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Author Topic: how often do we need to visit doctor's office?  (Read 2156 times)

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Offline sfguys

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  • Posts: 25
how often do we need to visit doctor's office?
« on: April 01, 2014, 01:40:41 PM »
hi, my partner and I got tested positive two days ago. We have been shocked and sad since. After talking to some social workers and knowing more about HIV, we feel much better now.

We both want to start the treatment right away. Unfortunately, we currently don't live in US any more. Both of us moved from US to an Asian country late last year. Now we need to re-think about where we want to live in the near future. We know we ultimately need to live in US given the country has much better medical system. But in next couple of years, is it still possible for us to live outside US for a couple of more years and come back to US regularly to get our blood tested and CD4 count and viral load monitored? I know when we initially start the treatment, we probably need to see doctors more often. But after the initial phase, how often do we need to see the doctors or nurses, assuming the treatment goes well? Both of us are under 40s and have had no health issues previously.

All these things happen so quickly. I really appreciate the information given on this forum.

Offline AusShep

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  • Posts: 207
Re: how often do we need to visit doctor's office?
« Reply #1 on: April 01, 2014, 02:05:01 PM »
I'm slightly confused.  Is there a reason you can't get your CD4 and viral load checked in Asia?  Are you planning on starting treatment there or not until you return to the US?

A lot of the timing is going to depend on what your numbers are, how you're responding to treatment, any other issues that come up, and what you and your dr are comfortable with.

Once you're stable, expect blood work every 3 to 6 months.  Maybe 3 for a while then just twice a year if nothing else is going on.


Offline Bizkits

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  • Posts: 105
Re: how often do we need to visit doctor's office?
« Reply #2 on: April 01, 2014, 02:27:20 PM »
As a newbie myself, I'm still in all the beginning phases. I do live in the US and this is what my doctor told me to expect and this is what I've done so far:

since diagnosis on 03/06/14, I have seen primary care and ID provider, I have had more blood drawn than I care to speak of on 4 different occasions (once per week since diagnosis). I will see ID provider again on 04/14/14 at which time I'm supposed to start on meds, providing that all the information from labs and what not are available to my doc. From there, she told me to expect to see her at least every 1-2 months for 6 months, labs every 2-4 weeks until my viral load is UD, stays UD, kidneys and liver are still working fine and there's no worries about my CD4 (which is over 800 right now, so I'm not worried about that). Once I'm "stable", she said I might be able to go on the "every 6-month" plan. She's given me explicit instruction to make myself available readily if needed and to not plan any long trips for the next couple of months. It's really been quite a whirl-wind.

I'm not sure how the healthcare system where y'all are varies from here and what y'alls eligibility may be. If y'all plan on staying abroad for a while, is there are reason y'all can't have labs done there or even begin treatment? It's still hiv no matter where you are, the basic path should be about the same, with maybe a few differences given all the variables specific to you and your partner. Seems it'd be more practical, at least until y'all return state-side permanently to seek out care where y'all are at?

Offline zach

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  • not fade away
Re: how often do we need to visit doctor's office?
« Reply #3 on: April 01, 2014, 02:51:32 PM »
You didn't specify where in Asia you. Some countries are very progressive, some are not. Depending on where you are, getting medical in place may not only be possible, but preferable.

To your question. Depends on your numbers right now. If bad, you'll see Dr more often until improved
gonna go up to the mountain, for to find a little peace
looking over the valley, for the beauty i see
out across the hills, forevermore

Offline sfguys

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  • Posts: 25
Re: how often do we need to visit doctor's office?
« Reply #4 on: April 01, 2014, 11:56:19 PM »
It is great to see your guys' answers so quickly. I met two doctors today and got more information as well.

The Asian country we moved to is China. It is still a country where people are still very afraid of HIV. My big concern is there is essentially no privacy in China. Once I seek treatment for HIV in China, the government will know and my life could be a lot different from there. I may be denied entry next time I want to visit China. So seeking treatment in China is out of question right now.

Here in US, my partner and I currently don't have any insurance since we didn't think we need it here. We are lucky enough to receive treatments from an Aids Foundation. People there are so kind and helpful. I almost wanted to cry in front of them today since I was so touched.

We got our blood drawn today to test CD4, viral load, genotypes, etc. The doctor there told us once she got the result, she will decide which medicine to use, which will probably be 4 weeks from today. I did ask her how frequent we need to see her. She indicated that after the treatment starts, we will need to get our blood tested again in 4 weeks to see if the medicine is effective. And after that, we only need to see her every 3 months until our situation is stable. Once it is stable, we can see her twice a year.

Based on what Bizkits described, it seems our doctor doesn't ask us to see her that often. I am wondering if it is because our doctor is describing the best case scenario . Our doctor also said she is pretty confident that the medicine will work for us after she knows the virus' genotype. She didn't mention we need to do labs every 2-4 weeks or get our liver or kidneys checked.

What are you guys experiences after you start treatments? How frequent did you see doctors and what do you need to see doctors for after treatment starts? The reason why I am asking is because even though it is great we are getting treatments for free right now, we also don't want to regret in the future because we are too cheap and stupid not to spend money and time on our health.

Many thanks!

Offline AusShep

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  • Posts: 207
Re: how often do we need to visit doctor's office?
« Reply #5 on: April 02, 2014, 12:13:10 AM »
It's really great that you'll be able to start treatment. 

Your Dr's plan sounds totally reasonable, and is the same I'd expect you would get in the US if you have decent CD4 counts and your viral load goes undetectable quickly.  She'll be checking other blood work numbers at 1 and 3 months and asking about side effects, etc.

Offline Bizkits

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  • Posts: 105
Re: how often do we need to visit doctor's office?
« Reply #6 on: April 02, 2014, 02:23:36 PM »
sfguys,

   As I am a RN, I can tell you from personal experience that every doctor has their own approach and style. Mine is a bit more "mother hen" than some. I'm totally okay with that, in fact, I kind of like it. That doesn't mean, though that y'alls doc is doing anything wrong. It seems perfectly reasonable and seems to be following the same pattern as mine, really...the same pattern of many. I don't think it's a "best case/worst case" scenario at all. Just the way that doc runs her ship.

Offline sfguys

  • Member
  • Posts: 25
Re: how often do we need to visit doctor's office?
« Reply #7 on: April 02, 2014, 09:13:21 PM »
AusShep & Bizkits, thank you for your info. It is quite comforting to know that our process looks like normal procedures. I am hoping that our numbers will be fine so that we don't run into too many issues with treatments. Our results should be back next week.

Today is the third day I know my status. For some reason, I feel very sad today. For the first two days, I was busy in trying to figure out how to get treatments. Now that seems settled, the reality has gradually sunk in. What side effects are we going to run into? How is this positive status going to affect our life? Can we still work hard and pursue our dreams, or we need to back off and just try to survive? After meeting doctors and reading posts here, it seems we will be fine as long as we keep taking medicine. But am I too optimistic to think that this is not going to affect our life? 

Offline buginme2

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  • Posts: 2,991
Re: how often do we need to visit doctor's office?
« Reply #8 on: April 02, 2014, 10:17:31 PM »
I would be concerned about receiving second tier older drugs in China. 

The choice for initial drug therapy is usually different in the US than in Asia.  You may very well be started on a drug that's no longer used in the US.

Offline Bizkits

  • Member
  • Posts: 105
Re: how often do we need to visit doctor's office?
« Reply #9 on: April 03, 2014, 09:28:17 AM »
Today is the third day I know my status. For some reason, I feel very sad today. For the first two days, I was busy in trying to figure out how to get treatments. Now that seems settled, the reality has gradually sunk in. What side effects are we going to run into? How is this positive status going to affect our life? Can we still work hard and pursue our dreams, or we need to back off and just try to survive? After meeting doctors and reading posts here, it seems we will be fine as long as we keep taking medicine. But am I too optimistic to think that this is not going to affect our life? 

I personally can't answer that of my own accord. This is only going on week #4 that I've known myself. The day I found out I was just numb...Aside from my own medical providers and nurses, I had told my partner and my best friend, who are both poz. We met out for happy hour promptly after work where I proceeded to drink my emotions and have a few laughs. I did have one good cry though before bed. I think it's important to feel sad, to grieve, to go through the whole process without keeping it all bottled in. I feel better every day, of course I have a poz partner and many friends that are poz, some "newer" than others and we've talked about that before...so I believe that has helped me in accepting becoming poz.  Do one more thing: Take a deep breathe, now let it out. You're not alone, it's ok to be feeling sad or angry...you're not alone. We'll all get through this together. It'll be okay.

While I would never wish hiv on anyone, I believe it can have a positive impact on your life. Of the friends I have that are poz, many have told me it was good that it happened to them because it changed their outlook on life: they are now in the best shape of their lives, their careers are going great, their support channels are well formed, many with long-term partners or husbands/wives...One of them who has been poz, I believe for 9 or 10 years has within the last 2 years become a world renound DJ on top of his other job and he's been travelling all over the place. So, are you in for some changes? Absolutely. Lifestyle modification? Better believe it. End of the world? Far from. Myself and I'm sure many others are going to be right there beside you. It would be interesting, don't you think to compare notes?

Of course there may be some things you can't do. I had to come to the realization that at least for now I couldn't participate in volunteering to go to Africa, as a nurse to work and teach in under developed countries. Maybe in the future I could consider it, but the resources and treatment I need now are not available there. I'm sure there will be some more hardships to overcome at one point or another but I haven't had to cross that bridge yet.

As far as all the ins and outs, I really can't speak of any. There are many people on this forum who are just wonderful, open, willing to share their experiences and a wealth of knowledge. Let them help act as your guide in a way, I am...But as the author says, only you can write your own book.

Offline kevinazus

  • Member
  • Posts: 23
Re: how often do we need to visit doctor's office?
« Reply #10 on: April 03, 2014, 05:31:27 PM »
Hey guys,

I'm pretty newly positive myself, tested positive on February 11. If it's any help, here's how my timeline has gone:

February 11:
Tested positive at local county clinic.
Assigned to an HIV caseworker.
Had blood drawn for Western blot confirmation as well as for CD4 count and viral load.
Also had a urinalysis, oral swab, and rectal swab for STDs.

February 18:
Got test results back. Western blot confirmed positive, STDs all negative, CD4 count 524, and viral load 245,000

February 26:
First meeting with HIV specialist where he did a history and physical exam, answered my 1 million questions, and talked about treatment options.
Had lots more blood drawn for HIV genotype testing, complete blood count, lipid panel, testosterone level, toxoplasma antibody, and vitamin D.

March 11:
Got all those test results back.
Started on meds - once a day Stribild.

March 18:
Second meeting with my HIV doctor at which he explained the results of all of my blood tests, asked about any drug side effects, and scheduled me for additional testing about a month later to see how my treatment is progressing.

April 15:
Will have more blood drawn to do another CD4 count and viral load, a PSA, and a Coccidioides serology (whatever that is).
Will also have a urinalysis I think to test kidney function.

April 22:
Will have my third meeting with the HIV doctor to go over my new CD4 count and viral load and see how I am responding to treatment.

After that, I'm a little unclear about the timeline. As I understand it, my doctor intends to do a CD4 count and viral load test at least once a month for a couple of months until my viral load is undetectable. He also explained to me that he will be doing another complete blood count, lipid panel, and vitamin D test to monitor my progress, but I'm not sure how long before those tests are run again.

He did say that once all the initial testing is done, that my viral load is undetectable, and that I am not having any problems with resistance to meds, that he anticipates only having to see me about every six months.

Good luck to you guys. Would be interested to hear how things go for you in China.

Kevin

Offline sfguys

  • Member
  • Posts: 25
Re: how often do we need to visit doctor's office?
« Reply #11 on: April 03, 2014, 06:35:17 PM »
Bizkits, I really admire you for that you are facing this with such a upbeat attitude and you have such a great support group around you. You even mentioned positive impact in our life with this positive status. That is really powerful.

I disclosed my HIV status to a good friend of mine yesterday since I felt so lonely and abandoned. He accepted it pretty well. We are going to meet with him tonight. He is also going to introduce one of his friends who has been positive for many years. I felt a little bit relieved because it means this HIV status is not going to drive away all the people we care or people who used to care for us. It means a lot.

Bizkits, how are you with your medicine?



I personally can't answer that of my own accord. This is only going on week #4 that I've known myself. The day I found out I was just numb...Aside from my own medical providers and nurses, I had told my partner and my best friend, who are both poz. We met out for happy hour promptly after work where I proceeded to drink my emotions and have a few laughs. I did have one good cry though before bed. I think it's important to feel sad, to grieve, to go through the whole process without keeping it all bottled in. I feel better every day, of course I have a poz partner and many friends that are poz, some "newer" than others and we've talked about that before...so I believe that has helped me in accepting becoming poz.  Do one more thing: Take a deep breathe, now let it out. You're not alone, it's ok to be feeling sad or angry...you're not alone. We'll all get through this together. It'll be okay.

While I would never wish hiv on anyone, I believe it can have a positive impact on your life. Of the friends I have that are poz, many have told me it was good that it happened to them because it changed their outlook on life: they are now in the best shape of their lives, their careers are going great, their support channels are well formed, many with long-term partners or husbands/wives...One of them who has been poz, I believe for 9 or 10 years has within the last 2 years become a world renound DJ on top of his other job and he's been travelling all over the place. So, are you in for some changes? Absolutely. Lifestyle modification? Better believe it. End of the world? Far from. Myself and I'm sure many others are going to be right there beside you. It would be interesting, don't you think to compare notes?

Of course there may be some things you can't do. I had to come to the realization that at least for now I couldn't participate in volunteering to go to Africa, as a nurse to work and teach in under developed countries. Maybe in the future I could consider it, but the resources and treatment I need now are not available there. I'm sure there will be some more hardships to overcome at one point or another but I haven't had to cross that bridge yet.

As far as all the ins and outs, I really can't speak of any. There are many people on this forum who are just wonderful, open, willing to share their experiences and a wealth of knowledge. Let them help act as your guide in a way, I am...But as the author says, only you can write your own book.

Offline sfguys

  • Member
  • Posts: 25
Re: how often do we need to visit doctor's office?
« Reply #12 on: April 03, 2014, 06:41:10 PM »
Hi Kevin, thank you for detailed explanation of your doctor exams. I don't know what my doctor tested our blood for but I assume she is testing everything. Before this HIV status, I had been pretty healthy so I am hoping there is no other issues with me. BTW, do you know how long it normally takes for viral load to go undetectable? 3 months, 6 months, one year or two years?


Hey guys,

I'm pretty newly positive myself, tested positive on February 11. If it's any help, here's how my timeline has gone:

February 11:
Tested positive at local county clinic.
Assigned to an HIV caseworker.
Had blood drawn for Western blot confirmation as well as for CD4 count and viral load.
Also had a urinalysis, oral swab, and rectal swab for STDs.

February 18:
Got test results back. Western blot confirmed positive, STDs all negative, CD4 count 524, and viral load 245,000

February 26:
First meeting with HIV specialist where he did a history and physical exam, answered my 1 million questions, and talked about treatment options.
Had lots more blood drawn for HIV genotype testing, complete blood count, lipid panel, testosterone level, toxoplasma antibody, and vitamin D.

March 11:
Got all those test results back.
Started on meds - once a day Stribild.

March 18:
Second meeting with my HIV doctor at which he explained the results of all of my blood tests, asked about any drug side effects, and scheduled me for additional testing about a month later to see how my treatment is progressing.

April 15:
Will have more blood drawn to do another CD4 count and viral load, a PSA, and a Coccidioides serology (whatever that is).
Will also have a urinalysis I think to test kidney function.

April 22:
Will have my third meeting with the HIV doctor to go over my new CD4 count and viral load and see how I am responding to treatment.

After that, I'm a little unclear about the timeline. As I understand it, my doctor intends to do a CD4 count and viral load test at least once a month for a couple of months until my viral load is undetectable. He also explained to me that he will be doing another complete blood count, lipid panel, and vitamin D test to monitor my progress, but I'm not sure how long before those tests are run again.

He did say that once all the initial testing is done, that my viral load is undetectable, and that I am not having any problems with resistance to meds, that he anticipates only having to see me about every six months.

Good luck to you guys. Would be interested to hear how things go for you in China.

Kevin

Offline pittman

  • Member
  • Posts: 223
Re: how often do we need to visit doctor's office?
« Reply #13 on: April 03, 2014, 10:47:45 PM »
As your doctor explained, it is typical to get more frequent tests in the beginning, but once stabilized, twice a year is pretty common.

However, I will add one more note, HIV+ individuals who have had receptive anal sex should be screened for anal dysphasia.  HPV infection is highly correlated with HIV infection in men.  It is typical to be screened every 6 to 12 months to catch any precancerous cells. I generally schedule them at the same time as my normal check up.

So your routine may end up being four visits per year where you can combine two at once.

Offline BangkokGuy

  • Member
  • Posts: 23
Re: how often do we need to visit doctor's office?
« Reply #14 on: April 04, 2014, 01:45:36 AM »
Depending on where in China you are, it could be a fairly cheap and quick trip to get somewhere for a doctor's visit and to pick up meds every once in a while.

Thailand (where I am) would seem to be a good choice, as the levels of treatment here are consistent with those in the West -- at a much, much lower price.

Medical tourism is a growing industry in Thailand, and all the big hospitals are happy to make it convenient for out of country visitors.
1 April 2013     HIV-
1 July 2013      very ill -- seroconversion?
1 March 2014   HIV+
                         CD4 787
4 April 2014     CD4 661 / 29%
                         VL 4,826
15 July 2014    CD4 588 / 30%
                         VL 16,364
03 Aug 2014    daily:  600mg Sustiva once; Combivir, twice

Offline sfguys

  • Member
  • Posts: 25
Re: how often do we need to visit doctor's office?
« Reply #15 on: April 04, 2014, 01:55:55 AM »
Thanks for pointing that out. I actually didn't know about HPV infection. My doctor didn't do any anal check when we got our blood drawn. Maybe she will do it at next appointment when we will start our treatment. I will write this down and ask her.
 
As your doctor explained, it is typical to get more frequent tests in the beginning, but once stabilized, twice a year is pretty common.

However, I will add one more note, HIV+ individuals who have had receptive anal sex should be screened for anal dysphasia.  HPV infection is highly correlated with HIV infection in men.  It is typical to be screened every 6 to 12 months to catch any precancerous cells. I generally schedule them at the same time as my normal check up.

So your routine may end up being four visits per year where you can combine two at once.

Offline sfguys

  • Member
  • Posts: 25
Re: how often do we need to visit doctor's office?
« Reply #16 on: April 04, 2014, 02:07:53 AM »
It is actually pretty convenient for me to go to Bangkok. The flight tickets are much cheaper than flying to US.
I have been to Bangkok several times and loves the city. I know you are also new in HIV. But I would love to hear your experiences in getting treatments in Bangkok. I am also trying to look at the option to get blood tested in Hong Kong. My doctor said she is fine doing appointments with me over the phone if I can send her blood test results. The only thing I am concerned about is to get right types of blood tests and right types of check-up, like anal dysphasia, liver, etc. Only HIV specialists would know what to check.

Depending on where in China you are, it could be a fairly cheap and quick trip to get somewhere for a doctor's visit and to pick up meds every once in a while.

Thailand (where I am) would seem to be a good choice, as the levels of treatment here are consistent with those in the West -- at a much, much lower price.

Medical tourism is a growing industry in Thailand, and all the big hospitals are happy to make it convenient for out of country visitors.

Offline BangkokGuy

  • Member
  • Posts: 23
Re: how often do we need to visit doctor's office?
« Reply #17 on: April 04, 2014, 03:50:03 AM »
Well, I am very recently diagnosed.  I am still in the phase of waiting for various blood checks.  There are other Bangkok-based people here, though -- you can search the forums for them.

Most people get their testing and meds at the Red Cross Clinic on Rajdamri Road (one skytrain stop up from Silom).  The tests are cheap (300 baht -- $10 -- for CD4 and 1,500 baht -- $50 -- for viral load).  All you need is a local doctor to give the prescription to get the meds.  From what I have read they will give you three or six months worth.  And they are very cheap here compared to other places.

I have been recommended doctors at many of the big hospitals.  Bangkok Christian (on Silom), Bumrungrad, Phayathai 2, etc.  I have not yet chosen who to go to.  I am waiting for my VL to come back first then will see someone next week.
1 April 2013     HIV-
1 July 2013      very ill -- seroconversion?
1 March 2014   HIV+
                         CD4 787
4 April 2014     CD4 661 / 29%
                         VL 4,826
15 July 2014    CD4 588 / 30%
                         VL 16,364
03 Aug 2014    daily:  600mg Sustiva once; Combivir, twice

Offline Bizkits

  • Member
  • Posts: 105
Re: how often do we need to visit doctor's office?
« Reply #18 on: April 04, 2014, 09:09:02 AM »
Sfguys,

  Thanks, no pun intended but I feel we need to stay positive. Once the initial shock wore off for me, it was basically what do I do: Go into a dark deep depressed state, sulk around in my woes or face this thing head on, do what I need to do to help me learn to live with it and may life go on. I chose #2. I know my life is not going to be exactly the same as before, a few more inconviences here and there, an added pill or 2 a day and healthier living. Nah...that's not going to stop me from doing anything. As far as my medication goes, I haven't started yet. Here's in a nut shell chronologically my chain of events:

-seroconversion?? possibly dec '13 - jan '14?
-routine pre-checkup labs drawn 02/27/14 (cbc, bmp, ua, hiv screening)
-hiv+ serum as well as WB results delivered 03/06/14 at primary Dr's appointment 
-referred to ID and they had a slot open up 03/07/14, so I saw her then
-03/10/14 first set of labs from ID, including sensitivity tests, genotype, hpv, hep panel, gt/cs, syphilus, tb, renal/creatinine and hepatic panels, vit d and one or 2 others I can't remember. (first CD4 882/33%, VL 27,000 and some change). My h&h, while still in "normal" ranges is starting to drop, though...and I for a while have had a very high level of rbc's on my ua's when I get those done...I know I have kidney stones, but they are non-obstructive, my cysto procedure was normal, IVP was normal, renal funcion panel normal...they can't find where I'm bleeding...but I've been dealing with this for a few years now. I don't know if hiv will affect this or not?
-03/17/14, 03/24/14 and 03/31/14 more of the same labs. (Doc said to check progression)
-04/14/14 next ID appointment, will likely start meds then when ID Doc. has all the lab info to go off of. (Since my partner is also poz, there is a possibility it may not be wild type) So, she had told me that she could start me on meds right away if I wanted, but she also said that it was only a month before my next appointment, she'll have all the data and it would be better to get meds right the first time around rather than chancing having to switch once all my blood work came back. She also asked me to trust her but that if I really, really wanted to start right away, she would do it. But, I considered everything I was given and opted to wait. I *think* my options, from what we discussed would be either truvada/issentress, truvada/tivicay, atripla or possibly stribild...She mentioned a couple other combos but commented those were generally not her favorites and only second line. 

So, it's a waiting game for the next 10 days. In that sense, it's dragging by. Have y'all made any decisions or moves yet?

Offline kevinazus

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  • Posts: 23
Re: how often do we need to visit doctor's office?
« Reply #19 on: April 04, 2014, 03:17:34 PM »
Hey sfguys,

Some of the people on here with much more experience than me might be better able to answer your question about how long it should take to become undetectable. However, my doctor tells me that with the new class of meds (I'm taking Stribild), he is hopeful that I might be undetectable by my first check up after five weeks of treatment, and that I should certainly be undetectable within three months if the meds are working properly with no resistance.

Kevin

Offline sfguys

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Re: how often do we need to visit doctor's office?
« Reply #20 on: April 04, 2014, 08:58:37 PM »
It looks like different doctors take different approach. Bizkits' doctor is apparently much more thorough and did blood testing 4 times before deciding which medicine to use. Our doctor only checks our blood once, maybe because she knows our travel plan, or maybe because she thinks one result is good enough. No matter what, it is the way it is. we will leave US soon and travel back to China. We will be back late April to start treatment.

Honestly it is very scared that we are going back to face our family. I feel regretful, ashamed and guilty. It was hard enough for them to accept me as a gay son. My HIV status will bring them great sorrow and pain, even though I know they will still love me. I know I am not going to tell them the truth. I don't know if I can hold my tears when I see them. But I will try my best.

Offline sfguys

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Re: how often do we need to visit doctor's office?
« Reply #21 on: April 04, 2014, 09:00:26 PM »
Re: 300 baht -- $10 -- for CD4 and 1,500 baht -- $50 -- for viral load

This is really reasonable. I was checking with private clinic in Hong Kong and it costs at least 350$ to do both check.
Well, I am very recently diagnosed.  I am still in the phase of waiting for various blood checks.  There are other Bangkok-based people here, though -- you can search the forums for them.

Most people get their testing and meds at the Red Cross Clinic on Rajdamri Road (one skytrain stop up from Silom).  The tests are cheap (300 baht -- $10 -- for CD4 and 1,500 baht -- $50 -- for viral load).  All you need is a local doctor to give the prescription to get the meds.  From what I have read they will give you three or six months worth.  And they are very cheap here compared to other places.

I have been recommended doctors at many of the big hospitals.  Bangkok Christian (on Silom), Bumrungrad, Phayathai 2, etc.  I have not yet chosen who to go to.  I am waiting for my VL to come back first then will see someone next week.

Offline sfguys

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Re: how often do we need to visit doctor's office?
« Reply #22 on: April 11, 2014, 08:30:40 PM »
Talked to doctor today over the phone and got our number:
vl: 1730 or 17300, I thought it is 1730 but 1730 seems to be too low. So I guess it is 17300
cd4: 670

my partner:
vl: 45000
cd4: 694

I guess these numbers look o.k. We will discuss treatments next time we meet with our doctor, which will be either later this month or next month. From this forum, I understand most people starts with stribild or Atripla. Does anyone know how doctors recommend which one to start? based on our tolerance on side effects? Personally I want to use Atripla because it looks like I can buy it from Bangkok for $200 for one month supply, in case there are some delays in getting my medicines from US.


Offline pittman

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Re: how often do we need to visit doctor's office?
« Reply #23 on: April 11, 2014, 09:45:01 PM »
From this forum, I understand most people starts with stribild or Atripla. Does anyone know how doctors recommend which one to start? based on our tolerance on side effects? Personally I want to use Atripla because it looks like I can buy it from Bangkok for $200 for one month supply, in case there are some delays in getting my medicines from US.

They generally test for resistance to confirm the combo selected will be effective. Other than that, the goal is to select something that you will take regularly, so side effects you may experience, simple dosing and yes, even cost can come into play.

You can discuss your preference on that with your doctor. It is perfectly reasonable to have that be one of the factors, as long as the combo selected works for you.

Offline Ann

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Re: how often do we need to visit doctor's office?
« Reply #24 on: April 12, 2014, 05:47:35 AM »

vl: 1730 or 17300, I thought it is 1730 but 1730 seems to be too low. So I guess it is 17300


Either number is totally possible. They are both low numbers and clinically not all that different.
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Offline sfguys

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Re: how often do we need to visit doctor's office?
« Reply #25 on: April 12, 2014, 12:11:33 PM »
I heard Atripla can cause depression. my partner has a little bit depression problem even before the diagnosis, so I am a little bit worried that Atripla can make his depression worse. 


They generally test for resistance to confirm the combo selected will be effective. Other than that, the goal is to select something that you will take regularly, so side effects you may experience, simple dosing and yes, even cost can come into play.

You can discuss your preference on that with your doctor. It is perfectly reasonable to have that be one of the factors, as long as the combo selected works for you.
« Last Edit: April 12, 2014, 12:17:10 PM by sfguys »

Offline Jeff G

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Re: how often do we need to visit doctor's office?
« Reply #26 on: April 12, 2014, 12:17:02 PM »
I heard Atripla can cause depression. my partner has a little bit depression problem even before the diagnosis, so I don't know if Atripla can work for him.



If it was my decision to make I would not choose Atripla due to the history of depression . There are many choices these days so why risk the CNS side effects or making the depression worse by choosing a med that is known to be contradicted for those of us that have a history of depression . Just my 3 cents of opinion .

Offline sfguys

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Re: how often do we need to visit doctor's office?
« Reply #27 on: April 15, 2014, 12:01:00 PM »
Thanks for the advice. I will talk to our doctor about this. My partner's depression has never been confirmed by a psychologist. Actually he has never seen one. I just know he often feels quite pessimistic so I need to cheer him up.

 
If it was my decision to make I would not choose Atripla due to the history of depression . There are many choices these days so why risk the CNS side effects or making the depression worse by choosing a med that is known to be contradicted for those of us that have a history of depression . Just my 3 cents of opinion .

Offline sfguys

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Re: how often do we need to visit doctor's office?
« Reply #28 on: April 16, 2014, 11:35:07 AM »
I have one question which I am not sure if I should ask here or ask my doctor. But since my doc appointment is still several weeks away, I will ask here first. I talked to a friend's friend who has been involved with social work of fighting HIV for about 10 years. One thing he highly recommended me to do is to do my CD4 and viral load testing at one place because what is more important is the trend of CD4 or viral load change, not their absolute values. If I conduct my blood testing in different labs, the results may not be comparable so I could miss the opportunity to see the trend.

I was thinking that I could do my blood tests sometimes in US and sometimes in Thailand, since I stays in Asia most of time. But based on his suggestion, I should not do that. Does anyone have any recommendations? Many thanks!

Offline zach

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Re: how often do we need to visit doctor's office?
« Reply #29 on: April 16, 2014, 11:42:40 AM »
thats kind of a toughie, there is some truth to what you say about different labs and different techniques. but me personally, i wouldn't jump through hoops just to have a slightly more accurate colorful bar graph (they are a cool hobby to build though). just get the labs where you are. and yeah, a single lab is only a snapshot, its the trends over time that really show the better picture. but still, sometimes we sweat to much.

by blood work is taken at the clinic, they send it out to a lab, for all i know they use a different lab everytime and i'm none the wiser. never asked, never occured to me to really care.

ask anything here, but always ask your Dr. too, and give their views more weight. far as i know there are no Dr's. here. the behavior of a few notwithstanding
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Offline Jeff G

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Re: how often do we need to visit doctor's office?
« Reply #30 on: April 16, 2014, 11:48:45 AM »
If you stay undetectable the cd4 will take care of itself in time . Its a matter of what you want really . I have been poz a long while and have never saved a single set of labs to view later .

Offline sfguys

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Re: how often do we need to visit doctor's office?
« Reply #31 on: April 17, 2014, 10:30:18 AM »
Got it. thank you guys! I will report back what my doc says when I meet with her.

 


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