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Author Topic: Emergency - access to meds blocked by civil war  (Read 3070 times)

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Offline LordBerners

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  • Posts: 415
Emergency - access to meds blocked by civil war
« on: April 28, 2010, 03:05:10 PM »
Sorry to be dramatic, but I have an unusual problem.  I don't know if the members of this forum have been following events here in Thailand, but there is something close to a civil war going on between the government and the 'red shirts'. 

Unfortunately, I get my medicines from the Red Cross, which is located near one of the areas of 'protest' and fighting.  So, just a couple of days ago the Red Cross closed down with no warning and no measures in place to contact or advise those of us who depend on them for meds.  There is no way to contact them as the phone is unanswered.  I'm sure the reasons for closure are good - from what I understand soldiers and 'protesters' were being shot to death right out side the door.  However I'm about to run out of medicine (in 15 days), so I need to prepare.

So, I have two questions:

Firstly, on a regimen of Abacavir, Atazanavir, Tenofovir, and Norvir, what would be the best method of ceasing treatment to try to avoid resistance.  All at once or should I curtail one medicine before another?

Secondly, to any members who reside in Thailand - I know many people get their meds at the Red Cross because it is the cheapest source..  have any of you had trouble getting your medicines?  Can anyone recommend alternative sources for medication (I normally get the meds free as part of a study, but can pay temporarily, and I have an old copy of my prescription, though it is impossible to contact any doctors from the Red Cross now).


Please, just call me Berners.. or Baron.

Offline Inchlingblue

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Re: Emergency - access to meds blocked by civil war
« Reply #1 on: April 28, 2010, 04:03:13 PM »
This sounds pretty stressful. The link below is for aidsmap, which allows searches by country for HIV/AIDS services and organizations, maybe you can find an alternative source for meds?

LINK:

http://aidsmap.com/cms1038779.asp

As far as the best way to stop treatment or maybe maximizing the doses you have (maybe if you are undetectable you can take the meds every other day?), you should ask Dr. Gallant and/or the doctors at thebody.com? I'm not advocating taking them every other day but in an emergency situation such as what you describe it could work, depending on the meds and if you are undetectable. One of the bloggers on poz.com (Shawn Decker) takes Reyataz/Truvada/Norvir on a one week on, one week off and he's doing well, you are on a similar regimen.

LINK:

http://www.poz.com/articles/shawn_decker_hiv_2303_16089.shtml

The best scenario, of course, is if you can find more meds before you run out.

Offline mecch

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Re: Emergency - access to meds blocked by civil war
« Reply #2 on: April 28, 2010, 04:30:27 PM »
Are you worried about a possible future problem, or are you running out of HAART now?
Just recently you posted that your study was over, and your dad was going to foot the bill for buying your meds.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline newt

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Re: Emergency - access to meds blocked by civil war
« Reply #3 on: April 28, 2010, 07:14:42 PM »
On the stopping, either stop them all together or stop the tenofovir 2-3 days before the rest. Hope it don't come to this. - matt
"The object is to be a well patient, not a good patient"

Offline LordBerners

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Re: Emergency - access to meds blocked by civil war
« Reply #4 on: April 29, 2010, 12:50:50 AM »
Are you worried about a possible future problem, or are you running out of HAART now?
Just recently you posted that your study was over, and your dad was going to foot the bill for buying your meds.

Yes I am running out of HAART now.

The request for assistance from father was me planning ahead - the study provides meds for a few months after the end of participation - I have one more three month batch coming to me (assuming they live up to the arrangement).  I had to go ask dad ahead of time in order to have an option in place for the future.

This problem with the closure of the Red Cross is more immediate - as I stated above, I only have 15 days (14 now) supply remaining. 
Please, just call me Berners.. or Baron.

Offline LordBerners

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Re: Emergency - access to meds blocked by civil war
« Reply #5 on: April 29, 2010, 12:54:02 AM »
On the stopping, either stop them all together or stop the tenofovir 2-3 days before the rest. Hope it don't come to this. - matt

Thanks Newt.  Back when I was becoming resistant to my old combo (Truvada/Sustiva), I became resistant to everything BUT tenofovir, so I was apparently taking tenofovir 'alone' for a few months.  My viral load became very high again, but no resistance to tenofovir.  Its all mysterious to me!
Please, just call me Berners.. or Baron.

Offline sanitex

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  • Posts: 388
Re: Emergency - access to meds blocked by civil war
« Reply #6 on: April 29, 2010, 12:56:33 AM »

hello LordBerners,my advice to you is to go to any hospital meet one of the infectious disease doctor's
tell them your problem most of them do work with goverment hospitals. like (chulalornkon hospital)they
can give you drug precription paper to buy your medication from their clinic i used to buy it there even now
mine remain same like yours.chuala open's mon to friday .i think this can help?bye san
27/12/07 cd4 20 vl 1million
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl undetectable
16/10/08 cd4 196 vl undet
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl undet 23%
24/2/12 cd4 545 vl undet 26%
on 22/2/12 change truvada to Recovir-EM
due to no stock on Truvada.
10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ulu/ml creatinine.eGFR blck 1.5 all fasting test morning.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
regimen ATRIPLA
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs test (quantitative ) Anti-HBs positive
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 change to Teevir
24/9/14 cd4 517 vl <40 22%

Offline joemutt

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  • Posts: 1,042
Re: Emergency - access to meds blocked by civil war
« Reply #7 on: April 29, 2010, 06:08:10 AM »
I will be heading into this problem soon if the stand-off lasts.
(the anonymous clinic is located between two 'red-shirt' occupied intersections).

I will go to my usual doctor, who writes my prescriptions, this Saturday and see what other possible sources are. Could you not ask the same from you treating doctor? If you dont have a treating doctor go to an ID specialist at one of the government or one of the not-international hospitals. Chula, Siriraj, etc.

There are government pharmacies (GPO), for instance at Siriraj Hospital,
but I don't know if they carry brands/meds you need. They might be able to fill your
prescriptions at a comparable price. Check that first.


If you have to go to an international hospital you may have to apply to your father's help sooner than planned.

ps check with Chula if outpatient department is open, they are located off one of
the occupied intersections  (Silom/Rama IV) and at one point moved their patients to the inner buildings and closed OPD.

ps2 I think it is an overstatement to speak of civil war, yet.
« Last Edit: April 29, 2010, 06:22:48 AM by joemutt »

Offline LordBerners

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Re: Emergency - access to meds blocked by civil war
« Reply #8 on: April 29, 2010, 06:55:21 AM »
... Could you not ask the same from you treating doctor?

No, alas, he works at the Red Cross - I was in a study.  So there is no way to access him as that place is closed (I even wonder if he's still in Thailand!)

I've heard that Chulalungkorn hospital is also closed. 
Please, just call me Berners.. or Baron.

Offline joemutt

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  • Posts: 1,042
Re: Emergency - access to meds blocked by civil war
« Reply #9 on: April 29, 2010, 06:59:43 AM »
Then you have to go to any ID doctor in a hospital outside the conflict zone and ask them prescriptions and info on availability/price. Many patients face this situation.

Offline mecch

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  • red pill? or blue pill?
Re: Emergency - access to meds blocked by civil war
« Reply #10 on: April 29, 2010, 09:41:50 AM »
I have a month spare truvada and intellence.  I am going on Prezista tonight for a month trial.  If you think mail will get to you, or dhl, contact me and we'll work it out. 

I think it would be wiser to be on another regimen for a month, with no interruption, instead of interrupting your HAART, especially if you are undetectable.  But should probably ask your doctor for the best solution of what to do.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline esper

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  • Posts: 57
Re: Emergency - access to meds blocked by civil war
« Reply #11 on: May 01, 2010, 10:50:15 AM »
I was in the same position this past week, down to 7 days of stocrin / truvada. I use Bumrungrad for tests / doc / meds.  went for tests Tuesday / Wednesday, bought few extra months meds supply, just not sure where the reds will be day to day. Cost will certainly be more there but they are open and tucked away from the protest sites. here's the number for the ID department, you can check if they have meds you need and cost, see if they can help. 02 667 2865 / 64. good luck, stay safe. esper




edited for typo
« Last Edit: May 01, 2010, 10:52:34 AM by esper »
tested positive June 26, 2009
06/26/2009-CD4 428: VL 56,200: 34.1%
09/28/2009-CD4 388: VL 105,000: 31.9%
11/16/2009-CD4 330: VL 242,000: 23.4%
12/11/09 started stocrin (sustiva) & truvada
02/02/2010-CD4 588: VL 204: 31.6%
04/27/2010-CD4 620; VL 154; 38.5%
08/25/2010-CD4 504; VL undet; 39.2%
11/16/2010-CD4 499: VL undet: 44.6%
03/01/2011-CD4 534: VL undet: 33.2%
06/01/2011-CD4 709: VL undet: 45.6%
12/11/2011-CD4 537: VL undet: 41.5%
06/10/2012-CD4 597: VL undet: 42.8%

Offline LordBerners

  • Member
  • Posts: 415
Re: Emergency - access to meds blocked by civil war
« Reply #12 on: May 02, 2010, 12:40:56 PM »
I have a month spare truvada and intellence.  I am going on Prezista tonight for a month trial.  If you think mail will get to you, or dhl, contact me and we'll work it out.  

I think it would be wiser to be on another regimen for a month, with no interruption, instead of interrupting your HAART, especially if you are undetectable.  But should probably ask your doctor for the best solution of what to do.

Thank you so much for the kind offer mecch, and sorry I didn't respond to it earlier.  Alas I am resistant to one of the meds in Truvada (the emtricitabine or FTC).  Also I don't actually know if I'm undetectable or not, but I wasn't quite at my last couple of tests, which seem a long time ago now (about six months).  I was at about 100 VL.  And my doctor is unreachable at the moment.

Excuse me for asking, Mecch, but are you in Thailand?

....Bumrungrad ... you can check if they have meds you need and cost, see if they can help.

Thanks for the kind advice, esper.  I'm considering going to Bumrungrad and asking to buy maybe a two weeks supply and hope the Red Cross re-opens somewhere/somehow.  Basically I don't have the funds to buy more than a couple weeks worth.. don't know if they'll sell them like that.  The free meds I have been getting for a couple of years as part of a study ends in just 3 months from now, so I had a plan in place for that time to pay for meds at the Red Cross price (my combo will run about 20,000 baht/month), but I have no idea how much more they would be at Bumrungrad.. surely not more than double.
« Last Edit: May 02, 2010, 12:42:30 PM by LordBerners »
Please, just call me Berners.. or Baron.

Offline mecch

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  • red pill? or blue pill?
Re: Emergency - access to meds blocked by civil war
« Reply #13 on: May 02, 2010, 02:08:50 PM »
no switzerland.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline joemutt

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  • Posts: 1,042
Re: Emergency - access to meds blocked by civil war
« Reply #14 on: May 03, 2010, 10:52:07 AM »
my doctor sent me with my usual prescription to the pharmacy of:
Ramabodhi hospital
270 Rama VI road
tel 02 201 1000, 02 201 1250.
Same price as anonymous clinic.
The price of my meds in Bangkok Hospital (comparable standard to Bumrungrad) is triple of that.
« Last Edit: May 03, 2010, 10:54:37 AM by joemutt »

Offline LordBerners

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  • Posts: 415
Re: Emergency - access to meds blocked by civil war
« Reply #15 on: May 03, 2010, 01:30:39 PM »
my doctor sent me with my usual prescription to the pharmacy of:
Ramabodhi hospital
Same price as anonymous clinic.
The price of my meds in Bangkok Hospital (comparable standard to Bumrungrad) is triple of that.

Thanks joemutt, good to know.  I am happy to report that the Red Cross is now more or less at least partially in operation again - in any case they are answering their phones and they say they will be open at a new temporary location inside a Chula Hospital.  I'll be visiting them later in the week if there isn't more fighting or other mishaps.  Good to know about Ramabodhi in case they close down again before Friday though!
Please, just call me Berners.. or Baron.

Offline LordBerners

  • Member
  • Posts: 415
Re: Emergency - access to meds blocked by civil war
« Reply #16 on: May 06, 2010, 04:00:51 PM »
Happy to report I managed to get a further three months supply today, and that office is open in another location a few hundred yards away and behind the main hospital walls.
Please, just call me Berners.. or Baron.

Offline mikejh

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Re: Emergency - access to meds blocked by civil war
« Reply #17 on: May 09, 2010, 10:52:53 AM »
Hi Guys
Do any of you know if it is possible to get Atripla in Thailand.
I travel on and off to Thailand from New York and can only get one months supply on my insurance, so sometimes i'm close to run out when in Thailand.
CD4   %
22 Sep 06   37     5  Started Atripla
5   Oct 06   82     9
1   Dec 06  258   13
25 Jan  07  263   14
1   May 07  403   18
6   Aug 07  438   22
7   Nov 07  417   19
30 jan   08  310   19
7   May  08  285   20
6   Aug  08  472   27
12  Nov 08  444   26
11  Feb  09 335    19
10  May  09  460  25

Offline LordBerners

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Re: Emergency - access to meds blocked by civil war
« Reply #18 on: May 09, 2010, 12:34:37 PM »
Hi Guys
Do any of you know if it is possible to get Atripla in Thailand.
I travel on and off to Thailand from New York and can only get one months supply on my insurance, so sometimes i'm close to run out when in Thailand.

I do believe it should be easy.  Truvada/Sustiva (same ingredients as Atripla), is as far as I know the most standard and common treatment here - certainly it is what I was put on firstly (though alas I am now resistant).
Please, just call me Berners.. or Baron.

Offline Inchlingblue

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Re: Emergency - access to meds blocked by civil war
« Reply #19 on: May 09, 2010, 02:08:18 PM »
Hi Guys
Do any of you know if it is possible to get Atripla in Thailand.
I travel on and off to Thailand from New York and can only get one months supply on my insurance, so sometimes i'm close to run out when in Thailand.


As LB says they probably have the same ingredients separately but they also might have generic Atripla, called Viraday. Keep in mind the names might be different, for example Sustiva is, I believe, Stocrin.

 


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