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Author Topic: Does One Month Make A Difference?  (Read 4154 times)

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Offline Nicolas2

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Does One Month Make A Difference?
« on: June 26, 2011, 09:44:11 PM »
Ok…

After 3 lab works, my doctor thinks I should start a treatment. Right away.

For certain reasons it would be convenient for me to start it one month later. He says it’s up to me (as always) BUT he strongly believe that I shouldn’t wait. My CDs are pretty much ok (he says), round 700, but VL is high – 100,000.

So this is completely different situation from the very beginning of this adventure. First, I was concerned that he suggests to wait to see the trend, and not start medication…and now after three months he urges me to start it.

My councilor from the support group tells me that I’m in charge (again-as always) and that if I think I should start the treatment – then I should AND if I don’t want to start it – then I don’t.

Basically that concerns me from the very beginning, from those days that I knew nothing about the treatment: that it’s not like other medical issues where doctors are the highest authority…but it’s much more complicated and the patients take control (AND responsibility AND the consequences) themselves..

But mu acute question is: does that one month of postpone makes that much difference?

Another thing…

That last time he saw me he wanted to do my general physical check up. For some reasons he didn’t, and now I have an appointment with the pharmacist next week AND another meeting with the doctor in almost 4 weeks when he’s going to perform those tests. My question is: are those tests relevant regarding starting medication, choosing a right combination…kidney parameters, liver parameters…cholesterol?

I like to trust completely to my doctor and would like to let HIM make all decisions… but since it doesn’t work this way – I’d like to hear what you guys think.
Thanks.

Offline surf18

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Re: Does One Month Make A Difference?
« Reply #1 on: June 26, 2011, 10:04:37 PM »
I don't know, I'm not an expert but my thought is the meds have got to be less toxic on your body than 100,000 vl is.

Offline Nicolas2

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Re: Does One Month Make A Difference?
« Reply #2 on: June 26, 2011, 10:16:03 PM »
Ok surf...thank you.

I did ask experts as well, but I just thought some of us here maybe also had this dilemma, at one point...and maybe they asked some other experts so we could exchange experience.


Offline thunter34

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Re: Does One Month Make A Difference?
« Reply #3 on: June 26, 2011, 10:19:37 PM »
from the set of circumstances you describe, i would wait out the month and do it when it is your preferred time.

1.  i think the physical at the outset is a good idea.  gives you some baseline data on your body.

2.  starting meds is serious business.  you need to be as ready - physically, mentally and emotionally - to be ready to commit to it properly.

3.  your cd4s can wait out the next month, and i've had WAY higher vl numbers.
AIDS isn't for sissies.

Offline Nicolas2

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Re: Does One Month Make A Difference?
« Reply #4 on: June 26, 2011, 10:31:14 PM »
Thank you thunter.

I am ready for medications, generally...it's just that the next month is really hectic for me, some guests in the house, many activities outside...and I'm not sure if I could handle all this IF the side effects those first weeks are severe and intense...

Then again - health is the most important and if it's really necessary to start it TODAY - then I will.
« Last Edit: June 26, 2011, 10:41:49 PM by Nicolas2 »

Offline mecch

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Re: Does One Month Make A Difference?
« Reply #5 on: June 27, 2011, 12:55:40 AM »
Mind telling us why you want to wait a month?
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Miss Philicia

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Re: Does One Month Make A Difference?
« Reply #6 on: June 27, 2011, 01:25:05 AM »
Uh, he did.
"I’ve slept with enough men to know that I’m not gay"

Offline mecch

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Re: Does One Month Make A Difference?
« Reply #7 on: June 27, 2011, 03:38:39 AM »
Oops, missed that.

Well listen, of course you are in charge of your own treatment.

If you are emotionally and psychologically ready to start in one month, then why not wait -- since its stressing you - not being able to cope with too much on your plate this month.  This is a pretty good reason to delay, temporarily.

But, are you sure you aren't delaying it because you aren't sure you want to start at all?
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline mecch

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Re: Does One Month Make A Difference?
« Reply #8 on: June 27, 2011, 03:41:23 AM »
PS - if you do decide to wait a month, its an opportunity to fill the prescription now, then you will have a month reserve instantly when you do start.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Ann

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Re: Does One Month Make A Difference?
« Reply #9 on: June 27, 2011, 12:29:21 PM »
With CD4s in the 700s, I don't think waiting one month would make much difference. Also, if yours is a very new infection, your body could still be getting to grips and bringing the VL down on its own.

What were your VL results from your first two sets of labs? I looked through your posting history but didn't find any mention of other lab results.
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Nicolas2

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Re: Does One Month Make A Difference?
« Reply #10 on: June 27, 2011, 05:27:15 PM »
Hi meccg. Thanks for your answer.


Well listen, of course you are in charge of your own treatment.

If you are emotionally and psychologically ready to start in one month, then why not wait -- since its stressing you - not being able to cope with too much on your plate this month.  This is a pretty good reason to delay, temporarily.

But, are you sure you aren't delaying it because you aren't sure you want to start at all?

I know what you mean but it's not that. No other delays (excuses) after this. It's just that I have my exams in 2 weeks and some high maintenance guests the whole month...and I would really lilke to have that general physical check up before I start the treatment.


What were your VL results from your first two sets of labs? I looked through your posting history but didn't find any mention of other lab results.

Hi Ann. Thanks for your reply.

My VL was 100,000 first time, then 30,000 next month and then up to 100,000 again.

Offline newt

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Re: Does One Month Make A Difference?
« Reply #11 on: June 27, 2011, 05:52:19 PM »
At your CD4 count a month will make sod all difference. Do it when it suits, if you are ready to do it now.

Your viral load is medium/average. Your C4 count is "normal." There's no rush.

- matt
« Last Edit: June 27, 2011, 09:29:26 PM by newt »
"The object is to be a well patient, not a good patient"

Offline Nicolas2

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Re: Does One Month Make A Difference?
« Reply #12 on: June 27, 2011, 06:09:29 PM »
Thanks matt.
« Last Edit: June 27, 2011, 06:14:42 PM by Nicolas2 »

Offline eric48

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Re: Does One Month Make A Difference?
« Reply #13 on: June 27, 2011, 07:08:04 PM »
Hi,

Welcome !

Now, a number of decision have to be taken by you and your doc and some key deciding factors are not detailed in your thread so, it is a tough call. (and this forum posters are in a vast majority non doctors)

First, you are NOT, by far, at death door...

VL bouncing a lot. have you been infected recently? may you know...

Key questions are:
- what meds
- when to start

Only a very very tiny fraction of HIVer will never have to start the meds, so unless you have evidence of the capability to control the virus naturally your entire life (some genetic test (HLA-Bw4 (incl.HLA-B*57, HLAB* 27) (see page 15 of :
http://www.translational-medicine.com/content/pdf/1479-5876-9-93.pdf
if you need a reference)

can , in some cases be predictive of that capability) one thing is (almost) certain: you WILL have to start meds at some point in your life.

If the lifetime left head of you is reasonably long enough, (I mean here, unless you are already '90), an other thing is also almost certain: you will not be on the same combo for 20- 30 years. the proportion of people who have had a combo change or adjustment during their treatment is high: better meds, simpler dosing: so the choice of initial combo may not be as critical as you might think (provided you have had the resistance test done)  

so, say, on a cursor indexed in months from 0 to , say 240 (that is 20 years), the cursor will have to be placed somewhere. Little you can do about that. (quite sorry for that, we are all in that same boat)

That being said, one month is nothing compared to the benefits of making a proper choice of meds

Have you had a resistance test done already ? it takes 3 weeks to a month. It is a must have

Have you had the  HLA-B*57 test if you consider Abacavir and if Abacaviir is an open option for you?
(takes a few days to a few weeks)

Your age is also an important decision factor (older people may take longer to recover, so they'd better start earlier)

CD4 percentage is also a key decision factor when CD4 count is above 500 in deciding where to put the 'start' cursor (mine was 500 ish but percentage was below 20)

your access to some 'modern' medication as first line (I thing maraviroc, for me was not an option in first line because of health insurance restrictions)

So, in you case, I would think that taking that one month to make an 'educated' choice of meds is not a waste of time.

One thing you may want to do during this month : buy 2 sets of cheap supplements that you may use as placebos. and try to take them 12 hours appart. It will help you find your own most suited strategies to train yourself towards 100% adherence, since 100% adherence is very important at initiation of treatment.
(after, say, 6 months, missing a few doses once in a while is not such a big deal) - but at initiation you will want to be religious about that. SO why not train yourself with some cheep pills. I had read this idea in some post here, and it work marvel for me: I chose supplement that had same size/color than the meds I was considering: psychologically it did help !

You will then find if twice daily is or is not a burden for you.

Some people get easily adjusted to twice daily. Me, I was fine with the twice daily, but I can vouch that I am much happier now that I can take my combo once a day.

side effects:
they may not come at all.
Some meds have a list of side effect that is as long as my arm
Do not get over impressed. If it were for the length of the SE list only, even aspirin would not be approved!

if they do, they come in 3 sorts: short terms that will NOT fade (and could be life threatening, immediate switch is warranted)(unfortunately quite unpredictable), short term that will fade, long term that are pretty hard to predict, but, bear in mind that you have options to switch to.

Some people have no SE, some people may take as long as 3-6-12 months to fully adjust (I am a good example...)

Some meds may be out of the picture (in your case nevirapine would be one NOW for 2 reasons, your high CD4 count, your high VL , but, if your resistance test allows, nevirapine, for example, could be considered in a switch-to strategy, should Efavirenz be hard to live with, as it occurs in some people) and Nevirapine is usually well tolerated (and not too expensive)

So when you discuss your options with your doc, you may want to discuss initiation /maintenance

(for example, when I choose my combo it was a 2 times a day combo, but we knew, at the time, that the once a day same combo would certainly be approved, as, in fact, it did...) the other option I was considering at the time was also twice daily and has remained so (thus far) since the once daily dosage has failed the trials...)

Given a favorable initial resistance profile, very adherent people have favorable switch histories, so the initial choice of meds may not be as critical either (if your doctor is not resistant to switches, some doctors are more liberal than others)

Also, when you get your prescription, you may want to wait for 1-2 weeks anyway, to build up a safety stock pile (you never know, shit happens, even Big pharma has shortages...)

Just some thoughts

Eric




 
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: NCT02157311 = 4d. ON, 3d. OFF)

Offline eric48

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Re: Does One Month Make A Difference?
« Reply #14 on: June 27, 2011, 07:50:04 PM »
I like to trust completely to my doctor and would like to let HIM make all decisions… but since it doesn’t work this way

Hum.... I yet have to read a thread where someone relates that he/she refused his/her doctor's choice of meds (there are some people who have prefered to wait for better meds, but, that, I believe, was in agreement with their doc)

I may have been the only one in the recent post to have initially questionned my doc's suggestion. Because, your only practical option is to get a second opinion from an other doctor (and that takes time...), and, once again, reading through this forum, I can't remember reading a patient history starting with:

my HIV specialist is completly nuts ! what should I do ?

(expect, again, for myself, because, he offered a combo that had been demoted, from 'preferred' to 'alternative', but, being on the guideline's board, he had a hunch that would would make a come back, which if fact it has...)

http://forums.poz.com/index.php?topic=33062.0;all

Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: NCT02157311 = 4d. ON, 3d. OFF)

Offline metekrop

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Re: Does One Month Make A Difference?
« Reply #15 on: June 28, 2011, 06:01:39 PM »
I don't think it makes a difference.  Nonetheless it all depends up each individual situations.  I start treatment when My CD was below 50 and VL was about half a million.  Now I am in about two and half years and think doing fine.
Diag on Dec 8, 2000, CD 440 VL 44K, No Meds
Dec/08 - Feb/09 CD< 50 & VL >500k hosp'z.
St. Atripla - July/09 CD 179, VL 197k
Oct/09 CD 300 VL UD Chol 267
Mar/10 CD 468 UD, Ch 220
Aug/10 CD 460 UD, Ch 195
Dec/10 CD 492 UD, Ch 172
Mar/11 CD 636 UD, Ch 201
Aug/11 CD 530 UD, Ch 98
Jan/12 cd 616 UD, ch 189
Jul/12 CD 640 UD, Ch ?
Dec/12 CD 669 Ud, Ch 125
May/7 CD711 Ud, Ch?
Nov/ 22 663 UD, Ch,
April 17 CD 797,
Oct, 14 CD 810 UD

Offline eric48

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Re: Does One Month Make A Difference?
« Reply #16 on: June 28, 2011, 06:45:05 PM »
Hi,

Please allow me to  copy here content of PM received by Nicolas2 for 3 reasons:
a- there is nothing really Personal (IMHO)
b- I only comment about the meds I take
c- others may have interesting/documented opinions

the content is below:

-------
In a month my CDs drop from 700 to 580 and VL raised from 31.000 to 115.000...so that's why doctor wants to put me on meds immediately.

He gave me Kivexa, Atanazavir and Ritonavir.

What do you think?
---------

my comment:
A - Kivexa (I can comment since I take it...) : a bit less popular than truvada, is nonetheless widely used, it has its own benefits if you are in the following case:
1- Negative to the HLA-B*57 test (I assume your doc has checked that as this is common pratice)
2 - have a low basal cardiovascular risk in the first place (if you already have smoking and or other cardiovascular related risk prior to taking the meds e.g. cholesterol, family history... you may want to point out this to your doctor as It seems advisable to avoid using abacavir in patients with high cardiovascular risk if there are suitable alternatives (which there usually are), but that stable patients already on the drug should remain on it unless there’s a compelling reason to switch)

For people who may have  kidney concerns and/ or injected drug usage, it also seems common to prefer Kivexa to Truvada.

Kivexa is by no means a bad choice (this is the one I selected, after all...)
Initial adverse effects are very rare (but if they occur, they may be severe) (which may help explain why it is a bit less popular...)

In other words, it may be a little more selective that Truvada, but, once the initial period is successfully passed, it is easy enough to take. You may feel a bit a anxiety/stress , but, for me, it seems to fade away.

B - Atanazavir and Ritonavir.: I do not comment on drugs I do not take. Others in this forum may share their experience with it.

I, personally, was in favor of a PI sparing regimen, due to my age and cholesterol obsession. Which is why I chose Viramune. I can comment on this...

You do not qualify for Viramune for 2 reasons:
- Your High CD4 count
- you VL at 100.000 (there is a selector rule here that people with VL > 100.000 should not start viramune.
(I was told by my doc that this rule is going to be revisited soon, but, as of today, this is the 'official' rule.)

There may be other reasons for the selection of Kivexa, Atanazavir and Ritonavir, mainly your resistance test.

Also, since you have a high level of CD4 to get started with and a moderately high level of VL, do not stress out if you do not get undetectable in 3 weeks as may be seen in other people starting at much lower CD4 counts. It is a possibility that your VL decay may take its own time and a reason for not choosing an NNRTI along with Kivexa (aside from your resistance test profile) as they have a lower barrier to resistance

My comment thus, is that eventhough your doctors did not choose NNRTI along with Kivexa for your initial treatment, (and under reservation that your resistance profile allows it), NNRTIs (such as viramune or efavirenz) remains a scheduled-switch-to option.

This is called Induction / maintenance (starting with something 'strong' that has very low chance to fail, then switch to something more manageable should you wish/need to)

Induction / maintenance is not standard procedure where I live, but, I think it is used in Germany

Because I had been told that Kivexa can be 'rough' at initiation, you may want to take the extra cautions I did (see my thread about it). My doc commented that I was over cautious... Well...I passed the initial Kivexa period with honors, so do not blame my self for recommending:

- night intake (preferred to morning) for the first few months
- drink lots of water
- take Kivexa 2 hours appart from the other meds for the first few months
- avoid initiate during exams or busy work schedule: summer vacation would be ideal
- ask your doctor what you should do his you are experiencing side effects: I mean here, what to do in case you can not reach your doc (vacations...) immediately

One last thing, there is no evidence that one combo gives a better CD4 count raise than an other. In your case, bear in mind that, since you are starting from a 'normal' CD4 count, a moderate increase in CD4 count would certainly not be a reason for concern. normal is normal: there is not a category named super normal...

see:
http://forums.poz.com/index.php?topic=33062.msg474896#msg474896

Be adherent and everything will work fine...

Cheers
Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: NCT02157311 = 4d. ON, 3d. OFF)

Offline Nicolas2

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Re: Does One Month Make A Difference?
« Reply #17 on: June 28, 2011, 07:12:00 PM »
Yes...I did want to tell the new details later today here, of course.

SO...I didn't have accurate numbers. I guess it's pretty much clear now why doctor was so determined to start treatment immediately with me (in our conversation he only mentioned VL, not CD4s, it was today with the pharmacist when I had all the information).

So that's it. Starting tomorrow...

Thanks to everybody, I'm sure these posts will be useful to the other people, as many others.

Offline Nicolas2

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Re: Does One Month Make A Difference?
« Reply #18 on: June 28, 2011, 07:18:46 PM »

Be adherent and everything will work fine...

Cheers
Eric


Thanks Eric for such a detailed explanation, time and effort.

Offline Ann

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Re: Does One Month Make A Difference?
« Reply #19 on: June 28, 2011, 10:04:59 PM »
At your CD4 count a month will make sod all difference. Do it when it suits, if you are ready to do it now.

Your viral load is medium/average. Your C4 count is "normal." There's no rush.

- matt


Your CD4 count (580) is still "normal". You can still afford to wait a month until your life is also back to "normal". Don't let Eric panic you with his long-winded posts.
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline metekrop

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Re: Does One Month Make A Difference?
« Reply #20 on: June 29, 2011, 10:58:31 AM »
PS - if you do decide to wait a month, its an opportunity to fill the prescription now, then you will have a month reserve instantly when you do start.

This is interesting.

And hence saving of some two thousand five hundred bucks. Lol
« Last Edit: June 29, 2011, 11:00:10 AM by metekrop »
Diag on Dec 8, 2000, CD 440 VL 44K, No Meds
Dec/08 - Feb/09 CD< 50 & VL >500k hosp'z.
St. Atripla - July/09 CD 179, VL 197k
Oct/09 CD 300 VL UD Chol 267
Mar/10 CD 468 UD, Ch 220
Aug/10 CD 460 UD, Ch 195
Dec/10 CD 492 UD, Ch 172
Mar/11 CD 636 UD, Ch 201
Aug/11 CD 530 UD, Ch 98
Jan/12 cd 616 UD, ch 189
Jul/12 CD 640 UD, Ch ?
Dec/12 CD 669 Ud, Ch 125
May/7 CD711 Ud, Ch?
Nov/ 22 663 UD, Ch,
April 17 CD 797,
Oct, 14 CD 810 UD

Offline mecch

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Re: Does One Month Make A Difference?
« Reply #21 on: June 29, 2011, 05:21:47 PM »
This is interesting.

And hence saving of some two thousand five hundred bucks. Lol


I dont understand your point.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Ann

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Re: Does One Month Make A Difference?
« Reply #22 on: June 29, 2011, 07:10:21 PM »
I dont understand your point.

Join the club. I think we need an app for that.
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Nicolas2

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Re: Does One Month Make A Difference?
« Reply #23 on: July 11, 2011, 05:51:12 AM »
Tomorrow is the day.

Why do I feel so depressed?  ???

It's a medicine. It will help.

But all I feel is pity for myself.

And for people I love (maybe even more).
« Last Edit: July 11, 2011, 05:53:55 AM by Nicolas2 »

Offline eric48

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Re: Does One Month Make A Difference?
« Reply #24 on: July 11, 2011, 06:32:46 PM »
Why do I feel so depressed?  ???
It's a medicine. It will help.

You should not feel depressed.

The first few months may be somewhat tough (for some people), but after a few months, it will as easy as taking bufferin

except that you should not forget the daily dose and quarterly blood draw.

I am at month 13 into treatment and , one step at a time, I can see the issue move to the back burner.

take it easy, one step at a time.

You should actually feel pride for taking good care of yourself (and of your loved ones)

Eric

NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: NCT02157311 = 4d. ON, 3d. OFF)

Offline Nicolas2

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Re: Does One Month Make A Difference?
« Reply #25 on: July 12, 2011, 02:56:16 AM »
Thank you Eric.

July 11, '11...11h11m...the first one.

Good luck to me and all good people..

Offline emeraldize

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Re: Does One Month Make A Difference?
« Reply #26 on: July 12, 2011, 07:25:08 PM »
Thank you Eric.

July 11, '11...11h11m...the first one.

Good luck to me and all good people..
Good Luck. I thought it was interesting all of your 11s in your start date.
I chose 10-10-10 so I could remember it cuz Imma Fruity Old Thang.

Offline Nicolas2

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Re: Does One Month Make A Difference?
« Reply #27 on: July 29, 2011, 08:06:32 PM »
After 11 days of treatment, my VL dropped from 115,000 to 1,000 and CD4s raised from 580 to 680.

Next lab work in 3 weeks.

I also switched from evening to morning taking pills...both doctor and the pharmacist said it's ok and there's no harm or risk to do that...hope they're right...

Offline eric48

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Re: Does One Month Make A Difference?
« Reply #28 on: July 30, 2011, 07:23:11 PM »
I also switched from evening to morning taking pills...

I did the same a few months into treatment but after a few days I realized I was so nervous during the day  could not endure it any more. I moved it back to evening and things came back to normal.

Then a few month later I tried again to move it to the morning and so far so good.

I find the morning dosing easier as you do not have to worry about carrying pills, etc. also easier to stick to a tighter schedule.

I take my meds religiously 24h apart sharp. Some meds and some people history/complexion are more forgiving than other.

I gave the bug no chance

down to 1000 is right on pattern.

now, it will enter a second phase that (statiscally) is slower: that is normal and expected.

even with a sharp initial decrease the second phase can take its time. it is neither you , the virus nor the potency of the drug that drive this decay (unless the drug do not match the virus, which is why they will keep close monitoring for a while...)

being religious about the meds (timing, dosing, etc.) for the first few months, until you become UD is the best way to go. Once UD, you can take a bit of that presure off you.

Cheers

Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: NCT02157311 = 4d. ON, 3d. OFF)

Offline Nicolas2

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Re: Does One Month Make A Difference?
« Reply #29 on: July 30, 2011, 08:03:13 PM »
Thank you, Eric.

I also decided to be fanatically religious in this - so I was concerned about that changing schedule. But as I said both doctor and the pharmacist said "Oh sure!" when I asked...

Having pills in the evening made me think about it A LOT during a day. This way, I take them in the morning and I completely forget about it until the next day. Also, having a huge breakfast (which I also religiously follow, maybe too much) is much better for me than huge dinner...

Cheers :)

Offline Ann

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Re: Does One Month Make A Difference?
« Reply #30 on: July 31, 2011, 08:58:05 AM »

I take my meds religiously 24h apart sharp. Some meds and some people history/complexion are more forgiving than other.
 

I hope you meant a word like constitution rather than complexion. I understand that English may not be your first language, but the word complexion has to do with the appearance of your skin, not your physical makeup.

I'm not usually this pedantic, but the way you used the word complexion could lead some to think that people of different skin colours may respond to the meds differently.


com·plex·ion
n.
1. The natural color, texture, and appearance of the skin, especially of the face.
2. General character, aspect, or appearance: findings that will alter the complexion of the problem.
3. A viewpoint, inclination, or attitude: a conservative political complexion.
4. The combination of the four humors of cold, heat, moistness, and dryness in specific proportions, thought in ancient and medieval physiology to control the temperament and the constitution of the body.

con·sti·tu·tion
n.
1. The act or process of composing, setting up, or establishing.
2.
    a. The composition or structure of something; makeup.
    b. The physical makeup of a person: Having a strong constitution, she had no trouble  climbing the mountain.

3.
    a. The system of fundamental laws and principles that prescribes the nature, functions, and limits of a government or another institution.
    b. The document in which such a system is recorded.
    c. Constitution The fundamental law of the United States, framed in 1787, ratified in 1789, and variously amended since then.
« Last Edit: July 31, 2011, 08:59:42 AM by Ann »
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Offline eric48

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Re: Does One Month Make A Difference?
« Reply #31 on: July 31, 2011, 05:46:16 PM »
your are correct.

Lesson learnt.

Thanks

Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: NCT02157311 = 4d. ON, 3d. OFF)

 


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