Protecting your Hearing

According to the CDC, hearing loss is one of the most prominent debilitating health conditions in the U.S., with almost two times as many reportings as diabetes or cancer. While hearing loss has traditionally been a concern in older individuals, this issue has begun to cross all age groups. This is due to the increasing rates of hearing loss observed in young adults.

So how is sound measured? Sound is measured in decibels (dB) indicative of sound intensity or loudness. To give you a standard of comparison, an individual with normal hearing can typically hear sounds ranging from 0-140 dB. While normal conversation usually meets a level of 50-65 dB, sounds above 85 dB can be detrimental, depending on the length and intensity of sound exposure.

What causes hearing loss? [Read more…]

We’re Moving!

Hawaii Family Health has been working hard, not just at making sure you receive the best healthcare in Hilo, but making sure all of Hilo has access to the highest quality health care around.  We been working for years to build our integrated healthcare team, currently including medicine, psychology, psychiatry, nutrition, nursing, care management and education of the next generation of healthcare providers.  And, as we have done so, we have outgrown our small office.  With the help of Koa Architects and Sun Construction, we have a new building on the way. [Read more…]

Broken Heart Syndrome

What do an octopus and your heart have in common? Well, sometimes they both can get stressed out. Dahhaha; ok not such a great punchline – but it is an interesting thing to think about. With the holidays coming up, I think most everyone is aware that it’s a tricky time to make healthy choices with all the sweets, and treats surrounding us. But all the festivities can also bring additional stress– with all the last minute shopping, countless potlucks you have to bring food for, and family tensions running high as everyone flies home. It’s a time of sharing happiness and love, but also it’s pretty darn hectic – and while we’re watching out for our waistlines, we need to also remember to look out for our heart in other ways too. So let’s learn a little bit more about this interesting phenomenon that can affect one of our most vital organs.   [Read more…]

Local Health Insurer Shutting Down

First – Hawaii Family Health is intact and staying here!

Family Health Hawaii (yes, they stole our name!) has been ordered to liquidate – that is a fancy way of saying they are shutting down. Family Health Hawaii is a health insurance plan, not our office. 


This website has some frequently asked questions:

But the most important is: can I still see my doctor? This is complicated.  You can still see your doctor, as you are still technically insured.  However, your doctor may not get paid.  Bummer. 

It looks like they Liquidator (I didn’t even know that job title existed) will be holding all of the medical claims and then reviewing them after they are all received. Only then will they be able to determine if Family Health Hawaii will be able to afford to pay the claims and at what rate, meaning it might only be a portion of the previously agreed upon rate. 

So, your doctor may usually get $60 when you go for a visit (1-3 months later), but now your doctor won’t even know for 6-12 months (or longer) if he will get paid at all and he may get anywhere from $0-$60 for that visit. The doctor cannot charge you for this difference, but it is kind of a problem for the doctor who already put in the work and was counting on that money to pay his staff, rent and other bills. 


 What can you do?

Please make sure you are working with your employer to get new health insurance. It’s important to stay insured. 

If you have a routine appointment scheduled prior to May 6,2016 or before you get a new health insurance plan, please push it back so you have more stable insurance.

Please be understanding to the doctors who are asking you to change your appointment until after you change insurance plans. We are people too – we are in this profession because we care but this is also our employment and we too have grocery bills!

If you have an urgent issue, please contact our office. We are still your health care home and will help you!

Thank you, Hilo Heart Walkers!

Another year of the Hilo Heart and Stroke Walk was a success!  Thank you to all of the walkers and the organizers and supporters for making the Big Island a healthier place. 

Hawaii Family Health put in a good showing – with a majority of our staff and families participating in the day. 

Getting a running start.

Getting a running start.

Looking bright and fresh at the beginning!

Looking bright and fresh at the beginning!


The day was beautiful, if you don’t count the vog, which we rarely do here.

Liliuokalani Park is really pretty if there isn't some big guy and cute doggy blocking your view.

Liliuokalani Park is really pretty if there isn’t some big guy and cute doggy blocking your view.


Even the dogs put in a good showing for HFH!

Just keep swimming, just keep swimming.

Just keep swimming, just keep swimming.


Most of the staff finished the walk.  We’ll find out who is missing when they don’t show up for work this week.  We’ll send out the search party and have them back by Friday. 

Finally, the end is in sight.

Finally, the end is in sight.


Thank you for all of the donations to the help the American Heart Association!

Now, rest up.  The next project is Relay for Life for the American Cancer Society on Saturday July 16, 2016.  Keep your walking shoes ready!

Join us for the Hilo Heart Walk!

We will be participating as an office in the Hilo Heart & Stroke Walk  – this Saturday, March 5 at Liliuokalani Park.  Come by for the walk between 6:30 – 11:00 AM to support healthier lives, free of cardiovascular disease and stroke!

Or swing by our office anytime to provide a donation to the American Heart Association.

Here is Hawaii Family Health wearing our red dresses on National Wear Red Day (February 5) in support of women’s heart health.  Don’t we look healthy and gorgeous!

Red office

Take care of your hearts, Everyone.  You aren’t given a spare!

Diabetic retinopathy

Diabetic retinopathy is the result of damage to the blood vessels in the eye due to chronic elevations in blood sugar, or diabetes.  The retina is responsible for detecting light and visual cues and sending them via your optic nerve into your brain to tell you what you just saw. 

Uncontrolled sugar levels leads to damage to the small blood vessels in the eye, allowing them to leak.  Over time, this leaking leads to swelling in the eye.  The end effect is a lack of blood flow and nutrients to the retina, resulting in loss of vision.  The body attempts to repair this damage by building new blood vessels, which are even more fragile and likely to leak.  All of this bleeding and blood vessel growth causes scar tissue to form, and as scars tend to do, they contract away from the surrounding tissue.  This pulling away can actually pull the retina off, leading to permanent visual loss. 

Unfortunately, there are often no symptoms of diabetic retinopathy.  Later symptoms may include visual floaters, increased visual difficulty, dark spots or difficulty with night vision.

This is why it is vital that people with diabetes get annual eye exams by an optometrist or ophthalmologist.  Since there are usually no symptoms, it is important to get a visual of your retina and its blood vessels to ensure there are no abnormal blood vessels. 

The best way to prevent diabetic retinopathy is to control your blood sugar.  Long term sugar control is measured via hemoglobin A1C, which can tell you how your sugar has been over the last 3 months.  An A1C of less than 8.0 can reduce your risk of developing diabetic retinopathy by more than 75%.  Don’t be discouraged if your A1C is not at that goal yet – studies show that for every 1 point reduction in A1C, there is a 35% reduction in retinopathy development.  So, small improvements can help while you are working toward your diabetic control goals. 

There are some treatment options for diabetic retinopathy, depending on the severity of the disease. 

An ophthalmologist may inject a medication directly into the eye.  One type of medication is to block a protein that stimulates blood vessel growth and leakage, vascular endothelial growth factor (VEGF).   Another is a steroid, which is used to reduce inflammation and can be an injection or implant. 

There are two different types of laser eye treatments used for treatment: focal laser surgery and panretinal photocoagulation.  Focal laser surgery uses a spot laser to concentrate in an area that is already leaking fluid into the macula, the central area of the retina.  Panretinal photocoagulation utilizes multiple laser spots to diminish current blood vessels and prevent new blood vessels from forming, thus preventing leaking in the future.

If there is severe bleeding, a vitrectomy may be needed.  This is removal of the gel in the center of the eye.  It is replaced with a salt solution.  Or a terminator eye, if you have a billion dollars to spare. 

We are fortunate to have these treatments available, but they usually don’t return vision after it’s been compromised by diabetes.  Our best hope is to slow the progression of further retinopathy once it has started.  If you do have diabetes, make sure you follow up with your ophthalmologist or optometrist for regular exam.  And, even more importantly, make sure you follow up with your health care provider to ensure you have optimal sugar control!

Dengue Fever

Dengue fever is a viral infection transmitted through the bite of an infected mosquito.  Because there are four different viruses, you can actually be infected multiple times with an actual dengue fever.  Here in Hawaii we do have the mosquito species (Aedes) that can transmit the virus, but the virus itself it not endemic to the area.  You cannot get Dengue from another person.

As there have been recent local cases of Dengue, you should be aware of the symptoms and ways to avoid getting bitten by infected (even unaffected!) mosquitos. 


Dengue Fever has a wide range of clinical symptoms, ranging from asymptomatic to severe.  Not to freak anybody out, but most Dengue infections in children under age 15 are without symptoms.  Adults are more likely to have the classic dengue symptoms of headache, muscle or joint pains or pain behind the eyes and sometimes a rash.  Patients can also have nausea, vomiting or diarrhea, or upper respiratory symptoms such as cough and sore throat.  These symptoms can appear 1-2 weeks, but as early as 2-3 days after the offending bite.  Symptoms can last for days to weeks. 

Some cases can progress to blood abnormalities, often seen as bleeding in the skin or nose or less commonly gastrointestinal tract.  These patients usually have a low white blood count and low platelet count and sometimes have abnormal liver enzymes. 

In severe cases, Dengue infection can progress to hemorrhagic fever, which is called such because of the spontaneous bleeding.  Yes, that sounds bad.  And it is. 

Technically, Dengue Hemorrhagic Fever may be classified as a different disease from Dengue Fever and has very specific diagnostic components, but it is a still a manifestation of the same viruses.  The increased vascular permeability can cause shock, and treatment is needed urgently.  Symptoms may include severe abdominal pain and vomiting, as well as increased lethargy in spite of resolving fevers.  Patients can have bloody vomitus, increased menstrual bleeding (during their period or even in between cycles), bloody stool, bloody nose or red spots and bruising on the skin for unknown reasons. 


Doctors can often diagnose Dengue based on symptoms or via blood tests.  Here in Hawaii, we’ll do a blood test because it’s not a common illness here and we’d need to confirm the diagnosis.  But in places where they are very familiar with the disease, you may not need the testing for the doctor to know what you have. 

Treatment is symptomatic, as this is caused by a virus – remember antibiotics do not fight viruses (read that post, please! 10/27/2015).  But severe cases may need to stay in the hospital or even get blood transfusions.


Ways to keep mosquitos away

Mosquitos love standing water, so rid yourself of this as you can.  Most of us cannot get rid of out catchment, but at least keep it covered.  Clean any containers that hold water, such as pet bowls or flower pots weekly to clear out mosquito eggs.  If you are outside, wear protective clothing, such as long sleeves and pants (easier said than done in Hawaii!) and bug repellant.  Unfortunately, only DEET or picaridin containing repellants are proven to keep the little buggars away, so use a formula containing 20-30% DEET or picaridin.  Don’t tell my aunt, who still swears by Skin-So-Soft, but since she’s not here in Hawaii at risk for Dengue, I’ll let that go.

Aedes mosquitoes are most active at dusk and dawn, so limit your potential exposures during that time.  Wear lighter colored clothing when you are out at those times, both for visibility and to avoid being mosquito-bait.

Always help children apply the bug repellant – prevent them from spraying it on.  Put it on your hands and then rub it on them.  Never put repellant on a child’s hands – it is very likely to end up in their mouth.  Don’t use a combination bug repellant/sunblock.  Review the post on sunblock (8/25/2015) to see how often you should be reapplying sun protection, and you’ll quickly overdose on the DEET, which doesn’t need the frequent reapplications. 


Protect yourself and your family, but if you’re worried your symptoms may be Dengue Fever, please make an appointment with your physician.