Lipo or something else ?

[yowsaa]

Hi All !

Is it possible to have lipoatrophy with a overall weight loss also? I have the sunken butt cheeks, thin, veiny arms/chicken legs... It feels like that fat has gone to my belly, but I also have an overall weight loss. Was on combivir/sustiva for 5 yrs , switched 8 mths ago to viread/3tc/sustiva. Cd4's / VL are great and seems all the ID doc cares about.

Past weights:
jan 03   180
apr 03   188
oct 03   180
feb 04   187
jun 04   179
sep 04   173
jan 05   175
may 05   180
aug  05  172
oct 05   173
sep 06   168

Seeing family doc Tuesday. What tests/ bloodwork should i ask him to check ? Scared as hell cause I don't know what is going on with my body.

Thanks.
+ 6 yrs
CD4 1250
VL <50 (try and never miss a dose people !!)

[yowsaa]

Ooops forgot 
Started meds sept 2000
CD4's 330
VL 33,000

Is this only the start of my lipo-nightmare ?

[pozniceguy]

Yowsaa... I was in a very similar situation when I started Meds.....1994....whgt 180...over the years that has gone down to 155  and holding steady....the Lipo is the fat loss part but the overall ( usually muscle tissue ) is usually "wasting syndrome"
No one really knows why this happens but there are several treatments..I used Serostim once a day for 3 yrs..stopped the wasting.. started a controlled ( using a personal trainer) regimen at the gym  and have rebuilt the muscle ( not a gymrat ) to where I can open a jar by myself again...  Now use the Serostim only on the night before a gym session ( three times a week )
There are other treatments using various steroids..some people tolerate one better than others. I hope you find a Dr that understands this phenomenon  and takes action for you.   don't let them tell you to just eat more   it doesn't work......the hard belly is usually attributed to the Lipo problem and the type of meds you are taking

Good Luck....Nick

[yowsaa]

pozniceguy, tyvm for responding.

Are the meds that i'm on now ok for this ??
As my counts are real good should i consider taking a drug holiday which might speed up the reversal of the lipo ? Really considering this one now.

Don't believe i'm wasting as defined by aids wasting. My theory now, as the fat redistributes to the belly it than puts pressure on the stomach causing it to 'shrink'. This gives me less of a feeling of being hungry, hence the weight loss.

In closing, how do I deal with the belly fat ? Can I do anything ?
High fat diet ?
Low fat diet ?
Situps ?
Will being off the AZT (8 mths now) alone help ?
Anything else ??

Need to stand up now as my bony butt hurts when I sit too long 

[pozniceguy]

I can only give you my experience..this syndrome seems to vary a lot depending on several factors.... The belly fat thing seems to be at least two complications....1, seems to be the Lipo effect and 2. seems to be the effect of certain Meds/combo of meds......sometimes the Dr's call this Crix belly  referring to Crixivan...( I have been on this since it was available ) ..I seem to have very little of this particular effect..  I have a "hard Belly "" but it does not really protrude and has been the same for years.  I am careful about too many fatty foods and exercise every day ( walk plus gym 3X wk)...  changing Meds doesn't seem to have a lot of effect on the Lipo ....there have been several threads in this site that refer to that ...Few individuals seem to see a difference after a med change..but for most there seems to be little or no effect....BTW there are people who have never been on Meds who have the Lipo as well....

All the info currently available ( see other threads)  says do not go on "holiday" from Meds.....It doesn't work  and may cause some longer term problems......a few people have tried various cycles and always  come back to the meds....it might feel good for a while but will catch up to you..

I know what you mean about "bony ass...also bony feet..bony knees   etc......  I try to always sit on a firm but not hard cushion...wear Schetchers  cross trainers ( nice thick padding) and always put a pad on the ground if I have to kneel down ( the firm rubber pads sold in garden depts work best)

[suzieque]

Hi,
 Did you say your CD4 is 1250? Has it been that way for awhile? If so I believe you could talk to your doctor about a possible treatment interruption. I did regain all of the fat when I took one, but if you do consider it you need to do it supervised. You need to know how to come off of the meds ( sometimes you have to stage it, as some meds stay in the system for longer), if you don't do this you could develop resistance. Doctors vary in their opinions about stopping treatment, so if yours does not want you to and you do not understand why ( have you ever had resistance to any meds etc) then you could always ask for another opinion. As I mentioned in another post by you my doctor and I believe that viread has caused lipoatrophy in me and others, so I am changing to two PI's and epivir. Will keep you posted! Good luck.

[yowsaa]

Hey Suz,
Yeah that 1250 is right. Couple years ago I was the poster child for modern meds, now I'm just your run of the mill basket case LOL.
Started meds @ 330, yr or so around 550, couple yrs in the 700-800 range, last 3 yrs steady increase to now.

Understand about the staging off. Doc asked me in sept if we want to talk about a drug holiday, i said ' if it aint broke don't fix it'. Think I need to revisit that possibility again. Guess I could always get a job at the Mirage in Vegas as the slowly dissappearing man 

I can really relate to the wicked witch in the wixard of oz when she says "I'm melting, I'm melting" nowadays.

Nope, no resis to meds that i know of. Sent you a PM.