Central Valley Health - Spring 2017

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Your

Community at Work

A REPORT ON WHAT IT TAKES TO MAKE A HEALTHY COMMUNITY

investing in

healthier

FUTURES

Caring for Central Valley families requires more than just medical care. It means investing to attract the brightest medical minds, to expand horizons for children and to enhance support for patients. In most years, Community Medical Centers spends more than all other area hospitals combined to provide uncompensated care, medical education, outreach and patient support services to create a MILLION healthier Valley for us all. California in “community requires hospitals to give back to their benefit” community to retain their nonprofit provided last designation. fiscal year

$214.4

Cystic fibrosis patient Dominic Bledsaw takes a deep breath for Dr. Nicole Barbera, a pediatric resident with UCSF Fresno, while Pediatric Pulmonologist John Moua supervises.

Training Tomorrow’s Doctors In a region with one of the lowest doctor-to-patient ratios in California, Community Medical Centers’ 42year partnership with one of the nation’s top rated medical schools has encouraged physicians to train – and stay in the Valley. The University of California, San Francisco’s Fresno medical education program trains 250 residents and 50 fellows annually at Community’s hospitals and clinics. Since 2000, half of those UCSF Fresno graduates have stayed to set up medical practices locally. Community invested more than $475 million in the past decade to bring expert faculty doctors, specialists and research to the Valley. Last year, UCSF

50%

of UCSF Fresno graduates stay in the Valley to practice medicine

Fresno and Community established the region’s first accredited cystic fibrosis program to treat adults and children. And among the 261 active research studies conducted at Community campuses last year, was a breakthrough on diagnosing Valley fever faster. “The patient care that is provided as a result of this university-community partnership is vital to the Valley,” said Michael W. Peterson, MD, associate dean at UCSF Fresno. “And Community provides the settings in which our faculty teach the next generation of physicians.” cmc.news/access

California

Valley

72 48

per 100,000 people

per 100,000 people

The Valley has far fewer primary care physicians than the rest of California

One Network. One Community.

Clovis Community Medical Center | Community Behavioral Health Center Community Regional Medical Center | Fresno Heart & Surgical Hospital

WHAT HAPPENS WHEN A HOSPITAL NETWORK AND ITS COMMUNITY ARE CONNECTED? FIND OUT AT cmc.news/may2017


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Summer 2017

Tackling taboo

14 18 22 26

Mental health advocates work to break the stigma and raise awareness about depression and suicide.

22

Blooming at Woodward Park The Art of Life Healing Garden is a gift to the community grown out of the Art of Life Cancer Foundation.

The littlest patients Valley Children’s Healthcare holds an annual reunion for NICU patients, physicians, nurses, staff and volunteers.

‘Ogre’ is a symbol of hope Personal trainer John Giannandrea knows what it’s like to lose big; now he helps others get fit.

26

8 Your Health 10 Voices 14 Heal 18 Live 26 Prevent 30 Eat

18 Greyson and Wyatt Burns, graduates of the Valley Children’s Healthcare NICU, play at a local park near their home in Visalia. The twins weighed under 2 pounds when they were born. They get to see former doctors, nurses and staff at the annual Valley Children’s Healthcare NICU reunion. PHOTOGRAPHY: Gary Kazanjian

6 SUMMER 2017 | Central Valley Health


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At Home

Giving hope

M

ental health is a hot-button issue, but it’s not one we want to shy away from here at Central Valley Health. So, with this edition of CV Health, we introduce a new columnist, Don Farris., a licensed clinical social worker who writes about mental health. He says, “Mental health education has nothing to do with counseling or therapy. It is not treatment. … The intent of education … is to equip the individual to provide for their own well-being — to prevent them from having to be a patient.” Read Farris’s column starting on page 12. We also tackle the taboo subjects of depression and suicide. Suicide is the second leading cause of death for young people between the ages of 10 and 24, according to suicidepreventionlifeline.org. But the more we talk about mental health issues, the less of a stigma there will be. Young people need to know there is hope, and there is help. Read Farin Montanez’s story starting on page 14. Speaking of hope, Valley Children’s NICU offers hope to families with babies born too soon. Valley Children’s Healthcare is one of the top neonatal hospitals in the country and has the

c e n t r a l v a l l e y. c o m

the highest level NICU possible in Central California. The hospital creates unique ties with its tiny patients and their families. Each year, the hospital holds a reunion of sorts with all the babies who have graduated from the NICU, including our cover models, Greyson and Wyatt Burns and their parents, William and Vatsana Burns. Read Dani Villalobos’ cover story starting on page 22. Now that the weather is warm, have you been to Woodward Park? Next time you go, be sure to visit the Art of Life Healing Garden. It grew out of the Art of Life, a healing arts program established by Dr. Christopher Perkins, and it’s truly a gift to the community. Read Katie Fries’ story starting on page 18. And, with warmer weather come farmers markets. On page 30, we give you the deets on area markets. Enjoy fresh fruit and veggies (and more) straight from area farmers. Cheers to your health,

Monica Stevens, Central Valley Health Editor

Central Valley Magazine | JUNE 2017 7


.................

about

Summer 2017/ Vol. 1, Issue 2 ......................... Central Valley Health is produced by the Custom Publications staff of The Fresno Bee and published by The Fresno Bee. Cover price $3.95 President & Publisher Tom Cullinan Vice President, Sales & Strategic Marketing John Coakley Custom Publications Editor Carey Norton | 559-441-6755 Advertising Sales Director Stan Diebert | 559-441-6127 Production Coordinator Anna Ramseier | 559-441-6751 Central Valley Health Editor Monica Stevens | 559-441-6149 Custom Publications Staff Katie Fries | 559-441-6332 Farin Montañez | 559-441-6677 Janessa Tyler | 559-441-6764 Dani Villalobos | 559-441-6759 Contributing Writers Don Farris, Cyndee Fontana-Ott Contributing Photographers German Amezcua, Matthew Drake, Gary Kazanjian, Farin Montañez Design Monica Stevens Reader inquiries Central Valley Health 1626 E St., Fresno, CA 93786 www.centralvalley.com 559-441-6755 All content © The Fresno Bee To contribute, please contact Carey Norton at 559-441-6755 or cnorton@fresnobee.com

The Fresno Bee fresnobee.com

8 SUMMER 2017 | Central Valley Health

Ride on Fresno County’s childhood poverty and obesity rates are among the highest in the state. When Mike Slayden, a teaching pastor at Fresno’s The Well Community Church, learned about these statistics, he decided to use his passion for cycling to help Valley students most affected by these factors. Slayden founded Off the Front in 2009 to give kids from impoverished neighborhoods the opportunity to improve their fitness levels — and earn cool incentives for doing so. In cycling jargon, “off the front” means to break away from the pack. Off the Front allows kids to do just that by increasing their physical fitness and encouraging them to pursue academic excellence. The program has three main components. Fourthgraders at the nine participating schools have the opportunity to earn a new bike, helmet and lock over the course of the school year. They accumulate points for attendance, grades, behavior and their participation in a health and nutrition program. Each week, Off the Front volunteers spend time in the classroom teaching small groups of students about healthy habits. Those who earn the minimum 900 points (out of 1,500) receive their award at a special ceremony at the end of the year. Students in other grades are still able to take part

The magic of Camp Kesem Words can’t describe the feeling of hearing your parent has been diagnosed with cancer. The ache in your heart and the pain in your soul is indescribable. But you aren’t alone: Camp Kesem has your back. The nationwide organization, spearheaded by college students, gives children a place of comfort and support during and after their parent’s battle with cancer. Since being founded about 16 years ago at Stanford University, Camp Kesem has provided love and support to thousands of children throughout the United States — as far as New York, South Carolina and Florida — by offering free, week-long camps. (Fun fact: Kesem means “magic” in Hebrew). Currently, there are 13 chapters in California — including Camp Kesem at Fresno State. In summer 2015, Camp Kesem at Fresno State launched by

in the Active Commute program, which has been implemented at all of the participating schools. Those who choose to walk or ride to school are given a RFID card that can be attached to a backpack. Each time they pass through a scanner that has been set up on campus, 10 cents is placed in a digital account. Once their funds have accumulated, students can spend them at a student store that sells items like school supplies and soccer balls. Finally, a mobile bike repair clinic visits the Off the Front schools on Saturday mornings. Volunteers repair — and teach kids to repair — their bikes, so minor damages like a flat tire don’t prevent them from being active. Parents, siblings and other community members can take advantage of the service as well. Off the Front relies on donors and volunteers to keep its programs running. For more information, visit www.offthefront.org.

hosting 26 campers at Camp Wawona in Yosemite National Park. In summer 2016, 32 campers traveled to Mt. Cross near Santa Cruz. With summer 2017 on the horizon, volunteers — including 15 board members and 12 counselors — hope to welcome 45 campers. Camp Kesem at Fresno State is open to children who live between Bakersfield and Merced, but extends an invitation as far as Los Angeles and the Bay Area. The best part? Camp Kesem is free. Activities include team-building exercises, making arts and crafts, playing games like Twister, eating s’mores and bonding around a campfire. Camp Kesem is funded by grants, donations and fundraisers. For Camp Kesem at Fresno State, Make the Magic was held in April — raising more than $24,000. Applications for summer 2018 will be accepted in January. Details: www.campkesem.org/fresnostate


Valley Children’s Pediatric ICU receives prestigious Beacon Award The Pediatric Intensive Care Unit at Valley Children’s Healthcare has once again earned the Beacon Award for Excellence from the American Association of Critical-Care Nurses. This is Valley Children’s third Beacon, which the AACN created to challenge acute and critical care nurses to improve the care provided to some of the most critically ill patients. “The PICU is an amazing team of individuals, working in collaboration to achieve the best possible outcomes for our patients,” says PICU and Transport Director Denise Johnson, BSN, RN. “The kids count on us to do everything we can to fight for their future and to send them home happy and healthy. Receiving this award just reminds us why we do what we do every day.” The Beacon Award recognizes the achievements of critical care teams in several areas, including professional practice, patient outcomes and work environments. Beacon provides the means for hospital units to measure themselves

A rare retreat Summer camp has become synonymous with an adolescent rite of passage of sorts — a time where people can learn, grow and, just from a seemingly fleeting experience, still manage to create lifelong memories. Well, Camp Hemotion is kind of like that, but a lot more specialized. Since 1858, the Hemophilia Foundation of Northern California has rallied behind what was once a small group of hemophilia patients to now providing education, resources, outreach and support to more than 3,000 Northern California families that are impacted by various blood disorders, factor deficiencies and rare clotting conditions. One of those popular programs: Camp Hemotion. The week-long residential summer camp is one of the first of its kind in the United States. Four nearly four decades, it has annually served around 100 people — ages 7 to 20 — living with blood-related disorders and their siblings. It’s designed to equip young participants with “the tools they need to overcome the challenges presented to them by their

against high-quality standards based on national criteria. Organizations that meet or exceed these standards are regarded as leaders in nursing. Last year, Valley Children’s Healthcare ranked in the top 10 percent of all hospitals in the country in preventing one of the most common types of healthcare-related infections. Valley Children’s marked one full year without a catheter-associated urinary tract infection, eliminating a harmful and often painful complication for patients. An interdisciplinary team of pediatric specialists, nurses and infection prevention experts at Valley Children’s began working toward eliminating CAUTIs throughout the hospital. They started in the Pediatric ICU — where most of those events were identified — due to the large number of patients who needed catheters. The team implemented an “evidence-based prevention bundle.” Patients with catheters are evaluated daily to determine whether the device is still medically necessary. The team of physicians and staff follows a set of safety measures each and every day aimed at reducing the risk for in-

illness and lead healthy, vibrant and, importantly, full lives,” according to HFNC’s website. The program’s breakdown mirrors that of what you’d find at a typical summer camp, including access to recreational activities like archery, high ropes and swimming, which are available on the Camp Oakhurst grounds. But it’s Camp Hemotion’s more “specific strategies” that truly aim to fit the needs of its guests. Self-infusion training, for example, is led by medical professionals to assist campers with learning how to properly handle their medicine, as well as administer injections intravenously in a painless, yet effective manner. “This is an important right of passage for children with hemophilia as most often their parents have performed this task since they were infants,” the website states. “Learning self-infusion is a critical step toward independence, as the intravenous medication is required sometimes as often as daily to sustain life for people with hemophilia.” Camp Hemotion 2017 is scheduled for June 18-24. Details: www.hemofoundation.org/hfnccamps!.html

fection. As soon they determine the catheter is not needed, they remove it. “The PICU-led initiative to reduce CAUTIs is one example of how that team puts the health and well-being of our children first,” says Dr. David Christensen, Valley Children’s senior vice president, medical affairs and chief medical officer. “The level of collaboration between our physicians and nurses is the highest I have ever seen. That strong, interprofessional partnership leads to outstanding care and our CAUTI rate is one example of that.” This is another national award for Valley Children’s. It was the first pediatric hospital west of the Rockies to receive the Magnet designation from the American Nurses Credentialing Center, with three consecutive designations beginning in 2004. The ANCC continues to recognize Valley Children’s for quality patient care, nursing excellence and innovations in professional nursing practice. Valley Children’s remains in an elite group of less than 7 percent of hospitals nationwide to receive this designation.

Fresno State School of Nursing receives $125,000 grant

Saint Agnes Medical Center recently awarded the Fresno State School of Nursing a $125,000 grant to expand the Community Health Mobile Unit. More than 4,000 individuals have received care since the mobile unit’s launch in the fall of 2015. It provides free, quality health care to residents in medically underserved rural and urban communities in Fresno County. It also provides hands-on training for students in the College of Health and Human Services and other healthrelated majors at Fresno State. The grant to the Fresno State Foundation will be used to allow the unit to visit more sites throughout the county and serve more residents. Saint Agnes awarded four grants to local organizations that provide care to meet the greatest health needs across the four-county region, including overall access to medical and behavioral health services and treatment of chronic conditions such as asthma, diabetes and obesity.

Central Valley Health | SUMMER 2017 9


The play’s the thing Most of us are familiar with the medical services Kaiser Permanente provides for its members, but many don’t realize the health care provider provides additional services and programming that benefit the entire community. Since 1985, Kaiser Permanente Educational Theatre has produced live theater productions that teach kids about the benefits of healthy living. Part of the Oakland-based health care company’s educational outreach arm, the Educational Theatre produces three ageappropriate plays that target concerns and challenges faced by specific age groups. The productions are offered as a free community benefit in Kaiser Permanente-served regions, including Fresno and Clovis. “The Best Me,” performed for grades kindergarten through fifth, teaches kids about the importance of a healthy diet and daily exercise. In “Peace Signs,” third through sixth graders learn about conflict resolution and violence prevention. “Nightmare on Puberty Street” delves into concerns many middle schoolers face, including peer pressure, depression and dating relationships. Each play is presented by a youthful, diverse cast and

Saint Agnes names new Chief Nursing Officer Kim Meeker, RN, BSN, MBA, has been named Saint Agnes Medical Center’s Chief Nursing Officer. Meeker is a seasoned nurse executive with nearly 30 years of experience. Her clinical experience is rooted in surgical services but also includes emergency, intensive care, pediatrics and maternity services. She has strong leadership expertise in the areas of nursing advocacy, strategic planning, Lean process improvement, patient satisfaction and educational development. Most recently, Meeker served as the senior operations administrator at Wiser Women and Infants’ Hospital in Jackson, Mississippi, one of four specialty hospitals within the Uni-

10 SUMMER 2017 | Central Valley Health

features music and humor to keep kids’ attention. Typically, each cast spends a week in the Fresno-Clovis area each year, performing at schools throughout the region. During the current (2016-17) school year, Kaiser Educational Theatre reached 5,510 students at 16 area schools. Details: www.etnortherncalifornia.kaiserpermanente.org/about-us

versity of Mississippi Medical Center system. Before that, she was vice president of surgical services for Mercy Health System in Toledo, Ohio. “I came to Saint Agnes Medical Center because of the very strong faith-based mission and associated culture of caring,” Meeker says. “Within the first few weeks here I realized how closely we connect with our mission and I am honored to be a part of it. I also strongly believe in a patient-centered care model and Saint Agnes embraces this model of care.” Meeker earned a master in business administration from Spring Arbor College in Spring Arbor, Michigan, and a bachelor of science in nursing from Nazareth College in Kalamazoo, Michigan.

Health matters The Fresno Unified Board of Education recently voted to build health clinics at six schools in Fresno Unified School District. The clinics will be built at Addams Elementary School, McKinley and Hughes avenues; Bakman Elementary School, Helm and Belmont avenues; Tehipite Middle School, Augusta Street and Highway 180; Sequoia Middle School, Hamilton and Cedar avenues; Duncan Polytechnical High School, Garland and Cedar avenues; and Sunnyside High School, Peach Avenue and Kings Canyon Road. The first round of openings is slated for the 20172018 school year. Modeled after the Gaston Middle School Health and Wellness Center, the clinics will be operated by Clinica Sierra Vista. In less than two years, the health and wellness center has served nearly 10,000 patients including children, teenagers and young adults in the surrounding community. The clinics — staffed with a registered nurse and licensed vocational nurse — will provide primary care and treatment, physicals, immunizations, vision care, laboratory services, referrals for dental care and substance abuse counseling. Along with Clinica Sierra Vista, the clinics are supported by the Fresno County Department of Public Health, Valley Children’s Healthcare, Kaiser Permanente Fresno, Saint Agnes Medical Center and Community Medical Centers. Details: www.clinicasierravista.org


What’s your number? It’s been quite a year for fitness in the Central Valley, with new studios offering everything from cycling to yoga opening in Fresno and Clovis within the past few months. Now two new studios, FIT36 and Orangetheory Fitness, have entered the local fitness scene. Both gyms offer high-intensity interval workouts, which consist of short bursts of high intensity activity with short recovery periods in between. The twist, at these fitness studios, is that participants wear heart rate monitors for the duration of their workout. At north Fresno’s FIT36, each session is only 36 minutes long. But don’t be tricked into thinking shorter equals easier. Here, members workout with equipment like TRX straps, Bosu balls and kettlebells. Anybody who has spent time in a gym will likely recognize that equipment, but the way its used is what sets FIT36 apart — and gets that heart rate up. “We’re using them in a functional way,” lead trainer Andre Nestle says. “You may have a squat shoulder press. You may have a lunge curl. They’re compound movements, which are most effective for caloric burn.” Participants move through stations, performing 12 such exercises — each a minute in length with a 30 second rest in between — twice. While they’re working, live heart rate data is transmitted to a large screen mounted in the middle of the room. “If you’re doing lunges or squats, or maybe you’re doing a box jump, at any point you can look up at the screen and see what your heart rate is and how many calories you’re burning in that moment,” says Nestle. The screens also alert participants to the “zone” they’re working in. “The zone where you’re most efficient is that anaerobic zone, and that’s the zone where you’re burning the most calories and being the most efficient. That’s where we want members to spend the most time,” Nestle explains. Working in the zone, he adds, “comes into play after your workout” because the body will continue to burn calories for up to 36 hours postworkout. This is known as excess post-exercise oxygen consumption, or after-burn. Achieving that after-burn is also the idea behind Orangetheory Fitness. At the new studio, also in north Fresno, each hour-long class includes both cardiovascular and strength training. “A very traditional Orangetheory class is 30 minutes on the cardio side and 30 minutes in the weight room,” says studio manager Frankie

Eszes. “On the cardio side, you’re doing intervals and in the weight room you’re doing a circuit.” On the cardio end of the room, she adds, members spend most of their time running or power walking on treadmills, changing up the pace and/or incline during intervals ranging from 30 seconds to four minutes. “You’re constantly bringing your heart rate up and down,” she says, “and when you’re wearing your heart rate monitor you can see where you are. If you’re working a little too hard, or if you’re not working hard enough, you can see.” During the strength portion of the class members perform exercises using TRX straps, dumbbells, rowing machines, Bosu balls and abdominal dollies. The workouts, she adds, are “modifiable for everybody. We have members looking for weight loss, we have members who are looking for athletic performance. We have people who may already be fit and are just looking for something

different.” Both studios have certified personal trainers, or coaches, who circulate the room and offer guidance and motivation. For many, this type of training will be different, but Nestle is confident his members, even those new to an exercise program, will reap the benefits. “You’re going to build strength and you’re also going to build endurance,” he says. “We’re promoting health, and it starts with the heart, so we’re building up that muscle. That’s going to allow you to do more things in general, even if it’s just being able to go for a walk.”

Central Valley Health | SUMMER 2017 11


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Voices

What makes us tick? Y Don Farris, LCSW, BCD, is a licensed clinical social worker in Fresno, providing counseling and psychotherapy to individuals, couples and families. He can be reached at donfarris1871@ gmail.com.

ILLUSTRATION: Getty

Images/Thinkstock

12 SUMMER 2017 | Central Valley Health

our opinion of yourself — how you think and feel about yourself — as well as others’ opinion of you, determines much of the quality of your life. Your relationship with yourself, and with others, is the emotional and social foundation your life is built on. Our need for connectedness with others seems to be an inborn human trait. It appears our earliest ancestors instinctively banded together for survival. They were not as fast or as strong as the animals they had to pursue or compete with for food or protect themselves from. But they were smarter. They survived through their intelligence and their relationships with one another. The quality of our self-concept, judgment and relationships with others continues to be essential to our well-being. We are all dependent on other people in everything we do. Our greatest achievements and most satisfying moments have been in the company of others. People with the best relationships have the best lives. We have always needed one another. The difficulty we have in understanding ourselves and others is a major obstacle to establishing more satisfying relationships. Why people sometimes say and do the things they do are often unexplainable mysteries to us. This happens when we try to explain

someone’s behavior on the basis of thoughts or reason alone. Human beings are emotional creatures. Sometimes we are driven more by emotions than by reason. Intense feelings of anger, fear, desire or any stress can override our judgment and determine what we say and do. They are often the cause of thoughtless and impulsive acts. Bottled up and hidden feelings make it even more difficult to understand ourselves and others. We often don’t acknowledge our unpleasant or embarrassing feelings to even ourselves. Additionally, much of the thoughts and feelings that drive us are unconscious. We are just not in touch with them. The unconscious can often explain it when we tell ourselves, “I don’t know why I do that, I just do.” Emotions, not thoughts, and the unconscious create the perplexing unknowns, which make our attempts to understand ourselves, others and relationships so difficult and so very vexing. Whenever anyone’s behavior, including your own, doesn’t make sense to you, it simply means you don’t know what caused it. Everything that exists was caused by something else. Everything is in response to something that went before. Things make sense when we know what caused them. Despite our conflicts with others, we need one


another. Rejection, isolation and loneliness are toxic to us. We need to love and be loved. We need at least one someone to give our love to who loves us in return. We also need to feel worthwhile to ourselves and others. This is the essence of our “psychosocial” well-being — the foundation of our psychological and interpersonal functioning. Our sense of worth is determined by what we achieve or produce. It is the “work” of being someone’s life partner, parent or friend, and by our contribution to whatever social, religious or professional groups we are involved in, as well as our employment. “Work” here is not drudgery. It is the efforts that produce the things we value. It gives meaning and significance to our lives and defines our existence. Finding meaning and purpose in life, and having a value system that provides us with direction, guidelines and standards of conduct is the supporting structure of our lives. It is important for physical and mental health, personal success, quality of life and longevity. We do best when we have something to believe in, something to live for and someone to share it with. There is a difference between our needs and our wants. A need is something that is necessary to achieve a goal, maintain a condition or sustain life. A want is something that we desire, but is not imperative for us to achieve or maintain something. A want may improve the quality of life, but it isn’t necessary for its

existence. A need is a necessity, a want is a preference. When our needs and wants are not met we experience stress, which can detract from our well-being, health and longevity. It makes good sense to have reasonable and worthwhile pursuits. Our need for human connectedness and for a responsible value system are united in our efforts to get our physiological and psychosocial needs met. The goal is to pursue them responsibly. A responsible person is someone who gets their needs met without interfering with any other person’s right or opportunity to get theirs met and certainly not at someone else’s expense. It is actualizing your value system — pursuing your wants and needs, according to what you say you believe in. It’s living up to your own declared standards. Otherwise, your values and principles are simply meaningless thoughts. Rather than achieving your potential, what you might have been becomes no more than wishful thinking — an unrealized fantasy that never sees the light of day. John Greenleaf Whittier wrote, “Of all the words of tongue and pen, the saddest are these, ‘it might have been.’ ” Whether you become something that “is” or something that “might have been” is up to you. It is your call. CV

John Greenleaf Whittier wrote, “Of all the words of tongue and pen, the saddest are these, ‘it might have been.’ ”

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Heal

Students at Clovis West High School hold signs in March to raise awareness about depression and suicide prevention.

Tackling taboo Mental health advocates work to break the stigma surrounding depression and suicide BY: Farin Montañez | PHOTOGRAPHY: German Amezcua, Farin Montañez

A

t his wits end, a 22-year-old man climbs over the railing of the Golden Gate Bridge and stands on a pipe, staring 220 feet below into the San Francisco Bay. With a feeling of hopelessness, Kevin Berthia is about to step off of the ledge at the most utilized site in the United States for loss of life by suicide. It’s a situation retired California Highway Patrol Sgt. Kevin Briggs saw all too often in his 23 years of patrolling the Bay Area. He’s been called the Guardian of the Golden Gate Bridge for stopping more than 200 people from jumping to their death from the landmark.

14 SUMMER 2017 | Central Valley Health

With that track record, one might think Briggs is an expert at talking people off of the ledge — but that’s where they’d be wrong. Briggs’ approach is more like listening them off of the ledge. Berthia chose to come back over the railing that day, on March 11, 2005, about an hour and a half after Briggs called out to him from atop the bridge. “You listened,” Berthia told Briggs after the experience. “We were there for 90 minutes,” Briggs recalls. “I spoke maybe four or five minutes out of that entire


time. All he wanted was for someone to listen and to be there. There’s no magic.” These days, the two Kevins share their stories at speaking engagements across the country, raising mental health awareness and conveying a message of hope. Clovis Community College invited Briggs to speak during Mental Health Awareness Week in April. During the previous semester, one of its students died by suicide and nearby Clovis West High School saw three of its students take their own lives. Briggs recommends teaching students — the younger, the better — about mental health to remove the stigma surrounding it. “Tell the young folks about it,” he says. “Tell them there is hope, there is help, here’s how to get help. You’re going to go through a lot of things, but it’s not just you with these stressors, it’s a lot of people. … It’s critical to tell them about it.” Suicide is the second leading cause of death for young people between the ages of 10 and 24, according to suicidepreventionlifeline.org. While California’s suicide rate is lower than the rest of the country, locally there has been a rise in teen deaths by suicide. For the threeyear period spanning 2013 to 2015, Fresno County had 10 teen suicides, but in 2016 alone, there were 11, according to the county’s behavioral health department. While local mental health experts are investigating possible causes of the spike, researchers at Columbia University and other institutions have found that suicide is contagious, especially among 15- to 19-yearolds. Students who are already at risk for depression and suicide “who see or hear about someone else taking action can thus be urged a little bit more past their threshold,” says Dr. DeQuincy Lezine, president and CEO of Fresno-based Prevention Communities. The American Foundation for Suicide Prevention has come up with a framework for how to report on suicide so the news media doesn’t further the contagion effect. “There has been some research about what has appeared in the media and how it facilitates the contagion factor,” Lezine says. “Being specific about the method of suicide, glorifying or romanticizing it, providing lots of details — those types of things have been discouraged.” There has also been a rising effort to educate the public, especially high school and college students and

their parents, about the warning signs of depression and suicide. Depression is more than just feeling sad — it’s a serious medical illness that can affect one’s thoughts, feelings, actions and health, according to the National Alliance on Mental Illness. It can run in families or be caused by stress, trauma and other factors. Symptoms vary by person and can happen suddenly or creep up slowly. Untreated depression can lead to thoughts of suicide and suicide attempts.

Fighting the stigma Registered nurse Naomi Forey, health services coordinator for Clovis Community College, gives a depression screening survey to every student who comes into the campus clinic for health services — whether it’s for a flu vaccine, birth control counseling or a TB skin test. “We try to raise awareness that way. No matter if their score is zero, which means no depression, or 25: severely depressed,” Forey says. “We give them information about how prevalent it is, that it affects every human on and off throughout life.” Out of 404 students surveyed last year, 37 percent said some time within the past 12 months they felt so depressed it was difficult to function, Forey says. “Around 50 percent said they felt lonely, helpless, anxious. The numbers were very high,” she says. “We want to create awareness so people can get help instead of suffering in silence.” Some students suffering from severe depression don’t want to see a psychologist because of the stigma attached to mental illness, Forey says. “They don’t want people to know they’re suffering like this. They think it means they’re crazy,” she explains. “We have to change the culture of the United States to realize this is an illness, like hypertension. We wouldn’t say ‘Hey, get over it. Snap out of it.’ ” Clovis Community College student Ciana Thong says she was almost killed by the stigma surrounding mental health. The 18-year-old suffered from ADD, depression and anxiety throughout her life and especially in high school, but didn’t realize her illness was real — and that there was something she could do about it. “In my senior year ... I almost took my life,” she says. “I kept telling myself in my head that my disorder wasn’t real, that I was just doing it for attention.” Through therapy, medication and support from her family, Thong survived and is thriving in school. “If you are struggling, it’s better to get help early on rather than waiting until you’re on the brink of suicide,” Thong says. “No matter how big or little your problems are, they are your problems and they are important.” Please see next page

Suicide warning signs

These signs may mean someone is at risk for suicide. Risk is greater if a behavior is new or has increased and if it seems related to a painful event, loss or change. Talking about wanting to die or to kill oneself Looking for a way to kill oneself, such as searching online or buying a gun Talking about feeling hopeless or having no reason to live Talking about feeling trapped or in unbearable pain Talking about being a burden to others Increasing the use of alcohol or drugs Acting anxious or agitated; behaving recklessly Sleeping too little or too much Withdrawing or feeling isolated Showing rage or talking about seeking revenge Displaying extreme mood swings Source: SuicidePrevention Lifeline.org

Mental health experts hope to break the stigma surrounding depression and suicide by educating the public.

Central Valley Health | SUMMER 2017 15


continued ...

Are you in a crisis?

Do you need help? The Central Valley Suicide Prevention Hotline is free and confidential for residents of Fresno, Madera, Mariposa, Merced and Stanislaus counties. Call (888) 506-5991. The National Suicide Prevention Lifeline is (800) 273-TALK (8255). If you’re a veteran, press 1. A Spanish-language line is available at 1 (888) 628-9454. Visit suicidepreventionlife line.org for additional resources. A national crisis text line is also available. Text HELLO to 741741.

Retired CHP Sgt. Kevin Briggs speaks about suicide prevention at Clovis Community College in April during Mental Health Awareness Week. Behind him is a photo of Kevin Berthia, who planned to jump from the Golden Gate Bridge in March 2005 until Briggs intervened.

Start the conversation It’s a myth that you shouldn’t ask someone if they’re contemplating suicide, for fear of planting the idea in their head, Forey says. “I hear the word ‘hopeless’ and that is a red flag. So I say, ‘Are you thinking of hurting yourself? Are you thinking of killing yourself?’ And when they are, they’re very honest about it. When they’re not, they’ll say ‘Oh! No, no!’ And I’ll take them at their word. ... I’ve never had anybody get mad at me for asking. When I do ask, they seem relieved that I asked and they’ll say ‘yes, I am.’ ” If someone in your life exhibits symptoms of depression, from changes in behavior and sleep patterns to drug or alcohol misuse, the first step is to start a conversation with them, says Briggs. Using the strategy he employs on the Golden Gate Bridge, Briggs says to be an active listener, providing verbal feedback and encouragement like summarizing and paraphrasing what the person is saying. Forey says it is essential to listen without judgment to someone who is opening up about their pain. “Realize that pain is real for that person, and you can’t decide whether this issue should cause pain or not,” Forey says. “One thing I’ve discovered throughout life — I was a school nurse as well — is the issues that are breaking kindergarteners’ hearts are the same issues that are breaking our hearts. … No matter what the age, if there’s pain, respect that. It’s pain for them.” And don’t try to offer advice, Forey says, just provide information about where and how to get help. “It’s not advice, it’s understanding that they need,” she says. “Make sure they know that you care.” Expressing love and caring for a person in pain is paramount, agrees Dr. Lezine. “The main thing is to convey that you care about this person,” he says. “There are myriad ways to say ‘I love you.’ Say, ‘I want you to be safe. You mean a lot to me. I think you have a bright future.’ ”

Get help It’s important to tell someone as soon as possible if a loved one has admitted to thinking about suicide, Lezine says. “It’s really hard to be alone with that type of responsibility, with that type of weight on your shoulders,” he says. “And if something happens, folks feel terrible about it and wonder whether they should’ve taken extra action.” Some people may feel that the person who confided in them may get upset if they tell someone else. But

16 SUMMER 2017 | Central Valley Health

Briggs has an answer for that: Would you rather them be mad or dead? “Don’t keep a secret on this. This is way too important,” he says. “They may be mad at you, but so what? They’re here.” Connect that person with the National Suicide Prevention Lifeline or a local hotline service where the people on the other end of the phone have been trained to do suicide risk assessments, Lezine says. Better yet, treat depression before suicidal thoughts begin, experts say. Locally, Fresno County Behavioral Health is home to several programs and facilities for treating mental illness in people from infants to seniors. Teenagers may be reluctant to seek help, especially if they are embarrassed or fearful of their parents finding out. But behavioral health clinical supervisor Jeffery Robinson says teens can seek mental health help without having to get consent from a parent. “A child that has the mental capacity to function in a competent, mature way in therapy can do their own consent, that way they don’t have to have their parents involved,” he says, citing a California law. This is helpful for youths whose mental health problems may stem from sensitive issues, such as their sexuality, sexual activity, pregnancy or drug or alcohol use, Robinson says. In his line of work, he has seen lots of teens and adults get the help they need to prevent suicide. “It is not uncommon for people to have thoughts or feelings that life isn’t as worth living or things would be better if they weren’t around. … Sometimes younger people feel as if they have disappointed or let down their family and this would be an option so I don’t keep disappointing my family or hurting my parents,” Robinson says. “We want to go in and talk about what makes you unique and special and what you have to live for.” CV


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bloom 18 SUMMER 2017 | Central Valley Health


The Art of Life Healing Garden at Woodward Park is a gift to the community BY: Katie Fries PHOTOGRAPHY: Matthew Drake

T

hough it’s not the title on her business card, Jenelle Higton is a gardener. On a windy spring day, the executive director of Fresno’s Art of Life Cancer Foundation embodies the role, detailing the Art of Life Healing Garden’s brief but rich history while leading a tour through the space. “This project has been in the making for less than two years,” she marvels, gazing at the nearly complete 3-acre garden she’s helped nurture. The Art of Life Healing Garden at Woodward Park grew out of the Art of Life, a healing arts program established in 2007 by Dr. Christopher Perkins. A breast cancer specialist at California Oncology, Perkins had noted many of his patients seemed to need an outlet for self-expression. The Art of Life Canvas Project partnered local artists with small groups of survivors to create collaborative works of art. “When you’re diagnosed with cancer, it requires a kind of mental and spiritual inventory. Most ... never really get a chance to process and then they roll through it, never have a chance to think about what they just rolled through. It’s a time to really collect

those thoughts with like-minded people and really complete the journey,” Perkins says, describing the purpose of the group sessions. The annual project included an unveiling ceremony for the participants’ family and friends. Eventually, says Higton, “people were lining up to participate … and people were also wanting to give so it could be a free experience for any survivor that needed it. “We said, ‘If it’s the artwork that really impacting lives the way we’re seeing and hearing, we need to bring it out to the most public of place.’ ” She says several public spaces, including City Hall, malls and the airport, were considered as hosts for the artwork. “We looked at everything, and that’s when the idea of a healing garden came about.” According to a 2012 Scientific American article, spending time in a garden can reduce a patient’s pain and stress levels. Many hospitals and medical centers have dedicated outdoor spaces in which patients can spend time. And the concept isn’t new — there’s evidence that European and Asian cultures had their own versions of healing gardens as early as the middle ages. But the unique idea behind the Art of Life Healing Please see next page

Volunteers planted the garden’s lavender labyrinth. The Art of Life Cancer Foundation’s executive director, Jenelle Higton, and California Oncology’s Dr. Christopher Perkins.

Central Valley Health | SUMMER 2017 19


Jensen Alfaro plays on the Log Tunnel in the Healing Garden. Isabel’s Tree, a memorial to Isabel Anderson, is decorated seasonally.

20 SUMMER 2017 | Central Valley Health

continued ... Garden, a space where cancer survivors can “gift what cancer has taught [them], what it has shown [them] about life ... [a gift] to the next person so they would never have to go through cancer to learn those things,” is different, says Higton. The establishment of the Art of Life Cancer Foundation as a 501(c)3 nonprofit in 2014, says Higton, was the first step in bringing its message to a public space. Here, people would be able to view the artwork created in Art of Life programs, meditate and spend time with others in play or reflection. Higton says Fresno Mayor Lee Brand, then representing District 6 as a member of Fresno’s City Council, was instrumental in bringing the Art of Life’s proposal to use part of Woodward Park for the proposed garden to the City Council, which voted in favor of allowing the foundation to build the garden on 3 acres within the park. The park’s close proximity to several of the region’s hospitals and medical centers, including Valley Children’s Healthcare, Kaiser Permanente Fresno Medical Center and Saint Agnes Medical Center, made it an ideal place for patients to stop and reflect before or after treatment. After receiving the city’s approval, things moved quickly. Construction began in 2015, with the first of three phases opening in September of the same year. The months since have been marked by the development, construction and unveiling of additional elements. Today, the foundation’s original vision is a near-complete garden that welcomes everyone. Higton points out its highlights, noting every ele-

ment was designed with a purpose. The flat concrete path that loops through the garden, she says, was designed to visually represent a cancer ribbon; its distinctive shape is visible when viewed from above, and the flat terrain is easily navigable for those with mobility impairments. Walking along the path, visitors encounter picnic tables and benches, children’s playscapes, art kiosks featuring works created by Art of Life artists, an amphitheater, a “garden” of whimsical tulip-shaped chairs, a lavender labyrinth and prospect refuges. She is quick to credit the community partners who gave of their time, money and resources to bring the garden to life. Among the early partners were Fresno State, whose engineering students and faculty helped design the garden, and East Fresno Kiwanis, which was responsible for purchasing and installing the play areas. And, as the project came to fruition, it captured the attention of more than just survivors and early donors. For Patrice Loretta, it started with a tree. After her father, Arthur Stanton, passed away in 2001, one of his business rivals purchased a tree in his name. Tree Fresno placed the tree in Woodward Park. Loretta and her family considered it a physical memorial to the family patriarch, whose remains had been scattered at sea. When the family noticed fences had been placed around the area Stanton’s tree stood in, they began to ask questions, wondering what was going on. Those questions led Loretta to Higton and the Art of Life Healng Garden. She recalls explaining the situation to Higton, who assured her they had no intention of cutting the tree


down and, in fact, would incorporate it into the garden’s design. As a result of that kindness, Loretta requested more information. When she and her sister discovered they could sponsor various design elements of the garden, they knew what had to be done. Soon, a bench dedicated in their parents’ memory sat in front of the tree. “The funny thing about all these threads,” Loretta says, “[is] after the bench was placed in February of last year, I was diagnosed with breast cancer. It’s a complete circle of events where all of these things were coming together in confluence.” During treatment, she remained active in the garden’s development. By the time members of the community gathered to plant the lavender labyrinth, she says, she had finished her cancer treatments and had “a wonderful prognosis.” Higton says some mistakenly assume the garden is a memorial to those who have lost their battles with cancer. While memorials do dot the garden in the form of trees, plaques and tiles, just as many celebrate a battle overcome. Still, memorials like the tree and bench dedicated to Loretta’s parents are essential parts of the healing journey for some who have lost a loved one. Higton points out a tree festooned with heart-shaped ornaments, each bearing a message. They’re Valentines for Isabel Anderson, a young girl who lost her battle with a rare form of leukemia. “Isabel’s Tree” has become a living memorial to the young girl who loved “Frozen” and wore bright bows in her hair. “I get messages weekly sometimes, from the mom, saying what it means for her to have this place to come and honor her daughter,” Higton says. Evelyn Rurik was introduced to the Art of Life in a different way. She had participated in the foundation’s painting sessions as an assistant to lead artist Arminee Shishmanian. On the day the paintings were exhibited in the garden, she and her husband George made a point of attending the event.

What they didn’t realize when they arrived, she says, was that all cancer survivors in attendance would be recognized. “They called all the cancer survivors to meet, and my husband went over there. I’d almost forgotten he’d had cancer 35 years ago ... he was the oldest survivor there.” Impressed, the family began supporting it in various ways. “I think it’s such a great place for meditation,” she says. “The view is wonderful. It’s so peaceful, and I think it’s very soothing. The excitement that is there gives cancer patients hope.” Cancer survivors do see its value. “When you go out to the Art of Life garden, you see all of those tiles, you see the people and what they’ve written, and it has tremendous impact,” says survivor Garry Bredefeld, who represents District 6 on Fresno’s City Council. “Drugs are much better than they used to be, but it’s still a dark path to walk,” says Loretta. “To have a place set aside that makes it feel like it’s for me and the other people who have walked my road ... I can’t think of anything else like it in Fresno.” One key piece — the 19-foot Family, Friends & Faith sculpture — has yet to be installed. The steel and stained-glass work of art, designed by Fresno artist Corky Normart, will stand near the entrance. The sculpture’s upraised hands signify “the beauty of support and giving support,” while multicolored stained-glass panels, when illuminated by the sun, will “create a rainbow of hope upon the garden.” Once financed through donations, she adds, “this will sort of be that last crowning moment on the garden. But truly, the garden will never be finished. It will always be its own canvas, where people are creating, developing and caring for the garden,” Higton says. Loretta agrees. “The garden represents so many different things to us in so many different ways. Gardens are places of life and hope. Harvest and joy. It’s a perfect picture to me of the connection we have to each other, and the connection we have to God.” CV

Adults and kids alike are drawn to large tulips that open to reveal chairs. One of the play structures donated by East Fresno Kiwanis features a wheelchair-accessible tunnel.

Central Valley Health | SUMMER 2017 21


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A special kind of care

Live

William and Vatsana Burns enjoy time with Greyson, left, and Wyatt at a local park near their home in Visalia.

Valley Children’s Healthcare’s NICU creates ties with its tiny patients and their families BY: Dani Villalobos | PHOTOGRAPHY: Gary Kazanjian

G

reyson and Wyatt Burns are, well, everywhere at the moment. One shifts between the comfort of his mom’s lap and the floor as the sounds of the “Power Rangers” theme song play from his dad’s confiscated smart phone, while the other loudly recites proper train terminology along with the tablet firmly secured in his hands. The scene is familiar to anyone with 4-year-old children, even more so when they’re twins. It can be tiresome for first-time parents, William and Vatsana, to

22 SUMMER 2017 | Central Valley Health

keep up, but the normalcy of it all is something both have come to appreciate. “They’re twins, but they’re two different babies — one’s night and the other is day,” Vatsana says. “Wyatt is more happy-go-lucky, bouncing off the walls, where Greyson is ‘give me my book or tablet and leave me alone.’ It was difficult in the beginning, but it got easier as they get older ... They are starting to comprehend, but whether they want to listen or not is a different story.” “You can’t hide anything from them anymore,”


William adds, with his wife nodding in agreement to this new development: “Greyson has eyes like a ninja.” But it wasn’t too long ago that the health of their sons’ peepers were hanging in the balance — a stark reminder of Greyson and Wyatt’s unconventional start to life that has spurred the family of four to cherish a very different kind of milestone each fall: Valley Children’s Annual Picnic for NICU Graduates. Just last year, the Madera-based hospital earned national recognition by U.S. News & World Report as one of the country’s best children’s hospitals in neonatology, and is the only regional Level IV Neonatal Intensive Care Unit — the highest level NICU possible — in Central California. The specially designed, 88-bed nursery provides the most advanced care for fragile infants, with experienced pediatric specialists, nurses and staff helping to attend to their tiny patients’ unique needs around the clock. And seeing those former residents as grown, healthy and energetic children is a special opportunity families, doctors, nurses and staff look forward to year after year with Valley Children’s popular reunion picnic. Last October’s 37th annual event boasted an attendance of roughly 300 “graduates” and a total of 800 guests — Greyson, Wyatt, William and Vatsana included. “We’ve tried to make every NICU picnic,” Vatsana says. “It’s one of those things you look forward to because you know you’ve jumped that hurdle and you’re on the other side.” William and Vatsana began referring to their sons as “miracle babies” early on. The Visalia couple experienced difficulties conceiving before turning to in vitro ferilization to help them along — an option that later resulted in the unexpected, yet exciting news that the Burnses were expecting twins. Vatsana could only describe her pregnancy as easy. Heck, the mom-to-be’s new focus on her and the babies’ health helped to reverse her borderline diabetes diagnosis as Greyson and Wyatt continued to grow. Still, regular checkups with her doctor and healthful choices couldn’t prepare the Burnses for the strain the babies caused on Vatsana’s short-torso frame. And at just 24 weeks, her body began to give. After an onslaught of startling back pain, Vatsana left her job at Bank of America a few minutes before her shift ended and headed to Kaweah Delta Health Care District. William works in the hospital’s security department, so the call of her sudden admittance into the facility’s care was quickly received. An evaluation of Vatsana’s condition pointed to the cause: she was in premature labor. “They were getting us prepared, and I was just shocked and scared and crying, thinking ‘Why? Why? Why?’ ” she recalls. “Even if I had to sacrifice myself, I didn’t care at that point. I just wanted them to be healthy.”

William and Vatsana Burns with their twin sons, Greyson and Wyatt, at Valley Children’s Healthcare in 2013. The twins were born at just 24 weeks. They both weighed less than 2 pounds.

Within a few days, Vatsana was transferred to Saint Agnes Medical Center more than 50 miles away. The plan was to postpone delivery of the twins for as long as possible, requiring her to remain on bedrest and on a series of medications to help stave off contractions. It wasn’t working. Five days after first experiencing signs of labor, Greyson was born at 6:27 p.m. on Jan. 20, 2013 — Wyatt came only a minute after. They both weighed less than 2 pounds. A neonatologist and accompanying staff from Valley Children’s were on-site before the emergency C-section to help prepare William and Vatsana for the steps to come and arrival of the neonatal transport teams, even snapping individual photos of the preemies in their isolettes for mom to hold onto before she could join them at the NICU a day later. Greyson and Wyatt wouldn’t sleep in their Visalia home until May 10 — the twins’ actual due date and four days after Greyson was given the clearance to go home. From first arriving at Valley Children’s nearly four months earlier, the two would take turns making progress, with Wyatt usually edging out his older brother until he took a small turn toward the end of their stay. “Every stage was different. We were so excited when they were able to graduate from the isolette to the crib and to what they call the Endeavor, which is where you Please see next page

Central Valley Health | SUMMER 2017 23


continued ...

Greyson Burns has some play time at the annual reunion picnic.

24 SUMMER 2017 | Central Valley Health

stay before you’re ready to go home and get a feel of how it will be day to day,” Vatsana says. “It was a process, but we’re glad we were able to have the staff of Valley Children’s there ... If we didn’t have that, I’d hate to think where the boys would be.” Connections developed with NICU staff were imperative to the Burnses’ daily routine, as it was through constant communication that the new parents learned the ins and outs of their sons’ conditions, updates on what happened while they were away and how to properly care for the twins as they grew more and more stable. Within the first few weeks, William says, parents are given the chance to choose primary care nurses who, when available, will monitor Greyson and Wyatt on a regular basis — just one of the various ways Valley Children’s Healthcare aims to integrate families directly into their child’s care. In fact, for the hard stuff, the NICU greatly depends on the rapport established with these specialized healthcare professionals. Neonatal nurse Carrie Raulino has been employed with Valley Children’s Hospital for 26 years, 19 of which have been spent working in its NICU. She remembers Greyson and Wyatt’s months-long stay at the hospital, and still receives a regular invite to the boys’ birthday party each year. If she can’t make it, well, there’s always the picnic. “You click with certain people, and since they were going to be there for a long time, I offered to [be their] primary. That way, they would get a nurse who knows their idiosyncrasies,” Raulino says. “Sometimes, if they have complicated issues, the explanation from doctors can be more questionable than they’d like. You try to put the best spin on everything, but also give them the worst possible scenarios. We’re human, so you try to treat them like a member of your family and how you’d

want them to be treated.” The Burnses got hands-on training about all the sounds and readings made by the high-tech equipment from their sons’ nurses, with Raulino and her team of colleagues ensuring that important experiences like skin-to-skin contact between the parents and Greyson and Wyatt took place along the way. Both boys received a special laser treatment to protect their eyesight, as the abundance of oxygen they’d received while in the NICU could result in Retinopathy of Prematurity and cause vision loss. Wyatt also underwent surgery for an inguinal hernia at just three months. Despite these setbacks, the Burns twins were eventually transferred to the Endeavor twin room, allowing their parents to get a taste of what life at home would be like. William and Vatsana’s willingness to learn from the staff even surprised certain nurses assigned to assist with cleaning the boys. “We did everything from taking off all of the monitors, giving them a bath and then putting it all back. She sat back, watched us and said, ‘You guys just did everything,’ ” William says. “We told her we had good nurses who taught us everything, and we were pretty much able to do their assessments for them where they would take our notes off of a paper towel, put them in the computer and then have time to chitchat with us.” The Visalia residents also took advantage of the neighboring Ronald McDonald House Charities of the Central Valley, using the resource as a space to sleep, cook, do laundry and relax outside of the hospital’s walls. But when William and Vatsana required more of an emotional backing, they looked to the Parent to Parent program. The largely volunteer-based program is run under Valley Children’s Healthcare’s NICU parent representative, Tracy Gong. Gong’s history with the hospital is quite personal, as her now-teenaged daughter was once a preemie in the specialized unit. Her unique perspective allows Gong to function as a parent voice within several of the hospital’s committees, and understands the importance of a comprehensive support system available to NICU parents. In what is now designated as the Parent Lounge, the room’s couch, small table, chairs and computer space offer a sort of reprieve for weary parents and a place to find help, camaraderie and even a sense of hope. After the Burnses spent time in the program and developed a personal friendship with Gong, parents can still find Greyson and Wyatt’s story displayed on the lounge’s walls — along with a rotation of various narratives from others who have once been in their shoes. “They’re not always perfect stories, but it gives them hope that there is the other side,” Gong says. “There is life outside of the NICU.” An annual manifestation of that keeps Gong and Raulino on their literal toes each October, with both


Leila, Maribel, Felix and Ken Ternate enjoy the reunion picnic.

trying to pose for photos and touch base with as many families as possible. “The fact that we have record numbers that come back year after year makes you feel good because you’ve made a positive impact on their lives,” Raulino says. “It makes you feel wonderful when they come running up to you, ‘Nurse Carrie! Nurse Carrie!’ ” For the Burns family, everyday life has evolved into their own brand of ordinary. Doctors informed William and Vatsana that developmental steps, like holding their heads up, crawling, walking and eating solid foods, would be at a pace behind their peers — not fully catching up until the age of 2. Both credit their enrollment in preschool last year as a helpful tool to speeding up their behavioral aptitude, and are now tackling the twins’ verbal, reading and writing skills. Trips to Valley Children’s Hospital remain routine, with various checkup appointments throughout the year to ensure Greyson and Wyatt are meeting the necessary standards of each developmental stage. But even as these will become less and less frequent as they grow older, the place where they spent the first few months fighting for their lives will always remain a big part of who they are. “As the boys get older, we want to teach them to give back to the nurses and staff because they were there for us in our time of need,” Vatsana says. “It’s one of those things you don’t want to remember because it was a harsher time, but we wouldn’t trade it for anything. It made us a family, and made our family stronger.” CV

It’s picture time for Ruth Olea, Nancy, Sofia Machego and her brother Steven at the reunion picnic at Valley Children’s Healthcare.

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John Giannandrea used to weigh almost 500 pounds (below) and is now a muscle-toned 260 pounds. Joanna Quiocho gets trained by John at his gym, Grit. Giannandrea’s brand, Ogre, a caricature made by a friend, is emblazoned on shirts, which he sells.

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Personal trainer’s approach is 50% training, 50% therapy; ‘Ogre’ is a symbol of hope BY: Cyndee Fontana-Ott | PHOTOGRAPHY: Tomas Ovalle

J

ohn Giannandrea’s tipping point was the loud thump behind his bathroom door. Four years ago, a close friend suffered a brain aneurism and collapsed in the small bathroom. Both men weighed more than 450 pounds each, and Giannandrea’s fallen friend virtually blocked the door. Giannandrea struggled to push through but only his girlfriend could fit through the opening. She helped him muscle the door so that Giannandrea could reach his friend, who eventually recovered. Immediately, the experience left Giannandrea exhausted and anxious. In the same situation, could someone save him? That night, he caught his reflection

26 SUMMER 2017 | Central Valley Health

in a mirror and saw a body as big as his closet door. That emergency, his weight — everything caught up to him. “I lost it — I broke down,” he says. “That was the day this whole thing started.” Now, Giannandrea is down more than 200 pounds, full of muscles and the owner of a personal training business in north Fresno. His True Grit business and “ogre” character (his face on T-shirts, for example) have become symbols of hope for clients and thousands of followers who want to lose weight. Giannandrea, 40, owns his heavyweight past — you’ll see the before (at 485 pounds) and after pictures on the gym wall, the True Grit website and his busi-


ness cards. That real-world honesty is a powerful draw along with an approach he describes as 50 percent training, 50 percent therapy. “I kicked my ass because I didn’t want to be fat any more,” he says. Giannandrea says he did it by learning how to eat, exercising portion control, changing his view of food from comfort to fuel, training and moving — a lot. Giannandrea’s methods have succeeded with clients like Joanna Quiocho, a single mother with two children who works for PG&E. She had already lost about 60 pounds when she met Giannandrea and heard his story. “I thought, ‘you’re real, you understand the struggle,’ ” she says. Quiocho was someone who felt intimidated by the gym and the often-cookie-cutter approach of trainers who brushed off the physical limitations of her two back surgeries. She says Giannandrea personalized her training, changed her view of food and supported her even when she fell off her eating plan or grew frustrated that the scale didn’t budge. Now down about 120 pounds, Quiocho says she’s inspired by her early morning training and even the similarly dedicated people who enter the gym as she is leaving. “I wouldn’t be able to do it on my own,” she says. Giannandrea doesn’t think you have to but believes that each person must want to change for themselves. He didn’t pack on the pounds overnight — and he didn’t lose them overnight either. “Every fat person has a story,” he says. Giannandrea didn’t have a storybook childhood. He says his mother was troubled and the family was poor, frequently bouncing between Southern California and the Central Valley. He says his father tied him to a tree so he would learn to stop crying, then left for good when Giannandrea was 8. As a boy, his grandfather criticized his weight — and his grandmother apologized with food. Giannandrea says he ran away from home as a teenager; he persuaded a homeless man to pose as his father at the DMV to get his learner’s permit at 15. He worked a variety of jobs — such as security — and earned a GED. He was never thin but in his 20s, a badly broken leg sidelined him for about nine months. Depressed, he started to put on weight — carrying 350 pounds on a nearly 6-foot frame before he was 30. Giannandrea bought bigger and bigger clothes and found comfort in food.

At McDonalds, for example, he’d order 40 chicken nuggets, two large fries and two Cokes. He hoped the two drinks would fool workers into thinking he was ordering for two. Giannandrea topped the scale at 485 pounds. Then came that wake-up call.

John Giannandrea lost more than 200 pounds, is full of muscle and the owner of a personal training business in north Fresno.

Please see next page

Central Valley Health | SUMMER 2017 27


continued ...

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John Giannandrea began exercising, starting with just walking, and practiced discipline and determination. He turned to YouTube and other sources to learn more about diet, training and exercise.

“I learned how to eat — I learned what foods are good for me, I learned what foods were bad for me,” he says. Giannandrea began exercising, starting with simply walking, and practiced discipline and determination. He turned to YouTube and other sources to learn more about diet, training and exercise. “I started putting the pieces together,” he says. In 15 months, Giannandrea lost 225 pounds and began to pack on muscle. There were no short cuts — just hard work. “I didn’t snort any magical unicorn powder,” he says. “And I’m still waiting to meet the fat person who binge eats chicken breasts and strawberries.” Today, Giannandrea follows a healthy, active lifestyle that emphasizes fruit, vegetables and protein (plenty of eggs and chicken, for example). He concentrates on shopping the borders of the grocery store to keep a focus on fresh food. As this certified trainer says, “a fat person’s job is never done.” With his clients and internet audience, he talks about issues familiar to a former heavyweight — loose skin, over-eating and sabotage. He’s extremely blunt, and his YouTube videos (under

his Biggie O’Donnell persona) are peppered with frank and coarse language. Much of his advice is practical. Set a goal you can see — walk one block. Don’t try to be someone else, just strive to be a better version of yourself. “Fat is tiring, but you don’t have to be fat forever,” he says. “And you can’t out-work a bad diet.” Giannandrea worked at a small gym before opening True Grit in 2016. The business includes a line of supplements and apparel such as “Army of Ogre/ Trust the Process” shirts. His fiancée, Jena Schwoob, also works at True Grit as a trainer. The two met when Giannandrea was at his heaviest; she says she heard his voice before she saw him. “That’s what attracted me to him,” Schwoob says. They’ve been together about 10 years. Giannandrea knows his clients see him as someone who has been in their shoes and as a role model. In his no-nonsense way, he talks to each one about their journey and the pitfalls, emotions and challenges they face. He says he’s inspired by their success. He’s also planning to take on motivational speaking as a way to reach and influence more people. Says Giannandrea: “I’m just a former fat guy who’s lost a lot of weight.” CV


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Eat

To market

The Central Valley is blessed to be overflowing with fresh produce and handmade products — thanks to the countless farmers, ranchers and artisans who are dedicated to their work. If you’re looking to shop at your local farmers market, we have you covered:

SEASONALLY

The River Park Farmer’s Market: 5-9 p.m., each Tuesday of the month, April through October, in River Park Shopping Center, Blackstone and Nees avenues Friday Night Farmers Market: 5:30-9 p.m., each Friday of the month, May through September, in Old Town Clovis, Pollasky Avenue and Fifth Street

OPERATING THROUGHOUT THE YEAR

The Kaiser Permanente Fresno Farmers Market: 8 a.m.-1:30 p.m., March through November, and 9 a.m.-1:30 p.m., December through February, each Wednesday of the month at Fresno Medical Center, 7300 N. Fresno St., Fresno Market on Kern: 9 a.m.-2 p.m., each Wednesday of the month, May through September, on Kern and M streets in downtown Fresno Vineyard Farmer’s Market: 3-6 p.m., each Wednesday of the month on northwest corner of Blackstone and Shaw avenues in northeast Fresno Vineyard Farmer’s Market: 7 a.m.-noon, each Saturday of the month on northwest corner of Blackstone and Shaw avenues in northeast Fresno Saturday Morning Farmers Market: 8-11:30 a.m., each Saturday of the month in Old Town Clovis, Pollasky Avenue and Fifth Street Manchester Center Farmers Market: 8 a.m.-4 p.m. each Friday in the Manchester Center parking lot, 1901 E. Shields Ave. BY: Janessa Tyler


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Call (559) 853-4629 to schedule your appointment! 1351 East Spruce Avenue, #130 Fresno, CA 93720 (559) 853-4629 www.ccent.com/phs

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When seeking treatment for your vein problems, you need the comfort of knowing that your doctor is fully trained and has been Board Certified in Phlebology (the diagnosis and management of varicose veins and other vein problems). Elmore Medical was the first, and is still the only medical practice in the Central Valley specializing exclusively in Vein Disease. When it comes to your health, you deserve the most current and skilled care available.

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the challenges they face and water shortages the drought has brought, we all should thank a Farmer!


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