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Stanford’s new, innovative tools to address chronic pain

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“In a world of hurt.” It’s a figure of speech not meant to be taken literally. But it’s a real place to those who inhabit the world of persistent pain, one whose moment-by-moment ramifications can upend and redefine life.  

There’s a continuum in this world of hurt: Pain is variable and many manage it themselves without going to the doctor. They can hold jobs and function, albeit through varying levels of pain. For others, severe chronic pain can mean an inability to sit comfortably, or far worse, to fall off to sleep at night, day in and day out. For some, pain brings an inability to work, to get out and see friends, to travel or to take in a movie. And, with those compounding, cascading inabilities, an ever-shrinking solitary “world” because of hurt.  

The threat of even more hurt must be defended against. “When you have chronic pain,” says 27-year-old Erika Delgado of South San Francisco, who has suffered with it her whole life, “it’s like constantly being in flight mode. You constantly feel that you’re in danger.”   

Often patients are reluctant to talk about pain that may send them to one doctor or therapist after another. Or pain that doesn’t have a clear diagnosis, or pain that doesn’t look obvious. They go stoic. “You adapt,” says “David,” a 68-year-old former executive who has been dealing with the after-effects of a sports injury and two back surgeries for two decades. “At some point, you’ve got to say that what you’ve got is what you’ve got.”  

Despite the constant burning sensation in his back, the healthy appearing Redwood City resident tries to cope with his chronic pain quietly — and, as much as possible, anonymously. “Nobody wants to acknowledge their disability,” says David, who nonetheless manages two contradictory things: an active schedule as a community volunteer – and usually only two hours of sleep a night.  

Except for those born with a rare congenital insensitivity which makes them literally feel no pain, everyone experiences it. A 2018 report for the U.S. Centers for Disease Control and Prevention estimated that 50 million Americans suffer from some form of chronic pain, and of that number, 19.6 million have pain severe enough that it frequently limits life or work activities. The economic toll is an estimated $560 billion in medical care, lost productivity and disability programs. The prevalence of pain, not surprisingly, goes up with age.  

Pain, however, is actually beneficial, warning of danger so people can respond, for example, by pulling a hand away from a hot surface. Episodes of acute pain go with the territory for stubbed toes and broken bones, but the symptoms usually resolve as the tissue heals or bones mend. Persistent, or chronic pain, on the other hand, can become a disease in its own right, as the nervous system over time becomes rewired, even spreading pain beyond the original area. That’s one of the reasons why it can be so challenging to treat and so frustrating to those who live with it. 

If there’s good news in all of this for Peninsula residents, it’s that advances are being made in better understanding the causes and effective treatments for pain, and with that the ability to offer more personalized approaches for targeting individual patients. Whether high-technology brain imaging, or no-tech therapies like breathing exercises and yoga, there are more alternatives available than just going home with a prescription for pain pills — something the nation’s opioid crisis has elevated as an urgent concern. 

Dr. Sean Mackey is chief of the division of pain medicine and director of neuroscience and the pain lab at Stanford University. He leads a multidisciplinary team which brings academic research findings into a clinical setting to help patients alleviate longstanding pain — and even to prevent pain, notably following surgery, from transitioning from acute to chronic. “Our message,” Mackey says, “is that you don’t have to suffer in silence, that there are approaches that can help.” 

Stanford Health Care’s Pain Management Center at 500 Broadway in Redwood City is one of the largest, most comprehensive pain centers in the United States, if not the world, according to Mackey, and has twice been designated a Center of Excellence by the American Pain Society. Physicians from multiple disciplines including psychiatrists, physical therapists, nutritionists and others get involved treating patients. 

“One of the things that I think is unique to the Stanford program is that we integrate our research and clinical missions very tightly,” he adds. Clinical knowledge can feed researchers with questions to go after, and research discoveries are translated into safe, effective therapies. One example of something that is being tested is transcranial magnetic stimulation – “brain zapping” – using something like a coil placed on top of the patient’s head. “It doesn’t hurt,” Mackey says. “There’s no pain and you can induce a current through it that generates a magnetic field that can activate different brain centers, and we can turn on and off the brain systems that are associated with pain. And we’ve had some really good results with it.”  

Stanford has been recruiting volunteers for further study of the efficacy of TMS for two kinds of pain, one of several studies that are planned.  Another one is seeking evidence of the benefits of acupuncture for low back pain.   

The Stanford scientists also study novel applications for medications, according to Mackey, as an example, repurposing naltrexone, which was originally used to treat drug and alcohol addiction. “But at much lower doses, like one tenth of the usual dose, it has a completely different action,” he says. “It blocks nerve inflammation so it’s been very useful with fibromyalgia, which predominately affects women in their 30s, 40s and 50s, as well as some other chronic painful conditions.” 

Among the other new alternatives, Stanford is also using implanted devices that can override pain signals to a specific nerve and provide relief.  

If the body had only a single “pain center,” obviously treating pain would be much simpler, but many parts of the brain and neural pathways are involved in the pain experience. One of the problems when pain becomes chronic is that it can alter both the peripheral nervous systems and the brain and spinal cord “so that it amplifies the experience of pain and that magnifies it,” according to Mackey. When that occurs, someone who has come through an injury or surgery may no longer need the original signals to keep on feeling pain.  

What is experienced as pain relies on many sensory cues, among them emotions, beliefs, thoughts and expectations, and one of the factors that can feed into chronic pain is known as “catastrophizing.” The big word can apply to anything. Bills. The job. The country. But with pain, rumination, hopelessness and a feeling that the condition will never get better can trap the brain in an endless loop that is very difficult to break out of.    

But the pain is still real. Unfortunately, in part because it’s “invisible,” patients commonly report feeling they are being blamed for their pain, according to Stanford associate professor Dr. Beth Darnall, who has a doctorate in clinical psychology and is a pain scientist. “(It’s) a misperception that somehow people are saying pain is all in your head. ‘You’re making it up. It’s not real. There’s not a medical basis for your pain, therefore there must be something wrong with you’ … (But) all pain is real. I always say that at the outset. All pain is real.”  

One of her primary interests is in developing low-cost, accessible treatments that empower patients so they can “begin participating in managing their symptoms rather than feeling at the mercy of them” — among them cycles of poor sleep, persistent worry and feeling helpless. Darnall, who teaches a class on this at Stanford’s Redwood City clinic four times a year, says studies demonstrate that in two months or so of cognitive behavioral therapy, improvement can be shown. “They have evidenced substantial volumetric increases in the regions of the brain associated with brain control — so literally increasing the brain matter in those regions that associate better regulation of pain.”  

It’s long been established that cognitive and behavioral therapies are important in addressing chronic pain. “What’s different is that we’re now focusing more and getting people better access to what works,” she says. Rapid access to relief is “kind of where the rubber hits the road.” 

Pain physician and professor Dr. Ming-Chih Kao is chief of Stanford’s network of pain clinics (including the one in Redwood City), which is expanding geographically: Patients who are already in pain benefit because they don’t have to drive so far for treatments and can come in more often. 

Kao started his career in internal medicine, intending to focus on cancer as his specialty, but decided to switch to pain management – in part because of how common pain complaints are, headaches and back pain topping the list. “In the primary clinic that I saw … about 20 to 30 percent of my patients could benefit from a pain specialist,” he says. But the diagnosis and treatment of pain, he also saw, is very complicated and requires a team approach.   

When he started at Stanford as a fellow, patients routinely were coming in who had been prescribed very high dosages of opiates. Primary care doctors, he says, were trying to do the right thing to reduce pain but “the nature of opiate medications is that patients get used to it very quickly. They develop tolerance. … They had to escalate the dose again and again and again. And pretty soon, some patients are finding themselves taking astronomical doses. And still not getting pain relief.”  

The issue has taken on new urgency as a result of the nation’s opioid crisis, which is commanding more public and regulatory attention. From a period when the drugs were overpromoted and the risks minimized, the pendulum has swung the other way, and in 2016 the Centers for Disease Control and Prevention recommended against opioids as a first-line treatment for chronic pain. There has been pushback from patients and physicians alike that things have gone too far the other way.  (Both Mackey and Darnall have spoken out against forced tapering of opioids.)  

Fortunately, Kao notes, there are new medications available that can be used safely to treat chronic pain, and many patients on large-dose opiates have been switching over successfully. There are 200-plus medications for pain management; 20 are opioids.  

With most patients who develop chronic pain, Kao observes, usually there’s not just one cause. It may start out with a herniated disk, nerve impingement, joint inflammation or a muscle or tendon issue. If pain persists and reaches a high level, secondary injuries from disuse or being bedbound can set in too.  

So for us, a patient coming in with back pain or a headache, we’ve got to figure out what parts of the pain cycle are important contributors to the chronic pain and then we try to tackle them one by one,” Kao says,” not just with the doctors but with the rest of our team.” 

Lifestyle changes can make a big difference. “Oftentimes patients find themselves essentially in a feedback loop where they become less and less active to avoid pain,” Kao says, “but unfortunately inactivity over long periods of time weakens muscles and that can cause secondarily more pain. So that’s actually the cycle we’re trying to break for a lot of patients.” The therapeutic prescription might include swimming, yoga, Nordic walking using poles, biofeedback and meditation and psychological counseling to improve coping skills and the ability to commit to a treatment program. 

San Mateo Medical Center – the county’s “safety net” hospital – offers a multidisciplinary pain clinic that includes similar therapies including meditation, physical therapy, yoga and art, as well as classes to help patients understand the physiology of pain. The program draws heavily on the work of Australian neuroscientist Dr. Lorimer Moseley, whose poplar and entertaining talks on You Tube help – as the title of one of his books puts it – “Explain Pain.”  

Clinic patient Douglas has the autoimmune disease fibromyalgia, which makes people hypersensitive to pain. Since she enrolled in the hospital’s program early this year, she feels better and has gained a new perspective about how the mind and the body are linked. “This class reminds us we’re not crazy,” she says. “Our pain is real.”  

It would be hard to find a more enthusiastic graduate than San Bruno resident John Acayan, a back pain sufferer who says the pain clinic has helped him get past being depressed about things he can no longer do and instead look forward to what he can do. “One of the things the pain management clinic has done for me is help me to realize that (if) you’re injured, perhaps you’re not going to be 100 percent the same, you’re not going to be able to do everything that you used to. But you can be happy. You can do other things.”   

He even tried acupuncture, and despite a fear of needles, “It was fantastic. I couldn’t believe it. It made everything go away. I’ll say literally the rest of that day was so tranquil. Absolutely no pain. Zero. That night, I slept fantastic.” The next morning was great, but after a few days the pain came back. He tries not to think about pain so much. At one time, in fact, he thought his medication needed to be stronger. He was taking 600 milligrams of tramadol a day and is now down to 50. The clinic team guided him to the realization that he didn’t need that much. “I could take a pill and be happy and lightheaded,” he says, “but that isn’t the way I want to feel. I want to feel normal. I don’t want to feel loopy.” 

This summer, Acayan got to try out something fairly new in the hospital’s treatment toolbox – virtual reality. Patients put on goggles and operate controls to throw things at friendly sea otters on a video screen and become completely engrossed. Another version has a biofeedback component that gives viewers some control as their heart rate changes.  

Chief Medical Information Officer Dr. Michael Aratow says virtual reality can calm people down in high-anxiety areas like emergency rooms. He brought the idea to Dr. Melissa Fledderjohann, a licensed clinical psychologist who directs the pain management clinic, and she readily agreed to offer it in her program. Most patients get a reduced pain sensation while they’re using VR, according to Fledderjohann. “We know that during and right after it, they definitely feel a decrease,” Aratow says. “The question is does that decrease persist until next time? The jury’s still out on that one.” 

Says Fledderjohann: “It helps reinforce the concepts in our classes, saying ‘There are tools you can do to manage your pain, reduce your pain. It’s not just an external thing that’s coming at you. You yourself can do your own pain management. And this would be a good example. By going though VR, you saw your pain reduced.’” 

Simon Koytiger, a physical therapist who manages Vibrant Care Rehabilitation in San Carlos, is also a proponent of a comprehensive and holistic approach to treating pain, which he views a symptom, not the root of the problem. Especially in the fast-paced Bay Area, lifestyle issues including lack of exercise, working long hours, stress, poor diet and anxiety can show up as back or knee problems, and Koytiger tries to help patients develop healthier habits. “We have this chronic pain issue,” he says. “Lifestyle is never going to show up on an MRI.” 

Exercise, he points out, helps reduce pain many ways, first by making people stronger and less fragile and improving the capacity of all tissues in the body.  Exercise also has endocrine effects, releasing the “happy hormones” serotonin and dopamine and reducing the production of the stress hormone cortisol.  

“I talk to patients about these three pillars very frequently: It’s physical exercise, it’s diet and nutrition and it’s mental health,” Koytiger adds. “And actually I’m a bit of a believer, even though I’m a physical therapist, that the primary pillar is mental health. Because who is the one who’s choosing to eat well? Who is the one who’s deciding to exercise that day or not? We make those decisions and if we are at ease and we have more peace and calmness in our minds, we are going to naturally do those things that are right for our body. If we are suffering with depression and anxiety and stress, it’s going to be much more challenging to balance those two domains.”    

Coming back from chronic pain can be a long haul.  

Woodside resident Brad Dary, 65, counts himself fortunate that he “came out the other side” of years of chronic pain, which began in 1995 with a laminectomy followed by fusion surgery for a vertebra five years later.  

For the first year after the surgery, “I felt like I was cut in half,” he says. “I moved home with my parents. I was literally in bed for a year after that operation. … It would take me about a half an hour to get from the bed to the bathroom. You can’t do anything without your back being involved. I used a walker.” He had to take morphine for the pain but “hated having a foggy brain” and couldn’t wait to get off of it.  

He tried acupuncture once but thought it was “silly.” But Dary, who is a videographer, says through a slow progression of pushing himself to do exercise and the healing process, he finally recovered. “You just fight it out,” he says. “My biggest thing was doing exercise and trying to build my muscles as best I could … Everyone’s situation is different. I had a lot of time to heal. It was 10 years.” Today he jogs three times a week and works out with weights.  He thinks having to work so hard to get where he is challenges him to be “more alive.” 

“Rose” – who did not want to be identified by her real name for this story – has made a remarkable comeback too from barely being able to get out of a hospital bed using a walker. The southern San Mateo County resident disciplines herself to walk two miles, three times a week and has worked up to doing 15 minutes on an exercise bike at the gym. She’s arrived at this point 15 years after a series of back surgeries over four years, the first to address stenosis and then two more that turned out to be needed because of damaged disks.  

When it all began, she had a job, but she had to give up working long ago.  

Patients tend not to do their physical therapy if it’s too painful, and she was prescribed fentanyl and vicodin to help her be better able to do the therapy she would need, which it did. “They put me on heavy opioids because they knew to get through years of it would be so painful because all of these core muscles were, waist to pelvis front and back, cut three times through three surgeries,” Rose explains. “So that is a huge amount of healing.”  

Fifteen years ago, her first pain management doctor assured her that it would easy to get off the opioids when the time came. “It’s no problem,” Rose clearly recalls him saying. “Literally, he told me ‘No problem. You just gradually step off the opioids.’”  

But when she had been on them for six years and was ready to start declining, she learned otherwise. It took three years of tapering to get off opioids, drugs so powerful that she had to cut back milligram by milligram, for a month perhaps and then wait two months to cut back again. Each time, she had to deal anew with increased pain, plus the jittery withdrawal symptoms. Her skin felt like it was crawling and she had no idea what it was until someone she knows who works with people in addiction explained it to her. 

“I’d never done drugs,” she says. “I didn’t know. I’m such an innocent Girl Scout.”  

She methodically tracked her dosage on an Excel spreadsheet. With such a plodding pace, it helped to be able to look back and confirm that she really was taking less. Rose says her current pain specialist is a Kaiser Permanente doctor who has been with her every step of the way and is her “cheerleader.” He emphasizes the importance to her of pacing activities, not overdoing and causing more pain that will trigger a desire for more opioids. Though she was already slender, when one of Rose’s physicians told her that losing five pounds would reduce the pain, she lost ten. “In my case,” she says, “it makes a huge difference.” 

More than anything, what has really gotten her through it all, says Rose, is her support system of her husband and friends and her Christian faith. A Bible study group from church met in her house when she could not get out, and it helped to know that they were praying for her. “Prayer is meditation,” she observes, “and the Bible study group was group therapy.” 

Rose’s advice to others with chronic pain? “From my experience, really slow is what does it,” she responds with a laugh, “like the old Aesop’s fable, the tortoise always wins.” 

 This story was originally published in the November print edition of Climate Magazine. 

Redwood City native named San Francisco Giants’ new GM

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Time to get a World Series ring for Mom.

Redwood City native Scott Harris, 32, said he’s “excited to come back home” during a press conference today announcing him as the San Francisco Giants’ 10th general manager.

A graduate of Menlo School in Atherton, Harris spent the past seven years with the Cubs, serving in the final two as assistant GM. He contributed to a Cubs team that went from losing 101 games in 2012 to making the postseason in four consecutive seasons (2015-2018), and earning the World Series championship in 2016.

That certainly pleased his father, Rob, who grew up in Chicago and turned Harris into a Cubs fan.

But Harris’ mom, Joanne, is from San Francisco and a Giants fan. As is his brother, Chris.

“I grew up in a split household,” Harris said, adding, “they divided the sons.”

Harris said the arrangement has put his nephew Teddy “in an awkward spot” as his dad loves the Giants and his uncle was working for the Cubs.

“Now, at least Teddy has a little more clarity,” he said.

After three straight losing seasons, the Giants hope Harris can help contribute to a turnaround of the organization in partnership with President of Baseball Operations Farhan Zaidi. Harris’ smarts, work ethic and determination were touted as reasons for optimism.

Harris played soccer and lacrosse in high school and club lacrosse at UCLA, where he graduated with a degree in economics. Upon entering the job market, Harris “wrote every team a letter, knocked on doors, attended meetings, did everything he could to find an opportunity” in a baseball organization’s front office. About a year after meeting with Major League baseball legend and former Giants general manager Al Rosen (a meeting secured by Harris’ grandmother Joan, according to the San Francisco Examiner), Harris landed an internship with the Washington Nationals, then got a job in baseball operations with the Cincinnati Reds, followed by a gig as coordinator for Major League operations for MLB.

At just 25 years old, he got a job with the Cubs, during which time he managed to earn his MBA at Northwestern.

“He loaded up his schedule with Saturday classes…at the end of the week, he would take a red-eye back to Chicago and made it work,” according to the Giants organization.

Harris said it’s a “privilege to come back home” and is humbled by the opportunity to join the Giants.

“I vividly remember what the game looks at the highest level by watching generations of Giants players come through Candlestick and this park. I’m really excited to reconnect with San Francisco. I’m excited to live in the city.”

Zaidi said the Giants are “thrilled in an executive of Scott’s caliber to help lead our baseball operations group,” noting his experience, contributions toward the championship-winning Cubs and, of course, his Bay Area roots.

“Our goal is going to be to get a ring for Mom, now,” Zaidi said. “Big Giants fan.”

Photo credit: SF Giants

Redwood City American Legion Post Marks it Centenary 

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Veterans Day will be special for Redwood City American Legion Post 105, which marked its 100th anniversary this year, highlighting a legacy that dates back to World War I, the hoped for “war to end all wars.” 

On October 10, 1919, a group of World War I veterans met at Sequoia High School and formed the post with a charter signed by 130 men. By 1932, that figure had reached 150 and the Redwood City Tribune ran a feature story on the local legionnaires’ accomplishments, among them the formation of a drum and bugle corps that performed at patriotic events. Most of the praise, however, was heaped on the post’s sponsorship of Aviation Day, a 1921 event the newspaper said was “one of the largest events occurring in Redwood City.”  Aviation Day featured 61 military aircraft as well as “a number” of civilian planes that participated at a time when the mere act of flying through the air was enough to capture the public’s imagination. Those who craned their necks witnessed planes participating in a 75-mile aerial derby as well as a flying circus highlighted by wingwalking and something called “plane changing.” 

Post 105 was one of the many American Legion posts formed in 1919. In March of that year, war-weary American veterans of World War I, a savage conflict that ended with an armistice on Nov. 11, 1918, met in Paris to form a veterans’ organization. Two months later a national caucus was held in St. Louis and “The American Legion” was adopted as the official name, giving birth to Legion posts that soon sprang up across the United States.  In addition to Post 105, the new contingents included Post 82 in San Mateo, which was organized on Sept. 29, 1919, and thus claims to be the “first continuously operating American Legion Post in San Mateo County.”  

The two San Mateo County posts will join forces on Veterans Day, Nov. 11, at Courthouse Square in Redwood City to celebrate the 100th anniversary of their birth. The festivities which start at 10 a.m. will be followed by a barbecue at 1 p.m. served at the Post 105 building at 651 El Camino Real. 

Over the years, the Legion, which today numbers more than two million members, has added to its accomplishments, particularly passage of the G.I. Bill. It was strongly backed by members who were World War I veterans. The former doughboys did not want to see World War II G.I.s end up as “forgotten men,” as many of them had been during the Great Depression. Today, November 11 honors all veterans, but at one time it simply recalled the day World War I ended. Today, the Legion is probably best known for its sponsorship of youth baseball teams and Boy Scout troops. 

Something the local post should be better known for is its fight against discrimination. Post 105 stood up to a Legion organization called 40/8, which is the English translation of the long, French notice displayed on railroad boxcars indicating that the car could carry 40 soldiers or eight horses. The 40/8 group became known for trains — actually rubber-tired vehicles that pulled a boxcar in parades. Sounds harmless enough, but the 40/8 banned “non-whites” from membership. In 1959 Post 105 backed the national American Legion when it broke ties with the group by forbidding 40/8 from using the Legion name and emblem in its activities. At the time, the commander of Post 105 was Alan Jensen, who said the only requirement to join the Legion was an honorable discharge from the service.  

The World War II tank that stands guard at Mezes Park is a visible reminder of Post 105’s ties to Redwood City. Post 105 helped bring the light Stuart tank to the park, site of the now long forgotten Mezes Hall, where the legionaries met before the hall on El Camino that is their home was built.  

Post 105 has welcomed many members since 1919. Its most illustrious was Mitchell Paige who was awarded the Congressional Medal of Honor for his heroic action in the Solomon Islands in 1942. According to his citation, Paige, then a Marine Corps sergeant, single-handedly withstood a Japanese attack after all his men were either killed or wounded. In 1960, Paige, who lived in Redwood City for five years, was made a lifetime member of Post 105.  He passed away in Southern California in 2003. His photo and a copy of his Medal of Honor citation hang on the entry wall at the Legion Hall. 

This story was originally published in the November print edition of Climate Magazine.

Climate Magazine wins top Press Club award

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Climate Magazine was honored Thursday night with 12 awards in the 42nd Annual San Francisco Press Club Greater Bay Area Journalism Awards, including first prize for overall excellence in the magazine category.

Climate’s Creative Director Jim Kirkland, Editor Janet McGovern and two columnists were also honored at the awards dinner in Burlingame for work they produced for the magazine during 2018.

Kirkland received five awards, four for his photography and a third place for a story he wrote about the Redwood City chapter of Miracle League baseball, for children with disabilities.

McGovern swept the headline-writing category, winning all three prizes, and won a third-place award for a feature she wrote on the Bay Area’s housing shortage.

Food columnist Emily Mangini received a first prize for several columns on that subject.  Climate’s history columnist, Jim Clifford, took home a second-place award.

More than 200 entries were submitted in the annual competition, which includes a variety of media including print, digital, broadcast and other forms. The entries were judged by press clubs in Milwaukee, San Diego, New Orleans and Cleveland.

The keynote address was presented by NBC Bay Area senior investigative reporter Stephen Stock. The press club also gave a First Amendment award to Kathi Duffel, a journalism teacher from Stockton and student writer Bailey Kirkeby.  The annual Bill Workman News Writer Award was presented to Michael Barba of the San Francisco Examiner.

Courthouse candlelight vigil planned for Transgender Day of Remembrance

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Ninth Annual Chanukah Festival

The community is invited to an annual Transgender Day of Remembrance on Wednesday, Nov. 20, that will begin with a candlelight vigil and procession at Redwood City Courthouse Square and continue with an event in the public library.

The gathering aims to remember 25 transgender and gender noncomforming people in the U.S. known to have been lost to anti-transgender violence this year.

“With this gathering, we aim to provide a space for communal healing, to celebrate the lives of those we’ve lost and to commit to fighting against discrimination and violence that our transgender community faces,” organizers said.

The event will begin at 5 p.m. with the vigil at Courthouse Square followed by a program from 6:30 p.m. to 8 p.m. in the nearby Main Library featuring community speakers, resources and information on how residents can help fight discrimination, intolerance and violence against members of the transgender community.

The event is presented by LGBTQ Commission , PRIDE Initiative, The San Mateo County Pride Center, African American Community Initiative, BHRS Office of Diversity and Equity, CORA and the Redwood City Public Library.

San Mateo County supes vote to ban sale of electronic cigarettes

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The San Mateo County Board of Supervisors has voted to ban the sale or distribution of electronic cigarettes in unincorporated areas of the county, potentially impacting 47 licensed retailers.

The board unanimously approved amendments to the ordinance prohibiting the devices, citing their negative health impacts and the rising trend of youth who use them.

Supervisor Carole Groom said the ban is not to harm small businesses but “really to make sure our young people are healthy and safe in this community.” She cited mounting reports of lung illnesses that have “sickened at least 2,051 people and killed 39,” according to this CNBC report citing the Centers for Disease Control and Prevention.

Young people are often impacted, particularly in San Mateo County, where the 2017-18 California Student Tobacco Survey showed that nearly 21 percent of high school students in San Mateo County use electronic cigarettes, higher than the statewide prevalence of 10.9 percent, according to County health officials. The cigarette use rate among high school students in the County is 3.1 percent.

Supervisor Dave Pine, whose son is in high school, said the rapid popularity of electronic cigarettes is on its own alarming.

“It really is incredible to the degree in which these devices have come into high schools,” he said, adding, “The use has really exploded.”

Last year, the Board banned the sale of flavored tobacco products and pharmacy sales of all tobacco products.

Enforcement of the latest ban won’t kick in for about six months.

Meanwhile, in San Francisco, the first major city to ban the sale of e-cigarettes, voters just decisively rejected a repeal of the ban.

Tight race for Redwood City School District parcel tax measure

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The proposed Redwood City School District parcel tax, Measure H, is just under the two-third voter approval needed to pass, according to semi-official results released Tuesday night by the San Mateo County Election’s Office. But with votes left to be counted, the measure’s supporters remain optimistic.

The measure, a parcel tax of $149 per parcel annually for 12 years, had received 65.61 percent support from voters as of the latest results reported Tuesday night, with 8,868 voting yes and 4,648 voting no, according to the San Mateo County Elections Office.

Factored into the count are all Vote by Mail ballots received in the mail by Nov. 5 and Vote by Mail ballots returned at Vote Centers and Drop Boxes by Nov. 4. The results also include all votes cast from Vote Centers.

Still to count, however, are Vote by Mail ballots received in the mail after Nov. 5, Vote by Mail ballots dropped off at Vote Centers or Drop Boxes after Nov. 4, and provisional ballots, according to elections officials.

The Elections Office is scheduled to update the results on Thursday, Nov. 7, at 4:30 p.m.

“The votes are coming in still and there are thousands left to be counted,” according to the Yes-On-H committee, adding the results received last night “are promising and expected and we’re optimistic Measure H will pass once the votes are counted.”

If it passes, Measure H would raise an estimated $3.45 million annually for the  school district that is reportedly facing a $10 million deficit.

The stated purpose of Measure H is to attract and retain highly qualified teachers, support quality reading and writing skills in schools, maintain science technology, engineering and math instruction and reduce class sizes in kindergarten and first grade.

In 2016, Redwood City School District voters approved an $85 per parcel tax that raises $1.9 million annually.

Photo credit: San Mateo County Elections Office

A look at what it takes to make it in the food business  

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MicroClimate caught up with Kyle Vogel, current owner of Woodside Deli, in an attempt to shed more light on the closing of this beloved institution. The sudden shuttering was a shock to locals who had been coming to the deli for imported meats, cheeses, hallmark sandwiches and various homemade foods for 61 years. As in most situations like this, perception does not always tell the whole story.  

Aficionados of the deli on Woodside Road know that it had been owned and operated by Dan Gallinetti, but when he retired in 2016, he sold it to Vogel. After extensive remodeling, the deli had reopened in 2018 to the delight of fans far and wide. 

When Vogel announced in September that Woodside Deli was closing, he explained that a 52 percent raise in his rent was a factor. “It was the straw that broke the camel’s back,” he says, “but not the main reason for shutting down.” Indeed, he accepts responsibility for not negotiating a new lease when buying the business, but the real culprit was one common to Bay Area employers.   

“It’s impossible to staff a business when your employees can’t afford to live in the area,” he says. “I had fewer and fewer options for where to find people.” 

Vogel quickly discovered that employee cost was his biggest challenge. To keep help working at the deli, he had to pay more, but his customers complained—loudly—when he raised the price of sandwiches 50 cents. 

“When you have 52 kinds of meats, 10 kinds of turkeys and no two sandwiches are alike, you need a lot of hands to get that work done,” Vogel explains. “For me to keep the doors open with the raise in rent and staff salaries would have ultimately required sandwiches that cost $13.” Vogel had to decide whether he could keep the business afloat under a new five-year lease. His chose not to, a reflection of a sad but unfortunate reality in this high-cost area. 

Making it in the food service business is indeed a challenge, especially in the high cost Bay Area, something Felix Tarnarider of Redwood City knew before he launched MisterSoftee NorCal almost three years ago. He’d had a career in tech before he decided to venture into the ice cream business by bringing MisterSoftee to the Peninsula. MisterSoftee was founded in 1956 in Philadelphia and is all over the Northeast. Tarnarider grew up in New York and well remembers as a kid hearing the ice cream truck coming and begging his parents for money – quick – so he could get a MisterSoftee before the truck moved on.  

When his fleet of five trucks (soon to be six) goes to corporate and public events, fundraisers and birthday parties, he sees customers lined up who have tears in their eyes because of nostalgia. (He’s also been surprised how many more have never heard of the brand.) When Tarnarider was a kid, the whole neighborhood would swarm the MisterSoftee truck, and he sees his business as a service that can help bring neighbors together.  “I hope it becomes a neighborhood staple,” he says.  

On top of the challenges that others in the food service industry have finding good, dependable employees and paying soaring rents, the ice cream business is seasonal. By late November, the weather gets cooler and the days are shorter, so Tarnarider’s business goes into kind of a hibernation, which he uses for things like catching up on truck repairs, although MisterSoftee trucks are still on the road for things like Thanksgiving and tree-lighting events. Meanwhile, Tarnarider is marketing to sponsors of public and private events about his capability to cater MisterSoftee for indoor parties and celebrations year-round. “Statistics show that people eat more ice cream in the winter than in the summertime,” he says. Instead of licking a dripping cone outdoors, people can sit indoors and eat.  

MisterSoftee is by no means all plain vanilla. There’s chocolate dip, cherry and Oreo dust cones, to name a few, plus sundaes and shakes, and a recent addition, sprinklings of “crunchies.” The company also has an app so ice cream fans can track the neighborhood truck in real time. No need for frantic appeals to mom and dad. Check it out at  

 This article was originally published in the November print edition of Climate Magazine. 

Man gets probation for lewd act case at Pump It Up in Belmont

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An 18-year-old man charged with taking inappropriate photos of a 7-year-old girl at a Pump It Up play center in Belmont and also sexually assaulting a 14-year-old girl was sentenced Friday to five years of supervised probation, according to prosecutors.

Tavi Benelli of Belmont was arrested in April after prosecutors said he lured a 7-year-old girl into a room at the Pump it Up bounce house center at 1309 Elmer St. in order to take inappropriate photos of her. Benelli reportedly told the girl, who had been at the play center with her nanny, that she had a scratch and that he could put a band-aid on it, prosecutors said. She liked band-aids, so she went with him, and while there Benelli told the girl to “turn around and start jumping up and down,” said prosecutors. Benelli then reportedly took photos of the girl’s behind and later told her she had a dead bug on her behind before touching her, claiming to brush it off.

The girl left the room and reported the incident to her nanny, who called police. When deputies asked to see Benelli’s cellphone, he “turned away and tried to delete the pictures,” prosecutors said. The deputy took the phone and found multiple pictures of the victim, which Benelli acknowledged was done for sexual gratification, prosecutors said.

The following month in May, Benelli faced additional charges after a 14-year-old girl came forward saying he sexually assaulted her for four months after they’d met through friends.

Benelli’s no-contest plea came with a sentence of five years probation and no jail time beyond the 182 days he’s already served. As part of his sentence, he must “register as a sex offender, have no contact with confidential victim number two, have no interaction with minors, submit to warrantless search and seizure and random polygraph tests, not enter stores selling pornography or possess pornography, and obtain Probation Department approval for any employment or change of address,” according to prosecutors.

Photo credit: San Mateo County Sheriff’s Office

Food for Fines starts today at County libraries

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Starting today, you can clear your pesky library fines with a food donations at participating San Mateo County libraries.

The Food for Fines program will be offered at city, county and college libraries throughout San Mateo County through Dec. 31.

Donations of non-perishable food items at libraries listed below will come with the reward of waived fines (although not for lost or damaged items). All collected foods will be donated to the Second Harvest Food Bank.

Foods must be in store-sealed cans, boxes or plastic containers within its expiration date, and no glass containers, perishable food or opened containers are allowed.

Participating libraries include:

Redwood City DowntownFair OaksSchabergRedwood Shores


Canada CollegeCollege of San MateoSkyline College

BayshoreJohn DalySerramonteWestlake


AthertonBelmontBrisbaneEast Palo AltoFoster CityHalf Moon BayMillbraePacifica SanchezPacifica Sharp ParkPortola ValleySan Carlos

San Mateo City Downtown MainHillsdaleMarina

Main Library, Grand Avenue

For more information call 650-780-7020

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