I need help im 26 and going crazy over my changing appearance

[Stillakoolkid]

Hi guys( and girls)

I recently had a bad experience, i had to quit a retail job because people were making snide remarks about my appearance. I've been poz since i was 19 and now it is starting to show in my facial appearance. I have early smile lines and my jaw line is sagging theres a  litte lump behind my chin its almost as if the muscles under my mouth have given way ( it looks horrible) my eyes look hollower. I really dont know what to do. I thought that maybe If i got a facial filler under my eyes that would help the hollows and lift up the cheeks so the sinking under my mouth will be better. Also i think fillers might be able to help with the smile lines. I have always had a "happy" heart shaped face with very full cheeks but now I look crazy and its depressing.

I dont wanna go outside I hated going to work. Even when I was filling out the paperwork for my job the manager asked me how old i was again and when i told her, she said " oh I would have taken you for so much older." I have an open HASA case in NY, but im currently between NY and GA. I really don't know what to do. I was hoping maybe the Sculptra people would help with their Payment Assistance progams, I really cant afford heavy plastic surgery Im still in school. Help!

[livelife83]

Hello Stillakoolkid,
I am going through the same situation as you are at the moment. I have been noticing these changes to my facial muscles for a little over a year now. I have been for Atripla for almost 3 years. I also have been feeling depressed and hating my appearance. I have scheduled an appointment with my Doctor for next week to discuss if I indeed have Facial Lipoatrophy. Speak to your doctor first and see what they tell you.

[razzmaniac]

I know Atripla is a huge seller and easy to take. . .but about 5 years ago i did some serious research online about lipoatrophy because i was getting it BAD. I was on the old stuff that is the culprit and then for a few years, on Atripla. My lipo was getting worse. From the confrences reports from CROI, Sustiva (in Atripla) had a huge saturation ratio in subcutaneous fat cells. Most doctors dont know the details of these side effects let alone most of the detailed studies. I took these reports to my Doctor and she took me off and put me on a new regimen that included Isentress, which suppossively doesnt affect the RNA or something like that in the Mitocondria. Anywho. . .if your numbers are doing good, ask for some other options. Sustiva has some bad side effects including vivid dreams etc. . . personally. . it was absolute poison for me.
Good luck bro. . .

[mecch]

Stillakoolkid -

Do you see an HIV or Infectious Disease specialist?

Have you ever discussed these concerns with the doctor(s) overseeing your HIV treatment?

Has any professional evaluated your face and specifically told you you have lipo?

______

Please also remember that a person changes a lot between 19 and 26.  Bye bye baby fat. 

But since you really are worried its lipo, the way forward is to get a real diagnosis and then a doctor's advice how to go forward....

[mecch]

You had these same concerns a year ago. 
What have you learned about it since then?  It might help people in this forum if you can follow up with your specific experience and what the doctors have said to you about your concerns.

[jkinatl2]

You had these same concerns a year ago. 
What have you learned about it since then?  It might help people in this forum if you an follow up with your specific experience and what the doctors have said to you about your concerns.

This is a very valid question. seems like we have a bunch of these Atripla-Lipo/Wasting posts come up each year, and to date I don't recall a single case of the lipo or wasting being verified, let alone ascribed to Atripla. i certainly have my own opinions regarding that drug, but lipo and wasting have all but fallen to the wayside as side effects of drugs used today by newly diagnosed persons.

[beentheredoneit]

I have not had this issue, but I have experienced side effects such as looking like I went out the night before.  This goes away the next day or after a better night of sleep.  It has been the same on every regimen.

However, I do think a lot of these side effects can be handled with proper nutrition.  I think a daily dose of vitamin C, staying hydrated, eating healthy nutritious green vegetables and fruits, and meals that are well-balanced are the key.  I think that Atripla, like any type of medicine you put in your body, has worse side effects without proper nutrition. 

You should see a nutritionist if this part is difficult for you or if your doctor is not of any help to you.

[Newguy]

Hi Stillakoolkid

I know this can be tough but perhaps it has nothing to do with your HIV status? Do you smoke? Drink heavily? Stress is probably the worst offender for aging in humans. I have had HIV for almost two years and been on meds for almost a year and look totally fine. You need to watch out for stress, I have seen it melt people's faces because of stressful situations they are in regardless of HIV status. Understandably so, HIV probably causes a lot of stress for many people and this might have a bigger impact on one's appearance.

Good Luck and like some other people here suggested, talk to your doctor.

[newt]

This is a very valid question. seems like we have a bunch of these Atripla-Lipo/Wasting posts come up each year, and to date I don't recall a single case of the lipo or wasting being verified, let alone ascribed to Atripla

The ACTG 5142 study reported higher rates of fat loss in people using efavirenz compared to Kaletra.

- matt

[scotty54]

Stillakoolkid,
Surely it is tough dealing with the appearance changes you described......especially at your comparatively young age.  I had some similar issues in my 40's, and it was difficult.

What is your GP telling you?  If you feel he is side-skirting the issue, get an appointment with a specialist that does alot of lipo injection work.  Try to find some older pictures of yourself.  Consultations are usually no-charge. 

As to whether Atripla causes lipo, not a doctor or a scientist.  I know that some of the older meds like Zerit/Retrovir/Crixivan are associated with the fat re-distribution abnormalities.  I also know that all of the meds (correct me if wrong)
contain a disclosure about MAY cause excess body fat.......or a loss of fat.....and so on. 

You have nothing to lose by taking the next step.  Oh, and that tactless manager that made a comment about you looking older than your age.........you can always come back with a quip like.....Certainly everyone must think you are far older than you look!

Wish you well