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Main Forums => Living With HIV => Topic started by: WillyWump on September 17, 2010, 03:25:07 pm

Title: A Mixed Bag of Results...
Post by: WillyWump on September 17, 2010, 03:25:07 pm
Had my 3 month results today.


First the good -  CD4 is 689 (I'm comin for ya 700!), VL UD, 38%. Yay Me. Keep in mind that these labs were taken about a week before I had the mystery Illness and hospital stay, so Im sure My CD4's are now wrecked, albeit temporarily

The bad- seems my Kindney function is trending down and has been ever since Ive been on Prez/Nor/Tru (although this is the first I've heard of this). She says it's @ 70 (not sure what that is measuring), and while its not bad yet, if it continues to trend down into my next labs she is going to take me off the Truvada. Which sucks, as I adore my regimin, and I abhor change :( In the meantime she wants me to drink more water and see if that helps any.

The not so bad, but just annoying- My Testosterone is @80, this is after a year of treatment, first gel, then patches. When I started treatment I was @32 and Ive only risen to 80. Sooo she said I am going to have to go to injections, and she expects ME to give myself injections, it's either me self amdinster them or go downtown every 2 weeks. We'll see. However I'm not looking forward to the highs and lows of Test injections, and I know the effects will be noticable because even with the patches I get a high just after putting them on every day.

Also, got my Flu shot today (with the piggy flu repellant) , it hurt as usual. However on the upside, there's a  new male nurse "alex" who is very easy on the eyes, too bad nurses dont do Prostate exams, hmmpfff.

So with all this in my mind, I have a couple questions...

1. Any input/experience on the high of the testosterone injections and then the crash or low after it wears off so I can know what to expect?

1. If i have to get rid of the Truvada will the Prezista and Norvir have to go as well? Or can another drug merely take the place of my Truvada in my regimin?


Peace out

-Will
Title: Re: A Mixed Bag of Results...
Post by: Miss Philicia on September 17, 2010, 04:28:12 pm
1) I advise using a dildo during the highs when getting testosterone injections. You'll find mancunt too much work.  I'm not sure why your doctor is so fixated on getting this number to normal within a certain amount of time where you'd upgrade to injections.  I can understand this if you are having wasting issues, but you aren't.  What is his/her reasoning on this?

2) If they swap out Truvada most likely they'll try another NRTI there and keep the rest of the regimen, if at all possible. Not sure what the next best one is.
Title: Re: A Mixed Bag of Results...
Post by: numbersguy82 on September 17, 2010, 05:19:56 pm
Ok I can't offer any usable advice, but I'm glad to hear your numbers are so good :)

You can't switch your combo.... you are my regimin buddy... but if it helps overall I guess I will allow it. Btw now I'm going to make sure I'm drinking plenty of water which is something I'm usually bad at.
Title: Re: A Mixed Bag of Results...
Post by: eric48 on September 17, 2010, 05:22:15 pm
Hi,

Since I am a bit new to it, take the following with caution, but I have been looking into my options , just in case...

Truvada (tenofovir DF + emtricitabine, TDF + FTC)

I read somewhere that FTC has the same (or very similar) resistance profile as 3TC

on the resistance chart I have, TDF quite close to ABC (abacavir), so, depending on your resistance history, sounds like KIVEXA could be a substitute for truvada

I am on Kivexa, and If I needed a change, I would think the substitute would be Truvada. and vice versa...

Now, Truvada may affect your kidneys and Kivexa (because of ABC) may affect your liver.

ABC is not for everyone; you will need to take a genetic test first.

Also, the liver will have to be monitored closely... As you see ABC (hence Kivexa) has more IFs ; a recent study also said people like Truvada better.

IF, I underline IF, If you can take ABC, it has advantages of its own (saves your kidneys, goes more into the brain, lowers blood sugar and insulin resistance, increases HDL a bit)

because of the IFs, it is less popular than Truvada, but those who take it do not complain.

Since i take it, my blood sugar profile has improved so much so I will not have to take Metformin.   

Also, you will most likely have more BW than others (liver monitoring), which may mean more opportunities to  chat with 'alex' ;-)

Cheers

Eric

Title: Re: A Mixed Bag of Results...
Post by: Miss Philicia on September 17, 2010, 05:22:15 pm
Ok I can't offer any usable advice,

You're only 28 so just smile and look pretty sweetheart.
Title: Re: A Mixed Bag of Results...
Post by: numbersguy82 on September 17, 2010, 05:33:07 pm
You're only 28 so just smile and look pretty sweetheart.

I was leaning towards the I'm newly diagnosed... but your right why overcomplicate lol
Title: Re: A Mixed Bag of Results...
Post by: WillyWump on September 17, 2010, 05:50:59 pm
Ok I can't offer any usable advice, but I'm glad to hear your numbers are so good :)


Thanks Fatty! Arent they to die for!


-Will
Title: Re: A Mixed Bag of Results...
Post by: numbersguy82 on September 17, 2010, 05:56:37 pm
Thanks Fatty! Arent they to die for!

-Will

Ok I don't think you should use the term "To die for" in this instance, but yes they are great!

Title: Re: A Mixed Bag of Results...
Post by: WillyWump on September 17, 2010, 06:04:17 pm
1) I advise using a dildo during the highs when getting testosterone injections. You'll find mancunt too much work.  I'm not sure why your doctor is so fixated on getting this number to normal within a certain amount of time where you'd upgrade to injections.  I can understand this if you are having wasting issues, but you aren't.  What is his/her reasoning on this?


She wants my Biceps bigger obviously. oh and thanks for the sage advice on the dildo.

w
Title: Re: A Mixed Bag of Results...
Post by: Assurbanipal on September 17, 2010, 06:11:03 pm
If you have to dump Truvada I think the next option is usually Epzicom.  There's Combivir too, but people seem to take against AZT...

I'm on Prezista/Norvir/Epzicom and the Epzicom part is just as easy as Truvada was.  Prezista can be a hassle (the food .. the twice daily) but if you are already used to that, switching to Epzicom should be a non-event .

(... well almost a non-event.   ;D  Now that I think back on it the color of Epzicom was quite a shocker the first few mornings.  Truvada is this really nice calm blue and ... well you'll see.  No need for coffee!!   :o  )

Best...
A
Title: Re: A Mixed Bag of Results...
Post by: numbersguy82 on September 17, 2010, 06:26:57 pm
See look at that Willy you can keep your pudgy lil Norvir afterall
Title: Re: A Mixed Bag of Results...
Post by: newt on September 17, 2010, 08:18:47 pm
Hello Willy

I am assuming the the @70 refers to a measure of kidney function called glomerular filtration rate (GFR).

If it is not this, then you must get this test. Other measures are not reliable in this situation.

If it is, 70 would indicate mild renal impairment. See http://www.patient.co.uk/doctor/Assessing-Renal-Function.htm for a handy reference.

In cases of kidney dysfunction you can either swap out the Truvada for a non-tenofovir based nuke pair, eg Epzicom (abacavir/3TC) or a non-nuke drug like Isentress (raltegravir) (+/- 3TC).

Or, more complicated, you can reduce the dose of tenofovir eg do it every other day, twice a week. How to do this is, I believe, noted in the Summary of Product Characteristics (prescribing info) that comes with Truvada (or perhaps just with tenofovir alone?) or accessible on the web.

Your doc should check for non-ARV causes eg blood pressure, cardiovascular causes, for reduced kidney function.

Hope this helps.

- matt
Title: Re: A Mixed Bag of Results...
Post by: odyssey on September 17, 2010, 09:11:14 pm
Willy- buddy- pal-

The only advice I can give you here is regarding the testosterone injections. As you know, I'm a transguy, so I take testosterone injections because my body doesn't make its own testosterone. Anyway, I give myself a shot of 100 mg of T once a week. In the beginning the up and down was a bit noticeable, but eventually the level builds up in the body or something, because I don't notice any swings anymore. Most docs will usually recommend a shot biweekly or even once a month, but if you're concerned about highs and lows, ask to go more often. Yeah, its kind of annoying having to stick a needle in your leg more often, but it can pay off in terms of eliminating extremes in T levels. If you have any questions about shots or anything, feel free to shoot me a PM. Or for any other reason, lol.

Take care,
odyssey
Title: Re: A Mixed Bag of Results...
Post by: WillyWump on September 17, 2010, 09:19:38 pm
Thanks Newt, as usual your information is Golden.

The link you povided "assesing Renal function" is very informative. I am thinking that the test was a GFR because she got several values from my labs and then mentioned something about my weight and turned to a calculator to get a final value of 80, which it appears they are doing in your link. However I will confirm that it was indeed a GFR with her.

I will start reviewing Epizicom and Isentress and others in the meantime so I can discuss a change if in fact I continue the downward trend.

@Odyssey, thanks for the great info on T injections,  I'll be doing them bi-weekly starting monday. Ill shoot you a Pm if I have any questions on it.


-Will
Title: Re: A Mixed Bag of Results...
Post by: Miss Philicia on September 17, 2010, 09:29:38 pm
Oh yes, another word of warning on those injections -- watch yourself at work.  I became even nastier than normal, if that's possible, the first two year of injections so much that I got in trouble at work a couple times for unsavory conduct with co-workers/bosses.  And that was even with 2mg of klonopin per day.
Title: Re: A Mixed Bag of Results...
Post by: WillyWump on September 17, 2010, 09:36:35 pm
I became even nastier than normal, if that's possible,

No, it's absolutely not possible.

...and what kind of "unsavory" conduct? I'm assuming it involved Dildos, Poppers and Urine?

-Will
Title: Re: A Mixed Bag of Results...
Post by: Miss Philicia on September 17, 2010, 09:55:47 pm

...and what kind of "unsavory" conduct?

No silly, just run of the mill fighting and screaming matches.
Title: Re: A Mixed Bag of Results...
Post by: Jody on September 17, 2010, 09:57:50 pm
Willy...Good luck going forward if you must have a meds switch, I know that can be a bit of a bummer but I'm certain it will work out for you...Assub- regarding Prezista I take two 400 mg tablets once daily with one Norvir and one Truvada.  Previously it was twice daily for Prez and Norvir.  Thanks to you, Newt and others here for your always bright and educated advice, it means more than you can know.
 
Jody
Title: Re: A Mixed Bag of Results...
Post by: WillyWump on September 17, 2010, 10:46:16 pm
I was just going through my Lab orders for my next round of blood draws in 3 months...

I saw something new...It's called "Histocompatibility (HLA) request". I googled this test and found that it is used  for "The primary use for HLA testing is to match organ and tissue transplant recipients with compatible donors"

http://www.labtestsonline.org/understanding/analytes/hla_testing/test.html#when

Why the HELL is she ordering a test to check on Organ donor compatibility???? Is she not telling me something?

Has anyone else ran across this test? Any Ideas?

Someone's getting a call bright and early Monday morning.

-W
Title: Re: A Mixed Bag of Results...
Post by: Jeff G on September 17, 2010, 11:45:20 pm
I was just going through my Lab orders for my next round of blood draws in 3 months...

I saw something new...It's called "Histocompatibility (HLA) request". I googled this test and found that it is used  for "The primary use for HLA testing is to match organ and tissue transplant recipients with compatible donors"

http://www.labtestsonline.org/understanding/analytes/hla_testing/test.html#when

Why the HELL is she ordering a test to check on Organ donor compatibility???? Is she not telling me something?

Has anyone else ran across this test? Any Ideas?















Someone's getting a call bright and early Monday morning.

-W



Hellraiser had it arranged in case he needs a new arm .
Title: Re: A Mixed Bag of Results...
Post by: Hellraiser on September 18, 2010, 02:32:03 am


Hellraiser had it arranged in case he needs a new arm .

I wanted his kidneys too but now that I see they're only functioning at 70% I'll pass...How's your liver?
Title: Re: A Mixed Bag of Results...
Post by: newt on September 18, 2010, 06:16:41 am
The HLA order is probably for the HLA B*5701 test which is used to see if you are likely to be allergic to abacavir.
Title: Re: A Mixed Bag of Results...
Post by: WillyWump on September 18, 2010, 09:11:23 am


Hellraiser had it arranged in case he needs a new arm .

I suspected 'Raiser was behind this somehow, already arranging a swap meet on my pieces and parts. Well I got news for ya Trey, There's no clearance sale on my body parts....at least not yet.

Thanks Newt for the info.

-Will
Title: Re: A Mixed Bag of Results...
Post by: Hellraiser on September 18, 2010, 11:20:44 am
I suspected 'Raiser was behind this somehow, already arranging a swap meet on my pieces and parts. Well I got news for ya Trey, There's no clearance sale on my body parts....at least not yet.

Thanks Newt for the info.

-Will

I already own the most important part.  Although it is rather smaller than one might have desired.
Title: Re: A Mixed Bag of Results...
Post by: pozniceguy on September 18, 2010, 12:19:41 pm
Hi Will  i am also on the once a day routine with  prezista,Norvir and Epzicom  been easy and no complications for over a year now,  just  have a small snack before bed  take pills and forget about it til bed time next day


good luck  with whatever changes you may make...  the T stuff can be tricky  lots of different reactions among different people...


Nick
Title: Re: A Mixed Bag of Results...
Post by: skeebo1969 on September 18, 2010, 12:28:15 pm



    I've been away for a few days and seemed to have missed a lot.  Sorry you lost your arm Willy.
Title: Re: A Mixed Bag of Results...
Post by: Rev. Moon on September 18, 2010, 12:35:29 pm


    I've been away for a few days and seemed to have missed a lot.  Sorry you lost your arm Willy.

Twasn't the arm, it was the cheeto.  La Trey keeps it in a jar by his bed.
Title: Re: A Mixed Bag of Results...
Post by: WillyWump on September 18, 2010, 11:05:36 pm
Although it is rather smaller than one might have desired.

that's not what yo momma said.

Title: Re: A Mixed Bag of Results...
Post by: aztecan on September 19, 2010, 12:27:04 am
Hey Willy,

Keep drinking plenty of water. Back in the old days, they told me to drink at least 64 ounces a day.

Of course, that was while I was taking Crixivan.

I still drink lots of water. I just feel better.

Hang in there youngun.

HUGS,

Mark

Title: Re: A Mixed Bag of Results...
Post by: tednlou2 on September 19, 2010, 02:13:39 am
I already own the most important part.  Although it is rather smaller than one might have desired.

Although Texas is a huge state, it isn't extremely far from Miss and Louisiana.  Have you guys had a booty call?
Title: Re: A Mixed Bag of Results...
Post by: Snowangel on September 19, 2010, 02:33:19 am
Hi Will-
I was just wondering how you like your current meds?  I just got switched to the same combo about a month ago and I am looking forward to see how my labs turn out. They took me off Atripla and I feel better than I felt in years, bathroom and nausea wise, but still feel fatigued.

I have to try to drink more water.  I think I have a fear of not having a bathroom nearby.

I still can't believe how bright the Prezista are, goes kind of nice with the blue. Reminds me of a funky go-go print.
Title: Re: A Mixed Bag of Results...
Post by: WillyWump on September 19, 2010, 10:51:03 am
@ My Marky - It was suggested that I cut back on the coffee and tea (Blasphemy!) and drink 8oz of water an hour, which is not as easy as it sounds, I feel like Im gonna float away, I had to get up twice to pee-pee last night. Water is so boring. But if it helps my Kidneys then I'm all for it.

But my GFR reading of 70 means I have mild Kidney impairment, which is very worrisome to me, I'm wondering If I should go ahead and make a switch from Truvada rather than waiting another 3 months as the doctor wants??? I also wonder if my Kidney fucntion declines further is it something that is permanent? or can I regain fucntion? See all these questions that I forget to ask when Im sitting in front of the Doc.*sigh*

@ Snowangel- I LOVE my Tru/Prez/Nor regimin, but of course it looks like the Truvada is doing a number on my Kidneys, apparently Im one of the few that has this happen. Doesnt mean it will happen to you, but jsut make sure your doc monitors your kidney fucntion (GFR) on every lab. AND drink lots of water. My CD4's and VL have been spectacualr on the regimin.  And yes I love the funky colors, I feel so patriotic when I take them, cause it kinda looks like a funky red/white and blue.


@Tedderz - I dont booty call with one armed cajuns (which 'Rasier will soon be if he doesnt go to the Dr.)

-Will
Title: Re: A Mixed Bag of Results...
Post by: newt on September 19, 2010, 04:47:59 pm
Any decline of kidney function from Truvada (well, tenofovir specifically) is likely to be reversible. Might take some time but should reverse. - matt
Title: Re: A Mixed Bag of Results...
Post by: WillyWump on September 19, 2010, 07:50:10 pm
Any decline of kidney function from Truvada (well, tenofovir specifically) is likely to be reversible. Might take some time but should reverse. - matt

Thanks Newt, I can sleep better tonight :)

-Will
Title: Re: A Mixed Bag of Results...
Post by: aztecan on September 19, 2010, 09:56:25 pm
Hey Will,

Generally , A GFR of 30 or less is when it gets serious. That is generally when you will be referred to a nephrologist.

So, 70 isn't horrible and, as Newt said, if caused by the Truvada, it most likely will reverse itself.

Oh, by the way, the standard rule of thumb is to drink two 8oz glasses of water for each cup of coffee you drink, or glass of tea, or soft drink.

Sooooo, get out your yellow hanky honey and let it fly!

I had better stop now, because my mind is taking me places I shouldn't go, well, not with others watching at least.  ;)

HUGS,

Mark
Title: Re: A Mixed Bag of Results...
Post by: tednlou2 on September 19, 2010, 10:24:28 pm

@Tedderz - I dont booty call with one armed cajuns (which 'Rasier will soon be if he doesnt go to the Dr.)

-Will

I know.  I saw your post about his not answering texts.  I hope all is okay with him.  I'm sure it is and he's just busy.  Of course, it could get a little freaky in bed with the nub.  That is only funny if all is okay with him.
Title: Re: A Mixed Bag of Results...
Post by: Hellraiser on September 19, 2010, 10:25:41 pm
I had better stop now, because my mind is taking me places I shouldn't go, well, not with others watching at least.  ;)

HUGS,

Mark


It's always more fun when people are watching I've found.