Readers’ Forum
Positively Aware will
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Positively Aware,
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Chicago, IL 60640-1405
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Subjects:
Grapefruit
juice
Hep C attitude
Moving cheeks
Insurance nightmare
Help for diarrhea
It’s still not safe
A Lad and His Dog
Ask The Buzz
Grapefruit
juice
Editor’s Note: In
the Medicine Chest
for July/August, I mistakenly edited the article to say that
grapefruit juice decreases the absorption of non-nukes and
protease inhibitors. My apologies to the author, Glen Pietrandoni,
a fine pharmacist and a fine writer. He says that, “In most
cases, grapefruit is an inhibitor, like Norvir. It will usually
raise the level of the drug.”—Enid Vázquez
Hep
C attitude
Editor’s Note: Sylvia
O’Shaughnessy wrote about her battle with hepatitis C in the
July/August issue (Positive
Empowerment). Good news: after three months of treatment,
her hep C viral load was undetectable, and was still undetectable
after six months, despite having type 1 hep C (which normally
has a lower response rate). Her HIV viral load is down, too,
so her doctor, Todd Hargan, thinks the hepatitis treatment
is doing something for her HIV, as well. Because she’s doing
well. and side effects are infrequent and weak, he’ll keep
her on the year’s course of treatment, which is standard for
genotype 1—EV.
Moving
cheeks
Editor’s Note: Writers to
the (HIV) Lipidlist e-mail listserve gave us permission to
reprint items regarding our article “New-Fill
for an Old Face” (May/June 2002).
I was glad to see your cautious
comments in a letter
to the editor in [the July/August] Positively Aware, responding
to Jeff Berry’s article on his New-Fill experience. That article
was far too positive in my opinion. I haven’t seen Jeff since
he finished his treatment, but I went to the same doctor with
mild facial lipoatrophy with no results that lasted longer
than three weeks (post-op swelling made the face look full
for a while). Another person who works with Jeff told me that
after six treatments with that doctor, he had no results that
lasted longer than six weeks and is looking into collagen
injections. Collagen also yields short-term results, as we
know. In your letter to the editor you mentioned going to
Tijuana and being very happy with your polyacrylamide treatment.
I’ve been to the facial wasting website several times and
have not seen any before and long-term after photos for this
treatment. I know there is now eight years of experience with
the product.
Name withheld
I would not waste my money
on collagen. The results dissipate too quickly. I am happy
with the BioAlcamid (polyacrylamide gel) I got in Tijuana
with Anna Love (she is a technician, not a doctor). The beauty
of this product is that any excess can be extracted. It feels
just like your flesh and is as permanent as silicone. I had
a mild case of facial wasting, so my pics are not that impressive.
It was nice to run into people in South Beach last week who
said I looked “younger” and wanted to know what I had done.
My friend and volunteer Ellen Hahn had a severe case. You
can see her pics at www.houstonbuyersclub.com.
Nelson Vergel
The author responds: Not
everyone sees the same results from New-Fill, a point which
had been covered in previous articles. However, I did mention
not to expect miracles, results are not guaranteed, and it’s
not for everybody. I know of some people who have had great
success with New-Fill, and others who have seen no improvement
whatsoever. I have seen some improvement in myself, which
to me has meant a great deal.—Jeff Berry
Insurance
nightmare
For nearly nine years I have
been a fanatic about taking my medications on time and without
ever missing any. I am super organized with a detailed list
of medications by name, manufacturer, strength, dosage, and
the number assigned to me by my pharmacy. When I moved, the
local druggists were purveyors of more gossip than good advice.
Then I found Statscript. All went well for nearly two years.
Then they started running
late. Oh, the stories I heard: Medicaid/Medicare changed the
rules, Medicare wouldn’t approve the liquid form (they did),
the doctor was late with refill approval, I screwed up by
getting diabetes medication not approved by Medicare (not
really so). I missed a day, then two days, three. The manager
of the local Statscript told me I was too difficult, too demanding,
too un-understanding. I went to Chronimed. They wanted details;
I refused at first. I finally revealed all (not my style).
Suddenly everything they told me couldn’t happen did. I got
all my medications on one day—except for the one they forgot
to include in the package and the one the doctor hadn’t approved
because he had “no record” of my existence! I told Chronimed
I would give it another month. Stupid. Right back to arrogance
and excuses and whines and groans.
My physician was livid and
said I should not tolerate missing a dose for any reason.
Chronimed wouldn’t tell me their opinion on missing doses.
They did tell me the problem was Medicare/Medicaid’s. So,
next time you write about missing doses, know there are other
reasons for this. I’ve taken action to help protect myself
in the future. Chronimed talks a good story; so does my local
Statscript manager. Neither will work with [me]. With no reasonable
communication, there is little hope for success. The nurses
and others at my doctor’s very large practice have had similar
experiences. I’ve been lucky and I’ve worked hard. I didn’t
expect this! Just thought you’d like to know.
Name withheld,
via the Internet
Editor’s Note: Thank you
for your story. There must be a thousand ways that all the
insurors, private and public, in all the different towns,
cities and states, can mess up your meds. People here had
some advice: Don’t wait until the last minute to get your
prescriptions filled (you probably didn’t).—EV
Help
for diarrhea
I have had severe diarrhea
for more than two years and my doctor recently told me to
try a new product. The maker of Imodium has created a product
called Probiotica, sold over the counter as chewable tabs
(60 for $15.99 at my pharmacy). It replaces the lost healthy
bacteria that is destroyed in our colon by taking medication.
It only took a matter of a few days and my severe diarrhea
stopped. I still have minor problems, but I am so much better
and having the diarrhea stopped has helped me gain weight
and feel and look better. I hope this information helps.
Name withheld,
via the Internet
It’s
still not safe
I just spent the past two
weeks in Barcelona working at the International AIDS conference.
There was a lot of sobering news about AIDS. The bottom line
is that things are getting worse. Scientists are now saying
that AIDS will kill 70 million people over the next 20 years,
and that we’ve yet to reach the peak of the epidemic. In other
sobering news, The New York Times reported on a study released
at the conference showing that of 5,719 gay and bisexual men,
a full 77% of those testing positive did not know that they
were infected [See “Perceived
Safety Intenifies Danger for Gay and Bisexual Men” in
this issue]. The figures were even worse for young black men.
Folks, the younger generation is not getting the word about
this plague (and some of the older folks are forgetting, thinking
the worst is past). Everybody, get tested. And if you have
any friends who think it’s safe to play without a condom,
yell at ‘em, because it’s not.
Name withheld,
via the Internet
A
Lad and His Dog
Editor’s Note: The following
letter was inadvertently dropped from a previous Readers Forum.
While Carlos Perez’s article
[Positively
Aware May/June 2002] offers an interesting chronology
of his personal battle with HIV, it hardly serves as a model
for responsible pet ownership. Pets, of any kind, are not
there merely to console us, provide companionship at our convenience,
or “decrease [our] risk factors.” Instead, they require ongoing
attention and care, particularly a Pit-Bull like Dickie. To
leave a dog locked in his crate for 24 hours without food,
water, or bio-breaks—as Mr. Perez did while he drank himself
into an alcoholic “stupor”—constitutes animal neglect and
cruelty. As the owners of three German Shepherd Dogs, my partner
of 10 years and I structure our lives in such a manner so
as to ensure the needs of our beloved dogs are met. After
all, when one accepts responsibility for any living being—human
or otherwise—part of that responsibility often includes personal
and financial sacrifice. While I highly recommend pet ownership—for
the joy and unconditional love a pet offers is a rare gift,
indeed—before you make the decision to bring an animal into
your life, make certain you are physically, emotionally, and
financially fit enough to provide for your pet. Please, don’t
waste an animal’s precious love and devotion, as Mr. Perez
seems to have done, simply as a means to console yourself.
Instead, adopt a pet because you are mature and stable enough
to provide a loving, nurturing environment for an animal in
need...for those of you who are and do, the rewards you’ll
receive, in this life and the next, will be immeasurable.
Name withheld,
Chicago
The author responds: “A
Lad and His Dog” is an article about somebody so depressed
by HIV that they are suicidal; about how some HIV-positive
people can’t take care of themselves because of their depression.
It’s an article about how having a dog can lift a person’s
outlook and help them change their lifestyle and become well
again. The reader was obviously completely unaware of what
the article was all about. Incredible!—CP
Ask
The Buzz
Upon my last visit to my
primary care physician, I discovered that my triglyceride
count was 510. He said that this was caused by Sustiva and
my immune system improving (my CD4 count was 1,063). He prescribed
10 mg once a day of Lipitor and said that he’ll double that
dosage in September. He also suggested eating less red meat.
Of course, I’m still supposed to keep my weight up. I don’t
get it. How should I prioritize this? Is it more important
to keep my weight up (I’m 6’2 and weigh 165 pounds, the most
I’ve ever weighed—negative or positive), watch what I eat,
or can Lipitor take care of the problem? And let’s not forget
that I’m not on disability and am trying to work while juggling
all these balls. I would appreciate some advice.
Name withheld,
via the Internet
Dr. Dan Berger replies:
Your triglyceride level does not seem terrible. I would like
to know if cholesterol is also elevated, though. It may be
that the Lipitor may in fact take care of what appears to
sound like a mild problem. Also, it is not clear that the
10 mg of Lipitor may absolutely need increasing; this depends
on your lipid levels after treatment with 10 mg and whatever
improvement can result from some dietary management. Watching
diet by way of reducing some fat may not necessarily lead
to your losing weight. All you may need to do is monitor your
calorie intake and have a nutritionist calculate your requirements
for maintaining your weight. Also, it is not the absolute
weight that is the most important, but your lean body mass.
I don’t know if you’ve had a body composition test done, but
an experienced dietician or nutritionist can also test for
that, if your physician is not able to. Anyhow, it would be
a good idea to have a nutritionist monitor you and help you
through these hoops. Thanks for writing me.
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