compiled by Martin Flynn
News
ON BECOMING A NON-SMOKER
Hot news from the frontline as yours truly finally
kicks the disgusting habit of smoking after 40 years.
Being joined in quitting by my partner, neighbour, HIV doctor and dentist’s
nurse means I daren’t slip up.
Having never really considered stopping before, and having laughed off all
the carping and preaching over the years, it took a painful chest infection
to finally persuade me enough was enough.
I was fascinated to learn nicotine only stays in your bloodstream for 48 hours
and after a couple of days without cigarettes the body stops craving the drug.
So it was a firm ‘no’ to nicotine patches, gums and other props.
And a firm ‘yes’ to cold turkey and avoiding the occasions when
the sad habit seems most attractive, like the pub and parties.
There are free support groups all over the country and many HIV charities
run programmes just for us. They are good sources of support and you are more
likely to succeed if you join one. But the key is still the smoker deciding
themselves they don’t want or need the vile habit anymore.
You have nothing to lose by quitting. My chest is already much better, my
skin much improved and my sense of smell and taste returning.
Doctors say the most effective thing people with HIV can do, apart from taking
their antiretrovirals, is stop smoking.
US research shows cigarette smoking is common in HIV positive people; 60 to
80 per cent of people living with HIV there are smokers, compared with 20
to 30 per cent of the general population.
And people with HIV have a significantly increased risk of lung cancer, according
to the US National Cancer Institute.
Dr Anil Chaturvedi told AIDSmeds.com: “Lung cancer risk is significantly
elevated among people living with HIV and smoking alone does not readily explain
all the excess lung cancer risk.”
The ban on smoking in public places becomes law in England this July so now
is the perfect time to stub it out
NHS Smoking Helpline: 0800 169 0 169 • www.gosmokefree.co.uk
QUIT: 0800 00 22 00 • www.quit.org.uk
GMFA Stop Smoking Courses: 020 7738 3712 • www.gmfa.org.uk
Road
to recovery...
Day 1 Blood pressure and pulse return to normal.
Oxygen, nicotine and carbon monoxide levels halve
Day 2 Carbon monoxide eliminated from the body. Lungs start
to clear out mucus and other debris.
Day 3 Nicotine has left body; taste and smell improves.
Day 4 Breathing easier, bronchial tubes relax; energy levels
increase.
6 weeks Circulation improves.
12 weeks Walking and exercise easier.
9 months Lung function increases by at least 10 per cent
and coughs and breathing problems improve.
5 years Risk of heart attack halves.
10 years Lung cancer risk falls to half of that of a smoker.
15 years The risk of having a heart attack decreases to the
same as those who have never smoked.
TRAVELLERS WARNED
OVER MALARIA
The sad death last month of 19 year old student Mathilda
Cooper from celebral malaria just weeks after returning from visiting her
father in Uganda is a timely reminder of the ever-present dangers of this
disease.
Miss Cooper took no anti-malaria drugs because she had previously lived in
Africa, and, as a frequent visitor, thought she was immune.
Eleven people in the UK died from malaria in 2005 the majority of whom took
either inappropriate or no preventative drugs. Over 2,000 cases of malaria
are diagnosed in UK travellers every year.
The Health Protection Agency is urging travellers to destinations where malaria
is present, particularly Africa, Asia and South and Central America, to take
precautions.
Travellers should also apply insect repellent; wear cover-up clothing and
sleep under an insecticide-treated bed net.
FRUITY BRITS DITCH
SWEETS
After
years of nagging to eat at least five portions of fruit and veg, the British
public might just be getting the message.
Latest figures from the Department for the Environment, Farming and Rural
Affairs, show UK household expenditure on fruit rose 12.9 per cent last year
and 6.3 per cent for veg.
Meanwhile, spending on confectionary fell 6.1 per cent, alcohol by 3.1 per
cent and fat intake fell to 38 per cent.
Minister Jeff Rooker said: “These healthier trends in food purchases
are promising, but we cannot be complacent. Consumers must remember that the
food choices they make can have a big difference not only to their health,
but to their environment and our countryside.”
Feature 10 TOP TIPS
FOR BETTER SLEEP
Cut
out caffeine
Caffeine keeps you awake and stays in your body longer than you think - up
to 14 hours. An Espresso at noon may explain why you are still awake at midnight.
Cut out caffeine at least four to six hours before bed or try eating carbs
like bread, cereals or crackers to help reduce effects.
Avoid alcohol as a sleep aid. It may initially help you drop off, but it also
causes disturbances in sleep.
Relax
Stress causes the brain to release a hormone called cortisol that wreaks havoc
on your sleep.
Stimulation - an exciting film, computer use or even an argument - before
bed can disturb sleep. A short pre-sleep ‘ritual’ to break the
link between the day’s stresses and bedtime can help. Try mediation,
soothing music, aromatherapy, yoga, light stretching or a warm bath. Some
write a list of their stresses along with a plan to deal with them to create
‘closure’ on the day. But don’t watch the clock. The steady
‘tick-tock’ will just tick you off.
Exercise at the right time
Regular exercise reduces the time it takes to fall asleep once in bed and
increases the length of time we sleep for. However, as you become more energised
and alert after exercise so you should allow five to six hours for the effects
to wear off before trying to get to sleep. So get to the gym in the early
evening.
Dim the lights
For many, even the slightest noise or light can disturb sleep. Use earplugs,
eye shades, blinds or curtains to create a slumber-friendly environment. Use
a small night light rather than overhead light if you need to get up. Most
sleep better and deeper in cooler weather. Between 68 and 70°F (20-21°C)
is ideal. Try a light cotton T-shirt in bed and avoid heavy bed covers. Open
a window, even in winter, to avoid a stuffy low-oxygen atmosphere.
Eat right, sleep tight
Don’t go to bed hungry, but avoid heavy meals just before bedtime. An
over-full belly can keep you up.
Some foods help. Milk contains tryptophan, a sleep-promoting substance, so
a warm milky drink before bedtime really works. Other foods known to help
promote sleep include tuna, pumpkin, almonds, eggs, peaches, walnuts, apricots,
oats, asparagus, potatoes and bananas. Too much fluid may lead to more nocturnal
trips to the bathroom.
Restrict nicotine
A smoke before bedtime may feel relaxing, but actually puts stimulant into
your bloodstream. Nicotine keeps you up and awake at night. Avoid smoking
particularly near bedtime or if you awake in the night. If you find yourself
tossing and turning in the night, get up, sit in a dark room, listen to relaxing
music while having a glass of milk rather than reach for the fags.
Napping
Napping can only make matters worse if you have problems falling asleep. If
you do need a nap, keep it short. The perfect Spanish siesta is less than
an hour, deep enough to go into REM (rapid eye movement or dream sleep) but
short enough not to wake up needing more and feeling shattered. A 45 minute
snooze after lunch can rejuvenate.
Keep pets off the bed
Does your pet sleep with you? This may cause you to awake during the night,
either from allergies or pet movements.
Avoid
heavy chats
Beds should be used for sleep and sex only. A good shag can release stress
and induce a deep, relaxing sleep. But avoid deep post-coital or emotional-laden
chats in bed. These distracting activities wind you up and drive sleep away.
Drugs
don’t help.
Avoid sleeping pills unless prescribed by your doctor. They knock you out
but you awake feeling shattered. Synthetic melatonin, used by long-haul flight
crews, can stabilise disturbed sleep patterns. Melatonin is unlicensed in
the UK but can be bought on the internet or from US or European health stores.
If you take the HIV drug efavirenz (Sustiva) and are having morbid dreams
or severe sleep disturbance, talk to your doctor about switching to an alternative
drug that works just as well against the virus but doesn’t drive you
quite as crazy.
Food for thought
BEYOND POPEYE
Iron is not made of girders but it is essential to our health
Readers
may be shocked to learn that muscle-bound Popeye couldn’t possibly have
drawn his legendary strength from spinach. Although the leafy veg is a good
source of iron, it contains a substance that makes it hard for our bodies
to absorb. The myth about spinach being super-rich is because 137 years ago
a scientist misplaced a decimal point when calculating its iron content.
What is it?
Iron is an metallic chemical element. Haem iron comes from meat and fish,
and non-haem from other sources. Haem iron is more easily absorbed and accounts
for around 75 per cent intake in non-vegetarians. Iron deficiency, or anaemia,
is the most common nutritional problem in Britain and worldwide.
What does it do?
Iron is an essential component of haemoglobin, the stuff in red blood cells
that carries oxygen around the body. When oxygen from air binds to iron in
our blood, it turns a reddish colour. Haemoglobin deposits oxygen then carries
waste carbon dioxide back to the lungs where it is breathed out.
Oxygen is needed for energy so the main symptoms of anaemia are tiredness,
lack of stamina and breathlessness. Anaemia is also associated with side-effects
of HIV drugs like AZT, though it is rare among people with CD4 counts above
200.
Which foods?
Liver, red meat, beans, nuts, dried apricots, whole grains, soybean flour,
strawberries and most dark green leafy vegetables like watercress and curly
kale are good sources. Avoid eating liver if pregnant because of its high
vitamin A content.
How much?
The Food Standards Agency recommends 8.7mg a day for men and 14.8mg for women.
Vitamin C-rich food (citrus, peppers, broccoli) help us absorb iron from non-meat
sources. Women who lose a lot of blood during their period should ask their
GP or dietitian if they need supplements.
Our expert* says:
Some studies have shown that HIV positive women have a higher rate of iron
deficiency than negative women. Although iron deficiency anaemia can be common,
often the anaemia associated with HIV is not caused by inadequate iron. Ask
your consultant if you are unsure.
Iron deficiency may possibly increase one’s resistance to infection,
however, toxic amounts of iron can also have a negative affect on the immune
system. Most women’s multivitamin supplements have extra iron in them
so look at the label to see how much you are getting. Be sure to keep your
intake below 45mg per day from both food and supplements.
Why not try...
ZINGY SALAD
Toss
a bag of baby spinach, peeled, cubed mango and cashews in a dressing made
of lemon, extra virgin olive oil, mustard and salt and pepper.
Top with roast chicken and halved cherry tomatoes. Vitamin C in the dressing,
mango and tomatoes improves the absorption of the iron from the spinach.
*Karen Klassen is lead HIV dietitian at St Mary’s Hospital, London
SURVIVAL TIPS
Winnie
Ssanyu Sseruma DX1988: ‘Better out than in’
I found out I was HIV positive while applying for a job. I was told I was
lucky; AZT had just come on the market, and I started straight away.
I was a basket case; incredibly stressed because I couldn’t tell anyone
and thought about death all the time. I also heard people talk badly about
HIV positive people.
Between 1988 and 1994 my mum and dad passed away, and I lost a brother to
HIV. I decide to returned to Uganda to die. I sold everything I couldn’t
carry and went to stay with a sister I hadn’t seen for years. She found
my meds before I figured out how I was going to tell her.
It was a relief to find she was incredibly supportive; I thought everybody
would respond negatively. After her reaction, there was no turning back.
On a visit to the UK I went to a Body and Soul support group; my second turning
point. When I saw the women there I thought: “I wanna be like that;
to do stuff, to be healthy, to be alive.” So I stayed in the UK and
volunteered at B&S, sharing my story in their newsletter and helping others.
Being able to access health care and being an active patient was fundamental.
It helped me dramatically.
As my health stabilised I felt free to do anything, and I’ve been shooting
my mouth off ever since. It’s so liberating. You wish everybody felt
the same, because the more people hide the more the stigma festers.
Some people have nasty experiences and obviously that puts them off telling
people but I’ve found most react positively. It depends on how you carry
yourself. If you hide it, always living in fear, people become suspicious.
If you are upfront and display courage and confidence – that’s
the way others treat you and you get the support you need.
