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Developing the college football student-athlete, Part 1 – State Of The U
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This is part 1 of a 2 part series on developing the college football student-athlete. I often use the terms that were started by Bill Connelly to describe the three-pronged process of a college football program: acquisition, development, and deployment. Acquisition would be recruiting (and that damn Transfer Portal). Development would be what were going to learn today- its power, movement, and psychology as well as sport specific skills. Deployment is the strategy used on game day.
A coach is supposed to be a teacher and mentor. As were all aware, in the cut-throat world of Division I College Football, mentorship is often transactional rather than transformational. The free labor is used rather than developed. The greater good is forgotten during the quest for fame and fortune. Its unfortunate. The idea of what a coach is supposed to be has fallen to the side, even at the youth levels (see: Friday Night Tykes or read about AAU baseball pitch counts).
If acquisition of talent (read more about acquiring the best players here) didnt matter Bud Elliot wouldnt have spent so much time on the Blue Chip Ratio, 247 Sports and other sites wouldnt have their level of traffic, and there wouldnt be rampant cheating in FBS recruiting. But acquiring the most talented doesnt always mean youre going to win, and if you are lucky enough to have talent overcome culture it wont be a sustained success.
To find The Best you need to have a vision of what the best looks like. What are your criteria? What do you want you team to look like, both on the field and off? When a head coach (or CEO) sits down to write their mission statement it has to mean something to them. From paper, to head, to heart. A head coach needs to define their Core Values and recruit players who match those CVs.
But its also the head coachs job to develop the talent they bring on campus from a high school prospect with potential into a college product, and hopefully an NFL draft pick (never hurts to be NFL U.). To truly be a coach and mentor, you have to be concerned with the mind, body and soul of the student-athlete. Many coaches focus on academics once players are on campus because of APR and public perception- but does it go further than a GPA?
Lets take a look at how to develop athletes off the field (weight room and meeting room) by first looking at what the game of football requires from a physical and energy system standpoint.
Football isnt the military. The consequences are as different as the training. The Navy SEALs dont believe you should train athletes the way you train SEALs and theyre right. You shouldnt. Its not the same and theres hardly a correlation. Do football players stay up for a week straight with little food or water under highest form of stress fearing for their lives every second of every day? Not most.
Also as much as I love using a variety of swear words at different volumes and cadences with ever changing creativity in use- saying them to or in front of someone is a lot different than saying them at someone. Coaches dont have to break them down or weed them out, we have to build them up and develop the whole athlete. Im not saying I havent MFed my share of people but you have to 1- admit you were wrong to the person and 2- work to grow and change.
Football is an anaerobic game played in the Phosphagen energy system. Im not damn scientist but what this basically means is that if the game is played in the PES, why would I try in the Glycolytic energy system or Aerobic oxidative energy system? You shouldnt. This is why Im so firmly against 300-yard shuttle runs, 110-yard sprints and jogging in general when it comes to football. Phosphagen exercises last 5-10 seconds. So typically, those would be 20-60 yard sprints, agility, COD, or sport skill specific workouts
For the coach that yells move move move! he or she is also not training for football re work to rest ratios. Football is played at a 1:7 work to rest ratio. Meaning that if a play lasts 5 seconds (as the average play does) and you rest 35 seconds (the typical rest interval between plays) then you should train with a 1:7 work to rest ratio, too.
Football, essentially, is a 5 second car crash played on one foot and/or with one arm, while off balance and distracted- followed by 35 seconds of standing around. When my players sprint or lift, they are expected to work disciplined and focused on that sprint, lift, or drill before taking a focused rest interval (notice I dont call it a break). We have to train it that way both in the weight room and on the field. If you need a conditioning test youre a shitty coach. Period.
Football also isnt a powerlifting competition nor a body building competition. Having bis and tris is a side effect of training, not something we prescribe into the workout. its something the athlete can do at home, but I dont have the time to program in curls or triceps extensions. Theyll come from pull-ups and other exercises we do program.
Tim Kights Focus 3 podcast is an outstanding resource to learn about being a leader in any type of organization but obviously through college football as a main focus. Hes aligned with THE Ohio State football program and their former coach Urban Meyer. Kights episode 49 on Mental Toughness is one of his best (you can listen above or by clicking here). Well get deeper into Mental Toughness later, but the keyword that comes up the most often is Confidence.
The most important part of being in the weight room is gaining confidence. Being a willing tackler is extremely rare in football. Its like punching someone in the face, everyone says they would do it but will you actually do it when the time comes? Probably not.
So where to begin? Most college off-season programs begin in January. Some programs bring athletes in and put them through a hell morning at 5am the first chance they get in January. Thats quite stupid, and counter-productive (see: jackleg former strength coach from Iowa who almost killed a dozen players). After a football season that hopefully rips from August through late December or even the new year, players are absolutely beaten down. Its like being through a dozen car crashes.
Instead of hell week, be an actual coach who does programming and cares about his/her talent. Recovery is the key to the first 2-3 weeks of a good off-season program. The S&C Coordinator will build a program around getting the players healthy and prepared to phase into the second part of the program which is absolute strength.
I would offer a movement test (and I dont mean running the 20-yard shuttle and the 40-yard dash) to see the flexibility and movement skills of players. Where theyre currently sore, injured, or deficient would be my focal point.
I am firmly against chasing numbers. However, there has to be a baseline strength acquired both by returning players and incoming freshmen. Louisiana Tech S&C Coach Kurt Hester believes that it takes a college athlete two weeks to regain their baseline strength for football. After baseline strength is met, I then begin to shift my focus from absolute strength to power and speed,
As previously said, the game of football is played on both feet (bilateral) or on one (unilateral) and with arms doing completely different actions (ex. shedding a block with the right while making a tackle with the left). So how do S&C coaches train athletes for sport?
Transfer effect. The key phrase is transferring your programming to sports. Not one sport, the weight room should really transfer to all sports. Name a sport specific lift... Im waiting. Now you may program volume and stress differently for different sports but the intensity or exercises themselves are the same.
My method for getting maximum power from athletes is a four day approach if Im lucky and a three day approach if Im not. Well discuss a four day approach here. First of all, no athlete should walk into a weight room after the season is over and just start doing power cleans, clean and jerks, and snatches. There is a system to follow and its progressive both in stress, volume and intensity.
As you can see above, my four day programming would be broken up into cleans, clean and jerks, snatches, and yoga (not shown but whatever). The progressive part is we will build our program from mastering green to yellow to orange to red to purple. We may never even do purple. It takes time and skill and at the high school level we rarely get there with more than 1-2 athletes.
We can progress, too, by taking one exercise and looking at how to start training the body. For instance, during early January recover a kettlebell goblet squat is a better idea than a front squat. Wrists are badly hampered after a season and we can slowly build to that point via unilateral lifts and yoga to get ready. The next progression would be a Zercher Squat. Then we would begin to Front Squat. This is a one month process. You have to have patience but its not like Im insisting on two years.
Far enough into the weeds at this point? Good. Now lets talk about unilateral lifts. Every workout needs to begin with a warm-up (typically a little movement before five body weight exercises), and I like to then transition into a corresponding series of unilateral lifts.
On a clean day, the unilaterals might be overhead forward lunges, 1-arm dumbbell bent rows, and 1-arm DB push presses. I will set a timer and they players will do 20 seconds on, 10 second rest interval on each side (ha and tha) before transitioning to the next exercise.
Then we get into the bilateral meat and potatoes. On a snatch day we might do snatch grip RDL, snatch grip shrug+pull (3 shrugs and then 3 pulls), a behind the neck (BTN) snatch grip press, before overhead squats. Thus, we are teaching the parts-of-whole every time we enter the weight room.
A more advanced clean workout might have clean grip dead lift, clean grip shrugs, clean grip pulls, barbell bent rows, and front squats. Again, the parts-of-whole. I dont even have to program the core exercise, and will NOT, if I dont feel were ready.
Just like I wouldnt walk out to practice and say, Hey, doot doot doot, go run dat power, fella! I wont say, Hey, go cleans you somethin, either. Im going to teach the kick out, down block, combo and QB/RB mesh for power just like Im going to teach the parts that make up the clean, clean and jerk, and snatch. Just like I would practice power in individual groups, then small group, then the whole offense I will practice the unilateral and bilateral work that accompanies a successful lift.
Psychology is a major aspect in Athletic Performance. From the more general idea of Sports Psychology and sports psychologists down to the smaller details such as character education, transformative coaching, and actual player development (not just a title that really means recruiting assistant).
In all aspects of life, you have to Maslow before you can do whatever it is youre truly attempting to do. What I mean by that is before you can Bloom (read: Teach) or Saban (read: Coach) you have to focus on the student-athletes Hierarchy of Needs. If your new recruit came from an environment with little room for food, water and sleep- theyre not okay. Such and so on up the list until football matters somewhere between Self-Actualization and No Where.
Unless youve done a horrible job of acquisition it shouldnt be a coachs priority to run off players. Thus, were talking about developing athletes into getting their peak performance. I can tell you that there is no learning to be done until the student-athlete (or just student) TRUSTS the coaching staff. The athletes have to believe that you care about them; they dont care what you know until they know you care- cheesy? cliche? Sure. Truth? Yes.
Love is spelled T-I-M-E. You arent going to gain the trust of your players unless you spend time with them. Sometimes that takes grabbing pizza, keeping an open door policy, or having a Madden Tournament. Sometimes that involves explaining your WHY to them and learning about their WHY. Once they trust you, then you can indoctrinate them with your culture.
Urban Meyers culture at Ohio State was in three parts: 1- relentless effort, 2- competitive excellence, 3- power of the unit. From there he has verbal cues the players can take with them. Everyone in his program knows 4 to 6, A to B, plus-2. Its mantra. Every week some character education lesson must be given that reinforces these Core Values.
A true player development coach would follow a student-athlete from initial recruitment through graduation and into their adulthood. They would offer access to job skills training, community counseling, and would be there to make sure players were retained and didnt leave after their freshmen year (common year for players to transfer and students to dropout).
If you have a coherent narrative, and know WHY you coach (purpose) then players will love and trust you. Once that attachment occurs the team can become a program and the program can become a system of culture and excellence.
Its in my professional opinion, as an outsider, that Miami does not have a strong culture in the locker room. Whether thats from observing the collapse in the past three bowl games, from hearing Manny Diaz say that there are culture issues himself, or reading between the lines on early departures to the Pros and the transfer portal open door... its fairly obvious.
In order to improve the culture three things have to occur:
1- The head coach needs to establish a coherent narrative. They must know their WHY and have their purpose, mission and vision in their heart and own it. They have to select Core Values and the Standards of Performance that create behaviors to support their mission.
2- The head coach must believe in that purpose and mission, and communicate it effectively in meeting rooms, on the practice field, in living rooms, on social media, on TV, and over team meals. Everything about that purpose needs to be delivered with clarity, confidence and conviction.
3- The acquisition of talent has to be done with Behavioral Skills and Culture Skills first, and Job Skills second. The head coach is going to have to pass on talent for someone who has a stronger cultural fit aka the best player for that program at that time. This will create a strong culture and locker room where then the head coach can take a risk on someone that doesnt fit the culture but is an elite athlete.
Stay tuned for part 2 of Developing the college football student-athlete.
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Developing the college football student-athlete, Part 1 - State Of The U
Standing Tall – POZ – POZ
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Lillibeth Gonzalez, 65, celebrated her 28th HIVersary in early June by dancing in her New York City apartment and chatting with her son and her friends via Zoom. Having survived addiction, domestic violence and the AIDS-related deaths of three siblings, she is doing well today, but living with HIV for 28 years has taken its toll.
There are days I wake up feeling well, and there are days I wake up feeling like Im 90 years old, she says. The good part is that from zero [CD4] T cells, I was able to come up to 1,030, due to the medications. Im healthy enough to work and exercise. When I feel good, I do as much as I can.
People living with HIVnearly half are now 50 or olderare prone to a variety of health conditions as they age. Research has shown that HIV-positive people may experience problems such as cardiovascular disease and non-AIDS-related cancers as much as a decade earlier than their HIV-negative peers.
One of these problems is lipodystrophy, or abnormal body fat distribution. Although not limited to older people, the chances of developing lipo increase with age. These days, lipodystrophy is most often seen among long-term survivors who took older antiretroviral drugs with more side effectsand Gonzalez has taken plenty of them over the years.
Lipodystrophy is often accompanied by metabolic complications, such as diabetes, high cholesterol and hypertension, which raise the risk of cardiovascular disease and other health problems. Whats more, it can lead to emotional distress, reduced adherence to HIV treatment and poorer quality of life.
Gonzalez, who has worked as a community health educator at GMHC for 14 years, after starting out there as a client, struggles with a big belly due to lipo as well as persistent gastrointestinal problems, arthritis and brain fog. But she doesnt let that get her down.
I look at myself in the mirror, and I say, Oh my God! Im getting old! I feel like I look like the man in Despicable Me, with the big stomach and the skinny legs. Ive come to just laugh about everything because I do not want to stress out. Im happy to be 65 and alive. Aging is just something you have to deal with as it comes. My body reminds me every day that Im getting old, but my mind is keeping me young.
What Is Lipo?
Lipodystrophy is an umbrella term that covers both fat loss (known as lipoatrophy), especially in the face, limbs and buttocks, and fat accumulation (known as lipohypertrophy), especially in the belly and breasts. Lipodystrophy was once thought of as body fat redistribution, but it is now understood that these conditions are independentrather than reflecting a shift of fat from one area to anotherand have different causes.
While an individual may experience both, they are almost certainly separate processes, says Marshall Glesby, MD, PhD, a professor of medicine and health care policy and research at Weill Cornell Medical College in New York City.
A gaunt face with sunken cheeks was once a common sign of AIDS, attributable both to overall wasting and the side effects of certain early medications. Although these drugs are no longer widely used and are not recommended in the United States, the facial fat loss they caused may never be fully reversed.
The advent of protease inhibitors and modern combination antiretroviral therapy in the mid-1990s finally enabled people to maintain control of their HIV. But soon after the new drugs arrived, many people who took them started seeing unexpected new health problems, including unusual body shape changes.
People withHIVmay experience wasting as their immune function declines, followed by weight gain as they return to health after starting treatment. But HIV-related lipohypertrophy goes beyond that.
Some people with HIV experience a buildup of fat around the midsection that may have little connection with how much they eat or exercise. Both women and men may experience breast growth (known as gynecomastia when it occurs in men), or they may develop a fat pad on the upper back known as a buffalo hump. A combination of fat loss and gain can give the appearance of a potato on toothpicks.
Fortunately, lipodystrophy is not as common as it used to be. In particular, facial fat loss is seldom seen among people who promptly start treatment with modern antiretrovirals, before they develop serious immune deficiency.
Lipoatrophy is generally something that we see in people who were treated with older drugs like stavudine and zidovudine.It is rarely seen in people who have never been on these older drugs but is also not a problem that typically goes away, says Glesby. Lipohypertrophy, in contrast, is something that still occurs and in many cases may be similar to the abdominal obesity and metabolic syndrome that is relatively common in the general population.
In recent years, theres been a growing recognition that weight gainoften as much as several poundsis common among people starting treatment with modern meds. Black women living with HIV appear to be particularly susceptible. Although this can occur after starting any type of antiretroviral drug, integrase inhibitors and the newer form of tenofovir (tenofovir alafenamide, a component of Descovy and other combination pills) are frequently implicated.
But general weight gain and normal obesity are not the same as lipohypertrophy.
Fat buildup can occur in two different patterns, one of which is linked to more health risks than the other. Subcutaneous fat builds up beneath the skin, often around the abdomen, hips, buttocks and thighs. It is soft and squishy, hence the nickname love handles. People with mostly subcutaneous fat often have a pear-shaped body.
Visceral fat builds up inside the abdomen and surrounds the internal organs. This extra fat pushes up against the muscles of the abdominal wall, resulting in a taut, hard belly. People with mostly visceral fat typically have an apple-shaped body and a larger waistline in relation to the size of their hips. This type of fat can be harder to reduce with diet and exercise.
While obesity and lipo both lead to large abdomens, people with normal obesity usually have pinchable fat under the skin and rolls of soft fat on their belly. HIV-associated hypertrophy, in contrast, is distinguished by the kind of fat that causes a hard belly.
In some cases, fat buildup can be severe enough to cause pain, limit movement or interfere with sleep. A protruding hard belly is especially worrisome because of its link to other health problems, including heart disease. And along with its physical effects, lipodystrophy can also lead to emotional distress and loss of self-esteem. (Click here to read The Stigma of Lipo.")
This has changed my life in a terrible way, Gonzalez says. I used to model, so I was always a size 4 in clothing. But I saw my stomach growing and growing. The clothes that I liked didnt fit me. I didnt know how to shop for a size 10, 12 or even a 14. I got up to a size 14, but only because of my stomach. Its the only thing thats huge. My legs, hands and arms are slim.
What Causes Lipo?
Four decades into the HIV/AIDS epidemic, experts still do not fully understand the causes of lipodystrophy or the best ways to manage it.
Older individuals are more likely to develop lipo. Men are more likely to experience fat loss, while women more commonly have fat buildup in the belly or breasts. People who have lived with HIV or used antiretrovirals longer, those who have a high viral load before starting treatment and those with low CD4 countsespecially if they ever had advanced immune suppression with very low CD4sare also at greater risk.
In the case of lipoatrophy, the biggest culprits are first-generation nucleoside reverse transcriptase inhibitors, especially AZT (Retrovir or zidovudine) and d4T (Zerit or stavudine). These drugs are toxic to the mitochondria, the tiny energy-producing powerhouses in cells, and can damage fat cells known as adipocytes.
Fat buildup was initially blamed on early protease inhibitorsit was once dubbed Crix belly after Crixivan (indinavir), one of the first drugs in this classwhich can cause metabolic abnormalities that contribute to fat gain. But it soon became clear that this was not the whole story.
We do not fully understand the causes of lipohypertrophy, Glesby says. Unlike lipoatrophy, there are not clear associations with use of specific antiretroviral drugs or classes of drugs. There are multiple hypotheses about the causes.
HIV infection itself can lead to body fat changes. The virus can trigger chronic inflammation, raising the risk of health conditions including heart, liver and kidney disease. Inflammatory cytokines, or chemical messengers produced by immune cells, can alter metabolism in ways that promote fat buildup.
Fat doesnt just take up space in the body. Rather, it is active tissue that produces cytokines and hormones of its own. Hormones made by fat tissue include estrogen, adiponectin (which regulates glucose and fat metabolism) and leptin (which controls appetite). Some of the cytokines released by fat cells can cause further inflammation, which, in a vicious cycle, can lead to more fat buildup.
HIV-related lipo often goes hand in hand with other metabolic abnormalities, such as insulin resistance, diabetes, high cholesterol and hypertension, collectively known as metabolic syndrome. It has been linked to health problems ranging from cardiovascular disease to dementia as well as to a higher risk of death. Visceral fat can sometimes accumulate inside the liver and other organs. Over time, fatty liver disease can lead to cirrhosis and liver cancer.
HIV can also affect hormones. For example, it has been linked to lower production of growth hormone by the pituitary gland in the brain or reduced responsiveness to it. This hormone helps build muscle and break down fat, and low levels can lead to excess belly fat.
Some experts think the seesaw effect of immune system damage caused by HIV, followed by immune reconstitution after starting treatment, also contributes to lipodystrophywhich helps explain why it occurs more often in those who have had low CD4 counts. Alterations in the gut microbiome related to HIV or antiretroviral drugs may also play a role, according to Glesby.
In addition, genetic traits, lifestyle factors such as diet and exercise and being overweight or having normal obesity can affect the likelihood of developing lipodystrophy. But for reasons that remain unclear, many people with HIV who appear to be at risk never develop lipo.
Managing Lipo
Suppressing HIV viral load, getting CD4 counts back into normal territory and adopting a healthy lifestyle are great for overall health, but they may not fully reverse body fat changes due to lipo. Lost facial fat, in particular, can be very difficult to restore, leaving a lasting legacy for long-term survivors.
People starting antiretrovirals for the first time or switching regimens should have their body weight and fat distribution monitored regularly, as its easier to address lipo early rather than trying to reverse facial fat loss or belly fat buildup later.
The first step in managing lipodystrophy is a comprehensive checkup and discussion with your doctor. This can help determine which specific factors are contributing to your body fat changes and distinguish lipo from other conditions, including normal obesity. Your clinician will want to know about your HIV treatment history, diet, exercise, sleep, smoking, alcohol consumption and recreational drug use.
Your doctor will likely feel your belly to see whether its hard or soft and measure your waist and hips to calculate your waist-to-hip ratio. Having a bigger waistline relative to the size of the hips can be a sign of lipo. CT, MRI or DEXA imaging scans may help show how fat is distributed in the body.
Your clinician may run blood tests for metabolic or hormonal abnormalities. These include tests for blood sugar (glucose), lipids such as cholesterol and triglycerides, and certain hormones. An overactive thyroid can lead to weight loss, while a sluggish thyroid can cause weight gain. Cushing syndrome, caused by high levels of the stress hormone cortisol, can lead to body fat changes that look like lipo. These conditions can be treated with medications.
If youre taking older antiretrovirals that can cause lipoatrophy, you and your doctor may want to switch to newer medications with fewer side effects. This is often a good idea anyway, because modern meds are more convenient and may do a better job of controlling HIV. But while stopping problematic meds can halt further facial fat loss, it generally doesnt reverse existing lipoatrophy. And changing HIV regimens does not seem to have much effect on lipohypertrophy, according to Glesby.
Your provider will likely suggest lifestyle changes, such as improving your diet, getting more exercise, getting enough sleep and quitting smoking. A combination of regular cardiovascular exercise and strength training to build muscles is key. Experts recommend at least 30 minutes of moderate-intensity activity at least five times a week. Stick with a diet and exercise program for at least six months to give it time to work.
Dietary modifications and exercise are important as general health measures to reduce cardiovascular risk, and they may specifically have an impact on lipohypertrophy, though there is a shortage of good data on this, Glesby says. Those with access to a registered dietitian could benefit from devising a tailored, balanced diet to reduce calories.
However, lifestyle changes alone are often not enough to alleviate lipodystrophy. If thats the case, adding medical treatments might help.
The medications Egrifta (tesamorelin) and Serostim (somatropin) may be helpful, especially if lipo is related to low growth hormone levels.
The Food and Drug Administration (FDA) approved Egrifta in 2010 to reduce excess belly fat in HIV-positive people with lipodystrophy. Its self-administered as an injection under the skin of the belly, usually once daily. The newer formulation approved last year, Egrifta SV, is easier to prepare, does not require refrigeration and can be administered with a smaller needle.
Egrifta is a growth hormonereleasing factor analogue, meaning it mimics a natural hormone produced in the brain that triggers the release of growth hormone. Clinical studies showed that it reduced visceral hard belly fat by up to 18%, on average; some people have a better response than others. However, lost belly fat usually returns within a few months after stopping treatment. Recent research has shown that Egrifta can also reduce liver fat in HIV-positive people with non-alcoholic fatty liver disease, but it is not approved for this purpose.
I took the shots for about six months, and it helped, Gonzalez says. This is a treatment that you must continue taking for the rest of your life, and I dont know if I want to continue injecting my stomach for the rest of my life. My stomach was getting a little sore. So I changed my diet, and people are telling me that my stomach has gone down more. I exercise. And I might ask my doctor to prescribe Egrifta again.
The older drug Serostim is a synthetic version of growth hormone approved by the FDA in 1996 to treat HIV-related wasting. Studies suggest it may also reduce visceral abdominal fat. Like Egrifta, it is administered as a daily injection.
Other medications may be used to manage the metabolic problems that often accompany lipodystrophy and reduce the risk of cardiovascular disease and other health problems. For example, Glucophage (metformin) may be prescribed to control blood sugar, and statins may be used to lower cholesterol levels. Some studies have found that Glucophage may help reduce visceral belly fat as well.
For some people, surgical approaches may be the answer. For those with lipoatrophy, facial fillers may be used to fill out sunken cheeks and smooth deep smile lines. In some cases, a fat graft can be transferred to the face from another part of the body.
Sculptra (poly-L-lactic acid) and Radiesse (calcium hydroxylapatite) are injectable synthetic fillers that stimulate the body to produce collagen to fill in the empty space. Both are approved by the FDA for treating facial lipoatrophy in people with HIV. The effects of Radiesse are apparent right away, while Sculptra builds up over a few months and lasts longer, typically around two to three years. While these fillers are broken down by the body over time, Bellafill (bovine collagen plus a synthetic filler) is semipermanent.
Liposuction, which uses a suction technique to remove fat tissue, may be an option for reducing excess breast fat or a buffalo hump. But it is not a safe way to remove visceral fat deep within the abdomen.
Breast reduction surgery is another option for those whose breasts have swelled enough to cause pain or limit movement.
However, the cost of medications, fillers and surgery for lipo can be a barrier, as many insurers consider them to be cosmetic.
My doctor recommended Egrifta injections, but Medicaid did not approve them. I had to wait till I was over 65, when Medicare kicked in, Gonzalez says. Medicaid hardly approves anything, and its so difficult to find a doctor who accepts Medicaid. Thats why people are falling out of care, and it gets me very angry. I wish I could do something about this health system.
The manufacturers of Egrifta and Serostim offer patient assistance programs to help cover medication costs and insurance co-pays. Medicare covers Radiesse and Sculptra for people who experience depression due to HIV-related facial lipoatrophy. Some people have managed to obtain coverage for lipo procedures by having their doctor classify them as reconstructive.
Managing lipodystrophy can be challenging, and you and your doctor may have to try a variety of approachesor a combination of thembefore finding a solution.
Today, Gonzalez draws on her own experiences to help other people with HIV deal with the challenges of aging. Helping others is what helps me, she says.
Im on the long-term survivors page on Facebook. We discuss everything. I talk about my lipodystrophy and how Ive managed it, Gonzalez says. I advise them to make sure they have a great rapport with their health care team. Look for what is best for you. You are the client.
What I can tell long-term survivors is that if weve come this far, we can continue living a healthy, happy life, she continues. What I offer them is to maintain a healthy mind, body and soul. Its so important that you have a healthy spirit because your spirit is whats going to lead you.
Alicia Green assisted with reporting for this article.
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Standing Tall - POZ - POZ
Boyertown senior center awarded $76,847 grant to buy new air-conditioning system – Reading Eagle
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The state Department of Aging on Wednesday awarded a $76,847 grant tothe Center at Spring Street, Boyertown, to buy a new air-conditioning system.
We are so happy to receive the grant, said Charlene Wysocki, grants administrator for Boyertown Area Multi-Service Inc. a nonprofit providing services for seniors. The seniors like to get out of the heat and into the air conditioning.
Wysocki said the agency applied for the grant in November to replace the aging air conditioning in the 15-year-old building at 200 W. Spring St.
The seniors have not been doing any activities at the center since March due to the coronavirus.
However, she said, the center is providing 150 grab-and-go lunches daily on weekdays.
Wysocki said the center does not plan to reopen on Friday, when the county moves to the green phase of Gov. Tom Wolf's reopening plan.
She said the center is working with the county to ensure all proper protocols are in place to prevent the spread of the coronavirus before reopening.
We want to make sure we are doing everything the right way before we reopen, she said.
The Boyertown center was one of 60 community centers throughout the state to receive a total of $2 million in grants funded through the Pennsylvania Lottery.
Senior community centers play an immense role for older Pennsylvanians by assisting them with aging in place, Wolf said in a release. The grants will empower these centers to make their desired changes to further benefit regular attendees while attracting a new generation of participants.
Aging Secretary Robert Torres said as the country returns to a sense of normalcy, older Pennsylvanians may be eager to return to their local senior community centers for the activities they enjoyed prior to the stay-at-home orders.
There are more than 500 senior community centers throughout Pennsylvania that provide a variety of offerings, such as nutritious meals, educational opportunities, transportation services, financial and insurance counseling and exercise programs.
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Boyertown senior center awarded $76,847 grant to buy new air-conditioning system - Reading Eagle
US Has Warned Azerbaijan Over War Games – Armenian Weekly
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The State Department has warned Azerbaijan about the lack of transparency in large scale military exercises, but discounted Congressional Armenian Caucus assertions that the $120 million in U.S. military aid to Baku could be used against Armenia and Artsakh.
WASHINGTON, DC In response to a Congressional Armenian Caucus inquiry regarding Azerbaijans May 18-22 war games, the State Department, this week, revealed that it has warned Azerbaijan regarding its lack of transparency regarding large-scale military exercises, reported the Armenian National Committee of America (ANCA).
We welcome the news that the State Department has warned Azerbaijan over its large-scale military exercises and encourage increased U.S. vigilance against Bakus reckless arms build-up, military escalation, and cross-border attacks against both Artsakh and Armenia, said ANCA Executive Director Aram Hamparian. However, in light of President Aliyevs own stated intentions, the fungible nature of security assistance, and the resources that U.S. aid frees up in Bakus military budget, we do take strong issues with the patently false assertion that the $120 million U.S. aid package to Azerbaijan does not violate Section 907 by contributing to its offensive capabilities. The U.S. military aid package to Azerbaijan represents a clear cut violation of Section 907.
The June 23rd Department of State letter, signed by Assistant Secretary for Legislative Affairs, Mary Elizabeth Taylor, states that The United States has conveyed its concerns to Azerbaijan previously about the lack of transparency regarding large-scale exercises and will continue to highlight with Azerbaijan, bilaterally and at OSCE meetings, the importance of complete and timely notification of military activities in accordance with VD11 commitments, particularly annual notification of at least one exercise or activity in the absence of any that exceed Chapter V thresholds. However, the letter notes that after reviewing the available information, to date the United States has not determined that the Azerbaijani military exercises that concluded on May 22 at any point exceeded VD 11 notification thresholds.
Further still, the letter discounts concerns about the possible use U.S. military assistance to Azerbaijan against Armenia, stating, The United States reviews such assistance thoroughly to ensure it will not undermine or hamper ongoing efforts to negotiate a peaceful settlement between Armenia and Azerbaijan and will not be used for offensive purposes against Armenia.
Congressional Armenian Caucus Co-Chair Frank Pallone (D-NJ) disputed that assertion in a May 20th letter, addressed to both the State Department and Pentagon, that raised alarms about Bakus reckless escalation during the global COVID-19 pandemic. The aid appears to have allowed Azerbaijan to shift resources toward offensive capabilities and further threaten Armenian lives and regional stability as the Co-Chairs of the Congressional Caucus on Armenian Issues warned in letters sent to you in September and November of 2019. We cannot allow Azerbaijan to use the global coronavirus pandemic as cover for these dangerous military operations, stated the Congressional Armenian Caucus letter, which, in addition to Rep. Pallone, was cosigned by Congressional Armenian Caucus Co-Chair Jackie Speier (D-CA), Vice-Chairs Gus Bilirakis (R-FL) and Adam Schiff (D-CA) and Representatives Judy Chu (D-CA), Katherine Clark (D-MA), Jim Costa (D-CA), T.J. Cox (D-CA), Anna Eshoo (D-CA), Raja Krishnamoorthi (D-IL), James Langevin (D-RI), Carolyn Maloney (D-NY), Grace Napolitano (D-CA), Linda Sanchez (D-CA), Albio Sires (D-NJ), Tom Suozzi (D-NY), and Juan Vargas (D-CA). A separate letter on this same subject was sent to the OSCE Minsk Group Co-Chairs.
Azerbaijans Armed Forces held large-scale offensive tactical military exercises from May 18th to 22nd, featuring, according of official announcements, massive artillery, air, and high-precision weapons. The Armenian Defense Ministry condemned the exercises noting that they exacerbate the security environment in the region, under the conditions of a global imperative for joint actions against the COVID-19 pandemic and despite the call for UN Secretary-General Antonio Guterres to establish a global ceasefire.
In May of this year, the ANCA issued an online call to action urging Americans to contact Congress to raise concerns that Baku risks starting a regional war amid a global pandemic with these actions and ongoing sniper attacks along the Artsakh and Armenia lines of contact.
The full text of both letters is provided below.
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State Department Response to Congressional Armenian Caucus Letter Regarding Azerbaijani Military Exercises
June 23, 2020
The HonorableFrank Pallone, Jr.House of RepresentativesWashington, DC 20515
Dear Mr. Pallone:
Thank you for your May 20 letter regarding military exercises conducted by the Republic of Azerbaijan from May 18-22, 2020. As a co-chair of the Organization for Security and Cooperation in Europe (OSCE) Minsk Group, the United States remains strongly committed to helping the opposing sides achieve a lasting, peaceful settlement to the Nagorno-Karabakh conflict, based on the Helsinki Final Act principles of refraining from the threat or use of force, the territorial integrity of states and the equal rights and self-determination of peoples.
Maintaining stability along the Line of Contact separating Armenian and Azerbaijani forces, as well as the Armenia-Azerbaijan international border, remains a key focus of the Minsk Group Co-Chairs discussions with the sides. In their recent public statements and ongoing consultations, including video conferences with the Armenian and Azerbaijani Foreign Ministers April 20-21, 2020, and May 18-19, 2020, the United States and other Minsk Group Co-Chairs stressed the importance of observing the ceasefire strictly and refraining from provocative actions in the current environment. They also called on the sides to take concrete measures to reduce tensions further. U.S. officials in Washington and in the South Caucasus region also have emphasized these points directly with Armenian and Azerbaijani interlocutors.
The United States is a strong proponent of adherence to arms control agreements and arrangements, including the commitments set out in the 2011 Vienna Document on Confidence- Building and Security-Building Measures (VD11). The value of arms control agreements and arrangements is diminished if participating States do not implement their obligations and commitments fully. After reviewing the available information, to date the United States has not determined that the Azerbaijani military exercises that concluded on May 22 at any point exceeded VD 11 notification thresholds. The State Department, in coordination with the Department of Defense, will continue to address any concerns regarding the actions of partners and co-participants in such agreements and arrangements through diplomatic engagement and will detail its findings in the Report on Adherence to and Compliance with Arms Control, Nonproliferation, and Disarmament Agreements and Commitments, submitted to Congress annually pursuant to 22 U.S.C. 2593a. The United States has conveyed its concerns to Azerbaijan previously about the lack of transparency regarding large-scale exercises and will continue to highlight with Azerbaijan, bilaterally and at OSCE meetings, the importance of complete and timely notification of military activities in accordance with VD11 commitments, particularly annual notification of at least one exercise or activity in the absence of any that exceed Chapter V thresholds.
The United States attaches great importance to strengthening its partnerships with both Armenia and Azerbaijan. These partnerships have advanced U.S. national security priorities, including the Resolute Support Mission, where Armenian and Azerbaijani forces serve alongside NATO forces in Afghanistan and for which Azerbaijan provides critical overflight access. The DoD maritime and border security cooperation programs with Azerbaijan, funded through a U.S. Building Partner Capacity program, are in the national interests of the United States, Azerbaijan, and other partners in the region as these borders are areas of significant concern for potential movement of terrorists, weapons of mass destruction, illicit narcotics, and other unlawful trafficking. Moreover, these programs increase Azerbaijans capability to counter threats to its critical energy infrastructure, which provides a critical alternative to Russian and Iranian energy resources for Western markets. The United States reviews such assistance thoroughly to ensure it will not undermine or hamper ongoing efforts to negotiate a peaceful settlement between Armenia and Azerbaijan and will not be used for offensive purposes against Armenia. These program activities do not occur at or near the international border between Armenia and Azerbaijan or the Line of Contact. The nature of the training and equipment provided (e.g., radars, patrol boats, diving gear, x-ray scanners, underwater surveillance, and visit, board, search, and seizure capabilities), is such that it does not contribute to the offensive capabilities of Azerbaijan and cannot be misused to threaten Armenia or regional stability.
The people of the region deserve to live in peace and security. The U.S. commitment to helping the sides achieve a lasting, peaceful settlement to this long-standing conflict is resolute, and we will remain actively engaged through the Minsk Group process.
We hope this information is helpful to you. Please let us know if we may be of further assistance.
Sincerely,
Mary Elizabeth TaylorAssistant Secretary of StateBureau of Legislative Affairs
=======================
Text of Congressional Letter to Secretary of State Pompeo and Secretary of Defense Esper
Dear Secretaries Pompeo and Esper:
We are gravely concerned about the military exercises reported to be held by the Republic of Azerbaijan from May 18 to 22, 2020. These exercises are dangerous, violate diplomatic agreements and have the potential to destabilize security in the South Caucasus at a time when the COVID-19 global pandemic has taken hundreds of thousands of lives and threatened the health of many more. We strongly urge the Department of State and the Department of Defense to condemn these egregious actions taken by the Azerbaijani military.
Even in normal circumstances, these exercises would be unacceptable due to their offensive nature and the failure to follow diplomatic notification practices. On May 14, the Azerbaijani Defense Ministry released information describing military exercises that would take place from May 18 to 22. Azeri reports state that the exercises are expected to include 10,000 servicemen, 120 artillery and armored vehicles, 200 missile systems, 30 aviation units, and various unmanned aerial vehicles. The failure to provide adequate notification as prescribed under the 2011 Vienna Document and the size of the exercises demonstrates Azerbaijani President Aliyevs intention of further aggravating historical tensions with the Republic of Armenia and Nagorno Karabakh.
We are especially concerned that over $100 million in security assistance the United States has sent to Azerbaijan over the last two years through the Section 333 Building Partner Capacity program has emboldened the Aliyev regime. This taxpayer funding defies almost two decades of parity in U.S. security assistance to Armenia and Azerbaijan. The aid appears to have allowed Azerbaijan to shift resources toward offensive capabilities and further threaten Armenian lives and regional stability as the Co-Chairs of the Congressional Caucus on Armenian Issues warned in letters sent to you in September and November of 2019.
We cannot allow Azerbaijan to use the global coronavirus pandemic as cover for these dangerous military operations. We urge you to immediately condemn the reckless actions of the Azerbaijani military and to work with our allies and international partners to halt the provocative actions being taken by the Aliyev Regime.
We look forward to your prompt reply to this request.
Sincerely,
The Armenian National Committee of America (ANCA) is the largest and most influential Armenian-American grassroots organization. Working in coordination with a network of offices, chapters and supporters throughout the United States and affiliated organizations around the world, the ANCA actively advances the concerns of the Armenian American community on a broad range of issues. To learn more, visit http://www.anca.org.
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US Has Warned Azerbaijan Over War Games - Armenian Weekly
The latest on the coronavirus outbreak for June 25 – CBC.ca
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Canada's proportion of COVID-19 deaths in long-term care double the average of other countries, study shows
A new study found the proportion of Canadian COVID-19 deaths that have occurred in long-term care facilities is about twice the average of rates from other developed countries. The analysis released Thursday by the Canadian Institute for Health Information (CIHI) provided a damning snapshot of senior care as of May 25, when long-term care residents made up 81 per cent of all reported COVID-19 deaths in the country compared to an average of 42 per cent among all countries studied.
The data compares Canada's record to that of 16 other countries in the Organization for Economic Co-operation and Development (OECD). The proportion of long-term care deaths ranged from less than 10 per cent in Slovenia and Hungary to 31 per cent in the United States to 66 per cent in Spain. At 5,324, the reported number of long-term care deaths in Canada was near the average but data varied widely among countries: from 28 in Australia to 30,000 in the U.S., with more than 10,000 in France, Italy, Spain and the United Kingdom. Researchers point to limitations that prevent some comparisons countries vary in COVID-19 testing and reporting practices, and in their definition of long-term care. In addition, COVID-19 cases are often under-reported and in the case of Italy, data was available from only 52 per cent of the nursing homes operating in the country.
Nevertheless, Tracy Johnson, CIHI's director of health systems analysis and emerging issues, said the data offers valuable insight into a tragedy many families, caregivers and residents have been trying to illustrate since the pandemic began. Johnson said countries that implemented additional long-term care precautions at the same time as standard stay-at-home orders including Australia, Austria and Slovenia had fewer long-term care infections and deaths. Johnson said the findings suggest such measures could be key to mitigating the impact of a possible second wave but for now, she notes several of Canada's hardest-hit facilities are still grappling with the devastating fallout of existing infections. "Even if all of these [measures are instituted], there will be other folks who will die because some people are infected right now, still, and the outbreaks are still ongoing," she said. "Some of the control measures though will probably help to at least keep the rates the same as they are."
The contrast in long-term care deaths is even more stark between provinces and territories, according to the report, which notes long-term care deaths represented more than 70 per cent of all COVID-19 deaths in Quebec, Ontario and Alberta and 97 per cent of all deaths in Nova Scotia. There were none in Newfoundland and Labrador, Prince Edward Island, New Brunswick and the territories at the time of the study. Two long-term care residents have since died in New Brunswick. Dr. Roger Wong, clinical professor of geriatric medicine at the University of British Columbia, said the numbers are "very concerning" and point to long-standing systemic problems that include inadequate staffing and resources and inconsistent standards. "There needs to be a fundamental reprioritization, focusing attention and resources, time and effort into the sector right away. Because I can tell you that what COVID-19 has shown us in terms of a major lesson is a fragmentation [of] seniors' care," said Wong, who is part of a federal task force working on national recommendations on how best to help long-term care homes battle COVID-19.
Following the report's release, Prime Minister Justin Trudeau floated the idea of bringing in national standards and reopening the Canada Health Act to address some of the vulnerabilities the pandemic has exposed in long-term care homes while accusing provincial governments of having "failed to support seniors." "I think one of the things that is very clear is our current system of supporting seniors across this country has not worked," Trudeau said. "What this recent report has shown, and quite frankly what this pandemic has shown from the very beginning, is that the job isn't being adequately done in long-term care centres across the country." Long-term care homes fall under provincial jurisdiction, but the prime minister said the federal government is willing to work with the provinces to address the problems in long-term care. The issue likely will be raised this evening during the weekly call between the prime minister and the premiers.
Click below to watch more from The National
Quebec stops publishing daily COVID-19 data despite leading country in number of cases
Quebec's Health Ministry said it will only provide weekly reports about COVID-19, rather than providing a daily rundown of the situation. The Health Ministry and the province's public health institute, INSPQ which had also been publishing daily updates will only publish the data on their respective websites every Thursday, the first of them being July 2. The ministry will also be sending out a news release with the figures on that day every week.
The move from daily to weekly updates appears to make Quebec the province to be providing data less frequently than any other Canadian province, despite leading the country in number of cases. Prime Minister Justin Trudeau addressed the change in his daily news conference on COVID-19, saying it's up to each province to decide how transparent it needs to be. He also said that Quebec still has a "significant number of cases" every day, and a significant number of deaths every day. "I certainly hope that Premier [Franois] Legault would continue to be transparent and open with Quebecers and indeed with all Canadians as he has been from the very beginning," Trudeau said.
The decision was first announced in a news release on Fte nationale, the province's annual holiday. In a follow-up email, Marie-Claude Lacasse, a Health Ministry spokesperson, said the "decision was made due to the evolving epidemiological situation, which is stabilizing." The government announcement appeared to take the INSPQ off guard. A notice on its website Tuesday said it would begin limiting its updates to weekdays only, rather than seven days a week. But on Thursday, following the Health Ministry's announcement, it said it, too, would only provide a weekly update. A spokesperson referred any questions to the Health Ministry. The number of daily cases and deaths in Quebec has declined in recent weeks, and the government has allowed most businesses to reopen, including restaurants, gyms and shopping malls, but bars remain closed.
Read more about what's happening in Quebec
U.S. watchdog details COVID-19 response failings
Incomplete and inconsistent testing data reported by the Centers for Disease Control and Prevention make it more difficult to know the COVID-19 infection rate in the United States and take informed decisions on reopening communities, a U.S. government watchdog said. The report issued by the Government Accountability Office on Thursday marked the first review of the U.S. government's response to the coronavirus pandemic, and made recommendations to lawmakers how to improve the fight to come out of the crisis.
The report detailed difficulties the Internal Revenue Service (IRS) had in determining individual eligibility for stimulus cheques. The challenges included delivering payments to those who did not file tax returns the past two years as well as those without bank accounts or with limited internet access. Crucially, the report said, the Treasury Department rushed to get stimulus cheques out and did not avail itself to third-party data such as death records maintained by the Social Security Administration that the IRS in ordinary times utilizes. "According to the Treasury Inspector General for Tax Administration, as of April 30, almost 1.1 million payments totalling nearly $1.4 billion US had gone to decedents," the report said. Additionally, "the absence of complete and consistent COVID-19 testing data reported through May 31, 2020, has made it more difficult to track and know the infection rate, mitigate the effect of infections and inform decisions on reopening communities."
The level of transparency around U.S. government spending to fight the pandemic has been a contentious issue between various watchdogs and government agencies. According to the watchdog, the U.S. government has set aside $2.6 trillion worth of spending to fight the pandemic, but spending so far is unknown as all agencies are not required to report their expenditures until July 2020. The report also said the country is missing a national aviation-preparedness plan for infectious diseases; as part of its recommendations to U.S. lawmakers, the watchdog said it is urging them to take legislative action to require the Transportation Department to work with others to develop a national plan. It also criticized the Small Business Association for failing to give detailed descriptions of loans made in its data, and not outlining plans to review loans worth less than $2 million. "SBA to date has failed to provide information critical to our review," the watchdog said.
Read more about what's happening in the U.S.
Students can earn up to $5,000 this summer for volunteer service amid pandemic
The federal government launched a new program today aimed at encouraging students to volunteer in the fight against COVID-19 more than two months after first announcing it, and just in time for those who haven't been able to find a summer job. Post-secondary students will be eligible to earn up to $5,000 this summer through a new volunteer service grant.
The Canada student service grant is available for a range of volunteer work, including mask making, tutoring, researching animal behaviour and designing exercise programs for seniors. The grant will be worth between $1,000 and $5,000, depending on the number of hours completed. For every 100 hours worked, a student is eligible for $1,000, which means someone must volunteer 500 hours to receive the full grant. The program opens today and runs until Oct. 31, 2020. Only students and recent graduates 30 years old and younger can enrol; applicants must be enrolled part-time or full-time in a recognized post-secondary education program in the spring, summer or fall of 2020, or must have completed post-secondary studies in December 2019 or later.
Back in April, Prime Minister Justin Trudeau announced the creation of the Canada student service grant a way of giving students who can't find summer jobs a chance to earn some money while volunteering in "national service" activities related to fighting the pandemic. The grant program was part of a multi-pronged, $9-billion investment by the federal government to cushion the economic impact of the pandemic on young people. Ever since, students and organizations that rely on volunteers have been anxiously awaiting details, worried that the window for their summer activities was rapidly narrowing. Today's launch of the "I want to help" https://www.jobbank.gc.ca/volunteer online platform provides details on the grant.
Read more about the program
How Canada could avoid a 2nd wave of COVID-19
The first wave of COVID-19 is subsiding in Canada, with daily case numbers and hospitalizations falling to rates not seen since the beginning of the pandemic. Predictions on when a second wave of COVID-19 could hit have ranged from the fall and winter months of this year when flu season traditionally starts to early next year, similar to the way the pandemic began, writes CBC's Adam Miller. But experts say the likelihood of a second wave isn't set in stone, and Canada could instead see several smaller waves in the coming months or avoid a second wave altogether especially if we keep our guard up.
"There's actually nothing preordained about a second wave," said Steven Hoffman, director of the Global Strategy Lab and a global health law professor at York University in Toronto who studies pandemics. "We might have a second wave, we might have a third, fourth and fifth wave we might not have a second wave at all." Dr. Isaac Bogoch, an infectious disease physician and scientist with Toronto General Hospital, said instead of one cohesive second wave, we'll likely face smaller outbreaks in the coming months that will need to be clamped down on quickly. "We're basically going to be trying to rapidly identify small outbreaks as soon as possible, quelling those small outbreaks and preventing them from snowballing into larger outbreaks and a larger epidemic," he said.
The largest risk factor for another wave of infection is connected to the fact that most Canadians are susceptible to COVID-19 simply because they haven't had it. Canada's Chief Public Health Officer Dr. Theresa Tam said almost 2.5 million Canadians have been tested for COVID-19, with an average of about four per cent testing positive and more than 100,000 confirmed cases. "We have very small penetration of this disease in our society," said Raywat Deonandan, a global health epidemiologist and an associate professor at the University of Ottawa. "That means the vast majority are still susceptible, and if they are susceptible, then it doesn't take a whole lot for something to trigger another explosive growth." For that reason, Deonandan said there is a mathematical probability that another wave of infection is possible, but it may be less severe based on what we've learned about how to control the virus in the past six months.
St. John's fitness instructor finds international success from her basement during pandemic
Gill Whelan had long thought about crushing the barriers to fitness classes by moving online. It took the COVID-19 pandemic to push her to do it. Now the St. John's fitness instructor is thriving from the comfort of her own home, with a following of more than 700 clients and no plans to change it up if and when COVID-19 is a thing of the past.
"The pandemic just allowed me the time to create the content and push it out there," Whelan told CBC News. While gyms in Newfoundland and Labrador are allowed to open as of today, when the province moves to Alert Level 2 of the phased economic reopening, Whelan said some people who fear the virus will inevitably not come back at all. There are also the regular barriers to joining a gym scheduling, social anxiety and cost.
She realized very early in her online venture that people enjoy working out from the comfort of their own home. "I told myself, if I could get a good group of 20 people to work with me in this fashion, it would be a huge success. But in the first month we had 120 participants." The following quickly grew to 700 people from all across Canada, some in the United States and the United Kingdom. Whelan livestreams her class on Zoom at 6 a.m. NT, and has about 250 people join her each morning. The classes are then posted on a private Facebook group where the rest of the members can access it throughout the day.
Read the full story about the online classes
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The latest on the coronavirus outbreak for June 25 - CBC.ca
Lockdown weight loss: Here’s how I lost 10 kilos in 3 months post my C-sec delivery – Times of India
Lose Weight Fast Comments Off on Lockdown weight loss: Here’s how I lost 10 kilos in 3 months post my C-sec delivery – Times of India
Getting back to your pre-pregnancy is a difficult journey and it requires a lot of patience. Ishita was determined to get back to her pre-pregnancy figure and took advantage of the lockdown to do so. Her transformation story is an inspiration. Read her story to learn some simple secrets!Name: Ishita Pandey
Occupation: Homemaker
Age: 30Height: 5 feet 2 inches
Highest weight recorded: 70 kilosWeight loss: 10 kilos
Duration: 3 months
The turning point: People always say that the earlier you start after giving birth, easier it is to lose weight. I ended up gaining so much weight post my C-section birth, it ended up exceeding my postpartum weight, which was around 65 kilos. Getting back in shape was important. I didn't want to look "chubby" and made it a plan to achieve my target weight before my baby's first birthday and get those perfect photos where I could look fit and fabulous.
Breakfast:My breakfast was always wholesome and nutritious. I usually had it around 11 am. It could include anything like milk, oats, honey, nuts and seeds, whole wheat bread, roti subji, chila or poha. There were no restrictions.
Lunch:I had a small lunch. I didn't stop having white rice. Whatever was made at home, like dal, cholai, rajma, kadhi or soya, I would have that with rice, some subzi, curd and a portion of salad.
Dinner:
I skipped dinner since I follow Intermittent Fasting (16:8). I have a cup of chai and some low-calorie snack around 6 p.m. I would have a bite of something from my husband's plate later, but that's all 🙂
If it's cheat day, you would find me devouring street foods! Puris, gulabjamuns, pav bhaji, golgappas or pastries are my favourite! However, I do try to limit my cheat meals to twice a month.
My workout:
My exercise routine was a bit different. Personally, I am not a fan of strength training. I started with cardio and used to extensively skip rope but ended up injuring myself due to overtraining. Ever since I decided to take it a little easier.
Since I am a homemaker, I stay busy doing a lot of household chores. From dusting, sweeping, organizing, or even taking care of the baby, I was active throughout the day.
Low-calorie recipe I swear by: Having small snacks can be good to lose weight. I loved having healthy peanuts, buttermilk, flax seeds, almonds, makhanas (foxnuts) or digestive biscuits.
Fitness secrets: I am a big fan of intermittent fasting and would recommend it to anyone looking to lose weight. It's not complicated and does not require any extensive prep. Simple everyday food would do. I drank lots of water, swapped out sugar for jaggery and as always, moderation is key.
As for me, there were no hard and fast rules. I stopped counting my calories after a while. The important thing to remember is to reach a calorie deficit, which helps burn fat. Make sure you exercise and follow a disciplined diet and you will see the progress for yourself.
What kept me motivated:
My baby's birthday was coming up and all I had are 3 months to shed kilos. I took advantage of the lockdown situation and started to work on my body. With no maid, I have been doing all household chores by myself, taking care of the baby and following intermittent fasting. This was enough to get going. The lockdown was the perfect time for me (or anyone) to lose weight!
How do you ensure that you don't lose focus? While staying locked in was tough, there were some advantages after all. We weren't eating out, doing work ourselves, no distraction or holidays. This ensured that my routine wasn't disturbed for 2+ months. I could see the change for myself as the number on the scale went down. I joined a support group for intermittent fasting. I even took part in a skipping rope challenge. It was so motivating!
What's the most difficult part of being overweight: The worst part was not fitting into my pre-pregnancy clothes. Losing weight also took care of my PCOS problem. When I was heavier, I feared developing health problems. My confidence levels went into an all-time low. The transformation made the change happen.What shape do you see yourself 10 years down the line: Honestly, in my 40s, I want to be so fit that I look like I am in my 20s. I will continue to follow intermittent fasting, stay active and limit junk food.
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Lockdown weight loss: Here's how I lost 10 kilos in 3 months post my C-sec delivery - Times of India
After two miscarriages I gave up comfort food and lost nine stone to fulfil my dream of becoming a mum – The Sun
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WHEN a doctor agreed her obesity was likely a factor in her recent miscarriage, Lori-Jay Clark hit rock bottom.
All the 28-year-old teaching assistant had dreamed of was becoming a mum and it was the second baby she had lost in the space of four years.
5
She says: In that instant I knew enough was enough.
I was emotionally drained, tired of blaming myself for being obese but not doing anything about it.
The ultimate goal in life for my husband Jimmy and I was to be parents, but I was so unhealthy I knew I couldnt bring a child into the world, mentally or physically. I had to change my ways.
And she did, shedding 9st to go from 20st and a size 22 to 11st and a size 10.
5
Lori-Jay, from Hundon, Suffolk, says: Food ruled my life. Id have takeaways four times a week, and order things like a pizza plus a chicken burger, eating till I felt sick.
Deep down, I was furious at myself for sabotaging my chances of being a mum, but I just couldnt stop.
Obesity during pregnancy increases the risk of miscarriage and comes with a one in five chance of losing the baby before 12 weeks.
Lori-Jays overeating began when she was a child, and by age 14 she was 12st and size 14.
She says: I was picked on at school. The boys would say, Dont sit on that, youll break it, and call me fat.
It made me feel worthless, and I turned to food for comfort.
In 2012, Lori-Jay met Jimmy, 30, a bricklayer, at a nightclub.
She says: He wasnt bothered about my weight and would tell me I was beautiful.
5
Lori-Jay's diet
Lori- Jay's diet before:
BREAKFAST: 4 slices of toast
LUNCH: Sandwiches, toast
DINNER: Takeaway, pizzas, burgers or ready meals
SNACKS: Biscuits, choc
Lori- Jay's diet now:
BREAKFAST: Fruit & yoghurt
LUNCH: Tuna salad
DINNER: Fakeaways homemade KFC or burger & chips
SNACKS: Quiche, gherkins
But despite being in love and happy with Jimmy, I still couldnt stop overeating.
Wed spend around 100 a week on takeaways, and get through a load of chocolate and crisps while cuddled up on the sofa watching TV.
The couple then started to try for the baby they dreamed of.
Lori-Jay says: When I discovered I was pregnant in May 2016, the feeling was out of this world, I was so happy.
5
But a few days after I did the pregnancy test, I started bleeding.
I was rushed to hospital, where scans revealed I had an ectopic pregnancy a fertilised egg had implanted in one of my fallopian tubes.
I needed an operation to urgently remove the egg and tube, which doctors explained could make it harder for me to conceive in future.
Following that shock, the couple took a break from trying for a baby. But when they married the following year, they decided to try again.
In March 2018 though, Lori-Jay suffered a miscarriage at around eight weeks.
She says: I was heartbroken. Wed got so close to having our dream baby, only for the dream to be taken away from us.
Again, Lori-Jay turned to food for comfort.
Id eat till I felt sick, then the guilt and shame would set in, she says. It was a vicious cycle and I lost all confidence in myself.
5
Id make excuses to avoid friends, and hide in the street if I saw someone I knew.
The following April, Lori-Jay had another miscarriage at around eight weeks. She says: Deep down, I always blamed myself.
And after going for a check-up, the doctor agreed that I needed to lose weight to be in the best position to carry a baby full-term. That was the wake-up call.
So, in June 2019, Lori-Jay joined a Slimming World group with Jimmy, who by then also weighed 20st.
In the first week I lost 13.5lb, which spurred me on, she says.
We swapped fast food for home-cooked fakeaways and salads and I started attending circuit training classes four times a week.
Lori-Jay now weighs 11st, while Jimmy has dropped to 16st, and doctors have told the couple they have a much better chance of becoming parents.
She says: When I saw that I got to my target weight, I cried. Im so excited for the future.
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Splash outThrifty family turn their trampoline into a massive back garden swimming pool
Just getting up in the morning was a struggle before because Id feel sluggish.
Now I have so much energy. Jimmy and I are so excited to start trying for a baby again.
I feel like at last our dream of becoming parents is within our grasp.
GOT a story? RING The Sun on 0207 782 4104 or WHATSAPP on 07423720250 or EMAILexclusive@the-sun.co.uk
Read More..Testosterone Replacement Therapy Market 2020: Challenges, Growth, Types, Applications, Revenue, Insights, Growth Analysis, Competitive Landscape,…
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The testosterone replacement therapy marketis segmented on the lines of its product type and ingredient type. Based on product type the testosterone replacement therapy market is segmented into oral, implants, gums/ buccal adhesives, injections, patches and creams/ gels. The testosterone replacement therapy market is segmented on the lines of its ingredient type like testosterone, testosterone cypionate, testosterone enanthate, testosterone undecanoate and methyl testosterone. The testosterone replacement therapy marketis geographic segmentation covers various regions such as North America, Europe, Asia Pacific, Latin America, Middle East and Africa. Each geography market is further segmented to provide market revenue for select countries such as the U.S., Canada, U.K. Germany, China, Japan, India, Brazil, and GCC countries.
Browse Full Report: https://www.marketresearchengine.com/upcommingreport/testosterone-replacement-therapy-market
Testosterone is responsible for the improvement of male sexual characteristics and this hormone formed by the testicles. It is also important to maintain various functions such as sexual function, bone growth, adequate levels of red blood cells, and a sense of well being and muscle bulk. Insufficient production of testosterone causes erectile dysfunction. Erectile dysfunction occurs due to decreased testosterone production to overcome this testosterone replacement therapy is used to improve the problem. Testosterone replacement therapy occurs in various forms containing its own set of advantages and hazards such as subdemal pellets, transdemal patches and injections. Testosterone replacement therapy also helps to recover symptoms of low testosterone. Low testosterone is caused due to age growth it generally lowers down after the mid 30s and further decreases accordingly to the age factor.
The scope of the report includes a detailed study of global and regional markets of Testosterone Replacement Therapy Market. The reasons given for variations in the growth of the industry in certain regions.
Global Testosterone Replacement Therapy Market is expected to exceed more than US$ 1.0 billion by 2024 at CAGR of 4% in the given forecast period.
The major driving factors of testosterone replacement therapy market are as follows:
Rise in incidence of testosterone deficiency.Increase in geriatric populace with high risk of testosterone deficiency.Increasing awareness about testosterone substitute therapy.
The restraining factors of testosterone replacement therapy market are as follows:
High possibility of side effects associated to testosterone replacement therapy.Patent expiry of key drugs and entry of generics.
The report covers detailed competitive outlook including the market share and company profiles of the key participants operating in the global market. Key players profiled in the report include AbbVie, Inc., Allergan plc, Bayer AG, Endo Pharmaceuticals, Inc., Eli Lilly and Company, Kyowa Kirin International plc, Mylan N.V., Novartis AG, and Pfizer, Inc. Company profile includes assign such as company summary, financial summary, business strategy and planning, SWOT analysis and current developments.
The Testosterone Replacement Therapy Markethas been segmented as below:
The Testosterone Replacement Therapy Market is Segmented on the lines ofProduct Type Analysis, Ingredient Type Analysis and Regional Analysis. By Product Type Analysis this market is segmented on the basis of Oral, Implants, Gums/Buccal Adhesives, Injections, Patches and Creams/Gels.
By Ingredient Type Analysis this market is segmented on the basis of Testosterone, Testosterone Cypionate, Testosterone Enanthate, Testosterone Undecanoate and Methyl Testosterone. By Regional Analysis this market is segmented on the basis of North America, Europe, Asia-Pacific, MEA and Rest of the World.
This report provides:
1) An overview of the global market for testosterone replacement therapy and related technologies.
2) Analyses of global market trends, with data from 2015, estimates for 2016 and 2017, and projections of compound annual growth rates (CAGRs) through 2024.
3) Identifications of new market opportunities and targeted promotional plans for testosterone replacement therapy.
4) Discussion of research and development, and the demand for new products and new applications.
5) Comprehensive company profiles of major players in the industry.
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Table of Contents
1 INTRODUCTION
2 Executive Summary
3 Global Testosterone Replacement Therapy Market Industry Analysis
4 North America Testosterone Replacement Therapy Market Analysis
5 Europe Testosterone Replacement Therapy Market Analysis
6 Asia Pacific Testosterone Replacement Therapy Market Analysis
7 Middle East and Africa (MEA) Testosterone Replacement Therapy Market Analysis
8 Latin America Testosterone Replacement Therapy Market Analysis
9 Global Testosterone Replacement Therapy Market, Country Snippets
9.1. Global Testosterone Replacement Therapy Market Revenue, by Country, (US$ Mn), 20142024 9.2. U.S. Testosterone Replacement Therapy Market Revenue, (US$ Mn), 20142024 9.3. Japan Testosterone Replacement Therapy Market Revenue, (US$ Mn), 20142024 9.4. Germany Testosterone Replacement Therapy Market Revenue, (US$ Mn), 20142024 9.5. U.K. Testosterone Replacement Therapy Market Revenue, (US$ Mn), 20142024 9.6. Canada Testosterone Replacement Therapy Market Revenue, (US$ Mn), 20142024 9.7. China Testosterone Replacement Therapy Market Revenue, (US$ Mn), 20142024 9.8. Brazil Testosterone Replacement Therapy Market Revenue, (US$ Mn), 20142024 9.9. Mexico Testosterone Replacement Therapy Market Revenue, (US$ Mn), 20142024 9.10. United Arab Emirates (UAE) Testosterone Replacement Therapy Market Revenue, (US$ Mn), 20142024
10 Company Profiles
10.1. AbbVie, Inc.
10.2. Allergan plc
10.3. Bayer AG
10.4. Endo Pharmaceuticals, Inc.
10.5. Eli Lilly and Company
10.6. Kyowa Kirin International plc
10.7. Mylan N.V.
10.8. Novartis AG
10.9. Pfizer, Inc.
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Walk It Off – Carthage Press
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I was visiting with the oldest daughter the other day, in fact I visit with her often as she calls her dad daily, when she began telling me about another party and their ailments. She indicated that their complaining was becoming a little bit annoying and she just wanted to do what I had always done and tell them to, Just walk it off.
I was taken back a little bit and she reminded me that when she and her siblings were growing up on the farm, occasionally someone would get injured. The injury would initiate a search for the nearest parent and if that happened to be me the following advice would be given: Is it broke or are you bleeding? If the answer was no, then I would respond, Well, just walk it off. In the event of a break or blood, they knew where the splints and band-aids were. If one wasnt enough, use two!
A couple of weeks ago I was in a conversation with Jeff Higgins. He made a statement regarding the fact that as men age, their hormone balance changes, and their body begins to produce more estrogen and less testosterone. I know that my testosterone level is low because after the cancer incident in 2009, the doctors have kept it at a low level. It seems that the type of cancer that I had actually feeds off of the male hormone. In addition, if my estrogen production has increased that would explain my new ability to cry at will. When I was younger, I had to pluck a nose hair in order to bring the tears. Chicks thought I was sensitive; therefore, it was a handy talent to have.
However, if this is what women are going through on a regular basis, it explains a lot! Now before you take this the wrong way, Im not making any misogynistic statements here, Im just saying that if this is the reality of the opposite gender, then it is an entirely new viewpoint for me and Im not real comfortable with it. I have never thought that I could endure pregnancy or childbirth either, but this takes everyday life to an entirely new level. I can now understand the irony of the following: Men say they wish women came with instructions. Whats the point? Have you ever seen a man read the instructions?
I liked the old me, but the new me is not the destination that I was aiming for. I really wanted to depart this world like my great-uncle Tobias, peaceful and asleep. Not like the rest of the people in the car screaming and yelling for him to get his hands back on the wheel! With this sudden heightened level of emotions, I probably fall into the more vocal group.
As this new condition tries to achieve a balance, I am undoubtedly forced to take my own advice as given to many in the past. Lets see if this works as I try to just walk it off!
-Paul Richardson is the proprietor of In Sane Marketing Solutions. He writes a weekly column, The Horse I Rode In On, for The Neosho Daily News and The Aurora Advertiser.
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Walk It Off - Carthage Press
Testosterone Cypionate Injection Market Analysis with Impact of COVID-19 on Growth Opportunity by 2024 – Owned
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Testosterone Cypionate Injection Market Industry Analysis 2020
The Testosterone Cypionate Injection Market report enlightens its readers about its products, applications, and specifications. The research enlists key companies operating in the market and also highlights the roadmap adopted by the companies to consolidate their position in the market. By extensive usage of SWOT analysis and Porters five force analysis tools, the strengths, weaknesses, opportunities, and combination of key companies are comprehensively deduced and referenced in the report. Every single leading player in this global market is profiled with their related details such as product types, business overview, sales, manufacturing base, applications, and other specifications.
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Major Market Players Covered In This Report: Cipla, Hikma, Perrigo, Pfizer, Sun Pharma, Genesis Pharmaceuticals, Perrigo, Paddock Laboratories, Meditech Pharmaceutical
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Testosterone Cypionate Injection Market has exhibited continuous growth in the recent past and is projected to grow even more throughout the forecast. The analysis presents an exhaustive assessment of the market and comprises Future trends, Current Growth Factors, attentive opinions, facts, historical information, in addition to statistically supported and trade validated market information.
The Global Testosterone Cypionate Injection Market Can Be Segmented As The key product type of Testosterone Cypionate Injection market are: 100mg/ml, 200mg/ml
Testosterone Cypionate Injection Market Outlook by Applications: Hospital, Clinics, Recovery Center
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The Testosterone Cypionate Injection market comprising of well-established international vendors is giving heavy competition to new players in the market as they struggle with technological development, reliability and quality problems the analysis report examines the expansion, market size, key segments, trade share, application, and key drivers.
Key players within the Testosterone Cypionate Injection market are identified through secondary analysis, and their market shares are determined through primary and secondary analysis. The report encloses a basic summary of the trade lifecycle, definitions, classifications, applications, and trade chain structure. Each of these factors can facilitate leading players to perceive the scope of the Market, what unique characteristics it offers and the manner in which it will fulfill a customers need.
By Company Profile, Product Image and Specification, Product Application Analysis, Production Capability, Price Cost, Production Value, Contact Data are included in this research report.
What Testosterone Cypionate Injection Market report offers: Testosterone Cypionate Injection Market share assessments for the regional and country-level segmentsMarket share analysis of the highest trade playersTestosterone Cypionate Injection Market Trends (Drivers, Constraints, Opportunities, Threats, Challenges, Investment Opportunities, and Recommendations)Strategic recommendations on key business segments
The Report Answers Following Questions: Over successive few years, which Testosterone Cypionate Injection application segment can perform well?Within which market, the businesses ought to establish a presence?Which product segments are exhibiting growth?What are the market restraints which are likely to impede the growth rate?However, market share changes their values by completely different producing brands?
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The report entails detailed profiling of each company, and information on capacity, production, price, revenue, cost, gross, gross margin, sales volume, sales revenue, consumption, growth rate, import, export, supply, future strategies, and the technological developments, are also included within the scope of the report. In the end, the Testosterone Cypionate Injection Market Report delivers a conclusion which includes Breakdown and Data Triangulation, Consumer Needs/Customer Preference Change, Research Findings, Market Size Estimation, Data Source. These factors are expected to augment the overall business growth.
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Testosterone Cypionate Injection Market Analysis with Impact of COVID-19 on Growth Opportunity by 2024 - Owned