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Author Topic: CD4 Only Needed Once A Year When UD, Another Study Says  (Read 5621 times)

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Offline elf

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #1 on: February 01, 2013, 06:28:04 PM »
I don't know...
This may be cost-cuttting influenced.
Let's have a Kiki!

Offline Newguy

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #2 on: February 01, 2013, 07:31:59 PM »
I was diagnosed last year and I decided to make own system regarding doctors appointments. Instead of going to see the doctor every three months which I hate, he gave me a stack of blood requisition forms. I can walk in to any blood drawing lab clinic and get my panel done. I due this every six months or so. The deal is that if there is a problem my doctor will call and he hasn't called yet so I assume everything is going alright. I have no idea what my numbers are. But I kinda of like it this way. He said it is a new approach but he respects my wishes and totally supports it. As long as I take my meds, he said there shouldn't be anything to worry about.

In a strange way it kinda of normalizes the experience, like I don't really have HIV but I do? Popping the pills is fine but when I go to the doctor that is when it hits me that I really have HIV.

Best to all!

Offline mitch777

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #3 on: February 01, 2013, 07:47:09 PM »
I don't know...
This may be cost-cuttting influenced.
ageed 100% ^ (this)

side note to Newguy...
if you are comfortable in your choice, i can not fault you, but i only hope that this study does not lead to ANY sort of cost cutting clampdown from insurance companies.
also, many hiv+ people don't have the best relationship with their health care provider.
31 years hiv+ (oct. 2013) with a curtsy.

Offline Newguy

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #4 on: February 01, 2013, 08:04:09 PM »
I am all about cost cutting as long as it does not jeopardize the quality of care to the patient. There is really no reason to see my doctor, he simply just reads the results to  me. This causes unnecessary anxiety. The real therapy is in the meds, they are doing the job. The doctor is just confirming that they are working.

I see this study as great news for people with HIV infection. It certainly makes me feel a lot better.

Offline Jeff G

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #5 on: February 01, 2013, 08:38:31 PM »
I was diagnosed last year and I decided to make own system regarding doctors appointments. Instead of going to see the doctor every three months which I hate, he gave me a stack of blood requisition forms. I can walk in to any blood drawing lab clinic and get my panel done. I due this every six months or so. The deal is that if there is a problem my doctor will call and he hasn't called yet so I assume everything is going alright. I have no idea what my numbers are. But I kinda of like it this way. He said it is a new approach but he respects my wishes and totally supports it. As long as I take my meds, he said there shouldn't be anything to worry about.

In a strange way it kinda of normalizes the experience, like I don't really have HIV but I do? Popping the pills is fine but when I go to the doctor that is when it hits me that I really have HIV.

Best to all!

If its working for you then who is to say other wise . I prefer to have that one on one interaction with all my doctors . I have found that my involvement and discussions with my HIV doctor has saved me allot of heartache down the road and over the many years I have caught more than a few things that needs to be addressed that wouldn't have been caught if I hadn't been there to ask questions . A good doctor patient relationship is more than just medicine and labs , far more in my estimation . Best of luck ! .

Offline Newguy

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #6 on: February 01, 2013, 09:04:45 PM »
If its working for you then who is to say other wise . I prefer to have that one on one interaction with all my doctors . I have found that my involvement and discussions with my HIV doctor has saved me allot of heartache down the road and over the many years I have caught more than a few things that needs to be addressed that wouldn't have been caught if I hadn't been there to ask questions . A good doctor patient relationship is more than just medicine and labs , far more in my estimation . Best of luck ! .

Agreed! And this is why HIV is an incredibly odd condition. Has there ever been a condition that affects everyone differently? From sero conversion to treatment. There is no consistent result. This is why patient care needs to be tailored to the individual. And what I have learned with this infection is that the more you know the better. Of course this should be the same with all things but like I said, I tailored my treatment my way. It is what helps me cope and deal with the virus. But others need that face to face interaction and that is fine too. I actually cant wait for a home CD4/viral machine where you can just do it yourself and avoid the medical experience all together save the meds.

Best to all!

J

Offline phildinftlaudy

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  • sweet Ann what you think babe...
Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #7 on: February 01, 2013, 09:35:11 PM »
I definitely don't agree with this study...
Seeing as my CD4s have fallen by more than 700 in the last 9 months while still remaining UD....

As a matter of fact, doc has already said that if next labs (which I get Feb 20th and results on March 6th) have fallen any lower while still remaining UD - she will be ordering additional tests/referrals to check for leukemia/lymphoma as these are typically the only conditions she has seen that will cause a continued CD4 drop, while remaining UD, with a corresponding increase in % of lymphocite...

While I could see twice a year - I think there are too many factors that can "pop up" that negates only getting them done one time a year.
September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline Newguy

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #8 on: February 01, 2013, 09:48:20 PM »
I definitely don't agree with this study...
Seeing as my CD4s have fallen by more than 700 in the last 9 months while still remaining UD....

As a matter of fact, doc has already said that if next labs (which I get Feb 20th and results on March 6th) have fallen any lower while still remaining UD - she will be ordering additional tests/referrals to check for leukemia/lymphoma as these are typically the only conditions she has seen that will cause a continued CD4 drop, while remaining UD, with a corresponding increase in % of lymphocite...

While I could see twice a year - I think there are too many factors that can "pop up" that negates only getting them done one time a year.

Like I said in my previous point a very strange infection indeed? You are UD and your CD4's have dropped? very strange indeed. Good luck with that and I hope it works out!

I hope you do not have lymphoma or leukemia.

Good Luck

Offline Jeff G

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #9 on: February 01, 2013, 10:06:05 PM »
Newguy ... I do truly hope you remain healthy but please keep in mind that even doctors needs a doctor from time to time . I understand you are trying to minimize the inconveniences that comes with living with HIV but I feel you may be in denial if you think you can manage HIV without the guidance of a doctor . I do hope that others wont make the same choice as you have ... I rather doubt many will make the same choice but just in case I thought it worth the effort to comment on .

Offline phildinftlaudy

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #10 on: February 01, 2013, 10:18:49 PM »
Just to add to my previous post - and also to affirm what Jeff has said -
Being HIV+ creates highly volatile situations in many people... at the same time, we also have a benefit.... In getting regular labs done, we are able to identify many problems (many not even HIV related) that other people without our condition may not identify for years or until they are way out of control....

So, while it may seem, at times, like people with HIV have more health issues than those without, my thought is that we are just made aware of potential health issues earlier than those who only visit the doctor once a year (or even less - like when something goes wrong).

Regular labs help us to know our bodies response and personal medical "normalcy" better ---- when something is off kilter, we are in a great position to identify it early.

My doctor didn't notice the downward trend in my CD4s, increase in lymphocites, decrease in CD4%, while remaining UD - but I did... I also knew that I had two hospitalizations during the same 9 month period - as well as a general feeling of "not feeling right."

Knowing our labs, being atuned to them on a regular basis - as well as knowing our own personal normal, puts us in a much better position to bring issues/trends to the attention of our doctors - who are normally only looking at the latest lab readings. To me, this is the strongest form of person advocacy and control I can take of my own health and shows my investment in my medical condition and care.

September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline buginme2

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #11 on: February 01, 2013, 10:20:48 PM »
Agreed! And this is why HIV is an incredibly odd condition. Has there ever been a condition that affects everyone differently? From sero conversion to treatment. There is no consistent result.

J

Yes, in fact every disease/condition out there doesn't affect everyone exactly the same.  My high cholesterol may cause me to have a heart attack and your high cholesterol may not.   My cancer may be fatal and yours may go into remission.  How exactly is HIV different?

Your reasoning that HIV affects everyone differently is precisely the reason why you should see your doctor one on with with a regular frequency.  That way you can manage your disease, as you may be one of the unlucky ones.
« Last Edit: February 01, 2013, 10:22:56 PM by buginme2 »

Offline Newguy

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #12 on: February 01, 2013, 10:22:09 PM »
Newguy ... I do truly hope you remain healthy but please keep in mind that even doctors needs a doctor from time to time . I understand you are trying to minimize the inconveniences that comes with living with HIV but I feel you may be in denial if you think you can manage HIV without the guidance of a doctor . I do hope that others wont make the same choice as you have ... I rather doubt many will make the same choice but just in case I thought it worth the effort to comment on .

Hi jg1962

My doctor is very much in charge! Nothing in my post seems to suggest otherwise. There is no deed to go physically see my doctor every three months. It is a waste of time, emotion and money. Let me guide you with how it works. He gave me blood panel requisite forms. These order the type of tests I need. From CD4 counts to Viral load counts to sugar, fats, liver all that crap. Every 6 months or so I walk into a private blood drawing clinic. They are a dime a dozen and are everywhere in the country. I don't pay anything instead I show them my health card and they charge the government. They take 8 vials of blood. They send them to the appropriate testing centers and the results go back to my doctor. He analyzes them and if there is no problem he does not call me. How is this different from taking a day off, driving to the doctor, paying for parking, waiting in the waiting room and having him sit me down and say everything is fine?

This is the new direction of HIV treatment. Although it is still a serious problem, you want to make the experience as easy as possible. This in itself is treatment. As long as I get my blood work done I think everything is fine. If freeing my doctor gives him more time in the lab doing research or helping other people more in need. And trust me there are much more in need than I totally support a system like this. Doctors are not psychologists they are there to fix you not make you feel better. And mine does exactly that. I have friends with HIV that see their doctors for an hour at one appointment. And I ask them what do they possibly discuss for an hour? They seem to never remember.

Best



Offline Newguy

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  • Posts: 127
Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #13 on: February 01, 2013, 10:25:07 PM »
Just to add to my previous post - and also to affirm what Jeff has said -
Being HIV+ creates highly volatile situations in many people... at the same time, we also have a benefit.... In getting regular labs done, we are able to identify many problems (many not even HIV related) that other people without our condition may not identify for years or until they are way out of control....

So, while it may seem, at times, like people with HIV have more health issues than those without, my thought is that we are just made aware of potential health issues earlier than those who only visit the doctor once a year (or even less - like when something goes wrong).

Regular labs help us to know our bodies response and personal medical "normalcy" better ---- when something is off kilter, we are in a great position to identify it early.

My doctor didn't notice the downward trend in my CD4s, increase in lymphocites, decrease in CD4%, while remaining UD - but I did... I also knew that I had two hospitalizations during the same 9 month period - as well as a general feeling of "not feeling right."

Knowing our labs, being atuned to them on a regular basis - as well as knowing our own personal normal, puts us in a much better position to bring issues/trends to the attention of our doctors - who are normally only looking at the latest lab readings. To me, this is the strongest form of person advocacy and control I can take of my own health and shows my investment in my medical condition and care.

If you ready the study correctly I believe 95% of people were in fact quite stable for the decade they monitored the study so I don't know where you are getting your highly volatile stats from. Hopefully not this site. Although this is great site remember most people tend to post negative experiences rather than positive ones. That is human nature.

Best

Offline phildinftlaudy

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  • sweet Ann what you think babe...
Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #14 on: February 01, 2013, 10:32:15 PM »
New... the problem I see with this approach, is that your doc is not looking for trends.... your doc is looking at ranges specified as normal ranges - and is not going to be cognizant of your own personal normal.  Especially, since most doctors have hundreds of patients....

For example... my body temperature runs around 96.5 degrees (not the "normal" 98.6).... when I see the doc because I am not feeling well, and the nurse says the temperature reading is only "slightly" above normal (at 99.8 degrees) - I know that this is not normal for me and that I have a fever (if a "normal" person has 98.6 and has a 102 temperature - the doc would say they have a fever.... but in my case, if I don't inform a new nurse of my "normal" reading he/she does not know...

Fortunately, from going to my doc regularly, they are aware of my normal temperature reading and know that my fever threshold is lower than the "average."  As a matter of fact, having this information, was why the my doctor ordered me to be held in the hospital for two extra days in September. The hospital doc thought my temperature was close enough to normal and was going to discharge me; however, after consulting with my doc and hearing what MY normal temp is, they decided to hold me - as I still had a significant fever according to my average temp.

Regular labs, seeing the doc allows them to get familiar with YOU specifically and not "ranges" or averages that may not apply to you.

But, it is your choice - I am just providing some guidance and knowledge based on having HIV for a bit over 4 years now and seeing how important it is to stay in tune w/ labs.
September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline phildinftlaudy

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  • sweet Ann what you think babe...
Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #15 on: February 01, 2013, 10:34:51 PM »
If you ready the study correctly I believe 95% of people were in fact quite stable for the decade they monitored the study so I don't know where you are getting your highly volatile stats from. Hopefully not this site. Although this is great site remember most people tend to post negative experiences rather than positive ones. That is human nature.

Best

Ok.... to emphasis what I said.... I said... "Being HIV+ creates highly volatile situations in many people" - I did not say all. Also, a study that shows 95% is only valid on the 95% who participated in the study. It can not be applied to assume that it would apply to 95% of persons with HIV.

The study was only done on 832 people - 95% would be 790 - however these are people who participated in the study... The fact that they participated in this type of longitudinal study goes a long way to showing that these are participants who are probably in tune with their medical care, their levels of normal - just by the very nature of committing to participate in a study.

Those not in tune with their medical care, their levels of normal, etc. would probably be less likely to commit or remain involved in such a longer term study...

This in addition to the fact that there are millions of HIV+ people in the world - makes me a bit skeptical of applying study results from 832 people to the wider population of those infected with HIV and their needs for more or less labs to assess CD4s.
« Last Edit: February 01, 2013, 10:39:37 PM by phildinftlaudy »
September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline Newguy

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #16 on: February 01, 2013, 10:39:23 PM »


But, it is your choice - I am just providing some guidance and knowledge based on having HIV for a bit over 4 years now and seeing how important it is to stay in tune w/ labs.
[/quote]

Did you read my post. I am very in tune w/labs and treatment, religiously actually. I just don't see the doc to get results.

Best

Offline wolfter

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #17 on: February 01, 2013, 10:47:27 PM »

Did you read my post. I am very in tune w/labs and treatment, religiously actually. I just don't see the doc to get results.

Best

I think it's poor form for your doctor to be ok with only seeing you yearly since you only tested positive last April.  I appreciate your opinion but I would never recommend it for others.

Wolfie
Complacency is the enemy.  ;)  Challenge yourself daily for maximum  return on investment.

Offline Jeff G

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #18 on: February 01, 2013, 10:53:19 PM »
All the doctors I know will not keep writing scripts for patients who refuse to keep appointments . I would think a doctor treating chronically ill patients puts themselves at an incredible amount of liability allowing patients not to come to clinic for checkups if something goes wrong .

Its not that I'm trying to argue with newguy , its that I'm rather shocked that a doctor would go along with something like this , especially with a condition as serious as HIV .

Newguy also reminds me of myself when I was younger . There was a time I convinced myself that I knew as much as my doctors did about HIV ... and boy was I wrong LOL .
I still have the tendency to diagnose myself but being wrong so many times has for the most part broke me of that habit .

Offline phildinftlaudy

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #19 on: February 01, 2013, 10:58:08 PM »


Did you read my post. I am very in tune w/labs and treatment, religiously actually. I just don't see the doc to get results.

Best

I did read your post. And unless I am misunderstanding or misreading - what I understood you to say is that you get your labs done and have a stack of orders for labs..... and that UNLESS your doc sees something that he/she considers out of the normal - you are not aware of what your labs are....

If this is correct, than what I said previously, stands in my opinion... That is, that your doc is looking at the labs that he/she has in front of him/her - not looking over your labs over the last few draws... and is only looking for readings that the laboratory indicates are out of the normal range (which is not necessarily indicative of what your personal normal/range is)....

Seeing my labs every few months allows me to be able to see trends/changes over time that my doctor is not going to be looking at - at least, not until something is out of whack.... My knowledge of my labs on an ongoing basis allows me to bring things to my docs attention - which she then knows to pay more attention to.

But, to each their own.
September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline Newguy

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #20 on: February 01, 2013, 11:00:22 PM »
All the doctors I know will not keep writing scripts for patients who refuse to keep appointments . I would think a doctor treating chronically ill patients puts themselves at an incredible amount of liability allowing patients not to come to clinic for checkups if something goes wrong .

Its not that I'm trying to argue with newguy , its that I'm rather shocked that a doctor would go along with something like this , especially with a condition as serious as HIV .

Newguy also reminds me of myself when I was younger . There was a time I convinced myself that I knew as much as my doctors did about HIV ... and boy was I wrong LOL .
I still have the tendency to diagnose myself but being wrong so many times has for the most part broke me of that habit .

Times have changed since you were younger. I don't like to think of myself as chronically ill. I have a chronic infection which is being treated.

Please read my post carefully. I am indeed under the care of a great doctor. The treatment of HIV infection has dramatically evolved for the better, and I expect this is the next rung in how treatment will be delivered.

Best

Offline Newguy

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #21 on: February 01, 2013, 11:03:29 PM »


Seeing my labs every few months allows me to be able to see trends/changes over time that my doctor is not going to be looking at - at least, not until something is out of whack.... My knowledge of my labs on an ongoing basis allows me to bring things to my docs attention - which she then knows to pay more attention to.

But, to each their own.
[/quote]

I am curious as to how much change you expect to see over a "few months" compared to six months?

Our bodies even with HIV are not that fragile

Best

Offline wolfter

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #22 on: February 01, 2013, 11:04:00 PM »
Times have changed since you were younger.

Best

But HIV hasn't. ;)
Complacency is the enemy.  ;)  Challenge yourself daily for maximum  return on investment.

Offline Newguy

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #23 on: February 01, 2013, 11:07:33 PM »
But HIV hasn't. ;)

I really don't know how to dignify that with a response. However I will try with this. In some unlucky individuals it has changed a lot! But fortunately for the majority of us it hasn't!

Not bad eh?

Offline phildinftlaudy

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #24 on: February 01, 2013, 11:12:39 PM »

I am curious as to how much change you expect to see over a "few months" compared to six months?

Our bodies even with HIV are not that fragile

Best

Look at my signature line to see the trend... As soon as I saw a drop from 1,200 to 700 with a corresponding drop in cd4%, and then ended up in hospital - I knew to keep an eye on them... This was within a three month period... Then a further drop.... ended up in hospital again.... and had a high (above range significantly) rise in lymphocites...

So, now doc and I are watchful waiting to see what next labs show...

Doc is now aware - because I was able to bring it to her attention to go back and look at labs over past 9 months - so, she sees the changes in multiple areas - thus, when I see her on March 6th - if they dip lower -it won't be something that she hasn't been made aware of from me keeping check on them over the period of every 3 month draws.

Had I only been having annual CD4s done... at the rate mine are dropping, I and my doctor would not be aware of it until they had dropped to a much lower level (if they continue in the direction they have been going)

So, I am a living example of the change that can occur in three months.
September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline Newguy

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #25 on: February 01, 2013, 11:14:41 PM »
I am curious what symptoms did you have that made you end up in the hospital?

Offline phildinftlaudy

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #26 on: February 01, 2013, 11:24:43 PM »
I am curious what symptoms did you have that made you end up in the hospital?

First time gastroenteritis - projectile vomiting; GI bleed; dangerously low potassium; fever; WBC extremely high

Second time - periocarditis - after having the flu in December; lymphocites pegged as high

At any rate, it is your decision.... no one is trying to come down on you - just sharing personal experience and the potential downfalls of not having a) CD4s done more than one time a year and b) not having an ongoing awareness of what your various lab results are (not just knowing them when you are "out of range" or when something is readily identifiable at wrong.
September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline wolfter

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #27 on: February 01, 2013, 11:36:24 PM »
Quote from the article that caused an eye rolling moment;

The investigators believe their results show that frequent, routine monitoring of CD4 cell count in people undergoing successful HIV treatment is unnecessary, even harmful.

Nothing like trying to scare people with non truths.  How can frequent testing be harmful?  Do I sense a bias?  Couldn't find additional information on the writer, but I'm on it once my head completely clears.
Complacency is the enemy.  ;)  Challenge yourself daily for maximum  return on investment.

Offline tednlou2

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #28 on: February 02, 2013, 01:02:26 AM »
I put in the title "another study says."  I thought there was at least one other study about this, but couldn't find it.  Wasn't there at least one other study?  Or not?  Didn't want to relay wrong info. 

Offline jkinatl2

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #29 on: February 02, 2013, 01:19:23 AM »
Quote from the article that caused an eye rolling moment;

The investigators believe their results show that frequent, routine monitoring of CD4 cell count in people undergoing successful HIV treatment is unnecessary, even harmful.

Nothing like trying to scare people with non truths.  How can frequent testing be harmful?  Do I sense a bias?  Couldn't find additional information on the writer, but I'm on it once my head completely clears.

Please do. I smell a really strong bias. From what I have read, this mode of operation works only with newly infected people, and only for those with the socioeconomic status to maintain drug adherence and availability over a sustained length of time.

This is, of course, barring unforeseen resistance, lipid and other issues.

I might be reading a lot into Newguy's writing, but I detect a level of condescension towards those who fall outside that rather narrow class of HIV infected persons that is difficult to ignore.

Is this the wave of the future? Probably. Along with treatment-as-prevention in lieu of condoms, and other advances. But I rather thinkit's arrogant to proclaim that one person's extraordinary luck with HIV treatment means that everyone else is doing it wrong.

Also, and in order to maintain my status as the grandmother who reminisces about WW2, extraordinary luck tends to run out. I hope that Newguy will take over the reigns at an ASO, or fight like hell to get the antiquated HIV criminalization laws stripped from the books, or perform services similar to the dinosaurs on whose shoulders he proudly stands.

Like running this forum, and stuff.

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

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Offline Common_ground

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #30 on: February 02, 2013, 03:26:20 AM »
Paul Sax raised this topic already 2 years ago. Here is his take on it, which also explains quite some of the questions asked here:

http://www.medscape.com/viewarticle/738175

He is also one of the cited authors for the article from Aidsmap.
2011 May - Neg.
2012 June CD4:205, 16% VL:2676 Start Truvada/Stocrin
2012 July  CD4:234, 18% VL:88
2012 Sep  CD4:238, 17% VL:UD
2013 Feb  CD4:257, 24% VL:UD -viramune/truvada
2013 May CD4:276, 26% VL:UD

Offline jkinatl2

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #31 on: February 02, 2013, 05:06:41 AM »
Paul Sax raised this topic already 2 years ago. Here is his take on it, which also explains quite some of the questions asked here:

http://www.medscape.com/viewarticle/738175

He is also one of the cited authors for the article from Aidsmap.


It is indeed radical, in that it demands that the patient not undergo traumatic or disruptive life experiences that might make adherence problematic (changing jobs and insurance for example) and it demands that the patient alone be the sole arbiter of his/her treatment, other than the once-yearly "check in" with a doctor.

I know that when my dad died, I sunk into a great depression that took me years to crawl out of. During that time I was of no use to anyone, and not particularly great at taking care of my own health. Had I not had thrice yearly cd4 count/viral load tests, along with what basically counted as a "welfare check" by my doctor, then several infections would have gone unnoticed. As it was, I contracted syphilis during that time, and in less than six months (thanks HIV for making things difficult) it bloomed into neurosyphilis, and required home health care, several lumbar punctures, and weeks on end of IV antibiotics.

Were I on a once-yearly doctor regimen, my descent into depression and then into a life-threatening illness would not have been noticed. 

Hey, maybe Newguy and people like him are simply above all that, better than that, stronger than that. But I can state with authority that I would not be alive were it not for the monitoring I have received since my HIV diagnosis. And it's not a young-old thing. HIV is a chronic illness that can bloom to acute status with little real warning, and the slipups and tribulations that most of us go through as we age through our 20s and 30s matter far more as regards our health than our HIV negative counterparts.

I just get a real Ayn Rand vibe from this thread.

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

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Offline YellowFever

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #32 on: February 02, 2013, 05:52:12 AM »
Gosh, people here tend to talk past each other and someone eventually whips out the "everyone's journey isn't the same"-card or "why don't you volunteer in the Am I infected? section"-card.

The question essentially boils down to the level of care your physician gives. Does he feel you? Look for spots on your bum? Do you pour out your grief to him? These I'm sure require physical presence at a physician's office. It seems that Newguy's doctor is only interested in interpreting those numbers without additional input from the patient (e.g Have you been tired lately? Experienced any dizziness?). There is a possibility that Newguy is communicating these things to his doctor via email/Skype/Text. Then the more interesting question would be whether telemedicine is suitable/recommended for HIV patients?

Ideally, I would want to be able to take the blood vials in any regular blood lab and let my doctor know if I feel something is wrong with my body without a traumatic visit to the "Infectious Disease Hospital" or "GUM Clinic". On the other hand, seeing as how even "tele-pharmacy"  (e.g. Curascript) could screw things up so badly for some people on this forum, maybe face-to-face care isn't such a bad deal after all.
08/2010 HIV- 08/2012 HIV+
10/2012 CD4 415(15%)
04/2013 CD4 457(15%)
10/2013 CD4 520 (20%) VL 650 (wtf?)
02/2014 CD4 410(20%) VL 390 (yay!)
08/2014 CD4 580(?%)

Offline Common_ground

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #33 on: February 02, 2013, 06:02:20 AM »
It is indeed radical, in that it demands that the patient not undergo traumatic or disruptive life experiences

that might make adherence problematic (changing jobs and insurance for example) and it demands that the patient alone be the sole arbiter of his/her treatment, other than the once-yearly "check in" with a doctor.

I know that when my dad died, I sunk into a great depression that took me years to crawl out of. During that time I was of no use to anyone, and not particularly great at taking care of my own health. Had I not had thrice yearly cd4 count/viral load tests, along with what basically counted as a "welfare check" by my doctor, then several infections would have gone unnoticed. As it was, I contracted syphilis during that time, and in less than six months (thanks HIV for making things difficult) it bloomed into neurosyphilis, and required home health care, several lumbar punctures, and weeks on end of IV antibiotics.

Were I on a once-yearly doctor regimen, my descent into depression and then into a life-threatening illness would not have been noticed. 

Hey, maybe Newguy and people like him are simply above all that, better than that, stronger than that. But I can state with authority that I would not be alive were it not for the monitoring I have received since my HIV diagnosis. And it's not a young-old thing. HIV is a chronic illness that can bloom to acute status with little real warning, and the slipups and tribulations that most of us go through as we age through our 20s and 30s matter far more as regards our health than our HIV negative counterparts.

I just get a real Ayn Rand vibe from this thread.

Well the studies in these two articles shows that for the majority (93% - 99%) thats not true, given that you stay adherent and have access to the meds, otherwise I doubt we would be reading these articles and having this discussion at all.

If it were more common with adverse events,treatment failures, life threatening infections then we would of course talk about having more frequent monitoring...or?

People needs to stay connected to health care and have access to it but I dont think that necessarily needs to equal visits to the doctor.
2011 May - Neg.
2012 June CD4:205, 16% VL:2676 Start Truvada/Stocrin
2012 July  CD4:234, 18% VL:88
2012 Sep  CD4:238, 17% VL:UD
2013 Feb  CD4:257, 24% VL:UD -viramune/truvada
2013 May CD4:276, 26% VL:UD

Offline buginme2

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #34 on: February 02, 2013, 12:33:09 PM »
You guys do realize that no one is talking about reducing doctor visits.

They are only proposing reducing the number of cd4 count tests.  They will still need to do viral load tests and all the other tests.  This is just one test that in the end doesn't affect treatment very often. 

Offline Miss Philicia

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #35 on: February 02, 2013, 12:59:18 PM »
You guys do realize that no one is talking about reducing doctor visits.

They are only proposing reducing the number of cd4 count tests.  They will still need to do viral load tests and all the other tests.  This is just one test that in the end doesn't affect treatment very often. 

Oh, I realize it -- unfortunately this thread was hijacked early on by Newguy.
"Iíve slept with enough men to know that Iím not gay"

Offline spacebarsux

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #36 on: February 02, 2013, 01:13:49 PM »
The article states:

"The study authors argued that reducing CD4 screens to once per year for virally suppressed patients would save both money and the anxiety patients often suffer from observing the fluctuations in CD4 counts that arenít clinically relevant."

I don't see how this makes much sense. You'd still need to check your VL, which is the more expensive test anyway. And besides, I'd feel more anxious not knowing my CD4.
Infected-  2005 or early 2006; Diagnosed- Jan 28th, 2011; Feb '11- CD4 754 @34%, VL- 39K; July '11- CD4 907@26%,  VL-81K; Feb '12- CD4 713 @31%, VL- 41K, Nov '12- CD4- 827@31%

Offline jkinatl2

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #37 on: February 02, 2013, 03:07:23 PM »
Gosh, people here tend to talk past each other and someone eventually whips out the "everyone's journey isn't the same"-card or "why don't you volunteer in the Am I infected? section"-card.

The question essentially boils down to the level of care your physician gives. Does he feel you? Look for spots on your bum? Do you pour out your grief to him? These I'm sure require physical presence at a physician's office. It seems that Newguy's doctor is only interested in interpreting those numbers without additional input from the patient (e.g Have you been tired lately? Experienced any dizziness?). There is a possibility that Newguy is communicating these things to his doctor via email/Skype/Text. Then the more interesting question would be whether telemedicine is suitable/recommended for HIV patients?

Ideally, I would want to be able to take the blood vials in any regular blood lab and let my doctor know if I feel something is wrong with my body without a traumatic visit to the "Infectious Disease Hospital" or "GUM Clinic". On the other hand, seeing as how even "tele-pharmacy"  (e.g. Curascript) could screw things up so badly for some people on this forum, maybe face-to-face care isn't such a bad deal after all.

Odd how even when we are in agreement you manage to put a dig in, Yellowfever.

The point I was making was that dismissing the opinions of those who have dealt with the AIDS side of HIV is a perilous journey. I find it particularly distasteful when our insights are handily dismissed but our efforts, this forum being one of them, are not considered relevant.

And I was responding to the hijacking poster, not the OP, for which I apologize. Should have requested the thread be split, since the removal of a single test does not in any way equal a radical departure from monitored care altogether.

My clinic can do cd4 counts on the premises, but viral load testing is done off-site. Which makes me wonder exactly whose sensibilities are suffering from knowing one's cd4 count in the first place.  While they can and do fluctuate, sometimes wildly, they are part of an overall snapshot that can indicate trends over time. I don't see how it truly matters, as the cd4 count is absolutely NOT the most expensive test on the table here.

Of course this forum gets people running breathlessly in a panic because of a drop in cd4 counts. But we also get the same breathlessness when people receive a viral load blip. It seems to be a lazy way to avoid educating people as to the importance of each individual test, the fluid state of the numbers, and the concept of trending over time.

And if people are put off by my hyperbole I strongly urge them to skip my posts, as it is not likely to get better.

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

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Offline buginme2

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #38 on: February 02, 2013, 03:28:40 PM »
The article states:

"The study authors argued that reducing CD4 screens to once per year for virally suppressed patients would save both money and the anxiety patients often suffer from observing the fluctuations in CD4 counts that arenít clinically relevant."

I don't see how this makes much sense. You'd still need to check your VL, which is the more expensive test anyway. And besides, I'd feel more anxious not knowing my CD4.

I think the reason they say it would reduce anxiety is because lets say someone has a cd4 count of 1000.  At the next test they have a cd4 count of 500.  That could be perceived as a big drop by the patient and would cause anxiety when in actuality it is still in the normal range and wouldnt change an treatment decision. 

Why put a patient through that kind of anxiety when its not going to change the treatment in anyway.  The majority of time as long as the person remains undetectable a drop if cd4 count will not change their treatment.

CD4 count test is still pretty pricey.   My clinic bills my insurance $250 for a cd4 count test. 

At my last doctor visit my doctor mentioned that he may start testing cd4 counts less often (currently I go twice a year).  That was before this study came out.  I'm more concerned about my viral load and CBC and lipid and metabolic panel than I am about cd4.

Offline thunter34

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #39 on: February 02, 2013, 03:57:46 PM »
I'm just now reading this thread, and this "barely there / I don't really wanna know" approach is blowing my mind.

I guess because I've been on the way down side of things, not just the "oops, I have hiv (lower case intended)" side.  And because my blood panel and stuff has gone totally haywire fast before, and my CD4 counts have also done temporary swan dives.  We were watching the trends and knew to be looking for it. 

I just don't trust this approach.  Have at it and good luck.  I like my doc, and will stick with what I've been doing.  I can see dropping the draws to six months, but I'd never cut out my doc visits.
AIDS isn't for sissies.

Offline jkinatl2

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #40 on: February 02, 2013, 03:59:15 PM »
But a 500 point drop IS worthy of a conversation, no?

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

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Offline jkinatl2

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #41 on: February 02, 2013, 04:16:46 PM »
I'm just now reading this thread, and this "barely there / I don't really wanna know" approach is blowing my mind.


The major issue I have with it is terror masked as bravado, and willful ignorance cloaked in dismissive arrogance.

Are some, perhaps many of us quite capable of handling our own care for the most part? Possibly. Probably, depending. But people are not automatons, and when dealing with a stigma-riddled illness like HIV, I have seen way too many people simply fall off the medical grid and not reappear until it was almost too late, if then.

Hence the Ayn Rand reference earlier.

I am curious, however, as to how often lab work of other sort is being encouraged. If the illness and treatment is observed by trends over time, what sort of time are we talking about? My case, while not totally rare, was not exactly usual. I managed to go from seroconversion and 800 cd4 cells to pneumonia and less than 100 cd4 cells within the span of a year.  I am lucky I pulled out of that, but I can easily see how someone could not.

Granted, the loss of a single test will still mean that a person gets regularly checked out, which is a good thing. I am just bemused (also amused sometimes) at recently infected people assuming that they have some sort of new version of HIV. While over the span of a few generations, this might be found true (some research suggests that HIV is, on a global and general scale, weakening pathologically,) this forum is rather replete with cautionary tales from people in their early twenties who disavow knowledge of and participation in their treatment.

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

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Offline Jeff G

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #42 on: February 02, 2013, 04:41:39 PM »
I have found that knowing my labs overtime has helped calm my fear when I do get that blip now and then . Knowing those trends or ups and downs with my labs as taught me to not overreact , in fact I have had to point this out to a few doctors over the years looking at me with sad eyes .

Many of us old dinosaurs or aidsosaurus as I'm fond calling us sometime didn't get where we are because we are stuck in the past and refuse to adapt . I think its not accurate to paint us like that at all because most of us have reinvented ourselves more times than we can remember . To be honest , the optimist in me likes the fact that I appear old and out of touch because I was told I would never get old much less so old I'm out of touch .

Offline leatherman

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #43 on: February 02, 2013, 04:46:20 PM »
Why put a patient through that kind of anxiety when its not going to change the treatment in anyway.  The majority of time as long as the person remains undetectable a drop if cd4 count will not change their treatment.
hmm, rather than reducing monitoring of a person's condition it sounds like maybe we should advocate for better behavior and education from doctors. Shouldn't a doctor clearly explain there is no reason for anxiety?

Heck I do it all the time here in these forums in a few typed lines when people freak about their cd4 counts: a cd4 count can change by 100 in just one day. the cd4 count should always be viewed as a trend over at least 3 times and a few months. CD4 count is not magic, because each person is different, a functioning immune system can be just as effective at 300 as at 1000. As long as your VL remains UD, a changing CD4 count is pretty unremarkable.

CD4 count test is still pretty pricey.   My clinic bills my insurance $250 for a cd4 count test. 
kudos for trying to be cost effective. ;) really. I agree; but just not to such an extent as of once a year. Each time I had issues, I went from UD to hospitalized and nearly dying in only 9 months. Testing every 6 months at the very least could prevent a lot of sickness and expensive.

Also since the treatment cascade shows that less than 25% of all American HIV+ people remain in care and remain undetectable, talking about getting more people treated and monitored seems much more appropriate than looking at ways to reduce care and lessen monitoring. While a rare few people might be able to handle such an arrangement taking the time to study this austerity issue at all, with the situation as it currently is, seems unneeded, unwarranted, and might lead to incorrect conclusions of what care actually needs to be to get the other 75% of positive people properly treated.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline leatherman

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #44 on: February 02, 2013, 04:50:45 PM »
I hope that Newguy will take over the reigns at an ASO, or fight like hell to get the antiquated HIV criminalization laws stripped from the books, or perform services similar to the dinosaurs on whose shoulders he proudly stands.

Like running this forum, and stuff.
to only go OT for just a moment, if we need another thread so be it; but I've noticed this recurring sentiment in some of your posts - and I applaud you for your tenacity. Keep pounding the drum! Would that all these people having such wonderful times with their HIV would get off their butts and take up the cause.

I remember first moving to SC and attending an ADAP funding rally. There were less than 200 people there and as I interviewed the crowd I found that most were paid case managers, DHEC employers, etc. Out of the 2,111 people using ADAP at that time, there were only 2 people in the crowd who used ADAP. While I understand that ADAP and the meds might have made all those other 2,109 people still able to work full time, not one person called in sick or took the morning off to help fight to ensure the funding continued and that they continued to receive medications. Since without meds AIDS is pretty much guaranteed, that means 2,109 people didn't care enough to fight for their meds, their own lives or the lives of others.  :'(

I guess without people dying all around them, without a sense of recent history, in this self-absorbed society, people just don't realize that the only reason we have meds and HIV clinics is because a lot of people stood up and fought to make today's situation come about. Society sure didn't care - it was the people infected and affected that got us to where once-a-year checkups can even be considered. Right now there are still 51 people on ADAP waiting lists just hoping they have meds next month (and that's down from nearly 10,000 just a little over a yr ago!) - not to mention all the people just barely hanging on to housing, meds, and food; or those for whom HIV has  been a devastating illness and can't imagine life not going to a doctor every month much less 6 months or a year.

Of course with several states not accepting Medicaid Expansion and the Sequestration ahead of us, we have quiet a dichotomy in our society as some people have easy access to meds and will only check in with a doctor once a year and others will struggle from month-to-month just trying to get access to meds unable to visit a doctor at all because there is no funding or no way to travel to a clinic.

And all the while, HIV infection rates are climbing.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline buginme2

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #45 on: February 02, 2013, 06:25:19 PM »
But a 500 point drop IS worthy of a conversation, no?

Yes, bad example on my part.

The major issue I have with it is terror masked as bravado, and willful ignorance cloaked in dismissive arrogance.

 this forum is rather replete with cautionary tales from people in their early twenties who disavow knowledge of and participation in their treatment.



I agree.  I don't get it (and I was diagnosed a few years ago although I'm no longer in my twenties).  However, it's not everyone newly diagnosed.  I go to the doctor no less than 6 times a year.  Twice a year to the HIV doc, once a year to the dermatologist, and three times a year to the anal dysplasia clinic which is part of the HIV program at the medical center I go to.  And those are just routine appointments, if I am sick it goes up.  I am very engaged in my care and stay on top of my treatment. 


« Last Edit: February 02, 2013, 06:27:13 PM by buginme2 »

Offline Newguy

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #46 on: February 02, 2013, 06:47:06 PM »
Please do. I smell a really strong bias. From what I have read, this mode of operation works only with newly infected people, and only for those with the socioeconomic status to maintain drug adherence and availability over a sustained length of time.

This is, of course, barring unforeseen resistance, lipid and other issues.

I might be reading a lot into Newguy's writing, but I detect a level of condescension towards those who fall outside that rather narrow class of HIV infected persons that is difficult to ignore.

Is this the wave of the future? Probably. Along with treatment-as-prevention in lieu of condoms, and other advances. But I rather thinkit's arrogant to proclaim that one person's extraordinary luck with HIV treatment means that everyone else is doing it wrong.

Also, and in order to maintain my status as the grandmother who reminisces about WW2, extraordinary luck tends to run out. I hope that Newguy will take over the reigns at an ASO, or fight like hell to get the antiquated HIV criminalization laws stripped from the books, or perform services similar to the dinosaurs on whose shoulders he proudly stands.

Like running this forum, and stuff.

WOW! I had no idea my sharing my personal experience with HIV treatment would cause such a fuss. One more time I will walk you through this.

I have an HIV infection. This means that I need to take medications to suppress the virus. Currently I am taking Truvada and Isentress. I have a year supply of prescription and pay for them via an insurance program here in Ontario. It is like 5% of my income. Secondly I have two doctors, my ID specialist and my family doctor. I don't like visiting the doctors every three months, it gives me anxiety! I hate taking the time off work and it costs me money. I have to pay for parking and so on and so forth. So, I asked him if he can give me a supply of requisite forms and I will go get my blood panel done and should there be any problems with CD4, Viral, sugar, lipids, liver and the other 10 biochemistry tests he looks at he will give me a call. How is this any different than going to see him in person to get the results? If I have some other problem, I go see my family doctor. I take my pills religiously and have been 100% compliant. I don't mess with the medication as I clearly understand the consequences. The less I see my ID doc the more time he can devote to cases that are more serious. I am still in treatment, very much engaged and I take my HEALTH VERY VERY VERY VERY seriously.

This thread was a research article stating that once a year CD4 monitoring might be fine. I feel more comfortable with twice a year blood panel but I do trust the scientists and doctors in control. I think this is great news for many people since it takes away the stigma that although HIV can still be very serious it can be managed if properly treated.

And as far as your ASO comment? I would never join one (I have my reasons) I am one. I have managed to get three guys to stop hard drug use and start treatment just in the last 6 months. All people with HIV should be walking ASO organizations, and help one another even if it is with just compassionate chat, it helps immensely! From experience.

Best

Offline Jeff G

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #47 on: February 02, 2013, 07:02:18 PM »
I hope it didn't seem like a fuss , its just more of the same of what we do here and that's exchange information and opinion .

Offline anniebc

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #48 on: February 02, 2013, 07:31:35 PM »
I hope it didn't seem like a fuss , its just more of the same of what we do here and that's exchange information and opinion .

I didn't see any fuss, just great advise and information from JK and the other old dinosaurs who know the ropes and tell it like it is, they don't talk to us like we are children, nor do they patronise us, like some people I could mention, I really like that about them.

Aroha
Jan :-*
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Never knock on deaths door..ring the bell and run..he really hates that.

Offline wolfter

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Re: CD4 Only Needed Once A Year When UD, Another Study Says
« Reply #49 on: February 03, 2013, 06:24:31 AM »

Many of us old dinosaurs or aidsosaurus as I'm fond calling us sometime didn't get where we are because we are stuck in the past and refuse to adapt . I think its not accurate to paint us like that at all because most of us have reinvented ourselves more times than we can remember . To be honest , the optimist in me likes the fact that I appear old and out of touch because I was told I would never get old much less so old I'm out of touch .

Major win....thank you!!!!  And though I appreciate perspectives from newbies, to be dismissed is a great disservice. 
Complacency is the enemy.  ;)  Challenge yourself daily for maximum  return on investment.

 


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