The 30-Day Mad Dash of December
Holiday "Survival Tips" for Those Living With HIV/AIDS
Santa Claus is coming to town and so are all the parties, food and snacks, and stresses that come with the holidays. The holidays can just wear you out. This is especially true for people living with HIV/AIDS. Not only do you have to worry about the usual stressors of your health and medications and finances, but you are often asked to take on many other responsibilities such as activities and celebrations. December can be a 30-day mad dash.
Everybody's family celebrates the holidays in different ways. Some families have large celebrations, others small, and some choose not to celebrate at all. The things that most celebrations have in common are food, the time involved, and the expenses. Most people tend to get so wrapped up in the holidays that they eat more than they should. They also get worn out physically. These people are often stressed by work, home, and finances. Their exercise program is shot or non-existent. And last but not least they often forget the real reasons that the holidays are important to themselves and their families and friends. The following are a few suggestions for eating better, managing fatigue and stress, maintaining an exercise program and remembering the spiritual reasons for the season.
Proper nutrition over the holidays is always a challenge. It is not so much that the food is not nutritious but that there is too much of it. The average American tends to gain about 7 pounds between Thanksgiving and New Years day and is only able to lose about 5 pounds of it before the next Thanksgiving. For years, people with HIV/AIDS didn't worry about the weight gain. In fact we actually encouraged it. However, we know better now. We know that many people living with HIV/AIDS can gain too much weight as well as the wrong kind of weight -- fat. It is also known that thanks to the medications, many people with HIV/AIDS are developing secondary complications such as high cholesterol, high triglycerides, high blood sugar (due to insulin resistance), as well as high blood pressure, kidney complications and liver disease.
Unfortunately all of these complications make it important to watch one's diet over the holidays. This does not mean you are not allowed to go to parties and dinners and eat and have a good time. It means you should try very hard to limit your fat and sugar intake as well as to limit your portion sizes. I do not recommend staying away from the foods you like and enjoy. Food is an important part of life and of celebrations. I do recommend eating in moderation. Have just a taste of your favorite foods that you know are high in fat and sugar. Fill up on the foods that are better for you -- such as vegetables. Ideally at this point you should know if you have any dietary limitations such as eating low fat, low sugar, low salt/sodium, or any other possible restrictions. These restrictions do not mean to give it all up but they do mean cut back and limit your intake. You and your physician should also be monitoring your lab results closely.
Another nutritional issue is alcohol consumption. In the HIV/AIDS community, opinion about whether to drink alcohol or not drink alcohol ranges from complete abstinence to limited intake. There are many reasons to abstain from alcohol. If you have a hepatitis co-infection then you should abstain from alcohol. If you have a problem with alcohol then you should abstain from alcohol. However, if your physician says it is okay to have a drink and you want a drink then have a drink but do not over do it -- everything in moderation.
Is it even possible to avoid fatigue? In people with HIV/AIDS the answer to that question is going to range from yes for some people to never for others, with most being someplace in between. The best advice I can give you is to eat right, exercise, get plenty of rest and to monitor your fatigue and energy level and then do what is necessary to keep yourself healthy and happy.
It might be helpful if you plan ahead so that you can limit your exertions and avoid getting too tired. You may have to plan to excuse yourself from a party early so that you can go home and get to bed. You may have to limit the number of parties and functions you go to. You could ask the host if there is a place you could lay down for a little while if necessary.
Limiting or avoiding alcohol, cigarettes, and other recreational drugs will also help you to manage your fatigue. Being hung over is never fun but if you are already tired from too many activities or functions then your fatigue level will be even worse. You should also be cautious with the interactions between alcohol, cigarettes, and other recreational drugs with your current medication regimen.
You may want to avoid gatherings that are incredibly stressful for you. If you know that certain friends, acquaintances, co-workers, or family members who stress you out are going to be at a gathering, then you may want to avoid that gathering.
It can also be helpful to learn how to say "no." During the holidays family, friends, co-workers, charities, and so on and so on are always asking for something. They want your time, your money, your energy, and your presence. Let's face it -- you cannot do it all; no one can. This is one place that many Americans need to learn how to say "no" and not feel guilty about it. When you have HIV/AIDS, it is very easy to overextend yourself anyway, physically as well as financially. It is not being selfishness to say "no," but rather self-preservation. If you have the energy, the time, and the finances to get involved then by all means get involved but do not let it get to the point that it is not any fun any more.
Exercise is one of the first activities sacrificed during the holidays, whether or not you have HIV/AIDS. There are parties and gatherings planned in the evenings, on the weekends, over the lunch hour, plus there is all the planning and preparation and shopping to get done so needless to say the exercise program is one of the first things out of your normal schedule to go.
Why is that? Well for one thing many people see exercise as being kind of an extra. If they have time then they will exercise. In reality for most Americans it should really be viewed as a necessity, especially if you have any medical condition such as HIV/AIDS. It becomes even more important if you have medication-related issues such as high cholesterol, high triglycerides, high blood sugar, and lipodystrophy/lipoatrophy. For most people exercise should be just as important as eating, sleeping and brushing your teeth, but it is not treated that way.
So how do you work exercise into a hectic holiday schedule? Well, once again, you have to make it a priority. It has to be a part of your daily schedule. If you are working, write it on your planner or calendar just like you do any other appointment or event you have to go to. If you are not working, then figure out what time of day works best for your workouts. You can also make it kind of a game in relation to your holiday preparations and activities. For example, if you have to go to the mall to do your shopping make yourself walk around the mall 2 or 3 times before you actually start shopping.
Another option is to try to be more active throughout your day. Take the stairs instead of the elevator. Park further away from the front door so you have to walk further, or if you take mass transit get off a stop ahead of your usual stop and walk the rest of the way. You can take short breaks throughout your day to stretch or to take a walk. Ideally if you sit all day at your desk or a computer you should take a five-minute break every hour to get up and stretch and move around to help your focus and protect your back and other joints. If you are physically able, volunteer to help carry packages and other objects for your co-workers.
If you are not working then find ways to be more active around the house. Go for short walks throughout your day, such as around the house, around the block or around a nearby park. If the weather is bad, find someplace indoors where you can walk. If the laundry facility is on a different floor of your apartment or house, take more trips up and down the stairs as you are doing your laundry. Every couple of hours perform a few stretching exercises as well as some basic strengthening exercises. It is really easy to watch television while you are doing arm curls or triceps press-ups or chest presses, etc.
If you are planning activities for a holiday party figure out a way to make those activities more active than the traditional party games. Instead of board games, play games like musical chairs or other childhood activities that you can play inside. Most adults tend to forget how to play and have fun. Your party guests will enjoy it also.
It is also important to be patient with yourself and not to get frustrated. Do not overextend yourself. Most important of all is to remember that doing something is better than doing nothing at all. You are better off doing a short workout then missing it completely.
Stress Management and Simplification
Stress is a major problem over the holidays as well. It is also a puzzle as to why this time of year causes so much stress and mental anguish when it should be a time of fun and joy and togetherness. Well, okay, maybe it's not really such a puzzle. There are often too many bad memories of holidays past, there are people we don't want to be around, and the holidays are expensive. They are expensive for everyone but if you are on a fixed income or most of your disposable income goes to pay medical bills or for medications, then the cost of the holidays can become stressful.
When you have HIV/AIDS, it is important to try to keep the stress out of your life at all times but especially over the holidays. Stress has a tendency to weaken your immune system and make you more susceptible to injury and illness.
Everyone copes with stress in a multitude of different ways. What is stressful to one person may not be stressful to another person. Some people thrive in environments where they are "pushed to the max" both mentally and physically. Different situations will also cause stress, especially around the holidays. For some people just the idea of the holidays themselves cause stress. For others the idea of being around family causes stress. For many people the thought of all the food and festivities are very stressful.
My main advice to people with HIV/AIDS regarding stress management both during the holidays and during other times of the year is to figure out what stresses you out and try to find the best means available to you to cope with it. Unfortunately we cannot just avoid stress, but we can try to limit it and control it.
It is difficult to just say to our friends and family that we are not participating, even though we would like to. However, it is possible to limit your activities. If you feel you have to go to various functions, whether they are work-related or with family or friends, then find a way to control how much you have to be there. For example, suppose your family wants you to be at their home for Christmas Eve as well as all day Christmas day and you really do not feel up to all of that. Take control of the situation and choose which day you would rather be there. Do not be rude about it. Explain to the family organizer that you either do not feel up to both days or that you have other plans (they don't have to be plans where you go someplace, if you would rather stay home and read a book or watch a movie, then those are other plans). Even more important to help keep your stress down is to not feel guilty about your decision. It is a legitimate decision in trying to control the stress and fatigue in your life.
It is even more complicated if you are in a relationship and both families want you to participate in the holidays at their homes and you both would rather stay home. For a few years, my partner and I tried to spend time with both families on the holidays but we both wound up totally exhausted. It might be different if both families lived in the same city as us, but his are two hours southeast of us while mine are three hours southwest of us. We used to drive this big triangle. It was ridiculous. My partner and I have worked out a system where we alternate going to each family each year, stay at home one year, and go on a trip one year (sometimes that trip is just to a hotel in town but away from the phones). We are not always successful at not seeing both families but most of the time we are, and our families have come to respect our point of view.
One of the biggest stressors during the holidays is financial, especially when living with HIV/AIDS. The best way to deal with the financial stresses is to plan ahead. This usually means sitting down and figuring out what you can afford to spend. You may have to limit how much you spend on each person on your list as well as on decorations and holiday food. It is also important to limit using credit cards, since this extends the stress of the holidays out for as long as it takes you to pay them off. The best time to plan your holiday budget is in January, just after the holidays. There do not seem to be many "Christmas accounts" available any more, but it doesn't mean you cannot set one up on your own to plan ahead for the following year. (A "Christmas account" is a savings account that you put a certain number of dollars into each month until the first of December when you get the money out to spend on the holidays. Even if you just put $10 a month in then you may be $120 ahead of where you were this year.)
Another way to help with the financial stresses is to get creative and make some cards and gifts for your friends and family. It can be as simple as baking some treats to getting out your needle and thread and making ornaments or some other kind of decoration. Some crafts and homemade gift ideas take some planning ahead so that you have time to actually make them, but the baked goods are usually better if they are fresh and sometimes even warm.
Other stresses that have to be dealt with are all the preparations. Many people love getting in the spirit of decorating and cooking and entertaining. Other people do not want to have anything to do with it. Figure out which you enjoy, but is not stressful to you and have a good time. Do not sit it out if it is something you really do enjoy.
My second piece of advice to people with HIV/AIDS regarding stress management and the holidays is to keep it simple. Find ways to celebrate that do not overextend you physically, mentally, emotionally, or financially. Get back to the basics of the season. One way of doing this is to plan on doing things that do not cost a lot nor do they take a lot of time or energy. As my family grew over the last five to ten years, it got expensive to purchase gifts for all of the adults (my siblings, and their spouses and cousins and aunts and uncles) and children in the family. We decided to only buy gifts for the children under 15 years old and to put a price limit of about $25 per child. It took a while for all of my siblings and cousins to buy into this, but for the last three years we have all agreed that it has made the holidays much more pleasant and affordable for everyone. When we all gather we have more time for talking, playing games, and enjoying each other's company.
Another thing we do is rotate the setting for the holiday gathering between households so that one person does not always have to feel burdened with cleaning the house, preparing food and decorating. We also each bring a dish so that one person does not have to do all the cooking.
Remember the Spiritual
I also firmly believe that getting back to basics is one of the most important parts of enjoying and surviving the holiday season. It does not matter what your religious beliefs (or non-beliefs) are. Find a way to explore the reasons we as a society have been celebrating the winter holidays and why these holidays are important to you. Living with HIV/AIDS often brings many people back to their spiritual roots. Only you can decide what you feel and believe. Take the time to meditate on the season and what it means to you as you continue to live with HIV/AIDS.
The holidays will be here before you know it. The holidays will bring loads of food, fun, fatigue, stress and the lack of exercise. How you choose to deal with each of these issues will play a role in how you enjoy the holidays. It is important to eat right, get plenty of sleep, exercise, and manage your stress level to make the most of your holidays and come out healthier than ever. Make the most of the holidays and enjoy yourself, your family, your friends and your co-workers. Remember the best revenge on HIV/AIDS is living not only a good long time but living a good healthy time.
Glenn R. Preston, M.S., R.D., L.D. is the C.E.O. of Real World Fitness, Inc. in Kansas City, MO. HIV-positive since 1985, he is a registered dietitian and combines fitness and nutrition with personal training for people with HIV and other chronic medical conditions. He can be reached at Prestonfit@aol.com.
Back to the December 2001 issue of Body Positive magazine.
This article was provided by Body Positive. It is a part of the publication Body Positive.