Profiles in Health: Dr. Maria Veronica Svetaz

By Jennifer Vogel

Being an immigrant is like having a chronic illness, says Dr. Maria Veronica Svetaz, a native of Argentina who runs a health program on Lake Street in Minneapolis tailored to the needs of Latinos. “Somehow it never goes away and will always be there, for good and for bad.” Svetaz is referring to the “extra layer of complexity” that can infuse virtually every aspect of an immigrant’s life, from the ability to communicate to the opportunity to earn enough money to the fortitude needed in navigating a byzantine immigration bureaucracy. “It makes you more vulnerable in some ways but also stronger and savvier in others.”

Dr. Maria Veronica Svetaz

“All of us can belong to lots of places…And we all have the ability to help the other to feel that they belong – with something so simple as a question or a word.” Caroline Yang / For Healthy States

Svetaz’s bilingual, bicultural health program, called Aqui Para Ti, which translates as “Here For You,” is part of Hennepin County Medical Center’s East Lake Clinic. It provides a range of services to young Latinos and their families including mental health and substance abuse counseling, assistance with birth control and prenatal care, and even help strengthening communication between parents and children who may not speak the same language, literally or figuratively.

“Mental health issues are higher in Latinos, particularly in Latino girls,” says Svetaz, 47, an energetic presence in a small, homey office, surrounded by cards and memorabilia. “It’s mainly depression. And suicide attempts, they are number one. One out of seven Latina teens will try to kill themselves. It’s the pressure of the two cultures. They get entangled.”

On the wall above her desk hangs a colorful collage of a woman with the inscription “No soy la mujer maravilla” or “I am not wonder woman.” The painting, from an art fair in Buenos Aires, is a reminder of how demanding Svetaz’s work can be and that, no matter how much she wishes the contrary, she can’t do it all. Working to close the health equity gap for her Latino clients and realizing that all many need is “a little love and tender care, puts you at moments at odds with trying to do too much,” she says. “And when you have so much passion, I learned that you need to ‘curb your enthusiasm’ as burn out is for real.” Continue reading

U.S. Ebola Guidelines Criticized as Lax

Obama on Ebola

Cabinet members and others listen as US President Barack Obama (R) makes a statement for the press after a meeting in the Cabinet Room of the White House October 15, 2014 in Washington, DC. Obama canceled campaign and fundraising travel for Democrats to attend the meeting on Ebola after a second case of the disease was contracted inside the United States. Brendan Smialowski/AFP/Getty Images

In response to the news that a second nurse at Texas Health Presbyterian Hospital has been diagnosed with Ebola, the Centers for Disease Control and Prevention acknowledged this week that its guidelines for protecting care workers needed to be stricter. Medical experts have called the original CDC caregiver guidelines for protection from Ebola “irresponsible.” The new federal guidelines come closer to those recommended by Doctors Without Borders, an organization with many years of experience with Ebola.

On Wednesday it was revealed that the second nurse who has been diagnosed with the virus was given the ok by the CDC to fly on a commercial airliner just hours before she was diagnosed, while she was reporting a mild fever.

Public health officials and the White House continue to assure the country that while Ebola is serious, it is not a significant threat to most Americans.

Congress will hold hearings today on the Ebola response. The head of the CDC, Dr. Thomas Friedan, is expected to apologize for not responding more vigorously to the Texas cases.

See NPR’s coverage of Ebola for more information.

ALS and the end of life

“Death Focuses You” – Bruce Kramer

This week MPR News aired Cathy Wurzer’s most recent conversation with Bruce Kramer. Wurzer has been recording conversations with 58-year-old Kramer since he was diagnosed with ALS, or Lou Gehrig’s Disease, in 2010. Kramer is a former academic dean at the University of St. Thomas and lives in the Twin Cities. He is married with two grown sons and one young granddaughter.

In this conversation we learn that Bruce is in the final stages of the disease. Kramer says they are working through their fear of death in order to accept the reality that he will die sooner than anyone wants. They are sad. And yet they are grateful for the chance to focus so keenly on how much they love one another.

What I have learned in this past four years is that death focuses you. It brings what’s important right to the front, and it cuts through the things that just really don’t need to take priority anymore.

Kramer says he is embracing this perspective to handle his own death. He also sees his purpose as helping others develop the same perspective.

I’m looking for the alignment of love and gratitude and acceptance and trying to help people, as they come in to see me, to have a little space for that in their lives. If they could find that same space for acceptance and gratitude, maybe it doesn’t take facing something like ALS to bring that along. And maybe that’s opportunity for tremendous growth as a human.

ALS is a disease that affects a person’s musculature but not one’s cognitive ability. Some have described the condition as “a living death” and those afflicted often struggle to maintain a will to live. People living with terminal illness have written about the power of dismissing fear and accepting death. They say it can dramatically improve quality of life — even if it’s just for one’s last few months.

Exercise may help prevent stress-induced depression

A man jogs in St James's Park on November 4, 2013 in London, England. Dan Kitwood/Getty Images

A man jogs in St James’s Park on November 4, 2013 in London, England. Dan Kitwood/Getty Images

You’ve already heard of the link between exercising and feeling good — often called a “runner’s high,” that is related to increased endorphin levels.

Now, in studies with mice, researchers in Sweden have found that exercise may actually help protect against stress-induced depression.

The Washington Post explains it like this: a stress-induced amino acid called kynurenine is associated with mental illness. The neuroscientists at Karolinska Institute in Stockholm who worked on the study found that exercise helps rid the body of that amino acid.

In other words, well-trained muscles purge the body of this harmful substance.

The authors suggest these findings could eventually lead to new principles for the treatment of depression.

You can read more coverage on the study from Forbes here.

“A Celebration of Women & Recovery” in Tweets

Last night at the Fitzgerald Theater in St. Paul, Healthy States and Hazelden Betty Ford Foundation presented “A Celebration of Women & Recovery.” Close to 700 people gathered to hear writer and musician Dessa speak with two authors, Jennifer Matesa and Gayathri Ramprasad, about their experiences of recovery from mental illness and addiction, and to celebrate the power and purpose of healthy recovery. Check out these Tweet samples to get a feel for the event.

NEJM Case Study: Multi-Generational “Social Determinants”

The New England Journal of Medicine this week published an unusual case history of three generations of a British family who were treated by the same general practitioner and whose health histories, including heart disease, depression, chemical dependency, abuse, and poverty, show a picture of familial health and social problems that survive across the generations. The case study is captured in this remarkable infographic timeline.

From the article by Caroline Sayer and Dr. Thomas Lee:

The case study revealed what will come as no surprise to primary care physicians: that “social determinants of health” actually do determine health. The life stories of these three people are punctuated by health care events: fractures, hospitalizations (for heart failure, chronic obstructive pulmonary disease, liver disease, kidney disease, seizures, and gastrointestinal bleeding), suicide attempts, and psychiatric admissions. Patterns of behavior associated with deprivation and mental illness have led to the development of a textbook range of chronic conditions.

An audio interview with Dr. Lee explores the issues for the primary care physician.

Atul Gawande on the End of Life

Surgeon and best-selling author Atul Gawande discusses his new book “Being Mortal, Medicine and What Matters in the End” with Jon Stewart on The Daily Show.

Gawande says the new work was inspired in part by helping his father make decisions about medical care after he was diagnosed with a tumor in his brain stem. He says the “medicalization” of aging has gone too far, and urges families to discuss end of life care before critical illness hits.

An excerpt of the book appears in Slate.

First baby born from uterus transplant

A baby was born to a woman with a transplanted womb for the first time. NPR reports it is being hailed as a huge step in fertility science.

The Associated Press says that’s because this case proved that what was once just a concept, can now be a reality for women who were born without a uterus or lost it to cancer.

In this case, the woman receiving the transplant was born without a uterus, and received one from a 61-year-old friend.

A year after receiving the transplant, the doctors decided the womb was functioning well and transferred a single embryo created in a lab dish using the woman’s eggs and her husband’s sperm, according to the Associated Press.

The team of researchers working on the project transplanted wombs into nine women since 2012. This was the first successful pregnancy brought to term from the project.

See more about the project from the University of Gothenburg in Sweden here:

Aetna Chief Bertolini on Getting Insurers Out of the Insurance Business

Aetna CEO Mark Bertolini’s son was diagnosed with then-incurable Lymphoma in 2001–an event that transformed the health care executive’s life and views of the insurance industry. In this presentation at the Mayo Clinic Center for Innovation’s 2014 Transform Symposium, Bertolini describes how he “moved into his son’s hospital room” and threw himself into managing his son’s care – and how that experience changed his views of the business he is in and his vision for a new health care ecosystem.

CDC: Heroin-related deaths double

 A sign hangs in the hallway of a Bupenorphine clinic November 4, 2002.  Jordan Silverman/ Getty Images

A sign hangs in the hallway of a Bupenorphine clinic November 4, 2002. Jordan Silverman/ Getty Images

Heroin-related deaths in the United States doubled from 2010 to 2012, according to a new report by the Centers for Disease Control and Prevention. Heroin overdose deaths rose from 1,779 to 3,635.

The Washington Post reports the CDC reviewed data from 28 states and found increases in both sexes and all ages and races (except for American Indians/Alaska Natives).

CBS News reports the CDC is directly tying the increase of heroin-related deaths to narcotic painkiller abuse.

“The overprescribing of narcotic painkillers (such as Oxycontin and Vicodin), which has been going on for 20 years, is responsible for the increase in heroin use and overdoses,” study co-author Dr. Len Paulozzi, a medical epidemiologist at CDC’s National Center for Injury Prevention and Control told CBS News.

The National Institute on Drug Abuse says one in 15 people who take non-medical prescription painkillers will try heroin within 10 years.