vampires

[Jim Allen]

Just donated to the vampires this morning and now waiting for my prescription to be filled.

CD4 971, UD  - wash rinse repeat in 6 months

Blood pressure 150/90  caused by eating crap, answering "Am I" posters and no exercise.

In other words as with most things, nothing to do with HIV
Solution eat less crap ... No, I'm not going to exercise screw that.

Jim

[CaveyUK]

Brilliant numbers Jim. I know you don't obsess over them like many do, but still - stoked for you.

I have the same eating crap and not exercising issues. I had planned to re-start my gym going this week but have had a week of hell (family death, gf urgently referred to breast clinic and finally broke my hand doing something insanely stupid) which has ground all best laid plans to a halt!

[Jim Allen]

Indeed, I waited 6 months to find out my numbers, new doc mentioned it otherwise I would not have even asked or found out 

Yeah, diet is a problem, and I know you like me have the curse of working in the office.
You know how it is, coffee, sweet drinks, cakes, food at the desk, food on the go, Friday pub grub and sitting in a chair all day.

Lol. Got to start doing something about it.

family death, gf urgently referred to breast clinic

My Condolences and I hope you gf is okay and its just a scare over nothing.
Take it easy.

Jim

[Wade]

Great numbers Jim !

Except for the BP...   Do you have another pill now ?


PS... Cavey , you have indeed had a shitty week...my condolences as well

[Jim Allen]

Except for the BP...   Do you have another pill now ?

Nah - its was a crap result last time as well but slightly less though 140/100 now 150/90
Ill see in 6 months if the BP is down or not and measure it from home a few times.

 I don't like the hospital and it means driving to Dublin so after an hours road rage to get to the hospital my guess it this + a poor diet puts the BP up,  So better diet and less rage should reduce it for the next visit I hope 

[leatherman]

great news Jim! 


exercise may not be all it's cracked up to be. LOL I've been going to the gym for an hour every day, 5 days a week, for 2.5 months. And what did I get for it? my cd4s dropped from 400 to 362 and now down to 319. 

I do have to admit after staying in the low 300s for so many years, I was a little suspicious  of the 3 counts just above 400 that I've had in the last two years. 

my BP is always up when I go to the doctor. LOL I used to get care here in a small city in South Carolina; but I switched about a year ago to a doctor up in North Carolina. (with all that ryan white quality improvement training I've gotten and all the work I've done with the Part A, B, and C quality committees, I knew I wasn't getting quality care and it was time to find a new doctor) unfortunately, it means I have to drive an hour to see the doctor - a long drive up the highway and through to the far side of Charlotte. it's posted as 55 mph going through CLT; but if you drive under 70 you're sure to be run over by a semi, or slammed into the center median by someone trying to get around your slow-ass driving. LOL Needless to say with the tunes jamming and the pedal to medal through heavy highway traffic, everything about me is elevated by the time I pull into the parking lot.

[DANIELtakashi]

Hi, Jim.

Great number.  I envy you.  Mine is always under 400.
Diet is a problem for me.  Junk food is everywhere - coffee, diet Coke, fast food...
I drink too much coffee everyday.

Exercise - l walk a lot, especially on weekends.
Plus l do this Tina Turner dance when nobody is watching 
https://youtu.be/hzQnPz6TpGc

Thank you for being a great moderator.

[Ptrk3]

Glad to read that you are doing very well with controlling and suppressing the HIV, Jim.  Your CD4 count is outstanding!

Yes, it's good to keep an eye on the blood pressure. In the States, 150/90 would be consider Stage 1 hypertension (if that was your consistent blood-pressure reading), so not crazy high.  Your doctor will keep a close eye on things.

[Jim Allen]

LOL Needless to say with the tunes jamming and the pedal to medal through heavy highway traffic, everything about me is elevated by the time I pull into the parking lot.

  - Yeah sounds familiar alright

Exercise - l walk a lot, especially on weekends.
Plus l do this Tina Turner dance when nobody is watching 
https://youtu.be/hzQnPz6TpGc

Tina Turner - Personally I don't have the legs for it 

Yes, it's good to keep an eye on the blood pressure. In the States, 150/90 would be consider Stage 1 hypertension (if that was your consistent blood-pressure reading), so not crazy high.  Your doctor will keep a close eye on things.

Yeah, they said similar - well part of me thinks it could be worse and it is what it is. Yeah back in October, slightly healthier diet and hopefully things will be better :-)

Jim 

[Tonny2]

      OJO       HELLO JIM...WOW!!!, I DIDN'T KNOW YOU HAD THOSE KIND OF NUMBERS. CONGRATULATIONS...NEXT TUESDAY IS MY TURN TO VISIT "DRACULA" AND MY ID DOCTOR, WISH ME LUCK...CUT DOWN ON THE SALT...YOU ARE A YOUNG MAN, AND YOU HAVE TO TAKE CARE OF YOURSELF, YOU HAVE TWO LITTLE ANGELS WHO NEED YOU AROUND...HUGS                                                                OJO

[Jim Allen]

Thanks  Sure things will be fine with you next week, keep us posted.

[paintedroom]

971 ? feckin savage..that`s hollywood sign scale.

[Jim Allen]

 

Thanks, everything was grand except for the BP, thankfully.

I've only ever missed 6 dozes of meds so not too bad on the adherence side, not that the CD4's care but it keeps the VL down.

The side conversation from the HIV specialist stuck with my brain a bit this time round. She asked if i took my meds, said yes and that she talked about how there was recently an increase of people (stable, and no abuse patients) at the hospital who swear blind during the visit they are UD and still taking the meds and than the clinc having to have them called back early as the labs show VL's in the 1000's if not 10.000's and it turns out they missed more meds than admitting or could recall on the first visit 

I could give her a solution or insights other than suggesting stressing adherence it to patients on visits or making them bring the bottles of meds in for a count (how nanny state would that be).

Maybe its the 1 pill a day combo's that is part of the problem? As its 1 pill a day perhaps as people don't have to think about it often, they simply forget and miss it. ? I don't know.

Jim

[CaveyUK]

Or she could of course have been exaggerating to make a point, especially for whatever reason they thought you may have been under-egging the number of doses you missed....

Seeing patients with VL's spiking into the 10,000's means either resistance and drug/combo failure or someone who has simply stopped taking their meds.

As a point of illustration - Until very recently, when the first case was found, there hadn't been a single case of anyone prescribed Dolutegravir as first line treatment who had become resistant to the drug. Now thats just one drug in a combo and It's not impossible that they have seen a sudden up-tick but I'd say it's unlikely to be down to the odd missed dose and resistance, and more because for whatever reason people are stopping their meds completely (if it's true at all). And in the days of once-a-day treatment, that is crazy if true IMO.

Given she had tied it to a point of adherence, my money is on exaggeration

[Jim Allen]

I don't know.
Why target me? 6 dozes missed since i started this stretch of treatment 4 years ago. always UD.

Seeing patients with VL's spiking into the 10,000's means either resistance and drug/combo failure or someone who has simply stopped taking their meds.

We did not get into the resistance part, this was indeed simply on people not taking meds, so adherence concerns. She was more talking about patients in general and asking what I thought, what i have heard and seen kinda way.

If you want to look at this for a logical reason it has been busier for them at the clinc, as last 4 years back to back the number of cases in Ireland has gone up and with that newer people starting treatment, so it could just her perception.  Could be the 1 pill a day thing is part of it.

Not that it bothers me i suppose, I mean people not taking their meds and having high VL's is up to them. Stupid but up to themselves, not new issue always been people like that.

As a point of illustration - Until very recently, when the first case was found, there hadn't been a single case of anyone prescribed Dolutegravir as first line treatment who had become resistant to the drug

But stopping treatment does not necessarily equal automatic resistance of course to any drug, we did not get into resistance, just adherence however it does seem Dolutegravir is particularly tough cookie.

Jim

[Jim Allen]

I'll have to ask her if she is taking the stats.
Issue across drug lines, population groups, age etc

Jim

[CaveyUK]

I don't know.
Why target me? 6 dozes missed since i started this stretch of treatment 4 years ago. always UD.

Dunno. Sometimes I find these specialists can say cooky things occasionally. There may have been a local instruction to really drive home the importance of adherence to everyone, or perhaps you mentioned the 'six times' thing - meaning from start of treatment - and for a second she thought you meant six times recently so drove into her anecdote?

Or maybe she though you just looked the 'sort' and needed to be scared straight before you run off the rails

I know the UK rate of adherence is really good, in general. Not sure about Ireland - I suppose the religious thing over there may generate stigma which impacts adherence a bit more? Would be interesting to ask for the stats - especially as you can explain that you help run one of the worlds most prominent international discussion groups on the subject!

[Jim Allen]

Dunno. Sometimes I find these specialists can say cooky things occasionally. There may have been a local instruction to really drive home the importance of adherence to everyone, or perhaps you mentioned the 'six times' thing - meaning from start of treatment - and for a second she thought you meant six times recently so drove into her anecdote?

Just to clarify I did not mention the 6 times to her, I mentioned that here on the forum only.
They tend to stick to the program with me unless they want someone thing  

She asked if i took my meds, said yes

I know the UK rate of adherence is really good, in general. Not sure about Ireland - I suppose the religious thing over there may generate stigma which impacts adherence a bit more? Would be interesting to ask for the stats - especially as you can explain that you help run one of the worlds most prominent international discussion groups on the subject!

Yeah last time i read on the UK specific it was in 2015 (ill have to dig it out) and it had 10%+ non adherence at the time, not sure if that has changed - I think for the UK the real question is, will the number be increasing? The NHS move to switching patients to older drugs over the next years, sometimes meaning a larger pill burden will this increase any non-adherence?  - Only time will tell.

But yes could be a number of local reasons/factors I mean if you look at that report the other day on "Adherence to Antiretroviral Therapy and Virologic Failure A Meta-Analysis"  https://forums.poz.com/index.php?topic=66234.0

I am sure there are differences between nations and local influences such as culture that plays a part.

Jim

[CaveyUK]

last time i read on the UK specific it was in 2015 (ill have to dig it out) and it had 10%+ non adherence at the time, not sure if that has changed

A bit higher since then I think...The 2016 article here http://www.aidsmap.com/Promising-trends-continue-in-UK-diagnosis-and-treatment-rates/page/3089185/ cites :

"Last year, 96% of people who accessed HIV care was on treatment. This is a significant rise from 90% in 2014 and is likely to reflect the change in UK treatment guidelines last year to recommend treatment for all on diagnosis. Of those, 94% were virally suppressed (89% of all in care). "

- I think for the UK the real question is, will the number be increasing? The NHS move to switching patients to older drugs over the next years, sometimes meaning a larger pill burden will this increase any non-adherence?  - Only time will tell.

I'm not sure the NHS are 'switching to older drugs' per se. At least not yet. There is the anomaly of the proposed switch of everyone on Dolutegravir to Raltegravir which is a bit perplexing, but would at least be in the same (fairly modern) class of drug. They are also looking to start first-line treatment with Efavirenz which is cheaper but not ideal and is counter to the UK guidelines, but other drugs can be prescribed if there is a need to on a patient by patient basis. The big change with the NHS appears to be the switch to generics where available, which will indeed increase the pill burden for many as you say, but I'm not convinced that having to take 2 or 3 pills rather than one will make that much difference if it is still once-per-day. Annoying yes, and it takes away the illusion of taking just one drug, but would it stop someone adherent now on 1 pill to miss doses? I'm not sure - I guess we will find out.

The depressing thing with the NHS approach is that after years of pushing ahead with the latest and greatest medical advances, it's the first sign of cost being king and a wind-back in drug availability of the latest advances. Perhaps the normalisation of HIV and the news that it can be so well controlled is a key driver in all this. I agree with the use of generics personally, but don't like the news about Dolutegravir and do worry where it may all lead. Especially if the good UK adherence % does end up being compromised as a result.

[OneTampa]

I have 99% adherence. Just had comprehensive lab work done. Will get results in about 2 weeks.

Should be interesting given that I am on a few more generics given my health plan pharmacy switch this year.

[Jim Allen]

"Last year, 96% of people who accessed HIV care was on treatment. This is a significant rise from 90% in 2014 and is likely to reflect the change in UK treatment guidelines last year to recommend treatment for all on diagnosis. Of those, 94% were virally suppressed (89% of all in care). "

Being UD on measurement or the measurement of the total on treatment, is not quite the same as adherence rate. Viral suppression under those on treatment in 2014 was about 87%. So only a 2% increase in 4 years.  The adherence of 95% under the total on treatment i suspect will have changed little, that's good in a way 90% ish adhering to 95%+ is okay. 100% would never be reached, that's just the human factor of course.

Yeah, generics meds makes sense, that part of it i get however not if it means increased pill burden or not advancing treatment options. Let me put it like this how long will the freeze on newer meds be?

I know the changes to 1 pill a day was "promoted" in a lot in clinics as easier management. In any case we will see the impact of the change in a few years from now or not i suppose, time will tell.

but don't like the news about Dolutegravir and do worry where it may all lead

Indeed, and part of me does wonder if in time, they will change their minds on this move once more feedback from clinics and specialists has been voiced back.

Another time will tell item.

Jim




 

[Wade]

Have to admit I've miss a few dosses here and there, i visited the vampire last week and all is well . Still UD and CD4s are in mid 500s...all is well.

I have never fretted over missing a dose, and it is not a habit...life happens sometimes 

[Jim Allen]

6 months later, Just donated to the vampires this morning and now waiting for my prescription to be filled.

CD4 640, UD  ... Lost 300 CD4's I blamed the recession hahaha.

No drama, wash rinse repeat in 6 months

[Jim Allen]

Finally at my laptop today so updating this.

Nothing much, usually condom and safer sex speach. Kindey and liver results excellent, they have been improving ever since I stopped drinking and smoking.

The only other thing was hepatitis b vaccine. New doctor in the clinic brought it up that it's not taken 3x3 and no luck. Anyhow despite being important I'm not in the mood for a 4th round of 3 jabs, so we decided to leave it.

Otherwise all good.

Jim

[daveR]

Hi Jim

I have had 3 attempts at the hep B vaccination and it has not worked for me yet. The doctor said it does fail to take in some people, even the latest version of it. This was before I tested positive and my ID Dr doesn't seem bothered about it now. I decided to just leave it.

Dave

[LeftyBowler300]

You guys and your high CD4's 

Donate plz 

[Jim Allen]

Lol.

Ill send them to you, on the way. Word of warning mine tend to be lazy bunch of bastards, just feed them pizza and sugar when you expect work from them.

Jim 

[Jim Allen]

Just back from latest donation 

3 hour wait
10 mins bloods
4 mins consultation

CD4's 800
VL suppressed.
Kidneys , fine
LDL, fine

Neuropathy, agreed to increase "pregablin" dosage. I've been increasingly in discomfort over the past 3 months or so but nothing to panic about.

Was asked about switching Doc " would you like or have you thought about it?" Me "No thank you, ill let you know when" Doc " okay, just know its not an issue to switch if you want"

Another 6 months of "Truimeg" script & 6 months in stock already.

Jim

[Loa111]

Awesome CD4 numbers. I’m envious 
You recovered from a very advanced case too?

Vincent’s hospital have a very efficient Id dept.. rarely more than 30+ min wait.

[CaveyUK]

Great numbers Jim.

My last CD4 test was done over a year ago now (July 2017 - was 552). At my latest visit, my doc said she was waiting another six months until January and then she will do one, but assuming I am still UD or don't have some terrible illness, her plan is to never ever ever do one again after that!

In some ways I'm not that bothered. The anxiety around if they go up or down, or how much they go up, can sometimes be a bit all consuming around the time of the tests, despite the knowledge that once you are UD and they are out of the danger zone, CD4s are largely meaningless. But still....NEVER...!?!?

[Tonny2]

      ojo.     CONGRATULATIONS JIM, I'm sorry about your pain, I know what it is to live with all the hubs if pains there are in one condition, do I make sebse!?. If someone wants to know about the diferent kind of pains there are, ask someone who is living with neuropathic pain.. I gave up taking pain medications for my neuropathic pain, I guess, I've learned to live with it as I did learn to live with "Pancho" (hiv), my most faithful partner, always there, he doesn't care how much I hurt him, he never goes away..."Pancho" and I, congratulate you for those 800 soldier's, keep up the good work, in general.. hugs.           ojo

[leatherman]

CD4s are largely meaningless. But still....NEVER...!?!?

the current US guidelines are:
After 2 years of ART, VL consistently suppressed and CD4 consistently 300-500:
Time between viral load test can extend to every 6 months for patients with consistent viral suppression for >=2 years.
With the cd4 test done every 12 months

After 2 years of ART, VL consistently suppressed and CD4 consistently >500 cells/mm3:
the CD4 test is Optional

https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/458/plasma-hiv-1-rna--viral-load--and-cd4-count-monitoring
"Table 4. Recommendations on the Indications and Frequency of Viral Load and CD4 Count Monitoring"
http://hiv.ucsf.edu/docs/hiv_monitoring_guideline.pdf
"Table. Summary of HIV-specific routine laboratory monitoring" (pg 5)

[Jim Allen]

Thanks Tony, appreciate the thoughts.

I've tried lots of pain meds over years it was all temporary, for neuropathic pain like you hint towards learning to live with it is part of getting on.  That said I've had a really good run of near pain free since July 2016 on
 Pregabalin so hopefully the dosage adjustment will get me back to a comfortable pain level.

Hugs jim

[Jim Allen]

Optional, sure i can imagine that bejond the 2 years there will be times a doc will still like to run a CD4 count, like post switching meds or during more severe illness etc, however stable patient its a rather pointless number to run.

Take mine drops 300 and than bounces back up the next time, its like a yoyo and indicates nothing much.

[Jim Allen]

Awesome CD4 numbers. I’m envious 
You recovered from a very advanced case too?

Vincent’s hospital have a very efficient Id dept.. rarely more than 30+ min wait.

St'Vincent hospital ... Posh area on the south side.   
I'm at the Mater Hospital, only because I dislike St james's  so much. Lol

Yeah, I was pretty sick when I started treatment, that said a lot of people here were far worse than me, and they are doing equally fine if not even better.

Large part is being adherent to the meds,  treating any underlying things that have been allowed to crop up, particularly in the first year and, giving your body time to heal.

After that initial stage asides from remaining adherence to treatment its, I think mainly just about having a positive mindset about life and oneself. Its not easy for everyone but look that is what works for me at least 

The CD4 counts are rather irrelevant once you are stable and UD, its not a measurement of health as the gents more or less pointed out.

Jim

[Tonny2]

Thanks Tony, appreciate the thoughts.

I've tried lots of pain meds over years it was all temporary, for neuropathic pain like you hint towards learning to live with it is part of getting on.  That said I've had a really good run of near pain free since July 2016 on
 Pregabalin so hopefully the dosage adjustment will get me back to a comfortable pain level.

Hugs jim

    ojo.   Hi asain Jim...I like you, tried all kind of meds to treat neuropathic pain, and I also had some relief I even had to mix it with Vicodin. The only medication that helped me for a while was nortriptyline combined with Vicodin. I have been living with pain since 1997. I tried the pregabalin, I do not like it because, as you know, you feet and legs are numb, and with this medication I don't feel my legs at all, making my walking uncomfortable and and unsafe... I'm glad that you are finding relief with this medication, good for you... I admire your dedication to these forums and the wisdom them of the words you offer to all of us...more hugs.                        ojo

[MadDog125]

Guys I'm a total law breaker.  I'm gay and I never go to a gym.  I sorta make up for it with a physical job.  As for diet pretty good but I have been known to take my meds with monster😊  Quick question when did you go from every three months to six?  Was it time or blood numbers based?

[Archimexican]

Wow, I didn’t know you were very sick before treatment. Congratulations on your numbers and thank you for the support and all the work you do

[Jim Allen]

Guys I'm a total law breaker.  I'm gay and I never go to a gym.  I sorta make up for it with a physical job.  As for diet pretty good but I have been known to take my meds with monster😊  Quick question when did you go from every three months to six?  Was it time or blood numbers based?

I work in an office and eat fast food & MacDonald, never worked out in my life. That said I like girls.

Anyhow moving from 3 to 6 months took I while for me, took me some time to go from 1 month to 3 months.

I suspect average is after having stable results they tend to move to 6 months after finishing the first year of treatment. It will vary per patient and per clinic.

I was a very bad patient 

Edit. I was on a 6 weeks clinc visits, not monthly before going to 3 months

[MarkintheDark]

Oh, y'all are a bunch of amateurs. I feed the vampires 3-4 tubes/month in the study and I....*klunk*

[why am I on the floor?]

[MadDog125]

I have to say I feel guilty hearing some of the waits and such you guys have experianced.  I go in about a week ahead of my appointments with my I'd Doc.  I've never waited more than ten minutes.  Chase Brexton is a series of clinics in the mid atlantic US.  They have been very good to me to date. 

Sorry to hear about the chronic pain.  I wish there were a more permanent fix.  Good news is medical science is advancing like crazy anymore. 

[Jim Allen]

10 mins, wow.

Its not all bad waiting 3-4 hours a visit I am sure sounds quite a luxury compared to others, also gives me time to read the newspaper and do a bit of people watching.

 

[Loa111]

Where I go, there's always registrars training up in the ID field. When I see a new one, they tend to take the case from the beginning again, which can be a bit frustrating with the questions, but then I realised that they also give me a really good physical examination each time. So it thought...hmmmm....this is like getting a free medical check up every month, nothing a bad thing at all! Often the head ID doc will come in & give me a quick look too. Being an advanced case has its advantages!

I actually dreaded going to the clinic the first few times, as i saw it as a place of terrible bad news for me, so now I try to enjoy the visit, get a coffee, do a bit of people watching too, nothing like a busy hospital for people watching, bit of variety to my normal schedule, try to flirt with the stern middle aged nurse LOL. 

[CaveyUK]

I never have a wait, or 5-10 mins at the most. I'm grateful to be honest, as I usually just want it done and get out of there

[paulT]

Amazing numbers Jim! It's just a great reassurance to all of us here that the treatment really works and with time CD4 will improve!

[Jim Allen]

Amazing numbers Jim! It's just a great reassurance to all of us here that the treatment really works and with time CD4 will improve!

Thanks Paul.

How's the sleeping going for you? Did you managed to get some rest post heatwave?

[Jim Allen]

    ojo.   Hi asain Jim...I like you, tried all kind of meds to treat neuropathic pain, and I also had some relief I even had to mix it with Vicodin. The only medication that helped me for a while was nortriptyline combined with Vicodin. I have been living with pain since 1997. I tried the pregabalin, I do not like it because, as you know, you feet and legs are numb, and with this medication I don't feel my legs at all, making my walking uncomfortable and and unsafe... I'm glad that you are finding relief with this medication, good for you... I admire your dedication to these forums and the wisdom them of the words you offer to all of us...more hugs.                        ojo

Hi Tony,
Yeah its true that pregabalin at least for me does leave an additional numbness to the limbs, it does sort 80% of day to day pain in my experience, the additional numbness "dead leg" feeling is particularly for me the right leg witch is the one effected by the nurve damage.

Sorry to hear nothing has really worked for you, I understand the pain and its certainly not an easy thing to live with.

[paulT]

Thanks Paul.

How's the sleeping going for you? Did you managed to get some rest post heatwave?

Sleeping much better, thanks! It was most probably hot weather!
My recent results UD and CD4 308 (after 11 weeks up from 238). Not sure if I should celebrate tbh. Was hoping for a bigger jump but hey you're such an inspiration so hopefully it will get better.

[Jim Allen]

Sleeping much better, thanks! It was most probably hot weather!
My recent results UD and CD4 308 (after 11 weeks up from 238). Not sure if I should celebrate tbh. Was hoping for a bigger jump but hey you're such an inspiration so hopefully it will get better.

Glad to hear the sleeping is much better, being sleep deprived is the horrible.
Great on the UD, and don't worry about the CD4's they could well be far more efficient than mine, and its not a measurement of overall health.

[Jim Allen]

Just back from latest donation 

3 hour wait
10 mins bloods
4 mins consultation

CD4's 800
VL suppressed.
Kidneys , fine
LDL, fine

Just attended the vampires this morning.

First 10min:

CD4 848, 40%
VL suppressed. (Not detected, on lab report)
Kidneys , fine
LDL, fine
All other bloods fine.

Blood pressure 168/90  I explained that my legs is fucking killing me at the moment hence it's up, due to pain need to see GP again regarding pain management adjustments for the neuropathy

Was due renew Prevnar vaccination (pneumococcal) however they are out of stock, agreed to do this in 6 months time.

Offered free STI screening, last one was 2'5 years ago (I know I'm bad) so that took 5 mins total

Just waiting now for 6 more months worth of Truimeg at the hospital pharmacy

Jim

[Jim Allen]

So follow up with the GP this morning, BP 100/165 & 100/145.

Because whenever I visit them i keep having higer BP readings then they like over the past 2 years on Friday they will fit me with a 24 hour monitor to have a correct measurement of what's going on.

Told the GP I'm happy to do it, sure why not, but I'm pretty confident it's fine

Jim

[beanstalk]

Just waiting now for 6 more months worth of Truimeg at the hospital pharmacy

I wish my hospital would give us the 6 bottles. Whenever I try to take more than one the farmacists just start saying they are low on stock blablabla (even tho I have the prescription for the 6 months). I'm thinking of when I actually have to go abroad for work to just tell them that if they do not give me the bottles I'm going anyway and it's not my problem if they get a pandemic when I come back with a raging sexual appetite

[fabio]

For one moment I thought it was a "cult" of vampires 👿.
Nice numbers. I gave blood to the vamps a week ago,but they didn't tell me my results cuz they take 2 days to look at them. In general they told me I'm a good boy for taking meds and that it's showing.

[Jim Allen]

I wish my hospital would give us the 6 bottles. Whenever I try to take more than one the farmacists just start saying they are low on stock blablabla (even tho I have the prescription for the 6 months). I'm thinking of when I actually have to go abroad for work to just tell them that if they do not give me the bottles I'm going anyway and it's not my problem if they get a pandemic when I come back with a raging sexual appetite

Being limited to a monthly supply and having to come back each time hmmm that sucks, i know this is common in some of the less fortunate locations of the world but, i did not know that its a problem in Lisbon.

Is it like this everywhere in Portugal? Perhaps something to start making noise about though the ASO?
Though I agree its worth telling them you need to travel for work and hence require your prescription to be filled.

BTW How are you doing ?

[leatherman]

i know this is common in some of the less fortunate locations of the world

like America where people who receive drug assistance from the Ryan White ADAP (aids drugs assistance program) and many others on private insurance who can only get 1 fill per month. 

[Jim Allen]

If I'm blunt it's one of the places that jumped to mind. As an outsider like a lot of things about the US, but how health care is managed would not be one of them

I know within the EU it varies as well, last time I had meds in The Netherlands is was 6 months script, but collect 3 months max at a time as example, being limited to a monthly supply like the Lisbon within the Europe feels pretty limiting.

Although in Ireland there is no postal service for meds (would fucking love it) and the only pharmacy that carries HIV meds for treatment are located in the major hospitals,  prehaps that factors into larger allowances

For one moment I thought it was a "cult" of vampires 👿.
Nice numbers. I gave blood to the vamps a week ago,but they didn't tell me my results cuz they take 2 days to look at them. In general they told me I'm a good boy for taking meds and that it's showing.

Not sure if I would call the heatlh service a "cult" but this did make me laugh 

[leatherman]

Although in Ireland there is no postal service for meds (would fucking love it)

when I first starting using this doctor across the state line, the pharmacy would mail my meds to me every month. Except for the times I was up in town at some health dpt quality management meeting or a client meeting at my clinic, and then I would pick up in person. But the pharmacy got busted (and sadly had to pay a fine) for not having the right licenses to mail medications across the state line. Somehow 30 miles apart in the same nation is a big deal.  It's been a year and a half that I've been waiting, but finally, as a great birthday present to me, they got things worked out and have mailed my meds to arrive tomorrow!

I saw the vampires not long ago. I think this was my 415th blood draw in all these years. My doctor is all atwitter because my cd4s dropped when they've been finally climbing towards 500. But I lol-ed at him when he wanted more blood for a do-over test. I lived with a 250 average for nearly 2 decades so I'm pretty sure that's around my normal and the 465 was the abnormality. LOL

[beanstalk]

Being limited to a monthly supply and having to come back each time hmmm that sucks, i know this is common in some of the less fortunate locations of the world but, i did not know that its a problem in Lisbon.

Is it like this everywhere in Portugal? Perhaps something to start making noise about though the ASO?
Though I agree its worth telling them you need to travel for work and hence require your prescription to be filled.

BTW How are you doing ?

It doesn't happen in all the hospitals, I heard Hospital Egas Moniz for example is giving more than a month. I'm in a more central hospital (Curry Cabral) and they probably have much more demand. By the way, there's a lot of talk in the news right now about some Trivicay that disappeared (stolen) from our storages (https://observador.pt/2019/03/12/desapareceram-mais-de-60-unidades-de-medicamento-usado-no-tratamento-do-vih/).

I'm doing OK. I got an infection of Campylobacter Fetus from something I ate at a restaurant (which is very strange since I don't even eat meat, I'm blaming undercooked eggs), spent some time at the hospital (fever, anemia, pain...) but the antibiotics worked wonders. My biggest problem right now is the red face that doesn't go away... I had my appointment with the autoimmune disease doctor in february, got blood drawn (again, a lot), but it seems there is too much demand for the doctors so I have to wait until the very last day of may. Someone told me about this ointment called Mirvaso that seems to work for people with lupus but I don't seem to be able to get it without a prescription. So here I am, waiting with a forever burning face, looking like a pikachu. Both my first HIV appointment after UD and the SLE one will be at the same time so I'll make a post by then. Next time I'll bring the pill bottle situation to the HIV doctor.

[fabio]

Here in Greece we only get meds in the big state hospitals once every month. Thankfully they can send them on express mail and they arrive the next day,as I and probably other people,live in islands and can't access immediate meds from the hospital.
I do have to go with the ferry though every 3 or 4 months for my appointments,which I think it's better,Because nobody really knows me there and I feel more comfortable waiting on the "hall of shame" lol.

[Jim Allen]

when I first starting using this doctor across the state line, the pharmacy would mail my meds to me every month. Except for the times I was up in town at some health dpt quality management meeting or a client meeting at my clinic, and then I would pick up in person. But the pharmacy got busted (and sadly had to pay a fine) for not having the right licenses to mail medications across the state line. Somehow 30 miles apart in the same nation is a big deal.  It's been a year and a half that I've been waiting, but finally, as a great birthday present to me, they got things worked out and have mailed my meds to arrive tomorrow!

I saw the vampires not long ago. I think this was my 415th blood draw in all these years. My doctor is all atwitter because my cd4s dropped when they've been finally climbing towards 500. But I lol-ed at him when he wanted more blood for a do-over test. I lived with a 250 average for nearly 2 decades so I'm pretty sure that's around my normal and the 465 was the abnormality. LOL

Glad to hear the mail service is back up and running for you. I would love that hear but they don't even have the meds outside of the hospital pharmacy yet mainly sue to knowledge issues with pharmacy's here and insurance i was once told.

Well once you do hit the 500 ill bake you a cake 

It doesn't happen in all the hospitals, I heard Hospital Egas Moniz for example is giving more than a month. I'm in a more central hospital (Curry Cabral) and they probably have much more demand. By the way, there's a lot of talk in the news right now about some Trivicay that disappeared (stolen) from our storages (https://observador.pt/2019/03/12/desapareceram-mais-de-60-unidades-de-medicamento-usado-no-tratamento-do-vih/).

I'm doing OK. I got an infection of Campylobacter Fetus from something I ate at a restaurant (which is very strange since I don't even eat meat, I'm blaming undercooked eggs), spent some time at the hospital (fever, anemia, pain...) but the antibiotics worked wonders. My biggest problem right now is the red face that doesn't go away... I had my appointment with the autoimmune disease doctor in february, got blood drawn (again, a lot), but it seems there is too much demand for the doctors so I have to wait until the very last day of may. Someone told me about this ointment called Mirvaso that seems to work for people with lupus but I don't seem to be able to get it without a prescription. So here I am, waiting with a forever burning face, looking like a pikachu. Both my first HIV appointment after UD and the SLE one will be at the same time so I'll make a post by then. Next time I'll bring the pill bottle situation to the HIV doctor.

  stealing tivicay that sucks.  I could think of much more cool drugs to steal that would have a bigger market 

Sorry to hear about the rough time and the infection, yeah under cooked eggs cab be nasty although I love it when the yoke still has some softness

As for the face sounds painful and waiting till May to get results even more so, has nothing OTC helped reduce the issue?

Hope you feel better soon.

Here in Greece we only get meds in the big state hospitals once every month. Thankfully they can send them on express mail and they arrive the next day,as I and probably other people,live in islands and can't access immediate meds from the hospital.
I do have to go with the ferry though every 3 or 4 months for my appointments,which I think it's better,Because nobody really knows me there and I feel more comfortable waiting on the "hall of shame" lol.

So Greece (no offence) can get it shit together and Ireland can't    Typical.

 

[Jim Allen]

So follow up with the GP this morning, BP 100/165 & 100/145.

Because whenever I visit them i keep having higer BP readings then they like over the past 2 years on Friday they will fit me with a 24 hour monitor to have a correct measurement of what's going on.

Told the GP I'm happy to do it, sure why not, but I'm pretty confident it's fine

Jim

Well got it fitted, and its pumping away every 15 mins of so, checked it once to look 161/108 .. I've decided to not look at it and to stop jerking off for today

[leatherman]

stop jerking off for today

stop taking your bp WHILE your doing it

[Jim Allen]

stop taking your bp WHILE your doing it

lol. See the thing is the Nurse said don't take it off and do what you normally do and she would call if the readings get too high

Ohhh ... I just had a thought now  I will not share it

[fabio]

Oh they don't have their shit together hahaa,but at least they do on us and cancer patients. Plus I'm in a university hospital,they invest a lot in these hospitals and the army hospitals,so the services are good.
However all other hospitals are quite shite......
Also we are quite a small country and shipping a box of meds next day is the easiest thing ever. All because the saints of the wards secretaries.

[Jim Allen]

So got the results of the 24 hours BP thingy
Averages:

143/83 - Daytime
132/71 - Nighttime

Edit: it's better results than I expected

Not too high but they want me to come in on Thursday to chat and go over the results.  From what i gather talking to the nurse they are more concern that it was not dropping (lowering) more during the night.

Jim

[Jim Allen]

So met with the doctor this morning.

Long story short day and night my blood pressure is off with spikes even at night off the charts. ( 210/x)

This combined with family history and my own medical  past they would start me on blood pressure meds today but they are reaching out to my HIV doc fist to sync up and to check what treatment options are best  I had to listen to the no salt, eat healthier speech as well of course.

Oh well not happy about it but it's not the end of the world, in fact without living with HIV I would not have known about this issue so in way I am Lucky I can do something about it earlier rather than later 😉

Best Jim

[Jim Allen]

So met with the doctor this morning.

Long story short day and night my blood pressure is off with spikes even at night off the charts. ( 210/x)

This combined with family history and my own medical  past they would start me on blood pressure meds today but they are reaching out to my HIV doc fist to sync up and to check what treatment options are best  I had to listen to the no salt, eat healthier speech as well of course.

Oh well not happy about it but it's not the end of the world, in fact without living with HIV I would not have known about this issue so in way I am Lucky I can do something about it earlier rather than later 😉

Best Jim

So they gave me "Perindopril" to take for the blood pressure, sure it will be grand

Jim

[leatherman]

my hubby and I are taking lisinopril. While he had the mild "it feels like you have to clear your throat" coughing side effect at first, it didn't have the ED issues of some of the other meds he tried first. I've had no issues with it....except I had to have the doctor cut the dosage. It was getting so that every time I stood up I almost passed out. So I went from hardly any hypertension to hypotension 

[Jim Allen]

So I changed Blood pressure meds.  It was giving me a dry cough not to mention I think it was messing up my sleep & giving me a feeling my heart was racing (It was not, just a mental thing).

Switched to Olmesartan 10 days ago and the coughing is gone and, sleep pattern back to normal & no more racing heart feeling.

Jim

[Jim Allen]

P.s

Next check up with the vampires is the 23rd of Aug, List of things to do include this round

- Discussing pain management (Need to up my meds)
- Pneumococcal vaccine
- Run thyroid panel (GP is concerned. i'm not)

In addition still on the waiting list to have a biopsy of the "rashes" the GP is panicking about at this stage, although i'm hoping the ID Consultant might have an idea just by looking given his extensive experience   

Jim

[wardp]

Hi Jim how often do you get your vaccination?

[leatherman]

So I changed Blood pressure meds.

i kind of changed mine too I stopped taking it at all. BP has been fine and I don't almost pass out just by standing up (which was making yard work at the new house this spring quite an adventure)

i also had to quit the gabapentin for the PN in my feet. It just made me too fuzzy and doped up. I've lived all these years with my feet feeling like I'm walking on hot sand (thanks zerit  ), so I guess I'll just keep visualizing beaches.

rashes?! ugh. is it itchy? everything makes me itchy. 

[Jim Allen]

rashes?! ugh. is it itchy? everything makes me itchy. 

Nah just ugly and freaking the GP out a bit ... I'm not as concerned, as stressing about it will not change it. 

kind of changed mine too I stopped taking it at all. BP has been fine and I don't almost pass out just by standing up (which was making yard work at the new house this spring quite an adventure)

"Changed" aha, dropped more like it. Well glad the BP is still fine though, do you monitor it at home? Glad you are feeling better though

i also had to quit the gabapentin for the PN in my feet. It just made me too fuzzy and doped up.

Yeah I hear that a lot from people taking Gabapentin. I'm on pregabalin so slightly different but in the same ballpark, not had too many issues myself although it makes my leg feel totally alien at times like it's not part of my body, it's preferable for me personally to deal with that instead of waking up screaming in pain during the night

[Jim Allen]

Hi Jim how often do you get your vaccination?

Meningococcal is every 5 years booster (could be shorter time-frame though I don't really recall)  and Pneumococcal they want to do again due to my health. Last two times they were out of stock when i was finally in the chair waiting the labs so fingers crossed this time.

The other is just the flu vaccine yearly, I tried the Heb B vaccine, 2 x the 3 times 1 shot and both attempts failed.

[Jim Allen]

So ...

Hair loss;
Doc confirmed my assessment of "alopecia areata " of course not HIV related but sure another little issue why not.

Night sweats & coughing
I think it was the Ace inhibitor, GP agreed and so does the Doc, but getting additional bloods & chest x-ray to rule out TB. If I was wrong I'll be called back within a week

Rash on neck
I'm on a 2-year waiting list for biopsy 
Although the Doc took a photo and will talk to a dermatologist. He is not sure what it is but said he should be able to skip the wait and get me seen within a month

HIV

VL - Suppressed
CD4 - 1140 and @42%

All other labs within the normal range.

Comments were " Your HIV is suppressed that's the main point as far as HIV goes, now as for anything else that pops up in life deal with it as it happens"   

[Jim Allen]

Just as an update.
Few months after switching to Olmesartan and all is well, happy days. BP is good and side effects from the Ace inhibitor are all gone, still, hair issues but whining about that serves no purpose and there are better things to worry about, also perhaps I am just about old enough not to care.

On the rash, no panic, know what is needed and got the waiting list shorted from 18 months to an appointment in Feb & April after having a word with my HIV consultant  So all good.

[Jim Allen]

Was visiting the vampires today

VL - ND (not detected)
CD4 - 670 was 1140 in Aug ..  who cares.

Also, STI screening all okay.

Shorter than normal return, back to 3 monthly appointments instead of 6 months to monitor my health closer.

[fabio]

Those are really nice stats! I feel,by saying that,that we are Pokemon or something haha.
I have an appointment with the vamps at 26 of this month. Gonna ask about my whole "work in healthcare" opportunities too.
Also I want to note that I'm very happy everyone is doing great in their labs!

[Jim Allen]

Yes, cholesterol, liver, etc etc etc were all within normal range as well, nice to have stable enough results

Well hopefully you get the information you need on the 26th.

[Loa111]

Are they offering STI checks at your clinic along with the routine hiv work? They asked me my last appointment at Vincent’s if I wanted an STI check too as it’s a new thing they’re offering.
I said sure but then they forgot to do it lol.

[Jim Allen]

Hiya,

Yeah, they offer it along with the routine bloodwork. 

The doc asked me if I had had any causal sex, told her the chance would be a fine thing, but, I'm too tired for that carry-on.

Jim

[Jim Allen]

Visited the clinic this week.

VL - ND (not detected)
CD4 - 610
Liver, kidneys, cholesterol etc all perfect. 

Blood pressure was high (152/80 and 151/80) but I ran out of blood pressure meds for a month so no surprise. I will be back in 4 months time for HIV and asked them to test for diabetes.

Tomorrow I have sugary to remove a cyst in my face. Should be grand and it should leave a minor scare less than an inch. (2.5 cm)

[fabio]

That's great, I haven't had the chance to do anything whatsoever,since my hospital is full of cases and the check ups are closed for now. All hospitals here are flooded and can't do much about it. I will have to wait though,I cant do much either .

[Jim Allen]

That's great, I haven't had the chance to do anything whatsoever,since my hospital is full of cases and the check ups are closed for now. All hospitals here are flooded and can't do much about it. I will have to wait though,I cant do much either .

Yeah, heard the same here for a lot of people. 
 
I've just been lucky in timing this last 12 months. I got sick, was on priority lists or had things planned when there were quiet moments in the Covid pandemic. 8 hospital visits, of this, had 3 for minor surgeries, 1 emergency stay and the rest was check-ups etc.

Nearly forgot I also entered that flu shot study and that had a follow-up visit as well.

[leatherman]

Visited the clinic this week.

Tomorrow I have sugary to remove a cyst in my face.

we saw our doc on monday. the doc, my hubby and myself have all had birthdays since we were last at the clinic, so now we're all old.  I hate that my doctor is a couple years older than me. It makes me worry just how long it'll be before we have to get a new doctor.

I was very happy to see that my cd4 was back below 500.  Over the last year and a little while, my cd4s climbed above 500 (680, 791, 600) which was completely out of the ordinary. I had been pretty surprised after 27 years of meds to see my cd4s creeping into the 400 range a couple years ago; but >500 seemed like incorrect lab results. Certainly the 791 wasn't right.  So I was glad to see my cd4s go back to 465, even though that seems a tad high for the normal 350-400 I've had for the previous 10 years.

Within the last few months, I have a small cyst appear at the corner of my left eye. My doctor is sending me to an ophthalmologist next week to get it removed.

congrats on your numbers and good luck with the surgery!

[Jim Allen]

we saw our doc on monday. the doc, my hubby and myself have all had birthdays since we were last at the clinic, so now we're all old.  I hate that my doctor is a couple years older than me. It makes me worry just how long it'll be before we have to get a new doctor.

Shit, I never thought about that. My doc has at least 20/25 years on me, so it can't be that long before he retires.

Belated happy birthday though.

I was very happy to see that my cd4 was back below 500.  Over the last year and a little while, my cd4s climbed above 500 (680, 791, 600) which was completely out of the ordinary. I had been pretty surprised after 27 years of meds to see my cd4s creeping into the 400 range a couple years ago; but >500 seemed like incorrect lab results. Certainly the 791 wasn't right.  So I was glad to see my cd4s go back to 465, even though that seems a tad high for the normal 350-400 I've had for the previous 10 years.

Congrats on the 465.

Kinda understand the feeling, when mine was rocking the 900 to 1100+ I suspected something was wrong, turned out I was right so I'm glad the last two times to see mine back at the 600's as that would be normal for me.

Within the last few months, I have a small cyst appear at the corner of my left eye. My doctor is sending me to an ophthalmologist next week to get it removed.

congrats on your numbers and good luck with the surgery!

Thanks and sorry to hear about the cyst, hope everything goes well with removing it. I was offered to leave mine alone as its deeper in but I opted to cut it out, no way I want to leave it and risk a repeat of what happened last year when my face got infected.

[leatherman]

Thanks and sorry to hear about the cyst, hope everything goes well with removing it. I was offered to leave mine alone as its deeper in but I opted to cut it out, no way I want to leave it and risk a repeat of what happened last year when my face got infected.

I had a little bump in the middle of my back some years back. It probably started as a pimple long ago and seemed of little consequence. But then it got a little larger and I decided to have it looked at. Had a little surgery and it turned out to be the size of a pecan....even though it was barely a bump from the outside. Now 3 yrs later I still have a small divot in the center of my back that has never filled in.

Yes, you live and you learn. One serious health issue can sure teach you to never let that happen again. LOL pcp pneumonia? bactrim for a decade, no problems. LOL Infection in your face? get rid of the cyst NOW. LOL

[TGun]

just food for thought Jim,, as a long time health care provider myself, i can assure you the skill set on most people actually doing your blood pressure on a MD visit here in the USA is marginal at best.  If they used the manual machine where they are required to use a stethescope, they may be somewhat inaccurate numbers TBH.  the round number or 150/90 is the first red flag.  Also if the BP cuff is slightly too small for the circumference of your arm it will also give you a higher reading than accurate.  I wouldn't worry unless you've had multiple visits with similar numbers.

[Jim Allen]

just food for thought Jim,, as a long time health care provider myself, i can assure you the skill set on most people actually doing your blood pressure on a MD visit here in the USA is marginal at best.  If they used the manual machine where they are required to use a stethescope, they may be somewhat inaccurate numbers TBH.  the round number or 150/90 is the first red flag.  Also if the BP cuff is slightly too small for the circumference of your arm it will also give you a higher reading than accurate.  I wouldn't worry unless you've had multiple visits with similar numbers.

Thanks. No, it's not the old stethoscope it's what I call "All in one trolly" that nurses are attached to. Anyhow, my own fault for stopping the meds, at home I was getting 151/91 but as I restarted my olmesartan it should start to level off again within 2 weeks.

[Jim Allen]

Yes, you live and you learn. One serious health issue can sure teach you to never let that happen again. LOL pcp pneumonia? bactrim for a decade, no problems. LOL Infection in your face? get rid of the cyst NOW. LOL

Yeah.

Well, sugary went okay today. 40 mins, 5 external stitches, she used mini forceps to open up the site and to clear out all the shit. So not too bad, and this time I could have anaesthetics so I did not feel a thing.  Sore and a bruised and swollen face/nose of course but it will be fine.

GP next week to remove stitches and they confirmed I should get my vaccine within the next 10 days.

Here the guidelines changed so I had thought I was moved to group 7 that is vaccinated just ahead of the general 18+ age group but the hospital confined my vaccine slot has been ordered as I'm in the "Extreme vulnerable group" so group 4 and ill be notified within the next 4 days and vaccinated within the next 10.  Happy days.

[leatherman]

sugary went okay today.
. . .
ill be notified within the next 4 days and vaccinated within the next 10.  Happy days.

glad to hear the surgery went well. Wishing you speedy healing!

glad to hear the vaccine is coming your way. Thursday was 2 weeks after our second shot and we celebrated by going out to the Mexican restaurant in our tiny town - the first sit down dining we've done in 15 months. The food was as good as always but only half the customers came in masked (the other half didn't! but of course we're living with the deplorables here in South Carolina). And the margaritas were terrible. They tasted more  like lime-aid with only one shot of tequila. I'm cooking at home tonight and making my own pitcher of margaritas - with extra tequila to make up for last night.

[leatherman]

sorry to hear about the cyst, hope everything goes well with removing it.

well, that was easy-peasy . . . until the numbing agent wore out on the way home (had to drive about 50 miles to go to a doctor in my neighboring state).Then it hurt!   but not as much as that damned needle for the numbing agent. I figured anything that close to the eye might be sensitive (the cyst was right where my upper and lower eyelids meet, on the outside edge) but that shot was one of the most painful things I've ever experienced. Thank goodness it was over in 30 seconds...but what a long 30 seconds it was.

The doctor was very friendly (we talked about how to contact her city water dpt to get a bill adjustment after filling up her pool), and she did a great job. She made a tiny incision and didn't even have to put in a single stitch. Like the cyst on my back, this one turned out to be much larger below the skin than was first noticed. So she did have to "dig around" some to get it all without enlarging the incision. In the end, it was the size of one of my blood pressure medication pills! The area did hurt all evening though and was quite red and swollen. But it's a million times better today. No pain, a little red, and healing already.

how are you doing with your surgery? It shouldn't be too many more days till you can get un-stitched  , right?

[fabio]

Get well soon,good thing you got rid of it.
Still haven't gone to the vampires yet since outpatient is closed due to covid. But it's ok.
By the way, I just realised I'm a future vampire going through initiation ,lol 🤭😂.

[Jim Allen]

well, that was easy-peasy . . . until the numbing agent wore out on the way home (had to drive about 50 miles to go to a doctor in my neighboring state).Then it hurt!   but not as much as that damned needle for the numbing agent. I figured anything that close to the eye might be sensitive (the cyst was right where my upper and lower eyelids meet, on the outside edge) but that shot was one of the most painful things I've ever experienced. Thank goodness it was over in 30 seconds...but what a long 30 seconds it was.

Same here.

The injections in the side of my nose could have brought tears to my eyes. Had injections plenty of times but I can't even describe the pain this caused.

The Doc said the worst apparently is having to have injections in the top of your ear, don't know if it's true or not but ill have to think twice about ever having anything done to my ears now.

The doctor was very friendly (we talked about how to contact her city water dpt to get a bill adjustment after filling up her pool), and she did a great job. She made a tiny incision and didn't even have to put in a single stitch. Like the cyst on my back, this one turned out to be much larger below the skin than was first noticed. So she did have to "dig around" some to get it all without enlarging the incision. In the end, it was the size of one of my blood pressure medication pills! The area did hurt all evening though and was quite red and swollen. But it's a million times better today. No pain, a little red, and healing already.

how are you doing with your surgery? It shouldn't be too many more days till you can get un-stitched  , right?

Glad to hear it went well without the need for stitches and the cyst is gone. 

I'm grand thanks. I had the 5 stitches removed last Friday.  My face was very bruised, and of course, it got infected despite best efforts, I half expected that but a round of antibiotics took care of it.

The funny thing was all the GP's I know were busy here so ended up travelling to a walk-in clinic provided by the insurance company in South Dublin (40 min drive). Got chatting to the Doctor who's from South Africa. He told me I'm the first patient in Ireland to openly admit I'm living with HIV, so we got chatting about stigma and issues.

Anyhow, I am glad the cyst is gone and ill live with the scare on my face.

[Jim Allen]

Visited the clinic this morning.

VL UD & CD4 41% @614

Liver enzymes okay, kidneys okay, and checked for diabetes & STI's.

[PozChilean]

This week it was my turn; thanks for keeping warm my spot at the clinic @Jim.

VL UD, CD4 637 29,4%
Vitamin D 68.8 (I've been supplementing for a while now)

[Jim Allen]

This week it was my turn; thanks for keeping warm my spot at the clinic @Jim.

VL UD, CD4 637 29,4%
Vitamin D 68.8 (I've been supplementing for a while now)

  Great lab results, hope you are feeling good as well.

[Loa111]

Had my 4 monthly vampire visit yesterday. It's so routine now, 3 1/2 years since my DX, that I forgot to ask how my CD4 level is! 

What I did find out, is the ID Clinic take a holistic health view to us HIV patients, which pleasantly surprised me. Since I turn 50 this year, I told the doctor that I'm missing a bit of "zap" from my energy * feel a bit of a drag in myself since Dx, and wondered about my testosterone levels. No problem she said, we'll check your testosterone levels off your bloods. Interesting to see if the Testo is a bit off, can I influence a prescription of Testo gel at my next appointment which will be Dec or Jan.

Even offer me a zoom session with the psychologist who works with the hiv side of the ID clinic as I mentioned I never reveal my status, and have no one to talk to about my poz situation (except you guys on here  ) I did not realise that service was available too. So all good.

Also found out my cholesterol is 4.8 which is ok (not 6.8 which I misheard at my last appt).

Got the final shot of the HPV vaccine too.

Dr. even offered a urine STI test. Then got my meds refilled for next few months.

Overall a very nice Vampire visit. All good, nothing to report.

Probably will be called back for the Flu shot in later October at the clinic.

[Bucklandbury]

Well, I got my new results today. I went in to see the PCP about the onoing neuropathy, but the ID wanted bloodwork in advance of my visit with her in early December, so how could I resist a two-for-one special? 

Looks better than June 2, so I won't complain. I assume I am still undetectable, but I don't see those results (yet). Interestingly, they ran a syphilis exam on me as well. It came back negative too, but I haven't had sex since last November, so I could have saved them the money... They had already tested me back in March too.

My CD8 levels came way down since June 2 (~1,400 back then), so that is the best take-away (I think). Plus the rise from 311 to 356 CD4s. I am glad to have hit above 350 within a year of treatment beginning.

My PCP wants me to try generic Cymbalta for the neuropathy. I told her I would give it a whirl. I took my first capsule today. I read the pharmacy info. sheets and will be on the lookout for black, tarry stools and vomit that looks like coffee grounds. (I kid you not.)

My PCP mentioned my having written about the possibility of switching from Biktarvy to another ARV. I don't think she or the ID are much keen on it, so I guess I will stay put.

==

[Jim Allen]

Glad your labs are looking good, no experience with Duloxetine but hopefully it helps.

It's funny you mentioned syphilis, I found out recently that on my past three labs the doc included syphilis, waste of time in my case.

[Bucklandbury]

I had one follow up on results that came in overnight. I don't like some of these results, but my doctor hasn't called me, so I may just be this way. I will try not to worry. Meh.

[CircularNatural]

Visited the clinic this week.

VL - ND (not detected)
CD4 - 610
Liver, kidneys, cholesterol etc all perfect. 

Blood pressure was high (152/80 and 151/80) but I ran out of blood pressure meds for a month so no surprise. I will be back in 4 months time for HIV and asked them to test for diabetes.

Tomorrow I have sugary to remove a cyst in my face. Should be grand and it should leave a minor scare less than an inch. (2.5 cm)

Hey there Jim, how have you been with your BP lately? I read this thread diagonally since I can see some of the posts are old now!

I thought of mentioning, in my humble opinion, that this is a very important topic since as we all know, nowadays HIV is a manageable chronic disease and most of us are told by our ID that our immune systems will most likely remain healthy thanks to HAART.

In my case, I'm on my 2nd month of HAART after a recent diagnosis, waiting to complete 3 months before my first blood check after starting with Dolutegravir + Lamivudine (I only had a blood check up when diagnosed and before HAART).

In my last consultation (last Friday), my ID told me that in my following visit (around 27th of November) he'll run full blood tests again + CD4 and VL to check if I'm already undetectable (hopefully!).

Going back to BP, it's really important for everyone to know that our primary concern should be to avoid cardiovascular and metabolic diseases, which are currently the first cause of morbidity and mortality for our population (and the general population).

High blood pressure is considered a "silent disease", it won't give symptomps until it's already giving your problems. Affected organs are mostly the arteries, heart, brain and kidneys. Even though we all know that avoiding salt and getting excercise are the natural way of avoiding high BP, this is not always possible.
If BP is not treated, the body begins a process called "Vascular remodelling", where the arteries, the heart, kidney and other end organs begin to dysfunctionally adapt to it by inflammation and fibrosis processes that in the long-term, produce more problems than solutions.

More about this can be read here:
https://www.ahajournals.org/doi/10.1161/hy09t1.096249
https://www.nature.com/articles/jhh201436

It is also known that ACE inhibitors (such as enalapril and the like) and ARBs (such as valsartan and the like) are known to stop this negative, long-term process of "vascular and myocardial remodelling":
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5192558/

This is much like HAART for HIV, we know that by treating it, one can expect to control the disease.
The same applies for high BP and eventually avoiding/treating metabolic syndrome/diabetes, which also produce inflammation/aging/disease in the body if left untreated.

Hope this helps anybody who has received a high BP diagnosis and is unsure on whether to add or not yet another pill to their box.

Stay healthy!

Kind regards

[Jim Allen]

My BP is fine again, thanks for asking.

The meds I take are not the ace inhibitor though as I developed the ace inhibitor cough. It was like coughing up my lung.

[CircularNatural]

Good to hear.

Yeah, that's a very usual side effect, which results in most people being changed to ARBs (valsartan, losartan and the like). These have the same cardioprotective benefits on the long-run.

Keep healthy!

Best regards

[Loa111]

A quick Vampire visit this morning for my Flu Shot & to gave blood samples for a study they are doing on Covid-19 vaccines & HIV+ folk.

I feel like crap all afternoon, tired, low energy, stiff muscles and "blah" feeling, which I always experience the evening after the flu shot.

Found out my CD4 is 319 from last visit there, that's ok, nothing I can do about that anyway, & more importantly UD still.

Got a testosterone blood test done recently too, which is 17.5 (just over 500 on the USA testo measurement), the max score is 35 & lowest 9 (I think). I'll be 50 soon, so  it is about average I am told. I wouldn't mind getting a Testo Gel or something, but unfortunately Ireland is a bit behind when it comes to TRT for aging men. I might fake ED next docs visit, whinge & moan & see can I get any lol 

[Jim Allen]

A quick Vampire visit this morning for my Flu Shot & to gave blood samples for a study they are doing on Covid-19 vaccines & HIV+ folk.

I feel like crap all afternoon, tired, low energy, stiff muscles and "blah" feeling, which I always experience the evening after the flu shot.

Found out my CD4 is 319 from last visit there, that's ok, nothing I can do about that anyway, & more importantly UD still.

Got a testosterone blood test done recently too, which is 17.5 (just over 500 on the USA testo measurement), the max score is 35 & lowest 9 (I think). I'll be 50 soon, so  it is about average I am told. I wouldn't mind getting a Testo Gel or something, but unfortunately Ireland is a bit behind when it comes to TRT for aging men. I might fake ED next docs visit, whinge & moan & see can I get any lol 

Sorry for the late reply. Not sure how I missed your post, I apologize.

UD 

Regarding the testosterone, all joking aside, keep an eye on it and to get the treatment you might need to end up doing something like you suggested when needed, it's what I have heard from others trying to get treatment here.

[Jim Allen]

That reminds me I will be seeing the vampires on Thursday, that is unless it gets covid cancelled due to the pressure the health service is under.

[leatherman]

my husband and I get the joys of blood-letting tomorrow.

which reminds me, I need to "fast" for some of those tests. I also need to drink some water. ugh. one time they could hardly get my blood out of me. I guess 2 liters of Coke a day just isn't always enough hydration. But before you think too badly of me, I have returned to my gym and I'm going 5 days a week again; so at half a bottle of water a day, I am drinking nearly 3 bottles of water a week now.

[Loa111]

Regarding the testosterone, all joking aside, keep an eye on it and to get the treatment you might need to end up doing something like you suggested when needed, it's what I have heard from others trying to get treatment here.

It was quite interesting Jim as the doctor at the ID clinic (St. Vincents) offered to run a testosterone test for me. She said they take a holistic view point re health matters of the HIV patients. I was pleased to hear this.
I'm back in next week for my regular hiv appointment (I'm in approx every 4 months these days)  so I am going to chase them up on the testosterone matter.

I noticed too they said there's no need to do my CD4 every time now, so I think that's checked every 2nd appointment approx twice a year. That's good to hear as it means things are nice & stable.

[Loa111]

I guess 2 liters of Coke a day just isn't always enough hydration. But before you think too badly of me, I have returned to my gym and I'm going 5 days a week again; so at half a bottle of water a day, I am drinking nearly 3 bottles of water a week now.

Good luck with your appointment Mikie. I hear you on the Coke. I am a glutton for Coke Zero & drink about 3/4 of a 2 litre bottle most evenings which is my only bad habit really.  I sip a lot of black tea at my desk through out the day so I get plenty of water that way. Then in the gym & I'm 5 days a week too, I demolish a lot of water there.

[leatherman]

I am a glutton for Coke Zero & drink about 3/4 of a 2 litre bottle most evenings which is my only bad habit really.  I sip a lot of black tea at my desk through out the day so I get plenty of water that way. Then in the gym & I'm 5 days a week too, I demolish a lot of water there.

when i was 21, I totally gave up sweet tea. (I know. I know. blasphemy for a boy in the Carolinas; but I lost a lot of my Southern cred when I moved to the North (Ohio) and lived with my Yankee partners for 2.5 decades.) I've been drinking at least 2 liters of Coke everyday since though. (unless a restaurant has the P-word (P@psi), then a glass of tea is great). For those who are counting, that's 38 yrs of Coca-Cola. mmmmm

Before leaving Ohio, my doctor (the one who had helped keep me alive AND deal with the death of my 2 Yankees  ) had a discussion about my 2 bad habits: caffeine and nicotine. I told him I was entitled to at least ONE bad habit (I mean, I DID survive AIDS twice, I deserve to have one bad habit) and he had a choice: I could either stop smoking or stop drinking Coke. Although, I'm always quick to bum a cigarette from friends at parties, it wasn't the Coke I gave up 12 yrs ago. LOL

Ok, I'm off to the gym early today since the doctor appt. is when we (my husband and I) usually hit up the gym. I'll try to drink more water so my blood flows better (at what is probably the 525th or something blood draw since 1992), but I'm not going to enjoy drinking it. 

[Jim Allen]

when i was 21, I totally gave up sweet tea. (I know. I know. blasphemy for a boy in the Carolinas; but I lost a lot of my Southern cred when I moved to the North (Ohio) and lived with my Yankee partners for 2.5 decades.) I've been drinking at least 2 liters of Coke everyday since though. (unless a restaurant has the P-word (P@psi), then a glass of tea is great). For those who are counting, that's 38 yrs of Coca-Cola. mmmmm

Before leaving Ohio, my doctor (the one who had helped keep me alive AND deal with the death of my 2 Yankees  ) had a discussion about my 2 bad habits: caffeine and nicotine. I told him I was entitled to at least ONE bad habit (I mean, I DID survive AIDS twice, I deserve to have one bad habit) and he had a choice: I could either stop smoking or stop drinking Coke. Although, I'm always quick to bum a cigarette from friends at parties, it wasn't the Coke I gave up 12 yrs ago. LOL

Ok, I'm off to the gym early today since the doctor appt. is when we (my husband and I) usually hit up the gym. I'll try to drink more water so my blood flows better (at what is probably the 525th or something blood draw since 1992), but I'm not going to enjoy drinking it. 

lol. I barely manage a litre of coke a month.

Good luck with the appointment.

That reminds me I will be seeing the vampires on Thursday, that is unless it gets covid cancelled due to the pressure the health service is under.

Well looks like my appointment is going ahead, they just called to do the COVID questionnaire and to confirm the appointment.

The good news is the weather forecast is good this week so since I have to be in Dublin on Thursday for the appointment I might take the time to have a walk around town before coming back and pretend to enjoy it.

[Jim Allen]

I could either stop smoking or stop drinking Coke. Although, I'm always quick to bum a cigarette from friends at parties, it wasn't the Coke I gave up 12 yrs ago. LOL

12 years, excellent.

Have to admit I do miss smoking, shame it's so bad for us.

[leatherman]

lol. I barely manage a litre of coke a month.

wimp 

Good luck with the appointment.

6 vials from me, 7 from my hubby; pneumovax for me, shingle-vax for the hubby
his arm hurts and mine doesn't.  we might have all our results by Fri.

had a student doc sitting in today. All of my HIV docs, in OH and here in the Carolinas, have always been part of training newbies so I'm gone through lots of students. It was kinda funny this time. In the past, the first 20 yrs of me living with HIV, these students were usually amazed that I was so sick, yet still alive, and with an amazingly good attitude. However this student, like the last few, got to see me wondering why my cd4 counts have gotten so high and wishing they were back lower. LOL What can I say? After living so long with low cd4s, these last 5 yrs as my cd4s counts have slowly been rising has been very weird. My husband (we share our 2 appointment times in one joint visit with the doctor) took some glee ragging on my about how anytime my cd4s are over 500 (it's been 4 times in the last 3 yrs now), that I am determined that the test results were simply wrong. But what's the alternative explanation? That as I'm getting older, I'm getting healthier?!? 

COVID questionnaire

so tired of all of those; but .... what are you going to do? I got so used to filling out the forms over the last 2 yrs every week when I went to visit my Nana in the nursing home that I can answer these in my sleep. I've had my booster AND I'm such a homebody that social distancing is just how I roll.

Have to admit I do miss smoking

that's why I never hesitate to get a few cigarettes whenever I'm around the few friends left who still smoke. I only quit because I was really poor at the time, and my doctor was threatening me about my Coke intake. LOL

[Jim Allen]

 

I had to cancel my appointment at the last moment. My Daughters classroom had two covid cases and although both her and my antigen tests were negative last night and within the current rules we don't count as close contacts, I decided to cancel as I don't want to risk spreading this shit to hospital staff and patients.

Were also isolating for the moment.

[Jim Allen]

wimp 

 

6 vials from me, 7 from my hubby; pneumovax for me, shingle-vax for the hubby
his arm hurts and mine doesn't.  we might have all our results by Fri.

The pneumococcal vaccine always makes my arm swell up, still worth it. Although I find the worst is the flu vaccine, not the vaccine itself though and this year it was fine but I swear some years the pharmacists are trying to inject the bone 

had a student doc sitting in today. All of my HIV docs, in OH and here in the Carolinas, have always been part of training newbies so I'm gone through lots of students. It was kinda funny this time. In the past, the first 20 yrs of me living with HIV, these students were usually amazed that I was so sick, yet still alive, and with an amazingly good attitude. However this student, like the last few, got to see me wondering why my cd4 counts have gotten so high and wishing they were back lower. LOL What can I say? After living so long with low cd4s, these last 5 yrs as my cd4s counts have slowly been rising has been very weird. My husband (we share our 2 appointment times in one joint visit with the doctor) took some glee ragging on my about how anytime my cd4s are over 500 (it's been 4 times in the last 3 yrs now), that I am determined that the test results were simply wrong. But what's the alternative explanation? That as I'm getting older, I'm getting healthier?!? 
so tired of all of those; but .... what are you going to do? I got so used to filling out the forms over the last 2 yrs every week when I went to visit my Nana in the nursing home that I can answer these in my sleep. I've had my booster AND I'm such a homebody that social distancing is just how I roll.
that's why I never hesitate to get a few cigarettes whenever I'm around the few friends left who still smoke. I only quit because I was really poor at the time, and my doctor was threatening me about my Coke intake. LOL

Students are funny at times.  Had one looking at my ass for no reason two years ago and a doctor giving out to me because, despite the student making silly presumptions, the doctor knew that I knew better, and could have corrected the student 

[leatherman]

Had one looking at my ass for no reason two years ago

hmmm. as a gay man, I need to tell you that there was a reason.   Quite frankly, asses are the only reason I tolerate watching when my husband has college football (the American kind of football) on the tv. 



So how did your blood draw go today?

[Jim Allen]

hmmm. as a gay man, I need to tell you that there was a reason.   Quite frankly, asses are the only reason I tolerate watching when my husband has college football (the American kind of football) on the tv. 

 

Sure, I have the same here about watching women tennis. No interest in the sport be it male or female, my partner does like womens tennis, but at least I get some joy out of having to watch it.

So how did your blood draw go today?

Not.

I had to cancel my appointment at the last moment. My Daughters classroom had two covid cases and although both her and my antigen tests were negative last night and within the current rules we don't count as close contacts, I decided to cancel as I don't want to risk spreading this shit to hospital staff and patients.

Were also isolating for the moment.

[leatherman]

Were also isolating for the moment.

ugh. I hate the unvaccinated. This might have been nipped in the bud last year; but now that it has mutated, I think we're going to be stuck with some version of covid, and some type of booster shot, during every winter season from now on.

...oh, and sadly don't forget that'll mean more dead people.

it's frustrating having spent years to end one epidemic, just to have people knowingly let another epidemic rage.

[Loa111]

Vampires ID Doc visit completed on Wednesday there. I'm going every 4th month now which is good, used to be every 3 months.

All good more or less on the HIV side, undetectable, nothing strange on the usual blood test results. CD4 319, Doc said 319 is fine, though they'd like in an ideal world to see me getting to CD4 500.  Just keep taking the meds & give it a few more years maybe.

I asked what my CD4 Percent is, which is 17%. I never enquired about percent before, just i see some of you guys posting about it on here, so thought I'd ask. I am not really sure what CD4 Percent means?

Interestingly, I am never too concerned about the HIV situation anymore or hearing about the specific blood test results. I take my meds daily, and once I hear I am UD, and my CD4 is ok, then that's it for me. Job done!

Luckily my ID Clinic take a holistic health ethos to us Poz folks, so if there's any other health concerns or questions, the doctors are usually very happy to have a look, check it out, run a test or refer us on to another department in the hospital. For this I am most grateful.

I've got my Testosterone level checked last appointment which was back in September last. My score as we use it over here in Europe is 17 which is right in the middle for a 50 year old man, not too bad but not brilliant either. I asked the head doctor if he could give me some Testosterone Replacement Therapy. He was reluctant to do this, as he said my levels are still ok, but he did agreed to ask a colleague doctor who is more expert in Testo matters, and said he'd talk to me again about it. I've been complaining about things slowing down for me & feel a Testo boost will help. Maybe next time?
What he did give me instead was a prescription for Viagara!!!!   

Also since I had Covid a couple of weeks ago, doc had a good listen to my chest & lungs, and told me to take it easy for a few more weeks instead of going full blast back into the gym.

Overall, it was a good Vampire visit & the docs & nurses & blood takers are always so nice & helpful to the Poz patients. I guess we'll be seeing each other a few times a year for decades to come. I actually enjoy most of my visits to the clinic due to this 

[Grasshopper]

Correct me if I'm wrong : when using Testosteron supplements for a year or longer, your body will stop making Testosteron on it's own. So you'll go from making "17" to "Zero", and you'll be depending forever on the supplements.
Thread with caution.

[Loa111]

Correct me if I'm wrong : when using Testosteron supplements for a year or longer, your body will stop making Testosteron on it's own. So you'll go from making "17" to "Zero", and you'll be depending forever on the supplements.
Thread with caution.

That’s certainly true for bodybuilders types who are using massive doses of testosterone. They cycle on and off the Testo, & on off cycles have to take other drugs post-testo to encourage the body to make it naturally again. So yes that type of massive dosing would cause one potential problems. Really this is drug abuse. Many do it via black market too. Many die young of heart or other health problems. Scary stuff.

I believe for TRT for ageing men, the dosage is very mild, minimal & tiny compared to the above and of course is monitored & managed by the doctor, that’s the only way I’d do it anyway. And if one wanted to stop TRT, they’d take care of that too.  It’s an anti ageing treatment. Gives a lagging man a bit more bounce.

I know people who are in both of these camps.

[fabio]

I also went to the vampires (although it was a month ago), everything went perfect. Actually, it went better than expected, my CD4 were 1300 and I am undetectable, of course.

Other than that, I also got a pep talk from my Doc (after 5 years of being positive!) that I am undetectable and can have sex...Gee thanks, lol. It was quite weird, I also asked her about working in healthcare and my concerns and she reassured me I can be a nurse without any issue(she is a little scary though, very serious, lol). She even made a guest appearance in the ER (where I do clinical practice), she scared me a little but she didn't recognize me with the mask and the scrubs    .

Not to mention I just realized, that one of my professors is also a doctor on my ID team and she greeted me, we talked and she also told me to not worry about working as a nurse or my future as one.

All in all I'm doing well, all my labs were super and I just have to repeat a vaccine (couldn't now because I had the 3rd dose).

[leatherman]

I also went to the vampires.......

wow! it's good hear things are going so well for you these days!

[Jim Allen]

Going to see the clinic on Thursday.

Standard blood work & refill for 6 months. Also, planning to ask for a referral to a new neurologist.

[daveR]

Good luck with the tests. I just did mine again, situation normal with the viral load and CD 4 count. Creatinine still slightly out of range despite the switch to Triumeq. All becoming rather routine now after nearly 6 years of being positive.

Dave

[Tonny2]

           Hi there!!…I met with Dracula last Tuesday, VL 490 I hope it’s one more blip in my 15 years of UD with the same treatment. I think it’s my third one, if indeed it’s a blip…to be continue


Ps. Every time that I go with Dracula, I take a picture of my arm with a needle, but I don’t know how to upload the photo so I owe it to you

[Jim Allen]

Good luck with the tests. I just did mine again, situation normal with the viral load and CD 4 count. Creatinine still slightly out of range despite the switch to Triumeq. All becoming rather routine now after nearly 6 years of being positive.

Dave

Thanks.

Creatinine being slightly off... Presume that after the switch it did improve somewhat though?

           Hi there!!…I met with Dracula last Tuesday, VL 490 I hope it’s one more blip in my 15 years of UD with the same treatment. I think it’s my third one, if indeed it’s a blip…to be continue


Ps. Every time that I go with Dracula, I take a picture of my arm with a needle, but I don’t know how to upload the photo so I owe it to you

Hiya,

If you want me to upload the picture to the forum just PM me and ill help.

The viral load sounds like a blip, presuming your doctor said the same?

[daveR]

Thanks.

Creatinine being slightly off... Presume that after the switch it did improve somewhat though?

The creatinine did drop to normal in a test done 6 weeks after the switch but is now back up to 1.24, where it was when I was on Complera. No protein in the urine so the Dr is not to concerned and it is far from kidney failure levels. I did point out to her that in 2012 before I was positive I had seen a level of 1.31, and nobody said a word about it. On some medical sites they class 1.3 a normal. She said there is nothing in Triumeq that would affect the kidneys so we will just check it again in 6 months.

[Jim Allen]

The creatinine did drop to normal in a test done 6 weeks after the switch but is now back up to 1.24, where it was when I was on Complera. No protein in the urine so the Dr is not to concerned and it is far from kidney failure levels. I did point out to her that in 2012 before I was positive I had seen a level of 1.31, and nobody said a word about it. On some medical sites they class 1.3 a normal. She said there is nothing in Triumeq that would affect the kidneys so we will just check it again in 6 months.

Wait and see approach, seems fair engough.

[Jim Allen]

Just got back.

All labs were normal range + CD4s 600 and UD. Discussed the hepatitis b vaccine but since I already tried 2 x 3 shots and it failed I wasn't open to trying again.


I got my 6 months refill for Triumeq so back in on the 22nd of September.

[Tonny2]

            ojo.           Hi Jim, thank you for offering to help me uploading picts, on my next visit to Dracula… about what the doctor said about my possible blip, I will see him next week, I’m sure he will say that it’s just a blip, two years ago, I got one like that.


Good labs, happy for you…keep up the good work!!

[Bucklandbury]

I actually went to the ID doc and labs today as well, but my CD4 count fell to 271, and it was 356 in October. I am not going to worry, though. My appt. was like 9 AM.

Date   VL per mL   CD4 Count   CD4 %   CD8 Count   CD8 %   CD4:CE8 Ratio
04/07/22   Undetectable (< 40)   271   24.80%   671   61.60%   40.39%
10/28/21   Undetectable (< 40)   356   23.11%   924   60.03%   38.53%
06/02/21   Undetectable (< 40)   311   16.13%   1402   72.79%   22.18%
04/12/21   211   258   10.07%   2011   78.45%   12.83%
03/16/21   1,500,000   60   8.67%   496   71.21%   12.10%

Got shingles vaccine #2, and, man, my arm is sore as hell this evening.

All caught up on vaccines, and cholesterol and lipids were back well under the lower range of normal.

[Jim Allen]

Good results and the % seems stable.

Got shingles vaccine #2, and, man, my arm is sore as hell this evening.

The shingles vaccine is not a thing here. Had Shingles though and best avoided if possible.  Hope the arm feels better soon.

EDIT: Stand corrected, they did bring it out here in the end, but it's not routinely given.

[J.R.E.]

 

I had HIV labs drawn on April 4th. Overall I am very pleased.

This surprised the hell out of me. This is the highest it's been in 21 years  ! Not to shabby for a 70 year old, going on 37 years with HIV.

CD4, ABSOLUTE   686      cells/uL   490-1740  (Was- 506)


CD4 % has always been low:

CD4, PERCENT   17   Low   %   30-61   (WAS- 21%)

Lymphocytes are a little high :

LYMPHOCYTES, ABSOLUTE   4118   High  Range cells/uL   850-3900


Viral load undetectable:

HIV VIRAL LOAD INTERPRETATION   Not detected 



Ray 

[fabio]

Good results and the % seems stable.

The shingles vaccine is not a thing here. Had Shingles though and best avoided if possible.  Hope the arm feels better soon.

EDIT: Stand corrected, they did bring it out here in the end, but it's not routinely given.

I remember when I had shingle, it was quite weird...not painful, just uncomfortable. I'll also go to the vampires soon, so I will update on that in a week. Hope everyone is doing well.

[Mindless]

I've entered my 5th year as HIV+a couple of months ago and visited the vampires at the beginning of April.: CD4 784, %37, VL 27

First time I see a number in the VL field instead of "UD" since a few months after starting meds. Doc explained the lab at Thai Red Cross just changed their sensitivity threshold from <40 copies to <20 as UD definition. So, either I had similar numbers before and they weren't detected or 27 is a blip. He suggested checking again at the next 6 months blood test.

The creatinine did drop to normal in a test done 6 weeks after the switch but is now back up to 1.24, where it was when I was on Complera. No protein in the urine so the Dr is not to concerned and it is far from kidney failure levels. I did point out to her that in 2012 before I was positive I had seen a level of 1.31, and nobody said a word about it. On some medical sites they class 1.3 a normal. She said there is nothing in Triumeq that would affect the kidneys so we will just check it again in 6 months.

This time I got  Cratinine at 1.22 and it had been on an increasing path for the last 4 years (used to be around 1). No other signs of kidney issues (urine test is normal). I used to be on Complera until about 1.5 years ago when I switched to Dovato (both generic). Doc said this means meds shouldn't be the cause, he also says Dovato (DTG+Lamivudine) shouldn't affect kidneys. He suggested checking again Creatinine in 3 months and see.

My concern now is the 3cm gallstone they found during a routine US. It's asymptomatic and Doc suggests a "vigilant wait and see" approach rather than rushing to a surgery. I'm not sure though, although having a surgery would be very complicate for many different reasons. I'm weighing my options.

[Jim Allen]

My concern now is the 3cm gallstone they found during a routine US. It's asymptomatic and Doc suggests a "vigilant wait and see" approach rather than rushing to a surgery. I'm not sure though, although having a surgery would be very complicate for many different reasons. I'm weighing my options.

Gallstone of 3cm, sorry to hear that. If it was me I would have it out but that's me. You need to weigh up your situation, I presume your doctor explained why they want to go with the wait and see approach, so now it's up to you.

First time I see a number in the VL field instead of "UD" since a few months after starting meds. Doc explained the lab at Thai Red Cross just changed their sensitivity threshold from <40 copies to <20 as UD definition. So, either I had similar numbers before and they weren't detected or 27 is a blip. He suggested checking again at the next 6 months blood test.

  If I had a VL of 27 my HIV would be considered fully suppressed and I would be happy if it was a blip or permanently kept at that level.

[Mindless]

If I had a VL of 27 my HIV would be considered fully suppressed and I would be happy if it was a blip or permanently kept at that level.

I fully agree with you. I consider myself very lucky.

As for the gallstones, it's a long story, related to my health insurance being paid by my employer. In the country I'm currently living in no insurance company covers HIV. Besides, stigma is incredibly high and diffused. If I had a surgery using insurance, chances are extremely high that they would find out from the surgery report, cancel or not renew my policy and inform my employer. That's why I'm weighing my options.

[daveR]

I've entered my 5th year as HIV+a couple of months ago and visited the vampires at the beginning of April.: CD4 784, %37, VL 27

First time I see a number in the VL field instead of "UD" since a few months after starting meds. Doc explained the lab at Thai Red Cross just changed their sensitivity threshold from <40 copies to <20 as UD definition. So, either I had similar numbers before and they weren't detected or 27 is a blip. He suggested checking again at the next 6 months blood test.

This time I got  Cratinine at 1.22 and it had been on an increasing path for the last 4 years (used to be around 1). No other signs of kidney issues (urine test is normal). I used to be on Complera until about 1.5 years ago when I switched to Dovato (both generic). Doc said this means meds shouldn't be the cause, he also says Dovato (DTG+Lamivudine) shouldn't affect kidneys. He suggested checking again Creatinine in 3 months and see.

My concern now is the 3cm gallstone they found during a routine US. It's asymptomatic and Doc suggests a "vigilant wait and see" approach rather than rushing to a surgery. I'm not sure though, although having a surgery would be very complicate for many different reasons. I'm weighing my options.

Sounds like your kidney function and mine are similar, probably caused by the Complera. My Dr just says it is ok.

Sorry to hear about the gallstone, there is always something. Life just wants to keep us permanently on our toes.

[racingagainstme]

Had my first follow up visit a couple days ago. Results are in.

CD4: 83
CD4%: 4.9%
VL: 120

Much better than expected considering I was at 500,000vl and <20 cd4 exactly a month ago. Don't know what my % was but now I'll keep track of that. Let's goo!

[Jim Allen]

Had my first follow up visit a couple days ago. Results are in.

CD4: 83
CD4%: 4.9%
VL: 120

Much better than expected considering I was at 500,000vl and <20 cd4 exactly a month ago. Don't know what my % was but now I'll keep track of that. Let's goo!

The VL load has really gone down fast, its great first results post starting treatment.

[leatherman]

we saw our doc last week. Since our last appt., both my doctor and I celebrated birthdays and went on vacations. (we went to AZ for 2 wks and he went to Hawaii. no wonder we all kept rescheduling this appt. We should have all just told each other about our vacations and we could have arranged this appt. a lot easier. )

My doc still thinks I'm crazy and I still think I must be broke. In the last year and a half my cd4s have been a little over 500 four times now. It's taken 30 years of meds to get here (wow! 30 yrs! damn, when did I get old?!?!  ) and it feels weird. Maybe in a couple of years I'll be used to it; but until then I'm going keep driving my doctor crazy by complaining every time my count is over 500. ROFLMAO

[Loa111]

Vampires visit yesterday - All good, UD <40, CD4 364. All other blood tests good kidneys, liver, vitamins etc.  Again they said optimal if my CD4 can reach 500 at some point, but there is no way of encouraging that to happen other than taking my meds daily.

One interesting point... Doctor yesterday asked me what time I take my meds daily, so 630 am Mon - Fri, and maybe 830 - 10am weekends. He advised me to try to take pill as close as possible to exact time everyday, and max stay within 1 hour of the time.
I asked the Pharmacist about this too, and she said yes what the doctor said is optimal as if take pills within the 1 hour window the drug level in blood stays consistent, where if I take them say 3 hours later on weekends, the drug level may not be so consistent.

Interesting... I'll see any I tighten up the weekend times, but then again I am not overly worried if I just stay with the system I have as it works for me & I'm still UD.

Had an unsightly wart on my forearm, which doc said was probably HPV wart. Now since they vaccinated me for HPV in the ID Clinic, I asked how come its HPV? Doc said the vaccine is for the more dangerous cancer causing HPV strain, however there's about 100 other HPV strains which most people have anyway. So they burned the wart off for me with liquid nitrogen. Good to get rid of it. 

Doc did notice my Creatine levels were up a bit and told me to drink more water. However I told him I was taking Creatine in my protein shake re weight training in the gym, and I stopped Creatine 7 days before appointment as Pharma advised me. So he seems happy enough with the explanation.

Asked the boss ID Doc again if any chance he could give me TRT since I feel "aged" since my DX. Said my testo levels at 17 is a good average for my age, and not even to the "low average". He feels there is not enough of a case to even consider TRT VS risk of side effects and also taking HIV meds. I mentioned people in their 50s+ I know in more TRT friendly countries on it, and how they say the feels great, but unfortunately again no luck with getting it.

Got an extra months supply of meds as an emergency back up as I am travelling international this summer, so good for peace of mind.

Back in Sept for next visit. So far so good, all in all a good tune up & service (like a car lol) . All I can do is keep taking my meds, and trying to stay fit & healthy. 

 

[leatherman]

it works for me & I'm still UD

Although I am not a doctor, I have lived with HIV for 38 yrs, and know that >=95% adherence has been proven to be the goal for successful treatment. Being off an hour or so occasionally (not skipping a dose but just taking it slightly earlier or later in the day) is nothing at all to worry about.

[Jim Allen]

Indeed*

95% is high for modern meds and the max one-hour thing sounds dated. The one-hour thing I have not heard from my clinic for years, although, might be different if you are talking some of the older meds combos.

Although, not bad to aim to take it at the same time or with the same routine daily as I think there is less chance of forgetting the meds. It works for me at least.

https://forums.poz.com/index.php?topic=73003.msg
https://www.thebody.com/article/do-i-have-to-take-my-hiv-meds-at-the-same-time-eve

[leatherman]

same routine daily as I think there is less chance of forgetting the meds

totally agree with the routine part. i take a few meds first thing in the morning (blood pressure, acyclovir, and the HIV med tivicay), I take the rest (HIV med prezcobix, since it's a med to be taken with food, and another acyclovir) at dinner . Dinner is "usually" the same time over 300 time year, but if the other 65 times end up at 4p or 8p, that's when I take them. While it's not a 7a/6p set routine, it is a routine within a few hours either way.

[Jim Allen]

Got an appointment to see the vampires on Thursday. Just routine bloodwork and to collect six more months of meds.

Though, hard to believe it has been six months already...

[Loa111]

I'm in tomorrow too, been about 4 months for me. Just the routine blood work too & a meds top up. They're very good with helping with any other heath niggles which may or may not be related  to hiv & I've a couple of minor ones to run by them.

They're always doing research at my clinic. I got a call last week & then a package arrived with a little plastic tub. They're asking everyone to take a dump at home & bring in a sample for a study on hiv and gut bacteria.  I know they are well used to things like this, but I feel a bit embarrassed at handing it in tomorrow! lol 

[Jim Allen]

I'm in tomorrow too, been about 4 months for me. Just the routine blood work too & a meds top up. They're very good with helping with any other heath niggles which may or may not be related  to hiv & I've a couple of minor ones to run by them.

They're always doing research at my clinic. I got a call last week & then a package arrived with a little plastic tub. They're asking everyone to take a dump at home & bring in a sample for a study on hiv and gut bacteria.  I know they are well used to things like this, but I feel a bit embarrassed at handing it in tomorrow! lol 

Well good luck at the clinic today. Hopefully no surprises, and it's just routine.

As for the stool sample, unless you have an accident with it, I don't see how anything to be embarrassed about. Part of the daily work routine for the Nurses.

[Loa111]

Thanks Jim. I managed to hand the sample in embarrassment free  actually the staff were fun about it as I mentioned I felt a bit awkward handing it over.

Vampires visit went well today. Still UD. CD4 is down a bit 280 ish but I know that fluctuates as per often discussed on this forum. In fact the CD4 being a bit lower it does not bother me at all, as long as I'm UD, and all I can do anyway is take my daily pills.

Docs running a few extra test for my niggles, including the prostrate blood test which I am very happy to be getting. I've been peeing a lot recently, like a weak bladder, so they asked for a urine sample too to check for any infections. Might just be from me drinking more liquid than I remember, but good to get this checked.

I've had trouble sleeping recently, like waking up after an hours sleep & troubling getting back to sleep. I asked for sleeping pills, got a no for that request but they gave me a Melatonin script instead which is fair enough.

Also since it's been a year since the checked my cholesterol, they'll check that again & are putting me on the list for some sort of a 10 year heart check. Not sure what that is, but good to check anyway.

They at least 15 vials of blood today too, I think re all the extra tests, & also some extra of the research study they're doing currently.

Had a bit of a close call today too!!! I'm very private & extremely confidential about my poz status. I was sitting awaiting my blood draw, when I looked up & saw a guy I know walking in to hand medical implements to the nurse! I know he works in the lab. I don't think he noticed me, & I ducked my face behind the curtain & he was literally 2 feet on opposite side of curtain. I was praying the nurses, who I all know, would not turn around & speak to me whilst he was there. It would have been rather awkward for me  & it would not take a genius to figure out what health condition I have sitting in the ID clinic on this particular day of the week, especially when one is staff there. Who knows, he might be checking my labs for all I know & seeing my name on the computer. He went after a minute or two. It's just I could really do without this chap (or anyone else for that matter) knowing my status, as I see him around a lot where I live, we know several people in common & we have a casual chat always.

All in all a good vampire visit. Happy to get a few extra tests done. Now let's see does this Melatonin help me sleep tonight? 

[Jim Allen]

Thanks Jim. I managed to hand the sample in embarrassment free  actually the staff were fun about it as I mentioned I felt a bit awkward handing it over.

Vampires visit went well today. Still UD. CD4 is down a bit 280 ish but I know that fluctuates as per often discussed on this forum. In fact the CD4 being a bit lower it does not bother me at all, as long as I'm UD, and all I can do anyway is take my daily pills.

Docs running a few extra test for my niggles, including the prostrate blood test which I am very happy to be getting. I've been peeing a lot recently, like a weak bladder, so they asked for a urine sample too to check for any infections. Might just be from me drinking more liquid than I remember, but good to get this checked.

I've had trouble sleeping recently, like waking up after an hours sleep & troubling getting back to sleep. I asked for sleeping pills, got a no for that request but they gave me a Melatonin script instead which is fair enough.

Also since it's been a year since the checked my cholesterol, they'll check that again & are putting me on the list for some sort of a 10 year heart check. Not sure what that is, but good to check anyway.

They at least 15 vials of blood today too, I think re all the extra tests, & also some extra of the research study they're doing currently.

Had a bit of a close call today too!!! I'm very private & extremely confidential about my poz status. I was sitting awaiting my blood draw, when I looked up & saw a guy I know walking in to hand medical implements to the nurse! I know he works in the lab. I don't think he noticed me, & I ducked my face behind the curtain & he was literally 2 feet on opposite side of curtain. I was praying the nurses, who I all know, would not turn around & speak to me whilst he was there. It would have been rather awkward for me  & it would not take a genius to figure out what health condition I have sitting in the ID clinic on this particular day of the week, especially when one is staff there. Who knows, he might be checking my labs for all I know & seeing my name on the computer. He went after a minute or two. It's just I could really do without this chap (or anyone else for that matter) knowing my status, as I see him around a lot where I live, we know several people in common & we have a casual chat always.

All in all a good vampire visit. Happy to get a few extra tests done. Now let's see does this Melatonin help me sleep tonight? 

I have a few comments but it will have to wait until I am back at my laptop.

Hope the Melatonin helped you fall asleep last night.

Ended up missing my appointment this morning  Caelan's school bus was 25 mins late and after that, my morning fell apart.

The only good news was my free travel card was approved so I can travel on the bus/train for free soon.

[Loa111]

Hope the Melatonin helped you fall asleep last night.

Ended up missing my appointment this morning  Caelan's school bus was 25 mins late and after that, my morning fell apart.

The only good news was my free travel card was approved so I can travel on the bus/train for free soon.

Sorry to hear you'd a messy morning Jim & missed your appointment, that's a headache for sure, as we all know the ID clinic takes up a lot of the day just going there & waiting etc.

I think the Melatonin helped a bit last night, not perfect, but better than nothing. The Pharmacist told me it can take several days of consistently taking it for the full effect to work, so fingers crossed.

We'll at least you can go travelling now with your free bus pass! 

[Jim Allen]

Sorry to hear you'd a messy morning Jim & missed your appointment, that's a headache for sure, as we all know the ID clinic takes up a lot of the day just going there & waiting etc.

I think the Melatonin helped a bit last night, not perfect, but better than nothing. The Pharmacist told me it can take several days of consistently taking it for the full effect to work, so fingers crossed.

We'll at least you can go travelling now with your free bus pass! 

Glad to hear the Melatonin helped a bit. How are you getting on now its been a few nights?

We'll at least you can go travelling now with your free bus pass! 

Yup. Tested the card last week. I travelled free by train to Dublin and a 70 bus back. Checked, and its valid on trains throughout Ireland, so prehaps ill do a journey to Cork or Galway later this year for free

Sorry to hear you'd a messy morning Jim & missed your appointment, that's a headache for sure, as we all know the ID clinic takes up a lot of the day just going there & waiting etc.

Yeah, the new appointment is on the 20th of Oct.

[Loa111]

Glad to hear the Melatonin helped a bit. How are you getting on now its been a few nights?

Melatonin I suppose helps a bit, but nothing major, I still wake up a lot to pee. I'm actually stopping drinking tea in the evening & cutting out my decades habit of a glass or two of 7up near bedtime, so see if that can minimize the several pee's during the night.  Doc did take blood for a prostrate test on my recent clinic visit just to be sure.

Enjoy your travel card. Galway is a great place to visit & love walking out by the sea to Salthill. It's worth going for a day just to do that.

Good luck with your next appointment & let us know how it goes for you.

[Jim Allen]

Hmmm.

At the clinic today. So CD4 890 @38% and VL below 50

Happy days although will have some comments on the clinic visit later.

[Jim Allen]

Hmmm.

At the clinic today. So CD4 890 @38% and VL below 50

Happy days although will have some comments on the clinic visit later.

The clinic visit was fine, a very nice but new doc, one week into their three-month rotation.

All labs are fine. However, a repeat MRI had been booked regarding my neuropathy as they want to double-check they didn't miss anything... It makes no sense to me if I am honest, and they want to do vascular studies in six months.

[Loa111]

All labs are fine. However, a repeat MRI had been booked regarding my neuropathy as they want to double-check they didn't miss anything

Glad to hear your clinic visit went well. I remember you saying you had to reschedule it from a few weeks ago. That's a great CD4 level Jim, obviously it strengthened over your years on treatment. Curious as to what was your lowest CD4 level ever?

That's nice the medical team is being thorough & sending you for a repeat MRI, it's good to have things double-checked even though it means taking a day to go in & do it.

Is there a long wait over at James ID clinic for your usual appointment?

I notice too where I go, there's always new doctors doing the appointment, & then if I've a question on anything, the boss sticks his head in to say hello and give me an answer (which I'm most grateful for). I'm guessing this rotation of doctors are training up to be ID consultants?

 

[Jim Allen]

I notice too where I go, there's always new doctors doing the appointment, & then if I've a question on anything, the boss sticks his head in to say hello and give me an answer (which I'm most grateful for). I'm guessing this rotation of doctors are training up to be ID consultants?

There seem to be two groups, ones that have a three-month rotation, prehaps they are more junior doctors only getting an "Intro" on the different departments and then there is a group doing a year's rotation on the ID clinic.

Is there a long wait over at James ID clinic for your usual appointment?

I'm at the Mater Hospital, and waiting times are not too bad. I think I was waiting 20 mins or so.

That's a great CD4 level Jim, obviously it strengthened over your years on treatment. Curious as to what was your lowest CD4 level ever?

You can have them. I might have plenty of CD4s floating about, but they are truly lazy little fuckers 

My lowest two counts were within a week of each other,  I believe it was 72 (or74) and 28...However, I would have to check my notes to be 100% sure. 

[Jim Allen]

@Loa111

How is insomnia going? Any further improvements?

[Loa111]

How is insomnia going? Any further improvements?

The Melatonin seems to be helping a bit, it certainly makes sleepy. I'm working on cutting down night time liquid consumption to minimise getting up for pee's in the middle of the night. Think I'd just one pee last night about 230am. Bad habit of drinking 7up or Coke Zero in late evenings/night & peeing does not help insomina.

Lol..yes please send me a few CD4s, I'm still stuck around 300 ish! Developing a case of CD4 envy! 

[Jim Allen]

The Melatonin seems to be helping a bit, it certainly makes sleepy. I'm working on cutting down night time liquid consumption to minimise getting up for pee's in the middle of the night. Think I'd just one pee last night about 230am. Bad habit of drinking 7up or Coke Zero in late evenings/night & peeing does not help insomina.

Glad to hear it's helping somewhat.

Cutting down on the coke zero late evenings might help as it still contains caffeine; I know you can get the 2L bottles of zero Sugar Caffeine Free Coke at Tesco and Supervalu.  Tesco has them on offer, two bottles for 4 euros.

[leatherman]

Coke

just like Beetlejuice, "Coke" has been uttered 3 times, so here I am. 


My sleep has always been f-ed up since just before I turned 30. Thirty years later, I've just come to accept and expect that somehow <=6 hrs. a night (and never multiple nights in a row) is somehow fine. It hasn't killed me yet. If I really want to sleep though I've been known to take half a Benadryl because it zonks me out. 

Larry and I go to the doctor on the 3rd for bloodwork and updating the doc on both of us having covid and me having whatever the hell that was I had a week ago.

[leatherman]

ouch!
A week ago the clinic called and asked us to change our appointment since our doctor would be out of the office. We really love and respect this doctor but this date-change thing happens a lot as he often travels as a speaker. Then the office called again the day before yesterday to say the doc still wouldn't be in but we could see one of the other clinic physicians if we wanted. Well, I didn't want to wait any longer for a flu and a covid booster so we went yesterday.

Although it wasn't just that easy. Our clinic has 4 locations and is currently remodeling the one we normally go to, so we had a different trip up to CLT. it was still an hour drive to get there, so this location wasn't any closer.

Since our last appointment, we both had covid - and so had this doctor. LOL Even though I'm still not certain of the cause, this doctor suggested that my "mystery illness" of a few weeks ago was mostly likely a viral GI infection or food toxin. He took the view of food toxin more though as he claimed to have had a similar situation himself a few years ago. Whatever caused it, as long as it doesn't happen again, I'll be happy.

So we had blood drawn and maybe today we'll start to get lab work back. In the meantime, my arm HURTS! Not the flu shot (those never bother me) but that damned covid booster. The first shot never bothered me; but each subsequent booster has left my arm hurting more and more the day afterwards and a little more.

[Loa111]

ouch!
Not the flu shot (those never bother me) but that damned covid booster. The first shot never bothered me; but each subsequent booster has left my arm hurting more and more the day afterwards and a little more.

Hope you feel better soon Mikie! Your timing is the same as mine, as I'd my Covid Booster yesterday too, which is my 4th shot. My arms feels a bit tender too & I feel like I've a slight cold today too, guessing it's a side effect. So perhaps some paracetamol for both of us & a good excuse to take it easy for a day or so.
I'm in for my flu shot on Tuesday, that usually leaves me a bit under the weather too, so let's see!

[leatherman]

you know what else I forgot to bitch about? The wait. We sat in the waiting room longer than ever. We sat in the exam room longer than ever. (We, Larry and I, "share" two appointments and see the doctor together. No hiding any health issues when your spouse is in the same room as you. LOL) After a total wait of and hour and 15 mins, we had been discussing just leaving and were starting to stand right as the doctor knocked and entered the room.  But we did get all our shots and labs done, even though we had to fight back through 5 o'clock traffic in the "big city". (LOL After Cleveland and Charlotte, I must say living in a city >10k is a lot quieter and the traffic is a LOT easier and that's why we don't live in CLT now.)

Don't get me wrong. Even though this wasn't our regular doctor (who actually isn't an MD but an HIV Specialist), this was one of the clinic's MD's and he's a good guy and good doctor. It's just that we really don't have many health issues, so we rarely see the Physicians in the clinic but just our guy (whose acronyms are MHS, PA-C, AAHIVS, DFAAPA instead of MD. LOL)

ok, now covid shots. This was our 4th booster. Just like the previous 2 shots, we didn't have any side-effects - until the sore arms the next day. I took 8 extra strength tylenol throughout the day and that really helped. Unfortunately about 24 hrs after the booster, I felt "weird". Sort of like I did before I get hit by all the vertigo and barfing a few weeks ago. But I took it easy and feel fine now.

It's sooo hard for me to "take it easy" most days  but now with the new pupper  (3 mos. old now.) and sooooo many acorns and leaves I need to get raked up out back  , it just killed me to sit around all day yesterday. So I'm better today, no lab results in yet, and about to go hit the gym (and the tanning booth!) before tackling all that yard work.

Don't rush it if you're not feeling well yet (that's partially why I was sick a couple seats ago. Not realizing my own limitations) but hopefully you'll perk up soon!!

[LeftyBowler300]

Vampires yesterday (19th).
CD4 379 17.9%
VL < 20
CBC/Metabolic looked good
The only “meh” was an LDL of 116. I guess Ben & Jerry has to go 

[Jim Allen]

Vampires yesterday (19th).
CD4 379 17.9%
VL < 20
CBC/Metabolic looked good
The only “meh” was an LDL of 116. I guess Ben & Jerry has to go 

 

[Loa111]

Had my latest Vampires appointment today. It's every 4 months these days.

I live less than 20 minutes from the clinic so I always make a bit of an occasion out of a visit so had a lovely breakfast of sausages, bacon, eggs etc & cappuccino in a cafe near by before heading in for my 11.45 am appointment. For some reason the waiting room was not so busy today, so I hardly had to wait 15 minutes before ID doctor called me in.

All good thankfully, VL is undetectable. CD4 around 360 where it seems to hover these days. Cholesterol is ok.

More good news in that they ran a prostrate blood test on me and the result came back as 1 which is well within the normal range.

These days I do not even hone on the the exact figures for my usual blood tests, once I hear UD, I am happy and understand that all I can do anyway is take my pills daily, & aim to stay healthy as I can. 

Gave my bloods, a new blood tech who forgot to get one of the samples off me so I had to be jabbed twice. Had a bit of fun banter & chit chat with the usual nurses who are there years.

Got my meds from clinic pharmacy, off home. It was quite an uneventful routine clinic visit which is a very good thing! 

Back in mid-May for my next appointment.

[leatherman]

Sorry you had to get stabbed twice; but your numbers are good, you feel good, and the next appointment isn't for months.

from the clinic so I always make a bit of an occasion out of a visit

back in 93, when the AIDS was killing me and the meds sucked, I started the practice of treating myself after every doctor/lab visit. Back in those days, my treat was always a bag of candy (I LOVE candy and go through phases of what I like the best at any given time) and a computer magazine. OMG! I just realized that I'm talking about a time when people barely even knew there was an internet. (All Hail AOL and their floppy discs!).

These days, I'm old enough and aren't so poor that I buy candy when I want it (all the time) and I haven't touched a computer magazine in years. (do they even still print magazines?) My big treat to myself now is simply to not have to cook dinner that night, since it's about 45 miles to our doctors office and we have to drive home during afternoon rush hour traffic in CLT. So we either go out for Mexican and Margaritas or we go by a drive-in restaurant in my old neighborhood for their delicious fried fish and the BEST tartar sauce in the world.

In the early days, the treat after the doctor visit was the incentive to even care about my treatment and health (those was bad, bad days). These days, the treat is a great reminder that I'm alive and life is good!

[Loa111]

I started the practice of treating myself after every doctor/lab visit. 

and a computer magazine.

 I haven't touched a computer magazine in years. (do they even still print magazines?) These days, the treat is a great reminder that I'm alive and life is good!

Yes I think it's a very good idea to build in a treat around our ID Clinic visits. Let's face it, generally it's a fairly boring task, go there, sit for a long time, wait, maybe an hour or more if bust, see doc, wait more for bloods & pharma, & of course get stabbed. So why not make it a more "fun" event?  With my treat usually a big breakfast before or a lunch after depending on the appointment time, & a couple of coffees, it actually causes me to look forward to the clinic visit. 

Oh yes I remember those computer magazines. I used to get them as a teenager. There'd also be a program you could type into your computer in BASIC (the old programming language) for a game or something, so I'd spend hours typing it in & it would never ever work due to a bug! lol.

I used to love buying magazines on my favourite hobbies etc and the good news is there's still plenty available however I find magazines these days kind of water down versions with lite articles and with mostly ads in them, compared to magazines back in their hey day.

[Jim Allen]

I have to visit the vampires next week Thursday.

It was supposed to be the first week of April, but I called in sick, As I had plenty of meds left and couldn't be arsed.

[leatherman]

we're going in two weeks. I was waiting on my meds to get delivered when the pharmacy called about needing to get refill prescriptions but my doctor's office was refusing to refill. So I called the doctor's and they were complaining that I needed to make my next appointment otherwise they wouldn't consider me still a patient and wouldn't issue any refills.

Ah! So their computer problems that wouldn't let them make an appt. when we were last in the office, and then their personnel issues with no one calling to make our next appt. are all my fault and now I have another little black mark against me for being a non-compliant patient. (I already have little black non-compliant marks from previous doctors when I gave up AZT after 9 months in 1993 and quit taking Sustiva back in 1999 after 9 months). That's me LOL a bad-ass non-complaint patient ROFLMAO

All this happened after having a discussion with our doctor about 5 months ago about how he was not planning to retiring for a long while yet. When you're long term survivors with a great doctor who has 30+ HIV experience and you're all getting to be 60ish (I'm 62, the doc is 63) you worry about these things. Then less than 3 months later he up and quit his practice to go play doctors without borders (for a month before returning to enjoy retirement back in the states) leaving us with the HIV PA he had been training. We're cool with the newer PA (he's younger but well-trained and knowledgeable. my volunteer work included working with him at the clinic with peer support and Ryan White stuff a few years ago when he was new to the practice.) but that left us with all sorts of paperwork to cover "switching" to a newer physician. ugh.

anywho, meds got delivered yesterday, an appt is set up for the 10th, and I'll put on a smiling face for the new PA and his vampire friends.

[Jim Allen]

now I have another little black mark against me for being a non-compliant patient.

Congratulations you made the shitlist

[leatherman]

Congratulations you made the shitlist

hell yeah! 

[Jim Allen]

]We're cool with the newer PA (he's younger but well-trained and knowledgeable. my volunteer work included working with him at the clinic with peer support and Ryan White stuff a few years ago when he was new to the practice.) but that left us with all sorts of paperwork to cover "switching" to a newer physician. ugh.

anywho, meds got delivered yesterday, an appt is set up for the 10th, and I'll put on a smiling face for the new PA and his vampire friends.

Well, at least you already know him so that's something, you are not being left with strangers taking over your HIV care. Hopefully, all goes well on the 10th.

[leatherman]

well, I've had two crappy HiV doctors (even if they did help keep me alive) and two GREAT AWESOME WONDERFUL doctors. I really expect this new one to end up in the Great category. Thankfully these days, I've got so few issues it should be easy for him to be a good doctor for me.

[BubbaPat]

I hear and feel ya LeatherMan.

My first doctor I went to gave me my diagnosis but we had just found out about having to move literally days before following up with our blood work.  I found out I was positive and moving across the county.  Luckily he KNEW A GUY. 
When we got to SF, the doctor there was AMAZING!!!  LOVE HIM.  Problem was he worked out of the university in town and SF General.  At SFG, I was a nuisance to the staff because apparently they thought working in the clinic meant they got paid to sit around and do NOTHING.  Now at University, Karen the receptionist was beyond AWESOME.
Then he retired for research.  Karen had to tell me after I showed up for my now retired doctor.  She gave me an okay one.  She warned me he was straight, dry but nice.
Then we moved BACK to Texas.  Got a referral for a friend for a GREAT doctor he loved!!  I always got the PA, never the doctor.  The PA was nice.  I found out they had sold the practice on my visit.  One of their LAST patients.  I finally met my doctor.  He acted like we were best buds and he was sorry but he was making the decision to go into research, which he did of a 3 months then back to practice he went but now on the far side of DFW, from me anyway.
So.. my replacement... a HARD CORE Republican who was gay and married.  4 kids, three boys and a girl.  I got to hear LOTS about them every visit I had.  Along with his MESSY divorce and what a "not nice person" the ex was.  When I asked about being depressed or ADD, he blew it off and continued with his family stories.
I stopped going and when my meds ran out, I didn't care.  My last doctor had made me feel such a waste of oxygen, I didn't want to go back.. EVER.
I finally pulled my head out of my rear and found a new Doc.  So far he has been fantastic!!  Got me on anti depressants and ADD meds an the world seems a little better place.
Finding that right doctor these days is tough.

Bubba hugs kiddo!!

[leatherman]

My first doctor in OH in 1992 (old straight white dude doing the esoteric "infectious diseases", which used to be just a lot of malaria vaccines before the rich jetsetted to some 3rd world county) got really freaked out by all the gays in his waiting rooms and all these patients dying. He fell into alcoholism and lost a lot of hospital privileges.

The 2nd doctor also in OH in 1999 was the best! He kept me from dying the second time AIDS almost got me, and then helped me through a couple combos before finding the meds and put me on the path I'm on today. (Every time I go back to OH to visit I stop in to say hey and thank him again for keeping me alive)

The third doctor I had was in SC (unfortunately NOT in Charlotte, NC; but a little 'burb across the state line in SC), was just blah. While plenty of people vouched for his experience in the previous decade, by the time I started seeing him, he was just phoning it in. I get that the HIV clinic was changing to a FQHC (federally qualified health center) but, damn man, the last visit I had with him he was only in the exam room 1 min and 20 secs. I know this because I had been timing the last 6 visits that had been under 5 mins. each.

So on to the the 4th doctor. (Especially after #3 wouldn't help with my husband's BP issue because he was just the HIV doctor.....well until the clinic became the FQHC and now he prescribes for all issues.) It's an hour drive up into CLT for this great HIV Specialist PA and worth every bit of the travel. I had worked with him a few years in the CLT TGA Ryan White program, so knew IMHO that he was the best HIV doc in the area. Gay, my age, been treating for almost all long as I have had HIV, open and approving of every lifestyle and kink, a traveling HIV speaker, and really smart.

Now it's onto #5 with high hopes. At least I don't need anyone trying to keep me alive in a hospital anymore so I should be ok.

[Jim Allen]

Viral load - Fully suppressed.
Lipid profile - All within normal range
CD4  - 728
All other labs - Normal range

[Jim Allen]

Viral load - Fully suppressed.
Lipid profile - All within normal range
CD4  - 728
All other labs - Normal range

Six months prescription and an MRI of my spin scheduled for 2024

The only comment was the 5 kg weight gain since last time and to eat less, better and move more. In short, they said I am fat, and that's okay I just wish they would say it straight out.

[leatherman]

In short, they said I am fat, and that's okay I just wish they would say it straight out.

great on the numbers!
hanging in there with everything else??

A week and a half till I have numbers. I won't give my blood till next wed. 

You know, right there is something that's gotten much better (at least here in the States) over the years. Used to, they took your blood and 2 or 3 weeks later you called your doctor to get the results. When you went into their office next, you may have even gotten a printout. Nothing fancy, just green and white continuous-feed paper printed in some tiny, smudge-able dot-matrix font. The doctor themselves probably wouldn't even address your results until at your next appointment in 2-3months.

Nowadays, by the next day after the blood draw, results start pouring in to the online portal...with doctor's notes even! The difference in technology and medicial practice in 3 decades has been amazing.

[Jim Allen]

hanging in there with everything else??

Yeah. Rough week but okay 👍

[Jim Allen]

A week and a half till I have numbers. I won't give my blood till next wed. 

You know, right there is something that's gotten much better (at least here in the States) over the years. Used to, they took your blood and 2 or 3 weeks later you called your doctor to get the results. When you went into their office next, you may have even gotten a printout. Nothing fancy, just green and white continuous-feed paper printed in some tiny, smudge-able dot-matrix font. The doctor themselves probably wouldn't even address your results until at your next appointment in 2-3months.

Nowadays, by the next day after the blood draw, results start pouring in to the online portal...with doctor's notes even! The difference in technology and medicial practice in 3 decades has been amazing.

Sounds efficient.

[leatherman]

Sounds efficient.

and that's electronic medical records, a part of Affordable Care Act, under President Obama, that I helped advocate for.

also, in my area, is an improvement with LabCorp, based out of NC. They improved collection of samples to get blood into the testing queue as soon as possible. while I still find that that the cd4 and vl counts take longer to arrive (1-3 days), regular CBC results start arriving into the system as soon as later that day or the next morning.

[Loa111]

My 4 monthly Vampires visit yesterday. Interestingly I just remember, this visit marked 5 years of visiting the ID clinic since my aids DX (approx end of May 2018).

All good. Undetectable as usual. CD4 377. ID Doc tells me 377 is ok, though said it would be better if it got up to 500 ish.  "Nothing we can do about that Doc, except I keep taking my pills, exercise & stay healthy", I said.

Cholesterol a little to the higher side. Nothing to worry about yet Doc said.. Apparently they take the average of two different types of cholesterol reading. When it hits a 7 then it might be time to do Statins. Think mine was about 5.6 if I remember correctly. Interesting, she didn't say anything about diet or ask me what I am eating or if I exercise re the cholesterol levels creeping up. Doc also did a Heart Score Percentage on the probability of getting heart disease later in life, think I was just over 2% or close to 2.5%.

I was peeing a bit a night so recently they ran a prostrate blood test, which is fine. Doc told me as men age, our peeing patterns can change due to the pipe shrinking as we age. She said that it has been noted on my file to potentially send me for a check up with a urologist at some point in the future, but no need to worry about if for now.

We spoke briefly about my several nights a week nagging Restless Leg Syndrome, which gets my left leg only. We agreed it is better for me to tough it out as best I can, instead of considering medication for it, at least for now, & if it gets worse, we can revisit the meds idea.

Nothing much else to report, all was good. Then after the Doc , I went into the nurse to get the blood draw, a pee test (not sure for what, but I give them a good sample anyway as I'd an extra coffee or two lol).

Actually the pee might have been for a STI screening which I think they offer as part of the HIV consultation as I see the poz gay guys at the ID clinic been given swab or a  big Q Tip thing for their bottoms & heading off to the bathroom with it, which they then hand back to the nurse.

Then I'd chat with the ID Pharmacist whilst getting my meds. She always asks & checks if I am taking any other meds, of vitamins or supplements etc.

Always nice to see the ID Docs, generally it's the same team of docs, and always the same team of nurses attached to ID clinic. It always a pleasant experience for me to go there these days. All lovely, nice people, who do their best to be cheerful & welcoming. It really does make a difference going there, with such as cheerful crew. I enjoy my clinic visits, always time for a bit of chit-chat with the staff. 

I really love how they take a good holistic view point of the full health of HIV patients at my clinic. I feel very comfortable to share any other health problems there, & indeed the encourage this too, especially as us Poz people age & get older, the docs want to keep an eye out for early signs of any other health conditions which might emerge, so they can investigate & treat them in time. I am most grateful for that.

It was interesting too, as I saw a couple of younger women there too getting their blood draws & Hiv pills. This caught my attention, probably because I am straight & have a roving eye for the women  & I was wondering recently were there many women with our health condition around (I know of course that there are, however so far I have rarely come across any).

As I said before, I like to make a bit of an occasion out of my visit to the ID Clinic. Luckily I only like a 20 minute drive away, if that even. However, being an early bird, I generally go for a coffee before the visit, then after I pull in for a nice bit of lunch somewhere on the way home. 

[Grasshopper]

about the "Pee test"   :

Two simple tests can help determine your kidney function:
Urine test called ACR (Albumin to Creatinine Ratio): ACR stands for “albumin-to-creatinine ratio.” It tests your urine for albumin, a type of protein. ...
Blood test to estimate your GFR (glomerular filtration rate).

[Loa111]

about the "Pee test"   :

Two simple tests can help determine your kidney function:
Urine test called ACR (Albumin to Creatinine Ratio): ACR stands for “albumin-to-creatinine ratio.” It tests your urine for albumin, a type of protein. ...
Blood test to estimate your GFR (glomerular filtration rate).

Fantastic info Grasshopper, thank you. This makes sense too, I actually take Creatine as a gym supplement, which the docs do not particularly like. I stop it at least 1 week before ID appointments as they say it may gave inflated kidney readings.

[Jim Allen]

Six months prescription and an MRI of my spin scheduled for 2024

The only comment was the 5 kg weight gain since last time and to eat less, better and move more. In short, they said I am fat, and that's okay I just wish they would say it straight out.

Viral load - Fully suppressed.
Lipid profile - All within normal range
CD4  - 728
All other labs - Normal range

So had a cardiologist appointment today, it's part of a follow up to my visit with the vampires.

Stickers and leads everywhere, but everything is perfectly fine, except the nurse said I should loose weight... 😐

I told her it's called "fat" but she said they don't say that to patients 

[leatherman]

Stickers and leads everywhere

omg. i hate that sooo much. I have a fairly hairy chest. (it just doesn't look hairy over my pecs because that's all turned white. It's like my hair color is bleeding out of me from my head down as I age. LOL) Nurses and techs have frequently apologized as they put on the leads on me for how it's going to feel ripping them (and my hair) off later.

Glad your test was good.

[Bucklandbury]

Slowly creeping up T-cell wise. I might die with more than 500 yet.

[leatherman]

Nurses and techs have frequently apologized as they put on the leads on me for how it's going to feel ripping them (and my hair) off later.

OMG! It's like I'm prescient or something. A month after my last post at my more recent visit to the doc, I found out the appointment was also my yearly physical - with EKG sticky pads included for fun.  It's so much easier when I only have to take out my nipple rings for MRIs or Xrays. LOL