A break from the doctors

Akone Manabe, 1 1/2, is doing well
after severe health problems
and enjoys a Maui diversion

Jersula and Dedric Manabe of Molokai surprised their children with a four-day Maui vacation over New Year's that was full of fun and free of doctors.

Their youngest, Akone, 1 1/2, has had a tough start in life with severe medical problems, frequent doctor visits and four operations.

"We needed a break, and since he was well enough, we went to the Maui Ocean Center," Jersula said. "All our other children (Bronson, 10, Hunter, 8, and Lahilahi, 4) said, 'No doctor appointments?'"

Still more surgery and medical tests are ahead for Akone, but he is "doing really well," said Jersula, who works at Hale Mahaolu, a nonprofit organization that helps seniors with housing. Her husband is self-employed.

She said Akone is "so rascal. He's into everything. He's curious and talks a lot. He thinks he's saying words. He's so adorable but he knows it. It's very hard to treat him normally. We carry him a lot. He should get scoldings."

Akone is scheduled for a fifth operation Wednesday at Kapiolani Medical Center for Women & Children.

The 3 1/2- to four-hour procedure is the second phase of surgery by urologist Robert Carlile to treat the infant for hypospadias, described as a relatively common birth defect of the male urethra. The first part of the operation was done last July.

Akone was born by emergency Caesarean section two months early on June 19, 2003. He weighed 4 pounds 9 inches and was 14.5 inches long.

A heart murmur was detected because of a constricted aorta, and Dr. Carlos Moreno, head of Kapiolani's pediatric cardiac surgery program, opened the artery with surgery about a month later, on July 21.

Cardiologists James Sim and John Moore performed an angioplasty on Akone on Nov. 13, 2003, and Dr. Lenhan Tran, otolaryngologist (nose, ear and throat specialist) inserted collar buttons in Akone's ears on April 17, last year, to improve drainage.

Carlile performed the first procedure for hypospadias last July 6. Akone's brother Hunter had a tonsillectomy at Kapiolani the same day.

Jersula said she brings Akone to Honolulu to see seven doctors, some monthly and others quarterly. Dr. Noa Emmett Aluli at the Molokai Family Health Center monitors the child for all of his doctors.

Ken Gonzalez, case manager with the state Health Department's Children with Special Health Needs Branch on Molokai, helps Jersula coordinate Akone's many therapy visits and doctor appointments.

"It gets crazy," Jersula said. It also gets expensive despite health coverage because of hundreds of dollars a month in medications, both for Akone and Hunter, who has many allergies.

"The only thing he doesn't have a problem with is his eyes," his mother said about Akone. "That is the only doctor that discharged him when he was born. One down, seven to go."