Showing posts with label exercise. Show all posts
Showing posts with label exercise. Show all posts

Wednesday, 24 May 2017

Quit It - Part Three



Part Three of dispatches from the front line after ONE YEAR without smoking


Have I smoked in the last year? No. Not one. Do I still want to? Yes. Will I give in? The hell I will.

The addict part of my brain will always be there but it’s become a puny, mewling thing.

One of the strongest triggers now is leaving a cinema; my first thought is still to light up. Last week I dreamed I was smoking and really enjoying it; for the next couple of days I really wanted one. An ex-smoker I know said this still happens to her occasionally, even after years.

People keep saying that I must feel so much better. In theory, my immune system should now have recalibrated, the cilia and cells in my airways regrown. My risk of coronary heart disease, heart attack and stroke has dropped to less than half that of a smoker. But it’s only in the last couple of weeks that I’ve actually started feeling well after being almost constantly ill for more than eight months - not just with post-smoking coughs and colds but with non-respiratory viruses.  The GP tells me this is normal. Bloody marvellous.

I’ve just got back to my pre-quitting weight. Maintaining it is hard and means not even looking at lovely, lovely sugar more than once a week. I’m eating less overall than I was too, which is a real challenge.

My knees have adjusted to the extra cardio and my bum muscles are a bit firmer than they were.

I’ve saved myself a couple of thousand pounds (my brand, Silk Cut Silver, now sells for £10.45 in my local supermarket, of which £5.19 is tax). Am I saving the NHS money? I may not need it for smoking-related diseases but if I live longer, I will need it for other things.

Since I quit, standardized cigarette packaging has been introduced and the ten pack is no longer available. The idea is that the drab boxes with big ugly health warnings will make more people quit and put children off starting. The evidence for quitting is very slim but there is some evidence that the boxes are less attractive to teenagers. 

Most of the legislation, constant price increases and public health strategies are aimed at preventing young people from starting. They won’t put off the addicts – and certainly wouldn’t have made me stop.

You can see why vaping is becoming more popular with its pretty colours and no health warnings or gruesome images. So far. Evidence is growing of the dangers of vaping if it is not used as a short-term quitting aid. 

Some tobacco companies have started selling tins to avoid the new packaging rules and keep their branding visible. One expert said “The fact that these tins appeared almost immediately prior to the branding and size restrictions coming into force is suspicious.” It’s not suspicious, it’s predictable. They are not going to go down without a fight for a global industry currently worth $770 billion a year.

I’ve learnt a lot about quitting in the last year, some of it scientific, some of it personal. The main messages are:
  • Quitting is bloody awful but if it was easy everyone would do it. I am super special sparkly
  • There is no good time to stop. This last year has been a bugger for many reasons
  • It’s different for everyone
  • Think before you open your mouth around a quitter
  • There will be consequences. Quitting is damage limitation, not resetting to zero
  • There are both genetic and cultural components to addiction
  • Public health information and support is very inadequate
  • It’s really important to get support from anyone who will listen to you constantly whining
  • Punching people won’t make you want to smoke any less

So that’s my year of quitting. Now give me that damn cake.


UPDATE APRIL 2018

Nearly two years in and I am now a much greater drain on the public purse than when I smoked. Sorry about that.

UPDATE MAY 2018

I keep dreaming I'm smoking again, possibly because it's coming up to two years since I quit and it's on my mind. Sometimes you just have to wake up and say Fuck off, brain.

We had an interesting talk at London Skeptics (which I run) about harmful behaviour. The speaker, Dr James Erskine, has done research that shows not thinking about something isn't the answer. That just increases the cravings and the likelihood of giving in. And when you do give in, you'll do way more than you used to as a kind of rebound effect (the return of the repressed). The trick is to acknowledge and observe the thought, which helps 'decouple it' (his words) from acting on it.

Wednesday, 24 August 2016

Quit It Part 2


The continuing saga of My Adventures in The Land Without Fags **

(Part 1 is here)

TWO MONTHS
The monkey on my back is no longer a mandrill, more of a vervet.

I still want to smoke, sometimes A LOT, but it’s slowly becoming more an emotional and mental need, a kind of nostalgia. I miss it like Wendy missing Neverland.

For the first time, smoke smells bad to me. A friend was smoking Rothmans, admittedly one of the stinkiest fags, and I didn’t like it. Up until now, I’ve stood next to friends while they smoked and even followed people in the street a couple of times (yes, I know).

The IBS has mostly calmed down. For the first month, my digestion was seriously messed up and sometimes I looked five months pregnant, not because of the stress of quitting but because of physical withdrawal from chemicals that have controlled appetite and digestion for over 30 years. It takes a while for that to normalise (and it pisses me off when people assume IBS is caused solely by stress and, by implication, that I’m a feeble, neurotic woman).

The weight gain is holding steady at around 3kg. I’m exercising like buggery to get rid of it but so far, no dice. I haven’t noticed any difference at the gym with the weights but I can go harder on the cardio and being really out of breath at the end feels good, an endorphin rush I haven’t had for years. My knees aren’t so keen though.

I spoke to my dentist about whether the inhalator is having an effect on my oral health and he said that as long as my mouth isn’t permanently dry, it should be OK long term. On the upside, circulation to my gums is greatly improved already. On the downside, the fast recovery means they are much more sensitive so a session with the hygienist was nasty even with painkilling gel.

I’ve discovered that when someone kisses you, they can’t taste the nicotine from the inhalator, so that’s a bonus.

I’ve noticed that inhalators are sold in the pharmacy section of my supermarket whereas vaping equipment is sold with smoking products.

The rage has mostly gone although there are still moments. I haven’t done anyone actual harm but I’ve come very close a couple of times. They deserved it. I can now see the appeal of being a vigilante superhero – judge, jury and executioner. I may have to work on that. Or buy a cape and mask.

Things not to say 1: If I say I want to smoke, don’t say ‘No you don’t’ and think you’re being helpful because I really do. Acknowledge the craving and help me deal with it by distracting me – make me laugh, do a little dance, whatever.

Things not to say 2: ‘What, still?’ Yes, still. Just because smoking doesn’t cause extreme and obvious behavioural changes like some drugs and alcohol can doesn’t make it any less powerful an addiction. I’m bored with it too, with how much attention it takes up - even when I’m thinking about something else at the same time. I want it to be over and done with. So kindly take your short attention span elsewhere.

Things not to say (or think) 3: Stop making a fuss and get on with it, you shouldn’t have been smoking in the first place. There’s a moral judgement attached to some people’s response to addiction, even if they don’t admit it. It’s based on ignorance about genetics, personality, environment, whether the people you most closely identified with did it, changing social acceptance, legality, and smugness. A lot of smugness. No one factor makes anyone a victim destined to be an addict but it’s a complex, multi-factorial thing and judging from your moral high ground really doesn’t help.

THREE MONTHS
The vervet has shrunk to a pygmy marmoset. I’ve decided to give her a name – Sparky. ***

Do I still want to smoke? Yes, every day, mostly in the evenings. But not for as long or as intensely as before, and it’s not making me miserable that I can’t.

I’m having regular dreams where I light up, then realise what I’ve done and wake up really angry with myself, so it looks like my unconscious is rooting for me too. Shame it can’t have a word with my metabolism.

From a 3kg peak, weight gain is now 1.5kg. I’m eating a bit less than I was before I quit but there really wasn’t much I could trim off my diet and now I’m hungry a lot of the time, which is miserable. The Nicotine Replacement Therapy is supposed to help with metabolism, hunger and weight gain. Maybe I’d have gained a lot more without it, there’s no way of knowing.

Public health and other advice websites assume that all smokers are fat bone-idle slugs so their weight gain advice is mostly just to be more active and avoid snacking, which is no use to me at all.

I’m trying HIIT as part of my regular workout (High Intensity Interval Training – basically doing sprints). There are many variations and I’m doing a 2:1 ratio: 20 second sprints then 10 seconds slower on the bike, repeated for four minutes, at the end of every workout (two weights, two cardio per week) plus an extra cardio session with HIIT, plus a lot of walking. Research shows HIIT is better for weight loss than longer periods of less intense cardio. I don’t know if I’ll be able to go back to my normal gym routine once I’ve lost the weight or if I’ll have to keep up this level of intensity forever to keep it off. I bloody hope not. I’ve had knee problems since I was a kid and compartment syndrome in both legs about six years ago so I don’t want to push my luck. My knees hate me right now.

Things I have learned 1: Nicotine is the third most addictive substance known, after heroine and cocaine, then alcohol and barbiturates. There is also an individual factor that makes some people more susceptible to some substances than others - I’ve used four out of those five and only become addicted to one.

Things I have learned 2: Smokers tend to have more visceral fat – the one that sits round the organs and causes serious health problems. It’s a stealth fat that even people who don’t look overweight can have. Because of chemical changes in the body, weight-gain after quitting is more likely to be subcutaneous fat (under the skin), which is less harmful, especially short-term. And it will be short term, if it kills me.

Things I have learned 3: Nicotine is not all bad. This shouldn’t be a surprise as poisonous plants like deadly nightshade have medical uses.

It has been found to protect against Parkinson’s disease. A small study has found that it may also protect against the early stages of Alzheimer’s disease.

There isn’t even much of a problem with addiction in its therapeutic use because, according to an article in Scientific American, other ingredients in tobacco smoke are necessary to amp up nicotine’s addictiveness. Those other chemical ingredients—things like acetaldehyde, anabasine, nornicotine, anatabine, cotinine, and myosmine—help to keep people hooked on tobacco. On its own, nicotine isn’t enough.

Another benefit is as a cognitive enhancer. According to Jennifer Rusted, professor of experimental psychology at Sussex University: “To my knowledge, nicotine is the most reliable cognitive enhancer that we currently have, bizarrely.” Many other studies back her up.

According to another article in Scientific American: Psychologists and tobacco-addiction specialists think it's now time to distinguish clearly between nicotine and smoking; the evidence shows smoking is the killer, not nicotine.

"We need to de-demonize nicotine," said Ann McNeill, professor of tobacco addiction at the Institute of Psychiatry, Psychology and Neuroscience at King's College London.


Things I have learned 4: There’s a lot of disagreement over whether addiction is a disease or a learned pattern of behaviour, whether addicts are helpless victims and should be treated as such or whether this view disempowers people and makes them less likely to try to take control and change. The term ‘brain plasticity’ gets bandied about a lot in terms of learning or unlearning behaviour, including addictive behaviour, but it’s pretty much empty of meaning and should be regarded with skeptical caution.

What next?
This is the point where I should think about stopping the NRT according to some guidance but I’m in no rush. One Everest at a time. And according to the research I’ve mentioned, it’s not doing me any lasting harm and may even have some benefits.

For the first time since I was a teenager I will have to deal with life’s vicissitudes without the comfort blanket of nicotine, which could be interesting. But Sparky and I will keep plodding down the long and winding road. Maybe I can train her to wear a little hat and bang cymbals.


** That's English fags, not American fags, obviously.
*** Monkey notes: the mandrill is the largest monkey, the pygmy marmoset the smallest and the vervet (not surprisingly) somewhere in between.

SIX MONTH UPDATE

Still not smoking. Still wanting to smoke or at least wanting the comfort of it. Still using the inhalator. Still haven’t lost all the weight.

For the last two months I’ve been constantly ill with colds, laryngitis, three day flu (despite having the jab), more colds. There are endless forums where quitters talk about how many times they’ve been ill since stopping. None of the public health advice sites warn you that the immune system can take a long time to recalibrate itself and, while it does, you’re vulnerable to every passing invader. Also, nerve cells in the respiratory tract are beginning to work normally again, which means you’ll feel pain and irritation that smoking damped down, and the cilia take time to regrow to help repel the invaders.

It really does feel like a kind of penance. I would very much appreciate it if everyone would just stop breathing on me.

SEVEN MONTHS

I seem to have emerged from the tunnel of germs. My knees no longer hate me and have adjusted to the extra cardio, and I've lost two of the three kilos I gained.

I've had some very difficult personal stuff to deal with, including a funeral and my first response was to reach for a cigarette. An actual physical reach for a pack that wasn't there. Someone said that it would be understandable and not a failure if I just had one, if that helped me cope. I explained that I can't just have one. Ever.

2016 was probably not the best year to quit, given what's been happening in my world. But then, there never is a best year. If not now - when?

NINE MONTHS

More colds and viruses.  I may not live any longer now but it sure as hell will feel like it. I need a way to surround myself with a cloud of smoke to keep the germs at bay without doing myself harm. Basically, I need to become a dragon.

Still haven't lost the extra weight, damn it.

And yes, I do still have nostalgia pangs for smoking, especially the lighting up part. But not nearly as often and the smugness helps keep them to a minimum, especially as the cost of a pack has now gone up to over £10.

One of my younger relatives told me that of the ten people on his course, he's the only one who doesn't vape. Not one of them were previously smokers. That's a worrying trend even if they never move onto cigarettes as there is increasing evidence of harm.  Tobacco companies are aiming to double their vaping sales  as fewer and fewer adults smoke. Profit has to come from somewhere and young people are a prime target because they think they'll live forever whatever they do.

Some smokers I know are starting to get defensive around me, which can be difficult.  "I know I should give up, but ...". I'm not making you feel bad, that's all on you. I know you'd feel better if I started again but I won't. Sorry about that.

On the upside, I’ve been keeping my hands busy.






Thursday, 7 April 2016

…. For I Have Sinned


Why exercise is not an act of contrition

Shirley Cramer, chief executive of the Royal Society for Public Health thinks activity icons on food packaging will help combat obesity. The idea is to use stick people to show how long it would take to run or walk off the calories you’re about to eat.

The RSPH think that people are suffering from information overload in food packaging and that this will help – by giving them even more information as there is no proposal to replace the current labelling. Their research has found that 63% of people would support its introduction, with 53% saying it would cause them to make positive behaviour changes such as choosing healthier products, eating smaller portions or doing more physical exercise.



There are several problems with this approach. Firstly, who are the times based on? Everyone has a different metabolism and burns calories at a different rate depending on gender, height, age, build, lifestyle and so on.

The recommended calorie intake is 2500 a day for men and 2000 for women, based on some mythical average human. Averages can be useful as guidelines but it should be made clear that pretty much no one is ‘average’. I’m certainly not and nor is anyone I know.

Judging by the comments on the BBC article about this initiative, people don’t even understand what calories do. Someone commented on how long they’d have to run to work off 2500 a day, for example. We need calories to survive, they are not the enemy. It makes a big difference what constitutes those calories though – fats, sugars and so on. Eating 2000 a day is not going to keep you healthy if they’re made up of pizza and chocolate no matter how much you exercise.

You don’t just burn off calories while exercising. People who exercise regularly have a higher resting metabolic rate, which means that they burn off more even when they’re doing nothing just to sustain the extra muscle. What’s more, exercise is not just for calorie or weight control. There are many other health benefits, both physical and psychological.

The RSPH press release says that ‘it is hoped that ‘activity equivalent’ calorie labelling would help promote and normalise physical activity’. This is my biggest problem with the proposal – the intention may be to get people to be more active but it very strongly promotes the idea of exercise as punishment or penance rather than ‘normalising’ activity.

It’s like a Catholic approach to health – commit the sin and then do penance. Exercise is not an act of contrition and framing it as such helps no one. If guilt is your motivation and you hate every minute of your workout, you’re much less likely to keep up the exercise. Or, if you think you can exercise away the muffin, you have no reason to stop eating them in a cycle of sin and do penance, sin and do penance. As one woman told me, this approach is ‘reinforcing the notions that food has a moral value based on its calorific content, and that exercise is some kind of punishment for making arbitrarily-determined ‘poor’ nutritional choices’. Exercise does not wash away your sin and restore your moral balance.

A woman at my gym once said to me ‘When I’m as thin as you I can stop coming’. She wasn’t happy when I pointed out that the only reason I stay fit is that I keep coming. Forever. And ever. Amen.

There’s another worrying aspect to this proposed initiative. As a friend has pointed out, ‘This promotes an inherently disordered framing of what food and exercise are ‘for’. The whole idea of exercising simply to compensate for the food you've eaten is so triggering to people in eating disorder recovery who need to unlearn this bullshit in order to have a healthy and moderate relationship with food. This is so harmful, in the sense that it might actually trigger restriction and a return to disordered eating behaviours’.

This proposal comes from a good intention to help empower consumers to make healthier choices and to tackle the obesity crisis. But we already know that some foods are healthier than others. People over-eat for many different and complex reasons. If you buy crisps or chocolate, you know they are not health food. Who looks at how many calories are in a bar of chocolate and then puts it back? No one.

Making people feel guilty about their choices is not going to solve underlying psychological problems, nor is promoting exercise just to balance the scales. It’s not going to change anyone’s relationship with what they put in their mouth or with their bodies. When it comes to obesity, no one-size-fits-all approach is going to work.

As to the 63% who support the introduction of the activity icons – the road to hell is paved with good intentions. Also, the road to gyms making a profit is paved with people who join and then stop going after a couple of months. People often answer health questions based on how they would like to see themselves, how they would like to be, rather than on a realistic self-appraisal.

There is also the issue of practicality. Legislation on the mandatory labelling of food and drink is currently decided at the European level. Even if the political will existed and the food and drink industry was on board, it could take several years to happen. The industry is generally not so keen on ideas that discourage people from eating their products – unless they can sell us other products to counteract their effect. Maybe they should start investing in gyms.

Finally, why is it that articles like this so often have a food porn image at the top? Does the BBC (for example) think that we’ll read anything if there’s a picture of a heap of chocolate at the top? And, as all chocolate-lovers know, there is no such thing as a standard chocolate bar.

Pray for us sinners.