health and family magazine 009 july 2009

FREE Take One | GRATIS Tome Una

Salud FamiliayNew England’s bilingual health magazine

JULY/ SEP 2009

Una Causa Común:Una Causa Común: Combatir el CáncerCuatro extraordinarias latinas del Dana Farber Cancer Institute de Boston comparten sus experiencias

A Common Cause:A Common Cause: Fighting CancerFour remarkable Latinas from Boston’s Dana Farber Cancer Institute share their experiences

Photos: Melissa Ostrow

Marissa Torres-Arzayus, Ph.D.Researcher

Magnolia ContrerasCo-facilitator, Grupo de Apoyo en Español

Rachel Allende Co-facilitator, Grupo de Apoyo en Español

Ana ValdezMember, Grupo de Apoyo en Español

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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

For more easy and delicious 3-A-Day of Dairy tips and family-friendly recipes visit www.3aday.org.

Monday

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“Power of 3” PlannerPower 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!

Breakfast Breakfast Smoothie: blend 1 cup of milk or yogurt, fruit and ice cubes

Lunch Pizza Roll Up: roll flour tortilla with 1-2 slices of part-skim Mozzarella cheese and tomato sauce for dipping

Snack Yo On-the-Go: pick up a 10-ounce bottle of cherry-flavored, drinkable yogurt

LunchChicks Mix: combine 1 cup of plain yogurt and lowfat Ranch dressing mix for a dip with baked chicken tenders

SnackCheesy Popcorn: toss 1/4 cup of tangy lowfat Colby cheese shreds with popcorn

DessertBanana Milksicle: freeze 1 cup of lowfat banana flavored milk in popsicle container

Breakfast Waffles That Wow: top whole wheat waffles with 1 cup of strawberry yogurt and berries

Dinner Cheesy Mac: bake a single serving of macaroni and top with 2 tablespoons of grated, robust Parmesan

Dessert Mousse Madness: stir together 8 ounces of lowfat chocolate milk and lite frozen whipped topping

BreakfastMilk Steamer: warm up 1 cup of flavored milk sprinkled with cinnamon

Snack Super Snack: dunk fresh veggie sticks into 1 cup of yogurt mixed with taco seasoning

DinnerHam and Cheese Quesadilla: layer 1/4 cup of shredded reduced fat Monterey Jackwith slices of lean ham in tortillas

BreakfastEgg-cellent Cheese Omelet: melt 1-2 slices of Cheddar or Provolone cheese in egg white omelet

LunchTopped Tater: spoon lowfat chili and 1 cup of plain yogurt atop baked potato

Snack Pretzel Wrap: roll a fat free pretzel rod in 1-2 slices of reduced fatSwiss cheese

JULY / SEP 2009 Salud y Familia | 3

Dyslexia is a language-based learn-ing disability that affects reading and writing skills by causing children and adults to have diffi culty 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 informa-tion in a less effi cient way. Dyslexia is hereditary (it runs in families). It is estimated that up to 20% of people in the US have diffi culty 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 pre-schoolers being to recognize letters and numbers, and they gradually re-member 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 diffi culty with handwriting, trouble learning letters and numbers, trouble with rhyming, diffi culty read-ing and writing one’s name, struggling with speech, or trouble remembering words. Dyslexia is generally diag-nosed when a child is in elementary school, but in some cases it becomes more apparent later on when read-ing comprehension and grammar are more important. Older children may read and spell below their grade level, have diffi culty 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 usu-ally employed by the school system.

Treating young children. If you no-tice that your preschooler is having diffi culty learning how to talk, tell your

pediatrician as soon as possible. Lan-guage-related problems such as com-municating verbally and learning to sound out letters and words can have less severe consequences if treatment is begun early. Children who have ear-ly language problems also may have more diffi culty in learning how to read and write. There are early intervention programs and school-based evalua-tions 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 be-come more self-conscious about her diffi culty. 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 fi nd strategies that help her complete her work. These can include using books on tape or a tape record-er, allowing some assignments to be modifi ed slightly, not penalizing her for spelling mistakes, having her type written work with a word processing program that has a spell checker, help-ing her take notes (or obtaining a copy of class notes from a teacher or class-mate), clarifying written instructions, and providing help with organizing and writing papers and long-term projects.

How you can help your child. Al-though your child may not enjoy read-ing because it is diffi cult, 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 activi-ties that she enjoys and is good at to build her self-confi dence. While aca-demic work may remain a challenge, bright children with dyslexia often go onto college, where there is also sup-port for challenges like dyslexia. Compiled by Sunindia Bhalla and re-viewed by Dr. Betsy Busch, MD. For more information, visit www.One-ToughJob.org.

Special Education: The ABCs of Dyslexia* Children’s Trust Fund


Children’s Health

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IN THIS ISSUE…EN ESTA EDICIÓN...• Children’s Health / Salud Infantil

The ABCs of DyslexiaCaracterísticas de la Dislexia P4-P5 -----------------------------------------• Oral Health / Salud Dental

Help Your Child Fight Tooth DecayAyude a su Hijo a Combatir las Caries P7-P8 -----------------------------------------• Healthy Stories / Historias Saludables

A Common Cause: Fighting CancerUna Causa Común: Combatir el CáncerP10-P13 -----------------------------------------• Life Style / Estilo de Vida

A Cultural Approach to Diabetes Treatment Un Enfoque Cultural para Aliviar la Diabetes P14-P15

EditorMarcela García [email protected](617) 937-5921PartnersNeighborhood Health PlanChildren’s Trust FundDana Farber Cancer InstituteContributorsMargarita PersicoMelissa OstrowRicardo HerrerasManuel ÁlvarezGraphic DesignJhosmer HernándezHealth & Family is Published ByEl Planeta PublishingA Phoenix Media/Communications Group CompanySalesCindy [email protected](617) 937-5922MarketingRaúl [email protected] (617) 937-5919Subscriptions(617) 937-5900EL PLANETA PUBLISHING126 Brookline AvenueBoston, MA 02215Phone: (617) 937-5900Fax: (617) 933-7677www.healthandfamilymagazine.com

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Estamos muy orgullosos de servir a nuestra comunidad por más de 22 años, y de seguir dando servicios de salud en las áreas de:

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Educación Especial: Características de la Dislexia


Salud Infantil

La dislexia es un problema de aprendizaje relacionado con el len-guaje que afecta la capacidad de leer y escribir correctamente. Esta afección hace que niños y adul-tos tengan difi cultad 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 efi cazmente. La dislexia es hereditaria (se transmite dentro de la familia). Se calcula que en Estados Unidos, un 20% de personas tienen difi culta-des 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 dislexiaExiste una edad normal en la cual la ma-yoría de los niños están pre-parados para aprender a leer. La mayoría de los niños en edad preescolar empiezan por re-conocer 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 pro-nunciar palabras y comenzar a leer libros simples. Algunos de los síntomas de dislexia en los niños en edad preescolar son: difi cultad para es-cribir, problemas para aprender le-tras y números, problemas con las rimas, difi cultad para leer y escribir su nombre, difi cultad para articular

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 difi cul-tad con las matemáticas (especial-mente 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 me-diante 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 difi cultad para aprender a hablar, avísele al pediatra lo antes posible. Sabemos que los problemas relacionados con el lenguaje (como aprender, comunicarse verbalmente y apren-der a pronunciar letras y palabras) pueden tener consecuencias menos graves si se comienza pronto con el tratamiento. Existen programas de interven-ción temprana y evaluaciones que se realizan en la escuela, incluso para niños muy pequeños con posibles retrasos. También hay fonoaudiólo-gos y especialistas en lectura que trabajan en las escuelas con los niños que padecen dislexia. Para obtener más información en es-pañol sobre el proceso de educación especial y la dislexia, consulte es-panol.onetoughjob.org.

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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 Ameri-can child is 17 years old, on average, he has had eight cavities. The good news is that you can help your child fi ght 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 fi ght 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 develop-ing 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.

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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Oral Health


Help Your Child Fight Tooth DecayYou, as a parent, play an important role in helping your child fi ght tooth decay - learn how* Neighborhood Health Plan

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your child candy, cookies, and sticky food between meals.4. Diets without fl uoride. Ask your child’s dentist or doctor about supple-ments.

Did You Know? Tooth decay is the most common chronic childhood dis-ease - fi ve times more common than asthma. Not taking care of this dis-ease 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 fl uoride var-nish 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 ap-plied, 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 offi ce.)

Applying fl uoride varnish is sim-ple and painless. Big advantages include:1. Varnish now comes in child-friend-ly fl avors.2. Doctors fi nd 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.


Salud Dental

Ayude a su Hijo a Combatir las Caries

¿Sabía usted que una de las enfer-medades más comunes de la infan-cia 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 em-

pezar escogiendo alimentos salu-dables o enseñando a sus hijos cómo mantener la boca limpia antes de acudir al dentista. El cuidado dental debe comen-zar 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 prema-turas. 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 lle-var a sus hijos al dentista para un chequeo cada seis meses para ase-gurarse 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 fl uoruro. Pregunte a su doctor acerca de suplementos ali-menticios adecuados. ¿Sabía qué? Las caries son la enfermedad cróni-ca 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 proble-mas dentales y de las caries es que son fácilmente prevenibles. Una nueva fórmula de combatir las caries: barniz de fl úor Usted puede pedir a su doctor que ponga barniz de fl úor 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

Healthy Tooth FoodsIf 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 FoodsThese foods contain sugar and oth-er substances that can contribute to cavities.

• Soda Crackers • Bread • Pretzels • Candy (and other sugary food)

4. It can be applied in the doctor’s offi ce.

Fluoride varnish provides an added benefi t for children; however, it does not take the place of tooth-paste. Ask your doctor about fl uo-ride varnish during your child’s next visit. Your doctor may perform an oral health risk check, give oral health ad-vice and may even refer your child to a dentist.

Note: Fluoride varnish can also be applied at your medical provider’s offi ce, clinic or other community-based setting by other properly trained medical professionals such as Physicians Assistants, Nurse Prac-titioners, Registered Nurses, and In-dependent Nurse Practitioners.

cuanto más temprano se le aplique al niño. Los jóvenes hasta la edad de 21 también pueden ser tratados. Aplicar barniz de fl úor es fácil y no duele. Entre sus ventajas es-tán:1. El barniz viene con sabores del gusto de los niños.2. Los doctores lo aplican de manera fácil y rápida. El barniz de fl úor puede ser aplicado directamente en los dien-tes en menos de tres minutos.3. El barniz de fl úor es seguro. Sólo una pequeña cantidad es usada y aún menos es tragada.4. Puede ser aplicada en cualquier consulta. El barniz de fl úor proporciona una ventaja extra para los niños; sin embargo, no puede ser considerado como sustituto del dentífrico. Pre-gunte a su doctor sobre el barniz de fl uoruro en su próxima visita. Nota: El barniz de fl úor también puede ser aplicado en la consulta de su proveedor médico, en una clínica o por otros profesionales correcta-mente entrenados como médicos o ayudantes, enfermeras practicantes, enfermeras tituladas.

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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

espanol.dana-farber.orgVisita nuestra página de Internet:

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Ana Valdez had an erroneous believe about cancer that laid a heavy emotional burden. “I thought it was something enor-mous 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 identifi ed 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 ben-efi ts 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 sup-port 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 psycholo-gist Carmen Ortiz. The support group, Círculo de Vida, has been operating since 1992.

“She really wrote the book, liter-ally, on how effective support groups are for women who were dealing with cancer,” says Contreras. “Hers was in specifi c to breast cancer. We broaden ours [support group] to all cancers because we believe that many of the issues that Latina women face are is-sues that they can relate with.” Much of the support they give these women happens on an indi-vidual basis, Contreras adds. They help them connect with each other on commonalities besides their diagno-sis – they deal with the issue of race, family, culture, and their limitations in this country when dealing with a serious disease. “When I fi rst came to the support group,” says Valdez in

Helping Latinas Fight Cancer in SpanishLaunched late last year, a support group conducted in Spanish is the only one of its kind in the area* Margarita Persico

Healthy Stories


Historias Saludables

Spanish, “the moment I started speak-ing, I would start to cry, and I was very depressed, but time passed on and I met other people. It has fortifi ed me.” Valdez says the meetings with other women who have similar situ-ation 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 as-serts. 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

that they are trying to play while they are actually dealing with the serious illness,” says Rachel Allende, co-facil-itator of the group. Some cannot make it to the meet-ings because of their illness, problems at home, work, childcare or transpor-tation. “Many are in treatment and may not feel well enough to attend. Oth-ers 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 direc-tor 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 fi ve or six women who have tended to be the core group of people that have come to the group on an ongoing ba-

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 meet-ings have been a personal success, she says. Members call each other, though they do not meet outside the monthly support group meet-ings, they speak on the phone. She remembers a Dana Farber support group colleague from Puerto Rico liv-ing in Worcester who sent her a book on depression. She says that gesture touched her. “This has helped me a lot deal-ing with my illness,” assures Valdez, who would like the meetings to be longer and more frequent, but would like to see also physicians as speak-ers to some of the meetings. Valdez’s outlook on life has changed. Even her relation with oth-ers has improved since she started meeting with the support group. “I learned to understand others better,” she added.

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.

La mejor atención médica de la epilepsia infantil está en Boston.

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.

Rachel Allende, Ana Valdez and Magnolia Contreras

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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 pur-suing their dreams is not to give up. She has been pursing for ten years her dreams here and she has ob-tained 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 bache-lor’s degree in chemistry and pharma-co-logy from the National University of Colombia in Bogotá, she earned an award and a fellowship to attend Wye College at the University of Lon-don to pursue a master’s degree and a PhD. in Biological Sciences. After fi ve years in England, she returned to Colombia to pursue her career, but at that time there were no opportunities in her scientifi c 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 Uni-versity 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 start-ed working for Dana Farber Cancer Institute, a Harvard medical institu-tion, where she is an instructor in medicine at the medical oncology de-partment. There she works research-ing breast cancer. “My career goals are to better understand the complexity of cancer in order to contribute to the develop-ment 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 work-

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 medi-cines were prepared. “I loved all the little glasses and fl ask … I was fascinated,” says Torres-Arzayus smiling as she re-membered her neighbor’s laboratory, which she compared to an “antique museum.” It was at that moment that To-rres-Arzayus knew medical research would be her chosen career path. But following her dreams, she says, was not easy. Many well in-tended people including family mem-

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”* Margarita Persico

Healthy Stories

Grupo Ayuda a Latinas a Combatir el Cáncer... en Español

Ana Valdez tenía una creen-cia 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 de-primida, Valdez llamó a la ofi cina de su doctor, y al hablar con la secre-taria 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 Insti-tuto de Cáncer Dana Farber creó un grupo de apoyo en donde se habla español para pacientes de cáncer y otros que lo han superado. “Identifi camos la necesidad de las pacientes latinas de Dana Farber, ellas necesitaban un apoyo adicio-

nal”, dice Magnolia Contreras, di-rectora de benefi cios 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 gru-pos 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 fortifi cado”. Valdez dice que las reuniones con otras mujeres en situación simi-lar han sido un pilar. Con estas mu-

jeres ha aprendido mucho sobre ella misma. Ahora, ella se siente emocio-nal y espiritualmente más fuerte. El grupo de apoyo en español para latinas con cáncer de Dana Far-ber 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 preocu-paciones. Once mujeres son parte de este grupo en donde se discuten todos los tipos de cáncer. Pero el de-safío es juntar todas al mismo tiem-po, dice Contreras. “Estas mujeres tienen dife-rentes roles en sus vidas y además tienen que lidiar con una enfermedad grave”, dice Rachel Allende, co-faci-litadora del grupo. Algunas no pueden llegar a las reuniones debido a la propia en-fermedad, 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 telé-fono la una a la otra regularmente. Ella recuerda que una participante puertorriqueña de Worcester le en-vió 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 so-bre 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”.

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¡APROVECHE EL VERANO!ESTUDIANDO INGLÉS EN EL YMCA

[email protected]

Administrado por el Departamento de Educación Primaria y Secundariade Massachusetts. Esta institución ofrece igualdad de oportunidades.

¡Alimentos aún cuando laescuela está de vacaciones!

Programa de Servicio Alimenticiode Verano del USDA

Los niños de 18 años de edad y menorespueden disfrutar de comidas y actividades gratis enlocalidades de Massachusetts durante todo el verano.A partir del 1º de julio, llame a la línea directa y gratuitaFoodSource de Project Bread al 1-800-645-8333 o visitenuestro sitio en el Internet www.meals4kids.org paraconsultar las localidades y horarios.

El Programa de Servicio Alimenticio de Verano delUSDA es una manera segura y divertida de quelos niños reciban comidas nutritivas cuando la escuelano está en sesión y es fácil participar ya que norequiere inscripción o identificación alguna.

De modo que, ¡ven a comer, hacer amigos y divertirte!


Historias Saludables

Una científi ca de corazón y vocación Cuando la doctora Marisa Torres-Arzayus tenía 12 años ella ya sabía que quería ser científi ca. Esto pasó en su natal Bogotá, Colombia, cuando el papá de un amigo, que era farmacéutico y médi-co, los invitó un día a su laboratorio a descubrir cómo se preparan las medicinas. Pero seguir sus sueños no fue tarea fácil. Mucha gente, como miembros de familia y profesores, intentó guiarla por otro camino pero siguió fi el a sus sueños y los con-siguió, además de ponerse nuevas metas. “Quiero ser independiente, y tener mi propio laboratorio”, dice. “Como latina tienes que traba-jar más duro”, dice, agregando que como investigador no paras nunca de trabajar. Hace nueve años que empezó a trabajar para el Instituto de Cáncer Dana Farber, una institución médica de Harvard, en donde es instructora

de medicina en el Departamento de Oncología. Ahí también trabaja con ratones investigando sobre el cáncer de mama. Torres-Arzayus ha contribuido signifi cativamente al campo de la medicina al lograr entender mejor dicho cáncer – contribuciones que fueron publicadas en el Cancer Cell Journal en 2004 y en el Cancer Re-search Journal en 2006. Pero el interés de Torres-Arza-yus llega más allá de su trabajo en el laboratorio; a ella le preocupan los latinos, quienes dicen estar de-masiado ocupados para atender sus propias necesidades de salud. “Si usted siente cambios en su cuerpo, no diga, ‘esto no es importante’”, subraya. “[Los latinos] tendemos a mini-mizar nuestros problemas médicos. Siempre pensamos en otros prim-ero”, dice Torres-Arzayus. “Esto es típicamente latino”.

ing at Myles Brown’s laboratory at Dana Farber Cancer Institute with mouse models, she has made some signifi cant 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 col-laboration with researchers from the pharmaceutical company Novartis and published in the Cancer Re-search [Journal] in 2006,” she says. But Torres-Arzayus health inter-est 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 think-ing of others fi rst,” says Torres-Arz-ayus. “This is very Latino.” On a personal tone, Torres-Arzayus says she still loves her fi rst childhood interest. “I always wanted to cook. … I love to improvise,” says Torres-Arzayus 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 enrich-ing their vocabulary with scientifi c terms. “They are wonderful … when I talk to my husband … [the twins] listen to us,” she says. “They start to play around and they start saying, ‘Oh, well, we are going to cook cells’.”

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 Dia-betes Association (ADA), Rivera is one of nearly 24 million diabetics in the United States, a number expected to double in four decades. As a Lati-na, 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 popula-tion. 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 direc-tor 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 Dis-parities Solutions Center nearly four

years ago to seek answers to per-sistent 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 educa-tion 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 Ed-die Horta works with patients to take control of their diabetes. As a liaison between doctor and patient, he tries to fi gure 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 af-ford their medications, but are too embarrassed to say as much. “Some are on a fi xed income or get paid only when they work,” says Dr. Enrique Caballero, director of the Latino Diabetes Initiative at the Har-vard-affi liated 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 offi cials 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 li-mited 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. Diabe-tes runs in Rivera’s family. “I have two [younger] brothers that are diabetic, my mom is diabetic, my [step] dad is diabetic, my grand-mother was diabetic,” says Rivera, a patient access representative at Bos-ton Medical Center.

CULTURAL COMFORT IN TREATING DIABETESCaballero, 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 dia-betes. 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 Ca-ballero. “And the prevalence of insu-lin resistance is higher in Latinos than in the white population.” For Rivera, her biggest obstacles are carbohydrates and foods con-taining 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 fi lled 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 cre-ated a pilot [program] of salsa danc-ing,” 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 grand-daughter’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 be-fore. “I have two angels watching over me,” Rivera says, referring to her medical doctor and nurse prac-titioner. “They never gave up on me, even though I would give up on myself.”

Life Style

A Medical and Cultural Approach to Diabetes TreatmentType 2 diabetes is on the rise among Latinos, and doctors are increasing their efforts to understand the ethnic aspect of treating the disease * Margarita Persico


Nancy Rivera’s sugar level was 500. Now it’s between 155-165.

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Estilo de Vida

We’re in this togetherrrr

If you’re meeting at the bars, clubs, online, or out in public, here are some things you can do to keep yourself safe:

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 PoliceCommunity Disorders Unit:617-343-4527

Go out with friends and check in with each other.

If you’re alone, see if there’s anyone you know.Even acquaintances can watch your back.

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.

Be aware of your surroundings, especially when alone outdoors at night.

Keep some identifi cation on you.

Have fun, be safe and look out for each other

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Un Enfoque Cultural para Aliviar la DiabetesLa 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 cons-tante. 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 Ameri-cana de la Diabetes (ADA, por sus siglas en inglés) hay 24 millones de diabéticos en Estados Unidos. Y es-tima que 5.7 millones de personas desconocen sufrir esta enferme-dad. “Hablando en términos de sa-lud, la diabetes es uno de los ma-yores retos de la comunidad latina”, dice el Dr. Alexander Green, director

asociado en el Centro para las Dis-paridades de la Salud en el Hospital General de Massachusetts, en Bos-ton. Algunos doctores se han dado cuenta de que sus pacientes no tienen sufi ciente dinero para pagar los medicamentos. “Muchos poseen salarios ajustados o sólo reciben dinero cuando trabajan”, dice el Dr. En-rique Caballero, director de la Ini-ciativa 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-

res] que son diabéticos, mi madre es diabética, mi padrastro es diabético, mi abuela era diabética”, dice Ri-vera, 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 resis-tencia 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 posibili-dades 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 ejer-cicio es básico para evitar los efectos de la diabetes. “Muchos de nuestros pacientes admiten no querer correr, sin em-bargo, 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 men-sualmente en una iglesia en Jamaica Plain. Rivera dice que está controlando su diabetes mediante la dieta y si-guiendo 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.

Black Bean and Tortilla Soup

Nutrition information per serving:

SM

Healthy Ideas...a simple way to know it’s healthy

health and family magazine 009 july 2009

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cup of milk

cup of plain yogurt

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