Malignancy is one of the most common causes and must be excluded. Hyperparathyroidism and other causes of hypercalcemia can coexist with malignancy. If calcium levels have been mildly elevated for months or years, malignancy is an unlikely cause. Hypercalcemia from malignancy usually is rapidly progressive; thus, rapidly rising calcium levels should increase suspicion of malignancy.
Kailua-Kona on Hawaiiâs Big Island is the site of Kona Brewing Companyâs brewery and first restaurant. The brewpub opened in November 1998. Prominently featured ohia wood found throughout the pub came from South Kona.
Most resorts are on the Kona side of the island, with the most exclusive resorts being found at Waikoloa and Kohala to the north. Hilo has a few hotels, but is the more âlocalâ side of the island. Kona and Hilo both have major airports. The Big Island is 95 miles tall and 80 miles wide.