Fact VS. Misconception

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It is a common misconception on parts of the island that there are no doctors to perform some of the more complicated surgical procedures and that people either have to take their pets to Oahu or there is really no hope. We have been told by numerous clients now that they have been referred off island or told they have to wait until the specialist comes to the island in order for their pets to have surgery. Really? Almost everyone one of these surgeries that have been described, we do here at our hospital. In fact one surgery in particular the TTA ( Tibial Tuberosity Advancement) Is done at our hospital by my dad regularly. We take referrals for this procedure and numerous others every single day. Back surgery for dogs with pinched nerves that are causing deficits in their hind limbs, yep we do it. We also do Myelograms to help diagnosis the problem so we can zero in on the exact location. PDA heart surgery you bet. Bile duct obstruction, thoracic surgeries, gall bladder surgery, difficult mass removals, leg limb deformity (some have even come to us from other islands), even oncology cases from other hospitals are all seen here regularly and with great success.

Did you know my dad was the first doctor in Hawaii to take the course and offer the TTA surgery? It's a fact. There are now 3 doctors in the state, one on Maui one on Oahu, but my dad right here in Kona was the first. Did you know my dad did an internship in small animal medicine and surgery right after vet school? He was also sent to additional training in Ohio with Synthes, for fracture and fixator courses both basic and advanced. My dad performs surgery on complicated fractures, shattered bones and corrective repairs on previously repaired fractures and surgeries daily. In addition to the surgeries we provide, we also offer advance workups in cardiology, internal medicine, VetStem, dentistry and more. This is of course in addition to the general wellness and annual care we provide.

There is a propagated misconception, that we are the most expensive practice on the island. We see everyone else's invoices and we know that is simply not true. What is true, is that we will not put your pet at risk by not doing pre-operative bloodwork or perform surgery without the benefits of monitoring devices, a catheter and IV fluids. We want your pet to have the best possible outcome. We have been told " if the doctor knows what they are doing they don't need all those safety nets". Well, as an AAHA accredited practice, we believe differently. We know that animals that are hydrated during surgery with IV fluids, do better after surgery. Animals lose blood during even routine procedures like spays and neuters and having an IV catheter in place to administer fluids can be very important to maintain proper blood pressure. You never know how an animal is going to react to anesthesia, some animals sail though and some really struggle. Having an IV catheter in place lets us give life saving drugs if we need it, when we need it. It also allows us to reverse the effects of certain medication in case of an emergency. Pre-op blood work is not a way for us to make money off you at all, we do it, because it could save your pets life. We want to know that your pet doesn't have a bleeding disorder or issues with it's kidney or liver functions prior to anethetizing them for a procedure. Your pets kidneys and liver have to process the medication we are giving during surgery, if they are not working correctly, it would be good to know before surgery not during a procedure.

Some procedures especially in animals already in crisis should NEVER even be done with out pre- op bloodwork before surgery and ECG, blood pressure monitoring, end tidal CO2, and O2 monitoring in place during surgery. These things are not options at our hospital, it is a standard of care we have chosen to provide and a commitment my dad made when he became a doctor and reinforced when we became AAHA accredited. Does it cost more, yes it does? Is it worth every penny, you bet. Pain management is another thing we take a lot of flack for. People tell us all the time "well if my pet is painful he will move around less and then I don't have to worry about him running around and getting hurt". Let me ask you, if my dad neutered you and removed your testicles or if he spayed your wife or girlfriend, removing her uterus and ovaries though an incision in her abdominal wall( assuming of course he was a human doctor and not a vet) would you want pain medication? What about if he amputated one of your limbs or plated one of your bones? What about if he extracted your teeth? Studies show that animals feel pain just like we do. They are programmed by evolution however, not to show it. I am sure you have heard of survival of the fittest right? Well we believe in pain management and not the kind that last for a few hours and then wears off. No we are talking about pain medications for days and sometimes weeks after surgery depending on the procedure. Yes even in spays and neuters.

As you can see there is a lot of misinformation out there. We believe in honesty and full disclosure. We know this may not appeal to everyone and well I guess you can't please them all. You can educated them however, by giving them all the information they need to make an informed decision. We have been providing high quality surgical and medical options and care to this island for over 5 and 1/2 years now. My dad has been practicing medicine and performing surgeries for 15 years. We send out information regularly to area veterinarians letting them know we are here and we are happy to help. In turn numerous veterinarians send us their more difficult or unique cases. Coming from emergency medicine my dad is used to seeing other doctors clients and patients and then sending them back to them for routine care. We understand that people build a relationship with their veterinarian and we respect that. This is why we want you to know that we want to help make your pet well, we are not trying to steal you away as a client. We believe in being up-front giving clients a quote for services, we know they will call around and look for whoever will beat our prices, our prices do not change based on the client or the quote they got from another veterinarian. We don't do that. It is not fair to the rest of the veterinary community and it is deceitful. As you can see it is not always an apples to apples comparison in terms of the services provided. It is always frustrating however that we can't all work together for the greater good of the patients. Veterinary medicine changes everyday, and we are committed to staying up to date on the changes. We will always try and learn more and be the best veterinary practice we can be. We know honesty is always the best policy, although it may not make you the most popular. After all your only humans.~ Ruff

She dances with angels wings...

"When the first baby laughed for the first time, the laugh broke into a thousand pieces and they all went skipping about, and that was the beginning of fairies. And now when every new baby is born its first laugh becomes a fairy. So there ought to be one fairy for every boy or girl."~ Peter Pan

Little did I know when I told you all about our new little friend a few weeks ago that we would be trying to come to terms with losing her.  How do you tell your child that their beautiful little friend so full of life and love is gone? With our daughter it was simple, she did the hard work for us. We told her that her friend had passed away and she asked a couple questions and then simply told us that it was ok and that she was not sick anymore and that now she could talk to her whenever she wanted. She spent days coloring pictures of her friend and writing and rewriting her name. She told her goodnight as we put her to bed like she was right there, smiling sweetly. While we tried to find words, she was building us a garden, planting rocks and seeds, placing sea shells and sprinkling glitter. Oh to see a world in a grain of sand, I thought. To see the loss through the eyes of my child while she is creating this world for her friend holding tight to her memory.

Pink like bubble gum and cotton candy, hibiscus and sunsets. The simple laugh, her "little talk" like a whisper. Her spirit like a lion, fighting for her right to remain even if it is just to touch the depth of our souls and reawaken our hearts. Where did she go? Where can I find her?  The answer comes with the question in the "Garden". She is where the fairies hide amongst the flowers,  in the early hours when the dew kisses the morning as it clings to the spiders web. The sun streams through the branches, cutting a path through the shadows where our hearts travel, searching for her smile and finding the warmth of her memory filling the cracks in our hearts. She sings her songs now on the wind. She soars on the wings of the butterflies and the birds with which she travels, commanding the dragonflies to carry forth her transformation. This is how we have chosen to remember her like she was in life, graceful and beautiful and perfect. What a gift to have had the chance to know her, to share in the journey! 

We feel so honored to have met her wonderful family. We have found friends though this process that only the depth of an ocean could bring.  We stand still just to listen to the wind whisper her name and know that it is our children who speak it. We can't find the words to express the depth of our sorrow for her family, we know only that the color pink will always belong to her and every butterfly will remind us of her grace in life. 

~Brian Froud said "Once upon a time, I thought faeries lived only in books, old folktales, and the past. That was before they burst upon my life as vibrant, luminous beings, permeating my art and my everyday existence, causing glorious havoc." 

Thank you Carmen Leolani White for causing glorious havoc and teaching us that life is about how you live, not how long. For "Just living is not enough" said the butterfly fairy, "one must have sunshine, freedom and a little flower." ~ Hans Christian Anderson  to you with all our love! 

For more about Carmen and her beautiful life or to Donate to Carmen's Makana please visit their website.  http://carmenleolaniwhite.blogspot.com

Photo by Heather White.

Tucker... and life lessons

When my sister came home from school on Friday she smelled like another dog, a golden retriever if I am not mistaken. She was talking about red blood cells and white blood cells and how they all worked. She mentioned that her new friend at school was the reason this awesome dog got to come visit her school. Then, on Sunday, my family got up before the sun, they got dressed in their running gear and headed out the door. When they returned hours later all my sister could talk about was this dog named Tucker, same smells as Friday, at least now I knew his name. She kept telling my dad how handsome Tucker was and what a good dog he was. She told my brother that Tucker had a very important job and that he actually had to work all the time. "I work all the time" I thought. Later that night my mom sat my sister down and showed her pictures of what Tucker did at work. I sat there watching as my sister pointed at pictures of Tucker on the beds of all these different children. In some he was sleeping while the children rubbed his back, in others he was standing beside them, guarding them like a sentry. I listened as my mom talked to my sister about Tucker and how his job was to bring happiness and comfort to all the children that needed him at hospital on Oahu. He was actually on staff there and was a true member of the Kapi'olani Children's Hospital team. 

My mom talked about how sometimes people get very sick and sometimes those people were like her new friend at school, very young. My sister asked what made them sick and my mom told her it was Cancer and that there are a lot of different kinds. Now we deal with cancer everyday at work. We perform mass removals and chemotherapy at our hospital so I knew the words mom was saying, but some how hearing about sick children made it seem that much more scary, that much more real. Mom talked about family we have lost to Cancer and how it has touched our lives. She spoke about how hard it must be for a family to care for a sick child and sometimes lose a child.  She told my sister how important it was to participate in events like the Run for Hope they were in that morning. She said the money they raise during these events goes to research so that hopefully one day they can cure Cancer. 

I looked at the pictures of my sisters new friend when she was very sick, Tucker is in a lot of these pictures, always watching over her. He looks so gentle, kind and wise. I sat there thinking about how hard his job must be, knowing that not all the little people he comforts get well. It made me think about the things that really matter like love and laughter. I watched as my mom rubbed my sisters arm that is still healing from her break as she laid her into her bed that night. She told my sister, her new friend was very brave as she leaned down to kiss her forehead. My sister said "and beautiful mom". "Of course and beautiful" mom replied. I heard my mom tell my dad that night as tears streamed down her face how she could not imagine going through all that with one of their children. They laid there in the dark and talked about the things that really mattered to them. They talked about Tucker and his wonderful mom Dr. Wendi and all the wonderful people they met recently. They spoke softly about my sisters friend and how sometimes the reminders we need in life come from the most unlikely places. As I climbed into my bed that night I thought back on the photos I had seen and the words I heard spoken that day. I realized that my family is right! Everything we need we already have. A healthy family, good friends, and love. If we could pay our way through the rest of our lives on the currency of love, we would never want for anything. As I closed my eyes I pictured what that kind of world that would be like, and it was one of the sweetest dreams ever. ~ RUFF!

For more information on Kapi'olani's dog Tucker and how you can get involved in the fight against Cancer and other childhood illnesses visit their website. www.kapiolani.org

Photo Credit Heather White Images. 
Published In West Hawaii Today 9/14/2012

Graduation Day

A night visitor.

Inside the tent was pure darkness the kind you only find in the wilds of your mind or the wilderness. My heart stopped when I heard the noise again, that had woken me from a deep high altitude sleep.. It was faint at first like a whisper on the wind. It was a cry I was certain, but from what I did not know. I gazed into the darkness listening . Was it an animal or a child? Was it the wind playing tricks as it was blowing through the trees? I could feel it’s presence as it came closer and I began to worry in earnest for my safety.  I tried to rationalize the sound, I tried in vain to wake from what certainly had to be a dream, brought on by the dinner of pepper and sausage I had eaten just a couple of hours before. Perhaps it was the extra glass of the lovely wine I drank by the campfire before retiring to the safety of my tent causing my mind to play tricks on me.

Then I heard the cry again only closer to me, I knew I was awake for certain. I also knew we had company. It was on the right side of the tent and it sounded like a wounded animal. I quietly fumbled for the flashlight, my fingers were shaking and I could not take hold of it properly. There was condensation on the flashlight  and it slipped from my clumsy grasp. I tried to awaken my husband, who was  sound asleep inside his sleeping bag. I nudged him gently and then with some force covering his mouth as to not startle our midnight guest. With my fingers pressed to my lips in the still of the night we listened. It slowly made its way around the edge bumping into the tent with its body, breathing and sighing heavily into crisp night air. I could hear the blood rushing in my ears as my heart tried not to leap from my chest, as we waited in silence, for the night visitor to make its next move.

I had found the flash light and we debated a plan in hushed whispers. We heard a crunching noise, just beyond the front of the tent out near the extinguished fire pit.  We thought we heard a muffled cry once more and then nothing. The noises began to fade away. What ever it was had decided to move on. Perhaps the rocks around the fire pit had grown cold and it went in search of something else entirely. We lay awake starring into each others eyes until we eventually fell asleep once again gripping each others hands like we were holding on to the edge of a cliff, willing the dawn to come quickly.

When we awoke the next morning to calm crisp mountain air. The fresh dew was shimmering like diamonds in the morning light, and we were scarred again in an instant. The dawn revealed  our nightmare with such clarity as to the “who” of our late night guest, that it left me trembling. There were large tracks circling our tent and a clear area where our guest had laid down near the fire pit and had its midnight snack. Like crumbs the feathers were left as a calling card giving us a new insight to our guests identity.  We took photos of the tracks and the feathered evidence so we could get a positive identification on our murderous guest.

I almost wished we had not had confirmation of the who, who was creeping around our tent in the night. The ranger said it was a mountain lion and from the looks of it he was hungry and big. I was thankful that our guest has brought his own meal and enjoyed it by the warm rocks and moved on. Even now the thought of that big cat circling our tent makes my hair stand on end. I decided then that our next camping trip we would spend the night in our car. I even suggested perhaps we camped in our back yard under the street light filled night sky. I knew for sure I was not sleeping in a tent the rest of the summer.  We have children and pets after all, and that was as close to the wild side as I need to be.