kauai

The 34th Muller - Ihrke Veterinary Dermatology Seminar & The 19th Veterinary M-E-D Seminar--- Official Program--- October 26 - November 3, 2018

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This year's Seminars include:

 A Short Course on 'Allergic Dermatitis in 2018'

Saturday, October 27

7:45-7:55         Welcome, Introductions – Kwochka 

7:55-8:45         Common Pitfalls in Veterinary Dermatology: How can we avoid them? – Torres 

8:45-9:00         Exhibit Hall – Refreshment – Email – Phone Break

9:00-9:50     Clinical Approach to Canine Alopecia – Bonenberger

9:50-10:20       Exhibit Hall – Refreshment – Email – Phone Break

10:20-11:10     The Great Impostor: Cutaneous Adverse Drug Reactions – Werner

11:10-11:25     Exhibit Hall – Refreshment – Email – Phone Break

11:25-12:15     A Practical Guide to Topical Therapy in Veterinary Dermatology – Logas

12:15-12:30     Industry Forum:  Mini-presentations by our Industry Partners – Klingborg

12:30-1:00       A Directed Panel Discussion on Diagnostic Testing in Dermatology, Canine Alopecia, Cutaneous Adverse Drug Reactions and Topical Therapy – All Speakers

Sunday, October 28

7:55-8:45         What’s New?  Key Clinical Updates for General Practice from the North American Veterinary Dermatology Forum and Recent Dermatology Publications – Kwochka

8:45-9:00         Exhibit Hall – Refreshment – Email – Phone Break

9:00-9:50         Challenging Eyelid Diseases: Dermatology or Ophthalmology? – Werner

9:50-10:20       Exhibit Hall – Refreshment – Email – Phone Break

10:20-11:10     Strategies to Treat Canine Superficial Pyoderma: Am I doing this right? – Torres

11:10-11:25     Exhibit Hall – Refreshment – Email – Phone Break

11:25-11:50     How I Diagnose and Treat Cats with Facial Ulcers – Bonenberger

11:50-12:15     How I Treat Viral Papillomatosis – Bonenberger

12:15-12:30     Industry Forum:  Mini-presentations by our Industry Partners – Klingborg

12:30-1:00       A Directed Panel Discussion on Eyelid Dermatoses, Canine Superficial Pyoderma and Feline Facial Ulceration – All Speakers

Monday, October 29-- Free Day

Golf Tournament

Optional Excursions

Explore the Island on Your Own

Tuesday, October 30

7:55-8:45         Cutaneous Draining Tracts: Confusing, Frustrating and Common – Bonenberger

8:45-9:00         Exhibit Hall – Refreshment – Email – Phone Break

9:00-9:50         Pemphigus foliaceus: The Most Common Autoimmune Challenge in General Practice – Werner 

9:50-10:20       Exhibit Hall – Refreshment – Email – Phone Break

10:20-11:10     Clinical Approach to the Pruritic and Overgrooming Cat – Bonenberger     

11:10-11:25     Exhibit Hall – Refreshment – Email – Phone Break

11:25-12:15    Malassezia Dermatitis: How to Diagnose and Treat this Common Skin Disorder – Torres

12:15-12:30     Industry Forum:  Mini-presentations by our Industry Partners – Klingborg

12:30-1:00       A Directed Panel Discussion on Cutaneous Draining Tracts, Autoimmune Skin Disease and Malassezia Dermatitis – All Speakers

Wednesday, October 31-- A Short Course on Canine Allergic Dermatitis--- 

This Short Course is open to DERM and M-E-D Attendees

7:50-7:55         Welcome, Introductions – Kwochka

7:55-8:45         A Practical Approach to Diagnosing the Pruritic Dog – Torres

8:45-9:00         Exhibit Hall – Refreshment – Email – Phone Break

9:00-9:50         New Concepts in the Pathogenesis and Management of Canine Atopic Dermatitis: Part 1 – Logas

9:50-10:20       Exhibit Hall – Refreshment – Email – Phone Break

10:20-11:10     New Concepts in the Pathogenesis and Management of Canine Atopic Dermatitis: Part 2 – Logas

11:10-11:25     Exhibit Hall – Refreshment – Email – Phone Break

11:25-11:50     What do we really know about Allergen Specific Immunotherapy? – Logas 

11:50-12:15     Cutaneous Adverse Food Reactions: Which diets and why? – Torres

12:15-12:30     Industry Forum:  Mini-presentations by our Industry Partners – Klingborg

12:30-1:00       A Directed Panel Discussion on Canine Atopic Dermatitis and Cutaneous Adverse Food Reactions – All Speakers

2:30 - 4:30       Optional Business Program

5:30 - 7:30       The Aloha Gala Reception and Halloween Costume Contest

Thursday, November 1, 2018-- 

7:55-8:00         Welcome, Introductions – J Klingborg

8:00-8:50         The Diagnosis, Consequences & Management of Chronic Cough–   Lee-Fowler

8:50-9:00        Refreshment – Email – Phone Break

9:00-9:50         Managing the Proteinuric Patient – Foster

9:50-10:10      Refreshment – Email – Phone Break

10:10-11:00     Treating Challenging Urinary Tract Infections – Foster

11:00-11:10     Refreshment – Email – Phone Break

11:10-12:00     Current Understanding of Feline Asthma – Lee-Fowler

12:00-12:30     Day 2, MED Speakers -- Questions and Discussion – All Speakers

Friday, November 2, 2018--  

8:00-8:50         Hypertension: perks and pitfalls of measurement and management-- Foster

8:50-9:00          Refreshment – Email – Phone Break

9:00-9:50         Antimicrobial decisions for respiratory patients with case examples– Lee-Fowler

9:50-10:10       Refreshment – Email – Phone Break

10:10-11:00    Management of Brachycephalic airway disease (and associated diseases) – Lee-Fowler

11:00-11:10     Refreshment – Email – Phone Break

11:10-12:00     Practical treatment of urinary incontinence- medications through intervention

12:00-12:30     Day 3, MED Speakers -- Questions and Discussion – All Speakers

The 2018 Seminars

CLICK HERE TO REGISTER!

 

 

 

ABOUT CE & RACE APPROVAL

 

Kaua’i, the garden isle

Kaua’I is the wettest of the Hawaiian Islands and is in the form of circle.   

The Island can be divided into four areas using a clock face and time to define each area. The North shore goes from about eleven to one o’clock and is green, wet and beautiful. It starts around the town of Kilauea and the Kilauea Lighthouse National Wildlife Refuge.  Lots of birds, maybe monk seals and if your timing is right you’ll see some whales.  As you travel counterclockwise from one o’clock towards eleven o’clock on the Island you’ll find: gorgeous farm land and wildlife refuges, many growing taro; the elegant Princeville Resort area; then one or two one-lane bridges as you enter Hanalei bay and the quaint town of Hanalei; then many more one-lane bridges as you head to the end of the road at the “wet cave” and a beach campground.  The road stops at the north end of the Na Pali Coast.

The second area, the East end, goes from about one o’clock to four o’clock and includes the towns of (from North toward South) Moloaa, Kapaa, Wailua and Hanamaulu.  Opaekaa Falls, Wailua Falls and the very beautiful Wailua River are major landmarks in this area.  The East End also hosts many public beaches with lifeguards and lots of surfers.  Old coconut groves make this area unique on the Island, and an older shopping center currently undergoing renewal, called the Coconut Marketplace, sits in the middle of the coconut grove area between Wailua & Kapaa.   

The South End effectively starts at about four o’clock at Lihue, the largest town on the Island and the location of the airport, and ends about eight o’clock around the town of Kekaha.  From Lihue you’ll travel south through the towns of Puhi, Koloa, Poipu, Lawai, Kalaheo, Ele Ele (with Port Allen), Hanapepe and Waimea before reaching Kekaha.  The best snorkeling and sailing on the Island is along this region.  Lihue has a major shopping center with a Macy’s, food stores, as well as other mainland retailers.

As you go south from Lihue to our headquarters hotel you’ll take the turn to the left toward Koloa Town and Poipu soon after going through Puhi.  Follow the signs to Poipu.    In this area you’ll also find Spouting Horn (a blow hole thrusting sea water into the air associated with wave action) along with local craft kiosks and many examples of the animal mascot of the Island, the chicken (with many roosters strutting their stuff).  The National Tropical Botanical Garden is also close to Spouting Horn.   Traveling west from Poipu you’ll find the towns of Kalaheo, Ele Ele with Port Allen (the major sailing and fishing port), Hanapepe, Waimea and the access road to Waimea Canyon State Park (the Grand Canyon of the South Pacific).

The West end goes from about 8 o’clock to 11:30 with road travel only to about nine o’clock (at Polihale State Park and Barking Sands Beach).  The Na Pali coast consumes the space between 9 and 11:30 and can only be seen is from a boat or the air.  Waimea Canyon is inland, is equally spectacular and well worth the drive. 

The world’s wettest spot is in the center of the Island, at Mt. Wai’ale’ale, with over 650 inches of rain per year.

Po’ipu hosts the Grand Hyatt Kaua’i, our headquarters hotel, and is about 30 minutes from Lihue (17 miles, the residents (and we) drive slow in Hawaii). The hotel has a great beach (Shipwreck Beach, is there a better name anywhere?), lovely grounds, adult-only and all age’s pools, a water slide (fun but not insane), a lazy river for floating, and a large salt-water lagoon with sand separated from the ocean for easy water sports.  It offers several restaurants, a great bar, superb views from all the rooms, tennis, golf and a huge spa.  I visited all the room styles offered and they are all spacious, well appointed and provide wonderful views (65% offer ocean views).  All guest rooms have private lanais, are 600 + square feet and have superior bedding.  Dining options in the hotel include the highly rated Tide Pools, Dondero’s Italian and a variety of more casual dinning options.

The Po’ipu area is evolving, with a new small shopping center hosting a variety of shops including about 10 eating establishments.  The older Po’ipu Shopping Village is still there but Roy’s restaurant has moved to the new location under a new name and offers a new menu.  The old Village still has a Starbucks, a Puka Dog and some other more casual restaurants plus a variety of shopping (as of our visit in March).  

At the new location (The Shops at Kukui’ula), just a few minutes by car from the hotel and maybe a mile beyond the older shopping village, you’ll find restaurants including:  Merriman’s Fish House; Tortilla Republic; The 1849 Eating House by Roy’s; Bubba Burgers; Josselin’s Tapas Bar & Grill; Merriman’s Gourmet Pizza and Burgers; Savage Shrimp; The Dolphin Restaurant, Fish Market & Lounge; Tortilla Republic Grill & Margarita Bar; and Lappert’s Ice Cream and Coffee.  There is also a market with farm to table organic foods and many shops and galleries.  This new shopping  area hosts a Farmer’s Market on Wednesdays from 3:30 to 6:00 pm with live music and beer and wine and a local music night Fridays from 6:30 to 8:30 pm.

The Poipu Bay Golf Course is adjacent to the hotel and is one of the best on all the Islands. 

During our site visit in early March we sat on our lanai and watched many humpback whales swim by, blowing frequently, breeching occasionally.  They breed and calve here and spend much of the rest of the year in Alaskan waters.  Depending on when winter hits Alaska we could see them during the meeting.

 

 

Kauai ATV Waterfall Tour

A guided tour taking about four hours and covering 23 miles of back roads and trails through tunnels, forests and farm/range lands.  Includes visits to a waterfall along with beautiful landscapes where parts of Hollywood productions including Jurassic Park, Pirates of the Caribbean, Seven Days and Seven Nights, among others, were filmed.

 

Wear a swimsuit and water-friendly shoes/sandals, and bring a towel.  They’ll provide a freshly laundered shirt and riding shorts to absorb most of the dust and some of the mud.  You’ll also receive a helmet, goggles and a great bandana that can serve as a mask over your nose and mouth.  They have dressing rooms, toilets and lockers at the starting (and finishing) point.

 

Depending on weather you may experience splashing water, mud, dust, debris and other fun stuff.  I experienced a “mini” exposure while doing a site visit recently and made it through unscathed wearing one of their shirts over my clothes and camera.  If I were on the full trip I expect I would have come away considerably more dirty.

 

I don’t recommend taking expensive cameras on this trip – very bumpy and potentially very dusty, wet or muddy.  Their motto is “Do Something Dirty” and they mean it (in the nicest way).  Plenty of pretty things to photograph, but phone photo should meet your needs.

 

A deli lunch with a local snack and beverage will be provided and you’ll get some history, geography, geology and Hollywood information from the guides while on your journey.  You’ll have time to frolic in a freshwater mountain pool at the base of Mount Kahili before returning to the starting point at the old sugar mill.

 

They provide a variety of ATV’s.  The Mud Bunny is a single passenger vehicle (the driver) for those going solo.  The Mud Bug is for a driver and passenger, and the Ohana Bug is for a driver and 3 passengers.  There are two types of Mud Bugs available, the fancy and colorful model imported from China, and the plain utility models that are imported from Israel. 

 

My experience was in the Israeli model and it was a blast.  Noisy and a bit dusty, it handled the dirt roads and trails beautifully and was surprisingly comfortable.  Be forewarned, however, this in not recommended for people with bad backs or those concerned about keeping clean and tidy.  Should you be pregnant I strongly suggest a different excursion.

 

 

Transfers from and return to the hotel are included, and only about 10 minutes away so your time is spent playing rather than driving to and from the location.

 

Do Something Dirty!

 

Don Klingborg, DVM

 

 


 

 


 

 


 

 

Waimea Canyon State Park-- Grand Canyon of the Pacific

     During our "free day" of the conference, we decided to make the drive over to Waimea Canyon. It was a scenic drive on good roads.  As we left the east side of Kauai and drove west toward the park, clouds seemed to loom overhead. We vowed not to be beaten by the weather, even though we had (unwisely) left our jackets back at the hotel.

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     Driving up to the Lookout Point, we could appreciate the altitude (over 3600 feet) and panoramic views.  As the driver, I was thankful when we arrived at the parking lot, so that I could take in all of the scenery.  There were nice restroom facilities there, too.

    The rust colored peaks and valleys look like they were newly formed.  From the high point of the Lookout, we felt like we were at 'bird level' as we watched our feathered friends fly and soar through the valley below.

     We decided to hike further down the road, and were intrigued by some of the native plant life. These small trees (picture below) reminded me of something I'd seen in a Dr. Seuss's book.

    On the way back, we stopped in a small town at the foot of the State Park and found an ice cream place.   It was a great way to spend part of our day off!

Grand Hyatt Anara Spa -- VETS Attendees get a discount!

The Anara Spa is located adjacent to the fitness center, and offers all the amenities in its 45,000 sq. ft. 

 The fitness center is spacious with lots of equipment scattered among a few connected rooms.  Flat screen TV’s, the latest in cardio and strength-training equipment and available to hotel guests 24 hours a day.  They offer treadmills, cross trainers, upright and recumbent bikes, free weights, strength machines, stability balls, stretching mats, resistance tubing, jump ropes and weighted bars. 

 


In the spa ancient healing traditions combine with island botanical essences to inspire lokahi—balance and harmony of body and spirit.  Massages, body treatments and facials are offered in elegantly appointed treatment rooms, each opening onto its own tropical garden.  Unwind in the dry sauna, steam showers, or relaxation room.  Swim in the lap pool, or soothe those gnarly muscles in the Jacuzzi.  Water, tea, fruit and nuts are freely available.  You may also order a light lunch from a menu.

 Following your treatment, shower in the secluded outdoor lava showers then enjoy a full compliment of toiletries, including sunscreen, body lotion, and deodorant.  There are blow driers and hairbrushes (each one sealed in plastic) as well as styling gel.  With any purchase of a spa treatment, you have full use of the spa for that day.

 I had a 50 minute massage followed by a 50 minute facial.  The masseuse and the esthetician were both very professional and experienced.  They graciously personalized their treatments to address my requests and the result was one contented wet noodle.

 Bev Klingborg


Koloa Zip Line

“Holy Zip!!”

This is a great course for both the novice and the experienced “zipper”. 

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The equipment is excellent, the guides are well trained and they provide a very useful “ground school” at the starting point.  I appreciated the attention to safety, the excellent launching and landing platforms and the unique options to match your experience with your preferences.

The “Flyin’ Kaua’iian” harness allows you to be hands and feet free, comfortably suspended and “Flyin” like Superman.   Another option is the “Aerobatics” harness that allows you to “Fly” upside down, backwards, spinning, in a spread eagle and starfish, and maybe in some other positions?  “Tandem” allows you to “Fly” with your kids (7 years and older) which is a great way to introduce them (or have them introduce you) to zipping.  Some of these options require a $20 upgrade fee and you can decide at the ground school.

Novices will want to ask for the rigging with the handlebar pulleys, allowing them more control as they fly between platforms.

Offering fantastic views, the course includes eight lines and takes about 3.5 hours to complete.  It runs through Hawaiian forests and hillsides with lovely views of the ocean, forest, rivers, mountains and the largest fresh water reservoir on the Island.  It includes three of the longest lines on Kauai with “the whopper” being Waita – ½ mile in length. 

A snack including a tasty tidbit from Anahola Granola, plus juice and water.  Only 12 at a time to minimize waiting and maximize “Flyin’”.

Minimum age for kids is 7 years, and those from 7 to 17 must be accompanied by a parent/guardian.  Weight limit is 270 lbs. max for solo zippers, 280 lb. combined weight for tandems.   You will have a couple of walks up the hill, each about 400 feet in length, and one is at a 45 degree angle, so low to moderate physical strength is required.  Those of you with heart conditions, bone/joint injuries or a bad back should seek out a different excursion.  Similarly, those of you who are pregnant are not allowed to participate. 

A shirt with sleeves is recommended (no tank tops).  Knee length or longer pants, bring a jacket just in case and sturdy CLOSED TOE shoes are required.  Sneakers and boots are great.  Sandals and Crocks or other slip-ons are not allowed.   You can bring a small backpack for personal items.  One bottle of water is supplied.  You’ll have great still and video photo opportunities, but be sure the camera is secured to your body as they are very difficult to find if they fall.

It’s only 10 minutes from the hotel and transfers are provide from the hotel and the return.

Whether you’re a novice or expert, I think this course has something for you to really enjoy.

Be your own version of a “Flyin’ Kaua’iian”!

Don Klingborg, DVM

 

 

 

Just Horsing Around (on the Big Island)

A whimsical blog by Don Klingborg, DVM (with superb editing by Sophie Klingborg)

Q.  When is a horse not a horse?        Answer: When it’s a fish!.

One of the photos above is of a horse (Genus Equidae) (in this case named “California Chrome”) and the other is a seahorse (Genus Hippocampinae) (in this case I’ve named her “Buttercup” in honor of Dale Evans’ horse- remember Roy Rogers?).

While there is no triple crown for seahorses (nor, sadly, was there for California Chrome), there are more than 30 seahorse species within the genus and they are all threatened due to habitat degradation and consumption to feed an Asian market for “traditional medicines”.

And then there is the Sea Dragon (Genus Phycodurus), a very strange critter indeed. The photo below is a Sea Dragon with no plant material in this picture.

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Seahorses (map on left) have a wide area of habitat,

 

 

 

 

Sea Dragons (map on right) not so much.

 

 

Seahorses are a fish, a carnivore and range from 1.5 to 35 cm “tall” (0.6 to 14 inches). They have a life expectancy of 1-5 years. The males have a brood pouch where the females deposit their eggs and then the male fertilizes them and sustains their “pregnancy”. The photo below is of a male “giving birth”, something our female friends have been waiting for for a very long time.

Poor swimmers, they rely on their tail to “hold on” in rough water. The fin on their back provides the propulsion, the ones on the back of their head steer

They have no teeth and suck their food (plankton and small fish or crustaceans). Their stomach is underdeveloped and they are essentially sustained by their intestinal tract however need to continuously “graze” since they can’t consume a meal, store it in their stomach and digest it later.

The Sea Dragon (a weedy variety below) is also a fish and can range up to 35 cm (~14 in) in the leafy variety, and 46 cm (18 in) in the weedy variety. They are perfectly camouflaged for their habitat in seaweed and kelp forests off southern Australia. They are related to the sea horse, and both are related to pipefish.

 

Their tails are not able to grip like those of the seahorse, so they simply “go with the flow” when the waters get rough.

The males are also responsible for bearing the offspring, and while they lack the pouch found in the seahorse they have a spongy brood patch under their tail where the female deposits their eggs. After four to six weeks of “pregnancy” the offspring are released and “on their own”.

Hopefully your interest is piqued, and a great afternoon awaits you at the Seahorse Hawaiian Foundation. Located just south of the Kailua-Kona airport, this group has been breeding seahorses and other endangered reef species (including Sea Dragons) for many years. As I recall they were once focused on the aquarium trade and have morphed their goals toward conserving genetic diversity, propagating endangered species and repopulating areas that can sustain these fragile creatures.

The tour is educational, fun, and when we did it three years ago we were able to have the sea horse “grab” our finger with their tail and “hang out together ” for a while – very cool. I can’t promise you that but I can promise you an aquarium room with many interesting and colorful species on display, plus a worthwhile educational program.

They won’t put together a tour for us only (we tried, they declined), but they do offer tours daily at noon and 2 pm and we think you’ll find it fun and informative. Their gift shop is cute and our granddaughters sure enjoy the T-shirts purchased there.

Check it out at the Ocean Rider Aqua Farm (www.seahorse.com), 73-4388 Ilikai Place, Kona, Hawaii (just south of the airport, same side of the road. 808-329-6840 for tour times and tickets).

Just 1.2 miles south of the Kona Airport exit, off of OTEC Road (also called Natural Energy Road). The road goes toward the beach, and then makes a 90-degree turn at the beach to the right (north) and you’ll go past the Wawalaloli Beach Park and see the entrance on your left. Go down toward the beachfront and you’ll see the signs on your right.

Enjoy!

Top 10 Reasons to Attend THIS CE meeting!

1. You’ve earned it.  You deserve time off to recharge your batteries AND learn new ideas that will benefit your practice!

2.   This meeting is loaded with VALUE. It takes place during the ‘shoulder season,’ which means your CE dollars will go farther than you might expect. Enjoy uncrowded beaches & pools and great rates for rooms with ocean views.

3.  Better Learning, By Design— As part of the program, our Speakers understand that they are to be available as your Consultants for the week.  So bring your tough case questions and talk with them one on one, or learn from the group at each day’s end when we hold a panel discussion. 

4.  It’s on a Hawaiian Island! Beaches, restaurants, art galleries, pools, snorkeling, waterfalls, botanical gardens and so many other adventures.  The dress for the meeting is Hawaii-casual.  Come in shorts and sandals, you’ll be in good company.

5.  You can Learn, Renew and Explore.  With lectures completed before 1 pm, there is ample time for you to relax or explore the island. Our family friendly locations and great excursions provide fun activities for all ages.

6.  All the CE you need in one meeting.  In one week, our seminars will cover the latest in  Dermatology, Endocrinology, Internal Medicine, and Infectious Disease. That’s over 25 CE units of practical information.

7.  Experience First Class CE. Comfortable, open meeting space and roomy seating.  Breakfast is included with the registration fees for all attendees.  Seminars are held in one hotel so you won’t feel like a rat in a maze trying to find the next lecture hall!

8.  Focus on the Practical.  Our speakers present practical information designed for the everyday practitioner.  If you weren’t likely to see a similar case within the previous 30 days, we probably won’t be talking about it.

9.  The Exhibit Hall.  Our schedule gives you plenty of time and one-on-one access to really get your questions answered by the various industry representatives. 

10.  We’ve designed the best CE meeting in the world.  Speakers you can talk to, a comfortable, uncrowded lecture hall, Half-Day Seminars give you time to absorb the morning’s lectures and go have fun in the afternoon, a beautiful tropical location that offers activities for all ages.

Helicoptering over Kauai-- I'd do it again!

I am spectacularly afraid of helicopters. I don't think those machines follow any of the laws of physics and am even worried when they fly over my house. But my spouse asked to go on the helicopter ride, and explained that Kauai was so remote that it was really the only way to see much of the island.  Within minutes of getting airborne, I'd forgotten my fears and enjoyed the scenery.

 

 

Before long, we learned why Kauai often the backdrop for many Hollywood movies.  Here are the twin falls seen at the beginning of the Fantasy Island credits. Later we got a great look at the spectacular waterfall seen in Jurassic Park.

 

 

 

 

 

 

 

 

 

We followed the waterfalls to their source and saw the rivers that snaked their way through deep canyons.

 

 

 

 

 

Soon, our helicopter steered toward the ocean where we saw the breathtaking views of the Na Pali coastline.

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Our helicopter ride over Kauai was an amazing once (or twice?) in a lifetime experience!