April 14, 2015

April 14, 2015
10 Questions to Ask Yourself
Before You Begin HIV Treatment
Part 2

Welcome to another day in my life. Today is Tuesday and I hope you had a beary safe and great week so far. Dab the AIDS Bear and I are busy with work while my partner is off for a week with the Army Reserve.

After being diagnosed as HIV positive, one of the first things a person has to deal with is finding out if and when they need to start treatment so yesterday I started blogging about questions you should ask yourself which I will finish today.

An HIV diagnosis comes with its very own set of questions to ask yourself and decisions to make. Among the biggest is: When should you start treatment? It's a Russian nesting doll of a decision, with many other questions tucked inside.

Here, in no particular order, are number five through ten of the most important questions to ask yourself before you begin taking HIV medications.

6. Why this regimen? When it comes to choosing your first regimen, you have a choice: You can either let your doctor choose your regimen for you, or you can be involved in the decision. As the person who has to go home and take the medications day in and day out, the second option is preferable.

Given that there are a number of very good regimens available to people who are new to HIV treatment, it makes good sense to ask your doctor: "Why this combination, and not that one?" or "What do you see as my best two options, which one do you prefer and why?" Also, if you have any specific concerns at all, like "I want to get pregnant" or "I do not want any disruption of my sleep," bring them to the table and plop them down for your doctor to consider.

7. What side effects am I willing to tolerate? Many times, people don't even get tested for HIV until later in the disease process, when they already feel terrible (which is likely why they got tested). These people may have an easier time starting treatment because they know they will feel better once they get the virus under control.

If you have no symptoms of HIV infection, though, it's easy to fear that you'll feel worse on treatment. Thanks to newer, less-toxic medications, chances are better than ever that you'll feel just fine. But it's important to be clear about what side effects you are willing to tolerate, particularly during those first few weeks that your body is adjusting to treatment (when side effects are most likely). If your answer is "nothing," then you might not be ready to do this.

8. How can I expect to feel on this regimen? Don't be surprised if your clinician only seems to talk about the likeliest medication side effects instead of the full range of possible ones. Maybe she or he fears that you are impressionable and talking about them will scare you off, or will make you think you have them when you actually don't.

But knowing whether a symptom you get might be drug-related is a big deal. That way, you'll know right away whether you should give your clinic a call and see what your clinician thinks about it.

So ask your doctor to give you the gamut of side effects -- but pay attention to what percentage of people get each one so you know how likely it might be for you. Remember: Even if the percentage is as high as 20 percent, that means 80 percent don't get it.

9. What if it doesn't work? As good as today's HIV medications are, it's possible that, for one reason or another, your first regimen might not work for you. Maybe you'll find you are missing doses regularly. Or maybe your lab tests will show that your viral load isn't dropping as much as it should. Or maybe some side effect will emerge that makes you want to just say no to treatment.

When you're researching your first regimen and discussing it with your doctor, why not consider your second, just-in-case regimen, too? In fact, it's a good idea to always have a plan B in mind.

10. Can I stop? This is a question that does not get enough attention. Doctors don't seem to relish talking about it -- HIV treatment is "lifelong therapy," after all, and studies have shown that people with HIV generally see their health slide when they stop taking meds.

However, occasions may arise that make a "treatment holiday" the realistic thing to do, so you might as well talk about it up front. This is especially important because some HIV drug regimens need to be stopped in a certain way, or in a certain order, to avoid the development of resistance.

Hope all this has help you decide when starting treatment is right for you or if you are already on treatment to help you when you talk with someone newly diagnosed or who hasn't started treatment yet.

Have a beary safe and great Tuesday!

Until we meet again; here's wishing you health, hope, happiness and just enough.

big bear hug,

Daddy Dab