FREE Take One | GRATIS Tome Una JULY/ SEP 2009
Una Causa Común: Combatir el Cáncer Cuatro extraordinarias latinas del Dana Farber Cancer Institute de Boston comparten sus experiencias
A Common Cause: Fighting Cancer
Ana Valdez Member, Grupo de Apoyo en Español
Four remarkable Latinas from Boston’s Dana Farber Cancer Institute share their experiences
Magnolia Contreras Co-facilitator, Grupo de Apoyo en Español
Marissa Torres-Arzayus, Ph.D. Researcher
Photos: Melissa Ostrow
Rachel Allende Co-facilitator, Grupo de Apoyo en Español
y Familia Salud New England’s bilingual health magazine
Lunes
Martes
Miércoles
Jueves
Viernes
Visite 3aldia.org para obtener más sugerencias fáciles y deliciosas, así como recetas para toda la familia, de 3-Al-Día. Salud y Familia | 2
JULY / SEP 2009
“Power of 3” Planner Power up your day with 3-A-Day – that‘s three servings of milk, cheese or yogurt for stronger bones and better bodies. This planner offers dairy-licious ways to pique your palate and pack a nutrient punch every day of the week. Try milk, cheese or yogurt in fat-free and low-fat varieties to meet your taste and nutritional needs. For an easy way to recall serving sizes, remember 1 cup of milk, 1 cup of yogurt and 1-1 1/2 ounces of natural cheese. “Bone“ Appetít!
TM
Monday Breakfast
Lunch
Snack
Breakfast Smoothie: blend 1 cup of milk or yogurt, fruit and ice cubes
Pizza Roll Up: roll flour tortilla with 1-2 slices of part-skim Mozzarella cheese and tomato sauce for dipping
Yo On-the-Go: pick up a 10-ounce bottle of cherryflavored, drinkable yogurt
Tuesday Lunch
Snack
Dessert
Chicks Mix: combine 1 cup of plain yogurt and lowfat Ranch dressing mix for a dip with baked chicken tenders
Cheesy Popcorn: toss 1/4 cup of tangy lowfat Colby cheese shreds with popcorn
Banana Milksicle: freeze 1 cup of lowfat banana flavored milk in popsicle container
Wednesday Breakfast
Dinner
Dessert
Waffles That Wow: top whole wheat waffles with 1 cup of strawberry yogurt and berries
Cheesy Mac: bake a single serving of macaroni and top with 2 tablespoons of grated, robust Parmesan
Mousse Madness: stir together 8 ounces of lowfat chocolate milk and lite frozen whipped topping
Thursday Breakfast
Snack
Dinner
Milk Steamer: warm up 1 cup of flavored milk sprinkled with cinnamon
Super Snack: dunk fresh veggie sticks into 1 cup of yogurt mixed with taco seasoning
Ham and Cheese Quesadilla: layer 1/4 cup of shredded reduced fat Monterey Jack with slices of lean ham in tortillas
Friday Breakfast
Lunch
Snack
Egg-cellent Cheese Omelet: melt 1-2 slices of Cheddar or Provolone cheese in egg white omelet
Topped Tater: spoon lowfat chili and 1 cup of plain yogurt atop baked potato
Pretzel Wrap: roll a fat free pretzel rod in 1-2 slices of reduced fat Swiss cheese
For more easy and delicious 3-A-Day of Dairy tips and family-friendly recipes visit www.3aday.org. JULY / SEP 2009
Salud y Familia | 3
IN THIS ISSUE… EN ESTA EDICIÓN... •
Children’s Health / Salud Infantil
The ABCs of Dyslexia Características de la Dislexia P4-P5 ----------------------------------------• Oral Health / Salud Dental Help Your Child Fight Tooth Decay Ayude a su Hijo a Combatir las Caries P7-P8 ----------------------------------------• Healthy Stories / Historias Saludables A Common Cause: Fighting Cancer Una Causa Común: Combatir el Cáncer P10-P13 ----------------------------------------• Life Style / Estilo de Vida A Cultural Approach to Diabetes Treatment Un Enfoque Cultural para Aliviar la Diabetes P14-P15
Editor Marcela García mgarcia@healthandfamilymagazine.com (617) 937-5921 Partners Neighborhood Health Plan Children’s Trust Fund Dana Farber Cancer Institute Contributors Margarita Persico Melissa Ostrow Ricardo Herreras Manuel Álvarez Graphic Design Jhosmer Hernández Health & Family is Published By El Planeta Publishing A Phoenix Media/ Communications Group Company Sales Cindy Campbell ccampbell@healthandfamilymagazine.com (617) 937-5922 Marketing Raúl Medina raulm@healthandfamilymagazine.com (617) 937-5919 Subscriptions (617) 937-5900 EL PLANETA PUBLISHING 126 Brookline Avenue Boston, MA 02215 Phone: (617) 937-5900 Fax: (617) 933-7677 www.healthandfamilymagazine.com
Salud y Familia | 4
Special Education: The ABCs of Dyslexia * Children’s Trust Fund Dyslexia is a language-based learning disability that affects reading and writing skills by causing children and adults to have difficulty in associating letters and words with their sounds. Dyslexia is a brain-based disorder, and can occur even in very bright people. It is unclear what causes the frustrating problem, but it appears that the brains of people with dyslexia write information in a less efficient way. Dyslexia is hereditary (it runs in families). It is estimated that up to 20% of people in the US have difficulty reading, and the majority of these individuals have dyslexia. At this time, there is no cure for dyslexia, but there are many ways to help your child manage the problem and succeed. Diagnosing dyslexia. Most preschoolers being to recognize letters and numbers, and they gradually remember the sounds associated with each letter. By age 6-7, most children are ready to sound out words and begin reading simple books. Some signs of dyslexia in young children include difficulty with handwriting, trouble learning letters and numbers, trouble with rhyming, difficulty reading and writing one’s name, struggling with speech, or trouble remembering words. Dyslexia is generally diagnosed when a child is in elementary school, but in some cases it becomes more apparent later on when reading comprehension and grammar are more important. Older children may read and spell below their grade level, have difficulty with math, or struggle with reading and writing. Chances are your child’s teacher will notice signs of dyslexia before you do. The disorder is diagnosed through an evaluation by a reading or educational specialist, or school psychologist usually employed by the school system. Treating young children. If you notice that your preschooler is having difficulty learning how to talk, tell your
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Children’s Health
pediatrician as soon as possible. Language-related problems such as communicating verbally and learning to sound out letters and words can have less severe consequences if treatment is begun early. Children who have early language problems also may have more difficulty in learning how to read and write. There are early intervention programs and school-based evaluations that are available even to very young children with possible delays. There are speech-language therapists and reading specialists who work in schools with children who suffer from dyslexia. They will break things down into smaller steps for your child, work with him in a smaller and quieter environment, read material to him, or use instructional aids such as books with big print or specially lined paper. Treating older children. As your child enters higher grades, there is more and more emphasis on reading and written communication at school, and some homework assignments may be challenging. She may become more self-conscious about her difficulty. Sometimes children with dyslexia experience low self-esteem and assume they are not as smart as others because of this. Children with dyslexia are entitled to assistance in public school from a reading specialist or tutor. Work with your child’s teach-
ers to find strategies that help her complete her work. These can include using books on tape or a tape recorder, allowing some assignments to be modified slightly, not penalizing her for spelling mistakes, having her type written work with a word processing program that has a spell checker, helping her take notes (or obtaining a copy of class notes from a teacher or classmate), clarifying written instructions, and providing help with organizing and writing papers and long-term projects. How you can help your child. Although your child may not enjoy reading because it is difficult, reading is important for both younger and older children and helps in developing their creativity, listening skills, and ability to understand things. You can continue to read to your child, even when he is older. You can also encourage him to read something fun, like a magazine. It is important that you support your child’s interest in non-academic activities that she enjoys and is good at to build her self-confidence. While academic work may remain a challenge, bright children with dyslexia often go onto college, where there is also support for challenges like dyslexia. Compiled by Sunindia Bhalla and reviewed by Dr. Betsy Busch, MD. For more information, visit www.OneToughJob.org. JULY / SEP 2009
Salud Infantil
Educación Especial: Características de la Dislexia La dislexia es un problema de aprendizaje relacionado con el lenguaje que afecta la capacidad de leer y escribir correctamente. Esta afección hace que niños y adultos tengan dificultad para asociar símbolos escritos (como letras y palabras) con sus correspondientes sonidos. La dislexia es un trastorno cerebral que puede manifestarse en personas muy inteligentes. No se sabe claramente cuáles son las causas de este problema, pero, al parecer, los cerebros de las personas que padecen dislexia procesan la información lingüística (especialmente la escrita) menos eficazmente. La dislexia es hereditaria (se transmite dentro de la familia). Se calcula que en Estados Unidos, un 20% de personas tienen dificultades para leer, y la mayoría de éstas padece dislexia. Actualmente no existe una cura para la dislexia,
pero sí existen diferentes maneras de ayudar a su hijo/a a controlar el problema para que pueda tener un buen rendimiento académico. La detección de la dislexia Existe una edad normal en la cual la ma-yoría de los niños están preparados para aprender a leer. La mayoría de los niños en edad preescolar empiezan por reconocer letras y números, y poco a poco van recordando los sonidos asociados con cada letra. Entre los 6 y los 7 años, la mayoría de los niños están preparados para pronunciar palabras y comenzar a leer libros simples. Algunos de los síntomas de dislexia en los niños en edad preescolar son: dificultad para escribir, problemas para aprender letras y números, problemas con las rimas, dificultad para leer y escribir su nombre, dificultad para articular
Beneficios de Seguro Social por Incapacidad y Accidentes de Automóvil Abogados: BAIN D. TESTA, Esq. D. LANCE TILLINGHAST, Esq.¹ ¹Abogado certificado por el National Board of Social Security Disability Advocacy* * Una organización privada cuyos niveles no son regulados por el estado de Massachusetts que certifica abogados.
Ayudamos a los clientes con el proceso de aplicación y también con el proceso de apelación para beneficios del Seguro Social.
Citas disponibles por teléfono.
Si no gana su caso, NO tiene que pagar. Llame gratis al 1-800-363-7186 Wyskiel, Boc, Tillinghast & Bolduc, P.A. JULY / SEP 2009
o pronunciar palabras y problemas para recordar palabras. La dislexia generalmente se diagnostica cuando un/a niño/a está en la escuela elemental, pero en algunos casos se detecta más tarde, cuando la comprensión de la lectura y la gramática cobran más importancia en el plan de estudios. Los niños más grandes pueden leer y deletrear a un nivel inferior al de su grado, pueden tener dificultad con las matemáticas (especialmente problemas con las palabras) o puede costarles leer y escribir. Es muy posible que el/la maestro/a de su hijo/a detecte los síntomas de dislexia antes de que usted lo haga. El trastorno se diagnostica mediante una evaluación realizada por un/a especialista en lectura o educación, o por un/a psicólogo/a escolar, generalmente contratado/a por el sistema escolar.
Tratamiento para los niños en edad preescolar Si usted observa que su hijo/a en edad preescolar tiene dificultad para aprender a hablar, avísele al pediatra lo antes posible. Sabemos que los problemas relacionados con el lenguaje (como aprender, comunicarse verbalmente y aprender a pronunciar letras y palabras) pueden tener consecuencias menos graves si se comienza pronto con el tratamiento. Existen programas de intervención temprana y evaluaciones que se realizan en la escuela, incluso para niños muy pequeños con posibles retrasos. También hay fonoaudiólogos y especialistas en lectura que trabajan en las escuelas con los niños que padecen dislexia. Para obtener más información en español sobre el proceso de educación especial y la dislexia, consulte espanol.onetoughjob.org.
Junio 27, 2009 Día Nacional de Consejería y Prueba del VIH Estamos muy orgullosos de servir a nuestra comunidad por más de 22 años, y de seguir dando servicios de salud en las áreas de: • Educación/Prevención del VIH • Prueba Rápida, gratuita y confidencial del VIH ¡Conozca su resultado en solo 20 minutos! • Clínica de Salud Mental Todos nuestros servicios son CONFIDENCIALES Para obtener más información acerca de nuestros servicios, por favor comuníquese con nosotros al siguiente número:
617-350-6900 ext 144 Si desea más información acerca de nuestros servicios visite: www.lhi.org, o cualquiera de nuestras oficinas
LHI Boston 95 Berkeley St., 6th Fl. Boston, MA 02116
LHI Brockton 142 Crescent St. Brockton, MA 02302
LHI Lowell 9 Central St., Ste. 400 Lowell, MA 01852
Latin American Health Institute Instituto de Salud Latinoamericana
Salud y Familia | 5
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Knows what’s important to me.
NHP offers you: ° Coverage for routine visits, checkups, specialty and emergency care. ° Access to a top provider network. ° Special member programs.
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Salud y Familia | 6
JULY / SEP 2009
Oral
Health
Help Your Child Fight Tooth Decay You, as a parent, play an important role in helping your child fight tooth decay - learn how Did you know that one of the most common childhood diseases is tooth decay? More than half of American children have had at least one cavity by age 5. And, by the time an American child is 17 years old, on average, he has had eight cavities. The good news is that you can help your child fight tooth decay. First, you can make sure your child follows the right eating and drinking habits, to prevent sugar buildup on teeth. Then, you can help your child care for her teeth. You play an important role in helping your child fight tooth decay. You can do this by choosing healthy foods, teaching your child how to keep teeth clean and visiting the dentist for regular check-ups.
Caring for the teeth should start as soon as baby teeth come in. It is important to start caring for baby teeth to avoid developing cavities before grown-up teeth come in, and to avoid problems with tooth spacing later in life. Help your child avoid cavities by choosing nutritious foods instead of sugary, sticky foods. Teach your child to brush their teeth at least twice a day to prevent cavities from developing early. A soft-bristle brush with a pea-sized amount of toothpaste is recommended. Remember to replace the toothbrush every six months. Finally, be sure to take your child to the dentist for a check-up every six months to make sure that any dental problems are spotted.
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* Neighborhood Health Plan
For Dental Health AVOID: 1. Putting your child to bed at night or during naps with a bottle containing milk or juice. This can lead to severe dental cavities later.
2. Poor care of teeth. Be sure to ask your pediatrician or dentist how to care for your baby’s mouth and child’s teeth properly. 3. Diets high in sugar. Avoid giving
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Salud y Familia | 7
Salud
Dental
your child candy, cookies, and sticky food between meals. 4. Diets without fluoride. Ask your child’s dentist or doctor about supplements. Did You Know? Tooth decay is the most common chronic childhood disease - five times more common than asthma. Not taking care of this disease will result in cavities, pain, and infection, which can lead to serious problems. The one good fact about dental decay and oral disease are highly preventable! A New Way to Help Your Child Fight Tooth Decay: Flouride Varnish You may be able to have fluoride varnish put on your child’s teeth by their
doctor. Ask your child’s doctor about this option. This service is mostly for children up to age three; the younger the child is when the varnish is applied, the better. If they do not have a dentist, young adults up to age 21 may also be treated by their doctor. (Before October 1, 2008, this service was only done in a dentist’s office.) Applying fluoride varnish is simple and painless. Big advantages include: 1. Varnish now comes in child-friendly flavors. 2. Doctors find it easy to use and fast to apply. Fluoride varnish can be swabbed directly on the teeth in less than three minutes. 3. Fluoride varnish is safe. Only a small amount is used.
4. It can be applied in the doctor’s office. Fluoride varnish provides an added benefit for children; however, it does not take the place of toothpaste. Ask your doctor about fluoride varnish during your child’s next visit. Your doctor may perform an oral health risk check, give oral health advice and may even refer your child to a dentist. Note: Fluoride varnish can also be applied at your medical provider’s office, clinic or other communitybased setting by other properly trained medical professionals such as Physicians Assistants, Nurse Practitioners, Registered Nurses, and Independent Nurse Practitioners.
Healthy Tooth Foods If your children aren’t allergic to the following foods, these foods contain nutrients that strengthen teeth. • Vegetables • Yogurt • Peanut Butter • Milk • Cheese
Not-So-Healthy Tooth Foods These foods contain sugar and other substances that can contribute to cavities. • Soda Crackers • Bread • Pretzels • Candy (and other sugary food)
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Ayude a su Hijo a Combatir las Caries
¿Sabía usted que una de las enfermedades más comunes de la infancia son las caries? Más de la mitad de los niños norteamericanos han tenido al menos una caries a los 5 años, y para cuando han cumplido 17 años, ya han tenido ocho. Pero la buena noticia es que usted puede ayudar a sus hijos a combatir las caries. Lo primero es asegurarse de que sus niños tengan los hábitos alimenticios correctos para prevenir la acumulación de azúcares en los dientes. Partiendo de esta base, ya puede ayudarles a cuidar sus dientes. Usted, como padre, puede emSalud y Familia | 8
pezar escogiendo alimentos saludables o enseñando a sus hijos cómo mantener la boca limpia antes de acudir al dentista. El cuidado dental debe comenzar en cuanto aparecen los dientes de leche. Es importante comenzar a cuidar la boca desde el inicio, para evitar el desarrollo de cavidades antes de la aparición de los dientes adultos. Ayude a sus hijos a evitar las caries escogiendo productos alimenticios nutritivos en vez de productos con mucha azúcar. Enseñe a sus hijos a cepillar sus dientes al menos dos veces al día para impedir el desarrollo de cavidades prematuras. Lo recomendado es un cepillo de cerda suave con una cantidad de pasta de dientes del tamaño de un guisante. Además, acuérdese de cambiar el cepillo de dientes cada seis meses. Finalmente, asegúrese de llevar a sus hijos al dentista para un chequeo cada seis meses para asegurarse de que cualquier problema dental es tratado y cuidado. Para unos dientes saludables, EVITE: 1. Poner a sus hijos a dormir con una
botella de leche o jugo, pues esta es una de las principales causas de caries. 2. Un pobre cuidado dental. Pregunte a su pediatra o dentista acerca del cuidado bucal de su bebé y de sus hijos mayores. 3. Dietas altas en azúcares. Evite dar caramelos, galletas y dulces a sus hijos entre comidas. 4. Dietas sin fluoruro. Pregunte a su doctor acerca de suplementos alimenticios adecuados. ¿Sabía qué? Las caries son la enfermedad crónica más común de la infancia - cinco veces más común que el asma. El no atender esta enfermedad puede causar dolor e infecciones que, a la larga, puede conducir a problemas serios. Pero lo bueno de los problemas dentales y de las caries es que son fácilmente prevenibles. Una nueva fórmula de combatir las caries: barniz de flúor Usted puede pedir a su doctor que ponga barniz de flúor en los dientes de sus hijos. Pregúntele al doctor sobre esta opción. Este servicio es sobre todo para niños hasta los 3 años; el barniz es más efectivo
cuanto más temprano se le aplique al niño. Los jóvenes hasta la edad de 21 también pueden ser tratados. Aplicar barniz de flúor es fácil y no duele. Entre sus ventajas están: 1. El barniz viene con sabores del gusto de los niños. 2. Los doctores lo aplican de manera fácil y rápida. El barniz de flúor puede ser aplicado directamente en los dien-tes en menos de tres minutos. 3. El barniz de flúor es seguro. Sólo una pequeña cantidad es usada y aún menos es tragada. 4. Puede ser aplicada en cualquier consulta. El barniz de flúor proporciona una ventaja extra para los niños; sin embargo, no puede ser considerado como sustituto del dentífrico. Pregunte a su doctor sobre el barniz de fluoruro en su próxima visita. Nota: El barniz de flúor también puede ser aplicado en la consulta de su proveedor médico, en una clínica o por otros profesionales correctamente entrenados como médicos o ayudantes, enfermeras practicantes, enfermeras tituladas. JULY / SEP 2009
Presentamos CeltiCare: el nuevo plan de seguro de salud de Commonwealth Care. Diseñado específicamente para personas que trabajan duro con ingresos limitados, CeltiCare es la opción más novedosa disponible ofrecida por Commonwealth Care: el programa estatal que ayuda a los residentes de Massachusetts a encontrar una cobertura de salud económica. CeltiCare le ofrece más beneficios y le ahorra dinero:
· · ·
Los mismos beneficios y servicios de alta calidad que los planes más costosos Primas más bajas que las que se pagan por otras opciones de Commonwealth Care Un innovador programa de recompensas que le permite ganar hasta $125 por cosas que usted ya hace, y usar ese dinero para las primas mensuales, los copagos y más.
Para inscribirse en CeltiCare o para obtener más información sobre todas las opciones de su plan de salud Commonwealth Care, llame al servicio a clientes de Commonwealth Care de lunes a viernes de 8 a.m. a 5 p.m. al 1-877-MA-ENROLL (1-877-623-6765), Teletipo 1-877-623-7773, o visite www.MAhealthconnector.org. Para más información sobre CeltiCare, llame al número gratuito 1-866-895-1786 (Teletipo 1-866-614-1949) o visite www.CeltiCareHealthPlan.com.
CeltiCare. La nueva opción para el cuidado de la salud económico.
Información sobre cáncer en español. Encuentra lo último en información y noticias sobre el cáncer en nuestra nueva página de Internet en ESPAÑOL: http://espanol.dana-farber.org Visita nuestra página web para: • Encontrar información sobre el cáncer • Encontrar información sobre grupos de apoyo • Aprender cómo recibir servicios • Aprender cómo entender diagnósticos • Encontrar información sobre servicios de intéprete
Visita nuestra página de Internet:
espanol.dana-farber.org JULY / SEP 2009
Salud y Familia | 9
Healthy
Stories
Helping Latinas Fight Cancer in Spanish Launched late last year, a support group conducted in Spanish is the only one of its kind in the area * Margarita Persico Ana Valdez had an erroneous believe about cancer that laid a heavy emotional burden. “I thought it was something enormous and people would reject me because of my cancer,” says Valdez, who is on remission from lymphatic cancer. One day when she was very depressed, Valdez says as her eyes welled up, she called her physician’s secretary who recommended Valdez to join a recently formed support group. Assuring she would meet other Spanish-speaking women in similar situations, Valdez, who is from the Dominican Republic, joined the group. Valdez’s position is not unique, which is why Dana Farber Cancer In-
stitute launched a support group just for Spanish-speaking cancer patients and survivors. “We identified the need for the Latina patients at Dana Farber who needed additional support in terms of how they were dealing with their cancer diagnosis,” says Magnolia Contreras, director of community benefits and co-facilitator of the support group. For several years, this institution has been interested in providing a whole array of services to the Latino community with cancer who went for treatment and care, says Contreras, one of these is the cancer support group in Spanish. It is the perfect time for this, since Dana Farber has now
the human resources necessary for this task, she says – many employees are bilingual and bicultural. Contreras and Dr. Verónica Sánchez-Valera, a colleague at Dana Farber, started this program for Latina patients in December of 2008. The support group is held in Spanish, which is a good thing, says Valdez, since she would not attend an English-speaking support group because Spanish is her native language. Before launching this support group, they look at what other support groups were doing nationally. One of them was run by Californian psychologist Carmen Ortiz. The support group, Círculo de Vida, has been operating since 1992.
“She really wrote the book, literally, on how effective support groups are for women who were dealing with cancer,” says Contreras. “Hers was in specific to breast cancer. We broaden ours [support group] to all cancers because we believe that many of the issues that Latina women face are issues that they can relate with.” Much of the support they give these women happens on an individual basis, Contreras adds. They help them connect with each other on commonalities besides their diagnosis – they deal with the issue of race, family, culture, and their limitations in this country when dealing with a serious disease. “When I first came to the support group,” says Valdez in
Sunday, October 4 from 11am to 5pm
Domingo 4 de octubre de 11am a 5pm
present: “ The largest Multicultural Health Event in Boston”
Reggie Lewis Track and Athletic Center, Roxbury Community College 1350 Tremont Street Roxbury Crossing, MA 02120
FREE! / ¡GRATIS!
Don’t miss Salud y Familia 2009, the largest annual Hispanic and multicultural health and wellness fair in Greater Boston.
Save the date: Sunday October 4 from 11am to 5pm. No se pierda Salud y Familia 2009, el evento hispano y multicultural de salud y bienestar más grande de Greater Boston.
Marque la fecha en su calendario: domingo 4 de octubre de 11am a 5pm. 5pm.
Would you like to promote your products/brand/services in Health and Family? Sponsorship opportunities still available for all kinds of budgets. Contact us now before the space is sold out: sales@elplaneta.com or 617-937-5900
Salud y Familia | 10
JULY / SEP 2009
Spanish, “the moment I started speaking, I would start to cry, and I was very depressed, but time passed on and I met other people. It has fortified me.” Valdez says the meetings with other women who have similar situation have been a pillar. With these women she has learned much about herself and in spite of her obstacles as a single mother also caring for her aging mother, she is now emotionally and even spiritually stronger, she asserts. The Latina Dana Farber cancer support group meets monthly for an hour-and-a-half to educate members on common issues cancer patients face, though most of the meeting time is dedicated to patients sharing their stories and issues. Eleven women are part of this support group that discusses all types of cancer. But the challenge is getting them all into the meetings at the same time, says Contreras who assures this keeps her up at night. “These women have a lot of roles
Melissa Ostrow
Historias
Rachel Allende, Ana Valdez and Magnolia Contreras that they are trying to play while they are actually dealing with the serious illness,” says Rachel Allende, co-facilitator of the group. Some cannot make it to the meetings because of their illness, problems at home, work, childcare or transportation. “Many are in treatment and may not feel well enough to attend. Others become scared about something someone said in the group. There tends to be no shows after a death of
a group member,” wrote in an e-mail Carmen Ortiz, Ph.D., executive director of Círculo de Vida Cancer Support and Resource Center in San Francisco, an organization that has served over 5,000 Latinos since 1992. Ortiz is also the author of ‘A Guide to Developing and Sustaining Spanish Speaking Support Groups.’ “We normally have about five or six women who have tended to be the core group of people that have come to the group on an ongoing ba-
Saludables
sis. And the group is open, so every month we welcome any new women who wants to come in and join us,” says Contreras. For Valdez, the group meetings have been a personal success, she says. Members call each other, though they do not meet outside the monthly support group meetings, they speak on the phone. She remembers a Dana Farber support group colleague from Puerto Rico living in Worcester who sent her a book on depression. She says that gesture touched her. “This has helped me a lot dealing with my illness,” assures Valdez, who would like the meetings to be longer and more frequent, but would like to see also physicians as speakers to some of the meetings. Valdez’s outlook on life has changed. Even her relation with others has improved since she started meeting with the support group. “I learned to understand others better,” she added.
La mejor atención médica de la epilepsia infantil está en Boston.
Una nueva dimensión de cuidado, para una nueva perspectiva de la vida. Los médicos de Boston Medical Center son reconocidos a nivel internacional por su experiencia tratando casos de epilepsia infantil y otros desórdenes convulsivos. Como el principal centro de enseñanza afiliado a la Escuela de Medicina de Boston University, nuestro grupo de expertos provee el servicio más excepcional y cálido, desde el diagnóstico hasta los tratamientos médicos. Atención excepcional para niños excepcionales, como los suyos. Para más información visite BMC.org/exceptional o llame al 877-930-2288 (llamada gratuita). Boston Medical Center es el principal centro de enseñanza afiliado a la Escuela de Medicina de Boston University.
JULY / SEP 2009
Salud y Familia | 11
Healthy
Stories
Grupo Ayuda a Latinas a Combatir el Cáncer... en Español Ana Valdez tenía una creencia errónea sobre el cáncer que le causaba una angustia emocional enorme. “Yo pensaba que la gente me rechazaría por tener cáncer”, dice Valdez, quien actualmente está en remisión de cáncer linfático. Un día que estaba muy deprimida, Valdez llamó a la oficina de su doctor, y al hablar con la secretaria del mismo, ella le recomendó unirse a un grupo de apoyo recién formado, y la paciente, originaria de República Dominicana, se unió al grupo. La situación de Valdez no es única razón por la cual el Instituto de Cáncer Dana Farber creó un grupo de apoyo en donde se habla español para pacientes de cáncer y otros que lo han superado. “Identificamos la necesidad de las pacientes latinas de Dana Farber, ellas necesitaban un apoyo adicio-
nal”, dice Magnolia Contreras, directora de beneficios comunitarios y co-facilitadora del grupo. Contreras, junto a la Dra. Verónica Sánchez-Valera, lanzó el programa para pacientes latinas en Dana Farber en diciembre de 2008. El grupo de apoyo es en español. Antes de iniciar el grupo, ellas estudiaron lo que otros grupos de apoyo hacían en diferentes ciudades del país. Uno de ellos era el de la psicóloga Carmen Ortiz en California, quien fundó Círculo de Vida en 1992. “Cuando vine al grupo de apoyo al momento de empezar a hablar, yo sólo lloraba y me eso me deprimía”, dice Valdez. “Pero el tiempo pasó y empecé a conocer más gente. Todo esto me ha fortificado”. Valdez dice que las reuniones con otras mujeres en situación similar han sido un pilar. Con estas mu-
jeres ha aprendido mucho sobre ella misma. Ahora, ella se siente emocional y espiritualmente más fuerte. El grupo de apoyo en español para latinas con cáncer de Dana Farber se reúne mensualmente durante una hora y media para educar a las pacientes sobre temas relacionados con el cáncer, aunque la mayor parte del tiempo se dedica a que ellas compartan sus historias y preocupaciones. Once mujeres son parte de este grupo en donde se discuten todos los tipos de cáncer. Pero el desafío es juntar todas al mismo tiempo, dice Contreras. “Estas mujeres tienen diferentes roles en sus vidas y además tienen que lidiar con una enfermedad grave”, dice Rachel Allende, co-facilitadora del grupo. Algunas no pueden llegar a las reuniones debido a la propia enfermedad, problemas en casa, el
trabajo, cuidado de sus niños o el transporte. Para Valdez, las reuniones de grupo han sido un éxito personal. Las participantes se llaman por teléfono la una a la otra regularmente. Ella recuerda que una participante puertorriqueña de Worcester le envió un libro sobre la depresión. El gesto la conmovió, según dice. “Esto me ha ayudado mucho a manejar mi enfermedad”, asegura Valdez, a quien le gustaría que las reuniones fueran más largas y más frecuentes. También le encantaría que se invitara a doctores al grupo y que sirvieran como oradores. La perspectiva de Valdez sobre su vida ha cambiado. Incluso su relación con otros ha mejorado desde que empezó a asistir a las reuniones. “Aprendí a entender mejor a los demás”.
A Scientist by Vocation “My career goals are to better understand the complexity of cancer in order to contribute to the development of new drugs and treatments” When Dr. Marisa Torres-Arzayus was twelve years old she knew she would become a scientist. This happened in her native Bogotá, Colombia, when her friend’s father, a pharmacist and a medical doctor, invited them one day to his laboratory to demonstrate how medicines were prepared. “I loved all the little glasses and flask … I was fascinated,” says Torres-Arzayus smiling as she remembered her neighbor’s laboratory, which she compared to an “antique museum.” It was at that moment that Torres-Arzayus knew medical research would be her chosen career path. But following her dreams, she says, was not easy. Many well intended people including family memSalud y Familia | 12
Melissa Ostrow
* Margarita Persico
Dr. Marisa Torres-Arzayus bers and teachers tried to discourage her by saying, “You must make money before anything else,” or “Why don’t you do something easier? Why do you want to do a PhD?” Her advice to other people pursuing their dreams is not to give up. She has been pursing for ten years her dreams here and she has obtained much, but she is still reaching towards other goals. “I want to be independent, and I
want to have my own lab,” she says. After graduating with a bachelor’s degree in chemistry and pharmaco-logy from the National University of Colombia in Bogotá, she earned an award and a fellowship to attend Wye College at the University of London to pursue a master’s degree and a PhD. in Biological Sciences. After five years in England, she returned to Colombia to pursue her career, but at that time there were no opportunities in her scientific branch. That is when she decided to move to the U.S. Without a sponsor, nor a mentor, she pursued her own opportunities by “knocking at many doors,” she says. Then Boston University gave her an opportunity for a postdoctoral fellowship working for a year-and-a-half with DNA repair in
the microbiology department. “As a Latina you need to work harder,” says Torres-Arzayus who adds that as a researcher, working hard never stops. Nearly nine years ago she started working for Dana Farber Cancer Institute, a Harvard medical institution, where she is an instructor in medicine at the medical oncology department. There she works researching breast cancer. “My career goals are to better understand the complexity of cancer in order to contribute to the development of new drugs and treatments,” says Torres-Arzayus, whose mother owned a fashion retail business and her father, known to philosophy, was a manager in the auto industry. Torres-Arzayus says while workJULY / SEP 2009
Historias ing at Myles Brown’s laboratory at Dana Farber Cancer Institute with mouse models, she has made some significant contributions towards understanding breast cancer, which were published in the Cancer Cell Journal in 2004. “Later on I published another important paper demonstrating how a new drug could be used to treat the type of tumors developed in this mouse model. This was done in collaboration with researchers from the pharmaceutical company Novartis and published in the Cancer Research [Journal] in 2006,� she says. But Torres-Arzayus health interest extends beyond her laboratory work; she worries about her fellow Latinos who generally say they are too busy to attend to their own health needs. “If you feel changes in your body such as digestion issues or a lump in the breast,� she emphasizes, “do not say, ‘it’s not important.� Her advice to women is to take
responsibility of their health by doing the breast self examination, and to everyone else, she says to follow up with yearly wellness appointments. “We tend to minimize our own health issues. We are always thinking of others first,â€? says Torres-Arzayus. “This is very Latino.â€? On a personal tone, TorresArzayus says she still loves her first childhood interest. “I always wanted to cook. ‌ I love to improvise,â€? says TorresArzayus who loves to prepare ajiaco, a Colombian soup made with many types of potatoes, chicken and corn. Torres-Arzayus, the wife of a scientist, is the mother of eight-year old twin girls who are following her steps early on in life by enriching their vocabulary with scientific terms. “They are wonderful ‌ when I talk to my husband ‌ [the twins] listen to us,â€? she says. “They start to play around and they start saying, ‘Oh, well, we are going to cook cells’.â€?
ÂĄAlimentos aĂşn cuando la escuela estĂĄ de vacaciones! Programa de Servicio Alimenticio de Verano del USDA
Saludables
Una cientĂfica de corazĂłn y vocaciĂłn Cuando la doctora Marisa TorresArzayus tenĂa 12 aĂąos ella ya sabĂa que querĂa ser cientĂfica. Esto pasĂł en su natal BogotĂĄ, Colombia, cuando el papĂĄ de un amigo, que era farmacĂŠutico y mĂŠdico, los invitĂł un dĂa a su laboratorio a descubrir cĂłmo se preparan las medicinas. Pero seguir sus sueĂąos no fue tarea fĂĄcil. Mucha gente, como miembros de familia y profesores, intentĂł guiarla por otro camino pero siguiĂł fiel a sus sueĂąos y los consiguiĂł, ademĂĄs de ponerse nuevas metas. “Quiero ser independiente, y tener mi propio laboratorioâ€?, dice. “Como latina tienes que trabajar mĂĄs duroâ€?, dice, agregando que como investigador no paras nunca de trabajar. Hace nueve aĂąos que empezĂł a trabajar para el Instituto de CĂĄncer Dana Farber, una instituciĂłn mĂŠdica de Harvard, en donde es instructora
de medicina en el Departamento de OncologĂa. AhĂ tambiĂŠn trabaja con ratones investigando sobre el cĂĄncer de mama. Torres-Arzayus ha contribuido significativamente al campo de la medicina al lograr entender mejor dicho cĂĄncer – contribuciones que fueron publicadas en el Cancer Cell Journal en 2004 y en el Cancer Research Journal en 2006. Pero el interĂŠs de Torres-Arzayus llega mĂĄs allĂĄ de su trabajo en el laboratorio; a ella le preocupan los latinos, quienes dicen estar demasiado ocupados para atender sus propias necesidades de salud. “Si usted siente cambios en su cuerpo, no diga, ‘esto no es importante’â€?, subraya. “[Los latinos] tendemos a minimizar nuestros problemas mĂŠdicos. Siempre pensamos en otros primeroâ€?, dice Torres-Arzayus. “Esto es tĂpicamente latinoâ€?.
G;1/ 7\bS`\ObW]\OZ :SO`\W\U 1S\bS` ! $ 6c\bW\Ub]\ /dS 0]ab]\
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Los niĂąos de 18 aĂąos de edad y menores pueden disfrutar de comidas y actividades gratis en localidades de Massachusetts durante todo el verano. A partir del 1Âş de julio, llame a la lĂnea directa y gratuita FoodSource de Project Bread al 1-800-645-8333 o visite nuestro sitio en el Internet www.meals4kids.org para consultar las localidades y horarios. El Programa de Servicio Alimenticio de Verano del USDA es una manera segura y divertida de que los niĂąos reciban comidas nutritivas cuando la escuela no estĂĄ en sesiĂłn y es fĂĄcil participar ya que no requiere inscripciĂłn o identificaciĂłn alguna. De modo que, ÂĄven a comer, hacer amigos y divertirte!
>`]U`O[O Sa^SQWOZWhOR] ^O`O ^`W\QW^WO\bSa $ \WdSZSa RS W\UZ{a >`S^O`OQWÂ&#x201E;\ ^O`O SZ B=34: 1ZOaSa ^]` ZO [OÂ&#x192;O\O g ^]` ZO \]QVS 7\dWS`bO SabcRWO\R] RS \]QVS >S`a]\OZ O[OPZS g QO^OQWbOR] 5`c^]a ^S_cSÂ&#x192;]a bcb]` O ^S`a]\OZ 3Z ^`SQW] RSZ Qc`a] Sa [S\]` O # ZO V]`O 7\aQ`W^QW]\Sa( :c\Sa 8cSdSa RS '( O[ Âł %( ^[ DWS`\Sa '( O[ Âł !( ^[
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Administrado por el Departamento de EducaciĂłn Primaria y Secundaria de Massachusetts. Esta instituciĂłn ofrece igualdad de oportunidades.
JULY / SEP 2009
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Salud y Familia | 13
Life
Style
A Medical and Cultural Approach to Diabetes Treatment Type 2 diabetes is on the rise among Latinos, and doctors are increasing their efforts to understand the ethnic aspect of treating the disease Nancy Rivera’s type 2 diabetes had been so out of control she feared for her life. “I was a walking time bomb… waiting to explode,” says Rivera, a 48-year-old mother of four who was diagnosed with type 2 diabetes. She had all the symptoms: she was overweight, constantly tired and always thirsty. Her blood sugar level was over 500, more than quadruple a normal blood glucose reading, which should typically fall between 80 and 120. She could have been in a coma. According to the American Diabetes Association (ADA), Rivera is one of nearly 24 million diabetics in the United States, a number expected to double in four decades. As a Latina, she is part of the nation’s fastest growing ethnic group — one that’s also being diagnosed with diabetes and its many complications at nearly twice the rate of the general population. Even though type 2 diabetes is associated with the elderly, it is now being diagnosed in younger people, including children and adolescents. One in every three Americans and one in every two Hispanic females born in the United States after 2000 are at lifetime risk of diabetes, according to a 2008 Center for Disease Control and Prevention (CDC) report. Worse, it is estimated that 5.7 million people are unaware that they have diabetes, according to the ADA. “Diabetes is … probably one of the most challenging problems that are going on right now in the Latino community in terms of health,” says Dr. Alexander Green, associate director of the Disparities Solutions Center at Massachusetts General Hospital (MGH) in Boston. The numbers have driven many health organizations to start diabetes initiatives and outreach interventions. For example, MGH started the Disparities Solutions Center nearly four Salud y Familia | 14
Margarita Persico
* Margarita Persico
Nancy Rivera’s sugar level was 500. Now it’s between 155-165.
years ago to seek answers to persistent racial and health disparities. One of their projects is the Diabetes Initiative, started in Chelsea in part because of the Boston suburb’s high population of Latinos — 48 percent, according to the last census. Green says nearly 50 percent of the initiative’s diabetic patients are Latinos. “If [patients] don’t have education in Spanish, for example, they may not be able to understand diabetes as well,” Green says. At MGH’s Chelsea HealthCare Center, where Rivera is a patient, Spanish-speaking diabetes coach Eddie Horta works with patients to take control of their diabetes. As a liaison between doctor and patient, he tries to figure out what barriers the patient is facing and tries to devise solutions — within a patient’s budget or health care plan. Some physicians have learned that patients may not be able to afford their medications, but are too embarrassed to say as much. “Some are on a fixed income or get paid only when they work,” says Dr. Enrique Caballero, director of the Latino Diabetes Initiative at the Harvard-affiliated Joslin Diabetes Center. “They don’t have the luxury to take a day off to go to the doctor … because that may cost them money.”
Another problem is the cost of “eating healthy” and the relative lack of stores that sell healthy foods in communities of color. To close that gap, Joslin’s Latino initiative sent two of its health officials and several patients to a local supermarket where they shopped for healthy foods on a budget. “Sometimes healthier foods are more expensive, but not all the time,” says Caballero. “So even within a limited budget, people can make better choices. And so now we go exactly to where people buy the food and teach people how to do that in a better way.” Latino patients, though, face more than economic barriers. Diabetes runs in Rivera’s family. “I have two [younger] brothers that are diabetic, my mom is diabetic, my [step] dad is diabetic, my grandmother was diabetic,” says Rivera, a patient access representative at Boston Medical Center. CULTURAL COMFORT IN TREATING DIABETES Caballero, a Latino himself, says that lifestyle factors — such as poor diet and lack of participation in physical activities — can greatly affect the probability of Latinos developing diabetes. Rivera agrees. “We know that, unfortunately, in
the Latino population, insulin doesn’t work as well, and that is what is called insulin resistance,” says Caballero. “And the prevalence of insulin resistance is higher in Latinos than in the white population.” For Rivera, her biggest obstacles are carbohydrates and foods containing a lot of fat. She doesn’t like sweets, but says she loves pork loin and “pasteles” — stove top cakes made from root vegetables and plantains, usually filled with meats and wrapped in banana leaves. Until last month, she explains, her typical breakfast was “sausage, home fries, eggs, [and] toast.” Frequent exercise is critical to higher survival rates — as is cultural comfort. “One example of our culturally oriented activities is that we just created a pilot [program] of salsa dancing,” Caballero says. “Many of our patients said they … didn’t like to run or jog, but that they would dance.” As a result, Caballero and his team hired a salsa instructor for a monthly meeting at a Jamaica Plain church. This year, Rivera says she wants to lose weight. She says she wants to be around to spend time with her grandkids; to celebrate her granddaughter’s “quinceañera,” or 15th birthday, and her daughter’s wedding next year. Rivera says she is controlling her diabetes now by watching her diet and following her doctor’s advice. She is taking insulin, and the result is a blood sugar level that now ranges between 155 and 165. It’s still not perfect, but it’s much better than before. “I have two angels watching over me,” Rivera says, referring to her medical doctor and nurse practitioner. “They never gave up on me, even though I would give up on myself.” JULY / SEP 2009
Estilo de Vida
Un Enfoque Cultural para Aliviar la Diabetes La diabetes tipo 2 de Nancy Rivera se había descontrolado hasta el punto de poner en riesgo su vida. “Yo era una bomba de tiempo”, dice Rivera, de 48 años, madre de cuatro hijos que sufre de diabetes tipo 2. Ella tenía todos los síntomas: sobrepeso, cansancio y sed constante. Su nivel de azúcar en sangre era superior a 500, cuatro veces mayor a lo normal, que es entre 80 y 120. Según la Asociación Americana de la Diabetes (ADA, por sus siglas en inglés) hay 24 millones de diabéticos en Estados Unidos. Y estima que 5.7 millones de personas desconocen sufrir esta enfermedad. “Hablando en términos de salud, la diabetes es uno de los mayores retos de la comunidad latina”, dice el Dr. Alexander Green, director
asociado en el Centro para las Disparidades de la Salud en el Hospital General de Massachusetts, en Boston. Algunos doctores se han dado cuenta de que sus pacientes no tienen suficiente dinero para pagar los medicamentos. “Muchos poseen salarios ajustados o sólo reciben dinero cuando trabajan”, dice el Dr. Enrique Caballero, director de la Iniciativa para Latinos Diabéticos en el Centro para la Diabetes Joslin. “Ellos no se pueden permitir el lujo de tomar un día libre par ir al doctor, es dinero que dejan de ganar”. Otro problema es el costo de “comer sano” y la relativa falta de establecimientos adecuados en las zonas donde viven. Además, inciden el factor genético y el estilo de vida asociado con los latinos. “Tengo dos hermanos [meno-
Camina mucho. Aliméntate mejor. Vive más años.
res] que son diabéticos, mi madre es diabética, mi padrastro es diabético, mi abuela era diabética”, dice Rivera, que ahora está preocupada por su hija, que va camino de tener los mismos problemas. “La enfermedad es producto de una mezcla genética y de estilo de vida”, dice Caballero. “Sabemos que, desafortunadamente, la insulina no es del todo efectiva en la población latina, que poseen una mayor resistencia a la insulina que la población blanca”. Caballero dice que el estilo de vida tiene mucho que ver en el desa-rrollo de la enfermedad. Tanto la mala alimentación como la falta de ejercicio incrementan las posibilidades de desarrollarla. “Mi abuela comía lo que le daba la gana porque decía que se iba a morir de todos modos, y que se moriría feliz”, dice Rivera, que
admite enfocar el problema con “la misma actitud”. Pero además de la dieta, el ejercicio es básico para evitar los efectos de la diabetes. “Muchos de nuestros pacientes admiten no querer correr, sin embargo, sí están dispuestos a bailar un poco de salsa”, dice Caballero, que considera el factor cultural también importante a la hora de enfrentar los problemas de la diabetes. Como resultado, Caballero y su equipo han contratado a un instructor de salsa con el que se reúnen mensualmente en una iglesia en Jamaica Plain. Rivera dice que está controlando su diabetes mediante la dieta y siguiendo los consejos de sus doctores. Está utilizando insulina y sus niveles de azúcar en sangre están entre 155 y 165. No es lo óptimo pero si está mucho mejor que antes.
We’re in this together r If you’re meeting at the bars, clubs, online, or out in public, here are some things you can do to keep yourself safe: Go out with friends and check in with each other.
DCR Hatch Shell
If you’re alone, see if there’s anyone you know. Even acquaintances can watch your back.
• Sábado 12 de septiembre • •
Charles River Boston
bostonheartwalk.org Presidente de Heart Walk:
Brent Shafer, Philips Healthcare
ROCK THE WALK! 12pm: concierto GRATUITO con Danny Klein’s Full House, rindiendo homenaje de la música de The J. Geils Band with Charlie Farren
NATIONAL START! SPONSORS
LOCAL START! SPONSOR
SIGNATURE SPONSORS
MEDIA SPONSORS
If your’re hooking up online or going out alone, tell someone where you’re going. Keep your drink in sight at all times and only accept a drink from the bar staff or people you know. A drink can be drugged while your back is turned. Know your limits and go home if things start to feel uneasy.
If you’ve been the victim of a crime and you need immediate help, call 911. If you’re LGBT and need further support please call: 617-927-6250 800-834-3242 (hablamos español) Boston Police Community Disorders Unit: 617-343-4527
Be aware of your surroundings, especially when alone outdoors at night. Keep some identification on you.
Have fun, be safe and look out for each other JULY / SEP 2009
Salud y Familia | 15
SM
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