The spectacular Kualoa Ranch, on the northeastern side of Oahu less than an hour from Honolulu, hosted this ultimate Hawaiian experience for the international field of trail runners for the third year in a row.

The 4,000-acre working cattle ranch reaches from the steep mountain cliffs to the sparkling sea and the terrain varies from dense rainforest to broad open valleys and from beautiful white sand beaches to awesome verdant cliff faces. The epic nature of Kualoa Ranch has inspired television shows and Hollywood films such as Jurassic Park, Windtalkers, Pearl Harbor, Godzilla, Tears of the Sun, 50 First Dates, and LOST.

I had decided last minute to run this race since I would already be in Hawaii for the Honolulu Marathon the following weekend, and visiting my friend, Steffen.  Apparently the decision was not a well thought out one.  I was super sore after the XTERRA half and barely able to run a good marathon!  The terrain was unreal and gorgeous, but the run was very rigorous.  Steep hills and slippery muddy trails left me breathless…literally.  Around mile 10, the volunteers at the water stations were telling the runners to be careful on the way down.  I didn’t think it was going to be that bad, until I had to run down the muddy trail holding on to ropes spanning the trees, so that I wouldn’t fall and cause a chain reaction of runners falling on top of one another, for most of the trail was a one track trail.  Meaning, only one runner at a time could be on trail, so it was very hard to pass anyone up or to get passed, unless you went off trail.  So, you had to keep up!  Up to date, I would say this race was the toughest I’ve ever ran, surpassing the La Jolla Half Marathon and any other marathons I’ve done.  The end result:  finishing time of 2:23:09, 295 out of 510 finishers.

Here is a link to one of the videos from the race.  Check it out:  http://www.xterra.tv/?bcpid=96876705001&bclid=30080813001&bctid=700952333001

Overall, patients were very receptive that our team could do fillings, unfortunately our portable unit was a bit unreliable and we lost the ability to provide this service after five days.  There was an increased demand for cleanings, but there were still some pretty bad dental cases, as most patients needed multiple extractions.  This was the first time that the team brought the patients from Los Planes and Los Oreros to the clinic, which was a successful endeavor. It was decided to bring the patients to the clinic because: With five dentists and only two portable chairs to bring, we would be able to serve more patients in the same amount of time at the clinic.  Also, clinic conditions were more sanitary due to access to running, clean water and supplies, while lessening the burden of driving out and lugging equipment and supplies.

We saw a total of 245 patients during the 10 days we worked.  The patients were very nice and very thankful for our services.  I now have learned a few more dental phrases in Spanish.  We all stayed in a bunk house with bunk beds next to the clinic.  The latrine was an interesting experience.  The outdoor shower kept us clean, but the water was a little on the chilly side.  It was a whole other experience being awoken by the loud sounds of roosters, cows, dogs, horses, screaming kids, etc. early every morning.  Meals were cooked for us by the local cooks, except for a couple of the nights, and laundry was stone washed and hung to air dry by them too.  There were so much beans, rice, and tortillas everyday.  On top of all the dentistry, we managed to be able to go on runs on most mornings with the cows and the dirt roads, and go on a couple of different hikes.  El Rosario was a cute little village up in the mountains.  It was about a 3 hour drive from our first and last night stay at The Banana Inn in La Lima by the San Pedro Sula Airport.  I would totally go again!  Hope you enjoy the pictures.

Pictures are uploaded to Picasa:  https://picasaweb.google.com/107148178637054294824

The main focus however, has been on the medical clinic.  ACTS sends teams of physicians, nurse practitioners, medical students, nurses and a few dentists to staff the local clinic about five times a year.  Beth became involved with this wonderful organization during our last year of dental school.  The head dentist selects a student every year, in order to expose young professionals to the great need found here.

I am currently planning my first trip for February 2011, and this will be Beth’s fourth trip.  For most people, the only dental care they have access to comes from us.  Because of the political instablity in Honduras in 2009, Beth was unable to plan a trip for 2010.  Consequently, there have been no dental volunteers since the last trip in February 2008.

Until 2005, the village did not have electricity, so the only treatment option was to pull, or extract, teeth.  Extractions are performed without normal equipment such as water, suction, x-rays or powered equipment.

With your help and donations, we were able to perform the first dental fillings on the 2008 trip.  A fellow dentist and renassaince man built one portable dental unit to bring to El Rosario.  This gave us access to the typical tools that we use state side, like drills and suction.   Also through donations, we were able to bring down a portable dental chair.  This allowed us to work in a more ergonomic position.   The other chairs consist of a field chair from World War II, and an office chair circa 1950.  Bleach water serves as our sterilization and we bring down everything we need in our checked luggage.  Even under such circumstances, these people prove to be among the best and most appreciative patients.

We continue to provide dental education, oral hygiene instruction as well as urgent care.  By performing skits, toothbrush demonstrations and installing toothbrush holders in school, we are trying to focus on preventative care for the younger generation.

ACTS has seen their efforts paying off slowly.   In 2008, many people walked over three hours for only a cleaning.  ACTS, along with the local people, want to improve the quality of care in El Rosario, but we need your help. We have successfully started offering more services, but desparately need more equipment to keep up with the demand.  We do not want to have to turn anyone away.  It takes much longer to do a quality filling than extract a tooth.  Ideally, we need more than one dental unit, so we can have have multiple units being utilized at once.

For every trip, members take time from their jobs and pay their own way to help contribute to this wonderful cause.  We want more people to have this opportunity, especially dental professionals.  With more equipment and more people, we can have a positive impact on the epidemic of dental disease that I have seen first hand.  Every donation of money or equipment goes directly to help these people.

For more information check out my page at:

http://www.firstgiving.com/theresapham2

Thank you for anything you can give,

Theresa Pham, D.D.S.

So all in all, I PR’ed!  Final time:  3:47:49.  Final rank:  1,038/10,650.  Now, I just have to shave off 7 minutes to qualify for the Boston Marathon.  I haven’t signed up for any marathons yet, but maybe I’ll run the Long Beach Marathon again this fall. 

Finish Time: 3:56:29

Surf City Marathon was on February 7, 2010.  I headed up to my parents’ in Orange County the afternoon before to pick up my bib and goodies, and had the usual carb dinner, which consisted of pasta, meatballs, broccoli, and some bread.  That Sunday morning, I woke up early and drove to my friend, Mimi’s place, in Huntington Beach to park.  Her house was just a few blocks away.  I was supposed to park in the garage, but someone had blocked off the driveway, so ended up parking on the street at a meter.  So, needless to say, I got a parking ticket when I returned to my car after.

The course itself was ok.  I feel like it just went back and forth on PCH.  The most scenic part was probably the last  stretch when we were right along the beach.  I probably started a little slower than I usually do, but all in all, it wasn’t my best or worst time yet.  Next up…San Diego Rock-N-Roll Marathon in June.

Before Implant

After Implant #20 Placement

After Sutures

PA Radiograph of #20 Implant

Patient NF had #20 missing.  She was interested in getting an implant in that area.  After all other restorative work was finished, I placed an implant.  NF had great bone in the area.  I used the Camlog system and ended up placing a 3.8 x 13mm implant.  The surgery went well, and patient is doing well.  Now, we just have to wait 4-6 months for the implant to integrate with the bone, before we begin the restorative process.

MS's smile before

MS's smile after

Retracted View Before

Retracted View After

Implant #11 Impression Coping

After Implant #11 crown and veneers 6-10

This case is probably one of my best cases thus far, with one of my favorite patients.  Patient MS presented with broken #11 (canine on the upper left).  The tooth was deemed unrestorable and #11 was treatment planned for and extraction and an implant.  The patient was also interested in finding a solution for her chipped front teeth.  We had discussed some composite bonding and veneers as well.  MS was referred to Dr. SM, a periodontist, for the placement of the implant.  After implant placement and extraction of #11, MS wore a flipper for a couple of months.  A temporary abutment was placed by Dr. SM and I then fabricated and placed a temporary crown on #11 to contour the tissue for the final restoration.  I checked the tissue contour every couple of weeks for about a month.  Once the patient and I were satisfied, we proceeded with prepping the teeth for the veneers.  We got them delivered, all but one, before MS went to Michigan for a family wedding.  #10 had fractured at try in, but I was able to temporarily cement that in while we waited for the final #10 veneer from the lab.   For the veneers, we went with Empress, and the implant crown was e.max with a zirconia abutment.