Living with HIV in the Philippines: Email 336: More Questions from Rolled Over

Hi Poz,

Good morning!

I hope you and Tag and the rest of the pusits are in good health. Well, this is really it, I already have my first set of ARV, Lamivudine, Ziduvudine and Efavirenz but I am planning to start my treatment next month because I have a a lot of summer fun this month and I don't want to skip nor forget a dose. I have always considered the fact that I have to be religiously taking the medicine as it has an adverse effect on the viruses on my body and to my health as well.

Meanwhile, I have already asked the doctor here is Cebu at Vicente Sotto about how to ensure proper dosage and considering the fact that my schedule is erratic that I need to switch shifts from night to day. Sort of crazy kind of schedule and they already told me about the possible side effect of Efavirenz of which it causes dizziness. For LamiZidu cocktail, I don't I will ever have a problem with that since it can be taken twice a day on a specific time frame. I want to follow your routine but the doctor said that there is a four hour window period from the exact time for me to take the medicine however on the Efavirenz part, let's say my shift is on 10pm to 7am, I planned to take it before I sleep at least I won't have a hard time dealing with the dizzy business then two weeks after my shift changes to 12am to 9am, can I just follow the four hours window period I mean as long as I don't skip a dose per day of my Efavirenz? OR does it really have to be that way of which the second dose has to be paired with Efavirenz? I am really confused because all that goes in my mind is that I SHOULD NOT SKIP A DOSE PER DAY but with my schedule, and the side effect I don't want to be a burden to my work, when I get dizzy I really get sick. I don't want to move and all but its a risk that I have to take on this because my CD4 has already dropped from 443 to 257 in less than two months but I am willing to get right through it next month.

Another question is, I asked my doctor about taking supplements, currently I am intermittently taking this chinese food supplement that increases appetite so I asked him if it can help keep me up with the treatment since according to him, LamiZidu pair really affects your appetite and for me, appetite lately is already a challenge, hence the reason why I bought this supplement and doc Cham said that I should stop taking it as it may deactivate the efficacy of the treatment worse, it may cause problems on my liver too. He even encouraged me to continue my intake on Conzace which I noticed really put me to sleep if I take it before work.

Third question is, I have this grape seed extract supplement which also has antiviral benefits however, I noticed that I suffer from mild headache which is still tolerable. Do you think I should stop taking it? Pozzie, I really appreciate everything you posted on your site, it helps me in every way.

Reading those emails from other pusits empowered me to do more. Somehow, I have a pozzie friend here who always pushes me to be always positive but I cannot deny the fact that death is apparent in every corner. He even said that I am such a nega person when in fact I look healthier and fit. I hope one day, there will be some sort of treatment that kills all the viruses in our body or maybe deactivate them completely if not killing them. I know that this cocktail we are taking inhibits reverse transcriptase binding, I hope one day my CD4 level will also shoot up. I've noticed that I am having these sort of skin allergy down there and it really embarrassing, they're not itchy but its bumpy like some sort of pimple. I think its because my CD4 has gone too low but hopefully it won't dropper lower next month. I easily go in panic if I know something unusual. Do you think it is okay to wait until next month for my treatment? I am afraid that someone will notice the medicines I am taking and will only jeopardize my work and private life that's why I will take it next month and not keep it in my bag when I am on trip.

Please shed some light on my fuzzy mind, I know you are good at this and I always believed you. Later, there will be a support group discussion by Cebu Plus Association here in Cebu and it will be my first time to possibly meet some pusits in Cebu, I hope I won't meet someone that I had sex with or well, I can't do anything about it. More power to you and Tag and rest of the Pusits.

Rolled Over

POZZIEPINOY’S RESPONSE

Hi Rolled Over

Once again, thank you for your email. I am so sorry that I answered your email late because I got tied up with work and family. Thank you also for thinking about Tag and the rest of the PLHIV's. Like you I do wish and pray that everybody's doing well.

With regards to taking ARV's, the rule of thumb is never be late and that you should have enough ARV's in your body for 24 hours. What your doctor is saying about the window period is true, however, doing it frequently MAY have a bad effect on the viral load in the long run. If you are confused about this, talk to your doctor again or call me at 0916-286-2066 so I can explain it further.

With regards to supplementation, initially, the doctor will ask you to refrain from using them as you will be monitoring the effects of the ARV's in your bodies. Your doctor is right in saying that may lower the efficacy of the medicines or may contribute to the side effects and may also harm your other body organs. If I were you, I would follow the advice of your doctor. Later on, after the 1st month of taking ARV's, you can discuss the supplements again to your doctor and if he agrees, then you can proceed in taking them. The rule there is always inform your doctor before taking anything. The ARV's are already heavy on our liver and other body organs and we don't want these supplements to add to the burden that our body organs are already carrying.

Waiting for next month is a choice you have to take. I can't force you to start now if you don't want to so it really is a decision you have to make.

I hope I was able to answer your concerns. Feel free to email me again if you have other questions.

Stay healthy,

Pozziepinoy

"WE ARE ALL IN THIS TOGETHER.

NO PLHIV is alone with his or her struggle with HIV!"

-Pozziepinoy-

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