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Main Forums => Living With HIV => Topic started by: John2038 on August 15, 2011, 02:24:51 pm

Title: How long time max have you been without doing labs ?
Post by: John2038 on August 15, 2011, 02:24:51 pm
Hi,

No labs since 14 months (various reasons) ! This is a very bad idea so, for the newbies, don't even think about doing that (risk of multi-classes resistances, late complications diagnosis, etc.).

But I'm going to have one this month.

I was wondering how long max have you stay out of labs .. and what was the result ?

Cheers
Title: Re: How long time max have you been without doing labs ?
Post by: spacebarsux on August 15, 2011, 02:48:15 pm
I am fairly certain I was infected in 2005 or very early 2006. I was diagnosed in jan 2011. So that's at least 5 years.  

My blissful ignorance could have had very bad results but it didn't, luckily.
Title: Re: How long time max have you been without doing labs ?
Post by: emeraldize on August 15, 2011, 02:55:51 pm
Hey John,

That's one thing I've not messed with --- I may have strayed a month or so out on quarterlies, but very infrequently.

Where I negotiate is length of time between visits. If there's no negative change in blood results or how I feel, I go for as few visits as possible. Generally, once every six months and even longer if I can have my way!!

I'm now of the belief that every six months might be okay for me for bloodwork and that may be my next request.

Em
Title: Re: How long time max have you been without doing labs ?
Post by: karry on August 15, 2011, 03:19:43 pm
every three months
karry
Title: Re: How long time max have you been without doing labs ?
Post by: buginme2 on August 15, 2011, 03:34:17 pm
It depends if your stable on medication or not.  In the begining I went every three months.  Now that I am undetectable and my blood tests have stabilized my dr says I can go every 6 months. 

You say its been 14 months but you don't say if your on meds or what your numbers are (or were).  It depends on your situation.
Title: Re: How long time max have you been without doing labs ?
Post by: Miss Philicia on August 15, 2011, 03:39:54 pm

You say its been 14 months but you don't say if your on meds or what your numbers are (or were).  It depends on your situation.


Regardless of being on meds or not, you're not going to find a doctor that recommends monitoring any less than six months.

This is a very bad idea so, for the newbies,

Uh, no -- it's not a "newbie" issue, it's not recommended for any patient no matter how many imaginary "various reasons" you may have.
Title: Re: How long time max have you been without doing labs ?
Post by: buginme2 on August 15, 2011, 06:39:30 pm
Regardless of being on meds or not, you're not going to find a doctor that recommends monitoring any less than six months.



You're right.  I'm not sure where I was going with that.  Get your ass to the doctor John.   ;D

Title: Re: How long time max have you been without doing labs ?
Post by: Nestor on August 15, 2011, 09:18:14 pm

Every three months with two exceptions. 

First, when I was newly diagnosed.  I got labs as soon as possible, and was supposed to get more labs a month later.  But for the next nine or ten months, I had to cancel every appointment because of work.  I was a substitute teacher in those days, and every time I had labs scheduled my school would call at the last minute and ask me to come in and substitute for someone, and I was far too poor to consider turning down work.  Plus, I was going through an "I just want to forget the fact that I have HIV" phase--a reaction against an earlier phase of being obsessed with HIV and thinking or reading about it non-stop.  I think, too, that I felt secure because of my first test results: with more than 700 t-cells and a low VL, it seemed unlikely that I was doing anything suicidal by delaying the next set of labs.  Of course those first results could have been a fluke, or I could have been progressing really fast, and I was lucky they weren't and I wasn't. 

Secondly, just this year.  I took a five-month back-packing trip in Asia from the end of December until the end of May.  I had my last set of labs before leaving at the end of November, and then one, almost as soon as I got back home, at the beginning of June.  I actually discussed this with my doctor before I left and she said that going six months without labs was unlikely to be a problem in this case. 

Title: Re: How long time max have you been without doing labs ?
Post by: phildinftlaudy on August 15, 2011, 09:26:40 pm
Three months is the longest for me -
Although at last visit with doc I asked about going to every 4 -
She said she would like to have me come every 6 - but not until the syphilis issue is resolved and my triglycerides are where they need to be.
Title: Re: How long time max have you been without doing labs ?
Post by: John2038 on August 16, 2011, 04:24:48 pm
Thank you everyone.

For info, last lab was something like cd4 900 UD 2 yrs. On atripla, never missed a dose.
Not sure what will be the results this month. Now if the meds keeps their promises, should be fine.
If so, every 6 months or less. But not more: not a good idea at all.. (despite I will have enjoy this fake sens of freedom) :)
Title: Re: How long time max have you been without doing labs ?
Post by: OneTampa on August 16, 2011, 10:06:23 pm
I go in every 6 months.
Title: Re: How long time max have you been without doing labs ?
Post by: weasel on August 17, 2011, 04:25:28 pm


                  I get LABS  done every three months .

                 I have NOT SEEN A    I.D. DOCTOR    SINCE OCTOBER !

                needless to say I am not too thrilled with the Saint Louis V.A.  system at the moment !

                  Over booking causes cancellations   and " THEY "   feel   I am doing  OK !

               I  am  CRASHING THE CLINIC  WHEN I GET BACK FROM  SEATTLE    :o

                There policy is to send LAB results   to my  home ! 

               But i have NEVER  seen one !     I have had a doctor in the past say   "   get back here now "

                 WE  live  127 miles from the V.A.   !   If I spend the day there , then getting a phone

              call to return ASAP  should   NOT be  unnecessary !   


             I just pray I am going good , Cause really at this stage I do NOT know    >:(


                                                                Weasel
Title: Re: How long time max have you been without doing labs ?
Post by: Hellraiser on August 17, 2011, 06:12:55 pm
Six months.
Title: Re: How long time max have you been without doing labs ?
Post by: aliveinla on August 19, 2011, 10:12:05 pm
Funny I was wondering about the same thing. It has been 10 months for me since the last test. I just went in 2 weeks ago to get my blood taken then scheduled to see my ID doc. His receptionist actually refused to take me w/o a new insurance referal from my PCP so i went ahead and got one. Going to see him next Thursday.

My ID doc is (a certain race). No offense, but I think he wants to make more money off me rather than caring about my health. He wants me to go test every 2 months and see him each time! Even though i was on meds and UD, everying was normal, for almost 3 years now.

Going to see him is a torture: he was never on time so I had to wait 1-2 hours sometimes 3, even I tried to schedule my appointment as the first one in the morning. Weirdly, he doesn't allow me to see my own chart, during those 3 hours he kept me waiting. He doesn't have emails, so I had to call and put on hold each time when I make appointments with his (edited out a certain minority) receptionist whose English is worse than mine. He is so judgemental that I stopped telling him the truth of how many men I have been with. Each time he only spends about 10 minutes with me, and apparently he had never seen my numbers until he got in the room and grabbed the chart, which was in the pocket outside the patient door that I am not allowed to access...

Is it a (edited to: that certain race) thing or is it just I got a bad doctor under my HMO? Why does he have to see me if I had no abnormal numbers? Why can't he just email me my numbers and let's both get on with our lives?

Title: Re: How long time max have you been without doing labs ?
Post by: buginme2 on August 19, 2011, 10:43:15 pm
Aliveinla:  you are a FOOL!  Did you really just make a Jewish comment on here?   
Title: Re: How long time max have you been without doing labs ?
Post by: Rev. Moon on August 20, 2011, 12:27:56 am

My ID doc is jewish. No offense, but I think he wants to make more money off me rather than caring about my health. He wants me to go test every 2 months and see him each time! Even though i was on meds and UD, everying was normal, for 2 almost years now.

Going to see him is a torture: he was never on time so I had to wait 1-2 hours sometimes 3, even I tried to schedule my appointment as the first one in the morning. Weirdly, he doesn't allow me to see my own chart, during those 3 hours he kept me waiting. He doesn't have emails, so I had to call and put on hold each time when I make appointments with his Latino receptionist whose English is worse than mine. 

Is it a jewish thing or is it just I got a bad doctor under my HMO? 

 ::)

Aliveinla:  you are a FOOL!  Did you really just make a Jewish comment on here?   

Girl, and never mind the fact that he did it twice.  Oh, and let us not ignore the gratuitous comment on the Latino bitch of a receptionist with her thick accent.  Some heads are just interesting, to say the least.

If I recall correctly, aliveinLA is "some sort of AZN"... I would expect this BS from some sock-wearing-nudist-meth-heads who pretend to be neg bug chasers in Fag Lawdergayle.

Title: Re: How long time max have you been without doing labs ?
Post by: GSOgymrat on August 20, 2011, 12:31:26 am
Aliveinla,

- I don't see why you would need to have labs every 2 months, or even see an ID doc, if you have been undetectable and stable for 2 years.

- A responsible physician will not allow you to just peruse your chart while you wait.

- If you don't like your physician, for whatever reason, just find a different one. If you can't trust him and be forthright he can't help you.

- Emailing confidential medical information is inviting a lawsuit.

- Contact your HMO to obtain a list of in-network physicians and then look online for red flags and ask your ASO for recommendations that are on your list. You live in a huge metropolitan area with lots of resources.
Title: Re: How long time max have you been without doing labs ?
Post by: Miss Philicia on August 20, 2011, 01:10:37 am

If I recall correctly, aliveinLA is "some sort of AZN"...

Chinese
Title: Re: How long time max have you been without doing labs ?
Post by: aliveinla on August 20, 2011, 01:48:39 am
Thanks for the clarification. I guess I somewhat misunderstood my doctor. Had never seen any regular doctor before, even not my PCP, so I'm still getting used to American medical system.

BTW, I have a good friend who is (xxx race), and we kept joking about each other's background so some of my comments might have slipped out and I apologize if i have offended anyone. I will go back and edit that out but can't take those already being quoted.

You guys all have fun...

Aliveinla,

- I don't see why you would need to have labs every 2 months, or even see an ID doc, if you have been undetectable and stable for 2 years.

- A responsible physician will not allow you to just peruse your chart while you wait.

- If you don't like your physician, for whatever reason, just find a different one. If you can't trust him and be forthright he can't help you.

- Emailing confidential medical information is inviting a lawsuit.

- Contact your HMO to obtain a list of in-network physicians and then look online for red flags and ask your ASO for recommendations that are on your list. You live in a huge metropolitan area with lots of resources.
Title: Re: How long time max have you been without doing labs ?
Post by: elf on August 20, 2011, 07:00:04 am
Here in Croatia, the max. time is 5 months, and we're given medication for 5 months in advance...
but if you work in another country, or travel the world (yes, there are many HIV+ sailors),
you go to see your HIV doctor every 12 months (and they give you meds for 12 months).

For people who are not on meds, the usual checkup is every 1-2 months.
Title: Re: How long time max have you been without doing labs ?
Post by: newt on August 20, 2011, 07:30:28 am
Quote
Regardless of being on meds or not, you're not going to find a doctor that recommends monitoring any less than six months.

Well don't know about that, we have a fair few people on annual meds at my clinic, but they's all on meds and have been a long time and doing very well. This is something dicussed between doctor and patient.

Quote
Emailing confidential medical information is inviting a lawsuit.

My clinic is just starting an email results service. This seems modern, if acceptable and chosen by the patient.

I see my doc once a year and go for labs 3 times a year, once for everything including CD4 count before seeing doc, twice just for viral load, liver, kidney and albumin. My meds get delivered, and I am joining the email results service asap (currently get them by phone). But the year before I started treatment, I was doing labs/seeing doc once every two months, and immediately after, once a month for 6 months. Depends where you are in your clinical journey.

- matt
Title: Re: How long time max have you been without doing labs ?
Post by: Assurbanipal on August 20, 2011, 07:41:19 am
I've started to stretch out the period between labs from 3 months to 4 months twice (and then the plan was to eventually extend to 6 months).  Both times something has come up in the lab work to reverse the decision.  The first time was about the trend in cholesterol levels, the second was a persistent low level viral load.  But things have been stable this past year so I'm trying it again -- hoping third time is a charm.
Title: Re: How long time max have you been without doing labs ?
Post by: Hoover on August 20, 2011, 05:04:23 pm
Here in Costa Rica, if you are on the national insurance, we go every 6 months after reaching undetectable.
Unlike Elf, who can get several months supply of meds, we must go every damn month to the capital city no matter how far away we live. It is a small country but driving 3 hours over there and 3 hours back is not fun. There are others who must longer distances..... The price of free meds. ???

Hoover
Title: Re: How long time max have you been without doing labs ?
Post by: Rev. Moon on August 20, 2011, 05:10:10 pm
I wouldn't mind driving to say Orlando or Ocala to get free meds.  It would be like a monthly HIV road trip.
Title: Re: How long time max have you been without doing labs ?
Post by: Zohar on August 20, 2011, 05:53:55 pm
Regardless of being on meds or not, you're not going to find a doctor that recommends monitoring any less than six months.

Uh, no -- it's not a "newbie" issue, it's not recommended for any patient no matter how many imaginary "various reasons" you may have.

This might be true in your region/country but it's not for everywhere since my doctor mentioned annual monitoring during my last consultation.
Title: Re: How long time max have you been without doing labs ?
Post by: Miss Philicia on August 20, 2011, 06:21:59 pm
This might be true in your region/country but it's not for everywhere since my doctor mentioned annual monitoring during my last consultation.

Correct me if I'm incorrect, but aren't you a patient who has been altering the normal dosing of their HIV medications?

And just in a July 12th post of yours you stated you were seeing you doctor again "in a couple of months" so I'm confused by this post.
Title: Re: How long time max have you been without doing labs ?
Post by: MitchMiller on August 26, 2011, 12:36:31 am
Been 3.5 years... taking epivir, ziagen, efavirenz now for almost 8.5 years and 99% adherent, so not concerned.   Previous doc said I could probably stay on the regimen for the rest of my time here, so long as I was nearly 100% adherent.
Title: Re: How long time max have you been without doing labs ?
Post by: buginme2 on August 26, 2011, 06:14:44 am
Been 3.5 years... taking epivir, ziagen, efavirenz now for almost 8.5 years and 99% adherent, so not concerned.   Previous doc said I could probably stay on the regimen for the rest of my time here, so long as I was nearly 100% adherent.
Mitch, I have some questions, do you mean you havent have any labs done in the las 3 1/2 years?

Why?
How do you know your regimen is still working?
What does your Dr. think?
Is your Dr, still prescribing your meds without doing lab work?
You cant be in the US, I cant imagine any doc writing a prescription for medication without doing lab work.
Title: Re: How long time max have you been without doing labs ?
Post by: Since2005 on August 26, 2011, 12:55:41 pm
Sorry offtopic..

Hey Buginme, since we are friends again :), I was wondering you could tell us if you are  in HR or from any kinds of medical profession as you seem to write a lots about benefits, treatments etc., just a curiosity.

On topic..

Question for Mitch - Even I am not from a medical profession, I have to ask if you did not have any major issues or concerns ( not justifying mine which is 6.5 years..) then why would not go to doc for 3 years? Just for hack of it or if you had other issues that we are not aware of? You dont have to share just wondering..

Personal opinion, if you are steady with your situation, then 3/4 months is good enough time in between labs and if you really steady ( LTNP. very steady with meds...) I would go the most 6 months laps between lab works and that's what  ( 3-6 months) I am planing do since I have started my medical process. I guess, answer is 3-6 months gap is okay depending on your med stats.
Title: Re: How long time max have you been without doing labs ?
Post by: MitchMiller on August 26, 2011, 10:22:29 pm
The story behind my case is that I went to work for a very small company.  To protect my employment, I opted out of health care coverage.  Some may think that was crazy, but I'm still employed while 70% of the company's employees have been laid off.  I can only assume I would have quickly been given the boot once the company figured out who caused their insurance rates to go through the roof.  I make a lot of $$$ at this job and if my health holds out, I will be one of the lucky ones that can retire... and retire early  - my dream :).  

My company has recently "transferred" my employment to a much larger company that is self-insured (part of a business agreement).  Since I cannot bill anyway for 18months due to the pre-existing condition clause and I don't want this co. to know my status, I'll just continue as is.  At least now I'm covered if I break a leg !!  I opted for the cheap-o high deductable plan.

I use an Indian pharmacy that charges only about $215/month total, for the cost of my meds.  Been on generics for 7.5 years now.   Based on studies published over the past three years on viral failure, the percent is really low if you've been undetectable for over three years and are 100% adherent.  

I went to a doc after I started work at the small co. a couple times, paying out of pocket, but he could never quote me a price for labs.  I refuse to obligate myself to pay for something with an unknown price.  I've read horror stories on this forum where some were billed well over $1000 for their labs.  One guy stated he was paying nearly $24K/year for his HIV treatment out of pocket!!  At that rate, I've saved about $75K!!!

Wouldn't recommend my course of action to others, but until I encounter a health problem, will just maintain the status quo.  My biggest fear is a Republican/Big Pharma endorsed dragnet to stop all foreign meds coming into the US.
Title: Re: How long time max have you been without doing labs ?
Post by: buginme2 on August 26, 2011, 11:06:29 pm
Thanks Mitch I didn't mean to pry, your explanation makes sense. 

I can attest that lab work indeed cost about $1000.  The clinic I go to charges just under $1000 for a cd4, viral load, cbc, and liver/kidney function.  Then they charge $400 to see the doctor.  My insurance requires I pay a portion but I have often wondered what I would do if I had an insurance lapse.

I have ordered viraday from a pharmacy in India (since I take Atripla and wanted to build up a 30 day extra supply incase something prevented me from getting my script filled ie hurricane , earthquake, a strike at Gilead).  I was amazed at how remarkably easy it was. 
Title: Re: How long time max have you been without doing labs ?
Post by: J.R.E. on August 27, 2011, 12:55:48 am

"How long time max have you been without doing labs ?"

Since 2003, no longer than 3 months between labs.  Prior to that, too many years without labs, and the result was not good.

Ray
Title: Re: How long time max have you been without doing labs ?
Post by: Ann on August 27, 2011, 09:46:01 am

My biggest fear is a Republican/Big Pharma endorsed dragnet to stop all foreign meds coming into the US.


Mitch, have you seen this thread (http://forums.poz.com/index.php?topic=37566.0)?
Title: Re: How long time max have you been without doing labs ?
Post by: Since2005 on August 27, 2011, 08:57:16 pm
Thanks Mitch for sharing. You would be another reason why USA needed the healthcare reform!
Title: Re: How long time max have you been without doing labs ?
Post by: RapidRod on August 27, 2011, 11:51:09 pm
Just was put on every 6 months.
Title: Re: How long time max have you been without doing labs ?
Post by: Miss Philicia on August 28, 2011, 01:36:57 pm
Some of the decision making processes here never fail to astound me.