Your symptoms are signals, not a weakness. The body knows how to heal once we identify and move whatever’s standing in its way.
About me…
Denise Pronesti, APRN, PMHNP- BC
Aloha! I am an Integrative Psychiatric Mental Health Nurse Practitioner, a veteran health care provider with decades of clinical and leadership experiences, also an Air Force veteran. However, my most important role ever has been as a mom of four amazing boys, one of whom lives with autism and a very rare genetic condition. Every part of that sentence shapes how I show up in this work for you.
This work is very personal.
I didn’t arrive here through theory and textbooks alone.
I arrived here because I needed answers—and they weren’t readily available.
When one son began regressing, at 18 months …. I did what most parents do.
I sought help. I was beside myself with worry.
What I found instead was a system that felt slow, fragmented, limited, and at many times very dismissive. I felt a sense of urgency, but we faced long waitlists (18 months for an evaluation with a developmental pediatrician, 4 years for ABA), providers unwilling to take on complex cases, and treatments that didn’t just fall short—but sometimes made things much worse.
I was told what was “normal and abnormal”. But not what was wrong with my son.
I was given labels, late in the journey. But I wasn’t given timely answers.
And I refused to accept that.
So, I took ownership. Radical ownership, like a momma Bear. A warrior Mom.
I went back to school for the third time. I immersed myself in understanding the body at a deeper level—studying integrative psychiatry, nutrigenomics, advanced functional laboratory testing, environmental medicine, and integrative, biomedical and holistic approaches to healing neuroinflammation and improving function.
What started as a search for answers for my son became something much bigger:
A commitment to never letting another parent feel as powerless as I once did.
About me: I value high quality, respect and integrity. My nursing career began at age 18, when I put myself through the University of North Carolina at Chapel Hill (Go Tarheels!) I earned a Bachelor of Nursing degree, then was selected for 2 highly competitive internships at the Medical College of Virginia in Richmond. I threw myself into Labor and Delivery, Neonatal ICU and the operating room, where my fascination with anatomy exploded. I loved open heart surgery, trauma, and organ transplant. I flourished in the rooms where the stakes were highest and collaborative teamwork was everything. I trained and became a RN First Assistant and was in heaven. Later a Director of surgery in numerous hospitals. I became an Adult APRN and then turned to health care administration, to raise my young family. When my son was ill and there were no answers, I delved into functional medicine, then integrative psychiatry.
During my early years, I was raised by a father who a MSgt in the Army and a Drill Sargent. He gave me structure. I also joined the service, the Air Force Reserves at Andrews AFB, D.C and trained as a flight nurse. I was deployed immediately in support of Operation Desert Storm. After seeing the world from the inside of transport planes, I decided to become a traveling nurse, driving solo in my red convertible across the USA to an assignment at a Navy Hospital in Oakland, California, eventually transferring to Travis AFB. I was deployed again for Operation Restore Hope and saw combat in Mogadishu, Somalia, the very setting later portrayed in the blockbuster movie, Black Hawk Down. I was promoted to the rank of Captain in the “MOG” and later was honored in the Women's Military Memorial in Washington DC. Serving our great country and caring for our military service members was such an amazing privilege and absolutely one of the greatest honors of my life! When folks say, “thank you for your service”, I always respond, no I was honored to serve, it was a privilege, and a transformative gift!
All of these experiences helped me build a high degree of resilience but also helped me to see issues with a different worldly perspective. I understand servant leadership, the absolute preciousness of life and I constantly search for all the joyful moments life can and will bring to us.
My Story
Protecting my own mental health after an intense deployment in Africa, I took a traveling nurse assignment in Hawaii and decided to make the Hawaiian Islands my forever home. I became the Chief Nurse of an Air Force medical unit and later the Chief of the Aeromedical Evacuation Team at JBPHH. I returned to school for a Master of Science in Nursing at the University of Hawaii (Go Bows!) and became licensed as an Adult Nurse Practitioner. I worked in acute care facilities and federally qualified health centers, in both clinical and administrative roles, while raising my family. After 27 years of service, I retired from the military at the rank of Lt. Col. When the dust of the pandemic and home schooling ended, I went back to school again to train as a Psychiatric Mental Health Nurse Practitioner. (Yes, I am very mission and goal oriented, love being a life-long learner-which I carry into my practice).
The reason for that final degree is simple; it was out of necessity. When one of my 4 sons was diagnosed (late) with Autism, then PANDAS, then serious genetic issues, we would not have answers if I was not persistent. I spent 16 years learning functional medicine and trying to unravel his mystery illness. I did what any mom does when she has already been to war twice. I put my combat boots back on and fought for my child. I learned to turn over every rock.
I learned all about functional labs and found that we had been exposed to serious toxins. So, I studied harder learning about nutrigenomics, hard-core biochemistry, GI health, neuro modulation, how to correct sleep dysregulation (theirs and mine), nutrient imbalances, allergies, and immune dysfunction, quality supplements of every category, treatment protocols for mold, heavy metals, gasoline, and parasites. I often joke that I learned so many things I never knew I needed to know, but I would do it all over again to help my innocent children be healthy, happy, and to be able to learn in school without struggling.
I would treat every child as my own. I believe, together, we can change the trajectory of their individual futures.
That long road gave me what I now call an advanced lens. I can spot patterns, barriers, and possible solutions much faster, because I have intimately lived inside this chaotic situation for many years. When a parent walks into my office, having been awakened at 3 a.m., exhausted and afraid, I already know that dark hallway. I have stood in it. I know the worry, fear of the future, chaos, the stress. I bring that lived experience and understanding into every mom visit, alongside a deep empathetic toolkit. I believe symptoms are signals, not a personality or parenting weakness, and not to be ignored.
My promise to my patients is straightforward. I will ask the questions other providers did not ask, look everywhere and treat you as a collaborative partner rather than a chart needing to be completed. I will never recommend a treatment that I would not offer my own family. I am direct, but non-judgmental, and I am here to supportively dig for root causes and build a personalized plan, not throw spaghetti at the wall and see what sticks. I like foundational information. When you take your car to the shop, they run a diagnostic…we need to do the same in psychiatric care, not just evaluate by symptoms alone, metabolic clues are there.
I built this clinic, because this is what I envisioned for my own family years ago. It didn’t exist-so I built it.
When I am not in the clinic, you will likely find me on the beach listening to Hawaiian music, avoiding danger now…including red flag beaches, traveling somewhere new to keep up with all the cutting-edge medical developments, or with my family at the movies, laughing about something with my boys or having my dog walk me. My Christian faith is the thread that runs through all of it-it is my foundation. I believe every person, child or adult, is an energetic and sentinel being who deserves compassion, access to real answers, cutting edge therapies and most importantly, deserves the chance to thrive and live their best life ever.
The sign sitting at the front of my clinic captures it best. It reads, "Think outside. No box required."
If any of this resonates with you, I would be honored to walk this health journey with you and help you create your own blueprint and personalized road map forward. Let’s get you back to your best self!
MOM of 4 boys- the most important credential!
Bachelor of Nursing, University of North Carolina at Chapel Hill
Master of Science in Nursing, University of Hawaii, Honolulu Hi
Master’s, Psychiatric Nursing, Walden University, Minneapolis, Minnesota
Advanced Practice Nurse Practitioner: Adult Medicine & Psychiatric Mental Health
Functional Medicine and Integrative Psychiatry trained
Lieutenant Colonel (R) Flight Nurse, United States Air Force Reserves/ HIANG
CREDENTIALS
Together, we can dig…. for answers!