A Even the most organized people can forget or ignore coping skills during the holiday rush and be stressed by too many holiday activities, irregular meals and overblown expectations.

First, set a realistic schedule. Set priorities, so the important tasks get done first and what doesn't get done won't matter so much. Delegate responsibilities. Keep activities simple. Use a calendar to schedule time for shopping, appointments, exercise and relaxation.

Reduce shopping stress by ordering gifts from catalogues, shopping in out-of-the-way places like historical society or museum gift shops, and avoiding stores during peak hours.

Eat regularly and don't skip meals. Stress can cause the body to use or excrete larger than normal amounts of essential vitamins and minerals. Food eaten on the run can cause heartburn or other digestive discomfort.

Avoid holiday weight gain by eating something before going to parties. Pass on the appetizers and alcoholic drinks, go for the vegetables (but not the dips!) and opt for fruit or nut breads rather than cake or pie.

And laugh! Humor has a healing effect. Looking for the humor in holiday challenges is one of the best coping strategies and will help you enjoy the season more.

—Jeffrey R. Gray, M.D., internal medicine, University Medical Center at Pantano (a medical office of University Medical Center), Tucson

Q How can I stick to my diet and still enjoy the holidays?

A In surviving the holiday food frenzy, remember that attitude plays a big role in successfully managing endless variety and quantity of holiday treats.

Be prepared. If you need to limit calories, or specific nutrients such as sodium or protein, find out beforehand which foods and beverages are high in calories or those nutrients. Sources of such information include food labels, food analysis books, the Internet or a registered dietitian.

Have a plan that sets realistic goals for what and how much you'll eat. Know what your temptations are, plan to have a small portion, then move away from the temptation. Eat a snack before attending a social event to curb your appetite.

Socialize at holiday events in a comfortable area away from the buffet tables. It's too easy to reach for "just one more" when it's an arm's length away! Offer to bring a dish to the event and make it a healthy one! If a co-worker always has goodies out, avoid passing that desk as much as possible.

Don't forget that alcohol counts, too. It's a high-calorie, low-nutrient food that's around more during the holidays. Alcohol affects how the liver metabolizes many medications, so find out if any of your medications require complete avoidance of alcohol. If you drink alcoholic beverages, limit them to about one per hour so your liver can break down the alcohol. Alternate an alcoholic beverage with a non-alcoholic beverage. For your safety, and the safety of loved ones everywhere, have a designated driver.

Continue an exercise/activity program. If you don't have one, start one — the gift of health is the best gift of all. Check with your physician if you haven't exercised in a while. Plan an extra walk to help burn extra calories.

Enjoy the special holiday foods, but keep in mind that you pay the price when you overindulge. Remember that holidays are more than food _ renew old friendships, make new friendships, visit with family. Use your mouth for conversation, not consumption!

—Deborah Pesicka, R.D., registered dietician, University Medical Center, Tucson

Q How can I cope during the holidays following a death in the family?

A Instead of being a time for remembering important and happy occasions and for looking forward to the future, the holidays can magnify feelings of loss, isolation and loneliness if there has been a death in the family, or serious illness or concerns about aging.

Planning ahead can help you — and others — get through these times. Remember that anticipating a holiday is much worse than the holiday itself.

Start by getting together with your family and deciding what each member wants to do for the holidays and what each can handle comfortably. Then let other people know the role you and your family will play during the holidays. Realize that it isn't going to be easy; just do the best you can.

Cut back on holiday cards, if you wish; contacts can be made throughout the coming year. Have someone else shop for gifts, or postpone gift-giving altogether. On-line buying may be an option to facing the crowds if you still want to participate in gift-giving. Decorate only to the extent to which you are comfortable.

Let someone else cook the main holiday meal, or change the time of day when it was traditionally served. If you live alone, invite someone over for a meal, go to a movie, or select a special book to start reading that day.

Be sure to take care of your needs; get adequate rest and exercise. Spend some time out of doors and pay attention to the things around you. It will help bring some distraction and quiet some of those hurtful thoughts and feelings.

Acknowledge the absence of your loved one; have a dinner or toast in their honor; light a candle for them, visit the cemetery or memorial site. Engage in spiritual activities that bring you comfort and solace.

All wounds take time to heal. You will feel sad at times. Crying won't ruin the day for others — it will provide them with the same freedom to cry.

Don't be afraid to cry. Don't feel guilty if something makes you smile. Enjoy the gifts found in special memories and in contact with family and friends.

—Julie Tackenberg, R.N., clinical supervisor, Home Health, University Medical Center, Tucson

Q What can I do to prevent health problems during holiday travel?

A The greatest health risk for travelers is not due to infections but to trauma, especially motor vehicle accidents. When driving, be sure to wear seat belts. When flying, keep your seat belt on to avoid injury in the event of sudden turbulence. If you're going to drive after a flight, keep in mind that one alcoholic drink consumed in-flight has the same impact as two to three drinks on the ground.

Serious illness during travel is most commonly due to pre-existing conditions such as coronary heart disease, hypertension, diabetes or asthma. The medicines you normally take may not be readily available during your travel, so bring plenty for the entire trip.

Other helpful items to pack include pain medicine (such as aspirin, acetaminophen and ibuprofen), an antihistamine (also useful for preventing motion sickness), skin moisturizer, band-aids and an antiseptic, such as Betadine. Be sure to bring mosquito repellant, sunscreen, sunglasses and wide-brimmed hats when traveling to southern U.S. destinations, tropical regions or higher elevations.

Motion sickness (nausea or vomiting) can be prevented with over-the-counter medications containing antihistamines. Be sure to follow package directions — once motion sickness has begun, the medications may not be effective.

Altitude sickness may occur at altitudes greater than 8,000 feet but is more common at altitudes greater than 14,000 feet. Mild symptoms, which include headache, poor appetite, sleep disturbances or just not feeling well, generally resolve on their own in a few days. Shortness of breath is an ominous sign. More severe illness should be treated by descent to a lower altitude.

Jet lag occurs when traveling through several time zones and tends to be more severe when traveling from east to west. Symptoms include fatigue lasting several days, disorientation, irritability and disturbed sleep patterns. To adjust to the new time zone, you generally need one day for each time zone crossed. If you begin your trip overtired, stressed or hungover, it will take longer. While melatonin appears to be somewhat effective in treating jet lag, I don't recommend it because the amount of melatonin in different preparations is not standardized, making it impossible to know whether the preparation you buy will be effective or not.

In general, no specific travel-related precautions for protection from infectious diseases are necessary for travel in the United States, Canada and Western Europe.

There is increased risk for certain infectious diseases in developing and semi-developed regions, depending on the specific country and setting within that country.

The most common infection is traveler's diarrhea, which may affect 20 to 50 percent of travelers to many of these regions. The risk for hepatitis A also is increased in countries in this category. Other illnesses for which specific prevention is available include malaria, meningitis, yellow fever, typhoid, polio and Japanese encephalitis.

If you're going to travel to areas where you'll be at risk for contracting these or other infectious diseases, consult your physician about preventive and treatment measures.

—Rod Adam, M.D., director, Traveler's Clinic, Department of Medicine, the University of Arizona College of Medicine, Tucson

Q Why is it that my arthritis always seems to be worse during the holidays—especially around New Year's Day?

A For the millions of Americans with arthritis, holiday stress can dramatically increase the already debilitating effects of arthritis by causing arthritic flare-ups. The time interval between the stressful event and the arthritic flare-up usually is about one week.

Ongoing research at the Arizona Health Sciences Center has demonstrated that stress can cause arthritis flare-ups. If you have a significant family stress, your physical and emotional reactions to the arthritis get worse, which puts more stress on the family, resulting in a painful cycle. Arthritis flare-ups appear to be caused by an overactive immune system resulting from an imbalance of stress hormones in the body.

Left unchecked, stress can cause arthritis to get out of control quickly. If you realize a stressful event is approaching, you can work around it. Recognize your physical and emotional limits and look for positive activities to counterbalance the negative effects of stress.

—David E. Yocum, M.D., rheumatologist and director of the Arizona Arthritis Center, the University of Arizona College of Medicine, Tucson

Editors Note: ASK AHSC is published by the AHSC Office of Public Affairs. Reporters may quote from ASK AHSC; we request that credit be given. ASK AHSC is available on the Internet at www.ahsc.arizona.edu/opa/answers.

Back