Edward Moncrief

Protecting Our Protectors

 

Edward Moncrief 6:59 a.m. PDT July 23, 2016

Snippet_Firefighters_HeartScan_July_2016

According to the US Department of Labor, firefighters have 200 to 300 percent greater risk of dying of a heart attack than any other professional group; moreover, they most often die on the way to a fire, during a fire, or leaving a fire.

Recently, a group of 70 City of Monterey Firefighters visited the Ryan Ranch Center for Advanced Diagnostic Imaging, a part of Salinas Valley Memorial Healthcare System. They had come for a heart scan, a relatively simple procedure — processed by a very complex coronary CT scanner — that could have life-saving consequences.

Doctors Christopher Oh and H. Robert Superko, both Fellows of the American College of Cardiology, know the value of these advanced imaging tools.

“This machine can help in both prevention and diagnosis,” Dr. Oh, a cardiologist with Salinas Valley Medical Clinic’s Central Coast Cardiology explained. “On the prevention side, the CT scan gives us a calcium score which is a measure of each patient’s level of risk of heart disease. This means we can see potential problems before a person ever has any symptoms of heart disease or heart failure. That is a powerful advantage.”

Dr. Superko is a fan of Salinas Valley Memorial’s CT scanner and is using the equipment to help in his latest study of heart risk among firefighters. Dr. Superko, a metabolic cardiologist and former medical director of the Lipid Research Clinic at Stanford University among other distinguished positions, founded the Cholesterol, Genetics and Heart Disease Institute (CGHDI) in 2000 to educate both the lay and medical communities on heart disease and its prevention.

After a career in cardiovascular genetics research, the doctor and his wife Brenda Garrett, a cardiovascular nurse and research associate, moved to Monterey County. During their “retirement,” they maintain a small practice at Prima Heart in Monterey; but most of the time they work as volunteers for the CGHDI, more commonly known as the Family Heart Foundation.

Dr. Superko described how his professional career and his post-retirement activities as a volunteer have combined to bring a firefighter heart disease prevention program to the Monterey Fire Department.

As the doctor spoke, we watched one of the Monterey firefighters, Raul Pantoja, a towering figure in uniform, position himself on the scanner’s cushioned bed. The technician scurried about, preparing for a coronary CT scan to determine a coronary calcium score. The whole process took under five minutes.

This local project is an outgrowth of an effort that started in another part of the country.

“This effort began in Gwinnett, Georgia,” Dr. Superko said. “Steve Rolader, the fire chief there contacted us. He was looking for help. He was aware that firefighters were at greater risk of dying from a heart attack. He wanted to learn what might be done to understand the risks and reduce the incidents and effects of heart disease within his department. Brenda and I were eager to respond. We had a special place in our hearts for firefighters. We remembered 9/11: how everyone was running from the towers except the firefighters. They were running into them.”

“We applied for and received from FEMA a federal grant to conduct the research,” he said. “We put together an outstanding team to study 296 active-duty firefighters from the Gwinnett County Fire Department; all of them 40 years and older. We used non-invasive imaging to discover if the population of firefighters being tested would show higher incidents of traditional risk factors for heart disease compared to the general population —such factors as high HDL cholesterol, high blood pressure, genetic propensity, diet, lifestyle, etc.”

Firefighter Pantoja stepped out of the room.

“Nothing to it,” he said, while Dr. Superko continued his narrative.

“The initial results indicated that the firefighters we tested were not significantly different from the general population concerning these traditional risk factors, Dr. Superko said. “So why, according to numerous studies and the Center for Disease Control, are firefighters dying of heart disease at higher rates?”

“With the more sophisticated imaging techniques you see here today, we conducted arterial wall imaging. We computed coronary artery calcium scores according to the age and sex of the patient. We measured plaque thickness, using an ultrasound machine equipped with specialized software, scanning the interior walls of the three arteries of the heart. We found a slightly higher incidence of blood-clotting issues among firefighters, but the difference, in and of itself, was not that significant,” he said.

“These tests and others led us to the conclusion that one-third of the firefighters who have both clotting issues and an underlying propensity for heart disease (from traditional factors) are at higher risk for suffering from a heart attack,” he continued. “Eventually, we concluded that the impact of clotting issues in combination with the other traditional risk factors is magnified because of firefighters’ exposure to physical and psychological stress, work-related dehydration (excessive sweating), smoke inhalation, and in some individuals, a growing problem with weight control.”

A heart disease prevention program aimed at firefighters, he concluded, could help reduce the high incidence of heart attacks among this population. “This is why we’re here today with the Monterey fire chief and about 70 of his men and women on the line,” he said. “We’ve had great cooperation putting this together.”

Normally, the combination of the blood test and the computerized tomography (scan) would cost each patient about $1,500. In this case, the services were provided free to the firefighters. The costs are covered through a partnership that includes the Family Heart Foundation, Salinas Valley Memorial Healthcare System, Boston Heart Diagnostics, and the City of Monterey Firefighters’ Union.

All of the partners have agreed to pay for a total of 300 blood tests and related costs to support this program here in Monterey County, so the group will be working with other local fire departments to conduct additional scans.

Dr. Superko had one last point.

“You know, any heart attack is a tragedy, but when a firefighter goes down on the job, it can have additional devastating consequences by increasing the risk of injury or even death for others,” he said. “When you think about incidents like 9/11, it’s not hard to imagine a scenario that could compromise our national security. Obviously, we have to do a better job making our firefighters aware that they are at higher risk and taking the right steps to mitigate those risks.”

Gaudenz Panholzer, fire chief of the Monterey Fire Department and Spencer Reade, the department’s wellness program officer joined the discussion.

“Preventive medicine makes so much sense,” Panholzer said. “We know, if we spend a little money now, we’ll save thousands on the back end. It’s also good for each firefighter to learn whether or not he or she is at risk; and, if so, make the necessary changes.”

Another great benefit, Boston Health Diagnostics is offering to each firefighter two phone sessions with a dietician.

During every fire, these guys are breathing noxious, irritating smoke and numerous carcinogens are contained in the smoke. Firefighters are sweating abnormally from carrying heaving equipment and wearing protective gear.

“Their health is going to get compromised if they’re not doing all they can to stay in shape and eat right,” Dr. Oh from Central Coast Cardiology said, “We’re really pleased to take part in this program and the focus it brings to the heart health of our firefighters. This is the kind of test that can benefit just about anyone, though. Having your calcium score is comfortable and convenient, and it gives you great insight into a common area of concern – your heart.”

Firefighter Reade also joined the conversation.

“This scan program gives each of us some peace of mind, just knowing where we are with regard to the risks of heart disease; but it’s also an opportunity to stay healthy in order to serve the community better,” he said.

 


The Owl and the Pussycat

TheOwl&ThePussycat

In 1871, Edward Lear published his children's poem, "The Owl and the Pussycat". For those who are not familiar with this whimsical journey, I have taken the liberty to post it below.

The Owl and the Pussycat

The Owl and the Pussycat went to sea In a beautiful pea-green boat, /They took some honey, and plenty of money, Wrapped up in a five pound note./  The Owl looked up to the stars above, /And sang to a small guitar,/ "O lovely Pussy! O Pussy, my love, What a beautiful Pussy you are,/ you are,/ you are,/ What a beautiful Pussy you are."

Pussy said to the Owl "You elegant fowl, How charmingly sweet you sing./ O let us be married, too long we have tarried;/ But what shall we do for a ring?"/ They sailed away, for a year and a day, To the land where the Bong-tree grows,/ And there in a wood a Piggy-wig stood With a ring at the end of his nose,/ his nose,/ his nose, /With a ring at the end of his nose.

"Dear Pig, are you willing to sell for one shilling your ring?"/ Said the Piggy, "I will"/ So they took it away, and were married next day/ By the Turkey who lives on the hill./ They dined on mince, and slices of quince, /Which they ate with a runcible spoon./ And hand in hand, on the edge of the sand./ They danced by the light of the moon,/ the moon,/ the moon,/ They danced by the light of the moon.

I have also posted my recently penned update of Lear's work. I hope you find this modern whimsical journey informative and thought provoking.

TheOwl&ThePussycat_2

 

The Trump and the Putin 

The Trump and the Putin went to sea all in a right-wing boat/ They took some honey and plenty of money/ Wrapped up in a rubled note./ The Trump looked up to the stars above/And sang to a small bandura,/ “O lovely Putin, O Putin, my love,/ I’m in awe of your bravura;/In awe;/ In awe, In awe of your bravura!

Putin said of the Trump, “What an elegant chump!/How charmingly sweet he sings!/ O lets be married! Too long we have tarried;/ But what shall we do for a ring?/ They sailed away for a year and a day/ To the land where demagogues grow;/ And there in the wood, a Manafort stood/ With a ring at the end of his nose,/ His nose,/ His nose,/ With a ring at the end of his nose.

“Dear Paul Manafort, are you willing to part with Your ring?”/ Said the lobbyist, “I will.”/ So they took it away, and were married next day/ By the Hacker who lives on the hill./ They dined on bytes and fanciful flights/ Which they downed with a mumpsimus spoon/ And hand in hand on the edge of the sand/ They danced by the light of the moon’/ The moon,/ The moon,/ They danced by the light of the moon.

 

 

 


Publishing--Even Self-Publishing--Is A Slow And Meticulous Process....

Visions and Revisions

Whether you're looking for a publisher or are self-publishing, think in terms of years not months to see your book on the shelves.

In mid-August, I submitted my final revisions of Raising the Blackbirds to my publisher, Hillcrest Media Group. By mid-September, Hillcrest’s staff will send me the final edited manuscript. As soon as I approve this final version, a new two-month window will open during which time we'll "go to press". Alleluia!

These first copies, however, will be available for marketing purposes only. Once the book is in physical form, the publisher and I will spend another two months distributing it. We'll put it out to a variety of channels such as reviewers, media outlets, websites for newly published literature, etc. We'll work at generating some buzz through press releases, interviews, and articles.

Once we complete the initial marketing phase, Hillcrest will publish the book and make it available in stores and on-line.  In all, we are told, we have another four-plus months (after September 15, 2016) before the book will be available for purchase. Conservatively, we're looking at January or February.

Hillcrest staff have been great to work with, but this is my first foray into book publishing. Frankly, I had no idea it would take as long as it has. Despite it all, I am excited about the progress we have made and about sharing Sixto’s story with all of you!

Stay in touch.


Cancer: A spouse tells of team battle

Edward Moncrief, The Salinas Californian 3:20 p.m. PDT October 16, 2015

You can’t speak to Tommy Moffitt for more than two minutes and not note the depth of love he had for his wife. The passion and clarity in his voice, and the anger that lies just beneath the surface, are not for his own situation but for what happened to this beautiful and vital woman. She suffered terribly and fought with all that she had — only to die at the age of 44.

“I realize this may be hard on you,” I say. “Tell me if I get too close.”

“Nothing’s too close,” he responds. “But you’re right. It sucks!”

We sit at a table in Portobello’s in south Salinas. Tommy wears a black biker vest with a small pink ribbon stitched on one shoulder and “Kelly,” his wife’s name, stitched on the other side; underneath, the date 1/2/2015.

“Is that your Harley parked in front?” I ask.

“No. I brought hers. It seemed like the right thing to do. We had some good times, riding together.”

At first glance, Tommy’s biker image with his stocky build, ruddy complexion, and scruffy beard seem incongruous with the affable smile and kind eyes. His expansive personality brings it all together. He reaches up and touches the ribbon.

“This is part of Memorial Hospital’s annual fundraising campaign for its Cancer Resource Center. It’s coming up this month on the 21st. It’s called ‘Toast for the Tatas.’ ” He smiles briefly, appreciating the boldness of the event’s title. “Kelly was the keynote speaker last year. She had just gone through surgery for brain tumors. We thought we were done with all that. She seemed like she had beat it. Six months later, she was dead.” His lips and eyes grow tight. The eyes fill with tears.

We spend the next 20 minutes getting some basic facts out of the way. They met in Reno; both working in the media business. Each was in an unhappy marriage. As their relationship developed, they both knew that it was time to make dramatic changes in their lives. They found they wanted, more than anything else, to be together.

“She had, let’s say, a difficult husband. I just married too young.”

In 2010, Tommy and Kelly were married.

Shortly after, they moved to Salinas. Eventually, Kelly took a job with The Salinas Californian as assistant sales manager. Tommy is a sales representative with Comcast.

“In March 2013, I was awarded a trip to the Bahamas as a top sales guy for the company. Just before we left, Kelly had a mammogram. When we returned, she was told that she suffered from Triple-Negative Breast Cancer. TNBC is a rarity. Both breasts were infected.

“When we got the diagnosis, I started doing research. I was driven to know everything I could about her condition: the treatments, the side effects, ways to mitigate the effects, what to do that might eliminate the symptoms.

“You have to understand, Kelly was a marathon runner, a competitive swimmer. She was active, smart, witty, positive, the picture of health … well, except for the diagnosis.”

Tommy takes a deep breath.

“I just wanted to support her through the battle. We made a deal. I would take care of the house; shopping, cooking, cleaning, paying the bills. She had only two jobs: show up for treatments and try to get well. I bought a book, The Cancer-Fighting Kitchen, to make sure that everything we ate was healthy. I drew up a matrix that tracked each symptom and found studies on line that pointed to mitigating measures. We developed an eating and exercise regimen. We did everything right to give Kelly the best chance possible to beat the odds. And to some degree it worked! She avoided a lot of the typical side effects of the chemo and medications. Halfway through chemo, she was working out every day on the treadmill.”

Tommy reaches into his vest pocket and pulls out his cell phone. He brushes it with two fingers and begins scrolling.

“Look,” he says pointing. “There’s Kelly jogging on the machine.” I peer at a side shot of Kelly’s intent efforts, a nylon cap pulled over her bald head.

“My bosses at Comcast were great! When it all started, they said, ‘Don’t worry about work. We’ll cover for you. We’ll handle it.’ They kept me on the payroll. I spent an hour or two a day at work when I could.

“Then in May, she had to have a bi-lateral mastectomy. They had discovered that fourteen lymph nodes were affected, seven of which tested positive. She began chemo once a week for 10 weeks; then two more months on a bi-weekly schedule; and after that, 31 days of radiation. By the time that was over, we felt everything was going to be fine. We tried to put it behind us.”

Tommy begins fingering a chain around his neck. He shows me the two rings dangling.

“These are our wedding rings,” he says. His voice is caught in his throat. He pushes on, “We were so in love. We cherished every moment. We were always laughing, telling jokes, going on rides, hiking. Kelly was alive! She was fun to be with ... God, she was a beautiful person.

“In March 2014, they started reconstructive surgery. They gave her silicon breasts. At that point again, we thought we were done with cancer. She was gonna make it.

“Two weeks later …” Tommy stops, places a fist over his mouth, and shuts his eyes. “She began having these intense migraine headaches. Her equilibrium was so bad, half the time she could hardly walk. She had another MRI. When we got home, walked in the door, the phone was already ringing. They said, ‘Get her to the emergency room, now!’ This time, she had a golf-ball size brain tumor that had metastasized. We were told that the cancer had spread from the breasts to the lymph nodes and from there to the brain. She went into surgery immediately, followed by 20 days of radiation focused on the area of the tumor.

“She went on disability; and for six months, we thought, again, we were going to make it. Then, in September, the migraines returned. We had another MRI done. They found three more tumors. She went to Mountain View to a specialist for what’s called cyber-knife treatments. That’s a non-invasive technique that delivers high doses of radiation, aimed at the tumor with extreme accuracy. There, she had another specialized MRI that was intended to map out the surgical paths to excise the tumors. But they found eight more, one on Kelly’s brain stem. They used the technique on that one first to try to keep her from becoming fully paralyzed.”

Tommy’s voice wavers again. He rests his chin on folded hands until he’s ready to continue.

“After the surgery, I met with the doctor privately in a side room. I told him that I had researched this cyber-knife technique. I said, ‘None of these treatments is going to prolong her life. Am I right?’ The doctor said, ‘I have a hard time giving up on a 44-year-old woman.’ ”

“When we got home, we called VNA and Hospice. We knew. The staff was incredible. They showed up faithfully every Tuesday and Thursday —Amy and Ellie. They provided great care and support. They became dear friends. Two weeks ago, I went there to see them. As soon as I walked in, Amy started crying and gave me a hug.

“During that final three-and-a-half months, people came from everywhere to help. Our Harley-Davidson group cooked for us on Mondays, Tuesdays, and Thursdays. Dave Ferrasci, the club director — a true friend — he organized that. The Harley dealer in town put on a fundraiser for Kelly. Over a hundred bikers showed up. Her plastic surgeon and the nurse practitioners from the Cancer Resource Center also came with food and drinks. The club raised $4,000 to help with our expenses.

“Dr. Payman Haghighat, Kelly’s oncologist, came to the house three times just to be with her and give her support. Kelly’s mom, Gloria, and sister, Tracy, moved in to take care of her. Friends wanted to be with her; but at a certain point, Kelly didn’t want them to come anymore. She couldn’t eat. Her body was emaciated. She didn’t want them to see her that way. She wanted them to remember her the way she was.”

We sit for a moment in silence.

Finally, Tommy says, “You know, 50 percent of the men … yeah, 50 percent, leave when a woman is diagnosed with breast cancer. I’m no saint. I had been through some things in my life. Both Kelly and I had been in previous relationships. Neither of us was happy. We fell in love and never looked back. And Kelly, after a bad marriage, she was just finding herself again. I’ve always been proud of my 29-year career in media; and of the fact that I’ve been sober for 20 years. Then all this happened; and when that first diagnosis came in, I decided that I would do everything I could to support her through it. From my research and reading on the Net, I pretty much knew early on what the end would be. I never told Kelly. I didn’t want her to be afraid.”

“What do you do with the anger?” I ask. There’s a pause.

“I’m handling it. I’ve taken up kayaking. I go on bike rides the way we used to. I rode up to Oregon to visit Kelly’s mom and sister. We’ve become much closer as a family. I rode Kelly’s bike to Asilomar Beach, one of her favorite spots. The bike club came with me, eight of us. We just sat and talked about her. We remembered some of her witty sayings. ‘Let’s bounce, bitches!’ That’s the way she would say, it’s time to go.

“I think, if only it hadn’t metastasized, it might have been manageable. There might have been a chance. If only we had found it earlier. That’s the key, early detection. Every woman should have a mammogram every year. You wait two years; it may be the difference between life and death.”

“What about the future?” I ask.

“I don’t know. I think, at some point, I might be helpful to others who are going through it. Not for a while. It’s still too tender…. You know, we were best friends. We had seven wonderful years together. I did all I could for her. I was a great husband; but still, in the end, it sucks.”


County job program supports local businesses, trainees

QuiedanOwerners_TomCeccarelli&JuanBatista_Snipped_May_2016

Everything grows better with structure — even people.

Just ask Sylvia Gonzalez. Sylvia’s new employer is Quiedan Company, an Ag structures design, manufacturing, and distribution company. Quiedan’s two large warehouses in Prunedale and the surrounding yard abound with boxes of fittings, stacks of aluminum tubing, stakes, roles of plastic sheeting, and samples of portable greenhouses, nurturing demonstration crops. The enterprise sells hoop houses and high tunnels for fruits and vegetables, trellis systems for grapes, and a variety of other agricultural related products.

 

Tom Ceccinelli and Juan Batista

Sylvia sat in its second-floor conference room.

“I don’t mind sharing my story,” she began, her calm eyes and easy smile supporting the statement. “I was ashamed at first. Now, I’m comfortable with how I’ve handled things, and I do continue with the counseling provided under AB109.

According to the State Department of Corrections’ Website, AB109 is “the cornerstone of California’s solution to reduce overcrowding, costs, and recidivism” in the State’s prison system.

Under the law, Sylvia is eligible for counseling not only for the alcoholism she struggled with for years but for job training and placement services from a federally funded and state – and county – administered program through America’s Job Center of Monterey County.

America’s Job Center counselors worked with Sylvia and eventually placed her with Quiedan Company. For the first three to six months of her stint, half of her salary is paid by the program. At some point during the enrollment period, she hopes to be hired full time as the company’s Human Resource Officer.

“In 1992, when I was 19 and just out of high school,” Sylvia continued, “I got a job as a bookkeeper for a small company in Castroville. I’ve lived in Castroville pretty much all of my life. I worked at that place for a year. Then I went to Wells Fargo Bank as a teller — again in Castroville. I was there for 13 years although the place changed hands a couple of times. Finally, Rabobank took over. Eventually, I became an assistant vice president and customer service manager. I was the bank’s go-to person. Now, I’m just happy to have this opportunity with Quiedan.

“I also got married in ’92. Within a month, my husband started being abusive physically and psychologically. I guess I thought the tension and stress was normal because of the way I was raised. My father, who had a drinking problem, left us when I was three. My mom raised my two brothers and me on her own. It seemed like we were always stressed about something. I’ve had problems with anxiety and depression off-and-on ever since I was a teenager.

“In my mid-20s, I was diagnosed with Post Traumatic Stress Disorder related to the stress or abuse I had experienced through most of my life. I know now, my mom did the best she could under the circumstances. I got a little bit of counseling after the diagnosis, but I didn’t stick with it. I have to say, it’s really not in our culture to ask for help. I was a very private person — still am — except now, if someone wants to know about my background, especially someone who needs help, I’ll share.

“In 2002, after putting up with my husband’s abuse for 10 years, I pressed charges. As soon as I did that, he split.

“Three years later, I married again. Not long after, I was at the beach. I slipped and broke my ankle. Once again, I started feeling anxious and depressed. For the first time, I began drinking pretty heavily. The second marriage wasn’t abusive, but because of my drinking, it didn’t last.

“My first DUI came in June of 2012. I was in an accident. The other person was hurt. Fortunately, the injury wasn’t serious. They put me in jail for 18 months, until December 2013. Then I was sober for more than a year, but on January 6, 2015 — the day my probation ended — I stopped the counseling and started drinking again. That very day, I got my second DUI. The officer said he hadn’t stopped me because I was driving erratically but because I had two low tires. What are the odds? I started thinking about that. I’m not a religious person, but it just seemed like there must have been a greater power at work.

“So when they put me back in jail, I realized that I had dug myself a hole so deep ... I heard stories about others who had been able to stay sober; but for a long time, I didn’t believe that was possible for me. Finally, with those low tires and the second arrest, I was ready to find help and I did.”

Juan Batista is one of Quiedan’s two owners.

“We weren’t really looking for a Human Resource Manager at that moment although we knew we needed one. Laura Kershner showed up one day. She’s with America’s Job Center and was working with Sylvia, trying to find the right placement for her. She explained the program to us. Quiedan has been here since 1975, but my partner, Tom Ceccarelli, and I bought it just 18 months ago. We’ve set three goals for the company: grow regionally; expand product line; and streamline our processes. We have 27 employees now, so we had been feeling the pressure and knew we would soon need an HR person. Sylvia’s been here since February and she’s fit right in. She’s very professional, agenda driven, and she understands the importance of time.”

Laura Kershner is Business Services Specialist at the America’s Jobs Center in Salinas. She combs the county searching out businesses that need new capacities to maintain or grow their enterprise.

“We’ve got about 900 businesses in the county that have taken in our trainees. Our efforts are focused on the area’s priority industries: Agriculture, Tourism, Healthcare, Retail, and Education. We meet with management to assess the needs of each of our business partners and match their needs with the trainees’ experience and skill set. The match may not always be exact, but what’s important is willingness on the side of management to teach and on the trainee’s part to learn on the job.

“Some of our trainees are referred from other businesses that are downsizing, others are looking to go back to work after raising a family; some, indeed, are referred by the court system under programs like AB109. In my experience, all of the people who walk into the center are dedicated to finding new opportunities for applying their experience to a new setting or for learning new skills in a changing marketplace.”

SylviaGonzalez_Snipped_May_2016Back in Quiedan’s conference room, Sylvia Gonzalez reflects on her journey to her current temporary position as Quiedan’s Human Resource Officer.

“When I got out of prison that first time, I was referred to America’s Jobs Center by the probation department. I actually worked for the center itself for 3 months. I was with Business Services, posting jobs for the people who came in looking for opportunities. My position was temporary. Then they placed me in a permanent job. But that didn’t last because I relapsed and found myself was back in jail.

“They have some effective rehab programs in prison, but you have to push for them because there are too many inmates. It’s especially hard to get into a program if you are a short-timer. That first time, I wasn’t ready to push for help. I didn’t think I needed it.

“The second time, I made a point of requesting help daily until I got into a counseling program. It was called “cognitive behavioral treatment.” It was very good for me. It helped me to understand

Sylvia Gonzalez

why I was the way I was and to do something about it.

“To change your life, first, you have to find the help you need; then, you have to do the footwork that’s required. Once I got out the second time, I was fortunate to have Laura supporting me along with the other counselors at America’s Job Center.

Now, I’m doing everything I can to make sure this temporary job with Quiedan becomes permanent.”

Edward Moncrief is a freelance reporter for The Salinas Californian. Contact him at efmoncrief@gmail.com. Visit his blog at edwardmoncrief.com.

 


Nonplussed, thanks to two Salinas nonprofits

EDWARD MONCRIEF 4:02 p.m. PDT April 12, 2016

YarelliBarrera_June_2016Yarelli Barrera is bravely fighting bone cancer and a heart condition. (Photo: Edward Moncrief/For The Salinas Californian)

Yarelli Barrera, 13, had occupied her sister and brother-in-law’s bedroom for the past two months and before that, the home of an aunt. The troubles began when the MRI, the X-rays, and the CAT scans revealed that Yarelli had a tumor the size of a golf ball in her knee. That was about the same time that her mother, father, two sisters and she lost their home.

Her mother, Hilda, explained in Spanish, “When we learned about the cancer, we asked the landlord if he would fix up the house. It was old and needed a lot of repairs: a sink that was plugged-up, cleaning and painting. He said he would take care of it if we would move out so he could do the work. We put our things in storage and eventually had to move in here with my daughter. We thought it would be for a month or so; but when we went back, the man had already rented our home to someone else. I don’t think that he did anything to repair that place.”

The plight of Yarelli’s family came to the attention of Coastal Kids Home Care. The organization was launched in 2005 by its co-founder, executive director, and registered nurse, Margy Mayfield. It provides pediatric in-home care to families who have a child suffering from chronic illness, injury, or a life-threatening condition. Coastal Kids Home Care is the only organization in Monterey County that provides such vital care to children. The local hospice focuses only on adults.

Yarelli lay on the bed, her head covered with a knit cap. She was dressed in sweatpants and a pullover. She clung to a light blanket. Crutches were set against the wall. With her mother and sister standing alongside, a reporter introduced himself and asked Yarelli if she would like to s share her story. She looked to her mother and her sister, Karen, for help.

“She’s kind of shy,” Karen explained and then continued for her. “At first, in December of 2014, we noticed bumps on her lower leg and then swelling. After a while, it seemed to go away. But then, it came back. This went on for several months. In May, we took her to Natividad. They transferred her to Stanford Children’s Hospital in Palo Alto for tests.”

Karen had broken the ice, but what did this aggrieved young girl have to say about it all.

“Did they tell you what was going on?” she was asked. She thought back to that hospital room so many months ago.

“After the tests,” she said, “they didn’t tell me anything; just talked to my mom. About a week later, they said I had cancer.”

She shrugged and smiled briefly as if that simple sentence explained it all.

When asked “What happened next?” Yarelli waited for her mom or sister to answer, but they urged her to continue.

“I started chemo right away. I got two medicines through an I-V; first the red bag for 15 minutes and then the yellow bag for 4 hours. I had to stay at Stanford for two weeks. Then I had to do it again. Two rounds in about a month.”

Yarelli spoke of her plight with a calm resignation; but the more she talked, the more strength and fight beneath the surface grew evident.

“I was supposed to keep going with the chemo,” she said, “but, in August, the doctors decided I should have surgery right away. They went in to remove the tumor in the bone, but they only got about 75% of it.”

“You have crutches. Were you able to start back to school in September?” she was asked.

“At first, I had an in-home teacher through Washington Middle School; but after the surgery, I had to make up the chemo sessions I missed. I went to Stanford once a week. Sometimes I’d have a bad reaction so they’d have to stop them for a while and then start up again.”

“She couldn’t keep up with the home schooling,” Karen added, “because of the time she spent at Stanford and because of the chemo. She had some pretty rough days.” Karen stood at the foot of the bed. Hilda knelt on the floor beside her daughter. Karen continued, “Then on January 1st, she had a fever of 104°F. She went into shock. Her whole system started shutting down. They said, if the ambulance had taken too long, she would have gone into a coma. It turned out that her body was under attack from bacteria. Her knee had become infected. They didn’t know if it was related to the medicines or the blood transfusion.”

As it turned out, Yarelli was diagnosed with a mycoplasma infection. In late January, she had to undergo a second surgery to try to clear the bacteria. After surgery, the doctors decided that the remainder of the tumor would have to be attacked with more chemo sessions.

Now, six weeks later, these sessions are just one more ordeal that Yarelli has successfully overcome.

“It’s been a long battle,” Karen said, looking proudly at her sister. “She’s been sad, frustrated, and depressed at times; but now, she’s happy to be done with all that chemo although she’s still has to take 12 pills a day to fight the infection.”

What’s next?

“I’m hoping to work with a home teacher again to start and complete my 7th grade before September.”

“Good for you. How about your friends,” the reporter asked. “Do they come to visit?”

Asked if her friends come to visit, he answered, “They used to. But then, I didn’t want them to come anymore.”

“You have to let your friends come see you,” she was told teasingly. “They want to know how you’re doing, don’t they?”

“I guess I’m embarrassed,” she said with a shy smile.

That smile was the perfect cue.

“Well, you know what I say to that?” her visitor said.

“What?”

“Get over it!”

Yarelli laughed right out loud.

The reporter finished the interview and thought he had gotten the essentials of Yarelli’s story. He stepped out of the bedroom, into the living room and started talking with Hilda and Karen.

The story was just beginning.

“Things have been a little tough for us,” Karen said. “I’m not working now and this place is small with all of us here. It’s only a one bedroom.”

“So, it’s you and your mom and Yarelli living here; and only one bedroom?” she is asked.

“Yeah. But then there’s also my husband and my 21/2-year-old, and my dad, and two other sisters.”

“You have eight people living in this one-bedroom apartment? How do you manage?”

“My mom shares the bed with Yarelli. We all find our space for the night. But, yeah, it’s kind of crazy. I heard there’s a three-bedroom opening up a few doors over, but it’s $1,600 a month. I don’t think we can go that high until the work starts up again.”

“I pick strawberries, but I won’t be going back to work until I know Yarelli’s OK,” Hilda said. “And we don’t know how long it will take for her to recover; and then, she has the other problem.”

Hilda looked at Karen, and Karen explained.

“When Yarelli was at Stanford, they discovered that she has a heart condition. One of the arteries isn’t working right. It’s twisted somehow. So, when she recovers from the cancer, they’re going to have to go in and fix the artery.”

Hilda’s motherly eyes welled up and tears came.

CHISPA to the rescue

Later, Karen explained that her father and husband were both working in the berry fields. Hilda and Yarelli’s dad, Israel, had applied to the Housing Authority and to CHISPA for an apartment, but were on the waiting lists.

That night, Alfred Diaz-Infante, CHISPA’s executive director, was told about Yarelli and the Berrera family’s living conditions. When he heard, Alfred was concerned and responsive.

“That’s a situation that we may be able to help with. It qualifies them for an emergency priority designation,” he said. “I don’t know if we have any units available, but I’ll find out.”

Two days later, Alfred had news.

“I spoke to our management staff. We have a four-bedroom coming open in the next couple of weeks. It’s $1,100 a month. Do you think they can handle that?”

Hilda confirmed that the couple had been paying as much for their former home — the one the landlord had rented to someone else.

The following day, Hilda and Israel Barrera stood at the counter at CHISPA’s office at South Main and Alisal in Salinas. They updated their application with fresh hope that perhaps some relief from their burdens was on the horizon.

Coastal Kids Home Care

Kim Hell, a registered nurse with Coastal Kids Home Care, has cared for Yarelli since first starting with the organization last September. During her 10-year career, she has provided direct care in children’s hospitals in St. Louis, Tucson, and Los Angeles. She also has worked in pediatric AIDS research and HIV community outreach and education.

“I love my work with children because I have the opportunity to engage with the whole family,” she said. “I help them learn how to care for their child at critical moments. It’s an honor to be invited into the home and minister to a child who is suffering from a life-threatening disease; to help relieve pain.”

She has encountered all kinds of situations, she said.

“We see a wide variety: kids with cancer or diabetes, pre-mature babies; circumstances, like Yarelli’s with great hope for the future, and others — unfortunately — beyond treatment.

“Generally, we’re there to assess the child’s health, draw blood, provide specific medical treatments; but nursing is so much more than medical procedures. Sometimes we’re teachers, sometimes counselors, helping the family to cope.

“The parents know their child, but they may not know how to care for them in the unusual circumstances they find themselves. We teach them what signs and symptoms to look for, so they know when to call the doctor. There observations and actions can often prevent the child from getting worse and having to be hospitalized. A large part of our work is to empower the parent and the child.

“Stanford is a long way away for a family struggling with a major illness. Because we’re there in the home once or twice a week, the time in the hospital and the number of trips back and forth to Palo Alto can be greatly reduced.

“Yarelli, for example, has had a nasal-gastric tube. It was uncomfortable and at first she kind of fought it. Then we were able to teach her how to insert it herself. She struggled to overcome her fear and the discomfort; but once she learned how, she found that she was in control. She could use it only when she needed it instead of having it there all the time with her having no control.

“Ultimately, we’re there to support the parents so that the child is as comfortable as possible and the appropriate treatments are maintained.”

In 2015, Coastal Kids Home Care provided in-home care to 661 children, 80% of whom were under the age of 10. In that year, its nurses and social workers made 4,798 home visits.

Kim shared her own 2-day-per-week schedule. She serves approximately 20 patients in any given month with one or two visits each week.

It was clear how important these two non-profits — Coastal Kids Home Care and CHISPA — are to the future of Yarelli and her family.

In the coming weeks, The Californian will follow-up with the Berrera family’s story as her parents complete the process of finding an adequate home through CHISPA and continue to receive vital support from Coastal Kids Home Care.

In the meantime, one comes away fairly certain that Yarelli will push forward her fight against the disease that has attacked her leg and then confront her coming heart surgery with the same indomitable albeit, at times, shy resolve.

 


Tommy Bothwell discusses his road to recovery

Edward Moncrief 4:49 p.m. PST February 26, 2016

TommuBothwell_June_2016Tommy Bothwell smiles as he celebrates seven months of being drug-free (Photo: Edward Moncrief/For The Salinas Californian)

Tommy Bothwell is a big man at 6 feet, 5 inches. His black dreadlocks tumbled down onto a red T-shirt. They framed the printed message: “Start with nothing. Finish with victory.” Even before we shook hands and introduced ourselves, his eyes were ready to make a new friend.

“I tell everyone who cares to know, I’ve got AIDS,” Bothwell said. “I’ve had it for 26 years. I’m a long-time survivor. I’m not gay and I’ve never used needles to do drugs; but still, I do have it. I’ve come up with two theories about how; maybe from some girl when I was in Korea in the Army or maybe from this other woman here. She and I used to hustle together.”

Bothwell started using drugs when he got out of the Army. He was in rehab in the VA Hospital in Menlo Park back in ’89.

“One day they came in and told me that I was HIV positive. I was ashamed and angry,” he said. “It took me seven years to get past the stigma and admit it openly to my friends.

“After diagnosis, I didn’t know how to relate. Back then, you basically thought that it was over; you’re going to die real soon. There ain’t no cure. You’re overwhelmed. The stigma’s the hardest part, the labels. There are haters out there who need to put someone down to build themselves up,” he said. “You feel outraged. You feel like you’re a leper. People with AIDS can be very vulnerable. I had a person invite me to dinner, and then he fed me on a paper plate.”

Bothwell left the VA rehab program and turned back to drugs, taking them and dealing them.

“I rejoined the ‘Coo-Coo for Coco Club.’ I started living on the street. I was beating myself up pretty bad. I got busted over and over; 3- and 4-year terms.”

He is eager to tell his story; to share what he’s learned through a life filled with disease, pain, and destitution.

“I was in and out of nine different prisons over the course of those 20 years. I’d get out and be [arrested] for possession and get sent back; Avenal, Folsom, New Folsom, Vacaville, Mule Creek, Susanville, Delano, Lancaster, San Quentin. Prison’s a great education though.”

“Let’s back up, Tommy,” I said. “Are you from Salinas?”

“No, no. I came to California after high school. I was recruited by Hartnell to play basketball. I was ranked 17th in the state among junior college players. I averaged 13 points, 13 rebounds, and 7 blocks,” he said and smiled proudly. “My mama was still back in North Carolina. I was slated to go to the 1983 Pan American Games, but then she got cancer. Instead, I went into the Army so I could make sure she had what

“I tell everyone who cares to know, I’ve got AIDS,” Bothwell said. “I’ve had it for 26 years. I’m a long-time survivor. I’m not gay and I’ve never used needles to do drugs; but still, I do have it. I’ve come up with two theories about how; maybe from some girl when I was in Korea in the Army or maybe from this other woman here. She and I used to hustle together.”

Bothwell talked more about his mother; how she fought the cancer for 10 years.

“In the Army, I worked in tech supply in Korea, which meant I did a lot of heavy lifting; so now all these years later, I’m on disability from the VA because I have neuropathy,” he said. “I’m in a lot of pain in my lower back and down to my feet. It’s got nothing to do with my AIDS.”

Some people, when they discover that they have AIDS, they don’t know what to do. They’re often in denial. They don’t want to think about it. They also don’t know where to get help. Maybe, like Bothwell, they have other health problems and are too weak to work and are depressed. They don’t know about insurance coverage. Maybe their friends don’t want to be with them anymore.

“That’s why I want to share my story,” Bothwell said, “I’m hoping that I can give back in some way. I know how important it is to have people you can turn to. As I said, when it happened to me, I turned to drugs. I had to learn the hard way. That was no answer.

“Most addicts are running from pain of one kind or another. When I was using, I jumped in all the way; started living on the street. I got me a tent, a sleeping bag, a lantern. I used to say, I’m lucky, here I am, sleepin’ under a million dollar bridge!” he said. “That lifestyle, on drugs and dealin’, it’s not for everyone. I did it over a 20-year period; but I had my rules; no dealing to kids and no proselytizing. I had respect because I gave it. My other rule was: ‘Don’t make enemies, make allies.’

“I used to sit out there in front of Nob Hill with Corona and Nina, my two dogs and my sign, ‘Homeless Vet. Please Help. God Bless. Thank you.’ I never used the money those good people gave me to buy drugs. Basically, I sold drugs because it meant that I got mine free. I’d buy for a hundred and sell for three hundred; that way I was makin’ money and payin’ for my own besides.

“I’ve been through a lot because of AIDS. It changed my whole life. I’m 54 now. It’s hard to have a relationship with a woman. Most aren’t ready to take the chance. Way back, I had twins but they died. One girl had an abortion; that haunts me,” he said.

“I thought a lot about what I was doing when I was on the street. I’d say to myself, I would just like to be a responsible person with a home and a family. That would be a gift from God ... maybe someday.”

Tommy Bothwell took a bite from the corndog he’d brought with him. He waited for the question he could see coming.

“Are you drug free now?” I asked.

“Yeah, I’ve been clean for the past seven months. I started going to counseling about seven years ago. Daniela was my counselor over at the Monterey County AIDS Project. She loves to help anyone who wants to help himself. When they closed down that organization, I followed her to

AIDS Support Network (ASN). Daniela and me, we’ve become good friends over the years. Now, she’s moved up in the organization, so I have a new counselor, Paris. Everyone at ASN makes you feel like you matter. I was lucky to find that place. But you know, counseling only makes a difference when you’re finally ready to change.”

After Tommy and I parted, I spoke to David Kilburn, executive director of ASN and Elena Ramirez, client services manager. The organization was founded in San Luis Obispo in 1984. It opened its offices in Monterey County in July of 2015. It’s the only local non-profit that serves the health and day-to-day living needs of both AIDS and Hepatitis-C patients.

Kilburn, himself HIV positive, spends two days a week in the Salinas office. He and Ramirez travel from the main office in San Luis Obispo to supervise ASN ’s benefits counselors and community volunteers.

“We’ve been here for only seven months and we’ve already seen some 150 Monterey County clients,” Kilburn said. “Perhaps one of our most important resources is emergency rent vouchers and other housing assistance.”

“Housing is connected to health in so many ways,” Ramirez said. “If you have a safe and stable place to live, you’re more likely to take your daily medication, eat regularly, regain the loss of weight and muscle strength, access other needed social services, receive job training; perhaps, return to work. You’re also more likely to have friends and neighbors who can be supportive.

“We offer a wide variety of services such as HIV and Hep-C testing, linkages to insurance and public benefits programs, and various kinds of financial assistance. We administer the ‘AIDS Drug Assistance Program’ that pays for HIV drugs. We help access local public transportation with vouchers. We’ve even work with the Mexican Consulate to address immigration issues.”

Kilburn picked up the conversation.

“Many people don’t realize that the new medicines can give people living with AIDS new hope to live long and fulfilling lives. New medications can clear the Hepatitis-C virus in as few as 12 weeks. We educate both the public and individual patients. We help new patients understand the importance of taking their medication daily without fail, and we support them if something is standing in the way.”

I met with Tommy Bothwell second time. He wanted to talk about what’s changed in his life.

“I was raised in the projects in North Carolina,” Bothwell said. “But, you know what, I’ve lived in barracks, RVs, trailers, tents, campers, you name it. Now, finally, I got a house. There’s this other organization, Building Bridges. Christopher Gaskins is the founder. He has helped me so much. He had this place available, so he said, ‘No drugs and I’ll let you stay there.’ That was a major turning point for me. I finally had a chance to get out of the lifestyle I had been in for 20 years. As I said before, I’ve been clean for seven months now.

“You got to recognize a blessing when it comes. The house is a blessing. It and ASN have helped me to turn my life around. Now, I just want to be a responsible person. I want to take what I’ve learned and teach others. If you have knowledge that makes you successful, you’ve got to pass it on,” he said. “I’m looking for ways to do that; take what I know and help others who are still in addiction or who are HIV positive and haven’t really faced that — admitted it to themselves or to others. Through my touch with death, I feel like I’ve found life. The truth is that my whole life was changed by this disease. I got to figure out what to do with the experience.

“I wrote a play for kids to try to teach them what I know; help them to avoid the mistakes I made. Maybe I can find a way to take that to the schools. I sometimes wonder if maybe I can be part of the research they’re doing on the disease. Plus, I still have friends who are addicted. I’m trying to reach back and help them. I’ve made my house a safe haven for some when they needed it,” he said.

“I’m still looking for where I go next, but I know this; I want to be where I feel respected. When I got something I need to talk about, I see Paris at ASN. He’s always there for me.

“People ask: Why are you smiling? You’re gonna die. I tell them, ‘Look, when I get up in the morning, I love the person I see in the mirror.’ I thank God for the life I have. I don’t have resentments. I’m not angry anymore. I’ve changed. You know what? Every day you’re above ground is a good day; still, if I were to die right now, I’d die happy because I’ve finally started living happy.”

When Tommy said that last line, I closed my notebook. We hugged and said goodbye; but I had the feeling that we are all going to hear more from Tommy Bothwell.

 

 

 

 

 


Latino men face heart disease challenges

Edward Moncrief, For The Salinas Californian 10:52 a.m. PDT March 18, 2016

FaustinoOrejel_March_2016-1

In early April 2014, Faustino Orejel — at age 49 — started feeling symptoms: tension in his jaw, tightening into his chest; a burning pain in his lower back. Over the next few weeks, the symptoms recurred. In mid-May, he was mowing his lawn. Once again, he felt the tension and spreading pain. He stopped and lay on the grass, but as soon as he rose and tried to complete his chore, the symptoms returned. He couldn’t continue.

“I told my wife, Marta, ‘I want to go to the hospital.’ At first, she thought I was joking, but then she looked at me and saw how white I was.”

“Okay, let’s go,” she said.

Orejel soon found himself at Salinas Valley Memorial Hospital, admitted to the Stanford Cardiac Surgery Program and seeing Dr. Christopher Oh. The hospital has forged a partnership with Stanford which has served to put the Stanford Cardiac Surgery Program at the forefront of life-saving technology    and innovative procedures.

Looking through pictures of his children, now grown, Faustino Orejel is grateful for his health.  (Photo: Jay Dunn/The Salinas Californian)

“Dr. Oh put me through various tests,” Orejel continued, “blood work, a ‘stress test’, an echocardiogram. I started walking on the treadmill. After a few minutes, they steepened the incline just a little and within 30 seconds, I thought I was having a heart attack. They gave me a nitroglycerin tablet to calm me down.

“The doctor told me that I had to stop working immediately and rest. I couldn’t walk to the bathroom without feeling that sensation in my jaw.”

Orejel and I spoke in his North Salinas home, located a few yards from the Landmark Missionary Baptist Church where he is pastor. The living and dining room were neatly furnished and faultlessly groomed. Despite his calm demeanor, Orejel appeared strong, energetic, and eager to share his experience.

“After that first day, more tests followed. Later, they told me that I was suffering from Coronary Heart Disease (CHD). Five arteries to my heart were blocked. I was relieved when they scheduled the surgery for mid-June.”

“Weren’t you surprised at your condition, considering how young you were?” I asked.

“Actually, I had always known that someday I might have a problem because my father had quadruple bypass surgery in 1999. He had four blocked arteries. My mom died at age 53 from a heart attack when I was only 21. The disease can be hereditary. I really don’t think that I would have survived without the surgery. When I met Dr. DeFilippi, he told me that the bottom half of my heart was slowly dying for lack of blood.”

Dr. Vincent DeFilippi is director of Stanford Cardiac Surgery at Salinas Valley Memorial Health Care Systems. He is board certified in both cardiothoracic and general surgery and a magna cum laude graduate of Duke University. He earned his M.D. from Columbia University and completed a general surgery residency and research fellowship at The University of Chicago/Pritzker School of Medicine. He received his cardiothoracic training at New York/Cornell and is a clinical professor of cardiothoracic surgery at Stanford.

His list of credentials and awards is long and impressive. He has won national recognition as America’s Top Doc, Patients’ Choice, Who’s Who in American Healthcare, and numerous other awards and honors described at http/:med.stanford.edu.

I later spoke to Dr. DeFilippi at his office on San Jose Street in South Salinas.

Faustino Orejel, photographed at the Cherry Bean in Salinas on Thursday, March 17th. Orejel had quintuple-bypass heart surgery in 2014.  (Photo: Jay Dunn/The Salinas Californian)

“The social pieces, of course, are important: genes and family history. Married men live longer than unmarried men. That may be because, generally, men are apt to ignore their symptoms when something goes wrong. Frequently, it’s the wives who convince them to get healthcare.

“In Faustino’s case, he had five blocked arteries; yet, for several weeks, he was just gritting his teeth and trying to get through his day instead of thinking, maybe I’d better get this checked out. Another social piece was his age. At forty-nine, he was probably thinking, I’m too young to have a heart attack.

“When you look at social factors like a poor diet or family history, the advantage of age can be neutralized. I’ve performed heart surgery on someone who was thirty. With all the junk food and sugars we have today, more people are becoming diabetic at a younger age, which can lead to heart problems even among the young.

“Faustino had the right eating habits and exercised regularly, but his family history was against him. Still, because he was in good physical condition, his odds of success were very high.

“Frequently, to do a bypass, we harvest a vein from the leg. In Faustino’ case, we performed a minimally invasive harvesting technique. Many other hospitals harvest the vein by making a long incision down the leg. Here, we make a very small incision to take out a piece of the vein. We then attach it to the aorta and bypass the parts of the artery that are blocked. We connect the vein to a point beyond the blockage so that blood can once again flow to the heart. We leave the blockage in place. Of course, with the minimally invasive technique, the leg heals much more quickly.

“We also have a whole process in place for blood conservation. Part of that process is a machine called a cell saver. The cell saver is extremely important because if there’s bleeding during surgery, the machine collects the patient’s blood and recycles it. Many hospitals use the cell saver, but here, we go further.

“You can imagine that with Faustino’s five blockages, that’s a pretty big surgery. In addition to the blood re-cycling, we employ certain surgical techniques and specialized post-op care. The whole blood conservation process is extremely important because with it in place, patients like Faustino are able to avoid transfusions; and statistics tell us that people who don’t have transfusions live longer. About 90 percent of our patients don’t have to have blood transfusions. Nationally, for these surgeries, only something over 50 percent gets by without transfusions.

I asked the doctor why these techniques are not used more widely across the nation.

“Because they take more attention to detail; they take more time and effort; they’re a little more expensive — which is an additional cost that this hospital actually is willing to absorb. But the bottom line is that we use them because they are better for the patient. In Faustino’s case, again because of these techniques, he was up and walking three miles a day within three weeks of surgery.”

Before we parted, I asked Dr. DeFilippi, “How many of these surgeries do you do each year?”

“About 150 to 200,” he responded. “Over the years, I’ve done more than 5,000.”

Back at Faustino Orejel’s home, he talked about the need for an aggressive program of heart-care education in the Latino community.

“I’ve always been aware of health issues and I’ve known that I was at risk of having heart disease; so, I’ve never taken risks with my health. Early on, I developed good eating and exercise habits. You won’t find any junk food in the house. We made our kids very conscious of the importance of eating properly. But I know a lot of men — especially Hispanic men — who do take risks. Unfortunately, we do have our macho attitudes. My dad was that way. He didn’t go for regular check-ups. If he had a problem, he wouldn’t admit it even to my mom.

“My brother wasn’t feeling well not long ago, but he wouldn’t tell anyone or even admit it to himself. I had been urging him for years that he should get regular check-ups, but he just didn’t want to hear that. Anyway, he kept getting weaker and weaker. My sister-in-law finally realized that something was wrong. She insisted he go to the doctor. They took him immediately. He had developed a bleeding ulcer.

“Men like my dad and my brother believe that seeing a doctor somehow is a sign of weakness. They deny anything is wrong until, finally, they really are weak and have no choice. Now, at last, my brother has changed his attitude. He does what the doctor tells him to do.

“Years ago, my father-in-law had been in pain but he too said nothing. We told him to see a doctor. He said, ‘whenever people go to the doctor, he tells them they‘re sick!’ It was as if he blamed the doctor or didn’t trust that he was telling the truth. With his pain, he waited until he couldn’t stand it anymore; and then, of course, it was too late. It turned out he had a malignant tumor. He later died of the cancer. So, too often, that’s how it is. Some of my friends don’t even want their wives to see a doctor.

Later, I spoke to SVMH President and CEO Pete Delgado.

“I appreciate Faustino sharing his story and urging Latino men to listen to their bodies and get help when they need it. We’re doing a lot of outreach and education in the community, and we plan on doing even more. Men especially need to be convinced of the importance of regular check-ups, exercise, and good eating habits. It takes time to change cultural influences, but the payoff is big; people taking care of their own health and the health of their family.”

Faustino summed up his feelings, “Based on what’s happened to me, I want to find a way to spread the word about seeing the doctor regularly and eating right. You have to love your family and take care of your children. That’s really what we’re talking about. We’re so lucky here in the Salinas Valley to be surrounded by the healthy food in our fields. I tell people, ‘Look around you. Eat what you see!’”


For Some, the Holidays Bring Both Joy and Pain…

Edward Moncrief 7:09 a.m. PST December 23, 2015

MattyShaver&JeremiahFreman_Dec_2015Matty Shaver and Jeremiah Freman

I met Michael Acosta at Sun Street Center’s Pueblo del Mar residential facility for recovering addicts. The Center’s Christmas Party was about to begin. Michael was dressed as one of Santa’s Elves. I spent the afternoon watching him and the other elves hand out gifts and smiles to all of the mothers and children in attendance; the families of the men living at Pueblo del Mar.

The following day, we have a chance to talk. Michael has doffed his elf’s cap and apron. He sits in the library at Sun Street Center just off Market Street in East Salinas. He stretches his lanky frame against a worn couch, but even as he speaks about restlessness, his disquiet shows itself, pushing him to rise and pace the room.

“Detoxification is the worst pain you can imagine. For a week, your whole body is in shock. You can’t get comfortable for even a moment. Your back aches. Your muscles are tight. You can’t relax. A million pins and needles are stabbing you, stabbing you, stabbing you, constant stabbing. You’re shaking, restless with anxiety….

“You can’t sleep. You can’t stay seated. You walk around, but then you can’t just keep walking forever, so you try to sit but that only makes you want to get up again. You can’t eat. You have no taste buds except for sweets; all you want is something sweet. But really all you want is to use so you can relieve the pain.

“My mom died of ovarian cancer when I was 12. That was tough because my dad was a drug addict and he wasn’t around much and wasn’t really there even when he was around. He was always either out getting high or in prison. Then, when I was 14, my favorite grandpa died.

“I was a freshman in high school — Salinas High. I played basketball. Although I had lost my mom and my grandpa, I was doing OK because I still had my grandma. After my mom died, she pretty much raised me. Then, Grandma was diagnosed with cancer. She was a fighter and she wasn’t going to let the cancer beat her, but it did. Just before Christmas, she died….

“She had been the rock of our family and my rock too. She had a beauty salon in south Salinas. I’d go there after school and be with her on weekends. She taught me everything; how to be a gentleman, how to cook, how to care for others, how to give back. She taught me about God … ”

At 28, Michael Acosta is good looking, articulate and comfortable sharing the ups and downs of his life over the past 14 years. He also listens well and seems to enjoy engaging with people. He has dark, gentle eyes and displays the easy charm of a natural storyteller. His expressive and supple face might have served him well as a stand-up comedian if his life hadn’t taken such a tragic turn.

“My grandma … this caring woman in my life suddenly has cancer and is undergoing chemo. What does she do? She starts sweeping up the hair in her shop and making wigs for some of the other women who are also undergoing Chemo. People later told me that she was the first one around here to do that for women who could never have afforded a wig otherwise.

“After she died, I was lost and angry. I went to a party on Christmas Day. For the first time, I drank hard liquor and I got high on meth. Before I knew it, I was doing drugs and drinking every day; I guess in a fruitless attempt to stop the hurt. That was the end of high school sports and just about everything else for me.”

“You know, Michael,” I say, “you strike me as someone with talent and brains. I can see you were dealt a rough hand, but you had a lot going for you.”

“Ya,” Michael responds, “you’re right, but that was also the problem. My charm and brains made me feel like I could get away with anything. I was into OxyContin, a synthetic heroin. And for a while, I made it work. I finished high school and enrolled for a semester at Hartnell. But it didn’t last. When you’re doing drugs, nothing else matters. You don’t care about anything but the next hit; not your family, not your work, not your future.”

Michael stops pacing and sits on the couch again. He leans forward and folds his hands on his knees.

“I’ve been trying to figure out why the holidays are so hard and emotional. When you’re doing drugs and drinking, your feelings are close to the surface. Christmas comes around and the memories flow over you. Everywhere you look, it all reminds you of the past … childhood … family … and you hate yourself for what you’ve done and what you’re doing.

“I had become everything I despise about my own dad. I had disappointed the people I loved and had ignored all they had taught me; my grandpa, and most of all, my grandma. And there’s the vicious cycle because the memories make you lose respect for yourself and you do more drugs and drink to try to forget that very pain … ”

Michael tells me that he first came to Sun Street Center seven years ago. He completed the rehab program.

“When I turned 20, I went for a year to live with my dad in Oklahoma. We worked together laying tile. We were both using cocaine. We were spending four or five hundred dollars a week on drugs and alcohol. By the time I left, I had lost all respect for him.

“I came back to Salinas. I turned 21 and kind of woke up. I had been working a good job as a dispatcher and was — I guess you’d say — engaged to my high school girlfriend. We set a date to get married. I spent five months here in counseling and group sessions and I cleaned up. Then, I got cocky. I figured that I could white-knuckle it.”

He explains that “white knuckling it” means going it alone; staying clean without the support of counselors and without help from a sober community of others struggling to maintain.

“Then, Christmas came around again. I was with my brother partying. I got so wasted, I passed out. My brother wanted me to go home, but I said no. So he went his way and I went mine. I ended up threatening some folks and got arrested. I spent 15 months in jail.”

“How can you hold a job while you’re doing drugs and alcohol?” I ask.

“You find a balance between getting high and coming down. Meth makes you high. Heroin brings you down. I don’t know if the people at work noticed or not. It didn’t matter.

“After I got out of jail, me and my girlfriend got back together. By then, she had had a child with someone else and they had split up.

“We got married and had a baby. I had a really good job as a plumber; but within six months, I relapsed. For the next couple of years, I tried to stop. I’d get some counseling and then go back to the drugs again. When you’re using, you lose all ability to distinguish right from wrong. As I said, nothing matters except the next fix.

“My wife wouldn’t put up with my relapses. We separated. During the summer, I went to see my dad back in Oklahoma. I spent a month there. He had cleaned up and he convinced me to do the same. I came back home to my family; but, once again, I started using. Then, this past October, my boss was going to promote me. I was slated to get a nice raise. Right now, I should be making $40 an hour; but I failed their drug test and lost the job.

“In November, I checked back into Sun Street Center. I knew I had to go to counseling, work the steps, get back to meetings and back to the Michael I used to be. Now, I’m living here and going through the classes and counseling again. But this time, I’m doing it for myself and for my family. I’ve got two boys that need a dad. My boss told me, ‘You get yourself straight. When you come back, there’s a job here for you.’

MichaelAcosta_SunriseHouse_23_Dec_2015“But here it is, the holidays again. This morning during counseling, I found myself crying. When you clean up, your level of emotion rises. You’re super sad. You think about what you’ve done and all the hurt and destruction you’ve left in your wake. You’re uncertain and fearful about staying clean.

“I know this much, I don’t want ever to go back to being an addict. If you use heroin for only three days, you’re going to go through withdrawals in order to quit. So, I just have to face the fear and uncertainty and overcome it.”

“Michael,” I ask, “where do you think you’ll be in five years?”

“Oh, God, that’s hard … All I ever wanted was to have a family and be a good father for my boys. Sun Street’s making that possible for me. I’m better now at accepting the help I need. I’m not going to try to white knuckle it again. I’ll stay in the program for as long as I need it. I can go back to work in 45 days.

“Sun Street operates Pueblo de Mar over in Marina. My family and I can live there for up to two years, so I’ll have ongoing support for a good while. But I can’t think too much about the future beyond that.

“One thing I’ve learned: The past is gone. I can’t do anything about it. I have to stop beating myself up for what has happened. Yesterday’s over. We don’t know what will come tomorrow. All we have is today. I’m just trying to get through today; and I’m confident I will because this Christmas, I’ve got my wife and kids close by.”MattyShaver&JeremiahFreman_Dec_2015

 

 


Chemo care bags bring pure joy and gratitude

MarshaFerguson&RobynLipeMarsha Ferguson and Robyn Lipe show off a Chemo Care Bag (Photo: Edward Moncrief/For The Salinas Californian)

Darren Sullivan was sitting in an “infusion chair” at Salinas Valley Medical Clinic’s Cancer Care facility. An I.V. pumped chemicals into a “port” inserted beneath his right shoulder. He was feeling depressed. His mother had died of Non-Hodgkin’s Lymphoma in April, only five months ago. Now, he was the victim of a dark improbability: Non-Hodgkin’s Lymphoma is not hereditary; yet Darren Sullivan had just been diagnosed with the same disease that had taken his mother.

“In September, I started having stomach pains. I had no appetite. I was losing weight. I went to the doctor. ‘You’re going in right now,’ he told me. The next thing I knew, I was sitting in that chair in Chemotherapy, feeling down, reflective, full of doubt about the future. It had been a tough year, what with my mom and all. Then this woman comes into the room, Bernadette.”

Bernadette Lucus Burch is Salinas Valley Memorial Health System’s oncology and breast health nurse navigator.

Sullivan continued, “She stepped in, carrying a colorful duffel bag.”

“’I have a gift for you,’” she said. “She handed the bag to me. ‘There’s a group of people out there — a group of women — who want you to know they care about you. You’re in their thoughts.’”

“My therapy is a seven hour ordeal,” Sullivan explained. “Your skin’s feeling dry, you’ve got nothing to do, your lips are chapped, you’re disheartened. I had literally just told a visitor that I wished I had something for dry lips; and in steps Bernadette with — I guess they’re calling it — a Chemo Care Bag. I looked at it and somehow it changed my attitude entirely. It truly was a gift and truly did make me feel like these people, whoever they were, cared for me.

“And then, sticking out of one of the side pocket of that beautiful bag, there’s the lip balm, Carmex. ‘Can I use this now?’ I asked. ‘Of course,’ Bernadette said. ‘It’s yours.’”

In March 2015, Marsha Ferguson first noticed the pain. She had a mammogram.

“Within 30 days, I was diagnosed with breast cancer, had undergone surgery, and then was in Cancer Care for chemo. When I first heard the words, ‘You have cancer,’ I was devastated. It was such a jolt. Really, the impact is multi-layered: psychological, physical, social,” Ferguson said.

“I had retired after thirty years in law enforcement and I had planned to start a new life. Now this was happening. I just wanted to avoid the whole thing. In fact, I tried to skip the first chemo, but my friend, Charlene — we grew up together in Seaside — she essentially kidnapped me and took me to the appointment. She, Jeri, and Cyndi also made sure that I got to future appointments,” she said.

Charlene’s mother had had breast cancer. She beat it and is still going strong.

“During chemo, you experience weight loss,” Ferguson continued. “You’re cold on the outside and the inside. Your mouth is dry. Your skin dries up. Your lips dry up.”

“Charm, another girlfriend, gave me this bag of things which might make me more comfortable: neck pillow, socks, snacks, a blanket. I mean, my chemo lasted three hours and you aren’t going anywhere. I really appreciated that bag.

“Nurse Navigator Bernadette — I call her “Bubbles” because she has so much energy and positive spirit — I met her during my sessions. She runs a class to encourage you to take care of yourself and to talk about the effects of chemo and ways to deal with ‘em. She gives tips on hair and make-up. Frankly, I didn’t use a lot of the advice she gave. I decided to go with the bald look. People told me they liked it, so I said forget about the whole wig thing!

“But some of it, I did use. I don’t have eyebrows anymore, so I listen to what she had to say about make-up and skin care.

“I had chemo June through November. Now I’m in radiation; the fourth week of a six week dosage.

“My support group has been fantastic; friends and friends of friends, at least thirty women out there who are looking after me in one way or another.

“People like Robyn; she’s the local sales director for Thirty-One, so she had these duffel bags that she sells out of her home, really nice and bright. I became a Thirty-One consultant, selling bags and other products at house parties, and she was my contact with the company.

“Well, the company encourages you to give back, so Robyn had this project with Ronald McDonald House up at Stanford. She was taking these Chemo Care Bags up there for the children at the hospital and using her commission from the sale to pack the bags with all these items that are lifesavers for people in chemo. She’d get our entire group together and we’d spend an evening just filling up the bags.

“After a while, I thought of the bag that Charm had given to me. I said to Robyn, ‘The Ronald McDonald House project is a beautiful thing, but I want to do something local as well.’

“Robyn and I decided to make the Chemo Care Bags our local project.

“We filled 29 bags with a whole bunch of items that we thought would be useful: a booklet on Chemo, books of crossword puzzles and other word games, an appointment book, bottled water, hard candy, chewing gum, lip balm, peppermint mint, snacks; and, most important, a blanket and socks.

“Another thing, when you’re in chemo, you’re prone to getting sick, maybe catch a cold or a flu bug, so we included hand sanitizers and other personal hygiene items.

“At first, we had assumed that the bags would go to women like me with breast cancer. But then, someone said, what about the men? So we made up some bags for them….”

Robyn Lipe is Salinas through and through, back to her grandparent’s generation.

As mentioned, Lipe’s the local sales director for Thirty-One, an in-the-home sales company. The name refers to the Old Testament’s Proverbs 31, which describes the qualities of the virtuous and industrious woman, “clothed in strength and dignity.”

Robyn said, “Thirty-One has a national association with Ronald McDonald House in most major cities.”

According to its website, RMDH helped reduce “the burden for nearly 5.7 million families in 2014. Since 1974, our network of local Chapters has been making children happier and healthier by keeping families together — giving them a place to rest and refresh; a place that feels like home.”

The houses provide lodging at no charge to families of children in treatment for diseases such as cancer.

Robyn has focused her giving on cancer patients because her own mother had breast cancer. She encourages the sales consultants under her charge to do the same. Her team of 20 women has sent 120 Chemo Care Bags to RMDH at Stanford.

“It was Marsha’s idea to develop a local focus as well,” Robyn said. “We started having Chemo- Care-Bag-packing parties in my living room and working with Salinas Valley Memorial Health System’s Nurse Navigator, Bernadette to decide where the bags should go.

“We also encourage our customers to join by purchasing a bag and donating it to those in treatment.

“The truth is, this whole Chemo Care Bag effort has changed my life. You feel like you’re on a mission. You really are giving back. You know that you can’t cure the disease, but you can do something to help people through it.”

Bernadette remembers, “I’m at my desk one day and in walks these women with 29 of these bags. I was speechless. Of course, I already knew Marsha. I thought, here’s a woman who has gone through this difficult journey and has come out the other side full of life and determined to make a difference.

DarrinSullivan_Jan2016“Then I took that first bag to Darren Sullivan. I saw the look on his face of pure joy and gratitude. He noticed the lip balm, and he asked me, ‘Can I use this now?’ It was as if Marsha was right there with him encouraging and supporting him. Only a person who has been through it would know so precisely what is needed.

“Those bags are a message to the patients; a message of hope and confidence in the future; a message that they are not alone, that people care…. I’m the lucky one. I get to deliver them and experience the pure joy and gratitude they engender.