My control -regarding VL and some questions..............

[SASA39]

Today I was at the control with my doc who is a good doc but a very closed as a person.
Because he is a chief of the staff here and there are only 3 doc in whole Serbia in this particularly department , switching a doctor would not bring any good because all others are submitted to him .

So here we go :
09.00 AM :
Me : Good day doc
D : Good day , how are you
M: So -so I have some questions to ask you .........
D: OK

Q1 : What about my VL in October .It was 0 and a CD4 was 58.How can it be?
A: Hm..........let me see.................oh yes .......we did not perform a VL that time so it was not 0 , you do not have it ..........( but the other doc said to me straightly on the Oct 3 , that they want { and that is a goal of therapy }to remain my VL undetectable-I could swear at it ! ).
Maybe they have lost it somewhere..............
"So, it went down to 0 in a 1,5 months and I`m pleased with it."
And I have posted a post regarding my undetectable VL before:
http://forums.poz.com/index.php?topic=12229.0

Q2: Sustiva is giving me a hard time , I can concentrate , and how I`m supposed to go to work in that way..............
A: Well..................it is usuall to feel that way.........................

Q3: My lower leg joints are swelling and I cannot take a lot of sunshine
A :...........Hmmmm......let me see...oh , you do not have a Jaundice ........so..........keep an eye on your legs and  wear a hat

Q4: I `m going to take a vacation abroad. Would you be able to give me some kind of your affirmation on paper in case of custom query ?
A:.........and who is going to fumble your luggage ? Custom ? Why ?
Just put your therapy in your luggage ( he did not emphasizes hand one ) and travel...............

Q5: What about Bactrim ?
A: You can stop it now , yes........................


Q6 : And I`m taking some additional supplements : C vitamin , alpha lipoic acid , omega3 fatty acids , ( last time he has told me that it might be OK )..........
A: I do not know , maybe you should stop them , there is almost no evidence that they improve someone health ,.............and yes vitamins , especially B12 , are you eating bread ? That should do .................

DOC : and yes , when was your last VL check -in March ? ( it was in Dec ) . We could do it now.......
Q : And what about CD4 ?
DOC : It is still broken.......................

DOC : Are you taking your escitalopram ?( 5mg a day is a questionable dose for a 6 feet 3 " and a 242 pounds person).
Just continue on it............here let me give to you another dosage............


And he forgot almost completely about my HPV that had reoccured again ( and he know it ) , Sustiva rash , and tiredness , and did not gave me to perform any blood or urine test so far   


Whole conversation took place for no more than 15` , 20` max. and I was almost at the end of a Que.End time was about 9.20 and all docs take patients daily only till 11 .When I left his office , there was only one man waiting.....

I was preparing to ask him some more ,( about new methods in HIV  treatman, participating here in forums) but after this I had to shut up , pack my things and say : " Thanks doc ......"
( And I have heard  (maybe wrong )that sometimes if he is not pleased with a fact that there could be a second opinion , he just say : " Well , go to him , and let him be your doc ....................."

Your thoughts and suggestions.................