Labs, Doctor's appt's and not wanting either now

[DingoBoi]

I'm in relatively good health.  I've typically tested between 800 and 1600 cd4's over the last year.

Now though, I don't want to go.

I don't want to spend the $30 for the doctors appointment only to tell me I'm ok.  I don't want to get the lab results that say my cd4's have plumetted and my virus load bloomed.

I've haven't been very adherent lately.  Mostly a factor of stopping drinking and then binging a bit.  I forget when I stop drinking.  I forget when I binge.  I don't forget when I drink normally for me.

Kinda worried about that.  I 'know' that nothing should be wrong or serious.  There is nothing the doctor can do for me so why go get labs done every 3 months and pay a $30 copay? 

The only reason to see him is to renew meds which I can do over the phone.  Why do any of you go to doctors appointments if nothing is 'wrong' and you get your labs by phone?

I think I just want to forget about this since hiv isn't something I can change and no matter how many doctor's appointments I go to, he can't change it either.  He can only maintain me with meds which a preschooler could select.  It's not rocket science in the treatment aspect.

[Iggy]

Bailey - I guess I'm jealous of your numbers as I was having a hard time getting worried for your health here....and then I understood what you were saying.

So let's switch tracks for a moment and think of it this way - isn't it better to just deal with the annoyance of doctor visits then to let it go so far as to rely on them for your very life?

Do your part to keep it the former.

[Miss Philicia]

I went EVERY MONTH for 14 years.  Numerically I did not have the luxury of only going every 3 months, so imagine how much MORE money I spent.

Ask your doctor if you can go every 6 months.  As long as your numbers are as high as you state... though as long as you're having adherence issues I don't personally think it's wise.  But hey, it's not my life.

$30 every 3 months vs. how much for alcohol during that same time period?  Not being judgmental, just something to consider.

[emeraldize]

Hi Bailey

Not every quarter, but about every other quarter, my doc/nurse will allow me to skip the office visit if I call in for lab results and there's been no change. Based on experience, I agree with Philly---ask if they'll do this.

I come at it from another perspective, however, which is that I don't want to take an appointment slot, essentially unnecessarily, that another patient could truly use to their advantage.

My next lab will be in this category of "do I really need to go in to hear status quo test results?"---so, I'll be asking right around the time of the lab draws.

Em

[DingoBoi]

for now, I just want to talk to my doc if I have a problem.

That's it.  I don't care about fluctuations now since they don't mean much (and I started meds at 550 due to a steadyline drop)  I've rebounded from my already good labs and don't think I can really deal with bad news... of course, the last time I tested 1600, i was drunk the entire week before.... so...  keeping the buggies drunk may be a good thing for me.

I just don't see the point of going to a doctor anymore until my labs dictate high care or I have a problem. 

Each appt is much like just talking about the weather.  Casual conversation.  nothing important.  If it was, I'd bring it up and make an appt for it.

Even if things turn sour, I'm coming from a place of immaculate numbers.  Even a serious drop over 6 months would not be bad as long as I'm not resistant

I guess i just don't want to know right now which is weird, because I've always wanted to know everything.  Now it's just fuckit.  Nothing I can reasonably do will change the outcome and in the event of bad labs, I'll change meds.. probably in the 300-400 cd4 range.

I just don't have to be as concerned (though I probbably should be) with my labs now. 

Maybe it's that I don't feel 'critical' in needing treatment.  I've even been thinking of taking a break if my numbers stay good.

at the same time, it stresses me not following teh pattern of testing and appts... even if i think they are mostly worthless.

[RapidRod]

I wasn't on meds when my numbers crashed. 1400+ to 52 within three months between lab tests. I don't just see my doctor for HIV, she gives me a complete physical each time I go in and schedules me for testing constantly. Xrays, Catscans and MRI's are my way of life along with the EKG, EMG, and stress tests. It just a way of life for me.

[DingoBoi]

sometimes, I think that would be best.

[Ann]

Dingo, would it be possible to compromise? Can you do your quarterly labs as usual, but have your results over the phone or via email? If the results warranted a face-to-face with your doc, you could then schedule an appointment. You'd have the best of both worlds that way - a handle on your labs and appointments only when necessary.

Ann

[appleboy]

Hey Dingo,
I do most of the talking with my dr via e-mail.  Granted it is a little odd at times like when you throw a question and there is delay of a day or two in the response.  I am also seeing 2 HIV Drs one close to home and one 30 minutes away.  Granted I am tired of being stuck at different times for the same labs so I am dropping the Dr close to home.  I also asked my Doctor about moving my appointments to 3-4 times a year instead of 6 times a year guess what she said yes.  So I guess what I am after is you are in charge of your medical care just as much as the doctor you see.  Be active in that process and question what you don't feel is correct (like going to the dr to only be told numbers or no change).  Tell your Dr could we change the amount of times I see you?  More than likely I am sure they will do whatever suits your fancy as long as it does not cause harm to your care.
Hope that helps
AppleBoy 

[newt]

Since you's well into treatment and CD4 good, f your viral load is undetectable then 6 month viral load tests and annual for CD4, lipids, bone profile etc seems fine.  Indeed, lipids etc your GP can do as part of primary care.  More frequent testing ain't gonna improve your adherence. Separate issue entirely.

Me, I go 2 x year for viral load and 1 x year for everything else, to the nurse for blood draw, and a senior nurse rings me with the results and discusses anything untoward (there's never been, so far).  Option to call/visit if concerned is a nice safety net, but truthfully, the only thing I miss at clinic is seeing friends/cruising. See a doctor? Nah!

- matt

[Moffie65]

Matt said what I was going to say, so I will simply echo his post, and add it to the number that feel you should probably take this thing by the horns and tell your medical team that you needn't see them so often.

Other than that, with the drinking being a real problem with adherence, then you need to address this also.  Going in twice a year is a good idea, but doing so without sticking to your HAART is possibly foolish.  You're a big boy, you know what I am saying here.

Love,