AIDS

Time Management and Tobacco Reduction: Tips to Get Started

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What is Time Management?

In our first tobacco workshop of the year, clients discussed the idea of looking at time management in two different ways:

  1. Having too many tasks, appointments, etc. and feeling as if there isn’t enough time to get them all done.
  2. Having too much free time and not knowing how to fill it.

Both of these situations can be overwhelming, and both can lead to an increase in feelings of stress, anxiety, frustration, and loneliness/depression. Which can result in an increased want or need to use tobacco products. Stress, in particular, is a commonly cited barrier for people attempting to quit their tobacco use, and often plays a role in slips and relapses during quit attempts. 

So how can one start to utilize time management skills in their daily life? Something I noticed when exploring ideas for this month’s blog is that most articles and blog posts offering time management tips revolve primarily around productivity and efficiency in the workplace. While productivity-based skills can be incredibly useful in many settings, they often don’t prioritize an individual’s overall wellbeing. The following list includes my top time management tips.

  • Start Small. It’s important to remember not to overwhelm yourself with major changes, even when they may benefit you in the long run. Scheduling every minute of every day is unnecessary and likely to increase negative feelings if you’re unable to meet those detailed time frames. Start with marking down important appointments and deadlines, and see what else would be helpful from there. 
  • Use a Planner or Calendar. While it seems obvious, using a calendar or planner can help you keep track of appointments, events, and other commitments. Keeping track of these will allow you to make appointments as needed while also helping to prevent you from double or overbooking yourself. Having these things planned out will also allow you to prepare for them.
  • Become a List Maker. Using lists can be incredibly helpful when you feel like you’re just not getting things done that you need to. Not only can they serve as a reminder for what needs to be done today (or tomorrow, or this week, etc), crossing off tasks as you complete them will provide you with a visual of how much you’ve accomplished.
  • Break Up Your Big Tasks. Oftentimes major tasks can seem intimidating and we can end up putting them off to avoid feelings of failure and anxiety. By breaking these big tasks up into multiple smaller ones, you can gain confidence in getting through your to-do list without trying to put them off. 
    • For example: You were sick in bed for a week and missed multiple appointments with your doctor, your case manager, your tobacco treatment specialist, your therapist, and a class. Rather than trying to reschedule everything in one sitting, space the calls (and the appointments) out with breaks in between. 
  • Prioritize! Though time management skills can certainly be helpful, they can’t change the fact that we only have 24 hours in the day and seven days in the week. Take time to determine which tasks are the most important, and which one(s) can wait until you have more time available.
  • Make Time for Yourself. While making it to your appointments and other commitments is important, remember that it’s equally important to set aside time for yourself to do things you enjoy whether that’s reading, taking walks, spending time with loved ones, or watching movies. 
  • It’s Okay to Say No Way. These tips and skills are supposed to help reduce stress, anxiety, and frustration in your daily life. Recognize that it’s okay to let people know when you have enough on your plate for that week and need to schedule for a better time in the future. 
  • Celebrate! With any change in your life, it’s important to remember to recognize your accomplishments even if they seem small. Made it on time to an appointment you’d missed and rescheduled a few times? Have a small treat! Completed a major task that’s been looming over your head for weeks? Give yourself a night where you can focus on relaxing and doing activities you enjoy.

As you begin to plan ways to put some of these tips to the test, remember that different things work for different people. Maybe most of these will work for you, or maybe only one will. Don’t be afraid to adapt these tips to benefit YOU and your time management needs. Ultimately, the goal is to find ways to help manage feelings of stress, anxiety, frustration, depression, and boredom that might lead to an increase in your tobacco use. 

Interested in finding out more about Unified’s Tobacco Reduction services? Contact your office’s Tobacco Treatment Specialist:

Detroit: 
Amber Jager – (313) 446-9800 
ajager@miunified.org

Ypsilanti/Jackson: 
Caitlyn Clock – (734) 961-1077
cclock@miunified.org

Quit Smoking Tip of The Week: Keep the weight off! Part 3

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So far we have covered nutrition and exercise as tools for a healthy weight and lifestyle. Now, third but definitely still just as important as the former two, is sleep! We often disregard or forget about this oh so important factor altogether, in the go-go-go lifestyle that comes along with our society. Sleep is one of the most crucial ingredients for health and well-being. Sleep is what regulates your hormones, repairs your body, promotes a healthy mental state, and so much more.

orange cat sleeping on white bed

If weight loss is your goal and you’re eating healthy foods and working out but not seeing much progress, it is time to evaluate your sleep. Not only will your “gains” from working out be lost if you are deprived of sleep, but your body will crave more food to help fuel your body as it goes into “overtime,” and usually the foods we crave are not the foods we need for proper nutrition. Let’s dig a little deeper, here, and see what else is effected by sleep and HOW to get the most out of your sleep!

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In addition to getting enough sleep (a recommended 6-8 hours for adults), the timing of your sleep is also crucial. Research shows that your body starts to release melatonin in the evening as it starts to get dark out, then begins to release cortisol as the sun begins to rise. Melatonin is the sleep hormone responsible for putting your body at rest and cortisol is the sleep hormone responsible for waking your body up. An optimal sleep schedule is to sleep from 10pm to 6am (8 hours), as 10pm-2am is the time in which your body reaches its peak hormone balance to promote optimal restoration for your cells. When you stay up too late, or sleep in too late, your body is thrown off by hormone dysregulation. This can explain why you may still feel tired even after getting a solid 7-8 hours of sleep, because getting 8 hours of sleep from 12am-8am, is not the same as a 10pm-6am schedule. When you go to sleep at 12am you have already missed the first two hours of REM sleep. Dr. Oz has a great article going deeper into the science behind the 10pm-2am cycle of restorative sleep here if you’re interested in learning more.

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What happens to your body when you get a good night’s sleep? A ton of great things, such as:

  • Blood sugar regulation, important for preventing type 2 diabetes
  • Your muscles rebuild themselves, utilizing essential amino acids that you have digested throughout the day (making your workout actually worth it!)
  • Your body repairs itself from internal and external stressors (inflammation reduces, mood regulates, free-radicals that cause disease are removed, all thanks to the antioxidant properties of melatonin)
  • Long-term memory is reinforced, helping you perform cognitive tasks more efficiently

All of the above (expect for the last point, which should still be an important factor for people) aid in weight loss. When you don’t get a quality amount of sleep, the above either will not happen or will occur at a much less efficient rate.

So, get those ZZZ’s because they’re a lot more important than you think!

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Setting a routine for better sleep

Now, let’s address HOW to get this restorative, restful sleep, because as we all know, insomnia can be a withdrawal for many smokers who begin their quit journey.

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  • Only use your bed for sleep and sex. When you do other activities in your bed (such as reading, watching tv or eating) your brain does not associate your bed with sleep as strongly, and your bed should only be associated with relaxation.
  • When you can’t fall asleep, get out of bed. This might sound like bad advice, but it goes along with the first tip. If it is taking you up to an hour to try to fall asleep, get out of bed and read on the couch or stretch until you feel sleepy, then hop back in bed. When you can’t sleep and stay in bed, feeling anxious or upset that you can’t fall asleep, you are unintentionally associating your bed with negative emotions.

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  • Exercise early in the day, if possible. It is proven that moderate exercise (try for 30 minutes a day, even if it’s just walking) will help adults get a better night’s sleep. Even further, if you exercise before 3pm you will be getting the most from this benefit as it is also proven that exercising after 3pm can cause your sleep hormone production (melatonin and cortisol) to get post-poned, potentially making it harder to initially fall asleep.
  • Consistency is key. Try to go to sleep at the same time each night, and wake up around the same time each morning. Building a consistent routine around your sleep schedule helps keep your hormones in check and makes it easier to fall asleep (and stay asleep) at night.

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  • Unplug! This one is so important in our busy, always accessible society. At least an hour before going to bed, stay away from your cell phone, computer, tv, or any other electronic device. Read a book, stretch or find another relaxing activity that you can participate in each night as part of your routine to help your body unwind and relax. This will help you rid yourself of your racing thoughts, as well as give your brain a rest by intentionally reducing the blue-light that you are exposed to. Blue-light interferes with our internal clock, which controls our sleep hormone (melatonin), causing hormone imbalance, anxiety and stress.
  • Ditch the late night snacks (or meals). Eating later in the evening and at night is tough on our digestive system. Historically speaking, when the sun goes down, so does our body. And with it, our bodily systems, such as digestion. Remember earlier when I said that our body repairs itself when we sleep? Well, when you eat a meal less than three hours before going to sleep, your digestive system is still doing a lot of work while your body is trying to rest! This might be why you wake up multiple times in the night to pee, can’t seem to get a deep sleep, or even have trouble falling asleep. Do yourself and your digestive system a favor and try to abstain from eating at least three hours before sleeping, four if you’re able to eat dinner earlier.
  • Dim your lights. Our sleep hormone, melatonin, is produced by our pineal gland which gets triggered to release or not release melatonin based on the light we receive. Similar to the idea of unplugging from technology, you should try to reduce the overall amount of light received as soon as the sun starts to set. In this way, you are mimicking the way nature intended and helping produce melatonin naturally in order to induce a restful sleep by 10pm.

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  • Reduce or eliminate your caffeine intake altogether. Caffeine is a stimulant and it has been proven that even having caffeine in the morning can effect your sleep at night. Try cutting down from 2 cups of coffee to 1, or switch to decaf if you really enjoy the taste. Be aware that a lot of teas have a ton of caffeine in them, so opt for the de-caffinated ones or something light like a white tea.

white bed comforter

Coming from someone who has personally had a bad relationship with sleep from my adolescence through my early 20’s, if you try all of these tips, you will be successful in helping to reset your sleep pattern. I never thought that I would have a “normal” sleep schedule, but the fact is most American’s are not getting a restful sleep due to the rise in technology and just lack of knowledge about how our sleep hormones are regulated and what environmental cues can throw them way off. Give it a try for a week, and be amazed that you will not need a sleep aid or other substances to help you sleep anymore! If you suffer from racing thoughts at night, as a lot of us do, and stretching or meditating is not working for you, you can try getting a magnesium supplement to help relax your mind (it also relieves muscle cramps!) or look into ashwaganda root to take mid-afternoon and in the evening for stress relief and relaxation. Always ask your doctor before adding any supplements to your daily regimen as some can interfere with medications.

Quit Smoking Tip of The Week: Keep The Weight Off! Part 1

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Post cessation weight gain can cause a lot of stress for most people. You don’t want to put on 10-15 extra pounds, especially if that will put you in the overweight or obese category. That’s completely understandable, and there are small changes you can make in order to achieve and maintain a healthy weight but most importantly a healthy and active lifestyle.

First, I do want to address the fear of gaining weight while quitting smoking. If you are concerned about the health implications of gaining weight, know that putting on a temporary 10-15 pounds is far healthier than continuing to smoke or use tobacco. This is something I touch on with my clients who bring up weight as a major concern or trigger in their reduction/quit journey. I also like to let clients know that the upside to quitting is that even when you do gain a few pounds, your body is continuing to detox and rebuild its cellular processes post smoking cessation. This means that you will be able to more efficiently burn fat and put on healthy amounts of muscle because you are no longer doing continuous damage to your organs (which must function optimally to lose the RIGHT kind of weight).

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With my background in nutrition and weight loss coaching, I understand that this can feel like an uphill battle oftentimes, but rest assured that all you need is patience and dedication and there is no reason that you won’t be able to prevent or remedy weight gain after quitting. The best thing you are doing for your physical health and appearance is quitting smoking. Let’s face it, it’s hard to be fit and also a smoker- something to keep in mind.

Okay, so HOW exactly do you manage your weight?

Now let’s get into the details: how do you lose weight or even prevent the weight gain altogether? This is going to be a multi-part blog series, because there is no one magic secret that is going to do the trick. Tons of things factor into weight and how you gain and lose it, and it takes a long time for both to happen. In America especially, we get so caught up in the “immediate results, immediate gratification” mindset that we don’t step back and take a look at the whole picture.

Two Major Components: Exercise and Nutrition

These are the most well-known components to a healthy weight and lifestyle, yet most people are still not eating the right types of foods and either not exercising enough or exercising too much.

vegetables and tomatoes on cutting board

A healthy diet includes a diet consisting of healthy fats, proteins and vegetables and a moderate amount of complex carbohydrates, such as the Mediterranean diet. The Mayo Clinic offers a great, easy to follow guide here.  One of the most important things that you can do for yourself regarding weight loss or maintaining a healthy weight is to eliminate as much processed food from your diet as possible. This includes chips, donuts, cereal, etc. This doesn’t mean that you can never eat these types of foods, but it’s encouraged to limit these to a “once in a blue moon” snack and not a daily (or even weekly) item to have.

bodybuilding close up dumbbells equipment

Now it’s time to touch on physical activity. You should strive to get 20-30 minutes of exercise each day at minimum. These guidelines are from the American Heart Association. This includes walking, so don’t let yourself get discouraged if you don’t have time (or the strength) to hit the weights every day. If you work, try to get up every hour or so to do a lap around your building. Take the long way to the restroom. Even park farther away (or, if you utilize public transportation and live in a safe area, try walking to your destinations as much as possible). Walking and more intense forms of cardio can be wonderful for jump starting a weight loss journey. But if you stick to JUST cardio, it will be just that and only that: weight loss. Not fat loss. Excessive cardio eats away your muscle, so you want to be careful to not overdo it. Muscle is what you want to keep, and build, in order to actually loose fat. The more muscle you have on your body, the higher your resting metabolism. It’s important to mix up your routine if you’re looking to lose fat rather than maintain your weight. Work on building strength, and the weight will come off (as long as you stick to a healthy diet—trust me, I have personal experience from years of learning that you can never out train a bad diet! Fat loss starts in the kitchen). Next week, we will go a little deeper in proper exercise and nutrition as well as touch on another important, but often neglected factor in healthy weight and lifestyle.

HIV IS NOT A CRIME – Michigan Lobby Day

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received_10153359466535938 By: Sidney Skipper

Sidney Skipper talks about his experiences at Michigan Lobby Day in Lansing.

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I’m in Lansing, Michigan at the State Capital Building, with officials from the Michigan Coalition for HIV Health and Safety (MCHHS), Kelly Doyle and Todd Heywood.  We’re joined by Teresa Perrin whose son is serving a seven year sentence under Michigan’s HIV Disclosure laws.  We’ve gathered here on this beautiful fall day to speak with State Representatives, Brian Banks, Winnie Brinks and Tom Cochran, about co sponsoring a bill that would amend the 1988 Michigan HIV Disclosure Laws, (MCL 333-5210), to place responsibility on the prosecutor to prove intent to transmit the virus, and that transmission actually occurred.  Right now the law is vague and left to interpretation, it ignores the intent requirement, and while the CDC categorizes spitting and biting as low risk for transmission, persons can still be prosecuted for these actions. Nor does the present legislation take into account that in 2016 an HIV diagnosis is a chronic manageable condition.

Did you know that in Michigan you can be charged with a felony and jailed for 4 years or more for not disclosing your HIV status to a partner?  An HIV diagnosis is no longer a death sentence, and yet men and women in Michigan and around the country are sitting in prison for non disclosure, and in some cases placed on a sex offender list, even if they didn’t transmit the virus to the accuser, even if they used a condom, and even if they’re on medication that lowers the chances of transmitting the virus by up to 96%. Thirty three states have laws that explicitly focus on people living with HIV, the only infection that can become a felony, in spite of the fact that there are other diseases that are transmitted in the same manner, and can also lead to death if left untreated, for example, Hepatitis B.  Iowa and Colorado are the only two states to have amended their laws to reflect the new science of HIV.

The US Department of Justice states, “While HIV specific state criminal laws may be viewed as initially well intentioned and necessary law enforcement tools, the vast majority do not reflect the current state of the science of HIV, and places additional burdens on individuals living with HIV.”   According to the PLHIV Stigma Index Detroit, 88% of respondents don’t trust Michigan courts to give them a fair hearing if they are accused of not disclosing their HIV status to a partner.  62% felt that it’s reasonable not to get an HIV test for fear of prosecution. 46% felt that it was reasonable not to disclose their HIV status for fear of prosecution. And over half of the respondents felt that it was reasonable not to seek care out of fear of prosecution.  Just because someone doesn’t disclose their HIV status doesn’t mean that they want to hurt their partner.  The choking fear of stigma and unjust prosecution is silencing, and it’s stifling our efforts to completely eradicate this disease.

I was diagnosed HIV positive twenty-five years ago, on October 29, 1989, and given a year to live. Since 2000, I’ve been on ART (Antiretroviral Therapy), one pill a day.  The virus is undetectable in my blood, which makes it unlikely that I can pass the virus to a partner during sexual intercourse. I will not deny the anguish that living with HIV causes, and has caused me over the years, but I have never held anyone but myself responsible for me contracting the virus.  As I told Representative Cochran:  To accuse a person of non disclosure, to jail them and ruin their life, while we no longer die from HIV if we’re in treatment with undetectable levels of the virus in our blood, seems to be cruel and unusual punishment to me.

All of the representatives or their aides that we spoke to on this day were gracious and receptive to our recommendations. The new bill that MCHHS crafted does not repeal the disclosure statutes all together.  A key part of the new legislation states, “A person who acts with the specific intent to transmit the HIV infection to another person, and engages in conduct that poses a substantial risk of transmission, and actually causes HIV infection to the other person, is guilty of a crime punishable by not more than 1 year or a fine of not more than $1,000, or both.”  When you take into consideration that HIV is no longer a death sentence, misdemeanor charges, rather than felony charges, are sufficient consequences for an intentional transmission of a treatable, infectious disease. If I might add, intending to infect someone with the Human Immunodeficiency Virus is very rare.

My personal feeling is that the laws should be repealed all together, but during a conference I attended earlier this year, I was told that because of the stigma, the animus surrounding HIV, prosecutors would use other legislation to prosecute offenders with the intent to infect, but with this legislation we are the gatekeepers.  UNIFIED: HIV Health and Beyond joins The White House National HIV/AIDS Strategy to End HIV, to support this bill, because it aligns with the  current science, and because we are dedicated to advancing prevention, providing access to healthcare, community research and above all, advocacy that we feel advances the dignity of people living with HIV.

My most memorable meeting of the day was at the Capital offices of the primary sponsor of the bill, the Honorable Jon Hoadley of Kalamazoo, Michigan.  Representative Hoadley is a formidable champion dedicated to modernizing the Michigan HIV Disclosure laws. He would like to have at least thirteen co sponsors for the legislation before he introduces it.  We’re already halfway there, thanks to the hard work of past advocates, and today we may have added four more. The MCHHS has another lobby day scheduled for November 11, 2016, and we need all of the advocates that we can muster to stand with us.  This is a call to action for those interested in reforming our outmoded, unjust HIV Criminalization Laws, to come on out and join us in Lansing, Michigan on November 11, 2016, in the gilded halls of the Michigan State Capital building.  Todd Heywood, the Policy Director for MCHHS encourages us to, “Take responsibility to empower ourselves to protect ourselves and our partner.”  For more information about the next Lobby Day contact Todd at, Todd@MCHHS.info, or call 517-899-6182.

AIDS Survival Syndrome Excerpt from Lust or Love: A Gay Odyssey

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received_10153359466535938By: Sidney Skipper

“Sweating, heart palpitating; suddenly I’m awake, sitting up in bed. “My body, something is happening inside my body.” The spot where I was sleeping is soaked. It’s 4am in the morning. Kenny is laying sound asleep next to me. “Something is happening inside my body.” Thoughts of AIDS rush around my mind: Flu symptoms, night sweats, high risk, enlarged lymph nodes, no cure. My anxiety is replaced with a decision to get tested immediately.

I try to go back to sleep, but when Kenny wakes at 7am I’m still wide awake. “We’ve got to get tested.” Kenny doesn’t know what I’m talking about. I show him the soaked spot on my pillow, and explain this dread fear that I have. “I may have AIDS and I need to know.” Now, Kenney is the type of man who feels that as long as he isn’t sick, he doesn’t want to know, or need to know, whether anything’s wrong. It’s important to me so after a couple of days of discussion he agrees to go with me to get tested for HIV.

It’s early October, 1989, the leaves on the trees are emblazoned with colors ranging from lush browns to bright yellow, vibrant red and orange. The air is crisp and clear. On the way to Henry Ford Hospital, where HIV/AIDS anonymous testing is done, I look out of the car window at natures kaleidoscope of color as if I’m looking at it for the last time.

When we arrive at the hospital we’re directed to an isolated wing where one person is drawing blood and counseling. Very little is known about HIV at the time. We’re told that we would have the results of our blood test in two weeks. “Two weeks.” Needless to say those two weeks are filled with visible anxiety for me. Kenny on the other hand appears apathetic. I call Kenny’s apathy invisible anxiety.

The phone is ringing. It’s 9am October 27, 1989. “Hello.” “Hello, Mr. Skipper, this is Bill Townsend. We need for you and your partner to come in to the clinic to receive your test results.” It’s the counselor from the testing center at Henry Ford Hospital. “Can’t you give them to me over the phone?” “No,” is the response, “Against policy.” I knew that. I don’t know why I asked. “OK, we’re on our way.”

The Palmer Park area off of Woodward Ave. and six mile road in Detroit was once a predominantly Jewish neighborhood. Now it’s a predominantly gay neighborhood. Most of the gay black males and females in Detroit pass through Palmer Park at some time in their life. The rent for apartments and housing surrounding the park range from moderate to very expensive accommodating tastes for the simple as well as the sublime. The park is about six miles in diameter, with a wooded area, a pond and an old log cabin with some historical merit. Summer art fairs are held there, the Hotter Than July Gay Pride picnic is also held there. There are areas for family picnics, a playground, golf course, tennis courts and a swimming pool for the children. The parks diametrically round landscaping makes it ideal for inner city joggers. Its large parking lots also make it a superb cruising spot for straight and gay cuties eager to show off their sexy bodies, and their array of wonderful new cars that only Detroit can produce.

After leaving the appointment at the Henry Ford Hospital clinic, Kenny and I drive to Palmer Park and park in one of the lots under the canopy of the magnificent autumn sky. We finish of a fifth of rum and coca-cola, and smoke a joint. Our HIV test results came back positive. We don’t discuss how we got the virus or who infected us. We don’t accuse one another because we have always practiced safe sex. We must have had the virus when we met. At this point where we got the virus from is not important. What to do next is. Although the doctor told us that we would be dead in a year, I’m not depressed. I’m a child of the sixties, the generation that questioned the inherent value of everything, and believed that we could achieve anything. “Pass the joint Kenny.”

That was twenty-five years ago. I watched and waited for death while my friends and lovers passed away before my very eyes. Kenny passed away in 2005. I woke up one day and realized that I had survived what they now call the “AIDS Generation,” those of us who contracted HIV over twenty years ago when it was a death sentence. We helped to build the successes that the newly infected now enjoy through years of advocacy and caring. We are the last of our generation. We hold all of its memory, all of its history. In the throes of a plague no one thought about those of us who would survive. How do you deal with life after expecting to die?

The national strategy to tackle HIV/AIDS now is focused on the youth and prevention, as it should be. The needs of Long Term Survivors are somewhat different and are only beginning to be addressed. Many HIV long term survivors suffer from what is known as AIDS Survival Syndrome (ASS), a form of PTSD. In 2012 Tez Anderson and Matt Sharp launched a grass roots community group for people who survived the early years of the AIDS epidemic, called Let’s Kick ASS. ASS is defined by chronic anxiety, isolation, survivor guilt, depression, substance abuse, insomnia, sporadic anger, sexual risks and a lack of future orientation. Those without partners often have less income making them vulnerable to financial hardship. Some are too emotionally damaged to form new relationships or friendships for fear of being abandoned. Given a year to live some liquidated their assets, signing away their financial future. Between 2009 and 2012 suicide accounted for 4% of all deaths among people living with HIV in San Francisco, far above the national average of 1.5%. Like in the early days of the AIDS epidemic when we rallied to care for each other and ourselves, we must rally once again to understand and overcome ASS.

UNIFIED – HIV Health and Beyond salutes our long term survivors. Since 1983 UNIFIED has been a port in the storm and trusted ally for people living with HIV. UNIFIED remains dedicated to servicing the needs of those infected and affected by HIV by advancing prevention, access to health care, community research and advocacy. After Kenny died I reached out to AIDS Partnership Michigan, now UNIFIED – HIV Health and Beyond. They helped to educate myself and my family about the realities of HIV. For more information about ASS and the Lets KICK ASS campaign visit their website at http://letskickass.org/UNIFIED is available to assist you with any issues you may have. Please feel free to contact us, 313-446-9800. www.miunified.org  You are not alone.

Sidney Skipper

PLHIV Stigma Index Leadership Council member

Author, Motivational Speaker