POZ Community Forums
Main Forums => Living With HIV => Topic started by: blondbeauty on July 25, 2006, 03:31:59 pm
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See this answer in thebody website. Dr young always talks about a normal lifespan. Here, Dr. Whol talks about 13 years... :'(
From now on I will only listen to Dr. Young.
http://www.thebody.com/Forums/AIDS/Meds/Current/Q176620.html
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13 years added to what? DAMN DUDE you got my panties all in a bunch! Someone get Dr. Whatshisnuts on the horn and have him issue a retraction! I need answers!
I want the truth and i CAN HANDLE the truth!
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I wonder how he calculated the 13 years. Haart is too new to rely on experience, so it's just a guess (maybe an educated one). But I would like to see what's the basis the 13 years. He does say that during those 10+ years, there will be new development that will further extend the life expectancy, so in fairness to him, he's not really saying that the life expectancy is 13 years. He implies that it is (or will be) longer than that.
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Well...he says 13 years thanks to meds (and living an unhealthy life full of drugs and alcohol...I guess) because the he adds another 10 years if you eat well exercise and sleep...so in total 23 years....
Dr Young is nicer!
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Where is his first tier peer reviewed data?
Or have i just become spoiled by jonathan and andy and ann and everyone else who calms the mental patients down in the AM I forum?
He should have to expand on that....
just sayin'....
Andrew
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Well...he says 13 years thanks to meds (and living an unhealthy life full of drugs and alcohol...I guess) because the he adds another 10 years if you eat well exercise and sleep...so in total 23 years....
Dr Young is nicer!
3. Life span. This is always difficult to predict //////but recent work suggest that you can expect about 13 years added life due to HIV therapies. //////Now, this is a ball park figure based on population data.////// But, I think it is reasonable to consider that if you take your meds religously, avoid bad things like crack cocaine and do not avoid good things like eating well, exercise and doctors,////// you can potentially live another 10+ years ////// during which there will be developments that extend survival even more Starting with really low CD4 cell counts does put you at a bit of a disadvantage but you can overcome that.
So instead of a TOTAL of 23 years I read AT LEAST 23 years ;D
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So basically Dr. Wohl is talking out his arse re: survival timeframe. I know people who've been on meds since the early 90s and have never been healthier than now. And people who've been on meds a few years and died quick like. BUT almost completely and mostly the former, recreational drugs or no, and they don;t look like they's into their last 3 years or on borrowed time right now. Arse. Just saying..ARSE. And again, ARSE.
- matt
Now playing: Hallelujah, Jeff Buckley
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Well I have asked
Dr A er Dr W to justify his assertion. Let's see if he does.
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I like Dr. Young too. And Dr. Holodniy. And a few others on that site. Dr. Wohl I do not. He can be a bit of an ass. A few weeks he told a non-US citizen coming to the States on an H1-B temporary work visa: sure, you can bring your meds from India, two years' supply, just bring a prescription note from your doctor saying they're for the treatment of your HIV, in case there are questions at customs. :o
Jay
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Ben is a cool doctor in person two!
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what is prostatin? Does anyone take this?
I have been on drugs for 17 years and have never been sick from hiv,just the drugs. Got a little tired last week after a three mle walk and a 23 mile bike ride in one day.
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I guess this is something that's always baffled me. The whole "life expectancy" guess. Because when dealing with a pathogen like HIV, so many factors come into play - and the factors are not necessarily static.
The virulence of the virus, it's initial mutations, and it's interaction with the host. The virus that might infect one person and create a LTNP might kill someone else whose system is tuned differently.
The lifestyle of the host. Partying, drugs, drinking, smoking, stress, financial/sociological pressures, predisposition to depression. All these things can directly influence the effect of HIV on the body, and impact things like med treatment, alternative therapy, etc. And, of course, changing/treating/reversing some of these lifestyle choices can also directly impact the effects of HIV and alter the outcome tremendously.
Mutations of HIV over time and exposure to meds. Again, this can mean drastically different things to different people. And it's impossible to predict at the onset of HIV infection what impact any specific drug therapy will have, especially over the course of time.
Side effects themselves, adverse long-term impact of HAART therapy, and the WIDELY variable experiences that a patient can have over time. Sustiva will save millions. And yet, some people simply cannot tolerate it. Some drug therapies raise cholesterol, cause severe CNS side effects, neuropathy, body disfigurement, et al. And not in everyone, either. Two people on the same therapy can experience truly diverse outcomes. One person dies, the other thrives. And for a large part, it's a crap shoot as to who experiences what.
And of course, I have to question the life expectancy guesses based on the development of new and improved medical treatment (as well as estimated improved access to treatment). Does the life expectancy depend on a "snapshot" of the HIV pandemic as it exists today? Does it take into account x number of new drugs coming through the pipeline? Is there a mathematical formula based on the possibility of the next breakthrough?
Epidemiological studies and extrapolation based on statistics are hardly mathematical. When you take a virus and an infection that, by it's very nature, is rather individual in it's impact on the patient... and add medical treatment that is also a very individual experience (both with certain wide perameters, granted) - its difficult to conceive of a single number of ANY relevance emerging from that broad brush.
I just don't get how they arrived at their numbers. And I notice that many doctors, especially online, don't like to footnote their sources. And frankly, a person is only as good as his source is valid (or sources are consistent). A doctor's experiences in the field is indeed relevant, but only within the demographics and contraints of his practice. I submit that a boutique doctor serving a well-insured, primarily wealthy clientele in a major US city is going to have a diffferent story about HIV life expectancy than a clinitian working with indigent and homeless persons in the inner city. Both are relevant to their demographics, but throw the two together and there is hardly a consensus.
I think that as long as there is the perception that you can put a number on a life expectancy, there will be a clamor for that number from professionals.
But for me, I think that working with my own doctor and being upfront and honest with him (and myself) about my personal HIV experience will give me a much more accurate picture of my own chances for survival. And of course, all that is subject to change as good drugs and bad habits drop away, and new ones emerge.
Just saying.
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I wonder about some doctors that push there own philosophy about drugs and/or drug companies. No one knows how long anything will last so using the best available whatever will give the best results. Dr. Young and his med staff have done a great job with me. I'm stronger and have more endurance less diarrhea and more go than last year. But, I wonder if this will last and what is to come. I remember complaining about the runs (diarrhea) for ages and blaming the meds, but Dr Young said po po the drugs are not to blame. Then I went on a drug test where the Norvir was cut in half and guess what, no more upset tummy and the runny poopy went by by. I eat what I want with no runny runnies in the end, but was the new found freedom to fart because we cut back on Norvir or because my fat body adjusted to what I was putting into it.
I'm beginning to wonder about all of this. What is best and what changes are good/bad for who. I guess what I'm trying to say is that only vigilance and an attitude of not giving up is our only hope. Best advice or worst advice is only what happens to you and is only as good as that. So, if you don't like what one doc is saying forget him/her and move on.
Just say'en
BB
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Dr young replied to my follow-up question (http://www.thebody.com/Forums/AIDS/Meds/Archive/History/Q176767.html)
Q: Recently Dr Wohl gave an average 13 year survival time (from point of diagnosis?) in an answer to a question. Would he please justify it, accounting for adherence, hepatitis C co-infection, CD4 count at time, time of diagnosis and therefore therapeutic interventions available. It seems to me far too absolute and, basically, unverifiable, therefore bad to mention in public with such certainty.
A: I'll let Dr. Wohl answer for himself; but the study that he referred to is this one:
http://www3.niaid.nih.gov/news/newsreleases/2006/AIDSsurvival.htm (http://www3.niaid.nih.gov/news/newsreleases/2006/AIDSsurvival.htm)
I find that the study actually reinforces the idea that successful medications can dramatically improve the life expectancy for those living with HIV. This study, like others, and like our professional opinions rendered here at TheBody are limited by being estimates of the future, rather than a trip from Back to the Future; I'd caution you from over-interpretation of this study's conclusions, or Dr. Wohl's review of the study.
... newt says - The NIAID study concludes that statistically speaking based on a computer model beginning treatment in 2003 means you can expect to live more than 13 years longer than if diagnosed in 1988. (It does not say you will live for 13 years!). It does not give any way to say if this will apply to you personally, and does not draw out differences for, eg, adherence, hepatitis C co-infection, CD4 count at time of diagnosis, quality of treatment access etc.
The important figures in this study for me are not the no. of years but the % of people living to see the next improvement in treatment, which leapt from 40% to 90% in 1996, the year we saw triple-drug combo for the first time.
I prefer Dr Young too.
- matt
Now playing: All creatures of our God and King, local church choir (is singing down the road this bright sunny morning after a night time storm)
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Thank you Matt. Very well explained! Like always... ;D
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Thanks Newt! Been looking forward to this response for awhile!