Overwhelmed

[xrel0aded]

I just had my follow up appointment with my ID doc, so that makes a total of three appointments. The last time after my appointment I went and did all the STI bloodwork and resistance tests etc. I wasn't resistant to anything, however during the past three weeks I somehow came in contact with scabies and it has been a b**** to get rid of. On top of that, my ID doc just called me today and said not only are my syphillis levels still mild, I tested positive for chlamydia, and I tested positive for TB, so I have to do a 3 month prophylaxis regimen.  The good news is my CD4 was still near 600 and my VL dropped 70k. I haven't started meds for anything besides treating the scabies yet and my DOC is not helping me decide what to treat first. The really f'd up part is the only sexual partner I've had in the past 6 months has been my partner...I can see this turning ugly. I am just really overwhelmed and want your advice as to where you would start. I'm leaving to LA for auditions for the Voice in a few weeks and just wish this wasn't happening.

[emeraldize]

Hi

As an avid watcher of the Voice, I shall first wish you luck.

There a folks a lot smarter than I who will weigh in here I assure you.

But first, when you say 3-month regimen --it seems in relation to TB. The way your sentence is written. Is it latent?

Family member of mine had to go on a 9-month regimen and I went sleuthing and can't find anything less than four months. So I offer you this...

Patients with a clinically significant result on tuberculin skin testing or a positive interferon-gamma release assay (IGRA) result should receive a course of therapy for latent TB, once active infection and disease are ruled out. Recommended regimens for latent TB published by the US Centers for Disease Control and Prevention (CDC) are as follows[8] :

Isoniazid 300 mg - Daily for 9 months
Isoniazid 900 mg - Twice weekly for 9 months (administered as DOT)
Isoniazid 300 mg - Daily for 6 months (should not be used in patients with fibrotic lesions on chest radiography, patients with HIV infection, or children)
Isoniazid 900 mg - Twice weekly for 6 months (administered as DOT; should not be used in patients with fibrotic lesions on chest radiography, patients with HIV infection, or children)
Rifampin 600 mg - Daily for 4 months

Edited to add: four treatment options

[emeraldize]

I think the f'd up part is that your doc isn't prioritizing and sequencing your med plan --period. Obviously your scabies is misery-making and contagious and you're being treated.  Good.

If it were me I'd be asking if there are any contraindications to addressing the TB and syph simultaneously and if not, do so ASAP. 

Then start an ARV regimen as soon as reasonable. If I were given the choice all over again, I would have started HIV meds earlier. The notion of preservation of CD4s rather than seeing how long one can go without is better in my opinion.

The CD4 rise is a rather slow journey to watch. 

Can you consult with another doc?

No wonder you're overwhelmed.

[xrel0aded]

Lots of stress factors. Partner is an IV drug addict whose POZ, he doesn't seem to think that affects me and weights heavy on my heart with all my worries and concerns about not only him but my health; my dad just lost his job of 25 years today and although I don't live with them or am supported by them, i have two younger brothers i worry about since my mom doesn't work and we were all on his insurance. Little vent side note, sorry. I just feel like a cocktail of sleeping pills would feel a hell of a lot better than all of this.

And I'm going to have to see a new doctor since I will no longer have insurance at the end of the month, but I guess the Chlamydia treatment is one pill that i'm picking up tomorrow morning since i'm off at 2am and taking. And the scabies should be treated. I'm going to go get the 3rd round of penicillin shots tomorrow just to make sure the spyhillis is not affecting me as long as it's okay to do that and the azithromycin for the chlamydia in the same day.

And it's latent TB or dormant or whatever the medical term for it's called. This is all new to me. I've never had to do so much for my health especially at once. As far as the TB my doc said it's a pretty new method of treatment to the rifampin 3 month course 3x a week, or something along the lines of that. i just don't want to start my HIV combo in the middle of all of this, but it's stressing me out to keep putting it off. I would like a cleaner slate before I start though, so i think i have a plan in my head. I just wish my doctor would be a little more helpful and not give me the all the reigns. Thanks for the support.

Also, as far as the Voice- yes, i'm excited! I got through a few rounds of the American Idol auditions last year and they told me to come back after I gained some confidence, but i missed the auditions. So whatever, I think the Voice is a better show/competition anyway. Cheers

[marcmoral16]

Xrel0aded


First off I'm so sorry that your going through all you're going through. Getting all those at one time can and will take a toll on you. I'm not the most knowledgeably person on all but I've been through a lot myself.

I don't know what's your CD4 % is that's a good indicator of your immune systems health. My partner tested positive for syphillis and cylamidia. All of which we later found we're not true, health department botched it. We had NO STI's.

We both started MEDS and were on all the antibiotics in the book. So I would assume its safe to start treatment and be on MEDS for HIV.

Your choices for MEDS are a lot three once a day pills

Atripla
Complera
Stribild

And tons of others

So if your CD4% is below I'd say 32% do it all at the same time.

BUT that's just my advice

[xrel0aded]

hey
ive been having a burning sensation in my penis when i urinate
so i'm certain that's what it is, with the results also coming back positive.

i'm not opposed to taking more than one pill per day, and if everything works out i'd like to be on tivicay+epzicom. im just trying to chill out and not feel so anxious/panicy. when breathing gets hard i've been trying to take a break and do yoga and just relax. sigh. and yeah, my numbers are  VL 52,500 CD4 589 and CD4%19.5

thanks for the advice

[marcmoral16]

Tivicay and epizcom are supposed to be great. Sometime next year they will come in one pill that would be awesome. What I'm going to start doing is speaking to a mental health counselor. Your going through a lot and should speak to someone about it. I'm all ears if ya need to. I just found out this year in Jan was a bad experience to say the least.

Just remember it's ok to cry and be angry it's natural don't keep it all in.

[Snowangel]

xrel0aded-
Sorry to hear so much is going on for your right now.

I was wondering if you have been able to find an Aid Service Organization or ASO in your area?  It might be good to get some help especially since you are not going to have insurance any longer. They might be able to find someone for you  to talk to as well. I have done that in the past and it can be very helpful.

I am so glad you have the Voice audition to look forward too, it is good to have something else to focus on to get you over this hard time. I wish you the best of luck.
Please don't give up on yourself.
Keep us posted
Snow

[mecch]

Lots of stress factors. Partner is an IV drug addict whose POZ, he doesn't seem to think that affects me and weights heavy on my heart with all my worries and concerns about not only him but my health; my dad just lost his job of 25 years today and although I don't live with them or am supported by them, i have two younger brothers i worry about since my mom doesn't work and we were all on his insurance. Little vent side note, sorry. I just feel like a cocktail of sleeping pills would feel a hell of a lot better than all of this.

Wow. The above. Plus your multiple health issues. Yes indeed, enormous stress!

First of all the scabies.  Have you been given the lotion, or the pills? In some European countries there is an oral treatment and its BRILLIANT.  How spread is the scabies on your body?  And has the treatment worked?  I know this is obvious but I want to check: your partner has to be treated and cured, too. And until you are sure he is cured, you can't sleep together and you can't share towels, etc.  You REALLY have to be strict about this. There is too much on your plate to be dealing with recurrent, annoying, scabies...

The elephant in the room is that, since you say your partner is your only sexual contact, we are going to assume that several of the other diseases, if not all of them, you picked up from him.  If you haven't personally thought about how continued contact is or isn't possible -- and very specifically how sexual contact is implicated in the treatment and control/cure of each of these STI, you need to do so. 

So you need some expert advice here?  I certainly would need expert advice about what is and isn't possible, what is safe sex, protection, and what isn't, with a partner who may or may not have TB and syphilis. Both HIV+ is more straightforward, or at least I know the deal. do you? reinfection isn't a problem for HIV.  But unprotected sex would seem not the way forward, considering the other infections...   

You can get yourself clear of the scabies and chlamydia, but the scabies could return on skin contact, and the chlamydia through some acts that are "protected" sex for HIV, but not for STI's like chlamydia. 

Hopefully you will only need one course of treatment to clear the syphilis, but again, seems like you could get it again through oral sex, if your partner has it.  (Is that right, experts?)    Etc etc.

You said above:  he doesn't seem to think that affects me.   Well obviously if you now have all these health challenges with him as the source, if effects you in every way imaginable.  Can I just add an exclamation loin here!   !

1) You understand his actions affect you, yes?  Put aside the love and concern you have for him, and please make sure you understand that your ability to live and enjoy life is seriously compromised if you continue to have multiple health challenges and infections with misc diseases...  It's simply too much on anyone's plate.  So, again, you have to know this in your bones.... And then act upon it. 

2) - this is my opinion.  My partner HAS to see that how he lives his life, has an effect on how my life is going.  That's my opinion. So I think you need to hear from your partner that he understands the implications, and that he is capable reducing the negative impact on YOUR LIFE of his actions.. 

I'm not saying you must break up, its not my place.  I will say at the very least you have to be very shrewd about the physical contact, going forward...   In general, my advice is be very wise and shrewd about avoiding any more actions with this person that are destructive to your life, both your daily life and your dreams going forward.

Also, you have got to set up how you are going to finance all the medical treatment you need, right now, and for the years to come.  Got to do that now...  I can see this is overwhelming because you mentioned suicide.  IMO you need some expert advice about finding some security now - this means secure financing for medical treatment, and if necessary, secure home where you are not subjected to possible continued exposure to disease. 

Finally, its great to have a dream but I will observe that for any rigorous future endeavour - such as doing a TV show - you are going to need the body and mind in top condition, so it doesn't distract from the task.  HIV can easily be controlled and completely managed.  But its damn expensive, with or without medicine, and if HAART is involved, it needs secure financing every month going into the future, and daily commitment to taking the pills.  I don't know what TB might require over the next months.  Nor how that treatment feels in the body.  Does your partner know his TB status and if he has it, is it active or latent like yours?  Your latent TB - not sure there needs to be a rush to treat... 

I think some people in this forum can give you some expert and precise info and advice.  Also I agree with Snowangel, if you are feeling overwhelmed, this forum alone, and a doc here or there for 30 minutes, may not be sufficient.  Sounds like you could use a caseworker or social worker or someone who can help process the combination of your challenges and prioritise them and help find the solutions.