Med Breaks?

[comino]

I take a month off my meds  every December just because I feel like a break from "it all" is good.  I think it's ok  and I rationalise it as so because it's not the irregular missed doses that I know can create resistance.  I have never really talked to my Dr. about it because I didn't want a lecture, now I have a Dr. I don't really like or trust so less of a chance for me to talk to him, so I ask  what do you all think about this?  The other 11 months of the year I miss maybe two or three times tops and it's usually because I fell asleep too early and just didn't wake up.  All in all my adherence is excellent I think.      What say you?

[bear60]

Mauricio....
Important information that you left out of this post was in your introduction: quote you " finally I found something my body could tolerate and now I'm on Atripla and doing very well (undetectable viral load, 700 CD4 count @ 50%) ".
I admire the fact that you are doing well and are "taking charge" of your health care and maintenance. I cannot comment on your drug holidays because I do not know enough about this subject. I just hope that you dont put your health at risk.

[RapidRod]

It's no longer advised to take breaks, unless it is for medical reasons. This is something you should discuss with your doctor.

[Miss Philicia]

From the sound of your post, comino, it sounds as if you've been doing this 1-month treatment break for years with no averse effect, but reading your initial intro post from 2 days ago I see in fact you've probably only done this twice.  Plus, you mentioned you've already switched combo regimens more than once in this 2.5 year period due to side effects, so in fact any treatment break would be hard to analyze.

What do I think of it?  I think first of all it's a horrible idea to "play doctor" with a disease as potentially fatal and serious as HIV/AIDS.  Secondly, you seem to just think that because you have decided it's "OK" that in fact it just "is" and that you "rationalise it"... what else are you doing this with?  I think that's really dangerous territory to enter from a logic perspective.  In fact, I still have no clue why you are doing this except that you think it's novel.

So I basically think this is a really bad idea on your part and would advise you or anyone reading this thread not to do this, and I'm quite sure any doctor would advise you of the same thing.

[comino]

HMM... I can't say that I was  expecting approval of my breaks necessarily but alas I don't think I was expecting such a harsh scolding...  a "You really should talk to your Dr."  would suffice.  I understand the urgency of the scolding, but I must say it really comes across as condescending, perhaps even a bit insulting.  Because I've only been poz for just 6 months short of 4 years does not mean that I am not well versed in the subject.  I value the input of those who have survived this for so long, hence my asking questions on the forum.  However maybe a message of this importance could be better given with a little more tact.
Mauricio
 

[bear60]

Mauricio
Hey you asked the question!!!
My take on the responses is that these people really do care about how you are going to do with the meds.  You know....long term.  Cause this aint some short term game...its for a LONG LONG time.
I can say that my friend who died recently had a doctor who switched him to new combos at the slightest blip in CD4count.  We think that he became resistant to all the meds because he did not stay with a "tried and true" combo and let the blips happen as they are wont to do. 

[allopathicholistic]

HMM... I can't say that I was  expecting approval of my breaks necessarily but alas I don't think I was expecting such a harsh scolding...  a "You really should talk to your Dr."  would suffice.  I understand the urgency of the scolding, but I must say it really comes across as condescending, perhaps even a bit insulting.  Because I've only been poz for just 6 months short of 4 years does not mean that I am not well versed in the subject.  I value the input of those who have survived this for so long, hence my asking questions on the forum.  However maybe a message of this importance could be better given with a little more tact.
Mauricio
 

Reply #2 said you need to discuss with your doctor. Please see http://forums.poz.com/index.php?topic=6278.0 as well

[mudman8]

I'm with the others on this, even if you don't like your Dr he has lots more info and knowledge than you do. put your ego away, sit up and listen to him.

I've heard that taking breaks from meds allows the virus to replicate which allows for mutations. It was fashionable years ago to go on breaks but I think research now says to stay on them full time till they don't work and then switch.  I was on AZT in the early 90s then went off them and went on a long trip to Italy, came home and was switching Drs and couldn't get on new cocktail for 6 months, I was so sick with opportunistic diseases it wasn't funny. Thankfully  I went from 80 Tcells to 700 in about 5 years.

I do forget a dose once in a while but that's nothing like a full month.

[megasept]

It's no longer advised to take breaks, unless it is for medical reasons. This is something you should discuss with your doctor.

This is debateable if by breaks we mean unlimited ones. I am on a 6 year break[/i---hardly a holiday---[/i]and at 7 years I expect to resume meds (new ones). Rapid Rod's statement is circular, since I assumed the question was medical, not social, financial, etc. My own break was requested of hundreds, more likely thousands, of relatively heallthy patients by my specialist and her colleagues. I argued, considered the issue, and dropped treatment as recommended. I realize there are common reasons to take breaks, like certain surgeries, treatments, etc and should be decided by treating physicians in discussion with the patient.

I strongly urge you not to take annual breaks. To me bad adherence, and that includes short holidays (RapidRod is correct on this) is the worst of both worlds. Take them or don't take them. A take charge patient is straight with their MD, willing to argue, listen, and study. If you can't do that with you MD, perhaps you should find a new one. That's my take.

  -megasept  PS to MUDMAN: The research you refered to was highly flawed and for the most part we read about it through magazines and newspaper accounts. I contacted a close colleague of one veteran researcher who was misquoted in support of the findings. She opposes the methods and conclusions! BTW. what the patients were told to do, and not how the numbers were collected is the key flaw here. PM if you want to know more.

[red_Dragon888]

not that anything I will tell you may change your mind but I think a month is too long and unless your real reason to take a break it to skip the side effects... well, maybe changing meds is a better approach.  Also, find a better Doctor.

[bryonut]

Mauricio

I have to agree with the rest of the group. Self imposed drug holidays are risky. You do have the right to manage your health as you see fit, but again it is a good idea to run this by your doctor and look at alternatives to drug holidays.

You mentioned you do not like your doctor. Are you going to Clinic 1a? I am interested in talking to you about this since we are both in the same city.

bry

[BT65]

I don't recommend this and am not really sure what your logic is for doing it.  I'm also not really sure why you don't like your doctor.  But as far as the meds go, I wouldn't condone an annual break.