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Home Explore Salud Coomeva Magazine - October - November/2018

Salud Coomeva Magazine - October - November/2018

Published by El Colombiano, 2018-10-04 18:32:23

Description: At Coomeva Medicina Prepagada, we promote self-care, mental health and well-being. For this edition, we tell you why WhatsApp conversations should not be equated to those that are physically engaged. In addition, we address fundamental issues such as the importance of developing fine motor skills in children and,also, why it is necessary to reach agreements in relationships.

Keywords: Children,Whatsapp,relationships


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ISSN 1692 - 5556 October - November 2018 - Issue 143 COUPLESAGREEMENTS

ISSN 1692 - 5556 Octubre - Noviembre 2018 - Edición 143 45 YEARS OF ACHIEVEMENT ACUERDOS EN PAREJA EIn 1973, we took our first up as services such as Coomeva Private the pioneers of private heal- Healthcare’s My Story platform, alsoIssue 143 thcare services in Colombia, an opportunity to create a healthyOctober - November 2018 offering the community the opportu- environment for themselves. This is anRevista Salud Founder nity to access high-quality healthcare innovative program for users to exami-Gilberto Lotero Muñoz (q.e.p.d.) services. Forty-five years later, we con- ne and discover what they are eating,Chairman of the Board tinue serving as a healthcare company and what their mental health and self-José Vicente Torres Osorio with a portfolio of services and pro- care habits are, allowing them to eva-Executive President Of the ducts that we have expanded through luate their state of health and learnCooperativo Coomeva Business Group innovation, technology and qualified about tips that prioritize the importan-Alfredo Arana Velasco employees that can meet the different ce of preventing disease, instead ofCEO Coomeva Sector Salud needs of our over 349,000 users. just finding a cure.Gilberto Quinche Toro Our milestones and achievements are For over four decades, we have beenPrepaid Medicine CEO many. A brief highlight of them includes dedicated to meeting the challenge ofJorge Alberto Zapata Builes our internationalization strategy, certi- providing streamlined, efficient and per-National Director of Strategy fied high-quality services, and our diffe- sonalized healthcare. Our goal continuesand New Business rent virtual assistance platforms provi- to be to improve the experiences of ourMauricio Castillo Pérez ded by our Digital Strategy, which redu- users through the different channels weNational Director of Marketing ces waiting times at our patient service offer because. Thanks to our users, weSector Salud areas and makes life easier for those continue to be a great organization thatCamilo Ernesto Diusaba Perdomo who place their trust in us every day. takes care of and supports them.General Manager Another way we provide our users Let’s celebrate this anniversaryDavid Montes Canal with a good quality of life is through together!Editorial Committee Editorial and Graphic Direction, Magazine General Editor Journalists CommercializationPascual Estrada Garcés prepress and printing Paula Andrea Montoya T. Isabel Vallejo Jiménez El ColombianoNational Director of Prepaid El Colombiano Magazine Editor Ana María López de Mesa Cali: Marisol MonsalveHealthcare Tel.: (4) 331 5252 Natalia Estefania Botero C. Natalia Ospina 310 544 2354Hernán Darío Rodríguez [email protected] Graphic Editor Liliana Klinkert [email protected] National Director Hugo A. Vásquez E. Diana Milena Ramírez Bogotá: Ana María EchandíaBlanca Inés Vélez Design Photography 3183764776National Director of Oral Health Luis Salazar G. Medellín: Mónica GómezSandra Viviana Muñoz Rodríguez 312 202 7269Director of Epidemiology [email protected] Lucía Varela RojasJefe Nacional Auditoría Médica The contents of all Salud Coomeva Medicina Prepagada S.A. magazine articles are illustrative in nature and/or for general knowledge. In no case areMartha Liliana Cifuentes 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,Coordinadora Nal. de diagnosis or treatment of a disease or health problem without consulting with a certified physician.Relacionamiento con Prestadores The product and service offers made in the ads published in the Salud Coomeva Medicina Prepagada S.A. magazine are the sole responsibility of theJulián Villegas advertisers. Also, the company is not liable nor obligated to provide its affiliates the services, procedures or treatments described in the contents ofNational Chief of Risk 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 plansManagement in Health and services. All rights reserved. May not be reproduced in any form or system. © 2018EditorDavid Montes CanalEditorial CoordinatorMelissa Arce PérezCollaboratorsMelissa Arce PérezGermán Santiago Salcedo CajiaoJuan Pablo Barba CastañedaAlexandra Arango RojasViviana Trujillo JiménezAna María Correa MontañoMarco Emilio OcampoHugo Ricardo Campo Cardona

TABLE OF CONTENTSOctober - November 2018 7 25 45 65( )YOUR MIND ( )YOUR BODY ( )YOUR WORLD ( )CORPORATE8 Trends 26 Grandparents 46 For him 66 Special Group chats Developing habits while The men of today Building a relationship and respect you are young of trust to live life to the fullest 50 Go natural Diabetes: Eating right 68 Prevention14 Couples 30 Little giants Breathing deep withoutCompromising as a Nose plugged? 52 Your generation limitationscouple to overcome fears There may be an Friends forever: A per- explanation sonal choice 72 Institutional It’s about you,16 Harmony in health 32 Trends it’s about your health Improve your rela- Discover the benefits tionship with food of going raw18 Focus 36 Infographic 56 Little giants 74 Directory Focus on Brief activities that Fine motor skills New providers and workplace stress give you energy through play updated contact information20 Prevention Accepting death as part 40 For your smile 60 Keep in mind of the cycle of life A soft toothbrush and Staying grounded floss: all you need with a good pair of shoes to take care of your gums 64 Games 42 Keep in mind Crossword and sudokus Remember to stretch and rest your hands

ESTAR AL DÍA CON TU SALUD TE PUEDE PREMIAR Realiza oportunamente el pago de tu Estado de Cuenta durante los meses de septiembre a diciembre del 2018 y participa en el sorteo de maravillosos premios: 1 Paquete turístico a Cartagena para 2 personas. 5 Tarjetas People Pass de $500.000 c/u.Condiciones y restricciones: Realizar el pago oportuno mes a mes del estado de cuenta de Coomeva MedicinaPrepagada dentro de las fechas establecidas de acuerdo al corte de cada contrato y durante los meses de agosto adiciembre de 2018. Contratos activos. Solo participan mayores de edad dentro del juego promocional. Aplica para eltitular del contrato de los planes Familiar.Aplica para las líneas de Coomeva Emergencia Médica, Coomeva Salud Oral yCoomeva Medicina Prepagada.Aplica para los contratantes que han realizado pago anticipado durante el mismo período.

)YOUR MIND ( )CON TU MENTE 4,7 % OF COLOMBIA’S POPULATION SUFFERS FROM DEPRESSION, ACCORDING TO THE WORLD HEALTH ORGANIZATION.SYMPTOMS SUCH AS STRESS, SADNESS AND HOPELESSNESSCAN BE INDICATIONS THAT A PERSON IS STRUGGLINGWITH A LIFE DILEMMA.DIFFERENT CAUSES BE EMPATHETIC WARNING SIGNSSome causes of depression can inclu- It is complicated to predict who may be Warning signs can include defensivede the death of a loved one, rela- going through these situations, which is behavior, impulsiveness, anxiousness,tionship problems, illnesses and finan- why it is important to learn more about crying, isolating oneself and experiencingcial concerns. another’s situation, before judging. abnormal physical symptoms. 7


(( ))CCOONNTTUUMMEENNTTEE tendenciasCHATEARCON RESPETOLas conversaciones en whatsapp no debenequipararse a las que se entablan de manerafísica. Asegúrese de ser asertivo y empático. ASESOR SANTIAGO DUQUE OCHOA - Médico psiquiatraGROUP CHATS AND RESPECTA look at the conversations you have on WhatsApp.Careful with treating them the same as the ones you havein person! And be sure to be assertive and empathetic. ADVISOR SANTIAGO DUQUE OCHOA- PsychiatristProbablemente sepa la historia de un You probably have heard the story of conocido suyo que se salió del grupo someone you know who left their de whatsapp de su familia porque su family’s WhatsApp group becausetía lo tenía colmado de las cadenas de ora- they were tired of receiving their aunt’sción que enviaba, todos los días, a la chain mail prayers that she would send outmadrugada, o también conozca el cuento every day early in the morning. Or maybede un tío que se distanció de su sobrino the story of the uncle who stopped speakingluego de tener un acalorado encuentro with his nephew after having a heated dis-sobre política por este mismo medio, pero cussion about politics on the app, withoutque nunca confrontaron frente a frente. confronting each other face to face. Las nuevas tendencias digitales nos The new trends of digital media areestán obligando a que asumamos distin- forcing us into communicating withtas maneras de comunicación en un each other in new ways: the virtualmundo virtual, al que muchas personas world. Many people from different ages,de diferentes edades, géneros y gustos genders and likings enter this worldingresan sin saber, o sin contar con without even realizing it, or withoutherramientas tan básicas como reglas de having a basic consideration for polite-urbanidad y respeto, las mismas que ness and respect, which should also bedeben primar en las relaciones sociales given priority in our every-day, face-to-físicas del día a día. face relationships. 9

( )CON TU MENTE( En 2017 entró en vigencia en Francia la Ley Khomri, conocida como el derecho a desconectarse del trabajo, para garantizar el respeto del tiempo libre y las vacaciones. Parece común o disparatado, pero esta Whether this is something you are usedcarencia de normas, ha tergiversado el to, or it is new, this lack of consideration hassentido, por ejemplo, de los chat o grupos managed to change the function of groupde whatsapp, que en un principio se conci- chats or WhatsApp groups, initially desig-bieron como el puente para unir familias, ned to bring people together such as fami-equipos de trabajo, amigos, compañeros lies, teams, friends or even gym buddies. It isdel gimnasio, para dar noticias, programar also used to share news, schedule events,encuentros, felicitar por los cumpleaños, send birthday greetings, among otherentre otros motivos, convirtiéndose, en things. Over time, this useful tool has tur-algunos casos, en un arma de doble filo ned into a double edge sword, making peop-que disgrega vínculos y trae conflictos. le disconnected and provoking conflict. “Estos grupos cumplen un sentido As the psychiatrist Santiago Duqueclaro y estricto, pero si este se desdibuja Ochoa explains, “These groups have a clearse empieza a perder la intimidad del ser and specific purpose, but if the lines of thishumano, cuando este intenta convencer purpose become blurry, you begin to losea otros de su punto de vista a través de the intimacy of what it means to bemensajes religiosos, políticos, sociales y human. When people try to place theircientíficos, lo que empieza a generar point of view on others through messagesroces entre los distintos contactos. Este involving religion, politics, social commen-es el primer límite que se rompe en estas tary or science, this can lead to conflictPONERSE DE ACUERDOPara lograr una adecuada interacción en los grupos de whatsapp, se recomienda:► Definir los contenidos que se van a tratar. cias, programar encuentros, sacar lo positivo de cada contacto.► Evitar tocar temas álgidos como política, religión, sexualidad, ► Abstenerse de enviar contenido explícito o pornográfico por diferencias intergeneracionales y dejarlos para los encuentros respeto a los integrantes del grupo. físicos. Evitar los juicios morales. ► Si un integrante recurre en información inadecuada, recordarle el sentido del grupo para que modifique su conducta.► Si va a manifestar enojo, contextualizar al grupo de la situación antes de enviar el mensaje. ► Los comportamientos no son los mismos en un chat de padres y madres del colegio, que en uno con los hermanos o► No creerse el dueño de la verdad, porque el otro puede sentir- se vulnerado e identificar esto como una agresión. compañeros de trabajo.► Usar la herramienta para dar información como ubicación, noti- ► Usar siempre las expresiones “por favor” y “gracias”.10

( )CON TU MENTE tendencias( In 2017, the Khomri Law was passed in France, which protects people’s right to disconnect from work, in order to respect people’s leisure time and vacation time.comunidades”, explica el psiquiatra among different members of the chat. ThisSantiago Duque. is often one of the first boundaries of these types of communities that get broken.”COMUNICACIÓN IDEALPor esto, el mayor reto que ofrece este GOOD COMMUNICATIONtipo de comunicación escrita, de emoti- The biggest challenge to this form of writtencones y audios, es desde el punto de vista communication, emojis and voice messa-del lenguaje, intentar que los mensajes ging is related to how we speak to each othertengan una importante carga de neutrali- and to having a good level of neutrality,dad, asertividad y empatía. “Muchas assertively and empathy in our messages.veces no entendemos el tono con el que “Oftentimes we don’t understand the toneel otro escribe las cosas y la puntuación, that the other is using when they writea veces, no es lo más adecuada, lo que se things or use punctuation. Sometimes it’spresta para malas interpretaciones. La not always the best, which can lead tolectura se modifica de acuerdo a la emo- misunderstandings. What you read changesción con la que yo estoy leyendo, enton- depending on the emotion you have whences pueden pasar dos o tres horas des- you read it. It may take two or three hourspués de un mensaje que pasó inadvertido before a person receives a message, and ify arranca una persona que se sintió vul- the person feels threatened by its content,nerada por esta información a confron- he or she may begin to argue (often inappro-GUIDELINES TO CONSIDERThe following are few recommendations for achieving positive interactions in WhatsApp groups:► Determine what content will be addressed. others feel vulnerable and they may perceive what► Avoid complicated issues such as politics, religion, sexuality, and inter- you say as an aggression. generational differences. Save these for face-to-face discussions. ► Use this app as a tool to provide information such as locations and► Be careful with how you express moral judgments. news, to schedule events, and to bring out the positive in everyone.► If you are going to express anger, provide a context for the ► If someone sends inappropriate information, remind the person group to understand the situation before sending the message. of the purpose of the group so they can change their behavior.► Refrain from sending explicit or pornographic content out of ► A group chat of a parents’ association is not the same as one respect for the members of the chat. with your siblings or coworkers.► Don’t believe that everything you say is true. This can make ► Don’t forget your pleases and thank you’s! 11

( )CON TU MENTE tar, muchas veces de forma inadecuada, a quien lo envió a partir de una lectura de su realidad”, agrega el especialista. Lo ideal, por tanto, es comprender el contexto en que ese interlocutor escribió, bajo qué emociones o situacio- nes, para aprender a no juzgar a priori y entablar conversaciones con informa- ciones correctas, coherentes, claras y contundentes que motiven a una charla positiva entre los distintos integrantes. También se vale, tomarse un tiempo de reflexión antes de responder a los men- sajes de manera explosiva, decidir si se quiere o no leer los contenidos o, sim- •plemente, desconectarse. El silencio también es un respuesta priately) with the person who sent the text as a result of perceiving things from their own context at the time,” the specialist adds. It is best to try and understand the context with which a text is written, as well as the emotion or circumstance of the message, in order to not jump to conclusions and to engage in conversa- tions with information that is accurate, coherent, clear and direct, leading to positive interactions amongst the diffe- rent members. It is also important to take time to reflect before responding to messages in an explosive way, or to deci- de whether you want to read their con- •tent, or if it is simply time to disconnect. Silence can also be a response12


( )CON TU MENTE COMPROMISING TO OVERCOME In order to foster lasting relationships, couples should understand the expectations they have of each other and freely express what they want. It’s not about changing each other, it’s about finding a balance and compromise that is best for both. MEDICAL ADVISOR CLAUDIA MARÍA MORENO GÓMEZ Psychologist, practitioner at Coomeva Private Healthcare Being able to share moments with someone that you deeply love is one of the best feelings there is to expe- rience. Having someone’s company makes our life so special, that we often decide to leave the comfort of being alone to becoming involved and developing a new life as a couple. But just as people decide to get married or live together, they also decide to separate, which is what makes it so common to question and be afraid of saying “yes.” As psychologist Claudia María Moreno Gómez explains, “I think lots of relationships begin with the intention of being lasting ones. We don’t start a relationship thinking that it could end. Longing, hope, friendship, expectations and fear can arise when you think that all those hopes and dreams could collapse all of the sudden. This fear can occur when we discover that our goals have changed.” When our expectations and goals seem to be in alignment, and unions finally form, other fears also tend to surface. It is not easy to deal with qualities in the other that could not be perceived prior to living together as they were overlooked out of the need to have company. A JOURNEY While the fear of failure is normal, focusing too much on it can make it feel like the other has too many defects to the point of exaggeration. “When two people want to share their lives with each other, they do so with the belief that they have things in common – their identities, they adapt to each other easily and communication is also comes easily. But often, these expectations are broken as people realize that their interests change, that there are challenges, that communica- tion does not always flow, problems arise that hadn’t before, and the charm begins to wear off,” Moreno states.14

G AS A COUPLE ( ( )CONYOTUUMR EMNINTDE FEARS couples The depth of these inconsistencies can’t be discovered if the 65fear of failure comes with communication problems that build upand are masked in silence in order to avoid arguments or expres- THOUSAND MARRIAGES,sing problems so that the other does not get hurt. APPROXIMATELY, OCCUR IN Other fears are rooted in idealizing the other and trying to COLOMBIA EACH YEAR,make the partner fit what was originally thought about them, but WHILE SEPARATIONS AREwas never addressed when deciding to be together. “I think thatthe fear of accepting the other is very common and that there is a AT ABOUT 25,000.constant desire to change what you don’t like: how the personsleeps, eats, relates and interacts with others, whether they drinkor are rude… Behaviors that we think will change when we livetogether, which doesn’t happen,” the psychologist explains. The problem with these differences and when our expectationsare not met, is the thought that everything will resolve with time,which can trigger anger and resentment that can make it challen-ging to live together. The following are some of the main reasons•why one in every three marriages in Colombia end in divorceOVERCOMING FEAR WHAT ISSUESThe fear of failing as a couple can be overcome if there is a SHOULDwillingness to compromise, to accept the other without trying BE TALKEDto change them and to respect their individuality. ABOUT?“Personality is nonnegotiable, but interests are. The funda-mental essence of your personality is something that cannot Some topics that couplesbe negotiated. It is possible to reach agreements about often overlook when theyissues that hinder good communication and cause worldviews begin a relationship thatto clash. Specifically, I refer to when, for example, your part- should be addressed beforener does not like your family or friends. While I can’t cast deciding to live togetherthem aside, I can accept my partner and the fact that they include finances, whethermay not attend certain events,” the expert explains. or not to have kids and howHaving clarity about how to determine what each person can to raise them, and makingcompromise on – understood as acceptance and understan- sure your short and long-ding, not as sacrificing – can help to overcome fears and allow term goals align.the relationship to flourish, where each can truly be the per-son that they want to be with for the rest of their lives. 15

YCOOUNRTMUINMDENTE( ) )harmony in healthIWMPRITOVHE YFOUOR ORELDATIONSHIP Pay attention to what you eat to identify when you use food as emotional relief. MEDICAL ADVISOR JAIME ADAMS DUEÑAS - Psychiatrist, practitioner at Coomeva Private Healthcare We live in busy and stressful times and one of BE AWARE OF THE WARNING SIGNS the manifestations of this chaotic way of life is how we eat. People do not just eat “on the Getting up from your bed or couch out of habit just to go,” they also eat anything that fills them up, satis- go to the kitchen to look for something to snack on is fying the natural desire to get our basic needs met. a clear symptom of emotional eating. With this beha- vior, whether related to stress, anxiety, sadness or This, in itself, is a health problem. Eating foods to depression, people are trying to process their feelings deal with what makes us stressed, sad or worried sig- through food. It is eating to forget your worries. nificantly raises the chances of acquiring physical ail- ments with serious consequences such as obesity or It’s not bad to occasionally give in to a craving to feel the decompensation of the body. This is a situation better, but when this becomes a habit, people do not rea- that experts call emotional eating. lize it, it becomes a normal activity and they only realize the problem once their body sends them warning signs: This habit consists of consuming foods when there abnormal changes in weight, difficulties digesting, etc. isn’t necessarily a physiological need for it. It’s eating when you have emotional hunger instead of physical Another sign of this disorder is when someone hunger as a way to get relief from critical situations refrains from eating as a result of their emotions or with our feelings. But feeding our emotional hunger feelings. “This is an extreme behavior that deserves does not solve our problems; they remain in the attention,” Adams states. body, which suffers the consequences with an addi- tional few, or many, pounds. When warning signs first appear, it is important for people to inform the person and if this behavior cannot These situations normally lead people to consume be controlled, a specialist should be seen to begin appro- high-calorie foods with low nutritional values. When priate treatment. Most commonly, doctors will refer the this becomes a daily habit, this can develop into patient to cognitive or behavioral therapy or treatment to serious physical conditions. improve self-control. The idea is for the person to learn what is good and what is not good for the body, and to Jaime Adams Dueñas, psychiatrist and expert in set limits between what they want and what they should eating disorders, affirms that “People must take con- eat in a controlled and conscious way. trol of their eating habits, prioritizing nutrition over cravings or compensating for a difficult situation.” Another way of fighting this condition through medicine is through a technique called mindfulness.16

( )CON TU MENTEThis technique consists of eating consciously; withthe idea that you eat to nourish the body. It’s not adiet, it’s a way of putting your mind and emotions towork so that you can develop the ability to pay atten-tion to what you eat. This is about establishing theright balance to optimize how the body functions. “Mindfulness consists of eating the right amount,with self-control and awareness about what you areeating; understanding what is good and what is badfor the body. It is a more rational and less automaticprocess,” the expert points out. Eating well is about reducing the urge to eat sugar andjunk food, and replacing it with a good serving of cons-ciousness and responsibility. It’s not about eating to fill avoid, it’s about eating to nourish the body.TIPS TO FIGHTEMOTIONAL EATINGExperts suggest following a few practices that can help inthe struggle to beat this disorder. They include:► Eating in a peaceful space without distractions like TV or music.► Chewing your food slowly.► Strengthen your willpower to avoid cravings.► Drink a glass of water if you feel hungry 3 hours after your last meal.► Do moderate physical activity to put off your desire to eat.► Eat three meals a day (breakfast, lunch and dinner), following the same schedule. 17

( )CON TU MENTE FOCUS ON WORKPLACE STRESS We all experience stressful workplace( )situations. The key is to find the right way to deal with it. MEDICAL ADVISOR CRISTIAN VARGAS UPEGUI Psychiatrist Learn more about workplace stress at

( ( )CONYOTUURMMEINNTDE focus onThe way we work today leads to an increasing number of Vargas Upegui. Different situations can cause this stress: people to suffer from workplace stress. Over time, this can having several different bosses that delegate tasks, having trigger different diseases and conditions that can affect inconsistent schedules, bringing work home, maintainingthe quality of employees’ lives, leading to symptoms of anxiety, correspondence through different forms of communication,irritability, and physical and mental exhaustion. working in a heavy work environment (where irony, heavy jokes or bullying is involved), being unsatisfied with your daily “As individuals, we try to balance ourselves with the envi- activities, having a low salary or performing activities you areronment that surrounds us. But when changes occur, or when not qualified for. Preventing workplace stress helps preventwe face challenges, this change can cause a type of stress that mental illnesses and other conditions from developing, suchis only positive when the individual adapts, steps up to take on as heart and muscle disorders, as well as burnout.the challenge and transforms,” explains psychiatrist CristianKNOW YOURSELF 1AND REFLECT OF EVERY 5 EMPLOYEESDetermining whether you are genetically pre- SUFFER FROM STRESS ANDdisposed to certain conditions that can causeanxiety or depression, measuring your levels of FATIGUE IN COLOMBIA.irritability and knowing what habits you have ACCORDING TO FASECOLDA,picked up that can compromise a healthy THE NUMBER ONE HEALTHlifestyle can help relieve the effects of externalfactors. Some helpful solutions include learning PROBLEM IN COLOMBIA ISabout meditation, receiving therapy, avoiding MUSCULOSKELETAL DISORDERS.alcohol and practicing good sleep hygiene.PROTECT 1974YOURSELF WAS THE YEAR IN WHICH THEIn order to face these challenges, and prevent symp- TERM “BURNOUT” WAS FIRSTtoms of stress from developing, it is important to: USED, WHICH CAN LEAD TO Aseparate leisure time from work time, exercise, setshort and long-term goals, know how to deal with LACK OF PRODUCTIVITY.conflict by finding the best solution, practice techni-ques on being assertive, plan for the tasks that lieahead and manage your emotions.2 to 3 A GOOD WORKING ENVIRONMENT TIMES A DAY IS HOW OFTEN EMPLOYEES SHOULD TAKE ► Fostering a good work environment and feeling good in the TIME TO RELAX THAT CAN workplace is essential. Rumors of layoffs are one of the fac-HELP THEM RECHARGE, REDU- tors that can have the most negative effect on a workplace. CE STRESS AND GET A FRESH This is why having direct conversations with your immediate boss is so important, so that information flows. PERSPECTIVE. ► Workplace harassment can happen from bosses to their subordinates, from employees to their superiors or bet- ween colleagues. Whatever the situation may be, addres- sing it directly is essential to avoiding its consequences and to taking appropriate measures to resolve it. 19

YOCOURNMTUINMDENTE(( ) )prevention ACCEPTING DEATH AS PART OF THECYCLE OF LIFE Supporting the During the last moments of their deal with the ensuing grief. “The impressi- dying process of a lives, the terminally ill often wish ve emotional impact that hits when we dis- terminal patient is to be surrounded by their loved cover that death is near, triggers a series of ones, as this company helps ease their pain physical and mental processes not just in possible with a and improve their wellbeing. But as the the patient but in the loved ones that little passion, love anesthesiologist and palliative care specia- surround the patient. When you can and understanding. list, Héctor Echeverri Tobón, explains, “It accept death, grief comes much easier. The is strange because families often act as if easiest pain to manage is physical pain, but MEDICAL ADVISOR the patient’s disease was contagious. In an the emotional aspects of pain are more HÉCTOR ECHEVERRI TOBÓN attempt to escape this difficult time – when difficult to heal,” Dr. Echeverri states. it is most necessary to address and discuss Anesthesiologist and the reality of the ensuing death – they try When there are not enough resources expert in palliative care to spend the least time possible with them, for there to be an interdisciplinary team leaving them feeling isolated.” of specialists that can provide support for this process through palliative care, family This behavior is justified by the enor- members will be needed that are willing mous gap between life and death that our to learn about how to deal with this phase western culture has created, one that has of life that the individual will experience. generally led to few wanting to talk about This can help prevent mistakes from affec- death, to the point in which it becomes ting the unity of the family and prevent invisible. It is important to address the bringing unnecessary suffering upon the issue through different scenarios, however, patient. All you need to provide this so that when it occurs without warning, support is love and understanding, the everyone is prepared to welcome it, and best form of support there is.20

REACHING AN ( )CON TU MENTEAGREEMENT 21► Choose the family member who will act as the mediator between the patient and their loved ones. If there is a healthcare professional in the family, this person can help guide the process.► The terminal patient is not in the conditions to serve as the recep- tionist in a waiting room, so it is important to find a place where the patient feels comfortable and safe. At home, patients can be more comfortable and can more freely express how they feel.► If the patient is at home, place them in the room closest to the bathroom; put the bed in the cen- ter of the room to allow entry and mobility on both sides; ideally, choose a room that has a window to establish a connection with the outdoors; and make sure plenty of liquids are available, that they have access to a bell, and that chairs are set out for visitors. Use something to freshen the air and try to obtain the same fragrance that the person used throughout their entire life.► Allow the individual to choose the person who will change their dia- pers and bathe them.► The suggestion is for the family itself to establish shifts for their care.

( )CON TU MENTE THE STAGES OF A TERMINALLY ILL PATIENT These phases* do not always occur in the same order, sometimes the patient spends more time on one or reverts back to another. In their own way, the family also experiences this same process. Normally, phases progress in this order: denial, anger, bargaining, depression and acceptance.ANGER DENIAL DEPRESSIONWhile the patient can direct their anger at When they first hear the news, patients Reactive: After dealing with hospitals,fate, more commonly, they will direct it and families often have the same reac- surgeries, chemotherapies or radiationtowards family members, nurses and doctors. tions: “It can’t be,” “There must be a mis- therapies, the patient becomes weakThey can become aggressive because for take,” or “Why me?” This is a useful and can no longer deny they have thisthem, everything has come to an abrupt stop defense mechanism that allows the mind condition. Anger and rage are replaced(work, future plans, life goals, vacations, and to gradually adjust and assimilate to rea- by a feeling of physical loss (amputa-family). It is important for the person suppor- lity. It is critical for the person that is ill tions, changes in weight), psychologicalting them to put themselves in the shoes of and the person supporting them to talk loss (losing independence), and financialtheir loved one so that their responses and openly about the disease, and how loss (selling their belongings to be ableattitudes do not lead to arguments. This per- serious it is, truthfully; and instead of to cover the cost of the treatment, forson should learn to listen to the patient and asking “Why?” ask “What for?” example). At this stage, the family musteven accept their anger, even if it is unjust or implement strategies to raise their spi-irrational, as this will bring relief to the patient ACCEPTANCE rits, encourage optimism and help themand help them better accept the process. If the patient has had time and support to to keep fighting. experience all these phases, they will finallyBARGAINING reach this phase, which is also the most difficult Preparatory: This is related to the painThis phase is brief. Here, the patient tries to for the patient and their family. In this phase, that the terminally ill patient goes through innegotiate with the whole world such as doc- they are no longer angry or depressed about preparation for their death. It is rooted intors or priests, in order to obtain a second their future. They will most likely have the imminent loss of all that the personopportunity – bargaining – in exchange for expressed how they feel, shown their loves (emotionally). Family plays an impor-making different promises. The most common detachment and will be prepared for their tant role here because it can either makeform of bargaining includes making a radical death. During this part of the process, the things easier or more complicated. Only thelife change: becoming more religious, dona- patient is almost indifferent and devoid of patient who has overcome their fears andting to the poor or donating their body to emotions; it is as if their pain has disappeared anxieties will find acceptance and die inscience – all of this in exchange for more time and silence has become their way of communi- peace. The person sleeps for long periodsto attend the wedding of their daughter or cating. The people supporting them will need of time and is in an evasive state of sleep tothe birth of their grandchild, for example. to be available at this phase to provide them relieve pain. Cycles come to an end.Generally, these promises are secret or are peace of mind and encourage them to let go.shared with people who are very close.* These phases are described in further detail in the book Morir sin miedo y sin dolor (“Dying without fear and pain”) by Héctor Fabio Echeverri.22


TUS HÁBITOS DE VIDA DEFINEN TU SALUD Aunque tengas predisposición genética a ciertas enfermedades, puedes prevenirlas y reducir su riesgo siguiendo hábitos saludables.Por eso, es importante evaluar tu estilo de vida para que sepas lo que debes mejorar.Realiza el test Mi Historia Coomeva MP y descubre cómo estás en:Alimentación. Bienestar mental. Autocuidado.Ingresa a o descarga nuestra App.Cuidarte es quererte.

500 CON TU CUERPOTO 600 LYMPH NODES ( ))YOUR BODYARE THE NUMBER OFLYMPH NODES FOUND THE LOCATION OFTHROUGHOUT THE A SWOLLENENTIRE HUMAN BODY. LYMPH NODE, ALONG WITH OTHER SIGNS AND SYMPTOMS, ARE CLUES TO DETERMINING THEIR CAUSE. OVERALL STATE OF HEALTH Lymph nodes are a part of your immu- ne system and are what allow your body to both recognize and spread infection. Blood tests can confirm or deny a diagnosis. FURTHER STUDIES The treating physician will recom- mend what procedures should follow to determine potential sour- ces of infection. REACTION TO A VIRUS Swollen lymph nodes caused by a virus can return to normal ones a viral infection is cured. 25

( )YOUR BODY grandparentsDEVELOPING HABITSTOWHILE LYOIUVAREE YLOUINFGE TOTHE FULLESTAdopting healthy routines from early on can havea positive impact on your quality of life and onyour ability to enjoy every moment.MEDICAL ADVISORMILIANA SOFÍA ÁLVAREZ BORRÉ – General PhysicianThe aging process can put the brakes on a rapid pace of cardiovascular disease. Healthy lifestyle practices can slow cer- life and it also brings an insistent desire to live a full and tain diseases from progressing. By not practicing them, on the healthy life. Fulfilling this desire, which is often shared other hand, they can lead to certain health conditions.”among the elderly, is possible if healthy routines are includedas part of a person’s daily activities; especially during the tran- By placing a priority on the development of prevention effortssition of aging. Including these routines, as simple as they may that can help people improve their health as they age, the Worldbe, can transform the way you live. Health Organization recommends that it is never too late to take on healthy habits at any point in life such as healthy eating, foste- For example, the Ministry of Health and Social Protection esti- ring opportunities to socialize, not consuming alcohol and tobaccomates that 80% of cardiovascular diseases and 30% of all cancers and engaging in physical activity. According to the Ministry ofin Colombia could be prevented by making lifestyle changes. This Health, physical activity alone can reduce heart disease by 30%, dia-means adopting practices that can improve your health and reduce betes by 27% and breast and colon cancer by 25%.your chances of developing non-communicable diseases, whichhave a significant impact on public health. MAKING IT A PART OF YOUR DAILY PRACTICE Engaging in healthy activities on a daily basis is important as As general physician Miliana Sofía Álvarez Borré states, people age as it has a direct influence on quality of life. Álvarez“Studies have shown that the cardiovascular risk of someone elaborates on this: “As we age, we lose muscle mass, whichwith unhealthy lifestyle practices increases by 60% to 70% makes us more fragile and causes us to lose less calories, espe-compared to those who do lead healthy lifestyles. It is impor- cially if we are not active. To prevent weight gain, it is impor-tant to remember that the main cause of death in Colombia is

CYONURTUBOCDUYERPO( ) )gragnrdapnadrpeanrtesntstant to eat less, but it is also important to consume nutrient- commitment, as all people have them. Just how our parentsrich foods. If you have never been an active person, starting a teach us to talk, walk, go to the bathroom, or eat, we can makeregular exercise regime can improve your resistance, strength, these habits part of our daily routine and say no to thosebalance and flexibility. It is also important to get good sleep, things that are not good for us,” Dr. Álvarez near friends and family, maintain healthy relationships,and surround yourself with people whose company you enjoy.” According to Dr. Álvarez, with all the information and professio- nal guidance that is available, it is also important for people to The key to these practices having a positive impact on your understand what the consequences of poor lifestyle habits are inhealth is to make them part of your daily routine. You can order to understand when they need to change, which can alsobegin at any time, but the earlier you begin, the greater effect help reduce trips to see your doctor. A prevention routine not onlythey will have on you as you age. •helps keep future woes and worries bay, it also helps people fulfill “It is very important to make healthy habits a personal their desire to live a full and healthy life, throughout all stages HEALTHY LIFESTYLE HABITS Some healthy habits the WHO recommends as for being part of a daily routine include: Getting physical Eating a healthy diet Maintaining good Maintaining good oral Avoid tobacco and activity This includes eating at mental health health alcohol This involves moving least five fruits and This involves fostering This goes beyond This recommendation the body (walking, vegetables each day, as opportunities to socia- aesthetics and a good comes from the unders- running, dancing) for well as decreasing how lize that allow people smile and affects diges- tanding that these at least a half hour much fat, salt and to express their emo- tion as well as people’s habits greatly impact each day, in adul- sugar you consume. By tions and connect bet- social lives. The recom- the deterioration of thood and old age. making it a practice to ter to their environ- mendation is to brush certain body functions. You can also try other cook at home, you can ment. Maintaining at least twice a day, Limiting your weekly recreational activities be more aware of what social bonds and floss and use fluoride consumption can help such as gardening. you consume. friendships is key. toothpaste. prevent behavior that can put you at risk.28


YCOOUNRTBUOCDUYERPO( ) )little giants NOSE PLUGGED? THERE MAY BE AN EXPLANATION Enlarged adenoids, the tissues located in the upper back part of the throat behind the nose, are a common ailment among children.30

( )CON TU CUERPOMEDICAL ADVISOR The adenoids are lymph tissues treated with surgery, this is not always ADRIANA MARÍA that function as a filter for the necessary. airway that connects the nose and AGUIRRE ROLDÁN throat. Their main function is to pre- Some patients are also born with ato- Family Practitioner vent the entry of all kinds of particles pic diseases (allergies) that are related such as dust or germs. To do this, they to this increase in size. rely on small hairs known as cilia that perform a broom-like function and pro- ENVIRONMENTAL CONDITIONS duce snot. The cilia have the vital task As Aguirre emphasizes, having enlar- of collecting foreign bodies so that they ged adenoids is not rare. This condi- do not reach the lungs or turbinates tion has actually become common (part of the nasal passages). If the ade- given the atmospheric conditions that noids become inflamed, explains family increase cases of allergic rhinitis caused practitioner Adriana María Aguirre by changes in temperature and the pre- Roldán, this is known as adenoid sence of more contaminating particles. hypertrophy (enlarged adenoids), an This brings infections that are difficult uncomfortable swelling that causes for this tissue to catch. mucus production to increase and makes the viruses and bacteria that Some of the warning signs of this cause infection to accumulate. disease include breathing through the mouth as the result of having a plugged As our specialist explains, this condi- nose (mostly at night), bad breath, tion generally occurs in children under cracked lips, dry mouth, runny nose or age seven, as some children are born persistent nasal congestion, restless with nasal structures that are “a little sleep, snoring, breathing that stops bit bigger than normal, causing condi- during sleep (apnea), and frequent ear tions such as allergic rhinitis or asth- infections. Other respiratory ailments ma.” After age seven, the adenoids that children may have include the flu adjust to the proportions of the child’s or viral rhinopharyngitis, pharyngitis face. While swollen adenoids can be •and croup – an infection that inflames the larynx TREATMENT OPTIONS1 IS REMOVING THE ADENOIDS AN ALTERNATIVE? 2 ALTERNATIVES TO ALLEVIATE SWELLING One of the medical alternatives for treating hypertrophic (enlar- There are other forms of treating inflammation in these ged) adenoids is to remove these issues. “It used to almost tissues. According to Dr. Aguirre, the main treatment is always be that when a child had frequent sinusitis, tonsillitis or through self-care. If the person is aware that their body has a respiratory infections, the general rule was to almost always ope- respiratory response to a stimulus because they are allergic – rate.” However, according to Dr. Aguirre, this is not the best such as smells, cigarette smoke, dust or changes in tempera- option, because the adenoids help protect the respiratory sys- ture – it is best to avoid contact with these stimuli. Another tem by producing immunological substances, which also provi- alternative is to clean the nose with saline solution. See your des protection from the environment. In this case, “Their absen- doctor to determine what treatment is right for you, which ce would only worsen the protection of the lungs or turbinates.” depending on the case, may include antibiotics. 31

CYOUNRTBUOCDUYERPO( ) )trendsGOINGDISCOVER THE BENEFITS OF A raw food diet means that 100% of RAW its ingredients are vegetable-based such as fruits, vegetables and While it is restrictive, seeds, and that when cooked, temperatu- this vegetable-based diet gets res do not rise above 118°F, approxima- tely the maximum temperature they can the most out of the vitamins reach when they are exposed to the sun. and nutrients in fruits, Essentially, this means that they are con- seeds and vegetables. sumed raw and are not processed, which preserves the enzymes, nutrients, vita- MEDICAL ADVISORS mins and fiber they provide – essential to ALICIA CLEVES HUERGO the chemical processes of the human Nutritionist and Dietitian, practitio- body. This is a diet that aligns the care of ner at Coomeva Private Healthcare your health, planet, ecosystems, and ani- mals, but also calls the nutritional value SANDRO GÓMEZ it provides the body into question. Nutritionist As Javier Medvedovsky states in the blog “Zen” from the Spanish newspaper El Mundo, raw foodism is a lifestyle that consists of eating fresh foods just as they are created in nature, “So while this diet is popular now, it actually dates back to ancient times.” Medvedovsky is a raw food chef and is the author of the book Espiritual chef. The culinary techniques of this type of cuisine include germinating, fermen- ting, blending, crushing, cutting with different techniques and dehydrating to32


( )CON TU CUERPODID YOU KNOW? achieve different textures and flavors. helps prevent constipation as it improves “People who follow this diet stay away the digestive tract. “Due to its fiber con-► Raw foodism is a form of veganism. from fast food and processed foods, tent and volume, these food groups make► This diet excludes the consumption which helps keep their blood sugar, cho- us chew more, which makes us more satis- lesterol and triglyceride levels under con- fied than if we were to consume them in of fried foods, refined products, trol. This diet is very restrictive, however, juices, purees or soups,” Cleves adds. processed foods and artificial pre- especially when it comes to proteins. The servatives, and it greatly reduces recommendation is for dishes to consist BE CAREFUL the consumption of gluten. of 70% of raw seeds, fruits and vegeta- Some schools of raw foodism include► Because this diet is based on raw bles and 30% of legumes,” explains eating raw meat, known as a raw animal fruits and vegetables, it also contri- nutritionist Sandro Gómez. In the best- food diet. Extra precautions must be butes a significant amount of liquids. case scenario, the idea is to also eat in a taken in this case, especially to avoid foo-► In some cases, overcooking cer- responsible, conscious way, respecting dborne illnesses, as poor hygiene can tain vegetables, especially in the nutritional needs of each individual. cause contamination. Specifically, pork water, can cause vegetables to can cause trichinosis while chicken and lose important nutrients. As the nutritionist Alicia Cleves eggs can cause salmonella poisoning if Huergo adds, any diet or nutritional plan they are raw or not thoroughly cooked. should be assessed by an expert in nutri- “These conditions are very dangerous for tion, as not all bodies are the same when pregnancies or for immunosuppressed it comes to eating certain types of foods, patients, as these people live in a very and health risks can become involved if vulnerable state,” Cleves adds. food groups are not consumed in a balanced way. Therefore, before following a diet just because it is popular, healthy or for per- In general, vegetable-based products sonal preferences, it is important to learn allow the body to receive all the vitamins, minerals and fiber they contain. Also, by •the benefits and drawbacks of it in order mixing these food groups together, this to make the best decision for yourself34


( )CON TU CUERPO BRIEF Taking a break or changing your ACTIVITIES posture every hour at work is very beneficial to your health. GIVE YOTHUAT ENERGY It reduces stress and work-rela- ted fatigue, prevents muscu- The more energy a person loskeletal disorders, brings has, the more productive oxygen to the brain, improves your concentration and rechar- they will be at work and the ges your energy. more physically and You don’t need to spend mentally productive they much time doing these acti- will be as well. vities. The mere fact of a standing up, going for short MEDICAL ADVISOR walk and getting a change of CATALINA MENA environment is enough. Occupational Therapist KEEP IN MIND: the back of your chair, bring your body close to your desk, ► Breathing correctly is key to place your forearms above the saving energy. Remember to table and use a footrest. inhale before making an effort ► When standing, don’t forget to use your knees to support and exhale when this effort yourself when bending down. reaches a maximum. ► When you are seated, keep your back supported against36

( ) )YCOOUNRTBUOCDUYERPO infographyTRY THE FOLLOWING EXERCISES,CATEGORIZED BY MUSCLE GROUP STRETCH YOUR BACK Seated on a firm chair, run your hands from your legs down to your feet little by little. Relax in this position for 20 seconds and let your neck hang loose. Repeat 2 times.LOOSEN YOUR CHEST AND ARMSInterlace your fingers and turn them so you can see thebacks of your hands. Stretch your arms forward and upuntil they are above your head. Hold for 30 seconds.Repeat 2 times. RELIEVE TENSION IN THE SHOULDERS With your hands resting on your legs, take a deep breath and move your shoulders in circles, bringing them forward and sending them back as you exhale. Repeat 2 times. RELAX YOUR NECK Take your right arm above your head until it reaches your left ear. Place pressure on it towards your right arm and hold for 20 seconds. Repeat the process on the opposite side. Repeat once on each side.ACTIVATE YOUR LEGSWhile sitting up straight, take one leg and cross yourankle over your opposing thigh. Hold this position for20 to 30 seconds.Repeat once on each side. 37

CYOUNRTBUOCDUYERPO( ) )for your smileA SOFT TOOTHBRUSH AND FLOSS: ALLGUMSYOU NEED TO TAKE CARE OF YOURProper oral hygiene of the gums, whosefunction is to protect the roots of the teeth, Gums are perhaps one of the body’scan also affect your overall oral health. tissues that we overcompensate for. Because we want to keep them MEDICAL ADVISOR clean, sometimes we can cause injury as we LINA MARCELA ZULETA tend to think that the harder we brush, the Periodontist cleaner we will be, to the point of causing pain or making the gums bleed. How soft we brush, as well as how soft our brush is, can help reduce poten- tial pain, prevent sensitivity and avoid our roots from being exposed. It is also important to remember to always angle the brush towards the tooth, instead of towards the gums. “Using dental floss properly also has a significant impact on your health, as it is the only way of reaching the gingival sul-40

cus – the space between the teeth and ( )CON TU CUERPOgums,” as the periodontist, Lina Marcela xxxxxxxxxZuleta Echeverri from CES University,explains. Over time, this can help pre- WHY DO GUMSvent the development of diseases such as BLEED AND SWELL?gingivitis and periodontitis. ► Not using dental floss properly makes theCATCHING THE PROBLEM ON TIME remains of food particles between theAs Zuleta explains, your general dentist teeth get stuck there, causing infectionscan evaluate the condition of your gums and gum disease.during a general checkup, and dependingon the outcome of this checkup, can deci- ► In women, this can occur as a result of hor-de whether it is necessary to send a patient monal changes, as such changes can affectto a specialist, in this case, a periodontist. the gums, making them more sensitive to other stimulus. This evaluation consists of doing anexam with a periodontal probe that can ► Sometimes gums can cover the teeth,help detect potential diseases in this which changes their size, one of the conse-organ, even with people who appear to quences of some medications used to treathave good oral hygiene. During this diseases such as hypertension or epilepsy.exam, situations that may call for perio-dontal plastic surgery may be detected GUM DISEASESsuch as when the gums cover the teeth,when the roots are exposed or –for The American Dental Association definesaesthetic reasons – when the gumline in gum disease (also known as periodontalthe front of your mouth can be made disease) as an infection of the tissues that surround and hold the teeth in. It also states•even to achieve the aesthetic parameters that it is one of the main causes through which adults lose their teeth. Gum disease isfor an acceptable smile often painless, so patients may not know that they have it. The following are some things to keep in mind: 1. The first phase of gum disease is known as gingivitis, when the gums become red, swo- llen and bleed. Treatment involves a profes- sional cleaning as well as practicing proper hygiene at home. 2. If the disease is not treated in time and progresses, it can cause periodontitis, which is when the tissues begin to disappear along with the bones. This causes the teeth to loo- sen or move and can happen at any age. Periodontitis can be categorized into chro- nic and aggressive periodontitis, the latter being the most harmful. 41

CON TU CUERPO( )xxxxxxxxx REMEMBER TO STRETCH AND REST YOUR HANDS The onset of carpal tunnel syndrome is often the result of repetitive muscle movements or diseases that affect the nerves. MEDICAL ADVISOR DAYRA ERAZO - Physiatrist, practitioner at Coomeva Private Healthcare42

( ( )CONYTOUUCRUBEORPDOY keep in mindAt some point you have surely nists, other musicians, gardeners, tailors, wrist joint, work stress, the repetitive use heard about carpal tunnel syndro- people who embroider, cooks and of vibrating hand tools, fluid retention me or you know somebody that mechanics. According to the U.S. during pregnancy, menopause, or deve-has had it. You may have even been given National Institute of Neurological loping a cyst or tumor in the tunnel.exercises to prevent it from happening, Disorders and Stroke, however, this con-but do you know how to identify it? dition is more frequent among women, HOMEWORK: PREVENTION most likely because their carpal tunnel is In terms of prevention, ergonomics and Its most common symptoms include smaller than that of men’s. taking active breaks are key. Ergonomicspain, numbness, a loss of strength and a involves keeping the wrists in a naturaltingling sensation that stretches from the WHERE IS THE CARPAL TUNNEL position at work, and active breaks con-wrist to the arm. Some may think that it LOCATED? sist of taking breaks and just a cramp, but when it becomes a According to Dayra Yolima Erazo Erazo also recommends not sleeping onfrequent and repetitive issue, it is time to Ordoñez – specialist in physical medici- top of the wrists and avoiding sleepingsuspect carpal tunnel syndrome. ne, rehabilitation and biological medici- with your wrists in a flexed position. She ne – the carpal tunnel is located at the also emphasizes the importance of This condition generally affects peop- base of the hand near the wrist. It is a keyboard placement, “When typing,le whose work involves repetitive and thin canal of ligaments and bones at the make sure your wrists are in a neutralmanual movements such as: people who base of the hand that contains nerves position and that they are not too curvedtype all day, hairstylists, people who do and tendons. This syndrome occurs or stretched out.”movements that require a lot of strength when this area is injured or when pressu-and work in fields such as carpentry, re is placed on the median nerve. If a diagnosis is made, treatmentassembly or packaging lines, and violi- Generally, it affects the dominant hand depends on the state of the condition. If and causes intense pain. the carpal tunnel is mild or moderate, measures include using a splint (semi-rigid While its warning signs begin slowly, as supports to keep the wrist in a neutral they worsen, holding onto objects can position), physical therapy, taking anti- even become a complicated maneuver. inflammatories, improving ergonomics This is because the median nerve is res- and including active breaks in your daily ponsible for bringing feeling to the thumb routine. When it is already severe, the pro- and fingers (except the pinky finger) as cedure is surgery. Surgery is suggested well as to some small muscles in the hand. when symptoms last longer than six months or if there is muscle damage. People with diabetes or nerve condi- tions are also known to suffer from this Last, the NIH explains that alternati- syndrome. The National Institutes of ve therapies such as acupuncture or see- Health (NIH) lists that other causes of ing a chiropractor “…have been benefi- this syndrome are wrist traumas or wrist cial to some people, but their effective- injury, obesity, an overactive pituitary ness has yet to be proven. One exception gland, hypothyroidism, rheumatoid is yoga, which has shown to reduce pain arthritis, mechanical problems in the and improve grip strength.” 43

CON TU CUERPO MUSCLE STRENGTHENING ROUTINES( )xxxxxxxxxxxx Upon the onset of carpal tunnel syndrome symptoms, physia-44 trist Dayra Erazo suggests practicing the following movements regularly as a preventive measure. 1 Put your palms together in a pra- yer position in front of your chest, with your fingers pointing upwards. Raise your elbows until you feel a stretch in both wrists and hold that position for about 30 seconds. Repeat 3 to 5 times a day. 2 Take the fingers of one hand and pull them backwards until you feel a stretch in the front part of the wrist. Do this for about 30 seconds and repeat with the other hand. 3 Place your wrist in a neutral position on a flat surface so that the palm of your hand is facing downwards. With your other hand, place pressure on the back of your wrist and try to lift your wrist upwards with your oppo- site hand placing resistance on it. Hold this position for 10 seconds and do 5 to 10 repetitions. 4 Lift a light ball in your hand with your palm facing upwards. Squeeze and flex your wrist. Do 2 to 3 sets of 10 repeti- tions with a break in-between. 5 Rotate your wrist so that the palm of your hand is facing down. Squeeze the ball tightly and flex your wrist •upwards. Do 2 to 3 sets of 5 to 10 repetitions with a break in-between

CON TU MUNDO ( ))YOUR WORLD40POUNDS A YEAR (20KG) IS HOW MUCHFOOD CAN BEGROWN IN ONESQUARE METER.YOU DON’T NEED A PLOT OF LAND TO GROW YOUR OWN FOOD.WITH AN URBAN GARDEN, YOU CAN GROW WHAT YOU WANTON A BALCONY, TERRACE OR PATIO.ORGANIC PRODUCTS A SUSTAINABLE PRACTICE SHOW THEIR IMPORTANCEGrowing your own food helps guarantee Another positive aspect of gardens is Plants are the basis of life. They arethat it is fresh and healthy. In an urban that they help protect the environment part of the water cycle, they producegarden, you can grow anything from as they improve air quality, reduce pollu- the oxygen that we breathe and aretomatoes to herbs. tion and promote biodiversity. part of what we eat. 45

CYOUNRTWU OMRULNDDO( ))forhimTODAYTHE MEN OF Social network users in Colombia are among some of the most activeMen are now taking a greater interest in users of these types of platforms infashion, appearance and in responsibilities the world. Almost half of Colombia has aaround the home. While their lifestyles may Facebook account, 60% of which access ithave changed, it is important to not let through their cell phone. Social networkshealthy habits slide. are therefore a new reference point for people and in some cases, they can serve MEDICAL ADVISORS as sources for learning about current CONSUELO SUSANA VIVAS PERDOMO practices and trends. These interactions Psychologist, practitioner at Coomeva Private Healthcare and new ways of communicating have AMPARO SALAZAR - Psychologist shaped the generations of today.46 Psychologist Consuelo Susana Vivas Perdomo explains that the explosion of social networks, the internet and access to TV series from around the world has had a large influence on the fabrication of con- temporary Colombian men – men who like to follow fashion trends, exercise, eat healthy and follow international cuisine, shave their beards as if they were European soccer players and cook like French lovers.

( )CON TU MUNDO In fact, for many years, plastic surgeries MEDIA-BASED LIVESwere thought to be only appealing towomen. But according to a report from According to psychologist Luz Amparothe Colombian Society for Plastic, Salazar, this influence comes from exposu-Aesthetic and Reconstructive Surgery re to the lives of famous people. She gives(SCCP), between 2012 and 2015, these the Kardashian family as an example, “It’sprocedures increased among men by 30%. as if the luxuries they have were free and they live a lifestyle where appearance takes As the specialist explains: “The men of priority. While everything started as a rea-today like to take good care of themselves, lity show, now the women from this pro-be in fashion, take an interest in their appea- gram are also posting on social networks.rance from their shoes to their haircut, have This strategy was then copied by so-calleda well-groomed beard and haircut, and only ‘influencers,’ who began to show howessential – have a good perfume. There is they cut their hair, how they dressed,also their lifestyle. One of the first things where they went shopping, where they ate,men want today is to buy a car and have the and where they spent vacation. This islatest cell phone. In sum: it’s all about how this model was brought to teenagers,appearance. They buy material objects to who are now today’s young people.”show them off on social networks as if to say,‘I’m the best.’ As they begin to mature, they This falls in line with Vivas’ hypothesisrealize that these things are not what people who maintains that while 10 years ago,truly value, are not what complete a person, the role model teens followed was theand they begin to change.” most popular boy on the block, role models today are now Instagram, 47

CYOUNRTWU OMRULNDDO( ))forhim Facebook or YouTube celebrities. with an informal job. “It is very likely Vivas further explains that men who that their mothers gave them chores such as making their beds, washing the are involved in the responsibilities of the dishes or even cooking. So when they home – modern men that cook, wash entered a relationship they could do a dishes, change diapers and bathe children lot on their own, unlike their fathers – are the result of the women’s move- who had everything done for them – a ment: “When women first began to leave result of the machismo that had been the home to work, men had to take on passed on for so many generations.” new responsibilities. The idea of the ‘macho man’ that doesn’t do anything at Each generation has been influenced home no longer exists. Millennials grew by different things and has evolved in up with the mentality that they should their own way. Today’s generation is a help, that they have a role in the home.” result of the women’s movement, of a mentality of equality, open-minded politi- As Salazar asserts, these modern men cal movements and, last but not least, got a firsthand experience of what it social networks and their “likes” of appro- means to be disciplined at home from val. All of this has led to men who take when they were little, because oftenti- care of themselves, take an interest in how mes they are sons that come from very fragmented family structures or whose •they look, and who have more than just mothers had to combine housework one duty to their home ESCAPIST BEHAVIOR As the times and lifestyles change, it is important to not only continue with good habits such as avoiding smoking and eating healthy. As specialists from the Mayo Clinic in the United States explain, it is also crucial to be aware of escapist behaviors that lead to depres- sion, such as alcohol or drug abuse; abusive, controlling or violent behavior; inappropria- te anger or irritability; and putting your- self at risk by driving irresponsibly.48


YCOOUNRTWU OMRULNDDO( ) )all natural DIABETES: in the body – such as white flours or vege- EATING RIGHT tables such as carrots, squash or beets, for example – should be avoided or reduced. It Watching portion size and calorie content is also essential to watch portion size. can help keep weight gain under control. However, each person’s metabolism is different and depends on factors such as MEDICAL ADVISOR SANDRA MORA - Endocrinologist and Nutritionist sex, age, height, weight, body size or physi- cal activity. “Keep track of how many calo- Cutting down on sweets is not the ries you consume each day, because if you only dietary restriction diabetics consume more than what you burn, you must adhere to. People with diabe- tend to gain weight, and this can affect tes must also manage their weight by your metabolic control,” Mora states. regulating their diet and exercise, espe- cially those patients that receive insulin It is important to keep in mind that as part of their treatment. while most foods contain carbohydrates, there are some that contain less. “With This is why a person’s diet becomes so dairy products, for example, one serving of fundamental to diabetes patients. “When milk generally contains between 10 and 15 a person with diabetes gains weight, their grams of carbohydrates, which is rather body becomes more insulin resistant, and acceptable. Nuts are also a good option can then act as if there is a deficiency or (peanuts, almonds and other types of the body may demand more of it. In turn, mixed seeds), but you have to be careful this increases blood sugar levels and because while they are low in carbohydra- when these levels are very high, they can tes, they are high in calories due to their induce a coma,” states endocrinologist high fat content,” the nutritionist explains. and nutritionist Sandra Mora. Last, between fruits and vegetables, FOODS HIGH IN SUGAR vegetables have the least carbohydrates, so All foods that contain a lot of sugar or that they are often preferable. While all types are converted into glucose when processed of fruits can be eaten, keep in mind that there are some with more fructose than others. While they contain a fair amount of sugar, avocadoes are low in carbohydra- •tes and rich in a very healthy fat, but their calorie content remains high50

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