How to Control Diabetes During the Holidays

Shopping, parties — the holiday season can be a whirlwind of activity. But you can still successfully manage diabetes, even at this busy time of year!

How To Keep In Diabetic Control During The Holidays

 

 

November and December are months of eating out at restaurants and parties. For people with diabetes this can be the time that "tries one's soul" for many reasons. First, the holidays are stressful times for many of us. Just read the article we shared with you last year at this time about stress and the holidays to get a flavor of what we all cope with. Stress that is not dealt with can be a prime motivation to break one's diet. Our unhappiness and unfilled wishes can be sated with food and drink of all nations, making us ill. Second, this is the season of eating at different times than usual and with people who may not know that you have specific dietary needs. Third, this is the season of sugar plums and more sweets than we see the rest of the year. We all know the new guidelines for carbohydrates which no longer forbid sugar, but the fat and calories in these foods can overload your medications in a few bites, especially if you have already eaten other foods.

What to do?

First, let's change the way we look at the holidays and parties we attend. This is a good way for anyone who is trying to stay on any diet to think about these situations. "Parties are social occasions" . Just keep repeating this to yourself. "You will meet new and interesting people with whom to talk. The festive atmosphere will make the evening memorable, not just the food. Friends are more important than food." Find a mantra that fits your thoughts and stick to it.

Second, let's plan ahead. This is very important. If you don't know how to change your meals and snack times, and mesh that with your medications, talk to your doctor or diabetic educator. Get information on how to regain control of your blood glucose levels if you overeat, or eat something that looks innocuous which turns out to blow the top off of a carbohydrate chart or glycemic index. Be honest with yourself. Are you really going to drink sparkling water at the New Year's Eve 2000 party or are you going to drink a sip or two of the bubbly? If you do, do you know the exchanges? Do you know how that flute of champagne can affect your blood glucose level? If not, you can be in for trouble. So let's plan ahead if you are going to eat out. As diabetics we eat the way the rest of the world should, and many restaurants indulge those of us who want to eat healthy by having a few entrees that will fit the bill. Ask your wait person to inquire of the chef if he/she can broil or roast some lean protein with the sauce on the side. Ask for a grilled vegetable platter with little oil. If you are at one of those restaurants that think "more is better" in terms of portion sizes, order two appetizers instead of an entree, and notice how quickly the trend grows among the guests who want to fit into their clothes the next day. Look for salads with the dressing on the side, fish and whole grain products. As we said before, try to have your food broiled or roasted, and remove any visual fat before you dine. At the buffet your boss gives each year, you know what will be served from years past. If there are vegetable trays, you win. If there are large fatty hams with mayonnaise and biscuits, creamy potatoes and vegetables, and butter laden desserts, you need to come prepared if this is your dinner hour.

If it is not, eat healthy at home and eat your night time snack at the party. Remember, this will be about 200 calories, so stop after that. If this is to be your dinner, try to pick the lowest fat and calorie items. You know the food will not be to your liking? Place a sandwich in your pocketbook or pocket. Place in your serving plate and eat. Need more calories, eat fruit either from the center piece or that you've brought from home. Some diabetics think that people will stare if they do this. To tell the truth, I used to think the same, but remember our mantra. If you handle it, and rethink the party as a social affair and not as a place to "pig out", then you will be just fine. You'll be surprised how many people will admire you for taking care of yourself, and envy your good luck in the food department. With 16,000,000 American people with diabetes, everyone knows someone with the disease, so relax and go talk to an interesting person you have always wanted to meet.

What else can you do to protect yourself? When going down the buffet line or ordering at a restaurant, take only what you need and want. Think. What size is my portion at home when I eat? What kinds of exchanges do I have usually? Make sure you look for hidden calories. Foe example, breaded foods have bread crumbs and are usually fried. Make sure, if that's all your hostess is serving, add in the fat and starch exchanges and turn down other foods or take only a bite or two after removing the coating. Remember that your friend may not cook the same low-fat way you do. Dessert time comes and everyone is ordering. What do you do? If you have exchanges left, look to fresh berries or other fruit or vanilla ice cream. Try a skinny cafe latte which will make you think you are overindulging. Stay away from large portions of the gooies, you know the sugar and fat-laden cakes and tarts. You can bake safer desserts at home. Just look at the recipes on the site and in our cookbooks. You can indulge in Buche Noel, tarts, genoise etc.

Here is a list of healthy foods. Carry this with you during the holidays to protect yourself.

Appetizers:

Tomato juice, unsweetened fruit juice, clear broth or consommé, raw vegetables, fresh fruit, fresh or steamed seafood.

Eggs:

Poached or boiled

Salad:

Tossed vegetables, lettuce, sliced tomato, cottage cheese or nonfat cheese (if allowed because of sodium count). low-calorie dressings, lemon juice, vinegars

Breads:

Whole grain

Starches:

Baked potatoes, plain rice or noodles

Fats:

Diet margarine, low fat sour cream or yogurt, low fat dressings

Vegetables:

Raw, stewed, steamed, boiled, roasted, stir-fried with cooking spray

Protein:

Roasted, baked, broiled or grilled poultry, fish, or seafood. Lean meats with fat trimmed. Sauces and gravies on the side

Desserts:

fresh fruit, fat-free or low-fat yogurt or ice cream (if fit into your diet)

From: www.diabeticlifestyle.com

One gene to change sexes

Faulty gene linked to disorders of sexual development

Scientists have discovered that the  alteration of a single gene could cause some male embryos to develop as females.

"These conditions occur when the testis or ovary does not develop properly in the embryo, causing genital abnormalities in one6 in 4500 babies."

 

The breakthrough will improve diagnosis and clinical management of patients with disorders of sex development (DSD). These conditions occur when the testis or ovary does not develop properly in the embryo, causing genital abnormalities in one in 4500 babies.

An international team including University of Melbourne researchers at the Murdoch Childrens Research Institute identified the gene alteration in a group of patients including two families with several affected members.

The alteration occurred in a gene called MAP3K1, which plays a role in switching on genes that direct the gonad to become a testis. Males normally have one X and one Y chromosome and females have two X chromosomes. But researchers found that the alteration of the MAP3K1 gene disrupted the normal process of testis development, resulting in a male XY embryo developing female characteristics including female genitalia and an overall feminine appearance.

Professor Andrew Sinclair, lead researcher from the University of Melbourne and Murdoch Childrens Research Institute said the discovery showed the underlying cause of testis failure in these patients, which would help provide a diagnosis and guide clinical management of cases in the future.

“To date, we know of only a small number of genes that are involved in gonad development, and can only diagnose about 20 per cent of DSD patients,” he said.

“Based on our study, we believe mutation of the MAP3K1 gene could be responsible for a further 20 per cent of XY DSD cases. This is a major breakthrough as the MAP3K1 gene provides new insights into normal testis development and significantly increases the number of DSD cases we can diagnose in the future.”

The study, published in Dec 7 2010 in the American Journal of Human Genetics, was undertaken in collaboration with the Women’s and Children’s Hospital, Adelaide, New York University School of Medicine, MRC Mammalian Genetics Unit, UK, Centre Hospitalier Universitaire de Nantes, France.

How Not to Marry the Wrong Guy

You've met a great man — wahoo! — and it's serious enough to imagine getting hitched. But is it possible to know if it'll last forever and (almost) always make you happy? Experts reveal six key factors you should consider.

Lately, it seems like you can't open your Web browser without seeing some headline about a famous married couple calling it quits. And while it's no surprise when Charlie Sheen's latest union implodes, you'd think that super-together stars like Sandra Bullock and Kate Winslet would be able to pick winners. How is it that a woman can pledge eternal love in front of all her family and friends and then discover that she's mistaken about the man?

In a recent Cosmo survey, nearly two-thirds of you reported being worried about making a bad choice and winding up divorced. But experts say you can protect yourself from that fate if you evaluate your relationship pre-engagement according to a few important elements. "There absolutely are ways to judge if a man is marriage-worthy and reduce the chances you'll pick the wrong partner," says marriage and family therapist Terri Orbuch, PhD, a sociology professor at the University of Michigan. "Considering these points will help you understand whether you and he have similar underlying values and whether you'd be getting married for the right reasons." Here are six things you should do to help determine whether your boyfriend is the love of your life or possibly your future ex-husband.

Don't Just Dismiss His Past
Is there a chapter of your boyfriend's history that bothers you because it so doesn't sound like the guy you know? Then you need to decide if your relationship could survive a repeat, because odds are good that old habits will return.

"The best predictor of his future behavior is his past behavior," says Orbuch. If his relationship history is a sordid tale of flings and bitter exes, it's tempting to think that you're the one woman fabulous enough to reform him.

"But when a man acts poorly in multiple unions, it's usually for deep-seated reasons that are going to persist," says Elizabeth Lombardo, PhD, a psychologist in Wexford, Pennsylvania. "He might be able to treat you well during the 'passionate love' stage, which usually lasts about 18 months, but after that, he'll likely start slipping into his old ways."

The goal is to still look this happy 20 years later.

That said, people can change — many of today's family guys wearing Baby Bjorns at the farmers market were serious players at 22. But here's where it gets tricky: You need to figure out if the sleazeball chapter of his past was specific to that stage of his life or if the traits he exhibited then are hardwired into his personality and just buried for now. "To find out, ask him what behaviors he considers to be a violation of trust, and tell him what your expectations are," says Orbuch.

If he's done things in the past that don't meet your standards for marriage, grab the bull by the horns and bring it up. Ask him to explain why he did what he did. If the reasons he gives are related to specific situations that no longer apply (say, he used to party too much because he lived with a bunch of his frat brothers after college), that's a strong sign that it was just a temporary thing. But if the triggers for his past bad actions could easily be present again once you're married — he used to party too much because he was stressed — it might mean that those habits are part of who he will always be.

Own Up to What You Need
So you love that your guy is a foodie or a stylish dresser. That's all great, as long as you're not so dazzled by those qualities that you overlook the fact that he's lacking more important ones.

"I tell my clients to draw a big circle with a smaller one inside it and then fill the inner circle with four or five qualities they absolutely need a husband to have, like sharing their views of religion, family, or money," says Lombardo. "Then they fill the larger circle with nice-to-haves. You should look for a partner who has all the inner-circle qualities and a few of the outer ones, not the other way around."

As you look over his qualities, consider whether they have downsides and if you can handle them. For instance, you might love that he has a hot career as a consultant, but if his job requires lots of travel, will his success compensate for his absence from your life? If you have a huge group of friends, it might not be an issue, but if you're a homebody who prefers to end each day snuggled on the couch with your honey, you won't be happy with a marriage in which he is always traveling.

Take Off Your Future-Goggles and See Him as Is
Say he's an MBA student with big plans to become a CEO. Will you feel just as lucky to have him if student-loan bills are the only concrete result of that degree? "Remember that you're marrying the guy he is now, not the man he might be one day," says couples therapist Jennifer Gauvain, coauthor of How Not to Marry the Wrong Guy. "It's great to be attracted to his passion, because that will stay consistent, but don't get attached to a certain potential career or financial outcome."

You need to be okay with the possibility that the rest of the world won't be as convinced of his talents as you are. "This is key because frustration with the difference between what you expected and the reality you got is one of the leading sources of marriage unhappiness over time," says Orbuch.

And if money worries are driving your quest for a ring, slam on the breaks. According to Gauvain, the desire for financial security is one of the main reasons women get hitched to the wrong guy. "Many women have told me that they were attracted to marriage because they felt like they were floundering and thought a joint income would help," she says. Adds Lombardo, "But there are plenty of wealthy couples who aren't happy."

Beware His Family Dynamics
Depending on how close he is to his family, it's not just him you're marrying. And while you might be able to ignore them now, his family will play a big role in your life once you're hitched. Remember that these people will be not be just at your wedding but also at roughly half your future holidays, at the hospital when your children are born, and quite possibly on your sofa for extended visits.

"You don't need to love each other's families, but you need to be on the same page about how much you'll include them in your lives," says Gauvain. "Take a hard look at his family traditions and how often he and his family see each other and communicate." If your family gathers for dinner every Sunday night but his has only a spotty record of celebrating Thanksgiving, your very different ideas of what family means will probably cause some problems.

This doesn't mean you have to rule him out, but you do need to talk about it and find a compromise. "Lay out expectations ahead of time so you understand what you're getting into," says Orbuch. If he has his family on a pedestal when the only raised platform they belong on is Dr. Phil's stage, that could be a problem. "It's okay if you don't see eye-to-eye with them all the time, but he can't put his family first or always side with them in disagreements," says Gauvain. "You should put each other first."

If There's No Spark, Forget It
With all this talk of shared values, don't forget this primal truth: There needs to be a sizzle. "In such uncertain economic times, it's easy for women to tell themselves that stability is more important than attraction, but you need chemistry for a relationship to work," says Gauvain.

Of course, if you've been together for years, you're not necessarily pinning each other down the minute you get in the door. But the urge to rip off each other's clothes should still strike on occasion. "Being successfully married means being more than best friends," says Lombardo. "Great sex won't make problems go away, but it can really cushion your relationship during the inevitable tough times."

Tear Up Your Bridal Time Line 

"If you nudge her, a woman will often admit that there's a magic age she thinks she should be married by," says Gauvain. Whether your number is based on beating your biological clock or more random factors, like how old your sister was when she got hitched, it can hold power over you and put you at a high risk of marrying the wrong guy as that birthday draws close.

"When women feel they're falling behind on their bridal time line, they are more likely to settle for Mr. Almost Right," says Gauvain. "They're scared of having wasted precious time, so they stick with guys they normally wouldn't." To make sure that such fears aren't driving your decision, ask yourself if you would still be with him if you were younger. If your answer isn't a strong "Hell, yes!" then recognize your urge to put a ring on it for what it is: fear of falling behind on your time line and being alone.

If a desire to have kids is freaking you out, know that the traditional marriage sequence has gone the way of the VCR. Now, few people bat an eye if you get knocked up by a BF or have a baby solo. "Women should trust that kids will happen for them one way or another, and marrying the wrong guy isn't the best way to get there," says Gauvain.

Are Your "Cold Feet" Normal or Not?
How do you tell if your jitters are just a fleeting thing or your intuition trying to tell you you're making a mistake? Pay attention to when your anxiety strikes — is it during wedding talk or when you're talking about him? "When you're about to be married, talking about your fiancé should fill you with calm and happiness," says Lombardo. "It's natural to be nervous about the wedding but not about the groom."

And another thing: "You should not be asking yourself or your friends 'How do I know if he's The One?' because it's kind of like an orgasm: If you're not sure that you had one, you didn't," she adds. "If after giving it thought you're still not sure your guy is The One, he probably isn't."

A Cool Sign
A recent study found that couples who laugh and smile when they retell how they met are statistically way less likely to end up divorced.

SOURCE: University of Washington Study

How to Start Romance Online

It is the time to connect via internet with the world.More and more people connect online with each other.Their are numerous ways like Social Media,Email,Chatting or SMS to connect online with each others in pursue of romance.There is not any rule and regulations developed for online romance or dating but we have listed some rules or guidelines you must have to follow them before you dive in to “Romance Ocean”.

Select Online Place for Romance

Select your place where you can sit and romance freely without any interruptions.It can be social media site like Facebook,Twitter,Hi5 or any dating site.

Install any Chat program like Google Chat or Yahoo Messenger Etc.

Install any chatting software on your computer where you can chat frequently with each others.If you want to add more value in your romantic session,you can install Google Voice on your computing system.

Setup your Profile

Go on dating site or the online place where you want to start romance with your like minded partner.You can also setup your profile on Facebook,Hi5 or on Twitter.com for instant sharing your thoughts.

Keep Some Privacy

While setup your profile for online romance,don’t disclose your personal details like Credit card,banking details or your contact numbers.Keep all things in your private spot.Avoid to share your personal images (except profile picture) ,family details or any confidential data.

Find the Person You are Looking For..

Find a Romance Partner online.You can find on your online dating or romance place like sites or chat program.Many sites provide the options to find dating partner want according to your taste.

Start Romance Online

After finding the person online,you can take further steps to create his or her interest to make you a partner for romance.Just share your taste,views,your thoughts or jokes.Slowly slowly move ahead and dive into the “Romance Ocean”. 

Be thoughtful of your romantic interest

They may have a bad day, and not feel like talking, or family or personal issues may arise that keeps them from a planned “rendevous”.

Send Occasionally “Gifts the Sign of Love”

Remember some important dates like Birthday or any important dates and send online Gifts and your wishes “the sign of your love”.

Be Honest With Your Online Friend

Stay tuned in your romantic session and be honest with your online friend.Don’t befool or cheat your friend.

Note:

Dive carefully in the “Ocean of Romance”.We are not responsible for any lose or profit you gain in the ocean.

From:

How to Protect My Skin in Winter

Winter months and cold weather can be harsh on your skin. During the winter months, the combination of lower temperatures and reduced humidity extracts moisture from your skin. Your skin needs moisture to stay hydrated and healthy. When moisture evaporates from the top layer of skin, your skin may look drier, redder, flakier and older looking.

All of the sudden it got really cold. It became necessary to make sure I was always carrying a few things: a scarf and everything and anything to keep my skin from succumbing to the horrors of winter.

How to protect your skin in Winter

Winter is not the best time for our skin. This is the time of the year when our skin turns dry and flaky. There are things you can do to prevent the dryness from getting worse. Keeping your skin well hydrated and moisturized is the best way you can do with your skin during this time.

There are several moisturizing products available in the market today. It is very important to find the best products suited for your skin type. Moisturizing soap and lotion are the most basic weapons against skin dryness during winter.

Dove winter care soap and Aveeno moisturizing lotion work best for my skin. They keep my skin well hydrated and dryness has never been a problem for me when the winter comes. They are specifically formulated to keep your skin moisturized all day and night.

More Tips

1. Drink water regularly throughout the day.
2. Give your skin steam treatments and steam baths. After the steam treatment, lock in moisture with a deeply replenishing cream, lotion or gel.
3. Don’t squint in the glare of snow and ice. Wear sunglasses when necessary.
4. Protect skin around eyes with a richer, cell replenishing formula in winter.
5. Protect lips with lip balm or gel.
6. Before winter sports, don’t forget to moisturize the skin on hands, ears, nose, and neck.
7. Protect your skin with gloves, scarves, hats and mufflers when you go outside.
8. Use sunscreen.

From:

Paracetamol risks asthma

Links between early paracetamol use and the development of allergies and asthma in five and six year old children have been confirmed by health researchers at the University of Otago, Wellington.

The report by Professor Julian Crane is based on the New Zealand Asthma and Allergy Cohort Study. It investigated the use of paracetamol by 505 infants in Christchurch, and 914 five and six year olds in Wellington and Christchurch to see if they developed any signs of asthma or allergic sensitivity. The study has recently been published in Clinical and Experimental Allergy.

“The major finding is that children who used paracetamol before the age of 15 months (90 per cent) were more than three times as likely to become sensitized to allergens and twice as likely to develop symptoms of asthma at six years old than children not using paracetamol,” says Professor Crane.

“However at present we don’t know why this might be so. We need clinical trials to see whether these associations are causal or not, and to clarify the use of this common medication.”

The research also found that by six years 95 per cent of the study sample were using paracetamol and there was a significant increased risk for current asthma and wheeze. However the findings depended on how much paracetamol was being used, with the risk greater for those with severe asthma symptoms.

“The results at this stage are supportive of a role for paracetamol in asthma and allergic disease,” says Professor Crane.

However there may be many different mechanisms operating in the links between paracetamol and allergy/asthma researchers say. For instance it has been shown that fever in infancy may reduce allergy in childhood, and that paracetamol may affect antigen processing in the immune system early in life, or may be linked to free radical damage and enhancement of allergic inflammation and bronchospasm.

The University of Otago study concludes that although direct causation between paracetamol and allergy/asthma has not been established, neither has paracetamol been shown to have a beneficial effect on disease outcomes when used against fever, and guidelines for its use are unclear.

From: http://www.sciencealert.com.au/news-nz/20103011-21640.html

10 Creative Ways to Say Thanks

Doesn't it feel good to give thanks? Keep up your attitude of gratitude beyond Thanksgiving day.

Thank You Very Much!

While a thank-you note is always a good idea, sometimes it's fun to include something extra. Try using homemade thank-you cards, sending a photo or video, or giving flowers from the garden to show your gratitude.

By Kristen Stewart

Medically reviewed by Pat F. Bass III, MD, MPH

 

We’ve all heard of the importance of writing a thank-you note to acknowledge receipt of a gift and our appreciation of the time and effort that went into its selection. However, sometimes it’s fun to extend our gratitude a little further with more creative ways to say thanks. This is especially important considering a thank-you is more than simply an act of etiquette — it’s a way to build a relationship.

Send a Picture

A picture can be worth a thousand words when it comes to gratitude. This is certainly true with a thank-you card. “Send a photo of yourself wearing the gift with a big smile on your face,” suggests Mary Mitchell, president of The Mitchell Organization in Seattle and author of The Complete Idiot's Guide to Etiquette (third edition). In the case of children, a photo of them playing with the gift can be a great way to show thanks.

Bake Some Treats

Give your thanks an extra boost by including some homemade cookies, cupcakes, muffins, or bread along with a handwritten note. Acknowledge the effort of that thoughtful friend, neighbor, or family member with something sweet to eat. A decorated muffin tin or basket with a cute napkin makes a perfect container. Including the recipe for your treat, especially if it is unique, can be an extra way of showing gratitude.

Give a Bouquet

Whether it’s a single stem or a lush bouquet, giving flowers can be a thoughtful way to convey thanks for a gift or kind deed. Clip some flowers from your yard, if you have one, instead of a professional arrangement. A few flowers can fit nicely into an old vinegar bottle or other container from around your house. Tie a ribbon around the “vase” or around the stems themselves if making a whole bouquet. Don’t forget a thank-you note to go along with them.

'Steal' From the Newspaper

“Sometimes I find perfect headlines in newspapers mentioning people who have the same name as my friends,” says Mitchell. “I cut them out and save them for the right occasion.” Another way she shows her gratitude is to cut out cartoons she sees that remind her of certain people and include them with a thank-you note when the need arises.

Give a Gift Card

Spending a lot on a gift card is not necessary when saying thanks — a small token amount will be appreciated. A perfect example is giving a gas card to a friend or family member who did the driving to an event. Even if there’s not an exact correlation between the gift card and the deed, it is still a thoughtful way to show your gratitude, especially in challenging economic times. “I loved a thank-you note I received that included a Starbucks gift card and read ‘Thanks a latte!,’” says Jodi R.R. Smith, president and founder of Etiquette Consulting in Boston, and author of From Clueless to Class Act: Manners for the Modern World.

Shoot a Video

This is a great way to show thanks and express gratitude, especially for a gift that was sent by a loved one who couldn’t give it in person at a party or other event. “Friends and family members who live far away love to be a part of the celebration,” says Amy Stevens, owner of Etiquette Southwest Missouri in Joplin. “Create a short video of the party as both a thank-you gift and a keepsake for family.” Your video can be sent through the mail, emailed, or posted online.

Make Your Own Thank-You Note

Who says a thank-you note has to be store-bought and generic? Grown-ups and kids alike can express their creativity — and gratitude — with a homemade thank-you card. Adults can use stamps and scrapbooking supplies while kids can decorate with everything from markers and glitter to stickers and paint. It’s also fun to use kids’ fingerprints and handprints as an added personalized touch.

Create a Photo Album

Making your own photo album is a great way to say thanks. Buy an inexpensive photo book and fill it with pictures the recipient would enjoy. Family members far away might like photos of events they missed, while an outdoor enthusiast might appreciate pictures of nature. Leaving some empty pages at the end is always a good idea so that more photos can be sent at a later date and easily added. Be sure to tuck in a handwritten thank-you note as well.

Give an IOU

Sometimes one good turn deserves another. Next time an expression of gratitude is in order, try providing an IOU ("I owe you") along with that thank-you card. Depending on the recipient, the IOU could be for anything from mowing the lawn or cleaning the house to a night out on the town. Design and print your IOU coupon on the computer or draw it by hand.

Show You're Thinking About Them

Nothing makes a person feel more special than knowing someone is thinking of her. Along with an expression of thanks, send a little something chosen uniquely for him. “Send a book that will help them with an issue they are going through,” suggests Demetria Pappas, co-owner of Mother, May I in Pittsburgh, “or call them about a news [item] that you know will interest them.”

How HIV Becomes AIDS

The rate at which HIV (human immunodeficiency virus) progresses is different for each person and is influenced by many factors — but not everyone living with HIV will develop AIDS.

How HIV Progresses to AIDS

If you're HIV positive, you can live for years without the virus progressing to AIDS — if you follow your HIV treatment plan.

By Elizabeth Connor

Medically reviewed by Lindsey Marcellin, MD, MPH

Once a person has been infected with the human immunodeficiency virus (HIV), the progress of the disease is influenced by factors both within and outside of the patient’s control. An effective form of HIV treatment, called highly active antiretroviral therapy (HAART), was introduced in 1996 and forever changed HIV disease from an almost certainly fatal condition to a difficult but long-term chronic illness.

Within a month or two after a person is exposed to HIV, he or she may come down with an illness that resembles the flu. Common symptoms of this illness include fever, headache, fatigue, and swelling of the lymph nodes in the neck and groin. Although the flu-like symptoms go away, a person in the early stages of HIV is still very infectious.

After the initial illness, a person may not experience any HIV symptoms for a long time, perhaps 8 to 10 years. However, 5 to 15 percent of people with HIV get sick more quickly than this, and a similar percentage remain symptom-free for longer than 10 years.

Staging HIV
The outward symptoms of HIV disease can look very different from one person to the next, so doctors use precise clinical tests to categorize HIV in one of three stages. The final stage of infection is acquired immune deficiency syndrome, or AIDS.

• Stage 1: In stage 1, a person does not have any of the diseases associated with severe HIV infection (called an AIDS-defining disease) and a relatively high level of the immune cells that fight infection (called CD4+ T-cells, or simply CD4 cells).
• Stage 2: In stage 2, there is still no AIDS-defining disease, but the level of CD4 cells has fallen dramatically.
• Stage 3: In the final stage, AIDS, a person has at least one of the AIDS-defining diseases and a very low level of CD4 cells.

Signature HIV Symptoms
As HIV disease progresses and the CD4 count drops, but before the definition of AIDS is met, many people with HIV infection experience the following symptoms:

• Sweats
• Fevers
• Swollen lymph nodes

When the CD4 count gets very low, the immune system can no longer protect the body against common infectious agents in the environment that would not normally cause illness. Certain cancers may also appear in HIV patients because of the body’s dramatically lowered immunity. When one of these conditions is diagnosed in someone with a CD4 count less than 200, it is said to be an AIDS-defining disease — therefore, the person now meets the U.S. Centers for Disease Control and Prevention’s (CDC’s) definition of having AIDS. The most common aids-defining diseases include:

• Severe herpes simplex virus infections
• Pneumocystis carinii pneumonia
• Cytomegalovirus infection of the eye
• Active tuberculosis
• Yeast infection of the esophagus
• Severe shingles outbreaks
• Encephalopathy (brain inflammation)
• Wasting syndrome
• Cancer of the lymph glands
• Kaposi’s sarcoma

A person with AIDS has a very weak immune system and frequently will come down with more than one serious, debilitating illness at a time.

Personal Characteristics Can Increase HIV Risk
The rate at which HIV progresses is different for each person, and can be influenced by many factors. Here are some facts:

• Older people infected with HIV are likely to become sick more quickly than those who are younger.
• How a person becomes infected with HIV can influence how quickly their HIV progresses. In one study, HIV progressed to AIDS most quickly among men who have sex with men. These men had a high rate of Kaposi’s sarcoma, a type of cancer that is rare among people without HIV. Injection drug users also often progress to AIDS faster than those who do not inject drugs.
• Both men and women with multiple sex partners progress faster from HIV to AIDS.
• A person’s immune system and genetics can affect whether they become infected with HIV after exposure and also how fast the HIV progresses.

Not everyone infected with HIV will necessarily progress to AIDS. In a study of the deaths of almost 500 HIV-positive people, only about 10 percent died from a disease strongly linked to AIDS. Frequently, the cause of death was a debilitating disease with a weaker association with HIV or a factor not related to HIV at all.

Between 1995 and 1996, the estimated remaining lifetime for a 25-year-old person with HIV was eight years. For the same person diagnosed between 2000 and 2005, the expected remaining time of life was about four times that, approximately 33 years. Many factors play a part in these dramatic gains in life span, particularly improved therapies and long-term behavior changes among people living with HIV.

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Protect Yourself From Medical Errors

Mistakes happen — especially when health care providers don't have a complete picture of your medical history.

Prevent Medical Errors With Health Records 

Looking to reduce the risk of medical errors? Communicating with your family doctor is key — and so is keeping accurate health records.

By Marie Suszynski

Medically reviewed by Lindsey Marcellin, MD, MPH

You can lower the risk of medical errors for yourself and your children by communicating more efficiently with your family doctor and by keeping up-to-date health records.

Preventing Medical Errors: Get Involved

The doctor's office is no place to be shy. Instead, speak up about your or your child’s symptoms, ask plenty of questions, and be part of the decision-making process regarding your family’s health.

The more information your family doctor has about your health, the better he can treat you and prevent medical errors. Start by giving your family doctor an accurate health history.

Preventing Medical Errors: Keep a Health Journal

It’s not easy to remember if your tetanus shot was 7 or 10 years ago or whether Aunt Sally had osteoporosis or osteoarthritis. That’s why it’s a good idea to keep health records in a health journal.

The more accurate information doctors have on their patients, the better the chance that an error, such as prescribing a drug that can cause an allergic reaction, won’t happen, says Thomas J. Vento, MD, a family doctor in private practice in Reisterstown, M.D. 

It’s a great idea to give your family doctor a copy to keep in his file, but it’s also very important to have your own copy of the health journal in case of a medical emergency, Dr. Vento says. Here’s what to include: 

• The exact names and dosages of medications, supplements, and vitamins each family member takes
• A list of drugs each family member is allergic to
• Dates of immunizations
• Medical tests and dates, such as a mammogram or colonoscopy
• Details about any hospitalizations
• Any family history of major health conditions, such as cancer, heart disease, stroke, diabetes, and arthritis

Keep all your doctors informed. Share your health journal with your family doctor or pediatrician, but don’t stop there. Be sure to give a copy to any of the specialists you see.

Preventing Medical Errors: Ask Questions About Treatments

Another part of preventing medical errors is making an effort to understand any treatment your family doctor prescribes. Bring a pen and paper with you to office visits and take notes — it’s easy to forget directions when you are trying to absorb a lot of information. “Make sure you know what the doctor’s doing before you leave the office,” Vento says. If not, you may find yourself walking out and not knowing what’s happening. 

If your doctor prescribes a medication, be sure to ask what the medication is for, how you should take it — such as with meals, if you should expect side effects, and if you need to avoid drinking alcohol, driving a car, or altering your schedule in any way while taking the drug. Find out if it is safe to take with other prescription and over-the-counter medications you’re already taking.

Look at the prescription. Can you read the handwriting? If you can’t, the pharmacist might not be able to either. Make sure it’s your name on the prescription and that it’s for the right medication. And once you get that script filled, verify the information on the bottle or package. 

Preventing Medical Errors: Other Tips

Just as you take the time to thoroughly understand any medication you are being prescribed, take the same steps when your doctor recommends any course of treatment, whether it’s surgery or a medical test. Be sure you understand why you need it and the pros and cons of having it.

Today doctors and pharmacists use electronic medical records that can catch mistakes before they happen, so medical errors occur less and less, Vento says. But being an active voice in health care is an integral part of getting the best care you can for yourself and your children.

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Want Younger-Looking Skin?

Stop smoking! Not only is it bad for your health, but smoking prematurely ages the skin, causing wrinkles.

5 Ways to Quit Smoking for Good 

You've made the decision to quit smoking — now you need a plan, resolve, and support. Here are five tips that will help you quit smoking for life.

By Dennis Thompson Jr.

Medically reviewed by Lindsey Marcellin, MD, MPH

Quitting smoking is no small feat. To do it successfully, it helps to know what worked for others. These tips will help you see it through, from beginning to end.

1. Start With a Stop-Smoking Plan
   • Pick a day to quit smoking. Having a specific day in mind will help you stick to your goal. One day next month would be best — that will give you enough time to plan for it, but not enough time to talk yourself out of it. Don't quit smoking during holiday periods or at a time when you can expect a lot of additional stress. Post the date on your calendar, and let family and close co-workers and friends know.
   • Visit your doctor. Discuss your decision to quit smoking, and ask if nicotine replacement therapy or other medications might help you quit.
   • Cut back now. In the days leading up to your quit-smoking day, begin cutting back on the number of cigarettes you smoke each day. Try to smoke just half a cigarette when you do light up.
   • Get smart. Read about what you'll be going through, especially nicotine withdrawal and the stresses of quitting. Start paying attention to triggers that make you want to smoke. You'll need to avoid or deal with these triggers once you've quit smoking.
   • Plan substitutes. Stock up on cigarette substitutes like carrot sticks, hard candy, straws, toothpicks, and sugarless gum.
2. Seek Help and Support to Stop Smoking
   • Tell family and friends about your quit-smoking day, and ask for their support. Just having someone to talk with can help you during low moments.
   • Ask those who still smoke not to smoke around you while you're trying to quit smoking.
   • Find a support group or a smoking cessation program in your area. Many groups like the American Lung Association and the American Cancer Society offer programs through which smokers can receive help and advice while they're trying to quit smoking.
3. Make Your Quit-Smoking Day Special
   • Don't smoke at all. Not one puff. This is it!
   • Get rid of all of your smoking paraphernalia. Toss out your cigarettes, matches, lighters, and ashtrays.
   • Plan to stay busy all day. Go for a walk or exercise. Go someplace where smoking isn't allowed, like the library or the movies. Eat foods you don't normally eat, and take routes you don't normally take. The idea is to avoid any association with your usual patterns of behavior.
   • Begin using a nicotine replacement, if you've decided that will help you.
   • Drink lots of water and juice. This will give you something to do and help flush the nicotine out of your body.
4. Be Prepared to Deal With Smoking Withdrawal Symptoms As time passes, you’ll need to confront rationalizations. You will come up with reasons to smoke that wouldn't normally make any sense to you except at this point, when you're in the middle of a powerful craving. Thoughts like, "Just one to get me through this rough patch" and "I can't deal with this today, I'll quit tomorrow" will go through your mind. See these thoughts for what they are, and ignore them. Here’s how:
   
   • Avoid situations that trigger the desire to smoke.
   • Find ways to deal with cravings. Take slow, deep breaths until the craving passes. Drink some water slowly and hold it in your mouth. Munch on carrot sticks or suck some hard candy. Focus on a crossword puzzle. Play with a rubber band.
   • If nothing else works, just tell yourself to hold off smoking for 10 minutes; often, that will get you past the craving.
5. Maintain Your Resolve, But Be Ready for a Slip Whenever you feel your resolve weakening, remind yourself of all the benefits of not smoking:
   
   • Count the money you're saving on cigarettes, consider how much better everything tastes and smells, and think about how your secondhand smoke is no longer affecting your family and friends.
   • Avoid alcohol. Drinking makes it more likely you'll slide back into smoking.
   • Eat right and exercise. A healthy diet and an exercise regimen can keep your mind off cravings and draw attention to how much better you feel now that you've quit smoking.
   • Reward yourself. Buy something special with the money you've saved on cigarettes.
   • Quickly regain control if you slip. Slipping is not the same as relapse — it's just a one-time mistake. You're still a non-smoker. Rededicate yourself, and use the slip as a learning opportunity by asking yourself what triggered your desire to smoke and what you can do to avoid it in the future.

Quitting smoking is difficult but not impossible. Many have done it before you and had to try a number of times before they were successful. Don’t give up!

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