
– ngā kōpeke mahana/makariri i raro i ētahi āhuatanga,
– te wero ngira, te mirimiri rānei (me ngā whakaaro haumaru, inā koa mēnā he wheua kua horapa, he mate toto rānei kua pāngia),
– te tautoko whānau me te tautoko pāpori.
He mea tino nui ngā maimoatanga kore-rongoā nā te mea ka āwhina i ngā tūroro kia kaha ake te wairua, me te whakaiti i te ahotea ka kaha ake ai te mamae.
Te Wawaotanga me te Whakaora Matepukupuku hei Whakahaere Mamae
I ētahi wā, ka taea te whakahaere pai ake i te mamae mā te wawaotanga hauora, hei tauira:
– te rongoā irahiko whakaora mō te mamae kua horapa ki te wheua,
– ngā aukati io, ngā werohanga rongoā rānei mō ētahi mamae,
– te papu whakamamae mamae, te werohanga opioid rānei i raro i ngā āhuatanga motuhake,
– ngā tikanga wheua mō te mōrearea o ngā whatiwhatinga nā te metastases,
– he pokanga whakaora mamae hei whakaiti i te aukati, te pēhanga rānei o te puranga pukupuku.
Hei tāpiritanga, ko te maimoatanga mate pukupuku tonu (te chemotherapy, te rongoā arotahi, te immunotherapy) ka whakaiti i te mamae mā te whakaiti i te pukupuku. Nō reira, he mea nui te whakawhitiwhiti kōrero i waenga i ngā tīma oncology me ngā tīma tiaki mamae.
Te Tūranga o te Rōpū Manaaki Mamae me te Whakawhitiwhiti Kōrero ki ngā Tūroro
Ehara i te mea ko te tiaki mamae anake mō te wāhanga mutunga o te ora. He huarahi e aro ana ki te kounga o te oranga mai i te tīmatanga o te mate, tae atu ki te whakahaere mamae me ētahi atu tohu, tae atu ki te tautoko hinengaro. Mā te mahi tahi a ngā tākuta, ngā nēhi, ngā kaiwhakaora rongoā, ngā tohunga hinengaro, me ngā minita ka āwhina i ngā tūroro ki te whiwhi tiaki whānui.
Me whai wāhi hoki ngā tūroro ki te whakatau kaupapa. Mā te whakamārama i ngā whāinga whakaora, ngā tumanakohanga, me ngā kōwhiringa e wātea ana ka pai ake te piripono me te whakaiti i te manukanuka.
Whakamutunga
He tukanga kua whakaritea, he āta haere, he mahi takitahi hoki te whakahaere i te mamae o te mate pukupuku. Ka taea te whakahaere i te mamae o te mate pukupuku mā te whakakotahi i ngā rongoā, te rongoā āwhina, ngā huarahi kore-rongoā, me ngā wawaotanga hauora ina hiahiatia. Ko te aromatawai tika i te mamae, te aroturuki i ngā pānga taha, me te whakawhitiwhiti kōrero whai hua i waenga i te tūroro, te whānau, me te tīma hauora ngā mea matua ki te angitu. Mā te whakahaere tika i te mamae, ka nui ake te tūponotanga o ngā tūroro mate pukupuku ki te mahi i ngā mahi o ia rā me te whakamarie, te whai tikanga, me te mana.
