Sunday, 9 February 2020

Reasons To Be Cheerful:- Why Don’t You Get Back Into Bed!

Dave R February 9th 2020

I decided yet again, it was about time I ‘looked at life from both sides now’ and stopped moaning and bitching about my lost youth. That feeling lasted for the two hours between waking up with the nerve pain, to taking the tablets to dampen it down. In between, I had to take my HIV pills, eat something to cushion the chemical blow and take my daily vitamins. I rattle like a tin of dried peas before lunchtime but it’s preferable to staggering everything over the whole day when I have to set the alarm to remember when I need to take what. Besides, I have to repeat the HIV meds and the pain killers in the evening anyway. How my kidneys have survived all these years...

Anyway, I digress...I get these rushes of optimism and yearnings to look for the bright side of life every now and then. It’s nagging guilt at wallowing in self-pity that causes it but generally those moments of gung ho, up ‘n at ‘em enthusiasm don’t last long and the daily grind kicks in again. However yesterday, I got as far as jotting down things that make life not so bad after all and today when I looked at the list again, I thought there might just be an article in there. Apart from that, I often find that the therapeutic elements of writing mean that you start off with a dilemma to muse over and at the end you convince yourself; so, working on the premise that I could maybe convince myself to see life in a brighter light, I started typing. I’m sure some people will be saying that that’s pure self-indulgence and no reason to impose my scribblings on others but I know I’m not the only one living my life and there’ll be others who will know exactly what I mean (I’m ducking here!)

I just felt that getting older and well-worn must have some benefits or Mother Nature would have built in legalised euthanasia from the beginning. Isn’t it funny, when you’re 7, you long to be 12; when you’re 12, you long to be 22 but then it goes into reverse and when you’re 62, you’re trying to drop decades! So kids, don’t rush to grow up too soon; the benefits I’m about to describe are only crumbs from the cookie really but hey, they’re better than nothing.

So, let’s see. I’m going to shrink the demographic even further here and just talk about those who’ve worked all their lives and are retired; or those who have been forced into early retirement due to poor health. If you’re still working: a) kudos to have physically survived so long in the workplace and b) try to cherish it; it’s social contact, it’s keeping your brain and body going, it’s bringing in much needed cash and it’s a thousand times more rewarding than sitting at home. Convinced? Probably not. But if you are sitting at home, whether voluntarily or not, there are plusses!

For instance, you wake up and you can do what the hell you want: within reason of course and depending on financial and health restrictions but you’ve finally got out of the clutches of the Man and his roller-coaster, work-till-you-drop ride and your life’s your own.

You can get up when you want: though it takes years to get rid of the guilt that you’re lying in bed much longer than the working world!

You can decide whether to shave or not that day (ladies too!) or grow a ‘tache, or beard, or goatee. Nobody’s going to see the scraggy first two weeks, so go for your inner woodsman but take it easy on the hair dye! There’s a lot to be said for the rugged Grizzly Adams look.

You can sit on the toilet for as long as you want; though you may be back more frequently than you might wish later in the day and probably at night too. You can even fart yourself a symphony if you’re so inclined (though any live-in partners may have something to say on the matter).

Your home can become your own little Neanderthal, man-cave and the socially required suits, ties, combed hair, male grooming and gleaming teeth, can be binned until you need to make an impression again. That said, the first time your conscience and the mirror ask you where your self-esteem has gone, may prick your conscience. After all, didn’t your mum teach you that cleanliness was next to godliness? It’s fun to be a hobo for a few days but hey, we’re gay, we’ve can’t let the image go completely! To the grave in Armani...I wish!

When you do finally stagger out of the house; the world need not be such a bad place after all because there are certain perks to be found, you just have to acknowledge them. You don’t have to rush anywhere for instance, or do something at any given time. If you do happen to mosey into the supermarket, a certain visible decrepitude will cause most (not all alas) staff members to address you politely and offer you senior discounts (“How very dare you! Do I look that old!”) You’ll grab any offers out of their hands of course. Cashiers will be more patient as you grub around for your reading specs and the necessary correct change and even force a smile when you thank them and a glare over your specs at the ‘tutters’ further back in the queue should teach them to mind their manners. If the shelf-fillers, or produce packers don’t give you the respect you deserve, then never forget the: - “I remember when I was your age...” or the, “things were so much better when I was young...” bombs in your armoury. Smart asses hate those!

Failing that, throw a good old tantrum. Everybody wants to steer clear of senior citizen, shopping aisle rage. It feels so good to play the age card and let rip every now and then...blows the cobwebs away! You don’t need to buy as much ‘stuff’ while you’re there either. A few rolls of toilet paper are probably enough and single food portions and airport security sized deodorants are the new marketing rage; win, win for us.

Having survived the shopping trip and reached the safety of the cave again; you can take a well-deserved nap in the afternoon, or if you’ve got the energy, go to an afternoon showing at the cinema in the safe knowledge that it will be less busy and not full of screaming kids. If you turn on the box; who’s going to care if you doze off in the middle of a show; or if your book falls off your lap; you know the endings anyway! That’s perhaps the greatest benefit of having lived a bit; there aren’t many story lines you haven’t already seen or read and you can revel in your own smirking cynicism when you predict what’s going to happen!

Having been thrifty at the shops, you can even turn your attention to changing from being a candidate for ‘Super Insane Hoarders’ on Bravo, to getting rid of three quarters of your shit at home. Seriously, I never realised how many things I hadn’t looked at for at least five years; how many clothes were last worn when watching Wham videos and how many boxes of trivia were cluttering up my spare room! It hurts like hell but once you’re over the, ‘that brings back such memories’ sentimentality, getting rid of your life’s worth of clutter is detox for the soul! You can do it slowly (you need the time to sort through mountains of junk) so the extra time you have can be well-spent.

Then there’s the internet; which on a serious note, since its invention, must have saved thousands of older souls from dying of sheer boredom. What did people do before the Net for God’s sake? I can’t remember; did we take long walks! Now in our dotage, we can blog or social network to our hearts content.

Senior blogs and social websites for senior entertainment are the fastest growing segment in cyberspace at the moment and I don’t just mean DaddyDater, or Granddads R US. Seriously there are more cool free games on the oldie sites than anywhere else!

That said, an HIV positive, mature person, with other neuropathic issues is not the most desirable catch in the Koi Carp dating pond but the internet does give us the chance to window shop and sample from the comfort of our own rockers in a way that we never could 30 years ago. If you do happen to get lucky and score a physical contact in the real world, look what those clever science boffins with their little blue pills, have done to prolong our sex lives – now that’s Nobel Prize-worthy!

Family and friends, while absolutely essential for many things, can also be a tad intrusive on your new-found personal freedom at times can’t they? Strategies need to be fine-tuned. Even though your faculties are as sharp as they were when you were 21 (possibly sharper depending on your history of youthful drug abuse), they don’t need to know that!

“I forgot,” or “You didn’t remind me,” or, “I didn’t hear you properly,” or “Oh was that today?” or, “I could have sworn that you said...” and “I was just thinking of doing that when you rang,” and the ever-useful, “I didn’t hear the phone,” or “I haven’t checked my mail today” are all ploys to confirm their worst fears of oncoming Alzheimer Light but keep you in control of what you want to do and what not. The day that all of the above happen to be true however...might be the time to have a chat with the doc.

Kids can be both a delight and a pain; in very small doses. Remember, they’re a constant reminder of your mortality when they visit. Their boundless energy is enough to have you reaching for the valium before they start and their constant wondering that you’re so old and yet have survived a childhood with so little, just hammers home the message. It’s a sort of compliment that you’re assumed to be wise and experienced on the level of Gandalf the Grey, just because you’re old but their disappointment is palpable when you betray your lack of technical texting skills. I’m not begrudging kids their youth and no I wouldn’t invent a machine to suck it out of them but I’m so glad I’m not that age any more but that of course, is knowing what I know now!

Finally, in the day’s quiet moments, when your eyes are hurting from the computer screen, or TV glare and you’re beginning to suspect rampant tinnitus because your ears have been bombarded for hours by TV audiences who insist on screaming hysterically for no apparent reason; certain other, more abstract benefits of your situation become apparent.

Why should we worry ourselves stupid about the same little things we worried about years ago? We ain’t got that long to go...let it go already! Forget about all the bad relationships and the traumatic mistakes; what’s the point of going over those again and again? You fucked up now and then, get over it! Concentrate on the good bits and the successes and the happy moments. You’re outliving your enemies and frenemies by now good is that! You also begin to realise that all those so-called experts in psychotherapy and social science, don’t know as much as they think they know, or that you thought they knew and that can be an epiphany! It’s wonderful when you realise that the emperors have no clothes. Okay, walking around constantly with a smile on your face may make people suspect that you’re forgetting your medication but fuck ‘em if they can’t take the jokes you’re laughing at in your head.

I’m not saying that the bowl of life-experience cherries hasn’t got quite a few sour ones mixed in and sometimes life really is a bitch and does your head in big time. Good grief, if old age was so much fun, cryogenics would be the world’s top industry. You sometimes just have to accept that you’re more often tired than you want to be and some days are just downright miserable when you’re feet and legs are hurting but realising that there are also still funny moments and moments when you can still pull a fast one over society, can raise the quality threshold and that’s surely what it’s all about. If you can’t raise a smile at Monty Python’s ‘Always look on the bright side of life’ and stick a finger up to the dominance of youth culture, I give up; I think you passed away a while ago!

The title of this article is a gentle reference to the late, great Ian Dury and the Blockheads and their hit, ‘Reasons to be Cheerful, Part 3’

Friday, 7 February 2020

Do Vitamin Supplements Give Ad Men Orgasms?

 Dave R February 2020

To all my little Hulkamaniacs, say your prayers, take your vitamins and you will never go wrong.”  Hulk Hogan

As a confirmed supplement taker, it struck me some time ago that I should really make more effort to understand what  I'm taking and why and whether I'm doing it in such a way that my body gains maximum benefit. I always suspected that swallowing a handful of vitamins and minerals with the orange juice every morning was possibly swallowing a whole lot of advertising propaganda at the same time. Yet still I did it (and forgot the orange juice too) because as someone with both HIV and neuropathy, I felt that my immune system was continually under attack and therefore needed boosting with supplements to enable it to fight off the unknown and unexpected.

However, I wonder if most people supplement their vitamins because they feel they should and not because of specific medical advice. Furthermore, when you read an article about the latest supplement claiming to help your particular problem, you're tempted to add it to your existing list. 

It was almost a cliché in the early eighties that desperate people trying to survive with HIV were taking twenty to thirty supplements a day and that seemed shocking then. However, that feeling that you're somehow letting your system down unless you use supplements, hasn't gone away and is actively fed by the supplement industry, the media and by the internet. Perhaps more worryingly, it is stronger than the underlying and unsettling feeling that you may actually be overdoing it! Hmm! Hints of addictive behaviour maybe! In my case I've just always felt that I needed someone to tell me how to supplement sensibly instead of leaving me to my own devices. Am I the only one? I somehow don't think so.

The problem is, despite that nagging feeling that I should really be more responsible both with my wallet and with what I throw down my throat, I still do it every day! I have a few medical problems for which there are no cures and I suspect it's a slightly panicked response to that. Eventually, my conscience pricked me enough to do some research to try to find out what really is necessary and what the best means of taking vitamins actually is. What I discovered was a maze of differing opinions concerning which vitamins are useful for what; when they should be taken and most importantly, what dosage strengths are recommended. The industry behind supplements has mushroomed and that has led to conflicting opinions as to what is truth and what is plainly lies, ad-speak and hot air.

What follows is a summary of what most experts have found (you will always discover doctors and nutritionists who disagree with various points). However, the only way an ordinary person, without a nutritional science degree but with significant health problems, can plot his or her way through the vitamin obstacle course, is to take the consensus opinion and trust that it's not going to do you any harm. Before you take any action however, you do need to talk to as many medical experts as possible and do your own research. Your home doctor and/or specialist should probably be the primary advice giver -- you don't want to be taking anything that will compromise your current medication (we all know about St. John's Wort and grapefruit for instance!)

The Harvard nutritionist Victor Herbert's famous Time magazine quote in 1992, that vitamins just give you "expensive urine", has stuck in many people's minds. However, sales figures since then would beg to differ, as would the American Food and Drug Administration, which to cite just one example, began requiring Folic acid (a form of vitamin B) to be added to grain products only four years later. That single smart move quickly prevented a worrying rise in cases of spina bifida in babies, caused by mothers not receiving enough folate in their diet and undoubtedly saved lives. Cases like this convinced more and more people that boosting their vitamin levels was a good idea.

According to the American Journal of Preventative Medicine, more than half of all Americans use vitamins or supplements and according to the Hartman Group, (a natural products marketing firm) they spend more than five billion dollars each year in the process! Whilst these astounding statistics are probably reasonably accurate for most developed countries, the rest of the world may regard the idea with some cynicism -- the cost and availability alone will make it prohibitive for many populations. I wonder if the statistics are even higher for people living with conditions such as HIV or cancer for instance; though again, it may depend on their demographic. Whether it's somewhat of a western luxury or not, the fact is that vitamin supplementation is here to stay and shows no sign of slowing down. So what's the truth behind the hype?

Why Do People Living With Immune Diseases Need Vitamin Supplements?

One of today's buzz words is 'micronutrients'. These are basically vitamins, minerals and anti-oxidants and although we don't require large amounts, they are essential for good health. As the body goes through its normal daily functions, the necessary chemical reactions in cells are 'fed' by micronutrients. However, many people living with immune problems need more, or supplemented, micronutrients to support cells damaged by their condition and to bolster the immune system.

Another problem for people with cancer, neuropathy, HIV and others, is getting the correct amount of nutrients via their diet. Viruses for instance and certainly the medications used to combat them, can affect your metabolism which in turn, prevents proper absorption of micronutrients. Apart from this; lack of appetite, diarrhoea and sickness, plus possible liver, kidney and intestinal problems can block essential intake of vitamins, anti-oxidants and minerals. It's not surprising then that the immune system is even further compromised.

The most common deficiencies include vitamins A, E, and B-complex (B1, B2, riboflavin, niacin, B3, B6, B12, B9 and folic acid), leading to various immune system related conditions and of course for readers of this blog, neuropathy. Some studies have concluded that micronutrient deficiencies can even worsen certain conditions but this is not universally accepted.

So What Are Vitamins and What Do They Do?

There are basically two sorts of vitamins and they are categorised according to how they're transported through the body. The body cannot manufacture vitamins itself (with the exceptions of vitamin D, which is manufactured by the body on exposure to sunlight; and vitamin K, which is created by bacteria in the intestine) and cannot survive without them.

Water-soluble vitamins are carried around your system by water. They need to be replenished daily because you lose them through fluids like sweat and urine.

They're mainly the B-vitamins: folic acid, biotin, pantothenic acid, thiamine (B1), niacin (B3), pyridoxine (B6) and cyanocobalamin (B12) and vitamin C.
Fat-soluble vitamins are carried by fats found in the blood stream. Since fat stores vitamins better than water, it's not so important if the daily dose is interrupted. These vitamins include, A (retinol), D (calciferol), E and K. However, overdosing with these vitamins can lead to a build-up of toxic levels. They're much harder for the body to dispose of through urination and that's why many doctors and nutritionists give out warnings.

Water-soluble vitamins (B, C, folic acid), are found in meat, fish, fruit, vegetables and whole grains and you should eat foods containing these every day. Over-cooking also destroys them, so it's always better to grill or steam rather than boiling. As I've already mentioned, many people with HIV have trouble eating normally and that's where supplementation comes in.

Fat-soluble vitamins (A, D, E, and K), are generally found in meat and meat products, animal fat and vegetable oils, dairy products and fish.

n.b.: This article is not going into the subject of minerals but it is important to remember that vitamins and minerals are two completely different things. In general, minerals help vitamins to work properly. Just for reference, the most important minerals are: calcium, iron, magnesium, iodine, copper, phosphorus, manganese, chromium, selenium and zinc. The last two are frequently recommended for people with autoimmune problems but they are not vitamins.

But What Do Vitamins Actually Do?

Vitamins are essential for good health and people whose immune systems are compromised do need to maintain a normal level of vitamins daily in their system. 

Vitamin A is the body tissue vitamin; helping to maintain and develop skin and bone. It also helps with vision, the functioning of the nervous system, reproduction and growth.

The B vitamins increase fat production along with proteins and carbohydrates and assist with metabolism, building red blood cells and maintaining the protective sheathes of the nerves (especially relevant for neuropathy patients).

Vitamin C is definitely an aid for immune system performance, helping to heal wounds as well as forming tissues, cells, bones and teeth.

Vitamin E protects the membranes on the outside of cells and therefore assists the immune system in fighting off illness.

Vitamin K is necessary for blood clotting at wound sites.

The following two sections, are probably the ones of most interest to most people and for that I apologise for the amount of information you had to wade through to get to this point. Although we want to know when to take these supplements and which daily dose is the right one; I always want to know what it is I take and what it's supposed to do. This is not so easy when researching neuropathic medications but is much easier with vitamins.

When Should We Take Them for the Best Effect?

For many people living with HIV specifically, their daily routine revolves around the time of day they take their HIV medications. It may be necessary to adjust your supplement intake accordingly but never the other way round -- your ARV intake is of prime importance.

Instructions on vitamin bottles can sometimes be so small; you need a magnifying glass to be able to read them. This is generally because of the amount of legally required information but that doesn't make it any easier for the user. Many people look at the recommended daily dose and take everything at the same time and when it's most convenient. However, this can lead to mal-absorption and thus a waste of your money.

Studies seem to show that concentrated man-made vitamins (the most commonly found on the supermarket shelves) need to actually bond with real food vitamins in order to be properly absorbed by the body. Just drinking water and popping vitamins may be a diet option but won't be maintaining your health the way you hope it will.

Another problem is the sheer variety of opinions amongst the medical and nutritional professions. I've tried to bring together the most often recommended times for taking vitamins but you will always find contradictions. The human body metabolizes food at different rates and times for different people. Some people metabolize slowly in the mornings and faster at the end of the day and for others it's the opposite. Hard and fast rules are difficult to prove then.

Most people start with a multi-vitamin. The general opinion is that the best time to take it is in the morning, within a half hour of a healthy, protein and fruit breakfast, (eggs, milk and an apple for instance). Busy people will see this as an unrealistic scenario, as they buy their sandwich and coffee to go in the bus or car to work but we have to try don't we! If you forget in the morning, it's best to wait until lunch, or the first substantial food intake, so that the multi-vitamin is properly digested and breaks down with your food.

Single vitamin supplements have their own "best times" and again, opinions differ according to what you read.

Most nutritionists state that vitamin Bs, vitamin B-complexes, vitamin C and vitamin E should be taken in the morning, with some food, so that you can best benefit from their energy giving properties.

If you then take your vitamin D (and necessary calcium) with the next meal, you won't have problems with the absorption of the calcium. Most multivitamins contain iron and iron can clash with the calcium, leading to poor absorption of both. Minerals such as calcium and magnesium (plus vitamin D) are natural muscle relaxants and can also be taken before going to bed.

Vitamins A, D, E and K should preferably be taken with foods containing fat or oil, so that they can form "micelles" to allow absorption (a handful of nuts is one option).

Although rare, some doctors advise taking vitamin supplements on an empty stomach because they feel the body will absorb the nutrients better. Vitamin C is not one of them because it is so quickly flushed out of the body. Vitamin C actually only lasts a few hours in the bloodstream, so should really be repeated two or three times a day but it's not a good idea to take it last thing in the evening because of its stimulant properties.

 Taking vitamins on an empty stomach can also cause heartburn and indigestion problems. If that's the case, it may be better to open up the capsules or grind the tablets and blend them into a smoothy.

Some nutritionists also advise taking vitamins on an empty stomach but with specific instructions that they should be chewed. Some think that a chewed tablet is far better than one swallowed whole. Again, the grinding into a drink option may be more appealing.

In general, most sources advise taking vitamins with, or just after food and the science seems to bear that out but as already mentioned, other experts think differently. Some people may be finding eating solid food difficult enough but still need the vitamin intake. It's best to take advice and then see what works for you.

What Is the Recommended Daily Dosage?

Another controversial topic is how much of each vitamin you need to supplement. Many people take their multi-vitamin and then take other vitamins at recommended daily dosages separately, forgetting that they've already ingested a substantial amount of their daily intake in the multi-vitamin. This can lead to health problems as well as being a waste of money.

Recommended daily intakes (RDI) are not an exact science. Your particular health problem may require larger doses of particular vitamins to help with your deficiency and you will possibly see different RDIs on every different brand. Multi-vitamins can be bewildering when you try to work out exactly how much they contain. It's a bit of a minefield and isn't helped by the various acronyms which almost nobody understands. Here's a short list of some of the nutritional values to help you make your decisions.

RDI: recommended daily intake (it is illegal in Canada for instance to print RDIs on a vitamin bottle, maybe for a good reason.)
RDA: Recommended Dietary Allowances
DV: daily value
RE: retinol equivalents
G: Gram
Mg: milligram (nutrients are expressed in a variety of units)
Ug (or mcg): microgram (for instance 0.5 mg is the same as 500 ug)
IU: international units

Unfortunately there's not enough room here to explain how you convert milligrams to IU, or what the other equivalents may be and some state that it's just not possible because they represent different values. Searching the internet may not make it any clearer; it's very complicated. What we can do is compare the same label descriptions between different makes but even that is risky because what some companies claim is both not accurate and in no way
comparable with others, or an international standard. Besides that, the difference between synthetic and "natural" vitamins is very significant. If any industry required urgent regulation, it's this one!

However, as vitamin users we have to make a judgement somewhere, or just not use them at all. After searching through many nutritional websites, the following recommendations from the European Union are at the bottom end of the scale in comparison with most others but again, every individual is different and your health status and age may require different daily intakes.

 The link that follows refers to the United States FDA and Canadian recommendations, which are slightly different in some cases. It is also not my job to recommend any sort of vitamin dosage to other people; that would be irresponsible. Apart from this, these are recommended daily intakes for normal, healthy people and we are not. It's very difficult knowing what's best but your doctor should be able to advise you.

Vitamin A: 800 mcg
Vitamin B1: 1.4 mg
Vitamin B2: 1.6 mg
Vitamin B12: 2 mcg
Vitamin C: 60 mg
Vitamin D: 5 mcg
Vitamin E: 10 mg
Folic Acid: 200 mcg


What follows are a few general tips that most reputable sites offer regarding vitamins and although they may go without saying, they're worth bearing in mind.

Cost is always an issue and generally, synthetic supplements are cheaper than organic and subject to aggressive marketing because they have a substantial market share to fight over. However, as mentioned earlier, you need to be more careful with how you take them in order to get optimum benefit.

Try to buy the best quality for the price you can afford.

Check expiry dates on boxes or bottles and store your vitamins in a cool place.

Buy cold-pressed capsules rather than tablets as they tend to be more easily absorbed than pills or tablets.

Vitamin supplements are rarely strictly regulated and it can be difficult to tell whether you're getting what the label claims, so it may be wise to confine your purchases to reputable brands.

Never buy vitamins online unless you can clearly verify their street address, phone number, e-mail address and refund policy.

Be wary of "extras" like gingko, ginseng or green tea in multi-vitamins. There is little evidence that the amounts provided have any meaningful effect.

Watch out of claims like, "high potency, super, complete or all natural" which may just be advertising jargon with no intrinsic meaning. Studies have shown that there is little difference between basic brands and those with extravagant claims. "Let the buyer beware" very much applies to this branch of the health industry.

We are a vulnerable group of people. We have health problems which can't be cured and sometimes the side effects of the illness, or the medication used to treat it can leave us looking for any relief, anywhere. It's human nature but we have to use our common sense and try to make decisions supported by expert advice and careful research. An unregulated industry can persuade you to swallow anything but people living with HIV and other diseases like neuropathy have learned to be sceptical of exaggerated promises and claims. It's only logical that we should be cautious with what we put into our bodies.