Update: Neuropathy/Tinnitus (Chronic Inflammation)

[RickDallas]

Since my last postings in March of 2016, I have switched ARV medications from Atripla to Genvoya. My ID doctor advised that the entricitabine component found in both drugs could be the root cause of my idiopathic paresthesia when I am active, specifically when wearing shoes/sneakers working and exercising. It appears that the burning sensation in both my feet may be caused chiefly by pressure when wearing shoes and/or sneakers on my peripheral nerves that could be inflamed by long-term HIV infection or a side effect of a particular drug. This is one theory. The other theory as proposed by my foot surgeon is metatarsalgia. I was referred to this foot surgeon by my neurologist because he thought I may have neuromas on the balls of my feet, which the foot surgeon ruled out with x-rays and a physical exam. My neurologist doesn’t think my case fits the classic presentation of neuropathy, and after two visits, I have managed to get an EMG ordered by him which should be more conclusive. My EMG is scheduled for June 29th. Upon the EMG findings, I will entertain the prospect of changing my drug regimen to Tivicay & Prezcobix as prescribed by my ID doctor. However, what I find incredibly frustrating is that my ID doctor cannot precisely/definitively provide me with a diagnosis. After he advised me concerning that entricitabine may be the root cause, he counters that it is still very rare and the onus is on me to change my drug regimen. He also advised that we should treat the symptoms with Lyrica. Frankly, I do not want to acquiesce to another drug until I find the root cause. After 31 years of living with HIV, I am finding more and more this kind of vacillation in the decision making processes of my doctors. I still believe that obtaining the most information about any health issue enables me to make more effective and informed medical decisions; however, it seems possible to argue that I have hit a brick wall because my ID doctor is in very new territory and is at a loss to make any definitive diagnosis. I truly believe that Chronic Inflammation due to HIV has blindsided most practicing ID specialists. After 4 years of dealing with bilateral tinnitus, probably caused by Atripla, I am managing to cope; however, this chronic inflammation/burning in my feet is causing me great distress and anxiety. It is truly affecting my work and state of mind.
Sorry for the lengthy post. I am hoping to get some feedback about my situation.
Best,
Rick