Susi Arias was worried. Her parents were not well, it was clear. But they refused to see a doctor. “My dad would say, people die in the hospital,” she recalls. “And my mom would always say she would do it later on.”
Neither of her parents, Concepcion and Jorge, had been to see a doctor in a decade or more. It never seemed urgent, and they never had the time. Concepcion cleaned houses and Jorge worked in agriculture. At their home in La Honda, Arias and her two siblings noticed a pronounced difference in their parents’ energy levels and temperaments.
“I didn’t know what to do, what to give them. I saw my mom was always sleepy. She went to bed right after dinner. And my dad was always in a bad mood,” recalls Arias.
That changed when Molly Wolfes knocked on their door. Wolfes, Puente’s Community Health Coordinator, was making the rounds with her Puente health promoter team, Yolanda and Yesenia, and Chris King, a San Mateo Nurse Practitioner and his Medical Assistant Rafael. When Wolfes asked Concepcion how she was feeling, she admitted she was “nervous because there was stuff that had happened.” Wolfes talked her into visiting the doctor at Puente’s Thursday night health clinic in Pescadero. She made an appointment on the spot for herself and her husband.
“I told her, ‘You think there’s something going on. The stress of worrying about being sick is going to make you more sick. So let’s do something about it,’” says Wolfes.
Less than a month later, the blood test results came in. Both Concepcion and her husband had uncontrolled diabetes. Her kidneys were struggling to do their job. Her blood glucose levels were dangerously high, and his were even higher. In the urgent testing that followed, it became clear that they were both at risk for further complications.
She sat in her car, weeping. “I was thinking, is this it?” Was this the end? A cousin of hers, much younger than Concepcion, had been diagnosed with Type I diabetes and was on insulin. She had two young kids. Life was a huge struggle.
The pain, the muscle aches, the weight gain and the exhaustion now made sense. But Concepcion was terribly frightened. And she didn’t yet know what to do about it.
Fortunately, neither Concepcion nor her husband needed insulin. What they did need was a major lifestyle overhaul. And that became the impetus for one. Rather than just take their prescription pills and hope for the best, Concepcion took her doctor’s advice and transformed both her physical activities and her family’s diet. Before long, they were eating more cauliflower, rice and fewer tortillas. The kids also got in on the act, helping cook the food and giving support to their parents.
“It lit a fire under them. I think the fear of getting sicker pushed them to change their lives,” says Wolfes.
The benefits of a healthy lifestyle have extended to Arias and her siblings. “Now I’m happier because my mom is feeling better. Our diet is different. I’ve lost weight and so have my brother and sister,” she says.
Today, Concepcion is out of the danger zone. Her blood glucose level is within the normal range, and she has lost more than 25 pounds since April – and counting. Her husband Jorge has been slower to make changes.
She’s proud of her progress, but can’t escape the guilt she feels at not having gone to the doctor earlier. “This could have been prevented. God has given us another chance. We need to make the most of it,” she says.
Puente’s in-house medical clinic, a satellite of San Mateo Medical Center’s Coastside Clinic in Half Moon Bay, sees a lot of patients like Concepcion with untreated diabetes, as well as blood pressure issues, heart conditions, and chronic repetitive stress injuries: a total of 121 unique patients, representing 355 appointments, since March 2015.
Often patients hold out until their symptoms become intolerable, which is never a good policy but can be due to fear or barriers getting to the clinic like transportation or lack of time.
Arias diagnoses the problem: fear. “People are scared. They don’t know what it’s like at the doctor or the dentist.”
That’s where Puente’s health promoters, or Promotores de Salud, come in. They make a one-on-one connection with people and give them a chance to discuss concerns about their health. They will sometimes talk people into seeing a doctor, like Wolfes did. And they schedule their appointments, whether for medical care or to renew their health insurance, through Puente.
Of course, the main incentive is accessibility. Before Puente opened the county-funded clinic, locals would have to drive to Half Moon Bay, San Mateo, Redwood City or Palo Alto to see a doctor.
“If the clinic had not been in Pescadero, I wouldn’t have gone to the doctor. I couldn’t take the time off from work,” says Concepcion.
For more information about Puente’s health promoter teams, email Molly Wolfes, Community Health Coordinator, at email@example.com.
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