Approximately 75% of all women have experienced vulvovaginal candidiasis (VVC) at least once in their lifetime. The VVC infection, commonly referred to as a “yeast infection,” is caused by an overgrowth of the Candida fungus in the genital area. The fungus is normally present in the body in small amounts; it lives in warm, moist areas, such as the mouth, the gastrointestinal tract, and the vagina. This natural presence of the organism does not cause symptoms – but certain predisposing factors can allow it to multiply, resulting in vaginal itching, soreness, and discharge.

The occasional yeast infection is common, and is usually easily treated with antifungal medications. But a growing number of women are plagued by yeast infections that resist treatment, or tend to recur. This chronic condition is known as RVVC: recurrent vulvovaginal candidiasis.

Understanding Yeast Infections:

RVVC is defined as four or more vaginal yeast infections in a given year. But it is important to understand the difference between a new infection, and one that has lingered due to improper treatment. With the increasing availability of over-the-counter medications for VVC, more women are attempting self-diagnosis and self-treatment. Yeast infection symptoms can be similar to those of several other genital conditions, including bacterial vaginosis, and urinary tract infections. What appears to be a yeast infection that “won’t go away,” may actually be something else entirely. For these reasons, it is advisable to seek diagnosis from a licensed healthcare provider – this usually involves taking a vaginal swab and testing the specimen for the presence of Candida.

Before we discuss the problems of RVVC further, let’s first take a look at yeast infections in general:

Symptoms of yeast infection can include vaginal itching or burning; redness and swelling of the labia; a thick, white discharge; painful or difficult urination; and painful sexual intercourse. In severe cases, the skin around the vaginal opening may become cracked and bleed.

Causes: Overgrowth of the Candida fungus can occur when there is a change in the normal acidity of the vagina, or during a change in a woman’s hormonal balance. Stress, poor diet, illness, lack of sleep, menstruation, and pregnancy, are all conditions that can lead to these changes. Wearing tight clothing around the genital area can also induce infection, because heat and moisture become trapped, creating an optimal environment for yeast to thrive.

Yeast infections are common in women with diabetes, and those that have a weakened immune system. Women who are taking antibiotics, or corticosteroid medications are also at high risk. These medications can kill the “friendly bacteria” that normally live in the vagina. The bacteria are capable of destroying the yeast fungus, keeping it in balance.

Although rare, sexual transmission of Candida can occur. Men can also become infected, and may develop an itchy rash on the penis. In some instances, a physician may advise that a woman’s partner be simultaneously treated for the infection.

Treatment: Antifungal medications for genital yeast infections are available in over-the-counter creams and vaginal suppositories. Oral medications, such as fluconazole, are also available by prescription. These treatments are effective in curing the infection with an 80%-90% success rate. But, as mentioned earlier, infections that don’t respond well to treatment are becoming more common. Approximately 5% of women who experience a yeast infection will develop RVVC.

Potential Causes of RVVC:

The causes of RVVC are not well understood — although diabetes, HIV infection, and the prolonged use of antibiotics or corticosteroid medications may play a significant role. But in many cases, no obvious explanation exists for recurrent infections.

Some early research was done to suggest that RVVC is caused by the continual presence of Candida in the intestinal tract, which then reinfects the vagina. But later studies have shown little difference in the amounts of gastrointestinal Candida in women who have RVVC and those who do not.

Another theory is that a woman becomes reinfected via sexual relations with her partner. But studies in which both partners were treated for the infection showed that treatment of the partner had no effect on the woman’s risk for recurrent infections.

New research is focused on the idea that women with RVVC may have an abnormal vaginal immune response to yeast. In other words, some women’s bodies may not have the natural ability to control growth of the Candida fungus. And since a small amount of the organism will likely remain in the vagina, even after treatment, the risk for infection is constantly present.

S-adenosylmethionine (SAM-e) is a compound found in all living cells of the body. SAM-e has shown benefit with depression, osteoarthritis, and liver disorders.

SAM-e is produced in the body from the amino acid methionine and the energy powerhouse, adenosine triphosphate (ATP). SAM-e is involved in over 40 biochemical processes in the human body including detoxification reactions, joint tissue structure and the production of brain chemicals. SAM-e has shown benefit with depression, osteoarthritis, and liver disorders. Exactly how it works in these unrelated applications hasn�t been determined but several theories have been suggested.

An inadequate amount of methyl donors have been implicated an underlying cause of depression. SAM-e, as a methyl donor, may affect brain function by activating brain neurotransmitters (brain chemicals). SAM-e appears to also make brain cells more responsive to neurotransmitters by improving the binding of the neurotransmitters to receptor sites, thus increasing brain levels of serotonin and norepinephrine, which are associated with emotional well being. SAM-e has been shown to be as effective as antidepressant medication without the side effects the side effects associated with the medication. Several studies have shown SAM-e is also effective at maintaining emotional balance.

SAM-e may promote cartilage formation and repair by enhancing synthesis of proteoglycans, compounds essential for cartilage health. It does this by donating a sulfur group. SAM-e can also restore and maintain healthy joint function.

Studies have shown impressive results with osteoarthritis. Morning stiffness, pain at rest and pain on movement all show improvement. SAM-e has been shown to be as effective as NSAIDS (non steroidal anti-inflammatory drugs) for pain control without the side effects.

SAM-e appears to promote healthy liver function. SAM-e improves the production of glutathione, a powerful antioxidant that plays a key role in detoxification of things such as alcohol, drugs and environmental toxins from the body. SAM-e also enhances healthy liver function by stimulating bile flow from the liver, maintaining normal levels of bilirubin (a component of bile) and improving liver cell membrane function.

SAM-e is not found in abundance in the diet. An essential precursor of SAM-e, methionine, is found in most protein foods. A deficiency of methionine, choline, vitamin B12 or folic acid can inhibit the body�s ability to produce SAM-e.

Healthy people do not need to take the supplement. Typical supplement levels for those who do need it are 1600 mg/day for depression, 800-1200 mg/day for osteoarthritis, 1200 mg/day for liver disorders. All amounts should be taken in divided doses.

SAM-e has been shown to be extremely safe in most individuals. Occasional nausea and gastrointestinal upset has been reported. This usually occurred with large doses being taken. It is recommended to start with a low dose and work your way up.

People with bipolar disorder, also known as manic depression, should not use SAM-e without the supervision of their doctors as it can aggravate the �up� cycles. Use of SAM-e is highly contraindicated with Parkinson�s disease. Both animal and human studies have shown increased methylation can cause depletion of dopamine and block the effects of L-dopa.

Where do you and I fit in all of this? We live in an open field of infinite possibilities for our lives. As we leave behind old ways of doing things and are faced with the incredible burst of technology in our lives, we are also entering into an extended lifespan. What used to be considered “old age” is now in the prime of life. Yogi Berra was right when he said, “The future ain’t what it used to be.” We have come to accept that life-long learning is the mode for the future. If we can say one thing for sure about the decades following our 40th birthday, we can say they are filled with change — some we can anticipate — some surprise us. The greatest talent we can develop is to become committed to being an “artist of change.” We may be given an outline for our mature years, but we add the color and texture. While some people in our lives may insist we color within the established lines, no one can control the direction of our artistry.
Between the ages of 40 and 55 we can expect to see the results of a metabolic slowdown that began in our 30s. We will also experience, in various ways, our body’s approach to a menopause. After 55, we enter a maze of conditions said to be typical of the older generations. But, these conditions exist only as possibilities, not as our destiny.

Change is natural to life. Being able to embrace the natural changes of our lives does not mean “growing old gracefully” In fact it doesn’t mean growing old at all. Old is a state of mind. Being ageless means being who we are, at this present moment, while challenging the boundaries of our experience with an ageless attitude. The truly creative and courageous artist of life grows into longevity with spirit and grace, and a mite of attitude.

Here are the ABCs of being ageless

A

Attitude

Having an “I am not the average woman” attitude is almost essential in order to face the onslaught of advertising focused on the prevention of aging. To be able to choose whether to cut away our wrinkles, lose our fat through suction, color our hair or use products to prevent others from knowing that we are growing older requires that we know our personal, true reasons for doing so. Low self-esteem is not cured by products and neither is aging. When we use these procedures for healthy reasons, they enhance our living. When we use products or procedures to make up for what we think are our shortcomings, there will always be something else we need to do to be “good enough.” Being aware of the natural changes of our bodies means we embrace them but are not limited by them. These changes include a slower metabolism, which requires us to pay closer attention to what and when we eat. Eating a diet filled with fresh fruit and vegetables and cutting down on fat and sugar will enhance our vitality and well-being. If our energy is not what it was at 20, we can still be involved and active at our new level.

Activity

Aging can also mean bone mass loss, which does not have to lead to weak or broken bones if it is checked by appropriate calcium intake and weight-bearing exercises. Simple things like walking, dancing, gardening jump roping can take the place of joining a gym. If you join a gym, try to find one that focuses on women. The equipment is more our size and the trainers are prepared to work with us to build healthy bodies.

B

Boldness

When we are young, being bold is just part of our learning experience. We are always trying new things because the world is new to us. When we are more experienced, we can sometimes lose our sense of wonder, and our sense of adventure. Change is here to stay. Our world is in a dynamic change mode, and if we are to not feel we are getting too old to keep up we must boldly enter into learning. Taking a class in a subject that interests you, yet is unfamiliar to you is a bold step. Joining a club or group for travel, cultural exchanges, book review, or bird watching is a bold move if you don’t know the other group members. There are many ways to be bold in life.

Balance

There is a fine line between accepting the natural changes of age and using our age as an excuse by claiming our limitations as the result of aging. The most common conditions attributed to aging include lack of energy, memory dysfunction, weight gain, crankiness and lack of participation. Many times these are brought on by unwise choices or by passively accepting that there is nothing we can do about them. By making wise choices in food and exercise, keeping involved with people, volunteering for something we believe in, and by keeping our minds actively exploring new topics and activities, we will maintain a balance between natural aging and the push to move beyond our conditions.

C

Courage

The kind of courage needed to be an Artist of Change is not the same as the courage to face a disaster or a rampaging mob. There is no adrenalin rush in making a decision to refuse a health challenge as permanent, or in joining a new exercise class. The courage of an artist is to step up to each blank canvas and create something new. The courage of an artist of change is to step up to each new day as if it were a blank canvas, letting go of past experiences and asking, “What shall I create today?” The courage to forgive makes a hurting relationship into a blank canvas. The courage to begin a new career turns our workday into a blank canvas. The courage to give up the myths of aging turns every day into a great adventure.

Commitment

True commitment has no chance of failure. True commitment is making and remaking our choices to bring ourselves back to what we truly value. It allows us to return to healthy choices after too many desserts and late-night snacks and return to exercise after something interrupts it. Commitment embraces everything about change in the outer world, while remaining true to the values, virtues and principles that are our compasses.

“Massage is the reason I’m able to remain independent,” says Bette Friend, who lives with the daily pain of fibromyalgia and chronic pain. “My quality of life is better because I get regular massages,” says the Fargo, North Dakota resident.

The American Massage Therapy Association (AMTA) estimates that each year, Americans visit massage therapists about 75 million times and spend between $2 and $4 billion on massage.

The estimated 160,000 U.S. massage therapists treat sports injuries, insomnia, stress, back pain, repetitive stress injuries, muscle pain, headaches, chronic pain, and help their clients ease tension and anxiety.

Healing Hands Massage is a healing art that uses touch to manipulate the body’s soft tissue. You’ve probably heard about the different kinds of massage: Swedish, Shiatsu, Acupressure, and Deep Tissue massage. You’re probably familiar with Swedish massage, which uses long strokes, kneading, and friction techniques on the more superficial layers of muscle.

Massage increases the blood and lymph flow, soothes the central nervous system, and increases oxygen in the blood. It also increases endorphins, the body’s natural painkillers that are stimulated during exercise.

Who Gets Massages? But massage has emotional benefits, too. Most people who get regular massages feel a sense of well-being and relaxation following a massage. And touch is healing for people of all ages, especially those who are “touch deprived,” as a result of divorce or widowhood.

Pregnant women can also benefit from the healing touch of massage. One study conducted by the Touch Research Institute at the University of Miami showed that pregnancy massage decreased anxiety and stress during pregnancy and lowered the amount of obstetric and postnatal complications.

Ron Venk, a licensed massage therapist in New York City, believes the recent surge of interest in massage is related to our increased awareness of the importance of exercise and relaxation in our busy lives. “My clients come in for massage for much-needed relaxation of mind and body. After a session, they’re better able to recover from pain related to tension, work stress, or injury.”

According to Steve Olson, president of the American Massage Therapy Association, massage therapy gives us a good indication of what is going on in our bodies, and helps us discover what is causing our pain or discomfort. “Your body may be telling you that you need to be more careful when you sit at the computer for long periods of time, or that you need to buy a new mattress or practice better posture.”

While massage can benefit most everyone, before you get a massage, let your therapist know if you have any of the following: tuberculosis, arthritis, skin infections, circulatory ailments, recent surgery, diabetes, phlebitis, or cancer. Be sure to tell her if you’re pregnant.

What Happens During Massage? A massage lasts about an hour. The therapist will ask about your medical history and any physical conditions or concerns. You will then be asked to remove as much clothing as you are comfortable with, cover yourself with a sheet or towel, and rest on a padded massage table. During the massage, the therapist will uncover only the part of your body that she is working on at the moment, and she will work on one part of you at a time–your head, neck, shoulders, arms, hands, back, legs, and feet.

The therapist will use oil, so be sure to let her know if you are allergic. Some therapists play music or light candles. Always discuss your preferences with your therapist–whether you’d like to talk during the session or get worked on in silence. Also, let your therapist know if anything she does causes pain, if you are cold, or uncomfortable.

How to Find a Qualified Massage Therapist The AMTA has established standards that have been incorporated into many existing state licensing laws. At least thirty states, plus the District of Columbia have legislation regarding the licensing of massage therapists. Make sure your massage therapist is licensed and that she’s been trained at a school whose curriculum meets the standards set by the Commission on Massage Therapy Accreditation. Ask whether she is certified by the National Certification Board for Therapeutic Massage & Bodywork.

Finding a compatible massage therapist is like shopping for any other health practitioner. Shop around until you find a therapist you can communicate with. Ask your friends, relatives, and your doctor for a recommendation. With massage becoming more popular, chances are someone you know is getting regular massages. Then, just lay down, relax, and feel your tension melt away.

Regardless of whether a woman follows a vegetarian diet or not, protein from tofu and other soy products can provide plenty of protein. getting enough protein is a nutritional concern during pregnancy, as well as the right kind of protein. A Journal study done by the American Dietetic Association found that women who got their protein during pregnancy mainly from soy were more likely to have good amounts of iron stores within their system than pregnant women who got their protein primarily from meat.

Iron is another main nutrional concern during pregancy, as any pregnant woman can tell you. Getting enough iron is of such importance that many doctors routinely prescribe iron supplemented pre-natal vitamins for their pregnant patients.

Tofu, soybeans, and other derived products are rich in iron. Because mild anemia during pregnancy is normal quite often, it is important to get lots of iron and best from natural food sources. Iron supplementation can mess up the body’s absorption of zinc, copper, and manganese.

A third major concern is calcium. You may not be aware that you can get calcium from tofu, but you can! Eating tofu made with calcium silicate is a good way to get more calcium into your diet. It’s also a change from the multiple glasses of cow’s milk routine that is so common in the household’s of many pregnant women.

You notice that his communication skills are not good.

If your doctor doesn’t seem to want to communicate with you, this should act as a real warning signal. If you want to be sure of getting the best in medical care, it is imperative that you have excellent communication with your doctor.� This means both give and take. Communication is a two-way street. When you choose your doctor, you should be able to feel confident that he will want to know about your symptoms and that he will want to talk with you about your concerns. Your doctor should listen to you thoroughly. He should not interrupt you while you are explaining your symptoms and concerns. That’s the way misdiagnoses occur or completely missed medical problems happen. Any good doctor will have enough time to listen to you and ask you questions about your symptoms, no matter how busy his schedule may be.

He just gives you a prescription without really knowing what the problem is.

If your doctor just writes you a prescription and doesn’t even think about exploring natural and alternative solutions, he is probably a bad doctor. A good doctor always weighs all the options and chooses the safest alternative. Of course, sometimes a prescription is the answer to your problem. However, prescription medications should not be the only solutions your doctor ever proposes. There are quite a few medical conditions that can be effectively treated with lifestyle change. Slightly elevated blood pressure is an example of this. Double check to be sure your doctor is telling you about all possible options before you agree to take a prescription.

Your doctor tells you to do one thing but does another himself.

A credibility gap is when your doctor tells you that you need to get more exercise and watch your diet, while he is quite clearly a junk-food-loving couch potato. Of course your doctor probably doesn’t have a lot of time to work out. Nonetheless, he doesn’t need to have a bunch of junk food wrappers and overflowing ash trays sitting around his office. Of course, a good doctor will lead by example. It is his obligation to model proper health behavior for you.

He leaves you confused.

When a bad doctor is finished with you, you still have questions. You know you have a bad doctor if he is in such a hurry to hand you your prescription and rush off to the next patient that he doesn’t even tell you what will happen next. A good doctor will explain your diagnosis, give you a list of tests that will be needed, tell you how to treat your condition, and explain any side effects you may experience with your medication. It is understandable that your doctor may not have time to do a complete presentation with slides and bar graphs; however, he should be able to tell you what you diagnosis is, give you a list of tests you will need to have, explain how you will need to treat your condition, and forewarn you about any side effects your medications may have. When you leave, you shouldn’t be more confused than you were when you arrived.

When you try to call a “bad” doctor, you will often be unable to reach him.

You can reach a good doctor when you need to. If you get an answering machine when you call his office and it just gives you the number of the emergency room, you will probably want to think about looking for another doctor. Good doctors take calls themselves or make arrangements with their colleagues to share the responsibility of taking calls. A good doctor makes sure his patients can always reach a doctor for proper care as needed.

Naturally, you will want your doctor to be up on the latest things. This includes not only conventional medicine, but also alternatives. Don’t let yourself be hurt by the unprofessional actions of a bad doctor.

I would never willingly choose to go through this experience again, but if I did, I�d count it yet another blessing. I�d like to share some of the gifts I received because of my cancer.

As is the case with many writers, one of my first and enduring loves is reading. When I went through chemotherapy, my vision would easily blur and nausea ensued if I tried to read anything longer than the Sunday comics. One of my best friends solved this problem for me. On Sunday afternoons, Colleen came to our house, made a pot of aromatic apple cinnamon tea, and sat down next to me under a cozy quilt (I was always cold) to read �Beauty: The Retelling of the Story of Beauty & the Beast by Robin McKinley She warmed me, body spirit, and soul.

I received chemo treatments on Fridays at noon. This enabled me to get my treatment and go home for the afternoon to recover. Then I�d have two days before I went back to work on Monday. As soon as I got home from the doctor�s office, I put on some upbeat music like Gloria Estefan�s album, �Into the Light,� sat in my recliner, leaning back with my eyes pressed closed to keep the room from spinning, and chanted my favorite mantra, �Tomorrow is Saturday. I will be well. Andrew and I will go to the park. Tomorrow is Saturday. I will be well. Andrew and I will go to the Park.� I was able to do this because on Fridays dear friends of ours took turns having our very active young son for the day. My Friday was quiet and uncomplicated. We never hid anything from Andrew, but we all needed a break from each other during this time. Beverly, Grace and Glyn gave me the gift of time to recover my composure and my body.

At the time I was diagnosed, I was working as a �temporary� and had applied for a permanent position with a company. The company told me that they would hold my position open until I�d had my surgery and recovery. They gave me the gift of financial stability, health insurance that covered pre-existing conditions, and flexibility to work my schedule around chemo and then daily radiation.

The entire first month after surgery, members of our church dropped by every afternoon. Some would stay to chat with Greg or me. Some were on their way home from work and were in a hurry. All of them left an entire dinner from soup to nuts on our dining room table. Greg had transitioned in the months prior to that to be our �Stay at Home Dad� and hadn�t learned the finer arts of meal preparation. In addition to the meals, these friends also left the recipes for what they brought so that he had a resource for future meals.

I had worked for a short time for Fran�s chocolates in Seattle. Many people sent flowers, Fran and her staff sent chocolate with a note saying, �It couldn�t hurt!� It renewed my spirit! As much as I loved the flowers (believe me, I LOVED the flowers, the gift of chocolate said, �Keep living. You have a special treat to eat.� Fran and friends gave me a healing message and one that I give myself to this day. I used to laugh when I read the phrase, �Life�s short. Eat dessert first!� Now I embrace it in every part of my life. Life is short and if we always wait until after we�ve done the �have to dos� we never have room for fun and frolic and chocolate.

As I was writing this Greg reminded me that there were plenty of negatives that went on during that time. We chose not to dwell on them. We gave them to God and went on with our lives. I have a loving husband and son, friends that helped at the drop of a hat, a job for the last ten years that has been the highest paying, with the most generous benefits of any company I�ve ever worked. I have to tell you what cancer gave me, not what it cost me.

The potency of herbs can be standardized through specific extraction processes. The quality of homemade herbal remedies depends on the quality of the plants used. Plants must be free from decomposition spots, insect holes, mold, and they must look, smell and feel healthy and vibrant. Dried or freshly picked, flowers, fruit, seeds, leaves, roots and gums, can be used in herbal preparations.

Our family herbal medicine cabinet is lined with small jars of dried herbs and spices, floral waters, herbal vinegar�s, tinctures, tonics, salves, syrups, Bach remedies, and essential oils.

There are many techniques available to start your own Eden Healing Cabinet, and each man will adapt methods using the following information and skills. Once herbs have been grown, harvested and dried, and you read up on the basics on herbal cosmetic and medicinal use, there�s nothing stopping you making rescue remedies for the whole family�s everyday first-aid, and simple health conditions.

Learning to use herbs for health and skin-care is a lifelong process. Yet, it can be very rewarding to be able to successfully treat an illness and learn a preventative way to live, as you become more familiar making and using different herbal preparations. The more comfortable you become, the more you�ll know which herbs and other natural resources to keep on hand, season to season. Both your family and personal habits will to some degree dictate what ingredients you need to store.

Sometimes, by treating a particular condition before it has a chance to take hold on your immunity, you can limit the chances of becoming seriously ill. Remember to keep all cooking and medicinal herbs separate, and although it might take a little time to get your supplies together, it will be well worth your efforts to be prepared, since prevention is the key to ageless aging for a lifetime.

It is good to be cautious and question things. We exist in an environment that looks to be geared toward dishonesty regarding consumers.

Is there proof that detox foot patches really work? Of course!

- The visual proof that you get after using a detox foot pad is amazing. There is a notable improvement after several continuous days of use.

- A widely recognized Environmental Laboratory, SRC Analytical Lab, studied several types of foot pads. Nickel, Mercury, Arsenic as well as other substance were found soaked into the pads.

- Multiple pads were examined using a syncrometer for some people. Isopropyl alcohol, asbestos, cadmium,� fast green dye, copper, methyl alcohol, thallium, benzene, mercury, nickel, aluminum, sudan black dye are the substances that the syncrometer detected in the used pads.

- Scientists examined people’s hair before and after the application of detox foot pads. The difference in the amounts of toxins was clear.

- Japanese scientists have done intensive research on foot pads utilizing Thermography. They found out that the pads had the ability to enhance circulation and then detoxify the body.

- An investigation found that the cleansing foot pads raise the occurrence of alpha brain waves. These movements contributed to the recovery and relaxation procedure.

Keep one thing in mind. Avoid fake, cheap detox foot patches.

They typically have diminished quality or in some situations, contain dangerous chemicals. This is the main reason that a lot of people received an unsatisfactory outcome when using detox foot pads.

However when you use verified and researched items, the outcome is amazing. There are high standard foot detox patches that continue to show amazing results.

Then make an inventory of WHEN you light up more on the road. Is it a time-related urge? Or could it be associated with a place/event, such as when you’ve merged onto the highway or onto a certain road, stopped at a light or were caught in rush hour? Do you stop by the side of the road to make business notes and light up then too?

Driving usually increases tension in people; it demands that we concentrate, sit erect, that we remain flexible and quite alert. If you’re driving for long periods of time, then you know how tired you can feel after a six-hour drive. Tension makes us want to seek the comfort of a ‘relaxing’ smoke. Rush hour traffic calls on our reserves of patience and tests the best of us.

If you want to change the car triggers, first make the decision to not smoke in the car. Then have the car cleaned, outside, and more importantly, INSIDE. Remove the smoke film from inside the windows. Remove the smell of existing smoke that’s in there, as much as you can. Buy some vinyl cleaner that has a ‘new car smell’. Some even have that written on the label right under the product name. Vacuum the seats and carpeting.

If you have passengers, enlist their help by requesting that they not smoke in the car. Tell them you really want to quit this time and that driving is a tough moment in your smoking day.

Remove the lighter and ashtray. If you think you’ll want to sell your automobile eventually, then store those items where you can’t easily get to them.

Now you have an empty space where the ashtray used to be. You can insert a small container or plastic bag of mints, pretzels or hard candy, so that every time you automatically open the ashtray to reach for the lighter, you find something else instead, a reward. Another positive suggestion is to put coins in that space. Every time you reach for the lighter, take a coin. When you stop somewhere, use the coins to buy yourself a reward for not having smoked. This is an important re-enforcement of your progress.

Study your driving habits again. If you’re not a singer, then become one every single time the urge to smoke strikes you. Either bring a tape or listen to a radio station and try to sing along. This means singing out loud. Switch stations or turn off the radio when the urge passes, as an urge usually lasts about three minutes. If you have passengers and you’ve enlisted their help, they will encourage you and may even sing with you, making light and even finding humor in a tough moment. Humor reduces tension. Ever thought of bringing along a cassette or comedy CD to listen to in the car?

Did you once have a routine schedule, such as traveling for a few hours before stopping? How about deciding on a game plan before leaving home? You could take it one hour at a time or even less, for instance. By that, I mean, plan to change your driving habit behavior, by exiting the highway and stopping every hour at a restaurant or highway truck stop (where you can write up your business notes for example). At the first stop you must reward yourself (you must!) for having driven an hour smoke-free. Buy a souvenir or treat yourself to something, a tape for instance. If you don’t want to eat, you can walk around a block, or a building, and burn some calories by doing that. The point is to cut out your past routine and create a new one by planning reasonable, manageable segments, no matter how short they are. Mark the end of the segment in some satisfying way. After all, you just made it though a usually strong trigger!

Happy traveling!