There's More to Health Than ART: Holistic Health
Part of A Practical Guide to HIV Drug Treatment for People Living With HIV
When you are living with HIV, staying healthy does not begin and end with antiretroviral drugs. Of course, they're a crucial part of treatment. But sometimes it's easy to get so wrapped up in treatment questions that we lose sight of the bigger picture. A more "holistic" approach means looking at that big picture -- your body, mind and spirit as a whole.
A few basics -- such as healthy food, rest and exercise, and attention to your mental and sexual health -- can go a long way toward keeping you well. They can build a strong, healthy foundation that puts you in the best position to deal with a chronic illness and to succeed on treatment when it becomes necessary. All of these things should be part of a lifelong plan for living with HIV, whether you are currently on drug treatment or not.
You are what you eat, and eating right is especially important for people with HIV. The nutritional needs of people with HIV are greater because the body needs to work harder to deal with the ongoing infection of the virus. HIV can also lead to a shortage of important nutrients, even during the early stages of HIV disease and even while CD4 counts are still high. These shortages can speed up the progression of HIV disease and can cause many symptoms of their own. Since virtually every known nutrient is important for some aspect of the immune response, it makes sense to maintain a healthy diet.
So what does that mean in practical terms? First, it means eating what's good for you as often as you can. This includes a balanced diet with a variety of foods. Here are some simple tips to build your daily menus:
- Have 7 servings of colourful fruits and vegetables each day.
- Add 6 to 8 servings of grains (choose unrefined complex carbohydrates, such as brown rice and whole-grain breads, crackers and pasta).
- Combine with 2 to 3 servings of milk products (such as milk, yogurt, kefir) and/or alternatives (such as soy or almond milk).
- Serve with 2 to 3 servings of meat (red meat, poultry, fish) and/or meat alternatives (such as eggs, legumes, tofu, nuts).
- Sprinkle lightly with 2 to 3 tablespoons of fats and oils. Choose "good" kinds of fats (monounsaturated fats, like olive oil and canola oil) over partially hydrogenated oils and "trans" fats.
- Enjoy with lots of healthful liquids (water, juices, herbal teas and the like; not chemical- and sugar-loaded junk drinks).
Also, make sure the food you eat and the water you drink are safe! People with weakened immune systems are more vulnerable to illness from food that has become contaminated by bacteria. This is especially important when you are travelling.
Make sure you take appropriate nutritional supplements. Having the right levels of nutrients can help slow the progression of HIV, improve long-term survival, and reduce or eliminate many symptoms and drug side effects (such as fatigue, skin problems, neuropathy, diarrhea and digestive problems). Start with a multivitamin/mineral formula that provides basic micronutrients (like vitamins A, B and D3, minerals and trace minerals), as well as antioxidants (such as vitamins E and C, alpha-lipoic acid, N-acetyl-cysteine, selenium, mixed carotenoids and coenzyme Q10).
CATIE's Practical Guide to Nutrition covers, in detail, the nutritional needs of people with HIV. Find it online at www.catie.ca or order your free copy through the CATIE Ordering Centre, available at www.catie.ca or 1-800-263-1638.
Not everyone can run a marathon, but people with HIV can benefit from many kinds of exercise. In addition to strengthening your immune system, regular exercise can help you maintain muscle, keep your heart and lungs healthy, manage your stress and fight depression. Start with a moderate amount of exercise that involves aerobic activity (such as walking, rowing, swimming, running, skating or some other heart-pumping exercise) as well as resistance training (muscle-building exercises like weight-lifting). You might be able to combine them in one exercise.
The term complementary therapies describes a wide range of practices. Perhaps the simplest definition is anything that isn't considered part of conventional Western medicine (by which we mean the care you typically get at doctors' offices, HIV clinics and hospitals). Complementary therapies are generally used in addition to, not instead of, conventional Western medicine. The two complement each other, and you can use both as you see fit. You might also hear the term complementary and alternative medicine (or CAM) to describe these practices.
Complementary therapies include many different kinds of therapy, from aromatherapy to yoga, herbal remedies to homeopathy. Some, like massage and other forms of touch therapy, are largely focused on your physical body. But even a physical therapy like massage can have profound effects on your mental and emotional state, relaxing you and dispelling stress. Many other complementary therapies are intended to help you heal not just physically, but mentally, emotionally and spiritually as well.
CATIE's Practical Guide to Complementary Therapies and Practical Guide to Herbal Therapies explore these topics in more depth. Find them online at www.catie.ca or order your free copy through the CATIE Ordering Centre, available at www.catie.ca or 1-800-263-1638.
Program the Mind for Healing
The mind has an amazing power to boost the body's ability to heal, and the power of hope is one of the best tools you can have for long-term survival. Anything that helps lower stress and create feelings of hope and a positive outlook -- including yoga, meditation, positive thinking, affirmations, massage, support groups and absolutely anything else that helps you thrive -- can be a powerful aid.
Dealing With Depression and Drug Use
From time to time, everyone experiences short periods of feeling down or "blue." However, some people feel a sense of sadness and helplessness they cannot shake. These are often accompanied by low energy, problems sleeping, eating or concentrating; and, in extreme cases, wanting to harm yourself or commit suicide.
This condition, called depression, is common among people with HIV, and many people with HIV feel depressed at some point during their lives. Like other emotional problems, depression limits a person's quality of life and may interfere with the immune system's ability to fight HIV. Also, people often find it harder to stick to any kind of routine if they are depressed. For example, they might find it hard to take medication on schedule or stick to other important routines -- even eating and sleeping properly.
Depression is not always just about feeling sad. It can also cause irritability, agitation and restlessness. Some people with depression lose their appetite and lose weight while others eat excessive amounts of food and gain weight. So if you are depressed, or even if your moods just don't seem right and aren't getting better, talk to a doctor or counsellor.
You can get help. The good news is that most people who are depressed can feel better with appropriate care and treatment. It is important to seek support so that the problem can be identified and treated.
Alcohol and recreational or street drugs are a part of many people's lives. Some people simply enjoy a few drinks, or shake off their day-to-day stresses by partying it up on weekends. But alcohol and drug use can sometimes be a problem, especially if they affect how you take care of yourself, like if they cause you to skip doses of antiretroviral drugs, take sexual risks you later regret, spend money that you need for other things, and neglect your health in other ways. Street drugs may also interact with other medications you're taking, which can cause serious problems in some cases (see "Making Sure Your Drugs Play Well Together"). This is something you should discuss with your doctor and pharmacist.
The stress and challenges of being HIV-positive may lead some people to use more drugs and alcohol. Drug use may be a way of coping, but in the end, may only make it harder to deal with the actual issues. Drug or alcohol use can also become an addiction -- something you are physically or psychologically unable to stop without professional help.
If you do use alcohol and/or street drugs, hopefully you feel able to talk about it honestly and openly with your doctor. (If not, try to find a counsellor who you can talk to. Many AIDS service organizations make referrals.) If drugs or alcohol start to interfere with your mental or physical health, your social life or finances, or if people close to you express concern, it may be time to take an honest look at your use. Help is available; don't be afraid to ask for it if you think you need it.
Quitting smoking is one of the best things someone with HIV can do for their health. You probably know that smoking can cause lung cancer and other kinds of cancer and lung disease and can greatly increase a person's risk of heart attack and stroke. Having HIV makes smoking even more hazardous to your health. If you smoke cigarettes, you should do everything you can to stop. Your doctor can help you.