Resolutions Gone Awry
Its that time of year. The end of January. Snow is falling. (A lot of it in New York!) And, your New Year’s Resolutions are on the verge of becoming history.
This week I’d like to encourage you to reconsider those resolutions. Perhaps they need to be altered. But, it may not be time to put off those goals for New Year’s Eve 2012.
What do Resolutions have to do with Aging and HIV?
Living with HIV into midlife and beyond requires adaptation to a great deal of change. There have been changes to your body, career, family, your friendship networks, and to the world around you. Optimal aging with HIV involves flexibility as you develop new strategies to cope with aging. Often this means discarding old patterns that no longer work for you and beginning the difficult task of learning new ways to care for yourself.
You may have used the new year to reflect on what has and hasn’t worked for you in the past, and developed some ideas about what you want for yourself in the year ahead. You may have made an intention to change the way you eat, to exercise more, to address your drinking, to make new friends, to join an organization, to look for a new job, or get yourself out there in the dating world. You may even have come up with a plan to reach those goals.
Well, now is the time to review how that plan is going. If you are still on target, then read this post in order to help you look for warning signs that your resolution is going awry. But, if you are anything like me, your commitment to change is starting to waver, and you are at risk for giving up altogether. If that is the case, let me tell you about my New Year’s Resolution.
My Story
At the end of December I realized that I had been gaining weight. In fact, a step on the scale revealed that I was the heaviest I had ever been. So, I resolved to lose weight in the new year.
I had helped many others through similar challenges and knew what pitfalls to avoid. For example, I knew that I needed a reasonable goal. If I tried to lose too much, too quickly, I would just feel deprived and give up. So, I decided that I would set a goal of 1-2 lbs per week. I also knew that I should not only change my eating habits, but also increase my exercise, so I joined a gym.
Great plan. (Do you see where I’m going with this story?) Well, its the end of January, and as of yesterday I have lost 1 lb.
This is where I want to say, “what’s the point? My metabolism has slowed and no matter what I do, I won’t be able to lose that weight!”
But, since I’m writing this post to help you, I have to take the following advice:
Don’t Give Up!
When a plan doesn’t succeed, it just means there’s something wrong with the plan. In every failure there is a learning opportunity.
So, first, before you dismiss the commitment you made to yourself, remind yourself what you wanted to accomplish, and why.
Do your reasons to meet that goal still seem rational? Then, you have to find a way to make it work.
Next, assess the steps you took to meet that goal. Did you do what you said you were going to? If not, ask yourself, why you didn’t.
Make Adjustments
Maybe the goal makes sense, but the way you are going about it is faulty. For example, I could have joined a gym near my apartment. But I don’t get home until late every evening, and am usually too tired to exercise then. It would be better for me to find a gym near work, where I can go during a break in the day.
Once you know why your plan hasn’t worked, you can make changes to the plan and try again.
Back Off
I often hear clients who have given up on their resolutions only to discover that the goal they set for themselves was unreachable. In my case, I set a very reasonable goal, but I got a cold and missed one week of exercise. I also didn’t consider that I would have to build my stamina slowly, having been away from the gym for some time. And, there was a learning curve, as far as my diet was concerned. It took me some time for me to learn what foods I could, and couldn’t eat, in order to stay on target for my weight goal.
Backing off is different from giving up. Its being honest with yourself about what you are, and are not, willing to do to accomplish your goal.
Ask for Help
There may be obstacles in your way that you are unaware of. If you have rethought your plan and are still getting nowhere, it may be time to get some help. Talk about your goals with a friend, your doctor or a counselor.
Change is hard. We develop patterns of taking care of ourselves and relating to others. Sometimes those rituals are deeply ingrained in our sense of ourselves, our memories of friends, and our families. Food, for me, is one of those issues. I still eat the same meal for breakfast that I did as a child. Changing my diet means changing my relationship to food, and that can have emotional meaning, as well.
Sometimes you just need a buddy. Share your resolution with a friend. (And, they can share theirs with you.) By including someone else in your plan, you have someone to support you, encourage you, and to hold you accountable when you want to give up.
Resources
On the resources link (above) there are a list of agencies that may be able to help you reach your goal.
I hope that this post helps you to recommit to your resolution, reassess your objectives, and get the help you need to achieve your goal. Please let me know if you set an intention for the new year, and how you are progressing on that goal.
Aging and HIV Conference
I just received this notice from hivaging.blogspot.com:
Aging and HIV Conference Scheduled The 2nd International Workshop on HIV and Aging has been scheduled for October, 2011 in Baltimore, Maryland. Abstracts are due September of 2011. For more information, go to: http://www.conferencealerts.com/seeconf.mv?q=ca1im80x
Thank you Dr. Emlet for keeping us posted.
Dr. Schmidtberger on Aging with HIV
Dr. James Schmidtberger, co-author of Aging with HIV: A Gay Man’s Guide was recently interviewed about his two decades experience working as a physician with people living with HIV. Read the article at the New York City Health and Hospitals Corporation website.
UCSF to Study Aging with HIV
Doctors at the University of California, San Francisco (UCSF), appreciate the unique challenges faced by their patients as they age with HIV. That is why the University has received funding to develop and evaluate programs that integrate HIV and geriatric services for HIV/AIDS patients who are 50 and older. Researchers at the San Francisco Department of Public Health and UCSF received a three-year grant to study new models of care and offer best-practice guidelines for treating HIV and aging throughout California.
To find out more about this timely study go to the UCSF website.
Do You Know About HAG?
Here’s what they say about HAG on their Facebook page: “Affectionately called HAG, the HIV Aging Group discusses all issues related to the senior HIV patient experience.”
If you are a facebook user you can join their discussion. Just go to your fb page, search for HAG and then put in a request to join.
Preparing for the Aging HIV Epidemic
POZ magazine on line listed this video on Aging with HIV as one of the top ten for 2010. The article, posted on May 12th by Willette Francis, includes a video of GMHC Executive Director, Dr. Marjorie Hill, reporting the results of their study, “Growing Older With the Epidemic: Aging and HIV.”
In case you missed the original article and video, here is the link: http://www.poz.com/articles/GHMC_HIV_aging_2296_18404.shtml
Stay Connected
The final post in December’s Self Care series is on staying connected.
The research demonstrates that having a rich social support network is integral to optimal aging with HIV. Having friends and family helps one to cope with some of the challenges of aging, and of living with HIV. The presence (or absence) of social support affects emotional and physical health. It is not merely the number of friends that matter, but how reliable they are in a variety of ways, and your satisfaction with these supports that matters.
But, many gay men have lost their entire friendship networks to the AIDS epidemic. Add to this the normal losses that occur with aging and we see that just as people need more support from friends and family to deal with the challenges of aging with HIV, they have fewer people in their life to rely upon.
The challenge at this stage of life is to maintain, reconnect, and rebuild social networks. There are many obstacles to rebuilding social networks. You must know yourself, what you like in a friend, and what you need in a friend (which are not always the same.) You also have to be willing to take a risk and even to experience the potential for more losses. A difficult challenge for people who have lost many friends in the past.
I’ve pulled a few suggestions on rebuilding social networks from Aging with HIV: A Gay Man’s Guide:
Renew old acquaintances. Contact friends from your past or deepen your involvement with extended family.
Seek out people with whom you have things in common. Join an organization. Many of the men I spoke with are in HIV or gay men’s support groups. But the options are as broad as your interests. Are you into doll collecting? Environmental issues? Chess? The Avengers? Macrobiotic cooking? Salsa dancing? There is a club for you. Look at your local gay community organization, AIDS service agency, newspaper, or on the web to find a group that fits your needs.
Talk to a stranger. Strike up a conversation with someone you see at the supermarket, in the building where you live, or the restaurant on the corner. If you don’t know what to say, ask a question. People love to talk about themselves.
Diversify your networks. Your friends should include people from different backgrounds. The wider and more varied your network, the greater your ability to manage what life throws at you. There may be straight, younger, or HIV-negative people in your life who would welcome the opportunity to develop a closer bond.
Don’t wait for people to contact you. If you want to talk to someone, pick up the phone (and leave a message at the beep). Every day. I don’t know anyone who can read minds. No one will know that you need help if you don’t ask for it.
Consider professional supports. You may feel more comfortable reaching out to a psychotherapist, pastoral counselor, or social worker than a friend when you are depressed or anxious.
Get a pet. Pets are great companions. And when you’re walking the dog, who knows who you might meet?
Pursue (or maintain) a romantic relationship. A stable marriage at age 50 is one of the predictors of healthy aging at age 75.
Use the Internet to cast a wider net. The Internet is not a replacement for human contact, but it can be an effective tool to rebuild your social network. Several aging organizations serving the lesbian, gay, bisexual, and transgender (LGBT) and HIV communities have resources on the web. Don’t be afraid to join Facebook, Twitter, or LinkedIn. They are great tools to stay in touch with people of all ages.
Form a reading group. At the end of the book I outline a strategy to use this book in a group setting. But you can form a reading group on any subject that interests you. Start advertising by word of mouth and then consider where you can post a flier or put in an ad to best reach like-minded people, such as your office or a local bookstore.
Just as a garden needs constant tending before your new plant can take root, you must nurture your relationships for them to mature. Keep showing up. Stay in regular contact with your friends. Time can weaken the bonds of friendship. Find ways to stay in touch, such as the telephone or Internet. Similarly, don’t allow arguments or miscommunication to jeopardize a good friendship. Try to work out your disagreements by talking to each other, or ask a friend or professional counselor to help you mediate the problem. Remember, maintaining friendships is as important as forming them.
Staying Fit
The third post in the December Self-Care series is about staying fit. For me, the challenge of exercising is getting started. I never want to exercise, but I always feel better after. My strategy to compensate for my inertia is to include some form of physical activity into my weekly routine, that way I don’t have to think about it, I just do it.
The benefits of exercise are multi-fold. A balance of aerobic exercise, strength training, and stretching helps cardiovascular health while maintaining muscle mass, balance, and flexibility. Regular exercise is not only an integral part of physical health for people aging with HIV, but exercise can also help you reduce stress, manage anger, and improve your mood. In addition, there is evidence that regular physical exercise can actually forestall the onset of non-HIV-related dementia.
Calisthenics, rapid walking, jogging, dancing, and hiking are aerobic activities. Strength training––using weights or other forms of resistance––is increasingly found to be important for building muscle mass lost with aging. Stretching is an important part of any exercise routine, and it is especially important to increase flexibility as we age. Yoga is an ancient form of exercise involving the mastery of postures that increase flexibility and strength. I recently heard one yoga instructor refer to spinal flexibility as, “the fountain of youth.”
Your exercise routine should include aerobics, strength training and stretching. Exercise does not need to be strenuous. Start slow with achievable goals and respect your limits. You may want to consider getting started with a fitness professional. Before starting an exercise program be sure to discuss it with your doctor.
Next post: Staying Connected
Eating Well
In the second installment to the December’s Self-Care posts, I wanted to discuss healthy eating. Well, actually, I do not want to discuss healthy eating, because I have to admit to everyone that I have not been eating well lately. With the release of the book, the stress of the holidays, and my inclination to eat more than I should at this time of year, I have put on a few pounds. So, I need to revisit this topic for myself and will bring you along for the ride.
You may have already made adjustments to your diet to adapt to HIV-related changes in your metabolism and the effects of medication. Aging, too, creates shifts in our body, and as we age we need to alter our diets to compensate.
I consulted with Dr. James Schmidtberger, from the Leicht Clinic, an HIV-clinic in New York City to get some guidance on eating well and aging with HIV. He offered some general suggestions in order to get us started. He also suggested following up with a doctor or nutritionist to respond to changes in your specific physical condition.
Here is what he had to say:
When we age we lose muscle mass and require fewer calories daily. Uncontrolled HIV can accelerate the loss of muscle mass. If you are concerned about HIV wasting you may be tempted to overeat. Without adequate exercise, this may result in excess fat which raises the risk of developing (or worsening) other chronic conditions such as diabetes and heart disease. This is why nutrition and exercise are so important to help you maintain your muscle mass. Nutrition is particularly important if you have other medical problems (such as high blood pressure, high cholesterol, diabetes, or prediabetes) or lipodystrophy. A balanced diet is important to help your body fight HIV and control (or prevent) those other conditions.
A good place to start is to assess your overall dietary habits. In general, you want to eat a balanced diet with plenty of fresh fruits and vegetables. A good rule of thumb is called the “plate method.” This is a simple way to devise a healthy meal and is recommended by the American Diabetes Association. Take your dinner plate and divide it in half. Fill one half with nonstarchy vegetables (such as spinach, broccoli, cauliflower, greens, salad, tomato, cucumber). Divide the remaining half again into two quarters. Fill one quarter with starchy foods (such as rice, pasta, corn, peas, whole grain breads/cereals). Fill the remaining quarter with proteins (lean meats, skinless poultry, seafood, tofu, eggs). Add a glass of nonfat or 1% milk or yogurt and a piece of fresh fruit. You can bring the plate method to the breakfast, lunch, or dinner table.
Consider the following small modifications. If you eat too much, try to limit your portions. If you drink soda, switch to seltzer or diet sodas. Avoid fast food. Switch to healthy oils, olive oil or canola oil, and avoid food with trans fats.
Depending on your situation, your nutritional needs may differ. For example, if you are fighting an opportunistic infection, your calorie requirements may be higher than usual. If you have heart disease, diabetes, or other complications, you may have specific dietary restrictions. Ask about nutrition. You may also want to consult with a nutritionist to assess your dietary needs.
Next week’s blog: Staying Fit
A Good Night’s Sleep
As we’ve been discussing on this blog , aging with HIV involves adapting to a great deal of change. One aspect of optimal aging with HIV is re-evaluating your coping strategies, to make sure they are meeting your changing needs.
This month we will be discussing Self Care. December can be a stressful month and you may want to make sure that you are doing everything you can to take the best care of yourself that you can.
Developing healthy sleep habits is an integral part of self care.
There are several things in life that could impact your sleep. Changes in medication, physical changes that accompany aging, stress, and environmental changes can all affect your ability to get a good night’s rest. The following are some recommendations for getting a good night’s sleep taken from Aging with HIV: A Gay Man’s Guide.
Many people’s sleep habits interfere with getting a good night’s sleep. For example, eating or drinking in bed, reading/playing cards in bed, and falling asleep with the TV on for background noise are just a few. These practices train your body to be awake in bed. If you are having sleep problems, try retraining yourself: go to sleep and get up at the same time every day, remove the TV from the bedroom, make your bedroom quiet and dark (use blackout shades if necessary), do not read in bed, and do not eat or drink in bed. The bed should be only for sleep (and sex). Establish a prebedtime ritual, such as turning off the TV and computer at least 30–60 minutes before bedtime, changing out of your day clothes, and flossing and brushing your teeth, to prepare your body for sleep. When you feel tired, go to bed. If you cannot sleep after 20 minutes, get up and leave the bedroom, but don’t turn on the TV or computer. Wait until you feel tired and try again. If you continue to have trouble sleeping, you should bring it up with your doctor.
Next post: Eating Well.
AHA Project 