She was always tired and developed severe swelling in her feet and lower legs. The swelling became so bad that she could no longer wear her shoes. One day, she could not even walk from her second-floor apartment to her car without stopping to catch her breath.

“I felt like I had cement in my lungs,” Guajaca recalled.

She went to the emergency department and learned she had congestive heart failure.

Heart failure is a serious condition in which the heart cannot pump enough blood to meet the body's needs. Guajaca's ejection fraction, a measure of how well the heart pumps blood, was just 13%. A normal ejection fraction is typically between 50% and 70%.

Over the next year, she visited different emergency departments throughout Sacramento at least twice a month. Doctors treated her with IV diuretics to remove excess fluid from her body, but the relief never lasted long.

“I thought it was an easy fix,” she said. “But they told me that every time this happened, it could make my heart weaker.”

Everything changed when Guajaca came to the UC Davis Health Department of Emergency Medicine. There, she found a team that not only treated her symptoms but also gave her reassurance that things would get better. She remembers her doctors telling her that with the right care, it was possible for her condition to improve.

“Before that, I didn't think there was any hope,” she said.

Guajaca was referred to the Comprehensive Heart Failure Program at UC Davis Health. The heart failure team worked to adjust her medications, address factors affecting her health and help her succeed long term. Most importantly, she said, they listened to her concerns.

“I was able to speak up for myself without feeling judged,” Guajaca said. “That built trust. We were a team fighting my condition together.”

Guajaca is now 34 years old, and has received a left ventricular assist device (LVAD), so she no longer lives with the constant fear of fluid buildup. She takes part in cardiac rehabilitation, working to rebuild her strength and improve her health. She also enjoys everyday activities that once felt out of reach. While she knows a heart transplant may still be in her future, she is grateful for the care that gave her a second chance.

“The heart failure team is amazing,” she said. “They truly care about you and your situation. Everyone there wants to help you get better. They saved my life.”

Spotlighting women's heart health at the Heart Failure Summit

For Guajaca, access to a coordinated team of specialists helped transform a life-threatening diagnosis into a path toward recovery. Her story reflects the approach at the Comprehensive Heart Failure Program at UC Davis Health, where a multidisciplinary team provides comprehensive, patient-centered care for people living with heart failure.

The program brings together experts in cardiology, advanced heart failure, transplant medicine, nursing, pharmacy, rehabilitation and supportive care to provide personalized, evidence-based treatment. By combining advanced therapies, innovative treatment options and coordinated care across inpatient and outpatient settings, the team works to improve outcomes and quality of life for every patient.

As part of its commitment to advancing heart failure care, the program hosts the annual UC Davis Health Heart Failure Summit. The Summit serves as a forum for medical professionals to exchange quality improvement and research findings important to improving understanding and outcomes related to cardiovascular care.

This year’s summit will spotlight women’s cardiovascular health and stories like Guajaca’s. The summit seeks to highlight the importance of early recognition, specialized treatment and long-term support for women living with heart disease.

“Improving cardiovascular outcomes for women requires a life-course approach, one that begins with prevention and continues through the treatment of heart failure and advanced cardiovascular disease later in life,” said Imo Ebong, professor of clinical internal medicine at UC Davis Health and advanced heart failure cardiologist for Christina Guajaca.

This focus aligns closely with California's efforts to reduce maternal mortality and improve the health of women and families throughout the state.

The keynote speaker for this year’s UC Davis Health Heart Failure Summit is Diana Ramos, California surgeon general. Ramos leads the Strong Start & Beyond initiative, which aims to improve maternal and infant health by addressing preventable maternal morbidity and mortality and creating healthier beginnings for California families.

Register today for the Heart Failure Summit to be part of the conversation to advance knowledge, inspire collaboration and improve cardiovascular care for patients across California like Guajaca.

For decades, health experts would gain insight into the disease only after a person died, when they could study the brain tissue and make a definite diagnosis.

Today, biomarker tests, including amyloid PET scans, can detect hallmark amyloid plaques in living patients and help guide diagnosis and care.

But the scientific progress has created a new question: What happens when patients and families receive that potentially life-altering information about what is happening in their brains?

Jennifer Lingler, associate dean for research at the Betty Irene Moore School of Nursing at UC Davis, has spent years seeking answers.

“We need to understand what this means in the real world,” Lingler said. “We still don’t know how this information affects your everyday patient and family.”

During this Breast Cancer Awareness Month, UC Davis Health is once again offering free mammograms to improve access to lifesaving screening. The program is made possible by the Department of Radiology and UC Davis Comprehensive Cancer Center. The screening mammograms are open to members of the community who do not have insurance or who have insurance but can’t afford the cost or the copay.

This year, UC Davis Health has expanded its program, offering more appointments with the goal of reaching even more patients than in years past.

Free screening mammograms

The free mammograms will be available on weekends: Oct. 10, 11, 17 and 18. They will take place from 7 a.m. – 3:30 p.m. at the Lawrence J. Ellison Ambulatory Care Center, 4860 Y St., Sacramento. Mammograms are available by appointment only.

“Regular screening mammography can help find breast cancer at an early stage when treatment is more likely to be successful,” said Marissa Bashore, health education supervisor for the cancer center’s Office of Community Outreach and Engagement. “We encourage those age 40 and older to talk with their healthcare provider about breast cancer screening and stay up to date with their mammograms.”

In Sacramento County, about a third of eligible individuals are not up to date on their breast cancer screening, Bashore said.

Who is eligible for the free screenings?

The mammograms are available for those ages 40-74 who have not had a mammogram in the past year and are not experiencing symptoms.

People with symptoms such as a lump, breast pain, swelling or nipple discharge may need a diagnostic mammogram — a different kind of test. They may also need other testing and should talk with a healthcare provider.

UC Davis Health has partnered with Wellspace Health to help connect patients with additional testing or follow-up care, if needed.

How to schedule your free screening mammogram with UC Davis Health

Appointments are required and are offered on a first-come, first-served basis. To request an appointment, call 916-734-0655, Monday through Friday, from 8:30 a.m. to 5 p.m. Ask to schedule a free Breast Cancer Awareness Month screening.

Language interpretation services are available.

Appointments fill quickly, so those interested are encouraged to call as soon as possible.

Read why it’s so important to get regular breast cancer screenings

UC Davis Health free screening mammogram details

When: Oct. 10, 11, 17 and 18, 7:30 a.m. – 3:30 p.m.

Where: Lawrence J. Ellison Ambulatory Care Center, 4860 Y St., Sacramento.

Who: Those ages 40-74 who are uninsured or can’t afford the cost.

How: Appointments are required. Call 916-734-0655, Monday through Friday, from 8:30 a.m. to 5 p.m. Ask to schedule a free Breast Cancer Awareness Month screening.

The UC Davis Translational Brain Tumor Center connects expertise from the UC Davis Weill School of Veterinary Medicine and UC Davis Comprehensive Cancer Center to study brain cancers across species. By combining laboratory research, veterinary clinical trials and human medicine, the center aims to shorten the path between scientific discoveries and treatments that can reach patients.

“Ultimately, success from this center will come back to the patient,” said Michael Mison, associate dean for Veterinary Medical Center operations and chief veterinary medical officer. “It’s the day when a family sitting across from one of our clinicians hears something they might not hear today: ‘We now have better options.’ That’s why this matters.”

Clinical trials offer new options for dogs

The center launches with clinical research already underway. Two National Cancer Institute-funded studies are recruiting dogs diagnosed with or suspected of having glioma, a type of brain tumor.

The CARE trial is evaluating an experimental drug intended to make glioma cells more vulnerable to radiation therapy. The PRISM trial is tracking the progression of canine gliomas and combining clinical information with genetic and immune profiling. Researchers hope the study will identify tumor subtypes that could eventually support more personalized treatment for dogs and more precise translation of findings to human patients.

Those trials join other cancer-related clinical trials available at the school. In June, the school profiled a certified therapy dog named Luna who received treatment through a clinical trial investigating fluorescence-guided surgery to remove canine brain tumors. The 9-year-old Maltese is back to work, bringing her calm nature to healthcare centers, schools, airports and other places. 

For dog owners in the Sacramento region and beyond, the trials may provide access to specialized care, advanced imaging and investigational therapies. The information collected could also help researchers better understand why brain tumors grow, resist treatment and respond differently from one patient to another.

“This center is something very exciting for us in the brain tumor research and treatment field,” said Orin Bloch, director of the Brain Tumor Program at UC Davis Comprehensive Cancer Center and professor in the Department of Neurological Surgery, “and something that is elevating UC Davis to the next level.”

Why study brain tumors in dogs?

Many early cancer studies rely on laboratory models that cannot fully reproduce the complexity of naturally occurring disease.

Companion dogs develop brain tumors that share important characteristics with human cancers, including genetic changes, neurological symptoms, patterns of growth, treatment resistance and interactions with the immune system. Dogs also live in the same environments as people and represent a more genetically diverse population than laboratory animals.

Studying dogs receiving care for naturally occurring tumors allows researchers to evaluate new diagnostic tools and treatments under clinical conditions. The goal is not simply to use veterinary patients as models for human disease, but to develop knowledge and therapies that benefit both species.

Expertise across UC Davis

The center is led by specialists in veterinary neuro-oncology, radiation oncology, human neuro-oncology and therapeutic development. The team is developing a framework in which insights can move among laboratory research, veterinary clinical trials and human medicine. The center also supports advanced imaging, molecular research, biobanking, multidisciplinary clinical care and education in comparative neuro-oncology.

“We have remarkable expertise across UC Davis,” said Christine Toedebusch, the center’s director and a veterinary clinician-scientist specializing in neurology and comparative neuro-oncology. “The greatest advances will come from connecting that expertise around shared questions. The center creates a structure for investigators and clinicians to work together from the beginning rather than waiting until a discovery is ready to be handed from one field to another.”

“I was off. I was not myself. I was surviving one step at a time,” Music said. “I began trying to get medication help with a psychiatrist. I was not well. I was battling a lot of trauma.”

Her trauma back then, about 11 years ago, included being diagnosed with a case of gestational diabetes so unusual that it has been highlighted at national conventions. Around the same time, she was involved in a serious car crash and had severe preeclampsia, which ultimately led to the emergency cesarean section and preterm birth of her son.

She was diagnosed with complex post-traumatic stress disorder, a mental health condition that develops from chronic exposure to trauma.

When Music became pregnant again, she sought help for her perinatal mental health issues — but this time wasn’t alone in facing her challenges.

She was referred to the maternal-fetal medicine division at UC Davis Health for high-risk pregnancies. She received medication and a referral to a weekly support group for OB/GYN patients who are pregnant or postpartum with a mental health diagnosis.

The support group is called Connected.

“We started this as a medication management group to provide weekly check-ins and medication refills for our pregnant and postpartum patients with mood and anxiety disorders. Over time, the group grew. So has the demand,” said Shannon Clark, the doctor who treated Music for anxiety and depression when Music was eight weeks pregnant.

Clark, a UC Davis triple board-certified doctor in family practice, obstetrics and perinatal psychiatry, split care with maternal-fetal medicine physician and gestational diabetes expert Nancy Field.

Connected referrals come from across Northern California and joining the group only requires a consult with Clark’s clinic.

For many patients, Connected has been a lifeline, providing support through mental health challenges that can arise unexpectedly during pregnancy and the postpartum period and touch people from all walks of life.

The only support group of its kind in the Sacramento region

Clark and Elizabeth DeFazio, an obstetrics nurse who is also a marriage family therapist, created this free service, which is the only one of its kind in the Sacramento region.

The group has about 60 active members with an average of 10 people who attend each week. Patients can attend the group up to two years postpartum. A host of trained volunteers help facilitate the sessions.

The event, where each student received a surgical cap, was a key step for the inaugural class in the Doctor of Nursing Practice — Nurse Anesthesia program. After months of coursework, the 16 students are now shifting into the clinical phase of their training. So far, they have taken advanced science courses and spent hours in simulation practicing airway management, regional anesthesia, anesthesia crisis management and simulation experiences.

But the surgical cap is only part of the story.

The students are in the first nurse anesthesia doctoral program in the University of California system and the sixth in California. The program has a clear goal: It was created to help meet a growing need for anesthesia care across the state.

California has nearly 40 million residents. As the population ages, more people will need surgery and other procedures that require anesthesia. The need for providers — whether anesthesiologists, anesthesiologist assistants or certified registered nurse anesthetists, known as CRNAs — is already growing faster than the supply. That gap could become much larger. By 2033, the nation could be short about 12,500 anesthesia providers.

UC Davis leaders say CRNAs — the professional role these graduates hope to attain — can help fill that gap. They are trained to provide safe anesthesia care in many settings. That includes areas where there are not enough doctors.

Preparing to serve California

The first UC Davis class includes students from Sacramento, the Bay Area, Ukiah, Fresno, Chico and San Diego. Program leaders say that range matters. It brings many views into the classroom and supports the school’s goal of serving the whole state.

The need for anesthesia care is also growing outside the traditional operating room. More procedures now take place in ambulatory surgical centers and other care settings. This includes the 48X Complex at UC Davis Health in Sacramento, one of the largest standalone ambulatory surgery centers in the country.

Nurse anesthetist doctoral Program Director Jakkarin “Jake” Sareerak reminded students at the capping ceremony that the next phase will require skill, focus and humility.

“Underneath all of those numbers is a person who has trusted you during one of the most vulnerable moments of their life,” Sareerak said. “For you, this may eventually become your third case of the day. For your patient, it may be one of the biggest days of their life.”

The first class builds the path

The ceremony also had special meaning because the inaugural class is setting the path for every UC Davis nurse anesthesia class that follows.

These 16 students entered with no alumni to call and no earlier class to show them what to expect. They are helping shape the program’s culture, standards and sense of community. At the same time, they are preparing for a field that demands skills, trust and sound judgment.

“Being part of the inaugural cohort carries a great deal of responsibility. We are helping establish the standard for the students who will follow us,” explained student Ray Lopez. “It is meaningful to know that our experiences will help shape a program that will educate future anesthesia providers for California.”

Dean Stephen Cavanagh echoed the fact that their role reaches well beyond campus.

“Our responsibility is not simply to prepare outstanding clinicians,” Cavanagh said. “It is to prepare a workforce capable of serving all of California.”

While the surgical cap symbolizes the start of a new phase of training, UC Davis marks the transition as a further step toward building the anesthesia workforce California will need for years to come.

“My goal is to bring the knowledge and experience gained at leading institutions to communities that may not otherwise have access to those resources,” Lopez added. “Regardless of location, every patient deserves the same safe, compassionate and excellent anesthesia care.”

The students will spend the next two years continuing coursework and clinical rotations at various UC Health campuses and other health systems across the United States, including Adventist Health Ukiah, Plumas District Hospital and Oak Valley Hospital in Oakdale. When they graduate in June 2028, they will have completed a scholarly project and a minimum of 2000 hours of clinical hours and will be prepared to sit for the National Certification Examination and become licensed Certified Registered Nurse Anesthetists.