Salud Coomeva Magazine June - July 2019

www.revistasaludcoomeva.co ISSN 1692 - 5556 June - July 2019 - Number 147 Padres muy presentes 1



Number 147 SELF-CARE June - July 2019 DURING VACATIONS Revista Salud Founder Jorge Alberto Zapata Builes Gilberto Lotero Muñoz (q.e.p.d.) General Manager Charmain of the Board Mid-year and vacation time is taking advantage of those unique José Vicente Torres Osorio nearing. Students are ready for moments one lives with the family. An a recess from activities and important recommendation is for skin Executive President of the alongside their parents or on their own care: avoid long periods of exposure to Cooperative Coomeva Business Group they will take advantage of a much deser- the sun’s UV rays and apply sun blocks. In Alfredo Arana Velasco ved rest period. Thinking about all this, addition, vaccines also become tools for Coomeva Private Healthcare extends an prevention especially if your travel desti- CEO Coomeva Sector Salud invitation to our affiliates to enjoy this nation is to tropical climates. Regardless Gilberto Quinche Toro time without neglecting their family’s of where you are, you can connect with health or their own. We recommend they our services at App Coomeva MP and Prepaid Medicine CEO follow their healthy nutrition routines, our Mi historia mobile and Web applica- Jorge Alberto Zapata Builes increase their physical activity when wal- tion where we make recommendations king, dancing, swimming or bike riding, according to your clinical status and your National Director of Strategy and New running or practicing any sports routine state of health. Remember that vacations Business that makes them happy. We recommend are a time to recharge your energy Mauricio Castillo Pérez that they spend some time with themsel- following the self-care guidelines to favor ves through practices like meditation, you physical, mental and social wellbeing National Director of Marketing Sector reading, and nice rest periods as well as because: “¡Cuidarte es Quererte!” Salud Camilo Ernesto Diusabá Perdomo Editorial and Graphic Direction, Magazine General Editor Journalists Commercialization Paula Andrea Montoya T. Isabel Vallejo Jiménez El Colombiano Health Division Human Administration prepress and printing Laura Jaramillo Arango Cali: Marisol Monsalve National Manager Magazine Editor Natalia Ospina 310 544 2354 Sandra Yanira Ocampo Sarmiento El Colombiano Natalia Estefania Botero C. Felipe Ortegón marisolm@elcolombiano.com.co Tel.: (4) 331 5252 Graphic Editor Diana Milena Ramírez Bogotá: Yulieth Acosta Galvis General Manager elcolombiano@elcolombiano.com.co Hugo A. Vásquez E. Adriana Cooper 315 479 7045 Xiomara Iveth Campo Medellín: Viviana Barrera Design Photography 310 411 6018 Editorial Committee Margarita Ochoa ShutterStock - Cortesía VivianaB@elcolombiano.com.co Pascual Estrada Garcés National Director of Prepaid The contents of all Salud Coomeva Medicina Prepagada S.A. magazine articles are illustrative in nature and/or for general knowledge. In no case are Healthcare they meant to replace the advice or guidance of a physician. Readers shall not use this information in order to self-diagnose and/or perform an analysis, Blanca Inés Vélez diagnosis or treatment of a disease or health problem without consulting with a certified physician. National Director of Oral Health The product and service offers made in the ads published in the Salud Coomeva Medicina Prepagada S.A. magazine are the sole responsibility of the Diana Cristina Sánchez Ramírez advertisers. Also, the company is not liable nor obligated to provide its affiliates the services, procedures or treatments described in the contents of Service Experience National Director articles that are not included in the coverage offered by Coomeva Medicina Prepagada S.A., nor shall they be obligated to include them in their plans Julián Villegas and services. All rights reserved. May not be reproduced in any form or system. © 2019 National Chief of Risk Managment in Health Bertha Varela Rojas National Chief of Medical Audit Mabel Irina Calero Chief of Brand Integral Medicine, Oral Health and International Business Juan Fernando Saavedra Aulestia National Head of CEM Brand, Conecta and Lenders Martha Liliana Cifuentes National Coordinator of Lenders Relations Sandra Viviana Muñoz Rodríguez Director of Epidemiology Collaborators Ana María Correa Montaño Marco Emilio Ocampo Alexandra Arango Rojas Érika Ximena López Macías Juan Pablo Barba Castañeda Viviana Trujillo Jiménez Hugo Ricardo Campo Cardona Jéssica Montes Díaz Dyllan Camilo González

TABLE OF CONTENT June - July 2019 q SIGUE LA RUTA DE Cuidarte es quererte 7 31 53 73 ( ) ( ) ( ) ( )WITH YOUR MIND WITH YOUR BODY WITH YOUR WORLD CORPORATE 8 For him 32 Nutrition 54 For her 74 Institutional Write your own The egg´s Even though more Companies deal with history as a father tasty world women are expressing emotional health their potentiality 14 Your generation 36 Keep in mind Confronting virtual Active and take care 58 Grandparents 76 Institutional harrasment of your thyroid gland These links grow Our medical network in knowledge in the southwest 18 Trends 40 X - ray Five reasons Prevention 62 Infographic 80 Color to begin to smile of asthma 24 hours Color with of wellbeing Patrulla Dental 22 Couples Love also speaks 44 Little giants 64 For your smile 82 Interaction in silence Appointment for Frequent questions Community loaded uninhibited talks in each stage with wellbeing 26 Harmony in health Cravings there is 48 Focus on 66 Prevention a reason for Myopia and Call on to create hipermetrophy and capture ideas 50 Go natural 70 Games Food for Crossword ethernal youth and sudoku 4

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Y TÚ ¿YA USASTE TUS ASISTENCIAS? Cuando eres asociado a Coomeva Cooperativa, disfrutas muchos más beneficios en tus programas de Coomeva Medicina Prepagada. Asistencias exclusivas según rango de edad: Mayor a 60 años de edad Entre 41 y 59 años de edad Entre 26 y 40 años de edad Menor de 25 años de edad Conoce más escaneando el código QR: Cuidarte es quererte

)WITH YOUR MIND 90 TO 100 MINUTES IS THE TIME THE DEEP SLEEPING CYCLE LASTS. ALONG THE NIGHT ONE HAS FROM 4 TO 5 DEEP SLEEPING CYCLES. Cuidarte es quererte SLEEPING IS MORE THAN JUST A ROUTINE; IT IS AN ESSENTIAL HABIT FOR PHYSICAL AND EMOTIONAL HEALTH. IT IS ABOUT RECHARGING ENERGY TO HAVE A BETTER DAY. ADEQUATE HYGIENE COMPENSATION UNBALANCED Going to bed at the same hour, conditio- When you rest the brain repairs. It con- Lack of sleep makes people look tired, ning your room to a good temperature, solidates the information and memories produces disorders of attention, concen- distancing your electronic devices are one has received and allows for libera- tration, memory and irritability practices that favor a good sleep. tion of chemical substances that favor throughout the day. the circulatory system.

( )CON TU MENTE ESCRIBA SU PROPIA HISTORIA COMO PAPÁ Vivir una paternidad afectiva significa involucrarse en la crianza y el cuidado de los hijos. Proteger, cuidar y educar es el reto. 8

( ))WCOITNHTYUOMURENMTIEND for him WRITE YOUR OWN HISTORY AS A FATHER Living an affective parenthood means to be involved in the breeding and caring of your children. Protecting, caring and educating is the challenge. ASESORES MARÍA TERESA GÓMEZ - Psicóloga ADVISORS MARÍA TERESA GÓMEZ - ANDRÉS FELIPE GÓMEZ LOPERA - Especialista Psychologist en terapia de pareja ANDRÉS FELIPE GÓMEZ LOPERA - Specialist on couple therapy Convertirse en padre trae una serie de desafíos que van desde el temor a no Becoming a father carries a series of cha- dar la talla frente a la responsabili- llenges from the fear of not being good dad, a no poder proveer económicamente enough in front of such a responsibility, los nuevos gastos o a responder con sabidu- to being unable of economically provide for the ría a cada etapa que llegará con ese recién new expenses or to wisely respond to each stage nacido. Miedos que irán desapareciendo a that will arrive with the newborn. Fears that medida que cada obstáculo es resuelto y el will disappear as each obstacle is resolved and vínculo entre papá e hijo se hace cada vez the link between father and child becomes each más inquebrantable. time more unbreakable. “Si el hombre se da la oportunidad de “If a man gives himself the opportunity of mimar a su hijo, jugar con él, darle el tetero, pampering his child, playing with him, feeding esperar a que concilie el sueño, cambiarle el him, waiting for him to sleep, changing his dia- pañal, sacarle los gases, sin pensar en el qué pers, taking his gas out, without thinking on dirán o demostrar sensibilidad, vivirá una what others will say or demonstrating sensitive- experiencia única de protección y cuidado”, ness, will live a unique experience of protection explica María Teresa Gómez, psicóloga. and care”, explains Maria Teresa Gomez, Psychologist. De alguna manera, se trata de reivindicar el papel del padre en la sociedad y en la In some way, the deal is to recover the construcción de la familia y romper con role of the father in the society and in the estereotipos que hasta hace poco se referían construction of the family and to break a la paternidad como una figura ausente, those stereotypes that until recently referred autoritaria y de pocas palabras. “Un papá es to fatherhood as an absent, authoritarian igual de importante a una mamá, cada uno and of few words’ individual. “A father is as tiene su lugar y ambos aportaron lo necesa- important as a mother, each of them has rio para traer a ese hijo a la vida. Por lo his/her place and they both contributed tanto, es ideal que se enlace en el proceso with whatever is needed to bring their child de gestación de su pareja, que le cuente to life. Therefore, it is ideal for the father to cómo se siente, qué dolores tiene, qué está get involved in his wife’s gestation process, pensando, que asistan juntos a las ecogra- talking about how she feels, what pains she fías, que lleven un registro de los cambios… has, what she is thinking about, going las sociedades de hoy son distintas y ellos together to echographies, keeping a record of the changes … the societies of today are 9

( )CON TU MENTE deben dejar el miedo a expresar o a esperar a que otros les pregun- ten sobre su situación”, explica el psicólogo Andrés Felipe Gómez Lopera, especialista en terapia de pareja. Cada papá, por tanto, tiene un libro en blanco y el ejercicio de escribir su propia versión del rol de acuerdo con el manual de ins- trucciones que tiene por instinto, por lo que aprendió de sus padres y que alimenta con reglas nuevas en la adultez según su experiencia. DAR SIN TEMOR Ser un buen padre, entonces, no solo depende de los recursos eco- nómicos, también de la disposición, de la vinculación y las ganas que este le imprime al proceso que inicia desde el día en que cono- ce la noticia de su embarazo. “Hay que tener cuidado porque muchas veces la futura mamá lo aparta de este proceso porque pien- sa que no está capacitado para hacer ciertas tareas o, por el contra- rio, es quien lo engancha en el rol. Además, es importante entender por qué actúa de cierta manera para no juzgarlo y frustarlo. Por ejemplo, si se critica porque no es afectivo, hay que preguntarse pri- mero qué fue lo que recibió de su progenitor y para él qué significa la afectividad, de esta manera se valoran y se aceptan las muestras de afecto sin sesgos”, agrega el psicólogo Andrés Felipe. En este sentido, un estudio del Instituto de la Familia de la Universidad de la Sabana asegura que el fin último y tradicional de un papá siempre ha sido el de educar y formar a los hijos, evi- denciando que en el último centenio se han empleado diferentes estrategias para lograrlo, que van desde la agresividad y el some- timiento hasta la tolerancia, el diálogo y el amor, prácticas actualmente muy comunes. Funciona dejar atrás la carga cultural y social, si se tiene, para actuar de forma más afectiva en el gran reto de convertirse en padre. La crianza con amor le brinda al niño el cariño, los cuida- dos, la protección y la compañía que necesita para crecer con un mejor bienestar y le da las herramientas suficientes para enfren- tarse al mundo con valentía. CADA UNO DA LO QUE TIENE Una investigación del Instituto de la Familia de la Universidad de la Sabana encontró que existe una marcada transmisión intergenera- cional en la paternidad desde tres líneas. Una determina que lo que el nuevo papá recibió del suyo lo replica en su experiencia propia y hace lo mismo que hicieron con él en materia de formación, otra tiene que ver con el que se cuestiona y toma elementos y aspectos de lo que considera correcto y, finalmente, el que decide romper con su pasado y asumir su propia forma de hacer las cosas. 10

( ))WCOITNHTYUOMURENMTIEND for him different and any couple should stop feeling fear to express themselves or just wait until others ask them about their situa- tion”, explains the Psychologist Andres Felipe Gómez Lopera, a specialist on couple therapy. Each father has therefore an empty book, and the exercise of wri- ting his own version of his role, in accordance with an instruction manual he has by instinct, and from what he learned from his parents and which he feeds with new rules during his adulthood according to his experience. GIVING WITHOUT FEAR Being a good father, then, not only depends on his economic resources, it also depends on his aptitude, his linking to and his will of getting involved in a process that starts since the day he learns about his wife’s pregnancy. “It is necessary to be careful, because frequently the future mother lets her husband apart from this process, thinking he is not pre- pared or capable of doing certain tasks or, otherwise she is the one who engages him in this role. In addition, it is important to understand why a father acts in a certain way, in order not to judge him or frustrating him. For example, if a father is criticized for not being affective, the first thing is to ask yourself what he received from his own father and what affectivity means for him, in this way the expressions of affection are valuated and accepted without bias”, she adds. To this end, a study made by the Universidad de la Sabana’s Family Institute, states that the last and traditional purpose of a father has always been to educate and form his children, evidencing that in the last century different strategies have been used to achie- ve such purpose, from aggressiveness and submission to tolerance, dialogue and love, these last ones currently very common practices. It works leaving behind the cultural and social load, if any, in order to act in a more affective way within the great challenge of becoming a father. Breeding with love offers the child the devotion, the cares, the protection and the company he needs for growing up with a better wellbeing and provides him sufficient tools for con- fronting the world with courage. EACH ONE GIVES WHAT ONE HAS An investigation made by the Universidad de la Sabana’s Family Institute found that a marked intergenerational transmission exists in fatherhood from three lines. One line determines what the new father received from his own father and replicates it in his own experience, and does the same that they did with him on the subject of formation; another line is related to the father who questions himself and takes elements and aspects of what he considers is correct and, finally, the father who deci- des to break up with his past and assumes his own way of doing things. 11

CWOITNHTYUOMURENMTIEND TAKE INTO ACCOUNT ( ))forhim For Gómez Lopera the balance in the family triangle, constituted by the family hierarchy, the inclusion and the balance in giving TENGA EN CUENTA and taking, is necessary for a true harmony to exist in a home. “It is fundamental to teach the children to respect the place each Para Andrés Felipe Gómez Lopera, terapeuta de pareja, el parent occupies, these are two different roles, and none of them equilibrio del triángulo familiar, constituido por la jerarquía de substitutes the other. This is why when sentences such as “I am la familia, la inclusión y la compensasión en el dar y el tomar, father and mother at the same time” or “I am better than you” es necesario para que se dé una verdadera armonía en el appear, a lack of negotiation between the two members in a hogar. “Es fundamental enseñar a los hijos a respetar el lugar couple is evidenced, as well as their need of dialogue”. que ocupa cada padre, son dos roles distintos y ninguno se suple entre sí. Por esto, cuando aparecen frases como “soy padre y madre a la vez” o “soy mejor que tú”, se evidencia la falta de negociación entre la pareja y la necesidad del diálogo”. ENFRENTE LAS DUDAS así como potenciar sus mayores fortalezas, podrá darle a su hijo bases de vida y aportarle mejores vivencias. ► Conozca a su hijo. El diálogo y la observación son fundamentales ► Ejerza una paternidad con seguridad. Saber qué busca y quiere para saber cuáles son los temas y pasatiempos de su preferencia. de su hijo le ayudará a acercarse a él y a acompañarlo en la toma Invítelo a comer helado, a salir a caminar, a cine, a jugar en el parque, son citas que afianzan lazos y fortalecen la confianza. •de sus decisiones y construcción de su proyecto futuro. No lo ► Analícese como padre. ¿Qué le hace falta para ser una mejor per- cuestione, mejor guíelo sona?, en la medida que identifique eso que le falta por mejorar, CONFRONT THE DOUBTS strengths, you will be able to give your child the basis for his life and contributing with better things for him. ► Know your child. Dialogue and observation are fundamental to ► Practicing fatherhood with security. Knowing what you are learn what are the issues and hobbies of his preference. Invite looking for and what you want from your child will help you your child to eat an ice-cream, to walk, to the movies, to play in the to get closer to him and accompany him in making his park. These are appointments that fasten ties and strengthen trust. •decisions and constructing his project of future. ► Analyze yourself as a father. What are you lacking for being a better person? In the extent you identify what you are lacking for Do not question him, guide him improving yourself, as well as for potentiating your greater 12

( )CON TU MENTE 13

CWOITNHTYUOMUERNMTIEND ( ))your generation CONFRONTING VIRTUAL HARASSMENT Cyber harassment is a harmful combination and is usually anonymous. Parents must promote dialogue about the interactions of their children on the Web. MEDICAL ADVISOR NOVER RUIZ - Psychologist and ethics professor An assault or annoyance received through the Internet or on Social Media may be equivalent to a physi- cal attack received on the street or to an impact from a rock hurled by a stranger. There is no one to ask for an explanation, there is confusion, and nevertheless, the pain is there in the place receiving the impact. That is how cyberbullying or cyberharassment is understood. It is an impact, an insult, a threat, even blackmail. The difference is that it is delivered on the Web, that is, in a virtual manner. Likewise, harassment may come disguised as fear as in the case of Momo Challenge, a figure with bloodshot eyes, black hair and an immense slim mouth whose name alludes to the Greek god of sarcasm and mockery, a dange- rous virtual challenge that incites minors into taking their own lives. The emissary can be an adult or a classmate. The receptor is usually a minor who has access to a computer, to 14

( )CON TU MENTE social media or any intelligent cell phone. Different from harassment experienced face to face, this type of harassment can reach another city or country. It can be delivered in the early hours of the morning. If the author so wishes it can remain and be shared through messages on the cell phone. For example, if a child is insul- ted during recess at school, the episo- de could end when he gets back to the classroom, when the affected child speaks to the teacher, the psychologist or the coordinator of the area so that pertinent measures can be taken. Contrariwise, when happens on the social networks, the mockery or insult become a commentary visible to dozens of individuals. DIALOGUE AND EMOTIONAL BALANCE Nover Ruiz is a Professor of Ethics and Coordinator of the Unidos por la Diferencia [Joined by Difference (TN)] of the Theodoro Herzl School. He was awarded second prize in the Santillana Prize on educational experiences in 2012 for his initiatives in prevention of bullying oriented to “improving cohabi- tation among children and youngsters both inside and outside the school, iden- tifying situations, bringing awareness and generating space for introspection.” The professor who has studies in Psychology and analyzes this issue on a permanent basis indicates that “by being on the networks, the mistreatment beco- mes permanent; a circumstance that does not disappear and that makes the situa- tion ever more difficult. In relation to the authors of these assaults, in many cases they are youngsters who are old enough to attend school and with difficulties in their social abilities, in communicating skills or in establishing relations. Some of them acquire power through this anonymity provided by the Web. Each case is diffe- rent and that is why it is difficult to gene- 15

CWOITNHTYUOMUERNMTIEND ( ))your generation ralize,” the professor explains. “The perpetra- issues dealing with the way one sees power, tors of the harassment,” he adds “have come the position of the child towards the idea of under mistreatment in their family group and other’s weakness, family dynamics or the seek to replicate what they have lived passing ways in which the child seeks to find security from victims to victimizers.” or feel strong and powerful. For this professional, the best way to prevent Asking questions, listening to what the cyberbullying is by promoting dialogue and child or the students think, approaching communication between parents, children and them in a real and effective way, establishing teachers. “The most effective way of preventing who is feeling scared, whether they are being this from happening and remaining is to pro- harassed or whether they behave inappropria- mote a conversation. In that conversation they tely towards others is fundamental to com- explain to the child what is good, what he prehending the situation. It is important to should be attentive to, and also parents are cau- understand that scolding only widens the gap tioned about observing when the child closes between parents and child and can even stop in on himself and does not want to speak or communication from flowing. The Professor express his feelings. It will also allow us to know also mentions the existence of protective what type of friends he has on the social net- applications for parental guidance such as works, who he communicates with and will Qustodio (www.qustodio.com) that offers provide guidelines of how to divert his fear in parents the ability to follow-up the activity of the face of figures such as Momo and the Blue their children on the Internet and promotes Whale,” says the specialist. the search for a joint solution in the face of a specific situation. In addition, these conversations engage in (Bullying: is the assault or annoyance directed at a person in a physical space. Cyberbullying is the harassment that occurs on the Internet. 16

( )CON TU MENTE UNDERSTANDING THE LANGUAGE The following terms help to better understand the practices carried out in the virtual universe with its realities and its threats: ► Sexting: is the combination of the word “sex” and “text”. It refers to messages sent through the social media or the cell phone whose contents are mainly sexual. According to a study published in 2018 by the JAMA Pediatrics Review based on several investigations, it is a manner of communi- cation above all by youngsters 15 years of age around 47% of who are male.. ► Grooming: is the desire of the adult to establish a friendship with a child to obtain sexual satisfaction by sending erotic or pornographic images. In many cases, the request for sending these images is sent to the cell phone of the social networks. According to a report in the Análisis del Cibercrimen Review published by the Direction of Judicial Investigation of the Police between 2017 and 2018 reports of this situation were filed by parents on a daily basis. ► Cyberdating: consists in setting up a date on a virtual space, such as a chat, instead of in a physical space. ► Stalk: Stalker is the figure that watches another in an obsessive manner in the virtual world. Stalk is the activity of this obsessive watching and follow-up. ► Bully: Is usually known as the person who harasses. •He is generally the author of the harassment 17

( )CON TU MENTE FIVE REASONS TO BEGIN WITH A SMILE This manner of contact brings a life of positive emotions that favors personal, social and work development. MEDICAL ADVISORS LUCILA AMPARO CÉSPEDES GALLEGO - Clinical psychologist JUAN D. TOBÓN LOTERO - Clinical psychologist A few years back a photographer embarked on a journey around India. As he roamed the streets he remarked on an individual that was lea- ning on a line of motorbikes and who was being illuminated by the lights of a shop. His face was grave and he had a beard and was wearing a skullcap. The pho- tographer lifted his camera but hesitated on seeing the severity of his expres- sion and his “gaze of stone.” He decided to look at other aspects of the place until he heard a voice saying, “Take a photo of me, too.” He turned around and asked the individual to smile. His face transformed. “It irradiated warmth, his eyes shone with humor that was not previously there. Even his posture softened. Then I knew what my next pro- ject would be.” The name of the photographer is Jay Weinstein and his project “Then I asked them to smile” @soiaskedthemtosmile on Instagram that has served to document the effect of a smile on a strangers face. “This simple act,” says Weinstein after tra- veling around several countries photographing men and women, “even if it is for- ced, transforms a face, changes the way in which we see a person and it is something universal that surpasses religions, ethnia, class, gender and language.” It is enough to look ourselves in the mirror to notice the effect on us. Beyond the physical transformation and beyond our medical studies that show that when we laugh we liberate endorphins and other substances that benefit the organism, Clinical Psychologists Lucila Amparo Céspedes Gallego and Juan Diego Tobón Lotero indicate some of the benefits for the mind. 18

WCITOHNYOTUURMMENINTDE ttreennddesncias (( )IT PROVIDES FOR SELF-KNOWLEDGE “This is the opportunity to go inward. When the person does not know 1himself well,” says clinical psychologist Lucila Amparo Céspedes “He will know what brings him well being, what makes him feel well and 2FINDING POSITIVE ANSWERSwhat makes him happy and, consequently, what makes him smile.” It can be reading, a kind of movie, dancing, going out with friends, a meal, exercising. “That is part of well being and the way I take care of myself, what I do for my mental health,” indicates the specialist. A smile, a good laugh, generates calming emotions that are agreeable to us and to others. An authentic smile transmits the message that you are a trustworthy individual and that you are more accessible than others. Also one that is well disposed toward others will get more positive results becau- se it is an act that transmits kindness. 3IT RECOVERS CHILDHOOD SPONTANEITY An unprepared smile, a much-desired smile makes us remember the way in which we laughed in childhood. A natural smile allows us to express ourselves and be ourselves. In some way, it is about recove- ring the ability to play, the luster. Learning to laugh about oneself and about certain everyday situations that really don’t need to be burde- ned with so much drama is what this is all about. 19

CWOITNH TYUOMURENMTIEND ( ))tentrdeenndcsias Tobón Lotero comments that a smile makes sense in so far as it THE MEANING OF LIFE transmits emotions. It produces a reaction from a non-verbal lan- FINDS A BALANCE 4 5guage because it is a very powerful communication tool. Smiles pro- CONNECTS WITH OTHERS It is necessary to understand that we are a weft of emotions; that it is well to smile, but also to accept that there are moments when one is sad. One needs to understand, also, that we are duce feedback: it is something natural that has to do with human different and that our processes must be undertaken in that contact. “Smile and half of the world will smile with you. Frown and difference. Psychologists explain that not everybody that smiles you will be frowning alone.” This is a phrase that explains itself well •is happy especially in a world that looks outward and on the and that the Personality and Social Psychology Society shares. social networks, where so many people hide behind masks BEING COHERENT Some quoted studies of the National Library of Medicine of the United States claim that when we smile even if genuinely, the brain will receive that information and will interpret it as a positive state that will yield its benefits. Psychologist Lucila Amparo Céspedes Gallego insists on the importance of being coherent and of working internally to produce joy and optimism that will really carry a sincere smile into life. 20

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( )CON TU MENTE LOVE 22 ALSO SPEAKS IN SILENCE In a couple what is expressed with words is just as important as what body language expresses. Self-knowledge is key to delivering the right message. MEDICAL ADVISORS CONSUELO VIVAS PERDOMO - Psychologist, practitioner at Coomeva Private Healthcare ADRIANA MARÍA MORA - Psychologist ASTRID VILLA - Trainer in positive discipline L et’s go to this scene after a couple has gotten into an argument:“Love, can we talk?” “Everything is all right, do not worry,” is the answer. But deep down one of them knows that the contrary is happening because the look in the eyes was enough to understand that something was still wrong with regard to the incident. The other person wanted to “conceal” something. This is a very common situation because in a couple communication especially the non-verbal one is not an easy task but it can be learned. Attention to this data: body or non-verbal language that con- sists in the physical disposition and expression, gestures, tone and volume of the voice represent 93% of communication. What is said, on the other hand, represents only 7%. Surely after reading these numbers many of you stopped to think how much one thing matches up with the other when you speak to your partner or even after an argument. For Astrid Villa, trainer in positive discipline, we are what we do beyond what we say we are. In order to achieve coherence bet- ween verbal and non-verbal communication the experts talks about self-knowledge. “We need to be aware of ourselves, who we are, what we like, what we want, what our skills are, our

( ))CWOITNHTYUOMURENMTIEND couples knowledge and also our limitations, In GUIDELINES FOR KNOWING ONESELF addition, we must act in accordance with our principles and values.” 1 o establish a clear relation with our internal couple, because human beings have a dual nature consisting of both a masculine and a feminine dimension. Connecting what we say with what the body says is a reflection of our personal con- 2 Being responsible for one’s own emotions; do not expect the other person to do that. trol. Gesture, gaze, and movements are, at times, such very unconscious issues that they 3 Allot space for silence and respect the other person’s need for silence. end up betraying our capacity for self-control. express them. “There is a blockade in the “External communication is a reflection family in this sense and it is necessary to of internal communication. That is why it know that emotions are not sacred and is necessary first to have a good communi- that when we “swallow” them we get ill. cation with oneself. I need to know what We must unweed these emotional pat- makes me get out of control, for example. terns,” emphasizes Mora. We are so little in control of ourselves that sometimes we unconsciously reveal oursel- SILENCE IS AN ALLY ves. It is necessary that we perform pro- It often happens that in the midst of cesses of greater control of our emotions the fear of silence and the stigmatiza- and that does not mean repression because tion it bears we forget to listen to our it has been quite damaging when they have couple and we dedicate to only hearing. For told us in the family about keeping our Consuelo Vivas Perdomo a Clinical feelings to ourselves,” explains Psychologist Psychologist listening Adriana Maria Mora Londoño. entails genuine interest for knowing what the THE FAMILY IS MASTER other person is thinking. “It is The family determines everything. Our not easy to practice this way of acting, formation and the example we receive from the family molds the way in which a person relates to the world and with one- self either positively or negatively. The specialist in positive disciplines explains that the better the relations constructed at home the better quality the relations crea- ted outside the family will be. “Thus, if the ties established at home were secure, where there was a clear image of oneself and there is self-esteem, then surely one will establish relations based on trust because the world is conceived as a safe place in which to relate to ones peers: siblings, friends from school and in the relations that at a future time they will establish with their couples.” In this sense it is important to make clear that the capacity each one has to express himself is also derived from what one learned in the family. That is why, attention must be called to that rooted belief inside the families that one must not brand emotions, or speak of them or 23

WCOITNH TYUOMURENMTINED ( ))couples because it is more frequent to be attentive to judging the message silence sometimes one uses words as a or to preparing what you are going to say. Listening means to cap- mechanism to block feelings. In this case, ture the meaning of words that you pronounce; comprehending “As we speak we cut the bridge of our sen- the message, the ideas. It means understanding the whole situation. sations. When we remain silent it is Empathic listening goes even beyond that: it is a heart to heart rela- easier to have greater bodily awareness, to tion between the two.” know what our sensations are and what is happening within ourselves. In that mea- She also adds that show of interest can be verbal or non-verbal sure I authorize myself to find myself so and that this is part of the arsenal of skills of a good interpersonal that I can later do the same with the communication. Keeping eye contact with the person speaking, a other person in a healthy way. What smile, a nod, “All these subtle signals of body language will trans- happens is that due to a strong need for mit an unconscious meaning of our attention and interest towards control, we wish to know everything that the person who is speaking.” is going on with the other person, what he thinks or feels and if we do not achie- When there is silence there is also communication and it is ve this we lose our calm. We must unders- necessary to learn to interpret it. The specialists point to the fact that in silence there is stillness, peace and a pause to reestablish •tand that silence is necessary,” is the con- internal communication to then return to an encounter with the other person, and with greater clarity. One must listen to the clusion Mora arrives at IN A COUPLE IT IS CONVENIENT TO UPDATE ON ASSUMPTIONS Communication allows confrontation and valida- tion of hypotheses. It is not bad to generate assumptions and expectations both the ones one has and the ones the other person has. What is not healthy is to think that they are true without taking the other person into account. “Communication is much more assertive in so far as it is clear to me what I think and that this is coherent with what I feel and manage to express in correct manner. In that same guise I find coherence in the message I receive from others. When there is some difference between what is expressed and what one thinks or feels, the integrity of the message is broken and even trust is hard to come by,” says Astrid Villa, trai- ner in positive discipline. 24

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( )CON TU MENTE CRAVINGS THERE IS A REASON FOR Factors such as excess of lack of sleep, alcohol consumption and sedentary practices have an incidence in putting on these excess kilos. Sadness or anxiety is also related. 26

( )CON TU MENTE Nuevo Servicio TOMOSÍNTESIS > MEDICAL ADVISOR SÍGUENOS: JAIME ADAMS DUEÑAS Psychiatrist, practitioner at Coomeva Private Healthcare 27 PBX. (4) 444 0019 / (4) 325 7070 Times when having excess weight was considered www.cedimed.com Medellín - Colombia healthy have gone by. The reason is not because of a sculptural ideal for the body or the fitness fad, but because it has been proven that someone who is overweight or obese is in huge risk of suffering disea- ses as opposed to those who have a normal weight. Recommendation of watching the body mass index, BMI, comes from the World Health Organization, WHO itself. It considers that obesity and overweight are an epidemic and estimates run in the number of 2,8 million people in the world who die due to this cause. The first thing an individual must do when he noti- ces an unusual increase in his weight is to consult the doctor in order to assess whether his condition puts his health at risk. According to Psychiatrist Jaime Adams Dueñas in this case there are both voluntary and invo- luntary factors. The voluntary ones can be controlled because they are related to the consumption of foods with high caloric content such as intake of extra drinks such as alcohol and soft drinks. Other habits, such as bad sleeping and leading of a sedentary life must also be evaluated to see whether they are related. SLEEP AND ALCOHOL IN AN ADEQUATE MEASURE When it is about sleep that is scarcely repairing a recent study from the Mayo Clinic in the United States points out that adults who sleep only four hours feel the need to eat foods containing carbohydrates in comparison with those who get 10 hours of sleep at night.

WCOITNH TYUOMURENMTIEND ( ))harmony in health 360 STATES THAT INTERFERE MILLION PEOPLE IN LATIN WITH NUTRITION AMERICA HAVE EXCESS There are multiple situations in everyday life WEIGHT OVER THE RECOM- that may have incidence on an individual being MENDED ONE ACCOR- predisposed to eating foods that do not nurtu- DING TO THE WHO. re his body well or to eat them in excess. Outstanding among others are: With regards to alcoholic beverages, the tendency to increase in kilos is due to the fact that such beverages ► Sadness: it is typical that many people try to contain carbohydrates and when the individual is eating calm their sorrows with intake of foods that them he does not worry about eating well. contain a large amount of carbohydrates such as chocolate or flour. In the same guise, adopting healthy life habits that not only include good nutrition, the formula for which ► Stress: even though it is usual to stop eating is very simple and consists in adding five fruit and vege- when there is tension, the contrary also tables, water and foods with low fat content, reduced occurs. That is to say eating more than salt and sugar consumption, but also centering on a enough while one resolves critical issues. bodily hygiene that benefits health in general. “The individual must rest, exercise or practice some form of ► Anxiety: individuals with this pathology gene- physical activity, avoid retention of liquids by hydrating rally lose control of their weight when they and also handle stress and depression,” says the profes- look to compensate what they are feeling by sional. These are simple recommendations that help to eating. bring greater awareness of the body. It is not a matter of punitive diets that often times do not come under ► Sedentary habits and procrastination: a poor medical supervision and that may harm the body. It is administration of time to carry out everyday a matter of combining a routine that can result in a chores, sleeping or resting at odd times crea- healthy and happy life. tes space for disorderly eating habits. On occasions healthy meals are substituted by THE MIND IS PART OF THE BALANCE snacks that are not nutritious. The specialist points out that there are factors that correspond to situation that have no relation with the life style such as hormonal issues or intake of medici- nes or specific pathologies. “There is also the psycholo- gical aspect. An individual undergoing stress or facing depression is usually more predisposed to alterations in his metabolism and to a condition to liberate more fat that affects his weight,” explains Dr. Adams Dueñas. He even asserts that many patients tend to •alleviate their sadness eating excessively, almost always foods that are not the healthiest 28

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WCOITNH TYUOMURENMTIEND WARNING SIGN FOR AUTISM ( ))tentdrendcsias ► Early diagnosis for this condition is KNOW MORE vital to initiating treatment as Paul S. Carbone and Alan I. Rosenblaty assert FACING in their book “Autism Spectrum COMMUNICATION Disorders: What Every Parent Needs to Know”, American Academy of An investigation published in the Nature Pediatrics, Editor. (USA) Ecology and Evolution Review suggests that our face has evolved not only due to ► Signs can be detected between 12 and factors such as diet or climate but “possi- 24 months of age. bly” to give greater opportunities to the non-verbal gestures and communication, ► The Health Ministry of Colombia in its vital skills in socialization and establish- protocol guide to Autism Spectrum ment of ample networks. In fact, our face Disorder points out that individuals expresses 20 categories of emotions with this diagnosis avoid visual contact through contraction or relaxation of the and prefer being on their own. They muscles. This skeletal complex, consisting are inexpressive or do not understand of 14 bones and that is our card of intro- the limits of personal space and also duction, has reduced in size from the homi- reject physical contact. nids to our modern day man. This happe- ned in so far as changes in our nutrition (KEEP IN MIND) have impacted the necessity to masticate large chunks, the study indicates. The Liga Colombiana de Autismo promotes not using this word in a 4 deprecating manner and offers DRINKS OR OVER IN WOMEN AND 6 information on this disorder. FOR MEN IS AN INDICATOR MARKING THE LIMITS ALCOHOL MUST HAVE ACCORDING TO CDV.GOV NOT SLEEPING WELL CONSUMPTION OF CHANGES OUR ALCOHOL TO THE LIMIT REACTION TO PAIN If you are beginning to question whether your Lack of sleep makes an individual more consumption of alcohol is surpassing limits, sensitive to pain as the study published in nutritionist Jolen Park in a conference at The Journal of Neuroscience asserts in its Ted.com explains that some consumers coe- review of an investigation carried out with xist with drinks in a “grey area” and do not 25 healthy adults in two different environ- believe they have a problem. Stress or a ments. Exploration of the brain yielded fin- sudden change of life, among other factors, dings showing that the group lacking sleep have an incidence on this. had increased the somatosensory cortex, an area in charge of interpreting the infor- mation coming from the tactile system. 30

)WITH YOUR BODY 80 % OF PAPAYA CONTAINS WATER AS INDICATED BY THE SPANISH FOUNDATION FOR NUTRITION Cuidarte es quererte PAPAYA IS A TROPICAL FRUIT THAT OFFERS NUTRITIONAL BENEFITS TO OUR ORGANISM. IT IS LOW IN CALORIES, SUPPLIES FIBER, MINERALS AND SEVERAL VITAMINS. BETTER EYESIGHT THE BODY IN MOVEMENT CLEANSING OF THE INTESTINAL TRACT It contains Vitamin A, caretaker of the It provides minerals such as magnesium, It enhances digestion, detoxifies, calms eyes thus guaranteeing optimal vision, calcium and potassium providing for the pain and inflammation of the stomach, especially at night. It is a skin caretaker good functioning of the muscles, bones, helps with constipation and eliminates as well as of the heart and kidneys. nerves and heart rate. parasites embedded in the intestine.

WCOITNH TYUOCUUREBROPDOY ( )nnuutrtirtiicoiónn THE EGG’S TASTY WORLD Its nutritional qualities make it unique. It is easy-to-access food. And yes, it is small but has huge nutritional proper- FROM YOLK TO EGG WHITE ties. Thus, the egg becomes indispensable in your pantry, as it is a substantial food that outstandingly ► The yolk is the central part of the egg where there is a provides proteins of high biological value. This means that concentration of the totality of lipids (fat) and vitamins it contains amino acids essential to the functioning of the such as A, D, E, and K, B1, B6 and B12 and folic acid, body, that when not synthesized in the organism must be among others. Nutrients such as carotenoid pigments that supplied in our diet. In addition, it delivers vitamins and give it is orange color can also be found there playing an minerals that are differentially distributed between the egg antioxidant function in the organism. It contains iron that yolk and the egg white. It is then fundamental to know its is better absorbed when you eat the entire egg. structure in order to enhance its nutritional qualities. ► The egg white, in turn, is composed primarily of albumin, On the issue of how many eggs to have, Nutritionist an excellent quality protein. In order to guarantee maxi- and Coordinator of Nutrition and Dietetics at the San mum benefits, it is recommendable to have the egg Vicente Hospital Foundation Sandra Milena Galeano white totally cooked. Ortiz indicates that when following an adequate nutri- tion plan and a healthy life style an egg a day does not 1 pose any risk to health; nevertheless, this quantity may vary depending on the specific nutritional requisites EGG OF 50G CONTAINS of each individual. 6,3 G OF PROTEIN. Outstanding is its versatility when used in the kit- ADVISOR chen due to its properties such as emulsification, foa- SANDRA MILENA GALENO ORTIZ ming, coagulation, anti-crystallization, coloring and fla- Nutrition and Dietetics Coordinator at voring allowing for use in many different preparations. San Vicente Hospital Foundation In this way it has become an essential ingredient in the elaboration of sauces, meringues, cakes, crèmes, flans and nougat, among others. It can be fried, boiled, baked. But our specialist suggests that we opt for other options in which the excessive use of oil and additional fat can be avoided. She also warns against consumption of raw eggs due to the high microbiologic risk that such practice presents and the meaningful decrease in the absorption of some of its nutrients in the intestine. •Following are three recipes based on this ingredient easily adaptable at any time of day 32

( )CON TU CUERPO Accompanying your intake of egg with broccoli enhances iron absorption. OPTION 1 SCRAMBLED EGGS WITH BROCCOLI NUMBER OF SERVINGS: 1 Kcal: 200 / Protein 7.7 g / Total fat: 14.9 g / Total cholesterol: 213 mg / Carbohydrates: 6g / Iron: 2.7 mg INGREDIENTS: INSTRUCTIONS: 80 g Broccoli -Bring the broccoli to a boil in a saucepan for three (3) minu- 1/2 White onion tes, drain, cut into small pieces and save. 1 Hen’s egg type A -Cut the onion into fine pieces; in a frying pan at medium heat add one tablespoon of the oil and stir-fry the onion 20 ml Olive oil until soft. Season. Salt and pepper to taste -Stir the egg in a bowl, add the broccoli and onion, mix all ingredients well. -Add 1 tablespoon oil to the saucepan, add the mixture and cook at low heat on each side to form the omelet -Serve with a side dish of bread or small corncake Suggested drink: strawberry, guava or orange juice in water. THIS IS A LOW FAT Strawberries contain OVO-VEGETARIAN fiber, Vitamin C and anti-oxidants. OPTION. 33

CON TU CUERPO OPTION 2 ( )xxxxxxxxx HOT MILK PUNCH (CASPIROLETA) Milk consumption benefits growth of the SERVINGS: 4 bones and promotes Kcal: 285 / Protein: 15.1g / Total fat: 14,6 g / healthy teeth. Total cholesterol: 290 mg / Carbohydrates: 23g INGREDIENTS: 1lt liter delectated or low-fat milk 5 units type A hen eggs 1/4 teaspoon vanilla extract 4 cinnamon splinters 1 teaspoon powdered cinnamon 1 teaspoon sugar (optional) pinch of salt INSTRUCTIONS: -Pour the milk into a large saucepan and add the cinnamon splinters and sugar to taste. -Cook at medium temperature, stir for about 3 minutes. -While the milk boils, separate the yolk from the egg whites and beat the yolks in a deep bowl. In another bowl beat the egg whites with salt. -Remove the cinnamon splinters from the milk and incorporate the beaten yolk; cook at medium heat stirring slowly. -Add the egg whites that have been beaten to stiff peaks and the vanilla extract, then lower the temperature and continue stirring until you get a homogeneous thickness. Remove from the heat and serve in cups; sprinkle with powdered cinnamon. Recommended side dish: a serving of saltine cookies (3 units) Cinnamon supplies hydro-soluble vitamins (that dissolve) such as vitamin C, B1 and minerals. THIS RECIPE IS IDEAL FOR CHILDREN. IT AIDS GROWTH 34

( )CON TU CUERPO Intake of garlic reduces risk of cerebrovascular accidents. OPTION 3 HARD-BOILED EGG SALAD SERVING SIZE: 1 CUP Calories: 120 /Protein: 6 g / Total fat: 10g / Total cholesterol: 120 mg / Carbohydrates: 0g INGREDIENTS: Parsley aids digestion and makes for good 5 units eggs 3 tablespoons mayonnaise intestinal transit. 1 tablespoon mustard 1/2 tablespoon onion 1 garlic clove 1 handful parsley pinch of salt INSTRUCTIONS: IT IS A SUBSTANTIAL FOOD THAT OUTSTAN- - Bring enough water to a boil in a saucepan and place the eggs there. Lower the temperature and let cook for about 10 minutes. DINGLY PROVIDES Add some salt and vinegar to peel them more easily. PROTEINS OF HIGH - Cut into squares and save the yolk separately. Fine cut the rest of the ingredients: onion, garlic and parsley. BIOLOGICAL VALUE. - In a separate container, mix the yolk with the mayonnaise, onion, garlic and parsley. Add a little salt and pepper (optional). Mix this sauce with the rest of the cooked egg. -Serve and decorate with a fresh bough of parsley. This salad is served cold and can serve as garrison for any type of dish. Recommended drink: A glass of water or any non-sugar beverage. 35

( )CON TU CUERPO ACTIVATE AND TAKE CARE OF YOUR THYROID GLAND Treatment is key in cases such as hypothyroidism manifesting as tiredne and weight gain. A good diagnosis is also key. MEDICAL ADVISORS CAMILO AGUILAR RINCÓN Internal Medicine and Endocrinology specialist SALOMÓN DAGUER Endocrinologist 36

( ))CWOITNHTYUOCUUREBROPODY keep in mind It is possible to have an optimum quality of life even if you suffer from hypothyroidism, albeit in full com- pliance of your treatment. In simple words, one can lay out a path for patients presenting with this disease who wonder whether they will be able to lead a normal life on a daily basis. Observation of the moment and process of the inta- ke of medication is one of the vital conditions that must be taken in account in order to succeed according to Internal Medicine and Endocrinology Specialist Camilo Aguilar Rincón. “Intake must be at the same hour, for example, and with water; 30 minutes to one hour is the time you should wait before intake of food. If you can achieve this, your life can be totally normal. It is all about a perfectly contro- R lled treatment.” (Weight gain is common Hypothyroidism pre- in people with a thyroid that is quite ess inactive. This is due to the fact that the sents when the thyroid hormone affects our metabolism. Diet gland is no longer able to and exercise may help to control it. produce sufficient thyroid hormone to keep the body functioning in a normal way. The bodily processes began to slow down and the person rea- lizes that he feels colder, becomes more easily fatigued, that his skin has dried up, presents with constipation and has a tendency to forget things or otherwise finds he is feeling depressed as indicated by the American Thyroid Association, ATA. LACK OF ENERGY “It is as if the body progressively lacked in ‘gasoline’” as Endocrinologist Salomon Daguer expresses it. “But since these symptoms can also be explained by the pre- sence of other pathologies, it is important to listen to the patient,” he adds. Hypothyroidism presents largely in women and adults over 50 years of age. According to ATA, among its main causes is autoimmune disease (Hashimoto 37

WCOITNH TYUOCUUREBROPDOY ( )keep in mind among the most common ones). Treatments include partial or total surgical removal of the thyroid gland and treatment with radioiodine in certain patients. Other causes are congenital (that the infant is born with), inflammation of the thyroid gland (generally caused by an autoimmune attack or by a viral infection) and either excess iodine or shortage of the same in the diet. DIETING AND EXERCISE Even though the patient lacks energy, in general, there are no restrictions for him to carry out his physical acti- vities unless there is evident and greater deterioration to his health. “In clinical practice, if a person is leading a healthy life, hypothyroidism is detected in the tests rather than by what he feels. There are no studies clai- ming that exercising can prevent this disease, but evi- dently there will be fewer symptoms for people with such diagnosis who exercise,” are the comments of Salomón Daguer. “Exercise and healthy eating habits are a recommendation for everybody independently of their presenting with hypothyroidism or not,” adds Camilo Aguilar Rincón to complement the above asser- tion. “Such activities will prevent mortality from cardio- vascular causes and will bring other additional benefits to the person’s state of mind. People presenting with this pathology may show a certain tendency towards depressive symptoms inspite of their treatment. In fact, depression is related to hypothyroidism. But with exerci- se and psychotherapy it can be mitigated.” Due to this pathology a slight increase in bodily weight may present but, upon treatment, the normal thing is to return to the original weight. “We cannot blame the thyroid gland or hypothyroidism for cases of obesity, given that it does not lead more than four kilograms of weight gain. If one is under treatment, this is not the cause for obesity but it is rather due to eating habits and the life style the individual is leading.” Finally, the correct dose of the medicine may vary in each case so that it is very important to follow the expert’s indications. The specialist will be the one to indicate how much to take as a function of the symptoms, the blood test results and the cause. Weight gain is common in people with a thyroid that is quite inactive. •This is due to the fact that the hormone affects our metabolism. Diet and exercise may help to control it 38

50 ( )CON TU CUERPO of age on average may present 39 with a greater number of hypo- thyroid cases. IODINE DEFICIENCY “Hypothyroidism of autoimmune origin or that requires surgical inter- vention or treatment with radioiodi- ne cannot be prevented,” says Internal Medicine and Endocrinology specialist Camilo Aguilar Rincón. “Only deficiency in iodine consumption in the diet opens the option to seek an equili- brium.” In this line of inquiry the ATA indicates that this mineral is present in common food, such as table salt (maximum intake of 6 g per day); and also in dairy products, fish, seafood, meat, bread and eggs.

WCOITNH TYUOCUUREBROPDOY ( )x-ray PREVENTION OF ASTHMA This respiratory disease can be controlled with adequate treatment and preventive measures that have a positive 235 impact on the quality of life of the patients. COMMON CAUSES MILLION PEOPLE IN THE WORLD HAVE ASTHMA. Genetic predisposition, tobacco THIS PATHOLOGY IS NOT consumption, exposure to TRANSMISSIBLE AND PRESENTS MORE environmental damage from inhaling FREQUENTLY IN of particles that provoke allergic CHILDREN ACCORDING TO THE WORLD HEALTH reactions or irritate the respiratory ORGANIZATION, WHO. airways, cold air, strong emotions such as fear or anger, some types of medication and practicing certain kinds of exercises can originate the asthmatic crisis. WHAT HAPPENS 50 % IN A CRISIS? OF ADULTS AND CHILDREN DO NOT During an asthma attack or out- FOLLOW THE break, the lining of the bronchi infla- PRESCRIBED TREATMENT mes and so their internal diameter RESULTING IN DEFICIENT decreases reducing the flux of air entering and leaving the lungs. CONTROL OF THE There are coughing sprees, oppres- SYMPTOMS AND sion of the chest, wheezing (noise) and difficulty in WORSENING OF THE breathing. Symptoms may DISEASE. vary several times a day or during the week. SOURCE WORLD HEALTH ORGANIZATION Each patient must learn to identify those (KEEP IN MIND) Control of a progression elements in his ambiance that bring on of asthma requires administering his/her asthmatic crisis, in order to avoid Recurrent episodes can cause insomnia, daily tiredness and medication such as inhaled coming in contact with them. decrease in work or school activity corticosteroids. in the patient. 40

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COWNITHU YCOUUERPBOODY ( ( ) )little giants APPOINTMENTS FOR Even though there is no book teaching us to take care of our children and they UNINHIBITED themselves are not born with an instruc- TALKS tions manual under their arm, the role the mother plays cannot be left to her intuition or During pediatric controls a general common sense alone. follow-up of the child is performed delivering important guidelines to the One of the issues that parents are most parents for the child’s good development. interested in, especially beginner parents, has to do with the frequency with which they MEDICAL ADVISORS must consult with the doctor for their chil- JAIME CÉSPEDES LONDOÑO - Pediatrician, dren. They also want to understand what the practitioner at Coomeva Private Healthcare main revisions are about, according to the MARTHA BELTRÁN - Pediatrician different growth phases of their children. Our main advice is not to change pediatri- cian constantly because the doctor that has known the child since a very early age knows each detail of his clinical history and the indicators with which to perform the follow- up; a trustworthy relation evolves between the doctor, the child and the family. 44

( )CON TU CUERPO THE MOST IMPORTANT REVISIONS 10 During the first 5 years of the child’s life it is key to follow-up on: TO 15 DAYS AFTER BIRTH OF THE BABY IS THE TIME FOR Respiratory diseases such as acute respiratory infec- THE FIRST VISIT TO THE 1 tion, acute otitis media, sinusitis and asthma that PEDIATRICIAN ACCORDING might require an appointment with a pulmonologist. TO THE UNITED STATES ACADEMY OF Pathologies of the skin, such as dermatitis or aller- PEDIATRICS. 2 gies to insects or allergens that are normally remi- tted to a dermatological consultation. Gastrointestinal disease, such as acute diarrhea and 3 constipation that according to its severity may requi- re a visit to the gastroenterologist Deformity of the lower limbs such as hip dysplasia, 4 flat feet and different torsions of the legs that requi- re assessment by an orthopedist. Evaluation of vision and audition that include a revi- 5 sion by the pediatrician and, on occasions, requires a diagnosis from an otorino. WHEN TO MAKE AN APPOINTMENT? child is 5 years of age. On her part, calm down at least for a moment when According to Colombia’s Ministry of Pediatrician Martha Beltrán recommends he hears you or when you lift him up in Health guidelines, medical appoint- that six-month-old babies should consult your arms? Does he sleep a bit more at ments must be constant until the child every month for timely detection of any some time of day or night? Are its vigil turns 11. From 12 years of age onward, problem and for disease prevention. time-periods longer in time? Does he routine medical check-ups must be sche- Routine controls include weight and follow you with his eyes and does he look duled with the general surgeon or height measurements to insure that the at attentively at your eyes and face when family doctor. In the case of adoles- physical and brain growth are the expec- you are close up? Does he react to your cents, accompaniment focuses on his ted ones as well as revision of the vacci- voice or other sounds, and other such? In growth process and development and, nes and exchange of experiences bet- turn, parents can clear doubts such as, according to findings, pathologies or ween the specialist and the parents. why does he regurgitate after eating? risk factors these consultations can Keep in mind that as parents, one must How do I prepare his bottle? What is the extend over into his adulthood, but not wait for the child to become ill in best way to cover him up? How fre- with a periodicity of 12 to 18 months. order to visit the doctor. This is an quently must one weigh and measure Along this line of thinking, Pediatrician opportunity to clear doubts about the him? When talking about such controls and Director of the Pediatric Hospital of wellbeing of the minor without any type it is best to organize a calendar, prepare a the Cardioinfantil Foundation Jaime of inhibitions or fears. Frequently asked questionnaire and be attentive to the sig- Céspedes confirms that, with the excep- questions by the pediatrician can be of nals that do not correspond to the well tion of a special situation, controls can be this nature: Can the baby lift his head being of the child in order to give timely held every six or twelve months until the when he is placed head down? Does he warning signs and to avoid setbacks. 45

CWOITNHTYUOCUUREBROPDOY ( ))little giants FOLLOW-UP BY STAGES ► From 0 to 1 year of age: Revision of his growth and measurements of the child where special attention is paid to his physical, cognitive and social deve- lopment as well as his language skills. A nutritional, visual and auditive evaluation is also important. ► From 1 to 3 years: Follow-up of growth and development. There is evaluation of the nutritional state, eating habits and visual and auditive health. The child must attend an odontological appointment and must get dewormed. It is key to check on his mental and sexual health. ► From 3 to 6 years: In addition to the nor- mal check-ups the specialist talks with the parents about his performance at school and begins an evaluation of his communi- cative skills. There is follow-up of the guideline •for his upbringing and self- care practices (Regular visits create close relations and trustworthy ones between the pediatrician, the parents and the child. Joint work helps in the development of physical, mental and social health of the minor. 46

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( )CON TU CUERPO FOCUS ON HYMPYEORPMIEATARNODPYThey both correspond to problems with vision that distort close-up ( )observation of objects and observation of objects at a distance. MEDICAL ADVISOR MARTÍN MORENO Ophthalmologist surgeon, Refractive Surgery and Cataract specialist The revistasaludcoomeva.co Website offers you more information on myopia and hypermetropy. 48

( )WCIOTHNYTOUUCRUBEORPDOY focus on If an individual feels he is expending a lot of effort to see things to look blurry and close up things to look clear. and that he cannot see objects either near or far with Contrariwise with hypermetropy the eyes frame the image enough clarity, he could be presenting with visual problems behind the retina. Both pathologies share symptoms such as known scientifically as refractive errors. The National Eye fatigue, headaches and visual overexertion just to focus. Institute of the United States explains that normal vision pre- Therefore, if they are not treated on time they could interfere sents when the light focuses directly on the retina and not in with every day activities such as reading, writing, watching TV front or behind the retina. This is why when myopia presents, the light locates directly in front of the retina causing distant •or driving. Regular eye check-ups with specialists are useful in detecting these and other visual deficiencies. CAUSES 1.300 These visual problems are generally MILLION PEOPLE IN THE hereditary. Nevertheless, there are WORLD LIVE WITH SOME individuals who develop an TYPE OF VISUAL DEFICIENCY accommodative myopia (avoidable) ACCORDING TO ESTIMATES associated with the excessive use of OF THE WORLD HEALTH electronic devices and visual effort in poor lighting conditions. ORGANIZATION, WHO. WHEN DO 35 % THEY INITIATE? OF ADULTS HAVE A 20/20 In the majority of cases myopia develops during VISION, AS STATED BY THE childhood. Likewise, in general, children are AMERICAN ACADEMY OF hypermetropes (farsighted) a normal condition OPHTHALMOLOGY REASON known as physiological hypermetropy that occurs FOR WHICH THEY NEED CON- because the eyes are small. This situation can be TACT LENSES, EYEGLASSES OR corrected around 7 years of age when these organs are fully developed. CORRECTIVE SURGERY. 80 % HOW TO CORRECT THIS? OF CASES WITH DEFICIENT ► With eyeglasses or contact lenses patients get to VISION ON A WORLDWIDE improve their vision. Nonetheless, these measu- SCALE ARE CONSIDERED res do not correct the problems. INEVITABLE, AS INDICATED ► Between 18 and 20 years of age visual defects BY THE WHO. usually set in so that it is pertinent to consider undergoing refractive surgery. Success lies in stopping the advancement of the condition ► There are situations in which pathologies conti- nue their course and it represents a very high range of cases. 49

( )CON TU CUERPO VARIETY MAKES FOR BALANCE ► Sour chocolate: supplies mag- ► Vegetables: like fruit, are a nesium that favors muscu- source of vitamins and mine- loskeletal functions and func- rals and are high in fiber. tions of the nervous system. Beets, for example, contain betaine a protector of the digestive system. ► Dried fruit: rich in selenium, essential to anti-oxidation at the cellular level can be found in walnuts. ► Fruits of different colors! This charac- ► Fish: especially salmon, for its abundant con- teristic relates to vitamins, minerals, tents of Omega-3 benefitting the immunologi- and enzymes that help the metabo- cal system. It is also a precursor to the forma- lism’s well being. They are important to tion of glutathione and is considered the “mas- the intestinal flora that is fundamental ter protector” of the body due to its role in for the absorption of nutrients and neutralizing free radicals. decomposition of food. Outstanding are avocado, guava, mango, sour sop, kiwi and red berries. FOOD FOR ETERNAL YOUTH Antioxidants supply the body with fundamental nutrients that help combat ageing. MEDICAL ADVISOR SANDRA ALFARO Nutritionist, dietitian , practitioner at Coomeva Private Healthcare 50